ENTERAL NUTRITION
HCP 24
PROGRAM GUIDE FOR HEALTH CARE PROFESSIONALS
National Educational Video, Inc.TM is an approved provider of continuing education. State Board provider numbers: Florida NCE2896, Alabama 5-97, California CEP8803, Kentucky 7-0045 and West Virginia WV96-0025RN. This activity provided by National Educational Video Inc. is approved as a provider of continuing education in nursing by Alabama State Nurses Association, which is accredited as an approver of continuing education in nursing by The American Nurses Credentialing Center's Commission on Accreditation.
NATIONAL EDUCATIONAL VIDEO, INC.TM ©1998
NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 PROGRAM DESCRIPTION Enteral feeding (gavage) is an alternative approach for maintaining optimal nutrition in those patients who are unable or unwilling to eat. This approach to nutritional support can be short term or long term. This program will give the participant all the necessary information about the types of feeding tubes, types of formulas and methods of feeding with actual demonstrations on patients. 3.0 contact hours. Video running time is 50 minutes.
OBJECTIVES At the conclusion of this program, the participant will be able to: 1.
Identify the types of patients in which enteral tube feedings might be beneficial.
2.
List the goals and patient benefits of enteral tube feedings.
3.
Describe the different types of feeding tubes available.
4.
List the various routes through which feedings can be administered.
5.
Discuss advantages/disadvantages of various feeding routes.
6.
Demonstrate the insertion of a feeding tube.
7.
Describe the various methods and scheduling of feeding tubes.
8.
List a variety of nutritional formulas available.
9.
Discuss the rationale for verifying placement and for aspirating and returning residual.
10.
Describe how to give medications through a feeding tube.
11.
Identify problems and their possible causes associated with enteral feedings and/or their tubes.
12.
Plan and implement nursing interventions to help prevent any possible problems.
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 GLOSSARY OF KEY TERMS Please COPY and hand out to each participant at the beginning of the program. ASEPTO SYRINGE:
has a rubber bulb instead of a plunger to push or pull solutions
ANOREXIA NERVOSA:
a condition characterized by self-imposed starvation
BUCCAL:
pertains to the cheek or the mouth
DYSPHAGIA:
difficulty in swallowing
ENDOSCOPE:
a long fiberoptic tube which is passed through a body orifice, so internal structures can be examined without surgery
ENTERAL:
within the intestines
GAVAGE:
feeding by a tube passed into the stomach
HYPERGLYCEMIA:
excess glucose in the blood
JEJUNOSTOMY:
a small tube placed into the jejunum of the small intestines through which the patient can receive nutrients and medications and through which decompression can be accomplished
KILOCALORIE (KCAL):
the amount of heat required to raise the temperature of one kilogram of water 1 degree Celsius
OSMOLARITY:
number of osmotically active particles in a unit of fluid
pH:
a measure of the acidity or alkalinity of a solution ranging from 1-14 with 7.0 being neutral; any number above 7.0 is alkaline and numbers below 7.0 are acid
PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: REGURGITATION:
method of inserting a feeding tube into the stomach via an endoscope
RESIDUAL:
remaining or left behind
abnormal backward progression of fluids or other vessel contents; undigested food from the stomach to the oral cavity
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NATIONAL EDUCATIONAL VIDEO, INC.TM The Nursing Process The nursing process is a systematic method of problem solving. It is called a "process" because it is on-going. The steps of the nursing process are as follows: Assessment: This is the systematic and continuing collection of information from multiple sources. Assessment begins when a nurse initially interviews a client and the client’s significant others. A physical assessment of the client involves collecting information from a number of sources: laboratory data, direct observations, assessing the client’s ability to carry out daily activities, noting signs observed by nursing personnel and symptoms reported by the client and any client responses to interventions. In long term care, resident assessment instruments are used to provide a comprehensive multi-disciplinary assessment. Problem Identification or Nursing Diagnosis: Assessment data leads to identifying client strengths and client problems. These may be actual problems the client currently experiences, or potential problems that may occur with that client in the future. Problems are stated and an indication of influencing factor or cause is included in the statement, when nursing diagnosis statements are used. Planning: The next step the nurse will complete is planning, with input from other care providers. It will focus on client goals (or outcomes). For each problem, a measurable, specific goal is identified. The plan includes nursing actions, based on of nursing theory, nursing science, other sciences, research findings and experience through practice. The beliefs and values of the nursing profession, in combination with the values of the client, are taken into account in the establishment of the nursing care plan. Implementation: Carrying out the nursing care plan. Evaluation: This is the component of the process where client goals and related outcome are evaluated to determine if they were met. The nursing care plan is revised accordingly. Evaluation may also identify additional resources that are needed for the client or the health care provider while continuing to utilize the nursing care plan. Professional Nursing Roles: As the nurse carries out the nursing process, the nurse enacts a variety of professional roles. These are: clinician
teacher
client advocate
leader
These roles may overlap. In the clinician role, the nurse may provide direct "hands on" care, or may assess a client's needs and direct others to provide services to meet those needs. The nurse may conduct patient and family teaching in a teaching role. The nurse may also teach other health professionals when a multidisciplinary team addresses the client's needs. The nurse is a client advocate when collaborating with the client, finding resources for the client, and acting on behalf of the client. The nurse is a leader when planning and assigning the care of a client to others, maintaining overall responsibility and accountability for that care, assisting other members of the health care team to set and meet goals or when providing resources to other health care providers.
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 PRE TEST - Part 1 Circle T if the following statement is true. Circle F if the statement is false. T
F
1.
Enteral feedings provide complete nutrition for the patient.
T
F
2.
All patients having mal-absorption problems would benefit from enteral feedings.
T
F
3.
A method used to measure the length of a nasogastric tube for insertion is the NEX method.
T
F
4.
Cyclic feedings are given over an 8-16 hour period while the patient is awake to allow for undisturbed sleep time.
T
F
5.
Monitoring the patient’s weight helps to evaluate the nutritional success of enteral.
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 DISCUSSION QUESTIONS Part 1 1. Mr. Campbell is a 28 year old car accident victim, has multiple fractures including a fractured jaw that will be wired closed for the next six weeks. He is to receive enteral feedings. What would be the best route to feed him and why? What would be the best method of feeding for him and why? What would be the disadvantage of this route and method? Nasogastric. This route is easily accessible and the feedings are instilled into the body’s normal reservoir. Also the feedings will only be for a relatively short period of time, therefore it is not necessary to insert a more invasive type of tube. The continuous method of feeding would be the best choice because of Mr. Campbell’s wired jaw. Chances of high gastric residuals are minimized, thus decreasing the risks of gastric reflux and aspiration. The disadvantage is that it is more restricting for the patient, but in this case he is somewhat restricted anyway because of his hospitalization, yet it won’t restrict his ambulation or rehabilitation during that time. The continuous feeding pump can be run on a battery and wheeled with the patient wherever he goes.
2. Mrs. McDavis is a renal patient receiving enteral feedings. What would be the best type of formula for her and why? Nepro is the formula of choice for patients with renal problems. Because the kidneys are not functioning properly, it is important for these patients to control those substances that are usually controlled by the kidneys. A renal diet usually provides decreased amounts of sodium, potassium, protein and Nepro is designed to satisfy a renal diet for those patients requiring one, but needing it administered via tube feedings.
3. Mrs. Larson had esophageal cancer. She came in to have the esophageal mass and part of her esophagus removed. Her physician has explained to her that it will be necessary to feed her via a tube into her GI tract. What type of tube will be the best option for her? Why? The G-tube is the tube of choice for Mrs. Larson. Neither a NG or an endoscope could be passed through her esophagus, the feedings will be long term and while she is in surgery and under anesthesia, the doctor could perform both procedures at the same time. Since it is sutured in place with a pursestring suture, it cannot be displaced into the trachea. Also its larger lumen decreases the risk of obstruction. In addition, the stomach is the body’s natural food reservoir and the gastric acids will help destroy any contaminants that may enter. Both of these make a more natural way of feeding Mrs. Larson.
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 DISCUSSION QUESTIONS Part 1 (Continued) 4. Mr. Bullock, a 53 year old patient had a G tube inserted six months ago. He will require enteral feedings on a permanent basis. He leads an active life and plans on maintaining his present life style. He plans on returning to work and pursuing golf and fishing which are two of his favorite past-times. He finds his present feeding tube hard to conceal and his present method of feeding too restricting and embarrassing. What can be done to help this patient with his individual needs? Mr. Bullock can have his present tube replaced with a LPGD, which is less conspicuous. One criteria is that a PEG or G-tube needs to be in place for at least 3 months in order that a healed stoma tract be present. His tube has been in place 6 months. Also he can be put on cyclic feedings. This will give him the freedom he wants during the day, while his nutrition will be provided during his sleeping hours.
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 POST TEST Part 1 Choose the best answer: 1.
In order to benefit from enteral feedings, a patient must a. have lost 5 lbs. in the past 30 days b. be able to absorb the nourishment into the blood stream c. be unconscious d. have a vitamin or mineral deficit
2.
A patient with which of the following problems would be a good candidate for enteral tube feedings? a. a patient with a paralytic ileus b. malabsorption syndrome c. dysphagia d. dysphasia
3.
What is the advantage of a small bore feeding tube such as a Keofeed tube over a levine tube when administering enteral feedings? a. it can be removed and re-inserted for each feeding b. it is more rigid, which makes insertion easier c. the sphincter at the entrance of the stomach closes more tightly around it, which makes regurgitation less likely to occur d. the nasogastric tubes are too soft, which makes them more difficult to insert
4.
Samuel Channing has an obstruction of the esophagus, due to a neoplastic tumor. Which of the following feeding tubes would be best for his situation? a. Keofeed b. Levine c. Dobhoff d. Gastrostomy
5.
What is a disadvantage of a Keofeed tube over other tubes used for enteral feedings? a. it is not easily accessible b. it is restrictive and does not allow for a variety of feeding methods c. it is not desirable for long term use d. it needs to be replaced frequently because the gastric acid in the stomach destroys it
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 POST TEST Part 1 (continued) 6.
Endoscopy is used to insert which of the following tubes? a. PEG b. LPGD c. G-tube d. Duo-tube
7.
What is the most accurate way of assessing tube placement? a. place end of tube in water and watch for bubbling when patient exhales b. aspirate gastric contents c. instill 10-20 cc of air and auscultate abdomen d. get an X-ray
8.
Mr. Corbit, a recent stroke patient with swallowing problems, also has Diabetes Mellitus. Which of the following formulas would you expect to be ordered for him? a. Ensure Plus b. Newtrition Isofiber c. Glucerna d. Polycose
9.
Mr. Jordan is a semi-conscious head injury patient, who is to be fed through a PEJ tube. Which of the following methods would be most appropriate for him? a. cyclic b. bolus c. continuous d. intermittent
10.
You are inserting a Keofeed tube into a patient. Which of the following instructions will facilitate its insertion? a. have the patient hyperextend their neck b. have the patient flex their head slightly forward c. have the patient take a deep breath when you start to insert it d. have the patient hold their breath until you pass the Nasopharynx
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 PRE TEST Part 2 Circle T if the following statements are true. Circle F if the statements are false. T
F
1.
Heating the formula in the microwave for a very short period of time, is acceptable for bolus feedings only.
T
F
2.
As long as some residual, regardless of how little is received, it is not necessary to check placement any other way.
T
F
3.
The only reason water is instilled into the feeding tube is to maintain tube patency.
T
F
4.
The only medication that can actually be added to the formula of a continuous enteral feeding is insulin, because of the formula’s high carbohydrate content.
T
F
5.
Enteric coated tablets are never crushed to be instilled into a tube feeding.
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 DISCUSSION QUESTIONS Part 2 1.
Mr. Matthews has a PEG tube in place and is receiving Bolus feeding every four hours. You go to administer his twelve o’clock tube feeding but are unable to because it is obstructed. What would be your course of action? The first action after determining that obstruction is definitely the problem, is to try irrigating the tube gently with warm water using a 60cc piston syringe. Without using undue force try instilling and withdrawing the warm water. If this does not work and it is permissible with the physician and institution’s policies, try irrigating the tube with a sugar free carbonated beverage. Usually one of those will work. If neither of those work, notify the physician.
2.
Mr. Karnes, a 50 year old S/P CVA patient has been receiving enteral tube feedings via a PEG tube. Last evening he started running a low grade temperature which has steadily increased. He has tenting of his skin, his tongue is dry and his lips are cracking. What would be some of your nursing interventions and explain your reasons. These are some signs of dehydration. To definitely verify this situation, check his intake and output records and laboratory results. Sometimes with dehydration there will be false elevation of blood components, such as red blood cells, hemoglobin and hematocrit as well as chemistries such as sodium, chloride and blood urea nitrogen (BUN). Also check what amounts of residuals have been obtained; if the residuals are high, you don’t want to over distend the stomach and possibly cause other complications. Notify the physician of your findings and if there are no other contraindications for administering extra fluid, administer extra water with his feedings, medications and between feedings until his situation is resolved.
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 DISCUSSION QUESTIONS Part 2 (Continued) 3.
Mrs. Scott is receiving continuous enteral feedings via a PEG tube. She has developed diarrhea over the last four days. Discuss the steps you would take in seeking possible causes of her problem. What would be some of your interventions? You should have already been monitoring and caring for any skin breakdown that might have occurred because of the diarrhea. Next check the rate of her feeding, the type of formula she is receiving, its expiration date, how long the formula remains in the bag and if the equipment is being maintained according to policy and procedure. Also check her medication administration record for any medications that might be causing the problem. In addition, check her laboratory results to make sure that changes in the electrolytes are not conflicting with the type of formula and amount of water she is receiving. When you have all information to assess the situation completely, consult with the dietician and the physician. It may be necessary to decrease the rate of infusion, decrease the strength of the formula, use additives, such as rice, discontinue and even change some medications.
4.
Mrs. Callahan, a 76 year old patient, was recently admitted with a CVA. She is unconscious and is receiving enteral feedings via a Keofeed tube. When you arrive in her room , she has vomitus on her face and gown, has a respiratory stridor and is slightly cyanotic. What do you suspect happened and give reasons for your suspicions and describe what actions you will take. What would be your interventions? Because of the evidence of emesis combined with the respiratory distress symptoms, you suspect aspiration. You immediately stop the feeding, suction Mrs. Callahan and ask that the physician be notified. In the meantime, raise the patient’s head from a 30-45 degree angle to a 90 degree angle, aspirate any residual gastric contents to prevent further aspiration and obtain an oxygen saturation level with a pulse oximeter. Depending on what the oxygen saturation level is, you may need to administer oxygen. A portable chest X-ray will probably be ordered. Stay with the patient and monitor her respiratory status until the physician arrives.
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 POST TEST Part 2 Choose the best answer: 1.
Mr. Clark is receiving Ensure 250cc every six hours through a PEG tube. The nurse receives 160ml aspirate when checking residual prior to administering the next feeding. What would be the correct nursing action? a. decrease the feeding by 100ml b. replace the residual and give the next feeding c. replace the residual, but hold the next feeding d. discard the residual and give the feeding
2.
When administering a continuous feeding, it is necessary to keep the head of the bed: a. flat b. in trendelenberg c. elevated 10-20 degrees d. elevated 30-45 degrees
3.
The type of medication that can be crushed for instillation into a G-tube is which of the following: a. enteric coated pills b. simple compressed tablets c. plain aspirin d. time released spansules
4.
A tube related problem includes which one of the following: a. aspiration b. electrolyte imbalance c. displacement d. diarrhea
5.
A sudden gain of 5lbs. might indicate which of the following conditions: a. hypovolemia b. nutritional goals are being accomplished c. fluid excess d. bowel obstruction
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 POST TEST Part 2 (continued) 6.
Instilling a tube feeding too quickly can cause: a. constipation b. weight loss c. otitis media d. nausea and vomiting
7.
If the formula is too concentrated it may cause: a. aspiration b. diarrhea c. constipation d. reflux
8.
Too little fiber in a tube feeding can cause a. aspiration b. diarrhea c. constipation d. reflux
9.
Of the following types of feeding tubes, which one is the nurse allowed to insert? a. G-tube b. Peg tube c. Keofeed d. LPGD
10.
After the feeding tube has been in 14 days or longer, which one of the following solutions is used to keep the insertion site clean? a. zinc oxide b. soap and water c. merthiolate d. iodine
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 ANSWER SHEET PRE TESTS PART 1 1. 2. 3. 4. 5.
PART 2
T F T F T
1. 2. 3. 4. 5.
F F F F T
POST TESTS PART 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
b c c d c a d c c b
NATIONAL EDUCATIONAL VIDEO, INC.TM ©1998
PART 2 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
c d b c c d b c c b
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 RESOURCE ADVISOR
MARYANN O’BRIEN RN, PA/HCA is a graduate of Temple University Hospital School of Nursing in Philadelphia, PA with a Bachelor in Professional Arts from Saint Joseph’s College in Windham, ME. Mrs. O’Brien’s work experience has been in acute care, home health and skilled nursing facilities. She has also been a reviewer and contributing writer for Rosdahl Textbook of Basic Nursing (1994). As well as an item writer for NCLEX-PN. Presently, Mrs. O’Brien is employed as an LPN instructor at Lorenzo Walker Institute of Technology in Naples, Florida. NEVCO® video educational programs are prepared using specific criteria designed by National Educational Video, Inc.TM All educational programs are coordinated and reviewed under the direction of the NEVCO® Director of Education, who is a master’s prepared nurse.
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 REFERENCES DeWit, Susan C. (1994) Rambo’s Nursing Skills for Clinical Practice, 4th ed. W.B. Saunders Co.: Philadelphia pp. 609-610 Dillon, Patricia. (1996) Testbook to Accompany Fundamental Skills and Concepts in Patient Care, 6th ed. Lippincott-Raven Publishers: Philadelphia pp. 66-68, 609-610 Ellis, Janice R., Nowels, Elizabeth A. & Bentz, Patricia M. (1996) Modules for Basic Nursing Skills II, Lippincott-Raven Publishers: Philadelphia pp. 379-380, 588-597 Forloines-Lynn, Sue (March 1996) How to smooth the way for cyclic tube feedings, Nursing 96 pp. 57-58 Hall, Joyce C. (June 1997) Low-profile gastrostomy devices, Nursing 97 pp. 62-63 Heximer, Betsy (July 1996) Troubleshooting G-tubes spontaneous balloon rupture, RN pp.22-24 Pratt, Joan Chartier & Tolbert, Carla G. (May 1996) Tube feeding aspiration, American Journal of Nursing pp. 37 Ricciardi, Elisa & Brown, Dee (October 1994) Managing PEG tubes, American Journal of Nursing pp. 29-31 Rosdahl, Caroline Bunker (1995) Textbook of Basic Nursing 6th ed. J.B. Lippincott Co.: Philadelphia pp. 314-320, 1233-1234 Smith, Sandra F. & Duell, Donna J. (1996) Clinical Nursing Skills, Basic to Advanced Skills, 4th ed. Appleton and Lange: Stamford, Connecticut pp. 458-465 Stright, Barbara R. & Harrison, Lee-Olive (1996) Study Guide to Accompany Fundamental Skills and Concepts in Patient Care 6th ed. Lippincott-Raven Publishers: Philadelphia pp. 204205 Thompson, Lisa (April 1995) Taking a closer look at percutaneous endoscopic gastrostomy, Nursing 95 pp. 62-63 Wilson, Jeanne M. RN, BSN, CNSN, CRNI (Nov./Dec.1996) Nutritional Assessment and its application Journal of Intravenous Nursing pp. 307-314
®
While NEVCO strives to remain current with federal and state regulatory requirements, the information contained in this program is always subject to governmental amendment. Therefore, we suggest that you contact your state and federal authorities for any possible revisions to regulatory requirements.
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 Participant Evaluation of Objectives Please evaluate this program by circling the number that best represents how well this program met the following objectives: 4=Excellent
3=Good
2=Average
1=Poor
1.
Identify the types of patients in which enteral tube feedings might be beneficial.
4
3
2
1
2.
List the goals and patient benefits of enteral tube feedings.
4
3
2
1
3.
Describe the different types of tube feedings available.
4
3
2
1
4.
List the various routes through which feedings can be administered.
4
3
2
1
5.
Discuss advantages/disadvantages of various feeding routes.
4
3
2
1
6.
Demonstrate the insertion of a feeding tube.
4
3
2
1
7.
Describe the various methods and scheduling of feeding tubes.
4
3
2
1
8.
List a variety of nutritional formulas available.
4
3
2
1
9.
Discuss the rationale for verifying placement and for aspirating and returning residual.
4
3
2
1
10.
Describe how to give medications through a feeding tube.
4
3
2
1
11.
Identify problems and their possible causes associated with enteral feedings and/or their tubes.
4
3
2
1
12.
Plan and implement nursing interventions to help prevent any possible problems.
4
3
2
1
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NATIONAL EDUCATIONAL VIDEO, INC.TM ENTERAL NUTRITION HCP 24 Participant Evaluation of Objectives (Continued)
COMMENTS:__________________________________________________________________ _____________________________________________________________________________ _ _____________________________________________________________________________ _ _____________________________________________________________________________ _
Do you feel you met your personal objectives?
_______________________
Time required to complete this program?
_______________________
Return this form to the facilitator who distributed the learning materials. Thank you.
NATIONAL EDUCATIONAL VIDEO, INC.TM ©1998
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NEVCO® Account # _________________
REQUEST FOR CERTIFICATES FOR CONTACT HOURS TYPE the NAMES, LICENSE NUMBERS AND JOB TITLES (RN, LPN, MSW, CNA, PT, etc.) of the people who are to be issued a certificate for contact hours for attending the continuing education program: ________________________________________________________________________________________ (Facility Name) ________________________________________________________________________________________ (Title and Number of Video Program) This request must be submitted along with the completed roster and evaluation sheets for the above named program.
NAME 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22.
LICENSE NO.
JOB TITLE
TIB Bank Center 599 9th Street N., Suite 207 Naples, Florida 34102-5625 (800) 252-5604 Fax (888) 877-7255 www.nevcoeducation.com
FACILITATOR’S EVALUATION (NEVCO® Video Education Program)
Must be completed by the facilitator
EVALUATION OBJECTIVES: (1) To assess extent to which the program was appropriate, adequate and effective. (2) To identify, continue to develop and evaluate effective quality assurance activities. Title of Program ________________________________________________________ Date _______________________ Place of Employment _________________________________________________Job Title _______________________ Please evaluate the presentation by circling the number that best describes your rating. 4 – Excellent 3 – Good 2 – Average 1 – Poor ORGANIZATION OF COURSE Material was organized to facilitate learning
4
3
2
1
The amount of material covered was adequate and accurate
4
3
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There was effective use of time to cover the subject
4
3
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The test material reflected the objectives listed
4
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Content can be used to improve nursing practice
4
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Content reflected knowledge level and needs of learner
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The material was current
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Pre-Test
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Discussion Questions
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Post-Test
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The presentation was
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The presenter explained the material
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The presenter demonstrated knowledge of material
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CONTENT OF THE FACILITATOR’S GUIDE List total number of objectives in this facilitator’s guide _____________________ List by number the objectives that were met _____________________________
Evaluate Test Questions
FACULTY PRESENTING (Video)
OVERALL RATING I felt this teaching method was
COMMENTS – (Please make suggestions for future topics and additional comments about the presentation or instructor) _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ ®
Thank you for your time in completing this evaluation! We appreciate your comments and suggestions. The NEVCO Educational Staff
©1995 Revised 10/2004
TIB Bank Center 599 9th Street N., Suite 207 Naples, FL 34102-5625 (800) 252-5604 Fax (888) 877-7255 www.nevcoeducation.com
EVALUATION
(NEVCO® Video Education Program) Must be completed by every participant
EVALUATION OBJECTIVES: (1) To assess extent to which the program was appropriate, adequate and effective. (2) To identify, continue to develop and evaluate effective quality assurance activities. Title of Program ________________________________________________________ Date _______________________ Place of Employment _________________________________________________Job Title _______________________ OBJECTIVES Total number of objectives in program _________ Circle the number of objectives that WERE met
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Circle the number of objectives that were NOT met
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Please evaluate the presentation by circling the number that best describes your rating. 4 – Excellent 3 – Good 2 – Average 1 – Poor ORGANIZATION OF COURSE Material was organized to facilitate learning
4
3
2
1
The amount of material covered was adequate and accurate
4
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The test material reflected the objectives listed
4
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Content and/or skills demonstrated can improve my ability to perform my job
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Content reflected knowledge level and needs of learner
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The material was current
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Time for questions was
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Effective use of time to cover subject was
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Graphics were beneficial
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The presentation was well prepared
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The presentation explained the material well
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The presenter demonstrated knowledge of material
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I felt this teaching method was
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Facilities and classroom were adequate
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CONTENT OF THE PRESENTATION
NEVCO® FACULTY (who prepared the program and/or appeared in interviews)
OVERALL RATING
COMMENTS – (Please make suggestions for future topics, content of program and instructors) _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Thank you for your time in completing this evaluation! We appreciate your comments and suggestions. The NEVCO® Educational Staff ©1995 Revised 10/2004
TIB Bank Center •· 599 9th. Street N., Suite 207 • · Naples, FL 34102-5625 (800) 252-5604 Fax: (888) 877-7255 www.nevcoeducation.com
CONTINUING EDUCATION ROSTER This form must be completed and returned to NEVCO®. Keep a copy for your facility, but return the original to NEVCO®. PRINT OR TYPE
Account # ____________________________________
Number and title of Video Program ___________________________________________ Dates Given _____________________________________________________________ Contact Hours ___________________________________________________________ Name of Facility __________________________________________________________ Address of Facility ________________________________________________________ City/State/Zip ____________________________________________________________
National Educational Video, Inc.TM is an approved provider of continuing education. State Board provider numbers: Florida NCE2896, Alabama 597.0, California CEP8803 and Kentucky 7-0045. This activity provided by National Educational Video Inc. is approved as a provider of continuing education in nursing by Alabama State Nurses Association, which is accredited as an approver of continuing education in nursing by The American Nurses Credentialing Center's Commission on Accreditation.
RN Facilitator ___________________Signature _________________________________
ROSTER OF PARTICIPANTS Participant Name 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
Participant Signature
License #
Soc. Sec. #
Participant Name 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32.
Participant Signature
License #
Soc. Sec. #
599 9th Street N., Suite 207 - Naples, FL 34102-5625 800-252-5604 Fax: 888-877-7255 – www.nevcoeducation.com
Certificate of Completion This is to certify that Attended and Completed National Educational Video, Inc.TM Program Number and Title
For ______ contact hours On _____________ Date
______________________________________________________________ Facility / Agency Name ______________________________________________________________ Facility / Agency Address ______________________________________________________________ RN / Facilitator
CERTIFICATE FOR ASSISTANTS ONLY National Educational Video, Inc.TM is an approved provider of continuing education. State Board provider numbers: Florida NCE2896, Alabama 5-97.0, California CEP8803 and Kentucky 7-0045. This activity provided by National Educational Video Inc. is approved as a provider of continuing education in nursing by Alabama State Nurses Association, which is accredited as an approver of continuing education in nursing by The American Nurses Credentialing Center's Commission on Accreditation.
CERTIFICATE OF COMPLETION For each participant who has successfully completed a continuing education program, please make a copy of the blank NEVCO Certificate (on reverse side) and fill in the following information: 1. 2. 3. 4. 5. 6.
Name of the learner Program title and number Number of contact hours Date the program was completed Name and address of your Agency / Facility Signature of the RN / Facilitator responsible for offering the program
