1- Course title
Nursing care retraining in the CCU

2- Course definition
The purpose of this course is to promote the quality of nursing services, increase the level of knowledge and professional skills of nurses in heart special care division of the CCU, and to secure the professional requirements of nurses at the beginning stages of entering the CCU division. It is also codified for nurses occupied in that department.

3- Course necessity, effects of executing the short-term professional course on health areas:
This course has been codified considering the special conditions of patients hospitalized at the CCU division, the importance of appropriate and high quality care of these patients, the fact that care in the CCU is on a technical and professional basis. The purpose of the present course is to secure professional requirements of the nursing graduates for working in the CCU division and to promote their professional skills in presenting professional and high quality nursing cares for patients within the CCU division.

During this course, the following goals will be accomplished:

Overall goal:
Introduction of learners to the CCU, heart problems, special disorders and necessary nursing cares in special care division for heart problems in order to apply these fundamentals in clinical conditions

Specific goals:
At the end of this course, the learner will be able to:
1- Describe the heart-specific caring system (including the physical environment of the CCU, necessary equipment and tools), environmental stimulus in different coronary-specific care divisions and how to control them
2- Explain the special cares for coroner vessels (thoracic angina, myocardia infraction) along with the symptoms, pathophysiology, diagnosis, forecasting, medical emergencies, effects and necessary cares based on the nursing process
3- State the fundamentals of the electrocardiogram
4- Diagnose various dysrhythmia and heart-blockages with electrocardiogram alterations
5- Describe the symptoms and symbols, treatment and nursing cares related to various dysrhythmia and heart-blockage
6- Explain the working principles of using artificial pacemakers, defibrillator, and monitoring alongside the necessary nursing cares related to each machine
7- Explain advance cardiovascular recovery with regards to the role of the nurse
8- Use creative thinking skills and merge theoretical learnings with moral-professional fundamentals and contents of in order to show the necessary readiness for employing the learned knowledge in clinical environments

4- Course capacity (number of admissions)
20 individuals

5- Training period
132 hours of theoretical training equal to 7.76 theoretical credit hours
150 hours of practical training equal to 3 novitiate credit hours
• Clinical departments
The CCU and angiography division of educational hospitals of Mashhad University of Medical Sciences
• Practical training
Educational environments
Nursing and Midwifery college conference hall has been chosen as the site for theoretical teaching
Technical equipment, computers and other special equipments
Data projector, computer, CCU equipment (from the Skill Lab at the Nursing and Midwifery college, CCU and angiography division of educational hospitals of Mashhad University of Medical Sciences)

6- Educational policies (attendance, other principles)
Regular attendance is essential during the course period.
If the number of absences is more than 4 for theoretical courses and more than 4 days for clinical novitiate courses then, the individual will be removed from the course.

7- Registration Fee
Total of 700 thousand tomans for each individual which includes: theoretical class fees: 4 million tomans with a capacity of 20 individuals; and practical classes fees: 1.5 million tomans plus each 5 companion with the hospital commissions which is 1 million tomans for 20 individuals; and the commission for the location of holding practical classes which is 1.5 million tomans for 20 individuals; and finally the 60 thousand toman fee of reception for each individual.

Context of training program
A) In the fields of knowledge, attitude and expertise
Knowledge, participants
1- Must explain the characteristics of the CCU division
2- Must explain the monitoring and care of CCU patients in terms of different physical and mental dimensions
3- Must state the evaluation and pain controlling methods for CCU patients
4- Must describe the stages of advanced CPR in CCU
5- Must state the fundamentals of the electrocardiogram
6- Must distinguish the natural electrocardiogram from the un-natural electrocardiogram
7- Must diagnose various dysrhythmia and heart-blockages using alterations of the electrocardiogram
8- Must describe the symptoms and symbols, treatment and nursing cares related to various dysrhythmia and heart-blockages
9- Must explain the working principles and the howness of using artificial pacemaker, defibrillators, and monitoring systems along with the nursing cares needed for these machines
10- Must be able to explain the advanced cardiovascular recovery processes in regards to the role of nurses

Attitude:
The most important aspect of attitude for this course is the complete, fundamental and comprehensive evaluation of CCU patients in order to achieve an early diagnosis of disorders, prevent damages, perform appropriate interventions according to the priority of the situation and also to create self-esteem and likeness in nurses in order to care for CCU patients.

Expertise:
1- Perform the necessary nursing care for the CCU patients according to diagnosis
2- To be able to make an early and fast diagnosis of arrhythmia and apply special nursing cares
3- Professional perform necessary cares for patients in need of angiography
4- Monitor and care for the respiratory system of the patient in CCU
5- Monitor and care for the cardiovascular system of the patient in CCU
6- Monitor and care for the urinary system of the patient in CCU
7- Monitor and care for the digestive system of the patient in CCU
8- Perform mental monitoring and care for the patient in CCU
9- Evaluate and control the amount of pain the patient in CCU is suffering from
10- Appropriately calculate and prescribe the medicines prescribed for the CCU patient
11- Evaluate the nutritional requirements of the CCU patient and make the appropriate interventions
12- Must be able to perform advanced CPR in CCU

B) Complete description of skill implementation:
The apprentice must follow 70 to 80 percent of parameters related to the appropriate implementation of skills for all skills.
C) Models and methods of training-learning
 Lectures
 Group discussions
 Practical presentation
Learners
- Characteristics and conditions of learners in order to enter the course and method of admission:

Learner conditions:
Occupied or non-occupied undergraduates, postgraduates and doctors.
- Skills and expertise which learners will achieve upon completing the course and professional activities they are allowed to perform after receiving these skills:
1- Achieving, monitoring and applying care skills for heart patients
2- Attaining monitoring and applying care skills for patients with heart arrhythmia
3- Attaining skills for applying a variety of appropriate oxygen therapy methods
4- Achieving skills in adjusting mechanical air conditioning machines and applying necessary cares for patients in ventilators in the CCU
5- Attaining skills in computing the right amount for prescribing drugs in the CCU
6- Achieving skills for evaluating and controlling pain in CCU patients
7- Achieving skills for evaluating and controlling the nutritional status of CCU patients
8- Attaining skills in correctly performing advanced CPR

Course supervisor
11- specifications and characteristics of the course supervisor (the documents must be attached according to Act 2 of the executional instructions and legal notes 1 and 2 of the mentioned Act in relation to the specifications of the course supervisor):

Name: Abbas Last Name: Heydari Last Academic Degree: Ph.D. in nursing
Graduation year: 1390

Academic degree: assistant professor associate professor

Evaluation
14- Method of evaluating learners:
Post tests and clinical evaluation
Minimum passing grade for theoretical exam: 12/20
Minimum passing grade for practical exam: 14/20

- References
- Phipps WJ,SandsJK,MarekJF. Medical –Surgical Nursing.6th. Philadelphia:Mosby Inc ;1999.
-Thelan Lynnea and et al Critical Care Nursing Diagnosis and Mangement 3thMosby ;1998
- Black J.M., Hawks J. HMedical Surgical Nursing,clinical management for positive out comes. 8th edition , philladelphia: Saunders.2012.
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., Cheever, K. H. Brunner & suddarth,s text book of medical surgical nursing, 11th edition2012, Philadephia: Lippincott Williams & Wilkins.