instructions for preparing a dxr nursing...

Instructions for Preparing a DxR Nursing CaseGetting Started.........................................................................................................................................3-7

Program Requirements..........................................................................................................3Browser Compatibility Information ................................................................................. 4Creating Directories................................................................................................................5Logging in to the Case Management Utility ..................................................................6Editing Student User Accounts...........................................................................................7Editing Case Delivery Options.............................................................................................8Descriptions of Case Delivery Options............................................................................9Determining Display of Nursing Diagnoses ...............................................................10Reviewing, Editing and Adding Learning Resources.................................................11Editing Questions in the Management Utility............................................................12

Step-by-Step Instructions................................................................................................................13-18Entering the Program..........................................................................................................13Performing an Assessment.................................................................................................14Performing a Physical Exam.........................................................................................15-16Selecting Nursing Diagnoses.....................................................................................17-18Creating Care Plans...............................................................................................................19Conducting the Progress/Evaluation.......................................................................20-21Answering Case Questions.................................................................................................22

Quick Reference Guide.....................................................................................................................23-26Navigation Buttons and Tabs...........................................................................................24Framework Categories.........................................................................................................25Exam Tools...............................................................................................................................26

DxR Nursing Student Activity Record UtilityWhat is the Student Activity Record Utility.....................................................................................28

Installation and Access.......................................................................................................29Getting Started: Importing Records...................................................................30-32

Student Record Screen ........................................................................................................... ....... 32-33Time-saving Tip and Matching.......................................................................................34

Assessment Section...........................................................................................................................35-37Selected Items........................................................................................................................35Category Placement.............................................................................................................35Physical Exam Conducted................................................................................................36Interpretations... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Initial Care Plans Section..................................................................................................................38-42Selected Diagnoses .......................................................................................................39Diagnosis Prioritization.......................................................................................................39Confirming Items............................................................................................................39-40Diagnosis Etiologies.............................................................................................................40Management Activities Selected ....................................................................................41Care Plan Rationales.............................................................................................................41Outcome Items Selected....................................................................................................42

Revised/New Care Plans Section.................................................................................................43-47Diagnoses Added...................................................................................................................44Diagnosis Etiologies..............................................................................................................44Management Activities Selected....................................................................................45Care Plan Rationales..............................................................................................................45Outcome Items Selected....................................................................................................46Teaching/Discharge Plan Summary ...............................................................................47

Case Questions Section..........................................................................................................48Record Statistics Screen...................................................................................................................49Adjust Criteria .................................................................................................................................. 50-54

Set Criteria........................................................................................................................51-52Set MSL/Weights.......................................................................................................53-54Set Values ....................................................................................................................... 54

Exporting and Importing Criteria........................................................................................................55Printing and Exporting Data (scores)....................................................................................... 56Scoring Notes......................................................................................................................................57-58Frequently Asked Questions..........................................................................................................59-61

Co n t e n t s

Mv1.7.4 DXRNInstr0610

2

©2010 DxR Development Group, Inc., 148 East Pleasant Hill Road, Suite 112 Carbondale, Illinois 62903-9919, for software template and icons. All rights reserved.

No part of this software program, including artwork and text, may beutilized, reproduced, stored, or transmitted in any form by any means, electronic ormechanical, or by any information storage or retrieval system, without permission inwriting from the copyright holder. Address inquiries to DxR Development Group, Inc.,148 East Pleasant Hill Road Suite 112, Carbondale, Illinois 62903-9919.

Licensee of the software does have permission to duplicate the printed manuals, andto print and duplicate manuals from the PDF files contained on the CD-ROM.

Intel and Pentium are registered trademarks of Intel.

Macintosh and Safari are registered marks of Apple, Inc.

Microsoft, Internet Explorer, and Windows are either registered marks or trademarksof Microsoft, Inc. in the United States and/or other countries.

Shockwave is a registered mark of Adobe, Inc.

Intel is a registered mark of Intel Corporation in the U.S. and other countries

Portable Document Format (PDF) and Acrobat are trademarks of Adobe, Inc.

Nursing Diagnoses - Definitions and Classification 2009-2011© 2009, 2007, 2005, 2003,2001, 1998, 1996, 1994 NANDA International. Used by arrangement with BlackwellPublishing, a company of John Wiley & Sons, Inc.

This work contains terms from the Nursing Interventions Classification (NIC) and theNursing Outcomes Classification (NOC). Copyright 2007-2008 Mosby, Inc. These termsare used by permission of Mosby, Inc.

DxR Nursing was made with Director®, a product of Adobe, Inc.

Brands and product references noted are the trademarks of their respectivecompanies.

Copyright Information

Tech support: 1-800-453-8040 3

G e t t i n g S t a r t e d : P r o g ra m R e q u i r e m e n t s C h e c k l i s t

Windows®

Any of the following operating systems:

Windows® XP (Service Pack 2 or later)

Windows® Vista (32 bit)

Adobe® Shockwave® Player (a browser plug-in) version 11 or later must be installed for the selected browser.

(http://get.adobe.com/shockwave/)

sound card

headphones

Internet connection and compatible browser (see Alert)

monitor capable of 800x600 resolution and thousands of colors

Macintosh®

Mac OS X 10.4 or later with Intel® processors

Macintosh®PowerPC

Adobe® Shockwave® Player (a browser plug-in) version 11 or later must be installed for the selected browser.

(http://get.adobe.com/shockwave/otherversions/)

Note: You must have the Shockwave® version 11 or later, using the FULL installation. Ifyou use a SLIM installation, you may encounter problems within the DxR Nursingsoftware.

headphones

monitor capable of 800x600 resolution and thousands of colors

Internet connection and compatible browser (See Alert.)

ALERTFor browser compatibility

information, see the insert to this

publication or visit our Web site at

http://www.dxrnursing.com/browser.html

4 http://www.dxrnursing.com/browser.html

Windows®

• Microsoft® Internet Explorer 6, or 7

• Safari® version 3.1 or later

• The latest version of the Adobe® Shockwave® Player plug-in must beinstalled for this browser to successfully access the program.

• Browser cache set to at least 15 MB and 'Update once per session'

For optimal performance, close all other applications before launching the DxR

Nursing program.

Macintosh®

• Safari® version 3.1 or later

• The latest version of Adobe® Shockwave® Player plug-in must beinstalled for this browser to successfully access the program.

• Browser cache set to at least 15 MB and 'Update once per session'

• Browser memory partition set to at least 30,000k

For optimal performance, close all other applications before launching the DxR

Nursing program.

Note: Browsers not listed here should not be used with the DxR Nursingsoftware. DxR Nursing does not support using America Online in conjunc-tion with any browser. Check the Web site at the address below for updatedbrowser compatibility information.


Browser Compatibility Information

Tech support: 1-800-453-8040 5

1. Open your browser and type in the Web address where your site administratorhas installed the DxR Nursing program.

2. Click the Directory Utility link and, when prompted, type in your institution’sadministrative password. When the password is properly entered, you will haveaccess to the Directory Utility, where you can install, hide, and show directoriesand the cases within them.

3. Enter a new alpha-numeric name in the text box next to “Directory” for the direc-tory to be added. Use only alphanumeric characters in your directory name. Donot use symbols such as :, /, etc. Spaces used in the name will be converted to"_" characters (e.g. jones_smith).

Note: Be sure to use a unique name when creating a directory. Duplicating a filename will delete existing case data.

4a. To create a new directory, click Create and proceed to step 5.

4b. To work with an existing directory, choose one of the following optionsunder the directory name.

• To add a case to an existing directory, click Install below the directory name,then proceed to step 5.

• To hide or reveal a case within your directory, click Hide/Show next to theDirectory name. On the screen that appears, select the cases you wish to hideor reveal. (See Hide/Show note.)

• To hide or reveal an entire directory on your Web site, click Hide/Show next tothe Directory name. On the screen that appears, click the checkbox to hide orreveal the directory on your Web site. (See Hide/Show note.)

5. Click in the check box(es) next to the name(s) of the case(s) to be added to thenew directory.

6. Click Install SELECTED Cases to install the cases you marked, or click Install ALLCases to install all available cases into your directory.

7. Review the list to verify that they are the cases you selected. To make changes tothe case list, click your browser’s “back” button.

8. Click Continue to verify your choices and add cases.

9. Enter an administrator password which will be used to enter the ManagementUtility for the cases in your directory.. (Do not lose this password.) ClickContinue.

10. After the installation is complete, click the link to your web site to access theManagement Utility where you can customize how your case is presented tostudents.

http://(site address)/

The Web site address is where DxR Nursing has been installed. The list of createdDirectories will be available at that site. (The site address may be obtain fromthe system administrator.)

D i r e c t o r y U t i l i t y > C r e a t i n g D i r e c t o r i e s

HIDE/SHOW NOTE

After you click Hide/Show beside your

directory name, if the next screen

shows your directory name OR case

name WITH a checkmark in front of it,

it is visible on your Web site. If your

directory name OR case name doesn’t

have a checkmark in front of it, it is

invisible on your Web site. To change

these settings, click inside the check-

box and then click Save Changes.

You can access the manage-ment utility from the set-upwindow by clicking the linkunder the Installation Completemessage, or by exiting theDirectory Utility and typing inthe Web address where yourcases have been installed.

ACC E S S I N G T H EM A N AG E M E N T

U T I L I T Y

Casefiles

You can access Casefiles thatcan be used in the SARU for grad-ing student records. Click the linkat the bottom of the DirectoryUtility page and type in the user-name and password provided todownload the Casefiles.

6 [email protected]

G e t t i n g S t a r t e d : L o g g i n g i n t o t h e M a n a g e m e n t U t i l i t y

Anytime after you set up your directories and have installed cases into them, you canaccess the DxR Nursing Management Utility to customize the specific cases in yourdirectory.

To gain access to the Management Utility, follow the steps listed below.

1. Open a compatible internet browser.

2. Type in the URL of your DxR Nursing site. This information may be obtained fromyour Site Administrator.

3. From the list of available directories that will appear, click the name of the direc-tory containing the cases with which you would like to work.

4. When the list of cases within your selected directory appears, click theManagement Utility link beneath the name of the case with which you wouldlike to work.

5. The Case Management Utility screen will appear. (See Figure 1.) The screen maytake a few minutes to load.

6. When the Management Utility screen has fully loaded, the sign-in fields willappear. Type in the administrative password that was designated when yourdirectory was created. Remember, keep this password confidential.

7. Click the buttons along the bottom of the Management Utility screens to navi-gate within the utility.

Figure 1. The DxR Nursing Management Utility’s title andsign-in screen.

ALERT!Before you make a case study

available to students, you must final-

ize your settings in the Management

Utility. Changes to User Accounts,

Case Delivery Options, Nursing

Diagnoses, or Questions must be

made before users begin working

through a case study.

You can change the pass-word used to gain accessto the ManagementUtility for a given case.Click the ManagementUtility link for the case.When the screen shownin Figure 1 is displayed,press Shift+Alt (onWindows) orShift+Option (on Mac)while clicking on the DxRlogo. Three fields willappear, allowing you tochange your password.

H E L P F U L H I N T

If you haven’t already opened the Management Utility for your selected case, com-plete 1-8 below. If you have already opened the Management Utility, skip to #8.

1. Open an internet browser and enter the address:


2. In the space marked Site Address, enter the address of the site where DxRNursing has been installed. The list of created Directories will be available atthat site. (The site address may be obtained from the system administrator.)

3. Select the directory containing the cases for which the student user accountswill be edited.

4. Select the name of the case to which user accounts are being added, edited, ordeleted.

5. Click the Management Utility link under the appropriate case name.

6. A new screen will open displaying the Management Utility title screen.

7. Type in your administrative password (from “Creating Directories,” page 5).

8. Click User Accounts to enter the User Accounts screen.

To import a list of students and create user accounts for them:

1. Create a properly formatted student list (roster) of the students for whom youwant to create accounts. (See Creating Student Lists.)

2. On the User Accounts screen click Import Student Roster to Create Accounts. Anew browser window will open. Read the on-screen instructions.

3. Scroll down to the field labeled Step 2 and click Browse to navigate to the filecontaining your properly formatted student roster. Open the file. The name ofyour file will appear in the Step 2 field.

4. If the file name in the Step 2 field is correct, move to the field labeled Step 3 andclick upload. The program will create user accounts for each user listed in yourroster.

To add student/user accounts individually:

Type in the information and click Add New Account.

Note: Give the ID portion of the user name to the student. When they enter thatID, the program will prompt the user with the first name/last name portion of theuser information to verify that it is the correct person. Keep student IDs secure.

To edit a student/user account:

Select an account from the accounts listed on the right side of the screen.

Modify the user information and then click Save Changes.

Note: Any modifications made to this user account information will take effectimmediately. Please advise the users when the account information has changed.

To delete a student/user account:

Select an account from those listed on the right side of the screen.

The student’s information will appear in the text fields on the left.

Click Delete Account.

To delete all student/user accounts:

Click Delete All Accounts. (See Alert)

This action permanently deletes ALL accounts and the associated records. Note: When you click Print, a new browser window appears where you can print youraccounts list.

To create a Student List (roster):1. Create a file using a spread-sheet (such as Microsoft® Excel),database, or word processor(such as Microsoft® Word). Seepage 60 for supported applica-tions.

A. Comma (,)- delimited textFirst name, Last name, ID

B. Tab-delimited textFirst name Last name ID

C. Slash (/)-delimited textFirst name/Last name/ID

2. Save the file as text file, withthe .txt file extension.

C R E AT I N G S T U D E N T L I S T S

M a n a g e m e n t U t i l i t y > E d i t i n g S t u d e n t Us e r Ac co u n t s

Student IDs

Student IDs can be any combination of

standard alpha-numeric characters (such

as abc 123). Please avoid using commas,

tabs, or slashes as characters in student

IDs.

ALERT!Deleting an account is a perma-nent action. Deleting an accountalso deletes any student recordsassociated with the useraccount(s). Use the DeleteAccounts function with caution.

Tech support: 1-800-453-8040 7

8 [email protected]

If you haven’t already opened the Management Utility for your selected case, com-plete 1-8 below. If you have already opened the Management Utility, skip to #8 below.

1. Open an internet browser and enter the address:


2. In the space marked Site Address, enter the address of the site where DxRNursing has been installed. The list of created Directories will be available at thatsite. (The site address may be obtained from the system administrator.)

3. Select the directory containing the cases for which the case delivery optionswill be edited.

4. Select the name of the case to which case delivery options are being changed.

5. Click the Management Utility link under the appropriate case name.

6. A new screen will open displaying the Management Utility.

7. Type in your administrative password (from “Creating Directories,” page 5).

8. Click Case Delivery Options to enter the Case Delivery Options screen.

To learn about any of the case delivery options:

Roll over the question mark icon next to a particular option to read about thefunction of that option.

To change any of the case delivery options:

If an option is checked, it is on. Click the check box next to a particular optionto change whether that option is on or off. If this delivery option is not select-ed (checked), students won’t have access to that particular portion of func-tion of the case.

NOTE: The default setting has all of the case delivery options turned on, withAccess to Case Questions set to display each answer and rationale immediatelyafter the student submits an answer. To undo changes that have been made andreturn to the default settings, click Reset Defaults.

To save your changes:

Click Save Changes to save the changes/entries on the Case Delivery Optionsscreen.

To access the Directory Utility:

Click the Directory ManagementOptions button. If you have made changesbut haven’t saved them, you will beprompted to do so.

The Directory Utility will open, allowingyou to hide or show directories or individ-ual cases within them. When you close theDirectory Utility, you can resume your workin the Management Utility.

M a n a g e m e n t U t i l i t y > E d i t i n g Ca s e D e l i ve r y O p t i o n s

ALERTSee page 9 of this manual for a

description of each case delivery

option.

Figure 2. Case Delivery Options screen with alloptions turned on.

When it is time to downloadstudent records for grading,your Case Delivery Optionssettings at the time ofdownload will determinewhat portions of the case areincluded in scoring. For exam-ple, if Teaching Plan andDischarge Plan/Summary areturned OFF, they won’t beincluded in the student’sscore.

S E T T I N G S N OT E

Tech support: 1-800-453-8040 9

Save Student Activity RecordsAllows a record to be kept of the student’s

work in this case. This record can later be imported intothe Student Activity Record Utility (SARU) for instructoranalysis.

Access to Physical Exam ScreenAllows students to perform a virtual physical

exam. Turning it off disables the button for entry intothe physical exam screen.

Access to Collaborative Problems DialogAllows students to enter Collaborative

Problems. Turning it off disables the button for entryinto the Collaborative Problems dialog.

Include Collaborative Problems in Nursing Dx ListIf a student identifies and enters one or more

Collaborative Problems in this case, the problems canbe displayed along with the Nursing Diagnoses on theNursing Dx List screen and prioritized along with theNursing Diagnoses. If this preference is turned off, onlyNursing Diagnoses can be prioritized.

Access to Select Diagnoses ScreenAllows students to select diagnoses after link-

ing client data items to Framework Categories. Turningit off denies users access to the Select Diagnosesscreen, where students view “clustered” data items andcompare them to defining characteristics/risk factorswhile choosing diagnoses. NOTE: If this preference isOFF, students will not have access to the CarePlanning and Progress sections of the case.

Access to Defining Characteristics (of Nursing Dx’s)Allows the Defining Characteristics (per

NANDA) to display with each diagnosis under consider-ation on the Select Diagnoses screen. If this preferenceis turned off nothing will display in the DefiningCharacteristics field of this screen.

Access to Care Plans ScreenAllows students to create Care Plans for facul-

ty-approved Nursing Diagnoses. Turning it off disablesthe tab for entry into the Care Plans screen. If this pref-erence is turned off, students can perform an assess-ment and diagnostic tasks but cannot create aTeaching Plan, Discharge/Summary Plan, or Care Plans,nor continue to other periods of virtual time in thecase.

If you allow access to the Care Plans screen and havepurchased the NIC/NOC module, choose the type ofCare Plans that will be used:

NIC/NOC Care PlansAllows you to require students to develop careplans using the NIC/NOC classification system.

DxR Care PlansAllows you to use the care plan classificationsystem that is standard in all DxR NursingCases.

Access to Teaching Plan ScreenAllows students to type in a Teaching Plan for

this client. Turning it off denies users access to thescreen where the plan can be typed in.

Discharge Plan/Summary ScreenAllows students to type in a Discharge

Plan/Summary for this client. Turning it off denies usersaccess to the screen where the plan can be typed in.

Access to Case Questions Makes the questions associated with the case

available for the student to answer after exiting thecase.

Display Options:Answer/Rationale with Each QuestionSelect this option to display the correct answerand a rationale for it immediately after the useranswers that question.

Answers/Rationales as SummarySelect this option to delay displaying the ratio-nales until after the user has answered all thecontent related questions for this case. Userswill not receive feedback designating the cor-rect answers for the questions until after theyhave completed all questions for the case.

No Answers/ No RationalesSelect this option to display only the questions,but not the correct answers or rationales forthe answers.

Settings Note: When it is time to download student records for

grading, your Case Delivery Options settings at the time ofdownload will determine what portions of the case are included

in scoring. For example, if Teaching Plan and Discharge

Plan/Summary are turned OFF, they won’t be included in the stu-

dent’s score.

M a n a g e m e n t U t i l i t y > D e s c r i p t i o n s o f C a s e D e l i v e r y O p t i o n s

10 [email protected]

Management Utility > Determining Display of Nursing Diagnoses

The Nursing Diagnosis screen of the Management Utility allows you to activate ordeactivate entire progress levels or specific nursing diagnoses for use in your DxRNursing case. If you haven’t already opened the Management Utility for your selectedcase, complete 1a-1h below. If you have already opened the Management Utility, skipto #1h below.

1a. Open an internet browser and enter the address:


1b. In the space marked Site Address, enter the address of the site where DxRNursing has been installed. The list of created Directories will be available atthat site. (The site address may be obtained from the system administrator.)

1c. Select the directory containing the cases for which the display of NursingDiagnoses will be edited.

1d. Select the name of the case for which the Nursing Dx display is being changed.

1e. Click the Management Utility link under the appropriate case name.

1f. A new screen will open displaying the Management Utility title screen.

1g. Type in your administrative password (from “Creating Directories,” page 5).

1h. Click Nursing Dx to enter the Nursing Diagnoses screen.

Activating/Deactivating Progress Levels

2. Click the Progress menu to see a list of the various progress levels built into yourcase. You can deactivate a progress level, meaning students won’t create careplans for any of the nursing diagnoses within that progress level and those diag-noses won’t be used as criteria for your case study.

When you select a progress level from the menu, the checkbox will bechecked if that progress level is activated. The box will be empty if theprogress level is deactivated. You can click inside the box to activate or deacti-vate that progress level. When you deactivate a progress level, you also deac-tivate any progress levels that follow it. You must have at least one activeprogress level.

When you select each of the progress levels, the nursing diagnoses enteredby the case author for that progress level will appear.

Inspect the nursing diagnoses for each progress level to determine if youwant to deactivate an entire progress level or any of the individual nursingdiagnoses within the progress level.

Activating/Deactivating Individual Nursing Diagnoses

3. Nursing diagnoses preceded by an “X” are activated, meaning they will be usedas criteria for the case and the student will berequired to create care plans for them. Nursingdiagnoses that are not preceded by an “X” aredeactivated, meaning they won’t be used as cri-teria for the case and the student will not createcare plans for them.

4. Click inside the box preceding the nursingdiagnosis to change whether it is active or inac-tive.

Important: You must have at least one active nurs-ing diagnosis for each active progress level inyour case.

5. Click Save Changes when you’re done.

Figure 3. The Nursing Diagnosis screen in theManagement Utility.

Grayed-out Progress LevelIf a progress level in the menuappears grayed out the first timeyou enter the ManagementUtility, there are no new nursingdiagnoses for that progress leveland therefore no diagnoses toactivate or deactivate.

If any nursing diagnoses orprogress levels are turnedOFF at the time you down-load student records forgrading, those items will beautomatically removedfrom scoring in the StudentActivity Record Utility.

S E T T I N G S N OT E

Management Utility > Reviewing, Editing, and Adding Learning Resources

If you haven’t already opened the Management Utility for your selected case, com-plete 1a-1h below. If you have already opened the Management Utility, skip to #1hbelow to begin editing or adding Learning Resources.



1b. In the space marked Site Address, enter the address of the site where DxRNursing has been installed. The list of created Directories will be available at thatsite. (The site address may be obtained from the system administrator.)

1c. Select the directory containing the cases for which the learning resources willbe edited.

1d. Select the name of the case to which questions are being added, edited, ordeleted.




1h. Click Learning Resources to enter the Learning Resources screen.

To review the learning resources already linked to your case.

2a. Click a Learning Resource from the list on the right side of the LearningResources screen.

2b. Click View Resource. This will open a Web page displaying the learningresource.

2c. Repeat for all existing learning resources.

To add a learning resource:

3a. Enter a name for your Learning Resource and its URL (Web site address) in thetext fields at the top left of the screen.

3b. Click Add As A New Resource.

Note: You may enter different learning resource names for the same Webaddress. This may be helpful in directingstudents to specific information on a par-ticular Web site.

To edit a learning resource:

4a. Select the resource you want to editfrom the box on the right side of thescreen.

4b. Change the learning resource data inthe text fields displayed on the left.

4c. Click Save Changes.

To delete a learning resource:

5a. Click the Learning Resource you wantto delete (located in the box on theright side of the screen).

5b. Click Delete Resource.

Note: When you delete a resource from a case, it is permanently deleted.

Figure 4. The Learning Resources screen

If you mistakenly deleteone of the learningresources included by thecase author, you canrestore the learningresource by followingthese steps.

a) Refer to the Case Criteria

material under the Case

Summaries heading. All

learning resources and their

URLs will be listed.

b) Type in the resource

information and click Add

As a New Resource.

If you do not have theEvaluation Criteriainformation, contact us at 1-800-453-8040.

N OT E

Tech support: 1-800-453-8040 11


If you haven’t already opened the Management Utility for your selected case, com-plete 1a-1h below. If you have already opened the Management Utility, skip to #1hbelow to begin editing or adding Case Questions.



1b. In the space marked Site Address, enter the address of the site where DxRNursing has been installed. The list of created Directories will be available atthat site. (The site address may be obtained from the system administrator.)

1c. Select the directory containing the cases for which the questions will be edited.

1d. Select the name of the case to which questions are being changed or added.




1h. Click Questions to go to the Questions screen, where you can add, edit, anddelete questions related to the content of the case study.

Adding Questions

2a. Use the arrow buttons to navigate through the questions. Click Add Question toinsert a new question.

2b. Choose either the Multiple Choice or True/False option.

2c. Click inside the Question Text box to remove the cover. Enter the text of yourquestion. For multiple choice questions, you must also type in up to five answeroptions (A, B, C, D, and E). If you want the students to select more than oneanswer, one of your answer options should be a combination of both correctanswers. The program will not allow students to select two separate answers forthe same question.

Example: E. Both A & C

2d. Identify the correct answer for your question by clicking the correspondingradio button.

2e. Click inside the Rationale text box to remove the cover. Enter a rationale for thecorrect answer selection.

Editing Questions

3a. Use the arrows at the bottom right of the screen to navigate through the ques-tions. Select the question you wish to edit.

3b. Click inside the text field containing thepart of the question you wish to edit. Makechanges by highlighting and changing thetext.

3c. To change the correct answer choice,click the radio button corresponding toyour new correct answer choice.

3d. Click Save Changes.

Deleting Questions

4a. Navigate to the question you wish todelete and click Delete Question.

Resetting Defaults

5. Click Reset Defaults to reinstate the origi-nal 10 questions only, without edits.

M a n a g e m e n t U t i l i t y > E d i t i n g Ca s e Q u e s t i o n s

Figure 5. Questions screen in the DxR NursingManagement Utility.

Always exit the programusing the Quit button

rather than closingthe window to ensure thatyour work is saved.

R E M I N D E R

When you click Print on theQuestions screen in theManagement Utility, a newbrowser window will open.,displaying all questions,their answers, and theirrationales. Click Print onyour browser’s navigationbar to print out these ques-tions.

P R I N T

ALERTDo not edit questions after stu-

dents have already entered the case

and have started answering questions.

Tech support: 1-800-453-8040 13

1. Set the monitor resolution to 800x600.

Shockwave® must be installed.

2. Open the browser to the Web site containing the list of case directories. (If adirectory has not yet been created, go to page 5 and follow the instructions pro-vided there.)

Use one of the previously listed Web browsers.

The Web site address can be obtained from the system administrator orcourse instructor.

3. Select the case to use by clicking the case name.

A Shockwave window will appear. Interactions with the program will occur inthis window.

4. Click Begin.

5. Enter your User ID created in the Management Utility, and click OK.

6. When your name appears, click Yes to confirm.

Note: Before reviewing the presenting situation, users will be reminded to work through the case

study efficiently. Linking excessive numbers of items can result in software performance problems.

7. Review the presenting situation and then click Yes to continue.

Time-Saving Note: Even before you start grading student records, you can begin to make deci-

sions that will make the process easier. We recommend that you print out the evaluation criteria for

your selected case (email us at [email protected] and we will provide this .pdf file.)

Read through the evaluation criteria either while or after you have worked through the case your-

self. Make note of any items or subsections that you want to remove from scoring. As you begin

grading student records, refer to your notes to make the process go more quickly.

D x R N u r s i n g C a s e S o f t w a r e > E n t e r i n g t h e C a s e

How to InstallShockwave®

If the current AdobeShockwave® Player is notinstalled, a downloadprompt should appearwhen you click a casename. Follow the on-screen instructions.

If a prompt does notappear, go to:http://www.adobe.com/

shockwave/download/

Select the AdobeShockwave® and Flashdownload link.

Follow the on-screendirections to download thecurrent version of theAdobe Shockwave® Player.

S H O C K WAV E ®I N S TA L L AT I O NI N S T R U C T I O N S

1. To review information attached to the client chart, click the Initial Assessment,Labs, or Medical Management tab.

A drop down menu will appear for the Initial Assessment and Labs tabs, con-taining a list of the available data or lab results. From the drop-down menu,select one of the available documents to review.

A drop down menu will not appear for the Medical Management tab.Available Medical Management data will appear automatically in the textarea.

2. Identify data in the selected document that is relevant to the client’s case.

3. To link/match relevant data to theappropriate Framework Categories,click the relevant client data to acti-vate it. Activated data will appear initalic type. It’s now ready to be linkedto a Framework Category.

Note: You can click Define (at the bottomof the category list) to see definitions ofeach Framework Category.

4. Find a corresponding FrameworkCategory and click the category but-ton. This links the data to the catego-ry.

When the activated data havebeen linked to a framework category,

the text will by change back to plain type.

To link a piece of data (such as a sentence) to multiple categories, hold downthe ALT key in Windows, or the OPTION key in Macintosh, while clicking theappropriate categories. Note: Release the key before clicking the final cat-egory or the data will remain activated and ready to be linked withanother category.

5. Repeat these steps until all material under the Initial Assessment, Labs, andMedical Management tabs until you have viewed all the information.

6. To review the matched data, click Open (button found at the bottom of the cate-gory list). A dialog box will appear. Select the desired category from the list onthe right to reveal the items you’ve linked to that category.

7. Click either Exam to perform the virtual physical exam or Select Diagnosis toproceed to the next section of the program.

Note: If either the Exam or Select Dx button (along the left side of the screen) isgrayed out, it means that portion of the case study has been turned off. If boththe Exam and Select Dx buttons are grayed out, they are turned off and you willnot be able to advance to those sections of the case. After you’ve completedyour work in the Chart, you would click Quit to exit the case.

Figure 6. The activated data appears in italics.

D x R N u r s i n g Ca s e S o f t w a r e > Pe r f o r m i n g a n A s s e s s m e n t


Items in the Chart and Exam

can be found using the Search

feature.

Click Search.

Enter key word or words for

the search. The search uses an

exact word match.

Click Search Chart.

Select the desired term in

the search results.

Click View.


Framework Categoriesrepresent a method of organiz-ing selected client information.

Definition: Framework Categories

Tech support: 1-800-453-8040 15

D x R N u r s i n g Ca s e S o f t w a r e > Pe r f o r m i n g a P hys i c a l E x a m

Click Exam to open the virtual Exam Screen. The default client body view that you willsee is the head. Select a tool

1. Select an Exam Tool to beginthe physical exam.

Once you select an ExamTool, the cursor will changeto an icon of the tool. Thename of the selected ExamTool will appear at the top ofthe text field to the right ofthe Body View window.

Select a body view and part

2. Next, click the Body View (head,body, chest, abdomen) showingthe specific body part you wantto examine.

Apply the Exam tool to thebody part you want to exam-ine. As you roll the cursor over the Body View image,the name of the body part that your cursor is touch-ing will appear at the top of the text field to the right of the body view pic-ture. Click the specific body part you want to examine.

Information revealed or collected in the exam will appear in the text box tothe right of the large client picture.

Interpret results

3. Certain exam items such as heart sounds or breath sounds will require you toenter an interpretation. All interpretations must be entered before proceedingto the Care Plans section. You must complete all interpretations before exit-ing the program.

A dialog box will appear if you are required totype in an interpretation. After typing in the inter-pretation, click Consult to see a professional inter-pretation.

If you are not prepared to make an interpretationat this time, click Continue and enter it later byclicking Interpret/Consult.

(Exam instructions continued on .)

Figure 7. The Exam screen with data displayed fromusing the blade tool.

Figure 8 . A heart sound screen.

D x R N u r s i n g Ca s e S o f t w a r e > Pe r f o r m i n g a P hys i c a l E x a m


Selecting relevant Exam data

4. Activate the relevant Exam data by highlighting the desired information.

Note: This differs from other sections of the program where you activate textby clicking it and it becomes italicized. To activate text in the exam, you musthighlight the text by clicking and dragging your cursor over the text.

Linking selected data to framework categories

5. Select the appropriate Framework Category and click that category button tolink the highlighted data to the category.

Once linked, the selected data will no longer be highlighted.

To link to multiple framework categories, in Windows, hold down the ALT key.In Macintosh, press the OPTION key in while clicking the appropriate cate-gories.

6. Repeat these steps until the examination is complete.

Reviewing linked data

7. To review client information linked to any of the Framework Categories, clickOpen (at the bottom of the category list). A dialog box will appear. Select theframework category to display all successfully-linked information.

Ending the physical exam

8. When the exam is completed, click Chart to finish the review of the chart itemsor click Select Diagnosis to proceed to the next section of the program.

Note: If the Select Dx button (along the left side of the screen) is grayed out, itmeans that portion of the case study has been turned off. After you’ve complet-ed your work in the Chart and the Exam, you would click Quit to exit the case.

Collaborative Problems/Potential Complications may beinvolved in some cases andsome courses.To organize data under theheading of CollaborativeProblems/ PotentialComplications, follow thesesteps:

Activate the relevant data(from Chart or Exam).

Click Collaborative Problems.

Type in the name of theCollaborative Problem/Potential Complication.

Click Confirm to add.

Select a CollaborativeProblem and click Delete toremove Collaborative Problems.


Click Select Diagnosis to open the Diagnosis screen.

1. Click each Framework Category to review the data linked to it.

The linked data will appear in the text field #2 (“Review client data”).

If the data for the selected Framework Category indicate a Nursing Diagnosis,continue to the next step. If not, review the next Framework Category.

2. Click in the box marked #3 (“Click below”) to reveal a menu of possible NursingDiagnoses.

3. Click a diagnosis to display its defining characteristics or risk factors. If the infor-mation is available, it appears on the right side of the dialog box (See Figure 9).

If the selected diagnosis is appropriate, click OK. Continue to the next step.

If the selected diagnosis is not appropriate, select another diagnosis or clickCancel to choose the next Framework Category as in step 1.

Users can still return to the Chart and Exam screens to link data that mayapply to a nursing diagnosis.

4. The selected diagnosis will appear in the box marked #3 (“Click below...” ) andthe defining characteristics will appear in text field #4 (“Review characteris-tics...”).

5. Compare the displayed Client Data with the defining characteristics of theselected diagnosis.

6. Click the client data in text field #2 that support the selected diagnosis.Activated data will become italicized.

7. Click Confirm and a dialog box will appear.

If it’s required, type in the etiology for the diagnosis (See Note).

Click Add to add the diagnosis to the Nursing Diagnosis List or click Cancel toclose the dialog box without adding the nursing diagnosis you selected.

8. Repeat steps 1-7 for each Framework Category to which you linked Client Data.You may select multiple nursing diagnoses within each category.

(Select Nursing Dx instructions continued on .)

D x R N u r s i n g Ca s e S o f t w a r e > S e l e c t i n g N u r s i n g D i a g n o s e s

Tech support: 1-800-453-8040 17

Figure 9. A menu with a list of possiblenursing diagnoses

You can use the Search fea-ture to find NursingDiagnoses.• Click the Search but-ton.• Enter the key word orwords for which you wantto search. The program willsearch for exact wordmatches for the term thatyou enter. For example:Searching for ‘aspiration’will yield more results than‘risk for aspiration.’• Click Search Nursing Dx’s.Select the desired term inthe search results.• Click View.

S E A R C H

If you as the instructordon’t intend to evaluate thestudents’ diagnosis etiolo-gies and don’t want stu-dents to spend time devel-oping them, you can tell thestudents that etiologies arenot required BEFORE stu-dents enter the case study.The program allows stu-dents to Add their diagnosiswithout typing in an etiolo-gy.

N OT E

9. When you’ve selected all the nursing diagnoses you think are appropriate forthis client, click End Select Diagnosis Process to go to the Nursing Dx List tab.

10. On the Nursing Dx List screen, prioritize the diagnoses by selecting a diagnosisand then clicking the Up and Down buttons to move it from its current positionin the list. Selected diagnoses will appear in italics.

Use the Delete button as needed to remove nursing diagnoses from the list.

11. When you are satisfied with the list, click End Select Dx and Prioritization to pro-ceed.

Warning: Once you click to enter the Care Plan section, the data in the Chartand Exam cannot be linked to Framework Categories. You will also be prohibit-ed from prioritizing diagnoses and from Adding diagnoses for that progresslevel.

Note: If the Care Planning section of the case study is disabled, a dialog box willappear, telling you that you have reached the end of the case study. You will beadvised to click the Quit button to exit the case study.

Figure 10. Prioritizing diagnoses on the Nursing Dx List screen.

D x R N u r s i n g Ca s e S o f t w a r e > S e l e c t i n g N u r s i n g D i a g n o s e s


Click the Care Plans tab to go to that section of the case.

1. Clicking the Care Plans tab opens a dialog box containing the indicated nursingdiagnoses as entered by the case author. Review the list and click Done to pro-ceed. When you are selecting nursing diagnoses you will choose any diagnosesyou feel are relevant to the client. However, when you enter the Care Plans sec-tion, you will be prompted to create care plans only for nursing diagnosesapproved by the case author.

2. Click Nursing Diagnosis.

A drop-down menu of diagnoses for which you should create Care Plans willappear.

Select a nursing diagnosis from the list to display a list of desired ClientOutcomes for that diagnosis.

3. Click Nursing Interventions .

A dialog box listing possible management activities for the selected diagnosiswill appear.

Click the activities that will assist in meeting the desired client outcomes. TheNursing Interventions you select will become italicized when you click them.

When you’re finished selecting Nursing Interventions for that nursing diagno-sis, click OK.

Type in a rationale for each care plan in the space provided.

4. (optional) The selected list of activities may be edited by using the Delete but-ton.

Select the management activity to be deleted.

Remove the activity by click-ing Delete.

5. Create Care Plans for all of thediagnoses (by repeating steps 1-4 above). Care plans can beprinted for the instructor’s eval-uation.

6. Some instructors and coursesmay require the creation of aTeaching Plan and/or aDischarge Plan/ Summary.

Click Create Teaching Plan orCreate Discharge Plan/Summary.

A dialog box will appear.Enter a plan in the space pro-vided.

The contents of the dialog box may be printed by clicking the Print All CarePlans button.

7. When all Plans have been completed, click Implement All Plans to continue.

Click Yes to end the Care Planning process.

Click OK to continue to the Progress/Evaluation.

Note: When you click Implement All Plans, the program will move forwardto a new period of virtual time.

D x R N u r s i n g Ca s e S o f t w a r e > C r e a t i n g Ca r e P l a n s

If you haven’t finished inter-preting data items whenyou select the Care Planstab, a warning message willappear. ClickInterpret/Consult to enterthe interpretations beforeproceeding to the CarePlans section.


Tech support: 1-800-453-8040 19

Figure 11. Menu of possible Nursing ManagementActivities.

ALERTOnce you enter the Care Planscreen, the data in the Chart andExam cannot be linked toFramework Categories nor candiagnoses be added or prioritized.

1. You arrive at the Progress screen by clicking Implement All Plans on the CarePlans screen or by clicking the Progress tab. From the menu that appears on theProgress screen, review all data listed under the various sections in the menu.

2. Most DxR Nursing cases includean audio scenario of a nurse/clientinteraction. You can access it in theNursing Notes section.

Click play to hear the audio. Anew screen containing the scenariotext will open. Type in any relevantinformation you gather from thisscenario in your Nursing Notes sothe text can be linked to the clientoutcomes associated with the nurs-ing diagnoses.

3. Enter data and comments in theNursing Notes dialog box.

Select Nursing Notes in theProgress tab menu.

Type notes into the dialog box.

4. Activate and link data relevant to the client’s progress in achieving the desiredOutcomes.

Note: To activate data in the Progress Reports and Nursing Notes, highlight it. Toactivate data in the Labs and Management sections, click the text and it willbecome italicized.

Click Current Diagnoses to reveal a list of the nursing diagnoses.

Select a nursing diagnosis to view the desired Outcomes associated with it.

Click the Client Outcome to which you want to link the activated data. Thedata you activated is now linked to that outcome.

5. When all relevant data havebeen linked, click Nursing Dx List toedit the list.

Note: Diagnoses with a previously creat-ed Care Plan cannot be deleted, but theycan be marked Resolved. See instructionsin #6 below.

6. A nursing diagnosis may bemarked Resolved if its Outcomeshave been achieved.

Click the diagnosis.

The selected diagnosis willbecome italicized.

Click Item Resolved.

The selected diagnosis will bemarked Resolved.

Figure 12. A view of Outcomes desired for the CurrentDiagnosis.

D x R N u r s i n g Ca s e S o f t w a r e > Co n d u c t i n g t h e P r o g r e s s / Eva l u a t i o n

Highlight and link itemsindividually from NursingNotes to the desiredOutcome items. (This is nec-essary for correct analysis inthe Student Activity RecordUtility.)



Figure 13. Current Diagnoses list with diagnoses marked as resolved.

7. You can also add nursing diagnoses to the Current Diagnoses list.

Click the Nursing Dx List tab to bring up that screen and click Add.

A dialog box will appear. Click the drop down list of Nursing Diagnoses.

Select the diagnosis you want to add.

Type in an etiology, if required, and click Add in the dialog box.

8. Once the list of nursing diagnoses has been edited, you should revise and createCare Plans for the unresolved and new diagnoses.

Click the Care Plans tab or by clicking the End Select Dx & Prioritization but-ton.

Click Yes if you want to end the process of editing the Nursing Dx List. ClickNo if you want to continue editing.

A new dialog box will appear with a list of new approved Nursing Diagnoses.

Click Done when you are ready to create Care Plans for the new diagnoses.

Repeat the process of creating Care Plans for all remaining nursing diagnoses.

9. When the Care Plans are completed, click Implement All Plans.

Click Yes when prompted to continue.

Click OK to end the current period of virtual time.

If the case is not completed, the program will advance to the next Progressperiod (period of virtual time). Repeat the Progress/Evaluation instructions.

The program will display a dialog box advising you when you have complet-ed the case. Click Quit to exit the program .

Go Back - This allows you to return immediately to the DxR Nursing Case.

Exit and Return later - This option allows you to exit the case now and re-enterit later, returning to the screen you last visited.

Exit Completed Case - This option ends your session with the DxR Nursing caseand allows access to the DxR Nursing Query Utility, where you can answercontent related questions. See for instructions.

Tech support: 1-800-453-8040 21

D x R N u r s i n g Ca s e S o f t w a r e > Co n d u c t i n g t h e P r o g r e s s / Eva l u a t i o n

D x R N u r s i n g Ca s e S o f t w a r e > Q u i t t i n g t h e P r o g ra m

You will create care plansonly for nursing diagnosesselected by the case authorand approved by theinstructor.

R E M I N D E R

Always use the Quit button to exit the DxR nursing program (rather thansimply closing the program window) to ensure that your work is saved. Whenyou click the Quit button, you will be given three options. Choose one of theoptions described below.

Before quitting the pro-gram, wait about 10 sec-onds to ensure that allinformation is saved.



When you complete a DxR Nursing case, you may be given the option of answering

content-related questions.

Clicking Exit by-passes the questions and allows you to exit the program.

Clicking Begin allows you to start answering questions in the Case Questionssection.

1. When the content-related questions appear, read the question and the possibleanswers carefully.

2. Select your answer by clicking the corresponding radio button.

3. Click Submit Answer. Depending on the settings activated for this case, the cor-rect answer may appear immediately after you submit your answer to each ofthe questions. The correct answer may or may not be accompanied by the caseauthor’s/editor’s rationale for the answer. In the alternative, correct answers tothe questions and their rationales will appear as a review after you haveanswered all content-related questions for the case.

4. Click Continue to move on to the next question.

5. Repeat steps 1-4 until you have answered all content-knowledge questions forthis case.

DxR Nursing Case Software > Answering Case Questions

Figure 14. After the user answers a question, the correct answerand the rationale for that answer will appear.

Content-related questionscan be helpful in preparingto take licensure examina-tions.

W H Y A N S W E R Q U E S T I O N S ?

CASE QUICK REFERENCE GUIDE

NAVIGATION BUTTONS

NAVIGATION TABS

FRAMEWORK CATEGORIES

EXAM TOOLS

DXR NURSING

CHARTThis button allows access to client datathat was previously recorded by otherhealthcare professionals.

EXAMThis button opens the virtual exam wherethe exam tools will become available.

SELECT DIAGNOSISUse this button to access the Select Dxscreen and enter your nursing diagnoses.

INTERPRET/CONSULT BUTTONClicking this button will open a new win-dow to enter an interpretation of clientfindings or to review available interpreta-tions of exam and lab results.

LEARNING ISSUESNotes or remarks for instructor review canbe entered by clicking this button. Thesenotes can be printed.

LEARNING RESOURCESThis button allows access to available out-side Web links containing sources to sup-plement this learning program.

NOTESUse this button to access a notebook tokeep personal notes. These notes can beprinted.

SEARCHThis button allows a search of the client’schart or the nursing diagnoses list. Thesearch will find only exact matches.

HELPThroughout the program, this buttonaccesses the help section that covers thecurrent screen or portion of the program.

QUITThis button allows you to exit the patientsimulation. You will have options to GoBack, Exit and Return Later, or to Exit theCompleted Case.

N av i g a t i o n B u t t o n s


At any time while using the DxR Nursing program, roll the cursor over thesebuttons to see their names.

INITIAL ASSESSMENTSelect this tab to view the client data collected duringan initial assessment. This information can includeadmission vital signs, medical history, medications, psy-chosocial factors, etc.

LABSThis tab will access the results from lab tests. The LabInfo button (displayed above the lab results) provides adescription of the tests and what abnormal results indi-cate.

MEDICAL MANAGEMENTUse this tab to review the medical managements pre-scribed by other health care professionals.

NURSING DX LISTSelect this tab to view and prioritize the chosen nursingdiagnoses and, if appropriate, collaborative problems.This tab will be activated only after the necessary pro-gram requirements have been fulfilled. You may printthis list if necessary.

CARE PLANSUse this tab to create care plans for each of the nursingdiagnoses approved for this client case. This tab will beactivated only after the necessary program require-ments have been fulfilled. Care plans may be printed forinstructor review.

PROGRESSThis tab will access the client’s progress information.

N av i g a t i o n Ta b s

Tech support: 1-800-453-8040 25

Fra m e wo r k Ca t e g o r i e s

CARDIOPULMONARY/MOBILITYItems concerning breathing and the function ofthe heart are placed in this category. Also, placeitems that relate to the client’s ability to move,exercise, and care for himself/herself.

ELIMINATION PROCESSThis category encompasses the body’s ability toeliminate wastes, including urinary or fecal elimina-tion.

NUTRIENT/METABOLIC PROCESSESPatterns of fluid and food intake and the body’sability to metabolize this intake are placed here.This category includes nutrient-metabolic process-es for both the client and an infant of the client.Furthermore, temperature regulation and skin- andtissue-integrity related items are placed here.

COGNITIVE/SENSORYThe ability to understand, think, and decide arenoted here along with information about the sens-es, such as hearing or vision.

EMOTION/SELF AWARENESSThis category concerns the client’s feelings, includ-ing those about the client’s self.

RESTFULNESS/SLEEPItems relating to the client’s ability to sleep, relax,and rest.

SEXUALITYItems about the client’s sexuality, including rapetrauma, if applicable, can be placed here.

SOCIAL PROCESSESInformation about the client’s relationships withothers, such as family members, is placed here.

SPIRITUALITYThis category involves the client’s spirituality andvalues.

STRESS MANAGEMENTItems having to do with the client’s ability to copewith changes, difficulties, trauma, or caregiving areplaced here.

HEALTH PRACTICESThe client’s overall health, both mental and physi-cal, is noted here. Information on compliance withpractices to improve or maintain health is placedhere.

DefineClick this button to access a definition of eachframework category, as well as the nursing diag-noses that correspond to that category.

OpenClick this button to access a window where you cansee the items you’ve linked to each category.

Figure 15. Chart screen with Framework Categories highlighted.


E x a m To o l s

FLASHLIGHTUse this tool to examine pupil reactions.

STOPWATCHThe stop watch can be used to count pulseand respiratory rates. It can also be used totest hearing.

COTTONSensation can be tested with this.

OPHTHALMOSCOPEThis tool is used to examine the client’soptic fundi.

OTOSCOPEThe client’s ears may be examined with thistool.

VIEWClick this icon to visually inspect the client.

BLADEUse the blade to examine the client’smouth.

STETHOSCOPEThis tool is used to listen to the client’schest, back, or abdomen.

HAMMERUse the hammer to test reflexes.

SPHYGMOMANOMETERThis tool is used to measure blood pressure.

THERMOMETERUse this to take oral, axillary, tympanic, orrectal temperatures.

PINThe pin can be used to test the client’s abili-ty to feel sharp sensations.

PERCUSSIONThis icon represents a tapping hand to per-cuss specific body parts.

FEELUse this hand icon to feel or palpate areas ofthe client’s body.

MOTIONThe icon showing a moving hand is used toassess range of motion, muscle strength,extraocular motion, etc.

TUNING FORKThis tool can be used to test hearing, vibra-tory sensation, and cold sensation.

POSITION SENSEThis icon can be used to determine theclient’s proprioception.

SPECULUMThe speculum can be used to inspect thevagina, cervix, or the nose.

TAPE MEASUREUse this tool to determine the client’sabdominal girth and with children, theoccipitofrontal circumference.

SCALEThe scale can be used to determine theheight and weight of the client.

OTHER EXAMSUse these exams to test mental status, abilityto perform complex maneuvers, and tomake other client observations.

BODY VIEW ICONSThese icons will present views of the client’shead, chest, abdomen, or full body for exam-ination.

DXR NURSING

STUDENT ACTIVITY

RECORD UTILITY

INSTRUCTIONS

WITH

DXR NURSING

FREQUENTLY ASKED QUESTIONS

The Student Activity Record Utility for DxR Nursing is the instructor’s tool for

assessing how a student or a group of students performed in workingthrough a client case using the DxR Nursing program. While the DxR Nursing

program itself is online, your assessment of student performance will not beweb-based. The Student Activity Record Utility:

reports students’ overall performance and group performance;

reports student performance in the four main case evaluationsections (assessment, initial care plans, revised/new care plans, andcase questions) as well as in their subsections;

allows the instructor to review and manually match items in thestudent list with standards set for the case study;

allows the instructor to set and/or adjust the weight assigned toeach section/subsection of the DxR Nursing case;

allows the instructor to set numeric values for the subjective rat-ings used to assess performance in various subsections (physicalexam conducted, diagnosis prioritization, diagnosis etiologies, teach-ing/discharge plan, care plan rationales, updated/new rationales, andinterpretations);

allows the instructor to change whether a criteria item is requiredand to change the point values assigned to criteria items; and,

allows the instructor to adjust criteria based on the educationlevel of the students (setting lower numbers of required items andlower minimum satisfactory levels for beginning students, while rais-ing those standards for more advanced students).

In addition, instructors can print a screen detailing student scores and/orexport data from the assessment of student performance to another spread-sheet program for further evaluation.


What is the Student Activity Record Utility?

Tech support: 1-800-453-8040 29

Installation and Access

WINDOWS®Installing from the CD to hard drive:*

1. Locate the SARU "setup" file. Double-click it.

2. Confirm the location in which you want to installthe SARU. The pre-set location is on your “C” drivein the Program Files folder. You may select anotherlocation by clicking Browse and then choosing analternate location. If you set a location other thenthe Program Files folder, make note of where youinstall the program.

3. Confirm and/or edit the name of your shortcut fold-er. Click Next.

4. Click Finish to complete the installation of theSARU.

* Windows Users: Please make certain you have administrative access to

both the hard drive of your computer and to the Program Files folder orother location where you choose to install the SARU.

To access the SARU from your hard drive:1. Click the Start menu on the menu bar at the bot-

tom of your screen.

2. Select Programs or All Programs from the menu.

3. Select DxR SARU or your shortcut file.

4. Select the Student Activity Record Utility (SARU)icon.

5. When the SARU title screen appears, click Begin.

MACINTOSH®Installing from the CD to hard drive:

1. Locate the SARU icon. Double-click it.

2. Copy the "Record Utility" and all "Casefiles" fold-ers and their entire contents to your computerdesktop.

3. Open the Record Utility folder.

4.Clicking the SARU icon launches the utility.

To access the SARU from your hard drive:1. Locate the "Record Utility" and all "Casefiles" fold-

ers on your computer desktop.

2. Open the Record Utility folder. Click the SARUicon.

3. When the SARU screen appears, click Begin.

All of your adjustments to student records are saved in the “casefiles” folder afterimport. If you are using a local network and you want to allow others access to thestudent records for archiving or review after you have completed your grading ses-sion, you must copy your “casefiles” folder to the local network. When using thelocal network file server, we recommend you rename your casefiles folder to dis-tinguish your records from others on the server. For example, if your name is Smith,you could name your casefiles “Smith casefiles.” This prevents confusion when mul-tiple instructors place their casefiles on the local server. If you rename your casefilesfolder, you should look for the new folder name when reopening those casefiles.

NOTE

When you import records, you will open the folder that corresponds to the version of the program used to create these records (e.g.

Casefiles v1.7.3 if records were created with v1.7.3 of the software. See the case title screen below the patient picture for the version

number).

You may download the Casefiles for the version of the software that you’re using by going into the Directory Utility and clicking on

the link at the bottom of the page. You must enter the username and password provided on the Directory Utility page to download

the casefiles for this version of the software. You may then place the downloaded Casefiles folder into the SARU folder on your com-

puter. (Make sure you back up your old Casefiles folder before you update to preserve your previous grading.)

After your students have worked through a DxR Nursing case, you can down-load their records for review, grading, adjustment, and grade distribution tothe students. Follow the steps below to begin using the Student ActivityRecord Utility.

1. Access the location where your Student Activity Record Utility is installedon your computer’s hard drive. (See instructions on page 29.)

2. Open the Student Activity Record Utility by clicking the SARU icon.

3. When the Student Activity Record Utility title screen appears, click Begin.The Index screen will open. On this screen you can:

Import Records that you haven’t yet reviewed;

Open records that you’ve already imported for further review;

Export Records to a spreadsheet application for compiling reports (seepage 55 for instructions).

Proxy Server SettingsIf your DxR Nursing site is hosted on your school’s servers and if your siteauthentication (a user name and password) is required to access the server,you may be prompted to type in that information during the import process.If your computer is set to use a proxy server other than the one used toaccess your DxR Nursing site, click Custom Proxy Server and follow theinstructions in the box on the left side of this page. If your DxR Nursing site ison DxR Development’s servers (the site address will end with dxrnursing.com)please ignore these Proxy Server Settings instructions and proceed to theinstructions below.

To Import or Open Records

1. On the Index screen, click Import Records.

2. The Import Records dialog box will appear (see Figure 16 below). Youwill have several options, described below. Review your options.

Add Case Folder - allows you to select the location of the folder you wish toreview, and then adds the folder to the list

Delete Case Folder - allows you to delete a selected folder from the list.

Import - to import a group ofrecords that you haven’t yetimported and reviewed, or toimport individual records that youhaven’t yet imported for this casestudy.

Open - to access student recordsthat you have already importedand that you may have begunreviewing

Note: The first time you use the StudentActivity Record Utility, the Folder Namefield will be empty. Subsequently, if anycase names appear in the Folder Namefield, that means those folders havebeen previously added. A “Y” precedingthe folder name means records forthat case have already been imported.An “N” preceding the folder namemeans no records for that case havebeen imported yet into this copy of theStudent Activity Record Utility.


Getting Started - Importing Records

Figure 16. Index screen with the ImportRecords dialog box.

Custom Proxy Server

If your school is using a proxy server other

than the one that your computer is set to

access, you will be asked to provide the IP

address and the port for the proxy server

that you are using. If the custom proxy server

requires a user name and password to

access it, click Proxy Server Authentication to

type in that information. This proxy server

information will be saved and used each

time you start to import records into the

SARU unless you clear this information.

To clear out your custom proxy server set-

tings, click the Custom Proxy Server button

to reveal the dialog box. Highlight each field

and delete the entries for each. Click Enter.

This will return your import settings to those

specified in the set-up of your computer.

3. The first time you import records, the Folder Name field of the ImportRecords dialog box will not contain the name of the folder that youwant to import. You will need to click Add Case Folder. You will beprompted to select the folder’s location (inside the casefiles folderinstalled on your computer) to add it to the list. See instructions below.

Tech support: 1-800-453-8040 31

Importing Records on the Index Screen

4 When the case folder name appears in the Import Records window,select the folder for the case you want to review. Example: Choose“Wentzel DxR” if reviewing the Wentzel case using the standard DxRcare plans system (see Note).

5a. If the selected folder is preceded by a “Y”:

place your cursor over the folder name to see the location of thecasefiles folders used to evaluate the records

either click Open to access only the records that you previouslyimported

OR

click Import to re-import the records, or to add to the student recordsthat you previously import. A dialog box will appear, advising youthat a file exists (from the initial import) containing grading criteriafor the case.

Click Overwrite if you want to import the records without preservingany prior changes that you made to the records.

Click Add if you want to add records to those you already imported,without losing any of your previous changes. (See pg. 58 for details.)

5b. If an “N” precedes the folder name, click Import. The “N” means therecords for that case have not previously been imported into the SARU.

6. If you are importing student records, you will be asked to enter the serv-er address of the case and records you wish to import. If necessary, editthe address and directory name. Click Enter when the address informa-tion is correct (see Server Address Note).

Windows usersOpen the location where your

Student Activity Record Utility is installed(the pre-set location is the C drive in theProgram Files folder, unless you set a newlocation). Open the “casefiles” folder byclicking the (plus)"+" sign. A list of casefolders will appear. Click and highlight thecase folder you want to import (do notclick the "+" sign located beside the recordname, only highlight) and then, click OK.

Macintosh users

Navigate to your "casefiles" folder

located on your computer. Select the

casefiles folder and click open A list

of case folders will appear. Click and

highlight the case folder you want to

import and then click the

Select/Choose button.

Note: Casefiles and Records Folder

If there is more than one Casefiles folder, select

the folder that corresponds to the version of

the program used to create these records (e.g.

Casefiles v1.7.2 if records were created with

v1.7.2 of the software -- see the case title

screen below the patient picture for the version

#). The casefiles folder contains the evaluation

criteria for each case. The evaluation criteria

were set by the case author.

• If you used the NIC/NOC module for

client care plans, you will need to select

and add the records folder for the

NIC/NOC version of the case (e.g.,

Wentzel NIC/NOC).

• If you did not use the NIC/NOC mod-

ule, you should select and add the

records folder for the standard DxR mod-

ule (e.g., Wentzel DxR).

When importing studentrecords, you will be prompt-ed to enter the address ofthe server where studentrecords are created andstored.Server Address is theInternet address of yourDxR Nursing site. If youdon’t know the serveraddress, contact your sys-tem administrator.Directory Name is thedirectory under which stu-dents have been creatingrecords. This directory namemust match identically tothe name you enteredwhen you created thedirectory, with spaces con-verted to underscores.

SERVER ADDRESSNOTE

Figure 17. Server Address window

7. When the program makes contact with the server at the address that youentered, it will display a list of the Student Records Found at that loca-tion along with the status of the student’s work in the case study. Youcan choose between importing:

only complete records (see note)

all records, or

only records that you select (by clicking them).

A message will advise you that the import process may take severalminutes. A second message will advise you when the download is com-plete.

8. A message box will ask you how you’d like your records sorted. Selecteither Alphabetically or By ID number. The program will advise youwhen it begins and finishes evaluating and converting student records.Once the process is complete, the list of students for whom recordswere found will appear in the “Student List” field. Preview this list to veri-fy that all requested student records were imported. The client’s lastname appears in the Case Name field. The names of students who didn’tanswer the case questions will appear in the “Records Not Downloaded”field.

9. Select whether student names should or should not be displayed on the otherscreens in the SARU (an X in the box denotes names WILL be displayed).

To navigate from the Index screen, you can:

Click a name in the Student List field to go to the Student Record screen forthat student.

Click Record Statistics to review statistical data on how the students per-formed on criteria items in the case study.

Click Adjust Criteria to reveal a series of screens where you can edit criteriaand scoring standards by which student performance is assessed.

Student Record Screen

The Student Record screen provides the instructor with an overview of a stu-dent’s performance in a DxR Nursing case. We recommend that you reviewthis data carefully to identify sections of the case where you want to makecriteria adjustments and/or manual matches with student responses. There’s aStudent Record screen for each student, with the student ‘s information andcase name displayed at the top of each of these screens.

A blue “S” beside a case section or subsection denotes satisfactory perform-ance in that part of the case. A red “U” denotes unsatisfactory performance ina section or subsection. An “I” means that section score is incomplete becauseit contains at least one subsection that hasn’t been assessed (see notebelow). Two hyphens in the place of a section or subsection score denotesthat part of the case has been removed from scoring, either manually or bythe Management Utility settings at the time of download. Subsections thatneed to be subjectively graded by you will be marked as “Not Assessed” untilyou make an assessment.

A blue upward-pointing triangle in the Group Performance Summary rep-

resents the individual student’s score. A red downward-pointing triangle

represents the group average. The vertical hash mark represents the mini-

mum satisfactory level. The green band represents the range of student

scores.


Importing Records and Student Record Screen

We strongly recommendthat after importingrecords, you begin workingon the Adjust Criteriascreen to import a criteriafile, make changes to theoverall case criteria andscoring standards beforeyou begin assessing indi-vidual student perform-ance. If you plan to importa criteria file, you must dothis before deleting anydiagnoses.

CRITERIA EDITING

A record is designated as“complete” when the stu-dent exits the completedcase study. If CaseQuestions are activated,they will appear after thestudent exits the casestudy. Consequently,records may be designatedas “complete” before thestudent answers the casequestions.

“COMPLETE”RECORDS NOTE

You must enter an assessment

for all subsections that are

marked as “not assessed” to

avoid an unintended score of

zero for that subsection, or you

can set the subsection weight to

zero so it won’t be included in

the student’s score.

NOTE

Navigating from the Student Record Screen

Use the Index, Record Statistics, and Adjust Criteria buttons to navi-gate to those screens;

Use the arrow buttons to move through the list of student records orto Quit the program;

Click a section/subsection title to access details of the student’sentries in that subsection, to manually match student answers withinstructor criteria, or to enter a subjective assessment of student per-formance, where applicable.

To see more information about the student’s selections in workingthrough a case, click Additional Data. This information includesStudent Notes recorded throughout the case, Learning Issues thatthe student identified, the student’s entries for Resolved Diagnoses,and Time Info, including the total amount of time the student spentin the case, as well as times and dates the student accessed and exit-ed the program.

Click Nursing Notes to review those notes from the progress sectionof the case.

To create notes for the student, click Notes to Student.

Click Delete Record to delete the record from the SARU.

The Student Record screen displays essentially four types of informa-tion:

at the top left side of the screen, the individual student’s overall perform-ance rating and overall case score;

on the lower left side of your screen, the student’s scores and point totalsfor each case section and subsection;

in the columns in the center of your screen, the section weights and mini-mum satisfactory level for the case as a whole and for each sec-tion/subsection of the case; and

on the right side of your screen, a summary of group performance for thecase and in the individual sections, compared to the individual student’sperformance. Consult Figure18 to locate where each type of informationis displayed on your screen.

Tech support: 1-800-453-8040 33

Student Record Screen

2 3

1

4

1

2

3

4

To arrive at the overallstudent score, multiply

the student score for eachsection by that section’sweight, total the results,and then divide the total bythe total for all sectionweights.

To arrive at the studentscore for a section,

multiply the student’s scorefor each subsection by thatsubsection’s weight, thentotal the results and divideby the total subsectionweights in that section. Forsubjectively scoredsubsections that have acorresponding percentagescore, the student score isthe average of all thepercentage scores withinthat subsection.

Section weights arerelative and need not

total 100. The minimumsatisfactory level is apercentage in subsectionsthat have a subjectiverating. The MSL is expressedas a number in subsectionsthat aren’t assessedsubjectively.

Group averages arebased on the section,

subsection, and overall casescores of all students in thegroup of records beingevaluated.

SCORING NOTES

1

2

3

4

Figure 18. The Student Record Screen

Time-saving Tip

Settings: If certain sections, functions, diagnoses, or progress levels in theDxR Nursing case study are turned OFF at the time that you import records,those parts of the case won’t be included in the student score. They areremoved from scoring automatically.

If you plan to import grading criteria that you exported from a previous grad-ing session, do so BEFORE you make other adjustments to the grading crite-ria. Learn more about this function on pg. 55 (Exporting and ImportingCriteria).

Matching DxR Nursing Student Activity Record Utility arrives at an assessment of stu-

dent performance by comparing a student’s answers/responses with the cri-teria entered by the case author. However, you as the instructor, may chooseto account for alternative wording, misspellings, or equivalent responses thatweren’t included when criteria for the case were set. As you review studentresponses in the case subsections, you may manually “match” items in thestudent’s list with items in the instructor list.

To match items that the program didn’t match for you, follow these steps.

1. Click an item you want to match in the Student Items that Did NotMatch Criteria field. That item will appear highlighted.

2. In the Unmatched Criteria list, find and click the criteria item that youwant to match the student item to. It, too, will appear momentarily high-lighted, and then both items will appear in bold type. The number in theStudent’s score for that subcategory will automatically be adjustedupward by the point value of that item.

3. Click Apply Manual Matches to All to activate this matching decisionfor all student records in the group.

To remove a match between items in the instructor list and the student’s list, fol-low these steps.

1. Click the item in the field labeled Student Items that MatchedCriteria. A dialog box will appear, displaying the criteria item to which itis matched, followed by all equivalents to the criteria item.

2. Click the Unmatch button on the dialog box to remove the matchbetween the student item and the criteria item.

3. Click Apply Manual Matches to All to activate this unmatching deci-sion for all student records in the group.

Note: Your decisions to match or remove matches can be applied to allstudent records. They may also directly affect the student’s categoryand overall scores and ratings (satisfactory/unsatisfactory). Subsectionswhere matching is not possible include Physical Exam Items,Interpretations, Teaching/Discharge Plan, Management ActivitiesSelected, Diagnosis Prioritization, Dx Etiologies, and Care PlanRationales.

Satisfactory/Unsatisfactory/Incomplete

A Satisfactory rating means the student met the Minimum Satisfactory Levelsand selected all required items.

Unsatisfactory means the student failed to meet either the MSL, failed toselect all required items, or both.

Incomplete means the section contains at least one subsection that hasn’tyet been assessed.


Time-Saving Tips and Matching

EQUIVALENTS

One method of accounting foralternative wording in studentresponses is to add the alternativewording found in student recordsas equivalents to the original crite-ria item.You can do this by clicking AdjustCriteria. For more information onadding equivalents, see page 52.

Even before you start grad-ing student records in theSARU, you can begin tomake decisions that willmake the process easier. Werecommend that you printout the evaluation criteriafor your selected case fromthe DxR Nursing EvalCriteria.pdf file located onthe SARU CD-ROM. Readthrough the evaluation cri-teria either while or afteryou have worked throughthe case yourself. Makenote of any items or sub-sections that you want toremove from scoring. Asyou begin working in theSARU, refer to your notes asyou adjust the criteria.

E VALUATIONCRITERIA

Assessment SectionYou can navigate to the Assessment section by clicking any of the links to theSelected Items , Category Placement , or Physical Exam Items subsections.The Selected Items/Category Placement subsections allow you to assess twoseparate mental tasks. In Selected Items, you will assess the student’s abilityto pick the items that are pertinent to the client case. In Category Placement,you will assess the student’s performance in associating that pertinent datawith the appropriate framework categories.. You may also manually matchitems in the student’s list with items in the instructor’s list, or remove match-es. In the Physical Exam Items window, only student-listeditems will appear for you to review and rate subjectively.

Selected Items

In the Selected Items subsection, you will be able to seeall items the instructor associated with the framework cat-egories compared to all the items the student selected forthe entire case.

Click Selected Items on the Student Record screen. The items in each list thathaven’t been matched are displayed in the Unmatched Criteria field. Studentselections that weren’t automatically matched to the case criteria are listed inthe field labeled Student Items that Did Not Match Criteria. Items that thestudent selected which are matched to criteria items will be displayed in theStudent Items that Matched Criteria field. You may add matches by clickingon items in the Student Items that Did Not Match field and the UnmatchedCriteria field. You can remove matches by clicking on an item in the StudentItems that Matched Criteria field and then clicking Unmatch in the dialog box(see pg. 34). The point value precedes each item in the Unmatched Criteriafield and the Student Items that Matched list. Items designated as “Required”are marked with an asterisk.

Tech support: 1-800-453-8040 35

Assessment Section

Assessment score =(Selected Items Score x Subsection weight)(Category Placement Score x Subsection weight)(Physical Exams Score x Subsection weight)

+ (Interpretations Score x Subsection weight)Total/sum of all subsection weights within the section

Figure 19. The Selected Items screen in theAssessment section of the SARU.

You may add a new criteriaitem ONLY to the SelectedItems subsection or to theCategory Placement sub-section. You can do this byclicking Adjust Criteria. Onthe Set Criteria screen, theAdd Criteria button willappear after you click onthe Selected Items subsec-tion or one of the cate-gories in CategoryPlacement. See pg. 52 forfurther details.

ADD CRITERIA

Category Placement

In the Category Placement subsection, you will be able to see and assess stu-dent performance in associating the items they selected with the properframework categories. You will be able to compare the items the studentassociated with each of the framework categories to the list supplied by thecase author.

To display items linked to each framework category, click Category Placementon the Student Record screen, or click the Assessment tab, followed by theCategory Placement tab. On the Category Placement screen:

1) Click the pull-down menu in the upper left of your screen.

2) Select the framework category for which you want to see studentselections and case author criteria.

3) Student items that matched criteria will appear in the upper leftfield. Student items that did NOT match will appear in the lower leftfield. Unmatched criteria will appear in the lower right field.

The point value for each criteria item is displayed with the item. Items in thecriteria list designated as “required” are marked with an asterisk. You can clickan item in the Student Items that Matched Criteria field to see the criteriaitem to which it was matched, along with all equivalents.

Other information available on the Selected Items/Category Placementscreen includes:

an S or a U in front of each Framework Category in the pull-downmenu, designating whether student performance in that subsec-tion/framework category is assessed as satisfactory or unsatisfactory;

the number of items the student entered, the student score, and thetotal possible score (displayed in the table in the upper right of thescreen), along with the student score and the minimum satisfactorylevel.

Physical Exam Items

This subsection displays a list of all exam procedures the student chose, list-ed in the order they were selected/performed. You will select one subjectiverating for the student’s Physical Exam selections.

Navigate to this subcategory by clicking Physical Exam Items on the StudentRecord screen or by clicking the Assessment tab, followed by the PhysicalExam tab. A screen will appear displaying each of the physical exam proce-dures the student chose in the order he/she selected them. Review this listcarefully and select the subjective rating that best describes the student’sphysical examination selections: Optimal, Acceptable, Marginal, Deficient, orUnacceptable. The percentage value assigned to the subjective rating thatyou selected will be applied to this student’s record and score.

Note: You can change the percentage values assigned to each subjective rating within the

case study. To change the values for the subjective rating, click Adjust Criteria, then click

Set Values. Follow the on-screen instructions for changing the values for the subjective rat-

ings.


Assessment Section

The score in this subsection is

based on the total points the

student earned in all

framework categories within

this subsection, divided by the

total points possible, expressed

as a percentage.

C ATEGORY PL ACEMENT

SCORING

Matching Note

If you manually match an item in the

Category Placement subsection, the

match WON’T automatically carry over to

the same item in the Selected Items sub-

section. To apply the match in both sub-

sections you must manually match the

item in both locations.

Interpretations

In the Interpretations subsection, you will review and assess your students’interpretations for three types of information from the physical examinationof the client: heart sounds, lung sounds, and skin assessment. You will enterone rating for all of the interpretations your students entered. Your subjectiverating for these interpretations will also carry a numeric value.

To enter your subjective rating for Assessment Interpretations, follow thesteps listed below.

1) Click Interpretations on the Student Record screen or click theAssessment tab followed by the Interpretations tab.

2) On the Assessment Interpretations screen, you will be able to see andevaluate each of the items that the student interpreted (e.g. heartsounds). Each will be listed by the exam tool and body part used toassess the client. Review the student’s interpretation for each exam.

3) Click See Consultant Text to review the consultant’s text for all examsthat have consultant text associated with them. (Click See ConsultantText again to hide the professional consultant’s interpretations.)

4) After you have reviewed both the student’s interpretation and the con-sultant’s text for each of the items the student interpreted, select a sub-jective rating (Optimal, Acceptable, Marginal, Deficient, or Unacceptable)that best describes the student’s interpretations. The numeric scoreassigned to the chosen rating will be applied to this student’s record.

5) You will need to review and assess the interpretations entered by eachstudent in the group.

Note: You can change the numeric value assigned to each subjective rating in theAdjust Criteria portion of the program. To alter the numeric values assigned toeach rating, click Adjust Criteria, then click Set Values. Follow the on-screeninstructions for changing the values for the subjective ratings.

Tech support: 1-800-453-8040 37

Assessment Section

Figure 20. The Interpretations screen in the Assessment section ofthe SARU. On this screen, you select a subjective rating for the stu-dent’s entries. The subjective rating has a numeric value attached.

Initial Care Plans

In the Initial Care Plans section, you can assess all aspects of the student’s per-formance in developing the initial care plan for the client. The assessment ofstudent selections is categorized into seven subsections: Selected Diagnoses,Diagnosis Prioritization, Confirming Items, Diagnosis Etiologies, ManagementActivities, Care Plan Rationales, and Outcome Items Selected. The Initial CarePlans screen displays all this data, except for Outcome Items Selected, whichhas its own screen.

The figure below displays the Initial Care Plans screen and the types ofassessment that can be made on this screen.

You can also click the Student Diagnoses or Confirming Items buttons toreveal screens where you can manually match items in those subsections.


Initial Care Plans Section

Key

The Student Diagnoses field

The Diagnosis Prioritization rating menu

The Confirming Items field

The Dx Etiology field andscoring menu

The Management Items field

The Rationales field and scor-ing menu

Scoring Table

1

2

3

4

5

6

7

Initial Care Plans score =(Selected Dx’s Score x Subsection weight)(Dx Prioritization Score x Subsection weight)(Confirming Items Score x Subsection weight)(Dx Etiologies Score x Subsection weight)(Management Activities Score x Subsection weight)(Care Plan Rationales Score x Subsection weight)

(Outcome Items Selected Score x Subsection Weight)Total/sum of all subsection weights within the section

Figure 21. The Initial Care Plans screen

1

2

3

4

5

6

7

Tech support: 1-800-453-8040 39

Running Head

Selected Diagnoses

In the Selected Diagnoses subsection, you will be able to see a list of all thediagnoses selected by the student and compare it to the criteria set for thecase. Diagnoses that haven’t been matched are shown in regular type.Diagnoses that have been matched are shown in bold type. If a matcheddiagnosis is preceded by an “E” the diagnosis is matched as an equivalent tothe diagnosis for which the students created care plans.

To see the Selected Diagnoses information, follow the steps listed below.

1) Click the Selected Dx’s on the Student Record screen or click the InitialCare Plans tab.

2) Review the student’s diagnosis list and any approved diagnoses thatweren’t selected by the student.

3) If you want to match an unmatched author-approved diagnosis with oneof those listed by the student, click Student Diagnoses. This action dis-plays a “matching” screen where you can match diagnoses by clickingon an item in the Unmatched Criteria list and then clicking on an item inthe field labeled Student Items That Did Not Match. After you’vematched a diagnosis, click Apply Manual Matches to All to activate thismatch for all student records that you’ve imported for this case.

Other information available in the scoring table for the Selected Diagnosessubsection includes;

the number of items the student entered, the student score, and thetotal possible score;

the student score and the minimum satisfactory level.

Prioritization

Each diagnosis in the Student Diagnoses list is displayed on the Initial CarePlans screen in the priority order the student selected in completing the DxR

Nursing case. After you have added or removed any matches, you are readyto assess the student’s priority order. Click the menu labeled Set Priority Scoreand select one of the five subjective ratings (Optimal, Acceptable, Marginal,Deficient, and Unacceptable) that best describes the student’s performancein prioritizing the diagnoses. The value assigned to the subjective rating thatyou selected will be applied to this student’s record.

You will need to repeat this process for each student record in the group.

Note: You can change the values assigned to each subjective rating within thecase study. To change the values for the subjective ratings, click Adjust Criteria,then click Set Values. Follow the on-screen instructions for changing the valuesfor the subjective ratings.

Confirming Items

The Confirming Items field on the Initial Care Plans screen displays the stu-dent choices that would confirm the selected diagnosis.

Items that didn’t match the case criteria are displayed first. Items in each listthat have been matched are displayed after the unmatched items under theStudent Matches heading. The point value for each criteria item is alsoshown. Items designated as “required” are marked with an asterisk.

To see the Confirming Items, follow the steps listed on the next page


EQUIVALENTS

One method of accounting foralternative wording in studentresponses is to add the alternativewording found in student recordsas equivalents to the original crite-ria item.You can do this by clicking AdjustCriteria. For more information onadding equivalents, see page 52.

1

2

3

If a diagnosis is matched(bolded) and preceded byan “E”, the diagnosis wasmanually matched by youduring grading. You canscroll down to the heading“Approved Dx’s Matched toan Equivalent” to see theapproved diagnosis thatthe student diagnosis ismatched to.

NOTE


Running Head

1) Click Confirming Items on the Student Record screen or click the InitialCare Plans tab.

2) Click a criteria diagnosis in the Student Diagnoses field to display all dataassociated with that diagnosis, including the Confirming Items.

3) Review the list of student matches, unmatched criteria, and studentitems that didn’t match the criteria.

4) Click the Confirming Items button to reveal a screen where you can addmatches or remove matches between the items selected by the studentand the case author’s criteria (see Matching instructions on pg. 34).

Optional: After you have added/removed matches in the Confirming Itemslists, you may wish to select a rating for each diagnosis etiology byselecting a rating in the Set Etiology Score menu (see instructions forDiagnosis Etiologies).

5) Repeat the steps listed above for each of the diagnoses in the StudentDiagnoses list.

Other information related to Confirming Items is available in the scoring tableon the Initial Care Plans screen, including;

the number of items the student entered, the student score, and thetotal possible score ;


Diagnosis Etiologies

The Diagnosis Etiologies subsection (on the Initial Care Plans screen) is whereyou assign a subjective rating to the student’s pathophysiologic explanationfor selecting a particular diagnosis. You will select a rating for each etiologythat’s associated with a criteria diagnosis.

1) Click one of the author-approved diagnoses in the Student Diagnoseslist. If the student entered an etiology for that diagnosis, it will appear inthe field in the lower left of your screen.

2) Review the text entered by the student.

4) Select a subjective rating (Optimal, Acceptable, Marginal, Deficient, orUnacceptable) for the student’s explanation. The value assigned to thatrating will be applied to the student’s record and score.

5) Repeat this process for each author-approved diagnosis in theStudent Diagnoses field.

You will not rate/score the etiology for any diagnosis that isn’tmatched to the case author’s criteria.



If a diagnosis is matched(bolded) and preceded byan “E”, the diagnosis eithermatches one of the caseauthor’s designated equiva-lents, or was manuallymatched by you duringgrading. Scroll down to theheading “Approved Dx’sMatched to an Equivalent”to see the approved diag-nosis that the student diag-nosis is matched to. Click onthis approved diagnosis tosee the other criteria(Confirming Items, etc.)associated with it.

NOTE

4

Matched Dx Etiology

If you want to rate the etiology

for a diagnoses that you manually

matched to an approved diagnosis,

click the criteria diagnosis under

the heading “Approved Dx’s

matched to an Equivalent”. This will

display all criteria items associated

with that diagnosis and its manu-

ally-matched equivalent.

Tech support: 1-800-453-8040 41

Running Head

Management Activities Selected

In the Management Activities subsection, you will be able to view the stu-dent’s chosen management activities for each of the diagnoses entered ascompared to the management criteria for the case study.

Unmatched criteria items are displayed first. Criteria items that the studentincluded in his/her care plan are displayed under the Student Matches head-ing. The point value for each criteria item is also displayed. Items in theinstructor list designated as “required” are marked with an asterisk.

To review Management Activities, follow the steps listed below.

1) Click Management Activities Selected on the Student Record screen orclick the Initial Care Plans tab.

2) Click an author-approved (criteria) diagnosis in the Student Diagnosesfield to see the management activities associated with that diagnosis.

3) Review the student matches, unmatched criteria, and student selectionsthat didn’t match.

Optional: As you are reviewing the Management items, you may wish toselect a rating for each rationale by choosing a rating in the SetRationale Score menu (see instructions for Care Plan Rationales).

5) Repeat this process for each author-approved diagnosis in the StudentDiagnoses field.

Other information available on the Management Activities/Rationales portionof the screen includes:

the number of items the student entered, the student score, and thetotal possible score; and


Care Plan Rationales

In the Care Plan Rationales subsection, you will review the student’s explana-tion for choosing the management activities for each author-approved diag-nosis. You will then enter a subjective rating for each rationale.

1) Click Care Plan Rationales on the Student Record screen or click theInitial Care Plans tab.

2) Click a criteria (author-approved) diagnosis in the Student Diagnosesfield to see the Care Plan Rational associated with that diagnosis. Thetext will appear in the field in the lower right of your screen. Review thetext entered by the student.

3) Select a subjective rating (Optimal, Acceptable, Marginal, Deficient, orUnacceptable) for the student’s rationale. The value assigned to that rat-ing will be applied to this student’s record and score.

4) Repeat this process for each author-approved diagnosis in the StudentDiagnoses field. You will not rate/score a rationale for incorrect diag-noses, since the student is prompted to create care plans and enterrationales ONLY for approved diagnoses.



5

6

There is no “matching” screen

for Management Items.

Management items are scored

based on the case author’s

criteria, so any changes you

make to scoring in this

subsection must be done by

adding equivalents or

adjusting point values and

requirements. To do this, click

Adjust Criteria and follow the

Set Criteria instructions on pp.

51-53.

NOTE


Running Head

Outcome Items Selected

On the Outcomes Items Selected screen, you will be able to see and reviewclient progress data that the student linked to a previously identified clientproblem. You will be able to compare the student’s list of outcome items foreach diagnosis with the instructor’s list for that same diagnosis.

Student Items That Matched Criteria are displayed in the upper left field, andUnmatched criteria for the case are displayed in the lower right field and thestudent selections that didn’t match criteria are displayed in the lower leftfield. The Item point value is displayed in front of each item in the UnmatchedCriteria and Student Items That Matched field. Items designated as “required”are marked with an asterisk. Note: In this subsection, you may need to do more matching between the stu-dent’s list and the case criteria, since some items are typed in by the student andare more likely to include misspellings, etc.

To see the Outcome Items Selected follow the steps listed below.

1) Click Outcome Items Selected on the Student Activity Record screen, orclick the Initial Care Plans tab and then click the Outcome ItemsSelected tab.

2) Click the pull-down menu labeled Select Category. This menu lists alldiagnoses and outcomes that have progress data associated with them.Each diagnosis may have multiple outcomes associated with it, andeach outcome may include several pieces of data that are indicators ofclient progress (or lack thereof ) toward that outcome. In the menu, thenumbers preceding each diagnosis/outcome denote the number ofindicators that the student matched (Example: 2 of 3 means the studentmatched 2 of the 3 indicators that are listed as criteria for this case.

3) Select one of the Diagnoses that has outcomes associated with it. Anycriteria that the student didn’t match will appear in the UnmatchedCriteria field. Matched items that appear in the Student Items ThatMatched Criteria field , and the remaining student selections will appearin the Student Items That Did Not Match field.

4) Add or remove matches between items in the lists (see pg. 34 for instruc-tions).

5) Repeat this process for each Diagnosis/Outcome listed in the pull-downmenu.

Other information available on the Outcomes screen includes:

an S or a U in front of each diagnosis in the pull-down menu, desig-nating whether student performance in that diagnosis/outcome cat-egory is assessed as satisfactory or unsatisfactory;

the number of items the student entered, the student score, and thetotal possible score (displayed in the scoring table); and

the student score and the minimum satisfactory level (displayed inthe scoring table).


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Revised/New Care PlansIn the Revised/New Care Plans section, the student’s ability to revise the diag-nosis list, management selections, etiologies, and rationales will be assessedin these subsections: Diagnoses Added, Diagnosis Etiologies, ManagementActivities Selected, Care Plan Rationales, Outcome Items Selected, andTeaching/Discharge Plan. The score for the Revised/New Care Plans section isarrived at by averaging the weighted scores for the subsections.

On the screens in the Revised/New Care Plans section, Progress Level buttonsallow you to review the student’s entries by progress level. Scores from thevarious progress levels in the case are combined to produce the Revised/NewCare Plans score.

The Revised/New Care Plans screen is similar, but not identical, to the InitialCare Plans screen. Review the figure below displaying the key parts of theRevised/New Care Plans screen.

Note: The Revised/New Care Plans screen includes a field for Previous Diagnoseswith New Management. Click on a diagnosis in this field to display the manage-ment items, rationales, and etiology associated with it.

Revised/New Care Plans Section

Revised/New Care Plans score =(Dx’s Added Score x Subsection weight)(Dx Etiologies Score x Subsection weight)(Management Activities Score x Subsection weight)(Care Plan Rationales Score x Subsection weight) (Outcome Items Selected Score x Subsection Weight)

+ (Teaching/Discharge Plan Score x Subsection Weight)Total/sum of all subsection weights within the section

1

2

3

4

5

6

7

Key

The Student Diagnoses/Diagnoses Added field

The Progress Level buttons

The Previous Diagnoses withNew Management field

The Dx Etiology field andscoring menu

The Management Items field

The Rationales field andscoring menu

Scoring Table

1

2

3

4

5

6

7


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Diagnoses Added

In the Diagnoses Added subsection (displayed in the Student Diagnoses fieldon the Revised/New Care Plans screen), you will be able to see and evaluatethe student’s list of diagnoses that came to light after reviewing the patient’sprogress and evaluation report. This list may include problems that havedeveloped since the original diagnoses, or they may reflect changes in a pre-vious diagnosis (Previous Dx’s with New Management). The student’sDiagnoses Added list will be compared with the list approved by the caseauthor.

Items that DIDN’T match the criteria are shown in regular type. Items thathave been matched are shown in bold type. Items in the case author’s crite-ria designated as “required” are marked with an asterisk.

To see the student’s Diagnoses Added, follow the steps below.

1) Click Diagnoses Added on the Student Record screen or click theRevised/New Care Plans tab.

2) In the Student Diagnoses field, review the student’s diagnosis list as com-pared with any approved diagnoses that weren’t selected by the student.

3) If you want to match an unmatched author-approved diagnosis with oneof those listed by the student, click the Student Diagnoses button. Thisaction displays a “matching” screen, where you can manually matchdiagnoses by clicking on an item in the Unmatched Criteria list and thenclicking on an item in the field labeled Student Items That Did NotMatch Criteria. Click Apply Manual Matches to All to activate the match-es you’ve just made for all applicable records imported for this case.

4.) Repeat these steps for each correct diagnosis in each progress levelby using the ‘progress level’ buttons.

Other information on the Diagnoses Added screen includes:

the total number of items the student entered, the student score, andthe total possible score for all progress levels combined; and


Diagnosis Etiologies

The Diagnoses Etiologies subsection (on the Revised/New Care Plans screen),is where you can assign a subjective rating to the student’s pathophysiologicexplanation for a new diagnosis. You will select a rating for each etiologythat is associated with a correct diagnosis.

1) Click one of the author-approved diagnoses in the Student Diagnoseslist. If the student entered an etiology for that diagnosis, it will appear inthe field in the lower left of your screen.

2) Review the text entered by the student.

3) Select a subjective rating (Optimal, Acceptable, Marginal, Deficient, orUnacceptable) for the student’s explanation. The value assigned to thatrating will be applied to the student’s record and score.

4) Repeat this process for each author-approved diagnosis in the StudentDiagnosis field in each of the progress levels. You will not score the etiol-ogy for any diagnosis that didn’t match the criteria for this case.

Note: You can change the values assigned to each subjective rating within the case study.To change the values for the subjective ratings, click Adjust Criteria, then click Set Values.Follow the on-screen instructions for changing the values for the subjective ratings.


Follow the directions on pg. 34for matching items.

Matching

1

2

4

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Management Activities Selected

In the Management Activities Selected subsection, you will be able to viewthe student’s management plan for each of the new diagnoses, along withany revisions in the management plans for previous diagnoses. The StudentList for Management Activities will be compared to the Instructor List foreach Progress and Evaluation level.

Unmatched criteria items are displayed first in the Management Activitiesfield. Criteria items that the student included in his/her care plan are dis-played under the Student Matches heading. The point value for each criteriaitem is also displayed. Items designated as “required” are marked with anasterisk.

To review Management Activities, follow the steps listed below.

1) Click Management Activities Selected under the Revised/New Care Plansheading on the Student Record screen or click the Revised/New CarePlans tab.

2) Click an author-approved diagnosis in the Student Diagnoses field or inthe Previous Diagnoses with New Management field to see the man-agement activities associated with that diagnosis.

3) Review the student matches, unmatched criteria, and other studentselections that didn’t match.

Optional - As you review the Management items, you may wish to select arating for each rationale by clicking a rating at the bottom of yourscreen (see instructions for Care Plan Rationales).

Other information related to the Management Activities is displayed in thescoring table, including:



Care Plan Rationales

In the Care Plan Rationales subsection, you will review the student’s explana-tion for choosing the management activities selected for each correct diag-nosis. You will then select a subjective rating for each rationale.

1) Click Care Plan Rationales below the Revised/New Care Plans heading onthe Student Record screen, or click the Revised/New Care Plans tab.

2) Click an author-approved diagnosis in the Student Diagnoses field or inthe field labeled Previous Diagnoses w/New Management to see theCare Plan Rationales associated with that diagnosis. It will appear in thefield in the lower right of your screen. Review the text entered by thestudent.

3) Select a subjective rating (Optimal, Acceptable, Marginal, Deficient, orUnacceptable) for the student’s rationale. The value assigned to thatrating will be applied to the student’s record and score.

4) Repeat this process for each author-approved diagnosis in the StudentDiagnoses field and the Previous Diagnoses field. You should also repeat thisprocess for all progress levels in the case and for each student record.

Note: The Revised/New Care Plans screen includes a field for Previous Diagnoseswith New Management. Click on a diagnosis in this field to display the manage-ment items, rationales, and etiology associated with it.

Revised/New Care Plans

5

6

Point Values for Management

Some Management items forPrevious Diagnoses have pointvalues of zero. This is becausethey are Management Items thatwere criteria for the Initial CarePlanning session. To avoid scoringthese items twice, their defaultpoint value is set at zero. If youwant to change this setting, clickAdjust Criteria. Follow the SetCriteria instructions for changingthe point values of these items.


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Outcome Items Selected

On the Outcomes Items Selected screen in the Revised/New Care Plans sec-tion, you will be able to review client progress data that the student linked toa previously identified client diagnosis. You will be able to compare the stu-dent’s list of outcome items for each diagnosis with the case author’s criteriafor that same diagnosis.

Student Items That Matched Criteria are displayed in the upper left field andUnmatched criteria for the case are displayed in the lower right field and thestudent selections that didn’t match criteria are displayed in the lower leftfield. The Item point value is displayed in front of each item in the UnmatchedCriteria and Student Items That Matched fields. Items designated as“required” are marked with an asterisk. Note: In this subsection, you may need to do more matching between the stu-dent’s list and the case criteria, since some items are typed in by the student andare more likely to include misspellings, etc.

To see the Outcome Items Selected follow the steps listed below.

1) Click Outcome Items Selected on the Student Activity Record screen, orclick the Revised/New Care Plans tab and then click the Outcome ItemsSelected tab.

2) Click the pull-down menu labeled Select Category. This menu lists alldiagnoses and outcomes that have progress data associated with them.Each diagnosis may have multiple outcomes associated with it, andeach outcome may include several pieces of data that are indicators ofclient progress (or lack thereof ) toward that outcome. In the menu, thenumbers preceding each diagnosis/outcome denote the number ofindicators that the student matched (Example: 2 of 3 means the studentmatched 2 of the 3 indicators that are listed as criteria for this case.

3) Select one of the Diagnoses that has outcomes associated with it. Anycriteria that the student didn’t match will appear in the UnmatchedCriteria field. Matched items that appear in the Student Items ThatMatched field , and the remaining student selections will appear in theStudent Items That Did Not Match Criteria field.

4) Add or remove matches between items in the lists (see pg. 34 for instruc-tions).

5) Repeat this process for each Diagnosis/Outcome listed in the pull-downmenu and for each Progress Level in the case EXCEPT the last progresslevel. (There will be no outcome items for the final progress level in eachcase study.)

Other information available on the Outcomes screen includes:

an S or a U in front of each diagnosis/outcome in the pull-down menu,designating whether student performance in that diagnosis/outcomecategory is assessed as satisfactory or unsatisfactory;



Revised/New Care Plans

There will be no Outcome Itemsin the final progress level ofeach DxR Nursing case study.

No Outcome Items

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Teaching/Discharge Plan

The Teaching/Discharge plan subsection has two parts where you will be ableto review and evaluate

the student’s explanation of the teaching issues he/she believesshould be addressed to the client in the DxR Nursing case, and

the student’s plan for nursing care as the client is discharged.

You can determine the weight to be assigned to each part of the plan. Theprogram’s default settings assign 50% of the subsection weight to theTeaching Plan and 50% to the Discharge Plan. (To change the weights for theTeaching and Discharge Plan Summary, click Adjust Criteria and then click SetWeights.)

1) Click Teaching/Discharge Plan on the Student Record screen, or click theRevised/New Care Plans tab and then click the Teaching/Discharge Plantab.

2) Carefully review the student’s Teaching Plan and/or DischargePlan/Summary, if the student entered them. (If the student didn’t enter ateaching/discharge plan summary, the words “Enter Teaching Plan here”and “Enter Discharge Summary here” may appear in the correspondingfield.)

3) Select a subjective rating for the student’s Teaching Plan and/orDischarge Plan/Summary. If you want to adjust the numeric valueassigned to the subjective ratings, click Adjust Criteria and then click SetValues. Follow the on-screen instructions for changing the values forthe subjective ratings.


Figure 24. The Teaching/Discharge Plan Summary screen of the Revised/New Care Plans section.


Running Head

Case QuestionsIn the Case Questions section of a DxR Nursing case, you can override theprogram’s scoring for case-related questions by marking student responses asCorrect or Incorrect.

Questions

In the Questions section, you will review and assess your students’ responsesto questions designed to gauge their content knowledge related to the case.On this screen you will be able to review the following information:

the text of the question;

the possible answers;

the student’s response;

the correct answer and the rationale for the correct answer;

the weight (point value) of the question and whether it’s designat-ed as “required;”

the number of questions in the case; and,

the student score and the minimum satisfactory level for the CaseQuestions section.

Importantly, you will also be able to change the scoring of a question byclicking the Correct/Incorrect button in one student’s record. For example, ifthe correct answer is A but you feel that answer B is also acceptable, youwould navigate to a student who selected answer B and click Make Correct.This allowance would also apply to any other student who selected answer B.

To evaluate the Questions section, follow the steps listed below.

1) Click Case Questions on the Student Record screen or click the CaseQuestions tab.

2) The Questions List field displays the first few words of all questions in thecase study. If the Question is displayed in blue text, the student answerfor that question is scored as correct. If the question is displayed in redtext, the student’s response is scored as incorrect.

3) Click a question in the Question List field to display its full text, all answerchoices, the rationale for the correct answer, and the student’s answer.

4) Review the student response in the field labeled Student Answer. If youwant to change the scoring for this question, click the MakeCorrect/Incorrect button immediately above the Student Answer field.If the item is “Required” for satisfactory performance, a check-mark willappear in the “Required” box above the selected question field. You canchange this designation on the Set Criteria screen. If you want tochange the weight assigned to a question or questions in the list, clickAdjust Criteria and then click Set Criteria.

5) Repeat steps three through five for each question in the case.

Case Questions Section

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Running Head

Record StatisticsOn the Record Statistics screen, you can see the case author’s criteria for eachof the subsections that are scored using objective evaluation criteria(Category Placement, Selected Items, Selected Diagnoses, Confirming Items,Initial Management Activities Selected,Outcome Items Selected, DiagnosesAdded, Revised ManagementActivities Selected, and Questions).You can also see the number of stu-dents who selected each item, as wellas the number and percentage of stu-dents who achieved a satisfactoryscore for that task (subsection or cate-gory).

This information may be useful indetermining the portions of the casewhere most students excelled and theareas where the group needs morework or instruction. The RecordStatistics information may also helpyou identify areas in the case study inwhich you want to adjust the criteria.For example, if you are generallypleased with the students’ lists of confirming items, but the record statisticsscreen reveals that a significant number of them received an unsatisfactoryrating when their work was compared to the case author’s standards, youmay determine that you would like to adjust the criteria for that subsectionto remove items that may be beyond the educational level of your students.

To begin your review of the Record Statistics for a DxR Nursing, follow thesteps listed below.

1) Click Record Statistics.

2) On the Record Statistics screen, take note of the subsections that are dis-played in black type (as opposed to being grayed out). Subsections dis-played in black (and the Case Questions section) are scored based onobjective criteria set by the case author.

3a) If the subsection title is followed by an arrow, click the arrow to revealthe categories within that subsection. Highlight and click one of thecategories to display the items in that category in the window on theright side of your screen, preceded by the number of students whoselected the item.

3b) If there is no arrow, click the subsection title to display the items in thatsubsection, preceded by the number of students who selected the item.

Note: In cases with more than one Progress Level, subsection listings forthe Revised/New Care Plan section will include a progress level designa-tion (P1, P2, P3).

4) When the criteria are displayed in the large field at the center of thescreen, click an item to see lists of students who did and did not includethe selected item.

Record Statistics

You can also print informa-tion displayed on theRecord Statistics screen.When you click PrintStatistics, you can choose toprint only the statistics thatare currently displayed(Displayed Items) or allinformation from RecordStatistics (All Items).

PRINTING STATS

Figure 25. The Record Statistics screen of theSARU.


Running Head

Adjust CriteriaIn the Adjust Criteria portion of the program, you will be able to alter almostany part of the criteria used to evaluate student performance in a DxRNursing case. So, if after reviewing student records you determine that someof the evaluation criteria must be altered, this part of the program providesthe flexibility to do that. You will be able to do any or all of the following taskson one of the three screens in this part of the program (Set Criteria, SetValues, Set MSL/Weights):

adjust the point values assigned to individual items within anycategory or subsection (Set Criteria screen);

change whether or not an item is “required” (Set Criteria screen);

change whether satisfactory performance in a section or subsec-tion is required for the student to achieve overall satisfactory per-formance (Set MSL/Weights screen);

change the minimum satisfactory level (MSL) for a subsection orsection (Set MSL/Weights screen);

add equivalents (answers that are equally acceptable) to criteriaitems in any objectively-scored category or subsection (Set Criteriascreen);

adjust the weights for the sections and subsections and separatelyadjust the subsection weight for the Teaching Plan and DischargePlan/Summary (Set MSL/Weights screen);

Set Values that correspond with the Subjective ratings applied tocertain subsections (Physical Exam items, Interpretations, DiagnosisPrioritization, Diagnosis Etiologies, Teaching & Discharge Plan, CarePlan Rationales, and Revised/New Rationales) (on the Set Valuesscreen);

export your adjustments to the grading criteria so you can importthat file later, when you’re grading the same case with another groupof students (Set Criteria screen), and;

apply your changes to all students (Set Criteria screen).

To get to the Adjust Criteria functions, click Adjust Criteria on any screen. Youwill go first to the Set Criteria screen. Click Set MSL/Weights or Set Values toaccess the other screens in the Adjust Criteria function.

Adjust Criteria

To see a list of the caseauthor’s evaluation criteriafor each case, consult theDxR Nursing EvalCriteria.pdf file located onthe CD-ROM that containedthe Student Activity RecordUtility. Call DxR Nursing at(800) 453-8040 for the pass-word needed to open theEval Criteria document.

E VALUATIONCRITERIA

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Running Head

Setting Criteria

On the Set Criteria screen, each section and subsection is displayed on theleft side of your screen. Subsection titles that are grayed out are subjectivelygraded, so there are no objective criteria to edit or alter on this screen. Activesections (those that are displayed in black type, not grayed out) are assessedbased on objective criteria that may be edited. Some subsections titles arefollowed by arrows, indicating they have pull-out menus for selecting a cate-gory within that subsection.

To see the Evaluation Criteria in a subsection without a pull-out menu:

Click the title of the subsection in the column along the left side ofthe screen. If that subsection doesn’t have a pull-out menu arrow, theevaluation criteria for that subsection will appear in the large field atthe center of the screen.

To see the Evaluation Criteria within a subsection with a pull-out menu:

Click the title of the subsection in the menu on the left side of thescreen to reveal the pull-out menu. Highlight and click a category inthe pull-out menu. The criteria items for that category will appear inthe large field at the center of the screen.

Repeat this process for each category you want to review.

The text of each criteria item and all its equivalents will be displayed, alongwith the point value and whether the item is “required.”

Editing criteria items and adding equivalents (other than diagnoses)

You can change a criteria item’s text, point value, required designation, oracceptable equivalents in the Set Criteria screen’s edit box. You may alsodelete criteria items and the point values associated with them or add newcriteria to Selected Items and Category Placement.

To begin editing a criteria item, click the item that you want to edit in thefield at the center of the Set Criteria screen (see below). The edit dialog boxshown in Figure 27a will appear.

Setting Criteria

Editing Case Questions

You will not be able to edit the text of the

case questions or their answers in the

Student Activity Record Utility. You can,

however, delete questions or alter their

point values. You may also change

whether or not each question is

‘required’.

Figure 26. The Set Criteria screen in theAdjust Criteria portion of the SARU.


To change whether an item is designated as “required”, click in the boxmarked “required.” An “X” in the box means the item is required. Save Changes.

To delete a criteria item, click Delete on the edit window. Save Changes.

To add a new criteria item (Selected Items or Category Placement only),click the Add Criteria button and then type in the information for your newcriterion. Click Save Changes.

To change the point value for a criteria item, highlight the point value in theedit window and type in the new value. Save Changes.

To add equivalents to criteria item (other than Selected Diagnoses,Diagnoses Added, or case questions), place your cursor in the field wherethe full text of the criteria item is listed. Type a slash to separate the previousequivalent from the text you will type in. After the slash (\), type in the equiv-alent(s) you would like to add. Be sure to separate each equivalent with aslash (\). Save Changes.

Note: The Student Activity Record Utility searches for an exactword match between criteria and student selections. So if you addan equivalent, it should be worded exactly as the text appears inthe case.

To change the text of a criteria item (other thanDiagnoses or case questions), in the edit box wherethe text of the criteria item is displayed, highlightthe text you want to change, delete it, and type inthe new text. (The new text will appear on theappropriate category or subsection screen only afteryou click Save Changes and then click Recalculate

Scores. However any items that were matched with the previous text willremain matched with your edited version.)

Note: Changing an item’s text in the Category Placement subsection DOESN’T automaticallychange the corresponding text in the Selected Items subsection (or vice versa). You will need tochange the text in both locations.

You must click Save Changes before closing the edit window, and then click SaveChanges on the Set Criteria screen to apply and preserve your changes.

Editing Diagnosis CriteriaYou will use the same process for deleting diagnoses,changing their ‘required’ designation, and changing theirpoint values as described above. However, you will not beable to change the text of Diagnosis criteria items andyou will not be able to match make a single student diag-nosis an equivalent for multiple criteria diagnoses.

To add an equivalent diagnosis, open the edit windowby clicking on the diagnosis on the Set Criteria screen.

When the edit window appears, click Add Equivalent. Thenew equivalent will appear in the Added Equivalentsfield. Click Save Changes to preserve your edits.

Select an Added Equivalent and click Delete Equivalent ifyou want to eliminate it.

Note: All diagnoses that you have hand-matched to a criteria diagnosis will appear in theAdded Equivalents field.

Setting Criteria

Requiring Items

In subsections, marking an item as

Required means the student must include

that item to receive a satisfactory rating

in that subsection. If the subsection is

also Required, the student must include

that item to receive a satisfactory score in

that section. If the section is also

required, the student must include the

item to receive a satisfactory score on the

case.

Figure 27a. The Edit Criteria window,accessed from the Set Criteria screen.

Figure 27b. The Edit Diagnosis window,accessed from the Set Criteria screen.

Tech support: 1-800-453-8040 53

Adjusting Section/Subsection Weights

You may want to emphasize certain sections or subsections while de-empha-sizing others. You may do this by:

adjusting the numerical weights assigned to the sec-tions/subsections in a DxR Nursing case;

marking some sections/subsections as “Required” to achieve a satis-factory rating for the case as a whole;

changing the Minimum Satisfactory Levels assigned to any section orsubsection in the case study.

You can do this on the Set MSL/Weights screen (see Fig. 28 below), accessedby clicking the Adjust Criteria button, and then clicking Set MSL/Weights.

Setting MSLs

By default, the minimum satisfactory level for the case as a whole and foreach section and subsection is set initially at 70%, meaning the student mustachieve a score of 70% or greater in that area in order to receive a satisfactoryrating. To change this setting, follow these steps:

1) Locate the Overall Case/Section/Subsection MSL that you want tochange.

2) Highlight and delete the current MSL, then type in a new percentagevalue between 0 and 100.

3) Click Save Changes.

Setting RequirementsBy default, no sections or subsections in a DxR Nursing case study are

“required.” For any section/subsection that you mark as required, the studentmust meet the MSL AND include all required items in this section/subsectionin order to receive a satisfactory rating. To change whether a section or sub-section is “required,” follow these steps:

1) Locate the section/subsection on the Set MSL/Weights screen.

2) Click inside the Required box for that section/subsection.

3) Click Save Changes.

Setting MSLs/Weights

Figure 28. The Set MSL/Weights screen in theAdjust Criteria portion of the SARU.


To Adjust Section/Subsection Weights, follow the steps listed below.

1) On the Set MSL/Weights screen, locate the section/subsection for whichyou want to adjust the weight.

2) Highlight and delete the existing value, then type in your new value.

Note: The weights are relative values. Consequently, the weights for the fourcase sections do not need to total 100, nor do the weight for subsec-tions within a given section.

3) Click Save Changes to preserve your edits.

To adjust weights for the components of the Teaching/Discharge Plan, fol-low the steps listed.

1) On the Set MSL/Weights screen, locate the weights assigned to theTeaching Plan and the Discharge Plan/Summary.

2) Highlight and delete the existing value, then type in your new value.

3) Click Save Changes to preserve your edits.

Setting Values

On the Set Values screen, you will determine the percentage values that cor-respond with the five subjective ratings used in certain subsections of a DxRNursing case study. Default values are as follows:

Optimal = 100%

Acceptable = 85%

Marginal = 70%

Deficient = 50%

Unacceptable = 0%To set values for subjective ratings, follow these steps:

1) Click Adjust Criteria and then clickSet Values.

2) Locate the subsection for which youwant to change the subjecting ratingvalues.

3) Highlight and delete the existingvalue, then type in a new value(Minimum=0, Maximum=100).

4) Repeat this process for each ratingand subsection for which you want tochange values.

5) Click Save Changes to preserve youredits.

Note: To apply one of these ratings to anindividual student’s record, you must navi-gate to the student’s record, go to theappropriate subsection, and select thedesired rating.

Setting MSLs/Weights and Setting Values

Even thoughSection/Subsection weightsare relative values, thedefault values assigned tothe sections within a casetotal 100. If you change theweights so they no longertotal 100 or if one or moresubsections are turned OFFin the Management Utilitywhen you import records,you will be prompted toconfirm that you are satis-fied with sec-tion/subsection weightsthat don’t total 100.

NOTE

Figure 29. The Set Values screen in the Adjust Criteria portion of the SARU.

Exporting and Importing CriteriaAfter you have completed your grading session, you can export the criteriafor use at a later time when grading records for the same case. This is useful ifyou use the same case study with different groups during different academicterms. For example, you could assign the Browne case study during thespring semester, make your grading and criteria adjustments, and thenexport the criteria. Then, when you assign the Browne case in the future, youcan simply import your new records and then import your the BrowneCriteria file that you exported previously to apply those same grading stan-dards to the new student records. To export criteria for later use, follow these steps:

1. Complete your grading session by making all desired manual matches,weight adjustments, etc.

2. Click the Adjust Criteria button.

3. Click Export Criteria. You will be prompted to enter a file name and selecta location for your exported criteria file. The default name of the export-ed criteria file contains the case name (e.g. Browne_Crit). You maychange this name, but we strongly recommend that you include thecase name in the criteria file name. Your file name should NOT includeslashes.

The default location for saving the exported criteria file is inside the Evalfolder inside the casefiles folder for the chosen case on Windows, or toyour desktop on Mac.

The exported criteria file will contain all adjustments, but won’t containany student data.

To import criteria from a prior grading session, follow these steps.

1. Open the Management Utility for the directory and case from whichyou want to import records. Make sure these settings match the set-tings of the criteria you previously exported.

If you can’t remember what settings you used, proceed to step 2 and3. If the settings don’t match, you will be alerted to the inconsisten-cies so you can make adjustments.

2. Import your new group of records into the SARU.

Important: Do not delete any diagnoses or make other criteriaadjustments before proceeding to steps 3 and 4.

3. Click the Adjust Criteria button.

4. Click the Import Criteria button, then navigate to and select the criteriafile that you previously exported.

5. If the settings in the exported criteria file match those for your newrecords, the program will apply the imported criteria and recalculatethe student scores.

If the settings for your new student records don’t match those in theexported criteria file, a screen will appear detailing the differences.Make note of the settings that you need to change to make the cur-rent case settings match the settings in the imported criteria file. Goto your DxR Nursing site and open the Management Utility for theselected directory and case. On the Case Delivery Options andNursing Dx screens, adjust your settings to match those in theimported criteria. Save your changes, reopen the SARU and reimportyour records. Repeat steps 2-5 above.

Tech support: 1-800-453-8040 55

Exporting and Importing Criteria

PrintingYou may print reports of student scores for your own records or for distribu-tion to your students.

To print student results, follow the steps listed.

1. Click Print Report on the Student Record screen, the Index screen, theAdjust Criteria screen or the Record Statistics screen.

2. From the menu of choices, select the type of report you want to print.Your choices include the options in thetable to the right.

3. After you select the type of report youwould like to print, a dialog box willappear asking you to choose whether youwant to print information for the currentstudent record only (Current) or for theentire group (All).

Other Printing Options

You can print a view of the Student Record screen by navigating tothe Student Record screen, finding the student record you would liketo print, and clicking Print Screen. This function prints only theStudent Record screen that you’re viewing.

On the Record Statistics screen, you can click Print Statistics andchoose between printing only the statistics that are currently dis-played (Displayed Items) or all statistics on all items from RecordStatistics (All Items).

Exporting Records (scores)You may also export the scoring data from the Student Activity Record Utilityto another application (such as a spreadsheet) for producing reports andgraphs on student performance. To do this, navigate to the Index screen andfollow the steps listed below.

1. Click Export Records.

2. Designate a location where you would like to export your data. You maycreate a new folder to hold this data to prevent confusion with otherfiles.

3. Save your scoring data to your selected location.

4. Launch your previously purchased and licensed spreadsheet or dataanalysis application. Open your exported records file in the spread-sheet/data application.

5. In setting up the new document, make sure you specify a “comma delim-ited” format.

6. Format your scoring data according to the application instructions.


Running HeadPrinting and Exporting Data

Overall Report - This is a scoring summary for each section in the case study.

Additional Data - This includes a scoring summary, plus the students’ notes, learn-ing issues identified, a list of diagnoses marked as “resolved” by the student,and information on the time the student spent in the case study.

Nursing Notes - This includes the Nursing Notes recorded by the student whileworking through the case study.

Notes to Student - Prints the notes to the student as you record them whileassessing the student’s record in the SARU.

Student Care Plan - This prints out the entire care plan developed by the studentfor all progress levels in the case.

Tech support: 1-800-453-8040 57

Running Head

Scoring

Required

When marking an item as Required, you are making a judgement that willmost directly affect the subjective assessment of student performance(Satisfactory/Unsatisfactory).

Example: If you mark an item as Required in a subsection, the student mustinclude the item to receive a Satisfactory rating for that subsection. Althoughthe student can still meet the Minimum Satisfactory Level without includingthe required item, the subsection rating will still be Unsatisfactory.

When you require a section, the student must receive a Satisfactory ratingfor the required section in order to receive a Satisfactory rating on the case asa whole.

When you require a subsection, a student must receive a Satisfactory ratingfor the required subsection in order to receive a Satisfactory rating for thesection to which it belongs.

Emphasizing Content

If you want to emphasize a particular item in a subsection or a category sostudents’ numerical scores are affected, you can raise the point value for thatitem.

If you want to emphasize a particular category within a subsection, you canadjust the point values for the appropriate responses.

If you want to emphasize a particular subsection within a section, you can

mark the subsection as Required to affect the section’s Satisfactory/Unsatisfactory rating, or

increase the weights for the selected subsections.

If you want to emphasize a particular section within a case, you can

mark that section as Required to affect the overall case rating of Satisfactory/Unsatisfactory, or

increase the section weight for each selected section.

Adjusting Criteria & MSLsIf you disagree with the case author’s selection of one or more criteria items,you can negate the influence of that item on the student’s case score byreducing the item’s point value to zero. If you zero-out the point value of anitem, remember that if the item is required and if the student failed to includethis item, the omission will still affect the student’s performance rating(Satisfactory/Unsatisfactory). To fully negate the influence of the item, youmust also remove the Required designation. You may accomplish the sameresult by deleting the item.

If you want to de-emphasize a section of the case without removing stu-dents’ exposure to it, you can adjust the weight and MSL of that section to0%, thereby eliminating the section’s influence on the student’s score. You

Scoring Notes


should also make sure the section is NOT marked as Required.

The default MSL settings are 70% for the case as a whole and for each of thesections. These MSLs can be edited to be more appropriate for the educa-tional level of your students and your preferences.

Matching

In the subsections where you can manually match student selections withthe instructor’s criteria (Selected Items, Category Placement, ConfirmingItems, Management, and Outcomes), it is possible to match one item in thestudent list to multiple criteria items. You might do this in the Outcomes sub-section because the student’s selected text may contain the information inmore than one criteria item.

For example, the student-selected text may include “respiration 36 with nocrackles, rhonchi, or wheezes.” There may be two separate criteria items forthe respiration rate and the lack of crackles, rhonchi, and wheezes. To creditthe student for including both, you would manually match the student itemwith the respiration rate criteria item and then immediately also match thestudent item with the criteria item on crackles, rhonchi, and wheezes.

If the student item is already matched to one criteria item, but you want tomatch it to another, you can unmatch it and then follow the steps above forre-matching it to both criteria items. You will need to click Apply Manual Matches to All to apply your matchingdecisions to all student records that you’ve imported for this case.

Assigning Cases in Sections

Some instructors may want to allow students access to only certain sectionsof the case (for example, Initial Assessment) before allowing them to proceedto the Physical Exam or other sections. You can control access to the sectionsand functions in the Management Utility.

If you want to review the Assessment section before students proceed toother portions of the case, you would do the following:

1. Complete the case as a whole yourself, import your record, and beginmaking criteria adjustments. Then, go to the Adjust Criteria screen andmanually zero out the portions of the case that you plan to turn off inthe Management Utility.

2. Import the records after students complete the Assessment section andreview that portion of the case. Provide students feedback on their per-formance to date.

3. After students have completed the next portion of the case, you wouldopen the SARU, add the case folder that contains your previous gradingdecisions and click Import. On the dialog box that appears, click Add.

4. In the Student Records Found window that appears, you should clickeach student record that you want to update and then click SelectedRecords. The program will update the records of all students you select-ed to include the most recently completed section. You will need toclick Adjust Criteria and change the Weights and MSLs to reflect thenewly-added section.

Scoring Notes

To assess records in sec-tions, start by importing arecord with all sectionsturned ON that you willeventually assess. Then youwill be able to use theImport>Add processdescribed here to updatethose records with the lat-est student entries.

NOTE

Tech support: 1-800-453-8040 59

Running Head

NOTE: DxR currently recommends the following browsers:For Macintosh® users: Safari® version 3.2.3, 4.0.4, or 5.0; Firefox 3.6.4

For Windows® users: Microsoft® Internet Explorer 6.0, 7.0, or 8; Safari®version 3.2.3, 4.0.4, or 5.0

1) Does it matter which Internet browser I use? Yes

Windows‚ Users: DxR currently recommends you use one of the following:

Microsoft® Internet Explorer® versions 6, 7, or 8

Safari® versions 3.2.3, 4.0.4, or 5.0

Version 11.5.7.609 of Adobe® Shockwave® Player plug-in must be installed to use this

program.

Macintosh‚ Users: DxR recommends you use one of the following:

Safari® versions 3.2.3, 4.0.4, or 5.0

Firefox® version 3.6.4

Version 11.5.7.609 of Adobe® Shockwave® Player plug-in must be installed to use this

program.

For the latest information on browser compatibility, visit our Web site at:http://www.dxrnursing.com/browser.html

For best browser performance, Mac users should set the browser memory partition to

at least 30,000K:

a. Find the main browser folder located on your hard drive (usually found inside theInternet folder). Click once on the main browser program icon to highlight it. Donot click on an alias.

b. Press "Command" + "I" and select "Memory" from the drop-down menu labeled"Show.”

c. Set the preferred memory to at least 30,000K.

d. Close the memory window.

Or

a. Go to the menu bar, click "File" then "Get Info" and select "Memory.”

b. Set the preferred memory to at least 30,000K.

c. Close the memory window.

Mac performance may also be improved with the virtual memory set to ON:

a. Click the Apple® icon in the menu bar, choose "Control Panels" and select"Memory".

b. Set virtual memory to ON.

c. Set the amount of virtual memory to 1 Megabyte more than the available built-inmemory. This should be the default setting.

2) Do I need to download any plug-ins before I use this program? Yes. It is important to be sure that the Adobe Shockwave® plug-in version 11 or later is

installed in the browser you intend to use for the program. Download the latest

Shockwave‚ browser plug-in from Adobe’s site at the following address.

http://www.adobe.com/shockwave/download/.

Frequently Asked Questions

Browser Compatibility

For the latest information on brows-

er compatibility, visit our Web site at

http://dxrnursing.com/browser.html


Note: Netscape® version 6.0 does not support the Shockwave plug-in necessary to

use the software.

3) How do I create a Student List or Roster?Use one of the following methods.Using SpreadsheetsFirst, create a file using a spreadsheet with the following fields, in the following order:

First name, Last name, ID

Next, the file must be SAVED AS tab-delimited text and must have the appropriate file

extension (.txt).

First name ‘|Last name ‘|ID

This roster file can now be uploaded.

Using DatabasesFirst, create a file using a database with the following fields, in the following order:


Next, the file must be EXPORTED as tab-separated text and must have the appropriate

file extension (.txt)


This roster file can now be uploaded.

Using Word ProcessorsFirst, create a file using a word processor with the following data in each line separat-

ed by one of the following delimiters: Comma (,), Tab, or slash (/). Examples of each are

shown below. Then, save the file as text only. This file must have the appropriate file

extension (.txt).



First name/Last name/ID

Note: SimpleText (for Macintosh®‚ only) is not a recom-

mended program for list or roster development, but can

be used. However, the following guidelines must be fol-

lowed to work properly:

FONT- must be Times or Times New Roman


Student IDs

Student IDs can be any combination of

standard alpha-numeric characters (such

as abc 123). Please avoid using commas,

tabs, or slashes as characters in student

IDs.

**Please see Table below fora complete list of applica-tions acceptable for rostercreation.**

HELPFUL HINT

Tech support: 1-800-453-8040 61

HARD RETURN- must follow the last character of the last line

4) Why can’t I type in double-quotes (“text”) in the DxR Nursing case?Double quotes have been found to cause errors with student records. So when you try

to type double-quotes, you will be told you can’t type them into the case. If your stu-

dents intend to paste in text from some other source (such as a word processing doc-

ument or a Web page), they must be careful not to paste in text that contains double

quotes. Pasting in text with double quotes causes problems with records.

5) Why can't I create care plans for the nursing diagnoses that I haveselected?The DxR Nursing program will allow you to select any nursing diagnoses that you feel

are relevant to the client. However, once you enter the care plans screen, you will be

prompted to create care plans for nursing diagnoses approved by the case author.

This method ensures you are creating care plans for the most relevant nursing diag-

noses.

6) When I try to proceed to the care plan section of the program or try toquit the program, I get a message stating that there are items that stillneed to be interpreted. Why do I get this message and how do I interpretthese items?You have received this message because you did not interpret specific items that

require an interpretation while performing a physical exam of client. To interpret these

items, complete these steps.

a. Click the Interpret/Consult button (4th button down on the tool bar to the left ofthe screen).

b. Select an item the needs to be interpreted.

c. Click Select.

d. A new screen will open to the exam items selected.

e. Review the sound or graphic and enter your interpretation.

f. Click Continue when finished.

Repeat these steps for other items that still need to be interpreted.

7) How do I review the consultant’s report for items that I have alreadyinterpreted?To review the consultant’s interpretation for an item that has been interpreted, com-plete the following steps.

a. Click the Interpret/Consult button (4th button down on the tool bar to the left ofthe screen).

b. Select an item that has already been interpreted.

c. Click Select.

d. A new screen will open to the exam item selected.

e. Click the Consult button. The consultant’s interpretation will appear in the win-dow.

Click Continue when finished.


Tech support: 1-800-453-8040 63

ALERT!If your browser or if any sec-

ondary utility for your browser

includes pop-up blocking capabili-

ty, you must make sure this func-

tion is DISABLED while using the

DxR Nursing software.

Windows®Microsoft® Internet Explorer® versions 6, 7, or 8Safari® versions 3.2.3, 4.0.4, or 5.0

Version 11.5.7.609 of Adobe® Shockwave® Player plug-in must be installed touse this program.Browser cache set to at least 15 MB and Update once per session

For optimal performance, close all other applications before launching the DxRNursing program.

Macintosh®Safari® versions 3.2.3, 4.0.4, or 5.0Firefox® version 3.6.4

Version 11.5.7.609 of Adobe® Shockwave® Player plug-in must be installed touse this program.Note: Be sure to install the FULL installation for OS X. If you use a SLIM installa-tion, you may encounter problems within the DxR Nursing software.

Browser cache set to at least 15 MB and Update once per session

Browser memory partition set to a minimum of 30,000k

For optimal performance, close all other applications before launching the DxRNursing program.

Note: Browsers not listed here should not be used with the DxR NursingSoftware. DxR Nursing does not support using America Online in conjunc-tion with any browser. Check the Web site at the address below for updatedbrowser compatibility information.


DxRNBrowReq0710

Browser Requirements

H

Health Practices 25Help 24Hide/Show 5

I

Importing a student list (roster) 7Adding to the List 7

Initial Assessment 14Navigation Tabs 24

Installation and Access, SARU 29Installing Cases 5Interpret/Consult button 24Interpretations 15, 19

L

Labs 14, 24Learning Issues 24Learning Resources 11, 24

M

Management Activities Selected 38Matching 34, 58Medical Management 14, 24Monitor resolution 13MSL (minimum satisfactory level) 53, 54, 57

N

Navigation Buttons and Tabs 24NIC/NOC 9, 31Notes 24Nursing Notes 20

Nursing Diagnoses 19, 24Confirming Nursing Dx 17Current Diagnoses 21Defining Characteristics 9, 17Display of 10Etiologies 17, 21Select Diagnosis 24

Nutrient/Metabolic Processes 25

O

Outcomes 19, 20Overall student score 33

Index

A

Accessing the Management Utility 5Adding Criteria 35, 52Adjust Criteria 32, 50, 57Assessment 14

B

Body View 15Browser Compatibility 4

C

Cardiopulmonary/Mobility 25Care Planning 9, 19, 24Implementing 21Nursing Interventions 19Revising 21

Case Delivery Options 8Descriptions of 9

Casefiles 31Category Placement 35, 36, 49, 52Matching Note 36Scoring 36

Chart Button 16, 24Cognitive/Sensory 25Collaborative Problems 9, 16Confirming Items 38

D

Diagnosis Etiologies 38Directories 5, 7Discharge Plan/ Summary 9, 19

E

Elimination Process 25Emotion/Self-Awareness 25Entering the Case 13Equivalent 34Evaluation Criteria 34Exam Tools 15, 26Exiting the Program 12, 21Exporting and Importing Criteria 34, 55Exporting Records 56

F

Framework Categories 14, 16, 17, 25

P

Physical Exam 9, 15Exam Button 24

Prioritization (of Dx) 38Prioritization of Diagnoses 18Program Requirements 3Progress/Evaluation 19, 20Progress Reports 20Progress Tab 24

Q

Questions 9, 12, 48Access to 8, 9Answering 22Display Options 9, 22

R

Rationales 38Record Statistics 49Required 53, 57Resolved 20Restfulness/Sleep 25Review Matched Items 14

S

Search 14, 24Selected ItemsMatching Note 36, 40

Setting Criteria 51Setting Values 54Settings 8, 9Sexuality 25Shockwave® Installation 13Social Processes 25Spirituality 25Stress Management 25Student Activity Record Utility 28Student Activity Records 9Student IDs 7Student List 7

T

Teaching Plan 9, 19Teaching/Discharge Plan 47

U

User Accounts 7Deleting User Accounts 7Editing a user account 7

V

Virtual time 19

W

Weights 53, 54Section weights 33

Working with an existing directory 5

instructions for preparing a dxr nursing...

Documents