Curricula Graduate in Nursing NURS 212 October 18, 2006
Phyllis M. Connolly PhD, APRNBC, CNS Professor, School of Nursing
Nursing's responsibility is awesome--in patient care and also in creating a new society (Nyberg, 1998, p. 209)
"To be active participants in shaping the health care system, nurses must learn new skills"
Alderman (2001, p. 50)
Questions to Consider
What role does history play in graduate nursing education? What are the major differences between the undergraduate, graduate and doctoral curricula? What are the significant internal and external factors affecting the development of graduate nursing programs? What are some outcome measures of graduate nursing education?
Critical Elements Affecting Graduate Nursing Education
History
Legislation
Role of women in society Societal needs War Military Industrialization Technology Immigration Nurse Practice Acts Medicare
National Policy Thirdparty reimbursement Inter and Intra Professional Organization
Standards Certification
Initial Graduate Education
1920s Case Western Reserve 1923 Yale University (Gold Mark Report & Rockefeller Foundation)
World War II 1945 to 1970s
Education Administration
Nurse educators Administrators Clinical nurse specialist Nurse practitioners
History of Advanced Practice Nurses: Nurse Anesthetist
Nurse anesthesia mid 1800s Today CRNA Sister Mary Bernard, St. Vincent's Hospital in Erie, PA 1877; formed a network of hospitals "Mayo Clinic" Alice Magaw by 1906 over 14,000 surgical cases--no deaths. Specialized field require education and moved away from nursing administrative structures. Greatly influenced by American military and major wars 1945 AANA initiated certification program 1999 28,000 CRNA in US 1973 University of Hawaii, first master's degree program, nurse anesthetist
Clinical Nurse Specialist
Responding to improving quality of nursing care Directors of Graduate programs responded 1954 1st CNS, Dr. Peplau 1954, Rutgers Influenced by National Mental Health Act 1946, psychiatric nursing a core discipline
Funding
Nurse Practitioners
1971 Idaho 1st state to authorize the expanded role controlled by Board of Nursing and Medicine
Loretta Ford, 1965, Colorado 1st Pediatric NP program, certificate; 4 months intensive then 20 months training and practice 1990 over 135 masters programs; 40 certificate 1998 over 750 masters and 12
Controversy over prescriptive authority
Nursing Education Baccalaureate Doctorate
BSN
Research Read & Evaluate
Master's
Doctorate
Evidence based; Develop evaluate use & do theories; models; tools; conduct MS; MSN; MS/MBA Certifications PhD; EdD; DNSc;DNP
Programs
Generic; accelerated; RN to BSN
Accreditation BRN;CCNE;NL BRN; CCNE; WASC N; WASC NLN;NONPF;WAS
Model of Master's Nursing Curriculum
Graduate Nursing Core Graduate Nursing Core
Administration
APN Clinical Core
Community Health Educator*
CNM
Specialty Curricula
CRNA Primary Care NP
NP
CNS
School Nurse CNS*
Acute NP
* Not part of AACN Essentials Model
P. M. Connolly 2006
Number of Advanced Practice Nurses in the US March 1996 %
TITLE TOTAL NUMBER CURRENTLY IN NURSING
% NATIONALLY CERTIFIED
CRNAs CNMs CNSs: Psy Peplau Rutgers 1954 NPs Ford, Colorado 1965 CNS/NPs NCMs
30,386 6,534 53,799 63,191
86.7 81.7 90.5 88.2
84.4 87.9 23.6 63.5
7,802 NO DATA
100 NO DATA
70.9 NO DATA
Hamric, Spross, & Hanson, 2000, p. 7
1980s 2006
Case Manager School Nurse Parish Nurse Informatics Clinical Nurse Leader
Core Curriculum
Research; evidencebased outcomes; health policy; nursing & Health related theory; organizational/leadership theory; environmental health; ethical & legal issues; multicultural care; economics & business theory; community partnerships; managed care; health care delivery systems
Curriculum Core Courses: 14 Units, SJSU
NURS 295 Research NURS 200 Health Design, 3 units Care Systems, 3 NURS 297 Seminar Units Project or Thesis, 1 unit NURS 202 NURS 297 Project or Theoretical Thesis, 2 units Foundations, 2 units NURS 204 Diverse Populations and Health Care, 3 units
Advanced Practice Curriculum
Advanced health assessment Pharmacology Physiology Advanced patho/physiology Core Specialty Practice
Nurse Educator Nurse Administrator
Anesthesia Nurse Practitioner Clinical Nurse Specialist Nurse Midwife School Nurse
Family Nurse Practitioner 30 Units
NURS 248 Adv. Health Asses, 3 units* NURS 250, FNP Theory I, 2 units* NURS 252, FNP Theory II, 2 units* NURS 253, FNP Practicum I, 5 units*
*Special Session Fees
NURS 254, FNP Practicum II, 5 units* NURS 256, FNP Practicum III, 5 units* NURS 258, FNP Professional Issues, 2 units* NURS 259 Advanced Pharmacology, 3 units; Dominquez Hills, online NURS 260 Advanced patho/physiology, Dominquez Hills, online
School Nurse Clinical Specialist & Credential
NURS 206, 3 units, Advance Health Assessment NURS 270, 3 units, School Nursing Pathophysiology & Pharmacology
NURS 272, 5 units, School Nursing I: Clinical Nurse Specialist (CNS) NURS 274, 5 units, School Nursing II: CNS 2 Education supporting courses, 3 units each
Nurse Administrator
NURS 246 Modern Organizations & Health Care, 3 units NURS 236A Nursing Adm. Theories, & Practicum I, 3 units NURS 236B, Nursing Adm. Theories, & Practicum, II, 4 units
NURS 266 Health Care Informatics BUS 220 Accounting Principles, 3 units BUS 285 Total Quality Management, 3 units BUS 286 Project Management, 3 units
Special Moore Foundation: MS & PostMS Certificate
Educator Track 16 months; Cohort II Fall 06 completion December 2007 Funded with forgivable loans All Special Session fees Stipends available ($20,000) Must attend Teacher/Scholar monthly seminars MS must agree to teach fulltime for 3 yrs. in any RN program in Alameda, Marin, Santa Clara, San Francisco or San Mateo Counties Post MS certificate agree to teach fulltime for 1 yr in any RN program in 5 Counties
Nurse Educator Option 22 Units
NURS 212 Curriculum Design, 3 units NURS 214 Nursing Education Theory & Practicum I, 5 units (240 hrs clinical) NURS 216 Nursing Education Theory & Practicum II, 5 units (240 hrs. clinical) 208 NURS Special Topics (20 clinical hrs.) or EDIT 272, Distance Education
NURS 266 Health Care Informatics on line course, 3 units* EDIT 186 Instructional Media/ 3 units; blended online and in person
IOM Rules for Redesign (2001)
Care is based on continuous healing relationships Care is customized according to patient needs & values The patient is the source of control Knowledge is shared & information flows freely Decision making is evidencebased
AACN: Role New Clinical Nurse Leader 2005
Leadership in care of sick across all environments Design and provision of health promotion and risk reduction services for diverse populations Provision of evidencebased practice Populationbased health care to individuals, clinical populations & communities
AACN: Role New Clinical Nurse Leader
Leadership in care of sick across all environments Design and provision of health promotion and risk reduction services for diverse populations Provision of evidencebased practice Populationbased health care to individuals, clinical populations & communities
Driving Forces Program Evaluation
Commission on collegiate Nursing Education (CCNE) NONPF BRN WASC University Review Policy
WASC
One of 6 regional accrediting associations Voluntary, nongovernmental Purpose to foster education excellence Institution must define quality & excellence File annual report Visit with selfstudy every 5 years Nine standards
Theoretical Frameworks for Evaluation
Total Quality Management Continuous Improvement Donabedian's Model
Structure Process Outcome
S
C O L U S
SCHOOL OF NURSING Total Program Evaluation Model
SCHOOL'S MISSION & PROGRAM EVAULATION PLAN
UNIVERSITY MISSION
Curriculum
CURRICULUM
Employers' Needs Society's Values
PROGRAM FEEDBACK
BSN MS RN to BSN FNP SNCred
Program Outcomes
GENERAL PUBLIC FEEDBACK
PUBLIC FEEDBACK OF EXPLICIT OBJECTIVES, MEANS, AND COSTS
ALTERNATIVE PROGRAMS LOCATIONS, CONTROLS, AND MONEY
Program Evaluation and Research Committee 10/97 Rev/ 4/99 Approved 2/12/01
CCNE 2001 Standards
I. Program Quality: Mission/governance II. Program Quality: Institutional Commitment & Resources IIII. Program Quality: Curriculum & TeachingLearning Practices IV. Program Effectiveness, Student Performance & Faculty Accomplishments
Process
Semester Curriculum Meetings
Curriculum Committee
Course Reviews
Curriculum review
Standing Committees Faculty Meetings
Task Force Reviews end of semester
School of Nursing Program Evaluation & Feedback System: On Going Systematic Evaluation
Full Faculty Meet Monthly
Curriculum Coordinating Committee Meet Monthly Represents All Semesters
Program Evaluation & Research Committee Meet Monthly Report: NCLEX, BSN Exam, Grad Rates, Employment Patterns, Demographics, Course Satisfaction
Semester Level Curriculum Committees Meet Monthly Represents all Faculty Teaching in Semester
Continuous Improvement Task Forces Meet End Each Semester
Continuous Improvement Task Forces Gerontology Adult; Community Psych/Mental Health
Graduate Semesters 3 - 8 Bridge Meet Monthly
Theory Process Skills Practicum
BRN Content Experts Specialization Experts Across the Curriculum
Review & Make Recommendations Based on Results of Standardized tests
Student Representatives
Recommendations To Curriculum Coordinating Committee
Recommendations To Curriculum Coordinating Committee
Recommendations To Curriculum Coordinating Committee
Masters SON Outcomes
"Implement care management, including but not limited to case management, resource management, advocacy, and outcome evaluation;" Apply critical thinking and ethical decision making including the use of the nursing and research processes;"
Program Outcomes
Incorporating systems theory concepts, ANA Social Policy Statement (1995), relevant ANA Standards of Care, AACN Essentials for Master's Education for Advanced Practice Nursing (1996),National Organization of Nurse Practitioner Faculties (NONPF); and the California Board of Nursing, the master's nursing graduate will: apply critical thinking and ethical decision-making including the use of the nursing and research processes; provide theory and research-based culturally competent, safe therapeutic nursing interventions for clients in advanced nursing practice; employ advanced interpersonal skills in professional relationships with clients, families/caregivers, and multidisciplinary health care team members; support health promotion and disease prevention activities in developing and monitoring holistic plans of care for well and at-risk clients, considering access, quality and cost;
Program Outcomes Cont.
demonstrate the collaborative and leadership skills required in advanced nursing practice within a multidisciplinary and multicultural (community) health care context; plan, implement, and evaluate advanced nursing practice that promotes and preserves health and healthy lifestyles of individual clients and aggregates; plan, implement, and evaluate advanced therapeutic nursing practice in a rapidly changing, multicultural health care environment; implement care management, including but not limited to case management, resource management, advocacy, and outcome evaluation; employ information technology in advanced nursing practice to evaluate and improve heath care delivery and outcomes; actualize the advanced nursing practice role by incorporating professional standards, ethical guidelines, legal mandates, and professional activities.
Graduate Publications
Beddoe, A., & Murphy, S.O. (2004). Does mindfulness decrease stress and foster empathy among nursing students? Journal of Nursing Education, 43, 305-312. Litarowsky, J., Murphy, S., & Canham, D. (2004).Evaluation of an anaphylaxis training program for unlicensed assistive personnel. Journal of School Nursing, 20(4), 57 -62. Moody, P. Gonzales, I., & Cureton Young, V. (2004). The effect of body position and mattress type on interface pressure in quadriplegic adults: A pilot study. Dermatology Nursing, 16(6), 507 512. Ngoh Toche, C., Lewis Daniels, I. & Connolly, P. M. (2005). Outcomes of inpatient geropsychiatric treatment. Journal of Gerontological Nursing, 31(4), 12 -18.
"Advancing knowledge to improve health of the world's people"