NURS 458/458L-Nursing Management and Leadership (5 units) SDSU-IV Campus Spring 2015 COURSE INFORMATION Class Schedule: Saturdays 0800-1200 (1/24, 2/7, 3/21, 4/18) & 0800-1300 (5/9) Course Units: 3 units – lecture Faculty: Helina Hoyt RN, MS, PHN (lecture) Office: East Faculty Building #116 Office Phone: 760-768-5680 E-mail: hhoyt@mail.sdsu.edu Office Hours: Saturdays before or after class and by appointment 2 units - clinical Course Overview Catalog Description: Theories and functions of nursing management and leadership within health care systems. Economics of health care. Course Purpose: The content of this course prepares students for the changing role of the professional nurse in complex and diverse health care settings. The theories and methods of leadership and management are explored and applied in the clinical experience. There is an emphasis on critical thinking, team building, communication, priority setting, collaborative decision-making and advocacy. Students will use nursing leadership and management theory as well as the basic and applied sciences and humanities from previous courses. This course introduces the management functions and leadership roles of professional registered nurses within the structure of an organization and is grounded in evidence-based leadership principles. Emphasis is given to organization theory, management theory, behavioral theory and political theory. Accountability for quality improvement in the provision of nursing care, interdisciplinary communication, and collaborative relationships are emphasized. Legal authority for nursing practice, the impact of political and legislative processes and ethical issues in management, are also discussed. Various modes of inquiry, including nursing process, problem-solving models and decision-making tools are emphasized. Information competence is increased through computerized database searching. An experiential learning approach, using group process and case studies, is used to foster critical thinking skills. Student Learning Outcomes: Upon completion of this course, the student will be able to: 1. Analyze the elements of organizational design 2. Analyze the integration of components into organizational systems 3. Analyze the concepts used in designing Patient Care Delivery Systems 1 4. 5. 6. 7. 8. 9. 10. 11. 12. Analyze the leadership role of the professional nurse Analyze the role of the professional nurse as a manager of client care. Analyze the role of the professional nurse in organizational management. Analyze selected principles of health care economics Analyze the financing and management of health care finances. Analyze the concepts of Quality Improvement. Analyze the components of Human Resource Management. Analyze the components of Organization Change. Examine the future role of professional nursing in health care. Enrollment Information Pre-requisites: NURS 415, 415L, & 416. Co-requisite: NURS 458L Course Materials Texts Required : Yoder-Wise, P (2015) Leading and Managing in Nursing, (6th ed). Elsevier/Mosby ISBN-13: 9780323185776 Course Structure and Conduct Lecture: Students are expected to keep up with assigned readings and Blackboard discussion questions & assignments as outlined in the Lecture/Lab Schedule. It is a basic responsibility of professionals to identify and fulfill their learning needs. On-campus lectures and lab conferences are meant to develop critical thinking skills and will require preparation for successful completion of learning activities and group work. Professional education is by its very nature demanding and time consuming. Students are urged to manage time carefully. Clinical Laboratory: All students will participate in the clinical portion of the course and must successfully complete 90 hours in the clinical setting by the end of the semester. Application of theoretical concepts and principles will be made under the direction and supervision of clinical instructors and preceptors. Performance and practice in the clinical setting constitutes a large portion of the students assigned time in the program. There will be group meetings during the clinical experience with all students and clinical faculty. Specific days/times for these meetings will be provided by the clinical faculty. It is the student’s responsibility to follow the syllabus and check Blackboard frequently for Announcements. Your clinical faculty will also identify preferred methods of communication in urgent and non-emergent matters. Course Assessment and Grading 2 Grading Scale: You will receive 2 grades for N458 (one final grade for the lecture component and one final grade for the clinical component. A grade lower than a C in either portion of the course will result in a course failure requiring that both components will have to be repeated. A AB+ 93-100 90-92 87-89 B BC+ 83-86 80-82 77-79 C CD+ 73-76 70-72 67-69 D DF 63-66 60-62 <60 Lecture Grading: Exam 1 = 25 % Exam 2 = 25 % Exam 3 = 25 % BB Discussion Questions/Assignments = 15 % Participation/attendance = 10 % Clinical Grading: Group Evidence Based Practice/Change Project = 50 % Journals = 22.5 % Clinical Preparedness and Professionalism = 22.5 % Preceptor(s) Thank You Letters = 5% LECTURE GRADING Exams: Attendance for all exams is expected. No provision is made for exams missed because of unexcused absences from class. Unless a prior arrangement for an excused absence is obtained, a grade of F (0%) will be given for the exam that is missed. Make-up exams may differ from the original exam and may be of a different nature (e.g., essay, short answer, matching, etc.) Test security is strictly maintained during both tests and review sessions. During exams, students must leave all parcels, phones, pagers, PDAs, etc. at the front of the room. Students are allowed to have pencils, erasers, and one scantron at their desks. Further, if you arrive to the classroom on an exam day after any students have turned in their exam and left the classroom, you will not be permitted to take the exam. Any student who, in the judgment of the faculty, is cheating during a test will receive a zero for that test and will be reported to the University Judiciary Committee for further action. It is the responsibility of the student to avoid any behavior which could give rise to a suspicion of cheating. During test reviews, neither writing nor recording are allowed. Scantrons: You can use the green scantrons available in the IVC bookstore. 3 Homework: Homework due dates and assignment point value and directions will be posted on Blackboard. Participation/Attendance: Class participation is the essence of any adult learning experience. The learning experience is enriched by those that actively engage and not solely influenced or born by faculty. We each share in the responsibility for achieving the defined objectives. Therefore, student grades (10 points overall) will reflect the degree of participation and overall contribution each student makes in achieving the goals of the course including attendance for on-campus lectures. Attendance will be taken at the start and end of each on-campus lecture. Criteria for Measuring Class Participation: 1. Be present and on time 2. Turn off cellular and/or mobile devices 3. Come prepared by completing all reading in the text and on blackboard 4. Complete all in-class assignments 5. Respect the people and the process 6. Ask relevant questions 7. Provide input/insight through personal reference and experience 8. Share additional information and materials (articles, etc.) that “add value” and enrich the learning experience for all involved 9. Attendance will be assessed using class sign rosters and weekly discussion questions. 10. Absences authorized in advance by the course coordinator can be made up through the following process. First absence – submit a 1 page essay on professionalism in nursing with 2 references within 1 week of missed class. Second absence – submit a 2 page reflective essay on your growth as a professional nurse during your tenure in nursing school, include at least one example of when you demonstrated professionalism in your practice. CLINICAL GRADING Clinical Lab Hour Requirements Each student will need to fulfill 90 clinical hours during the semester. Students will receive credit for their post conference time (determined by your clinical faculty member) as well as 8 hours for group work on your Evidence Based Practice Project. The remaining time will be met by working with your preceptor at your assigned agencies. In addition, participation in community events/professional meetings/conferences is expected and can be used to meet some of your clinical hours (these activities must be approved by your clinical faculty and the student must show how the event they are attending meets course objectives/outcomes). The number of clinical hours for these community activities will be determined by your clinical faculty member. Potential list of community activities (must be cleared with clinical faculty): Board Meeting (required)*can be hospital board, school board, Imperial County Board of Supervisors, Local Health Authority ACNL: Association for California Nurse Leaders-San Diego/Imperial County Section SDSU Student Research Symposium Toastmasters Local Nursing Organization/Chapter meeting (required) Sigma Theta Tau International Meeting 4 ACNL-Innovations Conference California Student Nurses Association Meeting AACN Meetings (1st Wednesdays/month at 1730; location & topic TBD) Oncology Nursing Society (ONS) meetings (3rd Thursday/ month; dinner meeting at 1800; topics and locations TBD) A visit to a local/state policy maker Attending leadership conference Evidence Based Practice workshops, presentations, meetings State/Local open forums Non-profit organizations- meetings, forums- especially anything related to health Evidence-based/change practice (EBP) project: Learning how to manage and facilitate change is one of the major components necessary to developing future nurse leaders. The group EBP project will provide the student the experience to initiate and coordinate planned change in a health care organization. The purpose of this assignment is to engage the student in an analysis of evidence-based practice within their clinical experiences. The assignment will account for 50% of the clinical grade and will be divided into 3 phases plus a peer review. Your clinical instructor will assign deadlines for each phase of the project. Phase I: Problem Identification and Evidence-Base 1. Problem Identification: EBP topics will be selected during lecture in Week #1. Students will work with their clinical faculty to best determine an appropriate PICOT question. 2. Review of literature: The review of literature should begin with a description of the search process used to identify articles. The majority of the literature reviewed should utilize systematic reviews, meta-analysis, or clinical guidelines. Individual studies, review articles and clinical articles can be used as supportive literature for clinical issues with limited research. Approximately 15 citations should be adequate (at least 5 per group member), see your clinical instructor if you have a problem with a particular content area. Students are encouraged to use evidence- based sources from the Internet, as appropriate. Use of a clinical/medical librarian is strongly encouraged and may be required by your clinical instructor. 3. Critical Analysis: The critical analysis section should include a discussion of the rationale for the existing clinical practice, as stated by the nursing staff in light of the review of literature. The existing practice should be contrasted and compared to the evidence gained from the review of literature. The individual sources should be critiqued and a summary evidence grid be completed. Phase II Proposal: Implementation Strategies: This section should describe the innovation or new practice based on the best evidence and explore strategies to implement the practice. Change theory should underpin the implementation strategies selected. Key stakeholders should be identified. Challenges to implementing evidence-based practice in the identified setting should be included with potential solutions for each challenge explored. A proposed implementation timeline should be included. Outcomes measures should be identified and an evaluation plan be proposed. Phase III Dissemination: This section will be the materials used to disseminate your project findings to the identified stakeholders. 1. Presentation of EBP Project: a 10-15 minute overview of the problem, evidence, and proposed plan. a. Actual PowerPoint slides or some other method of effective communication of project. b. Handouts materials for key stakeholders c. 2-3 discussion questions prepared by students to pose to their audience to generate discuss 5 about the project and potential for implementation d. Presentation delivery: professional demeanor, professional dress &discussion generated Peer Review: Please be aware that all members of a team for the group-based assignments are expected to function together and provide peer feedback to keep all students sharing the workload for the assignments equally. Each group will receive one grade and each group member will receive that grade for the project. 6 Evidence-Based Practice/Change Project Grading Guidelines Criteria for Evaluation Points Possible Points Earned Phase I: Problem Identification and Evidence Based Practice Project 1. Practice Problem Identification: Use EBP tools in Blackboard a. description of problem to be addressed b. significance of project, to be able to answer the question: So why is this problem significant c. Problem statement in PICOT format d. Query stakeholders about the change needed & identify range of responses 2. Review of literature: Use EBP tools in Blackboard a. Document search process for identifying articles. (consult librarian) b. Identify key search terms. c. Search for evidence using the hierarchy addressed in EBP lecture. d. Body of evidence presented was necessary and sufficient (15 source minimum) e. Fill in the Evidence summary Grid provided in the EBP lecture or by your clinical instructor (attach to paper). 3. Critical Analysis: Use EBP tools in Blackboard a. Synthesize the evidence. b. Summarize the implications for Nursing practice c. Summarize what the evidence supports as the best practice related to the problem you selected and a conclusion about whether or not the clinical practice is consistent with the best practice identified in the evidence. 15 15 20 Phase II: Implementation Strategy-Scholarly Poster or PowerPoint 3. Implementation Plan a. Protocol outlining the steps involved in the change in practice b. Clear identification of a change theory and its application in 25 designing the project. c. Identification of the organizational stakeholders d. SWOT analysis (strengths, weaknesses, opportunities, and threats) e. Cost benefit assessment f. Proposed timeline Phase Three: Dissemination 5. PowerPoint presentation to key stakeholders a. PowerPoint or Poster presentation b. Handout material for stakeholders (PowerPoint slides, evidence summary grid, others as needed) c. 2-3 discussion questions d. Presentation delivery 15 Professionalism (meeting timelines/quality of work) 10 7 TOTAL POINTS 100 Time Logs/Reflection of Learning: Students are responsible to submit a weekly time log through Blackboard (Discussion Board/Time Log File) every Sunday by 2359 as determined by your clinical instructor. These time logs should include the student’s perception of how they functioned in the leadership and management role achieving the clinical outcomes. Activities are compared with the course outcomes and logged. Self- evaluation should be included with each week’s log. This could be how the student feels about their performance, areas of growth, ideas for desired growth, goals for the following week, and analysis of the preceptor experience. Time logs will begin 2/15/15. A final time log is due at the start of lab on Friday, 5/8/15 outlining the total 90 hours completed. Clinical Preparedness & Professionalism Clinical preparedness and professionalism accounts for 22.5% of your overall clinical grade. Your clinical instructors will assign this grade based on the following over the semester: 1. Observed interactions with facility preceptor (nurse manager, nurse educator, clinical nurse specialist) – examples of interactions include did you clearly communicate what your goals for the day would be, were you an active participant in the activities that you were asked to attend? 2. Preparedness in the leadership setting: (were you prepared to participate in the activities your leadership preceptor assigned you and were you able to answer your leadership preceptor’s questions)? 3. Handing in assignments on time (i.e., journals and EBP/Change Project) 4. Attendance/tardiness (if you were absent did you notify your instructor in a timely mannerprovide a doctor’s note if warranted, were you on time for your leadership rotations and post conferences, etc)? 5. Were you dressed professionally for your leadership rotation? 6. Did you handle criticism/constructive feedback from your instructor, preceptor, or peers professionally? 7. Did you honor the confidentiality of the leadership environment you participated in? 8. Observed interactions with your fellow clinical group members (i.e., during work on EBP/Change Project and in Post Conferences) Note: Everyone will start the semester with a 100%. Your first offense in each category will result in a 2% point deduction. Example of point deductions: If you are late for clinical preceptorship or post conference one day you will lose 2% points. Repeated offenses in each category will result in a minimum of a 4% point deduction per offense and may result in being placed on a learning contract. Also major professionalism offenses that are viewed as major/severe by your instructor or preceptor may result in the loss of more than the 2% points for a first offense or the 4% points for a repeated offense. The total point loss for these major offenses will be left to the discretion of your clinical instructor and MAY result in a SIGNIFICANT loss of points or even course failure. Thank You Letters: We are guests at the clinical facilities & community agencies we are using throughout the semester. Further, the leadership preceptors that have agreed to work with us are doing so without any formalized compensation. Since each preceptor’s time is valuable, it is important to formally thank each of your primary preceptors by providing them with a thank you letter. Other Course Policies 8 San Diego Nursing Service-Education Consortium: Student Dress Code: Pre-clinical/Leadership Rotation: 1. Picture identification badge with name that meets the guidelines of AB 1439, which amended Chapter 1 of Division 2 of the Business and Professional Code of the State of California. Some facilities require both student and facility badges, or may allow either student or facility. Your clinical faculty will provide further direction on badge requirements. 2. Clean uniform or lab coat over street clothes of knee length or longer. No jeans or visible midriffs. A lab coat must be worn over scrubs. 3. Clean, low-heeled shoes with closed toes. Clogs must have a strap around the heels. No sandals or flip-flops. 4. Jewelry: Only wedding or simple rings and limited to one per hand. No piercings or jewelry/hardware may be evident other than one small stud earring per ear. 5. Hair color must fall within natural occurring shades, be neat, and if long, secured back. Facial hair must be neatly trimmed. 6. Tattoos must be covered at all times. 7. Fingernails must be trimmed short. Light or clear polish without chips is acceptable. No artificial or acrylic nails or components thereof are permitted. 8. Make up is to be worn in moderation. 9. No perfumes or scented lotions. 10. No low necklines. 11. Undergarments cannot be visible through the uniform Academic Dishonesty: Students are reminded to read the University policy on academic dishonesty/student discipline in the Undergraduate catalog. Academic dishonesty may include, but is not limited to, cheating, plagiarism, fabrication, and knowingly assisting others in an act of academic dishonesty. Any student that engages in cheating in any form will receive an automatic “F” as a grade and will be referred immediately to SDSU’s Judicial Procedures Office. Classroom Protocol: Behaviors that disrupt the classroom environment impede students’ ability to learn. Examples of these behaviors are: talking during lectures and video presentations, interrupting others while they are speaking, and arriving late and/or leaving early without previously notifying the instructor of compelling reasons for entering or exiting the classroom while class is in session (see the 2007-08 SDSU General Catalog, Student Discipline and Grievances, pgs. 447-448). Students will be notified the first time that his/her behavior is inappropriate. The next time this inappropriate behavior occurs, SDSU’s Judicial Procedures Office will be informed for disciplinary action. Disability Accommodation: If you are a student with a disability and believe you will need accommodations for this class, it is your responsibility to contact Student Disability Services at (619) 594-6473. To avoid any delay in the receipt of your accommodations, you should contact Student Disability Services as soon as possible. Please note that accommodations are not retroactive, and that accommodations based upon disability cannot be provided until you have presented your instructor with an accommodation letter from Student Disability Services. Your cooperation is appreciated. After accommodations have been authorized by SDS, students are responsible for notifying faculty in advance of the need for accommodation. This can best be accomplished by making an appointment to meet privately with the faculty member early in the semester, or as soon as possible in the event that a disability is diagnosed during the course of the semester. Syllabus Changes: While changes to the syllabus will be avoided as much as possible, I reserve the right to make changes to the syllabus at any time during the semester. If changes are made, they will be posted 9 to Blackboard. Be sure to check Blackboard on a daily basis in the event that changes or announcements are posted. Other Policies: This course requires students to participate in field trips, research or studies that include course work that will be performed off-campus. Participation in such activities may result in accidents or personal injury. Students participating in the event are aware of these risks, and agree to hold harmless San Diego State University, the State of California, the Trustees of the California State University and Colleges and its officers, employees and agents against all claims, demands, suits, judgments, expenses and costs of any kind on account of their participation in the activities. Students using their own vehicles to transport other students to such activities should have current automobile insurance. Detailed Student Learning Outcomes The student will have achieved 100% satisfactory completion by the end of the course: 1. Analyze the elements of organizational design 1.1 Examine the evolution of management theories. 1.2 Compare and contrast organizational structures such as functional, bureaucratic, matrix. 1.3 Analyze components of organizational culture. 2. Analyze the integration of components into organizational systems. 2.1 Examine the purpose and philosophy statements of organizations. 2.2 Appraise the transformation of goals into outcomes and plans of action. 3. Analyze the concepts used in designing Patient Care Delivery Systems 3.1 Compare Patient Classification Systems used in designing staffing systems. 3.2 Compare methods of assigning staff in hospital and community based care systems. 4. Analyze the leadership role of the professional nurse. 4.1 Examine the evolution of leadership theories. 4.2 Compare and contrast leadership styles. 4.3 Compare and contrast decision making models. 4.4 Examine the structure and implementation of power in the health care system. 5. Analyze the role of the professional nurse as a manager of client care. 5.1 Compare the role of the direct care provider and the case manager, shift manager, and unit manager in the delivery of client care. 5.2 Analyze the professional nurse's role in communication, coordination, consultation, and coaching in the delivery of client care. 5.3 Analyze the principles of delegation in client care. Lecture Clinical X X X X X X X X X X X X X X X X X 10 6. 7. 8. 9. 10. 11. 12. Analyze the role of the professional nurse in organizational management. 6.1 Evaluate the purpose and structure of groups. 6.2 Examine factors that determine group norms. 6.3 Analyze leadership and membership roles of groups. 6.4 Analyze the professional nurse's role in communication, coordination, consultation and coaching in organizational management. 6.5 Assess sources of organizational conflict. 6.6 Compare methods and techniques used in conflict resolution. Analyze selected principles of health care economics 7.1 Examine the principles of supply and demand. 7.2 Examine the principles of market economies. 7.3 Compare the health care market to other markets. 7.4 Evaluate the impact of political decisions on health care delivery. 7.5 Compare HMO, PPO, and fee for service structures' impact on clients, physicians, nurses and third party payers. Analyze the financing and management of health care finances. 8.1 Compare and contrast retrospective and prospective reimbursement for health care services. 8.2 Evaluate capitation methods for financing health care services. 8.3 Analyze the phases of budget preparation. 8.4 Identify methods of assessing and monitoring productivity. Analyze the concepts of Quality Improvement. 9.1 Examine phases of the control cycle. 9.2 Evaluate methods to assure quality through such as audits, benchmarking, professional standard setting and the role of Joint Commission. Analyze the components of Human Resource Management. 10.1 Examine methods of recruitment and retention of staff used by the health care agency. 10.2 Analyze the method of performance appraisal used by the health care agency. Analyze the components of Organization Change. 11.1 Examine theories used in the change process. 11.2 Analyze strategies used in creating change in the organization. 11.3 Evaluate tools used in implementing change. Examine the future role of professional nursing in health care. 12.1 Examine implications of differentiated practice of nursing in health care systems. 12.2 Question implications of advanced technology in the practice of nursing. 12.3 Evaluate expanded settings for health care delivery and the nurses' role in these settings. X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 11 LECTURE/LAB SCHEDULE Students are expected to complete assigned readings before each class. It is a basic responsibility of professionals to identify and fulfill their learning needs. Professional education is by its very nature demanding and time consuming. Students are urged to manage time carefully. Please check Blackboard Announcements frequently for updates/changes to the schedule. Lecture Hours (TOTAL=45): In-class (Saturdays: 1/24, 2/7, 3/21, 4/18 & 5/9) 21 hours + Online through Blackboard (24 hours) Lab/Clinical Hours (TOTAL=90): Weekly Time Logs will be required through Blackboard beginning 2/15 and are due each Sunday by 2359. Final time logs are required to be turned in at the start of lab on Friday, 5/8. WEEK 1 DATE & TIME January 24 0800-1200 CLASS Lecture On Campus 2 January 31 Online 3 TOPIC Introduction-Review Syllabus Beginning of Exam 1 Content CORE CONCEPTS Yoder Wise Chapters: 1-4 Yoder Wise Chapters: 5-10 End of Exam #1 Content ASSIGNMENT Research Article Critique DATE DUE January 31 BB Discussion Questions Prepare for Exam #1 February 7 February 6 1400-1530 Lab On Campus Clinical Overview EBP Projects COMPLIANCE Clinical Conference #1 February 7 0800-1200 Lecture On Campus EXAM 1 February 13 1400-1530 February 14 Lab On Campus Online Beginning of Exam #2 Content MANAGING RESOURCES Yoder-Wise Chapters 11-15 Clinical Conference #1 Assignment 5 February 21 Online 6 February 27 1400-1530 February 28 March 6 1400-1530 March 7 March 14 Lab On Campus Online Lab TBD Online Online 4 7 8 Clinical Conference #2 Clinical Conference #3 February 27 February 21 1st Time Log Due 2/15 by 2359 February 27 March 6 BB Discussion Questions Clinical Conference #4 March 7 March 27 BB Discussion Questions BB Discussion Questions Prepare for Exam #2 March 14 March 21 BB Discussion Questions BB Discussion Questions Clinical Conference #2 Assignment Clinical Conference #3 Assignment February 13 12 9 March 20 10 March 21 0800-1200 11 March 27 1400-1530 March 28 SPRING BREAK April 10 1400-1530 April 11 April 18 0800-1200 Lab On Campus Online Lecture On Campus April 24 1400-1530 April 25 May 2 May 8 1400-1530 Lab TBD Online Online Lab TBD May 9 0800-1300 Lecture On Campus 12 13 14 15 16 FINALS Section 1 Clinical Opportunity OPTIONAL Lecture On Campus San Diego/Imperial County ACNL Innovations Conference Beginning of Final Exam Content CHANGING the STATUS QUO Yoder-Wide Chapters EXAM 2 Lab Clinical Conference #4 Assignment Clinical Conference #5 April 10 BB Discussion Questions April 11 Clinical Conference #6 April 24 BB Discussion Questions April 18 EBP Project: Phase III Final Time Logs BB Discussion Questions Prep for Final Exam FINAL TIME LOGS Hard Copy May 8 Online Clinical Conference #5 Assignment INTERPERSONAL & PROFESSIONAL SKILLS THE FUTURE of HEALTHCARE Yoder-Wise Chapters 22-30 Clinical Conference #6 Assignment End of Final Exam Content EBP Projects Clinical Evaluations Imperial Valley Nursing Council EBP Conference Clinical Faculty Contact Information Gina Parker RN, MSN, PHN: gparker@mail.sdsu.edu May 2 May 9 FINAL EXAM Hospital Clinical Days Pioneers Memorial Hospital & Healthcare District TBD 13