NURS 458 Nursing Management and Leadership Syllabus Fall 2013 Course: NURS 458-Nursing Management and Leadership (5 units) 3 units – lecture 2 units - clinical Schedule: Fridays 1:00-3:40 AH 2108 Faculty: Office: Office Phone: E-mail: Office Hours: Michael Gates, Ph.D, RN Hepner Hall 149 (619) 594-3572 mgates@mail.sdsu.edu Mondays 1:10-5:00 PM Fridays 11:00-1:00 or by appointment 1 NURS 458 Nursing Management and Leadership Syllabus Fall 2013 Section Clinical Faculty Contact Information Hospital 2 1 Caroline Walker cwalker@mail.sdsu.edu Scripps La Jolla Clinical Days TBD 2 Olga Mote olgamotern@cox.net Kaiser TBD 3 Paula Muehlbauer paula.muehlbauer@gmail.com VA Thursday 4 Mina Attin mattin@mail.sdsu.edu Sharp Grossmont TBD 5 Julie Jurf jjurf@cox.net Sharp Chula Vista TBD 6 Kristi Cullum ckullum@mail.sdsu.edu Scripps Mercy Sharp Mary Birch TBD 7 Julie Jurf jjjurf@cox.net Sharp Memorial/ Sharp Mesa Vista TBD 8 Rebecca Long R911nurse@aol.com VA Thursday 9 Kristi Cullum (Scripps Chula Vista) Mina Attin (UCSD) kcullum@mail.sdsu.edu mattin@mail.sdsu.edu Scripps Chula Vista/ UCSD TBD 10 Helina Hoyt hhoyt@mail.sdsu.edu Imperial Valley Campus TBD NURS 458 Nursing Management and Leadership Syllabus Fall 2013 3 COURSE DESCRIPTION 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. COURSE OVERVIEW 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, problemsolving 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. NURS 458 Nursing Management and Leadership Syllabus Fall 2013 4 COURSE OBJECTIVES Course Objectives The student will have achieved 100% satisfactory completion by the end of the course: 1. 2. 3. 4. 5. 6. 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. 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. 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. 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. 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. 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 Lecture Clinical X X X X X X X X X X X X X X X X X X X X X X NURS 458 Nursing Management and Leadership Syllabus Fall 2013 7. 8. 9. 10. 11. 12. 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. 5 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 NURS 458 Nursing Management and Leadership Syllabus Fall 2013 REQUIRED TEXTBOOKS Yoder-Wise, P (2011) Leading and Managing in Nursing, (5th ed). Elsevier/Mosby ISBN: 9780-323-06977-9 EVALUATION & GRADING: Grading Scale: You will receive 2 grades for N458 (one final grade for the lecture component and on final grade for the clinical component. A AB+ 93-100 90-92 87-89 B BC+ 83-86 80-82 77-79 C F 70-76 <70 Lecture Grading: Exam 1 = 25 % Exam 2 = 25 % Exam 3 = 25 % Homework = 15 % Participation = 10 % Clinical Grading: Group Evidence Based Practice Project = 50 % Clinical (Journals & Professionalism) = 45 % Preceptor(s) Thank You Letters = 5% 6 NURS 458 Nursing Management and Leadership Syllabus Fall 2013 7 LECTURE Exams: Exams will be based on the readings, cases, and any material from class (lectures, discussions, presentations, videos, and in-class exercises). There are a total of three exams in this course. Make-up exams will only be granted if absolutely necessary in extenuating circumstances, if you receive permission from me in advance, and if documentation is provided. Please bring the normal (red) ParSCORE Scantron to class for the exams. The exam format will be multiple choice due to the large size of this class. 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. Please make arrangements to use the bathroom before each exam begins so that you do not need to leave the classroom during exams. 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. Class Participation: 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 will reflect the degree of participation and overall contribution each student makes in achieving the goals of the course. Attendance: Starting with the second day of class, I will display a list of about five randomly selected students’ names at the beginning, middle, or end of class. These students will need to let me know that they are present. Since names are randomly drawn, you can be chosen more than once. If you are called a second time and you are absent, you will lose half of your points. Do not come up at the end of class to ask if your name was on the list. Attendance is worth half (5 points of your total grade) of your Class Participation Grade. Criteria for Measuring Class Participation: 1. Be present and on time 2. Turn off cellular and/or mobile devises 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 NURS 458 Nursing Management and Leadership Syllabus Fall 2013 8 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. Homework: When homework is due, it is due at the beginning of class and in hard copy form. Note: Imperial Valley students are allowed to email homework assignments. 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. Student Disability Services: Students who need disability accommodation should provide documentation of their disability to Student Disability Services at 619-594-6473 (Calpulli Center, Suite 3101), and receive authorization for academic or clinical accommodations. 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 to Blackboard. Be sure to check Blackboard on a daily basis in the event that changes or announcements are posted. PLEASE NOTE: 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 NURS 458 Nursing Management and Leadership Syllabus Fall 2013 9 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. NURS 458 Nursing Management and Leadership Syllabus Fall 2013 10 CLINICAL 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 facilities. 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: Toastmasters Local Nursing Organization/Chapter meeting (required) Sigma Theta Tau International Meeting Sigma Theta Tau Odyssey Conference (Oct 31 & Nov 1 in San Diego) California Student Nurses Association Meeting Watch any President Obama’s speeches, (NOTE: You will need to reflect in your journal on the President’s key points and the response of each party 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 Journals: Students are responsible to submit a comprehensive journal weekly or as determined by your clinical instructor. These journals 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. Journals will be submitted via the method designated by the clinical faculty each week during the rotation until all hours are complete. NURS 458 Nursing Management and Leadership Syllabus Fall 2013 11 Journal Guidelines Writing in a journal can assist you in the process of getting the most out of your N458 clinical experience by helping you fully explore your clinical experiences. The process will be challenging and difficult at times, but also rewarding and fulfilling if you take some risks and use it for personal and professional growth. The experience journal is a written account of each clinical laboratory experience. Each clinical log is due within the week of the clinical experience. Guidelines include: 1. Provide an attainment of course outcomes, overview of activities and tracking for clinical hours. (Tracking form will be available on blackboard). 2. Provide a vehicle to communicate learning experiences, feelings, problems, and/or needs to the clinical faculty. 3. Facilitate formulation of learning outcomes for each experience. 4. Provide a summary retrospective analysis of individual growth. 5. Turn your journal in weekly until you finish your clinical hours – this means every week even if you aren’t in clinical. 6. Generally you will write from 1-2 8.5 x 11 pages. Longer isn’t better if you aren’t engaged in self-reflection, self-evaluation, and exploring your perceptions. 7. Stay focused on the course learning outcomes – remember this is how you will be evaluated by the clinical faculty. 8. The journal is about reflection and evaluation of your performance and experiences, identifying areas for growth, ideas for desired growth, goals for the following week. You will need to provide an analysis of your clinical experience based on your explanation of the concepts or theory contained in the outcome to which you are writing. 9. Remember your clinical faculty is not with you and your preceptor, and is only seeing you separate from your clinical experience activities via your journal, so the journal entries must document what you are learning as related to the course outcomes. Suggestions for how to structure it – the “content” 1. You should be paying close attention to the course learning outcomes each week and identifying goals for each clinical experience that are related to how you will meet the learning outcomes. 2. Be smart about how you use the journal – “This is an example of how I worked on outcomes 1”, or “I had 3 new challenging experiences this week, they were”. 3. Look at your leadership evolution over the rotation, talk about how you have tried/observed different leadership styles, how they worked, what leadership styles do you see other nurses using, what seems to work best? 4. What you are doing on-line each week should help guide how you approach your journal, review previous chapters in your text and link the content to what you are doing and seeing in the clinical setting, analyze, synthesize, reflect. This is not a list of task and activities that you did. 5. By the end of the semester there must be evidence in the journal how you met the learning outcomes. NURS 458 Nursing Management and Leadership Syllabus Fall 2013 12 Clinical Conduct: Clinical experience (unless there are site-specific guidelines identified by faculty) includes: 1. Picture identification badge with name, which meets the guidelines of AB 1439 of the Business and Professional Code of the State of California. 2. White lab coat over professional attire of knee length or longer. 3. Professional/business entire. No jeans or visible midriffs. 4. Clean shoes with closed toes. Clogs must have a strap around the heel. No open toe shoes for example, sandals or flip-flops. 5. Jewelry per the School of Nursing and clinical site policy. Pre/Post Conference There will be group meetings during the clinical experience with all students and clinical faculty in each section. Specific days/times for these meetings will be provided by the clinical faculty. The clinical faculty will be available on scheduled clinical experience days. The contact method, either beeper or cellular phone or other, will be discussed by each clinical faculty on orientation day. This contact is to be used for urgent and emergency needs requiring immediate attention. For non-emergent needs, the clinical faculty should be contacted during regularly scheduled office hours, via email, or at phone numbers given at orientation to the course. EVIDENCE-BASED 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. Your clinical instructor will assign deadlines for each phase of the project. Phase I: Problem Identification and Evidence-Base 1. Problem Identification: A clinical problem will be uncovered during clinical experiences in collaboration with the unit leaders and your clinical instructor. Digging up clinical problems can start with observation of practice on your assigned unit, asking staff about the problems they face delivering care, looking through policies and procedures and guidelines of care, and talking with patients about their perceptions of the care they are receiving. A clinical question should be developed using the PICOT process. 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 (or 3 per group NURS 458 Nursing Management and Leadership Syllabus Fall 2013 13 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 evidencebased care in the clinical setting should be identified 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. 1. Clinical practice: The description of clinical practice can be a client care scenario in which the student was involved or be clinical practices observed while in a given clinical area. The rationale nursing staff offers for engaging in the particular clinical practice should also be explored. 2. Innovation/New practice: The proposed change in practice should be outlined. 3. Implementation Strategies: An implementation strategy should be outlined with clear evidence of integration of the change theory chosen to guide the project. Phase III Dissemination: This section will be the materials used to disseminate your project findings to the clinical agency. 1. Presentation at Clinical Agency: a 10-15 minute overview of the problem, evidence, and proposed plan. Actual PowerPoint slides or some other method of effective communication of project. b. Handouts materials for unit leadership if indicated c. 2-3 discussion questions prepared by students to pose to their audience to generate discuss about the project and potential for implementation d. Presentation delivery: professional demeanor, professional dress, discussion generated a. NURS 458 Nursing Management and Leadership Syllabus Fall 2013 14 Evidence-Based Practice Project Grading Guidelines Criteria for Evaluation Points Possible Points Earned Phase I: Problem Identification and Evidence Based-Scholarly Paper 1. Practice Problem Identification a. description of clinical practice 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 staff about the rationale for the clinical practicesummarize range of responses 2. Review of literature 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 a. Synthesize the evidence in a 3-5 page summary format. 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. 10 20 20 Phase II: Implementation Strategy-Scholarly Paper 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 designing the project. c. Identification of the organizational stakeholders d. SWOT analysis (strengths, weaknesses, opportunities, and threats) e. Cost benefit assessment f. Proposed timeline 30 NURS 458 Nursing Management and Leadership Syllabus Fall 2013 15 Phase Three: Dissemination 5. PowerPoint presentation to unit leadership at clinical site a. Team Responsibility Form b. PowerPoint presentation c. Handout material for clinical facility (PowerPoint slides, 20 evidence summary grid, others as needed) d. 2-3 discussion questions e. Presentation delivery TOTAL POINTS 100 Comments: Project Reviewed by: Students: Note: 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. Each team should identify a team leader for each project. The form will document each person’s individual contribution to the group effort. Ream Member Name/Role TEAM RESPONSIBILITY FORM Contribution Signature NURS 458 Nursing Management and Leadership Syllabus Fall 2013 16 LECTURE 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 DATE August 30th TOPIC Course introduction Evidence-Based Practice Review READINGS Review Syllabus Yoder-Wise Chapter 21 September 6th Leadership Personality & Values Yoder-Wise Chapters 1, 3, & 4 Homework #1: Due. Reaserch article critique. Homework #2 due: Complete two self-assessments that will be available on Blackboard (What’s my basic personality?” and “what’s my Junigian 16-Type Personality?”) and turn in the completed assessments at the beginning of class (5 Pts). September 13th Leadership Continued & Patient Safety and Quality Managing with technology Yoder-Wise Chapter 2, 11, 20, & 22 Homework #3 due: Leadership discussion question (7 points). NURS 458 Nursing Management and Leadership Syllabus Fall 2013 September 20th Policy and Politics Legal and Ethical issues 17 Yoder-Wise Chapters 5 & 10 Homework #4 due: Case Study assignment 1 (7 points) September 27th Portfolios Job Market Careers in Nursing END EXAM 1 CONTENT October 4th Conflict Yoder-Wise Chapter 23, 24, & 25 Homework #5 due: Take the online self assessment entitled “What’s my preferred conflicthandling style? And bring printed results to class (5 points). This self assessment is available via Blackboard. October 11th EXAM I {1:00-2:30] October 18th Negotiation Delegation Yoder-Wise Chapters 6 & 26 Homework #6 due: Take the online self assessment entitled “What’s my negotiation style? And bring printed results to class (5 points). This self assessment is available via Blackboard. October 25th Groups and Organizations: Behavior and Structures (including multicultural and multidisciplinary groups) Yoder-Wise Chapters 7, 8, & 9 November 1st Motivation END EXAM 2 CONTENT Yoder-Wise Chapter 15 November 8th Managing resources Yoder-Wise Chapter 12, 13, 14 NURS 458 Nursing Management and Leadership Syllabus Fall 2013 November 15th Exam 2 [1:00-2:30] November 22nd Organizational Change November 29th Thanksgiving Holiday December 6th Role Transitions & Stress Management Final Exam (10:30-12:30) MONDAY December 16th 18 Yoder-Wise Chapter 16, 17, 18, &19 Yoder-Wise chapter 27, 28, & 29