NUR 5749: Adult-Gerontology CNS

UNIVERSITY OF DETROIT MERCY

McAuley School of Nursing

NUR 5749: Adult-Gerontology CNS 

Practicum I

Course Syllabus

Winter 2024

COURSE: NUR 5749 Adult-Gerontology CNS Practicum, CRN 24685 (section 1 & 2)

CREDITS: 2 Credits Clinical (2 credits = 13.3 hrs/wk X 15 = 200 hrs)  

PRE-REQUISITES: Core and Interdisciplinary Courses

Adv Theory (NUR 5020/7000)

Advanced Practice Courses

NUR 5160 Advanced Health Assessment

HLH 5900 Advanced Pathophysiology

CO-REQUISITES: NUR 5748 Adult-Gerontology CNS Role and Theory I

            NUR 5800 Pharmacology for the APRN

CLINICAL FACULTY: Molly McClelland, RN, PhD, ACNS-BC, CMSRN

COURSE LOCATIONS:  This course is on-line via Blackboard (BB) http://knowledge.udmercy.edu and at approved clinical locations. The Firefox browser (free download) is the recommended browser for the BB system. All BB system issues should be directed to IDS at 313-578-0580. 

COURSE DESCRIPTION 

The course focus is on AGCNS role development, age-appropriate advanced nursing care, management of patients/caregivers with complex problems that leads towards safe, quality, and cost-effective health outcomes. Students will practice in the patient sphere of impact across health care systems. 

COURSE OBJECTIVES                      

MASTER’S ESSENTIALS	NACNS COMPETENCIES PROGRAM OUTCOMES	EVALUATION METHODS
Articulate and advocate for the role and scope of practice of the AGCNS.	I (8), VI (3, 4, 5), VII (1, 2), IX (3) NACNS Competencies: P.1-16, N.1, O.3-5, O.10 Holistic Nurse Standards: 8-9,11,14 Program Outcome: 1	Reflections Clinical logs Preceptor interview Join CNS org Letter to legislature Clinical evaluation
Demonstrate AGCNS competencies in managing adult-older adult patients with complex needs from acute to EOL care.	I (1, 2), II (7), III (2, 6), IV (5), V (5), VIII (3, 8), IX (1, 2, 3, 4, 7, 8, 9, 13),   NACNS Competencies: P.1-16, N.1, O.3-5, O.10 Holistic Nursing Standards: 1-5, 5A, 5B, 5D, 6, 7, 8, 9, 13, 14 Program Outcomes: 1, 2, 3	Holistic plans of care Clinical logs Reflections Teaching project
Construct, implement, and evaluate adult educational management plan(s) for patients/caregivers using quality improvement strategies and principles of health literacy.	I (3, 4, 5, 6), II (1, 2, 4, 6, 7), IV (1, 5, 6), V (5, 6), VIII (3, 5), IX (3, 4, 12) NACNS Competencies: P.1-16, N.1, O.3-5, O.10 Holistic Nursing Standards: 1-5, 5A, 5B, 5D, 6, 7, 8, 9, 13, 14 Program Outcomes:  1, 2, 3	Teaching project Clinical logs Reflections Clinical evaluation
Use consultation and collaboration with patients/caregivers and healthcare professionals to provide compassionate, holistic care and a healing environment.	II (1, 2, 6, 7), III (1), IV (4), VII (3, 4) NACNS Competencies: P.1-16, N.1, O.3-5, O.10 Holistic Nursing Standards: 1-5, 5A, 5B, 5D, 6, 7, 8, 9, 13, 14 Program Outcome: 1, 3	Holistic plans of care Teaching project Reflections Clinical evaluation
Practice advanced nursing reflectively within moral, legal, and humanistic frameworks with a commitment to social justice and special attention to vulnerable patient populations and the needs of the nursing profession.	IV (2), IX (14, 15) NACNS Competencies: P.1-16, N.1, O.3-5, O.10 Holistic Nursing Standards: 1-5, 5A, 5B, 5D, 6, 7, 8, 9, 13, 15 Program Outcome: 1, 5	Reflection Clinical evaluation Teaching project  Holistic plans of care
Perform competently as a novice AGCNS in the patient sphere of impact.	IX (1, 2, 3, 5, 8, 11, 12, 13, 15)  NACNS Competencies: P.1-16, N.1, O.3-5, O.10 Holistic Nursing Standards: 1-5, 5A, 5B, 5D, 6, 7, 8, 9, 13, 14 Program Outcome: 1	Clinical Evaluation Teaching project Holistic plans of care

*The patient population of the Adult-Gerontology CNS is defined as late adolescents and emancipated minors, adults, and older adults (including the young-old, frail and old-old adults), in all contexts of care.

REQUIRED TEXTBOOKS/e-BOOKS/WEB-SITES (Same as theory portion of course).

Please note that an (*) before the textbook means the text is an e-book and can be accessed through the course site. For questions regarding library resources and assistance, please contact Jill Turner, RN, and Librarian at 313-494-6903 or by email at This email address is being protected from spambots. You need JavaScript enabled to view it.

ANA Code of Ethics for Nurses with Interpretive Statements  https://www.nursingworld.org/coe-view-only 

*Boltz, M., Capezuti, E., Fulmer, T., & Zwicker, D. (2021). Evidence based geriatric nursing protocols for best practice. New York: Springer Publishing Company. 

*Dossey, B. M. & Keegan, L. (2016). Holistic nursing: A handbook for practice (7th ed). Bulington, MA: Jones and Bartlett. (Use the 7th Edition) 

*NACNS 3rd Edition Statement on CNS Practice and Education (2019).  

Located at NUR 5748 Course site. (suggest you purchase at the NACNS website or copy the document located at the course site). This is your scope of practice.  

National Association of Clinical Nurse Specialists (NACNS) website: http://www.nacns.org/   

*Rancour, P. (2008). Tales from the pager chronicles. Indianapolis, IN: Sigma Theta Tau International. 

*Shay, A. C et al. (NACNS, 2021). Adult-Gerontology Clinical Nurse Specialist Certification Review.   Springer Publishing.  

*Zuzelo, P. R. (2010).  The clinical nurse specialist handbook. Sudbury, MA:   Jones and Bartlett Publishers. 

*Available as ebooks at course blackboard site

ON-LINE LIBRARY RESOURCES

There is an abundance of full-text on-line nursing journals available through the UDM “library” link that is located at our course site and through the library at http://libraries.udmercy.edu/ The Clinical Nurse Specialist journal is linked directly to our course site. 

Critically important is to use the CNS Library page linked with the course for access to all the ebooks on the list and our CNS journal. 

REQUIRED EQUIPMENT:  Because this course is taught on-line, students must have access to a computer on a routine and weekly basis.  Students must additionally have a camera (built in or added to their personal computer) for zoom calls or a Smartphone for Face time. Students and preceptors can meet face-to-face (virtually) with clinical faculty at mid-term and more often if needed. Virtual site visits can be scheduled anytime with the Clinical Faculy

TEACHING STRATEGIES: 1:1 mentoring and feedback on all clinical assignments  

University Of Detroit Mercy Mcauley School Of Nursing 

EVALUATION CRITERIA:                                       

CLINICAL ASSIGNMENT	WEIGHTED PERCENT
Preceptor Interview	2%
Reflections (2 @ 4%/ea)	8%
Teaching Project (2 parts @ 20%/ea)	40%
Holistic Plans of Care (3 @ 13.33%/ea)	40%
Mid-term Clinical Evaluation	2%
Final Clinical Evaluation	3%
Clinical Logs (4 total)	4%
Preceptor/Site Evaluation	1%

             

DESCRIPTION OF EVALUATION CRITERIA

All assignments should be done according to APA 7th edition unless otherwise specified.  

PRECEPTOR INTERVIEW (Due by January 22, 2024) Students will interview their preceptor to gain knowledge of the role and write a short reflection piece. Prior to doing the interview, familiarize yourself a little bit about the different spheres of the role.  Ask your preceptor to define and provide examples of a “complex patient” that she/he may be consulted on for care. Explore the components of the CNS role she/he is performing.  Are there ones they are less engaged in and why? Be creative and learn as much as you can about working as a CNS.  (A 1 – 2 page reflection paper should be posted to the BB site, references not needed for this assignment)

REFLECTIVE PRACTICE SUMMARIES (Due by February 5  & March 3)

Students will complete 2 self-reflections as part of professional practice and Jesuit tradition of discernment. ONE REFLECTION NEEDS TO RELATE TO THE PRESCRIBING EXPERIENCE.  THE OTHER SHOULD RELATE TO ANY OTHER CLINICAL EXPERIENCE.  Students should incorporate their own analysis and judgment of critical or important events that occur in the clinical setting and relate them to the role and practice of the AGCNS. The grading rubric is designed using the John’s Model of Structured Reflection (2004) (Zuzelo, 2010).  The rubric below will be used to grade reflections. 

• Prescribing Experience

The prescribing experience is meant for you to gain a perspective of how you will incorporate prescribing in your role as a CNS. You will shadow a regular prescriber at your clinical site for 24 hours. You will describe this patient in your Advanced Holistic Assessment. You will describe what you told the provider you would prescribe (see criteria 11 – rubric) based on treatment algorithms, the latest research, and standards of care. Provide any other relevant information you feel is important. The 24 hours can be completed in any way that is most convenient for you and your preceptor.  (For example, a few hours each time you are in the clinical setting, 3 eight-hour days, etc). 

CNS’s are approved in MI and many other states to prescribe medications, therapeutics, diagnostic studies, equipment and procedures. This is also a competency of CNS practice (P.6).  Time with prescribing clinical personnel is necessary to learn how to safely write & prescribe. Examples of preferred prescribers are your CNS or NP preceptor. Shadowing a Physician for prescribing is acceptable if an APN is not available. 24 hours and a reflection paper on the experience is required.  You many complete the 24 hours in any increment that works best for you, your CNS preceptor and the prescriber.  Just indicate pharmacy hours on your clinical log.  

Grading Rubric for Reflective Practice Summaries

Meaning of scores on REFLECTIONS 

Does not meet expectations (0 - 0.9)

Partially meets expectations (1 – 4)

Meets expectations (5) *meeting the criteria as listed below at the level of a novice AG-CNS

      

CONTENT AREA	Does not meet	Partially	Meets
The student describes an experience that is significant in some way.
The student describes what they were feeling and what made them feel that way.
The student describes their own action(s) at the time of the experience and if their actions were in tune with the values of professional practice.
The student describes what knowledge informed or might have helped to inform his/her actions.
The student speculates how they might more effectively respond if given the situation again.
6.    The student concludes by indicating how they NOW feel about the                    experience.
SUBSCALE  TOTAL (30 points possible):

Comments:

HOLISTIC, AGE-APPROPRIATE FOCUSED, ADVANCED NURSING CARE PLAN (Due January 29, Feb 26, April 8)

Students will select from among their patient population, in the clinical setting, three patients with “difficult” or “highly complex” issues to complete this assignment. Congruent with Jesuit and Mercy traditions, choosing and working with patients in most need due to social injustices or vulnerability should be an important consideration. ONE OF THE THREE PLANS OF CARE MUST BE ON AN OLDER ADULT PATIENT/FAMILY CAREGIVER. Students will submit a focused but complete SOAP note for each patient, documentation of a plan and implementation of the plan and the OUTCOMES achieved (quality and/or cost-effective).  The focused assessments need to be in respiratory, cardiovascular and gastrointestinal. As part of the assignment, students must be checked-off on the objective portion of the assessment by an appropriate observer (APRN or Physician). The check-off form will be located at the course site for each assessment. The write-up for this assignment should follow the categories on the grading rubric below.  Students should review the assessment sections in the Bates textbook used in the Advance Physical Assessment course (NUR 5160). 

*Please note item 11. As more CNSs across the country gain prescriptive authority, it is important for you to determine what you would prescribe as relevant to the problem. This could be pharmaceuticals, consults for certain therapies, home care, palliative care referrals, durable medical equipment, and wound care. Students need to assume this way of thinking in your future CNS careers. 

*Please note items 13 - 16. Unique to AG-CNS care is that the work of the AG-CNS crosses THREE SPHERES OF IMPACT. When working in direct care, the AG-CNS needs to thinking of ways care impacts nurses/nursing practice and the system at large. Every patient visit should relate somehow to work in the other two spheres. Every patient encounter should also result is high quality care that leads in some ways towards cost-savings for the patient and/or health care system. Being able to articulate your value in $ is very important to substantiating your salary. 

Grading Rubric for the Focused and Holistic Advanced Care

Meaning of scores on SOAP notes 

Does not meet expectations (0 - 0.9)

Partially meets expectations (1 – 4)

Meets expectations (5) *meeting the criteria as listed below       

CONTENT AREA	Does not meet	Partially	Meets
In a few brief sentences, indicate why this patient was chosen for AG-CNS care. The reason must show how this patient was in need of advanced nursing care.
A brief description of the patient is provided (age, sex, race/culture, co morbid conditions, living conditions, religious affiliation, etc.).
The subjective section clearly describes the patient’s/caregiver’s primary complaint and presenting symptom.
All age-specific, genetic risk factors, cultural, spiritual, QOL and/or lifestyle choices are documented.
The objective “focused” assessment includes relevant and complete data including laboratory and diagnostic studies.
The student performed the assessment at the level of an advanced practice nurse (see signed check-off).
The student used at least one advanced assessment and relevant technique (scores on a valid assessment tool or special techniques (ABG or EKG interprétation, etc.)
Data is organized in a logical and orderly fashion.
The student provides a brief analysis of the problem and develops a list of working diagnoses (medical & nursing) that is prioritized and relevant to AGCNS practice. NOTE: Only those dx that are relevant to AGCNS practice are included.
The student describes how evidence was used to develop and implement a plan that addresses one of more of the nursing diagnosis listed above.
The student describes what they would prescribe for the patient (pharmacological and/or non-pharmacological) if they had prescriptive authority.
Current research, standards of care, and treatment algorithms were used to develop the plan and are listed using APA format.
The student describes their actions (use of “I” statements) in the implementation of the plan and actions are in the realm of AGCNS behaviors in the competency of direct care.
The student describes the quality outcomes that were achieved with the patient/family and attributable to the student’s work (not simply projected outcomes).
*The student describes how they collaborated, coached or role modeled care associated with this patient for the nurse(s) to demonstrate care in the nursing sphere of influence.
*The student describes how her/his actions with the patient led towards OR could lead towards leadership at the systems level of care.
Students describes how their actions will lead towards cost savings ($) for the patient and/or health care system.
The write-up is clear, logical, neat, and without misspelled words, done in correct APA formatting, etc.
SUBSCALE  TOTAL (90 points possible):

TEACHING PROJECT USING PLAN, DO, CHECK, ACT (Parts 1-11 due February 12.  Parts 12 – 20 due April 22)

Students will incorporate EBP and the PDCA Model Improvement process to assess an existing patient education program and implement a health education project for patients/caregivers on their respective unit(s). Students will (Plan) identify a problem area in existing patient education, flow chart out the current process, gather information on the problem, (Do) design a new education plan, design or revise a patient education brochure, state specific learner objectives (using measurable terms, i.e., Bloom’s taxonomy), determine assessment/evaluative measures of patient learning, pilot the project, (Check) measure and evaluate how it went, make changes, (Act) implement it again with the stated changes.  Students will finish the project by actively “communicating” it to the appropriate others (CNS preceptor, nursing managers, nurse champions, etc.) for on-going implementation in the facility. 

Grading Rubric for the Teaching Project

Meaning of scores: 

Does not meet expectations (0 - 0.9)

Partially meets expectations (1 – 4)

Meets expectations (5) *meeting the criteria as listed below

CONTENT and SKILLS	Does not meet	Partially	Meets
PLAN
Describe the problem area in terms of importance to the organization and background information of relevance (statistics related to the problem, TJC requirements, never events, etc.).
Gathers input from others on the problem, i.e., patients, family members, nursing staff, nurse managers, CNSs, physicians, etc.
Develops a flow diagram of current processes.
Provides a short critique of the current process and describes where the process needs improvement.
Provides a brief overview of the literature related to problem of interest (could interventions from similar process improvement initiatives be replicated or adjusted to guide your work)
DO (Try and Test out the Solution)
The student clearly states 3-5 learning objectives they will use for each patient/family using Bloom’s Taxonomy.
Designs or revises patient education literature, brochure, etc., to be used in educating patients in the problem area.
Brochure design addresses correct font, appropriate reading level, concise content, use of pictures and visually appealing.
The student describes how principles of health literacy were used in the design of the healthcare brochure.
The student determines how they will measure that learning took place for each stated objective, i.e., patient responses and/or actions.
The proposed plan (all sections above) is written in correct APA format, without spelling/grammar errors, proper sentence structure and logical.
*Wait for Clinical Faculty Approval before Implementing
The student pilots the plan on 3 patients/families and provides a short narrative of each.
Description of first interaction is described to include the setting and time frame, the student’s methods and use of the brochure, if the patient met the stated learning objectives, follow-up teaching, etc., and any expected or unexpected occurrences.
Description of second interaction is described to include the setting and time frame, the student’s methods and use of the brochure, if the patient met the stated learning objectives, follow-up teaching, etc., and any expected or unexpected occurrences.
Description of third interaction is described to include the setting and time frame, the student’s methods and use of the brochure, if the patient met the stated learning objectives, follow-up teaching, etc., and any expected or unexpected occurrences.
CHECK
The student describes how effective the pilot was for each patient/family. Did it work as planned? (Be analytical here)
What improvements are needed to the brochure, the process, and/or the student’s methods in patient teaching?  Student also lists what needs to be altered to improve the project so staff nurses can take over the process.
ACT
Revisions are implemented and the student pilots the changes on one more patient/family.
Description of this fourth interaction is described to include time frame and expected or unexpected occurrences.
ARTICULATE OUTCOMES
Student describes a meeting that took place where they shared the brochure and the process with other nurse leaders in the organization.
Student ARTICULATES the sustainability plan for this intervention and how this project will improve organization outcomes.
SUBSCALE  TOTAL (100 points possible) COMMENTS:

ROLE AND COMPETENCIES MID-TERM AND FINAL CLINICAL EVALUATION (Due 2/26 & 4/22)

(COMPLETED BY YOUR PRECEPTOR – SEE POSTED FORM AT COURSE SITE)

Preceptors will complete the tool at week 7 (REQUIRED BUT NOT GRADED) and again at the end of the course (REQUIRED AND GRADED). Students are encouraged to perform a self-assessment at mid-term (formative) and again at the end of the clinical rotation (summative) using this tool. Clinical faculty will use the information to determine the final grade. Students who fail to submit this form as completed and signed by their preceptor at mid-term or at the final week of the rotation will receive a failing grade in the course. 

Grading Rubric for the Role and Competencies Evaluation Tool  

Meaning of scores:

Does not meet expectations (0 - 0.9) / Partially meets expectations (1 – 1.9)

Meets expectations (2) *meeting the criteria as listed below – Must be achieved in all areas to pass the course      

CONTENT AREA	Does not meet  expectations	Partially meets expectations	Meets expectations
1.  Articulates the role of the CNS in improving outcomes for adult/older adult patients to other healthcare providers.
2.  Uses relationship building communication to effectively promote health, wellness and healing with patients/caregivers, nurses and other health care providers in a variety of contexts (i.e., meetings).
3. Performs holistic health assessments of patients/families with complex needs at the level of a novice AG-CNS.
4. Advocates for patient/caregiver needs in different contexts of care.
5. Practices collegially in consultation and collaborations with other healthcare providers to effectively meet patient/caregiver needs.
6.  Effectively incorporates evidence-based practices and advanced nursing interventions in direct care of adult/older adults with complex needs.
7.Prescibes medications, therapeutics, diagnostic studies, equipment, and procedures.
8. Coaches patients with complex learning needs.
8.  Coordinates care with other healthcare providers and community resources that results in optimal patient outcomes.
10..  Monitors practice to achieve outcomes that lead to safe, quality, and cost-effective care.
11. The student is enthusiastic and self-directed in meeting the course objectives.
12.  The student accepts constructive criticism.
13 The student is punctual and organized.
14.. The student shows respect for others.
15.  Overall, the student conducted her/himself professionally and competently as a novice adult-gerontology CNS in the patient sphere of impact.
SUBSCALE TOTAL: 30 POINTS IF MEETS ALL EXPECTATIONS

Preceptor Comments: 

Clinical Faculty Comments: 

CLINICAL LOG SHEETS (see SAMPLE below) (Due at end of each quarter:  February 5, March 3, April 8, April 22)

Students are required to keep an accurate account of all activities and clinical hours. The log is submitted at the end of each month. The clinical log lists those activities of the student's experiences that are AGCNS competencies of practice and the respective and spheres of practice to count as clinical hours. Faculty will determine if the hours are acceptable and if additional experiences are needed.  A student who fails to submit their preceptor signed Clinical Log Sheets and keep up with the hours as expected will not progress in the program. 

Students will craft a table similar to the table below. 

SAMPLE

CLINICAL LOG

UNIVERSITY OF DETROIT MERCY

MCAULEY SCHOOL OF NURSING

ADULT-GERONTOLOGY CLINICAL NURSE SPECIALIST PROGRAM

Student: ___________________________________________________________

Date: ____________________________________

Clinical Record Sheet (Sample)

DATE	STUDENT CNS ACTIVITIES	TIME	COMPETENCY OF CNS PRACTICE and SPHERE OF IMPACT	HOURS
	Rounded on 3 units and met with nursing staff to determine needs		Direct care – Patient and Nursing Spheres of Impact
	Examined data base to identify patients at high risk for delirium		Research – Patient Sphere of Impact
	Attended Organ Transplant Taskforce Meeting		Systems Leadership – System Sphere of Impact

Students Signature/date __________________________________________________________

Preceptor Signature/date _________________________________________________________

Hours this log / Total Cumulative Hours to date:  ______________________________________

Preceptor and Site Evaluation (see course attachment at BB site) (Due April 22)

Students will evaluate both their preceptor and the clinical site at the end of the clinical rotation. Points are awarded for students who turn their evaluation. 

COURSE POLICIES

1. Clinical assignments are due as scheduled per topic outline (due dates are included on assignments in BB).  If a student is unable to complete an assignment for an “emergency situation,” it is the student’s responsibility to notify their clinical faculty and negotiate other arrangements.  Failure to do this will result in a zero score for the assignment – no exceptions.  All assignments must be completed or an “Incomplete” will be issued as the course grade.  Faculty will give student feedback on a late assignment, but the score will stand as a zero. For example, if the first part of the teaching project is turned in later than a specified time, the student will receive a score of zero for that section on the grading rubric but will receive faculty feedback on the assignment.
2. The policies related to Academic Integrity as described in the University of Detroit Mercy Catalogue and the McAuley School of Nursing Graduate Student Handbook regarding academic and professional performance must be adhered to at all times.  Failure to do so will result in probation and/or dismissal.

GUIDELINES FOR THE CLINICAL PRACTICUM

The practicum experience will provide students the opportunity to engage in-patient, nursing, and system level care to meet the competences for Adult-Gerontology CNS practice. 

Once the site and preceptor(s) is/are approved, students will contact the preceptor to negotiate workdays and hours. Students should plan for 2 full days/week for the 15 weeks. The student will keep this schedule as part of the professional obligation to the clinical experience.  If for some reason, a student is not able to attend the day’s clinical experience, then both the UDM clinical faculty and preceptor must be notified as soon as possible. Both the assigned UDM clinical faculty and clinical preceptor will be responsible for student guidance, mentoring, and supervision at the clinical site. 

Students must complete a total of 500 supervised hours in the role of the CNS in the program. The only exception is students who transfer in approved hours from a former master’s program following a gap analysis by the Program Coordinator. Approximately 200 hours of clinical during this semester is necessary to fulfill the course requirements.  A MINIMUM OF 24 HOURS SPENT WITH A PRESCRIBING HEALTH CARE PROVIDER IS REQUIRED AS PART OF THE 200+ HOURS EXPECTED THIS SEMESTER.  

The preceptor has volunteered her/his time and expertise to share and enhance the student’s clinical and professional development. They have the right to withdraw from the experience at any time. 

Students must comply with all OSHA, ACE, and health policy guidelines before any clinical hours can begin.  Students need to remain in compliance throughout the clinical practicum.  Failure to comply with these guidelines will result in administrative withdrawal from the course. Students MUST additionally complete any agency orientation requirements. Students may NOT be in clinical when the university is officially closed, i.e., MLK day and Easter Recess.   See also Graduate Clinical Handbook for additional information.  

GRADUATE PROGRAM GRADING SCALE AND GRADING POLICIES

To achieve satisfactory academic progress leading to continued progression, the student must maintain an aggregate grade of B (a university GPA of 3.0).  The MSON Graduate nursing program considers a grade below B- in any of the nursing core courses (NUR rubric) to represent unsatisfactory academic progress. Unsatisfactory academic progress may result in conditional progression, deceleration, withdrawal, probation or dismissal as described below.

Students may be denied progression or be required to do remediation prior to progression if they have not made satisfactory academic progress in their education.  When a graduate nursing student’s cumulative GPA falls below a 3.0 and/or a student earns a grade of less than B- in any of the core nursing curriculum courses, that person is dismissed from the program.

GRADING SCALE:

Percentage	Grade
>93	A
90-92	A-
87-89	B+
83-86	B
80-82	B-
77-79	C+
73-76	C
70-72	D
<69	F

ASSIGNMENTS

1. If a student is unable to complete weekly work, exams or their presentation for an “emergency situation,” it is the student’s responsibility to notify the instructor and negotiate other arrangements BEFORE THE DUE DATE.  Failure to do this will result in a zero score – no exceptions.  All assignments (participation, presentation, exams) must be completed or an “Incomplete” will be issued as the course grade.  Faculty will give student’s feedback on a late assignment, but the score will stand as a zero. 

2. The policies related to Academic Integrity as described in the University of Detroit Mercy Catalogue and the McAuley School of Nursing Graduate Student Handbook regarding academic and professional performance must be adhered to at all times.  Failure to do so will result in probation and/or dismissal.

Content Outline

Modules	Topics	Weekly To Do’s - Clinical
		MODULE 1
Week 1 01/8 - 14	Course Orientation CNS Role	Orientation (Orient with your preceptor on the unit where you’ll be doing your clinicals)
Week 2 01/15-21	Course Objective 1 & 4
		MODULE 2
Week 3 01/22-26	Course Objectives 2, 4, 5 & 6:	Consider ideas for teaching plan, email/call/zoom clinical faculty for ideas or confirmation of ideas. Discuss w your preceptor as well.  Preceptor Interview (Due 1/22)
Week 4 01/29- 4	Course Objective 1,2, 3, & 4	Care Plan #1       due 1/29
Week 5  02/5-11	Course Objective 2, 5 & 6:	Clinical Log #1     due 2/5 Reflection #1 (due 2/5) - (can describe a prescribing experience or regular clinical experience – need to do 1 regular reflection and 1 prescribing reflection by the end of the course)
		MODULE 3
Week 6 02/12-18	Course Objective 1,2 & 3:	Parts 1-15 of teaching project (due 2/12)
Week 7 02/19-25	Course Objectives 2,4,5 & 6:	Plan 3-way Virtual Meeting (Schedule anytime within the next few weeks that works for you and your preceptors)
		MODULE 4
Week 8  02/26 – 3/3	Course Objective 1, 2, 3, 4:	Holistic Plan of Care #2 (choose one of the remaining two body systems) due 2/26 Mid-Term Eval by preceptor due 2/26 Clinical Log #2    due 3/3 Reflection #2      due 3/3 (can pick prescribing experience or regular clinical experience – whichever one you haven’t completed yet)
Week 9 03/4-10 – SPRING BREAK
Week 10 03/11-17	Course Objective 2, 5 &6:	WORK ON IMPLEMENTING & COMPLETING TEACHING PROJECT
Week 11 03/18-24	Course Objective 2, 5 & 6:	WORK ON IMPLEMENTING AND COMPLETING TEACHING PROJECT
		MODULE 5
Week 12 03/25 – 3/31	Course Objective 2, 4, 5, & 6 :	(Easter Break – 3/31 – 4/1)
Week 13 04/1-7	Course Objectives 1, 2 & 3:	Nothing due – work on completing teaching project
Week 14 04/8-14	Course Objective 2, 5 & 6	Holistic Care Plan #3 due 4/8 (Complete the body system you haven’t yet done) Clinical Log #3     due 4/8
Week 15 4/15 - 21	Course Objectives: 1,2, 3, 5 & 6	Work on finalizing all assignments.  Can submit anytime before 4/22
Final’s Week 04/22-28		Final Teaching Project parts 16-26 due 4/22 Final Eval by preceptor due 4/22 Final Clinical Log #4 due 4/22 Preceptor & Site Evaluation due 4/22

Appendices

MSN Program Outcomes	DNP Program Outcomes
1. Demonstrate professional role practice consistent with the competencies of the unique specialty at the master’s level.	1. Engage own professional role practice consistent with the competencies of the Doctor of Nursing Practice.
2. Translate theoretical and conceptual knowledge into advanced nursing practice actions that promote optimal health care quality and patient safety outcomes.	2. Formulate innovative theoretical and conceptual frameworks that ensure optimal health care quality and patient safety outcomes.
3. Integrate informatics, health care technology, and interpersonal collaboration in the delivery of person centered nursing practice for individuals and populations.	3. Translate evidence to produce innovative models of care that integrate informatics, health care technology, and interpersonal collaboration to affect population health, outcomes, and support health care policy initiatives.
4. Engage in systems leadership with a focus on preventive care, policy development, and patient advocacy.	4. Lead health care systems and policy innovation with a focus on preventative care, quality improvement and patient advocacy.
5. Integrate the Jesuit and Mercy traditions in providing culturally competent, compassionate, holistic, and person-centered care with a commitment to human dignity in the contemporary world.	5. Integrate the Mercy and Jesuit traditions in providing culturally competent, compassionate, holistic and person-centered care with a commitment to human dignity in the contemporary world.

The Essentials of Masters and Doctoral Education for Advanced Nursing Practice

http://www.aacnnursing.org/Education-Resources/AACN-Essentials

http://www.aacnnursing.org/Portals/42/Publications/MastersEssentials11.pdf

http://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

NACNS CNS Core Competencies Statement on Clinical Nurse Specialist Education, 3rd edition (2019)
Competency P1	P.1. Uses relationship-building communication to promote health and wellness, healing, self-care, and peaceful end-of-life.
Competency P2	P.2. Conducts a comprehensive health assessment in diverse care settings including psychosocial, functional, physical, and environmental factors.
Competency P3	P.3. Synthesizes assessment findings using advanced knowledge, expertise, critical thinking, and clinical judgment to formulate differential diagnoses.
Competency P4	P.4. Designs evidence-based, cost-effective interventions, including advanced nursing therapies to meet the multifaceted needs of complex patients.
Competency P5	P.5. Implements customized evidence-based advanced nursing interventions including the provision of direct care.
Competency P6	P.6. Prescribes medications, therapeutics, diagnostic studies, equipment, and procedures to manage the health issues of patients.
Competency P7	P.7. Designs and employs educational strategies that consider readiness to learn, individual preferences, and other social determinants of health.
Competency P8	P.8. Uses advanced communication skills in complex situations and difficult conversations.
Competency P9	P.9. Provides expert consultation based on a broad range of theories and evidence for patients with complex health care needs.
Competency P10	P.10. Provides education and coaching to patients with complex learning needs and atypical responses.
Competency P11	P.11. Evaluates impact of nursing interventions on patients’ aggregate outcomes using a scientific approach.
Competency P12	P.12. Leads and facilitates coordinated care and transitions in collaboration with the patient and inter-professional team.
Competency P13	P.13. Facilitates patient and family understanding of the risks, benefits, and outcomes of proposed healthcare regimens to promote informed, shared decision-making.
Competency P14	P.14. Facilitates resolution of ethical conflicts in complex patient care situations.
Competency P15	P.15. Analyzes the ethical impact of scientific advances, cost, clinical effectiveness on patient and family values, and preferences.
Competency P16	P.16. Advocates for patient’s preferences and rights.
Competency N1	N.1. Provides expert specialty consultation to nurses related to complex patient care needs.
Competency N2	N.2. Promotes interventions that prevent the impact of implicit bias on relationship building and outcomes.
Competency N3	N.3. Advocates for nurses to practice to the full extent of their role in the delivery of health care.
Competency N4	N.4. Leads efforts to resolve ethical conflict and moral distress experienced by nurses and nursing staff.
Competency N5	N.5. Fosters a healthy work environment by exhibiting positive regard, conveying mutual respect, and acknowledging the contributions of others.
Competency N6	N.6. Employs conflict management and negotiation skills to promote a healthy work environment.
Competency N7	N.7. Assesses the nursing practice environment and processes for improvement opportunities.
Competency N8	N.8. Uses evidence-based knowledge as a foundation for nursing practice to achieve optimal nurse-sensitive outcomes.
Competency N9	N.9. Mentors nurses and nursing staff in using evidence-based practice principles.
Competency N10	N.10. Leads nurses in the process of planning, implementing, and evaluating change considering intended and unintended consequences.
Competency N11	N.11. Evaluates the outcomes of nursing practice using methods that provide valid data.
Competency N12	N.12. Facilitates opportunities for nurses, students, and other staff to acquire new knowledge and skills that foster professional development.
Competency N13	N.13. Engages nurses in reflective practice activities that promote self-awareness and invite peer feedback to improve the practice of nursing.
Competency N14	N.14. Mentors nurses to analyze legislative, regulatory, and fiscal policies that impact nursing practice and patient outcomes.
Competency O1	O.1. Cultivates a practice environment in which mutual respect, communication, and collaboration contribute to safe, quality outcomes.
Competency O2	O.2. Uses leadership, team building, negotiation, collaboration, and conflict resolution skills to build partnerships within and across systems and/or communities.
Competency O3	O.3. Consults with health care team members to integrate the needs, preferences, and strengths of a population into the health care plan to optimize health outcomes and patient experience within a health care system.
Competency O4	O.4. Leads and participates in systematic quality improvement and safety initiatives based on precise problem/etiology identification, gap analysis, and process evaluation.
Competency O5	O.5. Provides leadership to the interprofessional team in identifying, developing, implementing, and evaluating evidence-based practices and research opportunities.
Competency O6	O.6 Partners with research-focused doctorally prepared (e.g. PhD) colleagues to translate, conduct and disseminate research that addresses gaps and improves clinical knowledge and practice.
Competency O7	O.7. Leads and participates in the process of selecting, integrating, managing, and evaluating technology and products to promote safety, quality, efficiency, and optimal health outcomes.
Competency O8	O.8. Leads and facilitates change in response to organizational and community needs in a dynamic health care environment.
Competency O9	O.9. Evaluates system level interventions, programs, and outcomes based on the analysis of information from relevant sources.
Competency 010	O.10. Demonstrates stewardship of human and fiscal resources in decision-making.
Competency O11	O.11. Disseminates CNS practice and fiscal outcomes to internal stakeholders and to the public at large.
Competency O12	O.12. Promotes nursing’s unique contributions toward advancing health to stakeholders (e.g., the organization, the community, the public, and policy makers).
Competency O13	O.13. Advocates for equitable health care by participating in professional organizations and public policy activities.
Competency O14	O.14. Advocates for ethical principles in protecting the dignity, uniqueness, and safety of all.

UDM ACADEMIC INTEGRITY POLICY: As members of an academic community engaged in the pursuit of truth and with a special concern for values, University of Detroit Mercy students must conform to the highest standard of honesty and integrity in their academic work. The fundamental assumption under which the University operates is that work submitted by a student is a product of their own efforts. Among the most serious academic offensives is plagiarism, submitting the ideas or work of another source without acknowledgment or documentation. The consequences of plagiarism or any act of academic dishonesty may range from failure in a course to dismissal from the university.

COMPLIANCE WITH STUDENT POLICIES :  University of Detroit Mercy students are expected to be familiar with and comply with student-related policies and practices, including those found in the Detroit Mercy Student Handbook. The Student Handbook also contains contact information for the Dean of Students and the Dean of each College/School.

CHP HONOR CODE:  Students in the College of Health Professions at the University of Detroit Mercy are expected to exhibit behaviors that epitomize academic, professional and personal integrity. They are committed to the traditions of the Sisters of Mercy and the Society of Jesus that emphasize values, respect for others, and academic excellence.  Adherence to such high standards is necessary to ensure quality in education and clinical care in all College of Health Professions programs.  A student’s acceptance into a program of the College of Health Professions is conditional upon signing an affirmation of the Honor Code. To view the entire Honor Code copy and paste this link in your browser: http://healthprofessions.udmercy.edu/policies/honor-code/index.htm.  

University-Authorized Absences: The university recognizes that attending class is essential for student learning and engagement. In cases of university-authorized absences for university-sponsored activities, religious observances, or exigent circumstances, instructors shall provide students the opportunity to make up missed work without penalty up to 10% of the course meeting time. Instructors shall determine how students may access, substitute, and/or submit missed work. Students are responsible for all course content and activities missed due to university-authorized absences.

STUDENT SUPPORT RESOURCES:  University of Detroit Mercy has a wide array of support services available for free to all students. We encourage all members of the community to be aware of this list of student support resources — including contact information for reporting incidents or concerns. Students can also refer to the webpage for Current Students. COVID-related concerns, about yourself or anyone else, should be reported through the COVID referral form.

TECHNOLOGY RECOMMENDATIONS: University of Detroit Mercy Information Technology Services (ITS) posts current recommendations for student technology needs—including hardware, software, and internet connectivity—on their website.

IMPORTANT ANNOUNCEMENTS: Important messages will be communicated through Blackboard and/or emailed to your Detroit Mercy email address.

INSTRUCTIONAL CONTINUITY AND CLASS CANCELLATION: Instructional continuity refers to the continuation of instruction during unforeseen campus closure or instructor absence. Should the need to cancel a class session occur, students will be contacted through Blackboard and/or their Detroit Mercy email address. The following procedures will be in place to ensure continuity of instruction in this course: The faculty will send out email announcements via blackboard and the udm email system regarding an updated plan.  Students are responsible for all course material provided through this instructional continuity plan.

DISABILITY AND ACCESSIBILITY SUPPORT SERVICES:  The University of Detroit Mercy is committed to providing equitable access to learning opportunities for all students. The Office of Disability Support Services collaborates with students who have disabilities to arrange reasonable accommodations. If you encounter any barrier(s) to full participation in this course due to the impact of your disability, please contact DSS at the email and number below. Our office will confidentially discuss the barriers you are experiencing and explain the eligibility process for establishing academic accommodations.

Chyelle Pitts-Chatman, Coordinator
Disability Support Services
Student Success Center
Library, Room 319
This email address is being protected from spambots. You need JavaScript enabled to view it.
313-993-1158
https://www.udmercy.edu/current-students/support-services/disability

It is important that if you require an academic accommodation due to a documented disability, emergency medical condition, temporary disability or require special arrangements to be proactive in this process by requesting the accommodations before or at the start of every semester.

TITLE IX SYLLABUS STATEMENT:  Sexual violence and sexual harassment are contrary to our core values and have no place at the University of Detroit Mercy. In accordance with Title IX and related laws, Detroit Mercy prohibits sex and gender-based discrimination including discrimination toward pregnant/parenting students. If you experience sexual violence or sexual harassment that limits your ability to participate in this course or any other Detroit Mercy program or activity, there are resources and options available. Please be aware that I am not a confidential resource, and that I will need to disclose alleged incidents of sex or gender-based discrimination to the university’s Office of Title IX. You may also contact Megan Novell, the Title IX Coordinator, directly by calling 313.993.1802 or emailing This email address is being protected from spambots. You need JavaScript enabled to view it. to learn about supportive measures and options that are available to students alleging or alleged to have engaged in sex or gender-based discrimination.

REPORTING BIAS-MOTIVATED INCIDENTS :  University of Detroit Mercy is committed to fostering a diverse and inclusive environment for students, faculty, and staff. Acts of intolerance, discrimination, or harassment due to age, ancestry, color, disability, gender, gender identity, national origin, race, religious belief, sexual orientation, or veteran status are not tolerated (Discrimination and Harassment Prevention Policy) and should be reported by contacting the Dean of Students.

COMPLIANCE WITH STUDENT POLICIES: University of Detroit Mercy students are expected to be familiar with and comply with student-related policies and practices, including those found in the Detroit Mercy Student Handbook. The Student Handbook also contains contact information for the Dean of Students and the Dean of each College/School.

ACADEMIC INTEGRITY: As members of an academic community engaged in the pursuit of truth and with a special concern for values, University of Detroit Mercy students must conform to the highest standard of honesty and integrity in their academic work. The fundamental assumption under which the University operates is that work submitted by a student is a product of their own efforts. Among the most serious academic offensives is plagiarism, submitting the ideas or work of another source without acknowledgment or documentation. The consequences of plagiarism or any act of academic dishonesty may range from failure in a course to dismissal from the university.

COURSE COPYRIGHT: All course materials students receive or have online access to are protected by copyright laws. Students may use course materials and make copies for their own use as needed, but unauthorized distribution and/or uploading of materials without the instructor’s express permission is strictly prohibited. Students who engage in the unauthorized distribution of copyrighted materials may be held in violation of the Student Code of Conduct, and/or liable under Federal and State laws. In addition, distributing completed essays, labs, homework, exams, quizzes, or other assignments constitutes a violation of the Student Conduct policy.

RELIGIOUS OBSERVANCES STATEMENT:  It is the policy of University of Detroit Mercy to respect the faith and religious obligations of each student. Students with exams and classes that conflict with their religious observances should notify their instructor at the beginning of the semester in order to work out a mutually agreeable alternative. Please note that, regardless of whether an absence is “excused” or “unexcused,” the student is responsible for all missed course content and activities.

BLACKBOARD: In this course we will be using Blackboard for assignments, activities, and/or discussion. Students should have regular access to Blackboard and their Detroit Mercy email. The use of student data in Blackboard conforms to the Family and Educational Rights and Policy Act (FERPA) and information policies of University of Detroit Mercy. Downloading the Blackboard mobile app will also allow you to view content and participate in courses on an iOS or Android mobile device.

RECORDING OF CLASS SESSIONS: Video/audio recordings of class sessions (face-to-face or online) may be recorded for the benefit of students in the class. Recordings will be shared via platforms with access limited to other members of the class. I will attain consent from students if recordings of student comments or images will be shared with a broader audience. Students are prohibited from recording class sessions unless instructor permission has been granted. In the case of ADA accommodations, recordings of class sessions may not be shared or distributed.

IMPORTANT MESSAGES:  Important messages will be communicated through BlackBoard and/or UDM email addresses, assuming such mechanisms are functional and available. This course will not meet (virtually) for any class session when the McNichols campus is closed or classes are cancelled.

ON-LINE PROGRAMS:  Due to continual changes at the state level impacting nursing practice and education, it is the responsibility of all students in an on-line graduate nursing program to confirm if the program meets specific licensure requirements in the student’s state of residence. Students may contact the applicable licensing board at https://www.ncsbn.org/contact-bon.htm

The instructor of the course has the discretion to change the class timeline/schedule and the syllabus at any time (University Policy).

Instructional continuity refers to the continuation of instruction during unforeseen instructor absence. In the rare event of such an occurrence, the course material will be available on-line and the MSON will assign another qualified faculty member to move the content forward and facilitate learning of the stated objectives. Students remain responsible for all course material and deadlines as put forth in the course as any such instructional continuity plan unfolds.

Classroom Conduct during COVID-19: As members of the Detroit Mercy campus community, we pledge to keep one another safe during the COVID-19 pandemic. Please refer to the Titans Together website for up-to-date information regarding policies and safety protocols related to the COVID-19 pandemic. Students who do not follow these policies are violating standards of student conduct and will be subject to disciplinary action through the Dean of Students’ Office. 

Students must follow these safety procedures: 

• Follow current face covering protocol and any additional safety protocol included in the course syllabus. 
• Monitor your health. Stay home if you are not feeling well and contact your instructor about course content you missed. 
• Get tested if you or someone you have been in close contact with has symptoms of COVID-19, such as cough, chills, fatigue, shortness of breath, or loss of taste or smell. For more information on the symptoms of COVID-19, please go to https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html   
• Wash hands and/or use hand sanitizer frequently. 
• Sanitize your personal work/seating area before and after class with university-provided wipes.  
• Do not eat in classroom spaces. 

Students who show symptoms of or test positive for COVID-19, miss class due to illness, or are worried about a potential exposure should complete the COVID-19 referral form or contact the Wellness Center immediately at 313-993-1185. University staff will direct you to testing if necessary and help you find the support you need. 

Date developed: January 2015

Name of developer: Dr. Mitzi M. Saunders

Additional reviewers: Drs’ Molly McClelland, Rosanne Burson, and Kate Walters

Updated: Drs’ Molly McClelland, Karen Mihelich, Mitzi Saunders, & Taylor Long 11/8/22

Updated:  M. McClelland, 12/11/2023