Nursing (NURS) 614

Overview

NURS 614 Foundations of Advanced Practice Nursing will examine the advanced practice nursing (APN) recognized by the Canadian Nurses Association, specifically the nurse practitioner and clinical nurse specialist. Topics such as the education and regulation of APNs and the competencies required in each of these roles will be addressed. The determinants of health and concepts related to cultural competence and safety will also be explored as with the community development and primary health care principles.

Outline

NURS 614 consists of 13 weeks grouped into thirteen units.

Unit 1: Models of Advanced Practice Nursing

Unit 1 focuses on nursing models relevant to advanced practice nursing. In looking at selected nursing models you will examine the relevance of these theoretical models to APN practice.

Unit 2: Examining Advanced Practice Nursing Roles

Unit 2 introduces you to the regulation, education, and legislation of advanced practice nurses in Canada. While both health and education are provincial responsibilities, there are a number of national factors that have influenced the development of both educational programs and regulations for APNs.

Unit 3: Clinical Competency

Unit 3 focuses on clinical competencies for the advanced practice nurse. This is a central aspect of advanced practice nursing and APNs must meet a number of competencies in order to be able to practice safely and effectively.

Unit 4: Research Competency

Unit 4 focuses on research competencies for the advanced practice nurse. This is an important aspect of advanced practice nursing as APNs must be able to review findings from up-to-date research to practice effectively and provide the best possible evidence-based care

Unit 5: Leadership Competency

Unit 5 focuses on leadership as an essential component of both CNS and NP practice. Leadership can be enacted in both formal and informal ways and is distinct from being a manager, which requires a different skill set.

Unit 6: Consultation and Collaboration Competency

Unit 6 focuses on consultation and collaboration, both important components of CNS and NP practice. APNs work in teams and thus collaboration with other team members is essential. Consultation is a 'two-way' street with APNs consulting with clinical colleagues to either co-manage or take over care for complex clients. They also act as consultants for clinical colleagues where expert nursing care and knowledge is needed.

Unit 7: Practice Outcomes and Evaluation

Unit 7 has as its focus the evaluation of practice outcomes. It is important to know how effective, efficient, and timely APN practice is, for a variety of reasons, including: costs to the health care system, introduction of additional service providers, and the rationale for creating APN positions throughout the health care system. While NP practice outcomes are well articulated in the literature and practice, the evaluation of CNS outcomes remains somewhat elusive.

Unit 8: Community as Partner

Unit 8 introduces the student to the concept and practice of community as partner. For many students who have worked exclusively in acute care, this concept is a foreign one and understanding the notion of the entire community as the client as well as the partner in care is challenging. Core to understanding how to work within and with the community is understanding that people can identify and resolve their problems. Working in acute care is prescriptive; the client is provided with options perhaps, but these options are provided by 'experts' (nurses, physicians, allied health care providers) who 'know what is best' for the client. Working within and with the community involves supporting the members of that community in creating change in their community, building capacity, and developing the community.

Unit 9: Social Determinants of Health

Unit 9 focuses on the social determinants of health that influence all of us. These are factors that range from the individual (our genetic makeup) to the environment (where we live). The factors just are-they are not something that the individual must attain (a common mistake in understanding that students make). Some may be modifiable (healthy behaviours) while others are not. Understanding these determinants is important to the APN who must consider factors beyond individual characteristics to work with the client/family to improve health and promote motivation to change health behaviours.

Unit 10: Cultural Safety

Unit 10 addresses the issue of cultural safety, an important aspect of providing care to Canadian citizens, new immigrants, and refugee populations. Other than the various Aboriginal peoples who inhabited this country before colonization, we are a nation of immigrants with distinct cultural, ethnic, and religious practices and beliefs that influence our understanding of health and illness. In order to provide good, advanced nursing care we need to ensure that our patients/clients are safe from not just a care perspective but also from a cultural perspective.

Unit 11: Advocacy and Changes

Unit 11 focuses on advocacy and change. Most registered nurses will suggest that they advocate for their clients and encourage change in health behaviours to promote better health and prevention of disease or illness. However, that reflects an individual, or perhaps even a family, approach and this course focuses on communities and populations - the community as partner. This unit will build on the insights and learning from Unit 10.

Unit 12: Ethical Issues in Advanced Practice Nursing

Unit 12 has as its focus the ethical conduct of advanced practice. While the Code of Ethics for APNS is the same as for RNs, the roles and responsibilities of APNSs, especially for NPs who have prescriptive authority, has additional weight. In this unit we will discuss the unique challenges facing the APN in the areas of relationships with industry, medical cannabis issues, and informed consent to treatment.

Unit 13: Role Transition in Advanced Practice Nursing

Unit 13, the last unit in the course, addresses role transition for the newly graduated APN. While your university courses may be over, learning to function in this new capacity can be challenging. This unit links to Unit 1 and it may be helpful to review the readings and postings for that unit before you start your reading for this unit. Role transition can involve something called the imposter phenomenon that can impede successful role transition but mentorship and supervision can be helpful in supporting the novice APN.

Learning outcomes

1. examine characteristics and competencies of advanced practice nurses, including clinical nurse specialist, and nurse practitioners
2. analyze theoretical and research underpinnings of advanced nursing roles
3. discuss competencies of APN including advanced clinical care; research-based practice; clinical leadership; inter-professional practice including consultation and collaboration
4. describe the importance of the evaluation of practice and practice outcomes
5. explore the concept of community as partner including community health development and primary health principles
6. examine the social determinants of health and how they impact on the health of clients
7. describe the importance of cultural competence and humility in clinical care
8. understand the role of the APN as client advocate and change agent
9. explore role transition from RN to APN
10. identify moral and ethical issues that impact advanced nursing practice
11. develop strategies to integrate the concepts of continuing competence and life-long learning in advanced practice nursing roles

Evaluation

The assessment structure for NURS 614 is based on the following course activities, with the percentage weighting of each activity as indicated. Your final grade for the course will be a composite mark based on your performance on these course activities. Please read this ENTIRE section

Activity	Weight
Weekly Conference Participation/Teams Attendance	20%
Assignment 1 – Nursing Leadership	30%
Assignment 2 – Social Determinants of Health and Advanced Practice	30%
Assignment 3 – Content Quiz	20%
Total	100%

In order to pass NURS 614, you must achieve a minimum mark of 70% on conference participation and a minimum combined mark of 70% on the two written assignments. You must also score 70 on the content quiz.

If the minimum mark is not achieved on any of the 3 elements of the assessment structure (conference participation/Team attendance,  written assignments and content quiz), then a failing grade will be assigned for NURS 614.

Weekly Conference Participation/TEAMS Attendance (20%)

Students are expected to post a minimum of once per week: either an original scholarly post with references OR one scholarly response with references. Posts should be 300 words or less. Please note that cutting and pasting material from another source and placing it in your posting without quotation marks is not acceptable. Postings should represent your analysis of the literature and not simply be a quote from another source.

Students are expected to participate in a minimum of THREE out of the five (session number may vary) sessions offered. You can choose to attend the TEAMs sessions in person or if scheduling is an issue there will be 1 asynchronous session.

Assignment 1 Nursing Leadership (30%)

Assignment 1 provides an opportunity for you to examine nursing leadership in more depth. Students will review Leadership Competencies in the textbook and reflect on 4 important characteristics of leadership:

• Emotional Intelligence
• Communication

• Data/Evidence
• Change Management/Change Leadership

Assignment 2 SDOH and Advanced Practice Nursing (30%)

Assignment 2 provides an opportunity for students to focus on a marginalized population and issues with health system access for the chosen population.

• Indigenous
• Inner-City
• Rural and Remote
• LGBT2SQ
• Refugee and Migrant

 Content Quiz (20%)

The content quiz will be available to you during Week 12 of the course, it will be open book and you will not need to have a proctor for this exam.

Materials

eText

Registration in this course includes an electronic textbook. For more information on electronic textbooks, please refer to our eText Initiative site.

Technical Requirements

In order to successfully complete this course, you must own or have ready access to certain computer hardware and software programs. For complete and up-to-date information on the minimum computer requirements required to complete the graduate nursing courses, visit the Centre for Nursing and Health Studies technical site.

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