FACULTY: Peggy Leapley, Ph.D., RN, CS - Office: RNEC 107 - Telephone: 664-3110

CREDITS: Lab 4 (12 50-minute clock hours). Seminar 1 hour (50-minute clock hour).

SELECTED CLINICAL CLINICAL SEMINAR

(including project leadership/management)

WEEK 11 hours 1 hour 1 hour

QUARTER 110 hours 10 hours 10 hours

Definition of Preceptor: A preceptor is a competent, proficient or expert level registered nurse with a special area of expertise who is assigned or volunteers to help a novice or advanced beginner level nursing student. The preceptor guides and facilitates the student through the learning activities required to achieve the clinical course objectives. The preceptor actively participates in the evaluation of a student’s clinical performance, though the final judgment always rests with the faculty member for the course.

Qualifications of Preceptor: The educational level and clinical expertise of the preceptor should be greater than the student. Therefore, the education preparation for preceptors of baccalaureate students should be a BSN or higher degree and for master’s students a MSN or higher degree. The minimal clinical experience expected is two years of full-time employment in the special clinical area. This does not have to be two years with a specific organization. The preceptor must have a clear, current, active RN license in California. A contract must exist between CSU, Bakersfield and the preceptor’s healthcare agency or agency with a health component. The nurse executive or agency executive must agree to the employee serving as a preceptor.

Nomination of Preceptor: A preceptor can be identified by the following people: faculty member, student, self, nurse executive of a healthcare agency or agency with a health component, other preceptor. The preferred method of nomination of a preceptor is to complete the Preceptor Nomination form and submit it to Department of Nursing or the designated faculty member for the course. Nominations can also be made by verbal communication, such as telephone or written communication, such as e-mail, FAX, letter, or note. In these situations the Preceptor Nomination form should be completed by the faculty member or office personnel.

Preceptor Role and Responsibilities:

The preceptor functions as a resource person, facilitator, clinical role model, educator, and consultant to the student. The primary role is to provide a learning environment where the student can meet course and individual learning objectives.

The responsibilities of the preceptor are to:

1. Assist the student by arranging opportunities and resources to obtain learning experience appropriate to the course and individual learning objectives.

2. Assist the student in developing his or her learning objectives. This will include advising the student of possible learning opportunities.

3. Sign the student’s individual learning objectives following negotiation for appropriate learning experiences.

4. Assist the student in his or her orientation to the agency. This includes philosophy, policies and procedures of the agency and expectations of the student. Examples include- dress code, special equipment, emergency situations (fire, disaster, and codes), documentation, charting, medication administration and documentation, access to computer system for nursing documentation and retrieval of information, telephone and facsimile use.

5. Availability during the same schedule as the student. In most situations the student will need to match the preceptor schedule rather than the other way around. In rare situations, the preceptor may designate another agency member to assist the student. Designee must be an RN with sufficient experience to assist the student.

6. Sign the clinical timesheet verifying student attendance.

7. Provide ongoing and culminating evaluation on the student’s performance to the student and the assigned faculty member.

8. Meet with the student during the 5th week (midterm) and 10th week (final, end of term) to discuss and document student achievement or lack of achievement of course and individual learning objectives. This is documented on the student learning contract.

9. Notify the student and faculty member at any time during the course that a course or individual learning objective is not passed or when a student has not made sufficient progress toward reaching an objective.

10. Evaluate the student’s learning, in conjunction with the faculty, based on the course and individual learning objectives.

11. Evaluate the preceptor experience for the course.

12. Evaluate the preceptor orientation.

The descriptions of novice, advanced beginner, competent, proficient and expert are located in Benner, P., Tanner, C.A., & Chesla, C.A. (1996). Expertise in nursing practice: Caring, clinical judgment and ethics. New York: Springer.

QUALIFICATIONS, ROLE, AND RESPONSIBILITIES

Definition of Student: A CSU, Bakersfield nursing student is enrolled in the course and has met the prerequisite and corequisite requirements. A nursing student is at the novice or advanced beginner level (Benner, Tanner & Chesla, 1996). The student has ultimate responsibility for achieving the learning activities required to meet the clinical course objectives. The student actively participates in the learning of clinical performance skills. The preceptor and assigned faculty guide and facilitate the student’s learning and provide periodic and final evaluation of the student’s performance.

Qualifications of Student: The nursing student in Nursing 444 will have completed the beginning nursing courses in the areas of fundamental skills, medical and surgical, geriatric, maternity, pediatrics, and psychiatric/ mental health nursing. All students will have taken or be concurrently enrolled in community health nursing theory. All students must have the CSUB health clearance, malpractice insurance and completed the annual OSHA and CPR requirements. Some students will have completed the community health nursing experience. Some students will already be Registered Nurses. Most students will take the NCLEX (RN licensing examination) upon completion of all baccalaureate degree requirements (BSN graduation).

Selection of Clinical Experience and Preceptor: Students complete an information sheet prior to beginning Nursing 444. The information includes personal data, present and past employment, description and rationale for selected clinical experience and availability to nominate a preceptor. Students are not to have clinical experience in Nursing 444 in the agency where they are employed. This is to avoid role confusion between a student role and an employee role. Students are not to be paid for the clinical experience of Nursing 444.

A preceptor can be identified by the following people: faculty member, student, self, nurse executive of a healthcare agency or agency with a health component, other preceptor.

Student Role and Responsibilities:

The primary role of the student is to develop professional skills with an emphasis on clinical and leadership/management. The student’s focus is on learning activities to meet course and individual learning objectives.

The responsibilities of the student are to:

1. Prepare a learning contract with individual learning and course objectives, based on consultation and negotiation with the preceptor and assigned faculty.

2. Assure that signatures are obtained for the learning contract by the second week of the quarter and final signatures by the tenth week of the quarter.

3. Function within the framework of the assigned agency.

4. Participate in the orientation to the agency. This includes philosophy, policies and procedures of the agency. Examples include- dress code, special equipment, emergency situations (fire, disaster, and codes), documentation, charting, medication administration and documentation, access to computer system for nursing documentation and retrieval of information, telephone and facsimile use.

5. Develop a clinical experience schedule that matches the preceptor’s schedule and meets the required number of clinical hours without doing more than 16 hours in any one week. Observation related to the clinical objectives can be included in the schedule but are limited to eight hours or less for the entire quarter.

6. Assure preceptor’s signature on the clinical timesheet for each occasion of clinical experience.

7. Arrange for ongoing and culminating evaluation by the preceptor and the assigned faculty member.

8. Meet with the preceptor during the 5th week (midterm) and 10th week (final, end of term) to discuss and assure preceptor documentation of the achievement or lack of achievement of course and individual learning objectives. This is documented on the student learning contract.

9. Notify the preceptor and faculty member when not making sufficient progress toward reaching an objective or failing an objective.

10. Notify the preceptor and the assigned faculty member whenever an incident report is completed based on student error for a patient assigned to the student, such as a medication error or patient fall.

11. Notify the preceptor and assigned faculty member whenever a change in the clinical schedule is necessary, or clinical absence occurs. Notification of absence is to be made as early as reasonable and follow the Department of Nursing excused absence policy.

12. Maintain regular communications with the preceptor and assigned faculty member.

13. Provide opportunities for the preceptor and faculty to evaluate your progress in meeting individual learning and course objectives.

14. Evaluate the agency, preceptor and faculty member using the university and department provided forms.

15. Meet the requirements of the course through completion of course assignments.

The descriptions of novice, advanced beginner, competent, proficient and expert are located in Benner, P., Tanner, C.A., & Chesla, C.A. (1996). Expertise in nursing practice: Caring, clinical judgment and ethics. New York: Springer.

Definition of Faculty: An employee of CSU, Bakersfield and employed within the Department of Nursing. The nursing faculty member has to meet the university and department requirements for educational and clinical experience. A faculty member is at the competent, proficient or expert level (Benner, Tanner & Chesla, 1996). The faculty has ultimate responsibility for identifying clinical course objectives, course assignments and evaluation of students. The nursing faculty facilitate the learning environment for the student through coordination with the agency and the preceptor. The preceptor and assigned faculty guide and facilitate the student’s learning and provide periodic and final evaluation of the student’s performance. The faculty member retains ultimate responsibility for the evaluation of the student.

Qualifications of Faculty: Nursing faculty meet the educational, clinical and scholarly expectations of the university and department. Each nursing faculty must have a current, active and clear California RN license, meet expectations of the CSUB Department of Nursing health clearance, and have completed the annual OSHA and CPR requirements. Each nursing faculty member has an area of clinical expertise that is approved by the California Board of Registered Nursing. Some faculty have a California Public Health Certificate and some have national certification in a clinical specialty area. Some faculty are approved by the California Board of Registered Nursing as Nurse Practitioners and /or Clinical Nurse Specialists.

Selection of Nursing Faculty: Nursing faculty are assigned to courses based on their teaching and clinical experience. Faculty assigned to Nursing 444 will have a broad range of clinical experience but the primary focus will be medical, surgical, and community health nursing.

Selection of Clinical Experience and Preceptor: The nursing faculty in Nursing 444 have the ultimate responsibility for assignment of students to the clinical area and selection of preceptors. Based on the student’s information sheet and ranking of technical skills, availability of preceptors, agency agreement and contract, and consideration of the overall number of students assigned to an agency and area, the Nursing 444 faulty will assign each student to a clinical experience. Students will not be assigned to an agency or clinical area where they are employed.

A preceptor can be identified by the following people: faculty member, student, self, nurse executive of a healthcare agency or agency with a health component, other preceptor. Preceptors are assigned by the Nursing 444 faculty. In most cases a preceptor will only have one student assigned in a quarter. Preceptors must have completed the preceptor orientation and sign the preceptor agreement form.

Faculty Role and Responsibilities:

The primary role of the faculty is to plan the course, facilitate a learning environment for students, evaluate students in collaboration with the preceptor, and evaluate student assignments. The faculty’s focus is on assuring student learning activities to meet course and individual learning objectives.

The responsibilities of the faculty are to:

1. Prepare the course syllabus, including course objectives and assignments.

2. Obtain student information sheets for each student planning to take Nursing 444.

3. Provide an orientation for preceptors.

4. Assure that the University has a contract with each selected clinical agency.

5. Collaborate with agency administration in student clinical placement.

6. Assign students to the clinical experience.

7. Assign a preceptor for each student in Nursing 444.

8. Provide an orientation for nursing students.

9. Provide guidance in the student selection of individual learning objectives.

10. Facilitate ongoing and culminating student evaluation by the preceptor.

11. Communicate regularly with the preceptor and student.

12. Notify the preceptor and student when the student is not making sufficient progress toward reaching an objective or failing an objective.

13. Visit the clinical agency on a regular basis to observe the student’s performance and discuss progress with the student and preceptor.

14. Notify preceptors and students of any faculty absences and the designated faculty during the absence.

15. Arrange for another agency and preceptor if it is determined that the learning environment is not suitable for a student to obtain individual learning or course objectives.

16. Evaluate the agency, preceptor and student using the university and department provided forms.

17. Grade student assignments and provide written evaluation for each student based on the quality of the assignment.

18. Assign the final course grade to each student.

The descriptions of novice, advanced beginner, competent, proficient and expert are located in Benner, P., Tanner, C.A., & Chesla, C.A. (1996). Expertise in nursing practice: Caring, clinical judgment and ethics. New York: Springer.

1. Students are to do their clinical experience in a hospital (agency) other than where they are employed. This is necessary to ensure that the student remain in a student role rather than that of an employee. It is the student’s responsibility to notify faculty of any employee role conflict.

2. Under no circumstances are student to be paid for the clinical experience.

3. Students are to do no more than 16 hours of selected clinical experience per week.

4. Clinical experience can include some observation but the major focus of the course is on student application of the leadership/management and clinician roles in a selected clinical area. Observation should be limited to eight hours or less for the entire course.

5. Selected clinical experience is scheduled to correspond to the preceptor’s schedule.

6. Faculty are available by telephone, e-mail and pager communication. In cases of faculty absence, telephone message will indicate an alternative available faculty member.

7. Faculty make rounds to the clinical settings to talk with students and clinical preceptors. Students are expected to be in the clinical setting on the days and times specified in the information submitted to faculty. If any change or variation in the schedule occurs, faculty must be notified to avoid an unexcused absence should faculty visit the setting according to the schedule and not find the student present.

8. Students are to contact the supervising faculty by telephone, e-mail or pager to notify the faculty of any changes in their schedule, absences, clinical problems, or need for faculty at the agency during the clinical hours.

There are four graded assignments and five pass or fail assignments due during the quarter:

Assignment % Final Grade Due Date

1. Written Notice to Faculty of Pass-Fail Conference-2nd week

Clinical and Project Schedule and

Calendar of Clinical Hours (App. A)

2. Learning Contract/Clinical Pass-Fail Conference-2nd week(submitted)

Course Objective (App. B)

(including individual learning

objectives

3. Clinical Evaluation/Learning Pass-Fail Conference-last week(completed)

Contract

4. Timesheets (App. C) Pass-Fail Submitted at conference on

week 3, 6 and 9

Submitted by last day of quarter (completed)

5. Clinical Conference and Seminar 10% See schedule

participation (App. D)

6. Response/Reflection 45% Submit by 3rd, 6th and 9th weeks Communications(App. E) of quarter

7. Written Report of the 30% Conference and seminar - week 8

Leadership/Management Project

(App. F and G)

8. Verbal Report of the 15% Date, time, location and group

Leadership/Management Project to be arranged by student and

(App. H) approved by faculty must occur prior to week 9

9. Pass RN license examination

(NCLEX) or acceptable nationally Pass-Fail Submitted by last day

normed test(Mosby RN of quarter

Assess Test)

For a detailed discussion of the requirements for each assignment, see the appendixes noted parenthetically above.

No later than the second conference and seminar, each student should submit to the faculty a written notice of the clinical agency setting, clinical hours, preceptor at the selected clinical site and the telephone number where the student may be reached in the agency. In addition, for the project component of the course, each student shall identify the project setting, project title, contact person and telephone number, and the names of all the students contributing to the group project. The notice shall be submitted by completing Appendix A. A passing grade is assigned for completing and submitting Appendix A with complete information, approval signatures, and following N444 course requirements no later than the second conference and seminar. A failing grade is assigned if Appendix A is not complete and/or not submitted.

Each student shall develop a written learning contract for the selected clinical experience. Students are to add their individual learning objectives to the course objectives (Appendix B). The contract will identify the student’s individual learning objectives and the outcome criteria by which the student, preceptor, and the faculty can determine whether the objectives have been met. A minimum of two clinical skill objectives and two management/leader skill objectives must be included in the individual learning objectives. The content of the contract must be negotiated by the student with the preceptor and the faculty. The learning contract must be signed by the preceptor and submitted to faculty no later than the second clinical conference and seminar.

The student, preceptor, and faculty shall each receive a signed copy of the contract. The student is accountable for ensuring that the contract is signed and copies are received by the preceptor and the faculty by the due date.

Students are not to start the clinical practice prior to the faculty’s approval of the learning contract, but can start clinical orientation.

The contract (course objectives and individual learning objectives) will serve as the Pass-Fail evaluation tool for the student performance in the selected clinical experience portion of the course.

A passing grade is assigned to the learning contract for completing and submitting Appendix B (including individual learning objective) to the assigned faculty no later than the second conference and seminar. The individual learning objectives must meet the requirements described in the syllabus and be at senior baccalaureate nursing level. To achieve a passing grade, the student must meet criteria level 3, 4, or 5 for the course objectives and individual learning objectives.

The learning contract will be evaluated by the faculty and the preceptor in the clinical setting. Students will be held accountable for obtaining a completed and signed learning contract

(Appendix B) from the preceptor and submitting it to faculty by last conference and seminar. NO GRADE will be given for the course UNTIL the student submits a completed learning contract signed and dated by the preceptor.

The date, initial, and pass/fail section of the learning contract is to be completed by your preceptor at the selected clinical site. The student is to notify the preceptor when an objective has been met and obtain the necessary documentation (date, initial of preceptor, and either pass or fail indication).

The typewritten format for the learning contract is in Appendix B. The learning contract includes the individual learning objectives and the clinical course objectives.

In order to receive a passing letter grade for the course, the student must receive a "pass" grade on each item of the learning contract (clinical course objectives and individual learning objectives). If a student receives a "fail" grade on any item, he/she has failed the course regardless of other grades earned. Students will be evaluated in the clinical area on preparedness and performance of skills, patient care, communication skills, and written requirements.

The clinical timesheet is located in Appendix C. At the end of each day of selected clinical experience, the timesheet is to be signed by the preceptor in your clinical area. Submit the timesheet at the conference on week 3, 6 and 9 of the course. Failure to submit your timesheet as required can result in a failure of the course. In order to receive a passing grade, the clinical cumulative hours must total 110 hours by the last day of the quarter.

The absence policy for the Department of Nursing will be in effect. All excused absences over 12 hours must be made up before the end of the quarter. Notify the preceptor and faculty of any clinical absence before you are due at the clinical site. All unexcused absences must be made up before the end of the quarter. Any unexcused absence can result in a failure of the course.

The clinical hours are based on 50-minute clock-hours. Students are expected to take their breaks and meal-time accordingly.

The response/reflection communications shall be submitted to the assigned faculty by the clinical conference and seminar of the 3rd, 6th and 9th week of the quarter.

Each submission shall include the following information: student name and date of submission.

Literature Review Responses/Reflections: One review of literature per week for a total of 8. The literature review must be related to your selected clinical experience or leadership/management project. One of the articles reviewed must address an ethical dilemma/issue or an ethical case study. Two of the articles must be research based. Textbooks are not sufficient to meeting this requirement. Submit two communications by the 3rd week of quarter, three communications by the 6th week of quarter and three communications by the 9th week of quarter.

Clinical Responses/Reflections: Clinical communications must include observation and reflection on your progress toward course objectives through the clinical experience. Problems and successes should also be reflected in your communications. It is a major form of communication between you and the faculty. All clients should be referred to by use of initials in order to maintain confidentiality. In your clinical communication, identify ethical, legal, economic, and political issues related to your experience. You are to include current media (newspaper, articles, magazines) when responding to the issues related to your experience. It is expected that you will write a response/reflection communication following each clinical experience.

Leadership/Management Project Responses/Reflections: Project communications include observation and reflection on your progress toward course objectives through conduct of the project. Includes problems, successes, quandaries. Include the time spent on the project. It is expected that you will write a response/reflection communication for each week of the quarter.

Grading is 15% for literature review, 15% for clinical and 15% for leadership/management project responses/reflections. Grading is based on the quality of the writing (grammar, spelling); demonstration of critical thinking/evaluative ability; identification of legal and ethical responsibilities, and demonstration of advanced beginning clinical knowledge. Communications are expected to be at a professional colleague level. Communication with the assigned faculty is a major responsibility of each student. Lack of regular communication can result in failure of the course.

LEADERSHIP/MANAGEMENT PROJECT:

1. The leadership/management project is a group accomplishment. These groups can consist of 3-5 students. Exceptions to the number of students in a group may be made with permission of faculty. A peer evaluation will be used to determine the extent of participation within the group. Based on the "within group peer evaluation" score, the individual student’s written assignment grade will be adjusted. The "within group peer evaluation" score adjustment is as follows:

A = no change in grade

B = minus 4 points

C = minus 8 points

D = minus 12 points

F = minus 16 points or no credit for the assignment

2. An outline of the proposed project must be submitted for approval to the supervising faculty prior to the planning. Approval must be received from the agency and/or unit to implement the project. This approval must be submitted to the supervising faculty.

3. The project must be based on a needs assessment conducted by the students or by the agency. The planning, implementation, and evaluation phases of this project must be competed by the end of the quarter in which the student is enrolled.

4. Examples of possible project topics are attached. Discussions about the project will occur during some of the conference and seminar sessions.

5. A verbal report of the project is made to an appropriate group of nurses. If appropriate, the group could include interdisciplinary members. The supervising faculty approves the group, date, time and place for the verbal report.

WRITTEN REPORT OF THE LEADERSHIP/MANAGEMENT PROJECT

Each student shall implement a leadership/management project during the quarter. A paper derived from this project will be due no later than the 8th conference and seminar of the quarter. The grade for this report will constitute 30% of the course grade. The evaluation criteria for the project written report is in Appendix F.

Students are expected to complete or assist with a needs assessment, implement the project and evaluate its effectiveness. This project will be based on a proposal submitted to and approved by the agency concerned, the agency preceptor and the supervising faculty. The proposal may be modified, in consultation with the faculty, to fit within the time frame of the professional nursing practicum.

Students will collaborate on this particular project. When students collaborate, the final product shall reflect the efforts of each group member. It is advisable that group members maintain close editorial control over one another’s work to avoid disappointments if one or more members submit work of a lesser quality than is expected. Appendix G is the within group peer evaluation. This is submitted by each student in a sealed envelope with the paper. Student comments are necessary to support ratings of "limited" or "no evidence."

The final project report shall be written in standard project format. (See guidelines in the Suggested Outline for Written Project Report and Grading Considerations.)

Submit 2 copies of the paper (if you want one back) and a copy of each reference cited (including specific page from books with the source clearly identified.) There is no need to submit copies of references from the required texts. Papers will not be graded and treated as late papers until a copy of each cited reference is submitted. Submit all documents in a single folder/envelope. Five percentage points will be subtracted for every day the paper is late.

TITLE

Abstract

INTRODUCTION

Assessment of the problem

Background and significance of the problem identified

Purpose of the project

Goal of the project

REVIEW OF THE LITERATURE

Review of appropriate journals and research relevant to the identified problem

Synthesis of the literature review

METHODOLOGY

Assessment of need

Diagnosis of problem

Project Plan

Goals

Objectives

IMPLEMENTATION

Barriers

Positive Aspects

Group member responsibilities

EVALUATION

Effectiveness of Project

Goal achievement

Specific results and findings

Conclusions

RECOMMENDATIONS

IMPLICATIONS FOR NURSING ROLES (Clinician, Educator, Researcher and Leader)

REFERENCES

APPENDICES

Approvals (agency, resource person, faculty)

Timelines

Gantt charts

Tools

Evaluation form

The criteria for grading of the verbal presentations is in Appendix H.

The following are considerations and inclusion criteria for the evaluation of the verbal presentation.

1. Title of project, introduction of group members, and problem identification.

2. Summary of review of literature.

3. Methodology

4. Implementation

5. Evaluation

6. Recommendations

7. Implications for Nursing Role

8. Clarity of information and organization of material

9. Handouts

10. Professional appearance and behavior of students

11. Students’ ability to answer queries from audience

1. Have an abstract handout available for those attending presentation. Include the title and names of the students on the abstract.

2. All students must be present and participate in the verbal presentation.

3. Include time to answer questions of those attending.

A culminating expectation of the baccalaureate of nursing program is that each student can demonstrate the ability to successfully pass the RN license examination (NCLEX). This can be demonstrated by two methods.

1. Providing a copy of a valid, active California RN license. Other state RN licenses will also be accepted.

2. Passing the Secured Mosby RN Assessment test with a percentile ranking of 33 or above relative to RN norm group. Other nationally normed test will be accepted on an individual basis if taken within the previous six months. For other tests, the assigned faculty will set an equivalent percentile ranking for passing.

There are four comprehensive tests. Each test consists of 75 questions. Clinical and seminar conference two and four will be used for the test. You will need to plan to come either one hour early or one hour after the conference/seminar time so that two tests can be completed on each day.

Costs for all four comprehensive tests is $35.00. Checks to CSUB are due on the date of the first test.

The NCLEX-RN Test Plan is on reserve in the library.

If you do not attain a percentile ranking of 33 or above on the test, you must retake the test on your own time. The dates faculty are available to give the tests a second time will be arranged between the faculty members and the students. An additional cost of $35.00 will be necessary for students needing to retake the test.

If you do not demonstrate the ability to successfully pass NCLEX, you will receive a grade of C- or below(not passing) for Nursing 444.

Selected Clinical Experience

Students can have no more than 12 hours of excused clinical absence from their selected clinical experience. Students are to notify the faculty covering for the designated time period and also notify the preceptor or their designee at the selected clinical site. The student needs to obtain a faculty signature on their clinical time sheet for the excused absence. Unexcused absences are not acceptable and may result in failure of the course. Excused absences in excess of 12 hours and all unexcused absences must be made up by the last day of the quarter. Arrangements for making up for clinical hours is at the discretion of the faculty and preceptor.

A 93-100 C 73-76

A- 90-92 C- 70-72

B+ 87-89 D+ 67-69

B 83-86 D 63-66

B- 80-82 D- 60-62

C+ 77-79 F 59 or below

A grade of C (73) or better is required to pass a nursing course.

Objectives: To enable the student to:

Apply the steps of the management process

Analyze the ways that time can be managed

Compare activity time needs in relation to available time resources

Determine productivity of workers

Evaluate non-productive time use

Activities: The time management project will take place in any health care facility. The student will work with a nurse-manager preceptor on any of the following projects:

The use of a manager’s time: analysis of interruptions, how priorities are set by the manager, how goals are achieved. Tools such as PERT analysis, or Gantt charts may be used. The student should also note the delegation process: how the manager delegates, what projects are delegated, how the delegatee is selected, and how the manager follows the project. Meetings are analyzed through the group process theory. The student(s) will present their findings in a paper that includes strengths and weaknesses of the activities analyzed, and suggestions for improvement of time management processes addressed.

Objectives: To enable the student to:

Incorporate steps identified in systems theory

Recognize the synthesis of the agency mission into staffing policies

Identify health care and societal trends that influence staffing policies and practices

Activities: Working with a nurse-manager preceptor, the student plans the staffing of a hospital unit, home health unit, SNF, or community health facility. It would be enlightening to analyze the staffing of all of these facilities in order to determine how different patient needs, acuities, and staff skill mix influence staffing decisions. The student would need to analyze variations in the patient census and acuity, determine the average daily census, the average length of stay of patients with various medical diagnoses, the weight of each patient DRG, and note seasonal variations in admissions for particular diagnoses. Note types of care given: hands-on, indirect care, health teaching. The student would need to identify types of patients, needed nursing activities for those patients, and project the time that would be needed to perform those activities.

Nursing Management Process Projects

Objectives: Upon completion of these projects, the student will be able to:

Analyze the culture of a workplace, using a guide formulated from

del Bruno’s article

Discuss the role of organizational environment and culture

Describe organizational structure in terms of organizational theory

Compare and contrast the different types of organizational structures

Discuss the types of interorganizational relationships

Discuss the advantages of participative management styles, such as shared

governance

Suggested activities:

Culture Analysis:

The student, with a nurse-manager preceptor would formulate a questionnaire to distribute to the staff of a health care organization or organizations. This questionnaire could incorporate questions that would include the work, the environment, and the relationships between staff.

Organizational Structure:

The student(s) analysis of the organizational chart in order to identity relationships between staff and management.

Organizational Theory:

The staff and management attitudes toward change, both overt and covert can be analyzed. As the student works with the preceptor, values and beliefs of the institution would be formulated, using the philosophy and mission statements of the institution. The student would need to determine how these values and beliefs were derived from our larger society, and how these beliefs influence the health care services offered to the community. Several students or groups of students could work in several agencies, then compare their results to see how the philosophies and care offered by these agencies differ. Is the management of the organization best described by Weber, (bureaucracy); MacGregor (X & Y); Simon (Economic man or administrative man), etc.

Leadership Styles:

Leadership styles of the various managers can be analyzed, either through observation, staff feed-back, or self-analysis of the manager, using a questionnaire such as the Firo-B. The cognitive styles of various managers could be analyzed -- how does the manager problem solve, think, perceive, remember? Resource: (Witkin, H.A., Goodenough, D.R. (1982). Cognitive styles: Essence and origins. New York: International Universities Press.) The student(s) can compare the styles of overall leadership and management with existing management styles (MBO, shared governance, etc.) The student could formulate a plan to introduce a participative style, such as a shared governance, into an organization.

The role of licensing and accreditation agencies, such as state health departments, or JCAHO can be incorporated into the overall analysis of an organization.

The agency activities can be analyzed according to: clientele (demographics and use patterns), agency services (type, scope, depth, stages of care), research activities of the agency (funding, approval process, who participates in these activities), educational programs, and power structure (analysis of the formal structure, sociograms, impact of power.)

The student(s) can take note of acceptance of the expanded nursing role in the facility (nurse practitioner, clinical nurse specialist). How much influence or authority do these nurses have in the hospital or community agency?

Objectives: At the end of this project, the student would be able to:

Describe the recruitment and selection process

Explain job analysis

Discuss legal issues in hiring

Analysis of the interview process

Activities: Working with a nurse-manager preceptor, the student will participate in an analysis of the steps in hiring and orienting new staff.

Recruitment and Selection:

Several students can work with different health care organizations such as an acute care hospital, SNF, or community health agency. With the preceptor, the student will need to perform a job analysis. From this analysis, an interview guide will be planned. IF the preceptor is willing, the student could be present at actual job interviews, or could analyze interview with the preceptor. The decision-making process would be discussed. Possible decisions such as to select a certain applicant, reopen the search, or train someone in-house for the position would be considered. Questions for the student to consider: How did the opening come about? What were the qualifications of the person who held the job before? Is this a new position? How and why was it created? Are there influences, such as personality or dress, that influence the outcome of the interview? How is a "match" between the organization and the applicant determined? How is the job advertised?

Objectives: Upon completing this project, the student will be able to:

Describe Quality Improvement

Discuss nursing’s role in quality improvement

Formulate indicators and outcome standards for study

Activities: The student, working with a nursing CQI manager or group, will analyze the nursing standards formulated for a health care institution. The student will: identify a suitable topic for a patient care CQI study. Working with all those involved with the care (pharmacy, medicine, RT, PT, etc.), at least three criteria will be formulated with outcome standards. The group will agree on how the study is to be conducted and then the student, working always in cooperation with the other providers, will conduct the study over a designated period of time and report the findings and proposed corrective actions to the appropriate committee. The student could also work as a facilitator to assist with corrective actions (system corrections, staff education, etc.)

Steps would need to be taken to assure confidentiality of all findings and outcomes.

NURSING 444, PROFESSIONAL NURSING PRACTICUM

APPENDIX A

WRITTEN NOTICE TO FACULTY OF CLINICAL AND PROJECT

SCHEDULE AND CALENDAR OF

CLINICAL HOURS

 

STUDENT NAME: ___________________________________________________________

STUDENT TELEPHONE # : Home: ___________________ Other: ___________________

CLINICAL SETTING:

Unit Within the Agency: ___________________________________________________

Unit telephone number: ___________________________________________________

Name of Preceptor: _______________________________________________________

Clinical Hours: __________________________________________________________

(A calendar of clinical hours may be attached if day and time vary.)

PROJECT SETTING:

Project Title __________________________________________________________

Project Location __________________________________________________________

Approvals:

1. Agency ____________________________________ Date approved _____________

Telephone # ______________________

2. Resource Person ____________________________ Date ____________________

Telephone # _______________________

3. Faculty ___________________________________ Date ____________________

Names of all student collaborating on project _________________________________________

___________________________________________________________________________

___________________________________________________________________________

Verbal report of the project:

Group _______________________________

Date/Time ____________________________

Location _____________________________

Student/Name _____________________________ Instructor ____________________________

Course __________________________________ Date ________________________________

Evaluation will be based on the degree to which the student meets the course objectives as they are delineated by the criteria state in this evaluation tool.

A. To achieve a passing grade, the student must meet the criteria in one of the following ways:

5. Independent performance:

Performance safely and accurately each time without supportive cues from preceptor or instructor. Demonstrates dexterity and spends minimal time on task.

Focuses on client.

Applies theoretical knowledge each time.

4. Supervised performance:

Performs safely and accurately each time, requires supportive cues occasionally during performance of tasks.

Demonstrates coordination, and spends reasonable time on task.

Focuses on client with some focus on task.

Applies theoretical knowledge with occasional cues.

3. Assisted performance:

Performs safely and accurately each time, requires frequent supportive and occasional directive cues.

Demonstrates partial lack of dexterity.

Focuses primarily on task or own behavior, not on client.

can identify principles but needs direction to coordinate with application.

B. A student fails the objectives if any of the following are indicated:

2. Provisional performance:

Agreement to learning contract:

Date ____________________ _________________________________________

Student

Date ____________________ _________________________________________

Preceptor

Date ____________________ _________________________________________

Faculty

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Completion of learning contract:

Date ____________________ _________________________________________

Student

Date ____________________ _________________________________________

Preceptor

Date ____________________ _________________________________________ Faculty

________________________________________ Quarter _______ Year ______

Student Name

__________________________________ _______________________________

Agency Preceptor

*One ethical dilemma/issue or case study. Two research based.

Names of Project Group Members: ________________________________________________

___________________________________________________________________________

Title of Leadership/Management Project: ____________________________________________

___________________________________________________________________________

1. Introduction: assessment of the 15

problem, background & significance

of problem, purpose of project & goals

2. Review of the Literature 10

3. Methodology: assessment of need, 15

diagnosis of problem, project plan

(goals, objectives)

4. Project implementation, identification 15

of barriers, positive aspects, group

members’ responsibilities

5. Evaluation: effectiveness & project, 20

goal achievement, results & findings,

conclusions

6. Recommendations 5

7. Implications for Nursing Roles 10

8. References & Appendices 10

9. APA format: problems with spelling

errors and grammar will result in

deductions of up to 100 points

___________ ___________

TOTAL: 100

Note: Plagiarism will result in an F for the paper and the course grade

Title: ______________________________________________________________________

Date of Evaluation: ____________________ Name of Evaluator: ______________________

Names of other members of your group: ___________________________________________

__________________________________________________________________________

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Rating: 4 = Consistently outstanding Grading: 27-32 = A (no change)

3 = Usually very good 26-21 = B (minus 4 points)

2 = Average 15-20 = C (minus 8 points)

1 = Limited 9-14 = D (minus 12 points)

0 = No evidence 0-8 = F (minus 16 or no credit)

GROUP HEARING PRESENTATION: __________________________________________

NAMES OF GROUP MEMBERS: ______________________________________________

TITLE OF PRESENTATION: _________________________________________________

_________________________________________________________________________

DATE: ________________________ LOCATION: ____________________________

1. Title, introduction, problem identification 10

2. Summary of Review of Literature 5

3. Methodology 10

4. Implementation 5

5. Evaluation 10

6. Recommendations 10

7. Implications for Nursing Roles 10

8. Clarity of information and organization 10

of material

9. Handouts 10

10. Professional appearance/behavior of students 10

11. Ability to answer questions 10

_________ _________

TOTAL 100

COMMENTS: