bsn curicullum

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School of Nursing

Queens University

Bachelor of Nursing Science ProgramCurriculum Document

Nov 2004

Revised July 2012


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TABLE OF CONTENTS PAGE

INTRODUCTION 3

PHILOSOPHY 3

I. PROGRAM GOALS 4II. CURRICULAR CONCEPTS: 4

Figure 1: Foundational Curricular Concepts with Sub-concepts 5

Definitions of Concepts 5

III. CURRICULAR CONCEPT MAP 11Legend 11Table 1: Curriculum Concept map 14

IV. References 16


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INTRODUCTION

The Undergraduate Curriculum Committee of the School of Nursing prepared this

document in order for students and faculty to be able to clearly identify how our program

philosophy, goals, curriculum concepts and sub-concepts, curriculum content and theCollege of Nurses of Ontario (CNO) competencies are addressed throughout ourcurriculum.

Philosophy

The philosophy of Queens University School of Nursing is consistent with the missionand vision of Queens University, www.queensu.ca and reflects the nursing faculty belief

that exemplary nursing practice is built upon the foundational blocks of the sciences and

arts. The purpose of the nursing program is to educate individuals to competentlyaddress the health needs of individuals, families, and communities in a variety of

environments. Central to the program are the five core concepts of quality, health, client,environment and transitions.

Nursing is a dynamic profession requiring critical and reflective thinking based on

current scientific rationale, as well as humanistic perspectives. Partnering with

individuals, families, and communities, nurses assist their clients through various lifetransitions, using sound decision-making and therapeutic communication in their

interactions. Competent care requires not only an understanding of bio-psychosocial

processes, but also the socio-environmental and cultural contexts that affect clients,families, and communities.

We believe these approaches to academic excellence prepare practitioners to make caringconnections and allow learners to transition integrating sciences, humanities, and

evidence-based health care into their professional roles as nurses and life-long

learners. We believe students should have the opportunity to learn interprofessionallywith, from, and about each other. Students learn best from role models who foster caring

and inquiry into human transitions from theoretical, practice, and research perspectives.

The philosophy of the Queens University, Bachelor of Nursing Science program isreflected in our understanding of core foundational concepts underpinning the

curriculum. Five core nursing concepts with related sub-concepts provide the foundation

for the curriculum of the B.N.Sc Program (see Figure 1). The curriculum concepts

represent key components of the program goals and are layered within and across theprogram in a curriculum concept map which serves as a framework to situate core content

in a deliberate manner. The threading of the concepts in the curriculum concept mapdemonstrates how students move progressively towards the program goals (see Table 1).


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l. Program Goals

The program prepares graduates to:

Provide safe competent and culturally sensitive nursing service in response tochanging needs of society and according to prevailing legal and ethical standards

Use critical thinking, problem-solving, and scientific inquiry in the practice ofnursing and in monitoring and ensuring quality of health care practices

Communicate effectively in relationships with clients and health professionals Use nursing knowledge and skills in partnership with individuals and families and

other health care professionals to maintain and promote health and well-being and

provide care and support during illness

Use population-based and intersectoral approaches to assess, protect, and promotethe health of communities

Appreciate how specific environments and socio-political conditions affect healthbehaviour, professional practice and public policy

Apply leadership and managerial abilities and political skills to attain quality carefor client and quality of work-life for co-workers Engage in self-directed learning, reflective and evidence-based practice

ll. Curriculum Concepts

The five major nursing foundational concepts are: quality, health, client, environment,

and transitions. Each concept has related sub-concepts which are illustrated in Figure 1.Definitions of the major concepts and sub concepts follow.

Nursing is both an art and a science. It is a preventative, educational, restorative andsupportive health-related discipline/service/activity. Nursing is provided in a caring and

competent* manner for the purpose of enhancing an individuals quality of life, and when

life can no longer be sustained, supporting the dying person. Respect for the dignity,

worth, autonomy and individuality of each human being is inherent in all aspects ofnursing. Nursing is provided in any setting where individuals, families, groups, and

communities are in need of the benefits of nursing. Nurses work both independently and

collaboratively with other health care providers. Nurses meet the ethical and legalrequirements of their profession. Nurses practice life-long learning.

* professional competence is the habitual and judicious use of communication,

knowledge, technical skills, clinical reasoning, emotions, values, and reflection in dailypractice for the benefit of the individual and community being served. (Epstein &

Hundert, 2006)


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Figure 1. Foundational Curricular Concepts with Sub-concepts

DEFINITIONS OF CONCEPTS

QUALITY

Quality:

Qualityconsistsofthedegreetowhichhealthservicesforindividualsandpopulationsincreasethelikelihoodofdesiredhealthoutcomes(qualityprinciples),areconsistentwithcurrentprofessionalknowledge(professionalpractitionerskill),andmeettheexpectationsofhealthcareusers(themarketplace). (Burhans&Alligood,2010;Buttell,Hendler&Daley,2008)Caring

Caring is expressed through an interpersonal interaction between a nurse and client. Thenurse identifies in collaboration with the client their needs for self-maintenance or self-

regulation and assists the client to meet these needs. Nursing-specific interventions are

UndergraduateCurriculum

QualityCaring

Evidence-Informed Decision-Making

Evidence-Informed PracticeInterprofessional Collaborative

PracticeLeadership Health

Disease PreventionHealth PromotionHealth Protection

RehabilitationPatient Safety

ClientCommunity/PopulationDeterminants of Health

Individuals/ FamilyTherapeutic Relationships

EnvironmentCultural Competence

PoliticalPractice Setting

TransitionsDevelopmental

Health and IllnessOrganizational

Situational

Queens University School of Nursing

Foundational Curriculum Concepts


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applied to act for, guide, support and influence environmental conditions to promote the

personal development and health of the client. (Finfgeld-Connett, 2008; Morse, J. 1990).

Evidence-Informed Decision Making

Evidence-informed decision making is a continuous interactive process involving theexplicit, conscientious and judicious consideration of the best available evidence to

provide care. It is essential to optimize outcomes for individual clients, promote healthy

communities and populations, improve clinical practice, achieve cost-effective nursingcare and ensure accountability and transparency in decision-making within the health

care system. CNA (2010). Canadian Nurses Association Position Statement: Evidence-

informed decision making and nursing practice.

Critical ThinkingPracticing the cognitive skills of analyzing, applying standards, discriminating,

information seeking, logical reasoning, predicting and transforming knowledge.

(Martinez de Castillo, 2010).

CreativityA meta-cognitive process that: 1) generates novel and useful associations,

attributes, elements, images, abstract relations, or sets of operations, and 2) better

solves problems, produces a plan or results in a pattern, structure or product notclearly present before. (Fasnacht, 2003).

Evidence-informed practice

Nursing practice is based on various types of evidence, including experimental and non-

experimental research, expert opinion, and historical and experiential knowledge, shaped

by theories, values, client choice, clinical judgment, ethics, legislation, and workenvironments. Evidence-based decision-making is a continuous interactive process

involving the explicit, conscientious and judicious consideration of the best availableevidence to provide care. (Canadian Nurses Association, 2002b, 2010).

Interprofessional Collaborative Practice(IPCP) is designed to promote the active participation of each discipline in patient care.

It enhances patient and family-centred goals and values, provides mechanisms for

continuous communication among caregivers, optimizes staff participation in clinicaldecision making within and across disciplines and fosters respect for disciplinary

contributions of all professionals (Oandasan, 2006). Partnerships: Refers to situations

in which the nurse works with the client and other members of the health care team toachieve specific health outcomes for the client. Partnership implies consensus building in

the determination of these outcomes.

Interprofessional collaborative practice occurs when different health care professions

provide comprehensive services by working with patients, families and communities to


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deliver high quality of care across the settings. (WHO Framework for action on

interprofessional education and collaborative practice. 2010) http://

LeadershipProcess of persuading and influencing others toward a goal, through mostly non-coercive

means; typically composted of a wide variety of roles. (Marquis & Huston, 2006).

HEALTH

Health is a state of complete physical, mental, and social well-being and not merely the

absence of disease or infirmity. It involves the ability to achieve ones potential and

respond positively to the challenges of the environment. Health is seen as a resource for

everyday life not the objective of living.

Disease Prevention

Disease prevention covers measures not only to prevent the occurrence of disease, such

as risk factor reduction, but to arrest its progress and reduce its consequences once

established. Primary prevention is directed towards preventing the initial occurrence of adisorder. Secondary prevention seeks to arrest or retard existing disease and its effects

through early detection and appropriate treatment: tertiary prevention reduces the

occurrence of relapses and the establishment of chronic conditions through, for example,effective rehabilitation.

Disease prevention is sometimes used as a complementary term alongside health

promotion. Although there is frequent overlap between the content and strategies,disease prevention is defined separately. Disease prevention in this context is considered

to be action which usually emanates from the health sector, dealing with individuals and

populations identified as exhibiting identifiable risk factors, often associated withdifferent risk behaviours. (WHO, 1998, p.4)

Health Promotion

Health promotion is the process of enabling people to increase control over, and to

improve their health.

Health promotion represents a comprehensive social and political process. It not only

embraces actions directed at strengthening the skills and capabilities of individuals butalso action directed towards changing social, environmental and economic conditions so

as to alleviate their impact on public and individual health.

World Health Organization 1998, Health Promotion Glossary (Online). Available:

www.who.int/hpr/arcive/docs/glossary.pdf, August 1, 2006


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Health Protection

Those public health activities intended to protect individuals, groups, and populations

from infectious diseases, environmental hazards such as chemical contamination, and

from radiation. (Health Canada, 2002).

Rehabilitation of people with functional limitations or disabilities is a process aimed at

enabling them to reach and maintain their optimal physical sensory, intellectual,

psychological and social functional levels. Rehabilitation provides people with the toolsand resources they need to attain independence and self determination. Adapted from

WHO 2009a.

Patient Safety

Patient safety is the reduction of risk of unnecessary harm associated with healthcare to

an acceptable minimum. An acceptable minimum refers to the collective notions of givencurrent knowledge, resources available and the context in which care was delivered

weighed against the risk of non-treatment or other treatment. (P.15). (World Health

Organization, 2009b).

Is the reduction of risk of unnecessary harm associated with health care to an acceptable

minimum. An acceptable minimum refers to the collective notions of given current

knowledge, resources available, and the context in which care was delivered weighedagainst the risk of non-treatment or other treatment. (Canadian Patient Safety Institute,

2011).

CLIENT

The client/patient/person is the focus of nurses care and with whom the nurse is

engaged in a professional relationship. The client may be an individual, family group,

population or community. An individual is a single human being who may be arepresentative of any stage throughout the lifespan, of any culture, and who is unique and

inherently worthy. Families consist of individuals who are united by ancestry or choice.Groups and populations share common purposes or health needs. A community is a groupof people living in one place, bound by common characteristics and having common

health needs. The client/patient/person is in partnership with the health care team in

consensual determination of desired health outcomes.


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Community/Population: An organized group of persons bound together by ties of

social, ethnic, cultural, occupational origin or geographic location and sharing commoncharacteristics/interests which bind them together, or having common health needs. The

term community (when used to describe a client) does not mean providing care to an

individual in the community. Nursing practice aimed at the community as a client

involves assisting communities to identify, articulate and successfully manage theirhealth concerns. It is concerned primarily with care that is continuing, rather than

episodic. The focus is on the collective or common good, instead of an individuals

health. Population refers to all people sharing a common health issue, problem orcharacteristic. These people may or may not come together as a group (CNA, 2004a).

Determinants of Health

Social determinants of health are the economic and social conditions that influence the

health of individuals, communities and jurisdictions as a whole. These determinants of

health in combination influence health status.CNA (2005). Social determinants of healthand nursing: A summary of the issues.

Individuals: Single human beings throughout the lifespan, including neonates (birth to28 days), infants (29 days to 1 year), children (1 year to 12 years), adolescents (13 to 18years), adults (19-65 years) and elderly adults (65 years and older). Family: People

united by a common ancestry (biological families), acquisition (marriage or contract) or

choice, and their friends.

Therapeutic Relationship: a relationship that is professional and therapeutic and

ensures the clients needs are first and foremost. The relationship is based on trust,respect and intimacy, and requires the appropriate use of the power inherent in the care

providers role. The professional relationship between registered nurses and their clients

is based on the recognition that clients (or their alternative decision makers) are in the

best position to make decisions about their own lives when they are active and informedparticipants in the decision making process. (College of Nurses of Ontario, 2006;

CRNCBC, 2006c).

ENVIRONMENT

Environment surrounds individuals wherever they go and whatever they do; iscomposed of physical, political, economic, sociocultural, and biological components.

(Shookner, Scott & Vollman, 2008). (p. 85).

Environment refers to the external elements that affect the person; internal and external

conditions that influence the organism; significant others with whom the person interacts;and an open system with boundaries that permit the exchange of matter, energy, and

information with human beings. (McEwen & Wills, 2007).

Cultural Competence. Includes, but is not restricted to age or generation;-Cultural competence is the application of knowledge, skill, attitudes and personal

attributes required by nurses to provide appropriate care and services in relation to


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cultural characteristics of their clients. Cultural competence includes valuing diversity,

knowing about cultural mores and traditions of the populations being served and beingsensitive to these while providing care. (CNA, 2004). Promoting Culturally Competent

Care.

PoliticalNurses speak to and advocate for health issues to the public, governments and other

organizations through political action, representation and leadership. (CNA, 2011)

Practice Setting Quality practice settings create and maintain characteristics that

support professional nursing practice, including appropriate professional preparation,

suitable conditions for nursing practice, respect for nurses as responsible decision makersand recognition of professional expertise. (College of Nurses, 2009, Standard of Care:

Ethics, pg 4.)

TRANSITIONS

Transitions Transition in health and illness are a central substantive domain in thediscipline of nursing. Most nursing interactions occur due to disequilibrium or the risk of

disequilibrium caused by real, potential or perceived changes to well-being. Therapeutic

nursing interventions support the client experiencing transitions and reduce associatedrisks.

This field is concerned with the nature, impact, outcome, and management of the

following types of health and illness related transitions: developmental transitions such asbirth, death, and the passage to old age; illness transitions such as the passage to chronic

illness or the experience of a health crises; and finally, transitions through the health care

environment. (School of Nursing, Queens University, 2006).Developmental Transitions

Changes within an individual or a family related to the lifespan of the person in the caseof an individual or to family members in the case of a family. Adapted from Meleis, A

(1994).

Health and Illness Transitions

Changes involved in moving from wellness to illness or from illness to wellness. Adaptedfrom Meleis, A (1994).

Organizational Transitions

Changes within the organizational environment. Adapted from Meleis, A (1994).

Situational Transitions


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Changes in the internal or external environment which affect the life of an individual,family, community or population. Adapted from Meleis, A (1994).

lll.Curriculum Concept MapC = ClinicalCourseT = Theory/Classroom Course

NURSING

A. QUALITY YEARONE

YEARTWO

YEARTHREE

YEARFOUR

Caring 101- T100-T

108-C

202-C206-C

207-C209-T

371-C345-C

370-T325-T

401-T404-T

405-C492-C

Evidence-InformedDecision Making

101-T100-T108-T

207-C202T,C205-T206-C209-T

323-T371-C345-C305-T370-T325-T

401-T403-T404-T405-C414-T492-C

Evidence- informedpractice 101-T100-T 205-T206-C207-C209-T324-T

323-T370-T371-C345-C305-T325-T

401-T403-T404-T405-C414-T492-C

Interprofessionalcollaborative practice

101-T108-T

207-C 371-C345-C

401-T414-T492-C

Leadership 371-C345-C

401-T414-T492-C


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Curriculum Concept Map (continued)

B. HEALTH YEARONE

YEARTWO

YEARTHREE

YEARFOUR

Disease Prevention 100-T108-T

202-T205-T206-C209-T

305-T325-T

404-T405-C492-C

Health Promotion 100-T108-T

202-T,C209-T205-T

370-T325-T371-C345-C

404-T405-C492-C

Health Protection 100-T108-T

206-C209-T

370-T325-T

404-T405-C492-C

Rehabilitation 108-T 205-T207-C209-T

305-T325-T371-C345-C

403-T492-C

Patient Safety 108 202-T205-T206-C207-C209-T

305-T325-T345-C370-T371-C

403-T405-C414-T401-T492-C


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Curriculum Concept Map- Health (continued)

C. CLIENT YEARONE

YEARTWO

YEARTHREE

YEARFOUR

Community/Population 108-T 209-T 325-T 401-T404-T405-C492-C

Determinants ofHealth

108-T 202-T209-T

325-T 401-T404-T405-C492-C

Individual & Family 101-T, C

108-T

202-T

205-T206-C207-C209-T

305-T

325-T345-C370-T371-C

403-T

492-C

TherapeuticRelationships

101-T,C100-T108-T

202-T206-C209-T207-C

371-C345-C370-T325-T

404-T405-C414-T492-C


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Curriculum Concept Map- Health (continued)

D. ENVIRONMENT YEARONE

YEARTWO

YEARTHREE

YEARFOUR

Cultural Competence 108-T 205-T206-C207-C209-T

370-T325-T371-C345-C

401-T404-T405-C414-T492-C

Political 101-T108-T

209-T 370-T325-T371-C345-C

404-T405-C401-T414-T492-C

Practice Settings 101-T 207-C 325-T345-C371-C

401-T404-T405-C414-T492-C


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Curriculum Concept Map (continued)

E. TRANSITIONS YEARONE

YEARTWO

YEARTHREE

YEARFOUR

Developmental 100-T 202-T207-C205-T206-C209-T

305-T325-T370-T371-C345-C

401-T492- C

Health/ Illness 108-T 202-T205-T207-C209-T

305-T325-T370-T371-C

345-C

401-T403-T492- C404-T

405-TOrganizational 100-T 209-T 401-T414-T492- C

Situational 206-C207-C209-T

371-C345-C370-C325-T

401-T492-T


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