NORTHERN ARIZONA UNIVERSITY COLLEGE OF HEALTH …Stetina (Undergraduate) and Barbara Tomlinson...

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NORTHERN ARIZONA UNIVERSITY

COLLEGE OF HEALTH AND HUMAN SERVICES

SCHOOL OF NURSING

Global Learning Initiative

Final Addendum Report, May 30, 2013

Prepared by: Karen A. Plager, GLI Team Leader

Introduction

This document constitutes the final report for Global Learning Initiative (GLI) process in

the School of Nursing (SON). An extensive interim report was submitted in July 2012

that documented the first year and a half of work that the SON-GLI team completed in

collaboration and cooperation with the full nursing faculty. A Global Health (GH)

conceptual strand was added to the SON Philosophical and Organizing Framework in

order to integrate the 3 learning themes (global engagement, diversity education, and

sustainable environments) of the GLI into the SON program curricula. As per the interim

report there were 3 parts of the process yet to complete as follows:

1. Undergraduate programs: to integrate GH-related learning activities and

assessment strategies into the undergraduate courses that meet the 3 learning

themes of the GLI;

2. Graduate program: to complete development of GH-related student learning

outcomes for master’s level courses and integrate appropriate learning

activities and assessment strategies into the courses, again, that meet the 3

learning themes of the GLI;

3. Program evaluation: to develop programmatic level assessment strategies to

measure student learning of the GH strand learning themes of global

engagement, diversity education, and sustainable environments.

Process

The SON Faculty completed these final steps of the process during AY 2012-2013.

Members of the GLI Team sit on various faculty committees and worked diligently with

faculty to coordinate these remaining steps and see the process through to fruition. The

GLI Team members on SON committees are as follows: Sue Neder is a member of the

Undergraduate Committee, Enid Rossi is a member of the Graduate Committee, and

Donna Sutton chairs the Program Evaluation Committee. The team members worked in

coordination with the faculty who serve as chairs of these committees, including Pam

Stetina (Undergraduate) and Barbara Tomlinson (Graduate). As well SON faculty who

teach the undergraduate and graduate level courses each contributed to development of

course level students learning outcomes and developed learning activities and assessment

strategies for their respective courses related to the GH strand themes as was appropriate

for each particular course.

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Undergraduate and Graduate (Masters) Course Learning Activities and Assessment

Strategies

Each program of study (3 undergraduate and 2 masters) addresses the GLI learning

themes through incorporation of learning outcomes with relevant learning activities and

assessment strategies woven into the appropriate courses. Not every undergraduate or

graduate course, however, has one or more GH learning outcomes related to the 3 GLI

learning themes. See Exhibits A and B.

Programmatic Assessment Strategies

Program Evaluation has developed benchmarks for measurement of the programmatic

terminal outcomes for each level of our nursing programs. This document is still in draft

form and is expected to be approved by the full Nursing Faculty at the Welcome Back

Faculty meeting in August 2013. See Exhibit C.

Doctor of Nursing Practice Program

The SON admitted the first cohort of their new post-masters Doctor of Nursing Practice

(DNP) program in the fall 2012. As this program was developed and approved after the

acceptance of the GLI proposal for the SON, it was not included in the GLI proposal

activities. However, this program has developed programmatic terminal outcomes for the

3 GH learning themes which build on the master’s program terminal outcomes. See

Exhibit D. As the DNP courses were being developed, GH content was included. GLI-

theme learning outcomes, learning activities, and assessment strategies will be developed

further in these courses as they are taught and revised by faculty that teach the respective

courses.

Summary and Acknowledgements

The SON has completed our commitment to integrate the GLI into the nursing program

curricula. This has been an intense 2 1/2-year process that has required the work,

collaboration, and cooperation of everyone of our faculty. While this was a huge job, it

happened at a serendipitous time in the SON when we were just beginning a process of

major change to curricula in order to meet the revised American Academy of Colleges of

Nursing (AACN) baccalaureate and master’s education Essentials documents. All of this

better prepares us for our graduate program (masters re-accreditation and DNP

accreditation) site visit in November 2013. These important and pivotal processes have

been occurring in Nursing over the last 2 ½ years. Now that we have the GLI integrated

into our Nursing programs, the most exciting part will be to see the difference in our

nursing students and graduates who will be better prepared as global citizens and nursing

professionals. Our graduates will understand health issues at not only the local level, but

also at more global levels. Their education at NAU will prepare them for a wide palette

of possibilities in their careers, including careers in global health nursing.

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Finally, I would personally like to thank all of the GLI team—Susan Neder, Enid Rossi,

Donna Sutton, and Karine Crow (who retired in 5/2012)—for their hard work and

dedication to see the GLI process through to the finish. It has been a joy to work with

each of you. You each brought valuable knowledge, skills, and enthusiasm to this

process. I especially appreciate the work you have done this year while I was on

sabbatical to complete the final steps of the process. Last, but not least, I thank Dean

Debera Thomas for her support of the GLI process and every one of our SON faculty

who have contributed to the process. Without everyone’s commitment, we could not have

succeeded at this task.

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Exhibit A


School of Nursing

Undergraduate Course Learning Outcomes, Activities, and Evaluation for GLI

Content

May 2013

I. Traditional

Sophomore Year: 4th

term NUR 205, NUR 214, NUR 215

NUR 205 Transition into Nursing

Learning Activities: This course has a global health presentation that is required

of all students. The librarian does a presentation with the students on how to look

up and research their global health topic. During Summer 2013 a number of

students plan to participate in missionary activities in poor countries.

NUR 214 Intro to Health Assessment

Learning Activities: The American Indian Program site provides a distinct

cultural setting, located at St. Michaels on the Navajo Nation.

NUR 215 Pharmacology

Learning Outcomes:

Recognize variations in drug responses that occur with individuals of various

ages (Diversity Education).

Incorporate developmental, gender, genetic, economic and other issues that

affect drug therapy (Diversity Education)..

Discuss proper disposal of the portion of medications that will not be

administered (Sustainability).

Learning Activities

1. Online lectures

Medications and special populations in first module

Any issues related to specific drug classifications and treatment of specific

disorders is incorporated throughout

2. Readings

Pharmacokinetics - age and genetic considerations

Individual variation in drug responses

Drug therapy across the lifespan (pregnancy, breast feeding, pediatric patients,

geriatric patients)

Throughout text specific cultural issues are addressed related to treatment of

disorders or use of medications is altered or contraindicated in a specific

population group (ie. preferred treatment of hypertension in the black

populations

Weight-based medication dosage calculations and safe range information for

child dosing

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3. Synchronized lecture sessions

Discuss weight-based dosing

Discuss pharmacokinetics, cultural, or age related issues in various modules

(ie. administration of inhalers to children, use of spacers)

Traditional

Junior Year: 5th

term: NUR 208, NUR 321

NUR 208 Health-Illness Transitions in Chronic Illness

Lecture Learning Outcome and Related Learning Activities: Discusses the impact

of health equity and social justice on nursing and health care in a variety of settings

(Global Engagement).

Culture voice over powerpoint

Discuss health people 2020 (briefly)

Test questions about culture

Culture piece in patient education brochure (will move to clinical in Fall

2013)

Discuss statistical variations of disease processes (for example the increased

risk of prostate cancer in the African American culture and the impact of

HIV/AIDS in sub Sahara Africa)

Clinical Learning Outcome and Related Learning Activities: Plans culturally

appropriate care and/or teaching in selected situations (Diversity Education).

Handout about biohazardous waste

Simulation patients with diverse backgrounds (varying ethnicities, religious

beliefs, cultures, etc).

Culture section in care plan forms

NUR 321 Gerontology

Learning Activities: The course meets the global health outcomes through the Life

Review Interview and discussions throughout the course (Diversity Education) and

include:

Cultural diversity and reflection on caring for the older adult

Health equity and disparities

Aging theories

Impact of biopsychosocial complexities of the older adult health care needs.

Traditional

Junior Year: 6th term: NUR 212, NUR 216, NUR 320

NUR 212 Acute Health Illness

Learning Activities (Tucson section): Students compare guidelines between the

US and another country. They compare and contrast them and then they

write one guideline of the two. Lastly, they make a power point presentation for

the class to review and comment on (Global Engagement).

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Learning Activities (Yuma section: Students complete an Evidence-based

Practice Project that involves the comparison of clinical practice guidelines on a

particular topic between the US & an identified foreign country (Global

Engagement).

NUR 216 Psychiatric/Mental Health Nursing

Learning Outcome: Examines the impact of health equity and social justice on

nursing and health care in a variety of settings (Global Engagement).

Learning Activities:

Community Service Learning Assignment: Paired Volunteer Experience

with Shelters with related criteria: Examine how your experience at the

homeless shelter relates to social justice?

Reading assignment: Cultural Heritage Assessment.

For the online course the students visit the neighborhood and interact (read

biography and view videos) with families and family members from

Hispanic, Filipino, and European backgrounds. The students also blog on

topics related to the mental health of family members, and family

interactions around these issues (Diversity Education).

Assessment Criteria/Grading Rubric:

Start your cultural assessment to discover how the client sees himself in

terms of ethnic, age, gender, and location identity. Consider socio-

economic and literacy level.

In analyzing, bring together what you discovered about the

individualized/unique aspects of the patient including his cultural

identity. Investigate cultural values, beliefs and behaviors that are likely to

influence how the patient responds to treatment.

For planning include what you would do to incorporate culturally

reinforcing care as applicable.

NUR 320 Palliative Care

Palliative Care in Nursing addresses cultural competencies and humility in

palliative care settings. Holistic care is discussed and complementary and

alternative methods of healing that patients and families from other cultures might

utilize are introduce (Diversity Education).

Learning Activities: videos, readings and discussion are used.

1. Videos

Mourning

Mourning is the outward, social expression of a loss [Video]. How one

outwardly expresses a loss may be dictated by cultural norms, customs,

and practices including rituals and traditions. Some cultures may be very

emotional and verbal in their expression of loss, some may show little

reaction to loss, others may wail or cry loudly, and some may appear stoic

and businesslike. Religious and cultural beliefs may also dictate how long

one mourns and how the survivor "should" act during the bereavement

https://iris.nau.edu/OWA/redir.aspx?C=XqSIRtLl6Uarkc4w8QJsu3j1BP8-B9AIYYZJGaxoq7Sk8EgLTEVJGs0S9A1SDJ05xUUyxf5fC70.&URL=https%3a%2f%2fbblearn.nau.edu%2fwebapps%2fblackboard%2fcontent%2flistContentEditable.jsp%3fcontent_id%3d_1286476_1%26course_id%3d_40859_1

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period. In addition, outward expression of loss may be influenced by the

individual's personality [Video] and life experiences [Video] (Corless,

2006).

Angola Prison Hospice

2. Readings: In addition readings include:

Culture and Spirituality as Domains of Quality of Palliative Care

Societal Perspectives Regarding Palliative Care

3. Quizzes include questions about culture and care at the end of life.

Traditional

Senior Year: 7th term: NUR 211, NUR 350, NUR 424

NUR 211 Maternal-Child

Learning Activities: Students find a global health research article or journal

article related to women’s or pediatric health and then present a comparison of

that to our concept of care or availability/access to care here in the US, then they

present this to their peers during class (Global Engagement).

NUR 350 Family Case Management

Theory Learning Outcome: Analyzes safety and quality of health care outcomes

for diverse family populations in the home and community settings incorporating

principles of advocacy, leadership, and colaboration (Diversity Education).


Online discussion # 1: Providing nursing care for persons who come from

backgrounds, religious faiths, or life situations different from our own.

Online discussion #4: Impact of culture, ethnicity, and social class on

healthcare availability and utilization.

Online discussion #6: The role of the case manager (leadership).

Online discussion #7: Working with an interdisciplinary team – concepts

of communication, collaboration, coordination, and referral.

Online discussion #8: Healthcare funding sources and health disparities

that are affected by limited access to health care.

Online discussion #11: Cultural competence, cultural humility, and how to

develop cultural skills helpful in establishing an effective therapeutic

relationship.

Clinical Learning Outcomes and Related Learning Activities:

1. Promotes safety and quality of health care outcomes for diverse family

populations in the home and community settings incorporating principles of

advocacy, leadership, and collaboration (Diversity Education).

Clinical hours spent with FMC inpatient case manager.

Students work with healthcare agency interdisciplinary team to provide

care to a select family in the agency and home settings.

Students complete an in-depth assessment of a select family and mutually

agreed-upon goals are developed to guide the overall plan of care.

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2. Participates in collaborative efforts to improve aspects of the environment that

negatively impact the health of patients and families in the home and community

setting (Sustainability).

Written assignment to identify community healthcare resources available.

Environmental home and community assessment on family assessment project

form.

Cultural/socio-economic section on family assessment project form

NUR 424 Manager of Care/Health Care Systems


Students complete a group Quality Improvement Project (QIP). The main

topics covered in the course are: the essentials of baccalaureate education for

professional nursing practice, patient safety, health informatics & US Health

policy.

Additionally, students participate in group several discussions related to these

topics & the incorporation of evidence outside the US to support a particular

stance on an issue certainly seems reasonable & probable (Global

Engagement).

Traditional

Senior Year: 8th term: NUR 427, NUR 450C

NUR 427 Public Health Nursing

Learning Outcomes and Related Learning Activities:

1. Analyzes global and societal public health trends for health promotion, risk

eduction and disease prevention (Global Engagement).

Learning activity: 2 topics include a global health focus; Infectious

Disease Prevention & Control and Global Health with assigned

discussions. Clinical community assessment has a health

promotion/health protection focus.

2. Critiques the impact of health and social policy on global, national and state

communities and the profession of public health nursing (Global Engagement).

Learning activity: health policy is included in all topics and clinical

community assessment; students engage with legislator or health official

to advocate for health policy improvements

3. Evaluates scientific evidence in environmental heath to promote risk and

exposure reduction strategies for healthy communities (Sustainability).

Learning activity: Environmental health topic as well as 4 other topics

address exposures and risk reduction in the environment (Rural & Urban

Environments, Epidemiology, Disaster Management, Chronic Disease).

NUR 450C Nursing Leadership

Learning Activities: There are times a student is exposed to various ethnicities in

the hospital setting - that is not an outcome for NUR 450C.

II. RN TO BSN

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NUR 307 Health Assessment for Registered Nurses

None

NUR 320 Basic Principles in Palliative Care

Refer to Traditional Junior Year: 6th term (NUR 320 above pg. 3)

NUR 330 Nursing as a Discipline and Profession

Learning Outcome and Related Learning Activities: Examines one’s own

personal values, beliefs, and practices as compared to diverse populations in a global

society (Global Engagement/Diversity Education).

Completion of a self-assessment related to culture. There are text and

supplemental readings for this lesson that support/inform an in-class

discussion of culture and diversity (linking it with various aspects of caring

theory eventually).

There are also final course presentations related to global nursing and

public health nursing.

NUR 321 Gerontology

Refer to Traditional Junior Year: 5th

term (NUR 321, pg. 2)

NUR 420 Family Nursing Roles

Learning Outcomes

1. Analyzes safety and quality of health care outcomes for diverse family

populations in community settings incorporating principles of advocacy,

leadership and collaboration (Diversity Education).

2. Explores innovative approaches in holistic care to promote health equity and

social justice for families in community settings (Global Engagement).


5 topics address health equity, social justice, health care outcomes and

advocacy:

Cultural Influences, Ethics & Advocacy, Case Management & Interdisciplinary

Teams, Health Care Disparities, and Violence and Family Health.

Discussions, interviews and a report are assigned.

NUR 424 Management of Care/Health Care Systems

Refer to Traditional Senior Year: 7th





NUR 450C Nursing Leadership


term (pg. 5)

III. Accelerated BSN

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NUR 319 Fundamentals of Nursing Practice


1. Lecture: Identifies social, biological, cultural, and health literacy data and how

it impacts nursing practice (Diversity Education). (Note: this outcome has been

revised to better reflect course content. The change will begin Summer 2013. The

outcome below is the OLD outcome):

Students complete a patient education brochure addressing these items.

2. Clinical: Recognizes how responsible health care waste disposal reduces

environmental hazards (Sustainable Environments).

This was discussed in conference as well as conserving supplies in lab

when possible.

NUR 330 Nursing as a Discipline and Profession

Refer to RN to BSN (NUR 330 pg. 5)

NUR 331 Pharmacology

Refer to Traditional Sophomore Year: 4th

term (NUR 215, pg. 1-2)

NUR 332 Nursing Assessment and Process

Refer to Traditional Sophomore Year: 4th


NUR 333 Communication and Mental Health Nursing


Mental health nursing, mental health stigmas and global variations

Communication and global variations

Global health disparities in health care: mental health, homelessness, refugee

health care (Global Engagement).

NUR 334 Adult Health Nursing

Refer to Traditional Junior Year: 5th


NUR 335 Nursing Care of the Child-Bearing Families


Global health pediatric case studies

Birthing practices and global variations

Global disparities in health care: women and children

Childrearing practices and global variations

Violence and global variations (Global Engagement)




NUR 408 Fieldwork


1. Synthesizes principles of health equity and social justice for vulnerable

populations into the role of the professional nurse.

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Addressed through course readings and synthesized through clinical

journaling and blog/discussion.

2. Analyzes the role of the nurse as change agent related to improving local and

global environmental conditions which affect a population’s health.

Addressed through course readings, application in fieldwork/clinical

experience and discussed in reflective journaling/blogs/discussion.

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Exhibit B


School of Nursing

Graduate Course Learning Outcomes, Activities, and Evaluation for GLI Content

May 2013

NUR 510 Knowledge Development in Nursing

None

NUR520 Applied Pathophysiology for APNs

Global Health Learning Outcomes:

1. Analyze an environmental concern that affects health (Environmental

Sustainability)

2. Differentiate gender, genetic, cultural, and environmental issues that impact

human pathophysiology and response to disease processes (Diversity Education)

Learning Activities and Evaluation Strategies related to Global Health

Learning Outcomes:

1. There is a whole unit on Environmental Effects on the Body. Students do a

group class presentation on an environmental hazard choosing from one of five

possible topics, including effects of air pollution, heavy metal poisoning, water

pollution, radiation pollution, or food contamination. The assignment includes a literature

review, discussion of global and local impact of the problem, a community assessment of

a community impacted by the problem, finding a relevant assessment tool, developing a

health history for someone with the exposure, developing a concept map, and discussing

future prevention of the problem. A rubric tool is provided in the course syllabus for

evaluating the assignment.

Reading assignments are given from Nadakavukaren, A. (2006). Our global

environment (6th ed.). Long Grove, Il: Waveland Press, Inc.

2. No information on learning activity provided by faculty of record for course.

NUR 530 Advanced Principles of Evidence-based Practice


Explore leadership and/or research roles in developing, implementing, and

evaluating culturally-reinforcing nursing and other healthcare services from local

to global perspectives. (Global Engagement)


Learning Outcomes:

1. Documentation of specific teaching-learning strategies that addresses the global

health outcome: Finding and appraising relevant evidence; cultural factors.

2. Documentation of assessment criteria/grading rubric that evaluates the global

health outcome: Finding and appraising relevant evidence and development of an

Evidence Table 15 points out of 100 points possible.

https://bblearn.nau.edu/bbcswebdav/pid-484860-dt-content-rid-3373488_1/xid-3373488_1

https://bblearn.nau.edu/bbcswebdav/pid-484860-dt-content-rid-3373488_1/xid-3373488_1

https://bblearn.nau.edu/webapps/blackboard/execute/Articles/Environment/Nadakavukaren%20-%20Our%20Global%20Environment%20pages.pdf

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NUR 540 Pharmacology for Advanced Practice

None

NUR 550 Family Nursing Theory and Practice


Describe guidelines for advanced nursing practice for family-focused, culturally

competent care in health and illness (Diversity Education).


Learning Outcomes:

1. Focus on family and theory assessment application of family interventions in

advanced practice via:

Discussion regarding family health and culture by reading, substantive

discussion, and by interviewing person/family

Final paper using the Calgary Family Assessment Model (CFAM)

completing a comprehensive assessment of a family (includes assessment

of culture related to families).


health outcome:

The course is organized to view the family as a unit and focuses on the

students’ own thoughts, biases, beliefs, values, attitudes, experiences, and

practices.

Thoughtful open substantive discussions include acknowledging and

respecting diversity of values, beliefs, attitudes, and practices.

NUR 560 Rural Theory and Health Policy


1. Address health equity and social justice to reduce health disparities for rural or

at risk communities (Diversity Education).

2. Assume collaborative leadership in planning, implementing and evaluating

culturally reinforcing health care services in rural or at risk communities

(Diversity Education).


Learning Outcomes:

1. Rural community project assessment criteria related to global health outcomes:

Describe the demographics of your rural community including age,

gender, culture, religion and socio-economic aspects; an excellent source

is the U.S. A. Census data.

Considering your response to the first question, how would establish an

effective relationship with those from the predominant ethnic group in

your community considering socio-economic aspects?

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Based on parts 1 and 2, what are the likely health-related concerns from

your rural community’s perspective? Then prioritize the top four with

supporting rationale.

With the highest prioritized health-related concern, and using what you

have learned about the characteristics of rural communities and your

community, develop a plan to address this health concern.

2. Online conversation questions related to global health outcome:

How will the culture of rural communities and the unique characteristics

of your selected rural community guide you in planning the first encounter

with your community?

Considering the gaps and barriers, what are resources in rural and at risk

communities that are not part of the health care system? How can you as

the advance practice nurse incorporate these in your practice to bridge the

gaps and barriers?

3. Online course team questions related to global health outcome:

Considering the unique characteristics of your selected rural community

and rural communities in general, discuss how you could work within the

perspectives and beliefs of the residents.

Analyze collaborative approaches that would be most effective in

partnering with rural communities in general and your selected

community.

Dividing the workload among your team, investigate and discuss

characteristics of ethnic cultures in Arizona and your rural communities.

Rural elders can be considered a culture for this. This has been started

in Module 2. Your report can be used for your rural project. A wiki is

available for team work as you choose. Explore how you would

effectively establish an effective relationship. Be sure to provide your

resource references to share them with your team members.

Dividing the workload among your team, investigate and discuss

common characteristics of those who are working class and those are in

the low socio-economic challenge. Explore how you would effectively

establish an effective relationship with both. Be sure to provide your

references to share them with your team members. Your report can be

used for your rural project.

4. A rubric has been developed to evaluate these course projects

NUR 572 International, Intercultural, Transcultural Health Care in a Global

Society (Elective course)

Global Health Learning Outcomes: This course focuses primarily on the GLI

theme of Diversity Education, but on Global Engagement as well. Per the syllabus

section on Course Description: “This course focuses on assessing, contrasting and

comparing non-Western with Western health beliefs and practices of both U.S. minority

perspectives and society’s diverse populations in a global society”.

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Learning Outcomes: (quotations below are direct excerpts from syllabus)

1. Cultural Assessment: “You will write a theoretically based cultural assessment of

your own culture and another targeted population (non-western) using the concepts found

in the course content/outline. A written paper comparing and contrasting these

populations will be submitted in 2 intervals”.

2. Blog: “Please use the blog function to discuss topics questions or anything about the

topics as a form of communication between yourselves”.

3. Critiques: “Two critiques on journal articles related to the targeted populations’ ethics

and values”.

4. There are rubrics in the course to guide evaluation of each of the above 3 learning

activities.

NUR 605 Graduate Research Seminar


Analyze health equity and social justice issues related to research with culturally

diverse groups (Global Engagement).


Learning Outcomes:

This Global Health Outcome, assessment criteria, and teaching-learning strategies

will be implemented in Fall 2013 semester (development is in process).

NUR 608 Field Work Experience


Prioritize social and cultural factors that affect health when designing and

delivering care in selected clinical context. (Diversity Education).


Learning Outcomes:


health outcome: Development of a patient-population focused project/product =

30 points out of possible 100 points; Dissemination/presentation of the NUR 608

patient-population focused project/product = 10 points out of a possible 100

points.


health outcome: Students write a learning outcome that reflects his/her fieldwork

experience that is conducted in a self-selected clinical setting with a specific

patient population (identify and prioritize social and cultural factors, and health-

related influences).

NUR 650 Advanced Nursing Assessment


Address environmental factors and constraints affecting health and illness

(Sustainability).

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Learning Outcomes:

This Global Health Outcome, assessment criteria, and teaching-learning strategies

will be implemented in Fall 2013 semester (development is in process).

NUR 660 Family Primary Health Care I

None

NUR 661 Family Primary Health Care Practicum I

None

NUR 662 Family Primary Health Care II

None

NUR 663 Family Primary Health Care Practicum II

None

NUR 664 Family Primary Health Care III

None

NUR 665 Family Primary Health Care Practicum III

None

NUR 675 Advanced Roles Transitions


Examine the history of the advanced practice nurse (APN) from a global

perspective (Global Engagement).


Learning Outcomes:


health outcome: In the blog online environment, students will choose a country

and a role most appropriate to what they are studying and where they see

themselves in 5 years. They will then share with the class what they’d like to do,

why, and how advanced nursing education will prepare them to meet their self-

described idea, project, or dream.


health outcome: Graded blog assignment for students to discuss the roles for

APN’s globally.

NUR 676 Healthcare Systems: Technology, Quality, and Economics


Examine the role of current and emerging technologies in local and global

healthcare delivery (Global Engagement).

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Learning Outcomes:


health outcome: New course that still needs to be developed. It will be taught the

first time in fall 2013 semester.


health outcome: New course that still needs to be developed. Course will be

taught the first time in fall 2013 semester.

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Exhibit C

DRAFT of

Program Evaluation Benchmarks for Global Health Terminal Learning Outcomes

Global Engagement Advocates for health equity and social justice for vulnerable populations and the elimination of health disparities both locally and globally.

KAPLAN Nursing Diagnostic Test o Accreditation Category – Population Health

EBI Exit Survey – SON Item Global Engagement

EBI Exit Survey items – see EBI Exit Survey Outcomes

and Questions Document

Alumni Survey – SON Item Global Engagement

Alumni Survey items – see Alumni Survey Outcomes and Questions Document

Employer Survey items – SON Item Global Engagement

At the end of the program, students taking the KAPLAN Nursing Diagnostic Test will achieve a mean of 0.60 (i.e. 60% of items answered correctly)in the stated category indicating a sufficient level of knowledge acquired in from a basic nursing curriculum

>95% agree or strongly agree >95% agree or strongly agree >95% agree or strongly agree >95% agree or strongly agree >95% agree or strongly agree >95% agree or strongly agree

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Employer Survey items – see Employer Survey Outcomes and Questions Document

Diversity Education Promotes safety and quality of health care outcomes for diverse populations incorporating principles of advocacy, leadership, and collaboration.

NCLEX summary Test Plan Results for o Psychosocial-Cultural Functions

KAPLAN Nursing Diagnostic Test

o Accreditation Category – Cultural Diversity EBI Exit Survey – SON Item Diversity Education

EBI Exit Survey items – see EBI Exit Survey Outcomes


Alumni Survey – SON Item Diversity Education

Alumni Survey items – see Alumni Survey Outcomes

Compared to graduates from similar programs, graduates will achieve a 55th percentile rank or higher in the stated NCLEX categories

At the end of the program, students taking the KAPLAN Nursing Diagnostic Test will achieve a mean of 0.60 (i.e. 60% of items answered correctly)in the stated category indicating a sufficient level of knowledge acquired in from a basic nursing curriculum

>95% agree or strongly agree


>95% agree or strongly agree >95% agree or strongly agree

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Employer Survey items – SON Item Diversity Education

Employer Survey items – see Employer Survey Outcomes and Questions Document

>95% agree or strongly agree >95% agree or strongly agree

Environmental Sustainability Participates in collaborative efforts to improve aspects of the environment that negatively impacts health both locally and globally.

NCLEX summary Test Plan Results for o Safety and Infection Control

KAPLAN Nursing Diagnostic Test

o Client Needs – Safety and Infection Control EBI Exit Survey – SON Item Environmental

Sustainability

Alumni Survey – SON Item Environmental Sustainability

Employer Survey Items ) – SON Item Environmental

Compared to graduates from similar programs, graduates will achieve a 55th percentile rank or higher in the stated NCLEX categories

At the end of the program, students

taking the KAPLAN Nursing Diagnostic Test will achieve a mean of 0.60 (i.e. 60% of items answered correctly)in the stated category indicating a sufficient level of knowledge acquired in from a basic nursing curriculum

>95% agree or strongly agree >95% agree or strongly agree >95% agree or strongly agree

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Sustainability

Employer Survey Items – see Employer Survey Outcomes and Questions Document


These are the questions from the exit survey. Global Engagement

OQ08 The program prepared me to advocate for health equity and social justice for vulnerable populations and the elimination

of health disparities both locally and globally. Q064 To what degree did the nursing program teach you to: Understand the global health care environment Q074 To what degree did the nursing program teach you to: Act as an advocate for vulnerable patients

Diversity Education

OQ09 The program prepared me to promote safety and quality of health care outcomes for diverse populations incorporating

principles of advocacy, leadership, and collaboration. Q071 To what degree did the Nursing Program teach you to: Provide culturally competent care

Environmental Sustainability

OQ10 The program prepared me to participate in collaborative efforts to improve aspects of the environment that negatively

impacts health both locally and globally.

These are the questions from the alumni survey (used for 1 year and 3 year). Global Engagement

OQ09 The program prepared me to advocate for health equity and social justice for vulnerable populations and the elimination

of health disparities both locally and globally. Q037 To what extent did your Nursing education enhance this skill/ability and your knowledge base in this area: Act as an

advocate for vulnerable patients Q075 To what extent did your Nursing education enhance this skill/ability and your knowledge base in this area: Understand the

global health care environment

22

Diversity Education

OQ10 The program prepared me to promote safety and quality of health care outcomes for diverse populations incorporating

principles of advocacy, leadership, and collaboration. Q039 To what extent did your Nursing education enhance this skill/ability and your knowledge base in this area: Provide

culturally competent care Q072 To what extent did your Nursing education enhance this skill/ability and your knowledge base in this area: Understand the

effects of health policies on diverse populations Environmental Sustainability

OQ11 The program prepared me to participate in collaborative efforts to improve aspects of the environment that negatively


These are from the employer survey Global Engagement

OQ09 Employee demonstrates this ability: To advocate for health equity and social justice for vulnerable populations and the

elimination of health disparities both locally and globally. Q040 Employee demonstrates this ability: Understands the global health care environment.

Diversity Education

OQ10 Employee demonstrates this ability: Promote safety and quality of health care outcomes for diverse populations

incorporating principles of advocacy, leadership, and collaboration. Q04 Employee demonstrates this ability: Provides culturally competent care Q018 Employee demonstrates this ability: Supports fairness in the delivery of care.

Environmental Sustainability OQ11 Employee demonstrates this ability: Participate in collaborative efforts to improve aspects of the environment that

negatively impacts health both locally and globally. Q052 Employee demonstrates this ability: Develop strategies to promote healthy communities.

Approved by Program Evaluation Committee May 2013. Will go to full faculty August 2013.

23

Exhibit D

School of Nursing Programmatic Terminal Learning Outcomes

BSN Program Outcomes--approved MS Program Outcomes--approved DNP Program Outcomes—approved

Global Health

Global Engagement

Advocates for health equity and social

justice for vulnerable populations and the

elimination of health disparities both

locally and globally.

Diversity Education

Promotes safety and quality of health

care outcomes for diverse populations

incorporating principles of advocacy,

leadership and collaboration.


Participates in collaborative efforts to

improve aspects of the environment that

negatively impacts health both locally

and globally.

Global Health

Global Engagement

Transforms health care systems to

address health equity and social justice

thus reducing health disparities in

vulnerable populations.

Diversity Education

Assumes leadership and/or research roles

in developing, implementing, and

evaluating culturally reinforcing nursing

and other health care services from local

to global perspectives.

Prioritizes the social and cultural factors

that affect health in designed and

delivering care across multiple contexts.


Creates partnerships that promote

sustainable environmental health policies

and conditions.

Analyzes and promote social, political,

and economic policies that influence

Global Health

Global Engagement

Develop creative solutions for health care

systems to address health equity and social

justice thus reducing health disparities in

rural and/or disadvantaged populations.

Diversity Education

Analyzes social and cultural components of

health and wellness to create solutions that

are culturally and socially relevant and

acceptable.


Synthesize inter-professional and

interdisciplinary knowledge and approaches

that promote sustainable environmental

health policies and conditions as well as

reduce human health exposures.

-------------------------------------------------- Approved May 6, 2013 by SON Graduate

Committee and approved May 10, 2013 by SON

24

sustainable environments and reduce

human health exposures in a global

society.

Faculty

File: Cruizer/Corsair/GRADUATE PROGRAM COMMITTEE/AGENDA May 6, 2013/GLI DNP Program Outcomes_updated_approved.doc

1

NORTHERN ARIZONA UNIVERSITY

COLLEGE OF HEALTH AND HUMAN SERVICES

SCHOOL OF NURSING


Interim Report, July 24, 2012

Prepared by: Karen A. Plager, GLI Team Leader

Background

Northern Arizona University School of Nursing (NAU-SON) is an academic unit within the

College of Health and Human Services. We have over 30 full time faculty located at the

Flagstaff Campus and satellite programs in Window Rock, Tucson, and Yuma as well as a

number of part time faculty. We have both undergraduate and graduate programs, including

traditional pre-license BSN, accelerated BSN, RN to BSN, generalist master’s degree, family

nurse practitioner (FNP) master’s degree and post-master’s certificate, and a new post-master’s

doctor of nursing practice (DNP) program which will have the first cohort of students beginning

August 2012. We have over 400 students in these various programs with more than 300 in the

undergraduate programs and over 100 in the master’s degree/post-master’s certificate programs.

About 15 students will be in the first cohort of the DNP program beginning fall 2012.

After getting full faculty agreement/approval to movement forward with integrating the Global

Learning Initiative (GLI) into our nursing programs, in fall 2010 the SON submitted a proposal

to integrate the GLI themes into our various nursing curricula. The proposal was accepted in

December 2010. The SON began work on our proposal in January 2011 with the following team:

Karen A. Plager, PhD, RN, FNP-BC, Professor, Team Leader

Karine Crow, PhD, RN, Associate Professor, Team Member

Susan Neder, MSN, RN, Assistant Clinical Professor, Team Member

Enid Rossi, EdD, RN, Associate Clinical Professor, Team Member

Donna Sutton, MSN, RN, Assistant Clinical Professor, Team Member

Our GLI proposal focuses only on our baccalaureate and master’s degree programs. Our DNP

program was approved in October 2011, 10 months after the approval and initiation of our work

on the GLI proposal. However, the importance of global health was included in the development

of the DNP courses. As noted above, the first cohort of DNP students does not begin until fall

2012.

The SON is accredited by the Commission on Collegiate Nursing Education (CCNE) which is

the accrediting body of the American Academy of Colleges of Nursing (AACN). The AACN

develops and publishes documents that contain outcome expectations for graduates of

baccalaureate, master’s, and DNP programs. The Essentials of Baccalaureate Education for

Professional Nursing Practice (AACN, 2008) and the Essentials of Master’s Education in

Nursing (AACN, 2011) have recently been revised. Consequently, the SON was beginning the

process of revising our philosophy, organizing framework, and terminal outcomes for our

baccalaureate and master’s programs when we submitted our proposal for the GLI. This

propitious timing helped to integrate GLI activities with the need to update our SON documents

2

and curricula to be consistent with our accrediting body. Furthermore, the 3 GLI themes of

global engagement, diversity education, and environmental sustainability are consistent with and

integral to both the baccalaureate and master’s essentials documents. The Essentials documents

build on each other from baccalaureate to master’s to DNP education, leveling the Essentials

outcomes for the degree progression.

Process

Our GLI team has met approximately once or twice a month most months since we began our

work (December 16, 2010) to integrate the GLI into SON curricula. We have met regularly as a

team and coordinated with work of the full faculty and Undergraduate and Graduate Committees

to accomplish our tasks. In addition we have met on several occasions with the NAU GLI Team,

including Harvey Charles, Blasé Scarnati, Ron Hubert, Dawn Hawley, and their outside

consultants. The NAU GLI team met with our full faculty on 2 occasions during the process.

Early on in our work we met with Dental Hygiene to discuss the process that they used to

accomplish integration of GLI into their curricula. Members of our team have attended GLI

workshops that have been offered across campus.

One of the initial steps we took as a team was to complete an assessment of our existing nursing

courses for where we already had learning outcomes, content, teaching methods, and evaluation

that reflected the GLI themes. Our nursing curricula have had a fairly strong focus on cultural

diversity for a number of years as one of our curricular conceptual strands was “Cultural

Competence”. This strand (consistent with diversity education) was found in many/most of our

nursing courses. We have also had an expressed interest in global health amongst our faculty and

students so learning experiences have been available to students for study abroad, although those

activities were in addition to the required course activities. These include opportunities to study

abroad in Kenya through a collaborative effort with The School for Field Studies, Guatemala,

Dominican Republic, and the Netherlands.

Program Terminal and Course Learning Outcomes

As a full faculty we worked to re-write our School of Nursing Organizing Framework,

Philosophy, and Undergraduate and Master’s Terminal Outcomes. Part of that process involved

integrating the GLI themes into these documents, including Supplemental Definitions/Glossary.

As a faculty we voted to add an additional conceptual strand, “Global Health”, under which were

created terminal outcomes for each of the 3 GLI themes, global engagement, diversity education,

and environmental sustainability. There are 3 levels to the undergraduate curricula and,

therefore, 3 levels for the terminal outcomes, including the Global Health strand. The master’s

terminal outcomes build on level 3 of the baccalaureate program. These outcomes are also

consistent with the AACN Essentials documents as referenced above. The SON Organizing

Framework, Philosophy, and Undergraduate Terminal Outcomes were approved by SON Full

Faculty on January 9, 2012. Master’s Terminal Outcomes were approved by SON Full Faculty

on April 6, 2012. These documents can be viewed under Exhibit A (pp. 5-19) of this report.

The Undergraduate Committee worked to develop course outcomes for each undergraduate

course incorporating all the revised conceptual strands, including Global Health. These were

3

approved by the SON Full Faculty on April 6, 2012. The documents can be viewed under Exhibit

B (pp. 20-44) of this report.

During fall 2012 the Graduate Committee and individual faculty teaching master’s level courses

need to develop course learning outcomes for the new Global Health Strand. As many courses

already contain learning outcomes pertinent to diversity education (under the former Cultural

Competence conceptual strand), it remains for faculty to develop/strengthen master’s course

outcomes related to global engagement and environmental sustainability. This process was begun

at a 2-day SON Graduate Program Retreat in late May and will continue in the fall, especially as

the SON is also beginning to prepare a self-study for our master’s program re-accreditation site

visit in fall 2013.

Examples of diversity education learning outcomes already in our existing master’s level courses

can be viewed under Exhibit C. There are also examples of learning outcomes for global

engagement and environmental sustainable in existing master’s courses that can be viewed in

Exhibit C (pp. 45-47).

Learning Experiences

As noted above, the SON Undergraduate Committee has revised all undergraduate course

outcomes to include our new Global Health strand with the 3 GLI themes. It now remains for

individual faculty to develop learning experiences for the Global Health outcomes in the courses

they teach. During Academic Year (AY) 2012-2013, faculty will be developing these learning

activities in cooperation with the Undergraduate Committee. One example of a learning

experience already developed by a faculty who taught NUR 205 Transitions into Nursing (global

engagement) can be viewed in Exhibit D (pp. 48-49). One challenge that remains for the

Undergraduate Committee is to find ways in the various undergraduate programs of study to

integrate study abroad opportunities for students as part of the required curriculum rather than in

addition to the program requirements.

The Graduate Committee as noted above will be developing Global Health learning outcomes for

master’s level courses during AY 2012-2013. Individual faculty teaching those courses will

develop appropriate learning experiences. Master’s students can participate in study abroad

experiences as NUR 608 Field Experience or as part of their NUR 689 Professional Project.

Examples of learning experiences already used in NUR 660 Family Primary Health Care

(diversity education) and NUR 520 Applied Pathophysiology for APNs (environmental

sustainability) can be viewed in Exhibit E (pp. 50-51).

Assessment Strategies

In the past year the SON has totally revised undergraduate and graduate program terminal

outcomes to meet the revised AACN baccalaureate and master’s Essentials documents as well as

integrating the GLI into our curricula with the new Global Health strand. Consequently, during

fall 2012 our Program Evaluation Committee will be developing a plan for evaluation of all new

programmatic terminal outcomes. At the course level faculty teaching individual courses will be

4

responsible for developing formative and summative evaluation strategies within their courses

that measure student achievement of the various course learning outcomes.

Summary/Conclusions

The SON GLI Team has worked in collaboration and cooperation with the full Nursing Faculty

and with the University GLI consultants to integrate the GLI themes into our various curricula at

the undergraduate and master’s levels of our programs. This has been a year and a half process to

date. The steps that remain as described above must occur at the SON committee level (e.g.

Undergraduate, Graduate, and Program Evaluation) and individual course level. Faculty will

continue to work to accomplish these steps in AY 2012-2103. The primary work of the GLI

Team is complete. An addendum to this report will be written summer 2013 by Karen Plager to

demonstrate completion of these final steps.

The SON Faculty is committed to completing this process. Members of the GLI Team sit on the

various committees and are committed to work with faculty to see this process through to

fruition. The GLI Team members on SON committees are as follows: Sue Neder is a member of

the Undergraduate Committee, Enid Rossi is a member of the Graduate Committee, and Donna

Sutton is on the Program Evaluation Committee. We regret that one member of our team, Karine

Crow, has retired and will not be part of this work next year. Karen Plager will be on sabbatical

until May 2013, but will receive progress reports from the remaining team members in order to

write the final addendum to this report during summer 2013.

5

Exhibit A

School of Nursing

Organizing Framework, Philosophy, and Undergraduate and Master’s Terminal Outcomes

Northern Arizona University

School of Nursing

Philosophy and Organizing Framework

The philosophy of the School of Nursing at Northern Arizona University is based on an ethic of

caring that embraces students, faculty and staff, and the university community and the global

community within which we live and work. We also believe that caring is a conscious,

intentional discipline that is part of nursing’s unique body of knowledge and is practiced in

interdisciplinary contexts. Caring includes the creation and nurturing of an environment that

recognizes that students, staff and faculty have unique ways of viewing the world. This

philosophy promotes excellence for nursing education and practice in an environment of constant

change and emerging healthcare trends.

The faculty believes the transition to the role of competent professional nurse is a major

developmental achievement. We believe that nursing is an art and science that is an integral

component of health care. Applying the discipline of nursing to practice depends on a foundation

of natural and human sciences, humanities and arts, the application of research, and the diverse

backgrounds of learners. Societal influences in the evolving healthcare system challenge all

involved in nursing education.

Education is a dynamic, life-long collaborative process by which an individual pursues life goals,

broadens human potential, develops thinking and clarifies values. The faculty believes that

learning is the intentional acquisition, application, and integration of knowledge, skills and

attitudes. Learning is shaped by the environment and developmental level of the learner, and is

ultimately the responsibility of the learner. Faculty plan, guide, and facilitate learning while

supporting the learning needs of a diverse community of students. We believe that learning-

centered experiences with rigorous expectations and actively-engaged students result in higher-

level thinkers and graduates prepared for real world practice. We value incorporating rural and

global healthcare into a variety of educational experiences. Thus education not only expands the

thinking of the learner, but increases opportunities for application.

The faculty has developed a philosophy that values diverse persons, environment, health, and

nursing, and their inter-relatedness. The following meta-paradigm concepts guide the

implementation of the organizing framework for the curriculum.

PERSON

The faculty defines person as being the individual, family, groups and community. The faculty

places a high value on human life and dignity. All life experiences involve dynamic and complex

processes of human development and achievement of personal growth through learning. The

faculty recognizes the interdependence and interconnectedness of the human experience. People

come from diverse backgrounds which influence the ways in which each person perceives

6

reality, sets personal goals and discovers meaning in life experiences. Individuals have the right

to choose from multiple options that are available in daily living experiences but must also

accept responsibility for their choices.

ENVIRONMENT

Environment is more than the physical surroundings; it is an open, pan-dimensional system in

which we strive for health and well-being. The environment is all that exists. It is the totality of

forces, both internal and external, which influence the person. To achieve this, environmental

sustainability from the individual and local to global scale is essential.

HEALTH

Health is a dynamic process that is defined by individuals, families, groups and communities; it

is influenced by personal, family, cultural and societal norms. Health is not merely the absence

of disease, but a process that involves constant dynamic adjustments, adaptations, and transitions

in response to environmental influences.

NURSING

Nursing as a discipline is both an art and science. Nursing is recognized as a creative endeavor

that integrates multiple ways of knowing to nurture the wholeness and uniqueness of the person.

Nursing is a profession of caring that includes the essential elements of compassion, competence,

conscience, commitment, comportment and confidence. Nurses use the components of caring to

create a healthy, healing environment. Caring is a mutual human process whereby the nurse

responds to persons with authentic presence and with intention to create an environment

conducive to health.

ORGANIZING FRAMEWORK

The School of Nursing faculty has developed an organizing framework that serves as a guide and

provides direction for faculty to organize its programs of education and to focus research,

scholarship, clinical practice and community service. The aim of this framework is to prepare

nursing professionals for effective professional and civic engagement. The framework represents

a systematic organization of concepts which are the essential components of baccalaureate and

graduate education.

CURRICULAR MODEL

Curriculum includes the planned and unplanned learning that occurs in the process of advancing

education in the discipline of nursing. Building on prior life, educational and professional

experiences, the structure of the nursing curriculum moves the learner along the continuum from

novice to more expert levels of nursing practice. Embracing the essential need for lifelong

7

learning in the discipline, the faculty develops curriculum to provide educational advancement

from the baccalaureate through graduate levels of nursing practice.

BACCALAUREATE CONCEPT DEFINITIONS

Clinical Practice and Prevention

The professional nurse is prepared for clinical practice with patients across the lifespan and

across the continuum of healthcare environments. Clinical professional practice is rooted in both

theoretical and research-based frameworks. Professional clinical practice includes the

knowledge, skills and attitudes to plan for, provide, supervise and evaluate care outcomes in

changing practice environments. Health promotion and disease prevention at the individual,

community, and population levels are necessary components of professional nursing practice.

Communication

The professional nurse demonstrates competencies and confidence in using therapeutic

communication that will enable safe and effective patient-centered care. An essential component

is the recognition of the unique discipline-specific contributions among health care professionals

that are critical to delivering high quality and safe patient care. Fundamental to effective inter-

professional and intra-professional collaboration is a definition of shared goals, clear role

expectations of members, flexible decision making processes, effective use of information

technologies, and the establishment of open communication patterns and leadership.

Critical Reasoning

Professional nursing practice is grounded in the translation of current evidence to inform practice

and make clinical judgments. Knowledge and skills in nursing, information management and

patient care technology are critical in preparing professional nurses to deliver quality patient care

in a variety of healthcare settings. Critical thinking underlies effective clinical reasoning and

judgment. In addition, the practice of critical reasoning depends on an attitude of inquiry, and

openness to innovation and continued learning.

Leadership

Developing knowledge and skills in leadership is essential to provide high quality care.

Leadership skills include the ability to use information and technology to communicate, manage

knowledge, mitigate error and support decision-making. Leadership skills are needed that

emphasize ethical and critical decision-making, initiate and support collaboration, promote

respectful communication, and develop conflict resolution strategies. Healthcare policy and

ethics shape the nature, quality, and safety of professional nursing practice and the practice

environment. All professional nurses have the responsibility to participate in the political

process and to advocate for patients, families, communities, the nursing profession, and

healthcare system.

8

Professionalism and Professional Values

Professionalism is the demonstration of professional values applied to practice. Professionalism

involves accountability for one’s self and one’s nursing practice, including adherence to legal,

ethical, and professional standards, ongoing professional engagement, and lifelong learning.

Professionalism flows from an understanding of the historical and contemporary contexts of

practice.

Professionalism is based on an inherent valuing of advocacy, altruism, autonomy, caring, human

dignity, integrity, safety and social justice that are fundamental to the discipline of nursing.

Understanding the values that patients and other health professionals bring to the therapeutic

relationship is critically important to providing quality patient care. Professional nursing requires

a balance between research-based knowledge, skills, and attitudes and professional confidence,

maturity, caring, and compassion. In this global society, patient populations are increasingly

diverse. Therefore, essential to the care of diverse populations is the need for research-based

knowledge and responsiveness to variables such as age, gender, culture, health disparities,

socioeconomic status, race, and spirituality.

Global Health

The professional nurse is prepared to provide nursing and health care within an interconnected,

interdependent, diverse, culturally rich global world while promoting and maintain local and

global sustainable environments.

GRADUATE CONCEPT DEFINITIONS:

Master’s of Science


The master’s-prepared nurse applies and integrates broad, organizational, patient-centered, and

culturally responsive concepts into daily practice. Mastery of these concepts based on a variety

of theories is essential in the design and delivery (planning, management, and evaluation) of

evidence-based clinical prevention and population care and services to individuals, families,

communities, and aggregates/clinical populations nationally and globally (AACN, 2011, p. 25).

Communication

The master’s-prepared nurse serves as a patient advocate, cultural and systems broker, leader and

coordinator of interprofessional teams across care environments in order to reduce barriers,

facilitate access to care, and improve health outcomes. Leadership is achieved through skill

development and demonstrating effective communication, planning, and implementation of care

directly with other healthcare professionals. Fundamental to effective interprofessional

collaboration is inclusion of patients’ expressed values, needs, and preferences for shared

decision making and management of their care. The master’s-prepared nurse will actively

9

communicate, collaborate, and consult with other health professionals to manage care across

systems. (AACN, 2011, p. 22)

Critical Reasoning

The master’s-prepared nurse examines policies and seeks evidence for every aspect of practice,

thereby translating current evidence and identifying gaps where evidence is lacking. These

nurses apply research outcomes within the practice setting, resolve practice problems

(individually or as a member of the healthcare team), and disseminate results both within the

setting and in wider venues in order to advance clinical practice.

Master’s-prepared nurses lead continuous improvement processes based on translational research

skills and are engaged in identifying questions needing answers, searching and synthesizing the

evidence for potential solutions and innovations, evaluating the outcomes, and identifying

additional questions.

Master’s-prepared nurses lead the healthcare team in the implementation of evidence-based

practice. These nurses support staff in lifelong learning to improve care decisions, serving as a

role model and mentor for evidence-based decision making (AACN, 2011, p. 15 and 16).

Master’s-degree graduates are prepared to gather, document, and analyze outcome data that serve

as a foundation for decision making and the implementation of interventions or strategies to

improve care outcomes. They use statistical and epidemiological principles to synthesize these

data, information, and knowledge to evaluate and achieve optimal health outcomes (AACN,

2011, p. 18).

Leadership

Master’s-prepared nurses are members and leaders of healthcare teams that deliver a variety of

services bringing a unique blend of knowledge, judgment, skills, and caring to the team. As a

leader and partner with other health professionals, these nurses seek collaboration and

consultation with other providers as necessary in the design, coordination, and evaluation of

patient care outcomes. In an environment with ongoing changes in the organization and

financing of health care, master’s-prepared nurses have a keen understanding of healthcare

policy, organization, and financing. In addition, nurse practice at this level requires an

understanding of complexity theory and systems thinking, as well as the business and financial

acumen needed for the analysis of practice quality and costs (AACN, 2011, p. 11 and 12).

Master’s-prepared nurses will use their political efficacy and competence to improve the health

outcomes of populations and improve the quality of the healthcare delivery system. To

effectively collaborate with stakeholders, the master’s-prepared nurse must understand the fiscal

context in which they are practicing and make the linkages among policy, financing, and access

to quality health care. The graduate must understand the principles of healthcare economics,

finance, payment methods, and the relationships between policy and health economics.

Advocacy for patients, the profession, and health-promoting policies is operationalized in

divergent ways. Attributes of advocacy include safeguarding autonomy, promoting social justice,

using ethical principles, and empowering self and others (AACN, 2011, p. 20 and 21).

10


Master’s-prepared nurses build on the competencies gained in a baccalaureate nursing program

by developing a deeper understanding of nursing and the related sciences needed to fully

analyze, design, implement, and evaluate nursing care

Master’s-prepared nurses understand the intersection between systems science and

organizational science in order to serve as integrators within and across systems of care. Care

coordination is based on systems science (Nelson et al., 2008). Care management incorporates an

understanding of the clinical and community context, and the research relevant to the needs of

the population. Nurses at this level use advanced clinical reasoning for ambiguous and uncertain

clinical presentations, and incorporate concerns of family, significant others, and communities

into the design and delivery of care.

Master’s-prepared nurses use a variety of theories and frameworks, including nursing and ethical

theories in the analysis of clinical problems, illness prevention, and health promotion strategies.

Knowledge from information sciences, health communication, and health literacy are used to

provide care to multiple populations. These nurses are able to address complex cultural and

spiritual issues and design care that responds to the needs of multiple populations, who may have

potentially conflicting cultural needs and preferences (AACN, 2011, p. 9).

Global Health

The professional nurse is prepared to provide nursing and health care within an interconnected,

interdependent, diverse, culturally rich global world while promoting and maintain local and

global sustainable environments.

11

Supplemental definitions/glossary:

1. Altruism: the concern for the welfare and well being of others. In nursing, altruism is

reflected by the concern and advocacy for the welfare of patients, other nurses, and

health providers. (AACN, 2008).

2. Autonomy: the right to self-determination (AACN, 2008).

3. Caring: the conscious and intentional discipline that includes the essential elements of

compassion, competence, conscience, commitment, comportment and confidence.

(Roach, 2002; Watson, 1999).

4. Clinical judgment: the outcomes of critical thinking in nursing practice. Clinical

judgments begin with an end in mind. Judgments are about evidence, meaning and

outcomes achieved. (Pesut, 2001).

5. Clinical reasoning: the process used to assimilate information, analyze data, and make

decisions regarding patient care (Simmons, Lanuza, Fonteyn, & Hicks, 2003).

6. Compassion: a sensitivity to the pain and suffering of another that engenders a response

of participation, amelioration, and/or interconnectedness (Roach, 2002).

7. Comportment: caring as reflected in bearing, demeanor, dress and language (Roach,

2002).

8. Critical thinking: all or part of the process of questioning, analysis, synthesis,

interpretation, inference, inductive and deductive reasoning, intuition, application and

creativity. Critical thinking underlies independent and interdependent decision-making,

critical reasoning, clinical reasoning and clinical judgment (AACN, 2008).

9. Cultural reinforcement: the development of a congruent set of behaviors, attitudes and

policies that strengthen and support the patient’s health beliefs and practices (Cross,

Barzon, Dennis & Isaacs, 1989).

10. Disease prevention: activities that have as their goal the protection of people from

becoming ill because of actual or potential health threats. (Stanhope & Lancaster, 2008).

11. Diversity: the range of human variation, including age, race, gender, disability, ethnicity,

nationality, religious and spiritual beliefs, sexual orientation, political beliefs, economic

status, native language, and geographical background (AACN, 2008).

12. Environmental sustainability: the ethical and responsible use of natural resources on

order to maintain a sustainable environment (NAU Global Learning Initiative, 2010).

13. Evidence-based practice: the integration of the best research evidence, clinical expertise

and patient values into the planning and delivery of patient-centered care (IOM, 2003).

14. Global engagement: valuing the interconnectedness and interdependence of the human

experience on a global scale (NAU Global Learning Initiative, 2010).

15. Health disparity: differences in health status amount distinct segments of the population

including differences that occur by gender, race or ethnicity, education or income,

disability, or living in various geographic localities (Health People 2020; World Health

Organization, 2011).

16. Health equity: attainment of the highest level of health for all people. Health equity

entails focused societal efforts to address avoidable inequalities by equalizing the

conditions for health of all groups, especially those who have experienced

socioeconomic disadvantage or historical injustices (Healthy People 2020).

17. Health promotion: activities that have as their goal the development of human attitudes

and behaviors that maintain or enhance well-being (Stanhope & Lancaster, 2008).

12

18. Informatics: use of information and technology to communicate, manage knowledge,

mitigate error, and support decision making (QSEN).

19. Inter-disciplinary collaboration: effective teamwork with health-care team members

across disciplines with the goal of quality patient-centered care (QSEN).

20. Intra-professional collaboration: effective teamwork with nursing colleagues to achieve

continuity of effective patient care or other professional goals (AACN, 2008).

21. Patient: the recipient of nursing care or services. Patients may be individuals, families,

groups, communities, or populations. Patients may function in independent,

interdependent, or dependent roles. They may seek or receive nursing interventions

related to disease prevention, health promotion, or health maintenance, as well as illness

and end-of-life care (AACN, 2008).

22. Patient-centered care: includes actions to identify, respect and care about patients’

differences, values, preferences, and expressed needs; relieve pain and suffering;

coordinate continuous care; listen to, clearly inform, communicate with, and educate

patients; share decision making and management; and continuously advocate disease

prevention, wellness, and promotion of healthy lifestyles (IOM, 2003).

23. Quality improvement (QI): use data to monitor the outcomes of care processes and use

improvement methods to design, implement and evaluate changes to continuously

improve the quality and safety of health care systems (QSEN)

24. Quality (of care): a measure of health services that increase the likelihood of desired

health outcomes and are consistent with current professional knowledge (Robert Wood

Johnson Foundation, 2009).

25. Rural: communities with less than 20,000 residents or fewer than 99 persons per square

mile; as related to health care that it takes 30 minutes or longer to arrive at a health

service center. (Stanhope & Lancaster, 2008).

26. Safety: minimizes the risk of harm to patients and providers through both system

effectiveness and individual performance (QSEN).

27. Social justice: The equitable distribution of social, economic and political resources,

opportunities and responsibilities (World Health Organization, 2011).

28. Spiritual care: interventions that facilitate the ability to experience the integration of the

body, mind, and spirit to achieve wholeness, health and sense of connection to self,

others, and a higher power (American Nurses Association and Health Ministries

Association, 2005).

13

References Utilized:

American Association of Colleges of Nursing (AACN) (2008). The essentials of baccalaureate

education for professional nursing practice. Author: Washington, DC.

American Nurses Association and Health Ministries Association (2005). Faith

community nursing: Scope & standards of practice. Silver Spring, MD: ANA

Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical

transformation. San Francisco, CA: Jossey-Bass.

Benner, P., & Wrubel, J. (1989). The primacy of caring. Menlo Park, CA: Addison-Wesley.

Cross, T. L., Barzon, B. J., Dennis, K. W., & Isaacs, M. R. (1989). Towards a culturally

competent system of care. Washington, D.C.: CASSP Technical Assistance Center for

Children’s Mental Health; Georgetown University Child Development Center.

Institute of Medicine. (2003). Health professions education: A bridge to quality.

Washington, DC: National Academies Press.

Robert Wood Johnson Foundation. (2009). Glossary of health care quality terms. Retrieved

from: http://www.rwjf.org/qualityequality/glossary.jsp [February 4, 2011]

Northern Arizona University (2010). Global learning initiative. Retrieved from :

http://international.nau.edu/about_cie/task_force.html [February 9, 2011]

Pesut, D.J. (2001). Clinical judgment: Foreground/background. Journal of Professional

Nursing, 17(5), 215.

Porter-O’Grady, T. & Malloch, K. (2003). Quantum leadership: A textbook for new leadership.

Sudbury, MA: Jones & Bartlett.

QSEN: Quality and Safety Education for Nurses. (2011). Definitions retrieved:

http://www.qsen.org/ksas_prelicensure.php [February 9, 2011].

Roach, M.S. (2002). Caring, the human mode of being (2nd

revised edition). Ottawa, Ontario:

CHA Press.

Simmons, B., Lanuza, D., Fonteyn, M., & Hicks, F. (2003).Clinical reasoning in experienced

nurses. Western Journal of Nursing Research, 25, 701-719.

Stanhope, M. & Lancaster, J. (2008). Public health nursing: Population-centered health care in

the community. Thousand Oaks, CA: Sage.

Watson, J. (1999). Postmodern nursing and beyond. Edinburgh: Churchill Livingstone.

http://www.rwjf.org/qualityequality/glossary.jsp

http://international.nau.edu/about_cie/task_force.html

http://www.qsen.org/ksas_prelicensure.php

14

BSN PROGRAM OUTCOMES

LEVEL ONE OUTCOMES

LEVEL TWO OUTCOMES

LEVEL THREE/ PROGRAM

OUTCOMES


Demonstrates competency in providing

safe, effective patient-centered care that

is holistic and based in evidence to

protect and promote the health of

individuals.


Applies sound clinical judgment based in

theory and evidence to promote and

protect health in patients across the

lifespan and healthcare continuum.


Integrates theory, evidence, professional

perspectives, and patient preferences into

clinical judgment to provide holistic patient-

centered care across the lifespan and

healthcare continuum, and in healthcare

environments.

Communication

Demonstrates beginning professional

communication skills in clinical and

learning situations.

Communication

Applies professional and therapeutic

communication in clinical and learning

situations.

Communication

Incorporates effective communication into

professional nursing practice.

Critical reasoning

Displays a commitment to the use of

theory and research evidence to provide

safe, effective, patient-centered nursing

care.

Critical reasoning

Utilizes nursing knowledge, information

technologies and research evidence to

construct and implement safe, effective,

patient-centered nursing care.

Critical reasoning

Synthesizes evidence and nursing knowledge

to evaluate and modify clinical nursing

practice, in order to provide holistic, safe,

comprehensive, patient-centered care.

Integrates reliable evidence from multiple

ways of knowing to inform practice and

make clinical judgments.

Leadership

Organizes self to provide safe nursing

care to individuals.

Leadership

Applies principles of collaboration,

delegation and advocacy to manage safe

Leadership

Integrates knowledge and skills in leadership,

quality improvement, health care policy and

15


LEVEL ONE OUTCOMES

LEVEL TWO OUTCOMES


OUTCOMES

Demonstrates knowledge and skills of

leadership to provide safe and appropriate

patient-centered nursing care.

patient care. patient safety into practice to provide high

quality care.

Professionalism and Professional

Values

Demonstrates professional values and

their associated behaviors in the practice

of nursing.

Demonstrates ethical and legal

principles and professional standards in

nursing practice.

Demonstrates the ability to translate

caring’s affective characteristics into

patient-centered care and with other

healthcare professionals.


Values

Applies professional values and their

associated behaviors to the practice of

nursing.

Applies ethical and legal principles and

professional standards to nursing

practice.

Applies caring’s affective characteristics

into patient-centered care and with other



Integrates professional values and their

associated behaviors into the practice of

nursing.

Incorporates ethical and legal principles

and professional standards into nursing

practice.

Integrates caring’s affective characteristics

into patient-centered care and with other


Global Health

Global Engagement

Examines one’s own personal values,

beliefs, and practices as compared to

diverse populations in a global society.

Global Health

Global Engagement

Collaborates with patients and families to

identify mutually agreed upon goals and

health care outcomes for culturally

reinforcing care.

Global Health

Global Engagement Promotes safety and quality of health care

outcomes for diverse populations



16


LEVEL ONE OUTCOMES

LEVEL TWO OUTCOMES


OUTCOMES

Diversity Education

Identifies social, biological, cultural, and

health literacy data and how it impacts

nursing practice.


Recognizes how responsible health care

waste disposal reduces environmental

hazards.

Diversity Education Examines the impact of health equity and

social justice on nursing and health care in

a variety of settings.


Examines how nurses and institutions can

impact environmental sustainability across

multiple contexts in diverse health care

settings.

Diversity Education Advocates for health equity and social justice

for vulnerable populations and the

elimination of health disparities both locally

and globally.




negatively impacts health both locally and

globally.

17

BSN PROGRAM OUTCOMES MS PROGRAM OUTCOMES


Integrates theory, evidence,

professional perspectives, and

patient preferences into clinical

judgment to provide holistic

patient-centered care across the

lifespan and healthcare continuum,

and in healthcare environments.


Design patient-centered and culturally responsive strategies in the delivery of

clinical prevention and health promotion interventions and/or services to

individuals, families, communities, and aggregates/clinical populations.

Communication

Incorporates effective

communication into professional

nursing practice.

Communication

Develop and collaborate within interprofessional teams and partnerships by using effective

communication strategies.

Advance patient education, enhance accessibility of care, analyze practice patterns, and

improve health care and nurse sensitive outcomes by using information and communication

technologies.

Critical reasoning

Synthesizes evidence and nursing

knowledge to evaluate

and modify clinical nursing

practice, in order to provide

holistic, safe, comprehensive,

patient-centered care.

Integrates reliable evidence from

multiple ways of knowing to inform

practice and make clinical

judgments.

Critical reasoning

Integrate theory, evidence, clinical judgment, research, and interprofessional

perspectives using translational processes to improve practice and associated health

outcomes for patient aggregates.

18


Leadership

Integrates knowledge and skills in

leadership, quality improvement,

health care policy and patient safety

into practice to provide high quality

care.

Leadership

Analyze how policies influence the structure and financing of health care, practice, and health

outcomes.

Examine the effect of legal and regulatory processes on nursing practice, healthcare delivery,

and outcomes.


Values

Integrates professional values and

their associated behaviors into the

practice of nursing.

Incorporates ethical and legal

principles and professional

standards into nursing practice.

Integrates caring’s affective

characteristics into patient-centered

care and with other healthcare

professionals.


Advocate for patients, families, caregivers, communities and members of the healthcare team.

Incorporate core scientific and ethical principles in identifying potential and actual ethical

issues arising from practice, and assisting patients and other healthcare providers to address

such issues.

Global Health

Global Engagement

Advocates for health equity and

social justice for vulnerable

populations and the elimination of

health disparities both locally and

globally.

Global Health

Global Engagement

Transforms health care systems to address health equity and social justice thus reducing health

disparities in vulnerable populations.

19


Diversity Education

Promotes safety and quality of

health care outcomes for diverse

populations incorporating

principles of advocacy, leadership

and collaboration.


Participates in collaborative efforts

to improve aspects of the

environment that negatively

impacts health both locally and

globally.

Diversity Education

Assumes leadership and/or research roles in developing, implementing, and evaluating

culturally reinforcing nursing and other health care services from local to global perspectives.

Prioritizes the social and cultural factors that affect health in designed and delivering care

across multiple contexts.


Creates partnerships that promote sustainable environmental health policies and conditions.

Analyzes and promote social, political, and economic policies that influence sustainable

environments and reduce human health exposures in a global society.

20

Exhibit B

Undergraduate Course Learning Outcomes for Global Health Strand

BSN Program Level I

Courses: 205/205L, 214, 215

NUR 205: Transition into Nursing

Course Description: Emphasis on development of student as a caring competent nurse at

beginning level. Focuses on introduction to profession, skill development, and situational

transition to nursing student role.

.

NUR 205 Course Outcomes Level I Program Outcomes

Global Health

Examines health literacy data and its

impact on the practice of nursing.

Examines a patient's social,

biological, and cultural features and

how these influence the practice of

nursing.

Global Health






nursing practice.



hazards.

NUR 205L: Transition into Nursing Clinical

Course Description: Emphasis on development of student as a caring competent nurse at

beginning level. Focuses on introduction to profession, skill development, and situational

transition to nursing student role.

NUR 205L Course Outcomes Level I Program Outcomes

Global Health

Applies health literacy data within the

clinical setting.

Applies patient's social, biological,

and cultural features to patient care.

Global Health






nursing practice.



hazards.

21

NUR 214: Introduction to Health Assessment

Course Description: Introductory course emphasizes health history and physical

examination skills essential for holistic assessment using the nursing process. Provides

knowledge to develop health assessment skills and outcomes in healthy persons.


Global Health


beliefs, and practices as compares to


Global Health






nursing practice.



hazards.

NUR 214L: Introduction to Health Assessment

Course Description: Introductory course emphasizes health history and physical

examination skills essential for holistic assessment using the nursing process. Provides

knowledge to develop health assessment skills and outcomes in healthy persons.


Global Health


beliefs, and practices as compares to


Global Health






nursing practice.



hazards.

22

NUR 215: Pharmacology

Course Description: Introduces classifications, actions, and uses of pharmacotherapeutic

agents. Includes administration skills, safety, and legal considerations. Emphasizes

patient and nursing implications.


Global Health

Recognize variations in drug responses

that occur with individuals of various

ages, gender, and race.

Incorporate developmental, gender,

genetic, economic and other issues that

affect drug therapy.

Discuss proper disposal of the portion of

medications that will not be

administered.

Global Health






nursing practice.



hazards.

BSN Program Level II

Courses: 208/208L, 212/212L, 216/216L, 320, 321, 390W

NUR 208: Adult Health & Illness I

Course Description: This course focuses on nursing care of adults experiencing health-

illness transitions.

NUR 208 Course Outcomes Level II Program Outcomes

Global Health

Discusses the impact of health equity and



Global Health




reinforcing care.

Examines the impact of health equity and






settings.

23

NUR 208L: Adult Health & Illness I Clinical

Course Description: This course focuses on nursing care of adults experiencing health-

illness transitions.

NUR 208L Course Outcomes Level II Program Outcomes

Global Health

Plans culturally appropriate care

and/or teaching in selected situations.

Global Health




reinforcing care.







settings.

NUR 212: Adult Health & Illness II

Course Description: This course continues the focus on nursing care of adults

experiencing health-illness transitions


Global Health

Develops effective strategies to implement

culturally appropriate care.

Analyzes the impact of health equity and



Global Health




reinforcing care.







settings.

NUR 212L: Adult Health & Illness II Clinical

Course Description: This course continues the focus on nursing care of adults

experiencing health-illness transitions


Global Health




Global Health




24

reinforcing care.

Identifies how nurses and institutions can

impact environmental health and

sustainability in diverse health care

settings.

reinforcing care.



a variety of settings




settings.

NUR 216: Psychiatric and Mental Health Nursing

Course Description: Emphasis on nursing strategies for promoting, maintaining, and

restoring mental health utilizing therapeutic nursing interventions for clients along the

mental health/ disorder continuum.


Global Health




Global Health




reinforcing care.







settings.

NUR 216L: Psychiatric and Mental Health Nursing

Course Description: Emphasis on nursing strategies for promoting, maintaining, and

restoring mental health utilizing therapeutic nursing interventions for clients along the

mental health/ disorder continuum.


Global Health




reinforcing care.

Global Health




reinforcing care.



25





settings.

NUR 320: Basic Principles in Palliative Care

Course Description: Provides an overview of core principles of palliative care.

Emphasizes strategies to improve palliative care and the nurse as a member of an

interdisciplinary team.


Global Health

Describes approaches to work with

individuals, families, and/or communities

to implement culturally-reinforcing

palliative care.

Global Health




reinforcing care.







settings.

NUR 321: Gerontology

Course Description: Explores beliefs, attitudes, and stereotypes about the elderly.

Includes theories of aging, normal aspects and changes, ethical issues, and successful

aging through interdisciplinary health promotion and risk reduction strategies.


Global Health


social justice on nursing the older adult.

Global Health




reinforcing care.


26






settings.

NUR 390W: Nursing Research & Evidence Based Practice

Course Description: This course focuses on the research process as it relates to health

and nursing practice. It emphasizes developing abilities to interpret research reports and

apply research evidence to nursing practice. As the junior level writing course, it

emphasizes writing skills.

NUR 390W Course Outcomes Level II Program Outcomes

Global Health

N/A

Global Health




reinforcing care.







settings.

BSN Program Level III

Courses: 211/211L, 350/350L, 424, 427/427L, 450C, 451

NUR 211: Developmental and Health-Illness Transitions of Child-Bearing and Child-

Rearing Families

Course Description: Focuses on nursing care for child-bearing and child-rearing

families experiencing developmental, health, and illness transitions.

NUR 211 Course Outcomes Level III Program Outcomes

Global Health


outcomes for diverse childbearing and

childrearing populations, incorporating

Global Health





27

principles of advocacy, leadership, and

collaboration.








globally.

NUR 211L: Developmental and Health-Illness Transitions of Child-Bearing and Child-

Rearing Families

Course Description: Focuses on nursing care for child-bearing and child-rearing

families experiencing developmental, health, and illness transitions.

NUR 211L Course Outcomes Level III Program Outcomes

Global Health


improve aspects of the environment

that negatively impact the health of

childbearing and childrearing families

both locally and globally.

Global Health

Promotes safety and quality of health care











globally.

NUR 350: Nursing Care of Families

Course Description: Nursing care/case management of families experiencing complex

health transitions within community settings.


Global Health

Analyzes safety and quality of health

care outcomes for diverse family

populations in the home and

community settings incorporating


collaboration.

Global Health









28




globally.

NUR 350L: Nursing Care of Families Clinical

Course Description: Nursing care/case management of families experiencing complex

health transitions within community settings.


Global Health



populations in the home and

community settings incorporating


collaboration.


improve aspects of the environment

that negatively impact the health of

patients and families in the home and

community setting.

Global Health












globally.

NUR 424: Manager of Care/Health Care Systems

Course Description: This course provides the student with knowledge and skills to

manage care across the continuum, with information technology for quality outcomes

within the current health care delivery system.

UR 424 Course Outcomes Level III Program Outcomes

Global Health





Global Health











29


globally.

NUR 427: Public Health Nursing

Course Description: Provides a foundation for developing and implementing public

health promotion and disease prevention strategies for populations and communities

within the context of a global society.


Global Health

Analyzes global and societal public

health trends for health promotion, risk

reduction and disease prevention.

Critiques the impact of health and social

policy and standards on global, national

and state communities and the profession

of public health nursing.

Global Health












globally.

NUR 427L: Public Health Nursing





Global Health








Global Health












globally.

30

NUR 450C: Nursing Leadership

Course Description: This capstone course will provide students with the opportunity to

synthesize leadership principles into the baccalaureate role in nursing.

Global Health

Synthesizes principles of health equity

and social justice for vulnerable

populations into the role of the

professional nurse.

Analyzes the role of the nurse as

change agent related to improving local

and global environmental conditions

which affect a population’s health.

Global Health





Advocates for health equity and social justice

for vulnerable populations and the elimination

of health disparities both locally and globally.

Participates in collaborative efforts to improve

aspects of the environment that negatively


NUR 451: Nursing Leadership

Course Description: Clinical preceptorship for unlicensed nursing students provides

clinical experience in preparation for transition into professional nursing practice.

Global Health




professional nurse.





Global Health











Accelerated BSN Program Level I

Courses: 319/319L, 330, 331, 332, 333/333L

NUR 319: Fundamentals of Nursing Practice

Course Description: Fundamental concepts of nursing that provide the building blocks

of nursing care. Emphasis is placed on developing skills needed to assess, implement, and

monitor selected nursing interventions and technologies.


31

Global Health



nursing practice.

Global Health






nursing practice.



hazards.

NUR 319L: Fundamentals of Nursing Practice - Clinical

Course Description: Fundamental concepts of nursing that provide the building blocks

of nursing care. Emphasis is placed on developing skills needed to assess, implement, and

monitor selected nursing interventions and technologies.


Global Health



hazards.

Global Health






nursing practice.



hazards.

NUR 330: Nursing as a Discipline and Profession

Course Description: An introduction to nursing as a distinct discipline of knowledge and

a unique professional service.


Global Health




Global Health





32


nursing practice.



hazards.

NUR 331: Applied Pharmacology and Pathophysiology

Course Description: Introduces students to classifications, actions, and uses of

pharmacotherapeutic agents. Includes an overview of administration skills, safety, and

legal considerations. Emphasis is on the patient and nursing implications and related

pathophysiology.


Global Health

Recognize variations in drug responses

that occur with individuals of various

ages, gender, and race.

Incorporate developmental, gender,

genetic, economic and other issues that

affect drug therapy.

Discuss proper disposal of the portion

of medications that will not be

administered.

Global Health






nursing practice.



hazards.

NUR 332: Nursing Assessment and Process

Course Description: Study of fundamental nursing process knowledge while learning

cognitive and psychomotor skills in health history, assessments, and physical exams

across the life span.


Global Health



diverse populations in a global

society.

Global Health






nursing practice.



33

hazards.

NUR 332L: Nursing Assessment and Process

Course Description: Study of fundamental nursing process knowledge while learning

cognitive and psychomotor skills in health history, assessments, and physical exams

across the life span.


Global Health




Global Health






nursing practice.



hazards.

NUR 333: Communication and Mental Health Nursing

Course Description: Course focuses on developing therapeutic communication skills

with clients and other healthcare providers. Additionally, the course will focus on

promoting, maintaining, and restoring mental health, utilizing therapeutic nursing

interventions.


Global Health




Global Health




reinforcing care.







settings.

34

NUR 333L: Communication and Mental Health Nursing

Course Description: Course focuses on developing therapeutic communication skills

with clients and other healthcare providers. Additionally, the course will focus on

promoting, maintaining, and restoring mental health, utilizing therapeutic nursing

interventions.


Global Health




reinforcing care.

Global Health




reinforcing care.







settings.

Accelerated BSN Program Level II

Courses: 334/334L, 390W

NUR 334: Adult Health Nursing Theory

Course Description: This course establishes the foundation for caring for adults

experiencing disease and illness.


Global Health

Develops effective strategies to

implement culturally appropriate care.

Examines the impact of health equity

and social justice on nursing and health

care in a variety of settings.

Analyzes the impact of health equity



Global Health

Collaborates with patients and families

to identify mutually agreed upon goals

and health care outcomes for culturally

reinforcing care.




Examines how nurses and institutions

can impact environmental

sustainability across multiple contexts

in diverse health care settings.

35

NUR 334: Adult Health Nursing Theory

Course Description: This course establishes the foundation for caring for adults

experiencing disease and illness.


Global Health




reinforcing care.

Identifies how nurses and institutions can

impact environmental health and

sustainability in diverse health care

settings.

Global Health

Collaborates with patients and families

to identify mutually agreed upon goals

and health care outcomes for culturally

reinforcing care.



care in a variety of settings

Examines how nurses and institutions

can impact environmental sustainability

across multiple contexts in diverse

health care settings.







Global Health

N/A

Global Health




reinforcing care.







settings.

36

Accelerated BSN Program Level III

Courses: 335/335L, 408, 441/441L, 450C

NUR 335: Nursing Care of Child-Bearing and Child-Rearing Families

Course Description: This course examines transitions of individuals and families across

the life span, emphasizing childbearing processes, childhood experiences, and the effects

of illness on childbearing women and children.

Global Health


outcomes for diverse childbearing and

childrearing populations, incorporating


collaboration.

Global Health








and globally.




globally.

NUR 335L: Nursing Care of Child-Bearing and Child-Rearing Families Clinical

Course Description: This course examines transitions of individuals and families across

the life span, emphasizing childbearing processes, childhood experiences, and the effects

of illness on childbearing women and children.

Global Health


improve aspects of the environment the

negatively impacts the heath of

childbearing and childrearing families both



justice for vulnerable families and

communities.

Global Health











37

NUR 408: Fieldwork Experience

Course Description: Individualized supervised field experience in an appropriate agency

or organization

Global Health




professional nurse.





Global Health











NUR 441: Health Policy and Public Health Nursing

Course Description: This course provides a foundation for developing and

implementing public health promotion and disease prevention strategies for populations

and communities within the context of a global society.


Global Health








Global Health












globally.

38

NUR 441L: Health Policy and Public Health Nursing Clinical

Course Description: This course provides a foundation for developing and

implementing public health promotion and disease prevention strategies for populations

and communities within the context of a global society.


Global Health








Global Health












globally.




Global Health

Synthesizes principles of health equity and

social justice for vulnerable populations

into the role of the professional nurse.

Analyzes the role of the nurse as change

agent related to improving local and global

environmental conditions which affect a

population’s health.

Global Health











39

RN to BSN Program Level I

Courses: 307, 330

NUR 307: Health Assessment for Registered Nurses

Course Description: Clinical lab course provides cognitive and psychomotor skills in

health history, assessments, and physical exams across the life span


Global Health




Global Health






nursing practice.



hazards.

NUR 330: Nursing as a Discipline and Profession

Course Description: An introduction to nursing as a distinct discipline of knowledge and

a unique professional service.


Global Health




Global Health






nursing practice.



hazards.

40

RN to BSN Program Level II

Courses: 320, 321, 390W

NUR 320: Basic Principles in Palliative Care

Course Description: Provides an overview of core principles of palliative care.

Emphasizes strategies to improve palliative care and the nurse as a member of an

interdisciplinary team.


Global Health

Describes approaches to work with

individuals, families, and/or communities

to implement culturally-reinforcing

palliative care.

Global Health




reinforcing care.







settings.

NUR 321: Gerontology

Course Description: Explores beliefs, attitudes, and stereotypes about the elderly.

Includes theories of aging, normal aspects and changes, ethical issues, and successful

aging through interdisciplinary health promotion and risk reduction strategies.


Global Health


social justice on nursing the older adult.

Global Health




reinforcing care.







settings.

41







Global Health

N/A

Global Health




reinforcing care.







settings.

RN to BSN Program Level III

Courses: 408, 420, 424, 427/427L, 450C

NUR 408: Fieldwork Experience

Course Description: Individualized supervised field experience in an appropriate agency

or organization.

Global Health




professional nurse.





Global Health






for vulnerable populations and the


and globally.




globally.

42

NUR 420: Family Nursing Roles

Course Description: Explores roles of nurses working with families, including

application of theories to understand how families function and cope with stress.

Emphasizes family assessment, health promotion and role of genomics.

Global Health

Analyzes safety and quality of health


populations in community settings



Explores innovative approaches in

holistic care to promote health equity

and social justice for families in

community settings.

Global Health











NUR 424: Manager of Care/Health Care Systems

Course Description: This course provides the student with knowledge and skills to

manage care across the continuum, with information technology for quality outcomes

within the current health care delivery system.


Global Health





Global Health












globally.

43

NUR 427: Public Health Nursing





Global Health








Global Health












globally.

NUR 427L: Public Health Nursing





Global Health








Global Health












globally.

44




Global Health




professional nurse.





Global Health











45

Exhibit C

Graduate Course Learning Outcomes for Global Health Strand

Examples of diversity education learning outcomes in master’s level courses:

NUR 530 Advanced Prinicples in Evidence-Based Practice

Explore the concept of “rural and/or vulnerable population” and its

implication for conducting research.

Suggest clinical decisions based on evidence from the literature combined

with clinical expertise and patient preferences

NUR 550 Family Nursing Theory and Practice

Describe guidelines for advanced nursing practice for family-focused,

culturally competent care in health and illness.

NUR 560 Rural Theory and Health Policy

Discuss the implications of social and cultural factors on the delivery of health

care in rural areas.

Identify strategies to promote health in varying cultural, ethnic and social

groups throughout the rural communities in the Southwest.


Use knowledge of family theory, cultural diversity, spirituality and health

assessment in specifying the data to be collected for health promotion, health

maintenance, and common uncomplicated conditions for individuals and

families.

NUR 661 Family Primary Health Care Practicum I

Begin to apply knowledge of family theory, cultural diversity, spirituality, and

primary care assessment in specifying the data to be collected about

individuals and families with health promotion/disease prevention and health

maintenance needs.

NUR 664 Family Primary Health Care III

Use knowledge of family theory, cultural diversity and health assessment in

specifying the data to be collected, as well as the assessment and management

of acute, chronic and complex health conditions for individuals and families.

NUR 665 Family Primary Health Care Practicum III

Develop skills in the application of knowledge of family theory, cultural

diversity, spirituality, and primary care assessment in specifying the data to be

collected about individuals and families with acute and chronic health care

needs.

46

NUR 675 Advance Practice Nurse Roles

Articulate the role of the APN in delivery of health services to clients and

families 1iving in rural communities.

Analyze ethical dilemmas that may occur in practice

NUR 697 Advanced Principles in Palliative Care (an elective course)

Identify the impact of culture on delivery of end of life care with diverse

populations.

Describe and apply ways to work with individuals, families, and/or

communities to implement culturally appropriate end of life care.

Teach individuals, families, and/or communities as appropriate about the end

of life as it relates to their particular situation and concerns.

Discuss aspect of suffering for patients and families facing the end of life

situations.

NUR 697 Health Care in a Global Society (currently being taught as an independent

study elective)

Practice within the ethical and legal framework of nursing, reflecting cultural

and cultural safety accommodation

Design and implement cultural reinforcing or accommodating health care

promotion, protection, maintenance of health, risk reduction and prevention of

disease interventions for populations and communities in a global society

Promote cultural appropriate protection, enhancement and preservation of

health for populations and communities’ dignity and quality of life in a global

society.

Synthesize and utilize communication theory to express self in a culturally

effective manner in diverse community settings

Facilitate culturally effective communication to targeted populations and

communities.

Adapt uses of technologies in cultural appropriate ways to meet community

needs.

Elicit and clarify the cultural preferences and values of a targeted community

or population

Analyze past and present health beliefs, practices and current health needs of a

targeted community/region.

Interpret the health care providers’ role in a targeted community or population

in light of principles from transcultural nursing, medical anthropology and

ethics.

Synthesize theoretical concepts of world views and health beliefs from

transcultural nursing, medical anthropology and ethics

Analyze cultural factors influencing health beliefs and practices of both health

care providers and the targeted population or community

Analyze the community’s or populations’ diverse cultures and values and

apply findings to provide health care

Formulate and implement health care that demonstrates cultural competency

47

Design health care that utilizes an understanding of culture, environment,

communication, social organization, legal and political organization, nutrition

and spiritual/religious factors influencing health beliefs and practices of both

health care providers and consumers and current health needs of targeted

populations/community/region in a global society.

An example of environmental sustainability in learning outcomes in master’s level

courses includes:

NUR 520 Applied Pathophysiology for APNs

Analyze an environmental concern that affects health

An example of global engagement in learning outcomes in master’s level courses

includes:

NUR 675 Advance Practice Nurse Roles

Examine the APN role from a global perspective.

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Exhibit D

Example of Undergraduate Learning Experience

Class Assignment Description

For

Global Health Project

The class will be divided into pairs or groups. Each pair/group will have 10 minutes (or time

determined by individual Lecture Faculty) for their Global Presentation.

Global Health Topics:

Chronic Disease (Cardiovascular, pulmonary)

Health Education/Promotion

Healthcare Access

Nutrition (diabetes, stomach cancer)

Poverty

Mental health/substance abuse

Communicable Disease (HIV, TB, malaria, parasites)

Unintentional/Intentional Injuries

Populations: Pick a population in a country other than the United States

The presentation should be organized to include the following:

Succinct display of statistical data of your population

Who are at greatest risk within your population?

What is the prevalence of the global health topic within your population?

Provides specific example/observation of how global health topic is addressed within

your population.

How does the global health topic impact society?

Identify cultural implications and how the global health topic is being addressed

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Evaluation of Group Presentation In-Class Group Members:

Content/Topic

Comments

___/2 pts Succinct display of statistical data of your

population Who are at greatest risk within your population?

___/4 pts

What is the prevalence of the global health topic

within your population? Provides specific example/observation of how

global health topic is addressed within your

population.

___/2 pts

How does the global health topic impact

society? Identify cultural implications and how the

global health topic is being addressed

___/2 pts Approach:

Creative Appropriate appearance Used Power Point

® Within time limit Reference List (APA Format)

Additional Comments:

Score _______/10

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Exhibit E

Examples of Graduate Learning Experience

EXAMPLE 1


The assignment below meets the following course learning outcomes:

Use knowledge of family theory, cultural diversity, spirituality and health assessment

in specifying the data to be collected for health promotion, health maintenance, and

common uncomplicated conditions for individuals and families.

Teach clients and family members as necessary about health promotion, health

maintenance and common uncomplicated health conditions.

Discuss methods of establishing mutual goals with the individual and family which

demonstrate meeting their health promotion and health maintenance needs.

Integrate appropriate research and evidence-based findings into primary care practice.

GUIDELINES FOR CLINICAL DECISION MAKING PAPER

This paper will reflect the decision making process for working with a

patient/family around a health promotion (e.g. exercise or nutrition promotion) or

illness prevention issue (e.g. prevention of cardiac risk).This paper, however, is NOT

about a disease/illness process. (Your topic must be different than what you did for the

health promotion class presentation) This could also be a population group at risk or

with a health promotion issue. If addressing a population group at risk, you still

need to address how to approach an individual in the at-risk group in primary care

practice (i.e. all the sections below MUST be addressed in your paper).

Students wishing to take a more international focus may develop their paper using the

United Nations Millennium Development Goals. Choose from Goals 4 (Reduce Child

Mortality), 5 (Improve Maternal Health), or 6 (Combat HIV/AIDS, Malaria and Other

Diseases) only. See MDGs: http://www.undp.org/mdg/basics.shtml. You will follow the

same directions, but focus will be on some non-USA or refugee population.

For the text of the paper (i.e. does not include title page, teaching tool, or references),

there is a maximum of 10 typed, 12 point font, double spaced pages for this assignment

(APA 6th ed. format). Use headings and subheadings as described below.

SCORE: PART I: (Text) _____(10 pts.) A. Reason for health promotion/illness prevention (e.g., risk or concern).

Statement of purpose of paper

_____(10 pts.) B. Pathophysiology/etiology

_____(10 pts.) C. Pertinent history, including culturally appropriate assessment

http://www.undp.org/mdg/basics.shtml

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_____(10 pts.) D. Physical exam, as indicated

_____( 5 pts.) E. Diagnostics, as indicated

_____(10 pts.) F. Risk/benefits of intervention, including pertinent ethical and legal

issues

_____(15 pts.) G. Management with rationale, include risk/benefits

1. Therapeutic/Integrative/Complementary health strategies

2. Patient/family/community education and counseling, including addressing

health literacy

3. Address cultural appropriateness in how you would work with

someone from a cultural group different from your own. Pick a specific

cultural or ethnic group.

4. Community resources

_____(5 pts.) H. Follow-up

PART II:

_____(15 pts.) A. Appendix: Develop a brief teaching tool (15 minutes) appropriate for

primary care settings, including addressing health literacy. [Note: must be original work

and not a copy of existing tool]

_____( 5 pts.) B. Quality of references: will include authoritative (juried) journal

references that are different than syllabus readings and evidence-based references. If

Internet is used, must be authoritative references (NO Wikipedia).

_____( 5 pts.) C. Form and Style. Uses headings and subheadings in paper.

(100 possible)TOTAL:

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EXAMPLE 2

NUR 520 Applied Pathophysiology for APNs

The assignment below meets the following course learning outcome:

Analyze an environmental concern that affects health

GROUP ENVIRONMENTAL PRESENTATION RUBRIC

EFFECTS OF ENVIRONMENTAL HAZARDS ON HEALTH OF PERSONS

In a group of approximately 4 students, develop a presentation related to an

environmental hazard. Your PowerPoint presentation will be placed on the discussion

board. A sign-up sheet will be posted.

Each group should choose from one of the below topics. There may be more than 1 group

in a topic category.

Effects of air pollution

Effects of heavy metal poisoning

Effects of water pollution

Effects of radiation pollution

Effects of food contamination

When developing your topic you should:

Review literature on the chosen topic.

Briefly discuss the topic globally, and then bring to a more specific

local/community level.

Do a community assessment of the impact of the chosen topic on the community

Consider the impact of the environmental pollutant on the health of the chosen

community.

Give an example of an assessment tool that may be used to indicate possible

exposure to the hazard.

Develop a health history questionnaire that would indicate exposure to the hazard.

Develop a concept map illustrating the cycle of exposure and the ultimate effects

on the person’s health.

Discuss what can be done to prevent future illness or to minimize the effects of

the environmental pollutant (global prevention and local prevention related to

your specific exposure topic).

Your topic should be presented utilizing PowerPoint. In the notes view of the slide, place

what you would say during that slide if doing an oral presentation; each slide should have

something in the notes. The slide presentation should be turned in to me via the

assignment link by one person in the group and it should also be placed in the discussion

board under the environmental presentation link. Each group will also have a discussion

board link that is only accessible to members of the group to allow you to communicate

with each other as you are working on the document.

You are also required to participate in another group's discussion by making a minimum

of one substantive contribution to the discussion.

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Area Graded Exemplary

Good

Fair

Unacceptable

Description the impact of the

environmental hazard (10 pts)

Provides an accurate and

complete explanation of

the concepts, drawing

upon relevant literature.

Readers able to develop

an understanding of the

material. (10 pt.)

For the most part,

explanations of concepts

and theories are accurate

and complete. Readers

gain some knowledge of

the topic. (9 pt.)

Explanations of concepts

and/or theories are

inaccurate or incomplete.

Little attempt is made to

tie theory to practice.

Readers gain little from

the presentation (7.5 pt.)

No reference is made to

literature or theory.

Readers gain no new

insights.

(0 pt.)

Example of assessments used to indicate

exposure – case study (5 pts)

Provides well-developed

assessments related to the

environmental exposure.

Clear and concise. (5 pt)

Provided well developed

assessments but left out a

key indicator. (4 pts)

Provided assessments but

left out several important

items or they were

incomplete. (3 pts)

Does not provide an

assessment. (0 pt)

Health history questionnaire (5 pts) Provides a well-

developed

health history

questionnaire related to

the environmental

exposure. Clear and

concise. (5 pt)

Developed a health

history questionnaire

which addressed most,

but not all of the

important items (4 pt)

Developed a health

history questionnaire but

left out several important

items. (3 pt)

Does not provide a health

history. (0 pt)

Concept map of environmental hazard -

(5 pts)

Constructs an appropriate

and complete concept

map and includes

examples; places

concepts in an

appropriate hierarchy and

places linking words on

all connections; produces

a concept map that is

easy to interpret. (5 pt.)

Places almost all

concepts in an

appropriate hierarchy and

assigns linking words to

most connections;

produces a concept map

that is easy to interpret (4

pt.)

Places only a few

concepts in an

appropriate hierarchy or

uses only a few linking

words; produces a

concept map that is

difficult to interpret (3

pt.)

Inappropriate structure.

No differentiation of

ideas. No evidence of

meaningful relations. (0

pt.)

Future preventative measures (5 pts) In-depth presentation of Presented some Explanations of ideas Did not explain the

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Area Graded Exemplary

Good

Fair

Unacceptable

preventative measures. (5

pt.)

preventive measures but

left out a key point. (4

pt.)

were incomplete or

vague. (3 pt.)

concept or apply to the

clinical case study. (0 pt.)

Documentation / References (5 pts)

References should be current (within 8

years unless a classic reference on that

topic). If not, 2 points will be taken off

of your score in this area.

If you have 5 or more

citations. (5 pt)

If you have 4 citations (4

pt.)

If you have 3 citations

but they are all from

sources such as

Wikipedia, or details are

not given (3 pt)

If all citations are from

textbooks or sources such

as Wikepedia (no articles

utilized) (1 or 2 pts)

No resources cited (0 pt)

APA format for reference list (5 pts) If all resources are

written correctly (5 pt)

If most citations are

written correctly (4 pt.)

If 50 to 75% of citations

are written correctly (3

pt.)

If you do not have any

resources cited or most or

none are written correctly

(0 pt.)

Organization of presentation / design (5

pts)

Presents information in

logical, interesting

sequence which audience

can follow. Slides are

easy to read and follow.

(5 pt)

Information is logically

presented. Most slides

are easy to read. (4 pt)

Presenter jumps around

at times and is not always

easy to follow. Some

slides are difficulty to

read. (3 pt)

Totally disorganized. (0

pt.)

Responses to another groups

presentation (5 pts)

Response demonstrated a

complexity of thought

and was developed with

supporting detail. (5 pt)

Response showed some

depth and complexity of

thought and contained

supporting detail. (4 pt)

Posting was simplistic or

stereotypical in thought.

Minimal supporting

detail. (3 pt)

Response is not

completely developed

and fails to discuss the

topic. (0 pt)

NORTHERN ARIZONA UNIVERSITY COLLEGE OF HEALTH …Stetina (Undergraduate) and Barbara Tomlinson...

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