Introduction

This course is part of a program of study leading to the Advanced Graduate Diploma: Advanced Nursing Practice or the Master of Nursing degree.

In Nursing 524: Advanced Nursing Practice: Children, students study the primary health care principles of participation and collaboration and the community development principle of empowerment.

Students learn to provide primary health care, including clinical services, to children (infancy through adolescence).  This care includes wellness counselling of healthy children, management of acute and chronic conditions of children, and referral of conditions requiring management by other health professionals.  Students also consider community implications related to the health of children.  Students examine trends in the health of children and evidence-based health care and explore areas of children's health research.  

Students complete a minimum of 140 hours in the clinical practicum focusing on the health of children. You are required to have a successful clinical evaluation in order to achieve a passing grade; additional hours over and above 140 may be required in order to achieve course objectives. By the end of your NURS 524 practicum you must have logged a program minimum of 105hrs (or 75% of the required course hours) providing care to children 18 years of age and under in order to achieve a passing grade.

Course Goals

After completing this course, students should be able to:

1. critically analyze the primary health care and community development principles of participation, collaboration, and empowerment, and discuss how these influence the health of clients;
2. implement strategies to foster participation and interdisciplinary/intersectoral collaboration of individuals and communities in decision-making on health issues;
3. implement strategies to promote empowerment of individuals and communities in decision-making on health issues;
4. provide evidence-based clinical services to well children and to those presenting with acute and chronic health concerns, at a level appropriate to a beginning practitioner, including:
   1. health history and physical examination
   2. clinical decision-making
   3. ordering of laboratory and diagnostic tests
   4. prescription of medications
   5. therapeutic communication
   6. collaborative relationships;
5. refer, to other health professionals, children with health concerns that exceed the scope of practice of a beginning nurse practitioner offering clinical services; 
6. demonstrate integration of medical and nursing management of health concerns of children;
7. synthesize community assessment data to develop inferences about:
   1. participation of community members in decision-making about a community's health issues
   2. interdisciplinary/intersectoral collaboration in decision-making about a community's health issues
   3. group/organizational dynamics that could influence decision-making about a community's health issues
   4. community vulnerabilities and strengths in relation to the health of children
   5. the status of a community's health in relation to children;
8. discuss issues and trends that affect the health of children in a community;
9. review Internet-based sources of information about evidence-based health care for children;
10. suggest areas for research in advanced nursing practice with children.

Course Materials

NURS 524 comprises online, print-based, and mobile electronic course materials.

Online Materials

• Introduction: Provides essential information about the course materials, the design of the course, and the procedures you should follow to complete the course successfully
• Schedule: Outlines the timing of course activities
• Units: There are seven units in this course.
• Assessment: Outlines the assignments/evaluation procedures of the course
• Reference: Listing of required readings, mobile resources, and websites included in the units
• Clinical Practicum: Explains how to complete the clinical practicum requirements of the course
• Community Health Component: Explains how to complete the community assessment requirements of the course

Print Materials

The following textbook is used in this course.

Burns, C., Dunn, A., Brady, M., Starr, N., & Blosser, C. (2004). Pediatric primary care: A handbook for nurse practitioners (3rd ed.). St. Louis: Saunders.

Mobile Electronic Materials

Hill, N., & Sullivan, N. (2004). NPPediatrics for PDAs, Management guidelines for nurse practitioners working with children and adolescents (2nd ed.). Philadelphia: F. A. Davis.

Other Materials

Textbooks, mobile resources, and readings from other Advanced Nursing Practice courses will be used as appropriate.

Course Structure

In this course, you will access health-related websites worldwide. You will also participate in email and computer conferencing with other students. Students are expected to connect to an Internet Service Provider at their own expense.

Technical Requirements

Computer System

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

Course Outline

NURS 524 consists of the following 7 units:

Unit 1: Clinical Practicum and Community Assessment: Processes and Requirements
Unit 1 provides an overview of the processes and requirements of the clinical practicum and community assessment of Nursing 524 Advanced Nursing Practice: Children. As well, the unit poses questions for you to consider during your clinical practicum and community assessment, about the health status of children and the influence of participation, collaboration, and empowerment on health status. 

Unit 2: Primary Health Care and Nurse Practitioners: Participation and Collaboration
In this unit you will study the primary health care principles of participation and collaboration. Care of children and adolescents must include interactions with the family and community, interactions based on participation and collaboration. In this unit, you will study varying degrees of participation and consider issues related to the participation of children in decisions about their health. You will also study two types of collaboration: interdisciplinary and intersectoral collaboration.

Unit 3: Community Development and Nurse Practitioners: Empowerment
In Unit 3, you will study one of the principles of community development, empowerment. You will explore the elements and dynamics of empowerment and identify empowering strategies for individuals and groups in your care. You will also consider a number of issues related to this principle.

Unit 4: Well Children
Unit 4 lays the groundwork for a consistent approach to working with children and their families that can be used with all age groups. Family interviewing, pediatric history-taking, and pediatric physical examination are reviewed, and you will study the growth and development parameters of children.  Gordon's (2002) functional health patterns are addressed with an emphasis on understanding that families are often central to assessing and maintaining a child's health.

Unit 5: Children with Acute Presentations
Unit 5 explores acute infectious, communicable, and dermatological diseases of children.  In addition injury management, including both unintentional and intentional injury, is discussed with an emphasis on child maltreatment. The impact of acute illness on communities is discussed and the unit concludes with a discussion of the diagnostic and pharmacological implications of acute illness in children.

Unit 6: Children with Chronic Presentations
The unit opens with an examination of the impact of chronic illness on the family. You will then study several chronic illnesses that occur in the childhood population, focusing on the advanced nursing skills required to diagnoses and treat these chronic conditions. The pharmacological and diagnostic implications of chronic conditions will also be reviewed. 

Unit 7: Issues, Trends and Research in Children's Health
In the last unit of NURS 524, you will explore the relationship between ethical decision-making and the health of children and study the importance of collaboration and participatory decision-making in resolving ethical dilemmas. You will explore issues and trends that influence the health of children in your own community. Finally, you will examine collaborative research for your practice with children.

Assessment Structure

The assessment structure for NURS 524 is based on the following course activities, with the percentage weighting of each activity as indicated.  The final grade for the course is a composite mark based on performance on these course activities.

In order to pass NURS 524, you must achieve a minimum mark of 60% on each element of the assessment structure (conference participation, written assignments, and average mark on the health assessment examination and the final examination). That is, you must achieve a minimum mark of 60% (12/20) on conference participation, a minimum average mark of 60% (24/40) on the written assignments, and a minimum average mark of 60% (24/40) on the health assessment examination and final examination.

In addition to these activities, you must receive a satisfactory evaluation of the clinical practicum.

If the minimum mark is not achieved on any element of the assessment structure (conference participation, written assignments, exams or clinical practicum), then a failing grade will be assigned for NURS 524. If the student re-registers in NURS 524, then all elements of the course must be repeated (conference participation, written assignments, examinations and clinical practicum).

Conference Participation (20%)

Feedback regarding conference participation will be ongoing. Quality of input (not quantity) is the goal. Feedback will focus on the student's ability to provide organized and original contributions that reflect analysis and synthesis of the material presented.

Participation will be measured against the following criteria:

1. Complete online contributions during the unit conference timeframe.
2. Respond to online discussions at least twice each week.
3. Contribute original thoughts or ideas to online discussions.
4. Cite relevant resources to validate points made.
5. Demonstrate openness to divergent points of view.
6. Be respectful of the perceptions of others.
7. Integrate material from previous units to formulate ideas and generate dialogue.
8. Present responses that follow the rules of grammar and spelling in the online contributions.

Assignment 1: Rourke Baby Record (10%)

In this assignment, students develop a clinical presentation of one element of a well child assessment and then present to the class in an online conference.

Assignment 2: Community Health Development Record (10%)

Assignment 2 consists of completing a Community Health Development Record documenting a data and inferences obtained during a community assessment.

Assignment 3: Case Study (20%)

In Assignment 3, students analyze a case study that presents a health concern appropriate for a nurse practitioner to assess, treat, and follow up.

Health Assessment Examination (15%)

The health assessment examination consists of multiple choice questions that test your knowledge of health assessment of children and adolescents.

Final Examination (25%)

The final examination consists of multiple choice questions and tests content of the entire course.