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School of Nursing
Queens University
Bachelor of Nursing Science ProgramCurriculum Document
Nov 2004
Revised July 2012
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TABLE OF CONTENTS PAGE
INTRODUCTION 3
PHILOSOPHY 3
I. PROGRAM GOALS 4II. CURRICULAR CONCEPTS: 4
Figure 1: Foundational Curricular Concepts with Sub-concepts 5
Definitions of Concepts 5
III. CURRICULAR CONCEPT MAP 11Legend 11Table 1: Curriculum Concept map 14
IV. References 16
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INTRODUCTION
The Undergraduate Curriculum Committee of the School of Nursing prepared this
document in order for students and faculty to be able to clearly identify how our program
philosophy, goals, curriculum concepts and sub-concepts, curriculum content and theCollege of Nurses of Ontario (CNO) competencies are addressed throughout ourcurriculum.
Philosophy
The philosophy of Queens University School of Nursing is consistent with the missionand vision of Queens University, www.queensu.ca and reflects the nursing faculty belief
that exemplary nursing practice is built upon the foundational blocks of the sciences and
arts. The purpose of the nursing program is to educate individuals to competentlyaddress the health needs of individuals, families, and communities in a variety of
environments. Central to the program are the five core concepts of quality, health, client,environment and transitions.
Nursing is a dynamic profession requiring critical and reflective thinking based on
current scientific rationale, as well as humanistic perspectives. Partnering with
individuals, families, and communities, nurses assist their clients through various lifetransitions, using sound decision-making and therapeutic communication in their
interactions. Competent care requires not only an understanding of bio-psychosocial
processes, but also the socio-environmental and cultural contexts that affect clients,families, and communities.
We believe these approaches to academic excellence prepare practitioners to make caringconnections and allow learners to transition integrating sciences, humanities, and
evidence-based health care into their professional roles as nurses and life-long
learners. We believe students should have the opportunity to learn interprofessionallywith, from, and about each other. Students learn best from role models who foster caring
and inquiry into human transitions from theoretical, practice, and research perspectives.
The philosophy of the Queens University, Bachelor of Nursing Science program isreflected in our understanding of core foundational concepts underpinning the
curriculum. Five core nursing concepts with related sub-concepts provide the foundation
for the curriculum of the B.N.Sc Program (see Figure 1). The curriculum concepts
represent key components of the program goals and are layered within and across theprogram in a curriculum concept map which serves as a framework to situate core content
in a deliberate manner. The threading of the concepts in the curriculum concept mapdemonstrates how students move progressively towards the program goals (see Table 1).
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l. Program Goals
The program prepares graduates to:
Provide safe competent and culturally sensitive nursing service in response tochanging needs of society and according to prevailing legal and ethical standards
Use critical thinking, problem-solving, and scientific inquiry in the practice ofnursing and in monitoring and ensuring quality of health care practices
Communicate effectively in relationships with clients and health professionals Use nursing knowledge and skills in partnership with individuals and families and
other health care professionals to maintain and promote health and well-being and
provide care and support during illness
Use population-based and intersectoral approaches to assess, protect, and promotethe health of communities
Appreciate how specific environments and socio-political conditions affect healthbehaviour, professional practice and public policy
Apply leadership and managerial abilities and political skills to attain quality carefor client and quality of work-life for co-workers Engage in self-directed learning, reflective and evidence-based practice
ll. Curriculum Concepts
The five major nursing foundational concepts are: quality, health, client, environment,
and transitions. Each concept has related sub-concepts which are illustrated in Figure 1.Definitions of the major concepts and sub concepts follow.
Nursing is both an art and a science. It is a preventative, educational, restorative andsupportive health-related discipline/service/activity. Nursing is provided in a caring and
competent* manner for the purpose of enhancing an individuals quality of life, and when
life can no longer be sustained, supporting the dying person. Respect for the dignity,
worth, autonomy and individuality of each human being is inherent in all aspects ofnursing. Nursing is provided in any setting where individuals, families, groups, and
communities are in need of the benefits of nursing. Nurses work both independently and
collaboratively with other health care providers. Nurses meet the ethical and legalrequirements of their profession. Nurses practice life-long learning.
* professional competence is the habitual and judicious use of communication,
knowledge, technical skills, clinical reasoning, emotions, values, and reflection in dailypractice for the benefit of the individual and community being served. (Epstein &
Hundert, 2006)
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Figure 1. Foundational Curricular Concepts with Sub-concepts
DEFINITIONS OF CONCEPTS
QUALITY
Quality:
Qualityconsistsofthedegreetowhichhealthservicesforindividualsandpopulationsincreasethelikelihoodofdesiredhealthoutcomes(qualityprinciples),areconsistentwithcurrentprofessionalknowledge(professionalpractitionerskill),andmeettheexpectationsofhealthcareusers(themarketplace). (Burhans&Alligood,2010;Buttell,Hendler&Daley,2008)Caring
Caring is expressed through an interpersonal interaction between a nurse and client. Thenurse identifies in collaboration with the client their needs for self-maintenance or self-
regulation and assists the client to meet these needs. Nursing-specific interventions are
UndergraduateCurriculum
QualityCaring
Evidence-Informed Decision-Making
Evidence-Informed PracticeInterprofessional Collaborative
PracticeLeadership Health
Disease PreventionHealth PromotionHealth Protection
RehabilitationPatient Safety
ClientCommunity/PopulationDeterminants of Health
Individuals/ FamilyTherapeutic Relationships
EnvironmentCultural Competence
PoliticalPractice Setting
TransitionsDevelopmental
Health and IllnessOrganizational
Situational
Queens University School of Nursing
Foundational Curriculum Concepts
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applied to act for, guide, support and influence environmental conditions to promote the
personal development and health of the client. (Finfgeld-Connett, 2008; Morse, J. 1990).
Evidence-Informed Decision Making
Evidence-informed decision making is a continuous interactive process involving theexplicit, conscientious and judicious consideration of the best available evidence to
provide care. It is essential to optimize outcomes for individual clients, promote healthy
communities and populations, improve clinical practice, achieve cost-effective nursingcare and ensure accountability and transparency in decision-making within the health
care system. CNA (2010). Canadian Nurses Association Position Statement: Evidence-
informed decision making and nursing practice.
Critical ThinkingPracticing the cognitive skills of analyzing, applying standards, discriminating,
information seeking, logical reasoning, predicting and transforming knowledge.
(Martinez de Castillo, 2010).
CreativityA meta-cognitive process that: 1) generates novel and useful associations,
attributes, elements, images, abstract relations, or sets of operations, and 2) better
solves problems, produces a plan or results in a pattern, structure or product notclearly present before. (Fasnacht, 2003).
Evidence-informed practice
Nursing practice is based on various types of evidence, including experimental and non-
experimental research, expert opinion, and historical and experiential knowledge, shaped
by theories, values, client choice, clinical judgment, ethics, legislation, and workenvironments. Evidence-based decision-making is a continuous interactive process
involving the explicit, conscientious and judicious consideration of the best availableevidence to provide care. (Canadian Nurses Association, 2002b, 2010).
Interprofessional Collaborative Practice(IPCP) is designed to promote the active participation of each discipline in patient care.
It enhances patient and family-centred goals and values, provides mechanisms for
continuous communication among caregivers, optimizes staff participation in clinicaldecision making within and across disciplines and fosters respect for disciplinary
contributions of all professionals (Oandasan, 2006). Partnerships: Refers to situations
in which the nurse works with the client and other members of the health care team toachieve specific health outcomes for the client. Partnership implies consensus building in
the determination of these outcomes.
Interprofessional collaborative practice occurs when different health care professions
provide comprehensive services by working with patients, families and communities to
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deliver high quality of care across the settings. (WHO Framework for action on
interprofessional education and collaborative practice. 2010) http://
LeadershipProcess of persuading and influencing others toward a goal, through mostly non-coercive
means; typically composted of a wide variety of roles. (Marquis & Huston, 2006).
HEALTH
Health is a state of complete physical, mental, and social well-being and not merely the
absence of disease or infirmity. It involves the ability to achieve ones potential and
respond positively to the challenges of the environment. Health is seen as a resource for
everyday life not the objective of living.
Disease Prevention
Disease prevention covers measures not only to prevent the occurrence of disease, such
as risk factor reduction, but to arrest its progress and reduce its consequences once
established. Primary prevention is directed towards preventing the initial occurrence of adisorder. Secondary prevention seeks to arrest or retard existing disease and its effects
through early detection and appropriate treatment: tertiary prevention reduces the
occurrence of relapses and the establishment of chronic conditions through, for example,effective rehabilitation.
Disease prevention is sometimes used as a complementary term alongside health
promotion. Although there is frequent overlap between the content and strategies,disease prevention is defined separately. Disease prevention in this context is considered
to be action which usually emanates from the health sector, dealing with individuals and
populations identified as exhibiting identifiable risk factors, often associated withdifferent risk behaviours. (WHO, 1998, p.4)
Health Promotion
Health promotion is the process of enabling people to increase control over, and to
improve their health.
Health promotion represents a comprehensive social and political process. It not only
embraces actions directed at strengthening the skills and capabilities of individuals butalso action directed towards changing social, environmental and economic conditions so
as to alleviate their impact on public and individual health.
World Health Organization 1998, Health Promotion Glossary (Online). Available:
www.who.int/hpr/arcive/docs/glossary.pdf, August 1, 2006
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Health Protection
Those public health activities intended to protect individuals, groups, and populations
from infectious diseases, environmental hazards such as chemical contamination, and
from radiation. (Health Canada, 2002).
Rehabilitation of people with functional limitations or disabilities is a process aimed at
enabling them to reach and maintain their optimal physical sensory, intellectual,
psychological and social functional levels. Rehabilitation provides people with the toolsand resources they need to attain independence and self determination. Adapted from
WHO 2009a.
Patient Safety
Patient safety is the reduction of risk of unnecessary harm associated with healthcare to
an acceptable minimum. An acceptable minimum refers to the collective notions of givencurrent knowledge, resources available and the context in which care was delivered
weighed against the risk of non-treatment or other treatment. (P.15). (World Health
Organization, 2009b).
Is the reduction of risk of unnecessary harm associated with health care to an acceptable
minimum. An acceptable minimum refers to the collective notions of given current
knowledge, resources available, and the context in which care was delivered weighedagainst the risk of non-treatment or other treatment. (Canadian Patient Safety Institute,
2011).
CLIENT
The client/patient/person is the focus of nurses care and with whom the nurse is
engaged in a professional relationship. The client may be an individual, family group,
population or community. An individual is a single human being who may be arepresentative of any stage throughout the lifespan, of any culture, and who is unique and
inherently worthy. Families consist of individuals who are united by ancestry or choice.Groups and populations share common purposes or health needs. A community is a groupof people living in one place, bound by common characteristics and having common
health needs. The client/patient/person is in partnership with the health care team in
consensual determination of desired health outcomes.
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Community/Population: An organized group of persons bound together by ties of
social, ethnic, cultural, occupational origin or geographic location and sharing commoncharacteristics/interests which bind them together, or having common health needs. The
term community (when used to describe a client) does not mean providing care to an
individual in the community. Nursing practice aimed at the community as a client
involves assisting communities to identify, articulate and successfully manage theirhealth concerns. It is concerned primarily with care that is continuing, rather than
episodic. The focus is on the collective or common good, instead of an individuals
health. Population refers to all people sharing a common health issue, problem orcharacteristic. These people may or may not come together as a group (CNA, 2004a).
Determinants of Health
Social determinants of health are the economic and social conditions that influence the
health of individuals, communities and jurisdictions as a whole. These determinants of
health in combination influence health status.CNA (2005). Social determinants of healthand nursing: A summary of the issues.
Individuals: Single human beings throughout the lifespan, including neonates (birth to28 days), infants (29 days to 1 year), children (1 year to 12 years), adolescents (13 to 18years), adults (19-65 years) and elderly adults (65 years and older). Family: People
united by a common ancestry (biological families), acquisition (marriage or contract) or
choice, and their friends.
Therapeutic Relationship: a relationship that is professional and therapeutic and
ensures the clients needs are first and foremost. The relationship is based on trust,respect and intimacy, and requires the appropriate use of the power inherent in the care
providers role. The professional relationship between registered nurses and their clients
is based on the recognition that clients (or their alternative decision makers) are in the
best position to make decisions about their own lives when they are active and informedparticipants in the decision making process. (College of Nurses of Ontario, 2006;
CRNCBC, 2006c).
ENVIRONMENT
Environment surrounds individuals wherever they go and whatever they do; iscomposed of physical, political, economic, sociocultural, and biological components.
(Shookner, Scott & Vollman, 2008). (p. 85).
Environment refers to the external elements that affect the person; internal and external
conditions that influence the organism; significant others with whom the person interacts;and an open system with boundaries that permit the exchange of matter, energy, and
information with human beings. (McEwen & Wills, 2007).
Cultural Competence. Includes, but is not restricted to age or generation;-Cultural competence is the application of knowledge, skill, attitudes and personal
attributes required by nurses to provide appropriate care and services in relation to
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cultural characteristics of their clients. Cultural competence includes valuing diversity,
knowing about cultural mores and traditions of the populations being served and beingsensitive to these while providing care. (CNA, 2004). Promoting Culturally Competent
Care.
PoliticalNurses speak to and advocate for health issues to the public, governments and other
organizations through political action, representation and leadership. (CNA, 2011)
Practice Setting Quality practice settings create and maintain characteristics that
support professional nursing practice, including appropriate professional preparation,
suitable conditions for nursing practice, respect for nurses as responsible decision makersand recognition of professional expertise. (College of Nurses, 2009, Standard of Care:
Ethics, pg 4.)
TRANSITIONS
Transitions Transition in health and illness are a central substantive domain in thediscipline of nursing. Most nursing interactions occur due to disequilibrium or the risk of
disequilibrium caused by real, potential or perceived changes to well-being. Therapeutic
nursing interventions support the client experiencing transitions and reduce associatedrisks.
This field is concerned with the nature, impact, outcome, and management of the
following types of health and illness related transitions: developmental transitions such asbirth, death, and the passage to old age; illness transitions such as the passage to chronic
illness or the experience of a health crises; and finally, transitions through the health care
environment. (School of Nursing, Queens University, 2006).Developmental Transitions
Changes within an individual or a family related to the lifespan of the person in the caseof an individual or to family members in the case of a family. Adapted from Meleis, A
(1994).
Health and Illness Transitions
Changes involved in moving from wellness to illness or from illness to wellness. Adaptedfrom Meleis, A (1994).
Organizational Transitions
Changes within the organizational environment. Adapted from Meleis, A (1994).
Situational Transitions
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Changes in the internal or external environment which affect the life of an individual,family, community or population. Adapted from Meleis, A (1994).
lll.Curriculum Concept MapC = ClinicalCourseT = Theory/Classroom Course
NURSING
A. QUALITY YEARONE
YEARTWO
YEARTHREE
YEARFOUR
Caring 101- T100-T
108-C
202-C206-C
207-C209-T
371-C345-C
370-T325-T
401-T404-T
405-C492-C
Evidence-InformedDecision Making
101-T100-T108-T
207-C202T,C205-T206-C209-T
323-T371-C345-C305-T370-T325-T
401-T403-T404-T405-C414-T492-C
Evidence- informedpractice 101-T100-T 205-T206-C207-C209-T324-T
323-T370-T371-C345-C305-T325-T
401-T403-T404-T405-C414-T492-C
Interprofessionalcollaborative practice
101-T108-T
207-C 371-C345-C
401-T414-T492-C
Leadership 371-C345-C
401-T414-T492-C
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Curriculum Concept Map (continued)
B. HEALTH YEARONE
YEARTWO
YEARTHREE
YEARFOUR
Disease Prevention 100-T108-T
202-T205-T206-C209-T
305-T325-T
404-T405-C492-C
Health Promotion 100-T108-T
202-T,C209-T205-T
370-T325-T371-C345-C
404-T405-C492-C
Health Protection 100-T108-T
206-C209-T
370-T325-T
404-T405-C492-C
Rehabilitation 108-T 205-T207-C209-T
305-T325-T371-C345-C
403-T492-C
Patient Safety 108 202-T205-T206-C207-C209-T
305-T325-T345-C370-T371-C
403-T405-C414-T401-T492-C
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Curriculum Concept Map- Health (continued)
C. CLIENT YEARONE
YEARTWO
YEARTHREE
YEARFOUR
Community/Population 108-T 209-T 325-T 401-T404-T405-C492-C
Determinants ofHealth
108-T 202-T209-T
325-T 401-T404-T405-C492-C
Individual & Family 101-T, C
108-T
202-T
205-T206-C207-C209-T
305-T
325-T345-C370-T371-C
403-T
492-C
TherapeuticRelationships
101-T,C100-T108-T
202-T206-C209-T207-C
371-C345-C370-T325-T
404-T405-C414-T492-C
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Curriculum Concept Map- Health (continued)
D. ENVIRONMENT YEARONE
YEARTWO
YEARTHREE
YEARFOUR
Cultural Competence 108-T 205-T206-C207-C209-T
370-T325-T371-C345-C
401-T404-T405-C414-T492-C
Political 101-T108-T
209-T 370-T325-T371-C345-C
404-T405-C401-T414-T492-C
Practice Settings 101-T 207-C 325-T345-C371-C
401-T404-T405-C414-T492-C
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Curriculum Concept Map (continued)
E. TRANSITIONS YEARONE
YEARTWO
YEARTHREE
YEARFOUR
Developmental 100-T 202-T207-C205-T206-C209-T
305-T325-T370-T371-C345-C
401-T492- C
Health/ Illness 108-T 202-T205-T207-C209-T
305-T325-T370-T371-C
345-C
401-T403-T492- C404-T
405-TOrganizational 100-T 209-T 401-T414-T492- C
Situational 206-C207-C209-T
371-C345-C370-C325-T
401-T492-T
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