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NURS 5305/6305/7305 Syllabus

Course Syllabus

NURS 5305/6305/7305 - Quality Management in Nursing and Healthcare

3 Credit Hours

Course Information

Course Description:

This course provides a multidisciplinary background in the science of healthcare quality management. Students will learn to develop and plan for execution of quality improvement plans and will use a quality indicator assessment program, such as AHRQ or NDNQI. These will be used as the framework to develop a paper that identifies quality indicators, their measurements and nursing interventions to improve the quality measurement. Valued-based purchasing will be defined and interventions to assure quality and cost containment will be discussed.

 The topics studied in this course include:

  • evolution of the quality movement
  • theories and thought leaders
  • current quality of care issues
  • research and innovations
  • intervention strategies
  • instruments
  • analysis of quality management system models in healthcare
Course Outcomes:

At the conclusion of this course the student will be able to:

  1. Assess healthcare settings to determine existing quality management systems.
  2. Develop strategies, using common quality measures, to implement continuous quality improvement in a variety of healthcare settings.
  3. Demonstrate professional accountability for competent nursing administrative practices in quality management activities that incorporate professional nursing values.
  4. Discuss ethical/ legal factors affecting healthcare quality management. 
Prerequisites & Co-requisites:

Admission to the TN eCampus MSN program; prerequisites: NURS 5000, NURS 5001, NURS 5002 and NURS 5003. Pre- or co-requisites: NURS 5301, NURS 5302.

Course Topics:
  1. Introduction to Quality Management
    1. Definitions Related to Quality management
    2. Rationale for Quality Management
    3. History of Quality Management
    4. The Patient Safety Movement
    5. Implications for Nursing Administration
  2. Theories and Thought Leaders in Quality Management 
    1. Nightingale
    2. Donabedian & Bloch
    3. Structure, Process, Outcome
    4. Quality Beyond Healthcare
    5. Statistical Process Control
    6. Deming's Principles
    7. Theories of Error
    8. Cultures of Safety and Blame
    9. Specialization & Volume
    10. Failure to Rescue
    11. Aiken, Berwick and Others
  3. Major Quality Issues in Healthcare
    1. Patient Safety
    2. Nurse Sensitive Indicators
    3. Teamwork & Collaboration
    4. Medication Errors
    5. Pressure Ulcers
    6. Pain Management
    7. Staffing
    8. Patient Satisfaction
  4. Intervention Strategies
    1. Process Improvement Teams
    2. Evidence-Based Practice 
    3. Structured Care Methodologies
    4. Case and Care Management
    5. Technology
    6. Surveillance
    7. Rewarding Quality
      1. Baldridge Award
      2. Magnet Hospitals
      3. Beacon Award
    8. Financial Incentives
  5. Research and Innovations
    1. Evidence-Based Healthcare
    2. Outcomes Measurement
    3. Outcomes Research
    4. Research Designs
    5. Breakthroughs and Innovations
  6. Organizations, Reports and Regulatory Influence
    1. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
    2. Institute of Medicine (IOM)
    3. Agency for Healthcare Research and Quality (AHRQ)
    4. Institute for Healthcare Improvement (IHI)
    5. Emergency Care Research Institute (ECRI)
    6. Institute for Safe Medication Practices (ISMP)
    7. National Committee on Quality Assurance (NCQA) 
    8. National Patient Safety Foundation (NPSF)
    9. Leapfrog Group
    10. American Nurses Association (ANA)
  7. Ethical, Legal, and Policy Implications
    1. The Balance Between Quality and Access
    2. The Technologic Imperative
    3. Ethical Issues with Financial Incentives
    4. Legal Systems as Users of Standards & Guidelines
    5. Mandating Quality 
Specific Course Requirements:

Henriksen, K., Battles, J., Marks, E., &Lewin, D. (2005). Advances in Patient Safety: From Research to Implementation (Volumes I-IV). Rockville, MD: Agency for Healthcare Research and Quality.

Please note: these four volumes are available for FREE in the format of 4 books, approx. 500 pages per book, or in a searchable CD-ROM format, also FREE. The books usually take longer to ship than the CD- ROMs. To order free single copies of the CD-ROM or the printed set, contact the AHRQ Publications Clearinghouse at: 1-800-358-9295, or at ahrqpubs@ahrq.gov. Individual articles that comprise the four volumes are also available at http://www.ahrq.gov/qual/advances/index.html#Contents 

Textbooks, Supplementary Materials, Hardware and Software Requirements

Required Textbooks:

Please visit the Virtual Bookstore to obtain textbook information for this course. Move your cursor over the "Books" link in the navigation bar and select "Textbooks & Course Materials." Select your Program, Term, Department, and Course; then select "Submit."

Supplementary Materials:

Journal articles and web-based resources will also be assigned in relation to each module. 

Hardware and Software Requirements:

Minimum hardware requirements can be found here.

Minimum software requirements can be found here.

Common applications you might need:

Web Resources:

Purdue OWL Online Writing Lab (for APA, MLA, or Chicago style)

The Writing Center Online Writer's Handbook

Student Resources:
  • Technical support information can be found on the TN eCampus Help Desk page.
  • Smarthinking virtual tutoring is available FREE of charge. to access Smarthinking, visit the course homepage and select Smarthinking under Course Resources. You also view sample sessions to see what Smarthinking offers and how it works.
  • Information on other student issues or concerns can be located on the TN eCampus Student Resources page.

Instructor Information

Please see "Instructor Information" in the Getting Started Module for instructor contact information, virtual office hours, and other communication information. You can expect to receive a response from the instructor within 24-48 hours unless notified of extenuating circumstances.

Participation, Assessments, & Grading

Testing Procedures:

The Final Exam (20% of course grade) and all course requirements are submitted online. 

Grading Procedures:

Online Discussions ( Module 1 - 6 = 320% points; Module 7 = 2 points)
Quality Improvement Project 20%
Quality Leader Project 15%
Paper for Publication (Letter = 5%, 25% Outline = 5%; Final Paper = 15%)
Final Exam 20%

Total 100% 

Grading Scale:
A93-100
B85-92
C77-84
D70-76
F<70

 

Assignments and Projects:

Online Discussions (20%) - All students are expected to actively participate in online class discussions. The aim is to encourage thoughtful interaction among students and faculty, not simply to present information. Student responses to discussion questions must be substantive, and should demonstrate an awareness of comments previously posted and discussed. Repetition, or mere statements of concurrence (e.g. Yes, I agree with what the last person said.) are not usually helpful. If you agree or disagree with another student's comment, explain why. Because the D2L system has its own way of formatting material posted on the discussion feature, students will not be expected to strictly follow APA guidelines for discussion board submissions. However, the student is held to academic standards of writing style and the use of proper grammar, punctuation and spelling, as well as the expectation of documenting sources when citing the work or opinions of others. Discussion board participation will be graded as follows: Modules 1 - 6 = 3 points each; Module 7 - 2 points. These are worth a total of 20 points towards your course grade.

Quality Leader Project (15%) Each student will select a prominent health care quality leader from a list provided by the instructor. Students will prepare a powerpoint presentation to introduce their leaders to the class via the course website. Each presentation should include a brief biography, a description of the leader's philosophy(ies), his or her major professional contributions, the current status of this leader and his or her work, and a list of references in APA format. Powerpoint files are due to the instructor by the 2rd week of class. After review by the instructor, the files will be posted for other students to review.

Quality Improvement Plan (20%) - Students will document a quality of care problem and develop a quality improvement plan for a specific clinical setting, preferably a setting where they are employed. The problem focus and the setting must be approved by the instructor. More specific criteria for this project will be provided separately. The final plan will be due by the 7th week of class.

Paper (25%) Students will select a topic (problem, issue, or concept) relevant to health care quality that is suitable for publication, and choose a journal that might be interested in publishing such a paper. This assignment will include the following components:

  1. Approval of the topic and target journal by the instructor by the 2nd week of class.
  2. Submission of a query to the journal editor, copied to the instructor by the 3rd week of class, to determine the journal's interest in publishing this type of article. The query should include an overview of the article, why the topic was selected, why it would be a good fit for this journal, and the student's qualifications for writing it.
  3. An outline of the paper, a reference list in the journal's format (e.g. APA, AMA, etc.), and a copy of the journal's contributor guidelines is submitted by the 5th week of class.
  4. A final draft of the manuscript is submitted to the instructor by the 9th week of class. The paper should reflect a thorough review and synthesis of professional literature related to the topic; documentation of the current status of the problem, issue, or concept; and strategies for addressing the issue. The paper must adhere to the guidelines for the journal (e.g. page length, reference style, etc.).

Final Exam (20%) A final exam will be posted during the last week of the course. Exam content will be derived primarily from the powerpoint presentations and the course discussions. 

Class Participation:
Late Policy:

Students are expected to:

  • Check the course calendar for the due dates of assignments.
  • Check the course discussion board frequently for announcements. 

Course Ground Rules

The following two statements (1., 2.) were derived from the TBR System-wide Student Rules document, released January 2012:

RULES OF THE TENNESSEE BOARD OF REGENTS STATE UNIVERSITY AND COMMUNITY COLLEGE SYSTEM OF TENNESSEE SYSTEMWIDE STUDENT RULES CHAPTER 0240-02-03 STUDENT CONDUCT AND DISCIPLINARY SANCTIONS

Read the document in its entirety here.

1. Standards of Conduct:

  • Students are required to adhere to the same professional, legal and ethical standards of conduct online as on campus. In addition, students should conform to generally accepted standards of "netiquette" while sending e-mail, posting comments to the discussion board, and while participating in other means of communicating online. Specifically, students should refrain from inappropriate and/or offensive language, comments and actions.

2. Review the TN eCampus Academic Integrity/Academic Honesty Policy:

  • In their academic activities, students are expected to maintain high standards of honesty and integrity. Academic dishonesty is prohibited.

Such conduct includes, but is not limited to:

  • an attempt by one or more students to use unauthorized information in the taking of an exam
  • to submit as one's own work, themes, reports, drawings, laboratory notes, computer programs, or other products prepared by another person,
  • or to knowingly assist another student in obtaining or using unauthorized materials.

Plagiarism, cheating, and other forms of academic dishonesty are prohibited.

Students guilty of academic misconduct, either directly or indirectly through participation or assistance, are subject to disciplinary action through the regular procedures of the student’s home institution.  Refer to the student handbook provided by your home institution to review the student conduct policy.

In addition to other possible disciplinary sanctions that may be imposed, the instructor has the authority to assign an "F" or zero for an activity or to assign an "F" for the course.

Other Course Rules:

Students are expected to:

  • Participate in all aspects of the course
  • Communicate with other students
  • Learn how to navigate in Brightspace
  • Keep abreast of course announcements
  • Use the assigned course management (Brightspace) email address rather than a personal email address
  • Address technical problems immediately:
  • Observe course netiquette at all times.

Guidelines for Communications

Email:

  • Always include a subject line.
  • Remember without facial expressions some comments may be taken the wrong way. Be careful in wording your emails. Use of emoticons might be helpful in some cases.
  • Use standard fonts.
  • Do not send large attachments without permission.
  • Special formatting such as centering, audio messages, tables, html, etc. should be avoided unless necessary to complete an assignment or other communication.
  • Respect the privacy of other class members

Discussions:

  • Review the discussion threads thoroughly before entering the discussion. Be a lurker then a discussant.
  • Try to maintain threads by using the "Reply" button rather starting a new topic.
  • Do not make insulting or inflammatory statements to other members of the discussion group. Be respectful of other’s ideas.
  • Be patient and read the comments of other group members thoroughly before entering your remarks.
  • Be cooperative with group leaders in completing assigned tasks.
  • Be positive and constructive in group discussions.
  • Respond in a thoughtful and timely manner.

Library

The Tennessee Virtual Library is available to all students enrolled in TN eCampus programs and courses. Links to library materials (such as electronic journals, databases, interlibrary loans, digital reserves, dictionaries, encyclopedias, maps, and librarian support) and Internet resources needed by learners to complete online assignments and as background reading will be included within the course modules. To access the Virtual Library, go to the course homepage and select the Virtual Library link under Course Resources.

Students with Disabilities

Qualified students with disabilities will be provided reasonable and necessary academic accommodations if determined eligible by the appropriate disability services staff at their home institution. Prior to granting disability accommodations in this course, the instructor must receive written verification of a student's eligibility for specific accommodations from the disability services staff at the home institution. It is the student's responsibility to initiate contact with their home institution's disability services staff and to follow the established procedures for having the accommodation notice sent to the instructor.

Syllabus Changes

The instructor reserves the right to make changes as necessary to this syllabus. If changes are necessitated during the term of the course, the instructor will immediately notify students of such changes both by individual email communication and posting both notification and nature of change(s) on the course bulletin board.

Disclaimer

The information contained in this syllabus is for general information purposes only. While we endeavor to keep this information up-to-date and accurate, there may be some discrepancies between this syllabus and the one found in your online course. The syllabus of record is the one found in your online course. Please make sure you read the syllabus in your course at the beginning of the semester. Questions regarding course content should be directed to your instructor.


Last Revised on May 15, 2017