Overview
Mission
The Mission of the Uniformed Services University Adult-Gerontology Clinical Nurse Specialist (AG-CNS) program is to educate safe, competent Clinical Nurse Specialists who are able to practice independently in response to worldwide missions in the Uniformed Services in support of the adult and geriatric population across the wellness through acute care continuum with the specialty focus of perioperative nursing.
Philosophy
The Adult-Gerontology Clinical Nurse Specialist (AG-CNS) program is dedicated to graduate education of nurses in the uniformed services within the advanced practice role of the Clinical Nurse Specialist (CNS). The program prepares nurses for the care of the adult and geriatric population across the wellness to acute care continuum, and includes specialty preparation in perioperative nursing. The educational focus is on the integration of clinical practice, management & leadership, evidence-based practice/scholarship, education, and consultation into the single multifaceted advanced practice role of a CNS. The program integrates evidence-based theory and practice concepts to enable students to critically analyze scientific literature, evaluate nursing outcomes, translate evidence to support clinical, fiscal, and managerial decision-making, and develop advanced practice skills necessary to function in increasingly complex healthcare settings and assist in the transformation of healthcare to improve safety and outcomes for our patients.
The rigorous curriculum not only stresses concepts supporting direct care for individuals, families and populations; but also inter-professional relationships between nurses, physicians, and healthcare organizations in an effort to improve patient outcomes through process and system changes. As such, graduates from the program are uniquely qualified to manage quality care of the adult-geriatric population across the continuum from wellness through acute care; analyze healthcare systems/processes to optimize patient outcomes; and guide change in support of high reliability organizations in healthcare.
In addition to the role and population focus of the AG-CNS program, additional content is provided to support the specialty focus of perioperative nursing. From a specialty perspective, the program emphasizes building leadership within the perioperative environment to improve patient care outcomes; enhance the delivery of evidence based care; and improve the business side of healthcare focused on efficiency, productivity, and overall management in the care of the surgical patient. The specialty focus of the program supports the advanced practice CNS role across the perioperative continuum of care to enhance the care of patients and families undergoing operative and other invasive procedures.
Design
The Doctor of Nursing Practice (DNP) AG-CNS program is 36 months of full-time study combining didactic and clinical experiences across the wellness through acute care continuum within the five domains of the Clinical Nurse Specialist (CNS): leader/manager, consultant, educator, scholar (evidence-based practice) and clinical expert within the three spheres of influence for CNS practice (patient, nurse and organization). Within the 3 year program, on average, graduates will obtain over 1800 hours of clinical experience working with masters and doctorally-prepared managers, clinical nurse specialists, physician assistants, clinical and surgeon champions, and subject matter experts within Federal and civilian healthcare facilities. In addition to educational preparation for the role and 59 population, the program is designed to include clinical and didactic specialty content in perioperative nursing. All clinical assignments are designed in concert with the leadership at the clinical sites in an effort to develop “real world application” experiences that demonstrate the student’s ability to translate knowledge gained in the classroom into clinical practice. The approximate clinical hour distribution supporting the CNS role across the wellness through acute care continuum as well as within the perioperative specialty for the adult-gerontology population is as follows: wellness/primary care through acute care continuum – 297 clinical hours (16%); CNS role across 3 spheres of influence - 654 ( 35%); Systems-based scholarly project - 276 (15%); and CNS practice within the perioperative continuum – 650 clinical hours (35%).
The curriculum meets or exceeds the goals of the AACN 2021 Essentials: Core Competencies for Professional Nursing Education, and the National Association for Clinical Nurse Specialist (NACNS) National CNS Competency Task Force Organizing Framework and Core Competencies (2008). The curriculum is aligned with the2010 AACN Adult-Gerontology Clinical Nurse Specialist Competencies; the 2011 Criteria for the Evaluation of Clinical Nurse Specialist Masters, Practice Doctorate, and Post-graduate Certificate Educational Program, 2010 AACN Scope and Standards for Acute and Critical Care Clinical Nurse Specialist Practice; Association of periOperative Registered Nurses (AORN) 2006 Position Statement on the Perioperative Advanced Practice Nurse and the 2010 AORN Perioperative Advanced Practice Nurse Competencies.
Graduates from this program are prepared to sit for advanced practice certification as a Clinical Nurse Specialist in Adult-Gerontology offered by the American Nurses Credentialing Center (ANCC) and the American Association of Critical Care Nurses (AACN) Certification Corporation. Additionally, graduates are eligible to sit for specialty certification as an advanced practice Perioperative CNS offered by the Credentialing and Certification Institute (CCI). This specialty certification links the CNSs initial licensure certification as an APRN to that of specialty practice to validate specialty specific competencies at the APRN level of practice within the perioperative continuum of care.
Outcomes
AGCNS DNP Program–Specific Terminal Competencies
Upon completion of the AG-CNS DNP program the graduate will demonstrate mastery of the CNS Spheres of Influence and Roles of the CNS:
- Client: AG-CNS as an Advanced Practitioner
- Use advanced clinical judgment and critical thinking skills to diagnose client conditions related to disease, health and illness within cultural, ethnic, behavioral and other contexts across the lifespan.
- Implement client assessment strategies to improve patient outcomes through application of advanced cognitive, psychomotor, cultural, and physiological principles in assessment, diagnosis, monitoring, management and evaluation of human response to illness, surgical intervention or changes in life processes
- Conduct evidence-based, comprehensive specialty focused assessment of client health care needs, integrating data from multiple sources which could include the client and inter-professional team members with consideration given to safety, efficacy, standards of care, and advanced clinical knowledge and expertise.
- Design, implement and evaluate a broad range of evidence-based interventions for clients, which may include prescribing and administering pharmacologic and/or other therapeutic interventions.
- Advocate for the integration of client preferences and rights including consultation for complex health care needs utilizing a broad range of scientific and humanistic theories in support of health care decision-making among the interprofessional team.
- Nurse and Nursing Practice: AG-CNS as an Educator
- Identify and implement process/system interventions to decrease risk of iatrogenic injuries.
- Provide leadership to the inter-professional team to enhance practice skills and clinical knowledge in translating evidence to practice.
- Promote professional growth and develop inter-professional teams through the enhancement of direct care competencies including decisive responses to rapidly changing and complex situations.
- Apply principles of teaching/learning and health literacy to design, provide, and evaluate client and inter-professional education.
- Nurse and Nursing Practice: AG-CNS as a Scholar (Evidence-Based Practice)
- Integrate evidence-based principles/concepts from databases, benchmarks, and epidemiologic data to evaluate and improve system level programs and outcomes.
- Explore practice protocols, ensuring ethical and legal practices are maintained throughout the process.
- Apply theory based conceptual frameworks to guide practice.
- Critically analyze, synthesize and disseminate evidence supporting best practice to advance client care and health care delivery to improve the health of populations.
- Translate and disseminate evidence-based practice findings to guide clinical practice and improve patient outcomes.
- Organization/System: AG-CNS as a Consultant
- Utilize clinical expertise to collaborate and/or consult with members of the health care team regarding patient outcomes variations.
- Serve as nursing/subject matter expert and/or member of an inter-professional team in planning care for the adult-gerontology population.
- Incorporate the role of clinical expert, educator, scholar, and manager/leader in the application of change theory during the consultation process.
- Organization/System: AG-CNS as a Manager/Leader
- Design entrepreneurial programs of care that improve(s) delivery and outcomes of health care.
- Direct the analysis and dissemination of outcomes of client care programs and/or departmental systems to enhance patient outcomes and promote patient safety, quality of care, efficiency and/or productivity while considering epidemiologic, socioeconomic, cultural, and environmental factors.
- Provide leadership in building an inter-professional team and facilitate collaboration in support of innovative partnering practices that incorporate ethical principles in health care planning and delivery.
- Identify fiscal and other resources needed to evaluate interventions, products and services for system-level programs with consideration given to budgetary, logistical and staffing requirements needed to enhance clinical and fiscal outcomes.
- Use organizational and system theory to analyze health care policy and facilitate and create clinical environments that promote care delivery at the local, regional, and national level that is evidence-based, outcome-focused, collaborative, cost-effective, and ethical.
- Use information technology to promote safety, quality of care, and facilitate resource management in support of population health, improving the patients' experiences, and decreasing the cost of care.
- Demonstrate leadership by advocating for the profession of nursing through participating in professional organizations, boards and task forces at the institutional, local, state, national, and international levels.
*“client” represents patient, family, community, group, and population
AG-CNS DNP Program outcome requirements
- Comply with the GSN requirements for graduation.
- 36 months of full time study
- Complete the required number of semester credits and clinical hours outlined for the program
- DNP portfolio
- Scholarly project
- Comply with program requirements for graduation.
- Overall GPA of 3.0 or above
- Achieve the minimum grade required in each course
- Obtain a minimum of 1000 clinical hours in the population/role of the AG-CNS and over 1600 total clinical hours
- Complete all practicum requirements
- Maintain specialty certification (e.g., CNOR, CCRN, CEN)
- Maintain certification in BLS and ACLS (PALS, NRP optional) throughout the program
- Complete ePortfolio
- Meet the mission of the Adult Gerontology Clinical Nurse Specialist program.
- Meets the GSN and AG-CNS program’s terminal competency outcomes
- Recommended for graduation by the AG-CNS Program Director
Degree Requirements
Summer 1st year
| NURS 5110 | Advanced Health Assessment | 3 |
| NURS 5111 | Advanced Anatomy | 3 |
| NURS 5112 | Advanced Physiology | 3 |
| OPMS 5000 | Leadership and Teamwork in the Health Professions: A Military Perspective I | 1 |
| Total Credit Hours: | 10 |
Fall 1st year
| NURS 5121 | Advanced Pathophysiology | 4 |
| NURS 5122 | Advanced Pharmacology | 4 |
| NURS 5120 | Global Perspectives Seminar in Complex Healthcare Systems-I | 3 |
| NURS 6121 | Principles in Outcomes Management for CNS Practice | 2 |
| NURS 6510 | Advanced Diagnosis and Management in Adult Primary Care | 5 |
| OPMS 5001 | Leadership and Teamwork in the Health Professions: A Military Perspective II | 1 |
| Total Credit Hours: | 19 |
Spring 1st year
| NURS 5131 | Inquiry into Statistical Methods, Evidence Based Practice and Scholarship | 5 |
| NURS 5130 | Global Perspectives Seminar in Complex Healthcare Systems-II | 3 |
| NURS 5132 | Integrative Medicine Methodologies | 1 |
| NURS 5133 | Trauma & Combat Casualty Care | 3 |
| NURS 6131 | CNS Role Application Across the 3 Spheres of Influence | 3 |
| NURS 6132 | Business Administration for High Reliability Healthcare Organizations | 3 |
| OPMS 5002 | Leadership and Teamwork in the Health Professions: A Military Perspective III | 1 |
| Total Credit Hours: | 19 |
Summer 2nd year
| NURS 6612 | Advanced Assessment and Diagnosis in Management of the Older Adult | 1 |
| NURS 6210 | Medical Facility Design: Maximizing Patient Outcomes | 2 |
| NURS 6211 | Trauma Management in CNS Practice | 3 |
| NURS 6212 | Advanced Diagnosis and Management in Adult-Geriatric Acute Care | 3 |
| Total Credit Hours: | 9 |
Fall 2nd year
| NURS 5220 | Translation of Evidence for Health Care Practice, Policy, and Evaluation | 3 |
| NURS 6220 | Performance Metrics in Outcomes Management | 3 |
| NURS 6222 | Practicum for CNS Practice I: Advanced Concepts for CNS Independent Practice | 4 |
| Total Credit Hours: | 10 |
Spring 2nd year
| NURS 5134 | Healthcare Informatics | 3 |
| NURS 6231 | DNP Practicum for CNS Practice II: Systems Assessment for High Reliability Organizations | 4 |
| Total Credit Hours: | 7 |
Summer 3rd year
| NURS 6310 | DNP Practicum for CNS Practice III: Strategic Planning in Healthcare | 3 |
| Total Credit Hours: | 3 |
Fall 3rd year
| NURS 6320 | DNP Practicum for CNS Practice IV: Capstone Immersion for CNS Independent Practice | 6 |
| Total Credit Hours: | 6 |
Spring 3rd year
| NURS 5330 | Doctor of Nursing Practice Project | 6 |
| Total Credit Hours: | 6 |
Electives
| NURS 5404 | Operational Readiness: Critical Care Air Transport Team (CCATT) | 1 |
| NURS 5405 | Operational Readiness: Transitions of Care | 1 |
| NURS 5406 | Operational Readiness: Medical Management of Chemical and Biological Casualties (MMCBC) | 1 |
| Total Credit Hours: | 3 |
Total Credit Hours: 92