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 24 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 2 year program, on average, graduates will obtain over 1056 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 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 – 256 clinical hours (25%); acute care – 380 clinical hours (35%); and CNS practice within the perioperative continuum – 420 clinical hours (40%).
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 the 2010 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
Upon graduation, students will demonstrate mastery of the 3 Spheres of Influence: 5 Roles of the CNS:
Sphere of Influence: Client
AGCNS as an Advanced Practitioner
- Demonstrate critical thinking and sound scientific reasoning skills in clinical decision-making for the adult-gerontology population.
- Improve patient outcomes through application of advanced cognitive, psychomotor, cultural, and physiological principles in assessment, diagnosis, monitoring, management and evaluation of human response to acute and chronic illness, surgical intervention or the wellness continuum related to changes in life processes.
- Develop comprehensive nursing care plans/critical pathways based on current theories, evidence based practice, safety, efficacy, standards of care, and advanced clinical knowledge and expertise processes.
Sphere of Influence: Nurse and Nursing Practice
AGCNS as an Educator
- Identify and implement process/system interventions to decrease risk of iatrogenic injuries.
- Apply adult learning theory/principles to enhance practice skills and knowledge of clinical staff.
- Provide anticipatory guidance for expected and potential rapidly changing and complex situational events.
- Develop, coordinate, implement and evaluate an educational program for clinical staff and/or patient education.
AGCNS as a Scholar (Evidence-Based Practice)
- Expand the scientific base of nursing practice by utilizing, facilitating, and conducting research-based/evidence-based clinical projects.
- Explore practice protocols, ensuring ethical and legal practices are maintained throughout the process.
- Apply a theory-based conceptual framework to guide practice.
- Critically analyze the literature and apply evidence-based concepts in the management of the adult-gerontology population in the clinical setting.
- Contribute to the scientific nursing literature by presenting and publishing scholarly works.
- Disseminate recent innovations and evidence-based practice findings that are relevant to practice and patient outcomes.
Sphere of Influence: Organization/System
AGCNS as a Consultant
- Utilize clinical expertise to collaborate and/or consult with members of the health care team regarding patient outcome variations.
- Serve as nursing expert in support of an inter-professional team in planning care for the adult-gerontology population.
- Incorporate the role of clinical expert, educator, scholar (EBP/researcher), and manager in the application of change theory during the consultation process.
AGCNS as a Manager/Leader
- Perform departmental systems review to identify, develop, implement and evaluate programs in support of patient safety, patient outcomes, efficiency and/or productivity.
- Provide leadership in building an inter-professional team for collaborative relationships and innovative partnering practices in support of program development.
- Utilize financial and resource principles to formulate budgetary, staffing, supply, capital equipment management, and cost containment strategies.
- Evaluate implications of federal health care policy as they relate to health care professionals, clients, ethics and the delivery of care within the practice setting.
*“client” represents patient, family, community, group, and population
AG-CNS MSN Program outcome requirements
- Comply with the GSN requirements for graduation.
- 24 months of full time study
- Complete required number of program credits and clinical hours
- Complete the EBP proposal
- 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 500 clinical hours in the population/role of the AG-CNS and over 900 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
- Meet the mission of the Adult Gerontology Clinical Nurse Specialist program.
- Meets the GSN and AG-CNS program’s terminal competencies/expected 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 6230 | Practicum for CNS Practice II: Advanced Concepts for CNS Independent Practice | 7 |
| Total Credit Hours: | 7 |
Total Credit Hours: 74