NURS3002 Utilising Research to Promote Quality in Health Care

The module will explore technical and resource innovations, in professional practice and service delivery, with a focus on global sustainability in health care and encourage students to consider their role as future leaders and change agents.

• Leadership models, styles and theory
• Synonymous concepts of Leadership vs management
• Nurses as clinical leaders/leadership at clinical level
• Values-based approaches and emerging paradigms.
• Organisational leadership and the impact on working cultures
• Principles of performance excellence/management
• Application of nurse Leadership to scenarios exploring change.
• Serious Untoward Incidents (SUI’s) and Never Events
• Clinical Governance and risk management
• The nurse’s role in CG and Risk management
• Risk management tools, audits & benchmarking, Targets and KPI’s
• Practical applications of good governance:
• Record keeping
• Skill mix and staffing
• Risk assessment
• Principles of human factors, environmental factors and strength-based approaches when working in teams
• Principles of health and safety legislation and regulations and the nurse’s role in maintaining safe work and care environments
• Legal frame works of accountability
• Impact of policy on health and social care
• Empowering nursing practice through socio-political discourse
• The role of supervision and team reflection activities in practice development and service improvement
• The nurse’s role in service development and business planning

Learning Outcomes

1. Appraise contemporary leadership theories and models relevant to nursing practice and the nurses’ role as a leader, role model and change agent (Report)
2. Analyse the role of the nurse in delivering patient focussed outcomes through the use of field of practice specific demographic data, quality standards, risk assessment, audit, change and performance management (Report)
3. Appraise how politics impacts on the role of the registered nurse in influencing and developing quality of care, patient safety and cost effectiveness (Report)
4. Evaluate contemporary UK government health policy and the legal, political and cultural concepts that influence care delivery on a global, international and national scale (Report)
5. Critically explore the nurse’s role as a leader, a role model and change agent, in promoting and supporting health and global sustainability in the field of practice specific setting (Report)
6. Critically discuss the importance of team working; including appropriate delegation, supervision, utilisation of effective inter-professional working practices, recognising the contributions of all members of the health and social care team in the field of practice specialty (Report).

Module information

Teaching and Learning Strategies

A range of strategies will be used as dictated by factors such as group size, the topic, the learning environment and available resources.  Strategies may include:

• Lectures: to examine and explore different concepts, definitions, theories and applications;
• Groupwork: to explore problems and issues and provide experiential learning, drawing upon the knowledge and expertise of other group members: to develop necessary problem-solving skills; to encourage team building;
• Simulation sessions will enable students to be placed into situations which simulate real life clinical scenarios. Simulation enables students to practice skills in a safe environment and assists with the transfer of these skills to the ‘real life clinical setting’;
• Computer based learning/internet facilities to access web-based information including use of VLE.
• Tutorial PODs – students will be assigned to tutorial PODs; this is the opportunity for students to focus on issues they want to address as well as participate in a forum which can facilitate peer learning/engagement. Students are encouraged to send in to their allocated tutor a draft plan of their assignment for feedback/guidance.

Self-directed study – students will be expected to utilise various methods to enhance their insight of the subject areas within the module. At Level 6, students need to be building on the research and study skills developed in Level 4 and 5, and not relying solely on taught material.

Explore and reflect on the impact leadership has in dealing with critical incidents/events and service development.

Students are required to undertake a 2 part assessment which are both submitted together.

Part 1 Reflective Statement

Students produce a 500 word description of an untoward/serious incident or critical event they have witnessed/been aware of in practice. This should be written in the style of a reflection, and must be FoP specific, and keep clinical area and those involved anonymous

Consider-

• Detail of incident
• Who was involved
• What was the outcomes
• What could you learn from this?

we would advise you use Rolfe’s (2001) model of critical reflection as this is used by the NMC for revalidation. It is a useful model and only has 3 stages What, So what and Now What?

Adapted from: Rolfe, G., Freshwater, D., Jasper, M. (2001) ‘Critical reflection in nursing and the

helping professions: a user’s guide.’ Basingstoke: Palgrave Macmillan

Part 2 Critical Appraisal (2,500)

Produce 2500 words on how leadership and management principles could be applied to address the incident/event you detailed in your reflection. The Critical appraisal and any recommendations/suppositions should be supported with contemporary literature.

Consider-

• Appraise contemporary leadership theories and models relevant to nursing practice and the nurses’ role as a leader, role model and change agent.

Eg: How did/do theories and models inform/impact/influence your event?

• Analyse the role of the nurse in delivering patient focussed outcomes through the use of field of practice specific demographic data, quality standards, risk assessment, audit, change and performance management.

Eg. What methods/tools/data/assessments were/could be used to assess the impact of your event and develop a service change/improvment?

• Critically explore the nurse’s role as a leader, a role model and change agent, in promoting and supporting health and global sustainability in the field of practice specific setting.

Eg. What was the nurses’ role as leader/role model change agent in the event/incident, what did they do at the time/after the event to demonstrate leadership? Who did/could they influence, who did/could they support?

• Critically discuss the importance of team working; including appropriate delegation, supervision, utilisation of effective inter-professional working practices, recognising the contributions of all members of the health and social care team in the field of practice specialty

Eg. What was the contribution/impact of the team, was team working established, was it effective?

The Leicester School of Nursing and Midwifery’s position is that the coursework instructions for all levels within the module handbook will clearly state a maximum word count.  This maximum will include any margin for tolerance which has been set (e.g. a word count with +10% tolerances); if the module guide does not state that 10% tolerance will be given then it does not exist for that module.

If an executive summary or abstract is required, then a separate word count for this should be specified.

What is included in the word count?

Word count includes everything in the main body of the text (including headings, tables, citations, quotes, lists).

The list of references, appendices and footnotes are NOT included in the word count unless it is clearly stated in the coursework instructions that the module is an exception to this rule.

Appendices should be kept to a minimum and only contain reference materials illustrating and supporting arguments fully made in the main body of the work.  Any other materials included in appendices, except where specifically requested in the coursework instructions, will not be marked.

Penalty for exceeding the word limit

There is no De Montfort University regulatory/mandatory penalty for exceeding the word count.  Within the Leicester School of Nursing and Midwifery, markers will positively mark the students work up to the maximum word limit allowed.  Markers will identify the point on the student’s work where the maximum word limit has been exceeded and inform students that any work following this point will not be considered in the allocation of marks.

Due to the professional nature of programmes within the Leicester School of Nursing and Midwifery, the marker will read the remaining work written after the maximum word limit has been reached to ensure that no reference to unsafe practice has been made.  If any reference to unsafe practice has been made in work that falls beyond the maximum word limit, the normal sanctions for unsafe practice in written work will be applied.

Students may therefore be penalised for a failure to be concise and for failing to conclude their work within the word limit specified.  Likewise, a failure to meet the maximum word limit may result in lower marks based on the quality of the work because they may not have included the necessary information required for the assessment and met the stated module learning outcomes.

The word count needs to be clearly and correctly stated on the title page of the assignment.  Incorrectly understating the word count constitutes an academic offence and may result in further action being taken.

Process for students seeking to extend assessment deadlines or defer an assessment on the BSc Nursing or BSc Midwifery Programmes

Sometimes students are unable to meet assessment deadlines due to unforeseen circumstances, or significant personal or medical issues.  The university offers several options for students in such situations, which are outlined in:

• The General Regulations and Procedures Affecting Students

Decisions on students’ options should be taken in conjunction with your Personal Tutor and requests for deferrals or interruptions will require supporting evidence.

• Academic regulations

If you are unable to submit coursework by a particular deadline because of extenuating circumstances you should contact your Personal Tutor as soon as possible in advance of the assessment deadline date to discuss the reasons why.  Your Personal Tutor will be able to guide you as to whether seeking an extension or deferral is the best course of action, given your particular circumstances.

Extending assessment deadlines (extensions)

If an extension is deemed to be the most appropriate solution, your Personal Tutor will ask you to complete an extension to coursework application form.  Your Personal Tutor will contact the relevant Module Leader advising them that they support your application for an extension.  The reasons for the extension will not be discussed with the Module Team.  You will then need to take this form to the relevant Module Leader.  The Module Leader has the discretion to grant an extension of up to 14 calendar days or they can, if appropriate or practical, make alternative arrangements for the assessment.  Remember it may not always be possible to make alternative arrangements.

If a deadline extension is approved by the Module Leader, they will sign the completed extension form and confirm with you the revised deadline date.  You should keep a copy of this form as evidence that the extension has been approved.

Deferring assessments

If your circumstances are such that an extension of up to 14 calendar days would not be sufficient, or if you feel that, despite being granted an extension of up to 14 calendar days, your performance in a piece of coursework is likely to be seriously affected by personal or medical circumstances, you may apply formally to your Faculty panel for a deferral of assessment of coursework.  Students may request a deferral (delay) in submitting assessments or sitting formal examinations.  This means that you can take the assessment at a later date than scheduled without it having an effect on reassessment opportunities.  It is treated as a first attempt and the module mark is not capped.  Normally, students will be automatically registered to take deferred assessments at the first opportunity provided.  You will have to fill in the appropriate form, for either coursework or examinations available from: http://www.dmu.ac.uk/dmu-students/the-student-gateway/academic-support-office/deferral-of-assessments.aspx.

Deferral Request Forms are available from Student Advice Centres or Student Gateway; alternatively, you can complete the appropriate electronic form:

• Coursework
• Examinations

Please ensure that you keep a copy of the form for your reference. You will need to supply supporting evidence; forms should be submitted to the Student Advice Centre.

What are extenuating circumstances?

Extenuating circumstances are defined as ‘genuine circumstances beyond a student’s control, or ability to foresee, and which seriously impair his or her assessed work’, for example:

• Acute illness or injury that is serious and debilitating and occurs at the time of the assessments concerned;
• Flare up of chronic conditions, examples of such conditions may include asthma, allergies, depression or migraines;
• The death of a member of your immediate family or a very close friend; and/or
• Being a victim of a serious crime.

It does not include circumstances that:

• Arise from minor accidents or injuries, ailments (e.g. a cold) or conditions that you should normally be able to control (e.g. hay fever, headaches);
• Are symptoms relating to normal exam stress and anxiety? You should develop strategies to cope with this.  Guidance and leaflets are available from Student and Academic Services;
• Are not related to the time of the assessment;
• Arise from your failure to manage your time effectively;
• Arise from your own negligence or carelessness (e.g. not getting up on time, going to the wrong room);
• Arise as a result of bad planning (e.g. booking a holiday or making travel arrangements);
• Arise from poor time management; and/or
• Arise from your computer not working, or loss of work due to your computer ‘crashing’ or work not being backed up.

Where coursework is submitted later than the agreed deadline without an application for an extension or deferral is being approved, the following tariffs apply:

• Work which is submitted unauthorised up to 14 calendar days after the original submission date will receive a mark that is capped at 40%.
• Work which is submitted unauthorised more than 14 calendar days after the original submission date will receive a mark of 0%.

This module does mark written assessments anonymously

The aim of the Module Team is to ensure that your work, accompanied by feedback, is returned no later than four (4) weeks after submission (but this will vary if the University is officially closed).  Please note that your mark is always provisional, and unratified, until it has been confirmed by the relevant Academic Assessment Board.  The process for this is detailed in the following: once the first marker has reached a decision about the mark and the feedback to be given, all pieces of work are collated and a sample then given to the internal moderator who reviews the marking and, as necessary, may refer work back to the Module Leader.  A sample of all assignments will also be moderated by the External Examiner for that module.  The External Examiner is also sent the Internal Moderator’s report.  After each Academic Assessment Board, you will receive a formal notification of your ratified results by post to your home address and via the MyDMU results page of Blackboard. 

Obtaining your feedback and marks

• Please refer to the Blackboard site and access ‘Assessment Feedback Guidance for Students’
• Once submitted the feedback and marks for the assignment will also be delivered electronically and not via student services.
• Unratified marks, assignment feedback comments and annotated scripts will be released on or before four (4) weeks after the submission date and can be viewed from the “my grades” tab on the Blackboard shell for the module. If you require feedback in an alternative format, please contact the Module Leader.
• You are strongly advised to save the electronic feedback to your portfolio record (a copy can then be printed if required). See assignment content area on Blackboard for guidance on how to submit electronically and view your grades on Blackboard.

If you have queries or worries about your work and/or about any feedback you receive you are encouraged to discuss this with the first marker once your results have been ratified.  Although markers will endeavour to give instructive feedback, a form offers no opportunity for dialogue and clarification.  It is your Module Leader who has the responsibility to work on aspects of your academic development.  They will be able to read a selection of your work, and the feedback you have been given, so as to work with you on the best ways of responding to, and learning from, the feedback.

Submission of Assignments

• You will be required to submit your assignment electronically by file upload using the Turnitin assignment tool located in the Assignment Submission content area of the Blackboard shell for this module.
• You will not need to submit a paper copy of your assignment to the university.
• You must add your university P number as a header/footer to all pages of your submission and you must include the word count on the front page.
• You should include the module title/code and your P number in the file name when you save your work. You must indicate Final Copy in the file name when you submit the final time to Turnitin (i.e. the copy which is to be marked).
• Your leaflet and assignment will be due in by 12 pm on the submission date stated in the module guide (unless you have a previously granted an extension). You are strongly advised not to leave submission of your leaflet and assignment until the latest possible time but you are encouraged to submit in advance of the submission deadline.
• You should print and keep a copy of the Turnitin email receipt/Blackboard page acknowledging successful submission of the assignment, as this is your only proof of submission. If you receive an error message when submitting, please contact your Module Leader.
• Once submitted the feedback and marks for the assignment will also be delivered electronically and not via student services. Unratified marks, assignment feedback comments and annotated scripts will be released on or before four (4) weeks after the submission date and can be viewed from the Turnitin or “my grades” tab on the Blackboard shell for the module.  If you require feedback in an alternative format, please contact the Module Leader.  You are strongly advised to save the electronic feedback to your portfolio record (a copy can then be printed if required).

• Feedback on your submitted work will include annotation of the script using Turnitin GradeMark software; markers will write comments on your submitted work to assist in interpretation of feedback and the development of your academic style.
  • Unratified feedback is issued as an early indication of results but have no formal standing until the appropriate assessment board has met to consider the results. Unratified feedback forms part of the learning process and cannot be used as the basis for appeal against assessment board decisions. 

See below for guidance on how to submit electronically and viewing your grades on Blackboard.  This information is also available on the user guide tab located in Home page of Blackboard.

How to submit an Assignment through Turnitin

Turnitin is a text-matching tool used for plagiarism detection.  The aim of using this software is to deter plagiarism, rather than to detect it and punish you.  Turnitin will then compare your submitted work with that of your fellow students and against billions of items in its database culled from the internet, journals and other sources.

• You must ensure your name is NOT visible anywhere on the Assignment, including in footnotes or in the comments box when submitting the assignment to Turnitin.
• The submitted assignment MUST include the following information:
  • The Student P number;
  • The module code (NURS 1520) and
  • The title of the Assignment.
• You may submit your assignment multiple times through Turnitin. Please ensure that your final assignment submission is marked FINAL.
• Log in to your Blackboard module and click on the appropriate link to take you to your assessment area.
• Click the ‘View/Complete’ link next to the assignment name; the submission form will open.
• Click on the ‘author drop-down box’ and find and click on your name.
• Now enter your first name and last name (the system should auto fill your name) and a submission title in the appropriate boxes (your name will not be visible to the marking team).
• Click the ‘Browse’ button to locate the file on your computer that you want to submit. In the new window click on the relevant document and select open.
• Click ‘Submit’ to upload the selected file into Blackboard. You will be asked to confirm that this is the text you want to submit.  Select ‘Yes’ to submit this file.  After your work has been submitted successfully, you will receive an electronic receipt, which you should retain.
• The screen ‘Review Submission History’ will now be visible. It documents the date and time of your submission and you should be able to see that the attached file is there (this screen will only be visible up until 4 pm on day of submission).
• Your submission task is now complete so you can now use the menu to navigate away from this page.

For some assessments your tutors may allow you access to the Originality Report for your work.  You can view both your submission and report by clicking on the relevant assignment’s ‘View/Complete’ link.  

Click on the Originality Report percentage under ‘Contents’ to view your report.  Note that other students will not be able to see or view your report.  You will receive a report every time you submit work to Turnitin.  The Originality Report gives both an overall index of similarity with other work (either published, online or from other students) and also the break-down of sources for each component.  For example, the overall similarity index may be 10%, with ten instances of 1% from a selection of sources.  However, if you find that you had a high overall similarity index, especially if there are high scores from individual sources, you may want to consider looking closely at how accurately you reference material and your style of academic writing.  Please note that lecturing staff on the module have access to these reports for each student via Blackboard.  

Once the work has been marked and feedback is available, you will be able to access the same Turnitin link to which you submitted your work, and you will be able to view or download the feedback provided.  You can also access your mark via the ‘my grades’ tab, which is linked to Turnitin GradeMark.

Sharing examples of good academic work

The Module Team would like to share good academic practice.  To enable that, Module Team members will identify examples of good work, anonymise the work, and share it with other students in tutorials.  The work will only be available in the tutorial setting and will not be shared electronically or copied for use outside the tutorial.

If you do not wish your work to be shared, please advise the Module Leader prior to submission of your work.

Guidelines Indicating an Automatic Failure for Unsafe Practice in both Practice and Academic Assessment

All students (pre and post-registration) are expected to be familiar with the principles of safe practice and are expected to perform in accordance with these requirements.  Whilst it is usually the case that students recognise safe practice issues in placement experiences, this is not always reflected in academic work.  Feedback from External Examiners indicates that there are variations in the application of judgements regarding the demonstration of unsafe practice in assessments.  It is important to ensure, as far as is possible, equity of decision making in respect of assessments.  Thus, this guideline will apply to assessments in practice as well as for academic assessments.

This guideline is intended as a supplement to, and not a replacement for, the University’s marking criteria.  It is not possible to construct strict rules regarding what constitutes unsafe practice in all circumstances and professional judgement still has a role to play.  The guideline is aimed at assisting in making judgements and providing a basis for resolving cases where a difference of opinion might occur.

Guidelines for Breaches in Safe Practise in Academic Work

The purpose of these guidelines is to provide a mechanism through which breaches in safe practise in assignments, examinations or any assessed work will be managed within the Leicester School of Nursing and Midwifery.  The intention of the guidelines is not to be punitive, but to instil the importance of confidentiality and safe practise within professional practise.

As students of nursing, midwifery, paramedicine, health and social care, your learning takes place in classrooms and clinical settings, as well as other appropriate locations.  It is inevitable that your academic work will sometimes require you to draw on the experiences gained on placements or within clinical settings.  In drawing on these experiences however, as a student, you have a duty to ensure that the practise referred to is safe.  For practise to be safe it must be evidence-based, up to date and not put patients or any members of the public at risk.

These guidelines are intended as a supplement to, and not a replacement for, existing marking criteria.  It is not possible to construct absolute rules regarding what constitutes a breach in safe practise, as in all circumstances professional judgment still has a role to play.  These guidelines are aimed at assisting in making you aware of what constitutes safe practise and how decisions will be made if reference to unsafe practise is made in your academic work.

What is a Breach in Safe Practise?

A breach in safe practise is defined as an occurrence, event or a pattern of repeated behaviour that places the patient, family and/or others in jeopardy and/or at an unacceptable level of risk for physical, psychosocial and/or emotional harm (Scanlan, Care and Gessler, 2001).  According to Killam, Luhanga, and Bakker (2011), a breach in safe practise includes several elements such as:

• student actions, behaviours or attitudes that reflect ineffective personal interaction, including communication and relationship difficulties;
• knowledge and skill incompetence, including deficits or failures of appropriate application; and/or
• projections or reflections of an unprofessional image.

Continuum of Breaches in Safe Practise

Breaches in safe practise, occurrences and behaviour, or patterns of behaviour, can pose differing levels or degrees of risk and/or harm to the patient that can be presented along a continuum from minor (Level 3) to moderate (Level 2) to serious risk (Level 1) within your academic work.  Figures indicate the amount of percentage to be deducted from your final mark awarded.  For example, if it is a minor breach and your mark would have been 55%, then your final mark will be reduced to 45%.

Breaches in safe practise will be judged according to the seriousness of the breach as follows:

Level 3 (minor): you have included a breach of safe practise where an occurrence, event, attitude or student behaviour presents minimal risk to the patient or is not consistently incorrect throughout the assessment – 10%.

Level 2 (moderate): you have included in the assessment a breach of safe practise occurrence, event, attitude, student behaviour or pattern of behaviour that places the patient and/or others at an unacceptable risk for harm (physical, emotional and/or psychosocial), but it is not consistently followed throughout your assessment – 20%.

Level 1 (serious): you have consistently integrated in your assignment breaches of safe practise, student behaviours, or pattern of behaviours that compromises patient safety and/or is an event, occurrence or pattern of behaviours that results in high risk for harm or could harm the patient or others – 100%. 

Assessing Breaches of Safe Practise

Academic work will be considered to reference a breach of safe practise if the work has evidence of:

• practise where the actions could potentially cause harm to some client/patient or healthcare personnel;
• practise where there are omissions that could lead to harm for the client/patient or healthcare personnel;
• poor use of terminology which could potentially cause harm to client/patient or healthcare personnel;
• inflammatory or derogatory language that projects a poor professional image; and/or
• where underpinning evidence is out of date (e.g. citing clinical guidelines, which have been superseded).

Which Assessed Work do these Guidelines apply to?

The guidelines apply to all written work and oral presentations (e.g. poster presentations, vivas, OSCEs and practical assessments) and supplementary appendices included within written work.  The penalty applied in each situation will depend on the seriousness of the breach of safe practise and the year or level you are in of the programme you are studying.

Applying the Penalty

As the purpose of these guidelines is to instil safe practise as part of the learning process, a penalty will be applied according to your student experience.  Thus, if it is a first breach in year one of your pre-registration programme, you will not be penalised but will be required to complete a reflective piece of work.  Failure to complete the reflection, will result in your final grade having the penalty applied and your mark will be reduced by 10-20% depending on the breach. 

Further breaches would then have the penalties applied.  If you are a pre-registration student in years two and three, there is an expectation that safe practise is understood so any breaches would result in the appropriate penalty being applied.  If you are a post-registration student, you will have the same penalty applied as a pre-registration year three student.