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Johns Hopkins University - School of Nursing
 
News Release

Health Systems Management/Clinical Nurse Specialist

"The program opened up my eyes to see so much more than just clinical nursing."

Sharon H. Allan, MSN '05, CCRC, RN

Nearly three decades into her nursing career, Sharon Allan decided to pursue a master's degree. She had worked at Johns Hopkins since 1976 and decided to attend nursing school there for the "diversity, ethics, and cutting-edge approach." The HSM/CNS dual track turned out to be the best of both worlds. "The Health Systems Management program helped me to understand the global effects of healthcare and healthcare reform." More

 

Program
Overview

Program Overview

Completed Application Deadlines

March 15 for fall entry
September 1 for spring entry
January 15 or summer entry

Impacting Healthcare Environments

The Johns Hopkins University School of Nursing HSM/CNS master's program prepares the graduate to manage the entire spectrum of healthcare: design, change management, implementation, and evaluation. With practical experience in direct patient and family care, nurses stand uniquely prepared to serve as leaders and managers in the constantly evolving environment of healthcare management and delivery.

For this master's program, renowned Hopkins faculty have developed a curriculum that responds to your combined interests in adult or pediatric patient care and improved management of healthcare systems. With the Hopkins medical institutions as your classroom, you will develop a strategic understanding of organizational management philosophy and techniques to ensure the safe and effective nursing care of patients.

Those who earn a master's of science degree in health systems management/clinical nurse specialist:

  • Occupy positions as business and policy analysts; and as managers in pharmaceutical, consulting, and insurance companies, healthcare systems, and nonprofit and government agencies
  • Evaluate and manage the fiscal health of institutions to provide the best nursing care within budget
  • Collaborate with administrative and healthcare staff across departments to coordinate patient services
  • Regulate change in the clinical environment and the healthcare delivery system effectively
  • Are eligible to sit for the national certification examination administered by the American Nurses Credentialing Center (ANCC)

Program
Requirements

Program Requirements

Students may apply for full- or part-time study.

The school seeks individuals who will bring to the student body the qualities of scholarship, motivation, and commitment. The Admissions Committee is interested in each applicant as an individual and will consider both academic potential and personal qualities. Therefore, school records, test scores, recommendations, and essays about goals and interests are important.

Recommendations about a student's character, intellectual curiosity, seriousness of purpose, and range of extracurricular activities are considered.

Selection factors include:

  • Bachelor of Science degree in nursing
  • Scholastic Grade Point Average of at least 3.0 on a 4.0 scale from an accredited college or university
  • Graduate Record Exam (GRE) scores within the past five years (for MSN/MPH and MSN/MBA applicants only)
  • Demonstrated commitment to nursing practice and scholarly pursuit
  • Community service and professional commitment
  • Interview with faculty member*
  • Written expression of goals
  • Letters of recommendation
  • Applicants must submit evidence of current nursing licensure. Students must have or obtain Maryland Registered Nurse licensure for matriculation

*Interview with a faculty member may or may not be requested.

Additionally, applicants for the Adult-Gerontology Acute Care Nurse Practitioner program

  • Will be exceptional students who are carefully chosen based on a number of factors including previous experiences.  Direct care acute care experiences will be required;
    OR 
  • Will be required to attend part time during their first year in the program while working as a staff nurse in a critical care unit full time (more than 36 hours per week), and will not begin NP clinical courses until their second year.

Transfer of Credit

Transfer of credit is granted on an individual basis. The decision is based on equivalent content (for required courses), credit allotment and satisfactory completion of courses. You may petition for permission to substitute a course from another college or university by submitting a request to the Office of Admissions and Student Services along with the complete course syllabus.

Up to 6 credits of graduate course work taken at Johns Hopkins University or elsewhere may be accepted for transfer. Course work must have been completed within the last five years. Course work at the undergraduate level will not be considered for advanced standing credit.

Admissions
Procedures

Admissions Procedures

Start Early

Students are strongly encouraged to complete the application process early. Candidates for admission will be notified of a decision in writing after all the application documents are received and the Admissions Committee's review.

Note: The admissions committee for the Public Health Nursing, Nurse-Midwifery Track consists of representatives from both Johns Hopkins University and Shenandoah University.

Follow all instructions carefully to avoid delays in the processing of application materials. To expedite the application process, students may submit all supporting documentation, including official transcripts and recommendations, in sealed envelopes in one package (test scores excluded). Application supporting documentation may also arrive separately. Before a final admission decision can be made, all supporting documentation must be received.

Submit

  • Completed and signed application form
  • Signed statement acknowledging the School's Ethics Policy
  • $75 non-refundable application fee
    (Make check or money order payable to "Johns Hopkins University")
  • Goal statement
  • Three recommendations:
    • At least one recommendation from an academic source (current or previous professor)
    • Remaining two recommendations may be from either an academic or professional source (employment/volunteer supervisor)
    • Recommendations should be enclosed in sealed envelopes with the recommender's signature across the envelope flap
  • Official transcripts from all colleges and universities attended (including Johns Hopkins University)
  • Current résumé
  • Official GRE scores, if applying to the MSN/MPH or MSN/MBA programs, sent to the School of Nursing (School code: 5767)
  • Verification of current RN license, all RN's must obtain a Maryland RN license and present verification by the time of matriculation

Note: Due to changing clinical site regulations, students are required to undergo a criminal background check prior to matriculation. The School will provide information about this process to accepted students.

Applicants Who Have Studied Abroad

International applicants and applicants who have completed courses outside of the United States must submit:

More information for international applicants 
Office of International Student, Faculty, and Staff Services

Full
Curriculum

Full Curriculum


Core Courses (12 credits)

NR.110.500 Philosophical, Theoretical, and Ethical Basis for Nursing
This course will explore the conceptual, theoretical, and ethical bases of nursing. Selected conceptual models and frameworks of nursing and ethics will be analyzed with emphasis on implications for nursing practice. This course is designed to provide students with frameworks, concepts, and personal and professional exercises for approaching nursing practice issues and to enhance the student's understanding of theoretical, conceptual and ethical issues in nursing and in health care and to respond to them specifically.
NR.110.503 Applications of Research to Practice
This course prepares students for clinical, management, or education leadership roles in health care through translation of the best available evidence into practice within organizations and application of research for nursing practice. Students will develop skills and knowledge needed to review and synthesize the strength of evidence available, and recommend practice changes if indicated. Topics covered include: a review of the research process (including theoretical framework, design, and analysis, research design hierarchy), research critique, rating and synthesizing the strength of evidence, decision making for practice, research and research translation opportunities (outcomes, evaluation research, quality improvement, cost-effectiveness analysis), risk adjustment, measurement, research ethics and organizational change. Prerequisite: NR 110.501
NR.110.504 Context of Healthcare for Advanced Practice Nursing
This three credit course examines the scope and status of professional roles and responsibilities of nurses prepared for advanced clinical and managerial placements in diverse health care settings. Course content and activities will focus on understanding forces driving contemporary health care and enhancing skills in outcomes evaluation, as well as efficient and effective function in a continuous change health care environment.
NR.110.507 Statistical Literacy and Reasoning in Nursing Research
This course develops statistical literacy and statistical reasoning knowledge and skills, enabling students to critically read and evaluate healthcare and nursing literature. The emphasis is on understanding the relevance and use of statistics in nursing research. Published nursing research articles in peer reviewed nursing and healthcare journals will be used to motivate each topic covered in class.

Advanced Practice Core Courses  (9 credits)

NR.110.502 Physiological/Pathophysiological Basis for Advanced Nursing Practice I
This course focuses on the interrelationship between normal physiology and pathophysiology across the lifespan. It is designed to expand the student's understanding of the pathophysiology underlying dysfunction in selected diseases that advanced practice nurses may commonly encounter in their patient populations. Using an integrative approach, representative alternations in physiologic function common throughout the lifespan are addressed. Completion of this course will enable the student to analyze and address physiologic challenges of practice. In addition, it will provide foundational knowledge for use in research involving issues that impact clinical practice. Weekly lecture/discussions are organized based on systems and cover topics from the cellular level up to major organ systems. Prerequisites: Undergraduate anatomy, physiology, and pathophysiology.
NR.110.508 Clinical Pharmacology
This course focuses on the clinical uses and mechanisms of action of drug groups used in altered states of physiological function. Pharmacological mechanisms, drug interactions, side effects and contraindications will be presented as bases for clinical judgment and management of patients.
NR.110.536 Health Assessment and Measurement: Adult/Geriatric Variations
This course provides an intensive and comprehensive introduction to the skills of history taking and advanced physical assessment for the adult/geriatric patient. The online modules are designed to help students apply their knowledge of physical assessment of adult/geriatric clients to the primary care or acute care setting. Emphasis is placed on the differentiation between normal and abnormal findings, recognition of common health problems, beginning development of a differential diagnosis and the process of critically thinking through problems related to adult/geriatric health. Corequisite: NR.110.549
NR.110.537 Health Assessment and Measurement: Pediatric Variations
This course provides an intensive and comprehensive introduction to the skills of history taking and advanced physical assessment for the pediatric patient, from newborns through adolescence. Lectures are designed to help the nurse practitioner (NP) or Clinical Nurse Specialist (CNS) student apply their knowledge of physical assessment of pediatric clients to the primary care setting. Emphasis is placed on interviewing and physical exam techniques for different developmental levels, documentation of data, the differentiation between normal and abnormal findings, and the process of critically thinking through problems related to child health. Pre/Corequisites: NR.110.502, 110.508, 110.548, and 110.549
NR.110.549 Advanced Health Assessment and Measurement
This course provides an introduction to the skills of advanced history taking and physical assessment. Lectures are designed to help the students apply their knowledge of physical assessment to both primary and acute care settings. Emphasis is placed on differentiation between normal and abnormal findings, recognition of common health problems, and the process of critically thinking through problems. Pre/corequisites: NR 110.502, 110.508, 110.536 and/or 110.537

* Either NR.110.536 Adult/Geriatric Variation or NR.110.537 Pediatric Variation is taken.

Specialty Courses

NR.110.523 Clinical Judgment in Advanced Acute Care Nursing I
This course provides the clinical nurse specialist student with opportunities to increase the depth of their acute and critical care knowledge. Students will synthesize knowledge of complex disease, multisystem pathophysiology, and advanced physical assessment; identify and evaluate evidence based medical, nursing and symptom management plans of care; propose strategies for measuring outcomes driven care; recommend strategies for professional and patient education in the care of adult patients and families with critical care needs across the health care continuum; and suggest appropriate referrals and consultations.
NR.110.524 Clinical Judgment in Acute Care Nursing II
This course provides the clinical nurse specialist student with opportunities to demonstrate advanced clinical judgment and to increase their depth of acute and critical care knowledge. This course builds on NR.110.523 and extends the diversity and complexity of cases. Students will synthesize knowledge of complex diseases, multisystem pathophysiology, and advanced physical assessment. Students identify and evaluate evidence based medical, nursing and symptom management plans of care. Students propose strategies for measuring outcomes driven care; recommend strategies for professional and patient education in the care of adult patients and families with critical care needs across the health care continuum; and suggest appropriate referrals and consultations. Pre/corequisites: NR.110.520, NR.110.521, NR.110.523
NR.110.589 Human and Family Development through the Lifespan
This course provides an overview of major concepts, theories, and research related to human development across the lifespan from the prenatal period to death. Simultaneously, major theories and research related to family development across the lifespan are also examined. Significant factors that influence individual and family development functioning are also studied. A variety of assessment tools for assessing development and functioning of individuals and families as well as strategies for intervening with individuals and family are examined. The role of the APN in assessment, implementing intervention, and evaluating outcomes aimed at promoting optimal human development and family functioning are critically examined and discussed.
NR.110.609 Health Systems Management II - Specialty Practice
The focus of this practicum and didactic course is on specific strategies of management related to the administrative role of nurses within the contemporary health care environment. Managerial functions of planning, organizing, leading and evaluation will be applied and analyzed across the health care system and opportunities to develop management skills will be offered. Other topics such as resource allocation, labor relations, team building, business communication, performance management and career development are included. Prerequisite: NR 110.500. Recommended corequisite: NR.110.605
NR.110.520A CNS Role Specialty Practicum I - Acute/Critical Care
Based on a student's past experience with the specialty population, this practicum will be individualized to provide the student with opportunities to develop the ROLES and skills of a clinical nurse specialist. Relevant role foci include: clinical expert, consultant, researcher, and educator. Essential skills include leadership, collaboration and mentoring. Students are expected to integrate knowledge of disease, advanced assessment skills, symptom management, evidence based practice, care coordination, and principles of patient/staff education as components of advanced nursing practice in the care of patients and families with complex needs across the continuum of health care. Prerequisites: NR 110.500, 110.504, 100.502, and 100.549. Pre/corequisite: NR 100.508.
NR.110.546 Health Promotion & Disease Prevention
This course introduces the student to current issues, theories and research in health promotion and disease prevention related to individuals, families, aggregates and communities. The role of the advanced practice nurse in risk assessment, counseling, education and screening will be emphasized. Students, taking the course for 2 credits, will have the opportunity to apply course content to the development and implementation of an individual or community-based educational project designed to promote health and prevent disease. The first hour of each class will focus on the theoretical issues of health promotion and disease prevention. Practicum students in the second hour will examine the clinical issues relevant to health promotion throughout the lifespan. A case study approach will be emphasized.
NR.110.560 Program Development and Evaluation in Health Care
This course is an introduction to the basic methods of program evaluation. Emphasis is given to designs that are popular and feasible in health care settings, and to programs for vulnerable populations. Consultant and group facilitation skills are described and assessed. Prerequisites: There are no pre- or corequisites but recommended prior or concurrent courses include introductory graduate-level courses in descriptive and inferential statistics and research design.
NR.110.521A CNS Specialty Practicum II - Acute/Critical Care
Based on a student's past experience with the specialty population, this practicum will be individualized to provide the student with opportunities to further develop the SPECIALTY FOCUS of the clinical nurse specialist across various health care settings. Students are expected to integrate knowledge of disease, advanced assessment skills, symptom management, care coordination, and principles of professional and patient education as components of advanced nursing practice across the continuum of health care. Pre/corequisites: NR.110.502, 110.503, 110.520, 110.589 (Peds CNS only), 110.593 (Forensic CNS only)
NR.110.522A CNS Outcomes Specialty Practicum III - Acute/Critical Care
This capstone course focuses on the application of case management methods in a selected population. Biopsychosocial and ethical concepts, advanced health assessment skills, and systems theory presented in previous course work will be integrated and applied to the advanced specialty health care needs of patients. Proficiency in the entry, validation, analysis and presentation of patient outcomes data will be developed in the computer lab and applied in the clinical setting. Pre/corequisites: NR.110.501, 110.503, 110.521
NR.110.605 Leadership and Management in Health Care
This didactic course is focused on the analysis, integration and application of principles of leadership and management to health care organizations and to population-based efforts across the health care delivery system. Special emphasis is placed on the practical skills needed for nurses to succeed as leaders and managers in today's local, state, national and international health care environment. Prerequisite: NR 110.500 Recommended corequisite: NR.110.512
NR.110.608 Business Plan
This course is designed to integrate previous learning involving the important tools for business planning, strategic management techniques and decision making as it relates to a specific case study. Prerequisites: NR.110.512, 110.605, & Financial Management Theory requirement

Additional Courses

Education requirement (3 credits)
Financial Management requirement (2 credits)
Organization Management Theory requirement (2 credits)

* CNS Role Specialty Practicum I, II, and III topics are chosen by student and have a clinical component
 ** Pediatric HSM/CNS focus must take NR.110.589 Human Development Across the Lifespan (2 credits)

Sample Course
of Study

Sample Course of Study

Program Plan (full-time)

More than 500 clinical hours enable graduates to sit for national CNS certification exams.

Fall I (12 credits)

NR.110.500 Philosophical, Theoretical, and Ethical Basis for Nursing
This course will explore the conceptual, theoretical, and ethical bases of nursing. Selected conceptual models and frameworks of nursing and ethics will be analyzed with emphasis on implications for nursing practice. This course is designed to provide students with frameworks, concepts, and personal and professional exercises for approaching nursing practice issues and to enhance the student's understanding of theoretical, conceptual and ethical issues in nursing and in health care and to respond to them specifically.
NR.110.507 Statistical Literacy and Reasoning in Nursing Research
This course develops statistical literacy and statistical reasoning knowledge and skills, enabling students to critically read and evaluate healthcare and nursing literature. The emphasis is on understanding the relevance and use of statistics in nursing research. Published nursing research articles in peer reviewed nursing and healthcare journals will be used to motivate each topic covered in class.
NR.110.504 Context of Healthcare for Advanced Practice Nursing
This three credit course examines the scope and status of professional roles and responsibilities of nurses prepared for advanced clinical and managerial placements in diverse health care settings. Course content and activities will focus on understanding forces driving contemporary health care and enhancing skills in outcomes evaluation, as well as efficient and effective function in a continuous change health care environment.
NR.110.520A CNS Role Specialty Practicum I - Acute/Critical Care
Based on a student's past experience with the specialty population, this practicum will be individualized to provide the student with opportunities to develop the diverse ROLES and SKILLS of a clinical nurse specialist. Relevant role foci include: clinical expert, consultant, researcher, change agent, and educator. Essential skills include leadership, collaboration and mentoring. Students are expected to integrate knowledge of disease, advanced assessment skills, symptom management, evidence-based practice, care coordination, and principles of patient/staff education as components of advanced nursing practice in the care of patients and families with complex needs across the continuum of health care. Pre/corequisites: NR.110.500, 110.504, 110.508, 110.536 or 537, 110.546, 110.549, 110.593 (Forensic students only)

Spring I (15 credits)

NR.110.502 Physiological/Pathophysiological Basis for Advanced Nursing Practice I
This course focuses on the interrelationship between normal physiology and pathophysiology across the lifespan. It is designed to expand the student's understanding of the pathophysiology underlying dysfunction in selected diseases that advanced practice nurses may commonly encounter in their patient populations. Using an integrative approach, representative alternations in physiologic function common throughout the lifespan are addressed. Completion of this course will enable the student to analyze and address physiologic challenges of practice. In addition, it will provide foundational knowledge for use in research involving issues that impact clinical practice. Weekly lecture/discussions are organized based on systems and cover topics from the cellular level up to major organ systems. Prerequisites: Undergraduate anatomy, physiology, and pathophysiology.
NR.110.508 Clinical Pharmacology
This course focuses on the clinical uses and mechanisms of action of drug groups used in altered states of physiological function. Pharmacological mechanisms, drug interactions, side effects and contraindications will be presented as bases for clinical judgment and management of patients.
NR.110.609 Health Systems Management II - Specialty Practice
The focus of this practicum and didactic course is on specific strategies of management related to the administrative role of nurses within the contemporary health care environment. Managerial functions of planning, organizing, leading and evaluation will be applied and analyzed across the health care system and opportunities to develop management skills will be offered. Other topics such as resource allocation, labor relations, team building, business communication, performance management and career development are included. Prerequisite: NR 110.500. Recommended corequisite: NR.110.605
NR.110.549 Advanced Health Assessment and Measurement
This course provides an introduction to the skills of advanced history taking and physical assessment. Lectures are designed to help the students apply their knowledge of physical assessment to both primary and acute care settings. Emphasis is placed on differentiation between normal and abnormal findings, recognition of common health problems, and the process of critically thinking through problems. Pre/corequisites: NR 110.502, 110.508, 110.536 and/or 110.537
NR.110.536 Health Assessment and Measurement: Adult/Geriatric Variations
This course provides an intensive and comprehensive introduction to the skills of history taking and advanced physical assessment for the adult/geriatric patient. The online modules are designed to help students apply their knowledge of physical assessment of adult/geriatric clients to the primary care or acute care setting. Emphasis is placed on the differentiation between normal and abnormal findings, recognition of common health problems, beginning development of a differential diagnosis and the process of critically thinking through problems related to adult/geriatric health. Corequisite: NR.110.549
NR.110.605 Leadership and Management in Health Care
This didactic course is focused on the analysis, integration and application of principles of leadership and management to health care organizations and to population-based efforts across the health care delivery system. Special emphasis is placed on the practical skills needed for nurses to succeed as leaders and managers in today's local, state, national and international health care environment. Prerequisite: NR 110.500 Recommended corequisite: NR.110.512

Summer I (5 credits)

NR.110.560 Program Development and Evaluation in Health Care
This course is an introduction to the basic methods of program evaluation. Emphasis is given to designs that are popular and feasible in health care settings, and to programs for vulnerable populations. Consultant and group facilitation skills are described and assessed. Prerequisites: There are no pre- or corequisites but recommended prior or concurrent courses include introductory graduate-level courses in descriptive and inferential statistics and research design.
NR.110.521A CNS Specialty Practicum II - Acute/Critical Care
Based on a student's past experience with the specialty population, this practicum will be individualized to provide the student with opportunities to further develop the SPECIALTY FOCUS of the clinical nurse specialist across various health care settings. Students are expected to integrate knowledge of disease, advanced assessment skills, symptom management, care coordination, and principles of professional and patient education as components of advanced nursing practice across the continuum of health care. Pre/corequisites: NR.110.502, 110.503, 110.520, 110.589 (Peds CNS only), 110.593 (Forensic CNS only)

Fall II (15 credits)

NR.110.503 Applications of Research to Practice
This course prepares students for clinical, management, or education leadership roles in health care through translation of the best available evidence into practice within organizations and application of research for nursing practice. Students will develop skills and knowledge needed to review and synthesize the strength of evidence available, and recommend practice changes if indicated. Topics covered include: a review of the research process (including theoretical framework, design, and analysis, research design hierarchy), research critique, rating and synthesizing the strength of evidence, decision making for practice, research and research translation opportunities (outcomes, evaluation research, quality improvement, cost-effectiveness analysis), risk adjustment, measurement, research ethics and organizational change. Prerequisite: NR 110.501
NR.110.522A CNS Outcomes Specialty Practicum III - Acute/Critical Care
This capstone course focuses on the application of case management methods in a selected population. Biopsychosocial and ethical concepts, advanced health assessment skills, and systems theory presented in previous course work will be integrated and applied to the advanced specialty health care needs of patients. Proficiency in the entry, validation, analysis and presentation of patient outcomes data will be developed in the computer lab and applied in the clinical setting. Pre/corequisites: NR.110.501, 110.503, 110.521
NR.110.546 Health Promotion & Disease Prevention
This course introduces the student to current issues, theories and research in health promotion and disease prevention related to individuals, families, aggregates and communities. The role of the advanced practice nurse in risk assessment, counseling, education and screening will be emphasized. Students, taking the course for 2 credits, will have the opportunity to apply course content to the development and implementation of an individual or community-based educational project designed to promote health and prevent disease. The first hour of each class will focus on the theoretical issues of health promotion and disease prevention. Practicum students in the second hour will examine the clinical issues relevant to health promotion throughout the lifespan. A case study approach will be emphasized.
NR.110.608 Business Plan
This course is designed to integrate previous learning involving the important tools for business planning, strategic management techniques and decision making as it relates to a specific case study. Prerequisites: NR.110.512, 110.605, & Financial Management Theory requirement

Education Requirement (3 credits)
Organization Management Theory Requirement (2 credits)
Financial Management Requirement (2 credits)

* CNS Role Specialty Practicum I, II, and III topics are chosen by student and have a clinical component

Tuition

Tuition

Tuition and Other Costs

Billed Expenses (September 2013 - May 2014)
Tuition: $33,984* (full-time per year)
Per credit cost: $1,416
Matriculation fee: $500 (onetime only fee for first-time enrolled JHU students)
Health Insurance:$2,421**
Health Fee:$450
 

Estimated Other Expenses***

Room and Board:$12,294
Books/Supplies:$1,856
Personal Expenses:up to $1,350
Travel Expenses: up to $3,366

*Full-time: 12 credit hours per semester
**All students must have health coverage.  Purchase of the School’s plan is optional.
***Amounts for other expenses vary based upon student's selection of books, supplies, and living arrangements.

Billed expenses are subject to change without prior notice.       

For media inquiries, contact Jon Eichberger at (410)614-4695, je@jhu.edu.

Johns Hopkins University School of Nursing
525 N. Wolfe Street | Baltimore MD 21205 | (410)955-4766
 
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