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American Association of Colleges of Nursing (AACN) (2011), The Essentials of Master’s Education in Nursing
2007, http://www.mext.go.jp/b_menu/shingi/chukyo/chukyo0/toushin/05090501.htm
2011,
http://www.mext.go.jp/b_menu/shingi/chukyo/chukyo0/toushin/1301929.htm
2011,
http://www.mext.go.jp/b_menu/shingi/chousa/koutou/40/toushin/1302921.htm
2002 , 21
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AACN
25 1 24
AACN The
Essential of Master’s Education in Nursing, 2011
1999 IOM
Institute of Medicine
2001
IOM
IT
IOM 2005 QSEN Quality and Safety Education for
Nurses
3
QSEN
LACE Licensure, Accreditation, Certification and Education CRNA
CNM CNS
CNP 4 APRN
4 Consensus Model Consensus Model
APRN
6
2015
AACN The
Essentials of Master’s Education for Advanced Practice Nursing 1996
APN 2011 9
資料5
-
1996 The Essentials of Master’s Education for Advanced Practice Nursing
2011 The Essentials of Master’s Education in Nursing Essential
2011
IOM QSEN
IT
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B.
C.
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population health
資料5
-
IOM Inter Professional Education
2011
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Fusae Kondo Abbott (
•• : QSEN (http://qsen.org/)••
• IT• DNP• IOM: 2012• IOM: 2012
(http://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Report%20Brief.pdf)
•
(http://www.aacn.nche.edu/education/pdf/APRNReport.pdf)
資料5
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• 1999 IOM48,000 - 98,000
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2008 P t Ad i i• 2008 Present on Admission
Institute of Medicine IOM, 2001)
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Nursing/Future%20of%20Nursing%202010%20Report%20Brief.pdf)
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資料5
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QSEN• Quality and Safety Education for Nurses
–http://qsen.org/about-qsen/–2005– Robert Wood
Johnson Foundation AACN
•–
QSEN
• QSEN Informational Video, part 1 –http://www.youtube.com/watch?v=HnksQ
O7oi_Q
• QSEN Informational Video, part 2 –http://www.youtube.com/watch?v=A-
LzIlm2b2U
資料5
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APRN Consensus Model LACE• LACE Licensure, Accreditation, Certification and
Education
Li– Licensure :
– Accreditation :
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APRN
(APRN Joint Dialogue Group Report, July 7, 2008)
APRN Consensus Model LACE
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APRN Consensus Model LACE• APRN
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••••••
(APRN Joint Dialogue Group Report, July 7, 2008)
APRN Consensus Model LACE
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(APRN Joint Dialogue Group Report, July 7, 2008)
資料5
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Model of Master’s Nursing Curriculum
• :–
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(http://www.aacn.nche.edu/education/pdf/APRNReport.pdf)
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Semester 1N600 Theoretical Foundations for Health ProfessionalsN608 Leadership, Management and Organizational Behavior
in Healthcare
3 units3 units
Semester 2N612 Healthcare Finance 3 unitsN602 Analysis of Health Policy IssuesElective course
3 units3 units
Semester 3 N603 Epidemiology and Bio-StatisticsN607 Program Evaluation and Quality Improvement
3 units3 units
Semester 4 N601 Research Methods 3 unitsN620/620L Case Management 6 units
Semester 5N605/606 Synthesis RequirementN621L Practice and Seminar
3 units3 units
Total 36 units
Essential I
Essential II
Essential III
Essential IV
Essential V
Essential VI
Essential VII
Essential VIII
Essential IX
3Ps
N608 V V V
N601 V V V V
N602 V V VV V V
N603 V V V
N607 V V V V V V V
N612 V V V V
N620 V V V V V V V
N620L V V V V V V
N621L V V V V V V
N606 V V V V
N623/L
V V V V
N624 V V
N625 V V V
資料5
-
Semester 1N608 Leadership, Management and Organizational Behavior in
Healthcare N601 Research Methods
3 units
3 units
Semester 2N603 Epidemiology and Bio-StatisticsN602 Analysis of Health Policy Issues
3 units3 unitsN602 Analysis of Health Policy Issues
N623/623L Advanced Health Assessment for Nurse Case Managers3 units3 units
Semester 3 N612 Healthcare FinanceN624 Advanced Pathophysiology for Nurse Case ManagersN625 Advanced Pharmacological Management for Nurse Case
Managers
3 units2 units2 units
S 4Semester 4N607 Program Evaluation and Quality ImprovementN620/620L Case Management
3 units6 units
Semester 5N605/606 Synthesis RequirementN621L Practice and Seminar
3 units3 units
Total 37 units
School of Nursing
COURSE TITLE: N623/N623L: Advanced Health Assessment for Nurse Case Managers CREDITS: 3 units (including 1 unit Lab)
School of Nursing
COURSE TITLE: N623/N623L: Advanced Health Assessment for Nurse Case Managers CREDITS: 3 units (including 1 unit Lab)( g )
FACULTY:Office Hours: Contact: Email: DAY AND TIME:
DESCRIPTION:This course focuses on the strategies and skills needed to assess individuals throughout the life span in a case management setting. The expected outcome is competency in advanced health assessment as a Nurse
( g )
FACULTY:Office Hours: Contact: Email: DAY AND TIME:
DESCRIPTION:This course focuses on the strategies and skills needed to assess individuals throughout the life span in a case management setting. The expected outcome is competency in advanced health assessment as a Nurse g g p p yCase Manager. The analysis of assessment data, based on developmental and ethnic variation, is integrated into the case management clinical decision making process.
Advanced health/physical assessment includes the comprehensive history, physical and psychological assessment of signs and symptoms, pathophysiologic changes, and psychosocial variations of the client: the individual, family, or community. If the client is an individual, the assessment should occur within the context of the family and community and should incorporate cultural and developmental variations and needs of the client. The purpose of this comprehensive assessment is to develop a thorough understanding of the client in order to determine appropriate and effective health care including health promotion strategies.
g g p p yCase Manager. The analysis of assessment data, based on developmental and ethnic variation, is integrated into the case management clinical decision making process.
Advanced health/physical assessment includes the comprehensive history, physical and psychological assessment of signs and symptoms, pathophysiologic changes, and psychosocial variations of the client: the individual, family, or community. If the client is an individual, the assessment should occur within the context of the family and community and should incorporate cultural and developmental variations and needs of the client. The purpose of this comprehensive assessment is to develop a thorough understanding of the client in order to determine appropriate and effective health care including health promotion strategies.
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OBJECTIVES:At the conclusion of the course, the learner will be able to:
1. Demonstrate sound critical thinking and clinical decision making; 2. Develop a comprehensive data base, including complete functional
h l h hi h i l i i i di iassessment, health history, physical examination, appropriate diagnostictesting, and psychosocial system assessment;
3. Perform a risk assessment of the client including the assessment of lifestyle and other risk factors;
4. Identify signs and symptoms of common mental illnesses; 5. Perform basic laboratory tests and interpret other laboratory and
diagnostic data; 6. Relate assessment findings to underlying pathology or physiologic changes;6. Relate assessment findings to underlying pathology or physiologic changes;7. Cooperate in reaching a differential diagnosis based on the assessment
data and the trajectory of a disease; and 8. Develop an effective and appropriate plan of care for clients of all ages
that takes into consideration life circumstance and cultural, ethnic, and developmental variations, as well as end-of-life issues.
Theory Content Course Objectives
Lab Hours
Lab Content
Course Objectives
Week 1 & Week 2
1.Overview of case management practice: Case management models Roles and functions of case managers in each model
A. Model• Acute care
Obj 1, 2, 8
• Acute care• Post-acute: LTAC• Rehab• Long-term: SNF• Military and VA system• DM / care management /
population management/wellness • Public health/community-based• Physician groups• Physician groups• Home health/hospice/infusion
therapyB. Payer-based
• Commercial• Public• Self-Pay• Workers compensation• Other third party payors
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Week 3 2. Newman's model: holistic view Obj1, 2
21 hours Comprehensive physical assessment
Obj 1, 2, 3, 4, 5, 7, 8
Week 4 3 Physiological assessment: ObjWeek 4& Week 5
3. Physiological assessment:• Familial (genomics)• Interpretation of diagnostic
test results• Trajectory of illness and
medical treatment plan
Obj1,2,5,6, 7
Week 6 4. Functional assessmentOrem's self-care deficit h
Obj1,
theoryADLsIADLs
2, 4
Week 7 &Week 8
5. Psycho-social assessment • Family systems theory• Family and social support
system• Caregiver issues
Obj1, 2, 4
3 hours Functional assessment Functional assessment tools
Obj1, 2, 3, 4, 7, 8
Week 9 6. Cultural assessment• Health belief model• Cultural assessment tools• Religious and spiritual belief
systems
Obj1, 2
3 hours Focused interview: Psycho-socialassessment
Obj1, 2, 3, 7, 8
Week 10
7. Financial assessment• Insurance coverage• Personal finance• Third party liability
Obj1, 2
3 hours Focused interview: Cultural assessment
Obj1, 2, 3, 7, 8
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Week 11
8. Environmental assessment• Home environment• Work/employment settings• Eco-maps• Transportation
Obj1, 2
3 hours Focused interview: Financial assessment
Obj1, 2, 3, 7, 8
Week 12 &Week 13
9. Support for client decision making process• Choosing treatment options• End-of-life decision
Obj1, 8
3 hours Interview: Environmental assessment
Obj1, 8
Week 14 &
10. Develop CM plans• Triggers for CM interventions
Obj1, 2,
6 hours Communication: Decision
Obj1, 2,
Week 15
gg , ,6, 7, 8
makingsupport
, ,8
School of Nursing
COURSE TITLE: N624: Advanced Pathophysiology for Nurse Case Managers
School of Nursing
COURSE TITLE: N624: Advanced Pathophysiology for Nurse Case ManagersCOURSE TITLE: N624: Advanced Pathophysiology for Nurse Case Managers
CREDITS: 2 units
FACULTY:Office Hours: Contact: Email: DAY AND TIME:
COURSE TITLE: N624: Advanced Pathophysiology for Nurse Case Managers
CREDITS: 2 units
FACULTY:Office Hours: Contact: Email: DAY AND TIME:
DESCRIPTION:This course provides the theoretical framework for understanding disease processes and physiological aberrations in all ages, including chronic illness and population health. Emphasis will be placed on the application of pathophysiology in the identification of common disease processes, clinical syndromes, andthe trajectory and management of illness throughout a lifespan.
DESCRIPTION:This course provides the theoretical framework for understanding disease processes and physiological aberrations in all ages, including chronic illness and population health. Emphasis will be placed on the application of pathophysiology in the identification of common disease processes, clinical syndromes, andthe trajectory and management of illness throughout a lifespan.
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OBJECTIVES:At the conclusion of the course, the learner will be able to:
1. Apply current pathophysiological theory and research in the management of clients of all ages;
2. Discuss current pathophysiological theory related to commonly occurring health problems;
3. Synthesize and apply current research-based knowledge regarding pathological changes in selected disease states;
4. Describe the developmental physiology, normal etiology, pathogenesis, and clinical manifestations of commonly found/seen altered health states;
5. Demonstrate understanding of the cultural and ethnic variations and of the effects of genomics in pathophysiological processes;the effects of genomics in pathophysiological processes;
6. Analyze physiologic responses to illness and treatment modalities; 7. Demonstrate an understanding of the effects of disease on the patient
and family; and 8. Demonstrate the ability to communicate and relate to patients and their
families in an empathetic, facilitating manner.
Content Course Objectives
Unit 1 1. Medical necessity: Severity of illness• Definition: Medicare, Medicaid• InterQual Criteria• Milliman USA• Workers Compensation
Obj 1
Schedule of Classes
Clinical PathwaysUnit 2 2. InterQual training Obj 1, 2, 3Unit 3 3. Trajectory of illness and medical treatment plan: 6 common
diseases/health conditions (Care trails, pathways, & clinical guidelines)
• ACS• COPD• CKD• DM
Obj 1, 2, 3, 4, 5
DM• CVA/Stroke• Pneumonia
Unit 4 4. Level of care determination: • Acute: Acute care hospitals, Inpatient acute
rehabilitation, LTACPost-acute: SNF, hospice, home health, free-standing rehabilitation units, specialty pharmacy
Obj 7
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Unit 5 5. Facilitate agreement with plan of care:• Pt/family • Providers • Payors
Obj 7
h d dUnit 6 6. Six common chronic conditions in disease management (DM)• ACS• COPD• CKD• DM• Asthma• Complex chronic conditions
Obj, 1, 2, 3, 4, 5
Unit 7 7. Chronic Care Model Obj 1, 6, 7
Unit 8 8. Observation: DM practice (5 hours) Obj 6, 7, 8
School of Nursing
COURSE TITLE: N625: Advanced Pharmacological Management for Nurse Case Managers
School of Nursing
COURSE TITLE: N625: Advanced Pharmacological Management for Nurse Case Managers
CREDITS: 2 units
FACULTY:Office Hours: Contact: Email: DAY AND TIME:
DESCRIPTION:
CREDITS: 2 units
FACULTY:Office Hours: Contact: Email: DAY AND TIME:
DESCRIPTION:The focus of advanced pharmacological management for nurse case managers is clinical therapeutics, and it builds on prior knowledge of drug classifications, actions, interactions and side effects. The course concentrates learning on medications that are used in case management practice. Emphasis is placed on learning the clinical use of drugs in the management of specific illnesses throughout a lifespan; to include therapeutic dosages, clinical endpoints, patient monitoring plans and patient education.
Health-related information and medication compliance issues are of foremost concern throughout the course. This course builds on a sound foundation of pharmacology to facilitate comprehensive disease management.
The focus of advanced pharmacological management for nurse case managers is clinical therapeutics, and it builds on prior knowledge of drug classifications, actions, interactions and side effects. The course concentrates learning on medications that are used in case management practice. Emphasis is placed on learning the clinical use of drugs in the management of specific illnesses throughout a lifespan; to include therapeutic dosages, clinical endpoints, patient monitoring plans and patient education.
Health-related information and medication compliance issues are of foremost concern throughout the course. This course builds on a sound foundation of pharmacology to facilitate comprehensive disease management.
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OBJECTIVES:At the conclusion of the course, the learner will be able to:
1. Comprehend the pharmacotherapeutics of broad categories of drugs; 2. Analyze the relationship between pharmacologic agents and
physiologic/pathologic responses across a lifespan;p y g /p g p p ;3. Understand the motivations of clients in seeking prescriptions and the
willingness to adhere to prescribed regimens; 4. Understand safe and appropriate use of pharmacologic agents for the
management of client health problems, based on client variations, the problem being managed, and cost effectiveness;
5. Apply principles of adverse drug reactions and drug interactions to proactive dose modification or drug avoidance;
6 D t t ff ti ti t t hi t h i t ti i th6. Demonstrate effective patient teaching techniques to optimize the use of medications and to enhance patient compliance; and
7. Develop a case management plan for clients of all ages to evaluate client medication based on individual variations, including treatment options and financial resources.
Content Course Objs
Unit 1 1. Medical Necessity: Intensity of services • InterQual Criteria• Milliman USA• Workers Compensation• Clinical Pathways
Obj 2
Schedule of Classes
Unit 2 2. Trajectory of illness and medical treatment plan Obj 2
Unit 3 3. Formularies• Inpatient• Outpatient• Generic/Brand names
Obj 1, 5
Unit 4 4. Financial management Obj 6
Unit 5 5. Safe medication management: • Reconciliation on the continuum• Polypharmacy
Obj 4, 5, 6
• PolypharmacyUnit 6 6. Adherence to medical regimen
• Transtheoretical Model of Behavior Change • Self-efficacy theory
Obj 3, 6
Unit 7 7. Observation (5 hours)• Specialty pharmacy • Transitions of care• Outpatient medication management program
Obj 6, 7
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COURSE NUMBER: N6xx
COURSE TITLE: Theoretical Foundations in Advanced Nursing Practice
COURSE NUMBER: N6xx
COURSE TITLE: Theoretical Foundations in Advanced Nursing PracticeCOURSE TITLE: Theoretical Foundations in Advanced Nursing Practice COURSE UNITS: 3 Semester Units PREREQUISITES: Admission to the Samuel Merritt University (SMU) Program of Nurse Anesthesia or the Family Nurse Practitioner (FNP) Program
FACULTY OF RECORD: Jane M. Perlas, DNP, APRN, NP-C 3100 Summit Street, Room 3462 (510) 869-6511 ext 3798 [email protected] Office Hours: By Appt.
COURSE TITLE: Theoretical Foundations in Advanced Nursing Practice COURSE UNITS: 3 Semester Units PREREQUISITES: Admission to the Samuel Merritt University (SMU) Program of Nurse Anesthesia or the Family Nurse Practitioner (FNP) Program
FACULTY OF RECORD: Jane M. Perlas, DNP, APRN, NP-C 3100 Summit Street, Room 3462 (510) 869-6511 ext 3798 [email protected] Office Hours: By Appt.
DAY AND TIME: Every other week in-class meeting (physical campus attendance and online meetings). The number of days and times for physical campus attendance will be determined each semester by the faculty of record (FOR).
COURSE DESCRIPTION: This course provides an opportunity to explore the principles, practice, scientific inquiry and the integration of contemporary theories in advanced practice nursing (APN). Learners will analyze selected theoretical frameworks and their application to clinical practice. Foundational theories specific to the domains of clinical practice, informatics, patient safety and ethics will be examined. The principles of interdisciplinary education and practice are also emphasized.
DAY AND TIME: Every other week in-class meeting (physical campus attendance and online meetings). The number of days and times for physical campus attendance will be determined each semester by the faculty of record (FOR).
COURSE DESCRIPTION: This course provides an opportunity to explore the principles, practice, scientific inquiry and the integration of contemporary theories in advanced practice nursing (APN). Learners will analyze selected theoretical frameworks and their application to clinical practice. Foundational theories specific to the domains of clinical practice, informatics, patient safety and ethics will be examined. The principles of interdisciplinary education and practice are also emphasized.
COURSE OBJECTIVESAt the completion of this course the student will be able to:
1. Actively participate in the discussion of selected nursing theories (e.g., translational nursing, integrative APN, etc.).
2. Appraise the role of the APN in the translation of new knowledge into clinical practice.
3. Analyze and critique relevant theories and research in the field of informatics.
4 E l t th th ti l f d ti f ti t f t i4. Evaluate the theoretical foundation for patient safety inclinical practice.
5. Identify and integrate ethical and legal principles in APN using a case-based approach.
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Assignments (rubrics for each assignment will be provided in advance) % of Grade Due Date
Communication technology and Informatics theory essay 15%
Communication technology and Informatics theory presentation 10%
Biophyschosocial Model Group Presentation 20%
Completion of Module 1 and Module 2 of the National Patient Safety 10%Foundation Patient Safety Curriculum. Log-in/password information to these modules will be provided*
Active participation in “Ethical Dilemmas” and “Patient Safety Introduction” simulation sessions (3-hours per session, per student, in assigned small groups in the Health Sciences Simulation Center)
15%
Personalized action plan for ongoing patient safety learning (in required format as described in separate document) that spans the number of months that the student is enrolled in the clinical curriculum
10%
that the student is enrolled in the clinical curriculum
Completion of a wiki article to contribute to the class wiki on fundamental theories and concepts of health care ethics
10%
Completion of posts on discussion board and forums in the LMS as directed on course schedule
10%
* If SMU is unable to arrange for student access to the online NPSF modules of the NPSF Patient Safety Curriculum, an equivalent, online alternative will be established
CLO # Program Learning Outcome (PNA)
Program Learning Outcome (FNP)
Institutional Learning Outcome
AACN Master’s Essential
1 PLO 3a: Critical thinking through application of theory to practice in decision
5. Produce quality work that demonstrates graduate levelscholarly work and can
Critical Thinking
Essential I
Curricular mapping summary (CLO: Course Learning Objective)
to practice in decision-making/problems solving
scholarly work and canwithstand peer review.
2 PLO 3a (see above)PLO 4a: Effective communication with all individuals influencing patient care
2. Consult and refer within an interdisciplinarypractice model.
Critical Thinking
Essential VII
3 2. Consult and refer within an Information Essential Vinterdisciplinarypractice model.
Tech
4 3. Collaborate with patients and families to provideevidence-based primary care that is theoretically sound.
Information Tech
Essential V
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5 PLO 4b: Communication skills via utilization of all forms during the delivery of care
3. Collaborate with patients and families to provideevidence-based primary care that is theoretically sound.
Information tech Essential V
6 PLO 3b & 3c: Critical Thinking via planned care
1. Provide family-oriented primary healthcare:
Clinical Competence
Essential I
based on sound principles & research-based evidence
a. Elicit a detailed and accurate history, perform theappropriate physical exam, record pertinent data,and develops and implements plan of care.b. Perform and/or order and interpret relevantdiagnostic studies.c Perform appropriate officec. Perform appropriate officeprocedures.d. Provide health promotion and disease prevention.
7 PLO 1e: Safe patient care through compliance with JC & NPSF safety goals
1e. Integrates cultural considerations in the provision of primary care.
Clinical CompetenceCommunication
Essential III, VI
8 PLO 1e & 1f: Safe patient care through implementation of CRM principles
3. Collaborate with patients and families to provideevidence-based primary care that is theoretically sound.
Clinical CompetenceCommunication, Leadership
Essential III, VI
9 PLO 5b & 5c: Professional role as demonstrated by responsible/accounta
1. Provide family-oriented primary healthcare:a. Elicit a detailed and accurate history, perform the appropriate physical exam,
Ethics Essential II
ble practice & practice with integrity
record pertinent data, and develops and implements plan of care.b. Perform and/or order and interpret relevant diagnostic studies.c. Perform appropriate office procedures.d. Provide health promotion and disease prevention.e. Integrates cultural considerations in the provision of primary carethe provision of primary care.
10 PLO 5c: practice with integrityPLO 3a: Critical thinking through application of theory to practice in decision-making/ problems solving
4. Assume a leadership role in the profession at local, state, national and international level.
Ethics Essential II
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Mod
ule
Wee
k # General course topic
(Specific topic will be identified for final
syllabus)
Reading/Prep Learning ActivityF2F = on campus or
synchronous online session
1 1 Introduction to & l
Barker (2009), Chapters 18, 19, 29 21 & 22
- F2F lecture: 1.5 hoursO li di i ti
Schedule of Classes
course & generaltheory concepts
29, 21, & 22 - Online discussion posting
2 2 Informatics Barker (2009) Chapter 17Current Journal articles will be assigned
F2F Lecture
3 Informatics Current journal articles will be assigned
Online Discussion Board (DB) Posting
4 Informatics Current journal articles/online resources will be assigned
Online Lecture Materials/PodcastDB Postings
5 Informatics Current journal articles/online resources will be assigned
Communication technology and Informatics Theory Presentations and Essay due
3 6 BiopsychosocialModel (BPSM)
Current Journal Articles will be assigned DB Posting
7 BPSM Current Journal Articles will be assigned DB PostingIn class case studies
8 BPSM BPSM Group Presentation
4 9 Ethics Baker (2008). Chapters 27 & 28 - F2F lecture (2.0 hrs.) Ethics Current journal articles will be assigned Expert case-based
seminar discussions- Forum post assignments on ethical dilemmas
10 Ethics - Online resources will be assigned (includes videos)
- Ethics simulation sessions in assigned groups (3.0 hours)
11 Ethics - References/Resources as determined b l
- Complete wiki article (per b i ) i l d i fby learner rubric); includes review of
peer’s article
5 12 Patient Safety - Log into/Register for the NPSF Patient Safety Curriculum (or online equivalent); Reading for each module is indicated within module
- Selected chapters Sherwood & Barnsteiner (2012)
Online work:- NPSF Module 1- NPSF Module 2
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13 Patient Safety - Read Nance (2008) - all chapters- Journal articles will be assigned
- F2F session (2.0 hrs.) Guest Lecturer: Patient Safety Expert case-based seminar discussions- Videos (TEDTalk, NPSF) will be assigned - Forum postassigned Forum postassignments on each topic
14 Patient Safety - Selected chapters, Sherwood & Barnsteiner (20120)
- Current journal articles on human factors and non-
- F2F session (3.0 hr. experience for each student in assigned groups): Patient Safety Focused simulation sessions
technical skills will be assigned
CM
• SMU•• :
– ANA Credentialing Center• http://www.nursecredentialing.org/Certification/NurseSpecial
tiesCategory/CaseManagement
American Case Management Association– American Case Management Association• http://www.acmaweb.org/section.asp?sID=22
– Case Management Society of America• http://www.cmsa.org/Individual/MemberResources/Standard
sofPracticeforCaseManagement/tabid/69/Default.aspx
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Samuel Merritt University Core Learning Competencies and Outcomes
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TEL 03-6206-9451 FAX 03-6206-9452 E-mail [email protected]
https://doi.org/10.32283/rep.9b1fb879