††††† 201 KAR 20:062. Standards for advanced practice registered nurse (APRN) programs of nursing.

 

††††† RELATES TO: KRS 314.011, 314.111, 314.131

††††† STATUTORY AUTHORITY: KRS 314.111(3), 314.131(1), (2)

††††† NECESSITY, FUNCTION, AND CONFORMITY: KRS 314.111(3) and 314.131(2) require the board to promulgate administrative regulations to set standards for the establishment and outcomes of nursing programs, to approve schools of nursing and courses preparing persons for Advanced Practice Registered Nurse (APRN) licensure, and to monitor standards for APRN competency under KRS Chapter 314. KRS 314.131(1) authorizes the board to promulgate administrative regulations to implement KRS Chapter 314. This administrative regulation establishes APRN programs of nursing standards.

 

††††† Section 1. Definitions. (1) "APRN program of nursing" means the educational unit that prepares a person for practice and licensure as an advanced practice registered nurse and includes secondary or distance learning sites, if applicable.

††††† (2) "APRN program coordinator" means that individual who is responsible for the organization of the educational component and is licensed as an APRN in the designated role.

††††† (3) "Designated chief nursing academic officer" means that individual who has academic and administrative authority for the overall nursing program.

††††† (4) "National nursing accrediting body" means National League for Nursing Accreditation Commission (NLNAC), now known as the Accreditation Commission for Education in Nursing (ACEN), or the Commission for Collegiate Nursing Education (CCNE).

 

††††† Section 2. Requirements for Advanced Practice Registered Nursing Programs. (1) An educational institution that offers an APRN program of nursing shall ensure that the program:

††††† (a) Is offered by or affiliated with a college or university that is accredited under 201 KAR 20:260, Section 2(1);

††††† (b) Is a formal educational program, that is part of a doctoral, master's program, or a post-master's program in nursing with a concentration in advanced practice registered nursing and population foci as required for licensure in KRS 314.011;

††††† (c) Has presented evidence that it has applied for nursing program accreditation and meets accreditation standards; and

††††† (d) Offers a curriculum that covers the scope of practice for both the category of advanced practice registered nurse as specified in KRS 314.011 and the population foci.

††††† (2) The clinical practice component of the curriculum shall be congruent with current national professional organizations and nursing accrediting body standards applicable to the APRN role and population focus.

††††† (3) The program shall notify the board of any changes in hours of clinical practice or accreditation status and respond to board requests for information.

††††† (4) The program shall have financial resources sufficient to support the educational goals of the program.

††††† (5) The program shall establish academic and professional standards for admission to the program, progression in the program, and graduation from the program that shall be consistent with sound educational guidelines and recognized standards of professional conduct.

††††† (6) The program shall notify the board regarding any plans to expand the program to additional locations or increase the student enrollment by more than fifty (50) percent from the previously admitted cohort.

††††† (7) Voluntary closure of a program shall be in accordance with 201 KAR 20:360, Section 5.

 

††††† Section 3. Establishing a New APRN Program of Nursing. (1) An institution may receive consultation from the board prior to establishing an APRN program of nursing.

††††† (2) An institution that desires to establish and conduct an APRN program of nursing shall be accredited as outlined in 201 KAR 20:260.

††††† (3) An institution shall submit information to establish an APRN program of nursing along with the fee required by 201 KAR 20:240.

††††† (4) If the information is submitted to the board, the institution shall begin the application process with a national nursing accrediting body.

††††† (5) The information shall be submitted to the board no less than twelve (12) months prior to the first intended admission of students.

††††† (6) The information shall be completed under the direction of the registered nurse who shall serve as the designated chief nursing academic officer or the APRN program coordinator.

††††† (7) The institution shall not advertise or enroll students until the board has granted developmental approval status.

††††† (8) The information shall include:

††††† (a) General information about the governing institution including the:

††††† 1. Mission;

††††† 2. Ownership;

††††† 3. Method of financing;

††††† 4. Accreditation;

††††† 5. Enrollment;

††††† 6. Area served;

††††† 7. Institutional faculty qualifications; and

††††† 8. Resources that are sufficient to support defined outcomes and goals;

††††† (b) An organizational chart of the institution and a written plan which describes the organization of the program of nursing and its relationship to the institution;

††††† (c) A designation of the current or desired national nursing accrediting body to be used in the development of the program;

††††† (d) A description and rationale for the proposed type of APRN program to include the certificate or degree to be awarded and the population foci;

††††† (e) Approval from the governing body of the institution proposing the APRN program of nursing or other empowered approval bodies as applicable;

††††† (f) A copy of the curriculum vitae of the registered nurse identified as the APRN program coordinator;

††††† (g) Results of a needs assessment, including availability of an adequate number of potential students and employment opportunities for program graduates;

††††† (h) Evidence of support from the community of interest;

††††† (i) A timeline for the admission of students, projected graduation of the first class, and any plans for expansion;

††††† (j) A description of physical or virtual resources adequate to meet the needs of the faculty and students;

††††† (k) Evidence of a sound financial base and demonstrated financial stability available for planning, implementing, and maintaining the proposed program of nursing;

††††† (l) The philosophy of the APRN program and program outcomes for graduates;

††††† (m) Curriculum design for each identified track to include:

††††† 1. Proposed course sequence;

††††† 2. Description of courses; and

††††† 3. Credit hours delineating those credits assigned to theory and practice;

††††† (n) The availability of clinical experiences sufficient to accommodate the number of students to include the total number of clinical hours designated for each track or population foci;

††††† (o) A five (5) year plan for recruiting and retaining qualified nurse faculty; and

††††† (p) Recruitment plan and five (5) year projection for student enrollment and policies and procedures for student selection and progression.

††††† (9) Developmental approval shall be the designation granted to an APRN program of nursing that has met all the requirements of this administrative regulation including evidence that it has applied for accreditation from a national nursing accrediting body. This designation shall be for no more than a two (2) year period of time pending review and approval by a national nursing accrediting body.

††††† (10) When developmental approval has been granted by the board, the program may proceed with implementation including the admission of students. It shall be the responsibility of the APRN program of nursing to notify the board of the admission and graduation of the first class.

††††† (11) Developmental approval of an APRN program shall expire eighteen (18) months from the date of approval if a class of students is not admitted.

††††† (12) All formal communication between the APRN program of nursing and the national nursing accrediting body shall be forwarded to the board within thirty (30) days of receipt.

††††† (13) The APRN program coordinator shall notify the board within five (5) business days of any change in accreditation status.

††††† (14) The APRN program coordinator shall notify the board of pending site visits by the national nursing accrediting body.

††††† (15) The APRN program coordinator shall provide a copy of the report of the national nursing accrediting body to the board within ten (10) days of its receipt by the program.

††††† (16) The decision to grant full approval by the board shall be based on review of the following:

††††† (a) Achievement and continued full approval by a national nursing accrediting body; and

††††† (b) Site visit reports by the board representative conducted to evaluate program compliance with administrative regulations.

††††† (17) The board may grant full approval for a period of time not to exceed the approval period of the national nursing accrediting body.

 

††††† Section 4. Administrative Structure of Program. (1) The designated chief nursing academic officer shall hold the following qualifications:

††††† (a) A current, active, unencumbered registered nurse license or privilege to practice in Kentucky;

††††† (b) A doctoral degree earned from a university accredited by the United States Department of Education;

††††† (c) Educational preparation or experience in teaching and learning principles for adult education, including curriculum development and administration;

††††† (d) At least two (2) years of clinical experience; and

††††† (e) Current knowledge of APRN practice.

††††† (2) The qualifications for the APRN program coordinator shall include:

††††† (a) A current, active, unencumbered APRN license or privilege to practice in Kentucky;

††††† (b) A minimum of a masterís degree in nursing or health-related field in the clinical specialty from an accredited college or university which accreditation is recognized by the U.S. Department of Education;

††††† (c) Educational preparation or experience in teaching and learning principles for adult education, including curriculum development and administration; and

††††† (d) At least two (2) years of clinical experience.

††††† (3) The board shall be notified in writing of a vacancy or pending vacancy in the position of the APRN program coordinator within fifteen (15) days of the program of nursing's awareness of the vacancy or pending vacancy. If the APRN program coordinator vacates the position, the designated chief nursing academic officer shall submit to the board in writing:

††††† (a) The effective date of the vacancy;

††††† (b) The name of the APRN who has been designated to assume the administrative duties for the program and a copy of his or her curriculum vitae; and

††††† (c) Status reports from the APRN program of nursing national nursing accrediting body.

††††† (4) If there shall be a lapse between the date of the vacancy and the date the newly-appointed APRN program coordinator assumes duties, the designated chief nursing academic officer or the head of the governing institution shall submit a plan of transition to ensure the continuity of the program;

††††† (5) Progress reports shall be submitted if requested by the board;

††††† (6) The length of the appointment of an interim APRN program coordinator shall not exceed six (6) months.

††††† (7) Additional six (6) month periods may be granted upon request to the board based on a documented inability to fill the position.

 

††††† Section 5. Faculty, Adjuncts, and Clinical Preceptors. (1) The qualifications for nursing faculty within the program leading to licensure as an APRN shall be as follows:

††††† (a) A current, active, unencumbered APRN license to practice in Kentucky, unless the nurse faculty member will teach solely on-line and will not physically practice in this state in which case the nurse faculty member shall hold a current, active, unencumbered APRN license in the state in which they are located.

††††† (b) A minimum of a masterís degree in nursing or health related field in the clinical specialty;

††††† (c) Two (2) years of APRN clinical experience; and

††††† (d) Current knowledge, competence, and certification as an APRN in the role and population foci consistent with teaching responsibilities.

††††† (2) Adjunct clinical faculty employed solely to supervise clinical nursing experiences of students shall meet all the faculty quali≠fications for the program level they are teaching as designated in subsection (1) of this section.

††††† (3) Other qualified individuals may teach a non-clinical course or assist in teaching a clinical course in an APRN program of nursing within their area of expertise.

††††† (4) Clinical preceptors may be used to enhance faculty-directed clinical learning experiences. Clinical preceptors shall have demonstrated competencies related to the area of assigned clinical teaching responsibilities and shall serve as a role model and educator to the student. Clinical preceptors shall be approved by faculty and meet the following requirements:

††††† (a) Holds an unencumbered active license or multistate privilege to practice as a registered nurse and an advanced practice registered nurse or a physician in the state in which the preceptor practices or, if employed by the federal government, holds an unencumbered active registered nurse and an advanced practice registered nurse or a physician license in the United States; and

††††† (b) Has a minimum of one (1) year full time clinical experience in current practice as a physician or as an APRN within the role and population focus.

††††† (5) A clinical preceptor shall function as a supervisor and teacher and evaluate the studentís performance in the clinical setting. The program faculty shall retain ultimate responsibility for student learning and evaluation.

††††† (6) The preceptor may be a practicing physician or other licensed, graduate-prepared health care provider with comparable practice focus. A majority of the preceptors shall be nurses.

††††† (7) A clinical preceptor who is an APRN shall hold:

(a) National certification in the advanced practice category in which the student is enrolled; or

††††† (b) Current board licensure in the advanced practice category in which the student is enrolled.

††††† (8) A complete list of faculty members, clinical faculty, adjuncts, and preceptor appointments shall be reported to the board in writing annually.

 

††††† Section 6. Curriculum. (1) An educational program offered by an accredited college or university that offers a graduate degree or post-master's certificate with a concentration in the APRN role and at least one (1) population foci shall include the following components:

††††† (a) Clinical supervision as specified by the national certifying organizations applicable to the APRN role and population focus established in 201 KAR 20:056, Section 3(2); and

††††† (b) Curriculum that is congruent with:

††††† 1. AACN Essentials for Masters Education for Advanced Practice Nursing if the program grants a masterís degree or post-masterís certificate or AACN Essentials for Doctoral Education for Advanced Nursing Practice if the program grants a doctoral degree; or

††††† 2. NLNAC Standards and Criteria Masterís and Post-Masterís Certificate if the program grants a masterís degree or post-masterís certificate or NLNAC Standards and Criteria Clinical Doctorate if the program grants a doctoral degree.

††††† (2) APRN programs preparing for two (2) population foci or combined nurse practitioner/clinical nurse specialist shall include content and clinical experience in both functional roles and population foci.

††††† (3) Each instructional track shall have a minimum of 500 supervised clinical hours directly related to the role and population foci, including pharmacotherapeutic manage≠ment of patients.

††††† (4) The curriculum shall contain the following three (3) separate graduate level courses in addition to APRN core courses:

††††† (a) Advanced physiology/pathophysiology, including general principles that apply across the lifespan;

††††† (b) Advanced health assessment, which includes assessment of all human systems, advanced assessment techniques, concepts and approaches; and

††††† (c) Advanced pharmacology, which includes pharmacodynamics, pharmacokinetics and pharmacotherapeutics of all broad categories of agents.

††††† (5) Content specific to the role and population focus in the APRN core area shall be integrated throughout the other role and population didactic and clinical courses.

††††† (6) The curriculum shall include:

††††† (a) Diagnosis and management of diseases across practice settings including diseases representative of all systems and caused by major morbidities;

††††† (b) Preparation that provides a basic understanding of the prin≠ciples for decision making in the identified role; and

††††† (c) Role preparation in one (1) of the six (6) population foci of practice identified in KRS 314.011.

††††† (7) Preparation in a specialty area of practice is optional, but if included, it shall build on the APRN role/population-focus competencies. Clinical and didactic coursework shall be comprehensive and sufficient to prepare the graduate to practice in the APRN role and population focus.

 

††††† Section 7. Students. (1) A student entering into the APRN program shall have an active, unencumbered registered nurse license.

††††† (2) A student who wishes to complete a clinical experience in this state but is enrolled in an out of state APRN program shall have an active, unencumbered RN license in another jurisdiction, either in the U.S. or in another country. The following criteria shall be met:

††††† (a) The APRN program of nursing is accredited by a national nursing accrediting body;

††††† (b) The graduate program advises the student of expectations regarding student practice and required supervision;

††††† (c) The graduate program provides direct supervision of the clinical experience and informs faculty, preceptors and clinical facilities that the student is practicing under this limited exemption; and

††††† (d) The student limits practice to what is required for completion of the graduate program requirements.

 

††††† Section 8. Ongoing Approval. (1) Approved APRN programs of nursing accredited by a national nursing accrediting body may be subject to a site visit at intervals associated with their national nursing accreditation.

††††† (2) The board requires continuous accreditation by a national nursing accrediting body.

††††† (3) Factors that may indicate the need for a focused site visit and that jeopardize program approval status shall include:

††††† (a) Reported deficiencies in compliance with this administrative regulation;

††††† (b) Noncompliance with the governing institution or program of nursingís stated philosophy, mission, program design, objectives, outcomes, or policies;

††††† (c) Continual failure to submit records or reports to the board within the designated time frame;

††††† (d) Failure to provide sufficient clinical learning opportunities for students to achieve stated outcomes;

††††† (e) Failure to comply with requirements of the board or to respond to recommendations of the board within the specified time;

††††† (f) Failure to submit communication from the accrediting agencies within the time frames identified in Section 4 of this administrative regulation;

††††† (g) Withdrawal of accreditation for either the college or university or the national nursing accrediting body, or if accredited for less than the maximum accreditation period, the program may require additional reports regarding noncompliance;

††††† (h) Failure to obtain approval of a change that requires approval prior to implementation;

††††† (i) Providing false or misleading information to students or the public concerning the program of nursing;

††††† (j) A change in the ownership or organizational restructuring of the governing institution; or

††††† (k) Those necessary for the APRN program of national nursing accrediting body to evaluate compliance with referenced standards.

††††† (4) If the APRN program of nursing achieves reaccreditation and the board finds that all requirements have been met, the program shall be eligible for continuing full approval.

††††† (5) The board may visit a program of nursing on an announced or unannounced basis.

††††† (6) Board action following a site visit:

††††† (a) The board shall evaluate a program of nursing in terms of its compliance with this administrative regulation.

††††† (b) Following a site visit and prior to board consideration, a draft of the site visit report shall be made available to the APRN program coordinator for review and correction of factual data.

††††† (c) The APRN program administration shall be available during the discussion of the report at the board committee to provide clarification.

††††† (d) Following the boardís review and decision, a letter shall be sent to the APRN program coordinator and the head of the governing institution regarding the approval status of the program of nursing and any requirements to be met along with required timelines.

††††† (e) A program has the right at any time to present evidence to the board that any deficiencies have been corrected and may petition the board to restore full approval.

 

††††† Section 9. Approval Status and Withdrawal of Approval. (1) The board shall approve an APRN program of nursing if the program meets the requirements of this administrative regulation. The board may grant developmental approval for a period of two (2) years or less to an APRN program of nursing.

††††† (2) Full approval may be granted for the same period of time that is designated by the national nursing accrediting body.

††††† (3)(a) The APRN program coordinator of a nursing program that has its continuing approval-status rescinded by the board shall meet with representatives of the board to evaluate actions needed.

††††† (b) Following this meeting, the program may request a hearing pursuant to KRS Chapter 13B by filing a written request with the board within thirty (30) days of service of the board's order rescinding continuing full-approval status.

††††† (4) Conditional approval shall be the designation granted to a program of nursing if one (1) or more of the standards have not been met.

††††† (a) Following the decision of the board to place a program of nursing on conditional status, the program coordinator shall be notified of the areas of deficiency and the time frame allowed for corrective action to be implemented.

††††† (b) The APRN program coordinator shall, within thirty (30) days of the notice of deficiencies being sent, file a plan to correct each of the deficiencies.

††††† (c) The APRN program coordinator may, within thirty (30) days of the notice of the deficiencies, request to appear before the board to contest the boardís determination of deficiencies.

††††† (d) If the boardís determination of deficiencies has not been contested or if the deficiencies being sent are upheld after a request to contest them, the board may conduct periodic evaluations of the program of nursing during the time of correction to evaluate if deficiencies have been corrected.

††††† (e) If the plan of compliance is not completed satisfactorily within the time frame set by the board and if the program of nursing has not been granted additional time for completion, the approval status of the program of nursing shall be adjusted to probational.

††††† (5) Probational approval shall be the designation granted to a program of nursing if one (1) or more standards have continued to be unmet.

††††† (a) Following the decision of the board to place a program of nursing on probational status, the program coordinator shall be notified of the continued areas of deficiency. A new student shall not be admitted until the time the program of nursing comes into compliance. This period of time shall not exceed one (1) academic year.

††††† (b) The APRN program coordinator shall, within thirty (30) days of the notice of the deficiencies being sent, file a plan to correct each of the identified deficiencies.

††††† (c) The APRN program coordinator may, within thirty (30) days, of the notice of the deficiencies, submit a request to appear before the board to contest the boardís determination of deficiencies.

††††† (d) If the boardís determination of deficiencies has not been contested or if the deficiencies are upheld after a request to contest them, the board may conduct periodic evaluations of the program of nursing during the time of correction to evaluate if deficiencies have been corrected.

††††† (6) If the program of nursing has not corrected the deficiencies within one (1) academic year of being placed on probational status, a hearing pursuant to KRS Chapter 13B shall be conducted to evaluate whether to withdraw approval of the program of nursing.

††††† (7) If the board decides to withdraw approval of a program of nursing, upon the effective date of the decision the program of nursing shall be removed from the official approved status listing. A program of nursing whose approval has been withdrawn shall:

††††† (a) Allow a student who is currently enrolled in a nursing class to complete the program of nursing; or

††††† (b) Assist a currently enrolled student to transfer to an approved program of nursing.

††††† (8) A program of nursing whose approval has been withdrawn but continues to operate pursuant to subsection (7) of this section shall be continuously monitored by the board until the program closes.

††††† (9) The board may return an APRN program to full approval status if the program attains and maintains adherence to this administrative regulation.

 

††††† Section 10. Incorporation by Reference. (1) The following material is incorporated by reference:

††††† (a) "AACN Essentials for Masterís Education for Advanced Practice Nursing", 1996 Edition, American Association of Colleges of Nursing;

††††† (b) "AACN Essentials for Doctoral Education for Advanced Nursing Practice", 2006 Edition, American Association of Colleges of Nursing;

††††† (c) "NLNAC Standards and Criteria Masterís and Post-Masterís Certificate", 2008 Edition, National League for Nursing Accrediting Commission; and

††††† (d) "NLNAC Standards and Criteria Clinical Doctorate", 2008 Edition, National League for Nursing Accrediting Commission.

††††† (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Nursing, 312 Whittington Parkway, Suite 300, Louisville, Kentucky 40222, Monday through Friday, 8:00 a.m. to 4:30 p.m. (37 Ky.R. 637; Am. 1217; 1415; eff. 12-15-2010; 2895; eff. 8-17-2011; 40 Ky.R. 1328; 1708; eff. 2-19-2014.)