GENERAL GOVERNMENT CABINET
Board of Nursing
††††† 201 KAR 20:260. Organization and administration standards for prelicensure registered nurse or practical nurse programs of nursing.
††††† STATUTORY AUTHORITY: KRS 314.111(1), 314.131(1), (2)
††††† NECESSITY, FUNCTION, AND CONFORMITY: KRS 314.111(1) and 314.131(2) require the board to approve schools of nursing and courses preparing persons for licensure and to monitor standards for nurse 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 the organization and administration standards for prelicensure registered nurse or practical nurse programs.
††††† Section 1. Definitions. (1) "Campus" means a division of a college or university that has its own grounds, buildings, and students, but is administratively joined to the rest of the college or university.
††††† (2) "Clerical assistance" means the provision of administrative, secretarial, or clerical help by qualified individuals that assists the program of nursing.
††††† (3) "Clinical instructor" means a nurse who is employed by a program of nursing solely to provide students with traditional clinical or simulated experiences.
††††† (4) "NCLEX" means the National Council Licensure Examination.
††††† (5) "Nurse faculty" means a nurse who is employed by a program of nursing, either full-time, part-time, or adjunct, to provide didactic instruction, and may also provide clinical instruction or simulated experiences.
††††† (6) "Preceptor" means a nurse with demonstrated competence in a specific clinical area who serves as a role model and mentor to assist in the development and validation of the competencies of a student.
"Program of nursing" means the educational unit that prepares a
person for licensure as a registered or licensed practical nurse[ and
includes secondary learning sites, if applicable].
††††† (8) "Suspension of enrollment" means temporarily halting the admission of students into an approved program of nursing tract.
††††† Section 2. Organization or Administration Standards for Prelicensure Registered Nurse and Practical Nurse Programs. To be eligible for approval by the board, a program shall have:
††††† (1) A governing institution.
††††† (a) The governing institution that establishes and conducts the program of nursing shall hold accreditation as a postsecondary institution, college, or university by an accrediting body recognized by the U.S. Department of Education.
††††† (b) The governing institution shall assume full legal responsibility for the overall conduct of the program of nursing. The program of nursing shall have comparable status with the other programs in the governing institution and the relationship shall be clearly delineated.
††††† (c) The governing institution shall:
††††† 1. Designate a program administrator for the prelicensure program of nursing who is qualified pursuant to 201 KAR 20:310 and is responsible for fulfilling the duties specified in subsection (3) of this section on a twelve (12) month basis;
Assure that at least fifty (50) percent and up to 100 percent of the
program administrator's time shall be dedicated to complete the duties
specified in this administrative regulation at each program of nursing[
to 100 percent]. A governing institution that is unable to comply with this
standard may request an exemption from the board in writing.
††††† a. The request shall state the reasons for noncompliance and the efforts the institution has taken and will take to comply with the standard.
††††† b. If the exemption is granted, it shall be for one (1) academic year. During this time, the governing institution shall not open a new program of nursing and shall not increase enrollment at an existing program of nursing;
††††† 3. Establish administrative policies;
††††† 4. Provide evidence that the fiscal, human, physical, clinical, and technical learning resources shall be adequate to support program mission, processes, security, and outcomes;
††††† 5. Provide student support programs, services, and activities consistent with the mission of the governing institution that promote student learning and enhance the development of the student;
††††† 6. Make financial resources available to the program of nursing consistent with equivalent programs at the governing institution;
††††† 7. Employ nurse faculty pursuant to 201 KAR 20:310 in sufficient number and
expertise to accomplish program outcomes and quality improvement;
Provide written policies for faculty related to qualifications for the position,
rights and responsibilities of the position, criteria for evaluation of
performance, workload, and retention[
promotion, retention, and tenure];
††††† 9. Involve the nurse faculty in determining academic policies and practices for the program of nursing; and
10. Provide for the security, confidentiality, and integrity of faculty employment and student records.
††††† (d) The governing institution shall provide an organizational chart that describes the organization of the program of nursing and its relationship to the governing institution;
††††† (2) Administrative policies.
††††† (a) There shall be written administrative policies for the program of nursing that shall be:
††††† 1. In accord with those of the governing institution; and
††††† 2. Available to the board for review.
††††† (b) The board shall be notified in writing of a vacancy or pending vacancy in the position of the program administrator within fifteen (15) days of the program of nursing's awareness of the vacancy or pending vacancy. If the program administrator vacates the position, the head of the governing institution shall submit to the board in writing:
††††† 1. The effective date of the vacancy;
††††† 2. The name of the registered nurse who has been designated to assume the administrative duties for the program and a copy of his or her curriculum vitae;
††††† 3.a. If there is to be a lapse between the date of the vacancy and the date the newly-appointed program administrator assumes duties, the head of the governing institution shall submit a plan of transition to ensure the continuity of the program.
††††† b. Progress reports shall be submitted if requested by the board;
††††† 4.a. The length of the appointment of an interim program administrator shall not exceed six (6) months.
††††† b. Additional six (6) month periods may be granted upon request to the board based on a documented inability to fill the position; and
††††† 5.a. If the individual to be appointed as the interim program administrator is not qualified pursuant to 201 KAR 20:310, the head of the governing institution shall petition the board for a waiver prior to the appointment.
††††† b. A waiver shall be granted if the individual to be appointed meets at least the minimum requirements established in 201 KAR 20:310 for nurse faculty.
††††† (c) A written plan for the orientation of the nurse faculty to the governing institution and to the program shall be implemented.
††††† (d) There shall be a written contract between the governing institution and each agency or institution that provides a learning experience for a student. A contract shall not be required for an observational experience.
††††† 1. The contract shall clearly identify the responsibilities and privileges of both parties.
††††† 2. The contract shall bear the signature of the administrative authorities of each organization.
††††† 3. The contract shall vest in the nurse faculty control of the student learning
experiences subject to policies of the contractual parties.
††††† 4. The contract shall be current and may include an annual automatic renewal clause.
††††† 5. The contract shall contain a termination clause by either party;
††††† (3) A program or an interim program administrator who shall have authority and responsibility in the following areas:
††††† (a) Development and maintenance of collaborative relationships with the administration of the institution, other divisions or departments within the institution, related facilities, and the community;
††††† (b) Participation in the preparation and management of the program of nursing budget;
††††† (c) Screening and recommendation of candidates for nurse faculty appointment, retention, and promotion;
Within thirty (30) days of appointment to the program
of nursing, submit] the qualifications of all nurse faculty and clinical
instructors as set forth in 201 KAR 20:310, Section 4;
††††† (e) To provide leadership within the nurse faculty for the development, implementation, and evaluation of the program of nursing and program outcomes;
††††† (f) To facilitate the implementation of written program policies for the following:
††††† 1. Student admission;
††††† 2. Student readmission and advance standing;
††††† 3. Student progression, which shall include:
††††† a. The level of achievement a student shall maintain in order to remain in the program or to progress from one (1) level to another; and
††††† b. Requirements for satisfactory completion of each course in the nursing curriculum.
††††† 4. Requirements for completion of the program;
††††† 5. Delineation of responsibility for student safety in health related incidents both on and off campus;
††††† 6. Availability of student guidance and counseling services;
††††† 7. The process for the filing of grievances and appeals by students;
††††† 8. Periodic evaluation by the nurse faculty of each nursing studentís progress in each course and in the program;
††††† 9. Student conduct that incorporates the standards of safe nursing care; and
††††† 10. Publication and access to current academic calendars and class schedules;
††††† (g) To facilitate the continuing academic and professional development for the nurse faculty;
††††† (h) 1. To coordinate the development and negotiation of contracts with clinical facilities, the number and variety of which shall be adequate to meet curricular outcomes; and
To coordinate the development of written criteria for the selection and
criteria for] clinical facilities and ensure that
the criteria shall be utilized by the program of nursing;
††††† (i) The establishment of student-nurse faculty ratio in the clinical practice experience.
††††† 1. The maximum ratio of nurse faculty to students in the clinical area of patients-
clients shall be defensible in light of safety, learning objectives, student level, and patient acuity.
The student-nurse faculty ratio shall not exceed ten (10) to one (1) in the
clinical practice experience, including observational or other supervised
preceptored] experiences.[ Observational experiences shall
include an assignment where a student observes nursing and where the student
does not participate in direct patient or client contact but has access to a
clinical instructor as needed.]
††††† 3. This ratio shall not apply to on campus skill lab experiences;
††††† (j) The submission of the Certified List of Kentucky Program of Nursing Graduates, as incorporated by reference in 201 KAR 20:070, upon student completion of all requirements for a degree, diploma, or certificate, regardless of the state in which the graduate intends to seek licensure;
††††† (k) The development and maintenance of an environment conducive to the teaching and learning process;
††††† (l) To facilitate the development of long-range goals and objectives for the nursing program;
††††† (m) To ensure that equipment, furnishings, and supplies shall be current and replaced in a timely manner;
††††† (n) To ensure that the nurse faculty has sufficient time to accomplish those activities related to the teaching-learning process and program outcomes;
††††† (o) To coordinate an orientation to the roles and responsibilities of full-time, part-time, adjunct nurse faculty, and clinical instructors to the program of nursing and, as appropriate, to clinical facilities so that the mission, goals, and expected outcomes of the program shall be achieved;
††††† (p) To facilitate regular communication with the full and part time nurse faculty and clinical instructors in the planning, implementation, and evaluation of the program of nursing;
††††† (q) To ensure that recruitment materials provide accurate and complete information to prospective students about the program including the:
††††† 1. Admission criteria;
††††† 2. Nature of the program, including course sequence, prerequisites, corequisites, and academic standards;
Length of the program;
Current cost of the program; and
Transferability of credits to other public and private institutions in
††††† (r) To conduct or participate in the written evaluation of each nurse faculty member, clinical instructor, and support staff according to published criteria, regardless of contractual or tenured status;
††††† (s) To ensure the adherence to the written criteria for the selection and evaluation of clinical facilities utilized by the program of nursing;
††††† (t) To maintain current knowledge of requirements pertaining to the program of nursing and licensure as established in 201 KAR Chapter 20;
To attend a board orientation for program administrators[
Program Administrators Orientation] within one (1) year of appointment;
††††† (v) To develop a structure to allow nurse faculty to assist in the governance of the program; and
To ensure that the curriculum is developed and implemented pursuant
to 201 KAR 20:320[
as submitted to the board];
††††† (4) A system of official records and reports essential to the operation of the program of nursing maintained according to institutional policy. Provisions shall be made for the security and protection of records against loss and unauthorized distribution or use. The system shall include records of:
††††† (a) Currently enrolled students to include admission materials, courses taken, grades received, scores for standardized tests, and clinical performance records;
Minutes of faculty and committee meetings, which[
. These records]
shall be maintained a minimum of five (5) years, irrespective of institutional
††††† (c) Faculty records including:
††††† 1. Validation of current licensure or privilege to practice as a Registered Nurse in Kentucky;
††††† 2. Evidence of fulfilling the faculty orientation requirements established in 201 KAR 20:310, Section 3(5); and
††††† 3. Performance evaluation for faculty employed more than one (1) year;
††††† (d) Systematic plan of evaluation;
††††† (e) Graduates of the program of nursing; and
††††† (f) Administrative records and reports from accrediting agencies; and
††††† (5) Official publications including:
††††† (a) A description of the governing institution and program of nursing;
††††† (b) Policies on admission, progression, dismissal, graduation, and student grievance procedures;
††††† (c) A description of student services;
††††† (6) Clerical assistance and support staff.
number of clerical assistants shall be based upon the number of students and
There shall be[ secretarial and] clerical assistance and support staff[ assistants]
sufficient to meet the needs of the nursing program for the administrator,
faculty, and students at the main campus[ designated primary location,
as well as clerical support for secondary and distance learning sites, if
††††† (b) A non-main campus shall have additional clerical assistance and support staff sufficient to meet its needs.
††††† (7) Nurse faculty, full-time, and part-time, with the authority and responsibility to:
††††† (a) Plan, implement, evaluate, and update the program;
††††† (b) Assist in the design, implementation, evaluation, and updating of the curriculum using a written plan;
††††† (c) Participate in the development, implementation, evaluation, and updating of policies for student admission, progression, and graduation in keeping with the policies of the governing institution;
††††† (d) Participate in academic advisement and guidance of students;
††††† (e) Provide theoretical instruction and clinical learning experiences;
††††† (f) Evaluate student achievement of curricular outcomes related to nursing knowledge and practice;
Develop and implement student evaluation methods and tools for each course
to] measure the progression of the studentís cognitive,
affective, and psychomotor achievement of[ in] course and clinical
outcomes based on published rubrics and sound rationale;
††††† (h) Participate in academic and professional level activities that maintain the faculty memberís competency and professional expertise in the area of teaching responsibility;
clinical outcomes within the framework of the course;
Communicate clinical outcomes to the student, clinical instructor, preceptor,
and staff at the clinical site;
Assume responsibility for utilizing the criteria in the selection of clinical
sites and in the evaluation of clinical experiences on a regular basis;
(l)] Evaluate the studentís experience, achievement, and progress in
relation to course and clinical[ or] outcomes, with input from the
clinical instructor and preceptor, if applicable; and
††††† (l) Delegate to a nurse employed by a clinical agency the supervision of a student performing a procedure; and
Clinical instructors with the authority and responsibility[
††††† (a) Design, at the direction of the nurse faculty member, the studentís clinical experience to achieve the stated outcomes of the nursing course in which the student is enrolled;
††††† (b) Clarify with the nurse faculty member:
††††† 1. The role of the preceptor, if applicable;
††††† 2. The course responsibilities;
††††† 3. The course or clinical outcomes;
††††† 4. A course evaluation tool; and
Situations in which collaboration and consultation shall be needed;[
††††† (c) Participate in the evaluation of the studentís performance by providing information to the nurse faculty member and the student regarding the studentís achievement of established outcomes; and
††††† (d) Delegate to a nurse employed by a clinical agency the supervision of a student performing a procedure.
3. Notification of Change in[
Increased] Enrollment. (1)(a)
Within sixty (60) days of the effective date of this administrative regulation,
all existing programs of nursing shall submit to the board the maximum number
of students that the program is able to enroll in one (1) year. This number
shall be referred to as the programís enrollment baseline.
††††† (b) A program of nursing that begins operation after the effective date of this administrative regulation shall submit its enrollment baseline in the initial application.
A program of nursing shall submit a request for an increase in enrollment by
twenty (20) percent or more of the enrollment baseline[
enrolled] or ten (10) students, whichever is greater.[ (a)] The
request shall be sent in writing at least two (2)[ not later than six
(6)] months prior to the date for which the requested increase is
being sought. Exceptions to this time frame shall only be made for exigent
††††† (b) The request shall demonstrate that the program has sufficient resources to fulfill the standards established by this administrative regulation for the anticipated increase in enrollment. These sufficient resources shall include adequate:
††††† 1. Number of qualified faculty;
††††† 2. Classroom space;
††††† 3. Clinical sites;
††††† 4. Clerical support; and
††††† 5. Financial support.
††††† (c) The program shall investigate the projected impact of the increase on the operation of programs of nursing within a fifty (50) mile radius and shall submit a report to the board.
††††† (d) The program of nursing shall submit evidence that it has met the benchmarks set out in 201 KAR 20:360, Section 5(2)(f).
The board shall evaluate if the program has sufficient resources prior to
making the decision of whether to grant or deny the request.
††††† Section 4. Multiple Campuses. (1) A governing institution may have programs of nursing located on different campuses.
††††† (2)(a) The governing institution shall designate a main campus headed by a program administrator.
††††† (b) The program administrator shall have final responsibility and authority for the non-main campuses, but shall designate an assistant program administrator to assist in the governance of each non-main location. The assistant program administrator shall meet the qualification for a nurse faculty as set out in 201 KAR 20:310. The program administrator may designate the amount of release time for the assistant program administrator for administrative duties, but it shall not be less than twenty-five (25) percent.
††††† (3) For purposes of calculating benchmarks set out in 201 KAR 20:360, Section 4(2)(f), each campus shall individually report its data annually to the board. The board shall evaluate the benchmarks for each campus individually.
††††† Section 5. Suspension of Enrollment. (1) A governing institution that decides to suspend enrollment shall notify the board in writing within thirty (30) days following the decision.
††††† (2) The notification shall identify the reasons leading to the decision and how long it is anticipated that the suspension will be in effect.
††††† (3) The governing institution shall report to the board annually on the status of the suspension
††††† (4)(a) If the decision to reinstate enrollment is made within three (3) years of the decision to suspend enrollment, the governing institution shall notify the board in writing of the decision within thirty (30) days.
††††† (b) The notification shall state the date classes will begin. It shall also list the faculty and clinical sites that will be utilized.
††††† (5) If the decision to reinstate enrollment is made three (3) years or more from the decision to suspend enrollment, the governing institution shall comply with the procedures outlined in 201 KAR 20:280.
The board shall not grant approval for the increase in enrollment unless the
program has: (a) Full approval status; and
Program NCLEX pass rate for first time test takers for the preceding year of a
minimum of eighty-five (85) percent.]
GAIL WISE, President
††††† APPROVED BY AGENCY: December 11, 2015
††††† FILED WITH LRC: January 7, 2016 at 11 a.m.
††††† PUBLIC HEARING AND PUBLIC COMMENT PERIOD: A public hearing on this administrative regulation shall be held on February 22, 2016 at 10:00 a.m. (EST) in the office of the Kentucky Board of Nursing, 312 Whittington Parkway, Suite 300, Louisville, Kentucky. Individuals interested in being heard at this hearing shall notify this agency in writing five workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted until end of day, (11:59 p.m.), February 29, 2016. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.
††††† CONTACT PERSON:, Nathan Goldman, General Counsel, Kentucky Board of Nursing, 312 Whittington Parkway, Suite 300, Louisville, Kentucky 40222, phone (502) 429-3309, fax (502) 564-4251
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person: Nathan Goldman
††††† (1) Provide a brief summary of:
††††† (a) What this administrative regulation does: It sets organization standards for prelicensure RN and LPN programs of nursing.
††††† (b) The necessity of this administrative regulation: It is required by statute.
††††† (c) How this administrative regulation conforms to the content of the authorizing statutes: By setting standards.
††††† (d) How this administrative regulation currently assists or will assist in the effective administration of the statutes: By setting standards.
††††† (2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
††††† (a) How the amendment will change this existing administrative regulation: This amendment is part of a comprehensive review of the administrative regulations governing RN and LPN prelicensure programs of nursing. The relevant administrative regulations have been reviewed to ensure they are current and address all relevant issues. This particular administrative regulation, among several housekeeping changes, includes the following changes: providing for a program administrator who is responsible for the program year round; the recognition that some colleges/universities have multiple campuses with a main campus and non-main campuses and how those locations are to be treated; a change in how a program calculates an increase in enrollment and the process it needs to go through with the Board; and a new provision on reporting a suspension of enrollment to the Board.
††††† (b) The necessity of the amendment to this administrative regulation: The changes were needed to meet new circumstances and to improve the approval process for programs of nursing.
††††† (c) How the amendment conforms to the content of the authorizing statutes: The Board is authorized to make these changes.
††††† (d) How the amendment will assist in the effective administration of the statutes: By addressing the issues.
††††† (3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation: Current and future prelicensure programs of nursing; currently there are 56 RN programs and 30 LPN programs in Kentucky.
††††† (4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
††††† (a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
The actions each entity will have to take will differ depending on the particular circumstances of each program. Each program will be expected to be in compliance with the administrative regulation. The Board will work with each program to assist in this endeavor.
††††† (b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3): Any potential cost will depend on the particular circumstances of the program.
††††† (c) As a result of compliance, what benefits will accrue to the entities identified in question (3): They will be in compliance with the regulation.
††††† (5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
††††† (a) Initially: There is no additional cost.
††††† (b) On a continuing basis: There is no additional cost.
††††† (6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation: Agency funds.
††††† (7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment: No increase is needed.
††††† (8) State whether or not this administrative regulation established any fees or directly or indirectly increased any fees: It does not.
††††† (9) TIERING: Is tiering applied? Tiering was not applied as the changes apply to all equally.
FISCAL NOTE ON STATE OR LOCAL GOVERNMENT
††††† (1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation? The Kentucky Board of Nursing.
††††† (2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation. KRS 314.111, 314.131.
††††† (3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
††††† (a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year? None.
††††† (b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years? None.
††††† (c) How much will it cost to administer this program for the first year? No additional cost.
††††† (d) How much will it cost to administer this program for subsequent years? No additional cost.
††††† Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
††††† Revenues (+/-):
††††† Expenditures (+/-):
††††† Other Explanation: