GENERAL GOVERNMENT CABINET

Board of Nursing

(Amendment)

 

††††† 201 KAR 20:320. Standards for curriculum of prelicensure nursing programs.

 

††††† RELATES TO: KRS 314.011(5), 314.021, 314.041(1)(a), 314.111(1), 314.131(1), (2)

††††† STATUTORY AUTHORITY: KRS 314.041(1)(a), 314.111(1), 314.131(1), (2)

††††† NECESSITY, FUNCTION, AND CONFORMITY: KRS 314.041(1)(a) requires that an applicant for licensure as a registered or licensed practical nurse complete the basic nursing curriculum in an approved school of nursing. KRS 314.111(1) requires that schools of nursing regardless of delivery models shall meet minimum standards and be approved by the Board of Nursing. KRS 314.131(1) and (2) authorizes the board to promulgate administrative regulations necessary to approve programs of nursing. This administrative regulation establishes the curriculum requirements for prelicensure registered nurse programs.

 

††††† Section 1. Definitions. (1) "Debriefing" means an activity that follows a simulation experience, is led by a nurse faculty as defined in 201 KAR 20:310, encourages participantís reflective thinking, and provides feedback regarding the participantís performance.

††††† (2) "Distance learning" means didactic instruction offered by any means where the student and faculty are in separate physical locations.

††††† (3)["Associate degree program" means a program of nursing organized and administered by a community college, or a four (4) year college or university, which awards the graduate an associate degree in nursing upon meeting the requirements of the governing institution.

††††† (2) "Baccalaureate degree program" means a program of nursing organized and administered by a senior college or university which awards the graduate a baccalaureate degree in nursing upon meeting the requirements of the governing institution.

††††† (3) "Masterís degree program" means a program leading to a masterís degree, which is the individualís first professional degree in nursing and is conducted by an educational unit in nursing within the structure of a senior college or university.

††††† (4) "Multiple entry-exit program" means a program that allows a student to challenge the NCLEX-RN or NCLEX-PN examinations once the student has completed sufficient course work in a professional nursing program that meets all requirements for the examination.

††††† (5)] "Practical nursing program" means a program of nursing organized and administered by a vocational, technical, or adult education system or an independent school at a postsecondary level that awards the graduate a diploma in practical nursing upon meeting requirements of the program.

††††† (4)[(6)] "Prelicensure nursing education program" means an educational entity that offers the courses and learning experiences that prepare graduates who are competent to practice nursing safely and who are eligible to take the NCLEX-RN or NCLEX-PN examinations.

††††† (5)[(7)] "Registered nursing program" means a program of nursing organized and administered by an institution of higher learning that awards a degree in nursing upon meeting requirements of the program.

††††† (6) "Simulation" means an activity or a technique that replicates actual or potential situations in clinical practice that allows the participant to develop or enhance critical thinking.

††††† (7) "Traditional clinical experience" means academic time designated by the program of nursing for learning outside the classroom which includes observation or hands-on experience.[A registered nursing program is considered to be any program that culminates in the graduate being eligible for licensure. Examples of registered nurse programs are associate degree programs, baccalaureate degree programs, masterís degree programs, and multiple entry-exit programs.]

 

††††† Section 2. General. (1) An applicant for licensure shall complete a prelicensure program of nursing that meets the requirements of this administrative regulation.

††††† (2) Length.

††††† (a) A registered nursing program shall be a minimum of two (2) academic years, which may include prior articulated academic credits.

††††† (b) A practical nursing program shall be a minimum of one (1) academic year.

††††† (3) Philosophy, mission, and outcomes.

††††† (a) The philosophy, mission, and outcomes of the program of nursing shall be clearly defined in writing by the nursing faculty and be consistent with those of the governing institution.

††††† (b) The program outcomes shall describe the expected competencies of the graduate.

††††† (c) The program shall conduct an evaluation[assessment] to validate that identified program outcomes have been achieved and provide evidence of improvement based on an analysis of those results.

††††† [(d) The organizing framework shall serve as a foundation for level of progression, level of outcomes, and course sequencing.]

††††† (4) Approval.

††††† (a) A curriculum plan shall be approved by the board in accordance with this administrative regulation.

††††† (b) The curriculum plan shall enable the student to develop the nursing knowledge, skills, and competencies for the expected entry level and scope of practice.

††††† (c) Theory and clinical experiences shall provide the student with opportunities to acquire and demonstrate the knowledge, skills, and competencies necessary for safe practice.

††††† (5) Curriculum plan.

††††† (a) The development, implementation, evaluation, and revision of the curriculum shall be the responsibility of the nursing faculty including the program administrator with input from students.

††††† (b) The curriculum of the prelicensure nursing education program shall assure the development of evidence based practice for the level and scope of nursing practice. This shall include the skills to identify and apply best practices in nursing care by providing client-centered, culturally competent care and respecting client differences, values, preferences, and expressed needs.

††††† (c) A registered nursing program may determine that a portion of the curriculum fulfills the scope of practice for licensed practical nursing and allow students to exit the program and be made eligible for the NCLEX-PN examination. The registered nursing program shall submit its plan to the board for approval.

††††† (6) Organization of the curriculum.

††††† (a) There shall be a written plan, including supporting rationale,[and organizing framework,] which describes the organization and development of the curriculum.

††††† (b) The curriculum plan[design] shall reflect the philosophy, mission, and outcomes of the program.

††††† (c) There shall be a rationale for the amount of time or credits allocated to course and clinical practice experience.

††††† (d) A course syllabus shall be developed for each nursing course to include outcomes-planned instruction, learning activities, and method of evaluation.

††††† 1. Each course shall be implemented in accordance with the established course syllabi.

††††† 2. A copy of each course syllabus shall be on file in the program of nursing office and shall be available to the board upon request.

††††† (e) The curriculum plan shall be logical and sequential, and shall demonstrate an increase in difficulty and complexity as the student progresses through the program.

††††† (f) A course may be offered as a distance learning course. A distance learning course shall meet the same standards as established in 201 KAR 20:260 through 201 KAR 20:360 for any other course.

††††† (7) Curriculum components.

††††† (a) The curriculum of a registered nursing program or a practical nursing program shall prepare the graduate for licensure and full scope of practice as defined by current standards for nursing practice and expected competencies of graduates at the appropriate educational level.

††††† (b) The curriculum shall include theory and selected clinical practice experiences designed to enable students to provide nursing care to individuals throughout the life span.

††††† (c) Clinical practice settings shall be appropriate for the type of nursing program and the program outcomes and enable the student to observe and practice safe nursing care of persons at each stage of the life span. Experiences shall include opportunities to learn and provide care to diverse ethnic and cultural populations.

††††† (d) Clinical practice experience shall be supervised by board approved nursing faculty in accordance with 201 KAR 20:310[, including the utilization of clinical preceptors].

††††† (e) The curriculum shall have written measurable program competencies that reflect the role of the graduate.

††††† (f) Students shall have sufficient opportunities in simulated or clinical settings to develop psychomotor skills essential for safe, effective practice.

††††† (8) Curriculum change.

††††† (a) A prelicensure nursing education program that is not accredited by a national nursing accrediting body shall submit a written plan for major curriculum revisions to the board a minimum of four (4) months prior to the planned implementation.

††††† 1. A request for curriculum revision shall include the present plan, the proposed change with rationale and expected outcomes.

††††† 2. The board shall be available to assist if curriculum revisions are being considered.

††††† 3. Major curriculum revisions shall include:

††††† a. A change in the philosophy, mission or outcomes, which results in a reorganization or re-conceptualization of the entire curriculum; or

††††† b. The addition of tracks or alternative programs of study that provide educational mobility[; or

††††† c. The initiation of on-line learning in which a student may obtain fifty (50) percent or more of the nursing credits needed to meet program completion requirements].

††††† (b)[An accredited program of nursing shall submit to the board a copy of any curriculum revision submitted to an accrediting agency within thirty (30) days. The program of nursing shall submit a copy of all correspondence related to program accreditation from the accrediting agency to the board.

††††† (c)] A program of nursing that implements a curriculum change shall provide an evaluation of the outcomes of those changes through the first graduating class following full implementation of the curriculum change. The program of nursing shall also submit the evaluation with its annual report.

††††† (9) Integrated practicum.

††††† (a) The curriculum shall include an integrated practicum. The integrated practicum shall consist of a minimum of 120 clock hours of concentrated clinical experience of direct patient care in a health care facility or health care organization.

††††† (b) The integrated practicum shall be completed within a period not to exceed seven (7) consecutive weeks while the governing institution is in session during the last semester or quarter of a nursing program.

 

††††† Section 3. Simulation Standards. (1)(a) A program of nursing that uses simulation shall adhere to the standards set in this section.

††††† (b) A program of nursing shall not use simulation for more than fifty (50) percent of its total clinical hours required for graduation.

††††† (2) Upon request by the board, a program of nursing shall provide evidence that the standards set in this section have been met.

††††† (3)(a) The program of nursing shall provide adequate fiscal, human, and material resources to support the simulation activities.

††††† (b) Simulation activities shall be managed by a nurse faculty member as defined in 201 KAR 20:310 who is academically and experientially qualified in the use of simulation, both in its pedagogical and technical aspects. The managing faculty member shall demonstrate his or her qualifications by:

††††† 1. Attendance at simulation conferences;

††††† 2. Completion of educational activities related to simulation; or

††††† 3. Holding a credential issued by the Society for Simulation in Healthcare or the International Nursing Association for Clinical Simulation.

††††† (c) There shall be a budget that will sustain the simulation activities and training of the faculty.

††††† (d) The program of nursing shall have written rationale for the use and purpose of simulation within the curriculum.

††††† (e) The program of nursing shall have an orientation plan for faculty concerning simulation.

††††† (f) The program of nursing shall have a written procedure on the method of prebriefing and debriefing each simulated activity.

††††† (4) The program of nursing shall have appropriate facilities for conducting simulation. This shall include educational and technological resources and equipment to meet the intended objectives of the simulation.

††††† (5) Faculty, both didactic and clinical, that utilize simulation shall:

††††† (a) Have training in the use of simulation; and

††††† (b) Engage in on-going professional development in the use of simulation.

††††† (6) The simulation activities shall be linked to the program of nursingís course objectives and the programmatic outcomes.

††††† (7)(a) The program of nursing shall develop written criteria to evaluate the simulation activities.

††††† (b) Students and faculty shall evaluate the simulation experience on an ongoing basis.

††††† (8) The program of nursing shall include information about its use of simulation in its annual report to the board.

 

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, email nathan.goldman@ky.gov.

 

REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT

 

Contact Person: Nathan Goldman

††††† (1) Provide a brief summary of:

††††† (a) What this administrative regulation does: It sets standards for curriculum in 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: a new section had been added on the use of simulation in a program.

††††† (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: