Current through Register Vol. 43, No. 02, November 27, 2024
(1) All Alabama
prelicensure nursing education programs and advanced practice nursing education
programs, including Alabama distance nursing education programs, must be
approved by the Alabama Board of Nursing and accredited by a national nursing
accrediting agency recognized by the U.S. Department of Education by January 1,
2023, or within five (5) years of Approval by the Board, in the case of a new
program. If a program is unable to satisfy this requirement as the result of
ineligibility for accreditation due to the existence of a deficiency or order
issued by the Alabama Board of Nursing pursuant to this Chapter, the program
shall establish candidacy for accreditation within six (6) months of successful
resolution of the deficiency or satisfaction of the terms of the Order. Alabama
advanced practice nursing education programs in operation prior to December 31,
2020, are considered in approved status. Advanced practice nursing education
programs established in Alabama on or after January 1, 2021, shall obtain Board
approval prior to implementation.
(2) The governing institution, nursing
program administrator, and nursing faculty are accountable for the standards,
processes, and outcomes of the nursing education program.
(3) The governing institution offering the
nursing program shall be:
(a) A postsecondary
education institution that is authorized to offer nursing education and is
accredited by an organization recognized by the U.S. Department of Education.
(b) Approved and licensed by the
appropriate State of Alabama education agency(ies), as required by
law.
(4) The governing
institution shall provide support and resources sufficient to ensure
achievement of student learning and program outcomes. Resources include, but
are not limited to:
(b) Education program physical facilities, if
appropriate.
(c) Instructional and
learning equipment.
(d) Technology,
to include simulation tools.
(e)
Administrative, instructional, and support personnel.
(5) The governing institution's administrator
or program administrator shall notify the Board, in writing, of any substantive
changes in the program, including, but not limited to:
(a) Nursing program administrator.
(b) Governing institution administrator,
President, CEO, Chancellor, or Provost.
(c) Governance structure of the
institution.
(d) Accreditation
status and accreditation status reports related to the governing institution or
nursing education program.
(e)
Ownership or merger of governing institution.
(f) Name of the governing institution or
nursing education program.
(g)
Relocation of the governing institution or nursing education program.
(h) Significant curriculum changes.
(i) Intent to close a program.
(j) Expanding or collapsing, combining, or
separating programs, including, but not limited to, prelicensure programmatic
changes, and clinical/role populations preparing advanced practice registered
nurses in an approved graduate nursing education degree program, specialty, or
sub-specialty track.
(k) Reduction
in nursing program faculty size exceeding thirty percent.
(l) Annual turnover in faculty greater than
thirty percent.
(m) The percentage
of total nursing faculty (full-time, clinical, adjunct, part-time, and other)
employed at the institution as full-time faculty falls below thirty
percent.
(n) Utilization of virtual
or simulation lab in lieu of a "hands-on" lab for anatomy and physiology
lab.
(o) Utilization of virtual or
simulation lab in lieu of any required direct clinical hours for national
certification examination.
(6) There shall be an organizational chart
that depicts the authority, responsibility, and channels of communication
between the nursing program and the governing institution and other comparable
programs within the governing institution.
(7) A nursing education program shall be
administered by a qualified program administrator who is accountable for the
planning, implementation, and evaluation of the program.
(a) Minimum qualifications of a nursing
program administrator shall include:
1. An
active, unencumbered Alabama registered nurse license or a multistate
registered nurse license issued by a party state, as defined in Chapter 4 of
these rules.
2. An earned graduate
degree in nursing. Nursing program administrators for advanced practice nursing
education programs should be doctoral prepared.
3. Academic and experiential qualifications
to administer a nursing education program.
(8) The governing institution and nursing
program administrator shall provide sufficient numbers of qualified faculty to
ensure that curriculum implementation and expected program outcomes are
achieved and aligned with national nursing accrediting standards. Thirty-five
percent of the total faculty, excluding adjunct faculty, are employed at the
Institution as full-time faculty. Minimum qualifications of nurse faculty shall
include:
(a) An active, unencumbered Alabama
registered nurse license, or a multistate registered nurse license issued by a
party state, as defined in Chapter 4 of these rules.
(b) An earned graduate degree in nursing or a
related health field.
(c) Academic
and experiential qualifications to teach in the area assigned.
(9) Institutional and program
policies, procedures, and other publications, whether written or electronic,
shall:
(a) Be written, accurate, and
consistent as published, and publicly available.
(b) Address students' abilities to assume
clinical assignments including, but not limited to, educational preparedness
and physical, mental, and emotional behaviors.
(c) Provide opportunities for students to
regularly participate in the development, evaluation, and continuous
improvement of the program.
(d)
Provide for processes to manage and learn from student near misses and
errors.
(e) Provide for student
remediation strategies at the beginning of each course and ensure students are
aware of how to seek help.
(f)
Programs shall hold students accountable for professional behavior, including
honesty and integrity while in their program of study.
(g) Provide for availability of assistance
for students with disabilities.
(10) All faculty are provided formal
orientation and educated in basic instruction or teaching, adult learning
principles, curriculum development, test item writing, and simulation
standards, as appropriate to the faculty position.
(a) The program shall provide substantive and
periodic workshops and presentations devoted to faculty development.
(11) Faculty participate in and
are accountable for curriculum development, implementation, and
evaluation.
(12) The curriculum of
a nursing education program shall:
(a) Enable
the student to develop the knowledge, skills, and abilities necessary for the
level, scope, and standards of competent nursing practice expected at the level
of licensure, approval, or certification.
(b) Provide evidence-based, outcome-focused,
and culturally-sensitive theoretical and clinical experiences specific to the
expected scope of practice of graduates from each type of nursing education
program.
(c) Ensure distance
education methods are consistent with the curriculum plan.
(d) The curriculum course work of a
prelicensure nursing education program shall have didactic and clinical
learning experiences which include but are not limited to:
1. Liberal arts and a sound foundation in
biological, physical, social, and behavioral sciences supportive of the nursing
education program.
2. Anatomy and
physiology with a corresponding lab. Utilizing a "virtual lab" in lieu of a
'hands-on' lab is considered a substantive change and requires Board
notification.
3. Nursing
foundations, health assessment, pharmacology, nutrition, and community-based
nursing.
4. History and trends of
nursing, cultural diversity, legal and ethical responsibilities, and nursing
scope of practice responsibilities, including leadership, management,
delegation, and health care delivery systems.
5. Theoretical and clinical learning
experiences across the lifespan in the areas of adult, medical/surgical,
maternal/infant, child/pediatric, and psychiatric/mental health and community
health nursing that includes simulation, laboratory time, and direct patient
care in a licensed health care setting. Provided however, that community health
clinical experiences may be conducted in a non-licensed setting. This does not
prohibit additional experience in licensed non-health care setting. At least
50% of clinical experiences shall include direct patient care and include a
variety of clinical settings sufficient to meet program outcomes.
6. Simulation learning experiences conducted
according to acceptable faculty training standards and guidelines which
incorporate clinical objectives, student debriefing, and evaluation are
acceptable components of the clinical experience. Unless otherwise authorized
by the Board, Simulation shall not comprise more than 50% of the clinical
learning experience. Programs utilizing simulation shall ensure:
(i) There shall be a budget that will sustain
the simulation activities and training of the faculty.
(ii) Appropriate facilities for conducting
simulation. This shall include educational and technological resources and
equipment to meet the intended objectives of the simulation.
(iii) Faculty involved in simulations, both
didactic and clinical, are oriented and have training in the use of
simulation.
(iv) Simulation
activities and evaluation criteria are linked to programmatic
outcomes.
(v) The simulation
activities are managed by or management duties are assigned to an individual
who demonstrates continued expertise and competence in the use of simulation
through:
a. Certification as Certified
Healthcare Simulation Educator; or
b. Completion of two years of experience in
healthcare simulation or completion of one or more credit-bearing or continuing
education courses regarding healthcare simulation which includes content
specific to all of the four domains in the current version of the Certified
Healthcare Simulation Educator Examination Blueprint.
(vi) Students shall evaluate the simulation
experience on an ongoing basis.
7. Safe and Effective Care Environment,
Health Promotion, prevention of illness, and health maintenance, Psychosocial
Integrity, and Physiological Integrity across the lifespan.
8. Microbiology for students pursuing an
associate or baccalaureate degree.
(13) The governing institution, nursing
program administrator, and nursing faculty are accountable for selecting and
evaluating the teaching methods, delivery modalities, and processes used to
achieve expected program outcomes.
(14) Clinical supervision or preceptorship of
students shall comply with the standards set forth in this chapter.
(a) Clinical learning experiences shall be
supervised by a registered nurse with knowledge of educational strategies and
subject matter, and who is experienced in the clinical technologies essential
to the safe practice of nursing.
(b) The clinical supervisor or assigned
clinical faculty shall hold an active, unencumbered license to practice
professional nursing in Alabama, or a multistate registered nurse license
issued by a party state, as defined in Chapter 4 of these rules.
(c) The clinical supervisor or assigned
clinical faculty shall be readily accessible to assign or prescribe a course of
action, provide procedural guidance, direction, and evaluation for students
engaged in the clinical learning experience.
(d) The faculty-student ratio in clinical
learning experiences shall be collaboratively determined by the professional
nursing faculty, the School of Nursing administration, and the professional
nurse administrator, or designee, in the clinical agency. In licensed hospitals
that provide inpatient acute care, the faculty to student ratio shall not
exceed 1:8 during clinical learning experiences. The faculty-student ratio
shall be determined according to the:
1.
Complexity of the educational experience.
2. Acuity of the patient(s).
3. Physical layout of the clinical
setting.
4. Student's level of
knowledge and skills necessary to provide safe patient care.
(e) The nursing education program
shall work with clinical agencies for the planning, implementation, and
evaluation of clinical experiences.
(f) Clinical learning experiences shall
include the development of skills in clinical reasoning, management of care for
groups of patients, and delegation to and supervision of other health care
personnel performed in acute care and a variety of health care
settings.
(g) Nursing faculty shall
maintain responsibility and accountability for planning, implementation, and
evaluation of all student clinical learning experiences.
(15) Nursing programs that offer only
simulations or clinical testing do not meet the requirements for providing
clinical learning experiences for nursing students.
(16) Scores on external exams shall not be
utilized as the sole criterion for barring a student from graduating from the
nursing program who otherwise, has successfully completed all required
coursework.
(17) For licensed
practical nursing students, a Clinical Resource LPN may be used to enhance, but
not replace, faculty-directed clinical learning experiences. The supervising
faculty member remains responsible for all students in the clinical setting,
including those supervised by CRLPNs.
Rule
610-X-3-.01 was renumber to .02
as per certification filed September 25, 2006; effective October 30,
2006.
Author: Alabama Board of Nursing
Statutory Authority:
Code of Ala.
1975, §
34-21-2(2).