Chapter 3: Nursing Education, Accreditation and Regulation

Clinical experience (practicum)

Clinical practice experiences- planned learning activities in nursing practice that allow students to understand, perform and refine professional competencies at the appropriate program level

Clinical experience/practicum

Experiences must be planned, correlate with the curriculum, require intensive faculty supervision to facilitate effective learning and focus on active student engagement in the experiences, requiring extensive time and effort

American Association of Colleges of Nursing (AACN)

National organization that represents baccalaureate and graduate programs in nursing; activities include educational research, government advocacy, data collection, publishing and initiatives to establish standards for nursing degree programs

National Council of State Boards of Nursing (NCSBN)

Not for profit organization that represents all of the boards of nursing in the 50 states

Diploma schools of nursing

Nursing programs associated with a hospital that offer a nursing degree that is not offered through a college or university setting; typically 3 years in length; very few still exist

Distance education

Often offered online as a set of teaching and/or learning strategies to meet the learning needs of students separate from the traditional classroom

State boards of nursing implement the

State's nursing practice act and state regulations

Self directed learning

a process in which individuals take the initiative, with or without the help of others, in diagnosing their learning needs, formulating learning goals, identifying human and material resources for learning, choosing and implementing appropriate learning strategies, and evaluating learning outcomes

NCLEX-RN

National Council Licensure Examination for Registered Nurses required by all states for licensure

Nurse practice acts do the following for their state:

- define the authority of the board of nursing, it's composition and its powers - define nursing and boundaries of the scope of practice - identify types of licenses and titles - state the requirements for licensure - protect titles - identify the grounds for disciplinary action

Goals of the AACN:

- driving force for innovation and excellence in academic nursing - leading partner in advancing improvements in health, health care and higher education - primary advocate for advancing diversity and inclusivity within academic nursing - the authoritative source of knowledge to advance academic nursing through information

Goals of the OADN:

- education - leadership - inclusivity - collaboration - advocacy

Initial and renewal requirements for licensure:

- fee - passage of NCLEX - criminal background check - for renewal, continuing edu. contact hrs - for renewal, active employment - for renewal, hrs of professional nursing activities

Goals of the NLN:

- leader in nursing education - commitment to members - champion for nurse educators - advancement of the science of nursing education

During the accreditation process the review team assesses the schools of nursing for:

- mission &vision - structure & governance - resources & physical facilities including budget - faculty & faculty outcomes - curriculum & implementation - student support services - admissions process & other academic processes - policies & procedures - ongoing assessment process

Didactic course content for proper licensure prep needs to include:

- professional issues and trends - health assessment - pharmacology - adult health or medical surgical nursing - psychiatric/mental health nursing - pediatrics - maternal-child nursing - public/community health - gerontology - leadership and management - palliative care and care of dying patient - communication, collaboration and coordination - teamwork - evidence based practice - research - health policy - legal and ethical issues - quality improvement

Framework for professional licensure:

- risk of harm for the consumer - skill and training needed - level of autonomy - scope of practice - consumer expectation - alternative to regulation

2 critical problems to nursing education programs:

1. Faculty shortage 2. Access to clinical experiences

3 major nursing education organizations:

1. NLN 2. AACN 3. OADN

5 domains of interprofessional education:

1. Values and ethics 2. Roles and responsibilities 3. Interprofessional communication 4. Teams and teamwork 5. Interprofessional collaboration

Associate Degree in Nursing (AD/ADN)

2 year program established in community colleges began by Mildred Montag; less expensive and shorter for students

Academic Health Center (AHC)

A center of multiple health profession schools, accredited and connected to a teaching healthcare organization such as a hospital or health system

Clinical nurse leader (CNL)

A newer masters degree which prepares nurses for leadership positions that have a direct impact on patient care; provider and manager of care

Accreditation

A process in which an organization is assessed regarding how it meets established standards

Organization for associate degree nursing (OADN)

Advocates for associate degree nursing education and practice

RN-BSN program

Aka BSN completion programs are a way for ADN graduates to complete the requirements for a BSN; nurses often work for a bit then go back to school or work and go part time

Advanced practice nursing

Any form of nursing intervention that influences outcomes for individuals or populations, including the direct care of individual Patients, management of care for individuals and populations, administration of nursing and health organizations and the development and implementation of health policy

Articulation agreement

Describe the responsibilities of the partners, benefits to the students and how the students will meet the expected BSN outcomes or competencies; important mechanisms that enhance access to baccalaureate level nursing education

Nurse practice act

Each state has its own law that determines the nature of nursing practice in that state

Research based doctorate (PhD) in nursing

First offered as the doctorate of nursing science (DNSc), there are programs in nursing education that usually involving research; takes place after receiving a masters degree and takes 4-5 years to complete

Training

Focuses on fixed habits and skills, uses repitition, authority, and coercion, and emphasizes dependency

Interprofessional healthcare education

Focuses on interprofessional teams that collaborate in practice to have an impact on patient care

Education

Focuses on self-discipline, responsibility, accountability and self-mastery

Regulation

For practice and licensure, regulation is based on state laws; for professional regulation, the profession itself and its organizations regulate its practice

Accelerated Programs/Direct Entry Programs

For students with a baccalaureate degree in another major other than nursing; shorter but covering the same basic entry level nursing content at an accelerated pace

Standards

Guide decisions, organizational structure, process, policies and procedures, budgetary decisions, admissions and progress of students, evaluation/assessment, curriculum and other academic issues

Certified Registered Nurse Anesthetist (CRNA)

Highly competitive graduate program that has been a masters degree but is moving towards the level of doctor of nursing practice (DNP) in which nurses can administer anesthesia

To address the difficulty in accessing clinical experiences, nursing programs developed

Laboratory and simulation experiences

Nursing education standards are developed by

Major nursing professional organizations

Advanced Practice Registered Nurse (APRN)

Masters degree in any clinical area with specific state requirements and prescriptive authority that usually work indeoend

MSN

Masters degree in nursing; graduate education that was originally only offer in public health, teaching, supervision and few clinical specialties; typically 2 years

Certified Nurse-Midwife (CNM)

Masters degree that focuses on midwifery, pregnancy and delivery, as well as gynecological care of women and family planning

Masters degree in a functional area

Masters degree that focuses on the functional areas of administration or education; appeals to the growing need for nursing faculty

Nurse migration

Movement of nurses internationally after coming to study nursing in the U.S.; affects the country of origin which may then experience a shortage and the need to effectively integrate foreign nurses in the U.S. with different nursing education

Nurse Licensure Compact (NLC)

Mutual recognition for licensure portability that requires each state involved to enact legislation or regulation authorizing nurses to practice in several states

Differentiated nursing practice

Philosophy that structures the roles and functions of nurses according to their education, experience and competence; matching the varying needs of clients with the varying abilities of nurse practitioners

Curriculum

Plan that describes the programs philosophy, levels, student terminal competencies and course content

Accreditation

Process of reviewing what a school is doing and it's curriculum based on established standards

National League for Nursing (NLN)

Promotes excellence in nursing education to build a strong and diverse nursing workforce to advance the health of our nation and the global community

Mandatory overtime

The expectation that staff will work beyond the hours assigned, often accompanied by a real or perceived threat; this policy impacts quality of care and has affected staff satisfaction

Goldmark Report

The first report about U.S. nursing education with key recommendations such as: (1) separate university schools of nursing from hospitals, (2) change the control of hospital based programs to schools to nursing and (3) require a high school diploma for entry into any school of nursing

St. Thomas

The first school of nursing founded in -860 London, England by Florence Nightingale

Academic nursing

The integration of practice, education, and research associated with baccalaureate and graduate schools of nursing

Doctor of Nursing Practice (DNP)

The newest nursing degree; practice-focused doctoral degree program that prepare leaders for nursing

Apprenticeship

Used to introduce new recruits to nursing

Clinical Nurse Specialist (CNS)

an APRN who is an expert clinician in a specialized area of practice that usually work in hospital settings

Preceptor

an experienced and competent staff member who has received formal training to function as a preceptor and who serves as a role model to guide student learning, serving as a resource for the nursing student

BSN

baccalaureate degree in nursing; an entry level degree originally 5 years but now changed to 4; upon completion students can take the licensure exam and apply to nursing graduate programs