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Module 1: Nursing Education in Texas
Subtopic 2: Today
Professional Nursing Education
Today there are 2 diploma programs, 44 ADN programs, 6 LVN-ADN only programs, 25 BSN
programs, 1 basic master's program, and 6 specialty baccalaureate programs in the state
(ftp://www.bne.state.tx.us/2003list.pdf). These Professional nursing programs are expected
to produce large numbers of competent graduates to meet the needs of a growing nursing
shortage within the constraints placed on them by regulatory and accrediting agencies, such
as:
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Section 215.11-215.13 of the Rules And Regulations Relating to Professional Nurse
Education, Licensure and Practice published by the Board of Nurse Examiners.
Differentiated Entry Level Competencies published by the Board of Nursing
Examiners
2002 Standards and Criteria published by the National League for Nursing
Accrediting Commission.
Accreditation Standards published by the Commission on Collegiate Nursing
Education
Workforce Education Course Manual published by the Texas Higher Education
Coordinating Board
Field of Study Curriculum in Nursing published by the Texas Higher Education
Coordinating Board
The challenge to nursing faculties is to select the appropriate strategies for teaching
scientific knowledge, psychomotor skills, professional values, and most important of all, how
to think critically.
Vocational Nursing Education
Licensed practical and vocational nurses are a vital element in healthcare today. The role of
the LPN/LVN is ever changing. With the current demands on the health-care system today,
the opportunities for the LPN/LVN continue to grow. Practical Nursing education programs
must provide the student with new models, new theories, and new paradigms to address
their work requirements amidst the increasing complexities of the system in which they
work (Anderson, 2001). Nursing programs must adhere to regulations of multiple
accrediting agencies:
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Section 233.11-233.85 of the Rules and Regulations Relating to Vocational Nurse
Education published by the Board of Vocational Nurse Examiners.
http://www.bvne.state.tx.us/RULES Sept 2001.doc
Differentiated Entry Level Competencies published by the Board of Nurse Examiners.
http://www.bvne.state.tx.us/education_practice.htm
2002 Standards and Criteria published by the National League for Nursing
Accrediting Commission.
http://www.nlnac.org/Standards%20&%20Criteria%202002/pn_s&c_2002.htm
Workforce Education Course Manual published by the Texas Higher Education
Coordinating Board.
References:
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Anderson, M. (2001). Nursing leadership, management, and professional practice for the
LPN/LVN. Philadelphia: F. A. Davis.
Board of Vocational Nurse Examiners. (2002). Agency Strategic Plan. Retrieved February
2, 2003 from http://www.bvne.state.tx.us/Final%2020032007%20Strategic%20Plan.doc
ftp://www.bne.state.tx.us/2003list.pdf
ftp://www.bne.state.tx.us/del-comp.pdf
http://www.bne.state.tx.us/rr215.htm#1
http://www.nlnac.org/Manual%20&%20IG/2002_manual_III.htm#criteria
http://www.aacn.nche.edu/Accreditation/standrds.htm
http://www.thecb.state.tx.us/ctc/ip/core11_00/FOSCNursingFINAL.htm
Continue to Subtopic 3: Nursing Education - Tomorrow
Board of Nurse Examiners
Nurse Education - § 215
§215.1. General Requirements and Purpose of Standards.
(a) General Requirements. The Dean/Director and faculty are accountable for complying
with the Board's rules and regulations and the Nursing Practice Act.
(b) Rules for nursing programs shall provide reasonable and uniform standards within which
flexibility and creativity, based upon sound educational principles, are possible.
(c) Purpose of Standards.
(1) To promote the safe and effective practice of nursing.
(2) To serve as a guide for the development of new nursing education
programs.
(3) To provide criteria for the evaluation of new and established nursing
education programs.
(4) To foster the continued improvement of established nursing education
programs.
§215.2. Definitions.
Words and terms, when used in this chapter, shall have the following meanings unless the
context clearly indicates otherwise:
(1) Accredited nursing program - A school, department, or division of nursing
accredited/approved by the Board of Nurse Examiners for the State of Texas or other
authority which has jurisdiction over accreditation/approval of nursing programs.
(2) Affiliate agency - An agency, other than the governing institution, which provides
learning experiences for students.
(3) Alternative practice settings - settings which provide opportunities for clinical learning
experiences although their primary function is not the delivery of health care.
(4) Articulation - A planned process between two or more educational systems to assist
students to make a smooth transition from one level of education to another without
duplication in learning.
(5) Baccalaureate degree program for registered nurses - A program leading to a bachelor's
degree in nursing which admits only registered nurses.
(6) Basic nursing program - An educational unit whose purpose is to prepare practitioners of
professional nursing and whose graduates are eligible to apply for initial licensure by
examination.
(A) Associate degree program - A program leading to an associate degree in
nursing conducted by an educational unit in nursing within the structure of a
college or university.
(B) Baccalaureate degree program - A program leading to a bachelor's degree
in nursing conducted by an educational unit in nursing which is a part of a
senior college or university.
(C) Master's degree program - A program leading to a master's degree, which
is an individual's first professional degree in nursing, and conducted by an
educational unit in nursing within the structure of a senior college or
university.
(D) Diploma program - A program leading to a diploma in nursing conducted
by a single purpose school usually under the control of a hospital.
(7) Board - The Board of Nurse Examiners for the State of Texas composed of members
appointed by the Governor for the State of Texas.
(8) Board survey visit - An on-site visit to a nursing program by a board representative for
the purpose of evaluating the program of learning and gathering data to support whether
the program is meeting the board's requirements as specified in §§215.2 - 215.13 of this
title (relating to Definitions; Program Development, Expansion, and Closure; Accreditation;
Mission and Goals (Philosophy & Outcomes); Administration and Organization; Faculty
Qualifications and Faculty Organization; Students; Program of Study; Management of
Clinical Learning Experiences and Resources; Facilities, Resources, and Services; Records
and Reports; and Total Program Evaluation).
(9) Clinical learning experiences - Faculty-planned and guided learning activities designed to
assist students to meet stated program and course outcomes and to safely apply knowledge
and skills when providing nursing care to clients across the lifespan as appropriate to the
role expectations of the graduates. These experiences occur in nursing skills and computer
laboratories; in a variety of affiliate agencies or clinical practice settings including, but not
limited to: acute care facilities, extended care facilities, clients' residences, and community
agencies; and in associated clinical conferences.
(10) Clinical preceptor - A registered nurse or other licensed health professional who meets
the minimum requirements in §215.10(f)(5) of this title (relating to Management of Clinical
Learning Experiences and Resources), not paid as a faculty member by the governing
institution, and who directly supervises a student's clinical learning experience. A clinical
preceptor facilitates student learning in a manner prescribed by a signed written agreement
between the educational institution, preceptor, and affiliate agency (as applicable).
(11) Clinical preceptorship - An organized system of clinical learning experiences which
allows a nursing student, under the direction of a faculty member, to attain specific learning
objectives under the supervision of a qualified clinical preceptor.
(12) Clinical teaching assistant - A registered nurse licensed in Texas, who is employed to
assist and work under the supervision of a Master's or Doctorally prepared faculty member
and who meets the minimum requirements in §215.10(g)(4) of this title (relating to
Management of Clinical Learning Experiences and Resources).
(13) Coordinator - A qualified faculty who has the delegated responsibility for the day to day
administration of an accredited professional nursing program or one or more distance
education initiatives.
(14) Course - A specific set of organized learning experiences that must be met within a
stated time period. A course involves both organized subject matter and related activities.
In a clinical nursing course, the didactic content shall be taught either prior to or concurrent
with the related clinical learning experiences.
(15) Curriculum - Content designed to achieve specific educational outcomes.
(16) Dean/Director - A registered nurse who is accountable for administering one or more of
the following: basic nursing program or a post-licensure baccalaureate or higher degree
program for registered nurses and who meets the requirements as stated in §215.6(e) of
this title (relating to Administration and Organization).
(17) Distance education initiative - Instruction delivered by an accredited nursing program
by any means to any location(s) other than the main campus. A distance education initiative
may range from offering a single course or multiple courses to offering the entire program
of study.
(18) Dormant distance education initiative - No enrollment for a period of an academic year
in a distance education initiative that provides the entire program of study.
(19) Essential competencies - The expected educational outcomes to be demonstrated by
nursing students at the time of graduation, as published in Nursing Education Advisory
Committee Report, Volume I, "Essential Competencies of Texas Graduates of Education
Programs in Nursing", March 1993, as amended.
(20) Examination year - A twelve month period defined by the Board.
(21) Faculty currency/clinical competence - Maintenance of up-to-date knowledge and
professional practice as demonstrated by certification and/or through participation in:
continuing education, professional conferences, advanced academic courses, workshops,
research projects, seminars, publications, clinical practice, and/or extended orientation.
(22) Faculty member - An individual employed to teach in the nursing program who meets
the requirements as stated in §215.7 of this title (relating to Faculty Qualifications and
Faculty Organization).
(23) Faculty petition - A request submitted to the board petitioning to employ an individual
who does not meet the requirements stated in §215.7 of this title.
(24) Faculty role - The activities which require the time of the faculty member and are
related, directly or indirectly, to the performance of his/her professional education duties
and responsibilities.
(25) Faculty waiver - A waiver granted by the board to an individual who has a
baccalaureate degree in nursing and is currently licensed in Texas to be employed as a
faculty member for a limited period of time.
(26) Governing institution - An accredited college, university or hospital responsible for the
administration and operation of an accredited nursing program.
(27) Health care professional - An individual other than a RN who holds at least a bachelor's
degree in the health care field, including, but not limited to: respiratory therapists, physical
therapists, occupational therapists, dieticians, pharmacists, physicians, social workers and
psychologists.
(28) Innovative approach to nursing education - A board approved approach to professional
nursing education which departs from existing educational processes or guidelines and for
which the nursing faculty establish an educational goal, identify educational intervention(s),
and measure the outcomes of the intervention(s).
(29) Mission - The purpose and overall role of the educational unit in nursing which are
consistent with those of the governing institution.
(30) Mobility - The ability to advance without educational barriers.
(31) Observational experience - An assignment to a facility or unit where students observe
the functions of the facility and the role of nursing within the facility, but where students do
not participate in patient/client care.
(32) Pass rate - The percentage of first time candidates within one examination year who
pass the National Council Licensure Examination for Registered Nurses.
(33) Philosophy - The underlying belief system of the educational nursing unit.
(34) Post-Licensure nursing program - An educational unit the purpose of which is to
provide mobility options for registered nurses to attain undergraduate academic degrees in
nursing. Post-licensure programs may be components of educational units within basic
nursing programs or independent baccalaureate degree programs for registered nurses as
defined in this section.
(35) Professional nursing student - An individual enrolled in a professional nursing program
who has met admission criteria and is designated as a nursing student according to
governing institution's policies.
(36) Program goals/outcomes - The expected competencies of program graduates with
regard to professional nursing practice.
(37) Program of study - The courses and learning experiences that constitute the
requirements for completion of a basic nursing program (associate degree program,
baccalaureate degree program, master's degree program, or diploma program) or a postlicensure nursing program.
(38) Shall and must - Mandatory requirements.
(39) Should - A recommendation.
(40) Staff - Employees of the Board of Nurse Examiners.
(41) Supervision - Immediate availability of a faculty member, clinical preceptor, or clinical
teaching assistant to coordinate, direct, and observe at first hand the practice of students.
§215.3. Program Development, Expansion, and Closure.
(a) New programs.
(1) Proposal to develop a professional pre-licensure or post-licensure nursing
program.
(A) A governing institution accredited by a board recognized
approval/accrediting body is eligible to submit a proposal to
develop a professional nursing program. Notice of intent to
establish a nursing program shall be submitted in writing 12-18
months prior to the anticipated start of the program.
(B) The proposal shall be completed under the
direction/consultation of a registered nurse who holds at least a
master's degree in nursing and who has teaching and
administrative experience in the type of program being
proposed.
(C) The proposal shall include information outlined in board
guidelines.
(D) The proposal will be considered by the board following a
public hearing at a regularly scheduled meeting of the board.
The board may approve the proposal, may defer action on the
proposal, or may deny further consideration of the proposal.
(2) Application for initial accreditation.
(A) Following approval to develop a professional nursing
program, a director, faculty, and support staff shall be
employed to develop the application for initial licensure as
outlined in an Order of the Board.
(B) Initial accreditation must be granted prior to admission of
students.
(C) The director and faculty shall plan the program of learning.
(D) The application shall include information outlined in board
guidelines.
(E) The board shall review the application and supporting
evidence at a regularly scheduled meeting. If the program is
based upon sound educational principles and is in compliance
with the board's requirements as specified in §§215.2 - 215.13
of this title (relating to Definitions; Program Development,
Expansion, and Closure; Accreditation; Mission and Goals
(Philosophy and Outcomes); Administration and Organization;
Faculty Qualifications and Faculty Organization; Students;
Program of Study; Management of Clinical Learning
Experiences and Resources; Facilities, Resources, and Services;
Records and Reports; and Total Program Evaluation), then
initial accreditation may be granted and an initial accreditation
fee assessed per Rule 223.1 of this chapter (relating to Fees).
(3) Survey visits shall be conducted, as necessary, by staff until full
accreditation is granted.
(b) Program Expansion
(1) Only nursing programs that have full accreditation are eligible to initiate
or modify distance education initiatives.
(2) The board's approval is necessary prior to:
(A) implementation of an initial distance education initiative by
any accredited nursing program;
(B) implementation of additional distance education initiatives
by a basic nursing program;
(C) addition or deletion of courses to an existing approved
distance education initiative by a basic nursing program; or
(D) reactivation of a dormant or closed distance education
initiative by a basic nursing program.
(3) A basic nursing program intending to establish or modify a distance
education initiative or a post-licensure nursing program intending to establish
an initial distance education initiative shall submit a proposal using board
approved guidelines.
(4) A post-licensure nursing program with prior approval for a distance
education initiative must notify the board prior to implementation when the
program plans additional distance education initiatives or makes changes to
the course offerings at existing distance education initiatives.
(5) An expedited proposal approval process may be used for a basic nursing
program's request to modify existing distance education initiatives.
(6) Educational resources and services of the distance education initiative
shall meet the same standards as those of the governing institution and shall
meet the board's requirements as stated in §§215.2-215.13 of this title.
(7) The dean/director shall appoint a coordinator who meets the qualifications
of nurse faculty as stated in §215.7 (c) of this title (relating to Faculty
Qualifications and Faculty Organization) to supervise the implementation of
distance education initiative(s) which provide the entire program of study.
(8) Documentation of notification to the Regional Council of the governing
institution about plans for establishment or modification of distance education
initiatives shall be provided to the board prior to implementation, as
appropriate.
(9) Evidence of approval from the Texas Higher Education Coordinating Board
and other regulating/accrediting bodies shall be provided to the board prior to
implementation, as appropriate.
(10) When a distance education initiative of a basic nursing program which
provides the entire program of study has been dormant for more than two
academic years, the director shall:
(A) reactivate the distance education initiative by submitting a
proposal for reactivation using the guidelines for proposals for
distance education initiatives, or
(B) submit a plan to close the dormant distance education
initiative as outlined in subsection (d) of this section.
(11) Distance education initiatives of basic nursing programs which have been
closed may be reactivated by submitting a proposal for reactivation using the
guidelines for proposals for distance education initiatives.
(12) When a distance education initiative of a post-licensure nursing program
which provides the entire program of study has been dormant for more than
two academic years, the director shall:
(A) notify board staff of plans to reactivate the distance
education initiative, or
(B) submit a plan to close the dormant distance education
initiative as outlined in (d) of this section.
(13) Distance education initiatives of post-licensure nursing programs which
have been closed may be reactivated by submitting notification to board staff
prior to reactivation.
(c) Transfer of Administrative Control by Governing Institutions.
(1) A governing institution of a professional nursing education program which
has Full Accreditation status may request permission from the board to
transfer administrative control.
(A) A governing institution that proposes to transfer
administrative control of a nursing program to another
governing institution accredited by a board recognized
approval/accrediting body shall submit:
(i) notice of intent to transfer administrative
control in writing to the board 12 months prior to
the anticipated date of transfer; and
(ii) a written plan for closure of the nursing
program as required by subsection (d) of this
section.
(B) The governing institution which will assume responsibility
for the program shall submit a Proposal to Assume
Administrative Control to the board six months prior to a
regularly scheduled board meeting.
(i) The proposal shall be completed under the
direction/consultation of a registered nurse who
holds at least a master's degree in nursing and
who has teaching and administrative experience
in the type of program being proposed.
(ii) The proposal shall include information
outlined in board approved guidelines.
(iii) The proposal shall include documentation of
Texas Higher Education Coordinating Board
approval, as applicable.
(iv) The proposal will be considered by the board
at a regularly scheduled meeting.
(v) The board may approve, may defer action, or
may deny further consideration of the proposal.
(2) Accreditation status of transferred nursing program(s).
(A) If the governing institution that is assuming administrative
control previously has been responsible for an accredited
professional nursing program and does not intend to change
the program of study then the professional nursing education
program shall maintain its accreditation status.
(B) If the governing institution that is assuming administrative
control previously has been responsible for an accredited
professional nursing program and intends to alter the program
of study then that governing institution shall submit a proposal
to change the program of study in accordance with section
215.9(h) relating to Program of Study.
(C) If the governing institution that is assuming administrative
control has not previously been responsible for an accredited
professional nursing program then that governing institution
shall submit an application for initial accreditation in accordance
with section 215.3(2) relating to Program Development,
Expansion and Closure.
(d) Closing a Program or Distance Education Initiative.
(1) When the decision to close a program or a distance education initiative
which provides the entire program of study has been made, the director must
notify the board and submit a written plan for closure which includes the
following:
(A) reason for closing the program or distance education
initiative;
(B) date of intended closing;
(C) academic provisions for students;
(D) provisions made for access to and safe storage of vital
school records, including transcripts of all graduates; and
(E) methods to be used to maintain requirements and
standards until the program or distance education initiative
closes.
(2) The program or distance education initiative shall continue within
standards until all classes, which are enrolled at the time of the decision to
close, have graduated. In the event this is not possible, a plan must be
developed whereby students may transfer to other accredited programs.
§215.4. Accreditation.
(a) The progressive designation of accreditation status is not implied by the order of the
following listing. Accreditation status is based upon each program's performance and
demonstrated compliance to the board's requirements. Change from one status to another
is based on NCLEX-RN7 examination pass rates and annual reports or survey visits. Types of
accreditation include:
(1) Initial accreditation. Initial accreditation is written authorization to admit
students and is granted if the program meets the requirements of the board.
(2) Full accreditation - basic program. Full accreditation is granted to a basic
nursing program after the program has documented compliance with
subsection (c)(2)(A) of this section. Only programs with full accreditation
status may propose distance education initiatives and petition for faculty
waivers.
(3) Full accreditation - post-licensure nursing programs. Full accreditation is
granted to a post-licensure nursing program after one class has completed
the program and is based upon evidence that the program meets the board's
legal and educational requirements.
(4) Warning.
(A) Issuance of warning. When the board determines that a
program is not meeting legal and educational requirements, the
program is issued a warning, is provided a list of the
deficiencies, and is given a specified time in which to correct
the deficiencies.
(B) Failure to correct deficiencies. If the program fails to correct
the deficiencies within the prescribed period the board may
restrict admissions or other program activities until the
deficiencies are corrected or the board may place the program
on conditional accreditation or withdraw accreditation.
(5) Conditional accreditation. Conditional accreditation is granted for a time
specified by the board in order to provide additional time to correct
deficiencies.
(A) The program shall not admit students while on conditional
status.
(B) The board may establish specific criteria to be met in order
for the program's conditional accreditation status to be
removed.
(C) Depending upon the degree to which the board's legal and
educational requirements are met, the board may change the
accreditation status to full, warning, or withdraw accreditation.
(b) Withdrawal of accreditation. A program which fails to meet legal and educational
requirements of the board within the specified time shall be removed from the list of state
accredited nursing programs. Reasons for withdrawal of accreditation include but are not
limited to:
(1) continued lack of compliance with minimum requirements as set out in
§215, and
(2) failure to meet specific criteria set out by the board.
(c) Accreditation procedures. The continuing accreditation status of each program shall be
determined annually by the board based upon:
(1) Review of annual report. Each accredited professional nursing program
shall submit an annual report regarding its compliance with the board's legal
and educational requirements. Accreditation status is determined on the basis
of the program's annual report, NCLEX-RN® examination pass rate, and other
pertinent data when a program is not visited by staff during the examination
year.
(2) Pass rate of graduates on NCLEX-RN® examination.
(A) In order for the nursing program to attain or maintain full
accreditation, 80% of first time candidates who complete the
program of study at the main campus and 80% of first time
candidates who complete the program of study through each
distance education initiative must achieve a passing score on
the NCLEX-RN® examination for two consecutive examination
years.
(B) When first time candidates who complete the program of
study at the main campus or through a distance education
initiative fail to achieve at least 80% during one examination
year, the nursing program shall submit a self-study report that
evaluates factors which contributed to the graduates'
performance on the NCLEX-RN® examination and a description
of the corrective measures to be implemented. The report shall
follow Board guidelines.
(C) A warning will be issued to the program as a whole based
on the pass rate when the pass rate of first time candidates, as
described in subsection (c)(2)(A) of this section, is less than
80% for two consecutive examination years or for two out of
three examination years.
(D) A program may be placed on conditional accreditation if,
within one examination year from the date of the warning the
performance of graduates fails to be at least 80% or the faculty
fail to implement appropriate corrective measures.
(E) Accreditation may be withdrawn if the performance of
graduates fails to be at least 80% during the examination year
following the date that the program is placed on conditional
accreditation.
(d) Survey visit. Each nursing program will be visited at least every six years after full
accreditation has been granted, unless accredited by a board recognized voluntary
accrediting body.
(1) The board may authorize staff to a conduct survey visit at any time based
upon established criteria.
(2) After a program is fully accredited by the board a report from a board
recognized voluntary accrediting body regarding a program's accreditation
status may be accepted in lieu of a board survey visit.
(3) A written report of the survey visit, annual report, and NCLEX-RN®
examination pass rate will reviewed by the board at a regularly scheduled
meeting.
(e) Notice of a program's accreditation status will be sent to the director, chief
administrative officer of the governing institution, and others as determined by the board.
§215.5. Mission and Goals (Philosophy and Outcomes).
(a) The mission and goals (philosophy and outcomes) of the nursing program shall be
consistent with the mission of the governing institution. They shall reflect the diversity of
the community served and shall be consistent with professional, educational, and ethical
standards of nursing.
(b) The written mission and goals (philosophy and outcomes) shall be used as a basis for
planning, organizing, implementing and evaluating the program and shall be shared with
the students.
(c) The program outcomes or objectives shall be consistent with the program's philosophy
or mission.
(d) The faculty shall periodically review the mission and goals (philosophy and outcomes)
and shall make revisions to maintain currency.
§215.6. Administration and Organization.
(a) The governing institution shall be accredited by a board recognized accrediting/approval
agency.
(b) There shall be an organizational chart which demonstrates the relationship of the
professional nursing program to the governing institution, and indicates lines of
responsibility and authority, and channels of communication.
(c) In colleges and universities, the program shall have comparable status with other
academic units in such areas as salary, rank, promotion, tenure, leave, benefits and
professional development.
(d) The governing institution shall provide financial support and resources needed to
operate a program which meets the legal and educational requirements of the board and
fosters achievement of program goals. The financial resources shall support adequate
educational facilities, equipment, and qualified administrative and instructional personnel.
(e) Each basic nursing program shall be administered by a qualified nurse faculty member
who is accountable for the planning, implementation and evaluation of the professional
nursing education program. The dean/director shall:
(1) hold a current license to practice as a registered nurse in the state of
Texas;
(2) hold a master's degree in nursing;
(3) hold a doctoral degree, if administering a baccalaureate or master's
degree program;
(4) have a minimum of three years teaching experience in the type of
program being administered; and
(5) have demonstrated knowledge, skills and abilities in administration within
educational programs.
(f) When the director of the program changes, the director shall submit to the board written
notification of the change indicating the final date of employment.
(1) A new director qualification form shall be submitted to the board office by
the governing institution for approval prior to appointing a new director for an
existing program or a new nursing program.
(2) A vitae and all official transcripts shall be submitted with the new director
qualification form.
(3) If an acting director is appointed to fill the position of the director, this
appointment shall not exceed one year.
(4) In a fully accredited professional nursing program, if the individual to be
appointed as director does not meet the requirements for director as specified
in subsection (e) of this section, the administration is permitted to petition for
a waiver of the board's requirements prior to the appointment of said
individual.
§215.7. Faculty Qualifications and Faculty Organization.
(a) There shall be written personnel policies for nursing faculty that are in keeping with
accepted educational standards and are consistent with those of the governing institution.
Policies which differ from those of the governing institution shall be consistent with nursing
unit mission and goals (philosophy and outcomes).
(1) Policies concerning workload for faculty and the dean/director shall be in
writing.
(2) Sufficient time shall be provided faculty to accomplish those activities
related to the teaching-learning process.
(3) Teaching activities shall be coordinated among full-time, part-time faculty,
clinical preceptors and clinical teaching assistants.
(4) If the director is required to teach, he or she shall carry only a minimum
teaching load.
(b) A nursing education program shall employ sufficient faculty members with graduate
preparation and expertise necessary to enable the students to meet the program goals. The
number of faculty members shall be determined by such factors as:
(1) the number and level of students enrolled;
(2) the curriculum plan;
(3) activities and responsibilities required of faculty;
(4) the number and geographic locations of affiliate agencies and clinical
practice settings; and
(5) the level of care and acuity of clients.
(c) Faculty Qualifications.
(1) Documentation of faculty qualifications shall be included in the official files
of the program. Each nurse faculty member shall:
(A) hold a current license to practice as a registered nurse in
the State of Texas;
(B) show evidence of teaching abilities and maintaining current
knowledge, clinical expertise, and safety in subject area of
teaching responsibility;
(C) hold a master's degree, preferably in nursing. A nurse
faculty member holding a master's degree in a discipline other
than nursing shall hold a bachelor's degree in nursing from an
accredited baccalaureate program in nursing; and
(i) if teaching in a diploma or associate degree
nursing program, shall have at least six semester
hours of graduate level content in nursing
appropriate to his/her teaching responsibilities, or
(ii) if teaching in a baccalaureate level program,
shall have at least 12 semester hours of graduate
level content in nursing appropriate to his/her
teaching responsibilities.
(D) In fully accredited programs, if an individual to be
appointed as faculty member does not meet the requirements
for faculty as specified in subsection (c) of this section, the
dean/director is permitted to petition for a waiver of the board's
requirements prior to the appointment of said individual.
(E) In baccalaureate programs, an increasing number of faculty
members should hold doctoral degrees appropriate to their
responsibilities.
(2) Faculty who teach non-clinical nursing courses, e.g., pathophysiology,
pharmacology, research, management and statistics, shall have graduate
level educational preparation appropriate to these areas of responsibility.
(d) Teaching assignments shall be commensurate with the faculty member's education and
experience in nursing.
(e) The faculty shall be organized with written policies and procedures and/or bylaws to
guide its activities.
(f) The faculty shall meet regularly and function in such a manner that all members
participate in planning, implementing, and evaluating the nursing program. Such
participation includes, but is not limited to the initiation and/or change of academic policies,
personnel policies, curriculum, utilization of affiliate agencies, and program evaluation.
(1) Committees necessary to carry out the functions of the program shall be
established with duties and membership of each committee clearly defined in
writing.
(2) Minutes of faculty organization and committee meetings shall document
the reasons for actions and the decisions of the faculty and shall be available
for reference.
(g) There shall be written plans for faculty orientation, development, and evaluation.
(1) Orientation of new faculty members shall be initiated at the onset of
employment.
(2) A program of faculty development shall be offered to encourage and assist
faculty members to meet the nursing program's needs as well as individual
faculty member's professional development needs.
(3) A variety of means shall be used to evaluate faculty performance such as
self, student, peer and administrative evaluation.
§215.8. Students.
(a) Students should have mechanisms for input into the development of academic policies
and procedures, curriculum planning, and evaluation of teaching effectiveness.
(b) The number of students admitted to the program shall be determined by the number of
qualified faculty, adequate educational facilities and resources, and the availability of
appropriate clinical learning experiences for students.
(c) Written policies regarding nursing student admission and progression shall be developed
and implemented in accordance with the requirements that the governing institution must
meet to maintain accreditation. Student policies which differ from those of the governing
institution shall be in writing and shall be made available to faculty and students. In addition
to governing institution policies, nursing programs should adopt policies regarding:
(1) repetition of course;
(2) clinical safety;
(3) criteria for dismissal from courses or the program when unsafe behavior
occurs; and
(4) due process.
(d) Policies shall facilitate mobility/articulation, be consistent with acceptable educational
standards, and be available to students and faculty.
(e) Students shall have the opportunity to evaluate faculty, courses, and learning resources
and these evaluations shall be documented.
(f) Individuals enrolled in accredited professional nursing programs preparing students for
initial licensure shall be provided verbal and written information regarding conditions that
may disqualify graduates from licensure and of their rights to petition the Board for a
Declaratory Order of Eligibility. Required eligibility information includes:
(1) Texas Civil Statutes, Articles 4519a and 4525;
(2) Rules 213.27-213.30 of this Chapter (relating to Good Professional
Character, Licensure of Persons with Criminal Convictions, Criteria and
Procedure Regarding Intemperate Use and Lack of Fitness; and
(3) Declaratory Order Petition Request Form.
(g) Written receipt of the required information shall be documented on the Licensure
Eligibility Form which contains, at a minimum, the following elements:
(1) name, date of birth, and social security number of the individual enrolled
in the accredited professional nursing program;
(2) statement that the information cited in subsection (c) of this section was
received and explained; and
(3) signature of the individual who received the information and date of
receipt.
(h) The nursing program shall maintain written receipt of eligibility notification for up to six
months after the individual enrolled completes the nursing program or permanently
withdraws from the nursing program.
(i) The Director of the Nursing Program shall submit an affidavit each year with the Annual
Report which verifies that enrolled students received the eligibility information as indicated
(g) of this section.
§215.9. Program of Study.
(a) The program of study shall be:
(1) at least the equivalent of two academic years and shall not exceed four
calendar years;
(2) planned, implemented, and evaluated by the faculty;
(3) based on the mission and goals (philosophy and outcomes);
(4) organized logically, sequenced appropriately;
(5) based on sound educational principles;
(6) designed to prepare graduates to practice according to the Standards of
Nursing Professional Practice as set forth in the Board's Rules and
Regulations; and
(7) designed and implemented to prepare students to demonstrate the
essential competencies.
(b) There shall be a reasonable balance between non-nursing courses and nursing courses
which are offered in a supportive sequence with rationale and are clearly appropriate for
collegiate study.
(c) There shall be a rationale for the ratio of contact hours assigned to classroom and
clinical learning experiences. The recommended ratio is three contact hours of clinical
learning experiences for each contact hour of classroom instruction.
(d) The program of study should facilitate articulation among programs.
(e) The program of study shall include, but not be limited to the following areas:
(1) non-nursing courses, clearly appropriate for collegiate study, offered in a
supportive sequence with rationale.
(2) nursing courses which include didactic and clinical learning experiences
that teach students to use a systematic approach to clinical decision making
and prepare students to safely practice professional nursing through the
promotion, prevention, rehabilitation, maintenance, and restoration of the
health of individuals of all ages.
(A) Course content shall be appropriate to the role expectations
of the graduate.
(B) Professional values including ethics, safety, diversity, and
confidentiality shall be addressed.
(C) The Nursing Practice Act, Standards of Professional Nursing
Practice, Unprofessional Conduct Rules, Delegation Rules, and
other laws and regulations which pertain to various practice
settings shall be addressed.
(3) Nursing courses shall prepare students to recognize and analyze health
care needs, select and apply relevant knowledge and appropriate methods for
meeting the health care needs of individuals and families, and evaluate the
effectiveness of the nursing care.
(4) Baccalaureate and entry-level master's degree programs in nursing shall
include learning activities in basic research and management/leadership, and
didactic and clinical learning experiences in community health nursing.
(f) The learning experiences shall provide for progressive development of values,
knowledge, judgement, and skills.
(1) Didactic learning experiences shall be provided either prior to or
concurrent with the related clinical learning experiences.
(2) Clinical learning experiences shall be sufficient in quantity and quality to
provide opportunities for students to achieve the stated program outcomes.
(3) Students shall have sufficient opportunities in simulated or clinical settings
to develop manual technical skills, using contemporary technologies, essential
for safe, effective nursing practice.
(4) Learning opportunities shall assist students to develop communication and
interpersonal relationship skills.
(g) Faculty shall develop and implement evaluation methods and tools to measure students'
cognitive, affective and psychomotor achievement using sound educational principles.
(h) Staff approval is required prior to implementation of major curriculum changes.
Proposed changes shall include information outlined in board guidelines and shall be
reviewed using board standards.
(1) Changes that require approval include:
(A) changes in program mission and goals (philosophy and
outcomes) which result in a reorganization or
reconceptualization of the entire curriculum;
(B) an increase or decrease in program length by more than
25%;
(C) the addition of transition or bridging courses that facilitate
articulation into the existing program of study; and
(D) the addition of tracks/alternative programs of study that
provide educational mobility.
(2) Documentation of Governing Institution approval or Texas Higher
Education Coordinating Board approval must be provided prior to
implementation of changes, as appropriate.
(3) All other revisions such as editorial updates of mission and goals or
redistribution of course content or course hours shall be reported to the Board
in the Annual Report.
(i) A professional nursing program with full accreditation may submit a proposal for an
innovative approach to nursing education to the board for approval prior to implementation.
(1) A nursing program that proposes to initiate an innovative approach to
nursing education shall submit a proposal 90 days prior to a regularly
scheduled board meeting:
(A) the proposal shall include information outlined in board
guidelines.
(B) the proposal will be considered by the board at a regularly
scheduled board meeting. The board may approved, may defer
action, or may deny further consideration of the proposal.
(2) If the proposed innovative approach to nursing education includes the
creation of a distance education initiative or a major change in the program of
study, the proposal must meet the requirements outlined in §215.3(b) of this
title (relating to Program Development, Expansion, and Closure) or §215.9(h)
of this section, respectively.
(3) Approved innovative approaches may be implemented one time only.
(A) The program must submit a written report of outcomes
resulting from the innovative educational experience within 90
days of its completion.
(B) A request for an innovative approach to become a
permanent part of an accredited nursing program must be
submitted by the Director of the program after the final
evaluation of the project has been submitted and no less than
60 days prior to a regularly scheduled meeting of the board,
using board guidelines.
§215.10. Management of Clinical Learning Experiences and Resources.
(a) In all cases faculty shall be responsible and accountable for managing clinical learning
experiences and observational experiences of students.
(b) Faculty shall develop criteria for the selection of affiliate agencies or clinical practice
settings which address safety and the need for students to achieve the program outcomes
(goals) through the practice of nursing care or observational experiences.
(c) Faculty shall select and evaluate affiliate agencies or clinical practice settings which
provide students with opportunities to achieve the goals of the program.
(1) Written agreements between the program and the affiliate agencies shall
specify the responsibilities of the program to the agency and the
responsibilities of the agency to the program.
(2) Agreements shall be reviewed periodically and include provisions for
adequate notice of termination.
(d) The faculty member shall be responsible for the supervision of students in clinical
learning experiences.
(1) When a faculty member is the only person officially responsible for a
clinical group, then the group may total no more than 10 students. The
faculty member must supervise that group in only one facility at a time,
unless some portion or all of the clinical group are assigned to observational
experiences in additional settings.
(2) Direct faculty supervision is not required for an observational experience.
(A) Observational experiences may be used to supplement, but
not replace patient care experiences, and must serve the
purpose of student attainment of clinical objectives.
(B) Observational experiences should comprise no more than
20% of the clinical contact hours for a course and no more than
10% of the clinical contact hours for the program-of-study.
(e) Faculty may use clinical preceptors or clinical teaching assistants to enhance clinical
learning experiences and to assist faculty in the supervision of students.
(1) Faculty shall develop written criteria for the selection of clinical preceptors
and clinical teaching assistants.
(2) When clinical preceptors or clinical teaching assistants are used, written
agreements between the professional nursing program, clinical preceptor or
clinical teaching assistant, and the affiliating agency, when applicable, shall
delineate the functions and responsibilities of the parties involved.
(3) Faculty shall be readily available to students and clinical preceptors or
clinical teaching assistants during clinical learning experiences.
(4) The designated faculty member shall meet periodically with the clinical
preceptors or clinical teaching assistants and student(s) for the purpose of
monitoring and evaluating learning experiences.
(5) Written clinical objectives shall be shared with the clinical preceptors or
clinical teaching assistants prior to or concurrent with the experience.
(f) Clinical preceptors may be used to enhance clinical learning experiences after a student
has received clinical and didactic instruction in all basic areas of nursing or within a course
after a student has received clinical and didactic instruction in the basic areas of nursing for
that course or specific learning experience.
(1) In courses which use clinical preceptors for a portion of clinical learning
experiences, faculty shall have no more than 12 students in a clinical group.
(2) In courses which use clinical preceptors as the sole method of student
instruction and supervision in clinical settings, faculty shall coordinate the
preceptorships for no more than 24 students.
(3) The preceptor may supervise student clinical learning experiences without
the physical presence of the faculty member in the affiliate agency or clinical
practice setting.
(4) The preceptor shall be responsible for the clinical learning experiences of
no more than two students per clinical day.
(5) Clinical preceptors shall have the following qualifications:
(A) competence in designated area of practice;
(B) philosophy of health care congruent with that of the nursing
program; and
(C) current licensure as a registered nurse; or
(D) if not a registered nurse, a current license in Texas as a
health care professional with a bachelor's degree in that field.
(g) Clinical teaching assistants may assist qualified and experienced faculty clinical learning
experiences.
(1) In clinical learning experiences where a faculty member is supported by a
clinical teaching assistant, the ratio of faculty to students shall not exceed
2:15 (faculty plus clinical teaching assistant: student).
(2) Clinical teaching assistants shall supervise student clinical learning
experiences only when the qualified and experienced faculty member is
physically present in the affiliate agency or alternative practice setting.
(3) When acting as a clinical teaching assistant, the RN shall not be
responsible for other staff duties, such as supervising other personnel and/or
patient care.
(4) Clinical teaching assistants shall meet the following criteria:
(A) hold a current license to practice as a registered nurse in
the State of Texas;
(B) hold a bachelor's degree in nursing from an accredited
baccalaureate program in nursing; and
(C) have the clinical expertise to function effectively and safely
in the designated area of teaching.
§215.11. Facilities, Resources, and Services.
(a) The governing institution shall be responsible for providing:
(1) educational facilities,
(2) resources, and
(3) services which support the effective development and implementation of
the nursing education program.
(b) The director and faculty shall have adequate secretarial and clerical assistance to meet
the needs of the program.
(c) The physical facilities shall be adequate to meet the needs of the program in relation to
the size of the faculty and the student body.
(1) The director shall have a private office.
(2) Faculty offices shall be conveniently located and adequate in number and
size to provide faculty with privacy for conferences with students and
uninterrupted work.
(3) Space for clerical staff, records, files, and equipment shall be adequate.
(4) There shall be mechanisms which provide for the security of sensitive
materials, such as examinations and health records.
(5) Classrooms, laboratories, and conference rooms shall be conducive to
learning and adequate in number, size, and type for the number of students
and the educational purposes for which the rooms are used.
(d) The learning resources, library, and departmental holdings shall be current, use
contemporary technology appropriate for the level of the curriculum, and be sufficient for
the size of the student body and the needs of the faculty.
(1) Provisions shall be made for accessibility, availability, and timely delivery
of information resources.
(2) Facilities and policies shall promote effective use, i.e., environment,
accessibility, and hours of operation.
§215.12. Records and Reports.
(a) Accurate and current records shall be maintained in a confidential manner and be
accessible to appropriate parties. These records shall include, but are not limited to:
(1) records of current students;
(2) transcripts/permanent record cards of graduates;
(3) faculty records;
(4) administrative records, which include minutes of faculty meetings for the
past three years, annual reports, and school catalogs;
(5) the current program of study and curriculum including mission and goals
(philosophy and outcomes), and course outlines;
(6) agreements with affiliate agencies; and
(7) the master plan of evaluation with most recent data collection.
(b) Records shall be safely stored to prevent loss, destruction, or unauthorized use.
(c) The director shall submit an annual report each year.
§215.13. Total Program Evaluation.
(a) There shall be a written plan for the systematic evaluation of the total program. The
plan shall include methodology, frequency of evaluation, assignment of responsibility,
evaluative criteria, and indicators of program and instructional effectiveness. The following
broad areas shall be periodically evaluated:
(1) organization and administration of the program;
(2) mission and goals (philosophy and outcomes);
(3) program of study, curriculum, and instructional techniques;
(4) education facilities, resources, and services;
(5) affiliate agencies and clinical learning activities;
(6) students' achievement;
(7) graduates' performance on the licensing examination;
(8) graduates' nursing competence;
(9) faculty members' performance; and
(10) advisory committees.
(b) All evaluation methods and instruments shall be periodically reviewed for
appropriateness.
(c) Implementation of the plan for total program evaluation shall be documented in the
minutes.
(d) Major changes in the nursing program shall be evidence-based and supported by
rationale.
Available online: http://www.bne.state.tx.us/rr215.htm#1
Differentiated Entry Level Competencies of
Graduates of Texas Nursing Programs
Vocational (VN)
Diploma/Associate Degree (DIP/ADN)
Baccalaureate Degree (BSN)
Published by
The Board of Nurse Examiners for the State of Texas
&
Texas Board of Vocational Nurse Examiners
September, 2002
DIFFERENTIATED ENTRY LEVEL COMPETENCIES OF
GRADUATES OF TEXAS NURSING PROGRAMS
TABLE OF CONTENTS
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ii
Nursing Program Descriptions and Entry Level Competencies
Vocational Nursing Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Diploma/Associate Degree Nursing Programs . . . . . . . . . . . . . . . . . . . . . . . .
Baccalaureate Degree Nursing Programs . . . . . . . . . . . . . . . . . . . . . . . . . .
1
3
7
Differentiated Entry Level Competencies
Provider of Care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Coordinator of Care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Member of a Profession . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
23
29
Appendices
A. Committee List. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B. Essential Competencies Survey. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C. Survey Respondents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
D. Survey Collaborators. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
E. Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
F. References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
35
37
39
41
43
45
INTRODUCTION
DIFFERENTIATED ENTRY LEVEL COMPETENCIES OF
GRADUATES OF TEXAS NURSING PROGRAMS
VOCATIONAL (VN)
DIPLOMA/ASSOCIATE DEGREE (DIP/ADN)
BACCALAUREATE DEGREE (BSN)
In Texas, licensed nursing practice flows along a continuum from the licensed vocational
nurse to the doctorally prepared registered nurse. While selected aspects of nursing care
may be delegated by licensed practitioners to ancillary persons such as nursing assistants or
aides, Licensed Vocational Nurses (LVNs) and Registered Nurses (RNs) currently form the
core of providers of care, coordinators of care and members of the nursing profession.
Basic educational preparation for the LVN examination is at the vocational level. Programs
are provided through either community colleges, hospitals or proprietary schools and are
approved by the Board of Vocational Nurse Examiners for the State of Texas (BVNE).
Educational preparation for the RN licensure examination may be obtained through diploma,
associate degree and baccalaureate degree programs (including generic master’s degree
programs). Each program provides the necessary preparation for practice as a registered
professional nurse and is approved by the Board of Nurse Examiners for the State of Texas
(BNE).
The curricula of each of the nursing programs differ, resulting in differentiated entry level
competencies of graduates. The competencies progress from vocational nursing to
diploma/associate degree nursing to baccalaureate degree nursing. The competencies of
each educational level build upon the previous level.
METHODOLOGY
On January 20, 2000, the BNE charged the Advisory Committee on Education (ACE) to
review and revise the Essential Competencies of Texas Graduates of Education Programs in
Nursing (BNE, 1993). The Board of Vocational Nurse Examiners conducted a parallel process
to survey their programs for review and revision of the VN competencies and then joined
the ACE to finalize the process.
In as much as the constituencies represented in the original (1993) Nursing Education
Advisory Committee (NEAC) were very similar to those represented in the current ACE, a
review undertaken by ACE was felt to be comparable to that which might be conducted by
another statewide committee convened for this purpose and could be completed in a far
more timely and cost-effective fashion.
ACE instituted a subcommittee which included six nurses who represented Diploma, ADN,
and BSN education in addition to Texas League for Nursing (TLN) and Texas Organization of
Nurse Executives (TONE) members who represented nursing practice. This subcommittee
met August 9, 2000 to begin the process of review and revision.
The subcommittee analyzed the Essentials of Baccalaureate Education (AACN, 1998) and
the Educational Competencies for Graduates of Associate Degree Nursing Programs (NLN,
2000) and found that the framework of the original 14 competencies provided for inclusion
of the content of these two documents. The subcommittee also recognized that over the
past seven years, schools of nursing have used the 14 core competencies in various ways,
one of which was to revise course objectives and outcome statements. Therefore, major
changes to these competencies were discouraged.
The goal of the subcommittee was to receive information from schools of nursing and
employers of nurses for content revision in the areas of knowledge and clinical
behaviors/judgment. A survey was sent to Texas VN, Diploma, ADN, and BSN Program
Deans and Directors (Appendix B). A list of the survey respondents is included (Appendix
C). In order to avoid burdening nursing programs with a request for each program to
address all 14 competencies, each program was responsible for providing input related to
selected competencies. Any program could go beyond their identified competencies. The
survey facilitated inclusion of current and relevant knowledge, skills, judgment, and
professional values to update the competencies.
In order to assure broad-based input from the health care community, the subcommittee
requested that nursing programs involve selected health care agencies in their areas in the
discussion of the revisions and the completion of the survey. Such collaboration provided
input from a diversity of settings across Texas in order to strengthen the final revision. Each
agency’s name (Appendix D) as it appeared on the survey is included in this final report as a
collaborating institution.
COMPETENCIES
The competencies are written for nursing programs to meet the approval criteria established
by the Boards of Nursing (BVNE and BNE).
Competencies are defined as “effective demonstration, by the time of graduation, of
knowledge, judgment, skills and professional values derived from the nursing and general
education content (BNE, 1993, p. ii).” The competencies describe the expected outcomes for
students at the time of graduation. The intent of this document is not to include the
expected competencies of VN, DIP/ADN, or BSN prepared nurses who have been in practice
and have progressed beyond the novice level.
The competencies are organized according to three major roles of the nurse: Provider of
Care, Coordinator of Care, and Member of Profession. Broad competency statements
describe the expected behaviors of the graduate. The competencies are then further
described in terms of “knowledge needed to achieve the competency” and “related clinical
behaviors and judgments.”
The competency statements serve as guidelines for utilization of new graduates in practice
settings and the development of plans for building upon competencies (e.g., orientation
programs, job descriptions, clinical ladders, etc.). The competencies with general
descriptions of roles and responsibilities for each type of nursing follow. The competencies
are consistent with the Board of Nurse Examiners’ “Standards of Professional Nursing
Practice” and the Board of Vocational Nurse Examiners’ “Minimum Standards of Vocational
Nursing Education.”
The 14 competencies identified as headings have had minimal changes from 1993 as they
continue to reflect the updated Essentials of Baccalaureate Education (AACN, 1998) and the
Educational Competencies of Associate Degree Nursing Programs (NLN, 2000). The Pew
Health Professional Commission 21 Competencies for the 21s t Century (SC Colleagues in
Caring, 2001) were incorporated into the competencies.
Structure and terminology changes based on survey results included the following:
1. The term “aggregates” was replaced by the term “groups” and “society as a client” was
omitted.
2. The additional knowledge and additional clinical behavior/judgments were grouped
together under each competency according to type of education in the same section of
the document and horizontally aligned progressively from left to right.
VALUES AND ETHICS IN NURSING
Through the educational process, students are provided the necessary experiences to
develop the knowledge, behaviors and skills expected of practicing nurses. In addition, the
clinical judgments of the nurse are guided by various values and beliefs about oneself and
society. It is recommended that nursing educators strive to foster commitment to the
following values and ethical principles believed to be inherent to the nursing profession:
1) Altruism - Concern for the welfare of others seen through caring, commitment and
compassion.
2) Human Dignity - Belief in the inherent worth and uniqueness of the individual seen
through respectfulness, empathy, humanness, and trust.
3) Truth - Faithfulness to fact seen through honesty, accountability and authenticity.
4) Justice - Upholding moral and legal principles seen through courage, advocacy, and
objectivity.
5) Freedom - Capacity to exercise choice seen through openness, self-direction, and selfdiscipline.
6) Equality - Having the same rights and privileges seen through acceptance, tolerance,
and fairness.
7) Esthetics - Identifying the qualities of objects, events and persons that provide
satisfaction as seen through creativity, sensitivity and appreciation.
Values and beliefs about oneself and society guide the clinical judgments of the nurse. To
act as a moral agent and to advocate on behalf of patients, the nurse must be sensitive to
ethical issues inherent in health care settings and health care policies and be able to
systematically reason through ethical dilemmas. Through the educational process, students
clarify personal and professional values and develop the knowledge, behaviors, judgments,
and skills expected of nurses practicing ethically.
Professional values are enduring beliefs or ideals that guide practitioners and serve as a
framework for professional decisions and action. These values are the foundation for moral
standards of right and wrong, established in accordance with the profession’s norms and
traditions. As a practice discipline, caring is the fundamental value of nursing, growing from
altruism -- a concern for the well-being of others. Caring, as a human endeavor, places
demands on the character, knowledge, behaviors, judgments, and skills of the nurse. A
nurse’s first moral obligation is to be a competent practitioner.
Nursing ethics applies general moral principles and rules to address potential and actual
ethical issues arising within the health care encounter. This system of valued beliefs and
behaviors (identified as rights, duties, and obligations as well as good professional
character) guides the conduct of nurses.
A code of ethics for nursing embodies the profession’s central values and standards of
conduct, reflecting its responsibility to society and its collegial solidarity. It provides the
framework for decision-making for the profession and the parameters of professional
integrity. Violation of the code’s professional standards may result in disciplinary action.
IMPLICATIONS
This document has the potential to add clarity and consistency to educational outcomes. It
can be used by nursing programs to review curricula through content mapping for evidence
that knowledge, clinical behaviors and judgments, and skills of new graduates are relevant
and consistent with the educational program. This document provides a foundation for the
state’s nursing education programs to design seamless articulation plans for educational
mobility and for employers to create differentiated job descriptions for entry-level nursing
practice.
RECOMMENDATION
Periodic reviews and revisions need to be conducted to ensure that the competencies reflect
changes in nursing practice, education, and research.
NURSING
PROGRAM
DESCRIPTIONS
AND
ENTRY LEVEL
COMPETENCIES
VOCATIONAL NURSING PROGRAMS
The curriculum for vocational nurse education is delivered in a clinically intensive certificate
program of approximately one year in length. The Board of Vocational Nurse Examiners
(BVNE) minimum requirements encompass 558 theory and 840 clinical hours, although
most programs include more than the 1,398 minimum. The primary providers of vocational
nurse education are community colleges. Other providers include hospitals, technical
institutes and the military.
The Board of Vocational Nurse Examiners approved curriculum includes requirements for
instruction in the four basic areas of nursing care: adults; mothers and newborns; children;
and the elderly. The initial clinical instruction takes place in the skills laboratory and
progresses to clinical experiences in health care agencies. Classroom instruction is also
required in mental health/mental illness concepts, but a clinical component is not required.
Required support courses and content include: basic human anatomy and physiology;
microbiology; pharmacology; administration of medications; nutrition; life cycle/growth and
development; professional (vocational) adjustments; legal and ethical aspects of nursing
practice; and fundamental nursing skills. Content may be integrated within the core nursing
curriculum or may be taken as stand alone courses. Since technological advances allow new
techniques in instruction, most programs provide introduction to technology in computer
laboratories, simulated laboratory practice, and in the clinical practice arena.
Licensure to practice is issued by the Board of Vocational Nurse Examiners to individuals
who pass the National Council Licensure Examination for Practical Nurses (NCLEX-PN).
Qualified graduates of vocational nursing programs typically receive a temporary permit to
practice under direct supervision for a 90-day period while awaiting testing and licensure.
The primary role of the entry level graduate of a vocational nursing program is to provide
nursing care in structured health care settings for individual clients who are experiencing
common, well-defined health problems with predictable outcomes. The new graduate can
readily integrate technical skills and use of computers and equipment into practice.
With continuing education and experience the Licensed Vocational Nurse might practice in
unstructured settings with clients having complex health problems. The Texas title act for
LVNs allows an expanded practice according to documented education, experience, and job
description. The LVN and employer are jointly responsible for ensuring competence in
expanded practice. Although, the LVN is sometimes placed in practice situations where
complex decision making and independent clinical judgment skills are required, it is
discouraged until the next level of nursing education and licensure is obtained. Educational
opportunities exist for LVNs to articulate into Diploma/Associate Degree Nursing (DIP/ADN)
and Baccalaureate Degree in Nursing (BSN) programs.
The vocational nursing role represents the beginning level of the nursing practice continuum
as Provider of Care, Coordinator of Care, and Member of a Profession. The entry level
competencies of the Vocational Nursing (VN) graduate are listed below:
ENTRY LEVEL COMPETENCIES OF TEXAS GRADUATES OF
VOCATIONAL NURSING PROGRAMS
A. Provider of Care:
1. Assist in determining the health status and health needs of clients (individual) based on
interpretation of health related data, and preventive health practices in collaboration
with clients (individual), their families, and other members of the immediate health care
team.
2. Assist in the formulation of goals/outcomes and a plan of care in collaboration with the
client (individual), their families, and interdisciplinary health care team members.
3. Implement plan of care within legal and ethical parameters, including scope of
education, in collaboration with the client (individual) and interdisciplinary health care
team to assist client (individual) in meeting health care needs.
4. Implement teaching plan for client (individual) with common health problems and welldefined learning needs.
5. Assist in the evaluation of the client’s (individual) responses and outcomes to
therapeutic interventions.
6. Provide direct basic care to assigned multiple clients (individual) in structured settings.
7. Use the problem-solving approach as the basis for decision making in practice.
B. Coordinator of Care:
1. Assist in the coordination of human and material resources for the provision of care for
assigned clients (individual).
2. Collaborate with clients (individual) and the interdisciplinary health care team to provide
direct care to assigned clients (individual).
3. Participate in the identification of client (individual) needs for referral to resources that
facilitate continuity of care.
4. Participate in activities which support the organizational framework of structured health
care settings.
C. Member of a Profession:
1. Demonstrate accountability for own nursing practice.
2. Participate as an advocate in activities that focus on improving the health care of clients
(individual).
3. Demonstrate behaviors that promote the development and practice of vocational
nursing.
DIPLOMA AND ASSOCIATE DEGREE NURSING PROGRAMS
Although the programs for diploma nursing and associate degree nursing may vary in the
mission and philosophies of the sponsoring institutions, competencies have been identified
as common for graduates of both programs. These competencies are the entry level into
registered nursing practice. Specific program information is presented by program type.
Diploma Programs
Diploma programs are hospital based single purpose schools of nursing that consist of two
to three years general education and nursing courses. These programs are based on the
mission, values, and purposes of the governing institution and prepare graduates to provide
and coordinate health care of individuals and families throughout the life span across the
health continuum.
General education courses, from an accredited college or university, may be required as
prerequisites to or offered concurrently with nursing courses. The general education courses
provide a foundation in communication, psychology, human growth and development, and
related sciences to support the nursing courses.
Nursing courses prepare graduates to utilize a systematic approach in collaboration with
individuals and families to provide or coordinate health promotion, maintenance, and
restoration. Nursing management, nursing care supervision, legal/ethical concepts are
included throughout the nursing curriculum. Diploma programs offer a strong clinical
component and provide opportunities for the student to apply nursing knowledge and
clinical behaviors/ judgments in a variety of clinical settings.
The Board of Nurse Examiners for the State of Texas issues licensure to practice as a
registered professional nurse to graduates of diploma programs who pass the National
Council Licensure Examination for Registered Nurses (NCLEX-RN). Qualified graduates
typically receive a temporary permit to practice under direct supervision of a registered
professional nurse for a 60-day period while awaiting testing and licensure.
The primary entry level role of a graduate of a diploma program is to provide direct nursing
care to or coordinate care for a limited number of clients in various health care settings.
Such clients may have predictable or unpredictable health care needs and are identified as
individuals and families.
With continuing nursing experiences and education, the diploma graduate can provide
independent direct nursing care or supervise health care of individuals and families and
receive certification in various specialty areas. The Texas Articulation Model (TNA, 1997)
facilitates transfer of general education and nursing credits to RN-BSN and RN-MSN
programs for graduates to continue their education to prepare for expanded nursing roles.
Associate Degree Programs
Associate degree nursing programs, located in community colleges or senior colleges,
require a minimum of two years of full-time study, integrating approximately 70 credit
hours, with a reasonable balance in liberal arts and natural, social, and behavioral sciences
and the other half in nursing courses. Associate degree programs are geographically and
economically more accessible and provide entry into professional nursing practice in a
shorter period of time.
General education courses provide a foundation for nursing content in associate degree
programs. These include undergraduate education in communication, natural and social
sciences that enable graduates to apply theoretical content in the provision of nursing care.
In addition, ability in both basic intellectual competencies (reading, writing, speaking, math,
computer literacy) and workplace competencies (Secretary’s Commission on Achieving
Necessary Skills) is developed.
Nursing courses provide opportunities to demonstrate competence in the application of
nursing knowledge and clinical behaviors/judgments in health care settings. Nursing content
includes the importance of partnerships with clients and families in health promotion, health
maintenance, and health restoration. Nursing management, nursing care supervision, and
legal/ethical content are imbedded in the curriculum.
The Board of Nurse Examiners for the State of Texas issues licensure to practice to
individuals who pass the National Council Licensure Examination for Registered Nurses
(NCLEX-RN). Qualified graduates of associate degree nursing programs typically receive a
temporary permit to practice under direct supervision of a registered professional nurse for
a 60-day period while awaiting testing and licensure.
The primary role of the entry level graduate of an associate degree program is to provide
direct nursing care to or coordinate care for a limited number of clients in various health
care settings. Such clients may have predictable or unpredictable health care needs and are
identified as individuals and members of families.
With additional experience and continuing education, the associate degree graduate can
provide independent direct care or supervise health care of clients and families and receive
certification in various specialty areas. Through articulation, graduates can continue their
education (RN-BSN, RN-MSN) to prepare for expanded roles (TNA, 1997).
The entry level competencies of the Diploma (DIP) and Associate Nursing Degree (ADN)
graduate which build upon the entry level competencies of the Vocational Nursing (VN)
graduate are listed below:
ENTRY LEVEL COMPETENCIES OF TEXAS GRADUATES OF
DIPLOMA/ASSOCIATE DEGREE NURSING PROGRAMS
A. Provider of Care:
1. Determine the health status and health needs of clients (individual and family) based
upon interpretation of health data and preventive health practices in collaboration with
clients (individual and family) and interdisciplinary health care team members.
2. Formulate goals/outcomes and plan of care based on nursing diagnoses in collaboration
with clients (individual and family) and interdisciplinary health care team members.
3. Implement plan of care within legal and ethical parameters, including scope of practice,
in collaboration with the client (individual and family) and interdisciplinary health care
team to assist client (individual and family) in meeting health care needs.
4. Develop and implement teaching plans for clients (individual and family) concerning
promotion, maintenance, and restoration of health.
5. Evaluate clients’ (individual and family) responses and outcomes to therapeutic
interventions.
6. Provide for the care of multiple clients (individual and family) either through direct care
or assignment and/or delegation of care to other members of the health care eam.
7. Use critical thinking approach to analyze clinical data and current literature as a basis for
decision making in nursing practice.
B. Coordinator of Care:
1. Coordinate human and material resources for the provision of care for clients*
(individual and family).
2. Collaborate with clients (individual and family) and the interdisciplinary health care team
for the planning and delivery of care.
3. Refer clients (individual and family) to resources that facilitate continuity of care.
4. Function within the organizational framework of various health care settings.
C. Member of a Profession:
1. Assume accountability and responsibility for the quality of nursing care provided to
clients (individual and family).
2. Act as an advocate to promote the provision of quality health care for clients (individual
and family). Participate in activities that promote the development and practice of
professional nursing.
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BACCALAUREATE DEGREE NURSING PROGRAMS
Baccalaureate education, offered in university settings, provides students with a broad
perspective and understanding of nursing, health and healing, the environment and persons
as diverse individuals, families, groups and communities. The baccalaureate nursing
program of study integrates approximately 60 hours from liberal arts and natural, social,
and behavioral science courses and 60-70 hours of nursing courses.
In addition to a liberal education that provides a solid foundation for the development of
clinical judgment skills, “Baccalaureate education, with its broader more scientific
curriculum, best fits the requirements for adaptability to change” (US Department of Health
and Human Services, 1996, p.7). Baccalaureate education provides a strong foundation for
future critical thinking and problem solving skills with its inclusion of a broad range of basic
sciences, behavioral and social management sciences and communication and data analysis
content.
Community health nursing, research, and courses that provide depth and breadth in the
understanding of leadership, management, health promotion, pathophysiology,
pharmacology, and care of vulnerable groups are required in the baccalaureate curriculum
and are generally not addressed in the preceding levels of education. The BSN degree from
accredited nursing programs meets the educational requirements for eligibility to take the
exam (NCLEX-RN) for the Registered Nurse license as mandated for practice in the State of
Texas by the Nursing Practice Act and regulated by the Board of Nurse Examiners.
Baccalaureate graduates synthesize information from various disciplines, think logically,
analyze critically, and communicate effectively with clients and other health care
professionals. The baccalaureate graduate uses theory and research-based knowledge in the
direct and indirect delivery of care to patients, and in the formation of partnerships with
patients and the interdisciplinary health care team (AACN, 1998). BSN graduates
incorporate research findings into comprehensive long-term planning for the health of
clients, families, groups, and communities. Graduates are expected to demonstrate all the
competencies (knowledge, behaviors, judgments, and skills) of the preceding levels of
education, but with greater depth and breadth of application and synthesis.
“In today’s health care system, graduates of Baccalaureate programs are expected to
practice at higher levels more quickly, with increased knowledge and in greater number of
types of settings (structured and unstructured)” ( AACN, 1998, p. 17 ). The focus of care of
the new BSN graduate is usually with individuals, families, and groups as clients. With
additional experience and continuing education, BSN graduates are able to provide care for
communities and society within the context of the environment, available resources, and
technology. Graduates of baccalaureate programs are prepared to provide and direct care to
individuals, families, and groups who have complex and unpredictable health care needs in
structured and unstructured settings. Qualified graduates of baccalaureate nursing
programs typically receive a temporary permit to practice under direct supervision of a
registered professional nurse for a 60-day period while awaiting testing and licensure. These
graduates routinely begin their careers in structured settings but rapidly move into
community-based settings and/or leadership roles. A BSN degree is the most common
requirement for entry into graduate nursing education where nurses may further develop
their professional roles, to become nurse educators, researchers, administrators, or
advanced practice nurses.
The entry level competencies of the Baccalaureate Degree Nursing (BSN) graduate which
build upon the entry level competencies of the Diploma (DIP) and Associate Degree Nursing
(ADN) graduate are listed below:
ENTRY LEVEL COMPETENCIES OF TEXAS GRADUATES OF
BACCALAUREATE DEGREE NURSING PROGRAMS
A. Provider of Care:
1. Determine the health status and health needs based on expanded interpretation of
health-related data and preventive health practices in collaboration with clients
(individual, their families, and groups) and the interdisciplinary health care team.
2. Formulate goals/outcomes and plan of care using an evidence-based and theoretical
analysis of available data in collaboration with clients (individual, their families, and
groups) and interdisciplinary health care team members.
3. Implement plan of care within legal and ethical parameters, including scope of practice,
in collaboration with the clients (individual, their families, and groups) and
interdisciplinary health care team to assist client (individual, their families, and groups)
in meeting health care needs.
4. Develop and implement comprehensive teaching plans to meet the learning needs of
clients (individual, their families, and groups).
5. Evaluate clients’ (individual, their families, and groups) responses and outcomes to
therapeutic interventions.
6. Provide for the care of multiple clients (individual, their families, and groups) either
through direct care or assignment and/or delegation of care to other members of the
health care team.
7. Use an evidence based analytical approach as the basis for decision making in practice.
B. Coordinator of Care:
1. Coordinate human and material resources for the provision of care for clients (individual,
their families, and groups).
2. Collaborate with clients (individual, their families, and groups) and the interdisciplinary
health care team for the planning and delivery of care.
3. Refer clients (individual, their families, and groups) to resources that facilitate continuity
of care.
4. Function as a facilitator within the organizational structure of various health care
settings.
C. Member of a Profession:
1. Assume accountability and responsibility for the quality of nursing care provided to
clients (individual, their families, and groups).
2. Serve as health care advocate in monitoring and promoting access to and quality of
health care for clients (individual, their families, and groups).
3. Act as a leader in promoting nursing as a profession.
DIFFERENTIATED
ENTRY LEVEL
COMPETENCIES
Competencies of New Graduates
(definitions of “client “ for VN, Diploma/ ADN, and BSN at bottom of each page)
Provider of Care
VN
1. Assist in determining the health status
and health needs of clients* based on
interpretation of health- related data &
preventive health practices, in collaboration with clients*, their families,
and other members of the immediate
health care team.
Knowledge
A Four steps in a systematic process (i.
e. nursing process) which include
assessment, planning,
implementation, and evaluation.
B Basic components of nursing
diagnoses (e. g. North American
Nursing Diagnosis Association).
C Structured data collection tools and
techniques of assessment of clients*
inclusive of interviewing.
D Characteristics, concepts, and
processes related to clients*,
including anatomy and physiology;
physical and psychosocial growth and
development; pathophysiology and
psychopathology; ethical reasoning;
and cultural and spiritual beliefs and
practices related to health, illness,
birth, death and dying.
E Basic characteristics, concepts, and
processes related to transmission of
common communicable diseases
including individual risk factors
and preventive health practices.
Diploma/ ADN
1. Determine the health status and
health needs of clients* based upon
interpretation of health data &
preventive health practices in
collaboration with clients* and
interdisciplinary health care team
members.
Additional Knowledge
A Five steps of a systematic process,
which includes assessment, analysis,
planning, implementation and
evaluation.
B Classification system for nursing
diagnoses (e. g. North American
Nursing Diagnosis Association).
C Structured and unstructured data
collection tools and techniques for
assessment of clients*.
D Characteristics, concepts, and
processes related to disease
transmission, risk factors, preventive
health practices and their
implications for selected populations
and community resources.
BSN
1. Determine the health status and
health needs based on expanded
interpretation of health- related data &
preventive health practices in
collaboration with clients* and the
interdisciplinary health care team.
E
E
Characteristics, concepts, and
processes related to disease
transmission, risk factors, preventive
health practices and their implications for selected populations and
community resources.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
Additional Knowledge
A Systematic processes, including
nursing, epidemiologic, psychosocial,
and management.
B
C
D
Analysis of nursing, epidemiologic,
social data to draw inferences and
conclusions.
Components of comprehensive
databases & methods for collecting
data, health screening & case finding.
Characteristics, concepts, and
processes related to clients*
including history, statistics,
humanities, genetics, logical & ethical
reasoning.
Characteristics, concepts, and
processes related to communities,
including epidemiology, risk factors
and preventive health practices and
their implications for vulnerable
populations, resources and resource
assessment techniques, environmental factors and social
organizations.
Each educational level assumes previously stated competencies
VN
F Medical & other interdisciplinary
diagnoses & therapeutic interventions
for the client*.
Diploma/ ADN
F Medical diagnoses, pharmacotherapeutics and other therapies and
treatments.
G Introduction to established theories,
models and approaches that guide
nursing practice.
H Characteristics, concepts and
processes related to families,
including family development,
structure and function; family
communication patterns; and
decision- making structures.
I
Technologic applications.
J
Introduction to complex and multisystem healthcare problems.
K
Clinical Behavior/ Judgements
A Take client* history using structured
assessment tool.
B
Perform basic assessment to assist
identifying health status and monitor
change.
Political, economic and societal
forces affecting the health of
individuals and families.
Additional Clinical Behavior/ Judgements
A Take client* history using structured
and unstructured data collection
tools to obtain physical, psychosocial, spiritual, cultural, familial,
occupational, environmental
information, risk factors, and client*
resources.
B Perform assessment to identify
health needs and monitor for change
in health status.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
BSN
F Common medical diagnoses, drug
and other
G
Nursing theories, research findings
and a variety of interdisciplinary
models to guide nursing practice.
H Functional and dysfunctional
characteristics, concepts and
processes related to clients*,
including family development,
structure and decision-making
structures.
I Information systems.
J Complex and multi- system health
care problems, integrating traditional
and complementary healthcare
practices, and interventions and
solutions for the client*.
K “Global environment in which
healthcare is provided.” Comp. #4,
p. 6, South Carolina Colleagues in
Caring, 2000.
Additional Clinical Behavior/ Judgements
A Expand and modify data collection
tools.
B
Perform comprehensive assessment
to include factors impacting health
status and health needs of clients*.
Each educational level assumes previously stated competencies
VN
Clinical Behavior/ Judgements
C Report and document assessment
data.
Diploma/ ADN
Additional Clinical Behavior/ Judgements
C Validate, report, and document
assessment data using assessment
tools.
D Identify complex multi- system
health care problems of clients*.
BSN
Additional Clinical Behavior/ Judgements
C Evaluate usefulness of traditional and
complementary health care practices.
D
Identify common actual and potential
health care needs of clients*.
E
Make observations that assist the RN
in formulating nursing diagnosis.
E
Formulate nursing diagnoses based
upon analysis of health data.
E
F
Assist with health screening.
F
Perform health screening.
F
G
Analyze and interpret health data of
clients*.
G
H
Incorporate multiple determinants of
health in clinical care when providing
care for individuals and families.
Recognize that political, economic
and societal forces affect the health
of clients*.
H
I
D
I
J
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
Incorporate research findings in the
Identification of complex multisystem health care problems of
clients*.
Formulate nursing diagnoses based
on analysis of comprehensive
assessment.
Perform health screening and case
finding & identify links between
health, lifestyles, prevention and cost
of healthcare.
“Relate assessment findings to
underlying pathology or physiologic
changes in the client’s * condition.”
Comp. #3, p. 4, South
CarolinaColleagues in Caring, 2000.
Integrate and synthesize the multiple
determinant of health in clinical care
of clients*.
Examine populations at risk from
epidemiological, social and
environmental perspectives.
“Use epidemiological, social and
environmental data to draw
inferences about the health status of
populations.” Comp. #9, p. 11, South
Carolina Colleagues in Caring, 2000.
Each educational level assumes previously stated competencies
Provider of Care
VN
Diploma/ ADN
BSN
2. Assist in the formulation of goals/
2. Formulate goals/ outcomes and plan
2. Formulate goals/ outcomes and plan
outcomes and a plan of care in
of care based on nursing diagnoses in
of care using an evidence- based and
collaboration with the client*, their
collaboration with clients* and
theoretical analysis of available data in
families, and interdisciplinary health care interdisciplinary health care team
collaboration with client* and inter team members.
members.
disciplinary health care team members.
Knowledge
Additional Knowledge
Additional Knowledge
A Dynamics of the nurse- client*
A Principles of establishing nurseA Models for understanding the
relationship.
client* relationship.
dynamics of the nurse- client*
relationship.
B Written verbal and non- verbal
B Techniques of written, verbal, and
B Communication theory.
modes of communication including
nonverbal communication including
information technologies.
information technologies.
C Fundamental principles of disease
C Principles of disease prevention,
C Principles of epidemiology and
prevention, health promotion/
health promotion, education and
genetics.
restoration for clients*.
rehabilitation for clients*.
D Basic interventions to support the
D Clinical practice guidelines as a basis D Interdisciplinary interventions,
client* and family during life stages,
of interventions to support client*
including nursing care across all
including end- of- life care.
throughout the life span, including
settings.
end- of- life care.
E Relationships between the nursing
E Collaborative aspects of the
E Collaborative aspects of the
plan of care, the therapeutic
relationship between the nursing
relationship between the nursing plan
regimen, the plan of interdisciplinary
plan of care, the therapeutic
of care, the plan of interdisciplinary
health care team members, and cost
regimen, the plan of interdisciplinary
health care team members and cost
factors.
health care team members, and cost
factors in multiple settings.
factors.
F Criteria for setting priorities in
F A systematic approach for setting
F A variety of systematic approaches
planning and evaluating care.
priorities and strategies for
for problem solving and decision
coordinating plan of care.
making for care planning.
G Steps and procedures in discharge
G Strategies for collaborative discharge G Research findings related to nursing
planning
planning.
care and collaborative discharge
process.
planning.
H Principles of humanities & natural,
H Relationship of humanities & natural,
social, and behavioral sciences
social, and behavioral sciences as
applied to the care planning for
applied to care planning for clients*.
clients*.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
Each educational level assumes previously stated competencies
VN
Clinical Behavior/ Judgements
A Identify short- term goals/ outcomes,
select basic interventions, and
establish priorities for care in
collaboration with the client*.
B Contribute to the development of
nursing plan of care.
C
D
Identify obvious conflicts between
the nursing plan of care and the plan
of interdisciplinary health care team
members.
Participate in discussion of plan of
care with interdisciplinary health care
team members.
Diploma/ ADN
Additional Clinical Behavior/ Judgements
A Identify short and long- term goals/
outcomes, select interventions, and
establish priorities for care in
collaboration with the client*.
B Use current technology and
evidence- based information to
formulate and modify the nursing
plan of care.
C Contribute to the interdisciplinary
plan of care.
BSN
Additional Clinical Behavior/ Judgements
A Establish short term and long term
goals/ outcomes and plan care with
clients* and the interdisciplinary
team.
B Assist in the development of clinical
practice guidelines & coordinate
plans of care with the interdisciplinary health care team.
C Collaborate with multiple providers to
plan for obtaining diverse services for
clients*.
D
Communicate plan of care to nurses
and other interdisciplinary health
care team members.
D
E
Assist in the discharge planning of
selected clients*.
E
Initiate discharge planning in
collaboration with interdisciplinary
health care team.
E
F
“Recognize cost of care for nursing
interventions.” Comp. #10, p. 11,
South Carolina Colleagues in Caring,
2000.
F
Implement cost effective care.
F
G
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
Collaborate in developing goals for
community-based programs whose
primary goal is health promotion or
health restoration.
Participate in the research process
and use inter-preted research
findings to plan, implement, and
evaluate discharge plans.
Demonstrate fiscal accountability for
health care.
Integrate theory and research-based
knowledge from arts, humanities and
sciences for the direct and indirect
delivery of client * care..
Provider of Care
VN
3. Implement plan of care within legal
and ethical parameters, including scope
of education, in collaboration with the
client* and interdisciplinary health care
team to assist client* in meeting health
care needs.
Knowledge
A Common health practices and
behaviors of clients related to
developmental level, gender,
cultures, belief systems, and the
environment.
B Methods of therapeutic communication.
Diploma/ ADN
Implement plan of care within legal and
ethical parameters, including scope of
practice, in collaboration with the client*
and interdisciplinary health care team to
assist client* in meeting health care
needs.
Additional Knowledge
A Health practices and behaviors of
clients* related to developmental
level, gender, cultures, belief
systems, and the environment.
BSN
Implement plan of care within legal and
ethical parameters, including scope of
practice, in collaboration with the client*
and interdisciplinary health care team to
assist client* in meeting health care
needs.
Additional Knowledge
A Healthy lifestyles; early
manifestations of disease.
B
Patterns and modes of therapeutic
communication and collaboration
including conflict resolution and
negotiation.
Rights and responsibilities of clients*
related to health care.
B
Physiological and psychosocial
(spiritual, cultural, gender,
developmental level, financial)
aspects of nursing interventions.
Principles and factors that contribute
to the maintenance or restoration of
health.
Principles and rationale underlying
the use, administration, and
interaction of pharmacotherapeutic
agents, including intravenous
medications.
Management of the client’s*
environment.
Principles and strategies of stress
management and crisis intervention.
D
C
Basic rights and responsibilities of
clients* related to health care.
C
D
Basic physiological and psychosocial
(spiritual, cultural, gender,
developmental level, financial)
aspects of nursing interventions.
Fundamental principles and factors
that contribute to the maintenance or
restoration of health.
Properties, effects, and basic
principles underlying the use and
administration of
pharmacotherapeutic agents.
D
Basic principles of safety.
G
E
F
G
H
E
F
Coping mechanisms for managing
H
stress and identifying resources for
crisis management.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
C
E
F
G
H
Patterns and modes of therapeutic
communication, assertiveness,
negotiation, delegation, and
collaboration
Modes for advocating for client*
rights and
responsibilities.
Holistic understanding and
approaches to healthcare; including
health promotion & preventive
practices.
Research findings of factors that
contribute to the maintenance or
restoration of health.
Factors impacting clients’* responses
to pharmacotherapeutic agents from
research and clinical trials.
Environmental management and
risk management.
Theories and models of stress and
crisis responses and management.
Each educational level assumes previously stated competencies
VN
I
Code of vocational nurse ethics.
Diploma/ ADN
I
Code of ethics and framework for
ethical decision- making.
J
Legal parameters of vocational
nursing practice and health care.
J
Legal parameters of professional
nursing practice and health care.
K
Available resources within the
employment setting.
K
Interdisciplinary resources and
organizational relationships.
L
Key federal and state statutes and
institutional policies regarding client*
confidentiality.
Basic nursing procedures and skills
to implement plan of care.
L
Issues and factors impacting
confidentiality.
M
Nursing procedures and skills to
implement plan of care.
N
Decision- making, problem solving
and critical thinking processes.
M
Clinical Behavior/ Judgements
A Assist in promoting a safe, effective
care environment conducive to the
optimal health and dignity of the
client*.
B Implement plan of care to assist
client to meet basic physiologic
needs including: circulation,
nutrition, oxygenation, activity,
elimination, comfort, pain
management, rest and sleep.
C Implement nursing interventions to
promote health and rehabilitation.
Additional Clinical Behavior/ Judgements
A Promote a safe, effective
environment conducive to the
optimal health and dignity of the
client*.
B Implement plan of care to assist
clients* to meet physiological needs,
including: circulation, nutrition,
oxygenation, activity, elimination,
comfort, pain management, rest and
sleep.
C Implement nursing care to promote
health and manage acute and
chronic health problems and
disabilities.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
BSN
I
Ethical practices, current issues, and
client’s* rights in the health care
delivery system.
J Legal standards and implications for
nursing care in multiple health care
delivery settings.
K Structure, function and utilization of
health care delivery system
resources.
L Information systems management
consistent with principles of
confidentiality.
M Nursing interdisciplinary
interventions to promote health,
prevent problems & provide care.
N Research processes & logical
reasoning.
O Relationships between the health
care delivery system and other social
systems.
Additional Clinical Behavior/ Judgements
A Manage environmental risks to
address health issues of clients*.
B
Implement plan of care to assist
clients* and vulnerable populations
to meet comprehensive health care
needs in multiple settings.
C
Assist clients* to learn skills that
promote & protect health in multiple
settings.
Each educational level assumes previously stated competencies
VN
D Initiate basic interventions in
emergency situations.
E
F
Initiate basic nursing interventions to
foster client’s* psychosocial wellbeing.
Foster client* coping mechanisms
during alterations in health status.
Diploma/ ADN
D Adjust priorities and implement
nursing interventions in emergency
situations.
E Initiate nursing interventions to
promote client’s* psychosocial wellbeing.
F Facilitate the development of client*
coping mechanisms during
alterations in health status.
BSN
D Manage care based on rapidly
changing priorities.
G
G
Administer medications and
treatments and perform procedures
safely.
G
H
Monitor, document, and report responses to medications, treatments,
and procedures and communicate
the same to other health care
professionals clearly and accurately.
H
I
Perform therapeutic and preventive
nursing measures and administer
treatments and medications as
authorized by law and determined by
the BNE.
Evaluate, document, and report
responses to medications, treatments, and procedures and communicate the same to other health
care professionals clearly and
accurately.
Collaborate with other health care
providers with treatments and
procedures.
Inform and support health care
rights of clients*.
Use interdisciplinary resources within
the institution to address ethical and
legal concerns.
Utilize therapeutic communication
skills when
interacting with clients*.
Assist interdisciplinary health care
I
team members with examinations
and routinely performed procedures.
J
Observe and communicate Patient’s
J
Bill of Rights to clients*.
K Recognize and communicate ethical
K
and legal concerns through established channels of communication.
L Utilize basic therapeutic
L
communication skills
when interacting with clients*.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
E
Provide nursing & interdisciplinary
interventions to promote well- being.
F
Use research findings to facilitate the
development of client* coping
mechanisms during alterations in
health status.
Use epidemiologic process to manage
and reduce risks related to medi cation & treatment administration
and modify techniques in a variety of
settings.
Use research findings to assist in the
development of clinical practice
guidelines.
H
I
J
K
L
Promote interdisciplanary team
collaboration in carrying out the plan
of care.
Evaluate and clarify client’s*
understanding of health care rights.
Use institutional, community &
scholarly resources to address ethical
and legal concerns.
Apply communication theory &
techniques in maintaining
professional relationships.
Each educational level assumes previously stated competencies
VN
M Report unsafe practices
N
O
Use current technology to enhance
direct client* care.
Maintain client* confidentiality.
Diploma/ ADN
M Participate in peer review and quality
improvement processes.
N Use current technology to enhance
client* care.
O Act as a role model in maintaining
client* confidentiality.
P
Assume accountability when using
independent clinical judgement and
established protocols.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
BSN
M Manage personnel to maintain safe
practice.
N Manage the use of technology to
enhance client* care.
O Facilitate maintenance of client*
confidentiality by interdisciplinary
team members.
P Assume accountability by performing
nursing procedures safely and
effectively using current research
findings.
Q Provide direct and indirect care in
community-based programs whose
primary goals are health prevention,
promotion, or restoration.
R “Participate in healthy communities
initiatives.” Comp. #8, p. 10, South
Carolina Colleagues in Caring, 2000.
S “Implement health risk appraisal for
diverse communities.” Comp. #8, p.
10, South Carolina Colleagues in
Caring, 2000.
Each educational level assumes previously stated competencies
Provider of Care
VN
4. Implement teaching plan for client*
with common health problems and well
defined learning needs.
Knowledge
A Developmental stages and common
situational variables affecting
learning, such as stress, pain and
fear.
B Basic principles of the teaching/
learning process.
C
“Links between healthy lifestyles,
prevention and cost of healthcare.”
Comp. #8, p. 9, South Carolina
Colleagues in Caring, 2000.
Diploma/ ADN
4. Develop and implement teaching
plans for clients concerning promotion,
maintenance, and restoration of health.
Additional Knowledge
A Developmental stages and socio/
cultural variables affecting the
teaching/ learning process.
BSN
4. Develop and implement comprehensive teaching plans to meet the
learning needs of clients*.
Additional Knowledge
A Techniques for assessment of
learning needs
and factors affecting learning.
B
Principles, methods, strategies and
outcomes of learning and teaching.
B
C
Knowledge of community resources
related to teaching/ learning.
C
D
Clinical Behavior/ Judgements
A Identify basic health-related learning
needs of clients*.
B
Contribute to the development of a
teaching plan.
C
Implement aspects of an established
teaching
plan.
D
Additional Clinical Behavior/ Judgements
A Identify learning needs of clients*
related to health promotion,
maintenance and risk reduction.
B Collaborate with others to develop
and modify individualized teaching
plans based upon developmental and
health care learning needs.
C Individualize and implement
established teaching plans.
Assist in evaluation of learning
D Evaluate learning outcomes of the
outcomes using structured evaluation
client* receiving instruction.
tools.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
Learning theories & approaches for
evaluating methods, strategies, and
outcomes of learning and teaching.
Research findings related to
teaching/ learning.
Methods for advocating for client*
health..
Additional Clinical Behavior/ Judgements
A Assess genetic, protective and
predictive factors that influence the
health of clients*.
B Use current evaluation literature and
evidence-based findings in
developing and modifying
teaching plans and strategies.
C Design and implement comprehensive teaching plan for
promotion, maintenance and
restoration of health.
D Evaluate learning outcomes of
comprehensive teaching plans.
Each educational level assumes previously stated competencies
VN
E “Teach basic health promotion/
maintenance & selfcare to individuals
from a designated teaching plan.”
Comp. #8, p. 9, South Carolina
Colleagues in Caring, 2000.
F Provide the client* with the
information needed to make choices
regarding health.
Diploma/ ADN
E Modify teaching methods to
accommodate client* differences.
BSN
E Modify teaching methods for
vulnerable populations.
F
F
“Implement risk reduction strategies
to address social and public health
issues.” Comp. #8, p. 9, South
Carolina Colleagues in Caring, 2000.
G
Advocate for health education,
healthy lifestyles, & early detection
and treatment of disease, including
vulnerable populations.
G
“Apply knowledge of how changes in
clients’* personal behavior improve
client’s* health.” Comp. #8, p. 9,
South Carolina Colleagues in Caring,
2000.
Serve as model & resource for health
education & information.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
Provider of Care
VN
5. Assist in the evaluation of the client’s*
responses and outcomes to therapeutic
interventions.
Knowledge
A Common methods for measuring
client* responses and health goal
attainment.
Diploma/ ADN
5. Evaluate clients’* responses and
outcomes to therapeutic interventions.
BSN
5. Evaluate clients’* responses and
outcomes to therapeutic interventions.
Additional Knowledge
A Methods for evaluating clients’*
responses to interventions and
client* outcomes.
Clinical Behavior/ Judgements
A Using standard references, compare
expected and achieved outcomes of
nursing care.
B Identify and communicate reasons
for deviations from plan of care.
Additional Clinical Behavior/ Judgements
A Modify plan of care and/ or expected
outcomes.
Additional Knowledge
A Systematic processes to design
methods to evaluate clients’*
response to interventions & client*
outcomes.
B Reliability & validity of evaluation
tools.
C Performance improvement concepts
and research/evaluation outcome
measures to evaluate efficacy and
effectiveness of care.
Additional Clinical Behavior/ Judgements
A Alter plan of care for client* based on
research &evaluation data.
B
B
C
Analyze client* data to compare
expected and achieved outcomes for
client*.
C
Evaluate and communicate quality
and effectiveness of therapeutic
interventions.
Use evaluation tools to measure
processes and outcomes.
D
Identify and communicate reasons
and rationales for deviation from plan
of care to interdisciplinary health
care team.
D
Use research findings, clinical trials
and a variety of systematic processes to compare expected and
achieved outcomes for client*.
Use research findings to explain
deviations from plan of care to
interdisciplinary health care team.
D
B
Basic tools to evaluate specific
nursing interventions.
B
C
E
Common methods to evaluate health
care processes.
An introduction to performance
improvement concepts.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
C
E
Collaborate with interdisciplinary
health care team to promote quality
& effectiveness of care.
Analyze, select, and use a variety of
reliable and valid evaluation tools
and methods to measure processes
and outcomes.
Assist in modifying plan of care and/
or expected outcomes.
Report and document client’s*
responses to nursing interventions.
Each educational level assumes previously stated competencies
Provider of Care
VN
6. Provide direct basic care to assigned
multiple clients* in structured settings.
Knowledge
A Institutional policies and procedures
for delivery of nursing care.
B Basic characteristics, trends, and
issues of health care delivery.
C Basis for determining nursing care
priorities in client* care.
D Scope of responsibilities and
accountability for supervision and
collaboration.
E
Channels of communication for
decision- making processes within
the work setting.
Clinical Behavior/ Judgements
A Identify priorities and make
judgments concerning basic needs of
multiple clients* in order to organize
care.
B Implement plans of basic care for
multiple clients*.
C
Diploma/ ADN
6. Provide for the care of multiple
clients* either through direct care or
assignment and/ or delegation of care to
other members of the health care team.
Additional Knowledge
A Standards of Care; Standards of
Practice.
B Characteristics, trends and issues of
health care delivery.
C Principles for determining priorities
and organization of nursing care.
D Principles of delegation, supervision,
collaboration including delegation
rules from Texas Nursing Practice
Act.
E Principles of decision making.
BSN
6. Provide for the care of multiple
clients* either through direct care or
assignment and/ or delegation of care to
other members of the health care team.
Additional Knowledge
A Resource management and
organizational behavior.
B Models for health care delivery in
organizations and communities.
C Models of priority setting and
organization.
D Systems of nursing care delivery.
Additional Clinical Behavior/ Judgements
A Identify priorities and make judgements concerning the needs of
multiple clients* in order to organize
care.
B Manage care for multiple clients*.
Additional Clinical Behavior/ Judgements
A Manage priorities in providing care
for multiple clients*.
C
C
Apply management concepts in
assigning and/ or delegating nursing
care to other members of the
nursing team.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups.
E
B
Decision- making processes within
organizations and in communities.
Collaborate across settings to ensure
that healthcare needs are met,
including primary and preventive
health care.
Use management models in
assigning and/ or delegating nursing
care to other members of the
nursing team in a variety of settings.
Each educational level assumes previously stated competencies
Provider of Care
VN
7. Use the problem solving approach as
the basis for decision making in practice.
Knowledge
A A systematic problem- solving
process.
B
Establishing priorities.
C
Work setting resources available to
assist in decision making.
D
Examples of how nursing research
improves client* care.
Clinical Behavior/ Judgements
A Use problem- solving approach to
make decisions regarding care of
assigned clients*.
Diploma/ ADN
7. Use a critical thinking approach to
analyze clinical data and current
literature as a basis for decision making
in nursing practice.
Additional Knowledge
A A conceptual framework of nursing
practice as a means of planning care
and solving clinical problems.
B Critical thinking and decisionmaking processes.
C Application of current literature and/
or interpreted research findings in
improving client* care.
D Mechanisms for accessing and
evaluating current literature.
E Principles of change.
Additional Clinical Behavior/ Judgements
A Use systematic approaches for
decision making, including nursing,
epidemiological research, political,
social, and legal processes.
B Proactively manage priorities based
on emerging data.
B
Organize care based upon problem
solving and identified priorities.
C
Identify and communicate client*
care problems encountered in
practice.
C
D
Use resources within the work setting
to assist in decision making.
D
Use knowledge of societal trends and
current research findings to identify
and communicate client* care
problems.
Analyze and incorporate research
findings/ studies into nursing
practice.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
BSN
7. Use an evidence based analytical
approach as the basis for decision
making in practice.
Additional Knowledge
A Nursing framework, theories, and
models that relate to managing
health care delivery.
B Logical reasoning and the research
process.
C Research utilization.
D
Research/ evaluation methodologies.
E Change Theory.
Additional Clinical Behavior/ Judgements
A Use critical thinking as a basis for
decision making in nursing practice.
B
C
D
Prioritize client* care and follow- up
on problems that warrant investigation.
Use knowledge of societal trends to
identify and communicate client*
care problems.
Read and discuss relevant, current
nursing practice journal articles and
apply to practice.
Each educational level assumes previously stated competencies
Coordinator of Care
VN
Clinical Behavior/ Judgements
A Participate in discussion relating to
the evaluation of client* care with
members of the interdisciplinary
health care team.
B Identify providers & others who can
assist in client* care.
Diploma/ ADN
Additional Clinical Behavior/ Judgements
A Participate in the evaluation of care
Administered by the interdisciplinary
health care team.
B
C
D
E
F
Consult with, utilize and make
referrals to community agencies and
health care resources to provide
continuity of care.
Use organizational & management
skills when utilizing resources to
meet goals/ outcomes, & enhance
quality of nursing care and level of
client* satisfaction.
Use negotiation skills for the purpose
of achieving positive client*
outcomes.
Participate in interdisciplinary health
care team meetings/ conferences.
Apply change strategies to achieve
stated outcomes.
BSN
I Formal and informal organization
structure
and behavior.
Additional Clinical Behavior/ Judgements
A Assume leadership role to evaluate
the effectiveness of care provided by
the interdisciplinary health care
team.
B Use care management & case
management models for coordinating
delivery of health care services
across levels of care.
C Apply leadership and management
concepts in assisting the interdisciplinary health care team to
implement client’s* care.
D
Advocate for resources to meet
client’s* health needs.
E
Provide leadership at interdisciplinary
health care team meetings/
conferences.
Use change theory for effective &
efficientresource management.
Apply theories that facilitate health
care, organizational, and client*
goals.
F
G
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
Each educational level assumes previously stated competencies
Coordinator of Care
VN
2. Collaborate with clients* and the
Interdisciplinary health care team to
provide direct care to assigned individual
clients*.
Knowledge
A Basic structure and function of the
health care delivery system.
Diploma/ ADN
2. Collaborate with clients* and the
interdisciplinary health care team for the
planning and delivery of care.
BSN
2. Collaborate with clients* and the
interdisciplinary health care team for the
planning and delivery of care.
Additional Knowledge
A Structure, function, and interdisciplinary relationships within the
health care delivery system.
B Patterns and modes of effective
communication and collaboration
including conflict resolution and
negotiation.
Additional Knowledge
A Social, economic and political
processes impacting on health care
delivery systems.
B Modes of effective communication,
assertiveness, negotiation, delegation, and collaboration;
organization theories/ group
dynamics.
C Role theory, management and
leadership theory.
B
Methods of effective communication.
C
Roles of all levels of nursing and
other health care professionals.
C
Client* advocacy and consumer
rights and responsibilities.
Clinical Behavior/ Judgements
A Work with client and interdisciplinary
health care team for planning health
care delivery to improve the quality
of care across the life span.
B Promote the effective coordination of
client*-centered health care.
D
D
Principles of team management
& leadership.
Legal/ ethical processes related to
healthcare.
Additional Clinical Behavior/ Judgements
A Use models of health care delivery to
plan and improve healthcare across
the life span.
Political, legislative, legal & ethical
processes related to healthcare.
Additional Clinical Behavior/ Judgements
A Work with interdisciplinary health
care team members to provide
client* care across the life span.
B
B
Provide leadership in the effective
coordination of client* centered
health care.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
D
Participate in client* care planning
with clients*, their families and
interdisciplinary health care team
members.
Each educational level assumes previously stated competencies
VN
3. Participate in the identification of
client* needs for referral to resources
that facilitate continuity of care.
Knowledge
A Work setting and major community
resources.
B
Roles of family and significant others
in providing support to the individual.
Diploma/ ADN
3. Refer clients* to resources that
facilitate continuity of care.
BSN
3. Refer clients* to resources that
facilitate continuity of care.
Additional Knowledge
A Institutional and community
resources including agencies/
services and health care providers.
B Roles of family and significant others
in response to alterations in health
status.
C Referral processes.
Additional Knowledge
A Services and functions offered by
referral resources.
D
Issues and trends in health care
delivery.
Clinical Behavior/ Judgements
A Assess the adequacy of the support
system of the client*.
Additional Clinical Behavior/ Judgements
A Advocate on behalf of the client*
with other members of the interdisciplinary health care team to
procure resources for client* care.
B
Identify providers and resources to
meet the needs of clients*.
B
Work with family & community
resources to develop/ strengthen
support systems for client*.
C
Facilitate communication between
client* and institutional or
community resources.
C
Assess demographic trends & their
implications.
D
Assist client* to communicate needs
to his/her support systems and other
health care professionals.
B
C
Methods for improving access to
health care.
D Implications of demographic data on
the changing needs for health care
resources and services.
Additional Clinical Behavior/ Judgements
A Assume a leadership role to advocate
on behalf of the client* with other
members of the interdisciplinary
health care team to procure
resources for client* care.
B Based on demographic changes,
advocate for public policies to
support health care access for
vulnerable populations.
C Identify support systems of the
client*.
D
E
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
Roles and functions of multidisciplinary healthcare professionals.
Identify major community resources
that can assist in meeting client*
needs.
Communicate client* needs to family
or significant others and appropriate
members of the health care team.
Each educational level assumes previously stated competencies
Coordinator of Care
VN
4. Participate in activities which support
the organizational framework of
structured health care settings.
Knowledge
A Organizational mission, vision, and
values as a framework for care.
B
C
Lines of authority and accountability
within structured health care
settings.
Methods for promoting safety in the
work environment.
Diploma/ ADN
4. Function within the organizational
framework of various health care
settings.
Additional Knowledge
A Organizational mission, vision and
values as a framework for
management.
B Types of organizational frameworks
of various health care settings.
BSN
4. Function as a facilitator within the
organizational structure of various health
care settings
Additional Knowledge
A Organizational mission, vision and
values as a framework for leadership.
B
Organizational theories/ principles of
organizational behavior.
C
Methods for promoting safety in the
work environment consistent with
current Federal/ State/local
regulations and guidelines.
RN’s role in risk management.
C
Environmental management.
D
Key issues related to budgetary
constraints impacting the use of
resources.
Basic principles of management and
communication within an
organization.
Relationships among members of the
interdisciplinary health care team.
E
Nurse’s leadership role in risk
management.
Economics of health care.
Individual and group responses to
organizational change.
Strategies for initiating and
facilitating change within the work
setting.
H
D
VN’s role in risk management.
D
E
VN’s role in implementing established
cost containment measures.
E
F
G
H
I
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
F
Leadership and management theory,
practice and skills.
G
Roles and functions of interdisciplinary team members within
various health care delivery systems.
Change agent role.
I
Strategies for initiating and facilitating change within the
organization.
Each educational level assumes previously stated competencies
VN
Clinical Behavior/ Judgements
A Identify and participate in activities
to improve health care delivery
within the work setting.
Diploma/ ADN
Additional Clinical Behavior/ Judgements
A “Use basic management and leadership skills, act as a team leader,
supervise and delegate care and
contribute to shared goals.” Comp.
#17, p. 19, South Carolina
Colleagues in Caring, 2000.
B
Report the need for corrective action
within the organization.
B
C
Select human and material resources
that are optimal, legal, and cost
effective to achieve organizational
goals.
C
D
Analyze the management structure
and nursing care delivery system
within a health care organization and
recommend changes for
improvement.
Design and implement strategies to
respond to the need for corrective
action.
Collaborate with interdisciplinary
health care team to utilize human
and material resources that are
optimal, legal, and cost efficient.
BSN
Additional Clinical Behavior/ Judgements
A “Use management, leadership,
teambuilding and administrative
skills; organize, manage and
evaluate the functioning of groups of
individuals and staff.” Comp. #17, p.
19, South Carolina Colleagues in
Caring, 2000.
B Demonstrate a beginning leadership
role in achieving management goals.
C
Assist with the development of
standards of care congruent with
organizational structure and goals.
D
Participate in implementing changes
that lead to improvement in the work
setting.
E
Report unsafe client* care
environment and equipment.
Implement established cost
containment measures in direct
client* care.
F
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
Each educational level assumes previously stated competencies
Member of a Profession
VN
1. Demonstrate accountability for own
nursing practice.
Knowledge
A Code of ethics for the licensed
vocational nurse.
B Standards of vocational nursing
education.
C Legalities of vocational nursing
practice.
D
Diploma/ ADN
1. Assume accountability and
responsibility for the quality of nursing
care provided to clients*.
Additional Knowledge
A Code of ethics for nurses.
B
C
D
F
Issues affecting the vocational nurse
role and the delivery of client* care.
Sources of continuing education and
professional development.
Self- evaluation process.
G
Work setting policies and procedures.
G
H
Professional boundaries.
H
E
E
F
I
Standards of nursing practice and
care.
Legal parameters of nursing practice
including the Texas Nursing Practice
Act.
Issues affecting the RN role and the
delivery of client* care.
Career development options for
professional development.
Self- evaluation, staff evaluation and
peer evaluation processes.
Methods for the development of
policies/ procedures.
Communication techniques and
management skills to maintain
professional boundaries.
Basic principles of performance
improvement and outcome
measurement.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
BSN
1. Assume accountability and
responsibility for the quality of nursing
care provided to clients*.
Additional Knowledge
A Ethical codes and principles of ethical
decision making; advocacy process.
B Process for the development of
standards of care and practice.
C Legal principles & practice theories &
principles relative to health care.
D
E
F
G
H
I
Issues affecting the BSN role and the
delivery of client* care.
Principles of staff development.
Human resource management &
performance evaluation processes.
Role of committees in the development of health care policies &
procedures; “communication skills in
the area of writing, speaking and
presenting as required to function in
leadership positions.” Comp. #17, p.
19, South Carolina Colleagues in
Caring, 2000.
Leadership and role modeling to
maintain professional boundaries.
Principles and tools of performance
improvement and outcome measurement in systems of care delivery.
Each educational level assumes previously stated competencies
VN
Clinical Behavior/ Judgements
A Provide nursing care within limits of
professional nursing knowledge,
education, experience, and ethical/
legal standards of care.
B
“Provide holistic care that addresses
the needs of diverse individuals
across the life span.” Comp. #12, p.
13, South Carolina Colleagues in
Caring, 2000.
C
Evaluate the learning needs of self,
peers, or others and intervene to
assure quality of care.
D
Promote accountability for quality
nursing practice through participation
on policy & procedure committees.
Delegate/ assign to other health care
providers within legal parameters
and evaluate delivery of care.
E
F
Diploma/ ADN
Additional Clinical Behavior/ Judgements
A “Advocate for standards of practice
using professional, organizational &
political processes.” Comp. #18, p.
20, South Carolina Colleagues in
Caring, 2000.
B “Use knowledge of cultural
differences and vulnerable
populations to collaborate with
clients* to provide health care that is
sensitive to and consistent with their
cultural values, beliefs, customs and
special needs.” Comp. #12, p. 13,
South Carolina Colleagues in Caring,
2000.
C Promote the development of health
care staff member learning needs
based on strategic planning
priorities.
D Apply research findings and
principles of research to enhance
evidence- based practice.
E “Use information from multiple
sources in order to collaborate,
negotiate, coordinate, delegate and
evaluate delivery of care.” Comp.
#17, p. 19, South Carolina
Colleagues in Caring, 2000.
F Use leadership and role modeling
skills to promote professional
boundaries among the members of
the interdisciplinary team.
Use communication techniques and
management skills to maintain
professional boundaries between
clients* and individual health care
team members.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
BSN
Additional Clinical Behavior/ Judgements
A Provide nursing care within limits of
vocational nursing knowledge,
education, experience, and ethical/
legal standards of care.
B
Provide nursing care in a caring,
nonjudgmental, nondiscriminatory
manner.
C
Use self- evaluation process to
improve own nursing practice.
D
Assume accountability for own
nursing practice.
E
Follow established policies and
procedures.
F
Maintain professional boundaries in
the nurse/patient relationship.
Each educational level assumes previously stated competencies
Member of a Profession
VN
2. Participate as an advocate in activities
that focus on improving the health care
of clients*.
Knowledge
A Rights and responsibilities of clients*
regarding health care, including selfdetermination.
B Individual responsibility for quality of
nursing care.
Diploma/ ADN
2. Act as an advocate to promote the
provision of quality health care for
clients*.
Additional Knowledge
A Current issues and legal principles
relating to safeguarding client*
rights.
B Role of the nurse as client*
advocate.
C
Role of nurse in quality
improvement/ quality
assurance process.
C
Role of organizational committees,
peer review committee, nursing
organizations, and community
groups involved with improving the
quality of health care for clients*.
D
Responsibility for reporting to
licensing and public protective
agencies.
D
Role/ responsibility for public safety
and welfare.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups.
BSN
2. Serve as health care advocate in
monitoring and promoting access to and
quality of health care for clients*.
Additional Knowledge
A Economic, legal, and political factors
that influence health care delivery
and client* rights
B Research and theories related to
access to health care, including
vulnerable populations.
C Leadership role in organizational
committees, peer review committee,
nursing organizations, and
community groups involved with
improving the quality of health care
for clients*.
D Health care policies and regulations
related to public safety and welfare
and professional workforce
development.
E Formal and informal sources of
power and negotiation processes.
F Historical development of the
professional advocacy groups and the
growth of consumerism.
Each educational level assumes previously stated competencies
VN
Clinical Behavior/ Judgements
A “Respect the privacy and dignity of
the client*.” Comp. #2, p. 3, South
Carolina Colleagues in Caring, 2000.
B
Identify client’s* unmet health
needs.
C
“Act as an advocate for clients* basic
needs” (Comp. #2, p. 3, South
Carolina Colleagues in Caring,
2000.), including following
established procedures for reporting/
solving institutional client* care
problems.
Diploma/ ADN
Additional Clinical Behavior/ Judgements
A “Support the client’s* right of selfdetermination and choice even when
these choices conflict with values of
the individual professional.” Comp.
#2, p. 3, South Carolina Colleagues
in Caring, 2000.
B Identify problems that clients* have
in accessing health care including
vulnerable populations.
C Advocate on behalf of the client*
with other members of the
interdisciplinary health care team.
BSN
Additional Clinical Behavior/ Judgements
A “Apply legal and ethical principles to
advocate for human and societal well
being and preferences.” Comp. #2,
p. 3, South Carolina Colleagues in
Caring, 2000.
D
E
B
Identify client’s* unmet needs from a
holistic perspective.
C
Advocate on behalf of populations by
implementing strategies for
improving health care delivery.
Participate on organizational
committees, professional
organizations and community groups
to improve the quality of health care.
D
“Serve as a member of voluntary
health care and community teams to
provide services to individuals and
communities with unmet needs.”
Comp. #1, p. 2, South Carolina
Colleagues in Caring, 2000.
E
“Work with state legislators and
professional regulators to design
regulations that allow optimal access
to a competent health professions
workforce and protection of the
public’s safety and welfare.” Comp.
#2, p. 3, South Carolina Colleagues
in Caring, 2000.
“Initiate & participate in community
partnerships to provide health care to
underserved areas.” Comp. #1, p. 2,
South Carolina Colleagues in Caring,
2000.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
Each educational level assumes previously stated competencies
Member of a Profession
VN
3. Demonstrate behaviors that promote
the development and practice of
vocational nursing.
Knowledge
A Historical evolution of nursing
practice.
Diploma/ ADN
3. Participate in activities that promote
the development and practice of
professional nursing.
Additional Knowledge
A Historical evolution of professional
nursing.
B
B
C
D
E
Issues affecting the development and
practice of vocational nursing,
including multistate licensure.
The role of major vocational nursing
organizations, regulatory agencies
and health care organizations.
Factors affecting the public image of
nursing.
Distinctions between LVN and RN
roles.
C
D
Issues and trends affecting the
development and practice of
professional nursing.
The role of professional nursing
organizations, regulatory agencies,
and health care organizations.
Public perception of nursing.
BSN
3. Act as a leader in promoting nursing
as a profession.
Additional Knowledge
A Links between nursing history and
medical, social, political, religious
and cultural influences.
B Issues and trends affecting the
nursing profession and health care
delivery.
C Research related to organizational
and societal change.
D
E
The evolving practice roles of
professional nurses and their
contributions to the profession.
E
F
Political processes.
F
G
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups.
Strategies to influence the public
perception of nursing.
Evolving leadership roles in the
advancement of the nursing
profession; distinction of roles &
scopes of practice among nursing
and other health care professions.
Strategies to influence legislative
action processes and public policy.
Theories of leadership.
Each educational level assumes previously stated competencies
VN
Clinical Behavior/ Judgements
A Promote collegiality among
interdisciplinary health care team
members.
B Collaborate with members of nursing
and other health care organizations
to promote the profession of nursing.
Diploma/ ADN
Additional Clinical Behavior/ Judgements
A Provide leadership in the
interdisciplinary health care team.
BSN
Additional Clinical Behavior/ Judgements
A Work collegially with members of the
interdisciplinary health care team.
B
Collaborate with others outside the
health care industry to promote the
profession of nursing.
B
Demonstrate behaviors which
promote a positive image of
vocational nursing.
C
C
Articulate the values and roles of
nursing to the public.
C
D
Analyze the impact of nursing
organizations and regulatory
agencies upon the nursing
profession.
Provide leadership to ensure
maintenance of the Scope of Practice
boundaries among nursing and the
interdisciplinary health care team.
Participate in activities, that promote
consumer awareness of nursing’s
contribution to society.
D
Participate in activities individually or
in groups through organizations that
promote vocational nursing.
Recognize roles of vocational nursing
organizations, regulatory agencies
and organizational committees.
D
E
F
Participate in activities individually or
in groups through organizations that
promote the profession of nursing.
Recognize roles of professional
nursing organizations, regulatory
agencies and organizational
committees.
Practice within the RN role and Scope
of Practice.
E
Serve as a positive role model for
F
students, peers, and members of the
interdisciplinary health care team.
* VN - client = individual
Diploma/ ADN- client = individual and family
BSN - Client = individual, their families and groups
E
Practice within the LVN role and
Scope of Education.
F
Serve as a positive role model for
students and peers.
APPENDICES
Appendix A
COMMITTEE MEMBERS
Advisory Committee on Education (ACE) Members:
Elizabeth Poster, PhD, RN
Chair of the Advisory Committee on Education
Member of the Board of Nurse Examiners, (Representing Baccalaureate Degree Nursing
Programs)
Phyllis Adams, EdD, RN, CNS, FNP, (Representing the Texas Nurses’ Association)
Cora Clay, MA, RN (Representing the Texas Board of Vocational Nurse Examiners)
Blanca Rosa “Rosie” Garcia, PhD, RN (Representing the Texas Organization of Associate
Degree Nurses)
Annette Hallman, PhD, RN (Representing Diploma Programs)
Brenda Jackson, PhD, RN (Representing the Texas League for Nursing)
Linda Klotz, PhD, RN (Representing the Texas Organization of Baccalaureate Graduate
Nursing Educators)
Helen Reid, EdD, RN (Representing the Texas Organization of Associate Degree Nurses)
Kendra Slatton, MSN, RN, CDE (Representing the Texas Organization of Nurse Executives)
Nancy Yuill, PhD, RN (Representing the Texas Organization of Baccalaureate Graduate
Nursing Educators)
ACE Subcommittee Members:
Elizabeth Poster, PhD, RN, CHAIR, Member of the Board of Nurse Examiners
(Representing Baccalaureate Degree Nursing Programs)
Blanca Rosa “Rosie” Garcia, PhD, RN, (Representing the Texas Organization of Associate
Degree Nurses)
Annette Hallman, PhD, RN, (Representing Diploma Programs)
Robert Lumpkins, RN, MS, CNAA, (Representing the Texas Organization of Nurse
Executives)
Helen Reid, EdD, RN, (Representing the Texas Organization of Associate Degree Nurses)
Pamela G. Sanford, MSN, RN, C, CNS, (Representing the Texas League of Nursing)
Acknowledgment for ethics content in the Introduction: Ferne Kyba, PhD, RN
Appendix B
Competencies Survey
Please review your Essential Competencies of Texas Graduates of Education Programs In
Nursing, Volume I (1993) document to answer the questions below related to your assigned
competency #______
_________________________________________________________________________
___________
Please also review the associated additional knowledge and clinical behavior/judgments in
relation to the assigned competency. Please check “yes” if the competency is appropriate as
stated. If it is not, then check “no” and provide recommendations for changes and reason(s)
for the changes.
Yes
Competency#
Additional
Knowledge
a
b
c
d
e
f
g
h
i
j
k
l
m
n
Clinical
Behavior/
judgment
a
b
c
d
e
f
g
h
i
j
k
l
m
n
No
Recommendations
Additional comments: ( please feel free to review other competencies or provide input on
any issues related to the competencies here or on another attachment.)
Please list the health care agencies that have collaborated in this process.
Name of school__________________________
Contact person__________________________
Date___________
Please return by December 15, 2000
Appendix C
Survey Respondents
(List of those responding to the survey sent out in October 2000.)
Vocational Nursing Programs
Alvin Community College
Blinn College
Cisco Junior College
Coastal Bend College
Del Mar College
Extended Health Education, Arlington
Memorial Hermann Memorial City Hospital, Houston
South Plains College
Texas State Technical College
Tyler Junior College
University of Texas at Brownsville/Texas Southmost College
Victoria College
Diploma Programs
Baptist Health System
Covenant School of Nursing
ADN Programs
Alvin Community College
Amarillo College
Angelina College
Angelo State University
Austin Community College
Blinn College
Central Texas College
Cisco Junior College
College of the Mainland
Collin County Community College
Del Mar College
El Centro College
El Paso Community College
Galveston College
Grayson County College
Houston Community College System
Lamar State College - Port Arthur
Lamar University at Beaumont
Laredo Community College
Lee College
McLennan Community College
Midland College
Navarro College
North Harris Montgomery Community College District
Northeast Texas Community College
Odessa College
Panola College
San Antonio College
San Jacinto College Central
South Texas Community College
Southwestern Adventist University
St. Philip’s College
Tarrant County College
Temple College
Texarkana College
Trinity Valley Community College
Tyler Junior College
University of Texas- Pan American
University of Texas at Brownsville/Texas Southmost College
Victoria College
Baccalaureate Degree Programs
Baylor University
East Texas Baptist University
Houston Baptist University
Lamar University at Beaumont
Prairie View A&M University
Stephen F. Austin State University
Texas A&M University - Corpus Christi
Texas Christian University - Harris College of Nursing
Texas Women’s University
University of Mary Hardin-Baylor
University of Texas at El Paso College of Nursing and Health Sciences
University of Texas at Arlington
University of Texas - Pan American
University of Texas at Tyler
University of Texas Health Science Center at Houston
University of Texas Health Science Center at San Antonio
University of the Incarnate Word
Southwestern Adventist University
University of Texas at Brownsville/Texas Southmost College
ADDITIONAL CONTRIBUTORS:
San Jacinto College-South
Texas Tech University Health Sciences Center
University of Texas Medical Branch at Galveston
West Texas A&M University
Appendix D
SURVEY COLLABORATORS
(List of those responding to the survey sent out in October 2000.)
All Saints Episcopal Hospital
Alvin Independent School District
Amarillo Veteran’s Administration Hospital
Angleton/Danbury Medical Center
Arlington Memorial Hospital
Audie L. Murphy Memorial Veteran’s Medical Center
Baptist Memorial Hospital - San Antonio
Baptist Saint Anthony’s Health System
Baylor Center for Restorative Care
Baylor Medical Center at Grapevine
Baylor Medical Center Ellis County
Baylor Medical Center of Irving
Baylor Richardson Medical Center
Baylor Specialty Hospital/Our Children’s House
Ben Taub General Hospital
Bivins Memorial Nursing Home
Brooke Army Medical Center
Camino Real Community MHMR Center
Children’s Medical Center of Dallas
Christus St. John Hospital
Christus Spohn - Memorial
Citizen’s Medical Center
Columbia Medical Center - Bellaire
Columbia Medical Center - Clear Lake
Columbia North Bay Hospital
Cook Children’s Medical Center
Corpus Christi Medical Center
Country Care Village
Covenant health System
Cuero Community Hospital
Dallas Southwest Medical Center
Del Sol Medical Center
Denton Regional Medical Center
Detar Regional Health Care System
Devereux-Texas Treatment Network - League City
Doctor’s Hospital
East Texas Medical Center - Tyler
East Texas Medical Center - Athens
East Texas Medical Center
Edinburg Regional Hospital
Ft. Duncan Medical Center
Grand Court II Nursing Home
Harris Methodist Fort Worth
Harris Methodist - HEB
Harris Methodist Northwest
Harris Methodist Southwest
Hendrick Health Systems - Abilene
Huguley Memorial Medical Center
James L. West Special Care Center
King’s Daughters Hospital - Temple
Lake Granbury Medical Center
Las Palmas Medical Center
Los Barrios Unidos CHC
Louis Herrington School of Nursing of Baylor University
Mainland Medical Center-Texas City
Mary Shiels Hospital
McAllen Heart Hospital
McAllen Medical Center
McCallum Medical Center
Medical Center Hospital-Odessa
Medical Center of Arlington
Medical Center of Lancaster
Medical Center of Mesquite
Medical Center of Plano
Medical Center of Terrell
Medical City Dallas Hospitall
Memorial Health Center - Lufkin
Memorial Hermann Hospital
Mesquite Community Hospital
Methodist Hospital - San Antonio
Methodist Hospital - Dallas
Metroplex Hospital - Killeen
Midland Memorial Hospital
Mission Hospital
Nacogdoches Medical Center
Naval Air Station Hospital
Navarro Regional Hospital
Normandy Terrace, S.E.
Northwest Texas Hospital (UHS)
North Hills Hospital
Nueces County Public Health Department
Nursing Education Policy Coalition
Odessa Regional Hospital
Osteopathic Medical Center-Ft. Worth
Palestine Regional Medical Center
Palo Pinto General Hospital
Parkland Health & Hospital System
Park Plaza Hospital
Plaza Medical Center of Fort Worth
Presbyterian Hospital of Winnsboro
Presbyterian Hospital of Kaufman
Providence Health Center - Waco
Providence Memorial Hospital
RHD Memorial Medical Center
Rio Grande Regional Hospital
Rusk State Hospital
San Antonio Black Nurses Association
San Antonio Metropolitan Health District
San Antonio State Hospital
San Antonio Warm Springs Rehabilitation Hospital
San Angelo Community Medical Center
Santa Rosa Medical Center
Santa Fe Independent School District
Scott and White Hospital - Temple
Sears Methodist Center - Abilene
Select Speciality Hospital of Dallas
Seton Medical Center
Shannon Medical Center
Sid Peterson Hospital
Sierra Medical Center
St. Paul Medical Center
St. David’s Health Care Partnership
St. Luke’s Episcopal Hospital
Starr County Memorial Hospital
Texas League for Nursing
Texas Nurses Association
Texas Organization of Associate Degree Nurses
Texas Organization of Baccalaureate Graduate Nursing Educators
Texas Scottish Rite Hospital for Children
Texoma Medical Center - Denison
The University of Texas Health Center - Tyler
Thomason Hospital
Titus Regional Medical Center
Tri-City Health Centre, Inc.
Trinity Medical Center
Trinity Mother Francis Health System
US Army Academy of Health Science
VA North Texas Health Care System
Val Verde Regional Medical Center
Vencor Hospital Dallas
Vencor Hospital Fort Worth
Victoria County Health Department
Victoria Independent School District
Victoria County Medical Society
Wadley Regional Medical Center - Texarkana
Walls Regional Hospital
Whitehall Nursing Center
Wilford Hall Medical Center
Wilson N. Jones Hospital - Sherman
Wm. Beaumont Medical Center
Woodland Heights Medical Center - Lufkin
Zale Lipshy University Hospital
Thanks to all those responding to the requests sent out on October 5, 2001 and
February 11, 2002 asking for input and comments on the working drafts.
Appendix E
GLOSSARY
1. Client: individual recipient of care across the lifespan in consideration of diversity of
background. For the vocational nurse graduate includes the individual. For the diploma
and associate degree graduate, may include the individual and the family. For the
baccalaureate graduate, may include the individual, the family, groups or community.
2. Clinical Practice Guidelines: systematically developed statements that are designed to
assist nurses toward decisions on appropriate healthcare for specific conditions and
provide various diagnostic criteria and therapeutic interventions from national health
advisory boards and authoritative sources with which to carefully judge patient care
(Broughton, R. and Rathborne, B., 1999).
3. Collaboration: a joint effort focusing on the client(s) health goals and therapeutic
interventions of a team.
4. Communication: a process whereby information is transmitted between or among
individuals via verbal or written techniques.
5. Competency: effective demonstration by the time of graduation of the knowledge,
judgement, skills and professional values derived from the nursing and general
education content.
6. Community: includes the physical topographical characteristics of the setting, the view
of community held by its inhabitants, the nature of community groups and their
characteristic interaction patterns, and the dynamic interplay of dominant community
forces.
7. Coordinator of care: one who organizes and facilitates the delivery of comprehensive
services to clients using other provider’s services, human and material resources, and
collaboration with clients, their support services, and an interdisciplinary health care
team.
8. Delegation: RN authorization of an unlicensed person to provide nursing services while
the RN retains accountability for the outcome. It does not include situations in which an
unlicensed person is directly assisting a RN by carrying out nursing tasks in the presence
of a RN.
9. Entry Level Competencies: effective demonstration, by the time of graduation, of the
knowledge, judgement, skills, and professional values derived from the nursing and
general education content.
10. Evidenced-based Practice: integration of best research evidence with clinical expertise
and patient values (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000; and
Stevens, 2002).
11. Family: two or more people who may share a residence, who possess common
emotional bonds, share common goals, which include the health of the individuals in the
family, and perform/engage in interrelated social positions, roles and tasks (Taber’s,
2001).
12. Generic Master’s Degree Program: a program leading to a master’s degree, which is an
individual’s first professional degree in nursing, and conducted by an educational unit in
nursing within the structure of a senior college or university (Board of Nurse Examiners,
2001).
13. Holistic: emphasizing the importance of the interrelationships of the bio-psycho-socialspiritual dimensions of the person in mutual process with the environment while
recognizing that the whole is greater than the sum of its parts (American Holistic Nurses’
Association, 2001; and Taber’s 2001).
14. Interdisciplinary: collaborative and overlapping efforts of two or more health care
professions that transcend traditional discipline boundaries (Taber’s, 2001).
15. Licensed Nursing Practice: provision of health care by either an individual licensed in the
state by the Board of Nurse Examiners to practice as a registered nurse or an individual
licensed in the state by the Board of Vocational Nurse Examiners to practice as a
vocational nurse (Board of Nurse Examiners, 2001 and Board of Vocational Nurse
Examiners, 2001).
16. Member of profession: someone who accepts responsibility for the quality of nursing
care for clients; applies research findings and identification of further research; is aware
of legislative, regulatory, ethical, and professional standards; aspires to improve the
discipline of nursing and its contribution to society; and values the need for life-long
learning.
17. Predictable outcome: results that can generally be anticipated in advance.
18. Provider of care: one who provides nursing care to clients using a systematic process of
assessment, analysis, planning, intervention and evaluation.
19. Structured setting: geographical and/or situational environment where the policies,
procedures, and protocols for provision of health care are established and in which there
is recourse to assistance and support from the full scope of nursing expertise.
20. Unpredictable outcome: results that generally cannot be anticipated in advance.
21. Unstructured setting - geographical and/or situational environment which may not have
established policies, procedures, and protocols and have the potential of variations
requiring independent nursing decisions.
22. Vulnerable populations: groups who have an increased susceptibility or higher than the
national average risk for physical, psychological, and social health problems or who have
worse outcomes from these health problems than the population as a whole. The needs
of vulnerable groups are not fully addressed by the traditional service providers and
such groups feel they cannot comfortably or safely access and use the standard health
care resources (Aday, 2001; Burnam and Young, 1999; and Community Preparedness,
2001).
Appendix F
REFERENCES
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American Association of Colleges of Nursing (AACN). (1998). Essentials of baccalaureate
education for professional nursing practice. Washington, D.C.: Author.
American Heritage College Dictionary, 3 rd ed. (1993). New York, NY: Houghton Mifflin
Company.
American Holistic Nurses’ Association. (2001). http://www.ahna.org/about/whatis.html.
American Nurses Association. (2001). Code of ethics for nurses with interpretative
statements.
Washington, DC: American Nurses Publishing.
Board of Nurse Examiners for the State of Texas. (2001). Rules and regulations relating to
professional nurse education, licensure and practice. Austin, TX: Author.
Board of Nurse Examiners for the State of Texas and Texas Board of Vocational Nurse
Examiners. (1993). Nursing education advisory committee (NEAC) report -volume I:
Essential competencies of Texas graduates of education programs in nursing. Austin, TX:
Author.
Broughton, R. and Rathborne, B. (1999). What makes a good clinical guideline? Hayward
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Burnam, A. and Young, A. (1999). Vulnerable populations core. Los Angeles, CA: School of
Nursing, University of California-Los Angeles.
http://www.hsrcenter.ucla.edu/vulnerablepopulationscore.html.
Community Preparedness. (2002). Vulnerable populations. The Community Preparedness
Website Project. http://www.preparenow.org/pop.html.
Hunt, R. (2001). Community based nursing, 2 nd ed. New York, NY: Lippincott.
International Code of Nurses Code for Ethical Concepts. In: Ellis, J.R. and Hartley, C.L.
(2001).
Nursing in today’s world. New York: Lippincott, p. 316.
National Federation of Licensed Practical Nurses, Inc. (NFLPN). (2001). Nursing practice
standards for the licensed practical/vocational nurse. Garner, NC: Author.
National League for Nursing. (2000). Educational competencies for graduates of associate
degree nursing programs. New York: NLN Press.
SC Colleagues in Caring: Regional collaboratives for nursing workforce development Pew
Health Professions Commission 21 competencies for the 21 st century. (2000). Retrieved
Nov. 19, 2001 from http://www.sc.edu/nursing/cic/SCCICPub/PEWComps.html.
Sackett, D.L, Straus, S.E, Richardson, W.S., Rosenberg, W., & Haynes, R.B. (2000).
Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone.
Stevens, K.R. (2002). Academic Center for Evidence Based Practice. Personal
communication.
Taber’s Cylopedic Medical Dictionary, 19 th ed. (2001). Philadelphia, PA: FA Davis.
Texas Board of Vocational Nurse Examiners. (2000). Minimum standards for vocational
nurse
education. Austin, TX: Author.
Texas Board of Vocational Nurse Examiners. (2001). Chapter 302. Texas Occupations Codelicensed vocational nurses. Austin, TX: Author.
Texas Nurses Association. (1997). The Texas nursing articulation model 1997-2000. Austin,
TX:
Texas Nurses Association Publishing.
US Department of Health and Human Services (HRSA), Health Resources and Services
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and
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America 2000. Washington, DC: Author
NLNAC 2002 STANDARDS AND CRITERIA
STANDARDS
CRITERIA
I. MISSION & GOVERNANCE
There are clear and publicly stated
mission and/or philosophy and purposes
appropriate to post-secondary or higher
education in nursing.
1. Mission and/or philosophy of the nursing
education unit is congruent with that of the
governing organization, or differences are justified
by the nursing education unit purposes.
2. Faculty, administrators, and students participate
in governance as defined by the parent
organization and the nursing education unit.
3. Nursing education unit is administered by a nurse
who is academically and experientially qualified,
and who has authority and responsibility for
development and administration of the program.
4. Policies of the nursing education unit are
consistent with those of the governing
organization, or differences are justified by
nursing education purposes.
II. FACULTY
There are qualified and credentialed
faculty, appropriate to accomplish the
nursing education unit purposes and
strengthen its educational effectiveness.
5. Faculty members (full- and part-time) are
academically and experientially qualified, and
maintain expertise in their areas of responsibility.
6. Number and utilization of full- and part-time
faculty meet the needs of the nursing education
unit to fulfill its purposes.
7. Faculty performance is periodically evaluated to
assure ongoing development and competence.
8. The collective talents of the faculty reflect
scholarship through teaching, application, and the
integration and discovery of knowledge as defined
by the institution and the nursing education unit.
III. STUDENTS
The teaching and learning environment
is conducive to student academic
achievement.
9. Student policies of the nursing education unit are
congruent with those of the governing
organization, publicly accessible, nondiscriminatory, and consistently applied;
differences are justified by the nursing education
unit purposes.
10. Students have access to support services
administered by qualified individuals that include,
but are not limited to: health, counseling,
academic advisement, career placement, and
financial aid.
11. Policies concerned with educational and financial
records are established and followed.
IV. CURRICULUM & INSTRUCTION
The program accomplishes its
educational and related purposes.
12. Curriculum developed by nursing faculty flows
from the nursing education unit philosophy/
mission through an organizing framework into a
logical progression of course outcomes and
learning activities to achieve desired program
objectives/outcomes.
13. Program design provides opportunity for students
to achieve program objectives and acquire
knowledge, skills, values, and competencies
necessary for nursing practice.
14. Practice learning environments are selected and
monitored by faculty and provide opportunities for
a variety of learning options appropriate for
contemporary nursing.
V. RESOURCES
The program has effectively organized
processes and human, fiscal, and
physical resources necessary to
accomplish its purposes.
15. Fiscal resources are sufficient to support the
nursing education unit purposes commensurate
with the resources of the governing organization.
16. Program support services are sufficient for the
operation of the nursing education unit.
17. Learning resources are comprehensive, current,
developed with nursing faculty input, and
accessible to faculty and students.
18. Physical facilities are appropriate to support the
purposes of the nursing education unit.
VI. INTEGRITY
The program demonstrates integrity in
its practices and relationships.
19. Information about the program intended to inform
the general public, prospective students, current
students, employers and other interested parties,
is current, accurate, clear, and consistent.
20. Complaints about the program are addressed and
records are maintained and available for review.
21. Compliance with Higher Education Reauthorization
Act Title IV eligibility and certification
requirements is maintained.
VII. EDUCATIONAL
EFFECTIVENESS
The program has an identified plan for
systematic evaluation and assessment of
educational outcomes.
22. There is a written plan for systematic program
evaluation that is used for continuous program
improvement.
23. Student academic achievement by program
type is evaluated by: graduation rates, licensure
/certification pass rates, job placement rates, and
program satisfaction.
CCNE Accreditation
Standards for Accreditation of Baccalaureate
and Graduate Nursing Education Programs
Amended: August 1998
Introduction
Accreditation Overview
Accreditation is a nongovernmental process conducted by representatives of postsecondary
institutions and professional groups. As conducted in the United States, accreditation focuses on the
quality of institutions of higher and professional education and on the quality of educational
programs within institutions. Two forms of accreditation are recognized: one is institutional
accreditation and the other is professional or specialized accreditation. Institutional accreditation
concerns itself with the quality and integrity of the total institution, assessing the achievement of
the institution in meeting its own stated mission, goals and objectives. Professional or specialized
accreditation is concerned with programs of study in professional or occupational fields. Professional
accrediting agencies assess the extent to which programs achieve their stated mission, educational
philosophy and goals/objectives. In addition, the relevance of the mission, philosophy, and
goals/objectives is of importance to the accrediting agency in determining the quality of the
program and the educational preparation of members of the profession or occupation.
Commission on Collegiate Nursing Education
The Commission on Collegiate Nursing Education (CCNE) is an autonomous accrediting agency,
contributing to the improvement of the public's health. A specialized/professional accrediting
agency, CCNE ensures the quality and integrity of baccalaureate and graduate education programs
preparing effective nurses. CCNE serves the public interest by assessing and identifying programs
that engage in effective educational practices. As a voluntary, self-regulatory process, CCNE
accreditation supports and encourages continuing self-assessment by nursing education programs
and supports continuing growth and improvement of collegiate professional education. Because the
accreditation process is a voluntary enterprise, institutions that seek CCNE accreditation of their
baccalaureate and/or graduate nursing education programs are viewed to have a cooperative
relationship with CCNE in seeking ways to improve and enhance the educational program for
professional nursing students.
CCNE has established a peer review process in accordance with nationally recognized standards
established for the practice of accreditation in the United States and its territories. Accreditation by
CCNE serves as a statement of good educational practice in the field of nursing. Accreditation
evaluations are useful to the program in that they serve as a basis for continuing or formative selfassessment as well as for periodic or summative self-assessment through which the program,
personnel, procedures and services are improved. The results of such assessments form the basis
for planning and priority setting at the institution.
The CCNE accreditation evaluation consists of a review of the program's mission, educational
philosophy, and goals/objectives; and an assessment of the performance of the program in
achieving the mission and goals/objectives through the most effective utilization of available
resources, programs and administration. The evaluation process also calls for a review of evidence
concerning the application of these resources in assisting the students in attaining their educational
goals.
In evaluating a baccalaureate and/or graduate education program for accreditation, the standards
and key elements presented in this publication are assessed carefully. A self-study conducted by
the sponsoring institution prior to the on-site evaluation provides data indicating the extent to
which the program has satisfied the key elements and, ultimately, whether the program has
complied with the overall standards for accreditation.
The Commission formulates and adopts its own accreditation procedures. The accreditation
procedures are stated in Procedures for Accreditation of Baccalaureate and Graduate Nursing
Education Programs. This publication may be obtained by contacting CCNE offices.
Accreditation Purposes
Accreditation by CCNE is intended to accomplish at least five general purposes:
1. To hold nursing education programs accountable to the community of interest the nursing profession, consumers, employers, higher education, students and their
families - and to one another by ensuring that these programs have mission
statements, goals and outcomes that are appropriate for programs preparing
individuals to enter the field of nursing.
2. To evaluate the success of a nursing education program in achieving its mission,
goals and outcomes.
3. To assess the extent to which a nursing education program meets accreditation
standards.
4. To inform the public of the purposes and values of accreditation and to identify
nursing education programs that meet accreditation standards.
5. To foster continuing improvement in nursing education programs - and thereby in
professional practice.
CCNE Accreditation: A Value-Based Initiative
CCNE accreditation activities are premised on a statement of principles or values. These values are
that the Commission will:
1. Foster trust in the process, in CCNE and in the professional community.
2. Focus on stimulating and supporting continuous quality improvement in nursing
education programs and their outcomes.
3. Be inclusive in the implementation of its activities and maintain an openness to the
diverse institutional and individual issues and opinions of the interested community.
4. Rely on review and oversight by peers from the community of interest.
5. Maintain integrity through a consistent, fair and honest accreditation process.
6. Value and foster innovation in both the accreditation process and the programs to
be accredited.
7. Facilitate and engage in self-assessment.
8. Foster an educational climate that supports program students, graduates and
faculty in their pursuit of life-long learning.
9. Maintain a high level of accountability to the publics served by the process,
including consumers, students, employers, programs and institutions of higher
education.
10. Maintain a process that is both cost-effective and cost-accountable.
11. Encourage programs to develop graduates who are effective professionals and
socially responsible citizens.
12. Assure autonomy and due process in its deliberations and decision-making
processes.
Goals for Accrediting Nursing Education Programs
In developing the educational standards for determining accreditation of baccalaureate and
graduate nursing education programs, CCNE has formulated specific premises or goals on which the
standards are to be based. These goals include the following:
1. Developing and implementing accreditation standards that foster continuing
improvement within nursing education programs.
2. Enabling the community of interest to participate in significant ways in the review,
formulation and validation of accreditation standards and policies and in determining
the reliability of the conduct of the accreditation process.
3. Establishing and implementing an evaluation and recognition process that is
efficient, cost-effective and cost-accountable with respect to the institution and
student.
4. Assessing whether nursing education programs consistently fulfill their stated
missions, goals and purposes.
5. Assuring that nursing education program outcomes are in accordance with the
expectations of the nursing profession to adequately prepare individuals for
professional practice, life-long learning and graduate education.
6. Encouraging nursing education programs to pursue academic excellence through
improved teaching/learning and assessment practices and in scholarship and public
service in accordance with the unique mission of the institution.
7. Assuring that nursing education programs engage in self-evaluation of personnel,
procedures and services, and that they facilitate continuous improvement through
planning and resource development.
8. Acknowledging and respecting the autonomy of institutions and the diversity of
programs involved in nursing education.
9. Ensuring consistency, peer review, agency self-assessment, due process,
identification and avoidance of conflict of interest, and confidentiality, as appropriate,
in accreditation practices.
10. Enhancing public understanding of the functions and values inherent in nursing
education accreditation.
11. Providing to the public an accounting of nursing education programs that are
accredited and merit public approbation and support.
12. Working cooperatively with other agencies to minimize duplication of review
processes.
Curricular Innovation
CCNE standards and key elements are designed to encourage innovation and experimentation in
teaching and instruction. Without experimentation for the sake of experimentation and without
adversely affecting the educational outcomes, curricular innovations should ultimately serve the
needs of the student, the profession and the public. CCNE recognizes that advancements in
technology have enabled programs to facilitate the educational process in ways that may
complement or supplant traditional pedagogical methods. CCNE encourages the introduction and
use of technology in the curriculum and looks to the programs that it accredits to make available
this technology for the improvement and enhancement of student learning.
About this Document
This publication describes the standards, key elements and examples of evidence used by CCNE in
the accreditation of baccalaureate and/or graduate nursing education programs. The standards and
key elements, along with the accreditation procedures, serve as the basis to evaluate the quality of
the educational program offered and to hold the program accountable to the educational
community, the nursing profession and the public. The standards document has been adopted by
CCNE. Program compliance with the standards promotes good educational practice in the field of
nursing and thus enables CCNE to grant or confirm accreditation.
The standards are written as broad statements that embrace several areas of expected institutional
performance. Related to each standard is a series of key elements. Viewed together, the key
elements provide an indication of whether the broader educational standard has been satisfied. The
key elements will be considered by the evaluation team, the Accreditation Review Committee and
the CCNE Board of Commissioners in determining the extent to which the program is in compliance
with each standard. The key elements are designed to enable the broadest possible interpretation
of each standard in order to support institutional autonomy and encourage innovation while
maintaining the integrity of the accreditation process. The absence of prescriptive language
throughout this document is intentional.
Following each series of key elements is a list of examples of evidence that assists program
representatives in addressing the key elements and in developing self-study materials. The
examples of evidence are neither inclusive nor exclusive of all conditions to be present within a
program. Rather, they are to be used to guide program representatives and the individuals involved
in the accrediting process in determining sound educational practices. The Commission recognizes
that reasonable alternatives exist in addressing the key elements.
At the end of this document is a section titled "Operational Definitions," which is a glossary of terms
and concepts used in this document. Such terms and concepts include: Academic Policies, Academic
Support Services, Advanced Nursing, Chief Nursing Administrator, Community of Interest,
Curriculum, Curriculum and Course and/or Unit Objectives, Expected Results, Goals/Objectives,
Mission, Ongoing Improvement, Parent Institution, Philosophy, Professional Nursing Standards and
Guidelines, Scholarship, and Teaching-Learning Practices. The terms "educational program,"
"nursing education program," and "program" are used interchangeably throughout this document.
The standards, key elements, concepts and policies identified in this document are subject to
periodic review and revision. The next scheduled review of this document will include both broad
and specific participation by the CCNE community of interest in the analysis and discussion of
additions and deletions. Under no circumstances may the standards and key elements defined in
this document supersede federal or state law.
STANDARD I. PROGRAM QUALITY: MISSION AND GOVERNANCE
The mission, philosophy, and goals/objectives of the program should be congruent with those of the
parent institution, should reflect professional nursing standards and guidelines, and should consider
the needs and expectations of the community of interest. The faculty and students of the program
should be involved in the governance of the program and in the ongoing efforts to improve program
quality.
Key Elements:
I-A. The mission, philosophy and goals/objectives of the program are congruent with
those of the parent institution and are consistent with the professional nursing
standards and guidelines for the preparation of nursing professionals.
I-B. The mission, philosophy and goals/objectives of the program are reviewed
periodically and revised not only to reflect professional standards and guidelines but
also to reflect the expectations of the community of interest, all in pursuit of the
continuing advancement and improvement of the program.
I-C. Documents and publications should accurately reflect the mission, philosophy
and goals/objectives of the program.
I-D. Roles of the faculty and students in the governance of the program are clearly
defined and enable meaningful participation.
Examples of Evidence:
1. State the mission, philosophy and goals/objectives of the program and discuss
their relationship to the mission of the parent institution.
2. Present the context in which the program is offered, including discussion of
regional and institutional characteristics that influence the mission, philosophy and
goals/objectives of the program.
3. Provide the rationale for the selection of professional nursing standards and
guidelines used in formulating and evaluating the mission, philosophy and
goals/objectives of the program.
4. Describe how the needs and expectations of the community of interest are taken
into consideration in developing the mission, philosophy and goals/objectives of the
program.
5. Describe the scope, breadth and timing of the process employed in reviewing and
updating the mission, philosophy and goals/objectives of the program.
6. Define the roles of faculty and students in the governance of the program with
respect to the pursuit of the mission, philosophy and goals/objectives. Discuss the
effect these roles have on decision-making.
STANDARD II. PROGRAM QUALITY: INSTITUTIONAL COMMITMENT AND RESOURCES
The parent institution demonstrates ongoing commitment and support. The
institution makes available resources to enable the program to achieve its mission,
philosophy, goals/objectives and expected results. The faculty, as a resource of the
program, enables the achievement of the mission, philosophy, goals/objectives and
expected results of the program.
Key Elements:
II-A. The parent institution and program should provide and support an environment
that encourages faculty teaching, scholarship, service and practice in keeping with
the mission and philosophy of the program.
II-B. Resources are sufficient to enable the program to fulfill its mission, philosophy,
and goals/objectives, and these resources are reviewed, revised and improved as
needed. Academic support services are improved and upgraded on a regular basis to
meet program needs.
II-C. The chief nursing administrator is qualified to lead the program in its pursuit of
accomplishment of the mission, philosophy, goals/objectives and expected results.
II-D. Faculty members are qualified and sufficient in number to accomplish the
mission, philosophy, goals/objectives and expected results of the program.
II-E. The faculty roles in teaching, scholarship, service and practice are identified
clearly and correlate to the mission, philosophy, goals/objectives and expected
results of the program.
II-F. Documents and publications accurately reflect resources available to the
program.
Examples of Evidence:
1. Indicate the ways in which the parent institution takes into account the needs of
the program in governance, planning and resource allocation activities.
2. Describe how the parent institution and program provide and support an
environment for ongoing improvement, faculty teaching, scholarship, service and
practice.
3. Explain how academic support services facilitate achievement of the mission,
philosophy, goals/objectives and expected results of the program.
4. Describe the educational and experiential qualifications of the chief nursing
administrator.
5. Provide rationale to support the adequacy of number and qualifications of faculty
to accomplish the mission, philosophy, goals/objectives and expected results of the
program.
STANDARD III. PROGRAM QUALITY: CURRICULUM AND TEACHING-LEARNING
PRACTICES
The curriculum is developed in accordance with clear statements of expected results
derived from the mission, philosophy and goals/objectives of the program with clear
congruence between the teaching-learning experiences and expected results. The
environment for teaching, learning and evaluation of student performance fosters
achievement of the expected results by the students.
Key Elements:
III-A. The curriculum is based upon clear statements of expected results for students
derived from the mission, philosophy and goals/objectives of the program.
III-B.The baccalaureate nursing curriculum builds upon a foundation of the arts,
sciences and humanities which is essential to professional nursing. The master's
curriculum builds on the competencies of baccalaureate graduates and focuses on
advanced nursing roles.
III-C. The curriculum, teaching-learning practices and teaching environments foster
behaviors consistent with professional nursing standards and guidelines.
III-D. Curriculum and teaching-learning practices consider the needs and
expectations of the community of interest.
III-E. Curriculum and teaching-learning practices are reviewed on regularly scheduled
intervals to foster ongoing improvement.
III-F. The curriculum is sequentially and logically organized to facilitate student
achievement of expected results.

a. The baccalaureate nursing curriculum incorporates content and learning
experiences essential to practice in professional nursing.

b. The master's nursing curriculum incorporates content and learning
experiences essential to performance in advanced nursing roles.
III-G. Academic policies related to students are fair, equitable, published and are
reviewed and revised as necessary to reflect ongoing improvement.
III-H. Academic policies are justifiable. Academic policies relate to and support the
mission, philosophy and goals/objectives of the program and institution.
Examples of Evidence:
1. Describe how expected results are derived from the mission, philosophy and
goals/objectives of the program.
2. Show how the baccalaureate curriculum builds upon the arts, sciences and
humanities.
3. Show how the master's curriculum builds on the competencies of baccalaureate
graduates and focuses on advanced nursing roles.
4. Explain how professional nursing standards and guidelines for practice are used to
make choices about curricular content.
5. Describe the teaching-learning experiences provided and indicate the locations
where students apply content to achieve expected results.
6. Provide the rationale for the logic and sequence used in formulating the
curriculum.
7. Demonstrate how interdisciplinary collaboration is encouraged in the curriculum.
8. Show how teaching-learning experiences facilitate accomplishment of the expected
results by the students.
9. Describe the academic policies that enable the recruitment and admission of high
quality students for the program and that support student performance, achievement
and progress.
10. Describe the academic policies that stimulate individual student responsibility for
learning, progression and graduation.
STANDARD IV. PROGRAM EFFECTIVENESS: STUDENT PERFORMANCE AND FACULTY
ACCOMPLISHMENTS
The program is effective in fulfilling its mission, philosophy, goals/objectives and
expected results. Satisfactory student performance reflects achievement of the
expected results by the students in congruence with the mission, philosophy and
goals/objectives of the program as well as with professional nursing standards and
guidelines. Alumni satisfaction and the accomplishments of graduates of the program
attest to the effectiveness of the program. Faculty accomplishments in teaching,
scholarship, service and practice are congruent with the mission, philosophy and
goals/objectives of the program and with professional nursing standards and
guidelines. Program effectiveness reflects ongoing improvement. Program integrity is
reflected in documents and publications concerning the program.
Key Elements:
IV-A. Student performance is evaluated by the faculty and reflects achievement of
expected results. Grading policies are defined and consistently applied.
IV-B. Surveys and other data sources to collect information about student, alumni,
employer satisfaction and demonstrated achievements of graduates provide evidence
of program effectiveness. Data gathered about demonstrated achievements include,
but are not limited to, graduation rates, NCLEX scores and job placement rates.
IV-C. Faculty accomplishments in teaching, scholarship, practice and service
demonstrate program effectiveness and reflect the process of ongoing improvement.
IV-D. Records of student satisfaction/formal complaints are reviewed as a part of the
process of ongoing improvement.
IV-E. Current documents and publications distributed accurately reflect student
performance and satisfaction, as well as faculty accomplishments (i.e., truth in
advertising).
Examples of Evidence:
1. Describe how faculty and students are involved in the evaluation of individual
student performance. Describe how the evaluation of student performance is
communicated to the students and how it is used to foster improved performance.
2. Demonstrate how the results of aggregate student performance are used to
change or improve the curriculum.
3. Describe the student and graduate performance measures that are utilized by the
program to indicate success in meeting the program mission, philosophy and
goals/objectives.
4. Describe the process for evaluating faculty performance in teaching, scholarship,
service and practice. Describe how the results of evaluations are communicated to
individual faculty members and, in an aggregate sense, how they are used to foster
ongoing improvement.
5. Provide evidence that professional growth and development are supported by the
program and parent institution so that faculty can be expected to contribute
effectively to the mission, philosophy and goals/objectives of the program.
6. Describe how alumni, employers and graduates evaluate the program and explain
how results are used to improve the program.
7. Describe the process of the review and maintenance of records of student
satisfaction and formal complaints.
Operational Definitions
Academic Policies: Published rules that govern the implementation of the academic
program including, but not limited to, admission, progression, graduation, grievance
and grading.
Academic Support Services: Services available to the nursing education program that
facilitate faculty and students in achieving the expected results of the program. This
may include, but is not limited to, services provided by libraries, clinical and scientific
laboratories, computer, advising, counseling and placement centers.
Advanced Nursing: Nursing roles requiring advanced nursing education beyond the
basic baccalaureate preparation.
Chief Nursing Administrator: Denotes the chief academic officer and administrative
head of the nursing education program.
Community of Interest:
External-Individuals and groups that influence or participate in the nursing education
program to ensure the achievement of the expected results of the program.
Examples of external groups that may comprise the program's community of interest
include: prospective students and their families, organizations of professional nurses
and nurse educators, credentialing agencies such as the National Council of State
Boards of Nursing, employers, legislators, health care providers, volunteer
organizations and consumers.
Internal-Institutionally based individuals and groups that include administration,
faculty and students as well as the groups that govern the activities of faculty and
students.
Curriculum: All planned didactic and clinical educational experiences under the
direction of the program that facilitate students in achieving expected results.
Curriculum and Course and/or Unit Objectives: Curriculum and course and/or unit
objectives provide more specific detail regarding the expectations for the teaching
program. Professional guidelines should be considered in developing the curriculum
and course and/or unit objectives.
Expected Results: The expected results are the measurable indicators of the program
and are reflected in the intended student outcomes and in the accomplishments of
the faculty. Student outcomes may be demonstrated as attained competencies,
knowledge, skills and attitudes; student achievements; graduation rates;
employment rates; performance of graduates on licensing and certification
examinations; and accomplishments of graduates. Faculty accomplishments may be
demonstrated in the production of scholarly work and publications, in teaching, in
practice, and in service to the institution's community of interest. Evidence of
program effectiveness is shown in the evaluation of the expected results.
Goals/Objectives: The goals/objectives indicate the expectations for the program,
students and faculty. Goals/objectives are of three types: a) general statements that
reflect conditions, values and priorities that the institution expects the nursing
education program to achieve or accomplish; b) specific statements that reflect
knowledge, skills and attitudes to be learned by students; and c) specific statements
of expectations for teaching, scholarship, service and practice to be accomplished by
the faculty. Curriculum and course and/or unit objectives provide specific detail
regarding the teaching-learning expectations for the program.
Mission: The mission of the nursing education program is expected to reflect the
educational philosophy of the program and the professional nursing standards and
guidelines. A statement of the mission includes information about the unique nature
and scope of the parent institution and about the nursing education program.
Ongoing Improvement: The institution is expected to have in place a process that
demonstrates a commitment to ongoing assessment and enhancement of the
educational process and services offered by the nursing education program. While no
particular management philosophy is required or recommended, CCNE expects that
implementation of a useful self-study process will enable program representatives to
promote better management of the academic enterprise, including actual systems for
useful data collection, institutional analysis and problem-solving. Review of the
mission, philosophy and goals/objectives in light of the expected results is an
important element in the ongoing management and improvement of the program.
Analysis of data collected helps program faculty make choices about revisions to the
mission, philosophy and goals/objectives, and subsequently to the curricular content,
all in pursuit of strengthening program quality.
Parent Institution: The university, academic health center or college that has overall
responsibility and accountability for the program.
Philosophy: Statement of values adopted by program faculty to reflect nursing's basic
concepts (person, health, environment, nursing practice) and faculty's beliefs about
nursing education (teaching, learning, teaching-learning practices).
Professional Nursing Standards and Guidelines: Statements of expectations and
aspirations providing a foundation for professional nursing behavior developed by a
consensus of the professional nursing community. Examples include The Essentials of
Baccalaureate Education for Professional Nursing Practice, The Essentials of Master's
Education for Advanced Practice Nursing, Criteria for Evaluation of Nurse Practitioner
Programs and various professional practice standards of the American Nurses
Association.
Scholarship: In its broadest definition, scholarship includes teaching, research,
practice, community service and the pursuit of new knowledge through continuing
education and professional development. Research may be clinical, focusing on the
design, implementation and results of bench and clinical experiments, or it may be
sociological, socioeconomic or educational, focusing on the design, implementation
and results of the evaluation of hypotheses concerning people, social systems or
groups.
Teaching-Learning Practices: Teaching-learning practices define the mechanisms in
place to direct the instructional process towards achieving the goals/objectives.
The Standards for Accreditation of Baccalaureate and Graduate Nursing Education
Programs of the Commission on Collegiate Nursing Education (CCNE) was adopted by
the CCNE Board of Commissioners in February 1998. Minor amendments and editorial
changes were made to the standards document in August 1998, but the language
used in the standard and key element statements was not changed at that time.
Omitted from the standards document as it appears on the website is a series of
diagrams which are intended to help clarify the standards and key elements. You may
request a copy of the CCNE standards document by contacting CCNE offices at (202)
887-6791.
Copyright © 2002 by the American Association of Colleges of Nursing. All rights reserved.
Commission on Collegiate Nursing Education
One Dupont Circle, NW, Suite 530
Washington, DC 20036
Phone: (202) 887-6791 - Fax: (202) 887-8476
http://www.aacn.nche.edu/Accreditation/standrds.htm
Texas Higher Education Coordinating Board
http://www.thecb.state.tx.us/ctc/ip/wecm2000/main.htm
Field of Study Curriculum for Nursing
The following annotated set of courses, totaling 28 semester credit hours (SCH) of fully
transferable and applicable lower-division academic courses, and an additional set of
Workforce Education (WECM) nursing courses, make up the Field of Study Curriculum for
Nursing:
Academic Courses
Content Area
Number and type of courses
Anatomy &
Physiology
2 courses:
A&P I with lab and
A&P II with lab
1 course:
Microbiology with lab
1 course:
chemistry with lab
1 course:
Nutrition & Diet Therapy I
2 courses:
General Psychology and
Lifespan Growth &
Development
1 course:
Elementary Statistical Methods
Microbiology
Chemistry
Nutrition
Psychology
Mathematics
Texas Common Course Numbering System
Equivalents
BIOL 2401 and BIOL 2402 only
BIOL 2420 OR BIOL 2421
Any 4 SCH ACGM course including lab
HECO 1322 OR BIOL 1322
PSYC 2301 AND PSYC 2314
MATH 1342
1
Nursing Content Courses
NOTE: Lower-division nursing content is offered at community colleges through one of two
general types of programs: Blocked or Integrated. Because of the distribution of content, it
is extremely difficult to align curricula from one type of program to another. Students who
desire to transfer from a program utilizing one type of program into the other type of
program should be prepared to make up some content through a “bridge” course or through
the repetition of some content within courses. It is recommended that a student make
every effort to avoid transferring from one type of program to the other before completing
the associate degree in nursing in order not to lose credit.
Lower-division nursing content courses being transferred from a blocked-curriculum
program to another blocked-curriculum program should be applied to the degree on a
course-for-course substitution basis, in which the course transferred is applied IN LIEU OF
the course at the receiving institution, even if the number of semester credit hours awarded
upon the completion of the course varies between the sending and receiving institutions.
1
Prerequisite courses to BIOL 2401/2402 or the equivalent are not required for the Field of Study
Curriculum for Nursing.
The same procedure should be used when a student transfers from an integrated-curriculum
program into another integrated-curriculum program. For Nursing Content Courses,
CHOOSE EITHER Blocked Curriculum OR Integrated Curriculum BUT NOT BOTH:
BLOCKED CURRICULUM
Content Area
WECM Course Rubric & Number
Fundamentals
(including Basic Skills)
RNSG 1413/RNSG 1513
(basic skills incorporated)
OR
RNSG 1413/1513 PLUS RNSG 1105/1205
OR
RNSG 1209/1309 PLUS RNSG 1105/1205
OR
Any equivalent theory/lab combination
RNSG 2113/2213
RNSG 1412/1512
OR
RNSG 1251 PLUS RNSG 2201
OR
RNSG 2208/2308 PLUS RNSG 2201
RNSG 1331/1431 or 1231 PLUS 1232
PLUS
RNSG 1347/1447 or 1247 PLUS 1248
OR
RNSG 1341/1441 PLUS RNSG 1343/1443
OR
EQUIVALENT with OR without RNSG
1144/RNSG 1244
Mental Health
Obstetrics/Pediatrics
Medical/Surgical
Nursing
SCH Range
(Required Clinical
Corequisite)
2 to 6 SCH
1 OR 2 SCH
4 OR 5 SCH
2 to 6 SCH
OR
INTEGRATED CURRICULUM
Content Area
WECM Course Rubric & Number
Introduction to
Professional Nursing
for Integrated
Programs
RNSG 1423/RNSG 1523
(basic skills incorporated)
OR
RNSG 1423/1523 PLUS RNSG 1119/1219
OR
RNSG 1222 PLUS RNSG 1223 PLUS RNSG
1119/1219
RNSG 2404/2504
(basic skills incorporated)
OR
RNSG 2404/2504 PLUS RNSG 11XX/12XX
OR
RNSG 2203 PLUS RNSG 2204 PLUS RNSG
11XX/12XX
Integrated Care of the
Client with Common
Health
Care Needs
SCH Range
(Required Clinical
Co-requisite)
2 to 6 SCH
2 to 6 SCH
The following notes address special circumstances and are also part of the field of study
curriculum:
(1) Wherever possible, courses applied to fulfill field of study curriculum requirements
should also be used to satisfy requirements in the general academic core curriculum.
Generally, the math course, the biology or chemistry course(s), and one psychology course
should be able to fulfill requirements in both curricula.
(2) Courses selected for inclusion in the field of study curriculum are those that are common
to most baccalaureate nursing programs.
(3) Completion of the field of study curriculum shall not prevent a receiving institution from
requiring additional courses/content for specific degree programs.
(4) Students should not be required to repeat courses that they have completed
successfully.
(5) The academic courses and the unmodified WECM courses that are included in the Field
of Study Curriculum for Nursing should transfer immediately upon approval of the field of
study curriculum by the Coordinating Board. New WECM courses and courses that need
modification should be accepted in transfer as soon as those modifications have been
approved by the WECM Maintenance committee and added to the WECM inventory.
Implementation of the complete field of study curriculum should not take more than one
calendar year following addition of the new and modified courses to the WECM inventory.
New or modified WECM courses will be initiated with entering students. Programs may allow
sophomore students to continue with the previous curricula to prevent changing courses in
the middle of their programs. Full implementation of new and modified WECM courses must
be complete within two years after their addition to the WECM inventory.
Board of Vocational Examiners Education Rules
A. DEFINITIONS
233
233.1 Definitions. The following words and terms, when used in this chapter, shall have the following
meanings, unless the context clearly indicates otherwise:
(1)
Adjunct Faculty – instructors who teach non-nursing theory or clinical courses and are exempt
from meeting nursing faculty qualifications.
(2)
Affiliating Agency or Clinical Facility - refers to health care facility contracted for student
clinical practice by the controlling agency.
(3)
Assistant Program Coordinator - a registered nurse vocational nursing program faculty
member designated to assist with program management when the director assumes
responsibilities other than the program.
(4)
Challenge/Advanced Placement Student - a student who is allowed credit for previous nursing
courses and/or comparable performance by demonstrating through writing and/or performing that
he/she possesses the knowledge, skills and competencies of one or more courses in the
vocational nursing program.
(5)
Class Hours - shall be those hours allocated to didactic instruction in each subject and include
testing.
(6)
Clinical Conferences - denotes scheduled presentations and discussions of aspects of patient
care experiences.
(7)
Clinical Practice Hours - hours spent in actual patient care assignments, simulated laboratory,
observations, clinical conferences and clinical instruction.
(8)
Conceptual Framework - theories or concepts giving structure to the curriculum and enabling
faculty to make consistent decisions about all aspects of curriculum development,
implementation, and evaluation.
(9)
Concurrent Theory and Clinical Laboratory Experiences - coincide or operate at the same
time to produce a common effect.
(10)
Conditional Approval - refers to a probationary period set by the Board.
(11)
Controlling Agency - institution that has ultimate authority and administrative accountability for
the total program.
(12)
Correlated Theory and Clinical Practice - to have reciprocal relationship or to mutually respond
to each other.
(13)
Course - organized subject matter and related activities, including laboratory experiences,
planned to achieve specific objectives within a given time period.
(14)
Curriculum - course offerings which, in aggregate, make up the total learning activities in a
program of study.
(15)
Designate Supervisor - denotes a licensed nurse appointed by mutual agreement of affiliating
agency and controlling agency.
(16)
Differentiated Entry Level Competencies - the expected educational outcomes to be
demonstrated by nursing students at the time of graduation as published in, Differentiated Entry
Level Competencies of Graduates of Texas Nursing Programs, February 2002, as amended.
(17)
Director or Coordinator--denotes the nurse executive directly in charge of and responsible for
the program.
(18)
Director Affidavit--an official board form containing an approved nursing program's curriculum
components and hours, a statement attesting to an applicant's qualifications for vocational nurse
licensure in Texas, the official school seal and the signature of the nursing program director.
(19)
Entry-level Competencies - describe the desirable behaviors exhibited by graduates of
vocational nursing programs and are in accord with statutes governing nursing care and are
based on the Differentiated Entry Level Competencies
(20)
Full Approval - a status granted by the Board to schools complying with all requirements.
(21)
Inactive Program – An approved program that has not enrolled students for a period of not more
than 23 months.
(22)
Initial Approval - the approval status of a program during the first year of operation.
(23)
Innovative Curriculum - pertains to a curriculum which deviates from the traditional vocational
nursing curriculum.
(24)
Instructor - denotes all nursing education personnel employed by the controlling agency to teach
in the vocational nursing department.
(25)
LVN - the Licensed Vocational Nurse who has the authority to utilize the title under Chapter 302,
Texas Occupations Code.
(26)
Major or Required Clinical Areas - Medical-surgical nursing, maternal-child health nursing,
nursing of children and pharmacology.
(27)
May - denotes optional recommendations.
(28)
Nursing Process - serves as an organizational framework for the nurse-patient relationship in
nursing education and practice. It encompasses all the steps taken by the nurse in a systematic
approach to patient care: assessment, planning, intervention and evaluation.
(29)
Objectives - Clear statements of expected behaviors that are attainable and measurable.
(A) Program Objectives - broad statements used to direct overall student learning toward the
development of desirable terminal behaviors.
(B) Level Objectives - describe the student behaviors expected at the completion of major
stages in the curriculum.
(C) Course Objectives - identify desired behavioral changes in the learner upon successful
completion of specific curriculum content and shall serve as the mechanism for student
progression and can be further divided into enroute and terminal categories.
(30)
Philosophy - statement of concepts expressing fundamental beliefs, principles of reality, and of
human nature and conduct as they apply to vocational nursing practice and education.
(31)
Program - comprehensive system of education including development, implementation, and
evaluation of policies and curriculum.
(32)
Recommendations - statements of desirable standards for the development and maintenance of
quality programs.
(33)
Requirements - mandatory standards that a school must meet in order to gain and maintain an
approved status.
(34)
School - refers to a division or department offering a program in vocational nursing.
(35)
Shall - denotes mandatory requirements.
(36)
Should - denotes recommendations.
(37)
Special Student - a student recommended by board staff for enrollment in nursing courses to
meet specific curriculum deficiencies.
(38)
Stipulations - specified mandatory requirements.
(39)
Total Patient Care Assignment - is a manner of assignment whereby the student meets all
nursing needs of the patient within the scope of his or her education.
(40)
Traditional Curriculum - curriculum content which includes broad content areas for courses as
specified by the Board of Vocational Nurse Examiners and meets the minimum hourly
requirements for classroom and clinical instruction.
(41)
Transfer Credit - is credit given for satisfactory completion of courses which are required in the
vocational nurse curriculum.
(42)
Transfer Student - is a student who is allowed credit for previous nursing courses.
B. OPERATION OF A VOCATIONAL NURSING PROGRAM
233
233.11 Agencies Qualified to Operate a School - A school of vocational nursing can be operated by
general hospitals, public or private general education institutions, and proprietary schools.
Specialized institutions such as nursing homes, tuberculosis hospitals, and others do not qualify
as controlling agencies, but may participate with a program as an affiliating health care facility.
233.12 Controlling Agency - The controlling agency shall:
(1) be responsible for satisfactory operation of the vocational nursing program;
(2) meet rules and regulations as stated in this manual;
(3) select and appoint a qualified registered nurse director for the program who meets the
requirements of the Board and appropriate state education accrediting agencies (Texas
Workforce Commission or Texas Higher Education Coordinating Board);
(4) provide the number of faculty necessary to meet minimum standards set by the Board and to
insure a sound educational program;
(5) provide for suitable classroom and clinical facilities;
(6) provide adequate secretarial assistance;
(7) provide adequate funds.
233.13 Affiliating Agency - The affiliating agency shall:
(1) provide clinical facilities for student experience;
(2) provide space for conducting clinical conferences for use by the school if classrooms are
located elsewhere;
(3) provide assistance with clinical supervision of students by mutual agreement between the
affiliating agency and controlling agency;
(4) if available, provide office space for clinical instructors; and
(5) have no authority to dismiss faculty or students. Should the affiliating agency wish to
recommend dismissal of faculty or students, such recommendation(s) must be in writing.
233.14 Contractual Agreement – Before beginning a new clinical affiliation, schools shall submit clinical
affiliation approval forms to board office for approval. Means of cooperation between controlling
and affiliating agencies shall be defined in the contract. There shall be on file a written
contractual agreement between the controlling agency and each affiliating institution before the
affiliation begins. The agreement shall outline the total program and the responsibilities of each
agency entering the agreement. The agreement shall contain a withdrawal of participation clause
indicating a minimum period of time to be given for notice of such withdrawal.
233.15 Establishment of a New Program - a new program may begin after:
(1) new program application and fee are received;
(2) preliminary survey visit by a representative of the Board’s Division of Education;
(3) program proposal is approved by the Board;
(4) approval by appropriate funding agency.
233.16 Establishment of Extension Programs - Any institution already operating a vocational nursing
program desiring to begin an extension program duplicating teaching facilities and faculty shall
begin the extension as a new program. Board policies governing establishing a new school are in
effect.
233.17 Transfer of Controlling Agency - The authorities of the controlling agency shall notify the Board
office of an intent to transfer the controlling authority of the program. Application for approval and
fee will be required for the new program.
233.18 Reopening or Reactivating a Program – A closed program that was previously approved by the
Board must be re-approved by the Board before the enrollment of students. Programs requesting
to reopen shall meet the same criteria as required for the establishment of a new program. An
inactive program with full approval status shall notify the agency in writing of its intent to enroll
students at least three months prior to the enrollment date. An inactive program on conditional
approval status must seek Board approval prior to reactivation.
233.19 Closure of a School - A school desiring to close shall make the intentions known in writing to the
Board. The controlling agency shall be responsible for graduating enrolled students or ensuring
the satisfactory transfer of those students into another school. The controlling agency shall
provide for permanent storage of student records. A school which has not enrolled students for a
period of two years is deemed a closed school; if reopened it will be under initial approval.
233.20 Program Design - Program components are:
(1) rationale for the program;
(2) philosophy, conceptual framework, objectives, and entry-level competencies;
(3) curriculum plan: syllabi reflective of all required content areas, teaching schedule, and
clinical rotation schedules;
(4) organizational chart indicating lines of authority;
(5) well defined written faculty and student policies;
(6) copy of contractual agreement between controlling agency and affiliating health care facilities;
(7) description of classroom facilities, laboratory facilities, and clinical facilities;
(8) director and instructor job descriptions, including qualifications, performance evaluation
criteria;
(9) budget;
(10) documented systematic plan for on-going evaluation of the curriculum which includes, but is
not limited to, implementation of curriculum, congruency of curriculum with needs of society
and trends in health care and health care delivery, and revisions of curriculum based on
evaluation data;
(11) the initial program proposal shall contain a community needs assessment, impact on existing
vocational nursing programs in the service area, and estimates of the current/future applicant
pool.
233.21 Director
(a) Terms of Hire - The controlling agency shall ensure that:
(1) a new director qualification form is submitted to the Board office for approval prior to
hiring a new director for an existing program or a new program;
(2) the director is employed solely for the program development at least eight weeks
prior to beginning a new program;
(3) the director may have responsibilities other than the program provided that an
assistant program coordinator is designated to assist with the program management;
(4) a director with responsibilities other than the program may not have major teaching
responsibilities;
(5) there are written job descriptions which clearly delineate responsibilities of the
director and coordinator.
(b) Requirements - The director shall:
(1) be a registered nurse licensed to practice in the State of Texas;
(2) have been actively employed in nursing for the past five years, preferably in
supervision or teaching;
(3) have a degree or equivalent experience that will demonstrate competency and
advanced preparation in nursing, education, and administration. If the director has
not been actively employed in nursing for the past five years, the director’s advanced
preparation in nursing, education, and nursing administration and prior relevant
nursing employment may be taken into consideration by the Board staff in evaluating
qualifications for the position; and
(4) have had five years of varied nursing experience since graduation.
(c) Responsibilities - The director shall:
(1) be responsible to the controlling agency;
(2) inform the Board office of coordinator appointment;
(3) have the authority to direct the program in all its phases, including approval on
selection of teaching staff, admission, progression, probation, and dismissal of
students;
(4) provide to the Board an official roster of all graduates qualified to apply for licensure
by examination;
(5) distribute the “Application for Licensure” and “Application for Examination” forms to
students;
(6) have sole responsibility for certifying on a Director Affidavit, provided by the Board,
that each graduate who is an applicant for licensure by examination has:
(A) satisfactorily completed, with grades of no less than “C”, all curriculum
requirements as specified in Rule 233.58 of this title (relating to Curriculum
Requirements);
(B) maintained nursing performance and conduct that were satisfactory to the
officials of the controlling agency;
(C) holds a high school diploma issued by an accredited secondary school or
equivalent credentials as established by the General Education Development
Equivalency Test (GED); and
(D) completed all requirements for a certificate or diploma as set forth by the
nursing education program and the controlling agency.
(7) provide the date of program completion on the Director Affidavit;
(8) retain responsibility for the completion of the Director Affidavit unless permission is
granted by Board staff to delegate; and
(9) as agent for the board, issue temporary permits to eligible graduates upon program
completion.
233.22 Instructors - Instructors shall be nurses licensed to practice in the State of Texas or in
accordance with the rules of the Nurse Licensure Compact. Instructors shall have been actively
employed in nursing for the past three years. If the instructor has not been actively employed in
nursing for the past three years, the instructor’s advanced preparation in nursing, education, and
nursing administration, and prior relevant nursing employment may be taken into consideration by
the Board staff in evaluating qualifications for the position. Instructors shall have had three years
varied nursing experiences since graduation. Instructor qualifications forms shall be submitted to
the Board office for approval prior to hiring. Instructors shall have no other responsibilities but the
program. Instructors shall be responsible for all initial nursing procedures in the clinical area and
ascertain that the student is competent before allowing the student to perform an actual nursing
procedure independently. Instructors shall be responsible for developing, implementing, and
evaluating curriculum; participating in development of standards for admission, progression,
probation, and dismissal of students, and participation in academic guidance and counseling.
Adjunct faculty are exempt from meeting the instructor qualifications as long as the courses
taught are not nursing theory or clinical courses. Adjunct faculty shall not be included in the
required faculty/student ratio.
233.23 Designate Supervisors - Designate supervisors shall be nurses licensed to practice in the State
of Texas or in accordance with the rules of the Nurse Licensure Compact. A designate
supervisor shall have been actively employed in nursing for one year. A designate supervisor
shall be responsible for providing clinical instruction and/or supervision when faculty is
unavailable in clinical sites. The role of the designate supervisor is to augment the clinical
instruction provided by the program faculty. While acting in that capacity, the designate
supervisor shall be accountable for identified clinical objectives and will participate in student
evaluation. It is the responsibility of the faculty to provide written clinical objectives, evaluation
criteria, and a written description of expectations to the designate supervisor. The designate
supervisor is mandatory in health care facilities whose census and number of students cannot
support the assignment of a faculty member.
233.24 Minimum Teaching Personnel - There shall be a minimum of one full-time nursing instructor for
the program. A director/coordinator without major teaching or clinical responsibilities shall not be
considered a full-time instructor. There shall be a minimum of one nursing instructor for every 12
students in clinical. A nursing instructor for each affiliating agency is preferred to a designate
supervisor. Designate supervisors shall be excluded from the instructor/student clinical ratio.
Use of part-time nursing instructors is permissible. The number of part-time instructors shall not
exceed the number of full-time instructors in meeting the one to twelve ratio.
233.25 Faculty Continuing Education Requirements - To enhance teaching skills and knowledge,
program director and nursing faculty shall attend continuing education programs/activities of not
less than fifteen (15) hours annually. Foci shall include topics in one or more of the following
areas: nursing, health care and education. Budgeting shall include monies for program director
and nursing faculty to attend continuing education program/activities.
233.26 Clinical Facility - The Board office must be notified and approval given prior to beginning a new
clinical affiliation. Board staff will determine if there are sufficient patient care experiences to
support the affiliation of multiple vocational nursing programs for all major clinical areas. Clinical
facilities that do not require approval prior to affiliations are clinics, day care centers, physicians’
offices, geriatric centers, and psychiatric hospitals.
233.28 Updating Program Design – Schools shall apprise the board office of any program changes.
233.29 Substitute Faculty - Provision may be made to employ substitute faculty during illness,
vacations, and attendance at workshops and continuing education programs.
233.30 Military Faculty - Federal laws and regulations regarding licensure of military nursing personnel
shall apply to Texas based military faculty members functioning within military vocational nursing
programs.
C. APPROVAL OF PROGRAMS
233
233.41 Types of Approval
(a) Initial - Initial approval is extended to a new school beginning with date of first enrollment and
until licensing examination results of first graduates are evaluated by the Board. An
application fee and proposal for a vocational nursing program shall be submitted to the Board
office. Upon receipt of the application and fee the Board shall cause a survey of the
institution making such application to be made by a qualified representative of the Board.
(b) Conditional - Conditional approval is extended to existing schools which fail to meet and
maintain standards. Conditional approval shall be for a period of one year at which time the
Board will re-evaluate the program.
(c) Full – The Board grants full approval to programs that are in compliance with all
requirements. The Board may consider granting full approval with conditions to individual
programs that do not meet all requirements. Certificates of approval are issued annually
based on either a survey visit or review of the annual report.
233.42 Factors Jeopardizing School Approval - Approval may be reduced to conditional status or
withdrawn for the following reasons:
(1) noncompliance with two or more rules, minimum standards, or subsections of a minimum
standard;
(2) failure to acquire approval prior to hiring of nursing faculty;
(3) utilization of students for nursing service and hospital coverage;
(4) noncompliance with school’s stated philosophy, program design, objectives, and/or policies.
(5) continual failure to submit records and reports to the Board office in a timely manner;
(6) failure to provide sufficient clinical practice in both number and variety to provide learning
experiences for students to achieve stated objectives;
(7) failure to comply with Board representative’s stipulations within the specified time;
(8) multiple enrollments per year without sufficient faculty, facilities and/or patient census;
(9) failure to maintain a 75% passing rate on the licensing examination by first time candidates;
(10) failure of agency to annually document that all faculty have current licenses;
(11) other activities or situations as determined by the Board that a school is not meeting legal
requirements and standards;
(12) failure to submit required program survey fee in a timely manner.
233.43 Withdrawal of Approval: A program which fails to correct deficiencies identified in Rule 233.42
of this title (relating to Factors Jeopardizing School Approval) resulting in recommendations for,
and changes in, approval status will be invited to appear before the Board. A program whose
approval has been withdrawn will be removed from the list of state approved vocational nursing
programs.
D. VOCATIONAL NURSING EDUCATION STANDARDS
233
233.51 Curriculum Organization - The program shall be a minimum of 1,398 clock hours; 558 hours for
classroom instruction and 840 hours for clinical practice. A teaching schedule shall show
placement of courses or course content for the entire length of the program. The placement of
subjects within the teaching schedule shall be according to the needs of the program.
233.52 Student Time and Rotation Schedules - Scheduling of student time and clinical rotations shall
be made by the school faculty. Selected clinical learning experiences will remain unchanged
unless a patient’s condition demands reassignment. Reassignment must be approved with prior
consent of faculty.
233.53 Student Patient Assignments - The student’s daily patient assignment shall be made in
accordance with clinical objectives and learning needs of the students. The total number of daily
assignments shall not exceed five patients.
233.54 Class and Clinical Practice Hours - Class hours shall include actual hours of classroom
instruction. Clinical practice shall include actual hours of practice in clinical areas, clinical
conferences, and/or simulated lab experiences.
233.56 Innovative Curriculum Development - Before commencing an innovative curriculum a detailed
written proposal must be submitted to the Board for approval.
233.57 Challenging Curriculum - Schools may allow individuals to challenge the vocational nursing
curriculum, and shall develop and define such policies to meet theory and practice requirements
for challenging credit.
233.58 Curriculum Requirements.
(a) Curriculum.
of the curriculum.
The faculty shall be responsible for the development and implementation
(b) Framework.
The philosophy shall be the basis for curriculum development and shall
reflect the purpose of the organization, faculty beliefs, and education concepts. Terminal
learning objectives derived from the philosophy shall be representative of the Differentiated
Entry Level Competencies for preparation of a vocational nurse graduate. Level and course
objectives shall be stated in behavioral terms and shall serve as the mechanism for student
progression. The conceptual framework shall define the internal and external influences
impacting vocational nursing education and shall identify the educational method and focus.
(c) Design and Implementation. The curriculum shall be designed and implemented to prepare
students to demonstrate the Differentiated Entry Level Competencies. The curriculum design
shall allow for flexibility to incorporate current nursing education theories and the implications
of current developments in health care and health care delivery to assist graduates in
meeting professional, legal, and societal expectations. Educational mobility shall also be a
consideration in curriculum design.
(d) Specific Provisions. Instruction shall be provided in biological, physical, social, behavioral,
and nursing sciences, including body structure and function, microbiology, pharmacology,
and nutrition; signs of emotional health; and human growth and development. Vocational
adjustments and nursing skills shall also be included. Courses may be integrated or
separate. The selection and organization of the learning experiences in the curriculum shall
provide continuity, sequence, and integration of learning. Theory and clinical laboratory
experiences shall be concurrent. Correlated theory and clinical practice shall be provided in
the following areas, but not necessarily in separate courses:
(1) Nursing Care of Children. Experiences shall include care of children and meeting
their needs in a variety of age groups in the acute care setting. Day care and clinic
settings may be utilized as supplementary experience. Common health deviations,
physical, psychological, and neurological handicaps, and nutritional needs shall be
emphasized. Students shall have opportunities to develop understanding of normal
growth and development and the influences of the family, home, church, school, and
community. Student practice in caring for and understanding the needs of newborn
infants shall also be included.
(2) Maternity Nursing. Opportunities shall be provided for students to gain an
understanding of the psychological and physiological aspects of pregnancy, labor,
and puerperium. Assisting mothers in the care of their infants shall be emphasized.
A variety of settings, including clinics, organized maternity units, and maternity cases
in non-segregated units, may be utilized for provision of maternity nursing
experience.
(3) Nursing Care of the Aged. Opportunities shall be included for the care of
individuals experiencing specific changes related to the aging process. Students
shall develop an understanding of the physical and mental changes associated with
aging and the implications of aging in planning nursing care.
(4) Nursing Care of Adults. Opportunities shall be provided to the student through the
use of various resources to care for adults who have health deviations. Resources
used shall include learning experiences to illustrate the individual as a member of the
family, the responsibilities and functions of the community in the provision of nursing
care and the types of agencies where nursing is practiced. Preventive, therapeutic,
and rehabilitative aspects shall be provided. Experiences shall also include the
physical, psychological, and spiritual components of health and disease. Experience
shall include, but not be limited to, the acute care settings.
(5) Nursing Care of individuals With Mental Health Problems. Learning opportunities
shall include an understanding of personality development, human needs, common
mental mechanisms, and factors influencing mental health and mental illness.
Common mental disorders and related therapy shall be included. Clinical experience
in a unit or facility specifically designed for psychiatric care is optional.
(e) Summary of Experiences. Experiences shall include the administration of medications,
health promotion and preventive aspects, nursing care of persons with acute chronic and
aging illnesses and rehabilitative care. Students shall participate in instructor supervised
patient teaching. Students shall also be provided opportunities for participation in clinical
conferences. The focus of clinical conferences shall be student experiences in the clinical
setting. Simulated laboratory experiences may also be utilized as a teaching strategy in
classroom and clinical settings to meet objectives.
(f) Classroom Instruction. Classroom instruction shall include organized student/faculty
interactive learning activities, formal lecture, audiovisual presentations, and simulated
laboratory instruction.
(g) Minimum Hours. The minimum clock hours shall be 558 for classroom instruction and 840
for clinical practice. The minimum total program clock hours, including classroom and
clinical, shall be 1,398.
(h) Evaluation. There shall be provisions for continuous development, implementation, and
evaluation of the curriculum.
(i) Documentation. The curriculum plan, including course outlines, shall be kept current and
available to faculty and Board representatives.
233.60 Teaching Facilities.
(a) Classrooms - Classrooms and nursing skills laboratory facilities shall be provided to
accommodate the learning needs of the students.
(b) Nursing Skills Laboratory - An appropriately equipped skills laboratory shall be provided to
accommodate maximum number of students allowed for the program. The laboratory shall
be equipped with hot and cold running water. The laboratory shall have cabinets for storage
of equipment.
(c) Instructors’ Offices - Office space shall be provided for faculty. The director shall have
office space provided, other than the classroom.
233.61 Resource Materials.
(a) Library - A reference library shall be provided having the latest editions of professional and
vocational nursing textbooks and periodicals. Appropriate additions to the library shall be
made annually.
(b) Teaching Aids - Teaching aids shall be provided to meet the objectives of the program.
233.62 Restrooms and Lounges - Adequate restrooms and lounges shall be provided convenient to the
classroom.
233.63 Admission of Classes - The Board shall approve the maximum number of students per
enrollment, number of enrollments per year and the number of students assigned to an affiliating
institution for all programs. Schools shall not accept admissions after the third day of class.
233.64 Student Policies - The school shall have well defined student policies. Student policies shall be
based on statutory and Board requirements. Policies shall include notification to students of the
investigation questions contained in the application for licensure and the Board’s investigation
process. Copies of the student policies shall be furnished to all students at the beginning of the
school year. The school shall maintain a signed receipt of student policies in all students’
records. It is the school’s responsibility to define and enforce student policies.
233.65 Admission Criteria - Admission requirements shall be stated in the student policies. Schools
shall set reasonable educational requirements for admission. Applicants shall present evidence
of being in good physical and mental health. All students shall be pretested. Tests shall measure
reading comprehension and mathematical ability.
233.66 Dismissal Criteria - Reasons for dismissal shall be stated in student policies.
233.67 Schedule of Hours - The total weekly schedule throughout the length of the program shall not
exceed 40 hours per week including both class and clinical practice hours. Class and clinical
practice hours shall be continuous. Students shall be assigned two consecutive non class days
off each week.
233.68 Schedule of Clinical Practice - Schools shall NOT permit utilization of students for hospital
staffing. Students may be assigned by the school to evening clinical practice with faculty. After
seven months students may be assigned by the school to evening clinical practice with a
designate supervisor.
233.69 Vacation and Holidays - Students shall be allocated at least 18 days leave for vacation and/or
holidays. All scheduled holidays are to be observed on the holidays designated by the controlling
agency. Vacation time shall be scheduled at the same time for all students.
233.71 System of Grading - Licensing application indicating a grade of less than a “C” on any subject
equivalent to the specific provisions of curriculum requirements, Rule 233.58 (d) of this title
(relating to Curriculum Requirements), shall not be accepted.
233.72 Transfer and Advanced Placement of Vocational and Professional Nursing Students Acceptance of transfer students and evaluation of allowable credit for advanced placement
remains at the discretion of the director of the program and the controlling agency. All of the
program’s requirements must be met. On completion the individual is considered a graduate of
the school.
233.73 Special Students - Special students may be recommended for admission by the Board staff.
Acceptance of special students is at the discretion of the director of the vocational nursing
program and the controlling agency. The special student would not be considered a graduate of
that school.
233.74 Clinical Practice Evaluations - Faculty are responsible for student clinical practice evaluations.
Clinical practice evaluations shall be correlated with level and/or course objectives. Students
shall receive a minimum of three clinical evaluations during the program year.
233.75 Student Conferences - Records of student conferences shall be kept and made available to the
student involved and all faculty members. Students shall have written documentation of all
conferences.
233.76 Minimum Standards/Guidelines
(a) The staff of the Board of Vocational Nurse Examiners may develop minimum
standards/guidelines that may be used in evaluating a nursing curriculum, and in determining
compliance with the Board’s rules relative to vocational nursing programs.
(b) These minimum standards/guidelines are available for purchase at the Board office.
E. VOCATIONAL NURSE EDUCATION RECORDS
233
233.81 Student Forms - Student records shall be maintained on all students. Record forms may be
developed by an individual school. Hospital employment forms are not to be used for student
records.
233.82 Required Student Forms - The required student forms are the student application, physical
examination, clinical practice evaluation, nursing transcript, signed receipt of written student
policies, and statement of withdrawal.
233.83 Record Storage - School and student records shall be stored in a fireproof locked file. Student
records shall be maintained up to date and shall be accessible to all faculty members and to
Board representatives. Records of all graduates must be completed prior to permanent storage.
Records on students who withdraw from the program shall be completed up to the date of
withdrawal.
233.84 Retention of Student Records - All records must be maintained for two years. At minimum, a
transcript shall be retained as a permanent record on all students.
233.85 Required and Resource Program Documents
(a) Availability of documents from the Board office include:
(1) required reporting documents and
(2) resource documents
(b) Changes and/or clarification of required documents, resource documents, and/or applicable
fees will be communicated by Board staff. When applicable, original forms must be
completed and submitted according to specified directions.