201 KAR 20:320 - Standards for curriculum of prelicensure registered nurse and practical nurse programs
RELATES TO: KRS 194A.540(11), 314.011(5), 314.021, 314.041(1)(a), 314.111(1), 314.131(1), (2), 620.020(8)
NECESSITY, FUNCTION, AND CONFORMITY: KRS 314.041(1)(a) and 314.051(1)(a) require that an applicant for licensure as a registered or licensed practical nurse complete the basic nursing curriculum in an approved school of nursing. KRS 314.111(1) requires that schools of nursing regardless of delivery models shall meet minimum standards and be approved by the Board of Nursing. KRS 314.131(1) and (2) authorizes the board to promulgate administrative regulations necessary to approve programs of nursing. This administrative regulation establishes the curriculum requirements for prelicensure registered nurse and practical nursing programs.
Section 1. Definitions.
(1) "Debriefing" means an activity that
follows a simulation experience, is led by a nurse faculty as established in
201
KAR 20:310, Section 2, encourages participant's
reflective thinking, and provides feedback regarding the participant's
performance.
(2) "Distance
learning" means didactic instruction offered by any means where the student and
faculty are in separate physical locations.
(3) "External examination" means a
standardized or norm-referenced examination that is designed to compare and
rank test takers in relation to one another and is not produced by the program
of nursing.
(4) "Practical nursing
program" means a program of nursing organized and administered by a vocational,
technical, or adult education system or an independent school at a
postsecondary level that awards the graduate a diploma in practical nursing
upon meeting requirements of the program.
(5) "Program of nursing" means the
educational unit that prepares a person for licensure as a registered or
licensed practical nurse.
(6)
"Registered nursing program" means a program of nursing organized and
administered by an institution of higher learning that awards a degree in
nursing upon meeting requirements of the program.
(7) "Remediation" means the process by which
a student improves or corrects a knowledge deficit through external
examinations, other assignments, or activities.
(8) "Simulation" means an activity or a
technique that replicates actual or potential situations in clinical practice
that allows the participant to develop or enhance critical thinking.
Section 2. General.
(1) An applicant for licensure shall complete
a prelicensure program of nursing that meets the requirements of this
administrative regulation.
(2)
Length.
(a) A registered nursing program shall
be a minimum of two (2) academic years, which may include prior articulated
academic credits.
(b) A practical
nursing program shall be a minimum of one (1) academic year.
(3) Philosophy, mission, and
outcomes.
(a) The philosophy, mission, and
outcomes of the program of nursing shall be clearly defined in writing by the
nursing faculty and be consistent with those of the governing
institution.
(b) The program
outcomes shall describe the expected competencies of the graduate.
(c) The program shall conduct an evaluation
to validate that identified program outcomes have been achieved and provide
evidence of improvement based on an analysis of those results.
(4) Approval.
(a) A curriculum plan shall be approved by
the board in accordance with this administrative regulation.
(b) The curriculum plan shall enable the
student to develop the nursing knowledge, skills, and competencies for the
expected entry level and scope of practice.
(c) Theory and clinical experiences shall
provide the student with opportunities to acquire and demonstrate the
knowledge, skills, and competencies necessary for safe practice.
(5) Curriculum plan.
(a) The development, implementation,
evaluation, and revision of the curriculum shall be the responsibility of the
nursing faculty including the program administrator with input from
students.
(b) The curriculum of the
program of nursing shall assure the development of evidence based practice for
the level and scope of nursing practice. This shall include the skills to
identify and apply best practices in nursing care by providing client-centered,
culturally competent care and respecting client differences, values,
preferences, and expressed needs.
(c) A registered nursing program may
determine that a portion of the curriculum fulfills the scope of practice for
licensed practical nursing and allow students to exit the program and be made
eligible for the NCLEX-PN examination. The registered nursing program shall
submit its plan to the board for approval.
(6) Organization of the curriculum.
(a) There shall be a written plan, including
supporting rationale, which describes the organization and development of the
curriculum.
(b) The curriculum plan
shall reflect the philosophy, mission, and outcomes of the program.
(c) There shall be a rationale for the amount
of time or credits allocated to course and clinical practice
experience.
(d) A course syllabus
shall be developed for each nursing course to include outcomes, planned
instruction, learning activities, and method of evaluation.
1. Each course shall be implemented in
accordance with the established course syllabus.
2. A copy of each course syllabus shall be on
file in the program of nursing office and shall be available to the board upon
request.
(e) The
curriculum plan shall be logical and sequential, and shall demonstrate an
increase in difficulty and complexity as the student progresses through the
program.
(f) A course may be
offered as a distance learning course. A distance learning course shall meet
the same standards as established in
201
KAR 20:260 through
201
KAR 20:360 for any other course.
(7) Curriculum components.
(a) The curriculum of a registered nursing
program or a practical nursing program shall prepare the graduate for licensure
and full scope of practice as defined by current standards for nursing practice
and expected competencies of graduates at the appropriate educational
level.
(b) The curriculum shall
include:
1. Theory and selected clinical
practice experiences designed to enable students to provide nursing care to
individuals throughout the life span; and
2. Information regarding Kentucky nursing
laws, including scope of practice, licensure requirements, and the role of the
board of nursing.
(c)
Clinical practice settings shall be appropriate for the type of nursing program
and the program outcomes and enable the student to observe and practice safe
nursing care of persons at each stage of the life span. Experiences shall
include opportunities to learn and provide care to diverse ethnic and cultural
populations.
(d) Clinical practice
experience shall be supervised by board approved nursing faculty in accordance
with
201
KAR 20:310.
(e) The curriculum shall have written
measurable program outcomes that reflect the role of the graduate.
(f) Students shall have sufficient
opportunities in simulated or clinical settings to develop psychomotor skills
essential for safe, effective practice.
(8) Curriculum change.
(a) A program of nursing that is not
accredited by a national nursing accrediting body shall submit a written plan
for major curriculum revisions to the board a minimum of four (4) months prior
to the planned implementation.
1. A request
for curriculum revision shall include the present plan and the proposed change
with rationale and expected outcomes.
2. The board shall be available to assist if
curriculum revisions are being considered.
3. Major curriculum revisions shall include:
a. A change in the philosophy, mission, or
outcomes that results in a reorganization or reconceptualization of the entire
curriculum; or
b. The addition of
tracks or alternative programs of study that provide educational
mobility.
(b)
A program of nursing that implements a curriculum change shall provide an
evaluation of the outcomes of those changes through the first graduating class
following full implementation of the curriculum change. The program of nursing
shall also submit the evaluation with its annual report.
(9) Integrated practicum.
(a) The curriculum shall include an
integrated practicum. The integrated practicum shall consist of a minimum of
120 clock hours of concentrated clinical experience of direct patient care in a
health care facility or health care organization.
(b) The integrated practicum shall be
completed within a period not to exceed seven (7) consecutive weeks while the
governing institution is in session and within seven (7) months of
graduation.
Section
3. Simulation Standards.
(1)
(a) A program of nursing that uses simulation
shall adhere to the standards set in this section.
(b) A program of nursing shall not use
simulation for more than fifty (50) percent of its total clinical hours
required for graduation.
(2)
(a) The
program of nursing shall provide resources sufficient to support the simulation
activities, including training of the faculty, and programmatic
outcomes.
(b) Simulation activities
shall be managed by a nurse who is academically and experientially qualified in
the use of simulation, both in its pedagogical and technical aspects. The
managing nurse shall demonstrate his or her qualifications by:
1. Attendance at simulation
conferences;
2. Completion of
educational activities related to simulation; or
3. Holding a credential issued by the Society
for Simulation in Healthcare or a simulation preparation program recognized by
the International Nursing Association for Clinical Simulation.
(c) The program of nursing shall
have written rationale for the use and purpose of simulation within the
curriculum.
(d) The program of
nursing shall have an orientation plan for faculty concerning
simulation.
(e) The program of
nursing shall have a written procedure on the method of prebriefing and
debriefing each simulated activity.
(3) The program of nursing shall have
appropriate facilities for conducting simulation. This shall include
educational and technological resources and equipment to meet the intended
objectives of the simulation.
(4)
Faculty, both didactic and clinical, that utilize simulation shall:
(a) Have training in the use of simulation;
and
(b) Engage in on-going
professional development in the use of simulation.
(5) The simulation activities shall be linked
to the program of nursing's course objectives and the programmatic
outcomes.
(6) Beginning July 1,
2019, a program of nursing shall submit evidence of compliance with these
standards in the annual report required by
201
KAR 20:360, Section 3(1) of this administrative
regulation.
Section 4.
Use of External Examinations.
(1) External
examinations may be used to assist in the remediation of a student or as a part
of the final course grade..
(2) A
program of nursing shall not use an external examination as the sole basis to
determine a student's progression or graduation.
(3) A curriculum change that includes the
implementation of an external examination shall include consideration of
multiple evaluation criteria, and shall not be based solely on external
examination test results.
(4) A
program of nursing that utilizes external examinations as a component of
student remediation shall ensure that completion of remediation occurs within
the same semester or quarter.
(5)
The academic progression policy of the program of nursing and course syllabi
shall clearly outline the role of an external examination, including the
frequency of and schedule for the testing, and the weight to be applied to
results when calculating the final course grade. A course syllabus that
references an external examination shall include information needed to
calculate the impact of test results in any given external examination on the
final course grade. If a course syllabus requires a specific average test score
on all exams as a condition for passing the course, student results on external
exams shall be excluded from that calculation.
(6) A program of nursing shall not require
students who have completed all requirements for graduation to earn a specific
score or benchmark on an external examination as a condition for graduation or
for placing the student's name on the Certified List of Kentucky Program of
Nursing Graduates pursuant to
201 KAR
20:070.
Section 5. Curriculum Additions.
(1) Each program of nursing shall include
information in its curriculum that meets the requirements of
KRS
194A.540 related to domestic violence and
elder abuse, neglect, and exploitation.
(2) Each program of nursing shall include
information about:
(a) Pediatric abusive head
trauma as it is defined in
KRS
620.020(8);
(b) Suicide prevention and wellness topics
listed in subsection (3) of this section by August 15, 2022; and
(c) Implicit bias topics listed in subsection
(4) of this section by August 15, 2022.
(3) Suicide prevention and wellness topics
shall include:
(a) Chronic toxic stress and
secondary traumatic stress potentially increasing the incidence of suicide
amongst nurses;
(b) A confidential
and standardized pathway to care for nurses that addresses screening,
assessing, safety planning, referrals, and follow-up for nurses at risk for
suicide;
(c) Systems of care,
evidence-informed approaches, and best practices to reduce suicide rates;
and
(d) Ethical legal
considerations of caring for patients and nurses who are suicidal.
(4) Implicit bias topics shall
include:
(a) The impact of historical racism
and other forms of invidious discrimination on the provisions of
healthcare;
(b) Methods of
evaluation the presence and extent of implicit bias; and
(c) Measures that may be taken to reduce
implicit bias.
Notes
STATUTORY AUTHORITY: KRS 314.041(1)(a), 314.051(1)(a), 314.111(1), 314.131(1), (2)
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