ARC 3127C

ARC 3127C

NURSING BOARD[655]

Notice of Intended Action

Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."

Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.

Pursuant to the authority of Iowa Code sections 17A.3 and 147.76, the Iowa Board of Nursing hereby gives Notice of Intended Action to amend Chapter 2, "Nursing Education Programs," Iowa Administrative Code.

The proposed amendments to Chapter 2:

●Clarify existing definitions in the chapter.

●Add definitions to the chapter.

●Streamline the provisional approval process.

●Add a process for denial and withdrawal of Board approval.

●Streamline the process for closure of an approved program.

●Clarify the role and expectation of the head of the program to have two years of teaching experience in a nursing education program.

●Clarify language regarding the nursing curriculum.

●Add language regarding application of a standardized examination in a nursing education program.

●Add language on the use of simulation in a nursing education program based on National Council of State Boards of Nursing (NCSBN) model rules.

●Clarify the expectation of nursing education programs in regards to providing program-related information to prospective and current students (i.e., NCLEX^® passing percentages).

●Clarify the nursing program's responsibility concerning changes to the program.

●Streamline the process for programs that fall below 95 percent of the national NCLEX^® passing percentage.

●Clarify language concerning reports to the Board (i.e., annual reports).

●Clarify language concerning changes requiring Board notification and approval.

Any interested person may make written comments or suggestions on or before July 11, 2017. Such written materials should be directed to the Executive Director, Iowa Board of Nursing, RiverPoint Business Park, 400 S.W. 8th Street, Suite B, Des Moines, Iowa 50309-4685; or sent by e-mail to rules.comments@iowa.gov. Persons who wish to convey their views orally should contact the Executive Director at (515)281-3256 or in the Board office at 400 S.W. 8th Street, Des Moines, Iowa, by appointment.

Also, there will be a public hearing on July 11, 2017, from 8:30 a.m.to 10:30 a.m.at the Board of Nursing office, 400 S.W. 8th Street, Suite B, Des Moines, Iowa, at which time persons may present their views either orally or in writing. At the hearing, persons will be asked to give their names and addresses for the record and to confine their remarks to the subject of the amendments.

These amendments were approved by the Board on April 19, 2017.

After analysis and review of this rule making, no fiscal impact has been found.

After analysis and review of this rule making, no impact on jobs has been found.

These amendments are intended to implement Iowa Code chapters 17A, 147, 152, and 272C.

The following amendments are proposed.

Item 1. Amend rule 655—2.1(152) as follows:

655—2.1(152) Definitions.

"Approval" means recognition status given to nursing education programs based on the programs' compliance with the criteria specified in this chapter. Approval may be granted or continued within for any time frame period determined by the board for up to six years.

"Clinical facilities" means locations where students directly care for patients/clients under the supervision of a qualified faculty member so that program outcomes are met.

"Clinical instruction" means hands-on learning situations in which students directly care for patients/clients within a relevant setting, under the supervision of a qualified faculty member, so that program outcomes are met.

"Content" means the subject matter in a given area of study.

"Controlling institution" means the institution that has authority over and administrative accountability for the program(s).

"Curriculum" means content, lab/simulation, observation and clinical experiences developed, implemented and evaluated by faculty to facilitate achievement of program outcomes and to meet the learning needs of students.

"Debriefing" means an activity that follows a simulation experience and that is led by a faculty member, encourages a participant's reflective thinking, and provides feedback regarding the participant's performance.

"Faculty" means the teaching staff in a nursing education program. "Faculty" also means individuals who teach nursing in a nursing education program or who are hired to teach in a program on the basis of education, licensure or practice as a registered nurse. This definition includes anyone who provides didactic , simulation, laboratory, or clinical instruction in nursing when assigned by the program to provide this instruction for courses included in the nursing curriculum. The definition applies regardless of the amount of time spent teaching, the level of payment, the type of contract, the temporary nature of the position, or the location of the learner.

"First professional degree" means the title conferred by a college or university that signifies completion of the academic requirements for beginning practice in a given profession and a level of professional skill beyond that normally required for a baccalaureate degree.

"Head of program" means the dean, chairperson, director, or coordinator of the nursing education program(s) who is responsible for the administration of the program(s).

"Improvement status" means the status on which a program is placed after three consecutive years of NCLEX® results below the 95 percent of the national NCLEX® passing percentage.

"Interim approval" means approval granted to a new nursing program, at which time students may be admitted into the program.

"Lab/simulation" means activities that mimic the reality of a clinical environment and that are designed to demonstrate procedures, decision making and critical thinking through techniques such as role-playing and through the use of devices such as interactive videos or mannequins. "Lab/simulation" shall not take the place of clinical experiences with actual patients interactive experiences.

"Learning experiences" means experiences that shall include content and clinical instruction and that may include components of lab/simulation, practicum, and observation.

"Located in Iowa" means a college or university that is accredited by the Higher Learning Commission of the North Central Association of Colleges and Schools, that has made a substantial investment in a permanent Iowa campus and staff, and that offers a full range of courses leading to the degrees offered by the institution as well as a full range of student services.

"Master's degree" means the title conferred by a college or university upon completion of a program of graduate study that requires a level of academic accomplishment and subject mastery substantially beyond that required for a baccalaureate degree.

"National NCLEX® passing percentage" means the percentage of first-time testers who achieve a passing score on the NCLEX® examination for licensed practical nurse or registered nurse licensure, calculated on a calendar year basis.

"NCLEX®" means the National Council Licensure Examination, the examination currently used for initial licensure as a registered nurse or licensed practical nurse.

"NCLEX® passing percentage" means the percentage of first-time testers who achieve a passing score on the NCLEX® examination for licensed practical nurse or registered nurse licensure within six months of graduation from a nursing program, calculated on a calendar year basis.

"Observation" means learning experiences in a relevant setting , that meet program outcomes but do not require on-site faculty supervision and where the student does not directly care for patients/clients, that meet program outcomes but do not require on-site faculty supervision.

"Out-of-state program" means an approved nursing program within U.S. United States jurisdiction that provides clinical experiences in Iowa.

"Practicum" means a course of study designed especially for the preparation of nurses that involves the supervised practical application of previously studied theory.

"Preceptor" means a licensed individual who meets Iowa board of nursing qualifications as specified in this chapter, is on staff at the facility where the experience occurs, is selected by the educational facility in collaboration with the clinical facility, and is responsible for the on-site direction of the student over a period of time.

"Preceptorship" means an optional experience between a preceptor and a nursing student over a period of time that is congruent with program outcomes.

"Program" means a course of study by any method of instruction or delivery that leads to a nursing diploma, degree or certificate. Multiple-site programs offered by one controlling institution shall be considered one program if the philosophy and curriculum of all the sites are the same. Programs eligible for board approval shall include all of the following:

1.At least a one-academic-year course of study or its equivalent in theory and practice as described by the board that leads to a diploma in practical nursing and to eligibility to apply for practical nurse licensure by examination as described in 655—Chapter 3.

2.At least a two-academic-year course of study or its equivalent in theory and practice as described by the board that leads to a degree in nursing and to eligibility to apply for registered nurse licensure by examination as described in 655—Chapter 3.

3.A course of study designed for registered nurses that leads to a baccalaureate degree with a major in nursing.

4.A postbaccalaureate course of study that leads to a master's degree with a major in nursing.

5.A course of study designed for registered nurses that leads to a master's degree with a major in nursing.

6.A course of study designed for registered nurses who hold a master's degree in nursing that leads to a certificate in advanced practice nursing. When the certificate is in a clinical specialty area, the course of study shall lead to eligibility to apply for certification in the clinical specialty by a national professional nursing organization approved by the board and to eligibility for registration as an advanced registered nurse practitioner as described in 655—Chapter 7.

7.A post-master's course of study that leads to a doctoral degree with a major in nursing.

8.A course of study that leads to a doctorate in nursing practice.

"Qualified nursing faculty" means individuals who meet Iowa board of nursing faculty qualifications as specified in this chapter as well as and the qualifications of the parent institution.

Item 2. Renumber rules 655—2.2(152) to 655—2.4(152) as 655—2.3(152) to 655—2.5(152), and renumber rules 655—2.5(152) to 655—2.15(152) as 655—2.7(152) to 655—2.17(152).

Item 3. Adopt the following new rule 655—2.2(152):

655—2.2(152) Programs eligible for board approval. Programs eligible for board approval shall include all of the following:

1.At least a one-academic-year course of study or its equivalent in theory and practice as described by the board that leads to a diploma in practical nursing and to eligibility to apply for practical nurse licensure by examination as described in 655—Chapter 3.

2.At least a two-academic-year course of study or its equivalent in theory and practice as described by the board that leads to a degree in nursing and to eligibility to apply for registered nurse licensure by examination as described in 655—Chapter 3.

3.A course of study designed for registered nurses that leads to a baccalaureate degree with a major in nursing.

4.A course of study designed for registered nurses that leads to a master's degree with a major in nursing.

5.A course of study designed for registered nurses who hold a master's degree in nursing that leads to a certificate in advanced practice nursing and eligibility for licensure as an advanced registered nurse practitioner as described in 655—Chapter 7. When the certificate is in a population focus, the course of study shall lead to eligibility to apply for certification in the population focus by a national professional nursing organization recognized by the board.

6.A post-master's course of study that leads to a doctoral degree with a major in nursing.

7.A course of study that leads to a doctorate in nursing practice.

Item 4. Amend renumbered subrule 2.3(2) as follows:

2.3(2) The board shall approve or deny the program application to establish a nursing program. If the board approves the program application, the controlling institution shall then submit to the board a program proposal within one year of the application that includes, but is not limited to, the following:

a. Evidence of employment of the head of the program, including the individual's qualifications, at least six months prior to the beginning of the first nursing course.

b. Program philosophy, objectives and outcomes that reflect the proposed level of education.

c. Organizational chart of the educational institution documenting the relationship of the nursing program within the institution.

d. Curriculum plan that meets the criteria in rule 2.8(152) 655—2.10(152).

e. Letter of intent from clinical facilities securing clinical opportunities and documentation of the facility type, size, number of beds, and type of patients.

f. Evidence of provision of qualified faculty. Faculty shall be employed by the controlling institution prior to the beginning of teaching assignments. Faculty members who teach nursing shall meet the qualifications outlined in subrule 2.9(2) 2.11(2).

g. Updated time schedule.

h. Proposed five-year budget for the nursing education program.

Item 5. Amend renumbered subrules 2.3(4) and 2.3(5) as follows:

2.3(4) Interim approval may be granted to the program based on the program proposal and a site visit.

a. The controlling institution shall publish the interim approval status of the program.

b. The head of the program shall submit nine copies one electronic copy and one hard copy of a program progress report three four weeks prior to each regularly scheduled board meeting until full approval as described in rule 2.3(152) 655—2.4(152) is granted by the board. The progress report shall include the following:

(1)Updated information in all areas identified in the initial proposal.

(2)Current number of admissions and enrollments.

(3)Current number of qualified faculty.

(4)Course New course offerings, including descriptions, credit hours, outcomes/objectives, placement of course and curriculum submitted six months prior to the offering of courses.

(5)Detailed course syllabi submitted six months prior to the offering of courses.

(6) (5)Changes requiring board notification and approval as outlined in subrule 2.15(3) 2.17(3).

c. Interim approval shall continue until the board conducts a review of program materials, completes a site visit, and grants approval to the program following graduation of the first class and submission of results of the national examination for licensure or advanced practice certification, if applicable.

d. The board may at any time seek additional program information from the controlling institution and head of the program.

2.3(5) The board may deny interim approval based on the program proposal and a site visit.

a. In order to be reconsidered, the controlling institution shall resubmit a program proposal within six months from the time of program application.

b. One year from the initial application, the controlling institution shall may resubmit a program application to the board in order to be reconsidered.

Item 6. Amend renumbered subrule 2.4(2) as follows:

2.4(2) The program shall provide to the board the nursing education program report and requested materials addressing all aspects of the program outlined in rules 2.6(152) 655—2.8(152) to 2.15(152) 655—2.17(152) and documenting how the criteria for approval are met. Documentation may include current information submitted by the program to other approving and accrediting entities.

Item 7. Amend renumbered rule 655—2.5(152) as follows:

655—2.5(152) Provisional approval.

2.5(1) Provisional approval may be granted at the board's discretion to a program if the board determines that the program does not meet the criteria for approval : during the full approval procedure or at any time during the progression of the program.

a. At any time during the progression of the program.

b. During the full approval procedure of the program.

2.5(2) At the time of provisional approval, the board:

a. Shall notify the president of the academic institution and head of the nursing program, in writing, of the program's provisional approval status;

a. b.Shall meet with representatives of the program and controlling institution to determine discuss the length of provisional approval, set conditions for achieving full approval, and identify expected outcomes. The program shall notify students of provisional approval.; and

b. c.May require progress reports and a site visit.

c. Shall meet with representatives of the program and controlling institution prior to the expiration of the program's provisional approval to determine if outcomes are met.

d. Shall deny or withdraw approval if the board determines that the program failed to meet the conditions for full approval.

2.5(3) Throughout provisional approval:

a. The program shall notify all students and prospective students of the program's provisional approval status; and

b. The board may require progress reports, conduct site visits, and request board appearances.

2.5(4) Prior to the expiration of a program's provisional approval, the board shall meet with representatives of the program and controlling institution to determine if the outcomes are met. The board shall determine whether to grant the program full approval, extend provisional approval, or initiate proceedings to deny or withdraw approval.

Item 8. Adopt the following new rule 655—2.6(152):

655—2.6(152) Denial or withdrawal of board approval.

2.6(1) If a program does not meet the conditions imposed during provisional approval to return to full approval within the time period specified, the board may initiate proceedings to deny or withdraw approval of the program. To initiate proceedings, the board shall issue to the program a notice of intent to deny or withdraw approval. The notice of intent shall set forth the basis for the denial or withdrawal and describe the process for appealing the notice. If a program appeals, a contested case hearing shall be scheduled. The hearing shall be governed by the rules found in 655—Chapter 20.

2.6(2) If, after a contested case proceeding, the board denies or withdraws approval of a program, the program shall immediately notify all enrolled students of the denial or withdrawal of approval. Such notification must include the date of denial or withdrawal of approval and a statement that students must graduate from an approved program to be eligible for licensure. The program shall assist all enrolled students with transferring to an approved program.

Item 9. Amend renumbered rule 655—2.7(152) as follows:

655—2.7(152) Closure of an approved program.

2.7(1) Prior to program closure, the controlling institution shall submit a written plan for board approval. The plan shall include reasons for closure and the date of closure, which is defined as the date when the last student graduates. The plan shall also address a provision for the graduation of enrolled students, retention of adequate numbers of qualified faculty, retention of approved curriculum, maintenance of educational resources and student services, and a provision for student and graduate transcripts. When a program intends to close prior to the graduation of enrolled students who are actively taking nursing courses, the plan shall be submitted to the board at least 12 months prior to closure, except when closure is occurring as a result of an emergency or unforeseen circumstances. The board may shorten the 12-month time period if the board determines that the controlling institution has made adequate provisions for enrolled students.

2.7(1) 2.7(2) Voluntary closure. The program shall continue to meet the criteria for board approval until all enrolled students have graduated or the board has approved a plan for closure prior to graduation of the students. The board may require progress reports during the closure process. Prior to closure, the controlling institution shall notify the board regarding the location and maintenance of student and graduate transcripts and records to enable retrieval after the program closes.

2.7(2) Closure as a result of denial or withdrawal of board approval. The controlling institution shall implement the time frame established by the board for transfer of enrolled students to an approved program and report to the board the date of transfer for each student by name. Program closure shall occur when the last student has transferred. The board may require progress reports during the closure process.

2.7(3) Record storage. Prior to closure, the controlling institution shall notify the board regarding the location and maintenance of student and graduate transcripts and records.

Item 10. Amend renumbered subrules 2.8(1) and 2.8(2) as follows:

2.8(1) The program shall meet the following criteria:

a. Authorization. Authorization for conducting a program is granted in accordance with Iowa Code chapter 261B. Such authorization is provided by the Iowa secretary of state.

b. Authority and administrative responsibility. The authority and administrative responsibility of the program shall be vested in the head of the program, who is responsible to the controlling institution.

c. Organizational chart. The organizational chart(s) shall clearly indicate the lines of authority and communication within the program and with the central administration, other units within the controlling institution, cooperating agencies, and advisory committees.

d. Finances.

(1)The controlling institution shall allocate adequate funds to carry out the purposes of the program.

(2)The head of the program shall prepare the budget with the assistance of the faculty.

e. Ethical practices. Ethical practices and standards, including those for recruitment and advertising, shall be consistent with those of the controlling institution and shall be made available to students and prospective students.

f. Contractual agreements. Written contractual agreements shall exist between the program and the clinical facilities. The agreements shall include:

(1)Identification of responsibilities of both parties related to patient or client services.

(2)Faculty Provision for faculty control, selection and guidance of student learning experiences.

(3)Provision for termination of the agreement.

(4)Provision for annual review.

(5)Documentation Provision that the facility is in good standing with its regulatory agency.

g. Accrediting and approving agencies.

(1)The controlling institution or program shall be accredited by the Higher Learning Commission of the North Central Association of Colleges and Schools.

(2)When the program is located at a community college, the controlling institution shall be approved by the Iowa department of education.

(3)When the program is offered under the auspices of the United States armed forces, it shall be accredited by the U.S. Department of the Army.

h. Philosophy/mission and program outcomes. The faculty shall develop a philosophy or mission statement and program outcomes that shall be:

(1)Consistent with the philosophy or mission of the controlling institution.

(2)Reflective of faculty beliefs about nursing, education and professional standards.

(3)A guide in the development, implementation and evaluation of the program.

(4)Available to students and prospective students.

i. Program evaluation. A written plan shall outline the evaluation process for all aspects of the program and shall identify the methodology, tools, responsible parties and time frame. Evidence of implementation shall reflect achievement of program outcomes.

2.8(2) The head of a program shall meet the following requirements:

a. Current licensure as a registered nurse in Iowa. An individual is currently licensed when licensed in another state and recognized for licensure in this state pursuant to the nurse licensure compact contained in Iowa Code chapter 152E.

b. Two years of experience in clinical nursing.

c. Two years of teaching experience in a nursing education program.

d. Academic qualifications:

(1)The head of a program who was employed on or before July 1, 1992, shall be considered adequately prepared as long as that person remains in that position.

(2)The head of a program hired after July 1, 1992, shall have a master's or doctoral degree with a major in nursing at either level at the time of hire. A first professional degree as defined in rule 2.1(152) does not meet this requirement. The date of hire is the first day of employment as head of the program with compensation at a particular nursing education program.

(3)If a program offers a baccalaureate or higher degree in nursing, the head of the program shall have a doctoral degree at the time of hire.

e. Submission of qualifications to the board office within one month of appointment.

Item 11. Amend renumbered rule 655—2.9(152) as follows:

655—2.9(152) Resources of the controlling institution. The controlling institution is responsible for provision of resources adequate to meet program needs and outcomes.

2.9(1) Human resources. Human resources shall include the following:

a. Head of program.

b. Faculty.

c. Secretarial and other support and staff services to ensure appropriate use of faculty time and expertise.

d. Support staff for online or distance education or both.

2.9(2) Physical resources. Physical resources may include the following:

a. Classrooms, conference rooms, laboratories, simulation laboratories, offices, and equipment.

b. Student facilities.

2.9(3) Learning resources. Learning resources shall include the following:

a. Library.

b. Print media.

c. Computer-mediated resources.

d. Laboratory/simulation laboratory equipment.

2.9(4) Financial resources. Financial resources shall be adequate to support and carry out the mission of the controlling institution.

Item 12. Amend renumbered rule 655—2.10(152) as follows:

655—2.10(152) Curriculum.

2.10(1) The curriculum of a program shall:

a. Reflect the philosophy/mission and program outcomes supported by the nursing faculty.

b. Identify program outcomes and define how learning experiences support outcomes.

c. Reflect current standards of nursing practice and education.

d. Be consistent with laws governing the practice of nursing.

e. Ensure sufficient preparation for the safe and effective practice of nursing.

f. Include planned learning experiences and strategies that meet demonstrate integration of knowledge and attainment of the program outcomes.

g. Reflect the roles for which the student is being prepared.

h. Be evaluated on a regular basis by the faculty and reflect achievement of student outcomes as demonstrated in the program evaluation plan.

g. i.When offered within a college or university:

(1)Be comparable in quality and requirements to other degree programs within the college or university.

(2)Be planned in accordance with the college or university calendar.

(3)Assign credit hours for learning experiences that are consistent with the college or university pattern.

(4)Provide a teaching/learning environment (classroom, clinical, laboratory, or simulation) that supports achievement of expected outcomes.

2.10(2) Standardized examinations may be used to supplement a program's curriculum but shall not prevent a student's academic progression or graduation. At the time of enrollment, students shall be informed of the schedule and procedure for any standardized examinations utilized in the curriculum. The program shall have a process and procedure for remediation of students who do not pass the standardized examinations.

2.10(2) 2.10(3) Prelicensure programs.

a. The curriculum of a program leading to eligibility for initial licensure as a licensed practical nurse or registered nurse shall include:

(1)Content that is consistent with the practice of nursing as defined in Iowa Code section 152.1.

(2)Content in medical, surgical, gerontological, mental health, and nursing of childbearing families and children that reflects current nursing practice and that encompasses health needs throughout the life span.

(3)Opportunities to participate in the nursing process and to develop competencies in direct patient care, problem-solving methodologies, clinical judgment, communication, and the use of current equipment and technology.

(4)Content in nursing history and trends, including professional, legal, and ethical aspects.

(5)Supporting content from the natural and social sciences.

b. In addition to the requirements identified in paragraph "a" of this subrule, 2.10(3)"a," the curriculum of a program leading to a diploma in practical nursing and to eligibility to apply for practical nurse licensure by examination shall:

(1)Be consistent with the legal implications within the scope of practice of a licensed practical nurse as outlined in rules 655—6.3(152) and 655—6.6(152).

(2)Focus on supportive or restorative care provided under the supervision of a registered nurse or physician pursuant to Iowa Code section 152.1(4).

(3)Provide learning experiences in medical, surgical and gerontological nursing.

(4)Provide content in nursing of childbearing families and children and mental health that is supported by one or more of the following: clinical instruction, lab/simulation, or observation experiences adequate to meet program outcomes.

c. In addition to the requirements identified in paragraph "a" of this subrule, 2.10(3)"a," the curriculum of a program leading to a degree in nursing and to eligibility to apply for registered nurse licensure by examination shall:

(1)Be consistent with the legal implications within the scope of practice of a registered nurse as outlined in rules 655—6.2(152) and 655—6.7(152).

(2)Focus on attaining, maintaining and regaining health and safety for individuals and groups by utilizing the principles of leadership, management, nursing informatics, and client education.

(3)Provide learning experiences in medical, surgical, mental health and gerontological nursing.

(4)Provide content in nursing of childbearing families and children that is supported by one or more of the following: clinical instruction, lab/simulation, or observation experiences adequate to meet program outcomes.

(5)Provide content in nursing research when the program leads to a baccalaureate, master's or doctoral degree.

(6)Provide learning experiences in community health nursing when the program leads to a baccalaureate, master's or doctoral degree.

2.10(3) 2.10(4) Postlicensure programs for registered nurses who do not hold a baccalaureate degree in nursing.

a. The curriculum of a program that leads to a baccalaureate degree in nursing shall include learning experiences in nursing that will enable the student to achieve competencies comparable to outcomes of the prelicensure baccalaureate education, including content in nursing research and learning experiences in community health nursing.

b. The curriculum of a program that leads to a master's degree in nursing shall include content and learning experiences in nursing that will enable the student to achieve competencies comparable to outcomes of the prelicensure baccalaureate education and master's education, including content in nursing research and learning experiences in community health nursing.

2.10(4) 2.10(5) Master's, post-master's, and doctoral programs for registered nurses who hold a baccalaureate degree in nursing.

a. The curriculum of a program leading to a master's or doctoral degree in nursing shall include in-depth study of:

(1)Nursing science, which includes content, practicum experiences and research.

(2)Advanced role areas in nursing.

b. The curriculum of a program leading to a master's degree or post-master's certificate in a nursing clinical specialty area population focus, eligibility to apply for certification in the specialty area population focus by a national professional nursing organization approved by the board, and registration licensure as an advanced registered nurse practitioner shall:

(1)Be consistent with the legal implications within the scope of practice of the advanced registered nurse practitioner as described in 655—Chapter 7.

(2)Include advanced learning experiences in a specialty area of nursing.

2.10(5) 2.10(6) Nursing courses with a clinical or practicum component or both. The nursing program shall notify students and prospective students in writing that nursing courses with a clinical or practicum component may not be taken by a person:

a. Who has been denied licensure by the board.

b. Whose license is currently suspended, surrendered or revoked in any United States jurisdiction.

c. Whose license/registration license is currently suspended, surrendered or revoked in another country due to disciplinary action.

2.10(7) Nursing programs with a simulation component shall:

a. Ensure that the simulation component does not exceed 50 percent of total clinical hours in a course.

b. Demonstrate that the simulation activities are linked to program outcomes.

c. Demonstrate that simulation activities are based on evidence-based practices.

d. Have written policies and procedures regarding the method of debriefing each simulated activity and a plan for orienting faculty to simulation.

e. Have short-term and long-term plans for integration and maintenance of simulation in the curriculum.

f. Have faculty educated in the use of simulation and who demonstrate ongoing expertise and competence.

g. Evaluate simulation activities based on faculty and student feedback.

Item 13. Amend renumbered rule 655—2.11(152) as follows:

655—2.11(152) Faculty.

2.11(1) Program requirements. The program shall provide:

a. A sufficient number of faculty who satisfy the requirements in subrule 2.9(2) 2.11(2).

b. Written personnel policies and position descriptions.

c. A faculty development program that furthers the competence of individual faculty members and the faculty as a whole.

d. A written teaching-load policy.

e. A nursing faculty organization that operates according to written bylaws and that meets on a regular basis. Minutes shall be available for reference.

f. In a prelicensure program, a ratio of one faculty member to a maximum of eight students in practice situations involving clinical instruction for hands-on learning situations in which students directly care for clients in a relevant setting.

2.11(2) Faculty member requirements. A faculty member who teaches nursing shall meet the following requirements:

a. Current licensure as a registered nurse in Iowa prior to teaching. An individual is currently licensed when licensed in another state and recognized for licensure in Iowa pursuant to the nurse licensure compact contained in Iowa Code chapter 152E.

b. Two years of experience in clinical nursing.

c. Academic qualifications:

(1)A faculty member who was employed on or before July 1, 1992, shall be considered adequately prepared as long as that faculty member remains in that position. A faculty member who was hired to teach in a prelicensure registered nurse program after July 1, 1992, shall have at least a baccalaureate degree with a major in nursing or an applicable field at the time of hire. This person shall make annual progress toward the attainment of a master's or doctoral degree with a major in nursing or an applicable field. An individual who has earned a first professional degree as defined in rule 2.1(152) but who does not hold a master's degree as defined in rule 2.1(152) must meet the requirement for annual progress. One At least one degree shall be in nursing.

(2)A faculty member who was hired to teach after July 1, 1992, in a practical nursing program or at the first level of an associate degree nursing program with a ladder concept shall have a baccalaureate or higher degree in nursing or an applicable field at the time of hire.

(3)A registered nurse hired to teach in a master's program shall hold a master's or doctoral degree with a major in nursing at the time of hire. A first professional degree as defined in rule 2.1(152) does not meet this requirement. A registered nurse teaching in a clinical specialty area population focus shall hold a master's degree with a major in nursing, advanced level certification by a national professional nursing organization approved by the board in the clinical specialty population focus area in which the individual teaches, and current registration licensure as an advanced registered nurse practitioner according to the laws of the state(s) in which the individual teaches. Faculty preparation at the doctoral or terminal degree level shall be consistent with the mission of the program.

(4)A faculty member hired only to teach in the clinical setting shall be exempt from subparagraphs (1) and (2) if the faculty member is closely supervised to ensure proper integration of didactic content into the clinical setting. If hired after July 1, 1992, a faculty member hired to teach only in the clinical setting shall have a baccalaureate degree in nursing or an applicable field or shall make annual progress toward the attainment of such a degree.

(5)Pursuant to 655—Chapter 15, the head of a program may petition the board for a waiver of the requirements in subrules 2.6(2) and 2.9(2). Following a review of the circumstances and efforts by the program to meet the requirements, the board may issue a waiver for a specified period of time and indicate conditions that must be met.

2.11(3) Functions of faculty. Faculty members shall:

a. Develop, implement, and evaluate the purpose, philosophy/mission, and outcomes of the program.

b. Design, implement, evaluate, and revise the curriculum as demonstrated in the program evaluation plan.

c. Provide students with written policies as specified in subrule 2.10(1) 2.12(1).

d. Participate in academic advisement and guidance of students.

e. Provide for admission, progression, and graduation of students.

f. Provide for student evaluation, self-evaluation, and peer evaluation of teaching effectiveness.

g. Participate in activities to ensure competency in area(s) of responsibility.

Item 14. Amend renumbered rule 655—2.12(152) as follows:

655—2.12(152) Program responsibilities.

2.12(1) Policies affecting students. Programs shall provide for the development, implementation and communication of the following student policies on an annual basis:

a. Admission/enrollment. Licensure if applicable according to 655—subrule 3.2(1).

b. Transfer or readmission.

c. Withdrawal.

d. Progression.

e. Grading system.

f. Suspension or dismissal.

g. Graduation.

h. Health.

i. Counseling.

j. Grievance procedure.

2.12(2) Information about the program and controlling institution. The following information shall be published at least every two years and provided to prospective and current students on an annual basis:

a. Philosophy/mission and outcomes of the program.

b. General description of the program.

c. Curriculum plan.

d. Course descriptions.

e. Resources.

f. Faculty.

g. Tuition, fees and refund policies.

h. Ethical practices, including recruitment and advertising.

i. Official dates.

j. The program's NCLEX® passing percentage for the prior calendar year, as published by the board of nursing.

2.12(3) Changes to program. A nursing program may not make a change to a program during a student's academic plan of study unless the change confers the benefit to the student.

2.12(3) 2.12(4) Program records. The following records shall be dated and maintained according to the policies of the controlling institution:

a. Course syllabi.

b. Minutes.

c. Faculty personnel records.

d. Catalogs and program bulletins.

e. Curriculum revisions and reports to the board.

f. Graduate nursing file excluding the final transcript and summative performance statements.

2.12(4) 2.12(5) Student and graduate records.

a. Policies shall specify methods for permanent maintenance and protection of records against loss, destruction and unauthorized use.

b. The final record shall include the official transcript and summative performance statement.

(1)The final official transcript shall include:

(2)The final official transcript shall be maintained permanently.

(3)The summative performance statement shall relate the performance of the student at the time of graduation to the program outcomes and shall be maintained for three years.

Item 15. Amend renumbered subrule 2.15(2) as follows:

2.15(2) The qualifications of a preceptor shall be appropriate to support the philosophy/mission and outcomes of the program.

a. The preceptor shall be employed by or maintain a current written agreement with the clinical facility in which a preceptorship experience occurs.

b. The preceptor shall be currently licensed as a registered nurse, or licensed practical nurse, or advanced registered nurse practitioner according to the laws of the state in which the preceptor practices.

c. The preceptor shall function according to written policies for selection, evaluation and reappointment developed by the program. Written qualifications shall address educational preparation, experience, and clinical competence.

d. The program shall be responsible for informing the preceptor of the responsibilities of the preceptor, faculty and students. The program shall retain ultimate responsibility for student learning and evaluation.

Item 16. Amend renumbered rule 655—2.16(152) as follows:

655—2.16(152) Results of graduates who take the licensure examination for the first time. The program shall notify the board when the program or district national licensure examination program's NCLEX® passing percentage is lower than 95 percent of the national NCLEX® passing percentage for two consecutive one calendar years year. The NCLEX® passing percentage shall be based on all first-time applicants for registered nurse or licensed practical nurse licensure in any jurisdiction who take the examination within six months of graduation. Upon notification by the program, the board shall implement the following process.

2.16(1) The program shall submit to the board within six months an institutional plan for assessment and improvement of NCLEX® results, including outcomes and time lines. The plan shall address administration, faculty, students, curriculum, resources, policies, and the nursing advisory committee.

2.16(2) The program shall submit annual progress reports to the board as long as the NCLEX® passing percentage remains below 95 percent of the national passing percentage.

2.16(3) The program shall provide a brief description including outcomes of all institutional plans submitted to the board in the nursing education program report during the reapproval process, if applicable.

2.16(1) A program whose NCLEX® passing percentage is lower than 95 percent of the national NCLEX® passing percentage shall submit an institutional plan using the board's template and appear before the board as directed.

2.16(2) After submission of the institutional plan, for each consecutive calendar year that a program's NCLEX® passing percentage is lower than 95 percent of the national NCLEX® passing percentage, the program shall submit an institutional plan evaluation using the board's template and appear before the board as directed.

2.16(3) Programs with a NCLEX® passing percentage that falls below 95 percent of the national NCLEX® passing percentage for three consecutive calendar years shall be placed on improvement status after the third year.

2.16(4) A program on improvement status shall:

a. Notify all current and prospective students of the program's improvement status.

b. Submit quarterly reports using the board's template and present the reports to the board as directed.

2.16(5) Board staff may conduct a site visit to the program at any time while the program is on improvement status.

2.16(6) Programs that remain on improvement status for two consecutive calendar years shall submit a revised institutional plan and appear before the board as directed. The board shall:

a. Review the revised institutional plan and formulate an action plan for the program on improvement status.

b. Individualize the action plan for each program.

2.16(7) A program shall be removed from improvement status when the program's NCLEX® passing percentage is above 95 percent of the national NCLEX® passing percentage for one calendar year.

Item 17. Amend renumbered rule 655—2.17(152) as follows:

655—2.17(152) Reports to the board.

2.17(1) Annual reports. The board shall provide information to the program about the requirements of the annual report. The head of the program shall submit an annual report that includes:

a. Progress toward achievement of goals identified by the program for the previous academic year.

b. Qualifications and major responsibilities of the head of the program and each faculty member.

c. Policies for admission, enrollment, progression and graduation of students.

d. Policies for student health and welfare.

e. Current enrollment by class/cohort.

f. Number of admissions and graduations per year for the past five years.

g. Attrition and retention data by class/cohort.

g. h.Passing percentages of graduates on the national licensure examinations for the past five years.

i. Passing percentages of graduates on the advanced registered nurse practitioner certification examinations for the past five years.

h. j.Employment data for graduates.

i. k.Curriculum plan.

j. l.Descriptions of resources, clinical facilities, preceptorship experiences and contractual arrangements.

k. m.Copy of audited fiscal reports, including a Audited statement of income and expenditures of the nursing program.

l. n.Goals for the current academic year.

m. o.Catalog or equivalent of the controlling institution or program.

2.17(2) Special reports. The program shall notify the board of the following:

a. Change of controlling institution. Information shall include official name of the program(s) and controlling institution, organizational chart of the controlling institution, and names of administrative officials.

b. Changes in administrative personnel in the program or controlling institution.

c. Opening of a new site or campus.

2.17(3) Changes requiring board notification and approval. The program shall submit nine copies one electronic copy and one hard copy of a proposed change for board approval at least three four weeks prior to the next scheduled board meeting when the outcome will:

a. Lengthen or shorten the course plan of study.

b. Add or delete academic credit in a course required for graduation.

c. Add or delete a course required for graduation. Delete a course required for graduation.

d. Add a new course. A program shall submit the following to be implemented within six months of an offering of a course:

(1)Course description.

(2)Outcomes/objectives.

(3)Placement of course.

(4)Curriculum plan.

d. e.Alter graduation requirements.

e. f.Reduce the human, physical or learning resources provided by the controlling institution to meet program needs as described in rule 2.7(152) 655—2.9(152).

f. g.Substantively alter the philosophy/mission of the program.

g. h.Revise the predominant method of instruction or delivery, including transition from on-site to self-study or distance learning.

h. i.Entail delivery of a cooperative program of study with an institution that does not provide a degree in nursing.

i. j.Increase the number of student admissions by 20 percent or more.

2.17(4) If a program makes changes as part of a plan to improve the program's NCLEX® passing percentage, pursuant to rule 655—2.16(152), such changes must also be separately submitted to the board for approval pursuant to this rule.