Specifically, the board may establish minimum standards for schools for professional nurses and schools for licensed practical nurses, including all related clinical units and facilities, and make and provide periodic surveys and consultations to such schools. It may also establish rules to prevent unauthorized persons from practicing professional nursing. It shall approve all rules for the administration of chapter 441, Wis. Stats.
Plain language analysis:
Section 1 amends the definition of “annual pass rate” to include the advanced practice certification examination to reflect the examination taken by applicants who attend graduate school.
Section 2 returns institution accreditation to a regional accrediting entity. The change to national occurred with CR 14-004. Since the change the Board’s experience is the standards between regional and national are not comparable. With the withdrawal of federal recognition to at least one large national accrediting body, the Board does not want to create uncertainty for schools, students or clinical sites going forward. The return to requiring regional accreditation is in line with other health professional requirements. Section 3 repeals and recreates the definition for school of professional nursing to clarify the definition includes graduate schools and postlicensure bachelor degree schools. Postlicensure bachelor degree schools are schools for an associate degree registered nurse to obtain a bachelor’s degree in nursing.
Section 4 clarifies evidence of availability of sufficient clinical facilities is not a signed contract and that no contract can be signed until after the school receives authorization to plan a school of nursing.
Section 5 clarifies the educational administrator needs to meet the required qualifications. It also clarifies that the school only needs to show employment of faculty to teach the courses offered the first 6 months eliminating the need to hire faculty for all courses in the school prior to admitting students.
Section 6 repeals the requirement that the curriculum include a program evaluation plan.
Section 7 creates the requirement for documentation of a school evaluation plan and a plan for availability of student policies as part of the application for authorization to admit students.
Section 8 clarifies all contracts for clinical facilities contained in the application for authorization to admit shall be signed after the date the authorization to plan was granted.
Section 9 clarifies that clinical experiences shall represent all areas of nursing practice covered by the school of nursing’s curriculum prior to being granted authorization to admit students.
Section 10 creates a mechanism for schools to notify the board on a quarterly basis of faculty hiring to ensure that sufficient faculty are in place beyond the first six months. It also creates a provision which clarifies the board may review schools that are authorized to admit students but are not fully approved in a similar manner as approved schools.
Section 11 removes a confusing provision for when a school may apply for approval.
Section 12 amends the systematic evaluation plan to include the NCLEX or advanced practice certification pass rates.
Section 13 removes a typographical error created by CR 14-004. Section 14 removes an obsolete provision relating to nursing accreditation.
Section 15 removes the requirement for a contract and allows for documentation between the school of nursing and institutions for academic study, clinical facilities, and agencies for related services for students.
Section 16 creates a provision that the educational administrator at schools which offer a graduate degree nursing program holds a doctoral degree.
Section 17 repeals and recreates the educational administrator experience requirements. An educational administrator needs two years of experience as an instructor in the previous 5 years or if the person’s graduate program included education preparation, then only one year of experience.
Sections 18 and 19 clarify the educational administrator is required to notify the board within 5 days of a vacancy or change in the position and failure to report is considered unprofessional conduct. The institution shall designate an interim or permanent educational administer and notify the board within 5 business days. An interim educational administrator who does not meet the qualification may request board approval. An interim educational administrator may only serve 6 months unless the board grants an extension due to hardship. The institution shall notify the board within 5 business days of the hiring of a permanent educational administrator.
Sections 20 and 21 clarify a graduate degree in nursing is required for faculty. Shared faculty in interprofessional schools teaching non-clinical nursing courses can have advanced education for that content instead of a nursing degree (for example, a pharmacist teaching pharmacology in a school of nursing).
Section 22 clarifies the board may grant exceptions to faculty requirements who do not teach graduate level courses as long as a minimum of 50% of the faculty meet the requirements. A faculty member who does meet the requirements is required to supervise any faculty members who receive an exception.
Section 24 clarifies the emergency exception is for a person with a bachelor’s degree in nursing to teach in an emergency situation. It is for one semester and can’t be renewed. If there is a second consecutive emergency request, the school shall provide the board with a plan regarding staffing levels, courses being offered and the extenuating circumstances.
Sections 26 and 27 revises the non-nursing master’s degree exception for readability and clarification. This exception may be granted for a person who does not have a master’s degree in nursing but does meet the needs of the school in a specific content area. It also removes the limitation that the school may only have one exception of this type.
Section 29 recreates the annual pass rate section. For schools of nursing for with prelicensure students, the pass rate is based on the annual NCLEX pass scores. If the school grants a certificate of completion, then the pass rate considers both the registered nurse and practical nurse NCLEX exams. For schools of nursing with graduate level programs, the pass rate is based on the advanced practice certification examinations. The pass rate standard is a minimum of 80% of all test takers shall pass the examination. If the annual pass rate standard is not met, the school of nursing shall receive a warning letter. The school is required to submit an assessment of contributing factors and an institution plan for improvement. The plan must include outcomes and timeframes. The plan is to be submitted to the board within 45 days of the warning letter and acted upon by the board by July 15th. Failure to have a board approved plan by July 15 will result in a review of the school.
Section 30 indicates a date of February 1st for when annual self-evaluation reports are due. It also clarifies the school must only submit documents from nursing accreditation agencies related to compliance with accreditation standards. In addition, it clarifies the school must provide the board with notification of any actions, withdrawal or change in school nursing accreditation status within 30 days.
Section 31 updates provisions relating to when the board may review the school of nursing to determine whether standards are being met. When a complaint regarding conduct is received the board needs to “evaluate” the complaint instead of “validate”. In addition, the removal of “NCLEX” which only pertains to prelicensure schools and removal of “for more than 2 consecutive years”.
Section 32 updates language regarding review of the school for clarification purposes. A review may involve a “self-assessment” instead of “self-study”. In addition, a plan for improvement and any progress reports.
Summary of, and comparison with, existing or proposed federal regulation: None
Comparison with rules in adjacent states:
Illinois: Illinois approves prelicensure programs only. Illinois program approval process includes: a letter of intent, a feasibility study, hiring of a nurse administrator, submission of a curriculum proposal, and a site survey. Continued approval is based upon annual evaluation reports, full routine site visits and maintaining a NCLEX pass rate of 75% of first time test takers. Major and minor curricular changes are reported to the board. The standards for the school include institutional requirements, curriculum standards, clinical standards, nurse administrator and faculty qualifications (allows for variances to faculty standards) and student standards.
Iowa: Iowa approves all schools of nursing (prelicensure and graduate). Iowa program approval process includes: first step involves an application with information regarding the controlling institution and needs assessment; second step involves verification of employment of the head of program, submission of program’s philosophy and objectives, curriculum plan, letter of intent from clinical facilities, evidence of provision of faculty, proposed budget and timeframe for implementation; next step is interim approval based upon program proposal and site visit; final approval is upon graduation of first class and NCLEX pass rate results. Provisional approval may be granted to program until standards are met. Change of controlling institution and changes in administrative personnel in the program. The program shall submit annual reports. The standards for the school include institutional requirements, curriculum standards, clinical standards, nurse administrator and faculty qualifications, student standards and evaluation of the program. NCLEX pass rate standard is a minimum of 95% of the national passing percentage based upon first time test takers within 6 months of graduation.
Michigan: Michigan approves prelicensure programs only. Michigan program approval process includes: the first step requires submission of a letter of intent, evidence of funding and other support, copy of Michigan Department of Career Development approval (if necessary), evidence of availability of clinical experiences, proposed number of students, proposed first date of admission, plans for recruiting director of the program and faculty and a site visit; initial approval involves a self-student report and annual progress reports; full approval is after the graduation of the 2nd class, but no later than graduation of the 4th class (a class for each 12 month period) and requires submission of a self-study report and a site visit. Every 4 years the school shall submit a self-study report and accredited schools shall follow the schedule of the accrediting agency. Program changes shall be submitted to the board. The standards for the school include institutional requirements, curriculum standards, clinical standards, nurse administrator and faculty qualifications (allows for variances to faculty standards), student standards, and evaluation of the program. NCLEX pass rate standard is 75% of first time test takers.
Minnesota: Minnesota approves prelicensure programs only. Minnesota program approval process includes: Phase 1 requires letter of intent including institution information, timetable for development and implementation, documentation of availability of academic facilities, impact on nursing programs in the area; Phase II involves a site visit and documentation of compliance with educational standards in order to be granted initial approval; Phase III is full approval and continual approval based upon meeting the minimum first time NCLEX success rate and acquiring national nursing education accreditation. Minnesota requires surveys of all schools on a periodic basis to maintain approval. NCLEX pass rate standard is 75% of first time test takers. Annual reports shall be submitted to the Board. The standards for the school include institutional requirements, clinical standards, nurse administrator and faculty qualifications, student standards, and evaluation of the program. The curriculum standard is the program must provide diverse learning activities that are consistent with program outcomes. Minnesota has an approval process for schools applying for innovative approaches which may require exemption from certain rules.
Summary of factual data and analytical methodologies:
The Board considered the National Council of State Boards of Nursing’s model practice rules and the rules and processes of our neighboring states and Washington.
Analysis and supporting documents used to determine effect on small business or in preparation of economic impact analysis:
This rule was posted for economic comments and none were received.
Fiscal Estimate and Economic Impact Analysis:
The Fiscal Estimate and Economic Impact Analysis is attached.
Effect on small business:
These proposed rules do not have an economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department’s Regulatory Review Coordinator may be contacted by email at Kirsten.Reader@wisconsin.gov, or by calling (608) 267-2435. Agency contact person:
