2008 has been one of the most exciting years in the NLNAC's

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2 2008 M E S S A G E F R O M T H E E X E C U T I V E D I R E C T O R Dear Colleagues: 2008 has been one of the most exciting years in the NLNAC's history! We concluded our 10th year anniversary celebration by recognizing more than 100 colleagues for 10 years of dedicated service as program evaluators. This year another 20 evaluators will join their ranks as they reach the 10-year milestone of service. In addition, we are celebrating a second group of almost 200 volunteers for 5 years of continuous service. Volunteers serving as Commissioners, Evaluation Review Panelists, Site Visitors, and Committee Members are the reason the NLNAC remains the premier accrediting agency for nursing education has been a year of renewal and progress with the completion and publication of the new 2008 Standards and Criteria. The more than 2,000 individuals who participated in the process have ensured that the new Standards are reflective of contemporary practices both in the education settings where students learn and grow and the healthcare delivery systems in which they will care for patients and their families. Since February, when the Standards were released, we have received overwhelmingly positive feedback about the changes that reflect innovation and flexibility in the accreditation process while continuing to assure that the NLNAC Standards are valid and reliable indicators of quality for our six types of nursing education programs has been a year of growth for the NLNAC. I am pleased to report that we have received a record number of inquiries from programs interested in seeking initial accreditation as well as an ever-increasing number of programs successfully achieving Candidate status. Whereas many newly established programs are seeking initial accreditation, we also have quite a number of long-term nursing programs that are beginning

3 the accreditation process, recognizing the value of accreditation for their faculty, students, and graduates. Congratulations to those programs successfully achieving initial accreditation in 2008 as well as our programs achieving continuing accreditation; 176 programs achieved accreditation during the academic year! Several of our programs have now surpassed the 50-year mark for sustaining accreditation, a remarkable achievement. Once again in 2008, I am pleased to share the outstanding outcomes for graduates of NLNAC-accredited programs. NCLEX results for our entry-level programs, both PN and RN, continue to surpass the results of all graduates. Also, the certification results are significantly higher for graduates of NLNAC-accredited programs again in Outcomes related to graduation rates continue to show a significant difference as well. Year after year, graduates of NLNAC-accredited programs surpass their peers, a demonstration of quality in the more than 1,200 nursing programs that we accredit. This year we also introduced a newly designed Accreditation Manual, Directory of Accredited Programs, and a number of new online resources for programs seeking accreditation. Before the year ends, there are plans to implement a cuttingedge data management system and an innovative online program for program evaluators. The NLNAC is also partnering with the NLN to offer international nursing education services as well as accreditation for nursing programs. This year marks the end of my second year as the Executive Director for the NLNAC. It is an incredible privilege to serve nursing education in this capacity and such an honor to work among the many distinguished colleagues whose paths I have crossed during my travels this year. Not only am I afforded the opportunity to speak with you about the challenges you face in meeting the diverse demands of nursing education as faculty and administrators, but I also appreciate the creative and inspiring solutions you are seeking to meet the needs of your students and communities. Each day I am grateful for the nursing faculty member who urged me, as an undergraduate student, to envision myself as an educator, and I hope that you are encouraging your entry-level students to continue their education with the goal of becoming a nurse educator or promoting the role if you work with graduate students. Best wishes for a successful academic year! At the NLNAC, we look forward to working with you as we remain committed to serving you and your students Sincerely. Sharon J. Tanner, EdD, RN Executive Director, NLNAC NLNAC 2008 Report to Constituents Message form the Executive Director... NLNAC Board of Commissioners... NLNAC Staff... NLNAC Mission, Purpose, and Goals... The Accreditation Process and Outcomes... Overview... Commission Decisions... Reliability... Strengths and Areas Needing Development.. Strengths... Areas Needing Development... Denial of Accreditation... Focused/Follow-Up Reports... Review of Focused/Follow-Up Reports... Site Visit Evaluation... Overview... The Visit... The Self-Study Report... Summary... Presentation and Analysis of the NLNAC Annual Reports... Purpose and Use... Return Rate... Section I. Substantive Change... Section II. Student Academic Achievement... NCLEX Pass Rates... Certification Pass Rates... Graduation Rates... Job Placement Rates... Section III. Program Operations... Student Enrollment... Graduates... Faculty FTE... Faculty Academic Credentials... Complaints... Distance Education... Preceptors... Standardized Testing... Title IV Funding... Conclusions... Fall 2008 and Spring 2009 Accreditation Plans... Fall 2008 Scheduled Site Visits... Spring 2009 Scheduled Site Visits... NLNAC Schedule of Meetings & Forums... NLNAC 2009 Self-Study Forums... FC BC 1

4 NLNAC BOARD OF COMMISSIONERS NLNAC is governed by a fifteen member Board of Commissioners. The Board of Commissioners determines accreditation policy and makes accreditation, administrative, budget, and policy decisions. Commissioner Biographical Sketches are available on line at NURSING EDUCATION REPRESENTATIVES Grace G. Newsome, EdD, APRN, BC, FNP (Term ) - CHAIR, NLNAC Professor of Nursing, MS Coordinator North Georgia College & State University Dahlonega, Georgia Carol Easley Allen, PhD, RN (Term ) Chair, Department of Nursing Oakwood College Huntsville, Alabama Ruth Davidhizar, DNS, RN, ARNP, BC, FAAN (Term ) Professor and Dean, School of Nursing Bethel College Mishawaka, Indiana Dala J. DeWitt, MS, RN (Term ) Sr. Director School of Nursing and Education Community Mercy Health Partners Springfield, Ohio Elizabeth H. Mahaffey, PhD, RN (Term ) - TREASURER, NLNAC Dean, Nursing & Allied Health Hinds Community College Jackson, Mississippi Brenda Nichols, DNSc, RN (Term ) Dean, Arts & Sciences Lamar University Beaumont, Texas Marilyn K. Smidt, MSN, RN (Term ) - VICE CHAIR, NLNAC Director of Nursing Programs Grand Rapids Community College Grand Rapids, Michigan Deanna M. Suggs, MSN, RN, FNP-C (Term ) Director and Professor of Nursing New Mexico State University Carlsbad Carlsbad, New Mexico NURSING SERVICE REPRESENTATIVES Diane L. Dobbins, MPH, RN, BC, PHN (Term ) Disaster Programs Manager, Emergency Medical Services - Ventura County Public Health Oxnard, California Karen S. Hill, MSN, RN, CNAA, BC, FACHE (Term ) Vice President/Nurse Executive Central Baptist Hospital Lexington, Kentucky Rhonda Johnston, PhD, CFNP, CANP, CNS (Term ) Nurse Practitioner Pueblo VA Clinic Pueblo, Colorado PUBLIC REPRESENTATIVES David E. Ormstedt, JD (Term ) Counsel Wiggin and Dana LLP Hartford, Connecticut Marsha H. Purcell, CAE (Term ) Director, Program Development American Farm Bureau Federation Washington, District of Columbia Howard L. Simmons, PhD (Term ) - SECRETARY, NLNAC Professor and Chairperson, Department of Advanced Studies, Leadership and Policy Morgan State University Baltimore, Maryland Beverly L. Welhan, DNSc, RN, ANEF (Term ) Dean, Health Sciences Montgomery County Community College Blue Bell, Pennsylvania 2

5 National League for Nursing Accrediting Commission, Inc. 61 Broadway, 33rd Floor New York, New York Phone: Ext Ext.153 Fax: Website: NLNAC STAFF Sharon J. Tanner EdD, RN Executive Director Phone: Ext Anthony Bugay Board Liaison & Manager of Special Projects Phone: Ext Donna Marie Mirande Administrative Assistant Phone: Ext Dominique Dumlao Assistant to the Executive Director Phone: Ext Ngozi O. Nkongho, PhD, RN Deputy Director Phone: Ext Carol Gilbert, PhD, RN Deputy Director Phone: Ext Joe L. Ortiz, MBA Administrator for Accounting & Information Systems Phone: Ext Yvonne M. Lopez Special Assistant Phone: Ext Michael Philip Administrative Assistant Phone: Ext. 253/153 Alexander C. Mariquit Manager of Information Systems & Web Design Phone: Ext Jocelyn Pineda Accounting Specialist Phone: Ext

6 Assuring Quality for the Future of Nursing Education MISSION OF NLNAC The National League for Nursing Accrediting Commission (NLNAC) supports the interests of nursing education, nursing practice, and the public by the functions of accreditation. Accreditation is a voluntary, self-regulatory process by which non-governmental associations recognize educational institutions or programs that have been found to meet or exceed standards and criteria for educational quality. Accreditation also assists in the further improvement of the institutions or programs as related to resources invested, processes followed, and results achieved. The monitoring of certificate, diploma, and degree offerings is tied closely to state examination and licensing rules and to the oversight of preparation for work in the profession. PURPOSE The purpose of the NLNAC is to provide specialized accreditation for programs of nursing education, both postsecondary and higher degree, which offer either a certificate, a diploma, or a recognized professional degree (clinical doctorate, master's, baccalaureate, associate, diploma, and practical). GOALS The goals of NLNAC are to: Promulgate a common core of standards and criteria for the accreditation of nursing programs. Strengthen educational quality through assistance to associated nursing education units by evaluation processes, functions, publications, and research. Advocate self-regulation in nursing education. Promote peer review. Foster educational equity, access, opportunity, mobility, and preparation for employment based upon type of nursing education. Serve as gatekeeper to Title IV-HEA programs for which NLNAC is the accrediting agency. (These include some practical nursing and all hospital diploma programs eligible to participate in programs administered by the U.S. Department of Education or other federal agencies.) 4

7 The Accreditation Process and Outcomes Fall 2007 and Spring 2008 Overview During the Fall 2007 and Spring 2008 accreditation cycles, 177 nursing programs were reviewed for accreditation (Table 1). Twentyfour of these programs were reviewed for initial accreditation. ACCREDITATION Dr. Toni Barnett Professor MS/FNP Coordinator North Georgia College & State University Dahlonega, Georgia Accreditation is a volunteer peer review process that offers the faculty an opportunity to ensure excellence in their nursing program. Accreditation encourages us to strive for quality and helps us to maintain rigor so that patient safety is at the highest level. Commission Decisions The Commission actions for the programs visited during the Fall 2007 and Spring 2008 accreditation cycles resulted in 176 programs being granted initial or continuing accreditation and one program being denied initial or continuing accreditation (Table 2). Reliability The NLNAC aggregate reliability (internal consistency) for the three levels of the accreditation review for the Fall 2007/Spring 2008 cycles is.95 (n = 177) (Table 3). Additionally, correlation analysis continues 5

8 ACCREDITATION Dr. Frances Eason Professor of Adult Health Nursing East Carolina University Greenville, North Carolina As a program evaluator, I approach the nursing program as a professional and as a peer. My goal is to focus on the Standards and Criteria as the team verifies the evidence provided by the program in the Self-Study Report and during the visit. We provide the nursing program every opportunity to demonstrate compliance with the Standards. to demonstrate a positive correlation at the.01 level of significance. Individually, the Fall 2007 cycle reliability was.96 (n = 85) and the Spring 2008 cycle score was.94 (n = 92). The aggregate alpha for internal consistency across all accreditation cycles and program types since Spring 1997 is 0.92 (n = 2152) (Table 4). Strengths and Areas Needing Development Strengths The Strengths identified for programs reviewed continue to offer no clear patterns. Strengths were identified in all Standards. Because the data presented neither patterns nor trends, aggregate information per cycle was not compiled once preliminary analysis confirmed the lack of patterns. Areas Needing Development For the Fall 2007 and Spring 2008 cycles the identified Areas Needing Development present basically in the same rank order overall as the identified Areas Needing Development for the previous two cycles. Standard II Faculty is first and Standard VII Educational Effectiveness 6

9 ACCREDITATION Dr. Ann Schlumberger Professor and Chair Department of Nursing University of Arkansas at Little Rock Little Rock, Arkansas "Accreditation allows me as the nursing administrator and my faculty the opportunity to compare our program with national standards. We continues as second in this year's rank order (Table 5). The rank order of the Areas Needing Development by program type are generally have a long-standing the same. The exceptions are notable. For practical programs, Standard I values accreditation. Mission and Governance Being accredited is a now ranks first with major factors in the academic credentials and workload of the statement to the nurse administrator. For baccalaureate programs, the variance is between our program is a Standard V Resources and quality program. Standard VI Integrity. For master's programs, Standard VI Integrity is the most commonly identified of the Areas the nursing program Needing Development. For diploma programs, most and the graduates." notable is that with only nine programs reviewed the patterns of identified Areas Needing Development follow the aggregate order. accredited program that University, community, state, and beyond that Accreditation strengthens and benefits the students When compared to the overall aggregate ( ), the issues and the order generally remain the same, with the exception of Standard II Faculty. As noted last year, concerns regarding faculty academic credentials and workload have risen since 1997 from a second-tier concern to the most common Area Needing Development. Integrity issues related to published documents (paper and electronic) including completeness, accuracy, consistency, and clarity have shown improvement from 55% overall in the previous report period to 45% for the Fall 2007-Spring 2008 cycles. Denial of Accreditation For the Fall 2007 and Spring 2008 accreditation cycles, one of the 24 programs applying for initial accreditation was denied (Table 2). The program was found to be in non-compliance with multiple Standards including Standard II Faculty, Standard IV Curriculum and Instruction, and Standard VI Integrity. Focused/Follow-Up Reports The use of a Focused Report to demonstrate compliance for programs found to be in non-compliance with one or two David Ormstedt Commissioner, NLNAC Counsel Wiggin and Dana LLP Hartford, Connecticut ACCREDITATION As a public member of the Commission, I bring a different perspective to the accreditation process. I envision what type of care consumers want from nurses and ensure that the accreditation process includes that aspect. NLNAC allows the public to have input at all levels from the development of the Standards to the accreditation decisions. 7

10 NLNAC Accreditation Standards began with the Fall 2003 accreditation cycle. The report name was changed to Follow-Up Report in 2006 to better reflect its function. For the Fall 2007 and Spring 2008 cycles, 30% (n = 53) of the programs reviewed were found to be in non-compliance with one or two of the NLNAC Accreditation Standards, resulting in the Commission action to require a Follow-Up Report including 2 master's, 7 baccalaureate, 25 associate, and 19 practical programs (Table 6). In the Fall 2007 cycle, with the exception of Standard I Mission and Governance and Standard III Students, all Standards were represented. Standard II Faculty, Standard IV Curriculum and Instruction, and Standard VII Educational Effectiveness comprised the majority of those found in non-compliance. Of the 21 programs assigned a Follow-Up Report, 11 were found in non-compliance with one Standard and the remaining 10 were found in noncompliance with two Standards. All programs found in non-compliance with two Standards were found in non-compliance with Standard VII Educational Effectiveness. In the Spring 2008 cycle, the Standards of Faculty, Curriculum and Instruction, and Educational Effectiveness again comprised the majority of those identified. In addition, one program was found in non-compliance with Standard I Mission and Governance. Thirty-two Reports were assigned in the Spring 2008 cycle. Twenty-four programs were found in non-compliance with one Standard and four in non-compliance with two Standards. Once again, programs found in noncompliance with two Standards were found in noncompliance with Standard VII Educational Effectiveness. Dr. Gwen Lapham-Alcorn Associate Dean Health and Human Services Central Florida Community College Ocala, Florida ACCREDITATION My program has been accredited since the 1970s. At my college, we have a standard of excellence, and accreditation helps the nursing program to meet that standard. Accreditation improves nursing on a national level as well as helping to improve my own nursing program. It is a professional growth experience for the nurse administrator and faculty. To date, 20% (n = 159) of the programs reviewed since Fall 2003 (n = 816) have been asked to submit a Focused Report/Follow-Up Report (Table 7). Analysis demonstrates that the most commonly identified Standards in noncompliance are the same as the most commonly identified Areas Needing Development: 8

11 ACCREDITATION Dr. Geraldine Allen Director of MSN Program Troy University Montgomery, Alabama "We're in a state now where healthcare comes at a high cost, it is quality nursing education that makes a difference. Accreditation ensures that the nurses we produce in this nation are equipped to meet the needs of their communities." Educational Effectiveness 41%, Faculty 31%, and Curriculum and Instruction 17%. Review of Focused/Follow- Up Reports In the Fall 2007 cycle, 9 reports were reviewed. The Commission accepted the Follow-Up Reports submitted by all programs and affirmed their continuing accreditation and next visit date (Table 8). All programs presented one Standard: 6 of the reports addressed Standard VII Educational Effectiveness, 2 addressed Standard II Faculty, and 1 addressed Standard IV Curriculum and Instruction. In the Spring 2008 cycle, 10 reports were reviewed. The Commission accepted 9 of the Follow-Up Reports and affirmed each program's continuing accreditation and next visit date (Table 8). One report was not accepted and this program was denied continuing accreditation. Seven reports presented one Standard and 3 presented two Standards. Once again, all programs reporting on two Standards included Standard VII Educational Effectiveness in the reports. The reports addressing one Standard were generally equally distributed among Standard II Faculty, Standard IV Curriculum and Instruction, Standard VI Integrity, and Standard VII Educational Effectiveness. Since 2003, 61 of the 66 Focused/Follow-Up Reports reviewed have been accepted by the Commission. Site Visit Evaluation Overview As part of the accrediting process for each cycle, all nursing programs, team chairs, and team members are given an evaluation form to complete. The data are used to inform decision making regarding the organization and content of the Self-Study Forums, the Program Evaluator Forum, and ACCREDITATION Linda Cockrell Program Leader for Health Occupations Norfolk Technical Center, Norfolk Public Schools Virginia Beach, Virginia As a nursing coordinator of a program that has been accredited for more than 30 years, I value the prestige that accreditation offers a nursing program, particularly a practical nursing program. Being accredited offers us a unique status and provides our graduates the opportunity to progress into higher levels of education. 9

12 ACCREDITATION Dr. Barbara Box Professor Department of Nursing Missouri Southern State University Joplin, Missouri We are experiencing a faculty shortage in the US. As a program evaluator, I have the opportunity on site visits to encourage current students to think about being an educator. Accreditation expands my horizons and views and also expands the horizons of students and faculty. the pre-site visit conference calls conducted by the NLNAC professional staff as well as revisions in the review process. Data Presentation and Analysis Response Rate: For the Fall 2007 and Spring 2008 accreditation cycles, the overall response rate was 68%: Fall = 64%, Spring = 72% (Table 9). The Visit The evaluation data continue to demonstrate that the site visit is perceived by those involved as intended: a collegial peer review process. On a scale of 1-7 with 7 being excellent, the mean visit score was 6.6. The team chairs and team members also scored the visit highly with a mean of 6.7 (Table 10). Qualitative analysis supports the quantitative data. Analysis by program type was consistent with the overall results with no significant variation noted. Nursing programs continued to speak to the professionalism, collegiality, and expertise of the visit teams. The Self-Study Report Along with their assessment of the site visit, each team chair and team member is asked to rate the program's Self-Study Report for clarity and completeness. Based on the same scale of 1-7, the team's mean rating was 5.2 (good). The team chair's mean rating was 4.9, and the team members' mean rating was 5.3 (Table 10). These results parallel the data for the previous five cycles plus/minus 0.3. The data continue to assert the same two points for consideration. First, the site visitors' perception rating of the Self-Study Report, although "good" overall, still offers a wide range (1-7). Second, team members as a group continue to rate the Self-Study Report higher than team chairs do Summary Diane L. Dobbins Commissioner, NLNAC Disaster Programs Manager Emergency Medical Services Ventura County Public Health Oxnard, California The accreditation process continues to demonstrate a high degree of effectiveness in assuring a comprehensive review for all nursing program types. Further, the results of the implementation of the process demonstrate that the Standards and Criteria continue to assess program quality effectively. ACCREDITATION As a member of nursing service, it is important to me to know the quality of the graduates that I am hiring. Accreditation assures that the graduates are prepared to practice in the new world of healthcare. Accreditation also assures that the workforce is prepared and ready to meet the needs of the public. 10

13 Presentation and Analysis of the NLNAC Annual Reports Academic Year Purpose and Use The NLNAC Annual Report is used by the NLNAC to monitor components essential to the maintenance of a quality educational program. Additionally, the Report facilitates the generation and communication of trended aggregate data concerning quality education for all nursing program types to accredited programs and other interested individuals and groups. This presentation addresses data generated from the academic year (July 1, 2006-June 30, 2007) with the exception of enrollment figures and faculty numbers. Enrollment and faculty information is based on data available on a single day: October 15, To facilitate the presentation, information is presented in sections. Section I. Substantive Change addresses changes within programs. Section II. Student Academic Achievement tracks student academic achievement through NCLEX and certification results, rates of employment of program graduates, and graduation rates. Section III. Program Operations, includes enrollment

14 and graduation figures, faculty numbers and academic credentials, complaints, significant changes in enrollment, the use of online technology in program delivery, the use of preceptors, and the use of standardized tests. Finally, new to this reporting period is an item addressing program participation in Title IV funding (student loan program). As always, an open feedback item ends the report, along with a call for recommendations for NLNAC Program Evaluators and Commissioners. Return Rate The return rate for the Annual Report is over 91%. Outstanding reports are tracked, and a 100% return rate is expected. Section I. Substantive Change For the academic year, 337 substantive changes were reported across all program types. Review of the changes revealed that those most commonly reported were generally the same whether viewed in aggregate or by program type. Additionally, the order of frequency of the changes was comparable to previous reporting periods. As will be noted, curriculum changes continued to head the list (Table 1). Also of note is the percentage of programs planning the addition of a new program type at a higher level of credential. Finally, when compared with the previous year, the most notable difference is the increase in the total number of programs reporting the addition of a new location for program delivery. Section II. Student Academic Achievement NCLEX Pass Rates A review of the data demonstrate that the mean NCLEX-RN and PN pass rates for graduates of NLNAC-accredited programs continue to exceed the National Council of State Boards of Nursing (NCSBN) published national data. The NLNAC NCLEX-RN pass rate was 87.7%, whereas the NCLEX-PN pass rate was 92.8% (Table 2; Charts 1 & 2). Overall, 66% of accredited programs reported NCLEX-RN pass rates at or above the national average of 85.5%. By program type, the data are similar to previous years: the associate and diploma program graduates post higher success rates than the national means for that program type, and the baccalaureate graduates post a slightly lower success rate (Table 3). A review of the data demonstrates that 21% of the baccalaureate degree programs reported fewer than 20 students in their graduating classes, a factor that could easily distort the data set. This continuance in the number of smaller programs is due primarily to the influx of new programs that have successfully applied for and been granted initial accreditation. Although notable, it appears that the shifting program profile has had no significant 12

15 effect on the overall graduate performance on the licensure examination. These data appear to support the strength and validity of the NLNAC Standards and Criteria and the review process for accreditation. The practical nursing program information presents an even stronger picture of the effect of accreditation as 78% of programs reported pass rates at or above the national mean of 87.3%. A second point of interest is the range within the pass rates among nursing programs. Like last year's range, the reported low was 47%, the high 100%. Analysis of the qualitative data offered by programs within the Report and those reviewed during the accreditation cycles continues to add weight to the suggestion that the "culture" of test-taking might be changing. The success rate of repeat examination takers is demonstrated once again as the aggregate NCLEX-RN repeat pass rate for NLNAC accredited programs is 75.2% whereas the national average is 52.4%. For the NCLEX-PN, the repeat pass rate for NLNACaccredited programs is 81.3%, whereas the national average is 43.8% (Table 3). Certification Pass Rates The pass rate for graduates of master's programs on advanced certification examinations at 96.3% continues above the American Nurses Credentialing Center (ANCC) and National Certification Corporation (NCC) overall pass rates of 84.3% and 84% respectively (Tables 4 & 5). Also notable is that more than 92% of the programs reported pass rates at or above the ANCC mean pass rate. When subdivided into categories (nurse practitioner, clinical nurse specialist, and other), the data continue to demonstrate excellence. Whereas the ANCC mean pass rate for the nurse practitioner examinations was 85.2%, the mean pass rate for NLNAC graduates was more than 10% higher. The variance between the national mean for the clinical nurse specialist examinations and the NLNAC graduate results is even greater at 20+% (Table 4). 13

16 Graduation Rates Based on the NLNAC definition,* the graduation rate across all program types continues to be above 70%. The data range from 86.8% to 73.1%. As noted in last year's Report, these data clearly suggest that once registered in their first required nursing course, students have a high probability of remaining in the major and completing the program of study successfully. Also notable is a direct positive relationship between the completion rate and the type of nursing program, with the diploma and associate programs showing no significant difference in their results (Table 6). to explain the lower mean rate. However, analysis of the submitted Annual Reports, Substantive Change Reports, and other qualitative data suggests that this lower employment rate may be more a function of program graduates enrolling directly into another level of nursing education than an inability to obtain employment. Further, it was noted that once again over 65% of the 20 programs reporting the lowest employment rates offer either an associate or baccalaureate program within the nursing education unit. *Graduation rate: the number of students who complete the program within 150% of the time of the stated program length. Job Placement Rates The aggregate job placement rate by program type within 6-9 months of graduation continues to exceed the NLNAC-established benchmark of 95%, with the exception of practical nursing programs, as it has for the past 10 years of data collection (Table 7). As in previous years, analysis of the practical nursing group did not demonstrate any regional variance 14

17 Section III. Program Operations Student Enrollment Table 8 presents enrollment figures as of October Analysis demonstrates an increase in mean enrollment figures for all program types, with the exception of practical programs (Chart 3). Total enrollment figures increased for associate programs, did not vary significantly for master's and diploma programs, and decreased for baccalaureate and practical programs. The increased enrollment in the associate programs cannot be accounted for by changes in the number of reporting programs. Rather, they verify the trend toward increasing enrollment noted in the previous two reports (Table 9). The decrease in the total enrollment figures for the baccalaureate programs is more likely a product of the shifting profile of the accredited baccalaureate program than a true reflection of a decrease in number of students enrolled. In the current reporting period there are fewer programs reporting, and among those, the balance between new and longstanding programs has shifted slightly. Once again, reports of significant increases in enrollment (at least 10%) far exceed reports of decreasing enrollment. However, of note is the continued increasing numbers of programs that are reporting no change in enrollment (Table 9). Qualitative data addressing explanations for the changes in enrollment continue to demonstrate the themes previously noted, with more emphasis on the lack of qualified faculty. Reason(s) for Significant Increase Planned increase Addition of another location for program delivery Addition of distance education delivery systems Central administration mandate Reason(s) for Significant Decrease Insufficient number of qualified faculty applicants Planned decrease - In preparation for curriculum change - State Board mandate Nursing shortage - working overtime; no time for school Competition 15

18 Graduates Table 10 presents the information on the number of graduates. When compared to previous years, it will be noted that after a one-year decrease the mean number of graduates for the master's and baccalaureate programs has again increased (Table 11). Of note is that although the mean number of students graduating has risen for all program types, with the exception of practical programs, the total number of graduates has apparently decreased. A review of the data indicates that this variance is a function of the outstanding data (Annual Reports yet to be submitted) rather than a true decrease in the number of graduates. This variance notwithstanding, when adjusted for the outstanding Reports, at least 63% of the newly licensed nurses educated in the United States during the reporting period graduated from NLNAC-accredited programs (Chart 4). Faculty FTE For the reporting period, the mean faculty full-time equivalent (FTE) increased for practical, diploma, and associate programs, and decreased slightly for the master's and baccalaureate programs (Tables 12 & 13). However, when the FTE is compared to the total enrollment, it can be seen that the faculty-tostudent ratios improved significantly for practical programs; remained basically unchanged for diploma and associate programs; and increased for baccalaureate and master's programs. *Master's: 1:12.5 ( 1.5) Baccalaureate: 1:17.7 ( 1.3) Associate: 1:15.6 (.5) Diploma: 1:12.6 (.4) Practical Nursing: 1:9 ( 1.9) * This ratio is only a representation of a relationship between faculty and students. It is not meant to be an actual presentation of the faculty-to-student ratios used for program learning overall or for any particular course. Faculty Academic Credentials Review of the data demonstrates that overall and by program type, faculty academic credentials have improved since the last reporting period. These results continue the trend that can be dated to In addition, improvement can be seen in the previously identified associate and practical programs. 16

19 Master's: All programs reported doctorally prepared faculty. Fifteen programs reported having only doctorally prepared faculty teaching graduate students. Baccalaureate: Ninety-three percent of programs reported faculty holding doctoral degrees. Three programs reported having only doctorally prepared faculty teaching baccalaureate students. Eighty-nine programs reported at least one faculty member holding a baccalaureate degree as her/his highest academic credential. Sixty-seven percent of programs reported faculty in graduate study, including 76 of the 89 programs reporting faculty with nursing baccalaureate degrees as their highest academic credential. Associate: Two hundred fifty-nine programs reported faculty holding doctoral degrees. All programs reported faculty holding master's degrees. Sixty-one percent (n = 342) of programs reported at least one faculty member holding a nursing baccalaureate degree as the highest academic credential. Sixty-seven percent (n = 369) of programs reported faculty enrolled in graduate study, including 298 of the programs reporting having at least one faculty member with a nursing baccalaureate degree as the highest academic credential. Diploma: Thirty-six programs reported no faculty holding doctoral degrees. All programs reported faculty with graduate degrees with a major in nursing. Thirty programs reported faculty who hold a nursing baccalaureate as the highest academic credential. Thirty-nine programs reported faculty currently enrolled in graduate study. Practical: Fourteen programs reported at least one faculty member who is doctorally prepared. Four programs reported no master's prepared faculty. Three of these programs reported faculty in graduate study. All programs are being reviewed and monitored. Ninety-two programs (67% of reporting programs) reported faculty enrolled in graduate study. 17

20 Complaints Over the last three reporting cycles, the number of complaints and the percentage of programs reporting complaints have varied within a 4% range. The percentage of programs reporting at least one complaint has decreased for associate and practical programs; increased for diploma programs; and stayed statistically the same for the master's and baccalaureate programs. The total number of complaints reported overall has decreased slightly from 648 in the last reporting cycle to 590 in this reporting cycle (Table 14). Distance Education As the presentation in Table 15 demonstrates, the use of online methods for nursing program delivery continues to expand. Over 78% of the reporting master's, baccalaureate, and associate programs are now using some form of online delivery. For the diploma and practical programs, the inclusion of electronic delivery systems continues but at a significantly slower pace. Of note for this reporting period is the continued development of the use of online methods to offer multiple courses or whole programs/tracks among master's and baccalaureate programs and the use of online methods to offer multiple courses among associate programs. Master's: For the reporting period, 93% of programs noted use of online modalities in the delivery of their nursing program with 16.9% reporting offering the whole program or track online. Baccalaureate: For the reporting period, over 80% of programs noted use of online modalities in the delivery of their nursing program with 11.7% reporting offering the whole program or track online. Associate: At this time, 78.8% of reporting programs use online modalities in the delivery of their nursing program and 1.6% offer the whole program or track online. Diploma: The use of online modalities to deliver the nursing program continues to rise with 29.3% of the programs reporting use of online activities in one or more courses. Practical: For this reporting period, the use of online methods to offer multiple courses within a program of study showed the greatest change, from 4.1% to 8.4%. 18

21 Preceptors The NLNAC definitions for preceptor (one for graduate and one for undergraduate programs) were used to collect data for this reporting period. The data continue to reveal a significant use of preceptors in the delivery of all nursing programs, with the exception of practical nursing (Table 16). In comparison with the previous reporting period, the most notable change is the decrease in reported use of preceptors for all program types. As reflected in Table 17, pre-licensure and undergraduate programs tend to use preceptors in the last course of the program, whereas graduate programs, not unexpectedly, use preceptors throughout. Standardized Testing For the reporting period, data demonstrate that the vast majority of pre-licensure and undergraduate programs (baccalaureate, associate, diploma, and practical) use standardized tests in some way whereas graduate programs do so less frequently (Table 18). For this reporting period, graduate programs reported an 8% increase in the use of standardized tests whereas baccalaureate programs reported a 5.6% decrease. Most pre-licensure and undergraduate programs using standardized tests use them as part of individual courses (Table 19). The use of standardized tests as a program progression or outcome measure ranges from 35.7% for diploma programs to 60.6% for baccalaureate programs. 19

22 Title IV Funding For the reporting period, 78% of the programs noted that they participated in Title IV funding. Table 20 presents the participating programs by program type. Programs were also asked to identify their Title IV gatekeeper. All the master's and baccalaureate programs and over 87% of the associate programs reported their gatekeeper as one of the six regional accrediting agencies. Ninety-eight percent of the diploma programs and 42.5% of the practical programs identified NLNAC as their gatekeeper. Conclusions Programs accredited by the NLNAC continue to demonstrate higher levels of quality than nonaccredited programs, thus affirming the soundness of the NLNAC Standards and Criteria, including selected program and student achievement measures such as: Advanced Certification Pass Rates; NCLEX-RN and PN Pass Rates; and Graduation Rates. NLNAC-accredited programs contributed a significant majority of the newly licensed nurses to the health care delivery system within the US for the reporting period. Although faculty academic qualifications continue to improve, they still present major concerns within selected programs, especially associate and practical nursing programs. Faculty numbers, while improving slightly, are not keeping pace with the increasing enrollments within all types of nursing programs, with the exception of practical nursing. 20

23 Fall 2008 and Spring 2009 Accreditation Plans The planning phase for the Fall 2008 Accreditation Cycle has been completed; program Self-Study Reports are being submitted, and site visit teams will be starting their program reviews. Seventy-five programs will be reviewed this fall cycle including 17 applying for initial accreditation and 58 seeking continuing accreditation. For the Spring 2009 Accreditation Cycle **, planning is underway to schedule 90 programs for review. ** as of August 29, 2008 *Diploma programs are visited only in the Fall Accreditation Cycle. Comments regarding any of the programs scheduled for review may be submitted to NLNAC at our New York City office or online: NLNAC 61 Broadway, 33rd Floor New York, NY P ext. 153 F

24 FALL 2008 ACCREDITATION CYCLE Scheduled Site Visits SPRING 2009 ACCREDITATION CYCLE Scheduled Site Visits** 22

25 SPRING 2009 ACCREDITATION CYCLE (continued) Scheduled Site Visits** **as of August 29, 2008 Please visit us online at for the most updated information. 23

26 A quarterly electronic newsletter published by the National League for Nursing Accrediting Commission. Stay informed on the latest NLNAC accreditation activities. Visit us online to view/download current and past issues. To subscribe, register free at or call Alex Mariquit at ext.247 or by amariquit@nlnac.org 24

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