Comprehensive Program Review Report

Transcription

1 Comprehensive Program Review Report Program Review - Nursing Prepared by: Terri Paden RN, DNP Division Chair Nursing and Allied Health 2017 What are the strengths of your area?: RN Program Student Success: The Nursing Program has a high success rate with almost all the students completing the program. During the academic year of the program had 192 students enrolled in all four semesters. The students that did not complete the program either withdrew for personal reasons or academic failure. The RN program does allow the students one academic failure and a chance to repeat the course which contributes to our low attrition rate and high student success. In the academic year only 3 students failed the program. There were four withdraws for reasons other than academics. The RN program continues to have a high success rate and low attrition rate of 6.25% down 6% from the previous year (State average is 14% in Associate Degree programs). In addition to program success and student retention the RN program continued to have above the State average pass rates of 88.24% on the National Council Licensure Examination (NCLEX) exam. The continued success of the program appears to be due to all instructors collaboratively integrating an ongoing assessment tool, Assessment Technology Institute (ATI) for their course preparation, instruction and reinforcement. The ATI program purchased by students and grant funds provides the nursing student with assessments of their current knowledge level. ATI provides individualized remediation plans to support student success in achieving the COS RN program outcomes. ATI guides the student by using supplementary resources such as case scenarios to reinforce theory and clinical instruction and ATI live review after program completion prior to sitting for the NCLEX exam. The students that did complete the RN program are eligible to sit for the NCLEX exam. Enrollment Patterns: The program continues to accept 40 students a semester. Students who have completed the required prerequisite courses with a minimum 2.5 GPA and have taken the TEAS test (entrance exam) are then qualified to apply for the program. The selection process for acceptance is determined using the Multi-Criteria Admission Tool (documents). This tool is based on a 100 point system. The average point spread scored for acceptance in the past two semesters was points. The average point spread for the alternates was points. There were a total of 293 applicants for the academic year and 80 students were accepted into the program. The LVN-RN bridge option accepts LVNs into the second semester as space is available. During the last year no LVNs were accepted into the program as space was not available. The RN program has its own Student Success Program for students at risk for failure, struggling with nursing concepts and content, needing to develop study strategies, or having psycho-social issues. The students can voluntarily make arrangements with the student success instructor or can be referred to the student success instructor for assistance. The faculty of the RN program accommodates the learning and testing needs of the students at the Access and Ability Center.. Workload Measures: The RN program has eight core nursing courses ranging from 3 to 11 units. All the courses have a lab (clinical) component. The optimal student instruction occurs when the theory instructor also teaches in the clinical setting. This continuity of instruction is preferred to promote student learning and reinforces content recently taught in the classroom. The program currently has 11 full time nursing faculty with one full time faculty member on an extended sick leave during the academic year who returned Fall The remaining 10 full time faculty instructed at load and various overload and approximately 12 adjunct faculty instructors at various partial load. The program has been functioning with a full time vacant position in the Intermediate Medical-Surgical Nursing course and also has a full time retirement position opening following Spring 2018 in the Introduction to Medical-Surgical Nursing course. These vacancies will leave the program vulnerable to gaps in valuable instruction with the possibility of decreased student success and a drop in pass rates on the NCLEX exam. It is imperative that the vacancy and replacement faculty positions be a priority in program planning and effectiveness. Student Evaluations : Evaluations are based on 3 categories, Theory, Clinical, and Resources in all 4 semesters of the program. Graphs of all categories and the evaluation questions pertaining to those categories that the students have responded to are in the Summary of Program Effectiveness pages in the documents. Evaluations are delivered through Survey Monkey and based on a 5 point Likert Scale. The evaluation data analysis are summarized in a narrative followed by course 10/19/2017 Generated by Nuventive Improve Page 1 of 16

2 faculty review responding with a development of plan of action, pp Academic Quality: A Nurse Educator is a nursing specialty supported by the National League of Nursing (NLN). The standards set by the NLN are as follows: 1. Facilitate learning 2. Facilitate learner development and socialization 3. Use assessment and evaluation strategies 4. Participate in curriculum design and evaluation of program outcomes 5. Function as a change agent and leader 6. Pursue continuous quality improvement in the nurse educator role 7. Engage in scholarship 8. Function within the educational environment The nursing program faculty continually assesses, evaluates and implements needed changes and improvements to optimize student learning and success. This process is the foundation of nursing the faculty have been practicing from the beginning of their careers and is now transferred to the students in their clinical education. The Nursing Process is comprised of 5 elements: Assessment, Nursing Diagnosis, Planning, Implementation, Evaluation In addition to professional standards and years of nursing experience a majority of the Nursing Faculty attend an Elsevier Nurse Education conference during the Winter Break. New teaching strategies are acquired and implemented into the classrooms. Resource Efficiency: The Nursing Program is a CTE program that qualifies for VTEA grant money. The program has benefited greatly with needed skill lab equipment, student assessment testing, ATI live review and a consultant for the upcoming program curriculum change. In addition to VTEA funds the program has been able to increase FTES with the addition of 10 LVN-RN student through the Strong Workforce Initiative for the year. Resource efficiency is always low attributed to our Faculty/Student ratio in the clinical setting of 1:10. This ratio and limit of students in a clinical setting is a mandate by Board of Registered Nursing. Faculty Growth Template Summary: The FTES for was 243 which is consistent with the previous year. Noted this data is a year behind the academic year being evaluated. The program has always focused on the needs of the community by meeting industry demands. The community nursing needs have steadily increased in the last two years. The efficiency (E-WSCH/FTES) however, is 231 in productivity far below the state productivity goal. It would appear that we are not efficient but this is due to the design of our classes by state mandate. Each semester has a class of 40 students divided into 4 groups of a clinical lab with 1 instructor per 10 clinical lab students. The program has a total of eight core (required) courses which are all designed in the same pattern. Therefore it is virtually impossible to meet the state goal productivity value in the efficiency (E-WSCH/FTEF) category and also meet the Board of Registered Nursing state mandates. (documents-faculty Growth Template) Internal Relations: Many of the full time faculty are members of campus committees representing the RN Program, they inform the nursing faculty of the current topics and processes of these committees. The COS committees that include a representative for nursing faculty are: Curriculum, Distance Education, Academic Senate, Instructional Council, FEC, and Outcomes and Assessment. The RN program representatives that attend these meetings provide updates and information to the program Division meeting that is scheduled once a month. External Relations: The RN Program partners with multiple clinical sites for instruction in the community including Kaweah Delta Medical Center, Tulare Regional Medical Center, Hanford Adventist Health Hospital, Central Valley Regional Center Kaweah Delta Mental Health, Visalia Unified School Nurses, and 12 step addiction meetings. The clinical placements are coordinated by the San Joaquin Valley Nursing Education Consortium which is a computerized clinical placement program for all the hospitals and nursing programs in the region. The RN Program is a member and hosts the annual Advisory Board. Members include representatives of the hospitals and other nursing programs in the community. See documents for minutes. The RN Program also has an affiliation with the Health Workforce Initiative beneficial for the faculty for their required continual education units for RN license renewal with access to multiple courses at no charge. Certified Nurse Assistant (CNA) Program Course Success Rates: The CNA program is one course that is offered in the Fall and Spring semesters. The program consistently has a high success rate and is in high demand as the class fills immediately when registration opens with a wait list. According to the (a year behind) program review data matrix the student success rate is 97% (documents). The class has a maximum of 15 students a semester. The Fall 2016 class had 14 students with 13 students successfully completed the class with 1 student failing the 10/19/2017 Generated by Nuventive Improve Page 2 of 16

3 course. The Spring 2017 semester had 15 students and 14 students successfully completing the course with 1 student failing the class. The students who successfully complete the course are eligible to sit for the state certifying exam that is offered by 2 different organizations, American Red Cross and the National Nurse Aide Assessment Program Examination (NNAAP), and acknowledged by all health care facilities. The data provided from these certifying organizations provides the name of the student who passes but does not give the name of the student who fails. There is no documentation if the student did not take the test or failed the test. The instructor of record regularly checks the state certification web sites and has remained in contact with the students to obtain some of this missing information. Fall of 2016; 11 students are certified, 2 did not take the exam. The instructor last reviewed the status of certifications on August 29, Spring 2017; 5 students are certified, and no information on the remaining 9 students. The instructor last reviewed the status of certifications on August 30, Resource Efficiency: The CNA program has a low teacher/student ratio, 15-1 as mandated by the state, and does not require any additional instructors. The program also utilizes the Allied Skills Lab that is also shared with the EMT, PT, and PTA programs. Equipment and supplies are shared by the Allied Health Division. Enrollment Patterns: The program (1 course) accepts a maximum of 15 students per semester. Fall and Spring semester were filled and had 10 students on the waitlist to be enrolled if a student should drop the class prior to the start of the course. Workload Measures: The program was taught by a full time faculty instructor in the RN program. The course/program consists of a lecture and a lab. The program is structured for student learning in theory, instructor demonstration, student participation, and student skill demonstration. The students then progress to the clinical sites for patient care also taught by the same instructor. The theory hours and clinical hours required by the students are mandated by the state. Student Evaluations : As new action last year a student program evaluation was developed and implemented. The evaluation consists of 5 questions with responses based on a Likert Scale except for question 1 which asked the student's goal for taking the course. The results to question 1 were; 16 students took the course for the Registered Nursing application points and 13 students took the class for employment as a CNA. Textbooks and audiovisuals were helpful for all students but 1 who remained neutral. The question referring to "articles and handouts were helpful" received Strongly Agree responses except for 4 students who agree or were neutral. The same responses were tallied for the clinical sites that provided opportunities to practice skills. Finally, all students agreed or strongly agreed to the clarity of the course objectives in the syllabus. (N260 course survey in documents) The majority of the students taking the course for other reasons than to become employed as a CNA is concerning as certified CNAs is a skilled position in demand. CNA is a program that does not require prerequisites and often these students are registering at COS for the first time and cannot compete in enrollment status with RN majors with multiple units enabling enrollment priorities. Academic Quality: The CNA program prepares the student as an entry-level worker, providing basic nursing care to patients in acute care and long-term care settings by presenting course information in a variety of methods and reinforcing that information with practices when ever possible. Internal Relations: The CNA instructor was part of the COS nursing division and has access and invited to all the division meetings and advisory meetings. External Relations: The CNA program is part of the annual Registered Nursing Advisory Board including RN nursing faculty and representatives of the hospitals and other nursing programs in the region. (Advisory Board minutes attached) What improvements are needed?: 1. Continually improving student success and NCLEX pass rate. The program's attrition rate did decrease substantially and our NCLEX pass rates have remained stable in the 88% range but they are not at a goal of 100%. The continued support of funds to augment the student's ATI package will be needed to maintain and improve the pass rates. The faculty are also revising the Nursing Program curriculum that was developed in The curriculum is dated and does not represent all the new health care reform standards and mandates. This process will begin in the academic year. 2. Development and implementation of a non credit simulation course - Incorporating simulation as a continual thread in the Nursing program curriculum has been a need for years. Simulation in nursing education has progressed as the challenge for clinical sites or current clinical sites without sufficient amount of patients that can meet the clinical SLOs of the student. Simulation offers the students the opportunity to learn in situations that are comparable to actual patient encounters in a controlled learning environment. Students are able to transfer classroom knowledge to realistic patient scenarios meeting the required SLOs and mandated clinical hours. The skill lab currently has low, medium, and high fidelity simulators that are underutilized due to faculty workload, technological challenges, and the requirement for additional training. It is the norm for nursing programs to have a simulation lab with a designated faculty or simulation technician to manage, schedule and maintain 10/19/2017 Generated by Nuventive Improve Page 3 of 16

4 the simulators. The design of this course does not require employment of a new faculty member or technician but will be part of a current full time faculty load. A nursing faculty is preferable to a technician as they have the knowledge to integrate simulation across the curriculum, the ability to reverse the faculty role from teacher-centered to student-centered and becoming the facilitator in the student's learning process, and the knowledge to assess and evaluate student SLO success and completion. 3. A full time faculty vacancy position - Currently this position has been filled with faculty overload and adjunct instructors who work full time in 1 of our clinical sites. Although our adjunct are experienced nurses they do not have the knowledge of a nursing instructor as an educator. They also lack the time or interest in participatory governance, division meetings, curriculum decisions, and overall nursing program planning. Due the large unit value of this course it provides faculty load for 2 instructors. The 1 full time faculty in this semester has been working overload in theory and managing the semester independently. This is a 2 full time faculty course/semester. 4. A full time faculty retirement position replacement - Full time nursing instructors improve academic quality by adhering to the National League for Nursing Nurse Educator Competencies listed in the Academic Quality section. A full time faculty retirement replacement will maintain the quality of this course and success of the students when our faculty member retires next semester. 5. Part-time senior secretary - The Nursing Program needs a full time administrative assistant who manages all of the program's needs from scheduling to monitoring student clinical compliance requirements and graduation requirements for the Board of Registered Nursing. In fall of 2017 Nursing and Allied Health had administrative changes requiring our administrative assistant to split the duties between Nursing and Allied Health. The Nursing Division is in need of a part-time position senior secretary to fulfill the duties our current administrative assistant is unable to complete. 6. Classroom configuration - the faculty have had difficulty with the orientation of the classroom and the pathway to the front of the class. The current location of the projector screen requires the desks to face north. It is a safety hazard when bringing in teaching equipment and lecture materials into class. 7. Skill lab equipment - The equipment in the skills lab needs to be current with the equipment used in the clinical sites when administering patient care. A bladder scanner is a common ultrasonic device for assessment in patient urinary retention. Certified Nurse Assistant (CNA) Program Improvement Needed: An improvement needed is to increase the enrollment of students in the CNA program that want to make CNA as their career. A review of the RN Multi-criteria Admission tool will be reviewed for the points allowed for taking the CNA course. Describe any external opportunities or challenges.: RN Program Opportunities: There has been an increase in demand for nursing hires in the community. When the demand for nurses increases the health care facilities often develop and institute opportunities for the student during their nursing education. The RN program s largest clinical partner has reinstated the Student Nurse Intern position on multiple nursing units in response to our recommendation and also the hospital's need for nurses. This allows the nursing student during the last semester of training to work under the supervision of an RN doing patient care and advanced skills under the classification of unlicensed personnel. The student is paid an hourly wage, gains experience in patient care, and possible employment at the completion of the program and licensure. Challenges: 1. Clinical post conference space/rooms at the clinical sites - The clinical partners have not allowed the Instructors to schedule post conference meeting rooms at the clinical sites. This restriction has left the faculty and the students no other option but to return to campus following their clinical rotations. Class rooms need to reserved limiting the availability of other classes on campus to be scheduled. 2. Reduced patient census at a clinical partners- A Tulare County clinical site has been having financial, administrative, and management issues that do not seem to be improving. The faculty assigned to this facility has become very creative and resourceful in alternate teaching strategies to meet the student's SLOs. One of our faculty members has become competent in simulation and has been able to meet the clinical hour requirement by teaching a percentage of clinical in the simulation setting reinforcing the need for incorporation of simulation throughout the curriculum. 3. Limited available leadership mentors for the fourth semester, Leadership in Nursing course. Due to the nursing need the clinical partners are hiring many new grads that are assigned to the experienced RNs who frequently mentor our students. This 10/19/2017 Generated by Nuventive Improve Page 4 of 16

5 is a challenge but also an opportunity as these new nurses are our graduates. 4. The students in the Perinatal nursing specialty are not allowed to access the electronic medical record for their patients. The students need to rely on verbal information from the nurse or the patient to formulate a plan of care.. This is very limiting as the student does not have access to the patient's history. diagnostic tests, or lab values which is information required to formulate a of plan of care. The requirements from the clinical partners for our students are extensive including background checks, and signed HIPPA compliance documents and have the needed security clearance. The RN students must have access to all information the RN does. 5. A technological requirement for the students is to access patient information from the electronic medical record. This requires training in the clinical site computer training rooms. The hospital no longer provides this training and very has very limited access to the training rooms. They have required the faculty do this training on the floors but the faculty are not employees of the hospital and have not been trained nor have they used these systems in past employment. Certified Nursing Assistant (CNA) Program A challenge is the clinical site location a Kaweah Delta Medical Center Sub-Acute Hospital. There are multiple schools assigned to the hospital and it does not have many beds. Overall SLO Achievement: RN Program The nursing program has 8 core courses and the same 8 SLOs for each course (1. Caring, 2. Safety, 3. Critical Thinking, 4. Psychomotor, 5. Health Teaching, 6. Communication 7. Growth, Development and Adaptation, 8. Legal Ethical, and Professional Practice) These SLOs are semester leveled, meaning each semester's expectations of the student increase with complexity. The faculty assess all 8 SLOs by various evaluation methods; classroom testing, clinical observation, student demonstration, written care plans, and ATI testing. The goal of the faculty is to have 100% of their students meet each SLO. Each course and every SLO consistently met the established goal of 100% success rate also reflective in the program success and attrition rates Certified Nurse Assistant (CNA) Program Changes Based on SLO Achievement: Overall PLO Achievement: Changes Based on PLO Achievement: Outcome cycle evaluation: RN Program The college requirement for faculty SLO assessment is every 3 years. The Nursing Division Faculty decided 3 years is too long to assess the 8 SLOs for each of the classes as evaluation and improvement measures need to be identified and planned so the following semesters can benefit. At least 1 SLO is evaluated every year from every nursing core course. The faculty participate in tracdat outcome assessments in the beginning of the academic year, usually during Dialog Day as outcome assessment is scheduled into the agenda. Certified Nurse Assistant (CNA) Program The assessment cycle is the same as the RN program assessment cycle Action: Ensure Student Support in the Application Process To The RN Program Facilitate administrative support for students wanting information regarding the application process into the RN Program, support for the students applying to the RN Program, and the process in the selection of the students into the RN program Status: New Action Implementation Timeline: Start Date: 09/06/2017 Identify related course/program outcomes: District Objective 2.4: Increase CTE course success rates and program completion annually 10/19/2017 Generated by Nuventive Improve Page 5 of 16

6 District Objective 3.2: Increase training for academic and student services staff and faculty to respond to the unique need of our student population Rationale (With supporting data): The RN Program office assists students with multiple calls per week regarding the application process, the pre-requisite courses required, and the scheduling of the required TEAS (entrance exam) test. In addition to the information provided by phone and walk-ins assistance to the student is provided for the actual application submission. The amount of student applications processed in was 315. The amount of applications processed for the current academic year is 383. The application process for each student requires: Verification of the minimum qualifications Calculation of the overall GPA Calculation of the GPA for all 3 Biology course requirements Verifying number of attempt on the Biology's Transcript evaluation - COS and other Colleges The score and number of attempts on the TEAS test (entrance exam) Calculating the score on the Multi Measures application process (Multi-Criteria Admission Tool) Verification of the Multi Measure points the student has claimed English equivalency evaluation for students who did not take English 1 at COS Informal pass along - collect the syllabus and course outline For each student a file and student worksheet is assembled All student application criteria is then entered in a data base Letters are mailed to each applicant notifying the student of acceptance, waitlist status, and to the students that did not get into the program The total time to process the applications is approximately 1 to 1.5 hours per application or 315 to hours for the academic year Safety Issue: No Resources Description Classified- New/Replacement - Part-time 20 hour/week senior secretary (Active) Why is this resource required for this action?: This resource is required to maintain the secretarial services of the nursing division prior to the fall 2017 academic year Notes (optional): Cost Estimate: District Objectives Increase training for academic and student services staff and faculty to respond to the unique needs of our student population. Action: Full Time Nursing Faculty Vacancy Existing vacant intermediate Medical-Surgical nursing instructor position Status: New Action Implementation Timeline: Start Date: 09/07/2017 Identify related course/program outcomes: Full time faculty relates and supports all 8 program outcomes; Caring, Safety, Psychomotor Skills, Critical Thinking, Communication, Health Teaching, Growth, Development & Adaptation, and Legal, Ethical & Professional Practice. A full time nursing instructor represents and focuses on the institution, nursing program, and the goals of 10/19/2017 Generated by Nuventive Improve Page 6 of 16

7 the student Rationale (With supporting data): Currently this position has been filled with faculty overload and adjunct instructors who work full time in 1 of our clinical sites. Although our adjunct are experienced nurses they do not have the knowledge of a nursing instructor as an educator. They also lack the time or interest in participatory governance, division meetings, curriculum decisions, and overall nursing program planning. Due the large unit value of this course it provides faculty load for 2 instructors. The 1 full time faculty in this semester has been working overload in theory and managing the semester independently. This is a 2 full time faculty course/semester Safety Issue: Yes Resources Description Faculty- New/Replacement - Full time nursing faculty to fill vacancy (Active) Why is this resource required for this action?: Notes (optional): Cost Estimate: Action: Full Time Nursing Faculty Retirement Replacement Full time nursing faculty retirement replacement Status: New Action Implementation Timeline: Start Date: 09/06/2017 Identify related course/program outcomes: A nurse educator supports all 8 of the program outcomes of Caring, Safety, Psychomotor Skills, Critical Thinking, Communication, Health Teaching, Growth, Development & Adaptation, and Legal Ethical & Professional Practice Rationale (With supporting data): Full time nursing instructors improve academic quality by adhering to the National League for Nursing Nurse Educator Competencies 1. Facilitate learning 2. Facilitate learner development and socialization 3. Use assessment and evaluation strategies 4. Participate in curriculum design and evaluation of program outcomes 5. Function as a change agent and leader 6. Pursue continuous quality improvement in the nurse educator role 7. Engage in scholarship 8. Function within the educational environment Although our clinical adjunct instructors are meeting the objectives of the course and students are meeting their SLOs there is a gap in clinical expertise and an Educator's foundation Safety Issue: Yes 10/19/2017 Generated by Nuventive Improve Page 7 of 16

8 Faculty- New/Replacement - Retirement replacement for Medical Surgical nursing (Active) Why is this resource required for this action?: This resource is required to maintain the quality of this course and success of the students when our faculty member retires next semester Notes (optional): Cost Estimate: Action: Simulation Course Develop and implement a non credit simulation course students in all semesters will rotate through during their traditional clinical rotations. Status: New Action Implementation Timeline: Start Date: 09/12/2017 Identify related course/program outcomes: Relates to all 8 program outcomes; Caring, Safety, Psychomotor Skills, Critical Thinking, Communication, Health Teaching, Growth, Development & Adaptation, and Legal, Ethical & Professional Practice Rationale (With supporting data): The nursing skills lab has multiple level fidelity simulators that are underused due to lack of faculty time in simulation scenario prep and skill with the simulators. Simulation instruction is a nurse educator specialty that requires course training and development in the area of simulation pedagogy. Having a designated faculty member instructing the class will provide all semester students access to simulation. The benefits of the incorporation of simulation in the program curriculum is; 1. Active involvement of students in their learning process 2. More effective use of faculty in the teaching of clinical skills and interventions 3. Increased student flexibility to practice based on their schedules 4. Improved student instruction 5. Effective competency check for undergraduates 6. Correction of errors discussed immediately 7. Standardized, consistent, and comparable experiences for all students 8. Opportunities for collaboration Simulation can also be utilized for students to make-up clinical time as the BRN allows a certain percentage of the mandated clinical hours to be completed through simulation Safety Issue: Yes Resources Description Classified- New/Replacement - The instructor for the course will be a current full time faculty member. The course will be selected as part of faculty load. Planned load equivalency will be 2 clinical rotations or.64 load per semester (Active) Why is this resource required for this action?: The resource needed is an increase in current instructor costs as faculty or adjunct will teach the 2 available clinical rotations per semester that the simulation instructor would vacate to teach the simulation course. No new hires needed Notes (optional): Simulation in nursing education has evolved over the last 5 years to an expected and sometimes required part of nursing curriculum. Simulation is extremely expensive and COS's simulators are underutilized as there has not been a simulation instructor since their purchase. Nursing programs in our area and nationally have developed combined nursing faculty positions to include traditional instruction as well as simulation which have been very successful. 10/19/2017 Generated by Nuventive Improve Page 8 of 16

9 Cost Estimate: Action: Continued Student Success Maintain and contribute to high student success Status: Continued Action Implementation Timeline: Start Date: 09/12/2017 Identify related course/program outcomes: 1. Safety - comprehend safety in nursing care to assist the client to promote, maintain, or restore an optimal level of well-being 2. Critical Thinking - comprehend critical thinking in applying the nursing process to manage client care 3. Health Teaching - comprehend the principles of health teaching when promoting wellness 4. Growth, Development, and Adaptation - comprehend the principles that will result in optimal well-being 5. Legal, Ethical, and Professional Practices - comprehend the practices while acting as client advocate in providing nursing care to a diverse population - Nursing Faculty - Division Chair Rationale (With supporting data): The RN program NCLEX pass rate has improved with the assistance of grant monies spent last year that provided an NCLEX review seminar immediately following graduation. This funding has contributed to the consistent NCLEX pass rates of 88 to 89%. The grant money has also provided students with simulation technology for real clinical scenarios available to them on campus in their skill lab. The continued financial support funding is requested to maintain and improve student success Safety Issue: Yes Update on Action Updates Update Year: /15/2017 Completed: No 1. The program's attrition's decreased by 50% with a rate of 6.25% with a national average of 14%. This can be attributed to the program's implementation of identification of at risk students from the Nursing Entrance Exam, pre-admission counseling by the campus counseling department and by the Director, low Faculty to student ration in clinical areas, skills and computer labs for practice/remediation/review are available for four days per week, skill lab adjunct faculty to assist with math, care plan process, nursing process, and nursing skills, and continued Student Success Program (SSP) to identify at-risk students. The SSP provides support services and resources to assist in successful completion of the program National Council Licensure Examination for Registered Nurses (NCLEX) pass rate is 88.24% with a 0.65% decrease from the previous year. The BRN has not published all the California nursing school statistics for pass rates yet for the year as they are a year behind to compare COS to other programs in the state. Current interventions to improve NCLEX results are: To continually improve NCLEX pass rates the faculty integrate and utilize of Assessment Technologies Institute (ATI) material and NCLEX strategies and methodologies into course work, increase use of ATI resources and formalized remediation plan for practice scores below benchmark levels, offering onsite supplemental 3-day NCLEX live review by ATI to all students including atrisk students. During the academic year the funds to augment the student's ATI package that provide many of these ATI resources was obtained through a nursing grant. Impact on District Objectives/Unit Outcomes: The success of the nursing student will impact District Goal 2.1 and 2.4 the 10/19/2017 Generated by Nuventive Improve Page 9 of 16

10 number of students who earn an associate degree and increase the CTE course success rates Update Year: /18/2017 Completed: Yes A student 5 question evaluation of the course was developed, implemented, and evaluated Impact on District Objectives/Unit Outcomes: District Objective 2.4: Increase CTE course success rates and program completion rates Update on Resource Allocation Effectiveness Update on Resource Allocation Effectiveness: no resources were requested or needed for this action (09/18/2017) Resources Description Instructional equipment - Assessment Technology Institute (ATI) packages for each student. (Active) Why is this resource required for this action?: The students are required to purchase the ATI package for assessment testing through out the program grant monies has augmented their package with a live review (review for the NCLEX exam). The cost to the student is $25, the review course is approximately $860 without the funding Notes (optional): Cost Estimate: 8500 Action: 10 LVN to RN cohort Fall 2018 The second cohort of 10 LVN to RN students are scheduled to begin Fall 2018 as the initial cohort will graduate Fall These 10 students enter the program in 2nd semester and complete the program in 3 semesters. Strong Workforce Initiative supported the initial cohort which began Fall 2018 graduating Fall 2019 Status: New Action Implementation Timeline: Start Date: 09/07/2017 Identify related course/program outcomes: District Objective 2.2: Increase the number of students who earn an associate degree or certificate annually District Objective 2.4: Increase CTE course success rates and program completion annually Rationale (With supporting data): Currently our county is experiencing a nursing shortage and these additional graduates assist in alleviating this shortage. Safety Issue: Yes Resources Description Non-instructional equipment - The increase of nursing graduates meets the needs of the community by increasing the amount of RNs available for employment (Active) Why is this resource required for this action?: Notes (optional): Cost Estimate: /19/2017 Generated by Nuventive Improve Page 10 of 16

11 District Objectives Increase overall enrollment by 1.75% annually Action: Reconfigure Projector and Projector Screen in Room HR127, HR128, HR129 Change projectors, and screens to face the east wall Status: New Action Implementation Timeline: Start Date: 09/08/2017 Identify related course/program outcomes: This action focus is on faculty safety as the path to the current front of the class is a maze of student belongings Rationale (With supporting data): It has been very difficult for faculty to make their way to the front of the class with the current desk orientation. Should a faculty have a cart or rolling item it requires desks to be moved and multiple students moving their backpacks and books causing disruption. Priority: Medium Safety Issue: Yes Resources Description Instructional equipment - This resource is required for classroom safety. Currently the instructor has to navigate though student backpacks and items to reach the north side of the class from the south entrance of the classroom. (Active) Why is this resource required for this action?: This resource request will be requested through VTEA or Strong Workforce Notes (optional): Cost Estimate: 3000 Action: Nursing Division Equipment The skills lab is in need of a bladder scanner (ultrasonic hand held device). Used in the clinical sites for assessing urinary retention. The division is also in need of a new Faculty/Student identification badge unit used for Nursing and Allied Health. The current machine is malfunctioning and requires a new camera, software and a change in the COS logo. The cost of repairs exceeds the cost of a new unit. Status: New Action Implementation Timeline: Start Date: 09/07/2017 Identify related course/program outcomes: The addition of a bladder scanner to the skills lab relates to the program outcomes of Safety, Psychomotor Skills, and Critical Thinking Rationale (With supporting data): The nursing program is required to have a functioning and up to date skills lab where students can learn and practice their skills. It is imperative to have equipment that is currently being used in the clinical setting to prepare the students for actual patient care. The lab is staffed with adjunct nurses who are available to assist the students in their learning needs. The Identification Badge unit is shared by Nursing and Allied Health as well as other departments. It is mandatory that all staff and students entering a clinical site have the appropriate identification. Priority: Medium Safety Issue: No 10/19/2017 Generated by Nuventive Improve Page 11 of 16

12 External Mandate: Yes BRN mandate that RN programs have skill labs with current equipment Clinical site requirement to have appropriate identification name badges on at all times for the duration of the clinical instruction Resources Description Instructional equipment - A nursing assessment skill is to be able to determine urinary retention in a patient. In addition to physical assessment of palpation and patient response there is a device that can estimate the amount of urine in the bladder through ultrasonic waves (non-invasive). This information is beneficial to the nurse in the determination of an appropriate intervention. The ID badge machine is required to produce mandated identification of staff and students. The current machine is obsolete and malfunctioning (Active) Why is this resource required for this action?: Resource allocation will be requested through VTEA or Strong Workforce Notes (optional): The cost of the bladder scanner is 10,000. Waiting for cost of the ID badge machine Cost Estimate: Action: CNA Program - 100% of students enrolled into the CNA program with the goal of CNA employment Increase the number of students in the CNA program with the goal of CNA employment by increasing the enrollment in the CNA course. Revise the student evaluation question to determine if the student who took the class for the RN application points plans to work as a CNA while in the RN program if they are accepted into the RN program. Status: New Action Implementation Timeline: Start Date: 09/18/2017 Identify related course/program outcomes: District Objective - 2.4: Increase CTE course success rates and program completion annually Rationale (With supporting data): The need for CNAs is evident as documented by the EDD. Tulare County projected job openings for is 740 and California State openings are 41,700 for (documents) Priority: Medium Safety Issue: No Action: Perinatal Nursing Speciality, Secondary Medical-Surgical Instructor 10/19/2017 Generated by Nuventive Improve Page 12 of 16

13 Maintain the high level of student success in medical-surgical and perinatal nursing courses Status: Completed Implementation Timeline: Start Date: 08/11/ /01/2017 Identify related course/program outcomes: Rationale (With supporting data): Our current Nursing Program Director vacated the perinatal nursing specialty instructor position three years resulting in an open position. Currently our Fundamentals in Nursing Instructor has notified the nursing division she is planning on retiring on her birthday, January 4, 2016 which will result in two open positions. The success of this program is dependent on dedicated full time faculty that coordinate and consistently plan and monitor each semester in both the theory and clinical components. The nursing program is requesting the hire of a full time tenure track nursing faculty that is qualified to teach both medical surgical and perinatal nursing Safety Issue: Yes External Mandate: Yes In accordance with CCR Sections 1424(g) and 1425 Update on Action Updates Update Year: Completed: Yes The program was granted a full time perinatal instructor beginning Fall The position was filled successfully. Impact on District Objectives/Unit Outcomes: Update on Resource Allocation Effectiveness Update on Resource Allocation Effectiveness: Anticipating improved student success and satisfaction in the course with a dedicated full time expert in the area of Perinatal Nursing (09/15/2017) Action: Certified Nursing Assistant (CNA) Program Evaluation by Student Program 09/15/2017 Will evaluate the student satisfaction of the CNA program and assess the personal goals of the students who completed the program Status: Completed Implementation Timeline: Start Date: 09/02/ /18/2017 Identify related course/program outcomes: Assistant Director of Nursing and Divsion Chair of Allied Health Rationale (With supporting data): Currently do not have a student evaluation process in place. Safety Issue: No 10/19/2017 Generated by Nuventive Improve Page 13 of 16

14 District Objectives Reduce the achievement gap of disproportionately impacted student groups annually, as identified in the Student Equity Plan. Action: ATI Policy Implementaton Consistency All faculty shall adhere to the current ATI policy for integration of the ATI program into the nursing courses. Status: Completed Implementation Timeline: Start Date: 08/06/ /17/2015 Identify related course/program outcomes: Will promote success in all the program outcomes related to caring, safety, psychomotor, critical thinking, health teaching, application of legal, ethical and professional practices. Increase success rate on the NCLEX. Division Chair Allied Health, Assistant Director Rationale (With supporting data): Recent drop in NCLEX pass rates % for the academic year Currently 76.15% for the academic year Safety Issue: No Action: Nursing Program Student Success and Satisfaction Improve NCLEX pass rates by 5% (81% pass rate) and increase student satisfaction in the 3rd semester to be consistent with the entire program Status: Completed Implementation Timeline: Start Date: 08/06/ /18/2015 Identify related course/program outcomes: A majority of the faculty will be full-time which will promote success in all the program outcomes related to caring, safety, psychomotor, critical thinking, health teaching, application of legal, ethical and professional practices., Divsion Chair Allied Health, Assistant Director of Nursing Rationale (With supporting data): Student evaluations in Documents supporting the need for improvement in the 3rd semester. Recent reduction in NCLEX results 88.71% for the academic year , 75.70% in the academic year The 3rd semester FTE = 2.0. Spring of 2014 full time faculty taught 0.5 FTE with 1.5 FTE taught by adjunct. The Board of Registered Nursing recommends a majority of the faculty should be full-time Safety Issue: No External Mandate: Yes In accordance with CCR Sections 1424(g) and /19/2017 Generated by Nuventive Improve Page 14 of 16

15 Action: Student Success Maintain and contribute to high student success in the Registered Nursing Program. The division will apply for VTEA funds to purchase additional resources for nursing students, ATI materials (testing and learning modules). See documents Status: Completed Implementation Timeline: Start Date: 08/11/ /22/2015 Identify related course/program outcomes: 1. Safety - comprehend safety in nursing care to assist the client to promote, maintain, or restore an optimal level of well-being 2. Critical Thinking - comprehend critical thinking in applying the nursing process to manage client care 3. Health Teaching - comprehend the principles of health teaching when promoting wellness 4. Growth, Development, and Adaptation - comprehend the principles that will result in optimal well-being 5. Legal, Ethical, and Professional Practices - comprehend the practices while acting as client advocate in providing nursing care to a diverse population, Nursing Instructor, Divison Chair Rationale (With supporting data): To improve student success and reduce the current attrition rate of 15.6% and increase the current NCLEX score of 76% Safety Issue: No Action: Admission Criteria Policy revision The Admission Criteria Form will reflect the best applicant for the RN program Status: Completed Implementation Timeline: Start Date: 08/08/ /18/2016 Identify related course/program outcomes: The acceptance of a qualified nursing student will promote success in all the program outcomes related to caring, safety, psychomotor, critical thinking, health teaching, application of legal, ethical and professional practices., Assistant Director, Division Chair Allied Health Rationale (With supporting data): Students accepted into the nursing program with the new Multi-Criteria policy are scoring lower on their ATI exams than students that were accepted into the program by GPA only and also students that did not receive the 15 points for taking their pre-requisites at COS. Safety Issue: No 10/19/2017 Generated by Nuventive Improve Page 15 of 16

16 District Objectives Reduce the achievement gap of disproportionately impacted student groups annually, as identified in the Student Equity Plan. District Objectives Improve operational systems based upon data driven decision-making as described in the COS 2.0 manuals. 10/19/2017 Generated by Nuventive Improve Page 16 of 16