Annual Program Evaluation Practical Nursing Program St. Charles Community College. 2008/2009 Academic Year Math-Science-Health Chris Breitmeyer, Dean

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1 Annual Program Evaluation Practical Nursing Program St. Charles Community College 2008/2009 Academic Year Math-Science-Health Chris Breitmeyer, Dean Written by: Bernadette C. Moody, MSN, RN Director of Nursing Programs March 2010

2 Table of Contents I. MISSION AND GOALS A. College Mission Statement B. Practical Nursing Program Mission and Philosophy C. Practical Nursing Terminal Objectives and Competencies II. PROGRAM ASSESSMENT INSTRUMENTS A. PN COMPREHENSIVE PREDICTOR B. Work Keys: listening and writing C. NCLEX-PN III. PROGRAM ASSESSMENT DATA A. PN COMPREHENSIVE PREDICTOR B. Work Keys: listening and writing D. NCLEX-PN IV. PROGRAM GOALS AND ACHIEVEMENTS V. STATISTICAL PROGRAM DATA VI. PROGRAM REVIEW QUESTIONS VII. PROGRAM SUMMATION COMMENTS

3 I. MISSION AND PHILOSOPHY College Mission and Vision Statement St. Charles Community College enriches our community by providing life-changing educational and cultural opportunities focused on personal growth and student success in a global society. We will be a community college recognized for leadership in academic excellence, student success, instructional and technological innovation, and community responsiveness. The philosophy of the nursing department of St. Charles County Community College flows from the principles identified in the College mission statement. The practical and associate degree nursing faculty members agree that nursing is a distinct discipline developing its own theories and principles. They accept and utilize recognized theories of stress and adaptation and human growth and development as a valid framework for the construction of nursing curricula and adopt the nursing process as the tool for correlating their theoretical and practice components. The individual is a biopsychosocial being of dignity and worth with a unique potential for self-development. An individual "is a caring organism and enters into reciprocal caring relations that enable him to strive towards health, growth and self-actualization" (Bevis, 1983). The individual is both a recipient of and participant in nursing care. An individual is, also, the integral unit of society, which is, composed of individuals, families, and communities whose values and goals focus on survival and the improvement of the quality of life and health. The nurse is the designer and provider of nursing care to these members of society who, in turn, recognize nursing as a valuable service, a force for social good. Health is a term that describes the state of wholeness or integrity of a human being. "It is a dynamic state of being in which the developmental and behavioral potential of an individual is realized to the fullest extent possible. Each human being possesses various strengths and limitations resulting from the interaction of environmental and hereditary factors" (ANA: Nursing, A social Policy Statement, P. 5). An individual's level of health is dependent upon his/her adaptive capacity to respond to these factors or stressors. Nursing is a creative and expanding discipline occurring in a variety of settings. It may be defined as "the diagnosis and treatment of human responses to actual or potential health problems" (ANA: Nursing, a Social Policy Statement, 1989, p.9) and is designed

4 to promote, maintain, and restore an optimal level of health or to provide support toward a peaceful death. It is a humanistic service whose practice is based upon nursing theory and nursing process. Nursing combines concern with the individual and the environment with actual giving of care and utilizes principles from the physical, biological, and social sciences amplifying this knowledge through the application of health care concepts. St. Charles County Community College prepares practitioners at the practical and associate degree levels of practice. The nursing faculty recognizes "the differentiated levels of functions which exist within the profession of nursing and which result in collaborative, interdependent, and complementary parameters of practice consistent with the educational preparation of the practitioner" (Midwest Alliance in Nursing: Associate Degree Nursing: Facilitating Competency Development Project, 1984, p. 1). The licensed practical nurse (LPN) participates in the assessment, planning, implementation, and evaluation of patients with common nursing diagnoses under the supervision of a registered nurse. The LPN uses basic communication and technical skills in providing and documenting patient care and in teaching patients and families, utilizing a structured teaching plan. The nursing faculty believes that the provision of care to the elderly with non- acute deviations from health is a primary mission of the practical nurse. Education is a lifelong experience that influences the individual and the social system wherein one functions. It focuses on the development of the mind, capabilities, and character through formal and informal schooling. The nursing faculty members agree that a vocational education in basic sciences and fundamentals of social sciences is requisite to practical nursing education and that a broadly based liberal arts background including a foundation in the physical, biological, and social sciences is essential to the education of an associate degree nurse. They feel that educational preparation in the sciences and the humanities is the most effective means for the registered nurse to attain the self awareness and cultural understanding needed to function effectively in a demanding and dynamic health care system. The nursing faculty further agrees that nursing education does not cease with the completion of a formal program of education, and continuing education must be an integral part of the nurse s personal and professional developmental plan. Nursing education is the process that develops the knowledge, role, skills, and behaviors necessary to assist individuals and families in the maintenance of wellness and the treatment of illness throughout the life span. Nursing education should stimulate the students' ability to think critically, analytically, and creatively in arriving at sound solutions to nursing problems.

5 The nursing faculty believes that learning is a relatively permanent change in behavior resulting from the integration of knowledge and experience and that learning occurs best in an atmosphere where mutual respect is paramount. This respect should spring spontaneously from the recognition of the dignity and worth of the individual. They hold that learning is self-activated and can be facilitated by the provision of rewarding experiences which allow for discovery through reason and which are presented in a structured sequence. It is a passage from potentiality to actuality brought about in human persons by their own activities. The faculty recognizes that students should possess adequate levels of academic readiness and motivation and should assume the responsibility to work toward the attainment of objectives that are defined for each level of learning. They believe that evaluation is a vital component of an educational program and that self-evaluation is the highest form of evaluation. Evaluation is an ongoing process, which ascertains attainment of objectives and is a stimulating force leading to improvement. The majority of the students in the nursing department are adult learners who come to the program with life experiences, which influence their learning patterns. Curriculum design, supervision, and evaluation are functions of the nursing faculty who assume responsibility for directing the students' learning experiences. The overall goal of the nursing programs at St. Charles County Community College is to meet the needs of the St. Charles County community by preparing graduates for the entry level nursing practice who can respond to the changing health care needs of patients and their families.

6 Practical Nursing Terminal Objectives and Competencies: The graduate of St. Charles County Community College Practical Nursing Program is prepared to apply to take the National Council Licensure Exam for Practical Nursing and to: I. Recognize each person as an individual of dignity and worth. A. Exhibiting commitment to the conscientious and responsible care of patients. B. Participating in developing a plan of care that is unique to each individual. C. Employing the principles of therapeutic communication to all relationships in the heath care setting. II. Recognize and report common stressors that interfere with an individual's maintenance of wellness. A. Participating in the identification of those physical, psychosocial, spiritual, or ethno-cultural stressors, which are affecting or may affect the patient's health. B. Assisting the registered nurse in identifying problems, which may affect the patient and/or the family. III. Utilize the nursing process in applying knowledge derived from the principles of basic physical and social sciences to assist the patient to adapt to stress arising from his/her internal or external environment. Will utilize the nursing process to assist individuals in restoring or maintaining their optimal levels of health or assist them to a peaceful death. A. Collecting and reporting data relevant to the patients' problems. B. Assisting with the identification of patient problems. C. Assisting the patient and the registered nurse with the setting of realistic and specific goals. D. Administering safe, direct nursing care to persons of all ages with common health problems.

7 1) Performing nursing skills according to recommended guidelines. 2) Preparing, administering, and charting medications including intravenous therapy, with skill, knowledge, and safety within prescribed limitations. 3) Seeking guidance and assistance as necessary. 4) Communicating effectively all above information to health team members. 5) Documenting all steps appropriately. E. Assisting with the evaluation of progress toward goals. F. Assisting in the revision of nursing care plans. IV. Function effectively as a member of the health care team under the guidance of the registered nurse. A. Assuming appropriate responsibility for care of assigned patients. B. Communicating effectively with health team members. C. Participating in teaching the maintenance of health and the prevention of illness according to a prescribed plan. D. Participating in patient care conferences. E. Assisting in the evaluation of patient care. F. Assuming additional duties within limits of responsibility. V. Demonstrate knowledge and understanding of professional, ethical, and legal implications in the delivery of health care through appropriate behavior and actions. A. Complying with regulations and recognized standards of practice in delivering health care. B. Assuming responsibility for one's own behavior and actions.

8 VI. Recognize the need for continued intellectual and vocational growth. A. Assessing the need for continued learning. B. Attending workshops and classes. C. Using available resources to solve current problems. D. Seeking professional guidance and assistance as necessary.

9 IV. PROGRAM GOALS AND ACHIEVEMENTS: Established Goals for the 2008/2009: 1. Increase pass rate on NCLEX PN Licensing exam to 80% or better 2. Hire and mentor a new full time faculty person 3. Continue to monitor clinical faculty on conditional appointment until full approval is accomplished Achievements: Meeting of goals: 1. Pass rate on the NCLEX-PN licensing exam for the 2009 graduating class was 87.1%. National passing rate was 85.73%. We exceeded the national pass rate. Many students participated in the NCLEX review course offered at SCC. 2. Derronda Griesenauer is now a full time faculty person in the PN program, effective for the academic year. Her duties include teaching in the classroom, clinical, and skills lab. 3. Only one clinical faculty remains on conditional approval related to still not completing her BSN. Goals for 2009/2010: 1. Maintain a pass rate of at least 80% on the NCLEX-PN. Encourage students to participate in the NCLEX-PN review course offered after graduation and prior to the administration of the test. 2. Hire a part time clinical adjunct instructor with a BSN or better. 3. Obtain another long term care facility for clinical.

10 VI. PROGRAM REVIEW QUESTIONS: 2008/ The Practical Nursing Program has a capacity of 40 students. For the 2008/2009 academic year, the Fall 08 enrollment was 39 1 student dropped out before attending class the first day. 2. The Missouri State Board of Nursing requires that faculty for practical nursing programs have a minimum of a BSN. This year, all our faculty meet this requirement. It can be a challenge to find qualified instructors, related to the number of schools of nursing in the St. Louis metro area, but BSN prepared nurses are in more abundance than MSN prepared nurses. 3. With just two full time faculty, our practical nursing program would not be able to expand at this time. If we were to increase our numbers, we would need more faculty. 4. General education requirements for nursing students include Anatomy and Physiology I & II, Intro to Psychology, English 096 or greater, and Gerontology. 5. Enrollment for the last three years is as follows: ; ; Although there is a continued need for nurses in the community, our resources limit our ability to meet those needs, and the cap for accepting students in to our program will remain at 40. There is great competition for faculty and clinical sites! A larger class would also require more faculty and more classroom space, which is at a premium. 7. Full time faculty: Rusty St. John and Derronda Griesenauer are full time faculty. We also employ 3 part time adjunct instructors to assist with clinical. 8. Rusty St. John received 2 credit hours release time for her role as Coordinator of the Practical Nursing Program for the 2008/2009 academic year. 9. The class graduating in 2009 started with 39 students in January 2008, 7 of whom were ESL (English as a second language). 31 students of those students graduated in Of those 31students, 4 students were ESL. In January of 2009 we admitted 40 students, 11of whom were ESL students. We are seeing our population of students changing. We will offer assistance as needed, and will look into ways to be proactive in assisting these students.

11 VII. PROGRAM SUMMATION COMMENTS Of the 31 graduating students in 2009, 11 did not meet the 80% standard for all 3 assessment tests (NCLEX-PN Indicator; Workkeys Writing, Workkeys Listenning. Of the 11 students, all but 1 student was deficient in only 1 area. The one student was deficient in all 3 tests. This was an ESL student for whom the results of all testing were likely to have been affected by language % of the graduates in 2009 passed the NCLEX-PN the first time they took it. This surpassed the national average of 85.73%. Most jobs for practical nurses are in long term care facilities. Many graduates would like to work in acute care facilities (hospitals); however, the acute care facilities do not hire many LPNs nor pay as well as long term care facilities. This is not something that SCC can remedy. There are jobs available for graduates, but many wish to pursue their education to become RNs. Although they wish to attend SCC s ADN program, there is much uncertainty of gaining entrance. Many have to consider going to other schools and this is frustrating to them. The graduates feel that SCC should take some measures so that they can continue their education at SCC.

12 II. PROGRAM ASSESSMENT INSTRUMENTS The PN Comprehensive Predictor This test is developed by Assessment Technologies Institute. The purpose of the test is to predict the ability of the graduating PN student to pass the NCLEX- PN licensing exam. Students who score 60.6% or greater, have an 80% or greater chance of passing the NCLEX PN exam. The group mean-national is the average of all the PN group scores from the ATI test pool. For 2009, the group mean national was 67.5% The group score was the mean score of those at SCC who took the test. The group score was 65.7%. Although this was lower than the national mean, our group score falls within the 90% to 93% probability of passing the NCLEX PN. PN Comprehensive Predictor 2.0 Table provided by Assessment Technologies, Inc. (Predicted Probability of Passing the NCLEX_PN) Predicted Probability (Percentage Correct) of Passing NCLEX-PN > 76.1% > %- 75.6% %-72.8% %-70.6% %-67.2% %-64.4% %-62.2% %-60.3% %- 57.5% %- 55.2% %- 53.1% %-50.9% <41.7% <.10

13 Assessment Technologies, Inc. states, Use caution when interpreting the probability of passing the NCLEX-PN because numerous factors can influence performance on both the PN Comprehensive Predictor and the NCLEX-PN. Work Keys WorkKeys was developed by ACT. The assessments are performance based. Examinees write their own responses to Listening and Writing. Each response is scored twice once to indicate how well the individual listened, and once to indicate the individual s writing skill level. Each student took 2 tests as listed below. WorkKeys Testing Structure for Practical Nursing Program: Name Levels Type Time Listening & Writing: Listening 1-5 pen/paper 40 minutes 6 messages Listening & Writing: Writing 1-5 pen/paper 40 minutes Level 3 was set as the level for our 80 percent achievement level for our students to meet. 6 messages NCLEX-PN The National Council Licensure Exam (NCLEX-PN) is designed to test knowledge, skills, and abilities essential to the safe and effective practice of nursing at the entry level. NCLEX examination results are used by boards of nursing to make decisions about licensure. Only boards of nursing can release NCLEX examination results to candidates. To take the NCLEX examination, candidates must apply for licensure in the state in which they wish to be licensed, and meet all of the board of nursing s eligibility requirements for licensure. Students receive the NCLEX examination results within two weeks of completing the exam. A diagnostic profile is mailed to candidates who fail the examination. Using this information, failing candidates can determine their areas of strengths and weaknesses, and design their study accordingly, prior to retaking the NCLEX examination. Graduate results are reported to nursing programs quarterly, along with comparative statistics of passing rates from other schools and other states.

14

15 III PROGRAM ASSESSMENT DATA SKILLS TEST WORK KEYS Maintains 80% Level & above for Skills Assessment STUDENT # SIMULATED BOARDS LISTENING WRITING xxxxxx 70.6% 3 3 Yes xxxxxx 61.1% 4 4 Yes xxxxxx 61.7% 4 4 Yes xxxxxx 63.3% 4 3 Yes xxxxxx 71.1% 3 3 Yes xxxxxx 64.4% 3 3 Yes xxxxxx 74.4% 4 3 Yes xxxxxx 56.1% 4 4 No xxxxxx 76.1% 4 2 No xxxxxx 62.8% 3 2 No xxxxxx 67.8% 3 3 Yes xxxxxx 58.9% 4 3 No xxxxxx 71.1% 4 3 Yes xxxxxx 66.7% 3 3 Yes xxxxxx 73.3% 4 4 Yes xxxxxx 59.4% 3 3 Yes xxxxxx 52.8% 2 2 No xxxxxx 73.3% 4 3 Yes xxxxxx 53.3% 3 3 No xxxxxx 63.3% 4 3 Yes xxxxxx 62.8% 4 3 Yes

16 xxxxxx 55.0% 3 3 No xxxxxx 59.4% 3 3 No xxxxxx 74.4% 4 4 Yes xxxxxx 73.9% 4 4 Yes xxxxxx 70.6% 3 2 No xxxxxx 72.2% 3 2 No xxxxxx 63.9% 4 2 No xxxxxx 67.8% 3 3 Yes xxxxxx 70.6% 4 4 Yes xxxxxx 65.6% 4 4 Yes NCLEX-PN: Pass Rates Missouri National SCC PN Program 89.39% 85.73% 87.10%

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