THE VICTORIA COLLEGE ASSOCIATE DEGREE NURSING PROGRAM

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1 THE VICTORIA COLLEGE ASSOCIATE DEGREE NURSING PROGRAM SELF-STUDY REPORT for THE NATIONAL LEAGUE FOR NURSING ACCREDITING COMMISSION October 2012 VICTORIA COLLEGE ASSOCIATE DEGREE NURSING PROGRAM VICTORIA, TEXAS A SELF-STUDY REPORT Presented to THE NATIONAL LEAGUE FOR NURSING ACCREDITING COMMISSION

2 Table of Contents List of Tables List of Appendices iv v Section I: Executive Summary 1 General Information 2 Introduction 4 History of the Nursing Education Unit 6 Summary of Standards and Criteria 8 Analysis and Summary 15 Section II: Standard Standard 1 18 Criterion Criterion Criterion Criterion Criterion Criterion Criterion Criterion Criterion Criterion Standard 2 37 Criterion Criterion Criterion Criterion Criterion Criterion Criterion Criterion Criterion Criterion Standard 3 49 Criterion Criterion Criterion Criterion Criterion Criterion Criterion Criterion ii

3 Standard 4 68 Criterion Criterion Criterion Criterion Criterion Criterion Criterion Criterion Criterion Criterion Standard Criterion Criterion Criterion Criterion Standard Criterion Criterion Criterion Criterion Criterion Criterion Criterion Criterion Criterion Section III: Appendices 122 iii

4 List of Tables Table 1 Relationship College Mission Statement & A.D.N. Philosophy 20 Table 2 Faculty Service on Committees 23 Table 3 Faculty Continuing Education 38 Table 4 Location of Policies for Students 50 Table 5 Student Services Staff 62 Table 6 Curriculum Threads 69 Table 7 Relationship Among A.D.N. Philosophy, Program Objectives, 72 and Program Outcomes Table 8 Learning Activities Associated With Theory Content 76 Table 9 Required Nursing Courses 78 Table 10 A.D.N. Support Courses from the Sciences and Humanities 78 Table 11 Integration of Learning Outcomes, Instruction, Learning 82 Activities and Evaluation Table 12 Distribution of Required Courses 94 Table 13 Agencies Utilized for Clinical Experiences 97 Table 14 Classrooms 103 Table 15 Student Evaluation of Physical Facilities 104 Table 16 Student Evaluation of Library Services 106 Table 17 Faculty Evaluation of Library Services 106 Table 18 Student Evaluation of Learning Lab Facilities 108 Table 19 Student Evaluation of Technology Services 110 Table 20 Faculty Evaluation of Technology Services 110 Table 21 NCLEX- RN Pass Rates First Time Takers 115 Table 22 Program Completion Rates 117 Table 23 Student/Employer Satisfaction 117 Table 24 Job Placement Rates 118 Table 25 Online Compared to In-class Pass Rates 120 iv

5 List of Appendices Appendix 1 Organizational Chart 123 Appendix 2 A.D.N. Budget 125 Appendix 3 Faculty Credentials 127 Appendix 4 Evaluation Forms 130 Appendix 5 Syllabus Acknowledgement 133 Appendix 6 A.D.N. Applicant Data Form 135 Appendix 7 Letters 137 Appendix 8 Clinical Evaluation Form 144 Appendix 9 Student Services 146 Appendix 10 Leveled Outcomes 149 Appendix 11 Test Plan Summary 156 Appendix 12 Academic Status Report 158 Appendix 13 Systematic Plan Evaluation 160 v

6 Section 1: Executive Summary 1

7 GENERAL INFORMATION 1. The type of program being reviewed and purpose and date of the visit: Associate Degree Nursing Program NLNAC Accreditation: October 2-4, Name, address, and telephone number of governing organization: Victoria College 2200 E. Red River Victoria, Texas (361) Name, credentials, and title of chief executive officer of the governing organization: Tom Butler, Ed.D. President 4. Name of regional/institutional accrediting body and accreditation status: Southern Association of Colleges and Schools (SACS) Full Accreditation: February Name, address, and telephone number of nursing education unit: Associate Degree Nursing Program The Victoria College 2200 E. Red River Victoria, Texas Telephone #: (361) ; Fax #: (361) Name, credentials, and title of nurse administrator: LeAnn Wagner, MSN, RN Dean of Allied Health/A.D.N. Director Telephone #: (361) ; Fax #: (361) address: Alison Hewig, MSN, RN Associate Degree Program Chair Telephone #: (361) ; Fax #: (361) address: 2

8 7. Name of state board of nursing and approval status: Texas Board of Nursing 333 Guadalupe #3-460 Austin, Texas Continued Full Accreditation: May, Standards and criteria used in the self-study report: NLNAC Accreditation Manual 2008: Standards and Criteria 3

9 Introduction Victoria College is located in Victoria, Texas in south central Texas. The College serves seven counties (Calhoun, Dewitt, Goliad, Gonzales, Jackson, Lavaca, and Victoria) which are often referred to as the Golden Crescent area. The service area of approximately 5,960 square miles is predominately rural with Victoria being the largest city. Approximately 188,799 individuals currently reside within this area with 56.8% of the total population Caucasian, 5.4% Black, 34.6% Hispanic, and 3.2% other. The Hispanic population continues to experience the most rapid growth. The economy of this area is driven by very diverse business interests including oil and gas production, agribusiness, petrochemical plants, and manufacturing enterprises. Most recently, Caterpillar, International is building a large manufacturing facility in Victoria that will eventually employ over 800 individuals. Central to the mission of Victoria College is providing opportunities for the population to achieve their educational goals and therefore meet the workforce needs of both individuals as well as area employers. Victoria College was established in 1925 and is an open-access two year institution that grants the Associates of Arts, Associate of Science, and the Associate of Applied Science degrees; certificates in a number of allied health and workforce areas, non-credit continuing education courses, and foundational courses in reading, writing, and mathematics. From Fall 2009 to Fall 2011, academic enrollment at the College increased 12% to 4,514 students. The Workforce & Continuing Education headcount increased 42% to 6,753. The Associate Degree Nursing (A.D.N.) Program is organizationally part of the Allied Health Division. In addition to the A.D.N. Program, the Allied Health Division also has programs of study in respiratory care, vocational nursing, physical therapy assistant and medical laboratory technology. At the beginning of the Spring 2012, semester there 4

10 were 203 full-time students enrolled in the A.D.N. Program. In the fall of 2011, there were 741 students at Victoria College who had associate degree nursing as a declared major (http://www.victoriacollege.edu/images/files/ire/fall_2011_inside_numbers.pdf). The Allied Health Division is under the direct supervision of the Dean of Allied Health who reports directly to the Vice-President of Instruction. The Dean is also the Director of the A.D.N. Program with a full-time A.D.N. Program Chair who is responsible for the day-to-day activities of the Program. In addition to the Director and the Program Chair, there are 13 full-time A.D.N. faculty members, a Nursing Simulation and Laboratory Coordinator, and several adjunct faculty who assist in providing quality learning experiences for the students enrolled in the program. 5

11 History of the Nursing Education Unit The Victoria College Associate Degree Nursing (A.D.N.) was established to meet the local and regional needs for quality Registered Nurses. With the admission of the first class of 40 A.D.N. students in September, 1975, the tireless work of many community leaders was rewarded and their vision achieved. The program continues to have broad support from all communities of interest in the service area including the medical, nursing, and educational communities. Each program graduate has been given an opportunity to achieve the goal of becoming a skilled professional nurse who could provide the highest quality of safe nursing care to all patients. The A.D.N. Program was granted initial accreditation by the Board of Nurse Examiners (BNE) for the State of Texas in 1975 and received full accreditation in 1977 continuing with that status to the present time. In 1981, the A.D.N. Program and Victoria College, recognizing the importance of National League for Nursing (NLN) accreditation, sought and achieved initial accreditation. The program has maintained continuous accreditation since that time. The most recent NLNAC accreditation visit was in the fall of The Victoria College A.D.N. Program is located in the recently constructed Health Sciences Center on the main campus in Victoria, Texas. There are no satellite sites offering A.D.N. courses. The program does offer some on-line courses which assist in meeting the needs of students throughout our geographically large service area. The A.D.N. Program is a multiple entry/multiple exit program providing maximum flexibility for enrolled and returning students. The Generic Track consists of four semesters of nursing courses beginning with Level 1, which introduces students to the profession, and culminating with Level IV which begins the students transition to graduate nurse. Students who successfully complete Level II can (on a space available 6

12 basis) choose an optional summer rotation in the college Vocational Nursing Program which will, upon successful completion, allow them to take the NCLEX-PN and become Licensed Vocational Nurses. The A.D.N. Program also offers a Transition Track which is available only for LVN s and can be completed in three semesters. These students enter the LVN course in the summer followed by Level lll in the fall and Level IV in the spring completing the entire Transition Track in one calendar year. The basis of the A.D.N. Program is found in its philosophy. This philosophy is consistent with and reflective of the mission and goals of the parent institution. The A.D.N. conceptual framework and curriculum threads also serve as guides for the educational process. The A.D.N. faculty continues to review and update the program philosophy to ensure it remains reflective of current practices in nursing education. The Differentiated Essential Competencies (DECs) of Graduates of Texas Nursing Programs released in October 2012 were used as a guide to review and revise the program competencies and the curriculum. During the thirty seven years the A.D.N. Program has been preparing professional nurses, the faculty has been a major factor in the program s success. Their tireless dedication to nursing, students, patients, and community instills in students a high standard of professionalism. Diversity among the faculty provides students with a broad perspective of nursing as they transition from students to graduates providing the highest standard of nursing care to their patients. 7

13 Summary of Standards and Criteria Standard 1: Mission and Administrative Capacity The mission of Victoria College and the philosophy of the Associate Degree Nursing Program continue to be intricately related with shared values and goals. Both the College and the A.D.N. Program value integrity, respect for individuals, student success and excellence. The Program faculty, administrators and students continue to play a vital role in the governance of the College and the Program with faculty members serving on many college-wide committees. Nursing students have the opportunity to participate in the Victoria College Student Government and also to serve as representatives on the A.D.N. Faculty-Student Liaison Committee. The Student Nurses Association continues to be a very active group on campus and in the community. The community also plays a vital role in providing input into the decision making processes of the College and the A.D.N. Program. The Advisory Committee meets each Fall and Faculty Agency Committees meet each Spring. In addition, both the College and the A.D.N. Program continue to seek partnerships that promote excellence, enhance the profession and benefit the community. Most recently, the A.D.N. program signed a formal articulation agreement with the University of Houston-Victoria to facilitate admission of Victoria College A.D.N. graduates to their RN to BSN program. In addition, the A.D.N. program has recently joined the Consortium for Advancing Baccalaureate Nursing Education in Texas (CABNET). The main purpose of this consortium is to eliminate repetition of nursing content and offer students a cost effective and time efficient method to receive both an A.A.S. and a B.S.N. The anticipated outcome of this consortium s work is to increase the number of nurses with a B.S.N. or higher to meet the I.O.M. s recommendation of 80% of all Registered Nurses with at least a B.S.N. by 8

14 2020. (http://www.iom.edu/~/media/files/report%20files/2010/the-future-of- Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf). The A.D.N. Program is under the leadership of a nurse administrator who meets, and exceeds, requirements of the Texas Board of Nursing (BON). With over 36 years of nursing education experiences, she has extensive knowledge of nursing education, the Victoria College A.D.N. Program, the Victoria College, and the community. She is active in many state wide nursing groups and serves on a number of state-wide committees. Most recently, she served her second term as President of Texas Association of Deans and Directors of Schools of Professional Nursing; she was also elected Chair of the Advisory Committee on Education for the Texas Board of Nursing. She is assisted by the A.D.N. Program Chair who is responsible for the day-to-day operations of the program. With input from the program chair and faculty, the nurse administrator prepares and administers the budget of the A.D.N. program, which is the largest budget of any instructional department in the College. She also initiates grant applications to secure supplemental funds for special program needs and projects. Policies of the nursing education unit are comprehensive and are generally consistent with Victoria College policies. Because of the intense nature of the selective admission of Allied Health Programs, each program prepares a Student Handbook which gives the program specific policies and guidelines that governs that program. These Handbooks are approved by the Victoria College Board of Trustees each fall prior to the beginning of the academic year. The A.D.N. faculty continue to receive the Victoria College Board of Trustees Market Scarcity stipend which is based on significant difficulty in recruiting well qualified faculty members to a specific discipline. Workload for the A.D.N. faculty is 15 student contact hours per week which is consistent with the college policy. Both the College and the Program have developed policies to resolve concerns/complaints from the public, employees, and students. 9

15 Distance education within the Program is congruent with the mission of the College and the A.D.N. Program philosophy. The only nursing courses that are currently available for A.D.N. students are limited exclusively to students in the LVN to A.D.N. transition track. This allows students who are often employed to continue working a few days each week so that they can maintain facility benefits such as health insurance. Standard 2: Faculty and Staff All A.D.N. Faculty meet the requirements of the Texas Board of Nursing, the Texas Higher Education Coordinating Board, the Texas Workforce Commission, the Southern Association of Colleges and Schools as well as the requirements of the College. All full time Program faculty have Master s degrees in nursing with three or more recent years of direct patient care experience. The Nursing Simulation and Laboratory Coordinator provides faculty support and assistance for the students simulation experiences and also coordinates the use of the campus lab. She will complete requirements for her M.S.N. in December of The College employs an L.V.N. as a Nursing Laboratory Assistant to organize supplies and equipment for faculty use in the campus lab. With a wide variety of clinical nursing experiences the faculty are able to give students a broad perspective of nursing profession. A.D.N. students have direct faculty supervision in the clinical setting with one Master s prepared nurse supervising ten students. The number of students can increase to 15 if a Teaching Assistant (TA), who has a B.S.N., is assigned with the M.S.N. prepared faculty member, who is responsible for evaluating student performance. Many TAs are pursuing or have completed their Master s degrees. Part time faculty are not routinely hired for classroom teaching, but guest speakers that are experts in their fields are utilized throughout the curriculum. There are currently 13 full-time faculty members and a pool of approximately 10 part-time faculty who can be used, depending on the program enrollment. There is a full-time administrative assistant assigned to provide 10

16 support to the A.D.N. Program faculty and students. The Dean who is the Nurse Administrator also has a full-time assistant assigned to her office. New Faculty members are oriented to general college policies by Human Resources and to general policies of the Instructional Unit of the College by the Vice- President of Instruction and Deans. The Program Chair and the appointed Level Coordinators provide in-depth orientation to the A.D.N. Program policies. Participation in both college-wide and program committees also provides further insight into the college, the curriculum, and the Program as a whole. The College provides support and development for distance education through its Information Technology (IT) services and the Distance Education Director. All faculty members, both full-time and part-time, are evaluated by students every semester. Non-tenured full-time faculty members meet each semester with the Dean to review their overall performance as faculty members for the previous semester; this includes review of student evaluations. Tenured faculty members meet once every two years with the Dean for a Performance Evaluation Review. Part-time faculty members are evaluated by the Program Chair. Standard 3: Students A.D.N. students are expected to follow the policies of the Victoria College, as well as the Program. VC is an open admissions community college but the A.D.N. program is a selective admission program. All polices of the College and the Program are well articulated to the students using a variety of methods, including the Student Handbooks and course syllabi. Most recently, the A.D.N. faculty began meeting with all applicants for an advising session, not only to foster better communication about the application process, but also to strengthen retention efforts. All of the information about the Program is current, accurate, clear, and consistent. Written materials and information on websites are monitored and updated as necessary. The A.D.N. students are also supported by a wide array of student services and resources provided by the College. The major responsibility of student services is to 11

17 foster collaboration among departments in order to support, enhance, and facilitate a positive campus experience for all Victoria College students. At VC, helping students succeed in fulfilling their educational goals is a top priority. The College complies with the Family Education Rights and Privacy Act of 1974 (FERPA) as well as the Higher Education Reauthorization Act Title IV. Students have access to the VC Help Desk for any technology questions or problems that arise. An online orientation to Blackboard, the college web based instructional platform, is also available for students to assist them with technology issues. Standard 4: Curriculum and Instruction The A.D.N. Curriculum is an essential part of the program framework that helps prepare the qualified applicant to become the entry level associate degree nursing graduate. The Program has developed leveled objectives which assist the student to attain knowledge, skills, values, and competencies to achieve that goal. The Program uses the 2010 Differentiated Essential Competencies (DECs) required by the Board of Nurse Examiners for the State of Texas as its guide. The curriculum includes cultural, ethnic, and socially diverse concepts as part of the threads that are incorporated throughout the curriculum. In addition, Sociology 1301 Introduction to Sociology is a required general education course. A variety of teaching methodologies are used by the faculty to present the nursing content. In theory courses, students are tested by faculty written exams and standardized exams from Assessment Technologies Institute (ATI). In the clinical setting, students are evaluated weekly to monitor progress toward completion of the clinical course objectives. Students meet these objectives through observed patient care, written assignments, campus laboratory check offs, oral presentations and other methods of assessments. 12

18 The curriculum reflects educational theory, interdisciplinary collaboration, research and best practice standards. VC considers professional development in both the discipline and the teaching craft as an essential component of the job. Interdisciplinary collaboration is utilized in the clinical setting on a daily basis and in theory as content warrants. Guest speakers from other disciplines present content in each level. A.D.N. students have clinical experiences in a variety of settings, all of which strive for best practice standards and adhere to patient health and safety standards. Standard Five: Resources Despite continuing decreases in state funding, the A.D.N. Program continues to provide a quality program, which supports student success. The College provides exceptional financial support not only for the Program, but for all student services offered by the college. The library and technology services continue to provide a high level of support and assistance to both students and faculty. In the Spring of 2009, the Associate Degree Nursing Program relocated to a newly constructed building, the Health Sciences Center (HSC). The HSC provides a modern spacious learning environment for faculty, staff, and students. The faculty utilizes the increased lab space, including four simulation rooms, to augment student experiences in managing critical or hard to find clinical situations. In addition, the students have increased access to computers as well as individual and group study space. Standard Six: Outcomes The A.D. N. Program has a very detailed written systematic plan of evaluation (SPE) that emphasizes ongoing assessment and evaluation as the basis for program changes. The SPE drives the decision making processes and changes in the curriculum. The findings of the evaluation committee are shared at least yearly with communities of interest in a variety of ways that include, but are not limited to, Advisory Council meetings and Faculty - Agency meetings. 13

19 The A.D.N. Program continuously monitors program outcomes by evaluating licensure pass rates, program completion, program satisfaction, and job placement rates for all students, including those enrolled in distance education courses. The SPE also ensures that program graduates are able to demonstrate the competencies expected of a graduate nurse beginning their transition into the practice arena. 14

20 Analysis and Summary of Strengths and Areas Needing Improvement Areas of Strengths: One of the greatest strengths of the Program continues to be the nursing faculty. Not only do they meet the requirements of all the accrediting bodies but they exceed these requirements. They are active in the Program, the College, and the community. The faculty are deeply invested in the success of the individual students as well as the success of the Program as a whole. The evidence for this statement lies in the time spent working with individual students, serving on committees, preparing lectures, offering tutoring sessions, attending seminars, advising, and providing community service. Other significant Program strengths are the curriculum and the systematic plan of evaluation (SPE). The faculty continues to value the conceptual framework that the Program was built around along with the curriculum threads that make it complete. Because of the SPE, there is continuous review, refining, and evaluation of the curriculum. Input exists in this process from faculty, students, graduates, employers, and communities of interest. Faculty continuously strive to strengthen the Program and the graduates knowledge, skills, and problem solving abilities through attendance at professional development activities as well as collaboration with colleagues through committee work. The Program continues to enjoy strong support from the college s administration, the community and health care agencies. The College mission, values, and goals are the basis for those of the Program. The College has established processes and procedures that are followed by the Program, with exceptions made when necessary. The College remains committed to excellence as evidenced by continuing voluntary membership and participation in NLN and NLNAC even in times when extreme budgetary constraints were being placed on the College by the state. Health care agencies in Victoria and surrounding communities continue to hire Program graduates and request more. These agencies play an important role in providing feedback about the Program. The community showed their support for the College and the 15

21 Allied Health Programs by passing the bond issue to build the Health Sciences Center and they continue to provide scholarships for A.D.N. students even in this time of economic uncertainty. Areas Needing Improvement and Goals: As in the past, the self- study compels the faculty to review and evaluate every aspect of the Program. Since the last accreditation visit, the Evaluation Committee has been established and has become a significant strength of the Program. This committee is continuously scrutinizing the curriculum and all aspects of the Program looking for areas that need to be strengthened and improved. The two areas that continue to be areas of focus for the Program are evaluation of online courses and retention of students while maintaining a high graduation rate. The original process for gathering data from online course evaluations using an on-line evaluation tool did not yield an adequate number of responses for meaningful data analysis. The evaluation was changed to paper format, but this was complicated by the quantity of evaluations that nursing students must complete and again there were not adequate responses for analysis. The plan for evaluation for the coming academic year is for the course coordinators to ensure that online students complete a separate evaluation of the course. Secondly, retention coupled with continuing high student success, continues to be another area of concern. Since implementing many new strategies, the Program has seen improvement in completion and graduation rates. The challenge for the Program for the next few years will be to maintain the high student success and graduation rates that have been achieved during the anticipated retirement of several long time experienced faculty. 16

22 Section 2: Standards

23 I. MISSION AND ADMINISTRATIVE CAPACITY Standard I: The Nursing education unit s mission reflects the governing organization s core values and is congruent with its strategic goals and objectives. The governing organization and program have administrative capacity resulting in effective delivery of the nursing program and achievement of identified outcomes. Criterion 1.1: The philosophy / mission of the program in nursing is congruent with the mission and purposes of the governing organization. The Victoria College (VC) Mission Statement, Statement of Values, and Goals are reviewed annually and revised as needed to reflect changes taking place within the College, the community, and higher education as a whole. The Associate Degree Nursing (A.D.N.) faculty is a part of this process. The A.D.N. philosophy is also reviewed periodically to reflect changes taking place with the program, the College, the community, and nursing education in general. The mission of Victoria College and the philosophy of the A.D.N. program are intricately related and share complementary and similar beliefs (see Table 1). The mission of Victoria College is as follows: Victoria College is a public, open-admission college. Our mission is to provide educational opportunities and services for our students and the communities we serve. To that end Victoria College provides the following: University Transfer Academic courses that apply to baccalaureate degrees and meet the educational needs of students planning to transfer to a university. Workforce Education Career and technical courses and programs designed to satisfy local and regional employer demands and meet individuals' workforce training needs. Academic Foundations Compensatory education courses designed to prepare students effectively for success in college-level studies. 18

24 Continuing Education Non-credit courses and programs that meet the immediate technical and occupational skills needs of employers and the individual, and fulfill the personal enrichment and cultural needs of the individual and the community. Adult Education Adult education, basic skills, and English as a second language instructional programs that meet the specific educational needs of our adult constituency. Student Support Services and activities that support student success. Cultural and Intellectual Outreach Educational activities and events that enhance our community's quality of life. The A.D.N. philosophy is contained in its statement of purpose: The primary purpose of the Victoria College Associate Degree Nursing program is to prepare its graduates to successfully complete the National Council Licensure Examination for Registered Nurses (NCLEX-RN), and, therefore, assume the responsibility of functioning as a member of the health care team and demonstrate a commitment to life-long learning. The administration and faculty acknowledge the concurrent responsibility of preparing graduates to meet the nursing care needs of people of this community and surrounding communities and to meet the educational needs of students who wish to pursue nursing as a means of personally satisfying intellectual, financial, and self esteem needs. The A.D.N. program curriculum offers a variety of initial learning experiences in the cognitive, psychomotor, and affective domains which will enable the graduate to enter nursing with graduate level skills and personal behaviors consistent with professional expectations. The educational experience emphasizes development of an inquiring mind which recognizes that the 19

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