AGENDA ITEM IV A PROPOSED NEW ACADEMIC PROGRAM LOUISIANA STATE UNIVERSITY - ALEXANDRIA BACHELOR OF SCIENCE IN NURSING 1
AGENDA ITEM IV A PROPOSED NEW ACADEMIC PROGRAM LOUISIANA STATE UNIVERSITY - ALEXANDRIA BACHELOR OF SCIENCE IN NURSING BACKGROUND INFORMATION Expansion of its strong Associate Degree in Nursing program (ADN) into a Bachelor of Science in Nursing (BSN) program at LSU-A is logical as the institution transitions from two- to fouryear status. The ADN program, by far the largest program on campus, has enjoyed great success and provides graduates to serve the health care needs of central Louisiana. While Northwestern State University in Natchitoches has historically provided BSN completion services via distance learning and the Learning Center in Alexandria, the demand for bachelor s credentialed nurses far exceeds the supply. A Letter of Intent to offer the BSN program was approved by the Board of Regents in May, 2006. Establishment of a BSN will aid LSU-A in fulfilling its mission while more adequately serving the needs of its region. An External Review Committee (ERC) comprised of Dr. Gloria Green, ERC Chair, Director of Undergraduate Studies, Department of Nursing, Southeast Missouri State University; Dr. Mary Bliesmer, Professor and Chair, School of Nursing, Minnesota State University at Mankato; and Dr. Mary Carol Pomatto, Professor and Chair, Department of Nursing, Pittsburg State University in Kansas, met with faculty and the administration and toured the LSU-A campus on September 20, 2007. On September 21, the ERC met with NSU nursing faculty and administration at the Learning Center, then toured NSU nursing facilities at the medical complex in Alexandria. The ERC report was received in October and submitted to LSU-A for its response, which was submitted to the Board of Regents Academic Affairs staff in November. Additional information was requested by the staff; it was received in January 2008. STAFF ANALYSIS The proposed bachelor s program is a one hundred twenty-one (121) semester credit hours (SCH) program which requires twelve new nursing courses totaling thirty (30) SCH. The curriculum is generally consistent with BSN-completion programs. These type of programs are becoming more prevalent across the country as research increasingly ties improved patient outcomes and patient safety to baccalaureate-level nursing. Excerpts from the ERC report are followed by responses from LSU-A. Complete text from both of these sources is available in the Regents Division of Academic Affairs. NOTABLE STRENGTHS 2
1. Cohesive and committed faculty. 2. Flexibility and willingness to grow among the faculty. 3. Strong, positive Associate Degree students and alumni who will provide a consistent pool of applicants for the BSN-completion program. 4. Strong support from employers and community. 5. Coordinated usage/scheduling cooperation of shared clinical space with other programs/schools. 6. Strong performance of LSUA graduates on NCLEX and in clinical practice. 7. Willingness on the part of private hospitals to support LSUA s expansion into baccalaureate education. 8. Well-equipped skills laboratory. In summary, the consultants believe that this proposed BSN completion program has the potential to improve the level of health care in Central Louisiana. We are confident that LSUA s program can co-exist peacefully and healthily with the BSN completion program provided by Northwestern State University, with both programs working to serve the large number of Associate Degree nurses currently practicing in the area. There is no reason for Northwestern s mission or programs to change as LSUA s program is implemented. ANTICIPATED CHALLENGES 1. Limited diversity among faculty in terms of graduate degrees 2. Only doctorally prepared faculty member is the current chair 3. Limited opportunity for faculty to participate in scholarly activity, professional development, and pursuit of doctoral education 4. Philosophical incorporation of BSN education into a long-standing, well-established culture of Associate Degree nursing education 5. Provision of general education and required support courses for additional students 6. Establishment of a new baccalaureate degree in Nursing while LSUA is also converting the entire campus to a four-year institution 7. Provision of adequate sustainable resources to support the BSN completion program 3
RECOMMENDATIONS AND SUGGESTION OF THE EXTERNAL REVIEW COMMITTEE, WITH RESPONSES FROM LOUISIANA STATE UNIVERSITY- ALEXANDRIA Additional Faculty Needs Two doctorally-prepared faculty at a minimum of $60,000 annually before benefits [are needed.]. The University is committed to paying appropriate entry level salaries for doctorally prepared nurses. We anticipate that such salaries may be as much as $60,000 plus benefits. Of the $164,736 ($60,000 in salary for two positions plus 32% benefits for each plus 4% annual increase), the area hospitals have committed $100,000 for up to five years. Thus the University commitment for years 1-5 is $82,838 per year. [Staff Note: Two Alexandria hospitals have each committed $50,000 per year for five years for salary for each of the two additional doctoral faculty that are needed to offer the BSN program.] Timing of Faculty Hires [The University should hire] one of the two [additional] doctorally prepared faculty by Fall, 2008. The University has a search process underway with the goal of hiring a doctorally prepared nurse for the fall of 2008. The recruitment process includes the usual advertisements but also includes campus visits by a recruitment team from the University. The first of our recruiting visits has generated interest in our positions and we will proactively follow-up with prospective candidates with an eye to persuading them to move to central Louisiana. The University also anticipates pursuing active use of capitation funds provided by the State of Louisiana in an effort to grow our own doctorally prepared nurses for the longer term. New Faculty Must Have Appropriate Offices [The University should provide] appropriate furniture and equipment for new faculty offices The University engages in a systematic attempt to provide furniture and equipment for all new faculty. Each new faculty hire is assigned an office with desk, computer system, filing cabinet, bookshelves and reasonable access to basic supplies all of which are ordered centrally by the department. Although office space is in short supply on the LSUA campus (pending the construction of the Multipurpose Academic Building), we do not anticipate difficulty identifying 4
office space for new faculty and/or staff in the Department of Nursing. New Coordinator Must Have Release Time [The University should provide] quarter-time release for faculty member who will serve as coordinator of the BSN completion program The University agrees that the coordinator of the BSN completion program will receive a reduced teaching load of one-quarter time to coordinate the program. Professional Development Support Is Required Increase in funds and time available to faculty for pursuit of professional development. Faculty in the Department of Nursing (and throughout the University) have access to multiple opportunities for professional development. At present each department has a travel and professional development line item which amounts to $1000 per faculty member. All faculty are eligible for mini-grants under the Title III program mentioned above. There is a staff component to the mini-grant program. Through these programs, individuals may request up to $3000 for a specific professional development opportunity. The University also provides supplemental funds for travel and/or professional development when the need arises. There are three Endowed Professorships available to and restricted to faculty in the Department of Nursing and three additional Endowed Professorships available to all faculty (all on an application and competitive basis). Each Endowed Professorship has a professional development component attached to it. As part of the University s Title III grant, the LSUA Foundation is actively seeking funding for substantially increased professional development opportunities at LSUA; such funding would not replace but enhance existing programs. Faculty Pursuing Doctoral Degree Need Support Release time and/or stipends for faculty who pursue doctoral degrees [should be provided.] Faculty pursuing doctoral degrees will be given every consideration for release and/or reassigned time. The University has typically increased the allocation for adjunct faculty as a temporary replacement for full-time faculty pursuing advanced degrees. The University has taken advantage of leave of absence policies of the LSU System to foster completion of doctoral degrees in other disciplines and certainly would extend that opportunity to nursing faculty who are nearing completion of their degrees. 5
Resource Center Staffing Issues Additional staffing for the Nursing Resource Center to allow expansion of open hours to include evenings and weekends [is needed.] The University will increase the staffing for the Nursing Resource Center by the equivalent of.5 FTE. The increase will either come from a part-time employee or through an increased allocation of University student worker allocations. Individuals with the expertise to work in that capacity may well be students who are enrolled in the BSN program. Indeed, it should be noted that the current coordinator of the Nursing Resource Center is the holder of an ADN. Because it is quite likely that this staffing will come from student workers, the budgetary support is not reflected in the attached budget. Student workers are a separate line item for each department but are also separately budgeted because of the federal dollars involved. Additional Secretarial Support Is Needed [Department of Nursing] secretarial staffing should be enhanced by 0.5 [FTE] to raise the total to 2.0 positions. The University will add a.5 FTE secretarial position to the Department of Nursing beginning in the Fall 2008. First- year costs will be paid through funds allocated through the LSUA Foundation. Resource Center Should Be Enhanced [The University should] update video resources and DVD learning packages in the Resource Center. The faculty and staff of the Department of Nursing have been asked to identify specific learning packages which can be used to update the resources of the Resource Center. The library staff has set aside funds to purchase such materials as appropriate; the University has a mini-grant program (through a Title III grant) which is conducive to such proposals, too. We anticipate that a proposal from the Nursing faculty will receive favorable consideration through this mini-grant program. 6
Computational Equipment/Supplies Needed Additional computers, printers, and paper for students in the Nursing Resource Center [is needed.] The recommendation is that the University allocate more computers, printers and paper for students in the Nursing Resource Center. Through an aggressive use of the Student Technology Fee, computer resources in the student labs are upgraded every two-three years. This includes the Nursing Resource Center. Through that same fee, each student has an allocation of paper and access to printing; once students have exceeded their allocation (most never get close to using their allocation), they are charged on a per page basis. Congestion that does occur in the Nursing Resource Center is not a function of the number of computers and/or printers but rather a function of timing. Nursing students tend to seek access to the lab just prior to classes. The congestion can be minimized through use of other labs on campus (all of which are readily accessible because of the small size of the campus) and/or through advance planning. Overall (based on data from Educause) the University maintains a student to computer ratio that is comparable to many other campuses. The University will, however, monitor this situation to ensure that we are providing sufficient technical support for students in the Nursing Resource Center. Operating Expenses Allocations Should Be Increased [The University should provide] reasonable increase in other operating expenses (miscellaneous equipment, supplies, travel, etc.) The University will provide increases in operating expenses appropriate to the Department of Nursing. That department, as with other departments, is an active participant in the plan-driven budgeting process used by the University. A part of each year s request for new money is the pattern of existing use. Clearly the use patterns of the department will increase in proportion to the increase in the number of courses, number of faculty, and number of students served as the BSN is implemented. More specifically the University will continue its practice of providing professional development support in the amount of $1000 for each faculty member plus $1000 for departmental travel. This appears to be sufficient to meet departmental needs. Library Hours Should Be Expanded [The University should] expand library hours to include evenings and Saturdays 7
The University has recently increased the hours of operation for the Bolton Library. Based on a survey of sister institutions, the University has emphasized the increase in evening and Sunday hours. Other institutions in the state have not found that Saturday hours are particularly appropriate to the needs of students such as those whom we serve. The University will, however, continue to monitor this situation and is committed to expanding the hours for the library as the need arises. The fact that collections are accessible on-line on a 24 / 7 basis and the fact that much nursing specific information is available through databases which may be accessed from home has the effect of ameliorating the demand for the library to be opened on Saturdays. Accreditation Costs Must Be Covered [The University should cover] all costs associated with NLNAC accreditation of the BSN completion program. The University has given full support to the accreditation activities of all programs at the University as well as the necessary support for regional accreditation. Since much in the way of accreditation activities is not constant over time, the University budgets for accreditation through centralized funding that is directed to the appropriate department at the time of need. By way of example, the date for the NCATE visit is set for October 2009 and current accreditation dollars are directed to preparations for that visit. Should an NLNAC visit be scheduled in connection with the development of the BSN, we will budget accordingly. We anticipate that the BSN may well prompt a substantive change visit from the Commission on Colleges (SACS); the University has a continuing line item for support of SACS initiatives. Thus support for NLNAC accreditation activity will be in place at the appropriate time. Student Professional Activities Should Be Supported [The University should provide] assistance for students to participate in professional activities The LSUA Foundation is seeking funding to develop a program for student participation in professional activities. Even without that, the Student Government has a competitive grant program which allows student organizations to apply for funding for specific projects. Through this program, the nursing association is already eligible to apply. 8
BSN Scholarships Are Needed Expansion of available scholarships to include BSN completion students [is desirable.]. The University maintains a number of nursing specific scholarships. We are regularly seeking to increase the number and funding for such scholarships and with the area health care shortage we anticipate that this remain a major funding initiative for the foundation for several years to come. Faculty pursuing doctoral degrees will be given every consideration for release and/or reassigned time. The University has typically increased the allocation for adjunct faculty as a temporary replacement for full-time faculty pursuing advanced degrees. The University has taken advantage of leave of absence policies of the LSU System to foster completion of doctoral degrees in other disciplines and certainly would extend that opportunity to nursing faculty who are nearing completion of their degrees. Student Recruitment Plan Should Be Developed Development of recruitment plan to attract students from outside the LSUA service area and/or educational system [is needed.] As the consultants recognize, the primary service area of the University is central Louisiana. We have not nor do we expect to solicit large numbers of students from outside this region. However, the University now has on-campus housing, is actively initiating an international program, is expanding the reach of our recruitment activities. The expectation is that we will gradually increase the number of out-of-region students. Given the place-bound nature of so many LSUA students, the greater likelihood is that student increases will come from students already residing in central Louisiana or from those who relocate to this region as part of a employment or family-related relocation. A Departmental Evaluation Plan Should Be Developed A comprehensive evaluation plan for the Department of Nursing [should be developed.] The faculty and staff of the Department of Nursing are in the process of developing an evaluation plan for the Department of Nursing. That plan will be in keeping with a plan-driven budgeting process already in place at the University. That plan-driven budgeting process requires an annual report from each department or unit of the University. Those reports include 9
a review of service, a report on enrollment trends, a budgetary review, a report on assessment activities and the use of the results of assessment. Such annual reports are made available to the long-range planning committee of the University and to accreditors and others as appropriate. Revised Budget Which Reflects Consultants Recommendations/ Suggestions Should Be Provided Staff Comment: Virtually all of the recommendations will require a budgetary commitment from the University; therefore the provision of a detailed and realistic budget that provides sufficient resources to fulfill the recommendations is foundational to the approval of the program. Accordingly, with their written responses to the consultants recommendations, the University also submitted a revised budget. Our response speaks directly to the recommendations and suggestions made in the report and underscores our University commitment to implement the BS in Nursing as soon as practicable. (See Appendix I.) It is important to note that since the consultants visit, the faculty and staff of the Department have continued their curricular review, have initiated proposals for new courses which will support the BSN, have initiated recruitment of new faculty (two masters level faculty have already been identified, one from the capitation program and the other a current adjunct faculty member at the University), and have begun the development of an evaluation plan as suggested by the consultants. The first recommendation deals with the issue of University budgetary commitment. Please see attached year by year budget projections which constitute the University response to this recommendation. The larger context for meeting the needs of this program represents a subset of the issues facing LSUA as it develops its baccalaureate mission. Budgetary support for the University comes primarily from two sources, state funding and tuition/fees. While LSUA is most appreciative of the increase in state funding which brought the institution to a level appropriate to the formula, the formula, itself, classifies LSUA as a limited baccalaureate institution and thus one which is not funded on a level with other baccalaureate institutions. As system and state data indicate, LSUA remains below its peer institutions in the level of state support. The second primary source of funding for any initiative at the University is that of self-generated tuition and fees. The combination of the fact that LSUA has a lower rate of tuition and a lower fee structure than other baccalaureate institutions in the state (which is lower than many other states as reported through SREB) and the fact that the University has implemented a selective admissions policy (thus reducing the number of students eligible to enroll at the University) has meant a decline in self-generated funds. In order to address this dual funding issue, the University is seeking more state funding and is engaging in significant new enrollment initiatives to recruit more academically eligible students who can not only succeed at the University but increase the self-generated funds available for allocation to programs such as nursing. The challenge, of course, is one of finding a way to generate funds in the absence of the approval of new programs, the subsequent admission of qualified students, and the success of those students in achieving degree completion. Put another way, a key to 10
enrollment growth at the institution is the implementation of new programs. The BSN is a program which will generate significant new enrollment and thus will be a major source of self-generated funds. Having said this, the University is prepared to meet the needs of the first two years of the BSN program through external support which represents a combination of funding from the local hospitals (specifically for recruitment of doctorally trained faculty and for the salaries of those faculty) and funding from the LSUA Foundation. The latter represents a fund housed in the LSUA Foundation which is dedicated to nursing and allied health. The money is otherwise unrestricted as to its use. Details on the use of those funds are included in the attached five year budget projection. By year three it is anticipated that self-generated funds from increased enrollments in nursing will allow for significantly increased support from the University such that the foundation supplement can be eliminated; support from the area hospitals is designated for five years and while that commitment can certainly change, the University will designate state allocations and self-generated funds in years six and following to offset the likelihood that hospital support will not extend beyond the agreed upon first five years of the program. STAFF ASSESSMENT OF INITIAL UNIVERSITY RESPONSE, WITH COMMENTS FROM LOUISIANA STATE UNIVERSITY Staff Comment: Upon examination of LSU-A s initial response to consultants recommendations the staff was somewhat concerned about the level and amounts of University commitment to resolve program resource issues. Several specific items were discussed with the Provost who agreed to supply a revised budget and explanation. Attached is a revised budget for the proposed BS in Nursing. (See Appendix II.) In the revised budget, the University, acknowledging the advice of the staff of the Board of Regents, has increased institutional support to reflect travel, technology and operational needs associated with the hiring of new faculty member (terminal degree) and the admission of the first students in the program. The increases for travel and operations are carried through the five year budget with modest increases for operations and a $2000 increase in year two to reflect the hiring of a second terminally degreed faculty member. The technology increases are one-time expenditures for new faculty in this program. While the University agrees with the Board of Regents staff that it is desirable to purchase a new computing work station for new faculty and while we have projected that we will do so for our new nursing faculty, it should be noted that the University has had considerable success with the recycling of computers from our student laboratories. The recycling is quite systematic and occurs each year as student laboratories are upgraded using the proceeds from the student technology fee. Computers typically no more than two years old are then evaluated for 11
continued usefulness and most can, after evaluation, be placed in faculty offices. Except in very rare circumstances, this approach results in an upgraded computer for faculty members whether they be new to the faculty or continuing faculty. Exceptions to this approach have occurred when the faculty member has a demonstrated need for a more sophisticated hardware or software than that which comes from a student laboratory. While the staff of the Board of Regents has indicated that it might be good to show that the University is committed to using state funds to meet anticipated cost increases, it is more realistic for the University to take the approach that it is taking. That approach envisions using endowment income which is dedicated to Nursing and Allied Health combined with grants and other self-generated funds to establish the program. Once established it is anticipated that self-generated funds will fully support the program even after the grants from the local hospitals cease after five years. Increases in state funding, while highly desirable, are not as predictable. Even with recent increases LSUA remains funded at the lowest level of any baccalaureate institution in the state and, in keeping with the relatively lower levels of income in central Louisiana, the University maintains one of the lowest tuition rates for baccalaureate institutions in the state. Staff of the Board of Regents has also raised the question of library support for the program. LSU Alexandria engages in regular review of its library hours. Our commitment is to support all of our academic programs and to do so at times when our students have indicated that they most want to use the library. As with most libraries in Louisiana, our collections are available through on-line access. This is particularly true in a field such as nursing where electronic resources are rich. Our surveys consistently indicate that few students seek access to the library on Saturdays. This is doubtless a combination of easy on-line access to collections and the distance of the LSUA library from the population centers of Alexandria/Pineville. Nursing students, particularly those in the BSN program, will be even less likely to seek Saturday usage since all will be RN s and most will be undertaking weekend clinical shifts as a means of continuing their work even as they pursue the baccalaureate degree. The University has expanded evening hours in recent years and is now open on Sunday afternoons. Our commitment to providing quality library service means that the library must be staffed by at least one professional librarian at all times. Any expansion in library hours beyond that which we are already doing would necessitate the hiring of another professional librarian. It is both a matter of honoring use patterns and a matter of stretching scarce institutional resources that we are inclined to maintain library support as it is while we bring on the BSN program. We will, as we do with all programs, monitor library usage and engage in user-surveys to determine whether this approach works or whether we must reconsider our hours of operation in the future. Finally staff of the Board of Regents has asked whether we can adequately staff the Nursing Resource Center with student workers. Some clarification is in order. Our nursing resource center is currently staffed with a professional who holds the Associate Degree in Nursing. He is assisted by student workers from the ADN program. Our proposal will continue this practice but we will hire student workers who already have the RN. By definition all students admitted to the BSN program will be Registered Nurses. Related to this is the need to expand the size of the Nursing Resource Center. The University faces a difficult space issue. However the 12
construction of the long awaited (the first new building on campus since 1979) Multi-purpose Academic Center will ease congestion in Coughlin Hall as the Department of Arts, English and Humanities moves out; Coughlin Hall will remain home to the Nursing program but with the move of more than 20 faculty members from the building, there will be room to expand not only faculty office space but also the Nursing Resource Center. We thus anticipate enlarging the Nursing Resource Center when we can move the Department of Arts, English and Humanities to the Multi-purpose Academic Center. STAFF SUMMARY The staff appreciates the University s efforts to resolve all outstanding resources issues. Each problematic matter has been addressed, but some of the source funding (private support versus recurring state support) may be tenuous and amounts committed limited. Low tuition schedules for the institution exacerbate funding problems. As LSU-A moves from two to four-year status, multiple programmatic resource issues will become evident and tend to accumulate. This particular proposal is an important component of the University s efforts to fulfill its new role, scope, and mission. The demand for appropriately trained personnel to serve the local community are great and local industry is very dependent on LSU-A s ability to address their ever-present employment needs. To insure the smooth evolution of this essential program, the University must remain vigilant to ensure that any and all barriers to the success of students in the program, especially the inaugural class, are eliminated. Consequently, conditional approval with stipulations for implementation and required progress reports are appropriate. STAFF RECOMMENDATION The staff recommends that the Academic and Student Affairs Committee grant conditional approval for the Bachelor of Science in Nursing (CIP Code 51.1601) at Louisiana State University at Alexandria, subject to the following stipulations: 1. Implementation of the program shall be delayed until evidence of the hiring of an additional doctorally-qualified, full-time faculty member has been provided to the Associate Commissioner for Academic Affairs. The University projects such hiring by August, 2008. 2. Beginning December 31, 2008, and annually on that date thereafter until the BSN program has achieved NLNAC accreditation, a progress report which addresses external consultant concerns shall be submitted to the Associate Commissioner for Academic Affairs. 13
AGENDA ITEM IV A APPENDIX I 14
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AGENDA ITEM IV A APPENDIX II 16
Summary of Estimated Additional Costs for Proposed Program Institution: Louisiana State University at Alexandria Date: December, 2007 Program: Bachelor of Science in Nursing Major: Nursing Year One Year Two Year Three Year Four Year Five Amount FTE Amount FTE Amount FTE Amount FTE Amount Faculty $ 79,200 1.0 $ 164,736 2.0 $ 171,325 2.0 $ 178,178 2.0 $ 185,306 Graduate Assistants Support Personnel $ 14,520 0.5 $ 15,101 0.5 $ 15,705 0.5 $ 16,333 0.5 $ 16,986 Fellowships & Scholarships Subtotal $ 93,720 1.5 $ 179,837 2.5 $ 187,030 2.5 $ 194,511 2.5 $ 202,292 Facilities Equipment $ 2,000 $ 2,000 Travel $ 2,000 $ 4,000 $ 4,000 $ 4,000 $ 4,000 Supplies $ 4,140 $ 8,479 $ 8,682 $ 8,891 $ 9,104 Subtotal $ 8,140 $ 14,479 $ 12,682 $ 12,891 $ 13,104 Grand Total $ 101,860 $ 194,316 $ 199,712 $ 207,402 $ 215,396 Amount Percent Amount Percent Amount Percent Amount Percent Amount Amount & Percentage of Total Anticipated from: State Appropriations 0% 0% 0% 0% Federal Grants/Contracts 0% 0% 0% 0% State Grants/Contracts 0% 0% 0% 0% Private Grants/Contracts $ 100,000 98% $ 150,000 77% $ 100,000 50% $ 100,000 48% $ 100,000 Other:Tuition, Fees, etc. $ 1,860 2% $ 44,316 23% $ 99,712 50% $ 107,402 52% $ 115,396 Total $ 101,860 100% $ 194,316 100% $ 199,712 100% $ 207,402 100% $ 215,396 Difference $ 0 $ (0) $ (0) Notes: Year One: One faculty calculated at $60,000 and one half-time support staff plus 32% related benefits. Includes $2,000 travel per new faculty. Supplies & Services calculated from 07/08 Supplies and Operating Services budget per faculty/staff in Nursing with an increase allowance for new p Moveable Equipment calculated at $2,000 for new staff set-up expenses for first year only. Years Two through Five: One additional nursing faculty calculated at $60,000 plus 32% related benefits. Includes $2,000 travel per new faculty. Supplies & Services calculated from 07/08 Supplies and Operating Services budget per faculty/staff in Nursing with an increase allowance for new p Moveable Equipment calculated at $2,000 for new staff set-up expenses for first year only. Faculty salaries increased 4% annually. Supplies and Services increased 2.4% annually. 12/19/2007 17