ByMichelle Flores

Connie HeckmanNoah Sarr

Eileen Smith

The American Association of Colleges of Nursing

(AACN) has Nine Essential that every Nursing school in the nation must fulfill to be eligible to teach a Baccalaureate Education for Professional Nursing Practice

National Requirements

Liberal Education for Baccalaureate Generalist Nursing

Practice. A solid base in liberal education provides the cornerstone for

the practice and education of nurses. The sciences include:

· physical sciences (e.g., physics and chemistry), · life sciences (e.g., biology and genetics), · mathematical sciences, and · social sciences (e.g., psychology and sociology).

The arts include: · fine arts (e.g., painting and sculpture), · performing arts (e.g., dance and music), and · humanities (e.g., literature and theology).

Essential I

Basic Organizational and Systems Leadership for

Quality Care and Patient Safety

The program must teach and prepare student in the following twelve areas.

Essential II

The baccalaureate program prepares the graduate to: Apply leadership concepts, skills, and decision making in the provision of

high quality nursing care, healthcare team coordination, and the oversight and accountability for care delivery in a variety of settings.

Demonstrate leadership and communication skills to effectively implement patient safety and quality improvement initiatives within the context of the interprofessional team.

Demonstrate an awareness of complex organizational systems. Demonstrate a basic understanding of organizational structure, mission,

vision, philosophy, and values. Participate in quality and patient safety initiatives, recognizing that these

are complex system issues, which involve individuals, families, groups, communities, populations, and other members of the healthcare team.

Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions and describe the process of changing current practice.

Essential II Cont’d

Promote factors that create a culture of safety and caring. Promote achievement of safe and quality outcomes of care for

diverse populations. Apply quality improvement processes to effectively implement

patient safety initiatives and monitor performance measures, including nursesensitive indicators in the microsystem of care.

Use improvement methods, based on data from the outcomes of care processes, to design and test changes to continuously improve the quality and safety of health care.

Employ principles of quality improvement, healthcare policy, and costeffectiveness to assist in the development and initiation of effective plans for the microsystem and/or systemwide practice improvements that will improve the quality of healthcare delivery.

Participate in the development and implementation of imaginative and creative strategies to enable systems to change.

Essential II Cont’d

Scholarship for EvidenceBased Practice The baccalaureate program prepares the graduate to:

1. Explain the interrelationships among theory, practice, and research. 2. Demonstrate an understanding of the basic elements of the research process and

models for applying evidence to clinical practice. 3. Advocate for the protection of human subjects in the conduct of research. 4. Evaluate the credibility of sources of information, including but not limited to

databases and Internet resources. 5. Participate in the process of retrieval, appraisal, and synthesis of evidence in

collaboration with other members of the healthcare team to improve patient outcomes.

6. Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care.

7. Collaborate in the collection, documentation, and dissemination of evidence. 8. Acquire an understanding of the process for how nursing and related healthcare

quality and safety measures are developed, validated, and endorsed. 9. Describe mechanisms to resolve identified practice discrepancies between

identified standards and practice that may adversely impact patient outcomes.

Essential III

Information Management and Application of Patient Care Technology The baccalaureate program prepares the graduate to:

Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice.

Use telecommunication technologies to assist in effective communication in a variety of healthcare settings.

Apply safeguards and decision making support tools embedded in patient care technologies and information systems to support a safe practice environment for both patients and healthcare workers.

Understand the use of CIS systems to document interventions related to achieving nurse sensitive outcomes.

Use standardized terminology in a care environment that reflects nursing’s unique contribution to patient outcomes.

Essential IV

Evaluate data from all relevant sources, including technology, to inform

the delivery of care. Recognize the role of information technology in improving patient care

outcomes and creating a safe care environment. Uphold ethical standards related to data security, regulatory requirements,

confidentiality, and clients’ right to privacy. Apply patientcare technologies as appropriate to address the needs of a

diverse patient population. Advocate for the use of new patient care technologies for safe, quality care. Recognize that redesign of workflow and care processes should precede

implementation of care technology to facilitate nursing practice. Participate in evaluation of information systems in practice settings

through policy and procedure development.

Essential IV Cont’d

Healthcare Policy, Finance, and Regulatory Environments The baccalaureate program prepares the graduate to:

Demonstrate basic knowledge of healthcare policy, finance, and regulatory environments, including local, state, national, and global healthcare trends.

Describe how health care is organized and financed, including the implications of business principles, such as patient and system cost factors.

Compare the benefits and limitations of the major forms of reimbursement on the delivery of health care services.

Examine legislative and regulatory processes relevant to the provision of health care.

Describe state and national statutes, rules, and regulations that authorize and define professional nursing practice.

Explore the impact of sociocultural, economic, legal, and political factors influencing healthcare delivery and practice.

Essential V

Examine the roles and responsibilities of the regulatory

agencies and their effect on patient care quality, workplace safety, and the scope of nursing and other health professionals’ practice.

Discuss the implications of healthcare policy on issues of access, equity, affordability, and social justice in healthcare delivery.

Use an ethical framework to evaluate the impact of social policies on health care, especially for vulnerable populations.

Articulate, through a nursing perspective, issues concerning healthcare delivery to decision makers within healthcare organizations and other policy arenas.

Participate as a nursing professional in political processes and grassroots legislative efforts to influence healthcare policy.

Advocate for consumers and the nursing profession.

Essential V Cont’d

Interprofessional Communication and Collaboration for Improving

Patient Health Outcomes The baccalaureate program prepares the graduate to:

Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e., scope of discipline, education and licensure requirements).

Use inter and intraprofessional communication and collaborative skills to deliver evidencebased, patient centered care.

Incorporate effective communication techniques, including negotiation and conflict resolution to produce positive professional working relationships.

Contribute the unique nursing perspective to interprofessional teams to optimize patient outcomes.

Demonstrate appropriate teambuilding and collaborative strategies when working with interprofessional teams.

Advocate for high quality and safe patient care as a member of the interprofessional team.

Essential VI

Clinical Prevention and Population Health The baccalaureate program prepares the graduate to:

Assess protective and predictive factors, including genetics, which influence the health of individuals, families, groups, communities, and populations.

Conduct a health history, including environmental exposure and a family history that recognizes genetic risks, to identify current and future health problems.

Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations.

Use behavioral change techniques to promote health and manage illness.

Use evidencebased practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and followup throughout the lifespan.

Use information and communication technologies in preventive care.

Essential VII

Collaborate with other healthcare professionals and patients to provide

spiritually and culturally appropriate health promotion and disease and injury prevention interventions.

Assess the health, healthcare, and emergency preparedness needs of a defined population.

Use clinical judgment and decisionmaking skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations.

Collaborate with others to develop an intervention plan that takes into account determinants of health, available resources, and the range of activities that contribute to health and the prevention of illness, injury, disability, and premature death.

Participate in clinical prevention and populationfocused interventions with attention to effectiveness, efficiency, costeffectiveness, and equity.

Advocate for social justice, including a commitment to the health of vulnerable populations and the elimination of health disparities.

Use evaluation results to influence the delivery of care, deployment of resources, and to provide input into the development of policies to promote health and prevent disease.

Essential VII Cont’d

Professionalism and Professional Values The baccalaureate program prepares the graduate to:

Demonstrate the professional standards of moral, ethical, and legal conduct.

Assume accountability for personal and professional behaviors.

Promote the image of nursing by modeling the values and articulating the knowledge, skills, and attitudes of the nursing profession.

Demonstrate professionalism, including attention to appearance, demeanor, respect for self and others, and attention to professional boundaries with patients and families as well as among caregivers.

Demonstrate an appreciation of the history of and contemporary issues in nursing and their impact on current nursing practice.

Essential VIII

Communicate to the healthcare team one’s personal bias on

difficult healthcare decisions that impact one’s ability to provide care.

Recognize the impact of attitudes, values, and expectations on the care of the very young, frail older adults, and other vulnerable populations.

Protect patient privacy and confidentiality of patient records and other privileged communications.

Access interprofessional and intraprofessional resources to resolve ethical and other practice dilemmas.

Act to prevent unsafe, illegal, or unethical care practices. Articulate the value of pursuing practice excellence, lifelong

learning, and professional engagement to foster professional growth and development.

Recognize the relationship between personal health, self renewal, and the ability to deliver sustained quality care.

Essential VIII Cont’d

Baccalaureate Generalist Nursing Practice The baccalaureate program prepares the graduate to:

Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches.

Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology.

Implement holistic, patientcentered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings.

Communicate effectively with all members of the healthcare team, including the patient and the patient’s support network.

Deliver compassionate, patientcentered, evidencebased care that respects patient and family preferences.

Essential IX

Implement patient and family care around resolution of endoflife

and palliative care issues, such as symptom management, support of rituals, and respect for patient and family preferences.

Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care.

Implement evidencebased nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan.

Monitor client outcomes to evaluate the effectiveness of psychobiological interventions.

Facilitate patientcentered transitions of care, including discharge planning and ensuring the caregiver’s knowledge of care requirements to promote safe care.

Provide nursing care based on evidence that contributes to safe and high quality patient outcomes within healthcare microsystems.

Create a safe care environment that results in high quality patient outcomes.

Essential IX Cont’d

Revise the plan of care based on an ongoing evaluation of patient

outcomes. Demonstrate clinical judgment and accountability for patient

outcomes when delegating to and supervising other members of the healthcare team.

Manage care to maximize health, independence, and quality of life for a group of individuals that approximates a beginning practitioner’s workload

Demonstrate the application of psychomotor skills for the efficient, safe, and compassionate delivery of patient care.

Develop a beginning understanding of complementary and alternative modalities and their role in health care.

Develop an awareness of patients as well as healthcare professionals’ spiritual beliefs and values and how those beliefs and values impact health care.

Manage the interaction of multiple functional problems affecting patients across the lifespan, including common geriatric syndromes.

Essential IX Cont’d

Understand one’s role and participation in

emergency preparedness and disaster response with an awareness of environmental factors and the risks they pose to self and patients.

Engage in caring and healing techniques that promote a therapeutic nursepatient relationship.

Demonstrate tolerance for the ambiguity and unpredictability of the world and its effect on the healthcare system as related to nursing practice.

Essential IX Cont’d

Expectations for Clinical Experiences within the

Baccalaureate Program

In addition clinical experiences assist the graduate to:

develop proficiency in performing psychomotor skills

apply professional communication strategies to client and interprofessional

interactions; and

acquire a professional identity.

Essential IX Cont’d

Clinical immersion experience includes Being a provider of care

-evaluate client changes and progress over time-develop a beginning proficiency and efficiency in delivering

safe care A designer/manager/coordinator of care manage care transitions

be an active participant on the interprofessional teamidentify system issuesdevelop working skills in delegation, prioritization, and

oversight of care Being a member of a profession

evaluate one’s own practice assume responsibility for supporting the profession

Essential IX Cont’d

The Board of Registered Nursing (BRN) has the

following requirements for Institutions seeking Approval of New Prelicensure Registered Nursing Program.

The institution must have the authority to grant an associate of arts degree or baccalaureate or higher degree to individuals who graduate from the nursing program prior to submission of an application.

Submission for approval must follow a Nine Step process

California Requirements

Submit a Letter of Intent:

Submit a letter of intent to the Board of Registered Nursing (BRN) at least one year in advance of the anticipated date for admission of students. The letter must specify the name of the institution seeking approval; contact person; type of nursing program, e.g., associate degree, baccalaureate degree, entry-level master’s, etc., and its location; and proposed start date. The letter is to be addressed to:

Executive OfficerBoard of Registered Nursing P.O. Box 944210 Sacramento, CA 94244-2100

The Board will acknowledge receipt of the letter of intent.

Step 1

Submit Feasibility Study

Submit a feasibility study to the BRN documenting the need for the program and the program applicant’s ability to develop, implement, and sustain a viable prelicensure registered nursing program. The feasibility study shall include the following:

Step 2

Description of the institution and the institution’s experience

providing nursing or other health- related educational programs. Geographic area (community) served by the institution and a

description of the community and its population Description of the type of program being proposed (e.g., associate,

baccalaureate, entry-level master’s, etc.), the intended start date, projected size of the first class and enrollment projection for the first five years, and method for determining the projected enrollment.

Information on the applicant pool and sustainability of enrollment for the proposed new prelicensure registered nursing program. Include data on existing nursing programs preparing students for licensure (vocational, associate, baccalaureate, or entry level master’s) within a 50-mile radius. Include a statement on plans for promoting the proposed program.

Step 2 Cont’d

Description of proposed provisions for required subject matter and

support areas, including faculty and resources. The proposed program must be at least two academic years, not less than 58 semester or 87 quarter units, and must include all course areas specified in CCR 1426. Consult CCR section 1426, Required Curriculum, for required subject matter. Support areas include such items as the library, skills learning lab, computer labs, simulation labs, and tutorial and counseling services.

Budget projection that demonstrates initial and sustainable budgetary provisions for a full enrollment of the initial cohort. The projected budget demonstrates building of reserves to sustain the proposed program.

Evidence of availability of clinical placements for students of the proposed program. Include a list of the clinical facilities that may be utilized for learning experiences and a description of any plans for future addition or expansion of health facilities. Provide a completed “Facility Verification Form” (EDP-I-01 Rev 3/10) for each health care facility that has agreed to provide clinical placement for students of the proposed program. When available, verification shall include the accommodations specifying shift and days.

Step 2 Cont’d

Review of Feasibility Study

It is the responsibility of the program applicant to have staff or a consultant(s) who possess the requisite knowledge and expertise to complete a feasibility study that conforms to the requirements specified in the Instructions

Step 3

Education/Licensing Committee Recommendation on the Feasibility

Study Will be sumbitted to the the Board’s Education/Licensing Committee (ELC)

and the following will be considered1) Evidence of applicant’s ability to initiate and maintain a prelicensure registered

nursing program.

2) Evidence of initial and sustainable budgetary provisions for the proposed program.

3) Institution of higher authority to grant an associate of arts, baccalaureate, or higher degree.

1) For affiliated institutions, the agreement with an institution of higher education within 50 miles to grant an associate of arts degree or baccalaureate or higher degree to students completing the nursing program.

2) Evidence of availability of clinical placements for students of the proposed program.

1) Plans for administrative and faculty recruitment to staff the proposed program.

Step 4

Board Action on the Feasibility Study

The Board considers the criteria specified in Step 4 in rendering its decision.

The following action will be taken:

Step 5

1) Within ten (10) days after the Board decision on the feasibility study, the

Board will notify the program applicant in writing of its decision. 2) If the feasibility study is accepted, the program applicant may proceed

to Step 6. 3) If the feasibility study is not accepted, the Board notice will include the

basis for its decision. 4) If action on the feasibility study is deferred, the notice shall specify what

additional information and/or documents are needed from the program applicant in order for the feasibility study to be deemed complete and a due date for submission of the materials. The revised feasibility study will be considered at regularly scheduled ELC and Board meetings after the due date for submission of materials. If the revised feasibility study is not accepted, the Board will notify the applicant in writing within ten (10) days; the notice will include the basis for the Board’s decision.

5) An applicant whose initial or revised feasibility study is not accepted, and who still wishes to seek approval of a prelicensure registered nursing program must restart with Step 1. The Letter of Intent must include a statement summarizing the Board’s reason(s) for not accepting the prior feasibility study and subsequent corrective action the applicant has taken.

Step 5 Cont’d

Appointment of Program Director

Upon acceptance of the feasibility study, the program applicant shall appoint a director who meets the requirements of CCR section 1425(a).

Step 6

Self-Study Report and Site Visit

Upon Board acceptance of the feasibility study, a BRN Nursing Education Consultant (NEC) will be assigned as the BRN liaison for the proposed program. The program director will have responsibility for preparing the self-study for the proposed program and coordinating the site-visit. At least six (6) months prior to the projected date of student enrollment the program applicant must submit to the NEC a self-study that describes how the proposed program plans to comply with all BRN nursing program-related rules and regulations.

Step 7

ELC and Board Actions related to Approval of the

Proposed Program The NEC's written report is submitted to the Board’s ELC

for discussion and action at a regularly scheduled Committee meeting. The Committee may recommend that the Board grant or deny approval, or may defer action on the initial program approval to provide the program applicant a specified time period to resolve any problems and to resubmitted to the ELC. A representative of the proposed program must be present at the ELC meeting(s) to respond to any questions from the Committee.

After this the following may happen

Step 8

The action the Board may take, includes the

following:

1) Grant initial approval;2) Deny approval;3) Defer action on the approval to permit the program applicant a specified time period to resolve area(s) of non-compliance. After resolution of the area(s) of non-compliance, the proposed program must be submitted for Board action at another regularly scheduled meeting.

Step 8 Cont’d

Certificate of Approval

A certificate of approval will be issued by the BRN once the Board grants initial approval.

Step 9

Instructions for institutions seeking approval of new

prelicensure registered nursing program. (2010). Retrieved 10/25/2015, from http://www.rn.ca.gov/pdfs/regulations/edp-i-01.pdf

The essentials of baccalaureate education For nursing practice. (2008). Retrieved 10/25/2015, from

http://www.aacn.nche.edu/education-resources/BaccEssentials08.pdf

References