Agenda Item: 3.2.3. Prepared by: J. Hooper/V. Ayars

Board Meeting: July 2020

Report on Communication Activities With Nursing Education Programs

This agenda item is reserved to report the formal communication activities of the Nursing Consultants for Education with Texas pre-licensure nursing education programs and stakeholders. Texas Association of Deans and Directors of Professional Nursing Programs (TADDPNP) Board Staff attended the spring meeting of TADDPNP at the Omni Austin Hotel at Southpark on January 31, 2020. Kristin Benton provided a legislative update from the Board of Nursing; Jan Hooper presented current NCLEX data and information; Mark Majek provided information about plans to launch the ORBS system on April 20, providing a new portal for the Affidavits of Graduation and student records for licensing purposes. Education consultants also attended to network with program directors. Reports were also given by the other state regulating agencies. Nursing Education Newsletter A Nursing Education Newsletter was released electronically to all nursing education programs in March 2020 (See Attachment #1). A special edition newsletter was provided in April to update programs with COVID-19 information (See Attachment #2). This newsletter is prepared and submitted to programs at least twice each year and provides updates and educational information to directors and nursing faculty. Deans, Directors, and Coordinators Orientation The Education Consultants provide a New Director Orientation Workshop to new program directors, administrators, and staff of approved nursing education programs in Austin, Texas, three times each year. Twenty-seven individuals, including newly appointed program directors, administrators, and other program staff, attended the February 7, 2020, workshop in the Hobby Building. The all-day event included presentations from Kristin Benton (updates from the BON), Tony Diggs from the Enforcement Department (NCLEX eligibility questions), Mark Majek from Operations (examination application and process), and all Education Consultants (overview of the Board of Nursing and education rules). A new topic on successful leadership as a program director has been added to the regular agenda and the audience expressed this was a helpful topic. The attendee evaluations were very positive for the content presented. On June 5, 2020, due to issues surrounding the COVID-19 crisis, the Education Consultants provided a two-hour webinar New Director Orientation that provided an abbreviated version of the full day event. The webinar was attended by over 20 program representatives. Board Staff presented an abbreviated version of the regular orientation meetings that included a Board overview, review of education rules and processes, a tool box of documents and ideas to help

new program directors to assess and evaluate the status of their programs, and tips for successful leadership of the program. The next new director orientation workshop is scheduled for Fall 2020. Webinars Provided to Program Directors Regarding Nursing Education in a Pandemic On April 17, 2020, the Education Consultants presented two sessions of a webinar that provided information for nursing programs dealing with the challenges presented by COVID-19. A morning session was presented for professional nursing programs and an afternoon session for vocational nursing programs. Kristin Benton and the four consultants provided the following topics:

Temporary Waivers from the Governor COVID-19 Resources Shifting to Remote Teaching Effective Use of Virtual Simulation Curriculum and Clinical Adjustments

Consultants responded to questions following the presentations. There were over 200 attendees. COVID-19 Webpage Resources for Education Programs Throughout the pandemic the education team has pushed out information relevant to education programs frequently. In addition, information and resources have been posted on the agency COVID-19 Education webpage including videos, useful links, frequently asked questions and other helps. STAFF RECOMMENDATION: This is an informational report. No action is required.

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Nursing Education Newsletter

Spring 2020 Texas Board of Nursing Volume 8 Number 1

In This Issue • Greetings from the

Education Consultants (p. 1)

• ORBS Launching April 2020 (p. 1)

• Collaboration with Other Agencies (p. 2)

• Deans and Directors Orientation Session (p. 2)

• Future Update of the DECs (p. 3)

• Dual Credit High School Tracks (p. 4)

• Notification from NCSBN (p. 4)

• Program Certificates (p. 5)

• Truth About MEEPs (p. 5)

• Will My Program Have a Survey Visit? (p. 6)

• Online Delegation Course (p. 6)

• Poster Presentation (p. 7)

• Contact Information for the Education Team (p. 7)

Greetings from the Education Consultants Editor: Gayle P. Varnell, PhD, APRN, CPNP-PC (our FROG Expert)

Find, Reflect, Organize, & Generate news = FROG

The Texas Board of Nursing (BON) Education Consultants have prepared this newsletter for information purposes for programs. Please share with the nursing faculty in your school.

ORBS Launching April 20, 2020 Board Staff have been busy configuring the ORBS system in preparation for a launch date of April 20, 2020. The Affidavit of Graduation (AOG) portal will also be changing on April 20th but the Licensing Team is preparing a helpful how-to video to ensure the process is as seamless as possible.

The new AOG portal will include several new features that should help you have a smoother process when reviewing and submitting AOGs to the Board. The first change includes a search function which should make it easier to find specific students, especially if you only need to submit one or two AOGs.

Other features involve student graduation dates. Student information will now stay on the AOG list indefinitely which means students (and you!) no longer need to contact Rosemary Riojas to update a student’s graduation date so you can submit an AOG online. You will also have the ability to remove student information from your AOG list. This will be useful if a student is no longer in the program or if they are not your student at all.

You will have the ability to set your own password and also to reset your password without needing to contact Board Staff. This will give you more control over your AOG portal account. The AOG portal will also remain a web based process so you can still review and submit AOGs from any computer and location.

You will be receiving your new account information closer to the ORBS launch date.

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Upcoming Events

2020 Quarterly Board Meetings

January 23-24, 2020

April 23-24, 2020

July 23-24, 2020

October 22-23, 2020

All Board Meetings are held at the William P. Hobby Building in Austin, Texas.

Board Meeting agendas and minutes are available on the Board of Nursing website under the News heading.

Contact Information

Nursing Education PH: (512) 305-6816 Education Guidelines

Education FAQs

Texas Board of Nursing 333 Guadalupe Suite 3-460 Austin, Texas 78701

www.bon.texas.gov

Collaboration with Other Regulatory Agencies The BON Education Team meets twice a year with representatives from other state regulatory agencies to collaborate in monitoring nursing education in the state. The last meeting was held on November 18, 2019, at the BON.

From left to right are:

Dr. Kevin R. Johnson, Sr., TEA; Dr. Sheri H. Ranis, THECB; Dr. Virginia Ayars, BON; Dr. Paul D. Shuler, THECB;

Ann Amaefule, BON; Virginia Bosman, TWC; Dr. Jan Hooper, BON; Duane Hiller, THECB; and

Dr. Andrew Lofters, THECB.

Not featured in the photo is Dr. Kristin Benton, BON, meeting chair.

Deans and Directors Orientation Session The first Deans and Directors Orientation Session of the new year was held in Austin on Friday, February 7, 2020. The Education Consultants look forward to these sessions and the opportunity to get to know the new directors. The next orientation session will be June 5, 2020. Many directors choose to bring an administrative representative with them to allow administrators to become familiar with Board rules. New information is provided to directors during this all day session. Several directors have attended more than once and comments on the evaluations indicate that they have found this beneficial.

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Future Update of the DECs 2020 is the Year of the DECs! Board Staff have been collecting updated documents including research, standards, and information about current nursing practice and nursing education to ensure that competencies are relevant. The present-day DECs began when the 1988 Texas Legislature mandated establishment of a set of minimum performance expectations for nursing graduates. Three versions have been published:

• 1993 - Essential Competencies of Texas Graduates of Education Programs

• 2002 - Differentiated Entry Level Competencies (DELCs) • 2010 - Differentiated Essential Competencies of Graduates of

Texas Nursing Programs (DECs) The 2020 edition will be an update to assure inclusion of current practices, research, and advances in nursing. It will not involve a major revision because the DECs were carefully written to be a lasting document. The competencies are client-focused, rather than institution-based, and do not offer a prescriptive list of tasks. The competencies provide the essential role responsibilities, knowledge, clinical behaviors, and judgments in broad terms to allow nursing programs to develop and create curricula appropriate for their communities, level of education, and identified program outcomes.

Board Staff envision the development of a conceptual model and guideline to assist programs in using the DECs in their curriculum. Stay tuned!

Member of the Profession

Provider of Patient-Centered Care

Patient Safety Advocate Member of the Health Care Team

Nursing

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Reminder! Dual Credit High School Tracks

If you have a dual credit high school track or are considering establishing one, please refer to Education Guideline 3.7.5.a. to ensure compliance with Board rules. The Texas Education Agency has purview over college-level courses in the high schools. A dual credit high school track provides an opportunity for high school students to fulfill requirements in an approved nursing education program.

Notification from NCSBN: The Passing Standard for the NCLEX-PN Examination will be raised April 1, 2020

The passing standard for the NCLEX examinations is reconsidered every three years to ensure minimal competency of new nursing graduates. NCSBN uses multiple sources of information in the decision:

• The recommendation from a criterion-referenced standard-setting workshop where a panel of experts seriously deliberate about the appropriate pass rate;

• A review of the history of the NCLEX-PN passing standard and candidate performance; • The educational readiness of high school graduates who expressed an interest in nursing; and • The results from the most current practice analysis and national surveys of nursing professionals,

including nursing educators, directors of nursing in acute care settings, and administrators of long-term care facilities.

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Did you know? . . . 2020 is also the Year of the Certificate! Certificates of Approval

The BON mails Certificates of Approval to all approved nursing education programs in even years (2018, 2020, 2022) following the April Board meetings. NCLEX examination pass rates for RN programs are reported to the Board at the January Board meeting and NCLEX examination pass rates for VN programs are reported to the Board at the April Board meeting. By statute, the Board’s approval process occurs every two years. New certificates will be prepared and printed in late April – please expect them to arrive in May! They are ready for framing and it is recommended that you display them in your school. We thank Jackie Ballesteros for getting about 225 certificates mailed to programs!

The Truth about MEEPs

M

With a number of different educational models arising in nursing education, it is important to ask the question, “What is a MEEP?” The same definition appears in both Rule 214 and Rule 215, as follows: An exit option which is part of a professional nursing education program designed for students to complete course work and apply to take the NCLEX-PN® examination after they have successfully met all requirements needed for the examination. In actuality, a MEEP is part of an Associate Degree Nursing (ADN) Education Program that allows an option for the student to meet all requirements for the NCLEX-PN® examination – and to take the exam. The student may then continue with the ADN education making them eligible to take the NCLEX-RN® examination (or not). A MEEP program usually includes: • Additional coursework to incorporate knowledge about the LVN role; • Additional clinical learning experiences where the student practices in

the LVN role; • A separate admission process when the ADN student is evaluated as a

potential VN candidate before taking the VN-level preparation; and • Recognition by the BON as an approved VN program (based upon the

MEEP curriculum: approximately one year of ADN courses and additional VN focused courses/clinical).

The MEEP model is not meant to include the dual credit high school track or entry coursework for VN program admission. An approved nursing program that has an approved agreement with a public school district may have one of various tracks that include dual credit courses that apply to the high school diploma and that meet requirements for an approved VN program. These models range from a few courses that count toward both high school and nursing program requirements, to a complete VN option for high school students.

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Will My Program Have a Survey Visit this Year??? The Education Consultants make about 20 to 25 survey visits to nursing programs each year. If the nursing program is NOT accredited by a national nursing organization, the BON visits every six years for a regular visit. Other visits are made to new programs, programs on warning, or programs with other compliance issues. Whatever the reason, the Education Consultants appreciate seeing the director and faculty in their working environment. The Education Consultants, in collaboration with the program, find a date when the administration, program director, nursing faculty,

and nursing students are available for meetings. If possible, the consultants will visit a nursing class. They will review program documents, student and faculty files, student papers, the total program evaluation plan, and faculty minutes. The visit concludes with an exit interview when the consultants share their findings and conclusions. The Education Consultants plan for an efficient and effective visit that will be beneficial to the program and provide valuable information for the consultant. A survey visit report will be written within a few weeks and shared with the program director for any feedback. A Board report is prepared that includes the survey visit report and provided to the Board members as an agenda item for the next Board meeting. The goal is that the survey visit will offer a time to share information between the program and the consultant to offer insights for all stakeholders.

Texas Board of Nursing New Online Delegation Course: The Texas Board of Nursing has developed a new online educational offering to address the topic of Nursing Delegation. The purpose of this educational offering is to provide all licensed nurses with information on the current standards of nursing practice, rules, and regulations applicable to nursing delegation in Texas. Participation in this course will contribute to the nurse's ability to know and conform with the Texas Nursing Practice Act and Board's rules and regulations, which will promote and protect the welfare of the public of Texas. This course can be found on the Board’s website in the CNE Course Catalog at: https://www.bon.texas.gov/catalog/

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Poster Presentation Dr. Janice Hooper, PhD, RN, FRE, CNE, FAAN, ANEF, and Ashley Valentino, MSN, RN, Associate Professor of Nursing, Austin Community College, presented a poster on creative strategies and tools to help students prepare for the Next Generation (NGN) NCLEX at the Nurse Tim Next Gen Workshop. A copy of their poster presentation is provided below. Thank you, Jan and Ashley!

Contact Information for the Education Team:

Kristin K. Benton, DNP, RN, Director of Nursing Kristin.Benton@bon.texas.gov Virginia D. Ayars, EdD, MS, RN, CNE Virginia.Ayars@bon.texas.gov Janice I. Hooper, PhD, RN, FRE, CNE, FAAN, ANEF Janice.Hooper@bon.texas.gov Beverly Skloss, MSN, RN Beverly.Skloss@bon.texas.gov Gayle P. Varnell, PhD, APRN, CPNP-PC Gayle.Varnell@bon.texas.gov Bruce Holter, Information Specialist Bruce.Holter@bon.texas.gov Jackie Ballesteros, Administrative Assistant Jackie.Ballesteros@bon.texas.gov

EDUCATION NEWSLETTER A Special Edition from the Texas Board of Nursing

March 24, 2020 Edition 1, Volume 1

Message to Program Directors:

The Education Consultants have been receiving many questions from nursing programs about how to manage clinical requirements with clinical settings closing their doors to students because of the spread of COVID-19. We appreciate your phone calls and emails, and have taken the opportunity to speak directly to you in the midst of confusion.

The underlying questions are (1) whether programs can use more simulation in place of hands-on patient care and (2) whether moving to an online format would require Board approval. The short answers are Yes and No:

(1) Yes, this is an emergency and calls for emergency measures. It also points out how important simulation can be as a fill-in until the crisis is over. (This also provides evidence if you are asking for more resources or faculty training to improve your simulation experiences. See Education Guideline 3.8.6.a. Simulation in Pre-licensure Nursing Education)

(2) No, since it is a necessity at this time. Normally, a change in the format of delivery would require Board Staff approval to ensure all resources, faculty training, and technical support services are available. (Other evidences that your school may need to ensure sufficient budget is secured for quality online education.)

Protect Yourselves

It is important for the director and faculty to stay abreast of the latest information about COVID-19 and to follow all measures to protect yourselves and your students from COVID-19. Tips commonly stressed for protection from the virus are: Wash your hands frequently with soap and water. Practice social distancing as recommended by CDC, DSHS and local

public health authorities. If you feel sick, definitely stay home. Pay attention to a trusted news source. Have a supply of food and prescription medications on hand, but only buy

what you need.

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Be Knowledgeable

Valuable sources of information:

World Health Organization Centers for Disease Control

and Prevention Texas Department of State

Health Services Johns Hopkins University

Coronavirus Resource Center Texas Higher Education

Coordinating Board Texas Workforce Commission

The Centers for Disease Control and Prevention also offers guidance to colleges and universities here:

https://www.cdc.gov/coronavirus/2019-ncov/community/colleges-universities/index.html

Effects on the Licensing Examination

NCLEX examinations will resume on a limited capacity on March 25, 2020 at 60 Pearson VUE centers with additional sites open on March 28, 2020.

Best practice is to keep checking the NCLEX COVID-19 FAQ Page (https://www.ncsbn.org/14428.htm) for the most recent updates/changes. 

GOVERNOR ABBOTT WAIVES SEVERAL BOARD OF NURSING RELATIONS AFFECTING NURSING PROGRAMS Temporary waivers approved by Governor Abbott on March 21, 2020 include:

1. Rule 217.3(a)(2) and (4) related to temporary authorization to practice/temporary permits for graduate professional nurses and graduate vocational nurses to practice beyond the current 75 days up to 6 months. This will allow more time for the graduate to take the NCLEX® examination since that possibility is now delayed. This will allow employers to employ graduates who have GN or GVN temporary permits to meet health care demands during the emergency. These individuals must still be supervised by a licensed nurse while they are in their GN or GVN roles. Through this measure, the public will have greater access to care at a time when health care demands are stretched.

2. Rules 214.10(e)(3) and Rule 215.10(e)(3) related to Clinical Learning Experiences for Vocational Nursing and Professional Nursing Education Programs allows students in their final year of a nursing program to meet required clinical objectives by exceeding the 50% limit on simulated clinical learning experiences. This temporary waiver will permit senior level nursing students who currently are unable to carry out hands-on patient care in health care settings to complete their education by meeting clinical requirements through high-fidelity simulated experiences, thus allowing an on-time graduation of nursing students ready to enter the work force.

EDUCATION NEWSLETTER A Special Edition from the Texas Board of Nursing

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EDUCATION NEWSLETTER A Special Edition from the Texas Board of Nursing

Unplanned Learning Objectives

The current situation also lends itself to being a teachable moment for students to learn first-hand about communicable diseases, public health, population and global health. Use this time for an emphasis on infection control. Students can gather information from print, agencies, and the media and analyze the accuracy and helpfulness for the public.

Students may compare this situation to similar disturbances to normal life and health from the past to see what we have learned and how we are using that knowledge in dealing with this unknown virus.

Another topic for exploration is the importance of community and working together for the good of the whole.

It is not a good time but a learning time: let’s make the best of it.

An Example

Here is an example of measures begun in a nursing program jumping in front of the crisis and acting proactively to keep moving ahead:

Faculty are training during spring break to offer online courses.

Online group meetings for lecture, pod casts, power point voice-over will be used.

Labs will be taught using videos with student demonstrations via videos of themselves.

Moving to simulation for clinical practice will save on resources (masks, gowns, equipment).

A screening protocol for students who have traveled abroad will be activated.

The program will use more unfolding case studies to enhance decision-making.

(Lamar College – Port Arthur)

YOUR STORIES Please document your stories and share with us for a future newsletter.

BOARD STAFF AND WORK-AT-HOME Most Board Staff have moved their offices to their homes with total access to resources to continue regular work. The Education Consultants are available to take your calls and emails, and will respond quickly. We greatly respect the commitment of Program Directors, faculty, and staff of each program for adapting to change and continuing with the important job of educating nurses. Thank you.