Program Review for Nursing
Program Review Framework & Criteria
I. Connection: From interest to application (Qualitative, program head and dean)
1) Please provide a description of any changes to the program since the last cycle and the appropriate updates to the catalog (general education changes, program requirement changes, ancillary program costs for students, hours/credits of credentials, etc.).
The associate degree nursing program implemented the common statewide nursing curriculum beginning in fall 2018. The new curriculum transitioned NUR classes to NSG classes and went from a system based model to a conceptual model. The program is now five semesters in length which includes one pre-requisite semester and four clinical nursing semesters. The degree is 68 total credits (39 NSG credits and 29 other program requirements). From the period of fall 2018 through fall 2019 the associate degree program faculty taught two different nursing curriculums, as the old curriculum was phased out,. The last cohort accepted in spring 2018 (old curriculum) graduated in fall 2019, and the first cohort of new curriculum graduates occurred in spring 2020.
The program has participated in a NCLEX Site visit in May 2021 due to low first time NCLEX RN pass rates for the 2019 and 2020 year. Due to regulations from the Virginia Board of Nursing the program is approved with terms and conditions as a result of two years of first time NCLEX-RN pass rates falling below the required 80%.
The program participated in the ten year continuing accreditation visit in February of 2021. The visit was conducted virtually due to the continued pandemic. The accreditation process covers 6 standards which includes a total of 49 criterion. The site visit team concluded in their review process that we are compliant in Standards 1-5 and made no recommendations in those standards which included 45 of the 49 criterion. The program was non-compliant in Standard 6 (6.2) due to lack of evidence of meeting the 80% NCLEX requirement and (6.3) lack of evidence in the use of assessment data for program decision making. Areas of development included 6.1, 6.2 and 6.3. A follow up focused report will be due in March 2023, which ACEN reviewing the draft report in December 2022.
ACEN granted continuing accreditation with conditions for two years for the associate degree nursing program.
2) How do students find out about the program? Please provide examples of advising activities, marketing materials, or other outreach and engagement events designed to recruit students to the program.
The program continues to highlight the program in the college catalog. We also use the associate degree nursing program webpage: www.patrickhenry.edu/healthcareers (select Nursing -ADN)
The nursing department has a dedicated nursing retention specialist and she conducts nursing program information sessions that are required by all nursing applicants. The information sessions are advertised on the weekly calendars that are emailed out to all employees and students from the public relations department. They are also advertised on the TV screens throughout the campus buildings.
The nursing department now employs a full-time G3 Healthcare Advisor. Mrs. Lester is the main contact for pre-nursing students. She utilizes the departmental program specific advising sheet as a tool to direct students through the process of preparing to apply. These forms are also updated each semester and can be found on the ADN webpage.
The department also has brochures for the nursing program, they are currently being updated to reflect the appropriate messaging related to the accrediting and approval bodies requirements.
The program coordinates with the high school career coaches and counselors and offers information sessions on site at the area high schools to provide a direct connection to interested high school students. We also attend and participate in open advising sessions coordinated by DE and the campus admissions department.
Pre-pandemic the program participated in the high school field trips and provided mini-sessions to students who were considering applying to or planning to attend P&HCC. We continue to provide direct advising support to assist in answering questions or advising and registering students in high school sponsored events.
Over the last two years we have been advertising in the community on billboards, highlighting the Sovah and P&HCC Nursing Simulation Center that we have established as a result grant funding from the Harvest Foundation.
II. Entry: From application to pathway entry (Qualitative, program head and dean)
1) Please provide a description of your program credentials and how they stack into one another.
The associate degree nursing program is a total of 68 credits. The degree is not a stackable credential as it is a standalone associate of applied science degree. However, licensed practical nurses are eligible to complete an advanced placement option. The LPN who wishes to pursue the advanced placement option must apply when traditional students apply to the program. All program applicants compete for a seat in the program. The advanced placement option is on a space available basis. Advanced placed students may complete four instead of five nursing semesters and are awarded 12 NSG credits for their current unencumbered practical nursing license, if they are successful in the NSG 115 Transition Course.
Graduates of the program are eligible to apply for licensure as a registered nurse through the state licensing board.
Questions for consideration:
1.a. What is the employability (or transferability) of each credential?
The associate degree is not considered a transfer degree, however there a many opportunities for students to pursue a BSN through RN to BSN degree tracks at the university level. A few of the options that our students pursue post graduation at P &HCC include:
- ODU
- Radford University
- Western Governors
- VCU
- UVA
- JMU
This is by no means an exhaustive list but rather a few examples of opportunities. Most of the RN to BSN tracks are online or in a hybrid format as they are designed for the working RN who is in possession of an ADN degree and a current license to practice as a RN.
1.b. Do all credits from a sub-credential transfer into the parent credential?
The program has many students who are program placed in the Practical Nursing CSC or the Pre-BSN degree pathway, as well as others such as General Education. Not all credits in these pathways are intended to transfer into the parent credential since the credential is not designed to be stackable.
It may be worth mentioning that the Pre-Nursing CSC includes the Nurse Aide credential, nurse aide is not stackable into nursing it does not translate into a NSG credit in the nursing program because the Virginia Board of Nursing recognizes these as independent of one another.
1.c. What is the timeframe of completion for all credentials within the program (i.e. is the program setup to award sub-credentials prior to the parent credential)?
The associate degree program is five semesters in length. Once a student is accepted into the associate degree nursing program officially, they have four clinical semesters of nursing. The program currently accepts two cohorts per year, one each fall and one each spring.
Students are not program placed into the associate degree nursing pathway until they have been accepted through the competitive application process and ready to begin the clinical semesters of nursing.
2) Program enrollment, if applicable, disaggregated by specialization (Quantitative, IE)
The program previously accepted up to 30 students each fall and spring semester. Effective fall 2020 the number of students accepted has been reduced to 20 each fall and spring. There are several reasons for this change. There is limited clinical access, loss of adjunct faculty who provide necessary clinical support, we also reduced numbers during the pandemic due to social distancing requirements. Presently, additional clinical/lab adjuncts would be needed to increase enrollment, and there would have to be access to all clinical sites that the program had access to prior to the pandemic.
Currently, there are 63 associate degree nursing students actively taking classes this fall 2021 semester. The spring semester will include 20 new students who will begin the first semester of the associate degree nursing program.
Of the 63 current students, 6 are transition students and 57 are traditional students. There are 15 first year students (5 have withdrawn since August 2021), there are 12 second semester ADN students, there are 15 third semester students and 21 seniors began the fall semester of 2021.
a. Annual program FTE and HC over the last review cycle (To include SCHEV program ratios and SCHEV class ratios)
| Nursing (AAS) | 18/19 | 19/20 | 20/21 | 21/22 |
| Headcount | 120 | 114 | 97 | 91 |
| FTE | 82 | 72 | 59 | 51.53 |
III. Progress: Pathway advancement (Quantitative, IE)
1) Student learning outcomes data
The ADN program tracks the common program outcomes as directed by the common curriculum.
Program
Outcomes and EPSLO for the Associate Degree Nursing Program
(6.1)End of Program Student Learning Outcomes (EPSLO):Plan
was revised with spring 2021 cohort due to feedback from ACEN to include more
meaningful assessment data. The objectives align with the state common
curriculum, the measures continue to be monitored to ensure they are providing
the best evidence of program success.
1. Provide patient centered care promoting
therapeutic relationships, caring behaviors, and self-determination across the
lifespan for diverse populations.
·
Plan revised to include more meaningful
assessment data and 100% of graduates met for spring 2021
·
Measures of success:
o
100% of graduating students will score at the
satisfactory level of clinical proficiency by the end of NSG 270
o
The cohort mean score for the QSEN category
patient centered care on the Kaplan Diagnostic exam will be at minimum 65%
2. Practice safe nursing care that minimizes
risk of harm across systems and client populations.
·
Plan includes 4 measures- 100% of Spring 2021 graduates
met ¾ measures
o
100% of graduating students will score at the
satisfactory level of clinical proficiency in the safety category by the end of
NSG 270
o
100% of graduating students will satisfactorily
develop a safety plan for an assigned patient in NSG 270
o
100% of
graduating student will score 90% or higher on the drug dosage
competency exam in NSG 270
o
The graduate cohort mean on the Kaplan
Diagnostic Test for the client need category Safe and Effective Care will be at
or above 52%. (added to SPE for Spring
2021 graduate cohort)
3. Demonstrate nursing
judgment through the use of clinical reasoning, the nursing process, and
evidence-based practice in the provision of safe, quality care.
·
Plan includes four measures 3/4
must be met to meet the objective
·
Spring 2021 met 2/4 measures
o The graduate cohort mean score for the Nursing Process
categories as available from the Kaplan Diagnostic Exam will be at or above the
following:
§ Assessment: 62%; Diagnosis: 59%; Evaluate: 54%; Implementation:
53% and Planning: 62% (traditional
met 3/5; transition met 0/5; and the aggregate as a whole fell below)
§ The graduate cohort mean score for the category of
EBP on the Pharmacological/Parenteral Therapy A Kaplan Integrated exam will be at
or above 63% (met by traditional, not met by transition; aggregate below
benchmark)
§ 100% of graduating students will score at the satisfactory level
of clinical proficiency by the end of NSG 270 for the specified clinical
category
§ The graduate cohort mean score on the Kaplan
Integrated Diagnostics exam will be at or above 55% in the category making
nursing judgements
4. Practice professional
behaviors that encompass the legal/ethical framework while incorporating
self-reflection, leadership and a commitment to recognize the value of
life-long learning.
·
Plan includes three measures 2/3
must be met to meet objective
·
Spring 2021 met the all three
measures
·
A forth measure added for fall
2021; result pending:
o 100% of graduating students will score at the satisfactory level
of clinical proficiency by the end of NSG 270
o
100% of graduates will score an 80% (40/50
points) on the professional portfolio assigned in NSG 270
o
100% of graduates will score satisfactorily on
the graduate team lead clinical evaluation
o
The graduate cohort mean score on the Kaplan
Integrated NSG 230 Exam (Advanced Professional Nursing Concepts) will be at or
above 57% (aggregate exceeded benchmark, traditional exceeded benchmark,
transition fell below benchmark)
5. Manage client care through quality
improvement processes, information technology, and fiscal responsibility to
meet client needs and support organizational outcomes.
·
Plan includes two measures, met by
spring 2021 graduates
o 100% of graduates will satisfactorily identify an opportunity for
quality improvement in patient care and develop a satisfactory strategy or
revised policy to address the situation.
o The
graduate cohort mean on the Kaplan Integrated NSG 230 exam for the category
quality improvement will be at or above 46%
6. Demonstrate principles of collaborative practice
within the nursing and interdisciplinary teams fostering mutual respect and
shared decision-making to achieve stated outcomes of care.
·
Plan includes one measure, a second measure
added for fall 2021
o
100% of graduate cohort will satisfactorily
deliver an end of shift report to unit charge nurse using the SBAR method (new
measure -pending for fall 2021)
o
The graduate cohort mean score on the Kaplan
Integrated Exam for NSG 230 for the category teamwork and collaboration will be
at or above 61% (met by spring 2021 graduates)
EPSLO Overall Results for Spring 2021 Graduates
|
|
Aggregate |
Traditional |
Transition |
|
EPSLO #1- Patient/Client Centered Care |
Met |
Met |
Met |
|
EPSLO #2- Safe Nursing Care |
Met |
Met |
Met |
|
EPSLO #3- Nursing Judgement |
Not Met |
Met |
Not Met |
|
EPSLO #4- Professional Behaviors |
Met |
Met |
Not Met |
|
EPSLO #5- Quality Improvement |
Met |
Met |
Met |
|
EPSLO #6 Collaborative Practice |
Met |
Met |
Met |
(6.2) ELA#1 The most recent annual licensure pass rate will be at least 80% for all first-time test takers during the same 12-month period
ELA #2 Three year aggregate data
reflects that 80% of all graduates will pass the NCLEX-RN exam as first time
testers within 12 months of graduation.
|
Licensure Exam Pass Rate per year from NCSBN Pass Rate
Data |
|
2018- 86 % |
|
2019- 70.45% (state 71.1%) |
|
2020- 76.09% |
|
3 Year Avg: 77.51% (below 80_ |
ELA #3 Three year disaggregated data
reflects that 80% of program graduates, by program option, will pass the
NCLEX-RN exam as first time testers within 12
Traditional Disaggregated by
Calendar Year Transition Disaggregated by Calendar Year
Performance:
|
|
Sp |
F |
Total |
|
2017 |
9/9 |
15/18 |
88.88% |
|
2018 |
17/20 |
12/18 |
76.3% |
|
2019 |
13/18 |
21/26 |
77.27% |
|
2020 |
11/16 |
11/13 |
75.86% |
|
2021 |
3/8 |
P |
37.5% |
|
|
Sp |
F |
Total |
|
2017 |
6/6 |
7/8 |
86.67% |
|
2018 |
4/4 |
4/6 |
80% |
|
2019 |
2/21 |
------ |
100% |
|
2020 |
3/4 |
4/6 |
70% |
|
2021 |
1/22 |
n/a |
P-50% |
1 3-total
graduates only two tested
2 3-total
graduates only two have tested to date
2) Program credit attainment (15/12 in one semester, 30/24 for those who enrolled in two consecutive semesters)
| Nursing | 18/19 | 19/20 | 20/21 | 21/22 |
| Cohort Size | 120 | 114 | 97 | 91 |
| 12 or less credits (1 semester only) | 18 | 18 | 4 | 8 |
| 13-15 credits (1 semester only) | 1 | 2 | 0 | 4 |
| 24 or less credits (2 semesters) | 24 | 13 | 13 | 6 |
| More than 24 credits (2 semesters) | 1 | 1 | 1 | 0 |
| Total taking 2 semesters worth of credits | 25/120 | 14/114 | 14/97 | 6/91 |
3) Program retention and persistence relative to the start date of the program (subsequent term calculation)
(6.3) Program completion rates have
been updated to track on-time completion per ACEN changes to guidelines. This
is the measure we will be using going forward to track completion. However,
previously we utilized 150% completion time. Note the data below for our
aggregate data:
ELA #1-Three year aggregate data reflects that
65% of students who start the first semester of clinical courses will graduate
in 150% of the program length.
150% Completion Time Data: 2016-2018
(Calendar year) as of June 2021
|
3
Year Aggregate Data 2016-2018
*program started in these years |
||||
|
|
SP |
F |
Total |
Report Year |
|
2016 |
86.21 |
70.96 |
78.59% |
2019 |
|
2017 |
78.13 |
73.9 |
76.02% |
2020 |
|
2018 |
82.14 |
66.67 |
74.41% |
2021 |
|
TOTAL: 76.34% |
||||
IV. Completion: Credential attainment (Quantitative, IE)
1) Sub-credential attainment and timeframe (are students completing sub-credential prior to or at the same time as parent credential?)
There is no sub-credential. Graduates may apply for licensure with the State Board of Nursing post graduation.
2) Parent credential attainment and timeframe, if applicable, disaggregated by specialization
The new curriculum is five semesters in length, students do not program place into nursing until they are accepted to the program, upon program acceptance they have four clinical nursing semesters for students in the traditional track and three clinical nursing semesters in the transition track. Below is disaggregated completion rates based on 150% completion time:
|
Year |
Term |
Admission
Cohort |
Expected
Completion Date |
# Admitted |
# On-time
Graduates 4
semesters traditional 3
semesters transition |
Program
Completion |
|
|
Disaggregated |
|
||||||
|
2019 |
Spring |
Traditional |
Fall 2020 |
23 |
12 |
52.17% |
|
|
|
Spring |
Bridge |
Spring 2020 |
4 |
4 |
100% |
|
|
|
Fall |
Traditional |
Spring 2021 |
21 |
8 |
38% |
|
|
|
Fall |
Bridge |
Fall 2020 |
7 |
6 |
85.7% |
|
|
Aggregate |
|
|
30/55 54.54%
(13%
changed mind; 29% experienced academic failure, and 3% had other factors)
|
|
a. Are students completing within 6 semesters (150% of graduation time)?
(6.3) Program completion rates have
been updated to track on-time completion per ACEN changes to guidelines. This
is the measure we will be using going forward to track completion. However,
previously we utilized 150% completion time. Note the data below for our
aggregate data:
ELA #1-Three year aggregate data reflects that
65% of students who start the first semester of clinical courses will graduate
in 150% of the program length.
150% Completion Time Data: 2016-2018 (Calendar year) as of June 2021
|
3
Year Aggregate Data 2016-2018
*program started in these years |
||||
|
|
SP |
F |
Total |
Report Year |
|
2016 |
86.21 |
70.96 |
78.59% |
2019 |
|
2017 |
78.13 |
73.9 |
76.02% |
2020 |
|
2018 |
82.14 |
66.67 |
74.41% |
2021 |
|
TOTAL: 76.34% |
||||
|
Disaggregate Data
-Traditional 150% |
|
|
Calendar Year Avg.
|
|
|
2016 |
76.21% |
|
2017 |
70.75% |
|
2018
|
71.84% |
|
3-YR Avg 72.93% |
|
|
Disaggregate Data
-Transition 150% |
|
|
Calendar Year Avg. |
|
|
2016 |
75% |
|
2017 |
100% |
|
2018
|
100% |
|
3-yr average 91.66% |
|
V. Transition: Employment or transfer post-credential (Quantitative, IE)
1) Transfer outcomes (students who transfer with associate degree, students who transfer without)
The ADN is not a transfer degree however we do have students that pursue the RN to BSN tracts offered at the university level.
|
October 21, 2021- 30 graduates between July 1, 2020 and June 30, 2021- 24 are currently working in field. This is 80% of the 30 respondents. 6/30 have not yet passed boards. |
2) Student perspective/satisfaction
Nursing Graduate Surveys note the following:
Fall 2019: 58% of graduates who responded to the survey (100% response rate) rated the quality of the nursing program as satisfactory. (last cohort of old curriculum graduates)
Spring 2020: 82% of graduates who responded to the survey (55% response rate) rated the quality of the nursing program as satisfactory. (first cohort of new curriculum graduates)
Fall 2020: 75% of graduates who responded to the survey (84% response rate) rated the quality of the nursing program as satisfactory. (2nd cohort of of new curriculum graduates)
| Question | 2018-19 | 2019-20 | 2020-21 | 2021-22 |
| The courses I took at P&HCC prepared me for my educational goals. | 91.9 | |||
| The faculty at P&HCC are fair and supportive of students. | 90.2 | |||
| The faculty at P&HCC demonstrate thorough knowledge of the subject matter. | 91.3 | |||
| In the courses I took at P&HCC, classroom activities and outside assignments were appropriate and meaningful. | 93.2 | |||
| I would recommend the faculty at P&HCC | 92.9 |
VI. Sustainability: Future Program Outlook (Mixed methods, IE, program head and dean)
1) Program forecast (major expenditures, changes, personnel needs, etc.); any future costs should be explained in this section)
The program is fully staffed with full-time positions. There will need to be more adjuncts on staff to increase the program capacity. The BON regulates the number of students who may be in clinical and supervised by one instructor. It is a 10:1 student to faculty workload. The program has added a retention specialist as a result of grant funding who is providing direct support to students. In addition, she provides instructional support, teaching up to 12 credits per year. The grant funding will expire in approximately one year and the college will need to plan for continued support of the position. The program has also opened a Simulation Center in partnership with Sovah, as a result of a generous grant from the Harvest Foundation. The future of the simulation center will be dependent on Sovah after the grant funds expire. The Simulation Center provide approximately 14% of each nursing graduates required clinical hours in the program (both PN and RN). The program is dependent on this center to fulfill required clinical experiences.
a. Any other pertinent information relevant to the review process should be provided here (e.g. community need, state/federal requirements, external accreditation, SCHEV low enrollment warning, etc.)
The program has low first time NCLEX pass rates, below 80% for two consecutive years 2019 and 2020. The State Board of Nursing has placed the program on conditional approval with terms and conditions. They are monitoring the pass rates on NCLEX and have conducted a NCLEX site visit. The program has developed and implemented an improvement plan.
The program participated in the ten year continuing accreditation visit in February of 2021. The visit was conducted virtually due to the continued pandemic. The accreditation process covers 6 standards which includes a total of 49 criterion. The site visit team concluded in their review process that we are compliant in Standards 1-5 and made no recommendations in those standards which included 45 of the 49 criterion. The program was non-compliant in Standard 6 (6.2) due to lack of evidence of meeting the 80% NCLEX requirement and (6.3) lack of evidence in the use of assessment data for program decision making. Areas of development included 6.1, 6.2 and 6.3. A follow up focused report will be due in March 2023, which ACEN reviewing the draft report in December 2022.
ACEN granted continuing accreditation with conditions for two years for the associate degree nursing program.
b. Employment forecast for program (Analyst data)
There are more available jobs in nursing than the program can fill through graduates. There is a nationwide shortage of nurses and this is reflected locally based on current nursing vacancies.
| Occupation data for Patrick & Henry Service Region | Total Employed | Mean Wage | Projected Demand (5 years) |
| Registered Nurses | 536 | $57,700 | 142 |
| All Occupations | 47,606 | $42,000 | 25,599 |