Tenn. Comp. R. & Regs. 1000-01-.11

Current through October 22, 2024

Section 1000-01-.11 - CRITERIA FOR SCHOOLS OF NURSING

The organization and administration of the school of nursing shall be consistent with T.C.A. §§ 63-7-101, et seq., other relevant state and federal statutes and all rules and regulations of the Board. The school of nursing shall be an integral part of a governing academic institution.

(1) Educational Resources

(a) Library - A well-organized and up-to-date library should be provided for the use of students and faculty.

(b) Clinical Facilities

1. The clinical facilities shall be selected on the basis of adequacy for student learning experiences:

(i) The nursing faculty shall select facilities which permit them to conduct a program in keeping with their philosophy and educational objectives.

(ii) Facilities selected for clinical experiences shall be appropriate to the learning objectives.

(iii) The school of nursing shall establish formal relationships with the clinical facilities, evidenced by a written agreement:

(I) The written agreements shall clearly define the responsibilities of the school of nursing and the clinical facilities.

(II) The written agreements shall be approved by the appropriate administrative officers of both the school of nursing and clinical facility.

(2) Curriculum

(a) The curriculum of a school of nursing program shall enable the student to develop the nursing knowledge, skills and competencies necessary for the level, scope and standards of nursing practice consistent with the level of licensure/certification. From time to time the curriculum shall be revised as necessary to maintain a program that reflects advances in healthcare and its delivery.

(b) The curriculum, as defined by nursing education, professional and practice standards shall include at a minimum the following:

1. Experiences that promote the development and subsequent demonstration of evidence-based clinical judgment, skill in clinical management, and the professional commitment to collaborate in continuously improving the quality and safety of the healthcare system for patients.

2. Evidence-based learning experiences and methods of instruction, consistent with the curriculum plan.

3. Coursework including, but not limited to:

(i) Content in the biological, physical, social and behavioral sciences to provide a foundation for safe and effective nursing practice;

(ii) Content regarding professional responsibilities, legal and ethical issues, history and trends in nursing and healthcare;

(iii) Didactic content and supervised clinical experience in the prevention of illness and the promotion, restoration and maintenance of health from diverse cultural, ethnic, social and economic backgrounds. Patient experiences will occur in a variety of clinical settings and will include:

(I) Integrating patient safety principles throughout the didactic and clinical coursework.

(II) Implementing evidence-based practice to integrate best research evidence with clinical expertise and patient values for optimal care, including skills to identify and apply best practices to nursing care.

(III) Providing patient-centered, culturally competent care that recognizes that the patient or designee is the source of control and full partner in providing coordinated care by:

I. Respecting patient differences, values, preferences and expressed needs.

II. Involving patients/designees in decision-making and care management.

III. Coordinating and managing patient care across settings.

IV. Explaining appropriate and accessible interventions to patients and populations that may positively affect their ability to achieve healthy lifestyles.

(IV) Collaborating within inter-professional teams to foster open communication, mutual respect, and shared decision-making in order to achieve quality patient care.

(V) Participating in quality improvement processes to monitor patient care outcomes, identify possibility of hazards and errors, and collaborate in the development and testing of changes that improve the quality and safety of healthcare systems.

(VI) Using information technology to communicate, mitigate error and support decision-making.

(iv) Advanced Practice Registered Nurse education shall be congruent with national standards for graduate level and advanced practice registered nursing education, and consistent with nationally recognized advanced practice registered nurse roles and specialties and include:

(I) Clinical and didactic coursework comprehensive and sufficient to prepare the graduate to obtain national certification for licensure in and practice in the Advanced Practice Registered Nurse role/category and population focus.

(II) The curriculum of the APRN nursing education program must prepare the graduate to practice in one of the four identified APRN roles/categories, i.e., nurse practitioner, nurse anesthetist, nurse midwife and clinical nurse specialist, and at least one of the six population foci, i.e., family/individual across the lifespan, adult-gerontology, neonatal, pediatrics, women's health/gender-related or psychiatric/mental health. The curriculum shall include:

I. Three separate graduate level courses (the APRN core) in:

A. Advanced physiology and pathophysiology, including general principles that apply across the lifespan;

B. Advanced health assessment, which includes assessment of all human systems, advanced assessment techniques, concepts and approaches; and

C. Advanced pharmacology, which includes pharmacodynamics, pharmacokinetics and pharmacotherapeutics of all broad categories of agents.

II. Diagnosis and management of diseases across practice settings including diseases representative of all systems.

III. Preparation that provides a basic understanding of the principles for decision-making in the identified role.

IV. Preparation in the core competencies for the identified APRN role.

A. Role/category preparation in one of the six population foci of practice.

B. An advanced practice registered nursing core, including legal, ethical and professional responsibilities of the advanced practice registered nurse;

(v) Practical nursing education shall include:

(I) Sufficient classroom instruction to comply with the requirements of Rule 1000-01-.11 (2)(a) and (b):

(II) Clinical experience:

I. Medical-Surgical Nursing - 325 contact hours

II. Maternal and Infant Care - 35 contact hours

III. Pediatric Nursing - 35 contact hours

IV. Behavioral/Mental Health Nursing - 35 contact hours

(III) For public institutions of higher education, a total minimum of one thousand two hundred ninety-six (1296) contact hours or an equivalent number of credit hours.

(c) Major Curriculum Change - Any major change to school of nursing's curriculum must be presented to the Board for approval prior to implementation and may require a survey visit.

(3) Clinical Practice - Faculty supervised clinical practice shall include development of skills in direct patient care; making clinical judgments; care and management of both individuals and groups of patients across the lifespan, and delegation to and supervision of, as appropriate to level of education, other health care providers.

(a) Clinical experience shall be comprised of sufficient hours to meet Board standards and be supervised by qualified faculty and ensure students' ability to practice.

(b) Students must observe effective clinical practice and must have an opportunity to practice clinically. Effective clinical practice includes: use of opportunities to preserve and to teach health, prevention of illness, and care for the emotional, spiritual, social, and physical needs of patients.

(c) Facilities selected for clinical experience shall include sufficient rotations in acute care settings that are licensed for a minimum of 100 beds.

(d) All student clinical experiences, including those with preceptors, shall be directed by nursing faculty.

(e) Measurement of students' competencies shall focus on the students' demonstration of care management and decision-making skills when providing patient care in a variety of clinical situations and care settings.

(f) Delivery of instruction by distance education methods must be consistent with the program curriculum plan and enable students to meet the goals, competencies and outcomes of the educational program and Board standards.

(4) Students

(a) Students shall have at least a high school diploma or its equivalent.

(b) Students shall be provided with the opportunity to acquire and demonstrate the knowledge, skills and abilities required for safe and effective nursing practice, in theory and clinical experience, through faculty supervision and appropriate advisement.

(c) All policies relevant to applicants and students shall be readily available to applicants, students and the Board.

(d) Students shall meet health standards and criminal background check requirements. Background checks shall include a search of abuse and sex offender registries as well as Nursys.com©.

(e) Students shall be held accountable for professional behavior, including honesty and integrity while in their program of study.

(f) Each student enrolled in an advanced practice registered nurse program shall, prior to enrollment as an advanced practice registered nurse student, hold a current, active and unencumbered Tennessee registered nurse license or the multistate licensure privilege to practice as a registered nurse in Tennessee. The school shall participate in the Nursys.com e-Notify© program that provides continuous feedback of students' licensure status.

(5) Director Responsibilities and Qualifications

(a) Director Responsibilities - Each school of nursing shall have a director who is employed full-time for school administrative purposes. For the purpose of this rule, "fulltime" means that at least eighty percent (80%) of the director's employment time is devoted to school of nursing program administrative duties.

(b) Director Qualifications

1. Qualifications in a program preparing for Licensed Practical Nurse licensure shall include:

(i) A current, active and unencumbered Tennessee Registered Nurse license or multistate licensure privilege to practice as a registered nurse in Tennessee. The school shall participate in the Nursys.com e-Notify© program that provides continuous feedback of directors' licensure status;

(ii) A minimum of a bachelor's degree in nursing;

(iii) Experience in teaching and knowledge of learning principles for adult education, including nursing curriculum development, administration and evaluation; and

(iv) A current knowledge of practical nursing practice.

2. Qualifications in a program preparing for Registered Nurse licensure shall include:

(i) A current, active and unencumbered Tennessee Registered Nurse license or the multistate licensure privilege to practice as a registered nurse in Tennessee. The school shall participate in the Nursys.com e-Notify© program that provides continuous feedback of directors' licensure status;

(ii) A master's degree in nursing;

(iii) Educational preparation or experience in teaching and knowledge of learning principles for adult education, including nursing curriculum development, administration and evaluation; and

(iv) A current knowledge of registered nursing practice.

3. Qualifications in a program preparing for Advanced Practice Registered Nurse licensure shall include:

(i) A current, active and unencumbered Tennessee Registered Nurse license or the multistate licensure privilege to practice as a registered nurse in Tennessee;

(ii) A master's degree in nursing;

(iii) Educational preparation or experience in teaching and knowledge of learning principles for adult education, including nursing curriculum development, administration and evaluation; and

(iv) A current knowledge of advanced nursing practice.

(6) Faculty

(a) General Requirements

1. Each school shall have a number of qualified full-time faculty members that is sufficient to meet the objectives and purposes of the nursing education program. There shall be at least one instructor in each clinical specialty and major teaching area.

2. Each nurse member of the faculty shall hold a current, active and unencumbered Tennessee Registered Nurse license or the multistate licensure privilege to practice as a registered nurse in Tennessee. The school shall participate in the Nursys.com e-Notify© program that provides continuous feedback of faculty and preceptors' licensure status.

3. The clinical faculty to student ratio must support the standards for quality teaching and patient safety. In the case of training of practical nurses by schools of nursing, the faculty to student ratio shall not exceed 1:12, provided that two (2) of the twelve (12) students are in an observational capacity only.

4. The faculty as a group shall have clinical specialization and expertise in all clinical specialties of the curriculum.

5. The lead instructor shall have clinical specialization and expertise in the course the instructor is teaching.

6. Courses in which the content is primarily nursing must be taught by professional nurses.

7. Interdisciplinary (non-nurse) faculty members shall have advanced preparation appropriate to the subject matter which they teach.

(b) Preceptors - Preceptors may be used to enhance faculty-directed clinical learning experiences, provided that preceptors are used only as an adjunct to faculty-directed clinical learning experiences and not as a substitute for regular clinical faculty members. Clinical preceptors must possess and be able to demonstrate competencies related to the clinical areas for which they have teaching responsibilities, and they are also expected to serve as role models to the students. Clinical preceptors shall have an unencumbered license to practice as a nurse at or above the level for which the student is being prepared, in the jurisdiction where they are precepting students. The school shall participate in the Nursys.com e-Notify© program that provides continuous feedback of preceptors' licensure status.

(c) LPN Program Faculty - Qualifications for nursing faculty who teach in a program leading to licensure as a Licensed Practical Nurse shall include at a minimum:

1. Three (3) years of clinical experience as a Registered Nurse within the last five (5) years; or

2. Two (2) years of clinical practice as a registered nurse and twenty-four (24) semester hours or equivalent toward a higher degree in nursing; and

3. Current knowledge of Licensed Practical Nurse practice; and

4. Clinical faculty may work in collaboration with the school of nursing in implementation of the clinical component of the curriculum. Qualifications for nursing faculty whose only responsibility is the supervision of students in clinical practice in a program leading to licensure as a practical nurse shall include at a minimum:

(i) Three (3) years of clinical experience as a Registered Nurse within the last five (5) years; or

(ii) Two (2) years of clinical practice as a registered nurse and twenty-four (24) semester hours or equivalent toward a higher degree in nursing; and

(iii) Current knowledge of Licensed Practical Nurse practice.

(d) RN Program Faculty - There shall be at least one nursing faculty member with advanced preparation in each clinical and major teaching area who is primarily responsible for the theory and clinical nursing practice. Otherwise, qualifications for nursing faculty who teach didactic content and who develop and evaluate the curriculum in a program leading to licensure as a Registered Nurse include at a minimum:

1. A master's degree or higher in nursing is recommended; and

2. Sufficient nursing experience to demonstrate professional competence; and

3. Current knowledge of Registered Nurse practice.

4. In addition to nursing faculty who teach didactic content, a program leading to licensure as a Registered Nurse may utilize adjunct clinical faculty. Such adjunct clinical faculty shall be responsible only for supervising students in clinical practice, and they shall not be responsible for developing or evaluating the program's curriculum. Qualifications for adjunct clinical faculty in a program leading to licensure as a registered nurse include at a minimum:

(i) A master's degree or higher in nursing is recommended; and

(ii) Current knowledge of Registered Nurse practice and sufficient nursing experience to demonstrate professional competence; and

(iii) If a less qualified adjunct faculty member is employed because a qualified candidate is not available, such adjunct faculty member shall function as an assistant under the direct guidance of a faculty member fully qualified in the specific clinical area.

(e) APRN Program Faculty - Qualifications for nursing faculty who teach in a specialty-specific course leading to certification as an Advanced Practice Registered Nurse include at a minimum:

1. A master's degree or higher in nursing with a focus on a related clinical specialty or in the specified Advanced Practice Registered Nurse role/category is recommended; and

2. A certificate to practice as an Advanced Practice Registered Nurse if teaching an advanced practice specialty course; and

3. Current knowledge of Advanced Practice Registered Nurse practice; and

4. Clinical supervision must be congruent with current national-specialty-organization and nursing-accrediting-body standards applicable to the Advanced Practice Registered Nurse role and specialty.

Tenn. Comp. R. & Regs. 1000-01-.11

Original rule certified May 10, 1974. Amendment filed August 31, 2001; effective November 14, 2001. Repeal and new rules filed July 10, 2024; effective 10/8/2024.

Authority: T.C.A. §§ 63-7-117, 63-7-118, 63-7-119, and 63-7-207.