Chapter 03. Nursing Education Programs
Regulation .01 Definitions.LinkCopy Citation
A.
In this chapter, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Approval” means the status granted to a nursing education program that:
(a)
Is in compliance with the regulations of the Board; and
(b)
Holds a certificate of approval from the Board of Nursing.
(2)
“Articulation” means the process by which a registered nurse or licensed practical nurse who is enrolled in a nursing education program is given credit for previous nursing education.
(3)
“Board” means the Board of Nursing.
(4)
“Board-recognized nursing accreditation agency (BRNAA)” means a national or regional nursing education accreditation agency recognized by the:
(a)
Secretary of the United States Department of Education (USDOE); and
(b)
Board.
(5)
Clinical Learning Experience.
(a)
“Clinical learning experience” means faculty planned and guided learning activities designed to assist students to meet the course objectives and apply nursing knowledge and skills in the direct care of patients.
(b)
“Clinical learning experience” includes:
(i)
Direct care of patients within the relevant practice setting;
(ii)
Clinical support activities such as clinical conferences; and
(iii)
Simulation laboratories.
(6)
“Clinical nurse faculty” means an individual with at least a baccalaureate degree in nursing who is employed by the program solely for clinical learning of nursing students.
(7)
“Clinical preceptor” means a registered nurse employee of a cooperating clinical agency acting to facilitate and supervise student learning in a manner specified in a signed written agreement between the cooperating clinical agency and the educational institution.
(8)
“Clinical preceptorship” means an organized system of clinical experience that allows a nursing student to be paired with a clinical preceptor for the purpose of attaining specific learning objectives.
(9)
“Conditional approval” means a limited-time status that:
(a)
Is imposed by the Board if the Board finds evidence that the program has failed to meet or maintain the regulations or requirements, or both, set by the Board; and
(b)
Allows the program to continue to operate subject to the program conforming to the Board’s requirements and recommendations within a time period set by the Board.
(10)
“Controlling institution” means an organization that offers a nursing education program.
(11)
“Cooperating clinical agency” means an agency that provides the facilities and clinical resources for clinical learning experiences in nursing, with the nurse faculty or the clinical nurse faculty of the program responsible for the planning, implementation, and evaluation of these experiences.
(12)
“Curriculum changes” means changes in course offerings that will alter the curriculum, philosophy, objectives, outcomes, competencies, or conceptual framework of the program.
(13)
“Full time nurse faculty equivalent” means nursing faculty who are designated as full time employees by their institution.
(14)
“Generic student” means one who enters at the beginning of the nursing education program and plans to complete the entire curriculum.
(15)
“Initial approval” means the approval period from the first admission of nursing students to the program through the first full implementation of the curriculum and graduation.
(16)
“Informatics” means the use of technology in nursing practice.
(17)
“Licensed practical nurse” means an individual who:
(a)
Is licensed by the Board to practice licensed practical nursing; or
(b)
Has a multistate licensure privilege to practice licensed practical nursing.
(18)
“Multistate licensure privilege” has the meaning set forth in COMAR 10.27.01.01B.
(19)
“MHEC” means Maryland Higher Education Commission.
(20)
“Nurse faculty” means an individual with a graduate degree in nursing who is employed to teach full-time or part-time in a nursing education program.
(21)
Program.
(a)
“Program” means a registered nursing or licensed practical nursing educational program.
(b)
“Program” includes any of the following:
(i)
A college;
(ii)
A school;
(iii)
A division;
(iv)
A department;
(v)
An academic unit; or
(vi)
A program.
(22)
“Regional nursing education accrediting agency” means an accrediting agency that operates in a specific geographic region of the United States and accredits post-secondary institutions and primary and secondary schools.
(23)
“Registered nurse (RN)” means an individual who:
(a)
Is licensed by the Board to practice registered nursing; or
(b)
Has a multistate licensure privilege to practice registered nursing.
(24)
“Requirement” means a mandatory condition that a program meets:
(a)
For the program to be approved; and
(b)
To ensure that graduates of the program are eligible to take the NCLEX-RN® and NCLEX-PN®.
(25)
“Simulation” means instructional activities and strategies that mimic the reality of a clinical environment and complement other clinical learning experiences.
(26)
“Transfer student” means a student who is permitted to apply nursing courses completed at another institution to a nursing education program of study.
(27)
“USDOE” means the United States Department of Education.
Regulation .02 Approval of Programs Accredited by a Board-Recognized Nursing Accreditation Agency.LinkCopy Citation
A.
The Board shall place on its list of approved programs any nursing education program in Maryland granted accreditation by a BRNAA, provided the program meets all requirements of this chapter.
B.
A program approved by the Board and accredited by a BRNAA agency shall submit to the Board within 30 days of receipt:
(1)
Evidence of current accreditation;
(2)
Accreditation reports; and
(3)
Any correspondence related to the status of the program's accreditation.
C.
The Board shall continue to grant approval to programs in Maryland filing evidence of continuing accreditation by the BRNAA, provided those programs continue to meet all requirements of this chapter.
D.
The Board shall be notified in writing within 10 business days of any change in accreditation status by the nursing program.
E.
Withdrawal of accreditation, accreditation with warning, or failure to meet the requirements of this chapter or the standard for performance on the licensing examination shall be cause for Board review of the program in accordance with Regulations .16B and C and .17 of this chapter.
F.
A program on which the Board has taken action under Regulations .16B and C and .17 of this chapter shall be reported to MHEC.
G.
On a periodic basis, the Board shall compare its regulations to those of the BRNAA and the USDOE to ensure that the Board standards for programs are being met.
H.
The Board and MHEC shall inform one another in a timely manner of proposed changes to regulations that may affect nursing education programs.
Regulation .03 Board Approval of Nonaccredited Programs.LinkCopy Citation
A.
A Board-approved nursing education program that is not accredited by a BRNAA shall meet the requirements stated in Regulations .04—.16 of this chapter.
B.
In institutions having both a licensed practical nursing education program and a registered nursing education program and when only one of the programs is accredited by a BRNAA:
(1)
Except as otherwise provided in Regulation .18 of this chapter, the Board and the BRNAA shall conduct concurrent visits; and
(2)
The program shall submit an addendum to the accredited program's self-study describing the unique components of the nonaccredited program.
C.
A program on which the Board has taken action shall be reported to MHEC.
Regulation .04 Philosophy and Objectives, Outcomes, or Competencies.LinkCopy Citation
A.
The philosophy and program objectives, outcomes, or competencies shall be:
(1)
Developed by the nursing faculty and represent a consensus of that faculty;
(2)
Consistent with the characteristics of the specific type of nursing education program;
(3)
Communicated to those responsible for and participating in the program; and
(4)
Periodically evaluated.
B.
The philosophy of the program shall:
(1)
Be consistent with that of the controlling institution and governing body;
(2)
Articulate beliefs about individuals and their health, environment, nursing, adult education, and learning; and
(3)
Serve as a foundation for developing, implementing, and evaluating the educational program.
C.
The program objectives, outcomes, or competencies shall:
(1)
Evolve from the philosophy of the program;
(2)
Be clearly stated, measurable, and attainable;
(3)
Serve as a foundation for planning, implementing, and evaluating the program; and
(4)
Identify the expected competencies of the graduate.
Regulation .05 Administration and Organization.LinkCopy Citation
A.
The controlling institution shall:
(1)
Be accredited by the appropriate national or regional accrediting agency; and
(2)
Have a statement of equal educational opportunity.
B.
The organizational chart shall:
(1)
Demonstrate the relationship of the nursing program to the controlling institution;
(2)
Indicate lines of responsibility and authority; and
(3)
Indicate channels of communication.
C.
The program shall have comparable status with other academic units within the controlling institution.
D.
The controlling institution shall provide the financial support and resources needed to operate a program which:
(1)
Meets the requirements of the Board; and
(2)
Fosters achievement of program goals.
E.
The financial resources shall support:
(1)
Adequate educational facilities and equipment; and
(2)
Qualified administrative, clerical, and instructional personnel.
F.
The program shall be administered by a registered nurse who meets the qualifications stated in Regulation .07 of this chapter.
G.
When the nursing program administrator changes, the administrative officer of the controlling institution shall submit written notification to the Board of the change indicating that the new program administrator meets the Board’s requirements.
Regulation .06 Records and Reports.LinkCopy Citation
A.
Accurate and appropriate records shall be maintained that include, but are not limited to:
(1)
Current records of students;
(2)
Transcripts of graduates;
(3)
Faculty records;
(4)
Administrative records, which include:
(a)
Minutes of faculty meetings;
(b)
Annual reports of the program; and
(c)
School bulletins;
(5)
The current curriculum, including:
(a)
Philosophy;
(b)
Objectives or outcomes; and
(c)
Course outlines;
(6)
Agreements with cooperating agencies; and
(7)
A master plan of evaluation.
B.
Records shall be safely stored to prevent loss, destruction, or unauthorized use.
C.
The nursing program administrator shall submit an annual report to the Board on forms provided by the Board.
Regulation .07 Nursing Program Administrator.LinkCopy Citation
A.
Qualifications.
(1)
Qualifications of the nursing program administrator include:
(a)
Current licensure as a registered nurse in Maryland or possession of a multistate licensure privilege to practice registered nursing;
(b)
A graduate degree in nursing; and
(c)
Academic preparation or experience in administration.
(2)
A doctorate in nursing or a related field is recommended for the nursing program administrator.
B.
Responsibilities. The nursing program administrator, with the participation of the faculty, is responsible for:
(1)
Recommendations for faculty appointment and review;
(2)
The educational program or programs;
(3)
Preparing and administering the budget;
(4)
Formulating and implementing policies pertinent to the program, which include but are not limited to:
(a)
Admission and progression;
(b)
Advanced standing;
(c)
Transfer and articulation;
(d)
Withdrawal;
(e)
Reinstatement;
(f)
Evaluation;
(g)
Graduation requirements; and
(h)
Competency in oral and written communication of the English language;
(5)
Determining the student/teacher ratio based on the objectives of the course, method of instruction used, and the requirements of the faculty;
(6)
Determining the number of faculty, including clinical faculty, needed based on the:
(a)
Number and academic level of enrolled students;
(b)
Curriculum;
(c)
Activities and responsibilities required of the faculty; and
(d)
Number and geographic locations of the clinical facilities;
(7)
Developing, maintaining, complying with, and periodically reviewing written agreements with cooperating agencies;
(8)
Implementing a faculty orientation and development program;
(9)
Implementing the entire program in accordance with Board regulations;
(10)
Assuring that all publications pertaining to the nursing program are clear, accurate, and current;
(11)
Developing and implementing a written plan that provides that all students participating in clinical practice settings are physically and mentally competent at all times to provide safe client care; and
(12)
Developing appropriate clinical learning experiences that reflect an understanding of the program's philosophy, objectives, outcomes or competencies, and curriculum.
Regulation .08 Nurse Faculty and Clinical Nurse Faculty.LinkCopy Citation
A.
Qualifications of Nurse Faculty.
(1)
Nurse faculty shall:
(a)
Be currently licensed as a registered nurse in Maryland or have a multistate licensure privilege to practice registered nursing;
(b)
Be academically and professionally qualified;
(c)
Maintain expertise appropriate to their teaching responsibilities; and
(d)
Have a minimum of 2 years of clinical experience as a registered nurse.
(2)
Except as provided under §B of this regulation, nurse faculty shall have a graduate degree in nursing.
(3)
Non-nurse faculty, or nurses not meeting the requirements for nurse faculty, may teach selected portions of the nursing curriculum that relate to their areas of expertise.
B.
Waiver of Graduate Degree in Nursing Requirement for Nursing Faculty.
(1)
A program experiencing a faculty shortage may petition the Board for a waiver of the graduate degree in nursing required by §A(2) of this regulation.
(2)
The petition for a waiver of the graduate degree in nursing shall include documentation that the institution has attempted to hire nurse faculty with graduate degrees and a summary of those efforts.
(3)
The petition in §B(1) of this regulation shall include documentation verifying that the nurse faculty applicant for whom the waiver is requested has:
(a)
A baccalaureate degree in nursing and a graduate degree in another field; or
(b)
A baccalaureate degree in nursing and:
(i)
Is enrolled as a student in an approved graduate study program in nursing; and
(ii)
Will complete the graduate study program in nursing within 36 months.
(4)
If the graduate degree in nursing is waived by the Board:
(a)
The nurse faculty member for whom a waiver has been granted shall complete a minimum of 9 graduate credits in nursing within 24 months of the issuance of the waiver; and
(b)
The program shall submit documentation to the Board of completion of the required credits by the nurse faculty member within 24 months of the date when the waiver was granted.
(5)
If the nurse faculty member fails to complete the 9 graduate credits required in nursing within 24 months of the granting of the waiver, the Board may withdraw the waiver.
(6)
If the waiver has been withdrawn, the program shall require that the nurse faculty member cease functioning as nurse faculty. If the program fails to do so, the Board may take action under Regulation .17 of this chapter.
(7)
Once the nurse faculty member for whom the waiver was granted has met the 9 graduate credit waiver requirements, that nurse faculty member is considered to have met the educational requirements of §A(2) of this regulation.
(8)
The Board shall grant a waiver for a nurse faculty member:
(a)
With experience in teaching; and
(b)
Who is within a semester of graduation with a graduate degree in nursing.
C.
Qualifications of Clinical Nurse Faculty.
(1)
A clinical nurse faculty member shall:
(a)
Be currently licensed as a registered nurse in Maryland or have a multistate licensure privilege to practice registered nursing;
(b)
Have a degree in nursing at or above the baccalaureate level;
(c)
Have a minimum of 2 years of clinical experience as a registered nurse; and
(d)
Have the clinical experience necessary to function effectively and safely in the clinical nurse faculty's area of responsibility.
(2)
A program may not, in any academic year, fill more than 25 percent of the program’s full-time nurse faculty equivalent positions with clinical nurse faculty whose highest nursing degree is at the baccalaureate level.
D.
Responsibilities of Nurse Faculty and Clinical Nurse Faculty.
(1)
Responsibilities of the nurse faculty include participation in the planning, implementation, evaluation, and revision of the educational program.
(2)
Nurse faculty shall:
(a)
Develop and implement standards for admission, progression, and graduation of students;
(b)
Participate in academic advisement and guidance of students;
(c)
Evaluate student performance;
(d)
Maintain clinical skills in the nurse faculty’s area of responsibility;
(e)
Develop and implement a plan to assure that all instructional materials are accessible, current, and relevant to the curriculum;
(f)
Participate in the recruitment, selection, and promotion of nurse faculty and the recruitment and selection of clinical nurse faculty;
(g)
Participate in peer evaluation of nurse faculty and clinical nurse faculty performance; and
(h)
Elicit student evaluation of teaching effectiveness.
(3)
Clinical nurse faculty shall:
(a)
Provide clinical instruction and supervision of students; and
(b)
Evaluate student performance in clinical learning experiences.
Regulation .09 Faculty Policies.LinkCopy Citation
A.
There shall be written personnel policies for nurse faculty and clinical nurse faculty that conform to accepted educational standards.
B.
Policies concerning the teaching load for faculty and the nursing program administrator shall be in writing. Sufficient time shall be provided for faculty to accomplish those activities related to the teaching-learning process. If the program administrator is required to teach, the program administrator shall carry only a minimum teaching load.
Regulation .10 Faculty Organization.LinkCopy Citation
A.
The faculty shall be organized with written policies and procedures to guide its activities.
B.
The faculty shall meet regularly and function in such a manner that all members participate in planning, implementing, and evaluating the nursing program.
C.
Committees necessary to carry out the functions of the program shall be established with the duties and membership of each committee clearly defined.
D.
As appropriate, students shall participate on faculty committees.
E.
Minutes of faculty organization and committee meetings shall:
(1)
Document actions and decisions of the faculty; and
(2)
Be available for reference.
Regulation .11 Faculty Development and Evaluation.LinkCopy Citation
A.
There shall be a formal plan for orientation of new nurse faculty and clinical nurse faculty.
B.
A program of faculty development shall be offered to encourage and assist nurse faculty members and clinical nurse faculty in their professional growth and development.
C.
A variety of means shall be used to evaluate nurse faculty and clinical nurse faculty’s effectiveness of teaching within the classroom and clinical setting.
Regulation .12 Resources, Facilities, and Services.LinkCopy Citation
A.
Physical Facilities. The physical facilities shall be adequate to meet the needs of the nursing program and include the following:
(1)
Office for the administrator, faculty members, and staff;
(2)
Adequate space for privacy of faculty-student conferences;
(3)
Classroom, laboratories, simulation laboratories, and conference rooms;
(4)
Space for equipment and instructional materials; and
(5)
Space for noninstructional activities of nursing faculty and students.
B.
Learning resources shall be developed with faculty input and shall be:
(1)
Accessible to faculty and students;
(2)
Comprehensive; and
(3)
Current.
C.
Educational support services that facilitate students' abilities to achieve the program's objectives, outcomes, or competencies shall be available.
D.
Cooperating Clinical Agencies.
(1)
The appropriate authorities shall approve cooperating clinical agencies and all facilities used for clinical learning experiences.
(2)
Facilities with conditional or provisional approval status may not be used for student learning experiences.
(3)
Cooperating clinical agencies shall meet the following requirements:
(a)
Accreditation or approval by the appropriate authority;
(b)
A sufficient number and variety of clients to provide learning experiences for all students to achieve the stated objectives, outcomes, or competencies;
(c)
A sufficient number of registered nurses and other nursing personnel to ensure safe and continuous care of clients; and
(d)
Conformance with accepted standards of nursing care and practice.
E.
Written Agreements.
(1)
Written agreements between the program and the cooperating clinical agencies shall specify the responsibility of the program to the cooperating clinical agency and the responsibility of the cooperating clinical agency to the program.
(2)
Written agreements shall:
(a)
Be developed jointly with the cooperating clinical agency;
(b)
Be reviewed periodically; and
(c)
Include provision for adequate notice of termination.
Regulation .13 Curriculum.LinkCopy Citation
A.
The curriculum shall be:
(1)
Planned, implemented, and evaluated by the faculty;
(2)
Based on the philosophy and program objectives, outcomes, or competencies;
(3)
Organized logically and sequenced appropriately; and
(4)
Based on sound educational principles.
B.
The curriculum plan shall:
(1)
Serve as the foundation for curriculum development;
(2)
Define and organize philosophical beliefs, values, and concepts;
(3)
Operationalize the program objectives or outcomes;
(4)
Structure concepts and theories to enhance the teaching-learning process; and
(5)
Provide a model for progressive learning.
C.
The curriculum objectives, outcomes, or competencies shall:
(1)
Flow from the curriculum plan;
(2)
Measure the intended objectives, outcomes, or competencies for program graduates; and
(3)
Serve as a foundation for:
(a)
Sequencing of the program;
(b)
Course objectives;
(c)
Sequential arrangement of courses; and
(d)
Distribution of class and clinical hours.
D.
The curriculum of all programs shall:
(1)
Be appropriate to the level of the graduate's intended scope of practice;
(2)
Provide didactic and clinical learning experiences that are diverse and consistent with program objectives, outcomes, or competencies; and
(3)
Include:
(a)
Content in the arts and humanities, social and behavioral sciences, and biological and physical sciences;
(b)
The nursing process;
(c)
Didactic and clinical instruction which includes, but is not limited to, the following areas:
(i)
Nursing care of families and clients throughout the life span in a variety of care settings requiring nursing measures appropriate for either the maintenance or restoration of mental and physical health;
(ii)
Preventive, rehabilitative, and curative aspects of health care; and
(iii)
Biophysical, psychosocial, cultural, and spiritual components of health and illness;
(d)
Professional issues content including, but not limited to:
(i)
The historical development of nursing;
(ii)
Current issues and trends in nursing; and
(iii)
Ethical, legal, and professional aspects of nursing;
(e)
Multidisciplinary communication;
(f)
Evidence based practice;
(g)
Patient centered care;
(h)
Quality improvement; and
(i)
Informatics.
E.
The curriculum of baccalaureate degree programs in nursing shall also include:
(1)
Didactic and clinical experiences in community health nursing;
(2)
Study of nursing research and its application to nursing; and
(3)
Study and practice of leadership and management.
F.
Course objectives, outcomes, or competencies shall serve as:
(1)
Selection criteria for the location and type of clinical learning experiences; and
(2)
A basis for evaluation of student performance.
G.
Changes in course offerings that will alter the curriculum, philosophy, objectives, outcomes, competencies, or conceptual framework of the program shall:
(1)
Be reported to the Board in the annual report; and
(2)
Include the following information:
(a)
The rationale for changes; and
(b)
The methods of evaluation to be used to determine the effect of the change.
H.
Students shall be provided didactic instruction either before or concurrent with the related clinical learning experiences.
I.
Clinical learning experiences shall be sufficient in quantity and quality to provide opportunities for students to achieve the stated objectives, outcomes, or competencies.
J.
Students shall have sufficient opportunities to develop the knowledge, skills, and abilities essential for a safe and effective nursing practice.
K.
Evaluation methods and tools used for measuring students’ knowledge, skills, and abilities shall be developed and implemented in order to ensure satisfactory progression of students.
L.
There shall be a rationale for the ratio of classroom to clinical hours for each clinical nursing course.
M.
Clinical Preceptorships.
(1)
When clinical preceptors are used, the following conditions shall be met:
(a)
Written agreements between the cooperating agency and the nursing program shall delineate the functions and responsibilities of the parties involved;
(b)
There shall be written criteria for selecting clinical preceptors;
(c)
The clinical preceptor shall have the following minimum qualifications:
(i)
Current licensure as a registered nurse,
(ii)
2 years of experience as a registered nurse and clinical expertise in the area of nursing required for the experience; and
(iii)
A philosophy of health care congruent with that of the nursing program;
(d)
Written clinical objectives, outcomes, or competencies shall be specified and shared with the clinical preceptor before the preceptorship experience begins; and
(2)
The designated faculty member shall:
(a)
Be responsible for a student's learning experiences, and
(b)
Meet regularly with the clinical preceptor and the student for the purpose of monitoring and evaluating learning experiences.
(3)
A bachelor’s degree in nursing is recommended.
(4)
Nothing in this section shall be construed to prohibit any cooperating clinical agency’s registered nurses from assisting with clinical activities selected by the program’s nurse faculty or clinical nurse faculty.
(5)
The program’s nurse faculty or clinical nurse faculty may not be required to be in the cooperating clinical agency’s facilities but shall be immediately available by telephone.
Regulation .14 Students.LinkCopy Citation
A.
The following shall be available to students:
(1)
A written statement of students' rights and responsibilities;
(2)
The opportunity to participate in program development and evaluation;
(3)
A written grievance mechanism; and
(4)
Guidance and advisement services.
B.
Students shall have:
(1)
Membership on selected faculty committees, as appropriate; and
(2)
The opportunity to participate in an organization of self-governance.
C.
Exercise of the right and responsibility to discuss, inquire, and express opinion is encouraged.
D.
Each program shall have clearly defined written policies for the following:
(1)
Admission of:
(a)
Generic students;
(b)
Transfer students; and
(c)
Articulation;
(2)
Oral and written English proficiency in reference to Health Occupations Article, §8-302(e), Annotated Code of Maryland, and COMAR 10.27.01.05;
(3)
Withdrawals;
(4)
Readmissions;
(5)
Progression;
(6)
Counseling and guidance;
(7)
Representation on faculty governance;
(8)
Graduation;
(9)
Refund policies governing all fees and tuition paid by students; and
(10)
Ethical practices for the performance of activities, including recruitment, admission, and advertising.
E.
Each program shall have a written policy providing information to any student who may be subject to licensure denial under Health Occupations Article, §§-308(c) and 8-316(a), Annotated Code of Maryland, and amendments applying to that citation. The information shall be provided before admission to the nursing education program.
Regulation .15 Program Evaluation.LinkCopy Citation
A.
The faculty shall develop and implement a Board-approved evaluation plan for evaluating the total nursing education program not less than:
(1)
Every 10 years for programs that are accredited by a BRNAA; and
(2)
5 years for programs without BRNAA accreditation.
B.
The evaluation plan shall include:
(1)
All components of the program;
(2)
Evaluation time intervals;
(3)
Student, graduate, faculty, cooperating clinical agencies, and administration participation;
(4)
Instruments or methods used; and
(5)
Evidence that prior recommendations from the Board have been acted upon.
C.
The evaluation process shall provide evidence that the program is meeting its objectives or outcomes as well as the changing needs of nursing and society.
D.
The outcome of evaluation includes:
(1)
Recommendations for necessary program revisions; and
(2)
Direction for future action.
Regulation .16 Annual Review.LinkCopy Citation
A.
Annually, a program shall submit the following to the Board:
(1)
An annual report on the form that the Board requires;
(2)
A program catalog;
(3)
Any annual reports to the BRNAA;
(4)
Any correspondence related to the status of the program's accreditation;
(5)
A summary of practices followed in safeguarding the health and well-being of students;
(6)
An audited fiscal report covering the previous 2 years, including a statement of income and expenditures; and
(7)
Accurate and complete data including, but not limited to, number of enrollments, admissions, graduates, and faculty.
B.
Annually, the Board shall:
(1)
Review each program’s annual report, supporting documentation, and the licensure examination performance of first-time candidates from each program;
(2)
Notify each program achieving less than 90 percent of the national success rate; and
(3)
If necessary, conduct a survey or site visit, issue recommendations, place a program on conditional approval, or issue a formal notice of violation and withdraw approval in accordance with Regulation .17 of this chapter.
C.
Approval may be reduced to conditional status for the following reasons:
(1)
Noncompliance with this chapter;
(2)
Failure to hire faculty who meet the qualifications as stated in Regulation .08 of this chapter;
(3)
Noncompliance with the school’s stated philosophy, program design, objectives, or policies;
(4)
Failure to submit records and reports to the Board in a timely manner;
(5)
Failure to implement the approved curriculum;
(6)
In accordance with §D of this regulation, failure to maintain the required passing rate on the licensing examination by first-time candidates;
(7)
Failure to annually document that all faculty have current licenses; and
(8)
Other activities or situations, as determined by the Board, that indicate a program is in jeopardy of violating statutory and regulatory requirements and standards.
D.
Unacceptable Performance on Licensure Examination.
(1)
The Board shall issue a warning to a program when the pass rate of first-time candidates does not comply with §B(2) of this regulation.
(2)
For the first year a program does not meet the requirements of §B(2) of this regulation and following the warning in §D(1) of this regulation, the program shall, within 30 calendar days, provide to the Board:
(a)
A report that identifies the factors believed to have contributed to the unacceptable performance; and
(b)
An action plan to be approved by the Board.
(3)
Second Successive Year Not in Compliance.
(a)
For the second successive year that a program is not in compliance with §B(2) of this regulation, the program shall be placed on conditional approval and shall:
(i)
Provide the Board with a report analyzing all aspects of the educational program and identifying areas that may be contributing to the unacceptable performance; and
(ii)
Obtain the services of a Board-approved outside consultant with expertise in nursing education congruent with program needs.
(b)
The Board’s professional staff shall conduct a survey visit to the school and provide a report to the Board.
(4)
If compliance with the minimum licensure examination performance standard for first-time candidates is not made by the program within 1 examination year from the date of conditional approval, approval may be withdrawn.
Regulation .17 Removal from Approved List.LinkCopy Citation
A.
Pursuant to Health Occupations Article, §8-404, Annotated Code of Maryland, at least 30 days before issuing a formal notice of violation of regulations to a program, the Board shall notify the chief administrator of the controlling institution and the chief administrator of the nursing education program that the Board is considering issuing a formal notice of violation.
B.
During the 30-day period, the Board shall provide the chief administrator of the controlling institution and the nursing education program with an opportunity to meet with representatives of the Board to discuss the Board’s proposed action against the program.
C.
The program shall notify the Board within the 30-day period if it is interested in meeting with the Board. If the program requests a meeting, the Board shall set up the meeting.
D.
At the meeting, the program shall submit to the Board a plan with a proposed time frame for correcting the violations.
E.
The Board shall:
(1)
Evaluate the plan;
(2)
Approve or modify the plan; and
(3)
Have discretion to make changes to the time frames for correcting violations or other components of the plan.
F.
The program shall correct the violations within the time frames approved by the Board.
G.
Approval may be withdrawn for the following reasons:
(1)
Noncompliance with any of the regulations in this chapter;
(2)
Failure to hire faculty who meet the qualifications as stated in Regulation .08 of this chapter;
(3)
Noncompliance with the school's stated philosophy, program design, objectives, or policies;
(4)
Failure to submit records and reports to the Board in a timely manner;
(5)
Failure to implement the approved curriculum;
(6)
Failure to comply with the Board’s requirements within the specified time frames;
(7)
Failure to maintain the required passing rate on the licensing examination by first-time writers;
(8)
Failure to annually document that all faculty have current licenses; and
(9)
Other activities or situations, as determined by the Board, that indicate a program is not meeting statutory and regulatory requirements and standards.
H.
Withdrawal of Approval. If the program does not correct the violations within the approved time frames, the Board shall begin proceedings to remove the program from its list of institutions that offer approved nursing education programs in Maryland pursuant to Health Occupations Article, §§8-316—8-318, and 8-404, Annotated Code of Maryland.
Regulation .18 New Programs and Continuing Approval Requirements.LinkCopy Citation
A.
New Program Requirements.
(1)
An institution wishing to establish a nursing program shall submit to the Board:
(a)
A letter of intent;
(b)
Proof that the institution is accredited by the appropriate national or regional accrediting agency;
(c)
A copy of the prospectus and program proposal submitted to MHEC;
(d)
An addendum that describes in detail the:
(i)
Type and length of nursing program;
(ii)
Curriculum plan;
(iii)
Program objectives, outcomes, or competencies; and
(iv)
Description of available clinical resources;
(e)
Evidence that the proposed nursing program is based upon sound educational principles; and
(f)
Materials validating that the educational institution is prepared to meet the requirements specified in this chapter.
(2)
A nursing program providing on-site didactic or clinical instruction in Maryland shall comply with this chapter and receive Board approval of the on-site program before the commencement of instruction.
(3)
Both MHEC and the Board shall collaborate on program review.
(4)
Following review of the materials submitted, the Board shall notify the institution as to whether further clarifications or revisions are necessary.
B.
New Program Review.
(1)
The proposed nursing education program shall be reviewed at a regularly scheduled Board meeting.
(2)
The Board may:
(a)
Deny further consideration of the proposal;
(b)
Defer action on the proposal; or
(c)
Authorize a site visit by the Board’s professional staff and, following a report of the site visit by the Board’s professional staff, grant initial approval, defer action, or deny the request.
(3)
If deferred or denied, the institution shall be notified in writing of the reasons for the action.
C.
Initial Approval. Initial approval:
(1)
Is required before the admission of students;
(2)
Requires concurrence of the Maryland Higher Education Commission; and
(3)
Extends until the school or program has graduated its first class.
D.
Approval.
(1)
Following graduation of the first class, the Board shall evaluate the program for approval, considering the:
(a)
Report of a survey of the program by the Board’s professional staff, scheduled before graduation of the first class;
(b)
Results of the performance of the graduates on the National Council Licensure Examination; and
(c)
Program’s demonstrated continued ability to provide an educational program that meets the standards set by the Board.
(2)
Upon review of the survey report, the results of graduate performance on the National Council Licensure Examination, and an assessment of the program’s continued ability to meet the standards set forth in this chapter, the Board may:
(a)
Grant approval;
(b)
Place the program on conditional approval; or
(c)
Withdraw initial approval in accordance with Regulation .17 of this chapter.
(3)
Approval, if granted, shall be valid for not more than:
(a)
10 years for a program accredited by a BRNAA; and
(b)
5 years for a program without BRNAA accreditation.
E.
Reapproval Requirements.
(1)
The Board shall evaluate a program for reapproval:
(a)
Every 5 years if the program is without BRNAA accreditation; and
(b)
Not more than 10 years after approval is granted if the program has BRNAA accreditation.
(2)
Evaluation of continuing compliance shall include the submission of a self-study report by the program and a survey visit by the Board’s professional staff. The self-study report shall be submitted to the Board no less than one month prior to the survey visit.
(3)
If the program is accredited by a BRNAA, the reapproval survey visit may be made in coordination with a BRNAA visit.
(4)
Unscheduled survey or site visits may be conducted at the discretion of the Board.
(5)
A program that is accredited by a BRNAA and is subsequently placed on warning or whose accreditation by the BRNAA is withdrawn shall be scheduled immediately for a survey visit.
(6)
During each survey or site visit, the nurse administrator of the program shall make the following information available:
(a)
Data about the program, including the following:
(i)
The number of students;
(ii)
The legal body responsible for policy and support of the program;
(iii)
The organizational chart; and
(iv)
An audited fiscal report covering the previous 2 years, including a statement of income and expenditures;
(b)
The nurse administrator’s job description;
(c)
For each faculty member and clinical preceptor, the following:
(i)
Job descriptions;
(ii)
Selection policies;
(iii)
Orientation plan;
(iv)
Faculty organization by-laws;
(v)
Number of full-time and part-time faculty and non-nursing faculty with academic credentials and assignments; and
(vi)
Faculty-student clinical ratio;
(d)
Degree plan;
(e)
A copy of the current curriculum and course catalog with the date of last revision;
(f)
The testing process with test analysis and the written test procedure;
(g)
A description of education facilities, including classrooms, offices, libraries, and computers;
(h)
A list of clinical facilities and cooperating clinical agencies;
(i)
The number of students by classes; and
(j)
The policies for students as listed in Regulation .14D of this chapter.
(7)
During each survey or site visit, the nurse administrator shall make available the following:
(a)
The program’s administrators, faculty, support services personnel, and students;
(b)
Staff members of selected cooperating clinical agencies;
(c)
Faculty minutes for at least the previous 3 years;
(d)
Faculty and student handbooks;
(e)
Student records;
(f)
Policies and procedures;
(g)
Curriculum materials;
(h)
Cooperating clinical agency contractual agreements;
(i)
Program evaluation plan and evidence of program effectiveness; and
(j)
The program’s current catalog.
(8)
Upon review of the survey report and the results of graduate performance on the National Council Licensure Exam, and an assessment of the program’s continued ability to meet the standards set forth in this chapter, the Board may:
(a)
Grant reapproval;
(b)
Place the program on conditional approval; or
(c)
Withdraw approval in accordance with Regulation .17 of this chapter.
(9)
Reapproval, if granted, shall be valid for not more than:
(a)
10 years for a program accredited by a BRNAA; and
(b)
5 years for a program without BRNAA accreditation.
Regulation .19 Closure of Programs.LinkCopy Citation
A.
Upon request, the Board shall provide consultation concerning closing of a program.
B.
Upon the decision by a program to close, and at least 90 days before closing, the nurse administrator shall notify the Board of its intent, giving the following information:
(1)
Date and reason for closing;
(2)
Plans for phasing out the program;
(3)
Disposition of the records of students, graduates, and faculty; and
(4)
Title of the position of the individual to be responsible for the records and the name of the agency in which the records will be located.
Chapter annotations
Authority: Health Occupations Article, §§8-205, 8-401, and 8-404, Annotated Code of Maryland
History: Effective date: April 16, 1975 (2:8 Md. R. 566)
History: Chapter revised effective August 30, 1982 (9:17 Md. R. 1708)
History: Regulation .01 amended effective November 21, 1983 (10:23 Md. R. 2064); August 11, 1986 (13:16 Md. R. 1827)
History: Regulation .03 amended effective August 11, 1986 (13:16 Md. R. 1827)
History: Regulation .04 amended effective August 11, 1986 (13:16 Md. R. 1827)
History: Regulation .05 amended effective August 11, 1986 (13:16 Md. R. 1827)
History: Regulation .06 amended effective August 11, 1986 (13:16 Md. R. 1827)
History: Regulation .08 repealed and new Regulation .08 adopted effective August 11, 1986 (13:16 Md. R. 1827)
History: Regulation .09 amended effective November 21, 1983 (10:23 Md. R. 2064)
History: Regulation .09 repealed and new Regulation .09 adopted effective August 11, 1986 (13:16 Md. R. 1827)
History: Regulation .10 amended effective November 21, 1983 (10:23 Md. R. 2064)
History: Regulation .13 adopted effective November 21, 1983 (10:23 Md. R. 2064)
History: Regulations .01—.13 repealed and new Regulations .01—.20 adopted effective September 30, 1991 (18:19 Md. R. 2100)
History: Regulations .01, .06, .07, .09, and .11 amended as an emergency provision effective April 11, 1994 (21:9 Md. R. 745)
History: Regulation .01B amended effective August 1, 1994 (21:15 Md. R. 1305)
History: Regulation .06 amended effective August 1, 1994 (21:15 Md. R. 1305); February 12, 1996 (23:3 Md. R. 169)
History: Regulation .06A, B amended effective February 15, 1993 (20:3 Md. R. 259)
History: Regulation .07 amended effective August 1, 1994 (21:15 Md. R. 1305)
History: Regulation .09 amended effective August 1, 1994 (21:15 Md. R. 1305)
History: Regulation .11D amended effective August 1, 1994 (21:15 Md. R. 1305)
History: Regulations .01—.20, Registered Nursing Education Programs, repealed and new Regulations .01—.19, Nursing Education Programs, adopted effective August 10, 1998 (25:16 Md. R. 1274)
History: Chapter revised effective March 5, 2001 (28:4 Md. R. 418)
History: Regulation .02G amended effective July 18, 2005 (32:14 Md. R. 1276)
History: Regulation .02I amended effective February 18, 2002 (29:3 Md. R. 220)
History: Regulation .03A amended effective February 18, 2002 (29:3 Md. R. 220); July 18, 2005 (32:14 Md. R. 1276)
History: Regulation .08 amended as an emergency provision effective August 1, 2003 (30:19 Md. R. 1327); amended permanently effective January 5, 2004 (30:26 Md. R. 1915)
History: Regulation .08B amended as an emergency provision effective May 23, 2008 (35:13 Md. R. 1178); amended permanently effective August 25, 2008 (35:17 Md. R. 1489)
History: Chapter revised as an emergency provision effective November 3, 2008 (35:24 Md. R. 2069); revised permanently effective January 26, 2009 (36:2 Md. R. 101)
History: Regulation .01B amended effective July 2, 2018 (45:13 Md. R. 667); February 22, 2021 (48:4 Md. R. 177)
History: Regulation .02 amended effective February 22, 2021 (48:4 Md. R. 177)
History: Regulation .03B amended effective February 22, 2021 (48:4 Md. R. 177)
History: Regulation .05 amended effective February 22, 2021 (48:4 Md. R. 177)
History: Regulation .07A amended effective July 2, 2018 (45:13 Md. R. 667)
History: Regulation .08 amended effective February 22, 2021 (48:4 Md. R. 177)
History: Regulation .08A, C amended effective July 2, 2018 (45:13 Md. R. 667)
History: Regulation .09A amended effective February 22, 2021 (48:4 Md. R. 177)
History: Regulation .11 amended effective February 22, 2021 (48:4 Md. R. 177)
History: Regulation .12D, E amended effective February 22, 2021 (48:4 Md. R. 177)
History: Regulation .13 amended effective February 22, 2021 (48:4 Md. R. 177)
History: Regulation .14 amended effective February 22, 2021 (48:4 Md. R. 177)
History: Regulation .15 amended effective February 22, 2021 (48:4 Md. R. 177)
History: Regulation .16 amended effective February 22, 2021 (48:4 Md. R. 177)
History: Regulation .17 amended effective February 22, 2021 (48:4 Md. R. 177)
History: Regulation .18 amended effective February 22, 2021 (48:4 Md. R. 177)