Mo. Code Regs. tit. 20 § 2200-8.100

Current through Register Vol. 49, No. 24, December 16, 2024

Section 20 CSR 2200-8.100 - Educational Program

PURPOSE: This amendment aligns clinical simulation and distance education with the nursing curriculum.

(1) General Purpose.

(A) The program shall have a philosophy and/or mission which guides the curriculum practices.

(B) The curriculum incorporates established professional standards, guidelines, and competencies with clearly stated objectives, graduate competencies, and program outcomes.

(C) The educational program shall provide planned learning experiences essential to the achievement of the stated philosophy and/or mission and graduate competencies of the program and demonstrate logical progression.

(D) The educational program shall provide clinical education to facilitate transition to practice as a practical nurse, which includes clinical decision making, leadership, and management under the supervision of a registered nurse or a physician.

(E) Clinical learning should focus on Maternal/Newborn, Pediatric, Geriatric, and Complex Care Nursing (chronic illness care and multiple comorbidities); although Medical-Surgical Nursing should be included.

(F) The program that uses clinical simulation shall adhere to model standards of best practice. Mapping of clinical simulation experiences to course and clinical objectives as well as graduate competencies should be documented.

(G) The plan of study may be implemented in traditional or blended format. No more than twenty-five percent (25%) of theory instruction shall be delivered through distance learning.

(2) Curriculum Organization and Development.

(A) The nursing faculty shall have the authority and the responsibility to develop, implement, and evaluate the curriculum. Student learning experiences shall be directed and evaluated by the faculty and be consistent with the curriculum plan.

(B) There shall be a written curriculum plan that is logically structured to achieve expected individual and aggregate student outcomes.

(C) Curriculum design of the program shall foster seamless academic articulation toward a program of professional nursing.

(D) Policies for evaluation and awarding of credit for military education, training, and service that shall be in place.

(E) Number of credit or clock hours required for completion of the program shall not exceed seventeen (17) credit hours equivalent to four hundred (400) clock hours of instruction. This shall include no more than twelve (12) credit hours (one hundred eighty (180) clock hours) of theory and five (5) credit hours (two hundred twenty (220) clock hours) of lab/clinical/simulation instruction.

(F) Adjustments in credit or clock hour requirements shall be approved by the board.

(G) Total number of clock or credit hours, to include credit transcripted for military education, training, and service, shall not exceed clock or credit hour requirements of a comparable (generic) program of practical nursing.

(3) Curriculum Requirements. Content may be developed as a separate course or integrated. Integrated concepts shall be evident in the course objectives.

(A) Nursing Science. Theory and clinical instruction in nursing shall be based on the nursing process and encompass the promotion, maintenance, and restoration of physical and mental health and the prevention of illness for individuals and groups throughout the life cycle. Content shall enable the student to develop competency in each of the following areas while preparing for safe and effective practice as a practical nurse.

(B) The following program outcomes and competencies shall be addressed:

1. Discuss the differences between current military healthcare role and practical nursing;

2. Demonstrate therapeutic communication skills and caring behaviors to clients and their families across the lifespan;

3. Demonstrate critical thinking skills and problem-solving to provide holistic nursing care to clients;

4. Review types, classifications, pharmacokinetics, and pharmacodynamics properties of selected drugs;

5. Apply principles of safe medication administration for childbearing, pediatric, adult, and geriatric clients;

6. Perform data collection techniques for childbearing, pediatric, adult, and geriatric clients;

7. Implement the established plan of care for childbearing, pediatric, adult, and geriatric clients;

8. Apply anatomy, physiology, and pathophysiologic concepts to the care of clients with selected health alterations across the lifespan;

9. Apply integrated nutritional concepts that support health promotion and disease prevention to clients across the lifespan;

10. Describe laboratory and diagnostic examinations utilized for selected health alterations throughout the lifespan;

11. Identify developmental stages and transitions for adult, child-bearing, pediatric, and geriatric clients;

12. Demonstrate safe techniques and competent care in providing interventions for clients receiving intravenous therapy;

13. Calculate medication dosages safely and accurately;

14. Practice within the regulatory, legal, and ethical frameworks of practical nursing;

15. Demonstrate safe performance of selected clinical skills/procedures;

16. Communicate significant client findings and events to the registered nurse and other members of the healthcare team;

17. Demonstrate culturally sensitive, patient-centered care;

18. Describe the role of the practical nurse in the management of a group of clients under the direction of a registered nurse using time management, interpersonal communication, delegation, and organizational skills;

19. Apply elements of technology and information management to document and report client findings and conditions;

20. Demonstrate safe and competent care in providing nursing interventions for clients across the lifespan;

21. Identify various healthcare roles that are part of the healthcare team and differentiate the LPN role as defined by the Missouri State Board of Nursing;

22. Identify and complete the necessary steps of the licensure process;

23. Demonstrate skills that will aid in obtaining a position as a licensed practical nurse;

24. Apply principles of lifelong learning; and

25. Demonstrate preparedness to face unique psychosocial, spiritual, and physical stressors that healthcare professionals may encounter while carrying out their duties.

(4) Instruction shall be provided in the following areas:

(A) Foundations/Fundamentals of Nursing Care: Theory-four (4) credit hours (sixty (60) clock hours); lab/clinical/simulation- one and one-half (1.5) credit hours (sixty-eight (68) clock hours).

1. Clinical skills and therapeutic procedures.

A. Assisting with activities of daily living-

(I) Feeding;

(II) Dressing;

(III) Bathing;

(IV) Positioning;

(V) Ambulating/transferring patients;

(VI) Toileting; and

(VII) Grooming.

2. Vital Signs-Measurement of body temperature, pulse, respirations, and blood pressure.

3. Pain management.

4. Internal/external disaster planning.

5. Handling of hazardous and infectious materials.

6. Ergonomic principles.

7. Restraints and safety devices.

8. Admission/discharge/transfer procedures.

9. Wound care.

10. Oxygen therapy, tracheostomy care.

11. Urinary catheterization.

12. Ostomy care.

13. Care of nasogastric and feeding tubes.

14. Chest tube management.

15. Electrocardiogram/cardiac monitoring.

16. Medication administration throughout the lifespan-

A. Medication orders;

B. Drug preparations;

C. Dosage calculations;

D. Preparation of medications;

E. Medication administration methods; and

F. Documentation.

17. Collection of patient data-

A. Full-body assessment; and

B. Focused assessment.

18. Intravenous infusion therapy/venipuncture.

A. Scope of the practical nurse to include review of the-

(I) Missouri State Board of Nursing-Nursing Practice Act;

(II) Legal implications; and

(III) Documentation.

B. Blood collection.

C. Principles of IV therapy-

(I) Routine care and maintenance;

(II) Catheter site care;

(III) Flushing with saline or heparinized saline;

(IV) Client evaluation; and

(V) Equipment.

D. Complications/adverse reactions-

(I) Local;

(II) Mechanical; and

(III) Systemic.

E. Insertion of peripheral-short IV catheters.

F. Discontinuation of peripheral IV catheters-

(I) Peripheral-short.

G. Pharmacokinetics/pharmacodynamics for select IV fluids and medications-

(I) Hypo-/iso-/hypertonic solutions;

(II) Premixed/admixture medications; and

(III) Care of the blood transfusion patient.

H. Dosage calculations/regulating rates.

I. Administration of select intravenous solutions-

(I) Un-medicated solutions; and

(II) Premixed/admixed medications.

J. Care and maintenance of central line.

19. Clinical skills/therapeutic procedures for the child-bearing. Client/family/neonate.

A. Data collection.

20. Clinical skills/therapeutic procedures for the pediatric client.

A. Data collection;

(B) Medical-Surgical Nursing Through the Lifespan: Theory- four (4) credit hours (sixty (60) clock hours); Lab/clinical/simulation- two and one-half (2.5) credit hours (one hundred twelve (112) clock hours).

1. Holism.

A. Developmental life span considerations.

B. Stages of growth and development for pediatric/adult/geriatric and childbearing patients.

C. Health promotion and disease prevention for pediatric/adult/geriatric and childbearing patients.

2. Safe nursing practice.

A. Nursing care of adult/geriatric/pediatric patients with select alterations in health, human anatomy/physiology/pathophysiology, applicable laboratory and diagnostic examinations, medical management, nursing process, pharmacokinetics and pharmacodynamics of applicable medication classifications, diet and nutritional therapy-

(I) Disorders of the cardiovascular and peripheral vascular system;

(II) Disorders of the respiratory system;

(III) Disorders of the gastrointestinal system;

(IV) Disorders of the endocrine system;

(V) Disorders of the immune system;

(VI) Disorders of the integumentary system;

(VII) Disorders of the hematologic and lymphatic system;

(VIII) Disorders of the reproductive system;

(IX) Disorders of the musculoskeletal system;

(X) Disorders of the genitourinary system;

(XI) Disorders of the neurologic system;

(XII) Fluid/electrolyte and acid/base imbalances;

(XIII) Cancer;

(XIV) Mental health disorders-

(a) Behavior management;

(b) Crisis intervention;

(XV) Surgical patient-

(a) Preoperative;

(b) Intraoperative;

(c) Postoperative;

(C) Maternal/Newborn Nursing Practice: theory- two (2) credit hours (thirty (30) clock hours); lab/clinical/simulation- one (1) credit hour (forty (40) clock hours).

1. Nursing care of the antepartum patient and family.

2. Nursing care of the intrapartum patient and family.

3. Nursing care of the postpartum patient and family.

4. Nursing care of the neonate;

(D) Personal and vocational concepts shall exist as a discrete course in the curriculum; and include the following content and meet credit or clock hour requirements: Theory- two (2) credit hours (thirty (30) clock hours).

1. Critical thinking.

A. Nursing process-

(I) Data collection (assessment)-

(a) Components of a health history;

(b) Full versus focused assessment;

(II) Diagnosis;

(III) Planning;

(IV) Implementation;

(V) Evaluation.

B. Documentation-

(I) Electronic health records.

C. Therapeutic communication-

(I) Caring for the pediatric/adult/geriatric and childbearing patient.

2. Role development.

A. Collaboration within the healthcare team-

(I) Communication;

(II) Conflict resolution;

(III) Delegation;

(IV) Role in patient education, discharge planning, and patient involvement;

(V) Inter-professional patient care;

(VI) Continuous quality improvement.

B. Scope of practice-

(I) Nursing history and trends;

(II) Role transition;

(III) Standards of practice for the PN, RN;

(IV) State Nurse Practice Act;

(V) Agency specific guidelines.

C. Legal and ethical considerations in patient care.

D. Licensure process-

(I) National Council Licensure Examination;

(II) State Board of Nursing.

E. Transition into employment/further education-

(I) Professional appearance;

(II) Professional communication;

(III) Resumes;

(IV) Interview skills;

(V) Leadership and management-

(a) Concepts of delegation;

(b) Prioritization of care;

(VI) Life-long learning.

3. Holism.

A. Religious and spiritual considerations.

B. Cultural considerations;

(E) External nursing examinations, if used, shall not be used solely for program progression or graduation.

(5) Syllabus Construction. Syllabi shall be current and available to all faculty, students, and cooperating agencies. Each syllabus shall include:

(A) Course title, current date and year the course is offered, and required pre-requisites;

(B) Course description;

(C) Course objectives;

(D) Teaching or learning strategies;

(E) Evaluation methodologies;

(F) Grading scale;

(G) Course policies; and

(H) Clock hour requirements related to theory, lab, and clinical instruction. Each syllabus should reflect credit hour requirements for theory, lab, and clinical instruction, if used.

(6) Distance Education Measures and Opportunities.

(A) Veteran's Bridge programs and courses to practical nursing in part through distance education technologies shall meet the same academic program and learning standards as programs provided in face-to-face format, to include the following:

1. Budgetary support specific to distant learning resources;

2. Course management/delivery platform(s) that are reliable and navigable for students and faculty including measures to ensure exam security shall be in place;

3. Sufficient technical support to assist students and faculty to consistently meet program outcomes including communication of available technical support should be provided to students;

4. Learning and technology resources, to include library resources, that are selected with input of the nursing faculty and are comprehensive, current, and accessible to students and faculty;

5. Student outcomes consistent with stated mission, goals, and objectives of the program;

6. Collaborative and interactive learning activities that assist students in achieving course objectives;

7. Planned, faculty-guided clinical learning experiences that involve direct contact with patients;

8. Learning opportunities that facilitate development of students' clinical competence and judgment, role socialization, and transition to nursing practice;

9. Evaluation of student outcomes at set intervals;

10. Tracking of student retention and completion rates;

11. Faculty and student input into the evaluation process; and

12. Evidence that outcome data are consistently utilized to plan and improve distance learning.

20 CSR 2200-8.100

Adopted by Missouri Register September 1, 2017/Volume 42, Number 17, effective 10/31/2017

Amended by Missouri Register July 2, 2018/Volume 43, Number 13, effective 8/31/2018

Amended by Missouri Register July 15, 2022/Volume 47, Number 14, effective 8/31/2022