21 N.C. Admin. Code 36.0220

Current through Register Vol. 39, No. 9, November 1, 2024

Section 36 .0220 - REFRESHER COURSE

(a) A refresher course shall be designed for those individuals, previously licensed, who are not eligible for re-entry into nursing practice because their license has expired for five or more years.

(b) Satisfactory completion of a Board-approved refresher course shall be required of the individual who has not held an active license in any jurisdiction for five or more years and requests:

(1) reactivation of an inactive license;

(2) reinstatement of an expired license; or

(3) endorsement to North Carolina.

(c) If satisfactory completion of a Board-approved refresher course is required by the Board based upon action as authorized in G.S. 90-171.37 or based upon a license being inactive due to disciplinary action, the individual may be subject to Board-stipulated restrictions in the clinical component of the refresher course, based upon the terms of the disciplinary actions and the contents of the clinical components. All eligibility requirements for reinstatement of the license shall have been met prior to refresher course enrollment.

(d) Application for approval of a refresher course shall be completed and submitted by the provider at least 90 days prior to the expected date of enrollment and shall include evidence of complying with the rules as defined in this Chapter for refresher courses. No student shall be enrolled prior to Board approval. Board approval shall be granted to a provider for a period of time not to exceed five years. All changes in faculty, curriculum, or clinical facilities shall be approved by the Board prior to implementation, as set out in the Rules of this Chapter.

(e) The application for approval of a refresher course shall include:

(1) course objectives, content outline, and time allocation;

(2) didactic and clinical learning experiences, including teaching methodologies for measuring the registrant's abilities to practice nursing;

(3) a plan for evaluation of student competencies and ability to competently practice nursing;

(4) a faculty list that includes the director and all instructors, and identifies their qualifications and their functions in teaching roles; and

(5) the projected clinical schedule.

(f) The Board shall make site visits if it is unable to determine that all requirements have been met through application document review. A decision on an application to offer a refresher course shall be given within 30 days following receipt of a complete application.

(g) A provider of a refresher course shall be approved by the Board as set out in these Rules. A provider may be a post-secondary educational institution, a health care institution, or other agency.

(h) Administrative responsibility for developing and implementing a refresher course shall be vested in a registered nurse director.

(i) Instructors in the course shall be directly accountable to the nurse director. The director shall have had at least one year prior teaching experience preparing individuals for registered nurse or licensed practical nurse licensure at the post-secondary level or in a nursing staff development position. The director and each instructor shall:

(1) hold an active unencumbered license to practice as a registered nurse in North Carolina;

(2) hold a baccalaureate or higher degree in nursing; and

(3) have had at least two years experience in direct patient nursing practice as a registered nurse.

(j) Proximity of the instructor to students is the major factor in determining faculty-student ratio for clinical learning experiences. The ratio of instructors to students shall not exceed 1:10.

(k) Clinical preceptors shall have competencies, assessed by the registered nurse director of the refresher course or a designated instructor, related to the area of assigned clinical precepting responsibilities. Clinical preceptors shall hold an active unencumbered license to practice as a registered nurse in North Carolina.

(l) The refresher course shall include both theory and clinical instruction. Course objectives shall be stated that:

(1) show relationships between nursing theory and practice; and

(2) identify behaviors consistent with the ability to competently practice nursing.

(m) The curriculum for a registered nurse refresher course shall include at least 240 hours of instruction, at least 120 of which shall consist of clinical learning experiences, and shall incorporate:

(1) the scope of practice for the registered nurse, as defined in G.S. 90-171.20 and 21 NCAC 36 .0221, 36 .0224, 36 .0225 and 36 .0401; and

(2) instruction in and opportunities to demonstrate knowledge, skills, and abilities to competently practice nursing according to components of practice for the registered nurse as defined in 21 NCAC 36 .0224.

(n) The curriculum for a licensed practical nurse refresher course shall include at least 180 hours of instruction, at least 90 of which shall consist of clinical learning experiences, and shall incorporate:

(1) the scope of practice for the licensed practical nurse, as defined in G.S. 90-171.20(8) and 21 NCAC 36 .0221, 36 .0225 and 36 .0401; and

(2) instruction in and opportunities to demonstrate knowledge, skills, and abilities to competently practice nursing according to components of nursing practice for the licensed practical nurse as defined in 21 NCAC 36 .0225.

(o) The refresher course director or the designated refresher course instructor shall assess each refresher student and ensure the appropriateness of all clinical learning settings and assignments.

(p) Registered nurse and licensed practical nurse refresher courses shall limit simulation experiences to no more than 50 percent of clinical learning experiences, pursuant to 21 NCAC 26 .0321(m).

(q) Evaluation processes shall be implemented that effectively measure the refresher student's ability to competently practice nursing consistent with the level of licensure and scope as set forth in 21 NCAC 36 .0221, 36 .0224, 36 .0225, and .0401.

(r) Clinical resources shall indicate, in written contract, support and availability to provide the necessary clinical experiences.

(s) Individuals previously licensed in North Carolina and presently residing outside of North Carolina may meet the requirements of this Rule by successfully completing a refresher course approved by another state board of nursing.

(t) Individuals enrolled in refresher courses shall identify themselves as RN Refresher Student (R.N.R.S.) or LPN Refresher Student (L.P.N.R.S.), consistent with the course level, after signatures on records or on name pins.

(u) In a format specified by the Board, the course provider shall provide the Board with the names and license numbers of those individuals who have satisfactorily completed the refresher course at the appropriate level of licensure on the Board supplied form.

(v) Upon request, the Board shall provide:

(1) a list of approved providers;

(2) the format for applications for program approval; and

(3) the format for verification of successful completion to all approved programs.

21 N.C. Admin. Code 36 .0220

Authority G.S. 90-171.23(b)(3); 90-171.35; 90-171.36; 90-171.37; 90-171.38; 90-171.83;
Eff. May 1, 1982;
Amended Eff. January 1, 2007; July 1, 2000; June 1, 1993; April 1, 1989;
Readopted Eff. January 1, 2019.

Authority G.S. 90-171.23(b)(3); 90-171.35; 90-171.36; 90-171.37; 90-171.38; 90-171.83;
Eff. May 1, 1982;
Amended Eff. January 1, 2007; July 1, 2000; June 1, 1993; April 1, 1989.

Readopted by North Carolina Register Volume 33, Issue 15, February 1, 2019 effective 1/1/2019.