University of Hawaii Community Colleges
Instructional Annual Report of Program Data (ARPD)

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Review Year: College: Program:

College: University of Hawaii Maui College
Program: Nursing: Practical Nursing

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The last comprehensive review for this program was on February 2007. The written report is in the Nursing Office. Next review will be Spring 2015., and can be viewed at:
http://www.nlnac.org/forms/directorySearch.asp
STEM Program

Program Description

In the midst of innovation of our approach to curriculum, these are evolving statements, but the following web pages provide the goals and ideals that are essential to the success of the nursing program:

http://maui.hawaii.edu/nursing/program-learning-outcomes/

http://maui.hawaii.edu/nursing/philosophy/

The developing updates of our Vision and Mission statements are as follows:

Vision: We envision a nursing education program that produces caring, competent, and professional nurse leaders prepared to meet the healthcare demands of the community and the challenges of a dynamic healthcare system.

Mission: The mission of the UHMC nursing program is to provide a collaborative learning environment with access to multiple levels of nursing education, offering personal enrichment and career opportunities for our students. We create a rich learning community in which faculty, staff, and students from diverse backgrounds work together with the community at large to provide state of the art nursing education and practice.

Core values:

Part I. Quantitative Indicators

Overall Program Health: Cautionary

Majors Included: PRCN

Demand Indicators Program Year Demand Health Call
09-10 10-11 11-12
1 New & Replacement Positions (State) 63 72 78 Unhealthy
2 *New & Replacement Positions (County Prorated) 8 7 6
3 *Number of Majors 90 81 88
4 SSH Program Majors in Program Classes 1,543 1,936 1,917
5 SSH Non-Majors in Program Classes 25 87 147
6 SSH in All Program Classes 1,568 2,023 2,064
7 FTE Enrollment in Program Classes 52 67 69
8 Total Number of Classes Taught 24 19 11

Efficiency Indicators Program Year Efficiency Health Call
09-10 10-11 11-12
9 Average Class Size 29.2 31.7 37.7 Healthy
10 *Fill Rate 96% 86% 94%
11 FTE BOR Appointed Faculty 10 10 10
12 *Majors to FTE BOR Appointed Faculty 9.0 8.1 8.8
13 Majors to Analytic FTE Faculty 46.5 36.2 43.2
13a Analytic FTE Faculty 1.9 2.2 2.0
14 Overall Program Budget Allocation $693,653 $614,401 $628,284
14a General Funded Budget Allocation $714,153 $548,901 $364,912
14b Special/Federal Budget Allocation $0 $0 $0
14c Tuition and Fees Not Reported Not Reported $263,372
15 Cost per SSH $442 $304 $304
16 Number of Low-Enrolled (<10) Classes 0 1 0

Effectiveness Indicators Program Year Effectiveness Health Call
09-10 10-11 11-12
17 Successful Completion (Equivalent C or Higher) 96% 97% 87% Cautionary
18 Withdrawals (Grade = W) 17 17 9
19 *Persistence (Fall to Spring) 52% 83% 96%
20 *Unduplicated Degrees/Certificates Awarded 228 202 66
20a Degrees Awarded 0 0 0
20b Certificates of Achievement Awarded 70 76 66
20c Advanced Professional Certificates Awarded 0 0 0
20d Other Certificates Awarded 158 126 0
21 External Licensing Exams Passed Not Reported Not Reported 100%
22 Transfers to UH 4-yr 1 5 1
22a Transfers with credential from program 0 0 0
22b Transfers without credential from program 1 5 1

Distance Education:
Completely On-line Classes
Program Year  
09-10 10-11 11-12
23 Number of Distance Education Classes Taught 0 0 0  
24 Enrollment Distance Education Classes 0 0 0
25 Fill Rate 0% 0% 0%
26 Successful Completion (Equivalent C or Higher) 0% 0% 0%
27 Withdrawals (Grade = W) 0 0 0
28 Persistence (Fall to Spring Not Limited to Distance Education) 0% 0% 0%

Perkins IV Core Indicators
2010-2011
Goal Actual Met  
29 1P1 Technical Skills Attainment 90.10 100.00 Met  
30 2P1 Completion 45.00 72.73 Met
31 3P1 Student Retention or Transfer 56.00 92.66 Met
32 4P1 Student Placement 51.00 40.00 Not Met
33 5P1 Nontraditional Participation 16.25 15.57 Not Met
34 5P2 Nontraditional Completion 15.15 15.07 Not Met
Last Updated: August 6, 2012
Glossary | Health Call Scoring Rubric

Part II. Analysis of the Program

Practical Nurse (PN) Program Quantitative Indicators (See Appendix p.1-2 for Corrected data.)

Demand Indicators
The data used to prepare the Quantitative Indicators is inaccurate.  The graduation programs from UHMC Dec. 2011 and May 2012 accurately reflects the number of graduates: 66. Data from the IRO indicates 74 majors and from STAR indicates 76 major. 76 is the correct number. The 88 majors listed in the Quantitative indicators are incorrect.

Also, the analysis that the program is “Unhealthy” based on number of positions in the County, 6, is not accurate either.  From the AY 2012 graduating classes, one agency on Maui- Hale Makua, hired 10 LPNs. Another, Maui Memorial Medical Center, hired 8 LPNs, therefore 67% more than the projected need for Maui County. 
A recent article in the Maui News, October 15, 2012 (Appendix p.3) described the goal of completion of the West Maui Hospital by 2015.  The project facility is described as “40 bed skilled nursing facility, 40 bed assisted living facility 30,000 sq. ft. office/clinic.  The proposed facility will provide more than 200 jobs”. It is anticipated that with assisted living facility and clinic facilities a large number of employees will be Licensed Practical nurses.

Effectiveness Indicators

62/66 students who earned their PN certificate passed the Practical Nurse NCLEX exam, on their first attempt, to be awarded their PN license. The UHMC PN program is part of the Nursing Career Ladder and the vast majority of graduates continue immediately into the AS Nursing Program.  Although the graduates are technically enrolled in the PN program their career goal is RN. This year, 60 proceed to their RN year.

All program quantitative indicators are “Healthy”.

 

Perkin’s Core Indicators “unmet” goals

Part III. Action Plan

Specific Action Plans for the PN Program

Part IV. Resource Implications

The following requests will provide significant program enhancement:

Program Student Learning Outcomes

For the 2011-2012 program year, some or all of the following P-SLOs were reviewed by the program:

Assessed
this year?
Program Student Learning Outcomes

1

Yes
Clinical Judgment/Critical Thinking

2

Yes
Written Communication

3

Yes
Evidenced Based Practice

4

No
Oral communication-2012-2013.

5

No
Quantitative Reasoning -2010-2011.

6

No
Information Retrieval -2009-2010.

7

No
Ethics -2012-2013.

8

No
Leadership -2012-2013.

9

No
Health Care Systems -2013-2014.

10

No
Relationship-Centered Care-2009-2010.

11

No
Collaboration with members of the healthcare team -2009-2010.

12

No
Reflection on Practice - assessed 2010-2011.

A) Evidence of Industry Validation

The annual Nursing Advisory Committee provides a forum for agency feedback on graduate performance and reflection.  During planning and transition to the Statewide Nursing Consortium, 2008-2011 Advisory members actively participated in curriculum planning.  Kathy Bauer from Maui Memorial Medical center served on the Review board for the Comprehensive Program Review.

See attached Nursing Advisory Committee, Appendix p.4.

B) Expected Level Achievement

See Appendix p.5  for the entire Program Course Outline.

Clinical evaluation tool contain examples of the student’s critical thinking and clinical judgment skills and must reflect 2 or higher in 210 and 220 to pass the clinical component of the courses.  To advance into the second RN year, the 230 students must:

HESI PN Exit Exam Scores from December 14, 2011 and Julyy 10, 2012 are comparable to, or better than, the national comparison scores for all PN’s. Appendix p. 11-12. There is a 15% improvement from F11(2nd cohort) to the SS12 (3rd cohort), likely due to the maturation of our concept based teaching in the new curriclum.

"HESI Exit Exams Measure students' readiness for the NCLEX® examination with question formats and an exam blueprint matching the latest NCLEX-PN® Test Plan. Parallel versions are available, ensuring your students will never retest with the same exam or questions. No other testing company has a higher rate (100%) of accurately predicting NCLEX-PN® examination success." http://www.elsevieradvantage.com/article.jsp?pageid=10710

94%  of these students passed the NCLEX-PN on their 1st attempt. Appendix p. 13.

The retention rate from the the PN to RN year was 77% (28/36) for the Fall cohort, and 97% (37/38) from the SS group. This difference can be ascribed to individual student performance and issues outside of school for the F11 class. 2 of the F11 students are repeating 230 this F12, and if successful will increase that cohort retention rate to 83.3%.

C) Courses Assessed

HSNC Nursing Competencies: 1st Level-N210, 211, 212, 220, 230
1.  A competent nurse’s professional actions are based on core nursing values, professional standards of practice, and the law.
2.  A competent nurse develops insight through reflective practice, self-analysis, and self care
3.  A competent nurse engages in ongoing self-directed learning and provides care based on evidence supported by research
4.  A competent nurse demonstrates leadership in nursing and health care
5.  A competent nurse collaborates as part of a health care team
6.  A competent nurse practices within, utilizes, and contributes to the broader health care system
7.  A competent nurse practices client-centered care
8.  A competent nurse communicates effectively
9.  A competent nurse demonstrates clinical judgment/critical thinking in the delivery of care of clients while maintaining safety

PLO being assessed and courses being used to assess.

Data will be collected using the Nursing Program Assessment Matrix. 

The plan below illustrates the assessment plan with specific courses over the next five years.

Career Ladder Nursing Program Assessment Plan

Academic Year

NCLEX Results

Clinical Judgment

General Education

Nursing
PLO

2009-2010

X

X
all clinical courses

Standard 3
Information
Retrieval N256L

HSNC Benchmark 5, 7
Collaborates, Relationship Centered Care
ADN grads
Employer evaluations

2010-2011

X

X
all clinical
courses

Standard 2
Quantitative Reasoning
N210, 230 & N360

HSNC Benchmark 2
Reflective Practice
N230 & N360

2011-2012

X

X
all clinical
courses

Standard 1
Written Communication
N210 & N362

HSNC Benchmark 3, 8
Evidenced Based Care, Communication
N360

2012-2013

X

X
all clinical
courses

Standard 4
Oral Communication
N210 & N362

HSNC Benchmark 1, 4
Ethics, Leadership
N360
Employer Evaluation

2013-2014

X

X
all clinical
courses

Standard 5
Critical Thinking
N360

HSNC Benchmark 6, 9
Broader Health Care System, Clinical Judgment
N210 & N360

D) Assessment Strategy/Instrument


Assessment of Program Outcomes will be completed each year based on student achievement on the Nursing Program Assessment

Matrix.  Clinical Judgment Rubric (Appendix p.6-10),and results of National Council State Board of Nursing Practical Nursing Exam

Appendix p. 13) for NURS 210-230 in HSNC (Appendix p. 14-18).

E) Results of Program Assessment

Discovered about student learning:

See Expected Level of Achievement Data

NCLEX-PN pass rate remains high.

Faculty recognized that many of the students presented with a shy and quiet manner and felt that something needed to be done to help students increase their verbal skills and comfort level in the various clinical settings. Starting in the fall of 2011, several assertiveness workshops were offered to students to help them develop these skills. The objectives: identify assertive communications skills; practice these skills in role-playing, and plan for adoption of assertiveness skills in clinical practice.  After reviewing employer feedback on the new graduates need to be more effective in communication and to work more effectively as a team member, faculty need to explore ways of integrating assertive concepts into each course?  With the new curriculum having a stronger focus on communication and team building we anticipate much higher scores in these categories from the facilities that hire our graduates.

N210 Health Promotion Across the Life Span - Course Description:

This first year, first semester nursing course focuses on identifying needs of the total person across the life span in a wellness/health promotion model of care. Introduces the role of the nurse, nursing code of ethics, and the nursing process with emphasis on learning self-health and client health practices. To support self and client health practices, students’ access research evidence about healthy lifestyle patterns and risk factors for disease/illness, apply growth and development theory, interview clients in a culturally-sensitive manner, and work as members of a multidisciplinary team utilizing reflective thinking and self-analysis.

Teaching-Learning Strategies:

This course is designed to facilitate the learner’s understanding and implementation of culturally sensitive health promotion and wellness strategies across thelife span.  A variety of teaching methods are used including but not limited to: lecture, discussion, demonstration, simulation, problem-based learning, role playing,small group activities, student presentations, guest speakers, case studies, writing assignments, and a variety of multimedia presentations.

The course requires students to do a substantial amount of writing--a minimum of 4000 words, or about 16 pages. This may include informal writing. Depending on the course content, students may write analytic essays, critical reviews, journals, lab reports, research reports, or reaction papers, etc.

In-class exams and drafts are not counted toward the 4000-word minimum. In the N210 course, there are five (5) separate scholarly papers assigned aslearning assessments. This requirement, in turn, meets the Writing Intensive Designation criteria as established by the University of Hawai’i at Mano’a.

One example of an assigned course scholarly paper is the Health Fair Written Project. The purpose of this assignment is to assist students in developing critical thinking skills in identifying the health promotion needs of a community. Students use a problem-solving method to develop a health-promotion teaching project. The written project itself is an exercise in students’ ability to analyze the steps in the process, as well as to reflect on further development of professional skills. This Hawai’i Statewide Nursing Consortium Health Fair Written Project reflects all 9 Student Learning Objectives (Competencies) for NUR 210 - Health

Promotion Across the Lifespan.

Performance Outcomes for the Spring 2012 term:

There are 50 points assigned to the Health Fair Written project scholarly paper. Nursing students enrolled in the Spring 2012 term achieved the following grades

upon completion and faculty review of the work submitted:

Overall average score earned in class was 88%

Letter grade A - 23 scores from 90-100%

Letter grade B - 9 scores from 80-89%

Letter grade C - 3 scores from 70-79%

Letter grade D - 1 score from 60-69%

Letter grade F - 1 score from 50-59%

Program Strengths:

 Program Weaknesses:

Community engagement.

The UHMC Nursing Program is closely engaged in the community through a variety of activities including:  directly clinical learning in community sites,

special projects with the agencies, volunteer activities in collaboration with community partners, and faculty participation on community boards and committees.

 Direct clinical learning in Community sites- List of agencies and sites:

Special Projects:

Volunteer Activities:

F) Other Comments

Online Testing

In 2010 the Nursing Program moved to on-line computer testing for all exams. Using Professional Fee resources a computer classroom was created.  Experience with on-line testing is essential for nursing students who will take the all important licensure exam using an on-line format.

Workforce in Health Care
Although there is anecdotal information about “over supply of new nurses” across the United States, all workforce projections, including Hawaii indicate a continuing need for nurses for two key reasons:  age of nursing workforce and age of the population, thus requiring more nursing care.  The UHMC Career Ladder Nursing Program is ideal, providing workforce at the Nurse Aide, Practical Nurse, and Associate Degree Nurse, and easy articulation to the BSN, MSN, and Nurse Practitioner level.


“Employment of registered nurses is expected to grow by 22 percent from 2008 to 2018, much faster than the average for all occupations. Growth will be driven by technological advances in patient care, which permit a greater number of health problems to be treated, and by an increasing emphasis on preventive care. In addition, the number of older people, who are much more likely than younger people to need nursing care, is projected to grow rapidly http://www.hiwi.org/occprofiledata.asp?1=2&session=occdetail&geo=1501000000&geotype=&city=&zip=&radius=.

By 2020, the Hawai’i State Center for Nursing projects a shortage of approximately 2,670 registered nurses in Hawai’i. Nationwide, the Health Resources and Services Administration (HRSA) estimates indicate there will be a shortage of more than 1 million registered nurses by 2020. http://hinursing.org/pdf/ProjectedRNWorkforceHawaii_2007.pdf

G) Next Steps

Specific Action Plans for the PN Program