Title: Improved Nursing Licensure Exam Pass Rates Result From Refresher Design
1Improved Nursing Licensure Exam Pass Rates Result
From Refresher Design
- Matthew Grayson South Bay RHORC, Mission College
- Patricia Perkins, Interior Bay Area RHORC, CCSF
- Healthcare Initiative of the Economic Workforce
Development Programs - California Community Colleges Chancellors Office
- Data presented here were supported in part by
grant agreements 04-307-011 and 05-307-015
through annual funding from the California
Community Colleges Chancellors Office.
2About the EWD Program
- Mission of the EWD Program is to advance
Californias economic growth and global
competitiveness through quality education and
services
3Health Care Delivery Initiative
California Community College Economic Workforce
Development
4The Mission
To promote the advancement of Californias health
and Economic growth through quality education and
services focusing on workforce development and
continuous workforce improvement in health care
delivery.
5Health Care Initiatives Purpose
- Identify health care workforce development needs
- Develop solutions through a comprehensive
problem-solving process - assessment and analysis,
- planning and development,
- implementation and
- evaluation.
6Regional Health OccupationsResource Centers
- RHORCs
- Strategically located Statewide
- Facilitate collaboration between the education
segments and the health care delivery system to
respond to identified needs
7North/Far North RHORC - Butte College, Chico
Health Initiative Office -Sacramento City College
- Sacramento
EWD Health Care Delivery Initiative
Interior Bay RHORC - City College of San Francisco
Bay Area RHORC-Mission College, Santa Clara
Central RHORC-Hartnell College, Salinas
LA County RHORC - Mt. San Antonio College, Walnut
Orange County RHORC Golden West College,
Huntington Beach
South Coast RHORC - Santa Barbara City College
San Diego/Imperial RHORC - Grossmont College, El
Cajon
8Acknowledgements
- For LVN Refresher Development at CCSF Jewish
Vocational Services, San Francisco The
California Endowment, Woodland Hills, CA - For Implementation of the LVN Refresher at
Mission College The Health TrustTM, San Jose, CA - For Travel and Presentation Costs at CCCAOE
CCCCO Grants 04-307-011 05-307-015
9Acknowledgements
- Sylvia Moreno, LCSW formerly CCSF Welcome Back
Program, now Mission Neighborhood Health Center
for - Jim Torrens, MSW Jewish Vocational Services, San
Francisco for helping to institutionalize the
LVN Refresher program at CCSF - Naomi Marcus, MSW formerly Jewish Vocational
Services, now CCSF Welcome Back, for provision of
background history
10Need for LVN Refresher
- Goal of Healthy People 2010 Goal 23-8
- skilled workforce must be culturally and
linguistically competent to understand the needs
of and deliver services to select populations and
to have sensitivity to diverse populations - (see http//www.healthypeople.gov)
11Other Needs Address Nursing Shortage in Bay Area
- LVN Refresher Program helps identify, train, and
prepare for nurse licensure exams foreign trained
nurses for practice in acute care, nursing home,
and community clinic settings. - Satisfy goals of Healthy People 2010 and
consistent with RHORCs and community colleges
overall mission.
12Background to LVN Refresher Program
- History Academic-community partnership CCSF,
SFSU and community-based organization (CBO)
SF-based Jewish Vocational Services (JVS) - Partnership of long-term collaborators in health
training and social services delivery to
immigrants and displaced workers, even prior to
RHORC or Welcome Back
13Background to LVN Refresher, Cont.
- From 1990-95, JVS provided intensive case
management for foreign trained immigrant nurses
(Russian/former Soviet Union) RNs and US
nationals returning to nursing workforce. - For foreign-trained nurses, NCLEX pass rates
above 90 but unable to retain in full-time
hospital jobs - Language, cultural negotiation, and lack of
understanding of scope of practice and US
healthcare systems roadblocks to sustained
employment
14Background to LVN Refresher, Cont.
- JVS Executive Director approached Dean of SFSU
Nursing Program to develop a curriculum specific
to the RN Russian immigrant community - RN Refresher Course offered 3 times/year,
17-week, one semester course, from 1992-95
grant-funded - LVN Refresher developed out of the RN Refresher
with modifications for scope of practice
differences
15Background to LVN Refresher, Cont.
- Both the RN the LVN curricula include
- hospital clinical rotations
- medico-legal ethical issues
- RN and/or LVN scope of practice
- US healthcare system 101
- Working/studying in a dynamic and diverse
multi-ethnic and linguistic community difficult
for people coming from largely mono-ethnic/racial
cultures
16Background to CCSF JVS Collaboration
- By 1995, program shifts at JVS, with influx of
Bosnian other Eastern Europe refugees, and
mixture of persons from Central Latin America - Fewer openings for RNs as result of hospital
consolidation. In 1995, no recognition of nursing
shortage. - Results less placement opportunities for foreign
trained RNs
17Background to CCSF JVS, cont.
- Industry need JVS CCSF approached by area
health departments on expansion of LVN education
for skilled nursing, community clinics, SFGH - Board Response JVS and CCSF board members
shepherded concept of LVN Refresher to private
funders and CCSF nursing department
18Welcome Back Program Support
- Mission To build a bridge between the pool of
internationally trained health workers living in
California and the need for linguistically and
culturally competent health services in
underserved communities. - Funded through The California Endowment and now a
host of local, corporate, and national
foundations - Welcome Back RHORC funded the continued upgrade
of the LVN Refresher Program at CCSF, including
the programs case management delivery system
with JVS from 2001 to 2003.
19Welcome Back Program Support, cont.
- Program institutionalized at CCSF Spring 2004
JVS continues to provide case management, student
transportation stipends, childcare - Success at CCSF included 95 retention and 92
pass rate on the VN exam and/or the NCLEX RN exam
20LVN Refresher ExpansionMission College, Santa
Clara, CA
- Program and Grant Development
- Faculty and Curriculum
- Student Assessment and Placement
- Case Management and Social Worker Support
- Challenges
- Critical Pathway
- Successes
- Primary Recommendations
21Program and Grant Development
- In spring 2003, CCSF RHORC assisted with grant
development with Mission College for program
replication in Santa Clara - Program funded by Health Trust winter 2004
- Spring 2004, WB case manager Sylvia Moreno
assisted with goal to select 30 board eligible
foreign trained RNs residing in South Bay, all of
whom were WB participants
22Program and Grant Development
23Program and Grant Development
- Goals and Objectives
- Educate 30 foreign-trained nurses (100 hours)
- Pass Rate 14 out of 30
- Create Ongoing Program
- Share Best Practices and Program Development
242005 Number of Candidates Taking NCLEX
Examination and Percent Passing, by Type of
Candidate
- PN2
- Jan-Mar 2005 Apr-Jun 20053 Jul-Sep 2005 Year
to Date Total -
- First Time, US Educated
- 12,090 90.6 9,211 88.3 19,931 90.2 41,232 89.
9 - Repeat, US Educated
- 2,169 46.9 2,079 38.7 2,020 42.4 6,268 42.7
- First Time, Internationally Educated
- 410 55.1 480 49.4 430 47.4 1,320 50.5
- Repeat, Internationally Educated
- 372 25.3 451 18.4 458 22.1 1,281 21.7
- All Candidates
- 15,041 81.7 12,221 75.8 22,839 83.8 50,101 81
.2
252005 Number of Candidates Taking NCLEX
Examination and Percent Passing, by Type of
Candidate
- RN1
- Jan-Mar 2005 Apr-Jun 2005 Jul-Sep 2005 Year
to Date Total -
- First Time, US Educated
- Diploma 887 887 89.2 679 92.2 1,499 91.0 3,06
5 90.7 - Baccalaureate Degree 7,335 87.6 9,391 90.7 15,
691 85.1 32,417 87.3 - Associate Degree 12,189 86.7 17,480 90.7 25,86
0 87.0 55,529 88.1 - Invalid or Special 27 77.8 15 73.3 29 75.9 71
76.1 Program Codes - Total First Time, US Educated
- 20,438 87.1 27,565 90.7 43,079 86.4 91,082 8
7.9 - Repeat, US Educated
- 4,534 48.3 4,903 53.8 6,019 57.7 15,456 53.7
- First Time, Internationally Educated
- 3,838 58.1 4,489 57.2 4,379 56.2 12,706 57.1
- Repeat, Internationally Educated
- 3,434 27.0 4,106 26.9 3,928 26.9 11,468 26.9
- All Candidates
- 32,244 71.8 41,063 76.3 57,405 77.0 130,712
75.5
26Faculty and Curriculum
- Selection of Committed Faculty
- Identify Instructors
- Use Specialist OB/Gyn, Pedi, Psych
- Review Curriculum
- Foundations of Ideology
- Student Population Matchup
- Continued in Challenges
27Student Assessment and Placement
- Welcome Back Partnership
- Well Known Organization throughout Bay Area
- Purpose Filter foreign-trained health
professionals into appropriate health education
programs to enable re-entry into the workforce - Rely on referrals from WB to acquire 30 students
- Provide Case Management and Social Work Support
- ESL and Math Placement Testing at Mission College
28Case Management and Social Worker Support
- Student Placement Mission College
- ESL, Math, ATI Tests
- Educational Plan Welcome Back
- Review Class
- Future Planning to Become RN
- Time Management Welcome Back
- Confidence Support Welcome Back
- Students need to reconnect with their
skills/abilities
29Challenges
- Student Preparation Evaluation
- ESL Placement
- BVNPT Board Qualification Transcripts
- One Plan for Student Recruitment vs. Time
- Social Support Network
- Family Commitment
- Time Management
- Reality Check
30Challenges
- Curriculum Content and Faculty
- No Lead Instructor Coordinating
- Ideological Differentiation Between Faculty
- Skills and Abilities of Students Must be Verified
Prior to Clinical Rotations - Do Not Use Clinical Rotations for Observation
Time - Changing Leadership
- 3 RHORC Directors Over Life of Program
31Successes
- 5 students passed the NCLEX-RN
- 5 students passed the NCLEX-PN
- Gained further understanding on how to educate
foreign-trained professionals. - Significantly changed the lives of 10 people.
- Appropriately met Healthy People 2010 goals and
hospitals workforce needs. - Commitment and Flexibility of Faculty
32Primary Recommendations
- Review South Bay RHORC LVN Refresher Program
Workplan - Participants View Workplan From Your Packets
33Critical Pathway
34Primary Recommendations
- Identify Lead Instructor
- Establish Minimum ESL Level (ESL 960 for Mission
College, Santa Clara, CA) - Require BVNPT or BRN Approval Letters To Take
NCLEX-PN or RN by 3rd Week of Class - Counseling Student Placement, Educational Plan,
Time Management, Confidence Support - Identify Ongoing Funding
35Questions And Answers
- LVN Refresher Program Budget Information
Available from Matthew Grayson. - Thank You For Attending This Workshop
- For More Information You May Contact
- matthew_grayson_at_wvmccd.cc.ca.us
- rhorc_at_sfsu.edu