ITEM 112-2009-R0901    Attachment

Post-Master's Family Nurse Practitioner (FNP) Certificate Program

Objectives and Needs

1.       Centrality to or enhancement of the institutions approved mission and institutional objectives to be achieved by the addition of this program.

Montana State University (MSU) - Bozeman College of Nursing offers the only graduate program in nursing in Montana. It meets the needs of both in-state and out-of-state students through its distance delivery program that can be accessed at one of the college's four campus sites located in Billings, Bozeman, Great Falls and Missoula. The proposed program fits appropriately with the outreach, education and service arms of the universitys mission while helping to meet the primary health care needs of the citizens of Montana.

1.          Goals and objectives

Goals

The proposed 36 credit, non-degree, part-time certificate program will be offered over five semesters. The goals are to provide master's prepared registered nurses with additional didactic and clinical experiences to be eligible for national certification as Family Nurse Practitioners (FNPs) and licensure as advanced practice registered nurses (APRNs) in the state of Montana and beyond. FNPs provide primary health care to families across the lifespan. In addition, the rural nature of the FNP program at MSU-Bozeman combines the practitioner role with the unique features of rurality, rural nursing, and rural health care systems. Socialization into the role of advanced practice as a FNP emphasizes the development of a strong nursing identity as well as preparing the students for interdisciplinary collaboration.

Program Objectives

$                    Manage primary health care of individuals and families throughout the lifespan in environments characterized by sparse populations and limited health care resources.

$                    Demonstrate competency in collaborating with clients to meet their health care needs and goals.

$                    Demonstrate responsibility and accountability for clinical management decisions in accordance with the advanced practice role.

$                    Deliver nursing care based on theory and research to individuals and families in rural areas.

$                    Develop leadership roles within evolving health care delivery systems in rural areas.

$                    Participate in the process of analysis and investigation of nursing problems to develop new insights and build connections between theory, research and clinical practice.

$                    Develop proficiency in collaboration, referral and consultation with other disciplines and consumers.

$                    Demonstrate beginning skill in the role acquisition of the family nurse practitioner.

$                    Develop an active role in rural health care policy and implementation.

2.       Intellectual basis for the curriculum

Two of the objectives of the Rural Family Nurse Practitioner (FNP) program are to: Deliver nursing care based on theory and research to individuals and families in rural areas; and Participate in the process of analysis and investigation of nursing problems to develop new insights and build connections between theory, research and clinical practice. These students will come to the program with graduate education (master's prepared nurses) that included research and theory coursework and the completion of a scholarly project or thesis. This program will build on that background.

3.       Course of study - with draft catalog copy of specific courses required and recommended for completion of the program; with course rubric (dept. and number), credits, course title - indicating required elective, and other courses. Asterisk those which would be new if the program were implemented as proposed. (see Appendices A and B)

4.       Prospective instructional methods or delivery by telecommunications.

1.          If telecommunications will be used, indicate:

1.          The types or levels of courses within the program which would be appropriate for telecommunications,

All of the courses within the program would be appropriate for telecommunications with the exception of the clinical portions (16 crs) of the health assessment and primary care courses (N550, N561, N562, N563 and N571). In the current generic Rural FNP program, all of the courses (including the didactic portions of the health assessment and primary care courses) are delivered using either audio teleconference bridge (TCB), interactive video (IAV), or Web CT. The continued use of each of these modalities is anticipated.

2.          The percentage of total credits for the program which would be taught via telecommunications, and 

The total number of credits which would be taught via telecommunications is 20 of the 36 required credits or 55.6%.

3.          The estimated frequency and duration of face-to-face contact, if any, between the individual student and faculty, as well as the possibility for face-to-face contact among students.

The estimated frequency and duration of face-to-face contact between the students and faculty and students with other students is three times per semester in Bozeman. Depending on how many classes the students are enrolled in, the duration would be from 1-2 days per face-to-face class sessions. This is the frequency and duration of face-to-face contact that is currently in place for the generic Rural FNP students.

4. If the program exists on campus, and is proposed for delivery off-campus, indicate any differences in the curriculum from that offered on-campus. NA (the current Rural FNP program is offered off-campus)

2.          Need for program.

Justification should focus on documented need in the appropriate service area for the program -- national, statewide, regional, or community; provide objective data, studies, the results of institutional needs assessments appropriate to the programs nature and the expected outcomes and performance of its graduates. Justification may include:

1.          Student interest or demand; with data on enrollment trends, outreach interest;

The current 59 credit Rural FNP program at MSU-Bozeman, which leads to a Master of Nursing (MN) degree, began in Fall, 1994. By December 1997, eleven master's prepared nurses from across the country had inquired about a post-master's certificate program. As part of an informal pilot, two post-master's students completed the courses in Su-98 and three in Su-99. One student is currently enrolled in the courses, and two students will be enrolling in F-01. Three inquiries were received in 1999 and five in 2000.

There are similar programs in surrounding states such as Wyoming, Utah and Washington; however, students select the program at MSU-Bozeman because of the opportunity to study at a nationally recognized rural family nurse practitioner program.

The national certification boards, the American Nurses' Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP), have asked MSU-Bozeman to develop a formal certificate program to facilitate their approval of students to take these national certification examinations. Based on past data, we would anticipate 1-3 enrollees per year in a formal, non-degree certificate program.

2.                   Cultural, artistic, and intellectual growth of the targeted student, as well as enrichment to the general campus community;

Cultural aspects of nursing care in working with diverse clients across the lifespan are addressed in each course within the curriculum. The "rural" culture is the pervasive theme of the Rural Family Nurse Practitioner program. Section 1.B. above addresses the "intellectual basis for the curriculum" for intellectual growth of the targeted student. In addition, theoretical perspectives are presented in each individual course in the curriculum.

3.                   Economic growth and development; (NA)

4.                   Changes in occupation or profession, or advances in the discipline which require an "updated" approach within the curriculum;

As the educational programs to prepare FNPs have increased in number over the past decade or so, communities throughout the country have accepted these advanced practice registered nurses (APRNs) to provide the primary care needed in their communities. As a result of this acceptance of FNPs who are now required to be educated at the master's level, more and more FNPs are needed, especially in communities which have been unable to recruit physicians and particularly in rural communities such as those found in Montana. Many nurses with master's degrees who were educated in the 1960s and 70s as Clinical Specialists ultimately lost positions during the "downsizing" of the late 1980s and early 90s. As a result, these nurses are now desiring to "retool" and be educated as FNPs.

5.                   Manpower needs of local industry; indicating if needs are for new graduates or "retrained" current employees; and

Due to the current nursing shortage nationwide, including Montana, nurses at all levels of educational preparation are needed in the health care industry and Montana workforce. New graduates as well as "retooled" nurses are needed to fill the vacancies in both rural and urban areas. A part-time option for master's prepared nurses to obtain FNP education while they continue to work in their current positions offers an opportunity for them to continue to contribute to the crucially needed workforce while preparing to advance their own careers and move into the advanced practice arena as FNPs.

6.                   Reciprocal benefits to the institution -- e.g., internships, research funds or opportunities.

While the post-master's students continue their education part-time, they pay full tuition, and do not qualify for federal nursing traineeship funds. The generic Rural FNP program is currently budgeted for approximately 15 new students per year; post-master's students fill unused slots within the 15 budgeted. In addition, they work with preceptors around the state during each of their primary care clinical courses. Their tuition and the filling of unused slots benefits the institution. The primary care they provide in their clinical courses including the final semester of 5 crs of Clinical Preceptorship (N571) contributes to the health care of the citizens of the state. Students complete 720 clock hours of clinical practice while enrolled in 36 crs of coursework, including 300 didactic clock hours.

3.          New courses the program will add to the curriculum and course requirements for the program.

No new courses will be added. Current unused course slots will be used.

Adequacy, Accreditation and Assessment Issues

1.                   Adequacy of present faculty, facilities, equipment and library holdings in support of program, compared to known or anticipated minimum standards for accreditation.

Because these non-degree seeking students are filling unused generic Rural FNP graduate slots, there is no need for increased faculty, staff, equipment or space. No additional capital outlay is required or physical facilities needed. Library resources are adequate; all College of Nursing graduate students have access to Renne Library through distance technology.

2.                   If special accreditation will be sought, timetable and costs associated with attaining and sustaining full accreditation status as well as the level needed for each to fulfill anticipated minimum standards for accreditation (whether or not it would be sought).

The Commission on Collegiate Nursing Education (CCNE), the national organization that accredits baccalaureate and higher degree programs in nursing, has accredited the current BSN and master's (MN) programs in nursing at MSU-Bozeman for 10 years, extending to June 30, 2009. The post-master's certificate program is considered an option within the generic FNP program and will require that we notify CCNE regarding this additional option. At the time that CCNE does a site visit for the next accreditation cycle (Fall 2008), they will review the post-master's program as one of the options of our accredited MN program. Therefore, no additional costs will be incurred for the post-master's certificate program to be fully accredited by CCNE.

3.                   Assessment plan: how the program will "fit" within the Institution's internal, approved assessment process and specifically address the major assessment components of academic performance and program relevancy to student-society needs; complimenting the guidelines provided to campuses by the OCHE and the Intra-campus Committee on Outcomes Assessment (ICOA), which address the following factors:

1.       Entry level preparedness (i.e., competency and skills) and predicted success of students - collection of baseline data;

The MSU-Bozeman College of Nursing will continue to utilize its current approved assessment plan for the post-master's certificate program just as it does for the generic Rural FNP program. Measures of entry level preparedness of students includes:

•            a minimum of 1000 on the verbal and quantitative sections of the Graduate Record Examination (GRE),
•            successful completion of undergraduate courses in statistics, research, and physical assessment,
•            three letters of recommendation from professional colleagues,
•            a personal interview by faculty teaching in the graduate program,
•            an undergraduate GPA of 3.0 or higher, and
•            an essay regarding the role of advanced practice nursing.

2.                   Intermediate assessment of student performance by quantitative and qualitative measures;

Intermediate assessment of students includes:

•            successful completion of courses within the curriculum with the maintenance of a 3.0 cumulative GPA, and
•            passing the clinical objectives for each of the primary care courses.
•  

3.                   End-of-instruction assessment;

End of instruction assessment of students includes:

•            success on the national certification examination,
•            licensure as an advanced practice nurse with prescriptive authority, and
•            employment as a Family Nurse Practitioner.
•  

4.                   Student/alumni satisfaction/employer satisfaction; and

Surveys are conducted every other year to determine the satisfaction of FNP graduates and their employers regarding the performance (knowledge and skills) of the graduates. This data is reviewed by the College of Nursing Graduate Academic Affairs Committee (GAAC) in order that continuous improvement in the program may be assured.

5.                   Program review

The program is reviewed on an on-going basis to assure continued improvement. This is done both formally and informally through the Graduate Academic Affairs Committee (GAAC), students evaluating their courses, and individual faculty making course adjustments as needed based on student feedback. The next CCNE accreditation site visit will be scheduled for Fall 2008.

In summary, 100% of all of the graduates of the FNP program and all of the non-degree students who have completed the informal post-master's program to date have passed the national certification examination to become FNPs on the first try. Additionally, they have been licensed as APRNs in Montana or other states and are practicing as advanced practice nurses, many in medically underserved areas. This is the best possible outcome for this program. In addition, the graduates and their employers are surveyed every other year, not only for satisfaction but to determine if the objectives of the program have been met and if the students did have the knowledge and skills that the program indicated they would have.

Impact on Faculty, Facilities, Costs, Students, and Other Departments and Campuses

1.                   Additional faculty requirements, including qualifications, salary, and recruitment. Details may include:

1.                   Names and qualifications (i.e., rank, employment status, highest degree earned, percent of effort to be devoted to this program, projected teaching load for the first six years of the programs implementation, academic specialty):

Appendix C includes the list of faculty currently teaching in the Rural FNP program and who will continue to teach the courses that post-master's students are required to take. No additional faculty will be required to add the post-master's students to the current courses.

2.                    For necessary recruitment, the specific qualifications sought, the projected availability of such candidates, and the anticipated salaries each will command; and NA - no additional faculty will be recruited.

3.                    Profile of regular faculty to be hired full-time, as well as adjuncts. If the program will be delivered off-campus, how the profile of faculty for the proposed program would differ, if at all, from the on-campus profile. NA

2.                   Impact on facilities. Details may include:

1.                   Library -- major purchases (e.g., subscriptions, collections, computerized search capabilities) and services needed to support a new program. If the program will be delivered at distance, which purchases and services will be duplicative and/or unique to those provided on-campus; for graduate programs delivered at a distance, how quality research will be attained and sustained;

2.                   Computer services -- major purchases of software and hardware, as well as related services, needed to support the program;

3.                   Telecommunications -- major purchases of equipment and availability of systems and air-time;

4.                   Equipment -- new equipment, equipment repair and maintenance;

5.                   Space/capital requirements -- e.g., new facilities, building modifications, or renovations, expected costs, and sources of funds for capital projects unique to housing the program; types of space needs would include classrooms, laboratories, offices, library, special use rooms, general use rooms, support staff areas, medical facilities, residential facilities; other information to include would be the square footage and estimated costs for new construction or renovations; and

6.                   Support services-- other services necessary to support the program.

No additional library, computer, or telecommunications equipment or services are necessary. The few additional students (1-3 each year) will not add a burden to the current services and/or equipment. No additional space or capital requirements are needed.

Appendix A- Course of Study

Post-master's Family Nurse Practitioner (FNP) Certificate Program (Part-time)

Semester 1 - Fall

N550: Health Assessment 3 (1 lecture, 2 clinical lab)

N556: Pharmacotherapeutics I 3 (3 lecture)

N560: Advanced Physiological/

Pathophysiological Concepts

in Primary Care 4 (4 lecture)

Total Credits 10

Semester 2 - Spring

N555: Concepts of Family Care 2 (2 lecture)

N561: Primary Care I for Childbearing and

Childrearing Families 6 (3 lecture, 3 clinical lab)

Total Credits 8

Semester 3 - Fall

N562: Primary Care II for Midlife Families 6 (3 lecture, 3 clinical lab)

Total Credits 6

Semester 4 - Spring

N557: Pharmacotherapeutics II 1 (1 lecture)

N563: Primary Care III for Aging Families 6 (3 lecture, 3 clinical lab)

Total Credits 7

Semester 5 - Summer

N571: Primary Care IV - Clinical 5 (0 lecture, 5 clinical lab)

Preceptorship

Total Credits 5

GRAND TOTAL = 36 semester credits

[Note: There are no new courses in this Course of Study. All of these courses are required for the generic Family Nurse Practitioner program. Also, none of the courses are electives - all are required for the certificate program.]

Appendix B

Catalog Descriptionsof Required Courses in Post-master's FNP Program

(no elective courses are required)

N 550 HEALTH ASSESSMENT

F 3 cr. LEC 1 LAB 2

PREREQUISITE: Graduate standing

Students who have not completed a graduate health assessment course will be required to complete this course, consisting of study modules and videos based on various components of health assessment with emphasis on rural populations. Students will be required to demonstrate assessment competency to FNP faculty.

N 555 CONCEPTS OF FAMILY CARE

S 2 cr. LEC 2

PREREQUISITE: Graduate standing

The focus of this course is the analysis and synthesis of family theories from nursing and other disciplines. In addition, related concepts and theories will be analyzed as a basis for understanding the principles of family assessment and family health promotion from a nursing perspective. An emphasis is placed on the rural contextual factors which influence nursing practice within families.

N 556 PHARMACOTHERAPEUTICS I

F 3 cr. LEC 3

PREREQUISITE: Graduate standing

Provides a basis for understanding the pharmacokinetics and actions of specific group of drugs commonly used in primary care practice. Discussion will be presented on pharmacological action of drugs, side effects, appropriate dosing, drug interactions and guidelines for use of drugs. Legal and ethical considerations of prescriptive practice will also be addressed.

N 557 PHARMACOTHERAPEUTICS II

S 1 cr. LEC 1

PREREQUISITE: N 556

COREQUISITE: N 563

The focus of the course is application of the students- clinical and didactic pharmacokinetics knowledge. Case study format provides for focusing on medication needs with emphasis on monitoring and adjusting therapeutic dosage, particularly of the aging population. Prescriptive issues for Advanced Practice Registered Nurses (APRNs) will be addressed.

N 560 ADVANCED PHYSIOLOGICAL/PATHOPHYSIOLOGICAL CONCEPTS IN PRIMARY CARE

F 4 cr. LEC 4

PREREQUISITE: Graduate standing

Comprehensive study of the physiological/pathophysiological functioning of all human body systems. Age‑related variations in physiology/pathophysiology are emphasized in this course.

N 561 PRIMARY CARE I FOR CHILDBEARING AND CHILDREARING FAMILIES

S 6 cr. LEC 3 LAB 3

PREREQUISITE: N 555

Focuses on comprehensive assessment, intervention and preventive care for childbearing and childrearing families in primary health care settings. Advanced nursing practice is based on theoretical perspectives which serve as guides to identification and interventions for the common health needs. Recognizing and valuing the holistic nature of individuals within families, this course will include content on physiological, pathophysiological, psychological, sociocultural and spiritual primary health care needs of childbearing and childrearing families.

N 562 PRIMARY CARE II FOR MIDLIFE FAMILIES

F 6 cr. LEC 3 LAB 3

PREREQUISITE: N 561

Focuses on comprehensive assessment, intervention and preventive care for midlife families in primary health care settings. The use of theoretical perspectives for the advanced practice of nursing is continued. Recognizing and valuing the holistic nature of individuals within families, this course will include content on the physiologic, psychological, developmental, sociocultural and spiritual primary care needs of midlife families.

N 563 PRIMARY CARE III FOR AGING FAMILIES

S 6 cr. LEC 3 LAB 3

PREREQUISITE: N 562

COREQUISITE: N556

Assessment, treatment and preventive care for aging families in primary health care settings. Physiological, psychological, sociocultural and spiritual responses to acute and chronic conditions will be explored. Advanced nursing practice is developed through continued utilization of theoretical perspectives which serve as guides to the identification and treatment of the common health care needs of the aging family. There is added emphasis on the advocacy role of the nurse practitioner with this population.

N 571 PRIMARY CARE IV: CLINICAL PRECEPTORSHIP

Su 5 cr. LAB 5

PREREQUISITE: Final semester of course work

This practicum allows students to further refine their family nurse practitioner skills. Students may participate in the selection of a practice setting such as family health, pediatrics, women's health or gerontology or a broad based general practice based on availability. Theoretical perspectives are applied to enhance assessment and treatment skills for the selected area of practice.

Appendix C

Faculty Teaching in the Rural Family Nurse Practitioner (FNP) Program

(Required Courses for Post-master's Certificate Students)