Accreditation Journey Issue - April 2024

There are many building blocks to the sustainability of a nursing program. In addition to a strong curriculum, expert faculty, and motivated students, the acquisition of accreditation provides a stamp of legitimacy. The Department of Education states “the goal of accreditation is to ensure that institutions of higher education meet acceptable levels of quality” (U.S. Department of Education, 1/16/2024). The Accreditation Commission for Education in Nursing (ACEN) states their goal as being “a supportive partner in strengthening the quality of nursing education and transition to practice” (About the ACEN, www.acenursing.org). Preparing for an accreditation site visit demands intense scrutiny of the program by those who are preparing the Self-Study Report (SSR). That scrutiny is then validated and verified by the ACEN site visitors.

From 1994 to 2023, I had the privilege of serving at Johnson County Community College (JCCC) in Overland Park, Kansas, first in a faculty role, and then for the last eleven years as Program Director for their Associate Degree Nursing Program. During that tenure, I prepared for and participated in four ACEN site visits, the last two as Program Director. JCCC’s nursing program admitted their first students in 1971. They received their initial accreditation from the then National League for Nursing Accrediting Commission (NLNAC) in 1974. The program has met the requirements since then to have continuing accreditation for the maximum eight years after each subsequent visit.

The question of how the accreditation journey improved our program and outcomes is a good one. One could argue it’s a bit of a chicken and egg phenomenon. Is the program excellent because of being accredited, or did the program excellence yield the well-deserved accreditation? I think it’s a bit of both. From my experience, the process of creating a systematic plan for evaluation (SPE) that is a living, organic document, reviewed regularly, is the biggest contribution to a successful program. It compels the program to continually review the end-of-program student program learning outcomes (EPSLOs), as well as the outcomes of completion, NCLEX pass rates, and job acquisition. While many schools give most of the focus to an upcoming site visit to Standard 5 Outcomes, it truly is essential to deeply dive into each Standard in determining a program’s excellence.

Standard 1 reviews administrative capacity and resources. As colleges and universities frequently review their own mission, values, and priorities, so the nursing program within must also review those items, ensuring alignment with the governing body. The availability of adequate resources is paramount to a successful program and must be continually evaluated for sufficiency.

Standard 2 asks us to consider the make-up of our faculty. We should continually be considering the diversity of our core faculty, as well as those who teach in an adjunct role. We must strive to bring on new faculty who resemble our students and have a broad range of expertise. This Standard also gives programs the opportunity to reflect on the accomplishments of the faculty and to have that documented in the SSR.

Standard 3 speaks to our students. It is essential that programs continually reflect on their selection processes, as well as the adequacy of resources for admitted students that will contribute to their success. At JCCC, we revised our selection process to include both academic as well as non-academic accomplishments. This more holistic approach seems to yield a student body that is motivated, prepared to take on the rigor of the program, and who possess the emotional intelligence required of nursing.

Standard 4 asks programs to do that deep dive into the curriculum. Many state boards of nursing have prescriptive regulations on content that must be included in a pre-licensure program. ACEN also gives a blueprint for that. The National Council of State Boards of Nursing (NCSBN) provides the NCLEX test plan, which gives programs a helpful road map to guide curriculum development. Best practice would dictate an annual review of curriculum, with a more in-depth review done every 5-7 years. Due to changing trends in healthcare, this level of review should be compulsory. Any changes made in the curriculum should then be watched for trends in outcomes for a minimum of three years before additional substantive changes are made to avoid confusion over the cause and effect of outcomes.

Finally, Standard 5 provides a comprehensive review of program outcomes. EPSLOs are developed by the faculty, often with some prescriptive additions from the authority of state officials. Direct and indirect measures should be used to assess the attainment of those EPSLOs, and the more types of measures used, the more assurance of those outcomes. Trends in program completion, NCLEX pass rates, and job acquisition should all be monitored annually.

At the writing of this editorial, I am embarking on a home renovation. The contractor sought and received permits allowing the work to be done. As I pondered that, there seems to a parallel to nursing education accreditation. While I would never consider having unpermitted work done in my home, likewise, accreditation should be a goal to which all programs strive. Construction permits provide the stamp of approval from the city or county that the work being performed will be done correctly and safely by experts in the field. Nursing education accreditation provides a similar stamp. It ensures that the educational unit is committed to aligning with the governing body in mission and values, to the curation of a group of expert faculty, to the recruitment of students in a fair and comprehensive manner, supporting them with the requisite resources, to the development and teaching of an up-to-date curriculum that reflects current healthcare trends, and to the measurement of outcomes in a variety of ways to determine effectiveness of the program.

I am so proud to have been involved in nursing education in the state of Kansas for 29 years. Currently 19 out of 22 Associate Degree Nursing Programs in Kansas are ACEN accredited. With the knowledge that most graduates of community colleges remain and practice in their home communities, we have a vested interest in ensuring the excellence of our nursing programs. Accreditation is the culmination of the hard work completed to ensure that excellence. As stated before, our programs have a shared goal with ACEN, which is to have quality education that yields a safe transition to practice.

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