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Improved Nursing Licensure Exam Pass Rates Result From Refresher Design

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Improved Nursing Licensure Exam Pass Rates Result From Refresher Design

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    1. Improved 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.

    2. About the EWD Program Mission of the EWD Program is to advance California’s economic growth and global competitiveness through quality education and services

    3. The goal of my presentation to provide an overview of the Health Initiative and the RHORC’s as well as demonstrate to you the integration we have achieved in economic and workforce development. The outcomes of the RHORC’s exemplify the combination of both college focused programs and contract training focused centers. There are two parts to my presentation Statewide overview Highlights of each individual RHORCThe goal of my presentation to provide an overview of the Health Initiative and the RHORC’s as well as demonstrate to you the integration we have achieved in economic and workforce development. The outcomes of the RHORC’s exemplify the combination of both college focused programs and contract training focused centers. There are two parts to my presentation Statewide overview Highlights of each individual RHORC

    4. The Mission RHORC’s have always worked in both areas – economic development and workforce development, and have strived to integrate and blend these areas. RHORC’s have always worked in both areas – economic development and workforce development, and have strived to integrate and blend these areas.

    5. Health Care Initiative’s Purpose Identify health care workforce development needs Develop solutions through a comprehensive problem-solving process: assessment and analysis, planning and development, implementation and evaluation.

    6. Regional Health Occupations Resource Centers RHORCs Strategically located Statewide Facilitate collaboration between the education segments and the health care delivery system to respond to identified needs

    8. Acknowledgements 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

    9. Acknowledgements 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

    10. http://www.healthypeople.gov Need 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)

    11. Other 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.

    12. Background 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

    13. Background 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

    14. Background 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

    15. Background 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

    16. Background 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

    17. Background 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

    18. Welcome 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 program’s case management delivery system with JVS from 2001 to 2003.

    19. Welcome 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

    20. LVN Refresher Expansion Mission 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

    21. Program 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

    22. Program and Grant Development

    23. Program 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

    24. 2005 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%

    25. 2005 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% 3,065 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% 25,860 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 87.9% 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%

    26. Faculty 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”

    27. Student 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

    28. Case 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

    29. Challenges 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

    30. Challenges 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

    31. Successes 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

    32. Primary Recommendations Review South Bay RHORC LVN Refresher Program Workplan Participants – View Workplan From Your Packets

    33. Critical Pathway

    34. Primary 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

    35. Questions 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@wvmccd.cc.ca.us rhorc@sfsu.edu

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