In response to a number of concerns voiced from AACC members about nursing accreditation, AACC recently communicated through e-mail or/and telephone conversation with over 75 community colleges to garner a better understanding of the extent to which they are experiencing challenges with the Accreditation Commission for Education in Nursing (ACEN), and to ascertain if those colleges find particular aspects of the accreditation process or its standards particularly challenging.
The majority of those colleges indicated that they have had or were currently experiencing problems with accreditation. Others questioned the value of accreditation and/or reported no current interest in becoming accredited. Some non-accredited colleges also reported plans of considering accreditation with the new National League for Nursing agency, projected by the NLN to begin initiating site visits in September 2014.
A brief summary of the comments received is provided below. While this summary in no way encompasses all the views of community college officials on this critical issue, or even a “golden mean” of those views, it does provide a valuable snapshot of some of the issues that institutions are commonly facing. It also may help our community focus on ways to improve this situation in the weeks to come.
Why nursing accreditation matters
Given that in each state schools of nursing must demonstrate to a state board of nursing the quality of both their programs and graduates, some colleges suggested that professional accreditation is a duplicative process that diverts institutional resources from best meeting student needs. Indeed, the accrediting agency assesses many of the same characteristics of a school of nursing that state boards of nursing measure. Those characteristics include the educational credentials of faculty and the licensure exam pass rates of graduates. Furthermore, in some states colleges meet more rigorous standards for their state board of nursing than are required for professional accreditation, leading many to suggest the need for an accelerated or abbreviated accreditation process with reduced costs in states where this is the case.
Nevertheless, since many parties still think that accredited schools of nursing educate the best nurses, the majority of respondents suggested that professional accreditation is necessary when one or more of the following criteria exist:
- The college must be accredited to secure an articulation agreement with 4-year colleges.
- RN to BSN enrollment in some programs requires a nursing degree from an accredited school. (Some suggested that associate degree in nursing (ADN) graduates might secure enrollment in one of more than 400 online programs.)
- Local employers are reluctant or refuse to hire nurses credentialed by a non-accredited nursing school.
- Veterans’ facilities will not hire RNs who hold a degree from a non-accredited school.
- The college wants to compete for Health Resources and Services Administration funding (only available to accredited schools of nursing).
Barriers to accreditation
- Some colleges view meeting faculty educational standards as a major barrier to attaining accreditation. Currently, all full-time and 50 percent of part-time nursing faculty must hold a Master in the Science of Nursing degree (MSN). Compliance with the standard is exacerbated by a requirement for MSN-prepared faculty to teach allied health courses, i.e. drug and dosage calculations. Many colleges reported:
Demonstrating that employers and graduates value the nursing program and its graduates is challenging, and many colleges are struggling to find a way to increase one-year employer or/and graduate survey response rates.
Providing analytical data and proof of remediation for deficient program and individual student outcomes is difficult for many small programs that function without the support of effective research offices/departments. To comply with this standard, colleges need high quality assessment equipment and training.
Being pressured to award an ADN designed to be achieved in a total of 60 semester or 80 quarter credit hours, which includes program prerequisites and the college’s general education courses. The ACEN standards do not define a range or set number of credit hours.
Having insufficient budget and/or faculty levels to support the costs associated with the process.
- Providing support (tuition assistance and/or reduced teaching course load) to enable faculty to earn an MSN, but experiencing concern about whether this is a long-term solution to meeting the accreditor’s faculty standards. Colleges may require a teaching commitment of only a few years or none at all, particularly if the support is primarily in the form of reduced course workload. Some colleges reported past mistakes in which financial support was awarded without a contractual agreement.
- Being unable to secure MSN-prepared nurses to serve as faculty, with vacancies lasting a year or more. Many colleges reported offering faculty salaries that are insufficient to compete with other employers such as universities and health care providers.
- Being dependent on RNs prepared with a master’s or/and a doctorate degree in a health discipline to serve in nursing faculty or administrator roles. Some of those colleges met previous accreditation standards that allowed for such faculty to teach allied health courses.
Need for data to demonstrate the value of the ADN
Schools of nursing need a strong data collection system to objectively measure program and student outcomes to reliably earn state board of nursing or/and professional accreditation approval. Furthermore, the data colleges collect and analyze supports the adjustment of nursing curricula to improve graduate performance on the licensure exam and in the workplace. Most importantly, community colleges must invest in resources to collect evidence that underscores the quality of ADN education. An investment in a strong data collection system for the community college nursing program is an investment in the future of the ADN program and graduate.