Committee Meetings and Minutes

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Nursing Advisory Committee

Meeting Minutes

Current Status of Minutes: Final
Date	October 19, 2023
Time	9:00 AM - 11:00 AM
Location	Eastview Campus - Room 8362

Members Present
No member attendance has been recorded.
Guests Present
Alana Bejarano, Amie Bedgood, Charles McCoy, Estrella Barrera, Kara Krauskipf, Kelly Leach, Kim Barker, Laurie Dillon, Lizbeth Mahoney, Meaghan Atchinson, Megan Benthall, Moeshe Robertson, Nina Almasy, Pamela Foster, Sandra McCrary-Marshall, Sara Shannon, Tamara Barker, Tiffany Ricks

Item # 1:	Call to order/Approval of agenda
Presenter	Tiffany Ricks
Discussion	Agenda was approved by general consent with the addition of a new Committee Chair. Dr. Ricks reviewed the purpose and mission of the Advisory Committee.

Item # 2:	Approval of minutes
Presenter	Tiffany Ricks
Discussion	Review of the minutes for the April 2020 Meeting. No vote as the committee is entirely new.

Item # 3:	Introductions/Overview
Presenter	Tiffany Ricks
Discussion	The Nursing Advisory Committee has been recreated with all the new administrators and educators due to the many staffing changes that have taken place within the organizations of our clinical partners.

Item # 4:	Clinical Facilities Update
Presenter	All Members
Discussion	Acute Care: No report. Ascension- A. Bedgood reported on the growth at Ascension and the new Children’s hospital located outside Cedar Park. St. David’s- Kim B reported that no longer are new hires restricted to med-surg areas, issues that are arising is that the new nursing who are young people have a hard time communicating because they have spent their younger years on a phone. But the foundation must be established. Our ratios have increase across the country not just in Austin. We have a serious shortage of nurses. We have started going into high schools and even elementary. We have a step training program that allows new nurses to gain experience while working in Med-Surg. Alma Bejarano added that the hospital preceptor are really working with the students to change their minds about the joys of working in Med-Surg, rather than all the nurses wanting to go into Specialty areas. She suggested some extra benefits for remaining in med-surg. Christa Santa Rosa- Previously CTMC – Pam Foster reported they have a new CEO and a new CNO a lot of changing happening Long Term Care Agencies- Cornerstone recently acquired by Syon Health. Cornerstone RR currently has a 12-bed rehab unit, Cornerstone Austin-has a new Brain injury rehab unit. Rehabilitation Hospitals- No Representation Ambulatory Care/Clinic- No representation Behavioral/Mental Health Facilities – No Representation Community Clinic – ARA 35 Clinics currently and opening one more across the metro area and in each surrounding area. We offer after hours and triage. We have a medical assistant apprentice program which is grant funded, this is a paid apprenticeship with 12 graduates thus far. Program length is approximately four months. All graduates are currently employed at ARA. Hourly rate 17-22 dollars per hours.

Item # 5:	College Updates
Presenter	Nina Almasy
Discussion	Dr. Nina Almasy reported on the changes and updates at Austin Committee College. ACC is celebrating its 50 Years of Service to our community. She told the committee that Dr. Rhoades, our previous Chancellor, retired, and we have a new Chancellor Dr. Russell Lowery-Hart. Dr. Lower-Hart is out visiting the campuses, meeting employees and students. His moto is Loving Our Students to Success. Voters voted YES to our recent BOND to allow us to grow in many areas. There will be a new Health Sciences building in HAYS, we will expand all Health Sciences programs south. We will also expand our Health Sciences academic to HAYS. Dental Hygiene will be expanding which will double the size of that program at EVC, in addition to adding an extension program to HAYS. Dr. Almasy reminded the committee partners of the need for clinical placements if we are going to grow and expand. ACC offers an affordable, strong curriculum. We are actively partnering with our education partners in the high schools to move students through their education. We have apprenticeships with the Radiology program, and we are working on an apprenticeship with Vet Tech program. We are also shortening our Medical Coding program. We are also including earn and learn and stackable credentials to many of our programs. Current Grants – Coordinating Board -LMRT Track, VNG/CNA worked together to establish a streamline transition program. ACA Grant-Explore how we can partner with our high school Students to pursue health care careers. Reaching out to underserved communities in our area. We work with early college high school, with AISD and Manor ISD, which includes tours into healthcare facilities and participants receive a stipend at the end. Achieving the Dream Grant-Focus’ on Diversity in the Healthcare Workforce. House Bill 8-Shifts from an enrollment-based funding plan to an outcome base funding plan. So now the college is looking at how we can improve our outcomes while also increasing our enrollment. Holistic Admissions- Dr. Estrella Barrara reported that if we want a diverse workforce, we must have a diverse classroom. Consider the attributes of the students to develop what kind of employees you want. These are not always easy answers for us, but we are willing to do the hard work. The committee must have a stake in our admission process.

Item # 6:	Vocational Nursing Program
Presenter	Sandra McCrary-Marshall
Discussion	Current Enrollment: COHORT Level 1 Level 2 Level 3 EW Level 1 Total by Campus EVC 23 0 18 23 64 Past Graduates: Fall 2022 Graduates = 18 Traditional Daytime Spring 2023Graduates = 5 Evening/Weekend Summer 2023 Graduates = 25 Traditional Daytime TABLE 1: VN PROGRAM’S NLCEX PASS RATES FOR THE PREVIOUS INDIVIDUAL COHORTS Graduate Cohort # of graduates # students that passed NCLEX Fall 2022 18 18 Spring 2023 5 5 Summer 2023 25 23 (2 students have not yet tested) Curriculum: • The program continues to increase simulation within the curriculum. Areas of content include Medical-Surgical nursing, Pediatrics and Obstetrics. We are incorporating Mental Health simulations. Goal is to continue to increase simulation within the program. Feedback from students, continue to reflect knowledge of positive learning experience. TABLE 2: SIMULATION HOURS Three Semester Program Hours of Simulation/# of Clinical % of Simulation I 36/256 14% II 38/256 15% III 48/256 19% Total 122/786 16% Total Program • Feedback on the student evaluations of the clinical sites continues to be positive. • The program continues to expand into non-acute care sites: Clinics, doctor’s offices, schools, correctional facilities, rehabilitation hospitals, and dialysis facilities. RECAP FROM COVID 2020-2021 • Face to Face- Didactics were moved to synchronous online delivery. • Clinicals from mid-2020-2021, Long-Term Care facilities were not open due to COVID-19. Return to long term care facilities Fall 2021. • Limited Rehabilitation Hospitals reopened to students in Fall 2020. • Acute Care Hospital remained opened to clinical rotation during COVID-19 after July 6, 2020. • Spring 2020 Cohort- TEAS scores for applicant admission was waived due to limitation of testing to meet deadline for June 1ST application deadline. UPDATE: Statistical analysis reveals successful program completion is correlated with ATI TEAS scores of > 50. Most students that are unsuccessful completing the program scored less than 50 on the ATI-TEAS. Our current ATI TEAS score for admission to the program is 58.7%. Evening/Weekend VN Program Highlights • Accessibility into the Vocational Nursing program for students who cannot attend a day program • Course offerings aligned with End-of-Program Student Learning Outcomes (EPSLOs); program outcomes; and compliance with the Texas Board of Nursing requirements for the minimum contact hours for theory and clinical in a VN program; and compliance with the Accrediting Commission for Education in Nursing, Inc. (ACEN) standards • College/Department experience and support in development, implementation, and evaluation of programs • Potential applicant pool to support an Evening/Weekend VN program option • Experienced nurse faculty credentialed and prepared • Extensive student support services • Support of community The VN Program may implement admission to the evening/weekend track every fall semester versus every other fall semester. The Licensure NCLEX-PN® pass rates for the Vocational Nursing program graduates are above state and national means (Table 3). TABLE 3: NCLEX-PN® PASS RATES (FIRST TIME) Year Timeframe ACC Pass Rate State Mean National Mean (First Time, US Educated) 2020 January - December 86.27% 88.53% 83.09% 2021 January - December 93.22% 86.24% 79.60% 2022 January - December 91.38% 87.26% 79.93% The VN program recognizes that the designated expected level of achievement (ELA) of 75% for the rate of completion was not being met (Table 4). In Spring 2023, the faculty reevaluated the ELA and it was changed to 40% to better align with our governing organization completion rate. However, the faculty continues to evaluate and implement measures to improve the ELA as evidenced by the Systematic Plan for Program Evaluation (SPE). The faculty recognize that low completion rates are not solely due to the academic rigor/requirements of the program. Other factors such as financial, medical, family/personal, change in career path, and/or day course scheduling contribute to the completion rates; hence, the genesis of the Evening/Weekend VN program as a result of ongoing continuous program improvement. TABLE 4: TRADITIONAL-DAY VN PROGRAM’S COMPLETION RATES FOR THE PREVIOUS THREE (3) YEARS Cohort Admitted (# does not reflect readmits) Completed Rate of Completion (%) (ELA – 40%) FA 19 – S21 (EW) 20 6 30% FA 19 – FA 21 (EW covid alternate group) 10 8 80% SP 20 – FA 20 35 9 26% FA 20 – SU 21 44 25 57% SP 21 – FA 21 26 17 65% FA 21 – SU 22 16 15 94% SP 22 – FA 22 18 10 56% FA 21 – SP 23 (EW) 23 5 22% FA 22 – SU 23 20 13 65% The VN program’s designated ELA is 90% of those graduates seeking employment in nursing will be employed within six (6) months of graduation. Of those responding to the survey, the ELA continues to be met as evidenced in Table 5. TABLE 5: EMPLOYMENT OF VN PROGRAM GRADUATES Graduate Class Employment in Nursing ELA-90% Spring 2021 E/W 3/6 who returned survey 100% reported employment 3 out of 6 reported employment Fall 2021 Traditional Daytime 8/25 who returned survey 86% reported employment 6 out 7 reported employment Summer 2022 Traditional Daytime 18/28 who returned survey 94.4% reported employment 17 out of 18 reported employment The Evaluation committee has worked actively to increase the response rate for the survey. Efforts include incentives for survey return (gift cards for completing the survey), moving away from emailing/mailing the surveys to currently texting the survey to the students (Fall 2022 graduates with an increased response rate from 30% to 63%), and shortening the survey. PROGRAM OUTCOMES 1. The Licensure NCLEX-PN pass rates for the Vocational Nursing Program graduates are at 90% or above for first time test takers. 2. 90% of all graduates seeking employment as an LVN are able to obtain job placement within six months of graduation. 3. 40% of students admitted to the Daytime Program Vocational Nursing Program at ACC will complete the program within four semesters. 4. 40% of students admitted to the Evening and Weekend Vocational Nursing Program at ACC will complete the program within five semesters. 5. 90% of graduates through quantitative and qualitative measures, will agree that the Vocational Nursing Program prepared them in the following three areas: i. Clinical reasoning ii. Responsibility and accountability iii. Practicing safely within the LVN scope of practice 6. 90% of employers through quantitative and qualitative measures, will agree that the Vocational Nursing Program prepared them in the following three areas: i. Clinical reasoning ii. Responsibility and accountability iii. Practicing safely within the LVN scope of practice Vocational Nursing End of Program Student Learning Outcomes (EPSLO) Upon completion of the Certificate in Vocational Nursing program, the student will be able to: Legal & Scope of Practice 1. Provide patient care within the legal scope of practice in accordance with the policies and procedures of the health care facility, as well as all regulatory and governing bodies. Professional Practice 2. Assume responsibility and accountability for the quality of nursing care provided while demonstrating competency, self-directed learning, and promoting the development and practice of vocational nursing. Patient Safety 3. Ensure patient safety in a safe environment by implementing nursing best practices, safety protocols, and National Patient Safety Goals. Clinical Reasoning & Evidence-Based Practice 4. Use clinical reasoning and evidence-based practice to interpret health-related data and determine the health status and needs of culturally diverse patients within a directed and supervised scoped of practice. Communication & Reporting 5. Communicate, report, and collaborate in a timely manner with the interdisciplinary health care team, including the use of technology, to provide optimal patient care, prevent errors, and support decision-making. Committee Questions: Kim B from St. David’s said that they currently have 25 LVN positions that do not get applicants. Sandra asked Hailey to get Kim’s card and email her the information about how to share their job opportunities.

Item # 7:	Professional Nursing Program
Presenter	Laurie Dillon
Discussion	A. Enrollment • Spring 2022 Enrollment Total = 647 we increased our total incoming cohort from 160 to 180 this Fall 2023. Current Enrollment Breakdown: Level I Level II Level III Level IV Mobility Track 171 155 124 151 44 B. Graduates • Fall 2022-113 • Spring 2023-153 • Summer 2023-31 • Fall 2023 (Anticipated)- 151 C. Fall 2023 Curriculum Updates 1. End-of-Program Student Learning Outcomes Program Completion Rate 2022-80.6 % (Includes Traditional and Mobility) Job Placement Rate 2022-2023-100% of the student that replied to the survey were employed as a nurse 2. Holistic Admissions – a. Update: In the Spring of 2023, we began additional points on admission for any student who has honorably served in the Military (3 points) and LVN’s (3 points) with an unencumbered nursing license. We also, proposed that students who take a medical terminology course, Medical Terminology course 1106, they receive 2 points. As such we are attempting to improve our attrition for all students, while targeting capital idea students who have a greater socioeconomic deficit. D. NCLEX -RN Results • 2023-Spring 93.46% and U23-100% • 2022-80.94% • 2021-87.32% • 2020-92.34% • 2019-93.19% ANT Cohorts NCLEX Pass Rate Data: ANT Cohorts # of Graduate NCLEX Pass Rate Spring 2022 19 60% Pass Rate Spring 2023 24 95% Pass Rate E. Michael and Susan Dell Foundation Grant: Accelerated Nursing Track was closed. ANT was not a successful program. Our NCLEX pass rate was low and our student attrition rate was high. As such we could not continue the program as designed. We are hoping in the future to offer something similar, but as of right now projects are on hold for our ACEN review. F. The Addition of a Testing Platform: Our ADN program was able to obtain approval from the Board of Trustees to Purchase a new testing platform (ATI) as our previous platforms were defunct to prepare students for the New NextGen NCLEX that launched April 1, 2023. The approval was obtained in October of 2022, the roll out started with Level 1 in the fall, then shifting to Levels 2 and Level 4 in the Spring of 2023. Then finally Level 3, now in the Fall of 2023. Though difficult for faculty this roll out was successful and we did obtain the desired outcome. Students are learning to test in the new format. SB 1429 identified standard testing that prevented students from graduating. We do not have a high stakes exam that would prevent any student from graduating from ACC’s Professional Nursing Program. G. New Entrance Testing Platforms: As a result of the addition of the testing platform we did change from HESI to TEAS for or entrance exams. It was determined that a need to align the testing platforms would be advantageous for students and help prepare them for the expectations of the professional nursing program. H. Achieving the Dream: Achieving the Dream is a grant awarded by the Dream Foundation to the Professional Nursing in the Spring of 2023 to increase equity and diversity in nursing. Partnering with Capital Idea the Austin Community College Professional Nursing Program sought to add 20 additional Capital Idea students, to a cohort at the Round Rock Campus. In doing so we increased the overall size of the cohort from 60 to 80, but then split the cohort of 80 into two groups of 40. Utilizing funds from the ATD grant, we were able to bolster funding to provide additional resources for the students. We added additional faculty to support the two cohorts, an hourly lab staff, a skills tutor and an additional success coach to support the students in the program. We also added 2 high fidelity mannequins, med carts and some additional simulation supplies. At the completion of enrollment, we were able to add 16. Of that group of 16 two students we're not successful in the first eight weeks of the program in Level 1. The remaining 14 moved forward into the next section of Level 1. ACIA Program (formerly eSNIP) NCLEX Pass Rate ACIA Cohorts # of Graduates NCLEX Pass Rate Fall 2022 3 100% Spring 2023 13 100% Fall 2023 15 TBA I. ACIA: Austin Community College Clinical Immersion Apprenticeship is a partnership created with two clinical organizations that allow our Level 4 students to work and be paid as a PCT salary to attend clinical and receive credit for clinical hours in the Professional Nursing Program. Students are precepted by a RN employed by the facility and supervised by an ACC Nursing Faculty member. We have two clinical partners; they are Ascension and St David's. We are working to expand this program and create more growth to allow students the opportunity to work and go to school. The Ascension program is called ESNI (enhanced student nurse intern). Students who work in the ESNI program are employed by Ascension receiving full benefits and salary as a PCT. They are precepted by a Registered Nurse, while being supervised by ACC faculty. The program at St David's is called ASE (Advanced Student Experience). The students in the ASE program are not St David's employees in this program, but are paid for their time precepting with a registered nurse at St David's and supervised by ACC faculty. J. Feedback Needed: ACIA expanding to Level 3. Dr. Dillion asked the community partners if they found it advantageous to expand the apprenticeship program to our specialty areas. This would include obstetrics/ pediatric and Mental Health. Logistically this is more work for all involved because the expectation in level three to make the board of nursing standards for our community college is to rotating students through Level three for the specialties every five weeks. However, the benefit of this would be that students would obtain their 192 clinical hours as part of the preceptor program potentially decreasing the amount of residency time needed after graduation. Question: Do you have data to support this outcome from Ascension? Ascension has identified in that our students in Ascensions ESNI program cut their residency time by approximately 50% as a result of their participation in this program. They are higher functioning and out on the floor faster as a result. K. Feedback Needed: Evening/Weekend Plan for Mobility We are looking at the possibility of having an evening program we can plan for the mobility program. For evening we would probably be limited to just LVN’s though I cannot say that unequivocal because our traditional mobility program is not. Parts of this program have already been created including prerequisites so everything can be done simultaneously approximately 17 to 18 months. The risk to doing this is a much higher attrition rate based on work life balance for the students. WE anticipate that the students will be working during the week, therefore they have more struggles with work life balance. Technically they would not receive a day off from school or work if they are full-time employees. Is this an achievable goal and realistic expectation? L. Feedback Needed: Increasing cohort at EVC to 80 by adding a special track that would hold 20 placements for ACC LVN students. We were considering offering LVN students an opportunity for an additional route other than Mobility weekend program or Mobility Traditional. This would allow LVN’s to come into our traditional track at Level 2 after completing their program prerequisites. They would complete the program and traditional three semesters which would equate to one year having the summer off from school. This does allow from greater work life balance. However, it would require the student to be in school during the week. 2. RN-to-BSN Program A. Enrollment • Fall 2023 Enrollment Total = 76 Current Enrollment Breakdown: Spring 22 PT Spring 23 PT Fall 23 PT Fall 23 FT 12 22 8 34 B. Curriculum Updated 1. End-of-Program Student Learning Outcome Program Completion Rate: FT 2021- 77%/ PT 2022-85% 2. Program Outcomes C. Update: The RN to BSN Program added an online. Community Health & Leadership/Management have remained hybrid as the clinical component will need to remain in person. However, all other courses are fully online. With these changes we are offering more options to our students. D. Change in Course Sequence: Attached is the updated Spring part-time cohort RN-to-BSN course sequence. This will take effect for the cohort starting the program in Spring 2024. This course sequence better aligns with the Fall start course sequencing and gets the clinical courses in fall/ spring (and not in summer). It was approved by the RN-to-BSN faculty/staff team, recommended by the Professional Nursing Curriculum Committee, and approved by a vote of the Professional Nursing Faculty at the Sept FOC. E. Feedback Needed: Our enrollment in the RN to BSN program has sustained us but we have not grown. We are actively working with marketing to create a campaign to bolster this program. Any suggestions from our community partners it our advisory committee would be greatly appreciated.

Item # 8:	New Business
Presenter	All Members
Discussion	a. Committee Members Input Regarding ACC Nursing Program b. ACC Nursing Expansion Plan Decision/Actions: 1. Evening/Weekend Mobility Program-Approved by general consent of committee. 2. Expansion at the EVC campus by 20 per cohort with extra licensed LVN cohort. Committee approved by general consent that this was a great option as a way to expand the program. 3. Suggestions for the growth of the RN to BSN program-Sheila will send out a google form requested your suggestions.

Item # 9:	Announcements
Presenter	All Members
Discussion	PLSO’s will be emailed out. Job Posting Link and Instructions need to be sent out. Pinning Ceremony -Invitation will be sent out to members. Team Teal Event-Invitation will be sent out to Committee members.

Item # 10:	Next Meeting Date and Time
Presenter	Tiffany Ricks
Discussion	TBD - Summer 2024

Item # 11:	Adjournment
Presenter	Tiffany Ricks
Discussion	Meeting formally adjourned at 10:52. Motion approved by Dr. Laurie Dillon and seconded by Kim Barker.

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