Project SAIL
is supported by
the Sloan Foundation

Project SAIL
Partners

Advanced Placement and Online Nursing Degree Program
Community College of Denver
Denver, Colorado

The U.S. nursing shortage is no public secret and has grown even more urgent than the medical community first anticipated in 2002. According to recent government projections, an additional 450,000 nurses will be needed to meet demand by the year 2008. Trends in the graduate pipeline for nursing professionals indicate significant variances dependent on geographic settings. Colleges in rural areas are experiencing the largest reductions in graduates, followed by large towns and urban areas (National Center for Education Statistics, 2000). These patterns indicate rural community health services will be hardest hit by the growing nursing shortage.

The principal findings of the 2002 report, Health Care's Human Crisis: The American Nursing Shortage, funded by The Robert Wood Johnson Foundation, claim, “The current nursing drought is not like previous shortages, it is about to get worse, and the tried and true solutions of the past are unlikely to solve it (Johnson Foundation, 2002).” In addition to review and analysis, the report offers eight recommendations to address the nursing shortage. Of this series, and in order of priority, Recommendation 2 for addressing the shortage at a local level is to increase the supply of nurses through expanded educational capacity and opportunity.

Following the studies’ recommendations, American Community Colleges, as the primary educators of registered nurses entering the profession, recognize this imminent challenge and have explored a series of innovative options by providing broader access and flexible delivery to all segments of the population interested and motivated to serve the nursing profession.

The Community College of Denver has responded by investing, developing, and delivering an Online Advanced Placement Nursing Program aimed at increasing the capacity to educate nurses through flexible delivery formats. The program is targeted at licensed practical nurses currently working in the community who wish to advance themselves to registered nurse status (RN). Didactic instructional components of the Advanced Placement AAS degree are available online, while the clinical applications must be scheduled and delivered locally. The program provides 28 credits of nursing specific content, in both online and clinical settings. A short outline of the courses follows.

• Nursing Assessment and Diagnosis
  1 - 3 credit hours
  Develops skills of nursing assessment across the life span using effective communication and interview techniques and introduces physical assessment. The course develops critical thinking skills in assessment, data analysis, and derivation of actual or potential health needs.

• OB/Pediatric/Family-Centered Nursing
  5 credit hours
  Prepares the professional nurse to comprehend and apply advanced concepts in care of the high-risk child-bearing family and children with complex health problems from birth through adolescence. Emphasizes special needs and complications during the perinatal experience and altered functioning, special needs, and disease processes manifested in children. The nursing process is used as a framework to attain optimal levels of maternal-newborn and pediatric health and wellness. Legal and ethical accountability are integrated throughout the course.

• Principles of Psychiatric Nursing
  5 credit hours
  Develops concepts of psychosocial integrity and emphasizes the function and responsibility of nursing in promoting and maintaining mental health of individuals and families. The course emphasizes communication and caring through the application of the therapeutic relationship and nursing process in the care and treatment of common clinical conditions and disorders.

• Nursing Care of the Hospitalized Client (Medical-Surgical)
  Part I: 5 credit hours
  Focuses on the role of the registered professional nurse as care provider, teacher, manager, professional, and advocate in meeting the nursing needs of adults across the life span. Using the nursing process, the student is expected to integrate previous learning to assist the patient and family in achieving optimal functioning in various health care settings.
  
  Part II: 4 credit hours
  Continues to focus on the role of the registered professional nurse as care provider, teacher, manager, professional, and advocate in meeting the complex medical and surgical health care needs of adult clients. Using the nursing process, students integrate previous learning to assist the patient and family in achieving optimal functioning in various complex health care situations and settings.

• Leadership and Management in Nursing
  2 credit hours
  Socializes the student into the graduate RN role. The focus is on the exploration and analysis of contemporary nursing practice, current trends, and issues impacting nursing care delivery. Advanced leadership and management concepts are discussed as part of the nursing role.

• Pharmacology Math
  1 credit hour
  Introduces the nursing student to the concepts and techniques of dosage calculations and medication administration by a variety of routes. Learners will apply basic math concepts to complex conversion of dosages between and among various systems of weights and volumes. Learners will apply critical thinking skills to the calculation and administration of medications by oral and parenteral (including intravenous) routes of administration.

Strategies to maintain the personal touch of nursing education: Online nursing students have opportunities to meet face-to-face with their student peers and instructors during the scheduled clinical rotations. The face-to-face clinical instruction provides not only the hands-on experience needed in a nursing program, but also allows students to establish personal relationships that can help reduce perceived barriers of communication and isolation when they return to the online part of the curriculum. With advances in distance education and through creative design, many students report greater communication with their faculty and peers in the online setting than in traditional classroom instruction.

Summary

Since the program began in fall 2002, CCD has graduated 11 students from the online nursing program and will graduate another 12 students in May 2004. The success rate on the nursing board exam is equivalent to that of the traditional nursing program. The program has supported students from as far south as Raton, New Mexico; as far west as Grand Junction, Colorado; and as far north as Julesburg, Colorado. These remote students report that they would not have been able to go to school in their hometowns for the RN completion. Besides overcoming geographic barriers, the online nursing program has served students who are balancing full-time work with family responsibilities, and the online experience has made it possible for them to complete their RN education and licensure.

Ready-to-Roll Partner Transactions

The following models are offered to guide negotiation with prospective partners and institutions interested in delivering this program to students through home college offerings.

Model #1: Online Hosting Model

$25 per credit per student. CCCOnline hosts a separate section of the course for the partner institution. Partner institution provides faculty member. CCCOnline provides faculty training and student support services. CCD nursing faculty will consult with partner institution faculty as needed the first time course is offered at partner institution. Clinicals are arranged by partner institution. Partner institution transcripts the course.

Model #2: Purchase Course Content

Partner institution pays prices listed below for WebCT-based course content. Partner institution submits a Purchase Order to CCCOnline for course cost. CCCOnline sends WebCT files for partner to examine for 30 days. If partner wishes to use the content, CCCOnline will send invoice after the 30-day trial period. This is a one-time charge for product as is. No licensing agreement, maintenance, or ongoing services or charges will apply.

Model #3: Exchange Course Content

If partner institution has course content that CCCOnline would like to use, a simple exchange of courses can be negotiated.