VOLUME 4 { NO 2} EDITION 11

{ Official Publication of the NORTH CAROLINA Board of Nursing} . . . . . . . . . . . . . . WINTER

08

Elected

Members

- take office

EDUCATION SUMMIT # 5

Random

Audits to

begin this

summer

WINTER 2008 BULLETIN

NC BOARD OF NURSING

Nursing Bulletin is the official

publication of the North

Carolina Board of Nursing.

Office Location

3724 National Drive, Ste 201

Raleigh, NC 27612

Mailing Address

P. O. Box 2129

Raleigh, NC 27602

Telephone

( 919) 782- 3211

Fax

( 919) 781- 9461

Automated Verification

( 919) 881- 2272

Website

www. ncbon. com

Office Hours

8 a. m. to 5 p. m.,

Monday through Friday

Board Chair

Alexis B. Welch, RN, Ed. D.

Executive Director

Polly Johnson, RN, MSN, FAAN

Editor

David Kalbacker

Artists

Clifford Adams

Paulette Young

Photography

DayMeetsNight Photography

Mission Statement

The North Carolina Board of

Nursing is committed to protecting

the health and well- being of the

public through regulating the deliv-ery

of safe, effective nursing care.

Advertisements contained here-in

are not necessarily endorsed by

the North Carolina Board of

Nursing. The publisher reserves the

right to accept or reject advertise-ments

for the Nursing Bulletin.

All art ( photos, paintings, draw-ings,

etc.) contained in this publi-cation

is used under contractual

agreement.

126,000 copies of this document

were printed and mailed for a cost

of $. 12 per copy

The North Carolina Board of

Nursing is an equal opportunity

employer.

CREATED BY:

Publishing Concepts, Inc.

14109 Taylor Loop Road

Little Rock, AR 72223

Virginia Robertson, President

vrobertson@ pcipublishing. com

FOR ADVERTISING INFORMATION:

Greg Jones

gjones@ pcipublishing. com

501.221.9986 • 800.561.4686

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NC

VOLUME 4 { NO 2 } EDITION 11

Table of

11

14

Foundation for Nursing

Excellence

18

Frequently Asked Questions

27 Education Summitt # 5

CONTENTS

10 NC Board of Nursing

Julie George selected as

new Executive Director

15 Nomination Form for

2008 Election

16 Random Audits to begin

this Summer

17 Elected Members - Take Office

North Carolina Foundation

for Nursing Excellence Transition

to Practice Project Underway

23

DEPARTMENTS: 6 l e t t e r s t o t h e e d i t o r 7 f r o m t h e e x e c u t i v e

d i r e c t o r 8 f r o m t h e c h a i r 21 t h e B r e a k R o o m 25 S u m m a r y o f

A c t i o n s 28 C l a s s i f i e d s 29 2 0 0 8 W o r k s h o p R e g i s t r a t i o n F o r m

?

{ Of f i c i a l Publication of the NORTH CAROLINA Board of Nursing } . . . . . . . . . 6 . . . . . . . . . . . . . . . . . . . .

Nurse artist featured

This issue’s cover art was painted by Clifford Guy Adams, LPN. Having been an LPN since leaving the Air

Force in 1993, Adams has been employed in long term care and wound nursing.

“ I never pursued art as a career, maintained it only as a hobby until recently,” confessed

Adams. “ I’ve done pencil portraits for coworkers and charity organizations, watercolors of

family members and religious illustrations in acrylic. Between working in our family business

( a Spanish language newspaper) and home schooling our two youngest children ( Adams has

two boys and two girls), only now am I devoting more time to the pursuit of a career in art.”

“ This cover is a caricature of long term care and as nurses how we traverse all barriers of race,

religion and age,” notes Adams.

Adams is currently working on building his art portfolio with the goal of having a gallery show

in the not too distant future. The artist may be reached at clifgy@ gmail. com.

Send letters to: Editor, Nursing Bulletin,

North Carolina Board of Nursing, P. O. Box 2129,

Raleigh, NC 27602- 2129 or Email,

david@ ncbon. com

e t t e r s

t o t h e

ED I T O R L

EDITOR’S NOTE

I was recently given a binder of the Board’s newsletters from the early

1990s. I was amazed to read that in 1993 more than 13,000 of the

state’s 95,000 nurses voted in the annual election for members to the

Board. Now, 15 years later, a mere 2600 nurses, out of a total of more

than 126,000, made the effort to vote in the Board’s last election. If the elec-tion

process were a patient – now might be a good time to call the rescue squad!

While the election is many months away, your ideas and suggestions to increase

voter participation would be greatly welcomed. You may recall that for the past several

years, we even offered spa holidays as an incentive to those voting in the annual election.

We are no longer offering the trips because, not only did it not increase voter turnout, but

more than half of the holiday trips were never used.

The Year 2008 promises to be a busy one for the

NC Board of Nursing. We will complete the transition to a

cardless licensure system with the 2008 licensure renewals so that

all licensure verification can only be done through our database.

This can be done directly through our Web site at www. ncbon. com.

Beginning July 2008, each licensee shall attest to having met the

continuing competence requirements by completing one of the

approved learning activity options. At the same time, we will

begin the random audit process for proof of compliance with the

Board’s continuing competence requirements. Those licensees who

will be audited will be informed of this at the time they receive

their postcard notice of licensure renewal. Please refer to page 16

for further information on these requirements and the auditing

process. In collaboration with the NC Medical Board, we will also

begin random compliance reviews of nurse practitioners to assure

compliance with their approval to practice requirements as set forth

in law and rules.

Through an agreement with the NC Medical Board, we are

excited to report that as of January 2008, the Board of Nursing is

the single verification source of licensure and approval to practice

information for nurse practitioners in North Carolina. In addition,

all applications for approval and renewal will now be processed

through the Board of Nursing Web site and office. We expect to

greatly enhance the efficiency of our service to NPs with these

major changes, but it should be noted that both the NC Medical

Board and NC Board of Nursing continue to have joint regulatory

authority for nurse practitioners in our state.

In the midst of all the above activities, the Board and staff will be welcoming a new Executive Director. After a

national search, Julia George, RN, MSN, has been appointed to fill the Executive Director position beginning July 7,

2008. Julie is currently the Associate Executive Director for Programs here at the Board. She is already known to many of

you and is well- positioned to assume the role of Executive Director.

After more than eleven years as Executive Director and 20 years on staff here at the Board, I am looking forward to this

transition – both for me and for the Board! Over these years, the Board has become a proactive partner in patient safety

and public protection. I am proud of our many accomplishments in our journey toward excellence in regulation. As with

any important journey, there are always new challenges to face, and I am confident that the Board will successfully manage

these challenges with new leadership.

Polly Johnson, RN, MSN, FAAN

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f r o m t h e

E x e c u t i v e

D i r e c t o r

8 { Of f i c i a l Publication of the NORTH CAROLINA Board of Nursing } . . . . . . . . . . . . . . . . . . . . . . . . . . . .

I am humbled to accept the position as the new Chair of the NCBON. For the past

three years, I have had a great role model, Dr. Beverly Foster, RN, whom I have

learned to respect for her objectivity and consensus building skills.

As I turn my attention to you, the licensed nurses of North Carolina, I offer two

guiding principles of life as a nurse. The first principle is that of excellence.

Excellence is about being and doing your best, all the time, about having a higher

standard than the world around us. Achieving excellence requires consistency,

focus, and hard work more than it requires being brilliant.

The second principle is that of character. Character is the array of personal

attributes that define who you are. You have the capacity to act according to what

is true and right in all circumstances. As RNs or LPNs, we are expected to be the

“ Angels of Mercy.” The power of example is so crucial to the future of our practice.

There is a high expectation from our patients that we be the very best example for

safe patient care. Do everything you can to build character for nursing.

The year 2008 will be a year of difference as policy changes in the previous three

years will come to fruition. Remember continued competency audits start July 1,

2008. Are you competent? Nursing educators, remember those education rule

changes? Please continue to produce the best nursing workforce for our great state.

I want to thank my family, my nursing colleagues, my coworkers at Lenoir

Community College, and my fellow BON colleagues for their support. It takes a

team to implement the mission of the NCBON: The NCBON is committed to

protecting the health and well- being of the public through regulating the deliv-ery

of state, effective nursing care.

Just as our country was founded by a trust in God, I too want to acknowledge a

loving Heavenly Father in whom I put my faith and trust every day. In gratitude

and humility, I will serve with excellence and character and “ stand a little taller”

with you.

With best wishes

Alexis B. Welch, RN, Ed. D.

Chair

f r o m t h e

c h a i r p e r s o n

10 { Official Publication of the NORTH CAROLINA Board of Nursing } . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PICTURED ABOVE

North Carolina

Board of Nursing:

From Left to Right: Sara

Griffith, Ramon Whichello,

Deborah Jenkins, Gale

Adcock, Paul Rusk, Cynthia

Morgan, Alexis Welch, Martha

Harrell, Pam Edwards, Mary

Ann Fuchs, Jan Floyd, Carolyn

Moffett, Joan Guilianelli, Dan

Hudgins

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N

How do I complete the self assessment and learning

plan required by the Continuing Competence rules?

All nurses are required to reflect on their personal

nursing practice strengths and opportunities for growth

or improvement as they begin each two year license

renewal period. This thoughtful self assessment must address

four dimensions of practice:

1 - Professional Responsibility

2 - Knowledge- Based Practice

3 - Legal/ Ethical Practice

4 - Collaboration

Required information and related documents are available on

the Continuing Competence section of the Board’s Web site at:

www. ncbon. com. ( From the Board’s homepage, hover on Quick

Links and click on Continuing Competence.) While self assess-ment

and learning plan templates are available on this site,

each nurse may make revisions or substitute alternative assess-ment

and planning tools if better suited to their practice.

These documents are not computer- interactive and are not sub-mitted

to the Board after completion. They may be printed for

use and are retained by the nurse to guide their learning activi-ties

throughout their two year renewal period. The eight

approved learning activity options are also available on the

Board Web site.

Example # 1: Julie Nesta is an RN with 10 years experience.

She works in an Intensive Care Unit and plans to continue

working in this setting. She bases her self assessment and

learning plan on the patient care, ethical, and legal issues she

commonly encounters in a critical care environment. Julie

decides to focus on some of the newer patient care modalities

being used in her unit and plans to obtain national certification

( Learning Option # 1) in critical care nursing within her next

renewal period.

Example # 2: Jim Jones is an LPN with one year experience.

He works on an acute care hospital unit but is planning to seek

a position in long term care within the coming year. He bases

his self assessment and learning plan partially on his current

practice and partially on the needs he identifies for his future

role in a geriatric practice setting. Jim decides to focus on bet-ter

understanding the care of diabetic patients and on increas-ing

his knowledge about caring for geriatric patients. He plans

to complete 15 contact hours of Continuing Education in these

areas while also working at least 640 hours in active practice

( Learning Option # 8) within his next renewal period.

Example # 3: Kristin Smith is an RN who has not practiced

nursing for the past 15 years but has maintained an active

license and plans to continue doing so. She bases her self

assessment and learning plan on a “ What if?” scenario: What if

I return to active nursing practice within the next six to 12 months?

What type of position will I seek? What patient population will I

care for? What are my current nursing practice strengths and oppor-tunities

for growth and improvement in preparation for this role?

Kristin decides that she would possibly seek a pediatric staff

nurse position in her local hospital if she returned to work.

Therefore, she plans to complete 30 contact hours of

Continuing Education ( Learning Option # 2) focused on the

care of children within her next renewal period. In addition, as

a result of the reflective assessment process, Kristin recognizes

that the advances in nursing over the past 15 years are signifi-cant

and that her knowledge and skills are not current. She

decides that she will complete a Board- approved refresher

course ( Learning Option # 3) in the renewal period prior to her

actual return to active nursing practice.

What do I do if my practice changes significantly

within a two year license renewal period? Can I

change my self assessment and learning plan?

Yes, self assessments and learning plans are dynamic

documents, able to be amended or changed as your

nursing practice and learning needs change. If audited,

you would simply reference the reason for your revised goals

and focus.

F s

Frequently Asked

Questions

A

Q.

Q

A.

Q.

A.

C

14 { Official Publication of the NORTH CAROLINA Board of Nursing } . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Raleigh, NC -- At its January Board meeting, the North Carolina Board of Nursing announced

the selection of Julia L.( Julie) George, RN, MSN, FRE to serve as the next Executive Director of

the Board. George will fill the position on July 7, 2008, upon the retirement of Mary P. ( Polly)

Johnson, RN, MSN, FAAN, who has been the Board’s Executive Director for the past eleven years.

George has been a registered nurse for over 34 years and has held various positions on the staff of

the Board for 12 years. She currently serves as Associate Executive Director for Programs. Since

2001, George has been actively involved in efforts to re- frame regulatory initiatives related to prac-tice

errors and discipline. She has been instrumental in developing policy and programs focused on

patient safety, remediation and quality improvement. In 2005 George was the recipient of the

Board’s Employee Excellence Award. This award recognizes outstanding achievement of a Board

staff member nominated by their peers. In 2007, George was among the inaugural cohort of nurse

regulators to complete a four year Fellowship with the National Council of State Boards of Nursing

( NCSBN) Institute for Regulatory Excellence. She currently serves on the Board of Directors for NCSBN.

The North Carolina Board of Nursing is the state agency responsible for licensing North Carolina’s more than 126,000 nurs-es.

In addition to issuing, renewing and reinstating licenses of RNs and LPNs, the Board approves and monitors the state’s

nursing education programs which lead to initial licensure, investigates complaints against licensed nurses and maintains the

Nurse Aide II registry.

Founded in 1903, the North Carolina Board of Nursing was the first in the nation.

Julie George selected as new Executive Director

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NOMINATION FORM for 2008 ELECTION

Nomination of Candidate for Membership on the North Carolina Board of Nursing for 2008

Although we have just completed a successful Board of Nursing election, we already are

getting ready for 2008. This year the Board will have three openings: one for an RN who is

an advanced practice nurse; one for an RN who is a practical nurse educator; and one for a

RN staff nurse. This nomination form is for you to tear out and use. The form must be com-pleted

and postmarked on or before April 1, 2008. Following are instructions for completing

the form and guidelines for nominations. Be sure to follow all the instructions. Because all

Board members serve four year terms, no LPN position is open during the 2008 election.

Instructions

Nominations for all RN positions shall be made by submitting a completed petition

signed by no fewer than 10 RNs ( for an RN nominee) eligible to vote in the election. The

minimum requirements for an RN to seek election to the Board and to maintain member-ship

on it are as follows:

1. Hold a current unencumbered license to practice in North Carolina

2. Be a resident of North Carolina

3. Have a minimum of five years of experience in nursing

4. Have been engaged continuously in a position that meets the criteria for the specified

Board position, for at least three years immediately preceding the election, except for

the RN at- large position

Minimum ongoing- employment requirements for the RN member shall include continuous

employment equal to or greater than 50% of a full- time position that meets the criteria for

the specified Board member position, except for the RN at- large position.

If you are interested in being a candidate for one of the positions, visit our website at

www. ncbon. com for additional information, including a Board Member Job Description and

other Board- related information. You also may contact Angela Ellis, executive assistant, at

angela@ ncbon. com or ( 919) 782- 3211, ext. 259. After careful review of the information

packet, you must complete the nomination form and submit it to the Board office by April

1, 2008.

Guidelines for Nominations

1. RNs can petition only for RN nominations.

2. Only petitions submitted on the nomination form will be considered. Photocopies or

faxes are not acceptable.

3. The certificate number of the nominee and each petitioner must be listed on the form.

( The certificate number appears on the upper right- hand corner of the license.)

4. Names and certificate numbers ( for each petitioner) must be legible and accurate.

5. Each petition shall be verified with the records of the Board to validate that each nomi-nee

and petitioner holds appropriate North Carolina licensure.

6. If the license of the nominee is not current, the petition shall be declared invalid.

7. If the license of any petitioner listed on the nomination form is not current, and that

finding decreases the number of petitioners to fewer than ten, the petition shall be

declared invalid.

8. The envelope containing the petition must be postmarked on or before April 1, 2008,

for the nominee to be considered for candidacy. Petitions received before the April 1,

2008, deadline will be processed on receipt.

9. Elections will be held between July 1 and August 15, 2008. Those elected will begin their

terms of office in January 2009.

Please complete and return nomination forms to 2008 Board Election, North Carolina

Board of Nursing, P. O. Box 2129, Raleigh, NC 27602- 2129.

We, the undersigned currently licensed nurses, do hereby petition for the name of ________________________________, RN

( circle one), whose Certificate Number is ______________________, to be placed in nomination as a Member of the N. C. Board of

Nursing in the category of ( check one):

RN- Advanced Practice Nurse RN – Practical Nurse Educator RN, Staff Nurse

Address of Nominee __________________________________________________________________

Telephone Number: ( Home) _______________________ ( Work) _____________________________

E- mail Address: ______________________________________________________________________

PETITIONERS - ( At least 10 petitioners per candidate required. Only RNs may petition for RN nominations.)

TO BE POSTMARKED ON OR BEFORE APRIL 1, 2008

NAME SIGNATURE CERTIFICATE NUMBER

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

Please complete and return nomination forms to 2008 Board Election, North Carolina Board of Nursing, P. O. Box 2129, Raleigh, NC 27602- 2129

16 { Official Publication of the NORTH CAROLINA Board of Nursing } . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Random Audits to

begin this summer

Random audits of compliance with

Continuing Competence requirements will

be implemented for licensees renewing or

reinstating beginning July 1, 2008. For

example, for those nurses selected for

audit through the random automated

process, reminder notices sent out in May

for renewals due in July 2008 will include

notification of the random audit. Should

you be selected for an audit, evidence of

having met Continuing Competence

requirements is due no later than the

license renewal date or upon reinstate-ment.

Audited licensees failing to submit

timely, acceptable, and complete evidence

of having met the requirements will be

issued a license in accordance with Board

policy, but they are then subject to compli-ance

review and disciplinary proceedings.

A summary of Continuing Competence

requirements, learning options, and

acceptable evidence of having met chosen

learning options is available on the Board’s

Web site: www. ncbon. com. Click on

Continuing Competence under Quicks

Links on the Board’s homepage to review

this information. Should you have ques-tions,

contact: Tammy Edelen,

tammy@ ncbon. com or call 919 782- 3211

ext 281

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Elected

Members

- take office

• Pamela B.

Edwards, RN, MSN,

Ed. D.

Pamela B. Edwards is

returning to the Board

of Nursing after a two

year hiatus. She is cur-rently

an Associate

Chief Nursing Officer in the Duke University

Health System and Specialty Director of the

MSN Nursing Education Program at Duke.

Edwards has more than 29 years of nursing

experience in a variety of healthcare settings.

“ I believe that my nursing experience coupled

with my current role in nursing education

allows me a unique understanding of both edu-cation

and practice. I look forward to serving

on the Board again,” noted Edwards.

• Joan Guilianelli,

LPN

Joan Guilianelli is a new

member to the Board of

Nursing. With more

than 30 years in the pro-fession,

Guilianelli brings

a wealth of experience

to the Board. “ All

nurse’s roles change over time; I feel my expe-rience

in numerous patient settings can be of

great value as the Board revaluates nursing

scope of practice,” Guilianelli reports.

Originally from New York, Guilianelli now

works at the Durham Veterans Medical Center.

While she has worked in many areas including

ICU and CCU, Guilianelli has for the past ten years

worked in urology, an area where she has held certifi-cation

for more than eight years.

• Mary Ann Fuchs, RN,

MSN

Chief Nursing and Patient Care

Services Officer for Duke

University Hospital and Health

Systems, was elected to a four-year

term on the Board of

Nursing. Previously, Fuchs was

fulfilling the remaining term of

Jackie Ring, RN, MBA, who resigned. Fuchs has

more than 25 years of nursing experience. In addi-tion

to being a member of the Board Governance

Committee, Fuchs serves on the Joint Subcommittee

of the Board of Nursing and the Medical Board that

regulates nurse practitioners.

• Martha Ann Harrell of

Fayetteville has been reap-pointed

to a second four year

term as a public member to

the Board of Nursing. In addi-tion

to serving on Licensure

Review Panels, Harrell is a

member of the Board’s Audit

Committee.

• Paul Rusk, LPN was appointed to the Board to

fulfill the remaining term of Lynn Lancaster, formerly

an LPN who recently completed her education and is

now licensed as an RN. Rusk has more than 26

years of nursing experience and is currently the

Director of Azalea Place, an

assisted living community in

Wilmington, NC. Rusk is an

experienced Board member

having served in previous

years. In addition to serving

on Licensure Review Panels,

he is also a member of the

Audit Committee.

18 { Of f i c i a l Publication of the NORTH CAROLINA Board of Nursing } . . . . . . . . . . . . . . . . . . . . . . . . . . .

OUR MISSION

To improve the health outcomes for citizens of North

Carolina by enhancing the practice of nursing through leader-ship

development, research and demonstration projects.

OUR VISION

To become a significant conduit through which innovative

ideas related to health and healthcare can be evaluated and dis-seminated

to the principal arenas of professional nursing and

healthcare practice in North Carolina.

We will know we are achieving our vision when we:

1. Improve patient safety and nurse competence using a

statewide, evidence- based model for transitioning new

graduates into practice.

2. Reduce turnover of newly licensed nurses by 15 percent

during the first year of practice through implementation of

statewide transition to practice model. ( NOTE: Some lit-erature

indicates that 35 percent - 60 percent of new nurses

change jobs during the first year of employment.)

3. Enhance patient safety by implementing a learning and

quality improvement approach to reducing errors and

potential for errors in healthcare delivery settings

statewide. ( Use Just Culture and nurse competency assess-ment

tools to identify risk areas for safe patient care and estab-lish

learning/ corrective measures plans.)

4. Attract human and financial resources beyond our imme-diate

geographic location; and,

5. Develop evidence based strategies for improving care

delivered by all health professionals.

ACTIVITIES TO DATE

• The Foundation sponsored two invitational conferences

focusing on improving health care delivered to citizens of NC.

The Patient Safety Symposium was held to update attendees

on patient safety initiatives nationally and across North

Carolina and to identify opportunities to enhance patient safety

through collaboration among NC’s leading health care entities.

This symposium was the first of its kind held in North Carolina.

A research conference titled Building an Evidence- Based

Transition to Nursing Practice was held with the objective of

identifying core competencies needed by new nurses regardless

of practice setting and developing reliable measures to assess

their competence. This conference was partly funded by a grant

from Agency for Healthcare Research and Quality ( AHRQ).

• Transition to Nursing Practice Project – In 2004, the NC

Institute of Medicine issued a report on North Carolina’s nurs-ing

workforce with the recommendation that the NC Board of

Nursing convene a work group to study options to improve

school- to- work transitions for new nurses. The Foundation, in

collaboration with the NC Center for Nursing and NC AHEC

Programs, began meeting to develop strategies for an evidence-based

nurse transition program.

New nurses are entering into an increasingly complex health-care

environment. The goal of the Transition to Nursing

Practice Project is to ensure that new nurse graduates are

afforded the opportunity to gain confidence and competence as

they enter the workforce, thus enhancing patient safety and

increasing retention in the workplace.

Currently, there is no statewide model or standardized

approach to support the transition from student to entry level

safe practitioner. Nor is there any standard measurement of the

time required or the extent to which new grads improve their

competence and confidence following their entry into the work-force.

In early 2006, the FNE convened an information session to

share the vision of a future transition to practice program in NC

and received ideas from nurse educators, employers, and practi-tioners.

Stakeholders who represent the diversity of nursing

practice and education across our state continue to help guide

this work.

In June 2006, the FNE received a grant from the BCBSNC

Foundation to support a two year planning phase for this collab-orative

project.

In August, October and December 2007, data related to com-petence

development and risk for errors was collected from

newly licensed registered nurses and their preceptors in selected

hospitals across North Carolina as Phase I of this project.

Preliminary analysis of data should be available by March 2008

to inform the planning for Phase II of the project.

The long- term project goal is to create an evidence- based

statewide transition to practice program for new nurse graduates

by 2015.

• Building a Just Culture Community in North Carolina –

Just Culture, a term coined by David Marx, an engineer and

attorney, is described as follows: On one side of the coin, it is

about creating a reporting environment where staff can raise their

The Foundation for Nursing Excellence (“ the Foundation”) was created by the NC Board of Nursing in 2002 as a non- profit corporation

organized to improve health outcomes for the citizens of North Carolina by enhancing the practice of nursing and to support projects whose

efforts will provide new and innovative methodologies related to nursing regulation and safe, effective nursing practice.

c o n t i n u e d o n p a g e 2 0

FOUNDAT I O N FOR

NU R S I N G EXCELLENCE

{ Of f i c i a l Publication of the NORTH CAROLINA Board of Nursing } . . . . . . . . . 20 . . . . . . . . . . . . . . . . . . .

hand when they have seen a risk or made a mis-take.

On the other side of the coin, it is about

having a well- established system of accountabili-ty.

A Just Culture must recognize that while we

as humans are fallible, we do generally have

control of our behavioral choices.

Just Culture philosophy makes a distinc-tion

between human error, at- risk behavior

and intentional reckless behavior by looking

at why an event happened in a systematic

manner and determining whether the

actions of the individual warrant counseling,

remediation or punishment.

Just Culture uses a framework designed to

enhance patient safety by implementing a

learning and quality improvement approach

to reducing errors and potential for errors

The NC Board of Nursing has adopted

this framework for evaluating practice- relat-ed

complaints. The NC Center for Hospital

Quality and Patient Safety is facilitating a

collaborative with several NC hospitals to

implement a Just Culture environment.

NC Board of Nursing is piloting a Just

Culture partnership with six hospitals to pro-mote

consultation and assist employers in

identifying events that can be addressed in

the practice setting versus those that would

benefit from board intervention.

The Foundation, working in collaboration

with key stakeholders, seeks to extend this

learning and quality improvement framework

into a variety of healthcare settings with the

long term goal of creating a statewide Just

Culture Healthcare Community.

Planning meetings have begun with the

first priority focused on extension of this Just

Culture environment into long- term care

settings.

MAKE A DONATION

The Foundation is supported financially

through contributions from individuals,

foundations and organizations that share the

goal of improving the quality and safety of

patient care.

Tax- deductible contributions can be made

to the Foundation by visiting our Web site at

www. ffne. org. Click on “ Make a Donation.”

Contact Us:

Foundation for Nursing Excellence

P. O. Box 2129, Raleigh, NC 27602

Telephone: 919- 782- 3211

Fax: 919- 781- 9461

c o n t i n u e d f r o m p a g e 1 8

Name&

Address

C H A N G E

If requesting a name change, complete this form and return to the Board office with a photocopy of

a document that reflects your new legal name ( i. e. driver’s license, social security card, marriage

license or court document.) Name changes are usually processed within two to three business days

from date of receipt. You can confirm that the change has been made by verifying your license on

our Web site, www. ncbon. com, and clicking on VERIFY LICENSE or by calling our automated verifi-cation

line at ( 919) 881- 2272.

RN Cert. Number __________________________

LPN Cert. Number __________________________

NAII Listing Number ________________________

Provide name ( no nicknames) and address for Board records. Please print clearly.

name: _________________________________________________________

( first) ( middle) ( last)

address:__________________________________________________________

city: ___________________ __________ state: ____ zip/ postal code: _________

date of birth: _________________ social security number: _____-____-______

other last names: __________________________________________________

daytime phone number: ___________________________

signature:_______________________________________ date: ____________

email: _______________________________________

For RN and LPN only:

You are required to update the following information for each change of address submitted:

Primary State of Residence: ____________

Are you on active duty as an Armed Forces Nurse: ( circle one) YES NO

Please note that a duplicate license reflecting the changes will no longer be issued

due to the Board going cardless January 01, 2007.

Mail form and document to: NORTH CAROLINA BOARD OF NURSING

Attn: Barbara Nelson

P. O. Box 2129

Raleigh, NC 27602

Or fax to: ( 919) 781- 9461

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NC

" It is NOT how much you

do, but how much love

you put in the doing."

– Mother Theresa

" The trained nurse has

become one of the great

blessings of humanity,

taking a place beside the

physician and the priest."

– William Osler

the BREAK

r o o m

22 { Official Publication of the NORTH CAROLINA Board of Nursing } . . . . . . . . . . . . . . . . . . . . . . . . . . . .

North Carolina

Board of Nursing

Calendar

Board Meeting

May 15- 16, 2008

September 18- 19, 2008

Administrative Hearings

April 24, 2008

July 25, 2008

Licensure Review

Panels

March 13, 2008

April 4, 2008

May 8, 2008

June 12, 2008

Education/ Practice

Committee

April 9, 2008

August 27, 2008

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NC

North Carolina Foundation for Nursing Excellence

Transition to Practice Project Underway

Successfully transitioning newly licensed registered nurses ( RNs) into entry- level practice is a long- standing

issue in the U. S. The North Carolina Foundation for Nursing Excellence, created by the NC Board of

Nursing, in collaboration with the NC Center for Nursing and the NC AHEC Programs, has implemented a

multiphase Transition to Practice Study that will provide data to determine the essential components of an

evidence- based state- wide transition requirement for newly licensed nurses and will contribute to the evi-dence

base for best practices related to transition experiences for newly licensed nurses.

Phase I of the study, supported with a grant from Blue Cross Blue Shield North Carolina Foundation,

included newly licensed RNs in acute care hospitals. ( A detailed explanation of the study can be found

at www. ffne. org). Data collection for this phase will be completed in February 2008, and the completion

of data analysis is targeted for summer 2008. The anticipated outcome of Phase I is to identify factors

contributing to safe practice and critical areas of need for focused competence development for newly

licensed RNs entering practice. This information will provide the evidence for the next phase of the

transition pilot to create intervention activities intended to enhance competence development for

the delivery of safe, effective care by newly licensed nurses entering practice.

Planning for and recruitment of participants for Phase II of this study are currently underway.

Phase II will have a dual focus: replication of phase I with newly licensed RNs in practice settings

other than acute care hospitals and newly licensed LPNs in all practice settings ( including, but not limit-ed

to, acute care); and an intervention or demonstration project that will be developed based on the data

analysis of phase I.

Please consider participating in this very important project. An interest form can be found on the

Foundation for Nursing Excellence’s Web site. The staff would be delighted to talk with you about the

project or answer any questions that you might have and can be reached at email@ ffne. org.

Nurses Represent N. C. in NCLEX Development

The following nurses represented North Carolina in the NCLEX item development program

for the first half of 2007:

• Laura B. Clark, member, RN item writing panel

• Becky Ann Foushee, member, RN item review panel

• Sharon G. Nelson, member, RN item review panel

• Reginaldo Horwitz, alternate, RN item review panel

.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . NC

ADMINISTRATIVE MATTERS

• Approved modification of online application for license

renewal to allow nurses to make voluntary charitable contri-butions

to the Foundation for Nursing Excellence at the time

of license renewal.

• Approved implementation of plan to revise composition and

charge of Education and Practice Committee

• Approved NC Board of Nursing Communication Plan

• The Board approved proposed changes to the Nursing

Practice Act to be taken to the 2009 General Assembly. In

addition to technical changes and clarification regarding

what records are public or non- public in a disciplinary case,

proposed changes in the NPA would authorize the Board to:

( 1) order the production of records in the course of an

inquiry or investigation; ( 2) enter into consent orders with

licensees or applicants requiring participation in remediation

programs; and ( 3) at its discretion, conduct criminal history

background checks on persons who are applying for renewal,

reinstatement, or retuning to active practice.

EDUCATION/ PRACTICE MATTERS

Summary of Actions related to Education Programs

Ratified mail referendum

Waive 21NCAC 36.0317 Administration ( c) ( 2) and

approve Heather Jacobs as interim program Director for

Robeson Community College, Lumberton – ADN program.

Ratified Full Approval Status for the following nursing educa-tion

programs

Alamance Community College, Graham – ADN

Vance- Granville Community College, Henderson – ADN

Ratified Expansion in Enrollment in the following nursing edu-cation

programs

Presbyterian School of Nursing at Queens University of

Charlotte, Charlotte – BSN – Increase of 60 for a total of

180 students beginning Spring 2008

Assigned Warning Status

Brunswick Community College, Supply – PNE

Assigned Warning Status due to NCLEX Pass Rates

For 2006- 2007, the national pass rate is 87 percent for RN

and 88 percent for PN; 95 percent of this is 83 percent for

RN and 84 percent for PN. The two year pass rate is a true

calculation of the total number of first time test passers dur-ing

the two year period January 1, 2006, through December

31, 2007, divided by the total number of first time test takers.

The following programs did not meet the Standard for the

calendar year 2007. Their two year pass rates for the time

frame of January 1, 2006, to December 31, 2007, are reflected

as well as their single year pass rates for 2006 and 2007.

The following programs did not meet the Standard for the

calendar year 2006 and were already on Warning. Their

2007 pass rates are reflected. These programs are continued

on Warning Status for a second year, and a focused survey

will be scheduled.

The following program did not meet the Standard for the cal-endar

years 2005, 2006 and 2007. This is the second year on

warning status; they were assigned approval with stipulations

in 2005. A focused survey will be scheduled.

c o n t i n u e d o n p a g e 3 0

SUMMARY of ACTIONS

In keeping with public records and open meetings laws, the North Carolina Board of Nursing posts all actions in the Nursing Bulletin

or on its website, at www. ncbon. com. A regular meeting of the Board was held on January 24- 25, 2008, in Raleigh. The following is a

summary of the Board’s actions.

From the January 24- 25, 2008, Board Meeting

Program 2006 2007 2 year

Fayetteville State University, Fayetteville – BSN

None 64% 64%

UNC- Pembroke, Pembroke – BSN

None 68% 68%

Western Carolina University, Cullowhee – BSN

85% 77% 81%

Brunswick Community College, Supply – ADN

None 58% 58%

Caldwell Community College and Technical Institute, Hudson – ADN

90% 71% 80%

James Sprunt Community College, Kenansville – ADN

77% 85% 80%

Lenoir Community College, Kinston – ADN

97% 61% 80%

Region A Nursing Consortium, Clyde – ADN

84% 71% 77%

Rowan- Cabarrus Community College, Salisbury – ADN

100% 69% 82%

Southeastern Community College, Whiteville – ADN

83% 74% 77%

Rockingham Community College, Wentworth – PNE

80% 76% 78%

Program 2006 2007 2 year

Bladen Community College, Dublin – ADN

53% 81% 66%

Foothills Nursing Consortium, Spindale – ADN

71% 71% 71%

Randolph Community College, Asheboro – ADN

71% 88% 78%

Rockingham Community College, Rockingham – ADN

74% 64% 68%

Program 2005 2006 2007 2 year

North Carolina A& T State University, Greensboro – BSN

69% 69% 84% 76%

April 7, 2008, 8: 00 a. m. – 3: 30 p. m., Friday Center, Chapel Hill, NC

Keynote address on Conceptual Learning presented by Jean Giddens, Ph. D.

Workshop and poster sessions highlighting innovative approaches that are working in NC for sharing educational resources,

utilization of technology, evidence- based teaching practices, faculty development, recruitment and retention of faculty, and

clinical teaching.

Targeted Audience: Nurse educators including faculty, practice partners, staff development educators, and preceptors

both of students and new nurses.

Objectives:

1. Discuss innovative approaches being used in NC nursing education.

2. Identify characteristics of environments that support innovation in nursing education.

3. Describe the use of concept based curriculum in managing content saturation.

4. Identify teaching learning strategies that support the development of conceptual thinking.

Registration: Forms available on- line on the Education page at www. ncbon. com.

Cost: $ 100 – includes all materials, continental breakfast, and lunch.

Contact hours awarded: 5.5 – will be awarded for attending workshop in its entirety. No partial credit will be awarded.

EDUCATION SUMMIT # 5

The NC Board of Nursing is approved as a provider of continuing nursing education by the North Carolina Nurses Association, an accredited approver

by the American Nurses Credentialing Center’s Commission on Accreditation.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NC

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NC NC Board of Nursing Workshop Registration Form 2008

Continuing Competence Update ( 1.0CHs)

Information sessions related to board requirements

for demonstration of continuing competence.

No fee required for cont comp sessions.

Questions/ Directions? Contact Paulette at

( 919) 782- 3211, ext. 244, or via e- mail at PAULETTE@ ncbon. com.

LEGAL SCOPE OF PRACTICE ( 2.3 CHs)

The purpose of this offering is to provide information and

clarification regarding the legal scope of practice parameters for

licensed nurses in North Carolina. $ 40.00 Fee.

Questions/ Directions? Contact Pamela Trantham

919/ 782- 3211 ext. 279 OR Pamela@ ncbon. com

YOU DO NOT NEED TO COMPLETE/ SUBMIT THIS

FORM FOR THE ONLINE WORKSHOPS!

Go to www. ncbon. com

Select Events at top of homepage - Go to “ Workshops and

Conferences”. Click on “ Board Sponsored Workshops”

- Click on the link - follow instructions.

Orientation Sessions for Administrators of Nursing Services

and Mid- Level Nurse Managers ( 4.6 CHs)

( Raleigh- NCBON- 10a- 3: 55p)

ONLINE WORKSHOPS!

Information sessions regarding the functions of the Board of

Nursing and how these functions impact the roles of the chief

nurse administrator and mid- level nurse manager in all types of

nursing service settings.

Registration fee of $ 40.00.

PLEASE CHECK THE APPROPRIATE WORKSHOP BELOW

June 11, 2008

October 22, 2008

Registration at least two weeks in advance of a scheduled session is

required. No refunds will be made if canceled within 10 days of the

workshop, and last minute transfers to another date will be granted on

a space available basis. For directions, please go to:

http:// www. ncbon. com- Contact- Directions

( limit 20 people per session)

Questions/ Directions? Contact Linda Blain

919/ 782- 3211 ext. 238 OR Lindab@ ncbon. com

Rev Up Your Nursing Practice!

NCBON Regional Workshops

Registration fee of $ 40.00 for entire workshop. Seating is

limited. All workshops listed below begin and end at the

same time. Contact hours pending.

Questions/ Directions: Paulette Young – 919- 782- 3211 ext. 244

or PAULETTE@ ncbon. com

OBJECTIVES:

NCBON consultants will help you kick your nursing practice into

high gear! By the end of the interactive workshop, you should be

able to:

1) Discuss the continuing competence requirements,

2) Practice within your legal scope,

3) Identify the steps involved in the investigative process, and

4) Describe the NCBON's role as a resource for recovering nurses.

AGENDA

8: 30 a. m. – 9: 15 a. m. Welcome, Introductions and Board Update

9: 15 a. m. – 9: 45 a. m. Continuing Competence

9: 45 a. m. – 10: 00 a. m. Break

10: 00 a. m. – 11: 30 a. m. Legal Scope of Practice

11: 30 a. m. – 1: 00 p. m. Lunch ( on your own)

1: 00 p. m. – 1: 45 p. m. Investigative Process and Outcomes

1: 45 p. m. – 2: 00 p. m. Break

2: 00 p. m. – 3: 15 p. m. Alternative Programs/ Recovering Nurse

3: 15 p. m. – 3: 30 p. m. Q& A, Evaluations

PLEASE CHECK THE APPROPRIATE WORKSHOP BELOW

March 27, 2008 - Pitt County Memorial Hospital Auditorium

2100 Stantonsburg Road , Greenville, NC

May 21, 2008 - Mountain Area Health Education Ctr

501 Biltmore Avenue, Asheville, NC

Co- provided by MAHEC

July 15, 2008 - Carolinas Medical Center, College of

Health Sciences, Room 190 ( Auditorium)

1200 Blythe Blvd - Charlotte, NC

SCHEDULED PRESENTERS

Julia L. George, RN, MSN – Assoc Executive Director - Programs

Eileen Kugler, RN, MSN, MPH, FNP - Practice Consultant

Kathy Chastain, RN, MN – Manager- Practice

Carol Walker, RN, MS, CS - Practice Consultant

Kay McMullan, RN, MSN - Director of Investigations/ Monitoring

Kathy Chastain, RN, MN – Manager- Practice

Receiving Contact Hour Certificates: For all workshops listed on this registration form,

contact hour certificates will be presented to participants who attend the selected workshop in its entirety.

30 { Of f i c i a l Publication of the NORTH CAROLINA Board of Nursing } . . . . . . . . . . . . . . . . . . . . . . . . . . . .

The Education & Practice Committee approved the Rapid

Sequence Intubation Position Statement at the December 6,

2007, Education and Practice Committee Meeting. The

statement is online at www. ncbon. com under “ Practice,” -

“ Position Statements.”

The Education and Practice Committee received an FAQ as

information related to “ LPNs Administering and Reading TB

Tests” and “ Nurse Role in Sports Assessment.” The FAQ can

be found on the NCBON Web site ( www. ncbon. com) under

Practice – Practice FAQ ( Numbers 13 and 14, respectively).

INVESTIGATION AND MONITORING ACTIONS

Received reports and Granted Absolutions to two RNs, one

LPN.

Removed probation from the licenses of 17 RNs and eight

LPNs.

Accepted the Voluntary Surrender from 19 RNs and five LPNs.

Suspended the licenses of 11 RNs and two LPNs.

Reinstated the licenses of 19 RNs and one LPN.

Number of Participants in the Alternative Program for

Chemical Dependency: 147 RNs and 11 LPNs.

Number of Participants in the Chemical Dependency Program

( CDDP):

79 RNs, four LPNs

Number of Participants in Illicit Drug/ Alcohol Program: 37

RNs, 10 LPNs.

SUMMARY of ACTIONS c o n t i n u e d

Registration Payment/ Information Section

PLEASE INDICATE THE FOLLOWING:

Title/ Date of Workshop( s); ____________________________________________________

____________________________________________________

____________________________________________________

Registration fee: $ 40.00 per session per person for all workshops except for Continuing

Competence Update. NON REFUNDABLE ( Unless Workshop Cancelled)

General Information:

NAME:________________________________________________________________________

TITLE:________________________________________________________________________

NAME OF PRACTICE IN WHICH YOU ARE EMPLOYED ( ex: ABC Cancer Center):

______________________________________________________________________________

Home

ADDRESS: _____________________________________________________________________

CITY: ______________________________ STATE: ______ ZIP: ___________

HOME PH#: (____)________________

E- MAIL ADDRESS: __________________________________________________

Please give complete address as you will be mailed/ emailed a confirmation and/ or directions.

Make checks payable to North Carolina Board of Nursing or pay by credit card. Registration fee covers course materials.

Credit Card Type: MasterCard Visa Expiration Date: Month: _____ Year: _____

Cardholder Name ( as it appears on Credit Card):___________________________________

Cardholder Billing Address: _____________________________________________

CITY: ________________________________ STATE: _________ ZIP: _________

Total Amount: $____________________

Cardholder Signature: ________________________________________________

( Credit card payment cannot be accepted via fax or phone.)

Credit Card Number:

NC Board of Nursing Workshop Registration Form 2008 cont.

YOU CAN

REGISTER ONLINE!

To be placed on the roster for

the Orientation Sessions

Workshop or the Rev Up Your

Nursing Practice Regional

Workshop, go to

www. ncbon. com: Select Events

at top of homepage, Go to

“ Workshops and Conferences”,

Click on “ Board Sponsored

Workshops”, Click on desired

workshop.

( If you register online, please do

not submit this form.)

The North Carolina Board

of Nursing is an Approved

Provider of continuing nurs-ing

education by the North

Carolina Nurses

Association, an accredited

approver by the American

Nurses Credentialing

Center’s Commission on

Accreditaion.