Arizona State Board of Nursing
1740 W Adams Street, Suite 2000
Phoenix. AZ 85007
Phone: 602- 771-7800
Website: www.azbn.gov
APPLICATION FOR FULL APPROVAL OR
RENEWAL OF APPROVAL FOR BOARD APPROVED NURSING PROGRAMS
This application and the accompanying information is intended to assist your program in the approval
process. This application is a preliminary step in the process and should be mailed to the Board in a timely
manner. Site visits will not be scheduled until the complete self-study is submitted and reviewed. It may
take up to 30 days to review the self-study.
Program Name: ______________________________________________________________________
Parent Institution: _____________________________________________________________________
Other Sites___________________________________________________________________________
Address: ____________________________________________________________________________
Phone______________________________________________________________________________
Nursing Administrator_________________________________________________________________
Administrator Phone: _________________________________________________________________
Administrator Email: _________________________________________________________________
Date of last approval from the Board: _____________________________________________________
Anticipated date you will submit self-study: ________________________________________________
Preferred dates of site visit: _____________________________________________________________
Request oral report (see instructions): Yes No
______________________________________________________________________
Director of Program (Signature) Date
______________________________________________________________________
Print Name
______________________________________________________________________
Administrator of Parent Institution (Signature) Date
______________________________________________________________________
Print Name
click to sign
signature
click to edit
click to sign
signature
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INSTRUCTIONS FOR FULL APPROVAL or
RENEWAL OF APPROVAL FOR BOARD APPROVED NURSING PROGRAMS
In order to help you prepare the self-study, the following documents are available on the Board
website www.azbn.gov or at the links provided:
Nurse Practice Act (contains the Statutes & Rules)
Policy on Submission of Materials to Education Committee
Full Approval Application Worksheet
Please take a moment to review the policy on: Process / Progression of New Program Approvals
Please contact us for concerns or questions during application process.
GUIDELINES FOR THE SELF STUDY:
The administrator shall submit one copy all materials to the Board of Nursing Education Consultant not
less than 30 days before the planned visit and at 4 months before expiration of provisional approval. The
materials should be single-sided, on letter size white paper, consecutively numbered and bound together.
Please do not include folders, notebooks, or bulky materials, as they are difficult to file. You must include
the following items:
I. Self-study
A. Title page with program name, address of program site, phone of parent
institution/administrator, e-mail address, fax number, classification of nursing program by
both educational degree (diploma, ADN, BSN) and licensure (RN/PN/Multiple exit).
B. A description and short history of the program and parent institution.
C. The “Application Worksheet” that contains each and every rule to be addressed: R4-19-
201 to R4-19-206 with an accompanying narrative analyzing the extent to which the
program complies with the rule. When writing the narrative, do not just affirm that the rule
is met. The evidence demonstrating compliance with the full rule needs to be disclosed.
For example there are criteria for faculty evaluation. The fact that full-time faculty are
evaluated does not address the rule until all criteria as applied to all faculty are discussed.
D. An appendix to include supporting documents such as charts, comparison graphs, and the
evaluation plan (as described in the self-study guidelines). This is a list of documents to
include in the self-study is detailed below. Other materials may be requested during the
visit.
Regional or national and state accreditation documents
A comparison chart of the mission and goals statements of both the program and the
parent institution showing consistency of mission and goals
Sample clinical contract
Organizational chart(s) indicating the position of the program within the overall structure
of the parent organization and the organization within the program
Job description for nursing program administrator
Program Systematic Evaluation Plan with the trended and aggregate results of the
evaluation of each component and actions taken by the program in response to the data
collected.
Faculty evaluation tools/forms
Job descriptions for faculty
Faculty handbook/bylaws/policies that pertain to rule compliance (just include specific
pages or paste policies)
Nursing student policies that pertain to rule compliance (just include specific pages or
paste policies)
A chart of faculty including name(s), AZ or multi-state compact license #, educational
background (including whether master’s degree is with a major in nursing), teaching
responsibilities, and years of patient care experience
Curriculum evidencing congruency of program objectives/goals, level or course
objectives, and unit objectives with content. A comparison chart is recommended (see
below). Materials should include:
Program outcomes/goals
Course sequence
Course descriptions
Level objectives, if any
Course objectives for all courses
Unit objectives for at least one nursing course
Course content outline for at least one nursing course
If a preceptorship experience is offered, a description of the preceptorship consistent with the Boards
advisory opinion “Preceptorship for Pre licensure Students” available at https://azbn.gov/scope-of-
practice/advisory-opinions
II. Other Items: these items should be submitted to Board staff only; they do not need to be bound
into the self-study
A. One copy of the college catalogue (or electronic access)
B. One copy of the nursing student handbook (or electronic access)
C. One copy of nursing program faculty handbook (or electronic access)
Following submission and review of these materials, a determination of completeness will be made. If
substantially complete, a site visit will be scheduled.
APPLICABLE RULES
R4-19-208. Application for Full Approval of a Nursing Program
Rules are provided in the Full Approval Application Worksheet.
A. A nursing program seeking full approval shall submit an electronic and one paper copy of an
application that includes the following information and documentation:
1. Name and address of the parent institution,
2. Date the nursing program graduated its first class of students, and
3. A self-study report that contains evidence the program is in compliance with R4-19-201
through R4-19-206.
B. Following an onsite evaluation conducted according to A.R.S § 41-1009, the Board shall grant full
approval for a maximum of five years or the accreditation period for nationally accredited
programs governed by R4-19-213, to a nursing program that meets the requirements of this Article
and if approval is in the best interest of the public. A nursing program that is denied full approval
may request a hearing by filing a written request with the Board within 30 days of service of the
Board's order denying the application for full approval. Hearings shall be conducted in accordance
with A.R.S. Title 41, Chapter 6, Article 10 and 4 A.A.C. 19, Article 6.
R4-19-210. Renewal of Approval of Nursing Programs Not Accredited by a National Nursing
Accrediting Agency
A. An approved nursing program that is not accredited by an approved national nursing accrediting
agency shall submit an application packet to the Board at least four months before the expiration
of the current approval that includes the following:
1. Name and address of the parent institution,
2. Evidence of current institutional accreditation status under R4-19-201,
3. Copy or on-line access to:
a. A current catalog of the parent institution,
b. Current nursing program and institutional student and academic policies, and
c. Institutional and nursing program faculty policies and job descriptions for nursing
program faculty, and
4. One electronic copy and one paper copy of a self-study report that contains evidence of
compliance with R4-19-201 through R4-19-206.
B. Following an onsite evaluation conducted according to A.R.S. § 41-1009, the Board shall renew
program approval for a maximum of five years if the nursing program meets the criteria in R4-19-
201 through R4-19-206 and if renewal is in the best interest of the public. The Board shall
determine the term of approval that is in the best interest of the public.
C. If the Board denies renew al of approval, the nursing program may request a hearing by filing a
written request with the Board within 30 days of service of the Board's order denying the
application for renewal of approval. Hearings shall be conducted in accordance with A.R.S. Title
41, Chapter 6, Article 10 and 4 A.A.C. 19, Article 6.
PREPARING FOR THE SITE VISIT:
The purpose of the site visit is to clarify, amplify and verify the contents of the self-study submitted to the
Board. The rules (A.A.C. R4-19-201 to R4-19-207) will be used as the criteria that must be met in order
for Board approval to be granted. A site visit will not be scheduled until the entire self-study is received
at the Board and reviewed for completeness.
Some effort and planning will be needed to ensure a successful and efficient site visit. Contact key persons
well in advance to ensure that they are available and appraised of the importance of the visit. The
interviews are formal and participants will be informed that any responses may be used in a report to the
Board. There is no “talking off the record”. There should be no interruptions during the interview times.
Plan on the site visit taking at least two days.
Interview Guidelines:
The following meetings will need to be arranged. Suggested time frames for each meeting are indicated.
The site visitor will also need approximately 2 hours on site to examine documents and access to syllabi
and other documents to take off site. All original documents will be returned. Please send a copy of the
schedule to the Board office 2 weeks prior to the site visit.
Meetings and Suggested Times:
Director/dean/coordinator/chair of program - 2 hours initially and 1 hour prior to the exit report
Immediate supervisor of the director of the program - 1/2 hour
Director/administrator of the parent institution - 1/2 hour
Assistant Directors (if appropriate) - 1/2 hour
Library or resource director and tour - 15-30 minutes Faculty –1 hour
Advisors/counselors and admissions officer for the program (optional) - 30 minutes
Students— 1 hour--access to the consultant should be provided to all interested students - do not
select only certain students to meet the consultant
Graduates of the program (optional)
Tours:
Tour of parent institution Library Resource Center
Nursing Department including classrooms, offices, skills lab (if there are multiple sites- each site
needs to be toured)
Clinical sites (optional)
Documents to be examined on site:
This is a suggested list of documents to have on hand. The site visitor will need a quiet, secluded place to
examine the documents and about 2 hours on site. Other materials may be requested during the visit.
Program handbook
Regional or National Approval documents Nursing Department Budget (detailed)
Copy of clinical/course/program evaluation tools All Course syllabi/curriculum
All Clinical contracts Student policies Faculty policies Program policies Faculty files
Student files
Exams/examples of student work NCLEX Reports, if available
Reports of results from standardized testing (e.g. HESI, ERI)
EXIT REPORT:
Programs may request a preliminary oral exit report as part of the visit. Preliminary reports are not binding
and are subject to change. All personnel involved may be invited to the reading of the preliminary oral
report. The reading of the oral report is not an opportunity to debate the report but the consultant may
request assistance in the drafting of some aspects of the report and correction of errors. Programs are
requested not to publish the contents of the oral report. A written draft report will be provided to the
program nurse administrator within 30 days of the site visit. The program is requested to assist with
correction of facts and may comment and address any issues in the report.
AFTER THE SITE VISIT:
Based on feedback at the visit, the program may revise the self-study and submit 2 bound copies of the
self-study and one electronic copy in plain Microsoft Word format without hyperlinks with consecutively
numbered pages. (See Policy on Submission of Materials to Education Committee.
The consultant will make final revisions to the reports after the program administrator has provided
comment/correction to the draft reports and provide copies of her findings along with the self-study to the
program administrator and all members of the Education Committee. All communication about the
program will be directed to the nurse administrator of the program. Courtesy copies may be provided to
other individuals at the request of the program. Program approval is a 2-step process.
1. The self-study and consultant report is reviewed by the Education Committee in their regular
meeting for a recommendation to the Board. Programs are encouraged to send a representative to
this meeting to present any additional information and answer questions.
2. The Board will then take action on your approval at the next regularly scheduled meeting in
compliance with open meeting law. The Board will consider the recommendation of the Education
Committee, but the Board is not obligated to adopt any recommendations. Decisions made by the
Board may be different than the Education Committee recommendation. Programs are encouraged
to attend the Board meeting.
You will be notified of the dates of the Education Committee and Board meetings and offered a scheduled
time that the Board will consider the application. The Board may delay the time for any reason, but will
not consider the item before the scheduled time. Following the Board meeting you will be given a letter
apprising you of the board action. The most likely options the Board may consider are:
1. Grant full approval,
2. Grant full approval with conditions,
3. Continue provisional approval, or
4. Issue notice of deficiency.
*PLEASE NOTE THAT THERE ARE RULE CHANGES IN PROCESS*
EXAMPLES
EXAMPLE OF SELF-STUDY WORKSHEET
Rule
Met
Description of how program meets rule
requirement
(Document/Page#)
D. The parent institution shall
center the
administrative control of
the nursing program in
the nursing program
administrator.
Met
Administrative control is centered in the nursing
administrator. Dr. Susan Smith, the administrator of the
program, provides leadership for the faculty and
facilitates decision making. Dr. Smith represents the
faculty and program at College Council meetings.
Additionally Dr. Smith prepares and submits the program
budget, is a part of the grievance process, and evaluates
all faculty according to institutional policy and Arizona
State Board of Nursing rules. Dr. Smith and the faculty
jointly determine admission, graduation, and progression
Administrator Job
description; Faculty
meeting minutes;
Nursing program
Budget;
Grievance
Procedure (p. 24
Nursing Student
EXAMPLE OF CURRICULUM WORKSHEET--PROGRAM
Program outcomes
Level I outcomes
Level II outcomes
Level III outcomes
The graduate will work with
the patient and health team
members to establish priorities
and manage care to achieve
desired patient outcomes
The student will formulate
and implement a plan of
care for an individual
client in stable condition.
The student will
formulate and
implement a plan of
care for an acutely ill
client.
The student will collaborate with
other health care providers revise
plans of care for clients across the
lifespan to meet desired patient
outcomes and delegate selected
aspects of care to unlicensed
personnel.
EXAMPLE OF CURRICULUM WORKSHEET--COURSE
Course outcomes
Lesson Objectives
Content
Activities
The student will formulate and
implement a plan of care for an
individual client in stable
condition
The student will explicate
the components of the
nursing process.
The student will utilize the
nursing process in caring
for a single stable client
I. Components of the
Nursing process
A. Assessment
Physical assessment
Nursing Assessment
Analysis ……..etc
Group care plan Care plan
assignment Demonstration of
physical and nursing assessment
Return democheck-off
The student will apply the
nursing process in caring
for a patient with
respiratory disorders.
Compare and contrast
nursing interventions for
clients with common
respiratory diagnoses.
Assessment of the patient
with common respiratory
disorders
A. Physical findings;
lab tests
B. Functional abilities
II. Care of the patient
with common respiratory
disorders: pneumonia,
COPD, asthma,
emphysema
III E l ti f
Incentive spriometer demo
Suctioning Trach care
Oxygen administration Cough
and deep breathe