Commission on Collegiate Nursing Education

Proposed
Standards for Accreditation of Baccalaureate and Graduate Nursing Programs

INTRODUCTION

Accreditation Overview

Accreditation is a nongovernmental process conducted by representatives of postsecondary institutions and professional groups. As conducted in the United States, accreditation focuses on the quality of institutions of higher and professional education and on the quality of educational programs within institutions. Two forms of accreditation are recognized: one is institutional accreditation and the other is professional or specialized accreditation. Institutional accreditation concerns itself with the quality and integrity of the total institution, assessing the achievement of the institution in meeting its own stated mission, goals, and expected outcomes. Professional or specialized accreditation is concerned with programs of study in professional or occupational fields. Professional accrediting agencies assess the extent to which programs achieve their stated mission, goals, and expected outcomes. In addition, consideration of the program's mission, goals, and expected outcomes is of importance to the accrediting agency in determining the quality of the program and the educational preparation of members of the profession or occupation.

Commission on Collegiate Nursing Education

The Commission on Collegiate Nursing Education (CCNE) is an autonomous accrediting agency, contributing to the improvement of the public's health. A specialized/professional accrediting agency, CCNE ensures the quality and integrity of baccalaureate and graduate nursing programs.* CCNE serves the public interest by assessing and identifying programs that engage in effective educational practices. As a voluntary, self-regulatory process, CCNE accreditation supports and encourages continuing self-assessment by nursing programs and supports continuing growth and improvement of collegiate professional education. Because the accreditation process is a voluntary enterprise, institutions that seek CCNE accreditation of their baccalaureate and/or graduate nursing programs are viewed to have a cooperative relationship with CCNE in seeking ways to improve and enhance the educational programs for professional nursing students.

* Also applies to entry-level post-baccalaureate degree programs in nursing.

CCNE has established a peer review process in accordance with nationally recognized standards established for the practice of accreditation in the United States and its territories. Accreditation by CCNE serves as a statement of good educational practice in the field of nursing. Accreditation evaluations are useful to the program in that they serve as a basis for continuing or formative self-assessment as well as for periodic or summative self-assessment through which the program, personnel, procedures, and services are improved. The results of such assessments form the basis for planning and the setting of priorities at the institution.

The CCNE accreditation evaluation consists of a review of the program's mission, goals, and expected outcomes; and an assessment of the performance of the program in achieving the mission and goals through the most effective utilization of available resources, programs and administration. The evaluation process also calls for a review of evidence concerning the application of these resources in assisting the students in attaining their educational goals.

In evaluating a baccalaureate and/or graduate education program for accreditation, the CCNE Board of Commissioners assesses the standards and key elements presented in this publication carefully. A self-study conducted by the sponsoring institution prior to the on-site evaluation provides data indicating the extent to which the program has satisfied the key elements and, ultimately, whether the program has complied with the overall standards for accreditation.

The Commission formulates and adopts its own accreditation procedures. The accreditation procedures are stated in Procedures for Accreditation of Baccalaureate and Graduate Nursing Education Programs. This publication may be obtained by contacting CCNE offices.

Accreditation Purposes

Accreditation by CCNE is intended to accomplish at least five general purposes:

  1. To hold nursing programs accountable to the community of interest - the nursing profession, consumers, employers, higher education, students, and their families - and to one another by ensuring that these programs have mission statements, goals, and outcomes that are appropriate for programs preparing individuals to enter the field of nursing.
  2. To evaluate the success of a nursing program in achieving its mission, goals, and outcomes.
  3. To assess the extent to which a nursing program meets accreditation standards.
  4. To inform the public of the purposes and values of accreditation and to identify nursing programs that meet accreditation standards.
  5. To foster continuing improvement in nursing programs - and, thereby, in professional practice.

CCNE Accreditation: A Value-Based Initiative

CCNE accreditation activities are premised on a statement of principles or values. These values are that the Commission will:
  1. Foster trust in the process, in CCNE and in the professional community.
  2. Focus on stimulating and supporting continuous quality improvement in nursing programs and their outcomes.
  3. Be inclusive in the implementation of its activities and maintain an openness to the diverse institutional and individual issues and opinions of the interested community.
  4. Rely on review and oversight by peers from the community of interest.
  5. Maintain integrity through a consistent, fair, and honest accreditation process.
  6. Value and foster innovation in both the accreditation process and the programs to be accredited.
  7. Facilitate and engage in self-assessment.
  8. Foster an educational climate that supports program students, graduates, and faculty in their pursuit of life-long learning.
  9. Maintain a high level of accountability to the publics served by the process, including consumers, students, employers, programs, and institutions of higher education.
  10. Maintain a process that is both cost-effective and cost-accountable.
  11. Encourage programs to develop graduates who are effective professionals and socially responsible citizens.
  12. Assure autonomy and procedural fairness in its deliberations and decision-making processes.

Goals for Accrediting Nursing Programs

In developing the educational standards for determining accreditation of baccalaureate and graduate nursing programs, CCNE has formulated specific premises or goals on which the standards are to be based. These goals include the following:

  1. Developing and implementing accreditation standards that foster continuing improvement within nursing programs.
  2. Enabling the community of interest to participate in significant ways in the review, formulation, and validation of accreditation standards and policies and in determining the reliability of the conduct of the accreditation process.
  3. Establishing and implementing an evaluation and recognition process that is efficient, cost-effective, and cost-accountable with respect to the institution and student.
  4. Assessing whether nursing programs consistently fulfill their stated missions, goals, and expected outcomes.
  5. Assuring that nursing program outcomes are in accordance with the expectations of the nursing profession to adequately prepare individuals for professional practice, life-long learning, and graduate education.
  6. Encouraging nursing programs to pursue academic excellence through improved teaching/learning and assessment practices and in scholarship and public service in accordance with the unique mission of the institution.
  7. Assuring that nursing programs engage in self-evaluation of personnel, procedures, and services, and that they facilitate continuous improvement through planning and resource development.
  8. Acknowledging and respecting the autonomy of institutions and the diversity of programs involved in nursing education.
  9. Ensuring consistency, peer review, agency self-assessment, procedural fairness, identification and avoidance of conflict of interest, and confidentiality, as appropriate, in accreditation practices.
  10. Enhancing public understanding of the functions and values inherent in nursing education accreditation.
  11. Providing to the public an accounting of nursing programs that are accredited and merit public approbation and support.
  12. Working cooperatively with other agencies to minimize duplication of review processes.

Curricular Innovation

CCNE standards and key elements are designed to encourage innovation and experimentation in teaching and instruction. Without experimentation for the sake of experimentation and without adversely affecting the educational outcomes, curricular innovations should ultimately serve the needs of the student, the profession and the public. CCNE recognizes that advancements in technology have enabled programs to facilitate the educational process in ways that may complement or supplant traditional pedagogical methods. CCNE encourages the introduction and use of innovative teaching and learning strategies in the curriculum and looks to the programs that it accredits to make available this technology for the improvement and enhancement of student learning.

ABOUT THIS DOCUMENT

This publication describes the standards, key elements, and examples of evidence used by CCNE in the accreditation of baccalaureate and/or graduate nursing programs. The standards and key elements, along with the accreditation procedures, serve as the basis to evaluate the quality of the educational program offered and to hold the program accountable to the educational community, the nursing profession and the public. All programs seeking CCNE accreditation, including those offered via distance or "distributed" learning, are expected to meet the standards presented in this document. Program compliance with the standards promotes good educational practice in the field of nursing and thus enables CCNE to grant or confirm accreditation.

The standards are written as broad statements that embrace several areas of expected institutional performance. Related to each standard is a series of key elements. Viewed together, the key elements provide an indication of whether the broader educational standard has been satisfied. The key elements will be considered by the evaluation team, the Accreditation Review Committee and the CCNE Board of Commissioners in determining the program's compliance with each standard. The key elements are designed to enable the broadest possible interpretation of each standard in order to support institutional autonomy and encourage innovation while maintaining the quality of nursing programs and the integrity of the accreditation process.

Following each series of key elements is a list of examples of evidence that assists program representatives in addressing the key elements, in developing self-study materials, and in preparing for the on-site evaluation. If utilized, these examples of evidence may be included with the self-study document, or made available for review by the evaluation team on site. The examples of evidence are neither inclusive nor exclusive of all conditions to be present within a program. Rather, they are to be used to guide program representatives and the individuals involved in the accrediting process in determining sound educational practices. The Commission recognizes that reasonable alternatives exist in addressing the key elements.

Throughout this document, the need for programs to demonstrate the incorporation of professional nursing standards and guidelines is emphasized. CCNE recognizes the following sets of guidelines as the nationally accepted standards for baccalaureate or graduate pre-licensure programs in nursing, master's programs in nursing, and nurse practitioner programs, respectively: 1) The Essentials of Baccalaureate Education for Professional Nursing Practice (American Association of Colleges of Nursing, 1998); 2) The Essentials of Master's Education for Advanced Practice Nursing (American Association of Colleges of Nursing, 1996); and Criteria for Evaluation of Nurse Practitioner Programs (National Task Force on Quality Nurse Practitioner Education, 2002). Programs are expected to demonstrate incorporation of the appropriate standards into the curriculum. Programs may identify additional standards and guidelines selected as the basis for specialty programs, as appropriate.

At the end of this document is a section titled "Operational Definitions," which is a glossary of terms and concepts used in this document. The terms "educational program," "nursing program," and "program" are used interchangeably throughout this document.

The standards are subject to periodic review and revision. The next scheduled review of this document will include both broad and specific participation by the CCNE community of interest in the analysis and discussion of additions and deletions. Under no circumstances may the standards and key elements defined in this document supersede federal or state law.

STANDARD I. PROGRAM QUALITY:
MISSION AND GOVERNANCE

The mission, goals, and expected outcomes of the program are congruent with those of the parent institution, reflect professional nursing standards and guidelines, and consider the needs and expectations of the community of interest - all in the pursuit of the continuing advancement and improvement of the program. Policies of the parent institution and nursing program clearly support the program's mission, goals, and expected outcomes. The faculty and students of the program are involved in the governance of the program and in the ongoing efforts to improve program quality.

Key Elements:

I-A. The mission, goals, and expected outcomes of the program are written, congruent with those of the parent institution, and consistent with professional nursing standards and guidelines for the preparation of nursing professionals.

I-B. The mission, goals, and expected outcomes of the program are reviewed periodically and revised, as appropriate, to reflect professional standards and guidelines.

I-C. The mission, goals, and expected outcomes of the program are reviewed periodically and revised, as appropriate, to reflect the needs and expectations of the community of interest.

I-D. Roles of the faculty and students in the governance of the program are clearly defined and enable meaningful participation.

I-E. Documents and publications are accurate. Any references in promotional materials to the program's offerings, outcomes, academic calendar, admission policies, grading policies, degree completion requirements, tuition, and fees are accurate.

I-F. Policies of the parent institution and the nursing program are congruent with and support the mission, goals, and expected outcomes of the program; these policies are fair, equitable, published, and are reviewed and revised as necessary to reflect ongoing improvement. These policies include, but are not limited to, those relative to student recruitment, admission, and retention.

Examples of Evidence:

  1. State the mission, goals, and expected outcomes of the program and discuss their relationship to the mission of the parent institution.
  2. Explain the context in which the program is offered, including analysis of demographic and institutional characteristics that influence the mission, goals, and expected outcomes of the program.
  3. Identify all professional nursing standards and guidelines that are used in formulating and evaluating the mission, goals, and expected outcomes of the program. Explain the rationale for the choice of standards and guidelines.
  4. Provide copies of the professional nursing standards and guidelines used by the program(s).
  5. Define the community of interest and describe how the needs and expectations of the community of interest are reflected in the mission, goals, and expected outcomes of the program.
  6. Demonstrate how the program collects and analyzes input from the community of interest. Demonstrate that the results of these analyses are used to foster ongoing improvement.
  7. Document that the program has afforded the community of interest the opportunity to submit written third-party comments to CCNE, in accordance with accreditation procedures.
  8. Describe the scope, breadth, and timing of the process employed in reviewing and updating the mission, goals, and expected outcomes of the program. Provide evidence of implementation of the review process and any resulting changes.
  9. Demonstrate that policies support and are congruent with the program's mission, goals, and expected outcomes; enable the recruitment, admission, and retention of qualified students; and support student performance, achievement, and progress. Provide copies of program advertising directed at prospective students.
  10. Define the roles of faculty and students in the governance of the program with respect to the pursuit of the mission, goals, and expected outcomes. Discuss the effect of student and faculty participation on program improvement.
  11. Provide copies of student handbooks, faculty handbooks, and personnel manuals.
  12. Provide copies of current affiliation agreements with other facilities and institutions at which student instruction occurs.
  13. Provide copies of major institutional and nursing unit reports and records for the past three years, such as minutes of faculty meetings, strategic planning documents, and annual reports.
  14. Provide copies of reports submitted to and official correspondence received from applicable accrediting and regulatory agencies in the last ten years, as appropriate.

STANDARD II. PROGRAM QUALITY:
INSTITUTIONAL COMMITMENT AND RESOURCES

The parent institution demonstrates ongoing commitment and support. The institution makes available resources to enable the program to achieve its mission, goals, and expected outcomes. The faculty, as a resource of the program, enables the achievement of the mission, goals, and expected outcomes of the program.

Key Elements:

II-A. The parent institution and program provide and support an environment that encourages faculty teaching, scholarship, service, and practice in keeping with the mission, goals, and expected outcomes of the program.

II-B. Fiscal and physical resources are sufficient to enable the program to fulfill its mission, goals, and expected outcomes. These resources are reviewed, revised, and improved as needed.

II-C. Academic, library, and clinical resources are sufficient to ensure quality and are evaluated on a regular basis to meet program and student needs.

II-D. The chief nurse administrator is academically and experientially qualified and is vested with the authority to and does lead the program in the accomplishment of the mission, goals, and expected outcomes.

II-E. Faculty members are academically and experientially qualified and sufficient in number to accomplish the mission, goals, and expected outcomes of the program.

II-F. The faculty roles in teaching, scholarship, service, and practice are identified clearly and are congruent with the mission, goals, and expected outcomes of the program.

Examples of Evidence:

  1. Analyze the effectiveness of institutional policies and practices for resource allocation in enabling the nursing program to achieve its mission, goals, and expected outcomes.
  2. Describe how the parent institution and program provide and support an environment for ongoing improvement in faculty teaching, scholarship, service, and practice.
  3. Document that the program and parent institution provide resources for the professional growth and development of faculty.
  4. Provide copies of program budget documents (indicating revenues by source and expenditures by type) for the current year and previous two fiscal years.
  5. Demonstrate that academic support services facilitate achievement of the mission, goals, and expected outcomes of the program.
  6. Relate the educational and experiential qualifications of the chief nurse administrator to the achievement of the mission, goals, and expected outcomes of the program.
  7. Demonstrate that the scope of authority of the chief nurse administrator in decisions integral to the nursing program is comparable to that of administrators in similar academic units within the institution.
  8. Provide a list of names, titles, educational credentials, and teaching responsibilities of each faculty member and administrative officer associated with the program.
  9. Provide copies of faculty curricula vitae.
  10. Provide rationale to support the adequacy of number and qualifications of faculty to accomplish the mission, goals, and expected outcomes of the programs.
  11. Demonstrate that policies and practices regarding faculty teaching assignments and the number and size of classes support the accomplishment of the mission, goals, and expected outcomes of the program.
  12. Provide a copy of the faculty collective bargaining agreement and the policy regarding teaching assignments, if applicable.

STANDARD III. PROGRAM QUALITY:
CURRICULUM AND TEACHING-LEARNING PRACTICES

The curriculum is developed in accordance with the mission, goals, and expected outcomes of the program and reflects professional nursing standards and guidelines and the needs and expectations of the community of interest. There is congruence between teaching-learning experiences and expected outcomes. The environment for teaching, learning, and evaluation of student performance fosters achievement of the expected outcomes.

Key Elements:

III-A. The curriculum is developed, implemented, and revised to reflect clear statements of expected student learning outcomes that are consistent with professional nursing standards and guidelines and congruent with the program's mission, goals, and expected outcomes.

III-B. The curriculum is developed, implemented, and revised to reflect professional nursing standards and guidelines. These standards and guidelines are clearly evident within the curriculum structure and expected learning outcomes. Course/unit/level outcomes are consistent with the roles for which the program is preparing its graduates.

  1. The baccalaureate curriculum incorporates content and learning experiences identified in The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 1998).
  2. The master's curriculum incorporates content and learning experiences identified in The Essentials of Master's Education for Advanced Practice Nursing (AACN, 1996). Any specialty standards adopted for the master's program are incorporated into the curriculum. In addition, nurse practitioner program curricula demonstrate incorporation of the Criteria for Evaluation of Nurse Practitioner Programs (NTF, 2002).

III-C. The curriculum is logically structured to meet expected program outcomes.

  1. The baccalaureate curriculum builds upon a foundation of the arts, sciences, and humanities.
  2. The master's curriculum builds on the baccalaureate level foundation.

III-D. The curriculum and teaching-learning practices are evaluated at regularly scheduled intervals to foster ongoing improvement.

III-E. The didactic and clinical teaching-learning practices and learning environments support the achievement of student learning outcomes.

III-F. The curriculum and teaching-learning practices consider the needs and expectations of the identified community of interest.

Examples of Evidence:

  1. Provide evidence that the curriculum reflects clear statements of expected student learning outcomes.
  2. Analyze the extent to which the baccalaureate curriculum builds upon the arts, sciences, and humanities.
  3. Demonstrate that the master's curriculum builds on the baccalaureate level and leads to identified advanced nursing roles.
  4. Provide the rationale for the sequence used in formulating the curriculum.
  5. Explain how professional nursing standards and guidelines for practice are incorporated into the curriculum.
  6. Explain how the array of teaching-learning practices facilitates achievement of student learning outcomes.
  7. Provide copies of course syllabi.
  8. Provide examples of student work.
  9. Provide evidence of how review of curriculum and teaching-learning practices, including student evaluations, is used to foster program improvement.
  10. Provide examples of how input from the community of interest is used in curriculum development and revision.

STANDARD IV. PROGRAM EFFECTIVENESS:
STUDENT PERFORMANCE AND FACULTY ACCOMPLISHMENTS

The program is effective in fulfilling its mission, goals, and expected outcomes. Actual student learning outcomes are consistent with the mission, goals, and expected outcomes of the program. Alumni satisfaction and the accomplishments of graduates of the program attest to the effectiveness of the program. Actual faculty outcomes are consistent with the mission, goals, and expected outcomes of the program. Data on program effectiveness are used to foster ongoing improvement.

Key Elements:

IV-A. Student performance is evaluated by the faculty and reflects achievement of expected outcomes. Grading policies are defined and consistently applied.

IV-B. Surveys and other data sources are used to collect information about student, alumni, and employer satisfaction and demonstrated achievements of graduates. Student outcome data include, but are not limited to, graduation rates, NCLEX-RN® pass rates, certification examination pass rates, and job placement rates, as appropriate.

IV-C. Program outcome data are analyzed to provide evidence of program effectiveness and are used to foster ongoing program improvement.

IV-D. Faculty outcomes demonstrate achievement of the program's mission, goals, and expected outcomes, and enhance program quality and effectiveness.

IV-E. Formal complaints are reviewed in accordance with the policies and procedures established by the program; analyses of aggregate data are used to foster ongoing program improvement.

Examples of Evidence:

  1. Provide evidence of ongoing, systematic program evaluation, including documentation of survey responses and data summaries and other data as appropriate.
  2. Describe how faculty and students are involved in the evaluation of individual student performance. Describe how the evaluation of student performance is communicated to the students and how it is used to foster improved performance.
  3. Provide evidence that the program's graduates have achieved the competencies congruent with the professional nursing standards and guidelines the program has adopted.
  4. Document student and graduate performance measures, including NCLEX-RN® pass rates, certification pass rates, graduation rates, job placement rates, and other measures of student success, as deemed appropriate by the program.
  5. Demonstrate how the results of aggregate student performance are analyzed, and how the program's analyses are used to change or improve the curriculum.
  6. Describe the process for evaluating faculty performance in teaching, scholarship, service, and practice and how the outcomes of evaluations are communicated to individual faculty members.
  7. Provide a summary of faculty outcomes for the past three years and analyze the data in relation to expected program outcomes. Provide examples of how aggregate data on faculty performance are used to foster ongoing improvement.
  8. Describe how alumni, employers, and graduates evaluate the program and give examples of the use of these data to improve the program.
  9. Provide a copy of the policies regarding the review and maintenance of records of student satisfaction and formal complaints. Provide a record of formal complaints and grievances, if any, for the past three years.

OPERATIONAL DEFINITIONS

Academic Policies: Published rules that govern the implementation of the academic program including, but not limited to, admission, progression, graduation, grievance, and grading policies.

Academic Support Services: Services available to the nursing program that facilitate faculty and students in achieving the expected outcomes of the program. These may include, but are not limited to, services provided by libraries, clinical and scientific laboratories, computer, advising, counseling, and placement centers.

Actual Outcomes: Specific, data-based results of student learning and faculty accomplishments. Actual outcomes are analyzed in relation to expected outcomes to demonstrate program effectiveness.

Advanced Nursing: Nursing roles requiring advanced nursing education beyond the basic baccalaureate preparation.

Chief Nurse Administrator: The registered nurse with a graduate degree who serves as the administrative head of the nursing program.

Community of Interest: Individuals and groups that influence or participate in the development or ongoing improvement of the nursing program or benefit from its outcomes. The community of interest represents both internal and external constituencies and includes individuals and groups of diverse backgrounds, races, ethnicities, genders, values, and perspectives who are served and affected by the program.

Curriculum: All planned didactic and clinical educational experiences under the direction of the program that facilitate students in achieving expected outcomes.

Curriculum/Unit/Level Objectives: Statements detailing the knowledge, skills, and attitudes that are expected to be achieved by specific curricular elements (e.g., a course or level). These statements are consistent with the roles for which the program is preparing its graduates and with professional nursing standards and guidelines.

Expected Outcomes: The specific, measurable indicators of program quality and effectiveness as reflected in both student outcomes and in faculty accomplishments. Evidence of program effectiveness is shown in the evaluation of actual outcomes in relation to expected outcomes.

Faculty Outcomes: Statements of expected and actual achievements of faculty that support the program's mission and goals which may include teaching, scholarship, practice, and service components of the faculty role.

Goals: Statements of general expectations for the program that are consistent with the institutional and program missions, and reflect the values and priorities of the program.

Mission: A statement of purpose defining the unique nature and scope of the parent institution and the nursing program.

Ongoing Improvement: The process established by the program to conduct continuous assessment and analysis of actual outcomes in relation to expected outcomes. The results of these assessments and analyses are utilized as the bases for revisions to policies, practices, and/or curricula, as appropriate.

Parent Institution: The university, academic health center, or college that has overall responsibility and accountability for the program. CCNE requires that the parent institution be accredited by an accrediting agency recognized by the U.S. Secretary of Education.

Professional Nursing Standards and Guidelines: Statements of expectations and aspirations providing a foundation for professional nursing behaviors from graduates of baccalaureate and master's programs. Standards are developed by a consensus of professional nursing communities who have a vested interest in the education and practice of nurses. CCNE recognizes that professional nursing standards are established through state rules and regulations, nationally recognized professional nursing specialty organizations, national and institutional educational organizations, and health care agencies used in the education of nursing graduates.

CCNE requires that baccalaureate or graduate pre-licensure programs in nursing use The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 1998); that master's degree programs use The Essentials of Master's Education for Advanced Practice Nursing (AACN, 1996); and that nurse practitioner programs use Criteria for Evaluation of Nurse Practitioner Programs (National Task Force on Quality Nurse Practitioner Education, 2002). Baccalaureate and master's programs may incorporate additional specialty standards, as appropriate, consistent with the mission, goals, and expected outcomes of the program.

Program Outcomes: Statements of expected and actual achievements of graduates and faculty in the aggregate. Program outcomes are mission driven, reflect best nursing practices, are consistent with professional nursing standards and guidelines, and consider the needs of the community of interest.

Student Learning Outcomes: Learner-focused statements explicitly describing the actual characteristics or attributes that individuals demonstrate upon completion of the program.

Teaching-Learning Practices: Strategies that guide the instructional process toward achieving student outcomes.
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