21 NCAC 36 .0220 REFRESHER COURSE
(a) A refresher course shall be designed for those persons, previously licensed, who are not eligible for re-entry into nursing practice because their license has lapsed for five or more years.
(b) Satisfactory completion of a Board-approved refresher course is required of the person who:
(1) requests reactivation of an inactive license and who has not held an active license for five or more years;
(2) requests reinstatement of a lapsed license and who has not held an active license for five or more years;
(3) requests endorsement to North Carolina who has not held an active license for five or more years;
(4) is directed by the Board to complete such a course when the Board takes action as authorized in G.S. 90-171.37; or
(5) needs a refresher course as a result of the license being inactive for disciplinary action and has met all eligibility requirements for reinstatement of the license.
Those persons identified in Subparagraph (4) or (5) of this Paragraph may be subject to Board-stipulated restrictions in the clinical component of the refresher course.
(c) Application for approval of a refresher course shall be completed and submitted by the provider at least 90 days prior to the expected date of enrollment and shall include evidence of complying with the rules for refresher courses. Board approval shall be secured prior to the enrollment of students. Provider approval will be granted for a period of time not to exceed five years. However, any changes in faculty, curriculum, or clinical facilities shall be approved by the Board prior to implementation as set out in the Rules of this Chapter.
(d) The Board will make site visits if necessary. A decision on an application to offer a refresher course will be given within 30 days following receipt of the application.
(e) The provider of a refresher course shall be approved by the Board as set out in these Rules. A provider may be a post-secondary educational institution, a health care institution, or other agency.
(f) Administrative responsibility for developing and implementing the course shall be vested in a registered nurse director.
(g) Instructors in the course shall be directly accountable to the nurse director. The director shall have had at least one year prior teaching experience preparing individuals for LPN or RN licensure at the post-secondary level or in a nursing staff development position. The director and each instructor shall:
(1) be licensed to practice nursing as a registered nurse in North Carolina;
(2) hold a baccalaureate or higher degree; and
(3) have had at least two years experience in direct patient nursing practice as an RN.
(h) Proximity of the instructor to students is the major factor in determining faculty-student ratio for clinical learning experiences. In no case shall this ratio exceed 1:10.
(i) Course objectives shall be stated which:
(1) show relationships between theory and practice; and
(2) indicate behaviors consistent with the ability to safely practice nursing.
(j) The curriculum for the R.N. Refresher Course shall incorporate:
(1) common medical-surgical conditions and management of common nursing problems associated with these conditions, including mental health principles associated with management of nursing problems;
(2) functions of the registered nurse as defined in G.S. 90-171.20 and 21 NCAC 36 .0221, .0224, .0225 and .0401; and
(3) instruction in and opportunities to demonstrate ability to safely practice nursing and knowledge in caring for clients with common medical-surgical problems.
(k) The curriculum for the L.P.N. Refresher Course shall incorporate:
(1) common medical-surgical conditions and common nursing approaches to their management, including mental health principles;
(2) functions of the licensed practical nurse as defined in G.S. 90-171.20(8) and 21 NCAC 36 .0221, .0225 and .0401; and
(3) instruction in and opportunity to demonstrate ability to safely practice nursing and knowledge in caring for clients with common medical-surgical problems.
(l) The course shall include both theory and clinical instruction:
(1) The R.N. Refresher Course shall include at least 240 hours of instruction, at least 120 of which shall consist of clinical learning experiences.
(2) The L.P.N. Refresher Course shall include at least 180 hours of instruction, at least 90 of which shall consist of clinical learning experiences.
(m) Evaluation processes shall be implemented which effectively measure the refresher student's:
(1) knowledge and understanding of curriculum content; and
(2) ability to provide safe nursing care to clients with common medical-surgical conditions.
(n) Clinical resources shall indicate in written contract their support and availability to provide the necessary clinical experiences.
(o) The application for approval of a refresher course shall include:
(1) course objectives, content outline and time allocation;
(2) didactic and clinical learning experiences including teaching methodologies, for measuring the registrant's abilities to practice nursing;
(3) plan for evaluation of student competencies and ability to practice safe nursing;
(4) a faculty list which includes the director and all instructors and identifies their qualifications and their functions in teaching roles; and
(5) the projected clinical schedule.
(p) A course or combination of courses within a basic nursing curriculum may be considered a refresher course for re-entry into practice if:
(1) such course or combination of courses equals or exceeds requirements for refresher courses;
(2) such course or combination of courses is taught on a level commensurate with level of relicensure sought; and
(3) the Board designee approves such course or combination of courses as a substitute for a refresher course.
(q) Individuals, previously licensed in North Carolina, presently residing outside of North Carolina, may meet these requirements by successfully completing a North Carolina approved refresher course completed in another state or country. Agencies desiring approval for conducting refresher courses shall submit applications per Paragraphs (c) through (p) of this Rule. Clinical experiences shall be in agencies approved by the comparable state/country agency to the Board of Nursing. The agency applying for refresher course approval shall submit evidence of the agency approval.
(r) Individuals enrolled in refresher courses shall identify themselves as R.N. Refresher Student (RN RS) or LPN Refresher Student (LPN RS) consistent with the course level, after signatures on records or on name pins.
(s) Upon completion of a Board-approved refresher course, the course provider shall furnish the Board with the names and North Carolina certificate numbers of those persons who have satisfactorily completed the course and are deemed safe to practice nursing at the appropriate level of licensure on the Board supplied form.
(t) Upon request, the Board shall provide:
(1) a list of approved providers;
(2) forms for applications for program approval; and
(3) forms for verification of successful completion to all approved programs.
History Note: Authority G.S. 90‑171.23(b)(3); 90‑171.35; 90‑171.36; 90‑171.37; 90-171.38; 90-171.83;
Eff. May 1, 1982;
Amended Eff. January 1, 2007; July 1, 2000; June 1, 1993; April 1, 1989.