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TITLE 4. PROFESSIONS AND OCCUPATIONS

CHAPTER 19. BOARD OF NURSING

(Authority: A.R.S. § 32-1602 et seq.)

ARTICLE 1. DEFINITIONS AND TIME-FRAMES

New Article 1, consisting of R4-19-101, adopted effective July 19, 1995 (Supp. 95-3).

Article 1, consisting of R4-19-101 through R4-19-102, repealed effective July 19, 1995 (Supp. 95-3).

Section

R4-19-101. Definitions

R4-19-102. Time-frames for Licensure, Certification, or Approval

Table 1. Time-frames

ARTICLE 2. PROFESSIONAL AND PRACTICAL NURSING PROGRAMS; REFRESHER PROGRAMS

Article 2, consisting of R4-19-201 through R4-19-214, adopted effective July 19, 1995 (Supp. 95-3).

Section

R4-19-201. Organization and Administration

R4-19-202. Resources, Facilities, Services, and Records

R4-19-203. Administrator; Qualifications and Duties

R4-19-204. Faculty; Personnel Policies; Qualifications and Duties

R4-19-205. Students; Policies and Admissions

R4-19-206. Curriculum

R4-19-207. Application for Provisional Approval of a Nursing Program

R4-19-208. Application for Full Approval of a Nursing Program

R4-19-209. Nursing Program Change

R4-19-210. Renewal of Approval of Board-approved Nursing Programs

R4-19-211. Rescission of Approval

R4-19-212. Nationally Accredited Nursing Programs

R4-19-213. Voluntary Termination of a Nursing Program or a Refresher Program

R4-19-214. Approval of a Refresher Program

R4-19-215. Distance Learning Nursing Programs; Out-of-State Nursing Programs

ARTICLE 3. LICENSURE

Article 3, consisting of R4-19-301 through R4-19-308, adopted effective July 19, 1995 (Supp. 95-3).

Section

R4-19-301. Licensure by Examination

R4-19-302. Licensure by Endorsement

R4-19-303. Requirements for Credential Evaluation Service

R4-19-304. Temporary License

R4-19-305. License Renewal

R4-19-306. Inactive License

R4-19-307. Application for a Duplicate License

R4-19-308. Change of Name or Address

R4-19-309. School Nurse Certification Requirements

R4-19-310. Certified Registered Nurse

R4-19-311. Nurse Licensure Compact

R4-19-312. Practice Requirement

ARTICLE 4. REGULATION

Article 4, consisting of R4-19-401 through R4-19-404, adopted effective July 19, 1995 (Supp. 95-3).

Section

R4-19-401. Scope of Practice for a Practical Nurse

R4-19-402. Scope of Practice for a Professional Nurse

R4-19-403. Unprofessional Conduct

R4-19-404. Reinstatement or Issuance of License

R4-19-405. Repealed

ARTICLE 5. ADVANCED AND EXTENDED NURSING PRACTICE

Section

R4-19-501. Categories and Specialty Areas of Advanced Practice Registered Nursing

R4-19-502. Requirements for Advanced Practice Registered Nursing Programs

R4-19-503. Application for Approval of an Advanced Practice Registered Nursing Program; Approval by Board

R4-19-504. Recission of Approval of an Advanced Practice Registered Nursing Program

R4-19-505. Requirements for Advanced Practice Registered Nursing Certification

R4-19-506. Expiration of Advanced Practice Certificates; Practice Requirement; Renewal

R4-19-507. Temporary Advanced Practice Certificate

R4-19-508. Scope of Practice of a Registered Nurse Practitioner

R4-19-509. Delegation to Medical Assistants

R4-19-510. Use of Title

R4-19-511. Prescribing and Dispensing Authority; Prohibited Acts

R4-19-512. Prescribing Drugs and Devices

R4-19-513. Dispensing Drugs and Devices

R4-19-514. Scope of Practice of the Clinical Nurse Specialist

R4-19-515. Prescribing Authority of a Certified Registered Nurse Anesthetist

R4-19-516. Registered Nurse Anesthetist; Notification of the Board; Nurse Anesthetist Programs; Scope of Practice

ARTICLE 6. RULES OF PRACTICE AND PROCEDURE

Article 6, consisting of R4-19-601 through R4-19-615, adopted effective October 10, 1996 (Supp. 96-4).

Section

R4-19-601. Administrative Hearings

R4-19-602. Letter of Concern

R4-19-603. Representation

R4-19-604. Notice of Hearing; Response

R4-19-605. Docket

R4-19-606. Record of Hearings

R4-19-607. Recommended Decision

R4-19-608. Rehearing or Review of Decision

R4-19-609. Effectiveness of Orders

R4-19-610. Expired

R4-19-611. Expired

R4-19-612. Renumbered

R4-19-613. Expired

R4-19-614. Renumbered

R4-19-615. Renumbered

ARTICLE 7. PUBLIC PARTICIPATION PROCEDURES

Article 7, consisting of R4-19-701 through R4-19-706, adopted effective October 10, 1996 (Supp. 96-4).

Section

R4-19-701. Rulemaking Record; Directory of Substantive Policy Statements

R4-19-702. Petition for Rulemaking; Review of Agency Practice or Substantive Policy Statement; Objection to Rule Based Upon Economic, Small Business, or Consumer Impact

R4-19-703. Oral Proceedings

R4-19-704. Petition for Altered Effective Date

R4-19-705. Written Criticism of an Existing Rule

R4-19-706. Renumbered

ARTICLE 8. CERTIFIED NURSING ASSISTANTS

Article 8, consisting of Sections R4-19-801 through R4-19-815, adopted by final rulemaking at 6 A.A.R. 757, effective February 4, 2000 (Supp. 00-1).

Section

R4-19-801. Standards for Nursing Assistant Training Programs

R4-19-802. Curriculum

R4-19-803. Initial Approval of Nursing Assistant Training Programs

R4-19-804. Renewal of Approval of Nursing Assistant Training Programs

R4-19-805. Deficiencies and Rescission of Program Approval, Voluntary Termination, Disciplinary Action, and Reinstatement

R4-19-806. Nursing Assistant Certification by Examination

R4-19-807. Nursing Assistant Certification by Endorsement

R4-19-808. Temporary Certificate

R4-19-809. Certified Nursing Assistant Certificate Renewal

R4-19-810. Certified Nursing Assistant Register

R4-19-811. Application for Duplicate Certificate

R4-19-812. Change of Name or Address

R4-19-813. Performance of Nursing Assistant Tasks

R4-19-814. Standards of Conduct for Certified Nursing Assistants

R4-19-815. Reinstatement or Issuance of a Certified Nursing Assistant Certificate

ARTICLE 1. DEFINITIONS AND TIME-FRAMES

R4-19-101. Definitions

In addition to the definitions in A.R.S. § 32-1601, in this Chapter:

"Abuse" means a misuse of power or betrayal of trust, respect, or intimacy by a nurse or nursing assistant that causes or is likely to cause physical, mental, emotional, or financial harm to a client.

"Administer" means the direct application of a medication to the body of a patient by a nurse, whether by injection, inhalation, ingestion, or any other means.

"Administrator" means a nurse educator with the administrative responsibility and authority for the direction of a nursing program.

"Approved national nursing accrediting agency" means an organization recognized by the Department of Education as an accrediting agency for a nursing program.

"Certificate or diploma in practical nursing" means the document awarded to a graduate of an educational program in practical nursing.

"Clinical nurse specialist" means a nurse who, through study and supervised practice at the graduate level, is expert in a selected clinical area of nursing.

"Collaborate" means to establish a relationship for consultation or referral with one or more licensed physicians on an as-needed basis. Direct or onsite supervision of the activities of a registered nurse practitioner by the collaborating physician is not required.

"Contact hour" means 50 minutes of participation in a continuing education activity relating to nursing practice.

"Continuing education activity" means a course of study related to nursing practice that is awarded credit hours or units in nursing or medicine by an accredited organization.

"CNA" means a certified nursing assistant.

"CRNA" means a certified registered nurse anesthetist who provides anesthesia services under A.R.S. § 32-1661.

"DEA" means the federal Drug Enforcement Administration.

"Dispense" means to issue one or more doses of medication in a suitable container for subsequent use by a patient.

"Endorsement" means the procedure for granting an Arizona nursing license to an applicant who is already licensed as a nurse in another state of the United States or foreign country or an Arizona nursing assistant certificate to an applicant who is already listed on a nurse aide register in another state or territory of the United States.

"Full approval" means the status granted in writing by the Board when a nursing program, upon graduation of its first class, demonstrates the ability to provide and maintain a program in accordance with the standards provided by A.R.S. § 32-1601 et seq. and these rules.

"Good standing" means the license of a nurse, either practical or professional, or the certificate of a nursing assistant, is current, and the nurse or nursing assistant is not presently subject to any disciplinary action, consent order, or settlement agreement.

"Initial approval" means the permission, granted in writing by the Board, to an institution to establish a nursing or nursing assistant training program, after the Board determines that the program proposal meets the standards provided by the law and these rules.

"Licensed practical nurse" means a practical nurse licensed under this Chapter.

"NATCEP" means Nurse Aide Training and Competency Evaluation Program.

"NCLEX" means the National Council Licensure Examination.

"Nurse" means a licensed practical or professional nurse.

"Nursing practice" means assisting individuals or groups to maintain or attain optimal health, implementing a strategy of care to accomplish defined health goals, and evaluating responses to care and treatment.

"Nursing process" means applying problem-solving techniques that require technical and scientific knowledge, good judgment, and decision-making skills to assess, plan, implement, and evaluate a plan of care.

"Nursing program" means a formal course of instruction designed to prepare its graduates for licensure as professional or practical nurses.

"Nursing-related activities or duties" means client care tasks for which education is provided by a basic NATCEP.

"Parent institution" means the educational institution in which a nursing program or nursing assistant program is conducted.

"Pharmacology" means the science that deals with the study of drugs.

"Physician" means a person licensed under A.R.S. Title 32, Chapters 7, 8, 11, 13, 14, 17, or 29, or by a state medical board in the United States.

"Prescribe" means to order a medication, medical device, or appliance for use by a patient.

"P & D" means prescribing and dispensing.

"Preceptorship" means a clinical learning experience by which a learner enrolled in a NATCEP, nursing program, or nurse practitioner course of study provides nursing or nurse assistant services while assigned to a health care worker who holds a license or certificate equivalent to or higher than the level of the learner's program.

"PRN" means as needed.

"Refresher program" means a formal course of instruction designed to provide a review and update of nursing theory and practice to professional or practical nurses preparing to re-enter nursing practice.

"Regionally accredited" means an educational institution is accredited by the New England Association of Schools and Colleges, Middle States Association of Colleges and Secondary Schools, North Central Association of Colleges and Schools, Northwest Association of Schools and Colleges, Southern Association of Colleges and Schools, or Western Association of Schools and Colleges.

"Register" means a listing of Arizona certified nursing assistants maintained by the Board that includes the following about each nursing assistant:

Identifying demographic information;

Date placed on the register;

Date of initial and most recent certification, if applicable; and

Status of the nursing assistant certificate, including findings of abuse, neglect, or misappropriation of property made by the Arizona Department of Health Services, sanctions imposed by the United States Department of Health and Human Services, and disciplinary actions by the Board.

"RNP" means a registered nurse practitioner.

"SBTPE" means the State Board Test Pool Examination.

"Self-study" means a written self-evaluation conducted by a nursing program to assess the compliance of the program with the standards listed in R4-19-201 through R4-19-206.

"School nurse" means a professional nurse who is certified under R4-19-308.

"Supervision" means the direction and periodic consultation provided to an individual to whom a nursing task or patient care activity is delegated.

Historical Note

Former Glossary of Terms; Amended effective Nov. 17, 1978 (Supp. 78-6). Former Section R4-19-01 repealed, new Section R4-19-01 adopted effective February 20, 1980 (Supp. 80-1). Amended paragraphs (1) and (7), added paragraphs (9) through (25) effective July 16, 1984 (Supp. 84-4). Former Section R4-19-01 renumbered as Section R4-19-101 (Supp. 86-1). Amended effective November 18, 1994 (Supp. 94-4). Section repealed, new Section adopted effective July 19, 1995 (Supp. 95-3). Amended effective December 22, 1995 (Supp. 95-4). Amended effective November 25, 1996 (Supp. 96-4). Amended by final rulemaking at 7 A.A.R. 1712, effective April 4, 2001 (Supp. 01-2).

R4-19-102. Time-frames for Licensure, Certification, or Approval

A. In this Section:

1. "Applicant" means a person or entity seeking licensure, certification, approval to prescribe and dispense drugs, or approval of a nursing assistant program, a nursing program, a refresher program, or a nurse practitioner course of study.

2. "Application packet" means a Board-approved application form and the documentation necessary to establish an applicant's qualifications for licensure, certification, or approval.

B. In computing the time-frames in this Section, the day of the act or event from which the designated period begins to run is not included. The last day of the period is included unless it is a Saturday, Sunday, or official state holiday, in which event the period runs until the end of the next day that is not a Saturday, Sunday, or official state holiday.

C. For each type of licensure, certification, or approval issued by the Board, the overall time-frame described in A.R.S. § 41-1072(2) is listed in Table 1. The applicant and the Executive Director of the Board may agree in writing to extend the overall time-frames in Table 1. The overall time-frame and the substantive review time-frame described in A.R.S. § 41-1072(3) may not be extended by more than 25% of the overall time-frame.

D. For each type of licensure, certification, or approval issued by the Board, the administrative completeness review time-frame described in A.R.S. § 41-1072(1) is listed in Table 1 and begins to run when the Board receives an application packet.

1. If the application packet is not administratively complete, the Board shall send a deficiency notice to the applicant. The time for the applicant to respond to a deficiency notice begins to run on the postmark date of the deficiency notice.

a. The deficiency notice shall list each deficiency.

b. The applicant shall submit to the Board the information or the documentation listed in the deficiency notice within the period specified in Table 1 for responding to a deficiency notice. The time-frame for the Board to complete the administrative review is suspended until the Board receives the missing information or documentation.

c. If the applicant fails to provide the information or the documentation listed in the deficiency notice within the period specified in Table 1, the Board shall consider the application packet withdrawn and shall send the applicant a notice of withdrawal.

2. If the application packet is administratively complete, the Board shall send a written notice of administrative completeness to the applicant.

3. If the Board issues a license, certificate, or approval during the administrative completeness time-frame, the Board shall not send a separate written notice of administrative completeness.

E. For each type of licensure, certification, or approval issued by the Board, the substantive review time-frame described in A.R.S. § 41-1072(3) is listed in Table 1 and begins to run on the postmark date of the notice of administrative completeness.

1. During the substantive review time-frame, an applicant may withdraw an application packet.

2. The Board may investigate an applicant who discloses prior unprofessional conduct defined in A.R.S. § 32-1601 and may require the applicant to provide additional information or documentation as prescribed in subsection (E)(3) if the Board believes that the conduct is or might be harmful or dangerous to the health of a patient or the public.

3. During the substantive review time-frame, the Board may make one comprehensive written request for additional information or documentation. The applicant shall submit the additional information or documentation within the period specified in Table 1. The time-frame for the Board to complete the substantive review of the application packet is suspended from the postmark date of the comprehensive written request for additional information or documentation until the Board receives the additional information or documentation.

4. If the applicant fails to provide the information or documentation identified in the comprehensive written request within the time specified in Table 1, the Board shall consider the application withdrawn and shall send a notice of withdrawal to the applicant.

5. The Board shall grant licensure, conditional licensure, certification, or approval to an applicant:

a. Who meets the substantive criteria for licensure, certification, or approval required by the Board; and

b. Whose licensure, certification, or approval is in the best interest of the public.

6. The Board shall deny licensure, certification, or approval to an applicant:

a. Who fails to meet the substantive criteria for licensure, certification or approval required by the Board; or

b. Who has engaged in unprofessional conduct as defined in A.R.S. § 32-1601; and

c. Whose licensure, certification, or approval is not in the best interest of the public.

7. The Board's written order of denial shall meet the requirements of A.R.S. § 41-1076. The applicant may request a hearing by filing a written request with the Board within 30 days of receipt of the Board's order of denial. The Board shall conduct hearings in accordance with A.R.S. § 41-1092 et seq., and 4 A.A.C. 19, Article 6.

Historical Note

Adopted effective February 20, 1980 (Supp. 80-1). Former Section R4-19-02 renumbered and amended as Section R4-19-102 effective February 21, 1986 (Supp. 86-1). Section repealed effective July 19, 1995 (Supp. 95-3). New Section adopted April 20, 1998 (Supp. 98-2). Amended by final rulemaking at 7 A.A.R. 1712, effective April 4, 2001 (Supp. 01-2).

 

Table 1. Time-frames

Time-frames (in days)

Type of License,
Certificate, or
Program Approval

Applicable Section

Overall
Time-frame

Without
Investigation

Overall
Time-frame

With
Investigation

Administrative
Completeness
Time-frame

Time To
Respond to
Deficiency Notice

Substantive Review
Time-frame
Without
Investigation

Substantive Review
Time-frame
With
Investigation

Time to Respond to Comprehensive Written Request

Initial Approval of
Nursing Programs

R4-19-207

150

Not applicable

60

180

90

Not applicable

120

Full Approval of
Nursing Programs

R4-19-208

150

Not applicable

60

180

90

Not applicable

120

Approval of Refresher
Programs

R4-19-214

150

Not applicable

60

180

90

Not applicable

120

Licensure by Exam

R4-19-301

150

270

30

270

120

240

150

Licensure by
Endorsement

R4-19-302

150

270

30

270

120

240

150

Temporary License

R4-19-303

60

90

30

60

30

60

90

License Renewal

R4-19-304

120

270

30

270

90

240

150

School Nurse
Certification

R4-19-308

150

270

30

270

120

240

150

Reinstatement of License

R4-19-404

150

270

30

270

120

240

150

Nurse Practitioner
Program Approval

R4-19-503

150

Not applicable

60

270

90

Not applicable

120

Nurse Practitioner
Certification

R4-19-504

150

270

30

180

120

240

150

Prescribing and
Dispensing Approval

R4-19-507

150

270

30

270

120

240

150

Clinical Nurse Specialist Certification

R4-19-511

150

270

30

270

120

240

150

Prescribing Authority of
a Certified Registered
Nurse Anesthetist

R4-19-513

150

270

30

270

120

240

150

Approval of Nursing Assistant Training
Programs

R4-19-803

120

Not applicable

30

180

90

Not applicable

120

Renewal of Approval of
Nursing Assistant
Training Programs

R4-19-804

120

Not applicable

30

180

90

Not applicable

120

Nursing Assistant
Certification by
Examination

R4-19-806

150

270

30

270

120

240

150

Nursing Assistant
Certification by
Endorsement

R4-19-807

150

270

30

270

120

240

150

Temporary Certificate

R4-19-808

60

Not applicable

30

60

30

Not applicable

60

Nursing Assistant
Renewal

R4-19-809

120

270

30

270

90

240

150

Reinstatement or
Issuance of a Nursing Assistant Certificate

R4-19-815

150

270

30

270

120

240

150

Historical Note

Table 1 adopted effective April 20, 1998 (Supp. 98-2). Amended by final rulemaking at 7 A.A.R. 1712, effective April 4, 2001 (Supp. 01-2).

ARTICLE 2. PROFESSIONAL AND PRACTICAL NURSING PROGRAMS; REFRESHER PROGRAMS

R4-19-201. Organization and Administration

A. The parent institution of a nursing program shall be accredited as a post-secondary institution, college, or university, by an accrediting body that is recognized as an accrediting body by the U.S. Department of Education.

B. A nursing program shall have a written statement of mission and goals consistent with those of the parent institution and compatible with current concepts in nursing education.

C. A nursing program shall be an integral part of the parent institution and shall have equivalent status with other academic units of the parent institution.

D. The parent institution shall center the administrative control of the nursing program in the nursing program administrator.

E. A nursing program shall provide an organizational chart that identifies the relationships, lines of authority, and channels of communication within the program, and between the program and the parent institution.

F. A nursing program shall have a written agreement between the program and each clinical agency where clinical experience is provided to the program's students that:

1. Defines the rights and responsibilities of both the clinical agency and the nursing program,

2. Lists the role and authority of the governing bodies of both the clinical agency and the nursing program,

3. Allows faculty members of the program the right to participate in selecting learning experiences for students, and

4. Contains a termination clause that provides sufficient time for enrolled students to complete the clinical experience upon termination of the agreement.

G. A nursing program shall have written policies that provide a mechanism for student input into the development of academic policies and procedures and participation in the evaluation plan.

H. The parent institution shall appoint a nursing program administrator who meets the requirements of R4-19-203.

I. A nursing program shall have a written plan for the systematic evaluation of the total program. The plan shall include the methodology, frequency of evaluation, assignment of responsibility, and evaluative criteria. The following areas shall be evaluated:

1. Internal structure of the program, its relationship to the parent institution, and compatibility of program policies and procedures with those of the parent institution;

2. Mission and goals;

3. Curriculum;

4. Education facilities, resources, and services;

5. Clinical resources;

6. Student achievement of program educational outcomes;

7. Graduate performance on the licensing examination;

8. Faculty performance; and

9. Protection of patient safety.

J. A nursing program shall notify the Board of a vacancy or pending vacancy in the position of nursing program administrator within 15 days of the program's awareness of the vacancy or pending vacancy and do the following:

1. Appoint an interim administrator or a permanent administrator who meets the requirements of R4-19-203(A) within 15 days of the effective date of the vacancy, and

2. Notify the Board of the appointment of an interim or permanent administrator within 15 days of appointment and provide a copy of the administrator's credentials to the Board.

Historical Note

Former Section I, Part I; Amended effective January 20, 1975 (Supp. 75-1). Former Section R4-19-11 repealed, new Section R4-19-11 adopted effective February 20, 1980 (Supp. 80-1). Amended effective July 16, 1984 (Supp. 84-4). Former Section R4-19-11 renumbered as Section R4-19-201 (Supp. 86-1). Section repealed; new Section adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-202. Resources, Facilities, Services, and Records

A. The parent institution of a nursing program shall consider the size of the program faculty and number of program students and shall provide facilities for the program that meet the following requirements:

1. A private office for the administrator of the nursing program;

2. Faculty offices that are conveniently located and comparable to other faculty offices of the parent institution;

3. Space for private faculty-student conferences;

4. Space for clerical staff, records, files, and equipment;

5. Facilities including classrooms, laboratories, and conference rooms available at the time needed, and equivalent in size, number, and type to facilities provided by approved programs of equivalent size, or, in the case of no equivalent program, scaled relative to an approved program;

6. Acoustics, lighting, ventilation, plumbing, heating and cooling, seating arrangements, location, storage, and supplies to simulate patient care equivalent to those provided by approved programs of equivalent size and scope, or in the case of no equivalent program, scaled relative to an approved program;

7. Secretarial and clerical support personnel to assist the administrator and faculty;

8. Access to a collection of educational materials and resources that are current and equivalent to materials and resources provided by an approved program of equivalent size or scope, or, in case of no equivalent program, scaled relative to an approved program.

B. A nursing program shall maintain current and accurate records of the following:

1. Student records, including admission materials, courses taken, grades received, scores in any standardized tests taken, and health and performance records;

2. Faculty records, including Arizona professional nursing license number, evidence of fulfilling the requirements in R4-19-204, and performance evaluations or faculty employed by the parent institution for one or more years;

3. Minutes of faculty and committee meetings;

4. Administrative records and reports from accrediting agencies; and

5. The statement of mission and goals, current curriculum, and course outlines.

Historical Note

Former Section I, Part II; Former Section R4-19-12 repealed, new Section R4-19-12 adopted effective February 20, 1980 (Supp. 80-1). Former Section R4-19-12 repealed, new Section R4-19-12 adopted effective July 16, 1984 (Supp. 84-4). Former Section R4-19-12 renumbered as Section R4-19-202 (Supp. 86-1). Section repealed; new Section adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-203. Administrator; Qualifications and Duties

A. A nursing program shall appoint an administrator who holds a current Arizona registered nurse license in good standing or multi-state privilege to practice in Arizona under A.R.S., Title 32, Chapter 15 and:

1. For professional nursing programs, a graduate degree with a major in nursing; or

2. For practical nursing programs, a baccalaureate degree with a major in nursing.

B. The administrator shall have comparable status with other program administrators in the parent institution and shall report directly to an academic officer of the institution.

C. The administrator shall:

1. Administer the nursing education program;

2. Facilitate and coordinate activities related to academic policies, personnel policies, curriculum, resources, facilities, services, and program evaluation;

3. Prepare and administer the budget;

4. Recommend candidates for faculty appointment, retention, and promotion;

5. In addition to any other evaluation used by the parent institution, ensure that faculty are evaluated:

a. At least every three years,

b. By the nurse administrator or a nurse educator designated by the nurse administrator, and

c. In the areas of teaching ability and nursing knowledge and skills.

6. Maintain, enforce, and evaluate written policies and procedures that require all students, faculty, and preceptors who participate in clinical practice settings to be physically and mentally able to provide safe client care; and

7. Participate in activities that contribute to the governance of the parent institution.

D. The administrator of the nursing program shall not teach more than 45 contact hours per academic session.

Historical Note

Former Section I, Part III; Former Section R4-19-13 repealed, new Section R4-19-13 adopted effective February 20, 1980 (Supp. 80-1). Former Section R4-19-13 repealed, new Section R4-19-13 adopted effective July 16, 1984 (Supp. 84-4). Former Section R4-19-13 renumbered as Section R4-19-203 (Supp. 86-1). Section repealed; new Section adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-204. Faculty; Personnel Policies; Qualifications and Duties

A. A nursing program shall implement personnel policies for didactic and clinical nursing faculty members that conform to those for other faculty members of the parent institution or provide a written explanation of any differences.

B. A nursing program shall provide the number of qualified faculty members comparable to that provided by approved programs of equivalent size and program type, or, in the case of no equivalent program, a number scaled relative to an approved program.

C. The parent institution of a nursing program shall ensure that the ratio of students to nursing faculty while involved in the care of patients is not more than ten to one.

D. The faculty shall supervise all students in clinical areas in accordance with the acuity of the patient population, clinical objectives, demonstrated competencies of the student, geographic placement of the student, and requirements established by the clinical agency.

E. The parent institution of a nursing program shall ensure that every professional nursing program faculty member holds a current Arizona registered nurse license in good standing or multi-state privilege to practice in Arizona under A.R.S., Title 32, Chapter 15 and that every faculty member meets one of the following:

1. If providing didactic instruction:

a. At least two years of experience as a professional nurse providing direct patient care; and

b. A graduate degree. The majority of the faculty members of a professional nursing program shall hold a graduate degree with a major in nursing. If the graduate degree is not in nursing, the faculty member shall hold a minimum of a baccalaureate degree in nursing; or

2. If providing clinical instruction, as defined in R4-19-206, only:

a. The requirements for didactic faculty, or

b. A baccalaureate degree with a major in nursing and at least three years of experience as a professional nurse providing direct patient care.

F. The parent institution of a nursing program shall ensure that each practical nursing program faculty member has:

1. A minimum of a baccalaureate degree with a major in nursing,

2. A professional nurse license that is active and in good standing under A.R.S. Title 32, Chapter 15, and

3. At least two years of experience as a professional nurse providing direct patient care.

G. The nursing faculty, together with the program administrator, shall:

1. Develop, implement, and evaluate the program of learning; and

2. Develop and implement standards for the admission, progression, and graduation of students.

Historical Note

Former Section I, Part IV; Former Section R4-19-14 repealed, new Section R4-19-14 adopted effective February 20, 1980 (Supp. 80-1). Former Section R4-19-14 repealed, new Section R4-19-14 adopted effective July 16, 1984 (Supp. 84-4). Former Section R4-19-14 renumbered as Section R4-19-204 (Supp. 86-1). Section repealed; new Section adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-205. Students; Policies and Admissions

A. A nursing program shall have written policies available to students and the public regarding admission, readmission, transfer, advanced placement, progression, graduation, withdrawal, and dismissal.

B. A nursing program shall have written policies available to students that address student rights, responsibilities, grievances, health, and safety.

C. A nursing program shall provide accurate and complete information to all students and prospective students about the program including, but not limited to:

1. The nature of the program, including course sequence, prerequisites, co-requisites and academic standards;

2. The length of the program;

3. The current cost of the program;

4. The transferability of credits to other public and private educational institutions in Arizona; and

5. Program teaching methods and supporting technology.

Historical Note

Adopted effective February 20, 1980 (Supp. 80-1). Former Section R4-19-15 repealed, new Section R4-19-15 adopted effective July 16, 1984 (Supp. 84-4). Former Section R4-19-15 renumbered as Section R4-19-205 (Supp. 86-1). Section repealed; new Section adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-206. Curriculum

A. For the purposes of this Section, "clinical instruction" means the guidance and supervision provided by a qualified faculty member or designee while a nursing student is providing patient care.

B. A nursing program shall develop and implement a curriculum that includes level objectives, course objectives, measurable learning outcomes for each class session, and course content outlines for each course that:

1. Reflect its mission and goals;

2. Are logically consistent between and within courses;

3. Are designed so that a student who completes the program will have the knowledge and skills necessary to function in accordance with the definition and scope of practice specified in A.R.S. § 32-1601(12) and R4-19-401 for a practical nurse or A.R.S. § 32-1601(13) and R4-19-402 for a professional nurse.

C. A nursing program shall provide for progressive sequencing of classroom and clinical instruction sufficient to meet the goals of the program.

1. A registered nursing (RN) program shall provide clinical instruction that includes, at a minimum, selected and guided experiences that develop a student's ability to apply core principles of nursing in varied settings when caring for:

a. Adult and geriatric patients with acute, chronic, and complex, life-threatening, medical and surgical conditions;

b. Patients experiencing pregnancy and delivery;

c. Neonates, infants, and children;

d. Patients with mental, psychological, or psychiatric conditions; and

e. Patients with wellness needs.

2. A practical nursing program (PN) shall provide clinical instruction that includes, at minimum, selected and guided experiences that develop an understanding of physiological, psychological, pathological, and basic nursing care needs when caring for:

a. Patients with medical and surgical conditions throughout the life span,

b. Patients experiencing pregnancy and delivery, and

c. Neonates, infants, and children in varied settings.

D. A nursing program shall maintain at least a 75% NCLEX® passing rate for graduates taking the NCLEX-PN® or NCLEX-RN® for the first time within 12 months of graduation. The Board shall issue a notice of deficiency to any program that has a NCLEX® passing rate less than 75% for two consecutive calendar years.

Historical Note

Adopted effective February 20, 1980 (Supp. 80-1). Former Section R4-19-16 repealed, former Section R4-19-17 renumbered and amended as Section R4-19-16 effective July 16, 1984 (Supp. 84-4). Former Section R4-19-16 renumbered as R4-19-206 (Supp. 86-1). Section repealed; new Section adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-207. Application for Provisional Approval of a Nursing Program

A. Before establishing a nursing program, a parent institution shall submit 20 copies of an application for proposal approval to the Board that includes the following information and documentation:

1. Name and address of the parent institution;

2. Statement of intent to establish a nursing program, including the academic and licensure level of the program; and

3. Proposal that includes, but is not limited to, the following information:

a. Documentation of the present and future need for the program in the state including availability of potential students and need for entry level nurses;

b. Potential effect on existing nursing programs in a 50-mile radius of the proposed program;

c. Organizational structure of the educational institution documenting the relationship of the nursing program within the institution;

d. Accreditation status of the parent institution;

e. Purpose, mission, and goals of the nursing program;

f. Availability of qualified administrator and faculty;

g. Number of budgeted faculty positions;

h. Source and description of clinical resources for the program;

i. Anticipated student population;

j. Documentation of adequate academic facilities and staff to support the nursing program;

k. Evidence of financial resources adequate for the planning, implementation, and continuation of the nursing program; and

l. Tentative time schedule for planning and initiating the nursing program and the intended date for entry of the first class into the program.

B. The Board shall grant proposal approval to any parent institution that demonstrates:

1. The need for a program,

2. The resources to operate a program,

3. The availability of students,

4. The availability and resources to secure a qualified administrator and faculty, and

5. Satisfaction of the accreditation requirements in R4-19-201(A).

C. A parent institution that is denied proposal 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 proposal 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.

D. A parent institution that receives proposal approval may submit 20 copies of an application to the Board for provisional approval that includes the following information and documentation:

1. Name and address of parent institution; and

2. Plan for compliance with R4-19-201 through R4-19-206, including but not limited to the following:

a. Name and qualifications of appointed administrator;

b. Names and qualifications of nursing faculty for the first semester or session of operation at least 60 days before classes begin;

c. Final program implementation plan;

d. Curriculum, including course outlines, program objectives, and learning outcomes;

e. Descriptions of available and proposed physical facilities with dates of availability; and

f. List of available clinical facilities within the geographic area, including facility type, size, number of beds, and type of patients.

E. Following an onsite evaluation conducted according to A.R.S. § 41-1009, the Board shall grant provisional approval to a parent institution that meets the requirements of R4-19-201 through R4-19-206 if approval is in the best interest of the public. A parent institution that is denied provisional 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 provisional 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.

F. The provisional approval of a nursing program expires 12 months from the date of the grant of provisional approval if a class of nursing students is not admitted by the nursing program within that time. The Board may rescind the provisional approval of a nursing program for a violation of any provision of this Article according to R4-19-211.

G. If a nursing program fails to apply for full approval within two years of graduating its first class of students, the Board shall rescind its provisional approval. A nursing program whose provisional approval is rescinded may request a hearing by filing a written request with the Board within 30 days of service of the Board's order rescinding the provisional 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.

Historical Note

Adopted effective February 20, 1980 (Supp. 80-1). Former Section R4-19-17 renumbered and amended as Section R4-19-16 effective July 16, 1984 (Supp. 84-4). Former Section R4-19-17 renumbered as R4-19-207 (Supp. 86-1). New Section adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-208. Application for Full Approval of a Nursing Program

A. A nursing program seeking full approval shall submit 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. Twenty copies of 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 R4-19-212, to a nursing program that meets the requirements of R4-19-201 through R4-19-206 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.

C. A nursing program shall apply for full approval within a two-year period after graduating its first class or its provisional approval may be rescinded by the Board following notice and an opportunity for hearing.

Historical Note

Adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-209. Nursing Program Change

A. A nursing program administrator shall receive approval from the Board before implementing any of the following nursing program changes:

1. Changing the mission or goals,

2. Increasing or decreasing the length of the program,

3. Adding or deleting a geographical location of the program,

4. Increasing the student enrollment capacity by more than 20%,

5. Changing the level of educational preparation provided, or

6. Transferring the nursing program from one institution to another.

B. The administrator shall submit 20 copies of the following materials with the request for nursing program changes:

1. The rationale for the proposed change and the anticipated effect on the program administrator, faculty, students, resources, and facilities;

2. A summary of the differences between the current practice and proposed change;

3. A timetable for implementation of the change; and

4. The methods of evaluation to be used to determine the effect of the change.

C. The Board shall approve a request for a nursing program change if the program demonstrates that it has the resources to implement the change and the change is consistent with R4-19-201through R4-19-206. A nursing program that is denied approval of program changes 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.

Historical Note

Adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-210. Renewal of Approval of Board-approved Nursing Programs

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. Current regional accreditation status,

3. Copy of the current catalog of the parent institution,

4. Copy of current nursing program policies, and

5. Twenty copies 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 renewal 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.

Historical Note

Adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-211. Rescission of Approval

A. The Board shall, upon determining that a nursing program or a refresher program is not in compliance with R4-19-201 through R4-19-214, provide to the administrator a written notice of deficiencies that establishes a reasonable time, based upon the number and severity of deficiencies, to correct the deficiencies. The time for correction may not exceed 18 months.

1. The administrator shall, within 30 days from the date of service of the notice of deficiencies, file a plan to correct each of the identified deficiencies after consultation with the Board or designated Board representative.

2. The administrator may, within 30 days from the date of service of the notice of deficiencies, submit a written request for a hearing before the Board to appeal the Board's determination of deficiencies. Hearings shall be conducted in accordance with A.R.S. Title 41, Chapter 6, Article 10 and 4 A.A.C. 19, Article 6.

3. If the Board's determination is not appealed or is upheld upon appeal, the Board shall conduct periodic evaluations of the program during the time of correction to determine whether the deficiencies have been corrected.

B. The Board shall, following a Board-conducted survey and report, rescind the approval of, or restrict admissions to a nursing program or refresher program if the program fails to comply with R4-19-201 through R4-19-214 within the time set by the Board in the notice of deficiencies served upon the program.

1. The Board shall serve the administrator with a written notice of proposed rescission of approval or restriction of admissions that states the grounds for the proposed action. The administrator shall have 30 days to submit a written request for a hearing to show cause why the proposed action should not occur. Hearings shall be conducted in accordance with A.R.S. Title 41, Chapter 6, Article 10 and 4 A.A.C. 19, Article 6.

2. Upon the effective date of a decision to rescind program approval, the nursing program shall immediately cease operation and be removed from the official approved-status listing. A nursing program that has been ordered to cease operations shall assist currently enrolled students to transfer to an approved nursing program.

C. In addition to the cause in subsection (B), if the Board determines that the effectiveness of instruction to students is impaired, the Board may rescind approval of or restrict admissions to a nursing program for any of the following causes:

1. For a program that was served with a notice of deficiencies within the preceding three years and timely corrected the noticed deficiencies, subsequent noncompliance with the standards in R4-19-201 through R4-19-214; or

2. Failure to comply with orders of or stipulations with the Board within the time determined by the Board.

Historical Note

Adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-212. Nationally Accredited Nursing Programs

A. An approved nursing program that is accredited by an approved national nursing accrediting agency shall submit to the Board evidence of initial accreditation and shall submit evidence of continuing accreditation after each reaccreditation review.

B. The administrator shall submit to the Board any report from a national accrediting agency citing deficiencies or recommendations at the time the report is received by the nursing program.

C. The administrator of a nursing program shall notify the Board within 10 days of any change in accreditation status.

D. The administrator of a nursing program that loses its accreditation status or allows its accreditation status to lapse shall file an application for renewal of approval under R4-19-210 within 30 days of loss of or lapse in accreditation status.

E. Unless otherwise notified by the Board following receipt and review of the documents required by subsections (A) and (B), a nursing program continues to have full-approval status. The administrator of a nursing program that has its continuing approval-status rescinded by the Board may request a hearing by filing a written request with the Board within 30 days of service of the Board's order rescinding continuing full-approval status. Hearings shall be conducted in accordance with A.R.S. Title 41, Chapter 6, Article 10 and 4 A.A.C. 19, Article 6.

Historical Note

Adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-213. Voluntary Termination of a Nursing Program or a Refresher Program

A. The administrator of a nursing program or a refresher program shall notify the Board within 15 days of a decision to voluntarily terminate the program. The administrator shall, at the same time, submit a written plan for terminating the nursing program or refresher program.

B. The administrator shall ensure that the nursing program or refresher program is maintained, including the nursing faculty, until the last student is transferred or completes the program.

C. Within 15 days after the termination of a nursing program or refresher program, the administrator shall notify the Board of the permanent location and availability of all program records.

Historical Note

Adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4).

R4-19-214. Approval of a Refresher Program

A. An applicant for approval of a refresher program for nurses whose licenses have been inactive or expired for five or more years, nurses under Board order to enroll in a refresher program, or nurses who have not met the requirements of R4-19-312 shall submit a completed application that provides all of the following information and documentation:

1. Applicant's name, address, e-mail address, telephone number, and fax number;

2. Proposed starting date for the program;

3. Name and curriculum vitae of all instructors;

4. Statement describing the facilities, staff, and resources that the applicant will use to conduct the refresher program;

5. A program and participant evaluation plan that includes student evaluation of the course, instructor, and clinical experience; and

6. Evidence of a curriculum that meets the requirements of subsection (B).

B. A refresher program shall provide:

1. A minimum of 40 hours of didactic instruction and 112 hours of supervised clinical practice for a licensed practical nurse program;

2. A minimum of 80 hours of didactic instruction and 160 hours of supervised clinical practice for a professional nurse program;

3. A planned and supervised clinical experience that is consistent with course goals and provides an opportunity for the student to demonstrate safe and competent application of program content. The student may spend up to 24 of the required clinical hours in a supervised lab setting;

4. Curriculum materials, including:

a. An overall program description including goals; and

b. Objectives, content, and hours allotted for each area of instruction:

5. Instruction in current nursing care concepts and skills including:

a. Nursing process;

b. Pharmacology, medication calculation, and medication administration;

c. Communication;

d. Critical thinking and clinical decision making;

e. Delegation, management, and leadership; and

f. Meeting psychosocial and physiological needs of clients.

C. A refresher program may adapt the curriculum based on the need to incorporate content applicable to specialty and indirect care areas of nursing practice for students who plan to practice in those areas. The clinical experience for such students may include indirect care, depending on the course goals and objectives. The program shall include concepts and skills needed to deliver safe nursing care in any adapted curriculum.

D. The Board shall approve a refresher program that meets the requirements of subsection (A), if approval is in the best interest of the public, for a term of four years. An applicant who is denied refresher program 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 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.

E. The refresher program sponsor shall apply for renewal of approval in accordance with subsection (A) not later than 90 days before expiration of the current approval. The sponsor of a refresher program that is denied renewal of 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 renewal of approval. Hearings shall be conducted in accordance with A.R.S. Title 41, Chapter 6, and 4 A.A.C. 19, Article 6.

F. The sponsor of an approved refresher program shall provide written notification to the Board within 15 days of a participant's completion of the program of the following:

1. Name of the participant and whether the participant successfully completed or failed the program,

2. Participant's license, and

3. Date of participant's completion of the program.

Historical Note

Adopted effective July 19, 1995 (Supp. 95-3). Amended by final rulemaking at 7 A.A.R. 5349, effective November 8, 2001 (Supp. 01-4). Amended by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (05-1).

R4-19-215. Distance Learning Nursing Programs; Out-of-State Nursing Programs

A. An out-of-state nursing program that plans to provide both didactic and clinical instruction in Arizona shall comply with the application requirements of R4-19-207 and R4-19-208.

B. A nursing program that delivers didactic instruction by distance learning methods shall ensure that the methods of instruction are compatible with the program curriculum plan and enable a student to meet the goals, competencies, and objectives of the educational program and standards of the Board.

1. A distance learning nursing program shall establish a means for assessing individual student outcomes, and program outcomes including, at minimum, student learning outcomes, student retention, student satisfaction, and faculty satisfaction.

2. For out-of-state nursing programs, the program shall be within the jurisdiction of and regulated by an equivalent nursing regulatory authority in the state from which the program originates, unless also providing clinical experience in Arizona.

3. Faculty shall be licensed in the state of origination of a distance learning nursing program.

4. A distance learning nursing program shall provide students with supervised clinical and laboratory experiences so that program objectives are met and didactic learning is validated by supervised, land-based clinical and laboratory experiences.

5. A distance-learning nursing program shall provide students with access to technology, resources, technical support, and the ability to interact with peers, preceptors, and faculty.

C. A nursing program, located in another state or territory of the United States, that wishes to provide clinical experiences in Arizona under A.R.S. § 32-1631(3), shall obtain Board approval before offering or conducting a clinical session. To obtain approval, the program shall submit a proposal package that contains:

1. A self study, describing the program's compliance with R4-19-201 through R4-19-206; and

2. A statement regarding the anticipated effect on clinical placements for students currently enrolled in an Arizona-approved nursing program.

D. The Board may require a nursing program approved under this Section to file periodic reports for the purpose of data collection or to determine compliance with the provisions of this Article. A program shall submit a report to the Board within 30 days of the date on a written request from the Board or by the due date stated in the request if the due date is after the normal 30-day period.

E. The Board shall approve an application to conduct clinical instruction in Arizona that meets the requirements in A.R.S. Title 32, Chapter 15 and this Chapter, and is in the best interest of the public. An applicant who is denied approval to conduct clinical instruction in Arizona 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 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.

F. The Board may rescind an approval held by an out-of-state nursing program to conduct clinical instruction in Arizona, in accordance with R4-19-211.

G. If the Board finds that a nursing program located and approved in another state or territory of the United States does not meet requirements for nursing programs prescribed in R4-19-201 through R4-19-206, the Board shall provide a notice of deficiency to the program as prescribed in R4-19-211(A), (A)(1) and (A)(2).

1. If the program fails to correct the deficiency before the expiration of the period of correction, the Board shall rescind approval of the program as prescribed in R4-19-211(B)(1).

2. If the period of rescission, from the date of rescission to the date of reinstatement, is at any time concurrent with an applicant's education from the date of admission to the date of graduation, the Board shall withhold licensure unless the applicant meets all licensure requirements and completes any remedial education prescribed by the Board under R4-19-301(H). The Board shall ensure that the applicant has completed a curriculum that is equivalent to that of an approved nursing program.

3. If a nursing program provides evidence of compliance with R4-19-201 through R4-19-206 after the rescission of approval, the Board shall review the evidence, determine whether or not the nursing program complies with these standards, and reinstate approval of the program if the program complies with these standards.

Historical Note

New Section made by final rulemaking at 11 A.A.R. 451, effective March 7, 2005 (Supp. 05-1). Amended by final rulemaking at 13 A.A.R. 1483, effective June 2, 2007 (Supp. 07-2).

ARTICLE 3. LICENSURE

R4-19-301. Licensure by Examination

A. An applicant for licensure by examination shall:

1. Submit to the Board a verified application on a form furnished by the Board that provides the following information about the applicant:

a. Full name and any former names used by the applicant;

b. Mailing address, including primary state of residence, and telephone number;

c. Place and date of birth;

d. Ethnic category and marital status, at the applicant's discretion;

e. Social Security number for an applicant who lives or works in the United States;

f. Post-secondary education, including the names and locations of schools attended, graduation dates, and degrees received, if applicable;

g. Current employer or practice setting, including address, telephone number, position, and dates of service, if employed or practicing in nursing or health care, and previous employer or practice setting in nursing or health care, if any, if current employment is less than 960 hours within the past five years;

h. Any state, territory, or country in which the applicant holds a registered or practical nursing license and the license number and status of the license, including original state of licensure, if applicable;

i. The date the applicant previously filed an application for licensure in Arizona, if applicable or known;

j. Responses to questions regarding the applicant's background on the following subjects:

i. Pending disciplinary action by a nursing regulatory agency in the United States or its territories or current investigation of the applicant's nursing license in another state or territory of the United States,

ii. Felony conviction or conviction of an undesignated or other similar offense, and

iii. Unprofessional conduct as defined in A.R.S. § 32-1601;

k. Detailed explanation and supporting documentation for each affirmative answer to questions regarding the applicant's background; and

l. Certification in nursing including category, specialty, name of certifying body, date of certification, and expiration date.

2. Submit a completed fingerprint card for the purpose of obtaining a criminal history report under A.R.S. § 32-1606 if the applicant has not submitted a fingerprint card to the Board within the last two years; and

3. Pay the applicable fees.

B. If an applicant took the State Board Test Pool Examination (SBTPE), National Council Licensure Examination (NCLEX®) RN, or NCLEX-PN in any state or territory of the United States or in Canada, the applicant shall indicate on the application:

1. The date of the examination,

2. The location of the examination, and

3. The result of the examination.

C. If an applicant is a graduate of a nursing program in the United States that has been assigned a program code by the National Council of State Boards of Nursing, the applicant shall submit one of the following:

1. If the program is an Arizona-approved program, a statement signed by a nursing program administrator or designee verifying that:

a. The applicant graduated from a registered nursing program for a registered nurse applicant; or

b. The applicant completed a practical nursing program or graduated from a registered nursing program for a practical nurse applicant; or

2. If the program is located in another state or territory and meets educational standards that are substantially comparable to Board standards for educational programs under R4-19-201 to R4-19-206 when the applicant completed the program, an official transcript sent directly from one of the following as:

a. Evidence of graduation from a diploma registered nursing program, associate degree registered nursing program, or baccalaureate or higher degree registered nursing program for a registered nurse applicant.

b. Evidence of completion of a practical nursing program, associate degree registered nursing program, or baccalaureate or higher degree registered nursing program for a practical nurse applicant.

D. If an applicant is a graduate of a foreign nursing program and lacks items required in subsection (C), the applicant shall comply with subsections (A) and (B), submit verification of the status of any nursing licenses held, and submit the following:

1. To demonstrate nursing program equivalency, one of the following:

a. Evidence of a passing score on the English language version of either the Canadian Nurses' Association Testing Service, or the Canadian Registered Nurse Examination or an equivalent examination;

b. A Certificate or Visa Screen Certificate issued by the Commission on Graduates of Foreign Nursing Schools (CGFNS), or a report from CGFNS that indicates an applicant's program is substantially comparable to a U.S. program; or

c. A report from another credential evaluation service (CES) that is accepted by the Board. The Board shall accept reports from a CES if acceptance is in the best interest of the public and the CES submits the information required by the Board under R4-19-303.

2. If an applicant's pre-licensure nursing program provided classroom instruction, textbooks, or clinical experiences in a language other than English, a test of written, oral, and spoken English is required. Clinical experiences are held in a foreign language if the principal language of the country or region where the nursing program was held is a language other than English. An applicant shall ensure that one of the following is submitted to the Board directly from the testing or certifying agency:

a. Evidence of a minimum score of 540 on the paper and pencil version or 207 on the computer-based version of the Test of English as a Foreign Language (TOEFL) and a minimum score of 50 on the Test of Spoken English (TSE) or a minimum score of 76 on the Internet-based TOEFL,

b. Evidence of a minimum sco