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Evaluation of Alabama's MWandatory Continuiing Education Program



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Evaluation of Alabama s MWandatory Continuiing Education Program for Reasonableness Access and Value Jean B Lazarus EdD RN Anne Permaloff PhD and Charlie J Dickson EdD RN FAAN ABSTRACT Background As a measure of quality control the Alabama Board of Nursing subjected the regulations for mandatory continuing education MCE for licensure to an evaluation of their impact and effectiveness This study focused on licensees perceptions of the regulations regarding reasonableness access and value Metihod Evaluation research methods were used to answer research questions related to the rules governing continuing education CE requirements for nursing licensure Data were obtained from a survey of a random sample N 406 of RNs and licensed practical nurses Both qualitative and quantitative methods were applied to data analysis States are authorized to take whatever actions necessary to protect the public from incompetent practitioners One means of invoking this authority is through the provision of regulatory agencies empowered to admit qualified individuals to licensure In Dr Lazarus is Research Consultanit Alabama Board of Nursing Montgomery Alabama Dr Permialoff is Consumer Memlber Alabama Board of Nursing and Professor Departmenit of Political Scicnice an1d Public Administration Auburna University at Montgomery Montgomery Alabama Dr Dicksont is Chairperson Continuiig Competence and Continuting Education Committee Alabama Board of Nursing and Professor Tuskegee University College of Veterinary Medicine Allied Health and Nursing Tuskegee Alabama The authors acknowledge the other members of the Conitinuinig Comipetence and Continuing Education Committee Alabama Board of Nursing Yvonne Albert LPN Joyce Chappelear MSN RN Gregory Howard LPN Marjesta Jones LPN aind N Genell Lee MSN RN JD Executive Officer Address correspondence to Jean B Lazarus EdD RN Research Consultant Alabama Board of Nursing 770 WVashington Avellue Suite 250 Monttgomery Alabama 36130 3900 102 IIIIII Findings Requirements for CE were perceived as reasonable however concerns were identified related to cost access and quality of presentations Licensees perceived CE to be of value and applied CE to decision making and action in nursing practice Chi square analysis was significant to license type related to selected variables e g rights and responsibilities Qualitative analysis provided insight regarding licensees concerns and recommendations for change Conclusion Mandatory continuing education MCE plays a significant role in promoting competence in nursing practice and is a mechanism for enhancing public protection A high noncompliance rate on the MCE audit has ramifications for enforcement regulations Alabama continuing education CE has been mandated by the legislature as a measure of assuring health professionals are competent to practice Mandatory conitinuing education MCE for RNs and licensed practical nurses LPNs in Alabama was initiated in 1991 in accordance with Article 2 of The Nurse Practice Act 1989 Chapter 610 X 10 of the Alabamnn Administrative Code 1991 delineates required contact hours acceptable content and activities and the official period in which the CE contact hours must be earned for licensure The regulations also provide for an audit to determine compliance and establish criteria for entities to become providers of CE for nurses The rules have been amended three times to accommodate implementation of the law Currently licensees from numerous professions and organizations with political economic and social interests in the delivery of health care contest the Volume 33 Number 3 May June 2002 LAZARUS PERMALOFF DICKSON value of MCE Every state in the union and numerous other countries impose CE requirements for license renewal on various professions More than 50 of the states have mandatory CE requirements for nursing Additionally more than 50 of member boards of nursing specify requirements for CE for reinstatement or reentry into practice National Council of State Boards of Nursing Inc 1999 Annual audits conducted by the Alabama Board of Nursing have shown a noncompliance rate ranging from 9 to 37 Alabama Board of Nursing 1993 1998 Most noncompliance rests in failure of the licensee to meet the 30 day requirement of response to the notice of audit and in failure to earn the contact hours within the official earning period The rise in noncompliance sporadic complaints from licensees about acceptable activities and a continuing dialog on the value of CE as a contributor to continuing nursing competence resulted in a the Alabama Board of Nursing s decision to authorize a study of licensees perceptions of the program through research PURPOSE The purpose of the study was to evaluate the MCE program for nurses with Alabama licenses in relation to reasonableness access and value Intended aims were to use the findings to facilitate program improvement enhance decision making in relation to potential amendments to the rules and to promote licensee compliance with the legislature s mandate for CE An overall goal was and continues to be the enhancement of nursing practice for the public s safety and welfare LITERATURE REVIEW The merits of MCE have been debated formally and informally for more than 100 years Individuals of various occupations have contested the mandating of ongoing education However as early as 1889 the United States Supreme Court recognized the power of the states to impose conditions on the practice of certain professions for the protection of society Specifically the Court placed no limits on the state s power to regulate observing that the power of the state to provide for the general welfare of its people authorizes it to prescribe all such regulations as in its judgment will secure or tend to secure them from the consequences of ignorance and incapacity as well as of deception and fraud Dent v West Virginia 1889 Two later cases Gamble v Board of Osteopathic Examiners 1942 and State ex rel Week v Wisconsin State Board of Examiners in Chiropractic 1947 supportThe Journal of Continuing Education in Nursing 1 ed the concept of ongoing professional learning by citing the states authority to act on behalf of the general welfare of the public Courts at all levels have supported the rights of states to require CE for license renewal and to prescribe CE as a condition for the restoration or retention of a license Mann et al 1999 The courts did not justify CE s value or effectiveness they simply decreed its


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