21 NCAC 36 .0220 REFRESHER COURSE
(a) Completion of a Board-approved refresher course shall be required of previously licensed individuals who have not held an active license in any jurisdiction for five or more years and requests:
(1) reactivation of an inactive license;
(2) reinstatement of an expired license; or
(3) endorsement to North Carolina.
(b) If completion of a Board-approved refresher course is required by the Board following disciplinary action authorized pursuant to G.S. 90-171.37, the individual shall be subject to restrictions issued by the Board during the clinical component of the refresher course. The individual shall meet all requirements for reinstatement of the license prior to enrollment in 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 comply with the rules as defined in this Chapter. The application for Refresher Course is posted on the Board's website at www.ncbon.com. No student shall be enrolled prior to Board approval. Board approval shall be granted to a provider for a period of time not to exceed five years. All 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 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) a plan for evaluation of student competencies and ability to competently practice nursing;
(4) a faculty list that includes the director and all instructors, and identifies their qualifications and their functions in teaching roles; and
(5) the projected clinical schedule.
(e) The Board shall make site visits if it is unable to determine that all requirements have been met through application document review. A decision on an application to offer a refresher course shall be given within 30 days following receipt of a complete application.
(f) A provider seeking to offer a refresher course shall be a post-secondary educational institution, a health care institution, or other agency providing education in healthcare-related fields.
(g) The director of the refresher course is responsible for administering and implementing the course and maintaining compliance with this Rule. The director shall:
(1) hold an active unencumbered license to practice as a registered nurse in North Carolina;
(2) hold a baccalaureate or higher degree in nursing;
(3) have had at least two years experience in direct patient nursing practice as a registered nurse; and
(4) have at least one year prior teaching experience preparing individuals for a registered nurse or licensed practical nurse licensure at the post-secondary level or in a nursing staff development position which provides workforce education to nurses.
(h) Instructors for the refresher course shall report to the director of the refresher course and meet the requirements as set out in Subparagraphs (g)(1)-(3) of this Rule.
(i) The ratio of instructors to students for clinical experiences shall not exceed 1:10.
(j) Clinical preceptors for the course shall hold an active unencumbered license to practice as a registered nurse in North Carolina. Prior to becoming a clinical preceptor, the director or designated instructor shall ensure the competencies of the prospective preceptor align with the assigned clinical precepting responsibilities.
(k) The refresher course shall include both theory and clinical instruction. Course objectives shall be stated that:
(1) show relationships between nursing theory and practice; and
(2) identify behaviors consistent with the ability to competently practice nursing.
(l) The curriculum for a registered nurse refresher course shall include at least 240 hours of instruction, at least 120 of which shall consist of clinical experiences, and shall incorporate:
(1) the scope of practice for the registered nurse, as defined in G.S. 90-171.20 and 21 NCAC 36 .0221, .0224, .0225 and .0401; and
(2) instruction in and opportunities to demonstrate knowledge, skills, and abilities to competently practice nursing according to components of practice for the registered nurse as defined in 21 NCAC 36 .0224.
(m) The curriculum for a licensed practical nurse refresher course shall include at least 180 hours of instruction, at least 90 of which shall consist of clinical experiences, and shall incorporate:
(1) the scope of practice for the licensed practical nurse, as defined in G.S. 90-171.20(8) and 21 NCAC 36 .0221, .0225 and .0401; and
(2) instruction in and opportunities to demonstrate knowledge, skills, and abilities to competently practice nursing according to components of nursing practice for the licensed practical nurse as defined in 21 NCAC 36 .0225.
(n) The refresher course director or the designated refresher course instructor shall assess each refresher student and ensure the appropriateness of all clinical learning settings and assignments.
(o) Registered nurse and licensed practical nurse refresher courses shall limit simulation experiences to no more than 50 percent of clinical experiences, pursuant to 21 NCAC 36 .0321(p).
(p) Evaluation processes shall be implemented that effectively measure the refresher student's ability to competently practice nursing consistent with the level of licensure and scope as set forth in 21 NCAC 36 .0221, .0224, .0225, and .0401.
(q) The student shall complete both the theory and clinical components of the refresher course within 24 months of initial enrollment in the course.
(r) The provider shall contract, in writing, with the agency the support and availability to provide the required clinical experiences for the refresher course.
(s) Individuals previously licensed in North Carolina and presently residing outside of North Carolina may meet the requirements of this Rule by successfully completing a refresher course approved by another state board of nursing.
(t) Individuals enrolled in refresher courses shall identify themselves as RN Refresher Student (R.N.R.S.) or LPN Refresher Student (L.P.N.R.S.), consistent with the course level, after signatures on records or on name pins.
(u) The director of the refresher course shall provide the Board with a list of the names and license numbers of those individuals who have completed the refresher course at the appropriate level of licensure.
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;
Readopted Eff. January 1, 2019;
Amended Eff. March 1, 2024.