Alabama Administrative Code Chapter 610-X-3 — Nursing Education Programs

610 Alabama Board of Nursing

Ala. Admin. Code r. 610-X-3-.01 Definitions

(1) Approved Program: A nursing education program that meets all of the standards as specified in these rules.

(2) Articulation: A planned process between two or more educational programs or systems to assist students to make a smooth transition from one program to another without duplication in learning or coursework.

(3) Clinical and Theoretical Competence: The possession of knowledge, skills, and abilities necessary to meet current standards of nursing practice and education as specified in Chapter 610-X-6, Standards of Nursing Practice, Chapter 610-X-3, Nursing Education Programs, Chapter 610-X-4, Licensure, Chapter 610-X-5, Advanced Practice Nursing Collaborative Practice, and Chapter 610-X-9, Advanced Practice Nursing.

(4) Clinical Learning Experience: Organized plan of learning experiences, under the oversight of an experienced clinical supervisor, that provides student opportunities to integrate knowledge into assessment, planning, implementation, evaluation, and clinical reasoning of nursing care appropriate to the scope of practice for the level and type of program.

(5) Pre-clinical Learning Experience: An organized plan occurring prior to the learning experience, with information to span the lifespan for varied clinical settings, to ensure a safe transition to nursing practice in complex environments with pre- and post-clinical conferences.

(6) Simulation: A technique that amplifies “real-life” learning in an interactive manner with guided experiences that replicate significant aspects of reality of acute, chronic, and community health settings across the life-span.

(7) Prelicensure Clinical Supervisor: A licensed registered nurse, acting in a supervisory capacity of clinical learning experiences, who is accessible to assign or prescribe a course of action, give procedural guidance, direction, and evaluation for a nursing student(s). This term may include assigned clinical faculty or adjunct faculty.

(8) Preceptor (RN program or LPN program): a licensed nurse whose licensure is appropriate to the scope of practice with at least one year of experience, who is employed in a clinical setting and serves as a role model, resource person, and clinical educator to enhance the learning experiences of a student nurse.

(9) Clinical Supervisor, Clinical Coordinator, or Preceptor (Advanced Practice Program): an advanced practice registered nurse, a physician, or other appropriately licensed, population-focused clinician who provides guidance, serves as a role model, resource, and clinical educator to enhance the learning experiences of an advanced practice nursing student.

(10) Curriculum: An organized plan of study in nursing that includes both theoretical and clinical learning experiences essential for preparing students to be eligible upon graduation to apply for licensure as a registered nurse, licensed practical nurse, or certification and approval of an advanced practice nurse.

(11) Curriculum Outcomes: A common set of competencies expected of a program’s graduates upon completion of an organized plan of study. Outcomes are clear, measurable demonstrations of student learning.

(12) Deficiency(ies): Failure of a nursing education program to meet one or more of the standards as stated in Chapter 610-X-3, Nursing Education Programs.

(13) Distance Education: A formal educational process in which the majority of the instruction in a course/program occurs when instructors and students are not physically in the same location. The educational process may use various methodologies consistent with this chapter for communication, instruction, and evaluation.

(14) Nursing Faculty: Registered professional nurse, with at least one graduate degree in nursing or a health-related field, appointed by the governing institution and who are employed full-time or part-time and are responsible for developing, implementing, evaluating, and updating nursing program curricula.

(a) Nursing faculty for advanced practice nursing courses must meet national accreditation, certification, and educational standards for the specific program of study. This requirement does not apply to non-nursing faculty teaching non-nursing courses in an advanced practice curriculum.

(15) Licensed Hospital: A facility described in Code of Ala. 1975, Section 22-21-20(1), other than a health maintenance organization, which has an organized medical staff or which employs the services of a medical director who is a physician licensed to practice medicine in Alabama. The term hospital shall not include the private offices of physicians or dentists, whether in individual, group, professional corporation, or professional association practice.

(16) Nursing Program Administrator: Registered professional nurse with a master’s or higher degree in nursing who has primary accountability and responsibility for administration of the nursing program.

(17) Survey: A comprehensive, Board-authorized on-site evaluation or review of a written report, and/or documents, for a proposed or existing program in prelicensure or advanced practice education that serves to assess the program’s compliance with the Board’s education standards.

(18) Systematic Plan of Evaluation: A comprehensive written document that reflects ongoing evaluation of all program components that includes, but is not limited to, collection of objective data, evaluation of outcomes, and results in improvements based on evaluative data.

(19) Unencumbered License: an active license that has no current stipulations, conditions, or limitations.

(20) Governing Institution Administrator: Person with overall administrative authority for the instructional sites where the nursing program is located.

(21) Prelicensure Program Pass Rate: The percentage of those graduates of a prelicensure program taking the national licensure examination during a calendar year who achieve a passing score on the national licensure examination during the calendar year.

(22) External Exam: A standardized means of testing readiness to practice nursing, usually administered following completion of a program of study in nursing education.

(23) Notice of Deficiency: An official notice by the Board which identifies areas of deficiency and provides the expected date of correction. The notice may require follow-up site visits and submission of additional documents, evaluations, and reports.

(24) Notice of Correction: An official notice by the Board notifying a nursing education program of the correction of previous areas of deficiency and current approval status of the nursing program.

(25) Prelicensure program: a nursing education program that prepares graduates for licensure as a registered nurse or licensed practical nurse pursuant to Section 34-21-20, et seq. of the Code of Ala. 1975.

(26) Advanced practice program: a nursing education program that prepares graduates for approval to practice as an advanced practice nurse pursuant to Section 34-21-80, et seq. of the Code of Ala. 1975.

(27) Dual Role: preparation for two distinct patient population foci within a single advanced practice nursing education program of study.

(28) Patient Population Focus/Foci: one of six areas of concentration [Family/Individual Across the Lifespan, Adult-Gerontology (Acute or Primary), Neonatal, Pediatrics (Acute or Primary), Women’s Health/Gender-Related, and Psych/Mental Health] within advanced practice nursing education programs.

(29) Debriefing: an activity that follows a simulation experience, is led by a facilitator, encourages participant’s reflective thinking, and provides feedback regarding the participant’s performance.

(30) Student Nurse Apprentice Program: A board approved nursing program that establishes a student nurse apprenticeship program within their curriculum plan which allows nursing students engaged in a registered apprenticeship, pursuant to the Alabama Industry Recognized and Registered Apprenticeship Program Act and Chapter 610-X-15.

(31) Clinical Resource LPN (CRLPN): is an LPN with an unencumbered Alabama nursing license who has at least two years of experience within the past five years in a skilled care long-term care setting and who provides supervision, demonstration, and collaborative evaluation of practical nursing student performance with skilled care long-term care patients in a licensed health care facility.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(2).
• New: Filed September 25, 2006; effective October 30, 2006. Amended: Filed September 21, 2007; effective October 26, 2007. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed July 20, 2018; effective September 3, 2018. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published May 31, 2022; effective July 15, 2022. Amended: Published November 30, 2022; effective January 14, 2023.

Ala. Admin. Code r. 610-X-3-.02 Standards For Approval

(1) All Alabama prelicensure nursing education programs and advanced practice nursing education programs, including Alabama distance nursing education programs, must be approved by the Alabama Board of Nursing and accredited by a national nursing accrediting agency recognized by the U.S. Department of Education within five (5) years of approval by the Board, in the case of a new program. If a program is unable to satisfy this requirement as the result of ineligibility for accreditation due to the existence of a deficiency or order issued by the Alabama Board of Nursing pursuant to this Chapter, the program shall establish candidacy for accreditation within six (6) months of successful resolution of the deficiency or satisfaction of the terms of the Order. Alabama advanced practice nursing education programs in operation prior to December 31, 2020, are considered in approved status. Advanced practice nursing education programs established in Alabama on or after January 1, 2021, shall obtain Board approval prior to implementation.

(a) Practical nursing programs may satisfy the programmatic accreditation requirements by obtaining accreditation through the Council on Occupational Education (COE).

(2) The governing institution, nursing program administrator, and nursing faculty are accountable for the standards, processes, and outcomes of the nursing education program.

(3) The governing institution offering the nursing program shall be:

(a) A postsecondary education institution that is authorized to offer nursing education and is accredited by an organization recognized by the U.S. Department of Education.

(b) Approved and licensed by the appropriate State of Alabama education agency(ies), as required by law.

(4) The governing institution shall provide support and resources sufficient to ensure achievement of student learning and program outcomes. Resources include, but are not limited to:

(a) Financial.

(b) Education program physical facilities, if appropriate.

(c) Instructional and learning equipment.

(d) Technology, to include simulation tools.

(e) Administrative, instructional, and support personnel.

(5) The governing institution’s administrator or program administrator shall notify the Board, in writing, of any substantive changes in the program, including, but not limited to:

(a) Nursing program administrator.

(b) Governing institution administrator, President, CEO, Chancellor, or Provost.

(c) Governance structure of the institution.

(d) Accreditation status and accreditation status reports related to the governing institution or nursing education program.

(e) Ownership or merger of governing institution.

(f) Name of the governing institution or nursing education program.

(g) Relocation of the governing institution or nursing education program.

(h) Significant curriculum changes.

(i) Intent to close a program.

(j) Expanding or collapsing, combining, or separating programs, including, but not limited to, prelicensure programmatic changes, and clinical/role populations preparing advanced practice registered nurses in an approved graduate nursing education degree program, specialty, or sub-specialty track.

(k) Reduction in nursing program faculty size exceeding thirty percent.

(l) Annual turnover in faculty greater than thirty percent.

(m) The percentage of total nursing faculty (full-time, clinical, adjunct, part-time, and other) employed at the institution as full-time faculty falls below thirty percent.

(n) Utilization of virtual or simulation lab in lieu of a “hands-on” lab for anatomy and physiology lab.

(o) Utilization of virtual or simulation lab in lieu of any required direct clinical hours for national certification examination.

(6) There shall be an organizational chart that depicts the authority, responsibility, and channels of communication between the nursing program and the governing institution and other comparable programs within the governing institution.

(7) A nursing education program shall be administered by a qualified program administrator who is accountable for the planning, implementation, and evaluation of the program.

(a) Minimum qualifications of a nursing program administrator shall include:

1. An active, unencumbered Alabama registered nurse license or a multistate registered nurse license issued by a party state, as defined in Chapter 4 of these rules.

2. An earned graduate degree in nursing. Nursing program administrators for advanced practice nursing education programs should be doctoral prepared.

3. Academic and experiential qualifications to administer a nursing education program.

(8) The governing institution and nursing program administrator shall provide sufficient numbers of qualified faculty to ensure that curriculum implementation and expected program outcomes are achieved and aligned with national nursing accrediting standards. Thirty-five percent of the total faculty, excluding adjunct faculty, are employed at the Institution as full-time faculty. Minimum qualifications of nurse faculty shall include:

(a) An active, unencumbered Alabama registered nurse license, or a multistate registered nurse license issued by a party state, as defined in Chapter 4 of these rules.

(b) An earned graduate degree in nursing or a related health field.

(c) Academic and experiential qualifications to teach in the area assigned.

(9) Institutional and program policies, procedures, and other publications, whether written or electronic, shall:

(a) Be written, accurate, and consistent as published, and publicly available.

(b) Address students' abilities to assume clinical assignments including, but not limited to, educational preparedness and physical, mental, and emotional behaviors.

(c) Provide opportunities for students to regularly participate in the development, evaluation, and continuous improvement of the program.

(d) Provide for processes to manage and learn from student near misses and errors.

(e) Provide for student remediation strategies at the beginning of each course and ensure students are aware of how to seek help.

(f) Programs shall hold students accountable for professional behavior, including honesty and integrity while in their program of study.

(g) Provide for availability of assistance for students with disabilities.

(10) All faculty are provided formal orientation and educated in basic instruction or teaching, adult learning principles, curriculum development, test item writing, and simulation standards, as appropriate to the faculty position.

(a) The program shall provide substantive and periodic workshops and presentations devoted to faculty development.

(11) Faculty participate in and are accountable for curriculum development, implementation, and evaluation.

(12) The curriculum of a nursing education program shall:

(a) Enable the student to develop the knowledge, skills, and abilities necessary for the level, scope, and standards of competent nursing practice expected at the level of licensure, approval, or certification.

(b) Provide evidence-based, outcome-focused, and culturally-sensitive theoretical and clinical experiences specific to the expected scope of practice of graduates from each type of nursing education program.

(c) Ensure distance education methods are consistent with the curriculum plan.

(d) The curriculum course work of a prelicensure nursing education program shall have didactic and clinical learning experiences which include but are not limited to:

1. Liberal arts and a sound foundation in biological, physical, social, and behavioral sciences supportive of the nursing education program.

2. Anatomy and physiology with a corresponding lab. Utilizing a “virtual lab” in lieu of a ‘hands-on’ lab is considered a substantive change and requires Board notification.

3. Nursing foundations, health assessment, pharmacology, nutrition, and community-based nursing.

4. History and trends of nursing, cultural diversity, legal and ethical responsibilities, and nursing scope of practice responsibilities, including leadership, management, delegation, and health care delivery systems.

5. Theoretical and clinical learning experiences across the lifespan in the areas of adult, medical/surgical, maternal/infant, child/pediatric, and psychiatric/mental health and community health nursing that includes simulation, laboratory time, and direct patient care in a licensed health care setting. With the exception of individuals holding valid student nurse apprentice permits issued by the board and engaged in registered apprenticeships, pursuant to the Alabama Industry Recognized and Registered Apprenticeship Program Act, under no circumstances may clinical learning experiences related to health assessment, fundamentals, or adult health medical/surgical courses be conducted using a preceptor model of clinical training. Community health clinical experiences may be conducted in a non-licensed setting. This does not prohibit additional experience in licensed non-health care setting. At least 50% of clinical experiences shall include direct patient care and include a variety of clinical settings sufficient to meet program outcomes.

6. Simulation learning experiences conducted according to acceptable faculty training standards and guidelines which incorporate clinical objectives, student debriefing, and evaluation are acceptable components of the clinical experience. Unless otherwise authorized by the Board, Simulation shall not comprise more than 50% of the clinical learning experience for any course or patient population. Programs utilizing simulation shall ensure:

(i) There shall be a budget that will sustain the simulation activities and training of the faculty.

(ii) Appropriate facilities for conducting simulation. This shall include educational and technological resources and equipment to meet the intended objectives of the simulation.

(iii) Faculty involved in simulations, both didactic and clinical, are oriented and have training in the use of simulation.

(iv) Simulation activities and evaluation criteria are linked to programmatic outcomes.

(v) The simulation activities are managed by or management duties are assigned to an individual who demonstrates continued expertise and competence in the use of simulation through:

a. Certification as Certified Healthcare Simulation Educator; or

b. Completion of two years of experience in healthcare simulation or completion of one or more credit-bearing or continuing education courses regarding healthcare simulation which includes content specific to all of the four domains in the current version of the Certified Healthcare Simulation Educator Examination Blueprint.

(vi) Students shall evaluate the simulation experience on an ongoing basis.

7. Safe and Effective Care Environment, Health Promotion, prevention of illness, and health maintenance, Psychosocial Integrity, and Physiological Integrity across the lifespan.

8. Microbiology for students pursuing an associate or baccalaureate degree.

(13) The governing institution, nursing program administrator, and nursing faculty are accountable for selecting and evaluating the teaching methods, delivery modalities, and processes used to achieve expected program outcomes.

(14) Clinical supervision or preceptorship of students shall comply with the standards set forth in this chapter.

(a) Clinical learning experiences shall be supervised by a registered nurse with knowledge of educational strategies and subject matter, and who is experienced in the clinical technologies essential to the safe practice of nursing.

(b) The clinical supervisor or assigned clinical faculty shall hold an active, unencumbered license to practice professional nursing in Alabama, or a multistate registered nurse license issued by a party state, as defined in Chapter 4 of these rules.

(c) The clinical supervisor or assigned clinical faculty shall be readily accessible to assign or prescribe a course of action, provide procedural guidance, direction, and evaluation for students engaged in the clinical learning experience.

(d) The faculty-student ratio in clinical learning experiences shall be collaboratively determined by the professional nursing faculty, the School of Nursing administration, and the professional nurse administrator, or designee, in the clinical agency. In licensed hospitals that provide inpatient acute care, the faculty to student ratio shall not exceed 1:8 during clinical learning experiences. The faculty-student ratio shall be determined according to the:

1. Complexity of the educational experience.

2. Acuity of the patient(s).

3. Physical layout of the clinical setting.

4. Student’s level of knowledge and skills necessary to provide safe patient care.

(e) The nursing education program shall work with clinical agencies for the planning, implementation, and evaluation of clinical experiences.

(f) Clinical learning experiences shall include the development of skills in clinical reasoning, management of care for groups of patients, and delegation to and supervision of other health care personnel performed in acute care and a variety of health care settings.

(g) Nursing faculty shall maintain responsibility and accountability for planning, implementation, and evaluation of all student clinical learning experiences.

(15) Nursing programs that offer only simulations or clinical testing do not meet the requirements for providing clinical learning experiences for nursing students.

(16) Scores on external exams shall not be utilized as the sole criterion for barring a student from graduating from the nursing program who otherwise, has successfully completed all required coursework.

(17) For licensed practical nursing students, a Clinical Resource LPN may be used to enhance, but not replace, faculty-directed clinical learning experiences. The supervising faculty member remains responsible for all students in the clinical setting, including those supervised by CRLPNs.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(2).
• Filed September 29, 1982. Amended: Filed September 21, 1984; effective October 29, 1984. Amended: Filed July 23, 1997; effective August 27, 1997. Repealed and New Rule: Filed July 22, 2002; effective August 26, 2002. Amended: Filed September 27, 2004; effective November 1, 2004. Amended: Filed September 25, 2006; effective October 30, 2006. Amended: Filed March 12, 2007; effective April 16, 2007. Amended: Filed September 21, 2007; effective October 26, 2007. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed March 16, 2012; effective April 20, 2012. Amended: Filed April 21, 2015; effective May 26, 2015. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020. Amended: Published June 30, 2020; effective August 14, 2020. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published November 30, 2021; effective January 14, 2022. Amended: Published May 31, 2022; effective July 15, 2022. Amended: Published November 30, 2022; effective January 14, 2023. Amended: Published July 31, 2024; effective September 14, 2024. Amended: Published January 31, 2025; effective March 17, 2025. Amended: Published September 30, 2025; effective November 14, 2025.
• Editor's note: Rule 610-X-3-.01 was renumbered to .02 as per certification filed September 25, 2006; effective October 30, 2006.

Ala. Admin. Code r. 610-X-3-.03 Outcome Standards

(1) Graduates shall demonstrate theoretical and clinical competence for entry into practice.

(2) The Board-calculated prelicensure annual pass rate for each prelicensure program shall be published by the Board annually.

(3) Programs shall develop, maintain, and adhere to their written plan for the systematic evaluation of the program that is comprehensive, demonstrates ongoing evaluation, is based on program outcomes, and incorporates continuous improvement. The systematic evaluation plan shall include:

(a) Collection, aggregation, analysis and trending of data.

(b) Programmatic outcomes, levels of achievement, evaluative criteria, assignment of responsibility, frequency of assessment, methods of assessment, actions taken, and quantitative data collected.

(c) Ongoing evaluation and revisions based on the evaluation.

(d) A mechanism for accountability for academic integrity.

(4) Programs shall maintain and produce, at the Board’s request:

(a) An articulation plan for program graduates.

(b) A plan for accepting new or transfer students that ensures that due consideration is given to all prior general and nursing coursework that an incoming student has completed successfully with other accredited institutions.

(5) Approved Nursing Education Programs shall be evaluated for continuing approval by the Board not less than every five (5) years, but may be evaluated more frequently based on deficiencies, identified areas of concern, or receipt of a complaint.

(a) Additional oversight of new programs shall take place throughout the first five (5) years of operation. This may include progress reports every 6 months on program, leadership, consistency of faculty, numbers of students, and trends of NCLEX pass rates, as well as the regularly collected annual reports.

(6) Nursing programs shall complete the Nursing Education Annual Report in a format specified by the Board within the time specified.

(7) The Board may review and analyze various sources of information regarding program performance, including, but not limited to:

(a) Periodic Board survey visits, as necessary.

(b) Board-recognized national nursing accreditation site visit reports, to include results of findings, pass rates, and other pertinent documents. The Board may accept all or partial evidence prepared by a program to meet national nursing accreditation requirements. The nursing program shall:

1. Submit to the Board copies of accreditation related correspondence from the national nursing accrediting agency within 30 days of receipt.

(c) Results of ongoing program evaluation.

(d) Other sources of evidence regarding achievement of program outcomes, including, but not limited to:

1. Student retention, attrition, and on-time program completion rates.

2. Sufficient type and number of faculty, to include retention and turnover.

3. Clinical learning experiences that are sufficient to achieve program outcomes (goals and course objectives) through the practice of nursing care or observational experiences.

4. Degree of compliance with nursing program accrediting body requirements for national licensure examination pass rates as calculated and determined by the nursing program accrediting body.

5. Trend data/action planning related to overall NCLEX performance and advanced practice certification exam performance.

6. Performance improvement initiatives related to program outcomes.

7. Program complaints/grievance review and resolution.

(8) Education Program Annual Report.

(9) Continuing approval will be granted upon the Board’s verification that the program is in compliance with the Board’s nursing education administrative rules in Chapter 610-X-3.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-5.
• Filed September 29, 1982. Amended: Filed September 21, 1984; effective October 29, 1984. Amended: Filed July 23, 1997; effective August 27, 1997. Repealed and New Rule: Filed July 22, 2002; effective August 26, 2002. Amended: Filed September 25, 2006; effective October 30, 2006. Amended: Filed September 21, 2007; effective October 26, 2007. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed June 25, 2012; effective July 30, 2012. Amended: Filed April 21, 2015; effective May 26, 2015. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published September 30, 2021; effective November 14, 2021. Amended: Published May 31, 2022; effective July 15, 2022.
• Editor's note: Rule 610-X-3-.02 was renumber to .04 as per certification filed September 25, 2006; effective October 30, 2006. Rule .04 was renumbered to .05 and replaced by new .04 as per certification filed November 19, 2010; effective December 24, 2010. Rules 610-X-3-.03, Distance Education, and 610-X-3-.04, Out of State Programs Conducting Clinical Experience in Alabama, are repealed and Rule 610-X-3-.05 renumbered .03 per certification published November 30, 2020; effective January 14, 2021.

Ala. Admin. Code r. 610-X-3-.04 Deficiencies

(1) The Board shall conduct surveys and evaluations as often as necessary to determine compliance with all standards set forth in Chapter 610-X-3.

(a) Warning signs that may trigger a focused site visit include:

1. Complaints from students, faculty, and clinical agencies

2. Turnover of program administrators defined by more than three administrators in a five-year period

3. Frequent nursing faculty turnover

4. Frequent reductions in numbers of nursing faculty

5. Decreasing trends in NCLEX pass rates

(2) The Board shall, upon determining that a program is not in compliance with standards set forth in Chapter 610-X-3, provide to the governing institution administrator and nursing program administrator a written notice of deficiencies that establishes a reasonable time, based upon the number and severity of deficiencies, to correct deficiencies.

(3) A nursing education program that receives a Notice of Deficiency from the Board shall establish a written plan within the specified time and provide reports to the Board, as requested, to document progress in resolving deficiency(ies).

(4) The Board may initiate action regarding any program that fails to correct identified deficiencies within the time specified by the Board, either through a formal hearing or Board-approved informal disposition. The Board may:

(a) Withdraw approval from the nursing education program, resulting in students who graduate after approval is withdrawn being ineligible to take the licensing examination.

(b) Continue approval of the nursing education program for a specified time period.

(c) Direct the nursing program administrator to notify students in writing of the Board’s decision.

(5) Programs under a notice of deficiency issued prior to January 1, 2018, shall continue with their plan of correction, as specified in the notice of deficiency.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-5.
• Filed September 29, 1982. Amended: Filed July 23, 1997; effective August 27, 1997. Repealed and New Rule: Filed July 22, 2002; effective August 26, 2002. Amended: Filed September 25, 2006; effective October 30, 2006. Amended: Filed September 21, 2007; effective October 26, 2007. Amended: Filed May 16, 2008; effective June 20, 2008. Amended (Rule number only): Filed November 19, 2010; effective December 24, 2010. Amended: Filed June 25, 2012; effective July 30, 2012. Amended: Filed April 21, 2015; effective May 26, 2015. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published May 31, 2022; effective July 15, 2022.
• Editor's note: Rule 610-X-3-.03 was renumber to .05 as per certification filed September 25, 2006; effective October 30, 2006. Rule .05 was renumbered to .06 as per certification filed November 19, 2010; effective December 24, 2010. Rule 610-X-3-.06 renumbered .04 per certification published November 30, 2020; effective January 14, 2021.

Ala. Admin. Code r. 610-X-3-.05 Additional Requirements For Advanced Practice

Nursing Education Programs {#sec-610-x-3-.05 omnilex-key=us-al-regs-official--chapter-610-x-3--610-X-3-.05}

(1) Alabama advanced practice nursing education programs in operation prior to December 31, 2020, are considered in approved status. Advanced practice nursing education programs established in Alabama on or after January 1, 2021, shall obtain Board approval prior to implementation.

(2) The nursing education program shall ensure that clinical agencies, preceptors, planning, implementation, and evaluation of clinical experiences are provided for and/or available to students.

(3) Students shall have content and supervised experiences in accordance with national accreditation, certification, and advanced practice nursing education requirements and standards for the advanced practice registered nurse role and patient population.

(4) Dual role and patient population foci: advanced practice registered nurse programs shall include and address content and clinical experiences for both roles and patient populations. Students shall have documented clinical hours in accordance with certification agency requirements for each role and patient population.

(a) Clinical hours between role and patient population must be documented and addressed as to the clinical preparation for the two areas of practice.

(5) A copy of the current advanced practice curriculum and a copy of the clinical rotation plan shall be available to the Board on request.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-5.
• Published September 30, 2020. New Rule: Published November 30, 2020; effective January 14, 2021.

Ala. Admin. Code r. 610-X-3-.06 Establishing A New Program

(1) Phase 1: A governing institution that plans to establish a new nursing education program shall submit to the Board a minimum of six (6) months in advance of the expected opening date:

(a) A letter of intent identifying the governing institution, the type of nursing education program, and the status of approval from accrediting bodies and state agencies.

(b) A feasibility study that includes:

1. Purpose of establishing the new nursing education program.

2. Availability of health care agencies with sufficient practice experiences to support the program. Letters of commitment and signed clinical contracts are acceptable documents for inclusion to demonstrate compliance with the standard.

3. Enrollment projections and identification of potential students.

4. Availability of adequate educational facilities and practice sites for clinical learning experiences throughout the life span including evidence of clinical space availability for additional new students in the area.

5. Assurance of adequate financial resources to support the initial and continuing program including submission of the proposed initial budget and continuing budget. Financial statements of the governing institution for the past two fiscal years are acceptable documents for inclusion to demonstrate evidence of financial stability of the governing institution.

6. Plan and resources for recruiting and employing projected number of qualified faculty for theoretical and clinical instruction.

7. Timeline for planning and implementation of the proposed program.

8. Organizational structure of the governing institution and placement of proposed nursing education program within the overall organization.

9. An articulation plan, including agreements, that addresses the transition of students and graduates to other educational institutions.

(c) The Board shall review the letter of intent, feasibility study, and supporting documentation for completeness and compliance with rules and regulations and may provide guidance regarding forward progress of the plan.

(2) Phase II: The governing institution shall submit an application for approval to establish a new program at least three (3) months prior to expected review by the Board.

(a) The application for Establishing a New Program shall include:

1. Demonstration of the potential to meet all standards identified in this chapter, including seeking national nursing accreditation by an agency recognized by the U.S. Department of Education within five (5) years of initial approval.

2. Verification that a nursing program administrator or nursing faculty member is employed to develop the nursing program.

3. Verification of availability of qualified nursing faculty to support the proposed numbers of student admissions to the new nursing education program.

(b) Curriculum plan that complies with the standards identified in this chapter, or related to advanced practice education, as required by the accrediting bodies, to include, but not limited to:

1. Philosophy or Mission.

2. Graduate competencies.

3. Curriculum sequence.

4. Course descriptions and objectives, with number of credit hours for all courses.

5. An articulation plan which enables students to advance to the next degree level, if applicable.

(3) A survey may be conducted to amplify, clarify, and verify information in the application.

(4) If all standards for approval are met, the program shall receive approval.

(5) In the event that the proposed program submits an application that substantially satisfies the requirements for both Phases I and II applications, the Board, at its discretion, may grant approval for the program upon review of the initial application.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-5.
• *Filed September 29, 1982. Amended: Filed September 21, 1984; effective October 29, 1984. Amended: Filed July 23, 1997; effective August 27, 1997. Repealed and New Rule: Filed July 22, 2002; effective August 26, 2002. Amended: Filed September 25, 2006; effective October 30, 2006. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Published November 30, 2021; effective January 14, 2021. Amended: Published September 30, 2021; effective November 14, 2021. *
• *Editor's note: Rule 610-X-3-.04 was renumber to .06 as per certification filed September 25, 2006; effective October 30, 2006. Rule .06 was renumbered to .07 as per certification filed November 19, 2010; effective December 24, 2010. Rule 610-X-3-.07 renumbered .06 per certification published November 30, 2020; effective January 14, 2021. *

Ala. Admin. Code r. 610-X-3-.07 Closing A Program

(1) A nursing program may be closed due to withdrawal of Board approval or may close voluntarily.

(2) A governing institution seeking to close a nursing education program shall submit written notification to the Board at least six (6) months prior to the planned closing date.

(3) An acceptable nursing program closure plan shall be developed and submitted to the Board for approval within thirty days of nursing program closure notification. The governing institution shall ensure that all standards for nursing education programs are maintained and all necessary courses are taught until the last student is transferred or graduated.

(4) The governing institution shall secure and provide for the permanent custody and storage of records of students and graduates. The Board shall be notified of the location and method of retrieving information from these records.

(5) Any nursing program under a closure plan shall submit to the Board confirmation, in writing, that the closure plan has been fully implemented when the closure plan has been completed.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(1).
• Filed September 29, 1982. Amended: Filed April 1, 1985; effective May 6, 1985. Amended: Filed July 23, 1997; effective August 27, 1997. Repealed and New Rule: Filed July 22, 2002; effective August 26, 2002. Amended: Filed September 25, 2006; effective October 30, 2006. Amended (Rule Number Only): Filed November 19, 2010; effective December 24, 2010. Amended: Filed November 21, 2016; effective January 5, 2017. Amended (Rule Number Only): Published November 30, 2020; effective January 14, 2021. Amended: Published May 31, 2022; effective July 15, 2022.
• Editor's note: Rule 610-X-3-.05 was renumber to .07 as per certification filed September 25, 2006; effective October 30, 2006. Rule .07 was renumbered to .08 as per certification filed November 19, 2010; effective December 24, 2010. Previous Rule 610-X-3-.08 renumbered .07 per certification published November 30, 2020; effective January 14, 2021.

Ala. Admin. Code r. 610-X-3-.08 Distance Education (In-State And Out Of State)

(1) An Alabama distance-learning prelicensure program or advanced practice education program must be approved by the Alabama Board of Nursing and accredited by a national nursing accrediting agency recognized by the U.S. Department of Education by January 1, 2022, or within five (5) years of Approval by the Board, in the case of a new program.

(2) The delivery of instruction by distance education methods shall enable students to meet the goals, competencies, and objectives of the education program and the standards of the Board, including supervised clinical learning experiences.

(3) A distance-learning program shall establish a means for assessing individual student and program outcomes.

(4) The governing institution of any distance-learning program offering courses in Alabama shall have institutional accreditation by an organization recognized by the U.S. Department of Education.

(5) Distance-learning programs shall comply with all standards of this Chapter, including those related to clinical supervision of student learning experiences for any prelicensure program to include the requirements in 610-X-3-.02 (12)(d)5. The Board may request periodic reports for the purpose of data collection or to determine compliance with the provisions of this chapter.

(6) Nursing Faculty located outside of the state who are employed by the governing institution for delivery of instruction by distance education methods, online instruction, or satellite instruction for an Alabama nursing program shall meet the minimum qualifications for faculty as set forth in this Chapter, including a valid license to practice registered nursing issued by Alabama, or a multistate registered nurse license issued by a party state, as defined in Chapter 4 of these rules.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(2).
• New Rule: Published November 30, 2020; effective January 14, 2021. Amended: Published September 30, 2025; effective November 14, 2025.

Ala. Admin. Code r. 610-X-3-.09 Out Of State Programs Conducting Clinical

Experience In Alabama {#sec-610-x-3-.09 omnilex-key=us-al-regs-official--chapter-610-x-3--610-X-3-.09}

(1) The nursing program shall be a postsecondary education institution that is accredited by a national nursing accrediting agency recognized by the U.S. Department of Education by January 1, 2022.

(2) The governing institution offering the nursing program shall be a postsecondary education institution that is accredited by an organization recognized by the U.S. Department of Education.

(3) The nursing education program shall have full approval (local, state, federal, and regulatory board) in the state where located.

(4) Any student who is enrolled in an out of state nursing education program that requires the student to possess an RN license as a condition of enrollment and who is participating in clinical learning experiences in Alabama shall have a valid registered nurse license issued by Alabama, or a multistate license issued by a party state, as defined in Chapter 4 of these rules.

(5) A prelicensure program or advanced practice program based outside the state of Alabama that plans to provide students with clinical learning experiences in Alabama shall submit to the Board, within a minimum of fifteen (15) days in advance of the expected clinical learning experience, the following:

(a) A letter of intent identifying the governing institution, the type of nursing education program, and the status of approval from accrediting bodies and state where located. The letter shall include:

1. Name of student and license number of the student (where applicable).

2. Name and license number of the clinical supervisor. Clinical supervision shall meet the requirements set forth in this chapter.

3. Name and location of the clinical facility and statement from the Director of Nursing/Chief Nursing Officer of the clinical facility regarding the availability of clinical learning experiences for instate and out-of-state nursing students.

4. Learning outcomes expected of the student.

5. Name and Alabama registered nurse license number or, in the case of nursing faculty licensed in another party state, multistate registered nurse license number of the nursing faculty responsible for the evaluation and oversight of the student’s clinical learning experience.

(6) Effective January 1, 2023, those out of state nursing programs conducting clinical experiences in Alabama for a prelicensure program or advanced practice program shall submit an annual out of state Program fee of $500.00 in January of each calendar year, or upon submission of the program's letter of intent for that calendar year.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(2).
• New Rule: Published November 30, 2020; effective January 14, 2021. Amended: Published May 31, 2022; effective July 15, 2022. Amended: Published January 31, 2023; effective May 15, 2023. Amended: Published September 29, 2023; effective November 13, 2023.

Ala. Admin. Code r. 610-X-3-.10 Nursing Education Program Hearing

(1) The Board may utilize a hearing officer to conduct a hearing prior to withdrawing approval or denying approval of a nursing education program. Nursing education program hearings shall be conducted in compliance with the provisions of the Alabama Administrative Procedure Act, as may be amended from time to time.

(2) The nursing education program may present written or oral evidence for the Board's consideration at any Board hearing.

(3) The nursing education program may appeal the Board’s withdrawal of program approval to the Montgomery County Circuit Court.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(1).
• Filed September 29, 1982. Amended: Filed July 23, 1997; effective August 27, 1997. Repealed and New Rule: Filed July 22, 2002; effective August 26, 2002. Amended: Filed September 25, 2006; effective October 30, 2006. Amended (Rule Number Only): Filed November 19, 2010; effective December 24, 2010. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Published November 30, 2020; effective January 14, 2021.
• Editor's note: Rule 610-X-3-.06 was renumber to .08 as per certification filed September 25, 2006; effective October 30, 2006. Rule .08 was renumbered to .09 as per certification filed November 19, 2010; effective December 24, 2010. Previous Rule 610-X-3-.09 renumbered .10 per certification published November 30, 2020; effective January 14, 2021.

Ala. Admin. Code r. 610-X-3-.11 Withdrawal Of Board Approval

(1) If the Board withdraws approval from a nursing education program following an administrative hearing, the governing institution shall submit to the Board:

(a) Within thirty (30) days of the effective date of the Board’s order, a plan for transfer of students currently enrolled in the program.

(b) Within ninety (90) days of the effective date of the Board’s Order, a report detailing the transfer of students currently enrolled in the program. If unable to transfer students, a plan to teach out those students currently enrolled in the program.

(c) Specific arrangements for the secure storage and access to academic records and transcripts.

(2) The governing institution shall notify students accepted and enrolled in the program, in writing, of the Board’s withdrawal of approval within thirty (30) days of the effective date of the Board’s Order.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(j)(5).
• New Rule: Filed March 16, 2012; effective April 20, 2012. Amended: Filed November 21, 2016; effective January 5, 2017. Amended (Rule Number Only): Published November 30, 2020; effective January 14, 2021.
• Editor's note: Rule 610-X-3-.10, was repealed and renumbered to .11 as per certification filed November 21, 2016; effective January 5, 2017. Previous Rule 610-X-3-.10 renumbered .11 per certification published November 30, 2020; effective January 14, 2021.

Ala. Admin. Code r. 610-X-3-.12 Degree Completion Programs

(1) The Board may approve programs for completion of nursing degrees by nursing students who have not successfully completed an approved nursing programs previously, provided that such completion awards a degree or certificate. Completion programs shall be requested to:

(a) Give due consideration to all prior passing coursework and clinical learning completed by a student.

(b) Ensure that each student’s clinical and didactic learning experiences prior to completion of the degree are substantially validated and are equivalent to those completed by students in other approved prelicensure nursing education programs.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-5.
• New Rule: Published September 30, 2021; effective November 14, 2021.

Ala. Admin. Code r. 610-X-3-.13 Student Nurse Apprenticeship Programs

(1) A Board approved prelicensure nursing education program pursuant to 610-X-15 and the Alabama Industry Recognized and Registered Apprenticeship Program Act may establish a student nurse apprenticeship program and award clinical credit hours toward the student nurse apprentice's program requirements, provided that the training is congruent with the clinical course in which the clinical credit hours are awarded.

(2) The nursing program initiating a student nurse apprenticeship program shall submit its curriculum and/or clinical training plan changes to the Board as an additional program option change.

(3) The nursing program shall validate the nursing apprentice's competency to perform and/or knowledge of the selected nursing tasks, skills or activities prior to initiating the apprenticeship and assignment of skills unless the nursing concepts are didactic only thereby requiring the clinical training and skills/Competency validation to occur at the clinical site by the journey worker.

(4) The nursing program shall notify the Board in writing when an apprenticeship agreement between the program, employer and Office of Apprenticeship.

(5) The nursing program shall submit an eligible student nurse apprentice roster to the Board to include attestation of eligible student applicants seeking an apprenticeship permit.

(6) The nursing program shall notify the Board in writing when a nursing student apprentice withdraws from the program or apprenticeship.

(7) The nursing program shall retain clinical supervision oversight for all student nurse apprenticeships and monitor and evaluate their clinical activity periodically throughout each course.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(2).
• New Rule: Published May 31, 2022; effective July 15, 2022. Amended; Published November 30, 2022; effective January 14, 2023.

Ala. Admin. Code r. 610-X-3-.14 Designation As School Of Practical Nursing

(1) A Licensed Practical Nurse's scope of practice is completely encompassed within the scope of practice of a Registered Nurse.

(2) At the discretion of the Board, an approved prelicensure Registered Nurse program may be considered a School of Practical Nursing for purposes of permitting a student to be eligible to apply for licensure as a Licensed Practical Nurse by educational equivalency; provided that:

(a) The student shall have successfully completed at least one year of the approved prelicensure Registered Nurse program; and

(b) A review of the student's transcript demonstrates that, in the judgment of the Alabama Board of Nursing, the student has successfully completed all of the required didactic and clinical coursework required for successful completion of an LPN program; and

(c) The student shall have successfully completed a Board approved course on the LPN scope of practice.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(2).
• New Rule: Published May 31, 2022; effective July 15, 2022.