2019-120 Audit Scope and Objectives

Board of Registered Nursing—Oversight of Pre-Licensure Nursing School Programs

The audit by the California State Auditor will provide independently developed and verified information related to oversight of pre-licensure nursing school programs (nursing programs) by the Board of Registered Nursing (BRN). The auditís scope will include, but not be limited to, the following activities:

  1. Review and evaluate the laws, rules, and regulations significant to the audit objectives.
  2. Determine whether BRN is appropriately reviewing and approving nursing programs, including the following:
    1. Whether BRNís policies and procedures for approving, denying, or revoking its approval of nursing programs comply with laws and regulations.
    2. Whether the factors that BRN uses when considering a request from a school to expand its nursing program are reasonable.
    3. Whether BRN consistently and objectively applied these factors as part of its decision-making process for a selection of requests.
  3. Review complaints of regulatory violations related to nursing programs filed against BRN with the Office of Administrative Law over the last three years and summarize the outcomes of the complaint process.
  4. Determine whether there are adequate conflict-of-interest rules or policies for BRN staff, board members, and Certified Nursing Educators who work with nursing programs. Further, to the extent possible, identify whether BRNís staff or board members appropriately recused themselves from decisions regarding nursing programs with which they may have had a conflict of interest.
  5. Identify the process BRN uses to evaluate clinical displacement and whether it consistently and objectively uses that process across all nursing programs. For a selection of requests for increased enrollment or new nursing programs, assess the factors BRN evaluated in making its decisions and the resulting clinical displacement.
  6. Determine whether BRNís oversight of nursing programs is appropriate, including the following:
    1. Whether BRN is duplicating oversight of nursing programs conducted by other entities, including state and federal entities, as well as nursing school accreditors.
    2. An assessment of the expertise BRN relies on when it evaluates the curricula of pre-licensure nursing programs.
  7. Determine whether BRNís analysis of the health care workforce, including the adequacy of the number of nurses, is reasonable and consistent with the scope and breadth of current and future health care workforce needs as identified by similar analyses.
  8. To the extent possible, identify the time spent and resources used by BRN on each of its programs.
  9. Review and assess any other issues that are significant to the audit.

California State Auditorís Office
8/19/2019