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Medical professionals hold lives in their hands, and the public must trust those hands to be capable. But the Institute of Medicine’s 1999 study To Err Is Human: Building a Safer Health System revealed that healthcare errors in hospitals kill 44,000 to 98,000 patients each year. The accreditation process in nursing education helps ensure that programs meet standards, turning out safe and effective nurses.

For nearly 50 years, the National League for Nursing has been the only nationally recognized nursing accreditation agency to review general nursing programs. In February, however, U.S. Secretary of Education Richard Riley officially recognized the Commission on Collegiate Nursing Education as a national agency for the accreditation of baccalaureate and graduate-degree nursing education programs.

Steps to recognition

Before considering a petition for recognition, the Department of Education requires that an accreditation agency carry out accreditation activities for a year or two. According to Karen Kershenstein, director of accreditation and state liaison at the department, an agency petitioning for recognition has to meet about 90 requirements and be observed conducting accreditation activities.

First, the agency must establish accreditation standards. Later, when a program requests accreditation by the agency, an evaluation team is sent on-site to verify the program’s self-study as to how it meets the quality standards, and to examine curriculum, faculty, resources, clinical facilities and the institution in which the program resides.

The commission’s board chairwoman, Linda Amos, EdD, RN, FAAN, found that development of a national consensus on standards was a critical part of the start-up process, which took place in a series of cross-country meetings with more than 1,400 faculty, students, nurses, and consumers. "It was hard work trying to get that consensus, but we did really well with it," Amos said.

The commission also had to develop and test the program, train the trainers, screen and train about 400 volunteer on-site evaluators and conduct on-site evaluation visits. "[The commission] implements a new model of evaluation," commission director Jennifer Butlin, MA, said. "Our accreditation standards measure quality, but they’re not prescriptive. Our focus is on measuring programs against their own stated missions rather than dictating what their missions and goals ought to be. Our process doesn’t serve to inhibit curricular innovations, but facilitates them."

A year and a half after beginning its accreditation activities, the commission was granted official recognition for two years, standard for any new accrediting agency. "The bottom line is that it was determined that the agency complied with the criteria for recognition, and therefore the secretary granted the agency recognition," Kershenstein said.

The nursing league was well aware of the commission’s drive for recognition. "They’re a fine organization, and we were not expecting it to happen any way other than it did," said league CEO Ruth D. Corcoran, EdD, RN. "We believe that accreditation is an important process that contributes to the league’s mission to advance quality nursing education and are very supportive of all nursing programs being accredited."

The commission’s greatest advocate has been its parent organization, the American Association of Colleges of Nursing, whose purpose is to advance baccalaureate and graduate nursing education. According to Amos, the commission resulted from "strategic planning within the association, where proponents called for a change in accreditation to focus on the unique character of baccalaureate and graduate education," and provide a mechanism for the continuous improvement of education programs, as well as the profession and practice of nursing.

Butlin named other supporters of the commission, including deans of nursing programs, faculties at nursing programs, employers of nurses, state boards of nursing, and federal agencies.

Looking to the future

Steadfastly committed to the baccalaureate and graduate-level subset of nursing education programs, the commission has scheduled accreditation reviews of more than 400 nursing education programs.

"The trend towards baccalaureate and graduate nursing education throughout the country has been reflected by the demands from the marketplace," Amos said. "We have a quality process that really helps faculties engage in a continuous quality improvement program, and we think it’s going to advance nursing education in this country."

Unlike the commission, the nursing league assesses the quality of all levels of nursing education, from licensed practical nursing through the highest degree of education.

"I think it’s probably easier for the school, if they have multiple programs, to deal with the league than it is to deal with the commission just because they don’t accredit all types of programs," Corcoran said.

Nevertheless, Corcoran credits the commission’s entry into accreditation as promoting improvements for the profession and quality of nursing education.

"It makes the league be the very best accrediting body that we can be and helps the programs be the very best programs they can be," she said.