North Carolina Board of Nursing

Discipline & Compliance

PREP Remediation Program

Practitioner Remediation Enhancement Program

What is the PREP philosophy?  

The NC Board of Nursing is committed to protecting the public through regulating the practice of nursing. We believe:

  • Safe nursing care is promoted through collaboration with other organizations within the ever-changing healthcare environment.
  • Humans are fallible and errors are to be expected, even within the best systems.
  • Nurses who have identified needs related to increasing knowledge, skills or abilities have the potential to successfully upgrade competency and enhance performance.
  • Nurses should have an opportunity to upgrade knowledge and skills in a constructive, non-punitive manner.

What are the program goals? 

Historically, practice concerns are not addressed until there has been an error. PREP is a Board Sponsored Resource for the employer and the Licensee that focuses on how we can address "issues" before they become "violations".

Who benefits from PREP? 

The incentives/benefits derived from PREP participation are:

  • Nurse participates in interventions with opportunity for enhancing his/her clinical competencies.
  • Employer retains nursing staff and utilizes the Board a a resource to assist with remediation.

Board of Nursing takes proactive and non-disciplinary approach to facilitate the education and/or remediation of nurses demonstrating opportunities for improvement in the areas of clinical knowledge, skills or abilities, thus helping to ensure competent practitioners to care for the public.

What types of practice issues are eligible? 

PREP targets early identification of nurses demonstrating opportunities for improvement in the areas of clinical knowledge, skills or abilities.

A nurse is identified as a result of a recognized need for practice improvement, as might be the case with an inexperienced nurse (new graduate), a nurse returning to practice after an extended leave of absence, a long term employee who has drifted from safe practices, or as a result of minor issues that do not jeopardize patient safety, for example:

  • Competency or clinical judgment
  • Scope of Practice
  • Documentation
  • Medication Administration (excluding controlled substances)
  • Delegation/Supervision
  • Communication (involving a patient)

We believe that early intervention can make a difference by promoting safe practice and improving competencies.

What types of remediation does the PREP Program utilize?

The PREP Coordinator tailors a remediation plan specific to the nurse's identified practice needs. This may include any combination of the following:

  • On-line educational offerings, (or Employer sponsored education as available).
    Please note: While PREP is not fee based, recommended educational offerings have registration fees, which are normally the nurses' responsibility.
  • Pairing with a Mentor/Preceptor (when resources available through employer)
  • Performance Monitoring (employer)
  • Chart audits/Supervised med passes (if requested by and conducted by employer)

What are the Criteria for PREP?

Nurse's on-going practice poses no risk to public

  • Nurse exhibits skills and knowledge to practice safely
  • Concerns do not involve abuse, deceitful behavior, and/or use of drugs
  • Nurse acknowledges an opportunity for enhancement of his/her clinical skills, abilities or judgment
  • Nurse is truthful, cooperative and accepts responsibility for his/her practice
  • Nurse demonstrates motivation to improve practice.

How do I make a referral or self-refer to PREP?

What happens after a referral is made?

  • Licensee input is obtained regarding learning needs
  • Eligibility is determined by Board staff
  • PREP Coordinator outlines a Remediation Plan for implementation

Compliance is monitored by employer.

You may submit referrals by:

Fax: 919-781-9461


NC Board of Nursing
Attention: PREP Coordinator
PO Box 2129
Raleigh, NC 27602

Contact PREP Coordinator
919-782-3211 ext. 279