Annual NCLEX-RN performance. Statistical process control proportions chart for first-attempt pass rate by year of test administration. The center line denotes overall mean proportion passing the NCLEX-RN based on all values from 2009 to 2016. Diamonds and the lines connecting them denote mean NCLEX-RN pass rate at each individual NCLEX administration time point (each quarter). The uppermost and lowermost solid lines denote three sigma deviation upper and lower control limits, respectively (approximately 3 standard deviations above and below the mean). The points circled denote special cause signals, indicating significant deviations from the overall mean (p < .01). Arrows (L to R): The first two arrows denote changes in NCLEX-RN format or administration. The final arrow denotes Plan-Do-Study-Act (PDSA) cycles 1 and 2 (both conducted in 2015). The text boxes at the top of the figure describe the overall time line coinciding with the observed data trends.
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