Virginia Nurses Association Continuing Nursing Education: CE & Provider Application Workshop Sharon Broscious, RN, DSN Lolita Ramsey, RN, MSN, PhDc Co-Chairs July 23, 2009

Announcements  Contact hours will not be provided  Planners and presenters have no relevant financial relationships with any commercial companies pertaining to this workshop  There is no commercial support for this workshop  There is no endorsement of products or off-label product use in this workshop

ANCC Accreditation Program (COA) Accredits Accredited Approvers *(i.e. VNA) Approve Approved Providers Educational Activities Contact Hours Accredited Providers Figure 1: Structure of the ANCC Accreditation Program (pg 2 ANCC manual)

Overview  Nurses Association  Virginia Nurses Association Accredited Approver of Continuing Education Accredited Approver of Continuing Education CE Committee: Peer reviewer processCE Committee: Peer reviewer process Approve single activity and provider applicationsApprove single activity and provider applications Debbie Coats: CE CoordinatorDebbie Coats: CE Coordinator Contact: (804) or (800) Contact: (804) or (800) Application and instructions located at: and instructions located at: Nursing Continuing Education (left hand toolbar) Nursing Continuing Education (left hand toolbar) Electronically submit to: Electronically submit to:

Single activity application Objective: Identify the major elements required in the single activity application Identify the major elements required in the single activity application

Single activity application: Who is eligible to apply?  Any healthcare association/organization is eligible to apply.  For example: Hospitals/acute care facilities Hospitals/acute care facilities Specialty organizations Specialty organizations Nursing professional organizations Nursing professional organizations  Single activity programs (live or independent study) applying for a minimum of 1 contact hour  Applicants targeting multiple regions or areas  Future: Application Readiness Form

Eligibility: Activity meets the definition of CNE Continuing Nursing Education (CNE): ‘“Systematic professional learning experiences designed to augment the knowledge, skills, and attitudes of nurses and therefore enrich the nurses’ contributions to quality health care and their pursuit of professional career goals”’ - (ANCC 2009 Manual, p. 71; Scope and Standards of Practice for Nursing Professional Development, ANA, 2000, p.24).

Applicants not eligible  Applicants interested in obtaining contact hours for point of care/just in time activity/learner directed activities are not eligible to apply at this time  Presenters can not receive contact hours for their presentation, nor for their work for preparing for their presentation  New: Commercial entities are not eligible to apply

Single activity application fees Effective 7/1/09  Fees are based on the number of contact hours reviewed, not the number of contact hours the participant will receive.  Fees are based on the number of contact hours reviewed, not the number of contact hours the participant will receive.  offering 1 to 6 contact hours:  Programs offering 1 to 6 contact hours: Price will be $ Price will be $ Additional contact hours are $25.00 each additional hour Additional contact hours are $25.00 each additional hour

Fees continued…  Applications must be ed within 60 days of the program date.  Programs sent less than 60 days prior to the program date will incur a late fee.  Programs sent less than 60 days prior to the program date will incur a late fee.  We will not accept any applications that are less than 30 days prior to the program date.

Fees continued…  Late Fees: Programs 1 to 6 Contact Hours are $ Programs 1 to 6 Contact Hours are $ Programs greater than 6 Contact Hours are $ Programs greater than 6 Contact Hours are $  Payment receipt prior to review process  Payment should be sent separately to:  Payment should be sent separately to: Virginia Nurses Association Attn: CE Committee 7113 Three Chopt Road, Suite 204 Richmond, VA Virginia Nurses Association Attn: CE Committee 7113 Three Chopt Road, Suite 204 Richmond, VA (Please indicate on your check what activity each payment is for) (Please indicate on your check what activity each payment is for)

Activity approvals  Approvals for a period of 2 years  Contact hours will not be granted retroactively nor after an activity has taken place  Future: Fee will be incurred for additional reviews (more than 1 revision submission)  Future: Repeat activities will be periodically monitored

Application: Major elements 1). Planning committee 1). Planning committee 2). Needs assessment 2). Needs assessment 3). Purpose 3). Purpose 4). Presenters/faculty 4). Presenters/faculty 5). Educational design 5). Educational design (Objectives, content, time frame, (Objectives, content, time frame, presenter, method) presenter, method) 6). Commercial support 6). Commercial support

Application: Major elements continued… 7). Evaluation 7). Evaluation 8). Verification of successful 8). Verification of successful completion completion 9). Sample certificate- 9). Sample certificate- approval statement approval statement 10). Record keeping 10). Record keeping 11). Contact hour calculation 11). Contact hour calculation 12). Advertising material 12). Advertising material

1). Planning committee  Nurse planner: 1 RN, minimum BSN Oriented to ANCC criterion for educational design Oriented to ANCC criterion for educational design Directly involved in planning the educational activity (from beginning to end) Directly involved in planning the educational activity (from beginning to end)  At least one nurse planner and one other planner Represent 3 areas: Content expert, target audience, responsibility for ANCC criteria Represent 3 areas: Content expert, target audience, responsibility for ANCC criteria Planner may represent more than 1 area listed above Planner may represent more than 1 area listed above  Bioform completed for all planners  Ensure presenters/faculty meet qualifications  Update: Disclosure to learners of vested interest

2). Needs assessment  Identify the gaps in knowledge, skills and practice Annual needs assessment Annual needs assessment Learners/mgmt requested Learners/mgmt requested Quality studies Quality studies Trends in literature Trends in literature  Determine the target audience  Needs assessment should include the learner.  Develop teaching objectives, content, methods in response to the needs assessment

3). Purpose  Identify the purpose of the educational activity  Overall learning goal = purpose  Purpose should be appropriate for the target audience and congruent with learner objectives and content

4). Presenters/Faculty   Bioform: Declare vested interest & off-label   Do not send CVs   Qualifications of the presenter/ faculty   Planning committee assures qualifications of the faculty are appropriate and accurate   Future: Describe how the planning committee ensures presenter/faculty meet the qualifications   Update: Disclosure to learners of vested interest and resolution

5). Educational Design Consistency!!!!andCongruency!!!

5). Educational design: In-person activity, Form A  Objective in behavioral terms and measureable Hint: Bloom’s taxonomy Hint: Bloom’s taxonomy  Content is more than a repeat of objective Hint: Outline what will be presented Hint: Outline what will be presented  Time frame Hint: Should be consistent with agenda/brochure Hint: Should be consistent with agenda/brochure  Presenter presenting on the objective Hint: Make sure this presenter is listed on the application and bioform given Hint: Make sure this presenter is listed on the application and bioform given  Method of teaching congruent with objective

5). Educational design: Independent learning, Form B  Objectives in behavioral terms and measureable  Content: More than a restatement of objectives. Outline content  Teaching methods, strategies, materials and resources  Congruency!

6). Commercial support  Commercial support agreement signed by all parties  Written or verbal disclosure of commercial support (support and no support)  Verbal disclosure alone: Must complete verbal disclosure form during activity and submit  Content integrity and precautions to prevent bias  New: Applicants who are commercial entities are no longer allowed to apply for contact hours  Future: Section on how disclosures were made, copies of written disclosures on file

7). Evaluation  Evaluation form required for all events  A clearly defined evaluation method, which includes learner input  Evaluation should address objectives of the activity  Describe how evaluation will be used  How feedback will be provided to learner  Higher level evaluation: skill and attitude change, change in practice/performance, relationship of practice change to quality of service

8). Verification of successful completion  Criteria for successful completion Option: Submission of evaluation form Option: Submission of evaluation form The number of evaluation forms returned need to match the number of certificates given to participantThe number of evaluation forms returned need to match the number of certificates given to participant Option: Minimum hours of activity to be completed (i.e. attend 90% of the activity; attend no later than 5 minutes of start of activity and remain until end) Option: Minimum hours of activity to be completed (i.e. attend 90% of the activity; attend no later than 5 minutes of start of activity and remain until end)  How learners informed of completion

9). Sample certificate  Name and address of applicant  Line for name of learner  Title and date of activity  Number of contact hours  Approval number from VNA (optional)  Official approval statement (required word for word, stand alone)  NO CEU language 10 contact hours = 1 CEU 10 contact hours = 1 CEU

9). Sample certificate: Approval statement “ This continuing nursing education activity was approved by the Virginia Nurses' Association Continuing Education Approval Committee, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.”

10). Record keeping  Keep records on file for 6 years  Records are confidential, stored and secured in a safe, logical and consistent manner  Items required to be on file are listed under ANCC operational requirements (instruction sheet)  Future: Checklist of records on file

11). Contact hour calculation  Logical and defensible manner  60 min = 1 contact hour  Minimum of 1 contact hour per activity  Round down if using decimals (1/10 th, 1/100 th )  In-person/live activity: Provide a schedule with time for welcome, introduction, lunch, breaks, evaluation Provide a schedule with time for welcome, introduction, lunch, breaks, evaluation Pre-test, post-test, demonstration and evaluation is included in the contact hour calculation Pre-test, post-test, demonstration and evaluation is included in the contact hour calculation

11). Contact hour calculation  Independent study: Method used to calculate contact hours Method used to calculate contact hours Pilot study with target learners (can receive contact hours after activity approved)Pilot study with target learners (can receive contact hours after activity approved) Peer review (can receive contact hours after activity approved)Peer review (can receive contact hours after activity approved) Historical dataHistorical data Complexity of content and dataComplexity of content and data  Supportive documentation/rationale

11). Contact hour calculation  Poster session: Need to come up with a method of measuring time reviewing poster sessions Need to come up with a method of measuring time reviewing poster sessions Describe the method used Describe the method used Needs to be logical and defensible manner Needs to be logical and defensible manner

12). Advertising material  Brochures, registration, agenda, website, etc.  Consistent with application  If advertising released prior to activity approval, use new PENDING statement and not approval statement  Statement stands alone  Include contact hours  NO CEU language

12). Advertising material Pending approval for advertisements:  “An application has been submitted to the Virginia Nurses Association. Please call _(your org contact)___ at __(your #)__ for more information about contact hours.”  Update: “This activity has been submitted to the Virginia Nurses Association for approval to award contact hours. The Virginia Nurses Association is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation”

You are approved, now what?  Evaluation summary  Submit changes to Debbie Coats within 30 days of change  Major changes to an activity will have to re-apply for approval

Future plans  Section on disclosures  Monitoring of repeat activities  Updated forms and instructions  Single activity applicants can co-provide activities Written agreement and description of responsibilities Written agreement and description of responsibilities

Disclosures  Notice of requirements for successful completion  Conflict of interest  Disclosure of relevant financial relationships and mechanism to identify and resolve conflicts of interest  Sponsorship or commercial support  Non-endorsement of products  Off-label use  Expiration date for awarding contact hours- enduring educational documents

Commercial support

Provider application  Objective Identify the four criterion involved in the provider application. Identify the four criterion involved in the provider application.

Why apply to be a provider?  As an approved provider, you may provide contact hours for activities in your organization  Providers can not provide contact hours to other organizations (do not approve activities)  Providers are responsible for following the ANCC criteria and ensuring that activities follow the ANCC criteria  Depends on the needs of your organization (apply to VNA for every single activity vs. approved provider)

Provider application: Who is eligible to apply?  In order to be eligible: Must have planned, implemented and evaluated at least 3 separate educational activities approved by the VNA Must have planned, implemented and evaluated at least 3 separate educational activities approved by the VNA Direct involvement of a designated nurse plannerDirect involvement of a designated nurse planner Adhere to the relevant criteria of the ANCC accreditation programAdhere to the relevant criteria of the ANCC accreditation program Each learning activity at least 1 hour in lengthEach learning activity at least 1 hour in length Co-provided activities may not be counted as 1 of the 3 activitiesCo-provided activities may not be counted as 1 of the 3 activities

Provider application: Who is eligible to apply?  In order to be eligible: Demonstrate established provider unit in your organization Demonstrate established provider unit in your organization Single focused organization devoted to offering continuing education ORSingle focused organization devoted to offering continuing education OR A distinct, separately identified unit within a complex, multi-focused organizationA distinct, separately identified unit within a complex, multi-focused organization Provider unit must have been operational for a minimum of 6 months Provider unit must have been operational for a minimum of 6 months

Provider application: Who is eligible to apply?  NEW eligibility: Organizations targeting more than 50% of their educational activities in the previous calendar year to nurses in multiple regions (DHHS regions) are not eligible to apply to be an approved provider with the VNA. Organizations targeting more than 50% of their educational activities in the previous calendar year to nurses in multiple regions (DHHS regions) are not eligible to apply to be an approved provider with the VNA. Must apply through the ANCC as an accredited provider.Must apply through the ANCC as an accredited provider.

Provider application: Who is eligible to apply?  New eligibility: Organizations targeting more than 50% of their activities in the previous calendar year to nurses in a single state or region (contiguous region) may apply to the VNA for approval as a provider. Organizations targeting more than 50% of their activities in the previous calendar year to nurses in a single state or region (contiguous region) may apply to the VNA for approval as a provider. Internet is considered multi-region Internet is considered multi-region

Source:

Application readiness form  Future: Application readiness form to complete and submit prior to applying  Contact Debbie Coats for assistance if you are planning on applying  Confirm you are eligible before you start the process

Provider application fee  New provider fee: $1,250  Renewal fee: $1,075  Submit application to VNA electronically  Apply for renewal 90 days before approval expires Same application process for renewal, only difference is the fee Same application process for renewal, only difference is the fee Late fee $480 if application received less than 90 days before expiration of provider status Late fee $480 if application received less than 90 days before expiration of provider status

Approval as a provider unit  3 year approval period for providers  Provider may offer an unlimited number of educational activities during approval period

Provider application: Now that you are ready to apply…  Tips: Clearly outline and appropriately and correctly reference the attached page numbers Clearly outline and appropriately and correctly reference the attached page numbers Address all sections and do not leave any sections blank Address all sections and do not leave any sections blank Each section may sound repetitive, but complete each section in reference to that element Each section may sound repetitive, but complete each section in reference to that element

Approved Provider Criterion 1). Mission statement (Administrative criteria) 2). Educational design 3). Unit operations (Unit operations and resources criterion) 4). Provider unit evaluation Yellow- updated criterion; White- criterion as listed on application Updated application form pending

Criterion 1: Mission statement  Key element 1: Submit the beliefs and goals of the provider unit Submit the beliefs and goals of the provider unit If part of a multi-focused organization, describe how mission statement of provider unit links with the total organization If part of a multi-focused organization, describe how mission statement of provider unit links with the total organization  Key element 2: Organizational structure: Organizational chart, name and credentials Organizational structure: Organizational chart, name and credentials

Criterion 1: Application  Describe the provider unit (and parent organization if applicable, how provider unit fits in)  State the goals of provider unit and parent org- link goals with needs of prospective learners  Scope and standards incorporated in provider unit

Criterion 1: Application  Provider unit’s lines of authority and org structure with parent org (org chart/narr)  Strengths and areas for improvement with provider unit’s goals and organization  Sign attestation statement – last section of application  First time applicants- sample certificate as a provider (provider statement)

Criterion 2: Educational design  Design elements as described in single activity application  Provide 3 sample activities At least 1 hour in length At least 1 hour in length Activity not co-provided Activity not co-provided If sample activity is more than 3 contact hours (180 minutes), submit documentation for at least 3 contact hours. And keep documentation for complete activity on file and accessible. If sample activity is more than 3 contact hours (180 minutes), submit documentation for at least 3 contact hours. And keep documentation for complete activity on file and accessible.

Criterion 2: Educational design  Renewing applicants would use the following (stand alone) approval statement: “[Name of approved provider] is an approved provider of continuing nursing education by the Virginia Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.”

Criterion 2: Application  Educational activities in the past 3 years  Provide application, advertising, bioforms, certificate, summative evaluation for each activity (everything you would submit for a single activity application)  Make sure the 3 activities are complete and not deficient (complete with application revisions requested etc.)

Criterion 3: Unit operations  Nurse planner Contribute oversight and must be actively involved in planning, implementing, and evaluation of a continuing education activity. Contribute oversight and must be actively involved in planning, implementing, and evaluation of a continuing education activity. RN with a baccalaureate or graduate degree in nursing RN with a baccalaureate or graduate degree in nursing Knowledge of: Knowledge of: Accreditation program and requirementsAccreditation program and requirements Adult learning theoryAdult learning theory Policies and procedures of accreditation programPolicies and procedures of accreditation program Scope and Standards of Practice for Nursing Professional Development (ANA, 2000).Scope and Standards of Practice for Nursing Professional Development (ANA, 2000).

Criterion 3: Unit operations  Lead nurse planner Criteria of nurse planner AND Criteria of nurse planner AND Education or experience in the field of education or adult learning Education or experience in the field of education or adult learning Assures all nurse planners are appropriately prepared, oriented and trained to function in their role and meet the ANCC Accreditation program requirements Assures all nurse planners are appropriately prepared, oriented and trained to function in their role and meet the ANCC Accreditation program requirements

Criterion 3: Unit operations  Resources Sufficient human, material and financial resources are available Sufficient human, material and financial resources are available Submit descriptions of the above Submit descriptions of the above Future: Submit a report identifying the amount and frequency with which commercial support is received for educational activities Future: Submit a report identifying the amount and frequency with which commercial support is received for educational activities Future: Addition to attestation: business practices (compliance with laws and regulations) Future: Addition to attestation: business practices (compliance with laws and regulations)

Criterion 3: Application  Describe process for APIE with unit operations  Describe record keeping process, storage, confidentiality and retrieval (check as instructed)  Strengths and areas for improvement for unit operations (relate this to APIE)

Criterion 3: Application  Human resources – list names and provide bioforms  Material resources- describe or check list  Financial resources- describe, check all apply, check statement  Strengths and areas for improvement related to these resources

Criterion 4: Provider unit evaluation  Provider unit evaluation process Process used and what was identified as needing change or not Process used and what was identified as needing change or not  Provider unit evaluation participants Lead nurse planner Lead nurse planner Identify other participants to include Identify other participants to include  Provider unit evaluation results Results used to confirm, expand and improve the unit operations Results used to confirm, expand and improve the unit operations  Provider unit goals for improvement How goals addressed How goals addressed Changes and progress with goals Changes and progress with goals New goals identified for improvement New goals identified for improvement Operational plans for implementation with the goals identified Operational plans for implementation with the goals identified

Criterion 4: Application  Evaluation Criterion Describe how provider unit will be evaluated Describe how provider unit will be evaluated i.e. learning activities, unit goals, resources, planning processi.e. learning activities, unit goals, resources, planning process Describe how presenters/content experts, planners, learners will participate in eval process Describe how presenters/content experts, planners, learners will participate in eval process Informal or formal data collectionInformal or formal data collection Describe how you have used eval process described above to improve unit Describe how you have used eval process described above to improve unit Strengths and areas of improvement for evaluation process Strengths and areas of improvement for evaluation process

Criterion 4: Application  Provider unit self assessment summary List provider unit’s strengths for each criterion List provider unit’s strengths for each criterion Plans for enhancement of provider unit Plans for enhancement of provider unit Describe areas for improvement for each criterion Describe areas for improvement for each criterion Identify the current state of specific plan for implementing improvement Identify the current state of specific plan for implementing improvement

Operational requirements attestation  Provider unit’s responsibilities  Record keeping (what needs to be on file)  Verify participation and requirements for completion  Timely communication w/VNA CEA committee Notify w/in 30 days of changes (i.e. name changes, ownership or structural change, contact person, bioforms, new nurse planners) Notify w/in 30 days of changes (i.e. name changes, ownership or structural change, contact person, bioforms, new nurse planners)

Operational requirements attestation  Appropriate language- approved provider approval statement  ANCC contact hour credit calc, 2 decimals, round down  Provide but not approve activities Provide activities only which a provider unit nurse planner has actively participated in, from planning through evaluation Provide activities only which a provider unit nurse planner has actively participated in, from planning through evaluation  Ensure all continuing education free from bias, declare vested interest  Commercial support

Co-provided activities  If co-providing with an accredited provider, the accredited provider is the provider, approved provider is a co-provider  If co-providing with another approved provider, must determine who will retain responsibilities  If co-providing with a non-provider, approved provider is responsible  Co-provider written agreement

Co-provided activities  When the approved provider is the designated “provider”, the following responsibilities apply: Determine objectives and content Determine objectives and content Selection of planners and presenter Selection of planners and presenter Awarding of contact hours Awarding of contact hours Recordkeeping Recordkeeping Evaluation methods and categories Evaluation methods and categories Management of any sponsorship or commercial support Management of any sponsorship or commercial support

Now that you are approved... Provider annual report  Submit provider annual report before your annual anniversary to VNA  Record program in report every time a session was given (i.e. pain assessment given 4 times, record 4 different times)  Learner directed- record once for each person  Brief evaluation of program (not individual evaluation summary)  Future: Periodic monitoring

References  American Nurses Credentialing Center (2009). Accrediting excellence in continuing nursing education: Application manual, accreditation program. Silver Spring: MD: ANCC.  US Department of Health and Human Services (n.d.). Regions. Retrieved on July 22, 2009 from:  US Department of Health and Human Services (n.d.). Regions. Retrieved on July 22, 2009 from:

Questions??? Questions???