1. JANUARY 29, 2013 Continuing Nursing Education Retreat

2. Overview of 2013 Changes Criteria changes focus on structure, process, and quality outcomes that impact nursing professional development Changes in: Planning Committee structure

3. Conceptual Framework Structural Capacity Educational Design Process Quality Outcomes Nursing Professional Development: Continuing Nursing Education 2013 ANCC Primary Accreditation Application Manual for Providers & Approvers, 2013 Nursing Professional Development: Scope and Standards of Practice, ANA, 2010

4. Structural Capacity Commitment Accountability Leadership Resources

5. Educational Design Process Process defined as: Development Delivery Evaluation Based on: Adult Learning Principles Professional Education Standards Ethics Nursing Professional Development: Scope & Standards of Practice, ANA, 2010

6. Quality Outcomes Impact of Structure and Process Value/Benefit to Nursing Professional Development

7. Educational Design Changes Planning Committee structure Nurse Planner in charge of meeting MONA/ANCC criteria Content expert must be identified Primary Nurse Planner will only double check criteria compliance Focused more on ensuring content is: Based on most current available evidence Documentation should reflect quality of evidence chosen Resource(s) required to demonstrate “evidence”

8. Educational Design Changes (cont) Evaluation – requirement to define the category of evaluation removed Commercial support guidelines – following the ANCC’s Content Integrity Standards for Industry Support in CNE activities instead of ACCME Standards of Commercial Support Disclosures – separated into two categories Disclosures always required Disclosures required, if applicable

9. Provider Unit Organizational Chart Primary Nurse Planner Kelley Mullen, RN, BSN, MSN Senior Director of Clinical Operations Education Consultant Joan Williams, RN, MA Human Resource Consultant Nursing Educator Stephanie Weisenborn, RN, BSN Service Quality Coordinator Additional Nurse Planners Sally Anderson RN, BSN Kelly Hantack RN, BSN Dorene Cipriano RN, BSN Susan Wightman RN, BSN Provider Unit Support Andrea Ramirez Secretary III Provider Unit Support Elizabeth Sapienza Secretary I

10. Criteria 1: Assessment of Learner Needs 1.1 – The needs assessment  How did you determine you needed to have an activity on the chosen topic?  The process used must include nurses in the determination of the topic 1.2 – Target audience  How did you determine to whom you should present the activity?  Nurses must be at least part of your target audience

11. Criteria 1: Assessment of Learner Needs 1.3 – Development of the objectives, content, and teaching-learning strategies in response to the needs assessment  How did you decide what and how to present the topic?  Can not be by an outside commercial interest  The planning committee should make these decisions

12. Criteria 2: Qualified Planners & Presenters 2.1 – Planning committee  Must include people who represent Nurse Planner(s) Content Experts Target Audience  One person can represent more than one role  Can not include an outside commercial interest  May include other nonprofit agencies, if co-providing

13. Criteria 2: Qualified Planners & Presenters 2.1 – Planning committee (cont.)  Nurse Planner Qualifications Be a registered nurse licensed to practice in Missouri Hold at least a baccalaureate degree in nursing from an accredited program Be qualified by education and experience to guide the development of each activity offered by the Approved Provider Demonstrate knowledge of the ANCC COA/MONA Approved Provider criteria

14. Criteria 2: Qualified Planners & Presenters 2.1 – Planning committee (cont.)  Nurse Planner Responsibilities Contributes oversight and must actively be involved in the entire process of planning, implementation, and evaluation for any activity awarded contact hours. Is responsible for ensuring the quality of the educational activities provided Is responsible for ensuring adherences to the educations design criteria for each activity offered

15. Criteria 2: Qualified Planners & Presenters 2.2 – Biographical and Conflict of Interest Forms for each of the planning committee members and presenters including:  The role(s) played in the process of ensuring the quality of the educational activity.  The content expertise of the planning committee members and faculty involved in the educational activity (CV may be submitted in addition to an overall description.)  Any potential or perceived conflict of interest  Procedures used to resolve conflict or interest or potential bias  If faculty/presenters/authors will be discussing off-label uses and, if so, how the learners will be notified during the presentation

16. Criteria 2: Qualified Planners & Presenters 2.3 – How did planning committee decide the needed qualifications of the faculty/speakers 2.4 – How did the planning committee ensure the selected faculty/speakers met the needed qualifications

17. Biographical and Conflict of Interest Form Key things to Remember The goal is to identify any relationships that your planners or presenters have with commercial entities The form must ask the individual to identify whether or not a conflict of interest exists and also to describe the nature of the relationship The provider is responsible for reviewing completed forms and determining if a conflict needs to be resolved Completion of the form is required

18. Biographical and Conflict of Interest Form Form now includes s pouse or significant other relationships Combination biographical and conflict of interest form meets guidelines Disclosure is relevant for 12 months after termination of relationship Can assess the presence or lack of a conflict of interest by asking participants on evaluation if they perceive bias and include on summary after the event with explanation of how any perceived bias will be managed going forward

19. Criteria 3: Effective Design Principles 3.1 – Overall purpose of the activity  Should be a general objective for the entire activity  Use presentation objectives and content to meet the activity purpose  Learner Objectives – verbs matter  Content – needs to describe what will be presented to meet the objective(s)

20. Measurable behavioral objectives (Bloom’s Taxonomy of Cognitive Objectives) Area of TaxonomyDefinitionWhat the Participant Does KnowledgeRecalling of specific bits of informationDefine “primary care” Name the nurse who developed… List the steps in the nursing process State the reason for hospitalization ComprehensionUnderstanding of information; the ability to grasp meaning, translate and interpret information Compare Orem’s definition of nursing with Roy’s definition of nursing Interpret the lab values for the patient described in the case study ApplicationUse knowledge in new and concrete situations Demonstrate how to comfort a grieving family AnalysisExamining the parts of the whole; analyzing relationships; looking at organization Explain the impact managed care has had on health care economics Describe the order in which treatment should be instituted for a cardiac patient SynthesisPutting together the parts into a whole; use of information to create something new and different Design a new process for double checking transfusion orders EvaluationInvolves judging the value of materials and methods Evaluate the effectiveness of care

21. Measurable behavioral objectives (Verb List)

22. Criteria 3: Effective Design Principles 3.2 – Gap Analysis  What gaps in knowledge, skills, and/or practice does the activity address  Definition of a “Gap in Knowledge” – the missing knowledge, skills or practice identified during the needs assessment phase that an activity is designed to address.

23. Criteria 3: Effective Design Principles 3.2 – Gap Analysis  Example: After a recent needs assessment was conducted, a need was identified by many for a course in new diabetes therapies available The gap in knowledge is the nurses lack a full understanding of new therapies available to treat diabetes If was then decided to offer an activity (with the goal of) addressing new diabetic therapies available in the treatment and management of diabetes.

24. Criteria 3: Effective Design Principles 3.3 – Teaching/Learning Strategies  Delivery methods - PowerPoint slides, overheads, etc.)  Learner feedback mechanisms - Discussion, group discussion, etc.)  Resources used – policies & procedures, etc.

25. Criteria 3: Effective Design Principles 3.4 – Criteria for successful completion  What does the participant need to do to achieve successful completion of the activity and why 3.5 – Verification of completion  What mechanism will you use to determine whether or not participants successfully completed the activity

26. Criteria 4: Awarding Contact Hours 60 minutes = 1 contact hour Minimum number of contact hours awarded is one. Awarding contact hours should be calculated in the hundredths (i.e., two digits past the decimal point) or round down. Do not round up. Time allowed for introduction, breaks and meals should be excluded. Time allowed to complete evaluation should be included. Awarded contact hours are contingent on return of attendance list and evaluation summary.

27. Criteria 5: Activity Evaluation 5.1 – Describe the method used to evaluate the activity – a clearly defined method to evaluate the effectiveness of the activity must be used which includes learner input 5.2 – What type of evaluation will be used (see handout)

28. Criteria 5: Activity Evaluation 5.3 – Submit a copy of the Evaluation tool which must include:  How well the speaker met each of the stated objectives  Expertise of the speaker  Effectiveness of teaching strategies used  Anticipated impact of activity on practice  Appropriateness of the physical facility 5.4 – Describe how the evaluation data is used to improve activities – generate new activity topics, change teaching strategies, etc.

29. Criteria 6: Promotional Materials: What is Required? Title of program Presenter name and credentials Date and time of the activity Location of the activity Number of contact hours available Approval statement

30. Criteria 6: Promotional Materials: What is Required? Name of Approved Provider If activity is co-provided, then text similar to “ABC Activity co-provided by X Company and Y Company” Official approval statement Must be separated by a blank line before and after Must not be combined with any other language Must read word for word

31. Criteria 6: Promotional Materials Official Approval Statement Washington University School of Medicine is an approved provider of continuing nursing education by the Missouri Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

32. Criteria 6: Promotional Materials: What is Required? Number of contact hours Language indicating “approval” should never be used, i.e., “This activity has been approved for 1.0 contact hour” Acceptable examples of wording: o “1.0 contact hour” o “Participants can receive 1.0 contact hour” o “Participants meeting the successful completion requirements can receive a maximum of 1.0 contact hour” Disclosures you have identified will occur

33. Criteria 6: Promotional Materials Logo Usage Our logo is acceptable (http://brand.wustl.edu/) Commercial advertising or logos can be present in an exhibit room, but not in the room where presentations occur Slides and handouts must be free from company logos and advertising Give-away items or handout materials furnished by commercial entities with their logos or advertisements must be picked up by participants in an areas separate from registration

34. Criteria 6: Promotional Materials Types Save the Date Posters Brochures Website E-mail marketing Others

35. Criteria 7: Document of Completion 7.1 – Must include:  Name of the participant learner  Name and address of the Approved Provider  Title and date of the educational activity  Number of contact hours awarded  The official approval statement adhering to requirements by:  Placing a line before and after the approval statement  The statement must stand alone, meaning that it should be listed on a separate line from any other statement.

36. Criteria 7: Document of Completion 7.2 – Participant Roster must include:  Participant Name  Credentials (RN, MD, etc.)  Institution/Department  Address/Campus Box  Contact Hours Awarded, per participant if different  Should not have any sensitive identifying information including SSN, DOB, etc.

37. Criteria 8: Commercial Support & Sponsorship Commercial Support Definition: Financial, or in-kind, contributions given by a commercial entity which is used to pay for all or part of the costs of a continuing nursing education activity. Commercial Entity Definition: o Any entity either producing, marketing, re-selling, or distributing healthcare goods or services consumed by, or used on, patients, OR o An entity that is owned or controlled by an entity that produces, markets, re-sells, or distributes healthcare goods or services consumed by, or used on, patients. Exceptions are made for non-profit or government organizations and non- healthcare related companies.

38. Criteria 8: Commercial Support & Sponsorship Sponsorship Definition: : Financial, or in-kind, contributions given by a sponsor or co- sponsor which is used to pay for all or part of the costs of a continuing nursing education activity. Sponsor Definition: An entity providing sponsorship for an activity that is not considered a commercial entity These would include non-profit or government organizations and non- healthcare related companies. Co-Sponsors When an educational activity is supported by more than one sponsor, each entity is a co-sponsor.

39. Commercial Support Sponsorship Support must be disclosed to learners Must be documented in a signed agreement Approved Provider must be in control of Delivery of content Receipt and disbursement of funds Commercial Supporters do NOT participate in the planning, developing, and implementing the educational activity Support must be disclosed to learners Must be documented in a signed agreement Approved Provider must be in control of Delivery of content Receipt and disbursement of funds Sponsors and co-sponsors do NOT participate in the planning, developing, and implementing the educational activity Criteria 8: Commercial Support & Sponsorship

40. Commercial Support & Sponsorship Decision Tree What is the relationship between the agencies? Co-Provided Activity Non Co-Provided Activity See requirements for co- providing activities What type of agency is providing the support? Commercial Interest Non-Commercial InterestCommercial Support Cannot assist with the planning Agreement must be signed outlining support Disclosure of support must be made to learners Sponsorship Is this supporter participating in the planning of the activity? YesNo Supporter would be considered co-provider; not a sponsor Supporter can be listed as a sponsor Co-Provider Agreement necessary outlining responsibilities Agreement must be signed outlining support

41. Criteria 8: Commercial Support & Sponsorship 8.2 – How was the integrity of the activity content maintained 8.3 – Commercial Support Agreement 8.4 – How was bias prevented in the educational content, even if commercial support or sponsorship was not received

42. Criteria 9: Disclosures What is Required Participants must receive the required information regarding each and every activity in advance of, or at the time of, the event. How can disclosures be provided? Can be distributed within participant materials Slide presented at the beginning of the event Verbally during opening announcements o If the disclosure is provided verbally, there must be documentation provided by someone in the audience that the disclosures were appropriately made

43. Criteria 9: Disclosures What is Required How can disclosures be provided? (cont.) Certain elements can be disclosed within the promotional materials o Successful completion requirements o Commercial support and/or sponsorship o Non-endorsement of products

44. Criteria 9: Disclosures What is Required How can disclosures be provided? (cont.) Certain elements can be disclosed verbally or in slide format prior to individual sessions o Presence or lack of a conflict of interest o Conflict of interest resolution methods o Off label produce use

45. Criteria 9: Disclosures What is Required 9.1 – Items included in disclosure to participants  Requirements for successful completion  Number of contact hours available  Sponsorship and commercial support  Any conflicts of interest, or lack thereof  Non-endorsement of commercial products  Discussion of off label use  Expiration date for enduring materials

46. Criteria 9: Proof of disclosures 9.2 – Proof of disclosure Verbal disclosures Submit a copy of the Verbal Disclosure Document signed by the person providing the information Documentation from members of the audience that the disclosures were appropriately made If disclosures are written, the written document must be included in activity forms.

47. Example of written disclosures Successful Completion : Participants must complete an evaluation form to receive a certificate of completion Contact Hours: 5.5 contact hours are available to those who meet the successful completion requirements Sponsorship & Commercial Support: This activity has received no sponsorship or commercial support Conflict of Interest: No conflicts of interest were identified Non-Endorsement: Accreditation approval refers only to MONAs continuing education activities and does not imply MONA or ANCC Commission on Accreditation endorsement of any commercial products Off Label Use: There will be no discussion of uses of products other than what is approved by the FDA. Expiration: Contact Hours expire on Dec 10, 2012

48. Criteria 10: Co-Provider Information Co-Providership is the planning, developing, and implementing an educational activity by two or more organizations or agencies. Co-Providers may only include other nonprofit agencies A mutual, written agreement must be completed WUSM retains responsibilities as the Provider.

49. Criteria 10: Co-Provider Information Provider responsibilities are: Determination of the educational objectives and content Selection of the content specialist planners and activity presenters Awarding of contact hours, as appropriate Record keeping of attendees Evaluation methodology, completion, and review Management of any commercial support or sponsorship

50. Criteria 11: Post Activity Submit a summary of evaluation results Submit the participant roster  Must designate nurses  Must include participant addresses and number of contact hours awarded to each  Should not have any sensitive identifying information including Social Security numbers, license numbers, dates of birth, etc.