1. NLN CNEA Self-Study Reports: An Overview of the Process
Judith Halstead, PhD, RN, ANEF, FAAN
Executive Director, NLN CNEA
March 20, 2019

2. Objectives
Explain the purpose and role of the self-study report in the NLN CNEA accreditation process.
Describe the format and elements of the self-study report.
Describe strategies used to engage faculty and staff in the preparation of the self-study report.

3. What are Your Goals for Today?

4. Steps to the CNEA Accreditation Process
Determine program eligibility
Pre-accreditation candidacy application
Initial Program Application Subcommittee review
BOC Decision
Self-study report process
On-site program evaluation visit
Review of the program
Program Review Committee

5. Purpose of the Self-Study Report
Reflect the program’s accomplishments and areas for improvement
Document the program’s self-assessment of compliance with accreditation standards and quality indicators
Provide a framework of evidence to be used by the on-site program evaluators to guide their peer review of your program
Evaluators will verify, clarify and augment the self-study report

6. Self-Study Report Format
Document length (excluding appendices)
100 pages maximum for one program
150 pages maximum for two programs
More than two programs, contact CNEA
Font size 11 point; Calibri for narrative text
Tables may use font size 10 point – the use of tables is encouraged as an effective way to share data with reviewers
1” margins, double spaced

7. Self-Study Report Format
Organized by standards and quality indicators
Data sheet (use template provided by CNEA)
Executive Summary, not to exceed 2 pages, located at the front of the document
At the end of each standard, summarize program strengths and areas for improvement

8. Self Study Format – Appendix
At a minimum the following five elements are
required to be included in the appendix:
CV of chief academic nurse administrator
Faculty profile table listing each faculty by name, with credentials, FT/PT status, rank/position title, certifications, and area of teaching responsibilities
Institution and program organizational chart
Systematic evaluation plan
Curriculum sequencing plans for each program and track
Include any additional documents that you consider important to representing your program to the reviewers

9. Keys to Addressing Standards: An Overview
Use the self-study report to systematically address each quality indicator identified within each of the five accreditation standards. NOTE: Quality indicators should reflect the overall essence of the standard you are addressing – read the opening paragraph statement for each standard, making note of the context and concepts exemplified in that statement. Each standard is more than the sum of its quality indicators. Final accreditation decisions are based on the program’s ability to demonstrate that the standards have been met.

10. Keys to Addressing Standards: An Overview (continued)
Focus your writing on highlighting how the quality indicators are of critical importance in contributing to your program’s quality and integrity, allowing the program to meet its mission and goals.
As the NLN CNEA accreditation process is grounded in achievement of outcomes, inclusion of outcome evidence or documentation is critical in assessing the degree to which each standard is being met.
Discussions within the text of the self-study report should reflect the evidence you are presenting either within the self-study narrative or accompanying appendix.

12. Guidelines for Preparing a Self-Study Report – A Step-by-Step Approach

13. Step One – Identify Major Players
Identify the individual to assume responsibility for coordinating all self-study activities
Helpful skills for the coordinator:
Knowledge of the nursing program(s)
Knowledge of unit and program policies and practices
Comfort with the accreditation process
Knowledge of where critical documents are located
Knowledge of the implementation of the program’s systematic evaluation plan (SEP)
Time management skills; attention to details
Team facilitator
Writing skills; ability to conceptualize

14. Step One (continued)
Identify key individuals that can manage the drafting of particular standards and form the Steering Group for the self-study report
It is helpful to have a lead individual for each of the five standards
Individuals need to be knowledgeable about the concepts contained within the standard being managed

15. Step Two – Strategy Meeting of Steering Group
Suggested Agenda Items:
Identify documents/materials/sources for critical information needed for each standard and quality indicator
Identify information gaps and ways to fill gaps
Determine assignments and additional supports
Establish a timeline/Program Evaluation Review Technique (PERT) chart for completion of all activities
Decide what evidence to include in the self-study, what to place in the on-site resource room, and what to make available online
Schedule regular meetings
Plan for involving and informing faculty, students, staff, community of interest, and administration

16. Step Three – Engaging the Faculty
It is an expectation that faculty be involved in developing the self-study report
Staff should also be involved as appropriate
Examples of activities include:
Collecting and assembling evidence documents
Drafting wording related to standards and quality indicators
Identifying program strengths and areas for improvement
Contributing information to charts and tables
Gathering student work demonstrating students’ ability to meet course and program expectations/outcomes
Facilitating on site program evaluator visits to practice settings
Preparing students for their role in accreditation

17. Step Four – Drafting the Self Study
Start early – it always takes longer than anticipated
Systematically address each quality indicator by outlining essential information to include
Substance is important!
Note places where documents are needed to provide supporting evidence – pictures (tables) are often worth a thousand words
Identify those who have the critical information needed
Contact people regarding specific information needed, how it should be formatted, and by what date it should be provided

18. Step Five – Finishing the Working Draft of Each Standard
Set a deadline for the completion of the first draft
Make sure you have addressed the each standard’s quality indicators to your satisfaction
Double check that you have included the documents referenced in your dialogue and organized as part of an evolving appendix to the self-study
Check to make sure that the required writing requirements and format as stated by the NLN CNEA are evident – remember there are page limits!
Hand off work to self-study leader/coordinator for compilation of total draft

19. Step Six – Pulling it All Together
Compile each standard into the self-study report; if you are addressing more than one program, be sure you clearly identify evidence for ALL programs
Compile the appendix as supporting evidence to the self-study document
Read through to determine content/areas that are missing, overlap or contradictory information, and any areas in need of enhancement
Distribute this working draft to designated others for their review and feedback
Set clear deadlines for responses

20. Step Seven – Finalizing the Report
Have at least one external person read the report in final draft form for clarity, syntax and completeness
Assure there is reference agreement between the report’s narrative and appendix
Ensure there is an Executive Summary and TOC
Determine how final document will be
reproduced and distributed

21. CNEA Contacts accreditation@nln.org www.nln.org/cnea Lusetha Rolle
Judith Halstead
@DrJHalstead
Betsy Frank

22. Upcoming Workshops – Washington, DC
August 23, 2019-Writing Your Program's NLN CNEA Self-Study: Process And Outcomes
October 11, 2019-The ABCs of Developing Program Systematic Evaluation Plans for NLN CNEA Accreditation
November 15, 2019 Preparing Your Program for NLN CNEA Accreditation: Beginning the Journey

23. Website for Workshop Information and Registration

24. Upcoming Webinars
Please check our website for dates and times of webinars on:
NLN CNEA Focus on SEP Feedback
NLN CNEA Webinar Series: Focus on the NLN CNEA Standards of Accreditation

25. Pre-Summit Conferences – Washington, DC
These will be announced soon.