1. C ontinuing Education Committee: CE Workshop & ANCC 2013 Manual Update Presenters: Lolita Ramsey, RN, PhD Sharon Broscious, RN, DSN Co-Chairs/Nurse Peer Review Leaders April 20, 2013 Richmond, VA (South University) Part 1 of 2

2. Welcome and Introductions !

3. Overall Purpose  To provide the learner/applicant with: The ANCC and VNA criteria required for continuing education approval for contact hours The ANCC and VNA criteria required for continuing education approval for contact hours Overview of the new criteria from the ANCC 2013 manual Overview of the new criteria from the ANCC 2013 manual Learner objectives: Learner objectives: List the major changes in the ANCC 2013 criteria.List the major changes in the ANCC 2013 criteria. To identify the major elements required in individual activities.To identify the major elements required in individual activities. To identify the three criteria required of approved provider units.To identify the three criteria required of approved provider units. Define commercial support, sponsorship and bias in CNE.

4. Overview  Nurses Association  Virginia Nurses Association Accredited Approver of Continuing Education Accredited Approver of Continuing Education CE Committee: Peer reviewer process (volunteers)CE Committee: Peer reviewer process (volunteers) Approve single activity and provider applicationsApprove single activity and provider applications CE Coordinator: Germaine ForbesCE Coordinator: Germaine Forbes Contact: (804) 282-1808Contact: (804) 282-1808 Application and instructions located at: www.virginianurses.comApplication and instructions located at: www.virginianurses.com www.virginianurses.com Continuing Education (top blue toolbar, far right, click on link) Continuing Education (top blue toolbar, far right, click on link) Electronically submit to: vnacea@virginianurses.com Electronically submit to: vnacea@virginianurses.comvnacea@virginianurses.com

5.  The mission of the Virginia Nurses Association is to promote advocacy and education for registered nurses to advance professional practice and influence the delivery of quality care. The mission or belief of the VNA CEA Committee is to promote excellence in nursing practice through the approval of quality continuing education programs for nurses. The vision or goal of the VNA CEA Committee is to be a leader in nursing professional development and excel in the role of approving continuing education programs.

6. ANCC Accreditation Program (COA) Accredits Accredited Approvers (i.e. VNA) Accredited Providers Approve Approved Providers Educational Activities Contact Hours Adapted Figure 1: ANCC Primary Accreditation Program Structure (pg 4) Individual Activity Applicants

7. Rationale for ANCC Changes ANCC is committed to supporting the lifelong learning needs of professional registered nurses by ensuring that educational activities are designed using criteria that are evidence- based and that are independent from commercial influence. ANCC is committed to supporting the lifelong learning needs of professional registered nurses by ensuring that educational activities are designed using criteria that are evidence- based and that are independent from commercial influence.

8. Rationale for ANCC Changes ANCC’s commitment to continuous quality improvement. The ANCC is an ISO credentialed organization and continually review existing processes, adjust criteria as indicated by research or evidence, apply “lessons learned” with the goal of reviewing all organizations applying for approval consistently, fairly and reliably.

9. ANCC Mini-Manuals  Mini-Manuals (electronic and print) Educational Design Principles Educational Design Principles Approved Providers and Individual Activity Applicants Approved Providers and Individual Activity Applicants Buy directly from: ANCC Buy directly from: ANCC  VNA CEA Criterion document: Pending

10. Resources  ANCC Website: http://www.nursecredentialing.org/Accreditation/R esourcesServices/ManualUpdates.aspx http://www.nursecredentialing.org/Accreditation/R esourcesServices/ManualUpdates.aspx http://www.nursecredentialing.org/Accreditation/R esourcesServices/ManualUpdates.aspx http://www.nursecredentialing.org/Accreditation/R esourcesServices/ManualUpdates.aspx Crosswalks Crosswalks Webinars Webinars FAQ FAQ  VNA CEA Website: Pending Webinars and Samples Pending Webinars and Samples FAQ FAQ

11. Change: Applicant Information  Identify organization type Constituent member association of ANA Constituent member association of ANA College/university College/university Healthcare facility Healthcare facility Health-related organization Health-related organization Multi-disciplinary educational group Multi-disciplinary educational group Professional nursing education group Professional nursing education group Specialty nursing organization Specialty nursing organization Other Other

12. Change: Language  Changes in terms: Face to face vs. provider-directed, provider paced Face to face vs. provider-directed, provider paced (AKA live– in-person or webinar) (AKA live– in-person or webinar) Independent study vs. provider-directed, learner paced (AKA enduring material– print/journal, online, electronic) Independent study vs. provider-directed, learner paced (AKA enduring material– print/journal, online, electronic)

13. Educational Activity  Planning committee: Removal of target audience requirement  Needs Assessment: Additional details are requested (source of evidence)  Additional question on partial credit

14. New: Gap Analysis  Method of assessing learning needs  Using data to identify a gap Gap is the difference between the current state of “what is” and the desirable or achievable state “what should be or desired” Gap is the difference between the current state of “what is” and the desirable or achievable state “what should be or desired”

15. © 2012 American Nurses Credentialing Center Identification of a gap Knows: Learner has knowledge about the topic/subject Knows how: Learner is capable of applying the knowledge Shows how/does: Learner is able to apply knowledge and skills in a simulated setting (shows how) or the practice environment (does) Miller’s Model of Clinical Competence

16. Gap Analysis  Identify the appropriate gap that will be addressed: Gap in Knowledge (i.e. does not know) Gap in Knowledge (i.e. does not know) Gap in Skills (i.e. does not know how) Gap in Skills (i.e. does not know how) Gap in Practice (i.e. not able to show/do in practice) Gap in Practice (i.e. not able to show/do in practice)  Required documentation of detailed analysis- available upon request  Optional: Gap analysis form L

17. Optional Form L: Gap Analysis Desired State Current State Details of Identified Gap Gap due to: Knowledge, Skills or Practice? Purpose Outcome Measure(s)

18. Example

19. Example

20. Bioforms and Conflict of Interest  Bioform: Clearer section on role and description of experience and expertise Clearer section on role and description of experience and expertise Removal of discussion of off-label Removal of discussion of off-label New section: Completed by Nurse Planner New section: Completed by Nurse Planner  Conflict of Interest Review by Nurse Planner and resolution Review by Nurse Planner and resolution Form C: Bioforms Form C: Bioforms

21. Form A and B  Additional section: Content must be evidenced-based or based on the best available evidence. Identify source of content Organization/website such as CDC Peer reviewed journal/resource used Clinical guideline used Expert resource Textbook Other

22. Certificate  New: Acceptable to have web address instead of physical address  Same criteria as before Name Name Date and title Date and title Number of contact hours Number of contact hours Name and address of provider of activity Name and address of provider of activity Official approval statement stands alone Official approval statement stands alone VNA approval number optional VNA approval number optional

23. New: Sponsorship Agreement  Separate agreement from commercial support agreement  Form D-2  Signatures from both parties: Applicant and sponsor representative

24. Disclosures  Removed disclosure of off-label use  Removed disclosure of financial relationships and mechanism to resolve (falls under COI disclosure)  Exceptions: VNA CEA require disclosures be made regardless if present or not

25. New Attestation Statements  New attestation in single activity application  Approved provider: Additional attestation for providing contact hours and not acting as an approver

26. Approved Provider Changes  Removal of mission statement  Change in language (previously key elements)  Emphasis on description and example  Three criteria (new): Structural Capacity (SC) Structural Capacity (SC) Educational Design Process (EDP) Educational Design Process (EDP) Quality Outcome (QO) Quality Outcome (QO)

27. Approved Provider Changes  Emphasis on accountability by the lead nurse planner  Emphasis on quality outcomes and impact on professional nursing development  Removal of APIE narrative  Removal of strengths and weaknesses section

28. Approved Provider Changes  Sample activity must have majority of criteria met for approval (no revisions allowed)  Impact on review: Standardized review process by committee Standardized review process by committee Summary of findings provided to approved provider Summary of findings provided to approved provider Revisions/additional evidence accepted for approved provider application Revisions/additional evidence accepted for approved provider application

29. Crosswalk: 2013 from 2009 2013 Criteria2013 Requirements2009 Requirements Changes Organizational Overview 001 Demographics Description of PU: Scope of Service, size, geography Types of educational activities offered CR, KE1 002 Lines of Authority/Admin Support List of full names and credentials of LNP, other NP(s), all key personnel in PU Position descriptions of the above Chart with structure and all key personnel including LNP and all NP(s) CR1, KE2 CR3, KE1 CR3, KE2

30. Organizational Overview (cont.) 2013 Criteria Requirements 2009 003 Data Collection and Reporting 004 Evidence Completed demographic form Accredited Provider Continuing Education Summary CNE strategic goals for last 12 months Quality outcome measures specific to PU Quality outcome Specific to Nursing Professional Development Application for Provider CR3, KE2 CR4, KE4 New

31. 2013 from 2009 2013 Criteria2013 Requirements2009 Requirements Structural Capacity SC 1 LNP’s commitment to learner needs Includes how PU goals are revised based on data NEW SC 2 SC 3 SC 4 SC 5 SC 6 Organizational support of PU goals by leadership How LNP ensures training for ANCC criteria LNP resolves issues related to CNE LNP ensures NP(s)/key personnel maintain standards LNP advocates for resources CR3, KE 2 CR2, KE2 CR 3, KE1 New CR2, KE2 CR3, KE 1 CR3, KE 2

32. 2009 to 2013 2013 Criteria2013 Requirements2009 Requirements Changes Educational Design EDP 1 EDP 2 EDP 3 EDP 4 NP learning needs assessment NP data collection to determine gap Planning committee selection method Process to identify actual and potential COI CR2, KE1 CRS, KE 3 CR2, KE1 CR2, KE 3 CR2, KE2 CR2, KE 9 EDP 5 EDP 6 EDP 7 EDP 8 Resolution of COI Planning phase of learners successful completion Measurable educational objectives Evidence-based selection of activity CR2,KE 9 CR2, KE 3 CR2, KE1 CR2, KE3 CR2, KE1 CR2, KE3

33. 2013 from 2009 2013 Criteria2013 Requirements2009 Requirements Educational Design ( cont.) EDP 9 EDP 10 EDP 11 Content integrity for CNE activities Commercial support/sponsorship precautions Teaching methods rationale CR2, KE 1, KE 3 CR2, KE1, KE2, KE3, KE9 CR2, KE1, KE2, KE3, KE8 EDP 12 EDP 13 Summative evaluation for future activities Evaluation and change in nursing practice or professional development CR2, KE5 New

34. 2013 from 2009 2013 Criteria2013 Requirements2009 Requirements Quality Outcomes Q01 Q02 Process utilized for evaluating PU in delivering quality CNE How evaluation process for PU resulted in development or improvement of QO measure CR4, KE1 NEW Q03 Q04 Q05 Rationale for specific stakeholders participation in the evaluation process How input from stakeholders resulted in an improvement or specific QOM for PU How over past 12 mo., PU enhanced professional development CR4, KE2 CR4, KE3 NEW

35. Overall Form Changes  Reduced redundancy  Clarified previous questions with response options (i.e. how presenters are ensured they are qualified)  Removal of items not clear or provided response options  Removed category of evaluation

36. Q & A  Q & A regarding changes  Break!!!

37. Part 2: Single activity application Objective: Identify the major elements required in individual activities.

38. Single activity application fees  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 $125.00 Price will be $125.00 Additional contact hours are $25.00 each additional hour Additional contact hours are $25.00 each additional hour

39. Fees continued…  Cap on fee is $700  Applications must be emailed 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.

40. Fees continued…  Late Fees: Programs 1 to 6 Contact Hours are $200.00 Programs 1 to 6 Contact Hours are $200.00 Programs greater than 6 Contact Hours are $400.00 Programs greater than 6 Contact Hours are $400.00  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 23226 Virginia Nurses Association Attn: CE Committee 7113 Three Chopt Road, Suite 204 Richmond, VA 23226 (Please indicate on your check what activity each payment is for) (Please indicate on your check what activity each payment is for)

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

42. Review of Forms

43. Form A Learner Objectives (in behavioral terms – “The participant will be able to …”) Outline of Content for this Objective (must be more than a restatement of the objective) Time Frame for this Objective in Minutes Presenter for this Objective Teaching Methods (Teaching/ learning strategies, materials & resources for each objective) 1. 2. 3.

44. Example: Objective and content For Example: ObjectiveContent Incorrect1. Analyze six case studies for potential abuse situations. 1. Case studies Correct 1. Analyze six case studies for potential abuse situations. 1. Case studies: Elder abuse, child abuse, adult abuse situations – clues, interventions, legal issues, resources for help.

45. Example: Objective and Content For Example: ObjectiveContent Incorrect1.Objective 1… 2.Objective 2… 3.Objective 3… Content Correct 1. Objective 1Content 1 2. Objective 2Content 2 3. Objective 3Content 3

46. Form A or B  Objectives measureable and are in the perspective of the learner Use an active verb Use an active verb List one objective for each content, method, time, presenter List one objective for each content, method, time, presenter Who (the learner), how (the action verb), what (the content) Who (the learner), how (the action verb), what (the content)   Content must be evidenced-based or based on the best available evidence (include reference)

47. Sample certificate  Name and address of applicant (web address ok)  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 Differences: 10 contact hours = 1 CEU Differences: 10 contact hours = 1 CEU

48. Official Approval Statement: Single Activity Applicants This continuing nursing education activity was approved by the Virginia Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Revised 9/20/2010 by ANCC

49. Incorrect Approval Statement This activity has 2 contact hours. This CE 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. VNA Approval ###. This activity has 2 contact hours. This CE 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. VNA Approval ###.

50. Advertising material Pending approval statement for advertisements: 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.

51. Incorrect Pending Approval Statement This activity has been submitted to the Virginia Nurses Association for approval to award 6 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. Please register by May 1, 2010.

52. After Approval of Activity  Evaluation Summary  Participant Summary Form  Repeat Activity: Monitoring  Correct any pending approval statements on advertisements to approved statement

53. Provider application  Objective: Identify the three criteria involved in the provider application.

54. Why apply to be a provider?  Approved providers may provide contact hours for activities in their organization  Providers do not approve activities nor do they provide contact hours to other organizations  Providers are responsible for following the ANCC criteria and ensuring that activities follow the criteria  Depends on the needs of your organization (apply to VNA for every single activity vs. approved provider)  3 year approval period for providers  Provider may offer an unlimited number of educational activities during approval period

55. Provider application: Who is eligible to apply? Geographic 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.

56. Provider application: Who is eligible to apply ?  In other words… 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

57. Source: http://www.hhs.gov/about/regionmap.html

58. Provider application: Getting ready to apply…  Complete pg 1 of application assessing eligibility  Confirm you are eligible before you start the process  Contact Germaine Forbes for assistance if you are planning on applying  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

59. 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

60. Revision fee Effective 11/1/09  No fee the first 2 times an application is sent back to the applicant for revision.  After the second return: $25 per revision (each return to applicant for additional information)  After the second return: $25 per revision (each return to applicant for additional information)  Additional assistance will be offered to applicants as needed.  Additional assistance will be offered to applicants as needed.  This fee will apply in general to all applicants and incur on a case by case basis.

61. Approved Provider Application  Sample activities (using single activity forms)  Sections: Organizational Overview Organizational Overview Structural Capacity Structural Capacity Educational Design Process Educational Design Process Quality Outcomes Quality Outcomes

62. Approved Provider Application Forms

63. Practice Writing Narratives   A narrative description of how the organization operationalizes each criterion is required for the sections on Structural Capacity, Educational Design Process and Quality Outcomes.   Opportunity to tell how the organization is adhering to the accreditation/Approver Unit criteria and requires both a description (Describe) and an example (Demonstrate) for each criterion.   Narrative documentation with supporting evidence/examples: “Telling a story” “Description of the wonderful work done by your organization for registered nurses”   Examples may be chosen from supplemental activity files but examples may also come from other activities or work done within the organization   “Describe” – tell the story ; “Demonstrate” – provide evidence to substantiate the story

64. Practice Writing Narratives   Pause and reflect on the intent of the question   Answer the question directly   Do not add unnecessary extraneous information   If an individual’s name is used in the narrative, indicate the position/title of the individual to ensure the reader can follow the response   Give enough background/context for the reader to understand the response   Ask several colleagues to read the responses and tell you if they make sense   Remember to answer all parts of the criterion requirement in each response.  

65. Practice Writing Narratives   Process description should be a general overview of the process used by the Approved Provider applicant to meet the criterion requirement   Example should be a specific and detailed description demonstrating how the Approved Provider applicant operationalized the process. Examples should include details such as who, when, where, how and why.   Scoring examples…

66. Approved Provider Application  After approval, annual report form H  Additional monitoring as needed

67. Questions??? Questions???