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CEARP/CNE review & update.

Continuing Nursing Education (CNE) is the foundation of nursing practice. The change in both technology and evidence-based practice demands constant attention to redefine what was learned in basic nursing education programs and the textbooks purchased. The only constant is the Art of caring, human touch and focused listening-all administered with compassion. CNE enhances nursing practice, education, administration, and research to improve health care to the public. It involves "systematic professional learning experiences designed to augment the knowledge, skills, and attitudes of nurses and therefore, enrich the nurses' contributions to quality health care ..." (ANA/NNSDO Scope & Standards of Practice, Nursing Professional Development, 2010, p. 83.) Information taught in current nursing education programs is NOT CNE unless it is a RN refresher program or an update on new information. How to implement agency policies or operate equipment used on the job, or procedures used in the employment setting is NOT CNE.

CNE, once known as CEU (continuing education units) was the product of the 1980s based on an academic model of 50 minutes per unit. CNE with the 60 minute hour puts the profession in sync with other health professionals who might attend the same programs. In fact, the AACME and APCE and ANCC have been collaborating to create a seamless accreditation process for providers of medical, pharmacy and nursing continuing education. Colorado's Department of Regulatory Agencies (DORA), Board of Nursing once required CNE for license renewal. However, that requirement is not likely to reoccur in the foreseeable future.

CNA, like many other state nurses association affiliated with ANA, is both an approver of agencies and organizations (both for profit and not-for profit 501 3 Cs) that offer CNE, and a provider of CNE for a target RN audience. The Approval Board reviews applications for the role of "Approved Provider." This is a volunteer committee appointed by CNA leadership. A standing CNA committee appointed by CNA leadership plans and offers CNE as the "Provider Unit."

The Accredited Approver has applied for and received ANCC status to approve providers for three years or to approve individual CNE activities. Approved Providers have been granted a three year period to provide CNE either directly or jointly-sponsored with another agency or group. Jointly-sponsored programs must have agreements that acknowledge the Provider Unit's operational procedures and rules.

Provider Units need a Designated Nurse Planner to assure adherence to ANCC criteria as well as CNA approval criteria. Lead Nurse Planners have responsibility for individual programs in cooperation with the Designated Nurse Planner. The Provider Unit can offer CNE that is faculty directed or independent study. For one hour of CNE, 1 to 3 objectives are sufficient to complete the Educational Design.

Web-based lessons are considered "independent study" and must have a pilot study completed to determine the appropriate time to complete for CNE hours. Webinars are generally preplanned in an Educational Design, so do not need a preview by reviewers.

ANCC continuing education criteria made some changes in 2011. Provider Units will find a new section on Organizational Overview and fewer boxes to check indicating compliance with guidelines. Instead, a narrative that asks the applicant to cite examples will provide information on three focal areas. These are Structural Capacity, Educational Design Process, and Quality Outcomes. Narrative and anecdotal responses are requested.

The easiest, and yet the most challenging section, is the Educational Design Process. If the ED is completed as "Planning," then all the program planners need to do is to select a speaker and a venue that meets the plan. The speaker can be provided a copy of the ED and work with the planners to "tweek" the presentation. If the ED is completed after the speaker has been selected, then adjusting the outline to the ED can be more time consuming.

The lead Nurse Planner and a Content Expert (two nurses) are the fewest people who can be involved in the planning process. A representative from the target audience is nice, but not necessary. Before starting on the objectives, determine the target audience, gap analysis and learning styles. Formulate an outcome statement that tells the learners what they will be able do as a result of the learning activity. In terms of Nursing Process, the Assessment is of the target audience; the Planning considers the gaps and objectives. Implementation is the ED, and Evaluation is a summary statement about the activity.

Some of the implications from the Institute of Medicine (2010), The future of nursing: leading change/advancing health, the 2010 Carnegie Report, and Dr. Yoder-Wise and K. Esquibel (2011) in The future of nursing and continuing education, Journal of Continuing Education in Nursing. 42(3), 99-100), provided an impetus for revision of the AACN CNE process. The future of the profession needs to focus on leadership, change agency, inter-professional collaboration, advocacy, data collection for evidence-based practice and opportunity to support nursing residency and preceptor program leaders. Journal Clubs that have a faculty director, are an excellent example of CNE that might provide the recommended focus. Drug reviews with a pharmacist could serve the same purpose to improve nursing practice.

by Carole Mutzebaugh, EdD, NP, CNS
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Author:Mutzebaugh, Carole
Publication:Colorado Nurse
Date:Feb 1, 2012
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