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  1. This final installment of the 3-part “What I Wish I’d Known About Continuing Education,” series addresses the value of record keeping. Part 1 of this series addressed why knowing the details of your license and credential renewal requirements is so important. Part 2 set forth some ideas for how to manage your time and money to keep continuing education (CE) from breaking the bank. How do you keep track of your CE accomplishments? A file folder? A desk drawer? A mandated tracker app or online database? Whatever system you’re using now, it’s a good idea to take a second look, and ask yourself what else you might need to do. CE record keeping is necessary for all nurses and licensed medical professionals, but it’s especially relevant for advanced practice nurses, nurses with multiple credentials and specialties, nurses who maintain licenses in multiple states, and nurses who are changing employers or relocating to a different state. As a board-certified family nurse practitioner with specialty credentials, I’m meticulous about maintaining my own CE records for three main reasons: 1) accuracy and completeness; 2) safety; and 3) comprehensive, ongoing proof of meeting and exceeding requirements. Keep your own records for accuracy and completeness. Many credentialing agencies and some state licensing boards require specific online app-driven databases to help you maintain a running total of continuing education credits as you earn them. At first, this may sound like an ideal one-stop solution. But, if you rely on a single agency-sponsored online database as your only record of the CE credits you’ve earned, you run the risk of losing data, coming up short at renewal time, scrambling to prove you’ve met an employer’s requirements, or panicking during an audit. My preferred method Keeping my own records allows me the ultimate control to preserve relevant data and distribute it appropriately. I use a Microsoft Word (Word) table that contains relevant information for each credential or license but you could just as easily use an Excel spreadsheet or any other format you like. Working in Word gives me the flexibility to capture details like descriptions of courses. From my “master” document, I can easily enter accurate, specific, data into the appropriate platforms as needed. I have yet to find an e-platform that comprehensively records all the specific data I’m required to record while seamlessly integrating with other platforms. If you know of one, please share! Accuracy Different credentialing bodies require different information about each CE experience. As such, any online database that supports an agency is customized to meet that agency’s specific requirements. So, if you rely on a single agency’s platform to capture your data, such as a mandated tracking app, that one database may not be gathering all the details a different credentialing body may require. For example, one of my agencies requires me to record the date, title, and agency-specific provider approval number for each CE experience. Another agency requires date, title, and a content-oriented course description for each learning experience. If I rely only on one of those databases for my CE record keeping, necessary information will be lost. As discussed in Part 1, a single CE experience may not be counted the same by every credentialing body. Not only that, but there may be specialty hours allocations embedded within an individual CE credit total. I recently took a CE course where 6.2 of the 12 total CE hours were specific to pharmacology. While one of my credentialing agencies is only concerned with total CE’s, another requires me to tally a pharmacology-specific total in addition to a grand total. Keeping my own records allows me to track the details accurately and helps me meet my pharmacology-specific CE requirements on time. Completeness Inconsistencies across digital database fields from platform to platform are common. And some online databases may not allow entries beyond what is required, and you don’t want to lose track of anything extra you earn. At the time of my most recent board-certification renewal, the ANCC online data-entry portal would not allow additional entries to be made after the required total of 75 hours had been entered, despite the fact that the entered total did not include the required pharmacology-specific subtotal. Ultimately, submitting my data in hard-copy form was the solution. Here’s an additional side-note for advanced practice nurses: In some cases, certain professional activities other than earning continuing education credits may count toward credential renewal. For example, hours spent in practice, time spent volunteering, clinical hours precepting students, making presentations, earning an advanced degree, or doing research can all count toward renewing my FNP-BC board certification. Documentation of these activities is crucial, and keeping my own CE records consolidates this necessary task. Back up your records for safety. Keeping your own records won’t do you any good if you don’t keep them safe. I recommend keeping a hard copy, a digital backup, and a cloud-based digital backup. Ideally, your digital backups include images of your hard-copy certificates to mitigate against unforeseen circumstances. Your backups will save you a lot of headaches, especially in the unfortunate event of theft or disaster. Over the last 5 years, I’ve experienced data losses from the threat of natural disaster and due to theft. My emergency evacuation experience during the California wildfires reinforced the necessity of maintaining up-to-date digital copies of all my hard-copy CE certificates. And when my vehicle was broken into and both my laptop and backup drive were stolen, I realized the value of storing data in the cloud. Those of us who were born before the Internet sometimes need reminders! My efforts to keep a comprehensive, chronological record of CEs for myself have been helpful. Preserving original proof of completion for every continuing education credit you earn not only makes transferring data across credentialing organizations easier, it will serve you well in case of an audit. I was audited during a routine renewal of my California RN license, but because I had a system in place for preserving my original CE certificates, submitting the additional information the audit required was a simple, quick, and painless process. Plan to exceed minimum requirements. More is better when it comes to CE credits: The last thing you want to do is come up short at renewal time. It’s good practice to plan for a few extra credits. Keeping your own records offers comprehensive proof that you’ve met and exceeded minimum requirements. My policy of doing more than the necessary minimum has served me well on more than one occasion when minimum requirements changed during the renewal period. Having a few extra credits “in the bank” allowed me to fulfill my renewal requirements on time with zero stress. It also can be a lifesaver if you accidentally miscalculate your total hours, if your agency stops accepting credits offered by a particular provider, or if you relocate to a new state or different employer situation where requirements are different than what you’re used to. My gold and silver rules of continuing education With all this in mind, here’s my “golden rule” of continuing education: Never pass up a chance to earn a CE. If your employer offers free continuing education opportunities, try to make the time to attend, even if it’s not your favorite topic. Free is free and CE is CE. And my “silver rule" is this: Make sure you get credit for whatever you sit through. Be aware that electronic records are not failsafe. Sometimes that convenient nametag scanner at the conference doesn’t work properly. Or the automatic save from the online course you just took didn’t link to your mandated database as promised. Follow up. Print the proof. And if there’s a glitch, stay on top of it until you have proof of your CE credit in hand. In summary, you can take control of your CEs by keeping your own records. When you’re in charge, you won’t have to worry about malfunctioning electronics, natural disasters, theft, or other unforeseen circumstance. Make sure you have a comprehensive and accurate way to track your CEs. Make backups in multiple formats. And follow the gold and silver rules of continuing education. You worked hard to earn your professional licenses and credentials. Maintaining them can be relatively hassle free with a little pre-planning and due diligence. Questions for discussion: How do you keep track of your CEs? Do you use online tracker apps and what is your experience with them? What might make tracking your CEs easier? Sources and Resources 5 Reasons to Invest in Continuing Education ANCC 2017 Certification Renewal Requirements Continuing Education for License Renewal Lifelong Learning What I Wish I’d Known About Continuing Education: Know Your Requirement [Part 1 of 3] What I Wish I’d Known About Continuing Education: Managing Time and Money [Part 2 of 3]
  2. I recently renewed my family nurse practitioner credential (FNP-BC) for the first time since successfully sitting for the American Nurses Credentialing Center (ANCC) national board certification exam 5 years ago. I’ve always loved the idea of lifelong learning, and while I have benefited from leveraging continuing education to enhance my professional development, I’ll admit I’ve been frustrated with the level of detail and complexity involved in maintaining my professional credentials. While reflecting on what I can do, moving forward, to streamline my own overall license and credential renewal process, I came up with a list of things I wish someone had told me about continuing education and maintaining my professional licenses and credentials. Maintaining those hard-earned professional licenses and credentials requires a bit more than just taking a bunch of continuing education courses (CEs)—you’ll need to develop strategies and tactics for yourself in three categories: 1) knowing your renewal requirements; 2) managing your time and money; and 3) maintaining accurate records. In this first article of a 3-part series, I’ll share my view on why knowing your continuing education requirements is more complex than it seems on the surface. Requirements can change, certain CEs may not be recognized at all or in full, and not all types of CE credits convert to the number of hours you may expect. The complexity intensifies when you hold multiple licenses and credentials. Requirements Change You already know that continuing education and license renewal requirements vary by state, type of license, and credential. But did you know that your continuing education and certification renewal requirements are likely to change over time? Yes, credentialing bodies are constantly reviewing and revising their renewal criteria. It’s up to you to stay on top of these changes. First, be sure to get your information straight from the credentialing agency instead of relying on world-of-mouth information. Don’t depend on what your professors told you, what your classmates said, or what your colleagues discussed in the break room. Use what you’ve heard as a launching pad to conduct your own research: Go to the source and see it for yourself in writing. Second, build an ongoing plan for staying aware of changes. This means checking in with your licensing or credentialing organization periodically. Professional organizations can provide a gateway to finding out about these changes. Another way is to bookmark your credentialing bodies’ renewal criteria pages and check them routinely. Of course, this doesn’t work unless you actually remember to go and check the sites. I was amazed at how many of the criteria for my FNP board certification changed significantly during my 5-year renewal period. Know What Counts Not every continuing education activity you do will count for every license or credential renewal requirement you need to fulfill. (I know, right?!) Ideally, any continuing education credit you earn would be applicable cross the board, but that’s not always the case. Some CEs may not be recognized in full or at all by every credentialing agency. For example, the ANCC only recognizes 50 percent of the credit earned from providers not approved by the ANCC, and the California Board of Registered Nursing (CA BRN) only recognizes CE earned through CA BRN-approved providers. So, if I earn CE credits from a provider that is not recognized by the ANCC or the CA BRN, only half of those hours will count toward renewal of my FNP-BC, and none those hours will not count toward renewal of my state licenses. Conclusion? Before I enroll in a CE opportunity, I check to see if the provider is honored by the ANCC and the CA BRN. Being aware of this ahead of time helps me make savvy CE choices, and keeps me from being disappointed, frustrated, or panicked at renewal time. Some credentialing bodies allow professional activities other than CE courses to count toward license and/or credential renewal. For example, hours spent in clinical practice, precepting students, volunteering, making presentations, earning an advanced degree, or doing research can all count toward renewing my FNP-BC board certification if documented correctly. But, unfortunately, none of those things except taking academic nursing courses would count toward renewing my CA RN license. Knowing your requirements also means paying attention to the specific subject matter covered in the CE opportunity. For example, I need 75 continuing education hours every 5 years to renew my FNP board certification through ANCC and 25 of those must be specific for pharmacology. With this kind of specificity, the key is to make sure I earn enough pharmacology-specific hours to meet the pharmacology requirement. This can be tricky to track because some CE courses offer only a portion of the total hours as pharmacology-specific. For example, a CE course may offer 2 hours of total credit, but only 0.5 hours of that time counts as pharm-specific. Do The Math Closely related to the idea that not every CE credit you earn will count toward the renewal of every license or credential you hold, is the idea that the credits themselves are counted differently depending on who’s providing and who’s counting. The takeaway is: Know how ahead of time how each of your particular credentialing bodies recognizes, calculates, and converts CE hours. Admittedly, counting CE hours can be confusing. Descriptive words are a tip-off to how the calculations may vary. Various providers offer “contact hours,” “continuing education units (CEUs),” or “continuing medical education (CME).” Words matter because they are not all calculated or recognized the same way. The ANCC offers a conversion formula: 1 contact hour = 1 CME or 0.1 CEU or 60 minutes; 1 CEU = 10 contact hours. Make sure you know the conversion formula that is being used by your credentialing body. Be aware that any algorithms embedded in online renewal or CE tracking applications should include consistent conversion calculations, but they may not always be accurate. The bottom line: Do your own math and double-check it. Being aware of this and knowing how to count your credits will help you decide which CE opportunities are right for you and prevent the worst-case scenarios of coming up short at renewal time or during an audit. Ultimately, continuing education benefits both you and the patients you serve. However, I wish someone had told me, back in the day, that “knowing your requirements” involves in-depth proactive thought and planning, especially when you hold multiple licenses and credentials. My intention in sharing this is to help you streamline your own personal continuing education strategy. In Part 2, I’ll share my thoughts managing your time and money to keep continuing education from breaking the bank. Meanwhile, here’s a question: What do you wish you’d known about continuing education before you embarked on the adventure yourself? Sources and Resources 5 Reasons to Invest in Continuing Education ANCC 2017 Certification Renewal Requirements Continuing Education for License Renewal Lifelong Learning
  3. Continuing education - these two words either excite you or send you into a state of boredom-induced slumber unmatched by pretty much anything else in life. Nurses are required to complete continuing education to maintain their licensure. However, experts tell us that there are more significant benefits to continuing education than just keeping our ability to practice the craft of nursing. Here are a few reasons you should spend your time and money investing in your future. Maintaining Licensure Every state in the U.S. has a different set of expectations for nurse continuing education requirements. Some states mandate a certain number of continuing education. Others have specific courses or topics they require to address issues that happen in the state, such as child abuse, domestic violence, or laws governing your practice. Providers of continuing education courses must meet specific rules to ensure that information is current and meets laws and nursing practice as it changes. This safeguards you from completing materials today that was outdated years ago. Be sure your up to date on what you need to know about nursing licensure. Improving Safety Your patients expect to be safe when in your care. No one wants to be responsible for adverse drug events, falls, or other unsafe patient situations. While it is impossible to eliminate errors altogether, it should still be your goal. When nurses participate in continuing education that focuses on best-practices, patient-centered care, and safety prevention - errors lessen and patient satisfaction increases. Fostering a culture of lifelong learning in nursing is one of the pivotal practices that keep patients safe. In fact, when the 1999 To Err is Human: Building a Safer Healthcare System was published by the Institute of Medicine (IOM), it showcased some scary numbers about patient safety: Up to 98,000 patients die each year due to preventable medical errors Medical errors cost up to $29 billion each year nationwide You might think that the IOM would have been looking for high-tech ways to rectify these numbers. The Robert Wood Johnson Foundation and the IOM joined forces to establish eight recommendations with goals for the next 20 years. Half of the strategies created to fix the issues found were based solidly in education. The four learning strategies included implementing nurse residency programs, increasing the percentage of nurses with a baccalaureate degree, doubling the number of nurses with a doctorate, and engaging nurses in lifelong learning. I believe that this study illustrates the strength of continuing education in nursing. When nurses are empowered to increase their own understanding of the profession, patients are safer and more satisfied with their care. Meeting Certification Requirements Have you considered becoming certified in a nursing specialty? Accrediting bodies often have their own requirements you must meet to maintain your certification. You might need to complete courses on specific topics or areas to achieve the necessary requirements. For example, if you’re like me and have a certification in Case Management, you’ll need to show that you’ve completed 80 hours of approved continuing education specific to being a case manager. Many courses will meet the requirements you need for your certification while also keeping you compliant with your state board of nursing. Gaining New Skills and Meeting Changes Healthcare is becoming more innovative every day. From new drugs and treatments to the use of artificial intelligence and virtual reality, there’s so much to learn. Instead of waiting for hands-on training opportunities to come to you on the job, consider enrolling in a CE course that provides an overview of skills you know you’re going to need. It’s essential to remember that not all new skills are technical. While learning how to use equipment or how to assess for specific diseases is necessary, sometimes the skills you need most are interpersonal. If you’re struggling at work with communication, time management, or you’re considering moving up the career ladder, there are courses to help you gain the knowledge you need. Advancing Your Career Whether you’re considering certification, returning to school, or just want to stay up on the latest research - all of this learning will help to advance your career. Continuing education is an excellent place to start if you’re considering changing your specialty. You can choose a few courses to take to learn the basics of just about any nursing niche out there so that you can find out if it might be right for you. Continuing education might be mandated. However, if you can flip the script on how you approach continuing education requirements you might find that there are many reasons to invest in your professional development. How do you feel about mandated continuing education? Do you enjoy it or do you just complete it because it’s required to maintain your certification?
  4. The importance of continued education with any profession is paramount. Within the Nursing profession it is a requirement. In general, to maintain your license you need twenty-four continuing education credits (CEU's) every two years. This article will discuss, and hopefully motivate us to go above and beyond that requirement so that we may be able to take better care of our patients. In fact, one could argue that our patients will be safer due to the increased skill this knowledge will create. It has been almost twenty years since graduating with a bachelor's degree in Nursing and it has never been more evident how important it is to stay at the top of our practice by keeping our knowledge base of the most current trends in healthcare at its peak. Some ways we can do this are by attending conferences in our areas of specialty and reading evidence-based practice articles. Recently, I attended a national conference in my area of specialty. I cannot stress the importance of doing this. Just by being around your peers, all with the same desire to boost their knowledge base, is a very motivating experience. Some of your peers may be novices while others would be considered experts. Interacting with the varying skill levels will allow you to be educator and educated. This type of networking with peers is a great way to stay connected with the latest healthcare trends to better take care of your patients, which in my opinion should be the ultimate goal. Exchange contact information and share with your colleagues some of your successes and failures throughout the year, this will provide invaluable insight as to what works well and what you might want to avoid when it comes to your practice. Also, at these conferences the latest trends in your specialty will be talked about and usually accompany case scenarios that really help put the information together. Conferences will also expose you to vendors that carry specific products that may benefit your particular patient population. Products that might help you create a safer work environment or help make the care you give easier. Another way to keep current with the latest healthcare trends in your specialty is by reading articles regarding evidenced-based care. These articles will encompass many facets of the continuum of care including patient preferences, clinical expertise and studies that have been performed regarding particular aspects of care.There are a variety of medical journals available, and they will keep you abreast of the latest research and findings in your area of specialty. Many healthcare facilities have medical libraries available to their employees which carry these journals in all areas of specialty. In conclusion, continued education is a vital component to providing our patients the best possible care. The Nursing profession as a whole benefits when we grow as individuals in our knowledge base particular to our Nursing specialty. Let the desire we have to give our patients the best possible care be our biggest motivator in continued education.
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