Having instructor status and 1 point Copy of certification wallet card fulfilling minimum instructor each. or active certification credential obligations in courses utilized Maximum with expiration date. by the Nursing Department(if of 2 points. (Form Z) not part of the job role): ie, BLS, ACLS, PALS, NVCI Develop and deliver a clinical 1 point Program flyer with identifying education program offering each. information, attendance roster CEUs or contact hours Maximum and summative evaluation of 2 points. (Form AA) Develop and deliver a patient 1 point Written verification of education presentation each. presentation with date, time, Maximum roster, objectives and of 2 points. evaluations (Form BB) Receive a KentuckyOne Health 1 Copy of Certificate (Form CC) Nursing Award that is presented 4 times a year or less. Transformational Leadership Hold office or committee Written verification from chairmanship in a professional Nursing Organization outlining nursing organization (at least a office or committee on the 12 month term): applicant served. Include dates Local/Regional 1 of service. (Form DD) National 2 Active committee member in a 1 Written verification from professional nursing Nursing Organization committee organization (at least a 12 chairperson outlining office or month term): committee on which the Local/Regional/National applicant served. Include dates of service. (Form DD) Element Points Acceptable Evidence to Check if Support the using this Element: Use appropriate criteria templates and submit for your requested validation portfolio Active involvement in a Written verification from KentuckyOne Healthcare Committee chairperson facility committee/council for at of 2 confirming membership and least 12 months with attendance. (Form EE) documented 75% attendance* Chairperson/CoChairperson of a Written verification from KentuckyOne Healthcare Committee leadership sponsor facility committee/council for at confirming membership and of 2 attendance. (Form EE)
Having instructor status and fulfilling minimum instructor obligations in courses utilized by the Nursing Department(if not part of the job role): ie, BLS, ACLS, PALS, NVCI 1 point each. Maximum of 2 points. Copy of certification wallet card or active certification credential with expiration date. (Form Z) Develop and deliver a clinical education program offering CEUs or contact hours 1 point each. Maximum of 2 points. Program flyer with identifying information, attendance roster and summative evaluation (Form AA) Develop and deliver a patient education presentation 1 point each. Maximum of 2 points. Written verification of presentation with date, time, roster, objectives and evaluations (Form BB) Receive a KentuckyOne Health Nursing Award that is presented 4 times a year or less. 1 Copy of Certificate (Form CC) Transformational Leadership Hold office or committee chairmanship in a professional nursing organization (at least a 12 month term): Local/Regional National 1 2 Written verification from Nursing Organization outlining office or committee on the applicant served. Include dates of service. (Form DD) Active committee member in a professional nursing organization (at least a 12 month term): Local/Regional/National 1 Written verification from Nursing Organization committee chairperson outlining office or committee on which the applicant served. Include dates of service. (Form DD) Element Points Acceptable Evidence to Support the Element: Use appropriate templates and submit requested validation Check if using this criteria for your portfolio Active involvement in a KentuckyOne Healthcare facility committee/council for at least 12 months with documented 75% attendance* of 2 Written verification from Committee chairperson confirming membership and attendance. (Form EE) Chairperson/CoChairperson of a KentuckyOne Healthcare facility committee/council for at of 2 Written verification from Committee leadership sponsor confirming membership and attendance. (Form EE)
NPDPFinalCheckoff-5.docx