No STOP! Go back and read the information in the Provider Activity Documentation “Approved Tool Guidelines and If you have questions, contact your Approved Provider Criteria.” Unit’s Primary Nurse Planner. Have you read the ANCC “Content Integrity Standards”? Yes Please continue to the next question. No STOP! Go back and read the information in the If you have “Content Integrity Standards.” questions, contact your Approved Provider Nurse Planner. Unit’s Primary Activity Documentation Tool _________________________________________________________________________________ A. Description of the professional practice gap (e.g. change in practice, problem in practice, opportunity for page 4] improvement) [see “Guidelines” – Describe the current state: What are you seeing in practice that creates the need for this activity? B. Evidence to validate the professional practice gap (check all methods/types of data that apply) page 4] [see “Guidelines” – 1. Survey data from stakeholders, target audience members, content experts, etc. Input from stakeholders such as Registered Nurses, managers, or content experts Evidence from quality studies and/or performance improvement activities to identify opportunities for improvements Evaluation data from previous education activities Trends in literature, law and health care Direct observation Other Describe: – 2. Please provide a brief summary of data gathered that validates the need for this activity: C. Description of Target Audience page 4] [see “Guidelines” – Identify the Registered Nurse target audience for which this continuing nursing education activity is being designed: All Registered Nurses Advanced Practice Registered Nurses RNs in a specialty area Identify specialty:
No STOP! Go back and read the information in the “Approved Provider Activity Documentation Tool Guidelines and Criteria.” If you have questions, contact your Approved Provider Unit’s Primary Nurse Planner. Have you read the ANCC “Content Integrity Standards”? Yes Please continue to the next question. No STOP! Go back and read the information in the “Content Integrity Standards.” If you have questions, contact your Approved Provider Unit’s Primary Nurse Planner. Activity Documentation Tool _________________________________________________________________________________ A. Description of the professional practice gap (e.g. change in practice, problem in practice, opportunity for improvement) [see “Guidelines” – page 4] Describe the current state: What are you seeing in practice that creates the need for this activity? B. Evidence to validate the professional practice gap (check all methods/types of data that apply) [see “Guidelines” – page 4] 1. Survey data from stakeholders, target audience members, content experts, etc. Input from stakeholders such as Registered Nurses, managers, or content experts Evidence from quality studies and/or performance improvement activities to identify opportunities for improvements Evaluation data from previous education activities Trends in literature, law and health care Direct observation Other – Describe: 2. Please provide a brief summary of data gathered that validates the need for this activity: C. Description of Target Audience [see “Guidelines” – page 4] Identify the Registered Nurse target audience for which this continuing nursing education activity is being designed: All Registered Nurses Advanced Practice Registered Nurses RNs in a specialty area Identify specialty:
Activity_Documentation_Tool.docx