Credentialing

1. Credentialing CoNNO

2. Overview • This is a brief overview of the Nursing Credentialing programs in Australia. The Critical Care Nurses program is under review and not included in here. • This presentation shows that there are different processes for credentialing even though we use the word Credentialing.

3. ProfessionalSelf-regulation • Statutory regulation • Powers under legislation • Protection of the public from unqualified, incompetent or unethical practitioners • Authorisation to practice • Accreditation, Standards, Practice, Quality Control. • Self – regulation (self-governance, voluntary regulation) • Professional organisations • Self • Quality nursing care, professional excellence in area of expertise through standards of practice and education • Protection of the public?

4. CoNNO definition Credentialing • The process by which an individual nurse is designated as having met established professional competency standards, at a specified time, by an agent or body generally recognised as qualified to do so. • In Australia this is a voluntary process for nurses and credentialing is organised by the professional organisation and not nurse regulatory authorities. • The purpose of credentialing or certification is to assure other professionals and the public that the person has mastered the skills necessary to practise a particular specialty and has acquired the standard body of knowledge common to that specialty.

5. CoNNO definition Credentialing Principles • That credentialing apply to the individual nurse. • That the ICN position statement on regulation which places prime responsibility for standard setting for education and practice in the hands of the profession be adopted for credentialing. • That credentialing be voluntary. • That a person may not use the titles relating to credentials without evidence of holding the relevant nationally recognised credential. 5. That educational components of credentialing involve combinations of formal, informal, on the job and experiential components in acknowledgement of the variety of ways in which professional education may be acquired.

6. CoNNO definition (cont.) • That credentialing processes include demonstration of appropriate competencies (see definition of competence). • That credentialing processes be equitable and accessible to registered nurses regardless of their geographical location or the nature of their employment. • That, as a demonstration of professional accountability, information about specific credentialing content and processes be available to the profession broadly and to consumers. • That consistent, equitable and defensible assessment procedures apply to all credentialing processes. Such procedures may include written assessment standards, adequate training for assessors, mechanisms to assure inter-rater reliability of assessors, meeting equal opportunity

7. CoNNO definition (cont.) legislative requirements and providing appropriate appeal mechanisms. • That all principles above apply to re-credentialing. • With agreed nationally consistent frameworks, credentialing content and process be determined by the relevant national organisation(s). • That where a credential may regularly be sought across one or more related areas of practice the relevant national organisation(s) collaborate to discuss means of pursuing appropriate combinations for such credentials.

8. American Nurse Credentialing Centre • ANCC's certification and portfolio recognition programs validate nurses' skills, knowledge, and abilities. ANCC board certification and recognition empowers nurses within their professional sphere of activity and contributes to better patient outcomes.

9. Perceived Value of Certification • Previous studies – positive regard for certification even if not certified. • 11,000 respondents, 20 specialty nurse certification orgs - Certified nurses, non-certified nurses and nurse managers. • Top perceived values – personal accomplishment and satisfaction, professional challenge, enhance professional credibility, and provide evidence of professional commitment. • Important intrinsic value, but need to reduce barriers and offer recognition and incentives.

10. Perceived Value of Certification • American Board of Nursing Specialties; uniformity in nursing certification (accreditation) and to increase public awareness of the value of certification.

11. Who else credentials • Diabetes Educators • Gastroenterology nurses • Aust. College of Critical Care Nurses • Breast physicians • Australian College of Midwives • Stomal Therapy Nurses

12. Midwifery • Midwifery Practice Review is a formal, transparent, nationally consistent peer review mechanism that supports midwives to regularly reflect on their portfolio, their own midwifery practice and future professional development plans or identified needs.

13. ACM • This reflection is in relation to recognised professional standards for the provision of safe, high quality care to women and their families within the full scope of practice of the midwife

14. ACM • Midwifery Practice Review is relevant and open to midwives who currently care for women and their families. • Midwives are encouraged to undertake Midwifery Practice Review on a three yearly basis.

15. ACM • Midwifery Practice Review is an integral element of the College’s continuing professional development framework – MidPLUS • Midwifery Practice Review has been developed as a process of reflection, self-assessment and face to face discussion with specially trained peers and consumers. 

16. ACM • Midwifery Practice Review is a supportive, facilitative and positive professional process.

17. Diabetes Educators All CDE candidates must meet the following criteria before lodging their application:  • Complete a graduate certificate in diabetes education and management accredited by the ADEA in the six (6) years prior to applying

18. Diabetes Educators • Complete 1800 hours of practice in the specialty field of diabetes education over a maximum period of four (4) years prior to applying

19. Diabetes Educators • Submit evidence of participating in professional development relevant to the specialty field of diabetes education in the 12 months prior to applying as Initial Credentialing Points Guide.

20. Diabetes Educators • Submit a Referee's Report completed by a CDE of at least 12 months standing that addresses the National Core Competencies for Credentialed Diabetes Educators.

21. Diabetes Educators • Participate as a mentee in a mentoring relationship registered with the ADEA Mentoring Program.

22. Diabetes Educators • Undertake to practice in accordance to the  ADEA Code of Conduct and other ADEA standards of practice.

23. Diabetes Educators • Recognition as a CDE is a benefit for diabetes educators who have a current financial full ADEA membership.  Annual fee $250. Other applicants are charged a fee of $2,500 for the three (3) year credentialing period.  To learn more about ADEA membership, please return to the Membership benefits page.  

24. Credentialed Stomal Therapy Nurse Essential: • Qualified Stomal Therapy Nurse. • Full member of the Australian Association of Stomal Therapy Nurses Inc. • Have completed at least one year’s Continuing Professional Development (CPD) demonstrating 100 points CPD each year. • Have two years’ recent experience post Stomal Therapy Nursing qualification using Stomal Therapy knowledge to maintain clinical competence.

25. Credentialed Stomal Therapy Nurse Additional expectations of a Credentialed Nurse: • Able to provide or facilitate a range of activities and experience in the following core functions:- • Ostomy, Wound, Continence,Breast Care. • Education, Research,Leadership Management. • Prepared to complete a focused preceptorship workshop. • Able to provide a letter of commitment from employing institution to take stomal therapy nursing education program students for clinical placement.

26. Gastroenterology Nurses Credentialing is a process by which a non-governmental agency validates, based on predetermined standards, an individual nurse's qualification and knowledge for practice in a defined functional or clinical area of nursing. Credentialing is a voluntary process, which formally recognises advanced knowledge and skills within the specialty. Experienced Gastroenterology nurses, working in their specialty field, have developed such knowledge and skills for the benefit of improved patient care and the community at large.

27. Gastroenterology Nurses Credentialing the Gastroenterology nurse, therefore, offers tangible benefits for the individual, the employer, and most importantly the patient. It provides a benchmark process, which can assess such a nurse and give an indication of their advanced level within the specialty.The Credentialing Organisation of Gastroenterology Nurses Ltd. (COGEN) credentialing process is intended to set a high standard for the practice specialty Gastroenterology nursing.

28. Gastroenterology Nurses • Examination booklet available on the GENCA website.

29. American Credentialing Centre • Clinical Nurse Specialist in Paediatrics Certification Eligibility Criteria. • This is a Computer-Based Test (CBT). • Credential Awarded: PCNS-BC (Paediatric Clinical Nurse Specialist—Board Certified). NB Paediatrics was chosen as an example

30. American Credentialing Centre Eligibility Criteria • All requirements must be completed prior to application for the examination. • Hold a current, active RN licence in a state or territory of the United States or the professional, legally recognized equivalent in another country.      

31. American Credentialing Centre •  Hold a master's, post-master's, or doctorate from a clinical nurse specialist in a paediatrics program or a program that provides course work that addresses children's unique physiological, psychological, and developmental needs from birth through age 21 that is accredited by the Commission on the Collegiate of Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNAC).          

32. American Credentialing Centre • A minimum of 500 faculty supervised clinical hours in the Paediatric CNS role and specialty must be included in the educational program. This Paediatric CNS graduate program must include three separate courses in: • advanced health assessment     • advanced pharmacology     • advanced pathophysiology

33. ACMHN Mental Health Nurse Credentialing • Voluntary but formal peer review process. • Professional self regulation – quality practice, public protection, professional accountability. • Identifies you as a specialist mental health nurse. • Indicates to others that you have achieved professional standards for practice in mental health nursing (MHN).

34. ACMHN Credential for Practice Program • Education and regulatory developments – single register - specialist self-governance. • Late 1990s – ACMHN development and trial of credentialing process using peer review in Tasmania. • Implementation of Credential for Practice Program 2004 –intrinsic – recognition as a specialist mental health nurse. • Mental health nurses holding a credential for practice eligible to provide services under Medicare initiative (mental health care worker). • 2007 COAG Mental Health Nurse Incentive program - mental health nurses must be credentialed.

35. Mental Health Nurse Credentialing Credentialing offers tangible benefits for the individual the patient and community the employer Credentialing promotes professional accountability a commitment to ongoing education and practice development professional ethics and practice standards evidence based practice and quality health care delivery

36. Credentialed Mental Health Nurses Holds a current license to practice as a registered nurse within Australia. Holds a recognised specialist/post graduate mental health nursing qualification, or, equivalent. Has had at least 12 months experience since specialist/postgraduate qualification or 3 years experience as a registered nurse working in mental health. Has been practicing recently (within last three years). Has met continuing professional development standard – education AND practice. Is supported by two professional referees Completes a professional declaration agreeing to uphold standards of the profession. A credential is awarded for three years

37. ACMHN • I have expanded on the ACMHN version for a additional information only as an example, given that I know and have the information on hand.

38. CRITERIA 1 Registered Nurse in Australia Must be currently registered (and maintain registration while holding a credential). CRITERIA 2 Specialist/postgraduate qualification in mental health nursing undertaken in Australia Current benchmark: graduate diploma in mental health nursing Past courses - e.g pre-registration three year hospital course, post registration hospital certificate. Equivalence - recognition of alternative formal educational pathways where relevant, relevant experience and ongoing professional development. Applying for a Credential

39. Applying for a Credential CRITERIA 3 - Duration of Practice in Mental Health • Practice maybe clinical, educational, academic, management, health administration, research, consultancy or advisory (public or private). • It is not defined by who you work for but the nature of your practice. • Must be able to demonstrate primary focus in mental health. • Minimum 3 years FTE (5472hrs) as RN • or 12 months FTE (1824hrs) since obtaining relevant specialist qualification CRITERIA 4 - Recency of Practice in Mental Health • At least 3 months (456hrs) over the last year • OR, at least 6 months (912hrs) over the last 2 years • OR, at least 12 months FTE (1824hrs) over the last 3 years

40. Applying for a Credential CRITERIA 5 Continuing Professional EducationContinuing Practice Development • Is mental health nursing like riding a bike? • Purpose of CPD – maintenance and improvement of standards and competence. • Involves a range of activities. • Personal and professional achievements - enhance confidence • Developing a portfolio takes time but it provides an opportunity to reflect on one’s practice, identify one’s learning needs and stay in charge of one’s career.

41. Applying for a Credential CRITERIA 5 Continuing Professional EducationContinuing Practice Development • During immediate 3 years preceding application: • Minimum 100 pts per CPE and CPD • Must be relevant to MHN practice. • 1 point = 1 hr direct contact with activity. • Can only be claimed once per activity. • Note maximum points in each category on following slides. • Applicants expected to maintain a record of activities - EBR. • EBR submitted with application, evidence held by applicant. • CPE and CPD activities are coded and cross referenced with application form to provide totals.

42. Clinical supervision of you 50 Contribution to profession 50 College activities 40 EBP and clinical research 40 Clinical practice 35 Quality improvement 30 Clinical presenter 30 Working committees 30 Consumer/carer partnerships 30 NGO partnerships 30 Projects and consultancy 30 Community development 30 Promotion and prevention 30 Peer review/mentorship 30 Performance management 30 Your supervision of others Other professional bodies 20 Other CPD activity 15 Applying for a Credential CRITERIA 5bContinuing Practice Development (Code 25. Thus 25.1, 25.2 etc.)

43. Applying for a Credential CRITERIA 6 – Referees • Two referees – preferable that one a practicing mental health nurse. • Referees are important to the applicant. Guidelines for referees on the website. • Seek support of referee who understands the importance of your application. • It is advised that referees view and discuss the application and supporting documentation before it is submitted so that referees can offer advice and facilitate reflection on knowledge and skills. • Referees may be contacted about an application.

44. Applying for a Credential Declarations • Clinical Supervision – if claiming clinical supervision for CPD, details are declared on the form, and recorded in the EBR. • Recency of practice - Employer declaration • if self-employed, use statutory declaration. • Applicant declarations – restrictions on license to practice, validity of information provided, and commitment to the credential. Fees • Member of ACMHN $180 • Non member $430 • Appeal fee $110

45. Evidence Based Record (EBR) CRITERIA 5 – Evidence Based Record (EBR) Example of EBR – Download template from College websiteNo different from a diary or activity portfolio which can also double up as evidence of continuing education and practice development either for proof of NRB currency of practice (annual nurse registration) or performance management with line manager.

46. DATE ACTIVITY EVIDENCE HRS CODE CPE CPD COLLEGE EDUCATION PROGRAMS July 2004 ACMHN Hunter Sub-branch Seminar Len Bowers Making Acute Wards Safer Cert of attendance 3 24.2 3 Sep 2004 ACMHN International Conference A Changing Landscape Cert of attendance 3 days including meetings 28 24.2 28 May 2005 ACMHN HSB Conference: Lower Than Likely Cert of Attendance 6 24.2 6 Oct 2005 ACMHN International Conference Setting Sail for New Horizons Fremantle Cert of Attendance 3 days including meetings 28 24.2 28 18-19 May 2006 ACMHN HSB Conference: Acute Care, Getting it Right Cert of Attendance 1 day 8 24.2 8 3-8 Oct 2006 ACMHN International conference Mental Health at the Centre Cert of Attendance 3 days including meetings 28 24.2 28 TOTAL CPE / CPD POINTS 101 EBR

47. EBR – CPP Points Example Points Summary - CPE • ACMHN education programs 101 70 • Conference presentations 90 40 • Publications 75 40 • Relevant mandatory staff development 133 35 • Relevant ed. from other professional body 83 35 • Deliver formal lectures 198 30 • Curricula course development 60 30 • Convene education program 12 30 • ACMHN member 30 30 • Journal subscriptions 8 20 • Totals: all (“work”) 780 (270)

48. EBR – CPP Points Example Points Summary - CPD • Clinical supervision of you 75 50 • Contribution to profession 46 50 • College activities 22 40 • EBP/Clinical research 200 40 • Working committees 60 30 • QA (Service development) 65 30 • Performance management 105 30 • Other professional body activities 31 20 Totals: all (“work”) 604 (505)

49. Personal Perspective …being Credentialed I am able to demonstrate the advanced and specialist nature of my work. …credentialing shows me the regard in which my peers hold me. …clients are able to gain [various] benefits… this assists them in meeting their health needs. ….the process also encourages me to further my skills and to maintain my Credential in years to come.

50. Information • I hope that you have found this presentation of interest.