CONTINUING EDUCATION AGREEMENT. OPTION A Agency will pay an annual Program Review Fee to the College of Nursing in the amount of $250.

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1 CONTINUING EDUCATION AGREEMENT This agreement made and entered into this Day of, 2018 by and between The University of Tennessee, on behalf of its College of Nursing, hereinafter referred to as "College," and, hereinafter referred to as Agency. The College of Nursing will provide Continuing Education credit for the agency s conference under the direction of the Tennessee Nurses Association, an accredited approver by the American Nurses Credentialing Center s Commission on Accreditation. The agency will select an option from the two CE processes described below: OPTION A Agency will pay an annual Program Review Fee to the College of Nursing in the amount of $ A Certificate Fee of $10.00 per participant The agency will provide the following documentation to the College of Nursing prior to the event: Copy of the brochure or flier; both must include the following disclosure: This program provides contact hours through The University of Tennessee, College of Nursing. The University of Tennessee, College of Nursing is an approved provider of continuing nursing education by the Tennessee Nurses Association, an accredited approver by the American Nurses Credentialing Center s Commission on Accreditation. The specific criteria for awarding contact hours for this event include: *. *The lead nurse planner will choose from these examples based on course objectives. (Examples include: Attendance for a specified period of time (e.g., 100% of activity, or miss no more than 10 minutes of activity); Credit awarded commensurate with participation; Attendance at 1 or more sessions; Completion/submission of evaluation 1

2 form; Successful completion of a post-test (e.g., attendee must score % or higher); Successful completion of a return demonstration; Other - Describe:.) An agenda with specific times listed is used to calculate the exact number of contact hours. Contact hours must be printed on the brochure or other marketing materials. Lunch is not considered program content unless a speaker is presenting, and breaks are not included in program content unless a poster display is available during those times. Time used for participants to complete evaluations is considered program content and may be used to calculate final amount of hours for event. 60 minutes of program content= 1 Contact Hour for CE An Education Design form must be filled out that lists the objectives for each speaker/presenter. Each presenter must complete the Biographical Data & Conflict of Interest form. A Co-Provider Agreement form must be signed if there is a co-provider for an event. The agency will work with the CON faculty member they are collaborating with to complete the Faculty Directed Planning form. Evaluations will be provided by the agency for all attendees; the program evaluation should be based on the objectives provided in the Education Design forms. (The College of Nursing can provide an evaluation template upon the agency s request.) A copy of the collated responses from all attendees will be sent to the College of Nursing for our TNA CE approval process. Documentation of participation (copy of sign-in/check-in sheets verifying registrant attendance) 2

3 The College will provide the following: Approved TNA Contact Hours for each participant who attends program in full (documentation of completion required) CE Certificates for each participant reflective of program contact hours. All documentation must be turned in 14 calendar days prior to the event for proper review and approval. Once the event is approved for continuing education credit, the nurse planner will be notified by . Thirty days after the event, evaluations, evaluation summaries, and documentation of participation must be turned in for Tennessee Nurses Association documentation. Failure to turn in all documentation on time will delay and jeopardize continuing education approval and continuing education credit. 3

4 OPTION B The agency will pay a Program Review fee based on the number of contact hours to be provided: $100 per contact hour (up to a maximum of $1500) A Certificate fee of $10.00 per participant The agency will be responsible for providing the following documents to the College of Nursing prior to the event: Copy of the brochure or flier; both must include the following disclosure: This program provides contact hours through The University of Tennessee, College of Nursing. The University of Tennessee, College of Nursing is an approved provider of continuing nursing education by the Tennessee Nurses Association, an accredited approver by the American Nurses Credentialing Center s Commission on Accreditation. The specific criteria for awarding contact hours for this event include: *. *The lead nurse planner will choose from these examples based on course objectives. (Examples include: Attendance for a specified period of time (e.g., 100% of activity, or miss no more than 10 minutes of activity); Credit awarded commensurate with participation; Attendance at 1 or more sessions; Completion/submission of evaluation form; Successful completion of a post-test (e.g., attendee must score % or higher); Successful completion of a return demonstration; Other - Describe:.) An agenda with specific times listed is used to calculate the exact number of contact hours. Contact hours must be printed on the brochure or other marketing materials. Lunch is not considered program content unless a speaker is presenting, and breaks are not included in program content unless a poster display is available during those times. Time used for participants to complete evaluations is considered program content and may be used to calculate final amount of hours for event. 60 minutes of program content= 1 Contact Hour for CE 4

5 Agency will identify the CON faculty member they are collaborating with in the preparation of this event Agency will provide names and contact information for all presenters The College of Nursing will provide the following: The College will contact presenters and provide each with an Education Design form (speaker s objectives) to complete and return to the CON prior to the event. The College will work with the CON faculty in collaboration with agency to complete the Faculty Directed Planning Form. The College will contact presenters and provide each with a Biographical Data & Conflict-of-Interest form to complete and return to the CON prior to the event. The College will work with agency to complete a Co-Provider Agreement form (if applicable). The College will provide Evaluations based on the objectives provided in the Education Design forms. The College will provide CE Certificates for each participant who attends program in full, (documentation of completion required). Post-event, the College will compile all Evaluation Data and provide a summary of that data to the agency. All documentation must be turned in 14 calendar days prior to the event for proper review and approval. Once the event is approved for continuing education credit, the nurse planner will be notified by . Thirty days after the event, evaluations, evaluation summaries, and documentation of participation must be turned in for Tennessee Nurses Association documentation. Failure to turn in all documentation on time will delay and jeopardize continuing education approval and continuing education credit. 5

6 Please select CE option and complete the information below: Option A Option B Agency Name Contact Person (include /phone) Title of Event(s) Signature of Contact Person and Date Signature of College of Nursing Coordinator or Staff and Date For additional information please contact: Laurie Acred-Natelson, Faculty Coordinator of Continuing Education lacredna@utk.edu Virginia Fowler, Coordinator of Continuing Education vfowler2@utk.edu College of Nursing (865)