KANSAS STATE BOARD OF NURSING
LANDON STATE OFFICE BUILDING
900 SW JACKSON, SUITE 1051
TOPEKA, KS 66612-1230
LONG-TERM CNE PROVIDER
COVER PAGE
Assessing Need and Planning CNE
Please describe what advisory groups or planning committees were formed and what factors were reviewed to determine what CNE subjects should be presented and how those presentations will meet the definition of CNE in KSA 65-1117(a).
25 lines.
Process for Fee Assesment
Describe the method for determining the price to charge for CNE, what procedure is used in case of insufficient fund checks, and refund requests due to cancellations.
Process for Advertisements or Announcements
Describe what material will be distributed or used to announce your CNE. Include all information sources used and the media used, printed or electronic. Copies of each announcement must be attached. All announcements are required to contain the required language in KAR 60-9-107(b)(3)(C).
20 lines.
Process for Offering Approval
Please verify in writing that all information listed below will be completed for each offering before it is presented. 1. Summary of planning; 2. Behavioral objectives of the offering; 3. The content of the offering meets the definition of CNE pursuant to KSA 65-1117; 4. Documentation is received of each instructor's experience and education; 5. The bibliography of each presentation is received and up to date; 6. The evaluation form for the learner to assess achievement of the objectives and the expertise of the presenter. KAR 60-9-107(d)
Process for Awarding Contact Hours
Describe the method of calculating contact hours for actual attendance that will be awarded for each presentation, utilizing the attendance roster. This must include your method of calculating partial credit, more than one hour, because of early departures or late arrivals. Describe also how instructor credit is calculated and how independent study credit is calculated. If you offer independent study, you must provide the complete pilot study which determines the amount of contact hours the completed material is worth. KAR 60-9-107(e)
Process for Verifying Participation and Completion of Offering
Describe the contents of the roster of attendance and certificate of completion which you use, and documentation of independent study. A sample copy must be attached of each. KAR 60-9-107(f)(g)
Process for Record Keeping and Storage
Please verify that you will keep the records of the offerings for a minimum of two years after presentation. List what records will be retained, the location of the records and the steps taken to ensure confidentiality and security of the records. KAR 60-9-107(h)
Process for Notice of Change of Coordinator or Required Policies
Describe what methods will be used to notify KSBN of a change of coordinator or policies, and verify that you will notify KSBN of any change within 30 days. KAR 60-9-107(b)(3)(H)
10 Lines.
Total Program Evaluation
Verify that you will perform a total program evaluation each year. A copy of the proposed evaluation must be attached.
Note: Each applicant must attach all documents required by KAR 60-9-107(i)(1) for two separate offerings which have been developed for presentation.
Attestation I realize that this application is a legal document and by pressing the Submit button you are declaring under penalty of perjury under the laws of the State of Kansas that the information I have provided is true and correct to the best of my knowledge. If all the above information is correct please press the Submit button . Otherwise please go back and correct any information that is necessary.
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