tncc & enpc administrative procedures - nj-ena09/tnccenpcadminproce… · provider course two...

EMERGENCY NURSES ASSOCIATION TRAUMA NURSING CORE COURSE™

AND

EMERGENCY NURSING PEDIATRIC COURSE™

________________________

ADMINISTRATIVE PROCEDURES

REVISED SEPTEMBER 1, 2012

UPDATED JANUARY 2013 ENA IS THE SOLE AND EXCLUSIVE OWNER OF ALL RIGHTS, TITLES, INTERESTS, AND ALL ANCILLARY RIGHTS TO ANY AND ALL MATERIALS AND INFORMATION PERTAINING TO TNCC AND ENPC INCLUDING TRANSLATIONS (INCLUDING WITHOUT LIMITATION, COPYRIGHTS, TRADEMARK RIGHTS, PATENT RIGHTS, AND TRADE SECRET RIGHTS)

EMERGENCY NURSES ASSOCIATION ADMINISTRATIVE PROCEDURES

TRAUMA NURSING CORE COURSE AND EMERGENCY NURSING PEDIATRIC COURSE

REVISED SEPTEMBER 2012 PAGE 2 UPDATED JANUARY 2013

Courses The Emergency Nurses Association (ENA) offers the following two courses which provide core-level nursing education based on emergency nursing practice in the United States. The goals of the courses are to improve patient care in the emergency setting and increase the skill and confidence of emergency nurses who care for the patients.

Trauma Nursing Core Course (TNCC) TNCC is a standardized, interactive course recognized internationally for providing the learner with core-level trauma knowledge and psychomotor skill experience. TNCC integrates the trauma nursing process into the content. Emergency Nursing Pediatric Course (ENPC) ENPC is a standardized, interactive course recognized internationally for providing the learner with core-level pediatric emergency knowledge and psychomotor skill experience.

The following course levels are offered:

Provider Course Two day course in which a registered nurse (RN) participant receives verification as a TNCC/ENPC Provider for a four-year period. Prior to or upon expiration of the four-year period, a Provider must again successfully pass the course to maintain Provider status. The Provider may attend a Reverification course (see below), if applicable, challenge a Provider course, or retake the entire Provider course. Reverification Course One-day Provider review course in which a RN with current Provider status may renew his or her Provider status for four (4) additional years. The ENPC Reverification course will no longer be available after 12/31/2012. The TNCC 6th Ed Reverification course can continue to be offered beyond 12/31/2012; however, no contact hours will be awarded after 12/31/2012. Instructor Course One day course in which a TNCC/ENPC Provider may receive TNCC/ENPC Instructor Candidate status. Additional time will be required for retesting of provider status prior to the start of the course.

IMPORTANT THROUGHOUT THESE ADMINISTRATIVE PROCEDURES THE TERM “TNCC/ENPC” IS USED TO MEAN

TNCC OR ENPC




Administrative Procedures Statement of Purpose

________________________

The Administrative Procedures describe the requirements for TNCC/ENPC course administration. The Procedures are as follows:

Prescribe the course organization structure; Assign responsibilities to ENA, the Course Administration

Faculty, ENA State Councils, State Trauma and Pediatric Chairs, Course Directors, and Instructors; and

Include criteria for Participants, Instructor Candidates,

Instructors, Course Directors, and Faculty. ENPC and TNCC are standardized courses. Course requirements are defined in the Administrative Procedures. In the United States, no additional guidelines or procedures may be developed to restrict the dissemination of the courses. States may not place restrictions on who may serve as Course Directors, Instructors, and Faculty, or how they perform their roles across state lines beyond the requirements in the Administrative Procedures. International disseminations and course requirements are defined by contract.




Table of Contents COURSE ORGANIZATIONAL STRUCTURE AND RESPONSIBILITIES Course Elements .......................................................................................................................................07

Emergency Nurses Association (ENA) ..... 07 Course Administration Faculty ......................................................................................................07 ENA State Councils .......................................................................................................................08 State Trauma and Pediatric Committees ........................................................................................08 Course Directors ............................................................................................................................09 Instructors and Faculty ...................................................................................................................11 Marketing .......................................................................................................................................11 Co-sponsorship ..............................................................................................................................12 Librarying Manuals ........................................................................................................................12

Financial Elements ...................................................................................................................................12

Course Fees—Manuals, Indirect Fees, and Late Fees....................................................................12 Timely Payment .............................................................................................................................13 Course Assessments .......................................................................................................................13

PROVIDER COURSES Course Requirements ..............................................................................................................................13

Course Authorization .....................................................................................................................13 Course Content and Format ...........................................................................................................13 Course Materials ............................................................................................................................14 Participant-to-Instructor Ratio .......................................................................................................14 Allowable Number of Course Participants ....................................................................................15 Participant Requirements ...............................................................................................................15 Non-RN’s as Attendees ..................................................................................................................15 Continuing Nursing Education Contact Hours ..............................................................................17

Verification ...............................................................................................................................................17

Provider and Reverification Course Testing Requirements ...........................................................17 Verification Card ..........................................................................................................................18 Instructor Potential .........................................................................................................................18

Course Director .......................................................................................................................................19

Course Director Eligibility Criteria…………………………………………………...………….19 Course Director Requirement .......................................................................................................19 Financial Obligations .....................................................................................................................20




INSTRUCTOR COURSES

Course Requirements ........................................................................................................................20 Course Authorization .....................................................................................................................20 Course Content and Format ...........................................................................................................20 Course Materials ............................................................................................................................20 Participant-to-Faculty Ratio ...........................................................................................................21 Allowable Number of Course Participants ....................................................................................21 Participant Requirements ...............................................................................................................21 Pre-course Test Requirements .......................................................................................................21 Option in the Event of Unsuccessful Pre-course Tests ..................................................................22 Continuing Nursing Education Contact Hours .............................................................................23

Instructor Status ................................................................................................................................23

Achievement of Instructor Candidate Status .................................................................................23 Instructor Candidate Monitoring Requirements ............................................................................23 Instructor Card ...............................................................................................................................24 Maintenance of Instructor Status ...................................................................................................24 Updating Instructor Status—Course Revisions .............................................................................24 Failure to Teach .............................................................................................................................24 Quality Assurance (QA) Scores .....................................................................................................25

Faculty Status .....................................................................................................................................25

Faculty Eligibility Criteria .............................................................................................................25 Faculty Requirements ....................................................................................................................26 Maintenance of Faculty Status .......................................................................................................26 Updating Faculty Status – Course Revisions.................................................................................26

Bridging ..............................................................................................................................................26

Instructors.......................................................................................................................................26 Faculty ............................................................................................................................................27

Course Director .................................................................................................................................28

Course Director Qualifications .....................................................................................................28 Financial Obligations .....................................................................................................................28

INTERNATIONAL DISSEMINATION

Contracts ..............................................................................................................................................28 Course Director/Instructor Selection Criteria ......................................................................................28 Translation Guidelines .........................................................................................................................29




APPENDICES

Appendix A: Procedure for Suspension/Revocation of TNCC/ENPC Provider and/or Instructor Status ...........30 Review and Appeal Process ...........................................................................................................32

Appendix B:

Sample Email Text from Committee Member to Course Director Regarding Designee Appointment ..................................................................................................................................35

Appendix C:

Course Director Provider Course Activities ..................................................................................36 Appendix D:

Course Director Instructor Course Activities .................................................................................40

Appendix E: Guidelines for Use of Computerized Patient Simulators in TNCC/ENPC Courses ......................42

Appendix F:

Guidelines for Videoconferencing of TNCC/ENPC ......................................................................43 Appendix G:

Contact Hour Breakdown for Each Course ...................................................................................44 Appendix H :

Thirty Day ENPC/TNCC Book Receipt Waiver ...........................................................................49




I. Course Organizational Structure and Responsibilities

A. Course Elements

1. Emergency Nurses Association (ENA) a. Approves all TNCC/ENPC applications for both Provider and Instructor Courses.

No courses will be held without prior ENA approval. b. Maintains records of TNCC/ENPC course applications, post-course materials, and

related financial transactions. c. Provides course materials, mailings, and manuals, upon payment. d. Monitors course quality by reviewing and approving Course Director and

Instructor eligibility, as well as participant-to-instructor ratios. e. Maintains a database of Providers and Instructors. f. Assures that Instructor evaluation scores are periodically reported to the State

Trauma and Pediatric Chairpersons. g. Serves as a resource to the ENA State Councils, State Trauma and Pediatric

Committees/Chairpersons, Course Administration Faculty, and Course Directors and Instructors. Assists in resolving issues regarding course administration, Instructor or Instructor Candidate performance, and reverification issues.

h. Individuals who have concerns regarding courses and/or procedures within a state are encouraged to contact the State Chairpersons and/or State Councils. If there is not a satisfactory resolution after making contact with appropriate resources within the state, individuals may contact ENA for additional assistance.

i. Provides the continuing nursing education contact hours for the courses. j. Revises course content on a periodic basis. k. Facilitates changes to the Administrative Procedures as approved by the Course

Administration Faculty.

2. Course Administration Faculty a. Serves as a resource to the ENA Board of Directors, ENA Staff, ENA State

Councils, State Trauma and Pediatric Committees/Chairpersons, and Course Directors and Instructors.

b. Serve as course liaisons to facilitate communication at all levels and promotes the dissemination of TNCC/ENPC.

c. Assists in developing or enhancing quality improvement mechanisms. d. Reviews and updates Administrative Procedures as needed. e. Supervises the suspension/revocation process (see Appendix A).




f. Develops and reviews standards for the roles of State Trauma and Pediatric Chairs.

g. Reviews any identified interstate issues or those that cannot be resolved. h. Reviews the applications for international course dissemination faculty, to make

recommendations to the ENA President; acts as a resource for international disseminations.

i. Makes recommendations to the Board related to International course disseminations to countries rated at the lowest two economic rankings, by the World Bank.

3. ENA State Councils

a. Appoint a Chairperson and members of the Trauma and Pediatric Committees for their states based upon qualifications identified by the Course Administration Faculty as established in these Administrative Procedures.

b. Ensure that members of the Committees are geographically located throughout the state as much as possible. State Councils may choose to have one combined Trauma and Pediatric Committee.

c. Assign charges and/or goals to the Trauma and Pediatric Committees based upon the State Council’s planning priorities and with consideration of the course activities.

d. Monitor course activities for consistency and quality. e. Develop and approve budget plans for TNCC/ENPC assessments and grants and

other course monies. State Councils are encouraged to use course assessments to promote and support courses.

4. State Trauma and Pediatric Committees

a. Consist of members who meet the following requirements: i. Current RN license (or equivalent as defined by country outside of the United States); ii. Current membership in ENA (or equivalent organization defined by country outside of the United States); iii. Involvement in Chapter, State, or National ENA projects to demonstrate leadership; and iv. CEN and/or CPEN preferred

b. Committee Chairpersons must have at least two (2) years experience in emergency, trauma, or pediatric nursing care and must be current TNCC/ENPC Instructors.

c. Are responsible to the State Council (or country outside of United States).




d. Serve as a resource for TNCC/ENPC courses conducted within their jurisdiction. e. Monitor compliance with these Administrative Procedures. f. Monitor and evaluate the quality of the courses and Instructors within their state

(or country outside the United States). Each committee should comply with quality monitoring procedures as outlined in these Administrative Procedures.

g. Address problems or concerns with courses or instructors. ENA encourages resolution of issues at the state level. In addition, the committees may use ENA and/or the Course Administration Faculty as resources regarding adherence to the Administrative Procedures.

h. Evaluate Instructor Candidates. In order to carry out this responsibility, the committee member must be a TNCC or ENPC Instructor.

i. Designate in their absence, the authority to evaluate Instructor Candidates and/or remonitor Instructors. Instructors who will be considered qualified for this authority shall include:

Course Administration Faculty members State Faculty members Course Directors in good standing Experienced Instructors in good standing

State Committees are encouraged to develop a process for this delegation of authority. The designation must be made by the State Chair or a member of the Committee.

j. Provide opportunities to observe an Instructor Course, and subsequently teach in a separate instructor course (Faculty eligibility requirements must be met, and a letter of intent must have been submitted to the State Chair and/or President to be eligible for this process).

k. Provide opportunities and support to Instructor Candidates to be mentored and monitored teaching in a Provider Course in a timely fashion.

5. Course Directors

a. Ensure course integrity by conducting TNCC/ENPC courses in a professional manner in accordance with these Administrative Procedures.

b. Adhere to copyright law in regards to all TNCC and ENPC products. ENA is the sole and exclusive owner of all rights, titles, interests, and all ancillary rights to any and all materials and information pertaining to TNCC and ENPC including translations (including without limitation, copyrights, trademark rights, patent rights, and trade secret rights). This includes, but is not limited to: course materials; testing materials; and student scores.

c. Annually ensure that the Conflict of Interest Disclosure forms for Course Director, Instructors, and Instructor Candidates shall be completed online and submitted to




ENA. Conflict of Interest Disclosure forms reside on the ENPC and TNCC pages of the ENA web site and can be filled out and submitted from that location.

d. Complete and submit course applications, fees, and appropriate post-course documents to ENA in a timely manner. Appendices C and D outline Course Director Activities for the Provider and Instructor Courses.

e. Ensure the adherence to these Administrative Procedures. Maintain the security of testing materials and ensure exams are graded accurately. Report any concerns regarding adherence to the Administrative Procedures or test security to the State Chair or a Committee Member, and ENA Course Operations.

f. Maintain immediate in-person availability during the entire course to assist with problems and ensure Faculty and/or Instructors are prepared, utilize current materials, and maintain time schedules for lectures and psychomotor skill stations. Appendices C and D outline Course Director Activities for the Provider and Instructor Courses.

g. Review Instructor evaluations to provide immediate feedback to Instructors regarding their performance.

h. Notify State Chairpersons of course or Instructor concerns. Course Directors will not be required to send copies of the scantron evaluations to State Trauma or Pediatric Chairpersons, unless asked to do so by the Chairpersons.

i. Review course evaluations for consideration in planning future courses. j. Maintain a copy of the final course materials, including final participant roster,

final instructor roster, summary performance form, and psychomotor skill station evaluation sheets for participants who were unsuccessful, for a period of six (6) years.

k. Advise and support new Instructors and/or Faculty by providing constructive feedback including maintenance of course integrity and meeting course objectives.

l. When teaching outside his/her home state, the Course Director must inform the State Chairperson that he or she is teaching.

m. Maintain an environment conducive to learning and sensitive to students’ different learning and testing styles. Describe the testing environment at the beginning of the course, and inform students that if issues arise, they must let the course director know.

n. The Course Director must verify current provider status for all Reverification course and Instructor course attendees prior to the course. The ENPC Reverification course will no longer be available after 12/31/2012. The TNCC 6th Ed Reverification course can continue to be offered beyond 12/31/2012; however, no contact hours will be awarded after 12/31/2012.




NOTE: Course Directors may serve solely as a Course Director, or as both Course Director and Instructor. Prior to defining their role, Course Directors should consider potential late schedule changes, Instructor cancellations and Instructor Candidate monitoring.

6. Instructors and Faculty

a. Present lectures and psychomotor skill stations according to the current edition of the Provider Manual and in accordance with the Administrative Procedures.

b. Evaluate psychomotor skill stations according to the current edition of the Provider Manual and in accordance with the Administrative Procedures.

c. Adhere to copyright law in regard to all TNCC and ENPC products. ENA is the sole and exclusive owner of all rights, titles, interests, and all ancillary rights to any and all materials and information pertaining to TNCC and ENPC including translations (including without limitation, copyrights, trademark rights, patent rights, and trade secret rights).

d. Maintain a professional and supportive learning environment. e. Administer the multiple-choice examination as required by the Course Director. f. Complete all documentation as required by the Course Director. g. Ensure the adherence to the Administrative Procedures and security of testing

materials. Report any concerns regarding adherence to the Administrative Procedures to the State Chair or a State Committee member, and ENA Course Operations.

h. If an Instructor teaches in a state where he/she was not monitored, the Instructor should inform the State Chairperson that he or she is teaching.

i. Annually submit a Conflict of Interest Disclosure form to ENA. The form resides on the ENPC and TNCC pages of the ENA website and can be filled out and submitted from that location.

7. Marketing

a. It is important to market TNCC/ ENPC courses well in advance in order to ensure timely identification of course participants. Any marketing materials should clearly identify required course registration dates and deadlines. A clearly identified cancellation policy is also required.

b. The marketing materials must clearly state that only registered nurses (or the equivalent as defined in each country) who successfully complete the course can receive verification status and a Provider card.




i. In the United States, all marketing materials must contain the following ADA (Americans with Disabilities Act) statement: “In accordance with the Americans with Disabilities Act, please advise [insert name] if you have any disability that requires special materials and/or services so that appropriate personnel can be advised.” ii. Use of the ENA TNCC/ENPC logos is strongly encouraged.

8. Co-sponsorship

a. TNCC/ENPC courses may be presented in conjunction with other organizations including State Councils and Chapters, health care facilities, academic institutions, governmental agencies, and product companies. Co-sponsors may provide a source of financial support, equipment, or Instructors to assist in presenting the course. A co-sponsor may not alter the course content.

9. Librarying Manuals

a. All participants must have their own manual (current edition) for use during the course. Manuals cannot be shared during the course. Librarying of books is not allowed because the participants should be able to use the manual as a reference before, during, and after the course.

B. Financial Elements

1. Course Fees—Manuals, Indirect Fees, and Late Fees

a. The fee structure for TNCC/ENPC courses includes the cost of a manual plus an indirect fee.

i. The Course Director is responsible for collecting all fees from participants and submitting timely payment to ENA. Single payments from individual participants should NOT be submitted to ENA.

ii. Payment for manuals must be received by ENA prior to shipment. Course Directors are encouraged to order manuals at least six (6) weeks in advance of the course in order to make certain that participants have sufficient time to read the manual prior to the course. (Note: Once manuals are shipped to the Course Director or designee, they are the responsibility of the Course Director and cannot be returned to the ENA National Office for a refund or credit.)

iii. Indirect fees must be paid within 30 days of course end. A 10% discount will be applied to all indirect fees paid prior to the course start date.

iv. Indirect fees must be paid for all participants, including Auditors and non-RN participants.




v. A late fee will be charged for applications received less than three (3) weeks prior to the course start date.

vi. International countries will follow their contractual arrangements regarding fees.

2. Timely Payment a. All fees must be paid within 30 days of course end. Course Directors with

outstanding invoices 120 days beyond the course date, are subject to suspension of their Course Director status. If a Course Director’s status is suspended and the director’s accounts are not brought current within 150 days of the course date, his or her instructor status may be suspended as well.

3. Course Assessments

a. ENA provides an assessment payment to State Councils for every participant in Provider Courses conducted within the state. The payments are made quarterly. Assessments are paid on the following basis:

i. All post-course materials have been received; and ii. All fees have been paid and the course balance is zero (any credits must

have been refunded or applied to other courses). II. Provider Courses

A. Course Requirements 1. Course Authorization

a. Provider Courses must be conducted within the guidelines described in these Administrative Procedures. Authorization must be obtained from the ENA National Office prior to conducting any course. It is recommended that applications be submitted to the ENA National Office at least eight (8) weeks prior to the course date. Applications received less than three (3) weeks prior to the course start date will be subject to a late fee.

b. International countries must adhere to their contractual agreements.

2. Course Content and Format a. Provider Courses are designed to provide core-level knowledge and psychomotor

skills associated with the delivery of professional nursing care to the pediatric or trauma patient. This content is presented through lectures, online materials, and psychomotor skill stations.

i. While the courses are standardized with specific lectures and skill stations, it is recognized that nursing practice varies among states and countries. Nurse practice acts and institutional policies, which prescribe specific




independent and interdependent nursing activities, must be considered when implementing the described assessments, interventions, and evaluations for specific patients.

b. The use of computerized patient simulators in TNCC/ENPC courses may be a valuable adjunct to teaching and learning. However, each program using a simulator must be approved by ENA in advance. Appendix E outlines the ENA Guidelines for Use of Computerized Patient Simulators.

c. Videoconferencing is an acceptable method for teaching TNCC/ENPC courses, with prior approval from ENA Course Operations. In order to make this method of delivery a quality service, the guidelines outlined in Appendix F must be followed.

d. Provider Courses are designed as minimum 16-hour courses and are most commonly conducted in a two-day format. Internet based course materials may be provided as part of the course format. Supplemental didactic material and/or alternate scheduling formats may be implemented at the discretion of the Course Director provided that the 16-hour core didactic and psychomotor skills are presented. Examples of alternate schedules are courses scheduled over three (3) or four (4) consecutive evenings or over two (2) or three (3) weekends. i. Reverification Provider Courses are commonly completed in one (1) day. The ENPC Reverification course will no longer be available after 12/31/2012. The TNCC 6th Ed Reverification course can continue to be offered beyond 12/31/2012; however, no contact hours will be awarded after 12/31/2012.

e. Pre-tests are included as part of the course format to enhance learning validation.

3. Course Materials a. All participants must have their own Provider Manual (current edition) for use

during the course. Manuals cannot be shared during the course. Librarying of books is not allowed because the participants should be able to use the manual as a reference before, during, and after the course.

b. It is strongly recommended that all students be provided with their course manuals at least 30 days prior to the course.

c. Access to online material, where applicable, will be provided by course directors to participants.

4. Participant-to-Instructor Ratio

a. It is recommended that the participant-to-instructor ratio for psychomotor skill stations be 4:1. The maximum participant-to-instructor ratio may not exceed 6:1. If the ratio is extended from 4:1 to 6:1, the skill station times must be lengthened to allow a minimum of 15 minutes per participant, per station. Instructor




Candidates are not included in the 4:1 or 6:1 ratios. In general, ratios beyond 4:1 are not intended to be planned in advance, but to accommodate last minute changes in instructor availability to avoid course cancellation if a scheduled instructor is unable to teach unexpectedly.

5. Allowable Number of Course Participants

a. Provider Courses will be approved by ENA as long as the application reflects an adequate number of instructors for the number of participants scheduled to take the course. There is no limit to the number of participants that may attend a course; however, the participant-to-instructor ratios must be maintained and adequate equipment must be available. All attendees who are participating in the teaching and testing of the skill stations are included in the student count when calculating the ratio.

6. Participant Requirements

a. Registered nurses (or equivalent as defined in each country outside of the United States) are the only health care providers eligible for TNCC/ENPC verification.

b. Nurses in a variety of clinical areas would benefit from and should be encouraged to take TNCC/ENPC. (see #7 below)

c. Regardless of clinical background, all participants must be encouraged to thoroughly read the TNCC/ENPC Provider Manual prior to the start of the course.

d. To attend a Reverification Course, the participant must be a registered nurse with a current Provider status. The Course Director must verify current provider status for all Reverification Course attendees prior to the course.

The ENPC Reverification course will no longer be available after 12/31/2012. The TNCC 6th Ed Reverification course can continue to be offered beyond 12/31/2012; however, no contact hours will be awarded after 12/31/2012.

7. Non-RN’s as Attendees

Course Directors may elect to allow non-RN participants into a Provider course, at their discretion. If non-RN participants are registered for a particular course, they should not exceed 25% of the total course participants without prior ENA National office permission. There are two types of non-RN participants:

i. Non-RN Healthcare Providers who work in an emergency setting. ii. Auditors, which would primarily be student nurses who do not also work in

an emergency setting as a part of their employment.




a. The following guidelines apply to non-RN Healthcare Providers: (individuals who work in an emergency setting) i. Can participate in the written and skill station portion of the TNCC/ENPC

Provider course as long as the participant-to-instructor ratio is maintained. ii. Should be provided with a Provider manual to facilitate the learning

process.

iii. Must be listed on the non-RN Summary Performance Report as non-RN participants.

iv. Indirect fees must be submitted to ENA for all non-RN Healthcare Provider participants.

v. Will receive a certificate of attendance with the appropriate number of nursing Contact Hours awarded, but will not receive a verification card or verification status. This Certificate of Attendance is a different form than the one provided to RN attendees. The Course Director must request these forms from Course Operations prior to the course.

* Effective with the 4th Edition of the ENPC Provider course, which began on September 1, 2012, non-RN Healthcare Providers who work in an emergency setting can participate in the written and skill station testing portion of the ENPC Provider course. Effective January 2013, the same is true for the TNCC Provider course.

b. The following guidelines apply to Auditors: (individuals who do not work in an emergency setting)

i. Cannot participate in the written and skill station testing portion of the

TNCC/ENPC Provider course. ii. Can participate in the skill station teaching as long as the participant-to-

instructor ratio is maintained. iii. Should be provided with a Provider manual to facilitate the learning

process.

iv. Must be listed on the non-RN Summary Performance Report as non-RN participants.

v. Indirect fees must be submitted to ENA for all Auditors.

vi. Will receive a certificate of attendance with the appropriate number of nursing Contact Hours awarded, but will not receive a verification card or verification status. This Certificate of Attendance is a different form than the one provided to RN attendees. The Course Director must request these forms from Course Operations prior to the course.




8. Continuing Nursing Education Contact Hours a. The Emergency Nurses Association is accredited as a provider of continuing

nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. Contact hours are provided to participants for the portion of the Provider Course they attend regardless of performance during evaluation (see Appendix G, Contact Hour Breakdown for Each Course).

b. Participants will receive Contact Hour certificates from the Course Director at the end of the course. The Course Director will indicate the number of Contact Hours earned by each participant on the Summary Performance Report form.

c The ENPC Reverification course will no longer be available after 12/31/2012. The TNCC 6th Ed Reverification course can continue to be offered beyond 12/31/2012; however, no contact hours will be awarded after 12/31/2012.

B. Verification

1. Provider and Reverification Course Testing Requirements a. The vast majority of participants attend the lectures and the psychomotor skill

station teaching portions of the course prior to the evaluation and testing portion. It is also important that ENPC 4th Ed Provider Course attendees access the online pre-course modules, or borrow the available DVD’s from their course director and complete those materials in order to be successful in the course. Some participants may “challenge the course” at a full 2 day Provider Course by attending only the evaluation and testing portion of the course. Those who successfully challenge the course receive their 4-year verification, but do not qualify for Contact Hours. It is up to the discretion of the Course Director to allow Challengers in a two day Provider Course, and if so, how many. Challengers must be registered for the course so that the proper participant to instructor ratio will be met. Course Directors must submit an indirect fee for Challengers as well.

b. For verification, the participant must complete the following requirements: i. Multiple-Choice Examination

The multiple-choice examination consists of 50 questions. The examination evaluates the acquisition of the content presented in the TNCC/ENPC lectures, course manual, and psychomotor skill stations.

The passing score is 80% (40 correct answers). If a passing score is not achieved, but the participant has successfully completed all psychomotor skill station testing, the participant may complete one (1) retest of a different version of the test.

If a participant wishes to review his or her scored exam, the review must be done at the course, with the appropriate security in place. It is encouraged that the participant has the opportunity to




review their initial test in order to assure that they understand the correct answers to the questions that they missed.

The participant may retake the multiple-choice examination either immediately following the course or within two (2) weeks of the last day of the course. The arrangements are at the discretion of the Course Director.

If the participant is unsuccessful on retest, he/she must register to take another course or to challenge a subsequent course in order to pursue verification status.

ii. Psychomotor Skill Station Evaluation The skill stations are graded based on objective data that are tallied

on the Skills Evaluation Sheet. To successfully pass the skill station, all critical criteria and at least

70% of the total points identified on the evaluation sheet must be demonstrated. Double-starred criteria must be completed during the primary assessment and sequentially. Single-starred criteria must be done before completing the station.

The participant who does not successfully pass one (1) of the psychomotor skill station evaluations but has achieved a passing score on the written exam may be re-evaluated in that skill station once, on a different testing scenario. If there is an alternate testing instructor available, the participant should be tested by a different instructor. If the participant does not successfully pass the evaluation on retest, he/she must register to take another course or to challenge a subsequent course in order to pursue verification status.

iii. If the participant does not achieve a passing score on the multiple-choice examination AND is unsuccessful at one or more skill stations, he or she may not retest at either the multiple-choice examination or the skill stations. He or she must register to take another course or to challenge a subsequent Provider course in order to pursue verification status.

2. Verification Card a. Successful participant RNs will receive a card verifying the successful completion

of the Provider Course. Expiration of verification status will occur four (4) years from the last day of the month in which the course was completed.

3. Instructor Potential a. The Course Directors and Instructors review RN participants’ performances to

determine which participants meet the guidelines for Instructor Potential. It is recommended that the providers be considered for Instructor Potential if they have the following:




i. Achievement of at least 90% on the Provider multiple-choice examination ii. Achievement of at least 85% of total points in each Provider skill station iii. Two years of experience in the nursing care of the trauma or pediatric

patient. iv. Experience in teaching v. Recommendation by more than one (1) instructor (unless there is only one

(1) instructor) b. A Provider Course attendee who passes the Provider Course but does not score at

the Instructor Potential level may not retest just to improve his/her score. c. It is required that the designation of Instructor Potential be formalized in a

recommendation letter furnished by the Provider Course Director to the participant. The participant must submit a copy of the letter when applying for the Instructor Course. Upon successful completion of the Instructor Course, those participants who are designated with Instructor Potential will become Instructor Candidates.

C. Course Director (Provider Course)

1. Course Director Eligibility Criteria

a. Course Directors must meet the following requirements: i. Must be a registered nurse with a current license to practice (or equivalent

as defined by each country outside of the United States); and ii. Must have current TNCC/ENPC Provider and Instructor status; and iii. Must be a current ENA member (or membership in an equivalent

organization defined by country outside of the United States). iv. In addition, it is strongly recommended that the Instructor teach in a

minimum of two (2) Provider Courses prior to becoming mentored as a Course Director.

2. Course Director Requirement a. Once the eligibility criteria are met, the potential Course Director must be

mentored by a current Course Director in at least one Provider Course, prior to the potential Course Director holding his/her own course independently. Both the mentoring Course Director and the potential Course Director must be physically present for the course, and must fill out and sign the Course Director Mentoring form, and submit it to ENA with the post-course materials.

b. Once the Instructor has been mentored as a Course Director in TNCC, for example, the Instructor does not need to be mentored again in the other course, ENPC, for example, in order to move from an ENPC instructor to Course Director.




c. Ongoing communication with the mentoring Course Director is recommended when acting as a first time Course Director.

3. Financial Obligations a. Course Directors are responsible for all course fees. They must maintain their

accounts in good standing. Course Directors with outstanding invoices, 120 days beyond the course date, are subject to suspension of their Course Director status. If a Course Director’s status is suspended and the Director’s accounts are not brought current, within 150 days of the course date, his or her Instructor status may be suspended.

III. Instructor Courses

A. Course Requirements

1. Course Authorization a. Instructor Courses must be conducted within the guidelines described in these

Administrative Procedures. Authorization must be obtained from the ENA National Office prior to conducting any courses. It is recommended that applications be submitted to the ENA National Office at least eight (8) weeks prior to the course date. Applications received less than three (3) weeks prior to the course start date will be subject to a late fee.

b. International countries must adhere to their contractual agreements.

2. Course Content and Format a. The Instructor Course is a one day course, almost always presented in a one-day

format. Additional time will be required for reverification of Provider status, prior to the course start. (Refer to item 7 on Page 21 for specifics). The Instructor Course is designed to prepare Providers with Instructor Potential status to become instructors. The TNCC/ENPC instructor courses emphasize appropriate teaching strategies as well as correct evaluation methods.

3. Course Materials

a. Upon successful pretesting, the Instructor Supplement may be distributed to the participants. All participants must have their own Instructor Supplement (current edition). Supplements cannot be shared. Librarying of books is not allowed. To prepare for the microteaching lecture assignment, the Course Director should provide the Instructor Candidate with the relevant pages from the book, prior to the course.

b. The Instructor Supplement is designed to guide new Instructors on teaching the provider chapter content. The Supplement also includes material to prepare new Instructors with the principles of adult learning, methods for teaching content and




teaching psychomotor skill stations. c. The Supplement defines the expectations of Instructor Candidates and Faculty.

4. Participant-to-Faculty Ratio

a. It is recommended that the participant-to-faculty ratio be 4:1. The maximum participant-to-faculty ratio may not exceed 6:1. Observers and first-time faculty, as defined below under Faculty Status, C.2.a. (page 26), are not included in the 4:1 or 6:1 ratios.

5. Allowable Number of Course Participants

a. Instructor Courses will be approved by ENA as long as the application reflects an adequate number of Faculty for the number of participants scheduled to take the course. There is no limit to the number of participants that may be in a course; however, the participant-to-faculty ratios must be maintained and adequate equipment must be available.

6. Participant Requirements

a. TNCC/ENPC Instructor Courses may be attended by selected registered nurses (or equivalent as defined by another country outside of the United States) with current licenses who are currently verified as TNCC/ ENPC Providers. Instructor Course admission requirements are:

i. A letter furnished by a Provider Course Director stating that the Course Director will assist the participant with the monitoring necessary for completion of Instructor Candidate requirements is required; and

ii. Current TNCC/ENPC Provider status. iii. The letter of recommendation received from the TNCC/ENPC Provider

Course Director indicating Instructor Potential is required and must be forwarded to the Instructor Course Director.

7. Pre-Course Test Requirements

a. Instructor Candidates must reverify as a TNCC/ENPC Provider at the beginning of the Instructor Course they are attending. This includes achieving at least 90% on the Provider multiple-choice examination and achieving at least 85% of the total points on the Provider skill stations. No retests are allowed on either the multiple-choice examination or skill station testing.

b. The only exception to the above pre-testing requirement is an Instructor Candidate who has taken the Provider Course within 90 calendar days of the Instructor Course, and received Instructor Potential status from the Course Director, and scored at the Instructor Potential level on their first attempt, meaning they received a 90% or better on the written exam and an 85% or better on the skill station testing. (No retesting was involved). Any Instructor Candidate meeting




those specific requirements does not need to be pretested. There are no exceptions to this. In order to facilitate this, the Provider Course Director must provide the Instructor Potential attendee with the letter of recommendation that includes his/her scores, to bring to the Instructor Course. The Course Director of the Instructor Course must submit a copy of that form to ENA Course Operations with the Instructor Course post-course materials, along with a separate Summary Performance Report for those attendees who did not need to be pretested. Those Instructor Course attendees, who are not required to pretest, must still complete a test scantron form to ensure that ENA Course Operations has their most current demographic information. Note that an Instructor Candidate who has taken the Provider Course within 90 calendar days of the Instructor Course, and received Instructor Potential status from the Course Director, but did not score at the Instructor Potential level, must participate in the pretesting of the Instructor Course, on both the written test and the skill station testing. All Instructor Candidates who have taken the Provider Course more than 90 calendar days prior to the Instructor Course, must retest regardless of their scores.

c. All pretesting must be done by the Course Director of the Instructor Course, or their designee. All pretesting must be done within the 2 – 4 weeks (maximum of 28 calendar days) prior to the Instructor Course.

d. Note that any participant in an Instructor Course whose provider status is from an earlier edition of the course, MUST successfully pretest prior to the course regardless of whether or not their Provider Course was within 90 days of the Instructor Course.

e. Participants who are unsuccessful in achieving these criteria may not attend the Instructor Course, however their paperwork must be returned with the Instructor Course material. In this circumstance, the ENA National Office will not charge the Instructor Course indirect fee. See the next section regarding the potential for renewed Provider status in the event of unsuccessful pre-course tests.

8. Option in the Event of Unsuccessful Pre-course Tests

a. It is possible for a Provider with Instructor Potential to score too low to warrant continuing in the Instructor Course, but high enough to renew Provider status. In that event, the Provider will have the option to receive a new Provider card.

b. For those participants who are given a new Provider card, the Instructor Course Director must submit a Provider indirect fee to the National ENA Office along with a second Summary Performance Report listing those specific participants awarded Provider status. The National ENA Office will automatically assign a new Provider Course number upon receipt of the performance report.




9. Continuing Nursing Education Contact Hours a. The Emergency Nurses Association is accredited as a provider of continuing

nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. Contact Hours are provided to participants for the portion of the course they attend (see Appendix G: Contact Hour Breakdown for Each Course).

b. Participants will receive Contact Hour certificates from the Course Director at the end of the course. The Course Director will indicate the number of contact hours earned by each participant on the Summary Performance Report Form.

B. Instructor Status

1. Achievement of Instructor Candidate Status a. TNCC/ENPC Instructor Courses require that participants demonstrate their ability

to lecture, teach and evaluate selected psychomotor skill stations. Individuals who successfully complete these Instructor Course requirements become Instructor Candidates.

2. Instructor Candidate Monitoring Requirements a. To become a fully recognized TNCC/ENPC Instructor, the Instructor Candidate

must be successfully evaluated at a subsequent Provider Course within 12 months of the instructor course. The evaluation must be done by a current member of the State Trauma or Pediatric Committee (or of the comparable body for the military and country outside of the United States) who is a TNCC/ENPC Instructor, or a designee of the State Chair or Committee.

b. The candidate must be monitored (mentored) 1:1 during the skill station teaching and evaluation. No one Faculty can monitor more than two Instructor Candidates in a single provider course. The candidate must teach and test the allotted skill station time (a full rotation of at least 4 students).

c. Specifically, to achieve TNCC/ENPC Instructor status, the Instructor Candidate must:

i. Be evaluated while teaching a minimum of two (2) lectures, not all on the same day, (and no more than 3 lectures) during a Provider Course (not a Reverification course); and

ii. Be evaluated while conducting the teaching and testing of the entire skill station in a Provider Course during one (1) full rotation (a minimum of 4 students). For TNCC, the Instructor Candidate will be required to teach and test at the Trauma Nursing Process skill station. For ENPC, the Instructor Candidate is required to teach and test at the Management of the Ill or Injured Pediatric Patient skill station. The Instructor Candidate must teach the other skill stations to a simulated audience.




iii. Complete evaluation and monitoring requirements within those 12 months of successfully completing the Instructor Course. An Instructor Candidate has two (2) attempts within twelve (12) months to be successfully evaluated. On the second attempt, the Instructor Candidate cannot be monitored by the same person who monitored his or her first attempt. If unsuccessful on the second attempt, the Instructor Candidate must retake the Instructor Course if his/her provider status is still current, to continue to pursue Instructor status.

3. Instructor Card a. The ENA National Office will issue an Instructor card when all Instructor

Candidate requirements have been met. 4. Maintenance of Instructor Status

a. Instructors remain verified as Instructors and Providers by participating as an Instructor in at least one (1) Provider Course every 18 months and maintaining an average quality assurance score of 3.0 or greater.

b. Instructors and Course Directors must carefully monitor the dates of their last course taught to maintain eligibility to teach. If there are questions regarding an Instructor’s eligibility, the ENA National Office should be contacted.

5. Updating Instructor Status—Course Revisions a. In the event of a course revision, all Instructors must be updated in order to retain

their Instructor status. The updating process varies depending on what content is revised and the extent of the revisions.

6. Failure to Teach a. An Instructor who has not taught a Provider Course for more than 18 months, and

less than 24 full months, must be remonitored to regain Instructor status. The remonitoring process is the same as for the monitoring of an Instructor Candidate. The Course Director must submit an Instructor Candidate/Instructor Evaluation form as documentation of the remonitoring process. If an Instructor does not meet these requirements, he or she will no longer be verified as an Instructor.

b. An Instructor who has not taught a Provider Course for greater than 24 months must retake the Provider and Instructor Courses and then be successfully monitored as an Instructor Candidate to regain Instructor status.

c. If an Instructor has not taught a Provider Course for greater than 18 months because of military deployment outside of the United States or FMLA, he or she may contact the ENA National Office for an extension (generally consistent with term of leave). If possible, this contact should take place prior to the expiration of the Instructors’ status.




7. Quality Assurance (QA) Scores a. It is expected that Instructors will maintain a composite quality assurance score of

3.0 or higher in order to continue teaching TNCC/ENPC. This score is a compilation of participant evaluation scores from courses submitted to the ENA National Office during the rating period.

b. Course Directors are encouraged to review the quality assurance scores at the end of the course. This will allow Instructors more immediate feedback regarding their performance and the need for remonitoring. Course Directors who identify an Instructor with a quality assurance score less than 3.0 should develop a plan to address the problem in collaboration with the State Trauma or Pediatric Chairperson. This plan should be communicated to the ENA National Office via mail, fax, or e-mail.

c. Semiannually, ENA will make available to the State Trauma or Pediatric Chairs, scores only for those Instructors with cumulative scores less than 3. The Chairpersons will notify the Instructors of the scores and will develop an action plan if a plan or remonitoring schedule has not already been established. Within 60 days of the ENA notice, the State Pediatric or Trauma Chairperson must notify the ENA National Office whether remonitoring or an alternative action plan has been agreed upon.

d. If the Instructor fails to comply with the action plan, he or she will be placed in the suspension/revocation process. The Instructor will be immediately suspended from teaching, pending the outcome of the suspension/revocation process.

e. The remonitoring process is the same as for the monitoring of an Instructor Candidate. The Course Director must submit an Instructor Candidate/Instructor Evaluation form as documentation of the remonitoring process.

f. An Instructor can be remonitored a total of two (2) times. The second time, a different evaluator must do the remonitoring. If unsuccessful on the second attempt, the Instructor will no longer be able to teach TNCC/ENPC.

C. Faculty Status

1. Faculty Eligibility Criteria Definition: Faculty are instructors who teach the Instructor Course.

a. Eligibility criteria for TNCC/ENPC Faculty are: i. Must have current TNCC/ENPC Provider and Instructor status. ii. Must be a current ENA member (or membership in an equivalent

organization defined by country outside of the United States). iii. Must have taught at least four (4) Provider Courses in the past four (4)

years (TNCC or ENPC). iv. Must have served as Course Director in at least two (2) courses in the past

four (4) years.




v. Must have cumulative course evaluation scores of 3.5 or higher in the past year.

2. Faculty Requirements a. Those Instructors who meet the Faculty eligibility requirements and wish to

become Faculty must submit a letter of intent to their State Committee chairperson and/or State Council President. The State Chairperson and/or State Council President must assure that the applicant be given an opportunity to:

i. Observe the next scheduled Instructor Course. If one is not scheduled currently, Faculty applicants may seek a course outside of their home state to complete the observation requirement.

ii. Be supported teaching at a subsequent Instructor Course. If one is not scheduled currently, Faculty applicants may be supported teaching at a course outside of their home state.

b. Once these steps have been successfully completed, the applicant will be granted Faculty status.

c. The ratio of observers to students in an Instructor course is 1 observer to every 2 students.

d. The ratio of first time faculty to students in an Instructor course is 1 first time faculty to every 2 students.

3. Maintenance of Faculty Status a. Faculty must maintain their Instructor status which means they must participate as

an Instructor in at least one (1) Provider Course every 18 months and it is strongly recommended that they participate as Faculty in an at least one (1) Instructor course every 24 months. Faculty must maintain current ENA membership and uphold and adhere to these Administrative Procedures.

4. Updating Faculty Status—Course Revisions a. In the event of a course revision, all Instructors must be updated in order to retain

their Instructor status. The updating process varies depending on what content is revised and the extent of the revisions. There may or may not be an additional step to complete for faculty.

D. Bridging

1. Instructors

a. Instructor bridging is the process whereby an Instructor in one course can become an Instructor in the other course by meeting eligibility criteria and completing pretesting, course and teaching requirements.

b. TNCC Instructors must meet eligibility criteria to bridge to ENPC Instructors and likewise, ENPC Instructors must meet eligibility criteria to bridge to TNCC




Instructors. c. Eligibility criteria for Instructors bridging from one course to another are:

i. Their Instructor status must be current; and ii. Their Provider status must be current in the course to which they are

bridging. d. Eligible Instructors must complete the following requirements in order to bridge:

i. Reverify as a Provider in an Instructor course to which they are bridging. This includes achieving at least 90% on the Provider multiple-choice examination and achieving at least 85% of the total points on the Provider skill stations. No retests will be allowed on either the multiple-choice examination or skill station testing. The pretesting requirements are the same as defined in Section III. A. 7 (page 21).

ii. Attend the Psychomotor Skill Station Review and Psychomotor Skill

Station Teaching sections (content) of an Instructor Course, be included in all course documentation; and

iii. Be monitored as an Instructor Candidate following the guidelines listed in these Administrative Procedures, Section III.B.2 (page 23).

2. Faculty

a. Faculty bridging is the process whereby Faculty in one course can become Faculty in the other course by meeting eligibility criteria and completing course and teaching requirements.

b. TNCC Faculty must meet eligibility criteria to bridge to ENPC Faculty and likewise, ENPC Faculty must meet eligibility criteria to bridge to TNCC Faculty.

c. Eligibility criteria for Faculty bridging from one course to another are: i. Their Faculty status must be current; ii. Their Provider and Instructor status must be current in the course to which

they are bridging; iii. They must have served as a Course Director in the course from which they

are bridging in at least two (2) courses within the past four (4) years; and iv. Their cumulative course evaluation scores for both courses must be 3.5 or

higher in the past year. d. Those Faculty who meet the bridging Faculty eligibility requirements and wish to

become Faculty in the second course, must submit a letter of intent to their State Committee Chairperson and/or State Council President.

e. Eligible Faculty must be mentored teaching in an Instructor Course to which they are bridging in order to complete the Faculty bridging process. This eligible Faculty person being mentored teaching, is considered first time Faculty, and does not count in the participant to faculty ratio for the course.




E. Course Director (Instructor Course)

1. Course Director Qualifications a. Course Directors for Instructor Courses must meet the following requirements:

i. Must be a registered nurse with a current license to practice (or equivalent as defined by each country outside of the United States);

ii. Must have current TNCC/ENPC Provider and Instructor status; iii. Must be a current ENA member (or membership in an equivalent

organization defined by country outside of the United States); and iv. Must have served as full Faculty in at least one prior Instructor Course.

2. Financial Obligations

a. Course Directors are responsible for all course fees. They must maintain their accounts in good standing. Course Directors with delinquent accounts are subject to suspension of their Course Director status. If a Course Director’s status is suspended and the Director’s accounts are not brought current, his or her Faculty/Instructor status may be suspended as well.

IV. International Dissemination

ENA approves all TNCC/ENPC course applications for both Provider and Instructor courses. No courses will be held without prior ENA approval.

A. Contracts

1. International dissemination is governed by a contract between ENA and the sponsoring organization of the host country. All international courses must be approved in advance by the two parties to the contract.

B. Course Director/Instructor Selection Criteria

1. ENA will assemble dissemination teams per contract requirements with the host country. There will be an annual call for interested Faculty to apply to be considered for dissemination teams. Those applicants will be reviewed. The dissemination team will consist of Faculty chosen on the basis of the following criteria:

a. All team members must be experienced Faculty. b. All team members must demonstrate a consistent history of representing ENA in a

positive and professional manner. c. All team members must be Faculty who have preferably taught in an Instructor

Course within the past 24 months. d. All team members must have maintained a cumulative score of 3.0 or more on

both Provider and Instructor Course evaluations.




e. The dissemination team will preferably have no more than two new members. f. The Board liaison to the Course Administration Faculty Committee will be the

contact person for the team while it is on international assignment. g. All team members are appointed by the ENA President and ratified by the ENA

Board of Directors. h. All team leaders preferably will have experience teaching in two international

disseminations. i. For the first-time leader, the team preferably will include a past team leader as a

resource. 2. There will be an action report completed and submitted to ENA Course Operations

within 30 calendar days of the completion of the dissemination trip, by each team member and the team leader.

C. Translation Guidelines

1. If a country wishes to translate the course materials, it must be done at that country’s

expense. Permission to translate must be given by ENA. ENA holds the copyright to all translated materials.

2. It is recommended that translation of the course materials proceed in the following order:

a. Exam and skill station checklists b. Audiovisual materials c. Textbook

D. Countries with financial limitations, as defined by the World Bank, may contact ENA for further information.

E. International courses held outside of the dissemination process, must be approved in advance

by ENA. This would include a one-time provider course held by an approved Course Director, in a country that does not have a current contract with ENA. Instructor courses cannot be held in countries that do not have a current contract with ENA, unless it is a Military course held for Military RN’s.




V. Appendices

Appendix A: Procedure for Suspension/Revocation of TNCC/ENPC Provider and/or Instructor Status Appendix B: Sample Email Text from Committee Member to Course Director Regarding Designee Appointment

Appendix C: Course Director Provider Course Activities Appendix D: Course Director Instructor Course Activities Appendix E: Guidelines for Use of Computerized Patient Simulators in TNCC/ENPC Courses Appendix F: Guidelines for Videoconferencing of TNCC/ENPC Appendix G: Contact Hour Breakdown for Each Course Appendix H: Thirty Day ENPC/TNCC Book Receipt Waiver




Appendix A: Procedure for Suspension/Revocation of Trauma Nursing Core Course/Emergency Nursing Pediatric Course Provider and/or Instructor Status

1. In order to ensure the integrity of the Trauma Nursing Core Course (TNCC) and the Emergency Nursing Pediatric Course (ENPC), the Emergency Nurses Association (ENA) reserves the right to take disciplinary action against Providers, Instructors, or individuals seeking verification from the ENA for a valid cause.

2. The ENA’s TNCC or ENPC verification card and course related teaching materials

remain the property of the ENA and must be returned if the verification or Instructor status is withdrawn for cause. The Provider and/or Instructor number will be invalidated.

3. Cause for suspension or revocation of Provider or Instructor status could include, but are

not limited to:

a. Revocation, suspension, or restriction of professional registered nurse license, or equivalent as defined by another country outside of the United States, by nursing licensure authority.

b. Falsification of the TNCC or ENPC application, or any other TNCC- or ENPC-related information submitted to the ENA.

c. Failure to follow the TNCC/ENPC Administrative Procedures in the proper instruction and administration of the course.

d. Cheating on the TNCC or ENPC multiple-choice examination or psychomotor skills stations.

e. Utilization of the TNCC or ENPC content and/or audiovisual materials for other purposes outside of the course, without obtaining prior written consent from the ENA national office.

f. Unprofessional conduct or compromise to course integrity (including, but not limited to: a lack of test security, inappropriate language or supplemental materials).

4. The following steps will occur when a written complaint is received that is serious in

nature, such as the reasons above:

a. ENA National will investigate the allegation. b. The individual in question will be notified in writing by traceable mail and email,

that the ENA has received evidence of cause for suspension or revocation of verification. This notification will describe the reported cause. The notification shall request the individual to submit in writing within 20 business days of




notification, any evidence or argument concerning the proposed suspension or revocation of Provider or Instructor status.

c. Once the response is received, ENA National will perform any additional investigation required.

d. In addition to the original complaint, the evidence or argument will be reviewed by a task force composed of the following: (1) the Chairperson of Course Administration Faculty, (2) the Course Administration Faculty Board Liaison, and (3) an additional member of Course Administration Faculty.

5. Once the task force has reached a decision following their review, the individual will be

notified by traceable mail and email, regarding the decision of the task force. A copy of the decision will be sent to the State President and the State Trauma Chairperson or the State Pediatric Chairperson. This notice shall include a statement setting forth the reason for the decision, terms of suspension or revocation, and terms for reinstatement (if applicable). If the task force determines the need to suspend the individual’s Provider or Instructor status, the task force will forward information regarding the task force review and appeal process, which is attached to this Procedure for Suspension/Revocation of TNCC/ENPC Provider and/or Instructor status.

6. Any individual who wishes to appeal a decision of the task force must do so according

to the established review and appeal process. During the appeal process the decision of the task force will be upheld.

7. Noncompliance with the decision of a task force will result in further disciplinary action

up to and including permanent revocation of instructor, course director, and/or faculty status. No appeal is available at this point.

8. International countries and the military may develop their own suspension/revocation

and appeal processes using the above guidelines as a minimum standard.




Review and Appeal Process Under certain circumstances, as previously stated, Provider or Instructor status may be suspended or revoked. This review and appeal process has been developed for individuals seeking reconsideration or reversal of a decision regarding suspension or revocation of Provider or Instructor status. This process is conducted by an Appeal Committee directly with the individual who requests the appeal. The Appeal Committee will consist of five (5) individuals, whose main purpose is to ensure an impartial appeals procedure. The members of the Appeal Committee shall be qualified, through education and experience, to serve on the Committee to review individual decisions regarding verification. The ENA grants to the Appeal Committee full and final authority to suspend, revoke, or reinstate TNCC or ENPC Provider or Instructor status.

I. Circumstance for Review and Appeal

A. The appeal process is available to any individual seeking reconsideration or reversal of a suspension/revocation decision. However, any individual whose Provider or Instructor status has been revoked or suspended because of denial, revocation, or suspension of the individual’s professional license by the state, provincial, or national licensure agency, shall have no right to pursue an appeal.

II. Request for Appeal

A. Any individual who wishes to appeal a decision of the task force that suspended or revoked his or her TNCC or ENPC Provider or Instructor status must submit a written request for an appeal, which must be signed by the individual and include the following:

1. A statement of the individual’s reasons for believing that the decision was incorrect, along with six (6) copies of any supporting materials or documentation.

2. Desired outcome.

B. The statement must be sent by traceable mail to the ENA national office, to the attention of the Director, Member and Course Services. This request must be postmarked within 10 business days after receipt of the traceable letter / email regarding suspension or revocation. Any materials not postmarked within this 10-day period will not be considered in the review and appeal process.

III. Selection of Appeal Committee

A. The Appeal Committee will be appointed by the ENA President and Course Administration Faculty Chairperson.

B. If any member of the committee is affiliated with the appealing individual, or has any conflict of interest, a substitute member will be appointed.




IV. Appeal Committee Composition

A. The Appeal Committee will consist of five (5) individuals: a Chairperson and four (4) other voting members. The Chairperson will be the Chairperson of the Course Administration Faculty. The members of the Appeal Committee shall be qualified, through education and experience, to serve on the Committee to review individual decisions regarding verification. All details of the case will be held in strict confidence. Confidentiality statements will be signed by appeals committee members.

V. Appeal Process

A. If the individual (appellant) desires an opportunity to address the Appeal Committee in person, the appellant may do so, but he or she must bear the cost of such in-person review. The appellant can contact the ENA national office for an estimate of such cost. If the appellant desires an in-person review, such a request must be included with the statement of the appellant, described in this paragraph. The appellant can request a conference call with the Appeal Committee, which ENA will provide.

B. ENA staff member(s) may be present to moderate and observe as requested by the Appeal

Committee. C. The Board liaison to the Course Administration Faculty may be present on the call and speak

if requested. D. In advance of the review, all supporting materials for the case will be sent to the Appeal

Committee by the Director, Course and Member Services. E. An appellant may be represented by legal counsel at any meeting the appellant addresses the

Appeal Committee, whether in person or conducted by conference call. F. After receipt of a request for an appeal and the selection of the Appeal Committee, the Appeal

Committee will consider the case as soon as practical. G. At the request of individual members of the Appeal Committee, the Appeal Committee

Chairperson may submit additional questions in writing to the appellant. The appellant will have the opportunity to respond in writing.

H. The members of the Appeal Committee will review each case and reach a majority decision. I. The decision of the Appeal Committee will be final. There will be no appeal of the final

decision.




J. The Chairperson of the Course Administration Faculty will send the appellant its decision in writing by traceable mail and email, as soon as is practical after the review. The ENA President, the State Council President, and State Trauma or Pediatric Chairperson will be sent a written report by regular mail and email within the same time period.

K. Noncompliance with the decision of the Appeal Committee will result in further disciplinary

action up to and including permanent revocation of Instructor, Course Director, and/or Faculty status. No appeal is available at this point.

L. Written materials considered in the Appeal Process and written decisions of the Appeal

Committee will be retained in the ENA office beyond the term of the final decision. M. During the Appeals process, the original decision of the task force must be followed.




Appendix B: Email Text from Committee Member to Course Director Regarding Designee Appointment

SAMPLE:

SUBJECT LINE: Delegation of Instructor Monitoring TEXT MESSAGE: Dear [insert Course Director’s name]: [insert designee name] will be attending your TNCC/ENPC to monitor the Instructor Candidates on [insert dates]. Sincerely, [insert name] SEND COPY TO: cc: [insert designee name] on [insert dates]




Appendix C: Course Director Provider Course Activities

1. Pre-course Activities

a. Identifies Instructor Candidates and Instructors requiring monitoring. Notifies the Trauma or Pediatric Committee of the need to have a committee member or designee present at the course in order to evaluate Instructor Candidates or monitor instructors.

b. Selects the course site and dates. c. Selects qualified instructors. d. Assigns lectures and psychomotor skill stations to instructors. e. Ensures the rotation schedule for psychomotor skill stations is maintained at the

ratio of four (4) participants per one (1) Instructor (4:1). The ratio can be extended to six (6) participants per one (1) Instructor (6:1) if necessary. The skill station times must be lengthened to allow a minimum of 15 minutes per participant per station. Also ensure that Instructor Candidates are scheduled to teach and test a minimum of 4 students, while being monitored in accordance with these Administrative Procedures.

f. Facilitates the registration process. g. Prints and disseminates course schedule. h. Compiles all pre-course and post-course documentation.

2. Pre-course Activities: Eight (8) Weeks (or greater) Prior to Course

a. Completes and sends an application form to the ENA at least eight (8) weeks prior to the course. Applications received 21 days or less prior to the course will be charged a late fee.

i. Manuals will be sent to the Course Director or designee who assumes responsibility for providing manuals, course schedule and location information to participants. All manuals must be paid for prior to shipping. It is strongly recommended that all students be provided with their course manuals at least 30 days prior to the course.

ii. Any registrants admitted per course director discretion after the 30 day manual deadline will sign a waiver acknowledging their acceptance of the late manual distribution along with the receipt date of the book. See Appendix H for a 30-day book receipt waiver document.




iii. Once manuals are shipped to the Course Director or designee, they are the responsibility of the Course Director and cannot be returned to the ENA National Office for a refund or credit.

b. Provides for the security of registration fees. It is recommended that a nonrefundable fee policy be developed to cover the costs the Course Director may incur with late cancellations (including manual fee and indirect fee).

c. For ENPC 4th Edition Provider Courses only, identifies the course participants by utilizing eCourseOps, or submitting a form to Course Operations, so that emails will be sent to all participants with the link to the pre-course modules required to be completed, on ENA’s Center for eLearning.

d. Arranges for availability of equipment and patient models, if used. e. Arranges breaks and meal support, as needed. f. Assigns participants to psychomotor skill group assignment. g. Prepares Contact Hour certificates. h. Copies paperwork for course. i. Distributes or mails course schedule and location to Instructors; meets with

Instructors and models as needed. j. Ensures adequate equipment and supplies. If live models will be used at skill

stations, prepares instructions for the models to use. k. The Course Director must verify current Provider status for all Reverification

course attendees prior to the course.

The ENPC Reverification course will no longer be available after 12/31/2012. The TNCC 6th Ed Reverification course can continue to be offered beyond 12/31/2012; however, no contact hours will be awarded after 12/31/2012.

3. Course Activities: Day of the Course – the following activities must be performed

by the Course Director or Co-Director unless otherwise indicated. a. Welcomes participants and provides an overview of the participant expectations b. Examines the facilities and meets with Instructors to ensure course readiness.

Checks lecture classroom to ensure correct set-up and availability of equipment. c. Verifies availability of refreshments, as needed. (May be delegated) d. For ENPC 4th Edition Provider Courses only, collects a copy of the certificates

that the participants received following the completion of the online pre-course modules.

e. Ensures adherence to time schedule.




f. Instructs participants to complete course -evaluations/multiple-choice examination sheets and all psychomotor skill station evaluation sheets. It is important to ensure that all documents are completed and legible with no abbreviations.

i. Course evaluation sheets must be separated from the multiple choice sheet prior to handing them out to the participants to ensure confidentiality on the evaluations. The alternative to that is to instruct the students to tear them apart before turning them in.

ii. All participants must complete the demographic information on the course evaluation/multiple-choice examination answer sheet for the ENA National Office to maintain TNCC or ENPC data records. It should be stressed to the participants that they must complete the demographic information legibly and completely, without abbreviations.

g. Collects and counts all multiple-choice examinations to ensure that all have been returned.

h. Notifies participants of individual course performance. Coaches and counsels unsuccessful participants.

i. Manages any conflicts that may occur involving either participants or instructors. j. Completes and distributes Contact Hour certificates to all participants. k. Conducts reteaching and evaluation sessions, as needed. (May be delegated) l. Completes the Summary Performance Report form. m. Conducts a post-course meeting with Instructors to review Instructor and

participants’ performances and determine which participants have successfully completed the course.

n. Determine which participants meet the guidelines for Instructor Potential. (This does not have to be done on the day of the course.) Completes the appropriate form and distributes to the participant.

4. Post-course Activities: Within 30 Days of Course

a. Returns the following post-course materials to the ENA National Office via a traceable delivery service (i.e., UPS, certified mail, etc.):

i. All course Evaluation/Multiple-Choice examination answer sheets (all demographic information completed)

ii. Summary Performance Report Form and Course Roster iii. Final Faculty Roster iv. Instructor Candidate/Instructor Evaluation Forms, as necessary v. Appropriate retest materials once all retests are completed. Do not

withhold returning the course materials while waiting to complete any retests. Please make sure the course number is on all returned materials.




vi. Any additional applicable forms such as Course Director mentoring form, or change in Course Director form.

b. Submits payment for unpaid indirect fees and any other charges outstanding for the course. Materials and payment must be received at the ENA National Office within 30 days from the end date of the course.

c. Forwards a copy of the Provider Course Summary Performance Report to the State Trauma or Pediatric Chairperson.

d. Keeps copy of course paperwork for 6 years. This should include, at a minimum, the final faculty roster, the summary performance report, and any instructor candidate monitoring forms or Course Director mentoring forms. Ideally, a copy of all paperwork should be kept.




Appendix D: Course Director Instructor Course Activities

1. Pre-course Activities: Eight (8) weeks (or greater) Prior to Course a. Selects the course site and dates. b. Completes and sends application form for TNCC or ENPC Instructor Course to

ENA. i. Manuals will be sent to the Course Director or designee, who assumes

responsibility for providing manuals, course schedule and location information to participants. Manuals are shipped once payment is received. The Instructor’s Supplement must be provided to the Instructor course participants after they have successfully passed the pre-testing with a 90+ on the written test, and an 85%+ on the tested skill station.

ii. Once manuals are shipped to the Course Director or designee, they are the responsibility of the Course Director and cannot be returned to the ENA National Office for a refund or credit.

c. Selects qualified Faculty to maintain the required ratio. d. Selects Faculty observer candidates and/or first time Faculty to maintain the

required ratio. e. Instructor course attendees must reverify as a TNCC or ENPC Provider at the

beginning of the Instructor Course they are attending. No retests will be allowed on either the multiple-choice examination or skill station testing. They must pass with a 90+ on the written test, and an 85%+ on the tested skill station. Pre-testing may be done in the previous 2 to 4 weeks prior to the Instructor course, but no more than 28 calendar days in advance.

f. Assigns specific lectures and psychomotor skill stations to Faculty. g. Arranges for availability of equipment. h. Arranges breaks and meal support, as needed. i. Assigns participants to small groups. j. Assigns appropriate sections for microteaching exercise sections to candidates. k. The course director must verify current provider status for all Instructor course

attendees prior to the course. l. Facilitates the registration process. m. Prepares all course related paperwork including contact hour certificates.




2. Course Activities: Day of the Course

a. Checks facilities and Faculty to ensure course readiness. b. Ensures that time schedule is followed. c. Provides participants with course evaluation forms and collects the completed

forms. d. Completes and distributes contact hour certificates. e. Facilitates a post-course Faculty meeting or post-course communication to review

participants’ performances.

3. Post-course Activities: Within 30 Days of Course a. Returns material to ENA (see Instructor Course post-course checklist in the

Instructor Manual or in the Course Director only section of the ENA web site). b. Submits payment for indirect fees and any other charges made payable to ENA,

Course Operations. Include Course Director’s name, course number, and date of TNCC or ENPC Instructor courses. Materials and payment must be received at the ENA National Office within 30 calendar days from the end date of the course.

c. Reimburses Faculty and pays all bills.




Appendix E: Guidelines for Use of Computerized Patient Simulators in TNCC/ENPC Courses

1. The use of computerized patient simulators in TNCC/ENPC courses may be a valuable adjunct to teaching and learning. However, each program using a simulator must be approved by ENA in advance. The following guidelines will be used when considering proposals.

a. Any use of computerized patient manikins/simulators (or any other term signifying the same type of product) during a TNCC/ENPC course must be approved by ENA in advance.

b. The computerized program must be contained within a manikin; no other format or version is acceptable (i.e., no computer screen simulations).

c. The simulator may only be used for teaching and testing the patient scenario stations (Trauma Nursing Process and Management of the Critically Ill or Injured Pediatric Patient stations). In all cases, the information as provided in the TNCC/ENPC scenarios must be entered into, and reproduced by, the simulator exactly as stated in the scenarios.

d. Permission must be obtained from ENA before the computerization of the scenarios has actually been carried out.

e. ENA may exercise the right to examine the computerized simulation and/or courses delivered using the simulator at any time.

f. ENA retains all rights to the TNCC/ENPC scenarios. g. Computerized scenarios may never be given, sold, or shared with other programs

unless specifically approved by ENA. h. All other Administrative Procedures regarding the conduct of TNCC/ENPC

courses will apply to courses employing computerized simulator technology.




Appendix F: Guidelines for Videoconferencing of TNCC/ENPC

1. Video conferencing is an acceptable method for teaching TNCC/ENPC courses. In order to make this method of delivery a quality service the following guidelines must be followed.

a. All Administrative Procedures and policies and course scheduling are the same as original TNCC/ENPC teaching format and regulations.

b. A qualified TNCC/ENPC Instructor MUST be present at each site to coordinate materials, trouble shoot technical problems, answer questions, and to conduct testing and skill stations.

c. The 4:1 participant- to-instructor ratio must be present at each site. The 6:1 participant-to-instructor ratio is not allowed during videoconferencing.

d. A direct phone number from the satellite site to the origination site must be designated before the class and available throughout the course.

e. If any problems occur with transmission of the audio and/or video, the Instructor present at the site will be expected to complete the course presentation or segments until proper connections are re-established. Re-scheduling the lost components of the course is permissible and encouraged.

f. A written agreement between the Course Director and the site Instructors is recommended. This agreement should outline expectations of the Course Director and site Instructors and provide guidelines for dealing with any unexpected and unforeseen technical difficulties.

g. It is the responsibility of the Course Director to make sure the correct course materials are sent to the site coordinators.

h. It is the responsibility of the Course Director to collate the evaluation and testing materials from all the sites and forward the information to ENA.

i. Video reproduction of the videoconference or any rebroadcasting of the conference is strictly prohibited.




Appendix G: Contact Hour Breakdown for Each Course

Sample Two-Day Provider Course Schedule and Contact Hours – ENPC 4th Edition Time Minutes CE Hours Title Clinical Other Pediatrics

Pre-course 15 0.25 Pain X X Pre-course 25 0.42 Toxicological Emergencies X X Pre-course 20 0.33 Environmental Emergencies X X Pre-course 15 0.25 Stabilization and Transport X X Pre-course total CE Hours 1.25

Time Minutes Title Clinical Other Pediatrics

0800-0845 45 0.75 From the Start X X 0845-0930 45 0.75 Initial Assessment X X 0930-0945 15 Break 0945-1145 120 2 Clinical Considerations (x8 vignettes at 15 min each) X X 1145-1230 45 0.75 Respiratory Emergencies X X 1230-1300 30 Lunch 1300-1400 60 1 Trauma X X 1400-1445 45 0.75 Shock X X 1445-1500 15 Break 1500-1545 45 0.75 Prioritization X X 1545-1600 15 0.25 Demonstration of Ill and Injured Station X X 1600-1800 120 2 Ill and Injured Stations (x8 scenarios at 15 min each) X X

Day One total CE Hours 9 Time Minutes Title Clinical Other Pediatrics

0730-0745 15 0.25 Question and Answer X X 0745-0815 30 0.5 The Adolescent X X 0815-0845 30 0.5 Rhythm Disturbances X X 0845-0915 30 0.5 Disaster X X 0915-0930 15 Break 0930-1000 30 0.5 The Neonate X X 1000-1030 30 0.5 Behavioral Emergencies X X 1030-1100 30 0.5 Child Maltreatment X X 1100-1115 15 Break 1115-1215 60 1 Childhood Illness X X 1215-1230 15 0.25 Crisis X X 1230-1330 60 Lunch 1330-1500 90 1.5 Testing (written exam/Ill and Injured) X X 1500-1600 60 Dissemination of results/Retesting

Day Two total CE Hours 6 Total CE Hours by Category for 2-days and Pre-course: 16 0.25 16.25

Total CE Hours for 2-day course and Pre-course: 16.25




Sample Instructor Course Schedule with Contact Hours

ENPC 4th Edition Time Minutes Contact

Hours Title Clinical Other Pediatrics

Section I: Strategies for Teaching

0800–0815 15 0.25 Introduction X 0815–0930 75 1.25 Teaching ENPC

(Chapter 1) X

0930–0945 15 0 Break

Section II: Tools for Teaching 0945–1100 75 1.25 Microteaching Exercise

(Chapter 2) X

1100–1115 15 0 Break 1115–1245 90 1.5 Teaching the Prioritization

Lecture (Chapter 3) and Psychomotor Skill Station Review (Chapter 4)

X

1245–1315 30 0 Lunch 1315–1415 60 1 Psychomotor Skill Station

Review (cont.). X

1415–1425 10 0 Break

Section III: Teaching and Evaluating Psychomotor Skill Stations 1425–1525 60 1 Psychomotor Skill Station

Teaching (Chapter 5) X

1525–1530 5 0 Break 1530–1630 60 1 Evaluating a Psychomotor Skill

Station (Chapter 6) X

Section IV: Conducting an ENPC Provider Course 1630–1730 60 1 Coordinating an ENPC Provider

Course (Chapter 7) X

Total Contact Hours: 8.25 8.25




TRAUMA NURSING CORE COURSE (TNCC)

Provider Course 6th Edition Contact Hours (Calculated January 2007)

Lecture Time Allotted Contact Hours

Clinical Other

Introduction: Trauma Nursing Core Course and Trauma Nursing 10

0.17 X

Epidemiology, Biomechanics, and Mechanisms of Injury (not taught)

N/A N/A X

Initial Assessment 40 0.67 X Airway and Ventilation 30 0.50 X Shock 30 0.50 X Brain and Cranial Trauma 45 0.75 X Ocular, Maxillofacial, and Neck Trauma 30 0.50 X Thoracic Neck Trauma 30 0.50 X Demonstration of Trauma Nursing Process Station 30 0.50 X Skill Station Teaching Trauma Nursing Process A–C Trauma Nursing Process D–E Airway and Ventilation Teaching Stations Spinal Protection, Helmet Removal, and Splinting

Teaching Station

240 4.0 X

Abdominal Trauma 20 0.33 X Spinal Cord and Vertebral Column Trauma 30 0.5 X Musculoskeletal Trauma 30 0.5 X Surface and Burn Trauma 30 0.50 X Special Populations: Pregnant, Pediatric, and Older Adult Trauma 40

0.67

X

Disaster Management (40 min.) & Triage Exercise (20 min.) 60

1.0

X

Psychosocial Aspects of Trauma Care 30 0.50 X Transition of Care for the Trauma Patient 20 0.33 X Skill station testing, written exam 120 2.0 X

TOTAL 865 14.42




TRAUMA NURSING CORE COURSE (TNCC) Instructor Course

6th Edition Contact Hours (Calculated January 2007)

Lecture Time Allotted

Contact Hours Clinical Other

Teaching ENPC or TNCC (Chapter 1)

75 1.25 X

Microteaching Exercise (Chapter 2)

75 1.25 X

Psychomotor Skill Station Review and Teaching (Chapter 3)

180 3.0 X

Course Evaluation (Chapter 4)

60 1.0 X

Coordinating the ENPC or TNCC Provider (Chapter 5)

60 1.0 X

TOTAL 450 7.5




TRAUMA NURSING CORE COURSE (TNCC) Reverification Course

6th Edition Contact Hours (Calculated June 2009)

Lecture Time Allotted Contact Hours Clinical Other Introductions and Plan for the Day N/A N/A Reverification Course Lecture 210 0 X Pretest Review 30 0 X TNP and Helmet Removal Video 30 0 X Skill Station Review 180 0 X Skill Station Testing, Written Exam 75 0 X

TOTAL 466 0




Appendix H:

TNCC/ENPC Book Receipt Waiver

I, _____________________________________________, acknowledge that I am not receiving [PRINT NAME] my TNCC or ENPC manual thirty (30) days in advance of the class being held on _______________________ at ____________________________. I understand I am receiving [DATE OF CLASS] [LOCATION OF CLASS]

my book ____________________ days prior to participating in the class. I acknowledge it is my [ENTER NUMBER]

responsibility to read the book (including all chapter and skill station materials) prior to the

class in order to be prepared to attend and participate. I understand that I will receive

Contact Hours for the class, but will only receive a provider verification card upon

successful completion of the class.

________________________________ ________________

PARTICIPANT SIGNATURE DATE

________________________________ ________________

COURSE DIRECTOR DATE

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