1. Graebe, Jennifer MSN, RN, NEA-BC


In this month's Magnet Perspectives column, the director of Primary and Joint Accreditation for the American Nurses Credentialing Center reflects on the importance of continuing professional development for the chief nursing officer (CNO), the nurses, and the healthcare team the CNO leads, as well as the impact on patients.


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The healthcare environment remains unpredictable and dynamic, placing significant demands on the nursing workforce. The Quadruple Aim, as an expanded version of the Institute for Healthcare Improvement's Triple Aim, highlights the need to focus on care of the provider in order to effectively care for patients.1 One approach to caring for the provider is investing in continuing professional development (CPD).2

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Nurses and other members of the healthcare team must engage in CPD to deliver safe, high-quality care that positively impacts patient outcomes and to support achieving organizational goals such as improving nurse retention, patient satisfaction, and collaborative practice. Investing in CPD for nurses and other members of the healthcare team can improve the patient experience, increase resilience, and foster the delivery of safer, more efficient care at a lower cost.3 The American Nurses Credentialing Center's Magnet Recognition Program(C) requires organizations to provide evidence related to CPD for their nurses and the impact on patient and population outcomes, interprofessional education, and collaborative practice (Figure 1).4 Magnet(R) chief nursing officers (CNOs) are in a unique position to leverage CPD as an opportunity to both meet Magnet criteria and meet their organization's strategic goals.

Figure 1 - Click to enlarge in new windowFigure 1. Magnet program requirements related to continued professional development.

In 2010, the Institute of Medicine (IOM) released The Future of Nursing,5 charging nurses to lead change and assume critical roles in advancing health within the United States. In 2016, the IOM released a follow-up report detailing the progress achieved in response to the Future of Nursing recommendations.6 The follow-up report recommended that healthcare organizations invest in lifelong learning for their professional workforce, including making CPD an organizational priority. Lifelong learning was noted as a strategy to improve patient outcomes, increase cost savings, and increase job satisfaction; however, the follow-up report noted little progress had been made. In addition, the report described barriers for healthcare professionals to engage in lifelong learning, including lack of commitment from organizations for programming including financial support and an undervalued understanding of CPD.6 The follow-up report indicated that nurses should collaborate with other healthcare professionals and engage in interprofessional continuing education (IPCE) to develop and enhance team-based practice skills. IPCE provides nurses and other healthcare providers the opportunity to "learn from, and with and about each other."7 CPD enables nurses and all members of the healthcare team to learn and grow; to improve knowledge, skills/competence, and/or practice; and to positively impact patient outcomes.8 CPD should be implemented within a strategic context as it supports the professional practice of nurses to deliver safe, evidence-based, high-quality care. Strategic analysis and thinking are critical processes that are outcome driven to determine a preferred future (current state vs desired state). It is crucial that CPD be strategic and tied to professional practice gaps that are meaningful and relevant to nurses and to the organization. For example, nurses on a unit with high fall rates are more motivated to engage in CPD that is designed to address root causes of falls. In comparison, nurses who are not on units with high fall rates are not likely to find educational activities designed to address those gaps as meaningful or relevant. In addition, requiring all nurses to engage in "mandatory" education may not achieve desired results and can result in an inappropriate allocation of resources. For instance, if fall rates on some nursing units are low, those nurses likely do not need extensive fall prevention education. Nurses on units with high fall rates, however, may require a more comprehensive educational intervention to increase knowledge, plus role play or return demonstration to increase skills. Many times organizations focus on "mandatory" or "annual" education without analyzing or addressing professional practice gaps. Educational activities may be designed as the solution to a practice issue or problem, but without a root-cause analysis, there is no opportunity to prevent the issue from reoccurring or address if the actual cause was related to a lack of knowledge, skill, and/or practice that the education might address.


Magnet CNOs who invest in CPD and IPCE promote participation in lifelong learning as an organizational priority and create a positive work and learning environment. Magnet CNOs have the opportunity to align CPD initiatives with their organization's strategic planning processes to ensure that the investment in education has a positive return on investment.




1. Bodenheimer T, Sinsky C. From Triple to Quadruple Aim: care of the patient requires care of the provider. Ann Fam Med. 2014;12(6):573-576. [Context Link]


2. Cox M, Blouin A, Cuff , Paniagua M, Phillips S, Vlasses P. The role of accreditation in achieving the Quadruple Aim. The National Academy of Medicine, 2017. October 2017. Accessed May 1, 2018. [Context Link]


3. McMahon GT. The leadership case for investing in continuing professional development. Acad Med. 2017;92(8):1075-77. [Context Link]


4. American Nurses Credentialing Center. 2019 Magnet Application Manual. Silver Spring, MD: American Nurses Credentialing Center; 2017. [Context Link]


5. Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. The National Academies Press: Washington DC; 2011. [Context Link]


6. Institute of Medicine. The National Academies of Sciences, Engineering, and Medicine. Assessing Progress on the Institute of Medicine Report The Future of Nursing. The National Academies Press: Washington DC; 2016. [Context Link]


7. Joint Accreditation for Interprofessional Continuing Education. Accessed April 17, 2018. [Context Link]


8. American Nurses Credentialing Center. ANCC Primary Accreditation Provider Application Manual. Silver Spring, MD: ANCC; 2015. [Context Link]