Call for Presentations
The Nebraska Nursing Facility Association (NNFA), Nebraska Assisted Living Facility
Association (NALA), Nebraska Hospice and Palliative Care Association (NHPCA), Licensed
Practical Nurse Association of Nebraska (LPNAN), and Nebraska Health Care Learning
Center (NHCLC) welcome educational presentation proposals for use at conventions and
other events throughout the year.
Scheduled educational events, including numerous stand-alone programs and the
following conventions/conferences, can be found at nehca.org.
NNFA/NALA/NHCLC – NNFA/NALA conventions and NNFA/NALA/NHCLC events address the
educational needs of all levels of Nebraska nursing facility and assisted living community
staff and a range of disciplines: nurses, medication aides, nursing assistants, social services,
dietary, activities, billing, environmental services, physicians, administrators, and others.
Conventions:
 April 20-23, 2015 – NNFA/NALA Spring Convention, Younes Conference Center, Kearney
 Sept. 28-Oct. 1, 2015 – NNFA/NALA Fall Convention, La Vista Conference Center, La
Vista
NHPCA – NHPCA’s conference and other events address the educational needs of all levels
of hospice staff as well as a broader community of physicians, nurses, social workers, nursing
facility and assisted living administrators and staff, VA staff, hospital staff, and others from
Nebraska and surrounding states.
Conference: March 17-18, 2015 – “Living a Good Life…at the End of Life” Annual
Conference, Embassy Suites, Lincoln
LPNAN – LPNAN’s conference addresses the educational needs of Nebraska’s licensed
practical nurses and nursing students.
Conference: Oct. 22, 2015 – LPNAN Annual Conference, Holiday Inn, Kearney
Presentations with innovative and informative messages are sought to meet the
educational needs of all members. Presentations must not promote a specific product or
service. Areas of interest include, but are not limited to:
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Disease-specific information
Pain management and symptom
control
Care plan development
Quality improvement
Team relationships
Cultural and religious diversity
Bereavement and grief
Alternative therapies
Reimbursement
Volunteer management
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Veterans’ issues
Education techniques
Palliative care
Dietary/nutritional practice
Ethical issues
Collaboration
Spiritual care
Employee issues
Restorative therapy
Stress management
Customer service
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Direct questions to Pam Truscott, Director of Professional Development, at PamT@nehca.org
or 402-435-3551. Please share copies of this document with anyone who may be interested.
Selection Process
Submissions are accepted throughout the year for review by an education committee.
Proposals must be submitted no less than 12 weeks prior to the event start date (20
weeks prior for conventions/conferences).
Presenter Responsibilities
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Comply with proposal submission deadlines
Thoroughly complete all documentation (see list below)
Develop a handout and submit an electronic copy before deadlines
Call For Presentation Submission Requirements
Proposals can be emailed to PamT@nehca.org or faxed to 402-475-6289. Each must
include the following:
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4.
Presentation Submission Form (page 3)
Session description for publication in the education event’s program (page 4)
Bibliography with a minimum of three sources (page 4)
Biographical and Conflict of Interest Form for each speaker (pages 5-8)
Convention/conference sessions are 60-90 minutes in length. Other “stand-alone”
education events throughout the year provide for speaking opportunities that are 60
minutes to multiple days in length.
In order to be considered, the Presentation Submission Form must include:
Objectives
The objectives are what you hope participants will learn from your presentation. All
presentations must have at least three measurable objectives. Avoid general terms
such as know, understand, internalize, and appreciate. Use descriptive terms such as
explain, classify, diagram, diagnose, develop, apply, implement, translate, formulate,
solve, and evaluate.
Content
The content, or topic, of the presentation must be stated by objective. Thus, objective 1
will have content 1, etc.
Teaching Method
The teaching method can be the same for the entire presentation. Methods such as
lecture, discussion, case studies, etc., are common.
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Presentation Submission Form
Presentation Title
Preferred Presentation Date/Event (or indicate if unknown or no preference)
Primary Presenter
Co-Presenter
At least three objectives are required and each must be measurable.
Objectives
Content Outline
Time Frame
List at least three
objectives for your
presentation
List the content
(topics) for each
objective
List the time it
will take to
address each
objective
The participant will be
able to…
Objective 1
Content 1 (must
Presenter
Teaching Methods
List the name of
Provide teaching
the presenter
methods for each
for each
objective, i.e., lecture,
objective
discussion, case
studies, PowerPoint,
question/answer
Objective is Presenter
relate to Objective 1)
Teaching methods
for Objective 1
minutes in
length
Objective 2
Content 2 (must
Objective is Presenter
relate to Objective 2)
Teaching methods
for Objective 2
minutes in
length
Objective 3
Content 3 (must
Objective is Presenter
relate to Objective 3)
Teaching methods
for Objective 3
minutes in
length
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Session Description (100 words or less): The description should provide the reader with a
clear understanding of the session. The description may incorporate the proposed
objectives and/or content, or may be a narrative description.
“The purpose of this activity is to enable the learner to…”
BIBLIOGRAPHY: List the evidence-based references used for developing this
presentation. Include at least three sources. Examples include journal articles, books,
and websites.
1.
2.
3.
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Complete Sections 1, 3, 4, and 6
Biographical and Conflict of Interest Form
Title of Educational Activity:
Education Activity Date:
Role in Educational Activity: (Check all that apply)
Planning Committee Member
Faculty/Presenter/Author
Content Reviewer
Other – Describe:
Section 1: Demographic Data
Name with Credentials/Degrees
If RN, Nursing Degree(s):
AD
Diploma
BSN
Masters
Doctorate
Address
Phone
Email
Position/Title
Organization/Facility
Section 2: Expertise – Planning Committee Member
If a planning committee member, select area of expertise specific to the educational activity listed
above:
Nurse Planner (responsible for ensuring adherence to ANCC Accreditation criteria)
Content Expert
Other
Please describe expertise and years of training specific to the educational activity listed above.
(If the description of expertise does not provide adequate information, the Provider Unit may request
additional documentation.)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
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Section 3: Expertise – Presenter/Faculty/Author/Content Reviewer
An "X" on this line identifies the expertise information the same as listed above.
Please describe expertise and years of training specific to the educational activity listed above.
(If the description of expertise does not provide adequate information, the Provider Unit may
request additional documentation.)
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Have you spoken at conventions in the past? Yes_____ No_____
If yes, describe your experience including event name(s), topic(s), audience(s), attendance
number(s), and date(s):
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Have you spoken at workshops in the past? Yes______ No______
If yes, describe your experience including event name(s), topic(s), audience(s), attendance
number(s), and date(s):
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Section 4: Conflict of Interest
The potential for conflicts of interest exists when an individual has the ability to control or influence
the content of an educational activity and has a financial relationship with a commercial interest*,
the products or services of which are pertinent to the content of the educational activity. The Nurse
Planner is responsible for evaluating the presence or absence of conflicts of interest and resolving
any identified actual or potential conflicts of interest during the planning and implementation phases
of an educational activity. If the Nurse Planner has an actual or potential conflict of interest, he or
she should recuse himself or herself from the role as Nurse Planner for the educational activity.
*Commercial interest, as defined by ANCC, is any entity producing, marketing, reselling, or
distributing healthcare goods or services consumed by or used on patients, or an entity that is owned
or controlled by an entity that produces, markets, resells, or distributes healthcare goods or services
consumed by or used on patients. Commercial Interest Organizations are ineligible for accreditation.
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An organization is NOT a Commercial Interest Organization* if it is:
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A government entity;
A non-profit (501(c)(3) organization;
A provider of clinical services directly to patients, including but not limited to hospitals, health
care agencies and independent health care practitioners;
An entity the sole purpose of which is to improve or support the delivery of health care to
patients, including but not limited to providers or developers of electronic health information
systems, database systems, and quality improvement systems;
A non-healthcare related entity whose primary mission is not producing, marketing, selling or
distributing health care goods or services consumed by or used on patients.
Liability insurance providers
Health insurance providers
Group medical practices
Acute care hospitals (for profit and not for profit)
Rehabilitation centers (for profit and not for profit)
Nursing homes (for profit and not for profit)
Blood banks
Diagnostic laboratories
(*Reference: Accreditation Council for Continuing Medical Education (ACCME) Standards of
Commercial Support, August 2007 (www.accme.org) - ANCC’s definition is intended to ensure
compliance with Food and Drug Administration Guidance on Industry-Supported Scientific and
Educational Activities and consistency with the ACCME definition.)
All individuals who have the ability to control or influence the content of an educational activity must
disclose all relevant relationships** with any commercial interest, including but not limited to
members of the Planning Committee, speakers, presenters, authors, and/or content reviewers.
Relevant relationships must be disclosed to the learners during the time when the relationship is in
effect and for 12 months afterward. All information disclosed must be shared with the
participants/learners prior to the start of the educational activity.
**Relevant relationships, as defined by ANCC, are relationships with a commercial interest if the
products or services of the commercial interest are related to the content of the educational activity.
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Relationships with any commercial interest of the individual’s spouse/partner may be relevant
relationships and must be reported, evaluated, and resolved.
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Evidence of a relevant relationship with a commercial interest may include but is not limited to
receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest
(stock and stock options, excluding diversified mutual funds), grants, contracts, or other financial
benefit directly or indirectly from the commercial interest.
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Financial benefits may be associated with employment, management positions, independent
contractor relationships, other contractual relationships, consulting, speaking, teaching, membership
on an advisory committee or review panel, board membership, and other activities from which
remuneration is received or expected from the commercial interest.
Is there an actual, potential or perceived conflict of interest for yourself or spouse/partner?
Yes
No
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If yes, complete the table below for all actual, potential or perceived conflicts of interest*:
Check all
that apply
Category
Description
Salary
Royalty
Stock
Speakers Bureau
Consultant
Other
*All conflicts of interest, including potential ones, must be resolved prior to the planning,
implementation, or evaluation of the continuing nursing education activity.
Section 5: Conflict Resolution (to be completed by Nurse Planner)
A.
Procedures used to resolve conflict of interest or potential bias if applicable for this activity:
(Check all that apply)
Not applicable since no conflict of interest.
Removed individual with conflict of interest from participating in all parts of the
educational activity.
Revised the role of the individual with conflict of interest so that the relationship is no longer
relevant to the educational activity.
Not awarding contact hours for a portion or all of the educational activity.
Undertaking review of the educational activity by a content reviewer to evaluate for
potential bias, balance in presentation, evidence-based content or other indicators of
integrity, and absence of bias, AND monitoring the educational activity to evaluate for
commercial bias in the presentation.
Undertaking review of the educational activity by a content reviewer to evaluate for
potential bias, balance in presentation, evidence-based content or other indicators of
integrity, and absence of bias, AND reviewing participant feedback to evaluate for
commercial bias in the activity.
Other - Describe:
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Section 6: Statement of Understanding
An “X” in the box below serves as the electronic signature of the individual completing this
Biographical/Conflict of Interest Form and attests to the accuracy of the information given above.
Electronic Signature (Required)
Date ___________________________
_______________________________________________________________________________
Completed By: Name and Credentials
Nurse Planner Signature (* If form is for the activity Nurse Planner, an individual other than
the Nurse Planner must review and sign)
An “X” in the box below serves as the electronic signature of the Nurse Planner
reviewing the content of this Biographical/Conflict of Interest Form.
Electronic Signature (Required)
_______________________________________________
Completed By: Name and Credentials
____________________
Date
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