Record of Attendance for Continuing Education



Record of Attendance for Continuing Education

Foundations of Catholic Health Care Leadership – An Online Course

for Formation and Development

February 7, 14, 21, 28, March 7 and 14, 2014

|Full Name: (please print) |

|E-mail: (please print) |

|LICENSE TYPE* |STATE OF LICENSURE |

|(indicate one license per line) |(if applicable) |

|ACHE NACC RN…Other | |

|ACHE NACC RN…Other | |

|ACHE NACC RN…Other | |

|ACHE NACC RN…Other | |

* ACHE = American College of Healthcare Executives; NACC = Pastoral Care (National Association of Catholic Chaplains);

RN = Registered Nurse (Missouri Nurses Association)

|Please initial the sessions you attend. |Pastoral Care: The National Association of Catholic Chaplains (NACC) has |

|Successful completion of this program for CEU credit requires that you return this |approved this program for 12.00 continuing education hours. |

|completed form to Gail Tyrrell, gtyrrell@, following the program. | |

| |Registered Nurses: This continuing nursing education activity was approved |

|Friday, February 7, 2014 |by the Missouri Nurses Association, an accredited approver by the American |

|_____ Theological Heritage of Catholic Health Care |Nurses Credentialing Center’s Commission on Accreditation. |

| | |

|Friday, February 14, 2014 |[Approval number 215-2-925; 12.00 contact hours] |

|_____ Understanding the Ethical and Religious Directives for Catholic Health Care | |

| |Faculty Disclosure: All faculty participating in continuing nursing |

|Friday, February 21, 2014 |education activities sponsored by the Catholic Health Association are |

|_____ Community Benefit and International Outreach as Foundational Elements of |expected to disclose any real or perceived conflict(s) of interest related to|

|Catholic Health Care |the content of their presentation(s). The following speakers have indicated |

| |they have no financial or other relationships with commercial interests; do |

|Friday, February 28, 2014 |not endorse or intend to discuss unapproved/ investigative use of a |

|_____ The Social Justice Tradition and Ethical Decision Making |commercial product/device; have no relationship that would interfere with the|

| |objectivity of their presentations: Bruce Compton; Sr. Mary Haddad, RSM, |

|Friday, March 7, 2014 |MSW, MBA; Sr. Carol Keehan, DC, RN, MS; Rev. Tom Nairn, OFM, Ph.D.; Brian |

|_____ The Foundations of Leadership in the Catholic Tradition |Smith, M.Div., MS, MA; Sr. Patricia A. Talone, RSM, Ph.D.; Julie A. Trocchio,|

| |MSN. |

|Friday, March 14, 2014 | |

|_____ Challenges of Leadership in the Catholic Tradition | |

| |No commercial support was received for this program. |

|Executives: The Catholic Health Association is authorized to award 12.00 hours of | |

|pre-approved ACHE Qualified Education credit (non-ACHE) for this program toward | |

|advancement, or recertification in the American College of Healthcare Executives. | |

|Participants in this program wishing to have the continuing education hours applied |For further information, please contact Gail Tyrrell, mission program |

|toward ACHE Qualified Education credit should indicate their attendance when |administrator, at 314-253-3408. |

|submitting application to the American College of Healthcare Executives for | |

|advancement or recertification. | |

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