CHFN Recertification Application

Option 1 – Renewal by Practice Hours and Professional Development

List in the chart below 40 hours of continuing education in topics focused on care of patients with heart failure within the last three years. Note: If the title of the course or the course provider does not contain the words “heart failure”, you may be required to send the syllabus for verification of heart failure content.

Program
Dates / Title of Course / Course Provider / Approved Accrediting Organization / CNE
Credits
(contact hours)
Program
Dates / Title of Course / Course Provider / Approved Accrediting Organization / CNE
Credits
(contact hours)

Note: If the title of the course or the course provider does not contain the words “heart failure”, you may be required to send the syllabus for verification of heart failure content.

Completed either A or B criteria in the past three years:

A. Published one cardiovascular article in a peer-reviewed journal as first author. Note, only published work can be accepted. If an article is in the page press stage, ePub ahead of print stage or is in review by journal editor, please do not include.

Below, provide the full article citation: all authors last names and first name initials (recertification author’s name bold or underlined), article title, journal name, year published, issue and pages or open access code.
Example: Smith M, Powers S, Kim, P. Self-care and health literacy in patients with heart failure. Heart Lung 2012;16:329-334.

B. Or have completed two (2) of the following or one (1) of the following two times:

1. Served in a leadership role with a professional society (committee, task force, board service, professional society such as AAHFN, HFSA,ACC,AHA) Cannot be hospital based leadership role or a local community group – must be a professional organization that is incorporated/legally recognized.

Name of group______Title______Date of Service______

2. Published one clinical or professional article (editorial, leader message or interview with quotes within an article NOT included)

in a cardiovascular newsletter (from a professional society or work site).

3. Co-author of published cardiovascular manuscript (not first author). Note, only published work can be accepted. If an article is in the page press stage, ePub ahead of print stage or is in review by journal editor, please do not include..

Below, provide the full citation: all authors last names and first name initials (recertification author’s name bold or underlined), article title, journal name, year published, issue and pages or open access code.
Example: Smith M, Powers S, Kim, P. Self-care and health literacy in patients with heart failure. Heart Lung 2012;16:329-334.

4. Provided a formal lecture on a cardiovascular topic at work site (e.g. in-service or grand rounds) or at a local, regional, or national conference. Note: you must have been an oral presenter to include, should be at least one (1) hour long.

5. Presented an abstract or poster, as first author, related to heart failure care at a local, regional, or national conference (may be research outcomes, best practices or quality improvement).

6. Developed a program, service, or tool that is used in the management of patients with heart failure. Note: if developed by a multidisciplinary team, you must have been the leader of the project or lead developer.

7. Actively participated in (developed and implemented) a quality improved project related to heart failure care.

Project Type / Project Title / (1) Name of conference or hospital associated with lecture, abstract/poster presentation, program/service or quality improvement project; (2) city/state and, if no evidence to support your work, (3) provide the name and e-mail address of a supervisor who can verify your work / Date completed/
presented
ð Lecture
ð Abstract/
poster
ð Program/
Service
ð Quality
ð Lecture
ð Abstract/
poster
ð Program/
Service
ð Quality

8. Earned three (3) academic (university/college) credits in professional nursing courses

University / College Name / University City/State / Course name / Course start and end dates / Academic Credits

9. Received an additional 10 hours of continuing education in topics focused on care of patients with heart failure within the last three (3) years (Note: this is in addition to the 40 hour requirement.)

Program
Dates / Title of Course / Course Provider / Approved Accrediting Organization / CNE Credits
(contact hours)
Program
Dates / Title of Course / Course Provider / Approved Accrediting Organization / CNE
Credits
(contact hours)

Note: If the title of the course or the course provider does not contain the words “heart failure”, you may be required to send the syllabus for verification of heart failure content.