REGISTERED NURSE REMEDIATION

Using the 2025 ANCC NCPD Educational Design Process

Seven EDP Criteria | Standards for Integrity | K/S/P/A Domain Model

Educator Training Session — 90 Minutes

Nursing Practice Remediation Consortium

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Session Agenda

SESSION AGENDA

10 min

Background and rationale

Why standardized remediation matters

10 min

Framework update: 9 → 7 criteria

What changed in 2025 and what the consortium adds

25 min

The seven EDP criteria

Backward-design walkthrough with example

5 min

Documentation tools

Template, Checklist, Quick-Reference

25 min

Case study exercise

Individual plan completion — Sarah / insulin

10 min

Group review

Facilitator-led debrief with teaching points

5 min

Data collection overview

Local vs. consortium, de-identification, quarterly process

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Learning Objectives

LEARNING OBJECTIVES

1

Describe the rationale for using a standardized, evidence-based approach to registered nurse remediation within a Just Culture framework.

2

Identify and apply the seven EDP criteria plus Standards for Integrity when planning, implementing, and documenting remedial education.

3

Classify underlying educational need using the consortium's K/S/P/A model, and apply the affective scope boundary correctly.

4

Complete a remediation plan that demonstrates the backward-design chain: gap → need → competency → outcome → assessment → active learning → summative evaluation.

5

Describe the consortium data-collection process, including local-vs-consortium separation, de-identification, and unit-level finding routing.

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Why Standardized Remediation Matters

THE CASE FOR STANDARDIZATION

THE PROBLEM

No national standard

No common framework for how RN remediation is planned, delivered, or documented.��

Pre-intervention: only 35% completeness

In the 2018 JNPD study, only 35% of expected documentation elements were completed.��

Elements routinely missing

Learner engagement (0%), instructor competence (0%), COI disclosure (0%), time frames (17%).

THE SOLUTION

Apply the ANCC EDP to remediation

Use the same evidence-based design process used in accredited continuing education.��

Post-intervention: 100% completeness

After applying the framework, all documented elements reached 100% (p < .001).��

Consortium extends the model

Multi-site replication under the updated 2025 framework plus the K/S/P/A extension.

Harding, Sipe, Whalen, & Almeida (2018). JNPD, 34(6), E1–E7.

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The Published Evidence Base

EVIDENCE BASE

2012

Harding & Connolly

JONA's Healthcare Law, Ethics & Regulation

Established the employer's responsibility for remediation; defined stakeholder roles.

2013

Walker-Cillo & Harding

Advanced Emergency Nursing Journal

Clinical nurse specialist role in remediation; applied theoretical models and learning theories.

2016

Batista & Harding

Nursing Management

Administration-regulation intersection; responsibility gaps between employers and boards of nursing.

2018

Harding, Sipe, Whalen, & Almeida

Journal for Nurses in Professional Development

Applied the ANCC EDP to remediation. Documentation improved from 35% to 100%.

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Just Culture: The Foundation

FOUNDATIONAL FRAMEWORK

Reporting Culture

Safe environment for reporting errors and near misses.

Just Culture

Actions evaluated objectively, not punitively.

Flexible Culture

Hierarchy loosened to support safety reporting.

Learning Culture

Organization uses reported information to improve.

Reason's Safety Culture Framework (1997)

REMEDIATION IS NONPUNITIVE

Remediation applies ONLY when the Just Culture algorithm identifies a knowledge, skill, judgment, or knowledge/skill-adjacent affective deficit. Reckless behavior and values incompatible with nursing practice route to HR / management. System failures route to process improvement. Never to remediation.

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What Changed in 2025 ANCC

FRAMEWORK UPDATE

PREVIOUS — 9 Key Elements (2016)

1. Identification of Practice Gap

2. Evidence of the Practice Gap

3. Description of Expected Outcomes

4. Outcomes Measurements

5. Learner Engagement Strategies

6. Time Frames for Completion

7. Proof of Instructor Competence

8. Conflict of Interest Resolution

9. Summary of Outcomes

CURRENT — 7 EDP Criteria + SI (2025)

EDP 1 Professional Practice Gap + Evidence

EDP 2 Underlying Educational Need (K/S/P/A) ⟵ NEW

EDP 3 Established Competencies ⟵ NEW

EDP 4 Measurable Learning Outcome(s)

EDP 5 Assessment Method

EDP 6 Active Learning Strategies ⟵ BAR RAISED

EDP 7 Summative Evaluation ⟵ EXPANDED

Standards for Integrity (condensed attestation)

Elements 6 (Time Frames) and 7 (Instructor Competence) are no longer EDP criteria — they move to activity documentation and Nurse Planner attestation.

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The K/S/P/A Domain Model

CONSORTIUM EXTENSION

K

Knowledge

Learner does not know something they need to know — facts, concepts, rationale, policy content.

S

Skill

Learner does not know how to perform a task or procedure at the expected level.

P

Practice

Learner cannot integrate knowledge and skill into their daily practice setting.

A

Affective

CONSORTIUM EXTENSION

Knowledge/skill/judgment-adjacent affective gap: communication, escalation, civility.

AFFECTIVE SCOPE BOUNDARY

IN scope: communication hesitation, escalation reluctance, professional civility tied to clinical handoff.�

OUT of scope: values incompatible with nursing practice; reckless behavior. These route to Just Culture / HR / management — not remediation.�

Grounded in Walker-Cillo & Harding (2013). Extension — not ANCC doctrine. Label clearly on every plan.

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The Backward-Design Chain

HOW THE FRAMEWORK WORKS

The 2025 EDP is a chain. Each criterion depends on the one before it. A plan that documents each criterion in isolation can still fail alignment.

EDP 1

Gap + Evidence

›

EDP 2

Need (K/S/P/A)

›

EDP 3

Competency

›

EDP 4

Outcome

›

EDP 5

Assessment

›

EDP 6

Active Learning

›

EDP 7

Summative Eval

EDP 1

Document the gap and the evidence together

EDP 2

Classify: K, S, P, and/or A (extension)

EDP 3

Cite a published, external competency source

EDP 4

Write measurable outcomes in learner terms

EDP 5

Match the method to each outcome

EDP 6

Use ANCC-cited active learning — not passive review

EDP 7

Summarize results + identify unit-level findings

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Professional Practice Gap and Evidence

EDP 1

The gap and the supporting evidence are now combined under EDP 1.

WHAT TO DOCUMENT

• What occurred, in observable terms�

• Which policy, standard, or guideline was not met�

• How the gap was identified (incident report, observation, audit, complaint)�

• Objective evidence with dates, documentation, or data�

• Supporting references cited

COMMON PITFALL

Being too vague.

“The nurse made a medication error” is not enough.�

Specify:

• what happened�• what should have happened�• which standard was not met�• what objective evidence supports the gap��

Focus on the practice gap, not the person. No judgment language.

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Underlying Educational Need (K/S/P/A)

EDP 2

NEW under 2025 ANCC. Classify the gap as Knowledge, Skill, and/or Practice. Consortium extends with Affective.

KNOWLEDGE

Does not know something they need to know.

SKILL

Does not know how to perform the task.

PRACTICE

Cannot integrate into daily practice.

AFFECTIVE

K/S/judgment-adjacent communication, escalation, civility gap.

TEACHING POINTS

• More than one may apply. A case involving three or four domains is common.�

• Behavior itself is not a category. A behavior pattern is the presenting sign of a K, S, P, or (sometimes) A deficit.�

• Affective is a Consortium extension — always label it as such on the plan. Not ANCC doctrine.�

• Justify the classification in one or two sentences tying back to EDP 1 evidence.

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Established Competencies

EDP 3

The biggest structural change in 2025 ANCC. Cite a published competency source — educators may NOT create their own.

ACCEPTABLE SOURCES

• ANA Scope and Standards of Practice�

• ANA Code of Ethics for Nurses�

• Specialty organization competencies (ENA, AACN, AORN, ONS, AWHONN, others)�

• NPD: Scope and Standards of Practice�

• AACN Essentials (professional identity and sub-competencies)�

• TeamSTEPPS (for affective / communication / escalation)�

• Institutional policy linked to a published standard

NOT ACCEPTABLE

• Educator-written competencies�

• Institutional policy ALONE (without tie to a published standard)�

• Generic “the learner will follow policy” statements��

The consortium website hosts a curated competency source library. Use it.

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Measurable Outcomes and Assessment Methods

EDP 4 + 5

Each outcome maps to a K/S/P/A domain and aligns to the cited competency. Every outcome has a matched assessment method.

⚠ AVOID WEAK VERBS

Understand, know, appreciate, be aware of — these cannot be measured. Replace with observable verbs before writing the assessment method.

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Active Learning Strategies

EDP 6

Single biggest content change in 2025 ANCC. Several commonly-used strategies are now excluded.

ACCEPTABLE — ANCC-cited active learning

• Tabletop exercise (scenario-based problem-solving)�

• Simulation or skills lab with debrief�

• Think-pair-share exercise�

• Jigsaw discussion�

• Guided reflection paused during instruction�

• Case-based discussion with decision points�

• Structured problem-solving�

• Self-quizzing WITH feedback (not post-test only)�

• Return demonstration with coaching�

• Role-play (for affective scenarios)

EXCLUDED — NOT active learning

• Question-and-answer sessions�

• Post-tests�

• PowerPoint / slide presentations�

• Videos��

Also not sufficient on their own:�

• Lecture / one-on-one instruction�

• Passive policy review�

• Self-directed reading without an interactive step��

These may be used as delivery vehicles, but MUST be paired with a genuine active learning strategy.

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Summative Evaluation

EDP 7

Expanded in 2025 ANCC. Must now identify unit-level or aggregate findings — not just an individual-case summary.

7A

Final outcome determination

Met / Partially met / Not met. Select one.

7B

Narrative summary

For each EDP 4 outcome, state met / partially met / not met with supporting evidence.

7C

Unit-level or aggregate finding ⟵ NEW

Does this case suggest a pattern? Recurring knowledge gap, handoff failure, skill decay? If yes, route to the unit leader. If no, state “none” explicitly.

7C is where consortium data becomes most valuable — individual cases, aggregated, reveal unit and organizational patterns that case-by-case review misses.

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Standards for Integrity and Nurse Planner

SI + NP

Standards for Integrity is condensed to three attestations for local remediation. Site Champion = Nurse Planner.

1

Standard 1 — Independence

Content developed independent of ineligible companies. No influence from medical device, pharma, or similar.

2

Standard 2 — Identify / Mitigate / Disclose

Relevant financial relationships identified, mitigated, and disclosed to the learner before instruction.

3

Standard 3 — Content Validity

Evidence-based. No discredited practice. No product promotion.

NURSE PLANNER ROLE = SITE CHAMPION

The 2025 ANCC framework places EDP-level accountability on the Nurse Planner. In the consortium, the Site Champion serves that role — they review the plan against all seven criteria and the Standards for Integrity, and sign the Nurse Planner attestation. The educator signs the plan itself.

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Documentation Tools You'll Use

TOOLS

LOCAL

Remediation Plan Template

Structured on the 7 EDP criteria + SI. Educator completes for each case. Stays local — never uploaded to consortium.

LOCAL

Seven EDP Criteria Checklist

Site Champion quality review. Criterion-by-criterion check plus backward-design alignment. Gates de-identified data submission.

LOCAL

Educator Quick-Reference Guide

Pocket reference mirroring the template structure. Prompt questions for each EDP criterion. Keep on hand during live remediations.

CONSORTIUM

Google Form 1 — Event Data

De-identified data submission after Site Champion approves the plan. Site code + Educator code only. No PHI.

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CASE STUDY EXERCISE

Sarah — Insulin Administration

25 minutes — individual work

1. Read the Sarah scenario in your handout.�

A medical-surgical RN with a pattern of unsafe insulin administration across three events. Just Culture algorithm has ruled out reckless behavior.��

2. Individually, build a remediation plan that satisfies all seven EDP criteria.�

Use the Remediation Plan Template and Educator Quick-Reference Guide. Work the backward-design chain in order.��

3. Do not look at the Answer Key yet.�

We will debrief together afterward. Your plan does not need to match the key verbatim — the goal is to practice the chain.

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Key Teaching Points from Sarah's Case

CASE DEBRIEF

1

K/S/P — not Affective

Sarah's case is Knowledge + Skill + Practice. Behavior pattern is the sign, not the underlying need. Affective scope would be a miscategorization.

2

Published competency — not policy

Cite ANA Standard 5 (Implementation) for EDP 3. Policy MED-042 is EDP 1 evidence. Don't conflate them.

3

Four outcomes — not five

One per K/S/P. A separate 'accountability' outcome is scope creep — accountability is demonstrated through Practice integration.

4

Active learning — not policy review

Think-pair-share, simulation with debrief, structured problem-solving, guided reflection. Policy review alone does NOT satisfy EDP 6.

5

7C is not 'none'

Spot audit revealed 18% of insulin doses lacked pre-administration glucose docs on the unit. This is a unit-level finding. Route to unit director.

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Local vs. Consortium — What Goes Where

DATA COLLECTION

Firewall between local records and consortium data. No PHI, no learner identifiers, no plans leave the organization.

STAYS LOCAL

• Completed Remediation Plan (full document)�

• Seven EDP Criteria Checklist (completed)�

• Learner name, credentials, identifying information�

• Educator name (name-to-code key kept locally by Site Champion)�

• Patient information, EHR details, incident specifics�

• Unit-level finding routing to local leader (EDP 7C)

GOES TO CONSORTIUM

• Site code (assigned by consortium)�

• Educator code (assigned locally by Site Champion)�

• EDP 1 – 7 completeness (yes/no per criterion)�

• K/S/P/A classification�

• Competency source cited (EDP 3)�

• Active learning strategy used (EDP 6)�

• Final outcome (met / partial / not met)�

• Unit-level finding flag (yes/no) ⟵ NEW��

Submission via Google Form 1. De-identified.

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Your Rhythm Across the Consortium Period

ONGOING CADENCE

After each remediation

Educator completes plan → Site Champion reviews with Checklist → de-identified data submitted via Google Form 1 → Learner Satisfaction Survey link provided.

Every 3 months

Site Champion submits Quarterly Aggregate Report (Google Form 4). Includes counts, completeness, unit-level findings.

3 / 6 / 12 months

Educator Satisfaction Survey (anonymous, voluntary) — baseline post-training, then 6- and 12-month follow-ups.

Quarterly consortium calls

Site Champions join the network call. Share findings, surface common issues, update protocols as needed.

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THANK YOU

Questions, discussion, and next steps

WHAT TO DO NEXT

1. Download the Remediation Plan Template, Seven EDP Criteria Checklist, and Educator Quick-Reference from the consortium website.�

2. Complete the baseline Educator Satisfaction Survey (anonymous, voluntary).�

3. Begin using the tools for your next remediation. Site Champion reviews before data submission.�

4. Reach out to your Site Champion with questions — they are your first stop for support.

Andrew D. Harding, DNP, RN, NEA-BC, CENP, FACHE, FAHA, FAEN

Nursing Practice Remediation Consortium

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