Advanced Practice Nurse Annual Renewal

Advanced Practice Nurse has to renew privileges annually by submitting an Annual Renewal Packet to Charles Gooch in Nursing Education and Research Center.   The packet consists of the following documents.

1.__ Non-COA Nursing Professional Demographic Data Document (click here)

    As part of this document you will 
__ Complete Annual Course Curriculum in Children's University (formerly CHEX)

2.__ Confidentiality and Nondisclosure Statement Form (click here)

3.__ Non-COA Bedside Nurse with Patient Care Contact Continuing Competency Review Document (click here)
    Your supervisor is to complete this document verifying the following:
        __ You are qualified to provide bedside Patient Care for Pediatric Patients
        __ You have a current nursing license to practice in the State of Alabama
        __ Your Cardiopulmonary Resuscitation (CPR) training is up-to-date and you have a current card
        __ You are current with TB Skin Testing
        __ And your Varicella Status-Positive Titers, Immunizations and Hepatitis B Vaccine has been done or documented

4.__ Documents that must be turned into the Chief Nurse Office Secretary in Administration, 638-9664
          __ Copy of Current certification
          __ ABN Approval of Collaborative Practice Card
          __ Copy or sample of your Quality Assurance Plan project

Please route the completed forms (1,2,3) to Charles Gooch, Nursing Education and Research office, Suite 410, in the Children's Harbor building of Children's Hospital.   For further instructions or any questions call (205) 638-9985.

Charles Gooch , R.N.
(205) 638-9985 Office
(205) 954-6208 Pager
(205) 638-6066 FAX