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NSAG / Continuing Education / Nursing · CNE
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CE Specialty Track PREREQUISITE: Core CE Program Required

Cannabis Documentation and Burnout Governance in Nursing Practice

Two sessions. Two governance failures with direct patient safety consequences. Your patient’s cannabis use is clinically invisible. Your institution’s burnout response is structurally incapable of solving the problem. This track gives you a governance framework for both.

2.0
CNE Credit Hours
2
Add-On Sessions
On-Demand
Self-Paced Format
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CNE Specialty Track

Nursing CE

Your patient is on warfarin. Cannabis is not in their chart. This is not their failure — it is a governance failure. Thirty-five percent of primary care patients report using cannabis medically. Five percent have it documented. The interaction risk with warfarin, phenytoin, and immunosuppressants is not hypothetical. Session N1 gives nurses the clinical knowledge and governance framework to close that documentation gap.

Session N2 addresses nursing burnout with the same directness: organizational interventions produce significantly greater and more durable burnout reductions than individual interventions. The wellness program won’t solve it. Session N2 applies the Maslach six-domain burnout framework and Ulrich et al. (2008) evidence-based healthcare design standards to nursing specifically.

Who This Is For
  • Registered Nurses (RN)
  • Licensed Practical/Vocational Nurses (LPN/LVN)
  • Advanced Practice Registered Nurses (NPs, CNMs, CRNAs, CNSs)
  • Nursing administrators and nurse managers
  • Nurse educators and clinical faculty
  • Nursing informatics specialists
Accreditation Status
ANCC (American Nurses Credentialing Center)
2.0 ANCC contact hours (1.0 per session) — pending ANCC accredited approver review
In Process

Applying through Hawaii Nurses Association (ANCC Accredited Approver); nurse planner review and approval required before credit can be offered.

What’s Included

Each Session Includes

  • Pre-test (5 questions per session)
  • Timed prerecorded video session (60 minutes)
  • Post-test (5 questions per session; minimum 80% required for credit)
  • Practice application exercise (active written or structured response required)
  • Certificate of completion (issued on post-test completion; includes CE type and credit hours)
  • Written materials package (substantive outline, authority map, and hypothetical with model analysis)
Prerequisite

Core CE Program Required

This specialty track is an add-on to the 15-session NSAG Core CE Program. The core curriculum must be completed before enrolling in this track. The core program introduces the four-tier governance framework, six-dimension scoring model, and module-specific evidence bases that this track builds on.

View Core CE Program →
Session Structure

60-Minute Timed Agenda · Every Session

Both sessions in this track follow the same 60-minute structure. Pre-test and post-test are required for credit. The practice application exercise requires an active written or structured response.

Time Duration Segment Content Credit-Eligible
0:00–0:03 3 min Welcome & Disclaimers No legal/medical advice disclaimer; speaker conflict of interest disclosure; CE accreditation status statement; content validation date stated No
0:03–0:08 5 min Pre-Test 5-question pre-test assessing baseline knowledge of the session’s governance domain content. Required for credit. Yes
0:08–0:12 4 min Overview & Learning Objectives Three learning objectives stated; governance problem for this session introduced in one sentence with the primary evidence source named Yes
0:12–0:22 10 min The Governance Problem Evidence base for the governance gap: primary source cited, verbatim key finding presented, governance implication stated Yes
0:22–0:35 13 min Evidence Base & Research Foundation 2–3 primary peer-reviewed sources: study summary, verbatim key finding, DOI displayed; governance implication per source Yes
0:35–0:45 10 min Six Governance Dimensions Each dimension defined and illustrated with a profession-specific institutional example Yes
0:45–0:50 5 min PIONEERING Governance Standards Full PIONEERING tier criteria for this module — observable, documentable governance standards that distinguish PIONEERING from EMERGING Yes
0:50–0:57 7 min Practice Application Exercise Structured exercise requiring active written or multiple-choice response. Completion required for credit. Yes
0:57–1:00 3 min Post-Test & Certificate 5-question post-test; minimum 80% score required for credit; certificate of completion issued on successful completion Yes
Learning Outcomes

What You’ll Be Able to Do

Session N1 · 1.0 CNE Contact Hour

Cannabis Documentation in Nursing Practice

1

Apply a validated cannabis screening protocol to a described patient contact scenario, identifying appropriate screening instrument, timing, and documentation standard

Competency: Quality and Safety; Patient-Centered Care Evidence: Post-test: given patient scenario, select correct screening approach and identify documentation failure
2

Identify CYP450 drug interaction risks for cannabis use in a described patient’s medication profile, specifically for warfarin, antiepileptics, and immunosuppressants

Competency: Evidence-Based Practice; Patient Safety Evidence: Post-test: given medication list including cannabis, identify specific CYP pathways and clinical significance
3

Draft one element of a cannabis disclosure safety policy appropriate for a nursing unit, including intake language and EHR documentation standard

Competency: Professional Practice Environment Evidence: Application exercise: write non-stigmatizing intake disclosure language and one EHR documentation standard
Session N2 · 1.0 CNE Contact Hour

Burnout and the Nursing Built Environment

1

Apply Maslach’s six person-job mismatch domains to a described nursing unit’s working conditions, identifying the three highest-priority organizational governance gaps

Competency: Professional Practice Environment; Teamwork Evidence: Post-test: classify described unit conditions across six Maslach domains; identify organizational vs. individual targets
2

Distinguish organizational burnout interventions from individual interventions using Kiratipaisarl et al. (2024) meta-analysis findings and evaluate a described hospital burnout response program

Competency: Evidence-Based Practice Evidence: Application exercise: classify a hospital’s burnout response program by intervention type and predict effectiveness
3

Assess a described nursing unit’s built environment against Ulrich et al. (2008) acoustic and lighting standards, identifying governance deficits

Competency: Quality and Safety; Evidence-Based Practice Evidence: Post-test: given unit description, identify acoustic and lighting governance deficits relative to evidence-based standards
Sample Course Content

Practice Hypothetical & Model Analysis

The following is a representative hypothetical from this specialty track. Each session includes a practice application exercise based on a realistic institutional scenario. The model analysis below represents the level of analysis expected from practitioners completing this course.

Session N1 · Cannabis Documentation in Nursing Practice

Hypothetical N1: The Warfarin Patient

Margaret is a 71-year-old patient admitted for a routine INR check. She is on warfarin for atrial fibrillation (target INR 2.0–3.0). Her INR today is 4.8 — dangerously elevated. Her medication list has not changed since her last visit. Her chart contains no mention of cannabis.

During the intake interview, Margaret mentions to the nursing assistant that she has been using ‘a CBD gummy every night for sleep.’ The nursing assistant does not document this in the EHR. The charge nurse is not informed. The physician is not notified.

Discussion Questions
  1. Identify the CYP450 pathway implicated and the pharmacological mechanism by which CBD is likely elevating Margaret’s INR.
  2. Apply the NSAG M9 disclosure safety dimension: what governance failure allowed this interaction to go undetected?
  3. The nursing unit has no cannabis screening protocol. Draft the intake question that should have been asked and specify which EHR field it should populate.
  4. ANA Code of Ethics Provision 3.4 addresses responsibility in promoting safety. Identify the nursing governance obligation this case illustrates and what a PIONEERING nursing unit would have had in place.
Model Analysis
  1. CYP450 mechanism: CBD inhibits CYP2C9, the primary metabolic pathway for warfarin (S-enantiomer). CBD inhibition reduces warfarin clearance, increasing plasma concentration and anticoagulant effect. INR elevation to 4.8 is the predictable pharmacological consequence. VanDolah et al. (2019) identify this interaction as clinically significant with potential for hemorrhagic complications.
  2. Governance failure: Lapham et al. (2022) found 35.1% of primary care patients report implicit medical cannabis use while 4.8% have EHR documentation — from the same population. This is not Margaret’s failure to disclose; it is the institution’s failure to ask in a systematic, non-stigmatizing, EHR-integrated way. The governance deficit: no validated screening instrument, no EHR cannabis field, no disclosure safety policy communicating that cannabis information is clinically necessary and will not trigger adverse consequences.
  3. Draft intake question and EHR field: Question: ‘Some patients use cannabis products including CBD, THC, oils, edibles, or topicals for medical or wellness purposes. Do you currently use any cannabis products? This information helps us check for medication interactions.’ EHR field: Structured discrete field in Medications/Supplements: Cannabis/CBD Use: [Yes/No/Declines to Answer] — Type: [CBD-dominant/THC-dominant/Mixed]; Route: [Oral/Inhalation/Topical]; Frequency: [Daily/Weekly/Occasionally]; Last Use: [Date].
  4. Nursing professional responsibility: ANA Code Provision 3.4 requires advocacy for practice environments that enable safe, effective care. The absence of a cannabis screening protocol for patients on warfarin constitutes a system-level safety governance failure. PIONEERING governance would include: validated cannabis screening at every contact for patients on narrow-therapeutic-window medications; CYP450 training for all clinical nurses; structured EHR fields with alerts triggering for cannabis plus warfarin; documentation rate tracked as a QI metric.

This model analysis represents the depth of reasoning expected in the practice application exercise. The post-test (minimum 80%) assesses conceptual mastery of the session’s evidence base and governance framework.

View the full Evidence Library → for the primary sources cited in this and all other specialty track sessions.

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Institutional Access

License This Track for Your Organization

Institutional licensing includes cohort enrollment across both the Core CE Program and this specialty track, facilitator support, and options to integrate with existing CE tracking systems. Pricing includes all 15 core sessions plus this specialty add-on.

$5,000
1–50 employees
Core CE + This Specialty Track
$10,000
51–200 employees
Core CE + This Specialty Track
$15,000
201+ employees
Core CE + This Specialty Track
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Program description · All learning outcomes · Full 60-minute timed agenda · Accreditation status · No enrollment required.

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