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DAISY Nurse Leader Award for ANCC Pathway Program Director

Please complete the nomination form addressing all elements in the Nomination Criteria.

About The Nominee

First Name

Last Name

Credentials

Title

Email:

Phone

Mailing Street Address

City

Country

State:

Postal Code

Where Does The Nominee Work?

Name of Organization

Street Address of Organization:

City

Country

State

Postal Code

About You

First Name

Last Name

Credentials, if any

Title

Email Address

Phone Number

Name of Your Organization

Street Address of Organization:

City

Country

State

Postal Code

Your Nomination

Please provide detailed information in each section of the nomination below. 200-250 Words per answer

Section 1: Living Pathway and Sustaining the Culture (200-250 words)
Describe how the nominee lives the Pathway Standards and sustains the Pathway culture.
• Engages the team around a shared vision and helps connect individuals to the deeper purpose behind the Pathway journey.
• Integrates Pathway Standards into daily operations, leading organizational initiatives that reflect the Pathway framework, supporting engagement strategies, and ensuring the Pathway culture is sustained and visible throughout the organization.
• Contributes to multiple Pathway designations, demonstrating a commitment to excellence and continuous improvement.

Section 2: Dissemination
Explain how the nominee has shared lived experiences or disseminated Pathway-related information.
• Include presentations, publications, webinars, or other outreach efforts.
• Attach or link to any relevant materials (e.g., slide decks, articles) below.

Document 1

Document 2

Document 3

Document 4

Section 3: Mentorship (200-250 words)
Describe how the nominee has mentored others on the Pathway to Excellence journey.
• Include examples of partnerships, consultations, or collaborative efforts.
• Provide names of organizations mentored (if applicable).
• Share outcomes or feedback received.

Section 4: Demonstrated Improvements (200-250 words)
Provide evidence of significant improvements in outcomes related to the Pathway journey, driven by the nominee.
• Include metrics, data, or stories that show impact.
• Highlight improvements in patient care, staff engagement, or organizational culture.

Section 5: Engagement with the Pathway Program Office (200-250 words)
Share continued collaborations with the Pathway Program Office as an “ambassador” of positive practice environments.
• Include examples.

Supporting Materials
Upload any supporting documents, data, testimonials, or visuals that strengthen your nomination. If you have trouble uploading or need to send additional files, please email them to FaithThomas@DAISYFoundation.org.

Upload 2

Upload 3

Upload 4

Signature

By submitting this nomination, I affirm that the information provided is accurate.

Please click the "submit" button when you are finished entering your DAISY E-nomination.

First Name

Last Name

Date

For questions about this Award please contact Faith Thomas at FaithThomas@DAISYFoundation.org

If you have technical issues with this form, please contact Jacqueline Park at JacquelinePark@DAISYFoundation.org

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