CNS-CP. Certification and Recertification Candidate Handbook. Purpose of the Handbook

Transcription

1 CNS-CP Certification and Recertification Candidate Handbook Purpose of the Handbook The Competency and Credentialing Institute (CCI) provides a voluntary certification and recertification program for the Clinical Nurse Specialist (CNS) practicing in the perioperative setting (CNS-CP). This Candidate Handbook contains the information necessary for obtaining this credential. It is your responsibility to familiarize yourself with the contents of this handbook, as it has been created based on the test specifications, policies, and procedures used in developing the exam. Test content and pricing is subject to change. Make certain you have reviewed the most current information on our website ( prior to applying for the exam. If you have any questions, please feel free to contact CCI at NOTE: This handbook is valid for CNS-CP applications received from October 1, 2013 thru June 15, 2014 for the exam given between July 1, 2014 and July 31, 2014 only. Copyright October 2013 All Rights Reserved By 2170 South Parker Road, Suite 295 Denver, CO (303) (888)

2 CNS-CP Certification Definition of Certification Certification is the formal recognition of the specialized knowledge, skills, and experiences demonstrated by the achievement of standards specified by an agency or association. CNS-CP certification validates the achievement of the Clinical Nurse Specialist (CNS) who has chosen to seek current proficiency as an advanced practice nurse in the perioperative setting. This specialty certification is in addition to, not in place of, primary population-focused certification. Upon successful completion of the exam, the CNS-CP credential is awarded for a five (5) year period. A certificant may renew the credential in the fifth year by successfully completing one of the recertification methods in effect at that time. Otherwise, certification will expire on December 31 st of the fifth year. Purposes of Certification 1. Demonstrate a commitment to accountability to the general public for safe nursing practice. 2. Enhance quality patient care. 3. Provide employing agencies a means of identifying professional achievement of an advanced practice registered nurse in the perioperative setting. 4. Provide recognition for the CNS who is proficient in perioperative practice. Objectives of the CNS-CP Certification Program 1. Formally recognize those individuals who meet all the requirements of the CNS-CP. 2. Encourage advanced practice professional growth in perioperative nursing. Demonstrate accountability to the consumer, the community, the employer, and other members of the health care team by providing a high standard for the knowledge, skills and experience required for competent advanced practice as a CNS in the perioperative setting 1

3 Eligibility Requirements, Initial certification of CNS-CP Licensure Candidate must meet one of the two requirements: 1. Current full, unrestricted license (RN and/or APRN) OR 2. Current full, unrestricted RN license with recognition as a CNS by state board of nursing. Education Candidate must meet one of the two requirements: 1. Graduated from an accredited (CCNE or NLNAC) graduate, post-master s certificate, or postgraduate program in nursing (Master s or higher) which has prepared the applicant for the CNS role. The program must contain both didactic (advanced pharmacology, pathophysiology, and physical assessment) and clinical components OR 2. Masters in nursing along with documentation of serving in an advanced practice role may be accepted in lieu of advanced core courses (pharmacology, pathophysiology, and physical assessment) and 500 hours of supervised clinical hours. Experience Candidate must meet one of the two requirements: 1. If enrolled in a CNS program accredited with current accreditation standards (advanced pharmacology, physical assessment, and pathophysiology and 500 clinical hours), candidate may sit for the CNS perioperative specialty certification exam upon graduation OR 2. If graduated from a CNS program prior to implementation of these standards, applicant must validate 2,400 hours and 2 years as a practicing CNS in the perioperative setting. Candidate must also: Have completed a minimum of (2) years and 2,400 hours of work experience in perioperative nursing, with a minimum of 50% (1,200 hours) in the intra operative setting. Every requirement must be met at the time of application. An applicant s nationality, race, creed, lifestyle, color, sexual orientation, or age is not a factor in determining eligibility for certification. 2

4 CNS -CP Certification and Recertification Candidate Handbook CNS-CP Certification Process Preparing for the exam CCI provides a detailed bibliography of recommended study materials at AORN will offer a course on preparing for the exam. Please visit their website at for additional information. Some candidates may find it helpful to organize study groups. Please refer to the Job Analysis at the back of this handbook for specific subjects (domains) and associated task and knowledge statements for each subject area. Test details The CNS-CP exam consists of 120 multiple-choice questions; of these, 100 questions will be scored and used to calculate your test score. The remaining 20 questions serve as pre-test questions for possible placement on a future exam, and will not affect your score. Pre-test questions are dispersed throughout the exam and cannot be distinguished from scored questions. Your score is the total number of questions you answer correctly. Any questions left unanswered will be counted as incorrect, so it is to your advantage to answer each question even if you are not certain of the correct response. The test must be completed in 2 hours and 30 minutes. The computer will keep the official time. CCI has contracted with Prometric, a professional testing agency, to administer the CNS-CP exam through its testing centers, found across the United States. Candidates may take the exam Monday through Saturday, excluding holidays, from July 1 through July 31, The computerized format of the examination requires no previous computer experience. An optional preexamination tutorial will provide instructions on how to take the computer-based exam. It will also provide information on how to select answers and how to mark and return to any questions you may wish to review prior to submitting your exam. CNS-CP Exam Subject Areas (Domains) Domain % of questions on exam 1. Clinical expert in the delivery of advanced practice perioperative care 2. Consultant (Intra-and multidisciplinary) 3. Education (nurse, other healthcare providers, patient, family, and community) 4. Clinical inquiry (evidence-based practice projects and/or research) 5. Organizational and systems thinking 6. Professional accountability

5 CNS-CP Application Fee The fee for the exam given between July 1 and July 31, 2014 is $125. This special one-time price is only available for exams taken during this time frame. To complete the complete application, you will need the following information: Personal contact information - address, and phone number (home and work) Last four digits of your social security number Birth year Highest degree earned AORN information if applicable username ( address), password and membership number Employer contact information facility name, phone number RN information RN license issue date, state licensed to practice Perioperative work history last two years, date began working in the OR, current position, and current practice area Supervisor contact information (name, address, , phone number) Date began working as a perioperative CNS Year accredited CNS program completed Advanced practice population focus Payment information (check or credit card) Original transcript showing completion of CNS program (you may choose to have this document sent directly from your institution, either by mail or electronically Current resume/cv Verification of current RN/APRN licensure from your State Board of Nursing (copy of printout from SBON website is accepted) Verification of CNS certification, if held. A photocopy of wall certificate or wallet card is acceptable; however, CCI reserves the right to request an official letter of verification from the certifying body. The applicant is responsible for any charges related to procuring the letter. Notification of pass/fail Due to the special psychometric analyses required during the initial development of this exam, results of the CNS-CP exam will not be available to candidates for 6-8 weeks following their testing date. All candidates will then be provided a diagnostic scorecard with testing performance for each domain. A certificate will be sent electronically at that time to those candidates who have successfully passed the exam. Those applicants who have not been successful in their initial test-taking experience will be able to register and pay to re-take the exam anytime beginning in October The exam may be taken in the three months following the month registration is received. 4

6 CNS-CP Sample questions 1. A 9-month old girl has presented to the Eye/Ear/Nose/Throat (EENT) clinic with recurrent severe right ear pain and fever. On examination the right tympanic membrane is inflamed and bulging The CNS diagnoses acute otitis media and places the child on Amoxicillin until surgery can be scheduled. The child weighs 18 pounds. Standard dosing for otitis media is 80mg/kg/day. Using a BID schedule and dosage of 400 mg/5ml, what is the individual dose in ml? A. 0.4 ml B. 0.8 ml C ml D. 8.1 ml Correct answer: C ml Reference: Rationale: 18 pounds/2.2= 8.18kg 8.18 (KG) x 80 (mg/kg/day) = /2= mg/dose X= 4.09 ml (may round up to 4.10 ml) 2. A 36 year-old female patient scheduled for a subtotal thyroidectomy presents with a TSH of 1.6 mu/l (SI units) and a total T4 of 20 mcg/dl. The differential diagnosis includes which of the following conditions? A. Medullary thyroid cancer B. Grave s disease C. Pituitary adenoma D. Hashimoto s disease Correct answer: B. Grave s disease References: McCance, K.L., & Huether, S.E. (2010). Pathophysiology: The biologic basis for disease in adults and children (6 th ed.). Maryland Heights, MO: Mosby Elsevier, pp Pagana, K.D., & Pagana, T. J. (2013). Mosby s diagnostic and laboratory test reference (12 th ed.). St. Louis, MO: Elsevier Mosby, pp. 903,911. 5

7 Rationale: The patient s sex, age, and decreased TSH and elevated T4 levels are all indicative of Grave s disease. Hashimoto s disease and pituitary adenoma are both hypothyroid conditions, with elevated TSH and decreased total T4 levels. Thyroid cancers typically have normal T4 levels; of the four types, papillary accounts for the majority of thyroid cancers. 3. Based on the answer to #2 above, the CNS should consider the possibility which of the following intraoperative emergencies? A. Thyroid storm B. Myxedema coma C. Malignant hyperthermia crisis D. Pituitary infarct Correct answer: A. Thyroid storm Reference: McCance, K.L., & Huether, S.E. (2010). Pathophysiology: The biologic basis for disease in adults and children (6 th ed.). Maryland Heights, MO: Mosby Elsevier, pp Pagana, K.D., & Pagana, T. J. (2013). Mosby s diagnostic and laboratory test reference (12 th ed.). St. Louis, MO: Elsevier Mosby, p Rationale: Thyroid storm occurs most often in individuals with undertreated severe hyperthyroidism who are subjected to stress. A total T4 value greater than 20 mcg/dl is considered a critical value. 4. The CNS has been asked to assist in developing an orientation tool for perioperative staff based on Patricia Benner s Novice to Expert model. The CNS recognizes that the novice nurse will benefit most from: A. exposure to multiple unfamiliar situations. B. applying context-free principles and theories to direct patient care. C. caring for complex patients requiring a high level of technical expertise. D. being asked to anticipate patient care needs and respond appropriately. Correct answer: B. applying context-free principles and theories to clinical practice. Reference: Fulton, J.S., Lyon, B.L., & Goudreau, K.A. (2010). Clinical Nurse Specialist Practice. New York: Springer Publishing Co, pp

8 Rationale: Since the novice nurse does not have the experience on which to base actions, he/she must rely on knowledge gained from other means. A competent nurse has the experience to anticipate a likely course of events in a familiar situation and respond appropriately. 5. A significant increase in surgical site infections has been noted in total knee arthroplasties. The organism cultured from wound drainage has been identified as Clostridium difficile (C. difficile). The CNS knows that the most effective way to prevent this type of infection is through: A. increasing the number of alcohol-based hand washing stations in the department. B. ensuring that prophylactic antibiotics are administered within 60 minutes of surgical intervention. C. implementing airborne precautions for all patients admitted from long-term care facilities. D. appropriate hand washing using antimicrobial soap and water. Correct answer: D. appropriate hand washing using antimicrobial soap and water. Reference: Rothrock, J.C. (ed.). (2011). Alexander s care of the patient in surgery (14 th ed.). St. Louis, MO: Elsevier Mosby, p. 51. Rationale: C. difficile is a gram-positive organism found in the colon. It is transmitted through contact between individuals and contaminated objects. Alcohol-based hand rubs are ineffective in removing C. difficile from hands. CCI RESERVES THE RIGHT TO ESTABLISH, REVIEW, AND REVISE POLICIES AND PROCEDURES FOR CERTIFICATION/RECERTIFICATION AS DEEMED APPROPRIATE. Testing Center Regulations Prometric, the testing agency contracted through CCI, is responsible for: facilitating all test development committees in conjunction with CCI; development of the final form of the exam; development of measurement tools; administering and scoring exams; reporting results of exams to candidates and CCI; maintaining an item bank. Security measures Several security measures will be enforced during the administration of the exam to ensure the integrity of the program. Be aware that you will be observed at all times while taking the examination. This observation may include direct observation by test center staff, as well as video recording of your testing session. An educational video, What to expect on test day is available on Prometric s website at 7

9 Copying, retaining test questions, or transmitting the test questions in any form to other individuals, organizations, or study groups will result in forfeiting your right to have your examination scored and may result in civil prosecution and disciplinary action by CCI. Misconduct policy No personal belongings are permitted in the testing center with the exception of pencils and scratch paper which are provided by test center administrator. The computer will keep the official time. You may not eat, drink or use tobacco in the testing room. The test center administrator is authorized to dismiss you from the test session for any of the following reasons, and will notify Prometric and CCI of the action taken for: Failure to follow the test center administrator s directives. Creating a disturbance of any kind. Giving or receiving assistance of any kind. Using prohibited aids, such as reference materials, mechanical listening devices, and recording or photographic devices. Removing or attempting to remove test questions and/or responses (in any format) from the testing room. Removing or attempting to remove scratch paper from the test center. Attempting to take the test for someone else. Attempting to tamper with the operation of the computer. Leaving the testing room without permission. Leaving the test center/building at any time. Using electronic communications such as cellular phones, etc. Using notes, books, or other study aids. Bringing any materials to the test center that may compromise the administration of the exam. Sharing information about the test and/or test questions with any unauthorized person(s). If a proctor witnesses what he/she believes to be a security breach, the exam is stopped immediately; all related materials are retained and an incident report is generated and routed to Prometric. The Prometric Security Office makes a copy of the video and reviews it to determine if any inappropriate action requires follow-up with the test center personnel. The copy of the video and any related materials would then be delivered to CCI. If it is believed that an applicant or certificant violates the Misconduct Policy, breaches security, or fails to follow test center directions, CCI may render sanctions against the individual which include: suspension from the examination for an indefinite or specified period of time. notification, at the discretion of CCI s Board of Directors, of the candidate s employer, state board of nursing, insurance company, or other public health agency. 8

10 Test center irregularities Unlike cases of individual candidate misconduct, occasionally testing irregularities occur that affect a group of test takers. Such problems include, without limitation, administrative errors, defective equipment or materials, improper access to test content and/or the unauthorized general availability of test content, as well as other disruptions of test administration (e.g., natural disasters and other emergencies). When test center irregularities occur, Prometric will conduct an investigation to provide information to CCI. Based on this information, CCI may direct Prometric either not to score the test or to cancel the test score. When it is appropriate to do so, the Board will arrange with Prometric to give affected test takers the opportunity to take the test again as soon as possible, without charge. Affected test takers will be notified of the reasons for the cancellation and their options for retaking the test. The appeal process does not apply to test center irregularities. Americans with Disabilities Act Whenever possible, CCI is committed to providing reasonable accommodations in its exam processes to otherwise qualified individuals with physical or mental disabilities in accordance with the Americans with Disabilities Act (ADA). Pursuant to the ADA, accommodations will be provided to qualified candidates with disabilities to the extent that such accommodation does not fundamentally alter the exam or cause an undue burden to the agency. Candidates with disabilities must notify CCI in writing at the time of application stating the type of accommodation needed with current and appropriate documentation of the disability. Once a person is diagnosed as having a qualified learning disability under the ADA, the disability is normally viewed as life-long. Although the learning disability will continue, the severity of the condition may be altered over time. Because the provision of all necessary and reasonable accommodations is based on an assessment of the current impact of the individual s disabilities, the candidate must provide recent and appropriate documentation based on an evaluation within the past five (5) years. Candidates who submit documentation that is not within the past 5 years or that does not address the candidate s current need for accommodation(s) will be required to update the evaluation report. The purpose of this update is to determine the candidate s current need for accommodation(s). The documentation provided should include correspondence from a healthcare provider who has first-hand knowledge of the disability and which describes the nature of the disability and specific recommendations regarding the type of accommodations required to address the disability. The letter should be written on the health care provider s professional letterhead stationery and include his or her title, address, phone number, and original signature. Examples of requests for special testing accommodations that may be granted include: modification of seating or other physical arrangements in the test center. providing for the exam to be taken in an accessible location. providing for a reasonable extension of testing time. Examples of requests for special testing accommodations that may be denied include: modification of the content of an objective multiple-choice exam. providing for unlimited testing time permitting a reader to paraphrase test material or translate the material into another language. All accommodation determinations will be made by CCI at its discretion. 9

11 Certification Policies Confidentiality A system for safeguarding confidential information provided by certification applicants/candidates will be maintained. No outside agency or persons shall have access to individual certification files/records unless written permission is granted by the applicant/candidate. In the event of legal proceedings, written requests for records must be submitted by the court or the applicant/candidate s legal counsel. Verification Accuracy of information submitted on applications may be verified by telephone and/or letter at the discretion of CCI staff. All information gained through verification procedures will be kept confidential except in instances when the law demands disclosure of facts. Should any information on an application be found false, the applicant will be notified and declared ineligible to continue the certification process. Use of credential CNS-CP is the designation recognizing the registered nurse who has become certified as a Clinical Nurse Specialist in the perioperative setting. The mark CNS-CP is federally registered with the U.S. Patent and Trademark Office, and may only be used in accordance with CCI policy by those who have achieved and maintained the requirements associated with the credential. Use of the symbol R in a circle ( ) is legal and appropriate from a trademark sense. It is not necessary or desirable to use in connection with every use of the mark. Letterhead, signs, advertisements, and clothing are examples where the mark may be used; it is neither necessary nor desirable to use the symbol in text, on business cards, or on name badges. The credential should be written as follows: Jane A. Doe, RN, MSN, (any credential related to primary licensure/certification as a CNS), CNS-CP Request for amendment of CCI policy A process is available to an individual seeking amendment of a CCI policy. Supporting documentation must accompany the written request before it will be considered by CCI. Mail the request for amendment, by certified mail, to: The Competency and Credentialing Institute 2170 South Parker Road, Suite 295 Denver, CO Appeal process There shall be an external Board of Appeals available to a nurse seeking appeal of decisions made by CCI. Such Board of Appeals will be appointed as needed, and will be composed of six past board members of CCI (three members and three alternates). A written request for review by the Board of Appeals and supporting documentation must be submitted by the nurse within 30 days after receipt by the nurse of CCI s initial decision. Decisions of the external Board of Appeals shall be final and binding. All requests for amendment or appeal will be heard in accordance with the CCI policies in effect at the time of the appeal. 10

12 Revocation of credential CCI reserves the right to revoke the certified status of a Clinical Nurse Specialist (CNS) holding the CNS-CP credential upon receipt of information that the CNS has: falsified information on any application or in other documents submitted to CCI; a suspended, revoked, or restricted RN/APRN license; been placed on probation or received other disciplinary action by a state board of nursing; failed to comply with the conditions of the recertification requirements, including meeting specified deadlines; failed to achieve a passing score on the recertification examination; not paid any outstanding debts to CCI; committed a breach of confidentiality and/or security including cheating, failure to follow test center instructions, or violation of any examination policy. Certified nurses will be informed by letter of CCI s decision to revoke the status of their credential. There will be no refund if, for any reason, status is revoked. Misuse/misrepresentation of the credential Any person who is found to misuse or misrepresent the credential shall be subject to legal action by CCI. CCI may render sanctions against the individual that may include, but not be limited to: suspension from the examinations for an indefinite or specified period of time. notification, at the discretion of CCI s Board of Directors, of the candidate s employer, state board of nursing, insurance company, or other public health agency. Publicity CCI reserves the right to designate and approve national publicity concerning the certification program for purposes of marketing. AORN Headquarters, AORN chapters, and the AORN Journal may appropriately recognize AORN members who become certified. CNS-CP Recertification Definition of Recertification The documented validation of continued professional achievement of identified standards of care by an individual Clinical Nurse Specialist in the perioperative setting. Purpose of Recertification CNS-CP certification is a voluntary recognition program designed for Clinical Nurse Specialists whose practice emphasis is in the perioperative setting. Recertification of this credential recognizes the professional achievement of a Clinical Nurse Specialist who has chosen to maintain proficiency as an advanced practice nurse in the perioperative setting. All activities undertaken in the process of renewal of certification should extend the knowledge in and improve the candidate s ability to function as an advanced practice nurse in the perioperative setting. Recertification: 11

13 Recognizes the individual Clinical Nurse Specialist who is proficient in practice in the perioperative setting. Supports the development of theoretical constructs which strengthen perioperative nursing practice. Enhances professional growth through continued learning that results in acquisition of current information to expand advanced practice skill sets. Concurrent maintenance of CNOR credential For those holding both CNS-CP and CNOR credentials, recertification eligibility requirements must be met for each credential. Recertification cycle The certified status of an individual CNS-CP is conferred by CCI for a period of 5 years, at which time the candidate may seek recertification. On-line applications for recertification open on January 1st of the year a certificant is due to recertify. Applications received after Dec. 31 st of the recertification year will not be accepted under any circumstances. A lapsed CNS-CP credential may be reactivated by meeting all eligibility criteria and passing the CNS-CP exam. The recertification process will require a CNS-CP to complete the method of recertification in effect at the time recertification is due. Practice hours and activities must be accrued in the 5-year certification cycle. Practice hours must be at the advanced practice level in the area of perioperative nursing. Only completed applications with applicable payments will be eligible for approval. CNS-CPs cannot be recertified until the year in which the certification expires. Eligibility requirements, recertification Applicants for CNS-CP recertification must: Hold a current, unrestricted RN and/or APRN license in the United States. Hold a current CNS-CP certification. Be currently employed as a CNS in the perioperative setting in one or more of the following areas: o clinical expert in delivery of advanced perioperative care o consultant (intra-and multidisciplinary) o educator of nurses, other healthcare providers, patient, family, and/or community o clinical inquiry (evidence-based practice projects and/or research) o organizational and systems thinking o professional accountability Methods of CNS-CP Recertification The CNS-CP Recertification program is made up of two components: 1. Addressing knowledge deficits through ongoing continuing education. The number of contact hours required for recertification is based on the results of the exam (first recertification cycle) or the self-assessment/situational judgment exam (subsequent recertification cycles). In addition to any contact hours required for individual domain content areas, applicants must complete 10 contact hours related to pharmacology. 12

14 2. Demonstration of skills through a variety of self-selected activities meant to showcase the unique skills set of the Clinical Nurse Specialist in the perioperative setting. The 125 activity points required for CNS-CP recertification may be acquired through any of the 9 eligible activities listed below. Candidates are not required to submit points in every category. All points must be earned through activities that provide content specific to or with direct application to perioperative nursing. Recertification application process All applicants for recertification must: Hold a current CNS-CP certification Hold a current, unrestricted RN and/or APRN license in the United States Pay the renewal fee In addition, applicants must choose one of the following recertification options: Recertification Option A: Continuing education and Professional Activities Complete 125 Professional Activity points and the contact hours requirement Complete 1000 hours as a CNS in the perioperative setting in the 5 year recertification cycle. If the number of practice hours does not meet the minimum requirement, Option B must be chosen. Practice may be direct or indirect, including: o clinical expert in delivery of advanced perioperative care o consultant (intra-and multidisciplinary) o education of nurses, other healthcare providers, patient, family, and/or community o clinical inquiry (evidence-based practice projects) and/or research) o organizational and systems thinking o professional accountability Recertification Option B: Professional Activities and testing (if practice hour requirement cannot be met) Complete 125 Professional Activity points and the contact hours requirement Pass the certification exam. In order to prevent the credential from expiring, the last day to register for the examination is September 30 of the year certification is due to lapse. Certificants must take and pass the exam by December 31st of the year certification is due to lapse or their CNS-CP credential will expire. The same rescheduling, transferring examination windows, cancelling test appointment dates and late/no show policies for CNS-CP certification by examination apply to CNS-CP recertification. 13

15 CNS -CP Certification and Recertification Candidate Handbook Continuing Education For the first examination cycle the contact hour requirement for recertification will be based on the results of the CNS-CP examination. Continuing education requirements direct professional development by enhancing the knowledge level of the certificant. Contact hour requirements are generated from those domains scoring less than the standard. See the table below to determine the contact hour requirements for each domain. Domain 1. Clinical expert in the delivery of advanced practice perioperative care 2. Consultant (Intra-and multidisciplinary) 3. Education (nurse, other healthcare providers, patient, family, and community) 4. Clinical Inquiry (evidence-based practice projects and/or research) 5. Organizational and systems thinking 6. Professional accountability Required number of contact hours if scored less than the standard on exam 31 contact hours 16 contact hours 13 contact hours 15 contact hours 16 contact hours 9 contact hours Only continuing education which reflects the clinical focus of the domain may be used. In addition to any domain-related required continuing education, 10 contact hours associated with advanced practice pharmacology must be earned. Contact hours must be earned during the current 5 year recertification cycle. The same contact hours cannot be used for both CNOR and CNS-CP recertification. The certificant is responsible for maintaining a record of contact hours in the CCI online database. Requirements for using contact hours as part of recertification requirements The candidate must maintain a copy of the certificate of attendance for each approved program and submit such records if audited. An official log from an accepted provider containing the same information as that found on the certificate may be accepted in lieu of certificates. Each certificate of attendance must have an accreditation statement and provider number. Acceptable accredited providers for contact hours. To be counted, your contact hours must be awarded through one of the following providers: American Nurses Credentialing Center (ANCC) Any State Board of Nursing Any State Nurses Association American Association of Critical-Care Nurses (AACN) American Association of Nurse Anesthetists (AANA) American Academy of Nurse Practitioners (AANP) 14

16 American College of Nurse Midwives (ACNM) National Association of Nurse Practitioners in Women's Health (NPWH) National Association of Clinical Nurse Specialists (NACNS) Physician PRA Category 1 CME Approved topics To help ensure the validity of this credential and its consistency with industry standards, CCI requires contact hours earned for CNS-CP recertification to be related to the specialty of perioperative nursing at the advanced practice level. Although the following is not an all-inclusive list, it provides a broad range of APRN perioperative-related topics. o Advanced Pathophysiology o Advanced Physical Assessment, including differential diagnosis o Advanced Pharmacology o Legal issues related to advanced practice o Monitoring and treating physiologic responses to surgical stressors o Pain management, including pharmacologic and non-pharmacologic interventions o Change theory o Conflict resolution o Interprofessional collaboration o Strategic planning o Risk analysis/risk management o Teaching/learning theories o Educational programs that incorporate the three spheres o Clinical inquiry (evidence-based practice projects and/or research) o Healthcare economics o Health policy regulation/legislation The following DO NOT meet the criteria for recertification and are therefore not acceptable: 1. Any program approvers or providers not listed above in Acceptable Providers. 2. Handwritten accreditation statements or provider numbers. 3. Certificates of attendance without an appropriate accreditation statement and provider number. 4. Contact hours earned prior to the exam/situational judgment exam 5. Contact hours accrued for CNOR recertification cannot be used for CNS-CP recertification. The use of academic credits to fulfill continuing education requirement Academic credits may be used to fulfill the continuing education requirement for recertification of the CNS-CP. All academic credits must meet the following criteria in order for them to be acceptable for use toward CNS- CP recertification: 15

17 1. Course must be taken for credit at an accredited academic institution. 2. Any course required for a degree program is acceptable as long as subject matter is consistent with the domain. 3. The CNS-CP does not have to be enrolled in a nursing or other degree program. 4. Course must be at the graduate or post-graduate level. 5. To be acceptable, a grade of B or better must be achieved for each course. 6. If audited, an original grade report must be provided. Academic credit conversion to contact hours: 1 semester hour/credit 15 contact hours 1 quarter hour 10 contact hours The use of CME credits: CNS-CPs may submit unlimited Continuing Medical Education (CME) units to fulfill contact hour requirements. Each CME is worth 1 contact hour. Professional activities A list of eligible activities to be used in meeting the professional activities requirement for recertification is presented below. The candidate may choose from among the 9 titles. A maximum number of points are allowed for each activity. The candidate must earn a total of 125 points to recertify the CNS-CP credential. All activities must be completed within the 5-year recertification cycle. Academic study - graduate or post-graduate level Academic course content may be applied towards enhancement of professional perioperative nursing at the advanced practice level. Enrollment in a degree program is not required. A grade of B or higher is required. Maximum total points allotted: 100. Acceptable documentation: original school transcript and course description(s). Conversion rate for academic credit: 1 semester hour/credit 15 points 1 quarter hour 10 points Service as a Board Officer or Committee Member (e.g., facility APN committee, NACNS or AORN APN Specialty Assembly) Participation in national/regional/state/and local professional nursing organizations related to advanced practice which provides a mechanism for contributing to the growth of the specialty may be utilized for points. 16

18 Participation in other nursing specialty organizations whose mission is directly related to the care and support of perioperative patients is also acceptable for point accrual. Points are awarded for each year of office served. Maximum points allotted: 60. Acceptable documentation (only required if audited) Board report, minutes, committee report, or other documentation validating participation at a minimum of 4 contacts/year. International, national or state committee, elected officer or board member International, national, or state board member Local or facility level committee chair, elected officer or board member Local or facility committee member Other leadership position, any level 25 points/year 20 points/year 15 point/year 10 points/year 7 points/year Clinical Inquiry (evidence-based practice projects and/or research) The CNS-CP carries with it an expectation that the CNS in perioperative practice can interpret research findings and incorporate scientific inquiry to validate and/or change clinical practice. Some of these activities may be performed due to employer directives, but some are independent of employment status. To receive points in this category, you must have had the primary responsibility for developing, implementing, and evaluating the project. The activity must show evidence of the participation in or application of research that improves current practice and/or patient outcomes. Maximum points allotted to this activity: 80. Acceptable documentation (provide only if audited): A final report which summarizes evidence of participation in a research project or study, including its impact on current practice and/or patient outcomes. Primary investigator Co-investigator 30 points 20 points Instructor, Academic program CNSs in perioperative practice who teach in academic programs may use the same amount of credit awarded to the students enrolled in the course to maintain their certification. Courses must be a graduate, postgraduate, or post-graduate certificate level course in an accredited school and have a perioperative component. Students may include residents, interns, physicians, Physician Assistants, graduate/doctoral nursing students, and/or APRNs (Nurse Practitioner/Clinical Nurse Specialists/Certified Nurse Midwives, and Certified Registered Nurse Anesthetists). Maximum points allotted: 90. Acceptable documentation (only if audited) must include the following: Course description, syllabus with course objectives, number of credits, and methods of evaluation. If your name does not appear as the instructor in the syllabus, a signed letter from the department chair on school letterhead attesting to serving as instructor will be accepted. 17

19 Conversion rate for academic credit: 1 semester hour/credit 15 points 1 quarter hour 10 points Precepting Those CNSs in perioperative practice who precept APRN (NP, CNS, CNM, or CRNA) students may use the same amount of credit for recertification as that awarded to the students enrolled in the course. Nursing students must be enrolled in an accredited graduate nursing education program. Students must be present for at least one academic quarter, semester, or the entire clinical rotation. The preceptorship should be in a one-on-one relationship focusing on exposure to the role of the CNS in the perioperative setting. Preceptorships involving partial clinical experiences or undergraduate students will not be accepted. This option does not apply to orienting new staff to workplace. Maximum points allotted for this activity: 60 points. Acceptable documentation (only if audited) must include the following: Letter from sponsoring institution (on official letterhead and signed by faculty or department chair) indicating your responsibilities as preceptor and dates/hours of preceptorship. Conversion rate for precepting: 1 semester hour/credit 15 points 1 quarter hour 10 points Presentation for an Advanced Practice audience, non-academic (e.g., NACNS or AORN APRN Education track) Presentation must be related to advanced practice perioperative nursing in one or more of the following areas: direct patient care consulting education (patient, family, nurse, health care provider, and community) clinical inquiry (evidence-based practice projects and/or research) organizational/systems thinking professional accountability Maximum number of points allotted: 50. Acceptable documentation: flyer, brochure, handout or link with title of presentation, objectives, and outline of content. If poster is submitted, please provide a picture of completed work with proof of acceptance at conference. 18

20 Podium presentation (must be minimum 30 minutes in length) In-service (must be minimum of 30 minutes in length) Remote presentation (i.e. webinar, teleconference, etc.) (must be minimum 30 minutes in length) Poster presentation 30 points 25 points 20 points 10 points Author, book, journal article, or patient/family educational material To use a publication for recertification: Acceptable documents include original work for books, peer-reviewed journals, professional newsletters, patient/family educational material or electronic media that requires review and synthesis of current literature. Article/book must be related to advanced practice perioperative nursing in one or more of the following areas: o direct patient care o consulting o education (patient, family, nurse, health care provider and community) o clinical inquiry (evidence-based practice projects and/or research) o organizational/systems thinking o professional accountability. Except for publications aimed at patient/family education, publication must be directed at a professional audience. The item must have been accepted for publication during the 5-year recertification cycle even if actual publication date is past the recertification period. Maximum points allotted for this activity: 75. Acceptable documentation (only if audited): for shorter publications, provide a copy of the journal article, fact sheet, brochure, etc. For longer publications, e.g., textbook provide a copy of title page, table of contents, or abstract that includes your name as a contributor and the publication date. A copy of the publisher notification of acceptance is required if the publication date occurs after the recertification cycle. Primary author, chapter in book Secondary author, chapter in a book Subject matter expert or reviewer for journal article or chapter in book Author, book review Doctoral dissertation 50 points 35 points 20 points 15 points 50 points 19

21 DNP capstone project Editorial, peer-reviewed professional journal Primary author, peer-reviewed professional journal article Secondary author, peer-reviewed professional journal article Development of patient education tool or healthcare professional fact sheet 40 points 25 points 40 points 25 points 10 points Volunteer, CCI Test development committee (Item writer, item reviewer, form review, cut score/standards setting, other) CNSs who serve as subject matter experts for CNS exam test development committees (e.g., item writer, item reviewer, form review, cut score/standard setting, etc.) may use this experience towards recertification. Maximum points allotted for this activity=50. Acceptable documentation (only if audited): CCI acceptance letter. Job analysis Item writer Cut score/standard setting Item reviewer Form reviewer Other (please specify) 40 points/appointment 30 Points/appointment 30 points/appointment 20 Points/ appointment 15 Points/ appointment 15 points/appointment APRN Certification Maintenance and/or achievement of advanced practice certification in a population focus, e.g., ACNS-BC. Maximum total points allotted: 45. Acceptable documentation (only if audited): Copy of certificate or wallet card. 20

22 Conversion rate for APRN certification: Initial APRN primary (population) certification Maintaining APRN primary (population) certification Attaining/maintaining prescriptive authority 30 points 20 points/renewal period 15 points/renewal period CNS-CP Recertification notification Recertification notification will be mailed to you in January of the year in which your certification expires. If you do not receive the notification, please contact: Competency and Credentialing Institute 2170 South Parker Road, Suite 295 Denver, CO (303) (888) Audits A percentage of recertification applications will be randomly selected for audit. However, if there is reason to believe there has been a breach in the integrity of the process by an individual seeking recertification, CCI staff will also select those individuals to audit. Since CCI will conduct a random audit of all CNS-CP recertification applications, it is important to retain all supporting documentation. The process of collecting and organizing these documents takes time so you are wise to begin the process early in your recertification cycle. Those applicants to be audited will receive notification and further instructions after receipt of their applications. The required documentation for the audit is listed at the end of each Activity. Supporting documentation is to be submitted ONLY if you are audited. Those documents must be received prior to the deadline for recertification. COMPLETION TIPS Keep accurate and detailed records of your CNS perioperative practice activities that count toward Activity points. Activities must have been completed during the appropriate recertification cycle window. Your application, activity logs, and verification forms must be typed or computer generated. Handwritten documents will not be accepted. Electronic forms are available at Do not submit activity logs with excess points. Applications that contain points exceeding the required number will be returned. If you have questions, please call CCI at , or visit the CCI website at 21

23 CHECKLIST 1. The following will be required for a completed application: Online application Activity logs (typed or computer generated). Be sure to list the total number of points obtained per activity. Note the maximum number of points allowed for each activity. Curriculum vitae or resume, including current position summary reflective of Advanced Practice duties and responsibilities (typed or computer generated) 2. Pay on-line at or make a check payable to CCI. For information concerning recertification fees please see the CCI website. 3. Send all necessary forms and documentation to: info@cc-institute.org Mail packet to CCI, 2170 S. Parker Road, Suite 295, Denver, CO Fax to Please call within 20 minutes after sending to assure packet has been received by CCI 4. Please remember to retain your own copy of all submitted documents. Emeritus Status CNS-CPs who have retired from perioperative nursing may use the designation CNS-CP(E) after paying a onetime fee and submitting an application. The application must be submitted while the credential is current. The emeritus credential is not available after the credential has lapsed. CNS-CP(E) members may be considered for CCI Board and committee appointments. 22

24 CNS -CP Certification and Recertification Candidate Handbook CNS PERIOPERATIVE SPECIALTY CERTIFICATION EXAM Tasks and Knowledge Statements with Bibliography Domain 1: Clinical Expert in Delivery of Advanced Perioperative Care (31% of exam/31 questions) KNOWLEDGE STATEMENTS 1. Behavioral responses to physiological and psychological stressors 2. Communication 3. Community dynamics 4. Conflict resolution 5. Differential diagnosis 6. Diversity (cultural and/or generational) 7. Metabolic needs 8. National accepted clinical guidelines and recommended practices 9. Pain management 10. Pathophysiology/surgical pathology 11. Patient/family dynamics 12. Pharmacology 13. Physical assessment 14. Risk mitigation 15. Scope of Advanced Nursing Practice 16. Scope of Nursing Practice 17. Surgical/procedural anatomy 18. Treatment plans TASK STATEMENTS 1. Conduct comprehensive, holistic wellness and illness assessments using evidence-based techniques, tools, and methods. 2. Assess, monitor, and recognize complex physiologic responses of patients (i.e. continuous surveillance). 3. Collaborate with patients and families regarding discharge planning. 4. Demonstrate complex clinical judgment and reasoning in perioperative nursing care. 5. Appraise patients' knowledge regarding wound care and the phases of wound healing 6. Determine the presence and adequacy of a patient's support system and prescribes necessary modalities. 23

25 7. Develop or implement systems to ensure safe practices. 8. Diagnose, interpret findings, and manage the patient for signs and symptoms of alterations in health status. 9. Evaluate nutritional status and prescribe appropriate treatment modalities. 10. Evaluate patients' pain control needs and formulate an individualized pain management plan. 11. Evaluate protective measures to prevent alterations in health status of individuals and groups at risk. 12. Incorporate the patient's psychological, philosophical, cultural, and spiritual beliefs, values, and wishes concerning care when formulating the treatment plan. 13. Formulate differential diagnosis. 14. Formulate individualized treatment plans. 15. Evaluate the feasibility of the patients' expectations for the next level of care. 16. Identify patients who are at risk for the presence of physical barriers or potential hazards in the home. 17. Identify psychosocial issues specific to medication management. 18. Implement measures of psychological support to patients and family. 19. Independently integrate and apply in-depth principles of traditional, complementary, and alternative medicine to ensure optimal patient outcomes. 20. Order and perform procedures to compare and contrast clinical findings to ensure optimal patient outcomes. 21. Order, prescribe, initiate, and interpret diagnostic, therapeutic, and/or pharmacologic interventions. 22. Perform comprehensive and individualized patient assessments. 23. Perform history and physical examinations. 24. Provide an in-depth interpretation of patient conditions and gives rationales for procedures. 25. Provide anticipatory guidance for expected and potential situational changes. 26. Synthesize knowledge of therapeutic regimens and patient response for evaluation of care. 24