CPC Handbk Cpyright 2017 by the Natinal Bard f Certificatin and Recertificatin fr Nurse Anesthetists (NBCRNA). All Rights Reserved.
CONTENTS NBCRNA Overview... 4 Visin... 4 Missin... 4 Histry... 5 Purpse... 5 Structure... 6 NCCA Accreditatin... 6 ABSNC Accreditatin... 6 CPC Prgram Overview... 7 Categries f CPC Cmpliance... 7 Full CPC Cmpliance... 7 Interim CPC Cmpliance... 8 Requirements fr Full CPC Cmpliance... 8 First Eight-Year CPC Prgram Perid... 10 Initially certified n r after January 1, 2024... 11 Interim Cnditinal CPC Cmpliance... 12 Cnditinal CPC Cmpliance Perid... 12 Change in Status... 12 Examinatin Overview... 12 CPC Examinatin Perfrmance Standard... 13 CPC Examinatin Passing Standard... 14 Eligibility Requirements fr the CPC Examinatin... 14 Significance f Eligibility Status... 15 Expiratin f Eligibility Status... 16 Ineligibility t Take the CPC Examinatin... 16 Grunds fr Denial, Suspensin r Revcatin f Eligibility Status... 16 Applicatin fr CPC Examinatin... 18 Applicatin fr CPC Cmpliance... 19 Prcess fr Each Fur-Year CPC Cycle... 19 CPC-Specific Plicies and Prcedures... 20 CPC Cmpliance Perid... 20 CPC Handbk 2 Versin 04.02 Last Revised 3/26/2018
Denial f Reprted CPC Prgram Requirements... 21 Class A Assessed CE... 21 Class B Prfessinal Develpment... 21 Late Cmpletin f CPC Prgram r Late Applicatin... 21 Requesting Additins t Class B Credit Table... 23 Review Prcess fr Requested Additins t the Class B Table... 23 2-Year Check-In......... 24 Reasnable Accmmdatin fr Persns with Disabilities...25 Initial Certificatin f New Graduates...25 Discipline, Administrative Actin and Appeals.......26 CPC Examinatin Cntent Outline... 26 Dmain I: Airway Management (34%)... 26 Dmain II: Applied Clinical Pharmaclgy (24%)... 27 Dmain III: Human Physilgy and Pathphysilgy (24%)... 27 Dmain IV: Anesthesia Equipment and Technlgy (18%)... 29 Nte: Where used in this Handbk, the phrases irregular behavir r imprper behavir refer t (1) prvisin f false r incmplete infrmatin t the NBCRNA in relatin t the credentialing prcess; (2) vilatin f any f the rules r regulatins gverning any NBCRNA examinatin; r (3) engaging in any activity which is grunds fr disciplinary actin as described in the NBCRNA Plicies and Prcedures fr Discipline, Administrative Actin and Appeals. This publicatin cntains infrmatin abut NBCRNA s CPC Prgram requirements necessary t maintain primary certificatin by the NBCRNA. Nurse Anesthetists are respnsible fr knwing the cntents f this handbk as well as any additinal applicable NBCRNA plicies (e.g., please see NBCRNA s General Infrmatin and Plicies Handbk). All crrespndence and requests fr infrmatin shuld be sent t the NBCRNA at CPC@nbcrna.cm. The NBCRNA des nt discriminate n the basis f age, sex, race, religin, natinal rigin, ethnicity, disability, marital status, sexual rientatin, and gender identity. NBCRNA primary certificatin and recertificatin prgrams are accredited by the fllwing rganizatins: CPC Handbk 3 Versin 04.02 Last Revised 3/26/2018
NBCRNA Overview The Natinal Bard f Certificatin and Recertificatin fr Nurse Anesthetists (NBCRNA) is a nt-fr-prfit crpratin rganized under the laws f the state f Illinis. NBCRNA credentialing prvides assurances t the public that certified individuals have met bjective, predetermined qualificatins fr prviding nurse anesthesia services. A nurse anesthetist wh is certified by the NBCRNA is expected t respect basic human rights and the dignity f all patients; prtect the patient frm harm; advcate fr the patient s welfare and cllabrate with ther members f the health prfessins; be respnsible and accuntable fr his r her actins; maintain cnfidentiality f patient infrmatin, except when disclsure is required by law; and maintain the knwledge and skill necessary fr cmpetent nurse anesthesia practice. While state licensure prvides the legal credential fr the practice f prfessinal nursing, private vluntary certificatin indicates cmpliance with the prfessinal standards fr practice in this clinical nursing specialty. The certificatin credential fr nurse anesthetists has been institutinalized in many psitin descriptins as a practice requirement r as the standard fr demnstrating equivalency. It has been recgnized in state nurse practice acts and state rules and regulatins. The primary purpse f the NBCRNA is t seek t ensure that nurse anesthetists have the necessary knwledge and skills t practice safely and effectively. In s ding, it als prtects the value f the CRNA credential. The NBCRNA has designed bjective criteria intended t determine whether an individual hlding the NBCRNA-issued CRNA credential is prperly licensed, has attested t engagement in the practice f nurse anesthesia; has participated in cntinuing educatin and ther activities sufficient t indicate an effrt t keep current with advances, and is free f any mental, physical, r ther prblems that may interfere with the practice f nurse anesthesia. Whenever prgram eligibility criteria are develped and/r revised, the NBCRNA engages multiple stakehlders t ensure apprpriate cnsideratin has been given as t the impact f NBCRNA decisins. NCCA defines cmpetence as "the ability t perfrm a task, functin, r rle up t a set f prescribed standards" (NCCA, 2014) and cntinuing cmpetence as demnstrating "specified levels f knwledge, skills, r abilities nt nly at the time f initial certificatin but als thrughut an individual s prfessinal career" (NCCA, 2014). These cncepts serve as the fundatin underpinning the NBCRNA certificatin and cntinued certificatin prgrams. Visin The visin f the NBCRNA is t be recgnized as the leader in advanced practice nurse credentialing. Missin The missin f the NBCRNA is t prmte patient safety thrugh credentialing prgrams that supprt lifelng learning. CPC Handbk 4 Versin 04.02 Last Revised 3/26/2018
Histry The primary certificatin prgram fr nurse anesthetists was intrduced by the American Assciatin f Nurse Anesthetists (AANA) in 1945. It was initially administered by the Credentials Cmmittee f the AANA. In 1975, the AANA apprved the establishment f cuncils fr the accreditatin and certificatin prcesses, and the Cuncil n Certificatin f Nurse Anesthetists (CCNA) assumed the respnsibility fr the Natinal Certificatin Examinatin (NCE). By this actin, the prfessin recgnized that credentialing mechanisms, which include examinatin and certificatin, functin t prtect and benefit the public. Realizing that evidence f cntinued prfessinal excellence was becming increasingly imprtant in ur sciety, the AANA Bard f Directrs in 1968 directed the AANA Educatin Cmmittee t study the issue f recertificatin. At the AANA Annual Meeting in 1969, a bylaw was adpted t establish an ptinal prgram t prvide certificates t members wh had demnstrated they had cmpleted clinical and didactic experiences reflective f the changes in nurse anesthesia practice within a five-year perid. Recgnizing that cntinuing educatin prvides ne means t assess current educatinal and knwledge levels f practitiners, a mandatry cntinuing educatin prgram was adpted by the AANA membership at the 1976 Annual Meeting, with full implementatin effective August 1, 1978. In September 1978, the AANA membership adpted the bylaw revisins prviding fr an rganizatinal restructuring f the Assciatin and establishing a Cuncil n Recertificatin f Nurse Anesthetists (COR). Bylaw prvisins granting the COR autnmy were adpted in 1983. In 2007, the CCNA and the COR became independent f the AANA, and tgether they incrprated as the Natinal Bard f Certificatin and Recertificatin fr Nurse Anesthetists (NBCRNA). With its cntinued missin t prmte patient safety, the NBCRNA implemented the Nnsurgical Pain Management subspecialty certificatin in 2015 and the Cntinued Prfessinal Certificatin (CPC) Prgram in 2016. Purpse The purpse f the NBCRNA includes, but is nt limited t, seeking t ensure that nurse anesthetists have the necessary knwledge and skills t practice safely and effectively. In s ding, it als prtects the value f the CRNA credential. The NBCRNA is respnsible fr: Frmulating, adpting and cnfirming cmpliance f initial and subspecialty certificatin eligibility requirements fr nurse anesthetists Frmulating, adpting and cnfirming cmpliance f recertificatin and cntinued prfessinal certificatin (CPC) eligibility requirements fr nurse anesthetists Frmulating, adpting and cnfirming cmpliance f the requirements fr eligibility fr admissin t NBCRNA-administered examinatins including, but nt limited t, the SEE, NCE, NSPM exam, and the CPC exam Frmulating, adpting and administering NBCRNA-created examinatins t candidates wh have met all requirements fr examinatin and have been fund eligible CPC Handbk 5 Versin 04.02 Last Revised 3/26/2018
N natinal rganizatin can expect t determine the specific prcedures that any individual nurse anesthetist is qualified t perfrm. Neither can any natinal rganizatin determine whether an individual nurse anesthetist may have develped an impairment that culd interfere with the prper administratin f anesthesia. Ultimately, these judgments must be entrusted t the individual nurse anesthetist and t thse with whm he r she wrks. Structure The NBCRNA Bard f Directrs is cmpsed f nurse anesthetists wh hld the NBCRNA-issued CRNA credential and wh are actively engaged in clinical practice r in teaching r administratin f a nurse anesthesia educatinal prgram; a bard-certified surgen and a bard-certified anesthesilgist, bth f whm have a current wrking relatinship with nurse anesthetists; and a representative f the public at large. NCCA Accreditatin The primary certificatin and recertificatin prgrams f the NBCRNA are accredited thrugh April 2022 by the Natinal Cmmissin fr Certifying Agencies (NCCA), a private nt-fr-prfit rganizatin. The NCCA is the accrediting branch f the Institute fr Credentialing Excellence (ICE), which is the natinal standard setting rganizatin fr credentialing grups, including certificatin bards, licensing bards, and assciatins. The NBCRNA (and befre it, the CCNA and COR) has been cntinuusly accredited by the NCCA since 1980. NCCA accreditatin means that the NBCRNA credentialing prgrams meet the highest natinal vluntary standards fr private certificatin. It means that the prgrams have been reviewed by an impartial cmmissin and deemed t have met the natinally accepted criteria and guidelines f the NCCA. ABSNC Accreditatin The primary certificatin and recertificatin prgrams f the NBCRNA are accredited thrugh July 2022 by the Accreditatin Bard fr Specialty Nursing Certificatin (ABSNC) f the American Bard f Nursing Specialties (ABNS). The NBCRNA (and befre it, the CCNA and COR) was ne f the first natinal credentialing rganizatins t be recgnized and accredited by the ABSNC. The ABNS, established in 1991, is the natinal peer review prgram fr specialty nursing credentialing rganizatins. ABNS serves as the natinal umbrella rganizatin fr nursing specialty certificatin bards authrized and recgnized t certify nurse specialists in the United States. It prmtes the highest quality f specialty nursing practice thrugh the establishment f standards f prfessinal specialty nursing certificatin. CPC Handbk 6 Versin 04.02 Last Revised 3/26/2018
CPC Prgram Overview Thrugh the Cntinued Prfessinal Certificatin (CPC) prgram, the NBCRNA seeks t advance the quality f nurse anesthesia care prvided t patients. Specifically, it endeavrs t ensure that nurse anesthetists are maintaining their skills and keeping current with scientific and technlgical develpments. It als strives t assure that apprpriate limitatins are placed n thse wh are knwn t have develped cnditins that might adversely affect their ability t practice nurse anesthesia. The CPC prgram spans an eight-year perid, which is cmprised f tw fur-year cmpliance cycles. Each fur-year cycle has a specific set f requirements. The new CPC prgram replaces the frmer tw-year recertificatin prgram. Beynd apprpriate licensure and practice requirements, the CPC prgram cnsists f fur cmpnents required t maintain certificatin and the cntinued use f the NBCRNA-granted CRNA credential: Class A Cntinuing Educatin (CE) prgrams are prir-apprved educatinal prgrams directly related t anesthesia that cntain sme frm f assessment. The assessment shuld validate the CE activity s stated learning bjectives and verify that learning has ccurred. Class B Prfessinal Develpment Activities are defined as activities that enhance the anesthetist s fundatinal knwledge f nurse anesthesia practice, supprt patient safety, r fster the nurse anesthetist s understanding f the brader healthcare envirnment. A cmplete list f NBCRNA-apprved Class B activities is n the NBCRNA website. Cre Mdules prvide directed assessed CE in fur cre areas f anesthesia. CPC Examinatin assesses the critical cre knwledge needed t practice the art and science f nurse anesthesia. Categries f CPC Cmpliance NBCRNA recgnizes tw categries f CPC cmpliance: Full and Interim. Full CPC Cmpliance Applicants wh fulfill all requirements f the CPC prgram are granted Full CPC Cmpliance and receive a status f CPC Cmpliant. A status f CPC Cmpliant means that a nurse anesthetist has met all CPC Prgram requirements fr the current CPC cycle. In rder t achieve Full CPC Cmpliance, an applicant must submit all required applicatins (i.e., 2-Year Check-In at the midpint f each fur year CPC Cycle, and the CPC Cmpliance, at end f each fur-year CPC Cycle), remit all crrespnding fees, and cmply with all prgram requirements. CPC Handbk 7 Versin 04.02 Last Revised 3/26/2018
Interim CPC Cmpliance The purpse f Interim CPC Cmpliance is t prvide fr thse individuals wh, fr a specific reasn and fr a limited perid f time, may nt be in full cmpliance with all CPC requirements. Requirements fr Full CPC Cmpliance In rder t achieve Full CPC Cmpliance, an applicant must submit a CPC applicatin, remit the crrespnding fees, and cmply with all f the fllwing requirements prir t his/her CPC cmpliance expiratin date. The subsectins belw are required t be reprted every fur years; hwever, nurse anesthetists are als required t cmplete a 2-Year Check-In. The purpses f the mid-cycle check-in are t: Validate state and/r APRN licensure as apprpriate; cnfirm cntinued practice within the specialty; update persnal cntact infrmatin; and review prgress made tward fur-year CPC prgram requirements. Pssess Initial Certificatin granted by the NBCRNA, r its predecessr Licensure Dcumentatin f cmpliance with all state requirements fr licensure as a registered nurse perfrming nurse anesthesia, including a current unrestricted license t practice as a registered prfessinal nurse, with authrity t practice nurse anesthesia if such authrity is granted, in at least ne state and in all states in which the applicant currently hlds an active license. Fr thse individuals emplyed by the United States gvernment, state requirements refer t the requirements f any state r territry f the United States. Practice During each fur-year CPC cycle, the applicant must be engaged in the practice f nurse anesthesia prir t the applicant s CPC cmpliance expiratin date and must submit an accurate recrd f practice. The practice f nurse anesthesia may include clinical practice, nurse anesthesia-related administrative, educatinal r research activities, r a cmbinatin f tw r mre f such areas f practice. T be nurse anesthesia-related, activities must have as their primary bjective and be directly related t the delivery f anesthesia care t patients r the imprvement f delivery f anesthesia care t patients. NBCRNA n lnger requires the submissin f infrmatin regarding the specific number f hurs practiced during the CPC cycle at the time f applicatin. The decisin as t whether an applicant has satisfied the practice requirement is at the discretin f the NBCRNA. Certificatins by the Applicant Each applicant must make the fllwing certificatins: CPC Handbk 8 Versin 04.02 Last Revised 3/26/2018
That all current registered nurse licenses are in gd standing, are nt suspended r limited by any state, have never been surrendered r relinquished (whether vluntarily r invluntarily) and are nt the subject f a pending actin r investigatin. That all current advanced nurse practice licenses are in gd standing, are nt suspended r limited by any state, have never been surrendered r relinquished (whether vluntarily r invluntarily) and are nt the subject f a pending actin r investigatin. That he r she has nt been adjudicated by a curt r regulatry authrity t be mentally r physically incmpetent. That he r she des nt currently suffer frm substance use disrder (SUD) [drug r alchl addictin r abuse]. That he r she has nt been cnvicted f, r pleaded n cntest t, a crime. That he r she has nt engaged in unethical cnduct. That, prir t the date f applicatin submissin, he r she has been engaged in the practice f nurse anesthesia during the current CPC cycle and that the recrd f practice submitted with the applicatin is accurate. That the applicatin and all crrespnding cntent being submitted is accurate. If the applicant des nt s certify, he r she must prvide full dcumentatin f the reasns therefre with sufficient specificity t allw the NBCRNA t evaluate the pssible impact f the prblem r actin n the applicant s current ability t practice nurse anesthesia, and t reslve the issue t the NBCRNA s satisfactin. Waiver f Liability and Agreement f Authrizatin, Cnfidentiality and Nndisclsure Statements Each applicant fr CPC cmpliance must, by his r her signature, agree that he r she has read, understands, and intends t be legally bund by thse statements. Cmplete all CPC Prgram cmpnents required fr the specific CPC cycle, as detailed in the fllwing examples: Initially certified n r befre December 31, 2015 Applicants wh recertified in an even year (i.e., 2016) entered int CPC Prgram n August 1, 2016. Applicants wh recertified in an dd year (i.e., 2017) entered int CPC Prgram n August 1, 2017. Initially certified between January 1, 2016 and July 31, 2016 Individuals wh are initially certified between January 1, 2016 and July 31, 2016 entered int the CPC Prgram n the August 1 fllwing the date f initial certificatin. Initially certified n r after August 1, 2016 Applicants initially certified n r after August 1, 2016, entered (r will enter) int the CPC Prgram immediately after granting f the initial CRNA credential. CPC Handbk 9 Versin 04.02 Last Revised 3/26/2018
First Eight-Year CPC Prgram Perid First fur-year CPC cycle requirements: 60 Class A credits 40 Class B credits Fur Cre Mdules, ne in each f the fllwing fur tpics: Airway management techniques Applied clinical pharmaclgy Human physilgy and pathphysilgy Anesthesia technlgy and equipment Ntes: Mdules are ptinal fr CPC cycles ending n r befre July 31, 2021. Nurse anesthetists shuld lk fr NBCRNA-recgnized cre mdules. Secnd fur-year CPC cycle requirements: 60 Class A credits 40 Class B credits Fur Cre Mdules ne in each f the fllwing fur tpics: Airway management techniques Applied clinical pharmaclgy Human physilgy and pathphysilgy Anesthesia technlgy and equipment CPC Examinatin must be cmpleted n later than six mnths befre the CPC cmpliance expiratin date. The first CPC Examinatin is a perfrmance standard, NOT a Pass/Fail examinatin. It is taken nly ne time during this CPC cycle. Nte: Additinal cntinuing educatin activities (i.e., cre mdule(s)) may be required by the NBCRNA fr anyne nt meeting the CPC Examinatin perfrmance standard. Failure t achieve a perfrmance standard n this CPC Examinatin will nt result in lss f certificatin; hwever, failure t cmplete the additinal cntinuing educatin requirements prir t the CPC cmpliance expiratin date will result in lss f certificatin. Eligibility specifics, applicatin requirements, and plicies specific t the CPC Examinatin are fund in this handbk. CPC Handbk 10 Versin 04.02 Last Revised 3/26/2018
Secnd Eight-year CPC prgram perid First fur-year CPC cycle requirements: 60 Class A credits 40 Class B credits Fur Cre Mdules - ne in each f the fllwing fur tpics Airway management techniques Applied clinical pharmaclgy Human physilgy and pathphysilgy Anesthesia technlgy and equipment Secnd fur-year CPC cycle requirements: 60 Class A credits 40 Class B credits Fur Cre Mdules - ne in each f the fllwing fur tpics Airway management techniques Applied clinical pharmaclgy Human physilgy and pathphysilgy Anesthesia technlgy and equipment CPC Examinatin must be cmpleted n later than six mnths befre the CPC cmpliance expiratin date. A ttal f fur attempts are allwed t achieve the CPC Examinatin passing standard Failure t achieve a passing scre n the CPC Examinatin prir t the CPC cmpliance expiratin date will result in lss f certificatin Initially certified n r after January 1, 2024 Nurse anesthetists in this grup will immediately enter int the CPC prgram, cnsisting f tw fur-year cycles, each cmprising 60 Class A credits, fur Cre Mdules, and 40 Class B credits. The secnd furyear cycle will als include a CPC examinatin measured against a passing standard, which must be cmpleted n later than six mnths befre the individual s CPC cmpliance expiratin date. Thse wh d nt achieve the required passing standard and btain a passing scre n their first attempt may retake the examinatin up t three additinal times. Failure t achieve a passing scre n the CPC examinatin prir t the CPC cmpliance expiratin date will result in lss f certificatin. CPC Handbk 11 Versin 04.02 Last Revised 3/26/2018
Interim Cnditinal CPC Cmpliance Applicants wh have a restricted license t practice prfessinal nursing and, where applicable, nurse anesthesia, in any state in which the applicant currently hlds an active license, r whse license is n prbatin r cnditined upn meeting certain requirements, may, at the discretin f the NBCRNA, be granted Cnditinal CPC cmpliance, prvided that all ther CPC cmpliance requirements have been fulfilled. The Cnditinal CPC cmpliance will reflect any cnditins impsed by the apprpriate state licensure authrity. Examples f a restricted license include a license t practice nly under supervisin r a license t practice prvided the individual remains in a drug-related, alchl-related r ther type f treatment, mnitring r rehabilitatin prgram fr a stated perid f time. The Cnditinal CPC cmpliance card granted under this paragraph shall state that the nurse anesthetist is cnditinally CPC cmpliant. Cnditinal CPC Cmpliance Perid Cnditinal CPC cmpliance shall remain in effect as lng as the individual cmplies with all terms f the cnditins n his r her license. It shall be revked fr failure t cmply. The nurse anesthetist shall be respnsible fr prviding the NBCRNA with written dcumentatin frm the state bard f nursing that he r she has cmplied with all licensure cnditins fr the requisite perid f time. Change in Status Full CPC cmpliance may be changed t Cnditinal CPC cmpliance fr failure t maintain an unrestricted license t practice prfessinal nursing and, where applicable, nurse anesthesia, in all states in which the applicant currently hlds an active license. A request t change Cnditinal CPC cmpliance t Full CPC cmpliance must be accmpanied by fficial written dcumentatin frm the state bard f nursing sufficient t demnstrate that any licensure cnditin has been remved. The decisin t change an individual s CPC cmpliance status is at the discretin f the NBCRNA. Examinatin Overview The fllwing prvides an verview f the CPC examinatin. There are additinal eligibility requirements that must be met prir t sitting fr an examinatin. Fr these eligibility requirements, refer t the sectin belw, Eligibility Requirements fr the CPC Examinatin. A nurse anesthetist wh was initially certified n r befre December 31, 2023, will take the CPC exam during his r her first eight-year CPC perid, and will be required t achieve the perfrmance standard n the examinatin. This exam will be required during the secnd, fur-year CPC cycle f that first eight-year perid. He r she will be required t achieve the passing standard n the CPC examinatin during his r her secnd eightyear CPC perid and during all perids thereafter. This exam will be required during the secnd fur-year CPC cycle f that secnd eight-year perid. CPC Handbk 12 Versin 04.02 Last Revised 3/26/2018
A nurse anesthetist wh is initially certified n r after January 1, 2024, will be required t achieve the passing standard n the CPC examinatin during his r her first eight-year CPC perid, and during all perids thereafter. This exam will be required during the secnd, fur-year CPC cycle f that first eight-year perid. The CPC examinatin will assess the critical cre knwledge f experienced nurse anesthetists needed t safely practice the art and science f nurse anesthesia in the fur cre dmains f anesthesia practice, listed belw: Airway Management Applied Clinical Pharmaclgy Physilgy and Pathphysilgy Anesthesia Equipment and Technlgy Applicatin t sit fr the CPC examinatin is separate frm the applicatin prcess fr CPC cmpliance. The apprpriate CPC examinatin fr a given CPC cycle must be successfully cmpleted prir t submitting an applicatin fr CPC cmpliance. CPC Examinatin Perfrmance Standard The CPC examinatin administered t nurse anesthetists wh were initially certified n r befre December 31, 2023, will prvide an pprtunity t becme familiar with the CPC examinatin cntent utline and the electrnic examinatin frmat. Nurse anesthetists in this grup will take the CPC examinatin nly nce during their first eight-year CPC perid and will be required t achieve the perfrmance standard. This first CPC examinatin can be taken at any time during the secnd fur-year CPC cycle f their first eight-year perid but must be cmpleted at least six mnths prir t the individual s CPC cmpliance expiratin date fr that CPC cycle. This first CPC examinatin is intended t prvide feedback n the nurse anesthetist's relative strengths in different knwledge areas. The nurse anesthetist wh des nt meet ne r mre perfrmance standards n the first CPC examinatin will be required t take additinal cre mdules in any f the cre dmains in which he r she did nt meet the perfrmance standard. This requirement is in additin t the requirement fr fur Cre Mdules in each fur-year CPC and must be a different cre mdule frm the nes taken t fulfill the cre mdule requirements. Fr the purpses f the CPC Examinatin, the term perfrmance standard is being used t indicate the minimum scre that must be attained by an examinee n the first CPC Examinatin. Nn-attainment f the perfrmance standard will nt result in the lss f certificatin, but will result in additinal cntinuing educatin requirements in any cre areas deemed t be deficient. Failure t meet the perfrmance standard in any cre dmain n the CPC examinatin will nt result in lss f certificatin; hwever, failure t cmplete the additinal cntinuing educatin (i.e., Cre Mdule(s)) by the CPC cmpliance expiratin date fr that fur-year cycle will result in a lss f certificatin. CPC Handbk 13 Versin 04.02 Last Revised 3/26/2018
CPC Examinatin Passing Standard Fr nurse anesthetists wh are certified n r befre December 31, 2023, the CPC examinatin taken during their secnd eight-year CPC perid, and during all perids thereafter, will be measured against a passing standard. The term, passing standard is being used as the minimum scre that must be attained by an examinee n subsequent CPC examinatin cycles (i.e., after the first eight-year CPC Cycle). The passing standard will need t be attained by examinees, within fur attempts, in rder maintain certificatin. Fr nurse anesthetists wh are initially certified n r after January 1, 2024, the CPC examinatin taken during their first eight-year CPC perid, and during all perids thereafter, will be measured against a passing standard. The term, passing standard is being used as the minimum scre that must be attained by an examinee n all CPC examinatin cycles. The passing standard will need t be attained by examinees within fur attempts, in rder t maintain certificatin. The CPC examinatin measured against a passing standard is a pass/fail examinatin. It can be taken at any time during the secnd fur-year CPC cycle, but must be cmpleted n later than six mnths befre the CPC cmpliance expiratin date fr that cycle. Nurse anesthetists wh d nt pass their initial attempt at the CPC examinatin will have an additinal three attempts t pass the examinatin befre the final CPC cmpliance expiratin date f the fur-year CPC cycle. A nurse anesthetist must achieve a passing scre in rder t maintain certificatin. Nurse anesthetists wh d nt pass the CPC examinatin n the furth attempt will nt have an pprtunity t retake the examinatin again and will nt have the ptin t cmplete additinal cntinuing educatin (i.e. Cre Mdules). Failure t pass the CPC examinatin by the end f the CPC cycle will result in lss f certificatin. Nurse anesthetists wh have failed t pass the CPC examinatin n the furth attempt may submit a request fr an appeal f the adverse actin in accrdance with the NBCRNA Plicies and Prcedures fr Discipline and Appeals. Eligibility Requirements fr the CPC Examinatin In rder t be eligible t sit fr the CPC examinatin, applicants must: Submit dcumentatin f cmpliance with all state requirements fr licensure as a registered nurse perfrming nurse anesthesia, including a current unrestricted license t practice as a registered prfessinal nurse, with authrity t practice nurse anesthesia if such authrity is granted, in at least ne state and in all states in which the applicant currently hlds an active license. Fr thse individuals emplyed by the United States gvernment, state requirements refer t the requirements f any state r territry f the United States. Submit a cmplete, accurate and electrnically signed examinatin applicatin during the CPC cycle in which a CPC examinatin is required. Submit a clr, digital self-image taken within the previus six mnths. CPC Handbk 14 Versin 04.02 Last Revised 3/26/2018
Make the fllwing eligibility certificatins: That all current registered nurse licenses are in gd standing, are nt suspended r limited by any state, have never been surrendered r relinquished (whether vluntarily r invluntarily) and are nt the subject f a pending actin r investigatin. That all current advanced nurse practice licenses are in gd standing, are nt suspended r limited by any state, have never been surrendered r relinquished (whether vluntarily r invluntarily) and are nt the subject f a pending actin r investigatin. That he r she has nt been adjudicated by a curt r regulatry authrity t be mentally r physically incmpetent. That he r she des nt currently suffer frm substance use disrder (SUD) [drug r alchl addictin r abuse]. That he r she has nt been cnvicted f, r pleaded n cntest t, a crime. That he r she has nt engaged in unethical cnduct. That, prir t the date f applicatin submissin, he r she has been engaged in the practice f nurse anesthesia during the current CPC cycle and that the recrd f practice submitted with the applicatin is accurate. That the applicatin and all crrespnding cntent being submitted is accurate. If the applicant des nt s certify, he r she must prvide full dcumentatin f the reasns therefre with sufficient specificity t allw the NBCRNA t evaluate the pssible impact f the prblem r actin n the applicant s current ability t practice nurse anesthesia, and t reslve the issue t the NBCRNA s satisfactin. Sign the Waiver f Liability and Agreement f Authrizatin, Cnfidentiality and Nndisclsure statements, clarifying that the individual has read, understands and intends t be legally bund by thse statements. Pay the examinatin fee. Significance f Eligibility Status An applicant wh hlds CPC examinatin eligible status with the NBCRNA has successfully submitted a CPC examinatin applicatin and has been granted eligibility t take the CPC examinatin by the NBCRNA. The applicant with CPC examinatin eligible status has nt passed the CPC examinatin required t be CPC cmpliant. CPC Handbk 15 Versin 04.02 Last Revised 3/26/2018
Expiratin f Eligibility Status Eligibility t sit fr the CPC examinatin lasts fr a defined number f days crrespnding with the end f the CPC examinatin windw that the applicant selected, r until the applicant takes the CPC examinatin, whichever ccurs first. Ineligibility t Take the CPC Examinatin Applicants will be fund ineligible t take the CPC examinatin fr any ne r mre f the fllwing reasns: If, in the determinatin f the NBCRNA, the applicant was guilty f cheating n the CPC examinatin Failure t make the required eligibility certificatins and t prvide sufficient dcumentatin t reslve the issue t the satisfactin f the NBCRNA Failure t meet any f the ther eligibility requirements, including failure t sign r accept the waiver f liability and agreement f authrizatin, cnfidentiality and nndisclsure statements Failure t pass the CPC examinatin within the fur-year CPC cycle Grunds fr Denial, Suspensin r Revcatin f Eligibility Status The NBCRNA will autmatically deny, suspend r revke an applicant s eligibility t take the CPC examinatin in the fllwing circumstances: Failure by the applicant t maintain current and unrestricted licensure as a registered prfessinal nurse in at least ne state Lss r surrender f licensure r ther authrity t practice nurse anesthesia in any state fr any reasn that, in the judgment f the NBCRNA, relates t the anesthetist s safe r ethical practice f nurse anesthesia Adjudicatin by a curt r regulatry authrity that the applicant is mentally r physically incmpetent Suspensin r terminatin frm participatin in a federal health care prgram fr reasns relating t the, unsafe, unlawful r unethical practice f nurse anesthesia CPC Handbk 16 Versin 04.02 Last Revised 3/26/2018
Cnvictin f, r pleading n cntest t, a crime which, in the judgment f the NBCRNA, relates t the anesthetist s safe r ethical practice f nurse anesthesia The NBCRNA may, at its discretin, suspend, deny r revke an applicant s eligibility t take the CPC examinatin fr any f the fllwing reasns: Circumstances change s as t render ne f the eligibility certificatins made by the applicant invalid Falsificatin f the CPC examinatin applicatin, intentinal misstatement f material fact r deliberate failure t prvide relevant infrmatin n the examinatin applicatin r t the NBCRNA at any time, r assisting anther persn t d any f the abve Failure by the applicant t maintain current and unrestricted licensure as a registered prfessinal nurse in every state f practice, r lss f authrity t practice Lss r surrender f licensure r authrity t practice nurse anesthesia in any state fr any reasn ther than retirement r cessatin f practice unrelated t any disciplinary actin r cncern abut disciplinary actin; Cnvictin f, r pleading n cntest t, a crime Engaging in unethical cnduct Prvisin f false r incmplete infrmatin t the NBCRNA in cnnectin with the credentialing prcess Dishnest r deceptive behavir related t any NBCRNA examinatin, database, r intellectual prperty, cheating n an examinatin administered by the NBCRNA, inapprpriate use f examinatin questins, r assisting anther individual t engage in any such cnduct; Unauthrized use f any NBCRNA credential r ther health prfessinal designatin r false claim f certificatin r ther prfessinal designatin; Vilatin f any NBCRNA plicy r failure t cperate with an NBCRNA investigatin r audit Cheating r assisting anther persn t cheat n the CPC examinatin, r therwise engaging in dishnest r ther imprper behavir at any time in cnnectin with the CPC examinatin Dcumented evidence f retentin, pssessin, cpying, distributin, disclsure, discussin, r receipt f any CPC examinatin questin, in whle r in part, by written, electrnic, ral r ther frm f cmmunicatin, including, but nt limited t, emailing, cpying r printing f electrnic files, and recnstructin thrugh memrizatin and/r dictatin, befre, during r after the CPC examinatin Any ther cnduct that, in the judgment f the NBCRNA, calls int questin the ability f the nurse anesthetist t serve patients in an hnest, cmpetent, and prfessinal manner. CPC Handbk 17 Versin 04.02 Last Revised 3/26/2018
Applicatin fr CPC Examinatin The NBCRNA-administered CPC examinatin facilitates the measurement f knwledge, skills and abilities fr experienced nurse anesthetists wh hld the NBCRNA-granted CRNA credential. The CPC examinatin is ne cmpnent f the CPC Prgram that nurse anesthetists must successfully cmplete in rder t be deemed CPC cmpliant. Each applicant must successfully cmplete the CPC examinatin within the apprpriate time frame during the secnd fur-year CPC cycle f the eight-year CPC perid. In rder t take the CPC examinatin, every applicant must submit the fllwing materials t the NBCRNA: Applicatin and Fee(s) A cmpleted, signed, electrnic CPC Examinatin Applicatin and payment f all fees must be received by the NBCRNA prir t the requested CPC examinatin administratin windw in rder t allw adequate time fr prcessing and verificatin f infrmatin. Dcumentatin f Licensure Dcumentatin f cmpliance with all state requirements fr licensure as a registered nurse perfrming nurse anesthesia, including a current unrestricted license t practice as a registered prfessinal nurse, with authrity t practice nurse anesthesia if such authrity is granted, in at least ne state and in all states in which the applicant currently hlds an active license. Fr thse individuals emplyed by the United States gvernment, state requirements refer t the requirements f any state r territry f the United States. Dcumentatin f Practice A recrd f practice setting frth: A list f the facilities at which the applicant has practiced clinical nurse anesthesia r perfrmed nurse anesthesia-related administrative, educatinal r research services during the current CPC cycle and up t the date f submissin f the CPC examinatin applicatin The applicant s title r rle at each facility, such as practitiner r educatr The address f each facility The name and phne number f a cntact persn wh can verify emplyment at each facility The inclusive dates f practice at each facility Applicant Pht ID Every applicant must submit a clr, digital self-image that has been taken within the previus six mnths f the CPC examinatin applicatin submissin date. CPC Handbk 18 Versin 04.02 Last Revised 3/26/2018
Nte: Detailed CPC examinatin infrmatin (e.g., examinatin descriptin, scheduling, examinatin references, examinatin dates, fees, results reprting, etc.) will becme available clser t the CPC examinatin launch date f August 1, 2020. Applicatin fr CPC Cmpliance A new CPC cmpliance applicatin must be submitted at the end f each fur-year CPC perid. In rder t becme r remain CPC cmpliant, each applicant must submit the fllwing materials t the NBCRNA: Prcess fr Each Fur-Year CPC Cycle Applicatin and Fee(s) A cmpleted, signed, electrnic CPC Cmpliance Applicatin, including but nt limited t acceptable dcumentatin f cmpletin f Class A credits, Class B credits, Cre Mdules (if required), and payment f all fees must be received by the NBCRNA prir t the applicant s furyear CPC cmpliance expiratin date in rder t allw adequate time fr prcessing and verificatin f infrmatin. Dcumentatin f Licensure a) Every applicant must dcument cmpliance with all state requirements fr licensure as a registered nurse perfrming nurse anesthesia, including a current unrestricted license t practice as a registered prfessinal nurse, with authrity t practice nurse anesthesia if such authrity is granted, in at least ne state and in all states in which the applicant currently hlds an active license. Fr thse individuals emplyed by the United States gvernment, the license may be issued by any state r territry f the United States. b) If the applicant has practiced in mre than ne state during the prir fur-year perid, the applicant must prvide apprpriate dcumentatin f licensure fr the relevant time f practice in each state. Dcumentatin f CPC Prgram Cmpnents Acceptable dcumentatin f the cmpletin f all CPC prgram requirements must be received by the NBCRNA prir t the applicant s fur-year CPC cmpliance expiratin date in rder t allw adequate time fr prcessing and verificatin f infrmatin. a) Requirements fr each f the tw fur-year cycles leading up t the applicant s assigned CPC cmpliance expiratin date include: i. 60 Class A credits ii. 40 Class B credits iii. Fur Cre Mdules (ptinal fr certificants wh have CPC cycles ending n r befre July 31, 2021; required fr all ther CPC cycles) b) Examinatin (successful cmpletin required during secnd fur-year cycle) CPC Handbk 19 Versin 04.02 Last Revised 3/26/2018
c) All infrmatin prvided by the applicant during the CPC cmpliance applicatin prcess is subject t audit and verificatin by the NBCRNA. i. Nurse anesthetists are encuraged t prvide all dcumentatin substantiating Class B credits at the time f applicatin fr CPC cmpliance. ii. iii. Dcumentatin f Practice If an applicant s applicatin is selected fr audit, he r she must submit all requested materials t the NBCRNA electrnically within 14 business days frm the date f NBCRNA s request. Refusal t cmply with the audit prcess r failure t prvide adequate requested dcumentatin may, at the discretin f the NBCRNA, result in disciplinary actin, including revcatin f certificatin, in accrdance with the NBCRNA Plicies and Prcedures fr Discipline and Appeals. Every applicant must submit a recrd f practice setting frth: a) A list f the facilities at which the applicant has practiced clinical nurse anesthesia r perfrmed nurse anesthesia-related administrative, educatinal r research services within the preceding fur-year perid b) The applicant s title r rle at each facility, such as practitiner r educatr c) The address f each facility d) The name and phne number f a cntact persn wh can verify emplyment at each facility e) The inclusive dates f practice at each facility CPC-Specific Plicies and Prcedures The fllwing plicies r prcedures are CPC-specific. Please nte that there are additinal NBCRNA plicies and prcedures psted t the NBCRNA website that may apply. Nurse anesthetists are respnsible fr being aware f any, and all, applicable plicies. CPC Cmpliance Perid Full CPC cmpliance is effective fr a cycle f up t fur years, r the designated CPC perid. CPC cmpliance expires autmatically at the end f the CPC cmpliance perid, r CPC cycle, unless renewed. CPC cmpliance is required in rder t maintain certificatin. The NBCRNA will nt, under any circumstances, extend the expiratin date fr CPC Cmpliance. An applicant wh failed t cmplete the CPC prgram requirements fr Class A, Class B, Cre Mdules, r CPC Examinatin and/r failed t apply fr CPC cmpliance by the deadline f a given CPC cycle, will lse his r her certificatin until such time as the CPC prgram requirements have been satisfied. Please refer t the Late Cmpletin f CPC Prgram r Late Applicatin sectin belw fr specific requirements. An individual wh is nt CPC cmpliant fr mre than fur years, r wh has lst his r her license r authrity t practice nurse anesthesia fr mre than fur years, will be required t cmplete a Reentry CPC Handbk 20 Versin 04.02 Last Revised 3/26/2018
Prgram as specified by the NBCRNA. Please refer t the NBCRNA Reentry Prgram Handbk fr mre infrmatin. Denial f Reprted CPC Prgram Requirements Class A Assessed CE Cnsistent with nging NBCRNA prcedures, there is n NBCRNA-administered appeal prcess fr denial f Class A assessed CE activities. T avid pssible denial f CE activity as Class A, nurse anesthetists are strngly encuraged t seek ut CE activities that are advertised as being prirapprved t grant Class A assessed CE credits and ensure that their CE activity assessments have been successfully cmpleted. Class B Prfessinal Develpment Cnsistent with nging NBCRNA prcedures, there is n NBCRNA-administered appeal prcess fr denial f Class B prfessinal develpment activities. Individuals wh have experienced denial f a Class B activity during the auditing prcess will be given a reasnable amunt f time, as determined by the NBCRNA, t remedy the CPC cmpliance gap. An individual wh is selected fr audit prir t the clse f the CPC cmpliance cycle will be ntified f the Class B deficiency and will have the pprtunity t submit additinal qualified Class B credits t fill the gap prir t the expiratin deadline withut risk t his/her CPC cmpliance status. An individual wh is selected fr audit after the clse f the CPC cmpliance cycle and wh is ntified f a denial f Class B activity will be given a 15-business day grace perid t remedy any gaps prir t the NBCRNA mdifying the audited individual s CPC cmpliance status. Causes fr denial f a Class B credit under the audit prcess include, but are nt limited t, falsifying applicatin infrmatin r failure t prvide dcumentatin that has been previusly identified by the NBCRNA as being required t substantiate a claim fr a Class B credit. Cnsistent with NBCRNA plicies, submitting false CPC applicatin infrmatin, including submitting false infrmatin regarding cmpleted Class A r Class B activities, r failure t cmply with the NBCRNA auditing prcess, may result in lss f certificatin. Late Cmpletin f CPC Prgram r Late Applicatin An applicant wh failed t cmplete the CPC prgram requirements fr Class A, Class B, r the Cre Mdules and/r failed t apply fr CPC cmpliance by the CPC Cmpliance expiratin date f a given CPC cycle, will lse his r her certificatin until such time as the CPC prgram requirements have been satisfied, as detailed in the table belw. The fllwing table describes expectatins fr a nurse anesthetist wh has nt cmpleted the Class A, Class B, and/r Cre Mdule requirements fr the CPC Prgram and/r failed t apply fr CPC CPC Handbk 21 Versin 04.02 Last Revised 3/26/2018
cmpliance prir t the cmpliance expiratin date f his r her fur-year CPC cycle and has lst his r her certificatin. Table 1: Expectatins fr a nurse anesthetist wh has nt cmpleted the fur-year CPC Prgram requirements fr Class A, Class B, and/r Cre Mdules, r wh has failed t apply fr CPC cmpliance prir t the CPC cycle deadline and has lst certificatin. Timeframe Requirement Day 1 up t day 60 after CPC cycle deadline Day 61 up t 1 year after CPC cycle deadline 1 Year plus 1 day up t 2 years after CPC cycle deadline 2 years plus 1 day up t 3 years after CPC cycle deadline 3 years plus 1 day up t 4 years after CPC cycle deadline Cmplete missing requirements Pay fee Cmplete missing requirements and additinal requirements prrated t the date f applicatin Cmplete additinal 5 Class A assessed CEs beynd abve requirements Pay fee Cmplete missing requirements and additinal requirements prrated t the date f applicatin Cmplete additinal 15 Class A assessed CEs beynd abve requirements Pay fee Cmplete missing requirements and additinal requirements prrated t the date f applicatin Cmplete additinal 25 Class A assessed CEs beynd abve requirements Pay fee Cmplete missing requirements and additinal requirements prrated t the date f applicatin Cmplete additinal 35 Class A assessed CEs beynd abve requirements Pay fee An individual wh is nt CPC cmpliant fr mre than fur years, r wh has lst his r her license r authrity t practice nurse anesthesia fr mre than fur years, will be required t cmplete a Reentry Prgram as defined by the NBCRNA. Please refer t the NBCRNA Reentry Prgram Handbk fr mre infrmatin. Table 1 des nt include the CPC examinatin, fr which a separate appeal prcess is required if the applicant fails t pass the CPC exam by end f his r her fur-year CPC cycle. Failure t pass the CPC examinatin by the end f the CPC cycle will result in lss f certificatin. Nurse anesthetists wh have failed t pass the CPC examinatin n the furth attempt may submit a request fr review r appeal f the adverse actin in accrdance with the NBCRNA Plicies & Prcedures fr Discipline, Administrative Actin, and Appeals. CPC Handbk 22 Versin 04.02 Last Revised 3/26/2018
Failure t successfully cmplete the CPC examinatin prir t the CPC cmpliance expiratin date f an applicant s fur-year CPC cycle is nt cnsidered a late cmpletin r late applicatin situatin. Failure t successfully cmplete the CPC examinatin cmpnent f the CPC Prgram will result in lss f certificatin. Requesting Additins t Class B Credit Table A nurse anesthetist may submit a request t the NBCRNA via email at CPC@nbcrna.cm t have an activity r activity categry added t the Class B table. The prcess that shuld be used is as fllws: Send an email t CPC@nbcrna.cm cntaining a brief descriptin f the activity r categry Specify which f the fllwing aspect(s) f the Class B criteria definitin the activity r categry satisfies, and why: Enhances a nurse anesthetist s fundatinal knwledge f nurse anesthesia practice Supprts patient safety Fsters a nurse anesthetist s understanding f the brader healthcare envirnment Using a scale f 1 t 10 t indicate a cntinuum f effrt, include an estimate f Class B value fr the prpsed activity r categry. (NOTE: A single Class B activity may nt be given an effrt value greater than 10, and there is nt a ne-t-ne relatinship between the number f hurs attributed t the activity and the Class B value.) Fr example: Lw effrt = 1 fr attending a ne-hur, nn-assessed cntinuing educatin activity. Medium effrt = 5 fr publishing a peer-reviewed article. High effrt = 10 fr authring a bk. Review Prcess fr Requested Additins t the Class B Table Once a nurse anesthetist has submitted a cmplete request t have an activity r activity categry added t the Class B table, NBCRNA staff will cnduct an initial review and issue a decisin within 14 days f receipt f the request. If additinal input is required befre a decisin can be made, staff will crdinate the prcess and prvide a decisin in as timely a manner as pssible. All decisins regarding requests fr adding Class B activities r activity categries are final and nt subject t the NBCRNA appeal prcess. Once apprved, any new categries CPC Handbk 23 Versin 04.02 Last Revised 3/26/2018
r activities will be added t the NBCRNA Class B table and t the nline applicatin t allw the new activity r categry t be used by nurse anesthetists. 2-Year Check-In Certificants are required t check-in with the NBCRNA at the mid-pint f each 4-year CPC Cycle ( 2-Year Check-In ) in rder t prvide r verify relevant infrmatin n recrd. Certificants will be prvided with a deadline by which their check-in must be cmpleted. At the time f 2-Year Check-In, a certificant must: 1. Prvide, verify and/r crrect the fllwing infrmatin in his r her certificatin recrd: That all current registered nurse licenses are in gd standing, are nt suspended r limited by any state, have never been surrendered r relinquished (whether vluntarily r invluntarily) and are nt the subject f a pending actin r investigatin. That all current advanced practice nurse licenses are in gd standing, are nt suspended r limited by any state, have never been surrendered r relinquished (whether vluntarily r invluntarily) and are nt the subject f a pending actin r investigatin. That he r she has nt been adjudicated by a curt r regulatry authrity t be mentally r physically incmpetent. That he r she des nt currently suffer frm substance use disrder (SUD) [drug r alchl addictin r abuse]. That he r she has nt been cnvicted f, r pleaded n cntest t, a crime. That he r she has nt engaged in unethical cnduct. That she r she has been engaged in the practice f nurse anesthesia, r will be engaged in the practice f nurse anesthesia, prir t the end f current CPC cycle. That the mst recently reprted recrd f practice n file with the NCRNA is accurate and if nt, what the accurate recrd f practice is. That his r her cntact infrmatin is accurate, cmplete and up t date and if nt, what the current r knwn future cntact infrmatin is. 2. Pay a credentialing fee, as determined by the NBCRNA. Failure t cmply with this plicy will result in the fllwing actins unless the NBCRNA in its sle discretin, determines that impsitin f sanctins r additinal fees wuld be unjust in the circumstances: 1-30 days pst expected 2-Year Check-In deadline: Pay current fees, but n additinal financial penalty, nly ntificatin f failure t cmply with plicy. CPC Handbk 24 Versin 04.02 Last Revised 3/26/2018