Certified Healthcare Safety Nursing (CHSN) Examination Blueprint/Outline (Effective October 1, 2017) Exam Domains 135 Items 1. Patient Safety Fundamentals 54 Items/40% 2. Healthcare Safety Management 54 Items/40% 3. Accreditation, Compliance, & Voluntary Standards 27 Items/20% IBFCSM uses KR-20 statistics to determine reliability. Domain 1 Patient Safety Fundamentals (54 Items or 40%) This domain requires exam candidates to demonstrate competency by using recall, recognition, comprehension, and application of knowledge to correctly answer exam items related to nursing-related safety practice. Exam items can focus on identification, analysis, and control of risks/hazards related to patient safety fundamentals including maintaining a safe environment for staff, patients, and visitors. Items are distributed throughout the examination. Knowledge and job practice skills include the following: a. Evaluate facilities, medical equipment, products, systems, equipment, workstations, and processes by applying qualitative processes to ensure patient safety by identifying hazards and assessing risks. b. Adhere to recommended controls to prevent patient harm during medical procedures and on-going care. c. Eliminate hazards and reduce the risks posed during care processes and human errors. d. Evaluate controls by analyzing feasibility, effectiveness, reliability, and costs to achieve a best solution. e. Implement strategies by using the results of hazard identification and risk analyses to eliminate and/or reduce harmful exposure to patients and the care environment. f. Obtain certifications, listings, approvals or authorizations by identifying applicable regulations, and standards to ensure patient safety. g. Communicate hazards, risks, and controls to patients, their families, care staff, senior management, care providers, and the public.
Domain 1 Patient Safety Fundamental (54 Items/40%) 1. Accountability and responsibility 2. Adverse event reporting 3. Adverse patient event clinical safety 4. Analyzing processes 5. Care and medical errors 6. Clinical personnel and safety 7. Communication 8. Communication effectiveness 9. Continuous improvement 10. Defining error 11. Discipline and responsibility 12. Error prevention 13. High reliability methods 14. Human error 15. Human performance 16. Implementing safety 17. Learning and understanding 18. Medical procedure failure 19. Medication safety 20. Nursing care challenges 21. Learning organizations 22. Change analysis 23. Organizational structures 24. Organizational culture 25. Organizational dynamics 26. Organizational challenges 27. Patient safety challenges 28. Organizational structures 29. Patient centered healthcare 30. Patient clinical care 31. Patient harm incidents 32. Patient medical risks 33. Patient outcomes 34. Patient environment of care exposures 35. Patient safety action 36. Patient safety management 37. Patient safety concepts 38. Patient safety hindrances 39. Presenting safety information 40. Patient interventions 41. Patient care risks 42. Patient safety success 43. Proactive safety 44. Promoting patient safety 45. Safety culture development 46. Safety culture effectiveness 47. Senior leader involvement 48. Serious patient incidents 49. Sharp end principles 50. System safety 51. High reliability principles 52. System safety evaluations 53. Top leader communication 54. Trust and transparency
Domain 2 Healthcare Safety Management (54 Items/40%) This domain requires exam candidates to demonstrate competency by using recall, recognition, comprehension, and application of knowledge to correctly answer items related to healthcare facility and occupational safety. Candidates must understand the importance of safety leadership and management to promote safety as an operational priority. IBFCSM ensures distribution of all exam types of items throughout the examination. Knowledge and job practice skills include the following: a. Design, implement, and maintain comprehensive management systems by defining requirements, developing policies and procedures to protect patients, staff, visitors, property, and environment. b. Implement policies, procedures, and directives in systematic manner to protect patients, staff, visitors, property, and the environment. c. Determine the effectiveness of safety related function and relevant systems by measuring and evaluating performance indicators to ensure continuous improvement to protect patients, staff, visitors, and contractors. d. Apply sound management and leadership practices to efficiently use resources to improve safety. Use appropriate methods to ensure stake-holders understand their roles in formulation and implementation of safety. e. Present technical information to patients, care staff, medical providers, management, contractors, vendors, and the public about compliance requirements. f. Accept responsibility to promote safety by providing technical counsel and advice on issues related to accreditation and consensus standards to protect people, property, and environment. Domain 2 Safety Management (54 Items/40%) 1. Accident causal factors 2. Biohazard exposures 3. Costs of accidents 4. Deferring to expertise 5. Disaster preparedness 6. Education 7. Training 8. Emergency management 9. Employee safety hazards 10. Ergonomic hazards 11. Establishing priorities 12. Facility hazards 13. Fire safety 14. Hazard analysis 15. Hazard control management 16. Hazard controls 17. Hazardous materials 18. Hazardous substance risk 19. Hazardous materials management 20. Hospital worker hazards 21. Human and process errors 22. Human behaviors 23. Identifying facility hazards 24. Improving job performance 25. Incident investigations 26. Information analysis 27. Management concept 28. Management functions 29. Management theories 30. Management principles 31. Managing risks 32. Operational reliability 33. Personal protective equipment
34. Quality management 35. Risk management 36. Safe job accomplishments 37. Safety accountability 38. Safety agendas and objectives 39. Safety committees 40. Safety decisions 41. Safety function effectiveness 42. Safety improvement 43. Safety inspections and audits 44. Safety investigations 45. Safety leadership 46. Safety management 47. Safety leadership 48. Safety management functions 49. Safety controls 50. Safety priorities 51. Safety reporting 52. Supervising safety 53. Support department safety 54. Workplace injuries Domain 3 Accreditation & Compliance (27 Items/20%) This domain requires exam candidates to demonstrate competency by using recall and recognition, comprehension, and application of knowledge to correctly answer items related to ethical professional practice in the application of, and adherence to compliance, accreditation, and voluntary/consensus standards. Items are distributed throughout the exam. Knowledge and job practice skills include the following: a. Evaluate compliance through performance assessments and various forms of feedback in to ensure assure that training is effective. b. Conduct effective education and training by establishing objectives to impart knowledge and facilitate understanding of compliance, accreditation, and voluntary standards. c. Maintain a recordkeeping and data capture systems by to acquire, analyze, and distribute accurate data and to meet compliance requirements. d. Hold paramount protection of patients, property, and environment by working with management, governmental agencies, and voluntary standards organizations. e. Improve competency through continuing education and maintaining proficiency use of technologies. f. Refer to appropriate standards to guide compliance and accreditation actions: o Accreditation standards (JC, DNV, HFAP, CMS) o Code of Federal Regulations (CFR 10, 21, 29, 40, 42, 44, 49) o Federal Agencies (CDC, DHHS, DHS, DOT, EPA, FDA, FEMA, NRC, & OSHA) o Voluntary Organizations (ANSI, ASTM, ASHRAE, ASME, CGA, NFPA, NIOSH, UL)
Domain 3 Accreditation, Compliance, & Voluntary Standards (27 Items/20%) 1. Accreditation 2. Agency compliance 3. Agency responsibilities 4. Agency standards 5. Compliance agencies 6. Compliance requirements 7. Compliance standards 8. Employee health 9. Fire and emergency drills 10. Hazardous material exposure limits 11. Healthcare worker risks 12. Infection control 13. Injury reporting 14. Medical equipment regulations 15. OSHA authority 16. OSH Act 17. OSHA standard 18. OSHA major hazard 19. OSHA compliance priority 20. OSHA guidelines 21. Safety compliance 22. Safety violation 23. Voluntary federal agencies 24. Voluntary organizations 25. Voluntary healthcare standards 26. Voluntary standards organization 27. Voluntary consensus standard