CERTIFICATION Nephrology Nursing Certification Commission (NNCC)

OBJECTIVES: At the end of this presentation, the participant will be able to:  Describe the roles of the organizations associated with nephrology nursing certification  Explain the differences between licensure and certification  List at least 3 reasons to obtain specialty certification  Briefly describe the process of exam development

What is the Nephrology Nursing Certification Commission (NNCC)?  Established in 1987 for the purpose of developing a professional certification program for nephrology nurses  Formerly the Nephrology Nursing Certification Board (NNCB)  A separately incorporated, independent professional nursing organization  Comprised of 8 Commissioners credentialed by NNCC and representing each exam board; and one public member  The public member cannot be a nurse or other healthcare professional

NNCC Board Of Commissioners  Members are appointed from the examination boards.  Members represent a wide geographic distribution.  Members have experience in practice areas represented by the credential.

What Are Examination Boards  Within NNCC’s structure there are boards that oversee each examination program.  Members are selected from respective test committees.  Advanced Practice Board  CNN-NP  Nursing Board  CDN & CNN  Clinical/Technical Board  CCHT, CCHT-A, CD-LPN/LVN

Test Committees  One for each credential.  At least five members.  Selected by score, geographic area, willingness to serve.  Two year commitment, may be reappointed  Employment role does not include direct education responsibility.

What is a professional membership organization?  An organization of members for whom educational and professional offerings and events are provided.  Examples are the American Nephrology Nurses Association (ANNA) and the National Association of Nephrology Technicians/Technologists (NANT).  They promote professional growth.  They provide approved continuing education.  They promote, recognize, and/or endorse certification.  They do NOT administer certification examinations.

NNCC, ANNA, and NANT are independent organizations and are separately incorporated.

What does the American Board of Nursing Specialties (ABNS) say about this relationship? “A certifying organization (e.g., NNCC) is required to have organizational autonomy but can have a collaborative relationship with a national specialty association (e.g., ANNA, NANT) that supports the specialty and the standards of practice for the specialty.”

What is the American Board of Nursing Specialties (ABNS)?  ABNS is a not-for-profit, membership organization that focuses on improving patient outcomes & consumer protection by promoting specialty nursing certification.  The vision of ABNS is that specialty nursing certification is THE standard by which the public recognizes quality nursing care.  ABNS promotes the value of certification to all stakeholders.

What about the Accreditation Board for Specialty Nursing Certification (ABSNC)?  ABSNC is the only accrediting body specifically for nursing certification  ABSNC accreditation is a peer-review mechanism that allows organizations, such as NNCC, to obtain accreditation of their certification programs by demonstrating compliance with the highest quality standards available in the industry.

ABSNC (cont.)  Individuals who pass exams that have been submitted and met the Accreditation Standards of ABSNC are said to be “Board Certified”.  Currently the CDN & CNN exams are accredited by ABSNC so these certificants can say they are “Board Certified”.

What is the Center for Nursing Education & Testing (C-NET)?

Licensure – Certification... What are the Differences? Licensure  All graduate nurses must pass the National Council Licensure Examination (NCLEX) to become licensed  Licensure validates the entry level competence of basic nursing knowledge & skill  An agency of the state government (e.g., state board of nursing) grants permission to these individuals to engage in the practice of nursing as defined by the state nurse practice act; provides the legal authority to practice nursing

Licensure (cont.)  Permits the use of a particular title and defines the scope of practice  Others are prohibited from practicing the profession

Certification:  Defined by ABNS as “the formal recognition of the specialized knowledge, skills, and experience demonstrated by the achievement of standards identified by a nursing specialty to promote optimal health outcomes.”  Certification validates advanced knowledge and competence in a specialty  Usually a voluntary process for nurses by which a nongovernmental agency grants recognition to an individual who meets predetermined qualifications (i.e., experience, approved CNE, testing, etc.)

Certification (cont.)  A requirement by the Centers for Medicare and Medicaid Services (CMS) for dialysis technicians since 2008  The purpose of certification is to protect the public; it allows consumers of health care to easily identify competent caregivers

What is the Purpose of Certification Exams?  These exams evaluate the extent to which patient care providers have attained the knowledge & skills necessary for competent practice within an identified role in a particular specialty.  Certification indicates a higher degree of professional competence than the minimum requirement for licensure.  Patient care providers combine elements of basic nursing knowledge with knowledge in the specialty to deliver care to patients.  The certification exam is designed to measure the attainment of that knowledge at a defined level of competence.

What Are the Keystones of Exam Development?  The domains of practice  Standards and Scope of Practice - ANNA  Core Curriculum for Nephrology Nursing - ANNA  Core Curriculum for Dialysis Technicians - MEI/Amgen  Expert nephrology care givers from across the country  CMS regulations and interpretive guidance 2008  Validity  “Are we testing what we think we’re testing?”  “Does the test reflect current practice throughout the US?”  On-going test validation through practice analyses  Reliability  Consistency of the test in measuring the candidate’s ability level  Statistical evaluations of test performance

What is a Practice Analysis/Role Delineation Survey?  The activities involved in a practice analysis ensure the exams reflect current practice within defined roles.  Panels of national nephrology experts meet to identify domains of practice for each exam.  Panels develop lists of activities that make up the practice of nephrology caregivers.  National surveys of nephrology nurses and/or technicians are conducted to determine the frequency and importance of each activity.

Practice analysis (cont.)  Survey results are analyzed and used to develop an outline of the domains of practice (i.e., the major topics) to be addressed in each exam.  Specifics of the analysis are put together to create a “blueprint” for each exam.  Each test question is linked directly to the national survey results.  A practice analysis/role delineation study is conducted at least every five years for each exam.

 Test questions require the examinee to analyze and apply information in practice situations, not simply recall facts.  All test questions are supported by current published references.  All newly written questions are pilot tested before they are scored. What Should I Know About Test Questions?

Test questions (cont.)  Panels of expert nephrology nurses and/or technicians use an established standard process to set the passing score for each exam.  All test questions are reviewed and revalidated at least every three years.  Challenges to the development of a good test question:  Practice variations based on geographic location  Variances in practice among providers  Frequent changes in nephrology practice and roles  Federal and state regulations

Why should I become Certified?  To help ensure patient safety  To meet the challenge of providing patient care in a more complex environment including:  Advances in technology  Older patients with more co-morbidities  Culturally diverse patient populations  More complex government regulations & reimbursement issues

What’s In It For Me?  Self confidence in decision making  Enhanced professional credibility  Leadership  Competence  Initiative  Up-to-date knowledge base  Validation of skills  Inspiration to strive for excellence

How does my certification benefit the profession?  Demonstrated commitment to quality  Validation of professional achievement  More confident decision-making  High degree of accountability  Commitment to life long learning  Qualification for Magnet Status

Does the public benefit from caregivers becoming certified? Certification has been linked to:  Patient safety  Optimal patient outcomes  Decreased errors  Improved patient satisfaction  Increased staff retention and job satisfaction

What are some barriers to certification?  Financial  Cost of the examination  Lack of institutional reward  Lack of institutional support  Time Commitment  Inadequate supervisory support  Test anxiety  Continuing education requirements

You CAN break down those barriers !  Hold a certification examination review course.  Encourage incentives.  Free continuing education opportunities  Increase recognition of certified staff.  Announce certification successes at staff meetings.  Post lists of certified caregivers in the workplace with photos of newly certified staff.  Promote facility funded attendance at regional or national educational meetings.  Work to establish a work place program to encourage certification at your facility.

Need More Information?  Visit the NNCC’s website:   Call the NNCC’s national office:  NNCC (6622)  Like NNCC on Facebook

Join the Ranks - Get Certified!

References:  Altman, M. (2011). Let’s Get Certified. AACN Advanced Critical Care. 22(1)  Accreditation Board for Specialty Nursing Certification (2011). Accreditation Board for Nursing Specialties accreditation standards.  American Board of Nursing Specialties. Fact sheet.  American Board of Nursing Specialties (2005). A Position Statement on the Value of Specialty Nursing Certification.  American Nephrology Nurses’ Association (2008). Certification in nephrology nursing [Position statement].  American Nephrology Nurses’ Association (2013). Nephrology Nursing Journal, July/August, Vol. 40, no. 4

References (con’t):  American Nephrology Nurses’ Association (2009). Autonomy of the Nephrology Nursing Certification Commission (NNCC) [Position statement].  Garbin, P. (2014). Item Writer’s Manual Certification Examinations. Center for Nursing Education and Testing.  Kaplow, R. (2011). The Value of Certification. AACN Advanced Critical Care. 22(1),  Prowant, B.F. & Gallagher, N.M. (2007). Focus on issues related to nephrology nursing certification. ANNA Journal, 14(2),  Sayre, C., Wyant, S., & Karvenen, C. (2010). Effect of a Medical Surgical Practice and Certification Review Course on Clinical Nursing Practice. Journal for Nurses in Staff Development, 26(1), 11 – 16.  Valente, S.M. (2010). Improving professional practice through certification. Journal for Nurses in Staff Development. 26(4),