Certification and Recertification Candidate Handbook

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1 Certification and Recertification Candidate Handbook Purpose of the Handbook The CNOR Candidate Handbook provides essential information on policies and procedures pertaining to certification and recertification of the CNOR credential. Sample questions and an exam topic outline have been provided to aid in exam preparation. It is your responsibility to familiarize yourself with the contents of this handbook. If you have questions, please feel free to contact CCI at or institute.org. All information is subject to change including test content and pricing South Parker Road, Suite 120 Denver, CO / CNOR (2667) Copyright 2015 Competency & Credentialing Institute. All rights reserved.

2 Table of Contents CNOR Certification CNOR Application Fee... 3 Eligibility Requirements... 4 CNOR Certification Process... 4 Preparing for the CNOR Exam... 7 CNOR Certification Application Information... 7 CNOR Certification Policies... 8 Changing, Transferring, Center, Withdrawing, Late/No Show... 8 General Information... 9 CNOR Exam Test Center Regulations CNOR Exam Sample Questions CNOR Recertification CNOR Recertification Fees CNOR Recertification Process Audit Process Methods for Reactivating a Lapsed CNOR Credential Inactive Status Put Your Credential on Hold Emeritus or Retired Status Structure of the CNOR Certification Program/ Test Development Process Job Analysis Job Analysis Glossary of Terms Task and Knowledge Statements Page 2 of 29 CNOR 07.15

3 CNOR Certification Definition of Certification Certification, as defined by the American Board for Specialty Nursing Certification (ABSNC), is the formal recognition of the specialized knowledge, skills, and experiences demonstrated by the achievement of standards, identified by a nursing specialty to promote optimal patient outcomes. CNOR certification documents the validation of the professional achievement of identified standards of practice by an individual registered nurse, providing nursing care for the patient during the perioperative period, defined as before, during, and after surgery. This voluntary recognition program acknowledges the professional achievement demonstrated by an individual nurse s performance, which exceeds that required for competent practice in the perioperative setting. Purposes of Certification Demonstrate concern for accountability to the general public for safe nursing practice Enhance quality patient care Identify registered nurses who have demonstrated professional achievement in providing perioperative nursing care Provide employing agencies a means of identifying professional achievement of an individual practitioner Provide personal satisfaction for practitioners Objectives of the Certification Program Recognize the individual professional nurse who is proficient in practice Strengthen conscious use of theory in assessing, planning, implementing and evaluating patient care Enhance professional growth through continued learning that results in greater depth of knowledge and expanded skills Upon successful completion of the exam, the CNOR credential is awarded for a five- year period CNOR Application Fee Regular Fee: $ AORN Member Fee: $ All prices are subject to change without notice. Page 3 of 29 CNOR 07.15

4 Eligibility Requirements Eligibility requirements for sitting for the CNOR exam include: A current unrestricted RN license in the country where currently practicing; Currently working full time or part time in perioperative nursing in the area of nursing education, administration, research or clinical practice; and A minimum of 2 years and 2,400 hours of experience in perioperative nursing, with a minimum of 50% (1,200 hours) in the intraoperative setting. An applicant s nationality, race, creed, life- style, color, sexual orientation or age is not a factor in determining eligibility for certification or recertification. CNOR Certification Process All candidates for the CNOR credential must sit for and pass the national CNOR certification exam. CNOR Exam Being successful at passing the CNOR certification exam requires two things: 1. Having a thorough and sound foundation of the knowledge and skills required for competent clinical practice (see CNOR Exam Content Outline below). Knowledge can be obtained through work experiences and independent learning, as well as through formal educational programs. The experiential knowledge component of the exam requires that an individual have a minimum of two years of work experience in perioperative nursing. Thus, the CNOR exam is based on what a nurse with two years of practice in the OR is expected to know. The exam assesses a combination of experiential and cognitive knowledge, as together these forms the foundation of competent clinical practice. 2. Understanding of the test- taking process. There is a definite skill in answering multiple- choice questions. Becoming familiar with techniques for responding to the multiple- choice questions will improve your chances of a successful performance on the CNOR exam. You may learn more about taking the CNOR exam by attending or listening to one of our complimentary webinars. You may also gain exposure to taking a multiple- choice test with one of our practice exam products, which are available in the CCI Bookstore. These products are designed to simulate the CNOR testing experience. The CNOR exam consists of 200 multiple- choice questions; of these, 185 questions are used to calculate your test score. The remaining 15 items serve as pretest questions, and do not affect your score. Pre- test questions are dispersed throughout the exam and cannot be identified. The CNOR exam must be completed in 3 hours and 45 minutes. Because of the commitment to quality and test security, there are multiple forms of the CNOR exam. The computerized format of the exam requires no previous computer experience. An optional pre- exam tutorial will provide instructions on how to take the exam on the computer. It will also provide examples on how to select answers, and how to mark any questions you may want to return to and review, before finishing the exam. Your score on the exam is the total number of questions you answer correctly. It is to your advantage to answer each item, even if you are not certain of the correct response. Because Prometric verifies CCI test results for accuracy, hand scoring of the CNOR test is only available by request and for a nominal fee. Please contact the CCI Office at or info@cc- institute.org for additional information. Page 4 of 29 CNOR 07.15

5 Testing Window Candidate s three- month testing window opens immediately following approval of your application (e.g., if you apply in January, then you may test in February, March or April.) If You Apply in January February March April May June July August September October November December You May Take the CNOR Exam in. February, March, April March, April, May April, May, June May, June, July June, July, August July, August, September August, September, October September, October, November October, November, December November, December, January December, January, February January, February, March Testing Locations CCI has contracted with Prometric, a professional testing agency, to administer the CNOR exam at Prometric Testing Centers throughout the U.S. and internationally. Candidates may take the exam Monday through Saturday, excluding holidays, year round. Once CCI has reviewed and approved your application, you will receive an notification from CCI with instructions on how to contact Prometric to schedule your testing date and location. You have a 90- day testing window, starting the beginning of the month after your application is received. You pick the location and time that are most convenient for you. CNOR Exam Subject Areas (Domains) Subject Areas % Of Items # Of Questions 1. Preoperative Patient Assessment and Diagnosis 2. Develop Individualized Plan of Care and Identify Expected Outcomes 12% 22 10% 19 Page 5 of 29 CNOR 07.15

6 3. Intraoperative Activities 4. Communication 5. Transfer of Care 6. Cleaning, Disinfecting, Packaging, Sterilization, Transporting, and Storing Instrumentation and Supplies 7. Emergency Situations 8. Management of Personnel, Services, and Materials 9. Professional Accountability Total 27% 50 10% 18 6% 11 9% 17 11% 20 6% 11 9% % 185 Passing Score You will receive your test results at the Prometric testing center immediately after you take the CNOR exam. Scores will not be reported if the confidentiality of the exam is broken or misconduct at the test center is reported. Passing candidates will receive an e- certificate via e- mail message, within one week of passing the certification examination. Passing candidates do not receive their score, only a notification that they have passed. If you are not successful in passing the CNOR exam, your numerical score (given as a scaled score) is reported, along with the measurement of the competency level for each domain. Certification status is granted for a period of five years. Certification will expire on December 31 of the fifth year of the recertification cycle, unless you complete one of the recertification methods in effect at that time. Scaled Score For the CNOR examination, there is one reported pass/fail decision score. You need a total test scale score of at least 620 to pass the CNOR examination. Scores are determined by converting the number of questions answered correctly to a scale score that ranges from 200 to 800. A scale score is transformed from raw test score (the number of test questions answered correctly). The process is something like transforming height (your test performance) from centimeters (your raw score) into inches (your scale score). To interpret any test score, a uniform frame of reference is required. Scale scores provide that there is a correlation between the between the frame of reference, based on standards adopted by CCI, and the amount of knowledge necessary to pass the exam, without regard to specific test form or version taken. A scale score of at least 620 is required to pass. Please note that a scale score is neither the number of questions you answered correctly, nor the percentage of questions you answered correctly. Page 6 of 29 CNOR 07.15

7 Preparing for the CNOR Exam AORN Guidelines for Perioperative Practice The AORN Guidelines for Perioperative Practice is one of the primary references for the CNOR exam. The CNOR certification exam is updated every July to reflect thee current year s edition of the AORN Guidelines for Perioperative Practice, as well as other updated references. CNOR Exam Study Guide A study guide is available to assist in preparing for the CNOR exam. The CNOR Exam Study Guide is available through the CCI Bookstore. Other Materials and Courses There are a variety of tools to aid in preparation, including practice tests and preparation courses. Several organizations offer courses on preparing for the exam. Some certification candidates find it helpful to organize study groups. Please refer to the Job Analysis in the back of this Handbook for specific topic areas to study. CNOR Certification Application Information To complete the online application, you will need the following information. If you have all of this information, the process will take you 10 to 15 minutes. Personal contact information - address, , and phone numbers home and work Last four digits of your social security number Birth year Highest degree earned AORN membership information number, username, and password Employer contact information facility name, address, and 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) Payment information check or credit card Page 7 of 29 CNOR 07.15

8 CNOR Certification Policies Changing, Transferring, Center, Withdrawing, Late/No Show Changing Test Appointment within the Testing Window A. If it is at least: days prior to the end of your testing window OR days prior to your scheduled test date, THEN: You may reschedule your test appointment for no fee. To do so, you must complete two steps: 1. Contact Prometric and cancel your original appointment. 2. Reschedule your appointment with Prometric for another date within the 90- day testing window. B. If it is between 29 and five days prior to the end of the testing window or test date, THEN: You may reschedule your testing appointment for a $50 fee. You must complete two steps: 1. Contact Prometric and cancel your original appointment. 2. Reschedule your appointment with Prometric. The $50 fee will be charged each time you reschedule your appointment. C. If it is five days prior to end of your testing window or test date, THEN: You are unable to reschedule or cancel. You must appear and sit for the exam or all fees will be forfeited. Transfer to Next Testing Window A. If it is at least: days prior to the end of your testing window OR days prior to your scheduled test date, THEN: You may transfer your test appointment to the next 90- day testing window for a $75 fee. To do so, you must complete two steps: 1. Contact Prometric and cancel your original appointment. 2. Transfer from your testing window to the next testing window, by logging into your CCI account and completing the transfer request. A $75 fee will be charged. B. If it is between 29 and five days prior to the end of the testing window or test date, THEN: You may transfer your test appointment to the next 90- day testing window for a $125 fee. You must complete two steps: 1. Contact Prometric and cancel your original appointment. A fee of $50 will be charged. 2. Transfer from your testing window to the next testing window by logging into your CCI account and completing the transfer request. A $75 fee will be charged. C. If it is five days prior to end of your testing window or test date, THEN: You are unable to transfer or cancel. You must appear and sit for the exam or all fees will be forfeited. Withdrawal from Exam A. If it is at least: days prior to the end of your testing window OR days prior to your scheduled test date, THEN: Page 8 of 29 CNOR 07.15

9 You may transfer your test appointment to the next 90- day testing window for a $75 fee. To do so, you must complete two steps: 1. Contact Prometric and cancel your original appointment. 2. Withdraw your application, by logging into your CCI account and completing the withdrawal request. $75 of your exam fee is non- refundable. B. If it is between 29 and five days prior to the end of the testing window or test date, THEN: You may withdraw from the exam for a $125 fee. You must complete two steps: 1. Contact Prometric and cancel your original appointment. A fee of $50 will be charged. 2. Withdraw your application, by logging into your CCI account and completing the withdrawal request. $75 of your exam fee is non- refundable. C. If it is five days prior to end of your testing window or test date, THEN: You are unable to withdraw. You must appear and sit for the exam or all fees will be forfeited. Failure to Schedule Test Appointment/Late for Testing/ / No Show If you fail to schedule a testing appointment, are late for your test appointment by more than 15 minutes, or miss your scheduled appointment date, your entire testing fee is forfeited. All policies are subject to change at any time. General Information Confidentiality A system of 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 permission is granted in writing by the applicant/candidate, or where such files/records are required to be provided under applicable law, or in conjunction with regulatory investigations. Verification Information on applications may be verified. Authorized personnel will check applications for accuracy of information. We many verify information via telephone, and/or letter. All information gained through verification procedures will be confidential, except in instances where the law demands disclosure of facts. Should any information on the application be found false, the applicant will be notified and declared ineligible to continue in the certification process. Use of CNOR CNOR is the designation recognizing the nurse who has been certified in perioperative nursing. The letters do not in themselves stand for specific words or a title. CNOR certification is defined as: "the documented validation of the professional achievement of identified standards of practice, by an individual registered nurse, providing care for patients before, during and after surgery." CNOR means that you have demonstrated the knowledge and skills that denote competency in the specialized field of perioperative nursing. Page 9 of 29 CNOR 07.15

10 The CNOR mark is federally registered with the U.S. Patent and Trademark Office, Reg. No , and may only be used in accordance with CCI policy by those who have achieved and maintain the designation. In writing, proper usage is without punctuation as follows: Jane A. Doe, BSN, RN, CNOR Revocation of CNOR CCI reserves the right to revoke the certified status conferred upon a candidate through this program. Revocation may occur upon receipt of information verifying that a certificant: Falsified information on the certification application. Had her/his current RN license revoked by a state board of nursing. Had her/his current RN license suspended by a state board of nursing. Been placed on probation by a state board of nursing. Has not paid all outstanding debts to CCI. Has commissioned a breach of the confidentiality agreement signed at the time the exam was taken (i.e., via public or printed communication, Internet, etc.) or breach of security in connection with a CCI exam, including cheating, failure to follow test center instructions, or violation of any exam policy. Certified nurses will be informed by letter of CCI s decision to revoke the CNOR status. There will be no refund if, for any reason, the CNOR status is revoked. Misuse or misrepresentation of the CNOR credential Any misuse or misrepresentation of the CNOR credential by those not currently holding the credential shall be subject to legal action by CCI. CCI may render sanctions against the individual, which may include, but not be limited to: Suspension from the exam for an indefinite or specified period of time. At the Board s discretion, notify the respective State Board of Nursing, employer, insurance company, or other public health agency. Appeal Process There shall be an external board of appeals available to a CNOR candidate 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 candidate, within 30 days after receipt by the candidate, 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. Publicity CCI reserves the right to designate and approve national publicity concerning the certification program. National publicity may be authorized by CCI for purposes of marketing the program. AORN Headquarters, AORN chapters, and the AORN Journal may appropriately recognize AORN members who become certified. Replacement of Certificates A replacement certificate may be ordered on the CCI website. Candidates may also print a wallet card version of their certificates through their online account. Americans with Disabilities Act Page 10 of 29 CNOR 07.15

11 Whenever possible, CCI is committed to providing reasonable accommodation 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, in addition to providing current and appropriate documentation of the disability. Once a person is diagnosed as having a qualified learning disability under the Americans with Disabilities Act, the disability is normally viewed as life- long. Although the learning disability will continue, the severity of the condition may change over time. Because the provision of all necessary and reasonable accommodations is based upon 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 years. Documentation must be received and approved at least 90 days prior to the date that you will be testing. Candidates who submit documentation that is not within the past five 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 an 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, which describes the nature of the disability, and specific recommendations regarding the type of accommodation required to address the disability. The letter should be on that professional s 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 exam facility, providing for the exam to be taken in an accessible location, or 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. CCI has the prerogative to establish and revise policies and procedures for certification/recertification as deemed appropriate. CNOR Exam Test Center Regulations Security Measures Several security measures will be enforced during the exam administration. Be aware that you will be observed at all times while taking the exam. This observation may include direct observation by test center staff, as well as video recording of your testing session. Exams cannot be viewed, copied, or studied by any individuals. Copying or 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 exam scored, and may result in civil prosecution and disciplinary action by CCI. Misconduct Policy No personal belongings are permitted in the test center, except for the pencils and scratch paper by the 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 to notify Prometric and CCI of the action taken: Failure to follow the test center administrator s directions. Creating a disturbance of any kind. Page 11 of 29 CNOR 07.15

12 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 or recording equipment such as Palm Pilots, pagers, cellular phones, etc. Using notes, books, or other aids. Bringing any materials to the test center that may compromise the administration of the exam. Sharing information about the test and test questions with any unauthorized person(s). If a proctor witnesses what he 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 for quality, and to determine if there was any inappropriate action requiring follow- up with the test center personnel. The copy of the video and any related materials are forwarded to Prometric, which 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 may include but not be limited to: Suspension from the exam for an indefinite or specified period of time. At the Board s discretion, notify the State Board of Nursing, employer, insurance company, or other public health agency. Group 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 administrations (e.g. natural disasters and other emergencies). When group- testing 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 group testing irregularities. Page 12 of 29 CNOR 07.15

13 CNOR Exam Sample Questions The following sample questions are representative of actual test content and question format. An answer key to these questions appears at the end of this section. 1. The circulating nurse may begin positioning the patient who is undergoing a general anesthetic when: A. Stage one, induction, has been reached. B. Stage two, excitement, has been reached. C. Stage three, relaxation, has been reached. D. The anesthesia care provider indicates it is safe to do so. Correct answer: D. The anesthesia care provider indicates it is safe to do so. Reference: Phillips, N. (Ed.). (2013). Berry and Kohn s operating room technique, p St. Louis, MO.: Elsevier/ Mosby. Rationale: The patient should not be moved until the anesthesia care provider has indicated it is safe to do so. 2. Which of the following is most effective in supporting a change in practice that promotes safe patient care? A. Research studies from peer - reviewed journals. B. A cost/benefit analysis. C. Anecdotal evidence. D. Personal opinion based on experience. Correct answer: A. Research studies from peer- reviewed journals. Reference: Rothrock, J.C. (Ed.). (2015). Alexander s care of the patient in surgery, p. 12. St. Louis, MO: Elsevier/Mosby. Rationale: Nurses have an ethical responsibility to obtain and analyze evidence that supports implementation of strategies to improve patient care. 3. The preoperative antiseptic solution approved for use on the eye is: A. 5% ophthalmic aqueous iodine/iodophors. B. 10% aqueous iodine/iodophors C. Chlorhexidine gluconate. D. Baby shampoo and saline. Correct answer: A. 5% ophthalmic aqueous iodine/iodophors. Reference: AORN. (2015). Guidelines for perioperative practice, p. 51. Denver, CO: Author. Rationale: All other antiseptic agents can cause corneal damage. 4. The most effective way to evaluate your patient s understanding of his postoperative instructions related to the dressing change is through: Page 13 of 29 CNOR 07.15

14 A. Signing the postoperative instruction form. B. Verbalizing understanding of the instructions. C. Demonstrating the correct steps in the dressing change. D. Watching you perform the dressing change. Correct answer: C. Demonstrating the correct steps in the dressing change. Reference: Reference: Phillips, N. (Ed.). (2013). Berry and Kohn s operating room technique, p St. Louis, MO.: Elsevier/ Mosby. Rationale: To evaluate understanding, have the patient demonstrate the skill. 5. You are scrubbed for a laparoscopic cholecystectomy. The surgeon tells you that a smoke evacuator isn t necessary since the plume is inside the peritoneum. What is the best response based on current guidelines? A. You re right. It just makes it harder to achieve a pneumoperitoneum. B. Surgical smoke contains airborne contaminants, including viruses, dead cells, and toxic gases, which are released into the air when the abdomen is deflated at the end of the case. C. Our policy says we have to use a smoke evacuator with every minimally invasive procedure. D. The smoke evacuation tubing came with the pack. If we don t use it, we re just going to waste it. Correct answer: B. Surgical smoke contains airborne contaminants, including viruses, dead cells, and toxic gases, which are released into the air when the abdomen is deflated at the end of the case. Reference: Reference: AORN. (2015). Guidelines for perioperative practice, p Denver, CO: Author. Rationale: Surgical smoke is a health risk and can cause acute and chronic problems for health care personnel and patients. Page 14 of 29 CNOR 07.15

15 CNOR Recertification Recertification The certified status of an individual RN is conferred by CCI for a period of five years, at which time a CNOR may seek recertification. The recertification process requires a CNOR to complete one of the three methods of recertification, and to meet recertification eligibility requirements. Online applications for recertification open on January 1st, of the year a certificant is due to recertify. Application for recertification must be made by December 31st, of the year the certification expires using one of the recertification processes in effect at the time recertification is due. CCI offers a discount if a certificant recertifies on or before July 1st. Definition of Recertification The continued documented validation of the professional achievement of identified standards of practice by an individual registered nurse providing perioperative nursing care. Purpose of Recertification The purpose of recertification: Recognizes the individual professional nurse who is proficient in practice. Strengthens conscious use of theory in assessing, planning, implementing and evaluating nursing care. Enhances professional development through continued learning that results in acquisition of current knowledge and expanded skills and practice. Rationale for Recertification Certification is recognized for a period of five years, with recertification required at the conclusion of that five- year period. The rapid pace of change and the prevalence of technology in the modern perioperative setting require a conscious effort to maintain competency. The required CNOR recertification activities flow from, and are consistent with the knowledge statements of the Job Analysis, which is performed on a 5 year cycle. The recertification requirements guide professional development activities in providing parameters for acceptable activity, and in maintaining a link to the most current body of knowledge. Linking the certification period to the Job Analysis cycle ensures that certificants are engaged in activities pertinent to their professional development. Competency is the actual performance in a situation, and consists of three components: knowledge, skills and attitude. Each of these components is a necessary element. The CNOR recertification process acknowledges the need for active work in the maintenance of continuing competency, by directly addressing 2 of the 3 components. The practice requirement facilitates the maintenance of current skills, and also promotes the acquisition of new skills, through exposure to the practice setting. Other professional development activities i.e. continuing education, facilitates the acquisition of knowledge, which is the second essential component of competency. It is assumed that ongoing professional development and engagement guided by the recertification process will also indirectly influence the certificant, and thus effect positive change in attitude, the third component of competency. Page 15 of 29 CNOR 07.15

16 CNOR Recertification Fees CNOR RECERTIFICATION 2015 FEES AND ALTERNATIVE STATUSES Subject Areas Early Discount 1/1 7/1 Standard Fees 7/2 12/31 Regular AORN Member Regular AORN Member Contact Hours $295 $240 $370 $315 Points $295 $240 $370 $315 Exam $385 $310 $460 $385 Inactive $175 $175 $175 $175 Retired (one- time fee) $95 $95 $95 $95 All fees are subject to change without prior notification. CNOR Recertification Process To recertify a CNOR credential, certificants must do four things: 1. Meet the recertification eligibility requirements (these are different than those for original certification) 2. Complete one of the three recertification methods 3. Complete the application 4. Pay the applicable fee Recertification Eligibility Requirements CCI has expanded the recertification requirements, recognizing that certificants transition into a variety of roles, and all patients benefit from the care provided by a certified nurse. CNOR recertification candidates must meet five requirements: Be CNOR certified Hold a current unrestricted RN license Be presently working full or part time in perioperative nursing in the area of nursing education, administration, research, or clinical practice. Have worked a minimum of 500 hours in perioperative nursing within the five- year recertification cycle. These hours may be in the area of education, administration, research, or clinical practice that impacts care provided to patients in the intraoperative setting. At least 250 of the 500 hours must be in the area of nursing education, administration, research, or clinical practice that impacts the care provided to patients in the intraoperative setting. All requirements must be met at the time of the application. An applicant s nationality, race, creed, life- style, color, sexual orientation or age is not a factor in determining eligibility for certification or recertification. Steps to CNOR Recertification 1. Select Method of Recertification There are currently three methods: 1. Contact Hours Page 16 of 29 CNOR 07.15

17 2. Points 3. Exam 2. Complete requirements for each method. Please refer to institute.org for the latest requirements. 3. Complete Recertification Application A complete application Includes: Online application including personal and work information sections Required supporting documents if recertifying by contact hours or points Application fee Signed Statement of Understanding. 4. Submit Completed Application Certificants may submit their completed application via: Apply online: institute.org, or Mail to: Competency and Credentialing Institute 2170 South Parker Road, Suite 295 Denver, Colorado Fax to: (Please call CCI at to confirm that your application was received.) Deadlines The application, as described above, must be completed between January 1st and July 1st, to receive the early discount rate. The standard deadline is December 31st. Contact hours or point activities must be obtained by December 31 st, of the year prior to recertification. All applications are confidential, and only those persons directly involved with the processing will have access to them. Late submissions will not be processed. NOTE: 75 of the 125 contact hours earned must be related to perioperative nursing. Fees The appropriate fee must be submitted with the application form (see page 9). The fee may be paid by personal check, cashier s check, or money order made payable to CCI, or by MasterCard, Discover or VISA. Applications will not be processed without the accompanying fee. All outstanding debts to CCI must be paid by December 31st of the year the certificant is due to recertify. Verification Information on applications may be verified. Authorized personnel will check applications for accuracy of information. We may verify information via telephone, and/or letter. All information gained through verification procedures will be confidential, except in instances where the law demands disclosure of facts. Should any information on the application be found false, the applicant will be notified and declared ineligible to continue in the recertification process. All information on the application may be verified and may include verification of: Original certification date Applicant s RN license through state boards of nursing Current employment through contact with employer/employing institution Professional nursing history through contact with past employers It is the responsibility of the applicant to furnish any information found missing on the application. If recertifying by exam, you will receive further information on testing sites once you contact the testing agency. Page 17 of 29 CNOR 07.15

18 Audit Process 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, staff will also select those individuals for audit. Those applicants selected for the audit process will be required to submit copies of the certificates of attendance listed in the contact hour record, or acceptable documentation for all point activities, by the deadline specified on the form. Notification of Status A confirmation will be sent after your application has been processed and approved. Methods of Recertification Certificants may choose one of three methods to recertify. 1. Recertification by Contact Hours Recertification by continuing education contact hours requires 125 contact hours offered by approved providers, accrued within the five- year accrual period. Seventy- five of these contact hours must be related to perioperative nursing. Please refer to the table below to determine the period during which your eligible contact hours must be earned. Credential Valid Hours Must Be Earned Between Early Discount Application Due Early Discount Application Due Jan. 1, Dec. 31, 2014 July 1, 2015 Dec. 31, 2015 Jan. 1, Dec. 31, 2015 July 1, 2016 Dec. 31, Jan. 1, Dec. 31, 2016 July 1, 2017 Dec. 31, 2017 Accredited providers To be acceptable, contact hours must be approved by one of the following: 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) American College of Nurse Midwives (ACNM) National Association of Nurse Practitioners in Women's Health (NPWH) National Association of Clinical Nurse Specialist (NACNS) Physician PRA Category 1 CME (Fifty percent (62.5) of the required number of contact hours may be earned through CMEs) Page 18 of 29 CNOR 07.15

19 Approved Topics To ensure the validity of this credential and its consistency with industry standards, CCI requires contact hours earned for CNOR recertification to be related to the specialty of perioperative nursing. Although the following is not an all- inclusive list, it provides a broad range of perioperative- related subjects. The candidate must maintain a copy of the certificate of attendance for each approved program attended, and submit if audited. Every certificate of attendance must have an accreditation statement and/or provider number. Anatomy and physiology AORN Congress programs AORN Journal Home Studies Critical thinking skills Communication Disease management (HIV, hepatitis, diabetes, etc.) Discharge planning Ethics Home healthcare management Infection control Leadership/supervisory skills Legal issues Nursing process Pain management Perioperative scope of practice Pharmacology Pre-, intra-, and postoperative patient care (patient assessment) Precepting Professional development Recommended practices Research posters Surgical procedures Technology * If a candidate attended a program and did not receive, or lost the certificate of attendance, the applicant is responsible for contacting the program sponsor for a replacement certificate. The following DO NOT meet the criteria for recertification, and are therefore, not acceptable: 1. Any program approved by a provider not listed above in Acceptable Providers. 2. Handwritten accreditation statements or provider numbers. 3. Certificates of attendance without an appropriate accreditation statement, and/or acceptable provider number. 4. Contact hours earned prior to January 1st of the year certified. 5. Provider numbers that do not state Board of Registered Nursing. Academic Credits for Recertification CNORs may use academic credits in partial fulfillment of the requirements for recertification, through the contact hour method. All academic credits must meet the following criteria in order for them to be acceptable for use toward CNOR recertification. One half (62.5) of the 125 contact hours required for recertification may be earned through academic credits. Academic credits will be converted to contact hours using the following calculation: 1 semester hour = 15 contact hours 1 quarter hour = 10 contact hours13 Courses must be those that are required for a baccalaureate or higher degree. Although courses must be taken for credit, CNORs do not need to be enrolled in a formal degree program at the time the course is taken. To be acceptable, a grade of C or better must be achieved for each course, and an accredited educational institution must sponsor courses. CME Credits CNORs may submit CME (continuing medical education) units in partial fulfillment of the contact hour requirements. Each CME is worth 1 contact hour. Fifty percent (50% or 62.5) of the required number of contact hours may be those earned through CMEs. You are responsible for converting CME credits into contact hours using the ANCC conversion of: 1 CME credit = 1 contact hour Page 19 of 29 CNOR 07.15

20 2. Recertify by Points Recertification by Points recognizes that professional development and competency maintenance may be accomplished in a variety of ways, including successful participation in various professional activities. To recertify by points, you are required to earn 300 points within a five- year period. Points Earning Period The window during which you must complete the eligible activities for recertification by points is as follows: Credential Valid Hours Must Be Earned Between Early Discount Application Due Standard Deadline Jan. 1, Dec. 31, 2014 July 1, 2015 Dec. 31, 2015 Jan. 1, Dec. 31, 2015 July 1, 2016 Dec. 31, 2016 Jan. 1, Dec. 31, 2016 July 1, 2017 Dec. 31, 2017 How to Earn Points through Eligible Activities The following is a list of Eligible Activities to recertify your CNOR by points. You may pick and choose among the seven activities. You must earn a total of 300 points to recertify your CNOR credential. See institute.org for additional details. Continuing Education - A maximum of 100 points Academic Study - unlimited Teaching in Academic Setting - A maximum of 150 points Publishing - A maximum of 150 points Presentations - A maximum of 150 points Service on a Board or Committee - A maximum of 150 points Precepting/Mentoring - A maximum of 100 points 3. Recertification by Exam Certificants may also retake the CNOR exam. The last day to apply for the CNOR exam is September 30 th of the year a certificant is due to recertify. Certificants must successfully pass the CNOR exam by December 31st of the last year of their recertification cycle. All standard application deadlines and scheduling window requirements apply. Methods for Reactivating a Lapsed CNOR Credential If the CNOR credential expires, contact hours will NOT be accepted to regain certified status. The only ways to be reinstated as a CNOR are to successfully complete the Perioperative Portfolio Project or pass the exam. Page 20 of 29 CNOR 07.15

21 Inactive Status Put Your Credential on Hold Certificants may apply for Inactive Status if they are currently a CNOR and do not meet recertification eligibility requirements. Please review the important information below before submitting your application for Inactive Status: While your status is considered inactive, you MAY NOT USE your CNOR credential. Inactive status is for a three- year period. The fee for inactive status is $175. To reactivate your CNOR you must meet all the recertification requirements in effect at that time and pay the application recertification fee. Inactive Status does not provide additional years to accrue the nursing eligibility requirements. It only shifts the five- year window during which you must acquire them. You still have to meet the eligibility requirements for the method you have chosen by December 31, of the period prior to submission of your application. Emeritus or Retired Status CCI offers CNORs who are retiring from professional perioperative nursing the option to maintain their credential in an Emeritus capacity with the CNOR Emeritus status or CNOR (E). CCI established the Emeritus Status in 1995 to recognize retired perioperative nurses service and commitment to the perioperative profession, as well as their achievement and maintenance of the CNOR credential. Emeritus candidates apply online at cc- institute.org. The one- time fee for Emeritus Status is $95 for all CNORs regardless of AORN membership status. Once your application and fee have been received, your Emeritus Status certificate will be mailed to you within four to six weeks. Effective January 1, 2012, you must currently hold the CNOR credential in good standing to apply for the CNOR Emeritus status. The CNOR emeritus credential is not available if your CNOR credential has lapsed. If your credential has lapsed, you may regain it by taking the exam or completing the Portfolio program for reactivation. Structure of the CNOR Certification Program/ Test Development Process Certification Board CCI conducts voluntary certification/recertification programs for nurses. CCI was established for the purpose of developing, implementing, administering and evaluating these programs, and is accountable for the process. CCI shall confer the certified status and may revoke it in specified cases. Test Specification Committee Test specifications present the content outline of exam subject matter, from which questions (items) for the exam are written. Test specifications for the certification exam are derived from the analysis of performance tasks in which perioperative nurses are engaged. The test specifications are presented in a grid format, with job domains and phases of surgical intervention as the basic elements. The Test Specifications Committee is composed of CNORs involved on a daily basis with direct patient care during intraoperative intervention. Members represent different areas of practice insofar as possible. Page 21 of 29 CNOR 07.15

22 Item Writers Item writers are responsible for constructing questions specific to each section of the test specifications. The testing agency furnishes each writer with instructions on how to write multiple- choice questions along with a list of appropriate reference materials. Item writers are CNORs who volunteer to serve on this committee. Item Review Committee The Item Review Committee reviews all questions selected for the exam. Such matters as correctness of answers, prevention of geographic or gender bias, clarity of language, and appropriateness of items are considered during the item review process. The edited copy of the final form of each exam is reviewed and approved by the Item Review Committee. The Committee review constitutes a final check and balance system on the reliability of the exam. The Item Review Committee consists of CNORs volunteers who are currently active in perioperative nursing practice and were selected by the Board to serve on this committee. Testing Agency The testing agency is responsible for accomplishing the following functions: assist in developing the final form of the exam; assist in developing measurement tools; administer and score exams; report results in such exams; and maintain an item bank. Prometric is the agency currently under contract for these services. Job Analysis A Job Analysis, including Test Specifications, was developed by the Test Specifications Committee of CCI in cooperation with our testing agency, Prometric. The Job Analysis describes the overall functions and responsibilities, as well as the underlying knowledge and skills that are essential to ensure proficiency as a perioperative nurse. Some, but not all, of the task statements are of a sequential nature, building on the knowledge and skills specified in previous statements. The test specifications were developed on the basis of external ratings, and constitute a plan upon which the job- related certification exam was constructed for nurses functioning in the perioperative role. CCI intends this document to act as a guideline for development of the certification exam. It is recognized that the Job Analysis may not reflect all of the specific tasks performed by an individual perioperative nurse. Job Analysis Glossary of Terms Ambulatory Surgery. For purposes of this document: outpatient surgery, same- day surgery, day surgery, etc., are included on the term ambulatory surgery. AORN Guidelines for Perioperative Practice. As used in the Job Analysis, this term includes all sections of this document. Certification. The documented mastery of the knowledge base and standards underlying the professional practice of an individual nurse providing perioperative patient care. Community Resources. An agency or organization whose role is to provide services to the patient throughout the perioperative continuum. Domains. A categorization of job responsibilities to classify the functions, tasks, knowledge, and skills relevant to perioperative nursing. Used for designing the certification exam. Page 22 of 29 CNOR 07.15

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