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Nephrology Nursing Certification Commission (NNCC). ORIENTATION TO CERTIFICATION. OBJECTIVES: At the end of this presentation, the participant will be able to:. Describe the roles of the organizations associated with nephrology nursing certification

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objectives at the end of this presentation the participant will be able to
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
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 who are either CNN certified or CNN-NP certified; and one public member
  • The public member cannot be a nurse or other healthcare professional
what are examination boards
What Are Examination Boards
  • Within NNCC’s structure there are boards that oversee each examination program.
  • Advanced Practice Board
    • CNN-NP
  • Nursing Board
    • CDN & CNN
  • Clinical/Technical Board
what is a professional membership organization
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.
what does the american nephrology nurses association anna have to do with certification
What does the American Nephrology Nurses’ Association (ANNA) have to do with certification?
  • ANNA maintains that certification is an essential component of specialty nursing practice and that it must be designed to protect the public from unsafe & incompetent caregivers.
  • ANNA recognizes & endorses certification credentials where practice analyses and the credentialing body undergo an external peer review process.
  • ANNA encourages certification for all levels of nephrology nursing practice.
anna and nncc are not the same they are different
ANNA and NNCC are NOT the same:They are different!
  • Certification organization that promotes patient safety and quality of care
  • Certification of nephrology caregivers
  • Research and test development to ensure national relevance and reflection of current practice and roles in nephrology
  • Membership organization that promotes professional development and education
  • Provides educational resources to support certification
  • Advocates for the value of certification
what does the american board of nursing specialties abns say about this relationship
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
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
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
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
What is the Center for Nursing Education & Testing (C-NET)?

Meeting Nursing’s Assessment Needs

C-NET provides a full range of test development and test administration services, including:

  • Certification testing for specialty nursing practice
  • Preadmission testing for RN and LPN/LVN schools of nursing
  • Clinical Judgment Series of tests for nursing practice settings
  • Test construction workshops for nurse educators

C-NET works with the NNCC to ensure that all of the exams offered are reliable and valid and meet industry standards.

licensure certification what are the differences
Licensure – Certification ... What are the Differences?


  • 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
Licensure (cont.)
  • Permits the use of a particular title and defines the scope of practice
  • Others are prohibited from practicing the profession
  • 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
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
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 minimal 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
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 practitioners 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
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
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.
what should i know about test questions
What Should I Know About Test Questions?
  • 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.
test questions cont
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
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
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
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
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
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
You CAN break down those barriers!
  • Hold a certification examination review course
  • Encourage financial incentives
    • Merit pay increase
    • Free continuing education opportunities
  • Increase recognition of certified staff
    • Announcing certification successes at staff meetings
    • Posting lists of certified caregivers in the workplace with photos of newly certified staff
    • Promoting facility funded attendance at regional or national educational meetings
    • Working to establish a work place program to encourage certification at your facility
need more information
Need More Information?
  • Visit the NNCC’s website:
  • Call the NNCC’s national office:
    • 1-888-884-NNCC (6622)
  • Like NNCC on Facebook
receive a free continuing education credit
Receive a Free Continuing Education Credit

Take the post-test by clicking the link below and earn a credit of 0.5 contact hours good towards your NNCC certification or recertification:

NNCC: Orientation to Certification

  • Altman, M. (2011). Let’s Get Certified. AACN Advanced Critical Care. 22(1) 68-75.
  • Accreditation Board for Specialty Nursing Certification (2011). Accreditation Board for Nursing Specialties accreditation standards. Retrieved February 5,2012 from
  • American Board of Nursing Specialties. Fact sheet. Retrieved February 5, 2012 from
  • American Board of Nursing Specialties (2005). A Position Statement on the Value of Specialty Nursing Certification. Retrieved February 5, 2012 from
  • American Nephrology Nurses’ Association (2008). Certification in nephrology nursing [Position statement]. Retrieved February 5, 2012 from
  • American Nephrology Nurses’ Association (2013). Nephrology Nursing Journal, July/August, Vol. 40, no. 4
references con t
References (con’t):
  • American Nephrology Nurses’ Association (2009). Autonomy of the Nephrology Nursing Certification Commission (NNCC) [Position statement]. Retrieved February 5, 2012 from
  • Garbin, P. (2007). 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), 25-32.
  • Prowant, B.F. & Gallagher, N.M. (2007). Focus on issues related to nephrology nursing certification. ANNA Journal, 14(2),563-564.
  • 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), 215-219.