Nephrology Nursing Certification Commission (NNCC)
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
 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)?
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
 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.
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.)
 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:
 www.nncc-exam.org
 Call the NNCC’s national office:
 1-888-884-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) 68-75.
 Accreditation Board for Specialty Nursing Certification (2011).
Accreditation Board for Nursing Specialties accreditation standards.
www.nursingcertification.org
 American Board of Nursing Specialties. Fact sheet.
www.nursingcertification.org
 American Board of Nursing Specialties (2005). A Position Statement
on the Value of Specialty Nursing Certification.
www.nursingcertification.org
 American Nephrology Nurses’ Association (2008). Certification in
nephrology nursing [Position statement].
www.annanurse.org
 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]. www.annanurse.org
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), 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), 215219.