History of AACN Certification Corporation

In 1975, the American Association of Critical-Care Nurses established a separate entity, AACN Certification Corporation, to develop the CCRN certification program. The purpose of the program was to use the certification process as a means for developing, maintaining and promoting high standards of critical care nursing practice.

Today, AACN Certification Corporation administers certification programs to protect the healthcare consumer by validating the knowledge of nurses who provide care to acutely and critically ill patients. There are more than 93,000 neonatal, pediatric and adult certified nurses practicing worldwide. 



The first CCRN examination was administered, replacing the achievement exams. AACN established a Certification Committee, composed of critical care nurses, to recommend action on certification issues to the Board of Directors.

1984 - 1985

AACN Certification Corporation completed the Role Delineation/CCRN Validation Study, the first such undertaking by any nursing certification program. The study identified the body of knowledge used by practicing critical care nurses that formed the basis for the examination "blueprint" that delineated the percentage of the examination devoted to each content area. A revised CCRN examination, based on the new examination blueprint, was first administered the following year.


As a result of the Role Delineation Study begun in 1989, changes were made to the existing adult exam blueprint. Beginning in July, new certification programs for neonatal and pediatric critical care nurses began. Expanded clinical practice requirements that included clinical practice hours and specific clinical experiences were introduced. Also in July, the new AACN Certification Corporation Board of Directors took office.

1993 - 1994

The Certification Think Tank was convened to develop a framework for certified practice that could be used for the next role delineation study. They presented a reconceptualized model of certified practice that focused on the patient. The needs and characteristics of patients drive and influence the characteristics or competencies of nurses. When the nurse's characteristics match the patient's characteristics or needs, optimal patient outcomes can occur. This formed the basis for the Synergy Model.

1995 - 1999

AACN Certification Corporation undertook a comprehensive and systemic study of critical care nursing practice using the Synergy Model as the conceptual framework. A group of subject matter experts was convened to further define and clarify the model and pilot studies were completed. The Synergy Model was adopted as the framework for the CCRN exam and the redesigned exam 'went live' in August 1999. Eighty percent of the exam remained unchanged and still tests clinical judgment. The other 20 percent, referred to as the Professional Caring and Ethical Practice portion, tests nurses' knowledge of the other skills necessary for effective critical care nursing. For more information regarding these skills and the Synergy Model, please click on the above link.


AACN Certification Corporation began the transition to computer-based testing, which completely replaced pencil-and-paper exams by the beginning of 1998. Tests are given by computer at locations nationwide, allowing candidates to schedule their test for the date and time most convenient for them, on a year-round basis. All locations offer testing Monday - Friday, five days a week.


AACN Certification Corporation introduced a new credential, the CCNS, for Clinical Nurse Specialists in Acute and Critical Care. The first CCNS exam was administered in January 1999 nationwide. A new designation was also introduced, Retired CCRN Status, which allows CCRNs who are retiring from nursing to keep an important connection with the field of nursing.


The CCNS exam was first administered in January 1999. Approval of the exam and/or AACN Certification Corporation as a credentialing body for advanced practice was applied for in each of the 50 states. For a list of states that currently recognize the CCNS exam or AACN Certification Corporation as a credentialing body for advanced practice licensure, please click on the "CCNS" logo on this website's home page. The CCRN exam was updated to incorporate the Synergy Model of nursing practice, with updated exams replacing the older versions in August 1999.


AACN and AACN Certification Corporation retained the services of a large public relations firm in order to launch a program to bring critical care nursing and credentialing to the forefront in media relations and negotiations. This project, designed to unfold over a period of several years, is intended to introduce and champion the value of certification to patients, families, healthcare facilities and third-party payors.


AACN Certification Corporation introduced the Alumnus CCRN designation for CCRN-certified nurses who no longer provide direct bedside critical care but remain in the nursing profession in another capacity. This group of former CCRNs constitutes an invaluable pool of talent, experience, history and loyalty to CCRN certification, serving as mentors for others considering becoming certified.


AACN and AACN Certification Corporation released to the media a definitive report on the benefits that specialty certification for nurses bring to the public, employers and to nurses themselves entitled Safeguarding the Patient and the Profession: The Value of Critical Care Nurse Certification. The report puts forth a call to action for all who can influence and will benefit from certified nurses' contribution to patient care. The release of this white paper is a major part of AACN's initiative to raise awareness of the value of nurse certification.


With the guidance of many subject matter experts, AACN Certification Corporation undertook and completed a comprehensive study of critical care nursing practice, from entry level through advanced practice. Based on the results of this groundbreaking study, it was determined that nursing practice within the progressive care area can be differentiated from practice within the critical care environment. The concept that critical care exists on a continuum from acutely ill to critically ill was validated.


AACN Certification Corporation introduced a new credential, the PCCN, for progressive care nurses working with acutely ill patients. Over 400 nurses took the paper and pencil administration of the PCCN exam at the NTI conference in May 2004. AACN Certification Corporation announced plans for development of two new subspecialty certifications, Cardiac Medicine and Cardiac Surgery.


Two subspecialty certification examinations, Cardiac Medicine (CMC) and Cardiac Surgery (CSC), were launched. AACN Certification Corporation began development of an Acute Care Nurse Practitioner examination. Planning began to conduct a study of practice of the Virtual ICU environment.


AACN Certification Corporation conducted a job analysis on the virtual ICU environment to determine renewal requirements for CCRNs who no longer meet traditional bedside hours because they work exclusively or primarily in the tele-ICU (e.g., virtual ICU or e-ICU). Online exam registration became available for CCRN, PCCN, CMC, and CSC exams. The new Renewal by Synergy CERPs program was rolled out with a 3-year transition period between 2007 and 2010.


The CCRN-E renewal program was launched for CCRNs who work exclusively or primarily in a tele-ICU monitoring acutely/critically ill adult patients from a remote location. The ACNPC certification program for nurses educated at the graduate level to provide advanced nursing care across the continuum of health services to meet the specialized needs of adult patients with complex acute, critical and/or chronic health conditions was launched, with certification available by exam or endorsement. A national study of practice designed exclusively for nurse managers was completed with the goals of informing product development and developing a test plan for a potential certification exam.


AACN Certification Corporation conducts periodic studies of practice to inform and refresh the certification exam test plans. Two studies of practice were conducted in 2008, one for progressive care nursing and one for critical care nursing.


AACN Certification Corporation partnered with the American Organization of Nurse Executives and the AONE Credentialing Center to create and launch the CNML certification program for nurse managers and leaders.


Renewal by Synergy CERPs, based on the nurse competencies of the AACN Synergy Model for Patient Care, is launched as the primary renewal program for CCRN and PCCN-certified nurses.


The CCRN-E initial exam, an extension of the CCRN certification program, is made available to nurses working exclusively or primarily in a tele-ICU monitoring and caring for acutely/critically ill adult patients behind the camera from a remote location.


AACN Certification Corporation continues active involvement in partnering with schools of nursing, boards of nursing and other key stakeholders as preparations are made for the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education to go into effect by 2015. 


AACN Certification Corporation launches 3 Consensus Model-based APRN certification programs: ACNPC-AG for adult-gerontology acute care NPs; ACCNS-AG for adult-gerontology CNSs educated across the spectrum of wellness through acute care; and ACCNS-P for pediatric CNSs educated from wellness through acute care. 


The ACCNS-N certification program was launched as one more Consensus Model-based APRN exam for neonatal clinical nurse specialists educated across the spectrum of wellness through acute care. The CCRN-K certification program was launched for nursing knowledge professionals whose non-bedside practice influences patients, nurses and/or organizations to have a positive impact on acutely and/or critically ill adult, pediatric or neonatal patients.

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