The practice analysis (also known as a study of practice) was performed in 2018 at the request of AACN Certification Corporation, the certification organization for the American Association of Critical-Care Nurses. The purpose of the practice analysis was to describe the job activities of the acute/critical care nurse in sufficient detail to provide a basis for the development of a professional, job-related certification exam.
A Practice Analysis Task Force (PATF) was appointed by AACN Certification Corporation to conduct the activities necessary to identify the responsibilities of an acute/critical care nurse and to develop the test specifications. The diversity of this group reflects the acute/critical care nurse’s job. All PATF members demonstrate expertise in the duties and activities associated with the profession.
The study involved the development of a practice analysis survey, distribution of the survey to people involved in acute/critical care nursing and an analysis of the responses. Test specifications for the adult, pediatric and neonatal acute/critical care nurse were developed on the basis of this data. The PATF was responsible for the following six tasks:
- Developing a definition of the acute/critical care nurse
- Developing a sampling plan for the survey
- Identifying patient care problems, nursing actions and competencies for the survey instrument
- Determining rating scales
- Determining the relevant demographic variables of interest
- Integrating the definition, patient care problems, nursing actions, competencies, rating scale and demographics into a survey instrument
The draft practice analysis survey was distributed to the PATF for pilot testing. Modifications were made and the final survey was prepared for distribution.
In April 2018, invitations for the web survey were emailed to 19,377 individuals identified by AACN Certification Corporation, who held the CCRN, CCRN-K or CCRN-E credential, as well as those who were not certified. Of those who participated, 2,585 individuals had usable responses. It was determined that the usable response rate was approximately 13.5%. Additionally, the respondents' ratings displayed an acceptable level of interrater reliability for the patient care problems, nursing actions and competencies.
After the survey data were analyzed, the PATF reviewed the results and decision rules were established. These rules were used to determine which patient care problems, nursing actions and competencies were appropriate for assessment and, therefore, should be included in the final test content outline. Application of the decision rules also resulted in the retention of 137 patient care problems for the adult acute/critical care nurse, 101 for the pediatric acute/critical care nurse and 86 for the neonatal acute/critical care nurse. Application of the decision rules resulted in the retention of 82 nursing actions for the adult acute/critical care nurse, 51 for the pediatric acute/critical care nurse and 68 for the neonatal acute/critical care nurse. A review of the respondents’ comments resulted in the addition of one nursing action. Each multiple-choice exam will be composed of 125 scored items plus 25 unscored pre-test items. The resulting content outlines for the neonatal, pediatric and adult acute/critical care nurse will be used by AACN Certification Corporation’s exam development committees to assemble the exams.
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