2022 National Practice Analysis of Progressive Care Nurses

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Executive Summary

AACN Certification Corporation conducts regular national studies of practice, also known as practice analyses, as the basis for development of certification test plans, which are based on current clinical practice. The purpose of the PCCN study of practice is to describe the job activities of progressive care nurses in sufficient detail to provide a basis for the development of a professional, job-related specialty certification exam.

A Practice Analysis Task Force (PATF) was appointed by AACN Certification Corporation. The selected subject matter experts represented a wide variety of work-related characteristics, such as years of experience, work setting, geographic location and area of specialty. This diversity reduces the risk of bias as the PATF develops a scope of practice reflecting the roles and responsibilities of progressive care nurses.

The PATF met in August 2022 to identify the responsibilities of adult progressive care nurses and develop a web-based survey tool. The task force developed and piloted a survey that included 86 task statements and 105 knowledge statements across 12 content domains.

The final web survey was sent to individuals identified by AACN Certification Corporation as nurses practicing in progressive care (in areas such as intermediate care, direct observation, stepdown, telemetry and transitional care). The survey yielded 688 usable responses, with respondents' ratings displaying an acceptable level of interrater reliability for the patient care problems and nursing actions.

Reviewing the results of the survey, the PATF identified the task and knowledge areas that would comprise the revised test plan and finalized the weighting for each area with content distribution at the competency level as well as the topic level. With an increase in test plan content for the task and knowledge areas and a rise in patient complexity, the PATF recommended the exam length be increased to adequately cover these items.

Continuing with the exam development, the PCCN Item Writer Committee (IWC) and Item Review Committee (IRC) drafted and fine-tuned exam items for pretesting based on the updated test plan.

The PCCN Exam Pool Review Committee (EPRC) then reviewed the complete pool of exam items for relevance, accuracy and fairness, validating each item with at least one reference listed on the exam bibliography.

Last, the PCCN Score Evaluation Committee (SEC) analyzed the difficulty of the items in the final item pool to determine the passing standard, also known as the cut score. The multiple-choice specialty credential exam will be composed of 125 scored items plus 25 unscored pretest items. The PCCN Test Plan is available to exam candidates, review course instructors and other interested individuals and organizations.

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