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Pathway to Excellence Get Certified and be Recognized for this

Accomplishment!

Suzan Blacher, PhD, RN, CARN

Rosemary Smentkowski, MSN, RN, CARN, PMHNP-BC

Virginia Coletti, PhD, RN, NPP, CARN, CS

Carolyn Jewell, MSN, RN, PMHNP-BC, CARN-AP

ANCB Objectives

• Examine how certification examinations are

constructed through use of item writing

workshops for developing test questions

• Review what the Role Delineation Study/Practice

Analysis is and why it is important

• Explore how to apply for the Carolyn Jewell Steel

Magnolia Scholarship and the ANCB Members’

Scholarship Award

Board members

Rosemary Smentkowski, MSN, RN, CARN,

PMHNP-BC

President

Colleen T LaBelle, MSN, RN-BC, CARN

Vice President

Cheryl Rush, MSN, RN, ACNP, CARN

Treasurer

Carolyn Jewell, MSN, RN, PMHNP-BC, CARN-AP

Secretary

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Board members

Directors

Virginia A. Coletti, PhD, RN, NPP, CARN, CS

Elizabeth Flides, RN, EdD, CNE, CARN-AP

Elizabeth Maguire, MSN, RN, PMHNP-BC, CARN-AP

Jacqueline Perry, MA, RN, PMHN-BC, CARN, ALSP

Dana Siewertsen, BSN, RN, CARN, LCDCIII, RHIT

Virginia Singer, DNP, PMHNP-BC, CARN-AP

Will Maixner, MHA, FACHE, Public Member

Historical Timeline

1989

• National Nurses Society on Addictions (NNSA)

Board formed

• December 1989 the first Certified Addictions

Registered Nurse (CARN) exam

1990’s

• The first CARN re-certification, 1993

• Job analysis 1995

Historical Timeline

• Deemed status given to IntNSA by North

Carolina Substance Abuse Professional

Certification Board.

• CARN exam extensively revised, 1998.

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Historical Timeline

2000

• First Certified Addictions Registered Nurse-

Advanced Practice (CARN-AP) exam offered

2003

• CARN-AP eligibility criteria expanded

• Retired status established

2004

• First recertification for CARN-AP

Historical Timeline

2006

• First computer-based testing

2009

• Introduced ANCB logo

• Created by Jason Demetillo & Virginia Coletti

Historical Timeline

2011-2012

• Role delineation study completed by AMP

• Exam based on new blueprint

2014

• ANCB more autonomous with own bylaws

2017-2018

• Role delineation study initiated and summary by C-NET

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ANCB is Accredited!

October 2018

• ANCB received accreditation for the CARN and

CARN-AP certification from the Accreditation

Board for Specialty Nursing Certification

(ABSNC) for 5 years.

Accreditation

• Accreditation is a peer-review mechanism that

allows (nursing) certification organizations to

obtain accreditation by demonstrating

compliance with the highest quality standards

available in the industry.

“Anyone” can write a certification test – not all

certification tests are accredited

Value of Certification

Certification, as defined by the American

Board of Nursing Specialties (ABNS)

�Is the formal recognition of specialized

knowledge, skills, and experience

demonstrated by achievement of standards

identified by a nursing specialty to promote

optimal health outcomes.

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Value of Certification

� Elevates the standards of addiction nursing

practice

� Provides expanded career opportunities and

advancement

� Benefits the nurse, our profession and the public

we serve.

Value of Certification

Perceived value to self

�personal achievement,

�job satisfaction,

�validation of knowledge,

�greater earning potential,

�commitment to professionalism,

�access to a broad range of job opportunities

�validates our competence and engagement in lifelong

learning in our specialty areas of practice.

Value of Certification

To Others�Nurse managers expressed a preference for hiring

certified nurses because certified nurses have a proven

knowledge base and documented experience in a given

specialty.

�Some facilities assist in removing barriers to certification.

Example:

�Thomas Jefferson University &

�Jefferson Health in Philadelphia

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Specialized Knowledge

• According to Scope and Standards of Addiction

Nursing Practice (2004)

“Addictions Nursing Practice is a distinct specialty

that integrates

biological, behavioral, environmental, psychological,

social, and spiritual aspects of human responses to

the illness of addiction into nursing care provided to

those affected by this disorder/disease, regardless

of clinical setting.”

CARN/CARN-AP Development and

Implementation

Practice Analysis/Role

Delineation Study

� Purpose: to provide evidence to support validity

of the CARN and CARN-AP exam

� Evidence collected helps assure exam reflects:

• Current practices

• Legally defensible

• Psychometrically sound

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NUTS & BOLTS

ANCB Board: Practice Analysis Task Force (PATF)

� Charged: conduct activities to identify

responsibilities of general & AP practitioners

• Two subgroups to develop exam specifications

� Group diversity reflective of addictions nursing

practice throughout the U.S

� All PATF members: Vetted for expertise in their

respective areas of specialization

NUTS & BOLTS (cont.)

PA/RDS develop web-based role delineation survey

� Surveyed target practitioners, analyze responses

� Survey designed: analyses CARN and CARN AP

� Examination Specifications based on addictions

nurse data

� Exam Specifications:

• Detailed content outline

• Associated knowledge

• Required number of content items included

Determining Inclusion

Rules to determine:

• Activities and knowledge

• Appropriate assessment & inclusion skills

Detailed Content Outline:

• Part of Practice

• Importance to practice throughout US/Canada

• Importance regardless of educational preparation

• Importance to entry-level practitioners

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Practice Analysis Role

Delineation Study 2017

• Subject matter experts(SME)• Identify activities, knowledge, skills, abilities:

Competencies

• Part of practice for of addictions and advanced practice nurse.

• Responses of hundreds of nurses in addictions practice were evaluated • Competencies confirmed to be important to practice

• Separate content outlines for the CARN and CARN-AP• Exams developed based on Role Delineation Study

Survey Respondents for

CARNTotal Number: 137 from 30 states plus Canada

89.1% female

89.1% white, not of Hispanic origin

Nursing experience years: <1 year to 54 years

Addictions nursing years:<1 year to 45 years

Survey Respondents for

CARN-APTotal Number: 108 from 35 states plus Canada

88.9% female

87% white, not of Hispanic origin

Nursing experience years: <1 year to 53 years

Addictions nursing years:<1 year to 40 years

NP 73.1% CNS 35.2% Both NP/CNS 17.6%

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Survey Respondents

CARN Practice Settings

• OTC: 34.3%

• Inpatient acute treatment center: 25.5%

• Inpatient residential treatment center: 23.4%

• Hospital unit: 21.9%

• Mental health facility: 14.6%

• Community health: 8%

CARN-AP Practice

Settings

• OTC: 44.4%

• Acute Care (ED, In patient: 17.6

• Psychiatric facilities: 15.7%

• Residential: 13%

• Public Health/Community:

9.3%

• College/University: 7.4%

• MAT Clinic: 6.5%

CARN: What is the highest

education in nursing?

Diploma > 8%

ADN > 28%

BSN > 48%

MSN > 16%

ADN

28%

BSN

48%

Diploma

8%

MSN

16%

CARN: What is the highest

education in nursing?

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How the PA/RDS is Used

• Subject matter experts instructed on writing items (questions) • Write and submit items

• Items are subjected to an editorial and content review.

• Referenced, cited, validated as evidence-based practice.

• Review by subject matter experts helps ensure items

• Linked to blueprint specifications

• Clearly written, appropriate for nurses in addictions practice.

• Prior to being used to calculate candidates’ scores

• Items are pretested

• Evaluated for statistical characteristics of the items and candidate comments.

Blueprint of CARN Exam

→→→→ Domains of Practice

Patient problems ↓↓↓↓

Perform a

biopsychosocia

l SUD

assessment

Assess acute

care needs

of SUD

patients

Develop and

implement an

individualized

plan of care

Educate and

promote

behavioral

change

Care mgmt.,

treatment, and

evaluation, throughout

the recovery

continuum (including

special populations)

TOTAL

Opioid use disorder 5-6 5-6 7-8 5-6 13-1425%

(37-39)

Alcohol use disorders 5-6 5-6 7-8 5-6 13-1425%

(37-39)

Medication misuse

(sedative/hypnotics/anxiolytics,

gabapentinoids, etc)

3-4 3-4 4-5 3-4 8-915%

(22-24)

Co-occurring psychiatric/comorbid

medical disorders (process addictions,

infectious diseases, and mental health

disorders)

3-4 3-4 4-5 3-4 8-915%

(22-24)

Stimulant use disorders

(cocaine, amphetamines, caffeine)2-3 2-3 3-4 2-3 5-6

10%

(14-16)

Cannabinoids and other hallucinogens 1-2 1-2 1-2 1-2 2-35%

(7-9)

Tobacco use disorder (e.g., vaping,

nicotine)1-2 1-2 1-2 1-2 2-3

5%

(7-9)

Total15%

(22-24)

15%

(22-24)

20%

(29-31)

15%

(22-24)

35%

(52-54)

100%

(150)

Blueprint of CARN-AP

Exam

APRN Ac8vity →

Patient Problem ↓

Assess

& Diagnose

30%

Prescribe/

Intervene

30%

Education

25%

Consultation

10%

Practice Mgmt

& Research

5%

Total

100%

Opioid use disorder 10-11 10-11 8-93-4

1-224%

35-37

Alcohol use disorder 10-11 10-11 8-93-4

1-224%

35-37

Stimulant use disorder 6-7 6-7 5-62-3

1-215%

22-24

Co-occurring psychiatric/comorbid

medical conditions 5-6 5-6 4-5

2-30-1

13%19-21

Other use disorders, e.g.,

prescription drugs, inhalants,

hallucinogens, designer drugs,

process addictions

3-4 3-4 2-32-3

0-19%

13-15

Tobacco use disorder 3-4 3-4 3-41-2

0-18%

11-13

Cannabis use disorder 3-4 3-4 2-31-2

0-17%

10-12

Total 44-46 44-46 7-38 14-15 7-8 150

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Scholarships

• Carolyn Jewell Steel Magnolia Scholarship-

funded by proceeds from ANCB annual raffle

• ANCB Members’ Scholarship Award-funded by

Elizabeth Fildes, RN, EdD, CNE, CARN-AP

• Two scholarships are available for CARN or

CARN-AP examinations per year

• Go to advisoryancb@gmail.com for

qualifications and how to apply

CARN/CARN-AP Certification by State and Canada

Call for Action

• Who writes items?

• Do you have a burning inquiry?

• Are you an SME? Yes you are! Volunteer your

expertise:

• PA/RDS survey

• Item writing

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References

ABNS “About Us” (2019). http://www.nursingcertification.org/about/

Addictions Nursing Certification Board (2019). Historical Timeline.

C-NET at cnetnurse/addictions-nurse-certification/ for CARN and

CARN- AP Handbook.

Garbin, M. (2019). Executive Summary for the ANCB PA/RDS of

Addictions Nursing (CARN), NJ:C-NET.

Garbin, M. (2019). Executive Summary for the ANCB PA/RDS of

Addictions Nursing (CARN-AP), NJ:C-NET.

International Nurses Society on Addictions (2004). Scope and

Standards of Addictions Nursing Practice. Washington, D.C.:

American Nurses Association.

Questions?