Certified Healthcare Safety—Nursing
(CHSN)
Nursing is a high calling and the largest profession in healthcare. CHSN holders can improve safety at the sharp end of the care spectrum. The CHSN credential provides motivated nurses to earn a certification that can be worthwhile to personal professional development and to the organizations in which they serve. The CHSN exam addresses safety within the nursing sphere of responsibility and how nursing units relates to facility safety efforts. The CHSN exam addresses patient safety, infection control, unit safety, and occupational safety/health. Earning the CHSN sends a message to the public, patients, and the organization that those providing or managing care understand the importance of preventing harm. The designation can improve professional practice and prepare credential holders for greater responsibilities in the areas of nursing safety, risk management, quality improvement, occupational safety/health, and overseeing patient care activities.
(please note: applications expire within 90 days)
CHSN Exam Blueprint
Note: CHSN exams contain 125 to 160 multiple choice items depending on the Form taken. Items are weighted at 1 point or 1.5 points. The Board determines passing or cut scores using total points earned and then reports pass or fail results using a Standard Scaled Score.
| Domains | 100-150 items |
|---|---|
| 1. Patient Safety | 36% |
| 2. Safety Management | 28% |
| 3. Standard Compliance | 36% |
Domain 1 —Patient Safety (36%)
This domain requires candidates to demonstrate competency by using recall/recognition, comprehension, and application of knowledge to answer items related to patient safety. Exam items focus on the identification, analysis, and control of hazards to prevent accidents, reduce risks, and maintain a safe environment for staff, patients, and visitors. Items appear distributed throughout the examination. Knowledge and job practice skills include the areas described. Evaluate facilities, products, systems, equipment, workstations, and processes by applying qualitative techniques to identify the hazards and assess their risks. Recommend controls through design and engineering to eliminate hazards and reduce the risks posed by processes and human errors. Implement strategies by using the results of hazard identification and risk analyses to eliminate and/or reduce harmful exposure to patients and the care environment.
Domain 1 Topics
- Identify and respond to adverse events
- Identify the need for change analysis
- Identify critical elements of clinical communication
- Identify elements of collecting patient information
- Identify common patient never events
- Identify the importance of continuous learning
- Identify the need for discipline in non-punitive cultures
- Identify the importance of ethics
- Given a scenario identify steps to facilitate change
- Identify how transparency impacts healthcare organizations
- Identify issues related to harm free care
- Given a scenario identify the consequences of human error
- Given a scenario identify elements of improving reliability
- Identify concepts related to leading others
- Identify patient events common in malpractice allegations
- Identify medical staff issues related to safety
- Given a scenario identify medication safety events
- Identify factors that can impact operational safety
- Identify issues relevant to organizational assumptions
- Identify factors impacted by organizational climate
- Given a scenario identify organizational structure issues impacting safety
- Identify patient care risks in various settings
- Identify reasons that patient information collection is vital
- Identify ways patients can participate in their care
- Identify patient safety risks
- Identify the safety importance of personal accountability
- Identify how personnel behaviors impact safety performance
- Given a scenario identify risk management principles
- Identify concepts related to safety cultures
- Given a scenario identify senior leadership safety roles
Domain 2—Safety Management (28%)
This domain requires exam candidates to demonstrate competency by using recall, recognition, comprehension, and application of knowledge to correctly answer exam items related to nursing-related safety practice. Exam items can focus on identification, analysis, and control of risks/hazards related to patient safety and occupational health/safety. Items are distributed throughout the examination. Evaluate facilities, medical equipment, products, systems, equipment, workstations, and processes by applying qualitative processes to ensure patient safety by identifying hazards and assessing risks. Adhere to recommended controls to prevent patient harm during medical procedures and on-going care. Communicate hazards, risks, and controls to patients, families, staff, senior management, care providers, and the public.
Domain 2 Topics
- Identify accident investigation principles
- Identify the principles of hazard analysis
- Identify principles related to authority and discipline
- Identify behaviors that hinder communication
- Identify continuous improvement concepts and principles
- Identify principles relevant to good decision-making
- Identify disaster and emergency management objectives
- Identify safety education and training requirements
- Identify objectives for maintain a responsive employee health function
- Given a scenario identify facility safety priorities
- Identify elements of maintain a high reliability organization
- Given a scenario identify the human factors impacting safety
- Identify concepts related to leadership and management
- Identify training, education, and orientation needs based on empirical data
- Identify common preventable medical errors
- Identify occupational health risks for nursing personnel
- Identify hindrances to maintaining a good operational culture
- Identify crucial elements related to organizational dynamics
- Given a scenario identify key performance improvement objectives
- Identify actions to ensure safety policies reflect realistic priorities
- Identify quality improvement processes that help safety performance
- Identify key risk management principles
- Identify important concepts related to effective safety assessments
- Identify the importance of understanding the costs of adverse events
Domain 3—Standards Compliance (36%)
This domain requires exam candidates to demonstrate competency by using recognition/recall, comprehension, and application of knowledge to correctly answer items related to healthcare facility and occupational safety. IBFCSM ensures distribution of all exam types of items throughout the examination. Knowledge and job practice skills include the following. Determine the effectiveness of safety related function and relevant systems by measuring and evaluating performance indicators to ensure continuous improvement to protect staff, patients, and visitors. Apply sound management and leadership practices to efficiently use resources to improve safety. Use appropriate methods to ensure stakeholders understand their roles in patient and occupational safety.
Domain 3 Topics
- Identify requirements related accreditation standards (JC, DNV, HFAP, CMS)
- Identify antimicrobials & disinfectants compliance requirements
- Identify biological and chemical hazards compliance regulations
- Identify clinical department safety requirements
- Identify agencies/requirements of CFR 10, 21, 29, 40, 42, 44, & 49
- Identify major OSHA compliance standards (Bloodborne, HAZCOM, Electrical Safety, etc.)
- Identify consensus standard requirements (ANSI, ASTM, ASHRAE, FGI, NFPA, NIOSH, etc.)
- Identify emergency management requirements of CMS, ASPR, DHS, FEMA, etc.)
- Identify environmental management regulations
- Identify key elements and requirements for environment of care areas
- Identify compliance and voluntary standards addressing ergonomics
- Identify Federal agency requirements (CDC, EPA, FDA, NRC, & OSHA, etc.
- Identify major life and fire safety requirements
- Identify flammable and combustible risks
- Identify requirements for handling, storing, and disposing hazardous wastes
- Identify key infection control standards, guidelines, and recommendations
- Identify medical equipment safety requirements and hazards
CHSN Voluntary Study Resources
- Joint Commission Accreditation Standards: Environment of Care, Fire Safety, Emergency Management, Leadership, Patient Safety, and Infection Control
- CHSN self-study. Buy it HERE.
- Healthcare Hazard Control & Safety Management, 3rd Ed. Available at: ibfcsm.com
- Healthcare Safety for Nursing Personnel, CRC Press, Available at: www.ibfcsm.com
- Introduction to Hazard Control Management, Available at: ibfcsm.com
- Manual of Patient Safety & Quality Improvement, Washington University School of Medicine, St. Louis, MO, Wolters Kluwer, 2016, E. Fondahn, M. Lane, & A. Vannucci.
- OSHA Education & Training for Worker Safety in Hospitals at: www.osha.gov
- OSHA Hospital & Healthcare References at: www.osha.gov
- OSHA Hospital E-Tools: Hazards and Solutions at: www.osha.gov
- OSHA Safety Management Systems: Road Map for Hospitals www.osha.gov
- OSHA Tool Kit for Hospital Staff Safe Patient Handling at: www.osha.gov
- Understanding Patient Safety, R. Wachter & K. Gupta, McGraw Hill, 3d Ed, 2018.
(please note: applications expire within 90 days)