Certified Healthcare Safety—Nursing


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.

CHSN Exam Blueprint

Domains100-150 items
1. Patient Safety36%
2. Safety Management28%
3. Standard Compliance36%

Domain 1 —Patient Safety (36%)

IBFCSM exams contain 100-150 multiple choice items. Exam results permit the assessment to determine a candidate’s minimum competency for certification. The blueprint reflects specifications published in the JTA Technical Report. Percentages reflect proportion of test items in each domain. Candidates use recall, recognition, comprehension, and application to answer items related to professional practice.

Domain 1 Topics

1.1 Identify and respond to adverse events

1.2 Identify the need for change analysis

1.3 Identify critical elements of clinical communication

1.4 Identify elements of collecting patient information

1.5 Identify common patient never events

1.6 Identify importance of continuous learning

1.7 Identify the need for discipline in non-punitive cultures

1.8 Identify the importance of ethics

1.9 Given a scenario identify steps to facilitate change

1.10 Identify how transparency impacts healthcare organizations

1.11 Identify issues related to harm free care

1.12 Given a scenario identify consequence of human error

1.13 Given a scenario identify elements of improving reliability

1.14 Identify concepts related to leading others

1.15 Identify patient events common in malpractice allegations

1.16 Identify medical staff issues related to safety

1.17 Given a scenario identify medication safety events

1.18 Identify factors that can impact operational safety

1.19 Identify issues relevant to organizational assumptions

1.20 Identify factors impacted by organizational climate

1.21 Given a scenario identify organizational structure issues impacting safety

1.22 Identify patient care risks in various settings

1.23 Identify reasons that patient information collection is vital

1.24 Identify ways patients can participate in their care

1.25 Identify patient safety risks

1.26 Identify the safety importance of personal accountability

1.27 Identify how personnel behaviors impact safety performance

1.28 Given a scenario identify risk management principles

1.29 Identify concepts related to safety cultures

1.30 Given a scenario identify senior leadership safety roles

Domain 2—Safety Management (28%)

Domain 2 Topics

2.1 Identify accident investigation principles

2.2 Identify the principles of hazard analysis

2.3 Identify principles related to authority and discipline

2.4 Identify behaviors that hinder communication

2.5 Identify continuous improvement concepts and principles

2.6 Identify principles relevant to good decision-making

2.7 Identify disaster and emergency management objectives

2.7 Identify safety education and training requirements

2.8 Identify objectives for maintain a responsive employee health function

2.9 Given a scenario identify facility safety priorities

2.10 Identify elements of maintain a high reliability organization

2.11 Given a scenario identify the human factors impacting safety

2.12 Identify concepts related to leadership

2.13 Identify training, education, and orientation needs based on empirical data

2.14 Identify common preventable medical errors

2.15 Identify occupational health risks for nursing personnel

2.16 Identify hindrances to maintaining a good operational culture

2.17 Identify important elements related to organizational dynamics

2.18 Given a scenario identify key performance improvement objectives

2.19 Identify actions to ensure safety policies reflect realistic priorities

2.20 Identify quality improvement processes that help safety performance

2.21 Identify key risk management principles

2.22 Identify important concepts related to effective safety assessments

2.23 Identify the importance of understanding the costs of adverse events

Domain 3—Standards Compliance (36%)

Domain 3 Topics

3.1 Identify requirements related accreditation standards (JC, DNV, HFAP, CMS)

3.2 Identify antimicrobials & disinfectants compliance requirements

3.3 Identify biological and chemical hazards compliance regulations

3.4 Identify clinical department safety requirements

3.5 Identify agencies and requirements of the Code of Federal Regulations (CFR 10, 21, 29, 40, 42, 44, 49)

3.6 Identify major OSHA compliance standards (Bloodborne, HAZCOM, Electrical Safety, etc.)

3.7 Identify consensus standard requirements (ANSI, ASTM, ASHRAE, FGI, NFPA, NIOSH, etc.)

3.8 Identify emergency management  requirements of CMS, ASPR, DHS, FEMA, etc.)

3.9 Identify environmental management regulations

3.10 Identify key elements and requirements for environment of care areas

3.11 Identify compliance and voluntary standards addressing ergonomics

3.12 Identify Federal agency requirements (CDC, EPA, FDA, NRC, & OSHA, etc.)

3.13 Identify major life and fire safety requirements

3.14 Identify flammable and combustible risks

3.15 Identify requirements for handling, storing, and disposing hazardous wastes

3.16 Identify key infection control standards, guidelines, and recommendations

3.17 Identify key elements of safety related to ionizing & non-ionizing radiation

3.18 Identify medical equipment safety requirements and hazards

3.19 Identify key elements of handling blood and other pathological wastes

3.20 Identify key standards, guidelines, and recommendations for patient safety

CHSN Sample Questions

  1. What best describes the benefit of implementing a patient lifting program?

a. Improved patient quality of care*

b. Reduced workers' compensation costs

c. Greater resident satisfaction

d. Increased morale for employees


  1. Which NFPA publication exclusively addresses healthcare facility topics?

a. NFPA 13

b. NFPA 72

c. NFPA 99*

d. NFPA 101


  1. What control should be considered first when protecting workers from airborne contaminants?

a. Isolating the hazard far from most workers

b. Providing proper local and general ventilation*

c. Requiring use of supplied air respirators immediately

d. Conducting periodic monitoring in all exposure areas


  1. Which of the following processes is considered a rapid change method?

a. Fishbone Causation Analysis

b. Plan-Do-Check-Act*

c. Root Cause Analysis

d. Failure Mode & Effect Analysis

CHSN Study Resources

This study listing provides a guide of informative references that can help candidates prepare for the examination. IBFCSM does not require any candidate to purchase study materials, resources, or attend any review session to qualify for certification. Study references include the following resources:

  • Healthcare Hazard Control and Safety Management, 3rd Edition, CRC Press, Boca Raton, FL, 2014, J.T. Tweedy, ISBN: 978-1-4822-0655-5, Buy it here!
  • CHSN Self Directed Study Guide, Available in downloadable PDF or PRINT format. Buy it here!
  • Introduction to Hazard Control Management, CRC Press, Boca Raton, FL, 2014, J.T. Tweedy, IBSN: 978-1-4665-5158-9, Buy it here!
  • Healthcare Safety for Nursing Personnel, CRC Press, Boca Raton, FL, 2015, J.T. Tweedy, ISBN: 978-1-4822-3027-7, Buy it here!
  • To Do No Harm, Jossey Bass/Wiley & Sons, San Francisco, CA, 2005, J.M. Morath & J.E. Turnbull, ISBN: 0-7879-6770-X
  • NFPA 99-2012, Health Care Facilities Code Handbook, NFPA, Quincy, MA, 2011, MA, R.E. Bielen & J.K. Lathrop, ISBN: 978-161665141-1
  • NFPA 101-2012, Life Safety Code Handbook, NFPA, Quincy, MA 2011, ISBN: 978-006461807
  • The Essential Guide for Patient Safety Officers, Joint Commission Resources, 2009
  • Principles of Risk Management and Patient Safety, Jones & Bartlett, 2011