Nursing Case Management Certification Examination Content Outline

This is a paper-and-pencil exam

There are 125 questions on this part of the examination, which is administered to all candidates in nursing case management. Of these, 100 are scored questions and 25 are nonscored pretest questions. Questions are pretested to determine how well they perform before they are used on the scored portion of this part of the examination. The pretest questions cannot be distinguished from those that will be scored, so it is important that a candidate answer all questions. However, a candidate's score on this part of the examination is based solely on the 100 scored questions. Performance on pretest questions does not affect a candidate's score.

This Test Content Outline identifies the content areas that are included on this part of the examination. The percentage and number of questions in each of the major categories of the scored portion of this part of the examination are also shown.

Test Content Outline

1. Nursing Case Management Concepts
   1. Definition
   2. Principles
      1. Timeliness
      2. Coordination
      3. Accountability
      4. Partnership
      5. Continuity of care
      6. Cost-effectiveness
      7. Advocacy
      8. Autonomy
      9. Service integration
      10. Collaboration
      11. Outcome-focused care
      12. Performance improvement
      13. Privacy/Confidentiality (e.g., HIPAA)
      14. Other
   3. Roles
      1. Advocate
      2. Facilitator
      3. Provider
      4. Liaison
      5. Coordinator
      6. Collaborator
      7. Broker
      8. Educator
      9. Negotiator
      10. Evaluator
      11. Communicator
      12. Risk manager
      13. Mentor
      14. Consultant
      15. Researcher
      16. Assessor
      17. Other
   4. Models
      1. Acute and episodic care
      2. Community-based care
      3. Across-the-care continuum
         
         Note: All questions in domains II, III, and IV are also classified along a second dimension, Nursing Case Management Process. Thus, every question is classified first within the domain of practice that it tests. It then receives a second classification from the list below that indicates the component in the process that it tests:
         
              1. Assessment
              2. Planning/Implementation
              3. Evaluation
              4. Interaction
         
         
2. Clinical Practice
   1. Health promotion and illness prevention
      1. Psychological characteristics of wellness
      2. Physical characteristics of wellness
   2. Disease management
      1. Pathophysiological conditions
      2. Psychosocial conditions
   3. Education
      1. Client
      2. Family and/or significant other
      3. Staff
      4. Community
      5. Provider
      6. Payer
   4. Referrals
      1. Appropriate
      2. Timely
      3. Fiscally responsible
   5. Consultation
      1. Physical medicine rehabilitation team
      2. Enterostomal therapist
      3. Nutritionist/dietician
      4. Health care provider
      5. Pharmacist
      6. Behavioral health
      7. Other
   6. Collaboration
      1. Interdisciplinary teams (including client and family members)
      2. Payers
      3. Employers
      4. Social services (e.g., Social Security Administration, state and local human services departments)
      5. Other
   7. Tools
      1. Clinical guidelines
      2. Clinical pathways
      3. Algorithms and decision trees
      4. Standards of care (e.g., standards issued by the American Nurses Credentialing Center, American Academy of Pediatrics, American Cancer Society)
      5. Screening tools (e.g., CAGE, SF-36, BASIS 32, risk screening)
3. Data Management
   1. Types
      1. Individual data
         1. Collection
         2. Analysis
         3. Evaluation
         4. Reporting
         5. Application
      2. Aggregate data
         1. Collection
         2. Analysis
         3. Evaluation
         4. Reporting
         5. Application
   2. Processes
      1. Benchmarking
      2. Peer review
      3. Best-practice profiling
      4. Variance analysis
      5. Other
4. Resource Management
   1. Community services
      1. Voluntary organizations
      2. Social services
      3. Public health services
      4. Other
   2. Consultative services
   3. Supplies and equipment
   4. Pharmaceuticals
   5. Utilization management
      1. Benefits coverage
      2. Brokering
      3. Payer requirements
      4. Contract provisions
      5. Denial and appeals process
      6. Authorization and certification
         1. Preauthorization
         2. Concurrent review
         3. Retrospective review
      7. Other
   6. Diagnostic testing
   7. Level of care planning
      1. Home health care (e.g., skilled and unskilled services)
      2. Hospice
      3. Private-duty nursing
      4. Long-term care
      5. Skilled nursing
      6. Acute care
      7. Subacute care
      8. Assisted living
      9. Rehabilitation
      10. Other
   8. Transportation
5. Issues and Trends
   1. Legal and ethical issues
      1. Client rights
      2. Provider rights
      3. Delegation of care
      4. Documentation
      5. Advance directives
      6. Aggressive vs palliative care
      7. Legal responsibilities (e.g., abandonment, reporting of abuse, informed consent, guardianship)
      8. Confidentiality (e.g., HIPAA)
      9. Conflict of interest
      10. Government policies and regulations (e.g., related to occupational safety and health, workers' compensation, the Americans with Disabilities Act)
      11. Access to care
      12. Quality vs. cost
      13. Other
   2. Reimbursement
   3. Managed care
      1. Definition
      2. Models
   4. Information systems
   5. Capitation
   6. Vertically integrated delivery systems
   7. Other issues and trends

This page last revised 1/25/2007.