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Exam Name : Certified Rehabilitation Registered Nurse
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CRRN exam Format | CRRN Course Contents | CRRN Course Outline | CRRN exam Syllabus | CRRN exam Objectives

1. Rehabilitation nursing models and theories (6%)
2. Functional health patterns (theories, physiology, assessment, standards of care, and interventions in individuals with injury, chronic illness, and disability across the lifespan) (58%)
3. The function of the rehabilitation team and community reintegration (13%)
4. Legislative, economic, ethical, and legal issues (23%).

The CRRN exam Content Outline lists each domain with related tasks, knowledge, and skill statements. It is the best source of information for exam content.

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Domain I: Rehabilitation Nursing Models and Theories (6%)
Task 1: Incorporate evidence-based practice, models, and theories into patient-centered care.
Knowledge of:
a. Evidence-based practice
b. Nursing theories and models significant to rehabilitation (e.g., King, Rogers, Neuman, Orem)
c. Nursing process (i.e., assessment, diagnosis, outcomes identification, planning, implementation, evaluation)
d. Rehabilitation standards and scope of practice
e. Related theories and models (e.g., developmental, behavioral, cognitive, moral, personality, caregiver development and function)
f. Patient-centered care Skill in:
a. Applying nursing models and theories
b. Applying rehabilitation scope of practice
c. Applying the nursing process
d. Incorporating evidence-based practice
Domain II: Functional Health Patterns (theories, physiology, assessment, standards of care, and interventions in individuals with injury, chronic illness, and disability across the lifespan) (58%)
Task 1: Apply the nursing process to optimize the restoration and preservation of the individual's health and wellbeing.
Knowledge of:
a. Physiology and management of health, injury, acute and chronic illness, and adaptability
b. Pharmacology
c. Rehabilitation standards and scope of practice
d. Technology (e.g., smart devices, internet sources, personal response devices, and telehealth)
e. Alterations in sexual function and reproduction
Skill in:
a. Assessing health status and health practices
b. Teaching interventions to manage health and wellness
c. Using rehabilitation standards and scope of practice
d. Using technology
e. Assessing goals related to sexuality and reproduction
f. Teaching interventions and technology related to sexuality and reproduction (e.g., body positioning, mirrors, adaptive equipment, medication)
Task 2: Apply the nursing process to promote optimal nutrition.
Knowledge of:
a. Adaptive equipment and feeding techniques (e.g., modified utensils, scoop plates, positioning)
b. Anatomy and physiology related to nutritional and metabolic patterns (e.g., endocrine, obesity, swallowing)
c. Diagnostic testing
d. Diet types (e.g., cardiac, diabetic, renal, dysphagia)
e. Fluid and electrolyte balance
f. Nutritional requirements
g. Skin integrity (e.g., Braden scale, pressure ulcer staging)
h. Pharmacology (e.g., anticholinergics, opioids, antidepressants)
i. Safety concerns and interventions (e.g., swallowing, positioning, food textures, fluid consistency)
Skill in:
a. Assessing nutritional and metabolic patterns (e.g., nutritional intake, fluid volume deficits, skin integrity, metabolic functions, feeding and swallowing)
b. Implementing and evaluating interventions for nutrition
c. Implementing and evaluating interventions for skin integrity (e.g., skin assessment, pressure relief, moisture reduction, nutrition and hydration)
d. Teaching interventions for swallowing deficits
e. Using adaptive equipment
Task 3: Apply the nursing process to optimize the individual's elimination patterns.
Knowledge of:
a. Anatomy and physiology of altered bowel and bladder function
b. Bladder and bowel adaptive equipment and technology (e.g., bladder scan, types of catheters, suppository inserter)
c. Bladder and bowel training (e.g., scheduled self -catheterization, timed voiding, elimination programs)
d. Pharmacologic and non-pharmacological interventions
Skill in:
a. Assessing elimination patterns (e.g., elimination diary, patients history)
b. Implementing and evaluating interventions for bladder and bowel management (e.g., nutrition, exercise, pharmacological, adaptive equipment)
c. Teaching interventions to prevent complications (e.g., constipation, urinary tract infections, autonomic dysreflexia)
d. Providing patient and caregiver education related to bowel and bladder management
e. Using adaptive equipment and technology
Task 4: Apply the nursing process to optimize the individuals highest level of functional ability.
Knowledge of:
a. Anatomy, physiology, and interventions related to musculoskeletal, respiratory, cardiovascular, and neurological function
b. Assistive devices and technology (e.g., mobility aids, orthostatic devices, orthotic devices)
c. Clinical signs of sensorimotor deficits
d. Activity tolerance and energy conservation
e. Pharmacology (e.g., antispasmodics, vasopressors, analgesics)
f. Safety concerns (e.g., falls, burns, skin integrity, infection prevention)
g. Self-care activities (e.g., activities of daily living, instrumental activities of daily living)
Skill in:
a. Assessing and implementing interventions to prevent musculoskeletal, respiratory, cardiovascular, and neurological complications (e.g., motor and sensory impairments, contractures, heterotrophic ossification, aspiration, pain)
b. Assessing, implementing, and evaluating interventions for self-care ability and mobility
c. Implementing safety interventions (e.g., sitters, reorientation, environment, redirection, nonbehavioral restraints)
d. Using technology (e.g., mobility aids, pressure relief devices, informatics, assistive software)
e. Teaching interventions to prevent complications of immobility (e.g., skin integrity, DVT prevention)
Task 5: Apply the nursing process to optimize the individual's sleep and rest patterns.
Knowledge in:
a. Factors affecting sleep and rest (e.g., diet, sleep habits, alcohol, pain, environment)
b. Pharmacology
c. Physiology of sleep and rest cycles
d. Technology
Skill in:
a. Assessing sleep and rest patterns
b. Evaluating effectiveness of sleep and rest interventions
c. Teaching interventions and strategies to promote sleep and rest (e.g., energy conversation, environmental modifications)
d. Using technology (e.g., sleep study, CPAP, BiPAP, relaxation technology)
Task 6: Apply the nursing process to optimize the individual's neurological function.
Knowledge of:
a. Measurement tools (e.g., Rancho Los Amigos, Glasgow, Mini Mental State Examination, ASIA, pain analog scales)
b. Neuroanatomy and physiology (e.g., cognition, judgment, sensation, perception)
c. Pain (e.g., receptors, acute, chronic, theories)
d. Pharmacology
e. Safety concerns (e.g., seizure precautions, fall precautions, impaired judgment)
f. Technology
Skill in:
a. Assessing cognition, perception, sensation, apraxia, perseveration, and pain
b. Implementing and evaluating strategies for safety (e.g., personal response devices, alarms, helmets, padding)
c. Teaching strategies for neurological deficits
d. Teaching strategies for pain and comfort management (e.g., pharmacological, non-pharmacological)
e. Using technology (e.g., TENS unit, baclofen pump)
f. Implementing behavioral management strategies (e.g., contracts, positive reinforcement, rule setting)
Task 7: Apply the nursing process to promote the individuals optimal psychosocial patterns and holistic wellbeing.
Knowledge of:
a. Individual roles and relationships (e.g., cultural, environmental, societal, familial, gender, age)
b. Role alterations
c. Psychosocial disorders (e.g., substance abuse, anxiety, depression, bipolar, PTSD, psychosis)
d. Theories (e.g., self-concept, role, relationship, interaction, developmental, human behaviors)
e. Traditional and alternative modalities (e.g., medications, healing touch, botanicals)
f. Cultural competence
Skill in:
a. Assessing and promoting self-efficacy, self-care, and self-concept
b. Accessing supportive team resources and services (e.g., psychologist, clergy, peer support, community support)
c. Promoting strategies to cope with role and relationship changes (e.g., individual and caregiver counseling, peer support, education)
d. Including the individual and caregiver in the plan of care
e. Incorporating cultural and spiritual values
f. Promoting positive interaction among individual and caregivers
g. Evaluating the effects of values, belief systems, and spirituality of the individual
Task 8: Apply the nursing process to optimize coping and stress management skills of the individual and
caregivers.
Knowledge of:
a. Community resources (e.g., face-to-face support groups, internet, respite care, clergy)
b. Coping and stress management strategies for individuals and support systems
c. Cultural competence
d. Physiology of the stress response
e. Safety concerns regarding harm to self and others
f. Technology for self-management
g. Theories (e.g., developmental, coping, stress, grief and loss, self-esteem, self-concept)
h. Types of stress and stressors
i. Stages of grief and loss
Skill in:
a. Assessing potential for harm to self and others
b. Assessing the ability to cope and manage stress
c. Facilitating appropriate referrals
d. Implementing and evaluating strategies to reduce stress and Improve coping (e.g., biofeedback, cognitive behavioral therapy, complementary alternative medicine, pharmacology)
e. Using therapeutic communication
Task 9: Apply the nursing process to optimize the individual's ability to communicate effectively.
Knowledge of:
a. Anatomy and physiology (e.g., cognition, comprehension, sensory deficits)
b. Communication techniques (e.g., active listening, anger management, reflection)
c. Cultural competence
d. Developmental factors
e. Linguistic deficits (e.g., aphasia, dysarthria, language barriers)
f. Assistive technology and adaptive equipment
Skill in:
a. Assessing comprehension and communication (e.g., oral, written, auditory, visual)
b. Implementing and evaluating communication interventions
c. Involving and educating support systems
d. Using assistive technology and adaptive equipment
e. Using communication techniques
Domain III: The Function of the Rehabilitation Team and Community Reintegration (13%)
Task 1: Collaborate with the interdisciplinary/interprofessional team to achieve patient-
centered goals. Knowledge of:
a. Goal setting and expected outcomes (e.g., SMART goals, functional independence measures [FIM], WeeFIM)
b. Types of healthcare teams (e.g., interdisciplinary/ interprofessional, multidisciplinary, transdisciplinary)
c. Rehabilitation philosophy and definition
d. Roles and responsibilities of team members
e. Theory (e.g., change, leadership, communication, team function, organizational)
Skill in:
a. Advocating for inclusion of appropriate team members
b. Applying appropriate theories (e.g., change, leadership, communication, team function, organizational)
c. Communicating and collaborating with the interdisciplinary/ interprofessional team
d. Developing and documenting plans of care to attain patient-centered goals
Task 2: Apply the nursing process to promote the individual's community reintegration.
Knowledge of:
a. Technology and adaptive equipment (e.g., electronic hand-held devices, electrical simulation, service animals, equipment to support activities of daily living)
b. Community resources (e.g., housing, transportation, community support systems, social services, recreation, CPS, APS)
c. Personal resources (e.g., financial, caregiver support systems, caregivers, spiritual, cultural)
d. Professional resources (e.g., psychologist, neurologist, clergy, teacher, case manager, vocational rehabilitation counselor, home health, outpatient therapy)
e. Teaching and learning strategies for self-advocacy
Skill in:
a. Accessing community resources
b. Assessing readiness for discharge
c. Assessing barriers to community reintegration
d. Evaluating outcomes and adjusting goals (e.g., interdisciplinary/interprofessional team and patientcentered)
e. Identifying financial barriers and providing appropriate resources
f. Initiating referrals
g. Participating in team and patient caregiver conferences
h. Planning discharge (e.g., home visits, caregiver teaching)
i. Teaching health and wellness maintenance
j. Teaching life skills
k. Using adaptive equipment and technology (e.g., voice activated call systems, computer supported prosthetics)
Domain IV: Legislative, Economic, Ethical, and Legal Issues (23%)
Task 1: Integrate legislation and regulations to guide management of care.
Knowledge of:
a. Agencies related to regulatory, disability, and rehabilitation (e.g., CARF, The Joint Commission, APS, CPS, CMS, SSA, OSHA)
b. Specific legislation related to disability and rehabilitation (e.g., Medicare, Medicaid, ADA, rehabilitation acts, HIPAA, Affordable Care Act, workers compensation, IDEA, Vocational, IMPACT Act)
Skill in:
a. Accessing, interpreting, and applying legal, regulatory, and accreditation information
b. Using assessment, measurement, and reporting tools (e.g., functional independence measures [FIM], patient satisfaction, IRF-PAI)
Task 2: Use the nursing process to deliver cost effective patient-centered care.
Knowledge of:
a. Clinical practice guidelines
b. Community and public resources
c. Insurance and reimbursement (e.g., PPS, workers compensation)
d. Regulatory agency audit process
e. Staffing patterns and policies
f. Utilization review processes
Skill in:
a. Analyzing quality and utilization data
b. Collaborating with private, community, and public resources
c. Incorporating clinical practice guidelines
d. Managing current and projected resources in a cost effective manner
Task 3: Integrate ethical considerations and legal obligations that affect nursing practice.
Knowledge of:
a. Ethical theories and resources (e.g., deontology, ombudsperson, ethics committee)
b. Legal implications of healthcare related policies and documents (e.g., HIPAA, advance directives, powers of attorney, POLST/MOLST, informed consent)
Skill in:
a. Advocating for the individual
b. Documenting services provided
c. Identifying appropriate resources to assist with legal documents
d. Implementing strategies to resolve ethical dilemmas
e. Applying ethics in the delivery of care
Task 4: Integrate quality and safety in patient-centered care.
Knowledge of:
a. Quality measurement and performance improvement processes (e.g., Agency for Healthcare Research and Quality; Institute of Medicine; National Database of Nursing Quality Indicators)
b. Models and tools used in process improvement (e.g., Plan, Do, Check, Act; Six Sigma; Lean approach)
c. Federal quality measurement efforts
d. Reporting requirements (e.g., infection rates, healthcare acquired pressure injury, sentinel events, discharge to community, readmission rates)
Skill in:
a. Assessing safety risks
b. Minimizing safety risk factors
c. Implementing safety prevention measures
d. Utilizing assessment, measurement, and reporting tools (e.g., functional independence measurement; patient satisfaction)
e. Incorporating standards of professional performance

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Medical Nurse exam success

'extra irritating than nursing school': Ohio nurses wait months for state board to furnish licenses amid COVID-19 | CRRN exam dumps and Latest Topics

a person holding a glass of wine: Shavon Hall puts on her Cleveland Clinic RN badge as she prepares to leave for work as an RN at Cleveland Clinic Marymount Hospital Tuesday, Sept. 7, 2021 in Garfield Heights, Ohio. Hall waited four months for the Ohio Nursing Board to process her license.

© Karen Schiely, Akron Beacon Journal Shavon hall puts on her Cleveland medical institution RN badge as she prepares to go away for work as an RN at Cleveland health facility Marymount sanatorium Tuesday, Sept. 7, 2021 in Garfield Heights, Ohio. corridor waited four months for the Ohio Nursing Board to process her license.

In January Shavon hall got a proposal letter to work in Cleveland hospital's intensive care unit. She became elated, and he or she hoped to start working a couple of weeks after graduating nursing college in may additionally to aid fight COVID-19.

a person sitting on a couch: Shavon Hall checks works as an RN at Cleveland Clinic Marymount Hospital Tuesday, Sept. 7, 2021 in Garfield Heights, Ohio.

instead, she had to push lower back her birth date three times.

corridor finally received her registered nurse license at the conclusion of July, 4 months after submitting an application to the Ohio Board of Nursing in April.

"The board of nursing took forever," referred to corridor. "i used to be pissed off, since it became like a waiting online game, and then simply no longer having any solutions about what was going on."

corridor isn't on my own. She's amongst many who've complained in the past yr in regards to the long processing times and the lack of ability to reach any person on the nursing board.

With the renewal duration for nursing licenses at present underway, or not it's an extra barrier amid a COVID-19 pandemic that has exacerbated nursing shortages in hospitals and nursing homes.

distinct factors for delays

hall talked about earlier than the pandemic, it wasn't like this. When she received her licensed practical nurse (LPN) license in 2019, it best took a bit greater than two weeks.

Some out-of-state nurses have also observed that Ohio turned into now taking a very longer time to manner purposes compared to other states.

The state nursing board pinned the blame of any delays on the COVID-19 pandemic itself. For one, new Ohio legal guidelines supposed to fight the virus and boost staffing brought about more administrative burden, it noted.

From March 2020 except this previous July, residence bill 197 and apartment invoice 6 required the nursing board to concern temporary licenses to nursing software graduates with none licensure examination. That helped trigger a 35% boost within the number of purposes the board bought in much of 2020 over the prior year, at just about 17,000 functions.

It "required further guide techniques of license functions via a really restricted variety of licensure body of workers and necessitated staff to focal point on these examination functions," referred to the nursing board in a written response to questions from the United States today community Ohio bureau.

these transient licenses expired July 1, and main up to that date, there have been more and more purposes to make these licenses permanent. Cassandra Porter, a registered nurse working at a Rocky River nursing domestic, changed into one among them.

She had already gotten a short lived license late last 12 months earlier than relocating to Ohio from Arizona. Porter accomplished her criminal checklist exams in February and grew nervous expecting them to be processed when the end of June neared.

The nursing board Verified that technical considerations also performed a task in delays, chiefly with Ohio's Bureau of criminal Investigation. In may, BCI carried out computing device equipment alterations "which are nonetheless being resolved," the board noted, impacting crook checklist checks.

The board also pointed to finances and hiring freezes all over the pandemic as a reason for delays.

State employee count information, besides the fact that children, shows the worker count number has remained exceptionally sturdy earlier than and right through the pandemic for the board, hovering close or above eighty employees.

challenging to attain

The largest frustration for nurses waiting for licensure became the inability to get a hold of a person at the board.

Porter mentioned that after she concerned about how long her background exams have been taking, she referred to as the board. She acquired a message asserting nobody was within the office and to ship an electronic mail instead.

"I all started in probably can also or June, emailing the state board every single week, saying 'howdy, where's my license?'" pointed out Porter. "and that i bought zero response."

With the time limit closing in, Porter went to her state lawmaker on the counsel of her mother. inside three days, she got her license.

"It mustn't take attaining out to my state consultant to get my license," she observed.

a person standing in front of a car: Shavon Hall leaves her home for work as an RN at Cleveland Clinic Marymount Hospital Tuesday, Sept. 7, 2021 in Garfield Heights, Ohio.

corridor went via greater hassle. She referred to as round 15 instances before at last speakme to a live grownup. On five events, she became put on grasp, each time lasting two to 3 hours. Two of those instances, the name hung up.

On the mobilephone, she was advised her tips could be forwarded to a supervisor. She in no way heard back. So she began sending emails, and after multiple makes an attempt and long waits, hall become able to get her examination number and license.

"trying to call and make contact with a person changed into like non-existent. It changed into at all times like, 'We're experiencing excessive mobilephone calls at the moment; call back at a later time,'" spoke of corridor.

The multiplied amount of applications and constrained workforce are why verbal exchange hasn't been up to par, in response to the nursing board.

"There are periods of time when the board has prioritized the issuance of licenses over answering cellphone calls," it noted. "The rationale is that by way of some distance, probably the most usual name is to ask when a license can be issued."

The agency has no body of workers totally dedicated to answering calls and emails because all seven of its license personnel are vital to process functions, it noted.

The Ohio Nursing Board stated that it handles one of the largest number of licensees within the state yet is understaffed in comparison to other companies with fewer licensees. as an example, as of ultimate summer, the Ohio State scientific Board had ten more personnel but regulates roughly a 3rd of the Nursing Board's more than 300,000 licenses.

additional stress on nurses

The board, in response to its personal information, has performed distinctly well seeing that the situations. Between March 2020 and the conclusion of June, more than ninety three% of all 33,611 functions and license reinstatements submitted have been wholly processed.

That doesn't mean the longer waiting times haven't any bad affects.

Hospitals have open positions in a time the place staffing shortages have worsened under the pandemic's pressures. on account of the Ohio Nursing Board, those positions have to be empty for months.

a person sitting in a room: ICU nurse Kyle Day tends to his 25-year-old patient, Machaela Anderson, inside the COVID-19 ward of Mount Carmel Grove City Hospital on Dec. 09, 2020. Ohio ICUs have faced staffing shortages during the pandemic

© Gaelen Morse/Columbus Dispatch ICU nurse Kyle Day tends to his 25-12 months-historic patient, Machaela Anderson, internal the COVID-19 ward of Mount Carmel Grove city sanatorium on Dec. 09, 2020. Ohio ICUs have faced staffing shortages during the pandemic

local hospitals did not reply requests for remark. The Ohio medical institution affiliation referred to through a spokesperson that the nursing board "has been conscious of the need to expedite the licensure technique."

however anecdotally and on social media, some worker's have complained about their staffing cases and the way waiting months for somebody to get licensed isn't helping.

"The Ohio Nurses association is sympathetic to nurses whose frustrations were compounded with the aid of the Ohio Board of Nursing and we know anything need to change," spoke of Deborah arms, association president. "Ohio wants nurses on the bedside, and we will’t have enough money any delays with our licensing board."

Nursing home corporations Verified that such incidents have took place with them, too.

"participants needed to make do with out adequate nurses or the usage of company nurses all the way through the lengthen," pointed out Pete Van Runkle, head of the Ohio health Care affiliation. "extra currently, we’ve had some success accomplishing out to the board for our contributors and getting issues expedited."

The months-long wait is causing stress for nurses and soon-to-be nurses. For some, it feels frustrating no longer being able to bounce into the container after so plenty time spent learning and procuring a nursing profession. For others, not being able to get a license skill being jobless.

Porter became exceptionally anxious about her brief license expiring. while her RN license from Arizona intended she could nonetheless apply beneath Ohio's COVID-19 emergency declaration, she was in doubt if that was the case and feared being out of a job.

"or not it's like, we're anticipated to do something about these sufferers, however you are now not looking after us," she stated. "We pay funds for our license. we now have paid for our heritage assessments. you might be not getting whatever you are paying for, honestly, or not it's inexcusable."

Nursing board plans to enhance workforce, other fixes

The hope from the state government is such delays could be broadly speaking remedied in the near future as price range and hiring freezes carry.

Over the summer season, the nursing board become also approved to carry its personnel ceiling by way of six full-time positions, observed a spokesperson for the Ohio department of Administrative services.

The extra staffing might consist of full-time laborers committed to answering calls. The board is hiring personnel "as immediately as viable," it referred to.

Mike DeWine wearing a suit and tie: Kimberly Murnieks, director of the Office of Budget and Management, right, speaks while Ohio Gov. Mike DeWine watches in March 2019. OBM approved giving the Ohio Board of Nursing more resources to hire additional staffing.

© Joshua A. Bickel/Columbus Dispatch Kimberly Murnieks, director of the office of funds and administration, right, speaks whereas Ohio Gov. Mike DeWine watches in March 2019. OBM accredited giving the Ohio Board of Nursing greater elements to employ further staffing.

On the communication entrance, a brand new application that would enhance name instances became currently applied in June for the nursing company, and state officers predict which will raise consumer journey over time.

changes to the digital licensing system are consistently within the works, the Ohio Nursing Board said, from giving candidates the capability to investigate on the popularity of their software online to not requiring definite files on the time of licensure.

The board referred to it be continuing to study tips on how to additional automate the licensing technique, because it's been the guide procedures which have stalled granting licenses.

With the licensure manner at the back of her, corridor is looking forward to starting her new job this month and pursuing her passion for nursing.

She hopes, youngsters, that no person else will must go through what she went via.

"Nursing school changed into tough," hall noted. "just awaiting my quantity and simply attempting to hear back from the board of nursing, I suppose like that turned into extra frustrating than genuine nursing school."

Titus Wu is a reporter for the US today network Ohio Bureau, which serves the Columbus Dispatch, Cincinnati Enquirer, Akron Beacon Journal and 18 other affiliated information organizations throughout Ohio.

this article at first appeared on The Columbus Dispatch: 'greater frustrating than nursing faculty': Ohio nurses wait months for state board to supply licenses amid COVID-19

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