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ABOUT THIS HANDBOOK

This handbook describes the requirements for obtaining and maintaining the Certified Perioperative Nurse
(CNOR®) certification. Applicants and certificants must comply with the requirements outlined in this handbook.
Failure to do so may result in the Competency and Credentialing Institute (CCI) acting against your eligibility or
certification. It is the responsibility of each applicant and certificant to familiarize themselves with the content of
this handbook and any essential linked documents.

This handbook has clickable images and links within the text that lead directly to CCI documents. The Table of
Contents has anchored bookmarks, and a Table of Contents icon ( ) on the corner of each page will return you
to the Table of Contents page. New versions of this handbook will be published as needed, and applicants
preparing for future applications should check the current version before applying to ensure they adhere to the
current requirements.

CCI does not discriminate against any individual because of race, ethnicity, gender, age, creed, disability,
religion, marital status, sexual orientation, natural hair, or national origin. Allegations of discrimination can be
reported via our Contact Us Form.

CCI reserves the right to amend all procedures outlined in this handbook at any time and without notice. This
includes information related to testing content and examination fees.

Last updated: 1.1.2024

Copyright © 2024 by the Competency & Credentialing Institute, (“CCI®”), all rights reserved.

Unauthorized reproduction, copying, or transmission in any form is strictly prohibited.

All Trademarks utilized in this document are the sole property of the Competency & Credentialing Institute.
Unauthorized use or misrepresentation is strictly prohibited.

400 Inverness Parkway, Suite 265

Englewood, CO 80112
303.369.9566 / 888.257.2667
[email protected]

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 Table of Contents
INTRODUCTION TO CERTIFICATION .................................................................................................................. 1
Certification .............................................................................................................................................................................................. 1
Purposes of Certification .......................................................................................................................................................................... 1
Objectives of Certification ........................................................................................................................................................................ 1
Rationale ................................................................................................................................................................................................... 1
CNOR® CREDENTIAL BACKGROUND.................................................................................................................. 2
The CNOR® certification exam requires the following: ............................................................................................................................. 2
Exam Development ................................................................................................................................................................................... 2
Credential Accreditation ........................................................................................................................................................................... 2
CNOR® CREDENTIAL OVERVIEW ....................................................................................................................... 3
Eligibility Requirements ............................................................................................................................................................................ 3
Subject Areas on the Exam ....................................................................................................................................................................... 3
APPLYING FOR THE CNOR® CREDENTIAL........................................................................................................... 4
How to Apply ............................................................................................................................................................................................ 4
Certification Fees ...................................................................................................................................................................................... 4
Verification of Application Information .................................................................................................................................................... 4
INDIVIDUAL TAKE 2 .......................................................................................................................................... 6
CNOR® Take 2 Program ............................................................................................................................................................................ 6
Eligible Individuals for the CNOR® Take 2 Program .................................................................................................................................. 6
First CNOR® Exam Attempt ....................................................................................................................................................................... 6
If You Do Not Pass the First Exam Attempt............................................................................................................................................... 6
Transfer Exam Window ............................................................................................................................................................................. 6
Withdrawal from Exam Window............................................................................................................................................................... 7
Extended Term.......................................................................................................................................................................................... 7
FACILITY TAKE 2 PROGRAM .............................................................................................................................. 8
Facility Take 2 Fee ..................................................................................................................................................................................... 8
Interested in Facility Take 2 Program ....................................................................................................................................................... 8
Apply for First Exam Attempt.................................................................................................................................................................... 8
CNOR® EXAM ................................................................................................................................................... 9
Recommended Study Time for CNOR® Exam ........................................................................................................................................... 9
Reference Materials.................................................................................................................................................................................. 9
Schedule Exam Appointment.................................................................................................................................................................. 10
CNOR® Exam is Offered .......................................................................................................................................................................... 10
Failure to Schedule ................................................................................................................................................................................. 11
Tardiness or Missing Test Appointment ................................................................................................................................................. 11
Secondary Application and Testing ......................................................................................................................................................... 11
Test Development Process ..................................................................................................................................................................... 11
Scoring Methodology .............................................................................................................................................................................. 11
CNOR® Exam Results............................................................................................................................................................................... 12
SAMPLE EXAM QUESTIONS ............................................................................................................................ 13
WITHDRAWAL, CANCELLATION, RESCHEDULING, OR TRANSFER ..................................................................... 14
Definitions of Terms ............................................................................................................................................................................... 14
Withdrawal/Cancel: ................................................................................................................................................................................ 14
Transfer:.................................................................................................................................................................................................. 14
PSI GUIDELINES FOR CCI EXAMINATIONS ....................................................................................................... 16
PSI REMOTE SECURE PROCTORED EXAM GUIDELINES ........................................................................................................................... 16
Identification ...................................................................................................................................................................................... 16
Monitoring ......................................................................................................................................................................................... 16

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 Personal Belongings ........................................................................................................................................................................... 16
System Requirements ........................................................................................................................................................................ 17
Dismissal from a Test Session ............................................................................................................................................................ 17
PSI Test Center Exam guidelines ............................................................................................................................................................. 18
Identification ...................................................................................................................................................................................... 18
Monitoring ......................................................................................................................................................................................... 19
Personal Belongings ........................................................................................................................................................................... 19
Dismissal from a Test Session ............................................................................................................................................................ 20
EXAM IRREGULARITIES AT TESTING CENTERS ................................................................................................. 21
Group Testing Irregularities .................................................................................................................................................................... 21
ACCOMODATIONS ......................................................................................................................................... 22
Request an Accommodation ................................................................................................................................................................... 22
USING THE CREDENTIAL ................................................................................................................................. 23
Active Credential..................................................................................................................................................................................... 23
Use the Credential .................................................................................................................................................................................. 23
Using My Credential ............................................................................................................................................................................... 23
Certificate ............................................................................................................................................................................................... 23
Display My Name and Credential ........................................................................................................................................................... 23
MISUSE OR MISREPRESENTATION .................................................................................................................. 24
REVOCATION ................................................................................................................................................. 24
INTRODUCTION TO RECERTIFICATION ............................................................................................................ 25
Recertification......................................................................................................................................................................................... 25
Purposes of Recertification ..................................................................................................................................................................... 25
Recertification Justification .................................................................................................................................................................... 25
RECERTIFICATION ........................................................................................................................................... 26
Recertification Timeframe ...................................................................................................................................................................... 26
Accrual Period ......................................................................................................................................................................................... 26
Accrual Period Deadlines ........................................................................................................................................................................ 26
Recertification Requirements ................................................................................................................................................................. 26
Recertification Eligibility Requirements .................................................................................................................................................. 27
Recertification Fees ................................................................................................................................................................................ 27
RECERTIFICATION METHODS .......................................................................................................................... 28
Recertification Methods ......................................................................................................................................................................... 28
Recertification by Contact Hours ....................................................................................................................................................... 28
Recertification by Points .................................................................................................................................................................... 28
Recertification Application ..................................................................................................................................................................... 28
Audit ....................................................................................................................................................................................................... 29
RECERTIFICATION ALTERNATIVES ................................................................................................................... 30
Not Eligible to Recertify .......................................................................................................................................................................... 30
Extension Year ........................................................................................................................................................................................ 30
Extension Year Requirements ................................................................................................................................................................. 30
Extension Year Recertification ................................................................................................................................................................ 31
Emeritus .................................................................................................................................................................................................. 31
Emeritus Status Requirements ............................................................................................................................................................... 31
Obtaining Emeritus Status ...................................................................................................................................................................... 31
Taking my Credential Out of Emeritus .................................................................................................................................................... 31
Lapsed Credential ................................................................................................................................................................................... 32
ETHICS, VIOLATIONS, & APPEALS ................................................................................................................... 33
Ethics & Violations .................................................................................................................................................................................. 33
Appeals ................................................................................................................................................................................................... 33
GENERAL DATA INFORMATION ...................................................................................................................... 34
Information Confidentiality .................................................................................................................................................................... 34

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 Use of Personal Data............................................................................................................................................................................... 34
Credential Verification ............................................................................................................................................................................ 34
APPENDIX A: RECERTIFICATION BY CONTACT HOURS ..................................................................................... 35
APPENDIX B: RECERTIFICATION BY POINTS..................................................................................................... 38
APPENDIX C: RECERTIFICATION AUDIT DOCUMENTATION.............................................................................. 46
APPENDIX D: CERTIFICATION MARK USE POLICY ............................................................................................ 48

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INTRODUCTION TO CERTIFICATION

Certification
Certification, as defined by the American Board of Specialty Nursing Certification (ABSNC), is the formal
recognition of the specialized knowledge, skills, and experience demonstrated by the achievement of standards
identified by a nursing specialty to promote optimal health outcomes.

Purposes of Certification

• Demonstrates commitment to accountability to the public for safe nursing practice.

• Enhances quality patient care.

• Identifies registered nurses who have demonstrated professional achievement in providing

perioperative nursing care.

• Provides employing agencies with a means of identifying the professional achievement of an individual
practitioner.

• Provides personal satisfaction for practitioners.

Objectives of Certification

• Recognize the individual registered nurse who is proficient in practice.

• Strengthen the use of evidence-based theory in assessing, planning, implementing, and evaluating
nursing care.

• Enhance professional growth through continued learning that results in broader knowledge and
expanded skills and practice.

Rationale
CNOR® certification documents the validation of the professional achievement of identified standards of
practice by an individual registered nurse who provides nursing care for the patient during the perioperative
period, defined as pre-, intra-, and postoperative. This recognition program acknowledges the professional
achievement demonstrated by an individual nurse’s performance that exceeds what is required for competent
practice in the perioperative setting.

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CNOR® CREDENTIAL BACKGROUND

The CNOR® certification exam requires the following:

• Having a thorough and sound foundation of the knowledge and skills required for competent clinical
practice (see CNOR® Exam Subject Areas below). Knowledge can be obtained through work experiences,
independent learning, and formal educational programs. The CNOR® exam is based on what a registered
nurse (RN) with two years and 2,400 hours of practice in the perioperative setting is expected to know.
The exam assesses a combination of experiential and cognitive knowledge to form the foundation of
competent clinical practice.

• Understanding of the test-taking process. The exam is composed of 200 multiple-choice questions, of
which 185 are scored. Becoming familiar with the format of multiple-choice questions is important.
Ultimately, your competency is demonstrated by successfully having and applying knowledge in the
perioperative environment.

Exam Development
CCI periodically conducts test development activities to develop and maintain the CNOR® exam consistent with
accreditation standards. A complete list of test development committees is presented in CCI’s test development
process document. Key among these is the Job Analysis study. This is designed to capture the current knowledge
and skill set required of perioperative nurses with 2 years and 2,400 hours of experience. Test development
work is done in collaboration with CNOR®-certified subject matter experts and our testing partner, PSI. Task and
knowledge statements are developed using the results of the job analysis and constitute the blueprint for the
CNOR® exam (see the complete list of CNOR® task and knowledge statements). It is recognized that the task and
knowledge statements may not reflect all specific tasks performed by an individual functioning in this role,
especially in niche or highly specialized environments. Details regarding exam development can be found in CCI’s
test development process document.

Cultural bias occurs in testing materials when test items assess knowledge or experiences specific to a certain
culture. To address the issue of cultural bias, all questions on the CNOR® exam are screened for cultural bias by a
diverse panel of nurses holding the CNOR® credential. This review is conducted under the supervision of test
development experts from our testing partner.

Credential Accreditation
CNOR® is accredited by the National Commission for Certifying Agencies (NCCA) and the American Board for
Specialty Nursing Certification (ABSNC).

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CNOR® CREDENTIAL OVERVIEW
CNOR® is not an acronym in that the letters do not represent specific words or a title. To earn the CNOR®
credential, applicants must meet all eligibility requirements at the time of application and pass the certification
exam.

Eligibility Requirements
There are no waivers for eligibility requirements. To be eligible, you must:

• Hold a current, unrestricted RN license in the state or country where current practice occurs.

• Currently be working full- or part-time in perioperative nursing, including nursing education,

administration, research, or clinical practice.

• Have a minimum of 2 years and 2,400 hours of experience as a perioperative registered nurse (RN). A
minimum of 50% (1,200 hours) of those hours must be in the intraoperative setting.

• If you have earned your CFPN®, CST, TS-C, or hold the military equivalent, a minimum of 18 months and
2,400 hours of experience as a perioperative registered nurse is required.

Subject Areas on the Exam

The CNOR® exam is comprised of the following subjects. For a complete list of the task and knowledge
statements for the CNOR® exam, see our CNOR® Task and Knowledge Statements.

CNOR® Exam Subject Area Percent of Exam Number of Questions

1. Pre/postoperative Patient Assessment and Diagnosis 15% 28

2. Individualized Plan of Care Development and Expected
8% 15
Outcome Identification
3. Management of Intraoperative Activities

a. Patient Care and Safety 25% 46

b. Management of Personnel, Services and
9% 17
Materials
4. Communication and Documentation 11% 20
5. Infection Prevention and Control of Environment,
16% 30
Instrumentation and Supplies
6. Emergency Situations 10% 19

7. Professional Accountabilities 6% 10

Total 100% 185

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APPLYING FOR THE CNOR® CREDENTIAL
How to Apply
Applicants may apply for the CNOR® exam by creating an account or logging into their existing account. The
following information is required to complete the online application. The application will take approximately 15
minutes.

• Personal contact information: address, home and work phone numbers, and email

• Make sure you are using an email that you plan to use long-term, and will allow you to receive
communications from CCI. Your email will also be your login ID.

• Use your legal name as it appears on your original, valid (unexpired), government-issued photo ID
bearing a signature.

• RN license expiration date and number, state(s) licensed to practice.

• Perioperative work history: past 2 years, date began working in the OR, current position, and current
practice area.

• Employer contact information: facility name, address, and phone number

• Supervisor contact information: name, address, email, phone number

• Payment information

Certification Fees

Applications cannot be processed without payment. All fees and/or outstanding debts to CCI must be paid in
full. All required fees are non-refundable.

CNOR® Certification Fee Price

CNOR® Exam Application Fee $445

CNOR® Take 2 Exam Application Fee $495

*There is a $40 discount available for those who hold an active CCI credential outside of CNOR®. Discounts
cannot be combined and only one discount can be utilized per transaction.

If you are an applicant who has been the recipient of a Daisy Award, there is a $40 discount available. Applicant
must provide a copy of their official Award letter in order to receive this discount.

Verification of Application Information

Information on applications may be verified. A percentage of certification applications are randomly selected for
audit. If there is any reason to believe that any applicant has not met eligibility requirements, or if an outside
party informs CCI that an individual has not met certain requirements, the application may be flagged for audit.

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The Credentialing Department will contact the individual by email to obtain documentation to substantiate the
information in question. Information may be verified by telephone, email, and/or letter by the Credentialing
Department. All information gained through verification procedures will be confidential, except when the law
demands the disclosure of facts. Under no circumstances will the reporting party be disclosed. Verification may
include but is not limited to the following information:

• A current manager, supervisor, or HR must complete an employee verification form.

• Verification of applicant’s RN license through NURSYS.

• Verification of professional nursing history through contact with past employers if needed.

The applicant is responsible for submitting items requested through the audit process. Should any information
on the application be found false, the applicant will be notified and declared ineligible to continue in the
certification process. Delayed submission of documents and/or submitting incomplete documentation may
result in a shortened testing window. An email will be sent to the applicant detailing the audit results after
reviewing the documents.

Failure to comply with all audit requirements by the 30-day deadline or to successfully pass the audit will terminate your
application. No refunds of the application fee paid will be provided to applicants that do not successfully pass the audit.

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INDIVIDUAL TAKE 2

CNOR® Take 2 Program

The CNOR® Take 2 program allows a CNOR®-eligible nurse to take the CNOR® exam twice within a 12-month
period from the date of application submission if the first attempt is unsuccessful. Participants who pass the
CNOR® Exam on the first attempt will not receive another exam attempt. The second attempt cannot be
transferred to another person and is non-refundable. CCI may amend the Take 2 program at any time with or
without notice.

Eligible Individuals for the CNOR® Take 2 Program

Perioperative nurses who meet CNOR® eligibility requirements at the time of application may participate in the
program.

First CNOR® Exam Attempt

You may submit your Individual Take 2 application at any time. Once you submit your application, your 12-
month period begins.

If You Do Not Pass the First Exam Attempt

You may register to take the second exam after your initial 3-month window closes. You will apply for the exam
as before; however, payment will not be required. You must apply for your second exam attempt no later than 9
months after your initial application submission date. Failure to register and schedule a second exam attempt
within the allotted timeframe will result in forfeiture of the second attempt.

Transfer Exam Window

You are allowed to transfer your initial exam window only. A transfer requires a $75 fee. For more information,
please refer to the “Withdrawing, Canceling, Rescheduling or Transferring Your Exam” section in this handbook.

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Withdrawal from Exam Window
Individual Take 2 participants can withdraw only if they are in their first exam window attempt. Withdrawals will
not be granted during the second take. Participants must sit for the second attempt or forfeit all fees.

Extended Term
Extensions to the original 12-month term will not be granted and an applicant must complete both takes or
forfeit any unused exam attempts.

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FACILITY TAKE 2 PROGRAM
The CNOR® Exam Take 2 Facility Program is available to hospitals and health systems interested in bulk
purchasing exams for nursing staff.

Participants who pass the CNOR® Exam on the first attempt will not receive another exam attempt. The second
attempt cannot be transferred to another person and is non-refundable.

Facility Take 2 Fee

Facilities may register multiple nurses at a reduced rate. The fee for facilities that register a minimum of five (5)
CNOR®-eligible nurses is $445 per participant. All participants must be employed at the same facility. Payment
must be made in a single transaction by facility check or credit card; individuals may not make a payment on
behalf of the facility.

Interested in Facility Take 2 Program

If you are a facility registering five or more CNOR®-eligible nurses, download our CNOR® Exam Take 2 Facility
Order Form, which includes complete details on the Terms and Conditions of the CNOR® Exam Take 2 Facility
program.

If you are a facility adding Participants to your original term, download the CNOR® Exam Take 2 Facility
Participant Addendum located at the end of the order form.

CCI may amend the CNOR® Facility Take 2 program at any time with or without notice.

Apply for First Exam Attempt

A Facility Take 2 term will commence as determined by the date CCI approves the CNOR® Exam Take 2 Facility
Order Form and notifies the Administrator via e-mail. If the approval is between the first (1st) and fifteenth
(15th) of the month, the Term will begin on the first (1st) of the calendar month of order approval. If the
approval is between the sixteenth (16th) and the end of the month, the Term will begin on the first (1st) of the
following month.

To receive two attempts within the application, participants must apply for their first exam no later than month
5 of the term and their second attempt no later than month 9.

A facility may add participants to its original term until the end of month 5. The original term will not be
extended or modified for new participants. A CNOR® Exam Take 2 Facility Participant Addendum is required.
Substitutions may be granted on a case-by-case basis at CCI’s sole discretion.

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CNOR® EXAM
The CNOR® exam consists of 200 multiple-choice questions. Of the 200 questions, 185 are used to calculate your
test score. The remaining 15 questions serve as pre-test questions and do not affect your score. Pre-test
questions are dispersed throughout the exam and cannot be identified by an examinee.

The CNOR® exam is a timed test and must be completed in 3 hours and 45 minutes. The computer hosting the
exam will keep the official time.

The computerized format of the exam requires basic computer experience. If you elect to take your exam with
the Remote Secure Proctored Exam option, you must do a system check of your computer prior to scheduling
the examination. An optional pre-exam tutorial will provide instructions on how to take the exam on the
computer. It will also provide examples on selecting answers and marking any questions you may want to return
to and review before finishing the exam. The time allotted for completing the tutorial is separate from the actual
exam time.

Recommended Study Time for CNOR® Exam

The recommended study period to prepare for the CNOR® certification exam is three months. Reviewing the
task and knowledge statements for each subject will aid in identifying areas of strengths and possible
weaknesses. The CNOR® Study Plan aligns these identified areas with materials to assist with each section. Use
experiences at work to gain additional knowledge and skills in unfamiliar areas. Using a variety of preparation
aids and frequent review have been found to increase comprehension and retention of information.

As a certification organization, CCI’s role is in developing and administering certification examinations to

determine the qualifications of applicants for certification. CCI does not require or endorse any specific study
guides, review products, and/or training courses. Applicants may prepare for certification examinations with any
educational materials they choose. The purchase of CCI review materials is not a requirement for testing, nor
does the use of any review materials imply successful performance on the certification examinations. CCI offers
various study resources for the certification examinations, including an on-demand prep course, practice exams,
and a study guide. No study resources are prerequisites for the certification examinations.

Reference Materials
Four primary references are recommended in preparing for the CNOR® exam:

• AORN. (current edition). Guidelines for perioperative practice. AORN.

• Phillips, N., & Hornacky, A. (Eds.). (2021). Berry and Kohn’s operating room technique (14th ed.).
Elsevier.

• Rothrock, J. C. (Ed.). (2023). Alexander’s care of the patient in surgery (17th ed.). Elsevier.

• Odom-Forren, J. (Ed.). (2024). Drain’s perianesthesia nursing: A critical care approach (8th ed.) Elsevier.

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Schedule Exam Appointment
The CNOR® exam is delivered at PSI testing centers and online as a Remote Secured Proctored Exam (RSPE).
Once the application and payment have been received, the option to schedule will be available in your CCI
account and you will receive an Authorization to Test (ATT) email. This email contains important information on
your exam window, scheduling your exam, and PSI protocols; please read it carefully. You are responsible for
scheduling an appointment to take the exam. You are strongly encouraged to schedule your appointment as
soon as possible, as availability is on a first-come, first-served basis, and CCI cannot guarantee appointment
availability. PSI administers in-person exams by appointment only, Monday through Saturday, in test centers.
Appointment starting times may vary by location. You can search for a test center in your area here.

Online scheduling for remote proctored exams is available 24 hours a day, 7 days a week. To schedule online,
click the “PSI Exam Scheduling” button in your CCI account. This will direct you to PSI’s scheduling system.

If you are randomly selected for audit, the option to schedule will be available after submission and approval of
required documentation.

To schedule an examination by phone, please call PSI at 855-834-8752. Please note it may take up to 24 hours to
receive a response. Live operators are available at the following times:

Time Zone Monday-Friday Saturday-Sunday

Eastern 7:30am - 10:00pm 9:00am - 5:30pm
Central 6:30am - 9:00pm 8:00am - 4:30pm
Mountain 5:30am - 8:00pm 7:00am - 3:30pm
Pacific 4:30am - 7:00pm 6:00am - 2:30pm

CNOR® Exam is Offered

Applicants may take the exam Monday through Saturday, excluding holidays, year-round at a PSI testing center.
You may also take the CNOR® certification examination through Remote Secure Proctored Exam (RSPE) on your
personal computer. The use of RSPE allows more flexibility for the test taker to include appointments outside 24
hours a day, 7 days a week, based on availability.

Once your application has been approved, you have a 3-month window to schedule your test at either a PSI
testing center or via RSPE. An applicant’s 3-month testing window opens the month immediately following the
application submission, as illustrated below. It is the applicant’s responsibility to schedule an appointment and
ensure their appointment is completed before the end of their testing window.

Applicants may test only once during any testing window.

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 Application Testing Months Application Approved Testing Months
Approved
January February, March, April July August, September, October
February March, April, May August September, October, November
March April, May, June September October, November, December
April May, June, July October November, December, January
May June, July, August November December, January, February
June July, August, September December January, February, March

Failure to Schedule

If you fail to schedule an exam appointment in your 3-month testing window, your entire testing fee is forfeited.
Current eligibility criteria must be met to reapply, and the fee applicable at that time must be paid.

Tardiness or Missing Test Appointment

For testing center appointments, if you are more than 15 minutes late or miss your scheduled appointment
time, you will be considered absent and forfeit your eligibility and application fee for that exam window.

Applicants may log in for their exam up to 30 minutes prior to the scheduled start time but may not be
connected with a proctor until their exam time. If you do not start your exam within 15 minutes of your
scheduled appointment time, you will be considered absent and forfeit your eligibility and application fee for
that exam window.

Secondary Application and Testing

Subsequent exam applications cannot be submitted in the same exam window as an unsuccessful exam
attempt. You must wait for your 3-month testing window to expire before you can apply to retake the exam.
The full exam price must be paid for each testing attempt unless the applicant participates in the Take 2
Program (see “CNOR® Individual Take 2” that appears earlier in this handbook). A new application must be
submitted for each new exam attempt.

Due to CCI’s commitment to quality and test security, there are multiple versions of the CNOR® Exam, and those
retaking the exam will not take the same exam as their first attempt.

Test Development Process

The Competency and Credentialing Institute (CCI) collaborates with our testing partner, PSI, in the test
development process. Development and maintenance of the certification examination is the product of a
scientifically rigorous process subject to accreditation agency oversight and approval. Additional information on
the CCI test development can be found in our Test Development Process Guide.

Scoring Methodology

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For the CNOR® certification exam, there is one reported pass/fail decision score. Scores are determined by
converting the number of questions answered correctly to a scaled score that ranges from 200 to 800. You need
a total scaled score of at least 620 to pass this examination. Applicants should answer all questions on the exam,
as any question not answered may count against the final score.

A scaled score is neither the number of questions you answered correctly nor the percentage of questions you
answered correctly. A scaled score is transformed from the raw test score (the number of test questions
answered correctly). A scaled score allows for consistent scoring across multiple forms of the exam.

CNOR® Exam Results

You will be shown a pass or fail notification immediately after you complete the exam. If you pass the CNOR®
exam, your score report will not include a detailed break down and the passing score will not be revealed. A
more detailed score report will be e-mailed to you by PSI within 24 hours of exam failure. Scores will not be
reported if the confidentiality of the exam is broken or misconduct at the testing center is reported.

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SAMPLE EXAM QUESTIONS
The following questions represent similar content to what can be found on the examination. These questions
are provided solely to offer applicants insight into the format of the examination and are not intended as study
questions. Practice questions can be found online.

1. The narrowest part of a child’s airway is the

a. vocal cords
b. cricoid cartilage.
c. mouth opening.
d. bronchioles.

2. What type of plan should a healthcare facility have to address a breakdown in the medical gas delivery
system?

a. Fire safety plan

b. Patient care plan
c. Utility failure plan
d. Hazardous materials plan

3. If a pinprick to the palmar surface of the pinky finder is perceived as dull, this would indicate a possible
injury to the nerve.

a. radial
b. ulnar
c. palmar
d. medical

4. If an intracranial mass is suspected as the cause of increased intracranial pressure (ICP), which of the
following would be contraindicated?

a. Lumbar puncture
b. Burr hole
c. Administration of a non-osmotic diuretic
d. Intravenous transfusion of hypertonic mannitol

5. What is the normal range for an ejection fraction of an adult?

a. 40-50%
b. 60-70%
c. 80-90%
d. 90-100%

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WITHDRAWAL, CANCELLATION, RESCHEDULING, OR TRANSFER
You may withdraw/cancel your application to test, reschedule your exam appointment within your original 3-
month testing window, or transfer your exam to another 3-month testing window. For additional information,
please refer to the following definitions of terms and the table below. For information related to Take 2
programs, please review “CNOR® Individual Take 2” in this handbook.

Definitions of Terms

• Withdraw/cancel: You have submitted your application and have been placed into your initial exam
window but have decided to cancel the event.

• Rescheduling/changing the date for a previously scheduled exam: You have scheduled a date/time for
your exam and want to move the testing date to another day within the same testing window.

• Transferring a previously scheduled exam to another testing window: You have applied for your exam
and now want to move the testing date to a day in the next 3-month testing window.
Withdrawal/Cancel:

• $75 withdrawal fee is required. This fee is withheld from the original payment, and you will be refunded
the amount paid minus the withdrawal fee.
• You may not withdraw after completing a transfer.
Transfer:

• $75 application fee is required. Fee is non-refundable upon approval of your transfer request.
o Please ensure you have cancelled all appointments prior to requesting a transfer.
• You may only transfer your individual single take twice per exam application. Take 2 program
participants may transfer their initial exam window only.
• If an exam appointment is scheduled with PSI, the appointment must be canceled before CCI can
process a transfer.
Less than two business days prior to
At least two business days or more prior to end of testing
TIME FRAME end of testing window or scheduled
window or scheduled test date
test date
WITHDRAW/CANCEL 1. Contact PSI and cancel your appointment. You are unable to withdraw/cancel
AN EXAM 2. Log into CCI account and complete the withdrawal your exam appointment. You must sit
APPOINTMENT request. A non-refundable $75 fee will be charged by for the exam, or all fees will be
CCI. forfeited.
Note: you may not withdraw if you have previously transferred
your window.

RESCHEDULE AN 1. Contact PSI to cancel your exam appointment. You are unable to change or cancel
EXAM DATE WITHIN 2. Reschedule the new exam date within the 90-day test the date for your exam appointment.
THE SAME TEST window. You must sit for the exam, or all fees
WINDOW will be forfeited.
TRANSFER AN EXAM 1. Contact PSI to cancel your exam appointment. You are unable to transfer to a new
DATE OUTSIDE 2. Log into your CCI account and complete the transfer testing window for your exam. You
ORIGINAL TEST request. A non-refundable $75 fee will be charged by must sit for the exam, or all fees will
WINDOW CCI. be forfeited.

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 3. Schedule an appointment in the new exam window.
Note: you can only transfer twice within a single application. You
may not withdraw after completing a transfer.

For exams scheduled at a testing center impacted by inclement weather, power failure, or other unforeseen
emergencies affecting the site on the day of an examination, PSI will determine whether circumstances warrant
the cancellation and subsequent rescheduling of an examination. The examination will usually not be
rescheduled if the test center personnel are able to open the test center.

You may visit www.psionline.com/openings prior to the examination to determine if PSI has been advised that
any test centers are closed. Every attempt is made to administer the examination as scheduled; however, should
an examination be canceled at a test center, all scheduled applicants will receive notification from PSI regarding
rescheduling procedures.

Applicants are responsible for scheduling a new exam appointment within your exam window following a
cancellation made by PSI.

If an applicant fails to schedule an exam appointment within the 3-month testing window, the entire exam fee is
forfeited. To reapply, the applicant must meet the current eligibility criteria and pay the fee that is applicable at
that time.

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PSI GUIDELINES FOR CCI EXAMINATIONS
Extensive check-in and security measures are enforced at testing sites and during live, remote proctored exams
administered online. A FAQ page and Test Instructions, including quick videos for reviewing test center and
online proctored experiences, are available on the PSI website link.

PSI REMOTE SECURE PROCTORED EXAM GUIDELINES

Identification

You must present an original, valid (unexpired), government-issued photo ID bearing a signature. CCI
recommends bringing a second form of ID as well. No form of temporary identification will be accepted.

• Examples of valid forms of identification are photo ID, such as a driver’s license, state identification card
or passport. Military identification cannot be used for remotely proctored exams.
• If the name on your registration differs from what appears on your identification, you must bring proof
of your name change (e.g., marriage license, divorce decree, or court order).
• PSI may request a second form of ID bearing your name and signature (e.g., a credit card).

If there is any concern about the validity of your identification, PSI has the right to ask for additional
identification or refuse your admittance to the exam. Failure to provide appropriate identification at the time
of the examination is considered a missed appointment and will result in forfeiture of your exam fees. Please
contact PSI if you have any questions about acceptable forms of identification.

Monitoring

Several security measures will be enforced during the exam administration. PSI administration and security
standards are designed to ensure all applicants are provided the same opportunity to demonstrate their
abilities. Be aware that you will be observed at all times while taking the exam. This observation may include
direct observation by test center staff or a remote proctor and audio and video recordings of your testing
session.

No guests, visitors, or family members are allowed to enter the room in which you plan to take your test once
you have completed your check-in environment checks. It is recommended and encouraged to be in a closed
room with a door and to put a note on the door if there are other people in the room. People entering or
passing through the testing environment can result in termination of your exam.

Examinations are proprietary. No cameras, calculators, tape recorders, pagers, or cellular/smartphones are
allowed in the testing room. Possession of a cellular/smartphone or other electronic device(s) is strictly
prohibited and will result in dismissal from the examination without a refund.

Exams cannot be viewed, copied, or studied by any individual. Copying or retaining test questions or
transmitting the test questions in any form to other individuals, organizations, or study groups will result in
forfeiting your right to have your exam scored and may result in civil prosecution and disciplinary action by CCI.

Personal Belongings

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Your test environment must be clear of clutter and all personal belongings. Ensure that your desk is limited to
the computer (no monitors allowed), mouse and keyboard. All other items should be removed from the desk
space and there should be nothing within arm’s reach of the desk.

Your testing space/desk must be free of all personal items and valuables including but not limited to:

• Electronic devices of any type, including cellular/mobile phones, recording devices, electronic watches,
cameras, pagers, tablet computers (e.g., iPads), music players (e.g., iPods), smart watches, radios, or
electronic games including laptop computers not used for testing, must be stowed away from testing
area.
• Bulky or loose clothing or coats that could be used to conceal recording devices or notes. For security
purposes, outerwear such as, but not limited to, loose sweaters, cardigans, shawls, scarves, hoodies,
vests, jackets, and coats are not permitted in during testing. If you are asked to remove the outerwear,
appropriate attire, such as a shirt or blouse, should be worn underneath.
• Hats or headgear not worn for religious reasons or as religious apparel, including hats, baseball caps, or
visors.
• Other personal items including purses, notebooks, reference or reading material, briefcases, backpacks,
wallets, paper, pens, pencils, other writing devices, food, drinks, and good luck items.

You will be required, as part of check-in, to perform a series of room scans to confirm there are no prohibited
items in the testing area. Please allow for this time in addition to your exam time.

If any personal items are observed in the testing room after the examination starts, the examination will be
forfeited. Please visit the PSI website for additional test center regulations.

System Requirements

Remote Secure proctoring system requirements are regularly updated and should be checked in advance of
booking HERE.

PSI Bridge is not supported on tablets, hybrid devices, mobile devices, Surface Pros, or Chromebooks.

A link to the compatibility check is available during scheduling. Please run the compatibility check at least 24
hours before your scheduled exam. Passing the compatibility check does not guarantee that technical issues will
not occur. You can also access the compatibility check here: PSI Online Proctoring Compatibility Check.

Please be aware this is a hardware check only. The systems check that confirms your devices operating system
will be performed the day of the exam.

A PSI proctor will be monitoring the session throughout the entirety of the exam. Applicants are expected to
show their photo ID, take a selfie, and perform a room scan of the testing environment. The environment should
be private, well-lit, and free from reference materials and clutter. The proctor may ask that the space be cleared
before the release of the exam if not already done. No one is permitted to enter the testing area during the
exam.

PSI Proctors will not have access to your computer. PSI uses a secure browser that must be downloaded and
installed just before your scheduled appointment. Clicking the “Launch Exam” button up to 30 minutes before
your appointment will automatically start the download process. The secure browser will prevent the ability to
copy, paste, take screenshots, use instant messaging or other applications, and access other websites.

Dismissal from a Test Session

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The test center administrator or remote proctor is authorized to dismiss an applicant from a test session,
including but not limited to the following reasons:
• One’s failure to follow the test center administrator’s directions.
• Creating a disturbance of any kind.
• Possession of unauthorized personal belongings.
• Talking to or participating in a conversation with others during the examination.
• Giving or receiving assistance of any kind.
• Using prohibited aids, such as reference materials, mechanical listening devices, notes, and recording or
photographic devices.
• Removing or attempting to remove test questions and/or responses (in any format)
• Failing to demonstrate the destruction of scratch paper during a remotely proctored exam.
• Attempting to take the test for someone else.
• Attempting to tamper with the operation of the computer.
• Leaving the testing room or camera view without permission.
• Leaving the test center/building at any time.
• Using electronic communications or recording equipment such as cellular phones and like devices.
• Bringing any materials to the test environment that may compromise the administration of the exam.
• Sharing information about the test and test questions with an unauthorized person(s).

If a proctor witnesses what they believe to be a security breach, the exam is stopped immediately; all related
materials are retained, and an incident report is generated and routed to PSI. PSI reviews the session for quality
and to determine if there was any inappropriate action requiring follow-up. For test center examinations, a
report is provided to CCI.

If it is believed that an applicant violates the test center Misconduct Policy, breaches security, or fails to follow
test center directions, CCI may render sanctions against the individual, which may include but not be limited to
the following:

• The exam taker may receive a suspension for either a specific or undetermined amount of time.
• At the discretion of the CCI Certification Council and as allowable by law, CCI may notify the State Board
of Nursing, the applicant's employer, insurance company, or other public health agency.

PSI Test Center Exam guidelines

Identification

You must present an original, valid (unexpired), government-issued photo ID bearing a signature. CCI
recommends bringing a second form of ID as well. No form of temporary identification will be accepted.

• Examples of valid forms of identification are photo ID, such as a driver’s license, state identification card,
passport, or military identification card (on-site examinations only).

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 • If the name on your registration differs from what appears on your identification, you must bring proof
of your name change (e.g., marriage license, divorce decree, or court order).
• PSI may request a second form of ID bearing your name and signature (e.g., a credit card).

If there is any concern about the validity of your identification, PSI has the right to ask for additional
identification or refuse your admittance to the exam. Failure to provide appropriate identification at the time
of the examination is considered a missed appointment and will result in forfeiture of your exam fees. Please
contact PSI if you have any questions about acceptable forms of identification.

Monitoring

Several security measures will be enforced during the exam administration. PSI administration and security
standards are designed to ensure all applicants are provided the same opportunity to demonstrate their
abilities. Be aware that you will be observed at all times while taking the exam by test center staff. Test centers
are also equipped with video surveillance.

No guests, visitors, or family members are allowed in the testing room or reception areas.

Examinations are proprietary. No cameras, calculators, tape recorders, pagers, or cellular/smartphones are
allowed in the testing room. Possession of a cellular/smartphone or other electronic devices is strictly prohibited
and will result in dismissal from the examination without a refund.

Exams cannot be viewed, copied, or studied by any individual. Copying or retaining test questions or
transmitting the test questions in any form to other individuals, organizations, or study groups will result in
forfeiting your right to have your exam scored and may result in civil prosecution and disciplinary action by CCI.

Personal Belongings

No personal items, valuables, or weapons should be brought to the test center. Only wallets and keys are
permitted. Coats must be left outside the testing room. You will be provided with a soft locker or a locker with a
padlock to store your wallet and/or keys with you in the testing room. You will not have access to these items
until after the examination. Please note: personal items such as watches, hats, wallets, and keys will not be
allowed in the testing room except securely locked in the soft locker.

Once you have placed everything into the soft locker, you will be asked to pull out your pockets to ensure they
are empty. The proctor may also ask applicants to lift the ends of their sleeves and the bottoms of their pantlegs
to ensure that notes or recording devices are not hidden. Proctors will also carefully inspect eyeglass frames, tie
tacks, or any other apparel that could be used to harbor a recording device.

If all personal items do not fit in the locker, you must make arrangements to store these somewhere else (e.g.,
your vehicle), or you may be unable to test. The site will not store any personal belongings. Personal belongings
include, but are not limited to, the following items:
• Electronic devices of any type, including cellular/mobile phones, recording devices, electronic watches,
cameras, pagers, laptop computers, tablet computers (e.g., iPads), music players (e.g., iPods), smart
watches, radios, or electronic games
• Bulky or loose clothing or coats that could be used to conceal recording devices or notes. For security
purposes, outerwear such as, but not limited to, loose sweaters, cardigans, shawls, scarves, hoodies,
vests, jackets, and coats are not permitted in the testing room. If you are asked to remove the
outerwear, appropriate attire, such as a shirt or blouse, should be worn underneath.

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 • Hats or headgear not worn for religious reasons or as religious apparel, including hats, baseball caps, or
visors.
• Other personal items including purses, notebooks, reference or reading material, briefcases, backpacks,
wallets, pens, pencils, other writing devices, food, drinks, and good luck items.

If any personal items are observed in the testing room after the examination starts, the examination will be
forfeited. Please visit the PSI website for additional test center regulations.

Dismissal from a Test Session

The test center administrator is authorized to dismiss an applicant from a test session, including but not limited
to the following reasons:
• One’s failure to follow the test center administrator’s directions.
• Creating a disturbance of any kind.
• Possession of unauthorized personal belongings.
• Talking to or participating in a conversation with others during the examination.
• Giving or receiving assistance of any kind.
• Using prohibited aids, such as reference materials, mechanical listening devices, notes, and recording or
photographic devices.
• Removing or attempting to remove test questions and/or responses (in any format) from the testing
room.
• Removing or attempting to remove scratch paper from the test center.
• Attempting to take the test for someone else.
• Attempting to tamper with the operation of the computer.
• Leaving the testing room.
• Leaving the test center/building at any time.
• Using electronic communications or recording equipment such as cellular phones and like devices.
• Bringing any materials to the test center that may compromise the administration of the exam.
• Sharing information about the test and test questions with an unauthorized person(s).

If a proctor witnesses what they believe to be a security breach, the exam is stopped immediately; all related
materials are retained, and an incident report is generated and routed to PSI. PSI reviews the session for quality
and to determine if there was any inappropriate action requiring follow-up. For test center examinations, a
report is provided to CCI.

If it is believed that an applicant violates the test center Misconduct Policy, breaches security, or fails to follow
test center directions, CCI may render sanctions against the individual, which may include but not be limited to
the following:

• The exam taker may receive a suspension for either a specific or undetermined amount of time.
• At the discretion of the CCI Certification Council and as allowable by law, CCI may notify the State Board
of Nursing, the applicant's employer, insurance company, or other public health agency.

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EXAM IRREGULARITIES AT TESTING CENTERS

Group Testing Irregularities

Unlike cases of individual applicant misconduct, testing irregularities occasionally affect a group of test takers.
Such problems include, without limitation, administrative errors, defective test center equipment or materials,
improper access to test content and/or the unauthorized general availability of test content, as well as other
disruptions of test administrations (e.g., natural disasters and other emergencies).

When group testing irregularities occur, PSI will investigate to provide information to CCI. Based on this
information, CCI may direct PSI either not to score the exam or to cancel the exam score. When appropriate, CCI
will arrange with PSI to allow affected test takers to retake the exam as soon as possible, without charge.
Affected exam takers will be notified of the reasons for the cancellation and their options for retaking the test.
The appeal process does not apply to group testing irregularities.

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ACCOMODATIONS
Under the Americans with Disabilities Act (“ADA”), persons with disabilities may be entitled to accommodations
if (i) they have a physical or mental impairment, (ii) that substantially limits a major life activity (e.g., hearing,
seeing, learning, reading, or concentrating), or a primary bodily function (e.g., neurological, endocrine, or
digestive system). However, CCI is not obligated to provide accommodations that would fundamentally alter the
measurement of the skills or knowledge the exam intends to test or impose an undue burden on CCI.

Request an Accommodation
CCI is committed to providing reasonable accommodation in its exam processes to otherwise qualified
individuals with physical or mental disabilities complying with the ADA. CCI will make every reasonable attempt
to comply with Federal regulations concerning the test administration for qualified persons who are temporarily
or permanently disabled or who request accommodations for religious reasons at the time of the scheduled
exam in accordance with the following policies:

• A disability requires written documentation and validation. The documentation provided should include
correspondence from a healthcare provider with firsthand knowledge of the disability that describes the
nature of the disability and specific recommendations regarding the type of accommodation required to
address the disability. The letter should be on that professional’s letterhead stationery and include their
title, address, phone number, and original signature.

• The applicant must notify CCI of their temporary or permanent disability for testing and provide
supporting documentation at the time of application.

• The applicant must notify CCI of a request for accommodation for religious reasons at the time of
registration.

• This accommodation shall not compromise the content and validity of the exam.

• CCI will make all determinations for accommodations at its sole discretion. All reasonable attempts will
be made to accommodate the needs of the disabled person. If no feasible solution can be reached, the
applicant will be notified in writing, and a refund will be issued.

Examples of requests for special testing accommodations that may be granted include, but are not limited to:

• modification of seating or other physical arrangements in the exam facility,

• providing for the exam to be taken in an accessible location, or

• providing for a reasonable extension of testing time.

Examples of requests for special testing accommodations that may be denied include:

• modification of the content of an objective multiple-choice exam,

• providing for unlimited testing time, or

• permitting a reader to paraphrase test material or translate the material into another language.

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USING THE CREDENTIAL
CNOR® certification is defined as “the documented validation of the professional achievement of identified
standards of practice by an individual registered nurse providing care for patients pre-, intra-, and post-surgery.”

Active Credential
Certification is conferred for 5 years, with recertification available after that 5-year accrual period. When the
credential lapses, the nurse may no longer use the CNOR® designation in their credentials.

Use the Credential

The CNOR® mark is federally registered with the U.S. Patent and Trademark Office. It may only be used in
accordance with CCI policy by those who have achieved and actively maintained the credential. See Appendix D
for CCI’s “Certification Mark Use Policy.”

Using My Credential
The CNOR® credential can be used upon credential verification on the CCI website. Certificants can also print a
certificate from their CCI account profile.

Certificate
Within one week of passing the exam, your CCI certificate will be available within your CCI account. You may
download and print your certificate directly from your CCI account.

Display My Name and Credential

In writing, proper usage is as follows: Jane A. Doe, BSN, RN, CNOR®. CCI’s “Certification Mark Use Policy” can be
found in Appendix D.

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MISUSE OR MISREPRESENTATION
Any misuse or misrepresentation of the CNOR® credential by those not currently holding the credential shall be
subject to legal action by CCI. Misrepresentation includes the use of the CNOR® credential once the credential
has lapsed.

REVOCATION
CCI may deny, suspend, or revoke certification for cause, including but not limited to the following:

• Failure to complete or provide evidence of completion of the initial certification and certification
renewal requirements*
• Failure to maintain the required professional licensure
• The determination that initial certification or certification renewal was improperly granted
• Falsification or misstatement of information on any certification-related document
• Providing false or misleading information
• Misrepresentation regarding the credentialing status
• Cheating or assisting others to cheat
• Causing, creating, or participating in an examination irregularity
• Assisting others to wrongfully obtain initial certification or certification renewal
• Failure to comply with the scope and standards of practice in an area in which the certification is held
• Misuse of or misrepresentation with respect to the CCI credential
• Commission of a crime or gross negligence in the practice of nursing
• Violation of CCI policy or procedure
• Failure of audit processes
• Failure to comply with the American Nurses Association’s Code of Ethics for Nurses with Interpretive
Statements
• Conduct unbecoming of the nursing profession
• Has not paid all outstanding debts to CCI

*Certified nurses will be informed by letter of CCI’s decision to revoke the CNOR® status. There will be no refund if the CNOR® status is
revoked for any reason.

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INTRODUCTION TO RECERTIFICATION

Recertification
Recertification is the continued documented validation of professional achievement of identified standards of
practice by an individual registered nurse providing perioperative nursing care.

Purposes of Recertification

• Recognizes the professional nurse who demonstrates continued competency in perioperative nursing
practice.

• Strengthens conscious use of theory in assessing, planning, implementing, and evaluating perioperative
patient care.

• Enhances professional development through life-long learning that results in acquiring current
knowledge and expanded skills and practice.

Recertification Justification
The rapid pace of change and the prevalence of technology in the modern perioperative setting require a
conscious effort to maintain competency. Certification is valid for 5 years, at which time a CNOR® may seek
recertification. The required CNOR® recertification activities are created from and are consistent with the
knowledge statements of the Job Analysis, which is performed on a 5-year cycle. The recertification
requirements guide professional development activities by providing parameters for acceptable activity and
maintaining a link to the most current body of knowledge. Linking the certification period to the Job Analysis
cycle ensures that certificants are engaged in activities pertinent to their professional development.

Competency is the actual performance in a situation and consists of knowledge, skills, and attitude. Each of
these components is a necessary element. The CNOR® recertification process acknowledges the need for active
work to maintain continuing competency by directly addressing 2 of the 3 components. The practice
requirement facilitates the maintenance of current skills and promotes the acquisition of new skills through
exposure to the practice setting. Other professional development activities (e.g., continuing education) facilitate
the acquisition of knowledge, which is the second essential component of competency. It is assumed that
ongoing professional development and engagement guided by the recertification process will also indirectly
influence the certificant and thus effect positive change in attitude, the third component of competency.

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RECERTIFICATION

Recertification Timeframe
CCI confers the certified status of an individual RN for a period of 5 years, at which time a CNOR® may seek
recertification. The recertification process requires a CNOR® to complete recertification activities during the 5-
year accrual period, meet recertification eligibility requirements, and apply during their recertification year.

Accrual Period
The accrual period is the time frame the certificant must complete continuing education or professional
development activities.

Accrual Period Deadlines

Accrual Recertification Recertification Applications Recertification Application
Year Certified
Period* Year Accepted Deadline
2019 2019-2023 2024 Jan 1-Dec 31, 2024 December 31, 2024

2020 2020-2024 2025 Jan 1-Dec 31, 2025 December 31, 2025

2021 2021-2025 2026 Jan 1-Dec 31, 2026 December 31, 2026

2022 2022-2026 2027 Jan 1-Dec 31, 2027 December 31, 2027

*Certificant accrual periods begin on January 1 of the year certified or recertified.

Recertification Requirements
Choose recertification methods available based on your certification date (see table).

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 • Complete recertification activities during your accrual period.
• Meet the recertification eligibility requirements at the time of application.
• Complete CCI’s recertification application during your recertification year.
o New recertification and accrual dates will be listed in your CCI account once your application is
submitted.
• Pay the application fee.

Recertification Eligibility Requirements

CNOR® recertification applicants must meet the following eligibility requirements at the time of application:

• Hold an active CNOR® credential.

• Hold a current, unrestricted RN license.
• Currently working full-time or part-time in perioperative nursing in clinical practice, nursing education,
administration, perioperative quality assurance/improvement, or research.
• Have worked a minimum of 500 hours in perioperative nursing within the 5-year recertification cycle.
• Of those 500 hours, 250 hours must be in education, administration, research, or clinical practice that
impacts patient care in the intraoperative setting.
• Practice hours earned in a volunteer status while working in a CNOR® role may be utilized to fulfill this
requirement.

Recertification Fees
Please see below for the current list of recertification fees, options, and available discounts. Applications cannot
be processed without payment. All fees and/or outstanding debts to CCI must be paid by December 31 of your
recertification year.

Discounted Price*
CNOR® Recertification Method Standard Price
January 1 – June 30
Recertification by Professional Activity Points $425 $385
Recertification by Contact Hours $425 $385
CNOR® Extension Year $245 N/A
CNOR® Emeritus Status $175 N/A

*The discount of $40 for recertifications between January 1 – June 30, will automatically apply at checkout, the full recertification fee will
show in your cart until that time. Additionally, there is a $40 discount available for those who hold an active CCI credential outside of the
one you are recertifying. Discounts cannot be combined and only one discount can be utilized per transaction.

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RECERTIFICATION METHODS
Certificants must select a recertification method to maintain their CNOR® credential, including a specific plan for
their ongoing professional development. Certificants must complete their recertification activities within their 5-
year accrual period and apply for recertification within the following year.

As of January 1, 2019, newly certified certificants will be required to complete recertification using professional
points activities.

Recertification Methods
CNOR® certificants may choose one of the following methods to recertify the credential based on the year of
initial certification. Your accrual year begins January 1st of the year you are certified, regardless of the date of
initial certification or recertification. You cannot recertify by retaking the CNOR® certification exam.

CNOR® Certified in 2018 and Prior

Accrual Period Recertification Method Recertification Year Next Recertification Method

2018-2022 CE or Points 2023 Points

2019-2023 CE or Points 2024 Points

2020-2024 CE or Points 2025 Points

2021-2025 Points 2026 Points

2022-2026 Points 2027 Points

Recertification by Contact Hours

Recertification by contact hours requires 125 contact hours offered by approved providers, accrued within the
5-year accrual period. Of the 125 contact hours, 75 must be related to perioperative nursing. If audited, the
certificant is responsible for providing certificates of attendance from accredited providers. Appendix A outlines
the specific recertification requirements by contact hours, and lists approved providers.

Recertification by Points

Recertification by points recognizes that professional development and competency maintenance may be
accomplished in various ways. To recertify by points, you must earn 300 points within your 5-year accrual
period. Appendix B outlines the specific requirements of recertification by points.

Recertification Application
Recertification by contact hours or points requires an online application via your CCI account. You will need your
e-mail address associated with your account and password to log into your CCI profile. If you are unable to
access your account, do not create a duplicate account. A new account will not have your credential associated
with it. Contact the CCI Credentialing Department for assistance at 888-257-2667 or [email protected].

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Access the application from the CCI website to recertify by professional development points. A complete
application includes:

• Application, including RN license and current employment information

• Logged points activities obtained during your accrual period
• Acknowledgement of understanding of CCI’s terms and conditions
• Application fee

Audit
CCI randomly selects a percentage of recertification applications for audit. If there is reason to believe there has
been a breach in the integrity of the process by an individual seeking recertification, CCI may also select those
individuals for audit.

Applicants selected for audit will be notified by CCI and required to submit additional documentation within 30
days of notification. After reviewing the documents, an e-mail will be sent to the applicant detailing the audit
results. Delay in submission of documentation or submission of incomplete documentation may result in a delay
in the recertification process. Appendix B outlines the specific requirements for an application under audit.

Failure to comply with all recertification audit requirements by the 30-day deadline or to successfully pass the audit will
terminate your application. No refunds of the recertification application fee will be provided to applicants that do not
successfully pass the audit.

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RECERTIFICATION ALTERNATIVES

Not Eligible to Recertify

There are three options if you are not eligible to recertify:

 File for an Extension Year by logging into your CCI account to complete the online application.
 File for Emeritus status by logging into your CCI account to complete the online application.
 Allow the credential to lapse.

Extension Year
An extension year extends your recertification year to the following year, allowing one more year to accrue the
necessary points activities or contact hours for recertification and meet other eligibility requirements (e.g.,
current employment). Your CNOR® credential will remain active during this time. Please contact CCI’s
Credentialing Department at 1-888-257-2667 or info@cc- institute.org for more information.

Below are key points regarding the Extension Year process:

 An extension year is only available once every 10 years or 2 recertification cycles for the CNOR®
certification.
 You must apply in the year you are due to recertify.
 The extension year adds one calendar year to your original accrual end date. No additional time will be
granted for your extension year.
 Your current recertification options remain unchanged for the extension year.
 No refunds or discounts are applicable. The full recertification fee will be due when the recertification
application is submitted.

CNOR® Recertification Alternative Standard Price

CNOR® Extension Year $245

Extension Year Requirements

All fields (e.g., RN license and work information) in the certificant’s account must be updated. To recertify your
CNOR® credential following your extension year, you must meet all the recertification requirements in effect at
the time of application and pay the recertification fee.

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Extension Year Recertification
You may apply for recertification at any time during your new recertification year. Log in to your CCI account to
complete your recertification application available from your CCI account. See the table below for extension
year accrual periods and recertification dates.

Original Date to Original Accrual Period Last Date to New Date to

New Accrual Period
Recertify File Recertify
2023 Jan. 1, 2018 – Dec. 31, 2022 Dec. 31, 2023 Jan. 1, 2018 – Dec. 31, 2023 2024

2024 Jan. 1, 2019 – Dec. 31, 2023 Dec. 31, 2024 Jan. 1, 2019 – Dec. 31, 2024 2025

2025 Jan. 1, 2020 – Dec. 31, 2024 Dec. 31, 2025 Jan. 1, 2020 – Dec. 31, 2025 2026

2026 Jan. 1, 2021 – Dec. 31, 2025 Dec. 31, 2026 Jan. 1, 2021 – Dec. 31, 2026 2027

Emeritus

Emeritus status retires your credential. CCI established the emeritus status to recognize retired perioperative
nurses’ service and commitment to the perioperative profession and their achievement and maintenance of the
CNOR® credential. The designation for CNOR® emeritus is CNOR®(E). CNOR®(E) holders may be considered for
CCI Board and committee appointments.

Emeritus Status Requirements

You must currently hold an active CNOR® credential to apply for CNOR® emeritus status. Emeritus status is not
available if your CNOR® credential has lapsed. No recertification is required when you retire your credential.

Obtaining Emeritus Status

Emeritus applicants complete the process by logging in to their CCI account to complete the online application
and submit fees. Once your request and fee have been received, your emeritus status certificate will be available
to print immediately from your CCI account.

CNOR® Recertification Alternative Standard Price

CNOR® Emeritus Status $175

Taking my Credential Out of Emeritus

Once in emeritus status, should you choose to maintain an active credential once again, you must reapply, meet
eligibility requirements, and pass the CNOR® Exam.

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Lapsed Credential
You are not eligible to use the CNOR® credential after it has lapsed. Once your CNOR® credential has lapsed, you
must pass the exam to achieve certification and be eligible.

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ETHICS, VIOLATIONS, & APPEALS

Ethics & Violations

CCI strives to safeguard the integrity of its certifications. Nurses holding any CCI certifications are expected to
demonstrate safety, competency, and ethical behavior in compliance with applicable laws and rules.

Information regarding CCI’s Ethics Policy and the Ethics Violation Form are available on the CCI website.

Appeals

Individuals have the right to appeal certain decisions made by CCI staff or committees. An independent team of
individuals not part of the initial determination reviews all appeals to CCI. Appeals committees include members
appointed by or part of CCI Certification Council as needed. Appeals decisions are final and may not be further
appealed.

Information regarding various types of Appeals and the Appeal Request Form are available on the CCI website.

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GENERAL DATA INFORMATION

Information Confidentiality

The CEO, in consultation with CCI Leadership, will approve all requests for data and access to certificants.

Following accreditation requirements, CCI must make certain data about its certificants public (e.g., the
demographic breakdown of certificants, number of certificants, number of test-takers, and pass rates for
certification exams). All data is de-identified and shared in aggregate only, in accordance with Federal privacy
law.

Use of Personal Data

CCI may process certificant data based on the following grounds, as appropriate:

• You have provided your consent which can be withdrawn at any time.

• The processing is necessary for the performance of a contract to which you are a party, including the
processing of exams, certification, or recertification applications.

• The processing is necessary to meet legal obligations or to defend or maintain any claims involving us or
our applicants and certificants.

• The processing is required to protect your vital and legal interests or those of another person.

• The processing is necessary for the purposes of CCI’s operations and mission.

For additional details how CCI utilizes data, visit our Privacy Policy.

Credential Verification
Verification of your credential can be accessed through the CCI website.

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APPENDIX A: RECERTIFICATION BY CONTACT HOURS
Recertification by contact hours requires 125 contact hours offered by approved providers. Of the 125 contact
hours, 75 must be related to perioperative nursing. Certificants must maintain a copy of the certificate of
attendance for each approved program attended and submit such records if audited. If the applicant has an
official log from the provider with the same information as that on a certificate and the information on the
acceptable accredited provider, it may be used instead of certificates. The certificant is responsible for providing
the certificates of attendance. Each certificate of attendance must have an accreditation statement and/or
provider number. An activity with the same course information (name, content, etc.) may only be reported once
a year.

The following DO NOT meet the criteria for recertification and therefore are not acceptable:

• Handwritten accreditation statements or provider numbers.

• Certificates of attendance without an appropriate accreditation statement and/or acceptable provider
number.
• Contact hours earned outside of your accrual window.
• Provider numbers that do not state the Board of Registered Nursing.

Accredited, Approved Providers

Contact hours approved by any of the following groups are acceptable:

• Accreditation Council for Cont. Medical Education (ACCME)

• American Academy of Family Practitioners (AAFP)
• American Academy of Nurse Practitioners (AANP)
• American Academy of Physicians Assistants (AAPA)
• American Association of Critical-Care Nurses (AACN)
• American Association of Neuroscience Nurses (AANN)
• American Association of Nurse Anesthetists (AANA)
• American College of Nurse-Midwives (ACNM)
• American Health Information Management Association (AHIMA)
• American Nurses Credentialing Center (ANCC)
• An agency, organization, or educational institution accredited by ANCC
• Any State Board of Nursing
• Any state nurses’ association
• Association for Healthcare Resource and Materials Management (AHRMM)
• Association of periOperative Registered Nurses (AORN)
• Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN, formerly NAACOG)
• International Association for Continuing Education and Training (IACET)

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 • National Association of Nurse Practitioners in Women’s Health (NPWH)
• National Association of Pediatric Nurse Associates and Practitioners (NAPNAP)

Certificates from other groups deemed equivalent to those listed above may be accepted. The Director of
Credentialing will approve this decision in consultation with the Credentialing Department.

Approved Topics

To ensure the validity of this credential and its consistency with industry standards, CCI requires 75 contact
hours earned for CNOR® recertification to be related to the specialty of perioperative nursing. Although the
following is not an all-inclusive list, it provides various perioperative-related subjects.

• Anatomy and Physiology

• Critical thinking skills
• Communication
• Disease management (HIV, hepatitis, diabetes, etc.)
• Discharge planning
• Ethics
• Infection control
• Leadership/supervisory skills
• Legal issues
• Nursing process
• Pain management
• Perioperative scope of practice
• Pharmacology
• Pre-, intra-, and postoperative patient care (patient assessment)
• Precepting
• Professional development
• Professional guidelines
• Research posters
• Surgical procedures
• Technology
• Research
• Evidence-Based Practice
• Quality Improvement/Quality Assurance

Academic Credit

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At most, 50% (or 62.5 contact hours) of the 125 contact hours required for recertification may be earned
through academic credits. CNOR®s may use academic credits in partial fulfillment of the requirements for
recertification through the contact hour method. All academic credits must meet the following criteria to be
acceptable for use toward CNOR® recertification.

Courses must be those required for a baccalaureate or higher degree. Although courses must be taken for
credit, CNOR®s do not need to be enrolled in a formal degree program when the course is taken. To be
acceptable, a grade of C or better must be achieved for each course, and an accredited educational institution
must sponsor courses.

Academic credits will be converted to contact hours using the following calculation:

Course Contact Hours

1 semester hour/credit 20 contact hours

1 quarter hour 10 contact hours

CME Credits

CNOR®s may submit Category 1 CME (continuing medical education) credits to fulfill the contact hour
requirements. Category 2 CME may not be used for recertification.

You are responsible for converting CME credits into contact hours using the ANCC conversion of:

Category Contact Hours

1 CME Credit 1 contact hour

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APPENDIX B: RECERTIFICATION BY POINTS
You must earn a total of 300 points to recertify your CNOR® credential. The following is a list of eligible
activities which may be used to recertify your CNOR® by points. A maximum number of points is permitted for
each activity except for academic study and academic teaching, where you may earn unlimited points.

You do not have to choose every activity. Please see Appendix C for a list of documents to be supplied if the
certificant is audited.

• Academic Study
• Academic Teaching
• Additional Points Activities
• Board or Committee Service
• Case Study
• CCI Test Development Volunteer
• CCI Certification Support Volunteer
• Clinical Inquiry (Research, Evidence-Based Practice, Quality Assurance/Quality Improvement)
• Games
• Nursing Continuing Professional Development
• Ongoing Professional Development
• Perioperative Certification
• Precepting/Mentoring
• Professional Growth and Development: Digital Media
• Professional Organization Activities
• Professional Presentations
• Publishing
• Reflection
• Training Certificate
• Volunteer, (Non)Healthcare Related Service

Academic Study

Unlimited points may be earned in the Academic Study category. The course must be part of a degree
completion program, such as a healthcare degree (BSN, MSN, DNP, etc.) or a degree where the knowledge
attained is used to advance your perioperative nursing career (including an MBA).

Course Point Value

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 1 semester hour/credit 20 points

1 quarter hour/credit 10 points

Academic Teaching

Unlimited points may be earned in the Teaching category.

Course Point Value

8-week perioperative class taught 25 points

16-week perioperative class taught 50 points

Additional Points Activities

A maximum of 100 points may be earned for additional points activities, as determined by the Recertification
Committee. Recently approved activities include the following:

Role Point Value

10 Question Activities
10 points
• Approved by CCI Certification Council or CEO
20 Question Activities
20 points
• Approved by CCI Certification Council or CEO
Journal Club Attendee
15 points per year
• Minimum of 4 meetings per year
True North Award Packet Writer 15 points per packet

Board or Committee Service

A maximum of 150 points may be earned in the Service as a Board or Committee Member category.

Role Point Value

CCI Board of Directors 50 points per year

CCI Certification Council 50 points per year

International, National, or State Board Member 30 points per year

Local or facility-level committee 30 points per year

Non-healthcare related committee, any level 15 points per year

Case Studies

A maximum of 100 points may be earned for completing a case study activity.

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 Case Study Point Value

Free Case Study Activity in CCI store 50 points

CCI Test Development Volunteer

A maximum of 100 points may be earned per recertification cycle. A CNOR® who serves as a subject matter
expert for CCI exam test development committees may earn points for recertification.

All upcoming test development committees will be hosted remotely and jointly facilitated by CCI and PSI staff.
This does not change the point values offered below.

Committee Point Value

Alternate 5 points

Cut Score/Standard Setting 30 points

Form Review 25 points

Item Review 25 points

Item Writer 30 points

Job Analysis 100 points

Task Force 25 points

Survey Completion 5 points

Survey Review Call 10 points

Pilot Survey Review Call 10 points

Subgroup Analysis Call 15 points

Test Specs 25 points

Other: Ad Hoc Committee (specify) 15 points

CCI Certification Support Volunteer

A maximum of 100 points may be earned as a volunteer on the educational product Ad-Hoc committee.

Role Point Value

Certification Coaches
• Applicable towards the 100-point maximum allowed for CCI volunteer work 20 points per year
per recertification cycle.
Volunteer writing and submitting 20 questions per assignment 20 points

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Clinical Inquiry

A maximum of 100 points may be earned in the Clinical Inquiry category. Quality Improvement (QI), Quality
Assurance (QA), Evidence-Based Practice (EBP), and Research projects are accepted under this heading. To
receive points in this category, you must be primarily responsible for developing, implementing, and/or
evaluating projects in these categories. The activity must show evidence of participating in or applying clinical
inquiry that improves current practice and/or patient outcomes.

Role Point Value

Co-Investigator or Project Team 30 points per project

Primary Project Leader or Primary Investigator 50 points per project

Games

A maximum of 30 points may be earned for games activities.

Games Point Value

Free Games in CCI store 2 points

Nursing Continuing Professional Development

A maximum of 100 points (50 contact hours) may be earned from activities or Category 1 CME credits through
an approved provider:

Category Point Value

1 contact hour 2 points

1 CME Category 1 credit = 1 contact hour 2 points

Ongoing Professional Development

A maximum of 200 points may be earned in this category. In alignment with the CCI mission to promote
continuous professional development and lifelong learning, this category includes Microcredentials (MC) and
Certificates of Mastery (COM). Visit the CCI store to purchase a variety of MCs and COM on topics related to
perioperative nursing practice.

Role Point Value

Certificates of Mastery 150 points

Microcredentials 50 points

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Perioperative Certification

A maximum of 100 points may be earned for earning an accredited perioperative-related certification or
completing the recertification process for an accredited perioperative-related certification. Accredited
perioperative-related certifications include NEA-BC, CAPA, CPAN, CRCST, or ABCGN—accreditation by ANSI,
ABSNC, or NCCA. The list is not intended to be all-inclusive. Other accredited certifications deemed equivalent
by the CEO of CCI in consultation with the CCI Credentialing Department may be accepted. CCI Credentials,
excluding CFPN, qualify for additional points in this category. The credential currently in the recertification
process cannot be utilized for points toward that recertification (e.g., CNOR cannot be used for CNOR
recertification points).

Attain/Maintain an Accredited Perioperative Certification Point Value

Initial Certification 30 points

Renewal of Certification 20 points

Precepting/Mentoring

A maximum of 100 points may be earned in the Precepting/Mentoring Category. Examples include mentoring a
new employee, orienting a new employee, and teaching practicum students.

Precepting Point Value

1 Precepted or Mentored Employee
• A minimum of 80 hours must have been spent with each employee or
25 points
student.
• A maximum of four (4) different employees and/or students is allowed.

Professional Growth & Development: Digital Media

A maximum of 50 points can be earned in this category. The content must be healthcare-related, and live
events can be repeated if presented to a new audience.

Blogs:

• Content/objectives must reference the CNOR task and knowledge statements in the applicant
handbook.
• 300-word minimum word count per entry.
• Must have a minimum of one post per month for 12 consecutive months.
• If all requirements above are met, 50 points will be awarded.
Podcasts:
• Objectives must reference the CNOR task and knowledge statements.

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 • Host 60 minutes of content. (minimum of 15-minute segments) = 20 points
• Facilitate 60 minutes of content. (minimum of 15-minute segments) = 10 points

Live Events:
• Hosting and/or organizing symposiums (live event/virtual/in person)
• Flyer, marketing materials, or link to applicable events and other online content.
• 1 hour of content presented = 10 points
Professional Development Activities:
• Education/training activities must reference the CNOR task and knowledge statements in the applicant
handbook (digital media, i.e., puzzle books, virtual escape rooms)
• Receive 25 points per activity.

Professional Organization Activities

A maximum of 100 points may be earned for coursework-related activities from CCI. These activities are
available in the “Professional Organization Activities” section of the CCI store.

Activity Point Value

10-question activity 10 points

20-question activity 20 points

Professional Presentations

A maximum of 150 points can be earned. A presentation may be repeated if presented to another audience.
The presentation must be on a healthcare-related topic.

Material Point Value

CE Podium Presentations
30 points
• minimum 30 minutes
In-service
10 points
• minimum 30 minutes
Non-CE Poster Presentation
20 points
• minimum 60 minutes
Poster Presentations
20 points
• minimum 60 minutes

Publishing

A maximum of 150 points may be earned in the Publishing category.

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 Material Point Value

Author, Book Review 20 points

Contributing Author, Book Chapter 30 points

Developer/Author of a Patient Education or Healthcare Professional
20 points
Resource
DNP Capstone Project 150 points

Doctoral Dissertation 150 points

Editorial, Peer-Reviewed Journal 30 points

Guest Editor, Peer-Reviewed Journal Issue 50 points

Peer Reviewer 25 points

Poster Presentation at a Professional Meeting 20 points

Primary Author, Book Chapter 50 points

Primary Author, Peer-Reviewed Journal Article 50 points

Secondary Author, Peer-Reviewed Journal Article 30 points

Subject Matter Expert (SME) or Reviewer for Journal Article or Book
20 points
Chapter

Reflection

A maximum of 50 points may be earned for reflective activities.

Reflection Point Value

Reflective Activity in CCI Store 25 points

Training Certificates

A maximum of 30 points may be earned for certificates of training by an approved provider (e.g., American
Heart Association, American Red Cross, or Military Training Network).

Event Type Point Value

ACLS 10 points

BLS 5 points

NRP 10 points

PALS 10 points

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 TNCC 10 points
Non-CE
• live taught perioperative training program
10 points
• examples include laser training, Da Vinci Robotics training, and informatics
training
Other training may be approved by CCI on a case-by-case basis. Documentation
must be provided to CCI for review

Volunteer Healthcare Related Service

A maximum of 100 points may be earned for volunteer service activities. Any combination of perioperative
volunteer service may be used toward the 100-point maximum. Examples of local events include Red Cross
volunteer activities, hospice programs, community wellness clinics, and Handy Helper visits. State nursing
association activities would qualify as a state event. Project Cure is an example of a regional organization. A
surgical mission trip outside the country would qualify as an international event.

Event Type Point Value

Local/Facility 5 points per activity

National/International
• Participant
25 points per activity

• Leadership role 50 points per activity

Regional 5 points per activity

State 15 points per activity

Non-Healthcare Related 15 points

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APPENDIX C: RECERTIFICATION AUDIT DOCUMENTATION
A percentage of recertification applications will be randomly selected for audit. If you are selected, you will be
notified after you have submitted your recertification application. Applicants chosen for audit will be required to
electronically submit copies of specific documentation, as outlined below.

NURSING CONTINUING PROFESSIONAL DEVELOPMENT

• Copies of attendance certificate(s) from an accepted provider must be provided. Transcripts may be
accepted instead of certificates but must include the accredited provider's name and number.
Transcripts that do not include accrediting provider information will not be accepted.

• CEs imported from AORN to your CCI account must be verified with certificates or a transcript.

ACADEMIC STUDY TOWARD HEALTHCARE-RELATED DEGREE COMPLETION

Copy of official or unofficial transcript.

PUBLISHING
Copy of the title page, table of contents, or abstract indicating you are the author, co-author, or contributor.

SERVICE AS A BOARD OR COMMITTEE MEMBER

• Board summary, minutes, or committee report (minimum of four meetings per year required).

• If official summaries are unavailable, a supervisor may provide a letter confirming committee service
and details.

PRESENTATIONS
A program brochure, activity documentation form (ADF), or completed course evaluation must be provided.
Each document must include the title, the presentation date, and the objectives of the presentation.

TEACHING A PERIOPERATIVE-RELATED COURSE IN ACADEMIC SETTING

Syllabus, course description, or other documentation that verifies the name and role of the instructor must be
provided.

PRECEPTING/MENTORING IN THE PERIOPERATIVE NURSE ROLE

Letter from applicant’s supervisor confirming precepting/mentoring experience including a minimum of 80
hours and date range. Practicums: copy of the agreement between the organization and university.

CCI VOLUNTEER COMMITTEE TEST DEVELOPMENT COMMITTEE

• Certificate of completion from each committee assignment. If you need a copy of your certificate, please
email [email protected]

• Letter of Participation

CCI VOLUNTEER EDUCATION DEVELOPMENT PRODUCT COMMITTEE

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Copy of points certificate. If you need a copy of your certificate, please email [email protected]

CERTIFICATION COACH
Certificate of achievement from CCI. If you need a copy of your certificate, please email coaches@cc-
institute.org.

ATTAIN/MAINTAIN PERIOPERATIVE-RELATED CERTIFICATION

Copy of certificate or wallet card.

CLINICAL INQUIRY
A final report summarizing evidence of participation in a QA, QI, EBP, or research project, including its impact on
current practice and/or patient outcomes.

PROFESSIONAL PERIOPERATIVE-RELATED VOLUNTEER SERVICE

Letter from supervisor or mission director on organization letterhead attesting to dates and contributions of
volunteer.

PROFESSIONAL ORGANIZATION ACTIVITIES

A copy of the points certificate must be provided. The points activity is automatically imported to your CCI
account if completed through CCI.

TRAINING CERTIFICATES

• Copy of training certificate by an approved provider (BLS, ACLS, PALS, etc.)

• If training grants contact hours, these should be reported under the “Continuing Education” category.

PROFESSIONAL GROWTH AND DEVELOPMENT: DIGITAL MEDIA

Copy of or link to content/objective materials presented or other documentation that verifies the digital media
activity.

REFLECTION/GAMES/CASE STUDIES
Copy of points certificate. The points activity is automatically imported to your CCI account if completed through
CCI.

ADDITIONAL POINTS ACTIVITIES

• True North: submission confirmation page showing author’s name

• Journal club: club summary, minutes, or committee report (minimum of four meetings per year
required).

• Other: copy of points certificate.

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APPENDIX D: CERTIFICATION MARK USE POLICY
The Competency and Credentialing Institute (“CCI”) owns several certification marks (the “Certification Marks”)
related to CCI’s perioperative nursing certification programs (e.g., CNOR®, CSSM®, CNS-CP®, CFPN®, and
CNAMB®). These Certification Marks represent that authorized individuals performing perioperative nursing
services have satisfied applicable requirements established by CCI. This Policy establishes the rules and
requirements for using the Certification Marks, including proper use on occupational and business materials by
individuals certified by CCI. All CCI-authorized individuals should review this Policy carefully to ensure all uses of
the Certification Marks conform to the policy requirements.

This Certification Mark Use Policy states the terms and conditions under which CCI certificants may use the
Certification Marks.

1. CCI retains all intellectual property and other ownership rights concerning the Certification Marks. CCI
may create and use additional certification marks as it deems appropriate.

2. CCI grants limited permission to use the Certification Marks to qualified individuals who satisfy all
applicable CCI certification requirements. Consistent with applicable law and organizational policies, CCI
will ensure that the Certification Marks are displayed and otherwise used properly, as such use
represents CCI certification to the public.

3. Permission by CCI to use a CCI Certification Mark does not include authorization to use any CCI
trademarks.

4. Use of the Certification Marks is limited strictly to those individuals who are CCI certificants in good
standing. Each CCI certificant accepts and assumes sole responsibility for understanding and satisfying
all CCI organizational and legal requirements related to using and displaying the Certification Marks. CCI
will not be liable or otherwise responsible for any claims, complaints, suits, or damages relating to a
certificant’s use or display of a Certification Mark.

Among other requirements, each certificant is responsible for ensuring that the use of any Certification Mark on
occupational and business-related materials (e.g., business cards, stationery and/or letterhead, email signatures,
advertisements, brochures, or Internet websites) is consistent with this Policy, and is not in conflict with
applicable laws. CCI assumes no responsibility concerning the interpretation or application of such legal
requirements.

CCI certificants are prohibited from making any public statement or representation related to the CCI
certification programs that bring CCI into disrepute, that is materially false, or that is otherwise contrary to the
interests of CCI.

1. Permission to use the CCI Certification Marks is limited to CCI certificants. It may not be transferred to,
assigned to, or otherwise used by any other individual, organization, business, or entity.

2. Each individual CCI certificant must use the Certification Marks only in conjunction with their name and
in connection with the services related to the certification, i.e., perioperative nursing services. The
Certification Marks may not be positioned, displayed, or used in a manner that may lead the public to
believe that a company or organization is certified or otherwise endorsed by CCI.

Certification Marks must be associated only with the certified individual that is authorized. Certificants are
prohibited from using the Certification Marks to expressly or implicitly suggest an affiliation or other relationship
with CCI that is untruthful or inaccurate. Additionally, Certification Marks should always be used in their

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entirety. If a Certification Mark is protected by federal registration, the registration notice (“®”) must appear at
least once in the advertising copy.

Concerning other affiliation marks and/or logos, the CCI Certification Marks may be located near such other
marks or logos but must remain separate and distinct to avoid confusion concerning the source of the
certification and to avoid the appearance that other marks, certifications, credentials, designations, or
organizations are associated with, or endorsed by, CCI. Furthermore, the Certification Marks may not be
modified except only as authorized by CCI.

The Certification Marks denote more than merely a title; they confirm that the individual certificant has met
CCI’s high standards of excellence. Thus, proper use of a Certification Mark must specifically note such
certification, such as through the use of a term such as “professional,” “practitioner,” “certificant,” or
“certification.” Examples of proper use are noted below. Other proper uses include listing the particular
certification on a “CERTIFICATIONS” portion of a resume or social media profile. Use solely of a Certification
Mark itself at the end of the certificant’s name, with nothing more, is not the proper use of a Certification Mark.

Examples of proper uses and appearance of a CCI Certification Mark include, but are not limited to:

Jane C. Doe John A. Smith

CNOR® Certificant a CCI CSSM® Professional
Jane B. Thomas John D. Doe holds a
CNS-CP® Nursing Professional CNAMB® certification from CCI

1. A CCI certificant may not prohibit, restrict, or otherwise limit the authorized and appropriate use of a
CCI Certification Mark by another certificate.

2. Each CCI certificant is responsible for reporting the unauthorized use, misuse, or other violation of this
Policy to CCI promptly. This reporting responsibility includes any circumstance where the use of a CCI
Certification Mark is related to an individual or organization that is not a CCI certificant or where a CCI
certificant misuses a Certification Mark.

3. All mark misuse complaints and other matters concerning potential violations of this Policy will be
reviewed and resolved by the CCI’s designee. If, after notice and a fair opportunity to respond, the
designee determines that there has been a violation of the terms of this Policy, CCI reserves the right to
take any action consistent with CCI policies or applicable law, including but not limited to certification
suspension or revocation.

In addition, CCI may refer cases of Certification Mark misuse, infringement, or other similar matters to
appropriate agencies and other organizations or initiate appropriate legal action.

Updated 01/2024, Copyright © 2024, CCI® Competency & Credentialing Institute | CNOR® Handbook | 49