CSC (Adult) - Cardiac Surgery

Cardiac Surgery Subspecialty Certification (CSC) (Adult) subspecialty certification from the American Association of Critical-Care Nurses (AACN) recognizes certified nurses providing direct care to acutely/critically ill adult patients in the first 48 hours following cardiac surgery. These nursing professionals may include those working in post-anesthesia care or cardiovascular or cardiothoracic surgery or units.

Exam Format

The CSC (Adult) exam is a computer-based test with 90 multiple-choice questions. The exam consists of 75 scored questions and 15 unscored questions used to gather statistical data. The CSC test plan includes:

• Procedures: 11%

  • Cardiovascular 

  • Thoracic

• Complications (33%)

  • Cardiovascular

  • Respiratory

  • Endocrine

  • Hematology/Immunology

  • Neurology

  • Gastrointestinal

  • Renal

  • Multisystem

  • Behavioral/Psychosocial

• Therapeutic Interventions (43%)

  • Cardiovascular

  • Pharmacology

  • Respiratory

  • Endocrine

  • Hematology and Immunology

  • Neurology

  • Renal

  • Standards of Care

• Monitoring and Diagnostics (13%)

  • Cardiovascular

  • Respiratory

  • Neurology

Candidates may take the exam in person at PSI Testing Centers where proctors administer the exam via on-site computers. They may also opt for Live Remote Proctoring (LRP) to take the exam at home or elsewhere using a computer in an area free from people or distractions.

Whichever route candidates’ choose, their exam results appear on-screen after completing the exam. A detailed score report arrives via email within 24 hours. Those who pass receive their wall certificate via postal mail approximately 3 to 4 weeks after receiving exam results.

The certification is also available in the online Certification Verification system the day after the exam. Candidates may request a letter verifying their certificate be emailed to them, their employer, or their state board of nursing.

• Completion Time: Candidates have 2 hours to complete the CCRN-E exam

• Cost: $140 for AACN members and $230 for non-members / Retest $115 for AACN members or $160 for non-members

Unsuccessful candidates may reapply to the ACCN for a retest. Those who took the exam within their most recent eligibility period may receive a discounted retest fee. Candidates may retake the CSC exam up to 4 times within a 12-month period. After 12 months, they must sign a new honor statement.

Rescheduling, Cancellations, and Extensions

A candidate may reschedule or cancel their exam up to 48 hours before their scheduled testing date. Refunds or extensions aren’t given for missed appointments. To cancel or reschedule their appointment, candidates must:

• Log into the AACN customer dashboard

• Click Certification to reschedule the exam

• Select “Manage Appointment” under “My Certifications”

• Receive a rescheduling confirmation email from PSI with the new date and time

• Pay a $100 exam extension fee

Eligibility

Applicants must hold a current, valid, unrestricted, and unencumbered RN or APRN license. They also must complete one of two clinical practice hour requirements:

• Two-Year Option: Acquired at least 1,750 practice hours as an RN or APRN, providing direct care to acutely or critically ill adult cardiac surgery patients over the past two years

  • 875 hours within the 12 months immediately before applying

• Five-Year Option: Acquired at least 2,000 practice hours as an RN or APRN, providing direct care to acutely or critically ill adult cardiac surgery patients within the past five years

  • 144 hours within the 12 months immediately before applying

Practice hours must:

• Occur in a facility based in the U.S. or Canada or elsewhere if it’s comparable to U.S. standards

• Be spent actively providing direct patient care of acutely or critically ill adult patients

• Be verifiable by a clinical supervisor professional colleague (RN or physician)

  • Must provide contact information of person verifying clinical hours for potential audits

Application Process

• Apply online or submit a paper application

  • Online application has same-day processing

  • Paper applications may take 2 to 4 weeks to process

• Provide RN or APRN license and expiration date

• Provide name, address, phone number, and email address of the clinical supervisor or professional colleagues verifying practice hours

• Receive confirmation email with instructions on scheduling the exam and the eligibility period for taking the exam

• Contact AACN Customer Care at 1-800-899-2226 or [email protected] if email doesn’t arrive

• Determine preferred testing method, either PSI Testing Center or Live Remote Proctoring

• Schedule exam clicking the "Schedule Exam" button in the AACN customer dashboard

• Review the CCRN-E Exam Handbook and the Certification Exam Policy Handbook

CSC (Adult) certification is valid for three years. Certification begins the first day of the month the candidate passed the exam and expires three years later. AACn sends renewal notifications 4 months before the scheduled renewal date. Renewal applicants may renew online up to 4 months before their renewal date. They may also mail a paper renewal application, which must be postmarked or faxed on or before the renewal date. Certificants who renew online receive their new CSC certificate within 2 to 4 weeks. Those who renew through the mail or a fax receive their new CSC certificate within 3 to 4 weeks.

Renewal Requirements

• Maintain a current, valid, unrestricted, and unencumbered RN or APRN license

• Hold a current clinical nursing specialty certification to attach the CSC subspecialty that:

  • Involves direct adult patient care

  • Is nationally accredited by American Board of Specialty Nursing Certification (ABSNC) or National Commission for Certifying Agencies (NCCA)

  • Includes key nursing competencies as outlined by the Synergy Model for Patient Care

• Passed the CSC certification exam for adults

• Complete 432 RN or APRN practice hours within the three-year renewal period, which must:

  • Include 144 hours practiced within the 12 months immediately before the scheduled renewal date

  • Primarily focus on acutely/critically ill post-surgical cardiac patients in the first 48 hours of their operation

  • Include active involvement in the care of cardiac and/or cardiac surgery patients

  • Be verifiable by a supervisor or colleague (RN or physician) in writing

• Complete required CERPs or pass the CCRN-E exam again

Renewal Options

CSC (Adult) certification renewal options include renewal by Synergy Continuing Education Recognition Points (CERPs) or by exam. Certification status options include inactive, retired, or alumnus.

Renewal by CERPs

• Meet renewal eligibility requirements for CSC (Adult)

• Complete 25 clinical judgment CERPs in category A during the three-year certification period

Renewal by Exam

• Meet renewal eligibility requirements for CSC (Adult)

• Pass the CSC (Adult) exam before the certification renewal date

  • Candidates may not retest early, then attempt to renew by CERPs if they don’t pass the exam

Renewal by Inactive Status

CSC credential holders may choose to renew under inactive status if they don’t meet renewal eligibility requirements and don’t want to lose their certification status. Inactive status provides nurses additional time, up to three years, to meet renewal eligibility requirements and accrue 144 practice hours within the most recent year. However, nurses may not use the CSC credential during the inactive status. Nurses can’t use inactive status for two consecutive renewals but can use it multiple times.

Submit a renewal application and pay the required fees.

Cost:

• $115 renewal by exam for AACN members or $160 for non-members

• $75 renewal by CERPs for AACN members or $130 for non-members

• $55 inactive status renewal for for AACN members or $145 for non-members

Alternate Status

The alumnus status is available for nurses who no longer work in acute/critical care but are still in the nursing field. It’s valid for three years. The Alumnus CSC isn’t eligible to renew an active certification. Certificants must retake the exam as an initial applicant.

A candidate for retired status is eligible when no longer working in a position requiring an RN license and has no plans to return. A retired status renewal is valid for three years.

Renewing the CSC subspecialty by CERPs requires a total of 25 Category A Clinical Judgment CERPs with the three-year certification renewal period. CERPs must pertain to cardiology and may include any topic on the CSC Test Plan. Initial or renewal ACLS courses may be counted as CERPs for CSC renewal once during the three-year certification renewal period. Applicants may find free CE courses for CSC renewal on the ACCN website.

CSCs should maintain a logbook of completed CERPs for at least three years in the event of an audit. A CERP log is available in the CSC Renewal Handbook.

• The AACN provides comprehensive information about the application process, exam information, resources, and sample practice questions to help study for the exam in the CSC Exam Handbook.

• AACN CSC (Adult) Certification Practice Exam Subscriptions:

  • Basic subscriptions provide a 30-day access to 150 multiple-choice questions and answers. Cost: $25 for AACN members or $30 for non-members

  • Premium subscriptions include 180-day access to 100s of multiple-choice questions and answers. Cost: $65 for AACN members or $75 for non-members

  • Free trial subscriptions offer 7-day access to 30 practice questions and answers.

• The AACN Store offers numerous textbooks, resources, and practice exams for purchase.

• Cardiac Surgery Essentials for Critical Care Nursing, 3rd Ed. helps prepare nurses taking the CSC subspecialty exam and is a must-have reference for all nurses caring for acutely and critically ill post-surgical cardiac patients.

To be eligible for the CSC accreditation, a candidate must have an RN or APRN license and a clinical nursing specialty certification to combine the CSC cardiac subspecialty credential. Nurses may also combine the Cardiac Medicine Certification (CMC) subspecialty accreditation to the same primary certification. These certifications may include but aren’t limited to:

• Acute/Critical Care Knowledge Professional (CCRN)

• TeleICU Acute/Critical Care Nursing (CCRN-E)

• Progressive Care Certified Nurse (PCCN)

• Acute Care Nurse Practitioner Certification (ACNPC)

• Adult-Gerontology Acute Care Nurse Practitioner (AGACNP-BC)

• Acute Care Clinical Nurse Specialist (CCNS)

• Adult Clinical Nurse Specialist - Board Certified (ACNS-BC)

• Certified Perioperative Nurse (CNOR)

• Certified Registered Nurse First Assistant (CRNFA)

• Certified Post Anesthesia Nurse (CPAN)