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Test Number : CRRN
Test Name : Certified Rehabilitation Registered Nurse
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CRRN test Format | CRRN Course Contents | CRRN Course Outline | CRRN test Syllabus | CRRN test Objectives

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

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

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

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Medical Registered answers

Manufacturing scientific machine In China | CRRN Cheatsheet and test Questions

China is the “world’s factory,” a world manufacturing hub that produces the tremendous majority of electronics add-ons used all over the world. these accessories power every little thing from smartwatches to vehicles to home equipment, in addition to essential scientific machine corresponding to ventilators, ultrasound machines, medical institution beds, and more. however with particularly excessive tariffs imposed by way of the USA on many of these goods – including scientific machine – is it worth it for manufacturers to persist with their operations in China?

The business has been divided on that. You’ve likely viewed your fair proportion of stories about main OEMs moving some of their manufacturing operations to different international locations. This past spring, as creation strains shut down as a result of COVID, it’s no surprise individuals have been taking into account the advantages of reducing their reliance on China.

besides the fact that children, does fending off those tariffs warrant the massive effort it takes to relocate operations? After a protracted year and a lot of challenging selections, the overwhelming reply has been…no. for many manufacturers, the advantages outweigh the 25% tariffs.

So what are the merits of producing medical machine in China?

abilities #1: Staying in China poses much less chance than moving

With alternate comes possibility: that’s a fact of lifestyles. Switching manufacturing companions, even inside a place, has enormous challenges. Relocating to an entire new country is even more time-consuming, expensive and dangerous, with a steep learning curve that comprises extensive go back and forth, distinct factory excursions, work classes, and extra. And it’s a level of possibility many aren’t inclined to include.

in line with Forbes, “producers are sticking with partners they understand and have faith, despite the tariffs. With constrained go back and forth, de-risking new companions has been tremendously problematic, so most have opted to work with teams they know.”

moreover, China lived through COVID-19 for months before it impacted the relaxation of the area: that experience has enabled them to be on the forefront of constructing strict virus controls. With these controls, the forms of shutdowns that happened within the first months of 2020 are extremely not likely, and scientific device groups should be in a position to count on continuity and supply chain dependability moving ahead.

abilities #2: a massive, tremendously-expert labour force

China has the largest labour drive in the world, topping out at 783 million people. unlike international locations with comparable populations, like India, they've been a producing hub for 20 plus years, and have the depth and breadth of specialised skills required to construct the top rate-best electronics obligatory for clinical machine.

talents #three: Low labour expenses

yes, labour charges in China had been creeping up due to the fact minimal wages have been instituted in 1995, with jumps regarding wage increases in 2010 and 2019 – and they are larger than countries like India or Vietnam. but they are nonetheless dramatically lessen than in western countries. for example, in Guangdong, a key manufacturing region in China, minimal wage is approximately $2.15 an hour.

take into account that with these marginally bigger wages come skills and experience you gained’t locate in other regions, with more desirable speed and a good deal extra efficient lead times than other nations can give.

expertise #four: nice of logistics and infrastructure

groups can improvement tremendously from China’s dependent manufacturing background. they have mighty infrastructure in area to circulate every thing from raw materials to accomplished products directly and correctly in the course of the country and across overseas borders. 40% of China’s roads are countrywide highways, and they have 2/3 of the realm’s high-speed rail traces, spanning 290,000 km, with trains that may travel as much as 250 km an hour. Add modern cities, world-classification airports and marine ports to the combine, and you have got a setup no other nation can come close to.

in response to Wharton magazine, “China has arguably the foremost genuine infrastructure backyard the western world.”

abilities #5: a sturdy domestic clinical gadget market

the dimensions of the manufacturing China does for his or her own scientific market is colossal, representing close to $100 billion in fitness care spending. Which capability western agencies have access to a market focused on pleasant and innovation – one they could leverage for their own creation and growth. This also means they can draw on the nation’s effective manufacturing provide chain, including premiere, low-budget raw materials that can also be used for native production.

talents #6: State-of-the-artwork manufacturing amenities

China has more FDA-registered clinical manufacturing amenities (category II and class III) than some other nation other than the us. That can be why a few colossal scientific producers,  together with Roche and Johnson & Johnson (with Bayer and Novartis announcing upcoming plans), have moved no longer just production amenities to China, however additionally R&D operations.

The “Made in China” initiative is additionally expanding company confidence within the quality of chinese language goods. President Xi Jinping has dedicated to making the words “Made in China” synonymous now not with low cost, low-exceptional goods, but with ideal manufacturing, primarily for advanced products like clinical electronics.

The massive disadvantage: 25% tariffs have a big effect on profitability

due to change wars between the USA and China, tariffs have escalated to punitive tiers. and never simplest do they consist of accomplished items, however also metal alloys (together with metal and aluminum) used in lots of medical devices. From this standpoint, there’s no arguing that manufacturing in countries that haven’t had this tariff imposed on them is the more affordable choice.

now not all medical objects are discipline to the tariff, despite the fact. There are a few exceptions, which include microwave ablation antennas, tube suspensions used to place X-ray gadget, and food allergen analyzers. Plus, medical device manufacturers can apply for particular person exemptions, however that can also no longer be effortless: a few massive medtech enterprises have had their purposes rejected.

As a workaround, some producers were routing chinese language-made goods via other nations, like Vietnam, adding “Made in Vietnam” labels to stay away from the tariffs. They don’t advocate this tactic: both the U.S. and Vietnam frown upon fraudulent labeling, and any agencies found doing this are more likely to face heavy fines.

Negotiations with the united states govt over tariffs continue, and there is hope that with the incoming administration, the problem could be addressed in a means that’s beneficial to the industry. despite the fact, the influence of the new Presidency continues to be to be seen: political analysts predict that Biden is probably going to be a little softer with China than Trump has been. but regardless of some originally promising statements, there’s little indication he'll elevate the current tariffs.

ultimately, the talk we’ve been listening to about restructuring deliver chains has ended up being in the main that: speak. regardless of punitive tariffs and COVID issues, producers have overwhelmingly chosen to dwell put. They’re sticking with depended on partners, a skilled personnel, refined manufacturing capabilities, and low labour expenses, which for many, outweigh the tariffs.

now not certain if manufacturing your medical device in China is the appropriate option to your enterprise?

in case you’re brooding about moving your operations out of China, confer with us about factors to accept as true with. they are able to assist you weigh the pros and cons to look what works top-rated in your operation.

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