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Format | CRRN Course Contents | CRRN Course Outline | CRRN test
Syllabus | CRRN test
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
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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.
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.
a. Physiology and management of health, injury, acute and chronic illness, and adaptability
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
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.
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,
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)
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.
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,
c. Bladder and bowel training (e.g., scheduled self -catheterization, timed voiding, elimination
d. Pharmacologic and non-pharmacological interventions
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,
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.
a. Anatomy, physiology, and interventions related to musculoskeletal, respiratory, cardiovascular, and
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)
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.
a. Factors affecting sleep and rest (e.g., diet, sleep habits, alcohol, pain, environment)
c. Physiology of sleep and rest cycles
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,
d. Using technology (e.g., sleep study, CPAP, BiPAP, relaxation technology)
Task 6: Apply the nursing process to optimize the individual's neurological function.
a. Measurement tools (e.g., Rancho Los Amigos, Glasgow, Mini Mental State Examination, ASIA, pain
b. Neuroanatomy and physiology (e.g., cognition, judgment, sensation, perception)
c. Pain (e.g., receptors, acute, chronic, theories)
e. Safety concerns (e.g., seizure precautions, fall precautions, impaired judgment)
a. Assessing cognition, perception, sensation, apraxia, perseveration, and pain
b. Implementing and evaluating strategies for safety (e.g., personal response devices, alarms, helmets,
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
Task 7: Apply the nursing process to promote the individuals optimal psychosocial patterns and holistic wellbeing.
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
a. Assessing and promoting self-efficacy, self-care, and self-concept
b. Accessing supportive team resources and services (e.g., psychologist, clergy, peer 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
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
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.
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
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.
a. Goal setting and expected outcomes (e.g., SMART goals, functional independence measures [FIM],
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)
a. Advocating for inclusion of appropriate team members
b. Applying appropriate theories (e.g., change, leadership, communication, team function,
c. Communicating and collaborating with the interdisciplinary/
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.
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
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
Domain IV: Legislative, Economic, Ethical, and Legal Issues (23%)
Task 1: Integrate legislation and regulations to guide management of care.
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
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.
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
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.
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)
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.
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)
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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specialists say the starvation crisis has accelerated in the united states right through the COVID-19 pandemic.
they say a lack of healthy food can exacerbate fitness considerations, including heart ailment and excessive blood force, in americans of all ages.
They word that hunger can additionally have an effect on toddlers’s efficiency in school in addition to cause developmental delays.
All data and records are according to publicly attainable data at the time of book. Some assistance could be out of date. visit their coronavirus hub and follow their are living updates web page for essentially the most latest guidance on the COVID-19 pandemic.
“As quickly as I get the box, I delivery considering: i will be able to put the mixed vegetables with the floor meat. I can make soup and beef stew, rice and beans and pasta. I actually have stuff for salads. They’re even giving me eggs I can make for breakfast.”
That’s the concept system Mary Castillo goes through twice a month when she receives food packing containers for her household.
The Texas grandmother is raising six of her teenage grandchildren. on account of the COVID-19 pandemic, a few of those toddlers are remote learning from home.
That means they don’t get the breakfast and lunch they might at all times get at school. So offering those nutrition takes an even bigger chunk out of the family’s meals finances.
Castillo is one among tons of of families who line up at a San Antonio food bank two Saturdays a month.
“at this time, the food bank helps me fill in the gaps and stretch out my food so it lasts. I’m just grateful and very blessed,” she instructed Healthline.
experts say tens of millions greater households are “meals insecure” right now, involved a way to put food on the table in addition to the place their subsequent meal will come from.
A fresh survey discovered that some 29 million adults — 14 percent of the U.S. population — pronounced being food insecure. That’s in comparison to three percent earlier than the pandemic.
Advocates who combat starvation among toddlers say the graphic is much more alarming.
“We’ve considered a beautiful large increase in the variety of infants that are actually hungry every day,” referred to Caron Gremont, director of early childhood starvation at Share Their energy, the mum or dad firm of the No child Hungry campaign.
“What we’re estimating is that these days we’re taking a look at about 17 million infants dealing with hunger, compared to less than eleven million just a year ago,” Gremont instructed Healthline.
“Have I considered the results of meals insecurity right through COVID? arms down,” delivered Dr. Kofi Essel, MPH, a pediatrician at babies’s national scientific core in Washington, D.C.
“We do some thing in their medical space the place they display all of their households universally for meals insecurity,” Essel instructed Healthline.
“here's anecdotal as a result of they haven’t amassed the data, however my colleagues and myself are seeing loads of their adults answering the screeners positively and asking what components can be found. and they’re describing improved stress at home,” he defined.
experts say addressing starvation isn’t just an economic challenge however a fitness concern, too.
“Globally, here's very true for essentially the most susceptible populations in a community, including little ones under 5, [and] pregnant and breastfeeding ladies,” Bridget Aidam, PhD, director of technical services and innovation at motion in opposition t hunger, told Healthline.
“babies who are scuffling with food insecurity are at enhanced possibility for poor fitness, hospitalization, developmental delays, and poor educational efficiency” stated Gremont.
“if your stomach isn’t full, it’s more durable to focus in type. Your look at various ratings drop,” she delivered. “You come to be with reduce commencement prices. It’s directly connected to salary and job success.”
And stories have linked food insecurity to persistent situations in older adults reminiscent of excessive blood power, heart disorder, stroke, bronchial asthma, melanoma, arthritis, and diabetes.
On Friday, President Joe Biden signed an executive order designed to increase benefits to about 40 million american citizens who count on federal meals tips.
“they're in this condition via no fault of their personal,” Biden said at a news convention.
Even with the Supplemental meals suggestions software (SNAP) or food stamp merits all the way through the pandemic, many families nonetheless battle to position meals on the desk.
The order the president signed calls on the U.S. department of Agriculture (USDA) to expand the emergency SNAP advantages Congress accepted within the yr-conclusion COVID-19 reduction equipment to 12 million greater enrollees whose incomes weren’t low adequate for them to qualify.
moreover, it calls on the USDA to allow states to make it less complicated for greater people to enroll in the application.
The order also calls on the USDA to raise the Pandemic electronic advantage transfer (P-EBT) by means of 15 p.c. That advantage became designed to supply families additional cash to supply nutrients for their little ones who would perpetually get fed at school.
The strikes had been welcomed by groups working to combat hunger.
“We applaud the Biden Administration’s swift action. this is a fine first step,” said Eric Mitchell, the executive director of the Alliance to conclusion starvation.
“The president’s govt order will provide those families a little extra cash in their wallet to buy the food they need to support their babies thrive,” Mitchell told Healthline.
“My colleagues are seeing a lot of households who can be privately insured using substances like the food pantries to access food,” referred to Essel. “They make too lots money to access some of the federal food programs, in order that they ought to entry more without problems available emergency food programs.”
meals banks and food suppliers say they’re seeing extra households line up. commonly it’s their first time.
“We’re seeing individuals who are trained and had brilliant jobs, but their companies closed or shut down on account of the pandemic. They’re lining up with each person else,” noted Bernie Fowler Jr, government director and president of Farming 4 hunger, a firm that supplies sparkling produce and greens to meals banks in southern Maryland.
Share on PinterestCars line up at a food financial institution in significant Florida. Paul Hennessy/SOPA photos/LightRocket/Getty pictures
Fowler pointed out the pandemic and the dire want sent his organization scrambling to seem for brand new ways to get the job performed.
“We all started reevaluating what they are able to grow that may have an extended shelf life; that’s effortless to fix,” he advised Healthline. “i needed it to be used in these three things… soups, stews, and stir-fries. issues that may remaining for a number of foodstuff, can be frozen, otherwise you can mix the stir-fry with some rice.”
Essel stated the food banks and pantries fill an obtrusive want, however because they rely on volunteers and donations, they can’t do the job by myself.
For each meal a meals bank gives, SNAP is estimated to deliver nine.
“We know these federal food courses have documented evidence of rescuing households from meals insecurity, from poverty,” Essel spoke of. “They increase ordinary fitness and reduce admissions to the hospital. They’re legitimate and consistent.”
The president additionally requested the USDA to start revising the Thrifty eating regimen that determines the advantages for SNAP to make it enhanced reflect the cost of a in shape food regimen in nowadays’s dollars.
That overhaul become directed within the 2018 Farm bill.
As a part of his proposed American Rescue Plan, Biden is looking on Congress to:
extend the 15 % SNAP benefit raise.
make investments an additional $3 billion through the special Supplemental meals application for girls, children, and youngsters (WIC) to assist vulnerable moms and youngsters get the meals they want.
look for creative methods to guide eating places as a essential link in the food supply chain to aid feed families in need.
provide U.S. territories with $1 billion in additional foodstuff assistance funding.
Advocates say all of those measures will be crucial to tackle the starvation disaster.
“We recognize that the administration acknowledges that investing in federal nutrients programs similar to SNAP, WIC, and Pandemic EBT is an important a part of its COVID-19 restoration agenda,” Mitchell noted.
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