CHSN (Certified in Healthcare Safety-Nursing)

The International Board for Certification of Safety Managers, also known as BCHCM, was established in 1976 as a not-for-profit independent credentialing organization. The Board establishes certification and re-certification requirements for the Certified in Healthcare Safety - Nursing (CHSN). The Board operates as an independent professional credentialing organization that is not affiliated with any other membership group, association, or lobbying body. The Board exists solely for the purpose of issuing individual certifications to qualified candidates. Our mission is to 'Upgrade the Profession' by offering real world and practical certifications.


CHSN Background

IBFCSM developed the CHSN designation in 2014 to provide nursing personnel with an opportunity to earn a practical safety credential that addresses both patient safety and nursing occupational safety issues. CHSN Exams contain at least 100 multiple choice questions.  A qualified candidate for the CHSN credential must hold one of the following nursing designations:


Registered Nurse (RN) -  Master Level Candidate

Licensed Practical Nurse (LPN) - Master or Associate Level Candidate Depending on Qualifications

Licensed Vocational Nurse (LVN) - Master or Associate Level Candidate Depending on Qualifications

Certified Nursing Assistant/Aide (CAN) - Associate Level Candidate Only


CHSN Exam Outline


1. Patient Safety Principles (20%)

A. Quality Improvement Processes

B. Environment of Care Issues

C. Staff Education and Training

D. Information, Reporting, and Analysis Activities

E. Patient Safety Goals

F.  Emergency Management

G. Safety Systems and Cultures

H. Effective Communication with Patients

I. Staff Safety, Training, & Education

J. Root Cause Analysis & Improvement Methods

K. Staff Communications


2. Patient Safety Risks (20%)

A. Slip, Trip, & Fall Prevention

B. Negligent Care & Failure to Treat

C. Medication Errors

D. Improper Diagnosis

E. Patient Identification

F. Bed Safety & Bed Sores

G. Patient Moving & Positioning

H. Suicide & Elopement

I. Wrong Site Surgery

J. Infection Control

K. Restraint Safety

L. Operating Room Safety

M. Anesthetic Gases

N. Life Safety & Evacuation

O. Housekeeping Effectiveness

P. Medical Equipment Safety & Reliability

Q. Security & Violence Risks

R. Infant Abduction

S. Healthcare Acquired Infections

T. Opportunistic Infections


3. Patient Safety Standards & Organizations (10%)

A. The Joint Commission & Other Accreditation Standards

B. The Centers for Medicare & Medicaid Services

C. The Food and Drug Administration (FDA)

D. The Nuclear Regulatory Commission (NRC)

E. The American Hospital Association (AHA)

F. The Centers for Disease Control and Prevention (CDC)

H. The Institute of Medicine (IOM)

I. The Agency for Healthcare Research and Quality (AHRQ)

J. The Association of Healthcare System Pharmacists (AHSP)

K. The Institute of Safety Medication Practices (ISMP)



4. Environmental and Occupational Safety (25%)

A.  Occupational and Environmental Safety Management Principles

B.  General Management Principles

C. Occupational Safety and Health Administration (OSHA)

1. OSH Act and General Duty Clause (Dangerous Drugs, TB, Lasers, Workplace Violence)

2. Healthcare Related Standards

            (a) Hazard Communication (29 CFR 1910.1200)

            (b) Respiratory Standard (29 CFR 1910.134)

            (c) Electrical Standards (29 CFR 1910.303)

            (d) Bloodborne Pathogens (29 CFR 1910.1030)

            (e) Healthcare E-Tools (OSHA Website)

D. The Environmental Protection Agency (40 CFR)

E. The Federal Insecticide, Fungicide, and Rodentcide Act (FIFRA)

F. Nuclear Regulatory Commission (10 CFR)

G. Food and Drug Administration (21 CFR)

H. Department of Health and Human Services (42 CFR) NIOSH, CMS, AHRQ, ATSDR, etc.

I. Physical Hazards (Electrical, machine, equipment, tools, noise, radiation, etc.)

J. Chemical Hazards (Disinfectants, pesticides, solvents, dangerous drugs, gases, etc.)

K. Ergonomic/Environmental Hazards (Repetitive tasks, falls, musculoskeletal disorders, etc.)

L. Biohazards (Legionella, waste handling, sharps exposures, construction risks, etc.)

M. Psycho-Social Hazards (Workplace violence, security, substance abuse, stress, shift work, etc.)

N. Healthcare Clinical and Support Department Safety


5. Voluntary and Standards Organizations (25%)

A. National Fire Protection Association (NFPA)

B. American National Standards Institute (ANSI) and American Society of Testing Materials (ASTM)

C. American Society of Heating, Refrigerating, & Air Conditioning Engineers (ASHRAE)

D. Underwriters Laboratory (UL) and Factory Mutual (FM)

E. American Conference of Government Industrial Hygienists (ACGIH)

F. Joint Commission (EOC, Life Safety, and Emergency Standards)

G. American Osteopathic Association (AOA), Det Norske Veritas (DNV), and CMS

H. Life Safety (NFPA 101) and Healthcare Facilities (NFPA 99)

I. Fire Safety Management

J. Infection Control and Prevention

G. Pandemic Planning and Infection Related Medical Surge Issues


CHSN Study References

1. To Do No Harm, Jossey-Bass Publishers, 2005

2. The Essential Guide for Patient Safety Officers, Joint Commission Resources, 2009

3. Healthcare Hazard Control and Safety Management, 3rd Edition, Taylor and Francis, 2014

4. Principles of Risk Management and Patient Safety, Jones & Bartlett, 2011

5. Contact IBFCSM for additional information about self-study materials.

Example Questions

1. Which of the following best describes the benefit of implementing a patient lifting program?

a. Improved patient quality of care*

b. Reduced workers' compensation costs

c. Greater resident satisfaction

d. Increased morale for employees  

2.  Which NFPA publication exclusively addresses healthcare facility topics?

a. NFPA 13

b. NFPA 72

c. NFPA 99*

d. NFPA 101  

3. Which control measure should be considered first when protecting workers from chemical airborne contaminants?

a. Isolating the hazard far from most workers

b. Providing proper local and general ventilation*

c. Requiring use of supplied air respirators immediately

d. Conducting periodic monitoring in all exposure areas  

4. Which of the following processes is considered a rapid change method?

a. Fishbone Causation Analysis

b. Plan-Do-Check-Act*

c. Root Cause Analysis

d. Failure Mode & Effect Analysis  

5. Which of the following statements describes the mission of an environmental services function?

a. Ensure the entire facility looks clean, presentable, and shiny at all times

b. Manage the many polluted indoor and outdoor environments of healthcare organizations

c. Provide scheduled and on call cleanup services to all departments around the clock

d. Clean for safety and health first by controlling pathogenic microorganisms*  

6. Which of the following elements of a voluntary incident reporting system is most vital to its success?

a. Standardization

b. Feedback capability*

c. Accountability

d. Comprehensive