2025 CNAMB® Job Task Analysis
Elevating Professional Standards in Perioperative Nursing
The Competency & Credentialing Institute (CCI®) is committed to ensuring its certification programs reflect the evolving practices of the perioperative nursing profession.
Overview of the 2025 Job Task Analysis
To maintain the highest professional standards, CCI conducts a comprehensive Job Task Analysis (JTA) every 5–7 years. This gold-standard process is crucial for developing high-stakes professional examinations. The JTA process for the CNAMB® certification began in 2025 and was facilitated by PSI psychometricians. This rigorous, multi-step process ensures our exams remain current, fair, and reflective of the competencies required for safe and effective perioperative nursing in an ambulatory setting.
On November 16, 2025, the CCI Certification Council voted to adopt the results of the 2025 Job Task Analysis for CNAMB. As a result, the new CNAMB exams, informed by these results, will launch in 2027.
How Does the Job Task Analysis Work?
1. Committee Meeting
A diverse panel of subject matter experts (SMEs) collaborates to define the scope of practice by identifying essential tasks and knowledge areas. The panel reflected varied work settings, specialties, and geographic locations, ensuring a balanced and unbiased approach. The committee was tasked with refining both the task competency areas and knowledge statements through multiple days of discussion.
2. Survey
Practicing nurses across the field validate the committee’s work, ensuring the examination aligns with the current realities of ambulatory perioperative practice.
3. Examination Specifications
Using survey data, SMEs create an Examination Content Outline, which forms the basis for the updated certification exams.
JTA Timeline
What’s Changing?
The updated Examination Content Outline ensures a robust and relevant assessment for both early-career and experienced ambulatory perioperative nurses.
As a result, the exam will include the following eight key competency areas:
- Preoperative Patient Assessment and Plan of Care
- Intraoperative Care
- Postoperative Care and Transfer of Care
- Communication and Documentation
- Personnel, Services, and Materials Management
- Instrument Processing and Supply Management
- EmergencyManagement
- Professional and Ethical Responsibilities
What This Means for You
The JTA process ensures that CCI certifications remain a trusted benchmark of excellence, enabling perioperative nurses to demonstrate their competency, grow their careers, and contribute to the profession’s advancement. By participating in this robust, evidence-based process, you are part of a legacy of nursing excellence that raises the standard of patient care.
The new examination will have a total of 200 items with 175 being scored and 25 being unscored. The exam time permitted remains unchanged at 3 hours and 45 minutes.
Stay tuned for updates as we approach the implementation of the new exam content in 2027!
Knowledge Statements and Examinations Items per Competency Area
CNAMB Examination Content Outline
Select each tab below to view the CNAMB Examination Content Outline and list of knowledge statements in each competency area.
| 1 | Preoperative Patient Assessment and Plan of Care Exam Items CNAMB = 44 |
|---|---|
| 1A | Patient identifiers |
| 1B | Informed consent(s) and waivers (e.g., surgical, anesthesia, blood, photographs, visitors) |
| 1C | Anatomy, physiology, and pathophysiology |
| 1D | Pharmacology |
| 1E | Diagnostic procedures and results |
| 1F | Health assessment information (e.g., vital signs, pain, allergies, lab values, chart review, NPO status, medications, previous surgeries, special needs, comorbidities, preoperative instructions) |
| 1G | Health assessment techniques (e.g., interview, observation) |
| 1H | Pain management techniques (e.g., multi-modal, regional blocks) |
| 1I | Nursing process |
| 1J | Selection criteria (e.g., BMI, ASA score, sleep apnea, infectious disease, age) |
| 1K | Antibiotic stewardship |
| 1L | Advanced directives, DNR status, and Allow Natural Death (AND) protocol |
| 1M | Discharge needs (e.g., home care, durable medical equipment, transportation, caregiver availability, medications, rehabilitation) |
| 1N | Nursing diagnoses for plan of care development |
| 1O | Patient physiological responses in the perioperative setting (e.g., risk of infection, altered tissue perfusion, thermoregulation) |
| 1P | Patient psychological and behavioral responses in the perioperative setting |
| 1Q | |
| 1R | Preoperative patient preparation interventions (e.g., IV, removal of jewelry, hair removal) |
| 1S | Perioperative safety interventions (e.g., WHO surgical safety checklist) |
| 1T | Cultural competence (e.g., cultural and ethnic influences, family structures, spirituality and related practices, values) |
| 1U | Resources for patient and family/caregiver education (e.g., supplies, equipment, patient transfer agreements, emergency services) |
| 2 | Intraoperative Care Exam Items CNAMB = 44 |
|---|---|
| 2A | Surgical procedures (e.g. total joints, robotic-assisted) |
| 2B | Infection prevention and control |
| 2C | Aseptic technique and surgical conscience |
| 2D | Skin prep antisepsis |
| 2E | Intraoperative risks and complications |
| 2F | Patient positioning |
| 2G | Wound classification, closure, and healing |
| 2H | Medication and fluid management (e.g., timing, labeling, redosing) |
| 2I | Environmental factors (e.g., temperature, humidity, air exchange, noise, traffic patterns) |
| 2J | Hemodynamic status and protocols (e.g., blood transfusion, intake and output) |
| 2K | Use of equipment per manufacturers’ instructions for use (IFUs) |
| 2L | Patient and personnel safety |
| 2M | Ergonomics and body mechanics |
| 2N | Anesthesia management and anesthetic agents (e.g., airway maintenance, reversal agents and antagonists) |
| 2O | Moderate and local sedation/analgesia with appropriate monitoring |
| 2P | Surgical counts |
| 2Q | Hazardous/biohazardous materials |
| 2R | Surgical smoke management |
| 2S | Selection and management of surgical instruments, supplies, and equipment |
| 2T | Preparation of implants and explants |
| 2U | Perioperative documentation |
| 2V | Specimen management |
| 3 | Postoperative Care and Transfer of Care Exam Items CNAMB = 17 |
|---|---|
| 3A | Interdisciplinary and community-based services for care coordination (e.g., nutrition, wound care, social work, transportation, rehabilitation center, physical therapy) |
| 3B | Transfer of care (e.g., home, hospital, rehabilitation center) |
| 3C | Pain management education (e.g., multi-modal, regional blocks) |
| 3D | Discharge criteria (e.g., Aldrete score) |
| 3E | Guidelines for postoperative follow-up (e.g., phone calls, appointments) |
| 3F | Airway management |
| 3G | Hemodynamic monitoring |
| 4 | Communication and Documentation Exam Items CNAMB = 17 |
|---|---|
| 4A | Adaptive and therapeutic communication with the patient and family/caregiver (e.g., language barriers, interviewing techniques) |
| 4B | Methods of communication with the interdisciplinary team (e.g., read back verbal orders, hand-offs, SBAR) |
| 4C | Communication and documentation protocols for patient status information (e.g., critical lab values, medical condition, medications, allergies, implants/implantable devices) |
| 4D | Information technology and management (e.g., software applications, telehealth, security rules, HIPAA) |
| 4E | Perioperative patient education |
| 5 | Personnel, Services, and Materials Management Exam Items CNAMB = 16 |
|---|---|
| 5A | Product evaluation processes (e.g., cost-benefit analysis, product trial) |
| 5B | Perioperative resource management (e.g., equipment, supplies, staffing) |
| 5C | Implant management (e.g., regulatory and manufacturers’ instructions for use [IFUs]) |
| 5D | Roles and responsibilities of the auxiliary team (e.g., employee health, biomedical) |
| 5E | Waste management (e.g., reprocessing, supply standardization) |
| 5F | Scope of practice for the interdisciplinary team per regulatory guidelines (e.g., Nurse Practice Act, AST) |
| 5G | Role of visitors to the OR (e.g., vendors, students, family, caregivers) |
| 5H | Personal protective equipment (PPE) |
| 5I | Radiation safety (e.g., dosimetry badges, time, distance, shielding, lead protection) |
| 5J | Environmental management (e.g., spills, room turnover, terminal cleaning) |
| 6 | Instrument Processing and Supply Management Exam Items CNAMB = 14 |
|---|---|
| 6A | Cleaning/disinfecting agents and techniques (e.g., manual washing, ultrasonic, high-level) |
| 6B | Packaging materials and techniques (e.g., crates, peel packs, wraps) |
| 6C | Sterilization techniques (e.g., immediate use steam sterilization [IUSS], load parameters, low-temperature sterilization) |
| 6D | Transportation of equipment, instruments, and supplies |
| 6E | Storage of equipment, instruments, and supplies |
| 6F | Hazardous/biohazardous materials exposure mitigation and management |
| 6G | Documentation requirements for instrument sterilization, including biological and chemical monitoring |
| 6H | Regulatory requirements for tracking equipment, instruments, and supplies provided by external sources (e.g., AAMI) |
| 6I | Quality assurance testing (e.g., washer disinfector, sterilizer) |
| 7 | Emergency Management Exam Items CNAMB = 9 |
|---|---|
| 7A | Preparations for and management of patient medical emergencies (e.g., malignant hyperthermia [MH], anaphylaxis, cardiac arrest, hemorrhage, local anesthetic systemic toxicity [LAST]) |
| 7B | Roles and responsibilities of the interdisciplinary team during internal/external emergency situations (e.g., triage, awareness of community resources) |
| 7C | Preparations for and management of environmental hazards and natural disasters (e.g., fire, toxic fumes, natural disasters, terrorism, power outage, active shooter) |
| 8 | Professional and Ethical Responsibilities Exam Items CNAMB = 14 |
|---|---|
| 8A | Universal protocol |
| 8B | Patient rights and responsibilities (e.g., HIPAA) |
| 8C | Accreditation standards and organization guidelines (e.g., AORN Guidelines for Perioperative Nursing, Perioperative Explications for the ANA Code of Ethics for Nurses, ASPAN, APIC, AAMI, AAAHC, TJC) |
| 8D | Local, state, and federal regulatory agencies (e.g., FDA, CDC, CMS, OSHA, DEA) |
| 8E | Risk management (e.g., event reporting, good catch, disclosure of unanticipated events, recalls) |
| 8F | Responsibilities regarding behaviors that undermine a culture of safety |
| 8G | Delegation of tasks |
| 8H | Quality and process improvement activities (e.g., research, evidence-based practice, CMS quality measures, case start time, turnover time, patient satisfaction) |
| 8I | Patient advocacy |
