Last updated: November 4, 2020

In 1969, the American Association of Cardiovascular Nurses was formed to educate nurses in cardiac care. A few years later, in 1971, the association changed its name to the American Association of Critical-Care Nurses (AACN, 2019c). The association focuses on assisting nurses in giving the best care possible to critically ill patients. With that goal at the forefront in 1974, the first annual conference known as the National Teaching Institute & Critical Care Exposition (NTI) was started. The next year, the AACN Certification Corporation was founded to provide specialty certification for critical care nurses who were providing care for patients who were acutely or critically ill. The certification included care for patients across the lifespan. Their journal, Critical Care Nurse, was published in 1980 to provide continued information to their nurses. This was followed by a quarterly journal, Advanced Critical Care, published in 1989. In 1992 the American Journal of Critical Care was published, which provided a higher level of information. In 1999, the organization added the Critical Care Nurse Specialist certification for nurses educated at the graduate level who care for critically ill patients across the lifespan. Since that time, other subspecialty certifications have been added. In 2019 the AACN celebrates fifty years of supporting and educating critical care nurses (AACN, 2019c).

The AACN is guided by a mission, vision and four values, which include: accountability, innovation, leadership, and collaboration. The organization is governed by a board of directors consisting of 15 members. There is also an 11-member board that is responsible for the certification and renewal process that now includes 12 additional specialty and sub-specialty certifications. There is also a nominating committee that reviews the criteria to serve on the various boards and the standards for potential candidates. Nurses can review the current benchmarks and make a nomination if they know someone that might be suitable for a position on one of the boards (AACN, 2019a).

As patients’ needs change, there has been an increasing level of care required by nurses. The certification process for those who work with patients who are critically ill is one way to continue to strive towards better patient care and positive outcomes. Seeking certification allows the nurse to validate their level of knowledge and to develop that knowledge further. It enables the nurse to become a leader in their profession, improve practice standards, and in some cases, advance their career or obtain promotions because they have demonstrated a desire to be the best nurse they can be and to put patient care at the forefront (AACN, 2019b).

The certified critical-care registered nurse (CCRN) certification is awarded to nurses who are working with acutely and or critically ill patients upon successful completion of an exam. Nurses who are considering becoming certified must meet the criteria for eligibility before starting the certification process. The criteria include:

  • a current, unencumbered RN license issued in the United States,
  • evidence of practice as an RN or advanced practice registered nurse (APRN) in direct care of patients who are acutely or critically ill for 1,750 hours in a two-year period with 875 hours accrued in the year preceding application, or
  • evidence of practice as an RN or APRN in direct care of patients who are acutely or critically ill for 2000 hours in a five-year period with 144 hours accrued in the year preceding application (AACN, 2019d).

The practice hours have some specific requirements, which include that they must be completed in a United States or Canada-based facility for acute critical care nursing. Practice hours in another country would need to meet specific criteria, and the applicant would want to contact AACN. The number of hours listed above must be spent either providing direct care or acting as a supervisor of other nurses or nursing students and must be verifiable by a supervisor or a colleague (AACN, 2019d).

For the nurse seeking certification, there are a variety of options offered by AACN. The CCRN can be obtained in adult, pediatric, or neonatal care. The CCRN-K certifications indicate knowledge instead of direct care. This would be a person who influences or directs care but is not involved in direct patient care such as a manager, supervisor, or nurse administrator. The CCRN-E certification is for nurses that work in a teleICU. Multiple other certifications can be acquired through the AACN that involve acute or critical care in a variety of settings for RNs, APRNs, and clinical nurse specialists with specific criteria that would need to be met (AACN, 2019d).

Once the nurse decides to become certified, the AACN website can be referenced for more details and a step-by-step process outline. There are resources available to help prepare for the certification exam on the AACN website and others. There are handbooks, test banks with practice questions, seminars, and more to help the nurse become more confident and prepared to take the exam. Once the nurse becomes certified, the certification will need to be renewed with specific required criteria depending on the type of certification. Specific continued competency requirements usually include the option of retaking the initial examination or supplying evidence of a combination of practice hours and nursing professional development courses. These courses are available through the AACN and independent sites such as, and the renewal process is done through the AACN website (AACN, 2019d).