Upcoming CACP Exam Dates & Locations

Upcoming Exam Details

Specific details about the July exam in Evansville, IN are not available at this time but will be posted here as soon as they are available.

About the CACP Exam

Much of the information on this page and some additional information is available in the CACP Candidate Handbook. Click here to download the Candidate Handbook.

The Certified Anticoagulation Care Provider Exam covers the 5 domains shown below, weighted according to domain content.

Objectives of Certification

The National Certification Board for Anticoagulation Providers (NCBAP) endorses voluntary certification of anticoagulation providers who meet education and patient-care experiential requirements. The purpose of the certification process is to meet a societal need to protect public health and well being by:

1. Providing an accepted assessment of current knowledge, skills and competencies necessary for individuals providing direct anticoagulation education and therapeutic management.
2. Promoting individual professional growth and development in the practice of anticoagulation therapy.
3. Nationally recognizing and validating anticoagulation providers who fulfill certification requirements.

This certification process is designed and intended for practitioners whose primary role as an anticoagulation provider includes systematic, organized, and on-going patient education and therapeutic management.

Definition of Anticoagulation Provider Responsibilities

A Certified Anticoagulation Care Provider (CACP) is a health care professional who

• shows evidence of current activity as an anticoagulation provider.
• provides documentation of appropriate patient care and management during selected encounters with patients, and
• demonstrates achievement of advanced knowledge and skills by passing a comprehensive examination

This prescribed set of knowledge and skills are routinely drawn upon in the course of education and managing patients receiving antithrombotic therapies. Specific competencies demonstrated by a Certified Anticoagulation Care Provider include:

1. A working knowledge of the normal physiological processes of hemostasis and thrombosis, and the etiology, risk factors and clinical manifestations of pathologic thrombus formation.
2. Knowledge of the pharmacological properties of antithrombotic drugs.
3. Knowledge, skills and ability necessary to manage and monitor patients receiving antithrombotic therapies. This includes assessment of efficacy and potential toxicity, achievement of therapeutic goals, and evaluation of patient-related variables that affect therapy management.
4. Provide patient education regarding antithrombotic therapy in a coordinated program, including: individualized patient assessment, formulation of an educational plan with specific goals and objectives, implementation of an educational plan, assessment and evaluation of patient knowledge and skills pertaining to anticoagulation therapy, and documentation of all patient encounters.
5. Demonstrate an understanding of the issues, requirements and processes involved in developing a coordinated anticoagulation clinic or service.

Eligibility Requirements

To be eligible to take the certification examination, applicants must meet and provide documentation of professional and professional experience as outlined below.

1. Professional Qualifications/Requirements

Current United States license, registration, or certification as:

Registered nurse, Advance Practice Nurse, registered or licensed pharmacist, licensed physician, certified physician assistant.

....and....

2. Professional Experience

1. Current Activity: The candidate must provide evidence of current activity (e.g. within the previous 18 months) as an anticoagulation provider. To be eligible, the candidate must hold his/her professional license for a minimum of 18 months prior to the application deadline, and must directly provide anticoagulation education and drug therapy management to patients for at least 6 months.
2. Appropriate Patient Management: The candidate must provide documentation, using standardized documentation forms, (see Forms A and B) of appropriate management of anticoagulant therapy for a total of 36 separate patient encounters. To achieve this requirement, the candidate must submit encounters from any four of the following 6 categories:
   1. 3 patients new to warfarin, beginning with their initial visit to the anticoagulation clinic/service (Form A), and 2 consecutive, subsequent followup encounters for each patient (Form B).
   2. 3 patients who, during maintenance anticoagulant therapy, develop a bleeding complication or a thromboembolic complication (Form A), and 2 consecutive, subsequent follow-up encounters for each patient (Form B).
   3. 3 patients who present during maintenance anticoagulant therapy with a supra-therapeutic INR (Form A) and 2 consecutive, subsequent follow-up encounters for each patient (Form B).
   4. 3 patients who present during maintenance anticoagulant therapy with a sub-therapeutic INR (Form A), and 2 consecutive, subsequent follow-up encounters for each patient (Form B).
   5. 3 patients who present during maintenance anticoagulant therapy with a need for bridge therapy (Form A), and 2 consecutive, subsequent follow-up encounters for each patient (Form B).
   6. 3 patients who present at initiation or during maintenance anticoagulant therapy with special needs with respect to anticoagulant therapy (renal impairment, heparin-induced thrombocytopenia, pregnancy) (Form A) and 2 consecutive, subsequent follow-up encounters for each patient (Form B).

Assessment of Management of Anticoagulant Therapy

Each patient encounter will be reviewed by a member of the National Certification Board for Anticoagulation Providers, using the Reviewer's Comment and Approval Form (see Appendix A of Candidate Handbook) It is expected that all entries on Forms A and B are legible and complete. The reviewer has the right to return packets if they are deemed incomplete or inadequate. For each patient encounter, appropriateness of patient management will be assessed according to the following criteria:

1. the indication for anticoagulation is clearly identified
2. for warfarin, the goal INR is stated and is suitable for the indication (per ACCP Guidelines), and if not, an explanation if provided
3. for other anticoagulants, proper laboratory monitoring guidelines are identified and used
4. all potential risk factors for bleeding and for thromboembolism are identified
5. pertinent co-morbid medical conditions are listed/described
6. potential drug interactions are clearly marked with an asterisk on the medication list
7. a complete assessment of clinical and laboratory findings is described
8. the plan is consistent with subjective and objective findings, as well as the assessment
9. dosing adjustments are reasonable based on standard guidelines
10. the interval between laboratory tests is adequate

Certification Status and Use of Certification Mark

Only the National Certification Board confers the Certified Anticoagulation Care Provider (CACP) credential for Anticoagulation Providers. Certification is a process granting recognition to an individual who has satisfactorily met all eligibility requirements and has passed the examination. After notification of passing the CACP Examination, an individual may use the mark "CACP" following his/her name.

Recertification

The National Certification Board for Anticoagulation Providers requires all CACPs to recertify by examination every five (5) years. To be eligible for recertification, applicants must meet and provide documentation of professional qualifications and experience as outlined below.

1. Professional Qualifications/Requirements

Current license, registration, or certification as:

Registered nurse, Advance Practice Nurse, registered or licensed pharmacist, licensed physician, certified physician assistant.

....and....

2. Professional Experience

Applicants for recertification must provide a description of their current activities in anticoagulation therapy management. Individuals who are not currently actively engaged in the management of patients on anticoagulation therapies are not eligible for recertification. The applicant should clearly state if there have been any major changes in their scope of patient care responsibilities since the date of their previous certification.

Some examples of experiences, which will NOT be counted toward the professional experience requirement:

• Providing continuing education credit awarded to professionals, or receipt of professional continuing education credit.
• General medical, nursing, or pharmacy practice.
• Conducting/participating in research activities in which the candidate is NOT involved in direct anticoagulation education and patient management.
• Dispensing/prescribing antithrombotic medications or related equipment.
• Supervising and managing other professionals.
• Membership and committee work in professional organizations
• Any work or experience prior to receipt of license, registration or advanced degree.

Written requests for exceptions to these eligibility and documentation requirements may be petitioned to the Board for consideration.

Applicants for recertification are NOT required to submit documentation for 36 patient encounters.

Click here for information regarding online recertification.

Fees

A fee of $300.00 US is due at the time of the Candidate Application Submission. A check or money order made payable to the NCBAP should be enclosed.

Notice of withdrawal from a scheduled examination must be submitted in writing to the NCBAP. Applicants will receive a refund of the application fee minus a $100.00 administrative fee. This fee is non-refundable and covers the cost of application handling and review process. Individuals whose applications are NOT approved will receive a refund of the application fee minus a $100.00 administrative fee. Application packets will not be returned to the applicant. Notification of Approval and Admission to the Testing Site Approximately four weeks prior to the examination date, the applicant will receive a letter containing detailed instructions for reporting to the examination site. To gain admission, one must present this notification letter along with a current form of photo identification. All candidates should report to the examination site at least 30 minutes prior to examination start time. No candidate will be admitted after testing has begun.

Survey of Clinician Attitudes Towards the CACP Creditential

In 1999, the NCBAP conducted a survey of clinicians who had taken the CACP exam. 78% (49/63) of the surveys were returned. Of those who returned the survey:

• 88% (43/49) passed exam
• 50% (3/6) who did not pass 1st time, plan to retake exam
• 65% (28) who passed, intend to re-certify in 5 years
• 96% (47/49) recommend certification process to colleague

The breakdown of survey respondents was:

• Pharmacists: 71% (35)
• Registered Nurses: 16% (8)
• Nurse Practitioners: 10% (5)
• Physician Assistant: 2% (1)

When asked why pursue the CACP creditential, the responses were^*: