BACKGROUND: The preparation to become a critical-care nurse in Sweden consists of a college program. The programs need to meet a set of widely defined goals developed by the Board of Higher Education, but can differ in content and lay-out depending on the college curriculum. There is subsequently no pre-defined standards for the knowledge, competencies and capabilities a critical-care nurse should possess. This presents a problem for both employers, educators, nurses and students and can ultimately compromise patient safety.AIM: Our aim was to develop a final examination that would reflect theoretical knowledge, as well as practical skills and competencies for an entry-level critical care nurse.

METHOD: The content of the final examination was based on a previously developed assessment tool used for clinical rotations at our college. This assessment tool reflected the competencies stated by the national association of critical care nurses in Sweden (AnIva) as well as the goals required by the Board of Higher Education in Sweden. After development of the exam, which comprises a two-step assessment where the students´ skills and capabilities are assessed, and a theoretical part where the students´ nursing-care knowledge is assessed by explicit pre-determined standards, the exam was tested and then revised in several steps after several focus-group discussions with content-experts and students.

RESULT: The content-experts reported they were helped by having a set of explicit pre-determined standards to guide them. The students expressed similar sentiments as well as satisfaction from receiving “proof” of having reached an entry-level critical-care nurse level.IMPACT FOR PRACTICE: A set benchmark where knowledge-level and competency requirements are clarified for critical care nursing-practice aids students, educators and employers in setting goals for, and evaluating individuals working towards becoming a critical care nurse. This ultimately strengthens the profession and promotes patient safety.