C-ONQS Exam Study Guide 2026–2027 is a focused preparation resource for professionals preparing for the Obstetric and Neonatal Quality and Safety certification examination.

This guide approaches C-ONQS preparation from a quality and safety perspective, helping readers understand how to analyze perinatal care systems, identify gaps, evaluate performance, and implement sustainable improvements.

The book covers the major areas addressed throughout the guide, including:

Healthcare quality frameworks and the six domains of quality

Donabedian’s structure, process, and outcome model

Perinatal standards, regulation, accreditation, and evidence

Safety culture, Just Culture, and psychological safety

Gap analysis and data collection

Adverse events, root cause analysis, and disclosure

Human factors, cognitive bias, fatigue, and clinician well-being

SBAR, handoffs, briefings, huddles, and closed-loop communication

Team development, leadership, and change management

Education, simulation, and in situ drills

Staffing, work environment, and structural design

Aim statements, driver diagrams, and prioritization

Quality metrics, balancing measures, run charts, and control charts

PDSA, Lean, and Six Sigma improvement methods

Project teams, evidence appraisal, and data integrity

Error prevention and perinatal workflow reliability

Value, cost, return on investment, and waste

Sustainment and spread of quality improvements

Ethical principles and the distinction between quality improvement and research

The second half of the book provides six full-length practice examinations totaling 750 questions, with answers and rationales designed to reinforce the concepts covered in the learning chapters. The practice tests use the three-option format described in the guide and are structured as comprehensive exam simulations.

Whether you are building your foundational knowledge, strengthening weaker domains, or completing final practice before examination day, this study guide provides a structured way to review the quality, safety, improvement, measurement, leadership, and ethical concepts central to C-ONQS preparation.