1

Nebraska Wesleyan Nebraska Wesleyan UniversityUniversity

Nursing 236 – Introduction to Nursing 236 – Introduction to Nursing ResearchNursing Research

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Motivation for Motivation for Specialty Certification Specialty Certification

in Nursing Practicein Nursing PracticeJuly 2005July 2005

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StudentsStudents Barbara Barr, RNBarbara Barr, RN Pat Jackson, RNPat Jackson, RN Marva LaGrant, RNMarva LaGrant, RN Michelle Newton, RNMichelle Newton, RN Lavon Sanford, RNLavon Sanford, RN Susan Sweat, RNSusan Sweat, RN Jeanette Welch, RNJeanette Welch, RN Leah Wright, RNLeah Wright, RN Sherry Yeggy-Nail, RN, CCRNSherry Yeggy-Nail, RN, CCRN

Motivation

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How the Problem was IdentifiedHow the Problem was Identified

During preparation to attain magnet status, our institution During preparation to attain magnet status, our institution

discovered only 3 of 400 nurses were certified in their respective area. discovered only 3 of 400 nurses were certified in their respective area.

Then the question was posed, “Why are there only 3 nurses that hold Then the question was posed, “Why are there only 3 nurses that hold

specialty certification?” A group of managers proposed that the lack of specialty certification?” A group of managers proposed that the lack of

motivation to achieve specialty certification was based on lack of promotion motivation to achieve specialty certification was based on lack of promotion

within the institution and lack of monetary value. Many believe that these within the institution and lack of monetary value. Many believe that these

specialty certifications provide positive aspects for patients and the specialty certifications provide positive aspects for patients and the

institution.institution.

Motivation

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Problem StatementProblem Statement

What motivates nurses to become certified in a specialty area?

The purpose of the research is to study the factors that

motivate nurses to become specialty certified.

Motivation

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Literature ReviewLiterature Review

Motivation

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According to American Association of Critical-Care Nurse ( 2002), in November

of 2002 a Harris omnibus survey was taken in the United States. The results of the

survey revealed 96% believed that nurses play in imperative role in the patient’s welfare

and their recovery from illness. 73% of the people surveyed said that they were more

likely to select a hospital that had specialty certified nurses. Another study conducted in

2001 reported that 92% of managers in the critical care area encourage nurses to

become certified, but less than half of hospitals provide financial assistance (New Data

Reveals Nurse Certification Key Component of Patient Safety and Recruitment and

Retention Programs. (2003). American Journal of Critical Care, 12, 160-164.)

AACN recommends that employers support specialty certification to broaden

their commitment to safe and quality care and conduct studies to validate that certification

helps provide better patient outcomes, retention and increased job satisfaction.

Motivation

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The AACN conducted a study that was titled “Summary of Findings: Taking The AACN conducted a study that was titled “Summary of Findings: Taking

the Pulse – Key Influencer Survey”. The research objective was to survey the the Pulse – Key Influencer Survey”. The research objective was to survey the

perceptions of certification among influencers of healthcare. Telephone interviews perceptions of certification among influencers of healthcare. Telephone interviews

were conducted with a total of 78 participants. The participants included managers, were conducted with a total of 78 participants. The participants included managers,

administrators, legislators, educators, faculty of nursing schools, managed care administrators, legislators, educators, faculty of nursing schools, managed care

organizations and AACN ambassadors. Each interview conducted lasted about 15 organizations and AACN ambassadors. Each interview conducted lasted about 15

minutes.minutes.

Motivation

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Perceived Importance and Advantages of CertificationPerceived Importance and Advantages of Certification(n=78)(n=78)

American Association of Critical-Care Nurses. (2002) Summary of Findings: Taking the Pulse – Key Influencer Survey

54%

37%22%

22%

17%

10% 6%

Show know ledge/competence

Keep skills up to date

Professional benefits

Better quality nurses

Recognition

Recruitment and retention

Netw orking

Motivation

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Perceived Importance of Validating Knowledge in Specific AreasPerceived Importance of Validating Knowledge in Specific Areas“Very Important”“Very Important”

(n=78)(n=78)

American Association of Critical-Care Nurses. (2002) Summary of Findings: Taking the Pulse – Key Influencer Survey

96% 96% 92% 91% 90%76% 76%

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Motivation

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Strategies to Increase Certified Nursing PracticeStrategies to Increase Certified Nursing Practice(n=78)(n=78)

42%

27%

18%

18%

10%

8%

6%

5%

Offer financial support

Promote/reward/recognize

Peer support

Advertise or generateawarenwess

Recruiting certifiednurses/req. certification

Provide time to study

Provide on-site classes

Provide tutoring & prepclasses

American Association of Critical-Care Nurses. (2002) Summary of Findings: Taking the Pulse – Key Influencer Survey

Motivation

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Specialty certification for nurses will help to provide protection to critically ill

patients by nurses acquiring knowledge and competence. (American Association of Critical-

Care Nurses [AACN], 2004).

According to the Association of Perioperative Nurses, their review of literature

suggests the benefits of certification include:

Broader range of job opportunities

Challenge

Commitment to professionalism

Job satisfaction

(Byrne, M., Valentine, W., Carter, S., 2004.)

Motivation

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This article’s strength is ease of interpretation. The weakness one could This article’s strength is ease of interpretation. The weakness one could

easily identify, would be that the sample population was small. There was no easily identify, would be that the sample population was small. There was no

demographical or geographical data obtained, also.demographical or geographical data obtained, also.

Motivation

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Personal achievement and satisfaction

Professional obligation

Validation of knowledge

(Association of Perioperative Nurses [AORN], 2004).

The American Association of Perioperative Nurses conducted a study that

utilized the “Perceived Value of Certification Tool”. All studies using this tool were by

survey method. In the initial study, surveys were sent to 400 nurses that held the

Certification Nurse Operating Room (CNOR). The response rate was 61%. After minor

changes were made the final form was mailed to nurses who were certified (n=1398), non-

certified (n=594), and administrators (n=1577).

Motivation

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Value CertifiedNon-

CertifiedAdministrator

s

Accomplishment 97.2 94.9 98.1

Satisfaction 96.6 92.2 97.1

Specialized Knowledge 95.2 83 91.8

Professional Growth 93.7 79.8 92.4

Practice Standard Attainment 92.8 79.1 87.2

Professional Commitment 92.2 74.7 89.4

Challenge 91.8 83.6 91.3

Credibility 90.9 73.4 88.3

Clinical Ability 85 79.7 83.7

Clinical Competence 82.1 61.6 71.9

Accountability 81.9 57.5 72.9

Marketability 75.5 58.8 75

Peer Recognition 72.2 54.8 73.2

Professional Autonomy 69.9 47 67.7

Recognition of Other Health Care Professionals 66.8 53 71.1

Recognition of Employers 63.7 45.6 65.6

Consumer Confidence 50.5 33.1 44.9

Salary Benefits 30.7 22.2 31.8

Association of Perioperative Nursing. (2004). 79; 4, 825-835.

Motivation

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“Today, nurses hold more than 410,000 certifications in 134 specialties from 67

certifying organizations, and at least 95 different credentials designate these certifications.”

(Cary, A., 2001, p. 44). The methods used in “Certified Registered Nurses: Results of the

Study of the Certified Workforce” were mailing surveys to 40, 426 certified nurses. To

ensure that each organization was represented equally, the certification institutions with a

smaller amount of members would have larger proportions surveyed. Once the survey was

distributed, the researchers would not know who the respondents were on the completed

forms. The survey consisted of 34 questions. Approximately half of the surveys were

returned (48%). The four areas that were surveyed were the personal, professional, career

and practice characteristics.

Motivation

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The Benefits of Achieving Certification

Recognized as an expert in the field by colleagues 39%

Certification recognized or publicized 32%

Full or partial reimbursement of costs 28%

None 28%

Salary increase 19%

Advancement in career 11%

Retention in position 8%

One-time bonus 7%

Eligibility for a higher-level position 6%

Promoted to a higher-level position 4%

Respondents were allowed to choose more than one

response.

Motivation

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Certified Nurses' Responses to "Certification enabled me to …"

Personal  

Experience personal growth 77

Feel more satisfied as a professional nurse 67

   

Professional  

Serve as a resource to staff for patient-care concerns 39

Serve as a resource for organizational consultation 22

   

Career  

Fulfill my career aspirations 33

Feel more satisfied with my position 32

Obtain employment in a different organization 11

   

   

Practice  

Feel more competent in my skills as a professional nurse 65

Be seen as a credible provider 56

Feel more accountable as a professional nurse 54

Experience more confidence in my practice 53

Feel more confidence in my decision-making abilities 37

Feel more confident in my ability to detect early signs and  

symptoms of complications in my patients 29

top percentages of results

Motivation

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“During the current nursing shortage, retention of experienced, knowledgeable

nurses is of critical importance to the success of a healthcare institution.” (Jakubik, L.,

Grossman, M., Daly-Parker, M., Gaffney, L., Strauss, K., Mars, K. 2004) The Children’s

Hospital of Philadelphia, PA developed The Pediatric Medical Nursing Certificate Program

(PMNCP) to help retain nurses that want to specialize in pediatrics. They used classroom

and a clinical component to help provide the experiences necessary to retain nurses in the

pediatric acute care. Retention of these nurses by this method enhance job satisfaction,

knowledge and skills, and professional role development. The targeted nurses were those

who were experienced in pediatric acute care.

Motivation

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PMNCP Objectives

*Develop knowledge and skills specific to medical nurses

*Increase confidence

*Recruit and retain nursing staff

*Develop clinical ladders

*Establish mentoring relationships

*Promote job satisfaction

*Improve quality of patient care

*Promote interdisciplinary collaboration

*Strengthen investment in established mission of unit,

department, and organization

*Improve relationships between staff nurses, specialty physicians

and APNs

Jakubik, L., Grossman, M., Daly-Parker, M., Gaffney, L., Strauss, K., Mars, P. (2004).

Clinical and Professional Role Development Among Experienced Pediatric Nurses: The

Pediatric Nursing Certificate Program. Journal for Specialists in Pediatric Nursing, 9(4), 113-122.

Motivation

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The PMNCP program was a 6 month multisystem approach that involved classroom The PMNCP program was a 6 month multisystem approach that involved classroom

and clinical experiences. After the first 36 months of the program an evaluation was performed. and clinical experiences. After the first 36 months of the program an evaluation was performed.

Certificate program participants had improved from baseline 86% and non-certificate participants Certificate program participants had improved from baseline 86% and non-certificate participants

34% in knowledge scores. Skills scores for the certificate participants had improve 46% and the 34% in knowledge scores. Skills scores for the certificate participants had improve 46% and the

non-certificate participants 33%. Skill scores were based on the Likert scale 1-5, with 1 being non-certificate participants 33%. Skill scores were based on the Likert scale 1-5, with 1 being

poor and extremely high as 5. The key to success, based on the article, was maintaining poor and extremely high as 5. The key to success, based on the article, was maintaining

management support and the multidisciplinary team.management support and the multidisciplinary team.

An observation made about this article is, though it does not speak about specialty An observation made about this article is, though it does not speak about specialty

certification, it does offer data that enhances the ideal that nurses that have the knowledge to certification, it does offer data that enhances the ideal that nurses that have the knowledge to

obtain certification will improve in their skills and possibly could improve better outcomes for obtain certification will improve in their skills and possibly could improve better outcomes for

patients.patients.

Motivation

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In the article “Specialty Certification – More Than Just a Title” a group of In the article “Specialty Certification – More Than Just a Title” a group of

nurse managers were surveyed on their perceptions of the value of specialty nurse managers were surveyed on their perceptions of the value of specialty

certification. certification.

The American Board of Nursing Specialties (ABNS) performed surveys at The American Board of Nursing Specialties (ABNS) performed surveys at

exhibits in 2002 at nursing management conferences. A total of 139 surveys were exhibits in 2002 at nursing management conferences. A total of 139 surveys were

completed. Of theses that were completed the results were placed into three completed. Of theses that were completed the results were placed into three

categories: 1) preference of hiring certified versus a non-certified nurse (2) incentives categories: 1) preference of hiring certified versus a non-certified nurse (2) incentives

used to promote and recognize specialty certification (3) perceptions about the used to promote and recognize specialty certification (3) perceptions about the

differences in performance of certified and non-certified nurses.differences in performance of certified and non-certified nurses.

Motivation

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The results concluded that nurse managers stated that 86% would hire a certified

nurse over a non-certified nurse. Those managers that had never been certified were less

likely to hire a certified nurse over a non-certified nurse (82.8%). Only 11% of nurse

managers surveyed had more than 50% of staff at their institution certified in a specialty area.

In the chart provided on the next slide were the results of the survey responses of nurse

managers.

Motivation

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Reasons for hiring certified nurses vs. non-certified nurses %

(abbreviated)

proven knowledge base 75.5

greater professional commitment to lifelong learning 67.6

documented experience 54.7

role model for others and mentor 51.8

demonstrates increased confidence 48.2

serves as formal or informal leader in the unit 46.8

positively impacts patient outcomes 43.2

contributes to overall better patient outcomes 38.8

detects and initiates early intervention for patient comp. 32.4

Incentives for promoting and recognizing certification %

(abbreviated)

reimbursement of exam fees 36.7

advancement in clinical ladder 26.6

reimbursement for continuing education 28.8

increase in salary 24.5

reimbursement for recertification fee 23.7

paid time off for attending continuing ed. Classes 22.3

Stromborg, M.., Niebuhr, B., Fabrey, L., Muenzen, P., Spence, C., Towers, J., et al.

(2005) Specialty Certification – More Than a Title. Nursing Management, 2005, 36(5), 36-46.

Motivation

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This article does not adequately survey the nurse managers in the United States due to the

limited number of participants. Although one can make an assumption based on the statistical

information provided that the responses (if taken) from other managers would be similar.

Motivation

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The accountability of nursing is being demanded by many organizations in healthcare,

including third party payers. The public has become more concerned with the care that they receive and

question the competence of those that provide that care. A survey was conducted by the Certification

Board Perioperative Nurses (CBPN) Research Committee on those nurses that have achieved CNOR

certification for perioperative nurses and Certified Registered Nurse First Assistant (CRNFA) credentials.

(Gaberson, K., Schroeter, K., Killen, A., Valentine, W., 2003)

Based on a tool called “Perceived Value of Certification Tool” the survey was mailed to

participants who have already obtained the above mentioned credentials. The participants were selected

from the CBPN database and was representative of all geographical regions in the country. Those

selected were 2612 CNOR and 138 CRNFA.

Motivation

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A total of 1398 surveys were collected, about 50%. Only the responses without missing questions were

used in the study.

Value statements were included in the survey and scored on a Likert scale. For most, the

value statements were agreed in support. The only statement that scored less than 50% by participants

was the one titled “Increases salary”.

Motivation

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Value Statement %

Enhances feeling of personal accomplishment 97.2

Provides personal satisfaction 96.6

Validates specialized knowledge 95.2

Indicates professional growth 93.7

Indicates attainment of a practice standard 92.2

Provides evidence of professional commitment 91.8

Enhances professional credibility 90.9

Enhances personal confidence in clinical abilities 85

Indicates level of clinical competence 82.1

Provides of evidence of accountability 81.9

Increases marketability 75.5

Promotes recognition from peers 72.2

Enhances professional autonomy 69.9

Promotes recognition form other health professionals 66.8

Promotes recognition from employers 63.7

Increases consumer confidence 50.5

Increases salary 30.7

Gaberson, K., Schroeter, K., Killen, A., Valentine, W. (2003). The Perceived Value of Certification by Certified Perioperative Nurses. Nursing Outlook

2003, 51, 272-6.

Motivation

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A strong reliability was found on evaluation of the responses (standardized α = .924). The

instrument developed for this survey, the PVCT) is considered psychometrically strong and conceptually

consistent.

This article is a great tool to use in the future of more surveys. The survey here only consisted

of perioperative nurses and we cannot make any assumptions based on the data to correlate other

specialty certified nurses and their perceptions of certification.

Motivation

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Data collected by survey in the article “A Profile of Certification for Pediatric Nurses”

discussed the reasons why nurses allow their certification lapse. Surveys were mailed to 275

nurses who had maintained there certification and 317 who had not maintained certification. This

survey was only conducted for the pediatric certification through the Pediatric Nursing Certification

Board (PNCB). The tool used had a list of potential reasons for not maintaining certification,

reasons for maintaining certification. These statements were then ranked by the participant using

1-5 with 5 being most important.

The findings between the two groups did not differ significantly in basic RN education.

The following table explains the results the characteristics of the sample.

Motivation

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Characteristic Maintained certification Lapsed certification

  (n=159) (n=88)

Basic Education  

AD 29.5 16.3

Diploma 30.8 34.9

BSN/BS 39.7 48.8

Highest Degreea,b  

AD 22.9 8.1

Diploma 21.7 26.7

BSN 43.9 43

MSN 10.2 17.4

other 1.3 4.7

Currently enrolled in AP program 3.8 7

Currently practicing in Pedsa,c 94.3 74.4

Practice Settinga,d  

Clinic/Outpatient 21.9 32.2

In-patient 61.6 46.2

Administration 11.6 4.6

APN/CNS 2.7 12.2

Education/Research 2.1 4.6

a = significant difference between groups b = 10.633 2א , df = 3, p= .014

c = 19.669 2א , df = 1, p = .001 d = 10.423 2א , df = 3, p = .015

Motivation

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The top 5 reasons for lapsed certification were:The top 5 reasons for lapsed certification were:

Healthcare system does not value certification 58%Healthcare system does not value certification 58%

Certification exam too expensive 56.8%Certification exam too expensive 56.8%

No professional benefits for certification 53.4%No professional benefits for certification 53.4%

Certification has no value in terms of getting promoted 53.4%Certification has no value in terms of getting promoted 53.4%

Annual costs for certification maintenance prevent participation 50%Annual costs for certification maintenance prevent participation 50%

The top 5 reasons for maintaining certification were:The top 5 reasons for maintaining certification were:

Increases confidence in my knowledge of pediatric nursing care 80.5%Increases confidence in my knowledge of pediatric nursing care 80.5%

Encourages me to earn continuing education to maintain certification 80.5%Encourages me to earn continuing education to maintain certification 80.5%

Is recognized and respected within the healthcare system 60.4Is recognized and respected within the healthcare system 60.4

Provides special recognition among my nursing colleagues 58.5%Provides special recognition among my nursing colleagues 58.5%

Encourages me to maintain pediatric nursing practice in order to maintain certification 58.5%Encourages me to maintain pediatric nursing practice in order to maintain certification 58.5%

Motivation

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The results of this study that are interesting are that some of the participants that The results of this study that are interesting are that some of the participants that

allowed their certification to lapse were seeking higher education. So the results mean that allowed their certification to lapse were seeking higher education. So the results mean that

nurses do not always continue certification, but do appear to continue with educational growth.nurses do not always continue certification, but do appear to continue with educational growth.

This article is relatively easy to read and presents data in a fashion that is organized. This article is relatively easy to read and presents data in a fashion that is organized.

It makes some interesting correlations between lapse of certification and continuing education. It makes some interesting correlations between lapse of certification and continuing education.

The only weakness to this article would be that it does not describe the data in relation to The only weakness to this article would be that it does not describe the data in relation to

geographical region in is based only on pediatric certification.geographical region in is based only on pediatric certification.

Motivation

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Nurses who obtain specialty certification are more open to family involvement during Nurses who obtain specialty certification are more open to family involvement during

resuscitative measures and invasive procedures according to Ellison, S. (2003). The study in resuscitative measures and invasive procedures according to Ellison, S. (2003). The study in

which appears in the article “Nurses’ Attitudes Toward Family Presence During Resuscitative which appears in the article “Nurses’ Attitudes Toward Family Presence During Resuscitative

Efforts and Invasive Procedures” (2003) was conducted using 7 statements that used the Likert Efforts and Invasive Procedures” (2003) was conducted using 7 statements that used the Likert

scale and 6 open ended questions. Of the six open ended questions that data that was collected scale and 6 open ended questions. Of the six open ended questions that data that was collected

was on the following: attitudes, concerns, beliefs and current practice of the individual.was on the following: attitudes, concerns, beliefs and current practice of the individual.

Results concluded that “There was a positive correlation between specialty Results concluded that “There was a positive correlation between specialty

certification and attitudes accepting family presence (r = .216, P < .01).” One might can make the certification and attitudes accepting family presence (r = .216, P < .01).” One might can make the

assumption that by obtaining specialty certification the nurse is more knowledgeable and able to assumption that by obtaining specialty certification the nurse is more knowledgeable and able to

communicate easier to the family members.communicate easier to the family members.

Motivation

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Some of the reasons for not allowing family presence would be the lack of knowledge Some of the reasons for not allowing family presence would be the lack of knowledge

of the family, traumatic experience, too many people in the room and not enough staff to provide of the family, traumatic experience, too many people in the room and not enough staff to provide

support for the family. support for the family.

In conclusion of this article it is stated “Working in an environment with supportive In conclusion of this article it is stated “Working in an environment with supportive

colleagues such as those with higher education and specialized training is more likely to bring colleagues such as those with higher education and specialized training is more likely to bring

about change in behavior.” Education and learning how to develop nurses’ abilities to provide about change in behavior.” Education and learning how to develop nurses’ abilities to provide

emergency care with the presence of the family is the key to the needs of the families. As time emergency care with the presence of the family is the key to the needs of the families. As time

evolves more and more families will be in the room with a loved one, through education and evolves more and more families will be in the room with a loved one, through education and

higher learning these nurses will have the tools that they need to assist these family members.higher learning these nurses will have the tools that they need to assist these family members.

This article is exceptional in that it provides statistical data that makes correlations This article is exceptional in that it provides statistical data that makes correlations

between education and attitudes toward family presence in resuscitative efforts. The only between education and attitudes toward family presence in resuscitative efforts. The only

weakness is that this data was collected at only one hospital. Also some of the data weakness is that this data was collected at only one hospital. Also some of the data

interpretation requires statistical background in order to understand the results.interpretation requires statistical background in order to understand the results.

Motivation

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Representatives at a 3-day conference discussed the problems, consensus and the Representatives at a 3-day conference discussed the problems, consensus and the

recommendations on specialty certification (Oncology Nursing Certification Corporation Research recommendations on specialty certification (Oncology Nursing Certification Corporation Research

Committee and Executive Staff. (1999). Report of a State-of-the-Knowledge Conference on U.S. Committee and Executive Staff. (1999). Report of a State-of-the-Knowledge Conference on U.S.

Nursing Certification. Nursing Certification. Image: Journal of Nursing Scholarship, Image: Journal of Nursing Scholarship, 31(1)31(1), 51-5., 51-5. Many questions were Many questions were

posed and discussed. Some of the questions were:posed and discussed. Some of the questions were:

Is nursing certification needed? The answer was yes. Many consider that specialty certification Is nursing certification needed? The answer was yes. Many consider that specialty certification

is a standard of practice or should be. The public and managed care look to certifying bodies to is a standard of practice or should be. The public and managed care look to certifying bodies to

provide the standard of care in their respective area.provide the standard of care in their respective area.

Who should be responsible for specialty certification? They concluded that the certifying bodies Who should be responsible for specialty certification? They concluded that the certifying bodies

that already provide specialty certification to continue to do so.that already provide specialty certification to continue to do so.

Can Collaboration among certification organizations exist? Many certifications are provided by Can Collaboration among certification organizations exist? Many certifications are provided by

the American Board of Nursing Specialties (ABNS). The does require a BSN to certify under the American Board of Nursing Specialties (ABNS). The does require a BSN to certify under

their umbrella. Not all certifying bodies require a BSN.their umbrella. Not all certifying bodies require a BSN.

Motivation

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How should certification be measured? Most testing is paper and pencil, usually a multiple How should certification be measured? Most testing is paper and pencil, usually a multiple

choice test. A skills competency has not been required due to cost.choice test. A skills competency has not been required due to cost.

How often should competencies be measured? Some agencies require retesting while others How often should competencies be measured? Some agencies require retesting while others

require the accumulation of continuing educational hours.require the accumulation of continuing educational hours.

The conference was a meeting place for many specialties to come together and The conference was a meeting place for many specialties to come together and

discuss ideas for the future. The weakness of this article is that it is a consensus paper and has discuss ideas for the future. The weakness of this article is that it is a consensus paper and has

no statistical data that supports certification. The article was also published in 1999. The no statistical data that supports certification. The article was also published in 1999. The

strength of the article reveals that all specialty certifying bodies come to the same conclusion, strength of the article reveals that all specialty certifying bodies come to the same conclusion,

that certification could provide better patient outcomes based on the specialized knowledge of the that certification could provide better patient outcomes based on the specialized knowledge of the

nurse.nurse.

Motivation

38

Motivation

Our Plan for Implementing a Specialty Certification Program at Jefferson Regional Medical

Center

39

The Iowa Model of Evidence-Based Practice to Promote Quality Care is the model The Iowa Model of Evidence-Based Practice to Promote Quality Care is the model

that these researchers will follow to implement a Specialty Certification Program for Jefferson that these researchers will follow to implement a Specialty Certification Program for Jefferson

Regional Medical Center. Based on this model, there are problem-focused triggers and Regional Medical Center. Based on this model, there are problem-focused triggers and

knowledge-focused triggers. Once there is a trigger, we can follow those triggers and develop knowledge-focused triggers. Once there is a trigger, we can follow those triggers and develop

and implement our program. We will follow the diagram based on this model.and implement our program. We will follow the diagram based on this model.

Motivation

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Motivation

Step #1 Our trigger is a knowledge-focused trigger. Our institution is in the process Step #1 Our trigger is a knowledge-focused trigger. Our institution is in the process

of preparing for Magnet Recognition Certification through the American Nurses Credentialing of preparing for Magnet Recognition Certification through the American Nurses Credentialing

Center. The 14 forces of magnetism are:Center. The 14 forces of magnetism are: Quality of Nursing LeadershipQuality of Nursing Leadership Organizational StructureOrganizational Structure Management StyleManagement Style Personnel policies and ProgramsPersonnel policies and Programs Professional Model of CareProfessional Model of Care Quality of CareQuality of Care Quality ImprovementQuality Improvement Consultation and resourcesConsultation and resources AutonomyAutonomy Community and the hospitalCommunity and the hospital Nurses as teachersNurses as teachers Image of NursingImage of Nursing Collegial Nurse-Physician RelationshipCollegial Nurse-Physician Relationship Professional DevelopmentProfessional Development

41

We are focusing only on a few that deal with specialty certification and the benefits of We are focusing only on a few that deal with specialty certification and the benefits of

certification. Through the review of the literature we have established that specialty certification certification. Through the review of the literature we have established that specialty certification

relates to the professional model of care, quality of care, image of nursing, and professional relates to the professional model of care, quality of care, image of nursing, and professional

development. We believe that this topic is a priority for the organization based on the fact that development. We believe that this topic is a priority for the organization based on the fact that

Jefferson Regional Medical Center (JRMC) is in preparation for obtaining Magnet Recognition in Jefferson Regional Medical Center (JRMC) is in preparation for obtaining Magnet Recognition in

the near future. The following slides will detail our plan for the institution.the near future. The following slides will detail our plan for the institution.

Motivation

42

Motivation

Outcomes to be achieved:

•Better the quality of care for patients at JRMC as reflected by Press-Ganey scores.

•Increase awareness among nurses about specialty certification

•Improve ongoing Quality Management data in areas of medication errors, patient complaints, patient

outcomes.

•Support JRMC’s mission statement: Jefferson Regional Medical Center is committed to providing

measurable quality health services in a caring environment which fulfill the needs of our patients,

physicians, employers, employees and community.

Vision Statement: Jefferson Regional Medical Center will be widely recognized as the health care leader

and referral center of choice for South Arkansas by providing quality health care services in a cost

effective manner.

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Motivation

Baseline Data

•Quality Management data related to quality patient care

•Knowledge assessment tool pre-certification

•Only 3 specialty certified nurses out of 400.

44

Motivation

Evidence-Based Guidelines

•Practice will be based on the best practice models provided by certifying bodies

Pilot Units

•Areas selected will be those that have a specialty certification

•Critical Care

•Progressive Care

45

Motivation

Evaluate process and Outcomes

•Monitor data from Press-Ganey and Quality Management

Modify practice

•Upon completion of the data collected and interpreted make changes necessary to implement the

program house-wide.

A continuing assessment of process and outcome data will be conducted. Data on staff perceptions and

hospital costs will be assessed at least annually.

46

Detailed Plan

Motivation

47

Motivation

ASSESSMENT: To assess the nursing staff’s perception of specialty certification a tool similar

to the Perceived Value of Certification Tool (PVCT). The tool will be e-mailed to all nurses and

encouraged to respond on the nursing web site for JRMC. The results will be tallied and posted on the

website for all nurses to see and the plans for a Specialty Certification Program at JRMC.

48

Motivation

TEAM: Our team consists of the students in this class who are employed by JRMC. We have

reviewed the literature on many issues related to specialty certification on the prior slides. PANEL: A

panel of nurses will be formed to select the participants in the program. The panel will consists of 5

members to include a manager, a staff educator, a specialty certified nurse, a member of the Magnet

Team and the VP of Nursing. These panel members will be charged with the duty of an approval process

that the nurse seeking certification will apply.

APPLICANTS: The nurses that seek certification in their area of expertise will create a portfolio

to include: years of experience, areas of experience, educational level of nursing, certifications already

obtained, certified continuing education hours for the past six months to one year. This portfolio will be

submitted for review to the panel. A tool to evaluate the nurses knowledge will provide a pre-certification

level. The same tool will be used one year after certification to evaluate a post-certification level of

knowledge. Once the review of the portfolio has been completed the nurse will be interviewed by the

panel. Upon approval of the candidate, the candidate will sign a letter of commitment to obtain specialty

certification. Certification should be obtained within six months after the approval process.

49

Motivation

REIMBURSEMENT and RECOGNITION: The institution will provide half of the examination fees with the

application to the certifying body. Upon successful completion of certification the individual will be

reimbursed for the amount of the exam fees that they paid once the receipt and completion certificate are

submitted. The newly certified nurse will have there name in the Pulse (weekly newsletter) with there

newly obtained credentials, under the “Star Performers” section. A specialty certification plaque will be

maintained at the main entrance to the hospital and will bear the names of those who have achieved

specialty certification status. A specialty certification differential will be added to their pay that will consist

of an additional $1.00/hour. The incentive to retain certification status is that the differential will be

discontinued if they allow their certification to lapse or move to an area that the credential will not serve the

individual or the institution in a positive manner.

DATA COLLECTION: Quality Improvement data that continues to be collected will be interpreted at

various stages of the implementation. This data will compare the differences in care pre-certification and

in increments of post certification at 10%, 20% and 50% of staff obtaining specialty certification. Our goal

is to be a realistic goal for specialty certified nurses at our institution, with at least 50% of the nurses

obtaining certification.

50

Motivation

Self-Reflection of Project and Critique of

Research Utilization

51

Motivation

Strengths: The ability to collaborate among each other on all of the articles. Each person had the

opportunity to read over the others articles and we all discussed the findings. Each of us had different

perceptions of the articles and this helped for all of us open our minds and absorb other’s thoughts. We

enjoyed expressing our thoughts with each other on the subject of specialty certification.

Weakness: Some of the statistical data was confusing in the articles. It took some time to decipher the

results of some of the studies. Another weakness that could be considered is that with nine of us, mostly

managers, our perceptions are probably different form the average staff nurse as it relates to certification.

We as managers do value education because we strive for excellence in our departments.

52

Motivation

If we were to do it again, we may would change the focus of the research or use multiple foci in the

research. Specialty certification can be viewed from many angles, we chose motivation for seeking

certification because we need to elevate the education of nurses in regards to providing quality care to

patients. This research was based on a need for seeking Magnet Recognition.

This project would benefit our nursing practice at JRMC, and world wide, due to the increased level of

knowledge that nurses achieve when acquiring specialty certification. Each certifying body is believed to

be the guardians of their standards of practice, which will eventually equate to the golden standard of care

one day.

53

Motivation

The Iowa Model of Evidence-Based Practice to Promote Quality Care is the model that we chose. This

model is simple to use. Our institution uses a similar model when identifying problems. Once the problem

is identified, and it is a hospital wide problem, and team is formed to devise and implement a change.

JRMC uses the PDCA cycle – Plan, Do, Check, Act. While on our journey in seeking Magnet Recognition

our practice will change to evidence-based practice, more so than we are already. We would not be

surprised if one of the research models discussed in our text was adopted by our institution.

54

ReferencesReferencesAmerican Association of Critical-Care Nurses. (2002). Summary of Findings: Taking

the Pulse – Key Influencer Survey. Fleishmen-Hillard Knowledge Solutions.

New Data Reveals Nurse Certification Key Component of Patient Safety and

Recruitment and Retention Programs. (2003). American Journal of

Critical Care, 12, 160-164.

Byrne, M., Valentine, W., Carter, S. (2004). The Value of Certification-A Research

Journey. Association of Perioperative Nurses, 79(4), 825-835.

Motivation

55

ReferencesReferences

Cary, Ann H., PhD, MPH, RN, A-CCC. (2001). Certified Registered Nurses: Results of

the Study of the Certified Workforce. American Journal of Nursing, 101(1),

44-52.

Stromborg, M.., Niebuhr, B., Fabrey, L., Muenzen, P., Spence, C., Towers, J., et al.

(2005) Specialty Certification – More Than a Title. Nursing Management,

2005, 36(5), 36-46.

Gaberson, K., Schroeter, K., Killen, A., Valentine, W. (2003). The Perceived Value of

Certification by Certified Perioperative Nurses. Nursing Outlook 2003, 51,

272-6.

Motivation

56

ReferencesReferences

Ellison, S. (2003). Nurses’ Attitudes Toward Family Presence During Resuscitative

Efforts and Invasive Procedures. Journal of Emergency Nursing, 29(6),

515-21.

Jakubik, L., Grossman, M., Daly-Parker, M., Gaffney, L., Strauss, K., Mars, P. (2004).

Clinical and Professional Role Development Among Experienced Pediatric

Nurses: The Pediatric Nursing Certificate Program. Journal for Specialists in

Pediatric Nursing, 9(4), 113-122.

McClain, N., Richardson, B., Wyatt, J. (2004). A profile of Certification for Pediatric

Nurses. Pediatric Nursing, 30(3), 207-211.

Motivation

57

ReferencesReferences

Oncology Nursing Certification Corporation Research Committee and Executive Staff. Oncology Nursing Certification Corporation Research Committee and Executive Staff.

(1999). Report of a State-of-the-Knowledge Conference on U.S. Nursing Certification. (1999). Report of a State-of-the-Knowledge Conference on U.S. Nursing Certification.

Image: Journal of Nursing Scholarship, Image: Journal of Nursing Scholarship, 31(1)31(1), 51-5., 51-5.

Motivation