CHN Certification: Striving for Excellence

Community Health Nurses of Canada Conference May 17, 2011

Katie Dilworth kdilwor@toronto.caDebra Williams-Conliffe dwillia5@toronto.ca

Kim Dalla Bona KDallaBona@saintelizabeth.com

Objectives

• Learn about strategies to increase the number of nurses who attempt certification.

• Learn the relationships and connections between support, information and encouragement to help nurses to strive for certification.

Agenda

• CHN certification• Describe the collaborative study group• Recruitment history• Review Literature• Revised recruitment strategies

CHN Certification

CHN was designated by CNA as specialty nursing practice in 2005

first exam was launched by CNA in 2006 CHN is the fastest growing certification

specialty with an increase of 36.1% in 2009 Recertification rate in 2011 - 61%

Why encourage certification?

•Indicates qualified, competent and current in CHN’s •Indicates knowledge and skills are comprehensive•Validates your competency•Provides for Career advancement•Provides recognition•Provides university credit•Helps with participation in CHN development

•Certification is a way of striving to meet CCHN Standards

National Study

CHNC study: Influence of Certification on Community Health Nursing Practice (2010)

• Identify the influences of CNA’s community health nursing certification on nursing practice

• Identify the influences of CNA’s community health nursing certification on employing agencies

• Identify organizational facilitators and barriers for CCHN(C) renewal

Facilitators for Certification

Personal (Intrinsic)• Enhanced feelings of personal accomplishment• Higher personal satisfaction• Validation of specialized knowledge• Better professional growth• Attainment of practice standard or competency• Evidence of professional commitment and • Acceptance of professional challenge

Facilitators of Certification

Organizational• Reimbursement for examination costs• Work time to study• Provision of mentors• Reference materials• Continuing education onsite• Celebration and recognition of achievement

Barriers of Certification

Organizational• Absence of salary adjustment• Perceived lack of recognition of expertise• Perceived lack of support by the employer

SEHC and TPH Collaborative study group

•The whole greater than the parts: community health nurses working in virtual environments:

• SEHC – Team of more than 5,000 nurses, therapists and personal support workers delivering 4 million health care visits annually.• TPH – TPH is the largest PHU in Canada. 35 offices, 800 nurses in 12 offices with nurses• Other community agencies (PH and HH)

TPH/SEHC collaborative Study group

• Why: Intent to address both HH and PH content of the certification exam• How: teleconference, virtual Community of Practice, Collaborative planning and, facilitation.

Organizational commitment

• Organizational support from both organizations (e.g., Senior Nurse/Chief Nursing Officer, Practice councils, PPL nursing positions)• Consultant staff time to facilitate • Library resources• Financial support • Support for time for participant time to participate

Curriculum Structure

Collaboration between participants facilitated by consultant staff from each organization

•Dates•Competencies •Facilitators•Mentors

Schedule example

Recruitment Challenges

•Initial recruitment in 2006 saw a healthy group of nurses (n=10) participating in the study group.•This number remained constant in 2007 then declined in 2008 and 2009 to only two participants.

Sources of inspiration

Dillman- Survey recruitment•Frequent reminders•Provide incentives

Diffusion of Innovation theory •explains how, why, and at what rate new ideas spread – critical mass creating desire for innovation

Organizational change theory• increased visible support from senior staff

Dillman

Frequent reminders• Emails from: Senior nurse to staff, Professional

practice leader to staff, NPC• Literature sent: Packages to managers with letter

from Senior nurse, CNA pamphlets, posters, • TPH pamphlets, newsletter articles, posters in

offices, town hall display

Incentive• Congratulations letter from Senior nurse,• Recognition at nursing week event • Colleague and manager recognition,

Diffusion of innovation

Critical mass creating desire for innovation•Involved past participants: Q and A, professional development events and PHN competencies launch, accumulation of expertise.

Diffusion of innovation

Questions asked to certified nurses:

1.Why I should write the exam?

2.How much preparation time is required to study for the exam?

3.What is it like to write the exam?4.What support can I expect from Toronto Public

Health if I write my exam.

5.If I get my certification will I get paid more?

Diffusion of innovation

Example: Answer of certified nurses: Why I should write the

exam? “I’m proud to have those credentials after my name and I know others

respect it as well.”“I was amazed at how much I learned.”

“Why, to validate knowledge and re-assess assumptions that gather like an extra 10 lbs as your experience matures.”

“since studying and writing the exam I have a better understanding about other community health.”

Organizational change:

visible senior leader support

•Email messages from Senior nurse to staff nurses and to managers, also e-mail message from Senior Nurse to managers re support of their staff: “I hope you will support your staff who wish to participate in this study group with time to do so.”•Several managers certified and supportive

Results

The number of nurses attempting certification in 2010 tripled, 2011 numbers sustained this change!

Discussion and recommendations

1) Dillman, Diffusion of Innovation theory and Organizational change theory can inform strategy to increase participation in certification

2) Get creative and look for innovative solutions

References

1. Dillman D, Smyth, J., Christian L. (2009). Internet, mail, and mixed-mode Surveys. J Wiley and Sons; New Jersey p20.

2. Dllman, d. (1978). Mail and telephone surveys: the total design method / Dillman, Don A. -- New York, NY: John Wiley & Sons, 1978.

3. Dillman D, Smyth, J., Christian L. (2009). Internet, mail, and mixed-mode Surveys. J Wiley and Sons; New Jersey p22.

4. Nutbeam D., Harris H., Wise M., (2010) Theory in a nutshell a practical guide to health promotion theories. McGraw Hill: Sidney Australia. P23

5. Pederson A., O’Neill M., Rootman I. (1994). Health Promotion in Canada, Provincial, National and International Perspectives. W.B. Sanders Canada: Torotno P287.

6. Rogers, E. (1962). Diffusion of Innovations. Glencoe: Free Press.

Thank you

Questions ?