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Increasing Professional Nursing Certification: Breaking Down Barriers and Raising Up Nursing

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Increasing Professional Nursing Certification: Breaking Down Barriers and Raising Up Nursing Jessica Carney ADN, RN, CMSRN, Staff & Charge Nurse – PowerPoint PPT presentation

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Title: Increasing Professional Nursing Certification: Breaking Down Barriers and Raising Up Nursing


1
Increasing Professional Nursing Certification
Breaking Down Barriers and Raising Up Nursing
  • Jessica Carney
  • ADN, RN, CMSRN, Staff Charge Nurse
  • Amber Clark
  • ADN, RN, CMSRN, Staff Charge Nurse
  • Andrea Helt
  • ADN, RN, CMSRN, Staff Charge Nurse

2
Background
  • Nursing certification has been shown to advance
    the professional nurses knowledge and skill.
    This in turn has a direct impact on patient
    outcomes, such as NDNQI nurse-sensitive
    indicators and CMS Never Events.
  • Certification allows the RN to recognize their
    self-worth and be viewed as experts and owners of
    their practice.
  • Certification contributes to improved
    productivity, staff retention, and patient
    outcomes.

3
Saint Lukes Hospital Perspective
  • Saint Lukes Hospital of Kansas City recognized
    the importance of promoting certification,
    particularly in medical/surgical nursing
    practice.
  • The hospital believed that bedside nurses could
    fuel a powerful and passionate effort to
    eliminate barriers and create a culture of
    certification.

4
Background
  • The pilot unit, E4, was selected because they
    were an acute medical surgical unit that had a
    below benchmark percentage of certified
    registered nurses.
  • At the start of the pilot 1 of 37 (3) of RNs
    had attained a professional certification.
  • For like Adult Med-Surg Combined Units
  • 2Q2010 NDNQI
  • Mean certified 14.5
  • Magnet Hospital 90th Percentile 34.3

5
Objectives/Purpose
  1. Create a unit culture that recognizes the
    importance of professional nursing certification
    for the RN and those they serve.
  2. Identify strategies that may mediate stated
    barriers to certification.
  3. Design and implement creative approaches to
    diminish barriers to attaining professional
    nursing certification.
  4. Improve patient outcomes, including NDNQI
    nurse-sensitive indicators and CMS Never Events,
    through the benefits of professional
    certification.

6
Methods
  • Staff were surveyed about why they were not
    pursuing certification.
  • The results were used to target efforts to
    breakdown the stated barriers.
  • The top barriers were identified and ranked

7
Methods
  • Expenses
  • Grant monies used to pay exam fees in advance and
    memberships to local and national nursing
    organization
  • Lack of awareness of how certification would
    benefit them personally and/or professionally
  • Shared potential benefits of certification noted
    in the literature.
  • ? confidence, especially to intervene and prevent
    problems
  • ? nurse/physician collaboration
  • ? adverse events in patient care ? patient
    outcomes
  • ? patient satisfaction ratings
  • ? disciplinary events
  • ? work-related injuries
  • ? productivity and staff retention

8
Methods Cont.
  • Test anxiety/Fear of not passing
  • Education about test taking strategies
  • Highlighted St. Lukes Hospitals high prior pass
    rates for the exam (95 for SLH, only 80.3
    nationally)
  • Group study efforts
  • Cheerleading by study leaders
  • Goody bags
  • Access to Employee Assistance Program
  • Difficulty with scheduling (studying and testing)
  • Leadership engagement through flexible scheduling
  • Aide with enrollment in review course and exam

9
Methods Cont.
  • Inadequate study/preparation resources
  • Grant monies purchased study/preparation
    materials
  • Sample test questions were provided for
    preparation
  • Hospital library offered additional resource
    materials for certification
  • Perceived lack of recognition of certification
    status
  • Benefits shown in handouts, one to one mentoring,
    poster presentations and role modeling
  • Certified Nurses Day
  • Plaques
  • Certification credentials on name badge
  • Nursing News
  • Making Rounds

10
Methods Cont.
  • Perceived lack of support of unit/peers and
    hospital
  • Intentional role modeling support
  • Change in unit culture, via champions and peer
    support.
  • Friendly competition
  • Certification has now become an expectation
  • Now a matter of when
  • rather than if
  • they will become certified
  • Unintentional support
  • Certified RNs are now mentors, role models, and
    support for others journey to certification

11
Results
  • 19 nurses attained certification as of June 2010
  • Increased the percent of E4 certified nurses from
    3 to 54
  • 8 more staff have committed to attaining
    certification in the fall of 2010

12
Breaking Down Barriers Change of Perceptions
  • Staff value certification
  • Sense of accomplishment
  • Expectation of certification
  • Hospital-wide champions
  • Using knowledge gained to teach their peers

13
Breaking Down Barriers
  • Statistically significant change in rankings for
    expenses and scheduling
  • Once cost of expense was mediated, the top
    barrier became scheduling
  • Most common scheduling issue is meeting hours of
    practice requirement for testing.

14
Impact on Indicators in Literature
  • Increased RN confidence
  • Self-reports and reports by others concur
  • Improved nurse/physician collaboration
  • Physicians and RNs agree
  • Fewer disciplinary events
  • RN disciplinary actions decreased per manager
  • Fewer work-related injuries
  • Employee health noted a significant decrease,
    eliminated in 2Q2010
  • Fewer adverse events and improved patient
    outcomes
  • Fall rates with injury reduced and Pt ID errors
    eliminated in 2Q2010
  • Improvement in CMS SCIP Core Measures
  • Higher patient satisfaction ratings
  • 6 Pt satisfaction indicators improved (greatest
    change in nursing explanations and pain
    management)

15
Conclusion
  • Confidence with staff has increased shows in
    their practice and patient outcomes
  • More engagement of the nursing staff on the unit,
    organizational, and professional level
  • Patient satisfaction is on the rise
  • Palpable positive change in unit culture
  • Not only have we improved patient outcomes and
    satisfaction, the process of the project has
    created unit based leaders and an overall sense
    of accomplishment and confidence
  • Investment in Nurses Becoming Certified
  • Priceless!

16
References
  • American Association of Critical-Care Nurses
    (AACN). Retrieved November 6, 2008 from website
  • http//www.aacn.org/WD/Certifications/Content/bene
    fitsofcert.pcms?menuCertification
  • Academy of Medical-Surgical Nurses. 2004.
    Position Statement Paper Certification.
  • Academy of Medical-Surgical Nurses. (2010).
    Comparison of CMSRN versus RN-BC.
    http//www.amsn.org/cgi-bin/WebObjects/AMSNMain.wo
    a/wa/viewSection?s_ id1073744070ss_id536873595
  • Cary, A 2001. Certified Registered Nurses
    Results of the study of the certified workforce.
    American Journal of Nursing. 101(1)44-52.

17
References
  • Forces of Magnetism. (n.d.). Retrieved October
    31, 2008 from American Nurse Credentialing Center
    Website
  • http//www.nursecredentialing.org/Magnet/ProgramOv
    erview/Forces of Magnetism.aspx
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