Noncertified Nurses Research Articles

Evaluating the Perceived Value of Holistic Certification Among Nurses: A Descriptive Survey Study.

Purpose: Specialty nursing certifications serve as a validation of nursing knowledge in specific areas. Holistic nursing emphasizes comprehensive patient care and incorporates complementary alternative modalities (CAM) into daily care. Despite its significance, limited research has evaluated the perceived value of holistic nursing certification among nurses. Study Design: Descriptive survey design. Methods: The Likert-scale survey Perceived Value of Certification (PVCT)-12 Tool was given to holistic certified and non-certified nurses at a large, academic Magnet hospital in the northeast United States from 10/2022 to 2/2023. Additionally, non-certified nurses were asked to select the top three barriers to certification from a list of nine. The responses between certified and non-certified nurses were compared using the Chi-square test, Fisher's exact test, or Student's t-test as appropriate. Findings: A total of 59 nurses (25 certified, 34 non-certified) met inclusion criteria. Ninety-six percent of certified nurses versus 64.7% of non-certified nurses agreed that certification demonstrates a commitment to the nursing profession, p = 0.004, but, otherwise, responses to the PVCT-12 Tool were similar. Both groups felt certification was more strongly associated with intrinsic factors (e.g., sense of accomplishment) than extrinsic factors (e.g., salary). Conclusion: Nurses were consistent in their perceived value of holistic certification, regardless of their certification status.

The associations among nurse work engagement, job satisfaction, quality of care, and intent to leave: A national survey in the United States

ObjectivesEmployee work engagement, job satisfaction, quality of care, and intent to leave are critical indicators for healthcare organizational performance. This study aimed to analyze the current state of nurses’ work engagement and its factors to examine the associations among nurses’ work engagement, job satisfaction, quality of care, and intent to leave in the United States (US). MethodsThis is a quantitative descriptive cross-section design. Data were collected online from the US registered nurses from March to September 2022. Measures comprised the Utrecht Work Engagement Scale, the demographics, and questions regarding job satisfaction, perceived quality of care, and intent to leave. ResultsNine hundred nurses participated in the online survey. Among the participants, 79.2% reported holding a specialty certification, 59.4% scored high/very high on job satisfaction, 82.2% expressed high/very high on the perceived quality of nursing care, and 28.4% conveyed likely/very likely to leave in the following year. Nurses’ work engagement was positively associated with nurses’ job satisfaction and their perceived quality of care but negatively associated with intent to leave. More certified nurses reported high or very high job satisfaction than non-certified nurses. As for demographics, the linear regression analysis showed that nurses who were older, identified as White, and held doctorate degrees reported higher levels of work engagement in comparison to their counterparts. ConclusionsThis study shows that nurses’ work engagement is associated with their job satisfaction, perceived quality of care, and intent to leave. Nurses’ work engagement in this study is lower than in other studies, especially before the COVID-19 pandemic, which may indicate a possible association with the COVID-19 impact. Because nurses’ work engagement is significantly associated with job satisfaction, nurse leaders need to find ways to promote nurses’ job satisfaction and retention.

Differences in Perioperative Nurse Job Satisfaction by Specialty Certification Status

PurposeTo describe differences in perioperative RN job satisfaction by specialty certification status. DesignA retrospective, exploratory, cross-sectional design. MethodsWe conducted a secondary analysis of annual data from the National Database of Nursing Quality Indicators (NDNQI) RN Survey with 12 Job Satisfaction Scales. The sample consisted of 776 perioperative units in 206 hospitals with 13,061 study participants. We used multilevel mixed modeling to examine differences in job satisfaction for nurses holding CAPA (Certified Ambulatory Perianesthesia Nurse), CPAN (Certified Post Anesthesia Nurse), CNOR (certification for perioperative registered nurses), CRNFA (Certified RN First Assistant), other specialty certification, and not specialty certified. FindingsTwelve percent of RN participants held a perioperative nursing certification (CAPA, CPAN, CNOR, CRNFA), 15% held other nursing specialty certifications, and 73% were not certified. Regardless of certification status, nurses were the most satisfied with nurse-nurse interactions and task. They were the least satisfied with nursing administration, decision-making, and pay. CNOR certified nurses reported the lowest levels of job satisfaction in the study. CAPA and CPAN certified nurses reported higher job satisfaction than their noncertified colleagues on multiple job satisfaction scales (ie, CAPA 10 of 12; CPAN 5 of 12). CNOR certified nurses did not report meaningful differences in job satisfaction from non-certified nurses. ConclusionsAs job satisfaction impacts retention, productivity, and patient care quality, our findings have important implications for hospital leaders, nurses, and health care consumers. Based on our findings, we identified nursing professional development as a potential gap in job satisfaction that leaders can target for improvement. Our findings suggest that higher specialty nursing certification rates in perianesthesia nurses may potentially improve job satisfaction and retention of nurses.

A qualitative study of the value, organizational supports, and barriers to specialty nursing certification

BackgroundAttaining specialty nursing certification promotes improved performance through increased knowledge, skills, and competencies, all resulting in improved performance. Some specialty nurses decide to participate in the certification process while many others do not. This study explored how nurses value being certified and the barriers and organizational supports to certification they experience. MethodsIn this qualitative interpretive study we conducted semi-structured interviews with 11 certified and 10 noncertified specialty nurses. We used a convenience sample of hospital nurses that work in the United States Midwest region and utilized a blended deductive-inductive coding process for data analysis. ResultsA delineation of value between certified and noncertified nurses existed. Certified nurses tended to emphasize the intrinsic value of certification, while noncertified nurses leaned toward extrinsic value, with various contextual factors often discouraging them from becoming certified. ConclusionResults of this study indicated that hospitals that wish to increase their certified nursing staff need to provide financial and organizational support mechanisms to their nurses who tend to use extrinsic value to influence their decisions to become certified or not.

The Perceived Value of Certification of Plastic and Aesthetic Nurses.

There is no quantitative evidence as to how plastic and aesthetic nurses perceive the value of certification. The aim of this study was to determine how certified and noncertified plastic and aesthetic registered nurses (RNs), who are members of the International Society of Plastic and Aesthetic Nurses (ISPAN), perceive the value of certification. A secondary study aim was to compare perceptions of nurses who hold a CPSN (Certified Plastic Surgical Nurse), CANS (Certified Aesthetic Nurse Specialist), or both certifications with nurses who do not hold these certifications. Upon approval of the ISPAN Board of Directors, the researchers prepared a survey. The survey collected demographic information sufficient to capture a picture of the nurses participating in the survey and to compare profiles of certified and noncertified nurses. The Perceived Value of Certification Tool (PVCT)-12 was used to obtain information about the nurses' perceived extrinsic and intrinsic values of certification. Overall, the highest level of agreement was found with the intrinsic value statements. Across all 12 items of the PVCT-12, participants who held a CPSN and/or CANS certification reported greater perceptions of the value of the CPSN and CANS certifications than participants who did not hold a CPSN or CANS certification. Certified participants' intrinsic and extrinsic value scores were found to be significantly higher than noncertified participants' scores. The extrinsic value statements of the PVCT-12 were the least endorsed. Extrinsic rewards in combination with added support and recognition for nurses may be what is necessary to increase the proportion of certified nurses.

Factors Associated With Nurses' Knowledge of and Perceived Value in Evidence-Based Practices.

Little is known about how the education and specialty certification of intensive care unit nurses influence patients' outcomes. To examine the relationships between critical care nurses' education level and specialty certification, their individual psychosocial beliefs about their place on the intensive care unit team (in relation to 3 factors: professional identity, self-efficacy, and role clarity), and their perceptions of evidence-based practices used in the intensive care unit. A cross-sectional survey was emailed to nurses in 12 adult intensive care units within 6 hospitals in a single, integrated health care system. Of 268 respondents, 180 (71%) had a bachelor of science degree or higher, and 71 (26%) had critical care certification. Compared with noncertified nurses, certified nurses reported greater knowledge of spontaneous breathing trials (4.6 vs 4.4 on a 5-point scale, P = .03) and lung-protective ventilation (4.2 vs 3.9, P = .05). Certified nurses reported significantly higher self-efficacy (4.5 vs 4.3 on a 5-point scale, P = .001) and role clarity (4.4 vs 4.2, P = .05) than noncertified nurses. Certification was also associated with greater perceived value in specific practices (daily interruption of sedation: adjusted odds ratio 2.5 [95% CI, 1.0-6.3], P = .05; lung-protective ventilation: adjusted odds ratio, 1.9 [95% CI, 1.1-3.3], P = .03). Education level was not associated with greater knowledge of or perceived value in evidence-based practices. Nursing specialty certification was associated with nurses' individual psychosocial beliefs and their perceptions of evidence-based practices in the intensive care unit, whereas education level was not. Supporting nurses in obtaining specialty certification could assist with the adoption of evidence-based practices as a means to improve quality of care in the intensive care unit.

INTERRATER RELIABILITY DAN INTERNAL CONSISTENCY PENGKAJIAN LUKA KAKI DIABETIK THE NEW DIABETIC FOOT ULCER ASSESSMENT SCALE (DFUAS) BERBASIS FOTO

Diabetic foot ulcers have a high prevalence that requires good management of care. One of them is by assessing diabetic foot wounds. Currently, there has been a review of diabetic foot healing footage of New Diabetic Foot Ulcer Assessment Scale (DFUAS) which has been tested for validity and photo-based reliability. Nevertheless, in the DFUAS Assessment Reliability Test, there are still differences in perceptions on several DFUAS assessment variables on wound nurses. One reason is that there is no socialization given to the wound nurses on how to assess the DFUAS assessment. In addition, the previous DFUAS assessment reliability test is only performed on certified wound nurses whereas in health care services in patients with diabetic foot injuries are also performed by non-certified general nurses. This study aims to assess the interrater reliability and internal consistency of DFUAS-based on photo assessment on expert nurses and general nurses. The design of this study was cross sectional study. The samples in this study were certified nurses with ETN, CWCC, CWCCA and general non-certified Nurses with more than 2 years experience of wound care. The nurse as an observer evaluated 8 wounded images divided according to the wound stage (necrotic, slough, granulation and epithelial) using DFUAS assessment. Interrater reliability was assessed by spearman rho while internal consistency was assessed by cronbach's alpha. Interrater reliability shows good correlation with spearman rho> 0.60. Internal consistency shows good reliability between DFUAS assessment items and Cronbach's alpha 0.98. This study shows that the DFUAS assessment is reliable on different nurses both certified nurses and general nurses.

Exploring Inpatient Medication Patterns

Exploratory study to examine inpatient medication administration patterns. Data from multiple sources were utilized for this study. The outcome was time difference between medication schedule and administration. A 3-level hierarchical linear regression approach, both unadjusted and adjusted, was considered for this study where medication administration events are nested within patients nested within nurses or units. Intraclass correlation coefficients (ICCs) were calculated and compared. On average, medications were delayed by 12 (SD, 48.8) minutes. From the full model, patient ICCs decreased when "unit" replaced "nurse" as the 3rd level (0.541 vs 0.444). Patients who spoke Spanish had a significant 2.3- to 4.2-minute delay in medication administration. Certified nurses significantly give medications earlier compared with noncertified nurses by 1.6 minutes. Optimal medication administration is a multifactorial concern with nurses playing a role. Nursing leaders should also consider patient demographics and unit conditions, such as culture, for medication administration optimization.

Assessment of long-term impact of formal certified cardiopulmonary resuscitation training program among nurses.

Context:Cardiopulmonary resuscitation (CPR) and emergency cardiovascular care guidelines are periodically renewed and published by the American Heart Association. Formal training programs are conducted based on these guidelines. Despite widespread training CPR is often poorly performed. Hospital educators spend a significant amount of time and money in training health professionals and maintaining basic life support (BLS) and advanced cardiac life support (ACLS) skills among them. However, very little data are available in the literature highlighting the long-term impact of these training.Aims:To evaluate the impact of formal certified CPR training program on the knowledge and skill of CPR among nurses, to identify self-reported outcomes of attempted CPR and training needs of nurses.Setting and Design:Tertiary care hospital, Prospective, repeated-measures design.Subjects and Methods:A series of certified BLS and ACLS training programs were conducted during 2010 and 2011. Written and practical performance tests were done. Final testing was undertaken 3–4 years after training. The sample included all available, willing CPR certified nurses and experience matched CPR noncertified nurses.Statistical Analysis Used:SPSS for Windows version 21.0.Results:The majority of the 206 nurses (93 CPR certified and 113 noncertified) were females. There was a statistically significant increase in mean knowledge level and overall performance before and after the formal certified CPR training program (P = 0.000). However, the mean knowledge scores were equivalent among the CPR certified and noncertified nurses, although the certified nurses scored a higher mean score (P = 0.140).Conclusions:Formal certified CPR training program increases CPR knowledge and skill. However, significant long-term effects could not be found. There is a need for regular and periodic recertification.

The Value of Oncology Nursing Certification

The attainment of oncology nursing certification indicates that a nurse has the knowledge and expertise to competently care for patients with an actual or potential diagnosis of cancer. Research regarding the value nurses associate with certification is lacking; therefore, the Oncology Nursing Certification Corporation participated in a national study led by the American Board of Nursing Specialties Research Committee to explore the value of certification in a sample of certified and noncertified nurses and nurse managers. A total of 940 oncology nurses participated and completed a demographic survey and the Perceived Value of Certification Tool. Most were Caucasian women, with a mean age of 54 years; 36% were staff nurses, 19% were nurse managers, and 10% were advanced practice nurses. A high value of certification was reported. Barriers to certification included cost issues and lack of institutional reward and support. Benefits included institutional reimbursement and listing certification credentials on name badges or business cards. Both certified and noncertified nurses value certification. Increasing institutional recognition and financial support could improve nurse certification rates and ultimately may result in improved patient care.

Nursing Specialty Certification and Nursing-Sensitive Patient Outcomes in the Intensive Care Unit

To the public and to individual nurses, certification usually means expert, high-quality, competent nursing care. Little research, however, has yielded results that support, or refute, any differences in clinical practice between certified and noncertified nurses. To determine whether the proportion of certified nurses on a unit is associated with the rate of nurse-sensitive patient outcomes. A nonexperimental, correlational, descriptive design was used to anonymously survey 866 nurses working in 25 intensive care units in Southeast Michigan. The Conditions for Work Effectiveness Questionnaire-II was used to measure workplace empowerment, and an additional question was asked about certification status. Outcome data were simultaneously collected on 3 nurse-sensitive patient outcomes: (1) rate of central line catheter-associated blood stream infection, (2) rate of ventilator-associated pneumonia, and (3) prevalence of pressure ulcers. Data were aggregated and analyzed at the unit level. No significant relationship was found between the proportion of certified nurses on a unit and patients' outcomes. The association between nurses' perception of overall work-place empowerment and certification, however, was positive and statistically significant (r=.397, P=.05). Although a link between certification and nurse-sensitive outcomes was not established, the association between workplace empowerment and the proportion of certified nurses on a unit underscores the importance of organizational factors in the promotion of nursing certification.

Effect of Certification in Oncology Nursing on Nursing-Sensitive Outcomes

The study compared certified nurses with noncertified nurses for symptom management of nausea, vomiting, and pain; patient satisfaction; and nurse satisfaction to determine the effect of certification in oncology nursing on those nursing-sensitive outcomes. A total of 93 nurses-35 (38%) of them certified in oncology nursing-and 270 patients completed surveys. Chart audits provided additional data on symptom management. Certified nurses scored higher than noncertified nurses on the Nurses' Knowledge and Attitudes Survey Regarding Pain as well as the Nausea Management: Nurses' Knowledge and Attitudes Survey. The chart audits showed that certified nurses followed National Comprehensive Cancer Network guidelines for chemotherapy-induced nausea and vomiting (CINV) management more often than noncertified nurses. The study demonstrated that job satisfaction is fairly high for oncology nurses and patient satisfaction is high. In general, cancer pain and CINV were managed well but improvements can be made. Nurses and physicians continuously should be educated on evidence-based guidelines for symptom management of cancer pain and CINV, and a CINV knowledge and attitude assessment tool should be developed.

Identification of Barriers to Sexual Health Assessment in Oncology Nursing Practice

To explore oncology nurses' attitudes about and knowledge of sexual health. Sexual health is an integral component of quality of life, which is an Oncology Nursing Society research priority. A descriptive, cross-sectional design. A National Cancer Institute-designated comprehensive cancer center in the northeastern United States. A convenience sample of 576 RNs working in acute care, ambulatory, and perioperative services were approached during an annual mandatory training day. Attitudes and beliefs about patients' sexual health assessment in nursing practice were evaluated with the Sexual Attitudes and Beliefs Survey and 10 demographic questions. Oncology nurses' attitudes and beliefs regarding sexual health assessment of patients. A statistically significant difference was found in scores based on age and nursing experience, whereby younger and less experienced nurses had higher scores, indicating greater discomfort in discussing sexual health with patients. Statistical significance also was found in scores based on oncology certification and practice setting, whereby oncology certified nurses and outpatient nurses identified fewer attitudinal barriers than noncertified nurses and nurses working in the inpatient setting. The results suggest that this patient population may not be receiving a complete sexual health assessment. Nurses in the sample believed that sexuality was not too private an issue to discuss with their patients and claimed to understand how disease and treatment may affect patients' sexuality. Nurses also believed that their patients should not expect nurses to ask about their sexual concerns and often defer to the physician for any sexually related questions.

Effect of Certification in Oncology Nursing on Nursing-Sensitive Outcomes

The study compared certified nurses with noncertified nurses for symptom management of nausea, vomiting, and pain; patient satisfaction; and nurse satisfaction to determine the effect of certification in oncology nursing on those nursing-sensitive outcomes. A total of 93 nurses--35 (38%) of them certified in oncology nursing--and 270 patients completed surveys. Chart audits provided additional data on symptom management. Certified nurses scored higher than noncertified nurses on the Nurses' Knowledge and Attitudes Survey Regarding Pain as well as the Nausea Management: Nurses' Knowledge and Attitudes Survey. The chart audits showed that certified nurses followed National Comprehensive Cancer Network guidelines for chemotherapy-induced nausea and vomiting (CINV) management more often than noncertified nurses. The study demonstrated that job satisfaction is fairly high for oncology nurses and patient satisfaction is high. In general, cancer pain and CINV were managed well but improvements can be made. Nurses and physicians continuously should be educated on evidence-based guidelines for symptom management of cancer pain and CINV, and a CINV knowledge and attitude assessment tool should be developed.

Forum

Forum

Infusion Nursing Certification

Nursing certification acknowledges professional achievement and competent practice. To establish the importance of certification, it is necessary to determine the value that primary and secondary stakeholders place on certification. The Infusion Nurses Certification Corporation (INCC) participated in a national study on the Value of Specialty Nursing Certification. As a function of describing INCC's stakeholders, demographic characteristics of infusion nurses were examined. Using the Perceived Value of Certification Tool (PVCT), certified and noncertified nurses and managers were surveyed. The study clearly showed that CRNI certification is a valued credential.

The value of specialty nursing certification

The American Board of Nursing Specialties (ABNS) undertook a national study to validate nurses' perceptions, values, and behaviors related to certification. A Web-based survey was developed and disseminated to certified nurses, noncertified nurses, and nurse managers. Of the 11,427 respondents, 8,615 (75%) identified themselves as certified nurses, and 2,812 (25%) were noncertified nurses. Of these, 1,608 respondents (14%) held the position of Nurse Manager. Using the Perceived Value of Certification Tool (PVCT), certified and noncertified nurses showed a high level of agreement with the value statements on certified practice. Nurse Managers bolstered these perceptions with their correspondingly high rate of agreement on the certification value statements. Additionally, the study examined barriers and challenges to certification, incentives to certification, the impact of certification on lost workdays and nurse retention. This study took an important step in furthering understanding of nursing certification and the implications for health care organizations, nursing certification boards, and certified and noncertified nurses.

Differences in Perceptions of Empowerment Among Nationally Certified and Noncertified Nurses

To examine the difference in perceptions of empowerment between nurses who were nationally certified and those who were not. Nurses are encouraged to obtain certification in their specialty. The focus of most nursing research on certification has been on motivation to acquire certification and perceived benefits of certification. Research related to empowerment indicates that access to empowerment structures results in achievement and success. This descriptive comparative study used the Conditions of Work Effectiveness II Questionnaire to measure registered nurses' perceptions of empowerment. Certification status was recorded on the demographic section of the questionnaire. Significant differences were noted in empowerment scores for certified and noncertified nurses as measured by the Conditions of Work Effectiveness II Questionnaire. Findings suggest that nurses who are certified have higher perceptions of empowerment. Certification may increase nurses' perceptions of empowerment and therefore improve work effectiveness. Certified nurses in this study had increased access to job-related power and opportunity structures. Certification provides recognition of the nurses' knowledge and expertise in the specialty area which in turn is empowering. Organizations that support and recognize this achievement may experience improved turnover and retention rates.

Does certification status of oncology nurses make a difference in patient outcomes?

To test hypotheses that patients cared for by Oncology Certified Nurses (OCNs(r)) have superior outcomes compared to those cared for by noncertified nurses. Descriptive ex post facto. A homecare agency in the midwestern United States. 20 nurses (7 certified and 13 noncertified) and charts for 181 of their patients. Retrospective chart review. Symptom management (i.e., pain and fatigue), adverse events (e.g., infection and decubitus ulcers), and episodic care utilization (e.g., visits to care facilities, admissions to care facilities, unscheduled home visits). Contrary to hypotheses, the two groups did not differ with respect to assessment of pain at admission, number of pain assessments subsequent to admission, assessment of fatigue at admission, number of unplanned visits to care facilities, admissions to care facilities, and number of unscheduled home visits. As hypothesized, the OCNs(r) documented a higher number of postadmission fatigue assessments (p less than 0.05). Contrary to hypotheses, patients of OCNs(r) had a greater number of infections and fewer documented instances of patient teaching regarding infection. Little support was found for the hypothesis that nursing care by OCNs(r) results in superior patient outcomes in comparison to care by noncertified nurses. Further research is needed to examine the dimensions of clinical practice that may demonstrate the benefits of care by OCNs(r).

Research

Research