Nursing specialty certification and nursing-sensitive patient outcomes in the intensive care unit.

摘要

BACKGROUND: 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. OBJECTIVES: To determine whether the proportion of certified nurses on a unit is associated with the rate of nurse-sensitive patient outcomes. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.