Operation Certification: Increasing Nurse Certification Across Hospitals Through Cohort Creation

Operation Certification: Increasing Nurse Certification across Hospitals through Cohort Creation

Jennifer Popies, MS, RN, CCRN and Eunice Simmons, MSN, RN, CCRN-K

Wheaton Franciscan Healthcare, Milwaukee

(262) 397-4225, [email protected]

Submitting for poster presentation consideration

Background/Significance: The proportion of Registered Nurses with specialty certification in a healthcare system is correlated with improved nurse-sensitive outcomes such as fall rates. It is also associated with improved RN retention through increase in nurse job satisfaction and sense of empowerment and is linked with Magnet designation. Therefore, healthcare systems have begun to recognize the importance of increasing the proportion of RNs with specialty certification and made increasing certified nurses a strategic goal. Despite implementation of organizational incentives, such as reimbursement for certification review classes and exam fees and incorporation of certification in our Nurse Clinical Ladder, our critical care units across three hospitals had low rates of nurse certification. Only 6 out of 43 eligible nurses in our largest ICU, and 2 of 8 and 0 of 14 in our two smaller ICUs were certified prior to project implementation. : Shared Governance and leadership recognized the need to investigate reasons for the low rates of certification and tailor a unique program to increase our number of certified nurses.

Purpose: The purpose of this evidence-based quality improvement project was to create a program to increase the proportion of RNs with specialty certification in our critical care units.

Sample/Setting: Our project was implemented with critical care RNs in three hospitals; one large, urban teaching hospital, and two small, community hospitals.

Methods Practice/Development Council members created a list gathered from staff feedback during informal peer-to-peer discussions of reasons for not attempting certification. Reasons given were lack of knowledge of exam requirements and process of how to apply to test, fear of the test itself, lack of knowledge of review classes and resources, and lack of knowledge of how to obtain reimbursement after testing. Based on the feedback from staff and our evidence review that revealed the power of forming study/support groups, taking steps to alleviate cost concerns, and consistently recognizing certification achievement by unit leadership and the peer group, we created an “Operation Certification” cohort group for each of the past two fiscal years. Cohorts consisted of interested RNs that met AACN’s certification eligibility requirements with unit Nurse Educators serving as facilitators. Members of the cohort received benefits that included joining AACN and testing for specialty certification at a reduced cost, a free CCRN/PCCN review course, access to free online practice test questions, optional facilitated study group sessions that included assistance with registering to test, assistance with submitting reimbursement forms, and ensuring recognition by leadership and fellow staff.

Data Collection/Results: In our first cohort group, 17 RNs tested and 15 successfully certified; in our second cohort group, 14 RNs tested and 10 successfully certified compared to only 3 RNs testing and 2 passing in the year prior to project implementation. This has resulted in increasing the number of certified RNs to 16 of 50 eligible for our largest ICU, and 6 of 9 and 5 of 14 for our two smaller ICUs. Three Unit leaders also participated, resulting in all direct nursing leadership of critical care units in our three hospitals now holding certification. Conclusions and Implications: Our increase in the number of certified RNs has demonstrated our initiative has been successful in removing barriers to certification for our staff. Other units are now looking at adapting this cohort strategy for their areas as we have demonstrated that a focused effort on mitigating RN perceived barriers in obtaining certification can improve specialty certification rates in acute settings.