The Relationship Between Direct‐Care RN Specialty Certification and Surgical Patient Outcomes

Abstract

Specialty certification enhances patient safety in health care by validating that practice is consistent with standards of excellence. The purpose of this research was to explore the relationship between direct-care, specialty-certified nurses employed in perioperative units, surgical intensive care units (SICUs), and surgical units and nursing-sensitive patient outcomes in SICUs and surgical units. Lower rates of central-line-associated bloodstream infections in SICUs were significantly associated with higher rates of CPAN (certified postanesthesia nurse) (β = -0.09, P = .05) and CNOR/CRNFA (certified nurse operating room/certified RN first assistant) (β = -0.17, P = .00) certifications in perioperative units. Unexpectedly, higher rates of CNOR/CRNFA certification in perioperative units were associated with higher rates of hospital-acquired pressure ulcers (β = 0.08, P = .03) and unit-acquired pressure ulcers (β = 0.13, P = .00), possibly because of a higher risk of pressure ulcers in the patient population. Additional research is needed to clarify this relationship. Our findings lend credence to perioperative, SICU, and surgical nurses participating in lifelong learning and continuous professional development, including achievement of specialty certification.

Bylaws Committee 2017–2018 Changes

“…A study by Gaberson et al identified the perceived values of the CNOR and the CRNFA to the nurses earning the credentials as personal value, recognition by others, and professional practice. After this study, a study by Boyle et al examined the relationship of certification and surgical patient outcomes. The authors found that clinicians with CNOR/CRNFA and CPAN certifications were associated with lower central line–associated blood stream infection rates in surgical intensive care units .…”

“…After this study, a study by Boyle et al examined the relationship of certification and surgical patient outcomes. The authors found that clinicians with CNOR/CRNFA and CPAN certifications were associated with lower central line–associated blood stream infection rates in surgical intensive care units . However, there was an unexpected finding regarding pressure injuries: the authors conjectured that the same patients were at higher risk for pressure injuries and that additional research is warranted.…”

“…The authors found that clinicians with CNOR/CRNFA and CPAN certifications were associated with lower central line-associated blood stream infection rates in surgical intensive care units. 5 However, there was an unexpected finding regarding pressure injuries: the authors conjectured that the same patients were at higher risk for pressure injuries and that additional research is warranted. Sechrist et al 6 also examined the perceived value of certification among certified, noncertified, and administrative perioperative nurses with leadership responsibilities, but the results of this study were unclear as to a relationship between certification and the perceived value of certification by administrative nurses.…”

AORN Position Statement on Perioperative Nursing Certification

“…cognizant of the value of certification and must develop and implement programs to support certification in the workplace.” 5 A study by McHugh et al in 2013 associated nursing characteristics such as higher levels of education and certification with significantly lower rates of patient mortality and failure to rescue 6 . Research published in 2014 in the AORN Journal found that certified RNs working in the perioperative environment had a positive effect on patient outcomes 7 …”

“…6 Research published in 2014 in the AORN Journal found that certified RNs working in the perioperative environment had a positive effect on patient outcomes. 7 Because certification in perioperative nursing verifies what an accomplished perioperative nurse should know and do in the context of his or her daily work, all perioperative nurses are encouraged to pursue specialty certification as a means to demonstrate their mastery of nationally recognized nursing standards and evidence-based practices. In addition, perioperative RNs who complete their certification are excellent resources to mentor future candidates in appropriate practices through the knowledge and experiences they have gained in their specialty.…”