Surpassing NDNQI Certification Benchmarks in a Pediatric Intensive Care Unit

Purpose:
Nursing leaders are challenged to promote, facilitate, and inspire certification achievement among their staff. The NOM and CNS collaborated to increase specialty certification in this PICU. The initial goal was to surpass the certification benchmark of 15%.

Significance:
The NDNQI links the education and certification of the nursing workforce to improved nursing sensitive patient outcomes such as Ventilator Associated Pneumonia and Central Line Associated Blood Stream Infections. Certification is also linked to RN retention and job satisfaction.

Strategy and Implementation:
The NOM and CNS collaborated to promote a certified workforce. When discussing barriers for certification with the nursing staff, RNs reported the lack of a review course and out of pocket costs as the primary barriers. The strategy for increasing CCRN certification involved offering a local review course and maximizing incentive for the organization to pre-pay for certification in order to decrease the out of pocket expense for the nurse. Implementation consisted of the following: 1. Arrange certification review course 2. Pre-register staff in groups (cost savings for hospital = $100 per RN) 3. Decrease staff expenses by hosting course on site and offering course at a very reduced cost. 4. Maximize examination completion through hospital pre-payment of exam fees. 5. Prevent any out of pocket cost to staff unless the examinee was unsuccessful after second attempt or simply did not take the exam.

Evaluation:
The percentage of CCRN certified nurses increased from 7% to 24%. A second course was offered 18 months later. The overall certification rate increased to 40% in this PICU. A staff survey revealed that 76% of nurses would not have certified without the review course and pre-payment strategy.

Implications for Practice:
Certification is linked to RN retention and patient outcomes. RN turnover decreased by 51%, VAP by 80% and CABSI by 77%. This equates to retention of eight RNs, a reduction in 240 patient days, and cost savings of 1.3 million dollars associated with staff training and patient treatment.