Direct Care RNs with Specialty Certifications in Acute Care Hospitals

Purpose:
We provide a current description of direct care RNs with specialty certifications in acute care hospitals in the United States, including characteristics of certified RNs and the specific certifications held. We also describe characteristics of hospitals and units in which certified RNs work.

Background/Significance:
The nursing profession's efforts to improve healthcare quality have resulted in rapid growth in the number of both nursing specialty certifications and certified nurses. The lack of knowledge about direct care RNs with specialty certifications in acute care hospitals indicates the need for a comprehensive description based on a large sample. In response, the National Database of Nursing Quality Indicators® recently began collecting detailed nursing specialty certification data.

Methods:
We use a cross-sectional descriptive design with data from the web-based 2009 NDNQI RN Survey, combined with hospital and unit characteristics obtained from the NDNQI. The sample includes 270,423 direct care RNs in 770 NDNQI member hospitals across the United States. RNs who reported holding a specialty certification were asked to select their certifications from a list of 64 specialty certifications relevant to RNs providing direct care. Characteristics of RNs holding specialty certifications are described, as well as hospitals and types of units in which they work.

Results:
Fourteen percent (38,662) of the sample selected a specialty certification. Certified RNs were more likely to work in large, academic medical centers and Magnet hospitals. Peri-operative (16%) and critical care (16%) units had the highest percentage of certified RNs. Certified RNs are older than non-certified RNs (Mean age = 55 vs. 41) and have more professional tenure (Mean years = 20 vs. 14). More certified RNs than non-certified RNs have a BSN or higher (65 vs. 53%), and indicate a higher intent to stay on unit (85 vs. 82%). The most common certifications held are Certified Critical Care Nurse (CCRN), Certified Nurse Operating Room (CNOR), and Oncology Certified Nurse (OCN).

Conclusions and Implications for Practice:
Certified RNs are more experienced than non-certified RNs and tend to work in larger, more academic settings with magnet status. More research is needed to explore the impact of certified nurses. The NDNQI is a valuable source to explore the contribution of certified nurses to health care quality.