Order your essay today — written by real experts, guaranteed plagiarism-free, and ready to impress your professor!
Certified Nurses: Their Impact on Patient Satisfaction Nurses can obtain certifications to demonstrate their expert knowledge of a specialty areas. Some examples of nursing certifications include Advanced Oncology Nurse, Certified Pediatric Nurse, Certified Emergency Nurse, and Certified Critical Care Nurse. These specialty areas require a specific skill set to care for the complex medical needs of their patient population. Studies have shown that nursing units with certified nurses have more satisfied patients and less patient care errors.
Problem Statement
The patient experience is an important focus for health care organizations because it is often linked to the patient’s perceived level of satisfaction. Patient satisfaction survey scores are frequently used by various agencies to measure quality care which determines reimbursement rates for healthcare organizations (Berkowitz, 2016). Identifying innovative and cost-effective ways to improve the health care experience will also help to improve satisfaction scores. Although nursing certification in specialty areas is rising, more can be done by healthcare organizations to encourage and support nurses in their professional development.
Research Question
Nursing certification provides validation of advanced knowledge and skills that are needed to meet the complex needs of patients in specialty care areas (Boyle, Kramer, Potter, Gatua, & Stobinski, 2014). These patients are often in a critical state with increased anxiety and emotional stress. Being able to trust the expertise and have confidence in the ability of their care provider may reduce one’s stress during their hospital stay. Knowing that their nurse has been certified may improve their patient experience. In patients admitted to a specialized nursing unit, what is the effect of nursing certification on patient satisfaction?
Purpose
The purpose of this study is to examine the relationship between patient satisfaction and the prevalence of certified nurses on specialized nursing units. A positive correlation would provide evidence to support innovative programs at healthcare organizations to encourage nursing certification. Improved patient satisfaction scores and a reduction in patient care errors will ultimately improve the organizations bottom line. Further research is needed to explore specialty nursing certification and how it relates to patient satisfaction.
Literature Review
The findings in the literature varied between positive and inconclusive results. According to Beck, Brant, Donohue, Towsley, Berry & Donaldson (2016), no statistically significant relationships existed between certification status and care outcomes. However, Trinkoff, Lerner, Storr, Han, Johantgen & Gartell, (2015) found that in nursing homes led by those with advanced degrees or certifications had better pain control and decreased use of urinary catheters. Another study found a significant relationship between certified critical care nurses and decreased hospital acquired infections (Boev, Xue, & Ingersoll, 2015). Meanwhile, Boyle, Kramer, Potter, Gatua & Stobinski (2014) found a lower incidence of catheter acquired urinary tract infections in both the surgical and peri-operative units. Kehl, (2014) found that certified nurses tailored education towards the education level of the recipient whereas non-certified nurses did not.
Research Synthesis
Eight studies on nursing certification and patient satisfaction published between 2013 to the present were identified and examined. A summary of the research findings for all eight studies is included in Appendix A. While some studies showed inconclusive results (Beck et al., 2016), other studies showed positive patient outcomes to support improve patient satisfaction. Whether it was improved pain control, reduced urinary catheter use, a decrease in hospital acquired infections, or improved patient education and teaching, all of these findings demonstrate significant value of nursing certification to the patient experience (Trinkoff et al., 2015; Biel et al., 2014; Boev et al., 2015; Boyle et al., 2014).
Clinical Guideline
As a result of the positive findings in the literature review, it is apparent that health care organizations should invest in programs that promote nurse certification. The proposal is the incorporation of nursing certification into the clinical advancement ladder to promote and reward nurses who achieve certification (Burke, Johnson, Sites, & Barnsteiner, 2017). By implementing this proposal, nurses looking to obtain a merit increase during the annual appraisal period will be financially motivated to obtain certification.
While most institutions have education reimbursement accounts, not all institutions cover the expenses of nursing certification. In this proposal is a recommendation to expand the current employee education reimbursement policy to include the cost for a preparatory course and cost of the exam, pass or fail, once per employee. This will demonstrate strategic alignment with the organization while minimizing the financial risk to the nurse.
The clinical advancement ladder will be re-designed to incorporate Benner’s Novice to Expert nursing theory (Burke et al., 2017). The core values of this theory were utilized to promote patient safety, and enhance job descriptions, interview questions, orientation standards, and performance appraisals (Burke et al., 2017). Improving patient care outcomes demonstrates a commitment to evidence-based practice (Burke et al., 2017).
Implementation Plan
The implement plan will follow the seven-step Iowa Model of Evidence-Based Practice to Promote Quality Care. Over a one-year period the advancement ladder will be re-designed and re-implemented in four phases. Phase one will incorporate the first four steps of the Iowa model: 1) “Selecting a Topic,” 2) “Forming a Team,” 3) “Evidence Retrieval,” and 4) “Grading of Evidence.” Phase two will focus on step five, “Developing an EBP Standard.” Phase three will focus on step six, “Implementing the EBP” and phase four with focus on step seven, “Evaluation.”
Phase one. In an effort to improve patient outcomes and patient satisfaction, it was proposed that nursing certification would be a reasonable way to improve patient satisfaction and nurse satisfaction at the same time. A team was formed called the Nurse Certification Taskforce (NCT) which included directors, managers, Clinical Nurse Specialists, and frontline nurses from each clinical service line. The team conducted a literature review and research synthesis. Sufficient data was obtained to support the initiative and the protocol aligns with the organizations goal to improve patient satisfaction.
Phase two. During phase two, the NCT will focus on developing the evidenced-based standard. Obtaining nursing certification can be costly for a nurse which may be a barrier, preventing nurses from pursuing this advanced credential. Costs include fees for preparatory classes, study materials, the exam and continuing education expenses to maintain the certification. Having a program within the organization that supports the initiative by incorporating certification as a component into the clinical advancement ladder, reimbursing employees for fees incurred in obtaining certification and a merit increase during the annual review, would be a innovative strategy to increase certification and positively impact patient satisfaction and patient outcomes. The NCT will develop an executive summary to present the initiative to the senior leadership for consideration that highlights the many returns on investment for approving this plan. Once approved, the presentation will be shared with the nursing leadership to include all directors and managers.
Phase three. During the third quarter, the revised clinical advancement model and the enhanced employee reimbursement programs will be shared in various forums including webinars, E-mail communication, and live presentations at the Professional Development Fair. The NCT will organize this event and invite several guest speakers including various certification board representatives and the Chief Nursing Officer to discuss the importance of certification. Materials will be provided with frequent questions and answers, instructions on how to apply for the exam and obtain reimbursement for the associated expenses and information on how to submit proof of obtaining certification before the close of the appraisal period. If the event is not well attended, the fair will be presented on other date and time.
Phase four. During the final quarter, the FCT will evaluate the effectiveness of the clinical advancement ladder enhancement and the expansion in the employee reimbursement policy. The NCT will obtain data pre- and post-implementation on patient satisfaction, patient safety incident report frequency, nurse satisfaction, nurse retention rates, and utilization of the employee education reimbursement accounts related to certification. The outcome measure will be improved patient satisfaction measured by Press Ganey patient satisfaction survey scores. These findings will be analyzed quarterly and reported to the shared governance committee to gauge effectiveness. If the results are not favorable, the future of the program will evaluated.
ConclusionNursing certification is a way for nurses to demonstrate their expert knowledge in a specialty area. When a patient is cared for by a certified specialty nurse, there is a reduction in errors and increased patient satisfaction. Encouraging nursing certification may be an innovative way for healthcare organizations to improve patient satisfaction. Further research is needed to examine the impact of nursing certification on improved patient satisfaction.
