Study supports value of certified nurses

Nurses with specialty certification may play an integral part in speeding translation of the latest research into everyday clinical practice, thereby ensuring that critically ill patients receive the highest quality of care, according to a study conducted at UPMC (University of Pittsburgh Medical Center). A survey of 268 critical care nurses in six UPMC hospitals found a strong association between nurses who were certified in critical care and their knowledge of and perceived value in specific evidence-based practices used to care for patients receiving mechanical ventilation. The results, “Factors Associated with Nurses’ Knowledge of and Perceived Value in Evidence-Based Practices,” are published in the American Journal of Critical Care (AJCC).

Overall, respondents reported a high level of perceived knowledge of three specific evidence-based practices used in caring for patients receiving mechanical ventilation: spontaneous breathing trials, lung-protective ventilation and daily interruption of sedation. When compared with noncertified nurses, certified nurses reported greater perceived value of all three practices and significantly more perceived knowledge of spontaneous breathing trials and lung-protective ventilation. In addition, all respondents reported strong professional identity, self-efficacy and role clarity, all with mean scores greater than 4.0 on a 5-point scale. Nurses who held specialty certification reported higher levels of self-efficacy and role clarity than their noncertified colleagues.

An interdisciplinary research team with the Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center at the University of Pittsburgh’s Department of Critical Care Medicine conducted the study in 12 adult intensive care units (ICUs) within six UPMC hospitals. The 44-item survey was associated with a larger study examining ICU team function and the delivery of evidence-based practices, with funding from the U.S. National Institutes of Health and its National Heart, Lung, and Blood Institute.

“Many evidence-based practices remain underused, partly because of gaps between providers’ attitudes toward practices and the delivery of care at the bedside. Our findings support the value of nurses with specialty certification, especially among institutions that aim to improve outcomes and increase the adoption of evidence-based practices,” said co-author Kristin Hittle Gigli, PhD, RN, CPNP-AC, CCRN, a postdoctoral research fellow at the CRISMA Center.

The results did not indicate a strong relationship between nurses’ education levels and evidence-based practices, and the researchers point to the high percentage of respondents with a bachelor’s degree or higher (70.9%) as a potential factor in the lack of association. In addition, the survey did not ask about years of experience or certifications other than CCRN, which may be additional elements influencing nurses’ individual beliefs and perceptions.

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