University of Michigan School of Nursing, Ann Arbor, MI 48104-5482, USA.
Am J Crit Care. 2010 Nov;19(6):490-8; quiz 499. doi: 10.4037/ajcc2010406.
To the public and to individual nurses, certification usually means expert, high-quality, competent nursing care. Little research, however, has yielded results that support, or refute, any differences in clinical practice between certified and noncertified nurses.
To determine whether the proportion of certified nurses on a unit is associated with the rate of nurse-sensitive patient outcomes.
A nonexperimental, correlational, descriptive design was used to anonymously survey 866 nurses working in 25 intensive care units in Southeast Michigan. The Conditions for Work Effectiveness Questionnaire-II was used to measure workplace empowerment, and an additional question was asked about certification status. Outcome data were simultaneously collected on 3 nurse-sensitive patient outcomes: (1) rate of central line catheter-associated blood stream infection, (2) rate of ventilator-associated pneumonia, and (3) prevalence of pressure ulcers. Data were aggregated and analyzed at the unit level.
No significant relationship was found between the proportion of certified nurses on a unit and patients' outcomes. The association between nurses' perception of overall work-place empowerment and certification, however, was positive and statistically significant (r=.397, P=.05).
Although a link between certification and nurse-sensitive outcomes was not established, the association between workplace empowerment and the proportion of certified nurses on a unit underscores the importance of organizational factors in the promotion of nursing certification.
对公众和个别护士而言，认证通常意味着专业、高质量、有能力的护理。然而，很少有研究得出支持或反驳认证护士和非认证护士在临床实践中存在差异的结果。
确定单位内认证护士的比例是否与护士敏感的患者结局发生率相关。
采用非实验性、相关性、描述性设计，匿名调查密歇根州东南部 25 个重症监护病房的 866 名护士。使用工作环境效能问卷-II 来衡量工作场所的授权情况，并询问有关认证状态的额外问题。同时收集 3 项护士敏感的患者结局数据：（1）中心静脉导管相关血流感染率，（2）呼吸机相关性肺炎率，以及（3）压疮发生率。数据在单位级别进行汇总和分析。
单位内认证护士的比例与患者结局之间未发现显著关系。然而，护士对整体工作场所授权的感知与认证之间存在正相关且具有统计学意义（r=.397，P=.05）。
尽管未建立认证与护士敏感结局之间的联系，但工作场所授权与单位内认证护士比例之间的关联强调了组织因素在促进护理认证方面的重要性。
