Kristin Hittle Gigli is a postdoctoral fellow.
Billie S. Davis is a senior analyst.
Am J Crit Care. 2020 Jan 1;29(1):e1-e8. doi: 10.4037/ajcc2020866.
Little is known about how the education and specialty certification of intensive care unit nurses influence patients' outcomes.
To examine the relationships between critical care nurses' education level and specialty certification, their individual psychosocial beliefs about their place on the intensive care unit team (in relation to 3 factors: professional identity, self-efficacy, and role clarity), and their perceptions of evidence-based practices used in the intensive care unit.
A cross-sectional survey was emailed to nurses in 12 adult intensive care units within 6 hospitals in a single, integrated health care system.
Of 268 respondents, 180 (71%) had a bachelor of science degree or higher, and 71 (26%) had critical care certification. Compared with noncertified nurses, certified nurses reported greater knowledge of spontaneous breathing trials (4.6 vs 4.4 on a 5-point scale, P = .03) and lung-protective ventilation (4.2 vs 3.9, P = .05). Certified nurses reported significantly higher self-efficacy (4.5 vs 4.3 on a 5-point scale, P = .001) and role clarity (4.4 vs 4.2, P = .05) than noncertified nurses. Certification was also associated with greater perceived value in specific practices (daily interruption of sedation: adjusted odds ratio 2.5 [95% CI, 1.0-6.3], P = .05; lung-protective ventilation: adjusted odds ratio, 1.9 [95% CI, 1.1-3.3], P = .03). Education level was not associated with greater knowledge of or perceived value in evidence-based practices.
Nursing specialty certification was associated with nurses' individual psychosocial beliefs and their perceptions of evidence-based practices in the intensive care unit, whereas education level was not. Supporting nurses in obtaining specialty certification could assist with the adoption of evidence-based practices as a means to improve quality of care in the intensive care unit.
关于重症监护病房护士的教育程度和专业认证如何影响患者结局，人们知之甚少。
探讨重症监护病房护士的教育水平和专业认证与其个体在重症监护病房团队中的心理社会信念（与 3 个因素有关：专业身份、自我效能和角色清晰度）以及对重症监护病房中使用的基于证据的实践的看法之间的关系。
在单个综合医疗保健系统内的 6 家医院的 12 个成人重症监护病房内向护士发送了横断面调查电子邮件。
在 268 名应答者中，有 180 名（71%）具有理学学士或更高学位，有 71 名（26%）具有重症监护认证。与未认证护士相比，认证护士对自主呼吸试验（5 分制，4.6 分比 4.4 分，P =.03）和肺保护性通气（4.2 分比 3.9 分，P =.05）的了解程度更高。认证护士的自我效能感（5 分制，4.5 分比 4.3 分，P =.001）和角色清晰度（4.4 分比 4.2 分，P =.05）显著高于非认证护士。认证还与对特定实践的感知价值更高相关（每日镇静中断：调整后的优势比 2.5 [95%CI，1.0-6.3]，P =.05；肺保护性通气：调整后的优势比，1.9 [95%CI，1.1-3.3]，P =.03）。教育水平与对基于证据的实践的了解程度或感知价值无关。
护理专业认证与护士在重症监护病房中的个体心理社会信念及其对基于证据的实践的看法相关，而教育水平则不然。支持护士获得专业认证可以帮助采用基于证据的实践，从而提高重症监护病房的护理质量。
