Results from a recent study indicate specialty nursing certification contributes to improved surgical patient outcomes in hospitals nationwide. Published in the November 2014 issue of AORN Journal, the research was conducted by the staff at the National Database of Nursing Quality Indicators (NDNQI) and the University of Kansas. It was sponsored by the Competency & Credentialing Institute (CCI).

The study examined surgical patient outcomes in two unit types — surgical intensive care units (SICUs) and surgical units — and assessed some of the most common complications in surgical units and their occurrences amongst patients being cared for by certified vs. non-certified nurses. Researchers studied four specialty certifications commonly held by perioperative nurses in the hospital setting: certified ambulatory perianesthesia nurse (CAPA), certified postanesthesia nurse (CPAN), certified nurse operating room (CNOR) and certified RN first assistant (CRNFA).

The research showed higher rates of CPAN and CNOR/CRNFA certification in perioperative units were significantly associated with lower rates of central-line associated bloodstream infections in SICUs. Specifically, the study indicated that a 10 percent higher rate of CNOR/CRNFA and CPAN certification in perioperative units resulted in 16 percent and 8 percent (respectively) lower rates of central-line associated bloodstream infection rates in SICUs.

“While there has been much anecdotal speculation about the benefits of specialty nursing certification, our aim was to ascertain if a positive connection exists between certification and surgical patient outcomes,” said James Stobinski, PhD, RN, CNOR, one of the study authors and Director of Credentialing & Education at CCI. “We found that higher rates of CPAN and CNOR/CRNFA contributed to improved surgical patient outcomes in SICUs when controlling for a variety of unit and hospital characteristics.”

Using data from the largest, unit-based, national nursing quality program, the National Database of Nursing Quality Indicators (NDNQI), the researchers analyzed secondary data submitted from participating NDNQI hospitals, ultimately spanning 447 nursing units over the same time periods.

Merging 2011 unit-level clinical and administrative data — including patient outcomes, staffing and RN education — with the same survey data specific to national specialty certification and perceptions of the unit practice environment, the researchers were able to assess the impacts of specific specialty certifications on surgical patient outcomes. Aside from looking solely at what occurred within the OR, the data also assessed how those actions impacted patients as they moved from the OR into other areas of the hospital.

The study also found that higher rates of CNOR/CRNFA certification in perioperative units were associated with higher rates of hospital-acquired pressure ulcers and unit-acquired pressure ulcers. The association between certification rates and catheter associated urinary tract infections (CAUTIs) was also investigated. In this instance, while some positive correlations were discovered, the results were not found to be statistically significant.