Deborah Kendall-Gallagher1, Mary A Blegen. 1. Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104-6096, USA. debk@nursing.upenn.edu
Abstract
BACKGROUND: Adverse events that place patients at risk for harm are common in intensive care units. Clinicians' level of knowledge and judgment appear to play a role in the prevention, mitigation, and creation of adverse advents. Research suggests a possible association between nurses' specialty certification and clinical expertise. The relationship between specialty certification and clinical competence of registered nurses and safety of patients is a relatively new area of inquiry in nursing. OBJECTIVE: To explore the relationship between the proportion of certified staff nurses in a unit and risk of harm to patients. METHODS: Hierarchical linear modeling was used in a secondary data analysis of 48 intensive care units from a random sample of 29 hospitals to examine the relationships between unit certification rates, organizational nursing characteristics (magnet status, staffing, education, and experience), and rates of medication administration errors, falls, skin breakdown, and 3 types of nosocomial infections. Medicare case mix index was used to adjust for patient risk. RESULTS: Unit proportion of certified staff registered nurses was inversely related to rate of falls, and total hours of nursing care was positively related to medication administration errors. The mean number of years of experience of registered nurses in the unit was inversely related to frequency of urinary tract infections; however, the small sample size requires that caution be exercised when interpreting results. CONCLUSIONS: Specialty certification and competence of registered nurses are related to patients' safety. Further research on this relationship is needed.
BACKGROUND: Adverse events that place patients at risk for harm are common in intensive care units. Clinicians' level of knowledge and judgment appear to play a role in the prevention, mitigation, and creation of adverse advents. Research suggests a possible association between nurses' specialty certification and clinical expertise. The relationship between specialty certification and clinical competence of registered nurses and safety of patients is a relatively new area of inquiry in nursing. OBJECTIVE: To explore the relationship between the proportion of certified staff nurses in a unit and risk of harm to patients. METHODS: Hierarchical linear modeling was used in a secondary data analysis of 48 intensive care units from a random sample of 29 hospitals to examine the relationships between unit certification rates, organizational nursing characteristics (magnet status, staffing, education, and experience), and rates of medication administration errors, falls, skin breakdown, and 3 types of nosocomial infections. Medicare case mix index was used to adjust for patient risk. RESULTS: Unit proportion of certified staff registered nurses was inversely related to rate of falls, and total hours of nursing care was positively related to medication administration errors. The mean number of years of experience of registered nurses in the unit was inversely related to frequency of urinary tract infections; however, the small sample size requires that caution be exercised when interpreting results. CONCLUSIONS: Specialty certification and competence of registered nurses are related to patients' safety. Further research on this relationship is needed.
Authors: D Bracco; J B Favre; B Bissonnette; J B Wasserfallen; J P Revelly; P Ravussin; R Chioléro Journal: Intensive Care Med Date: 2001-01 Impact factor: 17.440
Authors: Mary A Blegen; Thomas Vaughn; Ginette Pepper; Carol Vojir; Karen Stratton; Michal Boyd; Gail Armstrong Journal: Am J Med Qual Date: 2004 Mar-Apr Impact factor: 1.852
Authors: Rafael Celestino da Silva; Márcia de Assunção Ferreira; Thémistoklis Apostolidis; Marcos Antônio Gomes Brandão Journal: Rev Lat Am Enfermagem Date: 2015 Sep-Oct
Authors: Diane K Boyle; Ananda Jayawardhana; Mary E Burman; Nancy E Dunton; Vincent S Staggs; Sandra Bergquist-Beringer; Byron J Gajewski Journal: Int J Nurs Stud Date: 2016-09-01 Impact factor: 5.837
Authors: Deborah Kendall-Gallagher; Linda H Aiken; Douglas M Sloane; Jeannie P Cimiotti Journal: J Nurs Scholarsh Date: 2011-04-01 Impact factor: 3.176
Authors: Kimberley R Monden; Julie Hidden; C B Eagye; Flora M Hammond; Stephanie A Kolakowsky-Hayner; Gale G Whiteneck Journal: J Spinal Cord Med Date: 2021-03-11 Impact factor: 1.985
Authors: Karen B Lasater; Rebecca R S Clark; Margaret A McCabe; Warren D Frankenberger; Paula M Agosto; Kathryn A Riman; Linda H Aiken Journal: J Clin Nurs Date: 2020-11-10 Impact factor: 3.036