AACN News—December 2005—Certification

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Vol. 22, No. 12, DECEMBER 2005

Paper-and-Pencil Certification Exams Scheduled for Spring

Two opportunities to take the paper-and-pencil version of certification exams administered by AACN Certification Corporation will be available next spring.

Trends in Trauma and Cardiovascular Nursing—The CCRN, PCCN, CMC and CSC exams are set for April 27, 2006, in Philadelphia, Pa. The application deadline is March 16, 2006. The special Trends Exam Handbook and Application as well as study resources are now available online.

NTI 2006—All exams will be offered in the paper-and-pencil format on May 22, 2006, in Anaheim, Calif. The application deadline is April 4, 2006.

The Journey to Certification
One Community Hospital’s Road Map to Success

By Sandra Hurley, RN, BSN,
and Linda O. Lathan, RN, MSN, CCRN, FNP-c

Martha Jefferson Hospital, a 126-bed community hospital nestled at the foot of the Blue Ridge Mountains in Charlottesville, Va., recently celebrated its 100th anniversary. Three years ago, a new chief nursing officer was hired to develop a nursing strategic plan that would guide Martha Jefferson’s future for the next 100 years. At the pinnacle of her multi-faceted strategic plan was a commitment to staff development at all levels. A crucial aspect was to improve the skills of the direct nursing caregiver at the bedside.

Using AACN’s white paper “Safeguarding the Patient and the Profession—The Value of Critical Care Nurse Certification” as a basis to launch an aggressive campaign for certification, the CNO’s enthusiasm and passion for certification were shared with the nurse managers. In turn, the nurse managers presented the goals to their staffs. While the nurse managers were educating and motivating their staffs toward certification, the CNO was working with hospital administration to obtain commitment and financial support for nurse certification.
ccording to AACN, less than half of the hospitals in the United States provide financial support to nurses seeking certification or recertification.1 Martha Jefferson currently financially supports both certification and recertification for its nurses.

Promoting the Merits
The manager of the telemetry-progressive care unit at Martha Jefferson enthusiastically embraced the strategic plan’s initiatives. She was convinced that having the right skill mix and number of qualified nurses were vital in achieving optimal patient outcomes. Working with the clinical nurse educator, the manager developed an intensive educational campaign focusing on the merits of certification. Again using AACN’s certification white paper as a guide, the following information was included in the campaign:

• Benefits of nurse certification to the public: Certification has been linked to a decrease in medical errors and costs.
• Benefits to employers: Validation that certified nurses possess specialty knowledge, skills and experience to deliver safe expert care; improved nurse retention; and improved public perception. (In the Harris omnibus survey, 73% of people polled said they were “much more likely to select a hospital with a high percentage of nurses with additional specialty certifications.”)
• Benefit to nurses: Certification goes beyond entry level knowledge and skills; certification is an “expert credential reserved for those who meet rigorous practice, continuing education and testing requirements in their specialty.” Certified nurses exhibit increased job satisfaction and confidence.

The campaign included posters, educational staff meeting sessions and one-on-one discussions with the staff nurses to review their professional goals. The clinical nurse educator researched the PCCN certification and presented in-services to the staff. A PCCN resource notebook and a complete study guide with practice exam questions were developed. The manager and educator actively “campaigned” for four to five months with the staff. At the end of the five-month campaign, four staff members were recruited to begin preparing for the PCCN certification. At the time, there were only eight PCCNs in the entire state.

Supporting the Candidates
These four staff members immediately began their studies. The manager hosted a staff breakfast to celebrate the four nurses who had accepted this challenge. Every nurse who attended the breakfast provided support for the PCCN group. Among those attending the breakfast were nursing directors, educators and the CNO. Copies of the study guide and practice exam were given to each applicant. They agreed to a 12-week time frame to complete the program and take the PCCN exam. After 10 weeks, the clinical nurse educator conducted a four-hour, question-and-answer “Jeopardy bowl” with the applicants. An active role by the nurse manager was important to the success of this program. In addition to setting aside time for the “Jeopardy bowl,” she scheduled the nurses for an eight-hour study day. She also provided verbal encouragement on a weekly basis.

Throughout the process, the staff frequently asked the applicants to describe how their preparation was advancing. The applicants responded with positive messages, such as “I’ve learned so much .. This study guide has really helped me understand some disease processes that I didn’t really understand before .. Even if I don’t pass the exam, this has all been worth it.”

The responses have been a catalyst in motivating even some of the most tenured staff to sign up to be among the next group to study for the PCCN exam. This “snowball” effect has been a primary motivator in keeping the staff engaged. An unexpected benefit has been physician interest in and encouragement of the PCCN applicants. The physicians have acknowledged the increased knowledge and confidence of the certified nurses. They have expressed their enthusiasm for developing future service lines that are in keeping with the hospital’s strategic plans because nurses have taken the initiative to obtain expert clinical knowledge in their specialty area. This has helped foster a continued collaborative nurse-to-physician environment in which the physicians recognize the contributions of the expert clinical nurses.

Finding Success
All four nurses in the initial group successfully passed the exam, and each was recognized individually for his or her accomplishment. The successful candidates received congratulatory notes from the CNO, the director of Critical Care, and other directors in the hospital. The PCCNs also received their official PCCN pins during a staff celebration of their success. Their name badges reflect their certification.

Each PCCN has passed along their study materials to another telemetry-progressive care nurse. The program was so successful that it was expanded to include five PCCN candidates, who are now preparing for the exam.

During the initial orientation for a new hire into telemetry-progressive care, the nurse manager sets forth the educational and professional expectations of being a team member on her floor. These include ongoing continuing education, participation in unit-based, shared governance committees and commitment to certification after completing the clinical hours required for certification. For existing staff, these expectations are communicated during staff meetings and incorporated into their annual performance appraisal.

In summary, Martha Jefferson’s road map for success in motivating staff members to attain certification has numerous aspects. Most important is having a CNO who champions certification and successfully motivates her nurse managers to share her passion as well as securing administrative and hospital support; the nurse manager and clinical educator working collaboratively to develop a plan for certification, marketing the plan to the staff, and continually communicating the expectations to the staff in many venues; removing the perceived roadblocks to certification by developing an in-house review course; and publicly celebrating the successes of the certified staff hospitalwide.

Sandra Hurley, RN, BSN, is nurse manager of the telemetry-progressive care unit, and Linda O. Lathan, RN, MSN, CCRN, FNP-c, is clinical nurse educator at Martha Jefferson Hospital, Charlottesville, Va.

1. American Association of Critical-Care Nurses White Paper: “Safeguarding the Patient and the Profession – The Value of Critical Care Nurse Certification.” Executive Summary. December 2002.

Online Registration Available for CMC and CSC Subspecialty Certifications

Take advantage of online registration for the Cardiac Medicine (CMC) or Cardiac Surgery (CSC) subspecialty certification examinations. This quick and convenient way to register for certification exams is currently available only for the CMC and CSC exams, but look for online registration for CCRN, PCCN and CCNS certification exams in the future. For more information, visit the AACN Certification Corporation Web site.

CCNS Renewal Audits Under Way

AACN Certification Corporation has begun to audit CCNSs who have renewed by CE. It is important to save your CE documentation from the previous renewal period, in case of audit. The CERP Keeper is relevant for all certification types, including CCNS. Visit the online catalog before the end of this year to take advantage of 10% discounts on the CERP Keeper.

July 1 Deadline for CCNSs to Make Up Clinical Hours

After July 1, 2006, CCNS candidates must have had 500 clock hours of supervised clinical practice as part of their CNS program. There will be no exceptions.
The window of time to make up hours through transcripted clinical practice will be closed after that date.

Arizona Accepts CCNS Exam

The Arizona Administrative Rules now accepts the CCNS adult, pediatric and neonatal exams for advanced practice status.

In the Circle: AACN Value of Certification Award

Editor’s note: Sponsored by AACN Certification Corporation, the AACN Value of Certification Award honors contributions that support and foster the advancement of certified nursing practice in critical care. Following are excerpts from exemplars submitted in connection with this award, part of the AACN Circle of Excellence recognition program, for 2005.

Beverly S. Farmer, RN, MSN, CCRN
Henderson, Ky.
Maria R. Shirey, RN, MS, MBA, FACHE, CNAA, BC
Evansville, Ind.
Lynn S. Schnautz, RN, MSN, CCRN, CCNS
Evansville, Ind.
Deaconess Hospital

In 2000, our Critical Care Department embarked on a mission to increase the number of certified bedside nurses. Our team headed the planning and execution of a CCRN drive. In collaboration with our local AACN chapter and through funding from the DH Foundation, we held our first CCRN drive. Since then, we have offered an annual CCRN review course and study sessions. Our efforts have resulted in increasing the number of CCRNs from 11 to 34 at DH and from 14 to 55 in our community.

Our commitment to certification has not stopped with CCRNs. In the spring of 2003, Shirey obtained funding from the DH Foundation to create a similar certification program for medical-surgical nurses. Farmer developed and co-taught the review course to 60 medical-surgical nurses, increasing the number of medical-surgical certified nurses from 0 to 37.

Our first CCRN drive was featured in AACN News and covered in a Fox 7 television story titled “A Day in the Life of a CCRN.” Our team petitioned and won the right to wear the CCRN title on hospital name badges. Our scholarly activities in promoting the value of certified nursing practice continue with our multiple presentations at local, regional and national venues. Our work in certification has been prominently featured in the Journal of Nursing Administration, and our article, “One Hospital’s Experience with a CCRN Drive,” was published in Critical Care Nurse. Currently, we are finalizing a manuscript of our descriptive study titled “What Are the Demographics of a Successful CCRN?”

Whether in the forefront or behind the scenes, we are spreading the news about the value of certification in nursing practice.

Kelly Jane Harris, RN, MSN, CCRN, CEN
Milliken, Colo.
Poudre Valley Hospital
When I say I believe in world-class healthcare, I mean it. It’s not enough for us to be an excellent hospital or an excellent unit; we have to be the best for our patients. I believe certification is one of the ways to attain that goal.

I love my job! I am the unit educator in the intensive coronary care unit. I have been in critical care for 14 years as an RN, first in the Emergency Department and since 1995 in intensive care units.

The ICU was very challenging. There was so much to learn. Many of my colleagues were CCRNs and by the end of my first year I was studying so that I could also pass the test.
Gaining that certification made me work even harder to increase my knowledge.

When I became the clinical educator here in 2002, my work was cut out for me. The ICCU was a very busy unit in the midst of a large turnover. Morale was low and people were just trying to survive each shift. During the first year, I started increasing awareness of AACN and bringing the Best Practice protocols to the bedside. Because the new nurses brought so much enthusiasm and willingness to learn to the work environment, I started with them.

In 2002, there was only one other CCRN. Our goal for 2004 was for 25% of our nurses to become CCRNs. We did it! The enthusiasm in our workplace is infectious. The turnaround in the past two years has been amazing. It’s all about attitude and “raising the bar.” It’s our mantra. Although our certification numbers are small, the change in attitude toward certification is huge. Certification shows that we have gone the extra step toward achieving world-class healthcare.
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