Retooling the RN workforce in long-term care: nursing certification as a pathway to quality improvement

Mary E Cramer; Robin High; Beth Culross; Deborah Marks Conley; Preethy Nayar; Anh T Nguyen; Diptee Ojha

doi:10.1016/j.gerinurse.2014.01.001

Retooling the RN workforce in long-term care: nursing certification as a pathway to quality improvement

Geriatr Nurs. 2014 May-Jun;35(3):182-7. doi: 10.1016/j.gerinurse.2014.01.001. Epub 2014 Jan 17.

Authors

Mary E Cramer¹, Robin High², Beth Culross³, Deborah Marks Conley⁴, Preethy Nayar², Anh T Nguyen², Diptee Ojha²

Affiliations

¹ College of Nursing, University of Nebraska Medical Center, Omaha, NE 68198, USA. Electronic address: mecramer@unmc.edu.
² College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA.
³ College of Nursing, University of Nebraska Medical Center, Omaha, NE 68198, USA.
⁴ Nebraska Methodist Hospital, Omaha, NE, USA; Nebraska Methodist College of Nursing, Omaha, NE, USA.

PMID: 24534720
DOI: 10.1016/j.gerinurse.2014.01.001

Abstract

This article describes a project to improve nursing care quality in long-term care (LTC) by retooling registered nurses' (RN) geriatric clinical competence. A continuing education course was developed to prepare LTC RNs (N = 84) for national board certification and improve technological competence. The certification pass-rate was 98.5%. The study used a mixed methods design with retrospective pretests administered to RN participants. Multivariate analysis examined the impact of RN certification on empowerment, job satisfaction, intent to turnover, and clinical competence. Results showed certification significantly improved empowerment, satisfaction, and competence. A fixed effects analysis showed intent to turnover was a function of changes in empowerment, job dissatisfaction, and competency (F = 79.2; p < 0.001). Changes in empowerment (t = 1.63, p = 0.11) and competency (t = -0.04, p = 0.97) did not affect changes in job satisfaction. Findings suggest RN certification can reduce persistently high RN turnover rates that negatively impact patient safety and LTC quality.

Keywords: Evaluation; Long-term care; Nursing homes; Nursing studies; Workforce issues.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Certification*
Clinical Competence
Education, Nursing, Continuing
Geriatric Nursing / standards*
Humans
Job Satisfaction
Long-Term Care
Multivariate Analysis
Nursing Staff / psychology
Power, Psychological
Quality Improvement*
United States