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Development of a professional recognition scheme for specialist nursing: Literature Review and Environmental Scan

Christine Ashley, ACMHN (2014)


The history of credentialing in Australia can be traced back to the introduction of nursing competency standards in the late 1980s, when there was recognition of the need to identify specialist or advanced practice. Since that time, a few organisations have developed their own credentialing programs, and efforts were made by Royal College of Nursing, Australia in the late 1990s to introduce a national credentialing scheme.


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Project To Develop the Coalition of National Nursing Organisations’ National Nurse Credentialling Framework: Literature Review
Denise Ryan and Christine Ashley (2011)


Credentialling (also credentialing or certification) has attracted considerable debate amongst nurses and other health professionals over the last 15 – 20 years, with some groups emphasising the potential benefits of introducing a credentialling process, and others expressing concerns and a lack of enthusiasm. The lack of consensus reflects widely differing views on what credentialling means, or should mean, the nature of what credentialling can achieve and for whom, and the costs or benefits it might deliver.


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Perceived effects of specialty nurse certification: a review of the literature

C. H. Wade, AORN Journal. 89 (1) (2009)


Review of literature between 1980 – 2008 relating to available evidence on the effect of nurse certification on patient outcomes, other health professionals and on the individual nurse. Key finding supports literature from the CoNNO review, that whilst certification has intrinsic value, most studies rely on descriptive and self reporting research, providing limited evidence of the benefits on patient outcomes.




Nurse specialty certification, inpatient mortality, and failure to rescue

D. Kendall-Gallagher, Journal of Nursing Scholarship. 43 (2) 188 – 194 (2011)


The purpose of the study was to determine if deaths of surgical inpatients following a major complication were affected by the certification status of nurses in the surgical units. The study reviewed data from all adult acute care hospitals in California, Florida, New Jersey and Pennsylvania. Analysis indicated that there was a decreased risk of inpatient mortality and failure to rescue associated with more highly qualified and educated nurses and with specialty certification. The number of years of experience of the nurse was not a predictor of patient mortality. Findings from the study suggest that certification of nurses who have undertaken higher education may be a promising investment for improving patient outcomes. 




The New Zealand Nurse Specialist Framework: clarifying the contribution of the nurse specialist

Kathryn Holloway, Policy Politics Nursing Practice (2013)


Presents an overview of the NZ Nurse Specialist Framework which has been adopted by some specialist nursing groups to provide consistency and to assist workforce planning. The paper explores taxonomical differences and difficulties, and discusses the distinction between competence and capability as applied to nursing. The paper argues that competencies are measured against standards and reveal what an individual knows or can do, whereas capability identifies the extent that individuals can adapt to change, generate knowledge and continuously improve their performance. It argues that capability is an integral part of specialist expertise. The framework includes role development as being implicit and considered within the overarching context of patient/health care needs, and provides a means of considering nursing skill mix and workforce planning. It also assists nursing specialty groups to identify and articulate their contribution to patient care.


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Mental health nurses in primary care: quantitative outcomes of the Mental Health Nurse Incentive Program

R. Lakeman, Journal of Psychiatric and Mental Health Nursing. 21 327 – 335 (2014)


The paper describes a study which explored the effectiveness of the Mental Health Nurse Incentive Program – a funding scheme in Australia that enables credentialed mental health nurses to work in primary care settings for as long as necessary to assist patients suffering complex mental health problems. The methodology of the study consisted of reviewing 64 completed case studies in which Health of the Nation Outcomes Scales (HoNOS) scores on admission were compared with the last completed rating to assess clinical outcomes. Whilst the authors identified limitations in the study, they concluded that the research suggests that the MHNIP does contribute positive and significant outcomes for some people – especially those with highly complex needs. The authors refer to other studies of the MHNIP which also support their findings with identified outcomes being reduced hospitalisations, and reduced demand for specialist health services.




Advanced Practice Registered Nurse Certification

Kim Alleman and Katherine Houle, Nephrology Nursing Journal. 40 (3). 219 - 222 (2013)


The paper describes the importance of certification for nephrology nurses and the components of the national Advance Practice Registered Nurses (APRNs) Consensus Model, introduced in 2006.This model includes four elements: licensure, accreditation of certification programs, a description of certification as being the formal recognition of the specialist and/or advanced knowledge skills and experience demonstrated by achievement of standards, and formal education (acronym ‘LACE’).  




Competence and certification of registered nurses and safety of patients in intensive care units

D. Kendall-Gallagher, American Journal of Critical Care. 18 (2). 106 - 113 (2009)


This study explores the relationship between the number of certified nurses in intensive care units and reductions in adverse events. The study analysed data using linear modelling of 48 intensive care units 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. Results indicated that specialty certification and competence of registered nurses are related to patients’ safety.

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