International Certification for Home Health Nurses: Can It Become a Reality?
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1 International Certification for Home Health Nurses: Can It Become a Reality? Mary Narayan, MSN, RN, HHCNS-BC, CTN-A Cathy Magowan, BSN, RN, MSN Student
2 Objectives Describe importance of specialty certification in the United States. Affirm home health nursing as a specialty area of nursing practice. Determine if there is international interest in pursuing home health nursing certification.
3 Certification in USA Important to demonstrate expertise in a specialty area of nursing practice: Ambulatory Care Nursing Case Management Nursing Critical Care Nursing Emergency Nursing Faith-Based Community Nursing Forensic Nursing Infusion Nursing Medical Surgical Nursing Nephrology Nursing
4 Certification in USA (continued) Oncology Nursing Pain Management Nursing Pediatric Nursing Perinatal Nursing Psychiatric -Mental Health Nursing Public Health Nursing Rehabilitation Nursing Wound Ostomy Continence Nursing And MANY more!!! BUT NO CERTIFICATION for HOME HEALTH NURSING!!!
5 What countries are you from? Is there a certification process for nursing specialties? Is there certification for home health nurses?
6 Is Home Health Nursing a Specialty Area of Nursing Practice? American Nurses Association s Scope and Standards of Home Health Nursing Practice Outlines the unique knowledge, skills, & competencies of Home Health Nursing Defines the specialized ways the Nursing Process is applied in home health nursing Identifies the competencies in 12 key areas of nursing practice and responsibilities. Neal Theory of Home Health Nursing (1999)
7 2,633,980 Registered Nurses in USA General hospitals: 1,545,370 Specialty hospitals: 52,240 Outpatient Care Centers: 92,350 Psych and Substance Abuse hospitals: 34,670 Home Health Care Services: 162,120 Department of Labor, Bureau of Labor Statistics 2012
8 Home Health Nursing Care is moving out of hospitals and into the community: More appropriate for chronic illnesses Enhanced safety = Less iatrogenic events Medication errors, hospital-acquired infections Less costly with good outcomes Is this happening in your country?
9 Benefits of Certification For the employer: 1.Spurred by the Magnet recognition program 2.Driver of increased employee satisfaction 3.Decreased employee turnover 4.Improved patient outcomes
10 Benefits of Certification For the patient: 1.Decreased incidence of patient falls 2.Decreased use of restraints 3.Decreased pressure ulcers 4.Improved outcomes
11 Benefits of Certification For the nurse: 1.Validation of expertise 2.Recognition of expertise 3.Feelings of workplace empowerment 4.Higher performance evaluation scores 5.Demonstration of a commitment to excellence 6.Improved patient outcomes
12 Negative Effects of No Certification Role models for best nursing practice not identified and validated. Impedes advancement of the practice of home health nursing Dampens professionalism of home health nursing: Discourages advancing education, clinical and career ladders, pay-for-performance, commitment to practice No professional nursing voice to address policy issues.
13 What value does certification have from your perspective? Should the IHCNO make this an organizational priority?
14 How does a Nurse become certified? One way is to take an Exam
15 How does a Nurse become certified? Another way is a Portfolio Process
16 Proposed Certification Criteria 1.Educated in nursing at Baccalaureate level. 2.Licensed as a Registered Professional Nurse. 3.Practiced as home health nurse for at least 4000 hours. 4.Demonstrates competence in ANA s Scope and Standards criteria: Patient assessment (physical, functional, medication, environmental, psycho-social, spiritual, caregiver, financial) Case management (coordinating care, mobilizing resources, practicing collaboratively with interdisciplinary team) Patient education (enabling independence and selfmanagement) Patient advocacy (accessing needed resources)
17 Proposal: International Certification IHCNO partner with ANCC ANCC requires support of an organization with a mailing list wants to know there is an interest ANCC does support international credentialing Requires education comparable to USA s BSN degree Robust process of developing criteria
18 How similar or different do you think home health nursing practice is in different countries? If an international home health nursing certification was available, would you pursue it?
19 References American Nurses Credentialing Center website. (2014). ANCC Certification Center. Boltz, M., Capezuti, E., Wagner, L., Rosenberg, M., & Secic, M. (2013 ). Patient safety in medical-surgical units: Can nurse certification make a difference? MEDSURG Nursing, 22(1), Guide to nursing certification organizations. (2012). Dimensions of Critical Care Nursing, 31(4), The Joint Commission Home (2011). Home The best place for health care: A positioning statement from The Joint Commission on the state of the homecare industry. _11.pdf Knudson, L. (2013). Nursing certification provides recognition for nurses, employers. AORN Connections, 97(3), C1, C9-C10.
20 References (continued) Krapohl, G., Manojlovich, M., Redman, R., & Zhang, L. (2010). Nursing specialty certification and nursing-sensitive patient outcomes in the intensive care unit. American Journal of Critical Care, 19(6), McCourt, C. (2009). Building a certification program. Retrieved from Occupational Employment Statistics. (2012). Retrieved from Shepherd, M. (2011, Fall). Why become certified? A personal perspective. Journal of Illinois Nursing, 109(3), Retrieved from
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