I have no actual or potential conflict of interest in relation to this program or presentation.

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1 Board Certification & Other Conversations Disclosures I have no actual or potential conflict of interest in relation to this program or presentation. Matthew Morris, MS, RN, NEA-BC Nurse Manager, Outpatient Surgery Johns Hopkins Outpatient ti t Center mmorri77@jhmi.edu Prestige? Why Become Certified? Power? Brand Recognition Privilege? Money? Join the Club? Recognition? Other Thoughts? Brand Recognition Brand Recognition There are some things money can t buy, for everything else The ultimate driving machine. Think outside the bun. Save money. Live better. There s never been a better time to

2 The Concept of Branding: Is It Rl Relevant tto Nursing? Branding is used to differentiate products through use of symbols. be a nurse. The symbols are the brands that are designed to communicate the value of products. Nursing has had many identifying i symbols, such as the nurse s cap and the white uniform, but these symbols have failed to clearly communicate the essence of nursing. Lack of a distinct nursing brand has led to confusion about the discipline. (Dominiak, 2004) AACN s CCRN Most Common Nursing Certifications Competency & Credentialing Institute s CNOR Oncology Nursing Society s OCN ANCC s Medical-Surgical i l Nurse MSN (RN-BC) (Wade, 2009) Brand Recognition or Alphabet Soup BLS, ACLS, PALS, NRP RN, LPN, CNA BSN, MSN, DNP CRNP, CNS, CRNA CNOR, CCRN, PCCN, CMSRN, OCN Some mentions in the literature t No one consistent definition of nursing certification exists and more than 50 nursing certification programs with different standards exist (Kaplow, 2011) A clearer, more widely accepted definition of certification is needed (Wade, 2009) A study characterized ACLS as a certification & counted a nurse as a specialist that was certified in a different specialty (Wade, 2009) Wikipedia s List - 1 Alphabetical Listing of Nursing and Related Credentials and Certifications [edit] AAAS - Associate of Applied Science AAN - Associate of Arts in Nursing Cardiac ACLS - Advanced Life Support (not intended for postnominal use) ACNP-BC - Acute Care Nurse Practitioner-Board Certified ACNPC - Acute Care Nurse Practitioner Certification ACRN - AIDS Certified Registered Nurse ADLS - Advanced Disaster Life Support ADN - Associate Degree in Nursing ALNC - Advanced Legal Nurse Cosultant ANP-BC - Adult Nurse Practitioner-Board Certified AOCN - Advanced Oncology Certified Nurse AOCNP - Advanced Oncology Certified Nurse Practitioner AOCNS - Advanced Oncology Certified Clinical Nurse Specialist APHN-BC - Advanced Public Health Nurse-Board Certified APN - Advanced Practice Nurse ARNP - Advanced Registered Nurse Practitioner ASN - Associate of Science in Nursing APRN- Advanced d Practice Registered Nurse [edit] BBLS Basic Life Support (not intended - for postnominal use) BDLS - Basic Disaster Life Support BM - Bachelor of Midwifery BN - Bachelor of Nursing BScN - Bachelor of Sciences in Nursing (Canada) BHSc Nsg - Bachelor Health Science - Nursing Nursing Qualification for RNs in Australia BSN - Bachelor of Science in Nursing [edit] CCANP - Certified Adult Nurse Practitioner CATN -P Course in Advanced Trauma Nursing -Provider CATN -I Course in Advanced Trauma Nursing -Instructor CAPA - Certified Ambulatory Perianesthesia nurse CARN - Certified Addictions Registered Nurse CBN - Certified Bariatric Nurse CCCN - Certified Continence Care Nurse CCM - Certified Case Manager CCNS - Certified Clinical i l Nurse Specialist CCRN - Certified Critical Care Nurse CCTC - Certified Clinical Transplant Coordinator CCTN - Certified Clinical Transplant Nurse CTRN - Certified Critical Care Transportation Nurse CDDN - Certified Developmental Disabilities Nurse CDE - Certified Diabetes Educator CDMS - Certified Disability Management Specialist

3 Wikipedia s List - 2 CDN - Certified Dialysis Nurse CDONA/LTC - Certified Director of Nursing Administration/Long Term Care C-EFM - Certified in Electronic Fetal Monitoring CEN - Certified Emergency Nurse CETN - Certified Enterostomal Therapy Nurse CFCN - Certified Foot Care Nurse CFN - Certified Forensic Nurse CFNP - Certified Family Nurse Practitioner CFRN - Certified Flight Registered Nurse CHES - Certified Health Education Specialist CGN - Certified Gastroenterology Nurse CGRN - Certified Gastroenterology Registered Nurse CHN - Certified Hemodyalisis Nurse CHPN - Certified Hospice and Palliative Nurse CHRN - Certified Hyperbaric Registered Nurse CIC - Certified in Infection Control CLC - Certified Lactation Counselor CLNC - Certified Legal Nurse Consultant CMA- Certified Medical Assistant CM - Certified Midwife CMC - Cardiac Medicine Certification CMCN - Certified Managed Care Nurse CMDSC - Certified MDS Coordinator CMSRN - Certified Medical Surgical Registered Nurse CNA - Certified in Nursing Administration CNE - Certified Nurse Educator CNL - Clinical Nurse Leader CNLCP - Certified Nurse Life Care Planner CNM - Certified Nurse Midwife CNML - Certified Nurse Manager and Leader CNN - Certified in Nephrology Nursing CNOR - Certified Nurse, Operating Room CNO - Chief Nursing Officer CNP - Certified Nurse Practitioner C-NPT - Certified in Neonatal Pediatric Transport CNRN - Certified Neuroscience Registered Nurse CNS - Clinical Nurse Specialist CNSN - Certified Nutrition Support Nurse Wikipedia s List - 3 COCN - Certified Ostomy Care Nurse COHN - Certified Occupational Health Nurse COHN/CM - Certified Occupational Health Nurse/Case Manager COHN-S - Certified Occupational Health Nurse Specialist COHN-S/CM - Certified Occupational Health Nurse Specialist/Case Manager CORLN - Certified Otorhinolaryngology Nurse CPAN - Certified Post Anesthesia Nurse CPDN - Certified Peritoneal Dialysis Nurse CPEN - Certified Pediatric Emergency Nurse CPHQ - Certified Professional in Healthcare Quality CPN - Certified Pediatric Nurse CPNA - Certified Pediatric Nurse Associate CPNL - Certified Practical Nurse, Long-term care CPNP - Certified Pediatric Nurse Practitioner CPON - Certified Pediatric Oncology Nurse CPSN - Certified Plastic Surgical Nurse CRN - Certified Radiologic Nurse CRNA - Certified Registered Nurse Anesthetist CRNFA - Certified Registered Nurse First Assistant CRNI - Certified Registered Nurse Intravenous CRNL - Certified Registered Nurse, Long-term care CRNO - Certified Registered Nurse in Ophthalmology CRNP - Certified Registered Nurse Practitioner CRRN - Certified Rehabilitation Registered Nurse CRRN-A - Certified Rehabilitation Registered Nurse Advanced CS - Clinical Specialist CSC - Cardiac Surgery Certification C-SPI - Certified Specialist in Poison Information CT - Certified in Thanatology (dying, death and bereavement) CTN - Certified Transcultural Nurse CTRN - Certified Transport Registered Nurse CTRS- Certified Therapeutic Recreational Specialist CUA - Certified Urologic Associate CUCNS - Certified Urologic Clinical Nurse Specialist CUNP - Certified Urologic Nurse Practitioner CURN - Certified Urologic Registered Nurse CVN - Certified Vascular Nurse CWCN - Certified Wound Care Nurse CWOCN - Certified Wound, Ostomy, Continence Nurse CWS - Certified Wound Specialist [edit] DDN - Doctor of Nursing DNP - Doctor of Nursing Practice Wikipedia s List - 4 DrNP - Doctor of Nursing Practice DNS - Doctor of Nursing Science also seen as DNSc [edit] EEdD - Doctor of Education EN - Enrolled Nurse ENPC - Emergency Nursing Pediatric Course (not intended for postnominal use) ET - Enterostomal Therapist [edit] FFAAN - Fellow, American Academy of Nursing FAAPM - Fellow, American Academy of Pain Management FAEN - Fellow, Academy of Emergency Nursing FNC - Family Nurse Clinician FNP-C - Family Nurse Practitioner (Certified by AANP) FNP-BC- Family Nurse Practitioner (Certified by ANCC) FPNP - Family Planning Nurse Practitioner FRCN - Fellow, Royal College of Nursing FRCNA - Fellow, Royal College of Nursing, Australia [edit] GGN - Graduate Nurse (awaiting RN licensure) GNP - Gerontological Nurse Practitioner GPN - General Pediatric Nurse GPN - Graduate Practical Nurse GRN - Graduate Registered Nurse [edit] HHNC - Holistic Nurse, Certified [edit] IIBQH - International Board for Quality in Healthcare IBCLC - International Board-Certified Lactation Consultant ICC - Intensive Care Certification INC - Intensive Neonatal Care certification IPN - Immunisation Program Nurse - Queensland Australia specialist qualification / endorsement [edit] LLCCE - Lamaze Certified Childbirth Educator LNC - Legal Nurse Consultant LNCC - Legal Nurse Consultant, Certified LNP - Licensed Nurse Practitioner - Used by the Commonwealth of Virginia, Board of Nursing, as a license status [1] LPN - Licensed Practical Nurse LSN - Licensed School Nurse LTC - Long Term Care (LPN Specific) LVN - Licensed Vocational Nurse [edit] MMA - Master of Arts MAN - Master of Arts in Nursing MICT - Master of Information and Communication Technology ME - Menopause Educator MEd - Masters in Education MEmerg Nsg - Masters Degree in Emergency Nursing Australia MHN - Mental Health Nurse - Registered Nurse Endorsed to practice Advanced nursing in Mental Health [1] MICN - Mobile Intensive Care Nurse MN - Master of Nursing Wikipedia s List - 5 MPH - Master of Public Health MS - Master of Science MSN - Master of Science in Nursing [edit] NNCSN - National Certified School Nurse NE-BC - Nurse Executive-Board Certified NEA-BC - Nurse Executive Advanced-Board Certified NNP-BC - Neonatal Nurse Practitioner NPC - Nurse Practitioner, Certified NPP - Nurse Practitioner, Psychiatric NZCFN - New Zealand Certified Flight Nurse [edit] OOCN - Oncology Certified Nurse ONC - Orthopaedic Nurse Certified [edit] PPALS - Pediatric Advanced Life Support (skill-based, not intended for postnominal use) PCCN - Progressive Care Certified Nurse PCNS- Pediatric Clinical Nurse Specialist PhD - Doctor of Philosophy PHN - Public Health Nurse PHRN - Pre-Hospital Registered Nurse PMHCNS-BC - Psychiatric Mental Health Clinical Nurse Specialist PMHNP-BC - Psychiatric Mental Health Nurse Practitioner PNP-BC - Pediatric Nurse Practitioner [edit] RRN - Registered nurse RIN - Rural and Isolated Practice Registered Nurses (RIPRN) (Queensland, Australia) RN-BC - Registered Nurse, ANCC Board Certified RN,C - Registered Nurse, Certified: American Academy Certified Nurse RNC-LRN - Registered Nurse Certified in Low Risk Neonatal Nursing RNC-MNN - Registered Nurse Certified in Maternal Newborn Nursing RNC-NIC - Registered Nurse Certified in Neonatal Intensive Care RNC-OB - Registered Nurse Certified in Inpatient Obstetrics RNCS - Registered Nurse Clinical Specialist RNCS - Registered Nurse Certified Specialist RNFA - Registered Nurse First Assistant RPN - Registered practical nurse [edit] SSANE-A - Sexual Assault Nurse Examiner-Adult/Adolescent SANE-P - Sexual Assault Nurse Examiner-Pediatric i SEN - State Enrolled Nurse SHN - Sexual and Reproductive Health endorsed RN - Queensland Australia SN - Student Nurse (RN preparation) SPN - Student Nurse (LPN preparation) SRNA - Student Registered Nurse Anesthetist(CRNA preparation) SVN - Student Nurse (LVN preparation) [edit] TTNCC-I - Trauma Nursing Core Course Instructor (not intended for postnominal use) TNCC P T N i C C P id ( t i t d d f t i l ) RNC MNN R i t d N C tifi d i M t l N b N i This list is incomplete; you can help by expanding it. The Premise Results: The proportion of hospital RNs holding a bachelor's degree or higher ranged from 0% to 77% across the hospitals. After adjusting for patient characteristics and hospital structural characteristics (size, teaching status, level of technology), as well as for nurse staffing, nurse experience, and whether h the patient's surgeon was board certified, a 10% increase in the proportion of nurses holding a bachelor's degree was associated with a 5% decrease in both the likelihood of patients dying within 30 days of admission and the odds of failure to rescue (odds ratio, 0.95; 95% confidence interval, in both cases). Conclusion: In hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rescue rates. The Response Recommendations for educational levels of leaders and staff Recommendations for certification Continuous demonstration of quality patient outcomes Source: Aiken et al (2003). Educational levels of hospital nurses and surgical patient mortality. JAMA, 290(12),

4 The Data IOM Report: The Future of Nursing Recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020 Recommendation 5: Double the number of nurses with a doctorate by 2020 Recommendation 6: Ensure that nurses engage g in lifelong learning Recommendation 7: Prepare and enable nurses to lead change to advance health Why Does Certification Matter? ANCC board certified nurses have met strong professional development standards. ANCC certification exams are a fair and accurate measure of professional competency. ANCC certification is accepted by governing boards, insurers, and the military. ANCC board certified nurses are in the greatest demand and command the highest salaries. Why Does Certification Matter? Certification is the formal recognition of specialized knowledge, skills and experience. The CENL or the CNML after your name demonstrates to the profession a high level of commitment to your field of practice and a high level of knowledge and skill unique to your role. Specialty certification enhances professional reputation of nurse leaders. Not Convinced? ANA states t ANA successfully champions professional nursing excellence through standards, code of ethics and professional development, such as credentialing and lifelong learning. The public has a right to expect registered nurses to demonstrate professional competence throughout their careers. ANA believes the registered nurse is individually responsible and accountable for maintaining professional competence. g g g/nursingstandards.aspx Is this convincing? Results suggest positive patient outcomes related to pain and CINV resulting from the nurses knowledge through oncology certification (Coleman, 2009) Overall workplace empowerment and certification were positively associated and statistically ti ti significant ifi (Krapohl, 2010) Inverse relationships between the number of certified nurses and the incidence of falls and skin breakdown are reported (Kaplow, 2011)

5 Is this convincing? Is this convincing? Declines in nurse turnover, decreased vacancy rate, increased patient satisfaction scores associated with increased certified nurses (Kaplow, 2011) National salary surveys reveal certified nurses have higher h salaries (Kaplow 2011) Certification is linked to increased confidence and self perception, job satisfaction, autonomy, credibility, competence, patient satisfaction and accountability (Wilkerson, 2011) CCRNs on code teams result in better performance on national benchmarks of code-related indicators (Wilkerson, 2011) Increased hours of care from certified nurses resulted in decreased healthcare associated infections, adverse events related to failure to rescue, and patient falls (Wilkerson, 2011) A 2010 Watts survey reports 8 of 10 people understand nurses can be certified; 3 of 4 would be more likely to choose a hospital with more certified nurses (Wilkerson, 2011) Is this convincing? Certification is positively associated with nurses Job satisfaction Sense of empowerment Sense of collaboration with other team members (Wade 2009) A follow up to The Premise Every 10% increase in BSN prepared nurses is associated with a 6% decrease in the odds of a patient dying Every 10% increase in BSN prepared nurses who are specialty certified is associated with a 2% decrease in the odds of patients dying These effects are the same for failure to rescue (Kendall-Gallagher, Aiken, et al, 2011) Leadership - Moving Forward Exemplar - The Red Cape The lack of extrinsic value makes it unlikely that increasing numbers of nurses will become certified unless there is increased opportunity for recognition and greater compensation additional pay and reimbursement are the exception not the rule. (Wade, 2009)

6 Does it really matter? Are you when you re applying for a job? when you interaction with peers or other disciplines? when you re leading your team? within the IOM recommendations? if you demonstrate mastery of the specialized body of knowledge of your specialty? if you demonstrate a commitment to lifelong learning? if you demonstrate a commitment to the profession? Butter nic Body B fied Organ SDA Certif US Other Things We Certify from acoustical devices to construction equipment, from dairy and livestock production to energy distribution, and many more. Bibliography Aiken et al (2003). Educational levels of hospital nurses and surgical patient mortality. JAMA, 290(12), Altman, M. (2011). Let's Get Certified: Best Practices for Nurse Leaders to Create a Culture of Certification. AACN Advanced Critical Care, 22(1), Coleman, E.A., Coon, S.K., Lockhart, K., Kennedy, R.L., Montgomery, R., Copeland, N., McNatt, P., Savell, S., & Stewart, C. (2009). Effect of certification in oncology nursing on nursing-sensitive outcomes. Clinical Journal of Oncology Nursing, 13(2), Dominiak, M. (2004). The Concept of Branding: Is It Relevant to Nursing?, Nursing Science Quarterly, 17(4), Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Retrieved from Kaplow, R. (2011). The Value of Certification. AACN Advanced Critical Care, 22(1), Kendall-Gallagher, D., Aiken, L., Sloane, D., & Cimiotti, J. (2011). Nurse Specialty Certification, Inpatient Mortality, and Failure to Rescue. Journal of Nursing Scholarship, 43(2), 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), Wade, C.H. (2009). Perceived effects of specialty nurse certification: a review of the literature. AORN Journal, 89(1), 183-8, Wilkerson, B. (2011). Specialty nurse certification effects patient outcomes. Plastic Surgical Nursing, 31(2), 57-9.