Predictors of specialty certification among paediatric hospital nurses

Aims and objectives To evaluate differences in hospitals' proportion of specialty certified nurses and to determine whether and to what extent individual nurse characteristics and organisational hospital characteristics are associated with a nurse's likelihood of having specialty certification. Background Prior research has shown that patients in hospitals with high proportions of specialty certified nurses have better outcomes including lower mortality and fewer adverse events, yet less is known about what motivates nurses to obtain specialty certification. Methods and design Cross-sectional study of paediatric nurses in 119 acute care hospitals. Multivariate logistic regression models were used to determine the association between individual nurse characteristics, organisational hospital characteristics and an individual nurses' likelihood of holding a specialty certification. STROBE was followed. Results The proportion of certified nurses varies substantially among hospitals, with Magnet (R) hospitals being significantly more likely, on average, to have higher proportions of certified nurses. Nurses in children's hospitals were no more likely than paediatric nurses in general hospitals to be certified. A nurse's years of experience and bachelors-preparation were significantly associated with higher odds of having certification. The strongest predictors of certification were favourable nurse work environments and Magnet (R)-designation of the hospital. Conclusions While individual attributes of the nurse were associated with a nurse's likelihood of having a specialty certification, the strongest predictors of certification were modifiable attributes of the hospital-a favourable nurse work environment and Magne (R)-designation. Relevance to clinical practice Hospital administrators seeking to increase the proportion of specialty certified nurses in their organisation should look to improvements in the organisation's nurse work environment as a possible mechanism.

Automated summary

The study evaluates the differences in hospitals' proportion of specialty certified nurses and identifies individual and organizational factors associated with a nurse's likelihood of certification. Results show that nurse work environment and hospital designation are the strongest predictors of certification, suggesting that improving these factors can increase the proportion of certified nurses in hospitals.