1. Section Editor(s): Roberts, Dottie EdD, MSN, MACI, RN, OCNS-C, CMSRN, CNE

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We have known for some time of the intrinsic benefits of orthopaedic nursing certification. In 2006 and 2008, the Orthopaedic Nurses Certification Board (ONCB) surveyed attendees at the certified nurses' recognition event at the NAON Congress. Certificants who completed the survey consistently indicated that certification enabled them to:

Dottie Roberts, EdD,... - Click to enlarge in new window

* Experience personal growth.


* Feel more competent in their skills as a professional nurse.


* Feel more satisfied as a professional nurse.


* Feel more confident in their practice.


* Be seen as a credible provider.


* Serve as a resource to staff for patient care concerns.


These represent powerful intrinsic benefits, personal satisfiers that prompted these nurses to seek and maintain orthopaedic nursing certification. Interestingly, when asked on the survey, "What rewards or benefits did you receive for achieving certification?" most also identified the intrinsic elements (e.g., recognition as an expert in their field by their colleagues) rather than extrinsic benefits such as an increase in salary or a one-time bonus.


Clearly, these survey results are a decade old. The strong influence of the Magnet recognition program has led many hospitals to provide more support for certification, particularly in the provision of salary differentials or bonuses. However, when ONCB members speak to certified nurses every year at the NAON Congress, we continue to find that most maintain their credentials because of personal pride in their achievement rather than any employer recognition. This anecdotal finding has been reinforced by frequently replicated research on the perceived value of specialty nursing certification, including a large study by the American Board of Nursing Specialties (ABNS) in which ONCB participated (Niebuhr & Biel, 2007).


Nursing certifying organizations have also turned their sights on the expected link of care by a certified nurse to patient outcomes. The ABNS Research Committee Subgroup completed a comprehensive review of the literature on this topic (Biel, Grief, Patry, Ponto, & Shirey, 2014). Nine studies were identified for inclusion in the review, with all but three finding a statistically significant relationship between specialty nursing certification and varied patient outcomes. Although none of the studies were conducted solely with patients with musculoskeletal health conditions, one finding that was both statistically and clinically significant was the inverse relationship between rate of patient falls and number of certified registered nurses. This result has great relevance for orthopaedic nursing practice. Research continues with such activities as analysis of nursing-sensitive data from the National Database of Nursing Quality Indicators.


Where is ONCB in this research movement? Because of their great interest in identifying the relationship between specialty nursing certification and patient outcomes, ONCB members continue to participate in all research activities spearheaded by ABNS. This body brings the power of numbers to its research, representing more than 500,000 certified nurses in the United States. As work continues, ONCB will report findings to help certificants make a strong business case for the extrinsic benefit of their credentials.




Biel M., Grief L., Patry L. A., Ponto J., Shirey M. (2014). The relationship between nursing certification and patient outcomes: A review of the literature. Retrieved from http:// [Context Link]


Neibuhr B., Biel M. (2007). The value of specialty nursing certification. Nursing Outlook, 55(4), 176-181. doi:10.1016/j.outlook.2007.02.002 [Context Link]