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certification, nursing certification, progressive care, progressive care certified nurse, progressive care nursing, specialty certification



  1. Benike, Linnea DNP, RN
  2. Wozniak, Janelle MSN, RN


ABSTRACT: Nurses working on progressive care units (PCUs) use specialized knowledge and skills to provide care to acutely ill patients. The literature suggests that specialty certification may have a positive impact on patient and nurse outcomes alike, although results are mixed. A project team set out to create a culture that encouraged nurses to pursue progressive care certified nurse (PCCN) certification on three cardiac medical PCUs at a large academic health center by implementing a Pathway to PCCN program, which is a structured, cohort-based approach to certification preparation.


The primary aim of the intervention was to achieve a 10% PCCN certification rate within one year. Additionally, the project team evaluated whether participating in the Pathway to PCCN program affected staff nurses' self-reported confidence in their clinical judgment in 10 patient care domains: cardiac, pulmonary, behavioral, neurological, musculoskeletal, hematological, endocrine, gastrointestinal, renal, and multisystem.


Project methods included structured strategies within a "4R" framework developed by the project team: recruitment, obtaining resources, providing reassurance, and celebrating certification through recognition. Project methods were evaluated using anonymous electronic surveys and staff interviews.


The percentage of staff with PCCN certification increased from 0% to 15.2%. The average confidence levels reported by nurses who participated in the project (N = 64) increased in eight out of nine (89%) of the clinical judgment domains tested on the PCCN examination in Cohort 2, and in nine of the clinical judgment domains in Cohorts 1 and 3. Implementing a structured cohort pathway for specialty certification using the 4R framework is a strategy that can increase rates of specialty certification among eligible nurses.