1. Craven, Heather MS, RN, CMSRN

Article Content


To increase the number of staff who hold nursing specialty certification, thereby creating an environment of nursing excellence for patients and staff at Virginia Commonwealth University Health System (VCUHS).



Certification is an objective, measurable way to ensure that a professional nurse has the knowledge to practice competently within his or her specialty. Given the complexity of healthcare and the increasing specialization of nursing practice, certification assures the public of expert knowledge and clinical judgment and increases patient confidence. Employers gain a skilled work force dedicated to career development and patient care, leading to greater job satisfaction and retention.



VCUHS values nurses pursuing professional certification as a demonstration of specialized knowledge and expert clinical judgment. To support the VCUHS nursing strategic plan, a nursing certification task force developed strategies to promote nursing certification, including the removal of potential barriers that may hinder nurses from seeking certification.



A group of Advanced Practice nurses met to develop strategies to change the organizational culture so that it supported staff nurse specialty certification. Strategies were also developed and implemented at the department and unit level, and outcome data were collected to document the impact of the change.



At the unit level, in January 2005, none of the staff on an acute care unit were certified. By January 2006, 67% of eligible RN staff had taken the certification exam and 53% had earned the CMSRN designation. RN turnover rate decreased from 21% to 8%, and the RN vacancy rate decreased from 8% to -6% in the same time frame. The unit was recognized by Professional Research Consultants, Inc, as having attained one of the highest patient satisfaction scores in the nation. At the organizational level, having certified nurses assisted in attaining the designation as an excellent organization for nursing practice by ANCC Magnet Recognition Program in February of 2006. In addition, nurses who attained certification reported the experience as providing for valuable personal growth and increased feeling of satisfaction as a professional nurse.



Organization, department, and unit-based initiatives to support staff certification had a positive impact on staff and patient outcomes.


Implications for Practice:

Advance Practice Nurses working at all levels of an institution can change organizational culture to support nursing specialty certification. As a result, barriers to certification can be overcome and staff and patient outcomes improved.