Introduction
Hospitalized older adulfs experience more safefy-related complications than
younger patients, including increased falls and injurious falls, pressure ulcers, and
adverse outcomes associated with restraint use. These clinical areas are dominantly
under the control of nursing practice and thus are regarded as nursing-sensitive
quality indicators. Certified nurses have demonstrated competency in evidencebased
gerontological nursing care practice. However, the influence of nursing certification
upon quality indicators is not established.
Purpose
The purpose of this study was to examine the relationship between nurse certification
(in any specialty practice as well as gerontological) and unit-level, nursingsensitive
quality indicators in units that primarily serve older adults.
Method
In a sample of 44 medical and medical-surgical units in 25 NICHE (Nurses
Improving Care for Healthsystem Elders) hospitals, a retrospective descriptive
design used multivariate regression techniques.
Findings
Binary logistic regression modeling yielded a significant relationship between certification
in any specialty and falls (chi-square wald=3.80, p=0.05, df=1).
Conclusion
Nursing-sensitive outcomes in hospitalized older adults may be influenced by
nurse certification. The data from this pilot study support a larger prospective
study that will investigate the relationship between nurse certification, workforce
factors, and nursing-sensitive quality indicators in all types of units in both NICHE
hospitals and non-NICHE hospitals. The inability of some program coordinators to
obtain unit-level patient data points to the need for management tools and education
related to quality improvement for mid-level managers