Nurse Certification May Promote Evidence-Based Practice in ICU

Nurses with specialty certification may speed translation of evidence-based research into everyday clinical practice, according to a study published in the January issue of the American Journal of Critical Care.

Kristin Hittle Gigli, Ph.D., R.N., from the University of Pittsburgh, and colleagues conducted an online survey of 268 nurses in 12 adult intensive care units across six hospitals in a single, integrated health care system. The survey assessed the relationships between critical care nurses' education level and specialty certification, their individual psychosocial beliefs about their place on the intensive care unit team (professional identity, self-efficacy, and role clarity), and their perceptions of evidence-based practices used in the intensive care unit.

The researchers found that 71 percent of respondents had a bachelor of science degree or higher education and 26 percent had critical care certification. Certified nurses reported greater knowledge of spontaneous breathing trials and lung-protective ventilation compared with noncertified nurses. Certified nurses also reported significantly higher self-efficacy and role clarity compared with noncertified nurses. There was an association between certification and greater perceived value in specific practices (daily interruption of sedation: adjusted odds ratio, 2.5; 95 percent confidence interval, 1.0 to 6.3; P = 0.05; lung-protective ventilation: adjusted odds ratio, 1.9; 95 percent confidence interval, 1.1 to 3.3; P = 0.03). There was no association between education level and greater knowledge of or perceived value in evidence-based practices.

"Supporting specialty certification among nurses is a plausible way to assist with the adoption of evidence-based practices as a means to improve intensive care unit quality and should be evaluated further," the authors write.

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