Increasing neuroscience RN certification rates

Profile of an outstanding post-master's DNP project

Clinical Issue/Practice Problem: A Midwest academic medical center hospital is certified by The Joint Commission as a Comprehensive Stroke Center (CSC) and is on the nursing Magnet journey. The CSC designation signifies excellence in caring for the most complex stroke patients. 16% of staff registered nurses (RNs) held neuroscience specialty certification. The aim of this quality improvement project was to develop and implement an initiative to increase RN neuroscience nursing certification.

Summary of Supporting Literature: Studies demonstrate that certified nurses improve nurse sensitive outcomes including timely activation of stroke protocols. Additionally, nursing certification is associated with increased nursing empowerment, sense of professional growth, autonomy and confidence. Magnet recognition requires a target of >51% of certified nurses within an organization.

Project Implementation: Review courses for two RN neuroscience certifications, the Certified Neuroscience Registered Nurse (CNRN) and Stroke Certified Registered Nurse (SCRN), were developed by content experts. Courses were held on-site with supplemental content available online. Printed review materials including practice exam questions were provided to participants.

Outcomes: There were 32 attendees at the CNRN course and 48 attendees at the SCRN course. Course survey evaluation results showed that 100% of RNs in both courses reported increased knowledge of the course content. 93% (CNRN) and 99% (SCRN) reported increased confidence in their ability to prepare for the exams. 100% (CNRN) and 96% (SCRN) reported an increased ability to identify effective study skills and test taking strategies as a result of the course. Regarding application to practice, 89% (CNRN) and 83% (SCRN) reported they would adopt elements learned in the course into their practice ‘to a great extent’. 100% of participants in both courses reported that they believed their practice would improve ‘to a great or moderate extent’ based on their participation. Three months after the initiative, the total number of certified neuroscience nurses increased from 16% to 22%. All 80 RNs who attended earned neuroscience continuing education credit.

Clinical Implications for Practice: Offering a certification review course promotes RN interest and preparation for specialty certification. The education advances excellence in practice for participants, regardless of intent to certify. This education model can be replicated for other specialty areas to promote RN specialty certification. For hospitals preparing for Magnet recognition, increasing the percentage of RNs holding a national certification is a key factor for success.