1. RN Specialty Certification:
An Answer for Continuing Education & Continuing Competence
This presentation addresses RN specialty certification as an effective policy remedy to the issues of RN continuing education and continued competence, which are key regulatory and patient advocacy matters. These regulatory and patient advocacy topics have arisen in part due to the growing dialogue on health care errors and on increasing health care complexities. Acceptance of specialty certification as a means to satisfy continuing education and continued competence requirements is a win-win for nurses, legislators, regulators, employers, and patients.

2. Certification Defined by American Board of Nursing Specialties (ABNS)
The formal recognition of the specialized knowledge, skills, and experience demonstrated by the achievement of standards identified by a nursing specialty to promote optimal health outcomes
ABNS is an acknowledged leader in recognizing and accrediting RN specialty certification boards.
Certification Defined by American Board of Nursing Specialties (ABNS)
Certification, as defined by the American Board of Nursing Specialties (ABNS), is the formal recognition of the specialized knowledge, skills, and experience demonstrated by the achievement of standards identified by a nursing specialty to promote optimal health outcomes.
Certification involves individuals voluntarily testing themselves against a national standard set via a nationally-recognized certification board’s examination.

3. What is State Licensure v. Certification?
Licensure allows you to legally enter practice (one time measurement through NCLEX-RN©)
Certification is voluntary and measures achievement in RN’s specific area of practice
Re-certification assures the public that the RN is maintaining competence through knowledge and participation in their specialty
What is State Licensure v. Certification?
RN licensure measures entry-level competence. While state licensure provides the legal authority for an individual to practice professional nursing, private voluntary certification is obtained through individual specialty nursing certifying organizations and reflects achievement of a standard beyond licensure for specialty nursing practice
The process of recertification seeks to assure the public that the certificant has maintained a level of knowledge in the specialty, as well as ongoing participation in activities that support the maintenance of competence in that specialty.

4. More About RN Specialty Certification
RNs enter the profession through licensure (authorized to practice across the entire Nursing Practice Act)
As RNs progress throughout their careers, specialty practice emerges
RNs who want to validate and enhance that specialty practice seek, prepare, and obtain specialty certification
More About RN Specialty Certification
Nurses validate their mastery of skills, knowledge, and abilities through certification and meet ongoing learning and practice requirements through recertification.
Certified nurses distinguish themselves through a commitment to lifelong learning and career advancement.
Certified nurses are role models of professional accountability.

5. What the Reports Says
90% of nurse manager respondents preferred hiring certified RNs over non-certified RNs
58% of nurse manager respondents see a positive performance differences in certified nurses
2009 IOM report stated that for RNs to keep their knowledge and skills up to date, the best way to achieve that was through ongoing certification that satisfies CE requirements
In 2002, an American Board of Nursing Specialties survey of nurse mangers demonstrated that nearly 90% of respondents clearly prefer hiring certified nurses over non-certified nurses. Furthermore, 58% stated that they see a positive performance difference in certified nurses.
A 2009 Institute of Medicine (IOM) report on continuing education for health professional noted that the purpose of CE is to enable health professionals to keep their knowledge and skills up to date, with the ultimate goal of improving performance and patient outcomes. This can best be achieved through ongoing certification that satisfies CE requirements for RNs.

6. Benefits of Hiring Certified RNs
Patients, families, employers, and nurses all benefit from specialty certification
Certification assures patients that RNs are competent
Employers supporting specialty certification are better positioned to prosper in highly competitive health care market
Patients – 1) Certification provides patients and families the validation that the nurse caring for them has demonstrated experience, knowledge and skills.
2) Increases patient safety and satisfaction.
Employers – 1) RN certification and the education required to maintain certification contribute to the creation of an environment of professionalism
2) Certification enhances in the workplace the utilization of evidence-based guidelines into practice.
3) Employer support of education and certification are drivers of nurses' job satisfaction and have been identified as essential elements of recruiting and retaining nurses.
4) Certification is a platform for hospitals to differentiate themselves from competitors by demonstrating to the public that the employer has attracted the most skilled and experienced nursing professionals.

7. Benefits of Certification to RNs
Validates specific nurse practice knowledge and skills to remain professionally competent in intricate health care environment
Improves capacity and use of evidence-based guidelines in nurse practice
Advances ability to remain on front edge with emerging technologies and processes
Meets challenges of evolving scopes of practice
Reinforces professional and career development
Certified RNs validate their expertise -- knowledge and skills -- positioning themselves for appropriate recognition.
According to studies, RNs whose clinical judgment has been validated through certification believe that they make decisions with greater confidence.
Certified RNs also report that certification enabled them to experience personal growth and feel more satisfied in their work.
As a voluntary process, specialty certification points to nurses' commitment to career development and dedication to patient care, particularly in ever-evolving health care environment. 
Ongoing education and experience reduces improves risk management, optimally preparing the RN to make informed decisions. Some insurers offer discounts on malpractice premiums to certified RNs.
Boosts potential for higher salary  as a certified RN.

8. BCEN Certification Project Benefits All Certified RNs
Board of Certification for Emergency Nursing (BCEN®) promotes RN specialty certification as a way to fulfill continuing education (CE) or continuing competence (CC)
BCEN supports all RN specialty certifications
Five pilot states initially targeted (FL, MO, OR, TX, VA)
For over two years, BCEN has conducted a certification project to increase the number of states allowing specialty certification to substitute for continuing education requirements or other continued competence initiatives.
As a baseline, BCEN researched the full landscape of regulatory requirements involving RN specialty certification. Since that time, the BCEN project has focused on five pilot states: Florida, Virginia, Texas, Oregon and Missouri.
Now BCEN is expanding the project to other states to:
-- seek state acceptance of specialty certification for CE/CC requirements;
-- encourage employers to support specialty certification; and
-- tie the certification project to the IOM Future of Nursing report initiatives.
BACKGROUND: The Board of Certification for Emergency Nursing develops robust certification exams fostering empowered nurses across the emergency spectrum, who contribute noticeably to patient care, safety and outcomes. The objectives of BCEN certifications are to promote quality emergency nursing, flight nursing, and critical care ground transport nursing by a) establishing the level of knowledge, requirements, and achievement necessary for certification; b) measuring the currency of the attainment and application of a defined body of specific knowledge needed to function at a competent level; c) encouraging continuing education; d) promoting professional development/career advancement; and e) recognizing RNs who meet all requirements of the BCEN certification process.

9. 32 States Recognize RN Specialty Certification for CE/CC
AR, DE, FL, GA, IA, KY, LA, MA, MI, MN, NC, NE, NH, NM, ND, OK, SC, TN, TX, VA, WA, WV & WY
AK, AL, CA, IL, KS, MT, NJ, PA & UT only allow the education leading toward certification to count toward CE/CC
32 States Recognize RN Specialty Certification for CE/CC
In total, 21 states provide a pathway for specialty certification to count toward CE requirements. They are: Alaska, Arkansas, Florida, Illinois, Kansas, Kentucky, Louisiana, Michigan, Massachusetts (like FL only the education leading toward certification counts for CE requirements), Minnesota, Nebraska, New Hampshire, New Jersey (like FL and MA), New Mexico, North Dakota, Oklahoma, Pennsylvania, South Carolina, Texas, Washington and West Virginia. Virginia is awaiting final adoption of the rule.

10. Certification Project Challenges
Some states do not mandate CE or CC requirements
15 states have no CE requirements: AZ, CO, CT, HI, IN, ME, MD, MO, MS, NY, OR, RI, SD, VT & WI
NC, TN & WY have no CE requirement but do have CC requirements
Seventeen states do not have any continuing education requirements in place for RNs: Arizona, Colorado, Connecticut, Georgia, Idaho, Indiana, Maine, Maryland, Missouri, Mississippi, Montana, New York, Oregon, Rhode Island, South Dakota, Vermont, and Wisconsin.
BCEN Certification Project Advocates in MO and OR faced this challenge with the respective state stakeholders (e.g., legislators, Board of Nursing, nurses) not supporting the concept of continuing education requirements.
Continued Competence
Three states do not have a formal requirement for continuing education, but do have requirements for meeting continuing competence requirements — North Carolina, Tennessee and Wyoming.

11. Certification Project Lessons Learned
States and health care professions are exploring ways to measure current practice
RN specialty certification is an excellent way to demonstrate ongoing competence ‒‒ it is tied to a specific practice focus beyond a general license
Grassroots coalitions of all stakeholders enhance advocacy
Linking RN specialty certification to IOM Future of Nursing recommendations is an advocacy strategy with potential
Devising comprehensive communications plans add value
Regulatory and legislative actions with boards of nursing and state legislators must be monitored
Certification Project Lessons Learned
RN-Specialty Certification Coalition: • Cast a wide net by inviting all nursing groups that have/support certification. • Reach out to employers. • Don’t forget about patient safety or state and local quality organizations. • Consider other health care practitioner groups that work with certified nurses. • Local malpractice carriers/insurance companies. • Ascertain where your state regulators and legislators are regarding RN-specialty certification as a means to satisfy continued competence and/or continuing education requirements, and having them early on the coalition can help get things moving faster.
Use the IOM report and its state-based activities to make sure specialty certification is a viable part of the continued competence landscape as specialty certifications meet rigorous standards of psychometric soundness and legal defensibility that can fairly and accurately assess skills, knowledge and abilities in RN-specialty practice areas.
Communications: • Use local trade and city media to publicize work. • Via monthly s update memberships or audiences on the work to keep people engaged and informed. • Develop social media to promote meetings, hearings, a new research study or local angle to keep the issue in the forefront. • Encourage opportunities to present and inform on the topics. Professional group programs, lunch and learn at work, informal elevator speeches with possible key influencers.

12. If your state accepts RN specialty certification for CE/CC
Practice Positive PR ‒ tell colleague, managers, HR departments, etc.
Write newsletter articles for employer and nurse newsletters and magazines in your state
Ask your board of nursing to promote it on its web site where RNs go to renew licenses
What Can You Do?
Work within states that have continuing education requirements to formally identify, accept and publicize specialty certification as a means to satisfy CE requirements. Mobilizing positive public relations in these states will benefit the nurses in those areas as well as in surrounding states that are discussing whether to accept certification for CE and continuing competence requirements. BCEN has developed resources to assist you and your networks.

13. What Can You Do?
If your state does not accept RN specialty certification for CE/CC
Encourage colleagues, management, patient groups, etc., to let board of nursing and legislators know how important specialty certification is for RNs and maintaining CE/CC
Write newsletter articles for employer and nurse newsletters and magazines in your state encouraging certification and CE/CC link
Make presentations advocating specialty certification at state nursing, health care, and patient-related groups in your state
Develop a stakeholder coalition

14. Seeking Further Support & Information
Contact:
Sandra T. Samargis
Executive Director
Board of Certification for Emergency Nursing
Phone: (630)
Certification advocacy toolkits
available on request
BCEN developed a Toolkit to assist and has research/information to enhance your grassroots advocacy campaign.