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The Impact of Critical Care Nursing Certification on Pediatric Patient Outcomes

Patricia A Hickey1,2, Kimberlee Gauvreau, Courtney Porter1

  • 1Cardiovascular and Critical Care Patient Services, Boston Children's Hospital, Boston, MA.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|June 19, 2018
PubMed

Insights

Higher Bachelor of Science in Nursing preparation and Critical Care Registered Nurse certification among nurses are linked to fewer patient complications in pediatric congenital heart surgery. These nursing qualifications improve outcomes for children undergoing complex cardiac procedures.

Area of Science:

  • Pediatric Cardiac Surgery
  • Nursing Professional Development
  • Patient Safety Outcomes

Background:

  • Congenital heart defects necessitate complex surgical interventions in pediatric populations.
  • Nursing expertise and unit characteristics are potential factors influencing patient outcomes post-cardiac surgery.
  • The impact of advanced nursing education and specialized certification on complication rates in pediatric cardiac surgery requires further investigation.

Purpose of the Study:

  • To investigate the association between nursing qualifications (Bachelor of Science in Nursing preparation and Critical Care Registered Nurse certification) and patient complications in children undergoing congenital heart surgery.
  • To explore the relationship between unit characteristics and patient complications in free-standing children's hospitals within the United States.

Main Methods:

  • A cross-sectional descriptive electronic survey assessed nursing and organizational characteristics in free-standing children's hospitals.
  • Survey data from 2014 were linked with patient-level data (n=12,324) from the Pediatric Health Information System (ages <18 years) for 2013-2014.
  • The Complication Screening Method of Congenital Heart Surgery was utilized to adjust for baseline patient differences.

Main Results:

  • In 2014, 77% of nurses had a Bachelor of Science in Nursing (BSN) or higher, and 24% held Critical Care Registered Nurse (CCRN) certification.
  • The overall complication rate for congenital cardiac cases was 34.4%.
  • Increased institutional percentages of nurses with BSN preparation (OR, 0.83; p=0.04) and CCRN certification (OR, 0.86; p=0.02) were significantly associated with decreased odds of patient complications.

Conclusions:

  • Bachelor of Science in Nursing education and Critical Care Registered Nurse certification are significantly associated with improved pediatric patient outcomes following congenital heart surgery.
  • Recognizing and promoting nursing and organizational characteristics linked to better outcomes is crucial for patients, families, and society.
  • Clinical leaders should prioritize hiring nurses with BSN degrees for Pediatric Intensive Care Units and foster a culture that supports professional nursing certification.
Abstract

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