Nurse-Level Predictors of Obtaining Specialty Registered Nurse Certification

To examine individual nurse predictors of obtaining specialty registered nurse (RN) certification.

Specialty RN certification is associated with improved patient outcomes, yet certification rates among staff RNs remain low.

A retrospective case-control study was conducted among 1503 staff RNs employed across 4 hospitals in a South Carolina health system. Certification was defined as attainment of at least one specialty certification after hire; RNs certified at hire were excluded. Logistic regression examined associations between certification status and education, experience, hospital tenure, age, gender, race, ethnicity, and primary practice site.

Only 20.76% of RNs obtained specialty certification. Nurses with a Bachelor of Science in Nursing (BSN) or higher degree had an 8.1 percentage-point higher probability of obtaining specialty RN certification compared with nurses with non-BSN preparation. Asian nurses were more likely to attain certification. Longer hospital tenure was associated with a higher likelihood of certification, whereas longer years of practice experience were not. Each additional year of hospital tenure was associated with a 1.0 percentage-point increase in the probability of certification. Attainment of specialty certification varied significantly across the study hospitals. No statistically significant associations were found for years of experience, age, gender, or ethnicity.

Increasing specialty RN certification rates may require organizational investments in education, nurse retention, and equitable certification support. Findings inform targeted organizational strategies to increase certification rates and strengthen nursing human capital.