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PubMed2002

Incomplete birth certificates: a risk marker for infant mortality.

OBJECTIVES: This study assessed the relationship between incomplete birth certificates and infant mortality. METHODS: Birth certificates from California (n = 538 945) were assessed in regard to underreporting of 13 predictors of perinatal outcomes and mortality. RESULTS: Of the birth certificates studied, 7.25% were incomplete. Underreporting was most common in the case of women at high risk for poor perinatal outcomes and infants dying within the first day. Increasing numbers of unreported items were shown to be associated with corresponding increases in neonatal and postneonatal mortality rates. CONCLUSIONS: Incomplete birth certificates provide an important marker for identifying high-risk women and vulnerable infants. Because data "cleaning" will result in the removal of mothers and infants at highest risk, birth certificate analyses should include incomplete records.

Adolescent↗
PubMed2006

The impact of parental leave on extending training and entering the board certification examination process: a specialty-based comparison.

OBJECTIVE: To study the impact of parental leave on extending residency training and the timing of entrance into the specialty board certification examination system. METHODS: From June 3, 2005, through December 28, 2005, primary specialty board policies regarding parental leave, absence from training, and the timing of entrance into the board certification examination process were reviewed for all American Board of Medical Specialties programs with a national enrollment of more than 100 residents. The impact of a 6-week parental leave on extending training and qualifying to enter the board certification examination system was compared among these specialties. RESULTS: All specialty boards studied, except for the American boards of neurosurgery, ophthalmology, psychiatry, neurology, and thoracic surgery, have defined limits on absences from training. The limits on absence from training among the 21 other residency programs studied are generally similar, but important differences exist. These differences include the maximum length of time away from training per year, whether absence from training can accumulate year to year, and whether the length of time away from training is consistent for each postgraduate year of the training program. The impact of a 6-week parental leave on qualifying for the board certification examination system on schedule varies from no impact to delaying entrance for 1 year. CONCLUSION: Specialty board policies regarding absence from training and entering the board certification examination process vary and could influence decisions about family planning, the length of time taken for parental leave, the use of vacation time for parental leave, and resident well-being.

Certification↗
PubMed1994

Competency-Based Certification Project. Phase II: Examination blueprint.

This is the second of three articles explaining the C.A.M.R.T.'s Competency-Based Certification Project--an effort to make the certification process more job-relevant. The first article (August 1994 Journal) explained the job analysis process used to specify and validate the list of duties and tasks of entry-level medical radiation technologists, the imaging and treatment procedures they perform, and the equipment they use. This article discusses how the results of the project's job analysis will help determine the content of the certification process. It explains the work involved in reviewing the C.A.M.R.T.'s examinations and summaries of clinical experience in the context of competency-based evaluation and the job analysis validation in each discipline. The resulting "examination blueprint" will become a key document for persons involved in the C.A.M.R.T.'s certification process. This article briefly describes the examination blueprint's components and related concepts. The third and final article of this series will examine the development of assessment standards for certification examinations and summaries of clinical experience.

Canada↗
PubMed1997

Supplier certification modified for health care.

There have been numerous articles written in detail regarding industrial-based supplier certification programs. These programs generally concentrate on suppliers of raw materials. After reviewing them, it is difficult to visualize how these programs could support the ambulatory or inpatient operations of a healthcare institution. The University of Maryland Medical Center, a 747-bed teaching hospital in Baltimore, took on the challenge to adapt the supplier certification program to support its healthcare institution. After months of struggle, a program emerged by expanding the Medical Center's current process management philosophy, to include its suppliers. Documentation from the program developed by the Medical Center indicates the level of supplier support has increased. Through this certification program, the supplier is aware of the Medical Center's expectations and needs. In turn, the Medical Center has become aware of how its internal processes can hinder the supplier's operation. The supplier certification program has provided a valuable communication conduit. This article covers a brief summation of the industrial-based supplier certification program and how the University of Maryland Medical Center has adapted the program to support all its operations.

Certification↗
PubMedDate not supplied

Professional certification in orthopaedic nursing.

Certification is a growing area of nursing that allows nurses the ability to attain additional credentials in their specialty. While certification has been present for many years in some professions, it is relatively new in nursing. There are many reasons to obtain certification, but the overwhelming one is personal satisfaction and professional growth. Suggestions for selecting a certification test and guides to prepare for the exam are provided in this article as well as suggestions for employers to reward employees for attainment of certification.

Career Mobility↗
PubMed1981

Medicare program; Medigap--certification of Medicare supplemental health insurance policies: Health Care Financing Administration. Proposed rule.

This proposal would establish a program of certification, by the Secretary, of Medicare supplemental health insurance policies (so-called Medigap policies) voluntarily submitted by insurers for review. It would implement, in part, section 507 of the Social Security Disability Amendments of 1980. HCFA will administer the certification program. The voluntary certification program would go into effect July 1, 1982, and would apply only to policies issued in those States that do not have in effect a program for regulating Medigap policies equal to or more stringent than the one to be described in these regulations. A Supplemental Health Insurance Panel, consisting of the Secretary or a designee and four State Commissioners of Superintendents of Insurance appointed by the President, will determine the adequacy of a State's program in relation to the standards contained in the regulations. These regulations would: (1) set standards for policies voluntarily submitted to HCFA for certification, (2) establish procedures for the certification program, and (3) promulgate the statutory requirements that the Supplemental Health Insurance Panel would use to approve State regulatory programs.

Certification↗
PubMed1999

Analysis of mortality in French diabetic patients from death certificates: a comparative study.

This study was implemented in France to determine the causes of death in diabetic patients, whether diabetes was mentioned or not on the death certificate, and to assess the underestimation of the prevalence of diabetes at death. Two stratified random samples of death certificates were selected in the national mortality data base. The first included certificates mentioning diabetes as a cause of death (cases). The second, included certificates with no mention of diabetes (controls). For each certificate, a record form was sent to the certifying physician to ascertain diabetes in the first group and to trace unrecorded diabetes in the second group. In case of diabetes, the characteristics of the patient and his disease were collected (age at onset, treatment, complications ...). We obtained complete data for 325 cases and 959 controls. Among cases, 1% of the subjects were not confirmed as diabetic, while almost 10% of the controls were identified as having diabetes. The corresponding ratio of the corrected prevalence at death to that provided by the French statistics was estimated to 4.0 in men and 3.1 in women. Particular features are that 2% of the total diabetic decedents died from acute metabolic complications (diabetic or hyperosmolar coma, acidoketosis, or acute hypoglycemia), and that 33% of the unreported diabetic decedents under 45 died from trauma or poisoning. These results show that in France, the death rates published in the statistics for diabetes dramatically underestimate the impact of diabetes. A high risk of death is linked to this disease, particularly in people aged under 45, a problem that health deciders should address.

Adult↗
PubMed2002

[Assessing the quality of medical certificates II--useful criteria or unnecessary schedule?].

BACKGROUND: In Norway, doctors must provide the National Health Insurance (NIS) with a special medical certificate if a sick-leave exceeds eight weeks. The aim of this study was to evaluate this medical information in relation to the NIS criteria for further sickness benefits and the usefulness of the certificate in assessing the need for early rehabilitative and vocational initiatives. MATERIAL AND METHODS: 2,237 consecutive eight-week medical certificates submitted to 21 NIS offices in the county of Hordaland in 1994 were independently evaluated by the NIS officer and the NIS medical consultant in a questionnaire survey. RESULTS: Both evaluators found sufficient medical information in the vast majority of medical certificates, though in about 12% of the cases the medical criteria for further benefits were not sufficiently documented. In less than 10% of the cases, active rehabilitative or vocational measures were called for at this point in time. However, there was a rather low degree of consensus between the NIS officer and the medical consultant about in which cases supplementary information or active measures were warranted. INTERPRETATION: We conclude that the eight-week medical certificate usually contains enough medical information but is of limited use in assessing the need for active intervention by the NIS. Supplementary information from the absentee and the employer should be collected at an early stage of the sick leave.

Certification↗
PubMed2000

National school nurse certification. Part I: An ongoing process.

The National Association of School Nurses proposed the concept of certification for school nurses in the 1970s. The development and evolution of the school nurse certification process, from concept to reality, is described in this article. It is the first of a 2-part series on national certification for school nurses. Part 2 will examine issues and answer questions about the certification, give information from past and current presidents and certified school nurses about their experiences, and present a forecast about the future of school nurse certification.

Certification↗
PubMed2002

Field experience with the FAA's Web-based medical certification system "AMCS/DIWS". Federal Aviation Administration.

The October 1, 1999, introduction in the U.S. of a Web-based medical certification process for civil aircrew opened a new era within civil aviation. The Federal Aviation Administration's (FAA) Aeromedical Certification System/Document Imaging Workflow System (AMCS/DIWS) has imposed certain new requirements on the designated Aviation Medical Examiners (AMEs), including the use of Internet systems and procedures. A number of AMEs elected to discontinue their work as the classic medical certification processes were replaced. The authors document their personal experience with respect to the new system, and cite the overall advantages that modernized medical certification procedures bring. These advantages include far fewer "mistakes of omission" by AMEs, more timely receipt by the FAA of aircrew certification data, and a developing master aircrew database for analytic studies.

Aerospace Medicine↗
PubMed2001

Advanced nursing skill certification in critical care.

Advances in critical care therapies demand that registered nurses maintain skills consistent with the ability to provide safe patient care. Advanced nursing function (ANF) certification is one way to achieve this goal. The purpose of this article is to describe the annual certification process that occurs in one general systems critical care unit within a large urban acute care setting. Two hundred registered nurses are certified annually in cardioversion/defibrillation, pacemakers, intraspinal analgesia, pulmonary artery catheters and intracranial pressure monitoring. Involving both conceptual and psychomotor skill assessments, ANF certification not only challenges educators to possess and maintain current knowledge about ANF procedures, but also readily identifies areas of strength and weakness for the nurse regarding knowledge and practice development about a particular procedure. The critical care education committee recognized the need for advanced nursing knowledge in order to provide quality, safe patients care and to meet the needs of patients with complex care requirements. ANF certification has proved to be an efficient, cost-effective method to educate many nurses in a relatively short period of time. Most importantly, ANF certification assists to maintain an optimum standard of care within the critical care unit and, at the same time, lends itself well to the development of other advanced critical care procedures in the future.

Certification↗
PubMed2003

Sickness certificates. To write or not to write.

Sickness certificates are legal documents. General practitioners may face disciplinary proceedings, or even civil or criminal action if they issue a false, misleading or incorrect sickness certificate. Never backdate a sickness certificate. Always record the actual date that the certificate was written and the date of the consultation--even if the certificate refers to a different period of absence from work.

Australia↗
PubMed2004

Quality of death certificates in Quemoy, Taiwan.

BACKGROUND AND PURPOSE: The age-adjusted mortality rate on the island of Quemoy was the lowest of any county in Taiwan in the years 2000-2001. However, the island's rate of mortality due to cardiovascular diseases fluctuates widely. This fluctuation suggests that Quemoy may be issuing inaccurate death certificates. METHODS: To assess the quality of death certificates from Quemoy, 123 (15.3%) medical records for 800 deaths between 1994 and 1998 were reviewed by 3 medical specialists. The underlying cause of death from the original death certificate was compared to the underlying cause of death determined by 3 reviewers based on review of all available medical records. RESULTS: The agreement index for all causes of death was 72.4%. Neoplasms had the highest sensitivity and positive predictive value for correct determination of underlying cause of death. Cardiovascular diseases had higher sensitivity, but lower positive predictive value than respiratory diseases. Neoplasms were under-reported by 25.5% but cardiovascular diseases were over-reported by 34.3%. CONCLUSIONS: Therefore, mortality statistics in Quemoy, which are based on death certificate data, may underestimate the frequency of neoplasms and overestimate cardiovascular diseases as underlying causes of death. Our findings also suggest that researchers should exercise considerable caution when using death certificate data to determine cause of death in etiologic studies, especially in neoplasms and cardiovascular diseases.

Aged↗
PubMed2004

Food safety certification regulations in the United States.

Food handlers often lack food safety training. Adequate training is important because foodborne illness results in costs of $7.7 to $23 billion per year to consumers, the food industry, and the national economy. Generally, however, training is evaluated through standardized examinations for which a certificate is awarded. Many states have turned to mandatory certification, but regulations vary. This paper summarizes state regulations with respect to mandatory certification. Among states that mandate certification, most require one certified food safety manager per site. The certified safety manager need not be on site at all times and must be recertified at least every five years. Certification is accomplished by passing one of the four exams previously recognized by the Conference for Food Protection (CFP), three of which the Conference for Food Protection-American National Standards Institute (CFP-ANSI) now accredits.

Administrative Personnel↗
PubMed2004

Certification of multiple sclerosis nurses: an international perspective.

The Multiple Sclerosis Nursing International Certification Board was formed as a special initiative of the International Organization of Multiple Sclerosis Nurses (IOMSN). The aim was to develop a certification examination for MS nursing practice. This certification should achieve the vision of the IOMSN and unite MS nurses worldwide through standard practices. Such practices are based on common knowledge and skills, and tasks that encourage the best outcome for the nurse-patient collaborative relationship. Certification allows recognition of an individual nurse's skill level, establishes a standard for all nurses treating patients with MS, improves patient care, and also benefits the neurological community. The Multiple Sclerosis Certified Nurse is revolutionary, as certification is an international effort to enhance and standardize MS care and develop MS nurse professionalism across borders.

Certification↗
PubMed1992

Evolving a blueprint for certification: the responsibilities and knowledge comprising American professional oncology nursing practice.

Ensuring adequate content validity of a certification examination is a major concern in the development and administration of a test. To establish content validity of the Oncology Nursing Certification Corporation (ONCC) certification exam, a job analysis study was conducted to provide empirical data about the responsibilities and knowledge areas required for practice at the level of the newly certified oncology nurse. The study involved The Profession of Oncology Nursing: An Inventory of Responsibilities and Knowledge (IRKPON), a questionnaire that was developed based on a review of the literature, professional practice information, interviews with oncology nurses, the original ONCC certification exam table of specifications, and evaluations undertaken by two advisory committees. The IRKPON consisted of three parts: 56 responsibilities clustered into eight job dimensions, 217 knowledge areas grouped into seven knowledge dimensions, and demographic information. The IRKPON was sent to a stratified random sample of 3,000 oncology nurses in the United States, who were asked to rate both the responsibilities and knowledge areas by level of importance. The 1,297 (43%) responding nurses rated 45 of 56 responsibilities (80.4%) as "very important" and 8 of 56 responsibilities (14.3%) as "extremely important"; they also rated 163 of 217 knowledge areas (75.1%) as "very important" and 41 of 217 knowledge areas (18.9%) as "extremely important." These findings identified the specific responsibilities most important to the oncology nurse role at the level of the newly certified nurse, as well as the knowledge areas necessary for competent performance. Subsequent ONCC certification examinations were modified; the test blueprint that guides the construction of the examination was revised, and the passing score was adjusted.

Adult↗
PubMedDate not supplied

R.T.s' interest in advanced-level certification and distance learning.

OBJECTIVE: To determine the interest of radiologic technologists in obtaining advanced-level certification and their acceptance of distance learning as an educational method to pursue advanced-level certification. METHODS: Researchers surveyed a random sample of 1300 registered technologists (R.Ts) certified in radiography. Data were analyzed using basic univariate statistics and logistic regression calculations. RESULTS: The majority of respondents (72%) expressed an interest in obtaining an advanced-level certification. Furthermore, 93% of those respondents indicated that distance learning was an acceptable method for obtaining the necessary course work. Interest in certification for computed tomography (CT) or magnetic resonance (MR) imaging was selected by nearly 25% of the respondents. Most plan to begin course work within the next 1 to 2 years, are willing to dedicate 4 to 6 hours per week and up to dollar 250 per year to obtain their goals. Although most employers (63%) do not contribute any financial assistance, most R.Ts (53%) indicated that employer support did not influence their decision to pursue a certification. CONCLUSION: This study supports the need for quality distance learning programs, particularly in the areas of CT and MR.

Adult↗
PubMed1991

Board certification and practice style: an analysis of office-based care.

BACKGROUND: The relationship between family practice certification and practice style has important health policy implications. We used data from the RAND Health Insurance Experiment to study the relationship between family practice certification and (1) patient characteristics including age and sex of patients, and (2) facets of practice style including probability of hospital admission, number of visits in an episode of care, number of physicians seen per episode, total charges per episode, charges per service category, and inputs per service category. METHODS: Data on health care service utilization by a sample of 5554 nonelderly individuals over a 1-year period were used to define episodes of care. Multivariate regression techniques were used to measure the association between family practice certification and patient characteristics and between family practice certification and practice style, controlling for the effects of patients characteristics. RESULTS: Patients of certified family physicians were an average of 3 years younger than patients of noncertified family physicians, but other demographic characteristics were similar. Certified family physicians had higher pathology services charges and inputs, but no statistically significant differences in other measures of charges and inputs. CONCLUSIONS: Certified and noncertified family physicians treat similar patients. Certification in family practice is not associated with major differences in total service charges, but is associated with differences in the use of laboratory diagnostic services.

Adolescent↗