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PubMedDate not supplied

A specialty certification incentive program. Costs versus benefits.

Certification benefits nurses and their institution of employment. Although certification seems costly initially, it can be used to help reduce hospital expenditures in the areas of staff retention and recruitment, liability, and quality of patient care. The financial implications of certification and the development of a successful hospital incentive program to assist nurses to obtain certification is reported. Staff development educators can use this information to evaluate the cost-to-benefits ratio of specialty certification and to determine if a similar program could work in their institution.

Certification↗

PubMed1990

The development of orthopedic certification in the United States.

The development of medical education standards and state licensure requirements occurred simultaneously in the 1900s. The result was that annual state licensure became the physician's certification. Eventually, the explosion of scientific knowledge due to hospital-based clinical practices and stimulation from national societies led to specialization within medicine. Primary specialty boards were organized in the 1930s to issue credentials and define qualifications for specialists. Just as licensure became the certification of a physician, primary boards became the certification of a physician specialist. Certification has become progressively more important in relationship to individual patients, national societies, hospitals, and third-party carriers. Recertification is the recognition by a primary board of a diplomate's continuing qualifications. The majority of primary boards have plans to institute recertification in order to evaluate pertinent cognitive knowledge of a diplomate and to respond to inadequate ongoing peer review. The expansion of scientific and technical knowledge, which led to specialization in the 1930s, inevitably has led to subspecialization. Orthopedic surgeons are using a wide range of fellowships, especially those just completing their residency education. The first certificate of added qualifications for orthopedics was in surgery of the hand.

Certification↗

PubMed1989

The certification process. History and significance for addictions nursing practice.

The addictions nursing certification process will become a reality for the nurse. Ideally, this process will provide a method of ensuring quality care while maintaining self-regulation by the profession. The literature supports certification based on standards of care as a measure of that quality of care and as a voluntary mechanism selected by the practicing nurse. Many professional issues lie ahead for specialty nursing practice in the 1990s. The addictions nursing certification established by the NNSA offers a quality basis for certification implementation. The addictions nursing practice certification credential can provide the acknowledgement that the nurse has mastered a body of knowledge and skills reflective of a specialty nursing area.

Certification↗

PubMed1979

Accuracy of birth certificate data for detecting facial cleft defects in Arkansas children.

A comparison of facial cleft defects reported on birth certificates during the period 1943 to 1974 that were reported on birth certificates was made with records maintained by the Arkansas Crippled Childrens Services (CCS). A total of 506 cases were reported of which 331 (65%) were recorded on the birth certificate. Moreover, the accuracy of the reporting was not good. Only 243 (48%) cleft malformations were correctly classified on the birth certificate. Birth certificate information is an inadequate measure of the true facial cleft occurrence in Arkansas. Caution must be exercised when this data source is used in epidemiological surveys because over one-third of such defects were not recorded. These findings serve to reemphasize the national need to improve the quality of such vital health statistics sources.

Arkansas↗

PubMed1973

The view behind and ahead: implications of certification.

The Medical Library Association's certification plan, never of real significance in employment and promotion practices in health sciences librarianship, does not reflect the many changes which have occurred in swift progression since adoption of the code in 1949. Solutions to the problems which have accumulated since then are sought in a brief examination of trends in credentialing and certification in the health professions and in the library field, both general and special. Emphasis is given to the historical development of provisions in the MLA Code for the Training and Certification of Medical Librarians, the limited opportunity for practical implementation of most of the provisions, the importance of the code in stimulating the Association's educational programs, the impact of the Medical Library Assistance Act, Regional Medical Programs, and increases in demand for health information on manpower requirements for health science libraries, the specific dissatisfactions MLA members have expressed over certification, and the role of the Ad Hoc Committee to Develop a New Certification Code.

Accreditation↗

PubMed1984

[Accreditation of educational programs and certification of laboratory and radiology technicians in the United States].

A general view is given of the accreditation of education programs and the certification of laboratory and radiology technicians and of members of the health professions in general. In addition, the functions of the federal government and the professional societies are described in a organizational chart, and the work done by each group participating in the accreditation and certification process is explained. Although a structured academic education is ordinarily required for certification, the agencies charged with it offer different possibilities in which a limited number of academic requirements may be replaced by clinical experience or experience in the field in question. Also included are the requirements for admission to written examinations for certification in laboratory and radiology technology in the United States. Special attention is given to the interconnection between accreditation and certification in those two professional fields.

Accreditation↗

PubMed1983

The effect of death certification and coding practices on observed differences in respiratory disease mortality in 8 E.E.C. countries.

National differences in respiratory disease mortality have been observed in eight member countries of the European Economic Community (E.E.C.). To investigate the extent to which death certification and coding practices explain such differences, a representative sample of certifying doctors in each country was asked to complete specimen death certificates for a bank of ten written case histories. The certificates from each country were coded firstly by their own offices and subsequently by the W.H.O. Reference Centre in the U.K. Large within- and between-country differences in the coded causes of death were found. Some of these differences were due to variations in the ways doctors certify deaths, others to the way certificates are coded in each country. These discrepancies explain part of the between-country differences in mortality in some disease categories. Comparisons of mortality statistics for respiratory diseases between different countries should therefore be viewed with caution. There is a need for further standardisation of death certification and coding practices in the E.E.C.

Death Certificates↗

PubMedDate not supplied

History of smoking from the Washington State death certificate.

Beginning in 1988, a question added to the Washington State death certificate asked whether the decedent had smoked during the last 15 years of life. We analyzed death certificate data to evaluate the effectiveness of this question in identifying groups with high smoking rates and occupations with high rates of respiratory disease death among nonsmokers. We obtained statistical death certificate data from the Washington State Department of Health for resident deaths occurring between 1988 and 1991. Analyses included information on age, sex, race/ethnicity, marital status, underlying cause of death, high school graduation, smoking during the last 15 years of life, and occupation. Based on logistic regression analysis, we found that male sex, youth, divorced status, or death from lung cancer, chronic obstructive lung disease, or ischemic heart disease predicted a higher risk of smoking during the last 15 years of life. Hispanic ethnicity, single or widowed status, high school graduation, or death from breast cancer, diabetes, motor vehicle accidents, other accidents, or homicide predicted a lower risk of smoking. In farming occupations, there was an excess number of chronic obstructive lung disease deaths among nonsmokers. Findings from this study suggest that patterns of smoking during the last 15 years of life among decedents can provide useful public health surveillance information. The collection of risk factor information, such as smoking, should be recommended for the U.S. standard death certificate. Questions on smoking should be both simple and answerable by informants who may not have known the decedent for a lifetime. Additional studies on the accuracy of smoking history from the death certificate should be conducted.

Adult↗

PubMed1993

Council on Certification Professional Practice Analysis.

The CCNA has completed a PPA and will begin implementing its recommendations with the December 1993 certification examination. The results of the PPA provide content validation for the CCNA certification examination. The certification examination is reflective of the knowledge and skill required for entry-level practice. Assessment of this knowledge is accomplished through the use of questions that are based on the areas represented in the content outline. Analysis of the PPA has resulted in changes in the examination content outline and percentages of questions in each area to reflect current entry-level nurse anesthesia practice. The new outline is based on the major domains of knowledge required for nurse anesthesia practice. These changes are justified by the consistency in the responses of the practitioners surveyed. There was overall agreement as to the knowledge and skills related to patient conditions, procedures, agents, techniques, and equipment that an entry-level CRNA must have to practice. Members of the CCNA and Examination Committee will use the revised outline to develop questions for the certification examination. The questions will be focused on the areas identified as requiring high levels of expertise and those that appeared higher in frequency. The PPA survey will be used as a basis for subsequent content validation studies. It will be revised to reflect new knowledge, technology, and techniques related to nurse anesthesia practice. The CCNA has demonstrated its commitment to the certification process through completion of the PPA and implementation of changes in the structure of the examination.

Certification↗

PubMed1993

Death certificates. The need for further guidance.

Although instructions for proper completion of the cause-of-death section of the death certificate are available, a number of published examples are controversial, confusing, or inconsistent with other recommendations and guidelines. Several such examples are described to illustrate the need for improved instructions for death certification, with the goal of improving the consistency, accuracy, and reliability of death statistics. Also discussed is the general relationship between state vital records registrars, the National Center for Health Statistics, and the World Health Organization, in terms of death certification paperwork, procedure, policy, and death certificate revision. Since medical examiners certify substantial numbers of deaths, the need for medical examiners to be involved in revisions of death certificate forms and policies is emphasized.

Coroners and Medical Examiners↗

PubMed1993

An evaluation of an educational intervention to improve death certification practice.

The objective of this study was to evaluate the effect of an educational intervention on the knowledge and behaviour of hospital staff pertaining to death certification. A questionnaire was administered, and certification error assessed both before and after written educational material was provided. Although the response rate to the questionnaire was disappointing (19.1%), the findings revealed a poor baseline understanding of the subject that improved after reading the educational material. Certification error fell from a baseline of 22.4 to 15.1% 2 months later, although the magnitude of the fall was not statistically significant. It was concluded that a simple questionnaire used in conjunction with educational material can focus attention on potential knowledge gaps relating to death certification. However, the educational effort needs to be sustained and linked to outcome assessment of certification performance in the institution.

Death Certificates↗

PubMed1995

Regulation of advanced nursing practice: Part Two--Certification.

PURPOSE/OBJECTIVE: To present an overview of issues related to the use of advanced practice nursing (APN) certification. DATA SOURCES: Published articles, position papers, and colleague experiences. DATA SYNTHESIS: Certification is used for credentialing APNs at the state level, and in some states, it is a requirement for second licensure. Presently, a great deal of variability exists in the purposes and procedures related to certification processes, thus devaluing its use. CONCLUSION: The lack of consistency among certifying agencies and the lack of documented impact of certified advanced nursing practice can negatively affect the value placed on certification as an advanced practice credential. In the current climate of increased regulation, nursing must maintain control of practice regulation. IMPLICATIONS FOR NURSING PRACTICE: Inconsistencies between states and among nursing organizations can negatively affect the mobility and career flexibility of APNs. The evaluation of outcomes related to certified advanced nursing practice must be a research priority in the current climate. Collaboration among specialty organizations also must occur to increase the credibility of certification as a nursing credential.

Certification↗

PubMed1996

[Is the new LAE 355 certificate useful for extended sick leave benefits?].

In Storstrøm county an investigation was carried out concerning certificates in connection with sickness benefit during a period of two months, and the general practitioners and the social-workers were asked about their opinion of and attitude to sickness-certificates. A total of 420 sickness benefit certificates were collected consecutively, and all the social-workers and 85% of the general practitioners participated. About half of the certificates were not completely filled out and only one fifth supplied constructive supplementary information. Forty-five percent of the social-workers and 33% of the general practitioners regarded the certificates as useless when dealing with social medical cases. A systematic followup of patients with long-term sickness is an important task in primary health care, and should be carried out in co-operation with other health- and social-workers.

Certification↗

PubMed1997

Results of the National Dental Examining Board of Canada written examination and implications for certification.

In 1994, following a request from the ten Provincial Licensing Authorities, the National Dental Examining Board of Canada (NDEB) implemented significant changes to the certification process for dentists seeking a license to practice in Canada. Prior to 1994, graduates of accredited Canadian dental programs were certified without further examination while graduates of United States and other international programs (non-Canadian, non-U.S.) were required to complete successfully a written and three-phase clinical certification examination. Changes implemented in 1994 required graduates of accredited Canadian programs to take both a Written and Objective Structured Clinical Examination (OSCE) Examination. The analysis of the results of the Written Examination for all candidates over the 1994-1996 period supports the following conclusions. There was no meaningful difference in performance of graduates across the ten Canadian dental programs; there was a small difference between the performance of graduates of Canadian and U.S. programs; and Canadian and U.S. graduates performed significantly better than graduates of other international programs. This level of candidate performance and changes to the respective accreditation processes supported the formal agreement providing reciprocal recognition of dental accreditation in Canada and the United States. As of January 1, 1997, graduates of dental programs in Canada and the United States are required to take the same certification examination while international graduates are required to complete a different certification process. These changes to the certification process were ratified by all ten Provincial Licensing Authorities, therefore maintaining a system of national portability for dental licensure in Canada that does not require preclinical or clinical board examinations for graduates of accredited North American dental programs.

Accreditation↗

PubMed1998

Clinical application of the new civil airman vision standards and certification procedures.

INTRODUCTION: The final rule revising the civil airman medical standards became effective September 16, 1996. The purpose of this study was to review changes in the vision standards and procedures and how they relate to the clinical optometrist. METHODS: Revision of Airman Medical Standards and Certification Procedures and Duration of Medical Certificates; Final Rule, (14 CFR, Parts 61 and 67) and the Guide for Aviation Medical Examiners, published by the Federal Aviation Administration's Office of Aviation Medicine, were reviewed, and those parts pertaining to the clinical optometrist were summarized. DISCUSSION: The uncorrected distance visual acuity standards for first- and second-class airmen have been deleted. New equivalent near-vision standards were established for all classes of airmen. A major change--for pilots > or = 50 years of age--was the addition of an intermediate vision requirement of 20/40 or better at 32 inches for both first- and second-class medical certificate holders. Although the third-class medical certificate is still valid for 24 months after the date of examination for those > or = 40 years of age, the certificate is now valid for 36 months for those < 40 years of age. CONCLUSION: The new vision standards primarily affect the elderly pilot. Ophthalmic considerations in the application of the new vision standards are reviewed.

Adult↗

PubMed1998

[Quality of data acceptable for perinatal epidemiology surveillance: assessment of the health certificate at birth and the national obstetrics medical file. Study in three Seine-Maritime maternal wards].

Data from several sources could be used for perinatal epidemiology surveillance aimed at an assessment of regional programs such as those proposed by the Superior Committee for Public Health. A retrospective study of 561 births was conducted in three maternity wards in the French Seine Maritime department in order to evaluate the reliability of two data sources: the national obstetrics medical file and the health certificate at birth. The delivery room records were used as the gold standard. The sensitivity of the obstetrics file was better than that of the health certificate. With the obstetrics file, it was possible to identify almost all the vaginal route interventions, almost all the premature births and all the cesareans. With the health certificate, 39-58% of the vaginal route interventions, 61% of the premature births and 61-72% of the cesareans performed in the three wards studied were identified. The quality of data in the obstetrics file appears to be better than that in the health certificate but only concerns 40% of births in the geographical area studied. Inversely, the health certificate is theoretically delivered for all births (actually delivered for 93%). Integrating these two information systems could be an optimum solution.

Bias↗

PubMed2003

Certification of deaths at Umtata General Hospital, South Africa.

BACKGROUND: Audited information on the causes of death is one of the basic components of a country's health information system. Data are usually derived from death certificates. There are many shortcomings in the routine collection of such information. A critical analysis of Umtata General Hospital's (UGH) death certification was done establish how these shortcomings might influence reporting. Such an audit is simple, cheap and useful for monitoring the quality of mortality information. It can be used in health planning and management. OBJECTIVES: To determine the accuracy of death certification by doctors in Umtata General Hospital. METHOD: The study was carried out at UGH. Three hundred and four (304) death notification forms collected over a period of 1 year from January 1999 to December 1999 were studied. These forms were obtained from different clinical departments. RESULTS: The majority of deaths (78.9%) were certified as cardiorespiratory failure. In the remaining (21.1%) cases the causes of death were stated as due to esophageal carcinoma, lobar pneumonia, severe shock, diarrhea, and unknown. CONCLUSION: Doctors at Umtata General Hospital are not experienced in death certification. Cardiorespiratory failure is neither a cause of death nor a mechanism of death. RECOMMENDATIONS: There is need for continuing education on death certification by doctors at UGH.

Journal Article↗

PubMed2001

A chassis test procedure to mimic the heavy-duty engine transient emissions certification test.

In-use emissions from vehicles using heavy-duty diesel engines can be significantly higher than the levels obtained during engine certification. These higher levels may be caused by a combination of degradation of engine components, poor engine maintenance, degradation or failure of emissions after-treatment devices, and engine and emissions system tampering. A direct comparison of in-use vehicle emissions with engine certification levels, however, is not possible without removing an engine from the vehicle in order to perform engine dynamometer emissions testing. The goal of this research was to develop a chassis test procedure that mimics the engine performance, and as such the expected emissions levels, from the engine certification emissions test prescribed in the U.S. Code of Federal Regulations. Emissions measurements were taken from two engines during testing on an engine dynamometer using the transient heavy-duty Federal Test Procedure (FTP). Additionally, each engine was installed in an appropriate vehicle, and emissions measurements were taken using a chassis dynamometer while employing a vehicle driving schedule intended to match closely the instantaneous torque and speed schedule of the engine FTP. Engine and chassis testing was performed with the engines in stock (unmodified) condition as well as in several modes to simulate either tampered or poorly maintained conditions. The use of a chassis test as a predictive tool for determining whether an engine in a vehicle would pass the engine certification test has proven to be worthwhile. Analysis of the data shows that identification of chassis-mounted engines with NOx emissions above certification levels is possible by employing engine-specific correction factors. In the case of PM emissions, significant data scatter allowed only the identification of gross PM emitters. Engine tampering and poor maintenance can raise PM and NOx emissions, and these increases can be correctly identified by a chassis test. Analysis of chassis and engine CO and HC emissions did not reveal a strong enough correlation to warrant the use of the chassis test for emissions screening of these two pollutants.

Air Pollution↗