- Email: [email protected]
How to prepare for certification
Certification Council
How to prepare for certification Happy New Year, OR nurses! This is going to be an outstanding year for OR nursing. After five years of waiting for a certification process for OR nurses, it is a reality. On Nov 10, 1979, the first group of candidates for certification for professional achievement in operating room nursing will participate in AORN’s first certification exam at testing sites in 60 cities in the United States. I am sure many of you are saying, “I have got to be there. I have waited so long; I must be one of the first to be certified.” Then examination jitters set in. “I have been a good OR nurse for ten years. I have consistently sought out educational opportunities to increase my knowledge of OR nursing. I am ready to be recognized for my achievements-but I have not taken an exam in ten years! I must begin preparing. There must be a way.” There are many ways. The 1977 AORN House of Delegates approved a proposal to include an educational component in the certification program. The AORN Board of Directors and Council on Certification agreed, and the Education Department assumed the responsibility for this portion of the program. The Education Departmenthas developed a two-day seminar that will be offered three times prior to the first certification exam in November.The seminar is designed to provide educational assistance to OR nurses interested in becoming certified, but attending the seminar will not obligate nurses to apply for certification or to take the exam. Emphasis will be on what the OR nurse needs to achieve certification. This will be accomplishedthrough
@
a self-assessment process whereby nurses can identify present knowledge and skills and what they needto learnto be certified. Information on all components of the certification process will be provided in the seminar, but the focus will be on the assessment mechanismof professional practice and on the broad areas of content from which the examination is being developed. Test teasers will give seminar participants the opportunity to experiencethe testing process. Immediate feedback on the test teasers and tips for taking tests will also be included. The first seminar is immediately prior to the 1979 AORN Congress, March 1 and 2, in St Louis. It was felt that offering the seminar at this time would provide an opportunity for a great number of OR nurses to participate in both the seminar and Congress without burdening them with more travel expenses. Additional information about the pre-Congress seminar can be found in the Congress brochure.Two more seminars will be held April 5 and 6 in San Francisco and May 3 and 4 in Richmond, Va. The Education Departmentis also preparing a self-study packet for those who cannot attend the seminars, which should be available in July 1979. It will contain much of the same informationpresented at the seminar. The cost and how to obtain this packet will be published in a future Journal. Now that the holidays are over and you have some free time, there are other things that you can do independently to prepare for certification. Certification applicants should be knowledgeable about six AORN publications: Standards of Nursing Practice: OR Standards of Administrative Nursing Practice: O R
dt AORN Journal, January 1979, Vol29, No 1
103
Other areas of study Some other suggestions for review for the first AORN certification exam are to: 0 read current publications on nursing and psychosocial and biological sciences 0 review the 1977-1978 “The experts research: Q & A” columns in the AORN Journal 0 complete programmed instruction units in publications such as the American Journal of Nursing 0 review your notes from workshops, regional institutes, and AORN seminars 0 review common medical problems, medical and surgical treatments, and associated nursing care for diseases and/or conditions, such as diabetes, cancer, and pain (current facts will be important) 0 request or arrange work experiences to use concepts you have learned, such as preoperative assessment 0 enroll in college continuing education courses about psychological and Standards of Technicaland Aseptic Practice: OR 0 Nursing Audit: Chaiienge to the O R Nurse Peer Review for Nursing Practice: Operating Room 0 “AORN-WICHE report” (AORN Journal, February 1978, 203-218). They are available from AORN Headquartersif you do not have copies. Study these documents and evaluate your own practice. How do you measure up to the published standards of your profession?What are your strengths and where are your weaknesses? What can you do about your weaknesses? I would also recommend that you read the article “From Standards into practice” (AORN Journal, October 1978, 603-642) and the editorial “Standards fundamental to certification, perioperative role” (AORNJournal, October 1978, 581-582). The AORN Seminar “Implementation of Standards of Nursing Practice: OR”will be offered five times prior to the first certification examination. This seminar will be helpful in assessing the present state of your practice and in reinforcing your knowl0
106
physiological assessment, pathophysiology, and other relevant subjects order a few paperback books on areas you need to cover, such as communication, nursing process, and crisis intervention 0 consult medical and nursing indexes for current literature on subjects attend hospital inservices given by nurses in other specialties, such as psychiatric, medical-surgical, etc 0 obtain lists of current books to be aware of what concepts are being advanced in the literature learn how to use indexes and library card catalogs efficiently so looking for material does not become time consuming and frustrating review anthologies and compilations of papers presented at conferences for overviews of thought, research, etc.
Gwen H Dodge, RN Assistant director of education edge of the nursingprocess as implemented in the OR. AORN has published numerous articles on the preoperative assessment of patients experiencing surgical intervention.This is an important part of the nursing process,and review of these articles is recommended.The August 1977AORN Journal contains several of these articles. The defined role of the operating room nurse is also an excellent tool to judge your practice. The May 1978 AORN Journal contains the report of the Project 25 Committee, which presented the perioperative role definition to the 1978 House of Delegates. The Project 26 Committee is preparing an educational session for the 1979 Congress entitled “Perioperative Encounters of Three Kinds.” The session is scheduled from 3 to 5 pm, Wednesday, March 7 . The application deadline for the first certification examination is July 9,1979. Nurseswho apply to take the certification exam must be currently licensed registered nurses with a minimum of two years’ professional OR nurs-
AORN Journal, January 1979, Vol29, No 1
ing practice. This is not required to attend the seminar, however. When applying, you will be expected to complete a self-assessment of professional practice and have two registered nurse colleagues assess your practice. The Certification Council has developed the assessment tool based on AORN standards. Peer Review for Nursing Practice: Operating Room will help you prepare for this part of the certification process. So, get started. You have ten months. If you spend only 15 to 30 minutes each day prepar-
ing for certification,you will be ready and comfortable when you enter the testing center. Was your New Year’s resolutionto become Mary Smith, RN, CNOR? If so, you are a pacesetter, and 1979 will be a great year for you. The AORN Journal will publishseveral more articles explaining the certification process. Watch for them.
Nancy Ertl, RN Certification Council
Small hospitals provide safe obstetric care Small rural hospitals provide safe obstetric care and at a lower cost than large metropolitan hospitals, according to a research report by an Iowa physician. Herman A Hein, MD,University of Iowa Hospitals and Clinics, Iowa City, made a detailed study of the results of obstetric care in all Iowa hospitals, both rural and urban. The report is included in the Journal of the American Medical Association (Nov 3,1978). His research is in response to a statement by federal health planners concerning hospitals delivering fewer than 500 infants per year. Dr Hein said proposed national guidelines for health planning had stated that in such hospitals, “the quality of care and efficiency are decreased significantly.” In Iowa, small rural hospitals have a lower neonatal death rate than large city hospitals, he said. In the category of smallest Iowa hospitals, those with 1 to 99 obstetric deliveries, the neonatal death rate in 1976 was 5.85%. The death rate in the largest category (1,000 or more deliveries) that year was 12.26%; the combined rate for all Iowa hospitals was 9%. The statistics reflect the results of a regional perinatal program formed by Iowa hospitals and physicians, Dr Hein said. The program emphasizes screening and early referral of high risk patients to urban hospitals where perinatal care centers have been established. The larger hospitals report a higher neonatal death rate
because they are handling more difficult deliveries. Maternity care for some 42,000 patients per year is provided by Iowa’s 135 hospitals, 82% of which deliver fewer than 500 babies annually. Dr Hein reported 42.5% of all births in Iowa occurred in small hospitals. The majority of these deliveries are attended by family practitioners rather than specialists in obstetrics. The average base charge for obstetrics services were lower in small town hospitals than in city hospitals. Dr Hein found delivery room charges increased with the size of hospital, from $57.19 for hospitals with less than 100 deliveries, to $158.57 for those with more than 1,000 deliveries. Average charges for hospital room and nursery similarly ranged from $93.74 to $144. From the information he collected, Dr Hein concluded, “the future of small community hospitals should be determined on the basis of available data rather than on speculation.” He continued, “medical services should be provided as close to the patient’s home as possible if the quality of care is not compromised and the services can be offered at reasonable cost. If federal health planners would support the development of regional systems of perinatal care and education, the cost of obstetric services is likely to be better contained than by requiring large-scale consolidation.”
AORN Journal, January 1979, Vol29, No 1
107
How to prepare for certification Happy New Year, OR nurses! This is going to be an outstanding year for OR nursing. After five years of waiting for a certification process for OR nurses, it is a reality. On Nov 10, 1979, the first group of candidates for certification for professional achievement in operating room nursing will participate in AORN’s first certification exam at testing sites in 60 cities in the United States. I am sure many of you are saying, “I have got to be there. I have waited so long; I must be one of the first to be certified.” Then examination jitters set in. “I have been a good OR nurse for ten years. I have consistently sought out educational opportunities to increase my knowledge of OR nursing. I am ready to be recognized for my achievements-but I have not taken an exam in ten years! I must begin preparing. There must be a way.” There are many ways. The 1977 AORN House of Delegates approved a proposal to include an educational component in the certification program. The AORN Board of Directors and Council on Certification agreed, and the Education Department assumed the responsibility for this portion of the program. The Education Departmenthas developed a two-day seminar that will be offered three times prior to the first certification exam in November.The seminar is designed to provide educational assistance to OR nurses interested in becoming certified, but attending the seminar will not obligate nurses to apply for certification or to take the exam. Emphasis will be on what the OR nurse needs to achieve certification. This will be accomplishedthrough
@
a self-assessment process whereby nurses can identify present knowledge and skills and what they needto learnto be certified. Information on all components of the certification process will be provided in the seminar, but the focus will be on the assessment mechanismof professional practice and on the broad areas of content from which the examination is being developed. Test teasers will give seminar participants the opportunity to experiencethe testing process. Immediate feedback on the test teasers and tips for taking tests will also be included. The first seminar is immediately prior to the 1979 AORN Congress, March 1 and 2, in St Louis. It was felt that offering the seminar at this time would provide an opportunity for a great number of OR nurses to participate in both the seminar and Congress without burdening them with more travel expenses. Additional information about the pre-Congress seminar can be found in the Congress brochure.Two more seminars will be held April 5 and 6 in San Francisco and May 3 and 4 in Richmond, Va. The Education Departmentis also preparing a self-study packet for those who cannot attend the seminars, which should be available in July 1979. It will contain much of the same informationpresented at the seminar. The cost and how to obtain this packet will be published in a future Journal. Now that the holidays are over and you have some free time, there are other things that you can do independently to prepare for certification. Certification applicants should be knowledgeable about six AORN publications: Standards of Nursing Practice: OR Standards of Administrative Nursing Practice: O R
dt AORN Journal, January 1979, Vol29, No 1
103
Other areas of study Some other suggestions for review for the first AORN certification exam are to: 0 read current publications on nursing and psychosocial and biological sciences 0 review the 1977-1978 “The experts research: Q & A” columns in the AORN Journal 0 complete programmed instruction units in publications such as the American Journal of Nursing 0 review your notes from workshops, regional institutes, and AORN seminars 0 review common medical problems, medical and surgical treatments, and associated nursing care for diseases and/or conditions, such as diabetes, cancer, and pain (current facts will be important) 0 request or arrange work experiences to use concepts you have learned, such as preoperative assessment 0 enroll in college continuing education courses about psychological and Standards of Technicaland Aseptic Practice: OR 0 Nursing Audit: Chaiienge to the O R Nurse Peer Review for Nursing Practice: Operating Room 0 “AORN-WICHE report” (AORN Journal, February 1978, 203-218). They are available from AORN Headquartersif you do not have copies. Study these documents and evaluate your own practice. How do you measure up to the published standards of your profession?What are your strengths and where are your weaknesses? What can you do about your weaknesses? I would also recommend that you read the article “From Standards into practice” (AORN Journal, October 1978, 603-642) and the editorial “Standards fundamental to certification, perioperative role” (AORNJournal, October 1978, 581-582). The AORN Seminar “Implementation of Standards of Nursing Practice: OR”will be offered five times prior to the first certification examination. This seminar will be helpful in assessing the present state of your practice and in reinforcing your knowl0
106
physiological assessment, pathophysiology, and other relevant subjects order a few paperback books on areas you need to cover, such as communication, nursing process, and crisis intervention 0 consult medical and nursing indexes for current literature on subjects attend hospital inservices given by nurses in other specialties, such as psychiatric, medical-surgical, etc 0 obtain lists of current books to be aware of what concepts are being advanced in the literature learn how to use indexes and library card catalogs efficiently so looking for material does not become time consuming and frustrating review anthologies and compilations of papers presented at conferences for overviews of thought, research, etc.
Gwen H Dodge, RN Assistant director of education edge of the nursingprocess as implemented in the OR. AORN has published numerous articles on the preoperative assessment of patients experiencing surgical intervention.This is an important part of the nursing process,and review of these articles is recommended.The August 1977AORN Journal contains several of these articles. The defined role of the operating room nurse is also an excellent tool to judge your practice. The May 1978 AORN Journal contains the report of the Project 25 Committee, which presented the perioperative role definition to the 1978 House of Delegates. The Project 26 Committee is preparing an educational session for the 1979 Congress entitled “Perioperative Encounters of Three Kinds.” The session is scheduled from 3 to 5 pm, Wednesday, March 7 . The application deadline for the first certification examination is July 9,1979. Nurseswho apply to take the certification exam must be currently licensed registered nurses with a minimum of two years’ professional OR nurs-
AORN Journal, January 1979, Vol29, No 1
ing practice. This is not required to attend the seminar, however. When applying, you will be expected to complete a self-assessment of professional practice and have two registered nurse colleagues assess your practice. The Certification Council has developed the assessment tool based on AORN standards. Peer Review for Nursing Practice: Operating Room will help you prepare for this part of the certification process. So, get started. You have ten months. If you spend only 15 to 30 minutes each day prepar-
ing for certification,you will be ready and comfortable when you enter the testing center. Was your New Year’s resolutionto become Mary Smith, RN, CNOR? If so, you are a pacesetter, and 1979 will be a great year for you. The AORN Journal will publishseveral more articles explaining the certification process. Watch for them.
Nancy Ertl, RN Certification Council
Small hospitals provide safe obstetric care Small rural hospitals provide safe obstetric care and at a lower cost than large metropolitan hospitals, according to a research report by an Iowa physician. Herman A Hein, MD,University of Iowa Hospitals and Clinics, Iowa City, made a detailed study of the results of obstetric care in all Iowa hospitals, both rural and urban. The report is included in the Journal of the American Medical Association (Nov 3,1978). His research is in response to a statement by federal health planners concerning hospitals delivering fewer than 500 infants per year. Dr Hein said proposed national guidelines for health planning had stated that in such hospitals, “the quality of care and efficiency are decreased significantly.” In Iowa, small rural hospitals have a lower neonatal death rate than large city hospitals, he said. In the category of smallest Iowa hospitals, those with 1 to 99 obstetric deliveries, the neonatal death rate in 1976 was 5.85%. The death rate in the largest category (1,000 or more deliveries) that year was 12.26%; the combined rate for all Iowa hospitals was 9%. The statistics reflect the results of a regional perinatal program formed by Iowa hospitals and physicians, Dr Hein said. The program emphasizes screening and early referral of high risk patients to urban hospitals where perinatal care centers have been established. The larger hospitals report a higher neonatal death rate
because they are handling more difficult deliveries. Maternity care for some 42,000 patients per year is provided by Iowa’s 135 hospitals, 82% of which deliver fewer than 500 babies annually. Dr Hein reported 42.5% of all births in Iowa occurred in small hospitals. The majority of these deliveries are attended by family practitioners rather than specialists in obstetrics. The average base charge for obstetrics services were lower in small town hospitals than in city hospitals. Dr Hein found delivery room charges increased with the size of hospital, from $57.19 for hospitals with less than 100 deliveries, to $158.57 for those with more than 1,000 deliveries. Average charges for hospital room and nursery similarly ranged from $93.74 to $144. From the information he collected, Dr Hein concluded, “the future of small community hospitals should be determined on the basis of available data rather than on speculation.” He continued, “medical services should be provided as close to the patient’s home as possible if the quality of care is not compromised and the services can be offered at reasonable cost. If federal health planners would support the development of regional systems of perinatal care and education, the cost of obstetric services is likely to be better contained than by requiring large-scale consolidation.”
AORN Journal, January 1979, Vol29, No 1
107