Nurses' decision making in heart failure management based on heart failure certification status.

BACKGROUND: Research findings on the value of nurse certification were based on subjective perceptions or biased by correlations of certification status and global clinical factors. In heart failure, the value of certification is unknown.

OBJECTIVES: Examine the value of certification based nurses' decision-making.

METHODS: Cross-sectional study of nurses who completed heart failure clinical vignettes that reflected decision-making in clinical heart failure scenarios. Statistical tests included multivariable linear, logistic and proportional odds logistic regression models.

RESULTS: Of nurses (N = 605), 29.1% were heart failure certified, 35.0% were certified in another specialty/job role and 35.9% were not certified. In multivariable modeling, nurses certified in heart failure (versus not heart failure certified) had higher clinical vignette scores (p = 0.002), reflecting higher evidence-based decision making; nurses with another specialty/role certification (versus no certification) did not (p = 0.62).

CONCLUSIONS: Heart failure certification, but not in other specialty/job roles was associated with decisions that reflected delivery of high-quality care.