Implications for practice and research

• ■ The study adds to the small evidence base that having more nurses with baccalaureate education and certification is associated with improved patient outcomes (30-day mortality and failure to rescue (death after complications)).

• ■ More studies are needed to determine the best types of certification and actual practice changes associated with certification.

Context

Certification of staff nurses by accrediting bodies and specialty organisations' attempts to recognise those who have developed expertise in particular areas. While the term certification is also used for advanced nurse practitioners and clinical nurse specialists; this study and commentary only address certification of non-advanced practice nurses. In the USA, certification is offered in 11 areas (not advanced practice) by the American Nurses Credentialing Center (http://www.nursecredentialing.org/Certification.aspx). Further, certification in specialty …