Organizational culture and roles in promoting nurse specialty certifications: A qualitative study in the United States.

Objectives: Nursing specialty certification validates nurses' mastery of specialty knowledge in disease management, education, or leadership above entry-level education and licensing. Research suggests direct relationships between nursing certifications and patient care quality. However, nurses' specialty certification rates are still low. This study aims to better understand nurses' perceptions of the facilitators and barriers in promoting nurses' desires and ability to obtain specialty certifications, which exclude advanced nursing practice roles, such as nurse practitioner or nurse midwife. Methods: This qualitative descriptive study took place virtually across the United States from May 2022 to September 2022. The study sample was a nested sample of a large national survey study. Among the nurses agreeing to be interviewed, a purposive sampling method was used to achieve maximum variation in diversity, such as years as a nurse, race, ethnicity, and certification status. Information saturation was used to gauge the sample size. Data were collected via in-depth virtual face-to-face interviews. The coding process was based on Colaizzi's method of data analysis. Results: Twenty nurses participated in the study. Five major themes emerged related to organizational culture and strategies to foster nurse specialty certifications. The five organizational strategies included 1) sharing resources, 2) a culture of ownership and a sense of belonging, 3) mentorship and role modeling, 4) recognizing nurses' efforts and accomplishments, and 5) cultivating a sense of meaning, purpose, and support. Conclusions: The findings indicate that organizational culture and leadership significantly promote continuing learning environments. Organizations need to develop an organizational culture that promotes nurses' specialty certifications. This study identified significant areas that are important to support nurses seeking certifications. Additional research is needed to evaluate which interventions significantly impact initial and continued certification levels, especially in the post-COVID-19 era.