Smith, Justin

Background: Effective communication and collaboration among clinical and nonclinical staff are critical to the health and safety of the staff, for optimal team performance and for safe patient care. While respiratory protective equipment are routine key strategies to protect healthcare workers from exposure to select respiratory pathogens, they have been demonstrated to disrupt speech intelligibility. The COVID-19 pandemic escalated the need for and utilization of respiratory protection in all healthcare settings. The purpose of this study was to evaluate the impact of various respiratory personal protection equipment (PPE) on speech intelligibility. Methods: Healthcare workers were invited to participate in audiology-based testing in which the audiologist read words from the Modified Rhyme Test (MRT) using two levels of background noise and rotating through six different types of respiratory PPE. Descriptive statistics and ANOVA were used for analysis. Findings: Modified Rhyme Test (MRT) scores were significantly lower when wearing the CleanSpace Halo (−10.22 points, 95% CI [−11.28, −9.20]) and the elastomeric half mask respirator (EHMR) with or without the exhalation valve filter (−2.28 points, 95% CI [−3.33, −1.20] and −3.22 points, 95% CI [−4.40, −2.18] respectively) after adjusting for noise level, listener respiratory PPE, and correlation within each participant. Conclusions/Applications to practice: Elastomeric half mask respirator (EHMR) decreased speech intelligibility compromising clear communications. Further research on respiratory PPE design is needed to optimize speech intelligibility and communication maximally.

OBJECTIVE: Certifications in psychiatric-mental health nursing promote safe practice by psychiatric-mental health nurse practitioners (PMHNPs) and nurses (PMHNs) and help protect the public from harm. This protection begins with the development of an examination that meets rigorous national education, practice, and accreditation standards and reflects PMHNPs’ or PMHNs’ clinical practice. Achievement and maintenance of a certification is a journey that involves a commitment to lifelong learning and the improvement of the field of psychiatric-mental health nursing through involvement in the examination process. METHODS: This discussion paper outlines the role nurses can play in the development of certification examinations. It describes the process of developing an effective certification examination, including the role of standards, accrediting bodies, and content experts; determining necessary tasks, knowledge, and skills; surveying practitioners to validate information; writing test questions; and ongoing analysis of examination content. The Psychiatric-Mental Health Nurse Practitioner (across the lifespan) Certification (PMHNP-BC) is presented as an example of the process. RESULTS: This discussion paper raises awareness of how certification exams are developed, PMHNPs participate in certification development, and volunteering promotes career development. CONCLUSION: The PMHNP-BC examination is based on education, practice, and certification accreditation standards and reflects current clinical practice. PMHNPs can (a) point to the rigor of certification as an indication of the quality of care they deliver, (b) volunteer to participate in the examination process to ensure examination rigor, and (c) advance their careers through the development and application of a valuable skill set.