Objective The management of the Neonatal Intensive Care Unit of the Emma Children’s Hospital/Academic Medical Center in Amsterdam, in pursuance of Dutch legislation, decided to have a system developed to test and register all nurses concerning the procedures reserved for specialists to secure quality of specialised care. It is hospital policy to recertify all nurses every four years.

Methods A working-group was formed. This group developed a cyclical system which aims to test and register a quarter of all nurses per year. A certificate is issued with a validity of four years. Testing takes place on the ward and in the skills lab. Existing protocols have been transferred into observation scales, describing the minimal knowledge and skills that has to be shown. The working-group (‘testers’) is authorised to test and register.

An evaluation of the system takes place each year by means of a questionnaire.

Results To date 41 nurses and 9 students have been tested and registered. One year is enough to test. The system is highly valued (8.3 on a scale from 0 to 10). Mostly the testers are able to test during their shifts. The number of testers was not sufficient, so we increased the number from 8 to 10.

Some procedures had to be transferred to the skills lab.

Conclusions We can conclude that we have developed an effective system of testing and registration of the reserved procedures for our ward. It is a system that meets the needs of the present time and will cope with future needs.