A national movement to transform U.S. nursing homes is occurring with the intent to support self-determination, dignity and choice for nursing home residents facilitated by the continuation of their routines and preferences. Ten competencies for nurses were identified to facilitate this culture change in nursing homes. These competencies are intended to: model resident-directed care; foster effective team work with direct care workers to solve problems and make decisions that support residents; and promote a positive work and home environment. The strategies used to identify and disseminate the ten competencies are described as well as implications of the competencies for practice, education, and research.
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The competencies were then distributed to the Coalition of Geriatric Nursing Organizations for their review and endorsement. Following endorsement from the CGNO, a comprehensive dissemination plan for the competencies was implemented to facilitate wide-spread awareness and use by stakeholders including professional nursing home and nursing organizations, nursing home corporations, nursing facilities, organizations that provide consultation to nursing facilities, state and federal agencies concerned with nursing homes, and schools of nursing. The dissemination plan was initiated with a press release listing the organizations that had endorsed the competencies. The competencies are on the Pioneer Network website ( http://www.pioneernetwork.net/Providers/ForNurses ) and any organization or individual can create a link to this website to access and/or download the competencies. They were also distributed to all attendees at the 2010 Pioneer Network annual conference. Since the press release, the competencies have been featured in nursing home publications (e.g., The Provider, Caring for the Ages). The competencies were also introduced to nursing faculty by AACN and the HIGN in a series of education modules and webinars developed through a grant from the Commonwealth Fund and Picker Institute. The purpose of the education modules and webinars was to provide faculty with guidance in developing clinical experiences for RN students in nursing home settings ( http://hartfordign.org/education/clinical_teaching_modules/ ) with a focus on resident-directed care.
This transformation requires that nurses, in particular, promote and facilitate resident-directed care approaches and practices. Nurses need to foster effective team work with direct care workers—guiding them in solving problems and making decisions that support residents. In 2010, an initiative, funded by the Commonwealth Fund and coordinated by the Pioneer Network and the Hartford Institute for Geriatric Nursing, was launched to identify and obtain consensus for a set of nurse competencies for nursing home culture change. This paper describes how these competencies were identified and their implications for nursing education, practice, and research.
- Nursing home culture change
- Person-directed care