Improving Gerontological Nursing Competencies In Skilled And Long Term Care Nurses In Rural Maine

1. Improving Gerontological Nursing Competencies In Skilled And Long Term Care Nurses In Rural Maine Valerie C. Sauda, RN-BC, MS Geriatric Nurse Service Instructor Rosscare Prepared for the Maine Nursing Summit March 21, 2012

2. Project goals • To develop and implement a staff training module program with special focus on gerontological nursing skill building and leadership development • To increase gerontological nursing knowledge and competency of staff and new graduate nurses who choose skilled/long term care as the first site of nursing practice.

3. Project funding and collaboration • Eastern Maine Healthcare Systems, Rosscare, Eastern Maine Community College, and First Atlantic Healthcare are collaborative partners • Start up funding through Betterment Fund, NY, NY

4. Project partnership-First Atlantic HealthCare Ross Manor Colonial HealthCare Dexter HealthCare Stillwater HealthCare Katahdin HealthCare

5. The Role of the Geriatric Nurse Service Instructor • Teach-Gerontological nursing best practices and concepts • Lead-Show by example • Mentor-New staff and new graduate nurses

6. Role of Teacher • Provide onsite module trainings • Provide one on one educational support to new staff or new graduate nurses • Provide direct clinical site experiences for nursing students

7. Role of Leader • Practice communication and delegation skills with nursing team members using best practices in nursing leadership • Help DONs and Administrators with challenging nursing issues through best practice resources and education

8. Role of Mentor • Provide transition to practice support for new graduate nurses who choose long term care/skilled units as first site of nursing practice • Offer non-supervisory based support to new graduate during transition

9. The GNS Instructor programs • Primary staff education provided to licensed nurses (RN and LPN staff) with some secondary education to CNA team members and other team members

10. Module trainings • Two tracks for modules: • Clinical • Leadership • One hour module trainings • Focus on most important best practices

11. Module content A variety of resources used including: • www.consultgerirn.org Developed by the Hartford Institute for Geriatric Nursing at New York University’s College of Nursing -Virginia Henderson Nursing Library-Sigma Theta Tau International -Best practice programs including “Advancing Excellence in Long Term Care” “Pioneer Network” and National Councils on State Boards of Nursing

12. Sample Module content

13. Lessons Learned • Ensure right person knows training schedule • Reinforce importance of continuity of participation with staff • Define clearly who is target audience • Use clinical examples

14. Lessons Learned • Geriatric Nurse Service Instructor is a NURSING champion and cheerleader! • A political lens and quality focus matter

15. Mentoring New Nurses • Provided email and telephone connections to new nurses and in person consultation and support on site at partnership home • Transitions to Practice model as focus with NCSBN vision

16. Examples of new nurse mentoring areas • Clinical skill supervision-PICC line management and wound care • Leadership skills-delegation conversations, how to advocate for needs with DON, time management and organization, tips for working evening and night shift

17. Lessons Learned to date • Prevalence of belief that acute care is preferred setting for new nurse • Retention continues to be a challenge in LTC/SNF setting for new nurses to setting • Some challenges between facility management policies and mentorship roles

18. Lessons learned to date • Change is frequent in setting (particularly in staffing patterns) which present interesting challenges for a new nurse • Structure of formal orientation much different than acute care orientation programs for new graduates

19. Lessons Learned to date • Gaps in staff understanding what new nurses have for clinical and leadership skills and how best to maximize knowledge and skill sets • Supporting the nurse to understand his/her professional role • Working with new nurses in enhancing safe delegation to the nursing assistants

20. Resources: • AACN Baccalaureate essentials • http://www.aacn.nche.edu/education/pdf/BaccEssentials08.pdf • AACN Gerocompetencies • http://www.aacn.nche.edu/Education/pdf/AACN_Gerocompetencies.pdf • Advancing Excellence in Long Term Care • http://www.nhqualitycampaign.org/star_index.aspx?controls=welcome • Hartford Institute for Geriatric Nursing • http://www.ConsultGeriRN.org • Long-term Care, Supports, and Services Competency Model-National • http://www.careeronestop.org/competencymodel/pyramid.aspx?LTC=Y • Vermont Nurses in Partnership www.vnip.org

21. For further information: Valerie C. Sauda, RN-BC, MS Geriatric Nurse Services Instructor Rosscare Email: vsauda@emh.org Telephone: 207-944-1100