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Resource to Help Nursing Homes Prepare to be Clinical Sites for Nursing Students

Resource to Help Nursing Homes Prepare to be Clinical Sites for Nursing Students. Mathy Mezey, EdD, RN, FAAN, Sarah Greene Burger, RN-C, MPH, FAAN Ethel Mitty, EdD, RN Hartford Institute for Geriatric Nursing, New York University College of Nursing.

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Resource to Help Nursing Homes Prepare to be Clinical Sites for Nursing Students

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  1. Resource to Help Nursing Homes Prepare to be Clinical Sites for Nursing Students Mathy Mezey, EdD, RN, FAAN, Sarah Greene Burger, RN-C, MPH, FAANEthel Mitty, EdD, RNHartford Institute for Geriatric Nursing, New York University College of Nursing Module 6 of Nursing Homes as Clinical Placement Sites for Nursing Students Series

  2. Acknowledgments This is a joint project of With support from Grant to the University of Minnesota School of Nursing

  3. This project is endorsed by: Project Steering Committee View List of Members

  4. About Module 6: Resource to Help Nursing Homes Prepare to be Clinical Sites for Nursing Students Negotiate with nursing programs to be a clinical site, specifically to describe: Benefits for a nursing home serving as a clinical placement site Student learning goals for clinical placements in nursing homes Factors nursing faculty see as important in choosing a nursing home Why schools may preferentially select nursing homes involved in culture change Aspects of the nursing home that are important to the nursing school Prepare your nursing home to be a clinical practice site Use a checklist to conduct a self-assessment to determine your readiness to be a clinical site Objectives/Purpose: At the end of this module you will be able to:

  5. Who Should Use This Module • Directors of Nursing of nursing homes • Nursing home administrators and CEOs • Nursing faculty seeking to establish clinical rotations in a nursing home

  6. Staff Recruitment and Retention Mentoring Recruitment tool Potential for faculty appointment Staff Development Access to academic resources, e.g. library, CE courses Access to courses Potential for presentations and publications Adoption of Best Practices Collaborative faculty/staff review of practice protocols Faculty /staff rounds and chart reviews Participation in research Visibility in the Community Recognized as teaching site Benefits to a Nursing Home When Serving as a Clinical Placement Site

  7. Entry Level Nursing Student Learning Goals that Can be Met by Clinical Placements in a Nursing Home • Professional attitudes, values, and expectations about physical and mental aging in providing resident-centered care • Resident-directed care and culture change • Resident assessment using valid and reliable tools • Strategies to prevent, identify and manage geriatric syndromes • Planning resident-centered care with consideration for mental and physical health and well being of informal and formal caregivers • An appreciation of the interdisciplinary team • Leadership and management

  8. Graduate Level Nursing Student Learning Goals that Can be Met by Clinical Placements in a Nursing Home • Assess the health status of physically and mentally frail older adults • Assess the impact of family and the environment on a frail older adult’s health status • Screen for, treat and manage acute and chronic mental health problems and disorders • Identify typical and atypical presentations of health problems • Determine decision-making capacity of residents • Adapt teaching-learning approaches for frail older adults • Provide educational experiences for caregivers and health professionals • Participate in an interdisciplinary team • Translation of research into practice

  9. Factors Faculty See as Important in Selecting a Nursing Home as a Clinical Placement • Excellence in quality of care • CMS 5 or 4 Star rating • High quality measures & minimal deficiencies • Outside accreditation (Joint Commission; CARF) • Stable nurse staffing and leadership • Involvement of advanced practice nurses (APRNs) • Resident-directed care/culture change • Effective interdisciplinary team • Commitment to the use of evidence-based practices • Willingness to facilitate innovative learning experiences • Administer medications to a group of residents • Serve as a team leader for a group of residents • Develop and implement a quality improvement project

  10. Why a Nursing Program May Preferentially Select a Nursing Home Involved in Culture Change as a Clinical Site • Observe staff using effective communication skills with residents • Observe adapted daily routines and “person-directed” care practices to accommodate resident preferences • Appreciate the importance of consistency of caregivers on resident outcomes • Participate in a team approach that includes residents and families in shared problem-solving, decision-making and planning

  11. Nursing Program Characteristics of Importance to a Nursing Home • Extent and quality of the course offerings in geriatric nursing • Clinical preparation of the faculty in geriatrics and in nursing home care • Types of research in geriatric nursing • Continuing education offerings in geriatrics Opportunities for clinical faculty appointments for NH staff • Length of time of the clinical placement in the nursing home • Personnel to help the NH develop contracts and collaborative arrangements

  12. The Nursing Program Web Site:Nursing Program’s Website as Source of Information about the Geriatric Program Key items to look for when reviewing a nursing program’s website are: • Program mission and goals • Undergraduate and graduate course offerings n geriatrics • Faculty credentials • Continuing education offerings in geriatrics • University-wide geriatric programs (Geriatric Education Center (GEC); a Center on Aging) • Program’s contracts office

  13. Assessing a Nursing Program’s Readiness to Partner and Collaborate with a Nursing Home Faculty are willing to: • Provide constructive feedback about nursing practice in the NH • Hear nursing home feedback about student activities in the NH • Learn about &/or teach principles and processes of a professional nurse practice model and resident- directed care to NH staff Nursing Program is willing to: • Discuss expectations and measurable goals associated with use of the nursing home as a clinical site. • Provide NH staff access to library and other resources (e.g. electronic; seminars) • Share teaching materials related to student clinical experience

  14. Congruency of Nursing Programs Goals and a Nursing Home’s Capacity to Serve as a Clinical Site Congruency can include consideration of the following: • The fit of the philosophy of nursing of the nursing program and the NH • Will the nursing students be in the NH for a sufficient length of time to establish a relationship with residents and staff and to learn about nursing in LTC? • Extent to which the NH can meet the nursing program goals for a clinical placement • Whether the NH has structures and policies that facilitate the student learning experience without excessive burden on the NH staff • Markers of the extent to which the use of the NH as a clinical site can be a mutually rewarding/enlightening experience for students and staff

  15. Discuss with staff the purpose of the affiliation, e.g. why the nursing home was selected and expectations of it as a clinical site Mentoring/teaching role of RN, LPN, CNA, Nurse Manager, MDS, Coordinator, in-service educator Student presence at/participation in care planning meetings; willingness to have students “shadow” staff Knowledge and experience with interdisciplinary teams APRN and physician involvement Work with residents and families to make sure they understand the student role and how they can support the student’s experience Resident & Family Council Individual residents Arrange for faculty & student amenities: Meeting space for student Class rooms Secure placement of outer garments, purse, etc Student and faculty Immunizations and other safety requirements Parking spaces, if needed Arrange for technology needs Computer terminal w/Internet access Electronic medical records (if available) MDS access Review policies necessary for collaboration/partnering with the nursing program Becoming a Clinical Placement Site: Preparing the Nursing Home Staff and Residents

  16. Becoming a Clinical Site: Preparing Faculty about Nursing Home Policies and Procedures • Resident and family introduction to students and faculty • Student administration of medications and treatments • Student and faculty communication • Assessment findings • Resident change of condition • Resident special requests and/or resident complaints • Medication and/or treatment error • Absence from, or late to, the clinical day

  17. Becoming a Clinical Site: Orientation of Students and Faculty • Resident Rights; Ombudsman role • Resident-directed Care • NH Table of Organization/Role & Responsibilities • The interdisciplinary team • Survey and inspection process • Fire and Safety • APRN involvement in care • Record keeping/documentation (including the electronic health record and MDS)

  18. Geriatrics in Nursing Education:Sources of Information American Academy of Colleges of Nursing (AACN) Essentials of Baccalaureate Education (2009)Older Adults: Recommended Baccalaureate Competencies and Curricular Guidelines for Geriatric Nursing Care. AACN and Hartford Institute for Geriatric Nursing. (2010) http://www.aacn.nche.edu American Nurses Association (ANA) Scope and Standards of Practice of Gerontological Nursing (Generic and Advanced Practice) http://www.NursingWorld.org The Hartford Institute for Geriatric Nursing (modules for nursing faculty to strengthen clinical rotations in nursing homes) http://www.HartfordIGN.org National Gerontological Nurses Association https://www.ngna.orgAmerican Nurses Credentialing Center (ANCC) Gerontological Nursing Certification http://www.nursecredentialing.org/Certification.aspx

  19. Self-Assessment of Readiness to be a Clinical Site A Nursing Home’s Readiness to Serve as a Clinical Placement Site for Nursing Students: Checklist for a Nursing Home

  20. Recap: Key Points for Nursing Homes Preparing to be Clinical Sites for Nursing Students • A nursing home can serve as valuable clinical placement for nursing students, but the process requires planning and reflection • Self- examination can help a nursing home assess their readiness to serve as a clinical site • A nursing home should expect to both give and gain from serving as a clinical site • Preparing the residents, staff and family can markedly enhance a nursing homes experience as a clinical site

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