RN Leaders Developing UAPs through Continuing Education MNA Annual Conference October 14, 2016

Transcription

1 RN Leaders Developing UAPs through Continuing Education MNA Annual Conference October 14, 2016 Presented by: Margo Preston-Scott, MSN, RN (SOARING Program Manager) Stefanie Mann, BSN, RN (SOARING Nurse Educator) 1

2 Learning Outcomes Upon completion of this presentation, the learner will be: 1.Informed about innovative and effective teaching strategies that can be used for continuing education and training for UAPs. 2.Provided with an ongoing education model that assists UAPs in reaching their highest potential. 2

3 UAP Defined Unlicensed Assistive Personnel includes: Certified Nursing Assistants (CNAs) Nursing Attendants Nursing Aides Nursing Support Technicians Patient Care Technicians Allied healthcare professionals assigned by a RNs to perform technical and non-technical services in treatment of patients and their families Spence, 2001, p

4 UAP Utilization: Historical Perspectives UAP used periodically during: Nursing shortages Need for cost containment 1950s UAP utilization started 1960s UAP utilization was cyclic 1970s - early1980s decrease use of UAPs 4

5 UAP Utilization: Historical Perspectives Late 1980s UAP recruitment was driven by nursing shortage 1990s UAP recruitment was driven by costcontainment efforts Over time, need for UAP increased and became popular in many acute-care settings 5

6 Hiring UAPs In 1990s, issues on UAP hiring surfaced due to the following assumptions: UAPs receive basic training and education to practice UAPs require only minimal orientation to perform duties Use of UAPs were a substitute for RNs Issues on UAP hiring addressed through: Licensing regulations Education and training requirements 6

7 UAP Role in Patient Care UAP has expanded role over time Perform basic care tasks vital signs, giving baths, changing linens, etc. Perform advanced clinical skills Monitoring blood glucose, phlebotomy, urinary catheter insertion, etc. UAPs provide 57% direct patient care compared to 35% provided by nurses 7

8 Continuing Education (CE) for UAP: What s in the Literature? 1990s early 2000s literature on UAP CE was limited Hospital-based training and education created to prepare UAP for acute and critical care areas and school clinics Education comprised of rigorous technical skills training Issues surfaced with training for new settings: Delegation Role clarity Team work 8

9 Continuing Education (CE) for UAP: What s in the Literature? Current literature on UAP CE still scarce Hospital and unit-based training mostly focused on: Clinical content mastery Skills training Hands-on practice on new equipment Outcomes includes shortened unit orientation, improved skills level, increased self confidence, and reduced attrition 9

10 Continuing Education (CE) for UAP: What s in the Literature? Code of Federal Regulations for Public Health requirement for CNAs: Minimum of 75 hours of initial training including: 16 hours of didactic session 16 hours of directly supervised practical training CNAs must complete 12 hours of CE annually Code of Federal Regulations,

11 Continuing Education (CE) for UAP: What s in the Literature? Standardized continuing education for UAPs is lacking Consequently, this led to variations in standards of training, education and practice 11

12 Institutional Practices Across MD THINK TANK then SHARE 12

13 Designing, Implementing and Evaluating CE for UAPs Creation of Clinical Practice Enrichment Program (CPEP) Hospital-wide needs assessment conducted to determine topics and competencies needed Adopted a competency model 13

14 Designing, Implementing and Evaluating CE for UAPs CPEP three phase implementation: Didactic classes Skills review Skills competency assessment Outcomes of CPEP: Provided opportunity for CTs to practice at full extent of their certification Enabled RNs to work at their highest scope of practice 14

15 Designing, Implementing and Evaluating CE for UAPs Determining annual CE topics and CT learning needs CTs polled yearly NM and RN-CT champions surveyed yearly New hospital-wide initiatives (policies & standards, equipment, patient-care initiatives) Curriculum and instructional content developed and created by nurse educators expert on topic/competency 15

16 Designing, Implementing and Evaluating CE for UAPs Schedule of classes disseminated to all units Classes: 4 hours each topic NM/unit leaders schedule CTs for classes Requirement: complete 16 hours of CE classes/year 16

17 Designing, Implementing and Evaluating CE for UAPs Evaluation: Short quiz at end of every class Passing score of 80% or higher CTs surveyed at end of each class Compliance report sent out to all units Compliance rate: 95-97% 17

18 Designing, Implementing and Evaluating CE for UAPs Feedback from CTs: Thank you for giving us the opportunity to be here and learn a lot on handling patients. Oct. 8, 2015 This class is very informative and helpful for me to improve in my everyday job performance. Oct. 10, 2015 I think we should be educated more often. Aug. 27, 2015 I really enjoyed the class discussion and look forward to see you guys again. Sept 17, 2015 More interactions with CTs and RNs will become beneficial to all employees. Oct. 22, 2015 I am always excited when it comes to the SOARING classes. It is very interesting to me. July 6,

19 Benefits of Continuing Education: Based on literature Continuing education benefits for UAPs: Increases knowledge Advances skills Improve patient outcomes Increases patient satisfaction scores Increases job satisfaction scores Reduces attrition 19

20 QUESTIONS and FEEDBACK 20

21 References Ashwill, J.W. (1998). The patient care assistant program: The nursing profession s and a community college s response to educating unlicensed assistive personnel. Journal of Continuing Education in Nursing, 29 (3), Retrieved from Castle, N. (2007). Assessing job satisfaction of nurse aides in nursing homes. Journal of Gerontological Nursing, 33(5), Gursky, B., & Ryser, B. (2007). A training program for unlicensed assistive personnel. Journal of School Nursing, 23(2), doi: / Kalisch, B. (2011). The impact of RN-UAP relationships on quality and safety. Nursing Management, 42 (9), doi: /01.NUMA a2 Lerner, N., Resnick, B., Galik, E., & Flynn, L. (2011). Job satisfaction of nursing assistants. The Journal of Nursing Administration, 41(11), doi: /NNA.0b013e e7a Lerner, N., Resnick, B., Galik, E., & Russ, K. (2010). Advanced nursing assistant education program. Journal of Continuing Education in Nursing, 41(8), doi: / Prestia, A & Dyess, S. (2012). Maximizing caring relationships between nursing assistants and patients. The Journal of Nursing Administration, 42(3), doi: /NNA.0b013e efd 21

22 References Province, J. (2008). Bridging the gap from long-term care nursing assistants to acute care nursing assistants. Journal for Nurses in Staff Development, 24(6), doi: /01.NND Small, A., Okungu, L., & Joseph, T. (2012). Continuing education for patient care technicians: A unit-based, RN-led initiative. American Journal of Nursing, 112(8), doi: /01.naj c4 Spencer, S. (2001). Education, training, and use of unlicensed assistive personnel in critical care. Critical Care Nursing Clinics of North America, 13(1), Retrieved from CINAHL Plus with Full Text: Trinkoff, A., Johantgen, M., Lerner, N., Storr, C. Han, K., & McElroy, K. (2013). State regulatory oversight of certified nursing assistants and resident outcomes. Journal of Nursing Regulation, 3(4), doi: /S (15) Ward, S., Stewart, D., Ford, D., Mullen, A.M., & Makie, M.F. (2014). Educating certified nursing assistants, educational offerings on the run and more. Journal for Nurses in Professional Development, 30(6), doi: /NND