Critical Care Plus: Grants Focus on Improving Nursing Skills

ANA, Mather Institute Promote Specialization in Separate Programs

The ramifications of an aging nursing faculty plus a nursing turnover rate of almost 26% are particularly serious for geriatric care, says Linda Hollinger-Smith, PhD, director of research at the Mather Institute on Aging in Evanston, IL. But the Learn, Empower, Achieve and Produce (LEAP) staff development program Hollinger-Smith started has reduced her facility’s turnover rate from 76% to 34% for CNAs and from 47% to 22% for RNs.

LEAP, begun as an initiative to help RNs in long-term care, is funded by a grant from the federal Health Resources and Service Administration (HRSA). Mather LifeWays is using the funds in collaboration with nursing schools at three major universities to offer a Web-based distance-learning program that gives nursing faculty in 26 states the latest geriatric nursing information.

The program consists of six online courses of eight weeks each that students may take at their own pace and can complete in about a year. Rush University in Chicago, Yale University, and the University of Wisconsin/Milwaukee are partnering with Mather on the program, which allows nursing faculty to enter at any time during the three-year grant period.

Hollinger-Smith says she started LEAP in 1999 to help RNs, CNAs and practical nurses develop and remain in their health care careers. The program focuses on the so-called "soft skills" such as learning how to communicate, developing positive relationships with supervisors and co-workers, and learning how to recognize and reward good behavior.

"We call those essential skills," Hollinger-Smith says. "They have to be in place before you can start looking at quality indicators and other things the government wants us to focus on." Nursing students, she observes, choose working in critical care because the money’s much better than in long-term care.

Hollinger-Smith says her program succeeds by building a "career ladder" that offers CNAs financial incentives for increasing their skills in specialized areas such as skin care or dementia care, for example. "We’re also teaching directors of nursing from many other facilities how to teach and implement LEAP," she says. "We’re concentrating on training the trainers now." The Florida Department of Services for the Aging has adopted LEAP as a model program.

One of the key elements in retention, Hollinger-Smith says, is providing a thorough orientation that makes new health care workers feel welcome in their workplace and encourages them become mentors for those hired after them.

"We’re focusing on this instead of on recruitment because all of the literature says there are not enough people in the wings waiting to enter the work force,"explains Hollinger-Smith. She points out that over the next seven-and-a-half years there will be one million positions for CNAs, but according to the Bureau of Labor Statistics, only about 400,000 women will be available to choose that career path.

"Even if every one of them went into the direct care workforce, there just aren’t enough people," Hollinger-Smith says. "We really have to focus on how we can better develop and retain the folks we have now."

ANA Gets $5 Million Aging-Care Grant

Another new program aimed at boosting nursing skills is offered by the American Nurses Association (ANA) with a $5 million grant. The program, called "Enhancing Geriatric Competence of Specialty Nurses," seeks to help more than 400,000 nurses deliver better care to aging adults.

The ANA will work with specialty nursing organizations to implement the grant, which has three goals:

  • creating permanent structures for geriatric activities in specialty nursing associations;
  • promoting gerontological certification of specialty nurses;
  • developing a web-based comprehensive geriatric nursing resource center.

Virtually all nurses provide care to older adults at some point in their careers. Current demographics project that the over-65 population will double over the next 30 years, reaching 70 million by 2030. Those over age 85 are the fastest growing segment of this population, which makes by far the biggest demand on health care services and facilities. Figures from the Bureau of Labor Statistics indicate that the current nursing shortage will soon reach crisis proportions, with more than one million new nurses needed by the year 2010.

The grant, from the Atlantic Philanthropies and implemented through a strategic alliance between ANA and the Hartford Institute for Geriatric Nursing, promotes gerontological nursing certification at generalist and specialist levels. Though geriatric care is one of the fastest-growing nursing specialties, less than 1% of nurses hold geriatric nursing certifications.

(For more information, contact Linda Hollinger-Smith at [847] 492-6815; and the American Nurses Association [800] 274-4262.)