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Agency uses self-learning packets and checklists
Home care agencies increasingly are training staff to handle specific diseases or conditions, such as wound care and psychiatric nursing. But they may be overlooking an important need to divide staff education by patient age group.
Obviously, neonatal and new mother care is a specialty area for some agencies and staff. Patients should be divided into more groups, however, than just those of infants and all others.
Richmond Home Health Services in Rockingham, NC, has addressed this issue by developing a full set of age-specific competencies for all field staff. The categories are: birth to 1 year; children 1 to 11; adolescents 12 to 17; adults 18 to 65; and geriatric adults, over 65.
"We developed a self-study packet to be used for new people coming on board," explains Sharyn Campbell, RN, performance improvement coordinator of the agency, is based in Richmond Memorial Hospital in Rockingham and serving eight counties in south-central North Carolina.
Before the agency began its age-specific competency program, managers had no way to document that nurses trained to work with one particular population of patients actually were competent in that area. "When we screen and hire people, we talk to them about their different experiences. We might have one nurse who is more experienced in geriatrics, and another with pediatrics skills, but we never had anything in their case files to document their competency," Campbell says.
Managers realized they needed a more formal program during a mock survey conducted to prepare them for a survey by the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL. First, agency managers developed the various competencies, with a different one for each discipline, including RNs, LPNs, home health aides, speech therapists, occupational therapists, physical therapists, and medical social workers. "Every one who has patient contact has to go through it," Campbell says.
Each competency includes some general skills and tasks, as well as specific items that would only apply to a particular age group. (See geriatric competencies for RNs, LPNs, and home health aides, inserted in this issue.)
Then Jenny Alfredson, RN, a team leader, assembled the self-learning packets, using a variety of information acquired during her years of working in staff development. Each self-learning segment, which numbers up to 20 pages, takes 30 to 60 minutes to read.
To launch the educational program, the agency supplies the material, which instructors would read to staff. Instructors were employees with the most experience in a particular area. The self-study guides were used by employees hired after the competency program began or those who couldn’t attend the inservices.
Field staff also must complete tests based on the lecture material. (See home health aide vital signs and competency tests, inserted in this issue.) "We made it a requirement that it be done now and then at least every three years for the professional staff," Campbell says. "Paraprofessionals, like home health aides, have to be assessed annually, so they’ll have to complete it annually."
The agency contacted employees though voice mail to tell them they were required to take the classes. While staff studied the competency training material over a two-day period, the agency used part-time staff to cover their visits.
The competency training also included a demonstration of skills, which the agency turned into a fun session in which some staff could bring their children to portray pediatric patients. They also brought in covered dishes to share.
"We tried to have fun with it, rather than make it a boring regulation we had to comply with," Campbell says. "Some staff members in different age groups acted, and others had family members, such as parents and grandparents, act."