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Core Competencies in Nursing

Supported by The Commonwealth Fund

Project Start Date: 09/08

The Hartford Institute of Geriatric Nursing (HIGN), The Coalition for Geriatric Nursing Organizations (CCGNO), and the Pioneer Network have long recognized that nurses need to be a stronger partner, and more appropriately even, leaders in the culture change movement. However, to date, nurses have felt marginalized and, in fact, have not been active participants. This initiative will augment the work of the Hartford Centers for Geriatric Nursing Excellence in Nursing Homes Collaborative in identifying the principles and characteristics of a nursing practice model that includes role definition and culture change competencies of all members of the nursing service (i.e., directors of nursing, supervisors, managers, RNs and LPNs, certified nurse assistants, advanced practice nurses).

To further explore and make recommendations about the role and competencies for nurses with regard to nursing home culture change, in 2008 the Hartford Institute for Geriatric Nursing at NYU College of Nursing, in collaboration with the Coalition for Geriatric Nursing Organizations and the Pioneer Network, convened an interdisciplinary Expert Panel of leaders in culture change and in gerontological nursing for a one-and-a half-day meeting. The purpose of this meeting was to foster dialogue, to identify facilitators and barriers to nurses' involvement in culture change, and to identify actions that the culture change movement and the broad nursing community might consider in order to promote competencies for nurses in a resident-directed care environment in nursing homes.

The Issue Paper Nurses' Involvement in Culture Change: Overcoming Barriers, Advancing Opportunities summarizes the Expert Panel discussion and frames the competencies that need to be developed for nurses involved in culture change and resident-directed care. The paper encompasses five sections: culture change and research supporting culture change; nursing in nursing homes; culture change, nursing practice, and nursing education; recommendations; and next steps. The paper includes the following recommendations pertaining to the practice and the academic training of nurses in culture change:

  • Develop and distribute a Statement of Goals for Practicing Nurses in Culture Change Nursing Homes.
  • Develop competencies for nurses practicing in culture change nursing homes.
  • Conduct a comprehensive review of culture change content in pre-licensure (associate degree and bachelor of nursing) nursing programs.
  • Disseminate existing tools/resources on culture change and nursing's role in culture change to academic nursing programs, including strategies for incorporating this content into the curriculum.
  • Create new tools/resources based on the competencies for nurses in nursing homes.
  • Identify research priorities for examining the role of nurses in nursing home culture change.

As next steps, HIGN and the CGNO will partner with Pioneer Network to develop core competencies and quality indicators in nursing that are guided by culture change principles and a cross-disciplinary approach to care. It is expected that the process and model developed through the work with Medical Directors are transferable to the development of core competencies for person-centered care in nursing. The transfer will assure consistency in core competencies within care teams.

Click here to download the Issue Paper Nurses' Involvement in Culture Change: Overcoming Barriers, Advancing Opportunities and here to download the Executive Summary.