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Ground-breaking “Nurse Competencies for Nursing Home Culture Change” Released

Hartford Institute for Geriatric Nursing in Collaboration with the Coalition of Geriatric Nursing Organizations and Pioneer Network Finalize Competencies Completed in a Two-Year Initiative of Historic Proportion

Pioneer Network

For Immediate Release
Thursday, May 27, 2010
Contact: Christie Dobson
Operations Manager
585.271.7570 / 585.244.9114

ROCHESTER, NY – Pioneer Network Executive Director Bonnie Kantor announced today that a two-year initiative designed to develop  nursing competencies specific to nursing home culture change that brought together nursing and geriatric experts from across the country is now complete.
The resulting document, "Nursing Competencies for Nursing Home Culture Change" offers ten competencies deemed most relevant and critical for creating and sustaining person-directed care. The initiative was supported by the Commonwealth Fund.

In 2008 Hartford Institute for Geriatric Nursing (HIGN) collaborated with Coalition of Geriatric Nursing Organizations (CGNO) and Pioneer Network (PN) to convene a panel of 31 nursing and other experts to explore opportunities and barriers for nursing and culture change. The panel worked to answer the question, "what is the role for nurses in achieving and sustaining this change?" The decision was made by a core group of nurses and clinical nurse leaders involved in cultural transformation to concentrate on those competencies that are unique to culture change nursing, building on the work already done to identify specific clinical competencies for geriatric nursing (see and Position Descriptions and Related Competencies for Long Term Care Nursing Positions ( "Nursing Competencies for Nursing Home Culture Change" is a result of that collaboration.

The "Nursing Competencies for Nursing Home Culture Change" are useful in identifying specific skills needed by nurses working in care settings involved in culture change. It is a first step in creating measurement and other tools useful in educating and supporting nurses in this work. The competencies include:

  1. Models, teaches and utilizes effective communication skills such as active listening, giving meaningful feedback, communicating ideas clearly, addressing emotional behaviors, resolving conflict and understanding the role of diversity in communication
  2. Creates systems and adapts daily routines and "person-directed" care practices to accommodate resident preferences
  3. Views self as part of team, not always as the leader
  4. Evaluates the degree to which person-directed care practices exist in the care team and identifies and addresses barriers to person directed care
  5. Views the care setting as the residents' home and works to create attributes of home
  6. Creates a system to maintain consistency of caregivers for residents
  7. Exhibits leadership characteristics/ abilities to promote person-directed care
  8. Role models person-directed care
  9. Problem solves complex medical/psychosocial situations related to resident choice and risk
  10. Facilitates team members including residents and families, in shared problem-solving, decision-making, and planning

To view and download a complete copy of "Nursing Competencies for Nursing Home Culture Change" please visit /Providers/ForNurses/.

"I'm excited by these competencies because they are the first step in defining the role nurses must play in this civil rights movement we call Culture Change," notes Diane Carter, CEO of the American Association of Nurse Assessment Coordinators (AANAC).  It is just simply the right thing to do." 

Pioneer Network Board Member Joanne Rader, nationally-recognized for her work improving care for persons with dementia and a lead on the project says, "These competencies were created by nurses actively involved in culture change. They are designed to help nurses at all levels identify their areas of strengths and areas where they can grow." She adds, "The competencies can also be a guide to identifying the education, support and resources long term care nurses need to provide person-directed care and develop supportive systems that insure sustainability.

Lorraine Tarnove, Executive Director of the American Medical Director's Association says "The announcement of core competencies in culture change for licensed nurses in nursing homes is another signal that nursing home professionals are embracing culture change and making it part of their profession.  Along with administrators and physicians, nursing leaders realize that defining these competencies gives direction to the profession seeking to participate in culture change in nursing homes as well as giving consumers some concrete ideas of what to look for as they seek patient centered nursing home care." She adds, "AMDA spent over a year defining the competencies for physician medical directors and is now undertaking the same process to define them for attending physicians.  As we look at the nursing competencies we see many like items.  These commonalities are potential bridges for the interdisciplinary care team members to bring the power of their profession's skills and their leadership to make culture change happen."
The competencies can be helpful in a variety of organizational and educational settings. Christine Mueller of the University of Minnesota, School of Nursing says, "These competencies are useful for nurse educators to guide the development of curricula and courses for nursing students so they will be prepared to engage as an effective member of the nursing team focusing on person-directed care."

"Culture change is so natural for professional nursing," notes Sarah Burger from the Hartford Institute for Geriatric Nursing. "These competencies are the building blocks we need to make that a reality."

Randy Linder, President and CEO of the National Association of Long Term Care Administrator Boards (NAB) offered this comment: "We are thrilled to see this additional step of integrating the nursing team into the core competencies of culture change in nursing homes. This initiative builds upon the collaborative effort that the NAB and the Pioneer Network started three years ago with the update of the Nursing Home Administrator's core competencies with a focus on Culture Change. The NAB's recently released 5th Edition of the NAB Nursing Home Administrators Study Guide also includes a chapter authored by the Pioneer Network titled Culture Change and Resident Centered Care. The NAB is the national leading authority on licensing, credentialing, and regulating administrators of organizations along the continuum of long term care.

The release of "Nursing Competencies for Nursing Home Culture Change" is supported by eight esteemed national nursing organizations, part of the Coalition of Geriatric Nursing Organizations (CGNO):
  • American Academy of Nursing (AAN), Expert Panel on Aging
  • American Assisted Living Nurses Association (AALNA)
  • American Association for Long Term Care Nursing (AALTCN)
  • American Association of Nurse Assessment Coordinators (AANAC)
  • Gerontological Advance Practice Nurses Association (GAPNA)
  • Hartford Institute for Geriatric Nursing (HIGN)
  • National Association of Directors of Nursing in Long Term Care Administration (NADONA)
  • National Gerontological Nursing Association (NGNA)

Pioneer Network is at the forefront of changing the culture of aging and long-term care of elders in America. A growing coalition of organizations and individuals from across the nation, Pioneer Network is dedicated to making fundamental changes in values and practices to create a culture of aging and long-term care that is life-affirming, satisfying, humane and meaningful. Pioneer Network advocates for public policy changes, creates communication, networking and learning opportunities; builds and supports relationships and community; identifies and promotes transformation in practice, services, public policy and research; develops and provides access to resources and leadership; and hosts a national conference to bring together interested parties with a desire to propel this important work. To learn more about the Pioneer Network, visit

This endeavor was supported by the Commonwealth Fund, a national, private foundation based in New York City that supports independent research on health care issues and makes grants to improve health care practice and policy. The views presented here are those of the authors and not necessarily those of the Commonwealth Fund, its directors, officers, or staff. For more information, visit

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