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Learning Objective 1: The learner will be able to identify the nurse competencies for nursing home culture change and how they might be applied to other interprofessional practises.
Learning Objective 2: The learner will be able to compare and contrast a routine task vs. person-directed bathing practise.
Culture Change is the term commonly used to describe moving from a task oriented focus to a resident directed focus. This shift is creating some confusion for long term care (LTC) nurses regarding their role. In 2010, the Nurse Competencies for Nursing Home Culture Change were developed through a collaboration of Pioneer Network and the Hartford Institute for Geriatric Nursing, but have not been systematically implemented. Following an introduction of the competency tool by the GNLA fellow, a group of 10 nurses with a combined total of 134 years of LTC experience completed a self-assessment of the competencies and attended a focus group to discuss culture change principles. The fellow guided initial meetings to engage the group in establishing a vision. They then agreed to participate in a project to advance resident directed care and chose bathing as the practice most in need of change. The project team developed and distributed an informal survey to residents and staff regarding choice and satisfaction with the overall bathing experience. Using survey data, they developed an action plan that including interdisciplinary participation. It is anticipated that residents will report increased choice about bathing and increased satisfaction with the experience. Nurses will report increased use of resident-directed nursing practices, greater job satisfaction, and a willingness to use their new competencies in other areas. Recommendations include: sustaining changes and expanding the interventions to the rest of the nursing home and campus; enhancing resident directed focus to other interdisciplinary practices. The fellow will provide leadership and expand her influence at the organizational, state and national levels by disseminating results and promoting change through organizational decision making committees, Oregon Center of Nursing work groups and presenting at national conferences and webinars on the role of the nurse in culture change.
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