Gerontologic Nursing Competency Tool Testing Among Pre-Licensure Students in Six Diverse Schools/Colleges of Nursing

Purpose: Adequately meeting the complex healthcare needs of the aging population will remain a global challenge for ensuing decades. The United Nations (2012) elucidated the continual upward trajectory of global population aging through 2050. Similarly, as reported by Colby & Ortman (2015), the U.S. Census Bureau predicts an increase in older adult population of age 65 or older from 46.3 million to 98 million by the year 2060. Older adults bear multiple vulnerabilities, including nutritional (Porter-Starr, McDonald, & Bales, 2015); pharmacologic (Kuerbis, Sacco, Blazer, & Moore, 2014); and most notably, fall risk (CDC, 2016; Lukaszyk, C., 2016). In the U.S., the older adult healthcare workforce challenge is highlighted through the continuing increase in U.S. hospitalizations for Medicare patients (Dartmouth, 2017). Therefore, continued expanded and targeted training for the unique and comprehensive healthcare needs of the older adult continues to be an important area for nursing research and enhanced nursing education. While there are resources and competencies for practicing registered nurses generously provided by The Hartford Institute for Geriatric Nursing and there is an expanding interest in studies examining various aspects of nursing students and care of the older adult, including attention to promoting empathy (Chen, et al., 2015) and perceptions of care (Koehler, 2016); at the initiation of this project and through a current search of literature, there are no known published tools or toolkits specifically designed for pre-licensure nursing students. Thus, our project team chose to approach this important nursing workforce preparedness and transition to practice issue through development of a geriatric nursing competency skill tool and with an accompanying web-based resource toolkit for utilization by pre-licensure nursing students and faculty. The tool was developed and initially piloted over a 2-year timespan. The final phase of work is presented here focusing on the multi-site testing and utilization among pre-licensure nursing students and respective faculty in the U.S.

Methods: A total of six schools/colleges of nursing located in the Southwestern U.S. agreed to serve as partner sites for their faculty and students, resulting in a wide spectrum of geographic and cultural diversity from private and public institutions. Participating sites had a designated project liaison, with on-site training provided by the PI and Co-Investigators. Project support was also provided throughout the 4-month data collection period. IRB review and approval was obtained prior to data collection. Participating site faculty completed the geriatric nursing skills validation tool for their students in varied settings including traditional acute care settings; rehabilitation settings; dedicated education units; and/or simulation learning centers. All participating students and faculty completed surveys evaluating the geriatric competencies skills tool. Additional procedures included site faculty and student reviews of a web-based geriatric nursing toolkit followed by completion of a website survey.

Results: Over 350 students and faculty participated by completing the competency skills tool as well as project surveys for the tool and web-based toolkit. The site liaisons also completed site summary data forms. Demographic data were reflective of the current U.S. demographics for nursing faculty and students with the majority of participants indicating female gender. Students designating Hispanic ethnicity were well represented in this sample, with representatives from other self-reported ethnicities other than Caucasian as well. Qualitative results from the survey forms and quantitative feedback from narrative items revealed that most participants found the tool and toolkit easy to use and appropriate for pre-licensure nursing students. Insightful suggestions for further refinement, particularly with regard to more detailed faculty-use instruction, were provided by faculty participants and are being incorporated into the final release version of the tool and toolkit. Additional inclusion items for the web-based toolkit were also submitted for incorporation. The project team worked collaboratively with the project funding agency to determine a publically accessible website for placement of both the final version of the Gerontology-focused nursing skills competency tool and web-based accompanying resource toolkit. The web-site will be accessible at no cost and amenable to nursing student and faculty utilization.

Conclusion: Standardizing essential gerontologic nursing skill competencies for pre-licensure nursing students can enhance healthcare workforce readiness to provide holistic care for the ever increasing older adult population. Further, this project’s Gerontology-focused nursing tool and toolkit will be available for utilization globally via an open-access website to promote further enhancements in nursing education and clinical care outcomes for older adults.