Be In the Know!

Did you hear about the study released by the UNC Institute on Aging?  It identified three programs being introduced to nursing homes in North Carolina in hopes of improving client care and reducing the number of sub-standard fines and sanctions placed against the state’s nursing homes.

The study was led by Thomas R. Konrad, PhD, a research professor of health policy and management at the UNC Gillings School of Global Public Health, and a senior scientist at the Institute on Aging.  Here’s what he had to say:  “The study shows North Carolina’s unique partnerships between the state, the university and nursing homes are effectively leveraging federal funds to improve the lives of those who live in, as well as those who work in, nursing homes,”

Konrad’s study was conducted in North Carolina nursing homes between 2004 and 2007.  What’s interesting is that it was funded by civil monetary penalties – funds collected from nursing homes for deficiencies in care.  The goal was to improve client care by redistributing the penalty funds back into the same nursing homes in the form of three initiatives:

1. The Win a Step Up program focused on the nursing assistants by upgrading their knowledge and skills, increasing their job commitment and providing rewards and recognition for a job well done.
2. Quality Improvement Collaboratives, in which groups of nursing homes worked together with the statewide Quality Improvement Organization to improve specific quality care measures, such as reducing pressure sores, reducing resident falls or limiting the use of restraints.
3. Culture Change Initiatives was designed to assist nursing homes with changing their structures or routines to make their environments more “homelike.”  This initiative fell in line with goals that all nursing homes have recently made a priority.

The study found that the participating nursing saw a number of improvements, including:

• Facilities using the Win a Step Up saw a decrease in pressure sores among their residents, and experienced a drop in employee turnover when compared to the previous year.  As you know, having continuity with your staff will go a long way in making sure your facility runs at its full potential.
• Nursing homes participating in the Quality Improvement Collaboratives saw a significant reduction in incontinence and a decrease in the use of restraints.  Most significantly, resident falls were almost cut in half after the study.
• Facilities using the Culture Change Initiatives also saw a reduction in the use of restraints, as safer and more comfortable alternatives were taught and implemented.  In addition, resident satisfaction increased dramatically, especially relating to resident independence and quality of life.

At In the Know, we applaud the idea of putting penalty funds back into nursing homes-especially when the focus is to increase the knowledge base of nursing assistants.  As we always say, when people learn more, they achieve more!

Till next time,

Evan

As you are well aware, a nurse aide’s job can be quite stressful.  Being on the frontlines of client care is tough!  Most nursing assistants are not fully prepared for the challenges that lie ahead on a daily basis.  As a result, job burnout and quick turnaround of CNAs are very real problems being faced by many administrators.

One way to help reduce the stress felt by your nurse aides is to implement a relaxed (but professional) continuing education program.  Here are some ideas for doing just that:

Home Study…Having the flexibility to study the material from the comfort of home is a great option.  With In the Know inservices, you have the freedom to make as many copies as you need (within your single facility) of the inservice topic.  You can send the learning materials home with your aides.  (If you have email addresses for your CNAs, you can also simply email the “learner’s section” of the inservice to each of them.)  All you’ll have to do is grade and file their quizzes!  This method allows your CNAs to complete their necessary continuing education at their own pace.

Grab a Partner…Allow your aides to partner up (or assign them a study partner).  Most of the time, having to work with someone else creates a higher sense of accountability.  Working as partners also fosters teamwork, promotes problem-solving skills and gets your CNAs talking amongst themselves about the learning materials.  They can think out loud, share ideas and learn from one another.

Take It As It Comes…Another idea is to create a library of inservices that is accessible to your CNAs during their work hours.  Develop a “sign up sheet” (or use the one provided by In the Know).  Then, allow your nurse aides to complete the inservices at work “on the clock” as time allows. Not only will you have more time for other aspects of your job, but your aides will feel like they are in control of their own learning.

With a flexible inservice plan, you’ll head off burnout and CNA turnover at your workplace.  For more information, give us a call at 877-809-5515.

Do you have any different methods for inservicing your CNAs that you’d like to share?  We would love to hear them!

As the “baby boomer” population in the United States ages, the need for additional nurse aides is something that cannot be ignored.  The Census Bureau projects that by 2030 there will be over 70 million Americans aged 65 and older, more that twice their number in 1995.  According to the Bureau of Labor Statistics (BLS), the overall number of nurse aide jobs is projected to grow an additional 36% — from 2.1 million to 2.9 million jobs.

Further, experts project there will be a demand for nearly 1 million more of these workers in the next decade, and perhaps a total of 3 million more by 2030 — when all surviving members of the 78-million-strong boomer generation are older than 65.  Attracting and retaining quality nurse aides will become an even greater focus for most healthcare organizations. One way you can do that is via a high-caliber continuing education program that helps your CNAs prepare for the demands of their jobs.

The consequences of ill-trained and overburdened nurse aides can be costly and painful to a healthcare organization.  A quality education program, attracts, retains and empowers your nurse aides to put their best foot forward everyday.  After all, knowledge is power!  And, the more your CNAs know, the more they can achieve.

The numbers are dramatic.  An older population means more people with health and personal care needs and greater use of health and long-term care services.  Are your nurse aides ready?  How is your organization preparing for the aging baby boomers?  We would love to hear from you!  Any tips or suggestions are highly encouraged and much appreciated!

Please add your comments to this blog or simply email me at mariaeaston@knowingmore.com.  Thanks!

Lack of support has often been cited as a major factor in the turnover of nurse aides.  One way your organization can reduce the crushing expense of nurse aide turnover is to implement a quality inservice program.  Think about this…….it costs on average, a year’s wages to replace an employee.  Do you know your nurse aide turnover rate?  It’s easy.

Divide the number of CNAs who terminated with you (for any reason) during the past 12 months by the average number of CNAs you had on staff for the same 12 months.  You will get a percentage number.  Ideally, the closer you are to 0%, the better, however, that is nearly impossible for any employer.  Did you know the industry average for CNA turnover is 93%?  That means that at least 9 out of 10 CNAs leave their employment within a 12 month period of being hired!

What can you do to keep the turnover rate low in your organization?  Consistent on-the-job training can make the difference between a CNA staying or leaving.  Certainly, competitive pay ranks as equally important but many employers find that their workers care very strongly about the training and education opportunities available to them at work.  Ongoing training is imperative to keeping nurse aides enthused and informed about their job responsibilities.  Most importantly, it gives them the tools they need to perform their duties properly.

Nursing assistants are the heart of your business!   Time is precious in the healthcare field, however, your nurse aides are on the “front line” everyday with their clients.  Empowering them with a solid, quality education program will result in lower turnover rates, and most importantly, enhanced client care.

How is the nurse aide retention rate in your organization?  Please share any tips you have for keeping quality nurse aides.  Or, share the challenges you have with your organization’s retention.  We would love to hear from you!

Best wishes,

Maria

Maria Easton (mariaeaston@knowingmore.com)

The internet offers some terrific options for nursing paraprofessionals who are looking to learn new things. However, it’s easy to get “lost” in cyberspace when searching for relevant information. Here are just a few sites that we feel have a lot to offer CNAs—and anyone who works in health care. You may want to pass them on to your nursing assistants and/or home health aides.

Nursing Assistant Resources on the Web
For ten years, three nursing assistants named Patti, Kim and Heather have worked diligently to create a central location for CNAs to access information on the web. They believe that “the more informed CNAs are, the better quality work they will produce.”

On this site, you’ll find a blog filled with important information for CNAs and anyone who is part of the healthcare system. I regularly read their blog postings! The blog is interactive which means readers can post their comments (the same as here on the In the Know blog).

Nursing Assistant On-line Video Lessons
Your CNAs are bound to find the Nursing Assistant On-line Video Lessons interesting. This site was created by Fox Valley Technical College and Northeast Wisconsin Technical College as a resource for nursing assistant students.

While the videos are copyrighted, you are welcome to watch them online for free. There are 80 different videos to help CNA students reinforce their classroom learning and to give working CNAs a refresher on a variety of topics. The videos alone cannot count as inservices, but they still provide a great learning experience.

Nursing Assistant Central
This is another great site that has great information for both students and working CNAs. This website offers information about becoming a CNA and tips for succeeding as a CNA.

There is also a very active message board which provides an excellent place to ask questions, learn and socialize with others in the field. All are welcome to participate, whether you’re a past, present or prospective CNA.

We recommend taking a long look around Nursing Assistant Central. You’re bound to learn a thing or two. We did!

National Network of Career Nursing Assistants
Have your heard of the National Network of Career Nursing Assistants? It is a non-profit educational organization that promotes recognition, education, research, advocacy and peer support development for nursing assistants in nursing homes and other long term care settings. Genevieve Gipson NA RN MEd RNC is the director. She advocates tirelessly for direct-care workers across the United States.

One of our favorite spots on this site is a page of Frequently Asked Questions. These questions (and answers) relate to transferring CNA certification from one state to another, finding a local CNA training program, and much much more!

Last but not least, you may want your nurse aides to check out our Just for CNAs blog. On it, we strive to provide them with information that will help them in both their careers and their personal lives.

Till next time,
Linda

Linda Leekley BS, RN

Have you ever hired nursing assistants and, after HR paperwork and a quick tour of your facility or agency, sent them off to a full day’s work? Does orientation seem like a waste of time with CNAs? After all, many of them don’t stick around long, so why bother? Well, here’s a tale from my past that spells out the problem with that theory:

When I started my first job as a new nursing graduate, it was on a busy hematology/oncology unit at a big teaching hospital. I was green, intimidated and in need of a good orientation. Did I receive it? Nope…instead I was thrown into a full patient assignment. (There was a preceptor assigned to me, but she was busy with her own caseload.) When I expressed my concerns to my preceptor, she said to me, “Look, we know an orientation would be nice. But, you’re a warm body to fill a spot on this shift. Just do the best you can because none of us have time to help you.”

What happened? Well, thankfully, I avoided causing any harm to my patients! But, my stress level went sky high; I felt alienated from my co-workers; and I spent my days off worrying about work. Before long, I developed strep throat and walking pneumonia. After a month, I transferred to another oncology unit where the staff was willing to orient me.

So, guess what? Once again, the heme/onc unit was short staffed! Their neglect of my learning needs was shortsighted and cost them another “warm body”. And, as time went on, I found out that the cycle continued; very few nurses wanted to work on that unit. Their attitude about orientation harmed everyone: the supervisor, the staff and the patients!

It’s the same with nursing assistants. If they are not oriented properly to their role within your workplace, they are likely to become stressed, overwhelmed and anxious to move on to another job. This vicious cycle is part of why CNA turnover is so high across the United States.

There is good news. Studies have shown that, on average, when an organization institutes a high quality orientation, their turnover rate decreases by 50% within two years! That’s one reason why we developed a complete CNA Orientation Program entitled, “Getting Off to a Good Start”. We wanted to help you with your aide retention rates AND provide the tools and support that nursing assistants need when they begin a new job.

“Getting Off to a Good Start” includes information on professionalism, communication, teamwork, patient rights, infection control, time management, stress management, personal wellness, customer service, cultural diversity, quality improvement, documentation and LOTS of practical client care tips. And, the program gives the learner SIX hours of inservice credit…right off the bat!

If you want more information on our CNA Orientation Program, please feel free to give us a call at 877-809-5515. We’re happy to answer any questions you have and/or email you a preview of the program.

Happy Hiring!
Linda

Linda Leekley BS, RN
www.knowingmore.com

Continuing education should do more than fulfill annual inservice requirements. It should meet the learning needs of your CNAs and, in turn, have a measurable impact on client care. That’s what you get when you use inservices from In the Know. Consider these examples from just a few of our customers:

Renee F. at Fountainbleau Nursing Center: “We were having a large number of falls among our residents. We gave our CNAs the ‘Understanding Fall Risk Factors’ inservice to educate them on this issue. In the past month, our falls have been cut in half!”

Temika Y. at Generation Solutions: “After presenting the ‘Understanding Diabetes’ inservice to our home health aides, one aide recognized the signs of hypoglycemia and impending insulin shock in her client. She called EMS and literally saved the client’s life because of the information she learned from In the Know!”

Beth R. at Bellamy Fields Assisted Living: “Our CNAs had poor documentation skills–and were even using ‘White Out’! We purchased In the Know’s inservice, ‘Reporting & Documenting Client Care’, and made it a requirement for every nursing assistant. Their documentation has improved significantly!”

Wouldn’t you like to see measurable results like these from your inservice program? You can! Start developing top-notch CNAs today by creating your own library of In the Know inservices.

If your budget is tight, start with one key inservice that addresses a specific aspect of client care that you’d like to improve. We also offer special discounts when you buy three, six, nine or twelve inservices.

And, be sure to download our FREE inservice, Customer Service in Health Care. Many of our customers have noted a measurable increase in both employee and patient satisfaction after presenting this inservice to their nursing assistants. So, take action today and start seeing measurable results tomorrow!

Happy Teaching,
Linda Leekley BS, RN

Are you responsible for selecting inservice materials for your nursing assistants? If so, here are a few tips to help you get the best product for meeting the learning needs of your aides.

1. Look for a Wide Range of Well-Written, Relevant Topics
Most nursing supervisors agree that providing aides with knowledge of problem solving, communication skills, self-care and stress management are just as important as teaching them about a disease process. When selecting an inservice provider, make sure the company offers a variety of topics including mandatory topics, psycho-social issues, basic skill reviews, disease processes and professional development issues.

Find out who develops the inservices. While it may look impressive to have physicians authoring the inservices, how much direct experience do most physicians have with nursing assistants? Ask if the authors have taught and/or supervised CNA’s.

A first-rate inservice provider should offer current information in each inservice and should update topics on a regular basis. And, since a good way to encourage retention of your nursing assistants is to create a “career ladder” for them, review the available topics to see if they support career advancement for your aides.

Do the inservices contain quick “soundbytes” of information on a variety of topics or are they an in-depth study of one topic? To be of real value, look for inservices that get to the real heart of a subject.

Quality inservices should also help learners think “outside the box” so they are prepared for the unexpected situations that will occur during client care. Pick an inservice provider who encourages critical thinking.

2. Make Sure the Inservices Are Easy to Use
Time is probably the most precious commodity for any nursing supervisor, right? A good inservice provider recognizes this and will help you save time in your busy schedule.

Look for inservices that can be utilized in a variety of ways. For example, can the inservice be offered as a self-study packet as well as a group presentation?

Videotapes may seem easy to use, but consider the fact that learners have no way to review the information later, at their own pace. Your aides may prefer an inservice which provides handouts that they can keep and reread.

Sometimes, the need for an inservice is immediate. Find out if the inservice provider can get you the materials right away, via email, when you need them.

3. Consider the Value You’re Getting for Your Money
Creating an inservice yourself can easily eat up 12 hours—or more—of your time each month. Multiply that time by your hourly salary and you’ll see that each inservice is costing hundreds of dollars! Keep this in mind when you evaluate the cost of purchasing inservices from a provider. In addition, be sure to ask these key questions:

Is the price of each inservice for a “one time” use or can the inservice be used over and over, indefinitely?

If your workplace has multiple locations, can you get a discount if you order inservices for every location?

4. Assess the Company’s Customer Service & Satisfaction
You can tell a lot about an inservice provider from their customer service. Ideally, it should be easy to get in touch with the provider’s customer service representatives. They should be willing and able to answer all your questions and should readily provide you with references. (We recommend that you take time to contact a few references. They can give you the real scoop about the quality of the inservices, how the staff reacts to them and the level of customer service you can expect after you make your purchase.)

There are a number of other factors that influence how satisfied you’ll be with an inservice provider. Of course, you’ll want any inservices you purchase to pass muster with surveyors. Ask the provider how their inservices will help meet your survey requirements…and how a surveyor will know that your aides have completed a particular inservice.

Enhancing the quality of client care is a key goal of CNA inservice education. Look to see if the available inservices provide the knowledge necessary to meet the needs of your client population. To improve client satisfaction, you should also look for topics that boost the skills of your CNA’s.

When you purchase inservices from a quality provider, your aides should look forward to each inservice, rather than dreading it as something to get through. Check to see that the inservices are presented in an engaging manner and that they encourage participation and discussion. Insist on a free sample topic that you can try out with your nursing assistants…before you make a purchase.

Have you noticed a shortage of nursing assistants? The CDC estimates that by 2030, the U.S. will need at least 25% more CNA’s than are working today. By carefully selecting a quality inservice provider, you’ll be taking an important step toward building a satisfied and professional CNA staff.

Happy Teaching,
Linda Leekley