Nurses interested in promoting and sustaining person-directed care and culture change in nursing homes now have a new resource called “Nurse Competencies for Nursing Home Culture Change” (pdf), which identifies specific skills that nurses need to develop to make changes.

A list of 10 competencies that were deemed to be the most relevant and critical for licensed nurses to create and maintain nursing home culture change is the outcome of a two-year initiative by the Hartford Institute for Geriatric Nursing, in collaboration with the Coalition of Geriatric Nursing Organizations and the Pioneer Network.

“In our work supporting nurses that are employed in culture changing organizations, they have expressed a fair amount of dissatisfaction with the change process,” said National Director of PHI Training & Organizational Development Services Susan Misiorski, who is also a Pioneer Network board member.

“This is due in part to confusion over their role and lack of adequate skill building in person-directed competencies,” she continued. “Reports such as these provided the impetus for convening this initiative.”

The Process

The organizations brought together 31 nursing and geriatric experts to explore opportunities and barriers for nursing and culture change. The group was charged with answering the question “What is the role for nurses in achieving and sustaining this change?”

To identify the competencies critical to creating culture change, the panel:

• reviewed existing competencies for nurses and other disciplines in long-term care and care of older adults;
• consulted with nurse experts, actively engaged in the work of culture change and considered role models; and
• solicited input from nurses throughout the country via a survey.

Communication Skills Essential to Change

The first competency that the collaborators identified is “modeling, teaching and utilizing 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.”

An early proponent of positive communication and collaborative problem solving as ways to strengthen nursing home teams and caregiving relationships — the building blocks of culture change — PHI has developed a unique approach to teaching these core skills.

“PHI’s training directly addresses the first of the competencies because you learn not only to utilize effective communication, but you truly learn what it means to model it for others,” said Pioneer Network Executive Director Bonnie Kantor.

PHI, which has been at the vanguard of providing training on relationship-centered care and achieving nursing home culture change, recently sponsored a two-day seminar on the PHI Coaching Approach to Supervision that was attended by national leaders in gerontological nursing education and culture change.

The Nurse Competencies for Nursing Home Culture Change was supported by the Commonwealth Fund, and is considered an important step in creating measurement and other tools useful in educating and supporting nurses in culture change work.

To learn more about PHI Coaching Approach training, visit the PHI Training & Organizational Development Services website.

– by Deane Beebe