A New Era in Geriatric Nursing Education

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    Journal 2014A NEW ERA IN GERIATRICNURSING EDUCATIONGINETTE A. PEPPER PHD, RN, FAANAssociate Dean for Research and PhD Program, andProfessor, College Of Nursing, University of Utah

    Salt Lake City, UTDirector, Hartford Center Geriatric Nursing Excellence

    College Of Nursing, University of UtahSalt Lake City, UT

    E-mail: ginny.pepper@nurs.utah.eduS TATISTICS DOCUMENTING AGING of the developed worlds populations and the impact on health care arewidely recounted. There is hope that age-related disability may be postponed due to progress in disease control

    and healthy aging, a major focus of gerontological nursing science. Yet longer life spans will undoubtedly intensifydemand for competent geriatric nursing care. Since 1996 when the John A. Hartford Foundation (JAHF) began its 20-year investment in geriatric nursing, a rich scientific evidence base has been developed as a foundation for geriatricnursing practice and education, comparable to other population specialties such as pediatric and maternity nursing.Recognizing that the greatest barrier to improving geriatric care was the lack of academic capacity, JAHF commenced ageriatric nursing initiative in 2000 focused on nursing education at all levels from associate degree to postdoctoraleducation (Bednash, Mezey, & Tagliareni, 2011). Over $83 million in support has been awarded to nursing schoolsand professional organizations by JAHF for elaboration of educational competencies, professional development inteaching geriatrics, and providing accessible educational resources for existing faculty; award of predoctoral andpostdoctoral fellowships to support preparation of a cadre of new faculty as future leaders of the field; and designationof one institute and nine centers of geriatric nursing excellence to advance education, practice, and research.As JAHF redirects its funding priorities downstreamfrom building academic capacity in medicine, nursing, andsocial work to focus on practice change initiatives, the finalexit grant in the JAHF nursing initiative ends in 2016.Academic nursing faces challenges not just to maintain theimprovements in geriatric nursing education and researchof the past 20 years, but also to sustain growth andmomentum to ensure that the nursing workforce isprepared to provide competent nursing care as the numberof older adults in our healthcare system doubles over thenext 20 years. Without deliberate planning by academicleadership on the institutional and national level, theprogress of the last two decades could be in jeopardy inboth advanced practice and basic nursing education.

    One of the greatest threats to preserving the profes-sions covenant with aging Americans is whether therewill be sufficient advanced practice registered nurses223

    of Professional Nursing, Vol 30, No. 6 (November/December), 201Elsevier Inc. All rights reserved.(APRNs) adequately prepared to provide primary care forolder adults. The APRN Consensus Model (2008)established adult-gerontology as a population focus toincrease the number of APRNs qualified to provide careto older adults. Graduate students in this focus arerequired to receive a rich and intense exposure togeriatrics based on the Adult-Gerontology Nurse Practi-tioner and Clinical Nurse Specialist Competencies (2010)in preparation for expanded coverage on certificationexams. The consensus model also provided that APRNsprepared for family or gender specific population caremust be prepared to meet the needs of the older adultpopulation. Yet, 62% of all primary care nurse practi-tioners who care for adults are family nurse practitioners(FNPs), and 84.9% of nurse practitioners see patientscovered by Medicare, the majority of whom are olderadults (AANP, 2013). Not only were the majority ofFNPs prepared prior to the consensus model and thushave varying geriatric preparation, but also the infra-structure to ensure that future FNP graduates are4: pp 443444 443http://dx.doi.org/10.1016/j.profnurs.2014.10.001


  • 444 GUEST EDITORIALadequately prepared is underdeveloped; national com-petencies, curricular standards, and enhanced certifica-tion testing are lacking.

    While tremendous strides were made in the past20 years to enhance geriatric content in basic nursingprograms, dedicated geriatric nursing courses taught byfacultywith graduate preparation in gerontological nursingremain the exception, while coursework by qualifiedfaculty in other population foci (pediatrics, maternity,and mental health) is virtually universal. A growingproportion of prelicensure students, particularly those insecond degree programs, recognize the relevance ofdemographic changes for their future practice, yet manyundergraduate learning activities emphasize positiveattitudes toward aging, rather than critical competenciessuch as evidence-based models of gerontological care thatpromote quality and safety and use of guidelines to preventand manage geriatric syndromes (Lyons et al., 2014).

    It is difficult to imagine the state of geriatric nursingeducation without the impetus of JAHF over the past twodecades, but without concerted, continuing effort, it isunlikely that nursing will meet the challenges of 2030. Apriority for organized nursing is to provide the academicand professional development structure to ensure thatAPRNs have current geriatric nursing knowledge.Likewise, basic programs need to ensure that qualitygeriatric nursing education, whether integrated or in adedicated course, is taught by qualified content experts.

    ReferencesAANP (2013). NP facts. http://www.aanp.org/images/

    documents/about-nps/npfacts.pdf2013 (RetrievedOctober 3, 2014).Bednash, G., Mezey, M. & Tagliareni, E. (2011). The

    Hartford Geriatric Nursing Initiative experience in geriatricnursing education: Looking back, looking forward. NursingOutlook, 59, 229235.

    Consensus model for APRN regulation: Licensure, accred-itation, certification & education (2008, July 7). http://www.aacn.nche.edu/education-resources/APRNReport.pdf (RetrievedOctober 4, 2014).

    Lyons, C. M., Benefield, L., Holtsclaw, B., De Shea, B., Short, D.& Wilson, J. S. (2014). Enhancing gerontology in undergraduatenursing programs. The Oklahoma Nurse, 59, (2), 812.

    Adult-gerontology nurse practitioner and clinical nursespecialist competencies (2010, March). http://www.aacn.nche.edu/geriatric-nursing/adultgerocnscomp.pdf (Retrieved October4, 2014).


    A New Era in Geriatric Nursing EducationReferences