From Competencies to Outcomes:Nursing Care of Older Adults

Christine Mueller, PhD, RN, FGSA, FAANProfessor, University of Minnesota, School of NursingApril 11, 2014

CompetencyKnowledge• Scope and Standards of Practice• Content from science and humanities• Content from Nursing science

Skill• Psychomotor• Communication• Interpersonal• Diagnostic

Attitude• Capacity to act effectively and requires--

• Listening• Emotional intelligence• Openness to feedback• Self knowledge of strengths and weakness

In two minutes– make a list of knowledge, skill and attitude competencies specific to nursing care of older adults.

Outcomes

Quality of Care

Quality of Life

In two minutes– make a list of quality of care and quality of life outcomes for residents in nursing homes or assisted living facilities.

• Improvement in functional status

• Skin integrity• Continent

• Engagement in meaningful activities• Dignity• Satisfaction

Types of competencies

• Gerontological• Quality and safety• End of life• Cultural• Culture change• Others?

The Future Nursing --Core Competencies• Patient Centered Care• Professionalism• Leadership• Systems based practice• Informatics and technology• Communication• Team work and collaboration• Quality improvement• Evidence-based practice

Competencies specific to nursing care of older adults• AACN Competencies to improve care of older adults• Multidisciplinary Competencies in the Care of Older Adults• Geropsychiatric nursing competencies• Geriatric Competencies for nurses in hospitals• Nurse competencies for nursing home culture change• Geriatric nursing competencies for nursing specialties

Olderadultfocus.org competencies

Awareness

• Increase own and others' awareness of attitudes, values, and expectations about aging and their impact on care of older adults and their families.

Olderadultfocus.org Competencies

Communicate

• Communicate effectively, respectfully, and compassionately with older adults and their families/ caregivers.

Olderadultfocus.org Competencies

Assess• Use appropriate

assessments for the functional, physical, cognitive, psychological, social, and spiritual status of older adults.

Olderadultfocus.org Competencies

Adapt• Plan, implement,

and evaluate care that is adapted to meet the individual functional, physical, cognitive, psychological, social, and endurance capabilities of older adults.

Olderadultfocus.org Competencies

Maximize

• Plan, implement, and evaluate care that assists older adults and their families/caregivers to meet personal goals, express preferences, maximize function, maintain desired level of autonomy and independence, and live in their chosen environment.

Olderadultfocus.org Competencies

Optimize

• Plan, implement, and evaluate care that promotes optimal aging.

Olderadultfocus.org Competencies

Decisions• Guide older adults

and their families/caregivers in making complex decisions that arise with aging.

Olderadultfocus.org Competencies

Systems• Work effectively

within and across organizational systems to promote quality care for older persons.

Olderadultfocus.org Competencies

Advocate• Advocate for health,

social, and financial needs of older adults at the policy level.

Teaching/Learning to Achieve Competence

Activity

• Objective: Apply teaching and learning strategies that can be used with nursing students and nursing staff to achieve competencies in nursing care of older adults.

Directions• At your tables you have:• One of the nine competencies• Several teaching strategies

• Each competency has a short list of components that will help to build the competency.

• Select a component and select a teaching strategy• Create a learning activity to address learning around the

component using the teaching strategy

Example• Competency: Assess• Component: Recognize atypical presentation of illness in older

adults• Teaching strategy: Games (Structured group interactive exercise or

contest with rules to promote new perspectives , introduce new concepts, reinforce definitions of terms)

• Teaching/learning strategyDevelop a Jeopardy game that includes a category of

atypical presentation of illness in older adults. Use the jeopardy game in a class setting with students.

Resources• See handout