Resource to Help Nursing Homes
Prepare to be Clinical Sites for
Nursing Students
Mathy Mezey, EdD, RN, FAAN,
Sarah Greene Burger, RN-C, MPH, FAAN
Ethel Mitty, EdD, RN
Hartford Institute for Geriatric Nursing,
New York University College of Nursing
Module 6 of Nursing Homes as Clinical Placement Sites for Nursing Students Series
Acknowledgments
This is a joint project of
With support from
Grant to the
University of Minnesota
School of Nursing
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
This project is endorsed by:
Project Steering Committee
View List of Members
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
About Module 6: Resource to Help Nursing Homes
Prepare to be Clinical Sites for Nursing Students
Objectives/Purpose:
Negotiate with nursing programs to be a clinical
site, specifically to describe:
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At the end of this module
you will be able to:
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Benefits for a nursing home serving as a clinical
placement site
Student learning goals for clinical placements in nursing
homes
Factors nursing faculty see as important in choosing a
nursing home
Why schools may preferentially select nursing homes
involved in culture change
Aspects of the nursing home that are important to the
nursing school
Prepare your nursing home to be a clinical practice
site
Use a checklist to conduct a self-assessment to
determine your readiness to be a clinical site
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Who Should Use This Module
• Directors of Nursing of nursing homes
• Nursing home administrators and CEOs
• Nursing faculty seeking to establish clinical rotations in a
nursing home
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Benefits to a Nursing Home
When Serving as a Clinical Placement Site
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Staff Recruitment and
Retention
Mentoring
Recruitment tool
Potential for faculty
appointment
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Staff Development
Access to academic resources,
e.g. library, CE courses
Access to courses
Potential for presentations and
publications
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Adoption of Best Practices
Collaborative faculty/staff
review of practice
protocols
Faculty /staff rounds and chart
reviews
Participation in research
Visibility in the Community
Recognized as teaching site
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Entry Level Nursing Student Learning Goals that Can be
Met by Clinical Placements in a Nursing Home
Professional attitudes, values, and expectations
about physical and mental aging in providing residentcentered care
 Resident-directed care and culture change
 Resident assessment using valid and reliable tools
 Strategies to prevent, identify and manage geriatric
syndromes
 Planning resident-centered care with consideration
for mental and physical health and well being of
informal and formal caregivers
 An appreciation of the interdisciplinary team
 Leadership and management
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© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Graduate Level Nursing Student Learning Goals that
Can be Met by Clinical Placements in a Nursing Home
• Assess the health status of physically and mentally frail older adults
• Assess the impact of family and the environment on a frail older
adult’s health status
• Screen for, treat and manage acute and chronic mental health
problems and disorders
• Identify typical and atypical presentations of health problems
• Determine decision-making capacity of residents
• Adapt teaching-learning approaches for frail older adults
• Provide educational experiences for caregivers and health
professionals
• Participate in an interdisciplinary team
• Translation of research into practice
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Factors Faculty See as Important in Selecting a
Nursing Home as a Clinical Placement
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Excellence in quality of care
 CMS 5 or 4 Star rating
 High quality measures & minimal deficiencies
 Outside accreditation (Joint Commission; CARF)
Stable nurse staffing and leadership
Involvement of advanced practice nurses (APRNs)
Resident-directed care/culture change
Effective interdisciplinary team
Commitment to the use of evidence-based practices
Willingness to facilitate innovative learning experiences
 Administer medications to a group of residents
 Serve as a team leader for a group of residents
 Develop and implement a quality improvement
project
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Why a Nursing Program May Preferentially Select a Nursing
Home Involved in Culture Change as a Clinical Site
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Observe staff using effective
communication skills with residents
Observe adapted daily routines
and “person-directed” care
practices to accommodate resident
preferences
Appreciate the importance of
consistency of caregivers on
resident outcomes
Participate in a team approach that
includes residents and families in
shared problem-solving, decisionmaking and planning
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Nursing Program Characteristics of
Importance to a Nursing Home
Extent and quality of the course
offerings in geriatric nursing
 Clinical preparation of the faculty in
geriatrics and in nursing home care
 Types of research in geriatric nursing
 Continuing education offerings in
geriatrics
Opportunities for clinical faculty
appointments for NH staff
 Length of time of the clinical
placement in the nursing home
 Personnel to help the NH develop
contracts and collaborative arrangements
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© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Nursing Program’s Website as Source of Information
about the Geriatric Program
Key items to look for when reviewing a nursing
program’s website are:
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Program mission and goals
Undergraduate and graduate course offerings n
geriatrics
Faculty credentials
Continuing education offerings in geriatrics
University-wide geriatric programs (Geriatric
Education Center (GEC); a Center on Aging)
Program’s contracts office
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Assessing a Nursing Program’s Readiness to
Partner and Collaborate with a Nursing Home
Faculty are willing to:
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Provide constructive feedback about nursing practice in
the NH
Hear nursing home feedback about student activities in
the NH
Learn about &/or teach principles and processes of a
professional nurse practice model and residentdirected care to NH staff
Nursing Program is willing to:
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Discuss expectations and measurable goals associated with
use of the nursing home as a clinical site.
Provide NH staff access to library and other resources (e.g.
electronic; seminars)
Share teaching materials related to student clinical
experience
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Congruency of Nursing Programs Goals and a Nursing
Home’s Capacity to Serve as a Clinical Site
Congruency can include consideration of the following:
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The fit of the philosophy of nursing of the nursing program and the NH
– Will the nursing students be in the NH for a sufficient length of time to establish a
relationship with residents and staff and to learn about nursing in LTC?
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Extent to which the NH can meet the nursing program goals for a clinical
placement
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Whether the NH has structures and policies that facilitate the student
learning experience without excessive burden on the NH staff
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Markers of the extent to which the use of the NH as a clinical site can be a
mutually rewarding/enlightening experience for students and staff
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Becoming a Clinical Placement Site: Preparing
the Nursing Home Staff and Residents
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Discuss with staff the purpose of the
affiliation, e.g. why the nursing home
was selected and expectations of it as
a clinical site
 Mentoring/teaching role of RN, LPN,
CNA, Nurse Manager, MDS,
Coordinator, in-service educator
 Student presence at/participation in
care planning meetings; willingness
to have students “shadow” staff
 Knowledge and experience with
interdisciplinary teams
 APRN and physician involvement
Work with residents and families to
make sure they understand the
student role and how they can support
the student’s experience
 Resident & Family Council
 Individual residents
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Arrange for faculty & student
amenities:
 Meeting space for student
 Class rooms
 Secure placement of outer garments,
purse, etc
 Student and faculty Immunizations
and other safety requirements
 Parking spaces, if needed
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Arrange for technology needs
 Computer terminal w/Internet access
 Electronic medical records (if
available)
 MDS access
Review policies necessary for
collaboration/partnering with the
nursing program
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© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Becoming a Clinical Site: Preparing Faculty about
Nursing Home Policies and Procedures
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Resident and family introduction to
students and faculty
Student administration of
medications and treatments
Student and faculty communication
 Assessment findings
 Resident change of condition
 Resident special requests
and/or resident complaints
 Medication and/or treatment
error
 Absence from, or late to, the
clinical day
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Becoming a Clinical Site: Orientation of
Students and Faculty
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Resident Rights; Ombudsman
role
Resident-directed Care
NH Table of Organization/Role &
Responsibilities
The interdisciplinary team
Survey and inspection process
Fire and Safety
APRN involvement in care
Record keeping/documentation
(including the electronic health
record and MDS)
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Geriatrics in Nursing Education:
Sources of Information
American Academy of Colleges of Nursing (AACN) Essentials of
Baccalaureate Education (2009)
Older Adults: Recommended Baccalaureate Competencies and
Curricular Guidelines for Geriatric Nursing Care. AACN and Hartford
Institute for Geriatric Nursing. (2010) http://www.aacn.nche.edu
American Nurses Association (ANA) Scope and Standards of Practice
of Gerontological Nursing (Generic and Advanced Practice)
http://www.NursingWorld.org
The Hartford Institute for Geriatric Nursing (modules for nursing faculty
to strengthen clinical rotations in nursing homes)
http://www.HartfordIGN.org
National Gerontological Nurses Association https://www.ngna.org
American Nurses Credentialing Center (ANCC) Gerontological Nursing
Certification http://www.nursecredentialing.org/Certification.aspx
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Self-Assessment of Readiness to be a
Clinical Site
A Nursing Home’s Readiness to Serve as a Clinical Placement Site
for Nursing Students:
Checklist for a Nursing Home
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing
Recap: Key Points for Nursing Homes Preparing to be
Clinical Sites for Nursing Students
A
nursing home can serve as valuable
clinical placement for nursing students,
but the process requires planning and
reflection
Self-
examination can help a nursing
home assess their readiness to serve as
a clinical site
A
nursing home should expect to both
give and gain from serving as a clinical
site
Preparing
the residents, staff and family
can markedly enhance a nursing homes
experience as a clinical site
© 2010 The Hartford Institute for Geriatric Nursing and The American Association of Colleges of Nursing