Expert Geriatric Nurses Advocate for US Nursing Home Reform

Building on recommendations released last fall by the Centers for Medicare and Medicaid Services’ Coronavirus Commission for Safety and Quality, expert geriatric nurses writing in Nursing Outlook put forth additional guidance to assist federal policymakers in efforts to reform nursing home care. 

“As expert geriatric nurses, we make four recommendations to federal policymakers that build on commission recommendations so that they are more than a temporary solution. These recommendations are made to help ensure that quality care becomes a reality,” wrote the authors, who are associated with schools of nursing at a half-dozen universities across the United States. 

The article recommends around-the-clock registered nurse (RN) coverage in nursing homes, adequate compensation to maintain staffing levels based on the care needs of residents, and ensuring RNs have geriatric nursing and leadership skills. According to the article, many RNs currently working in nursing homes do not have the specialized knowledge necessary to deliver competent care to older residents. 

Additionally, the authors call for increased efforts to recruit and retain RN staff in nursing homes. Although the commission called for expanding the certified nursing assistant workforce in its recommendations—advice the authors agreed with—it failed to consider the chronic shortage of RNs in nursing homes, they pointed out. 

Finally, the authors recommend federal policymakers support care delivery models that strengthen the RN role. Doing so would promote quality resident-centered care in nursing homes, they explained. 

“Focusing on the care delivery system, as well as the professional development and practice environment needs of RNs, has the potential to address other issues plaguing nursing homes—specifically recruitment and retention of RNs. When RNs can practice in an environment that supports professional nursing practice, turnover decreases and retention increases…” they wrote. “Thus, if the quality of nursing home care is to be improved, it is imperative to strengthen the RN practice environment in nursing homes.” 

—Jolynn Tumolo

Reference:

Bakerjian D, Boltz M, Bowers B, et al. Expert nurse response to workforce recommendations made by the coronavirus commission for safety and quality in nursing homes [published online ahead of print, 2021 Apr 5]. Nurs Outlook. 2021;S0029-6554(21)00091-9. doi:10.1016/j.outlook.2021.03.017