Gerontologic competence of RNs.
RNs in nursing homes are 48% associate-, 25% diploma-, and 22% bachelor of science in nursing-prepared. Most have no preparation in geriatric nursing. Gerontologic certification is tangible evidence of competence for both the facility and the individual RN. According to the American Nurses Credentialing Center (ANCC), approximately 14,000 RNs are currently certified in gerontologic nursing. This represents less than 1% of all RNs.
The ANCC now offers its gerontologic nursing certification examination in a computer-based format, available seven days a week in more than 200 sites nationwide (http://www.nursecredentialing.org/certification/cert/certs/specialty.html). This change is part of Nurse Competence in Aging (NCA), an initiative of the ANA, the ANCC, and the John A. Hartford Foundation Institute for Geriatric Nursing at New York University, to incorporate a geriatric presence and enhance competence in aging in more than 50 specialty nursing associations, with membership of more than 400,000 nurses (http://www.geronurseonline.org).
Information on the care of frail older adults, as well as a free online course to help nurses prepare for ANCC gerontologic certification, is available at http://www.hartfordign.org.
Gerontologic competence of advance practice nurses.
Advance practice nurses (APNs) have been shown to significantly improve the care of older adults in nursing homes. Yet according to a spokesperson at the ANCC, only approximately 3,400 APNs have gerontologic certification, representing less than 6% of all APNs. Only a few APN programs specialize in geriatrics, and other nurse practitioner (NP) and clinical nurse specialist (CNS) programs lack standards for geriatric content. In 2004 the American Association of Colleges of Nursing (AACN) addressed the standardization issue by publishing competencies for NP and CNS programs in gerontologic nursing (http://www.aacn.nche.edu/Education/Hartford/OlderAdultCare.htm). Necessary competence in nursing care of older adults is consistent with the recommendations of an expert panel convened by the Hartford Institute and the Coalition for Geriatric Nursing Organizations. Recognizing the AACN competencies, the panel called for educational programs preparing family and adult NPs and CNSs to require gerontologic content.-Sarah Greene Burger, RN-C, MPH, FAAN
Sources: American Nurses Credentialing Center. 2003. http://www.nursingworld.org/ancc/certification/cert/certfaqs.html; Kane RL, et al. J Am Geriatr Soc 2003;51(10):1427-34; Spratley E, et al. 2000. http://bhpr.hrsa.gov/healthworkforce/reports/rnsurvey/rnss1.htm#14; Berlin L, et al. 2002-2003 enrollment and graduations in baccalaureate and graduate programs in nursing. Washington, DC: American Association of Colleges of Nursing. 2003.