NGNA-PositionPaperMandatoryGerontologicalNursingEducation

8/10/2019 NGNA-PositionPaperMandatoryGerontologicalNursingEducation

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NGNA: Position Paper on Mandatory

Gerontological Nursing Education in all

Registered Nursing Programs and

Gerontological Nursing ContinuingEducation for all RNs in the US

Jane Nunnelee PhD. RN-BC, GNP

Introduction/Problem Statement

The intent of this position statement is to affirm the need to mandate that all registered nursing

education programs offer stand-alone didactic and clinical courses in Gerontological nursing as

part of the undergraduate curriculum. Further, that all registered nurses should be required to

participate in a geriatric continuing education event for continued licensure. All nurses will care

for older adults during their career either professionally or personally regardless of their

specialty. The challenge of the 21st

century for nursing is to educate the profession about the

geriatric population for best practice.

Rationale and Supporting Information

The 21st

century brings a dramatic gain in the aging population globally. Anticipation of the

aging population has spawned numerous concerns for health care. Health care professionals

need to be prepared educationally to care for the older adult population and their unique

needs. The normal process of aging tends to be complicated with the atypical presentation of

diseases which often are under detected with poor outcomes. With a third of baccalaureate

nursing programs offering a stand-alone didactic course in Gerontological nursing, two-thirds of

nurses are missing the knowledge they need to understand and care for this unique population.


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Gerontological nursing must be a required element of training for the next generation of health

care professionals.

In the early part of the 20th

century, pediatrics gained approval to be taught as stand-alone

didactic and clinical courses. The institutions that trained health care workers in the 20th

century responded to the demographics and embraced the need to prepare the health

professional in pediatrics it was a requirement for all nursing and medical programs to have

pediatric rotations and courses. The time has come for a similar commitment to recognize

gerontology/geriatrics and its uniqueness with the appropriate course and clinical for all

nursing students to experience.

To date, there are approximately 1% of registered nurses and 3% advanced practice nurses

certified in Gerontological nursing in the U.S. Since nurses play a critical role in the care of

older adults in various settings of health care, it is vital to promote education in this specialty

area. Nursing schools must raise the profile of Gerontological nursing to attract the new nursesin this field and create collaborative relationships with community healthcare facilities and

institutions. There is an essential need to be proactive in the approach to moving evidence-

based clinical knowledge into practice settings.

The age of 65 has traditionally been considered the beginning of the senior years in the US

because of Social Security and Medicare. The U.S. Census Bureau reported that Americans over

the age of 65 years make up 13% of the population today. By the year 2030, older adults will be

20% of the total population. The growth in the numbers of older adults is unprecedented in the

history of the US and the world. This flourishing of growth is due to the Baby Boomer

generation entering 65 years of age in 2011 and continuing to infiltrate older age through 2030

with a doubling in numbers, becoming one in five Americans.

An aging population means that nursing has an obligation to understand aging and the older

adult. Understanding of normal physiology of aging along with chronic illness and disabilities is

vital in the care of this population. Approximately, 80% of older adults have one chronic health

condition with 50% having at least two. Medicare has begun to hold healthcare facilities

responsible for the errors made with the older population. In 2008, Medicare issued a list of

number of health care mistakes and other preventable situations they will no longer pay for if

the claims are submitted. Medicare will not pay for complications that are preventable. This is astrong financial indicator that health professionals must be educated in the proper care of this

population.

The American Association of Colleges of Nursing noted that approximately 63% of newly

licensed registered nurses work predominately with older adults in their patient load. Further,

older adults care represents 50% of hospital days, 60% of all ambulatory adult primary care


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visits, 70% of home care visits, and 85% of skilled care facilities residents. It is anticipated that

strong job opportunities in clinical practice will be with the older population. We are woefully

unprepared to care for the older population in health care due to the lack of clinical knowledge

and education for the uniqueness of their health-related needs.

In general, graduate nurses need the Gerontological nursing perspective to practice successfully

with the older population to avoid errors in care. Best practices are formed in the

undergraduate nursing programs and must include mandatory didactic and clinical in

Gerontological nursing. Education at the basic level of nursing education and on-going

continuing education must be mandatory for best clinical practice in Gerontological nursing.

Research shows that nurses with preparation and education in geriatrics/gerontology provide

measurably improved care to older adults. When nurses are prepared in both geriatrics and

other specialties such as medical-surgical nursing, this becomes profitable to hospitals and the

community.

All Registered Nurses should and must recognize the physiological, cognitive, psychological,

social changes, and atypical presentations of disease associated with aging and understand that

age alone puts older adults at risk for complications. Since older adults care is complicated due

to usual aging physiological changes coupled with increased incidence of chronic health

conditions, Registered Nurses and Advanced Practice Nurses need to achieve competency in

Gerontological nursing to deliver best practice care. It is strongly advised for Registered Nurses

to seek National Certification to benefit the population of patients served. Raising the standards

of nursing care for older adults through undergraduate education and continuing education for

practicing nurses will ensure that older adults will age with optimal function, comfort, care anddignity.

The Affordable Care Acts goal is to improve the delivery of health care for every American. The

financial incentive and dignified quality care are two motivating constituencies to set this

position in motion. To move forward, American Nurses Association, Board of Nursing in each

state, Medicare and Medicaid (CMS), health care organizations stakeholders (hospitals, clinics,

community agencies), and all professional nursing organizations must strive to adopt this

position and demand Gerontological/geriatric knowledge and skills for the improved care of

older adults by nurses and must provide incentives for adoption for best practices. Together,

we can improve care for this older population and allow dignity and best care practices for all

older adults.

Recommendations

Registered Nursing Programs institute a 3 hour didactic Gerontological stand-alone

nursing course for all undergraduate nursing students by 2013.


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Registered Nursing Programs institute a 3 hour clinical course in geriatrics for all

undergraduate nursing students by 2013.

All practicing nurses in the U.S. participate in a 2 hour minimum continuing education

class on a geriatric topic every year for relicensure in each state.

Registered Nursing Program Faculty teaching adult/geriatric course participate in a

Geriatric continuing education program are encouraged to seek national certification in

Gerontological nursing or annual continuing education in Gerontological nursing.

References:

American Association of Colleges of Nursing /John A. Hartford Foundation (March 2006). Caring

for an Aging America: A Guide for Nursing Faculty. Washington, D.C.

http://www.aacn.nche.edu/geriatric-nursing/monograph.pdf

Census, U.S. (2011). Facts for features: Older Americans Month: May 2011.

http://www.census.gov/newsroom/releases/archives/facts_for_features_special_editio

ns/cb11-ff08.html

Fagin, C., Franklin, P. (2005). Why Choose Geriatric Nursing? Geriatric Nursing,

September/October 2005, 72-76.

http://www.nsna.org/Portals/0/Skins/NSNA/pdf/Imprint_SeptOct05_geriatric_fagin.pdf

Hartford Institute for Geriatric Nursing. (2011). Hartford Geriatric Nursing Initiative (HGNI).New

York.http://consultgerirn.org/resources/hartford_geriatric_nursing_initiative_hgni/

Committee on the Future Health Care Workforce of Older Americans, Institute of Medicine

(2008). Retooling for an Aging America: Building the Health Care Workforce.

www.iom.edu/agingamerica

Mezey, M., Fulmer, M. (2002). The Future History of Gerontological Nursing. Journal of

Gerontology: Medical Science, Vol. 57, No. 7, 438-441.

National Center for Chronic Disease Prevention and Health (2009). Healthy Aging Improving and

Extending Quality of Life Among Older Americans.

http://www.cdc.gov/nccdphp/publications/aag/pdf/healthy_aging.pdf

Medical Negligence: The Role of Americas Civil Justice System in Protecting Patients Rights. (

2011).

http://www.justice.org/resources/Medical_Negligence_Primer.pdf
http://www.aacn.nche.edu/geriatric-nursing/monograph.pdfhttp://www.aacn.nche.edu/geriatric-nursing/monograph.pdfhttp://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb11-ff08.htmlhttp://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb11-ff08.htmlhttp://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb11-ff08.htmlhttp://www.nsna.org/Portals/0/Skins/NSNA/pdf/Imprint_SeptOct05_geriatric_fagin.pdfhttp://www.nsna.org/Portals/0/Skins/NSNA/pdf/Imprint_SeptOct05_geriatric_fagin.pdfhttp://consultgerirn.org/resources/hartford_geriatric_nursing_initiative_hgni/http://consultgerirn.org/resources/hartford_geriatric_nursing_initiative_hgni/http://consultgerirn.org/resources/hartford_geriatric_nursing_initiative_hgni/http://www.iom.edu/agingamericahttp://www.iom.edu/agingamericahttp://www.cdc.gov/nccdphp/publications/aag/pdf/healthy_aging.pdfhttp://www.cdc.gov/nccdphp/publications/aag/pdf/healthy_aging.pdfhttp://www.justice.org/resources/Medical_Negligence_Primer.pdfhttp://www.justice.org/resources/Medical_Negligence_Primer.pdfhttp://www.justice.org/resources/Medical_Negligence_Primer.pdfhttp://www.cdc.gov/nccdphp/publications/aag/pdf/healthy_aging.pdfhttp://www.iom.edu/agingamericahttp://consultgerirn.org/resources/hartford_geriatric_nursing_initiative_hgni/http://www.nsna.org/Portals/0/Skins/NSNA/pdf/Imprint_SeptOct05_geriatric_fagin.pdfhttp://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb11-ff08.htmlhttp://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb11-ff08.htmlhttp://www.aacn.nche.edu/geriatric-nursing/monograph.pdf


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Department of Health and Human Services: Office of Inspector General. (November 2010).

Adverse Events in Hospitals: National Incidence among Medicare Beneficiaries.

http://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf
http://oig.hhs.gov/oei/reports/oei-06-09-00090.pdfhttp://oig.hhs.gov/oei/reports/oei-06-09-00090.pdfhttp://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf

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