Nursing Competence in Geriatric and/or Long Term Care Curriculum Development for Baccalaureate Nursing Program: A Systematic Review

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1 Presenter : Pei-Lun Hsieh

Authors: 1 _{Pei-Lun Hsieh,}2 _{Ching-Min Chen}

1 _{MSN, RN, Doctoral Student, Institute of Allied Health Sciences,}

College of Medicine; 2_{DNS, RN, Professor, Department of}

Nursing,

National Cheng Kung University, Tainan, Taiwan 2016/08/16

Nursing competence

in

Geriatric

and/or

Long Term Care

Curriculum

Development for Baccalaureate Nursing

Program:

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Sources: 1. Ministry of the Interior, “2013 Demographic Fact Book R.O.C.”

2. National Development Council, “Population Projections for R.O.C. (Taiwan)

Note: Dependency ratio = ( ( Age 0-14 + Age 65+ ) / Age 15-64 ) x 100% Potential support ratio = Age 15-64 / Age 65+

Population Projections for R.O.C. (Taiwan):

2014~2060

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Research Gap

 Few nursing students have been exposed to

specialized knowledge about care of older adults or disable people.

 Lack of nursing care competence of older adults or

disable people.

 Lack of standards of geriatric long-term care nursing education curriculum investigation.

Geriatric Long Term Care (GLTC) education……

 All student nurses do not have the gerontology or long

term care knowledge, and experience to address this issue.

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Purpose



To

review

and

discuss

the current

geriatric and long term care curriculum

in baccalaureate nursing programs.



To

explore

the nursing program of

curriculum design

,

, and

effectiveness

in student’s

knowledge,

attitude, clinical practice and nursing

competence of GLTC

.

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Data sources and search strategy

Inclusion criteria

• (1) articles published from January since 2000 between 2015 • (2) quasi-experimental, cohort, cross-sectional survey, or qualitative studies; • (3) peer-reviewed research; • (4) research was on GLTC curriculum/program/course for undergraduate nursing student;

• (5) English or Chinese language

Exclusion criteria • Research focusing on educating for registration nurses or nurse petitioners 5 Keywords through database searching:

“geriatric nursing curriculum”, OR “long term care curriculum”, AND

“effect” “impact” “influence”, “baccalaureate", "nursing student”, “ Knowledge “, “ Attitude “, ” competence”

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6 Articles on synthesis:

They were all published in 2004 between 2015. Quasi -experimental (3): Knowledge, Attitude Cross-sectional (13): program development, clinical practice, knowledge, teaching strategy, competence Qualitative (2): Attitude PRISMA checklist flow diagram

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Results

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Research Background US, Hong Kong,

Belgium, Canada and United Kingdom (UK) Knowledge & Attitude Clinical Care Practice, Experience Faculty development & Teaching strategy GLTC Core Competency GLTC Curriculum

(Baumbusch et al., 2012; Aud et al., 2006; Lo, Lai, & Tsui, 2010; Deschodt, Casterl, & Milisen, 2010; Brown, Nolan, Davies, Nolan, & Keady, 2008; McLafferty, 2005; Ryan, & McCauley, 2004);

(Aud et al., 2006; Shellman, 2007; Deschodt et al, 2010; Rebecca, Beel-Bates, & Jensen, 2008; Brown et al., 2008; Xiao, Paterson,

Henderson,& Kelton, 2008; Blais, Mikolaj, Jedlicka, Strayer, & Stanek, 2006)

(Berman et al., 2005)Plowfield, Raymond, & Hayes, 2006; Burbank, Dowling-Castronovo, Crowther, & Capezuti, 2006 ).

(Aud et al., 2006; Shellman, 2007; Plowfield, Raymond, & Hayes, 2006)

Characteristics and Description of the Studies

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Geriatric Long Term Care (GLTC)

Course

 Credit hours:

Theory--> 2 to 3; Clinical practice0 to 3.

Total course credits ranged from 2 to 6 credits in the complete the baccalaureate curriculum.  offered in third (Junior) - and

fourth (Senior) -year bachelor nursing studen t 76% Stand-alone course

 Elective course 24 %  Didactic component:

Risk assessment of illness associated with old age

Human development, Nutrition, Pathology, and Pharmacology Chronic health problems exacerbated of aging

 Teaching strategy: classroom lecture and discussion,

videotapes and service learn in long term care fields.

(Aud et al., 2006; Deschodt et al, 2010; Gilje, Lacey, & Moore, 2007; Lo, Lai, & Tsui, 2010; Deanna et al., 2014; Plowfield et al., 2006; Gilje, Lacey, & Moore, 2007; Lo, Lai, & Tsui, 2010).

9

Faculty

development Teaching

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of

Geriatric Nursing and Long Term Care

• Most of knowledge integrated in GLTC course.

•

Knowledge of GLTC including:

Health promotion & Disease prevention, illness and disease management,

information and health care technologies, ethics, human diversity, global health care,

health care systems and policy

•

Knowledge would

increase

among students

taking the geriatric nursing or long term care course.

Knowledge

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Attitude

of geriatric nursing and

elderly care

• Clinical placement in LTC facilities (such as nursing home, day care center and community-based care or home care) has been found to

improve nursing students’ negative attitudes toward the elderly and disability people.

• Clinical placements that focus on the

generational differences in ways of learning and

perceiving may enhance positive attitudes toward

older adults.

Ex: service learning experience

Attitude

(Baumbusch et al., 2012; Aud et al., 2006; Ryan, & McCauley, 2004; Blais et al, 2006; Deschodt et al., 2010; Plowfield et al., 2006) 11

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• Clinical component & practicum placement offered

about 40%.

• Time: 32 to 348 hours.

• Clinical practicum settings: nursing homes (100%),

hospitals or residential or day-care (60%),

community-based care or home care (44-60%). • The clinical component: skilled assessment,

monitoring of chronic conditions, and identification and treatment of acute conditions, and promotion of health and safety of the health of older adults or

disabled patients.

Clinical Care Practice Experience

(Aud et al., 2006; Deanna et al., 2014; Deschodt et al., 2010; Plowfield et al., 2006) 12

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Core competency &

Role development of GLTC

GLTC Competency Illness management Assessment Communication Critical thinking Member of a profession Designer, manager, and coordinator of care Providers of care Technical skills

(Berman et al. 2005; Aud et al., 2006; Gilje et al., 2007; Deanna et al., 2014; Deschodt et al., 2010; Plowfield et al., 2006). GLTC Core Competency 13

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Outcome of GLTC curriculum



The outcome of geriatrics and long term care

curriculum, included:

Knowledge,

Attitude toward the elder and disable

people,

Nursing competence & role development

(Ryan,& McCauley, 2004; Gilje et al, 2007; Burbank, Dowling-Castronovo,

Crowther, & Capezuti, 2006; Aud et al., 2006; Deanna et al., 2014; Deschodt et al., 2010; Plowfield et al., 2006).

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Conclusion

 GLTC course must be recognized and

interdisciplinary education in baccalaureate

nursing curricula, and need to offer a determined

content on geriatric and disable care as a

foundation for learning experiences early in the curriculum.

 Pre-defined principles to measure the competence

of students, as criterion-referenced assessment students’ equitable and reliable test in GLTC.

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Thank you

Hsieh, Pei-Lun

National Cheng Kung University,

Tainan, Taiwan