Residency Programs for Home Health and Hospice Nurses

Abstract

The Institute of Medicine’s report, “The Future of Nursing: Leading Change, Advancing Health,” calls for “transition-to-practice” residencies for new nurses and nurses transferring to new types of settings. In this study, we examine the current residency landscape for home health and hospice nurses and compare it with responses from their peers in hospitals and nurse-led primary care clinics. We find that just 2% of surveyed home health and hospice settings offer residencies, while almost 49% of hospitals and 11% of nurse-led primary care clinics provide them. Major barriers cited include lack of available preceptors and financial costs. We discuss ways in which the federal government could help spur the development of residencies in this sector.

Implementation and Evaluation of a Home Healthcare Nursing Transition-to-Practice Pilot Program

“…Because only 2.2% of HHC agencies offer nurse residency programs (Pittman et al, 2014), PMAH nursing leaders (including the NPDS) reviewed the literature and CCNE standards and consulted with the health system nurse residency program director to develop a framework for the development of an 18-month program. Because PMAH utilizes a team-based approach to care delivery composed of various disciplines including physical, occupational and speech therapy, psychosocial services, and pharmacy, interprofessional education was essential for promoting collaborative teamwork known to be linked to improved health outcomes (Meterko et al, 2004; World Health Organization [WHO], 2010).…”

The Future of Home Health Care

“…Studies have raised a number of concerns related to the home health workforce, particularly for registered nurses (RNs), including turnover and clinical training in skilled areas of care. 30 One study identified nursing residency programs as an opportunity to gain skills and reduce turnover, but found that the prevalence of these programs in home health and hospice providers was relatively low (only 2.2% vs. 42.9% for hospitals). 30 The IOM workshop on the future of home health raised additional concerns about the home health workforce, including availability of family caregivers, changing demographics of care workers and patients, the need to improve geriatrics training among the home health workforce, the need to address low wages and benefits, and the overall health of the U.S. economy.…”

“…30 One study identified nursing residency programs as an opportunity to gain skills and reduce turnover, but found that the prevalence of these programs in home health and hospice providers was relatively low (only 2.2% vs. 42.9% for hospitals). 30 The IOM workshop on the future of home health raised additional concerns about the home health workforce, including availability of family caregivers, changing demographics of care workers and patients, the need to improve geriatrics training among the home health workforce, the need to address low wages and benefits, and the overall health of the U.S. economy. 1 The workshop describes the Department of Veterans Affairs' (VA) homebased primary care as a comprehensive model, one in which care is provided by an interdisciplinary team of nurses, physicians, social workers, rehabilitation therapists, dieticians, pharmacists, and psychologists.…”

Adaption of the Casey-Fink Survey Tool for Nurse Residency Programs

“…3 Despite the existence of doctoral and physician assistant postgraduate hospice and palliative care residency programs, there are very few transition-to-practice programs for new nursing graduates in this specialty field. 1,4 In addition, the End-of-Life Nursing Education Consortium (ELNEC), which was established to provide educators with the tools and information necessary to ensure both undergraduate nursing students and postgraduate RNs receive the appropriate education and training to confidently transition to everyday practice, routinely seeks professional-level feedback to inform biannual updates to the core competencies and content within the ELNEC curriculum across several practice areas (eg, critical care, geriatric, pediatric, oncology, and veterans). 5 Despite the obvious need for a feedback loop between practicing end-of-life care workers and educational and training programs, there is currently no standardized assessment of professional growth and confidence in nurses who work in specialty hospice and palliative care settings that can be used to inform the development and availability of much needed transitional training for future hospice and palliative care nurses.…”

“…As many as 87% of nurses across all specialty fields reported burnout and 83% reported their mental health suffered, numbers which may have been exacerbated by the lack of preparation recent graduates felt they received for providing end-of-life care 3 . Despite the existence of doctoral and physician assistant postgraduate hospice and palliative care residency programs, there are very few transition-to-practice programs for new nursing graduates in this specialty field 1,4 . In addition, the End-of-Life Nursing Education Consortium (ELNEC), which was established to provide educators with the tools and information necessary to ensure both undergraduate nursing students and postgraduate RNs receive the appropriate education and training to confidently transition to everyday practice, routinely seeks professional-level feedback to inform biannual updates to the core competencies and content within the ELNEC curriculum across several practice areas (eg, critical care, geriatric, pediatric, oncology, and veterans) 5 .…”