Caregiving and dementia/Projects/Dementia nursing competencies

Overview
Nurses working in specialities such as intensive care, paediatrics and cancer have striven to improve their standards of practice and to bring about consistency in their education by developing competency frameworks [6]. This project extended this approach into the area of dementia care by establishing a competency framework that will inform the education, recruitment, clinical practice and performance monitoring of RNs providing specialist care for people with dementia.

The competency framework was used to guide the design of the Post Graduate Certificate in Dementia Care Nursing being developed by the NSW/ACT DTSC.

This project resulted in the publication of a set of evidence based competencies for RNs engaged in the care of people with dementia.

A project undertaken for the Primary DCRC by Professor of Nursing Lynn Chenoweth from the University of Technology Sydney (UTS), Professor of Nursing and Dean of the Faculty of Health and Behavioral Sciences in the UoW and Associate Professor of Nursing Victoria Traynor from the UoW has drawn attention to the benefits that would flow on from the development of a competency framework describing the characteristics of a RN specializing in the care of people with dementia [3, 7]. This work is in keeping with desire of other nursing specialties to define their areas of specialization and to establish standards for quality care [6].

The advantages of establishing such a framework have been identified as:-
 * 1) Contributing to the development of a nursing workforce capable of meeting the current and future needs of people with dementia.
 * 2) Informing the development of a nationally recognised dementia nursing curriculum that will be sufficiently flexible to meet local needs whilst addressing issues associated with long-term workforce preparation.
 * 3) Contributing to standardising the wide variation in scope and levels of practice within the nursing profession.
 * 4) Assisting the health and aged care industry develop selection criteria for the appointment of nurses who will be responsible for the provision of specialised care to people with dementia.
 * 5) Providing a foundation for the development of assessment tools and methods for demonstrating ongoing competence.

There is a growing retention problem in aged care. The Productivity Commission Draft Report, 2011, stated that “Despite an increase in the workforce overall, the number of full-time equivalent registered and enrolled nurses working in RACFs decreased from 27,210 to 23,103 between 2003 and 2007 (Table 11.2). This represents a decrease from 35.8% to 29.3% of all full time equivalent direct care employees in only four years, with most of the reduction occurring at the RN level.”

While it is readily accepted that one of the driving forces behind this reduction in the presence of RN is the relatively poor pay available in the aged care sector, research has also indicated that the lower status of aged care nurses compared with their acute and community nurse counterparts contributes significantly to the poor retention figures [8].

It is anticipated that the development of a competency framework that will lay the foundation for the recognition of the specialty of ‘dementia nurse’ will go some way to improving the status of RNs in this field and therefore make a contribution to improving retention.

The need for this project is therefore supported by the views of eminent nursing academics as put forward in publications commissioned by the Primary Dementia Collaborative Research Centre (DCRC) and independent research on factors contributing to the decline in the numbers of RNs working in aged care. It is a fundamental step towards the professionalisation of the nursing work force.

More information

 * 1) TBA