The Effectiveness and Need for Facility Based Nurse Aide Training Competency Evaluation Programs.

Backgroundursing facilities (NF) are beleaguered with significant staffing issues at all levels of employees (Decker, Harris-Kojetin, & Bercovitz, 2009). Especially problematic is staff turnover, which is associated with poor quality of care and low staff morale (McGilton, Boscart, Brown, & Bowers, 2014). In practice, turnover appears to be systemic, with a top-down approach. Systemic turnover leads to licensed staff (e.g., nurses) turnover, which leads to subsequent attrition among direct care workers (e.g., nurse aides) (Brannon, Zinn, Mor, & Davis, 2002). Recognizing that nurse aides provide the bulk of direct care in NFs (Bowers, Esmond, & Jacobson, 2000), it becomes imperative that providers not only provide staff with an atmosphere conducive to employment, but also one that meets the specific needs of nurse aides as well.Nurse aide training opportunities, aimed at improving employee morale and job satisfaction, become especially important given that many NFs are plagued by increasing turnover, job dissatisfaction, unrealistic job expectations , and poor performance among nurse aides (Han, Trinkoff, Storr, Lemer, Johantgen, & Gartrell, 2014). Studies report that average annual turnover rates for nurse aides surpass 70% (Castle & Engberg, 2006; Decker et al" 2009). Exacerbating the problem is the significant contribution that nurse aides make to the provision of care of older adults. These employees endure stressful working conditions and little to no career mobility, and they are among the lowest paid workers in healthcare (Barry, Brannon, & Mor, 2005). It is believed that such compounding factors are the driving forces behind the high turnover with nurse aides in NFs.Researchers posit many theories to explain the difficulty of recruiting and retaining nurse aides. The industry recognizes that recruitment and retention problems exist, and it has investigated potential remedies for several years (Harris-Kojetin, Lipson, Fielding, Kiefer, & Stone, 2004). It was previously held that wages were the most significant factor contributing to issues of nurse aide recruitment and retention, however extant research has changed this thinking, and it is now widely accepted that nurse aides need an atmosphere of respect, advancement, and autonomy as employees to remain satisfied with their job (Barry et al., 2005; Sengupta, Ejaz, & Harris-Kojetin, 2012). The low state of nurse aide attitudes toward their job can also help explain the problems of recruitment and retention.Training, then, should serve as a catalyst of change to help redirect nurse aide's attitudes. At present, nurse aides are provided minimal training, and what is offered does little more than prepare them for rudimentary, on-the-job tasks and ensure they pass their state certification examination (Sengupta, Harris-Kojetin, & Ejaz, 2010). The minimal training should be more comprehensive to extend beyond basic skills into job-enhancing techniques, which may also bring a sense of empowerment into the workplace. For instance, providing nurse aides with training on decision-making empowers the trainee with autonomy to make decisions in the workplace, which should enhance workplace satisfaction (Chaudhuri, Yeatts, & Cready, 2013).Many facilities have levered a program called Nurse Aide Training and Competency Evaluation Programs (NATCEPs). This program is heavily regulated by state and federal regulations that govern over NFs. A significant barrier to utilizing the program is the ability of a facility to provide NATCEP training. This ability hinges closely upon the regulatory success of the facility, which involves the subjectivity of state and federal regulations and surveys. Certain occurrences in a facility, such as an extended survey, denial of payment, or certain civil monetary penalties can prohibit a facility from possessing or continuing a NATCEP program (Requirements for Long Term Care Facilities, 2011). …