Float and Travel Nursing Staff Lacked Required LTC Competency Training
Penalty
Summary
The facility failed to ensure that float and travel nursing staff possessed the necessary job-specific competencies and skill sets required to care for long-term care (LTC) residents. Record review revealed that a significant number of float and travel nursing staff did not have current LTC training in key areas, including Activities of Daily Living (ADL) Coding and Definitions, Behavioral Health (BH), Quality Assurance Performance Improvement (QAPI), Dementia care, and Trauma Informed Care. Specifically, out of 20 nursing staff personnel files reviewed, 17 lacked current training in ADL Coding and Definitions, BH, QAPI, and Trauma Informed Care, while 11 lacked current training in Dementia care for LTC. Interviews with facility staff, including the Clinical Nurse Educator and House Supervisor, confirmed that the only tracked and required training for float staff assigned to the LTC unit was related to abuse and neglect. The Clinical Nurse Educator was unaware of the requirement for dementia-specific modules, and float staff did not complete the same training as core LTC staff. One float nurse stated that only general orientation was provided, with no education on dementia care, trauma-informed care, or cultural competency prior to working in the LTC unit. Review of facility policies and training modules showed that the facility had established training programs for ADL coding, behavioral health, QAPI, dementia care, and trauma-informed care, all of which are critical for providing appropriate care to LTC residents. The facility assessment indicated that a majority of residents required assistance with ADLs and that several residents had behavioral health conditions, including dementia, depression, anxiety disorders, schizophrenia, and PTSD. Despite these needs, the lack of required training for float and travel staff placed all residents at risk of not receiving the necessary specific treatment and care to attain or maintain their highest practicable well-being.