University of Wisconsin–Madison

Is a Nurse Residency Program Right for You?

Research shows that nurse residency programs improve nurse retention, lower costs and improve nurse preparedness for safe and competent practice. Traditionally available only in acute care settings, Geri-Res offers the same benefits to long-term care organizations with a residency tailored specifically to nursing in the long term care practice environment. Geri-Res curriculum is appropriate for new nursing school graduates as well as experienced nurses new to long term care.

Next Level Nursing Starts Here

Geri-Res is turnkey, giving you everything you need to implement a world-class geriatric care nurse residency program. Two program components, Clinical Coach and RN Resident, leverage a mentor/mentee model to create the best learning environment for new nurse success. You appoint two experienced nurses within your organization to be the Geri-Res Clinical Coaches. The Clinical Coach prepares for a mentor role by going through six learning modules. The RN Resident goes through sixteen learning modules, one a week for sixteen weeks. Each module takes about 1 hour, and is paired with exercises, quizzes, and time with the Nurse Coach. The online format means curriculum modules can be accessed anywhere, anytime.

Elevating the Status of Long-Term Care Nursing

Geri-Res addresses the transition-to-practice gap often experienced by both new graduates and experienced nurses entering a long-term care practice setting. Geri-Res RN Residents learn geriatric care best practices, problem solving techniques, and communication strategies. Geri-Res Nurse Coaches learn how to successfully mentor new staff. Organizations using Geri-Res immediately begin to see improvements in nurse knowledge, confidence, and job satisfaction.

World Class Education for Long-Term Care Nurses

Logo for School of Nursing on blue wallThe Center for Aging Research and Education at the University of Wisconsin-Madison School of Nursing has worldwide recognition as a leader in developing innovative methods for improving the quality of care for older adults. Geri-Res translates current evidence into relevant and accessible workforce solutions for the contemporary long term care practice setting, bridging research and practice.

GERI-Res Curriculum

  • Geri-Res Clinical Coach Course Modules

    Module 1: Role of the Clinical Coach

    The Clinical Coach model for education has a long history dating back to the time of Florence Nightingale. Clinical Coaches serve as role models, educators, and socializers. Serving as resources and role models in one-to-one relationships, Clinical Coaches help socialize RN Residents to the nursing role through direct involvement in the teaching-learning process.

      • Clinical Coaches:

      • Partner with RN Residents to determine and modify learning needs and goals
      • Facilitate opportunities for safe and effective nurse resident practice
      • Provide RN Residents with feedback regarding clinical progress
      • Serve as professional role models by demonstrating and implementing nursing practice in long term care
      • Provide RN Residents with a socialization experience

    Module 2: What Clinical Coaches Should Know about New Long Term Care Nurses
    Module Objectives:

        • Discuss the readiness of new nurse hires to begin long term care practice
        • Define strengths and limitations of the long term care setting that may support or hinder success of the new nurse hired in your organization
        • Identify strategies to develop a supportive environment for nurses new to your organization

    Module 3: Adult Learning: How New Nurses Learn
    Module Objectives:

        • List three characteristics that are unique to adult learning
        • Describe strategies to effectively teach adult learners
        • List factors that facilitate nurse and those that limit learning and knowledge transfer

    Module 4: Helping New Nurses Learn Clinical Knowledge and Expertise
    Module Objectives:

        • Describe the concepts and importance of clinical grasp and clinical forethought.
        • List the nursing transition phases as described by Benner, Tanner and colleagues.
        • Describe strategies to teach new nurses to become strong nurse colleagues.

    Module 5: Helping New Nurses Learn Clinical Judgement
    Module Objectives:

        • Define the key components of clinical judgment.
        • Describe examples of how a new nurse demonstrates advanced clinical judgment.
        • Reflect on your own case examples where clinical judgment enhanced your clinical practice.

    Module 6: Helping RN Residents Learn Interdisciplinary Practice
    Module Objectives:

        • Understand the importance of the Clinical Coach role in promoting interdisciplinary practice (IDP)
        • Identify key components of effective interdisciplinary health professions practice
        • Identify when it is important for nurses to initiate interdisciplinary collaboration
        • Identify strategies to promote RN Resident learning interdisciplinary practice skills in the long term care setting

    Module 7: Providing Feedback to New Nurses
    Module Objectives:

          • State the importance of the Clinical Coach providing feedback
          • List a variety of effective methods for providing feedback
          • Discuss strategies for assessing whether feedback with the RN Resident has been effective

     

  • Geri-Res Nursing Home RN Resident Course Modules

    Module 1: Intro to Long Term Care
    Module Objectives:

    • Describe some of the recent changes in nursing home care;
    • List the types of long term care services available and the general profile of people needing these services;
    • Discuss how legislation affects long term care residents;
    • Identify the nurse’s many roles in long term care;
    • Describe the required skills and knowledge base for the long term care nurse;
    • Explain the quality assurance mechanisms used in long term care; and
    • Discuss financial issues impacting long term care residents, services, and organizations.

     

    Module 2: Resident Quality of Life
    Module Objectives:

    • Describe the legal and personal rights of the resident;
    • Define the multiple components of resident quality of life;
    • Summarize how care practices can interfere with resident quality of life; and
    • Discuss how to implement practices that support resident quality of life.

     

    Module 3: Communicating with the Team
    Module Objectives:

    • Describe why effective communication in long term care nursing is vital;
    • Identify communication skills and tools to use with CNAs and other health care providers to improve teamwork and care quality; and
    • Use communication skills to collaborate effectively with colleagues.

     

    Module 4: Communicating with Families
    Module Objectives:

    • Hear and appreciate what family members say without becoming defensive;
    • Understand where some family conflicts and concerns originate and how families evaluate quality of care;
    • Identify several strategies to overcome barriers and develop positive, collaborative relationships with family members;
    • Understand how families evaluate the quality of care;
    • Describe some of the areas in which both family and staff describe themselves to be primarily responsible;
    • Advocate for family members and residents where appropriate; and
    • Support family members in areas of concern.

     

    Module 5: Cultural Diversity
    Module Objectives:

    • Have a better understanding of how life course and culture shape experiences and circumstances throughout one’s life.
    • Be able to identify how culture and history influence a person’s perspective and experience.
    • Have increased awareness of how personal experiences and circumstances influence work and life within long term care settings.
    • Know how to apply the principles of person-centered care to engage staff and residents in supporting a culturally competent environment.

     

    Module 6: Sensory Changes
    Module Objectives:

    • Describe normal age-related changes in vision, hearing, taste, smell, and peripheral sensation experienced as a result of the aging process;
    • Identify factors that can lead to excess disability; and
    • Select interventions to assist with sensory challenges

     

    Module 7: Skin Health
    Module Objectives:

    • Articulate normal versus abnormal variations is skin health in older adults;
    • Care for aging skin;
    • Understand the effective systems and strategies for monitoring skin health in the nursing home setting;
    • Describe evidence-based approaches to treating common skin abnormalities; and
    • List situations where referral to a skin and/or wound specialist is indicated.

     

    Module 8: Pharmacological Considerations
    Module Objectives:

    • Describe how age-related physiologic changes and pathologies common in older adults impact medication absorption, distribution, metabolism, and excretion;
    • Identify risk factors for Adverse Drug Events (ADEs) in older adults;
    • Explain how polypharmacology impacts risk for adverse effects;
    • Recognize medications that are potentially harmful for older adults; and
    • Implement strategies to enhance the safety and efficacy of pharmacologic therapy for older adults.

     

    Module 9: Geriatric Nutrition
    Module Objectives:

    • List three physical signs of malnutrition and when to refer to a registered dietitian (RD);
    • Name two risk factors for dehydration in frail older adults;
    • Identify signs and symptoms of chewing and swallowing difficulty, when to refer to other professionals, and how to identify appropriate interventions;
    • List goals of diabetes management for older adults in long term care settings; and
    • Describe the changes in appetite during the dying process.

     

    Module 10: End of Life Care
    Module Objectives:

    • Identify signs of general decline in residents approaching end of life;
    • Utilize the FAST tool to assess and document a resident’s stage of dementia;
    • Implement non-pharmacological and pharmacological interventions for symptoms of discomfort;
    • Communicate effectively with residents, families, and other professionals at resident end of life and ease the end-of-life processes for the resident; and
    • Differentiate among types of advance directives.

     

    Module 11: Urinary Incontinence
    Module Objectives:

    • Recognize the risk factors for UI;
    • Distinguish the various types of UI based on symptom history;
    • Assess continence status;
    • Determine the cause of UI in older adults; and
    • Design and implement individualized plans of care.

     

    Module 12: Cognitive Impairment
    Module Objectives:

    • Define how normal age-related changes, dementia, and delirium differ;
    • Identify early changes in mental status;
    • Conduct a mental status assessment;
    • Describe nursing interventions to manage delirium; and
    • Describe nursing interventions to manage dementia-related behavioral symptoms.

     

    Module 13: Depression in Older Adults
    Module Objectives:

    • Recognize common symptoms and atypical presentation of depression;
    • Administer and interpret two common screening tools used for depression in older adults with and without dementia;
    • Assess the risk for suicide; and
    • Learn about different treatment options that have demonstrated efficacy in older adult populations.

     

    Module 14: Pain
    Module Objectives:

    • Identify the adverse consequences of untreated pain;
    • Use and interpret pain assessment tools for both the cognitively intact and the cognitively impaired;
    • Understand the risks and effectiveness of medications and other treatment options; and
    • Identify appropriate pain management and treatment strategies.

     

    Module 15: Maintaining Mobility
    Module Objectives:

    • Recognize the types and risks of limited mobility and the five levels of physical function;
    • Use evidence-based tools and measures to accurately assess mobility status;
    • Demonstrate competency in selection and use of assistive devices and proper footwear;
    • Identify falls risk factors, long term care residents at risk of falls, and interventions to prevent falls;
    • Discuss the issues concerning the use of restraints and alarms; and
    • Effectively collaborate with direct care workers (DCWs) to identify and implement strategies for maximizing resident mobility.

     

    Module 16: Change in Condition and Care Planning
    Module Objectives:

    • Describe both obvious and subtle presentations of change in condition
    • Complete an effective assessment that identifies pertinent signs and symptoms related to condition changes
    • Understand how to effectively communicate condition changes to health care providers such as physicians, physician assistants, and nurse practitioners
    • Work effectively with certified nursing assistants (CNAs) to identify and respond to resident condition changes

     

  • Geri-Res Assisted Living RN Resident Course Modules

    Module 1: Introduction to Assisted Living
    Module Objectives:

    • Relate the recent history of AL;
    • Provide a profile of AL residents;
    • Describe the legislative rules that govern AL care;
    • Address the nurse’s role in AL; and
    • Introduce the nurse’s scope of practice and delegation considerations.

    Module 2: Resident Quality of Life
    Module Objectives:

    • Address quality of life concerns that are important to AL residents;
    • Describe how care practices could interfere with residents having the best possible quality of life; and
    • Present care planning techniques to improve resident well-being and quality of life.

    Module 3: Communicating with the Team
    Module Objectives:

    • Offer ways to convey information to other health care providers;
    • Share strategies for effective listening and communicating; and
    • Present solutions for common communication issues.

    Module 4: Communicating with Families
    Module Objectives:

    • Discuss the various perspectives, concerns, and priorities of family members with older relatives in AL;
    • Highlight the benefits of quality communications with family members;
    • Relate the common challenges to forming effective partnerships; and
    • Offer best techniques for involving families in care and managing sensitive issues.

    Module 5: Cultural Diversity
    Module Objectives:

    • Explores how diversity affects daily lives;
    • Shows how AL nurses can foster personal and organizational cultural competence; and,
    • Explains how to use cultural competence to promote person-centered and person-directed care practices.

    Module 6: Sensory Changes
    Module Objectives:

    • Address the common sensory changes that occur as a part of the aging process;
    • Define the condition of excess disability in older adults;
    • List indicators of sensory changes in AL residents; and
    • Show appropriate interventions for common sensory issues.

    Module 7: Skin
    Module Objectives:

    • Relate the differences between normal and abnormal changes in skin condition;
    • Discuss the risk factors for skin problems in older adults;
    • Outline the processes for inspecting and caring for aging skin, and
    • Describe processes for preventing, assessing, and treating skin tears and pressure injuries.

    Module 8: Pharmacologic Considerations
    Module Objectives:

    • Strengthen your understanding of age-related physiological changes;
    • Explain how these changes impact how older adults process medications;
    • Describe common issues related to medication management;
    • Explain the nurse’s role in preventing and identifying medication-related complications; and
    • List “Key Principles” of medication management, which are intended to serve as general guides for daily decision-making regarding medication management.

    Module 9: Nutrition
    Module Objectives:

    • Familiarize nurses with the signs of malnutrition and dehydration;
    • Explain the risk factors associated with altered nutrition status;
    • Describe treatment options for older adults who struggle to get enough nutrients and liquids;
    • Help nurses understand diabetes management; and
    • Explain appetite changes at the end of life.

    Module 10: End of Life Care
    Module Objectives:

    • Describe the functions of and principles guiding the nurse at end of life;
    • Introduce the tools commonly used for assessing and measuring decline;
    • Outline the signs, stages, and types of decline in the end of life process;
    • Address special considerations for residents with dementia;
    • Differentiate among types of advance directives; and
    • Clarify the function of hospice in AL.

    Module 11: Urinary Incontinence
    Module Objectives:

    • Describe the effects of UI;
    • Provide information about the various types of UI;
    • Explain how to assess residents; and
    • List treatment and management options.

    Module 12: Cognitive Impairment
    Module Objectives:

    • Discuss the age-related changes in cognition believed to be normal and those considered to be pathological;
    • Describ degrees of cognitive impairment; and
    • Relate the nursing assessment and intervention strategies used to manage changes in condition.

    Module 13: Pain
    Module Objectives:

    • Address the impact of untreated pain on the quality of life of older adults;
    • Describe common methods and tools used in AL to identify and address pain;
    • Outline methods of pain management and treatment for older adults; and
    • Discusse pain in older adults who are cognitively impaired.

    Module 14: Depression
    Module Objectives:

    • Relate the types of and risk factors for depression;
    • Describe signs and indicators of the illness;
    • Explain the assessment and treatment of depression in older adults; and
    • Address suicide and other depression-related issues relevant to assisted living.

    Module 15: Maintaining Mobility
    Module Objectives:

    • Describe the scope and levels of functional ability;
    • Relate the effects of low mobility and immobility for older people;
    • Introduce tools for assessing residents’ levels of mobility;
    • Discuss assistive walking devices; and
    • Outline strategies for fall prevention.

    Module 16: Change in Condition/Care Planning
    Module Objectives:

    • Discusses the changes in condition that can occur with AL residents;
    • Describes how to establish baseline conditions for residents and systems for monitoring changes;
    • Promotes communication about changes in condition between members of the care team; and
    • Addresses the development of resident care plans.
  • Geri-Res Home Health RN Resident Course Modules - Coming Soon!
  • Geri-Res LPN Resident Course Modules - Coming Soon!

Nurse Residency in Long-Term Care: A Case Study

Like many long-term care facilities, Attic Angel Place experienced turnover among its nursing staff. Their rate was much lower than the industry average, but it was still higher than the organization wanted it to be. Knowing that nursing turnover ...

The Cost of Nurse Turnover

Evidence shows that nurse residencies increase nurse retention and save costs.* But can the cost savings be measured in hard dollars? Using the Turnover Calculator, you can determine your nurse turnover rate and how much turnover is costing your organization.

Here’s how it works: choose a period of time to capture a snapshot of your nurse turnover. A 12 month time period is best, but if you don’t have 12 months of data consider using the past six months.

  1. Enter the number of months you are using (“the period”)
  2. Calculate the total number of nurses that remain employed at the end of each month, and add these numbers together.
  3. Calculate the total number of nurses that have left your employment each month, and add these together.
  4. The calculator will give you your Turnover Rate.
  5. To calculate the cost of turnover to your organization, multiply the number of nurses that have left the organization by $58,000* (*turnover average based on national data and includes orientation costs, recruitment costs, overtime costs, and background checks).

Equally important, there are other “costs” to an organization associated with high turnover: remaining employee burnout, poor staff morale, reputation in the community and impact on residents.

*Van Camp & Chappy, 2017

For example, Sunnyside Skilled Nursing decides to measure their nurse turnover rate using 6 months of data. They add the total number of nurses they employ at the end of each month:

Month 1 = 8
Month 2 = 1
Month 3 = 7
Month 4 = 8
Month 5 = 9
Month 6 = 8
Total = 48

They calculate the total number of nurses that have left employment each month:

Month 1 = 0
Month 2 = 1
Month 3 = 1
Month 4 = 0
Month 5 = 0
Month 6 = 1
Total = 3

Sunnyside’s turnover rate is 37.5.