Education for Certified Nursing Assistants in Skilled Nursing Facilities: A Needs Assessment and Pilot Intervention

Abstract

Objectives: To assess educational needs for certified nursing assistants (CNAs) in skilled nursing facilities (SNFs), develop an adapted curriculum based on identified priorities, and evaluate its impact on CNA attitudes toward clinical care and self-care.

Design: Multi-institutional interprofessional needs assessment followed by implementation and evaluation of an educational intervention.

Setting and participants: A CNA educational needs assessment survey was conducted among health care professionals in SNFs, including CNAs, staff nurses, and administrators. A pilot educational intervention was delivered to CNAs recruited from SNFs, primarily in Illinois.

Methods: A needs assessment survey was sent to SNF employees in various roles, including but not limited to CNAs. The survey included Likert-scale questions (1-5) about the value of CNA education and the need for training on specific topics. Results were used to adapt and deliver an existing educational curriculum for CNAs. Surveys were administered before and after the training series. These included Likert-scale (1-5) questions about self-rated confidence; participants also provided free-text responses about their perceptions of the curriculum.

Results: Ninety-one participants completed the needs assessment. Participants strongly agreed that further training for CNAs is important to SNF residents' health and safety, operational outcomes, and CNA professional development. Topics rated with the highest importance included both clinical skills like dementia management and professional skills like self-care. Pre/postcurriculum surveys showed that self-rated confidence in all clinical skills assessed improved significantly; self-care was the most common free-text response regarding something learned to be applied in the future.

Conclusions and implications: This study highlights that SNF employees recognize the need for both knowledge and professional skills training for CNAs to improve care. Findings suggest greater emphasis on self-care can positively impact CNA attitudes toward training. Future research should explore long-term impacts of educational interventions on career sustainability and integrate CNA perspectives to guide workforce development strategies.

Keywords: Skilled nursing facility; education; self-care.