SKILLS NURSING ASSISTANT 2017

SKILLS NURSING ASSISTANTS 201702

An analysis by Aspiring Minds, the global leader in standardized employability assessments with presence in India, US, Philippines, China, Middle East and Africa. With millions of candidates assessed annually, Aspiring Minds’ assessments provide a comprehensive measure of language, aptitude, behavior and hundreds of work skills. This analysis is in continuation of Aspiring Minds’ efforts in gauging employability of young and upcoming workforce, providing an insight into the skill gaps of trained/semi-trained nursing assistants. The report is based on data collected by assessing 3,000 nursing assistants on a comprehensive and standardized assessment.

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I. Introduction

The job paradox exists around the world: On one hand, there are people searching for jobs and on the other, job vacancies do not get filled. According to a Manpower Group survey1 of nearly 40,000 employers in 42 countries, 40% of employers globally are having difficulty in filling open positions. Chief factors contributing to the talent shortage are lack of specific functional skills required for a particular role and lack of available applicants. The vacancies most difficult to fill are for skilled trades and vocational workers. Nursing professionals are among the top 10 jobs under skilled trades.

A report published on the bulletin of the World Health Organization read - Wanted: 2.4 million nurses, and that’s just in India2. The shortage of nursing professionals is a global phenomenon. While the developed world is able to meet its requirement by enticing nursing professionals from the farther worlds, it is the developing and the developed nations where the gap between the demand and supply is further widening.

One major reason identified for this gap is lack of hard skills and information among people about these jobs. The hard skills shortage is most

commonly explained as a lack of industry-specific professional qualifications or a lack of industry-specific skilled trade certifications. To address this gap, substantial measures & policies are proposed by governments, industry organizations and NGOs all around the world. In context of nursing assistants, Ministry of Skill Development And Entrepreneurship and National Skill Development Corporation in India took considerable steps to catalyze the training and credentialing ecosystem by providing funding to enterprises, companies and organizations that provide skill training.

Keeping in mind these efforts, we embark upon doing a national audit of employability of nursing professionals to investigate whether the training intervention has been effective. We wish to find how candidates trained as nursing assistants across India fare in the various employability skills needed in the job.

This analysis is along the same lines as Aspiring Minds’ earlier commitment of gauging the employability of plumbers3, engineers4 and graduates5 for various jobs. This report has not only become an authoritative source for employability statistics for nursing professionals,

1 Talent Shortage Survey 2016-172 Wanted: 2.4 million nurses, and that’s just in India3 Aspiring Minds Skills Report | Plumbers | 20154 Aspiring Minds National Employability Report | Engineers | 20165 Aspiring Minds National Employability Report | Graduates | 2013

SKILLS NURSING ASSISTANT 2017

SKILLS NURSING ASSISTANTS 201702

but also provides multiple insights on the competencies which training institutions should focus on. We recognize the need for new methods to train and guide the budding nursing assistants in this country, helping them become industry ready.

This analysis will provide an insight about the skills that currently trained nursing assistants lack, and areas where we should aim to introduce training interventions. At the same time, it will also provide a better idea to all stakeholders to what the industry and job requires. We believe such reports are indispensable to enable training institutions recognize the need to take targeted interventions to update both curriculum and pedagogy. In turn, it will also help the industry design better programs. Although the data is from India, this is a case study which may provide

insights for programs across the globe.

The analysis is done with the same rigor as all earlier studies by Aspiring Minds. It is defined by a theoretical understanding and empirical validation of the knowledge, cognitive skills and domain expertise required. The test instruments are scientifically designed, follow global standards and are validated by the industry. They measure competencies like functional knowledge, soft skills, handling real-world situations and understanding of health and safety. Most importantly, they were delivered with credibility, electronically, on tablets in a scalable way..

We hope that the policy makers, the educators, and the industry will find this report useful as they embark on building a better employment ecosystem around the world.

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II. Study Design

In order to ascertain the impact of learning through the training programs conducted for nursing assistants, Aspiring Minds conducted a study of over 3000 candidates who underwent a training of 1-2 months across India during the year 2017.

The aim of the study was as follows:

A. To understand what skills are deficient in the trained Nursing Assistants vis-à-vis the skills that are needed for the profession.

B. To provide standardized intervention inputs that the training institutions and the individuals can use to bridge the existing gaps, if any.

To test the candidates’ knowledge and understanding of nursing and related aspects, a standardized test was designed and delivered at the end of their training.

Every year more than 400,000 blue-collar workers take the test on the TESLA platform, Aspiring Minds’ flagship framework for vocational assessments. The test helped establish the level of proficiency attained by the candidates through the training for various skill trades.

Given the fact that Nursing Assistant is a very hands-on job, it is important that they possess a practical know how of providing basic patient care by performing duties such as - feeding, bathing, dressing, grooming, moving patients and changing linens. To perform these and other such similar tasks, it is imperative that they understand the basics of various daily care and grooming rituals; are well acquainted with the medical tools and equipment used and are aware of the various health and safety standards to be upheld. The test therefore was designed to gauge

the performance of candidates specifically in the following three areas:

● Daily care and grooming of patients: If the person is trained to groom and take care of patients on field.

● Handling and maintenance of medical equipment: If the person knows how to han-dle and maintain medical equipment while and after use.

● Health and safety : If the person knows about the various safety symbols used in workplace and which protective equipment to use in different situations.

SKILLS NURSING ASSISTANTS 201704

III. Vocational Assessment Framework

TESLA is Aspiring Minds’ framework for vocational assessments. It has been designed keeping a balance between theoretical knowledge and practical skills needed to handle a particular job role. TESLA brings technology to vocational certifications both in terms of assessment construction and delivery. The item banks are built to evaluate practical and relevant work tasks using a variety of item types that include

audio/visual stimulus, automated simulation based questions and case based scenarios that represent a simulated work environment which probe to understand the candidate’s response to those amongst others. The assessment scoring is based on standardized rubrics of evaluation benchmarked against experts for every job role. The test suite is available in multiple languages, delivered on a tablet and/or IVR platform.

Figure 1: TESLA - Aspiring Minds’ framework for vocational assessments

TESLA : Assessment Framework

Theore�calKnowledge

Ques�ons on basicknowledge required

Case-based prac�calscenario ques�ons

Automated Simula�on based ques�ons

Audio/Video basedques�on over

telephone/computer

Text or picture basedques�ons with

answers by key/touch

Manual/Technologydriven proctoring

Prac�cal Skills

Competency based problem taxonomy

Test content: Fundamental and Prac�cal

Medium and Delivery: State-of-the-art Technology

Mul�-Lingual AssessmentsEnglish | Arabic | Mandarin | Hindi | Tamil

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IV. Observations & Results

Daily care and grooming of patients: Nursing assistants are often employed in the hospitals, nursing homes, community or senior living centers where they are required to help patients of all ages perform the most basic daily tasks.

Through the test, the certified nursing assistants’ understanding of these daily yet primary tasks was assessed. Between 50-70% candidates were

able to respond well to questions testing the theoretical and analytical ability of the candidates. Yet the responses of about 30-50% candidates reflected a lack of understanding

and inefficient training. This is alarming and calls for more focus on real world situation handling and exhaustive on-the-job training.

In the question given in figure 2, for instance, 65% candidates were able to identify ‘A’ as the correct response. Rest of the candidates showed inability in comprehending or addressing the issue correctly and might be unaware of the fact that diabetic people are more prone to foot infections. This lack of knowledge may lead to severe complications in the patient’s condition.

The role of a nursing assistant also involves being sensitive to the patients’ needs. For instance, to untangle the long, tangled hair of a patient, s/he requires having some regard for the patient, and not do anything otherwise. While 52% knew the right way to untangle hair, there were about 21% who chose the option of rather cutting the hair short than tackling the situation sympathetically.

2/5th of the total candidates reflect a

lack of understanding and inefficient training

in daily care and grooming of patients

Figure 2: Daily care and grooming - Care for patients with Diabetes

SKILLS NURSING ASSISTANTS 201706

Another important and noticeable element that emerged from the test was the potential of training and certification to be able to distinguish a nursing assistant from a layperson or a novice caregiver. On one of the questions (figure 4), a majority- almost 65%, candidates replied inappropriately. It asked the candidates about

using the boiling technique to sterilize medical equipment in a hospital. While a lay person, may consider boiling as an appropriate method of sterilization, in hospitals and other similar facilities it might lead to the deformation of the equipment without even sterilizing them in the best possible manner.

Question: A�er removing the thermometer from an an�sep�c solu�on, in which direc�on should you wipe it dry before use? Consider '1' as the star�ng point and '2' as the end point of wiping the thermometer.

Op�on A

100%

62.4%

4.1%

29.9%

3.9%

80%

60%

40%

20%

0%Op�on B Op�on C Op�on D

2

1

1

2

1

2

2

1A) B) D)C)

Figure 3: Handling of medical equipment - Preparation of medical equipment

Question: State if the following sentence is true of false: Boiling is a process that can be used to sterilize all the equipment in the hospital.

100%

80%

60%

40%

20%

0%Op�on A

64.2%

35.8%

Op�on B

A) TrueB) False

Figure 4: Handling of medical equipment - Medical equipment sterilization

Handling of medical equipment: Usually the Nursing Assistants work under a Registered Nurse’s supervision, yet they extensively deal with patients directly which is why it is important for them to know how to handle and maintain medical equipment while and after use. To be able to assist well they need to be able to use and disinfect simple tools like thermometers, syringes, masks etc.

Assessing the practical knowledge of the Nursing Assistants in this specific domain through suitable

questions brought forth the unpreparedness of candidates to a certain extent.

The question in figure 3 below quizzes candidates about the right way to wipe a thermometer which may seem very basic but is an acute skill to possess for a nursing assistant. Through a comprehensive practical training that focuses on basics, the percentage of candidates responding correctly and further applying it well can go much higher than the current 62%.

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Question: You have to take a blood sample from the ward to the laboratory in a hospital. Which of the following personal protective equipment (PPE) will you wear?

Option A

100%

1.2% 0.4%

97.5%

0.8%

80%

60%

40%

20%

0%Option B Option C Option D

A) B) D)C)

Figure 5: Health and Safety - Personal Protective equipment

Health and Safety: Nursing Assistants play a key role in the lives of their patients and help senior nurses and doctors stay up to date on vital information about the patients’ conditions. This makes it relevant and important for the assistants to be aware of various healthcare and safety norms to be followed while performing their duty. The test results showed that most of the candidates, almost 90%, are aware of the basic protective measures to be taken so as to maintain health and safety at workplace.

The questions included, tested the candidates’ knowledge about various gears, safety symbols and usage of personal protective equipment used in the healthcare sector and the candidates fared well on this section.

In figure 5, the question tests the candidates’ knowledge about the usage of various personal protective equipment, 97% candidates chose the correct option.

97.6%

SKILLS NURSING ASSISTANTS 201708

V. Conclusion

The study has brought forth the varying competence levels of the Nursing Assistant candidates in the three core domains tested. The findings are summarized below:

●  31%-45% candidates lack proper training to carry out daily care activities like trans-ferring a paralyzed patient from a bed to a wheelchair. This is concerning and calls for more focus on real world situation handling and exhaustive practical training on the field.

●  While 3/5th of the candidates know how to clean and handle medical equipment as basic as a thermometer, only a little less than 2/5th of the candidates know the procedures to sterilize other medical equipment.

●  Most of the candidates are aware of the basic protective measures to take in order to maintain health and safety at workplace. This includes knowledge about safety sym-bols and usage of personal protective equip-ment used in the healthcare sector.

It is evident that the training has helped the candidates possess a sound understanding of the health and safety guidelines but there is a need to reform the areas concerning handling of medical equipment as that is central to the job requirements of a Nursing Assistant.

The daily care and grooming activities like- dressing, bathing, skin care, mouth and hair care are a part and parcel of the aides’ daily routine and with their growing need at nursing homes, assisted living centers, senior care houses etc., it will help to have this element made an essential hands-on component. The design of the future training programs should have all learning

activities designed in such a manner that the students are exposed to theoretical context along with practical experience. activities designed in such a manner that the students are exposed to theoretical context along with practical experience.

To conclude, it is noteworthy that in general, the type of people attracted to nursing as a profession and becoming a nurse assistant are people with a strong sense of empathy for the needs of others. With a strong feeling of care for the sick or the elderly, it is a challenging job that requires complete commitment, and occasionally putting others first. The training hence should make a real life impact on their learning, one that compliments and supports the desire to make a difference in an important area of healthcare services.

Notes

www.aspiringminds.com

About Aspiring MindsAspiring Minds, a job and skills credentialing leader, delivers AMCAT - the world’s most widely-used employability test and the only standardized test designed for job matching. AMCAT™ is a proven, scientific, comprehensive solution that uses patent-pending technology to help companies dramatically improve their hiring while enabling job seekers to evaluate and certify their skills and find appropriate career opportunities. More than 2 million candidates have taken the cloud-based, data-driven test, resulting in 400,000 job matches and awarding of millions of credentials.

A strong in-house research and development team with alumni from IITs and MIT form the development back bone of the patent pending assessment tools. Aspiring Minds’ products and solutions have been adopted by more than 2000 corporations across 4 continents, including some of the world’s largest multinational companies, and 4,000 educational institutions and various government and non-government institutions.