Elevating Certified Nursing Assistants On-Boarding Education to Improve Disease-Specific Acute Care

Introduction: Historically my stroke unit in a large community-hospital setting has a high certified nursing assistants (CNA) turnover rate. After a significant deep dive into the cause of the turnover, a disease-specific education gap was identified in this acute care team role. Our turnover rate was at a high of 78% in July 2018.

Purpose: We began a process improvement to include an in-depth expanded CNA orientation experience that included disease-specific education and shadowing sessions with specific allied ancillary departments providing specific tools to care for the ever-changing acute stroke and neuroscience population.

Description: We began this process improvement with a goal to measure the turnover rate at quarterly intervals after the initiation of the improved CNA onboarding process to evaluate the need to continue the planned process improvement or to regroup.

Evaluation/outcome: Our CNA turnover rate went from a high in July 2018 of 78% to 39% after 6 months following the implementation of the new onboarding education. This success substantiated our need to continue this program. CNAs felt more prepared to care for different types of stroke patients as well as capture a holistic view of the care team. We were able to sustain that turnover rate throughout the following year (2019).