Administrators, Directors of Nursing and Directors of Staff Development,

Please note the enclosed information regarding the rationale for consistent assignments for our residents and CNAs, then review and discuss with your IDT for their input.

The reasons for utilization of consistent assignments are compelling. Consider the following:

  1. Consistent assignment allows staff to develop closer relationships with our residents.
  2. CNAs definition of good caregiving is based on having good relationships with their patients.
  3. CNAs report that having consistent assignments result in higher job satisfaction.
  4. Comparative studies find improved clinical outcomes related to formation of decubitus ulcers, discharge expediency, increased ambulation and even decreased death rates.
  5. CNA turnover is significantly reduced.
  6. Licensed staff report that they feel more accountable in planning and can implement care more efficiently and effectively.
  7. Residents feel more secure, as the CNAs are able to discern their needs in advance.

In the event you make the choice to change to consistent assignments, you may experience some initial resistance from staff members. While this is a common reaction, most facilities report that once consistent assignments have been in place for a few weeks, their staff would not have it any other way. Still, change can be scary, so below are a few ideas for you to consider that will enable you to best manage the proposed change:

  1. Readily share the results of the studies mentioned above with your staff.
  2. Have the DSD meet with all 3 shifts of CNAs, separately to allow them the freedom to express themselves in a safe environment.
  3. Suggest that you’re using our facility as a pilot facility, so there’s time and a process to trouble-shoot for problems.
  4. Enlist the CNAs’ input by requesting them to ‘grade’ the acuity of our residents, based on the degrees of challenge each resident presents.
  5. Allow the CNAs to participate in the development of the assignments based on their previous input about degrees of challenge.
  6. Meet every 3 months, or as often as needed for ongoing input by the CNAs, regarding the level of care and amount of time needed for each assignment and make appropriate changes.

Individualized care is the desired result from consistent assignments. Quality care that is anticipated by our CNAs is the optimal result that can be achieved in our facility. Relationships are keystone to rendering best practices related to caregiving and consistent assignments foster relationships. Additionally, this provides an arena for residents to feel safe, which promotes a sense of well-being. This well-being translates into aiding our residents to promote and maintain their highest practicable level of function.

Thank you for this consideration,