Geriatric nursing specialists have proposed an actionable four-point strategy to increase certified nursing assistants’ engagement in COVID-19 vaccination programs.

Nursing home administrators and medical directors undoubtedly are doing their best to provide information and reassurance, acknowledged the experts, from the Hartford Institute for Geriatric Nursing, Rory Meyers College of Nursing, New York University. Yet despite having what has been called “the most dangerous job in America” during the COVID-19 pandemic, certified nursing assistants working in nursing homes continue to have high levels of vaccine hesitancy, they said. 

“Each day, [CNAs] weigh the threat of compromising their health and the health of their families and loved ones with their duty to ensure vulnerable nursing home residents get their basic needs met,” wrote senior author Jasmine Travers, Ph.D., RN, and colleagues. “Providing CNAs with information, resources, support, and opportunity will not only serve to improve vaccine receptivity, but may also have downstream benefits.” 

To encourage vaccine engagement, they recommend that clinical administrators home in on four factors in a strategy based on a theory of structural empowerment. A paper published June 1 in JAMDA details each factor and the possible actions to be taken. These include the following (summarized, with key examples):

Information refers to the data, knowledge and expertise required to function effectively in a given role. For example: Although many healthcare settings are considering making vaccines mandatory, it is important to note that mandates can backfire if a population resents being coerced and has not received sufficient education about the safety and efficacy of a vaccine. 

Resources refers to the time, materials, money, supplies and equipment necessary to accomplish organizational goals. For example: If organizations wish to see 100% of their staff members vaccinated, then they must provide them with the necessary resources. Nursing homes should anticipate the need for additional staffing and consider staggering vaccine administration when possible.

Support encompasses feedback and guidance from colleagues. For example: CNAs participating in vaccination efforts also must be acknowledged, particularly those who contribute to CNA community vaccine organization and conversations.

Opportunity relates to job conditions that allow an employee to advance in a position and develop knowledge and skills to grow in their career. For example: Providing CNAs with opportunities to shape when and how vaccines are delivered support an assets-based approach to addressing vaccine hesitancy. Such an approach has been shown to be a powerful driver for employee behavior.

“Ultimately, providing CNAs with opportunities for growth and development will have benefits for them and their place of employment that outlast the pandemic,” the authors concluded.

More details are provided in the full article.