Iowa: Recommended Standards To Improve Quality Of Care

Ruzanna Harutyunyan's picture
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In the six weeks before her husband died of brain cancer, Dawn Taylor of Des Moines needed help. The agency she hired assigned 10 direct care workers to help in shifts with everything from changing her husband's bed linens to personal hygiene. "When the quality of care was good, it was great," Dawn said. "When it was bad, though, it was unbearable and affected the whole family." Although many of these direct care workers were highly competent, Dawn struggled with those who lacked training.

Unfortunately, Dawn's experience with the inconsistent quality of care from direct care workers is all too common. And with more than 800,000 Iowans expected to reach retirement age by 2030, these problems could only get worse.

"The way to improve the quality of direct care in our current health care system is to ensure that these important workers are appropriately qualified and consistently trained," said Iowa Department of Public Health Director Tom Newton. "Our state is leading the way in creating a system that allows Iowans to expect a certain level of quality when they rely on services from direct care workers."

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According to a report just released by the Iowa Department of Public Health, there are at least 75,000 direct care workers in Iowa representing as many as 40 job titles. (These are not to be confused with licensed nurses.) Only one of these professions-certified nurse aides-must have proper credentials to practice. The report, Recommendations for Establishing a Credentialing System for Iowa's Direct Care Workforce, is part of a 2007 legislative mandate and the first of its kind in the United States to make such comprehensive recommendations for direct care worker certification. Included in the suggestions are:

* Establishing a state board of direct care workers; and

* Certification of direct care workers in three skill levels; and

* Development of a standardized training curriculum and continuing education requirements.

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