A Mixed-Method Evaluation of a Workforce Development Intervention for Nursing Assistants in Nursing Homes

The Case of WIN A STEP UP

Workforce Improvement for Nursing Assistants: Supporting Training Education and Payment for Upgrading Performance (WIN A STEP UP) is a workforce development intervention aimed at nursing assistants (NAs) in North Carolina nursing homes (NHs).

The WIN A STEP UP curriculum consisted of continuing education, on-site training and financial incentives. Study participants were site informants, NAs, supervisors, and managers from 18 sites (8 program and 10 control sites) who were interviewed and surveyed at baseline and at follow-up. Along with analysis of the qualitative data, propensity scores were used to match 77 NA participants to 81 program and 135 control participants.

Key Findings:                       

  • Almost all participating managers evaluated WIN A STEP UP positively and reported an impact in morale and quality of care. Additionally, nurse supervisors stated that the program positively impacted their and their peers’ management practices.
  • WIN A STEP UP participants reported significant improvements in team care and quality of co-workers. NA performance improved in nursing care and supportive leadership and NAs reported higher career and financial reward ratings.
  • Turnover at three months was somewhat reduced in six settings where participants completed the program.

Given the positive feedback from NAs, managers, and nurse supervisors, WIN A STEP UP is a viable option for connecting better jobs for NAs to better care.