The Nursing Assessment Toolkit: Improving Nursing Staff Knowledge and Skills to Identify Changes in Resident Status

Under a grant from the State of Maryland Office of Health Care Quality, nurse educators worked with 15 Maryland nursing homes to provide hands-on education and training on how to provide early identification for changes in resident status.  This training addresses a deficit of training resources pertaining to the assessment of residents in long-term care settings. The toolkit developed under this grant is available for use by long-term care facilities.  

The Nursing Assessment Toolkit is a resource to assist long term care nursing staff to sustain and improve their assessment skills. It is recognized that nursing homes and assisted living communities are serving an increasingly complex resident population.  Residents often have multiple diagnoses requiring careful monitoring.  Changes in status can occur quickly, requiring prompt recognition and action.  These factors demand that nursing staff have competency in assessing residents.  The resources in this toolkit are intended to assist nursing staff in this effort.

Please note:  The information contained in this Toolkit is for educational and guidance purposes only.  It should not be construed as medical advice.  Any policies or actions created as a result of this information should be reviewed by qualified medical authorities.



The Toolkit consists of eight sections. There are six sections designed for licensed nurses.  Each of these sections contains a recorded slide presentation, ranging from 20-28 minutes, that reviews the content related to the topic.  Additional fact sheets related to the topic are included, along with a test and answer key.  Knowledge and skills pertaining to assessing the specific function or system are reviewed in the slide presentations.  Normal and abnormal findings are reviewed with step-by-step instructions on how to assess; regulatory requirements related to the topic are also discussed as appropriate.  

  The licensed nurse sections include:


A program is included for the geriatric nursing assistant (GNA), including a 11 minute recorded slide presentation, test, answer key, and handout that describes observations that the GNA should note and report to the nurse:

                   The GNA: Vital Support to Nursing Assessment


Lastly, a General Resources section is included, containing handouts on various topics related to assessment.



This Toolkit was produced as part of a grant titled Improving Nursing Staff Knowledge and Skills to Identify Changes in Resident Status from

the Office of Health Care Quality, DHMH, Maryland