Module 1: Introduction To Nurse Assistant

Transcription

Module 1: Introduction to Nurse AssistantModule 1: Introduction to Nurse AssistantMinimum Number of Theory Hours: 2Suggested Theory Hours: 5Recommended Clinical Hours: 0Statement of Purpose:The purpose of this unit is to introduce the student to California Code of Regulations, Division 5, Title 22, which regulates health carefacilities, and to introduce the roles and responsibilities of the Nurse Assistant, including requirements for Nurse Assistantcertification, professionalism, ethics, and vities of Daily Living (ADL) sheetCalifornia Code of RegulationsCalifornia Department of Public Health (CDPH)CitationConfidentialityDignityEthicsHealth & Safety codeHealth Insurance Portability and Accountability Act(HIPAA)10. Insubordination11. Job description12. Long-term care facility13. Mandated reporter14. MediCal15. Medicare16. Nursing Facility17. Omnibus Budget Reconciliation Act (OBRA)18. Privacy19. Professionalism20. Scope of Practice21. Skilled nursing facility (SNF)22. Title 22, Division 523. ViolationPatient, resident, and client are synonymous terms referring to the person receiving care8California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018Page 1 of 25

Module 1: Introduction to Nurse AssistantPerformance Standards (Objectives):Upon completion of the two (2) hours of class plus homework assignments, the learner will be able to:1. Define key terminology2. Discuss the legal implications of California Code of Regulations, Title 22, Division 5, and OBRA3. Identify Nurse Assistant requirements as set forth in Title 22, and OBRA4. Describe the qualities of a successful Nurse Assistant5. Describe the role and responsibilities of the Nurse Assistant6. Describe professionalism for the Nurse Assistant.7. Explain the ethical behavior expected of the Nurse Assistant8. Describe behaviors that maintain confidentialityCalifornia Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 20188Page 2 of 25

Module 1: Introduction to Nurse AssistantReferences:1. Acello, B. & Hegner, B. (2016). Nursing Assistant: A Nursing Process Approach. (11th ed). Boston, MA. Cengage Learning.2. Acello, B. (2016). Workbook to accompany: Nursing Assistant: A Nursing Process Approach. (11th ed). Boston, MA. CengageLearning.3. California Code of Regulations, Division 5, Chapter 2.5, Title 22, 71801-71853 and 72F8F0CF1411E2BBC7856865668A6E?viewType FullText&originationContext documenttoc&transitionType CategoryPageItem&contextData (sc.Default) -act-obra4. Carter, P. J. (2017). Lippincott Essentials for Nursing Assistants: a Humanistic Approach to Caregiving (4th ed.) Philadelphia,PA. Lippincott Williams & Wilkins5. Carter, P. J. (2017). Lippincott Essentials for Nursing Assistants: a Humanistic Approach to Caregiving (4th ed.). Philadelphia,PA. Lippincott Williams &Wilkins.6. Deck, M. L. (2004). Instant Teaching Tools for the New Millennium. St Louis, MO. Mosby7. Gillogly, B. & Conley, M., (2010). Skills and Techniques for the New Assistant. (8h ed). Irvine, CA. MedCom, Inc.8. Haroun, L. & Royce, S. (2004). Teaching Ideas and Activities for Health Care. Albany, NY. Delmar Publishers.9. Hedman, S. A., Fuzy, J., & Rymer, S. (2018). Hartman's Nursing Assistant Care: Long-Term Care (4th ed.). Albuquerque, NM.Hartman Publishing, Inc.10. Hegner, B., Acello, B. & Caldwell, E. (2010). Nursing Assistant: A Nursing Process Approach. Clifton Park, NY.Thompson Delmar.11. HIPAA Regulations ty/laws-regulations/index.html.12. Kelly, R. (2008) Workbook and Competency Evaluation Review for Mosby’s Textbook for Nursing Assistants (7th ed.) St.Louis, MO. Mosby Company13. Mosby (2009) Nursing Assistant Skills Video for Basic Principles. St. Louis, MO., Mosby Company14. Pearson Vue (2018) California Nurse Assistant Candidate Handbook for National Nurse Aide Assessment Program.Philadelphia, PA. Pearson Education, Inc.15. Health Workforce Initiative www.ca-hwi.org16. Sorrentino, S. A., Remmert, L., & and Kelly, R. (2018) Workbook and Competency Evaluation Review for Moby’s Textbook forNursing Assistants (9th ed.) St. Louis, MO. Mosby Company17. Sorrentino, S.A. & Remmert, L. (2018) Mosby’s Textbook for Nursing Assistants. (9th ed.). St Louis, MO. Elsevier18. Weaver, L. & Wilding, M. (2013) The Dimensions of Engaged Teaching: a Practical Guide for Educators. Bloomington, IN.Solution Tree Press.19. The Omnibus Budget Reconciliation Act of 1987, 1989, 1990.19931987- https://www.ncbi.nlm.nih.gov/pubmed/26719551989- 1990- -bill/3299/text1993- -bill/2264California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 20188Page 3 of 25

Module 1: Introduction to Nurse AssistantContent OutlineObjective 1Define key terminologyA. Review the terms listed in the terminology sectionB. Spell the listed terms accuratelyC. Pronounce the terms correctlyD. Use the terms in their proper contextObjective 2Discuss the legal implications of California Code of RegulationsTitle 22, Division 5 and OBRA.A. California Code of Regulations (CCR) Title 22, Division 51. California state laws enacted by legislature to establisha. Licensing and certification standards of health facilitiesb. Minimum standards of care for the patient/residentc. Regulations which govern the Nurse Assistant TrainingProgramd. Nurse Assistant certification requirements – initial andrenewal2. Skilled Nursing Facilities must be licensed3. Skilled Nursing Facilities must have policies and proceduresto ensure patient’s/resident’s rights and safety4. Violations of Title 22 may lead to issuance of a state citationwith a fineRecommended TeachingStrategies andAssignmentsClinical Demonstration/Method of EvaluationA. Lecture/DiscussionB. Games: word searches,crossword puzzles,Family Feud, Jeopardy,bingo, spelling bee,hangman, andconcentrationC. Encourage use ofinternet, medicaldictionary, andtextbooksD. Create flashcards forlearning purposesA. Have students selectfive words from the listof key terminology andwrite a sentence foreach defining the termB. Administer vocabularypre-test and post-testC. Uses appropriateterminology whencharting and reporting tolicensed personnelA. LectureB. DiscussionA. Written testB. Class participationCalifornia Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018Page 3 of 35

Module 1: Introduction to Nurse AssistantB. Omnibus Budget Reconciliation Act (OBRA) of 1987 incorporatedinto Federal law (42 Code of Federal Regulations (CFR) part 483subpart B)1. Requirement that nurse aides receive training and pass acompetency exam within four months of employment in askilled nursing facility2. Establishes standards of patient/resident care for Medicareand Medi-Cal reimbursement3. Authorizes the Federal Government to contract with theindividual states to do Federal onsite surveys for compliancewith regulations4. Violation of Federal regulations may lead to remediation suchas:a. Loss of the facility’s ability to provide a Nurse Assistanttraining programb. Civil money penaltiesc. Directed in-servicesd. Denial of paymente. State monitoringf. Termination of facility licenseObjective 3Identify Nurse Assistant requirements as set forth in Title 22 andOBRAA. Complete Nurse Assistant training course approved by theCalifornia Department of Public Health (CDPH)1. Minimum of 60 hours of mandated theory, including 10required hours for Alzheimer’s Disease and Elder Abuse2. Minimum of 100 hours of clinical training in a skilled nursingfacility3. Course content must comply with Title 22 and OBRA4. Students who are employees of a skilled nursing facility mustbe paid an hourly wage while in training5. Criminal screening upon enrollment in Nurse Assistant coursework6. History & Physical exam, Tuberculosis clearance7. HS - 283B Initial application formA. Lecture/DiscussionB. Share with students howto access forms onlineat CA Department ofPublic Health Websitefor ams/CHCQ/LCP/Pages/CNA.aspxC. Show samples ofApplications forms1. Handout 1.3a-A. Written testB. Application formcompletedC. Criminal screeningcompletedCalifornia Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018Page 4 of 35

Module 1: Introduction to Nurse AssistantB. Successfully complete the state competency test1. Includes a written and skills test2. Three opportunities to pass3. Competency test fee4. Facility must pay competency test fee if the student is anemployee5. If student is hired by a skilled nursing facility within a year ofpassing the competency test, the facility must reimburse thecompetency test feeC. California has contracted with two vendors to give the statecompetency examination1. Chancellor’s Office, California Community Colleges, whichcontracts with Pearson Vue, administrators of the NationalNurse Aide Assessment Program (NNAAP) Examination forthe California Nurse Assistant Registry2. American Red CrossD. Criminal clearance prior to certificationE. Certification renewal requirements1. Complete the CDPH renewal application – HS 283C form2. Complete 48 hours of approved in-service/continuingeducation hours every two years with at least 12 of the 48hours completed in each of the two years. 24 of these hourscan be done online now3. Verify at least one day of work for pay, providing nursing related services in the past two years4. Criminal clearance – repeat fingerprinting not requiredF. Competency Evaluation Approval by CDPH1. If approved to test, candidate will receive the Certified NurseAssistant Competency Evaluation Approval Form CDPH 932(06/09)2. Form must contain the state stamp and seal to be valid3. Form lists date by which the candidate must successfully passthe evaluation4. Form must be presented at time of testing5. Candidate’s Right thumb fingerprint will be applied to formeach time candidate testsHS283B also foundin Appendix E2. Handout 1.3bHS283C also foundin Appendix F3. Note when copyingHS283C form, copyon yellow paperD. Maintain student files forcompliance with CDPHincluding Title 22 andOBRAE. Share other resources1. Pearson VueCalifornia NNAAPwebsitewww.pearsonvue.com2. Regional TestingCenter So. Californiawww.regionaltestingcenter.org 714-89587083. NNAAP TestingCenter No. California916-485-60004. NNAAP TestingCenter CentralCalifornia 805-9650581 x 27835. American Red Cross323-780-7627California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018Page 5 of 35

Module 1: Introduction to Nurse Assistant6. If candidate does not pass testing, the candidate will need to.7. Retain the form for re-testing.Objective 4Describe qualities of a successful Nurse Assistant.A. DependableB. ConsiderateC. PleasantD. EmpatheticE. FlexibleF. HonestG. Compassionate and caringH. Sensitive to othersI. RespectfulJ. CooperativeK. Team playerL. ObservantM. Well groomedN. OrganizedO. Respectful of cultural differencesObjective 5Describe the role and responsibility of the Nurse Assistant.A. Health care team members1. Patient/resident2. Family3. Registered Nurse (RN)4. Nurse Practitioner (NP)5. Physician’s Assistant (PA)6. Licensed Vocational Nurse (LVN)7. Certified Nurse Assistant (CNA)8. Restorative Nurse Assistant (RNA)9. Physician10. Physical Therapist (PT)11. Occupational Therapist (OT)12. Speech Therapist13. Dietician14. Activities DirectorA. Lecture/DiscussionB. Have students researchthe history of nursingand report findingsregarding current NurseAssistant duties,professionalism andbehaviorA. Written testB. Demonstrates qualitieswhen providing care topatient/residentA. Lecture/DiscussionB. Role play activity:Students take on one ofthe team member rolesand describes what therole would be for apatient/resident whohas had a stroke orother debilitatingdiseaseC. Have students create awall size organizationalchart for the classroomwith the lines ofauthorityCalifornia Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018Page 6 of 35

Module 1: Introduction to Nurse AssistantB.C.D.E.15. Social Worker16. Clergy17. OmbudsmanHealth care settings in which Nurse Assistants are employed1. Skilled nursing facility (SNF)2. Acute hospital3. Intermediate Care Facility (ICF) – ICF/DevelopmentallyDisabled Habilitative (ICF/DDH) –ICF/DevelopmentallyDisabled Nursing (ICF/DDN)4. Hospice5. Assisted Living/Residential Care/Board & Care Facilities6. Psychiatric Facilities7. Clinics8. Prison System Facilities9. Alzheimer’s unitsSupervision of Nurse Assistant1. The direct supervisor of the Nurse Assistant is a licensednurse (RN, LVN or LPN) that is functioning as the ChargeNurse2. May also be accountable toa. Director of Staff Development (DSD)b. Director of Nursingc. Facility/Agency Administratord. Physician (in a clinic setting)Nurse Assistant Scope of Practice1. Scope of Practice— are the tasks that the Nurse Assistant isallowed to perform according to state and federal law andfacility policies2. Provide uniform, safe care3. Provide care according to educational standards4. Legal concept—functioning within the scope of practiceprotects the Nurse Assistant and the facilityResponsibility of Nurse Assistant in patient/resident care1. Provide a safe environment for the patient/residenta. Proper use of equipment and protective devicesb. Awareness of potential hazards (such as liquid spills)Abuse reporting formSOC341 also found inAppendix G and onlineat:www.cdss.ca.govE. Have students searchseveral job descriptionsfor local employingagencies, focusing onexpectations andcommitment required foremploymentCalifornia Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018Page 7 of 35

Module 1: Introduction to Nurse Assistantc. Practice personal hygiene and cleanlinessd. Care for patient’s/resident’s personal propertye. Adhere to standard precautions2. Meet the patient’s/resident’s physical needsa. Observe changes in patient’s/resident’s physical statusand report as neededb. Assist with activities of daily livingc. Assist with medical and rehabilitative activities (vital signs,turning, collecting specimens, ambulation, etc.)d. Maintain a clean environmente. Assist with ADLs in a timely mannerf. Document care provided as required by facility policy3. Assist the patients/residents to meet their psychosocial,emotional, spiritual and cultural needs4. Observe changes in patient’s/resident’s mental status andreport as needed5. Assist with patient/resident comfort and anxiety relief6. By protecting Patient’s Rights, the Nurse Assistant will ensurethat the patient/resident will:a. Be treated with dignity and respectb. Feel securec. Be recognized as an individuald. Love and be lovede. Feel a sense of accomplishmentf. Feel good about themselvesg. Follow personal beliefsh. Receive nursing care that assures cultural recognition andacceptanceF. Mandated Reporter1. Nurse Assistants are legally required to report suspected orobserved abuse or neglect2. Abuse Report form SOC341G. Responsibilities of Nurse Assistant to employer1. Report to work on time2. Fulfill assigned schedule reliably3. Notify supervisor when ill in a timely mannerModel Curriculum for Nurse Assistants - Revised December 2018Page 8 of 35

Module 1: Introduction to Nurse Assistant4. Work as a team member5. Perform one’s job to the best of his or her ability as specifiedby job description6. Conserve supplies and equipmentObjective 6Describe professionalism for the Nurse Assistant.A. Definition of professionalism. Carrying out patient/residentcare in a manner that is:1. Ethical2. Competent3. Knowledgeable4. Caring5. Committed6. Representative of high standardsB. Professional behaviors or attitudes1. Being skilled and caring while performing care2. Being responsible, trustworthy, truthful (e.g., reporting changeof address to CDPH, keeping a record of in-serviceeducation/CEU’s)3. Attending in-service/educational activities to improve skillsand knowledge4. Showing compassion for others5. Being a team player6. Doing the best job possible7. Asking for assistance when necessary8. Being a mandated reporter9. Understanding scope of practice for licensed personnel (RN,LVN, DON)a. Nurse Practice Actb. Delegation of dutiesc. Job description of permitted nursing skills for nurseassistant10. Maintaining current Nurse Assistant certification11. Maintaining a professional appearancea. Daily bath/shower and use of deodorantb. Shampoo hair on a regular basis, treat dandruff and otherlditiModel Curriculum for Nurse Assistants - Revised December 2018A. Lecture/DiscussB. Role play scenariosA. Written testB. Demonstratesprofessional behaviorand appearancePage 9 of 35

Module 1: Introduction to Nurse Assistantg. Uniform should be clean and pressed daily.h. Follow facility policy for body piercings and tattoos.Objective 7Explain the ethical behavior expected of the Nurse Assistant.A. Ethical behavior for patient/resident care means the NurseAssistant should1. Protect life2. Promote health3. Preserve dignity4. Keep personal information confidential5. Respect each person as an individual (e.g. religious beliefs,cultural differences)6. Give care based on need, not gratuitiesB. Ethical behavior for work includes1. Working assigned shift2. Arriving on time for work3. Being absent only when necessary4. Notifying employer prior to necessary absences in a timelymanner5. Following instructions given by supervisor within scope ofpractice6. Being a loyal, flexible cooperative team memberC. Unacceptable behaviors which may result in dismissal1. Any abuse of patients/residents2. Stealing or willfully damaging property3. Insubordination4. Neglecting duties5. Altering or falsifying records or reports6. Working under the influence of alcohol or drugs7. Dishonesty in any form8. Breaching confidentialityObjective 8Describe behaviors that maintain confidentiality.A. Confidentiality can be maintained by discussing personalinformation only with appropriate health team members atappropriate times and appropriate placesModel Curriculum for Nurse Assistants - Revised December 2018A. LectureB. DiscussionA. Written testB. Demonstrates ethicalbehavior inpatient/resident careA. Lecture/DiscussionB. Have students accessthe HIPAA guidelinesA. Written TestB. Maintainspatient/residentPage 10 of 35

Module 1: Introduction to Nurse AssistantB. Examples of maintaining confidentiality1. Adhering to HIPAA guidelines2. Discussing observations with nurse or patient’s/resident’sphysician3. Discussing the patient’s/resident’s care whileparticipating in team conference/planningC. Examples of breaching confidentiality include discussing personalinformation with:1. Another patient/resident2. Concerned friends or visitors3. Members of the news media4. Members of Nurse Assistant’s family5. Persons in the community6. Health team not directly involved with patient/resident careModel Curriculum for Nurse Assistants - Revised December als/security/lawsregulations/index.htmlPage 11 of 35

Module 1: Introduction to Nurse AssistantSample Test: Module 1- Introduction to Nurse Assistant1. The term used for persons living in long-term care facilities is:A. Senior citizenB. Elder adultC. RetireeD. Patient/resident2. The successful Nurse Assistant should be:A. HonestB. DependableC. OrganizedD. All of the above3. The responsibilities of a Nurse Assistant are listed in a:A. Job descriptionB. ProcedureC. Job titleD. Resume4. As a Nurse Assistant, your scope of practice includes:A. Bathing and dressing patients/residentsB. Taking telephone orders from the doctorC. Assigning patient careD. Giving medications5. What should the Nurse Assistant do if asked to do something he or she doesn’t know how to do?A. Ask another Nurse Assistant to do the taskB. Tell the nurse he or she is uncertain and ask for helpC. Refrain from doing the taskD. Do the task anywayCalifornia Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018Page 12 of 35

Module 1: Introduction to Nurse Assistant6. Which member of the long-term health care team provides the most hands-on care to the resident?A. PhysicianB. Charge nurseC. Nurse AssistantD. Nursing supervisor7. The direct supervisor of the Nurse Assistant is the:A. PhysicianB. Charge nurseC. AdministratorD. Director of Nursing8. California Code of Regulations, Title 22 establishes:A. Salary for certified Nurse Assistant’sB. Minimum standards of patient careC. The certified Nurse Assistant’s work scheduleD. Maximum standards of patient care9. Which of the following describes the minimum number of theory and clinical hours in a Nurse Assistant program approved by theCalifornia Department of Health Services?A. 54 Hours theory, 180 hours supervised clinical trainingB. 48 Hours theory, 150 hours supervised clinical trainingC. 40 Hours theory, 60 hours supervised clinical trainingD. 60 Hours theory, 100 hours supervised clinical training10. A California Nurse Assistant is renewing his/her certification. How many in-service/continuing education hours must anindividual take in a two-year period in order to renew Nurse Assistant certification?A. 28 HoursB. 30 HoursC. 48 HoursD. 58 HoursCalifornia Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018Page 13 of 35

Module 1: Introduction to Nurse Assistant11. How many hours must a Nurse Assistant work for pay in each renewal period?A. 48 HoursB. 8 HoursC. 24 HoursD. 50 Hours12. Which best defines Medicare?A. State Medical Welfare FundingB. Medical funding for persons under 65 years of ageC. Medical funding for children onlyD. Medical benefits for persons age 65 and over13. Which of the following situations should the Nurse Assistant report to the Director of Nursing?A. A patient/resident has fallenB. The nurse in charge is suspected of abusing a patient/residentC. The physician has asked for the Nurse Assistant’s helpD. A patient/resident refuses to cooperate with treatment14. The role of the ombudsman is to:A. Drive the buses for special outingsB. Listen to and resolve patient/resident problemsC. Serve snacksD. Bring newspapers and magazines15. HIPAA refers to:A. Hepatitis AB. ConfidentialityC. Standard precautionsD. NutritionCalifornia Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018Page 14 of 35

Module 1: Introduction to Nurse Assistant16. A Nurse Assistant may insure a patient’s/resident’s dignity by:A. Knocking on the patient’s/resident’s room door before enteringB. Introducing him/herself prior to giving careC. Calling the patient/resident by his/her proper nameD. All of the above17. The Nurse Assistant must submit fingerprints to the CDPH:A. After taking the state testB. When changing employersC. Every 2 yearsD. Once in a lifetime upon enrollment in a Nurse Assistant course18. A mandated reporter:A. Must report suspected abuseB. Must report actual abuseC. Must report abuse told to them by a visitorD. All of the above19. Prior to working directly with patients/residents, the Nurse Assistant must complete a facility orientation and:A. Have a TB clearanceB. Buy a wrist watchC. Have a negative drug testD. Receive CDPH certification20. The responsible Nurse Assistant will arrive at work:A. Exactly at the designated timeB. A few minutes before the designated timeC. Within 15 minutes of the designated start timeD. With enough time to be ready to start work at the designated timeCalifornia Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018Page 15 of 35

Module 1: Introduction to Nurse Assistant21. Upon successful completion of a Nurse Assistant training program, the candidate has how much time to complete the statecompetency exam?A. 4 monthsB. 6 monthsC. 1 yearD. 2 years22. The overall purpose of OBRA is to:A. Set hours when clinical training may be doneB. Improve quality of life for patients/residents in nursing facilitiesC. Keep safety records up to dateD. Prevent injuries23. What is the maximum number of times that the State Competency Exam may be taken?A. Once (1)B. 3 timesC. 5 timesD. 10 times24. A Nurse Assistant may be dismissed from a job because of:A. Falsifying documents or recordsB. Patient/resident neglectC. Theft of a patient/resident or hospital propertyD. All of the above25. The Nurse Assistant should not:A. Make a self-introduction to the patient/residentB. Ask about the patient’s/resident’s bank accountC. Ask how the patient/resident would like to be addressedD. Knock each time before entering the patient’s/resident’s roomCalifornia Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018Page 16 of 35

Module 1: Introduction to Nurse AssistantSample Test Answers: Module 11. D2. D3. A4. A5. B6. C7. B8. B9. D10. C11. B12. D13. B14. B15. B16. D17. D18. D19. A20. D21. D22. B23. B24. D25. BCalifornia Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018Page 17 of 35

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Nurse Aide Assessment Program (NNAAP) Examination for the California Nurse Assistant Registry 2. American Red Cross D. Criminal clearance prior to certification E. Certification renewal requirements 1. Complete the CDPH renewal application – HS 283C fo