Nurse Aide
Training Program
Handbook
2010-2011
Health Occupations Education
In Cooperation with the NC Dept. Health and Human ServicesDivision of Health Service Regulation Center for Aide Regulation and Education
Public Schools of North Carolina
Department of Public Instruction
Academic Services and Instructional Support
Career and Technical Education
2 3 4 5 7 11 12 17 24 25 26 27 28 29 32 33 34 35 38 41 44 49 50 53 54 55 56 57 58 59 62 63
Clinical Experience Options for AHSII/Nurse Aide
Faculty Approval Request
Program Coordinator Summative Primary Teacher Information Additional Teacher Information amoore@dpi.state.nc.us
Skills Perspective / Curriculum vs NNAAP™
Nurse Aide Training Program Eligibility Critieria***
2009-2010 Nurse Aide in Review and What's Ahead
Unit O Supplements
Master Outline for Nurse Aide Training
Healthcare Personnel Vaccination Recommendations Chapter 3 Faculty and Program Coordinator Information
Student Clinical Preparation Checklist
Clinical Time Summary
Varicella - Chicken Pox Assessment
Clinical Site Change Request Program Coordinator Information
Chapter 4 Classroom Training Laboratory
Equipment Required for NA Training per DHHS/DHSR/CARE Chapter 2 Nurse Aide Training Master Outline / DHSR / CARE Supplements
Introduction to Health Occupations - Nurse Aide Training Forward
Who Does What in Nurse Aide?
Nurse Aide Training Program
Handbook
2010-2011
Agnes Moore, RN, BSN HOE Nurse Aide Program Manager
Office: 919-807-3893 Fax: 919-807-3899 6358 Mail Service Center
Raleigh, NC 27699-6358
TABLE OF CONTENTS
Chapter 1
Clinical Site Planning
HOE Student Nurse Aide Function / HOE Observation Function Nurse Aide Clinical Supervision
Board of Nursing on Supervision of Nurse Aide Students Chapter 5 Clinical Experience Information
Skill Acquisition Process
Skill Acquisition is Muscle Memory!
Optional Worksheet for Documenting Class Skill Mastery Skills to be Mastered in the Lab (MSSS Part I and II) Nurse Aide Training Laboratory Requirements and Layout 7-17-2010 Enrollment Memo To C&TE Administrators
Why Teach Nurse Aide Supplements?
Criminal Background Checks - Policies Supplemental Instructor Information
67 68 69 70 72 73 76 77 78 79 80 81 82 85 86 87 88 89 91 92 93 95 99 100 101 104 105 106 107 109 110 115 116 117 121 123 124 125 126 127 128 129 130 131 133 135 Chapter 10 145 148
Updates and Memos
Parent Contact Log Media Resources
Good Hair Day (Inspirational)
NC Board of Nursing Website
DHSR Nurse Aide I Registry Webpage Who Will Help Me? (Inspirational) NCDPI Nurse Aide Webpage
PearsonVUE® Nurse Aide I Webpage for Test Takers
"Why Do They Do That?" by Teepa Snow DVD Order Form Clinical Rotation Schedule - Template (Excel)
Completion of Nurse Aide Training - Requirements***
NNAAP™ Application Hardcopy - Instructions NNAAP™ Online Application
Journaling in the Nursing Home
Handling Challenging Situations in NA training - Pregnancy Handling Challenging Situations in NA training - Attitudes Completion of Nurse Aide Training Certificate - Template 1 Completion of Nurse Aide Training Certificate - Template 2
Class File Checklist
Purchasing Vouchers for NNAAP™ from Pearson VUE®
Pearson VUE® Letter Regarding Passwords and Account Login Guidelines
Journaling in the Nursing Home - Writing a Paragraph NACES Evaluation
Chapter 6
Equipment/Supply Requirements for NNAAP™ Exam/Evaluation Candidate Identification Requirements for the NNAAP™ Exam Atypical Social Security Cards…FYI
In-Facility Test Site Process In-Facility Test Site Application Criteria for Testing Rooms
Chapter 9 Faculty and Program Coordinator Information
DHSR - CARE Newsletter / Vol.1 Issue 1 May/June 2010 NNAAP™ Application
Chapter 8 Helpful Tools
HOE/Nurse Aide Instructional Make Up Plan
AHSII/Nurse Aide Training Verification Form for 2010-2011 Nurse Aide Training Program Audit/Review SAMPLE REPORT Chapter 7
DHSR Licensed Facilities Webpage
DHSR / Health Care Personnel Registry Section Webpage Student File Checklist
Nurse Aide Training Program Audit/Review Process Skills for Clinical Site - MSSS Part III
Health Agency Affiliation Agreement (from AHSII SC CD 2000) Ordering NNAAP™/ PearsonVUE® Candidate Handbooks
DHSR Memo: New Online Testing Application and Fee Changes Clinical Rotation Schedule - Template (Word)
National Practitioner Data Bank - HIPDB
Completing and Printing the NA Training Program Application 2010-2011 Nurse Aide I Training Program Application
Accountability
NNAAP™ Results - How They are Obtained
PearsonVUE® Results for North Carolina - Summary COMPLAINT PROCESS for NACES testing
Chapter 1
AHSII / Nurse Aide Training Program
Forward
North Carolina Health Occupations Education teachers have the opportunity to offer Nurse Aide Level I training to qualified students. The Department of Public Instruction signed a Memorandum of Understanding (MOU) with the North Carolina Division of Health Service Regulation that gives management responsibility for Nurse Aide Level I training of Allied Health Sciences II completers to the Health Occupations Education Nurse Aide office. Nurse aide training within Allied Health Science II is optional. You may offer this option to some, all, or none of your students. In view of recent Perkins IV legislation and continued emphasis on the credentialing of students, local education units and schools should give serious consideration to offering nurse aide training as an option. In fact, student credentialing is a significant criteria for North Carolina’s accountability plan to justify some of the funding. Currently, in Health Occupations, Nurse Aide certification is the primary credentialing opportunity for our students. Increasing the numbers of students who receive certification is extremely important.
The sole purpose for AHS II Nurse Aide Training Programs is to provide nurse aide “training.” Competency evaluation is done by Pearson VUE® , a nationally recognized provider of assessment services. Pearson VUE®, together with the National Council of State Boards of Nursing, Inc., has developed the National Nurse Aide Assessment Program (NNAAPTM) to meet the nurse aide evaluation requirement of federal and state laws and regulations. Nurse Aide Competency Evaluation Service (NACES) works with Pearson VUE® to score and report the results of the NNAAPTM Examination for the North Carolina Nurse Aide I Registry. Third party testing began July 1, 2006.
Candidates receive a hardcopy of the faxed pass/fail report on the day of testing while at the test site. Quarterly reports are sent to the training facility. The candidate’s results can also be viewed on the Pearson VUE® Business Intelligence Portal. Instruction on how to access reports on the Pearson VUE® Business Intelligence Portal will be given later in this handbook. Teachers should share the NACES competency test results with CTE Directors/Coordinators. This data can be used in the CTE Director’s local plan. Teachers should do everything possible to encourage students to follow through with competency testing so that the credential is achieved. Perkins IV (2006) reads, “Core indicators for secondary students shall include: …a proficiency credential in conjunction with a secondary diploma.” Funding is tied to meeting Perkins indicators.
You will receive confirmation from the nurse aide office as soon as your program is approved. If you have not received a notification within 3-4 weeks after submitting your application, call the DPI nurse aide office at 919-807-3893 or email
amoore@dpi.state.nc.us. Much of the communication during the year, including program approval confirmations, is done via email.
This nurse aide handbook contains a wealth of information and should be read thoroughly and kept in close proximity for reference. Clarifications and changes are communicated throughout the year via the nurse aide e-group. It is your responsibility to stay abreast of updates. You are encouraged to use Chapter 10 in the back of the nurse aide handbook
2009-2010 NA in Review and What’s Ahead
NCHOE/Nurse Aide training programs have just completed the fourth year of state competency testing. North Carolina has renewed the contract with PearsonVUE so our
relationship with PearsonVUE and NACES will continue. Many HOE/nurse aide teachers have discovered the benefits of participating in in-facility testing and working as nurse aide evaluators (NAEs). A big “thank you” goes to those who went the extra mile to provide in-facility testing (IFT) for students! As of 5-3-2010, 62 high schools have been identified as IFT sites.
This has been another year of economic challenge and uncertainty. However, our mission of training caring and competent health care workers has not wavered. According to the State of
NC Workforce – Assessment of the State’s Labor Force – 2007 to 2017, the need for Home
Health Aides is expected to rise 3.9% by 2017. The need for Nurse Aides is expected to grow 2.5% by 2017. Nurse aide competency certification makes it possible for some to secure jobs and serves as a pathway to higher education for others.
There have been significant improvements in compliance with standards for equipment and supplies. Seventy-five Health Occupations Education Nurse Aide Programs were reviewed on location between January, 2010 and May, 2010. Some stipulations were sited but overall training program compliance is improving. Many CTE Directors have been a part of the program audits. This has resulted in an increased understanding of nurse aide training regulations and increased rapport.
2010-2011 will be the pilot year for Health Science II and Nursing Fundamentals. The course description for Nursing Fundamentals reads as follows:
Course Number: NAXXX Fixed Maximum Enrollment: 10
Recommended Hours of Instruction: 270-360 (Two units of credit) Prerequisites: Health Science I and Health Science II
Nursing Fundamentals is designed for students who are interested in medical careers where personal care and basic nursing care skills are used. This course is an enhanced adaptation of the North Carolina Division of Health Service Regulation Nurse Aide I curriculum. Students who successfully complete the course will be prepared to take the National Nurse Aide Assessment Program (NNAAP) competency exam for Certified Nurse Aide I. Clinical internship in a long term facility is required. Health care clinical sites may require tuberculosis and/or drug screenings, evidence of immunizations, and criminal background checks. HOSA activities support networking with health care agencies and professionalism through the development of clinical expertise and volunteerism.
PearsonVUE will be implementing an online application for candidates effective July 1, 2010. You will receive a letter from PearsonVUE about these changes. As always…be sure you are using the most recent NACES documents.
Who Does What in Nurse Aide
Division of Health Service
Regulation Health Care
Personnel Registry Section
Center for Aide Regulation and
Education
DHSR
CARE
This state agency has been
given authority by the Board
of Nursing to regulate Nurse
Aide I training and registry in
North Carolina
The National Nurse Aide
Assessment Program
NNAAP™ This examination program is
designed to determine
minimal competency required
to become listed on the
registry as a Nurse Aide I
National Council of State
Boards of Nursing
NCSBN
Developers of the NNAAP™
competency examination
designed to meet the nurse
aide evaluation requirement
of federal and state laws and
regulations
Pearson VUE
®Pearson
VUE
®Pearson VUE
®is the
authorized administrator of
the NNAAP™ in North
Carolina. This company
scores, and reports the results
of the NNAAP™
Examination to NC Nurse
Aide I Registry
Nurse Aide Competency
Evaluation Service Plus
Foundation
NACES
This company contracts with
Pearson VUE
®to
administer
the NNAAP™ written and
skills examinations North
Carolina nurse aide
candidates
Reviewed for inclusion by Kris Winning 6-17-2010,DATE: 07/17/2009
TO: Career and Technical Education Administrators
FROM: Rebecca Payne, State Director, Career and Technical Education Mary Jo Nason, Interim Section Chief, Curriculum
Re: Allied Health Science II/Nurse Aide Class Enrollment
For students to deliver safe, competent personal care in a sound educational environment and maintain good relationships within the medical community, enrollment expectations must be met.
Enrollment Standards
Recommended classroom enrollment cap is 16 for Allied Health Sciences II. (Standard Course of Study)
The North Carolina Board of Nursing Administrative Rule 21 NCAC 36.00318(i)
requires the ratio of one teacher to 10 Nurse Aide students or less while in the clinical area.
(i) Nurse faculty members shall be sufficient in number to implement the curriculum as demanded by the course objectives, the levels of the students, and the nature of the learning environment, and shall be sufficient to provide for teaching, supervision and evaluation. The faculty-student clinical ratio shall be 1:10 or less for Nurse Aide students.
Health Occupations Education (non Nurse Aide) students must have clearly delineated supervision. Classes with 16 or less students enrolled
Allied Health Sciences II/Nurse Aide programs with one full time teacher must limit
enrollment to 16 in one section and provide adequate supervision for both Nurse Aide and non Nurse Aide students for Nurse Aide program approval to occur.
The Nurse Aide teacher who has Nurse Aide students in the clinical area cannot leave those students to physically monitor other Health Occupations Education students in separate observational areas.
Schools may utilize medical facility personnel to supervise Health Occupations Education (non Nurse Aide) students when appropriate and approved arrangements are made between the school and the medical facility.
In situations where appropriate and approved medical facility supervision for non Nurse Aide students is not possible, additional faculty, local education agency employee approved by the host medical facility, must be provided to monitor Health Occupations Education students in observational areas while Nurse Aide students are
Classes with more than 16 enrolled
As the enrollment number increases, so do the responsibilities of the instructor to ensure that every student entering a clinical facility can provide safe, competent, and quality care to clients.
Allied Health Sciences II/Nurse Aide classes with an enrollment greater than 16 will require an additional teacher.
Schools may utilize medical facility personnel to supervise Health Occupations Education (non Nurse Aide) students when appropriate and approved arrangements are made between the school and the medical facility.
In situations where appropriate and approved medical facility supervision is not possible, additional faculty, local education agency employee approved by the host medical facility, must be provided to monitor Health Occupations Education students in observational areas concurrently while Nurse Aide students are in long-term type care facilities with the other teacher.
For more information or technical assistance contact Agnes Moore, Nurse Aide Program Manager at 919-807-3893 or amoore@dpi.state.nc.us.
C: Greg Gift
Regional Coordinators Joan Thompson Agnes Moore
Nurse Aide
Training Program Eligibility Criteria
Criteria #1 TRAINING PROGRAM SCHEDULING & ENROLLMENTNurse aide training should be scheduled at a time that allows for adequate clinical experiences
Morning classes provide better personal care opportunities to apply nurse aide skills
Afternoon classes should be avoided if at all possible. If afternoon classes are scheduled, care must be taken to assure adequate skill application opportunities for students.
16 is the absolute enrollment limit for one section/class of AHSII/Nurse Aide
Refer to 7-17-2010 memo to Career and Technical Administrators from Rebecca Payne, CTE Director and Mary Jo Nason, Section Chief Curriculum Re: Allied Health Science II/Nurse Aide Class Enrollment (10 is the absolute enrollment limit for the Nursing Fundamentals PILOT)
There are no exceptions
Criteria #2 FACULTY
Teachers must be approved by the DPI/HOE/Nurse aide office
Registered Nurse, with unencumbered license, licensed to practice in North Carolina
Minimum of two years work experience as a registered nurse
Completed a course in teaching adults or experience in teaching adults or experience in supervising nurse aides
Teachers must be present and teach the nurse aide class 90 % of the total class time
Faculty must be adequate for the enrollment of the AHSII/Nurse Aide class
16 is the absolute enrollment limit for one section/class of AHSII/Nurse Aide
10 is the absolute enrollment limit for the Nursing Fundamentals pilot
There are no exceptions
Criteria #3 HOE SCOPE/SEQUENCE
HOE scope and sequence is clearly followed as outlined in the Programs of Study in regard to course content, sequence and satisfaction of recommended prerequisites. Inclusion of NA I competency instruction as outlined by the Division of Health Service Regulation/Center for Aide Regulation and Education and the Department of Public Instruction is apparent.
Use of current HOE curriculum guides, course blueprints and test item banks for AHS I or (MS I) & AHS II apparent
Master Skills Summary Sheet Part II (MSSS Part II) completed
Master Outline completed with special attention to Unit O supplemental materials that must be taught for nurse aide training
Criteria #4 PROGRAM TRAINING LABORATORY
Simulated patient care unit, equipment and supplies outlined in the DHSR list are
readily available to the students for skill acquisition, refinement, and retention.
Simulated patient care unit includes bed, hanging curtains with 360 privacy, bedside stand or functional equivalent, bedside chair, over bed table in an area of at least 100 square feet for one bed and 80 square feet for two beds
Hanging curtains must be substantial and functional
to direct patient contact.
Master Skills Summary Sheet Part I (MSSS Part I) must be completed in ink and filed in each nurse aide student’s individual file
(MSSS Part I) must be kept current during skills acquisition time
(MSSS Part I) must be totally completed prior to direct hands on care of patients
(MSSS Part I) is a legal document showing proof of skill proficiency
Curricular skills performance sheets are used in the lab for skill acquisition. A set of curricular skills must be kept in the class file for each year of nurse aide
students
Teacher must teach from the most current skills performance sheets available
Students are given a score in the grade book for skills demonstrated in the training lab
Skills in the NC Nurse Aide I Candidate Handbook are NOT taught as the
standard of care. These skills are used in competency evaluation preparation only. NNAAP™ skills represent minimal competence and do not represent the standard of patient care
Criteria #5 CLINICAL TRAINING
Required immunizations and other preparation required by the host medical facility completed prior to clinical experience
Use of approved clinical facilities evident
Constanton unit direct supervision of 10 students or less by 1 teacher
Emergency action plan for students to follow when a student on the clinical floor needs immediate (stat) assistance
40 hours of long term care as outlined in one of the four options for clinical
Students demonstrate proficiently the subset of skills required by DHSR in the clinical area and same documented on the MSSS Part III
Criteria #6 COMPETENCY TESTING FOLLOW UP
Teacher completes certificate of completion of nurse aide training after all nurse aide training requirements are met
Teacher monitors the application to test
Teacher can access Pearson VUE® Business Intelligence Portal results of competency testing
Teacher reviews Pearson VUE® reports and adjust teaching strategies accordingly
Sends Pearson VUE® quarterly reports to local CTE Director
Criteria #7 TEACHER’S UITLIZATION OF NURSE AIDE TRAINING RESOURCES
Teacher has/uses a current hardcopy of the nurse aide handbook
Teacher has/uses a current hardcopy of NC Nurse Aide I Candidate Handbook
Teacher is able to access the nurse aide resources on the NCPublicSchools.org website
Teacher receives, reads, and saves for future reference, group emails from the Nurse Aide Program Manager
Criteria #8 MAINTAINANCE OF RECORDS
Student records and class files locked in a file cabinet
Individual file or individual section of a notebook kept for each student completing nurse aide training per handbook instructions
Class file for each section of AHSII/Nurse Aide training
Criteria #9 NOTICE OF TRAINING PROGRAM CHANGE
The approved training program faculty and/or administration is responsible for notifying the nurse aide office immediately when program changes occur
Such changes include but are not limited to: faculty, clinical sites, location changes, school schedule changes that affect nurse aide training, program coordinator, principal, and CTE Director
Chapter 2
MASTER OUTLINE &
SUPPLEMENTS
FOR NURSE AIDE TRAINING
A copy of the completed
Master Outline and
Supplements
should be placed in the CLASS
FILE for each section of nurse aide training.
Completed means that the teacher signs and
dates the
Master Outline and Supplements
Circle A
Circle B
Circle A = Allied Health Science II NCDPI Curriculum
Circle B = DHSR State Approved Nurse Aide Curriculum
When the NCDPI Allied Health Science II
curricu-lum is taught as outlined in the blueprint and the
curriculum guide, approximately 85% of DHSR
nurse aide curriculum is taught.
To satisfy all requirements for state approved nurse
aide training, additional competencies must be
taught! COMPETENCIES MUST BED TAUGHT.
See below...
Supplemental Materials found in UNIT O must be taught to
com-plete nurse aide training. Unit O includes restorative care, mental
health, death and dying, legal/ethical, and foot care.
Employability Skills, Dental / Pharmacy Skills,
Information Services, and
Environmental Medical Skills.
AHSII / Nurse Aide Training Program
Nurse Aide I Master Outline
TEACHER SHOULD DATE EACH UNIT AS IT IS COMPLETED, AND SIGN WHERE INDICATED TO VERIFY THAT THE UNIT HAS BEEN
COMPLETELY TAUGHT.
This outline includes the basic AHSII curriculum PLUS supplemental materials needed to fulfill nurse aide training.
Follow the AHS II course outline/blueprints and include all additions noted within this outline.
NNAAP™ skills are listed in bold/italics.
Some areas have additional supplemental materials which are listed in the reference column. Textbook(s) used for NA I instruction should be no older than five years.
Recommended Materials/Resources:
Alvare, Dugan, Fuzy. Nursing Assistant Care. Hartman Publishing, (latest edition). Simmers, Louise. Diversified Health Occupations. Delmar Publishers, (latest edition). Sorrentino, Sheila. Mosby’s Textbook for Nursing Assistants, (latest edition).
DHHS, DHSR. Model Curriculum NA I Training Program (supplement included). Unit/
Comp #/Obj.
AHS II Course Outline Nurse Aide Requirements Skills for NA Certification
Reference Additions
Unit A Health Care Systems Entire Unit None None
Unit A instruction completed on this date: Signature of teacher:
Unit B Client Communications
Analyze effective/ineffective communication practices Entire Unit + Demonstrates ability to communicate effectively with residents who have:
Difficulty hearing Difficulty seeing Difficulty speaking Depression Confusion Memory loss Communicates based on resident’s stage of development Documenting on medical records
Unit B instruction completed on this date: Signature of teacher:
Unit C Employability Skills None None None
Unit C instruction completed on this date: Signature of teacher:
Unit D Legal/Ethical Responsibilities
Analyze legal roles and
Entire Unit + Participates in Resident Council. Identifies what is None Supplement From NAI State curriculum
Explains role of “advocate” and facility’s grievance policy. Assists in resolving grievances when appropriate. Nurse Aide handbook
Unit D instruction completed on this date: Signature of teacher:
Unit E Safety Practices Entire Unit Observing fire safety
Using body mechanics
Unit E instruction completed on this date: Signature of teacher:
Unit F Infection Control Entire Unit +
New skills listed
Hand washing Standard
Precautions (Don and Remove Gown)
Maintaining isolation technique
Disposing of equipment from Unit With Transmission-Based precautions
Unit F instruction completed on this date: Signature of teacher:
Unit G Emergency Care Skills Entire Unit Performing CPR, one
person Performing CPR, two
person
Performing CPR, infant and child Airway obstruction: conscious victim Airway obstruction: unconscious victim Demonstrating the use of an AED
Unit G instruction completed on this date: Signature of teacher:
Unit H Diagnostic Skills Cont. Entire Unit +
Additional skills listed
Measures/records
oral temp. using a glass thermometer Measuring/recording temperatures electronically (oral, axillary, rectal) Measuring/recording a tympanic temperature Measuring/recording a radial pulse
Measuring/recording apical pulse Measuring/recording height Measuring/recording weight
Unit H instruction completed on this date: Signature of teacher:
Unit I Nutrition and Diet Therapy
Recognizes adaptive devices used to assist patients with eating. Identifies alternate methods of feeding Entire Unit + Food Guards Divided plates Built-up handled utensils Easy grip mugs/glasses Parenteral feeding Enternal feeding – Nasogastric/gastrostomy tubes NA responsibilities
2005 Food Guide Pyramid
Feeds Client Who
Cannot Feed Self
Measuring/recording intake and output Measures/Records
Urinary Output
Unit I instruction completed on this date: Signature of teacher:
Unit J Dental/Pharmacy Skills
None None None
Unit J instruction completed on this date: Signature of teacher:
Unit K Nursing Skills Entire Unit +
Additional skills listed
Foot care – see
supplement.
Making/Opening closed bed
Making an occupied bed
Provides Mouth Care
Cleans & Stores Dentures
Giving special mouth care Giving a back rub Complete bed bath Provides Perineal Care
Provides Foot Care
Provides Fingernail Care
Dresses Client with Affected Arm
Helping patient with a tub bath/shower
Gives Modified Bed Bath
(Partial)
Shampooing hair in bed Shaving a patient
Assisting with a bedpan
Assisting with a urinal Assisting to bedside
commode
Assisting to bathroom Obtaining a routine urine
specimen
Collect specimen under Transmission-Based precautions
Collect stool specimen Empty a urinary drainage
catheter
Administer a cleansing enema
Transfers Client bed to wheelchair
Transferring to a stretcher Applying restraints
Turns/positions with & w/o turn sheet
Transferring with mechanical lift Positions Client On
Side
Moving patient up in bed Puts On Knee-High Elastic Applying warm/cold applications Applying elastic bandages Applying non-sterile dressing Assisting with cough/deep breath exercises
Unit K instruction completed on this date: Signature of teacher:
Unit L Therapy and Sports Medicine
Entire Unit Performs Passive
Range of motion (One Knee/One Ankle) & (Shoulder)
Ambulation with a
walker/cane
Ambulation with a
gait belt
Unit L instruction completed on this date: Signature of teacher:
Unit M Information Services None None None
Unit M instruction completed on this date: Signature of teacher:
Unit N Environmental/ Medical Careers
None None None
Unit N instruction completed on this date: Signature of teacher:
Unit O Restorative Care Assist with care/use of prosthetic devices Artificial eye Eyeglasses Contact lenses Hearing aid Braces Artificial limbs Breast forms None Supplement From NAI State curriculum Included in this HOE Nurse Aide handbook
Remember to review diseases/disorders of the body systems throughout the year as related information from AHS I will be included on the NA I exam.breakdown
Areas pressure ulcers most frequently occur
Unit O Mental Health and Social Needs
Psychological Effects of Aging
Identifies basic human needs and ways to meet those needs for resident Identifies developmental
tasks of aging Identifies defense
mechanisms residents may use in response to stress Encourages age
appropriate behavior for all people
Recognizes family’s role in resident’s emotional support
Identifies ways that age, illness, and disability affect sexuality
Lists symptoms displayed by residents with dementia Identifies special needs
when caring for resident with Alzheimer’s disease Demonstrates use of reality
orientation skills
Identifies skills needed to care for emotionally stressed/ demanding/ agitated/paranoid thinking and depressed residents
PLUS SUPPLEMENTAL CONTENT None Supplement From NAI State curriculum Included in this HOE Nurse Aide handbook
Unit O Death/Dying Identifies special needs of
dying resident and nurse aide’s role Describes psychological stages of grief/loss/death Identifies signs of approaching death Respects resident’s religious beliefs Considers family and
attempts to meet their needs as they encounter dying process
Describes hospice philosophy
Perform Postmortem care
CNA SUPPLEMENT - 1
Mental Health and Social Needs
Objective: Recognize how age, illness, and disability affect sexuality.
Expressed by individuals of all ages
Ways to show feminine or masculine qualities o Clothing styles and colors
o Hairstyles
o Hobbies and interests
o Sexual habits (continue into old age) o Gestures
Forms of sexual activity o Sexual intercourse
o Caressing, touching, holding hands o Masturbation
Patients have the right to be involved in sexual activity Guidelines for the nurse aide
o Assist in maintaining sexual identity by dressing patients in clothing appropriate for men or women
o Assist with personal hygiene as needed
o Assist patients to prepare for special activities by “dressing up”
Select attractive clothing Style hair in a special way Apply cosmetics
Assist in application of special perfume or aftershave
o Help patients to develop a positive self–image o Show acceptance and understanding for patient’s
expression of love or sexuality Provide privacy
Knock prior to entering a room Assure privacy when requested o Avoid exposing the patient
o Accept the patient’s sexual relationships
o Provide protection for the non-consenting adult
o Be firm but gentle in your rejection of a patient’s sexual advances
Injury and illness effects on sexuality
o Disfiguring surgery may cause a person to feel: Unattractive and ugly to others
Mutilated and deformed Unworthy of love or affection
o Chronic illness and certain medications can affect sexual functioning
o Disorders that cause impotence Patients with diabetes Spinal cord injuries
Discuss appropriate reactions of health care personnel to various sexual activities performed by patients. Instructor will discuss ways to deal with the sexually aggressive patient.
Have the class consider the various illnesses and
injuries that affect sexuality.
effects on sexuality
Removal of prostate, testes, uterus, ovaries, breast. Colostomy or ieostomy
o Disorders affecting the ability to have sex Stroke
Nervous system disorder Heart disease
Chronic obstructive pulmonary disease Circulatory disorders
Arthritis or conditions affecting mobility and or flexibility
Teacher Signature:
Date of Completion:CNA SUPPLEMENT - 2
Legal / Ethical
Objective: Explain the purpose and value of a patient council. Patient Council – Advisory Group
Provides opportunity for discussion May make recommendations for:
o Facility policy
o Decisions regarding activities o Exploration of patient’s concerns o Resolving grievances
Gives patients a voice in facility operations
Members include patients, facility staff members, and representatives from the community
Invite a member of a patient advisory group to speak.
Objective: Assure patient’s freedom from abuse, mistreatment, neglect, diversion of drugs, fraud, or misappropriation of property. Mistreatment of the Elderly
Federal and state definitions:
o Abuse means the willful infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm pain or mental anguish.
o Neglect means a failure to provide goods and services necessary to avoid physical harm, mental anguish or mental illness.
o Misappropriations of property mean the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a patient’s belongings or money without the patient’s consent.
o Diverson of drugs means the unauthorized taking or use of any drug.
o Drug means any chemical compound that may be used on or administered to humans or animals as an aid in the diagnosis, treatment or prevention of disease or other condition or for the relief of pain or suffering or to control or improve any physiological pathological condition. o Fraud means an intentional deception or
benefit to him or some other person. It includes any act that constitutes fraud under applicable federal or state law. Patients Right to be Free From Abuse
o Physical o Verbal o Sexual o Mental o Corporal Punishment o Involuntary Seclusion Signs of Abuse o Fractures
o Bruises of face, upper arms, upper thighs, abdomen o Fearfulness
o Withdrawn, paranoid Examples of Abuse
o Threatening a patient o Frightening a patient
o Pinching, slapping, pushing or kicking a patient o Withholding food or fluids
o Restraining a patient against her/his will without an apparent reason
o Leaving a patient in soiled linen or clothing o Yelling angrily at or making fun of a patient o Refusing to reposition a patient or give treatment o Not answering a call light/bell/signal
o Humiliating a patient
o Making disparaging derogatory remarks o Sexual coercion
o Sexual harassment o Verbal harassment Advocates
o Plead the cause of another o Resolve grievances o Protect patient’s rights o Advocates can be:
Health care workers / staff
Member of a patient’s family/support system Patient’s guardian
Ombudsman
o Patient’s Right to Voice Grievances concerning Services furnished
Services not furnished Behavior of others
Nurse aide must report grievances to nurse manager
o Facility Policy Components
Acknowledgement of grievance Attempt to resolve grievance
Apprise patient regarding grievance resolution
Role play appropriate responses to behavior
Review NC law and federal regulations regarding abuse
Review facility grievance policy
Suggest a patient grievance that might occur and role play
CNA SUPPLEMENT - 3
Restorative Care
Objective: Assist in care and use of prosthetic devices.
Course Content Learning Activities
Artificial Eye (glass eye)
Encourage patient to remove, clean and replace eye prosthesis if able and necessary.
Regular removal of the prosthesis is not always recommended unless there are problems or discomfort. (Nursing Assistant Care by Alvare,
Dugan and Fuzy © 2005.)
Some artificial eyes are surgically implanted. (NAC)
If eye is removed it should be stored in an eye cup or basin with a soft cloth or a piece of 4 x 4 gauze and filled with saline or water to prevent deposits from drying on the surface. Close the container, and label with the resident’s name. (NAC)
Artificial eyes are held in by suction. (NAC)
They will come out quickly when pressure is applied below the lower eyelid. (NAC)
Artificial eyes may be washed in mild soap and warm water. (NAC) You may rub it with moist gauze to remove surface secretions. (NAC) Rinse well. (NAC)
If the eye is removed, wash the eye socket with warm water or saline. Use a clean 4 x 4 gauze to clean it.
Clean the eyelid.
Wipe from the inner corner outward. Eyeglasses
Made of plastic or glass
Stored in protective case to prevent damage when not in use. Hold and handle by the frames
Wash under running water using mild detergent. o Rinse well with water
o Dry with tissue or soft cloth
Observe tops of ears and nose for redness or irritation from glasses. Report such findings.
Wash hands before and after cleaning patient’s glasses. Contact Lens (hard or soft)
Encourage patient to care for lenses. Report any unusual observations.
o Redness, itching, swelling, complaints of pain, blurring or scratching sensations.
Hearing Aid
Ear piece is cleaned daily with soap and water. This is the only washable part.
Ear piece and tubing should be soft.
Special equipment is needed to clean wax from tubing. Batteries should be checked for power.
Observe skin for redness or irritation in or around the ear. Report such findings.
Have students collect necessary supplies for
washing, and storing a prosthetic eye. Use marbles as eyes. Provide guided practice as students wash and store the eye. Provide feedback as needed for skill refinement.
Have students practice cleaning eye glasses or sunglasses.
o Turn the volume to lowest level or off. o Gently lift ear piece up and out to the ear. o Use tissues to wipe wax off ear piece. Applying a hearing aid
o Turn volume toward maximum, until hearing aid whistles. Then, lower volume until whistling stops.
o Replace batteries if whistle cannot be heard. o Gently insert ear piece into ear canal and adjust for
comfort.
o Tubing and body of hearing aid are looped over the ear for over-the-ear models.
o Adjust volume to patient’s satisfaction.
Ask patient to show students how to test batteries for his/her hearing aid.
Discuss ways to avoid loss of hearing aids.
Braces
Support a weak part of the body Prevents movement of a joint Correct deformities
Prevents deformities
Made of metal, leather, and or plastic
Bony parts under brace require protection in order to prevent skin irritation.
Report any worn, loose, or missing parts. Check custom fitted shoes for:
o Broken shoe laces o Worn heels or soles o Worn or torn leather
o Odor or stain damage from perspiration
Suggest areas of body where a brace might be applied.
Show braces used most often such as a leg brace for
patients suffering from a stroke.
Amputation
Definition – the partial or complete removal of a body part. o Usually an arm or leg
o For the leg, below the knee amputation is the most common
Some prosthetic devices include artificial arm, foot, arm, and hand. Prosthetic devices are custom made to fit the individual patient.
Handle device with care and store in appropriate place when not in use.
When assisting residents with artificial limbs:
o Have the correct device for the correct patient o Check all parts for damage
o Evaluate the resident’s limb for irritation and swelling o Assist in padding the area of prosthesis touching the
patient’s skin
o Clean the prosthesis according to individual instructions o Report any needed repairs to the licensed nurse
o Observe and report any skin changes to a licensed nurse
Assign the class short reports to be researched and given orally on a fictitious patient with a below the knee amputation.
Discuss the different types of artificial limbs.
CNA SUPPLEMENT - 4
Foot Care
Objectives:
Discuss the care of the resident’s nails and feet List three purposes of nail/foot care
Identify factors to be considered when giving a resident nail care
Foot care is required daily and includes cleaning the feet and assuring that the toenails are trimmed and smooth
Patients with diabetes have a particular need for foot care to be performed consistently
Toe nails should be kept short, clean, free of rough edges Purpose of nail and foot care
o Prevent infection
o Prevent injury (long toe nails can get caught up in bed linens)
o Prevent odors General guidelines
o Trimming nails after soaking feet makes trimming easier o Nail clippers should be used to cut/trim nails
o Trim/clip nails straight across
o Push back cuticle with orange stick after softening nails by soaking
o Use file or emery board to smooth rough edges o Use care not to injury skin when clipping
o Residents with diabetes and circular problems will have their nails trimmed only by a licensed nurse or podiatrist (foot doctor)
o Review resident care plan and check with supervisor prior to trimming nails
Foot care procedure
o Wash feet using warm water and mild soap o Dry feet carefully, especially between the toes
o Apply lotion to the tops and bottoms of feet only; not between the toes
o Check the feet daily for redness, warmth or constant pain, numbness or tingling, dry, cracked skin, swelling, blister, cuts, scratches, other sores, ingrown toenails, corns, calluses
o DO NOT use a heating pad on resident’s feet o Keep footwear on, never let resident go barefoot o Change socks and shoes daily
o Foot injuries and infections can lead to gangrene and amputation, especially in patients with diabetes
o Notify supervisor immediately of any unusual observations of the feet Demonstrate nail care Show pictures of patients with gangrene secondary to foot injury and diabetes
Facilitate students to perform foot/nail care on each other in class
Teacher Signature:
Date of Completion:Chapter 3
FACULTY &
PROGRAM COORDINATOR
INFORMATION
HOE/NA Program Coordinator
Information
Program Requirement Regarding PCs
All HOE-NA programs must have a qualified Program Coordinator.
The Program Coordinator Agreement Form must be completed as part of the program application and must be submitted to the nurse aide office with the program
application.
If a program does not have an instructor that meets the criteria for coordinator, a Registered Nurse that meets the criteria must be secured.
Requirements
Registered Nurse, with unencumbered license, licensed to practice in North Carolina Minimum of two years experience as a registered nurse
At least one year experience (2,000 hrs. Full Time Equivalent) in the provision of long term care facility services demonstrated by:
A. working in a long term care facility licensed as a skilled nursing facility or a skilled nursing facility* which is a distinct part of a hospital. *Skilled nursing
facility is defined as: a nursing facility which is a distinct part of a hospital eligible for federal program certification under Medicare/Medicaid OR
B. experience supervising or teaching of students in a long term care facility or a skilled nursing facility* which is a distinct part of a hospital.
NOTE: Chronic care is not the same as long term care in a skilled nursing home. The Program Coordinator (PC), must have had good NA program audits, clear of
stipulations if the PC teaches HOE/AHSII/Nurse Aide
The PC may serve as PC for their individual program as well as other schools/programs in or out of county
Responsibilities
Ensures that the NCDPI/HOE/NA training policies/procedures are implemented and followed.
Serves as a liaison between the HOE-NA Office, the school(s) and the LEAs. Designs a plan that reflects how the program(s) being covering will be monitored.
PCs may hold periodic meetings with the program instructors, periodic phone checks, and or attend on site audits.
Reads and applies the policies and procedures outline in the 2010-2011 Nurse Aide Training Handbook and on the HOE e-group.
Completes and submits a separate faculty application for “Program Coordinator” if the individual has never served as a PC.
Submits a RN verification print out from the NC Board of Nursing Website. ALL instructors; primary, additional, supplemental and the PC must submit
verification of an unencumbered RN license annually. Go to http://www.ncbon.com and click on “Verify License.” You may search by entering social the security
number or the RN nursing license number. Print verifications for all teachers in your program and attach them to the program application.
Completes a PC SUMMATIVE AGREEMENT FORM indicating all the nurse aide training programs the PC is responsible for. The electronic file of this form can be
AHSII/Nurse Aide Training Program
PROGRAM COORDINATOR (PC)
SUMMATIVE AGREEMENT FORM
2010-2011
Listed below are the high school nurse aide programs you have agreed to serve as program coordinator.
Review/complete the list and notify the Health Occupations Education Nurse Aide office if you see an error or have a question. Call 919-807-3893 or email
amoore@dpi.state.nc.us
Review/complete your personal information and correct any errors
Sign and mail to: Agnes Moore, RN
HOE/Nurse Aide Office – 6358 Mail Service Ctr. – Raleigh, NC 27699-6358 (PC) Name Home Address Employer Work Address Work Email Work Phone RN License #
Name of School (training program) County or School System 1 2 3 4 5 6 7 8 9 10 11 12 13 14
Signature of Program Coordinator____________________________________ Date__________________________
AHSII / Nurse Aide Training Program
HOE/NA Primary Instructor
Requirements:
Registered Nurse, with unencumbered license, licensed to practice in North Carolina. Minimum of two years experience as a registered nurse.
Completed a course in teaching adults or experience in teaching adults or experience in supervising nurse aides.
If provisionally certified, continue to work toward a clear teaching certificate. The Primary Teacher Agreement Form must be completed as part of the program
application and must be submitted to the nurse aide office with the program application.
Responsibilities:
Serve as a contact person and disseminate information as needed to the program faculty and administration.
Ensure that your school’s nurse aide training program is in good standing.
Confirm that a Registered Nurse instructs the AHSII/nurse aide training program at least 90% of the time.
Report any instructor or clinical facility changes or additions to the HOE – Nurse Aide office immediately! For example: teachers out on extended leave, teachers leaving their teaching post, new instructor(s) in the program.
Assure that only approved nurse aide instructors sign the Application for Registration
by Competency Evaluation. If a signature on the application is not an approved
instructor, students will not be allowed to take the state competency evaluation. Facilitate the submission of completed student applications to test to PearsonVUE®
per PearsonVUE® guidelines.
Stay updated concerning nurse aide education matters by reading and applying the policies and procedures outline in the 2010-2011 Nurse Aide Training Handbook and through participation in the HOE e-group.
Encourage students to follow through with state competency evaluation and assist students as needed in the completion and submission of the NACES application. Complete and submit a separate “faculty” application. (FOR NEW TEACHERS
ONLY)
Submit a RN verification print out from the NC Board of Nursing Website.
ALL instructors; primary, additional and supplemental must submit verification of an unencumbered RN license annually. Go to http://www.ncbon.com and click on “Verify License”. You may search by entering social the security number or the RN nursing license number. Print verifications for all teachers in your program and attach them to the program application.
AHSII / Nurse Aide Training Program
HOE/NA Additional Instructor
Requirements:
Registered Nurse, with unencumbered license, licensed to practice in North Carolina. Minimum of two years experience as a registered nurse.
Completed a course in teaching adults or experience in teaching adults or experience in supervising nurse aides.
If provisionally certified, continue to work toward a clear teaching certificate. The Additional Teacher Agreement Form must be completed as part of the program
application and must be submitted to the nurse aide office with the program application.
Responsibilities:
Help ensure that your school’s nurse aide training program is in good standing.
Help ensure that a Registered Nurse instructs the AHSII/nurse aide training program at least 90% of the time.
Help in reporting any instructor or clinical facility changes for your program to the HOE – Nurse Aide office immediately! For example: teachers out on extended leave, teachers leaving their teaching post, new instructor(s) in the program.
Assist in the completion and submission of the Nurse Aide Application for
Registration by Competency Evaluation to PearsonVUE®. If a teacher signature on the application is not an approved instructor, students will not be allowed to take the state competency evaluation.
Stay updated concerning nurse aide education matters by reading and applying the policies and procedures outline in the 2010-2011 Nurse Aide Training Handbook and on the HOE e-group.
Encourage students to follow through with state competency testing and assist students as needed in the completion and submission of the NACES application. Complete and submit a separate “faculty” application. (FOR NEW TEACHERS
ONLY)
Submit a RN verification print out from the NC Board of Nursing Website.
ALL instructors; primary, additional and supplemental must submit verification of an unencumbered RN license annually. Go to http://www.ncbon.com and click on “Verify License”. You may search by entering social the security number or the RN nursing license number. Print verifications for all teachers in your program and attach them to the program application.
AHSII / Nurse Aide Training Program
HOE/NA Supplemental Instructor
Requirements:
Registered Nurse, with unencumbered license, licensed to practice in North Carolina. Minimum of one year, or one year equivalent of 2,000 hours, experience as a
registered nurse.
Completed a course in teaching adults or experience in teaching adults or experience in supervising nurse aides.
Supplemental teachers are clinical instructors. It is not required that they pursue teacher licensure through DPI.
The Supplemental Teacher Agreement Form must be completed as part of the program application and must be submitted to the nurse aide office with the program application.
Direct supervision of nurse aide students is the only duty a supplemental teacher can fulfill at one time. Supplemental teachers can not be in “name only” while fulfilling other duties such as director of nursing, staff nurse (while on duty as a nursing home employee), or filling any role other than direct supervision of nurse aide students. Supplemental teachers may not be on duty as a staff nurse and concurrently serving as supplemental teacher. On the other hand, it is totally permissible for a DON to serve as a program coordinator.
Responsibilities
The supplemental instructor has no classroom responsibilities.
Assist the primary and or additional instructor in supervising students as they perform nurse aid skills on patients in the clinical area.
Stay updated concerning nurse aide education matters by reading and applying the policies and procedures outline in the 2010-2011 Nurse Aide Training Handbook and on the HOE e-group or through good communication with the other program
instructors.
Encourage students to follow through with state competency testing.
Complete and submit a separate “faculty” application. (FOR NEW TEACHERS ONLY)
Submit a RN verification print out from the NC Board of Nursing Website.
ALL instructors; primary, additional and supplemental must submit verification of an unencumbered RN license annually. Go to http://www.ncbon.com and click on “Verify License”. You may search by entering social the security number or the RN nursing license number. Print verifications for all teachers in your program and attach them to the program application.
AHSII/Nurse Aide Training Program
FACULTY APPROVAL REQUEST FORM
(1 of 2 pages)New teachers must submit this form to the NCDPI/HOE/Nurse Aide office for approval. Returning teachers need only to submit the “teacher agreement” part of the nurse aide program application. Changes in nurse aide training faculty must be reported to the nurse aide office immediately! Complete the form electronically, review, apply handwritten
signature/date and mail to the NCDPI/Nurse Aide office. Submit an electronic form to amoore@dpi.state.nc.us.
Approval will be granted when the signature hardcopy of the application is received and processed.
Section #1 Applicant RN and Contact Information Teacher’s Name as it appears on RN
license Teacher’s RN Certificate #
RN – BON confirmation # and date
School Email Attach BON RN Verification to this application
Home Email Cell: (Opt.)
Program Coordinator Primary Instructor Additional Instructor
POSITION(S) REQUESTED beside position requested
Supplemental Instructor
DPI Use
Section #2 School Information
Program Name ( School’s Legal Name)
School Phone Number Ext. School Mailing Address
Section #3 Registered Nursing Employment History List most recent RN employment first - Do not list any non-RN experience.
DATES From: To:
Month Day Year Month Day Year
Nursing Facility Employer Type of Facility
Address of Employer
Phone Indicate Part time or Full time
Hours worked per week Position / Duties
Supervised nurse aides as part of job? Total time worked for this employer
DPI Nurse Aide Office Use: LTC? Chronic?
DATES From: To:
Month Day Year Month Day Year
Nursing Facility Employer Type of Facility
Address of Employer
Phone Indicate Part time or Full time Hours worked per week Position / Duties
Supervised nurse aides as part of job? Total time worked for this employer
DPI Nurse Aide Office Use: LTC? Chronic?
DATES From: To:
Month Day Year Month Day Year
Nursing Facility Employer Type of Facility
Address of Employer
Phone Indicate Part time or Full time Hours worked per week Position / Duties
Section #4 Teaching/Supervisory History (2 of 2 pages)
Nurse Aide Instructors must have completed a course in teaching adults or experience in teaching adults or experience in supervising nurse aides. In the space below, describe how this requirement has been met.
Section #5 Applicant Affirmation and Signature
In signing below I affirm the information in this application is accurate to the best of my knowledge.
Signature: Date:
Additional Information or Comments:
Chapter 4
SKILLS TRAINING
LABORATORY
SKILL ACQUISITION
IS
MUSCLE MEMORY
Muscle memory, also known as motor learning, is a form of procedural memory that involves consolidating a specific motor task into memory through repetition. When a movement is repeated over time, a long-term muscle memory is created for that task; eventually allowing it to be performed without conscious effort. This process decreases the need for attention and creates maximum efficiency within the motor and memory systems. Examples of muscle memory are found in many everyday activities that become automatic and improve with practice, such as riding a bicycle or typing on a keyboard.
Krakauer,J.W., & Shadmehr, R. (2006). Consolidation of motor memory. Trends in Neurosciences, 29: 58-64.
IS NOT
MENTAL MEMORIZATION
Memorization or memorizing is the process of committing something to memory. The act of memorization is often a deliberate mental process undertaken in order to store in memory for later recall items such as experiences, names, appointments, addresses, telephone numbers, lists, stories, poems, pictures, maps, diagrams, facts, music or other visual, auditory, or tactical information. Memorization may also refer to the process of storing particular data into the memory of a device. Wikipedia
NURSE AIDE
SKILL ACQUISITION PROCESS
Demonstration of the skill
Formative Assessment (NC Falcon) = Clear Learning Targets/Criteria for Success Student Question: Where Am I Going?
Best if modeled by the teacher
Can be done via video/DVD etc. if the demonstration is accurate and clear Do not introduce distracters
Student actively observes
Guided practice
Formative Assessment (NC Falcon) = Collect & Document Evidence / Analyze Evidence Student Question: Where Am I Now?
Formative Assessment (NC Flacon) = Descriptive Feedback / Adjustment to Instruction Student Question: How Do I Close the Gap?
Student participates in the skill with teacher supervision Teacher is watching, correcting, and encouraging
Independent practice
Formative Assessment (NC Falcon) = Descriptive Feedback / Adjustment to Instruction Student Question: How Do I Close the Gap?
Student practices the skill with limited supervision Peers may provide feedback
Student may refer to the skill performance checklist for self correction
Repeated practice help students gain confidence and decrease the time needed to perform the skill
Proficiency Check-Off
Summative Assessment!
Student performs skills without prompting from skill sheets or individuals Pass or fail
Student who fail proficiency check off need to go back through the cycle of demonstration, guided practice, and independent practice.
Skills Practice Perspective
The ≈ 69 nurse aide curriculum skills and the National Nurse Aide Assessment Program (NNAAP) skills which are evaluated by NACES have different purposes. These two different types of skill items should not be viewed as being incongruent. The NNAAP skills have been modified for testing purposes and reflect minimal competence. The ≈ 69 nurse aide curriculum skills represent the golden standard for patient care. NNAAP skills are a subset of the
curriculum skills.
Curriculum Skills: ≈ 69 NNAAP Skills: 24
Use for TEACHING Skills
Use for NNAAP TEST preparation
Industry Standard of Care
Minimal CompetenceBest Practice
Modified for testing purposesHOE/AHSII Nurse Aide Training Program
Training Laboratory
The HOE/AHSII nurse aide training laboratory must be dedicated space set up similar to a resident’s room, complete with equipment and supplies normally found in a resident’s room, as well as those items needed for skills instruction, practice and return
demonstration. This simulated resident unit must contain a minimum of 100 square feet for one bed or a minimum of 80 square feet for each bed for two or more beds per federal regulations. Below is an example of an 80 square foot patient unit. It is highly recommended that square footage beyond the minimum be dedicated to enhance teaching and learning.
The average size for basic furniture found in a resident care unit is as follows. Hospital Bed: 7 feet long, 3 feet 5 inches wide
Over bed Table: 30 inches long, 16 inches wide
Wheelchair or some other type of patient chair: 25 inches wide, depth 25 inches plus leg room for lounge chairs or wheelchair legs when raised. Bedside Cabinet: 1 foot 8 inches long, 1 foot 8 inches wide
Curtains
Each bed must have ceiling suspended curtains which extend around the bed to provide total visual privacy in combination with adjacent walls and curtains. Example, if a bed is in the corner of a room, curtains will be needed only on two sides as existing walls provide the visual privacy needed on the other two sides. If the head of the bed is at the wall and the bed is not in a corner, curtains would be needed on three sides to provide total visual privacy. It is acceptable to suspend curtains from a wall mounted device as long as the curtain is freely movable as though it was suspended from the ceiling. The curtains should be over five feet in height to prevent visualization of the patient. Screens may not be substituted for suspended curtains.
Hospital Bed
Each hospital bed that is considered a part of a resident care unit must be fully functional. It does not matter if the bed is electric or manual but it must be functional and safe with appropriate bedding and comfortable mattress. The bed must have side rails that work. The bed height must be able to be raised and lowered. The head of the bed and the knees must be able to be raised and lowered. The bed must have functional bed locks that can be locked and released.
Patient Closet Space
In a real resident care unit, the patient must be provided with clothes racks and shelves accessible to the resident. There must be some storage space in the training laboratory that simulates this patient storage space.
Toilet and Bathing facilities
Each resident room must be equipped with or located near toilet and bathing facilities. A bedside commode labeled “toilet” may be substituted for a flushable toilet in the training lab. A simulated shower should be constructed from PVC pipes or by other creative means.
Samples of simulated Showers:
Debbie Sousa, RN – North Rowan
