Transcript Nursing Assistant

Nursing Assistant
Introduction
Federal & State Regulations

California Code of Regulations (CCR)
Title 22w, Division 5
– CA state laws establishing
•
•
•
•
Licensing & Certification standards
MINIMUM standards of care for residents
CNA training regulations
CNA certification requirements
– Licensing of Skilled Nursing Facilities
California Code of Regulations

Skilled nursing facilities must have
policies & procedures ensuring resident
rights & safety
– Ombudsman can evaluate

Violations may lead to state citation &
fine
Omnibus Budget Reconciliation
Act of 1987 (OBRA)
Federal law requiring nurse aides
receive training & pass competency
exam within 4 months of employment
 Establishes standards of care for
Medicare & Medi-Cal reimbursement
 Improves resident quality of life
 Authorizes onsite surveys

OBRA

Violation of federal regs may lead to:
– Loss of ability to provide training programs
– Monetary penalties
– Directed inservices
– Payment denial
– State monitoring
– Termination of facility license
CNA Requirements-CCR, OBRA

Training course approved by DHS
– Minimum 50 hours theory plus 10
recommended hours of Alzheimers
Disease & Elder Abuse
– Minimum 100 hours clinical in SNF
– Course content must comply with Title 22 &
OBRA
– Criminal screening upon enrollment
CNA Requirements (cont)
Students who are employees of SNF
must be paid hourly wage while in
training
 History & Physical, TB clearance
 DHS 283B Initial application form

CNA Requirements

Successfully complete competency test
– Written & skills test
– Three opportunities to pass
– Must be taken within 2 years of
successfully completing course
– Competency test fee ($90 for ARC)
– Facility must pay test fee if student is an
employee or is hired within a year of
passing the test
CNA Requirements

2 Vendors give state competency exam
– Chancellor’s office, CA Community Colleges
– American Red Cross

Criminal clearance prior to certification
 Certification renewal requirements
– DHS renewal form 283C form
– Complete 48 hours of continuing education in 2
years
– Verify 8 hours of paid work as CNA in last 2 years
Certification Renewal (cont)
Criminal clearance – fingerprinting NOT
required
 Renewal fee payment

Qualities of a Successful CNA








Dependable
Considerate
Pleasant
Empathetic
Flexible
Honest
Compassionate & Caring
Sensitive to others
Qualities of a Successful CAN
Responsible
 Respectful
 Cooperative
 Team player
 Observant
 Well groomed
 Organized

Qualities of a Successful CNA

When providing care:
–
–
–
–
–
–
–
–
Wash hands
Gather supplies
Knock on door
Introduce self
Check identification
Explain procedures
Obtain permission
Provide privacy
Role/Responsibility of CNA

Member of the health care team which
includes:
– Resident & family
– RN, LVN, CNA
– Physician, RNP, PA
– PT, OT, Speech therapist
– Dietician, Activities Director, Social worker
– Clergy, Ombudsman
Role & Responsibility of CNA

Health care settings where employed
– SNF, Acute care hospitals, Intermediate
care facilities
– Hospice
– Assisted living, Residential care
– Psychiatric facilities
– Clinics
– Prisons
Role & Responsibility of CNA

CNA responsible to:
– Licensed nurse
– DSD
– RN Supervisor
– Director of Nursing
– Facility/Agency Administrator
– Physician if in a clinic setting
Responsibility in Resident Care

Provide a safe environment
– Proper use of equipment/protective
devices
– Awareness of potential hazards (spills, etc)
– Provide personal hygiene/cleanliness
– Care for resident’s personal property
– Adhere to standard precautions
Responsibility in Resident Care

Meet the resident’s physical needs
– Assist with ADLs in a timely manner
– Assisting with medical & rehab activities
(VS, turning, specimen collection,
ambulation, etc)
– Maintaining clean environment
Responsibility in Resident Care

Assist resident’s to meet psychosocial,
spiritual, & cultural needs
–
–
–
–
–
RESIDENT RIGHTS
Treated with dignity & respect
Feel secure & recognized as individual
Love & be loved
Feel sense of accomplishment & good about
themselves
– Follow personal beliefs
Fulfill Responsibility to
Employer
Reporting to work on time
 Reliably fulfilling assignments
 Notifying supervisor when ill
 Working as a team member
 Doing one’s job to the best of his/her
ability according to JOB DESCRIPTION
 Conserving supplies/equipment

Professionalism for CNA

Carrying out resident care in a manner
that:
– Ethical & Competent
– Knowledgeable & Caring
– Committed & Giving of dignity
– Representative of high standards
Professionalism for CNA

Professional behaviors or attitudes
– Skilled & caring when giving care
– Responsible, trustworthy, truthful (reports change
of address to DHS, keeps record of inservices)
– Attending inservices, maintaining state certification
– Following chain of command & scope of practice
– Being a team player
– Asking for assistance if needed (from who?)
– Being a mandated reporter
Ethical Behavior for CNA

Ethical Behavior for Resident Care
– Protect life & promote health
– Keep personal info confidential
– Respect each person as an individual
– Give care based on need, not gratuities
Ethical Behavior for CNA

Ethical behavior for work
–
–
–
–
–
–
Working assigned shift
Arriving on time
Being absent only when necessary
Notifying employer prior to necessary absences
Following instructions within scope of practice
Being loyal, flexible, & cooperative – a team
member
Ethical Behavior for CNA

Unacceptable behavior which may
result in dismissal:
– Abuse
– Stealing or willfully damaging property
– Insubordination & neglecting duties
– Altering or falsifying records
– Working under influence of drugs/alcohol
– Dishonesty & breech of confidentiality
Confidentiality
Maintained by discussing personal info
only with appropriate health team
members at appropriate times & places
 Examples –

– Adhering to HIPAA guidelines (Health
Insurance Portability & Accountability Act)
which limits sharing of information without
patient consent
Examples of Confidentiality cont.
Discussing observations with nurse or
physician
 Discussing resident’s care while
participating in team conferences or
planning

Examples of Breeching
Confidentiality

Discussing personal information with
– Another resident
– Concerned friends or visitors
– Members of the news media
– Members of the CNA’s family
– Persons in the community
– Health team members not directly involved
with resident care