nursing assistant introduction. federal & state regulations california code of regulations (ccr)...
TRANSCRIPT
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Nursing Assistant
Introduction
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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
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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
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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
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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
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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
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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
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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
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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
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Certification Renewal (cont)
Criminal clearance – fingerprinting NOT required
Renewal fee payment
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Qualities of a Successful CNA
Dependable Considerate Pleasant Empathetic Flexible Honest Compassionate & Caring Sensitive to others
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Qualities of a Successful CAN
Responsible Respectful Cooperative Team player Observant Well groomed Organized
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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
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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
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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
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Role & Responsibility of CNA
CNA responsible to:– Licensed nurse– DSD – RN Supervisor– Director of Nursing– Facility/Agency Administrator– Physician if in a clinic setting
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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
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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
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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
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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
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Professionalism for CNA
Carrying out resident care in a manner that:– Ethical & Competent– Knowledgeable & Caring– Committed & Giving of dignity– Representative of high standards
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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
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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
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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
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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
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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
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Examples of Confidentiality cont.
Discussing observations with nurse or physician
Discussing resident’s care while participating in team conferences or planning
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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