Presentation on theme: "Nursing Assistant Course"— Presentation transcript:
1Nursing Assistant Course Upon completion of this course, students are eligible for the Minnesota Nursing Assistant Competency Exam.Completion of course includes completion of 18 hours clinical experience.
2Introduction to Nursing Assistant/ Home Health Aide Unit OneIntroduction to Nursing Assistant/ Home Health Aide
3Upon Completion of this Unit Students will : List personal qualifications of a Nursing AssistantDiscuss Productive work Habits for NAR’sDescribe how federal and State regulations are related to Nursing Assistant Responsibilities
4Objectives for unit one Define Ethics and Etiquette for the Nursing AssistantDescribe the Residents Bill of RightsDescribe the Vulnerable Adult LawDescribe Patient Self- Determination ActDiscuss legal implications for the NAR’sDescribe the need for individualized care compared to institutionalized care.
5List Personal Qualifications of Nursing Assistants Behavior:Honest - will not liePatient- self controlledCaring- feel concernCourteous - polite/respectfulDependable - reliableSensitive - responsiveAccountable for actions/manage assignments
6Positive Attitude of respect and dignity towards individuals of pride in what you doof maturity/ control your own emotionsof cooperation and team workof practicing high standards
7Personal Health good general health free from back injury or problems with liftinggood personal hygiene, groomingclean neat appearancepractice stress reducing exercises
8PRODUCTIVE WORK HABITS The Role of the nursing assistant is to provide or assist with personal care for residents under direct supervision of the licensed nurseMale and female nursing assistants care for both male and female residentsNursing assistants are expected to care for any resident in a facility
9Define Organizational Chart A diagram showing levels and lines of authority in a long term care facilityLine of responsibility include the nursing assistant being responsible to the charge nurse who may be an LPN or RN.
10Team work ConceptThe goal is to provide the best care for the residents with cooperation of the entire staff of the facilityThe NAR is usually assigned to a specific group of residents to provide continuity of care
11Describe Responsibilities of NAR’s Getting the jobMust complete NAR courseMust pass competency examComplete interview process including criminal background check.
12Examining a job description A job description is a detailed listing of tasks and responsibilities expected of the nursing assistant.Review copy********
13Responsibilities include job limitations DO:provide personal caremeasure vital signspractice safety measurespractice infection control measurespractice effective communicationsassist residents with ADL’sDO NOTgive medicationstake doctors ordersperform procedures requiring sterile techniqueperform procedures not taughtperform tasks prohibited by facility
14Keeping your NAR job Keep nursing assistant registration current work at least 8 hours in a long term care facility every two years providing nursing or nursing related services for compensation.Complete continuing inservice education, a minimum of 12 hours per year.Practice attribute listed in personal qualifications
15EMPLOYER EXPECTATIONS Focus on residentBe on timeBe flexibleAvoid absencesNo drug or alcohol usePrioritize duties
16Describe team approach in Health care Nursing Assistants work with other staff members to provide a team approach in caring for the resident. All work together, support each other to achieve resident goals.
17Members of the Team Resident nursing assistant licensed nurses activity staffoccupational therapistphysical therapisthousekeeping staff
18Team members Licensed social workers family clergy doctor volunteers laundry staffmaintenance staff
19Describe the purpose of Resident care Plans The Care Plan:Is a written plan designed for each residentIs developed in a care conference where the resident and family is invited to participate. The care plan is reviewed and updated periodically.Has long and short term goals defined and who is responsible for goal implementation.
20The Nursing Assistant is responsible to know the content of the care plan. If you have difficulty understanding anything in the care plan, it’s YOUR responsibility to ask the charge nurse.
21Observation Skills Required Use all your senses when observing the residentsListen to what the residents saysLook - observe residents skin, movements and behaviorsfeel the residents skin for warmth and textureSmell -changes in odor
22It’s YOUR Responsibility to: Report accuratelyRecord information per facility policyReview copy of Care plan/ assignment sheet*********
23Federal and State Regulations related to Nursing Assistants OBRA 87 - In 1987 the Federal government passed a law called the Omnibus Reconciliation Act, which regulates the education and registration of Nursing Assistants.Federal Law also regulates care of residents in long term care. Standards are monitored by an annual survey process.
24Ethics vs EtiquetteEthics is a moral code (knowing right/ wrong) which guides the behavior of health care workers. An ethical worker is one who:Promotes health, independence, safety and quality of life for each resident.Respects the residents area as his/her home.Does not discuss personal problems with resident and family
25The Ethical workerDoes not discuss facility issues with resident and family.Does not share or discuss own personal opinions regarding religious, political, cultural beliefs or customs, or living or financial conditions.Works within job description, know limitations of job and self, seeks help, advice and clarification when needed
26The Ethical worker Maintains confidentiality Accepts no “tips” for service to the residentAccepts responsibility for job and own behavior and is willing to accept constructive criticism and suggestions graciously
27Etiquette is:Good manners and maintaining a polite, courteous, kind attitude to resident, visitors, and other staff.Practice the “Golden Rule”. Do for others as you would want done for you.Address others by preferred name.Knock on residents door before entering.Close door and privacy curtain.
28Ask family and visitors to leave when giving personal care. Work quietly. Avoid unnecessary noise.Use respectful/appropriate languageNever whisper outside a patients room.
29ValuesThe standards that assist one to make decisions and guide ones behaviorPersonal values include:Culture, religion, education, rules, language, lifestyle, belief systems.
30Legal implications for Nursing Neglect: Failure to provide goods and services necessary to avoid physical or mental harm.Example: Failure to residents bed in low position.Liability: Responsibilities according to law.Know standards of care & qualifications
31Legal implications ( cont) Malpractice: Negligence is the basis for mal practice.Court will decideNursing assistants are responsible to work within your job description and understand legal guidelines.
32THE BILL OF RIGHTSThis Minnesota and Federal law provides nursing home residents with the same rights given to all citizens.
33Resident Bill of Rights This Federal law provides nursing home residents with the same rights given to all citizens.ALL MEMBERS of the health care team must respect the Bill of Rights,Resident rights are preserved when the nursing assistant uses skills which maintain and protects the residents dignity
34Residents have the right to: Be informed about rightsExam state or Federal survey reportsBe accorded dignity in personal relationships with staff.Be given in writing their doctors name and numberReceive quality care regardless of age, race, color, ethnic origin, religion, marital status, sexual preference or handicap.
35Residents have the right to: Receive encouragement and support in making personal choices to accommodate individuals needsBe protected from harm, both verbally and physicallyReceive continuity of careRefuse treatmentPrivacy during proceduresBe addressed by name preferredBe informed of costs and services
36Residents have the right to: Confidentiality maintained regarding their medical condition/careBe free from non-therapeutic chemical and physical restraintsWear their own clothing, keep personal possessions, have own moneyHave family or significant others participate in care conferencesexercise citizenship rights
37Residents have the right to: Have assistance and privacy in personal communicationHave personal possessions treated with respect and safeguarded.Be informed of diagnosis, treatment alternatives and risksBe informed of procedures in filing complaints and grievancesParticipate in religious and political activitiesOrganize, maintain and participate in resident and family councils
38The residents Bill of Rights Must be posted in an easy to see place in the long term care facility. A copy of the Bill of Rights must be given to all residents or guardians upon admission to the facility,
39Procedure to resolve grievances The Bill of Rights gives residents the right to voice grievances without fear of reprisal.When conflicts occur between residents the main concern is safety,Report information regarding conflicts immediately to charge nurse.State ombudsman services assist the residents to resolve conflicts with facilities.
40Minnesota Vulnerable Adult Law A Minnesota law which provides for protection of adults considered vulnerable due to physical, mental or emotional impairment.Protects adults who cannot help themselves if they are hurt or misused by others,
41Vulnerable Adult ActProvides for safe institutions for vulnerable adults who have been abused.Investigates reports of abuse or neglectIncludes person age 18 and over living in a licensed agency
42Define abuse:Abuse is non-accidental harm or threatened harm to a residents health or welfarePhysical abuse: Conduct that produces pain or injury and is not an accidentVerbal abuse: Repeated conduct that produces mental or emotional stressSexual abuse: Any sexual contact between staff and resident or client of that facility.
43Define Neglect and exploitation Neglect is failure to provide the vulnerable adult with the necessary food, clothing, shelter, healthcare or supervision.Exploitation is the illegal use of vulnerable adults person or property through undue influence, duress deception or fraud. Absence of financial management that through neglect might lead to exploitation.
44ABUSE Reported immediately. Follow facility policy. Confidentiality of reporter is protectedNo reprisal or retaliation to reporter if done in good faith,Persons who do not report are guilty of a misdemeanor and liable for damages.
45Facility responsibility Maintain written policies and procedures.Keep records of incidents of self injury or aggression between residents.Develop individual prevention plans
46Patient Self Determination Act This is a federal law which requires federally funded health care facilities to inform residents about their right to make treatment choices.Residents must be asked if they have a living will or a durable power of attorney for health care.
47Institutionalized Care Vs Individual Task orientedDepersonalizedFragmentedSchedule drivenOne size fits allsLittle ivolvement in decisions by direct care staff
48Institutionalized vs individual Individualized care ( resident centered)Caregivers are consistentCare is focused on resident choices, interests, needs, life style, preferences and abilities.Food, mealtime, bed time, activities are resident decisions.
49Terminology for resident centered Snacks vs nourishmentsHome vs facilityMusic vs, music therapyFamily room vs. resident loungePantry vs. nourishment roomGoal is to provide homelike atmosphere
51Introduction to HHA GOALS: Discuss history and goals of Home care Describe Home Health Care TeamDiscuss Role of Home Health AideDiscuss Ethics and Etiquette in Home Care
52History and Goals of Home Care Most people received health care in their homes until the early 1900’s. Then hospital care became more popular and practical due to advances in medicine.Family members cared for each otherneighbors assisted with birth and death careDoctor visited people in their homes
53History The home is returning as a place of choice for health care. High cost of hospital care leads providers to look for less costly alternatives.Fast growing elderly population may need some care, but not all services of a hospital or long term care facility.People prefer to be cared for in their homes.
54Payment for Home Care services Provider coverage of health care services is part of the decision where care will be given.HMOs, health insurance companies and others vary regarding their coverage of home care costs.Coverage is usually for short term and intermittent care
55Payment sources: Medicare reimbursement requires the person to be: confined to the homeunder the care of a doctor who certifies the need for careneeding skilled carereceiving care from a Medicare certified home health agency
56Who receives home care?Newborn to people over 100 may receive home care. Most fit into the following groups.Chronically ill - have one or more chronic conditions or disease and need assitance.Acutely ill - Need skilled care, sometimes high tech for a short time.Terminal illness - death is expected.Developmentally/mentally disabled.
57Referral SourcesHospital discharge planners identify needs and evaluate sites for continuing care.Family members, friends, clergy, and others often identify people at risk and need.Road to receiving home care is not always straight or clear.
58Goals of Home Care Assist to meet highest physical and mental function Provide service in comfort of clients homePromote client control of health and lifestyleEncourage family participation
59Who is the Health Care Team? Home care services are provided by an expanding network of community services.Home care agencies, transportation services, medical equipment services, public health services, chore services, social services &,senior centers.
60What does a case manager do? Case managers assess the needs of a client. They decide and arrange services.Review care plans by all team members and assures client is progressing according to plan of care.
61What does a supervisor do? The supervisor makes the first assessment visit to the client and directs client care.The supervisor makes periodic visits to assess client and care being given.The supervisor instructs and supervises the home health aide with client care.
62The Supervisor is responsible to: Orient home health aide to client and care planInstruct home health aide regarding specific duties related to client careInstructs home health aide on new proceduresInstructs HHA regarding information to be recorded and reportedInstructs HHA on limitations of dutiesProvides HHA with annual performance evaluation
63What is the role of the Home Health Aide? HHA provide or assist client with ADL’s and therapies according to care plan under the supervision of the nursing supervisor or case manager.A HHA will assist client with light housekeeping tasks to assists client in maintaining a clean safe environment.
64Responsibilities of a HHA Complete combined nursing assistant/ home health aide courseComplete state competency exam for NA/HHAComplete additional training required by agency such as first aid or CPR.Complete facility testing, evaluations and required inservice training.
65Home Health AidsNeed to follow agencies policies and procedures concerningpersonal hygieneUniform and groomingtransportation: use of car for travel or to travel between clients
66Limitations of HHADo not perform services for client unless the agency has provided training.Do not perform sterile proceduresDo not insert, remove or irrigate tubesDo not alter care plan without supervisors approvalDo not transport client or family unless service is part of the plan of care.
67Limitations of HHA’s Do not make financial transactions for client HHA’s care for clients needs but does not care for or assist entire family.
68Important qualities of HHA Independent and dependable workerThere are no other health care workers in the homeWell organized, uses time wiselywilling to follow instructionsGood problem solverAble to get the facts,see the problem, and make a decision.Flexibleopen to changing hours and flexibleDependable transportation
69Qualities of HHA’s Good customer service attitude Adaptable Good communication skillsAdaptableWill have to adjust to using skills in the home environmentwill have to use a variety of equipment
70Ethics and Etiquette for HHA’s Schedules and activities follow the home routine. HHA’s are guests in the clients home.Cultural and religious practices will be more evident in home vs public settings.Family members/significant others will participate more in client care, respect their role,