1. Kathy Turner, Assistant Chief Health Care Personnel Education and Credentialing Section NC Division of Health Service Regulation 2015 Nurse Aide Update --NC NCDPI Career & Technical Education Summer Conference

2. Welcome Barbara Burt!

3. Presenters Kathy Turner – Assistant Chief, Division of Health Service Regulation/Health Care Personnel Education and Credentialing Section (the State, Raleigh; oversees the contract with PV) Diana Brosko-Carelli – Program Manager, Health Services, Pearson VUE, Inc. (PV contracts with the state, only vendor for the NCSBN NNAAP® exam) Linda S White – Associate Program Director, NACES Plus Foundation (NACES subcontracts with PV to administer NAI exam in NC, hires evaluators – subsidiary of Texas Nurses Assoc.)

4. Update Overview 2 015 NNAAP Scores Report Lowest and top performing skills Skill clarifications Accommodations Handbook Updates PV Customer Service Center Registration reminders (planning for end-of-year testing), in-facility testing and grievances State-approved vs non state-approved Reminders re: GA and HCA certifcates for listing

5. A Note About Your Moodle In order for teachers and students to achieve success in the Nursing Fundamentals class, as well as in the NNAAP® registration, scheduling, and testing processes, high school teachers must access the documents on the MOODLE.

6. Social Security Numbers and Cards All NNAAP ® testing candidates MUST have a valid, non-laminated SS card, which has their signature (not their parents’) Unless they have DACA documents (deferred action) or social security cards, candidates cannot register/test in North Carolina. This is for testing and registry listing only. If students without this enroll in your classes they need to be told about this in the beginning.

7. Names Do Matter Students must register using the FIRST and LAST names. These FIRST and LAST names must be the same as those on the identification documents (driver’s licenses, passports, military dependent IDs, and of course, social security cards) These type of requirements should be shared with students early in the semester in order for them to be prepared for testing.

8. Candidate Handbook Update May 2015 (current edition) Pg 9 – under Absence Policy: added “…and mailed to NACES…” Pg 9 – under Weather Emergencies: a new sentence was added to, “check the email account used in registration…” Pg 11 – updated instructions for name changes

9. Candidate Handbook Update May 2015 (current edition) Pg 41 – under Exam Results & Skills Evaluation: phone number changed Pg 44-45 – under The Registry/Initial Listing: there’s no automatic verification system, website added Pg 45 – under Change of Address or Name, 2 nd paragraph: last 4 instead of SSN

10. Candidate Handbook Update May 2015 (current edition) Pg 46 – under Listing Renewal: added a page number and text re: renewals Added Appendix B which lists all of the skills To order new handbooks for your students, refer to the information on the inside front cover of the current handbook.

11. Accommodations School/LEA/DPI Enrollment criteria and passing standards Syllabus and lessons Complies with Federal Requirements per MOU DHSR Course Content re: NA Program Coordinator Requirements Faculty Requirements Criteria for Approval All things NNAAP® testing (includes PV and NACES)

12. ADA IS NOT A LAST-MINUTE TESTING ISSUE Fact: Neither DHSR nor PV/NACES determines who may enroll in your NF (NAI) course Fact: To register for the NNAAP® exam as a state-approved candidate, the student MUST PASS Nursing Fundamentals (NF). Fact: If the student does not pass NF, he/she may CURRENTLY* register as a “challenger” or “other trained” candidate. Fact: ADA requests should be discussed with student, parent/guardian, and appropriate school personnel prior to or at the very beginning of the course. *may change in the future

13. Pearson VUE Confidential. Do Not Distribute.13 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. ADA Accommodations www.pearsonvue.com/accommodations Review web page: If still requesting accommodations Scroll to bottom choose program Review web page: -Guidelines -Forms

14. Pearson VUE Confidential. Do Not Distribute.14 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. ADA Accommodations Accommodations Request Form: Accompanied by supporting documentation from a qualified professional who diagnosed your condition. Supporting documentation School records that show participation in special education services Individualized Education Plans (IEPs) Transcripts from middle school or high school Other records that show a history of academic difficulties due to your disability

15. 2014-15 NNAAP ® : HIGH SCHOOL PERFORMANCE Diana Brosko-Carelli, Program Manager, Pearson VUE, Inc.

16. Pearson VUE Confidential. Do Not Distribute.16 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. North Carolina Nurse Aide High School Site Statistics July 2012- June 2013 July 2013- June 2014 July 2014 – 5-31-15 INF pass %86% 79% RTS pass %72% 58% Testing % (INF) 61% 58% # INF sites65 75 # approved HS 226 196

17. Pearson VUE Confidential. Do Not Distribute.17 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. WHO TO CONTACT PEARSON VUE® Schedule, reschedule or cancel an examination Ask questions about On-Line Registration Obtain information regarding your Score Report Obtain information regarding your examination (888) 723-6773 Monday – Friday 8 a.m. – 11 p.m. Saturday 8 a.m. – 5 p.m. Sunday 10 a.m. – 4 p.m. or email pearsonvuecustomerservice@pearson.com NACES Plus FOUNDATION, INC Request an excused absence Submit a grievance Request a candidate handbook Submit questions or issues about testing Naces Plus Foundation North Carolina NNAAP® 8501 North Mopac Expressway, suite 400 Austin, TX 78759 (888) 282-6904 Fax: 1 (866) 95 NACES Monday – Friday 8:30 a.m. – 6:30 p.m.

18. Pearson VUE Confidential. Do Not Distribute.18 Scheduling Screens

19. Pearson VUE Confidential. Do Not Distribute.19 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. High School vs State Skill HS 7/14-5/15 Pass % HS 7/13-5/14 Pass % State 7/14-5/15 Pass % State 7/13-5/14 Pass % Provides Mouth Care80%78%73%75% Gives Modified Bed Bath81%80%75% Provides Perineal Care82%79%69%70% Provides Catheter Care83% 74%75% Counts and Records Radial Pulse 84%86%79% Positions on Side85%83%79%75% Overall Pass Rate71%70%61%

20. Pearson VUE Confidential. Do Not Distribute.20 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. NC High School Highest to Lowest Skills July 1, 2014- May 31, 2015 SkillPass %SkillPass %  Counts and records respirations  Washes hands  Cleans upper or lower denture 97% 96%  Assists with the use of bedpan  Feeds client who cannot feed self  Measures and records weight 88%  Donning and removing PPE  Provides foot care  Applies knee-high stocking 95% 93% 92%  Performs passive ROM shoulder  Transfers from bed to wheelchair  Dresses client with weak right arm 87% 86%  Performs passive ROM knee & ankle  Measures and records blood pressure  Measures and records urinary output 92% 91%  Positions on side  Measures and records radial pulse  Provides catheter care 85% 84% 83%  Assists to ambulate using transfer belt90%  Provides perineal care for female  Gives modified bed bath  Provides mouth care 82% 81% 80%

21. Pearson VUE Confidential. Do Not Distribute.21 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. July 1, 2014- May 31, 2015 Highest to Lowest Skills Skill State Pass % HS Pass % CC Pass % Pro Pass % Nurs -ing Sch E4 Pass % E6 Pass % E7 Pass % Other Pass %  Washes hands  Applies knee-high stocking 93% 84% 97% 92% 97% 91% 95% 91% 95% 89% 77% 90% 79% 83% 74% 98% 93%  Assists to ambulate using transfer belt  Assists with the use of bedpan 87% 79% 90% 88% 93% 89% 94% 83% 85% 87% 82% 69% 85% 73% 76% 66% 91% 81%  Cleans upper or lower denture  Counts and records radial pulse 93% 79% 96% 84% 98% 86% 96% 82% 97% 89% 71% 93% 74% 87% 73% 95% 86%  Counts and records respirations  Donning and removing PPE 89% 86% 97% 95% 94% 92% 91% 95% 85% 78% 87% 81% 76% 72% 91% 90%  Dresses client with weak right arm  Feeds client who cannot feed self 79% 82% 86% 88% 85% 91% 88% 87% 77% 79% 70% 72% 79% 81% 63% 68% 82% 87%  Gives modified bed bath  Measures and records blood pressure 75% 81% 91% 86% 88% 81% 83% 91% 84% 65% 73% 72% 75% 63% 73% 84% 86%

22. Pearson VUE Confidential. Do Not Distribute.22 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. July 1, 2014-May 31, 2015 Highest to Lowest Skills (con’t) Skill State Pass % HS Pass % CC Pass % Pro Pass % Nurs -ing Sch E4 Pass % E6 Pass % E7 Pass % Othe r Pass %  Measures and records urinary output  Measures and records weight 83% 80% 91% 88% 91% 88% 84% 92% 76% 72% 80% 75% 74% 71% 88%  Performs passive ROM shoulder  Performs passive ROM knee & ankle 86% 80% 92% 87% 92% 88% 92% 85% 88% 87% 80% 71% 85% 76% 73% 66% 87% 85%  Positions on side  Provides catheter care 79% 74% 85% 83% 89% 86% 88% 79% 76% 67% 69% 63% 78% 68% 65% 57% 87% 82%  Provides foot care  Provides mouth care 85% 73% 93% 80% 94% 80% 91% 78% 90% 78% 75% 65% 79% 70% 76% 58% 89% 82%  Provides perineal care for female  Transfers from bed to wheelchair 70% 69% 82% 86% 82% 93% 78% 81% 79% 82% 56% 77% 62% 79% 49% 74% 73% 92% OVERALL Pass %61%71%73%69%65%48%55%44%72% % of Testing100%9%35%7%1%26%11%10%2% RTS INF 57% 79%

23. Pearson VUE Confidential. Do Not Distribute.23 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. Missed Steps – Critical Elements Step 1Step 2Step 3Step 4Step 5Step 6Step 7Step 8Step 9 Step 10 Step 11 Step 12 Step 13 Step 14 Step 15 Step 16 Step 17 Step 18 Step 19 Hand Hygiene (Hand Washing) 6% 1% Applies one knee-high elastic stocking 10% Assists client to ambulate using transfer belt 4% 6% Assists client with use of bedpan 10% Cleans upper or lower dentures Counts and records radial pulse 19% Counts and records respirations 6% Donning and removing PPE (gown and gloves) 12%6% Dresses client with affected (weak) right arm 10% Feeds client who cannot feed self 6% Gives modified bed bath (face and one arm, hand and underarm) 15% Measures and records blood pressure 16% Measures and records urinary output 4% Measures and records weight of ambulatory client 13% Performs modified passive range of motion (ROM) for one knee and one ankle 7% Performs modified passive range of motion (ROM) for one shoulder 12% Positions client on side Provides catheter care for female 16%17% Provides foot care on one foot Provides mouth care 10% Provides perineal care (Peri-Care) for female 10%14% 22% Transfers client from bed to wheelchair using transfer belt 3% 7%

24. Pearson VUE Confidential. Do Not Distribute.24 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. Missed Steps – Privacy, signal device, wash hands Step 1Step 2Step 3Step 4Step 5Step 6Step 7Step 8Step 9 Step 10 Step 11 Step 12 Step 13 Step 14 Step 15 Step 16 Step 17 Step 18 Step 19 Hand Hygiene (Hand Washing) 6% 1% Applies one knee-high elastic stocking 18% 10%8%5% Assists client to ambulate using transfer belt 4% 6% 5%7% Assists client with use of bedpan 11% 10% 4% Cleans upper or lower dentures Counts and records radial pulse 27%17%19% Counts and records respirations 29%14%6% Donning and removing PPE (gown and gloves) 12%6% 7% Dresses client with affected (weak) right arm 10% 7%8% Feeds client who cannot feed self 6% 8%7% Gives modified bed bath (face and one arm, hand and underarm) 13% 15% 6% Measures and records blood pressure 22%15%16% Measures and records urinary output 12%4% Measures and records weight of ambulatory client 14%13% Performs modified passive range of motion (ROM) for one knee and one ankle 17% 7%6%5% Performs modified passive range of motion (ROM) for one shoulder 21% 12% 7% Positions client on side 16% 7%5% Provides catheter care for female 11% 16%17% 16%6% Provides foot care on one foot 21% 16%7% Provides mouth care 23% 10% 24%10% Provides perineal care (Peri-Care) for female 11% 10%14% 22% 15%7% Transfers client from bed to wheelchair using transfer belt 27% 3% 7% 16%9%

25. Pearson VUE Confidential. Do Not Distribute.25 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. Missed Steps Step 1Step 2Step 3Step 4Step 5Step 6Step 7Step 8Step 9 Step 10 Step 11 Step 12 Step 13 Step 14 Step 15 Step 16 Step 17 Step 18 Step 19 Hand Hygiene (Hand Washing) 6% 1% Applies one knee-high elastic stocking 18% 10%8%5% Assists client to ambulate using transfer belt 4% 33%6% 18% 5%7% Assists client with use of bedpan 11% 10%44%22% 17% 16% 4% Cleans upper or lower dentures 15% Counts and records radial pulse 27%17%19% Counts and records respirations 29%14%6% Donning and removing PPE (gown and gloves) 12%6% 7% Dresses client with affected (weak) right arm 39%10% 7%8% Feeds client who cannot feed self 24%6% 29%30% 19% 33% 8%7% Gives modified bed bath (face and one arm, hand and underarm) 13%43% 15%18% 30% 16%6% Measures and records blood pressure 22%15%16% Measures and records urinary output 16%15%12%4% Measures and records weight of ambulatory client 15% 14%13% Performs modified passive range of motion (ROM) for one knee and one ankle 17% 7%6%5% Performs modified passive range of motion (ROM) for one shoulder 21% 12% 7% Positions client on side 16% 19% 7%5% Provides catheter care for female 11%20% 16%17%15% 16%6% Provides foot care on one foot 21% 15% 16%7% Provides mouth care 23% 10% 33%21% 24%10% Provides perineal care (Peri-Care) for female 11%16% 10%14% 22% 15%7% Transfers client from bed to wheelchair using transfer belt 27% 3%23%7% 16% 9%

26. PV Customer Service For registration AND scheduling needs, call this number FIRST! Please do not call Diana unless directed to do so. 888-723-6773 8 am – 11 pm M-F 8 am – 5 pm Saturday 10 am – 4 pm Sunday

27. NNAAP ® - SKILLS REVIEW Linda Sue White, Assistant Program Director for NACES

28. NACES Contacts Monica Cavazos, BSN, RN Program Director Linda Sue White, BSN, RN Associate Program Director Rolando Gonzalez Program Coordinator Charissa Ellis Administrative Assistant 28

29. MISSION To provide qualified nurse aide candidates the opportunity to achieve certification by demonstrating their skills in a supportive and objective environment so the state’s most vulnerable citizens are assured safe and competent care. 29

30. Candidate Examination Expectations Pages 5 & 8 of Candidate Handbook Registration/scheduling Done online by candidate at least 12 days prior to test date  https://i7lp.integral7.com/ncna https://i7lp.integral7.com/ncna  Contact Pearson VUE for support at (888) 723-6773 8am-8pm EST or www.pearsonvue.com/nc/nurseaideswww.pearsonvue.com/nc/nurseaides  Name used to register must match IDs If rescheduling before test taken, candidate must notify Pearson VUE at least nine (9) calendar days before examination date  If less than 9 days, unless an Excused Absence (page #9 of Candidate Handbook) is approved, candidate will have to pay to reschedule 30

31. Candidate Examination Expectations Registration/scheduling INF Reminders  Be flexible with test dates BEFORE communicating with evaluator  Inform evaluator of the # of students to ensure agreeable  Unless more than 10-12 students to test, set up only 1 test date  Instruct students not to wait until the last minute to register for test  Students who miss the deadline to register must test at regional site  If less than 5 students registered for skills exam, date will be cancelled & students will be rescheduled into regional test site date In order for the process to work, program coordinators and instructors will need to work closely with NACES and evaluators. 31

32. Candidate Examination Expectations – Written Exam Pages 10 -12 of Candidate Handbook Check-in ( candidate is to arrive 30 minutes prior to exam time ) Sign roster – names on roster and IDs must match!  If hyphen/suffix is in IDs for first or last name, must be on roster (how candidate registered) NAE screens candidates for issues that would prevent them from being a “client” for certain skills (this should be done individually) Seated 3 feet apart facing same direction Candidate has up to 2 hours to complete exam 32

33. Candidate Examination Expectations – Skills Exam Pages 20-24 of Candidate Handbook Check-in (candidate is to arrive 30 minutes prior to start of exam time and times are approximate so plan to spend the day) 2 forms of current, not expired, official signature bearing IDs, one must be U.S. government- issued social security card, signed and non-laminated and one must be a photo bearing ID from the approved list Sign roster – names on roster and IDs must match!  If hyphen is in IDs for first or last name, there must be hyphen on roster (how candidate registered) If skills only, NAE screens candidates for issues that would prevent them from being a “client” for certain skills (this should be done individually)  Candidates should be dressed with flat, slip-on, non-skid shoes, a loose-fitting top with short sleeves or tank top and loose-fitting pants 33

34. Skills Exam Expectations (Continued) Candidates will be brought into testing area in pairs NAE will read “client” instructions aloud to both candidates NAE will identify and demonstrate all equipment and supplies in testing area to both candidates NAE will read specific instructions to testing candidate aloud and provide laminated skills card for candidate to read and reference Candidates may ask questions about supplies and equipment prior to the beginning of the exam NAE will use a timer, will provide a 5 minutes remaining reminder Candidates may be stopped to don or remove gloves for sanitary reasons 34

35. Skills Exam Expectations (Continued) NAE may stop the timer and halt the exam in certain circumstances: BP skill, mannequin placement, equipment malfunction, etc. NAE may not answer candidate questions about skills before, during or after the exam! Guests, visitors, pets, or children are NOT allowed at the testing site – guests would include program personnel. We do not want the program personnel engaging the NAE or candidates during a testing event Questions regarding the testing event or any grievances from candidates should be directed to NACES or Pearson VUE in writing following the testing event 35

36. Skills Exam Common Misconceptions NAE was rude Wouldn’t answer my questions Kept telling me what to do Wouldn’t tell me why I failed NAE helped the other candidates Told my partner what to do Got another client for one of the candidates Gave more time to another candidate NAE did not know what they were doing Took the pulse/BP a second time, after I already wrote down my results Took way too long and I had to wait all day to take test 36

37. Candidate Grievance Procedure Page 44 of Candidate Handbook NAEs are not permitted to discuss the candidate’s exam results with candidate or instructors If candidate determines a grievance needs to be submitted, it must be written and sent (along with Score Report(s)) to NACES or the State within 30 days of exam date - NACES APD reviews grievance to determine whether or not it is substantiated. Resources used for this determination may include but are not limited to: Order and review of Score Report(s) and Measurement sheet Contact NAE and review of NAE’s detailed notes Review NAE Incident Report Call and survey other candidates on their test experience Reference testing materials and Candidate Handbook Review findings with other APD(s) and Program Director (PD) Determination letter is written and sent to candidate including detailed resolution of grievance within 30 days of NACES receipt State is notified of resolution 37

38. All Skills can be found in Candidate Handbook pages 25-40 38

39. Pearson VUE Confidential. Do Not Distribute.39 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. High School vs State July 2014 – May 2015 Skill High School Pass % State Pass % Provides Mouth Care80%73% Gives Modified Bed Bath81%75% Provides Perineal Care82%69% Provides Catheter Care83%74% Counts and Records Radial Pulse84%79% Positions on Side85%79% Overall Pass Rate71%61%

40. Pearson VUE Confidential. Do Not Distribute.40 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. Step #Step Description Fail rate for the step is 10% - 15% Fail rate for the step is 16% -25% Fail rate for the step is >26% 2 Privacy is provided with a curtain, screen, or door 23% 3 Before providing mouth care, client is in upright sitting position (75-90 degrees) 10% 8 Cleans mouth (including tongue and surfaces of teeth), using gentle motion 10% 11 Candidate wipes mouth and removes clothing protector 12% 12 After rinsing toothbrush, empty, rinse, and dry the basin and place used toothbrush in designated basin/container 33% 13 Places Basin and toothbrush in designated dirty supply area 21% 15 After placing basin and toothbrush in designated dirty supply area and disposing of used linen, removes and disposes of gloves (without contaminating self) into waste container and washes hands 24% 16 Signaling device is within reach and bed is in low position 10% #49 P ROVIDES M OUTH C ARE

41. Step #2 – Privacy is provided with a curtain screen or door Candidate may forget this step for this skill as it is not one where the client will be ‘exposed’. Remember, if candidate provides privacy for first skill it is required and never pulls curtain back to un-provide, they will receive credit for any other skill it is required. Step #3 – Before providing mouth care, client is in upright sitting position (75-90 degrees) Candidate has to ensure client’s head is elevated, and if NAE has to direct them to do so, they get a ‘no’ for this step. Client can sit up in bed or sit on side of bed. Step #12 – After rinsing toothbrush, empty, rinse and dry the basin and place used toothbrush in designated basin/container Candidate has to do all components to get credit – many will throw the toothbrush away, or they forget to rinse the toothbrush or dry the basin. 41

42. # 49 P ROVIDES MOUTH C ARE Step #13 – Places basin and toothbrush in designated dirty supply area Candidate has to do all components to get credit – many will throw the toothbrush away, or forget to place the basin/toothbrush in the dirty supply area. Step #15 – After placing basin and toothbrush in designated dirty supply area, and disposing of used linens, removes and disposes of gloves (without contaminating self) into waste container and washes hands Candidate must do all components to get credit – many miss this one automatically due to throwing the toothbrush away, or again, they contaminate themselves when removing their gloves. Step #16 – Signaling device is within reach and bed is in low position Candidate must do all components to get credit – as long as candidate ensures signaling device is in reach and bed in low position at beginning of exam, and those conditions do not change, they get credit. 42

43. Pearson VUE Confidential. Do Not Distribute.43 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. Step #Step Description Fail rate for the step is 10% - 15% Fail rate for the step is 16% -25% Fail rate for the step is >26% 2 Privacy is provided with a curtain, screen, or door 13% 3 Removes gown while keeping client covered 43% 4 Before washing checks water temperature for safety and comfort and asks client to verify comfort of water 11% 6 Beginning with eyes, washes eyes with wet washcloth (no soap), using a different area of the washcloth for each eye, washing inner aspect to outer aspect then proceeds to wash face. 15% 7 Dries face with towel 18% 10 Washes arm, hand, and underarm keeping rest of body covered 10% 11 Rinses and dries arm, hand, and underarm 12% 13 Puts clean gown on client 30% 14 Empties, rinses, and dries basin 12% 15 After rinsing and drying basin, places basin in designated dirty supply area 13% 18 After placing basin in designated dirty supply area, and disposing of used linen, removes and disposes of gloves (without contaminating self) into waste container and washes hands 16% #40 G IVES M ODIFIED B ED B ATH (F ACE & O NE A RM, H AND & U NDERARM )

44. Step #3 – Removes gown and places in soiled linen container, while avoiding overexposure of the client Candidate forgets to take the gown off all together or only partially removes off of arm being washed, and then once bath is finished they just put dirty gown back on. Candidate takes gown off, but then does not immediately place in soiled linen container. Step #4 – Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water Candidate has to do all components to get credit - usually does one or the other but not both. Make sure they are very obvious about this to the NAE. Step #6 – Beginning with eyes, washes eyes with wet washcloth (no soap), using a different area of the washcloth for each stroke, washing inner aspect to outer aspect then proceeds to wash face Candidate has to do all components to get credit - usually does one or the other but not both. Make sure they are very obvious about this to the NAE. 44

45. #40 G IVES M ODIFIED B ED B ATH (F ACE & O NE A RM, H AND & U NDERARM ) 45 Step #7 – Dries face with towel Candidate must use a towel (can be hand towel). Step #10 – Washes arm, hand, and underarm keeping rest of body covered Candidate must use soap in order to get credit for ‘washing’, and they have to keep candidate covered except for the arm. Candidate has to wash under the arm (armpit). Step #11 – Rinses and dries arm, hand, and underarm Candidate has to rinse and dry under the arm (armpit). Step #13 – Put clean gown on client If candidate forgets to take the gown off, they will miss this step.

46. #40 G IVES M ODIFIED B ED B ATH (F ACE & O NE A RM, H AND & U NDERARM ) Step #14 – Empties, rinses, and dries basin Candidate forgets to rinse or dry, or sometimes both. Step #15 – After rinsing and drying basin, places basin in designated dirty supply area Candidate forgets to rinse or dry, or sometimes both, and/or does not place in dirty supply area. Step #18 – After placing basin in designated dirty supply area, and disposing of used linens, removes and disposes of gloves (without contaminating self) into waste container and washes hands Candidate must do all components to get credit – many contaminate themselves while removing gloves (must be glove to glove, then skin to skin). Can also miss automatically if they forget to dispose of the linens. Also, may miss this step if they don’t ‘wash hands’ immediately after removing gloves. 46

47. Pearson VUE Confidential. Do Not Distribute.47 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. Step #Step Description Fail rate for the step is 10% - 15% Fail rate for the step is 16% -25% Fail rate for the step is >26% 2 Privacy is provided with a curtain, screen or door 11% 3 Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water 16% 6 Exposes perineal area while avoiding overexposure of client 11% 8 Washes genital area, moving from front to back, while using a clean area of the washcloth for each stroke 10% 9 Using clean washcloth, rinses soap from genital area, moving from front to back, while using a clean area of the washcloth for each stroke 14% 10 Dries genital area moving from front to back with towel 11% 11 After washing genital area, turns to side, then washes and rinses rectal area moving from front to back using a clean area of the washcloth for each stroke. Dries with towel 22% 13 Empties, rinses, and dries basin 13% 14 After rinsing and drying basin, places basin in designated dirty supply area 12% 15 Disposes of used lined into soiled linen container and disposes of linen protector appropriately 10% 17 After disposing of used lined and placing equipment, in designated dirty supply area, removes and disposes of gloves (without contaminating self) into waste container and washes hands 15% #50 P ROVIDES P ERINEAL C ARE FOR F EMALE

48. Step #2 – Privacy is provided with a curtain, screen, or door Candidate has to provide 360 degrees of privacy to get credit. Once privacy is provided for any skill, as long as the curtain remains in place, the candidate gets credit for privacy step on any other skill. Step #3 – Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water Candidate has to do all components to get credit - usually does one or the other but not both. Make sure they are very obvious about this to the NAE. Step #6 – Exposes perineal area while avoiding overexposure of client Candidate has to ensure the client’s upper and lower torso (from knees down) are covered. Step #8 – Washes genital area, moving from front to back, while using a clean area of the washcloth for each stroke Candidate has to do all components to get credit – sometimes they do not wipe front to back, or they use same area of cloth. If done correctly, candidate can use the ‘one swipe’ technique and get credit. 48

49. # 50 P ROVIDES P ERINEAL C ARE FOR F EMALE Step #9 – Using clean washcloth, rinses soap from genital area, moving from front to back, while using a clean area of the washcloth for each stroke Candidate has to do all components to get credit – sometimes they do not wipe front to back, or they use same area of cloth or don’t get a clean cloth. If done correctly, candidate can use the ‘one swipe’ technique and get credit. Step #10 – Dries genital area moving from front to back with towel Candidate has to do all components to get credit – sometimes they do not wipe front to back, or they do not use a towel. Step #11 – After washing genital area, turns to side, then washes and rinses rectal area moving from front to back using a clean area of the washcloth for each stroke. Dries with towel Candidate has to do all components to get credit – sometimes they forget to do this step entirely. Sometimes they do it all correctly, except they forget to dry using a towel. Sometimes they do not wipe anywhere near the rectum, just the buttocks, or they wipe back to front. 49

50. # 50 P ROVIDES P ERINEAL C ARE FOR F EMALE Step #13 – Empties, rinses, and dries basin Candidate forgets to rinse or dry, or sometimes both. Step #14 – After rinsing and drying basin, places basin in designated dirty supply area Candidate forgets to rinse or dry, or sometimes both, and/or does not place in dirty supply area. Step #15 – Disposes of used linen into soiled linen container and disposes of linen protector appropriately Candidate may forget to dispose of all used linen, or they place on top of container lid, or they leave the linen protector in the bed. Step #17 – After disposing of used linen, and placing used equipment in designated dirty supply area, removes and disposes of gloves (without contaminating self) into waste container and washes hands Candidate must do all components to get credit – many contaminate themselves while removing gloves (must be glove to glove, then skin to skin). Can also miss automatically if they forget to dispose of the linens. Also, may miss this step if they don’t ‘wash hands’ immediately after removing gloves. 50

51. Pearson VUE Confidential. Do Not Distribute.51 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. Step #Step Description Fail rate for the step is 10% - 15% Fail rate for the step is 16% -25% Fail rate for the step is >26% 2 Privacy is provided with a curtain, screen or door 11% 3 Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water 20% 5 Places line protector under perineal area before washing 11% 8 While holding catheter at meatus without tugging, cleans at least 4 inches of catheter from meatus moving in only 1 direction (away from meatus) using a clean area of the cloth for each stroke 16% 9 While holding catheter at meatus without tugging, rinses at least 4 inches of catheter from meatus, moving only in 1 direction, away from meatus, using a clean area of the cloth for each stroke 17% 10 While holding catheter at meatus without tugging, dries at least 4 inches of catheter moving away from meatus 15% 11 Empties, rinses, and dries basin 13% 12 After rinsing and drying basin, places basin in designated dirty supply area 13% 13 Disposes of used lined into soiled linen container and disposes of linen protector appropriately 13% 15 After disposing of used lined and cleaning equipment, removes and disposes of gloves (without contaminating self) into waste container and washes hands 16% #47 P ROVIDES C ATHETER C ARE FOR F EMALE

52. Step #2 – Privacy is provided with a curtain, screen, or door Candidate has to provide 360 degrees of privacy to get credit. Once privacy is provided for any skill, as long as the curtain remains in place, the candidate gets credit for privacy step on any other skill. Step #3 – Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water Candidate usually does one or the other but not both – make sure they are very obvious about this to the NAE. Step #5 – Places linen protector under perineal area before washing Candidate can use a towel, actual linen protector or chux. 52

53. # 47 P ROVIDES C ATHETER C ARE FOR F EMALE Steps #8 & #9 – While holding catheter at meatus without tugging, cleans/rinses at least four inches of catheter from meatus, moving in only one direction (i.e., away from meatus) using a clean area of the cloth for each stroke For both steps, candidate has to hold at the meatus, no tugging, wash/rinse front to back. Ok to use the one or three swipe technique. Step #10 – While holding catheter at meatus without tugging, dries at least four inches of catheter moving away from the meatus Candidate forgets to dry, does not hold at meatus, tugs or moves towards meatus. Step #11 – Empties, rinses, and dries basin Candidate forgets to rinse or dry, or sometimes both. 53

54. # 47 P ROVIDES C ATHETER C ARE FOR F EMALE Step #12 – After rinsing and drying basin, places basin in designated dirty supply area Candidate forgets to rinse or dry, or sometimes both, and/or does not place in dirty supply area. Step #13 – Disposes of used linen into soiled linen container and disposes of linen protector appropriately Candidate may forget to dispose of all used linen, they place on top of container lid, or they leave the linen protector in the bed. If they never place the protector, they automatically miss. Step #15 – After disposing of used linen, and cleaning equipment, removes and disposes of gloves (without contaminating self) into waste container and washes hands Candidate must do all components to get credit – many contaminate themselves while removing gloves (must be glove to glove, then skin to skin). Can also miss automatically if they forget to dispose of the linens. Also, may miss this step if they don’t ‘wash hands’ immediately after removing gloves. 54

55. Pearson VUE Confidential. Do Not Distribute.55 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. Step #Step Description Fail rate for the step is 10% - 15% Fail rate for the step is 16% -25% Fail rate for the step is >26% 4 Signaling device is within reach 27% 5 Before recording, washes hands 17% 6 After obtaining pulse by palpating in radial artery position, records pulse rate within plus or minus 4 beats of evaluator’s reading 19% #35 C OUNTS AND R ECORDS R ADIAL P ULSE

56. Step #4 – Signaling device is within reach As long as candidate ensures signaling device is in reach at beginning of exam, and those conditions do not change, they get credit. Step #5 – Before recording, washes hands Candidate has to verbalize they would wash hands before they record the results, and they should face and speak loud enough for NAE to hear. Step #6 – After obtaining pulse by palpating in radial artery position, records pulse rate within plus or minus 4 beats of evaluator’s reading Candidate must do all components to get credit – if the candidate did not take pulse in radial artery, they automatically miss this step, even if rate is the same as NAE’s. NAE will re-take pulse on same side as candidate to ensure there is no discrepancy in client’s pulse rate by location. Candidate should take for 1 full minute to ensure accuracy. 56

57. Pearson VUE Confidential. Do Not Distribute.57 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969. #46 P OSITIONS ON SIDE Step #Step Description Fail rate for the step is 10% - 15% Fail rate for the step is 16% -25% Fail rate for the step is >26% 2 Privacy is provided with a curtain, screen or door 16% 6 Places or adjusts pillow under head for support 19% 8 Supports top arm with supportive device 19% 10 Places supportive device between legs with top knee flexed; knee and ankle supported 10%

58. #46 P OSITIONS O N S IDE Step #2 – Privacy is provided with a curtain, screen, or door Candidate has to provide 360 degrees of privacy to get credit. Once privacy is provided for any skill, as long as the curtain remains in place, the candidate gets credit for privacy step on any other skill. Step #6 – Places or adjusts pillow under head for support Candidate forgets to ‘touch’ the pillow (even if ends up correctly placed after turning on side, candidate must touch it). Step #8 – Supports top arm with supportive device Candidate forgets to do this step, or places it under the bottom arm. Step #10 – Places supportive device between legs with top knee flexed; knee and ankle supported Candidate has to support both the knee and the ankle. 58

59. S KILLS C LARIFICATIONS Hand Washing – Skill scoring of step #7 – If candidate does a “surgical scrub” and washes all the way up their arm to elbows, if soap is left on any area above wrists during rinsing but no soap on wrists, hands or fingers, as long as all other components are met, the candidate gets a ‘yes’ for this step. Assists with Use of Bedpan – Skill scoring of step #12 – If candidate fails to raise the bed as directed in step #7 and the bed is already in low position, the candidate should get a ‘yes’ for step #12. Measures and Records Urinary Output – Skill scoring of step #8 – If candidate records in ounces – even if they record ounces as the unit of measurement, they get a ‘no’ for this step. Per the NCSBN, the direction in step #8 of skill 42 Measures and Records Urinary Output is: the candidate “records contents of container within plus or minus 25 ml/cc of evaluator’s reading” – meaning the response must be recorded in the acceptable unit of measurement of ml or cc. 59

60. S KILLS C LARIFICATIONS Measures and Records Weight of Ambulatory Client – Skill scoring of step #2 – If candidate has client wear shoes to the scale but then tells them to take the shoes off and weighs them without their shoes on, they will get a ‘no’ for this step. Skill score for steps #3/#4 – NCSBN reworded both steps and kept the ruling that if the candidate misses step #3, they automatically miss step #4. 60

61. Reminders In-facility testing – send list in advance to Rolando at NACES In-facility testing – changes in testing date, location, etc. must be communicated to students by instructor Importance of training completion dates – is not necessarily your last day of class/school, etc. Grievances – facts, along with who, where, when, how, etc. If student called PV/NACES, be able to provide name/date/time of call.

62. Proper Planning for Scheduling INF NACES/PV Deadline* Dates for In Facility Testing Your INF Date05/20/2016 Student must complete NNAAP registration/scheduling (12 days) 05/08/2016 The date NAT must be complete(12 days)05/08/2016 The date NACES must have received your list of students that will test (15 days) 05/06/2016 * Moodle - There is an Excel form that will automatically calculate your dates. USE IT!

63. Grievances The grievance policy is the SAME for all NNAAP® candidates. The policy/procedure is listed on page 44 of the candidate handbook. Candidates (your students) submit grievances – not instructors/parents. Teachers assist them in the process. (Refer to Moodle) Remember, this is a standardized exam.

64. QUESTIONS? Thank you for all you do for your students!