3. Settings where the CNA may work  Acute care  Hospitals and surgical centers  Pts are admitted for short stays for surgery or diseases  Offers 24 hour skilled care for temporary but serious illness or injury

4. Settings where the CNA may work  Subacute care  Hospital or a nursing home  Pts need more daily care than a nursing home  Outpatient care  Less than 24 hours of care for people who have had treatments or surgery requiring short term skilled care  Rehabilitation  Care is provided by a specialist  PT, OT, SLP  Improve a patients function after an illness or injury

5. Settings where the CNA may work  Home care  In home care  May offer many of the same services offered in other settings  Assisted living  Patients need some assistance with daily care, but do not require skilled care  Ex: showers, meals, medications  Hospice care  For people who have 6 months or less to live  Provides physical and emotional care and comfort for the patient and support for the family  May be in a separate facility or at home

6. Settings where the CNA may work  Long-term care (LTC)  Patients who require 24 hour care and assistance for long term conditions  Nursing home, skilled nursing facility, nursing facility, extended care facility  Patients are usually elderly and/or disabled; may have terminal illnesses and/or chronic illnesses

7. Settings where the CNA may work  LTC  Nursing staff will have longer relationships with LTC residents than in any other facility  Patients who live in nursing homes are called residents  Residents within a LTC facility have differing diagnoses (medical conditions) requiring different levels of care for each person

8. LTC facilities  May offer different levels of care; may also specialize in a specific population of resident (ex. Alzheimer’s)  Skilled nursing care  Assisted living  Dementia care  Subacute care  Typically offer personal care for all residents and more specialized care on a resident by resident basis

9. Medicare and Medicaid  Centers for Medicare and Medicaid Services (CMS)  Run Medicare, Medicaid and CHIP  Federal agency within the US Department of Health and Human Services

10. Medicare  Federal health insurance program for people over 65 years old or younger than 65 if disabled.  Covers a percentage of health care costs  Pay LTC facilities a fixed amount for services for residents  Fee is based on resident’s needs on admission

11. Medicaid  Federal medical assistance program for low- income people.  Limited coverage; must qualify to receive it  Also pay LTC facilities a fixed amount based on needs at admission.

13. So, what is the role of the CNA?  The CNA performs delegated or assigned nursing tasks, such as taking a resident’s temperature.  A CNA also provides personal care.  May also be called a nursing assistant, nurse aide, or certified nursing assistant

14. CNA duties  Feeding residents  helping residents with toileting and elimination needs  assisting residents to move safely around the facility  Keeping residents’ living areas neat and clean  Encouraging residents to eat and drink  Caring for supplies and equipment  Helping dress residents  Making beds  Giving back massages  Assisting residents with mouth care

15. NOT What am I NOT supposed to do?  Give medications  Insert/remove tubes  Change sterile dressings  Give tube feedings

16. CNA  CNAs spend more time with residents than anyone else on the health care team  YOU are the “eyes and ears” of the health care team  OBSERVATION is key!  Always REPORT abnormal findings  Writing important information down is a must and very helpful (documentation/charting)

17. The Health care team  The resident and his/her family are crucial members of the health care team  The other members of the team may vary depending on the condition of the patient  The health care teams goals are to help residents recover from illnesses or to do as much as possible for themselves

18. The Health Care Team  Registered Nurse (RN)  Provide skilled nursing care to the resident, including a care plan  Plan for each resident to achieve certain goals  Develop a nursing assistant care plan for each resident  The RN assigns tasks and supervises the CNA’s daily care of the residents  Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN)  Passes medications and performs treatments  Physician (MD)  Diagnose disease or disability and prescribe treatment

19. The Health care team  Physical Therapist (PT)  Administers therapy in the form of heat, cold, massage, ultrasound, electricity and exercise to muscles, bones and joints  Help residents to use a cane, walker or wheelchair  Occupational Therapist (OT)  Helps residents learn to compensate for disabilities  Ex: teaches a resident to use a special spoon to feed themselves and remain independent longer

20. The Health care Team  Speech Therapist (ST)  Helps residents with communication, especially after a stroke  Evaluates a person’s ability to swallow  Registered Dietitian (RD)  Also called a nutritionist  Creates special diets for people with special dietary needs  Special diets may improve health and help manage illness  Medical Social Worker (MSW)  Helps residents with social needs  Ex: arrange clothing and personal items for a resident who’s family isn’t involved

21. Chain of Command  The CNA carries out instructions given to him/her by a nurse  The Nurse acts on instructions from the physician  Guarantees residents get proper care and protects the CNA and their employer from liability

22. Liability  Liability - a person may be held responsible for harming someone else  If you accidentally harm a resident while caring for him and the task you were performing was within the care plan, you aren’t responsible. However, if you harm a resident performing a task not within the care plan, you are responsible

23. Liability  CNAs must understand what they can and cannot do so that they don’t harm a resident or cause a lawsuit.  Scope of practice - defines the tasks a licensed individual is allowed to do and how to perform tasks correctly

24. Policies and Procedures  Policy - a course of action that should be taken every time a certain situation occurs  Ex: a patient’s plan of care must be followed  Procedure - a particular method or way of doing something.  There is a procedure for reporting information about your residents  All employers will have polices and procedures for every resident care situation  You are responsible for knowing all policies and procedures!  Are posted on the unit or on the internet

25. Professionalism  How you behave when you are on the job:  How you dress  Your speech  What you talk about  Being on time  completing tasks  Reporting to the nurse  For the CNA - follow the care plan, being careful to make observations and always report accurately

26. Professional relationships with residents  Keeping a positive attitude  Doing only the tasks assigned and ones you are trained to do  Speaking politely and cheerfully to the resident, even if you are not in a good mood  Never discussing any of you personal problems  Calling the resident by the name he/she prefers  Listening to the resident  Explaining the care you will provide before you provide it  Always following care practices, such as hand washing, to protect yourself and the resident

27. Professional relationships with your employer  Maintain a positive attitude  Complete your duties efficiently  Consistently following all policies and procedures  Always documenting and reporting carefully and correctly  Communicating problems with residents or duties  Reporting anything that keeps you from completing duties  Asking questions when you don’t know or understand something

28. Professional relationships with your employer  Taking direction or criticism without becoming upset  Being clean, neatly dressed and on time  Notifying your employer if unable to report for work  Following the chain of command  Participating in educational programs  Being a positive role model for your facility at all times

29. Qualities of a great CNA  Compassionate  Caring, concerned, understanding  Honest  Conscientious  Always trying to do your best  Dependable  Respectful  Considerate  Understanding of the resident’s feelings and privacy  Nonjudgmental