1. Nursing Assistant Introduction

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. Certification Renewal (cont) Criminal clearance – fingerprinting NOT required Renewal fee payment

11. Qualities of a Successful CNA Dependable Considerate Pleasant Empathetic Flexible Honest Compassionate & Caring Sensitive to others

12. Qualities of a Successful CAN Responsible Respectful Cooperative Team player Observant Well groomed Organized

13. 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

14. 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

15. 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

16. Role & Responsibility of CNA CNA responsible to: –Licensed nurse –DSD –RN Supervisor –Director of Nursing –Facility/Agency Administrator –Physician if in a clinic setting

17. 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

18. 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

19. 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

20. 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

21. Professionalism for CNA Carrying out resident care in a manner that: –Ethical & Competent –Knowledgeable & Caring –Committed & Giving of dignity –Representative of high standards

22. 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

23. 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

24. 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

25. 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

26. 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

27. Examples of Confidentiality cont. Discussing observations with nurse or physician Discussing resident’s care while participating in team conferences or planning

28. 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