TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER c: LONG-TERM CARE FACILITIES
PART 395 LONG-TERM CARE ASSISTANTS AND AIDES TRAINING PROGRAMS CODE
SECTION 395.300 BASIC NURSING ASSISTANT TRAINING PROGRAM


 

Section 395.300  Basic Nursing Assistant Training Program

 

The BNATP shall include, at a minimum, the following:

 

a)         Module I – Introduction to Health Care

 

1)         Functions of Health Care Organizations.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Describe the purposes and services of health care facilities/agencies, which include, but are not limited to, the following health care settings:

 

i)          Long-term care facilities;

 

ii)         Hospitals;

 

iii)        Rehabilitation facilities;

 

iv)        Home health agencies; and

 

v)         Hospice care.

 

B)        Person-Directed Care Across All Settings.  Objectives:  upon completion of the unit, the student will be able to:

 

i)          Explain the philosophy of person-directed care;

 

ii)         Discuss the concepts of person-directed care, which are self-determination, individual needs, ability focused, person before task, individualized choices, relationship building, holistic focused, and spontaneous activities;

 

iii)        Contrast person-directed care with task-centered care;

 

iv)        Explain how the CNA can apply the concepts to provide person-directed care; and

 

v)         Discuss the impact of a person-directed care model on those involved, including caregiver, elders and the health care facility.

 

2)         The Interdisciplinary Team.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Discuss the purpose of the Interdisciplinary Team;

 

B)        Describe ways to enhance the ability of the Interdisciplinary Team to accomplish its purpose;

 

C)        Describe the role of each member of the Interdisciplinary Team;

 

D)        Examine ways in which a CNA can become an effective team member; and

 

E)        Discuss the crucial role of the CNA with the health care team.

 

3)         The CNA Role Across Health Care Settings.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Demonstrate professional behaviors expected of a CNA in appearance and behaviors;

 

B)        Describe work ethics for CNAs, including qualities, legal implications and ethical behaviors;

 

C)        Identify competency standards in CNA practice, which include standardized testing and maintaining safety;

 

D)        Discuss person-directed qualities by describing the attributes of:

 

i)          An effective communicator and demonstrate effective interpersonal communication techniques;

 

ii)         A resident advocate and describe methods to promote a resident's independence in decision making;

 

iii)        A relationship builder and examine ways to build effective interpersonal relationships; and

 

iv)        An effective team player and describe ways to promote the quality of life for persons in the CNA's care;

 

E)        Discuss the importance of the scope of practice for a CNA;

 

F)         Examine the legal limits of the CNA role;

 

G)        Explain the importance of a job description for a CNA;

 

H)        Explore the components of a CNA job description; and

 

I)         Discuss the importance of delegation and list the five rights of delegation:

 

i)          Right task;

 

ii)         Right circumstance;

 

iii)        Right person;

 

iv)        Right direction/communication; and

 

v)         Right supervision.

 

4)         Nursing Assistant as a Para-professional.  Objective:  upon completion of this unit, the student will be able to:

 

A)        Discuss current State and federal regulations related to CNA certification;

 

B)        Explain the requirements for maintaining CNA certification on the Health Care Worker Registry, which include accessing, updating information and maintaining certification;

 

C)        Discuss the purpose of and disqualifying convictions for the Health Care Worker Background Check; and

 

D)        Develop awareness of resources to enhance career development for CNAs through CNA organizations, continuing education and career ladders.

 

5)         Information Sharing.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Know frequently used medical terminology and abbreviations;

 

B)        Describe the purpose and list components of the health care record;

 

C)        Discuss pertinent information that should be reported to the nurse and give examples of observations that need to be reported immediately;

 

D)        Know the legal aspects of recording in the health care record;

 

E)        Discuss the requirements for recording in the health care record; and

 

F)         Describe how the Interdisciplinary Team works together to develop an individualized plan of care:

 

i)          Define the nursing process;

 

ii)         Differentiate between the role of the CNA and the role of the nurse in the nursing process;

 

iii)        List the steps of the nursing process;

 

iv)        Differentiate between objective and subjective information; and

 

v)         Discuss the role and the responsibilities of the CNA in reporting observations, developing a plan of care, and following the person's individualized plan of care.

 

b)         Module II – Rights and Relationships

 

1)         Rights.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Identify basic human rights;

 

B)        Discuss the importance of State and federal regulations in promoting resident rights:

 

i)          Describe the purpose of the Health Insurance Portability and Accountability Act (HIPAA);

 

ii)         Explain the role of the CNA in ensuring compliance with HIPAA;

 

iii)        Identify resident rights according to the Omnibus Budget Reconciliation Act of 1987 (OBRA);

 

iv)        Discuss how following the State and federal regulations enhances the resident's quality of life;

 

v)         Discuss how following the State and federal regulations enhances the resident's quality of care; and

 

vi)        Describe the purpose of the Ombudsman Program (Older Americans Act);

 

C)        Identify key concepts for person-directed care and discuss ways to apply the concepts for person-directed care:

 

i)          Discuss the importance, principles and methods of building relationships with residents and family.  The principles include, but are not limited to, trust, respect and commitment;

 

ii)         Discuss methods for building relationships;

 

iii)        Discuss ways to promote care partnerships;

 

iv)        Discuss strategies the CNA can use to support a culture of home;

 

v)         Examine the CNA's role in promoting care partnerships;

 

vi)        Differentiate between care practices that are person-directed versus an institutional model; and

 

vii)       Discuss some of the limitations that the CNA may encounter focusing on person-directed care;

 

D)        Discuss the importance and describe the principles of culture competence:

 

i)          Examine ways in which the culture of an elder may differ from the culture of the caregiver, such as generational, communication, family and religious differences, and differences in customs; and

 

ii)         Recognize the impact of the CNA's views and values on the care provided;

 

E)        Discuss abuse, neglect and theft:

 

i)          Describe the types of abuse, neglect and theft that occur in the health care setting;

 

ii)         Discuss ways that elder abuse, neglect and theft can be prevented;

 

iii)        Describe indications of abuse, neglect and theft;

 

iv)        Explain the CNA's role in reporting elder abuse, neglect and theft;

 

v)         Discuss requirements for reporting abuse, neglect and theft; and

 

vi)        Discuss consequences of abusing, neglecting or stealing from a resident.

 

2)         Holistic Care.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Explain the importance and describe the components of holistic care, which include, but are not limited to:

 

i)          Physical;

 

ii)         Social:

 

iii)        Psychological; and

 

iv)        Spiritual;

 

B)        Discuss the culture of aging:

 

i)          Describe the impact that physical changes may have on a person's self-image;

 

ii)         Discuss the psychological effects of loss on the elder;

 

iii)        Discuss the impact of aging on the family; and

 

iv)        Describe how elders are viewed in society;

 

C)        Describe ways in which the CNA can meet basic human needs of the elder and implement evidence-based practices to provide holistic care.

 

3)         Communication.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        List the components of communication;

 

B)        Describe the principles of communication;

 

C)        Identify the types of communication:

 

i)          Distinguish between verbal and non-verbal communication; and

 

ii)         Describe the appropriate use of touch in communication;

 

D)        Identify effective techniques for enhancing communication, which include, but are not limited to:

 

i)          Active listening;

 

ii)         Focusing on feelings;

 

iii)        Providing feedback;

 

iv)        Observing non-verbal clues; and

 

v)         Defusing anger;

 

E)        Discuss barriers to the communication process, which include, but are not limited to:

 

i)          Language;

 

ii)         Culture;

 

iii)        Perception; and

 

iv)        Situation;

 

F)         Discuss the CNA's responsibility for effective communication.

 

4)         Interpersonal Relationships.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Describe professional boundaries in relationships with residents;

 

B)        Discuss the importance of developing therapeutic relationships;

 

C)        Discuss the importance of building relationships within the health care team; and

 

D)        Describe appropriate relationship boundaries for a CNA as a member of the health care team.

 

c)         Module III – Infection Control in the Health Care Setting

 

1)         Infection Control Issues.  Objectives:  upon completion of this unit, the student will be able to explain the following:

 

A)        Microorganisms

 

i)          List the different types of microorganisms;

 

ii)         Differentiate between non-pathogens and pathogens;

 

iii)        Describe the role normal flora play in resisting infection;

 

iv)        Explain the importance of practicing asepsis in order to decrease a person's chance of developing a facility-acquired infection;

 

v)         Identify common microbes that are drug resistant;

 

vi)        Describe the implications of drug-resistant microbes; and

 

vii)       List the requirements that microorganisms need for survival and growth;

 

B)        Chain of infection

 

i)          Explain the role that each link in the chain of infection plays in transmitting disease; and

 

ii)         Identify factors that increase a person's risk of acquiring an infection;

 

C)        Signs and symptoms of infection

 

i)          List and describe signs and symptoms of infection, which include, but are not limited to, pain, heat, redness, swelling and change in resident behavior; and

 

ii)         List ways in which a CNA can prevent the spread of infection;

 

D)        Asepsis in health care 

 

i)          Differentiate between clean and sterile techniques; and

 

ii)         Describe principles for medical asepsis;

 

E)        State and federal regulations.  Discuss the role of the CNA in meeting current State and federal regulations related to infection control in health care settings;

 

F)         Skills in hand hygiene

 

i)          Identify situations requiring hand hygiene techniques;

 

ii)         Describe techniques for proper hand hygiene; and

 

iii)        Demonstrate proper hand hygiene techniques;

 

G)        Skills in isolation techniques

 

i)          Discuss the impact of isolation on a person's well-being;

 

ii)         Differentiate between standard precautions and transmission-based precautions;

 

iii)        Contrast nursing care for persons with each category of transmission-based precautions;

 

iv)        Demonstrate procedures according to established guidelines for Personal Protective Equipment (PPE);

 

v)         Select the appropriate PPE for both standard and transmission-based precautions; and

 

vi)        Demonstrate the procedure of removing PPE used in isolation. 

 

2)         Equipment and Supplies.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Discuss methods of disinfection;

 

B)        Discuss methods of sterilization; and

 

C)        Explain the role of the CNA in properly caring for equipment and supplies.

 

d)         Module IV – Emergency Procedures

 

1)         Fire Safety.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        List the three main types of fire:

 

i)          Oil/grease;

 

ii)         Electrical; and

 

iii)        Paper/wood;

 

B)        List the three elements necessary for a fire;

 

C)        Describe risk factors for a fire, which include, but are not limited to:

 

i)          Oxygen;

 

ii)         Impaired cognition;

 

iii)        Electrical hazards; and

 

iv)        Smoking;

 

D)        Explain safety precautions when oxygen is in use;

 

E)        Describe the responsibility of the CNA in fire prevention;

 

F)         Describe the actions a CNA should take in the event of a fire, including:

 

i)          Initial response;

 

ii)         Demonstrating the proper use of a fire extinguisher; and

 

iii)        Listing methods other than a fire extinguisher that may be used to extinguish a fire.

 

2)         Disasters.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Describe appropriate actions of the CNA in response to natural disasters, which include, but are not limited to:

 

i)          Storm/tornado;

 

ii)         Severe weather;

 

iii)        Floods; and

 

iv)        Earthquake;

 

B)        Describe appropriate actions of the CNA in response to man-made disasters, which include, but are not limited to:

 

i)          Bomb threats; and

 

ii)         Terrorist attacks;

 

C)        Explain the role of the CNA in relation to emergency preparedness.

 

3)         Foreign Body Airway Obstruction.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Differentiate between partial airway obstruction and complete airway obstruction;

 

B)        Demonstrate the procedures for dislodging a foreign body in:

 

i)          A conscious victim; and

 

ii)         An unconscious victim.

 

4)         Incidents.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Identify the responsibility of the CNA when:

 

i)          Assisting a resident who has fallen;

 

ii)         A resident has eloped;

 

iii)        A resident has sustained a thermal injury;

 

iv)        A resident has a skin tear or bruise; and

 

v)         A resident has ingested a harmful substance;

 

B)        Identify the role of the CNA in providing psychosocial support after an incident/emergency.

 

5)         State and Federal Regulations.  Objective: upon completion of this unit, the student will be able to review current State and federal regulations pertaining to resident rights during an emergency.

 

e)         Module V – Injury Prevention in the Health Care Environment

 

1)         Risk Management.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Explain and discuss State and federal regulations:

 

i)          Explain the role of the CNA in meeting current State and federal regulations pertaining to injury;

 

ii)         Discuss the role of the Occupational Safety and Health Administration (OSHA) in relation to injury prevention; and

 

iii)        Explain the purpose of the Material Safety Data Sheets;

 

B)        Explain and discuss ergonomics:

 

i)          Explain the importance of ergonomics to the health care worker;

 

ii)         Describe risk factors for the CNA that may contribute to injury;

 

iii)        Demonstrate consistent use of body mechanics while providing care;

 

iv)        Explain the principles of body mechanics;

 

v)         Discuss techniques to ensure proper body mechanics; and

 

vi)        Describe equipment to assist in promoting proper body mechanics.

 

2)         Resident Safety.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Discuss the importance of maintaining safety for the resident;

 

B)        Identify factors in the elderly that contribute to an increased risk for injury;

 

C)        Determine the CNA responsibility regarding each of the following safety issues:

 

i)          Falls;

 

ii)         Elopement;

 

iii)        Resident identification;

 

iv)        Thermal injury;

 

v)         Skin tears;

 

vi)        Choking; and

 

vii)       Poisoning;

 

D)        Explain and discuss restraint safety:

 

i)          Analyze the adverse psychological and physical effects of restraining a resident;

 

ii)         Explain how to maintain resident's rights when a safety device or restraint must be applied;

 

iii)        Discuss the legal implications of restraint usage;

 

iv)        Discuss the right of a resident not to be restrained;

 

v)         Discuss industry movement toward restraint-free environments;

 

vi)        Explore the various alternatives to applying restraints;

 

vii)       Demonstrate application of a less restrictive alternative;

 

viii)      Recognize when a device is considered a restraint; and

 

ix)        Compare and contrast chemical and physical restraints with less restrictive alternatives and positioning devices;

 

E)        Examine the responsibilities of the CNA in maintaining resident safety in regard to:

 

i)          Person-directed strategy;

 

ii)         Observation of actual risk and potential risk;

 

iii)        Documentation; and

 

iv)        Reporting.

 

3)         Personal Safety.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Describe environmental factors that have an impact on personal safety in the workplace;

 

B)        Explain and discuss workplace violence:

 

i)          Discuss the various types of violence encountered in the work environment;

 

ii)         Explain risk factors for violence in the workplace; and

 

iii)        Discuss techniques to decrease the likelihood of encountering workplace violence.

 

4)         Equipment Safety.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Discuss the responsibility of the CNA for assuring safe use of equipment; and

 

B)        Examine the importance of proper reporting of unsafe equipment.

 

5)         Documentation.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Describe various types of documentation required when safety infractions have occurred; and

 

B)        Discuss the responsibility of the CNA for documenting problems related to safety.

 

f)         Module VI – Care of the Resident

 

1)         Resident Living Space.  Objectives:  upon completion of this unit, the student will be able to: 

 

A)        Explain why a comfortable environment is important to a person's well-being;

 

B)        Identify and discuss factors related to residential living space:

 

i)          Identify the environmental factors that can affect a person's comfort in his or her living space; and

 

ii)         Discuss the importance of personal belongings in the person's environment;

 

C)        Explain and discuss the role of furniture and equipment in residential living space:

 

i)          Discuss safety issues when operating a bed;

 

ii)         Demonstrate how to operate a bed;

 

iii)        Examine reasons for use of various bed positions;

 

iv)        Demonstrate placing a hospital bed in various positions;

 

v)         Explain how the over-bed table is used by the health care team and the resident;

 

vi)        Demonstrate how to raise and lower the over-bed table;

 

vii)       Describe how the bedside stand is used by the health care team and the resident;

 

viii)      Explain why curtains and screening devices are important for the purposes of privacy;

 

ix)        Identify the limitations of curtains and screening devices; and

 

x)         Identify other equipment that is generally part of a resident's room;

 

D)        Explain the rules for proper maintenance of the resident's living space;

 

E)        Explain and discuss call system devices:

 

i)          Demonstrate prompt response to signal lights or call system devices;

 

ii)         Explain various types of call systems; and

 

iii)        Discuss use of alternatives if a call system fails;

 

F)         Explain and discuss bed making:

 

i)          Explain the importance of bed making for the person's comfort and well-being, encouraging personal preferences, and identifying the person's preferences when handling personal linens;

 

ii)         Explain and demonstrate aseptic techniques when handling linens;

 

iii)        Discuss the guidelines for making beds;

 

iv)        Explain the difference between an unoccupied and occupied bed; and

 

v)         Demonstrate making a closed bed an open bed and an occupied bed, according to established standards;

 

G)        Examine the importance of frequent observations of the resident in his/her living space, including, but not limited to:

 

i)          Side rails;

 

ii)         Bed position:

 

iii)        Call light;

 

iv)        Safety alarms;

 

v)         Personal items;

 

vi)        Linens; and

 

vii)       Personal preferences;

 

H)        Demonstrate consistent maintenance of resident's comfort and safety.

 

2)         Admission, Transfer, Discharge.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Discuss admission procedures:

 

i)          Compare and contrast admission to various types of health care settings;

 

ii)         Discuss the emotional responses a person may experience when admitted to a health care facility;

 

iii)        Identify the equipment needed to admit a person;

 

iv)        Describe the process for admitting a person to the facility; and

 

v)         Recognize the CNA's role in the care of a person being admitted;

 

B)        Discuss room transfers:

 

i)          Identify the need for room transfers;

 

ii)         Discuss the emotional responses that a person may experience when transferred to a different room;

 

iii)        Describe the process used to transfer a resident from one room to another;

 

iv)        Recognize the CNA's role in the care of a person transferring to a different room; and

 

v)         Discuss the strategies the CNA uses to support a smooth transition to another room;

 

C)        Discuss discharge procedures:

 

i)          Identify places to which a person may be discharged;

 

ii)         Discuss the emotional responses a person may experience when being discharged  to various facilities;

 

iii)        Described the process for discharging a resident; and

 

iv)        Recognize the CNA's role in the care of the person being discharged;

 

D)        Demonstrate skills: height, weight:

 

i)          Identify the purpose of obtaining height and weight measurements; and

 

ii)         Demonstrate obtaining a person's height and weight measurements according to established standards.

 

3)         Psychosocial Concerns.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Explain the importance of recognizing psychosocial concerns;

 

B)        Discuss psychosocial concerns common to residents;

 

C)        Describe common behaviors associated with how a person is feeling;

 

D)        Recognize the CNA's role in meeting the resident's psychosocial needs, which include:

 

i)          Person-directed strategies;

 

ii)         Observations;

 

iii)        Documentation; and

 

iv)        Reporting.

 

4)         Promoting Resident Comfort and Managing Pain.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Recognize indicators that a resident is not comfortable and the CNA's role in maintaining a person's comfort, which includes:

 

i)          Person-directed strategies;

 

ii)         Observations;

 

iii)        Documentation; and

 

iv)        Reporting;

 

B)        Discuss the importance of identifying when a person is experiencing pain:

 

i)          Recognize indicators of a person experiencing pain;

 

ii)         Compare various methods used for pain level evaluation;

 

iii)        Examine non-pharmacological methods a CNA may use to assist a person in managing pain, which may include massage, imagery, relaxation technique, music or pet therapy;

 

iv)        Recognize the CNA's role in caring for a person experiencing pain, which includes person-directed strategies, observations, documentation and reporting.

 

5)         Body Structure.  Objectives:  upon completion of this unit, the student will be able to explain the organization of the human body, including cells, tissue, organs and systems.

 

6)         Integumentary System.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Identify the structures of the integumentary system;

 

B)        Identify the functions of the integumentary system;

 

C)        Discuss how changes in the skin may affect a person's life physically, psychologically and socially;

 

D)        Discuss healthy skin:

 

i)          Discuss the importance of maintaining healthy skin;

 

ii)         Describe factors affecting the maintenance of healthy skin; and

 

iii)        Recognize the CNA's role in promoting healthy skin;

 

E)        Discuss common health concerns:

 

i)          Identify various skin conditions, such as too moist, too dry, poor skin turgor, alterations in color, fragility and allergic reactions;

 

ii)         Discuss common communicable diseases affecting the skin, such as shingles, scabies, fungal infections and pediculosis; and

 

iii)        Discuss common injuries to the skin and examine various methods to prevent injuries, which include, but are not limited to, skin tears, contusions and burns;

 

F)         Discuss pressure ulcers:

 

i)          Identify the persons at risk for developing pressure ulcers;

 

ii)         Identify the stages of pressure ulcers;

 

iii)        List the sites where pressure ulcers are likely to develop;

 

iv)        List the causes of pressure ulcers;

 

v)         Explain interventions the CNA can take to prevent pressure ulcers;

 

vi)        Describe various treatments for pressure ulcers; and

 

vii)       Examine various actions taken by the CNA to care for the person with skin abnormalities;

 

G)        Recognize the CNA's role in preventing pressure ulcers, which includes:

 

i)          Person-directed strategies;

 

ii)         Observations;

 

iii)        Documentation; and

 

iv)        Reporting;

 

H)        Explain and demonstrate oral hygiene skills:

 

i)          Explain why oral hygiene helps meet the person's basic needs;

 

ii)         Identify the supplies needed for oral hygiene;

 

iii)        Demonstrate how to assist the person to brush his/her teeth, according to established standards;

 

iv)        Demonstrate how to brush a person's teeth according to established standards;

 

v)         Describe how to floss a person's teeth according to established standards;

 

vi)        Describe special measures a CNA needs to practice when handling dentures;

 

vii)       Demonstrate cleaning of dentures, according to established standards;

 

viii)      Demonstrate insertion of dentures;

 

ix)        Demonstrate removal of dentures;

 

x)         Describe the special measures that need to be taken when providing mouth care for the unconscious resident;

 

xi)        Explain when mouth care should be given to the unconscious resident;

 

xii)       Describe how to perform mouth care on an unconscious resident, according to established standards; and

 

xiii)      Recognize the CNA's role when providing oral hygiene;

 

I)         Discuss bathing skills:

 

i)          Explain why bathing is important for meeting basic needs;

 

ii)         Identify the factors that influence the bathing method chosen by a person and the health care team;

 

iii)        Discuss the bathing schedule;

 

iv)        Compare various types of skin care products;

 

v)         Recognize the CNA's role in the application of skin care products;

 

vi)        Describe the procedural steps for various types of bathing, such as complete bed bath, partial bath, tub bath and shower;

 

vii)       Perform a complete bed bath, according to established standards;

 

viii)      Demonstrate giving a partial bed bath, according to established standards;

 

ix)        Explain procedures used when assisting a person to take a tub bath, according to established standards;

 

x)         Demonstrate procedures used when assisting a person to take a shower, according to established standards;

 

xi)        Discuss alternatives to traditional bathing methods; and

 

xii)       Recognize the CNA's role in bathing the resident;

 

J)         Discuss and identify back massage skills:

 

i)          Identify the purpose of a back massage; and

 

ii)         Demonstrate a back massage, according to established standards;

 

K)        Explain and discuss perineal care skills:

 

i)          Explain the purpose of perineal care;

 

ii)         Discuss the indications for perineal care;

 

iii)        Demonstrate female and male perineal care according to established standards; and

 

iv)        Recognize the role of the CNA in providing perineal care;

 

L)        Identify and demonstrate hair care skills:

 

i)          Identify the importance of providing hair care;

 

ii)         Demonstrate brushing and combing hair, according to established standards;

 

iii)        Explain various methods of shampooing hair; and

 

iv)        Recognize the CNA's role in providing hair care;

 

M)       Explain and demonstrate shaving skills:

 

i)          Explain the importance of shaving as it relates to meeting basic needs;

 

ii)         Demonstrate a shave, according to established standards; and

 

iii)        Recognize the CNA's role in shaving a resident;

 

N)        Explain and demonstrate nail care skills:

 

i)          Identify the importance of nail care;

 

ii)         Discuss nail care, for a person with special conditions, such as diabetes, impaired circulation and fungus;

 

iii)        Demonstrate nail care, according to established standards;

 

iv)        Differentiate between nail care for hands and feet; and

 

v)         Recognize the CNA's role in providing nail care to the resident;

 

O)        Explain and demonstrate dressing and undressing skills:

 

i)          Identify the importance of being appropriately dressed;

 

ii)         Demonstrate dressing and undressing a person, according to established standards;

 

iii)        Describe special considerations, such as physical limitation, medical equipment, and special needs in dressing and undressing;

 

iv)        Discuss the impact of appropriate dress on a person's quality of life and comfort; and

 

v)         Recognize the CNA's role in dressing and undressing a resident;

 

P)         Discuss therapeutic applications:

 

i)          Identify various types of applications;

 

ii)         Compare and contrast moist and dry applications;

 

iii)        Explain the purpose and principles involved in the application of heat;

 

iv)        Describe the effects of heat applications;

 

v)         Explain the purpose and principles involved in the application of cold;

 

vi)        Describe the effects of cold applications;

 

vii)       Describe the procedure used for various applications;

 

viii)      Identify a person at risk for complications associated with various applications; and

 

ix)        Recognize the CNA's role in caring for a person receiving therapeutic application.

 

7)         Musculoskeletal System.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Describe the structures of the musculoskeletal system, including the following:

 

i)          The types of bones;

 

ii)         The function and types of joints;

 

iii)        The major functions of muscles; and

 

iv)        The types of muscles;

 

B)        Describe the functions of the musculoskeletal system;

 

C)        Discuss how age-related changes in the musculoskeletal system may affect a person's life physically, psychologically and socially;

 

D)        Identify the complications of immobility, including, but not limited to, contractures and atrophy;

 

E)        Explain the importance of preventing complications of immobility and identify interventions to prevent these complications;

 

F)         Identify common health concerns:

 

i)          Arthritis. Identify types of arthritis and recognize the CNA's role in caring for a person with arthritis, such as person-directed strategies, observations, documentation and reporting;

 

ii)         Factures.  Identify types of fractures and describe common causes of fractures, including osteoporosis; recognize the CNA's role in caring for a person in a cast or in traction, or who has had a hip fracture or hip replacement;

 

iii)        Amputation.  Identify common causes of amputation and describe the impact of an amputation on a person's life.  Recognize the CNA's role in caring for a person with an amputation;

 

G)        Discuss range of motion exercise skills:

 

i)          Identify the purpose of range of motion;

 

ii)         Explain the safety and comfort guidelines for range of motion exercises;

 

iii)        Identify types of range of motion exercises, including active, passive and active-assistive;

 

iv)        Describe and demonstrate the movements of range of motion exercise, which include abduction, adduction, extension, flexion, plantar flexion, dorsi-flexion, opposition, internal rotation, external rotation, pronation and supination; and

 

v)         Recognize the CNA's role in performing range of motion exercises;

 

H)        Discuss prosthetic and orthotic devices skills:

 

i)          Identify the purpose of prosthetic and orthotic devices;

 

ii)         Describe the types of prosthetic and orthotic devices; and

 

iii)        Describe how to apply and remove various prosthetic and orthotic devices;

 

I)         Discuss lifting and moving skills:

 

i)          Identify the principles of lifting and moving;

 

ii)         Demonstrate various methods for turning a person on his/her side;

 

iii)        Demonstrate various methods for moving a person to the head of the bed;

 

iv)        Demonstrate various methods for moving a person to the side of the bed;

 

v)         Demonstrate various types of lifts; and

 

vi)        Recognize the CNA's role in lifting and moving;

 

J)         Discuss repositioning skills:

 

i)          Identify the purpose of repositioning;

 

ii)         Explain the principles of repositioning;

 

iii)        Demonstrate various types of positions; and

 

iv)        Recognize the CNA's role in repositioning the resident;

 

K)        Discuss transfer skills:

 

i)          Explain the principles of transferring a person safely;

 

ii)         Demonstrate various procedures for transferring a resident using a transfer/gait belt, including the proper application of a transfer/gait belt;

 

iii)        Demonstrate various procedures for transferring a resident to a stretcher; and

 

iv)        Recognize the CNA's role in transferring a resident;

 

L)        Discuss ambulating skills:

 

i)          Discuss the importance of ambulation;

 

ii)         Explain the principles of ambulation;

 

iii)        Describe assistive devices used for ambulation, such as transfer/gait belts, walkers and canes; and

 

iv)        Demonstrate various ambulation techniques and recognize the CNA's role in ambulation of a resident;

 

M)       Discuss transporting skills:

 

i)          Explain the principles of transporting;

 

ii)         Demonstrate various methods of transporting a person; and

 

iii)        Recognize the CNA's role in transporting the resident.

 

8)         Gastrointestinal System.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Identify the structures of the gastrointestinal system;

 

B)        Identify the functions of the gastrointestinal system;

 

C)        Discuss how age-related changes in the gastrointestinal system may affect a person's life physically, psychologically and socially;

 

D)        Discuss basic nutrition:

 

i)          Identify the importance of nutrition;

 

ii)         Discuss healthy nutrition based on the daily requirements; and

 

iii)        Identify basic food groups and discuss factors affecting a person's nutrition;

 

E)        Discuss hydration:

 

i)          Identify the importance of hydration;

 

ii)         Explain the principles of hydration; and

 

iii)        Discuss factors affecting a person's hydration;

 

F)         Discuss therapeutic diets/nourishments:

 

i)          Identify the purpose of therapeutic diets/nourishments;

 

ii)         Explain the principles of therapeutic diets/nourishments;

 

iii)        Describe the various types of therapeutic diets;

 

iv)        Identify the various types of supplements and nourishments; and

 

v)         Recognize the CNA's role in caring for the person receiving a therapeutic diet/nourishment;

 

G)        Discuss dining experience:

 

i)          Identify the importance of creating a positive dining experience;

 

ii)         Explain the principles involved in the dining experience;

 

iii)        Describe methods of creating a person-directed dining experience;

 

iv)        Discuss types of dining experiences, including restaurant style and buffet; and

 

v)         Recognize the CNA's role in supporting the dining experience;

 

H)        Discuss assistance with the dining experience:

 

i)          Identify the importance of providing assistance during dining;

 

ii)         Explain the principles involved in providing assistance during dining, which include positioning, prep and set up, and assistive devices;

 

iii)        Demonstrate safety measures when assisting with the dining experience;

 

iv)        Demonstrate assisting the person to eat according to established standards;

 

v)         Demonstrate adaptations for assisting a person with special needs.  Special needs may include, but are not limited to, visual and cognitive impairment;

 

vi)        Discuss special concerns, such as recognizing indications of dysphagia, squirreling or pocketing of food, and aspiration;

 

vii)       Demonstrate aspiration precautions; and

 

viii)      Recognize the CNA's role in assisting with the dining experience;

 

I)         Discuss bowel elimination:

 

i)          Identify the characteristics of normal bowel elimination;

 

ii)         Identify the resident's normal bowel habits/patterns;

 

iii)        Discuss the factors affecting bowel elimination;

 

iv)        Discuss how age-related changes affect bowel elimination;

 

v)         Describe common health concerns association with bowel elimination, which include, but are not limited to, constipation and diarrhea;

 

vi)        Recognize the CNA's role regarding bowel elimination;

 

vii)       Demonstrate assisting a resident with bowel elimination procedures, which include, but are not limited to, bedpans, commodes, briefs and incontinent care, according to established standards; and

 

viii)      Describe the procedures for collecting a stool specimen.

 

9)         Urinary System.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Identify the structures of the urinary system;

 

B)        Identify the functions of the urinary system;

 

C)        Discuss how age-related changes in the urinary system may affect a person's life physically, psychologically and socially;

 

D)        Describe common health concerns associated with urinary elimination, including urinary tract infection and incontinence;

 

E)        Discuss intake and output:

 

i)          Explain the purpose of measuring intake and output;

 

ii)         Describe the guidelines for intake and output;

 

iii)        Demonstrate the measurement of intake and output, according to established standards; and

 

iv)        Recognize the CNA's role in caring for the person on intake and output;

 

F)         Discuss urinary elimination:

 

i)          Identify characteristics of normal urinary elimination;

 

ii)         Identify the person's urinary elimination habits/patterns;

 

iii)        Discuss factors affecting urinary elimination;

 

iv)        Demonstrate the procedure for assisting a person to use a urinal, bedpan or commode/toilet;

 

v)         Describe the use of various incontinence products;

 

vi)        Identify types of urinary incontinence;

 

vii)       Describe methods of prevention of urinary incontinence;

 

viii)      Describe the CNA's role in the care of the incontinent resident;

 

ix)        Discuss the purpose of urinary catheters;

 

x)         Describe the types of urinary catheters;

 

xi)        Describe the CNA's role in caring for a resident with an indwelling urinary catheter;

 

xii)       Describe the procedures for collecting various urinary specimens; and

 

xiii)      Recognize the CNA's role in regard to urinary elimination.

 

10)       The Reproductive System.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Identify the structures of the reproductive system;

 

B)        Identify the functions of the reproductive system;

 

C)        Discuss how age-related changes in the reproductive system may affect a person's life physically, psychologically and socially;

 

D)        Differentiate between sex and sexuality, including:

 

i)          Discuss promoting sexuality;

 

ii)         Recognize the importance of maintaining sensitivity related to a person's sexuality; and

 

iii)        Discuss ways that a person may inappropriately express sexuality and describe interventions that the CNA may use when caring for sexually aggressive residents and residents who display inappropriate sexually explicit public behaviors;

 

E)        Discuss common health concerns of sexually transmitted diseases:

 

i)          Define sexually transmitted diseases;

 

ii)         Identify the various types of sexually transmitted diseases;

 

iii)        Describe the signs and symptoms of the various sexually transmitted diseases; and

 

iv)        Recognize the CNA's role in caring for a person with a sexually transmitted disease.

 

11)       The Cardiovascular System.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Identify the structures of the cardiovascular system;

 

B)        Identify the functions of the cardiovascular system;

 

C)        Discuss how age-related changes in the cardiovascular system may affect a person's life physically, psychologically and socially;

 

D)        Identify the signs/symptoms of various cardiovascular diseases, which include, but are not limited to:

 

i)          Hypertension;

 

ii)         Coronary artery disease;

 

iii)        Angina pectoris;

 

iv)        Myocardial infarction; and

 

v)         Congestive heart failure;

 

E)        Recognize the CNA's role in caring for a person with a cardiovascular disease;

 

F)         Discuss dietary modification related to cardiovascular diseases; and

 

G)        Describe the role of the CNA in the application and removal of anti-embolism stockings (TED hose).

 

12)       The Respiratory System.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Identify the structures of the respiratory system;

 

B)        Identify the functions of the respiratory system;

 

C)        Discuss how age-related changes in the respiratory system may affect a person's life physically, psychologically and socially;

 

D)        Discuss common health concerns:

 

i)          Identify various types of chronic obstructive pulmonary diseases (COPD);

 

ii)         Discuss the psychosocial needs of the resident with COPD;

 

iii)        Describe the signs and symptoms of various respiratory illnesses, which include asthma, pneumonia and tuberculosis; and

 

iv)        Recognize the CNA's role in caring for a person with a respiratory illness;

 

E)        Discuss oxygen therapy:

 

i)          Identify the purpose of oxygen therapy;

 

ii)         Explain the principles involved in oxygen therapy;

 

iii)        Identify the types of oxygen delivery;

 

iv)        Recognize the CNA's role in caring for a person receiving oxygen therapy;

 

v)         Identify the purpose of artificial ventilation; and

 

vi)        Recognize the CNA's role in caring for a person with a ventilator;

 

F)         Identify the purposes of sputum collection and explain the procedure used when collecting a sputum specimen;

 

G)        Discuss vital signs:

 

i)          Identify the purpose of measuring temperature;

 

ii)         Identify the types of thermometers;

 

iii)        Identify sites where temperature may be measured;

 

iv)        Demonstrate obtaining an oral temperature according to established standards;

 

v)         Identify the purpose of measuring the pulse;

 

vi)        Identify the sites where a pulse may be measured;

 

vii)       Demonstrate obtaining a pulse according to established standards;

 

viii)      Identify the purpose of measuring respirations;

 

ix)        Discuss various respiratory patterns;

 

x)         Demonstrate obtaining respiration according to established standards;

 

xi)        Identify the purpose of measuring blood pressure;

 

xii)       Explain the principles involved in obtaining a blood pressure;

 

xiii)      Demonstrate obtaining a blood pressure according to established standards; and

 

xiv)      Recognize the CNA's role in measuring vital signs;

 

H)        Discuss CPR:

 

i)          Discuss the purpose of performing CPR;

 

ii)         Explain the principles involved in providing CPR;

 

iii)        Demonstrate the performance of CPR, including one-rescuer adult, child and infant CPR and two rescuer adult, child and infant CPR;

 

iv)        Demonstrate the performance of foreign airway obstruction for adult, child and infant victims; and

 

v)         Recognize the CNA's role related to CPR.

 

13)       The Nervous System.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Identify the structures of the nervous system;

 

B)        Identify the functions of the nervous system;

 

C)        Discuss how age-related changes in the nervous system may affect a person's life physically, psychologically and socially;

 

D)        Discuss common health concerns:

 

i)          Discuss the signs and symptoms of various nervous disorders, including cerebrovascular accident, Parkinson's disease, multiple sclerosis and types of traumatic injuries;

 

ii)         Identify communication problems resulting from hearing disorders;

 

iii)        Discuss communication strategies when caring for a person with a hearing disorder;

 

iv)        Identify special concerns associated with caring for a person with a visual disorder;

 

v)         Discuss ways the CNA can promote independence of a person with a visual disorder; and

 

vi)        Recognize the CNA's role in caring for a person with various nervous system disorders, including observations, critical thinking, documentation and reporting;

 

E)        Discuss hearing instrument skills:

 

i)          Identify the purpose of hearing instruments;

 

ii)         Discuss the various types of hearing instruments;

 

iii)        Explain the insertion and removal of the hearing instrument; and

 

iv)        Recognize the CNA's role in caring for a person with a hearing instrument;

 

F)         Discuss visual aids skills:

 

i)          Identify the purpose of visual aids;

 

ii)         Discuss the various types of visual aids;

 

iii)        Explain the care of visual aids; and

 

iv)        Recognize the CNA's role in caring for a person with visual aids;

 

g)         Module VII – Fundamentals of Rehabilitation/Restorative Care

 

1)         Philosophy.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Explain the philosophy of rehabilitation;

 

B)        Review basic human needs;

 

C)        Identify individual motivations for a person participating in rehabilitation; and

 

D)        Apply holism to the philosophy of rehabilitation. 

 

2)         Objective:  upon completion of this unit, the student will be able to discuss principles of rehabilitation.

 

3)         Objective:  upon completion of this unit, the student will be able to compare and contrast rehabilitation and restorative nursing.

 

4)         Objective:  upon completion of this unit, the student will be able to identify the members of the rehabilitation team.

 

5)         Objective:  upon completion of this unit, the student will be able to identify State and federal regulations that have an impact on rehabilitation/restorative care.

 

6)         Objective:  upon completion of this unit, the student will be able to recognize the CNA's role in providing rehabilitation/restorative care, which includes:

 

A)        Importance;

 

B)        Care-giving modifications;

 

C)        Observations;

 

D)        Reporting; and

 

E)        Documentation.

 

7)         ADL Programs.  Objectives: upon completion of this unit, the student will be able to:

 

A)        Describe the types of ADL programs available for persons needing rehabilitation/restorative care, which include, but are not limited to:

 

i)          Eating:

 

ii)         Dressing/grooming;

 

iii)        Mobility; and

 

iv)        Communication;

 

B)        Explain the purpose of ADL programs;

 

C)        Discuss adaptive devices:

 

i)          Describe the adaptive devices available to assist with performance of ADL;

 

ii)         Explain the purpose of adaptive devices; and

 

iii)        Recognize the CNA's role in caring for the person using an adaptive device, including importance, care-giving modification, observations, reporting and documentation.

 

h)         Module VIII – End-of-Life Care

 

1)         End-of-Life Issues.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Discuss attitudes:

 

i)          Discuss the impact that spiritual and cultural beliefs have on one's attitudes; and

 

ii)         Examine one's feelings about providing care for the terminally ill person;

 

B)        Explore legal issues associated with end-of-life care, which include, but are not limited to:

 

i)          Self-determination;

 

ii)         Guardianship;

 

iii)        Advance directives, including the significance of living wills and power of attorney; and

 

iv)        Implications of do-not-resuscitate (DNR) orders and the Physician's Order for Life Sustaining Treatment (POLST).

 

2)         State and Federal Regulations.  Objectives:  upon completion of this unit, the student will be able to discuss current State and federal regulations related to end-of-life issues, such as:

 

A)        Resident rights;

 

B)        Resident behaviors and facility practices;

 

C)        Quality of life; and

 

D)        Quality of care.

 

3)         Care of a Dying Person.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Discuss physical aspects:

 

i)          Identify the signs of approaching death;

 

ii)         Discuss how to preserve the dying person's rights;

 

iii)        Discuss ways to promote comfort for the dying person; and

 

iv)        Recognize the CNA's role in meeting the physical needs of the dying person;

 

B)        Discuss psychosocial aspects:

 

i)          Discuss the importance of celebrating a person's life;

 

ii)         Describe strategies to celebrate a person's life;

 

iii)        Describe the grieving process as it may pertain to the dying person, friends/loved ones, and the care givers:

 

iv)        Discuss various facility practices to honor deceased residents; and

 

v)         Recognize the CNA's role in meeting the psychosocial needs of the dying person, which include observations, critical thinking, documentation and reporting;

 

C)        Discuss hospice care and palliative care:

 

i)          Discuss the philosophy of hospice and palliative care;

 

ii)         Discuss the goals of hospice and palliative care; and

 

iii)        Describe ways that hospice and palliative care are incorporated into the plan of care.

 

4)         Post-mortem Care.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Explain the principles involved in caring for the body after death; and

 

B)        Perform post-mortem care according to established facility practices.

 

i)          Module IX – Alzheimer's and Other Dementias

 

1)         Cognitive Impairment.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Differentiate between normal aging and dementias;

 

B)        Describe how dementias are diagnosed;

 

C)        List types of reversible dementia; and

 

D)        List types of non-reversible dementia.

 

2)         Alzheimer's Disease.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Describe the physical changes that occur as the person progresses through Alzheimer's Disease; and

 

B)        List the signs and symptoms of Alzheimer's Disease.

 

3)         Impacts of Cognitive Impairments.  Objectives:  upon completion of this unit, the student will be able to describe the impact of cognitive impairment on society, the family and the individual.

 

4)         State and Federal Regulations.  Objectives:  upon completion of this unit, the student will be able to discuss current State and federal regulations related to the care of the person with dementia.

 

5)         Ability Centered Care:

 

A)        Overview.  Objectives:  upon completion of this unit, the student will be able to:

 

i)          Discuss the philosophy of person-directed, ability-centered care;

 

ii)         Describe the goals of ability-centered care;

 

iii)        Discuss the importance of a team approach in caring for a person with dementia; and

 

iv)        Discuss the role of the CNA in providing ability-centered care;

 

B)        Therapeutic Environment.  Objectives:  upon completion of this unit, the student will be able to:

 

i)          Discuss elements of a therapeutic environment; and

 

ii)         Discuss creative strategies to promote a therapeutic environment;

 

C)        Communication.  Objectives:  upon completion of this unit, the student will be able to:

 

i)          Describe how challenges in communication change as the person progresses through the stages of dementia;

 

ii)         Discuss creative strategies to enhance communication; and

 

iii)        Discuss appropriate techniques for physical touch with someone with dementia;

 

D)        Relationships.  Objectives; upon completion of this unit, the student will be able to:

 

i)          Examine the importance of relationships between care givers and the person who has dementia; and

 

ii)         Describe ways that the CNA can enhance his/her relationship with the person with dementia;

 

E)        Activities.  Objectives: upon completion of this unit, the student will be able to:

 

i)          Discuss examples of activities appropriate for persons in different stages of dementia;

 

ii)         Discuss approaches the CNA can use to engage residents in activities;

 

iii)        Compare and contrast traditional versus non-traditional activities; and

 

iv)        Compare and contrast structured versus spontaneous activities;

 

F)         Activities of Daily Living (ADL).  Objectives:  upon completion of this unit, the student will be able to:

 

i)          Discuss the purpose of restorative goals, including improving performance, maintaining abilities and preventing complications;

 

ii)         Explore physical challenges, psychosocial challenges, environmental challenges and approaches to support resident's independence related to each ADL, which include, but are not limited to, dressing, bathing, grooming, oral hygiene, toileting and eating/nutritional issues.

 

6)         Understanding Behaviors as Unmet Needs.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Explain the difference between symptoms and behaviors;

 

B)        Describe defense mechanism/coping behaviors used to compensate for cognitive impairment;

 

C)        Examine ways in which the CNA can diminish behavioral challenges;

 

D)        Explore creative strategies to manage common behavioral challenges:

 

i)          Purposeful wandering;

 

ii)         Agitation and aggression;

 

iii)        Catastrophic reaction;

 

iv)        Combativeness;

 

v)         Delusions/hallucinations/paranoia;

 

vi)        Rummaging and hoarding;

 

vii)       Sexual behavior;

 

viii)      Sleep disturbances;

 

ix)        Sundowning;

 

x)         Wanting to go home;

 

xi)        Indifference;

 

xii)       Purposeful waking; and

 

xiii)      Other behaviors.

 

7)         Safety.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Describe challenges in maintaining the safety of the resident while supporting the resident's need to remain active.  These include physical, psychosocial and environmental challenges; and

 

B)        Investigate creative strategies to provide for the safety of the person with dementia.

 

8)         Psychosocial Needs.  Objectives:  upon completion of this unit, the student will be able to:

 

A)        Discuss the Person with Dementia:

 

i)          Describe role changes and reversals that the person with dementia experiences;

 

ii)         Identify stressors;

 

iii)        Discuss grief and loss issues; and

 

iv)        Describe coping strategies for the person with dementia, including understanding disease progression, realistic expectations and self-care;

 

B)        Discuss Family and Loved Ones:

 

i)          Describe the role changes and reversals that family members go through when a loved one has dementia;

 

ii)         Describe ways to manage the stresses of caring for persons with cognitive impairment;

 

iii)        Discuss grief and loss issues; and

 

iv)        Discuss the psychological support that family and loved ones might need in coping with dementia;

 

C)        Discuss Caregivers and Staff:

 

i)          Identify stressors;

 

ii)         Discuss grief and loss issues; and

 

iii)        Describe coping strategies for those caring for persons with cognitive impairment, including understanding disease progression, realistic expectations, self-care and recognizing burnout.

 

9)         Resources.  Objectives:  upon completion of this unit, the student will be able to identify community resources available to the following:

 

A)        Persons with dementia;

 

B)        Families and loved ones; and

 

C)        Caregivers and staff.

 

(Source:  Amended at 37 Ill. Reg. 10546, effective June 27, 2013)