NHA CCMA EXM

MA Scope of Practice: DO

Clinical:

• Vitals, height/weight/BMI

• 12-lead ECG and rhythm strips

• capillary and venous blood collection

• waived CLIA/lab testing

• Ear irrigation

• Administer medication

• Prep patients, supplies, and exam room real time documentation and update/verify patient information

Administrative: anything that doesn’t require a professional's judgment/medical license

Medications MAs can administer

PO, topical, inhaled, and injections per state law

MA Scope of practice: DO NOT

Clinical:

• diagnose

• interpret test results

• change/adjust/prescribe medication/treatments

• invasive/complex procedures

• pelvic exams/pap smears

• sedate

• act outside of training, policy, or state law

Administrative:

• give medical advice (in person/over the phone)

• Prescribe medications

• Sign official orders/plans

• Obtain formal informed consent

POCT (Point of Care Testing) - allowed

Urinalysis (UA), blood glucose, pregnancy test, strep A, flu A and B, COVID, Occult Blood (FIT), RSV (if waived)

Lab Specimen Collection: allowed

Capillary (finger or heel stick), Venous (venipuncture)

Diagnostic tests: allowed

12-lead ECG & rhythm strips, spirometry (if trained and permitted)

When required, always make sure get …

Provider order

What to do with abnormal findings

Report immediately

When to escalate to provider

abnormal vital signs, critical lab or POCT results, medication reactions, patient distress, any task outside scope of practice, questions/concerns

True or False: regulations and policies are the same in every state and for every employer

false

Government - role in healthcare system

create laws, policies, and fund health programs

Financing - role in healthcare system and examples

Pay for healthcare services. Ex: insurance companies, medicare, medicaid

Providers

Doctors, nurses, allied health professionals, and other healthcare workers

Facilities

place where healthcare is provided

patients

receive care and follow treatment plans

Private healthcare

run by individuals or businesses for profit

Public healthcare

run by government and funded by taxes

not-for-profit healthcare

run by organizations that use money to improve services, not for profit

managed care

combines insurance and healthcare services to control costs and improve quality

Ambulatory/outpatient care

patients go in and out the same day

Ambulatory care examples

physician offices, clinics, urgent care, outpatient surgical centers, diagnostic and imaging centers

Ambulatory care focus

prevention, early detection, treatment that doesn’t require overnight stay

Inpatient/Acute care

patients stay overnight for medical care and treatment

Inpatient care examples

Hospitals, ICU, maternity units, surgical units, emergency department

Inpatient care focus

treating serious illness, injuries, and conditions that require 24 hour care

Long-term/continuing care

care for people with chronic conditions or disabilities

Long-term care examples

Nursing home, assisted living, rehab, hospice, home health care

Long-term care focus

help with daily activities, recovery, comfort, and maintaining quality of life

Community care/public health

services that promote and protect community health

community care examples

health departments, immunization clinics, WIC programs, school health and health education services

community care focus

prevention, education, and improving community health

Physicians

diagnose and treat illnesses

Nurses

provide and coordinate patient care

MA

support clinical and administrative tasks

Allied health professionals

Lab tech, phlebotomists, radiology techs, PTs, etc

administrators

manage and organize healthcare services

Spoken words on the phone are an example of what type of communication (verbal, nonverbal, written, electronic)

verbal

tone of voice is an example of what type of communication (verbal, nonverbal, written, electronic)

nonverbal

To effectively communicate, be…

respectful, clear, concise, complete, concrete, correct, courteous, considerate, confidential, and a good listener

effective communication allows for

safe, high quality patient care

barriers to effective communication

noise, environment, language, cultural differences, emotional/physical/technological barriers

therapeutic communication techniques

Open ended questions (what/how/why), close ended questions (is/are/do), active listening, reflecting, summarizing back to patient, clarifying

best communication technique for building rapport

active listening

Communicating with patients

1. greet patient and introduce yourself

2. use patients name

3. explain procedures in simple terms

4. speak clearly at normal pace

5. eye contact

6. caring attitude

7. respect privacy and cultural differences

8. encourage questions

9. thank the patient

Make patients feel

heard, safe, respected

SBAR

Situation - Background - Assessment - Recommendation: use for reports and updates for healthcare teams

communicating with the healthcare team

1. SBAR

2. Share accurate and complete info

3. ask questions

4. follow chain of command

5. be professional and respectful

Documentation

1. chart facts only

2. accurate, clear, complete, timely

3. correct spelling and grammer

4. NEVER guess

Poor communication leads to

misunderstandings, errors, poor patient care

Teach-back method

Ensure patients understand instructions by having them repeat them back in their own words. Clarify and re-explain if needed

Low health literacy: what to do

1. simple words and short sentences

2. avoid medical jargon

3. speak slowly and clearly

4. use visuals, models, or written instructions

5. teach-back method

Cultural competency: what to do

1. be respectful and open-minded; avoid assumptions or stereotypes

2. ask about beliefs or preferences that might affect care

3. inclusive language

4. respect privacy and personal boundaries

Translators/interpreters: best practices

1. use professionl medical interpreters when available

2. introduce the interpreter and explain their role

3. speak to patient not interpreter

4. use short setnances and pause to allow time for interpretation

5. maintain confidentiality

6. teach-back method

Nonverbal communication: what to do

1. maintain eye contact

2. calm, friendly tone

3. smile and nod to show empathy and understanding

4. sit at eye level

5. be aware of personal space and touch

6. pay attention to nonverbal cues

Nonverbal clues to look for

confusion, discomfort, pain, fear, anxiety

Superior/cranial

towards head

inferior

towards feet

medial

towards midline

lateral

away from midline

proximal

closer to point of limb attachment or trunk

distal

farther from trunk

dorsal

toward the back

ventral/anterior

toward the front

superficial/external

toward or at the body surface

deep/internal

away from body surface, closer to core

flexion

decrease angle between bones

abduction

move away from midline

medial rotation

rotate towards midline

extension

increases angle between bones

adduction

move towards midline

lateral rotation

rotate away from midline

sagittal plane

divides body into right and left

frontal/coronal plane

divides body into front and back

tranverse/horizontal

divides body into upper and lower

midline

imaginary line that divides body into equal left and right halves

bilateral

applies to both sides of the body

unilateral

applies to one side of the body

ipsilateral

on the same side

contralateral

on the opposite side

caudal

towards tailbone or lower part

palmar/volar

palm of hand

plantar

sole of foot

olfactory

regarding sense of smell

oral

regarding mouth

antebrachial

regarding forearm

popiteal

regarding back of knee

anatomical

supine/horizontal recumbent

prone

lateral recumbent

fowler’s

high fowler’s

trendelenburg

reverse trendelenburg

sims’ position

head of bed elevated 30-45 degrees

semi-fowler’s

knee-chest (genupectoral)

prone with pillow

lithotomy

head of bed elevated less than 30 degrees

semi-recumbent