CNA: QUIZ 1 PREPARATION

You go over the parts of the textbook that she said to focus on. REMEMBER THE THING THAT CAMBRIDGE ALREADY GAVE YOU? DONT SPEND TOO MUCH TIME ON THE EASY STUFF. JUST EMPHASIZE THE PARTS THAT YOU NEED TO REMEMBER THE MOST

CH1

ACUTE CARE

IMMEDIATE, URGENT : THIS IS AN EMERGENCY, SOMEONE GOT A GUNSHOT WOUND OR IS HAVING A STROKE

SUBACUTE CARE

This is NOT IMMEDIATE ANYMORE.

Someone is recovering from surgery, or is recovering from a stroke, and they need to stabilizied.

they need short-term rehabilitation

Long term care

 is for people who need 24 hour skilled care

Assisted living facility

 is for people who DON’T NEED 24 HOUR SKILLED CARE , but need SOME HELP WITH DAILY CARE

(like at the brookeville home: there are no nurses in there 24-hours, only CNAs)

WHAT FACILITY IS FOR PEOPLE WHO DON’T NEED 24 HOUR SKILLED CARE (NURSE CARE) , BUT NEED SOME HELP WITH DAILY CARE?

Assisted living facility

WHAT TYPE OF FACILITY IS FOR PEOPLE WHO NEED 24-HOUR SKILLED CARE?

Long term care

HMO (Health Maintenance Organization) offers…

Lower monthly cost but requires that you stay within in-network care.

- You must select a primary care physician to coordinate all care

- Out-of-network care is only provided in emergencies.

This insurance plan is more rigid

PPO (Preferred Provider Organization) offers..

Higher monthly cost, and it allows you to see in-network and out of network doctors, but it costs more.

- No Primary Care Physician (PCP) is required

This insurance plan is more flexible

What is the difference between rehabilitation and subacute care?

Subacute care - is given in hospitals and long-term facilities. IT IS TO STABILIZE THE PATIENT

Rehabilitation - is care given by specialists and professionals. Physical, occupation, and speech therapists HELP RESTORE OR IMPROVE FUNCTION AFTER AN ILLNESS OR INJURY.

THEY ARE ESSENTIALLY THE SAME, EXCEPT SUBACUTE CARE IS MORE STRUCTURED AND SHORT-TERM, TAKING PLACE RIGHT AFTER A SURGERY OR MEDICAL EMERGENCY OCCURED

This is NOT IMMEDIATE ANYMORE.

Someone is recovering from surgery, or is recovering from a stroke, and they need to stabilizied.

they need short-term rehabilitation

Subacute care

IMMEDIATE, URGENT : THIS IS AN EMERGENCY, SOMEONE GOT A GUNSHOT WOUND OR IS HAVING A STROKE

Acute care

Rehabilitation

Physical, occupational, and speech therapists help restore or improve function after an illness or injury.

It is usually in subacute care, but is not the same as subacute care.

Physical, occupational, and speech therapists help restore or improve function after an illness or injury.

It is usually in subacute care, but is not the same as subacute care.

Rehabilitation

Activities of daily living (ADLs)

Skin, nail, and hare care; mouth care; assistance with walking, eating and drinking, transferring and elimination

CNAs DO NOT PUT ANYTHING..

INSIDE THE PATIENT!!!

WE DO NOT PUT CATHETERS

INSIDE THE PATIENT

DON’T PUT A CATHETER

INSIDE THE PATIENT

A policy

is a course of action that should be taken every time a situation occurs

A procedure

is a method or way of doing something

WHAT ARE COMMON POLICIES ARE A LONG-TERM CARE FACILITY?

• ALL RESIDENT INFORMATION MUST REMAIN CONFIDENTIAL

• THE RESIDENT’S CARE PLAN MUST ALWAYS BE FOLLOWED

• NURSING ASSISTANTS SHOULD NOT DO TASKS OUT OF THEIR SCOPE (SUCH AS NOT PUTTING IN CATHETERS)

• NURSING ASSISTANTS SHOULD NOT DISCUSS PERSONAL PROBLEMS WITH RESIDENTS

• NURSING ASSISTANTS SHOULD NOT TAKE MONEY OR GIFTS FROM RESIDENTS (BUT FOOD FOR THE TEAM IS OKAY)

• NURSING ASSISTANTS MUST BE ON TIME FOR WORK AND MUST BE DEPENDABLE

What insurance plan is primarily used for low-income adults, children, pregnant women, and people with generally limited income and resources?

Medicaid

Medicaid’s plan is a..

It is a needs based program, because anyone who has low-income or limited resources will eligible for it.

For example, people who are wards of the state, will typically be eligible for medicaid.

What insurance plan is primarily used for low-income adults, children, pregnant women, and people with generally limited income and resources?

Medicaid

Medicare is primarily for..

People 65+ and those with specific disabilities or diseases.

Medicare is a federal health insurance program primarily for individuals aged 65 and older and certain people with disabilities.

What insurance plan is primarily used for people aged 65+ and those with specific disabilities or diseases?

Medicare

MEDICARE

PART A

helps pay for IN-PATIENT CARE: such as care in a hospital or skilled nursing facility or care from a home health agency or hospice

MEDICARE

PART B

helps pay for OUT-PATIENT CARE: doctor services and other medical services and equipment

MEDICARE

PART C

allows private health insurance companies to provide Medicare benefits

also known as Medicare Advantage, is an "all-in-one" alternative to Original Medicare.

Many people choose Part C because it covers extra benefits that Original Medicare does not, such as:

• Routine dental and vision care: Cleanings, X-rays, eye exams, and eyewear.

• Hearing aids: Routine testing and fitting evaluations.

• Wellness extras: Gym memberships or fitness programs.

MEDICARE

PART D

helps pay for medications prescribed for treatments:

• Covers Medications: Pays for brand-name and generic drugs you pick up at a pharmacy or receive via mail order.

• Controls Costs: Utilizes a tiered "formulary" (a list of covered drugs) to determine your copays or coinsurance.

CH2

WHO IS THE MOST IMPORTANT MEMBER OF THE CARE TEAM?

THE RESIDENT AND THE RESIDEN'T’S FAMILY.

PROVIDING PERSON-CENTERED CARE MEANS PLACING THE RESIDENT’S WELL-BEING FIRST AND GIVING HER THE RIGHT TO MAKE DECISIONS AND CHOICES ABOUT THEIR OWN CARE.

The resident and resident’s family is..

the most important member of the care team

WHAT ARE THE COMMON DUTIES OF A NURSING ASSISTANT?

• BATHING RESIDENTS

• ASSISTING WITH GROOMING TASKS

• HELPING WITH ELIMINATION

• ASSISTING WITH RANGE OF MOTION EXERCISES AND AMBULATION

• TRANSFERRING RESIDENTS FROM BED TO WHEELCHIR

• MEASURING VITAL SIGNS (TEMPERATURE, PULSE, RESPIRATION, AND BLOOD PRESSURE)

• ASSISTING WITH MEALS

• HELPING RESIDENT DRESS AND UNDRESS

• GIVING BACK RUBS

• HELPING WITH MOUTH CARE

• MAKING AND CHANGING BEDS

• KEEPING RESIDENTS LIVING AREAS NEAT AND CLEAN

• CARING FOR SUPPLIES AND EQUIPMENT

ANOTHER IMPORTANT DUTY THAT NURSING ASSISTANTS HAVE IS CALLED CHARTING OR DOCUMENTING PROCEDURES

PROFESSIONAL

means having to do with work or job

YOU MUST BEHAVE PROFESSIONALLY

How can you behave professionally?

If you dont have knowledge or skills, you wont be professional

You need knowledge and skills to be professional

You have to know your job, your work, your assignment

You have to dress by following the hospital policy (you cant wear whatever you want)

Speaking professionally: having a welcoming voice: also having eye contact and smiling

Being on time: start before going to bed, try to sleep, at latest 12, try to get up earlier

Completing tasks: NEVER LEAVE YOUR WORK UNFINISHED

Follow the care plan

Making careful observations and reports

A professional relationship with resident includes: PERSON-CENTERED CARE: focused ON THE PERSON

(e.g, the person is talking how they miss their cat, you dont bring up your dog, you pay attention to what they have to say)

Keep a positive attitude: NEVER bring your problems to the workplace (if you get a bf/gf, and have problems, dont bring your problems there). No discussing personal problems, be a friend. (Unless you have a good friend outside of work)

WHAT QUALITIES MUST A NURSING ASSISTANT HAVE?

• COMPASSIONATE

• EMPATHETIC

• SYMPATHY

• HONEST

• TACTFUL

• CONSCIENTIOUS

• DEPENDABLE

• PATIENT

• RESPECTFUL

• UNPREJUDICED

• PROACTIVE

• COMPASSIONATE

Feeling a deep concern for the suffering of others and taking tangible action to relieve it

• EMPATHY

MEANS IDENTIFYING WITH THE FEELINGS OF OTHERS. The ability to understand and share the feelings of another person.

• SYMPATHY

Acknowledging another person's emotional hardships, often from an outside perspective. MEANS SHARING IN THE FEELINGS AND DIFFICULITIES OF OTHERS

Tactful:

Communicating delicately and avoiding giving offense, especially when dealing with sensitive topics.

Respectful:

Showing high regard for others' dignity, values, and boundaries.

Unprejudiced:

Treating everyone fairly, without bias or preconceived judgments. [1, 2, 3, 4, 5]

Conscientious

Being guided by a strong sense of moral obligation and doing one's work thoroughly and well.

Dependable

Being reliable and consistently trustworthy in fulfilling responsibilities.

Patient:

Remaining calm, steady, and maintaining emotional control even in the face of delays, difficulties, or frustration.

Proactive:

Anticipating future needs or problems, and taking initiative to address them before they escalate

WHY IS THE CHAIN OF COMMAND IMPORTANT?

it helps protect against liability and malpractice. It ensures that every role in the care team only takes on the instructions assigned to them, and no one takes on any tasks that would be out of their scope of practice.

Liability

is a legal term that means someone can be held responsible for harming someone else

FOR STUDYING THE NURSING CHAIN OF COMMAND

( GO TO UR STUDY MATRIX AND FIND THE FLASHCARDS FOR IT, but ill add some here anyway

Director of nursing (DON)

manages the nursing staff at a facility

Assistant Director of Nursing (ADON):

assists the DON with management of nursing staff

Staff Development Coordinator

directs the training of employees at a facility

Minimum Data Set (MDS) Coordinator/Resident Assesment Coordinator

manages the assessment of resident needs and delivery of required care in a long-term care facility (usually a specially trained nurse)

Nursing Supervisor

supervises and supports nursing staff of entire facility or multiple nursing units, assisting with resident care as needed

Charge Nurse

supervises and supports nursing staff of a particular unit and treats a limited number of residents

Staff Nurses (RNs, LPNs/LVNs)

provide nursing care as prescribed by physician

Nursing Assistant (NAs)

perform assigned nursing tasks, assist with routine personal care, and observe and report any changes in resident's’ conditions and abilities

THEY DO NOT PUT ANYTHING INSIDE THE RESIDENT!!!

charge nurse supervises over

one specific unit

nurse supervisor, supervises

multiple units

Scope of practice

defines the roles, responsibilities and procedures that are within the knowledge, training, and legal definition of a profession

WHY IS THE CARE PLAN SO IMPORTANT?

The care plan is a vital roadmap that ensures you deliver safe, personalized care to every patient or resident. It outlines exactly what Activities of Daily Living (ADLs) require assistance, preferred personal routines, and any physical or cognitive limitations.

IT ENSURES THAT EACH PATIENT HAS INDIVDUALIZED CARE, PERSONALIZED BASED ON THEIR PHYSICAL AND COGNITIVE NEEDS

FOR EXAMPLE: IF IT WASNT FOR THE CARE PLAN, YOU WOULDNT KNOW IF A PATIENT IS ALLERGIC TO PEANUTS. AND IF YOU GAVE THEM PEANUTS, THAT WOULD BE VERY BAD!!

EXAMPLE OF WHY CARE PLAN IS IMPORTANT

IF IT WASNT FOR THE CARE PLAN, YOU WOULDNT KNOW IF A PATIENT IS ALLERGIC TO PEANUTS. AND IF YOU GAVE THEM PEANUTS, THAT WOULD BE VERY BAD!!

CARE PLANS MUST BE..

REVIEWED REGULARLY (AT LEAST EVERY 60 DAYS) AND UPDATED AS THE RESIDENT’S CONDITION CHANGES.

IT ESSENTIAL THAT NURSING ASSISTANTS MAKE OBSERVATIONS (OBJECTIVE OBSERVATIONS) AND REPORT THEM TO THE NURSE.

WHAT IS OBJECTIVE INFORMATION THAT A NURSING ASSISTANT SHOULD COLLECT BEFORE REPORTING TO THE NURSE?

VITAL SIGNS!!!! ALSO ANYTHING THAT CAN BE OBSERVED WITH YOUR SENSES, SUCH AS SIGHT, SMELL, HEARING, AND TOUCH.

DON’T NECESSARILY JUST COLLECT SYMPTOMS (SUBJECTIVE INFORMATION), YOU NEED TO COLLECT SIGNS (OBJECTIVE INFORMATION) THROUGH WHAT YOU CAN PERCIEVE WITH YOUR SENSES AS WELL AS FROM VITALS

WHY IS IT IMPORTANT FOR A NURSING ASSISTANT TO REPORT OBJECTIVE INFORMATION RATHER THAN SYMPTOMS?

BECAUSE OBJECTIVE INFORMATION IS BETTER

((THE ONLY EXCEPTION TO NEEDING TO COLLECT OBJECTIVE INFORMATION IS WHEN THERES A MEDICAL EMERGENCY. THEN YOU CAN REPORT TO THE NURSE IMMEDIATELY

WHAT IS THE EXCEPTION TO NEEDING TO COLLECT SIGNS (OBJECTIVE INFORMATION), BEFORE REPORTING TO THE NURSE?

IF THERES A MEDICAL EMERGENCY, SUCH AS IF THE PATIENT IS HAVING A HEART ATTACK OR STROKE

Delegation

in nursing is the process of transferring the authority to perform a specific, routine task to a qualified healthcare team member,

CNAS DO NOT DELEGATE. NURSES DELEGATE RESPONSIBILITIES TO THE CNAS!!!

do CNAs delegate?

NO. Only the nurse delegates responsibilities to the CNA!!!!

THE NURSE DELEGATES

RESPONSIBILITIES TO THE CNA!!!

CH3

Ethics

are the knowledge of right and wrong

Laws

government-enforced, and what MUST BE FOLLOWED

WHAT ARE GUIDELINES FOR LEGAL AND ETHICAL BEHAVIOR?

• BE HONEST AT ALL TIMES

• PROTECT RESIDENTS’ PRIVACY

• KEEP STAFF INFORMATION CONFIDENTIAL. DO NOT SHARE INFORMATION ABOUT YOUR CO-WORKERS TO ANYONE

• REPORT ABUSE OR SUSPECTED ABUSE OF RESIDENTS

• FOLLOW THE CARE PLAN AND YOUR ASSIGNMENTS

• DO NOT PERFORM ANY TASK OUTSIDE YOUR SCOPE OF PRACTICE

• REPORT ALL RSIDENT OBSERVATIONS AND INCIDENTS TO TE NURSE

• DOCUMENT ACCURATELY AND ON TIME

• FOLLOW RULES FOR SAFETY AND INFECTION PREVENTION

• DO NOT ACCEPT GIFTS OR TIPS

• DO NOT GET SEXUALLY INVOLVED WITH RESIDENTS OR THEIR FAMILY MEMBERS OR FRIENDS

what is the purpose of OBRA (Omnibus Budget Reconcillation Act)?

THEIR PURPOSE IS TO PREVENT ABUSE AND ENSURE THAT CAREGIVERS ADHERE TO STANDARDS OF CARE

WHAT LAW IS SET WITH THE PURPOSE OF PREVENTING ABUSE AND TO ENSURE THAT CAREGIVERS ADHERE TO STANDARDS OF CARE?

OBRA (Omnibus Budget Reconcillation Act)

Minimum Data Set (MDS)

is a resident assessment system that measures the physical and mental health of residents

WHAT IS INFORMED CONSENT?

is the process by which the doctor ENSURES THAT THE PATIENT IS INFORMED ABOUT THE RISKS AND BENEFITS, about their medical care, and then consents to that care

ENSURES THAT THE PATIENT IS INFORMED ABOUT THE RISKS AND BENEFITS, about their medical care, and then consents to that care

INFORMED CONSENT

OBSERVING AND REPORTING: ABUSE AND NEGLECT

• Poisoning or traumatic injury

• Teeth marks

• Belt buckle or strap marks

• Bruises, contusions, or welts

• Scars

• Fractures or dislocation

• Burns of unusual shape and in unusual locations, or cigarette burns

• Scalding burns

• Scratches or puncture wounds

• Scalp tenderness or patches of missing hair

• Swelling in the face, broken teeth, or nasal discharge

• Bruises, bleeding, or discharge from the vaginal area

• Yelling obscenitities

• Fear, apprehnsion, or fear of being alone

• Poor self-control

• Constant pain

• Threatning to hurt others

• Withdrawal or apathy

• Alcohol or drug abuse

• Agitation, anxiety or signs of stress

• Low self-esteem

• Mood changes, confusion, or disorientation

• Private conversations not alloed, or the family member/caregiver present during all conversations

• Reports of questionable care by the resident or her family

SIGNS OF NEGLECT

• Pressure injuries

• Unclean body

• Body lice

• Unanswered call lights

• Soiled bedding or incontinence briefs not being changed

• Poorly fitting clothing

• Unmet needs relating to hearing aids, eyeglasses, etc

• Weight loss or poor appetite

• Uneaten food

• Dehydration

• Fresh water or beverages not being offered regularly

• Resident reports not receiving prescribed medication

Mandated reporters

are people who are legally required to report suspected or observed abuse or neglect because they have regular contact with vulnerable populations, such as elderly

IF AN NA SUSPECTS ABUSE…

THEY SHOULD KEEP REPORTING UP THE CHAIN OF COMMAND UNTIL ACTION IS TAKEN. IF NO APPROPRIATE ACTION IS TAKEN AT THE FACILITY, SHE CAN CALL TH STATE ABUSE HOTLINE OR CONTACT THE PROPER STATE AGENCY.

Confidentiality

means to keep private things private

electronic health records (EHR)

is a secure, real-time digital version of a patient's medical history

HIPAA’s purpose is to….

to protect sensitive patient health information from unauthorized disclosure while improving the portability of health insurance when individuals change jobs

PROTECT PATIENT CONFIDENTIALITY!!!

WHAT LAW WAS PASSED IN ORDER TO PROTECT PATIENT’S HEALTH INFORMATION?

HIPAA

GUIDELINES: PROTECTING PRIVACY

• MAKE SURE YOU ARE IN A PRIVTE AREA WHEN YOU LISTEN TO OR READ YOUR MESSAGES

• KNOW WITH WHOM YOU ARE SPEAKING ON THE PHONE. IF YOU ARE NOT SURE, GET A NAME AND PHONE.

• DO NOT TALK ABOUT RESIDENTS IN PUBLIC

• USE CONFIDENTIAL ROOMS WHEN REPORTING TO OTHER CARE TEAM MEMBERS

• IF YOU SEE A RESIDENT’S FAMILY MEMBER OR A FORMER RESIDENT IN PUBLIC, BE CAREFUL WITH YOUR GREETING

• DO NOT BRING UP FAMILY OR FRIENDS TO THE FACILITY TO MEET RESIDENTS

• MAKE SURE NOBODY CAN SEE YOUR PROTECTED HEALTH OR PERSONAL IFNORMATION ON YOUR COMPUTER SCREEN WHILE YOU ARE WORKING'

• DO NOT GIVE CONFIDENTIAL INFORMATION IN DEMAILS

• DO NOT SHARE RESIDENT INFORMATION, PHOTOS, OR VIDEOS ON ANY SOCIAL NETWORKING SITE

• MAKE SURE FAX NUMBERS ARE CORRECT BEFORE FAXING HEALTCARE INFORMATION

• DO NOT LEAVE DOCUMENTS HWERE OTHERS MAY SEE THEM

• STORE, FIL OR SHRED DOCUMENTS ACCORDING TO YOUR FACILITY’S POLICY

Advance directives

are legal documents that allow people to decide what kind of medical care they wish to have in the event that they are unable to make those decisions for themselves

A living will

outlines the medical care person wants, or does not want: IN THE EVENT THAT THEY HAVE A COMA OR ARE UNABLE TO SPEAK

durable power of attorney for health care

is a legal document that lets you name a trusted person—your health care agent or proxy—to make medical decisions for you if you become incapacitated and unable to communicate your own wishes

A PERSON MAY SELECT A FRIEND, FAMILY MEMBER OR SPOUSE/BF/GF

Do not resuscitate (DNR)

means YOU DO NOT PERFORM CPR ON THE PATIENT

Do not intubate (DNI)

MEANS NO BREATHING TUBE WILL BE IN THE PERSON

Do not hospitalize (DNH)

IT MEANS THAT THE PATIENT DOES NOT WANT TO BE SENT TO THE HOSPITAL FOR TREATMENT

WHAT ORDER MEANS THAT THE PATIENT WILL NOT RECIEVE A BREATHING TUBE?

Do not intubate (DNI)

CH4

Communication

is the process of exchanging information with others

WHAT ARE THE THREE STEPS IN THE COMMUNICATION PROCESS?

Step 1: The senders sends a message

Step 2: The receiver receives the message

Step 3: The receiver gives feedback or responds to the message

The sender and receiver continuously switch roles and process is repeated throughout the communication process.

(FEEDBACK IS GIVEN TO SHOWN THAT THE RECIEVER RECIEVED THE MESSAGE, THAT THEY UNDERSTOOD IT)

WHY DOES THE RECIEVER GIVE FEEDBACK?

TO SHOW THEY RECIEVED OR UNDERSTOOD THE MESSAGE

Verbal communication is

oral or written speech

Nonverbal communication is

communicating without using words: body language or tone of voice

Body language sends nonverbal language too

FOR EXAMPLE WITH BODY LANGUAGE:

Ms. Susie says..

“I’m fine”, her body language looks frustrated: she’s rigid and frowning,

she’s not okay (IT DOES NOT MATCH HER WORDS)

Body language sends nonverbal language too

FOR EXAMPLE WITH BODY LANGUAGE:

Ms. Susie says..

“I’m fine”, her body language looks relaxed: she’s smiling and her shoulders are relaxed,

she’s most likely okay (IT MATCHES HER WORDS)

Written words are..

VERBAL COMMUNICATION: it is VERBAL