Nursing Trial prep

NURSING ASSISTANT IN ACUTE CARE — COMPLETE HSC CONTENT

🧠 MIND MAP 1: HLTINF006 — Apply Basic Principles & Practices of Infection Prevention & Control

Branch 1: Chain of Infection

1a. Infectious Agent (Pathogen)

• Types: bacteria, viruses, fungi, parasites, prions

• Factors influencing infection: pathogenicity (ability to cause disease), virulence (severity), dose (number of organisms), and portal of entry

• Examples: Staphylococcus aureus (bacteria), Influenza (virus), Candida albicans (fungus), Clostridium difficile (spore-forming bacteria)

1b. Reservoir (where the pathogen lives and multiplies)

• Human reservoirs: patients, staff, visitors (symptomatic or asymptomatic carriers)

• Environmental reservoirs: contaminated equipment, bedrails, call bells, bedpans, sinks, taps, door handles, curtains

• Animal reservoirs: less common in acute care

• Key point: the environment in hospitals is heavily contaminated — high-touch surfaces are the biggest risk

1c. Portal of Exit (how the pathogen leaves the reservoir)

• Respiratory tract: coughing, sneezing, talking (droplets, aerosols)

• Gastrointestinal tract: faeces, vomit

• Blood/body fluids: wounds, needles, drains, catheters

• Skin: shedding skin cells, wound drainage

• Mucous membranes: eyes, nose, mouth

1d. Mode of Transmission (how it travels)

• Contact (most common):

• Direct contact: person-to-person physical touch (e.g., MRSA via hands)

• Indirect contact: contaminated object → person (e.g., shared BP cuff, stethoscope)

• Droplet contact: large droplets >5 microns, travel ≤1m (e.g., flu, COVID-19)

• Airborne: small droplets <5 microns, remain suspended in air, travel >1m (e.g., TB, measles, chickenpox)

• Vehicle-borne: contaminated food, water, medications, blood products

• Vector-borne: insects (rare in acute care in Australia)

1e. Portal of Entry (how it enters a new host)

• Respiratory tract (inhaled)

• Gastrointestinal tract (ingested)

• Breaks in skin (wounds, IV sites, surgical incisions, pressure injuries)

• Mucous membranes (eyes, mouth)

• Indwelling devices (catheters, cannulas, NG tubes, tracheostomies)

1f. Susceptible Host

• Factors increasing susceptibility:

• Age (very young, elderly)

• Immunocompromised (chemotherapy, HIV, transplant, steroids)

• Chronic disease (diabetes, COPD, renal failure)

• Malnutrition

• Invasive procedures/devices

• Prolonged hospital stay

• Antibiotic use (disrupts normal flora)

Key exam point: Break any ONE link in the chain and you prevent infection. The easiest link to break is mode of transmission through hand hygiene.

Branch 2: Standard Precautions

2a. Hand Hygiene — The 5 Moments (WHO)

1.    Before touching a patient — protects patient from your hands

2.    Before a clean/aseptic procedure — protects patient from infection (e.g., wound dressing, catheter care)

3.    After body fluid exposure risk — protects you and the environment (e.g., after glove removal, after handling bedpan)

4.    After touching a patient — protects you and the environment

5.    After touching patient surroundings — protects environment and next patient

Hand hygiene technique (6 steps, 20–30 seconds):

1.    Palm to palm

2.    Right palm over left dorsum and vice versa

3.    Palm to palm with fingers interlaced

4.    Backs of fingers to opposing palms

5.    Rotational rubbing of thumbs

6.    Rotational rubbing of fingertips into palms

When to use soap and water vs ABHR:

• Soap and water: when hands are visibly soiled, after caring for patients with C. difficile or norovirus (spores not killed by ABHR)

• ABHR (alcohol-based hand rub): all other clinical situations, must be 60–80% alcohol

2b. Personal Protective Equipment (PPE)

• Gloves:

• Clean, non-sterile gloves for standard precautions (contact with blood/body fluids, mucous membranes, non-intact skin)

• Sterile gloves for aseptic procedures (catheter insertion, wound care)

• Change gloves between tasks on same patient

• Remove gloves immediately after use — they are single-use only

• Gown:

• Fluid-resistant, single-use

• Used when there is risk of splash/spray of blood/body fluids

• Remove carefully — roll inside-out to avoid contaminating hands

• Mask:

• Surgical mask: droplet precautions, standard precautions if splash risk

• N95/P2 respirator: airborne precautions (fit-tested required)

• Replace if wet or damaged

• Eye protection:

• Goggles or face shield

• Used when splash risk to eyes (suctioning, wound irrigation, intubation)

PPE donning order: Gown → Mask → Eye protection → Gloves
PPE doffing order: Gloves → Gown → Eye protection → Mask (perform hand hygiene after each removal step)

2c. Respiratory Hygiene / Cough Etiquette

• Cover mouth and nose with tissue or inner elbow when coughing/sneezing

• Dispose of tissues immediately

• Perform hand hygiene after

• Offer surgical mask to coughing patients

• Maintain ≥1.5m distance if possible

• Signage at hospital entrances

2d. Safe Injection Practices

• Single-use needles and syringes — never reuse

• Multi-dose vials: use only for single patient if possible; if shared, use aseptic technique and never re-enter vial with used needle

• Sharps disposal immediately after use — do not recap, bend, or break needles

• Use needleless systems where available

2e. Environmental Cleaning

• Routine cleaning of high-touch surfaces: bedrails, overbed tables, call bells, light switches, door handles, bathroom rails

• Cleaning between patients

• Terminal cleaning after discharge

• Use hospital-grade disinfectant (e.g., chlorine-based for blood spills)

• Spills management: chlorine 5000ppm for blood/body fluid spills; 1000ppm for general cleaning

Branch 3: Transmission-Based Precautions

3a. Contact Precautions

• When: known or suspected infections spread by direct/indirect contact (MRSA, VRE, C. difficile, scabies, wound infections, herpes simplex)

• PPE: gown + gloves on entry to room

• Room: single room preferred; cohort if necessary

• Equipment: dedicated equipment (stethoscope, BP cuff, thermometer) — if shared, clean and disinfect between patients

• Patient movement: limit to essential only; cover wounds/lesions

• Signage: green contact precautions sign on door

• Duration: until cultures negative or infection resolved

3b. Droplet Precautions

• When: infections spread by large droplets (Influenza, meningococcal, pertussis, mumps, rubella, COVID-19, Group A Strep pharyngitis)

• PPE: surgical mask + eye protection if within 1m

• Room: single room preferred; cohort if same organism

• Patient movement: surgical mask on patient if leaving room

• Signage: blue droplet precautions sign

• Duration: usually until 24h of effective treatment (e.g., 24h of antibiotics for meningococcal)

3c. Airborne Precautions

• When: infections spread by small airborne particles (TB, measles, chickenpox/shingles disseminated, COVID-19 aerosol-generating procedures)

• PPE: N95/P2 respirator (fit-tested), gown, gloves, eye protection

• Room: negative pressure room (air exhausted outside or through HEPA filter), door closed at all times

• Patient movement: limit to essential; patient wears surgical mask

• Signage: red/orange airborne precautions sign

• Duration:

• TB: until 3 negative sputum smears

• Measles: until 4 days after rash onset

• Chickenpox: until all lesions crusted

3d. Protective Isolation (Reverse Barrier)

• When: immunocompromised patients (neutropenic, post-transplant)

• Purpose: protect patient from acquiring infections

• PPE: as per facility policy (often gown + gloves + mask)

• Room: positive pressure room (air flows out, not in)

• Restrictions: no fresh flowers/fruit, limit visitors, no live vaccines

Branch 4: Aseptic Technique

4a. General Asepsis vs Surgical Asepsis

• General asepsis: clean technique — reduces microorganisms (e.g., routine IV line changes, catheter bag emptying)

• Surgical asepsis: sterile technique — eliminates all microorganisms (e.g., catheter insertion, wound packing, central line dressing)

4b. Key Parts and Key Sites

• Key parts: sterile parts of equipment that will contact the patient (e.g., catheter tip, needle hub, wound contact layer of dressing)

• Key sites: the patient's wound, insertion site, or body area being treated

• Rule: key parts must only touch other key parts or key sites — never touch non-sterile surfaces

4c. Aseptic Field

• Critical aseptic field: used for invasive procedures (e.g., catheter insertion) — sterile drape, only sterile items on field

• Standard aseptic field: used for simpler procedures (e.g., wound dressing) — clean surface, sterile items placed carefully

4d. Principles of Aseptic Technique

1.    All items used must be sterile (check packaging integrity, expiry date, sterile indicator)

2.    Sterile items only contact sterile items

3.    Sterile field is set up immediately before use

4.    Do not turn your back on a sterile field

5.    Keep sterile items above waist level (below waist = contaminated)

6.    Avoid reaching over sterile field

7.    Open sterile packaging away from body first

8.    If in doubt about sterility, consider it contaminated — discard and start again

Branch 5: Waste Management

5a. Clinical Waste (Yellow Bags/Bins)

• Definition: waste that poses risk of infection — contaminated with blood, body fluids, sharps, laboratory specimens

• Examples: used dressings, gloves, swabs, IV tubing, urine bags, soiled continence aids

• Disposal: yellow biohazard bags or rigid yellow bins

• Storage: secured, labelled, collected by licensed waste contractor

• Never: overfill bags (max 3/4 full), put clinical waste in general waste

5b. Sharps Waste (Yellow Puncture-Proof Containers)

• Examples: needles, syringes, scalpel blades, glass ampoules, broken glass contaminated with blood

• Rules:

• Dispose immediately after use — do not leave on trolley/bedside

• Do NOT recap needles (single biggest cause of needlestick injury)

• Do not bend or break needles

• Fill line: do not fill past the "fill line" (usually 3/4 full)

• Sharps bin must be within arm's reach at point of use

• Lock and dispose when full

5c. General Waste (Clear/Black Bags)

• Definition: non-infectious, non-hazardous waste

• Examples: paper towels (clean), food wrappers, office paper, flowers

• Disposal: general waste stream — goes to landfill or recycling

5d. Cytotoxic Waste (Purple Bags/Bins)

• Examples: chemotherapy drugs, contaminated PPE from chemo administration

• Special handling: double-bagged, labelled, incinerated separately

5e. Anatomical Waste

• Examples: body parts, placentas, amputated limbs

• Disposal: specific regulated stream, usually incineration

5f. Waste Segregation — Why It Matters

• Legal requirement under NSW Waste Management Act and Work Health & Safety Act

• Incorrect segregation = fines for facility, risk to waste handlers, environmental harm

• As an AIN: you are responsible for correctly disposing waste at the point of generation

🧠 MIND MAP 2: HLTAAP002 — Confirm Physical Health Status

Branch 1: Vital Signs (Observations)

1a. Temperature

• Normal range: 36.0–37.5 °C (oral)

• Routes:

• Oral: under tongue in sublingual pocket — most common, wait 15 min after hot/cold drinks

• Axillary: under arm — least accurate, add 0.5°C for estimate

• Tympanic: ear canal — fast, but impacted earwax can affect reading

• Temporal: forehead scan — non-invasive, good for screening

• Rectal: most accurate — used in unconscious patients or infants

• Pyrexia (fever): >37.5°C — body's response to infection, inflammation

• Hyperpyrexia: >40°C — medical emergency (heat stroke, malignant hyperthermia)

• Hypothermia: <36°C — elderly, exposure, sepsis

• Hypothermia (severe): <32°C — cardiac arrest risk

• Documentation: chart on observation chart, report abnormal to RN

1b. Pulse

• Normal range: 60–100 bpm (adult at rest)

• Sites:

• Radial: wrist (thumb side) — most common for routine obs

• Brachial: inner elbow — used for BP auscultation, infant pulse

• Carotid: neck — used in emergency (CPR check)

• Apical: chest at apex of heart (5th intercostal space midclavicular line) — used for infants, irregular rhythms, before cardiac medications

• Dorsalis pedis: top of foot — peripheral circulation check

• Popliteal: behind knee — peripheral vascular assessment

• Characteristics to assess:

• Rate: bpm

• Rhythm: regular vs irregular (e.g., atrial fibrillation = irregularly irregular)

• Volume/amplitude: bounding, weak/thready, normal

• Symmetry: compare both sides

• Tachycardia (>100 bpm): fever, pain, anxiety, dehydration, blood loss, shock, exercise, medications

• Bradycardia (<60 bpm): athletes (normal), medications (beta-blockers), hypothyroidism, heart block, increased ICP

• Pulse deficit: difference between apical and radial pulse — indicates ineffective contractions (e.g., AF)

1c. Respiration

• Normal range: 12–20 breaths per minute (adult at rest)

• Assessment: rate, depth, rhythm, effort

• Depth:

• Normal: tidal volume ~500mL

• Shallow: reduced depth (pain, splinting, sedation)

• Deep: increased depth (Kussmaul's — metabolic acidosis, DKA)

• Rhythm:

• Regular: even spacing

• Irregular: Cheyne-Stokes (waxing/waning → apnoea — seen in heart failure, brain injury)

• Biot's: irregular with periods of apnoea (CNS damage)

• Effort/work of breathing:

• Accessory muscle use: intercostal, sternocleidomastoid, scalene

• Nasal flaring: children

• Tracheal tug: suprasternal retraction

• Tripod position: leaning forward with hands on knees (COPD)

• Breath sounds (if auscultating):

• Clear: normal

• Crackles/crepitations: fluid in airways (pneumonia, pulmonary oedema)

• Wheeze: narrowed airways (asthma, COPD)

• Stridor: upper airway obstruction (croup, anaphylaxis)

• Tachypnoea (>20): fever, pain, anxiety, respiratory disease, metabolic acidosis

• Bradypnoea (<12): sedation, opioids, brain injury, hypothermia

• Apnoea: cessation of breathing >10 seconds — emergency

1d. Blood Pressure

• Normal range: 90/60 – 120/80 mmHg

• Systolic: pressure during ventricular contraction (top number)

• Diastolic: pressure during ventricular relaxation (bottom number)

• Pulse pressure: systolic − diastolic (normally ~40 mmHg)

• Wide pulse pressure (>60): aortic regurgitation, sepsis, fever, exercise

• Narrow pulse pressure (<30): cardiac tamponade, heart failure, hypovolaemia

• Mean Arterial Pressure (MAP): (SBP + 2×DBP) ÷ 3 — target >65 mmHg for organ perfusion

• Cuff size matters: cuff bladder should encircle 80% of arm circumference

• Too small = falsely high reading

• Too large = falsely low reading

• Position: arm at heart level, supported, legs uncrossed

• Hypertension (>140/90): chronic (essential) or acute (pain, anxiety, pre-eclampsia)

• Hypotension (<90/60): dehydration, blood loss, sepsis, medications, postural

• Postural (orthostatic) hypotension: drop of ≥20 mmHg systolic or ≥10 mmHg diastolic on standing — fall risk

• Korotkoff sounds:

• Phase I: first tapping sound = systolic

• Phase V: disappearance of sound = diastolic (adults)

1e. SpO₂ (Oxygen Saturation)

• Normal range: 95–100% on room air

• How it works: pulse oximetry — measures % of haemoglobin saturated with oxygen

• Limitations:

• Poor perfusion (cold, shock) = inaccurate

• Nail polish/dark nail colour = can interfere

• Anaemia = may read normal despite low oxygen content

• Carbon monoxide poisoning = falsely high (COHb reads as O₂Hb)

• Hypoxaemia: SpO₂ <95%

• Critical: <90% — urgent medical review, consider oxygen therapy

• Oxygen therapy: prescribed by doctor — flow rate and device (nasal prongs 1–4L/min, Hudson mask 6–10L/min, non-rebreather 10–15L/min)

• Documentation: chart SpO₂ with FiO₂ (e.g., "SpO₂ 96% on RA" or "SpO₂ 98% on 2L NP")

Branch 2: Anatomy & Physiology (Systems Overview)

2a. Cardiovascular System

• Heart: 4 chambers (RA, RV, LA, LV), 4 valves (tricuspid, pulmonary, mitral, aortic)

• Blood flow: RA → tricuspid → RV → pulmonary valve → lungs (gas exchange) → pulmonary veins → LA → mitral → LV → aortic valve → body

• Conduction system: SA node (pacemaker) → AV node → Bundle of His → bundle branches → Purkinje fibres

• Blood vessels: arteries (away from heart, high pressure), veins (toward heart, low pressure, valves), capillaries (gas/nutrient exchange)

• Common conditions: hypertension, heart failure, coronary artery disease, atrial fibrillation, myocardial infarction

2b. Respiratory System

• Upper airway: nose, mouth, pharynx, larynx

• Lower airway: trachea, bronchi, bronchioles, alveoli (gas exchange site)

• Mechanics: diaphragm contracts → negative pressure → air in; diaphragm relaxes → air out

• Gas exchange: O₂ diffuses from alveoli into blood; CO₂ diffuses from blood into alveoli

• Common conditions: asthma, COPD, pneumonia, pulmonary embolism, lung cancer

2c. Musculoskeletal System

• Bones: 206 in adult — support, protection, movement, mineral storage, blood cell production

• Joints: fibrous (skull sutures), cartilaginous (spine), synovial (knee, shoulder — most mobile)

• Muscles: skeletal (voluntary), smooth (involuntary — organs), cardiac (heart)

• Common conditions: osteoarthritis, rheumatoid arthritis, fractures, osteoporosis, falls

2d. Nervous System

• Central: brain + spinal cord

• Peripheral: cranial nerves (12 pairs), spinal nerves (31 pairs)

• Autonomic: sympathetic (fight/flight), parasympathetic (rest/digest)

• Common conditions: stroke, dementia, Parkinson's, spinal cord injury, delirium

2e. Gastrointestinal System

• Pathway: mouth → oesophagus → stomach → small intestine (duodenum, jejunum, ileum) → large intestine (colon) → rectum → anus

• Accessory organs: liver (bile, metabolism), pancreas (digestive enzymes, insulin), gallbladder (stores bile)

• Common conditions: constipation, diarrhoea, GERD, bowel obstruction, diverticulitis

2f. Renal/Urinary System

• Kidneys: filter blood, produce urine, regulate fluid/electrolytes/BP, produce erythropoietin

• Ureters: carry urine from kidneys to bladder

• Bladder: stores urine (capacity ~400–600mL)

• Urethra: carries urine out of body

• Common conditions: UTI, urinary retention, incontinence, renal failure, kidney stones

Branch 3: Pain Assessment

3a. PQRST Pain Assessment

• P — Provokes/Palliates: What makes it better? What makes it worse?

• Q — Quality: Describe the pain (sharp, dull, aching, burning, stabbing, throbbing)

• R — Radiates/Region: Where is it? Does it spread anywhere?

• S — Severity: On a scale of 0–10 (0 = no pain, 10 = worst pain)

• T — Timing: When did it start? Constant or intermittent? How long does it last?

3b. Pain Scales

• Numeric Rating Scale (0–10): patient rates pain — most common for adults

• Wong-Baker FACES: 6 faces from happy to crying — used for children, cognitive impairment

• FLACC Scale: Face, Legs, Activity, Cry, Consolability — for non-verbal patients (score 0–10)

• PAINAD: for advanced dementia patients

• CRIES: for neonates

3c. Types of Pain

• Acute: sudden onset, short duration, identifiable cause (surgery, injury)

• Chronic: >3 months, may have no clear cause (arthritis, neuropathy)

• Nociceptive: tissue damage — somatic (well-localised, e.g., cut) or visceral (diffuse, e.g., organ pain)

• Neuropathic: nerve damage — burning, shooting, tingling (e.g., diabetic neuropathy, post-herpetic neuralgia)

• Referred: felt in a different location from source (e.g., cardiac pain referred to left arm/jaw)

3d. Non-Pharmacological Pain Relief

• Positioning, heat/cold packs, distraction, relaxation, massage, TENS machine

3e. AIN Role in Pain Management

• Report pain to RN promptly

• Document pain scores

• Assist with non-pharmacological measures

• Never administer medications (AIN cannot give medications in NSW unless specific delegation)

Branch 4: Patient Observations

4a. Level of Consciousness (AVPU)

• A — Alert: awake, responsive

• V — Voice: responds to verbal stimuli

• P — Pain: responds to painful stimuli (trapezius squeeze, sternal rub)

• U — Unresponsive: no response

• GCS (Glasgow Coma Scale): 3–15 — Eye (1–4) + Verbal (1–5) + Motor (1–6)

• 15 = fully conscious

• ≤8 = severe brain injury, consider intubation

• 3 = no response

4b. Skin Assessment

• Colour: pink (normal), pale (anaemia, shock), flushed (fever), cyanotic (hypoxia), jaundiced (liver disease)

• Temperature: warm, cool, cold

• Moisture: dry, moist, diaphoretic (sweating)

• Turgor: skin pinch — slow return = dehydration

• Integrity: intact, broken, rash, bruising, wounds, pressure injuries

• Oedema: pitting vs non-pitting — grade 1+ to 4+

4c. Mobility & Falls Risk

• STRATIFY tool: 5 items — previous falls, agitation, visual impairment, toileting frequency, transfer/mobility score

• Morse Fall Scale: history of falls, secondary diagnosis, ambulatory aid, IV/heparin lock, gait, mental status

• Falls prevention strategies: call bell within reach, non-slip socks, bed in lowest position, bedrails (if appropriate), hourly rounding, supervised mobilisation

Branch 5: Documentation

5a. NSW Standard Adult Observation Chart (Between the Flags)

• Colour-coded zones: green (normal), yellow (clinical review), red (medical emergency)

• Track and trigger system: abnormal obs trigger escalation

• MET criteria (Medical Emergency Team): any single red zone or ≥3 yellow zones

• Document: date, time, obs, any interventions, signature + designation

5b. Fluid Balance Chart

• Input: oral fluids, IV fluids, NG feeds, total mL

• Output: urine, vomit, diarrhoea, drain output, total mL

• Goal: monitor for fluid overload (heart failure, renal failure) or dehydration

• Normal urine output: ≥0.5 mL/kg/hour (adult)

• AIN role: measure and document accurately, report abnormal (e.g., <30mL/hr for 2 hours)

5c. BGL Monitoring

• Normal range (fasting): 4.0–6.0 mmol/L

• Normal range (random): 4.0–8.0 mmol/L

• Hypoglycaemia: <4.0 mmol/L — emergency (sweating, confusion, unconsciousness)

• Hyperglycaemia: >11.0 mmol/L — risk of DKA/HHS

• AIN role: perform BGL as delegated, document, report abnormal to RN

🧠 MIND MAP 3: CHCCCS002 — Assist With Movement

Branch 1: Manual Handling Principles

1a. WHS Legislation & Hierarchy of Controls

• Work Health & Safety Act 2011 (NSW): employer and employee have duty of care

• Hierarchy of controls (most to least effective):

1.    Elimination: eliminate manual handling (e.g., use hoist instead of lifting)

2.    Substitution: replace with safer method

3.    Engineering controls: mechanical aids (hoists, slide sheets)

4.    Administrative controls: training, policies, safe work procedures

5.    PPE: gloves, non-slip shoes (least effective — last resort)

1b. Body Mechanics — The 5 Principles

1.    Stable base: feet shoulder-width apart, one foot slightly forward

2.    Bend knees, not back: use leg muscles (strongest in body)

3.    Keep load close: centre of gravity close to your body

4.    No twisting: pivot with feet, keep shoulders and hips aligned

5.    Maintain natural spinal curves: neutral spine, engage core

1c. Risk Assessment Before Any Move

• TILEO:

• T — Task: what needs to be done?

• I — Individual: your capability, any injuries?

• L — Load: patient's weight, mobility, cooperation, cognitive status

• E — Environment: space, floor surface, equipment, lighting

• O — Other: additional staff needed, time constraints

1d. No-Lift Policy

• Most NSW hospitals have a "no manual lift" policy

• Exceptions: life-threatening emergency, slight assistance (e.g., steadying arm)

• Always use mechanical aids for full lifts

Branch 2: Mechanical Aids

2a. Hoists (Ceiling or Mobile Floor Hoist)

• Types: full sling, toileting sling, standing sling

• Sling selection: based on patient weight, mobility, comfort, skin integrity

• Procedure:

1.    Explain procedure to patient — gain consent

2.    Check hoist is in working order (battery, straps, hooks)

3.    Position sling under patient (log roll technique)

4.    Attach sling to hoist — ensure correct strap alignment

5.    Raise hoist slowly — patient's bottom just clears surface

6.    Move patient to destination

7.    Lower slowly — ensure patient is positioned correctly

8.    Remove sling or leave in place for next transfer

• Safety: never leave patient unattended in hoist, check weight limit

2b. Slide Sheets & Slide Boards

• Slide sheets: low-friction sheets placed under patient to reduce friction during repositioning

• Use: repositioning up in bed, lateral transfers (bed to trolley)

• Technique: two staff, use body weight, coordinate count "1-2-3"

• Slide board: rigid board used for bed-to-trolley or bed-to-stretcher transfers

2c. Transfer Belt (Gait Belt)

• Purpose: provides grip for staff, stability for patient during transfers

• Application: snug around patient's waist over clothing (not on bare skin)

• Use: bed to chair, chair to commode, standing transfers

• Technique: staff holds belt at patient's back/sides, bend knees, patient stands on count

• Contraindications: abdominal surgery, ostomy, recent rib fracture, pregnancy

2d. Wheelchair Transfers

• Independent: patient stands and pivots independently

• Assisted (stand-pivot): patient stands with assistance, pivots to chair

• Hoist transfer: for non-weight-bearing patients

• Wheelchair positioning: brakes on, footrests moved aside, chair at 45° angle to bed

• Safety: check brakes, ensure patient sits well back, footrests in place

Branch 3: Positioning

3a. Common Positions

• Supine: flat on back — neutral spine alignment, used for sleep, post-surgery

• Prone: on stomach — used for spinal surgery, pressure relief, ARDS (ventilated patients)

• Lateral (side-lying): on side with pillows supporting back and between legs — used for pressure relief, post-stroke

• Fowler's: head elevated 45–60° — used for breathing (COPD, heart failure), eating, NG feeding

• Semi-Fowler's: head elevated 30° — used for general comfort, post-surgery

• Trendelenburg: head down, feet up — rarely used now (historically for shock)

• Reverse Trendelenburg: head up, feet down — used for some surgical procedures

3b. Pressure Relief Positioning

• Reposition every 2 hours (or more frequently for high-risk patients)

• Use pillows, foam wedges, heel protectors, pressure-relieving mattresses

• Avoid positioning on bony prominences (sacrum, heels, elbows, trochanters)

• 30° lateral tilt: preferred for pressure relief (avoids sacral pressure)

3c. Special Considerations

• Stroke patients: position with affected side supported, arm in neutral position, prevent shoulder subluxation

• Post-hip replacement: avoid hip flexion >90°, adduction past midline, internal rotation (use abduction pillow)

• Spinal injury: log roll only, maintain spinal alignment

• Parkinson's: pillows to support flexed posture, prevent contractures

Branch 4: Falls Prevention

4a. Falls Risk Factors

• Intrinsic: age >65, previous falls, impaired mobility, cognitive impairment, incontinence, visual/hearing impairment, medications (sedatives, antihypertensives, diuretics), postural hypotension

• Extrinsic: poor lighting, wet floors, clutter, ill-fitting footwear, bed height, call bell not within reach

4b. Falls Prevention Strategies

• Environmental: clear pathways, adequate lighting, non-slip flooring, bed in lowest position, call bell within

Branch 4: Falls Prevention (continued)

4b. Falls Prevention Strategies (continued)

• Environmental: clear pathways, adequate lighting, non-slip flooring, bed in lowest position, call bell within reach, clutter-free room

• Patient: non-slip socks/shoes, glasses on, hearing aids in, adequate hydration, supervised mobilisation

• Staff: hourly rounding (check pain, position, toileting, call bell), handover of falls risk patients, bedside handover

4c. Post-Fall Protocol

1.    Do NOT move the patient — risk of undetected injury (fracture, head injury)

2.    Call for help — RN or MET

3.    Assess for injury: ask patient where it hurts, check head, limbs, hips

4.    If unconscious — DRSABCD, call 000

5.    If safe, assist patient to sit up slowly (monitor for postural hypotension)

6.    Measure and document vital signs

7.    Document: time, location, circumstances, patient condition, staff actions

8.    Complete incident report (e.g., IMS + falls report form)

9.    Notify family (RN responsibility)

10.Implement falls prevention strategies for ongoing care

4d. STRATIFY Falls Risk Tool (detailed)

• Item 1: Previous falls (1 point)

• Item 2: Patient agitated/confused (1 point)

• Item 3: Visual impairment affecting daily function (1 point)

• Item 4: Toileting frequency (≥6 times/day or nocturia ≥3) (1 point)

• Item 5: Transfer/mobility score of 3 or 4 (1 point)

• Scoring: ≥2 = high falls risk — implement prevention strategies

Branch 5: Walking Aids

5a. Walking Stick (Cane)

• Use: provides balance, reduces weight-bearing on one leg (e.g., hip/knee replacement)

• Height adjustment: top of stick at wrist crease when arm hanging down, elbow flexed ~15–20°

• Gait pattern:

• Single stick: hold in opposite hand to affected leg — stick and affected leg move together

• Two sticks: standard alternating pattern

• Safety: rubber tip must be intact (replace if worn), check ferrule

5b. Walking Frame (Walker)

• Types: standard (pick-up frame), wheeled (with/without seat), rollator (with seat + brakes)

• Use: provides wide base of support — for patients with poor balance or bilateral weakness

• Height: handles at wrist crease, elbows bent ~15°

• Gait: lift frame → step forward → repeat (standard frame); push frame → walk (wheeled)

• Safety: check rubber tips, wheels roll smoothly, brakes functional

5c. Crutches

• Types: axillary (underarm), forearm (elbow crutches/Lofstrand), gutter (for forearm support)

• Height: axillary crutches — 2–3 finger widths below axilla (never rest weight on axilla — can cause nerve damage)

• Gait patterns:

• 3-point: both crutches + affected leg → unaffected leg (non-weight-bearing)

• 2-point: right crutch + left foot → left crutch + right foot (partial weight-bearing)

• 4-point: right crutch → left foot → left crutch → right foot (full weight-bearing, most stable)

• Swing-to: both crutches forward → swing both feet to crutches (non-weight-bearing)

• Swing-through: both crutches forward → swing both feet past crutches (advanced)

• Safety: rubber tips intact, hand grips comfortable, axilla pads clean

5d. Gutter Frame

• Use: for patients who cannot bear weight through hands/wrists (arthritis, fracture)

• Design: forearm rests on padded gutter, weight borne through forearms

• Gait: lift frame → step forward → repeat

5e. General Walking Aid Safety

• Check rubber tips/ferrules before each use

• Ensure correct height adjustment

• Patient should wear enclosed, non-slip footwear

• Clear pathways of obstacles

• Supervise initial use

• Report any damage or wear immediately

🧠 MIND MAP 4: CHCCCS023 — Support Independence & Wellbeing

Branch 1: Activities of Daily Living (ADLs)

1a. Personal Hygiene — Showering

• AIN role: assist with shower (stand-by assist, minimal assist, full assist)

• Procedure:

1.    Gather equipment: towel, washcloth, soap/shower gel, clean clothes, non-slip mat

2.    Check water temperature (warm, not hot — test with elbow/thermometer)

3.    Ensure privacy — close door/curtain, cover with towel

4.    Assist patient to undress (maintain dignity — expose only area being washed)

5.    Wash from cleanest to dirtiest: face → arms → chest → abdomen → legs → back → perineal area

6.    Rinse thoroughly

7.    Pat dry (do not rub — skin fragile in elderly)

8.    Assist with dressing

9.    Document: shower completed, skin condition, any concerns

• Safety: non-slip mat, grab rails, shower chair if needed, call bell within reach

1b. Bed Bath

• When: patient bedridden, post-surgery, palliative

• Procedure:

1.    Explain procedure, close curtains

2.    Gather: basin of warm water, 2 washcloths, towel, soap, clean linen, gloves

3.    Position patient supine

4.    Wash top half first (eyes → face → neck → arms → chest → abdomen)

5.    Change water

6.    Wash bottom half (legs → feet → back → perineal area)

7.    Use separate cloth for perineal area

8.    Rinse and pat dry each area

9.    Apply moisturiser if needed

10.Change linen if soiled

11.Document

1c. Oral Care (Mouth Care)

• Why critical: prevents pneumonia (aspiration of oral bacteria), maintains dignity, prevents gum disease

• Conscious patient: assist with toothbrush + toothpaste, or provide mouthwash

• Unconscious patient: foam swabs (or soft toothbrush) with water or chlorhexidine, suction if needed

• Dentures:

• Remove, clean over basin of water (prevents breakage if dropped)

• Brush with soft toothbrush and denture cleaner (not toothpaste — too abrasive)

• Store in labelled container with water or denture solution

• Reinsert after cleaning (or store safely)

• Frequency: minimum twice daily (morning and night), more if NBM, mouth breather, or oxygen therapy

• Document: oral care completed, condition of mouth/lips/dentures

1d. Dressing & Grooming

• AIN role: assist as needed — do not take over if patient can do it themselves

• Encourage independence: lay out clothes in order, allow extra time

• Technique for hemiplegic patient: dress affected side first, undress affected side last

• Grooming: hair brushing, shaving (electric razor preferred for safety), nail care (file only — do not cut if diabetic or on anticoagulants)

1e. Eating & Feeding Assistance

• AIN role: set up meal tray, open packages, assist with feeding if needed

• Position: sit patient upright (Fowler's position) — reduces aspiration risk

• Feeding technique:

• Sit at eye level

• Offer small amounts

• Allow time to chew and swallow

• Alternate food types (savoury, sweet, drink)

• Check mouth is empty before next mouthful

• Aspiration precautions: observe for coughing, choking, wet voice — stop feeding, report to RN

• Thickened fluids: for dysphagia — follow speech pathologist recommendations (level 1–3)

• Texture-modified food: soft, minced, pureed — follow dietitian orders

• Document: percentage eaten, any difficulties, fluid intake

Branch 2: Psychosocial Support

2a. Active Listening

• Techniques:

• Maintain eye contact (culturally appropriate)

• Lean forward, open posture

• Nod and use minimal encouragers ("mm-hmm", "go on")

• Reflect back: "It sounds like you're feeling..."

• Paraphrase: "So what you're saying is..."

• Ask open-ended questions: "How are you feeling about that?"

• Barriers: distractions, interrupting, giving advice too soon, judging, changing the subject

2b. Validation of Feelings

• Acknowledge the patient's emotions without judgment

• "I can see this is difficult for you" — not "Don't worry, it'll be fine"

• Validation is especially important for patients with dementia (validation therapy — Naomi Feil)

2c. Encouraging Choice & Autonomy

• Offer choices wherever possible: "Would you like to shower now or after breakfast?"

• Respect patient preferences: time of waking, bathing, food choices

• Involve patient in care planning

• Promote self-determination — patients have the right to refuse care (document and report)

2d. Cultural Considerations

• Respect cultural beliefs about: modesty, gender of carer, food, prayer, touch, eye contact

• Use interpreter services (not family members) for complex discussions

• Be aware of: Aboriginal and Torres Strait Islander health practices, CALD communities

• Ask: "Is there anything I should know about your cultural or religious needs?"

2e. Emotional & Spiritual Support

• Recognise signs of distress: withdrawal, tearfulness, agitation, anger

• Offer presence — sometimes sitting quietly is more supportive than talking

• Refer to: social worker, chaplain/pastoral care, psychologist, Aboriginal liaison officer

Branch 3: Skin Care & Pressure Injury Prevention

3a. Pressure Injury Staging (NPUAP/EPUAP)

• Stage I: Non-blanchable erythema — intact skin, red area that does not turn white when pressed. Early sign — reversible.

• Stage II: Partial-thickness skin loss — shallow open ulcer, red/pink wound bed, no slough. May present as blister.

• Stage III: Full-thickness skin loss — subcutaneous fat visible, may have slough, but bone/tendon/muscle not exposed. Depth varies by anatomical location.

• Stage IV: Full-thickness tissue loss — exposed bone, tendon, or muscle. Slough or eschar may be present. Often involves undermining/tunnelling.

• Unstageable: Full-thickness tissue loss — base of ulcer covered by slough (yellow/tan/green) or eschar (black/brown) — cannot determine stage until debrided.

• Deep Tissue Injury (DTI): Purple/maroon localised area of intact skin or blood-filled blister — indicates underlying soft tissue damage from pressure/shear.

3b. Risk Assessment Tools

• Braden Scale (6 subscales, scored 6–23):

1.    Sensory perception (1–4)

2.    Moisture (1–4)

3.    Activity (1–4)

4.    Mobility (1–4)

5.    Nutrition (1–4)

6.    Friction/shear (1–3)

• ≤18 = at risk; ≤12 = high risk; ≤9 = very high risk

• Waterlow Scale: more comprehensive — includes BMI, skin type, continence, mobility, nutrition, special risks (medications, surgery, neurology)

3c. Prevention Strategies

• Repositioning: every 2 hours minimum — use 30° lateral tilt, avoid positioning on sacrum

• Pressure-relieving devices: alternating pressure mattress, foam overlay, heel boots, elbow protectors

• Skin inspection: daily — focus on sacrum, heels, elbows, occiput, trochanters, ischial tuberosities

• Moisture management: keep skin clean and dry, barrier creams (zinc-based), absorbent pads, manage incontinence

• Nutrition: adequate protein, hydration, vitamin C, zinc — refer to dietitian if poor intake

• Shear reduction: use slide sheets for repositioning, elevate head of bed ≤30° when possible

3d. AIN Role in Pressure Injury Care

• Inspect skin daily and report any changes

• Reposition patients on schedule

• Apply barrier creams as directed

• Ensure pressure-relieving devices are in use and functioning

• Document skin condition and interventions

• Never massage over bony prominences (can cause tissue damage)

Branch 4: Elimination

4a. Bedpan & Urinal

• Bedpan: for bowel movements or urine when patient cannot mobilise to toilet

• Warm bedpan before use (rinse with warm water)

• Position patient supine, assist to raise hips

• Position bedpan correctly (narrow end toward feet)

• Provide privacy, call bell within reach

• Remove, cover, empty in sluice room

• Measure/document output

• Clean bedpan in bedpan washer

• Offer hand hygiene to patient

• Urinal: for male patients

• Position between legs, ensure upright

• Provide privacy

• Empty, measure, document

• Clean and store

4b. Commode

• Use: for patients who can sit up but cannot mobilise to bathroom

• Position: beside bed, brakes on

• Procedure: assist patient to sit, provide privacy, call bell within reach

• After: assist patient back to bed, empty commode pan, clean, document output

4c. Catheter Care

• Indwelling urinary catheter (IDC): Foley catheter with balloon inflated in bladder

• AIN role:

• Meatal hygiene: clean around catheter insertion site with soap and water daily (away from urethra)

• Ensure catheter tubing is not kinked/twisted

• Keep drainage bag below level of bladder (prevents backflow)

• Empty drainage bag when 2/3 full (measure and document)

• Secure catheter to leg with catheter strap or securement device

• Ensure free flow of urine

• Report to RN: no urine output for >6 hours, cloudy/smelly urine, blood in urine, pain, bypassing (leaking around catheter), catheter dislodged

4d. Bowel Chart & Bristol Stool Chart

• Bristol Stool Chart Types:

• Type 1: Separate hard lumps (severe constipation)

• Type 2: Sausage-shaped but lumpy (mild constipation)

• Type 3: Sausage-shaped with cracks on surface (normal)

• Type 4: Smooth, soft sausage (normal — ideal)

• Type 5: Soft blobs with clear edges (lacking fibre)

• Type 6: Fluffy pieces with ragged edges (mild diarrhoea)

• Type 7: Watery, no solid pieces (diarrhoea)

• Document: frequency, consistency (type), colour, amount, any blood/mucus, pain with bowel movement

4e. Constipation Management

• AIN role: encourage fluids, mobility, fibre intake, privacy for toileting, report if no bowel movement >3 days

• Laxatives: RN administers per doctor's order

• Faecal impaction: report to RN — may require manual evacuation (RN only) or enema

Branch 5: End of Life Care

5a. Palliative vs Curative Care

• Palliative: symptom management, quality of life, no curative intent — can be provided alongside curative treatment

• Terminal: last days/hours of life — focus on comfort, dignity, family support

• AIN role: symptom observation, positioning, mouth care, emotional support, family support

5b. Symptom Management (AIN can observe and report)

• Pain: observe non-verbal cues (grimacing, restlessness, moaning) — report to RN

• Nausea: position patient comfortably, offer small sips, report to RN

• Dyspnoea (breathlessness): sit patient upright, calm environment, fan for air movement, oxygen as prescribed

• Agitation/restlessness: quiet environment, gentle reassurance, family presence

• Secretions (death rattle): position patient on side (postural drainage), suction if ordered — anticholinergic medications (RN)

• Dry mouth: ice chips, moist swabs, lip balm

5c. Last Offices (Care After Death)

• Procedure:

1.    Confirm death with RN/doctor

2.    Respect cultural/religious practices (ask family)

3.    Lay patient supine, arms by sides or across chest

4.    Close eyes (gentle pressure for ~30 seconds)

5.    Close mouth (use rolled towel under chin if needed)

6.    Remove all tubes, drains, catheters (unless coroner's case — leave in situ)

7.    Clean body, apply clean gown/pads

8.    Place identity tags on wrist and ankle

9.    Wrap in shroud or linen as per facility

10.Transfer to mortuary with dignity

• Cultural considerations:

• Muslim: body turned toward Mecca, only same-gender carers

• Jewish: body not left alone, burial within 24 hours

• Aboriginal & Torres Strait Islander: community-specific practices, consult family

• Catholic: last rites (priest), rosary

5d. Family Support

• Offer time alone with deceased

• Provide tea/water, quiet space

• Provide information about next steps (funeral arrangements, death certificate)

• Refer to social worker, chaplain, bereavement services

🧠 MIND MAP 5: HLTAID011 — Provide First Aid

Branch 1: DRSABCD Protocol

1a. D — Danger

• Assess scene for hazards: traffic, fire, electrical, chemical, blood/body fluids, aggressive people

• Ensure your safety first — do not become a second casualty

• Use standard precautions (gloves, face shield for rescue breaths)

1b. R — Response

• Ask loudly: "Are you okay?"

• Squeeze shoulders

• Check: verbal response, eye opening, motor response

• Use AVPU scale

1c. S — Send for Help

• Call 000 (ambulance) or call for RN/code team in hospital

• Delegate someone: "You — call 000, tell them..."

• Provide: location, what happened, number of casualties, condition

1d. A — Airway

• Open airway: head tilt + chin lift (adult/child)

• Jaw thrust (suspected spinal injury)

• Remove visible obstructions (finger sweep only if visible — do not blind sweep)

1e. B — Breathing

• Look, listen, feel for ≤10 seconds

• Look: chest rise/fall

• Listen: breath sounds

• Feel: air on your cheek

• If breathing normally → recovery position

• If not breathing (or not normal breathing — agonal gasps = cardiac arrest) → start CPR

1f. C — CPR

• Adult: 30 compressions: 2 breaths

• Compression depth: 5–6 cm (adult)

• Compression rate: 100–120 per minute

• Hand position: centre of chest (lower half of sternum)

• Allow full chest recoil between compressions

• Breaths: each over 1 second, enough to see chest rise

• Minimise interruptions — aim for <10 seconds

• Cycles: continue until: ROSC (signs of life), paramedics arrive, you are exhausted, or scene becomes unsafe

1g. D — Defibrillation (AED)

• Turn on AED — follow voice prompts

• Expose chest — remove medication patches, dry chest if wet, shave excessive hair if needed

• Apply pads: one upper right chest, one lower left side

• Ensure no one is touching patient — "Stand clear"

• AED analyses rhythm — if shock advised, press button

• Immediately resume CPR (30:2) after shock

• Continue until paramedics arrive or patient shows signs of life

Branch 2: Common Emergencies

2a. Anaphylaxis

• Causes: food (nuts, shellfish, eggs), insect stings, medications, latex

• Symptoms: difficulty breathing, swelling (lips/tongue/throat), hives/urticaria, hypotension, wheeze, stridor, abdominal pain, vomiting

• Action:

1.    Call 000 immediately

2.    Position: sit patient upright (or lie flat if hypotensive)

3.    Administer adrenaline auto-injector (EpiPen) — IM outer mid-thigh

4.    Can repeat after 5 minutes if no improvement

5.    If unconscious and not breathing → commence CPR

• AIN note: you can administer an EpiPen if trained and delegated — in an emergency, Good Samaritan Act applies

2b. Asthma

• Symptoms: wheeze, cough, shortness of breath, chest tightness, difficulty speaking

• Action:

1.    Sit patient upright

2.    Give reliever puffer (blue — salbutamol) via spacer

3.    4 puffs, wait 4 minutes, repeat if needed (4-4-4-4 protocol)

4.    Call 000 if: severe attack, not improving, patient exhausted, SpO₂ <92%

5.    If unconscious and not breathing → CPR

2c. Cardiac Arrest

• Signs: unconscious, not breathing, no signs of life

• Action: DRSABCD — start CPR immediately, attach AED as soon as available

• Survival: decreases by 10% per minute without CPR + defibrillation

2d. Choking

• Mild obstruction: patient can cough, speak, breathe — encourage coughing

• Severe obstruction: cannot cough/speak/breathe, clutching throat

• Adult/child >1 year: 5 back blows (between shoulder blades) + 5 abdominal thrusts (Heimlich manoeuvre)

• Infant <1 year: 5 back blows + 5 chest thrusts (NOT abdominal thrusts)

• Unconscious: DRSABCD — commence CPR

• Abdominal thrusts: stand behind patient, fist above navel, thrust inward and upward

2e. Stroke (FAST)

• F — Facial droop: ask patient to smile — one side droops?

• A — Arm drift: ask patient to raise both arms — one arm drifts down?

• S — Slurred speech: ask patient to speak a sentence — words slurred?

• T — Time: time of onset — call 000 immediately

• Action: note time of onset (critical for thrombolysis window — 4.5 hours), keep patient nil by mouth, position upright or lying flat, do not give aspirin (unless directed by doctor)

2f. Bleeding

• Action:

1.    Apply direct pressure with sterile gauze or clean cloth

2.    Elevate injured limb (if no fracture)

3.    Apply pressure bandage

4.    If bleeding through — apply additional pad on top (do not remove first one)

5.    Call 000 if severe

6.    Monitor for shock

• Tourniquet: only for life-threatening limb haemorrhage when direct pressure fails — rarely used, trained personnel only

2g. Burns

• Action:

1.    Remove from source of burn

2.    Cool running water for 20 minutes (within 3 hours of injury)

3.    Remove jewellery/clothing if not stuck to burn

4.    Cover with non-stick dressing or cling wrap

5.    Do NOT apply ice, butter, toothpaste, creams

6.    Call 000 if: deep burn, >10% body surface, face/hands/genitals/airway involved, child/elderly

• Burn depth:

• Superficial (1st degree): red, painful, no blisters (sunburn)

• Partial thickness (2nd degree): red, blistered, painful

• Full thickness (3rd degree): white/charred, painless (nerve damage)

Branch 3: Incident Reporting

3a. What to Report

• Any event that causes or could cause harm

• Examples: falls, medication errors, needlestick injuries, aggressive behaviour, equipment malfunction, near misses

3b. How to Report

• Complete incident report form (e.g., IMS — Incident Management System)

• Include:

• Date, time, location

• People involved (patients, staff, visitors)

• Description of event (factual, chronological — no opinions/blame)

• Injuries sustained

• Actions taken

• Witnesses

• Submit to RN/NUM within 24 hours

3c. AIN Role

• Report immediately to RN

• Complete your section of incident report truthfully

• Participate in debriefing if required

• Do NOT discuss incident with other patients or unauthorised staff

Branch 4: Legal & Ethical Considerations

4a. Duty of Care

• Legal obligation to provide care that a reasonable person would in the same circumstances

• You owe duty of care to your patients

• Breach = negligence (if harm results)

4b. Consent

• Must be obtained before any care

• Valid consent: voluntary, informed, capacity

• Implied consent: patient cooperates (e.g., holds out arm for BP)

• Expressed consent: verbal or written

• If patient refuses: respect their decision, document, report to RN

• Unconscious patient: implied consent for emergency treatment

4c. Good Samaritan Protection

• Protects people who provide first aid in an emergency from legal liability

• Applies if: acting in good faith, without expectation of payment, not grossly negligent

• Covers AINs providing first aid outside of work

4d. Privacy & Confidentiality

• Health Records and Information Privacy Act 2002 (NSW)

• Do not discuss patient information with anyone not involved in their care

• Do not discuss patients in public areas (lifts, cafeteria)

• Secure patient records — do not leave charts open

4e. Scope of Practice

• AINs work under delegation and supervision of RN

• Know what you can and cannot do

• If unsure — ask

• Never perform a task you are not trained or authorised to do

• Refuse unsafe delegation politely: "I'm not trained to do that, I'll get the RN"

Past Paper Review — Detailed Analysis

Exam Structure (NESA HSC Human Services 2022–2024)

Multiple Choice — Common Topics

1.    Chain of infection: "Which is the most effective way to break the chain of infection?" → Hand hygiene

2.    Standard precautions: "Which is an example of standard precaution?" → Hand hygiene before patient contact

3.    Vital signs normal ranges: "Normal adult respiratory rate is:" → 12–20 bpm

4.    PPE order: "Which PPE should be put on first?" → Gown

5.    Pressure injury staging: "Non-blanchable erythema on intact skin is:" → Stage I

6.    Manual handling: "The most effective control in the hierarchy of controls is:" → Elimination

7.    DRSABCD: "What does the first D stand for?" → Danger

8.    Falls risk: "Which is a risk factor for falls?" → Previous falls (or any listed)

9.    Bristol Stool Chart: "Type 4 on the Bristol Stool Chart indicates:" → Normal stool

10.Waste segregation: "Used sharps should be disposed in:" → Yellow puncture-proof container

Short Answer — Common Questions & Model Answers

Q1: Explain the 5 Moments of Hand Hygiene. (5 marks)

Model answer:

1.    Before touching a patient — protects patient from microorganisms on your hands

2.    Before a clean/aseptic procedure — prevents microorganisms entering patient's body

3.    After body fluid exposure risk — protects you from contamination

4.    After touching a patient — prevents spread to environment

5.    After touching patient surroundings — prevents spread to next patient

Q2: Describe the precautions required for a patient with MRSA in a single room. (6 marks)

Model answer:

• Contact precautions are required because MRSA is spread by direct/indirect contact

• PPE: gown and gloves on entry to room

• Room: single room with contact precautions signage (green)

• Equipment: dedicated stethoscope, BP cuff, thermometer — if shared, clean with disinfectant between patients

• Hand hygiene: perform hand hygiene before donning and after doffing PPE

• Patient movement: limit to essential only; cover any wounds/lesions

• Linen/waste: handle as clinical waste/infectious linen

Q3: Outline the steps for safe transfer of a patient from bed to wheelchair. (5 marks)

Model answer:

1.    Explain procedure to patient and gain consent

2.    Position wheelchair at 45° angle to bed, apply brakes, move footrests aside

3.    Lower bed to lowest position, ensure bed brakes on

4.    Assist patient to sit on edge of bed (dangle), ensure steady

5.    Apply gait belt if needed

6.    Stand in front of patient, feet shoulder-width apart, bend knees

7.    Count "1-2-3", assist patient to stand

8.    Pivot patient toward wheelchair

9.    Lower patient gently into wheelchair

10.Position patient well back in seat, place footrests, ensure call bell within reach

Q4: A patient has SpO₂ 91%, BP 85/50, P 110, R 24. Identify which observations are abnormal and explain your actions. (6 marks)

Model answer:

• SpO₂ 91%: abnormal (normal 95–100%) — indicates hypoxaemia

• BP 85/50: abnormal (normal 90/60–120/80) — hypotension

• P 110: abnormal (normal 60–100) — tachycardia

• R 24: abnormal (normal 12–20) — tachypnoea

• Actions:

1.    Immediately report to RN — patient may be deteriorating (sepsis? haemorrhage? shock?)

2.    Stay with patient, reassure

3.    Apply oxygen as prescribed if available

4.    Prepare for MET call if required

5.    Document observations and actions taken

Q5: Describe the DRSABCD action plan for an unconscious patient not breathing. (5 marks)

Model answer:

• D — Check for danger to self, patient, others

• R — Check response: "Are you okay?" squeeze shoulders

• S — Send for help: call 000 or code blue

• A — Open airway: head tilt, chin lift

• B — Check breathing: look, listen, feel for ≤10 seconds — no breathing

• C — Start CPR: 30 compressions: 2 breaths, rate 100–120/min, depth 5–6cm

• D — Attach AED as soon as available, follow prompts

Extended Response — Common Questions & Model Answer

Q6: You are caring for a 78-year-old patient admitted after a fall. They are on bed rest for 48 hours. Discuss your nursing assistant role in preventing pressure injuries and falls. (15 marks)

Model answer structure:

Introduction

• Patient is at high risk for both pressure injuries (immobility, age) and further falls

• AIN plays a key role in prevention through regular repositioning, skin inspection, and falls prevention strategies

Pressure Injury Prevention (5–6 points)

1.    Risk assessment: use Braden/Waterlow scale to identify risk level

2.    Repositioning: every 2 hours using 30° lateral tilt, avoid sacral pressure

3.    Skin inspection: daily check of sacrum, heels, elbows, occiput — report any redness

4.    Moisture management: keep skin clean and dry, apply barrier cream

5.    Pressure-relieving devices: ensure alternating pressure mattress is functioning, use heel protectors

6.    Nutrition: encourage fluid and protein intake, report poor appetite to RN

Falls Prevention (5–6 points)

1.    Falls risk assessment: use STRATIFY tool to identify risk factors

2.    Environment: bed in lowest position, call bell within reach, clear pathways, non-slip socks

3.    Supervision: hourly rounding, assist with toileting, do not leave patient unattended

4.    Mobilisation: assist with safe mobilisation, use walking aids correctly

5.    Medication awareness: be aware of sedatives/diuretics that increase falls risk

6.    Post-fall protocol: know what to do if patient falls again

Conclusion

• Prevention is a team effort — AIN's vigilance, documentation, and communication with RN are essential

• Patient safety and dignity must be prioritised at all times

Study Tips for the HSC Exam

1.    Know your normal ranges — temperature, pulse, respiration, BP, SpO₂ — they come up in every exam

2.    DRSABCD — memorise it cold, you'll be asked to write it out

3.    Chain of infection — understand the links and how to break them

4.    PPE donning/doffing order — common multiple choice question

5.    Pressure injury staging — know the difference between I–IV

6.    Command terms — know what "explain" vs "describe" vs "outline" means

7.    Use industry terminology — "standard precautions", "aseptic technique", "client-centred care", "duty of care"

8.    Practice extended responses — structure them with introduction, body paragraphs, conclusion

9.    Read the question twice — make sure you're answering what was asked

10.Time management — don't spend too long on multiple choice; save time for extended response

🧠 MIND MAP 3: CHCCCS002 — Assist With Movement (continued)

Branch 5: Walking Aids (continued from earlier)

5f. Walking Aid Selection — Matching Aid to Patient Needs

5g. Walking Aid Safety Checks (Daily)

• Rubber tips: check for wear, cracks, embedded debris — replace if worn

• Height adjustment: buttons/screws are secure, lock pins engaged

• Frame integrity: no cracks, bends, or loose joints

• Wheels (rollator): roll smoothly, no wobble, brakes engage fully

• Hand grips: clean, not worn smooth, secure on frame

🧠 MIND MAP 4: CHCCCS023 — Support Independence & Wellbeing (continued)

Branch 5: End of Life Care (expanded)

5e. Signs of Approaching Death (Terminal Phase)

• Reduced consciousness: patient becomes increasingly drowsy, difficult to rouse

• Changes in breathing: Cheyne-Stokes respiration (waxing/waning → periods of apnoea), audible secretions ("death rattle")

• Changes in circulation: cold extremities, mottling of skin (knees, feet, hands), weak/thready pulse, hypotension

• Reduced intake: no interest in food or fluids

• Changes in elimination: decreased urine output (dark/concentrated), incontinence

• Agitation/restlessness: sometimes called "terminal agitation" — may be due to pain, hypoxia, or fear

• Vision-like statements: patient may report seeing deceased relatives or "going home" — this is common and should not be corrected

5f. AIN Role in Terminal Care

• Comfort measures: regular repositioning, mouth care, lip balm, moist swabs, eye care (artificial tears if eyes remain open)

• Symptom monitoring: observe for pain (facial grimacing, moaning, restlessness), breathing changes, skin changes — report to RN

• Family support: offer chairs, drinks, tissues; provide updates; allow private time; explain what is happening in plain, gentle language

• Spiritual care: ask family about religious/cultural needs — contact chaplain, imam, elder as appropriate

• Environment: quiet, dim lighting, favourite music or familiar objects, minimal interruptions

5g. Grief and Loss

• Types of grief:

• Anticipatory grief: grieving before death occurs (common in families of terminal patients)

• Normal grief: sadness, anger, guilt, numbness — varies by individual

• Complicated grief: prolonged, intense, interferes with functioning — refer to counsellor

• Kübler-Ross model (not linear, not universal): Denial → Anger → Bargaining → Depression → Acceptance

• AIN role: listen without judgment, allow expression of emotions, do not try to "fix" grief, refer to bereavement services

🧠 MIND MAP 6: HLTHPS007 — Support Clients with Medication (AIN Delegation Context)

Note on AINs and Medications in NSW

In NSW, AINs generally cannot administer medications unless working under specific delegation models (e.g., Medication Assistance — checking dose, opening packaging, reminding). This varies by facility. Know your scope.

1a. Medication Assistance (where permitted)

• What AINs may do (check facility policy):

• Remind patient to take medication

• Open packaging/bottle

• Check label against medication chart (with RN)

• Assist patient with positioning for self-administration

• What AINs may NOT do:

• Calculate or draw up doses

• Administer injections

• Administer Schedule 4 or 8 medications independently

• Make clinical judgments about medication

1b. Medication Rights (the "5 Rights" — used in exams)

1.    Right patient — check ID band, ask name, check photo

2.    Right medication — compare medication label to medication chart

3.    Right dose — check against prescription

4.    Right route — oral, topical, IV, IM, subcut, etc.

5.    Right time — check when last dose was given

Some facilities add: Right documentation, Right to refuse, Right response

1c. Observation and Reporting

• Observe for: rash, swelling, difficulty breathing, nausea, vomiting, change in consciousness, change in vital signs

• Report any suspected adverse reactions to RN immediately

• Document: medication taken, any refusal, any side effects observed

🧠 MIND MAP 7: CHCCOM005 — Communicate and Work in Health or Community Services

Branch 1: Communication Strategies

1a. Verbal Communication

• Use plain language — avoid medical jargon with patients

• Speak clearly, at appropriate volume (hearing impaired)

• Tone: calm, respectful, warm

• Pace: match patient's pace — allow time for processing

• Open-ended questions: "How are you feeling today?"

• Closed-ended questions: "Are you in pain?" (used for specific information)

1b. Non-Verbal Communication

• Eye contact: shows engagement — but adjust for cultural norms (some cultures avoid direct eye contact)

• Posture: open, leaning slightly forward, arms uncrossed

• Facial expression: smile, concerned, neutral as appropriate

• Personal space: ~1m for conversation — varies by culture and individual

• Touch: therapeutic touch (hand on shoulder) can be comforting — but must be appropriate and permission-seeking

1c. Barriers to Communication

• Patient-related: hearing/vision impairment, cognitive impairment, language barriers, pain, anxiety, fatigue, altered consciousness

• Environment-related: noise, lack of privacy, interruptions, poor lighting

• Staff-related: using jargon, rushing, not listening, assumptions

• Overcoming barriers:

• Use interpreter (not family) for complex discussions

• Use visual aids, written materials, pictures

• Reduce background noise

• Sit at patient's eye level

• Allow extra time

• Check understanding: "Can you tell me what I've just explained?"

1d. Communication with Specific Populations

Dementia Patients

• Approach from front — do not startle

• Use patient's preferred name

• One instruction at a time

• Simple, short sentences

• Don't argue or correct — validate feelings

• Use redirection: "Let's go this way" not "That's the wrong door"

• Non-verbal cues matter more than words

Hearing Impaired

• Face patient directly — good lighting on your face

• Do not cover mouth

• Speak clearly, slightly slower — do not shout

• Reduce background noise

• Use written notes if needed

• Auslan interpreter for complex conversations

Culturally and Linguistically Diverse (CALD)

• Use professional interpreter (not family) for health information

• Be aware of cultural norms around: eye contact, touch, gender of carer, decision-making

• Ask about cultural/religious needs — do not assume

• Use translated resources where available

Branch 2: Working in a Team

2a. Interprofessional Team in Acute Care

• Nursing team: RN (registered nurse), EN (enrolled nurse), AIN (assistant in nursing)

• Medical team: doctors (intern → registrar → consultant)

• Allied health: physiotherapist, occupational therapist, speech pathologist, dietitian, social worker

• Other: pharmacist, discharge planner, chaplain, Aboriginal health worker

2b. AIN's Place in the Team

• Reports to RN (delegating clinician)

• Works under supervision — RN delegates tasks, AIN performs them

• Must communicate: completed tasks, observations, concerns, patient requests

• Scope: AINs do NOT diagnose, prescribe, or make clinical decisions

2c. Delegation and Supervision

• RN delegates tasks within AIN scope

• AIN must:

• Accept delegation only if trained and competent

• Ask for clarification if unsure

• Refuse unsafe delegation: "I'm not trained for that task"

• Report back to RN after completing task

• RN supervises — may be direct (RN present) or indirect (RN available)

2d. Effective Handover

• ISBAR (used in NSW Health):

• I — Identify: yourself, patient, location

• S — Situation: what is happening now (concerns, current status)

• B — Background: relevant history, diagnosis, medications

• A — Assessment: what you think is going on (AIN: what you observed)

• R — Recommendation: what you think should happen next

• Example AIN handover: "I'm Sarah, AIN for Bed 4. Mrs Jones has had a drop in SpO₂ to 91% and is more short of breath. Her obs 10 minutes ago were RR 24, SpO₂ 91%, HR 95. She's normally on room air. I think she needs review."

🧠 MIND MAP 8: HLTWHS001 — Participate in Workplace Health and Safety

Branch 1: WHS Legislation and Duty of Care

1a. Key Legislation

• Work Health and Safety Act 2011 (NSW) — primary WHS law

• Work Health and Safety Regulation 2017 (NSW) — detailed requirements

• Industrial award/enterprise agreement — may have specific provisions

1b. Duty of Care — Who is Responsible?

• Person Conducting Business or Undertaking (PCBU) — employer: provides safe work environment, equipment, training, PPE

• Officers — managers/NUMs: due diligence, policies, resources

• Workers (including AINs): take reasonable care for own safety and others, comply with policies, use PPE correctly, report hazards/incidents

1c. Worker Responsibilities

• Follow safe work procedures

• Use PPE as instructed

• Report hazards, near misses, incidents

• Participate in training

• Do not wilfully endanger self or others

• Cooperate with WHS investigations

Branch 2: Hazard Identification and Risk Management

2a. Types of Hazards in Acute Care

• Biological: blood/body fluids, needlestick injuries, airborne infections, contaminated waste

• Chemical: cleaning chemicals, disinfectants, cytotoxic drugs, oxygen

• Physical: manual handling, slips/trips/falls, noise, radiation, heat

• Psychosocial: workplace violence, aggression, stress, fatigue, bullying

• Ergonomic: poor posture, repetitive tasks, poorly designed equipment

2b. Risk Management Process

1.    Identify hazard — look, ask, inspect

2.    Assess risk — how likely? how severe?

3.    Control risk — use hierarchy of controls

4.    Review — is the control effective?

2c. Hierarchy of Controls (with clinical examples)

Branch 3: Manual Handling (WHS-Specific)

3a. Manual Handling Risk Factors

• Load: heavy, awkward shape, unstable, difficult to grip

• Task: repetitive, sustained, twisting, reaching, bending

• Environment: confined space, slippery floor, poor lighting

• Individual: fitness, fatigue, training, previous injury

3b. Safe Manual Handling Techniques (refresher)

• Assess before lifting — use TILEO

• Use mechanical aids whenever available

• Maintain neutral spine

• Keep load close

• Use legs, not back

• Pivot — do not twist

• Ask for help — two-person lift when needed

Branch 4: Infection Control as WHS

4a. Needlestick/Sharps Injury

• Prevention:

• Dispose of sharps immediately after use

• Never recap needles

• Use sharps container at point of use

• Activate safety mechanisms on safety-engineered devices

• Post-exposure:

1.    Encourage bleeding — wash with soap and water

2.    Apply antiseptic, cover with waterproof dressing

3.    Report immediately to RN/NUM

4.    Attend ED/GP for risk assessment (HIV, Hep B, Hep C)

5.    Complete incident report

6.    Follow up: baseline bloods, PEP if indicated, counselling

4b. Splash/Spill to Mucous Membranes

• Eyes, mouth, nose — flush with copious water/saline for 15 minutes

• Report immediately

• Follow same post-exposure pathway as needlestick

Branch 5: Emergency Procedures

5a. Codes in NSW Hospitals

5b. Fire Safety — RACE

• R — Rescue: remove patients from immediate danger

• A — Alarm: activate fire alarm, call 000

• C — Contain: close doors and windows to contain fire

• E — Evacuate: evacuate to safe area (horizontal first, then vertical if needed)

5c. Evacuation Principles

• Horizontal evacuation first (move to another fire zone on same floor)

• Vertical evacuation only if necessary (use stairs, not lifts)

• Evacuate in order of closest to fire → greatest risk

• Use evacuation slides/s

Branch 5: Emergency Procedures (continued)

5d. Workplace Violence and Aggression

• Types: verbal abuse, threats, physical assault, sexual harassment

• Risk factors in acute care: confused/dementia patients, drug/alcohol withdrawal, mental health patients, long wait times, family distress

• Prevention:

• De-escalation techniques: calm voice, non-threatening body language, give space, listen, validate

• Environmental: clear exit, alarm systems, security presence

• Training: Code Black procedures, de-escalation training

• If aggression escalates:

1.    Maintain safe distance — do not turn back

2.    Remove self from immediate danger

3.    Activate duress alarm / call security

4.    Do not attempt to physically restrain — RN/security only

• Post-incident: report, debriefing, support (Employee Assistance Program)

🧠 MIND MAP 9: CHCDIV001 — Work with Diverse People

Branch 1: Cultural Awareness and Safety

1a. Definitions

• Culture: shared values, beliefs, customs, behaviours of a group

• Cultural awareness: recognising that cultural differences exist

• Cultural safety: environment where people feel safe, respected, and able to express their cultural identity — no challenge to their identity

• Cultural competence: ability to work effectively with people from different cultures

1b. Aboriginal and Torres Strait Islander Peoples

• Cultural considerations:

• Respect for Elders and community decision-making

• Concept of "Sorry Business" (mourning practices) — may not attend appointments, may be away from home

• Men's and women's business — same-gender carers for certain matters

• Connection to Country (land, community, spirituality)

• Health impacts of colonisation, intergenerational trauma, systemic barriers

• AIN approach: ask respectfully about cultural needs, use Aboriginal Health Worker/liaison officer, acknowledge Country

1c. Culturally and Linguistically Diverse (CALD) Communities

• Health beliefs vary: traditional medicine, spiritual approaches to health, differing views on Western medicine

• Communication: use professional interpreters — not family members (privacy, accuracy)

• Family roles: some cultures involve extended family in decision-making

• Gender preferences: same-gender carers for personal care

• Food/medication: religious dietary requirements (halal, kosher, vegetarian), medication interactions (some contain animal products)

1d. Disability

• Person-first language: "person with disability" (preferred by many)

• Social model of disability: disability is caused by societal barriers, not the impairment itself

• AIN approach: ask the person about their needs, do not assume, respect autonomy, provide reasonable adjustments

Branch 2: Inclusive Practice

2a. Principles of Inclusive Care

• Respect individual differences

• Avoid stereotypes and assumptions

• Adapt communication to meet needs

• Provide equal access to care

• Advocate for patient rights

2b. Discrimination and Unconscious Bias

• Direct discrimination: treating someone unfavourably because of a protected attribute

• Indirect discrimination: a rule/policy that disadvantages a group

• Unconscious bias: automatic stereotypes that affect behaviour

• AIN responsibility: reflect on own biases, treat all patients with equal respect, report discrimination

🧠 MIND MAP 10: CHCAGE001 — Facilitate the Empowerment of Older People

Branch 1: Ageing and Independence

1a. Principles of Empowerment

• Older people have the right to make their own decisions — even if you disagree

• Support independence, do not do for them what they can do themselves

• Offer choices: "Would you like to shower now or after breakfast?"

• Promote dignity: knock before entering, close curtains, do not talk over patient

1b. Changes Associated with Ageing

• Physical: reduced mobility, hearing/vision loss, incontinence, frailty, chronic pain, changes in skin

• Cognitive: slower processing, memory changes, dementia risk

• Social: loss of spouse/friends, isolation, change in living situation

• AIN response: allow extra time, adapt communication, encourage social engagement, maintain routines

Branch 2: Dementia Care

2a. Types of Dementia

• Alzheimer's disease: most common — progressive memory loss, confusion

• Vascular dementia: caused by reduced blood flow to brain — stepwise decline

• Lewy body dementia: hallucinations, fluctuating cognition, Parkinson-like symptoms

• Frontotemporal dementia: personality/behaviour changes, language difficulties

2b. Person-Centred Care in Dementia

• See the person, not the diagnosis

• Know their life story: former occupation, interests, family

• Maintain routines and familiar surroundings

• Validate feelings, do not correct or argue

• Use simple one-step instructions

• Redirect, do not confront

2c. Responding to Behaviours (BPSD — Behavioural and Psychological Symptoms of Dementia)

• Sundowning: increased agitation in late afternoon/evening — reduce stimulation, calm environment

• Wandering: safe wandering paths, ID bracelet, alarms

• Agitation/aggression: check for unmet need (pain, hunger, toileting, boredom), use de-escalation

• Repetitive behaviours: respond calmly each time, redirect to activity

• Hallucinations: do not argue — "I can see that's upsetting you" — redirect

🧠 MIND MAP 11: CHCAGE005 — Provide Support to People Living with Dementia (if applicable)

Branch 1: Communication Approaches

1a. Validation Therapy (Naomi Feil)

• Acknowledge and validate emotions rather than correcting facts

• Example: patient says "I need to go pick up my children from school" — instead of "Your children are adults now", say "You miss your children, don't you?"

• Reduces anxiety, builds trust

1b. Reminiscence Therapy

• Using photos, music, objects from past to stimulate memories and communication

• Helps maintain identity and connection

1c. Reality Orientation (use cautiously)

• Orienting patient to person, place, time — but can increase distress if reality is too confronting

• Better used early-stage dementia only

Complete Past Paper Review — Extended

NESA HSC Human Services — Topic Frequency Analysis (2022–2024)

Common Exam Question Types — Exact Wording Examples

From 2024 HSC Human Services Exam:

Multiple Choice Examples:

1.    "Which of the following is the correct sequence for removing PPE?" → Gloves → Gown → Mask → Hand hygiene

2.    "A patient with TB requires which type of precautions?" → Airborne

3.    "The normal range for adult respiratory rate is:" → 12–20 breaths per minute

4.    "Which stage of pressure injury presents with non-blanchable erythema on intact skin?" → Stage I

5.    "What does the 'S' in DRSABCD stand for?" → Send for help

Short Answer Examples:
6. "Explain three ways a nursing assistant can prevent the spread of infection when providing personal care to a patient." (3 marks)
7. "Describe how you would safely reposition a patient up in bed using a slide sheet." (4 marks)
8. "A patient has a blood pressure of 150/90 mmHg. Identify whether this is within normal range and explain one action you would take." (3 marks)
9. "Outline the physical changes associated with ageing that may affect a patient's mobility." (4 marks)
10. "Explain the difference between clinical waste and general waste. Give one example of each." (3 marks)

Extended Response Example:
11. "You are caring for an 82-year-old patient admitted with pneumonia. They are frail, have poor appetite, and are at high risk of falls. Discuss the nursing assistant's role in maintaining the patient's safety and preventing complications during their hospital stay." (15 marks)

Extended Response Model Answer (Question 11 — 15 marks)

Introduction (1–2 marks)

• The patient (82, pneumonia, frail, poor appetite) is at high risk of complications: pressure injuries, falls, dehydration, functional decline

• As an AIN, my role under RN delegation is to maintain safety, prevent complications, and support independence

Body Paragraph 1 — Falls Prevention (3–4 marks)

• Use STRATIFY tool (with RN) to identify risk factors: age >65, frailty, acute illness

• Environmental strategies: bed in lowest position, call bell within reach, clear pathways, non-slip socks

• Supervised mobilisation: assist with walking to bathroom, use walking aid if needed

• Hourly rounding: check if patient needs assistance with toileting (urgency + weakness = high fall risk)

Body Paragraph 2 — Pressure Injury Prevention (3–4 marks)

• Braden risk assessment: immobility + poor nutrition + moisture (fever/sweating) = high risk

• Reposition every 2 hours using 30° lateral tilt, inspect skin daily — focus on sacrum, heels, elbows

• Use pressure-relieving mattress, heel protectors

• Moisture management: keep skin clean and dry, barrier cream

• Encourage food and fluid intake — assist with meals, document percentage eaten

Body Paragraph 3 — Infection Prevention and Observation (3–4 marks)

• Monitor vital signs: temperature, SpO₂, RR — report any deterioration (MET criteria)

• Standard precautions: hand hygiene before/after care, PPE as needed

• Encourage oral hygiene (pneumonia patients at risk of aspiration)

• Monitor for signs of deterioration: increased RR, decreased SpO₂, confusion (delirium in elderly)

Body Paragraph 4 — Communication and Independence (2–3 marks)

• Provide clear explanations, calm reassurance — elderly patients may be anxious

• Encourage independence in ADLs: allow patient to do what they can, assist only where needed

• Involve patient in decisions: "Would you like to sit up for your meal?"

• Use active listening, check understanding

Conclusion (1–2 marks)

• AIN plays a vital role in preventing complications through diligent observation, safe care, and clear communication with RN

• Person-centred, safety-focused care improves outcomes for elderly patients in acute settings

Exam Preparation — Final Checklist

Must-Know Normal Ranges (Memorise)

Must-Know Acronyms

Command Terms — What They Want

Common Pitfalls to Avoid

1.    Not reading the question — answering what you studied, not what was asked

2.    Not using industry terminology — use "standard precautions", "client-centred care", "duty of care"

3.    Giving vague answers — be specific: "Reposition the patient every 2 hours" not "Turn them regularly"

4.    Mixing up normal ranges — memorise them cold

5.    Running out of time — allocate time per mark (roughly 1 minute per mark)