Prescribed curriculum part A. Common curriculum with personal support specialist




НазваниеPrescribed curriculum part A. Common curriculum with personal support specialist
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PRESCRIBED CURRICULUM OF NURSING ASSISTANT TRAINING PROGRAMS


Approved by the Maine State Board of Nursing

September 2008

CONTENTS


INTRODUCTION 3


HOW TO USE THIS MANUAL 5


PHILOSOPHY 6


COURSE OBJECTIVES 7

PRESCRIBED CURRICULUM

Part A. COMMON CURRICULUM WITH PERSONAL SUPPORT SPECIALIST

Unit I: Entering the Health Care and Human Service Fields 8

Unit II: Basic Work Skills and Job Maintenance 13

Unit III: Legal and Ethical Aspects of Care 16

Unit IV: Communication 24

Unit V: Observation, Reporting, and Documentation 28

Unit VI: Health, Safety, and Fire Prevention 32 _____________________________________________________________________


Part B. SPECIFIC TO THE NURSING ASSISTANT


Unit VII: Becoming a Certified Nursing Assistant (CNA) 40


Unit VIII: Infection Control 45


Unit IX: Patient Environment 49


Unit X: Caring for the Patient 52

A. Introduction to Anatomy and Physiology 53

B. Caring for the Patient’s Skin 53

C. Caring for the Patient’s Skeletal System 56

D. Caring for the Patient’s Muscular System 58

E. Caring for the Patient’s Gastrointestinal System 60

F. Nutritional Needs of Patients 62

G. Caring for the Patient’s Respiratory System 64

H. Caring for the Patient’s Cardiovascular System 66

I. Vital Signs 69

J. Caring for the Patient’s Endocrine System 71

K.Caring for the Patient’s Urinary System 72

L. Caring for the Patient’s Nervous and Sensory Systems 74

M. Caring for the Patient’s Reproductive System 76

Unit XI: Care of the Patient in Special Settings 79

A. Care of the Patient with Unique Needs/Mental Health 80

B. Care of the Pediatric Patient 82

C. Care of the Preoperative and Postoperative Patient 84

D. Care of the Geriatric Patient 86

E. Care of the Patient in Home Setting 89


Appendices

A. Examples of Patient Observations 91

B. Skills Checklist 94

C. Examples of Abbreviations 101

D. Maine Health Occupations Education Association (MHOEA) Admission

Retention Dismissal Policy 103


Bibliography 108


INTRODUCTION


In 1987, the Maine State Legislature authorized the Maine State Board of Nursing to prescribe a curriculum for the training of nursing assistants. In December 1988, the Board voted unanimous approval of this curriculum. In 1998 a review and update of the curriculum was conducted by an advisory committee. In June 1999, the Board reviewed the proposed revision to the curriculum and on October 7, 1999 the Board voted to accept the curriculum. In January 2003, the curriculum was reordered. Units I-VI coincide with the Personal Support Specialist (PSS) curriculum part I. The Prescribed Curriculum For Nursing Assistant Training Programs is available through the Maine Department of Education to program instructors in Maine or from the Maine State Board of Nursing. The Introduction to Health Care and Human Services for the Patient Support Specialist (PSS) and Certified Nurses Assistant (CNA) Training Program (Units I-VI is available through the Department of Education, Maine State Board of Nursing, and the Department of Health and Human Services. The curriculum is generic in nature and is designed to prepare the student to provide basic nursing assistance under the supervision and delegation of a registered professional nurse. Basic skills learned will enable the certified nursing assistant to do the following:


1. Maintain a proper physical and emotional patient environment

2. Report and record observations

3. Provide assistance in personal hygiene

4. Assist with body movement and ambulation

5. Assist with nutrition and elimination

6. Assist with emergency situations

7. Communicate in an effective, positive manner

8. Assist the registered professional nurse to provide general patient care.


The registered professional nurse (RN) may delegate to a nursing assistant/student only those tasks for which the individual has been satisfactorily prepared to accept, as documented by the instructional staff.


It is the responsibility of the professional instructor to remain current on federal and state laws and rules and regulations, applicable to training and certifying nursing assistants. Refer to the OBRA regulations Federal Register 42 CFR parts 431, 433and 483 Medicare and Medicaid

Programs: Nurse Aide Training and Competency Evaluation Programs and Chapter 5 Rules and Regulations of the Maine State Board of Nursing


It is hoped that this standardized approach to programming will improve the quality of educational programs preparing nursing assistants and ultimately be reflected in improved quality of patient care.


Upon successful completion of this program and an evaluation of competency through testing, the nursing assistant will be issued a standardized certificate of training by the educational program, which will keep a record of all certificates issued for at least 3 years.


The curriculum will be made available upon request to all approved agencies and facilities offering educational programs to prepare certified nursing assistants. Additionally, loan resources, including audiovisual aids, will be made available through the Curriculum Resources Center at United Technologies Center in Bangor.


The quality of educational programming ultimately rests with the professional nurse instructor, who is legally responsible for the administration and supervision of the program.


The Maine State Board of Nursing is grateful to all those who gave unselfishly of their time and effort in developing, editing, and designing this manual. The Board extends a special thank you to those who served on the advisory committees established by the Board to develop and revise and update this curriculum.


The Prescribed Curriculum for Nursing Assistant Training Programs Advisory Committee

March 2008


Diane Dalton, R.N.C., Chair Anne Ambler-Cote, R.N., DNS

Mid Coast Senior Center Greenwood Center

Brunswick, Maine Sanford, Maine


Marian Rector, R.N. Instructor Roanne S. Seeley, R.N. Consultant

Mid Coast School of Technology Maine Department of Education

Rockland, Maine (until March 31, 2007) currently

employed by

Acadia Health Education Coalition

Bangor, Maine


Lisa Harvey-McPherson, R.N. Gail Defiore, R.N., Instructor

EMMC-Rosscare Maine Medical Center

Home Health Care Portland Adult Education


Carol Cole R.N. Virginia deLorimier, R.N.

Denise Osgood, R.N. Assistant Executive Director

Division of Licensing and Certification Maine State Board of Nursing

C N A Registry

HOW TO USE THIS MANUAL


This manual includes program objectives, unit objectives, and a content outline. Policies pertaining to attendance, grading, progression, and retention shall be developed by the instructor and made available in writing to the students upon admission. A copy of the MHOEA policy is included in this document as a resource beginning on page 106.


The minimum hours for this curriculum shall be:


Theory 90 hours

Skills laboratory 20 hours

Clinical 70 hours

Total 180 hours


The instructor responsible for the delivery of the program shall be a currently licensed registered professional nurse in the State of Maine with demonstrated competence in teaching techniques. Contact the Department of Education for information on the Train the Trainer Programs for CNA instructors. Members of other disciplines may assist in teaching the C NA program as necessary and desirable. Tools for evaluating student performance in the skills laboratory and in the clinical setting shall be developed by the instructor. There are five texts that are recommended for use with this curriculum. The test must up to date and no less than 5 years old.You may request one text from each of the textbook companies. When you have made a decision on the appropriate one, order the instructor’s guide that will provide you with lesson plans, activities, exams, etc. Many of the guides are on CD and are easy to use. Often they will include powerpoint presentations that will make the didactic more meaningful to the student. The texts that are recommended are:

Essentials for Nursing Assistants, Pamela J. Carter, RN, Med, Lippincott, Williams, and Wilkins

Nursing Assistant: A Nursing Process Approach, Barbara Hegner, Barbara Acello, Esther Caldwell, Cengge Learning/Delmar

Being A Nursing Assistant, Francie Wolgin, Brady/Prentice Hall

Being A Nursing Assistant, Sheila A. Sorrentino, Elservier Mosby/Saunders

The Effective Nursing Assistant, Ruth Ann Stratton, Roanne Mancari, Glenco/Mcgraw Hill


The clinical instructor/student ratio shall be no greater than one instructor for every ten students. However the ideal clinical instructor/student ratio is one to one, and this ratio may be at times necessary for adequate learning and safe patient care.


All objectives must be met to successfully complete this course. All skills must be demonstrated, and the student must perform return demonstrations satisfactorily, either in the clinical setting or the skills laboratory.


It is recommended that a system of pass/fail be used in grading the skills laboratory portion of the course. The criteria necessary to pass each skill should be determined by the instructor and be available to the student prior to the skill test. Students are tested through direct observation by the instructor, who determines how many attempts the student should have for each test. Some students may need a one-to-one practice session. Makeup time for any missed classroom, skills laboratory, and clinical hours must be provided according to school policy.


This curriculum sets minimum standards. Units I through VI must be taught at the beginning of the program utilizing the accompanying Introduction to Health Care and Human Resources manual. Because the first 6 units of the curriculum are common to the PSS and C N A curricula, it is imperative that the 6 units are taught the way they are presented so that a student may choose to continue on the PSS or the CNA track.


Content in Units VIII through XI need not be taught in the order listed. Time should be added and emphasis made by instructor to highlight certain aspects of this portion of the curriculum. Nothing may be taught beyond the guidelines set forth in Chapter 5: Regulations Relating to Training Programs and Delegation by Registered Professional Nurses of Selected Nursing Tasks to Certified Nursing Assistants.

PHILOSOPHY


Nursing care is concerned with the basic needs of individuals, all of whom have physical, mental, spiritual, social, and cultural dimensions. The CNA with appropriate education and training, is capable of providing nursing care under the supervision and delegation of a registered professional nurse.


Learning involves the whole person, including his or her intellect, feelings, values, attitudes, and interests. Learning progresses from simple to complex and takes into consideration the past experiences that serve as a basis for new knowledge and understanding.


The instructor helps the student to fulfill the program’s objectives by creating a climate in which shared knowledge and the exposure of the learner to planned experiences will effect a change in the behavior of the student.


All efforts should be made to preserve the safety, dignity, individuality, privacy, and confidentiality of the patient.


The certified nursing assistant is a valuable member of the nursing team. The certified nursing assistant’s role is to assist the registered professional nurse in tasks that support nursing practice.


COURSE OBJECTIVES


Upon course completion the student will be able to:


1. Maintain a proper physical and emotional patient environment.


2. Report and record observations.


3. Provide assistance in personal hygiene.


4. Assist with body movement and ambulation.


5. Assist with nutrition and elimination.

6. Assist with emergency situations.


7. Assist the RN in providing general patient care.


8. Communicate in an effective and positive manner.


9. Demonstrate understanding of skills appropriate for the CNA.


Unit I


Entering the Health Care and Human Service Fields


Upon completion of this unit the student will be able to:


1. Describe the different kinds of health care and human service programs available to consumers.


2. Describe the important values in health care and human services.


3. Describe the scope of career options within the health care and human service systems (e.g., the types of employment available).


Unit I


Entering the Health Care and Human Service Fields


Objectives Content


1. Describe the different kinds of health care 1. Health care and human services in

and human service programs available to Maine consumers. A. Short-term care

1. acute care (hospitals)

a. definition

2. Same day surgery centers

B. Long-term care

1. Nursing facilities (NFs)

a. definition

b. services

i. 24-hour care

ii. consumer care

iii. personal care

2. Assisted housing programs

a. definition

b. services

i. residential care facilities

ii. assisted living programs

iii independent housing with services

3. Assisted housing services

a. personal supervision

b. protection from

environmental hazards

c. assistance with activities of

daily living (ADL) and

instrumental activities of

daily living (IADL)

i. ADL definition

ii. IADL definition

d. administration of medication

e. diversional, motivational, or

recreational activities

f. dietary services

g. nursing services

4. Home and community based

services

a. MaineCare Benefits

Objectives Content


i. home and community waivers

1. Describe the different kinds of health care b. in-home and community

and human service programs available to support services

consumers. (continued) i. description

ii. adult day services (ADS) iii. home health care services

iv. hospice care

v. personal support specialist (PSS)

vi. homemaker services

vii. respite care services

2. Regulating health care and human

services

A. The Maine Department of Health and

Human Services (DHHS)

1. Office of Maine Care Services

2. Office of Elder Services

a. Adult Protective Services

(APS)

b. home and community based

care services

i. home delivered meals

ii. outreach information and assistance

iii. transportation

iv. employment

v. volunteer services

vi. public education

vii. legal services

c. investigations of violations

d. regulates/licenses

i. assisted living

ii. residential care programs

iii. adult day care programs

B. Behavioral Health

1. Adult Mental Health

2. Adults with Cognitive and Physical Disability

3. Children’s Behavioral Health

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