CAREER OPPORTUNITY IN NURSING : 07/10/23

Monday, July 10, 2023

Bloodborne pathogen
Bacteria or virus in the human blood and body fluids that can cause disease

Disinfection
The process of cleaning something to remove all germs, with exception of spores

Exposure

Coming in contact with or not having protection from something

Hand hygiene

Washing hands with soap and water or with alcohol-based rubs to prevent the spread of germs or bacteria

Infection control breach

When there is a break in following established infection control procedures that prevent the spread of germs

Mucous membranes

The moist, inner tissue of the eyes, nose, or mouth

Non-critical items

Medical equipment that comes in contact with intact skin

Other potentially infectious materials (OPIM)

Human body fluids that can spread infection from one person to another through direct or indirect contact

Source person

The person involved in the exposure to the healthcare worker

Standard precautions

Guidelines developed for healthcare workers to help prevent and reduce the spread of bacteria

Sterilization

The process of making something free of germs and spores

What is a bloodborne pathogen?

Bloodborne pathogens are bacteria and viruses that can be found in human blood. They may also be in other fluids in the body.

Those other fluids are called other potentially infectious materials (OPIM).

HIPPA

This module will review the following:

The Privacy Rule
The required Notice of Privacy Practices
Specific rights of people that are protected by the Privacy Rule

If there is reason to believe that information can be used to identify someone, it should be protected.

Notice of Privacy Practices

All people receive a Notice of Privacy Practices (NPP). It tells them how the facility uses or shares their PHI with others. The NPP describes the facility’s duty to protect privacy. It explains their rights as people being cared for by the facility. If they have questions or wish to make a complaint, the NPP also includes contact information for the person who can help

In certain circumstances, people have the right to ask to whom their PHI has been disclosed. This is their right to an accounting of disclosures. People can request a report on when and why their health information was shared. The facility provides a written report of disclosures. The report includes the following:

    When the facility shared the PHI
    Who received the PHI
    What PHI the facility shared
    Why the facility shared the PHI

This request is related to the use and release of health information that was not for care, payment, or facility operations.

People can request a report for up to the last six years. The facility provides the report within 60 days of the request. The NPP describes the steps to request a report. The NPP also includes the name of the person to contact to request a report. The facility provides the first report within a year for free. They can charge for additional reports within the same 12-month period.

Confidential communication
Paper documents with a shield and lock on top of them.

People can tell a facility how to contact them. This is the right to confidential communication. A person may not want their family to know about a health issue.

The individual tells the facility how to communicate with them. The facility needs to use the number or address the individual requests.

Filing a complaint

If a person believes their rights have been denied or their health data is not safe, they can:

File a complaint with their provider or health insurer.
File a complaint with the Office for Civil Rights.

The NPP explains whom to contact so that complaints can be addressed quickly. It is important that healthcare workers learn what is in the NPP. It will state who is responsible for handling privacy complaints at the facility.

To ensure appropriate use of Neutral Spine Precautions for patient mobility.

Description

To ensure appropriate use of Neutral Spine Precautions for patient mobility.
Behavioral Criteria

It is expected that all staff will gather all necessary equipment, perform effective hand hygiene, don appropriate personal protective equipment, identify patients using two appropriate patient identifiers, and explain procedures to patients and family members, as appropriate, before beginning any skill or procedure.

Nurse has reviewed appropriate reference procedure/protocol for this skill/equipment and verbalizes understanding.

Identifies components of Neutral Spine Principles (NSP); including keeping shoulders, hips and knees in line during all activities and positioning

    No bending over/stooping, no bending sideways or backwards
    No reaching arms behind / across body;
    No arching or bridging back
    No twisting / turning shoulders to reach or look behind body
    No raising knees higher than hips when sitting / standing
    Keep legs in symmetrical position when resting or still.
    Limit sitting time to no more than 30 minutes or per provider order
    No lifting anything heavier than your walker or approximately 3 pounds, or per provider order
    No walking without your walker until cleared by provider

Ensure patient demonstrates adherence to Neutral Spine Principles in all daily activities.
Notifies RN of any abnormalities
Documents Patient's tolerance and distance ambulated in the electronic health record.

Evidence of Achievement

    Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete

References

    White, C. C. IV, et al. (2014). EMS spinal precautions and the use of the long backboard: Resource document to the position statement of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma. Prehospital Emergency Care, 18, 306–314. Accessed April 2020 via the Web at https://tandfonline.com/doi/pdf/10.3109/10903127.2014.884197?needAccess=true (Level VII)
    The Royal Melbourne Hospital. (2015). “TRM08.04 management of the patient with spinal precautions” [Online]. Accessed April 2020 via the Web at https://www.thermh.org.au/sites/default/files/media/documents/clinical/TRM0804_0.pdf (Level VII)

CNA Care of the patient undergoing Bariatric Surgery

CNA Care of the patient undergoing Bariatric Surgery

    Additional Ratings

Description

Assists the professional nursing staff in caring for patient undergoing bariatric surgery
Behavioral Criteria

    Recognizes the increased potential for postoperative complications in bariatric surgery patients
    Monitors food and fluid intake
    Ensures compliance with small feedings
    Encourages modification in eating habits
    Reports noncompliance in food and fluid intake
    Provides routine post-op care and reports any abnormal finding to the nursing staff
    Attends sensitivity training in order to empathize with the patient
    Provides emotional support patient and family
    Anticipates patient's special need related to inability to move independently

Evidence of Achievement

    Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete

References

    Toolbox (Policy/Procedure)

        Musculoskeletal Injury Prevention Plan and Policy (MIPP)

        Care and Management of the Bariatric Patient


    Thiele, T., & Osterreicher, A. (2011). Caring for your bariatric patient: A resource guide to the literature on care of the morbidly obese. Bariatric Nursing & Surgical Patient Care, 6(1), 43-48
    Grindel, M., & Grindel, C. (2006). Nursing care of the person having bariatric surgery. MEDSURG Nursing, 15(3), 129-146
    Muir, M., Heese, G., McLean, D., Bodnar, S., & Rock, B. (2007). Handling of the bariatric patient in critical care: A case study of lessons learned. Critical Care Nursing Clinics Of North America, 19(2), 223-240

CNA Cardiac (Monitoring)

CNA Cardiac (Monitoring)

    Additional Ratings

Description

Cares for patient with continuous cardiac monitoring
Behavioral Criteria

Placing Electrodes on Patient:

    Prep skin: select a flat, non-muscular area, Clean skin , Remove hair using clippers ( do not use a razor)
    Apply electrodes- 5 lead
        White "Right" (Directly below the clavicle and near the Right shoulder)
        Black- "Smoke over fire" (Directly below the clavicle and near the Left shoulder) )
        Red- "Fire under Smoke" (Left Lower abdomen)
        Green- (Right Lower abdomen)
        Brown- ( On the 4th intercostal space at the right sternal border)
    Changes electrodes daily or more often, if needed to prevent irritation
    Assist in changing batteries when directed by nurse
    Report abnormal findings or alarms to nurse

Evidence of Achievement

    Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete

References

    Toolbox (Policy/Procedure)
        Cardiac Telemetry Monitoring
    Toolbox: How to Guides to Technology Systems & Devices
    Critical Care Nursing Clinics of North America. (2006). Practice Standards for ECG Monitoring in Hospital Settings: Executive summary and Guide for Implementation
    Heart Lung. (1991). Electrode Site Preparation Techniques: A Follow Up Study.

CNA Baseline Urinary Elimination

CNA Baseline Urinary Elimination

    Additional Ratings

Description

Assists professional nursing staff in caring for patients with urinary elimination needs
Behavioral Criteria

    Observes urinary elimination including frequency, odor, volume, amount and color
    Obtains urine specimens as directed (non sterile)
    Measures continuous bladder irrigation output as delegated by nurse
    Secures urinary catheter and maintains closed urinary drainage systems
    Maintains drainage bag below bladder, not touch floor, ensure tubing free of kinks.
    Apply initial Purewick to famales as delegated by nurse, then change Purewick as needed or once a shift. Keep suction between 40-60 mmHg degrees.
    Apply initial Condom catheter as delegated by nurse, then change as needed

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete
References

    Toolbox (Policy/Procedure)
        Care of the Patient with an indwelling cahteter
    Craven, H. (2009). Core curriculum for medical-surgical nursing . (4ed.). New Jersey: Academy Of Medical Surgical Nursing
    DiGiulio, M., Jackson, D., & Keogh, J. (2007). Medical-surgical Nursing Demystified. McGraw-Hill Professional
    Cayir, G., Beji, N., & Yalcin, O. (2007). Effectiveness of nursing care after surgery for stress urinary incontinence. Urologic Nursing, 27(1), 25-33

CNA Baseline Tubes & Drains

CNA Baseline Tubes & Drains

Additional Ratings

Description

Assists the professional nursing staff in caring for patient with tubes, drains, and pouches
Behavioral Criteria

Empties Jackson Pratt (JP) and Hemovac drains
Measures and Documents in Electronic Health Record (EHR)
output from JP,
Hemovac,
nasal gastric (NG),
colostomy, ileostomy, and/or
urinary drainage bags,

    Reports abnormal finding to nursing staff

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete
References

    Toolbox (Policy/Procedure)
        Patient safety Attendants (PSA)
    Carter,P. (2007). Lippincott's essentials for nursing assistants: a humanistic approach to caregiving. Philadephia: Lippincott Williams & Wilkins
    Hegner, B., Acello, B., Caldwell, E. (2008). Nursing assistant: a nursing process approach. Clifton Park, NY: Thomson Delmar Learning
    Frazer, C. (2012). Managing chest tubes. Med-Surg Matters, 21(1), 1
    Doenges, M. E., Moorhouse, M., & Geissler-Murr, A. (2008). Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care. F.A. Davis Company

CNA Baseline Tubes & Drains

CNA Baseline Tubes & Drains

    Additional Ratings

Description

Assists the professional nursing staff in caring for patient with tubes, drains, and pouches
Behavioral Criteria

    Empties Jackson Pratt (JP) and Hemovac drains
    Measures and Documents in Electronic Health Record (EHR) output from JP, Hemovac, nasal gastric (NG), colostomy, ileostomy, and/or urinary drainage bags,
    Reports abnormal finding to nursing staff

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete
References

    Toolbox (Policy/Procedure)
        Patient safety Attendants (PSA)
    Carter,P. (2007). Lippincott's essentials for nursing assistants: a humanistic approach to caregiving. Philadephia: Lippincott Williams & Wilkins
    Hegner, B., Acello, B., Caldwell, E. (2008). Nursing assistant: a nursing process approach. Clifton Park, NY: Thomson Delmar Learning
    Frazer, C. (2012). Managing chest tubes. Med-Surg Matters, 21(1), 1
    Doenges, M. E., Moorhouse, M., & Geissler-Murr, A. (2008). Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care. F.A. Davis Company

CNA Baseline Postoperative/Post Procedure Care

CNA Baseline Postoperative/Post Procedure Care

    Additional Ratings

Description

Assists the professional nursing staff in caring for the post-op patient
Behavioral Criteria

    Assist the patient out of bed to chair
    Encourages coughing and deep breathing exercises
    Encourages use of incentive spirometer
    Assists patient to ambulate
    Reports complaints of pain to nursing staff
    Reports patient's tolerance for increase in activity to nursing staff
    Reports significant decrease in urine output to nursing staff
    Applies sequential compression stocking as ordered
    Takes vital signs and documents in Electronic Health Record
    Reports changes in condition to nursing staff

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete
References

    Toolbox (Policy/Procedure)
        Prevention of Respiratory Complications with ICOUGH
    Carter,P. (2007). Lippincott's essentials for nursing assistants: a humanistic approach to caregiving. Philadephia: Lippincott Williams & Wilkins
    Hegner, B., Acello, B., Caldwell, E. (2008). Nursing assistant: a nursing process approach. Clifton Park, NY: Thomson Delmar Learning
    DiGiulio, M., Jackson, D., & Keogh, J. (2007). Medical-surgical Nursing Demystified. McGraw-Hill Professional

CNA Baseline Patient Hygiene

CNA Baseline Patient Hygiene

    Additional Ratings

Description

Provides Bathing/shower, oral hygiene , perineal and catheter care and linen change
Behavioral Criteria

    Assists with bed bath or assisted bath
    Assists patients with Medicated baths who have Central lines (includes PICC, Dialysis catheters and Mediports)
    Daily bed linen change (Top sheet, bottom/draw sheet, Pillow cases)
    Assist patient with medicated bath who is scheduled for surgery
    Assists patient with ADL, as permitted with focus on improved self care
    At a minimum, peri care/Foley Catheter care to be completed twice daily
    Cleans incontinent patients
    Changes wet or soiled linens
    Assists patient to brush teeth and/or clean dentures after each meal and bedtime
    Document care or refusal in the EHR

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete
References

    Toolbox (Policy/Procedure)
        Management of Patient Hygiene
        Nose to Toes Pre-Operative Decolonization Procedure
    Campbell, L., Gilbert, M. A., & Laustsen, G. R. (2010). Clinical Coach for Nursing Excellence. F. A. Davis Co
    King, P., & Crawford, D. (2009). Healthcare assistants in the children's intensive care unit. Pediatric Nursing, 21(1), 48-51
    BUTLER-WILLIAMS, C., JAMES, J., COX, H., & HUNT, J. (2010). The hidden contribution of the health care assistant: A survey-based exploration of support to their role in caring for the acutely ill patient in the general ward setting. Journal Of Nursing Management, 18(7), 789-795
    Conway, J., & Kearin, M. (2007). The contribution of the Patient Support Assistant to direct patient care: An exploration of nursing and PSA role perceptions. Contemporary Nurse: A Journal For The Australian Nursing Profession, 24(2), 175-188

CNA Baseline Patient Hygiene

CNA Baseline Patient Experience, including age related/cultural/religious considerations

CNA Baseline Patient Experience, including age related/cultural/religious considerations

    Additional Ratings

Description

Builds patient trust and confidence through effective communication and visible demonstration of staff teamwork Interacts with patient in a manner that is appropriate for developmental or chronological age to provide safe and effective care and communication Identifies cultural and religious needs of patient for individualized care
Behavioral Criteria



    General Considerations for Patient Centered Care:
        Receives report from off-going staff; ensures all members of patient team have received report, using ISBAR and bedside handoff
        Reviews and updates goals with patient using communication board in room.
        Maximizes perception of time spent with patients by speaking slowly with courtesy and respect, using eye contact, and giving patients time to ask questions or voice concerns
        Uses plain language; presents information in an appropriate and clear manner with an understanding of age-specific guidelines, cultural considerations, and culturally appropriate language; asks specifically about preferences and needs
        Displays respect and understanding for patient’s values and practices; makes effort to learn about patient needs and preferences, especially concerning healthcare treatment and ways of communicating/interacting
        Listens attentively; responds appropriately to patient/family requests, questions, and concerns; shows compassion and empathy
        Explains all tasks to be performed with/on patient so that patient understands what is happening and why and what is expected of him/her.
        Asks patient to describe using own words what has been taught about his/her health and care, i.e. activities, diet, medication and side effects, restrictions, etc.
        Engages and includes family members; recognizes their importance in patient’s care
        Stop to check on patient and respond to requests when a call bell is lit; participates in Purposeful Rounding schedule with healthcare team to anticipate patient needs.

    General Considerations for Age-Specific Care:

    Note: Chronological age may not reflect developmental age, especially in special needs patient population. Plan of care should be tailored to reflect specific needs of each patient.
        Recognizes vital signs, labs that are out of normal range for age of the patient. Responds as required
        Chooses equipment and supplies appropriate to patient’s age/size.

    General Considerations for Cultural and Religious Practices:
        Asks patient about any cultural or religious beliefs or practices that will affect the patient’s hospital stay, including practices the patient would like to continue, and communicates information to healthcare team
        Contacts spiritual advisors, as indicated by patient
        Asks patient about food preferences
        Asks patient about preferred language, whom to include in conversations and teaching and communication practices that should be avoided (eye contact, touching)
        Utilizes hospital's interpreting services whenever needed
        Asks open ended-questions, allowing ample time to answer
        Assures patient of healthcare team’s desire to understand patient’s needs and concerns
        Identifies resources to seek information about patient behavior related to their culture or religion
        Documentation reflects considerations and individualized interventions.

Evidence of Achievement

    Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete

References

References:

    Borenstein, K. MSN, RN, CCRN (Oct 2011). Bedside Report: A change project could result in improved patient and nurse satisfaction.” Advance for Nurses, Vol. 8, Issue 9, 24.
    Copeland, L., Desmond, J. (2000). Communicating with Today’s Patient: Essentials to Save Time, Decrease Risk, and Increase Patient Compliance. New Jersey: Jossey-Bass
    Shelton, Patrick J. (2000). Measuring and Improving Patient Satisfaction. New York: Aspen Publishing
    N.A. (2005). Improving Patient Safety through Informed Consent for Patients with Limited Health Literacy. National Quality Forum. Retrieved from: http://www.ethics.va.gov/ETHICS/docs/infocus/InFocus_20060401_Teach_Back.pdf
    N.A. (Nov/Dec 2005). Case Study: Improving Medication Compliance – One hospital targets patient education, medication compliance, and medication reconciliation. The Joint Commission Benchmark, Vol. 7, No. 6, 4-10.

CNA Baseline Oxygen Therapy

CNA Baseline Oxygen Therapy

    Additional Ratings

Description

Assists the professional nursing staff in the caring for patient with oxygen therapy
Behavioral Criteria

    Recognizes abnormal respiratory patterns and reports to the nursing staff
    Encourages the patient to cough and breathe deeply
    Maintains nasal cannula and simple face mask
    Obtains and reports pulse ox
    Recognizes hypoxia and abnormal respirations
    Assists patients with oxygen therapy safely for turning and moving
    Safe transport of patient- ensures portable oxygen tank is full (greater than or equal to 1500 PSI) switches wall oxygen to portable tank at arrival of transporter

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete
References

    Toolbox (Policy/Procedure)
        Patient Care- Oxygen Administration in the Adult Patient
    Hegner, B., Acello, B., Caldwell, E. (2008). Nursing assistant: a nursing process approach. Clifton Park, NY: Thomson Delmar Learning
    Craven, H. (2009). Core curriculum for medical-surgical nursing . (4ed.). New Jersey: Academy Of Medical Surgical Nursing
    Woodrow, P. (2007). Caring for patients receiving oxygen therapy. Nursing Older People, 19(1), 31-36
    McGloin, S. (2008). Administration of oxygen therapy. Nursing Standard, 22(21), 46-48

CNA Baseline Nutrition Feeding

CNA Baseline Nutrition Feeding

    Additional Ratings

Description

Participates in meeting the nutritional needs of patients with feeding difficulty
Behavioral Criteria

    Assists or feeds patient who is unable to feed self
    Observes for coughing, choking and reports observations to nurse
    Arranges food in relation to numbers on a clock if patient is visually impaired
    Records calorie count
    Reinforces swallowing precautions
    Documents Percent taken of meals in Electronic Health Record.

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete
References

    Toolbox (Policy/Procedure)
        Plan for Provision of Nursing Care
    Carter,P. (2007). Lippincott's essentials for nursing assistants: a humanistic approach to caregiving. Philadephia: Lippincott Williams & Wilkins
    Hegner, B., Acello, B., Caldwell, E. (2008). Nursing assistant: a nursing process approach. Clifton Park, NY: Thomson Delmar Learning
    Simmons, S. (2007). Quality improvement for feeding assistance care in nursing homes. Journal Of The American Medical Directors Association, 8(3), S12-7

CNA Baseline Lab Specimen Collection and Labeling

CNA Baseline Lab Specimen Collection and Labeling

    Additional Ratings

Description

Demonstrates appropriate technique when acquiring lab specimens
Behavioral Criteria

    Identifies patient using two patient identifiers and verifies orders for sample
    Utilizes computerized barcode labeling system to collect & label specimens at bedside
    Uses appropriate specimen collection receptacle

    During down times, labels specimen at the bedside, in the presence of the patient, including time and date of collection, own initials, and source of specimen, if non-blood
    Prepares/transports specimen to appropriate place, ensuring specimen is in labeled, sealed biohazard container/bag with appropriate paperwork

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete
References

    Toolbox (Policy/Procedure) Speciment Collection utilizing Soft ID
    Toolbox: How to Guides to Technology Systems & Devices
    Becton, Dickinson and Company. (2004). "Midstream clean catch urine procedure" [Online]. Accessed April 2020 via the Web at http://legacy.bd.com/resource.aspx?IDX=11181
    Craven, R. F., et al. (2017). Fundamentals of nursing: Human health and function (8th ed.). Philadelphia, PA:Wolters Kluwer
    MedlinePlus. (2017). "Clean catch urine sample" [Online]. Accessed April 2020 via the Web at http://www.nlm.nih.gov/medlineplus/ency/article/007487.htm
    Sharma, L. (2018). Evidence summary. Fecal specimen: Collection and assessment. The JBI EBP Database. AN: JBI211

CNA Baseline Infection Control

CNA Baseline Infection Control

    Additional Ratings

Rater
Huang, Judy C
Not Yet Rated
Peer
Nurse, Nurse
Not Yet Rated
Description

Adheres to infection control practices
Behavioral Criteria

    Demonstrates knowledge of medical asepsis and contamination
    Demonstrates appropriate hand washing
    Implements Standard Precautions to reduce the risk of pathogens
    Utilizes personal protective equipment
    Wears gloves when touching blood, body fluids, secretions, excretions and contaminated items
    Changes gloves between tasks and procedures
    Handles used equipment per organization policy
    Transports and handles linen that is soiled as per organization policy
    Prevents injuries when handling and cleaning sharp instruments after procedures

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete
References

    Toolbox (Policy/Procedure)
        Infection MRSA, C-Diff
    Infection Control Flip Guide
    Rowley, S., Clare, S., Ruffell, A., & Beer, J. (2010). High impact actions: fighting infection. Nursing Management - UK, 17(6), 14-19
    Lewis, K., & Thompson, J. (2009). Health care professionals' perceptions and knowledge of infection control practices in a community hospital. Health Care Manager, 28(3), 230-239
    Hegner, B., Acello, B., Caldwell, E. (2008). Nursing assistant : a nursing process approach. Clifton Park

If certain equipment is NOT used in practice area, please indicate this exception(s) in Comment section.

CNA Baseline Equipment General Use

    Additional Ratings

Description

Safely and appropriately demonstrates use of all features listed for each piece of equipment (see Resources).
Behavioral Criteria

If certain equipment is NOT used in practice area, please indicate this exception(s) in Comment section.

    Vital sign Machine
    AED/Defibrillator
    Ambu bag
    Bladder scanner
    Low Air Loss Pump for Patient bed
    Vertical and horizontal patient transfer devices (hovermat, z-slider)
    Powered Air Purifier Respirator (PAPR)
    Safe Patient Handling Equipment- (Sara Steady, Sara Plus, Sky lift, etc.)

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete
Resources

    Link to clinical lift and transfer devices

References

     Toolbox (Policy/Procedure)
        Fall Prevention
        Musculoskeletal Injury Prevention Plan and Policy (MIPP)
        Safe Patient Handling
    Toolbox: How to Guides to Technology Systems & Devices

benefit link

https://flimp.live/El-Camino-Benefits-Showcase

CNA Baseline Duties as a Patient Safety Attendant (PSA)

CNA Baseline Duties as a Patient Safety Attendant (PSA)

    Additional Ratings

Description

Standard Duties of Patient Safety Attendant (PSA)
Behavioral Criteria

Get report from off-going PSA and nurse

Complete documentation for safety observations (activity, behaviors, interventions)

Try to keep patient on normal sleep/wake cycle

Wake patients, assist with toileting/diaper changes, oral care (open window blinds)

Have patient out of bed and performing activities as much as possible during daytime hours

Provide bedtime care (offer lavender lotion/oil, give sleep hygiene)

Collect vital signs at ordered times, report data to Nurse as soon as completed

Bathe patients

Prepare patient for meals including hand washing and sitting them up in the chair if appropriate

Ensure assistive devices in place (dentures, glasses, etc.)

Help patients who can’t feed themselves

Ambulate patients or turn patients

Provide toileting regularly, do not leave patient unattended in bathroom

Provide activity for confused patients (i.e. wheeling around the unit, using items from the GREAT kit)

Prepare and accompany patient for off unit procedures

Report any changes in baseline to the nurse

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete
References

    Toolbox (Policy/Procedure)
        Duties as a Patient Safety Attendant
        Handoff Communication
    Mezey, M. (2016). Decision-making and dementia. Try this: Best practices in nursing care to older adults with dementia, D9. Accessed April 2020 via the Web at https://consultgeri.org/try-this/dementia/d9decision2016r3.pdf

    The Joint Commission. (2020). Standard NPSG.07.01.01. Comprehensive accreditation manual for hospitals. Oakbrook Terrace, IL: The Joint Commission. (Level VII)
    World Health Organization. (2009). "WHO guidelines on hand hygiene in health care: First global patient safety challenge, clean care is safer care" [Online]. Accessed April 2020 via the Web at https://apps.who.int/iris/bitstream/handle/10665/44102/9789241597906_eng.pdf?sequence=1 (Level IV)
    National Institute on Aging, National Institutes of Health. (2017). "Talking with your older patient: Communicating with a confused patient [Online]. Accessed April 2020 via the Web at https://www.nia.nih.gov/health/communicating-confused-patient

CNA Baseline Collecting and documenting vital signs and measuring weight

CNA Baseline Collecting and documenting vital signs and measuring weight

    Additional Ratings

Description

Monitoring/Documenting Vital signs, pain level and patient measurements (weight, height, neck circumference)
Behavioral Criteria

Verify the identity of your patient, and explain that you are going to take their Vital Signs (Blood Pressure, pulse, temperature, oxygen saturation):

Blood Pressure:

    Position of patient -sitting or lying down, Legs kept uncrossed and remain quiet (no talking)
    Select the appropriate size cuff and apply it directly over the skin, above the elbow.
    Does not take blood pressure on Restricted Extremity, over an intravenous line (IV), injured or painful extremity.
    Obtain reading from display and document Systolic, Diastolic and Mean Arterial Pressure (MAP) in Electronic Health Record (EHR)
    Notify nurse of abnormal reading

Pulse Oximetry:

    Ensure patient hand is clean (no nail polish or false nails)
    Place oximetry probe onto one of the patient's fingers
    Obtain reading from display and document in EHR
    Notify nurse of abnormal reading

Respiratory Rate:

    Observe the patient as they breathe, and count each rise and fall of the chest as one respiration. Count the breaths for one minute.
    Record the respiration rate in the EHR.
    Notify the nurseif patient is having any difficulty with achieving regular deep breaths

Pulse:

    Obtain reading from display and document in EHR
    Notify nurse of abnormal reading

Temperature:

    Select appropriate placement for oral, axillary, or temporal to obtain temperature
    Obtain reading from display and document in EHR
    Notify nurse of abnormal reading

Pain Level:

    Obtain/document stated pain level from patient
    Notify nurse of pain level

Weighing Patient:

Standing scale

    Check that scale reads zero to ensure accurate measurement.
    Assist patient onto the scale and remain close to the patient to prevent falls
    Have the patient stand as still as possible for accuracy
    Obtain reading from display and document in the EHR
    Notify nurse if abnormal reading

Bed Scale

    Zero bed prior to weighing patient
    Weigh patient
    Obtain reading and document in the EHR

Measuring Neck Circumference

    Use paper measuring tape- place around patient's neck.
    Record measurement in cm in EHR.

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in EHR accurate and complete
References

    Toolbox (Policy/Procedure)
        Specimen Collection Utilizing Soft Id System

    Mohammad, Y., et al. (2010). "Clinical use of pulse oximetry: Pocket reference 2010" [Online]. Accessed January 2021 via the Web at https://www.networks.nhs.uk/nhs-networks/south-east-coast-respiratory-programme/documents/OximetryPG.pdf

    The Joint Commission. (2021). Standard NPSG.07.01.01. Comprehensive accreditation manual for hospitals. Oakbrook Terrace, IL: The Joint Commission

    World Health Organization. (2011). "Pulse oximetry training manual" [Online]. Accessed January 2021 via the Web at https://www.who.int/patientsafety/safesurgery/pulse_oximetry/who_ps_pulse_oxymetry_training_

    Hanlon, P. (2015). Patient monitoring: Oximetry enhances care. RT for Decision Makers in Respiratory Care, 28(2), 15–18.

    American Association of Critical-Care Nurses. (2016). "AACN practice alert: Obtaining accurate noninvasive blood pressure measurements in adults" [Online]. Accessed April 2020 via the Web at https://www.aacn.org/clinical-resources/practice-alerts/obtaining-accurate-noninvasive blood-pressure--measurements-in-adults

    Kallioinen, N., et al. (2017). Sources of inaccuracy in the measurement of adult patients’ resting blood pressure in clinical settings: A systematic review. Journal of Hypertension, 35, 421–441. [Online]. Accessed April 2020 via the Web at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5278896/

    Davie, A., & Amoore, J. (2010). Best practice in the measurement of body temperature. Nursing Standard, 24(42), 42–49.

    Geijer, H., et al. (2016). Temperature measurements with a temporal scanner: Systematic review and meta-analysis. BMJ Open, 6(3), e009509. Accessed April 2020 via the Web at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823400/

    Tipton, P. H., et al. (2012). Patient safety: Consider the accuracy of height and weight measurements. Nursing, 42(5), 50–52. Accessed April 2020 via the Web at https://journals.lww.com/nursing/Fulltext/2012/05000/Consider_the_accuracy_of_height and weight

CNA Baseline Bed and Chair Alarm Safety Features Copy

CNA Baseline Bed and Chair Alarm Safety Features Copy

Additional Ratings

Description

Demonstrates competency in use of safety features of bed and chair alarms
Behavioral Criteria

Bed features

Connect bed to power source
Operate bed functions including, brake, side rails, CPR function, height, and head/foot adjustments
Zero bed and utilize bed scale
Set bed alarm appropriate for level of activity of patient
Utilize iAwareness, when available

Chair alarm features

    Connect pad (single-patient use) to chair alarm
    At Mountain View Campus, connect auxiliary cord to nurse call panel
    Verbalizes that bed exit alarms and chair alarms will be utilized on all patients deemed to be High Fall Risk

Evidence of Achievement

    Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete

References

    Toolbox (Policy/Procedure)

        Patient Safety Visual Centralized Monitoring

        Fall Prevention

        Musculoskeletal Injury Prevention Plan and Policy (MIPP)
      Toolbox : How to Guides to Technology Systems & Devices

CNA Baseline Application of Non-Violent Restraints

CNA Baseline Application of Non-Violent Restraints

    Additional Ratings

Description

Assists professional nursing staff in caring for patients in restraints
Behavioral Criteria

    Implements alternative to restraints as delegated by nurse
    Applies soft restraints as directed by nurse
    Demonstrates securing devices using a quick release
    Observes for breathing, skin redness, color, temperature and reports observations to nurse
    Performs patients needs for elimination, hydration and safety are addressed while restraints are in use
    Demonstrates removal of restraint as directed by nurse
    Verbalizes understanding that vest restraints are used only in CCU-MV

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete

Admission and Discharge

CNA Baseline Admission/Discharge/Transfer

    Additional Ratings

Description

Assists the nurse in preparing for patient admission/discharge/transfer
Behavioral Criteria

Admission:

    Verifies if the patient is arriving via wheelchair or stretcher
    Ensures room has been cleaned and admission bed is ready
    collects admission kit and arranges IV pole, patient gown, equipments for checking vital signs, suction, etc.
    Places bed in appropriate position
    Places call bell in reach
    Greets the patient by name
    Accommodates patient family
    Provides for privacy
    Completes and Documents personal belongings on arrival in Electronic Health Record (EHR)
    Obtains and documents vital signs on arrival in EHR
    Assists patient with clothing change
    Orientates patient and family to room, bed and unit
    Provides information about TV controls, visiting hours policy, meal times, etc.
    Notifies the nurse about any abnormal findings

Discharge and Transfer:

    Assist patient with clothing
    Completes and Documents personal belongings in Electronic Health Record (EHR)

Evidence of Achievement

Direct observation of competency in all areas through patient care or simulation / case study; documentation in electronic health record accurate and complete
References

    Toolbox (Policy/Procedure)

        Patient Safety Visual Centralized Monitoring; Handoff Communication

        Management of Patient Belongings and Valuables

        Patient Safety Visual Centralized Monitoring

    Conway, J., & Kearin, M. (2007). The contribution of the Patient Support Assistant to direct patient care: An exploration of nursing and PSA role perceptions. Contemporary Nurse: A Journal For The Australian Nursing Profession, 24(2), 175-188
    Knibb W 2006 The Contribution of Assistants to Nursing: Report for the Royai College of Nursing London, Royal College of Nursing
    Waldie, J. (2010). Healthcare assistant role development: a literature review. Journal Of Advanced Perioperative Care, 4(2), 61-72
    Hopkins S, Hughes A, Vaughan P 2007 Primary healthcare. Healthcare assistants in general practice: Delegation and accountability Primary Healthcare 17 (1)1-10

PHI test

Congratulations, you passed this test!
Question 1 of 5 Correct
Select the best answer: Protected health information (PHI) is data about a person and the healthcare they have received. What does the HIPAA Privacy Rule say about PHI?
Your Answer
Keep PHI private from people unless the Privacy Rule allows them to see it.
Feedback
Protected health information (PHI) should be kept private from other people unless the Privacy Rule allows them to see it.
Question 2 of 5 Correct
Fill in the blank: There are a few times when covered entities (CEs) can use and disclose protected health information (PHI) without permission from the person. One example of this is when __________.
Your Answer
Other providers need to give treatment.
Feedback
There are times when other providers giving treatment to the person will need their PHI. Other examples include when others might be at risk of harm and also for the purpose of submitting claims for payment.
Question 3 of 5 Correct
Fill in the blank: A healthcare worker observes a visitor looking through a person's medical file. This breach should be reported ______________.
Your Answer
Right away
Feedback
A breach should be reported right away to a manager, the privacy officer, or the compliance hotline or other reporting portal.
Question 4 of 5 Incorrect
Select the best answer: Administrative safeguards help covered entities (CEs) know when they can share protected health information (PHI). What is a safeguard that a CE may use?
Your Answer
Put guardrails around high platforms.
Correct Answer
Have a set of rules for the CE.
Feedback
An example of an administrative safeguard for CEs is having a set of rules or policies and procedures to run the facility.
Question 5 of 5 Correct
Select the best answer: What can a healthcare worker do to make sure the person who speaks little English knows how their protected health information (PHI) will be used?
Your Answer
Provide a copy of the Notice of Privacy Practices (NPP) in their preferred language.
Feedback
Healthcare workers should provide a Notice of Privacy Practices (NPP) the first time a person receives a service. It should be provided in the person's native or preferred language.

Reporting a breach right away will help a facility figure out if there are any risks. It will also help meet the deadlines for telling the affected people and the regulatory authorities.

The Breach Notification Rule says CEs have to report breaches. If there is a breach, a facility will need to do the following:

More than 500

If more than 500 people are affected, the CE has to let the local media know. This also has to be done within 60 days of the breach being discovered.

Report to HHS

For any number of breaches, a CE has to tell the Secretary of the U.S. Department of Health and Human Services (HHS). There is a form on the HHS website that has to be sent. If there are over 500 people affected, HHS has to be told within 60 days of a breach. Breaches affecting less than 500 people have to be reported within 60 days of the end of the calendar year.

The CE has to document all breaches. It also has to keep proof that the required notifications were made. Other responsibilities of the CE include the following:

Having a policy and procedures regarding breach notification
Training employees in HIPAA policy and procedures
Holding staff accountable if breach policy and procedures are not followed

If a staff member thinks there has been a breach of PHI, how soon should they report it?

Report it one month later.

Correctly unselected

Report it at their performance review three months later.

Correctly unselected

Report it right away.

Correctly selected

Report it only when someone asks them if they noticed anything.

This module has reviewed the following about the Privacy Rule:

The Notice of Privacy Practices

The rights of people being cared for

Extreme risk protection orders

The Breach Notification Rule

Sometimes a staff member may not be sure if something is a breach.

Sometimes a staff member may not be sure if something is a breach. However, it has to be reported right away, even if the person is not certain. The facility's policy and procedures for reporting should be followed.

Here are possible ways to report a breach:

Telling a manager

Telling the privacy officer

Calling the compliance hotline or similar HIPAA reporting portal

PHI and Rights

Protected health information is data about a person and the healthcare they receive. It should be kept private from other people unless the Privacy Rule allows them to see it or the person agrees to share it.

PHI includes individually identifiable health information created or received by a covered entity (CE). It is personal data that is spoken, written, or in electronic form.

Individually identifiable health information relates to any of the following:

A person's past, present, or future physical or mental health or condition

Any healthcare given to a person

The past, present, or future payment for healthcare given to a person

Provide an NPP the first time they provide a service. If not in person, provide the NPP electronically.
Have the individual respond in writing that they received the NPP.
Post the NPP in an easily seen area and provide a copy when asked. Provide in different languages as needed.
Update the NPP when the law or policies change. Make updates available to all individuals receiving care.

The Privacy Rule explains how to follow the law when using, sharing, and protecting PHI.

There are only certain circumstances when a mental health professional is allowed to share a person's mental healthcare notes without the person giving their approval.

An individual has the right to decide if they want to be in the facility directory. If they decide not to be in the directory, then no one can give out their data.

A mental health professional documents mental healthcare notes during a counseling session. The notes are for the professional's personal use. They are not used for any other purpose.

Information in a person's medical record includes their diagnosis, symptoms, treatment plan, etc. This information can be shared according to the Privacy Rule.

There are times when CEs can use and disclose PHI without permission from the individual:

The minimum necessary standard

The Privacy Rule includes the minimum necessary standard. This standard says that a CE has to do its best to use, disclose, and request only the minimum amount of PHI to meet the purpose of the use, disclosure, or request.

CEs have policies and procedures in place to limit uses and disclosures to the minimum necessary. Healthcare staff should refer to their policies and procedures for guidance before sharing data.

Access to PHI is restricted based on a person's job within their organization. Healthcare workers should only access the PHI they need to do their job.

Healthcare staff should share only the minimum necessary data. If anyone has a question about it, they should speak to their manager or the privacy officer.

Reasonable reliance

All CEs have to follow the minimum necessary standard. Because of this, it would make sense that a CE (e.g., a lawyer who is a business associate) would know to only ask for the minimum necessary data. However, they may simplify a request by asking for an entire medical record instead of just the parts they need.

It is good practice to ask them if they need certain identifiers in the data they request. These include data like dates of birth or Social Security numbers. If they do not need them, they should be removed. This will help meet the minimum necessary requirement. This will also ensure both CEs are in compliance.

De-Identification of PHI

Healthcare data is studied and compared to help improve healthcare and outcomes. To do this, data about people from many healthcare organizations may be collected and analyzed. The de-identification standard tells organizations which data should be removed from PHI. This helps protect each person's privacy during this process.

There are two ways that a person's identifying data can be removed:

A qualified expert such as a scientist can determine if data is free of identifying information.
Use the safe harbor method, which is the removal of a list of data that might identify a person.
Extreme Risk Protection Orders
An extreme risk protection order (ERPO) is a court order that stops a person who can cause harm from getting guns. This person might put themselves or others in danger.
Police, family members of the individual, and healthcare providers might need PHI to ask a court for an ERPO.
Here are some examples of when a healthcare provider would be allowed to share PHI for an ERPO:
A CE gets a court order asking for PHI to support an ERPO. The CE can only share the PHI approved by the court order.
A person wants an ERPO because their spouse talked about shooting them with a gun. Their spouse has been getting mental healthcare. The Privacy Rule allows the therapist to share the minimum necessary PHI to support the ERPO.
A CE can provide PHI for an ERPO application in response to the following:
Court orders
An administrative tribunal
A legal group that settles conflicts between individuals and the government
A subpoena
A document ordering a person to show up in a legal court
Breaches
A breach is when someone gets, looks at, or shares PHI with others against HIPAA rules. Breaches harm the security or privacy of PHI. Examples of breaches include the following:
A healthcare worker's car was broken into while they were in a store, and their work laptop was stolen.
A healthcare worker talks about a person in their care while in front of other people in their care.
A healthcare worker faxes parts of a medical record to the wrong number.
A set of rules to run a business, called policies and procedures
A policy that makes sure a CE does not discipline someone who makes a complaint
Instructions for making a complaint
A person who makes sure people follow the Privacy Rule
Training for the staff
An explanation of what to do when someone does not follow the rules
A way to deal with anything bad that happens from sharing PHI
Ways to keep data safe
When a breach occurs, a facility determines if it puts a person at risk or not. These three exceptions to the definition of breach help organizations figure this out:
When a staff member or someone working for a covered entity or business associate (BA) accidentally gets, sees, or uses PHI in good faith and within their authority
When someone who is allowed access to PHI by a CE or BA accidentally discloses PHI to another person who also is allowed access by the CE or BA, as long as the PHI is not further used or disclosed against the Privacy Rule
When PHI is disclosed to a person who is not allowed access, but the CE or BA believes in good faith that the person who received it would not be able to retain the information
A staff member receives and opens an internal email from a nurse containing an individual's PHI. The nurse sent this email to the staff member by mistake. The staffer realizes the email has been sent by mistake, deletes it, and tells the nurse sender.
A nurse speaking on phone and using a computer.
n example:
A staff member receives and opens an internal email from a nurse containing an individual's PHI. The nurse sent this email to the staff member by mistake. The staffer realizes the email has been sent by mistake, deletes it, and tells the nurse sender.
In this situation, the privacy officer may say that the person whose PHI was breached does not need to be told. This is because the staff member:

Was allowed to access the PHI.
Recognized it was not meant for them to see.
Lessened the risk by deleting the message and telling the nurse who sent it.
In this situation, the privacy officer may say that the person whose PHI was breached does not need to be told. This is because the staff member:
Was allowed to access the PHI.
Recognized it was not meant for them to see.
Lessened the risk by deleting the message and telling the nurse who sent it.

When a breach occurs, a facility determines if it puts a person at risk or not. These three exceptions to the definition of breach help organizations figure this out:

A person pointing at something on a computer screen as they speak on a phone.

A discovery request
A legal document to request a person to hand over certain data

Other legal action

A family member is worried because a person talked about taking a gun to work to shoot their boss. The therapist knows that the person has a gun and agrees that the person could cause harm. The therapist applies for an ERPO. The Privacy Rule allows the therapist to warn people right away about a threat.

A CE gets a court order asking for PHI to support an ERPO. The CE can only share the PHI approved by the court order.

HIPPA right Privacy Rules

This module will review the following about the Privacy Rule:

The Notice of Privacy Practices

The rights of people being cared for

Extreme risk protection orders

The Breach Notification Rule

Accountable

When someone has to do something or will be disciplined for not doing it

Authority

Being allowed to do something

Business associate (BA)

A person or entity that performs activities on behalf of, or provides certain services to, a covered entity

Court order

A requirement from a judge to do or not do something

Covered entity (CE)

Health plans, healthcare clearinghouses, and any healthcare providers that transmit health information in electronic form

De-identify

To remove data from a person’s record so they cannot be identified

Disclosure

Sharing private information

Electronic medical record (EMR)

The digital record of a person’s health history

Exception

Something that is not included

Health Insurance Portability and Accountability Act (HIPAA)

The law that says how protected health information can be used and shared

Mental healthcare

Services for emotional, psychological, and social well-being

Therapist

A person skilled in a certain kind of therapy or treatment

Pages

Monday, July 10, 2023

Notice of Privacy Practices

More than 500

Report to HHS

Reasonable reliance

De-Identification of PHI

Extreme Risk Protection Orders

Here are some examples of when a healthcare provider would be allowed to share PHI for an ERPO:

Breaches

A staff member receives and opens an internal email from a nurse containing an individual's PHI. The nurse sent this email to the staff member by mistake. The staffer realizes the email has been sent by mistake, deletes it, and tells the nurse sender. A nurse speaking on phone and using a computer.

n example:

A staff member receives and opens an internal email from a nurse containing an individual's PHI. The nurse sent this email to the staff member by mistake. The staffer realizes the email has been sent by mistake, deletes it, and tells the nurse sender.
A nurse speaking on phone and using a computer.