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Questions and Answers
The two governmental levels that set standards for healthcare agencies are the ______ and state governments.
The two governmental levels that set standards for healthcare agencies are the ______ and state governments.
federal
An agency must meet standards for licensure, ______, and accreditation to operate legally and maintain its reputation.
An agency must meet standards for licensure, ______, and accreditation to operate legally and maintain its reputation.
certification
California Code of Regulations, specifically ______ 22, establishes minimum standards set for patient care in healthcare facilities.
California Code of Regulations, specifically ______ 22, establishes minimum standards set for patient care in healthcare facilities.
title
Title 22 provides regulations governing the Nurse Assistant Training Program, including Nurse Assistant ______ requirements.
Title 22 provides regulations governing the Nurse Assistant Training Program, including Nurse Assistant ______ requirements.
Skilled Nursing Facilities are required to have ______ and procedures in place to protect the rights and ensure the safety of their residents.
Skilled Nursing Facilities are required to have ______ and procedures in place to protect the rights and ensure the safety of their residents.
The Omnibus Budget Reconciliation Act, also known as ______, federal law established minimum training and competency evaluation requirements for nursing assistants working in nursing centers.
The Omnibus Budget Reconciliation Act, also known as ______, federal law established minimum training and competency evaluation requirements for nursing assistants working in nursing centers.
OBRA establishes standards of resident care for those using ______ and Medi-Cal reimbursement, focusing on individuals aged 65 years or older.
OBRA establishes standards of resident care for those using ______ and Medi-Cal reimbursement, focusing on individuals aged 65 years or older.
OBRA requires that nursing assistants receive training and pass a ______ exam within four months of being employed in a long-term care facility.
OBRA requires that nursing assistants receive training and pass a ______ exam within four months of being employed in a long-term care facility.
Facilities that violate Title 22 may face a state ______ and fines, indicating a failure to meet required standards.
Facilities that violate Title 22 may face a state ______ and fines, indicating a failure to meet required standards.
Violations of federal regulations can lead to the loss of a facility's ability to provide a ______ training program.
Violations of federal regulations can lead to the loss of a facility's ability to provide a ______ training program.
Successful completion of a state ______ exam is required for nursing students to become certified.
Successful completion of a state ______ exam is required for nursing students to become certified.
Before certification, nursing students need to undergo a ______ clearance.
Before certification, nursing students need to undergo a ______ clearance.
CDPH requires a minimum of ______ hours of clinical training in a long-term care facility to complete an approved CNA training program.
CDPH requires a minimum of ______ hours of clinical training in a long-term care facility to complete an approved CNA training program.
To take the State competency test, CNA candidates have up to ______ years, providing a specific timeframe to complete the certification.
To take the State competency test, CNA candidates have up to ______ years, providing a specific timeframe to complete the certification.
Prior to certification, nursing students are required to obtain ______ Clearance, ensuring they meet the necessary background standards.
Prior to certification, nursing students are required to obtain ______ Clearance, ensuring they meet the necessary background standards.
CNAs must complete 48 hours of approved 'in-service' also known as ______ every two years to meet renewal requirements.
CNAs must complete 48 hours of approved 'in-service' also known as ______ every two years to meet renewal requirements.
CNAs must verify 8 hours of ______ work as a CNA in the last two years.
CNAs must verify 8 hours of ______ work as a CNA in the last two years.
CNAs need to submit a money order or cashier's check to cover the cost of renewal fees and ______ clearance charges.
CNAs need to submit a money order or cashier's check to cover the cost of renewal fees and ______ clearance charges.
The direct supervisor of a Nurse Assistant is a licensed ______ functioning as the Charge Nurse.
The direct supervisor of a Nurse Assistant is a licensed ______ functioning as the Charge Nurse.
The actions a Nurse Assistant is legally permitted to perform are defined by the ______ of practice, which is determined by state and federal laws.
The actions a Nurse Assistant is legally permitted to perform are defined by the ______ of practice, which is determined by state and federal laws.
The tasks the Nurse Assistant is allowed to perform are defined according to state and federal law and facility ______.
The tasks the Nurse Assistant is allowed to perform are defined according to state and federal law and facility ______.
All of a Nursing assistants duties are listed in a ______.
All of a Nursing assistants duties are listed in a ______.
Providing a safe environment for residents includes proper use of equipment, awareness of potential ______ and having someone to help when needed.
Providing a safe environment for residents includes proper use of equipment, awareness of potential ______ and having someone to help when needed.
Meeting the physical needs of residents include assisting them with 'activities of ______ living'.
Meeting the physical needs of residents include assisting them with 'activities of ______ living'.
Ensuring a resident will feel secure and be recognized as an individual are ways of protecting ______ rights
Ensuring a resident will feel secure and be recognized as an individual are ways of protecting ______ rights
Nurse Assistants should never insert tubes or objects into body openings, nor ______ them from the body without proper authorization.
Nurse Assistants should never insert tubes or objects into body openings, nor ______ them from the body without proper authorization.
Nurse Assistants should never take oral or ______ orders from a doctor.
Nurse Assistants should never take oral or ______ orders from a doctor.
Nurse Assistants should never tell the family of the person's diagnosis or ______ or surgical treatment plans.
Nurse Assistants should never tell the family of the person's diagnosis or ______ or surgical treatment plans.
Maintaining resident ______ involves adhering to HIPAA guidelines, limiting information-sharing without consent and private discussions.
Maintaining resident ______ involves adhering to HIPAA guidelines, limiting information-sharing without consent and private discussions.
Limits the sharing of information without patient consent when adhering to ______ guidelines.
Limits the sharing of information without patient consent when adhering to ______ guidelines.
Nurse Assistants are legally required to report suspected or observed ______ or neglect.
Nurse Assistants are legally required to report suspected or observed ______ or neglect.
Nurse Assistants who suspect abuse can use the standard reporting form titled ______.
Nurse Assistants who suspect abuse can use the standard reporting form titled ______.
As a part of professional responsibility CNAs need to ensure they ______ to work on time.
As a part of professional responsibility CNAs need to ensure they ______ to work on time.
An important professional behavior for healthcare workers is ______ compassion when assisting residents.
An important professional behavior for healthcare workers is ______ compassion when assisting residents.
An important professional behavior for healthcare workers is being a ______ player in the facility.
An important professional behavior for healthcare workers is being a ______ player in the facility.
A critical component of professional behavior is adhering to one's scope of ______, ensuring duties are within legal and ethical boundaries.
A critical component of professional behavior is adhering to one's scope of ______, ensuring duties are within legal and ethical boundaries.
Maintaining current Nurse Assistant ______ is part of showing professionalism in the workplace.
Maintaining current Nurse Assistant ______ is part of showing professionalism in the workplace.
Ethical behavior in resident care includes protecting life, keeping information confidential, respecting everyone, proper care and treating the resident like they are in their own ______.
Ethical behavior in resident care includes protecting life, keeping information confidential, respecting everyone, proper care and treating the resident like they are in their own ______.
The most commonly known unethical behavior in the workplace is ______ patients and coworkers.
The most commonly known unethical behavior in the workplace is ______ patients and coworkers.
______ in the nursing home assists residents with conflicts.
______ in the nursing home assists residents with conflicts.
Flashcards
Healthcare standards
Healthcare standards
Federal and state governments set standards for healthcare agencies.
Title 22
Title 22
A California state law that regulates healthcare facilities and establishes licensing/certification standards, minimum care standards, and training program regulations.
OBRA
OBRA
Federal law establishing minimum training and competency evaluation requirements for nursing assistants.
CNA requirements
CNA requirements
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CNA Training Program
CNA Training Program
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CNA Renewal
CNA Renewal
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Health Care Team
Health Care Team
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Scope of Practice
Scope of Practice
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Responsibilities in Resident Care
Responsibilities in Resident Care
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Role Limits
Role Limits
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Maintaining Confidentiality
Maintaining Confidentiality
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Mandated Reporter
Mandated Reporter
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Responsibility to Employer
Responsibility to Employer
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Professional Behaviors
Professional Behaviors
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Ethical Behavior for Resident Care
Ethical Behavior for Resident Care
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Ethical Behavior in the Workplace
Ethical Behavior in the Workplace
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Unacceptable Behavior
Unacceptable Behavior
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Breaching Confidentiality
Breaching Confidentiality
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Ombudsmen
Ombudsmen
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Study Notes
Objectives
- Review the legal implications of the California Code of Regulations, Title 22, Division 5, and OBRA
- Identify Nurse Assistant requirements as set forth in Title 22 and OBRA
- Learn what qualities make a successful Nurse Assistant
- Review the role and responsibilities of the Nurse Assistant
- Explain the ethical behavior expected of the Nurse Assistant
- Understand the behaviors that maintain confidentiality
Federal and State Standards
- Standards are set by federal and state governments
- Agencies must meet standards for licensure, certification, and accreditation
California Code of Regulations (CCR) Title 22
- Minimum standards are set for patient care
- State law regulates healthcare facilities
- California state laws establish licensing and certification standards for health facilities
- Also establish minimum standards of care for the resident
- Regulations govern the Nurse Assistant Training Program, and Nurse Assistant certification requirements
- Skilled Nursing Facilities must be licensed, and have policies and procedures to ensure residents’ rights and safety
- Violations of Title 22 may lead to a state citation and a fine
Omnibus Budget Reconciliation Act (OBRA)
- OBRA was established in 1987 as federal law
- Prior to the 1980s, minimal training was required for nursing assistants
- OBRA set minimum training and competency evaluation requirements for nursing assistants working in nursing centers in 1987
- OBRA establishes standards of resident care for Medicare patients age 65 and older and Medi-Cal reimbursement
- Federal law applies to all 50 states
- OBRA requires training and competency exams within four months of employment in a LTC facility for nursing assistants working in long term care facilities
- Onsite surveys ensure compliance with regulations and an improved overall quality of care for residents in nursing facilities
Violations of Federal Regulations
- Penalties include loss of the ability to provide a CNA training program, civil money penalties ($50-$3,000 a day), and denial of payment
- State monitoring, and termination of the facilities license can also result
State and Federal Laws & Nursing Students
- Must complete Nurse Assistant training course and a state competency exam
- Criminal clearance is required for certification
- Maintaining certification requires renewal
CNA Training Requirements
- Programs must be approved by the California Department of Public Helath (CDPH)
- Requires a minimum of 60 hours of mandatory theory and 100 hours of clinical training in a LTC facility
- Course content must comply with Title 22 and OBRA
- Criminal screening is also required before clinical training, in addition to physical and TB tests
State Competency Test
- Must be successfully completed and includes a written and skills test
- Three opportunities to pass the state competency test
- Pay a competency test fee, and have up to 2 years to take the state competency test
- Criminal clearance is required prior to certification
Renewal Requirements
- Renewals require a complete CDPHS renewal application, 48 hours of approved in-service (CEU) every 2 years, and verification of 8 hours of paid work as a CNA in the last two years
- Criminal clearance, fingerprinting during the initial application, and a money order or cashiers check for renewal fees are also required
Health Care Team
- Resident
- Family
- Registered Nurse (RN)
- Nurse Practitioner (NP)
- Physician’s Assistant (PA)
- Licensed Vocational Nurse (LVN)
- Certified Nurse Assistant (CNA)
- Restorative Nurse Assistant (RNA)
- Physician (MD)
- Physical Therapist (PT)
- Occupational Therapist (OT)
- Speech Therapist (ST)
- Dietician
- Activities Director
- Social Worker
- Clergy
- Ombudsman
Places of Employment
- Skilled nursing facility (SNF) (LTC)
- Acute hospital
- Intermediate Care Facility (ICF) – ICF/Developmentally Disabled Habilitative (ICF/DDH) –ICF/Developmentally Disabled Nursing (ICF/DDN)
- Hospice
- Assisted Living/Residential Care/Board & Care Facilities
- Psychiatric Facilities
- Clinics
- Prison System Facilities
- Alzheimer's units
- Surgery center
Supervision of Nurse Assistant
- Direct supervisor is a licensed nurse functioning as the Charge Nurse
- Nurse Assistants are also accountable to a Director of Staff Development (DSD), Director of Nursing (DON), RN Supervisor, Facility/Agency Administrator, or Physician
Scope of Practice
- The Nurse Assistant is allowed to perform tasks according to state, federal law, and facility policies
- Nursing assistants' duties are listed in a Job description and ensure uniform, safe care, as well as provide care according to educational standards
Resident Care Responsibilities
- Providing a safe environment
- Meeting the resident's physical needs
- Assisting residents with their psychosocial, emotional, spiritual, and cultural needs
- Observe changes in resident's mental status; report as needed
- Assisting with resident comfort and anxiety relief
- Protecting resident rights
Providing a Safe Environment
- Use equipment and protective devices properly
- Maintain awareness of potential hazards (such as liquid spills)
- Practice personal hygiene and cleanliness
- Care for resident's personal property
- Adhere to standard precautions
- Ask for help if unsure
Meeting Physical Demands
- Observe changes
- Facilitate activities of daily living and medical/rehabilitative activities
- Assist with vital signs, turning, collecting specimens, ambulation, etc.
- Maintain a clean environment
- Assist with ADL's in a timely manner
- Document care provided as required by facility policy
Protecting Resident Rights
- Treat residents with dignity and respect
- Ensure the resident feels secure, recognised and loved
- Offer nursing care that assures cultural recognition and acceptance and respect for the resident’s personal beliefs
- Ensure the resident feels a sense of accomplishment and good about themself
Role Limits
- Never give medications, insert tubes into body openings—or remove them from the body
- Do not take oral or telephone orders from a doctor
- Perform no procedures requiring sterile technique
- Nurses Assistants should not tell the family of a person's diagnosis or medical/surgical plans and never supervise
- Do not ignore an order that exceeds legal limits
Maintaining Confidentiality
- Nurse Assistants must adhere to HIPAA (Health Insurance Portability and Accountability Act) guidelines, thus limiting information-sharing without patient consent
- Discuss observations with the nurse or physician in private
Mandated Reporters
- Nurse Assistants are legally required to report suspected or observed abuse or neglect
- Use Abuse Report form SOC341
Responsibilities towards Employer
- Report to work on time and fulfill assigned schedule reliably
- Notify a supervisor when ill in a timely manner
- Cooperate and work as a team member
- Perform one's job to the best of their ability as specified by job description
- Conserve supplies and equipment
Professionalism
- Being skilled and caring during care
- Being responsible, trustworthy, and truthful
- Attending inservice/educational activities to improve skills and knowledge
- Showing compassion and being a team player
- Work to the best of one's ability and adhere to scope of practice
- Conserve maintaining a current Nurse Assistant certification, a professional appearance, and asking for assistance when needed
Professional Apperance
- Long and/or brightly painted fingernails
- Stains on uniform
- Untidy hair
Ethical Behavior
- Protecting life and promoting the health of patients
- Keeping personal information confidential
- Respecting each person as an individual
- Giving care based on need, not gratuities
- Refer to Residents by their proper name; treat them like they are in their own home
Applying Ethical Behavior
- Arriving at work on time, being absent only when necessary, and notifying the employer of necessary absences
- Following instructions within the scope of practice, and being loyal, flexible, and cooperative as a team member
Unacceptable Behavior
- Abusing patients and/or co-workers
- Stealing or willfully damaging property
- Acting insubordinate and neglecting duties
- Altering or falsifying records
- Working under influence of drugs/alcohol
- Acting dishonesty and breaching confidentiality
Breaching Resident Confidentiality
- Includes discussing personal information with another resident, friends, or visitor
- Releasing information to members of the news media or sharing patient details with members of your family, community, or health team members who are not treating them
Ombudsmen
- Advocates for residents in Nursing homes, Board and Care, SNF, Assisted living,
- They help find facilities and resolve conflicts for residents
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