NRS 101: Nurse Assistant

• demonstrate basic nursing skills to provide safe, quality care to residents
• recognize the special needs of the long-term care resident including persons who are mentally challenged, have Alzheimer's, cerebral palsy, epilepsy, and dementia
• accurately measure and record: vital signs, pain level, height, weight, meal percentages, fluid intake, fluid output, and distinguish between standard and military or 24-hour time
• consistently utilize proper body mechanics while performing positioning, lifting and mobility tasks
• identify and describe the principals behind rehabilitative nursing
• describe the roles and responsibilities of a certified nursing assistant
• describe the emotional, social and spiritual needs of the resident
• describe the purpose and intent of the (Omnibus Budget Reconciliation Act) OBRA legislation and Title 22 regulations
• plan, organize, and provide age-appropriate assistance to patients with self-care deficits
• demonstrate the ability to prevent and/or manage unusual occurrences
• operate various medical equipment according to manufacturer's directions
• consistently demonstrate the use of medical asepsis, proper hand washing, and use of personal protective equipment
• describe the stages of grief, and the emotional/spiritual needs of the dying patient and their family

1.  Module 1: Introduction
   1. Roles and responsibilities of a Certified Nurse Assistant (CNA) 
   2. Title 22, division 5, California Code of Regulations, overview
   3. Requirements for nurse assistant certification
   4. Professionalism
   5. Ethics and confidentiality
2. Module 2: Patients' Rights
   1. Title 22 
   2. Health and Safety Code
   3. Code of Federal Regulations
   4. Preventing, recognizing, and reporting residents' right violations.
3. Module 3: Interpersonal Skills
   1. Communications
   2. Defense Mechanisms
   3. Sociocultural factors
   4. Attitudes toward illness and health care
   5. Family interactions
4. Module 4: Prevention and Management of Catastrophe and Unusual Occurrences
   1. Emergency
   2. General safety rules
   3. Fire and disaster plans
   4. Roles and procedures for Certified Nurse Assistants (CNA)
   5. Patient Safety 
5. Module 5: Body Mechanics
   1. Basic rules of body mechanics
   2. Transfer techniques
   3. Ambulation 
   4. Proper use of body mechanics and positioning techniques
6. Module 6: Medical and Surgical Asepsis
   1. Micro-organisms
   2. Universal precautions (Standard Precautions)
   3. Basic Principles of asepsis
7. Module 7: Weights and Measures
   1. The Metric system
   2. Weight, length, and liquid volume
   3. Military time,i.e., a 24-hour clock
8. Module 8: Patient Care Skills
   1. Bathing and medicinal baths
   2. Dressing
   3. Oral Hygiene  
   4. Hair care, hair shampoo, medicinal shampoo, nail care, and shaving
   5. Prosthetic devices
   6. Skin care including prevention of decubitus ulcers
   7. Elimination needs 
   8. Bowel and bladder retraining
   9. Weighing and measuring the patient
9. Module 9: Patient Care Procedures
   1. Collection of specimens including stool, urine, and sputum
   2. Care of patient with tubing to include but not limited to gastric, urinary, oxygen, and Intravenous. This care does not include inserting, suctioning, or changing the tubes.
   3.  Intake and output 
   4. Bed making
   5. Cleansing enemas and laxative suppositories
   6. Admission, transfer, and discharge
   7. Bandages and non-sterile dry dressing, including the application of non-legend topical ointments to intact skin surfaces 
10. Module 10: Vital Signs
    1. Purpose of vital signs
    2. Factors affecting vital signs
    3. Normal ranges
    4. Methods of measurement
    5. Temperature, pulse, respiration
    6. Blood pressure
    7. Abnormalities
    8. Recording 
11. Module 11: Nutrition
    1. Proper nutrition
    2. Feeding techniques
    3. Diet therapy
12. Module 12: Emergency Procedures
    1. Signs and symptoms of distress
    2. Immediate and temporary intervention
    3. Emergency codes
13. Module 13: Long - Term care Residents
    1.  
       1. Special needs of persons with developmental and mental disorders including intellectual disability, cerebral palsy, epilepsy, Parkinson's disease, and mental illness 
       2. Special needs of persons with Alzheimer's disease and related dementias
    2. Introduction to anatomy and physiology
    3. Physical and behavioral needs and changes
    4. Community resources available
    5. Psychological, social, and recreational needs
    6. Common diseases and disorders including signs and symptoms 
14. Module 14: Rehabilitative Nursing
    1. Promoting patient's potential
    2. Devices and equipment
    3. Activities of daily living
    4. Family interactions
    5. Complications of inactivity
    6. Ambulation
    7. Range of motion 
15. Module 15: Observation and Charting
    1. Observation of patients and reporting responsibility
    2. Patient care plan
    3. Patient care documentation
    4. Legal issues of charting
    5. Medical terminology and abbreviations
16. Module 16: Death and Dying
    1. Stages of grief
    2. Emotional and spiritual needs of the patient and family
    3. Rights of the dying patient
    4. Signs of approaching death
    5. Monitoring of the patient
    6. Postmortem care
17.  Module 17: Abuse (as per HSC 1337.1 and 1337.3)
    1. Preventing, recognizing and reporting instances of resident abuse

Lab Content is provided in a long-term-care facility under the direct supervision / guidance of a DHS approved Licensed nurse.

1. Module 2: Resident's Rights
   1. Knock on door before entering
   2. Pull privacy curtains during personal care
   3. Keep patient information confidential
   4. Treat patient with respect and dignity
   5. Encourage patient to make choices
   6. Explain procedures to patient
2. Module 4: Prevention and Management of Catastrophe and Environmental Emergencies
   1.  Demonstrate fire/disaster procedures
   2. Handles oxygen safely
   3. Use of fire extinguisher 
3. Module 5: Body Mechanics
   1. General use of gait belt
   2. Assist patient up to head of bed with two assistants 
   3. Turn and position the patient
      1. Position supine 
      2. Side-lying
      3. Use of lift sheet
   4. Assist transfer from bed to chair or wheelchair
   5. Assist transfer from chair or wheelchair to bed
   6. Use of mechanical lift
4. Module 6: Medical and surgical asepsis
   1. Hand washing
   2. Proper handling of linen
   3. Use of standard precautions
      1. Gloving
      2. Gowning
      3. Applying mask
   4. Dispose of trash and waste by double-bagging
5. Module 7: Weights and Measures
   1. Measure oral intake
   2. Measure urinary output
   3. Use military time in documentation 
6. Module 8: Patient Care Skills
   1. Back rub
   2. Bed bath and partial bath
   3. Tub bath
   4. Shower
   5. Assist with oral hygiene
   6. Mouth care of the unconscious patient
   7. Denture care
   8. Nail care
   9. Comb patient's hair
   10. Shampoo bedridden resident
   11. Shampoo with shower or tub bath
   12. Use of Medicinal shampoo
   13. Shave patient with razor and electric shaver
   14. Dress and undress patient
   15. Change clothes of patient with IV
   16. Assist with use of the urinal
   17. Assist with use of the bedpan
   18. Assist to toilet or bedside commode
   19. Bladder retraining 
   20. Bowel retraining
   21. Perineal care
   22. Care and use of artificial limbs
   23. Use and application of splints
   24. Apply and remove behind-the-ear hearing aid
   25. Measure height of patient in bed
   26. Weigh patient in bed
   27. Measure and weigh patient using upright scale
7. Module 9: Resident Care  Procedures
   1. Collect and identify specimens
      1. Sputum 
      2. Urine: clean catch
      3. Stool
   2.  Make occupied bed
   3. Make unoccupied bed
   4. Administer commercially prepared cleansing enema
   5. Administer enemas - tap water, soap suds
   6. Administer laxative suppository
   7. Empty urinary bag
   8.  Care for patient with tubing:
      1. Oxygen
      2. IV
      3. Gastrostomy
      4. Nasogastric
      5. Urinary catheter 
   9. Apply antiembolic hose, elastic stockings (TED hose)
   10. Admit, transfer and discharge patient
   11. Apply non-sterile dressing
   12. Apply topical non-prescription ointment
8. Module 10: Vital Signs
   1. Measure and record temperature using mercury-free and electronic devices for:
      1. Oral
      2. Axillary
      3. Rectal
   2. Measure and record pulse: radial and apical
   3. Measure and record respiration
   4. Measure and record blood pressure: Manual (stethoscope, sphygmomanometer), and digital/electronic 
9. Module 11: Nutrition
   1. Feed the patient who is unable to feed themselves
   2. Assist patient who can feed self
   3. Verify patient given correct diet tray
   4. Use of assistive devices such as orthopedic utensils, cups and other devices
10. Module 12: Emergency Procedures
    1. Apply postural supports as safety devices
    2. Apply soft wrist/ankle restraints as safety devices
    3. Heimlich maneuver for conscious patient
    4. Heimlich maneuver for unconscious patient
    5. Position call light properly
11. Module 13: (as per HSC 1337.1 and 1337.3)
    1. Use of dementia-related communication skills, including listening and speaking strategies
    2. Identify your name and purpose of interaction
    3. Make eye contact at patient's eye level
    4. Use of a continuum of verbal and other non-physical techniques such as redirect, for combative patients
12. Module 14: Rehabilitative/Restorative Care
    1. Perform range of motion exercises
    2. Assist ambulation of patients using gait belt
    3. Assist patient to ambulate with walker
    4. Assist patient to ambulate with cane
    5. Proper use of rehabilitative devices
13. Module 15: Observation and Charting
    1. Report appropriate information to charge nurse
    2. Document vital signs, and activities of daily living timely and correctly
    3. Document changes in patient bodily functions and behavior
    4. Participate in resident care planning