natcep day 1

NATCEP Day OneNATCEP Day OneProgram Overview

ObjectivesObjectives

Identify the purpose of the Training and Competency Evaluation Program (TCEP)

List the role and responsibilities of the PC/PI and NA

State the purpose of the TCEP conducted by the director

Describe how to be recorded and maintained in Ohio’s NA Registry

Discuss issues related to abuse, mistreatment, neglect and misappropriation of resident property

Discuss title of State Tested Nurse Aide (STNA)

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Omnibus Budget Reconciliation Omnibus Budget Reconciliation Act of 1987 (OBRA)Act of 1987 (OBRA)

◦ The Omnibus Budget Reconciliation Act of 1987 (OBRA) is a federal law. Purpose is to improve the quality of life of

nursing center residents. This law sets minimum training and

competency evaluation requirements for nursing assistants.

Each state must have a nursing assistant training and competency evaluation program (NATCEP).

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◦ The training program OBRA requires at least 75 hours of instruction. There must be at least 16 hours of supervised

practical training (clinicals).◦ Competency evaluation

The competency evaluation has a written test and a skills test.

OBRA allows at least 3 attempts to successfully complete the evaluation.

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Purposes of the Training Purposes of the Training Program in OhioProgram in Ohio

Prepare the nurse aide (NA) in a long-term care facility (LTCF) to care for the residents

Prepare the NA in the LTCF to take and pass the competency evaluation program

Prepare the NA to function as part of the team

Make the NA aware of the principles of nursing delegation

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NATCEP Role & ResponsibilityNATCEP Role & Responsibility

Program Coordinator/Instructor Program Instructors = Mrs. Payne & Ms. Tway

◦Provide classroom & clinical knowledge/training◦Follow rules of the state program◦Provide materials and tools for program/testing◦Facilitate learning◦Evaluate performance◦Address specific learning needs of the individual

learner

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NA Student = YOU!Classroom

◦Attend class Can miss/makeup 16 hours Must achieve an average score of 75% on all

NATCEP Exams All missed work must be made up within 1 week

of return to school. State requirement = 60 days◦Follow program rules◦Review all handouts and obtain and review

skills booklet for testing

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NA Student = YOU!Long-term Care Facility (LTCF) = Clinicals

◦Occurs at the completion of classroom training◦Scheduled for March/April◦Provide care for the LTCF residents under the

direction of the program instructor◦Protect the LTCF resident◦Function as part of the team offering

information during the care conferences

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Purpose of the State TestPurpose of the State Test

Test knowledge Test skills3 failures = must retrain

◦Available through PRCTC Adult Education◦Total Cost is $649

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Successful Completion of the Successful Completion of the State Test for OhioState Test for Ohio

Complete 75 hour Nurse Aide Training and Competency Evaluation Program (NATCEP)

Pass the Competency Evaluation Program (CEP) written test with an 80%◦79 questions ◦Must have 64 questions correct

Pass the CEP skills test ◦5 of 25 possible◦Handwashing for everyone; 4 skills will be randomly

chosen◦80% plus all bolded items must be demonstrated

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◦ OBRA requires a nursing assistant registry in each state. It is an official record or listing of persons who

have successfully completed that state’s state-approved NATCEP.

The registry has information about each nursing assistant.

All information stays in the registry for at least 5 years.

Any agency can access registry information. You receive a copy of your registry information. You can correct wrong information.

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◦ Other OBRA requirements Retraining and a new competency evaluation

program are required for nursing assistants who have not worked for 24 months.

Agencies covered under OBRA must provide 12 hours of educational programs to nursing assistants every year.

Performance reviews also are required.

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Ohio Nurse Aide RegistryOhio Nurse Aide Registry

Managed through the Ohio Department of Health

List of all State-Tested Nurse Aides (STNAs) in Ohio

Rules are located at http://www.odh.ohio.gov

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Ohio Nurse Aide RegistryOhio Nurse Aide Registry

Entered into registry◦ Successfully pass all both the written and skills components of the

CEPSTNAs working outside of the LTCF setting must provide

proof of employment as an STNA to the registry every 2 years

Name and address changes must be sent in writing to the Nurse Aide Registry (NAR)

Social Security changes must be accompanied by 2 pieces of documentation to verify

Registry cards are issued by the testing company; contact them for replacement

Contact number = 800-582-5908

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Abuse, Mistreatment, Neglect or Abuse, Mistreatment, Neglect or Misappropriation of Resident Misappropriation of Resident PropertyProperty

Allegations of abuse, mistreatment, neglect or misappropriation of a resident’s property against STNA◦Investigation◦Consequences

Reported to registry

If you witness it, report to charge nurse! Findings of abuse are never removed from the

registry

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State Tested vs. CertifiedState Tested vs. Certified

Train vs. Regulate practiceCompleted requirements vs. licensedMonitor vs. renew

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NATCEP Day OneNATCEP Day OneWork Environment

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Describe his or her role as a STNA on the interdisciplinary team

Discuss the roles of the other interdisciplinary team members

Define levels of care and where LTCF fits in the health care system

Describe primary purpose of long-term care

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STNA RoleSTNA Role

NAs spend the most time with residentsWork under the delegation & supervision

of a licensed nurse (RN or LPN)Inform the nurse of any changes in the

resident’s conditionWorks from the plan of care developed by

an interdisciplinary team for each resident

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Interdisciplinary Team MembersInterdisciplinary Team MembersNursingNursing

Director of Nursing◦Responsible for resident care; supervises

nursing staff◦Reports to the Administrator

Licensed Nurse◦RN – Registered Nurse◦LPN – Licensed Practical Nurse◦CNP – Certified Nurse Practitioner (RN)

STNA

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Interdisciplinary Team MembersInterdisciplinary Team MembersMedicineMedicine

Medical Director◦Oversees the quality and delivery of medical

care◦Maintains surveillance of the employees’ health

statusPrivate Physician for resident

◦Hired by the resident of other significant other◦Directs the resident’s medical care including

medications & treatments

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Interdisciplinary Team MembersInterdisciplinary Team MembersProfessional StaffProfessional Staff

DieticianSocial WorkerPhysical TherapistActivity DirectorOccupational TherapistSpeech/Hearing TherapistSpiritual Care TeamRespiratory TherapistPsychologistPharmacist

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Interdisciplinary Team MembersInterdisciplinary Team MembersOther MembersOther Members

Food Service Secretary/ClerkMaintenanceHousekeepingLaundryBusiness OfficeMedical RecordsSecurity

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Interdisciplinary Team MembersInterdisciplinary Team MembersAdministrationAdministration

Administrator◦Responsible for the overall operation of the

facility◦Responsible to the governing board or owner(s)

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Interdisciplinary Team MembersInterdisciplinary Team MembersGoverningGoverning BodyBody

Determines the facility’s mission◦Logan Elm

“We remain a leader in health care because of the high standards we have set for ourselves. We are committed to providing the highest quality of care possible and to preserve the dignity of every person we serve by effectively meeting his or her medical, social, emotional & spiritual needs.”

Sets & approves policy, budget, & capital expenditures

Has legal & financial responsibility for the facility

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Interdisciplinary Team MembersInterdisciplinary Team MembersOthersOthers

VolunteersPetsSurveyors

◦From Ohio Dept of Health: inspect facilities to make sure that they comply with state & federal standards of care

Ombudsman◦Located in the Ohio Dept of Aging. Works as

the resident’s advocate among the residents, family & facility

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Levels of Care: LTCF RolesLevels of Care: LTCF Roles

Acute CareSubacute CareLong-term CareHome CareHospiceAssisted LivingAdult Day CareAlzheimer/dementia CareMental Health

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Primary Purpose of the LTFCPrimary Purpose of the LTFC

To assist resident/client to achieve and maintain a maximum level of functioning (Quality of Life) and maintain their sense of individuality (Quality of Life)◦Person-centered care◦Restorative/rehabilitative care◦End-of-Life care

Comfort Palliative

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NATCEP Day OneNATCEP Day OneRoles and Responsibilities of the

STNA

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State purpose of STNA role in ADLs Describe the STNA’s responsibility in caring for the resident’s

unit Describe the STNAs responsibility in providing and recording

residents’ nourishment Describe the STNA’s responsibility with record keeping and

communication Describe the STNA’s responsibility in promoting residents’ rights Describe the STNA’s role in maintaining confidentiality State an understanding of time management as it relates to

resident care Describe the STNA’s role in resident’s safety Identify the STNA’s responsibility for attending in-services

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ActivitiesActivities of Daily Living of Daily Living

Dress and UndressBathe and maintain hygieneMobility/WalkingElimination – ToiletingEating and DrinkingBed mobility

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Care of the Resident’s Care of the Resident’s UnitUnit

Make bedMaintain a safe and clean environment

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NourishmentNourishment

Assure correct dietFeed or assistFill water pitcher and assist in obtain fluidsCalculate and record what is eatenAssist to and from dining room

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Recordkeeping & Recordkeeping & CommunicationCommunication

Record intake and outputRecord vital signsAssist in admission, transfer and

discharge Document care on flow sheets or other

formsAssignment sheetsComplete assignmentReport on/off duty

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Promote Promote ResidentResident RightsRights

Established within Omnibus Budget Reconciliation Act of 1987 (OBRA)

Legal rights of residents as US citizensProtected by state and federal lawCenters cannot interfere with these rights

◦Information◦Refusing Treatment◦Privacy & Confidentiality◦Personal Choice◦Work

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ConfidentialityConfidentiality

Trusting others with personal and private information

Need to Know RecordsAway from work

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Prioritizing/Prioritizing/TimeTime ManagementManagement

Organize work and set priorities◦What do you need to do first?◦Resident condition?◦Does the resident have any treatments

scheduled or appointments?◦What can be done while the residents are eating?◦What can be done while resident is at therapy or

an activity?◦When are special rooms available (shower)?◦What do you need help with?

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Assuring Resident Assuring Resident SafetySafety

First Priority!Guard against accidentsPrevent accidentsKnow what to do in the event of an

emergency◦Fire◦Falls◦Drills◦Medical Emergencies

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In-servicesIn-services

Training Expected to attend as required by

employerOBRA requires employer to provide 12

hours per year required◦Examples

CPR Training

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NATCEP Day OneNATCEP Day OnePolicy & Procedure Manuals

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Identify the purpose of the facility’s policy and procedure manual

Describe how to use the policy and procedure manuals

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PurposePurpose

Contains the facility’s position regarding the implementation/enforcement of a procedure (WHY)

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Use of Policy & Procedure ManualsUse of Policy & Procedure Manuals

Policy Manual explains “why” behind practices or standards set by the facility

Procedure Manual: how-to guide◦Step by step◦All caregivers must provide care in same way

following procedures◦Foundation for good nursing practice◦Standard of care

Location: Nursing Station

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natcep day 1

Health & Medicine

state program

training program obra

obra obra

na state

registry information

program rules

nurse aide na

nursing assistant registry