The National Association of Health Care Assistants has been around for many years; it’s an excellent CNA advocacy group and offers individual and facility memberships. Through this group, CNA’s have an opportunity to engage in a professional course designed to further their knowledge and skills with caring for the elderly.

Description
The Geriatric Care Specialist Program is a 10-module correspondence study course for certified nursing assistants. This course is designed to assist nursing assistants with enhancing their knowledge and skills in the field of geriatric care. The certification expires annually. To maintain certification, submit annual verification that 12 hours of in-service have been completed, along with $5 renewal fee.

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Syllabus

Module One
Anatomy and Physiology

Module Two
Age Related Disorders

Module Three
Geriatric Urinary Incontinence

Module Four
Pressure Ulcers, Wound Healing, and Skin Care

Module Five
Caring for Residents with Dementia

Module Six
Psycho-Social Needs of the Geriatric Resident

Module Seven
Communicating in Long Term Care

Module Eight
Restorative Care

Module Nine
Observation, Reporting, and Documentation

Module Ten
Survey Process and Federal Regulations
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Go HERE for more details.

Everything You Need To Know About Being a CNA

Nursing Home Magazine does it again: AN excellent article about dysphagia and swallowing problems, some of which is aimed at CNA’s:

Dysphagia is not unusual among older adults living in long-term care facilities. One study recorded the presence of mealtime difficulties in nursing home residents and found that nearly 90% had impairments that included dysphagia, poor oral intake, positioning problems, or challenging behaviors. Furthermore, 68% of the residents experienced dysphagia, compromising their ability to enjoy meals, let alone consume the necessary calories to meet nutritional requirements. Dysphagia can lead to aspiration, choking, dehydration, malnutrition, and pneumonia. In fact, aspiration pneumonia is the fifth leading cause of death in people over 60 years of age and the third leading cause of death in people over 80. Clearly, food intake is crucial to many residents’ health and quality of life.

Residents with dysphagia often require modified diet consistencies, such as thickened liquids or pureed foods. In addition, nursing assistants must often comply with specialized feeding techniques, such as placing food in the non-impaired side of the mouth, limiting the use of straws, or facilitating the use of adaptive feeding equipment. In the dining room, nursing assistants who provide help to, monitor, or feed residents must follow the techniques for the residents’ safety and nutritional health. Failure to successfully comply with swallowing and feeding recommendations can cause inadequate hydration and nutrition and unsafe feeding.

More:

Through therapy, a speech-language pathologist can help many residents with dysphagia learn compensatory swallowing techniques. Researchers have found that poor staff training and a lack of understanding about feeding recommendations can cause malnutrition and dehydration in long-term care. McGillivray and Marland conducted a review of the literature on assisting people with dementia during meals. Their review found that mealtime assistance is often stressful for residents and staff because feeding becomes task centered and staff have not been sufficiently educated or trained.

I think ALL staff could use more training.

Did you know?

Signs and Symptoms of Dysphagia
Some signs and symptoms of dysphagia are not commonly known. For example, did you know that a persistent low-grade fever might be a sign of dysphagia? Did you know that if a resident is spitting food at meals, he or she might have oral phase dysphagia and might be unable to chew properly? Review the list below with your staff. Residents displaying the following signs and symptoms of dysphagia should be seen by a speech-language pathologist:

* Having trouble recognizing food
* Difficulty placing food in mouth
* Drooling or spitting
* Food falling out of mouth
* Pocketing of food in mouth
* Rocking tongue back and forth while chewing
* Food left in mouth after the swallow
* Chewing for a long time
* Coughing before, during, or after the swallow
* Delayed or absent rise of the larynx during the swallow
* Requiring 3–4 swallows after each bite
* Continuous throat clearing during or after the meal
* Wet or hoarse voice
* Complaining of something caught in throat
* Refusing to eat or very slow eater
* Lasting low-grade fever
* Unplanned weight loss or unexplained loss of appetite
* Pneumonia
* Malnutrition or dehydration

This article provides an excellent review of swallowing problems for nursing home residents and would be a timely and good resource for an in service.

It’s all in the technique?

Working together to reduce the occurrence of pressure ulcers in patients throughout various care settings, members of the New Jersey Hospital Association’s Pressure Ulcer Collaborative have reported a 70 percent reduction in the incidence of new pressure ulcers after nearly two years of applying shared best practices and preventive techniques.

Each year, pressure ulcers, commonly known as bed sores, affect more than 1 million patients and residents in nursing homes and hospitals nationwide. Costs associated with pressure ulcer treatment exceed $1.3 billion. More importantly, the human toll of pain, depression, altered self-image, infection and increased mortality is immeasurable.

The NJHA Collaborative, which first met more than 22 months ago to develop and share standardized preventive strategies, is comprised of 150 hospitals, nursing homes and home care agencies. The 70 percent reduction in the incidence of pressure ulcers was reported from data that was tracked from September 2005 through May 2007.

Everyone knows the dangers of pressure sores; the time and effort and costs to clear them up is very high. And we also know for the most part, pressure sores are preventable.

So what special techniques were used?

Common improvement techniques used by staff at hospitals, nursing homes and home care settings alike included: complete skin evaluation within eight hours of admission; evaluation of the risk of skin breakdown using the internationally respected Braden scale; implementation of preventive strategies, such as proper positioning and use of assistive devices; and ongoing observation of the condition of patients’ skin, particularly for those identified as being at high risk for developing a pressure ulcer.

That’s IT?? This is good old fashioned nursing care. If we did this more and provided decent and ethical staff, pressure sores would be a thing of the past.

A reminder of some of the materials here, that can be used without charge, for CNA educational purposes or for inserivces.

Horizontal Violence

A Call For Action

Being Professional: Guide For CNA’s

CNA’s & Respect

Workplace Culture: CNA’s can make it or break it

Shift Wars

Tips & Timesavers For CNA’s

Legal Issues For CNA’s

The Nursing Process & CNA’s

Observation Skills For CNA’s

Continuing Ed For CNA’s: Just Another Inservice?

Email us for a TEXT or WORD version of these materials.

In the near future we have several more posts that will be up for grabs:

Falls: The CNA’s Role in Assessment and Prevention

Mentoring: A SKILL for CNA’s

FYI:

An aide is in major trouble for giving residents a bath in water that is TOO HOT.

Paula Marie Drew, 40, was charged on Wednesday with two counts of caretaker neglect for two incidents at the Green Park Nursing & Rehab Center, where she worked before she was suspended March 1.

According to an affidavit filed with the charge, Drew gave showers on March 1 to two residents who later were found to have been scalded.

When Drew placed the first resident in the shower, he suffered a seizure, fell, and hit his head, states the affidavit by Steven Johnson, a criminal investigator with Attorney General Drew Edmondson’s office.

Drew summoned a nurse to the shower room, and the nurse found burns and peeling skin on the man’s face, neck, stomach and thighs, the affidavit says.

The resident, who was blind and mentally retarded, was hospitalized with burns over 20 percent of his body and a head injury, according to court records.

The next day, a second patient at Green Park developed large blisters on his hand and arm, the affidavit says. Drew also had given a shower to that resident March 1, the affidavit says. That patient, who was mentally retarded, was hospitalized with burns over 6 percent of his body.

The day after the scaldings, a state Health Department nurse checked the facility’s water temperature and found that it was 126 degrees, nine degrees higher than allowed by state regulations.

Drew told investigators that “she did not intentionally burn” the residents but “did admit that she left both residents alone in the shower too long for an unknown length of time,” the affidavit states.

Often the nursing home also must take responsibility for these types of injury. More and more though, aides are being held personally accountable because they can and should KNOW when water is TOO HOT…they should always seek supervision when in doubt about this stuff. It matters little that the residents were left unattended in the specifics of bathing (although this is another crime altogether); what matters is hot water burns on contact.

Where I work we have water thermometers located in each tub area as well as where every shower is located. LNA’s are expected to measure water temp before placing a patient in the water. Any temp over 104 means TOO HOT= NO BATH/SHOWER. We get the nurse and document this and call maintenance. We have these safeguards in place precisely to prevent burns.