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WorkForce21 – Workforce Development Series Health Support Specialist Table of Contents Health Support Specialist Registered Apprenticeship Program Introduction USDoL Summary Definitions Qualifications Apprenticeship 1. Certified Nurse Aide Description Processes Schedule (Competencies) Health Support Specialist Related Theoretical Instruction Related Theoretical Instruction: Medical Terminology Related Theoretical Instruction: CPR/First Aid/AED Related Theoretical Instruction: Dementia Care Related Theoretical Instruction: Culture Change 2. Rehabilitative Aide Description Processes Schedule (Competencies) Related Theoretical Instruction 3. Certified Medication Aide Description Processes Schedule (Competencies) Related Theoretical Instruction 4. Environmental Services Description Processes Schedule (Competencies) Theoretical Instruction 5. Dining Services Description Processes Schedule (Competencies) Theoretical Instruction 6. Advanced Health Support Specialist Introduction Description-Home Processes Schedule (Competencies) Theoretical Instruction 7. Activity Director Description Processes Schedule (Competencies) Theoretical Instruction Health Support Specialist Registered Apprenticeship Program (Universal Worker)
The Health Support Specialist Registered Apprenticeship Program allows adult care facilities to assist new and current employees through a career ladder to become a Universal Worker. Apprentices are able to begin the career ladder while being employed full time at the facility in three different areas involving Health Care. This will allow the apprentice to work under the direction of a Mentor and Licensed Nurse (an employee whom is deemed skilled by the participating facility apprenticeship committee in his or her area) to increase their skills and knowledge through additional on-the-job training. Health Support Specialist Apprentices will become involved with the residents from a person-centered approach, working with residents together as a team. The apprentices obtain state certifications upon completion of training at the facility as a CNA and/or CMA. These classes are taught through an area community or technical college. The certificate of completion as a Rehabilitative Aide is earned through the local community college or technical school. Certificates are also obtained in CPR/First Aid and ServSafe (a National Restaurant Association Education Program). The ServSafe certificate allows for increased knowledge of personal hygiene in relation to food safety, maintenance of sanitary facilities and equipment, and food safety from the purchasing of food through receiving, preparation, and service. Upon completion of the Health Support Specialist Registered Apprenticeship program, the apprentice will receive a Completion of Apprenticeship certificate. Apprentices may be employed in Dietary service or Environmental services, which do not require a certificate to work in the facility while attending related instruction to obtain certification as a CNA and/or CMA. Related instruction in Dietary services and Environmental services along with on-the-job learning will allow the adult care facilities the advantage of addressing the critical shortage areas in their facilities, while providing increased quality of care and quality of life for the residents of their facilities. A medical terminology course will also be required to assist the student with charting and documentation. This course will assist employees obtain additional skills and knowledge to help ensure the smooth flow of documentation to other team members. The work process includes competencies for the Health Support Specialist to increase knowledge and skills necessary to meet the needs of the growing geriatric population beyond the required related theoretical instruction. Advanced specialty training for the adult care facilities utilizing Home Health Aides (HHA) and Activity Professionals will also be taught through a local community or technical college. Related instruction in Dietary services and Environmental services along with on-the-job-learning will allow the adult care facilities the advantage of addressing the critical shortage areas in their facilities, while providing increased quality of care and quality of life for the residents of their facilities. The Health Support Specialist Registered Apprenticeship Program allows facilities to grow their own employees and be better prepared to meet the needs of our aging population by addressing staff retention with less staff turn over and increased skills. With the addition of Registered Apprenticeship to the current certifications, adult care facilities will be able to build a better-prepared and skilled work force.
USDoL Approved Summary HEALTH SUPPORT SPECIALIST O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA Description: The Health Support Specialist allows adult care facilities to assist new and current employees through a career ladder to become a Universal Worker. Provide care to elders living in a household/adult care residential facility. The primary role is to protect, sustain and nurture the elders by providing assistance with activities of daily living and meeting other needs as required. The core goal of the work of the Health Support Specialist will be to provide assistance, which promotes a high quality of life and a positive elder hood. The responsibilities of the Health Support Specialist include care of the elder and the elder’s environment including cooking, laundry and housekeeping. The Health Support Specialist is a member of a self- managed work team and is responsible for coordinating aspects of the teams work. Definitions
Apprentice: Any individual employed by the employer meeting the qualifications described in the Standards of Apprenticeship who has signed an Apprenticeship Agreement providing for training and related instruction under these Standards, and who is registered with the Registration Agency. Apprenticeship Agreement:
The written agreement between the apprentice and the Apprenticeship Committee setting forth the responsibilities and obligations of all parties to the Apprenticeship Agreement with respect to the apprentices employment and training under these Standards. Each apprenticeship agreement must be registered with the Registration Agency. Apprentice Committee: The Apprenticeship Committee established by the sponsor under these Standards who will be charged with the operation of the program. Certification of Completion of Apprenticeship: The Certificate of Completion of Apprenticeship issued by the Registration Agency to those registered apprentices certified and documented as successfully completing the apprentice training requirements outlined in these Standards of Apprenticeship. Employer: Generally, an employer means any person or organization that employs an apprentice under these Apprenticeship Standards. Employer Acceptance Agreement: The written agreement between the sponsoring organization and the individual employer wishing to participate in the apprenticeship program under which these Standards are registered. Mentor: An individual who has documented sufficient skill and knowledge of an occupation, either through formal apprenticeship or through practical on the-job experience and formal training. This individual is recognized by his/her employer as being fully qualified to perform the work of the occupation. On-The-Job-Learning: Tasks learned on-the-job in which the apprentice must be proficient before a completion certificate is granted. The learning must be through structured, supervised work experience. Program Sponsor: The Apprenticeship Committee in whose name these Standards will be registered, and who will have full responsibility for administration and operation of the Registered Apprenticeship program. Related Instruction: An organized and systematic form of instruction designed to provide the apprentice with knowledge of the theoretical and technical subjects related to his/her occupation. Standards of Apprenticeship:
This entire document including any future modifications or additions approved by the Registration Agency. Supervision of Apprenticeship Program: An individual designated by the program sponsor to supervise or have charge and direction of an apprentice. Term: Competency based
Competency Total hours: 2,500 – 5,000 Theoretical Instruction Total hours: 386 Qualifications for Apprenticeship
Age: Apprentices must not be less than 16 years of age. Education: A high school diploma or GED equivalency is required. Applicant must provide an official transcript(s) for high school and post high school education and training. All GED records must be submitted if applicable. Physical: Applicants will be physically capable of performing the essential functions of the apprenticeship program, with or without a reasonable accommodation, and without posing a direct threat to the health and safety of the individual or others. Applicants may be subject to a physical agility or fitness test, or screened for the current illegal use of drugs or both on acceptance into the program and prior to being employed. Ratio of Apprentices to Mentor: The ratio of peer-mentor to apprentices is the ideal standard for training the maximum number of apprentices while insuring proper supervision, training, safety, and continuity of employment. The ratio for peer-mentor to apprentice will be no greater than 1-1 on any given shift. Supervision of apprentices will always remain under the direct supervision of the charge nurse. Term of Apprenticeship: The term for Health Support Specialist shall be competency based for minimum of 1 year with on-the-job learning attainment supplemented by the required hours of related instruction. Work Experience: During the Registered Apprenticeship, the apprentice will receive such on-the-job learning and related theoretical instruction in all phases of the occupation necessary to develop the skills and competence detailed in the apprentice work process outline. The on-the-job learning will be under the direction and guidance of the departmental supervisor of the apprentice(s). The related instruction will be correlated as closely as possible to the practical experience and training received on-the-job. Each apprentice will be notified of the number of college credits available during each related instruction phase of the apprenticeship. The Apprenticeship Committee will be responsible for contacting the appropriate Community College or Vocational School to set up the related instruction. This allows related instruction to be taught at the facility per memorandum of agreement with the Registered Apprenticeship Program. Supervision of Apprentices: The employer will be responsible for training apprentice on the job. Apprentices will be under the general supervision of the employer and under the direct supervision of the mentors and charge nurse to whom they are assigned. The supervisor of the apprentice(s) designated by the employer will, with the advice and assistance of the Apprentice Committee, be responsible for the apprentices work assignments and ensuring the apprentice is working under the supervision of a skilled mentor and charge nurse, the evaluation of work performance, and the completion and submission of progress reports to the apprenticeship Committee. Certificate of Completion of Apprenticeship: Upon successful and satisfactory completion of the requirements of the Registered Apprenticeship program as established in the Standards, the facility will certify completion in writing to the Registration Agency and request that a Certificate of Completion of Apprenticeship be awarded to the completing apprentice(s). Each request shall be accompanied by the requested documentation for both the on-the-job learning and the related instruction as may be required by the Registration Agency. Amendments or Modifications: These Standards may be amended or modified at any time by the sponsor provided that no amendment or modification adopted shall alter any Apprenticeship Agreement in force at the time without the consent of all parties. Such amendment or modification will be submitted to the Registration Agency for approval and registration prior to being placed in effect. A copy of each amendment or modification adopted will be furnished to each apprentice to whom the amendment or modification applies. WORK PROCESSES SCHEDULE CERTIFIED NURSE AIDE O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA Description: Certified Nurse Aide apprentices will have a combination of classroom and clinical instruction on basic patient care. Skills learned include daily personal hygiene, activities of daily living (ADL’S), bed baths, accurate recording of vital signs, correct patient positioning and transfer of patients. Complete an accurate compliance to HIPPA guidelines, including rights and social service needs of residents and their families. APPROXIMATE 1. Communication
Demonstrate how professional attitude and behavior enhances
communication among CNA, resident, resident’s family and staff.
Explain how the Nurse Aide promotes independence and
Explain the Nurse Aid’s responsibilities in health care delivery
and identify who is responsible for actions of the nurse aide.
Demonstrate effective hand washing techniques following all
rules of asepsis, including hand washing when entering and
Recognize safety precautions to avoid resident injuries.
Describe and demonstrate disaster and/or fire escape plans.
Demonstrate practices that reduce the transfer of infection in
residents living area, bathroom and disposal of soiled articles
and cleaning equipment after resident use.
Demonstrate the correct use of disposable gloves when in
with body fluids, blood, urine, vomitus and saliva.
Demonstrate correct feeding techniques, identifying safety
measures, encouraging independence and how to promote
Assist or provide a bath using shower, tub, sponge or bed bath
Encourage independence with appropriate choices with dressing
Assist residents with urination and bowel elimination needs
providing for safety and privacy while using the toilet commode,
Demonstrate accurate perineal cleansing to prevent genitourinary
Demonstrate safe transfers, using the gate belt and/or mechanical
Identify important body mechanics for personal and resident safety.
Assist with ambulation so that the resident feels safe and utilizes
Assist and/or provide grooming assistance for resident including
oral care/mouth, gums, teeth or dentures, nail soaking and cleaning,
filing, hair brushing or combing, beard care or shaving. Assist
residents dress per resident’s choice and activity.
Describe and demonstrate skin care, demonstrate when, what and
to whom observations need to be reported.
Demonstrate accurate measurement and recording of weight and
height measurement and recording of vital signs:
Explain the Nurse Aide’s responsibility in restorative care
Explain how to follow the residents care plan
Demonstrate safety techniques involved with restorative care
Understanding and reporting of early signs and symptoms of
Understand and describe the rights of residents in an Adult
Explain documentation and Nurse Aide responsibilities
Understand legal aspects of documentation
Understand and know appropriate Medical Terminology
Demonstrate correct hand washing technique
Understand blood borne pathogen standards
Explain and demonstrate how to prevent equipment accidents
Explain how to properly handle hazardous substances
Explain the correct handling of a fire extinguisher
Total Hours RELATED INSTRUCTION OUTLINE CERTIFIED NURSE AIDE O*NET-SOC CODE: 3 1-1011.00 RAIS CODE: 1086AA APPROXIMATE Classroom training includes:
a. musculoskeletal b. respiratory c. circulatory
d. digestive e. urinary f. skin, hair, nails g. endocrine h. reproductive i. nervous j. special senses, eyes, ears, and tongue
Total Hours RELATED INSTRUCTION OUTLINE MEDICAL TERMINOLOGY O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA APPROXIMATE
Know and understand formation of medical words.
Define prefixes and suffixes, root words, and combining forms.
Name the different areas of medicine and its specialties.
Use anatomical and directional terms appropriately.
Understand basic anatomy and physiology.
Total Hours RELATED INSTRUCTION OUTLINE CPR/FIRST AID/AED O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA Description: This course is designed to prepare individuals to respond to injuries and sudden illnesses that may arise in everyday life. This is a first aid and cardiopulmonary resuscitation training program. It is offered to give individuals the knowledge and skills necessary to prevent, recognize, and provide basic care for injuries and sudden illnesses until medical personnel arrive and take over. Apprentices will focus on the basic knowledge of CPR/First Aid/AED lecture and skills and then will demonstrate the skills that they learned. APPROXIMATE
1. Demonstrate the correct procedures in adult CPR.
2. Demonstrate the correct procedures in child CPR.
3. Demonstrate the correct procedures in infant CPR.
4. Demonstrate the correct procedure of using an AED device.
5. Identify signs and symptoms of a heart attack, heat/cold related
injuries, broken bones and other first aid related topics.
6. Recognize when to use rescue breathing as opposed to
7. Name and demonstrate the basic steps of how to respond
8. Legal aspects involved in giving CPR and first aid.
9. Identify ways of preventing disease transmission.
10. Demonstrate the correct procedure in rescue breathing for
11. Identify situations in which prioritizing care is necessary.
Total Hours RELATED INSTRUCTION OUTLINE DEMENTIA CARE O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA APPROXIMATE
a. Aging in America (Facts vs. Stereotypes and Myths) b. General Principles of aging
i. Things that contribute to how people age
Overview of Alzheimer’s disease and other Dementing illnesses
a. Defining Dementia and Delirium b. Conditions that cause Dementia and Delirium c. Alzheimer’s
d. Description e. Statistics f. Diagnosis and Risk Factors g. Suggested Stages-Global Deterioration Scale
Effective communication techniques with the person with memory loss. a. Defining communication b. Barriers to normal communication c. Sensory changes and communication d. Tips for communication effectively with the person with AD Common Behaviors and Challenges Associated with Alzheimer’s disease a. Identification of common Behaviors and Challenges b. Common Triggers to Unwanted Behaviors c. Suggested Approaches to behaviors Personal
a. Identification of Personal Care Issues b. Suggested Approaches to Avoid, Defuse, Cope with
Developing a Meaningful Activities Program for the Memory Impaired Older Adult a. The components of a meaningful activities program b. Categories and types of activities c. Examples of activities that work well Family Caregiver Issues
a. Issues families face when dealing with AD b. Family caregiver Options and Coping Strategies c. Common Issues for family and Professional Caregivers d. Positive Aspects of Aging
Total Hours RELATED INSTRUCTION OUTLINE CULTURE CHANGE (SAMPLE) O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA
Goal: To improve the well being of elders and those who care for them by transforming the communities in which they live and work. By the end of the 10-week program apprentices will understand the three plagues of nursing home care and the antidotes to eliminate them. APPROXIMATE
Session 1: The three plagues of loneliness, helplessness and boredom
account for the bulk of suffering among our elders. Session 2: An Elder-centered community commits to creating a Human
Habitat where life revolves around close and continuing contact with plants, animals and children. It is these relationships that provide the young and old alike with pathway to alike worth living. Session 3: Loving companionship is the antidote to loneliness;
Elders deserve easy access to human and animal companionship. Session 4: An Elder-centered community creates opportunity to give as
well as receive care. This is the antidote to helplessness. Session 5: An Elder-centered community imbues daily life with variety and
spontaneity by creating an environment in which unexpected an unpredictable interactions and happenings can take place. This is the antidote to boredom. Session 6: Meaningless activity corrodes the human spirit. The opportunity
to do things that we find meaningful is essential to human health. Session 7: Medical treatment should be the servant of genuine human caring,
never its master. Session 8: An Elder-centered community honors its Elders by de-emphasizing
top-down bureaucratic authority and seeking instead to place the maximum possible decision-making authority into the hands of the Elders or into the hands of those closest to them. Session 9: Creating an Elder-centered community is a never-ending process.
Human growth must never be separated from human life. Session 10: Wise leadership is the lifeblood of any struggle against the three
plagues. For it, there can be no substitute. Session 11: The magic wand. This part of the Eden Alternative training creates a paradigm shift from the institutional model to person centered care (culture change) and implementation of the previous principles. Total Hours WORK PROCESSES SCHEDULE REHABILITATIVE AIDE O*NET-SOC CODE 31-1011.00 RAIS CODE: 1086AA
Description: The Rehabilitative Aide performs restorative duties under the supervision of a Registered Nurse. An alternate is designated who must also complete the Rehabilitative Aide course. The alternate is used as necessary. The Rehabilitative Aide is a critical team member, due to the many hours they spend in “hands-on” activities with the resident. Observing the resident and reporting concerns are important roles. The Rehabilitative Aide often contributes to the team by providing special information on the resident, gathered by their close daily interactions with the resident. APPROXIMATE (passive)
The apprentice will demonstrate the use of passive range of motion to increase flexibility.
The apprentice will demonstrate the use of Active-assist.
a. The apprentice will demonstrate the correct way to apply splint
b. The apprentice will demonstrate the correct care and cleaning of splints. c. The apprentice will demonstrate the proper adjustment of straps. d. The apprentice will demonstrate how to set up and maintain a splinting
e. The apprentice will demonstrate proper removal of a splint. f. The apprentice will demonstrate how to document where, breakdown
g. The apprentice will know whom to contact if problems arise.
a. The apprentice will know the importance in assisting the resident in
moving from side to side to promote self care.
b. The apprentice will demonstrate the correct protocol for the resident to
c. The apprentice will demonstrate how to use adaptive methods or
equipment to assist the resident with self positioning in bed.
d. The apprentice will demonstrate and understand the importance of
a. Demonstrate transfer activities moving from one surface or plane. b. Demonstrate the correct use of assistive devices for transfers:
c. Demonstrate strengthening exercises for upper and lower extremities
d. Demonstrate sitting balance exercise. e. Provide resident education for safety training. f. Demonstrate protective reflex training. g. Demonstrate walking training. h. Demonstrate balance exercises
a. Demonstrate upper extremity strengthening exercise. b. Know and understand the importance of fine motor training programs. c. Understand adaptive methods/adaptive equipment. d. Understand task segmentation, cuing, Hands on training. e. Understand repletion training in sequencing. f. Demonstrate activities that involve dressing, undressing, undressing,
bathing, or grooming, or hygiene, with instruction and training, with or without physical assist.
a. Demonstrate use of assistive devices. b. Demonstrate Hands-on patterning or cuing. c. Demonstrate the correct posture for feeding. d. Demonstrate the correct set-up of equipment. e. Demonstrate postural exercises that facilitate alignment in the
a. Demonstrate the correct application and removal of a prosthesis. b. Demonstrate wellness care of a stump.
a. Explain the use of adaptive equipment. b. Understand self performance activities in functional communication. c. Understand the importance of scheduled periodic evaluations by a
d. Know the importance of documenting the evaluation in the clinical record. e. Understand the importance of supervision by nursing staff documentation.
a. Understand measurable objectives. b. Understand documentation in a care plan.
Total Hours RELATED INSTRUCTION OUTLINE REHABILITATIVE AIDE O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA Qualifications: Successful completion of a Certified Nurse Aide Program. APPROXIMATE WORK PROCESSES SCHEDULE CERTIFIED MEDICATION AIDE O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA
Description (Prerequisite Certified Nurse Aide): Provides training to the apprentice to develop the skills required for the Medication aide. This course includes the development of medicine knowledge, use of medicines, affects of medicine, administering medications, including preparation and accurate distribution of medicine for safety of the resident. APPROXIMATE Safety and Medication Administration: Pharmacodynamics
Explain the relationship between medication and drugs.
State the four basic medication actions.
Name and describe the four body processes that affect
Identify factors influencing mediation action and identify
State the difference between therapeutic effects and side effects.
Differentiate between local and systemic effects.
Recognize descriptions of major adverse reactions.
Identify the meaning for the terms, which describe unwanted
Differentiate between synergism and antagonism.
Explain the difference between physiological and physical
Name classifications of drugs that are commonly abused.
Safety and Medication Administration: Forms of Medication
Identify forms in which medications are available and
Tell how lotions, liniments, and ointments should be applied.
3. State the correct procedures for storing and using tinctures, fluid
extracts, elixirs, spirits and suspensions.
4. Explain what delayed-release tablets and capsules are and how
5. State the rules for giving enteric-coated tablets and capsules. 6. List and describe the routes for administering medications. 7. Explain who is qualified to give medications by the parenternal route.
Safety and Medication Administration: Mathematics, Weights, and Measures 37.5-75
Identify what professionals are responsible for calculating drug dosages.
Identify the importance of correct dose measurement.
Correctly read and write lower case roman numbers ½ through 30.
Define the prefixes used in the metric system.
Describe the disadvantages of the household system of measurement and medication use.
List two drugs that are measured in units, convert grams to milligrams, and vice versa.
List some of the most common equivalents among the different systems of measurement.
Safety and Drug Administration: Drug Standards and Names
Define drug standards and tell how they are determined.
Explain why drug standards are necessary.
Identify the need of “U.S.P.” following a drug name.
List and describe two types of names by which drugs are known.
Differentiate between generic and brand names for drugs.
Safety and Drug Administration: Drug Resources Information
Identify names of resources for drug information.
Demonstrate ability to use drug resources to obtain drug information.
Drugs and Body Systems: Urinary System
Identify basic structures and functions of the urinary system.
State the three functions of the urinary system.
3. Define the key terms for the urinary system, especially:
a. Anuria b. Catheter c. Dysuria d. Hematuria e. Incontinence f. Nephritis g. PH h. Pyuria
Explain how changes in the urine give clues to disorders in the urinary system.
Define the symptoms of urinary system disorders and fluid imbalances.
Describe the causes of dehydration and its treatment.
Describe the following drug groups or treatments by giving examples of common medications or treatments and their actions, and listing nursing care and side effects associated with that type of drug/treatment:
a. Antispasmodics b. Antibiotics c. Urinary
Replacement electrolytes (potassium, calcium, etc.)
Identify drugs used to treat urinary tract disorders and nursing
State the purposes of a urinary catheter.
Identify nursing actions to monitor a diuretic’s actions, to observe
for complications and promote comfort for the resident.
Identify the reason that potassium replacement drugs are used with diuretics.
Identify nursing actions to prevent medication reactions.
Drugs and Body Systems: Respiratory System
Identify the major structures and functions of the respiratory system.
Explain how gases are exchanged in the lungs.
Describe the major respiratory disorders
List and describe common signs and symptoms of
respiratory disorders using correct medical terms.
Describe the actions, give examples, nursing care and
side effects for these drug groups: antihistamines,
8. Explain and demonstrate how to administer medication
Explain and demonstrate how to administer medication
Drugs and Body Systems: Digestive System
1. Identify the basic structures and functions of the digestive
State the five main functions of the gastrointestinal (GI) system.
Name the major parts of the GI system and tell what they do.
Define the symptoms of gastrointestinal disorders.
5. Describe the major gastrointestinal disorders for which
Describe the actions, give examples, nursing care and side effects for these drug groups:
a. Antacids b. Antisecretory drug c. Digestants d. Antiflatulents e. Emetics f. Antiemetics g. Anticholinergics h. Antispasmodics i. Diarrhea
j. Cathartics (laxatives and purgestives) k. Antiparasitics
Discuss non-drug means of controlling diarrhea and for
9. Identify principles to remember in administering medications for the digestive system safely.
Drugs and Body Systems: Nervous Systems
Identify the two major divisions of the nervous system.
Describe the common structures associated with these divisions.
Use the appropriate terms associated with signs of nervous system disorders.
Describe disorders of the nervous system, especially those associated with aging: Parkinson’s disease, myasthenia gravis, multiple sclerosis, drug induced movement disorders, seizure disorders, stroke, tumors, inflammation and infections.
Identify related medications and treatments for disorders of the nervous system.
Discuss implications for nursing care and side effects of medications associated with major nervous system disorders.
Describe the actions and give examples of the following drug groups: CNS cerebral stimulants, respiratory stimulants, CNS depressants, narcotic and non-narcotic analgesics, antidepressants sedative/hypnotics, antipsychotics, antimanic psychotherapeutic, and anti-Parkinson’s disease drugs.
Identify drugs that are often involved in drug abuse.
Describe general nursing care when giving medications for the nervous system.
List medications, which may result in transient of permanent drug-induced movement disorders.
Describe several mental conditions for which psychotropic medications may be given as treatment.
List medications, which may result in a high potential for the resident to fall.
Describe the advantage of scheduled pain medication versus PRN Medication for chronic pain control.
Define placebo. Discuss the ethical issues associated with using placebos.
Drugs and Body Systems: Drugs Affecting the Special Senses: Eye
Identify basic structures and functions of the eye, terms and abbreviations referring to the eye.
Describe the effects of aging on the structures of vision.
Identify major disorders of the eyes and vision.
List terms and abbreviations associated with providing medications to the eyes.
Describe the proper procedures for administering eye drops and ointments.
Identify measures, which help ensure safety for the resident with glaucoma.
Identify the name and actions of drugs used to treat glaucoma.
Identify reasons why anti-infective drugs may be used in the eye and give some examples of drugs used.
Identify actions, uses and names for eye lubricants.
Drugs and Body Systems: Drugs Affecting the Special Senses: Ear
Identify major structures of the ear and their functions.
2. Describe the effects of aging on auditory structures and functions. 3. Describe the major disorders of the ear for which medications are given. 4. Describe the actions and give examples of nursing care and side effects
of these drug groups for disorders affecting the ear: antibiotics, anti-inflammatory, vasoconstrictives, antihistamines, analgesics, and ear wax softeners.
5. Describe the methods/steps/proper procedure for correctly administering
Drugs and Body Systems: Musculoskeletal Systems
1. Identify the major structures, functions of the musculoskeletal system. 2.
Identify the major disorders that affect the musculoskeletal system, especially associated with aging.
Explain the difference between gout, osteoarthrities and rheumatoid arthritis.
Discuss malfunctions of bone marrow and their effects on the blood.
Name related medications, their actions, uses, side effects and implications in treatment of musculoskeletal disorders.
Describe the usual care of residents with musculoskeletal disorders, especially as it relates to medication administration.
Drugs and Body Systems: Endocrine System
1. Identify the major structures and functions of the endocrine system. 2. Describe the regulatory mechanisms of the endocrine system. 3. Illustrate why disorders may be prefixed with “hypo” or “hyper”.
Give examples of disorders of the endocrine system names in the manner.
4. Give examples of drugs used for hormone replacement therapy for
thyroid diseases, pituitary disorders, and diabetes.
5. Use correct medical terms when referring to parts of the endocrine
system and symptoms of hormone imbalances.
6. Describe how the body malfunctions in diabetes and what changes
occur in the urine of an untreated diabetic.
7. State what factors influence the diabetic resident’s insulin needs. 8. Identify diet, activity and medication as treatments of diabetes. 9. List the kinds of insulin available for treatment of diabetes mellitus. 10. Recognize the symptoms of hyperglycemia and hypoglycemia and
11. Give examples of oral hypoglycemics used for diabetes treatment
12. State names, action, side effects of oral hypoglycemia agents. 13. Explain why diabetics must have frequent blood tests. 14. State the actions of glucocorticoids and mineral corticoids and give
15. List at least three uses of corticosteroids. 16. List at least five possible side effects of long-term corticosteroid therapy.
Drugs and Body Systems: Reproductive System
1. Name the main parts of the male and the female internal and
2. Use correct medical terms to describe the parts, functions, and
3. Name the hormones produced by the male and female gonads
4. Describe the actions of gonadotropins, oxytocin, and prolactin. 5. Recognize descriptions of the major disorders that affect the
6. List the main uses of hormones in drug therapy. 7. State the major side effects of sex hormone therapy. 8. State action, side effects and names of male and female hormones
Drugs and Body Systems: Integumentary System
1. Identify three layers of skin, their location, structure, and other
2. Describe the major functions of the skin. 3. Identify common changes in the integumentary system associated
4. Describe major disorders affecting the skin. 5. Identify related medications, nursing care and side effects for the
6. Identify non-drug measures to help treat skin disorders. 7. Identify general issues for skin and skin care, specific types of
dressing and methods of administering skin medications.
Drugs and Body Systems: Anti-Infective Agents
1. Identify cause, control measures, signs and symptoms of infection. 2. Describe methods of reducing infection. 3. Discuss how aging contributes to increased risk for infection(s). 4. Identify terms describing topical anti-infective agents. 5. Name topical anti-infective agents and actions. 6. Identify terms describing systemic anti-infective agents. 7. Recognize some of the common drugs, nursing care and side effects
a. Pencillin’s b. Cephalosporins c. Sulfonamides d. Fluoroquinolones e. Tetracycline f. Aminoglycosides g. Macrolide, lincomycin, and clindamycin h. Vancomycin i. Metronidazole j. Antiviral k. Antifungal
8. Demonstrate methods of identifying action, use, side effects,
adverse reactions, interactions with food or other drugs, contraindications, and special nursing care which should be considered in giving medications.
9. Describe what actions the medication aide should take in administering
medication which may result in changes in laboratory results or which place the resident at particular risk for:
b. Heart rate changes c. Breathing difficulties d. Gastrointestinal upset
10. Name signs or symptoms of a medication sensitivity reaction. 11. Describe methods of preventing medications sensitivity reactions. 12. Name the most severe form of medication sensitivity reaction and
how the medication aide should respond in the event a resident has this type of reaction.
Drugs and Body Systems: Vitamins, Minerals, and Herbs
1. Identify the major food groups from the Food Guide Pyramid. 2. State what general functions vitamins have in the body. 3. Discuss situations when vitamins may be used. 4. Give some examples of vitamins. 5. Discuss the general differences among: fat-soluble and water-
soluble vitamins, macrominerals and microminerals.
6. Identify resources for adult Recommended Daily Allowances for the
7. Identify the actions and give examples of iron preparations. 8. State the measures to use when administering iron to minimize side effects. 9. Identify the action and give an example of calcium medications. 10. Give examples of alternatives to traditional pharmacological interventions. 11. Describe common herbal and food supplements and their uses. 12. Explain some of the adverse effects which herbal remedies can produce.
Administration of Medications: Preparing to Administer Medications
Identify ways in which drugs are supplied to the nursing home.
Describe unit dose and multiple dose packaging of drugs.
Explain proper storage of medicines in the medication room, medication cart and resident’s bedroom.
Describe proper storage of controlled drugs.
Identify proper methods to store equipment and supplies related to the administration of medications.
Describe a method to verify medications orders.
Explain the responsibility of the medication aide in questioning medication orders, including what to do if the order is not clear or legible.
Discuss methods for ordering drugs from the pharmacy.
Identify the basic components of a medication order.
Transcribe orders from the ordering practitioner for medications/treatments under the supervision of a licensed nurse.
List times on the clock using “military time”.
Communicate medications administered and the resident’s responses to medications to the licensed nurse.
Explain how a Kardex, medication cards, and a Medication Administration Record (MAR) are used to communicate medication orders. Demonstrate how to document administration of a medication.
Explain how controlled substances can be accounted for at the beginning of each shift and why this is done.
Identify and demonstrate specific techniques to administer medications using the “Five Rights” of medication administration including
techniques for specific forms of medications.
Identify and demonstrate ways to prevent the transfer of infection.
List three ways to identify the resident.
Identify drugs, which may require special controls or record keeping, and name the controls, which are used.
Administration of Medication: Recording Medication Administration
Identify general guidelines to follow in recording medication administration.
Describe the content of a resident’s clinical record.
Document accurately activities related to administration of medications and treatment.
Describe the principles of clinical documentation.
Demonstrate how to correct an error in a resident’s clinical record.
Describe how to document a medication that was not administered, held, or refused.
Identify appropriate documentation procedures when medication is given at times other than when regularly scheduled.
Demonstrate the process for correcting an error.
Demonstrate the process for documenting a late entry in a clinical record.
Discuss why it is important to follow federal/state laws/regulations and facility policy when documenting in a resident’s record.
Record resident’s response to medication.
Report medication errors immediately to the licensed nurse supervisor.
Administration of Medications: Administering Medications of the Elderly 37.5-75
Describe the major changes that take place in the various body systems during aging.
State why treatment of elderly residents must be individualized according to each person’s needs.
Describe the effects of aging on absorption, distribution, metabolism and excretion of drugs.
Explain how medication orders are usually adjusted to take into account the pharmacokinetics of the older resident.
Explain why the presence of more diseases in old age makes drug therapy more complicated.
State what types of adverse reactions health care workers must look for in administering drugs to the aged.
Explain how elderly residents are affected by the attitudes and actions of health care workers.
Review safe medication administration practice and the principles that are specific for the elderly resident.
Explain how you can overcome the difficulties of administering medications to the elderly.
List ways in which residents can take an active part in their own medication therapy.
Identify and demonstrate methods of safe and effective drug administration by the following routes:
a. Oral b. Inhaler c. Nebulizer d. Rectal e. Vaginal f. Eye g. Ear h. Skin
Demonstrate the use of standard precautions when administering medications.
Correctly identify, use and write abbreviations for medication forms, routes, administration times and general medical abbreviations.
Total Hours RELATED INSTRUCTION OUTLINE CERTIFIED MEDICATION AIDE O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA APPROXIMATE
Safety and Medication Administration: Pharmacodynamics
Safety and Drug Administration: Forms of Medications
Safety and Drug Administration: Mathematics, Weights, and Measures
Safety and Drug Administration: Drug Standards and Names
Safety and Drug Administration: Drug Resources Information
Drugs and Body Systems: Respiratory System
Drugs and Body Systems: Digestive Systems
Drugs and Body Systems: Drugs Affecting the Special Senses: Eye
Drugs and Body Systems: Drugs Affecting the Special Senses: Ear
Drugs and Body Systems: Musculoskeletal System
Drugs and Body Systems: Endocrine System
Drugs and Body Systems: Reproductive System
Drugs and Body Systems: Integumentary System
Drugs and Body Systems: Anti-Infective Agents
Drugs and Body Systems: Vitamins, Minerals and Herbs
Administration of Medications: Preparing to Administer Medications
Administration of Medications: Recording Medication Administration
Administration of Medications: Administering Medications to the Elderly
Total Hours WORK PROCESSES SCHEDULE ENVIRONMENTAL SERVICES O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA Description: Apprentices will learn to maintain a clean environment by completing housekeeping, laundering, and simple maintenance tasks within the guidelines of facility policies and procedures in addition to knowledge of State and Federal regulations. APPROXIMATE Introduction environmental Services Infection Procedures
Basic chemicals used for infection control
Learn the proper methods for safe movement of furniture and equipment
Checkout procedures for supplies and equipment
Housekeeping Carts, Janitor’s Closet and Supply Closet Maintenance
Hazardous chemicals; carpet clean-up procedure
Buffing, stripping Housekeeping
Windows-draperies, shades, glass, blinds
Cleaning Procedures 40-80
Specialized Service 40-80 Pest Control
Chemical usage-proper dilution and treatment of injury
Total Hours RELATED INSTRUCTION OUTLINE ENVIRONMENTAL SERVICES O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA APPROXIMATE
The apprentice will be able to use the related theoretical
instruction to keep the apartments, public areas and clothing clean.
The apprentice will understand the regulations governing the
delivery of housekeeping and laundry services.
The apprentice will know how to read and use the information
The apprentice will understand how universal precautions relate
The apprentices will be able to develop a schedule that will
accomplish the delivery of housekeeping and laundry services to the elders living in the assisted living.
Total Hours WORK PROCESSES SCHEDULE DINING SERVICES O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA Description: Prepares and cooks family-style meals for crews or residents and employees of institutions: Cooks foodstuffs in quantities according to menu and number of persons to be served. Washes dishes, bakes breads and pastry. Cut meat, plans menu, taking advantage of foods in season and local availability. May serve meals, order supplies and keep records and accounts. May direct activities of one or more workers who assist in preparing and serving meals. Certification in ServSafe is received following a three-hour course completion. APPROXIMATE Vegetable Preparation (cooked) Preparation cooking) c. Cooking (meats and vegetables) d. Make soups, gravies, sauces
1. Selection and cutting roasts, steaks and chops 2. Preparation of boiled, fried, roasted and broiled meats
vii. Preparation of different kinds of servings, roasting,
broiling, frying or fricassees vegetables
1. Use of generally used vegetables 2. Cleaning and peeling vegetables 3. Different ways of preparation (sliced, diced, etc.)
e. Cooking Foods Preparatory to Serving
1. Combining proper items for soups 2. Time control for cooking 3. Preparation and use of seasoning
1. Cooking various roast and control of the
required length of time cooking each kind of roast
2. Cooking meats by boiling and practice in the
different procedures for salt and fresh meats
3. Broiling meats and time control required for
4. Frying meats for short orders, dinners and
1. Preparation of different fowl orders for roasting,
2. Preparation of various kinds of dressings 3. Preparation and use of seasoning
1. Control of timing for cooking different vegetables 2. Preparation and cooking potatoes in different
styles such as pan fried, French-fried, boiled, baked and scalloped
f. Preparation of Salads, Dressings and Sauces
i. Use of items used in preparation of salads, dressings
ii. Use of the different kinks of dressings such as olive
oil, mayonnaise, French dressing, Russian dressing and Roquefort dressing
iii. Preparation and use of standard sauces and
i. Preparation and baking of bread and rolls
ii. Preparation and baking of cakes and cookies
iv. Preparation and baking of French pastries
v. Preparation and baking of Danish pastries
h. Purchasing Supplies and Planning Menu
i. Purchasing supplies with close check on local market
iii. Attractive placement of foods on menu
iv. Practice in receiving food orders from waiters in
i. Appetizers and Relishes
i. Preparation and use of appetizers and relishes
ii. Use of various suitable combinations
j. Preparation of Beverages k. Food Storage
i. Storing of food for deep freeze and refrigeration
ii. Checking food in storage for prevention of waste
i. Use of the different types of refrigerators and
iii. Cleaning and defrosting refrigerators
m. Banquet Department
i. Estimating, preparing and cooking for a banquet
iii. Serving food that is hot at time of serving
n. Inspection for Requirements of Law in Food Business o. ServSafe Certification
ii. How to provide safe food Ensuring proper personal
iii. Keeping foods safe from purchasing and receiving
iv. Maintaining sanitary facilities and equipment
p. Specialty Dining In-service Learning
i. Why increased learning of dining room service?
1. A goal for Dining Services is to refine service
2. Residents have commented on service delivered
3. Your co-workers have indicated a desire to learn
more about upgrading service to residents
1. In-service education 2. Practicum 3. Supervision and evaluation
iii. What is to be covered by this in-service?
a. Focal point not only for dining but also
b. Balance of quality food and gracious dining
a. Actions show your feelings and mental state b. Good, positive feelings of wait staff
a. Sanitary practices b. Uniforms c. Report to work on time d. Follow cleaning schedule e. Serve hot food hot and cold food cold f. Meals will be ready on time g. Clean as you go h. Put items in their proper place i. Acknowledge
RELATED INSTRUCTION OUTLINE DINING SERVICES O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA APPROXIMATE
Demonstrate how to correctly prepare and cook foods to
Demonstrate understanding of State Regulations in regard to
Demonstrate complete understanding of company policy by
Demonstrate how to develop and implement a complete meal menu.
Demonstrate how to track food supply inventory and safely store
Total Hours ADVANCED HEALTH SUPPORT SPECIALIST
Description: In order for an Apprentice to become an Advanced Health Support Specialist they must complete the following: Many Adult Care Facilities have a growing need for Home Health Aides and Activity Directors. To meet the needs of these Adult Care Facilities, Home Health Aide and Activity Director has been added to address these areas of concern. A facility may choose one or both of these certifications to allow the Health Support Specialist to grow and meet the needs of the facility. WORK PROCESSES SCHEDULE HOME HEALTH AIDE O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA
Description: Prerequisite Certified Nurse Aide: Home Health Aide apprentices give personal care to clients as specified and supervised by a Licensed or Registered Nurse. They help maintain stability in the home by carrying out routine home management tasks and assisting the client and/or family to resume these functions. APPROXIMATE
The apprentice will develop a plan of care to provide care in
The apprentice will be able to identify factors that lead to client
The apprentice will demonstrate appropriate responses to client
The apprentice will be able to discuss different characteristics of
The apprentice will be able to understand and identify the role of
the home health aide in situations where there is mental illness.
The apprentice will be able to recognize and define developmental
disability, and explain the role of the home health aide when working
with a client with a developmental disability.
The apprentice will be able to describe family abuse and understand
the responsibility of the home health aide and know whom to report
The apprentice will maintain a clean, safe, healthy environment.
The apprentice will describe how to adapt personal care activities to
The apprentice will assist the client with medication by understanding
The apprentice will understand how to store medications safely.
The apprentice will understand and document observations regarding
The apprentice will discuss the correct way to dispose of old medications.
The apprentice will understand the responsibility of the Home
Health Aide in assisting the client with Oxygen Therapy.
The apprentice will describe guidelines for care of a client
The apprentice will identify correct use of a vaporizer or humidifier.
The apprentice will identify ways to help in emergency situations.
Total Hours RELATED INSTRUCTION OUTLINE HOME HEALTH AIDE O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA APPROXIMATE
Adapting personal care activities in the client’s home
Total Hours WORK PROCESSES SCHEDULE ACTIVITY DIRECTOR O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA Description: Activity Directors are recognized as vital contributors to quality of care and providing good quality of life to the individuals they serve. A complete program enhances the physical, mental, social, emotional, and spiritual needs of elders by providing a home like environment. This program is designed to develop the programming, documentation, and professional skills necessary to lead such a program. APPROXIMATE
The apprentice will be able to list different settings in which activity
The apprentice will be able to become aware of Theories on Aging,
disorders, sensory losses and individual that are served.
The apprentice will be able to describe the day to day activities of
an activity director, what it means to be a professional, and professional organizations available.
The apprentice will be able to evaluate the environment in which
The apprentice will be able to establish leisure and recreational goals
through programming for all levels of functioning.
The apprentice will be able to become aware of the new culture change
taking over long term traditional environments to a more home like
environment providing opportunities for companionship.
The apprentice will be able to establish programming levels of activities
The apprentice will be able to become aware of all documentation required
by state and federal regulations, new approaches, forms, assessment
The apprentice will be able to become introduced to monitoring tools,
Quality Assurance and Management techniques to evaluate programs.
The apprentice will be able to establish facility councils and volunteer
The apprentice will become aware of residents rights, behavior
management, policies, procedures, regulations and survey process.
Total Hours RELATED INSTRUCTION OUTLINE ACTIVITY DIRECTOR O*NET-SOC CODE: 31-1011.00 RAIS CODE: 1086AA APPROXIMATE
Orientation to Activity Director program
Documentation, State and Federal regulations
Resident rights, regulations and survey process
Summary of the 7th annual NOREPOS workshop Hurdalsjøen, 20 - 21 September 2012 This year’s workshop was organized by the Oslo group and the venue was Hurdalsjøen Hotel and Conference Center in Akershus. Twenty-seven researchers from across Norway interested in epidemiologic osteoporosis research met for two days and discussed research results and future plans. Professor Karl Michaëlsson f
Jahresbericht 2008 Abteilung für Innere Medizin einschließlich internistische Intensivmedizin Leiter: Prim. Univ.-Doz. Dr. Bernhard Föger, Chefarzt-Stv. LKH Bregenz (Additivfacharzt für Stoffwechsel und Endokrinologie, Additivfacharzt für internistische Intensivmedizin) Sekretariat: Margit Fink bis 31.08.08 (email@example.com) www.lkhb.at/interne Claudia Almer ab 01.09.08(in