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State of Michigan Department Of Licensing And Regulatory Affairs Bureau of Community and Health Systems Long Term Care Division
Paid Dining Assistant Curriculum August 1, 2015 PREFACE………………………………………………………………………………………………………………………………………. ……………………i DIRECTIONS FOR USE OF THE DINING ASSISTANT CURRICULUM………………………………………………………………….……v
Unit 1 Role of the Dining Assistant…………………………………………………………………………………………………………………..1 Role of the Dining Assistant………………………………………………………………………………………………………………2 Federal Regulations…………………………………….. …………………………………………………………………………………..2 Course Requirements……………………………………………………………………………………………………………………….2 Supervision…………………………………………………………………………………………………………………………… ………….3 Resident Selection…………………………………………………………………………………………………………………………….3 Records………………………………………………………………………………………………………………………………… ………….3
Unit 2 Communications and Interpersonal Skills……………………………………………………………………………………………..5 Communications Skills………………………………………………………………………………………………………………………6 Interpersonal Skills……………………………………………………………………………………………………………………………7 Communicating with Residents and Families……………………………………………………………………………………8 Communicating with Residents with Special Needs………………………………………………………………………….9 Observation and Reporting…………………………………………………………………………………………………………….11 Recognizing Behavior Changes……………………………………………………………………………………………………….11
Unit 3 Resident Rights……………………………………………………………………………………………………………………………………13 Ethics, Confidentiality and Privacy…………………………………………………………………………………………………..15
Dignity……………………………………………………………………………………………………………………………………………. 15 Legal Issues……………………………………………………………………………………………………………………………………..15 Mistreatment of Elderly………………………………………………………………………………………………………………….16 Definitions………………………………………………………………………………………………………………… ……….....16 Signs and Examples of Abuse………………………………………………………………………………………………….17 Identification of Residents at Risk for Abusing Other Residents……………………………………………..17 Identification of Residents at Risk for Being Abused…………………………. …………………………………...17 Report Abuse……………………. ……………………………………………………………………………………………………18
Unit 4 Safety and Emergency Procedures………………………………………………………………………………………………………19 Basic Emergency Procedures and Resident Safety…………………………………………...... 20 Safety Measures to Prevent Accidents and Injuries…………………………………………………………………………20 Assisting Residents with Choking…………………………………………………………………………………………………….21 The Heimlich Maneuver………………………………………………………………………………………………………………….22 Assisting with Heart Emergencies……………………………………………………………………………………………………22 Assisting Residents with Seizures…………………………………………………………………………………………………….23 Reporting Emergency Situations……………………………………………………………………………………………………..24
Unit 5 Infection Control………………………………………………………………………………………………………………………………….25 Infection Transmission…………………………………………………………………………………………………………………...27 Medical Asepsis……………………………………………………………………………………………………………………………….29 Standard Precautions………………………………………………………………………………………………………………………30 Handwashing……………………….………………………………………………………………………………………………..30
Unit 6 Nutrition and Hydration………………………………………………………………………………………………………………………32 General Principles.. …………………………………………………………………………………………………………………………34 Food Guide Pyramid and Basic Food Groups.. …………………………………………………………………………………36 Therapeutic Diets..……………………………... ………………………………………………………………………………………….37 Adaptive Devices..………………………………. ………………………………………………………………………………………….38 Preparing and Serving Resident’s Meals.. ……………………………………………………………………………………….38 Dining Techniques.. …………………………………………………………………………………………………………………………39 Serving Supplementary Nourishments... ………………………………………………………………………………………….39 Providing Fresh Drinking Water………………………………………………………………………………………………………40 Challenging Dining Problems…………………………………………………………………………………………………………..41 Setting up a Meal Tray and Dining a Resident. …………………………………………………………………………………41
Appendix A – Instructional Objectives and Performance Checklist Summary………………………………………………….43
Appendix B – Performance Checklist Index…………………………………………………………………………………………………….48
Appendix C – Instructional Objectives and Task Checklist Summary……………………………………………………………….50 Performance Checklists…………………………………………………………………………………………………………………..51
Preface Paid Dining Assistant Curriculum
On September 26, 2003, the Centers for Medicare and Medicaid Services (CMS) published the final regulations for requirements for paid dining assistants in Long Term Care Facilities (Federal Register/Vol. 68, No. 187/Friday, September 26, 2003/Rules and Regulations, page 5539).
The regulations are found under 42 CFR 483, Subpart B § 483.35, 483.75, Subpart D § 483.160; and 42 CFR 488 Subpart E § 488.301.
House Bill 5389 was signed into law by Governor Snyder on January 10, 2015 and amends the Michigan Public Health Code to allow the use of dining assistance in nursing homes.
The federal and state regulations stipulate that facilities must not use any individual employed in the facility as a dining assistant unless that individual has successfully completed a State- approved training program for dining assistants, as specified in the regulations. Under F373 in the SOM, “Facilities may use their existing staff to assist eligible residents to eat and drink. These employees must have successfully completed a State-approved training course for paid feeding assistants…….”
The regulations do not apply to licensed nursing personnel, or nurse aides. They do not apply to volunteers, families or friends. However, any individual employed by the facility who feeds residents, if only for a short time each day or occasionally, must successfully complete State- approved dining assistant training because s/he is functioning as a dining assistant. This includes individuals whose services at the facility may be paid under contract with another employing agency.
For each person providing paid dining assistance, the facility must maintain a record of the successfully completed State-approved curriculum for dining assistants.
A facility must ensure that a dining assistant feeds only residents who have no complicated dining problems. Complicated dining problems include, but are not limited to, difficulty swallowing, recurrent lung aspirations, and tube or parenteral/IV feedings. The facility must base resident selection for being fed by a dining assistant on the charge nurse’s assessment, the resident’s latest assessment, and the resident’s plan of care.
A dining assistant must work under the supervision of a registered nurse (RN) or licensed practical nurse (LPN).
6 In an emergency, the dining assistant must call a supervisory nurse for help using the resident call system. In the SOM under F373 Paid Feeding Assistants, it is noted under the Interpretive Guidelines section: “Residents may be receiving assistance in eating or drinking in various locations throughout the facility, such as dining areas, activity room, or areas such as patios or porches in which a resident call system is not readily available…Regardless of where a resident is being assisted to eat or drink, in the case of an emergency, the facility needs to have a means for a paid feeding assistant to obtain timely help of a supervisory nurse. Therefore, for the purposes of this requirement, a ‘resident call system’ includes not only the standard hard- wired or wireless call system, but other means in an emergency situation by which a paid feeding assistant can achieve timely notification of a supervisory nurse.”
To meet minimum federal requirements, a program must consist of at least 8 hours of a state approved training course for dining assistants. The course must meet the requirements of § 483.130 and must include the following:
(a) Dining techniques. (b) Assisting with dining and hydration. (c) Communication and interpersonal skills. (d) Appropriate responses to resident behavior. (e) Safety and emergency procedures, including the Heimlich Maneuver. (f) Infection control. (g) Resident rights. (h) Recognizing changes in residents that are inconsistent with their normal behavior and the importance of reporting those changes to supervisory nurse. (I) End of life.
This curriculum does not include bloodborne pathogen training. Facilities are already required by OSHA to provide this training prior to exposure to individuals with bloodborne pathogens and on an annual basis, thereafter. The principles and application of gloving, gowning, mask and eyewear protection are not included in this curriculum. It is the responsibility of the facility to provide the appropriate training in applying and removing PPE for any individual who needs this type of protection when providing dining assistance to a resident. Material on Standard Precautions is limited to basic required application for all residents and does not address Droplet Precautions, Contact Precautions, or Transmission-Based Precautions.
This curriculum is approved for meeting the requirements of the regulations governing the training of dining assistants. Additional components that expand the curriculum may be
7 added, but not substituted. A minimum of 8 clock-hours of instruction, including skills competency, is required. All skills in this curriculum should be successfully demonstrated with instructor supervision prior to feeding a resident and prior to completion of the program. No attempts have been made to establish a test or grading system for successful completion. The primary instructor, based on instructor evaluation and documented skills competency, will determine successful completion of the program. The goal of the program is competency, not failure.
The course must be taught by qualified licensed health professionals such as a Registered Nurse (RN) or Occupational Therapist. Other licensed health care personnel with at least one year of experience in their fields may supplement the instructor.
Up-to-date textbooks are an important learning resource for students. It is recommended that instructors review several and select one that will provide resources to complement the curriculum.
To meet minimum state requirements as outlined in MCL 333.1101 to 333.25211 amended to add Section 21794, the following conditions must be met by the facility:
a. Receive documented consent from the resident or resident’s guardian. b. Maintain a written record for each paid dining assistant which includes: 1. Criminal background check results 2. Complete name and address of the individual 3. Documentation of completion of the PDA training and date of successful completion of program c. A supervising nurse shall be immediately available. d. A dining assistant must not be included in computing the ratio of patients to nursing personnel or used to supplement or replace nursing personnel. e. A dining assistant assigned to provide dining assistance to a resident in their room must not be assigned to another resident at the same time.
The paid dining assistant must:
a. Be at least 17 years of age or older. b. Not provide any nursing functions, including, but not limited to, assistance with transportation, ambulation, transferring or, toileting residents, or the distribution of medication. c. Pass a criminal background check.
Statutory Definitions
8 1. Dining Assistant: An individual who meets the requirements of this section, is paid by the facility, provides dining assistance to residents, and is not a Registered Nurse, Licensed Professional, or Certified Nurse Aide.
2. Immediately available: Being capable of responding to help if needed at any time either in person, by voice or call light system, radio, telephone, pager or other method of communication during a dining experience.
3. Nurse: An individual licensed as a Registered Professional Nurse or Licensed Practical Nurse under Article 15 to engage in the practice of nursing.
4. Under the Supervision of a Nurse: A nurse who is overseeing the work of a dining assistant is physically present in the nursing home and immediately available. Adequate supervision by a supervising nurse does not necessarily mean constant visual contact or being physically present during the meal/snack time.
5. Charge Nurse: The facility must base resident selection for feeding assistance on the charge nurse’s (RN or LPN) current assessment of the resident’s condition, latest comprehensive assessment, and plan of care. Charge nurses may wish to consult with interdisciplinary team members, such as speech-language pathologists or other professionals, when making their decisions.
6. Supervisory Nurse: May be a RN or LPN. The supervisory nurse should monitor the provision of the assistance provided by paid feeding assistants to evaluate on an ongoing basis: their use of appropriate feeding techniques; whether they are assisting assigned residents according to their identified eating and drinking needs; whether they are providing assistance in recognition of the rights and dignity of the resident; and whether they are adhering to safety and infection control practices.
7. The charge nurse and the supervisory nurse may or may not be the same individuals.
Directions for Use of the Dining Assistant Curriculum
The Dining Assistant curriculum has been prepared for two groups of people. First, the students for whom we wish to provide the knowledge and the clinical skills necessary to become competent Dining Assistants. Second, the teachers for whom we wish to provide a curriculum that can be used to complement their teaching skills and help them to educate individuals to become knowledgeable, efficient, caring Dining Assistants. 9 The curriculum has been divided into six major sections. Content pertaining to recognizing changes that are inconsistent with normal behavior, and the importance of reporting those changes to the supervisory nurse, are included throughout the curriculum.
Unit 1. Role of the Dining Assistant.
Unit 2. Communication, Interpersonal Skills and Appropriate Responses to Resident Behavior.
Unit 3. Resident Rights and Appropriate Responses to Resident Behavior.
Unit 4. Safety and Emergency Procedures.
Unit 5. Infection Control.
Unit 6. Nutrition and Hydration, Dining Techniques and Assisting with Dining and Hydration.
The curriculum pages have been divided into three columns. The first column lists the “Unit Objectives.” The second column, “Course Content,” provides an outline of the information to be covered to meet the objective. The third column, “Learning Activities,” is provided for listing individual activities the instructor might choose to enhance student learning. Medical terms, along with definitions, are included at the beginning of each unit.
Skills are listed at the appropriate points in the instructional content. Individual performance checklists for each skill are included in Appendix A, along with Instructional Objectives and Performance Checklist Summary. Instructors should use the performance checklists to document individual performance and demonstration of skills by the student. A copy of the Instructional Objectives and Performance Checklist Summary, as well as the individual Performance Checklists, should be maintained in each employee’s record to document successful completion of the program.
No attempt has been made to determine a grading policy. The grading policy developed by individual programs should be followed. Competency-based education is about mastery of behavioral objectives with sufficient time allotted for the individual to achieve mastery.
10 11 Unit 1
Role of the Dining Assistant
Terminology Defined
1. Dining Assistant: Any individual who has successfully completed a State approved dining assistant curriculum in accordance with Federal Requirements 42 CFR 483.160 and who works under the supervision of a licensed nurse, feeding residents; does not include nurse aides or licensed nurses when feeding is performed as part of their regular nurse aide or nursing duties.
2. Immediately available: Being capable of responding to help if needed at any time either in person or by voice/call light system, radio, telephone, pager, or other method of communication during a dining experience.
3. Nurse: An individual licensed as a registered nurse or a licensed practical nurse, under Article 15, to engage in the practice of nursing.
4. Under the Supervision of a Nurse: A nurse is overseeing the work of a dining assistant, is physically present in the nursing home, and is immediately available.
12 Unit 1: Role of the Dining Assistant Page: 2 Objectives Course Content Learning Activities 1.1 Examine the role of the i) The Role of the Dining Assistant Discuss regulations 42 CFR Dining Assistant A) Federal Regulations Describing a single task worker, the 483.35, 483.160, 483.301, Dining Assistant 4837, 483.75
B) Aging population in facilities more acute than ever before B.1) More staff time taken with high levels of care. B.2)Less time for routine tasks like dining residents who need minimal assistance.
C) Goal of Regulations C.1)To supplement, not replace, CNAs. C.2)To provide more residents with assistance in eating and drinking. C.3)To reduce unplanned weight loss. C.4)To reduce incidence of dehydration.
D) Requirements to become a Dining Assistant List the course requirements to D.1) Must complete a state-approved 8-hour minimum become a Dining Assistant training course. D.2) Course must include content on: (D.2.a) Dining techniques (D.2.b) Assistance with dining and hydration (D.2.c) Communication and interpersonal skills (D.2.d) Appropriate responses to resident behavior (D.2.e) Safety and emergency procedures, including the Heimlich Maneuver (D.2.f) Infection control (D.2.g) Resident rights (D.2.h) Recognizing changes in residents that are inconsistent with their normal behavior, and the importance of reporting those changes to the 13 supervisory nurse
E) Important Points to Remember E.1)The Dining Assistant does not give nursing care. E.2)Dining Assistants should only perform those tasks for which they have been trained. E.3)CNAs or other licenses personnel feed the more complicated resident. E.4)Dining Assistants should only feed residents selected by charge nurse.
ii) The Role of Facilities Using Dining Assistants 1.2 Examine the role of A) Supervision of the Dining Assistant facilities using Dining A.1) Must work under the supervision of a Registered Assistants Nurse (RN) or Licensed Practical Nurse (LPN). A.2) In an emergency, the Dining Assistant must call the supervisory nurse for help using the resident call system.
B) Choosing Residents for the Dining Assistant B.1)The facility must ensure that only residents who have Describe three eating problems no complicated dining problems are selected a resident might have that B.2)Complicated dining problems include, but are not would not support the use of a limited to: Dining Assistant (B.2.a) Difficulty swallowing (B.2.b) Recurrent lung aspirations (B.2.c) Tube or parenteral/IV nutrition B.3)Resident selection based on the charge nurse’s assessment and the resident’s plan of care.
C) Maintenance of Records C.1)Facilities must maintain a record of individuals used by the facility who have successfully completed the training for a Dining Assistant
14 C.2)Dining Assistant List three facility (C.2.a) An individual who meets the requirements responsibilities when using a of the federal regulations, and Dining Assistant (C.2.b) An individual who is used under an arrangement with another agency or organization. (C.2.c) Dining Assistants should keep copy of record of successful completion for their records.
Unit 2
Communication and Interpersonal Skills
Terminology Defined
1. Abbreviation: A shortened form of a word or phrase.
2. ADL: Activities of daily living.
3. Aphasia: Inability to express oneself properly through speech, or loss of verbal comprehension.
4. Cognitive: Mental process by which an individual gains knowledge.
5. Communication: The exchange of information; a message sent is received and interpreted by the intended person.
6. Feeling: State of emotion, not able to be measured; subjective data.
7. Legible: Written in a manner that can be easily read. 15 8. Paraphrase: Repeat a message using different words
9. Resident Record: A written account of the resident’s physical and mental condition.
10. Rapport: A close relationship with another.
11. Recording: Documenting resident care and observations.
12. Reporting: A verbal account of resident care and observations.
13. Sensory: Relating to sensation involving one or more of the five senses (seeing, hearing, touching, smelling, tasting).
16 Unit 2: Communication and Interpersonal Skills Page: 6 Objectives Course Content Learning Activities 2.1 Demonstrate appropriate i) Communication Skills Have the class identify and effective communication A) Elements That Influence Relationships With Others examples of these elements skills. A.1) Prejudices. and discuss ways to handle A.2) Frustrations. each of the examples A.3) Attitudes. presented. A.4) Life Experiences.
B) Requirements for Successful Communications Role-play the process of B.1)A message. communication. B.2)A sender. B.3)A receiver. 2.1.1 Describe the importance of developing good listening C) Listening Skills skills. C.1)Show interest. Discuss ways of showing C.2)Hear the message. interest. C.3)Avoid interrupting. 2.1.2 Identify five positive C.4)Ask appropriate questions for clarification. Have the class divide into listening skills that can be C.5)Be patient and help resident express feelings and groups of three. Select a sender used. concerns. to give a message to two C.6)Avoid distractions. receivers (all senders will use C.7)Note silence between sounds. the same prepared message.) C.8)Become involved with the message and resident. Have the receivers write down 2.1.3 Recognize barriers to C.9)Concentrate and be attentive. what they heard. Follow small effective communications. group discussions with class D) Barriers to Effective Communications discussion. D.1) Labeling. D.2) Talking too fast. Role-play how the Dining D.3) Avoiding eye contact. Assistants show interest in the D.4) Belittling a resident’s feelings. resident, and help residents D.5) Physical distance. express feelings and concerns. 2.1.4 Explain how one will D.6) Sensory impairment. need to modify his or her (D.6.a) Confusion Have the class share past behavior in response to the (D.6.b) Blindness experiences when a resident’s behavior. (D.6.c) Aphasia communication barrier caused (D.6.d) Hearing impairment them to end a conversation. 2.1.5 Define the terms D.7) Changing the subject. “sympathy,” “empathy,” and D.8) False assurances and clichés. Staff talking to staff over a “tact.” D.9) Giving Advice. resident without including the D.10) Ineffective communication. resident in the conversation. (D.10.a) Disguised messages Role-play ways in which (D.10.b) Conflicting messages sensory impairment can lead to (D.10.c) Unclear meanings breakdowns in communication. (D.10.d) Abstractions (D.10.e) Perception List false assurances. (I.E. “Everything will be fine. You’ll ii) Interpersonal Skills see.”) A) Determined By A.1) Standards and values. Consider clichés rather than A.2) Heredity. abstracts and discuss how the A.3) Interests. meanings could differ for A.4) Feelings and stress. residents. Example: A.5) Expectations others have for us. 1) “The grass is always greener A.6) Past experience. on the other side.” 2) “A bird in the hand is worth B) Dealing with Resident Behavior two in the bush.” B.1)Accept every resident. B.2)Listen to every resident. Have the class discuss why B.3)Comply with reasonable requests, when possible. resident behavior shouldn’t be B.4)Display patience and tolerance. taken personally. B.5)Make an effort to be understanding. B.6)Develop acceptable ways of coping with negative feelings. Define anger and role-play (B.6.a) Leave the room after providing for safety situations of an angry and (B.6.b) Tale with nursing supervisor about your worried resident that lashes feelings out at a health care worker. (B.6.c) Involve yourself in physical activity Discuss how these situations (B.6.d) Learn to use relaxation techniques that ease could be handled. stress B.7)Be sensitive to resident’s moods. B.8)Be able to handle disagreements and criticism.
C) Treat Residents as Unique Individuals C.1)Do things their way when possible. C.2)Anticipate their needs. C.3)Ask for their opinion.
2.3 Develop effective non- D) Be Able to See Things from the Other Person’s Point of verbal communications in View keeping with one’s role with Discuss effects of positions and residents and their families. iii) Communicating with Residents and Families postures when communicating. A) Nonverbal Communications 2.3.1 List four examples of A.1) Posture. Role-play examples of body non-verbal communications. A.2) Gestures. language that differ from the A.3) Level of activity. verbal message being sent. A.4) Facial expressions. A.5) Appearance. A.6) Touch.
B) Verbal Communications B.1)Speak clearly and concisely. B.2)Give message by tone of voice. B.3)Face resident, at eye level, when speaking. B.4)Avoid words with several meanings. Have the class use paraphrasing B.5)Present thoughts in logical, orderly manner. for a message and discuss their B.6)Learn to paraphrase. understanding of the message. B.7)Types of communication. (B.7.a) Person to person (B.7.b) Oral report
C) Communicating with the Resident’s Family and Visitors C.1)Ask how they are doing. C.2)Indicate that you are glad to see them. C.3)Be warm and friendly. C.4)Use talking and listening skills you would use with resident. C.5)Share knowledge about your unit. (C.5.a) Visiting hours (C.5.b) Restrictions to visitors (C.5.c) Any restrictions on bringing resident’s food C.6)Report stressful or tiring visits to supervisory nurse. C.7)Refer requests for information on the resident’s Give examples of information condition to the supervisory nurse. from family members that C.8)Share information from family/visitors that would would affect resident dining. affect dining resident with the supervisory nurse. 2.3.2 Describe specific factors C.9)Report visitor concerns or complaints to the that should be considered supervisory nurse. when communicating with the hearing impaired D) Factors to Consider When Communicating with Hearing resident. Impaired Residents D.1) Encourage resident to use hearing aid. D.2) Speak slowly and use simple sentences. D.3) Face resident at eye level when speaking. D.4) Allow resident to lip read if it helps. D.5) Lower pitch of your voice. D.6) Direct speech to stronger ear. D.7) Use gestures when possible to clarify statements. 2.3.3 Identify factors to D.8) Write when necessary. consider when D.9) Learn some basic signing if interested. Speaker to discuss blindness communicating with residents and adaptations. that have decreased vision. E) Factors to Consider when Communicating with a Resident with Decreased Sight E.1)Speak as you enter the room. E.2)Sit where the resident can best see you. E.3)Make sure lighting is sufficient. E.4)Allow resident to touch objects and yourself. E.5)Encourage resident to wear glasses if they help. E.6)Use touch and talk frequently to communicate your location. E.7)Encourage resident to use magnifying glass if it helps. 2.3.4 Consider factors that E.8)Use descriptive words and phrases. would assist the resident that E.9)Make large print materials available. Charades may be used to point has difficulty speaking to out frustration of not being communicate. F) Factors to Consider when Communicating with Residents able to speak. The class can Who Have Difficulty Speaking explore ways to turn this game F.1)Encourage resident to use hands to point out objects. into a helping tool for residents F.2)Use communication boards/cards. who have difficulty speaking. F.3)Repeat what you heard to be sure you understood resident. 2.3.5 Recognize techniques F.4)Allow resident to express feelings. that can be used to help a F.5)Ask yes and no questions. depressed resident to communicate. G) Communicating with Depressed Residents G.1) Exercise patience. 2.3.6 Identify ways one can G.2) Allow time for resident to express feelings. Have class members share communicate with residents personal experiences with with memory loss. H) Communicating with Resident with Memory Loss individuals with memory loss. H.1) Encourage resident to talk. H.2) Talk about things resident remembers. H.3) Ask one question, containing one thought, at a time. 2.3.7 Communicate with H.4) Keep questions simple. residents according to their H.5) Rephrase questions that are not understood. Have class members share stage of development. H.6) Avoid asking resident to make a choice. personal experiences with developmentally disabled. I) Communication Based on Stage of Development I.1) Treat all residents with dignity and respect. I.2) Encourage residents to make choices when Discuss ways to develop appropriate. rapport with residents. I.3) Use simple sentences. I.4) Emphasize positive qualities. I.5) Do not attempt to exert power over the resident. Have class members talk with I.6) Encourage residents to do all they can for themselves. two residents described in this I.7) Be patient. section. Ask the students to: I.8) Use age appropriate speech. 1) Identify communication I.9) Allow residents to express feelings, ideas, and problems experienced. frustrations. 2) Describe body language I.10) Gain resident’s attention and speak clearly, in a observed. 2.4 Observe by using the normal voice. senses to report resident I.11) Never assume that you aren’t heard or understood. behavior to the nurse. I.12) Never address residents as if they are children.
iv) Observation and Reporting A) Using Sense for Observation and Reporting A.1) Sight. (A.1.a) Rash (A.1.b) Skin Color A.2) Hearing. (A.2.a) Wheezing (A.2.b) Moans A.3) Touch. (A.3.a) Cold (A.3.b) Hot (A.3.c) Perspiration A.4) Smell. 2.4.1 Recognize changes that (A.4.a) Odor of breath are inconsistent with normal (A.4.b) Odor of wounds Have the class prepare a list of behavior. (A.4.c) Odor of body behaviors and physical changes that would be inconsistent or B) Recognizing Changes abnormal. B.1)Observe continuously using senses methods. B.2)Listen and talk to the resident. B.3)Ask questions. B.4)Be aware of a situation and any changes. B.5)Observe for changes in attitude, moods, and emotional 2.4.2 Recognize changes that condition. are inconsistent with normal B.6)Pay attention to complaints. Practice reporting information behavior. B.7)Be alert to changes in condition or usual happenings. in small groups with group members changing roles. 2.4.3 Discuss differences C) Reporting between objective and C.1)Reports are made to the supervisory nurse: subjective data. (C.1.a) Promptly (C.1.b) Thoroughly 2.4.4 Discuss changes that (C.1.c) Accurately Role-play a situation and have may occur in residents’ end of C.2)Use pad and pencil to jot down information for the class report objective and life. reporting. subjective data. C.3)Report only facts, not opinions. (C.3.a) Objective data (C.3.b) Subjective data v) Unit 3 vi) vii) Resident Rights viii) ix) x) Terminology Defined xi) xii) 1. Abuse: The willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish. xiii) xiv) 2. Advocate: One that pleads the cause of another. xv) xvi) 3. Aiding and Abetting: Not reporting dishonest acts that are observed. xvii) xviii) 4. Assault: Attempt or threat to do violence to another. xix) xx) 5. Battery: An unlawful attack upon another person. xxi) xxii) 6. Confidential: Keeping what is said or written private, or to oneself. xxiii) xxiv) 7. Defamation: Injuring the name and reputation of another person by making false statements to a third person. xxv) xxvi) 8. Dignity: The quality or state of being worthy, honored, or esteemed. xxvii) xxviii) 9. Discrimination: Prejudiced or prejudicial outlook, action or treatment. xxix) xxx) 10. Drugs: Any chemical compound that may be used on or administered as an aid in the diagnosis, treatment or prevention of disease or other condition or the relief of pain or suffering or to control or improve any physiological pathologic condition. xxxi) xxxii) 11. Diversion of Drugs: The unauthorized taking or use of any drug. xxxiii) xxxiv) 12. Ethics: A set of moral principles and values. xxxv) xxxvi) 13. Fraud: An intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person. This includes any act that constitutes fraud under applicable Federal or State Law. xxxvii) xxxviii) 14. Gossip: Talking about residents or co-workers. xxxix) xl) 15. Grievance: A cause of distress felt to afford reason for complaint or resistance. xli) xlii) 16. Harassment: To worry or annoy persistently. xliii) xliv) 17. HIPPA: Health Information Privacy and Portability Act. xlv) xlvi) 18. Invasion of Privacy: A violation of a person’s right not to have one’s name, photography, or private affairs exposed or made public without giving consent. xlvii) xlviii) 19. Misappropriation: The deliberate misplacement, exploitation, or wrongful temporary or permanent use of a resident’s belongings or money without the resident’s consent. xlix) l) 20. Neglect: A failure to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness. li) lii) 21. Negligence: An unintentional wrong in which a person fails to act in a reasonable and prudent manner and thereby causes harm to another person or the person’s property. liii) liv) lv) Unit 3: Resident Rights lvi) Page: 15 lvii) Objectives lviii) Course Content lix) Learning Activities lx) 3.1 Support the resident’s i) Residents’ Rights clii) right to make personal A) Basic Human Rights cliii) choices to accommodate A.1) Protected by the Constitution. cliv) A.2) individual needs. Laws clarify these rights. clv) (A.2.a) Right to be treated with respect lxi) clvi) (A.2.b) Right to live in dignity lxii) clvii) (A.2.c) Right to pursue a meaningful life lxiii) clviii) Brainstorm and list (A.2.d) Right to be free of fear lxiv) personal choices that would A.3) Behaviors that infringe on these rights: lxv) contribute to a meaningful (A.3.a) Addressing residents as children lxvi) life. (A.3.b) Demeaning nicknames for residents lxvii) (A.3.c) Not providing privacy clix) lxviii) (A.3.d) Threatening a resident with harm clx) lxix) cxliv) clxi) lxx) B) Resident Rights clxii) lxxi)3.1.1 Describe the B.1)Ethical and legal basis. clxiii) Resident’s Bill of Rights. B.2)Federal and state regulations. clxiv) lxxii) B.3)Posted in facility. clxv) lxxiii) B.4)Distributed on admission in many facilities. clxvi) Review: Residents’ lxxiv) B.5)Residents have the right to: Rights and HIPPA lxxv) (B.5.a) Considerate and respectful care clxvii) lxxvi) (B.5.b) Obtain complete current information clxviii) concerning diagnosis, treatment and prognosis. lxxvii) clxix) (B.5.c) Receive information necessary to give lxxviii) clxx) informed consent prior to treatments or procedures lxxix) clxxi) (B.5.d) Refuse treatment lxxx) (B.5.e) Privacy of resident’s body, records, and clxxii) lxxxi) personal affairs clxxiii) lxxxii) (B.5.f) Confidential treatment of all records clxxiv) lxxxiii) (B.5.g) Reasonable response to request for service clxxv) lxxxiv) (B.5.h) Examine bill and receive explanation of clxxvi) lxxxv) charges clxxvii) lxxxvi) (B.5.i) Be informed of any facility rules/regulations clxxviii) lxxxvii) cxlv) clxxix) lxxxviii) C) Behavior that Maintains Residents’ Rights clxxx) lxxxix) 3.1.2 Demonstrate C.1)Address as Mr., Mrs., or Miss unless asked to use a clxxxi) behavior that maintains specific name. clxxxii) C.2) residents’ rights. Avoid being rude or unkind. clxxxiii) (C.2.a) Never withhold social responsiveness xc) clxxxiv) (C.2.b) Don’t ignore residents xci) clxxxv) (C.2.c) xcii) Make eye contact (C.2.d) Allow residents to complete sentences prior clxxxvi) xciii) to leaving room clxxxvii) xciv) (C.2.e) Don’t shut or slam door to quiet a resident clxxxviii) xcv) C.3)Never threaten or intentionally hurt. clxxxix) xcvi) C.4)Help meet emotional, spiritual, and social needs. cxc) xcvii) C.5)Explain the dining assistance you plan to give. cxci) xcviii) C.6)Observe safety precautions. cxcii) xcix) C.7)Obtain express consent after identifying resident. cxciii) c) C.8)Treat all residents equally. cxciv) List advantages of ci) C.9)Promote positive attitudes. explaining dining assistance cii) C.10) Report errors to your supervising nurse to a resident prior to immediately. ciii) starting. cxlvi) civ) cxcv) ii) Mistreatment of the Elderly cv) cxcvi) A) Federal and State Definitions of Mistreatment of the cvi) 3.2 Administer dining cxcvii) Elderly: assistance that ensures cxcviii) A.1) Abuse. that the resident is free A.2) Neglect. cxcix) from abuse, neglect, A.3) Misappropriation of property. cc) misappropriation of A.4) Diversion of drugs. cci) property, diversion of A.5) Fraud. ccii)Define terms using State drugs, and fraud. and Federal regulations. cvii) B) Resident’s Right to be Free from Abuse cciii) cviii) B.1)Physical. cciv) cix) B.2)Verbal. ccv) cx) B.3)Sexual. ccvi) cxi) B.4)Mental. ccvii) B.5)Corporate punishment. cxii) ccviii) cxiii) B.6)Involuntary seclusion. ccix) cxiv) cxlvii) ccx) cxv) C) Signs of Abuse ccxi) cxvi) C.1)Fractures. ccxii) C.2) cxvii) Bruises of the face, upper arms, upper thighs, or ccxiii) abdomen. cxviii) ccxiv) C.3)Fearfulness. cxix) ccxv) C.4)Withdrawn. cxx) ccxvi) cxlviii) cxxi) D) Examples of Abuse ccxvii) cxxii) D.1) Threatening a resident. ccxviii) cxxiii) D.2) Frightening a resident. ccxix) cxxiv) D.3) Pinching, slapping, pushing, or kicking a resident. ccxx) cxxv) D.4) Withholding food or fluids. ccxxi) cxxvi) D.5) Restraining a resident. ccxxii) cxxvii) D.6) Leaving resident in soiled linen or clothing. ccxxiii) cxxviii) D.7) Yelling angrily at or making fun of a resident. ccxxiv) D.8) Refusing to treat or reposition a resident. cxxix) ccxxv) D.9) Not answering a call light/bell/signal. cxxx) ccxxvi) D.10) Humiliating a resident. cxxxi) ccxxvii) D.11) Making disparaging, derogatory remarks. cxxxii) D.12) Sexual coercion. ccxxviii) cxxxiii) D.13) Sexual harassment. ccxxix) cxxxiv) D.14) Verbal harassment. ccxxx) cxxxv) cxlix) ccxxxi) cxxxvi) E) Identification of Residents at Risk for Abusing Other ccxxxii) cxxxvii) Residents ccxxxiii) cxxxviii) E.1)Resident with history of aggressive behavior. ccxxxiv) cxxxix) cl) ccxxxv) cxl) F) Identification of Residents at Risk for Being Abused ccxxxvi) cxli) F.1)Noisy individuals. ccxxxvii) F.2)Wandering individuals. cxlii) ccxxxviii) Role-play F.3)Philandering individuals. cxliii) appropriate responses to F.4)Socially/logistically isolated individuals. observed mistreatment of cli) the elderly. G) Report Abuse ccxxxix) G.1) If observed, report immediately to supervisor. ccxl) G.2) Cause for immediate dismissal of perpetrator if ccxli) proven. ccxlii) G.3) Know your state law. ccxliii) G.4) Aiding and abetting. ccxliv) ccxlv) ccxlvi) Review Michigan law and Federal regulations regarding abuse. ccxlvii) Unit 4 ccxlviii) ccxlix) Safety and Emergency Procedures ccl) ccli) cclii) Terminology Defined ccliii) ccliv) 1. Convulsion: Violent and sudden contractions or tremors of muscles. cclv) cclvi) 2. Cardiopulmonary Resuscitation (CPR): Combines the techniques of artificial respiration and cardiac compression to restore circulation. cclvii) cclviii) 3. Dementia: Progressive mental deterioration due to organic brain disease. cclix) cclx) 4. Disoriented: Confused about time, place and person, or objects. cclxi) cclxii) 5. Heimlich Maneuver: A forceful upward thrust on the abdomen, between the sternum and the navel. cclxiii) cclxiv) 6. Seizure: Involuntary muscle contraction and relaxation. cclxv) cclxvi) cclxvii) cclxviii) cclxix) cclxx) cclxxi) cclxxii) cclxxiii) cclxxiv) cclxxv) cclxxvi) cclxxvii) cclxxviii) cclxxix) cclxxx) Unit 4: Safety and Emergency Procedures cclxxxi) Page: 20 cclxxxii) Objectives cclxxxiii) Course Content cclxxxiv) Learning Activities cclxxxv) 4.1 Assist with basic i) Basic Emergency Procedures cdxxxiv)Review the general emergency procedures. A) General Safety Rules safety rules and have the cclxxxvi) A.1) Walk in the halls and on stairs. Never run. class relate these to their cclxxxvii) 4.1.1 Adhere A.2) Keep to the right-hand side of the hall. homes, as well as the to general safety rules. A.3) Approach swinging doors with caution. health care facility. cclxxxviii) A.4) Use handrails going up and down stairs. cdxxxv) cclxxxix) 4.1.2 List ten A.5) Keep handrails in halls and on stairs free of cdxxxvi) rules of general safety. obstacles. cdxxxvii) A.6) ccxc) Check labels on all containers prior to using cdxxxviii) contents. ccxci) cdxxxix) A.7) Wipe up spilled liquids. ccxcii) cdxl) A.8) Pick up litter and place it in the proper container. ccxciii) A.9) Follow instructions of your supervisory nurse. cdxli) ccxciv) A.10) Report shocks and injuries promptly. cdxlii) ccxcv) A.11) Never use damaged or frayed electrical cords. cdxliii) ccxcvi) A.12) Ask for an explanation of things you don’t cdxliv) ccxcvii) understand. cdxlv) ccxcviii) A.13) Provide for restraint safety. cdxlvi) ccxcix) A.14) Check linen for personal items contained in folds cdxlvii) ccc) prior to sending to the laundry. cdxlviii) A.15) Report unsafe conditions when noticed. ccci) 4.2 Identify safety cdxlix) measures that prevent cdx) cdl) Discuss students’ personal accidents to residents. ii) Safety Measures that Prevent Accidents experiences with accidents cccii) A) Keep Frequently Used Articles Within Reach of Resident and consider the general ccciii) cdxi) safety rules that may have ccciv) B) Lock Brakes on Movable Equipment prevented the accident. B.1)Wheel chairs. cccv) cdli) B.2)Beds. cccvi) cdlii) cdxii) cccvii) cdliii) C) Properly Position Residents. Ask Nurse Aide to Properly cdliv) cccviii) Position Resident In: cdlv) cccix) C.1)Bed. cccx) C.2)Wheelchair. cdlvi) cccxi) C.3)Chair. cdlvii) cccxii) cdxiii) cdlviii) cccxiii) D) Provide Mealtime Assistance to Prevent Hot Liquid Spills cdlix) cccxiv) cdxiv) cdlx) E) cccxv) Identifying Residents cdlxi) E.1)Use identification bracelets. cccxvi) cdlxii) E.2)Call resident by name. cccxvii) cdlxiii) E.3)Use I.D. systems that incorporate photographs. cccxviii) E.4)Realize that dining the wrong resident can threaten life. cdlxiv) cccxix) cdxv) cdlxv) cccxx) F) Preventing Other Injuries cdlxvi) cccxxi) F.1)Keep resident’s bed in lowest position except when cdlxvii) cccxxii) giving bedside dining assistance. cdlxviii) cccxxiii) F.2)Place call bell/signal within reach. cdlxix) cccxxiv) cdxvi) cdlxx) cccxxv) 4.3 Discuss the iii) Assisting with a Choking Resident cdlxxi) emergency treatment of a A) Causes of Choking cdlxxii) choking resident. A.1) Occurs when the throat is blocked or closed up, and cdlxxiii) air cannot pass through. cccxxvi) cdlxxiv) A.2) Victim cannot breathe or speak. cccxxvii) cdlxxv) cdxvii) cccxxviii) cdlxxvi) B) Common Airway Blockages cccxxix) cdlxxvii) B.1)Food. cccxxx) B.2)Foreign objects. cdlxxviii) cccxxxi) B.3)Vomitus. cdlxxix) cccxxxii) B.4)Blood. cdlxxx) cccxxxiii) cdxviii) cdlxxxi) cccxxxiv) C) Tilting the Head Back May Clear the Airway cdlxxxii) cccxxxv) 4.3.1 Assist C.1)Pulls the tongue forward, clearing the blockage. cdlxxxiii) with cleaning an cdxix) cdlxxxiv) obstructed airway. D) If Victim is Coughing, Do Not Intervene cdlxxxv) cccxxxvi) D.1) Coughing sound only occurs with air moving cdlxxxvi) cccxxxvii) through airway. cdlxxxvii) cccxxxviii) D.2) Encourage coughing, as it is the most effective way cdlxxxviii) cccxxxix) to dislodge obstructions. cccxl) D.3) Stay near. cdlxxxix) cccxli) cdxx) cdxc) cccxlii) E) Signals of a Complete Airway Blockage cdxci) cccxliii) E.1)Unable to speak. cdxcii) E.2) cccxliv) High pitched sounds with inhalation. cdxciii) E.3)Grasping the throat in distress. cccxlv) cdxciv) cdxxi) cccxlvi) cdxcv) iv) The Heimlich Maneuver cccxlvii) cdxcvi) A) Equipment/PPE cccxlviii) A.1) Gloves cdxcvii) cccxlix) cdxxii) cdxcviii) cccl) B) Procedure cdxcix) Demonstration: cccli) B.1)Seek assistance from Nurse Performance Checklist #1 ccclii) (B.1.a) Use emergency alarm d) The Heimlich Maneuver cccliii) (B.1.b) Use resident call system di) dii) cccliv) (B.1.c) Call for help Discuss the reason for chest thrusts instead of ccclv) cdxxiii) abdominal thrusts for obese ccclvi) v) Assisting with Heart-Related Emergencies residents. ccclvii) A) List of Agencies Providing CPR Instruction: A.1) American Heart Association. diii) ccclviii) A.2) div) ccclix) 4.5 Discuss and American Red Cross. dv) explain your A.3) EMS Squads. responsibilities in assisting cdxxiv) dvi) with the resident who B) Common Observations, or Complaints, That Signal a Heart dvii) may have an emergency Problem: dviii) involving the heart. B.1)Chest discomfort. dix) (B.1.a) Pressures, fullness, squeezing, or pain in ccclx) dx) center of chest behind breastbone ccclxi) dxi) B.2)Radiating pain. ccclxii) dxii) (B.2.a) Pain may spread to either shoulder, neck, ccclxiii) jaw, or arm dxiii) ccclxiv) B.3)Symptoms continue for longer than a few minutes. dxiv) ccclxv) B.4)Symptoms which may come and go: dxv) ccclxvi) (B.4.a) Fainting dxvi) ccclxvii) (B.4.b) Sweating dxvii) ccclxviii) (B.4.c) Nausea dxviii) ccclxix) (B.4.d) Shortness of breath dxix) ccclxx) cdxxv) dxx) ccclxxi) C) Seek Immediate Assistance dxxi) ccclxxii) C.1)Use emergency alarm. dxxii) C.2) ccclxxiii) Use resident call system. dxxiii) C.3)Call for help. ccclxxiv) dxxiv) cdxxvi) ccclxxv) dxxv) vi) Assisting with Convulsive Disorders (Seizures) ccclxxvi) dxxvi) A) Causes of Convulsive Disorders ccclxxvii) A.1) Seizure syndrome. dxxvii) ccclxxviii) A.2) Head injury. dxxviii) ccclxxix) A.3) Stroke. dxxix) ccclxxx) A.4) Infectious disease. dxxx) ccclxxxi) 4.6 Discuss and A.5) Omitted medication. dxxxi) explain your cdxxvii) dxxxii) responsibilities in assisting B) Types of Seizures dxxxiii) the resident until B.1)Partial. dxxxiv) professional help arrives B.2)General. dxxxv) for convulsive disorder. (B.2.a) Tonic-clonic (grand mal) dxxxvi) ccclxxxii) (B.2.b) Absence (petit mal) dxxxvii) ccclxxxiii) B.3)Unclassified. dxxxviii) ccclxxxiv) cdxxviii) dxxxix) ccclxxxv) C) Seek Assistance from Nurse dxl) Discuss the differences in C.1)Summon help using resident call system. ccclxxxvi) types of seizures. ccclxxxvii) C.2)Stay with resident. C.3)Protect resident from injury. dxli) ccclxxxviii) (C.3.a) Lower resident to floor, if appropriate. dxlii) ccclxxxix) (C.3.b) Move objects away that might cause injury. dxliii) cccxc) C.4)Do not restrain resident. dxliv) cccxci) C.5)Loosen constricting clothing, particularly around the dxlv) cccxcii) neck. dxlvi) cccxciii) C.6)Place pillow under head and turn face to one side. dxlvii) cccxciv) C.7)Note time seizure began and report to supervisory dxlviii) cccxcv) nurse. dxlix) Discuss how to cccxcvi) C.8)Allow resident to rest after seizure. physically protect the cccxcvii) (C.8.a) Resident will be very tired resident. cccxcviii) (C.8.b) Resident may be confused dl) cccxcix) (C.8.c) Resident will often be disoriented dli) cd) cdxxix) dlii) cdi) vii) Report Emergencies dliii) Suggest reasons why A) cdii) Remain Calm and Do Not Panic the face would be turned to A.1) Observe your surroundings. cdiii) the side. A.2) Assess available resources. cdiv) dliv) cdxxx) cdv) dlv) B) Evaluate the Situation dlvi) cdvi) B.1)Check resident’s condition. dlvii) cdvii) B.2)Determine safety of environment. dlviii) cdviii) cdxxxi) dlix) cdix) 4.7 Report C) Call or Send for Help Immediately dlx) emergencies accurately cdxxxii) dlxi) Provide the class with a and immediately. D) Know Your Limitations description of an accident cdxxxiii) or health emergency that E) Reassure the Resident has occurred. The student is the only person on the scene. Ask them to explain how s/he would handle the situation. dlxii) dlxiii) dlxiv) dlxv) dlxvi) dlxvii) dlxviii) dlxix) dlxx) Unit 5 dlxxi) dlxxii) Infection Control dlxxiii) dlxxiv) dlxxv) Terminology Defined dlxxvi) dlxxvii) 1. Asepsis: Being free of disease-producing microorganisms. dlxxviii) dlxxix) 2. Biohazardous Waste: Refers to items that are contaminated with blood, body fluids, or body substances that may be harmful to others. dlxxx) dlxxxi) 3. Bloodborne Pathogens: Disease causing microorganisms that are present in human blood and can cause disease in humans; these pathogens include, but are not limited to Hepatitis B Virus (HBV), Human Immunodeficiency Virus (HIV), and Hepatitis C Virus (HCV). dlxxxii) dlxxxiii) 4. Contaminated: Dirty, unclean, or soiled with germs. dlxxxiv) dlxxxv) 5. Disinfection: The process of destroying most, but not all, pathogenic organisms. dlxxxvi) dlxxxvii)6. Exposure Incident: A mucous membrane, non-intact skin, or sharps-injury leading to contact with blood or other potentially infectious materials during the performance of an employee’s duties. dlxxxviii) dlxxxix) 7. Fomite: Any object contaminated with germs and able to transmit disease. dxc) dxci) 8. Germ: A microorganism, especially one that causes disease. dxcii) dxciii) 9. Isolation: An area where the resident with easily transmitted diseases is separated from others. dxciv) dxcv) 10. Medical Asepsis: The practice used to remove or destroy pathogens and to prevent their spread from one person or place to another person or place; clean technique. dxcvi) dxcvii) 11. Microorganisms: Living bodies so small they can only be seen with the aid of a microscope; especially bacteria. dxcviii) dxcix) 12. Pathogen: A microorganism that is harmful and capable of causing an infection. dc) dci) 13. Personal Protective Equipment (PPE): Specialized clothing or equipment worn by an employee for protection against a hazard. dcii) dciii) 14. Phagocyte: A cell that can ingest bacteria, foreign particles, and other cells. dciv) dcv) 15. Other Potentially Infectious Materials (PIM): dcvi) Human body fluids: Semen, vaginal secretions, cerebrospinal fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, and saliva in dental procedures. dcvii) Any tissue or organ (other than intact skin) or tissue or organ cultures. dcviii) dcix) 16. Precautions: CDC procedures that contain two tiers: dcx) Standard Precautions are those designed for the care of all residents, regardless of their diagnosis or presumed infection status. Standard Precautions include setting up barriers to prevent contact with blood, blood serum derived from body fluids, fluids that contain blood, and any moist body substances. dcxi) Transmission-Based Precautions are to be used when caring for only those residents who are known or suspected to be infected or colonized with contagious pathogens that can be transmitted by airborne, droplet transmission or contact with skin or contaminated surfaces. dcxii) dcxiii) 17. Virus: The smallest organism identified using an electron microscope. dcxiv) dcxv) Unit 5: Infection Control dcxvi) Page: 27 dcxvii) Objectives dcxviii) Course Content dcxix) Learning Activities dcxx) 5.1 Apply the basic i) Infection Transmission dcclxviii) principles of infection A) Microorganisms (Germs) dcclxix) control. A.1) Microscopic: seen with the aid of a microscope. dcclxx) A.2) dcxxi) Live all around us. dcclxxi) (A.2.a) In the air we breathe dcxxii) dcclxxii) (A.2.b) On our skin and in our bodies dcxxiii) dcclxxiii) (A.2.c) dcxxiv) In the food we eat (A.2.d) On every surface we touch dcclxxiv) dcxxv) A.3) May cause: dcclxxv) dcxxvi) (A.3.a) Illness dcclxxvi) dcxxvii) (A.3.b) Infection dcclxxvii) dcxxviii) (A.3.c) Disease dcclxxviii) dcxxix) A.4) Benefit us by maintaining balance in our dcclxxix) dcxxx) environment and body. dcclxxx)Have the class list ways dcxxxi) A.5) Require certain elements to survive: in which nonpathogenic dcxxxii) (A.5.a) Oxygen (aerobic) organisms benefit mankind. dcxxxiii) (A.5.b) No oxygen (anaerobic) (They culture milk products, dcxxxiv) (A.5.c) Warm temperatures ferment certain foods, (A.5.d) Moisture dcxxxv) cause bread to rise, (A.5.e) Dark area to grow dcxxxvi) decompose organic (A.5.f) Food materials, etc.) dcxxxvii) A.6) Our body’s defenses against germs: dcclxxxi) dcxxxviii) (A.6.a) External natural defenses: dcclxxxii) dcxxxix) (A.6.a.1) Skin dcclxxxiii) dcxl) (A.6.a.2) Mucous membrane dcclxxxiv) dcxli) (A.6.a.3) Cilia – fine microscopic hairs dcclxxxv) dcxlii) (A.6.a.4) Coughing and sneezing dcclxxxvi) dcxliii) (A.6.a.5) Stomach acid dcclxxxvii) dcxliv) (A.6.a.6) Tears dcclxxxviii) dcxlv) (A.6.b) Internal natural defenses: (A.6.b.1) Phagocytes dcclxxxix) dcxlvi) (A.6.b.2) Inflammation dccxc) dcxlvii) (A.6.b.3) Fever dccxci) dcxlviii) dcxlix) (A.6.b.4) Immune response dccxcii) dcl) A.7) Chain of infection: dccxciii) dcli) (A.7.a) Causative agent dccxciv) (A.7.a.1) dclii) Bacteria dccxcv) (A.7.a.2) Virus dcliii) 5.1.1 Identify how dccxcvi) (A.7.a.3) Fungi diseases are transmitted. dccxcvii) Have class (A.7.a.4) Protozoa dcliv) members select a causative (A.7.b) Reservoir of the agent dclv) 5.1.2 List the six agent and illustrate the (A.7.b.1) Humans, either presenting components of the chain chain of infection. symptoms or as carriers of infection. dccxcviii) (A.7.b.2) Animals dclvi) (A.7.b.3) Fomites dccxcix) dclvii) (A.7.b.4) Environment dccc) dclviii) (A.7.c) Portal of entry dccci) dclix) (A.7.c.1) Cuts/breaks in skin dcccii) dclx) (A.7.c.2) Openings in mucous membrane dccciii) dclxi) (A.7.c.3) Cardiovascular system dccciv) Relate fomites to facility dclxii) (A.7.c.4) Respiratory system supplies and discuss objects dclxiii) (A.7.c.5) Gastrointestinal system that might be involved in dclxiv) (A.7.c.6) Urinary system the spread of infection. (A.7.c.7) Reproductive system dclxv) dcccv) (A.7.c.8) Fluid exchange from mother to fetus dcccvi) dclxvi) Have the class relate the (A.7.d) Portal of exit AIDS virus to portals of dclxvii) (A.7.d.1) Tears entry and exit dclxviii) (A.7.d.2) Saliva dcccvii) dclxix) (A.7.d.3) Urine dcccviii) dclxx) (A.7.d.4) Feces dcccix) dclxxi) (A.7.d.5) Wound drainage dcccx) dclxxii) (A.7.e) Mode of transmission dcccxi) dclxxiii) (A.7.e.1) Contact dcccxii) dclxxiv) (A.7.e.1.i) Direct (person-to-person) dcccxiii) dclxxv) (A.7.e.1.ii) Indirect (fomite-to-person) (A.7.e.1.iii) Droplet (common cold) dcccxiv) dclxxvi) (A.7.e.2) Common vehicle (salmonella in food) dcccxv) dclxxvii) (A.7.e.3) Airborne (tuberculosis) dcccxvi)Have the class discuss dclxxviii) (A.7.e.4) Vectorborne (mosquitos carrying and give examples of the dclxxix) dclxxx) malaria) various modes of disease dclxxxi) (A.7.f) Host: Individual who harbors infectious transmission. dclxxxii) organisms dcccxvii) dclxxxiii) dcclxiii) dcccxviii) ii) dclxxxiv) Medical Asepsis dcccxix) A) Practices that Remove or Destroy Pathogens and Prevent dclxxxv) dcccxx) Illness dclxxxvi) dcccxxi) dcclxiv) dclxxxvii) dcccxxii) B) Lists of Aseptic Practices: dclxxxviii) 5.2 Define dcccxxiii) B.1)Washing hands after using the bathroom. medical asepsis. dcccxxiv) B.2)Washing hands prior to handling food. dclxxxix) B.3)Washing fruits and vegetables before serving or dcccxxv) dcxc) consuming. dcccxxvi) dcxci) B.4)Providing individual personal items for each resident dcccxxvii) dcxcii) 5.2.1 Identify practices during dining. dcccxxviii) Have the class one can use to promote B.5)Covering the nose and mouth prior to coughing, relate medically aseptic medical asepsis. sneezing, or blowing nose, and then immediately practices to other area of dcxciii) washing hands. employment (teachers, dcxciv) B.6)Bathing, washing hair, and brushing teeth on a regular food workers, sales people, dcxcv) basis. etc.) dcxcvi) B.7)Washing cooking and eating utensils with soap. dcccxxix) dcxcvii) B.8)Adhering to sanitation practices. dcccxxx) B.9)Washing hands after dining each resident. dcxcviii) dcccxxxi) B.10) Washing hands prior to dining a resident. dcxcix) dcccxxxii) B.11) Washing hands before meals. dcc) dcccxxxiii) B.12) Maintaining a clean resident unit. dcccxxxiv) dcci) B.13) Cleaning all reusable equipment after use. dcccxxxv) dccii) B.14) Using approved waterless hand cleaner. dcccxxxvi) dcciii) B.15) Not sitting on a resident’s bed. dcciv) B.16) Not transporting equipment from one resident’s dcccxxxvii) dccv) room to another. dcccxxxviii) dccvi) dcclxv) dcccxxxix) dccvii) iii) Standard Precautions – CDC Procedures to Control And dcccxl) dccviii) Prevent Infections dcccxli) dccix) A) Use for Care of All Residents dcccxlii) dccx) dcclxvi) dcccxliii) dccxi) B) Precautions: dcccxliv) dccxii) B.1)Dining Assistant should not touch blood, body fluids, dcccxlv) dccxiii) secretions, or excretions. dcccxlvi) B.2) dccxiv) 5.3 Demonstrate an Immediately report all incidences of contact with dcccxlvii) blood, body fluids, secretion, and excretions to nurse understanding of the dcccxlviii) supervisor. basic principles of dcccxlix) dcclxvii) Standard Precautions. dcccl) dccxv) C) Handwashing Techniques C.1) dcccli) dccxvi) Equipment: (C.1.a) Sink dccclii) dccxvii) (C.1.b) Running water dcccliii) dccxviii) (C.1.c) Soap dispenser dcccliv) dccxix) (C.1.d) Paper towels dccclv) dccxx) (C.1.e) Waste container dccclvi) dccxxi) C.2)Reasons for Handwashing: dccclvii) dccxxii) (C.2.a) Everything you touch harbors germs. dccclviii) (C.2.b) Handwashing is one of the most effective dccxxiii) dccclix) ways of controlling infection is done properly. dccxxiv) dccclx) (C.2.c) Prevents cross contamination. dccxxv) dccclxi) dccxxvi) (C.2.d) Prevents growth of, and washes away, many microorganisms on skin. dccclxii) dccxxvii) (C.2.e) Handwashing must be done prior to and dccclxiii) dccxxviii) after dining assistance. dccclxiv) dccxxix)5.3.1 Identify the C.3)To properly wash your hands: dccclxv) reasons for washing (C.3.a) Use warm, running water dccclxvi) hands frequently and (C.3.b) Use clean paper towels to turn hand- using good technique. dccclxvii) operated faucets off dccxxx) dccclxviii) (C.3.c) Avoid touching the soap dish when using bar dccclxix) dccxxxi) soap dccclxx) dccxxxii) (C.3.d) Hold hands and forearms lower than the dccclxxi) dccxxxiii) elbows during the procedure dccclxxii) dccxxxiv) (C.3.e) Give frequently missed areas added dccxxxv) attention, such as: dccclxxiii) dccxxxvi) 5.3.2 (C.3.e.1) Sides of hands dccclxxiv) Demonstrate proper (C.3.e.2) Knuckles dccclxxv) handwashing technique (C.3.e.3) Thumbs dccclxxvi) Demonstration: dccxxxvii) (C.3.e.4) Little fingers Performance Checklist #2 dccxxxviii) (C.3.e.5) Under nails dccclxxvii) Handwashing dccxxxix) (C.3.e.5.i) Use a file for this area, or dccclxxviii) (C.3.e.5.ii) dccxl) Rub tips of fingers against soapy dccclxxix) palms dccxli) dccclxxx) (C.3.f) For handwashing to be effective: dccxlii) dccclxxxi) (C.3.f.1)Use enough soap to produce a lather dccxliii) (C.3.f.2)Create friction with vigorous rubbing dccxliv) (C.3.f.3)Rinse well dccxlv) (C.3.g) Use a brush to remove resistant substances. dccxlvi) (C.3.h) Use a lotion after cleaning to: dccxlvii) (C.3.h.1) Prevent chapping dccxlviii) (C.3.h.2) Prevent dry skin dccxlix) C.4)Wash with soap and water immediately or as soon as dccl) possible following contact with blood or other potentially infectious materials. dccli) C.5)Use alcohol gels only if hands are not visibly soiled, and dcclii) there has been no exposure to blood or other dccliii) potentially infectious materials dccliv) dcclv) dcclvi) dcclvii) dcclviii) dcclix) dcclx) dcclxi) dcclxii) dccclxxxii) dccclxxxiii) dccclxxxiv) dccclxxxv) dccclxxxvi) dccclxxxvii) dccclxxxviii) dccclxxxix) dcccxc) dcccxci)Unit 6 dcccxcii) dcccxciii) Nutrition and Hydration dcccxciv) dcccxcv) dcccxcvi) Terminology Defined dcccxcvii) dcccxcviii) 1. Anemia: A deficiency of red blood cells, hemoglobin, or both. dcccxcix) cm) 2. Aspiration: Breathing fluid or food into the lungs. cmi) cmii) 3. Calorie: The amount of energy produced from the burning of food. cmiii) cmiv) 4. Carbohydrates: Nutrient which provides the greatest amount of energy in the average diet. cmv) cmvi) 5. Dehydration: A decrease of the amount of water in body tissue. cmvii) cmviii) 6. Dysphagia: Difficulty swallowing cmix) cmx) 7. Fats: Nutrients that provide most concentrated form of energy. cmxi) cmxii) 8. Malnutrition: Poor nutrition that lacks adequate food and nutrients. cmxiii) cmxiv) 9. Metabolism: The chemical processes that occur within a living organism in order to maintain life. cmxv) cmxvi) 10. NPO: Nothing by mouth. cmxvii) cmxviii) 11. Nutrient: A substance that is ingested, digested, absorbed and used by the body. cmxix) cmxx) 12. Nutrition: The entire process by which the body takes in food for growth and repair and uses it to maintain health. cmxxi) cmxxii) 13. Osteoporosis: The most common metabolic disease of bone in the United States, caused by a decrease in the mass of bony tissue. cmxxiii) cmxxiv) 14. Peristalsis: Involuntary muscle contractions in the digestive system that move food through the alimentary canal. cmxxv) cmxxvi) 15. Protein: Nutrient essential for growth and repair of tissue. cmxxvii) cmxxviii) 16. Recommended Dietary Allowances (R.D.A): The amounts of essential nutrients adequate to meet the needs of practically all healthy people. cmxxix) cmxxx) 17. Therapeutic Diet: Modification of the normal diet used in the treatment of specific health conditions. cmxxxi) Unit 6: Nutrition and Hydration cmxxxii) Page: 34 cmxxxiii) Objectives cmxxxiv) Course Content cmxxxv) Learning Activities cmxxxvi) 6.1 Identify the i) Principles of Nutrition mccvi) general principles of basic A) Good Nutrition mccvii) nutrition. A.1) Promotes physical and mental health. mccviii) A.2) cmxxxvii) Provides increased resistance to illness. mccix) A.3) Produces added energy and vitality. cmxxxviii) mccx) A.4) Aids in the healing process. cmxxxix) mccxi) A.5) Assists one to feel and sleep better. cmxl) mccxii) cmxli) mclxxi) B) Functions of Food mccxiii) cmxlii) B.1)Provides energy. mccxiv) cmxliii) B.2)Grows and repairs tissue. mccxv) cmxliv) B.3)Maintains and regulates bodily processes. mccxvi) cmxlv) mclxxii) mccxvii) cmxlvi) C) Factors Influencing Dietary Practices mccxviii) cmxlvii) C.1)Personal preferences. mccxix) cmxlviii) 6.1.1 C.2)Appetite. mccxx) Recognize factors that C.3)Finance. mccxxi) influence dietary C.4)Illness. mccxxii) practices. C.5)Culture. mccxxiii) cmxlix) C.6)Religion. mccxxiv) cml) (C.6.a) Days of fasting mccxxv)Discuss the religious cmli) (C.6.b) Dietary practices/restrictions practices related to food by cmlii) 6.1.2 Review cultural (C.6.c) Some forbid cooking on the Sabbath the various denominations variations in diet. (C.6.d) Some forbid eating leavened bread represented in the class. cmliii) (C.6.e) Some forbid serving milk and/or milk mccxxvi) cmliv) 6.1.3 List five products with meat mccxxvii) examples of foods (C.6.f) Some have strict rules regarding sequence in avoided by various which milk products and meat must be consumed mccxxviii) religious denominations. mclxxiii) mccxxix) cmlv) D) Age-Related Changes Affecting Nutrition mccxxx) cmlvi) D.1) Need for fewer calories. mccxxxi) D.2) Vitamin and mineral requirements change. cmlvii) mccxxxii) cmlviii) D.3) Medications affect how nutrients are absorbed and mccxxxiii) cmlix) used. mccxxxiv) cmlx) D.4) Teeth/dentures affect ability to chew food. mccxxxv) D.5) cmlxi) Diminished sense of taste and smell. mccxxxvi) D.6) Assistance required with eating. cmlxii) 6.1.4 Cite five age- mccxxxvii) D.7) Decreased saliva secretions. related changes that mccxxxviii) affect the resident’s D.8) Discomfort caused by constipation. D.9) Decreased appetite and thirst. mccxxxix) nutritional status. mccxl) cmlxiii) mclxxiv) E) Signs of Good Nutrition mccxli) cmlxiv) E.1)Healthy, shiny looking hair. mccxlii) cmlxv) E.2)Clean skin and bright eyes. mccxliii) cmlxvi) E.3)A well-developed, healthy body. mccxliv) cmlxvii) E.4)An alert facial expression. mccxlv) cmlxviii) E.5)An even, pleasant disposition. mccxlvi) cmlxix) E.6)Restful sleep patterns. mccxlvii) cmlxx) 6.1.5 Recognize the E.7)Healthy appetite. mccxlviii) signs of good nutrition. E.8)Regular elimination habits. mccxlix) cmlxxi) E.9)Appropriate body weight. mccl) cmlxxii) mclxxv) mccli) cmlxxiii) F) Signs of Poor Nutrition mcclii) cmlxxiv) F.1)Hair and eyes appear dull. mccliii) cmlxxv) F.2)Irregular bowel habits. F.3)Weight changes. mccliv) cmlxxvi) F.4)Osteoporosis and other diseases. mcclv) cmlxxvii) F.5)Lack of interest/mental slowdown. mcclvi) cmlxxviii) F.6)Poor skin color and appearance. mcclvii) cmlxxix) F.7)Anemia leading to: mcclviii) cmlxxx) 6.1.6 Report five (F.7.a) Fatigue mcclix) results of poor nutrition. (F.7.b) Shortness of breath mcclx) cmlxxxi) (F.7.c) Increased pulse mcclxi) cmlxxxii) (F.7.d) Pale skin mcclxii) cmlxxxiii) (F.7.e) Poor sleep patterns cmlxxxiv) (F.7.f) Headaches mcclxiii) cmlxxxv) (F.7.g) Problems with digestion mcclxiv) cmlxxxvi) mclxxvi) mcclxv) cmlxxxvii) ii) Six Basic Food Groups (Food Guide Pyramid) mcclxvi) cmlxxxviii) A) Vegetable Group mcclxvii) cmlxxxix) A.1) Provides: mcclxviii) (A.1.a) cmxc) Vitamins mcclxix) (A.1.b) Minerals cmxci) mcclxx) (A.1.c) Fiber (roughage) cmxcii) mcclxxi) A.2) Easier to chew if cooked, chopped, or diced. cmxciii) A.3) Recommended daily servings: three to five. mcclxxii) cmxciv) mclxxvii) mcclxxiii) cmxcv) 6.2 Discuss the six B) Fruit Group mcclxxiv) basic food groups that B.1)Provides: mcclxxv) contribute to a well- (B.1.a) Vitamins mcclxxvi) balanced diet. (B.1.b) Minerals mcclxxvii) cmxcvi) (B.1.c) Fiber (roughage) mcclxxviii) cmxcvii) B.2)Recommended daily servings: two to four. mcclxxix) cmxcviii) mclxxviii) mcclxxx) cmxcix) C) Dairy Group (Milk, Yogurt, and Cheese) mcclxxxi) Have the class m) C.1)Provides: relate medically aseptic mi) (C.1.a) Proteins practices to other area of mii) (C.1.b) Vitamins employment (teachers, miii) (C.1.c) Minerals (calcium) food workers, sales people, (C.1.d) Carbohydrates miv) etc.) (C.1.e) Fat mv) mcclxxxii) C.2)Recommended daily servings: two to three. mvi) mcclxxxiii) mclxxix) mvii) mcclxxxiv) D) Grain Group (Breads, Cereal, Rice, and Pasta) mcclxxxv) mviii) D.1) Provides: mcclxxxvi) mix) (D.1.a) Carbohydrates mx) (D.1.b) Fiber mcclxxxvii) mxi) D.2) Recommended daily servings: six to eight. mcclxxxviii) mxii) mclxxx) mcclxxxix) mxiii) E) Meat Group mccxc) mxiv) E.1)Provides: mccxci) mxv) (E.1.a) Protein mccxcii) mxvi) (E.1.b) Fat mccxciii) E.2)Recommended daily servings: one to two. mxvii) mccxciv) mxviii) mclxxxi) mccxcv) mxix) F) Fats, Oils, Sweets Group mccxcvi) mxx) F.1)Provides: mccxcvii) mxxi) (F.1.a) Little to no nutritional value mccxcviii) (F.1.b) mxxii) High calorie content mccxcix) F.2)No recommended servings or serving sizes. mxxiii) mccc) mclxxxii) mxxiv) mccci) iii) Therapeutic Diet mxxv) mcccii) A) Purposes of Therapeutic Diets mxxvi) A.1) Add or eliminate calories to cause a change in body mccciii) mxxvii) weight. mccciv) mxxviii) A.2) Assist with digestion of food by taking foods out of mcccv) mxxix) the diet that irritate the digestive system. mcccvi) mxxx) A.3) Restrict salt intake to prevent or decrease edema. mcccvii) mxxxi) A.4) Help organs to maintain and/or regain normal mcccviii) mxxxii) function. mcccix) mxxxiii) A.5) Treat metabolic disorders by regulating food mcccx) amounts. mxxxiv) mcccxi) Hand out examples of mclxxxiii) mxxxv) sample menus for B) mxxxvi) 6.3 Define a Types of Therapeutic Diets discussion. therapeutic diet and B.1)Clear liquid. mcccxii) B.2)Full liquid. recognize the need for mcccxiii) B.3)Bland. alterations in a regular mcccxiv) B.4)Restricted residue. diet. mcccxv) B.5)Controlled carbohydrate (diabetic). mxxxvii) B.6)Low fat. mcccxvi) mxxxviii) 6.3.1 List three B.7)Low cholesterol. mcccxvii) purposes of a therapeutic B.8)Low calorie. mcccxviii) diet. B.9)High calorie. mcccxix) mxxxix) B.10) Low sodium. mcccxx) mxl) B.11) High protein. mcccxxi) mxli) B.12) Soft, chopped, or pureed. mcccxxii) mxlii) mclxxxiv) mcccxxiii) mxliii) 6.3.2 Discuss the types C) Residents May Have Difficult Accepting Special Diets mcccxxiv) of therapeutic diets that mclxxxv) mcccxxv) the physician might order iv) Adaptive Devices for a resident. A) Food Guards mcccxxvi) mxliv) mclxxxvi) mcccxxvii) mxlv) B) Divided Plates mcccxxviii) mxlvi) mclxxxvii) mcccxxix) mxlvii) C) Built-up Handled Utensils mcccxxx) mxlviii) mclxxxviii) mcccxxxi) D) mxlix) Easy Grip Mugs/Glasses mcccxxxii) ml) mclxxxix) mcccxxxiii) Demonstrate the v) mli) Preparing and Serving Resident’s Meals use of adaptive devices. A) Meals Are an Enjoyable, Social Experience mlii) Encourage students to mcxc) mliii) handle equipment. B) Provide Pleasant Environment mliv) mcccxxxiv) B.1) Clean area. mcccxxxv) mlv) B.2)Odor-free area. mcccxxxvi) mlvi) 6.4 Recognize B.3)Adequate lighting. mcccxxxvii) adaptive devices used to B.4)Pleasant temperature. assist residents with B.5)Flowers/decorations and music add can add interest. mcccxxxviii) eating. mcxci) mcccxxxix) mlvii) C) Resident Preparation mcccxl) mlviii) C.1)Face and hands washed. mcccxli) mlix) C.2)Raise the head of the bed. mcccxlii) mlx) C.3)Assure resident is in comfortable position. mcccxliii) mlxi) C.4)Check to be certain resident receives correct tray with mcccxliv) mlxii) correct diet. mcccxlv) mlxiii) 6.5 Identify the C.5)Food should be attractively served and placed within mcccxlvi) reach. responsibilities in mcccxlvii) C.6)Assist resident as needed with: preparing and serving mcccxlviii) residents’ meals. (C.6.a) Cutting meat mcccxlix) mlxiv) (C.6.b) Pouring liquids mcccl) mlxv) (C.6.c) Buttering bread (C.6.d) Opening containers mcccli) mlxvi) C.7)Residents should be encouraged to do as much as mccclii) mlxvii) possible for themselves. mcccliii) mlxviii) C.8)Allow time for resident to complete meal. mcccliv) mlxix) C.9)Display a pleasant, patient attitude. mccclv) mlxx) C.10) Remove tray when meal is finished. mccclvi) mlxxi) C.11) Report unconsumed food to supervisory nurse. mccclvii) mlxxii) C.12) Place call signal and supplies within reach. mccclviii) mlxxiii) C.13) Wash hands before and after assisting resident. mccclix) mlxxiv) mcxcii) mccclx) vi) mlxxv) Dining Techniques mccclxi) A) Follow These General Guidelines: mlxxvi) mccclxii) A.1) Use a spoon and fill it only half-full. mlxxvii) mccclxiii) A.2) Give the food from the tip of the spoon. mlxxviii) A.3) Introduce food on non-paralyzed side of mouth. mccclxiv) mlxxix) A.4) For blind or confused residents, name each mccclxv) mlxxx) mouthful of food. mccclxvi) mlxxxi) A.5) Offer foods in logical order. mccclxvii) mlxxxii) A.6) Allow hot foods to cool. mccclxviii) mlxxxiii) A.7) Feed the resident slowly. mccclxix) mlxxxiv) A.8) Encourage, but do not force, resident to eat. mccclxx) mlxxxv) A.9) Warn resident when offering something hot. mccclxxi) A.10) Use a straw for liquids, if resident prefers. mlxxxvi) mccclxxii) A.11) Be sure resident’s mouth is empty before offering mlxxxvii) mccclxxiii) more food. mlxxxviii) mccclxxiv) vii) Supplementary Nourishments mccclxxv) Have students mlxxxix) A) Types of Nourishments practice dining techniques mxc) A.1) Milk. with their class members, mxci) A.2) Juice. using appropriate mxcii) A.3) Gelatin. techniques. mxciii) 6.6 Describe dining A.4) Custard, ice cream, or sherbet. techniques. A.5) Crackers. mccclxxvi) mxciv) A.6) Nutritional supplementation products (e.g. Ensure, mccclxxvii) mxcv) Mighty Shake, etc.) mccclxxviii) mxcvi) mcxciii) mccclxxix) mxcvii) B) Usually Served: mccclxxx) mxcviii) B.1)Midmorning. mccclxxxi) B.2)Mid-afternoon. mxcix) mccclxxxii) B.3)Bedtime. mc) mccclxxxiii) C) Ordered by Physician. mci) mccclxxxiv) mcxciv) mcii) mccclxxxv) D) Served as Directed by Supervisory Nurse mccclxxxvi) mciii) mcxcv) mccclxxxvii) mciv) E) Provide Necessary Eating Utensils (Straw, Napkin, etc.) mccclxxxviii) mcv) mcxcvi) mccclxxxix) mcvi) viii) Serving Supplementary Nourishments mcccxc) mcvii) 6.7 Discuss the carious A) Procedure mcccxci) types of supplementary mcxcvii) mcccxcii) ix) nourishments. Fresh Drinking Water mcccxciii) A) Fresh Water Should Be Provided Throughout the Day mcviii) mcccxciv) mcxcviii) mcix) mcccxcv) B) Encourage Resident to Drink Six to Eight Glasses, If mcx) mcccxcvi) Appropriate mcxi) mcccxcvii) mcxii) mcxcix) C) Note Residents Who have Special Fluid Orders mcccxcviii) mcxiii) C.1)N.P.O. mcccxcix) mcxiv) C.2)Fluid Restrictions (remind resident of such restriction.) mcd) mcxv) C.3)Force fluids. mcdi) mcxvi) (C.3.a) Offer fluids in small quantities mcdii) mcxvii) C.4)No ice. mcdiii) mcxviii) mcc) mcdiv) mcxix) D) Supplies: Cart, Pitchers, Cups, Ice Scoop, and Straws mcdv) mcxx) mcci) mcdvi) mcxxi) E) Procedure mcdvii) Performance Checklist mcxxii) mccii) #3 Serving Supplementary mcxxiii) x) Aging Changes Nourishments mcxxiv) A) Aging Causes Physiological Changes mcdviii) mcxxv) 6.8 Demonstrate the A.1) Decreased number of taste buds. mcdix) Performance Checklist procedure for serving A.2) Slowing of peristalsis, causing constipation. #4 Providing Fresh Drinking supplementary A.3) Slower absorption of nutrients. Water nourishments. A.4) Difficulty chewing or swallowing. mcdx) A.5) Loss of bowel muscle tone. mcxxvi) mcdxi) A.6) Decrease in amount of digestive enzymes and saliva mcxxvii) 6.9 Identify the mcdxii) production. special fluid orders that mcdxiii) A.7) Decreased appetite. the physician could write mcdxiv) for residents. A.8) Loss of teeth. A.9) Altered taste and smell. mcdxv) mcxxviii) mcdxvi) mcxxix) mcciii) mcdxvii) mcxxx) xi) Challenging Dining Problems mcdxviii) mcxxxi) A) Dysphagia mcdxix) mcxxxii) A.1) Signs and symptoms: mcdxx) (A.1.a) mcxxxiii) Food “pocket” in cheeks mcdxxi) (A.1.b) Resident says food will not go down mcxxxiv) mcdxxii) Follow facility (A.1.c) Excessive drooling mcxxxv) policy for distribution of (A.1.d) Unexplained weight loss drinking water. mcxxxvi) (A.1.e) Frequently coughs or chokes mcdxxiii) mcxxxvii) (A.1.f) Complains of heartburn mcdxxiv) mcxxxviii) (A.1.g) Recurrent pneumonia mcdxxv) Suggest a reason mcxxxix) 6.9.1 A.2) Report to nurse supervisor signs of dysphagia when why some residents would Demonstrate the dining a resident. add a lot of salt to their procedure for providing A.3) Do not continue to feed resident with dysphagia. food. fresh drinking water. mcciv) mcdxxvi) mcxl) B) Stroke Victims mcxli) 6.10 Identify normal B.1)Stroke victims with dysphagia should not be fed by a mcdxxvii) changes in the digestive Dining Assistant. mcdxxviii) system as they relate to B.2)If dysphagia is not present: mcdxxix) the aging process. (B.2.a) Introduce spoon on unaffected side of the mcdxxx) mcxlii) mouth. mcdxxxi) mcxliii) (B.2.b) Utilize adaptive dining utensils. mcdxxxii) mcxliv) (B.2.c) Observe for “pocketing” of food on affected mcdxxxiii) mcxlv) side. mcdxxxiv) (B.2.d) One sip, then swallow. mcxlvi) mcdxxxv) (B.2.e) Approach from the unaffected side. mcxlvii) mcdxxxvi) mccv) mcxlviii) mcdxxxvii) C) Blind Residents mcxlix) 6.11 Discuss signs and mcdxxxviii) symptoms of dysphagia. C.1)Tell resident what is on the tray. C.2)Arrange and describe location of foods according to the mcdxxxix) mcl) face of a clock. mcdxl) mcli) mcdxli) mclii) mcdxlii) mcliii) mcdxliii) mcliv) mcdxliv) mclv) mcdxlv) mclvi) mcdxlvi) mclvii) mcdxlvii) mclviii) mcdxlviii) mclix) mcdxlix) mclx) mcdl) mclxi) mcdli) mclxii) 6.11.1 Demonstrate mcdlii) dining techniques for use mcdliii) with the resident who has mcdliv) had a stroke. mcdlv) mclxiii) mcdlvi) mclxiv) mcdlvii) mclxv) mcdlviii) Performance mclxvi) Checklist #5 Dining a mclxvii) Resident mclxviii) mclxix) 6.11.2 Demonstrate dining techniques for use with the blind resident. mclxx) mcdlix) mcdlx) mcdlxi) mcdlxii)APPENDIX A
mcdlxiii) mcdlxiv)
mcdlxv)
mcdlxvi) mcdlxvii) INSTRUCTIONAL OBJECTIVES AND PERFORMANCE CHECKLIST SUMMARY mcdlxviii) mcdlxix) mcdlxx) mcdlxxi) mcdlxxii) mcdlxxiii) mcdlxxiv) mcdlxxv) mcdlxxvi) mcdlxxvii) mcdlxxviii) mcdlxxix) mcdlxxx) mcdlxxxi) mcdlxxxii) mcdlxxxiii) mcdlxxxiv) mcdlxxxv) mcdlxxxvi) mcdlxxxvii) mcdlxxxviii) mcdlxxxix) mcdxc) mcdxci) mcdxcii) mcdxciii) mcdxciv) mcdxcv) mcdxcvi) mcdxcvii) mcdxcviii) mcdxcix) md) mdi) mdii) Instructional Objectives and Performance Checklist Summary mdiii) mdiv) Student Name:______Instructor Name:______mdv) mdvi) mdvii) Note: Upon completion of this Dining Assistant course, all information should be completed and placed in the Dining Assistant’s file. mdviii) mdix) Column A: Date taught mdx) Column B: Date skill successfully demonstrated, when applicable mdxi) Column C: Instructors initials mdxii) mdxiv) mdxv) mdxvi) mdxiii) A B C mdxvii mdxviii mdxix) mdxx) ) 1 ) mdxxi) mdxxii mdxxiii mdxxiv 2 ) ) ) mdxxv) mdxxvi mdxxvi mdxxvi 3 ) i) ii) mdxxix mdxxx) mdxxxi mdxxxi ) 4 ) i) mdxxxiii) The Role of Dining Assistant mdxxxiv) 1. Explain the role of the Dining Assistant. mdxxxv) 2. Lists course requirements to become a Dining Assistant mdxxxvi) 3. Explain the role and responsibilities of facilities that mdxxxvii) choose to use Dining Assistants. mdxxxviii) 4. Describe three dining problems that a resident might mdxxxix) have that would not allow dining by a Dining Assistant. mdxl)
A) B) C) D)
E) F) G) H) I) J) K) L) M) N) O) P) Q) R) S) T) U) V) W) X) Y) Z) AA AB AC AD AE AF AG AH AI) AJ) AK AL A AN AO AP AQ AR AS AT AU AV A AX AY AZ mdxli) Communication and Interpersonal Skills mdxlii) 5. Define terms important to the study of Communication mdxliii) and Interpersonal Skills. mdxliv) 6. Describe effective communication skills. mdxlv) 7. List elements that influence relationships with others. mdxlvi) 8. Describe the importance of developing good listening skills. mdxlvii)9. Identify positive listening skills that can be used. mdxlviii) 10. Recognize barriers to effective communication. mdxlix) 11. Give examples of situations in which the Dining Assistant mdl) must modify his/her behavior in response to the resident’s mdli) behavior. mdlii) 12. Define sympathy, empathy, tact, and anger. mdliii) 13. Demonstrate effective non-verbal communications. mdliv) 14. List examples of nonverbal communications. mdlv) 15. Describe effective communication with the resident’s family mdlvi) and visitors. mdlvii) 16. List specific factors to consider when communicating with hearing impaired residents. mdlviii) mdlix) mdlx) mdlxi) mdlxii) mdlxiii) mdlxiv) mdlxv) mdlxvi)
A) B) C) D)
E) F) G) H) I) J) K) L) M) N) O) P) Q) R) S) T) U) V) W) X) Y) Z) AA AB AC AD AE AF AG AH AI) AJ) AK AL A AN AO AP AQ AR mdlxvii)Communication and Interpersonal Skills (cont.) mdlxviii) 17. List factors to consider when communicating residents that mdlxix) have decreased vision. mdlxx) 18. List ways to communicate with residents with memory loss. mdlxxi) 19. List factors to consider when communicating with a resident mdlxxii)that has difficulty speaking. mdlxxiii) 20. Demonstrate effective communication with residents who mdlxxiv) have hearing, vision, speaking or memory loss difficulties. mdlxxv)21. Identify techniques that can be used to help the resident to mdlxxvi) communicate. mdlxxvii) 22. List techniques to communicate with residents based on their mdlxxviii) developmental stage. mdlxxix) 23. List the elements in the Senses Method of observation, giving mdlxxx)an example of each. mdlxxxi) 24. Describe behaviors that are inconsistent with normal resident behavior. mdlxxxii) 25. Define objective and subjective data. mdlxxxiii) 26. Explain the elements essential for reporting to the supervisory nurse. mdlxxxiv)
A) B) C) D)
E) F) G) H) I) J) K) L) M) N) O) P) Q) R) S) T) U) V) W) X) Y) Z) AA AB AC AD AE AF AG AH AI) AJ) AK AL A AN AO AP AQ AR AS AT AU AV mdlxxxv) Resident Rights mdlxxxvi) 27. Define terms important to the study of Resident Rights. mdlxxxvii) 28. Describe the laws that protect the resident’s right to make mdlxxxviii) personal choices. mdlxxxix) 29. Give examples of behavior that would infringe on resident mdxc) rights. mdxci) 30. Describe the Resident’s Bill of Rights and HIPPA and how mdxcii) they are used in resident care. mdxciii)31. Identify behaviors that help maintain residents’ rights. mdxciv)32. List the advantages of explaining dining assistance to a mdxcv) resident prior to starting. mdxcvi)33. Identify important elements defined in Federal and State mdxcvii) definitions of mistreatment of the elderly. mdxcviii) 34. List signs of abuse of the elderly. mdxcix)35. List examples of abusive behavior. mdc) 36. Identify individuals that might be at risk for being abused. mdci) 37. Describe important elements to observe when reporting mdcii) suspected abuse. mdciii) mdciv) mdcv) mdcvi) mdcvii) mdcviii) mdcix) mdcx)
A) B) C) D)
E) F) G) H) I) J) K) L) M) N) O) P) Q) R) S) T) U) V) W) X) Y) Z) AA AB AC AD AE AF AG AH AI) AJ) AK AL A AN mdcxi) Safety and Emergency Procedures mdcxii) 38. Define important terms used in Safety and Emergency mdcxiii)Procedures mdcxiv)39. List rules of general safety. mdcxv) 40. Identify safety measures that prevent accidents. mdcxvi)41. Discuss key elements that might block the airway of mdcxvii) a resident. mdcxviii) 42. Enumerate the key steps for assisting to clean an mdcxix)obstructed airway to include the Heimlich Maneuver. mdcxx) 43. Correctly perform the Heimlich Maneuver. mdcxxi)44. Explain the responsibilities for assisting with a resident mdcxxii) who may have an emergency involving the heart. mdcxxiii) 45. Discuss and explain the responsibilities when assisting mdcxxiv) the resident with seizures. mdcxxv) 46. List important elements to observe when reporting mdcxxvi) emergency situations.
A) B) C) D)
E) F) G) H) I) J) K) L) M) N) O) P) Q) R) S) T) U) V) W) X) Y) Z) AA AB AC AD AE AF mdcxxvii)
A) B) C) D) mdcxxviii) mdcxxix) Infection Control mdcxxx) 47. Define key terms important to Infection Control mdcxxxi) 48. Discuss general principles that guide Infection Control mdcxxxii) techniques. mdcxxxiii) 49. List the components of the chain of infection, giving mdcxxxiv) examples of each. mdcxxxv) 50. Identify practices that promote medical asepsis. mdcxxxvi) 51. Demonstrate a basic understanding of standard mdcxxxvii) precautions. mdcxxxviii) 52. List reasons for washing hands frequently. mdcxxxix) 53. List key steps to proper handwashing. mdcxl) 54. Correctly demonstrate handwashing. mdcxli) mdcxlii)Nutrition and Hydration
A) B) C) D)
E) F) G) H) I) J) K) L) M) N) O) P) Q) R) S) T) U) V) W) X) Y) Z) AA AB AC AD AE AF mdcxliii) 55. Correctly define Nutrition and Hydration terms. mdcxliv) 56. Discuss the purpose of good nutrition and the mdcxlv)functions of food. mdcxlvi) 57. Discuss factors influencing dietary practices. mdcxlvii) 58. List examples of foods avoided by various religious mdcxlviii) denominations. mdcxlix) 59. Cite age-related changes that affect the resident’s mdcl) nutritional status. mdcli) 60. Identify signs of good nutrition. mdclii) 61. Describe results of poor nutrition. mdcliii) mdcliv) mdclv) mdclvi)
A) B) C) D)
E) F) G) H) I) J) K) L) M) N) O) P) Q) R) S) T) U) V) W) X) Y) Z) AA AB AC AD AE AF AG AH AI) AJ) AK AL A AN AO AP AQ AR AS AT AU AV A AX AY AZ BA BB BC BD BE BF BG BH BI) BJ) BK BL) B BN BO BP BQ BR BS BT BU BV B BX BY BZ CA CB CC CD CE CF) mdclvii)Nutrition and Hydration (cont.) mdclviii) 62. List the basic food groups. mdclix) 63. List purposes of therapeutic diets. mdclx) 64. List types of therapeutic diets. mdclxi) 65. Recognize and describe adaptive devices used in mdclxii)dining assistance. mdclxiii) 66. Demonstrate the use of adaptive devices used in mdclxiv) dining assistance. mdclxv)67. Identify Dining Assistance responsibilities in mdclxvi) serving resident meals. mdclxvii) 68. List steps in preparing the resident for dining mdclxviii) assistance. mdclxix) 69. List techniques used when assisting with dining. mdclxx)70. Demonstrate dining techniques. mdclxxi) 71. Discuss the various types of Supplementary mdclxxii) Nourishments. mdclxxiii) 72. Identify when Supplementary Nourishments mdclxxiv) are usually served. mdclxxv) 73. Correctly demonstrate Serving Supplementary mdclxxvi) Nourishments. mdclxxvii) 74. Identify how often fresh water should be provided mdclxxviii) to a resident each day and the amount to be encouraged. mdclxxix) 75. Identify and describe special fluid orders that the mdclxxx) physician could write for a resident. mdclxxxi) 76. Correctly demonstrate Providing Fresh Drinking mdclxxxii) Water. mdclxxxiii) 77. Identify normal changes in the digestive system as mdclxxxiv) they relate to the aging process. mdclxxxv) 78. Discuss the signs and symptoms of dysphagia. mdclxxxvi) 79. Identify dining techniques to be used with residents mdclxxxvii) who have had a stroke. mdclxxxviii) 80. Identify dining techniques to be used with residents mdclxxxix) who are blind. mdcxc) 81. Correctly demonstrate dining a resident. mdcxci) mdcxcii) mdcxciii) mdcxciv) mdcxcv) mdcxcvi) mdcxcvii) mdcxcviii) mdcxcix) mdcc) mdcci) mdccii) APPENDIX B mdcciii) mdcciv) mdccv) mdccvi) mdccvii) mdccviii) mdccix) mdccx) PERFORMANCE CHECKLISTS INDEX mdccxi) mdccxii) mdccxiii) mdccxiv) mdccxv) mdccxvi) mdccxvii) mdccxviii) mdccxix) mdccxx) mdccxxi) mdccxxii) mdccxxiii) mdccxxiv) mdccxxv) mdccxxvi) mdccxxvii) mdccxxviii) mdccxxix) mdccxxx) mdccxxxi) mdccxxxii) mdccxxxiii) mdccxxxiv) mdccxxxv) mdccxxxvi) mdccxxxvii) mdccxxxviii) mdccxxxix) mdccxl) mdccxli) mdccxlii) mdccxliii) mdccxliv) mdccxlv) mdccxlvi) mdccxlvii) Dining Assistant Curriculum mdccxlviii) mdccxlix) mdccl) Performance Checklists Index mdccli) mdcclii)Performance Checklist No. mdccliii) mdccliv) Unit 1 Role of the Dining Assistant
mdcclv) None
mdcclvi) mdcclvii) Unit 2 Communication and Interpersonal Skills
mdcclviii) None
mdcclix) mdcclx) Unit 3 Resident Rights
mdcclxi) None mdcclxii) mdcclxiii) Unit 4 Safety and Emergency Procedures
mdcclxiv) Performing Heimlich Maneuver. ………………………………………………………………………………………………………….51 mdcclxv) mdcclxvi) Unit 5 Infection Control
mdcclxvii) Washing Hands……………………………………………………………………………………………………………………………………52 mdcclxviii) mdcclxix) Unit 6 Nutrition and Hydration
mdcclxx) Serving Supplementary Nourishments………………………………………………………………………………………………..53 mdcclxxi) Providing Fresh Drinking Water. ………………………………………………………………………………………………………….54 mdcclxxii) Setting up a Meal Tray and Dining a Resident………………………………………………………………………………………55 mdcclxxiii) mdcclxxiv) mdcclxxv) mdcclxxvi) mdcclxxvii) mdcclxxviii) mdcclxxix) mdcclxxx) mdcclxxxi) mdcclxxxii) mdcclxxxiii) mdcclxxxiv) mdcclxxxv) mdcclxxxvi) mdcclxxxvii) mdcclxxxviii) mdcclxxxix) mdccxc)
mdccxci) mdccxcii) APPENDIX C
mdccxciii)
mdccxciv)
mdccxcv) mdccxcvi) mdccxcvii) PERFORMANCE CHECKLISTS mdccxcviii) mdccxcix) mdccc) mdccci) mdcccii) mdccciii) mdccciv) mdcccv) mdcccvi) mdcccvii) mdcccviii) mdcccix) mdcccx) mdcccxi) mdcccxii) mdcccxiii) mdcccxiv) mdcccxv) mdcccxvi) mdcccxvii) mdcccxviii) mdcccxix) mdcccxx) mdcccxxi) mdcccxxii) mdcccxxiii) mdcccxxiv) mdcccxxv) mdcccxxvi) mdcccxxvii) mdcccxxviii) mdcccxxix) mdcccxxx) mdcccxxxi) mdcccxxxii) mdcccxxxiii) mdcccxxxiv) Performance Checklist For Dining Assistant mdcccxxxv) mdcccxxxvi) Procedure 1: Performing Heimlich Maneuver Name______mdcccxxxvii) mdcccxxxviii) To be completed by instructor during observation of 100%, unassisted mastery of procedure. Date and sign below. mdcccxxxix) Equipment: No equipment mdcccxl) mdcccxli) Conscious victim: mdcccxlii) _____ 1. Ask person who appears to have choked but who is not coughing, “Are you choking?” mdcccxliii) mdcccxliv) _____ 2. Determine that victim cannot expel object on own and state that you will help. mdcccxlv) mdcccxlvi) _____3. Call for help. mdcccxlvii) mdcccxlviii) _____4. Stand behind victim. mdcccxlix) mdcccl) _____5. Wrap arms around victim’s waist. mdcccli) mdccclii) _____6. Clench fist, keeping thumb straight. mdcccliii) mdcccliv) _____7. Place clenched fist, thumb side in, against abdomen between navel and tip of sternum. mdccclv) mdccclvi) _____8. Grasp clenched fist with opposite hand. mdccclvii) mdccclviii) _____9. Push abdomen forcefully with upward thrusts until object is removed, victim starts to cough or becomes unconscious. mdccclix) mdccclx) Chests thrusts for obese victim: mdccclxi) _____1. Stand behind victim. mdccclxii) mdccclxiii) _____2. Place arms around victim directly under armpits. mdccclxiv) mdccclxv) _____3. Form fist and place thumb side of fist against sternum, level with armpits. mdccclxvi) mdccclxvii) _____4. Grasp fist in opposite hand and administer thrusts, pulling straight back, until object is removed, victim starts to cough, or becomes unconscious. mdccclxviii) mdccclxix) Unconscious victim who obstructed airway: mdccclxx) _____1. Place victim on back. mdccclxxi) mdccclxxii) _____2. Activate EMS system. mdccclxxiii) mdccclxxiv) _____3. Finger sweep mouth to remove object. mdccclxxv) mdccclxxvi) _____4. If unsuccessful, open airway with head-tilt/chin-lift maneuver. mdccclxxvii) mdccclxxviii) _____5. Try to ventilate; if still obstructed, reposition head and try to ventilate again. mdccclxxix) mdccclxxx) _____6. If ventilation unsuccessful, give five abdominal thrusts: mdccclxxxi) mdccclxxxii) a. straddle victim’s thighs or kneel next to victim mdccclxxxiii) b. place heel of one hand on abdomen above navel mdccclxxxiv) c. place other hand in same position over first mdccclxxxv) d. keep elbows straight and thrust inward and upward five times mdccclxxxvi) mdccclxxxvii) ____7. If unsuccessful, finger sweep mouth. mdccclxxxviii) ____8. Repeat steps 4-7 until effective or EMS arrives mdccclxxxix) mdcccxc) Pass______Instructors Signature______Date______mdcccxci) The above signature attests that the evaluator did not prompt, give hints, or otherwise assist the individual in the performance of the skills, when the individual was being evaluated for competency. mdcccxcii) mdcccxciii) Performance Checklist For Dining Assistant mdcccxciv) mdcccxcv) Procedure 2: Washing Hands Name______mdcccxcvi) mdcccxcvii) To be completed by instructor during observation of 100%, unassisted mastery of procedure. Date and sign below. mdcccxcviii) mdcccxcix) Equipment: Soap or soap dispenser, sink, running water, paper towels, waste receptacle mcm) mcmi) mcmii) ____1. Assemble equipment if necessary. mcmiii) mcmiv) ____2. Push sleeves and watch 4-5 inches up on arms. mcmv) mcmvi) ___3. Stand back from sink and adjust water temperature until warm. mcmvii) mcmviii) ___4. Wet wrists and hand without splashing and with fingertips pointed downward. mcmix) mcmx) ___5. Apply soap using friction. mcmxi) mcmxii)___6. Lather well, keeping hands lower than elbows. mcmxiii) mcmxiv) ___7. Rub hands together in circular motion, being sure to wash between fingers and two inches above wrists. mcmxv) mcmxvi) ___8. Clean under nails by rubbing against palms. mcmxvii) mcmxviii) ___9. Wash for at least 15 seconds or longer, if grossly contaminated, according to facility policy. mcmxix) mcmxx)___10. Rinse wrists and hands with running water. mcmxxi) mcmxxii) ___11. Dry hands thoroughly with paper towel and discard towel into waste receptacle. mcmxxiii) mcmxxiv) ___12. Turn faucets off with new paper towel and discard into waste receptacle. mcmxxv) mcmxxvi) mcmxxvii) mcmxxviii) mcmxxix) mcmxxx) mcmxxxi) mcmxxxii) mcmxxxiii) mcmxxxiv) Pass______Instructor’s Signature ______Date ______mcmxxxv) mcmxxxvi) mcmxxxvii) mcmxxxviii) mcmxxxix) The above signature attests that the evaluator did not prompt, give hints, or otherwise assist the individual in the performance of the skills, when the individual was being evaluated for competency. mcmxl) mcmxli) mcmxlii) mcmxliii) mcmxliv) Performance Checklist For Dining Assistant mcmxlv) mcmxlvi) Procedure 3: Serving Supplementary Nourishment Name______mcmxlvii) mcmxlviii) mcmxlix) To be completed by instructor during observation of 100%, unassisted mastery of procedure. Date and sign below. mcml) mcmli) Equipment: Nourishments, napkins, dining aids (straws, utensils) mcmlii) mcmliii) mcmliv)_____1. Receive directions from supervisor regarding individuals with special dietary needs. mcmlv) mcmlvi)_____2. Wash hands. mcmlvii) mcmlviii) _____3. Assemble supplies. mcmlix) mcmlx) _____4. Allow each resident to choose from available nourishments. mcmlxi) mcmlxii) _____5. Place nourishment, napkin and dining aids with reach. mcmlxiii) mcmlxiv) _____6. Provide assistance as needed. mcmlxv) mcmlxvi) _____7. Remove glasses and dishes after use. Do not touch rim of glass. mcmlxvii) mcmlxviii) _____8. Repeat steps 4-7 for each resident. mcmlxix) mcmlxx) _____9. Return used equipment to kitchen to be washed. mcmlxxi) mcmlxxii) _____10. Wash hands. mcmlxxiii) mcmlxxiv) mcmlxxv) mcmlxxvi) mcmlxxvii) mcmlxxviii) mcmlxxix) mcmlxxx) Pass______Instructor’s Signature ______Date ______mcmlxxxi) mcmlxxxii) mcmlxxxiii) mcmlxxxiv) mcmlxxxv) mcmlxxxvi) mcmlxxxvii) mcmlxxxviii) The above signature attests that the evaluator did not prompt, give hints, or otherwise assist the individual in the performance of the skills, when the individual was being evaluated for competency mcmlxxxix) mcmxc) mcmxci) mcmxcii) mcmxciii) mcmxciv) Performance Checklist For Dining Assistant mcmxcv) mcmxcvi) mcmxcvii) mcmxcviii) Procedure 4: Providing Fresh Drinking Water Name______mcmxcix) mm) mmi) To be completed by instructor during observation of 100%, unassisted mastery of procedure. Date and sign below. mmii) mmiii) mmiv) Equipment: Cart, pitchers, cups, trays, ice, scoop for ice, straws mmv) mmvi) _____1. Receive directions from supervisor regarding residents with special needs (NPO, fluid restrictions, no ice.) mmvii) mmviii) _____2. Wash hands. mmix) mmx) _____3. Assemble supplies. mmxi) mmxii) _____4. Take cart with clean supplies and add ice and water to pitchers (use scoop for ice). Do not allow handle of scoop to touch ice. mmxiii) mmxiv) _____5. Place fresh drinking water within reach. mmxv) mmxvi) _____6. Offer to fill cup with fresh water. mmxvii) mmxviii) _____7. Provide assistance as requested or needed. mmxix) mmxx) _____8. Return cart containing any used supplies to kitchen to be washed. mmxxi) mmxxii)_____9. Wash hands. mmxxiii) mmxxiv) mmxxv) mmxxvi) mmxxvii) mmxxviii) Pass______Instructor’s Signature ______Date ______mmxxix) mmxxx) mmxxxi) mmxxxii) mmxxxiii) mmxxxiv) mmxxxv) mmxxxvi) The above signature attests that the evaluator did not prompt, give hints, or otherwise assist the individual in the performance of the skills, when the individual was being evaluated for competency mmxxxvii) mmxxxviii) mmxxxix) mmxl) mmxli) mmxlii) mmxliii)Performance Checklist For Dining Assistant mmxliv) mmxlv) Procedure 5: Setting up a Meal Tray and Dining a Resident Name______mmxlvi) mmxlvii) To be completed by instructor during observation of 100%, unassisted mastery of procedure. Date and sign below. mmxlviii) mmxlix)Equipment: Basin, towel, washcloth, soap, oral hygiene products mml) mmli) mmlii) _____1. Knock before entering room. mmliii) mmliv) _____2. Address resident by name. mmlv) mmlvi) _____3. State your name and title. mmlvii) mmlviii)_____4. Identify resident. mmlix) mmlx) _____5. Explain procedure and obtain permission. mmlxi) mmlxii) _____6. Wash hands. (Wearing gloves is not a substitute for hand washing.) mmlxiii) mmlxiv)_____7. Check tray for correct name, type of diet, and food. Inform resident what is on tray. mmlxv) mmlxvi)_____8. Position towel/napkin/clothing protector under chin if requested. mmlxvii) mmlxviii) _____9. Prepare food by opening cartons, removing covers, cutting meat and/or buttering bread. mmlxix) mmlxx) _____10. Assist as needed, while encouraging resident to do as much as possible for his or her self. mmlxxi) mmlxxii) _____11. Allow hot foods to cool before offering. mmlxxiii) mmlxxiv) _____12. Use straw for liquids if appropriate. mmlxxv) mmlxxvi) _____13. Feed from tip of half-filled spoon. mmlxxvii) mmlxxviii) _____14. Tell resident what he or she is eating. mmlxxix) mmlxxx) _____15. Provide time to chew. mmlxxxi) mmlxxxii) _____16. Alternate solids and liquids. mmlxxxiii) mmlxxxiv) _____17. Wipe mouth as needed. mmlxxxv) mmlxxxvi) _____18. Encourage to eat as much as possible; observe that all food is swallowed and not pocketed in cheek. mmlxxxvii) mmlxxxviii) _____19. Wash hands when finished. mmlxxxix) mmxc) _____20. Provide comfort with call signal in reach. mmxci) mmxcii)_____21. Report any abnormal observations to supervisor. mmxciii) mmxciv) mmxcv)Pass______Instructor’s Signature ______Date ______mmxcvi) The above signature attests that the evaluator did not prompt, give hints, or otherwise assist the individual in the performance of the skills, when the individual was being evaluated for competency