AZBN Monthly Education Meeting with Arizona Nursing Assistant Programs Thursday, November 12, 2020 1:00pm
Summary
➢ Welcome The meeting began at 1:01pm with Cindy George facilitating the call. ➢ Roll Call: Alhambra High School Arizona Career institute Arizona Medical Training Institute Cochise College Coconino Community College Combs High School Department of Education (Aden Ramirez) East Valley Institute of Technology Facets Healthcare Gateway Community College Gila Community College/Eastern Arizona College - Gila Pueblo Campus Meadows of Northern Arizona Mesa Community College - MAIN Mesa Community College - Red Mountain Campus Northland Pioneer College Pierson High School Pima County JTED Pima Medical Institute Saguaro High School Star Canyon School of Nursing Valley Vocational Academy West-Mec Yavapai College Yuma Union
➢ Department of Education Update for High Schools (Aden Ramirez) Aden gave an update on high schools amid the COVID pandemic. He stated that each high school makes decisions within their local district, new guidelines for each school is up to the individual school/district. Aden has started monitoring each high school, reach out if you have any questions. Aden will also be sending out a high school summary after each CNA meeting. Aden and Cindy will be working to get a quarterly meeting for the high schools in the new year.
➢ Renewal packets- Numbering of pages and ranges (Cindy) Please make sure you number your pages straight through starting with #1 and then all the way through. Also, please do not put ranges on where to find things, just give page numbers, if it is more than one place, just page numbers. I will be sending back any renewal submissions that are not numbered correctly or have ranges in them. It is very time consuming to try to locate things. Thank you.
➢ Program updates ( in class or all online?)(Cindy) Discussion on where schools were at as far as being online or in person. There is a mix of where everyone is at. Some are online and some school districts are possibly looking to going back to online learning. Please keep Cindy/Lyn updated on where your program is at so we can keep track of where everyone is at. Please submit any program changes needed. ➢ CMS Testing for LTC’s (Cindy) CMS testing is changing daily for the LTC’s, please refer back to your information that was given so you have an idea where the percentages are at for your community. Also keep in close contact with your clinical sites to see what is required of your students.
➢ Clinical sites (Cindy) Lots of changes daily on the clinical sites, we will see more changes if the numbers rise. Try and get any clinical hours done that you can if you have an open site. Also, make sure you have turned in program changes for in classroom clinicals if needed. Discussion was had by the programs on supplies that are needed to bring to the clinical sites, some are requiring masks, shields and gloves, please check with your sites to see what is required of your program.
➢ TAP Updates (Cindy) Cindy thanked the members of the TAP committee for all their hard work this year. and went over the changes and took questions. Changes were approved at the November 13, 2020 Arizona Board Meeting and will be posted on our website this week. Here are the changes.
COMPETENCY EXAM CHANGES
The annual review of the Nursing Assistant (NA) Manual Skills and Written Tests and testing procedures was conducted on October 30,2020, at the meeting of the ad hoc Test Advisory Panel (TAP) on a virtual at the Arizona Board of Nursing.
Background:
The ad hoc Test Advisory Panel (TAP) is made up of volunteers who are directly involved with the education or supervision of NAs. Attendees at the NA Conference are asked if they would like to serve on this panel and selection is made based upon past attendance, past or potential contributions to the process and representation of rural/urban areas and program types. Most volunteers are offered at least one opportunity to participate on a TAP.
Changes Effective February 1, 2021
KNOWLEDGE TEST ● ACTIVE TEST BANK
o Current number of active test questions in the test bank is 1269.
o 254 questions were reviewed by the panel and of the 254 questions, the panel approved 129 for inclusion in the test bank.
● PRACTICE TEST BANK
o Test bank update, 1008 questions were reviewed and update by the panel
Test Plan Total Questions 75
WRITTEN Test Plan AZ
Test Plan
Safety 7
Communication 7 Infection Control 8
Resident (Client) Rights 6
Data Collection 6
Basic Nursing Skills 9
Role / Responsibility 7
Disease Process 4
Mental Health 4
Personal Care 9
Care Impaired 4
Aging Process/Restorative Care 4
Grade Level Reading Range 5.31-5.46
Predicted Alpha Range for Test Set .80-.82
Index Creation Range for Test Set 82.9-83.1
AZ
Replic to version 41 9/29/15
P-value filter 9/11/19
Written Version 26
Written Cut Score 75
Subject Area Safety 91
Communication 58
Infection Control 68
Resident Rights 105
Data Collection 51
Basic Nursing Skills 257
Role / Responsibility 113
Disease Process 172
Mental Health 59
Personal Care 45
Care Impaired 60
Aging Process/Restorative 50 Care/Growth & Devel
Total Active Questions 1269
Last update 10/29/2020
Skill Task Cut Score 80
Skills Version 68
AZ
SKILLS TASK CHANGES
MANDATORY TASKS WITH HAND WASHING EMBEDDED: BEDPAN AND OUTPUT WITH HAND WASHING:
PPE (gown and gloves) will be added to this task.
The new task is:
Donning Isolation Gown and Gloves – Bedpan and Output with Hand Washing
For the setup of this task, the waterproof pad will already be placed under the Actor. The steps for this task are at the end of this document.
ISOLATION GOWN AND GLOVES/EMPTY A URINARY DRAINAGE BAG WITH HAND WASHING:
PPE is being removed from Emptying a Urinary Drainage Bag and Catheter Care will be added.
The new task is:
Catheter Care – Emptying a Urinary Drainage Bag with Hand Washing
This task will be demonstrated on a female manikin. The steps for this task are at the end of this document.
OTHER TASKS:
DENTURE CARE: Step of: ‘Place dirty dentures in the emesis basin’. IS BEING REMOVED
DRESSING A BEDRIDDEN RESIDENT: The step of “Removes gown from unaffected side first.” Will be an * step (double points).
FEEDING A DEPENDENT RESIDENT: The range for the fluid consumed is being increased from 30ml’s to 45ml’s.
MOUTH CARE - BRUSHING TEETH: The following steps have been changed: · ‘Empty emesis basin’ will be changed to:
o Empty container. ▪ (The container could be the emesis basin or a disposable cup that the Actor has spit in.)
· ‘Rinse and dry emesis basin with a clean, dry paper towel’ will be changed to:
o Rinse and dry emesis basin, if used, with a clean, dry paper towel, or discard disposable items in trash can.
· ‘Return emesis basin and toothbrush to storage’ will be changed to:
o Return equipment to storage.
VITAL SIGNS - TEMPERATURE PULSE AND RESPIRATIONS:
The temperature is being removed from this task. The new task will be:
Pulse and Respirations The following steps will be removed from this task:
▪ Correctly turns on digital oral thermometer and place sheath on thermometer.
▪ Gently insert bulb end of thermometer in resident’s mouth under tongue.
▪ Leave thermometer in place for appropriate length of time.
▪ Remove thermometer and read and record the temperature reading on provided, previously signed recording form.
▪ Candidate’s and RN Test Observer’s recorded temperature recordings match.
▪ Discard sheath appropriately.
The following steps have been reworded to:
OLD: ‘Count pulse for 60 seconds or 30x2 and record pulse rate on the provided, previously signed recording form.’
NEW: Count pulse for 60 seconds or 30x2. a. Tell the RN Test Observer when you start counting and tell him/her when you stop counting. Record your reading on the previously signed recording form.
OLD: ‘Count respirations for 60 seconds or 30x2 and record respirations on the provided, previously signed recording form.’
NEW: Count respirations for 60 seconds or 30x2. a. Tell the RN Test Observer when you start counting and tell him/her when you stop counting. Record your reading on the previously signed recording form. The temperature is being removed from this task.
VITAL SIGNS - TEMPERATURE, RESPIRATIONS, PULSE OXYGEN AND ELECTRONIC BLOOD PRESSURE: This task is being removed from testing. NEW MANDATORY TASKS DONNING AN ISOLATION GOWN AND GLOVES / BEDPAN AND OUTPUT WITH REQUIRED HAND WASHING (ONE OF THE POSSIBLE MANDATORY FIRST TASKS)
1. Perform hand hygiene. a. Cover all surfaces of hands with hand sanitizer.
b. Rub hands together until hands are completely dry.
2. Face the back opening of the gown.
3. Unfold the gown.
4. Place arms through each sleeve.
5. Fasten the neck opening.
6. Fasten the waist, making sure that the back flaps cover clothing as completely as possible.
7. Put on gloves.
8. Glove overlap gown sleeves at the wrist.
9. Greet resident by name.
10. Introduce self by name.
11. Explain the procedure to the resident.
12. Provide privacy – pull privacy curtain for resident. 13. Raises bed to a comfortable working height.
14. Positions resident on bedpan correctly using correct body mechanics.
15. Raises head of bed to comfortable level.
16. Leaves call light and tissue within reach of resident.
17. Lowers bed.
18. Steps away to a private area of room away from resident.
19. When signaled by the RN Test Observer the candidate returns.
20. Raises bed to a comfortable working height.
21. Washes/assists resident to wash hands using a wet wash cloth with soap.
22. Assists resident to dry hands.
23. Lowers the head of the bed.
24. Discards soiled linen in appropriate container.
25. Candidate gently removes bedpan and holds while the Observer adds a known quantity of fluid.
26. Candidate measures output.
27. Lowers bed if raised.
28. Empties, rinses, and dries bedpan and graduate.
29. Records output on the previously signed provided recording form.
30. Candidate's recorded output is within 30ml’s of RN Test Observer’s recording.
31. Leave call light or signaling device within reach of the resident.
32. Leave water within reach of resident.
33. Maintain respectful, courteous interpersonal interactions at all times.
34. Remove gloves, turning inside out.
35. Remove gloves BEFORE removing gown. 36. Dispose of the gloves in the designated container (trash can or bag).
37. Unfasten gown at the waist.
38. Unfasten gown at the neck.
39. Removes gown by slipping hands underneath gown at the neck and shoulder.
40. Remove gown by folding soiled area to soiled area.
41. Dispose of gown in the designated container (trash can or bag).
42. Washes Hands: Begins by wetting hands.
43. Applies soap to hands.
44. Rubs hands together using friction for at least 20 seconds with soap.
45. Interlaces fingers pointing downward with soap.
46. Lathers all surfaces of hands and wrists with soap.
47. Rinses hands thoroughly under running water with fingers pointed downward.
48. Dries hands on clean paper towel(s).
49. Turns off faucet with a clean dry paper towel(s).
50. Discards paper towels into trash container.
51. Does not re-contaminate hands at any point by touching the faucet or sink during/after the procedure.
CATHETER CARE / EMPTYING A URINARY DRAINAGE BAG WITH REQUIRED HAND WASHING (ONE OF THE POSSIBLE MANDATORY FIRST TASKS)
1. Perform hand hygiene.
a. Cover all surfaces of hands with hand sanitizer.
b. Rub hands together until hands are completely dry.
2. Greet resident by name. 3. Introduce self by name.
4. Explain the procedure to the resident.
5. Provide privacy – pull privacy curtain for resident.
6. Put on gloves.
7. Lift resident’s gown to expose catheter area.
8. Check to see that urine can flow, unrestricted, into the drainage bag.
9. Use soap and water to carefully wash around the catheter where it exits the urethra.
10. Hold catheter where it exits the urethra.
11. With fingers near the urethra, clean 3-4 inches down the catheter tube.
12. Clean with stroke(s) only away from the urethra.
13. Use clean portion of cloth for stroke(s).
14. Rinse using stroke(s) only away from the urethra.
15. Rinse using clean portion of cloth for stroke(s).
16. Pat dry.
17. Do not allow the tube to be pulled at any time during the procedure.
18. Replace top cover over resident.
19. Leave resident in a position of safety and comfort.
20. Place a barrier on the floor under the drainage bag.
21. Place the graduate on the previously placed barrier.
22. Open the drain to allow the urine to flow into the graduate.
23. Completely empty drainage bag.
24. Avoid touching the graduate with any part of the tubing.
25. Close the drain. 26. Wipe the drain with alcohol wipe AFTER emptying drainage bag.
27. Replace drain in holder.
28. Place graduate on level, flat surface
29. With graduate at eye level, read output.
30. Empty graduate.
31. Rinse graduate.
32. Dry graduate.
33. Record output on the previously signed provided recording form.
34. Candidate's recorded output measurement is within 30mls of the RN Test Observer's output reading.
35. Leave call light or signaling device within reach of the resident.
36. Leave water within reach of resident.
37. Maintain respectful, courteous interpersonal interactions at all times.
38. Wash hands: Begin by wetting hands.
39. Apply soap to hands.
40. Rub hands together using friction with soap.
41. Rub hands together for at least twenty (20) seconds with soap.
42. Interlace fingers pointing downward with soap.
43. Lathers all surfaces of hands with soap.
44. Lathers wrists with soap.
45. Rinse hands thoroughly under running water with fingers pointed downward.
46. Dry hands on clean paper towel(s).
47. Turn off faucet with a clean, dry paper towel.
48. Discard paper towels to trash container. 49. Does not re-contaminate hands at any point by touching the faucet or sink during/after the procedure.
➢ Pass Rate Update (Cindy) Pass rates are 82% and 82%, we had gone up on the knowledge portion and then went back down. Will report every month.
➢ Request for suggestions for mobile drug testing services (Cindy) Schools gave feedback to Tamara G. to help her find places for her upcoming school.
➢ Textbook recommendations and updates and Online versus hardcover textbooks? (Cindy) Much discussion was had on textbooks and how to pick textbooks. Online versus hard copy books. Much was talked about costs, illustrations, length of programs. Programs brought forward knowing your audience when picking books, complexity of books, taking in mind ESL students and size of classes. ➢ Other topics brought forward from Tammy G. (Cindy) Suggestions for west side clinical sites, clinical hours for the programs and any tips for new programs.
ADDITIONAL IMPORTANT INFORMATION, PLEASE READ: Those students who requested an electronic fingerprint card and submitted a fee for a temporary license are being rejected for the temporary license due to there being no way for us to know when the fingerprint card is submitted. The fingerprint agency will not send us anything. They will process the fingerprint results and will send the fingerprint result to us. If they requested an electronic fingerprint card, we will not issue the temporary license. The electronic fingerprint results come back to the AZBN quickly and students will receive the LNA license very quickly. Just make sure when they request an electronic fingerprint card at the end of the process that they get a receipt that their electronic fingerprint card went through and the phone number of the fingerprint agency in case they have to call and find out where their status is.
➢ Innovations/Concerns (All) Please be sure to complete the Monthly Clinical Update Form for the prior month: https://forms.gle/cqyV45hjfuCZtXTG9 ➢ Suggestions for Next Meeting - Please send suggestions to Board Staff (Thursday, July 9th, 2020)
➢ Meeting adjourned at 1:57pm