STANDARD 14: NURSE AIDE SCOPE OF PRACTICE - IN.gov

1 STANDARD 14: NURSE AIDE SCOPE OF PRACTICE The NURSE aide will perform only the tasks in the course standards and Resident Care Procedures manual, unless trained appropriately by licensed staff of the facility with policies and procedures and a system for ongoing monitoring to assure compliance with the task, , (see supplements for examples). This additional training would only apply for tasks, which are not prohibited by paragraphs 2 and 3 of this section and by current rule, which prohibits the giving of injections.

2 The NURSE aide will not perform any invasive procedures, including enemas and rectal temperatures, checking for and/or removing fecal impactions, instillation of any fluids, through any tubing, administering vaginal or rectal installations. The NURSE aide will not administer any medications, perform treatment or apply or remove any dressings. Exception to the above would be the application of creams/ointments to intact skin, such as moisture barrier cream. ABDOMINAL BINDERSTEPRATIONALE1. Do initial steps.

3 2. Check the skin for redness, open areas, Allows you to identify early signs of skinbreakdown and the need for cleansing prior tobinder Place binder flat on the bed and haveresident lie down with the upper border atthe waist and the lower border at the levelof the gluteal fold. If resident is in bed,assist him/her to roll side-to-side whileplacing binder underneath him/her in thesame A binder placed above the waist interferes withbreathing, one placed too low interferes withelimination and Bring the ends of the binder around theresident, and overlap them.

4 Beginning at thebottom of the binder, secure the velcrofastener strip so that the binder fits A snug fit provides maximum support. If thebinder is too loose, efficacy is impaired. Ifit is too tight, resident may be Ensure that there are no wrinkles or creasesin the Wrinkles and creases put pressure on the skinincreasing the risk for Do final steps. I verify that this procedure was taught and successfully demonstrated according to facility _____Student/CNA SignatureDate_____ _____Student/CNA SignatureDate_____ _____Student/CNA SignatureDate_____ _____Instructor SignatureDateABDUCTION PILLOWSTEPRATIONALE1.

5 Do initial steps. 2. Place the pillow between the supineresident's legs. Slide it with thenarrow end pointing toward the groinuntil it touches the legs all alongits Placing pillow between resident's legsprevents adduction of the hip Place the upper part of both legs in thepillow's indentations. Raise each leg slightlyby lifting under the knee and ankle to bringstraps under and around leg and then securethe straps to the Securing the straps prevents the pillow fromslipping out of Do final steps.

6 5. Report resident intolerance or complaintof pain upon application to the Provides NURSE with information to assessresident's condition and needs. I verify that this procedure was taught and successfully demonstrated according to facility _____Student/CNA SignatureDate_____ _____Student/CNA SignatureDate_____ _____Student/CNA SignatureDate_____ _____Student/CNA SignatureDate_____ _____Instructor SignatureDateAM CARESTEPRATIONALE1. Do initial steps. 2. Put on gloves (according to procedure #2).2.

7 Protects you from contamination by bodily Assist resident with elimination perineal care as needed(according to procedure #34).3. Often residents will need to urinate uponarising in the morning. Provision of perinealcare enhances self-esteem while assisting inthe prevention of pressure Assist resident to wash face, hands, andunder Refreshes resident, increases Assist resident with oral hygiene (accordingto procedure #27), including denture care(according to procedure #26), as Refreshes resident, increases Shave male residents (according toprocedure #24 or #25).

8 6. Refreshes resident, increases Assist resident with dressing including anyjewelry per resident Refreshes resident, increases Comb and style resident's hair (according toprocedure #29).8. Refreshes resident, increases Assist with application of any assistivedevices/adaptive devices ( , glasses orcontact lenses, hearing aides, dentures,artifical arm, leg, or breast, etc.).9. Ensures that resident will be able to function athis/her maximum Assist resident out of bed utilizing properprocedure specific to Prepares resident for transportation to Do final steps.

9 I verify that this procedure was taught and successfully demonstrated according to facility _____Student/CNA SignatureDate_____ _____Instructor SignatureDateAPPLICATION OF INCONTINENT BRIEFSSTEPRATIONALE1. Do initial steps. 2. Unfasten and remove brief resident iscurrently Residents should have soiled briefs removedpromptly to decrease risk of skin Provide perineal care as indicated(according to procedure #34).3. Prevents infection, odor, and skin breakdown;improves resident's Place back of brief under resident's hips,plastic side of disposable brief awayfrom resident's Plastic may cause irritation of theresident's Bring front of brief between resident's legsand up to his/her waist.

10 6. Fasten each side of brief and adjust Adjusting brief to a snug fit will Finish dressing resident. 8. Do final steps. I verify that this procedure was taught and successfully demonstrated according to facility _____Student/CNA SignatureDate_____ _____Student/CNA SignatureDate_____ _____Student/CNA SignatureDate_____ _____Instructor SignatureDateARJO TUBSTEPRATIONALE1. Do initial steps. 2. Fill tub with water before bringing residentto bathing Tub takes an extended time to fill with Help resident remove clothing.