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Essential Roles and Responsibilities of CNAs in an Aging Population: An Overview

The aging population, particularly those over 80 years old, is growing rapidly, impacting healthcare demands. This presentation highlights the evolution of roles and responsibilities for Certified Nursing Assistants (CNAs) and Registered Nurses (RNs) since the 1980s. It discusses important laws like the Nurse Practice Act and the Omnibus Budget Reconciliation Act (OBRA), which define training requirements and competency evaluations for CNAs. Understanding these regulations and the delegation of tasks is crucial for ensuring quality care in various healthcare settings.

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Essential Roles and Responsibilities of CNAs in an Aging Population: An Overview

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  1. Facilities and C.N.A. Roles Denise Morris, RN MSN Taylor Hudson, CNA

  2. Introduction • Population is aging quickly • Population over 80 y/o is the fast growing • 1990 – Life expectancy was 49 y/o • 2004 – Life expectancy was 74 y/o • 1/6 jobs is in health care • LTC, Hospice, Homes, Dr. Office, Assisted Living

  3. The Law • Federal, State and Agency Policy govern rules and Fx • Law • Job description • Person’s condition • Amount of supervision

  4. The Law • You need to know: • What you can do • What you can’t do • What is right and what is wrong

  5. History and Current Trends • Prior to 1980 • Training not required by lay • RN gave OJT training • 1980 • Team Nursing common – RN team leader assigned care according to need and skill • Primary Nursing common mid 1980’s - RN gave all care in hospitals, CNA used in nursing homes

  6. History and Trends • Criteria motivating change in training Program • Caused rise in RN use • Increasing cost • Prospective payment limited hospital stay • Reduction in quality • Nurse Practice Act – Defines Scope

  7. State and Federal Law • 1987 Omnibus Reconciliation Act • Funded by Medicare at Federal Level • Funded by Medicaid at State Level

  8. State and Federal Law • Nurse Practice Acts • Define RN/LPN/CAN roles • Describe scope of practice and license requirements • Protects the public from practicing without a license • Allows for Revocation • Convicted of a crime • Selling/distributing drugs • Using person’s drugs for yourself • Placing a person in danger from overuse of drugs • Negligence • Aiding or assisting another to violate practice rules • Making medical diagnosis

  9. Omnibus Budget Reconciliation Act (OBRA) • Applies in all 50 states • Purpose • Decrease cost • Increase quality • Sets minimum training and competency training • Requires each state to have CNA training program to include: • 75 classroom hours • 12 days of clinical experience

  10. Omnibus Budget Reconciliation Act (OBRA) • Areas of Study • Communication • Infection Control • Safety • Resident Rights • Basic Nursing • Personal Care • Feeding • Skin care • Elimination • Transferring and turning • Dressing • Ambulation • ROM • S&S of common diseases • Caring for cognitively impaired

  11. Omnibus Budget Reconciliation Act (OBRA) • Competency Evaluation • Written exam • Practical Test • Nursing Assistant Registry • OBRA requires state to keep list of CNA’s for 5 years • Any agency can access registry

  12. Roles and Responsibilities • Vary from state to state, but generally: • ADL’s • Special Procedures • Support Services • Documentation

  13. Roles and Responsibilities • Professionalism • Characteristics of professional behavior: attitude, appearance, confidentiality, advocacy, security • Personal characteristics necessary for CNA: sensitive, mature, dependable, empathetic,

  14. Roles and Responsibilities • Delegation • Nurse practice act only allows nurse to delegate tasks that don’t require special skills (i.e. ADL’s) • RN still accountable • Who can delegate? • RN to LPN/CNA • LPN to CNA • CNA can’t delegate

  15. Roles and Responsibilities • Delegation Process • Must be within legal limits of provider • Task in job description and OK in state • Have had training and competent • Experience in doing task independently

  16. Roles and Responsibilities • 5 Rights of Delegation • Right Task • Right Person • Right Directions/Communication • Right Supervision • Right Circumstances

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