2. ObjectivesObjectives
Identify the purpose of the Training and
Competency Evaluation Program (TCEP)
List the role and responsibilities of the PC/PI and
NA
State the purpose of the TCEP conducted by the
director
Describe how to be recorded and maintained in
Ohio’s NA Registry
Discuss issues related to abuse, mistreatment,
neglect and misappropriation of resident property
Discuss title of State Tested Nurse Aide (STNA)
Slide 2
3. Omnibus Budget ReconciliationOmnibus Budget Reconciliation
Act of 1987 (OBRA)Act of 1987 (OBRA)
◦ The Omnibus Budget Reconciliation Act of
1987 (OBRA) is a federal law.
Purpose is to improve the quality of life of
nursing center residents.
This law sets minimum training and
competency evaluation requirements for
nursing assistants.
Each state must have a nursing assistant
training and competency evaluation program
(NATCEP).
Slide 3
4. Omnibus Budget ReconciliationOmnibus Budget Reconciliation
Act of 1987 (OBRA)Act of 1987 (OBRA)
◦ The training program
OBRA requires at least 75 hours of
instruction.
There must be at least 16 hours of supervised
practical training (clinicals).
◦ Competency evaluation
The competency evaluation has a written test
and a skills test.
OBRA allows at least 3 attempts to
successfully complete the evaluation.
Slide 4
5. Purposes of the TrainingPurposes of the Training
Program in OhioProgram in Ohio
Prepare the nurse aide (NA) in a long-
term care facility (LTCF) to care for the
residents
Prepare the NA in the LTCF to take and
pass the competency evaluation program
Prepare the NA to function as part of the
team
Make the NA aware of the principles of
nursing delegation
Slide 5
6. NATCEP Role & ResponsibilityNATCEP Role & Responsibility
Program Coordinator/Instructor
Program Instructors = Mrs. Payne & Ms.
Tway
◦ Provide classroom & clinical knowledge/training
◦ Follow rules of the state program
◦ Provide materials and tools for program/testing
◦ Facilitate learning
◦ Evaluate performance
◦ Address specific learning needs of the individual
learner
Slide 6
7. NATCEP Role & ResponsibilityNATCEP Role & Responsibility
NA Student = YOU!
Classroom
◦ Attend class
Can miss/makeup 16 hours
Must achieve an average score of 75% on all
NATCEP Exams
All missed work must be made up within 1 week
of return to school. State requirement = 60 days
◦ Follow program rules
◦ Review all handouts and obtain and review
skills booklet for testing
Slide 7
8. NATCEP Role & ResponsibilityNATCEP Role & Responsibility
NA Student = YOU!
Long-term Care Facility (LTCF) = Clinicals
◦ Occurs at the completion of classroom training
◦ Scheduled for March/April
◦ Provide care for the LTCF residents under the
direction of the program instructor
◦ Protect the LTCF resident
◦ Function as part of the team offering
information during the care conferences
Slide 8
9. Purpose of the State TestPurpose of the State Test
Test knowledge
Test skills
3 failures = must retrain
◦ Available through PRCTC Adult Education
◦ Total Cost is $649
Slide 9
10. Successful Completion of theSuccessful Completion of the
State Test for OhioState Test for Ohio
Complete 75 hour Nurse Aide Training and
Competency Evaluation Program (NATCEP)
Pass the Competency Evaluation Program
(CEP) written test with an 80%
◦ 79 questions
◦ Must have 64 questions correct
Pass the CEP skills test
◦ 5 of 25 possible
◦ Handwashing for everyone; 4 skills will be randomly
chosen
◦ 80% plus all bolded items must be demonstrated
Slide 10
11. Omnibus Budget ReconciliationOmnibus Budget Reconciliation
Act of 1987 (OBRA)Act of 1987 (OBRA)
◦ OBRA requires a nursing assistant registry in
each state.
It is an official record or listing of persons who
have successfully completed that state’s state-
approved NATCEP.
The registry has information about each nursing
assistant.
All information stays in the registry for at least 5
years.
Any agency can access registry information.
You receive a copy of your registry information.
You can correct wrong information.
Slide 11
12. Omnibus Budget ReconciliationOmnibus Budget Reconciliation
Act of 1987 (OBRA)Act of 1987 (OBRA)
◦ Other OBRA requirements
Retraining and a new competency evaluation
program are required for nursing assistants
who have not worked for 24 months.
Agencies covered under OBRA must provide
12 hours of educational programs to nursing
assistants every year.
Performance reviews also are required.
Slide 12
13. Ohio Nurse Aide RegistryOhio Nurse Aide Registry
Managed through the Ohio Department of
Health
List of all State-Tested Nurse Aides
(STNAs) in Ohio
Rules are located at
http://www.odh.ohio.gov
Slide 13
14. Ohio Nurse Aide RegistryOhio Nurse Aide Registry
Entered into registry
◦ Successfully pass all both the written and skills
components of the CEP
STNAs working outside of the LTCF setting must
provide proof of employment as an STNA to the
registry every 2 years
Name and address changes must be sent in
writing to the Nurse Aide Registry (NAR)
Social Security changes must be accompanied by
2 pieces of documentation to verify
Registry cards are issued by the testing
company; contact them for replacement
Contact number = 800-582-5908
Slide 14
15. Abuse, Mistreatment, Neglect orAbuse, Mistreatment, Neglect or
Misappropriation of ResidentMisappropriation of Resident
PropertyProperty
Allegations of abuse, mistreatment,
neglect or misappropriation of a resident’s
property against STNA
◦ Investigation
◦ Consequences
Reported to registry
If you witness it, report to charge nurse!
Findings of abuse are never removed from the
registry
Slide 15
16. State Tested vs. CertifiedState Tested vs. Certified
Train vs. Regulate practice
Completed requirements vs. licensed
Monitor vs. renew
Slide 16
18. ObjectivesObjectives
Describe his or her role as a STNA on the
interdisciplinary team
Discuss the roles of the other
interdisciplinary team members
Define levels of care and where LTCF fits
in the health care system
Describe primary purpose of long-term
care
Slide 18
19. STNA RoleSTNA Role
NAs spend the most time with residents
Work under the delegation & supervision
of a licensed nurse (RN or LPN)
Inform the nurse of any changes in the
resident’s condition
Works from the plan of care developed by
an interdisciplinary team for each resident
Slide 19
20. Interdisciplinary Team MembersInterdisciplinary Team Members
NursingNursing
Director of Nursing
◦ Responsible for resident care; supervises
nursing staff
◦ Reports to the Administrator
Licensed Nurse
◦ RN – Registered Nurse
◦ LPN – Licensed Practical Nurse
◦ CNP – Certified Nurse Practitioner (RN)
STNA
Slide 20
21. Interdisciplinary Team MembersInterdisciplinary Team Members
MedicineMedicine
Medical Director
◦ Oversees the quality and delivery of medical
care
◦ Maintains surveillance of the employees’ health
status
Private Physician for resident
◦ Hired by the resident of other significant other
◦ Directs the resident’s medical care including
medications & treatments
Slide 21
22. Interdisciplinary Team MembersInterdisciplinary Team Members
Professional StaffProfessional Staff
Dietician
Social Worker
Physical Therapist
Activity Director
Occupational Therapist
Speech/Hearing Therapist
Spiritual Care Team
Respiratory Therapist
Psychologist
Pharmacist
Slide 22
23. Interdisciplinary Team MembersInterdisciplinary Team Members
Other MembersOther Members
Food Service
Secretary/Clerk
Maintenance
Housekeeping
Laundry
Business Office
Medical Records
Security
Slide 23
24. Interdisciplinary Team MembersInterdisciplinary Team Members
AdministrationAdministration
Administrator
◦ Responsible for the overall operation of the
facility
◦ Responsible to the governing board or owner(s)
Slide 24
25. Interdisciplinary Team MembersInterdisciplinary Team Members
GoverningGoverning BodyBody
Determines the facility’s mission
◦ Logan Elm
“We remain a leader in health care because of the high
standards we have set for ourselves. We are
committed to providing the highest quality of care
possible and to preserve the dignity of every person
we serve by effectively meeting his or her medical,
social, emotional & spiritual needs.”
Sets & approves policy, budget, & capital
expenditures
Has legal & financial responsibility for the
facility
Slide 25
26. Interdisciplinary Team MembersInterdisciplinary Team Members
OthersOthers
Volunteers
Pets
Surveyors
◦ From Ohio Dept of Health: inspect facilities to
make sure that they comply with state &
federal standards of care
Ombudsman
◦ Located in the Ohio Dept of Aging. Works as
the resident’s advocate among the residents,
family & facility
Slide 26
27. Levels of Care: LTCF RolesLevels of Care: LTCF Roles
Acute Care
Subacute Care
Long-term Care
Home Care
Hospice
Assisted Living
Adult Day Care
Alzheimer/dementia Care
Mental Health
Slide 27
28. Primary Purpose of the LTFCPrimary Purpose of the LTFC
To assist resident/client to achieve and
maintain a maximum level of functioning
(Quality of Life) and maintain their sense
of individuality (Quality of Life)
◦ Person-centered care
◦ Restorative/rehabilitative care
◦ End-of-Life care
Comfort
Palliative
Slide 28
30. ObjectivesObjectives
State purpose of STNA role in ADLs
Describe the STNA’s responsibility in caring for the
resident’s unit
Describe the STNAs responsibility in providing and
recording residents’ nourishment
Describe the STNA’s responsibility with record keeping and
communication
Describe the STNA’s responsibility in promoting residents’
rights
Describe the STNA’s role in maintaining confidentiality
State an understanding of time management as it relates
to resident care
Describe the STNA’s role in resident’s safety
Identify the STNA’s responsibility for attending in-services
Slide 30
31. ActivitiesActivities of Daily Livingof Daily Living
Dress and Undress
Bathe and maintain hygiene
Mobility/Walking
Elimination – Toileting
Eating and Drinking
Bed mobility
Slide 31
32. Care of the Resident’sCare of the Resident’s UnitUnit
Make bed
Maintain a safe and clean environment
Slide 32
34. Recordkeeping &Recordkeeping & CommunicationCommunication
Record intake and output
Record vital signs
Assist in admission, transfer and
discharge
Document care on flow sheets or other
forms
Assignment sheets
Complete assignment
Report on/off duty
Slide 34
35. PromotePromote ResidentResident RightsRights
Established within Omnibus Budget
Reconciliation Act of 1987 (OBRA)
Legal rights of residents as US citizens
Protected by state and federal law
Centers cannot interfere with these rights
◦ Information
◦ Refusing Treatment
◦ Privacy & Confidentiality
◦ Personal Choice
◦ Work
Slide 35
37. Prioritizing/Prioritizing/TimeTime ManagementManagement
Organize work and set priorities
◦ What do you need to do first?
◦ Resident condition?
◦ Does the resident have any treatments
scheduled or appointments?
◦ What can be done while the residents are
eating?
◦ What can be done while resident is at therapy
or an activity?
◦ When are special rooms available (shower)?
◦ What do you need help with?
Slide 37
38. Assuring ResidentAssuring Resident SafetySafety
First Priority!
Guard against accidents
Prevent accidents
Know what to do in the event of an
emergency
◦ Fire
◦ Falls
◦ Drills
◦ Medical Emergencies
Slide 38
43. Use of Policy & Procedure ManualsUse of Policy & Procedure Manuals
Policy Manual explains “why” behind
practices or standards set by the facility
Procedure Manual: how-to guide
◦ Step by step
◦ All caregivers must provide care in same way
following procedures
◦ Foundation for good nursing practice
◦ Standard of care
Location: Nursing Station
Slide 43
Editor's Notes
Federal and state laws and agency policies combine to define the roles and functions of each health team member.
The nursing assistant training and competency evaluation program must be successfully completed by nursing assistants working in nursing centers, hospital long-term care units, and home care agencies receiving medicare funds.
Some states require more than 75 hours. Students perform nursing care and procedures on another person during the practical training. A nurse supervises this practical training. The written test has multiple-choice questions. The number of questions varies from state to state. The skills test involves performing nursing skills. There is a fee for the evaluation. If you work in a nursing center, the employer pays this fee.
States can require: A new competency evaluation Both retraining and a new competency evaluation These requirements help ensure that nursing assistants have current knowledge and skills to give safe, effective care. Each state NATCEP (Nurse Aide Training and Competency Evaluation Program) must meet OBRA (Omnibus Budget Reconciliation Act of 1987) requirements. If you want to work in another state, contact the state agency responsible for NATCEPs and the nursing assistant registry.
