Certified
Nurses Assistant (CNA):
Under the supervision
of a licensed nurse (registered or vocational), a CNA provides basic
nursing services to ensure the safety, comfort, personal hygiene,
and protection of patients/residents in a licensed long-term or
intermediate health care facility. CNAs may not perform any nursing
services that require a professional nursing license. For a specific
list of the types of procedures which may be performed by CNAs.
Where CNAs Work
Non-licensed individuals who provide nursing services must be certified
as a nurse assistant to work in:
-
Skilled nursing facilities (SNFs)
-
"Distinct
part" skilled nursing facilities (DP/SNF) within general
acute care hospitals, where "distinct part" is defined
as a part of the hospital set aside for the care of long-term
care patients.
-
Intermediate Care Facilities (ICFs) General acute care hospitals
may also hire CNAs; however, unlike SNFs, ICFs and DP/SNFs,
they are not required by state or federal law or regulations
to do so.
CERTIFIED
NURSE ASSISTANT FUNCTIONS
This functional statement has been developed by the DHS as appropriate
CNA functions to be performed under the supervision of a licensed
nurse in a licensed health facility. The Board of Registered Nursing
agrees that these functions do not infringe upon the practice of
nursing. Communicate with the resident; observe resident responses
to treatment and/or environment and report changes to licensed nurse.
Provide the following personal care and comfort measures:
-
CPR
(with current certification)
-
Apply
non-sterile dry dressings to intact skin surfaces
-
Apply
non-legend topical ointments, creams, lotions, and solutions
to intact skin surfaces
-
Chart
the medical record
-
Insert
cleansing enemas, laxative suppositories
-
Heimlich
maneuver
-
Bathing:
bed, tub, and shower
-
Haircare,
shampoos, medicinal shampoos
-
Shaving
-
Dressing
and undressing
-
Oral
hygiene and denture care
-
Toileting
-
Nail
care (except that which requires a podiatrist)
-
Care
of hearing aids, glasses, prosthetic devices, personal equipment
and belongings
-
Incontinence
care
-
Routine
skin care
-
Prevention
of pressure ulcers
-
Perineal
care
-
Assistance
with mobility: range of motion, transfers, ambulation, positioning,
exercises as ordered and demonstrated by an RN or physical therapist
-
Maintenance
of a clean and healthful environment
-
Feed
patients
-
Take
vital signs: temperature, pulse, respirations, and blood pressure
-
Measure
height and weight
-
Measure
and record in-take and out-put
-
Assist
with use of bedpan, urinal, and commode
-
Collect
specimens; urine, stool, and sputum
-
Assist
with bowel and bladder retraining
-
Provide
perineal care
-
Provide
or assist with bath
-
Provide
care to patients with urinary, gastric, oxygen, and intravenous
tubing (excluding inserting, suctioning, changing or respositioning
the tubes)
-
Make
beds
Home
Health Aides (HHA):
Through a licensed home health agency or hospice program, and under
the instruction and supervision of an RN, HHAs provide basic nursing
services, food preparation, and household services for individuals
receiving physician-prescribed care in their homes. An HHA may not
provide any services that require a professional nursing or medical
license. Included in this publication is a functional statement
for HHAs that lists specific procedures that may be performed by
HHAs. Where Certified HHAs Work Certified HHAs most typically provide
services in private residences through their employment with a home
health agency or hospice. Certified HHAs may also provide home health
services to residents in a licensed residential care facilities
when the facility contracts with a licensed home health agency or
hospice that employs the HHA.
Limits/Benefits of Certification
Only certified HHAs may represent themselves with the title “
certified home health aide.” However, HHAs may use the title
only when employed by a licensed home health agency or hospice program.
They may not advertise or represent themselves as certified HHAs
when providing personal care services independently. For example,
an individual with HHA training and experience may be directly employed
by residential care facilities but not as a certified home health
aide.
Requirements
for HHA Certification
To become a certified HHA, applicants must:
-
Be at least 16 years of age
-
Submit
an application for certification, fingerprints, and fees
-
Meet
the pre-screening requirements
-
Complete
an ATCS-approved training program and be deemed competent by
an
ATCS-approved instructor for certification in California
Training
Requirements
The minimum training requirements for HHA certification in California
are 65 hours of theory and 55 hours of supervised clinical training
in a program approved by ATCS and taught by ATCS-approved instructors.
However, if an applicant has an active nurse assistant certificate
or is enrolled in a combined CNA/HHA training program, training
may be limited to 40 hours (20 hours theory and 20 hours clinical)
of supplemental home care training. Upon completion of HHA training,
the training program will submit to ATCS the Home Health Aide Certification
List (HS 183 form) for those students who were successful. These
training requirements also apply to nursing students, nursing service
personnel from the U.S. armed services, out-of-state licensed nurses,
and foreigntrained nurses who are applying for HHA certification.
HOME HEALTH
AIDE FUNCTIONS:
This functional statement has been developed by the DHS as appropriate
HHA
functions to be performed under the supervision of a licensed vocational
or
registered nurse through a licensed home health agency. The certified
HHA shall
demonstrate competency prior to providing patient care. The Board
of Registered
Nursing agrees that these functions do not infringe upon the practice
of nursing.
Communicate with the patient and observe patient response to treatment
and/or environment and report changes to licensed nurse and therapist.
Provide and record the following personal care and comfort measures:
-
Chart
the medical record
-
Apply
non-legend topical ointments, creams, lotions, and solutions
to intact skin surfaces
-
Apply
non-sterile, dry dressings to intact skin surfaces
-
CPR
(with current certification)
-
Heimlich
maneuver
-
Insert
cleansing enemas, laxative suppositories
-
Bathing:
bed, tub, shower
-
Haircare,
shampoos, medicinal shampoos
-
Shaving
-
Dressing
and undressing
-
Oral
hygiene and denture care
-
Toileting
-
Nail
care (except that which requires a podiatrist)
-
Care
of hearing aides, glasses, prosthetic devices, personal equipment
and belongings
-
Incontinence care
-
Routine
skin care
-
Prevention
of pressure ulcers
-
Perineal
care
-
Assistance
with mobility: range of motion, transfers, ambulation, positioning,
exercise as ordered and taught by an RN, physical therapist,
or other appropriate health personnel
-
Meal
planning, food purchasing, preparation, serving, sanitation,
and storage
-
Maintenance
of a clean and healthful environment
-
Home safety and appropriate home emergency intervention
-
Feed
patients
-
Take
vital signs: temperature, pulse, respirations, and blood pressure
-
Measure
height and weight
-
Measure
and record in-take and out-put
-
Assist
with use of bedpan, urinal, and commode
-
Collect
specimens; urine, stool, and sputum
-
Assist
with bowel and bladder retraining
-
Provide
perineal care
-
Provide
or assist with bath
-
Provide
care to patients with urinary, gastric, oxygen, and intravenous
tubing (excluding inserting, suctioning, changing or repositioning
the tube)
