Unit 3 - Opportunity Aide Training Program

Unit 3: Personal Care Services

Minimum Number of Hours: Theory 25, Clinical 45

Statement of Purpose:

The purpose of this unit is to provide the CNA with expanded knowledge of safety and personal care as it is delivered in the home. Personal care skills, body mechanics, safety and emergency procedures are reviewed, and methods to improvise and adapt these procedures for the home care client are presented.

Performance Standards (Objectives)

Upon the completion of the twenty-five (25) Theory hours and forty-five (45) Clinical hours plus assignments, the learner will be able to:

1. Define the terminology.
2. Describe the steps and guidelines for common personal care skills.
3. Explain the importance of improvising equipment and adapting care activities in the home.
4. Discuss personal care delivery in home care.
5. List examples of home equipment that can be utilized to provide personal care.
6. Discuss the benefits of self-care in promoting wellness.
7. Describe key principles of body mechanics.
8. Explain how to adapt body mechanics in the home setting.
9. Describe adaptations that can be made in the home for ambulation and positioning.
10. Identify the purpose of passive and active Range of Motion exercises.
11. Describe high risk factors for skin breakdown and methods of prevention.
12. Describe stages of pressure ulcers/decubitus ulcers and report observations.
13. List types of ostomies and describe how to empty and change the pouch.
14. Recognize emergencies in the home and define critical steps to follow.
15. Relate the chain of infection to the home care setting.
16. Describe infection control measures to use in the home care setting.
17. Describe the role and responsibilities of the HHA in assisting the client to self- administer medications.

Terminology

ambulation device
ambulatory
apical
aspiration
assistive devices
atrophy
base of support
bony prominence
catheter
center of gravity
clean
coccyx
colostomy
contagious
contamination
dehydration
dermis
diarrhea
diastolic
dirty
dysuria
epidermis
erythema
extinguish
force fluid
fracture

gait belt
hazard
immobilize
immune system
impaction
incontinence
isolation
laxative
mobility
necrotic
nocturia
NPO
oral hygiene
paralysis
perianal
peristalsis
polyuria
postural support
prosthesis
restraint
restrict fluid
suppository
systolic
TED hose
TPR
void

Learner Activities/Assignments

1. Class discussion: Discuss how personal care skills would be adapted in the home setting.
2. Activity: Have groups of students compete to list principles of body mechanics.
3. Activity: Body Mechanics – Individual/Group problem solving given scenario. (p.61)
4. Activity: Students practice improvising equipment for ambulation and positioning.
5. Activity: Students sit on a hand for 5 minutes to experience the effects of pressure.
6. Activity: Skin Care – Individuals/Group problem-solving given scenario. (p. 62)
7. Activity: Falls – Individual/Group problem-solving given scenario. (p. 64)
8. Crosswords: Infection Control (p. 65-67)
9. Activity: Infection Control – Individual/Group problem-solving given scenario. (p. 69)
10. AIDS Skit (optional – see Appendix, Figure 2)

Teaching Strategies

1. Lecture
2. Small and large group discussion
3. Handouts: supply kit (p. 60), hepatitis (p. 68), medications (p. 70-71)
4. Manual Skill demonstration:
  - empty ostomy pouch (p. 63)
  - sitz bath (p. 58)
    - arm foot soak (p. 59)
5. AIDS skit (optional – see Appendix, Figure 2)

References

Balduzzi, S., & Spatz, A. (2005). Homemaker home health aide (6th ed.). Clifton Park, NY: Thomson Delmar Learning.

Birchenall, J.M., & Streight, E. (2003) Mosby’s Textbook for the home care aide (2nd ed.). St. Louis, MO: Mosby.

Certified Nurse Assistant Model Curriculum (2nd ed.). (2004). Sacramento, CA: California Community College Chancellor’s Office.

Fuzy, J. & Leahy, W. (2005). The home health aide handbook (2nd ed.). Albuquerque, NM: Hartman Publishing Inc.

Sorrentino, S. A. (2004). Assisting with patient care (2nd. ed.). St. Louis, MO: Mosby. Zucker, E. & Ebrite, L.J. (2006). Being a home maker/home health aide (5th ed..). Englewood

Cliffs, NJ: Prentice-Hall.

CONTENT OUTLINE		SUGGESTED LEARNING ACTIVITIES
1. Define the terminology		Evaluation Written Test
ambulation device ambulatory apical aspiration assistive devices atrophy base of support bony prominence catheter center of gravity clean coccyx colostomy contagious contamination dehydration dermis diarrhea diastolic dirty dysuria epidermis erythema extinguish force fluid fracture gait belt	hazard immobilize immune system impaction incontinence isolation laxative mobility necrotic nocturia NPO oral hygiene paralysis perianal peristalsis polyuria postural support prosthesis restraint restricted fluid suppository systolic TED hose TPR void

2. Describe the steps and guidelines for common personal care skills		Evaluation Written Test
Review: Body Mechanics, Transfers, Ambulation, Positioning, NATAP or DHS Module 5 Comfort and Adaptive Devices, Range of Motion, NATAP or DHS Module 14 Hand washing, Universal Precautions, NATAP or DHS Module 6 Care Skills, NATAP or DHS Module 8 TPR, BP, NATAP or DHS Module 10 Specimens, Bed Care, Bandages, Lotions, NTAP or DHS Module 9		Clinical Evaluation Demonstrates competency in performance of common personal care skills.
Personal Care Skills (Nurse Assistant) Universal Precautions Hand washing TPR and blood pressure Weight Shampoo Bed-bath, tub, shower Peri/Anal care Skin care Back rub Oral hygiene Dentures Shave Unoccupied and occupied bed Comb/brush hair Dressing and undressing Nail care TED hose Toileting and elimination Catheter care Emptying catheter bag Specimen collection Colostomy care Apply non-sterile, clean, dry dressing Body mechanics Transfers Range of motion Ambulation Positioning Apply prosthetics Additional Personal Care skills found in home Sitz bath used for discomfort from hemorroids and other rectal or perineal conditions *See Manual skill: Sitz Bath (p. 58)* Foot Soak to soften callouses and nails clean and soften skin See Manual skill: Fook Soak (p. 59)
		SUGGESTED LEARNING ACTIVITIES
3. Explain the importance of improvising equipment and adapting care activities in the home.
Improvising equipment and adapting care activities Home equipment setting versus facility equipment setting Resources/staff in the home setting vs. resources/staff in a facility Planning ahead for adaptations *Handout: Supply Kit (p. 60)*
4. Discuss personal care delivery in home care		Evaluation Written Test Performs personal care activities in the home setting
Plan ahead Protect modesty during personal care Use universal precautions Maintain privacy issues and modify Adapt equipment as necessary Consider client’s home schedule Encourage wellness vs. illness roll (e.g., dress in stree clothes, encourage self care) Activities of daily living prioritize bath/shower oral care shave hair care dress shampoo as needed – use special shampoo tray if nescessary nail care Cleanup and storage of equipment
5. List examples of home equipment that can be utilized to provide personal care.		Evaluation Written Test
Items that can be adapted for use in home care:		Learner Activity #1 Class Discussion: Have students list common personal care skills performed by HHA that might be done for a client. Discuss how each skill would be adapted in the home setting.
Equipment	Alternative
Gloves	No alternative
Bed bathing equipment	Bowls, pots, pans, bucket, paper towels, washcloths, etc.
Swabs for oral care	Soft washcloth, padded tongue blades, cotton swabs, etc.
Bedpans for incontinence	Plastic bags, spare sheets, shower curtain, towels, sanitary pads, etc.
Shampoo tray	Plastic bags, bucket, milk jug, towels, dry shampoo
Urinal	Sheets, towels, jars, coffee can
		SUGGESTED LEARNING ACTIVITIES
6. Discuss the benefits of self-care in promoting wellness.		Evaluation Written test
Components of wellness Physical/functional Emotional/Psychosocial Spiritual Benefits of self-care Improved physical strength and functionality Improved self-esteem Increased speed of recovery Activity Graded activities ADL’s Movement/exercise Social interaction Adaptations Working with the family Explanation of benefits Instruction of appropriate helping Difference between recuperative and terminal illness Recuperative – encouragement and instruction Terminal – offer opportunities and provided comfortable care
7. Describe key principles of body mechanics.		Learner Activity #2 Using flip cart and pens or, on the board, having groups “complete” to put up principles of body mechanics in five minutes.
Refer to Body Mechanics, NATAP or DHS Module 5 Review key principles of body mechanics Use as many muscles as possible Good alignment and posture – keep back straight, knees bent, weight even between feet (12 inches apart and one slight ahead of the other) Keep load close when lifting and lift smoothly Better to push, pull or roll than lift Let legs do the work and arms support Face your work area Avoid twisting at waist – away turn or pivot completely around Work as a team with family, others – one person as the leader who counts
		SUGGESTED LEARNING ACTIVITIES
8. Explain how to adapt body mechanics in the home setting.		Evaluation Demonstration/return demonstration
Benefits of self-care Kneel down rather than bending when the client has a bed that does not rise to working height. Kneel when cleaning low objects When giving personal care to a client in a low bed it may be better to kneel sit on side of bed sit on chair at the side of bed Make sure the client is positioned to the side of the bed from which the HHA is working. Slide furniture rather than lifting it Use a wheeled device to move any heavy or awkward objects Transfers Apply principles of body mechanics lock client’s knees Rules/Critical steps prepare client for transfer – footwear encourage client to assist in transfer use assistive devices or assistance for others who are capable Equipment for transfers sliding/transfer boards (ironing board, cutting board) mechanical lifts Consideration for adaptation Home furniture at different height (bed, chair) Bathroom Work in small area Safety factors Review Mechanical lifts, NTAP or DHS Module 5 Manual Skills		Learner Activity #3 Body mechanics (p. 61) Optional Activity Possible visit to a rehabilitiation facility to observe equipment in use. Have student volunteers act out and demonstrate. Adapts body mechanics techniques in the home setting

9. Describe adaptations that can be made in the home for safe ambulation and positioning.
Ambulation Home hazards and limitations furniture clutter narrow hallways equipment pets Safety of equipment ramps rails skid-proof of strips of rugs, tubs Positioning Home adaptation for positioning improvise a draw sheet towels washcloths sheets blankets foam paper towel holders
		SUGGESTED LEARNING ACTIVITIES
10. Identify the purpose of passive and active Range of Motion exercises.		SUGGESTED LEARNING ACTIVITIES
Passive – prevents deterioration of joint function from disuse/immobility HHA support the extremity and moves joints through ROM Active – preventative and restorative activity of joint function HHA assists the client in putting each joint through full ROM HHA may be asked to carry out specific ROM activities as established by a physical or occupational therapist		Evaluation Return demonstration Assist with ROM exercises as prescribed

11. Describe high-risk factors for skin breakdown and methods of prevention.		Evaluation Written Test
Anatomy and function of the skin Epidermis – top layer of skin is dead tissues and has no blood supply – serves to protect and reduce fluid loss. Dermis – moist layers that contains never endings, blood supply, hair follicles, sweat glands – layer for sense of pain, pressure, and temperature. Subcutaneous – tissues that lie below “skin” – fat, muscle, bone, layer of thermal insulation. Causes of skin breakdown/high-risk factors Immobility/decreased mobility Dehydration/poor nutrition Incontinence (diaper vs. “Attends” briefs) Moisture Poor circulation Pressure/friction Prevention Gentle handling Turn and re-position frequently Decrease pressure Use techniques to improve circulation Increase physical activity Keep skin clean and dry Adaptive equipment alternative mattresses Prevent dry skin

12. Describe stages of pressure ulcers/decubitus and report observations.		Evaluation Written Test
Stages of pressure ulcers/decubitus ulcers Stage I – persistent erythema (redness) Stage II – superficial skin breakdown (blister or crack) Stage III – skin breakdown through dermis – can have necrotic tissue Stage IV – deep skin breakdown to fat, muscle or bone Describe and report changes in skin condition Size – approx. size of any redness or open area Location Presence of drainage Wound Care: HHA responsibilities Observe condition of dressings Apply moisture barrier as ordered Report to supervisor on condition of dressing the HHA may change a non-elastic bandage or non-sterile dry dressing at the direction of RN or MD. The HHA may apply a non-legend topical ointment to unbroken irritated skin surfaces such as a diaper rash.
		SUGGESTED LEARNING ACTIVITIES
13. List types of ostomies and describe how to empty and change the pouch.
Brief review – anatomy and function of the bowel Small bowel – ileum about 20 feet long absorbs all nutrients and reabsorbs about 8000 cc. of gastric fluids Large bowel – colon about 6-8 feet long absorbs last of water and forms waste Genitourinary tract kidneys, ureters, bladder, and urethra form and eliminate urine. Common types of ostomies ileostomy on lower ileum has liquid or semi-liquid-type drainage continuously pouch may need to be emptied every 2-3 hours drainage contains gastric juices and can cause major throughout the day colostomy on ascending or transverse colon – will have soft stool throughout the day on descending or sigmoid colon – will have formed stool, may be regulated to once a day urostomy replaces bladder to drain ureters urine is produced continuously must protect skin and empty pouch frequently Care of ostomy types of pouches how to empty pouch how to rinse pouch and reapply (peri bottle or “turkey baster”) check wafer (stoma adhesive) and report leakage document output and condition of appliance See manual skill: Emptying an ostomy pouch (p. 66)		Clinical Evaluation Utilizes appropriate techniques to empty ostomy pouches

14. Recognize emergencies in the home and define critical steps to follow.		Learner Activity #7 Falls (p. 64)
Emergencies in the home – situations requiring immediate actions to prevent injury, disability or death Steps to follow Follow agency policy – agency will have policies and procedures for common emergencies Assess the situation – need information for proper intervention Call 911 for help – may need assistance Common Situations Falls very common occurrence in the home intervention assess patient and situation, check airway, breathing, circulation (ABC’s) of CPR not obvious injury assess pain get help utilize agency procedure keep client still, do not move until help arrives Bleeding a little bit can look like a lot intervention apply direct pressure to bleeding areas with clean, thick cloth do not remove existing bandage get help – utilize agency procedure Shock can occur in a number of situations – pain, injury, Myocardial Infraction s/s: pale, restless, anxious, weak, cool, skin, clammy skin, diaphoresis, N/V, change in level of consciousness intervention keep patient quiet, warm elevate lower extremities watch ABC’s get help – utilize agency procedure Burns tissue damage due to heat (fire, electrical, chemical, sun, steam) seriousness varies due to depths, site, size, client’s age, and condition intervention apply cool, clean, moist dressing do not remove material if it is sticking do not apply ice directly to skin if skin is blistered or broken, should be seen by a physician Seizures s/s: involuntary movement, jerking or rigidity, drooling intervention protect client from injury from objects in the environment do not try to put anything in client’s mouth during the seizure check airway turn client on side after seizure subsides allow client to rest after the seizure Respiratory Arrest s/s: unconscious, pulse present but no respirations intervention perform breaths and described for CPR get help immediately notify emergency response (911) Cardiac Arrest s/s: unconscious, no pulse or respirations intervention perform CPR get help immediately notify emergency response (911) Obstructed Airway s/s: respiratory difficulty, inability to speak or cough, universal choking sign intervention Heimlich maneuver Diabetic emergencies most common is either a lower blood sugar or high blood sugar s/s: high blood sugar – flushed face, lethargy, fruity breath odor, hot/dry skin s/s: low blood sugar – clammy skin, pallor, irritability, trembling, mental confusion interventions high blood sugar or unconscious client – notify agency and utilize agency procedure low blood sugar – fruit juice or sugar can be given to conscious client		Evaluation Written Exam Identifies and responds appropriately to emergencies in the home
		SUGGESTED LEARNING ACTIVITIES
15. Relate the chain of infection to the home care setting.		Evaluation Written test
Review Medical and Surgical Asepsis, NATAP or DHS Module 6 Transmission reservoirs in the home setting Other household members (direct contact, droplet) Care providers, visitors (direct contact, droplet) Insects (vector) Pets (vector)		Learner Activity #8 Do crosswords in class to review key principles (p. 65-67)

16. Describe infection control measures to use in home care settings.		Evaluation Written Test
*Review universal precautions, NATAP or DHS Module 6* Methods of disinfection in the home – according to agency policy Hand washing is important Use of soap and water – clean surfaces Disinfection agents bleach alcohol povidone (betadine) Disposal of hazardous waste Agency policy Bagging Sharp container or bottle Unit 5 HHA curriculum has additional information		Handout: Hepatitis (p. 68) Learning Activity #9 Infection Control (p. 69) Utilizes infection control measures and universal precautions when providing care in the home

17. Describe the role and responsibilities of the HHA an assisting the client to self-administer medications.		Assists clients to self-administer prescribed medications
Legal – HHA cannot pour medications or administer medications Medications must be prepared by client, family, licensed nurse, or physician. Patient must take medications themselves. *Handout: Medication (p. 70-71)*

Unit 3: Personal Care

Manual Skill: Sitz Bath

Equipment:
disposable sitz bath
bathtub
towels
hot water
blanket

Criteria:

1. Assemble equipment.
2. Wash hands.
3. Explain procedure to the client.
4. Assure privacy.
5. Set up a disposable kit according to the manufacturer’s instructions. If using tub, fill tub with approximately 6 inches of water at 95-110 degrees F. Place a folded towel in the hollow of the tub.
6. Help the client sit in the sitz bath.
7. Keep upper body warm, using a blanket, if necessary.
8. Check water temperature every 5 minutes, replenishing warm water as necessary.
9. Have client remain in sitz for 10-20 minutes, or as ordered.
10. Help client out of sitz and assist with drying off with a towel and dressing.
11. Clean and store equipment.
12. Wash hands.
13. Document.

Unit 3: Personal Care

Manual Skill: Warm Foot Soak

Equipment:
basin towel
clean socks and shoes
newspaper or plastic sheet
bucket or large container of warm water (105 F/degrees)

Criteria:

1. Assemble equipment.
2. Seat client in chair.
3. Place newspaper or plastic sheet on floor in front of chair under client’s feet.
4. Place basin on newspaper or plastic sheet in front of chair and client.
5. Fill basin approximately ½ full of warm water.
6. Place client’s feet in the basin.
7. Add or replenish water to achieve level to cover feet without overflowing and maintain temperature.
8. Discontinue treatment within 15-20 minutes.
9. Remove client’s feet one at a time, drying each as it is removed, especially between toes and inspect each foot for skin irritation.
10. If feet appear to have dry skin, apply lotion and rub in well.
11. Put clean socks, and shoes, on client’s feet.
12. Remove the basin and supplies, clean and store equipment, and dispose of used newspaper.
13. Document the task and any unusual observations.

Unit 3: Personal Care

Handout: Supply Kit

A nice item to have for “home emergencies” and as a backup for home care when needed.
baby wipes
paper towels
spare gloves
scissors
orange sticks
emery boards
gauze dressings 2” x 2” or 4” x 4”
bottle of H2O – 1 quart
alcohol/betadine swabs
safety pins
plastic bags, large and small
roll of tape
sugar source for client’s with Diabetes Mellitus lotion, powder (no perfumes or alcohol)
soap
one way valve mask
tongue blades

Unit 3: Personal Care

Activity: Body Mechanics

Instructions:

Review the following scenario and write responses to the following questions. A group discussion will follow. Your instructor will guide you through the legal and ethical issues involved.

You are the home health aide assigned to work with Mr. Brown. Mr. Brown is 6’2” and weighs 225 pounds. He has recently had a CVA with right hemiplegia. The nurse informed you that it is very important that Mr. Brown sit up in the chair every day. After working with Mr. Brown, you think that getting Mr. Brown into a chair will require two people. Mrs. Brown and her teenage son are in the home. Mr. Brown prefers to sit in his recliner.

Critical thinking questions:

1. What do you think are important data/information/observations in this situation? What additional information would be helpful to have?
2. What do you think is the problem or problems in this situation?
3. Which of the problems would be your priority? What would be most important to do first?
4. What action or activities could you implement to improve or correct the situation or problems?
5. What might be the results of your actions or activities?

Unit 3: Personal Care

Activity: Skin Care

Instructions:

Review the following scenario and give a written response to the questions. Group discussion will follow and you instructor will guide you through the legal and ethical issues.

Mr. Smith is caring for his 86-year-old wife. Mrs. Smith is your last client of the day, Saturday at 3:00 p.m. While giving Mrs. Smith a bath, you notice that her peri area is red, and tender. Mr. Smith states that for the last 48 hours, Mrs. Smith has had no control of her urine and at times of her stool. He states that he cannot keep her bed dry.

Critical thinking questions:

What do you think are important data/information/observations in this situation? What additional information would be helpful to have?
What do you think is the problem or problems in this situation?
Which of the problems would be your priority? What would be most important to do first?
What action or activities could you implement to improve or correct the situation or problems?
What might be the results of your actions or activities?

Unit 3: Personal Care

Manual Skill: Emptying An Ostomy Pouch

Equipment:
drainable ostomy pouch or urostomy pouch with valve clamp (if drainable)
peri bottle or a glass, or a turkey baster
gloves
toilet paper or paper towel
graduate
protective drape (newspaper or garbage bags)

Criteria:

1. Gather equipment.
2. Explain the process to the client.
3. Ensure client privacy.
4. Wash hands.
5. Apply gloves.
6. Position protective drape.
7. Empty the pouch according to procedure for specific type of appliance.
8. Measure output.
9. Cleanse pouch according to procedure for specific type of appliance.
10. Ensure closure of the pouch.
11. Clean equipment.
12. Remove gloves.
13. Wash hands.
14. Document procedure.

Unit 3: Personal Care

Activity: Falls

Instructions:

Review the following scenario and write responses to the following questions. A group discussion will follow. Your instructor will guide you through the legal and ethical issues involved.

Scenario:

Ms. Penny lives by herself in a small older home with seven (7) stairs. The home has vinyl floors and many throw rugs. The living room is dark and crowded with stacks of old magazines. Ms. Penny has fallen twice in the last four months, once in the house and once on the stairs. Currently, she is recovering from a broken hip.

Critical thinking questions:

1. What do you think are important data/information/observations in this situation? What additional information would be helpful to have?
2. What do you think is the problem or problems in this situation?
3. Which of the problems would be your priority? What would be most important to do first?
4. What action or activities could you implement to improve or correct the situation or problems?
5. What might be the results of your actions or activities?

Unit 3: Personal Care Activities

Learning Activity

Crossword: Infection Control

Across

Down

1. small living things that cannot be seen without a microscope

4. ____ is the #1 best method of medical asepsis

8. direct contact, air, food, and insects are some methods of ____

10. _____ is the process by which all microorganisms are destroyed

11. a _____ is a microorganism that is harmful and causes infection or disease

12. _____ includes one always wearing gloves when in contact with body secretions

2. the first line of defense against infection is our ______

3. warmth, moisture, a food source, and O2 are needed for microorganism’s _____

5. the absence of pathogens is _____

6. _____ means free from pathogenic microorganisms, be not sterile.

7. undergone a chemical/physical process by which microorganisms are slow or killed

9. when an item is exposed to microorganisms, it is considered to be _____

Word Bank

ASEPSIS

CLEAN

CONTAMINATED

DISINFECTED

GROWTH

HANDWASHING

MICROORGANISMS

PATHOGEN

SKIN

STERILIZATION

TRANSMISSION

UNIVERSAL PRECAUTIONS

Unit 3: Personal Care

Handout: Hepatitis

	Hepatitis A	Hepatitis B	Hepatitis C – Post
Transmission	oral and sexual practices contaminated food, water, and shellfish feces saliva	blood and blood products transfusions needle sticks IV drug use blood fluids – saliva, semen, vaginal secretions maternal – fetal transmission	blood and blood products transfusions needle stick IV drug use and/or sexual contact
Incubation	2-6 weeks most contagious during the few weeks before 1-2 weeks after signs and symptoms appear	6 weeks to 6 months contagious as long as serum marker can be a carrier for life	2 weejs to 6 months contagious from time when signs and symptoms appear can be a carrier for life
High-Risk	Household contacts sexual contacts	household contacts sexual contacts IV drug users medical personnel multiple blood transfusions	multiple blood transfusions sexual contacts medical personnel
Isolation Procedures	universal precautions special care with linens	universal precautions get vaccine	universal precautions

Unit 3: Personal Care

Activity: Infection Control

Instructions:

Review the following scenario and write responses to the following questions. A group discussion will follow. Your instructor will guide you through the legal and ethical issues involved.

Your agency contacts you to go out to the Jones’s home. Mr. Jones is a 32-year-old AIDS client who is living in his parent’s home. Upon arrival, you find Mr. Jones’s mother providing bowel care after Mr. Jones had used the bedside commode. She is not wearing gloves. You note that the bedside commode contains a large amount of liquid stool that appears to have blood in it. The mother states that Mr. Jones has a raw, sore bottom from so much diarrhea. She says that the diarrhea occurs with such urgency that it gets on the sheets and vinyl floor.

Critical thinking questions:

1. What do you think are important data/information/observations in this situation? What additional information would be helpful to have?
2. What do you think is the problem or problems in this situation?
3. Which of the problems would be your priority? What would be most important to do first?
4. What action or activities could you implement to improve or correct the situation or problems?
5. What might be the results of your actions or activities?

Unit 3: Personal Care

Handout: Medications

I.Common Features of Medications

- Medications can benefit the client.

- Medications have the potential for harm to the client.

- Medications have a limit to the amount that is safe for use.

- Medications have a generic name (this includes the names of the active ingredients i.e., acetaminophen).

- Medications have a brand name (this is the manufacturer’s name for the drug, i.e., Tylenol).

- Medications have the possibility of becoming weaker under certain conditions (such as when not taken as directed, when stored for a long period of time, or stored incorrectly).

There can be a risk when taking combinations of medications or taking them in combination with food or alcohol.

II.The Effects of Medications

Medications or drugs are chemical substances. They are used to treat diseases. There are many different types to treat different diseases. Drugs can be given for infections or pain, or to help a body system improve functioning.
Serious health conditions can arise from the use of specific medications, from using two or more drugs within the same time period, or from attempts at self-treatment without the advice of a physician.
The client and the family should know what effects any medication used is expected to have, and to know why symptoms or side effects might indicate an allergy or other dangerous situation.

III.Safety Factors

- Encourage the client and/or family to keep all medications out of reach of anyone who might misuse them. If there are older people who are not responsible for their actions or children in the home, it is best to keep medications in a locked cabinet or in bottles with a safety lid. This includes aspirin, vitamins, and iron tablets, which, if taken in quantity by a child, could be fatal.

- Your client may be used to finding the medication in a certain place within the medicine cabinet or a storage area. Do not move the medicines without permission.

Encourage the client and family to use labeled containers or a medication reminder system (such as a medi-set) set up by a professional.

IV. Assisting the Client to Self-Administer Medications

- HHA’s DO NOT ADMINISTER MEDICATIONS. THIS IS THE RESPONSIBILITY OF THE LICENSED NURSE, CLIENT, FAMILY, OR DOCTOR.

- The licensed nurse, family, or physician will make out the medication schedule for the client to follow. The HHA will not give medication but will observe whether the client takes the medication, and should report any problem related to the administration of medication.

- When someone is taking medication, be certain they have their glasses on and proper light so that the medication can be seen clearly.

- Remind the client to wash his/her hands.

- Assist the client self-administer oral medications as necessary.
  - Support the client’s hand if necessary as he/she pours medication into a spoon, cup, or hand.
  - Hand the client a glass of water.
  - Check to see that the client has swallowed the medication.
Assist the client to self-administer eye medications as necessary.
- Position client so head is tilted back.
- Support the client’s hand as he/she drops the medication into the lower eyelid.
Assist the client to self-administer topical medication (ointments, lotions) as necessary.
- The HHA may only apply a non-legend topical ointment to unbroken skin irritated skin surfaces
- Remind the client to wash their hands before and after application.
Assist the client to self-administer a rectal suppository as necessary.
- Assist the client to unwrap the suppository.
- Give the client disposable gloves to put on.
- Assist the client to a side-lying position.
- Guide the client’s hand to the rectal area.
- Help hold the buttocks together for a few minutes while the suppository is absorbed.
- Help the client assume a comfortable position.

Note: The only rectal suppository that the HHA may administer to a client is a laxative suppository.

- Help client with hand washing

Notify your supervisor if the client tells you that he/she will not take medications.

QuizzesStatus

Unit 3 Exam

Unit 3 Vocabulary Exam

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Unit 3: Personal Care Services

Minimum Number of Hours: Theory 25, Clinical 45

Statement of Purpose:

Performance Standards (Objectives)

Terminology

Learner Activities/Assignments

Teaching Strategies

References

CONTENT OUTLINE

1. Define the terminology

2. Describe the steps and guidelines for common personal care skills

3. Explain the importance of improvising equipment and adapting care activities in the home.

4. Discuss personal care delivery in home care

5. List examples of home equipment that can be utilized to provide personal care.

6. Discuss the benefits of self-care in promoting wellness.

7. Describe key principles of body mechanics.

8. Explain how to adapt body mechanics in the home setting.

9. Describe adaptations that can be made in the home for safe ambulation and positioning.

10. Identify the purpose of passive and active Range of Motion exercises.

11. Describe high-risk factors for skin breakdown and methods of prevention.

12. Describe stages of pressure ulcers/decubitus and report observations.

13. List types of ostomies and describe how to empty and change the pouch.

14. Recognize emergencies in the home and define critical steps to follow.

15. Relate the chain of infection to the home care setting.

16. Describe infection control measures to use in home care settings.

17. Describe the role and responsibilities of the HHA an assisting the client to self-administer medications.

Unit 3: Personal Care

Manual Skill: Sitz Bath

Unit 3: Personal Care

Manual Skill: Warm Foot Soak

Unit 3: Personal Care

Handout: Supply Kit

Unit 3: Personal Care

Activity: Body Mechanics

Unit 3: Personal Care

Activity: Skin Care

Unit 3: Personal Care

Manual Skill: Emptying An Ostomy Pouch

Unit 3: Personal Care

Activity: Falls

Unit 3: Personal Care Activities

Learning Activity

Crossword: Infection Control

Unit 3: Personal Care

Handout: Hepatitis

Unit 3: Personal Care

Activity: Infection Control

Unit 3: Personal Care

Handout: Medications

Unit 3 Exam

Unit 3 Vocabulary Exam