Home Health Aide/CNA

Job Description

“Home health aide” means a person who is trained or qualified, as provided by rule, and who provides hands-on personal care, performs simple procedures as an extension of therapy or nursing services, assists in ambulation or exercises, or assists in administering medications as permitted in rule and for which the person has received training established by the agency under s.400.497(1).

Must complete at least forty hours of training in: communication skills, observation, reporting, and documentation of patient status and the care provided, reading and recording temperature, pulse, and respiration, basic infection control procedures, basic elements of body functions, that must be reported to the registered nurse supervisor, maintenance of a clean, safe, and healthy environment, recognition of emergencies and knowledge of emergency procedures, physical, emotional, and developmental characteristics of populations served, appropriate and safe techniques in personal hygiene and grooming, including bed bath, sponge, tub, or shower bath, shampoo, tub or bed, nail and skin care, oral hygiene. Safe transfer techniques and ambulation, normal range of motion and positioning, adequate nutrition and fluid intake, the role of the aide in the home, differences in families, food, and household management.

Home Health Aides/CNAs assisting with self-administered medication, must receive a minimum of 2 hours of training (which can be part of the 75-hour home health training), prior to assuming this responsibility. Training must cover state law and rule requirements with respect to the assistance with self-administration of medications in the home, procedures for assisting the resident with self-administration of medication, common medications, recognition of side effects and adverse reactions and procedures to follow when residents appear to be experiencing side effects and adverse reactions.

Training must be performed by or under the general supervision of a registered nurse. The HIV and AIDS educational requirements also must meet, a minimum of 1 hour of lifetime training. The training should include universal precautions and infection control procedures to ensure proper practices are followed. Training must be provided to obtain and maintain a certificate in cardiopulmonary resuscitation.

Each home healh aide must be able to read the prescription label and any instructions. Individuals who cannot read must not be permitted to assist with prescription medications. Ensure HIPAA guidelines and procedures are maintained.

Lines of authority and reporting responsibilities: Report to the Director of Nursing/Nurse Supervisor, Administrator.

The Home Health Aide/CNA must provide services that are ordered by the physician in the plan of care and that the aide is permitted to perform under state law. Shall perform the following duties:

1. All the personal care activities contained in a written assignment by a licensed health professional employee, or contractor, and which include activities such as:

   a. Assisting the patient with personal hygiene
   b. Assisting the patient with ambulation/physical transfer
   c. Assisting the patient with eating
   d. Assisting the patient with dressing
   e. Assisting the patient with shaving

2. Maintenance of a clean, safe, and health environment, which may include light cleaning and straightening of the bathroom, straightening the sleeping and living areas, washing the patient’s or client’s dishes or laundry, and such tasks to maintain cleanliness and safety for the patient or client. Patient-related activities as taught to the Home Health Aide/CNA by a Licensed Health Professional employee for a specific patient. Such activities include:
   a. Assisting with change of colostomy bag, reinforcement of dressing
   b. Measuring temperature, pulse, respiration, or blood pressure
   c. Measuring intake and output of fluids
   d. Assisting with the use of devices for aid to daily living example, a walker or wheelchair.
   e. Assisting with prescribed range of motion exercises (such exercises are limited to those taught to the Home Health Aide/CNA and the patient by a professional employee)
   f. Assisting with prescribed ice cap or collar
   g. Doing simple urine tests for sugar, acetone, and albumin
   h. Measuring and preparing special diets
3. Keeping records of personal health care activities
4. Observing appearance and gross behavioral changes in the patient and reporting to the registered nurse.
5. Supervision of self-administered medication in the home limited to: obtaining medication container from the storage area for the patient, ensuring that the medication is prescribed for the patient, remind the patient that it is time to take the medication as prescribed, and observing the patient self-administering the medication.
6. The Home Health Aide/CNA may also provide the following assistance with self-administered medication, as needed by the patient, in accordance with 400.488.F.S
   a. Prepare necessary items such as juice, water, cups, or spoons, to assist the patient in the self-administration of medication.
   b. Open and close the medication container or tear the foil of prepackaged medications.
   c. Assist the resident in the self-administration process, such as steadying the arm, hand, or other parts of the patient’s body so as to allow the self-administration of medication.
   d. Assist the patient by placing unused doses of solid medication back in the medication container

Assisting with tasks associated with elimination:

1. Toileting
2. Assisting with the use of the bedpan and urinal
3. Providing catheter care including changing the urinary catheter bag
4. Collecting specimens
5. Emptying ostomy bags, or changing bags that do not adhere to the skin.

THE HOME HEALTH AIDE/CNA SHALL NOT PERFORM THE FOLLOWING TASKS:

1. Changing of sterile dressings.
2. Irrigating body cavities such as giving enema.
3. Irrigating colostomy or wound.
4. Performing gastric irrigation or enteral feeding.
5. Catheterizing a patient.
6. Administering medications.
7. Applying heat by any method.
8. Caring for a tracheostomy tube.
9. Any personal health service that has not been included by the Registered Nurse in the patient care plan

Physical Requirements:

1. Able to speak, read and write English
2. Able to read assignments, follow directions.
3. Able to communicate and respond clearly on telephone and respond to patient’s spoken needs.
4. The ability to physically transfer, lift or assist patients whose average weight is 160 pounds with or without the aid of mechanical devices.
5. Able to spend 80% of the work shift standing and/or moving about.
6. Able to walk, climb stairs, stoop, twist, bend, and squat to perform essential job functions.

This Job Classification will have a Potential risk for Occupational Exposure to Blood and other Potential Infections and body fluids, protective equipment will be provided by our Agency to limit the exposure and will promote self-protection practices in the delivery of Home Health Care, to provide appropriate treatment to home health care workers in the event of exposure incident and to promote compliance with the universal precautions.

Mental Requirements:

1. Able to concentrate on detail with frequent interruptions.
2. Able to follow, complete and remember daily routines and requirements.
3. Able to comprehend and utilize professional education materials.
4. Able to cope with the mental and emotional stress of the position

In cases where a home health aide or CNA will provide assistance with self-administered medications, an assessment of the medication for which assistance is to be provided shall be conducted by a licensed healthcare professional to ensure the unlicenced caregiver provides assistance in accordance with their training and with the medication prescription. A licensed healthcare professional shall inform the patient/caregiver, that the patient may receive assistance with self-administration medication by an unlicensed person. The patient/caregiver must be given written consent for this arrangement.

Home Health Aide shall be supervised by the Registered Nurse, Registered Therapist, or the Director of Nursing at all times.