Nurse Assistant Training Program Review

Nurse
Assistant
Training
Program
Review
EvergreenValleyCollege
Spring 2012


Mission Statement for the College

With equity, opportunity and social justice as our guiding principles, Evergreen Valley College’s mission is to empower and prepare students from diverse backgrounds to succeed academically, and to be civically responsible global citizens.

Department/Program Name: Nurse Assistant Training Program (Nurs109)

Last Review: Not applicable

Current Year: 2011-2012

Area Dean:Sandra DeWolfe, RN, MS Interim Dean of Nursing and Allied Health

Program Description

Brief Summary

The Nurse Assistant Training Program (NURS109) was developed in order to provide interested students with a foundation of basic nursing care. The program was officially approved by the California Department of Public Health (CDPH) on January 19, 2010. Upon successful completion of the 6.5 unit course, students are qualified to take the California State Certification Exam to become Certified Nursing Assistants (CNAs). CNAs are eligible for employment in Skilled Nursing Facilities, Acute Care Hospitals, as well as in the home setting through Home Health Care Agencies. However, the State Certification is a regulatory requirement only for nursing assistants that want to work in the long-term care setting. Students can receivetraining within skilled nursing facilities. With an increasing aging population, CNAs are needed more than ever in the skilled nursing facilities.

Requirements for the EVC course are: High School Diploma or GED, valid social security number, Physical Health Exam clearance, TB exam clearance, current CPR for Healthcare Provider, and Background Clearance. The course is open to all students with the aforementioned requirements and is based on open enrollment. The course is offered in the Spring or Fall semesters and can accommodate 30 (2 clinical sections) to 45 (3 clinical sections) students per semester. Those who successfully complete the training program and pass the state certification exam can work as CNAs, and/or further their education in nursing.

Program Effectiveness

Students must successfully complete the course with a “C” or better in order to take the State Certification Exam. The course includes skills lab practice at the schooland the performance of basic nursing skills in the clinical setting under the supervision of a Registered Nurse. The CDPH approved curriculum consists of 61 lecture hours and 100 clinical hours; a portion of the clinical hours (an average of 3 to 4) takes place in the skills lab setting at EVC. In addition, extra skillslab practice is encouraged, although voluntary. Successful completion of course SLOs promotessafe and competent basic nursing care.

Results of Measures

The pass rates for the State Certification Exam are as follows:

  • Spring 2010: written: 95.7% or 22/23; skills: 91.3% or 21/23 (overall =93.5%)
  • Fall 2010: written: 95.8% or 23/24; skills: 79.1% or 19/24 (overall =87.5%)
  • Spring 2011: written: 96.2% or 25/26; skills: 92.3% or 24/26 (overall = 94.3%)

The California Department of Public Health (CDPH) currently takes the average of the written and skills pass rates in order to determine pass rates. Thus, our overall pass rate for the 3 semesters is 91.8%; these results show that the program is doing considerably well for being less than 2 years old. Three years from now, the goal will be that the results will remain at or above 90%, with students successfully finding jobs upon completion of the course and passing the state exam. At least 21 students who have completed the course have gained employment in the healthcare field: 7 students from Spring 2010, 6 students from Fall 2010, and 8 students from Spring 2011. It is difficult to obtain accurate data for employment rates, as it is voluntary for students to furnish such information upon course completion. In addition, 8otherstudents are currently enrolled in an RN program.

PART A: Overview of the Program

The Nurse Assistant Training Program is within EVC’s Department of Nursing and Allied Health; our current CTAs are outlined below. The Program helps the college fulfill its Mission by preparing interested students to embark in an entry-level healthcare profession that allows them to provide compassionate care to the infirm (especially to the fragile elderly), therefore helping serve humanity as responsible citizens.

Department of Nursing and Allied Health CTA’s

  1. Community Engagement
  2. Build an awareness of campus programs, both internal and external; communicate and network
  3. During the course of a program, students will participate in a minimum of one community event
  4. At least one faculty member will participate as club advisor and support one campus clubs
  5. Seek articulation with local high schools on all levels of courses
  6. One division faculty member will participate in 50% of the meetings/events with the Medical Magnet Program at Andrew Hill High School
  7. One division faculty member will participate in the annual College Connection
  8. One division faculty member will participate in the annual KinderCaminata
  9. Organizational Transformation
  10. Increase online and hybrid course and program offerings
  11. Develop one new online course, within the division
  12. 90% of the courses, in the division, will use the college’s course management system
  13. Increase persistence, retention and success rate for all courses
  14. The nursing faculty will identify two variables that can be changed in order to increase student success in the nursing program and on the NCLEX
  15. The nursing program will offer a minimum of one TEAS workshop this academic year
  16. Review, strengthen and implement emergency preparedness/response procedures
  17. At least one faculty member will represent the division on the Emergency Preparedness Committee
  18. Provide training and support for employees to effectively offer online and hybrid courses and student support services
  19. >30% of the faculty will have opportunities for faculty development through grant funds
  20. Strengthen and implement accountability, compliance structures, and transparency in the budget process, including stable leadership over finances
  21. Dean will include an update on the campus budget, as well as any grant funds, at 100% of the division meetings
  22. Faculty will research and apply for, at least, one grant to help improve a program or course
  23. Student Centered
  24. Reassess and develop a balanced scheduling of course offerings to better meet the needs of students, including additional CTE offerings. Increase the number of course offerings on Fridays and Saturdays.
  25. FCS will offer a minimum of one class on Fridays
  26. Division will offer a minimum of one class on an alternate schedule
  27. Expand the number and type of course offerings and student services available via alternative instructional delivery systems including online and hybrid courses.
  28. Develop one new online course, within the division
  29. Annually maintain and update Nursing and CNA websites on the EVC webpage
  30. 90% of division courses will offer course materials on the campus course management program
  31. Tutoring services will be posted on >90% of division course management sites

Community Partnerships

Through the Program, EVC has developed partnerships with the following:

  • Lincoln Glen Nursing Facility (San Jose)- students have their clinical rotation at this facility
  • The California Department of Public Health- the Program maintains its regulatory approval through the CDPH
  • American River College (Sacramento) - testing for the Certification Exam was originally processed through this regional testing center. Program faculty currently maintains contact with American River College’s CNA Program faculty
  • Mission College (Santa Clara)- testing location for Certification Exam for the first 3 semesters of the Program
  • The American Red Cross (Los Angeles Chapter)- as of July 2011, testing for the Certification Exam is done through the American Red Cross

Accomplishments

Three recent accomplishments for the program:

  • Improvement in course retention (86% Spring 2010; 93% Fall 2010; 100% Spring 2011)
  • Improvement in certification exam pass rate (from 93.5% to 94.3%)
  • Home Health Program approval by the CDPH (obtained July 14, 2011)

Program Goal/Focus

The goal of the Program is to allow students who complete the course to gain entry-level knowledge and employment in the health care (nursing) field. Because the Program is only one semester long and State testing is completed shortly after course completion, students could potentially become employed within 4-5 months upon enrolling in the course. This provides opportunities for those who (because of family commitments or lack of financial resources or time, etc.) are not able to attend college for a longer period. The course is also an option for students waiting to get into the nursing program.

Another goal is to offer a Home Health Aide (HHA) component (combined CNA/HHA course) beginning with the Fall 2012 semester.

Student Demographics

Currently, student demographics for NURS109 are incorporated into data for the nursing discipline. The program faculty has devised a general demographics survey to utilize at the beginning of each semester as of Fall 2011 in order to obtain demographical data (in the event that EVC’s Research Department is unable to separate course data from the nursing discipline). Data for students’ gender and age was obtained from the students’ initial CNA application form (form HS283B). Please note that data for ethnicity is based only on faculty’s best knowledge and cannot be considered 100% accurate.

GENDER

Spring 2010 / Fall 2010 / Spring 2011
Female
Male / 23/29= 79%
(4 dropped; 83%
retention, 78%
success
6/29= 21%
(100% retention/
success) / 25/30= 83%
(2 dropped; 92%
retention, 80%
success
5/30= 17%
(100% retention/
success) / 24/27= 89%
(100% retention/
success)
3/27= 11%
(100% retention/
success)

ETHNICITY- Spring 2010 (29 Students)

Headcount / Retention / Success
African American / 4=14% / 4=100% / 4=100%
Asian (all other) / 0 / n/a / n/a
Asian/Cambodian / 0 / n/a / n/a
Asian/Chinese / 2=7% / 2=100% / 2=100%
Asian Indian / 1=3% / 1=100% / 1=100%
Asian/Vietnamese / 1=3% / 1=100% / 0
Filipino / 9=31% / 9=100% / 9=100%
Latino / 7=24% / 4=57% / 4=57%
Native American / 0 / n/a / n/a
Pacific Islander / 0 / n/a / n/a
White / 5=17% / 4=80% / 4=100%
Other/Unknown / 0 / n/a / n/a
29/29 / 25/29=86% / 24/29=83%

ETHNICITY - Fall 2010 (30 students)

Headcount / Retention / Success
African American / 2= 7% / 2= 100% / 1= 50%
Asian (all other) / 1= 3% / 1= 100% / 1= 100%
Asian/Cambodian / 0 / n/a / n/a
Asian/Chinese / 0 / n/a / n/a
Asian Indian / 3= 1% / 3= 100% / 3= 100%
Asian/Vietnamese / 5= 17% / 5= 100% / 5= 100%
Filipino / 8= 27% / 8= 100% / 8= 100%
Latino / 5= 17% / 5= 100% / 5= 100%
Native American / 0 / n/a / n/a
Pacific Islander / 0 / n/a / n/a
White / 5= 17% / 4= 80% / 4= 100%
Other/Unknown / 1= 3% / 0= 0% / n/a
30/30 / 28/30=93% / 27/30=90%

ETHNICITY – Spring 2011 (27 Students)

Headcount / Retention / Success
African American / 3=11% / 3=100% / 3=100%
Asian (all other) / 0 / n/a / n/a
Asian/Cambodian / 0 / n/a / n/a
Asian/Chinese / 1= 3.7% / 1=100% / 1=100%
Asian Indian / 1= 3.7% / 1=100% / 1=100%
Asian/Vietnamese / 2= 7% / 2=100% / 2=100%
Filipino / 6= 22% / 6=100% / 6=100%
Latino / 10= 40% / 10=100% / 10=100%
Native American / 1=3.7% / 1=100% / 1=100%
Pacific Islander / 0 / n/a / n/a
White / 2=7% / 2=100% / 2=100%
Other/Unknown / 1= 3.7% / 1=100% / 1=100%
27/27 / 27/27=100% / 27/27=100%

AGE

Spring 2010 / Fall 2010 / Spring 2011
19 or < / 1 (1 dropped) / 0 / 0
20-24 / 10 (1dropped) / 18 (1 dropped) / 16
25-29 / 7 (2 dropped) / 6 / 4
30-34 / 3 / 4 (1 dropped) / 4
35-39 / 3 / 1 / 0
40-49 / 4 / 1 / 2
50 or > / 0 / 0 / 1
28 students / 30 students / 27 students
GRADES / Spring 2010 / Fall 2010 / Spring 2011
A / 15 / 17 / 18
B / 3 / 8 / 8
C / 6 / 2 / 1
D / 1 / 0 / 0
F / 0 / 1 / 0

Enrollment Patterns

  • The majority of students in the program have been female. While the discipline of nursing and nursing care has historically been a predominately female career, there has been an increasing amount of males in the profession (Where are the men? Nursing, July 2003) due to a shortage of nurses and change in gender attitude.
  • Most of the students have been in the age group of 20-24 or 25-29.
  • With the Bay Area being a cultural melting pot, it is not surprising that the students come from various ethnic backgrounds, with the largest group coming from Filipino and Latino backgrounds.
  • The above data is consistent with the general nursing course data.
  • Many of the students have expressed that they plan to pursue the field of nursing and have found the course to be a valuable foundation.

Program Productivity (WSCH/FTEF)

Because the CDPH mandates a ratio of 15:1 for instruction in the clinical and laboratory settings, the WSCH/FTEF (Weekly Student Contact Hours and Full Time Equivalent Faculty) for the Program will always be less than the 525 breakeven point:

  • Spring 2010: 359.6
  • Fall 2010: 391.7
  • Spring 2011: 346.3

Clinical groups, however, are combined into one lecture class to enhance course efficiency.

Success rate and patterns

The two students who did not successfully complete the course (i.e. with a “C” or better) were both female, one being of African-American descent, the other being of Asian/Vietnamese descent. In identifying possible causes of unsuccessful course completion, program faculty learned that the first student was a single mother; the second student worked full time in her family’s restaurant business and expressed having family problems that caused considerable stress. Both students chose to stay in the course because they valued the experience and knowledge that they were gaining.

It is important to note that not all students who successfully completed the course have passed the state certification exam (please refer to Certification Pass Rates on page 3). Only those who successfully complete the course are eligible to take the exam. Also, not all students who successfully completed the course have opted to take state certification exam (either due to lack of funding to pay the $90 examination fee or theywanted to continue taking nursing courses without working as CNAs). Thus far, 10 students who have taken the exam have failed the skills component of the exam; 2 of those 10 students also failed the written component. Demographics:

  • 3 male, 7 female
  • 4 ages 20-24; 3 ages 25-29; 1 age 30-34; 2 age 40-49
  • 1 African American; 1 Asian/Vietnamese;3 Filipino; 3 Hispanic; 1 Other/Pakistani;

1 White

The demographics for those who did not pass the certification exam are consistent with the overall demographics of the Program and of the nursing general course (i.e. most being female, in between the ages of 20-29, of Filipino or Hispanic descent.

At least ten students who completed NURS109 are currently employed within the healthcare field. It is interesting to note that one did not successfully pass the course, but was offered employment based on the experience she gained in clinical over the semester. Another student passed the course but did not pass the certification exam. Both of these students are not called CNAs, but “patient caregivers”.

Advisory Boards and/or Professional Organizations

As of Fall 2011, testing for the state certification exam takes place through the American Red Cross, Los Angeles Chapter (applicants need not travel to the LA area, as there are various test sites throughout the Bay Area.

PART B: Curriculum

Courses offered

Currently NURS109 is the only course offered in the Nurse Assistant Training Program. It is a goal to offer aHome Health Aide (HHA) component (combined CNA/HHA course) beginning with the Fall 2012 or Spring 2013 semester.

How has program remained current in the discipline?

  • The program faculty utilizes the most current State-approved Model Nursing Assistant Curriculum (the 2010 version, offered through The California Community College Health Care Initiative and the Butte College Regional Health Occupations Resource Center).
  • The program faculty also utilizes the 2010 edition of Hartman’s Nursing Assistant Care.
  • The program faculty plans to have affiliation with the Santa Clara Long Term Care Nurses Council.The Council provides in-service education on current topics of interest related to long-term care.

Course Outlines

The following course outline is based on the state required topics presented in the 2010 Model Nursing Assistant Curriculum and will be reviewed either every 6 years orsooner if an updated version of the model curriculum comes out, whichever is first:

1) Introduction

A. Role and responsibilities of the Certified Nursing Assistant

B. Title 22: State Regulations pertaining to Certified Nursing Assistant Programs

C. Requirements for nurse assistant certification

D. Professionalism

E. Ethics and confidentiality

2) Patients' Rights

A. Title 22

B. Health and Safety Code

C. Code of Federal Regulationsregarding Nurse Aide Training and Competency Evaluation

3) Communication and Interpersonal Skills

A. Communications

B. Defense mechanisms

C. Socio-cultural factors

D. Attitudes- illness/health care

E. Family interaction

4) Prevention and Management of Catastrophe and Unusual Occurrences

A. EmergencyCare Procedures

B. General safety rules

C. Fire and disaster plans

D. Roles and procedures for C.N.A.

E. Patient Safety

5) Body Mechanics

A. Basic body mechanics

B. Transfer techniques

C. Ambulationtechniques

D. Proper body mechanics/positioning techniques

6) Medical and Surgical Asepsis

A. Microorganisms

B. Universal precautions

C. Principals of asepsis

7) Weights and Measures

A. Metric system

B. Weight, length, and liquid volume measurements

C. Military time, i.e., a 24-hour clock

8) Patient Care Skills

A. Bathing/medicinal baths

B. Dressing

C. Oral Hygiene

D. Hair care, shampoo, medicinal shampoo, nail care, shaving

E. Prosthetic devices

F. Skin care/decubitus ulcers

G. Elimination needs

H. Bowel and bladder retraining

I. Weighing/measuring the patient

9) Patient Care Procedures

A. Collection of specimens: stool, urine, and sputum

B. Care of patient with tubing: gastric, oxygen, urinary, IV. This care does not include inserting,

suctioning, or changing the tubes.

C. Intake and output

D. Bed making

E. Cleansing enemas, laxative suppositories

F. Admission, transfer, discharge

G. Bandages, non-sterile dry dressing application of non-legend topical ointments to intact skin

10) Vital Signs

A. Purpose of vital signs

B. Factors affecting vital signs

C. Normal ranges

D. Methods of measurement

E. Temperature, pulse, respiration

F. Blood pressure

G. Abnormalities

H. Recording

11) Nutrition

A. Proper nutrition

B. Feeding technique

C. Diet therapy

12) Emergency Procedures

A. Signs and symptoms of distress

B. Immediate and temporary intervention

C. Emergency codes

13) Long-term Care Resident

A. Needs of persons with retardation, Alzheimer's, cerebral palsy, epilepsy, dementia, mental illness

B. Introduction to anatomy and physiology

C. Physical and behavioral needs and changes

D. Community resources available

E. Psychological, social, and recreational needs

F. Common diseases/disorders, including signs and symptoms

14) Rehabilitative Nursing

A. Promoting patient potential

B. Devices and equipment

C. Activities of Daily Living (ADLs)

D. Family interactions

E. Complications of inactivity