NACES Contacts Jean Morita, MSN, MBA, NEA-BC, RN Program Director Linda Sue White, BSN, RN Associate Program Director Marilyn Golden, BSN, RN Associate

NACES ContactsJean Morita, MSN, MBA, NEA-BC, RNProgram Director

Linda Sue White, BSN, RN Associate Program Director Marilyn Golden, BSN, RN Associate Program Director

Rolando GonzalezProgram CoordinatorKristen Duplechian Administrative Assistant

1

MISSION

To provide qualified nurse aide candidates the

opportunity to achieve certification by demonstrating

their skills in a supportive and objective environment so

the state’s most vulnerable citizens are assured safe

and competent care.

2

Candidate Examination Expectations – Written Exam Page 10 -13 of Candidate Handbook

Check-in (candidate needs to arrive 30 minutes prior to start of exam time)

•If arrive even one minute past the exam time, NAE is not permitted to admit the candidate and they will have to reschedule at their own cost•2 forms of current, not expired, official signature bearing ID’s, one must be U.S. government- issued social security card, signed and non-laminated and one must be a photo bearing ID from the approved list

3

Candidate Examination Expectations – Written Exam Page 10 -13 of Candidate Handbook

Check-in•Sign roster – names on roster and IDs must match!

If hyphen/suffix is in IDs for first or last name, must be on roster (how candidate registered)

•NAE screens candidates for issues that would prevent them from being a “client” for certain skills (this should be done individually)•Seated 3’ apart facing same direction•Candidate has up to 2 hours to complete exam

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Candidate Examination Expectations – Skills ExamPage 20-24 of Candidate Handbook

Check-in (candidate needs to arrive 30 minutes prior to start of exam time)

•2 forms of current, not expired, official signature bearing ID’s, one must be U.S. government- issued social security card, signed and non-laminated and one must be a photo bearing ID from the approved list

•Sign roster – names on roster and IDs must match! If hyphen is in IDs for first or last name, must be hyphen on roster (how candidate registered)

•If skills only, NAE screens candidates for issues that would prevent them from being a “client” for certain skills (this should be done individually)

•Candidates will be brought into testing area in pairs

5

Skills Exam Expectations (Continued)

•NAE will read “client” instructions aloud to both candidates

•NAE will identify and demonstrate all equipment and supplies in testing area to both candidates

•NAE will read specific instructions to testing candidate aloud and provide written skills card

•Candidates may ask questions about supplies and equipment prior to the beginning of the exam

•NAE will use a timer, will provide a 5 minute remaining reminder

•NAE may stop the timer and halt the exam in certain circumstances BP skill, Mannequin placement, Equipment malfunction, etc.

6

Skills Exam Expectations (Continued)

•Candidates may be stopped to don or remove gloves for sanitary reasons

•NAE may not answer candidate questions about skills before, during or after the exam!

•Guests, visitors, pets, or children are NOT allowed at the testing site – guest would include program personnel. We do not want the program personnel engaging the NAE during a testing event.

•Questions regarding the testing event or any grievances from candidates should be directed to Pearson VUE or NACES in writing following the testing event.

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Candidate Grievance ProcedurePage 44 of Candidate Handbook

NAEs are not permitted to discuss the candidate’s exam results with candidate or instructors

If candidate determines a grievance needs to be submitted, it must be written and sent (along with Score Report(s) to NACES or the State within 30 days of exam date -NACES APD reviews grievance to determine whether or not it is substantiated. Resources used for this determination may include but are not limited to:

•Order and review of Score Report(s) and Measurement sheet•Contact NAE and review of NAE’s detailed notes•Review NAE Incident Report•Call and survey other candidates on their test experience•Reference testing materials and Candidate Handbook•Review findings with other APD(s) and Program Director (PD)•Determination letter is written and sent to candidate including detailed resolution of grievance within 30 days of NACES receipt•State is notified of resolution

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All Skills mentioned in remaining slides can be found in Candidate

Handbook pages 25-40

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There is a table of contents for the skills in the CTE electronic program!

Pearson VUE Confidential. Do Not Distribute. 10 Copyright © 2012 Pearson Education, Inc. or its affiliate(s). All rights reserved. 800 837 8969.

High School vs State July 2013 – June 2014Five Skills with Lowest Pass Rates HS

SkillHigh School

Pass %State Pass %

Provides Mouth Care 78% 75%

Provides Perineal Care 79% 70%

Gives Modified Bed Bath 80% 75%

Positions on Side 83% 79%

Provides Catheter Care 83% 75%

Overall Pass Rate 70% 61%


Step # Step Description Fail rate for the step is 10% - 15%

Fail rate for the step is 16% -25%

Fail rate for the step is >26%

2 Privacy is provided with a curtain, screen, or door 19%

3 Before providing mouth care, client is in upright sitting position (75-90 degrees)

10%

8 Cleans mouth (including tongue and surfaces of teeth), using gentle motion

11%

11 Candidate wipes mouth and removes clothing protector 13%

12 After rinsing toothbrush, empty, rinse, and dry the basin and place used toothbrush in designated basin/container

24%

15 After placing basin and toothbrush in designated dirty supply area and disposing of used linen, removes and disposes of gloves (without contaminating self) into waste container and washes hands

18%

16 Signaling device is within reach and bed is in low position 11%

#49 PROVIDES MOUTH CARE

#49 PROVIDES MOUTH CARE Step #2 – Privacy is provided with a curtain screen or doorCandidates may forget for this skill as it is not one where the client will be ‘exposed’. Remember, if candidate provides privacy for first skill it is required and never pulls curtain back to un-provide, they will receive credit for any other skill it is required.

Step #12 – After rinsing toothbrush, empty, rinse and dry the basin and place used toothbrush in designated basin/container.Candidate has to do all components to get credit – many will throw the toothbrush away, or they forget to rinse the toothbrush or dry the basin.

Step #15 – After placing basin and toothbrush in designated dirty supply area, and disposing of used linens, removes and disposes of gloves (without contaminating self) into waste container and washes handsCandidates must do all components to get credit – many miss this one automatically due to throwing the toothbrush away or again, they contaminate themselves when removing their gloves.

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SKILLS CLARIFICATIONSProvides Mouth Care

Step 13: Places basin and toothbrush in designated dirty supply area.

Previously: If candidate starts to store toothbrush in area other than basin or designated dirty supply area, direct candidate to place in basin or dispose of into wastebasket and mark “YES” for this step.

NCSBN clarification (10/5/2013): The toothbrush is to be placed in the basin and disposed of in the designated dirty supply area not the waste basket. If candidate starts to place/store equipment in area other than designated dirty supply area, direct candidate to place in dirty supply area and mark “NO” for this step.

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3 Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water

20%

9 Using clean washcloth, rinses soap from genital area, moving from front to back, while using a clean area of the washcloth for each stroke

14%

11 After washing genital area, turns to side, then washes and rinses rectal area moving from front to back using a clean area of the washcloth for each stroke. Dries with towel

22%

13 Empties, rinses, and dries basin 16%

14 After rinsing and drying basin, places basin in designated dirty supply area

13%

15 Disposes of used lined into soiled linen container and disposes of linen protector appropriately

11%

17 After disposing of used lined and placing equipment, in designated dirty supply area, removes and disposes of gloves (without contaminating self) into waste container and washes hands

16%

18 Signaling device is within reach and bed is in low position 10%

#50 PROVIDES PERINEAL CARE FOR FEMALE

#50 PROVIDES PERINEAL CARE FOR FEMALEStep #3 - Before washing, checks water temperature for safety and comfort and asks client to verify comfort of waterCandidate had to do all components to get credit -usually does one or the other but not both. Make sure they are very obvious about this to the NAE.

Step #11 – After washing genital area, turns to side, then washes and rinses rectal area moving from front to back using a clean area of the washcloth for each stroke. Dries with towel.Candidate has to do all components to get credit – sometimes they forget to do this step entirely. Sometimes they do it all correct except they forget to dry using a towel. Sometimes they do not wipe anywhere near the rectum, just the buttocks or they wipe back to front.

Step #13 – Empties, rinses, and dries basinCandidate will forget to either rinse or dry or sometimes, both and just place in dirty supply area after emptying

Step #17 – After disposing of used linen, and placing used equipment in designated dirty supply area, removes and disposes of gloves (without contaminating self) into waste container and washes handsCandidates must do all components to get credit – many contaminate themselves while removing gloves (must be glove to glove then skin to skin). Can also miss automatically if they forget to dispose of the linens.

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SKILLS CLARIFICATIONS

Provides Perineal Care for Female Client

Step 14: After rinsing and drying basin, places basin in designated dirty supply area.

Previously: If candidate starts to place/store equipment in area other than designated dirty supply area, direct candidate to place in dirty supply area and mark “YES” for this step.

NCSBN clarification (10/5/2013): If candidate starts to place/store equipment in area other than designated dirty supply area, direct candidate to place in dirty supply area and mark “NO” for this step.

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2 Privacy is provided with a curtain, screen, or door 11%

3 Removes gown while keeping client covered 35%

4 Before washing checks water temperature for safety and comfort and asks client to verify comfort of water

14%

6 Beginning with eyes, washes eyes with wet washcloth (no soap), using a different area of the washcloth for each eye, washing inner aspect to outer aspect then proceeds to wash face.

12%

7 Dries face with towel 16%

13 Puts clean gown on client 32%



12%

18 After placing basin in designated dirty supply area, and disposing of used linen, removes and disposes of gloves (without contaminating self) into waste container and washes hands

15%

#40 GIVES MODIFIED BED BATH (FACE & ONE ARM, HAND & UNDERARM)

#40 GIVES MODIFIED BED BATH (FACE & ONE ARM, HAND & UNDERARM)

Step #3 –Removes gown and places in soiled linen container, while avoiding

overexposure of the client•Forget to take the gown off all together •Only partially remove off arm being washed and then once bath is finished they just put

dirty gown back on•Take gown off but then do not immediately place in soiled linen container

Step #7 - Dries face with towel•Candidate must use a towel (can be hand towel)

Step #13 – Put clean gown on client•If candidate forgets to take the gown off, they will miss this step

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#46 POSITIONS ON SIDE




2 Privacy is provided with a curtain, screen or door 12%

6 Places or adjusts pillow under head for support 19%

7 Candidate positions client so that client is not laying on arm

10%

8 Supports top arm with supportive device 19%

10 Places supportive device between legs with top knee flexed; knee and ankle supported

10%

#46 POSITIONS ON SIDE

Step #6 –Places or adjusts pillow under head for supportForget to ‘touch’ the pillow (even if ends up correctly placed

after turning on side, candidate must touch it)

Step #8 – Supports top arm with supportive deviceCandidates forget to do this step or some place it under the

bottom arm


Positions on SideStep 5: Slowly rolls onto side as one unit toward raised side rail.Question: Is it acceptable to cross ankle and/or reposition client’s knee

prior to turning/perform log roll for this step?Clarification (06/02/14): Lateral positioning (this skill) is not the same as

logrolling. The reference specifies that “the upper leg is in front of the lower leg,” which may make it make it wrong to cross the client’s ankles.

Step 7:Candidate positions client so that client is not lying on armPreviously: candidate had to touch the client’s armNCSBN clarification (11/13/13): The candidate may observe that the

client is not lying on his or her arm without having to actually touch it. As long as proper placement of the client lying on arm has been met, this step has been met.





3 Before washing, checks water temperature for safety and comfort and asks client to verify comfort of water

23%

5 Places line protector under perineal area before washing 12%

8 While holding catheter at meatus without tugging, cleans at least 4 inches of catheter from meatus moving in only 1 direction (away from meatus) using a clean area of the cloth for each stroke

16%

9 While holding catheter at meatus without tugging, rinses at least 4 inches of catheter from meatus, moving only in 1 direction, away from meatus, using a clean area of the cloth for each stroke

17%

10 While holding catheter at meatus without tugging, dries at least 4 inches of catheter moving away from meatus

15%



12%

13 Disposes of used lined into soiled linen container and disposes of linen protector appropriately

14%

15 After disposing of used lined and cleaning equipment, removes and disposes of gloves (without contaminating self) into waste container and washes hands

15%

#47 PROVIDES CATHETER CARE FOR FEMALE

#47 PROVIDES CATHETER CARE FOR FEMALE

Step #3 - Before washing, checks water temperature for safety and comfort and asks

client to verify comfort of waterCandidate usually does one or the other but not both –make sure they are very obvious about

this to the NAE

Steps # 8 & #9 - While holding catheter at meatus without tugging, cleans/rinses at

least four inches of catheter from meatus, moving in only one direction (i.e., away

from meatus) using a clean area of the cloth for each strokeFor both steps, Candidate has to hold at the Meatus, no tugging, wash/rinse front to back. Ok

to use the one or three swipe technique.

Step #11 – Empties, rinses, and dries basinCandidate will forget to either rinse or dry or sometimes, both and just place in dirty supply

area after emptying

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Provides Catheter Care for Female

Step 12: After rinsing and drying basin, places basin in designated dirty supply area.



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Fail rate for the step is

>26%

4 Puts on clean gloves before handling bedpan 13%

6 Removes and disposes of gloves (without contaminating self) into waste container and washes hands 42%

7 After positioning client on bedpan and removing gloves, raises head of bed 26%

9 Hand wipe is within reach and client is instructed to clean hands with hand wipe when finished 16%

12 Head of bed is lowered before bedpan is removed 13%

14 Empties and rinses bedpan and pours rinse into toilet 17%

#33 ASSISTS WITH USE OF BEDPAN

#33 ASSISTS WITH USE OF BEDPANStep #6 – Removes and disposes of gloves (without contaminating self) into waste

container and washes hands Candidate has to do all components to get credit –many forget to remove their gloves before

continuing with the skill and/or contaminate themselves when they do. Remember, if the NAE has to remind the candidate to remove their gloves, they can’t correct it and get a ‘no’.

Step #7 - After positioning client on bedpan and removing gloves, raises head of bed Candidate forgets to raise the head of the bed

Step #9 – Hand wipe is within reach and client is instructed to clean hands with hand wipe when finished.

Candidate has to do all components to get credit – many forget to instruct the client what to do with the wipe

Step #14 – Empties and rinses bedpan and pours rinse into toilet Candidate will forget to pour the rinse into toilet

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Assists with Use of Bedpan

Step 15: after rinsing bedpan, places bedpan in designated dirty supply area.



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Documents

NACES Contacts Jean Morita, MSN, MBA, NEA-BC, RN Program Director Linda Sue White, BSN, RN Associate Program Director Marilyn Golden, BSN, RN Associate