Reviewed

January, 2009
Copyright 1996, 1998, 2009 Home Care Association of Florida

Home Health Aide Competency Testing Manual For the exclusive use of HCAF Members
TO: HCAF Members FROM: Gene Tischer DATE: October 6, 1999 SUBJECT: Home Health Aide Competency Testing Manual Enclosed is HCAFs Home Health Aide Competency Testing Manual. This comprehensive evaluation was compiled and produced by the HCAF (formerly AHHIF) Regulatory Sub-Committee in 1990 and has been reviewed as necessary. This valuable test model is being exclusively provided to HCAF members. The test is designed for agencies to administer to their employees or potential employees in order to determine competency as a home health aide. This written and practical test is recognized as meeting both state and federal regulations. Should you have questions, please feel free to call the HCAF office. Lastly, since this is being provided to HCAF members exclusively, we must enforce strict limitations on reproduction and request that you not share or reproduce this model with non-member agencies. Thank you.
NOTE: HCAF is not engaged in legal, accounting, financial or other professional counseling, and readers are cautioned to contact their professional advisors for direction. HCAF gathers information from various sources in order to keep the membership informed. Copyright 1998, 1994, 2009 Home Care Association of Florida. All rights reserved. No reproduction without HCAF's permission.

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 Home Health Aide Competency Test Written Examination

ROLE OF THE HOME HEALTH AIDE An aide may perform certain duties. Mark the following true or false for tasks you may legally perform as a home health aide. T=True F=False 1. Reinforce a dressing 2. Apply a hot pack 3. Give an enema 4. Administer medication 5. Change a sterile dressing 6. Change a colostomy bag 7. Give a rectal suppository 8. Give a tubal feeding 9. Give insulin 10. Cut nails CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER. 1. As a home health aide, you: a. b. c. d. work alone work as part of the health care team may become the leader of the health care team will never get any further training after orientation

2. When you work in the home, you will be: a. b. c. d. responsible for making decisions without any help working under the supervision of a professional supervisor away from your office and have no way to contact your employer responsible for calling the physician with information

3. As a home health aide, it is your responsibility to: a. b. c. d. plan the clients care do only the tasks that the registered nurse assigns to you try to do your best, but not ask for any help compare assignments with your co-workers

4. A patient has cancer which has spread, and the doctor says he is not likely to live long. The patient asks you several questions about how long he will live. What should you do?
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a. b. c. d. I.

tell the patient what you think explain to the patient that he should ask his nurse and doctor tell the patient he is going to live a long time tell the patient that doctors dont know everything

COMMUNICATION

Mark the following true or false. T=True F=False 1. In the home, it is important to be a good listener. 2. Always tell the patient what you are going to do before starting a procedure. 3. You only communicate through words. CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER 1. Which of the following is important in communicating with people: a. b. c. d. courtesy tact listening all of the above

2. Body language is: a. b. c. d. a way of communicating feelings by using the body, facial expressions and the eyes only used by clients to tell their doctors what is causing them problems only used by persons who are deaf and mute the newest dance craze

3. Nursing care for a conscious patient should be preceded by: a. b. c. d. II. asking the patient for his permission to go ahead with the procedure telling the patient you would like to have his cooperation giving an explanation of what is going to be done explaining to the patient that the doctor ordered this done

OBSERVATION, REPORTING AND DOCUMENTATION

Mark the following true or false. T=True F=False 1. If you do not chart a task that you do for a patient, legally, it was not done 2. If the patient has a new area of skin breakdown, and the nurse is coming in two days, you do not need to report the skin breakdown to your supervisor 3. A rapid pulse and shortness of breath in a patient usually indicates the patient is excited and does not need to be reported to the nurse CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER
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1. The patient tells you he has not moved his bowels in three days. What should you do? a. b. c. d. tell him not to worry about it tell him to take a laxative report it to the nursing supervisor pretend you didnt hear him

2. After arriving to care for Mr. Jones, he complains he has had severe cramping pains in the calf of his left leg for the last three hours. You call your supervisor and then record on your progress note the following: a. b. c. d. "States he has leg cramps" "Complains of pain" "Left leg hurts a lot" "States he has severe cramping pains in the calf of his left leg for three hours"

3. Objective observation means: a. using all your senses (seeing, hearing, touching, etc..) in detecting changes in the patients condition b. signs and symptoms described by the patient c. deciding what the patient needs d. describing objects in the patients room III. READING AND RECORDING TEMPERATURE, PULSE AND RESPIRATIONS

Mark the following true or false. T=True F=False 1. Always report a pulse rate if the beats per minute are under 60 or over 100 2. The temperature of an unconscious patient should be taken orally since they are not moving about 3. Recording a patients "TPR" or vital signs is not important as long as you remember what they were. CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER 1. For which, if any, of these body areas is 99.6 degrees F. a normal temperature? a. b. c. d. axilla mouth rectum none of the above

2. When taking a patients pulse, you should take it for: a. b. c. d. 15 seconds one full minute 45 seconds two minutes

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3. When a patients respirations are being counted, it is best that the patient: a. b. c. d. IV. try to breath evenly breathe as deeply as he can sit up straight not be aware that the respirations are being counted

BODY FUNCTIONS AND CHANGES

Mark the following true or false. T=True F=False 1. Diarrhea can cause dehydration and other serious complications and should be reported 2. If a person complains of pain, it is important to have the patient describe the pain and then report it to the nurse and record it in your notes. 3. Its normal for most people to complain of pressure, swelling, or bloating in their ankles, feet, stomach or legs. CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER 1. If you notice the patients catheter is not draining, the first thing you should do is: a. b. c. d. call your supervisor empty the drainage bag check the tubing to see if it is kinked do nothing, this is the nurses problem

2. Which of the following is not recommended for promoting good daily bowel habits: a. b. c. d. plenty of water laxatives exercise well balanced meals

3. The patients pulse has been between 90 and 110 beats per minute since his first aide visit. Now you find it to be 58 beats per minute. What should you do next? a. b. c. d. V. tell the patient he must be getting better wait 15 minutes and take the pulse again inform the supervisor right away just record the pulse in the normal way

INFECTION CONTROL

Mark the following true or false. T=True F=False 1. Hand washing is the single best way to decrease the transfer of pathogens 2. Gloves should be worn when handling items soiled by body fluids 3. The catheter drainage bag must be lower than the bladder, but not on the floor
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CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER 1. During a visit, you need to wash your hands: a. b. c. d. before you give physical care to the patient after you pet the dog before you leave the patients home all of the above

2. In what situation should gloves be used? a. b. c. d. the patient is vomiting the patient has been incontinent of stool the patient has a draining wound all of the above

3. When soiled linen is removed from the patients bed, it should be: a. b. c. d. VI. shaken folded exactly hem to hem held away from ones uniform inspected for tears

MAINTENANCE OF A CLEAN, SAFE, HEALTH ENVIRONMENT

Mark the following true or false. T=True F=False 1. A bedside call bell needs to be available so the bedbound patient can summon assistance 2. Bedrails should never be used to secure vest restraints 3. Smoking in bed is fine for anyone who is not confused CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER 1. To prevent poisoning of people (including children) which of the following actions is best: a. b. c. d. keep poisons locked up or in places where children cannot reach them keep an antidote ready in case someone takes poison have an emergency number to call store in cool, dry place

2. Part of your duties as a home health aide are to assure safe home environment. This includes: a. b. c. d. proper infection control with good hand washing electrical and fire safety moving things which may cause the patient to fall all of the above

3. Bad breath or body odors on a home health aide will be LEAST likely to be noticed by the:
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a. b. c. d. VII.

patient nurse aide patients family

EMERGENCY PROCEDURES

Mark the following true or false. T=True F=False 1. For an injury with profuse bleeding, apply pressure and call for assistance 2. If the patient begins to have a seizure, your first responsibility is to prevent the patient from injuring himself 3. If the patient falls and complains of pain in his hip, you should help him to get up and walk to the bed CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER 1. In case of fire in the home, what is the best procedure to follow: a. b. c. d. tell the patient to be calm, call the fire department and then take the patient out of the house get the patient and yourself out of the house and call the fire department try and put the fire out yourself call your supervisor and the fire department, then leave the house

2. A patient is choking on some object that is caught in his airway. Before first-aid measures are applied, find out: a. b. c. d. if the patients pulse rate is over 80 if the patient can swallow clear fluids if the patient can speak or cough what medications the patient has taken in the past 24 hours

3. While giving a bath on a shower chair, the patient suddenly gasps and becomes unresponsive. The home health aide should: a. call for family assistance and continue with the bath b. leave the patient and call 911 c. lower the patient to the floor, call for the family to call 911, determine if CPR is needed and initiate it if indicated d. tell the family to stay with the patient while you call 911 and the supervisor VIII. HUMAN DEVELOPMENT

Mark the following true or false. T=True F=False 1. Every patient is the same and has the same needs and wants 2. It is all right to use any item in the home without asking as long as it is for the patients personal care 3. You may use the telephone in the patients home without asking permission
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CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER 1. Patients may sometimes talk about religious beliefs with which you do not agree. What would be your best reaction? a. b. c. d. it is best to pretend to have the same beliefs as the patient you have the right to explain your own beliefs in detail when a person is sick, it is the best time to teach him true religion each person has a right to his own beliefs which should be respected

2. A neighbor has asked you some questions about he patient you are presently taking care of. "Mrs. Collier is dying, isnt she?" How will you answer her? a. b. c. d. "Mrs. Collier is doing as well as can be expected" "I am sorry, but I cannot discuss Mrs. Collier" "Yes, its too bad, but shes very ill" "How did you know about Mrs. Collier and her illness?"

3. The main purpose of having written client rights in home care is to: a. b. c. d. IX. protect the client from abuse or neglect by the homemaker/home health aide make sure the client is getting the services he is entitled to insure the homemaker/home health aide is doing the job correctly all of the above

PERSONAL CARE

Mark the following true or false. T=True F=False 1. It is important to keep a patient covered during a bedbath except for the part being washed 2. Massaging of bony prominences helps to prevent skin breakdown by increasing the blood supply to the area 3. When giving peri-care to a patient after a BM, wash using a front to back motion in order not to spread fecal material to other areas. CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER 1. Which of the following is the most appropriate practice to promote good skin care in the elderly: a. b. c. d. keep the skin clean and well moisturized apply alcohol to bare areas of the skin wash daily with scented soaps all of the above

2. If dentures are not worn when sleeping, where should you store them? a. wrap in a washcloth b. put in a sterile container
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c. wrap in a gauze pad d. place in a clean container in clean water 3. If you do not know how to do an assigned task, you should: a. b. c. d. X. call another aide and ask him ask the client if he knows how to do it call the supervisor and ask for help handle every situation by yourself

SAFE TRANSFER TECHNIQUES AND AMBULATION

Mark the following true or false. T=True F=False 1. Always transfer a patient towards his good side 2. There is no need to be near an object to pick it up, just reach 3. Its best to use a gait belt if a patient is unsteady CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER 1. A patient lying on his back has slid down in bed and needs help in moving up again. To start this, the patient should, if possible: a. b. c. d. raise himself on his elbows separate his legs widely arch his back flex his knees and push with his heels

2. Before helping a patient into or out of a wheelchair, which of these actions are necessary? a. b. c. d. have the brakes unlocked and leave the foot pieces down lock the brakes and fold the foot pieces up have the brakes unlocked and the foot pieces up lock the brakes and leave the foot pieces down

3. When assisting a patient to walk with his walker, you should: a. b. c. d. XI. clear a pathway and remove all safety hazards stay close to the patients side stand on the other side of the room a and b

NORMAL RANGE OF MOTION AND POSITIONING

Mark the following true or false. T=True F=False 1. Passive range of motion exercises are for the prevention of contractures in patients with paralyzed limbs
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2. During range of motion exercises, if you feel resistance or the patient complains of pain, you should continue anyway. 3. Its best to have a pillow between the legs of a patient with a new hip replacement CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER 1. To prevent bedsores in the elderly, you should: a. b. c. d. change the patients position every two hours if they are unable to do so themselves get the patient out of bed if they are allowed to do so ensure adequate nutrition with special emphasis on protein intake all of the above

2. When turning a bedbound patient to rub his back, you find a slightly red area the size of a quarter at the base of the patients spine. What would be the best thing to do for the patient before reporting the finding? a. b. c. d. omit the back rub rub his back well and tape a large "donut" over the red area apply an antiseptic to the spot complete the backrub and leave the patient supported on his side

3. When positioning a patient with a fractured hip, it is best to: a. b. c. d. XII. ask the patient to relax turn the patient to the unaffected side with a pillow between his legs turn the patient to the unaffected side without a pillow ask the patient to bend his knees

NUTRITION

Mark the following true or false. T=True F=False 1. Soy sauce is good to spice up a low salt diet 2. A regular diet is a well balanced diet with no restrictions 3. Bread and potatoes are a good source of protein CHOOSE ONE CORRECT ANSWER FOR EACH QUESTION BELOW AND CIRCLE THE CORRESPONDING LETTER 1. Foods on a liquid diet would include: a. b. c. d. chicken, eggs and toast chopped and strained foods broth, tea and jell-o lightly seasoned foods

2. Foods that are high in vitamin C include:

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a. b. c. d.

oranges, tomatoes and watermelon potatoes, raisins and bananas liver, beef and chicken cheese, milk and cottage cheese

3. If there is 50cc left in glass and the glass holds 150cc you should record the intake as: a. b. c. d. 90cc 120cc 100cc 50cc

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 ESSAY QUESTIONS 1. Mr. Jones says, "No way; no bath today!". What would you do? 2. Mrs. Smith tells you she wants to shower, and the care plan says a sitting commode bath. What do you do? 3. On your first visit to Mr. Doe, he tells you he always wants to be bathed at 10:00 a.m. What do you do?

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 HOME HEALTH AIDE COMPETENCY EVALUATION WRITTEN EXAMINATION ANSWER SHEET

We have not provided a scale for passing/failing. The Aide should be competent in all tested areas. ROLE OF THE HOME HEALTH AIDE True and False: 1. T 2. F 3. F 4. F 5. F 6. T 7. F 8. F 9. F 10. F Multiple Choice: 1. b 1. b 1. b 1. b I. COMMUNICATION

True and False: 1. T 1. T 1. F Multiple Choice: 1. d 2. a

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3. c II. OBSERVATION, REPORTING AND DOCUMENTATION True and False: 1. T 2. F 3. F Multiple Choice: 1. c 2. d 3. a III. READING AND RECORDING TEMPERATURE, PULSE AND RESPIRATIONS True and False: 1. T 2. F 3. F Multiple Choice: 1. c 2. b 3. d IV. INFECTION CONTROL

True and False: 1. T 2. T 3. T Multiple Choice: 1. d 2. d 3. c V. BODY FUNCTIONS AND CHANGES

True and False:

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1. T 2. T 3. F Multiple Choice: 1. c 2. b 3. c VI. MAINTENANCE OF A CLEAN, SAFE, HEALTH ENVIRONMENT True and False: 1. T 2. T 3. F Multiple Choice: 1. a 2. d 3. c VII. EMERGENCY PROCEDURES True and False: 1. T 2. T 3. F Multiple Choice: 1. b 2. c 3. c VIII. HUMAN DEVELOPMENT True and False: 1. F 2. F 3. F Multiple Choice:
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1. d 2. b 3. d IX. PERSONAL CARE True and False: 1. T 2. T 3. T Multiple Choice: 1. a 2. d 3. c X. SAFE TRANSFER TECHNIQUES AND AMBULATION True and False: 1. T 2. F 3. T Multiple Choice: 1. d 2. b 3. d XI. NORMAL RANGE OF MOTION AND POSITIONING True and False: 1. T 2. F 3. T Multiple Choice: 1. d 2. d 3. b XII. NUTRITION
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True and False: 1. F 2. T 3. F Multiple Choice: 1. c 2. a 3. c

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 HOME HEALTH AIDE SKILLS PERFORMANCE EVALUATION PERFORMANCE STANDARDS (Required)

I. READING AND RECORDING VITAL SIGNS A. Temperature 1. Prepares thermometer correctly 2. Waits to take oral temperature for at least 20 minutes after patient has smoked or consumed hot/cold fluids 3. Leaves thermometer in place: 3 minutes - oral 4 minutes - rectal 5 minutes - axillary 1. Cleans thermometer after use and stores properly 1. 2. 3. 4. Reading accurate to within 2/10 of a degree Documents reading per agency policy Reports temperature of 99 degrees or above to supervisor Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________

A. Pulse 1. 2. 3. 4. 5. Counts pulse for one full minute Rate accurate to within four beats per minutes Documents reading per agency policy, noting any irregular rhythm Reports changes/abnormalities to supervisor Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________

A. Respirations
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1. 2. 3. 4. 5.

Counts respirations for one full minute Rate accurate to within two respirations per minute Records rate per agency policy, noting any abnormalities Reports changes/abnormalities to supervisor Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________

II.

PROVIDING PERSONAL CARE A. Bed Bath 1. Assembles equipment before beginning 2. Provides for patient privacy/warmth 3. Explains procedure to patient before beginning 4. Performs bath in appropriate order 5. Keeps patient covered except for body part being washed 6. Encourages patient to participate 7. Provides for patient safety at all times 8. Cleans and stores equipment after use 9. Documents care given according to agency policy 10. Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________ A. Other bath 1. Assembles equipment before beginning 2. Provides for patient privacy/warmth 3. Explains procedure to patient before beginning 4. If tub or shower bath, uses tub/shower seat and non-skid mat 5. Tests water temperature before beginning 6. Encourages self-care as much as possible 7. Performs bath in appropriate order 8. Provides constant supervision 9. Provides for patient safety at all times 10. Cleans and stores equipment after use 11. Documents care given according to agency policy 12. Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________

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A. Shampoo 1. Assembles equipment before beginning 2. Explains procedure to patient before beginning 3. Protects patients clothes/bedclothes 4. Uses water at safe and comfortable temperature 5. If bed shampoo, uses shampoo tray or device properly 6. Lathers hair well and massages scalp while shampooing 7. Rinses hair thoroughly 8. Dries hair completely and combs 9. Cleans and stores materials after use 10. Records care given according to agency policy 11. Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________ A. Nail Care 1. 2. 3. 4. 5. 6. 7. Assembles equipment before beginning Explains procedure to patient before beginning Soaks fingernails/toenails in warm, soapy water Cleans under and around nails Uses emery board or nail file to smooth nail edges according to agency policy Records care given according to agency policy Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________

A. Skin Care 1. 2. 3. 4. 5. 6. Inspects all skin areas for redness or breaks in skin Massages with lotion with special attention to bony prominences Smoothes clothes/bedclothes under patient If patient is bedbound, instructs patient/caregiver in principles of good skin care Records care given according to agency policy Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________

A. Oral Hygiene 1. Assembles equipment before beginning

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2. Explains procedure to patient 3. Provides mouth care according to agency policy 4. If necessary, removes and properly cleanses dentures, taking precautions to prevent damage. Assists patient to replace dentures as needed 5. Cleans and stores materials after use 6. Records care given according to agency policy 7. Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________ A. Toileting and Elimination 1. Toilet/Bedside Commode a. b. c. d. e. Positions patient properly on toilet/BSC Provides for privacy Allows adequate time for elimination Assists, as necessary, to clean perineal and/or rectal area Assist patient to wash hands

1. Bedpan a. b. c. d. e. Properly places bedpan and positions patient for comfort and to prevent spills Provides for privacy and safety of patient Allows adequate time for elimination Assists, as necessary, to clean perineal and/or rectal area Properly disposes of waste and cleans bedpan

1. Ostomy a. Assembles equipment before beginning b. Explains procedure to patient c. Provides care using proper technique and according to agency policy and procedure d. Records care given according to agency policy 1. Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________ III. ASSISTING WITH TRANSFERS AND AMBULATION A. Transfers - bed to chair/wheelchair
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1. 2. 3. 4. 5. 6.

Properly positions and secures chair/wheelchair next to bed Explains procedure to patient Uses proper body mechanics and provides for patient safety at all times Properly assists patient to stand and pivot into chair/wheelchair Assists patient back to bed, reversing the procedure Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________

A. Ambulation 1. With assistive device a. Clears pathways and checks for safety hazards b. Provides appropriate physical support c. Assists patient in proper placement and use of assistive device 1. Without assitive device a. Clears pathways and checks for safety hazards b. Provides appropriate physical support 1. Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________ IV. RANGE OF MOTION AND POSITIONING A. Range of Motion exercises 1. Passive a. Moves joints through normal ROM to extent possible b. Does not force joints or cause patient discomfort c. Provides support above and below joint 1. Active a. Assists patient to move joints through normal range of motion to extent possible, providing assistance as necessary 1. Other ________________________________________________________________________ ________________________________________________________________________ _____________________________________________
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 A. Positioning 1. 2. 3. 4. Demonstrates proper technique for turning patient Assures correct body alignment when positioning patient Uses pillow or other devices to correctly and adequately support patient Other ________________________________________________________________________ ________________________________________________________________________ ____________________________________

I.

SHAVING A. Electric razor 1. 2. 3. 4. 5. 6. 7. Uses electric razor when available Assembles equipment before beginning Explains procedure to patient before beginning Avoids using near water Demonstrates proper technique in use Cleans razor after use and stores safely Documents care given according to agency policy

A. Safety razor 1. Assembles equipment before beginning 2. Protects patients clothes/bedclothes 3. Explains procedure to patient 4. Uses fresh blade each time 5. Applies shaving soap properly 6. Shaves in direction hair grows 7. Rinses razor frequently 8. Takes special care in areas around nose and lips 9. Cleans and stores equipment after use 10. Documents care given according to agency policy II. COMMUNICATION SKILLS A. B. C. D. E. III. Exhibits good rapport with patient and caregiver Accepts patient in non-judgmental manner Friendly, courteous and empathetic with patient and caregiver Demonstrates understanding of patients needs Demonstrates good listening skills

OBSERVATION, REPORTING AND DOCUMENTATION

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A. Checks home health aide assignment/care plan in home before beginning care. Contacts supervisor if non present B. Exhibits understanding of abnormalities which must be reported to supervisor C. Observes for changes in patients condition or situation and reports changes to supervisor D. While bathing patient, inspects skin carefully for evidence of pressure, breakdown, or other skin problems and reports to supervisor as necessary E. Documents observations, care given and communication with supervisor according to agency policy IV. INFECTION CONTROL A. B. C. D. E. F. V. Demonstrates proper handwashing technique Adheres to Universal Precautions at all times according to agency policy Demonstrates proper technique in putting on, taking off and disposing of gloves Keeps dirty linen separate from clean Holds dirty linen away from uniform Properly disposes of dirty linen and wastes

SAFETY A. B. C. D. Observes for and informs patient and supervisor of safety hazards Stores cleaning supplies out of reach of children Uses and teaches proper safety techniques when oxygen is in use Uses gain/transfer belt if available and necessary, when assisting patient with transfers and ambulation

VI.

KNOWLEDGE OF EMERGENCY PROCEDURE A. Demonstrates understanding of 911 system B. Verbalizes understanding of procedure to be followed if patient falls or is injured during visit C. Has current CPR card

VII.

RESPECT FOR PATIENT AND PROPERTY A. B. C. D. Uses Mr./Mrs./Ms. When addressing patient, family or caregiver Asks permission to go into other rooms and to obtain any materials necessary to provide care Asks permission to use phone and uses phone only when necessary to contact office Exhibits courtesy and respect for patient at all times

VIII.

BODY MECHANICS A. Demonstrates routine use of proper body mechanics when lifting, turning or transferring patient

IX.

PERSONAL APPEARANCE AND HYGIENE A. Wears clean, neat, professional-looking uniform and appropriate footwear
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B. C. D. E.

Hair neat and clean looking Wears minimal jewelry Fingernails short and clean No body odor apparent

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 SKILLS PERFORMANCE EVALUATION (Required)

NAME: ___________________________________________ DOH: _________________________________________ A REGISTERED NURSE MUST OBSERVE AND EVALUATE THE HOME HEALTH AIDE PERFORMING THE FOLLOWING TASKS: ELEMENT I. Reading and Recording Vital Signs A. Temperature B. Pulse C. Respirations II. Providing Personal Care: A. Bed Bath B. Other Bath 1. Sponge 2. Tub 3. Shower C. Shampoo 1. Sink 2. Tub/Shower 3. Bed D. Nail Care E. Skin Care DATE C N/T N/O COMMENTS

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A. Oral Hygiene 1. Teeth 2. Dentures 3. Mouth G. Toileting and Elimination 1. Toilet/BSC 2. Bed Pan 3. Catheter Care III. Assisting with Transfers and Ambulation A. Transfers B. Ambulation 1. With assistive device (Type ______________ __) 2. Without assistive device IV. Range of Motion and Positioning A. ROM exercises 1. Passive 2. Active B. Positioning

HCAF 1331 E. Lafayette Street, Suite C Tallahassee, FL 32301 850.222.8967 www.homecareFLA.org

 ELEMENT I. Shaving a male patient A. Electric Razor B. Safety Razor II. Communication skills III. Observation, reporting and documentation IV. Infection Control V. Safety VI. Knowledge of emergency procedures VII. Respect for patient and property VIII. Body mechanics IX. Personal appearance and hygiene

DATE

N/T

N/O

COMMENTS

HCAF 1331 E. Lafayette Street, Suite C Tallahassee, FL 32301 850.222.8967 www.homecareFLA.org

 HOME HEALTH AIDE COMPETENCY RE-EVALUATION

NAME: ____________________________________________ DATE: ____________________________________________
Communication Skills: Demonstrates appropriate verbal and non-verbal skills. Demonstrates positive and helpful attitude toward the patient and others.

Yes

No*

Follow- up

Personal Appearance and Hygiene: Demonstrates compliance with agencys dress code. Demonstrates appropriate hygiene and grooming.

Observation, Reporting and Documentation: Reports appropriate observations including patients status. Demonstrates appropriate documentation.

Confidentiality: Respects patients rights, property, and maintains confidentiality.

Safety: Appropriately identifies and reports safety hazards. Demonstrates use of appropriate safety techniques including safe transfer/ambulation, body mechanics, ROM, and positioning. Demonstrates appropriate use of equipment. Verbalizes understanding of medical emergencies and knowledge of emergency procedures.

HCAF 1331 E. Lafayette Street, Suite C Tallahassee, FL 32301 850.222.8967 www.homecareFLA.org

Basic Infection Control Measures: Demonstrates compliance with universal precautions.

Patient Care Activities: Demonstrates understanding of, and compliance with, care assigned. Demonstrates competent skills and expertise. Demonstrates understanding of adequate nutrition and fluid intake.

Comments __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ ______________________________ ______________________________________________________________________________ ______________________________________________________ RN, Supervisor, Signature and Date * If no, explain in comment section and document follow-up/reassessment.

HCAF 1331 E. Lafayette Street, Suite C Tallahassee, FL 32301 850.222.8967 www.homecareFLA.org