The Roles and Responsibilities of

Unlicensed Assistive Personnel

Lesson 2

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Lesson 2: The roles and Responsibilities of Unlicensed

Assistive Personnel

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Now that you have become familiar with the Healthcare system and settings, let’s look at the

different roles in Home Health Care

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Home Health Agency

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Registered Nurse (RN)

In a home health agency, a registered nurse coordinates, manages and provides care. The registered nurse also supervises and trains home health aides before they can be sent to a workplace, and the RN continues to supervise the home health aides during the duration of work with a client.

Registered nurses are usually assigned to clients and are responsible to develop the plan of care and/or assignment that the home health aide is required to provide. Registered nurses play an important role in the care that is expected to be provided by home health aides in the home care setting.

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Certified Home Health Aides

Certified Home Health Aides is a vital part of home care. Home health aides perform tasks, assigned and supervised by Registered nurses, such as taking vital signs, assisting with personal care routines and activities of daily living. Home health aides spend more time with clients that other members of the health care system, which is why they automatically act as the “eyes” and ears” of their client(s).

Home health aides are also responsible to observe and report all tasks performed and any changes to the client’s condition or abilities. They are also responsible for maintaining a safe, secure and comfortable home life for clients and their families.

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Home Health Aides are required to

follow State and Government

Regulations in order to become Licensed

and maintain Licensure

• Training hours (federal and state): HHAs must complete at least 76 hours of training (60 hours of classroom instruction and 16 hours in hands on clinical skills instruction).

• In-service training: HHAs must have at least 12 hours of education (in-service training) every year.

• OSHA rules: HHAs must comply with OSHA rules about bloodborne pathogens, Standard Precautions, and tuberculosis.

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• Taking vital signs (Temperature, pulse, respirations and blood

pressure)• bathing/showering, perineal

care, oral care, nail care (filing only), skin care and

hair Care• Assisting with dressing

• Mobility (transfers to and from bed, chair, etc.)

• Range of motion exercises

• Laundry• Toileting

• Companion care • Running errands

• Preparing/serving meals (assisting with feeding when

necessary)• Supervising/reminding clients to take medication, prescribed

by a physician • Light housekeeping

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Home health aides are not permitted

to assist clients with any of the

following:

• Shaving with a razor; shaving may only be performed with a safety razor and/or electric razor

• Clip nails or remove cuticles; nail filing is permitted

• Administering medications and/or injections; home health aides may supervise medications being provided

• Apply medically prescribed creams, lotions or ointments

• Remove or insert tubes or other objects, except for thermometers

• Provide procedures involving sterile techniques (i.e.changing sterile dressings on deep or open wounds)

• Diagnose illnesses and prescribe medications/treatments

• Telling a client the treatment plan

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Home Health Aide are Role Models

Home health aides play the role of role models in clients’ lives. They promote clients’ independence by practicing good housekeeping, nutrition, hygiene, and healthcare skills. They are expected to encourage clients to do tasks for themselves to help maintain good health in between home care visits. Home health aides support and strengthen clients and their families.

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It is important to always remember that you are a guest in the client’s

home.

Working in someone’s home differs from working as a nursing assistant or nurse’s aide in many ways. It is very important to respect the client’s home, routines, and ways of doing things.

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Physicians, MDs, Doctors

Doctors play the role of diagnosing diseases and/or disabilities and prescribe treatment. Doctors generally decide when patients need home health care and typically refers them to home health agencies.

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Physical TherapistsPhysical Therapists evaluate a person’s physical abilities and develops a treatment plan to increase movement, improve circulation, promote healing, reduce pain, prevent disability and help clients regain and maintain mobility. Therapy may be administered in the form of heat, cold, massage, ultrasound, electrical stimulation, and exercise to muscles, bones and joints.

Clients may experience loss of mobility in the home and Physical therapists play a major role in clients’ ability to prolong and/or treat immobility.

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Speech Language Pathologists Speech language pathologists, also known as speech therapists, identifies communication disorders, addresses factors involved in recovery and develops a plan of care to meet recovery goals. Exercises may be assigned that can help improve and overcomes speech impediments, as well as a person’s ability to swallow food and liquids.

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Occupational Therapists

Occupational therapists help clients to learn how to adapt to disabilities. Occupational therapists play the role of retraining clients to perform activities of daily living (ADLs), such as dressing, bathing, and eating. Occupational therapists may order adaptive/assistive devices to help with activities of daily living, such as utensils with bigger handles for better grip.

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Registered DieticiansRegistered Dieticians teach clients and their families about special diets to improve their health and help

manage illnesses.

Medical Social WorkersSocial Workers determine clients’ needs and help them get support services, such as, home health care, counseling,

meal services, transportation services, adult day care services and financial assistance.

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Client Care Plan

A client care plan is individually designed by a Registered nurse and is developed to assist home health aides to achieve certain goals with the clients. The care plan consists of a list of tasks that home health aides must perform and how often the tasks must be performed and how they should be carried out. Client care plans are extremely important because they are designed to generally strengthen the client’s abilities and maintain a safe and secure environment.

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Factors that are considered while creating a client care plan

• Client’s health and physical condition• Diagnosis and treatment• Goals or expectations• Other needed services and resources, such as

transportation, equipment, and additional income

• Psychological (mental and emotional) and socioeconomic (social and economic) status of the client

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Tasks listed on a Care plan May include: • Range of motion exercises• Vitals signs (temperature,

pulse, respirations, blood pressure)

• Diet and fluid intake requirements

• Transfers• Feeding assist• Meal preparation• Oral care

• Hair Care• Nail care• Bathing/showering• Errands• Light housekeeping• Laundry• Changing Bed Linen

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The process of Creating a Care Plan

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The Chain of Command for Proper Care• It is important to understand the chain of command when caring for a client in home health care. Home health aides must carry out the instructions provided by the nurse, while the nurse must act on the instructions of a doctor and/or member of the care team. Following the proper chain of command helps protect home health aides and their employer from any liability or be held responsible for harming someone else.

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Let’s review the Chain of Command for Home

Health Care

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Policies and Procedures

What is a Policy? - a course of action that should be taken every time a certain situation occurs.

What is a procedure - a method, or way, of doing something

It is always important to follow policies and procedures while working with a client. Policies and procedures helps deliver the proper care to each client safely and efficiently.

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Examples of Common Policies in Home Health• All client information must remain confidential. Client information must

not be shared with anyone but the client’s care team. Not only is this a common policy, but it is also a law.

• A client plan of care must always be followed, and home health aides must not perform any tasks outside of the client care plan.

• Home health aides are required to report to their supervisor frequently regarding any changes to the client’s condition or abilities.

• Personal problems should not be discussed with clients of the client’s family. It is unprofessional to discuss personal problems within the workplace.

• Home health aides a required to be punctual and dependable• Deadlines for reporting and documenting must be followed at all times. • Any and all client care must be provided in a professional and pleasant

manner.• Home health aides must not give or accept gifts. This is considered

unprofessional and may lead to problems in the future.

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Professional Versus Personal Relationships in Home Health Care

Examples of Personal Relationships

Discussing financial hardshipDiscussing

Discussing relationship issuesDiscussing

Providing gifts or accepting giftsProviding

Sharing personal informationSharing

Discussing payroll issues/ pay rate informationDiscussing

Examples of Professional Relationships

• Keeping client information confidential

• Being polite and keeping a positive attitude

• Not using profanity• Using “Mr.”, “Mrs.”, “Ms.” while

addressing clients• Following policies and procedures• Maintaining good attendance

Professional refers to having to do with work or a job, whilepersonal refers to your life outside of your job, such as family,

friends and personal life.

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Practicing Good personal Hygiene

Regular grooming not only makes you feel good but helps others to feel confident about the care that you provide. Here are a few examples:

• Maintaining regular bathing or showering, oral care, hair care (hair must be brushed and away from the face) and nail care (nails must be kept short)

• No visible tattoos and extra piercings• Wearing clean, comfortable and closed toe shoes/sneakers• No hanging jewelry to avoid injuries• Lightly scented or no perfume• Clean, wrinkle-free work attire

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Organizing Care Assignments to work Efficiently

Keeping an organized care assignment will help to complete all tasks on the care plan within the time of care. Some clients only receive two-four hours of care per visit. It may seem challenging to complete all tasks in a timely manner, but any task not completed can effect the client’s safety and well being.

Here are a few ways to help organize your tasks:

• Make a list of your assigned tasks

• Arrange your tasks in order

• Work quickly, without putting yourself or your client at risk of injury

• Communicate with your client constantly to avoid misunderstanding the tasks that take priority over others

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Being a Good Home Health Aide

What does it mean to be a good Home Health?

Providing good quality care, support and encouragement makes you a better fit for your clients’ needs.

Always wear an identification badge. This helps to identify who you are and makes clients feel at ease.

Always be compassionate. Be caring, concerned, considerate, empathetic and understanding.

Always show empathy and sympathy. Showing empathy gives you the opportunity to understand and share your client’s feelings.

Always be conscientious and try your best.

Always keep an honest attitude.

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