TM1 Portfolio_HCS NCII.pdf

TRAINER’S MET HODOLOGY I PORTFOLIO

HEALTH C ARE SERVICES NC II Submitted in the Realization of the Requirements for National Assessment for TM 1 Submitted to:

TM1 PANEL OF ASSESSORS TESDA-C AR

Submitted by:

WARREN J AE M. S ANDOVAL, RN J une 6, 2014 NATIONAL ASSESSMENTFOR T M LEVEL 1

District: Name of Candidate: Qualification: Date of

Pre-Orientation: Portfolio Doc s. Rec eived on: Portfolio Doc s. Reviewed on:

C HECKLISTOF REQUI REMENTS C OC 1: DELIVERTRAINING SESSION A. PLAN TRAINING SESSION-Written Report and Portfolio EMARKS R 1. Sample Session Plan Sample Learning Materials and PowerPoint Presentation with Video Sample Assessment Tools Training Activity Ma trix 2. Training Certific ates 3. Third Party C ertificates B. FAC ILIT ATE LEARNINGSESSION-Demonstration with Oral Questioning and interview C. UTILIZ E ELEC TRONIC MEDIATO FACILIT ATE TRAININGDemonstration with Oral Questioning and Interview D. MAINTAIN T RAINING FAC ILIT IES-Portfolio and Written Report 1. Shop lay-out 2. Maintain Sc hedule 3. Inspec tion Checklist 4. Waste Segregation Plan 5. Sample Equipment Purc hase Request 6. Third Party C ertificates E. SUPERVISE WORK-BASE D LEARNIN G-Portfolio and Written Report 1. Sample Training Plan 2. Sample Monitoring Sheet 3. Sample Evaluation Form 4. Sample Training C ertificates 5. Third-Party C ertific ates C OC 2: C ONDUC T C OMPETENCY ASS ESSMENT - Demonstration wit h Oral Q uestioningnd a Interview A. B. C. D. E.

Prepare C andidate (10) Gather Evidence (10) Make Assessment Decisions (15) Record and Report the Assement Results (10) Provide Feedba c k (10)

C HEC KEDBY AND REVIEWE D BY:

Date:

Republic of the Philippines Tec hnic al Educ ation and Skills Development Authority Province of Benguet

DEC LARATION

TO WHOM IT MA Y CO NC ERN: This is to hereby declare that all doc uments, lea rning materials and forms in the portfolio are of my own effort and represent my capabilities accurately. Acc omplished this 6th of J une, 2014 at Baguio C ity, Philippines.

WARREN J AE M. SANDOVAL

TABLE OF C ONTENT S I.

Preliminary Pa ges

Title Page

............................................................................................... i

C hec klist of Requirements

.......... .......... .......... ........... .......... .......... ....ii

Declaration.......... .......... ........... .......... .......... .......... ........... .......... .......... ... iii Table of C ontents.................................................................................... iv II.

Plan Training Session

Session Plan ............. .............. .............. ............... .............. .............. ............. 1 Learning Style Inventory ............... .......... ........... .......... .......... ........... .......2 C harac teristic s of Learning Style ............... ........... .......... .......... ........... ..5 Form 1.2: Evidence of C urrent Competencies ...................................8 Self-Assessment Tool ............. ............... .............. .............. ............... ........12 Session Plan..............................................................................................15 Summary of C urrent C ompetencies...................................................17 Trainee’s C harac teristic s.......................................................................22 Summary of Trainee’s C harac teristics .......... .......... .......... ........... .......25 Training Needs ........................................................................................26 C ompetenc y-Based Learning Materia l ................................................50 Training Ac tivity Matrix............................................................................27 C lass Progress C hart ........... ........... .......... .......... ........... .......... .......... .......33 Ac hievement Chart .......... .......... .......... ........... .......... .......... ........... ........3 6 Training Session Evaluation Form ..........................................................43 Third Party C ertificate .............................................................................47 III.

Maintain Training F ac ilities ...........................................................49

C ontents

......... ........... .......... .......... ........... .......... .......... ........... .......... 50

Laboratory Lay-out

........... .......... .......... ........... .......... .......... ........... 51

Equipment Maintenance Sc hedule

............................................52

Housekeeping Inspec tion C hec klist

............................................54

Equipment Maintenance Inspec tion C hec klist ................................55 Waste Segregation Form .............. ........... .......... .......... ........... .......... ....56 Purchase Request ......... ........... .......... .......... ........... .......... .......... ........... 58

Operational Procedure ......... ........... .......... .......... ........... .......... .......... ..60 Housekeeping Sc hedule ........... .......... .......... .......... ........... .......... .........6 1 Tag-out Index .........................................................................................63 Breakdown/ Repair Report .......... .......... .......... ........... .......... .......... ......64 Inspec tion Report ......... .......... .......... ........... .......... .......... ........... .......... ..65 Work Request ........... .......... .......... ........... .......... .......... ........... .......... .......66 Salvage Report ............. .......... .......... ........... .......... .......... ........... .......... ..69 Third Party C ertificate ............................................................................70 IV.

Supervise Work-Based Training ....................................................71

C ontents .......... .......... .......... ........... .......... .......... ........... .......... .......... ......72 Training Plan ............................................................................................73 Training Session Evaluation Form .........................................................76 Trainee’s Rec ord Book...........................................................................79 Trainee’s Progress Sheet ..................................................................... 101 Interpretation and Analysis of Program Evaluation ...................... 104 Average Ratings.......... .......... .......... ........... .......... .......... ........... .......... 106 Self-Evaluation.......... ........... .......... .......... ........... .......... .......... .......... .... 107 On The J ob Monitoring Sheet ........... .......... .......... ........... .......... .......108 Memorandum of Agreement ........................................................... 109 Third Party C ertificate ......................................................................... 111 V.

C onduct C ompetency Assessment............. .............. ............... 112

C ontents ........... .......... .......... ........... .......... .......... ........... .......... .......... .. 113 Attendance Sheet ........... .......... .......... .......... ........... .......... .......... ......114 C ompetency Assessment Results Summary .......... .......... ........... .... 115 Self-Assessment Guide ................. .......... .......... ........... .......... .......... .... 117 Rating Sheet .......... .......... .......... .......... ........... .......... .......... ........... .......119

Plan Training Session

FORM 1.1 LEARNI NG STYLE INV ENT ORY Inst ructions:

To better understand how you prefer to learn and proc ess information, encircle the letter of the appropriate choice, and then use the scoring directions at the bottom of the page to evaluate your responses.

This 20-item questionnaire is not timed and has neither right nor wrong answer. Respond to each statement as honestly as you can. 1. What kind of book would you like to read for fun? a. A book with lots of pictures in it b. A book with lots of words in it c . A book with word searc hes or c rossword puzzles 2. When you are not sure how to spell a word, what are you most likely to do? a. Write it down to see if it looks right b. Spell it out loud to see if it sounds right c . Trac e the letters in the air (finger spelling) 3. You're out shopping for clothes, and you're waiting in line to pay. What are you most likely to do while you are waiting? a. Look around at other clothes on the racks b. Talk to the person next to you in line c. Fidget or move back and forth 4. When you see the word "c at," what do you do first? a. Picture a cat in your mind b. Say the word "c at" to yourself c . Think about being with a c at (petting it or hearing it purr) 5. What's the best way for you to study for a test? a. Read the book or your notes and review pic tures or charts b. Have someone ask you questions that you can answer out loud c . Make up index cards that you can review 6. What's the best way for you to learn about how something works (like a c omputer or a video game)? a. Get someone to show you b. Read about it or listen to someone explain it c . Figure it out on your own 7. If you went to a school dance, what would you be most likely to remember the next day? a. The fac es of the people who were there b. The music that was played c . The danc e moves you did and the food you ate Document No. Issued by:

Date Developed: May 2014

Health Care Services NC II

Date Revised:

Assist in Client. Patient Mobility

Developed by: SANDOVAL,

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8. What do you find most distrac ting when you are trying to study? a. People walking past you b. Loud noises c . An uncomfortable chair 9. When you are angry, what are you most likely to do? a. Put on your"mad" fac e b. Yell and scream c . Slam doors 10. When you are happy, what are you most likely to do? a. Smile from ear to ear b. Talk up a storm c . Ac t really hyper 11. When in a new place, how do you find your way around? a. Look for a map or direc tory that shows you where everything is b. Ask someone for direc tions c . J ust start walking around until you find what you're looking for 12. Of these three classes, which is your favorite? a. Art class b. Music class c . Gym class 13. When you hear a song on the radio, what are you most likely to do? a. Picture the video that goes along with it b. Sing or hum along with the music c . Start dancing or tapping your foot

14. What do you find most distrac ting when in class? a. Lights that are too bright or too dim b. Noises from the hallway or outside the build ing (like traffic or someone c utting the grass) c . The temperature being too hot or too cold 15. What do you like to do to relax? a. Read b. Listen to music c . Exercise (walk, run, play sports, etc.) 16. What is the best way for you to remember a friend's phone number? a. Picture the numbers on the phone as you would dial them b. Say it out loud over and over and over c . Write it down or store it in your phone contac t list 17. If you won a game, which of these three prizes would you choose? a. A poster for the wall b. A music C D or mp3 download c . A game of some kind (or a football or soc c er ball, etc.)

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18. Whic h would you rather go to with a group of friends? a. A movie b. A c once rt c . An amusement park 19. What are you most likely to remember about new people you meet? a. Their fac e but not their name b. Their name but not their fac e c . What you talked about with them 20. When you give someone directions to your house, what are you most likely to tell them? a. A description of building and landmarks they will pa ss on the way b. The names of the roa ds or streets they will be on c . "Follow me—it will be easier if I just show you how to get there." 21. When I operate new equipment I generally: read the instructions first listen to an explanation from someone who has used it before c. go ahead a nd have a go, I c an figure it out as I use it 22. When I need direc tions for tra velling I usually: a.

b.

look at a map ask for spoken direc tions c. follow my nose a nd maybe use a compass 23. When I cook a new dish, I like to: a.

b.

follow a written recipe call a friend for an explanation c. follow my instincts, testing as I cook 24. If I am teac hing someone something new, I tend to: a. b.

write instructions down for them give them a verbal explanation c. demonstrate first and then let them have a go 25. I tend to say: a.

b.

watc h how I do it listen to me explain c. you have a go 26. During my free time I most enjoy: a.

b.

going to museums and galleries listening to music and talking to my friends c. playing sport or doing DIY 27. When I go shopping for clothes, I tend to: a.

b.

imagine what they would look like on discuss them with the shop staff c. try them on and test them out 28. When I am choosing a holiday I usually: a.

b.

a. b. c.

read lots of broc hures listen to recommendations from friends imagine what it would be like to be there Document No. Issued by:



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29. If I was buying a new c ar, I would: read reviews in newspapers and magazines discuss what I need with my friends c. test-drive lots of different types 30. When I am learning a new skill, I am most comfortable: a.

b.

a. b. c.

watc hing what the teac her is doing talking through with the teacher exactly what I’m supposed to do giving it a try myself and work it out as I go

Sc oringProcedures Directions: Add up your answers for everyrespective letter of your choice. Then, rank them from 1-3, 1 being the highest and 3 as the lowest.

Points

Ranking

A B C

Please refer to the table below and the description under it to see what kind of learner you are. A- Auditory B- Visual C- Kinesthetic / Tac tile C harac teristics of Learning S tyles Auditory U

If you are an auditory learner, you learn by hearing and listening. You understand and remember things you have heard. You store information by the way it sounds, and you have an easier time understanding spoken instructions than written ones. You often learn by reading out loud because you have to hear it or speak it in order to know it. As an auditory learner, you probably hum or talk to yourself or others if you become bored. People may think you are not paying attention, even though you may be hearing and understanding everything being said. Here are some things that auditory learners like you can do to learn better. Sit where you can hear. Have your hearing checked on a regular basis. Use flashcards to learn new words; read them out loud. Read storie s, assignments, or direc tions out loud. Record yourself spelling words and then listen to the recording. Have test questions read to you out loud. Study new material by reading it out loud. • • • • • • •




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Remember that you need to hearthings, not just see things, in order to learn well. Visual U

If you are a visual learner, you learn by reading or seeing pictures. You understand and remember things by sight. You can picture what you are learning in your head, and you learn best by using methods that are primarily visual. You like to see what you are learning. As a visual learner, you are usually neat and clean. You often close your eyesto visualize or remember something, and you will find something to watch if you become bored. You may have diffic ulty with spoken direc tions and may be easily distrac ted by sounds. You are attrac ted to c olor and to spoken language (like stories) that is rich in imagery. Here are some things that visual learners like you can do to learn better: Sit near the front of the classroom. (It won't mean you're the teac her's pet!) Have your eyesight checked on a regular basis. Use flashcards to learn new words. Try to visualize things that you hear or things that are read to you. Write down key words, id eas, or instructions. Draw pictures to help explain new concepts and then explain the pictures. C olor code things. Avoid distrac tions during study times. •

• • • • •

• •

Remember that you need to see things, not just hear things, to learn well Kinest hetic/ Tac tile If you are a kinesthetic/ tac tile learner, you learn by touching and doing. You understand and remember things through physic al movement. You are a "hands-on" learner who prefers to touch, move, build, or draw what you learn, and you tend to learn better when some type of physical activity is involved. You need to be ac tive and take frequent breaks, you often spea k with your hands and with gestures, and you may have diffic ulty sitting still. As a tactile learner, you like to take things apart and put things together, and you tend be to find to tinker and or move when you become bored. You may very reasons well coordinated have around good athletic a bility. You c an easily remember things that were done but may have diffic ulty remembering what you saw or heard in the proc ess. You often c ommunic ate by touching, and you appreciate physically expressed forms of encouragement, such as a pa t on the back.




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Here are some things that tac tile learners like you can do to learn better: Partic ipate in ac tivities that involve touching, building, moving, or drawing. Do lots of hands-on ac tivities like completing art projects, taking walks, or ac ting out storie s. It's OK to c hew gum, walk around, or roc k in a c hair while reading or studying. Use flashcards and arrange them in groups to show relationships between ideas. Trac e words with your finger to learn spelling (finger spelling). Take frequent breaks during reading or studying periods (frequent, but not long). It's OK to tap a pencil, shake your foot, or hold on to something while learning. Use a c omputer to reinforce learning through the sense of touch. •

•

•

•

• •

•

•

Remember that you learn best by doing, not just by reading, seeing, or hearing.

EVIDENC ES/ PROOF OF C URRENTC OMPETENCIES Document No. Issued by:



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Form 1 .2: Evidenc e of Cur rent Co m pe tenc ies a c q ui red rel ated to Job/Occupation

Basic Competencies C urrent c ompetencies

Participa te in Workplac e Communication •

•

•

Obtain and convey workplace information Participa te in workplac e meetings and discussions Complete relevant work related documents

Work in Team Environment •

•

•

Desc ribe team role and scope Identify own role and responsibility within team Work as a team member

Prac tic e C areer Professionalism •

• •

• • •

Diploma Employment Certificate


Identify hazards and risks Evaluate hazards and risks C ontrol hazards and risks Maintain OHS awareness

Means of validatin g

Submitted authenticated c opy of Employment Certificate

Submitted authenticated c opy of Employment Certificate C opy of Signed Certificate of Participation

Diploma

Integrate personal objectives Employment with organizational goals Certificate Set and meet work prio rities Maintain professional growth and development

Prac tic e O cc upational Health and Safety Procedures •

Proof/ Evidence


Submitted authenticated c opy of Employment C ertificate and Basic First Aid Training C ompletion Certificate Submitted authenticated c opy of Employment Certificate Certificate of Participation




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C OMMON C OMPETENCIES C urrent c ompetencies

Implement and monitor infection c ontrol polic ies and procedures •

•

•

Provide information to the work group about the organization's infection c ontrol polic ies and procedures. Integrate the organization's infection control polic y and procedure into work practices Monitor infection control performance a nd implement improvements in prac tic es

Respond effectively to difficult/ c hallenging behavior • • •

Plan responses Apply response Report and review incidents

Proof/ Evidence

Diploma Employment Certificate At least one certificate signifying


Submitted authenticated c opy of Employment Certificate C opy of Signed Certificate of Participation

partic ipa tion in a seminar, training or workshop regarding infection control policies


Submitted authenticated c opy of Employment Certificate

At least one certificate signifying

C opy of Signed Certificate of

partic ipa tion in a Participation seminar, training or workshop regarding group mechanics or the like. Apply basic first aid • •

•

Assess the situation Apply basic first aid techniques C ommunicate details of the incident

Ma intain high standard of patient services •

•

•

•

C ommunicate appropriately with patients Establish and maintain good interpersonal relationship with patients Ac t in a respec tful manner at all times Evaluate own work to maintain a high standard of patient servic e

Diploma

Submitted authenticated c opy of Employment Employment Certificate, Basic C ertificate and Basic First Aid Training C ompletion First Aid Training Certificate Diploma Employment Certificate At least a month of training or didac tics in an health care institution

Submitted authenticated c opy of Employment Certificate Certificate of Participation




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C ORE C OMPETENCIES C urrent c ompetencies

Proof/ Evidence

Diploma 1. Prepare and maintain beds •

• •

I. Photocopy of the following: a. Diploma b. C ertific ate of Employment

C ertific ates of Employment

Prepare a rea for bed making Ma ke bed Perform aftercare activities


C ertific ate of trainings attended C ertific ate of related NC (Caregiving NC II) Certificate of graduation/OTR on related medica l course/s

c . C ertific ates of Partic ipation in trainings attended d. Other certificates related to NC e. Certificate of graduation/OTR on related medic al course/ s

Diploma 2. C ollec t and maintain linen stocks at end-user locations •

•

•

C ollec t soiled linen Dis tribute clean linen Maintain linen stock levels

3. Assist in client/ patient mobility •

•

•

I. Photocopy of the following: a. Diploma C ertific ates of b. C ertific ate of Employment Employment c . C ertific ates of Partic ipation C ertific ate of trainings in trainings attended attended d. Other certificates related to NC C ertific ate of related NC (Caregiving NC II)

e. Certificate of graduation/OTR on related medic al course/ s

Certificate of graduation/OTR on related medica l course/s Diploma

I. Photocopy of the following: a. Diploma b. C ertificate of Employment Prepare to assist c. C ertificates of Participation with patient C ertific ate of trainings in trainings attended mobility attended d. Other certificates related to Assist with patient NC C ertific ate of related mobility i. Certificate of NC (Caregiving NC II) C omplete pa tient graduation/OTR on mobility related medica l assistance course/s Certificate of II. Properly demonstrated how to graduation/OTR on assist in patient mobility related medica l course/s C ertific ates of Employment




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4. Assist in transporting Diploma clients/patients C ertific ates of Employment Prepare pa tient

I. II.

•

for transport •

•

Assist in patient transport Perform posttransport procedures

C ertific ate of trainings attended C ertific ate of related NC (Caregiving NC II) Certificate of graduation/OTR on related medica l course/s Diploma

5.

•

Assist in biopsychosocial support care of clients/ pa tients

C ertific ates of Employment C ertific ate of trainings attended

Establish and maintain rapport with the patient

C ertific ate of related NC (Caregiving NC II)

Obtain information regarding the biopsychosocial needs of the patient Provide assistance to meet patient needs as direc ted

Certificate of graduation/OTR on related medica l course/s

•

•

5. Handle waste in a Health Care Environment •

•

•

•

•

Diploma C ertific ates of Employment

Determine job requirements

C ertific ate of trainings attended

Identify and segregate waste

C ertific ate of related NC (Caregiving NC II)

Transport and store waste C onduc t quality c ontrol activities Clean up work areas

Properly demonstrated how to assist in patient transport Photocopy of the following: a. Diploma b. Certificate of Employment

c . C ertificates of Participation in trainings attended d. Other certificates related to NC III. Certificate of graduation/OTR on related medic al course/ s I. Photocopy of the following: a. Diploma b. Certificate of Employment c . C ertificates of Participation in trainings attended d. Other certificates related to NC i. Certificate of graduation/OTR on related medica l course/s II. Submitted an authentic ated copy of the required certificate/s III. Photocopy of the following: a. Diploma b. Certificate of Employment c . C ertificates of Participation in trainings attended

Certificate of graduation/OTR on related medica l course/s

d. Other certificates related to NC i. Certificate of graduation/OTR on related medica l course/s IV. Submitted an authenticated copy of the required certificate/s Document No. Issued by:



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SELF-ASSESSMENTC HECK INSTRUC TIONS: This Self-Check Instrument will give the tra iner necessary data or information which is essential in planning training sess ions. Please check the appropriate box of your answer to the questions below. BASIC C OMPETENCIES YES

CA N I… ?

NO



1. Participate in Workplace C ommunic ation

a.

Obtain and convey workplace information



b.

Participate in workplac e meetings and discussions



c.

C omplete relevant work related documents

 

2. Work in a Team Environment

a. Describe team role and scope



b. Identify own role and responsibility within team



c . Work as a team member

 

3. Prac tice C areer Profess ionalism

a. Integrate personal objectives with organizational goals



b. Set and meet work priorities



c . Maintain professional growth and development



d. Integrate personal objectives with organizational goals



e. Set and meet work priorities



f.



Maintain professional growth and development



4. Prac tice Oc c upational Health and S afety Procedures



a. Identify hazards and risks b. Evaluate hazards and risks



c . C ontrol hazards and risks



d. Maintain oc cupational health and safety (OHS) awareness






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C OMMON COMPETENCIES YES

CA N I …?

1. Implementand monit or infection c ontrol polic ies and procedures

a. Provide information to the work group about the organization’s infection control policies and proc edures b. Integrate the organization’s infection control policy and procedure into work prac tices. c. Monitor infection control performance and implement improvements in prac tices.

NO

    

2. Respond eff ectively ot difficult/ c halleng ing behavior



a. Plan responses



b. Apply appropriate responses



c. Report and review incident/s



3. Apply basic fir st aid



a. Assess the situation



b. Apply ba sic first aid techniques 

c. C ommunic ate details of the incident/ event



6. Maintain high tsandard of patientservices



a. C ommunic ate appropriately with c lient/pa tients b. Establish and maintain good interpersonal relationship with clients/patients

 

c. Ac t in a respectful manner at all times

d. Evaluate own work to maintain high standard of client/patient  services

C ORE C OMPETENCIES YES NO

CA N I …? 1.

Prepare and maintain beds

a. Prepare the area for bed making?



b. Perform bed making?






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c. Perform aftercare activities of materials and equipment used? 2.

3.

4.

5.



C ollect and maint ain linen tsocks at end-user locations

a. C ollec t soiled linen?



b. Distribute clean linen?



c. Maintain linen stock levels?



Assist in client/patient mobilit y

a. Prepare to assist with client/p atient mobility?



b. Assist with client/ patient mobility?



c. Complete client/ patient mobility assistance?



Assistin transporting clients/patients

a. Prepare client/patient for transport?



b. Assist in client/patient transport?



c. Perform post-transport proc edures?



Assist in bio-psychosocial su pport c are of c lient s/ patients

a. Establish and maintain rapport with client/pa tient?



b. Obtain information regarding the bio-psychosocial needs of the  client/patient? c. Assist patient in meeting his bio-psychosocial needs? 6.



Handle waste in a health care envir onment

a. Determine job requirements related to handling waste?



b. Identify and segregate waste?



c. Transport and store waste?



d. C onduct quality control ac tivities?



e. Clean up work areas?






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SES SION PL AN Sector QualificationTitle Unitof C ompetency Module Title :

:

HEALT H, SOCIAL AND OTHERC OMMUNITYDEVEL OPMENTSERVICES : HEALTH C ARE SERVICES NC II : ASSISTIN C LIENT/ PATIENTMOBILITY ASSIS TING IN C LIENT / PATIENTMOBILITY

Learning O utc omes: LO1. Prepare to assist with patient mobility LO2. Assist with client/pa tient mobility LO3. C omplete c lient/pa tient mobility assistanc e A. INTRODUCTION This module provides the framewo rk and information nec essary for Nursing Assistants to be ab le to understand and c onduct assisting in the mobility of clients/ pa tientsc orrec tly, safely and efficiently. Knowing how to assist c lients in their mobility is important since it motivates the patient to go up one level at a time in his/ her overall health and functioning. By doing this, we are providing an opportunity for the patient to participate actively in their own health c are, thus hastening wellness.

Furthermore, knowing the correct procedures protects both the client and the health care provider from unnecessary stressand/ or injury. B. LEARNING C ATIVITIES LO 1: Prepare to assist with patient mobility LearningC ontent

a. Patient confidentiality and p rivac y requirements

Methods

Presentation

Prac tice Feedbac k

Resour c es

•

Modular

Information Sheet

Do the SelfCheck

Co mpare answer to Self-chec k key answer

Information Sheet

•

Video Presentation

Video Documentary Do the SelfPresentation Check

Co mpare answer to Self-chec k key answer

•

Role Play

Documentary Video Laptop LCD Projector/ Screen Performance C riteria C hec klist

Task Sheet

Perform Task Sheet 1.1-1 Evaluate Performance Criteria

Time (hours) 5

b. Infection Control Principles and Procedures

•

•

c. Use of Proper Body Me cha nics and Equipment

Modular

Information Sheet

Lecture with Illus tration Lecture/ Information Sheet

Do the SelfCheck

Co mpare answer to Self-check key answer

Perform Task Evaluate Hygiene 1.1-2 Performance Materials C riteria C hec klist for Task sheet 1.1-2Performance Criteria Checklist Do the Self- Co mpare answer LCD Projector Check to Self-check key Hospital Bed and answer Assistive Devices Information Sheet

•

Demonstration

Task Sheet

•

Modular

Information Sheet

•

Lecture with

Slide Presentation

Evaluate Perform Task Performance

Demonstration

Assistive devices

1.1-3

C riteri a Csheet hec klis1.1-3 t for Task

C . ASS ESSMENTPLAN Observation Demonstration Oral questioning Third pa rty repo rt D. TEAC HER’SSEL F-REFL ECTION OF THE SE SSION • • • •




Date Revised:



Jae M.

LCD Projector PPT Presentation Board & Marker PPE

Page 16 of 122

Warren Revision 01

#

7

7

Summar y of Current C ompetencies versus Required Competencies

Required Units of C ompetency/Learning Outc omesbased on CBC

C urrent C ompetencies

Basic Competencies 1. PARTICIPAT E IN WORKPLAC E COMMUNIC ATION

1.1 Obtain and c onvey workplac e information

Obtain and c onvey workplac e information

Partic ipa te in 1.2 Partic ipate in workplac e workplac e meetings meetings and disc ussions and discussions Complete relevant 1.3 Complete relevant work work related related documents documents 2. WORK IN T EAM ENVIRONMENT

2.1 Describe team role and Desc ribe tea m role and scope scope 2.2 Identify own role and responsibility within team

Identify own role and responsibility within team

2.3 Work as a team member

Work as a team member

3. PR AC TICE CAREER PROFESSIONALISM

3.1 Integrate personal objectives with organizational goals

Integrate personal objectives with organizational goals

3.2 Set and meet work priorities

Set and meet work priorities

3.3 Maintain professional growth and development


Training Gaps/Requirements

4. PRAC TICE OC C UPATIONAL HEALTH AND SAFETY PROC EDURES

4.1 Identify hazards and risks

Identify hazards and risks

4.2 Evaluate hazards and risks

Evaluate hazards and risks

4.3 C ontrol hazards and

C ontrol hazards and

risks

risks

4.4 Maintain OHS awareness

Maintain OHS awareness Common Competencies

1. IMPL EMENT AND MONITOR INFE C TION CONTROL POLICIESAND PR OC EDURES

1.1 Provide information to the work group about the organization's infection control policies and procedures.

Provide information to the work group about the organization's infection c ontrol policies and procedures.

1.2 Integrate the organization's infection c ontrol polic y and procedure into work practices

Integrate the organization's infection c ontrol polic y and procedure into work practices

Monitor infec tion 1.3 Monitor infection control performance c ontrol performanc e a nd and implement implement improvements in improvements in practices practices 2. RESPOND EF FECTIVELY TO DIFFICULT/ C HALL ENGING BEHAVIOR

2.1 Plan responses

Plan responses

2.2 Apply response

Apply response

2.3 Report and review incidents

Report and review incidents Date Developed:

Health Care Services NC II Assist in Client. Patient Mobility

May 2014

Date Revised:

Document No. Issued by: Page 18 of 122


Warren Jae M.

Revision # 01

3. APPLY BASICFIRST AID

3.1 Assess the situation

Assess the situation

3.2 Apply basic first aid techniques

Apply basic first aid techniques

3.3 C ommunic ate details of Communicate details the incident of the incident 4. MAINTAIN HIGH STANDARDS OF PATIENTSERVIC ES

Communicate 4.1 C ommunic ate appropriately with appropriately with patients patients 4.2 Establish and maintain good interpersonal relationship with patients

Establish and maintain good interpersonal relationship with patients

4.3 Ac t in a respectful manner at all times

Ac t in a respec tful manner at all times

Evaluate own work to 4.4 Evaluate own work to maintain a high maintain a high standa rd of standard of patient patient service service Core Competencies 1. Prepare and Maintain Beds

1.1 Prepare a rea for bed making

Prepare a rea for bed making

1.2 Perform bed making

Perform bed making

1.3 Perform after care ac tivities of materials and

Perform after care ac tivities of materials

equipment used

and equipment used

Date Developed:


May 2014

Date Revised:



Warren Jae M.

Revision # 01

2. Collect and Maintain Linen S tocks

2.1 C ollec t soiled linen

C ollec t clean linen

2.2 Distribute c lean linen

Distribute c lean linen

2.3 Maintain linen stock levels

Maintain linen stock levels

3. Ass istin Client/Patient Mobility 3.1 Prepare to assist with patient mobility

Prepare to assist with patient mobility

3.2 Assist with client/patient mobility

Assist with client/patient mobility

3.3 Complete client/patient mobility assistance

Complete client/patient mobility assistanc e

4. Assis t in Transporting Clients/ Patient

4.1 Prepare c lient/pa tient for transport

Prepare client/patient for transport

4.2 Assist in client/patient transport

Assist in client/patient transport

4.3 Perform post transport Perform post transport procedures procedures 5. Ass istin Bio-Psychosocial SupportC are of Patients

5.1 Establish and maintain rapport with client

Establish and maintain rapport with client

5.2 Obtain information regarding the biopsychosoc ial needs of the

Obtain information regarding the biopsychosoc ial needs of

patient

the pa tient

Assist patient in 5.3 Assist patient in meeting meeting his biohis bio-psychosocial needs psychosoc ial needs

Date Developed:


May 2014

Date Revised:



Warren Jae M.

Revision # 01

6. Handle Waste in a Health Care Envir onment

6.1 Determine job requirements

Determine job requirements

6.2 Identify and segregate waste


6.3 Transport and store waste

Transport and store waste

6.4 C onduct quality control ac tivities

C onduc t quality control ac tivities

6.5 C lean-up work area s

Clean up work areas

Date Developed:


May 2014

Date Revised:



Warren Jae M.

Revision # 01

DataG athering Inst rument or f Trainee’s Charac teristics

Please a nswer the following instrument ac c ording to the charac teristic s desc ribed below. Encircle the letter of your c hoice that best desc ribes you as a learner. Blank spac es are provided for some data that need your response. C haracteristics of learners

Language,

Average grade in:

Average grade in:

literacy and numeracy (LL&N)

English

Math

C ultural and language background

a. 95 and above

a. 95 and ab ove

b. 90 to 94

b. 90 to 94

c . 85 to 89

c . 85 to 89

d. 80 to 84

d. 80 to 84

a. 75 to 79

e. 75 to 79

Ethnicity/c ulture:

a. Ifugao b. Igorot c . Ibanag d. Gaddang e. Muslim f. Ibaloi g. Others( please spec ify)_____________

Education & general knowledge

HighestEducational Attainment :

a. High Sc hool Level b. High School Graduate c . C ollege Level d. C ollege G rad uate e. with units in Master’s degree f. Ma steral G rad uate g. With unitsin Doctoral Level h. Doctoral Graduate

Sex

a. Male b. Female Date Developed:


May 2014

Date Revised:



Warren Jae M.

Revision # 01

C haracteristics of learners

Age

Your age: _____

Physical ability

Previous experienc e with the topic

Previous learning experience

Training Level completed Spec ial courses

Learning styles

1. Disabilities(if any)_____________________ 2. Existing Health Conditions (Existing illness if any) a. None b. Asthma c . Heart disease d. Anemia e. Hypertension f. Diabetes g. Others(please spec ify) ___________________ a. Hea lth Care Services related b. C are Services Worker c . Hea lth Care Services C ourse related graduate List down trainings related to Health C are Services NC II ___________________________ ___________________________ ___________________________ National Certific ates ac quired and NC level ___________________________ ___________________________ Other c ourses related to TM a. Units in education b. Master’s degree units in education c . Others(please spec ify) _________________________ a. Visual - The visual learner takes mental pictures of information given, so in order for this kind of learner to retain information, oral or written, presentations of new information must contain diagrams and drawings, preferably in color. The visual learner can't concentrate with a lot of activity around him and will focus better and learn faster in a quiet study environment. Date Developed:


May 2014

Date Revised:



Warren Jae M.

Revision # 01

C haracteristics of learners

b. Kinesthetic - described as the students in the classroom, who have problems sitting still and who often bounce their legs while tapping their fingers on the desks. They are often referred to as hyperac tive students with c onc entration issues. c .

Auditory- a learner who has the ability to remember speeches and lectures in detail but has a hard time with written text. Having to read long texts is pointless and will not be retained by the auditory learner unless it is rea d a loud.

d. Ac tivist - Learns by having a go e. Reflector - Learns most from ac tivities where they can watch, listen and then review what has happ ened. f. Theorist - Lea rns most when ideas are linked to existing theories and c onc epts.

Other needs

g. Pragmatist Learns most from tolearning ac tivities that- are direc tly relevant their situation. a. Financially challenged b. Working student c . Solo parent d. Others(please spec ify) ___________________________

Date Developed:


May 2014

Date Revised:



Warren Jae M.

Revision # 01

SUMMARY OF TRAINEE’S HARAC C TERISTICS

Trainee’s Name

SABAYTON, J un TELIO, Rosanna LUMA-ANG, Warner

BANGCADO, Tony LUIS, April Ma y

C ultura l Educatio and n and x e e g Language General S A Backgroun Knowledg d e Tag alog C ollege M 21 Graduate Ibaloi College F 24 Graduate Ibaloi With units M 23 in Master’s Kankana-ey

Tag alog

LARDIZABAL, Valentina

Tag alog

SALDA, Giselle

Ibaloi

Degree College Graduate With units in Master’s Degree With units in Master’s Degree Masterals Graduate

l a ic s y h P

Previous Previous Training Experience Learning Level with the Experience Complete topic d

y it il b A

l ia c e p S

e s r u o C

Learning Style

Others

Visual

Employed

None

None

None

None

None

None

None

None

None

None

Kinesthetic Employed Kinesthetic Employed

None

None

None

None

None

21

None

None

None

None

None

Visual

Employed

F

22

None

None

None

None

None

Kinesthetic

Employed

F

23

None

None

None

None

None

Kinesthetic Employed

F

26

None

None

None

None

None

Kinesthetic Employed

M



Date Revised:


Developed by:


SANDOVAL, Warren Jae

M.

Revision # 01

TRAINING NEEDS Training N eeds

Module it Tle/Module o f Inst ruction

(Learning Outc omes)

Preparing and Maintaining Beds

C ollecting and Ma intaining Linen Stocks

• • •

Prepare to assist with patient mobility ASSIST ING IN C LIENT / PATIENT Assist with client/patient mobility MOBILITY C omplete c lient/pa tient mobility assistance

Assistin T ransporting Clients/ Patient

Assis t in Bio-Psychosocial Support C are of Patients

Handle W aste in a Health Care Environment



Date Revised:


Developed by:


SANDOVAL, Warren Jae

M.

Revision # 01

COMPETENCY BASED LEARNING MATERIAL

Sector

:

HEALTH, SOCIAL AND OTHER COMMUNITY DEVELOPMENT SERVICES

Qualification Title

:

HEALTHCARE SERVICES NC II

Unit of Competency

:

ASSIST IN CLIENT/ PATIENT MOBILITY

Module Title

:

ASSISTING IN CLIENT/ PATIENT MOBILITY BVS Colleges

Km.5 La Trinidad, Benguet

HOW TO USE THIS COMPETENCY BASED LEARNING MODULE Welcome! The unit of competency, "Assist in Client/ Patient Mobility" is one of the competencies of Health Care Services NC II; a course which comprises the knowledge, skills and attitudes required for a Nursing Assistant to possess. This unit of competency contains knowledge, skills and attitudes required for Health Care Services NC II. This module contains training materials and activities for you to complete. You are required to go through a series of learning activities in order to complete each learning outcome of the module. In each learning outcome are Information Sheets, Self-Checks and Job Sheets. Follow these activities on your own. If you have questions, don’t hesitate to ask your instructor for assistance.

Recognition of Prior Learning (RPL)

You may already have some or most of the knowledge and skills covered in this learner's guide because you have been working for some time already completed training in this area. If you can demonstrate to your trainer that you are competent in a particular skill or skills, talk to him/her about having them formally recognized so you don't have to do the same training again. If you have a qualification or Certificate of Competency from previous trainings, show it to your trainer. If the skills you acquired are still current and relevant to the unit/s of competency they may become part of the evidence you can present for RPL. If you are not sure about the currency of your skills, discuss this with your trainer. This module was prepared to help you achieve the required competency in “Assisting in Client/ Patient Mobility”. This will be the source of information for you to acquire knowledge and skills in this particular competency independently and at your own pace, with minimum supervision or help from your instructors. Most probably your trainer will also be your supervisor or manager. He/she is there to support you and show you the correct way to do things. Your trainer will tell you about the important things you need to consider when you are completing activities and it is important that you listen and take notes.

Date Developed:


May 2014

Date Revised:


Developed by: SANDOVAL, Warren Jae M.

Revision # 01

You will be given plenty of opportunity to ask questions and practice on the job. Make sure you practice your new skills during regular work shifts. This way you will improve both your speed and memory and also your confidence.

REMEMBER TO: •

Work through all the information and complete the activities in each section.

•

Talk to your trainer and agree on how you will both organize the Training of this unit. Read through the module carefully. It is divided into sections, which cover all the skills, and knowledge you need to successfully complete this module.

•

Read information sheets and complete the self-check. Suggested references are included to supplement the materials provided in this module.

•

Use the Self –Check and Job Sheets at the end of each section to test your own progress.

•

Talk to more experience workmates and ask for their guidance.

When you feel confident that you have had sufficient practice, ask your instructor to evaluate you. The results of your assessment will be recorded in your Progress chart and Accomplishment Chart.

PRE REQUISITE: Basic and Common Competencies

Date Developed:


May 2014

Date Revised:



Revision # 01

TABLE OF C ONTENT S Title Page1 2 How to Use ThisC ompetency-Based Learning Material

Rec ognition of Pr ior L earning 2 List of Competencies

4

Module C ontent

5

Learning Outc ome Summar y

6

Learning Experiences

8

Information Sheet 3.1-1 :Patient’s 10 Rights Self-C heck 3.1-1: Patient’sRights

12

Infor mation S heet 3.1-2: Asepsisand Infec tion Contr ol 14 Self-Check 3.1-2:Asepsisand Inf ection Control 25 Infor mation Sheet 3.1-3: Procedure for Pr oper HandWashing29 32 Task Sheet 3.1-1: Hand Washing

Performance C hecklist 3.1-1: Hand Wash ing 33 Information hee S t 3.1-4: Procedures or f Donning a nd removing G loves34 38 Task Sheet 3.1-2: Donning and removing Gloves

Performance Checklist 3.1-2: Donni ng and Removing Gloves 39 Infor mation S heet 3.1-5: Health Care Wast e Management40 Self-Check 3.1-3: Health Care Waste Management 47 Infor mation Sheet 3.1-6: Principles of Proper Body Mec hanics52 Self-Check 3.1-4: P rinciples ofProper Body Mechanics 56 Infor mation Sheet 3.1-7: Client S afety Equipme nt 58 Self-Check 3.1-5: ClientSafety Equipment63 65 Information Sheet 3.1-8: Handling of Hospital Equipment

Operation Sheet 3.1-1: Operate a Manual and Electronic Hospit al Bed69 Performance C riteria Checklist 3.1-3: Operate a Hospit al Bed 70 J ob Sheet 3.1-5: Prepare to Assist in Client Mobility

71

72 Evaluation Instrument

Evidence Plan

74

Table of Spec ifications 75 Writte n Test

76

Written Test Self Chec k

86

Performanc e Test

96

98 Questioning tool

Referenc es

100

HEALTH CARE SERVICES NC II COMPETENCY-BASED LEARNING MATERIALS List of Competencies No. Unit of Competency

Module Title

Code

PREPARE AND MAINTAIN BEDS

PREPARING AND MAINTAINING BEDS

HCS323314

COLLECT AND MAINTAIN LINEN STOCKS AT ENDUSER’S LOCATION

COLLECTING AND MAINTAINING LINEN STOCKS AT END-USER’S LOCATION

HCS323315

3.

ASSIST IN CLIENT/PATIENT MOBILITY

ASSISTING IN CLIENT/PATIENT MOBILITY

HCS323316

4.

ASSIST IN TRANSPORTING CLIENTS/PATIENT

ASSISTING IN TRANSPORTING CLIENTS/ PATIENT

HCS323317

ASSIST IN BIOPSYCHOSOCIAL SUPPORT

ASSISTING IN BIOPSYCHOSOCIAL SUPPORT

CARE OF PATIENTS HANDLE WASTE IN A HEALTH CARE ENVIRONMENT

CARE OF PATIENTS HANDLING WASTE IN A HEALTH CARE ENVIRONMENT

1.

2.

5.

6.

Date Developed:


May 2014

Date Revised:

HCS323318

HCS323319



Revision # 01

MODULE CONTENT UNIT OF COMPETENCY

:

MODULE TITLE

ASSISTING IN CLIENT/PATIENT MOBILITY

:

ASSIST IN CLIENT/PATIENT MOBILITY

MODULE DESCRIPTOR:

This unit covers the knowledge, skills and attitudes required to assist incapacitated patients in basic physical movements.

NOMINAL DURATION

: 200 hours

QUALIFICATION LEVEL

: High School Graduate

SUMMARY OF LEARNING OUTCOMES: Upon completion of this module, the trainee/student must be able to: LO 1. Prepare to assist with patient mobility LO 2. Assist with client/patient mobility LO 3. Complete client/patient mobility assistance

ASSESSMENT CRITERIA: 1. Requirements for assisting with patient mobility are confirmed with concerned institutions health personnel and care plan 2. Equipment are selected according to the institutions prescribed plan of care 3. Prescribed mobility procedure is clearly communicated with patient 4. Patient mobility is carried out using safe handling method and equipment as required by the institution 5. Patient comfort and safety is ensured throughout positioning of movement 6. Communication with patients during movement is undertaken according to established procedures 7. Patient is moved to prescribed position using the appropriate equipment 8. Equipment is cleaned in accordance with prescribed institution standard procedure 9. Malfunctioning equipment is reported immediately to designated personnel

Date Developed:


May 2014

Date Revised:



Revision # 01

LEARNING OUTCOME SUMMARY Learning Outcome No. 1 PREPARE TO ASSIST WITH PATIENT MOBILITY CONTENTS: •

Patient confidentiality and privacy requirements

• • • •

OSH procedures Infection control guidelines Equipment use and specifications Body Mechanics

ASSESSMENT CRITERIA: 1. Requirements for assisting with patient mobility are confirmed with concerned institutions health personnel and care plan 2. Equipment are selected according to the institutions prescribed plan of care 3. Prescribed mobility procedure is clearly communicated with patient

CONDITIONS: Students/trainees must be provided with the following: •

•

Access to relevant workstation - Workshop area Manual on: Workplace health and safety manual Infection control manual Standard Operating Procedure manual Equipment manufacturer’s instructions Equipment and materials relevant to the proposed activities Hospital bed Wheelchair Stretcher PPE Uniform Mask Gloves Shoes -

-

-

• •

-

-

-

-

-

-

-

-

METHODOLOGIES: • • •

Simulation One-on-one teaching video tapes lectures

Date Developed:


May 2014

Date Revised:



Revision # 01

ASSESSMENT METHODS: • • •

Demonstration Oral questioning Portfolio

Date Developed:


May 2014

Date Revised:



Revision # 01

Learning Experiences Learning Outcome 1 PREPARE TO ASSIST WITH PATIENT MOBILITY Learning Activities

Special Instructions

1. Read Information Sheet 3.1-1 on Patients’ Rights 2. Answer Self-check 3.1-1 about Patient’s Rights Compare your answer with Self-Check Answer Key 1.1-1.

Read and understand the information sheet and Check yourself by answering the Self-check. You must answer all questions correctly before proceeding to the next activity

3. Read Information Sheet 3.1-2 on Asepsis and Infection Control

4. Answer Self-check 3.1-2 about Asepsis and Infection Control Compare your answer with Selfcheck Answer Key 3.1-2 5. Read Information Sheet 3.1-3 on Procedures for Proper Hand Washing 6. Perform Task sheet 3.1-1 on Hand Washing Evaluate your output using the Performance Criteria Checklist 3.1-1 before showing it to your trainer.

7. Read Information Sheet 3.1-4 on Procedures for Donning and Removing Gloves 8. Perform Task Sheet 3.1-2 on Donning and Removing Gloves Evaluate your output using the Performance Criteria Checklist 3.1-2 before showing it to your trainer.

9. Read Information Sheet 3.1-5 on Health Care Waste Management 10. Answer Self-check 3.1-3 about Health Care Waste Management Compare your answer with Self-check Answer Key 3.1-3 Date Developed:


May 2014

Date Revised:



Revision # 01

11. Read Information Sheet 3.1-6 about Principles of Proper Body Mechanics

12. Answer Self-check 3.1-4 about Principles of Proper Body Mechanics 13. Read Information Sheet 3.1-7 about Client Safety Equipment

Self-check 3.1-5 about 14.Client Answer safety Equipment

Date Developed:


May 2014

Date Revised:



Revision # 01

Information Sheet 3.1-1 Patient’s Rights Learning Objectives After reading this Information Sheet, you should be able to: 1. Identify the patient’s rights being practiced in the local hospitals 2. Differentiate practices that honor the patient’s rights from those that violate them. To be able to perform your tasks as a health care giver properly and correctly, one of the factors that you will need to consider is the patient’s rights. Knowing the rights of the patient addresses the expectations, privileges and responsibilities of the patient while receiving care in the hospital and ranges from hospital care to preparing to leave the hospital and eventually even home based care. With health care provision progressing from hospital based care to home care, we must also take in consideration how different institutions and health care professional groups define patient’s rights. Here are some of the most common rights health care professionals acknowledge.

Financial Issues •

•

Without looking at the aspect of monthly income, a patient has the right to be treated with considerate and respectful care. The patient has the right to examine and receive an explanation of his bill regardless of the source of payment.

Health Care Treatment Issues •

•

•

The patient has the right to know from his physician what his/ her present diagnosis is, the treatments to be done and given, the status of prognosis and those persons involved in the care as simply as can be understood by the patient. If information is deemed to be harmful to the patient or is medically inappropriate, it can be disclosed to an appropriate person. An informed consent should first be made by a patient before undergoing any kind of treatment (medication, therapy, etc.)include or procedure (surgery, radiography, etc.) The informed consent should identifying what procedure or treatment will be done, the risks that may likely occur if the procedure or treatment is done, even if there is risk of dying, and knowing who the persons involved in the treatment or procedure are. An Alternative treatment/ procedure should be given as an option to the patient. The patient has the right to refuse any treatment, procedure or any lifegiving measure as long as the patient is able to decide for himself/ herself with the possible consequences of his actions explained to him/ her. Date Developed:


May 2014

Date Revised:



Revision # 01

•

The patient has the right to request for services from the hospital as long as it is reasonable and within the institution’s capacity. If in case the hospital lacks resources to serve the patient’s needs, a referral may be made with other services aside from the institution or to another health care facility. The transfer of a patient from one health care professional, department or institution to another should only be made if it is medically permissible for the patient and if all information (including risks and alternatives) has been fully given. However, the transfer of the patient from one health care professional, department or institution to another can only be completed if the health care professional,

department or institution accepts the patient. The patient has the right to expect reasonable continuity of care, to know in advance the appointment times the physicians are available and where. The patient also has the right to expect the health care institution to provide information regarding the patient’s continuing health care requirements following discharge either from his/ her physician or a delegate. • The patient has the right to know what hospital rules and regulation apply to his conduct as a patient. Privacy Issues • The privacy of the patient is very important. Case discussions, consultations, treatments, and examination are confidential and should be strictly conducted discreetly. Researches, case studies, interviews, etc. from those not directly involved in the patient’s care must have permission from the patient first. •

•

All communications treated as confidential.(written, spoken, non-verbal) should always be

Research and Academic Issues •

The patient has the right to know if the hospital he/ she is admitted in has any relationship with other health care service and/ or educational system, and if his/ her health care provider is not of his preference (e.g a student, a midwife, the gender of the provider, etc.) The patient has the right to choose and/ or change his/ her health care provider.

•

The patient has the right to refuse or participate in a research project the health care provider/ institution is conducting. He/ she must be advised appropriately regarding the research experiment affecting his/ her care and treatment.

Date Developed:


May 2014

Date Revised:



Revision # 01

Self-Check 3.1-1 Patient’s Rights IDENTIFICATION This quiz will test how well you understood the topic on Patient’s Rights and is designed in seven items to be completed within an ideal duration of 15 minutes. The following are health care situations. Identify whether they honor the patient’s rights or not. Draw a CIRCLE ( ) on Column B if the situation honors the right of the patient and an X mark if it violates them. A

B

1. Mr. Raul is due for surgery of his appendicitis. The surgeon has explained how the surgery will be done, the risks during and after surgery and the alternative treatment available. 2. Nurse Ana is in charge of Mrs. Lampitoc in the Delivery Room-Charity Ward and intentionally does not replace her gloves in every other Internal Examination because the patient does not afford buying three sets of sterile gloves. 3. Mrs. Lo has just delivered a premature baby under poor prognosis due to asphyxiation during the birthing process. Mrs. Lo asks for her baby’s condition but her obstetrician refuses to answer. 4. Mr. Yoso, a cognitively able stage-4 lung cancer patient has signed for an informed consent and a Do-Not-Resuscitate order. By 3 am, he seizes and undergoes cardiac arrest. The nurse in charge of his care gives him morphine for pain but does not start CPR. 5. Nurse Karen does not continue the administration of enema to Ms. Gina, a patient with a recent rape history, as she refuses to accept any treatment given through the anus. 6. The nurse in charge of Mr. de la Merced, who is requesting for a respiratory therapist for her nebulization, rejects him justifying that a respiratory therapist is too costly and that it easy for a nurse to operate a nebulizer. 7. Nurse Alan and Nurse Jackson are close friends and work in the same hospital but in different wards. Nurse Alan sees from the other ward that Nurse Jackson is caring for his ex-girlfriend’s new boyfriend and so asks Nurse Jackson about the patient’s diagnosis and condition. Nurse Jackson refuses to answer.

Date Developed:


May 2014

Date Revised:



Revision # 01

Self-Check Answer Key Patient’s Rights

A

B

8. Mr. Raul is due for surgery of his appendicitis. The surgeon has explained how the surgery will be done, the risks during and after surgery and the alternative treatment available. 9. Nurse Ana is in charge of Mrs. Lampitoc in the Delivery Room-Charity Ward and intentionally does not replace her gloves in every other Internal Examination because the patient does not afford buying three sets of sterile gloves. 10. Mrs. Lo has just delivered a premature baby under poor prognosis due to asphyxiation during the birthing process. Mrs. Lo asks for her baby’s condition but her obstetrician refuses to answer. 11. Mr. Yoso, a cognitively able stage-4 lung cancer patient has signed for an informed consent and a Do-Not-Resuscitate order. By 3 am, he seizes and undergoes cardiac arrest. The nurse in charge of his care gives him morphine for pain but does not start CPR. 12. Nurse Karen does not continue the administration of enema to Ms. Gina, a patient a recent rape history, as she refuses to accept any treatment given throughwith the anus. 13. The nurse in charge of Mr. de la Merced, who is requesting for a respiratory therapist for her nebulization, rejects him justifying that a respiratory therapist is too costly and that it easy for a nurse to operate a nebulizer. 14. Nurse Alan and Nurse Jackson are close friends and work in the same hospital but in different wards. Nurse Alan sees from the other ward that Nurse Jackson is caring for his ex-girlfriend’s new boyfriend and so asks Nurse Jackson about the patient’s diagnosis and condition. Nurse Jackson refuses to answer.

Date Developed:


May 2014

Date Revised:



Revision # 01

Information Sheet 3.1-2 Asepsis and Infection Control Learning Objectives After reading this Information Sheet, you should be able to: 3. Explain the chain of infection and the identify means to break each link. 4. Explain the Concepts of Medical and Surgical Asepsis 5. Identify interventions to reduce risks for infections. 6. Correctly implement aseptic processes 7. Enumerate the different classifications of health care waste 8. Describe the measures for health care waste management.

Being a Health Care Service provider, it is necessary for us to be knowledgeable about the different concepts of Asepsis, Infection Control and Health Care Waste Management, especially that we are working with peoples. When we talk about Asepsis and Infection Control, we are focused on preventing the transmission of microorganisms from one entity to another, say, from a person to another, from an animal to a person or from an object to a person. Microorganisms are all around us and we cannot simply generalize by thatmicroorganisms. all of them are harmful. of our harmful; body surfaces are even inhabited Some areMost naturally however, even the “harmless” microorganisms become harmful in certain circumstances. Health Care Waste Management is a universal system that health care providers follow to ensure the minimization of waste production and the contamination of peoples from unnecessary sources. Examining this section will help you know how to get involved in the identification, prevention, and control of infection; and participate in health care waste management by knowing the different procedures and systems of waste segregation.

Asepsis Microorganisms are tiny, microscopic entities naturally present and thriving in the environment. Two Types of Microorganisms 1. Non-pathogens are microorganisms that do not cause diseases 2. The pathogens are microorganisms that cause diseases.

Resident Flora/ Normal Flora are naturally present microorganism (usually bacteria) that thrives in or on specific parts of the body like the skin or the digestive system which aids in the functioning of the body part or system. Date Developed:


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However, these microorganisms may also cause an infection if their number rises substantially higher than usual or when the microorganisms migrate to another part of the body. For example, the normal flora E. coli in the large intestines can become infectious to the host if it migrates to the mouth or the vagina.

Infections are invasions of the body tissue by microorganisms and their eventual population in that area. Infection results when the body is invaded by pathogens.

Infectious agent: A microorganism that produces an infection Asymptomatic Infection: an infection that does not produce any sign or symptom of disease. Nosocomial Infection: are infections obtained from the health care facility or because of a given health care therapy. Disease: An obvious and abnormal change in normal tissue function. Virulence: a microorganism’s ability to produce disease. Opportunistic Pathogen: A pathogen that only produces disease on immunosuppressed (individuals whose immune system are intentionally brought down because of medical regimen like that of chemotherapy or organ transplant, or because of a current disease process like that of HIV or AIDS) or susceptible individuals. Client safety in the health care environment requires the reduction of microorganism transmission. Thus, infection control practices are directed at controlling or eliminating sources of infection. Health care workers are responsible for protecting clients and themselves using the aseptic technique.

Asepsis is a condition of freedom from disease-causing microorganisms. Aseptic Technique is a strategy used to decrease the possibility of transferring microorganisms from one place to another. Two Types of Asepsis 1. Medical Asepsis includes all practices intended to confine a specific microorganism to a specific area, limiting the number, growth and transmission of microorganisms. In medical asepsis, objects are referred to as clean, which means the absence of almost all microorganisms, or dirty which means likely to have microorganisms, some of which may be capable of causing infections. U

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2. Surgical Asepsis, also known as Sterile Technique, refers to those practices that keep an area or object free of all microorganisms; It includes practices that destroy all microorganisms and spores. Sterile technique is used for all procedures involving the sterile areas of the body like the internal organs and cavities. Date Developed:


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Types of Microorganisms Causing Infections Bacteria: the most common infection- causing microorganisms. There are several hundreds of species that can cause disease in humans and can live and be transported through air, food, water, soil, body tissues and fluids and inanimate objects. Viruses: consists primarily of nucleic acid and therefore must enter living cells in order to reproduce. a membersuch of a as large group of molds, eukaryotic organisms that includes Fungi: microorganisms yeasts and as well as the more familiar mushrooms

Types of Infections Colonization: the process by which strains of microorganisms become resident flora. Local Infection: an infection that is limmited to the specific part of the body where the microorganisms remain. Systemic Infection: if the microorganisms spread ad damage different parts of the body. Bacteremia: When a culture of a person’s blood reveals microorganisms. Septicemia: When bacteremia results in systemic infection. Acute Infections: infections that generally appear suddenly or last a short time. Chronic Infections: occurs slowly, over a very long period and may last for months or years. The Chain of Infection U

An infection, which is a state of the body in disease resulting from the presence of pathogens in or on the body, occurs as a result of a cyclical process that involves the following elements: 1. An infectious I etiologic agent or pathogen 2. A reservoir or source for the growth of a pathogen 3. A portal of exit or method of escape of the pathogen from the reservoir 4. A mode of transmission 5. A portal of entry to the host 6. A susceptible host

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Infectious Agent (Etiologic Agent or Pathogen) are Pathogenic organisms that include bacteria, viruses, fungi and parasites. The extent to which any microorganism is capable of producing an infectious process depends on the following: a. b. c. d.

number of organisms virulence or ability to produce disease ability to enter and survive in the host susceptibility of host

Reservoir is basically the habitat of the pathogen. Pathogens have many sources or reservoirs for growth. Common sources are other humans, the client’s own microorganisms, plants, animals, or the general environment (air, water, food, soil). A carrier is a person or animal reservoir of specific infectious agent that does not usually manifest any clinical signs of disease. Portal of Exit Before an infection can establish itself in a host, the pathogens must leave the reservoir. If the reservoir is a human being, the pathogens can have the following exits: Respiratory tract : droplets, sputum Gastrointestinal tract : saliva, vomitus, feces, drainage tubes Urinary tract : urine, urethral catheters Reproductive tract : semen, vaginal discharges Blood : open wound, needle puncture site

Mode of Transmission Pathogens are carried or transmitted from the reservoir to the host through the following mechanisms: 1. Direct Transmission involves immediate and direct transfer of pathogens from person to person through touching, biting, kissing, or sexual intercourse. 2. Indirect Transmission may be either vehicle-borne or vectorborne. a) Vehicle-borne transmission. A vehicle is any substance that serves as an immediate means to transport and introduce an infectious agent into a susceptible host through a suitable portal of entry. Examples include fomites, (inanimate materials and objects), like handkerchiefs, toys, soiled clothes, surgical instruments or dressings); water, food, blood, serum and plasma.

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b) Vector-borne transmission. A vector is an animal or a flying or crawling insect that serves as an immediate means of transporting the infectious agent. Examples are rats, snails, mosquitoes.

3. Airborne Transmission. It may involve droplets or dusts. Droplet nuclei, the residue of evaporated droplets emitted by an hostLikewise, can remain in the air for longinfected periods. dust particles containing the infectious agent can be transmitted by air currents to a suitable portal of entry, usually the respiratory tract, of another person

Portal of Entry includes body orifices like the mouth, nose, ears, eyes, vagina, rectum or urethra. Breaks in the skin or mucous membranes from wounds or abrasions increase chances for pathogens to enter the host. Pathogens can enter the body through the same routes they use for exiting. A Susceptible Host is any person who is at risk for infection. A compromised host is aisperson “at increased risk to ,” an individual who for one or more reasons more likely than others acquire an infection. Impairment of the body’s natural defenses and a number of other factors can affect susceptibility to infection. Examples include age, (the very young and the very old), clients receiving immune suppression treatment for cancer, chronic illness, or following a successful organ transplant; and those with immune deficiency conditions.

Stages of the Infectious Process U

• Incubation Period

is the interval between the entrance of the pathogen into the body and the appearance of the first symptoms. (e.g., chickenpox, 2-3 weeks; common colds, 1-2 days; influenza, 1-3 days; mumps, 18 days) • Prodromal Period

is the interval from the onset of nonspecific signs

and symptoms (malaise, fever, fatigue) grow to more specific symptoms. It is during this low-grade stage that the pathogens and multiply, so that the person is more capable of spreading the disease to others. • Illness Period.

Interval when the client manifests signs and symptoms specific to type of infection (e.g., common cold manifested by sore throat, sinus congestion, rhinitis; mumps manifested by earache, high fever, parotid and salivary gland swelling) •

Convalescence Period is the interval when acute symptoms of infection disappear. The length of recovery depends on the severity of infection and the client’s general state of health. Date Developed:


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Asepsis is the absence of all disease-producing microorganisms. Aseptic technique is the effort to keep a client free from hospital microorganisms. The two types of asepsis are medical and surgical asepsis.

Breaking The Chain of Infection U

Medical Asepsis or “clean technique” includes practices or procedures that reduce the number and transmission of pathogens. Medical asepsis destroys organisms after they leave the body. This types of asepsis protects the health care giver. Surgical asepsis or “sterile technique” includes practices or procedures that destroy all microorganisms and their spores. Sterile technique is practiced in the operating room and treatment areas. In this type of asepsis, an area or object is considered contaminated if touched by any object that is not sterile. Surgical asepsis destroys organisms before they enter the body. This type of asepsis protects the client.

Medical Aseptic Practices 1. Hand washing - the single most important infection control practice. 2. Cleaning - the physical removal of visible dirt by washing using soap and water. 3. Disinfection -the use of chemical preparations to reduce the number of pathogens on inanimate objects but not necessarily destroying the spores. 4. Use of barriers or techniques that prevent the transfer of pathogens from one person to another. The most commonly used barriers are gloves, masks, caps, gowns, shoe coverings, goggles or face shields, waterproof disposable bags for linens and trash, labeling and bagging of contaminated equipment and specimen, private rooms and the control of airflow into the sterile areas and out of contaminated areas. 5. Proper waste segregation and disposal 6. Isolation systems Surgical Aseptic Practice 1. Sterilization- The process that destroys all microorganisms including spores and viruses using moist heat, gas, radiation, chemicals and boiling water. 2. Donning and removing cap and mask. For sterile surgical procedures in the operating room or delivery room, a cloth or paper cap is worn over the head covering all the hair. Date Developed:


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A mask is also worn fitted snugly over the nose and mouth to prevent droplet nuclei. After a surgical procedure, remove gloves before removing mask and cap to prevent contaminating the hair, neck and face. Untie the mask, hold it by the ties and discard it with the cap. 3. Donning sterile gloves There are two methods of donning sterile gloves: open and closed. Open gloving is usually used when changing dressings and inserting urinary catheters. The closed method is practiced in the operating room and special treatment areas. U

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Standard Precautions for Infection Control U

Standard Precautions are to be used for all clients receiving care in hospitals without regard to their diagnosis or presumed infection status. Standard Precautions apply to blood; all body fluids, secretions and excretions except sweat, regardless of the presence of visible blood; non-intact skin; and mucous membranes.

Wash Hands (use plain soap) • • •

Wash after touching blood, body fluids, secretions, excretions and contaminated items. Wash immediately after gloves are removed and between patient contacts. Avoid transfer of microorganisms to other patients or environments.

Wear Gloves • • •

Wear when touching blood, body fluids, secretions, excretions and contaminated items. Put on clean gloves just before touching mucous membranes and non-intact skin. Change gloves between tasks and procedures on the same patient after contact with material that may contain high concentrations of microorganisms. Remove gloves promptly after use, before touching non-contaminated items and environmental surfaces, and before going to another patient, and wash hands immediately to avoid transfer of microorganisms to other patients or environments.

Wear Mask and Eye Protection or Face Shield •

Protect mucous membranes of the eyes, nose and mouth during procedures and patient-care activities that are likely to generate splashes or sprays of blood, excretions.

body

fluids,

secretions

or

Wear Gown •

Protect skin and prevent soiling of clothing during procedures that are likely to generate splashes or sprays of blood, body fluids, secretions or excretions. Remove a soiled gown as promptly as possible and wash hands to avoid transfer of microorganisms to other Date Developed:


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patients or environments.

Patient-Care Equipment •

Handle used patient-care equipment soiled with blood, body fluids, secretions or excretions in a manner that prevents skin and mucous membrane exposure, contamination of clothing, and transfer of microorganisms to other patients and environments. Ensure that reusable equipment is not used for the care of another patient until it has been appropriately cleaned and reprocessed and single use items are properly

discarded. Environmental Control •

Follow hospital procedures for routine care, cleaning and disinfection of environmental surfaces, beds, bedrails, bedside equipment and other frequently touched surfaces.

•

Handle, transport, and process used linen soiled with blood, body fluids, secretions or excretions in a manner that prevents exposures and contamination of clothing and avoids transfer of microorganisms to other patients and environments.

Linen

Occupational Health and Blood-borne Pathogens •

•

•

•

Prevent injuries when using needles, scalpels and other sharp instruments or devices; when handling sharp instruments after procedures; when cleaning used instruments; and when disposing of used needles. Do not remove used needles from disposable syringes by hand; and do not bend, break or otherwise manipulate used needles by hand. Place used disposable syringes and needles, scalpel blades, and other sharp items in puncture- resistant sharps containers located as close as practical to the area in which the items were used, and place reusable syringes and needles in a puncture resistant container for transfer to the reprocessing area. Use resuscitation devices as an alternative to mouth-to-mouth resuscitation.

Never recap used needles using both hands or any other technique that involves directing the point of a needle toward any part of the body; rather, use either a one-handed “scoop” technique or a mechanical device designed for holding the needle sheath Date Developed:


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Patient Placement •

•

Use a private room for a patient who contaminates the environment or who does not (or cannot be expected to) assist in maintaining appropriate hygiene or environmental control. Consult Infection Control if a private room is not available.

Principles of Basic Infection Control U

In all aspects of patient care, the following principles should be observed to minimize the spread of microorganisms.

Principle

Rationale

1. Microorganisms move through space on air currents.

Because of this movement, avoid shaking or tossing linens.

2. Microorganisms are transferred from one surface to another whenever objects touch. When a clean item touches a less clean item, it becomes “dirty,” because microorganisms are transferred to it.

Therefore, keep your hands away from your own hair and face, keep linens away from your uniform, and always keep clean items separate from dirty ones. If you drop anything on the floor, consider it dirty.

3. Microorganisms are transferred by gravity when one item is held above another.

Avoid passing dirty items over clean items or areas because it is possible for microorganisms to drop off onto a clean item or area.

4. Microorganisms are released into the air on droplet nuclei whenever a person breathes or speaks. Coughing or sneezing dramatically increases the number of microorganisms released from the mouth and nose.

Avoid having a patient breathe directly into your face, and avoid breathing directly into a client’s face.

5. Microorganisms move slowly on dry surfaces but very quickly through moisture.

For this reason, use a dry paper towel when you turn off faucets, and dry a bath basin before you return it to a bedside stand for storage.

6. Proper hand washing removes many of the microorganisms that would be transferred by the hands from one item to another.

Wash your hands not only when they are obviously soiled, but whenever you move from one client to another or from patient contact to contact with the general environment or vice versa.

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7. Blood-borne infections may be spread to another person by contact with items contaminated with blood and body substances that contain the blood-borne organism through open wounds and sores, non-intact mucous membranes, and penetrating injuries.

Health care workers can protect themselves from these bloodborne infections by using precautions that prevent contact with blood and body fluids that transmit blood-borne pathogens.

Principles of Surgical Asepsis 1. A sterile object remains sterile only when touched by another sterile object. a. Sterile touching sterile remains sterile. b. Sterile touching clean becomes contaminated. c. Sterile touching contaminated becomes contaminated. d. Sterile touching questionable is contaminated. 2. Only sterile objects may be placed on a sterile field. All items are properly sterilized before use. 3. A sterile object or field that is out of vision and an object held below the waist level are considered unsterile. Do not turn your back on a sterile tray or leave it unattended. 4. A sterile object or field can become unsterile by prolonged exposure to airborne microorganisms. 5. Moisture that passes through a sterile object draws microorganisms from unsterile surfaces above or below to the sterile surface by capillary action. 6. Fluids flow in the direction of gravity. A sterile object becomes contaminated if gravity causes a contaminated liquid to flow over the object’s surface. 7. The edges of a sterile field are considered unsterile. Place all sterile objects more than 2.5 em. inside the edges of the sterile field. 8. The skin cannot be sterilized and so is unsterile. 9. All items brought in contact with broken skin, used to penetrate the skin to inject substances into the body, or used to enter normally sterile body cavities should be sterile (e.g.; dressings to cover wounds and incisions, needles for injection and urinary catheters). 10. Avoid talking, coughing, sneezing, or reaching over a sterile field or object to prevent contamination by droplets from the nose and mouth or by particles dropping from the worker’s arms. 11. Conscientiousness, alertness and honesty are essential qualities in maintaining surgical asepsis.

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Surgical Aseptic Practices 1. Donning and removing cap and mask. • For sterile surgical procedures in the operating room or delivery room, a cloth or paper cap is worn over the head covering all the hair. • A mask is also worn fitted snugly over the nose and mouth to prevent droplet nuclei. • After a surgical procedure, remove gloves before removing mask and cap to prevent contaminating the hair, neck and face. • Untie the mask, hold it by the ties and discard it with the cap. 2. Donning sterile gloves • There are two methods of donning sterile gloves: open and closed. • Open gloving is usually used when changing dressings and inserting urinary catheters. • The closed method is practiced in the operating room and special treatment areas.

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Self-Check 3.1-2 Asepsis and Infection Control MULTIPLE-CHOICE

This quiz will test how well you understood the topic on Asepsis and Infection Control and is designed in ten items to be completed within an ideal duration of 20 minutes. The following are questions or statements that pertain to microorganisms, asepsis and infection control. Choose the letter of your chosen answer and write them in capital letters in Column B.

A

B

1. They are tiny living beings that make their presence known only by their effect. a. Dwarves b. Microorganisms c. Organisms d. Pathogens 2. These are microbes that are useful to human beings a. Eubacteria b. Microorganisms c. Non-pathogens d. Pathogens 3. They are microbes that causes diseases to human are called: a. Eubacteria b. Microorganisms c. Non-pathogens d. Pathogens 4. Which of the following is not a classification of microorganisms? a. Bacteria b. Cholera c. Protozoa d. Virus 5. Which statement is true about the Human Normal Flora? a. Normal body flora are cells that attack foreign bodies b. Normal body flora are flowers that normally grow inside the human body c. Normal body flora are naturally residing microorganisms in the human body. d. Normal body flora are the same in each part of the body

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6. Among the chain of infection, this is the part that causes the disease a. Causative agent b. Mode of transmission c. Portal of exit d. Reservoir 7. This is a person who will become ill from the entry of pathogens into the body. a. Causative agent b. Portal of entry c. Reservoir d. Susceptible host 8. It is where the pathogens can survive. a. Causative agent b. Portal of entry c. Reservoir d. Susceptible host 9. Which is not a way of transmitting a disease a. Airborne transmission b. Contact transmission c. Droplet transmission d. Mucosal transmission 10. These are people who have pathogens in their bodies but does not show signs of the disease are called: a. Carriers b. Immune c. Parasites d. Pathogens

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Self-Check Answer Key Asepsis and Infection Control

A

B

1. They are tiny living beings that make their presence known only by their effect. a. Dwarves

2.

3.

4.

5.

6.

b. Microorganisms c. Organisms d. Pathogens These are microbes that are useful to human beings a. Eubacteria b. Microorganisms c. Non-pathogens d. Pathogens They are microbes that causes diseases to humans: a. Eubacteria b. Microorganisms c. Non-pathogens d. Pathogens Which of the following is not a classification of microorganisms? a. Bacteria b. Cholera c. Protozoa d. Virus Which statement is TRUE about the Human Normal Flora? a. Normal body flora are cells that attack foreign bodies b. Normal body flora are flowers that normally grow inside the human body c. Normal body flora are naturally residing microorganisms in the human body. d. Normal body flora are the same in each part of the body Among the chain of infection, this is the part that causes the disease a. Causative agent b. Mode of transmission

c. Portal of exit d. Reservoir 7. This is a person who will become ill from the entry of pathogens into the body. a. Causative agent b. Portal of entry c. Reservoir d. Susceptible host

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B

C

D

B

C

A

D



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8. It is where the pathogens can survive. a. Causative agent b. Portal of entry c. Reservoir d. Susceptible host 9. Which is not a way of transmitting a disease a. Airborne transmission b. Contact transmission c. Droplet transmission d. Mucosal transmission

C

D

10. These are people who have pathogens in their bodies but does not show signs of the disease are called: a. Carriers b. Immune c. Parasites d. Pathogens

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Information Sheet 3.1-3 Procedures for Proper Hand Washing Learning Objectives After reading this Information Sheet, you should be able to: 1. Explain the correct sequence of proper hand washing. 2. Perform the correct hand washing procedure. In the previous information sheet you have read about Asepsis and Infection Control, you have learned that there are two aseptic techniques that can be used to deter microorganisms on a body surface- the medical asepsis and the surgical asepsis. Medical asepsis reduces the amount of microorganisms in a body surface and protects the health care giver while surgical asepsis is a practice that eliminates all microorganism in a body surface and is used to protect the patient. There is a proper way to perform hand washing and three factors are of utmost importance: soap, friction and water.

Purposes: • To reduce the number of microorganisms on the hands. • To reduce the risk of transmission of microorganisms to clients. • To reduce the risk of cross-contamination among clients. • To reduce the risk of transmission of infectious organisms to oneself. Equipment: • • •

Liquid/ bar soap Cloth or paper towels Water

Action

Rationale

1. Assess condition of hands for hangnails, cuts or breaks in the skin, as well as extent and areas of contamination.

Intact skin acts as a barrier to microorganisms. Breaks in skin integrity facilitate development of infection and should receive extra attention during cleaning.

2. Remove jewelry. Roll sleeves of uniform.

Microorganisms can lodge in the settings of jewelry and under rings. Provides access to skin surfaces. Facilitates cleaning of hands and forearms.

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3. Stand in front of the sink. Keep hands and uniform away from the sink surface.

The sink is a contaminated area.

4. Consider type of faucet. Turn on the

Running water removes microorganisms. Warm water is more comfortable and is less likely to open

water. Adjust the flow and temperature. Water temperature should be preferably warm. 5. Wet hands and wrists thoroughly under running water. Keep hands and forearms lower than elbows. Avoid splashing water and touching the sides of the sink.

Reaching over the sink increases risk of touching the edge which is contaminated.

pores and remove oils from the skin.

Water should flow from the least to the most contaminated area The hands are generally considered more contaminated than the lower arms. Splashing of water facilitates transfer of microorganisms. Touching of any surface during cleaning contaminates the skin.

6. Apply about 5 ml. (1 teaspoon) of liquid soap. Lather thoroughly. If bar soap is used, rub it firmly between the hands. Rinse soap and drop it into the soap dish.

Liquid soap harbors less bacteria than bar soap. Lather facilitates removal of microorganisms. Rinsing the bar of soap prevents the spread of microorganism to the next user.

7. Wash hands using plenty of lather and friction for about 10-

Friction and circular action mechanically loosen and remove dirt and

15 seconds. Use firm, rubbing and circular movements to wash the palm, back, wrist and fingers of each hand. Interlace the fingers and thumbs, and move the hands back and forth. Rub the fingertips against the palm of the

microorganisms. Interlacing the fingers and thumbs cleans the interdigital spaces. The nails and fingertips are commonly missed during hand washing.

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opposite hand. If nails are dirty, clean these using a flat toothpick or use the fingernails of the opposite hand. 8. Rinse hands and wrists thoroughly keeping hands lower than the elbows.

Rinsing washes away dirt and microorganisms. Gravity allows water to drain from an area of lesser contamination to an area of greater contaminated.

9. With a towel, blot hands and forearms to dry thoroughly. Dry in the direction of fingers to wrist and forearm. Discard paper towels in the proper receptacle.

Blotting reduces chapping of skin. Drying from cleanest (hand) to least clean area (forearm) prevents transfer of microorganisms to cleanest area.

10. Turn off the faucet with a clean dry paper towel.

Prevents contamination of clean hands by a less clean faucet.

• •

•

•

•

•

Three elements of hand washing: water, soap and friction. Soaps and detergents help remove dirt because these lower surface tension and act as emulsifying agents. Wash hands for 10 - 30 seconds for minimal contamination 1 - 2 minutes for moderate contamination and 3 - 4 minutes for heavy contamination. Repeat washing procedure as necessary. When hands are heavily contaminated; a second and even a third washing is necessary to remove all dirt and organisms. Wash at least 1 inch above area of contamination. Clean under the nails using a flat toothpick

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Task Sheet 3.1-1 Title

Hand Washing

Performance Objective

Given a task with several clients, you should be able to perform the hand washing procedure correctly following the steps given in the previous information sheet in duration of not less than 30 seconds, but not more than three minutes.

Supplies/ Materials/ Equipment

Liquid/ bar soap Cloth or paper towels Running Water Procedure Checklist (Use Information Sheet 3.1-3) 1. Gather needed supplies to a sink. 2. Using the steps provided in the Information Sheet, demonstrate the proper hand washing technique. 3. Make sure to briefly explain important points during the hand washing procedure 4. Implement after-care procedures.

Steps/ Procedure

Assessment Method

Demonstration Portfolio Assessment using the Performance Criteria Checklist

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Performance Checklist 3.1-1

Criteria

Yes

No

Did you… 1. Have a complete set of supplies? 2. Assess condition of hands for hangnails, cuts or breaks in skin,any as well as extent and your areassleeves of contamination. 3. the Remove jewelry and rolled up to your elbow? 4. Keep distance from the sink surface while you were performing the procedure? 5. Assess the type of faucet, examining it before actually turning it on? 6. Gradually turn on the faucet so that it will not spray water? 7. Wet your hands thoroughly under running water? 8. Keep your hands lower than your elbows while washing, and making sure that your hands don’t touch the surface of the sink? 9. Lather thoroughly with a 5 ml of soap or rubbed firmly with a bar soap between your hands and eventually dropping the bar of soap once you were done? 10. Wash hands using plenty of friction in a firm, rubbing and circular manner for 10 - 30 seconds for minimal contamination 1 - 2 minutes for moderate contamination and 3 - 4 minutes for heavy contamination? 11. Use a flat toothpick or the nails of your opposite hand to clean through dirty finger nails? 12. Rinse your hands and wrists thoroughly keeping your hands lower than your elbows? 13. Repeat washing procedure as necessary when hands are extra dirty? 14. Blot your hands from fingers to wrist to forearm with a dry paper towel to dry your hands? 15. Use a clean paper towel to turn off the faucet? 16. Explain the importance of doing significant procedures as you perform the hand washing technique? 17. Implement after care procedures

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Information Sheet 3.1-4 Procedures for Donning and Removing Gloves Learning Objectives

After reading this Information Sheet, you should be able to: 1. Explain the significance of surgical asepsis. 2. Handle sterile objects properly. 3. Efficiently don sterile gloves using the sterile technique 4. Appropriately remove and dispose used gloves. In the previous learning material you have read about the concept of asepsis and infection control. You have also practiced how to perform medical asepsis through the proper hand washing technique in the previous task sheet. Here, you are going to practice surgical asepsis or sterile technique. When we talk about surgical asepsis, we are eliminating all possible microorganisms in a body surface for the primary purpose of protecting the client from infection, and preventing contamination of a sterile field. Run through the following procedures and practice proper donning of gloves which is one of the most common ways of maintaining sterility. Purposes: • To protect the hands when the nurse is likely to handle any body substances like, blood, urine, feces, sputum, mucous membranes, and non-intact skin. • To reduce the likelihood of nurses transmitting their own endogenous microorganisms to clients receiving care. • To reduce the chance that the nurse’s hands will transmit microorganisms from one client or a fomite to another client. Equipment: • Package of proper-sized sterile gloves.

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Actions 1. Wash your hands. 2. Place sterile glove package on clean, dry surface at or above you waist. 3. Open the outside wrapper by carefully peeling the top layer back. Remove inner package handling only the outside of it.

Rationale Deters the spread of microorganisms. Moisture could contaminate the sterile

gloves. Any sterile object held below the waist is considered contaminated. This maintains sterility of gloves in inner packet.

4. Place the inner package on the work surface with the ‘cuff end’ closest to the body.

Allows for ease of glove application.

5. Carefully open the inner package. Fold open the top flap, then the bottom and sides. Take care not to touch the inner surface of the package or the gloves. 6. With the thumb and first two fingers of the non-dominant hand, grasp the folded cuff of the glove for dominant hand, touching only the exposed inside of the glove. 7. Keeping the hands above the waistline, lift and hold the glove up and off the inner package with fingers down. Be careful it does not touch any unsterile object.

The inner surface of the package is considered sterile. The 1 inch border of the inner package is considered contaminated.

Unsterile hand touches only inside of glove. Outside remains sterile.

Glove is contaminated if it touches unsterile object.

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8. Carefully insert dominant hand palm up into glove and pull glove on. Leave the cuff folded until the other hand is gloved.

Attempting to turn upward with unsterile hand may result in contamination of sterile glove.

9. Hold the thumb of the gloved hand outward.

Thumb is less likely to become contaminated if

Place fingers of the the glovedthe hand inside cuff of the remaining glove. Lift it up from the wrapper, taking care not to touch anything with the gloves or hands. 10. Carefully insert non-dominant hand into glove. Pull the glove on, taking care that the skin does not touch any of the outer surfaces of the gloves.

held outward. Sterile surface touching sterile surface prevents contamination. Prevents contamination of clean hands by a less clean faucet.

11.so that Adjust each glove it fits smoothly, interlock fingers, and carefully pull the cuffs up by sliding the fingers under the cuffs. 12. Place the first two fingers of the bare hands inside the cuff of the opposite glove. Pull the second glove off the fingers and the first glove by turning it inside out.

Glove is removed andwith held without contact soiled surfaces.

13. Dispose soiled gloves properly. 14. Wash your hands

Contact of gloved hand with exposed hand results in contamination.

Glove is removed and held without contact with soiled surfaces. Exposes only the clean surface of the glove. Reduces the chance of transferring any microorganism by direct contact.

Prevents transmission of microorganisms. Deters the spread of microorganisms.

Date Developed:


May 2014

Date Revised:



Revision # 01

• •

Wash hands each time gloves are changed between client contact Wash hands each time gloves are removed because a) the gloves may have imperfections or be damaged during wearing allowing entry of microorganisms. b) the hands may become contaminated during removal of glove.

Date Developed:


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Revision # 01

Task Sheet 3.1-2 Title

Donning and Removing Gloves

Performance Objective

Given a sterile package of surgical gloves, you should be able to demonstrate efficient donning of gloves and accurately remove them afterwards.

Supplies/ Materials/

A pair of sterile surgical gloves

Equipment Steps/ Procedure

1. Gather needed supplies in a working table. 2. Using the steps provided in the information sheet 3.1-4, demonstrate the proper methods of donning and removing gloves. 3. Make sure to rationalize every action that is being performed. 4. Implement after care procedures.

Assessment Method

Demonstration Portfolio Assessment using the Performance Criteria Checklist

Date Developed:


May 2014

Date Revised:



Revision # 01

Performance Checklist 3.1-2

CRITERIA

YES

NO

Did you… 1. Gather all needed materials? 2. Place the inner package on the work surface with the ‘cuff end’ closest to the body to allow ease of access to the gloves? 3. Open the packaging carefully, making sure not to touch beyond one inch from the borders of the packaging? 4. Reach for the dominant hand’s glove with your nondominant hand by the folded cuff to preserve sterility? 5. Carefully insert the dominant hand palm up into glove and pull glove on, leaving the cuff folded until the other hand is gloved? 6. Hold the thumb of the gloved hand outward while placing the fingers if the gloved hand inside the cuff of the remaining glove and taking care to preserve the sterility of the glove? 7. Carefully pull the gloves on to better fit them onto your hands, making sure that the skin does not touch any outer surface of the gloves? 8. Pull the second glove off the fingers and the first glove by turning it inside out? 9. Rationalize every action that is being performed? 10. Implement after care procedures such as throwing the used gloves into the right receptacle and washing your hands?

Date Developed:


May 2014

Date Revised:



Revision # 01

Information Sheet 3.1-5 Health Care Waste Management Learning Objectives After reading this Information Sheet, you should be able to: 1. Enumerate the different classifications of health care waste 2. Describe the measures for health care waste management.

Being part of the health care delivery system, we are obliged to follow, not just strict aseptic technique, but also proper and systematic health care waste management. This section will introduce you to the principles of health care waste management and the universal system of health care waste management.

Health Care Waste Management U

•

Health care wastes include all the wastes that is generated or produced as a result of any of the following activities: –

Diagnosis, treatment, or immunization of human beings or animals

–

Production or testing of biologicals and

–

Waste srcinating from minor or scattered sources.

Categories of Health Care Waste 1. General Waste • Comparable to domestic waste, this type of waste does not pose special handling problem or hazard to human health or to the environment. • It comes mostly from the administrative and housekeeping functions of health care establishments and may also include waste generated during maintenance of health care premises. • They should be dealt with by the municipal waste disposal system.

2. Infectious Waste • This type of waste is suspected to contain pathogens (bacteria, viruses, parasites or fungi) in sufficient concentrations or quantity to cause disease in susceptible hosts. • Kinds of Infectious Wastes • Cultures and stocks of infectious agents from laboratory work • Waste from surgery and autopsies on patients with infectious diseases Date Developed:


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Revision # 01

Wastes from infected patients in isolation wards Waste that has been in contact with infected patients undergoing hemodialysis • Infected animals from laboratories • Any other instruments or materials that have been in contact with infected persons or animals 3. Pathological Waste • Consists of tissues, organs, body parts, human fetus and animal carcasses, blood and body fluids. • Within this category, recognizable human or animal body parts are also called anatomical waste. • This category should be considered as a subcategory of infectious waste, even though it may include healthy body parts 4. Sharps • Include needles, syringes, scalpels, saws, blades, broken glass, infusion sets, knives, nails and any other item that can cause a cut or puncture wound. • Whether or not they are infected, such items are usually considered as highly hazardous health care waste. 5. Pharmaceutical Waste • •

•

•

Includes expired, unused, spilt and contaminated pharmaceutical products, drugs, vaccines and sera that are no longer required and need to be disposed of appropriately. This category also includes discarded items used in handling of pharmaceuticals such as bottles or boxes with residues, gloves, masks, connecting tubing and drug vials.

6. Genotoxic Waste • Genotoxic waste may include certain cytostatic drugs, vomit, urine, or feces from patients treated with cytotoxic drugs, chemicals and radioactive materials. • This type of waste is highly hazardous and may have mutagenic, teratogenic or carcinogenic properties.

Harmful cytotoxic drugs can be categorized as follows 1. Alkylating agents: • Cause alkylation of DNA nucleotides, which leads to cross-linking and miscoding of the genetic stock; 2. Anti-metabolites: • Inhibit the biosythesis of nucleic acids in the cell; mitotic inhibitors prevent cell replication. • Cytotoxic wastes are generated from several sources and include the following: •

Date Developed:


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Revision # 01

1. Contaminated materials from drug preparation and administration, such as syringes, needles, gauges, vials, packaging; outdated drugs, excess solutions and drugs returned to wards. 2. Urine, feces, and vomit from patients which may contain potentially hazardous amounts of the administered cytotoxic drugs or of their metabolites and which should be considered genotoxic for at least 48 hours and sometimes up to 1 week after drug administration. 7. Chemical Waste •

•

•

•

Solid, liquid, and gaseous chemicals, for example from diagnostic and experimental work and from cleaning, housekeeping, and disinfecting procedures. 2 Classifications of Chemical Wastes • Hazardous Chemical Waste • Non-hazardous Chemical Waste Chemical waste is considered hazardous if it has at least one of the following properties: • Toxic • Corrosive • Flammable • Reactive • Genotoxic Non-hazardous chemical waste consists of chemicals with none of the abovesalts properties, such as sugars and certain organic and inorganic

8. Waste with high Content of Heavy Metals • Wastes with a high heavy-metal content represent a subcategory of hazardous chemical waste, and are usually highly toxic. • Mercury Waste: typically generated by spillage from broken clinical equipment. • Whenever possible, spilled drops of mercury should be recovered. • Residues from dentistry have high mercury content. • Cadmium Waste • Comes mainly from discarded batteries. • Certain reinforced wood panels containing lead is still being used in radiation proofing X-ray and diagnostic departments. 9. Pressurized Containers • Many types of gas are used in health care and are often stored in pressurized cylinders, cartridges and aerosol cans. • Aerosol cans should be disposed of right away • Whether inert or potentially harmful, gases in pressurized containers should always be handled with care; containers may explode if incinerated or accidentally punctured.

Date Developed:


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Revision # 01

10. Radioactive Waste • Includes disused sealed radiation sources; liquid and gaseous materials contaminated with radioactivity; Excreta of patients who underwent radionuclide diagnostic and therapeutic applications; paper-cups, straws, needles and syringes • It is produced as a result of procedures such as in vitro analysis of body tissues and fluids, inn vivo organ imaging, tumor localization and treatment, and various clinical studies involving the use of radioisotopes.

Health Care Waste Minimization

Residual Disposal Treatment Recycling Source reduction

In addressing waste management, waste minimization basically utilizes the first two elements that could help reduce the bulk of health care wastes for disposal- minimizing of waste by reducing the production from the source and recycling.

Waste Handling, Collection, Storage •

The effective management of health care waste considers the basic elements of waste minimization, segregation and proper identification of the waste.

Segregation •

•

•

•

The process of separating different types of waste at the point of generation and keeping wastes isolated from each other

Appropriate handling, treatment and disposal of waste by type reduce costs and do much to protect public health. Segregation at source should always be the responsibility of the producer. Segregation should take place as close as possible to where the waste is generated and should be maintained in storage areas and during transport Date Developed:


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Revision # 01

•

Hazardous Waste •

•

•

Should be placed in clearly marked containers that appropriately labeled for the type and weight of the waste.

are

Except with sharps and fluids, hazardous wastes are generally put in plastic bags, plastic lined cardboard boxes, or leaked proofed containers that meet the specific performance standards.

General waste containers placed beside infectious waste containers could result in better segregation.

Color Coding Scheme for Health Care Waste •

The most appropriate way of identifying the categories of health care waste is by sorting the waste into color-coded plastic bags or containers.

COLOR OF CONTAINER/ BAG

TYPE OF WASTE

Black Non-infectious, dry waste Green Non-infectious, wet waste (kitchen, dietary, etc.) Yellow Infectious and Pathological waste Yellow with Black Band Chemical waste including those with heavy metals

Orange Radioactive waste Red Sharps and pressurized containers

Apart from the color-coding system for health care waste, the following practice should also be observed a. Residuals of the general health care waste join the stream of domestic refuse or municipal solid waste for proper waste management. b. Sharps should be collected together, regardless of whether or not they are contaminated. –

Containers should be puncture proof (metal or high-density plastic) and fitted with covers.

Date Developed:


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Revision # 01

–

–

–

c.

Containers should be rigid and impermeable to contain not only the sharps but also any residual liquids from syringes. To discourage abuse, containers should be tamper proof (difficult to open or break) and needles and syringes should be rendered unusable. Where plastic or metal containers are unavailable or too costly, containers made of dense cardboard are recommended.

Bags and containers for infectious waste should be marked with international infectious substance symbol.

d. Highly infectious and other hazardous waste should, whenever possible, be treated immediately by any method recommended (It therefore needs to be packaged in bags that are compatible with the proposed treatment process. e. Cytotoxic waste, most of which is produced in major hospital research facilities, should be collected in strong, leak proof containers clearly labeled “cytotoxic waste” f. Radioactive wastes should be segregated according to its physical form: –

Solid

–

Liquid

–

According to its halflife or potency

g. Small amount of chemical or pharmaceutical waste may be collected together with infectious waste. h. Large quantities of obsolete or expired pharmaceuticals stored in hospital wards or departments should be returned to the pharmacy for disposal. –

–

Other pharmaceutical waste generated at this level, such ass expired drugs or packaging containing drug residues should not be returned because of the risk of contaminating the pharmacy. It should be deposited in the specified container at the point of generation.

i. Large quantities of chemical waste should be packed in chemical resistant containers and sent to specialized treatment facilities (if available). –

–

The identity of the chemicals should be clearly marked on the containers. Hazardous chemical waste of different types should never be mixed.

j. Waste with high content of heavy metals should be collected separately. These wastes can be sent to waste treatment facility available in the area. k. Aerosol containers may be collected with general health care waste once they are completely empty. Aerosol containers should not be burnt or incinerated. l. Appropriate containers or bag holder should be placed in all locations where particular categories of waste may be generated. Date Developed:


May 2014

Date Revised:



Revision # 01

m. Staff should never attempt to correct errors of segregation by removing items from a bag or container after disposal or by placing one bag inside another bag of a different color. –

If general and hazardous waste are accidentally mixed, the mixture should be classified as hazardous health care waste.

n. Cultural and religious constraints in certain parts of the country make it unacceptable for anatomical waste to be collected in the usual yellow bags –

Such waste should be disposed of in accordance with the local custom, which commonly specifies burial.

Date Developed:


May 2014

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Revision # 01

Self-Check 3.1-3 Health Care Waste Management ENUMERATION

This quiz will test how well you understood the topic on Heath Care waste and Health Care Waste Management and is designed to be completed within an ideal duration of 15 minutes. The following are questions or statements that pertain to concept of health care waste management, categories of health care wastes, and Color Coding Scheme for Health Care Waste. Follow the succeeding instructions and enumerate what is being asked for by the following items and write those down on the boxes provided. 1. Enumerate ten (10) classifications of health care wastes and give at least one example for each classification. Classification

Example

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Date Developed:


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Revision # 01

2. Enumerate the six colors of waste containers used on the first column; give the description of what type of wastes each colored container should contain on the second column and an example of a waste product on the third column. Color of Container

Description

Date Developed:


May 2014

Date Revised:

Example



Revision # 01

Self-Check Answer Key Health Care Waste Management 1. Ten (10) classifications of health care wastes and examples for each classification.

Classification

Example

1. General Waste

Paper, residuals, boxes, plastic bottles

2. Infectious Waste

Laboratory cultures, wastes from surgery or autopsies, wastes from infected patient, wastes from infected patients in isolation wards and undergoing hemodialysis, infected animals or instruments and materials that has made contact with infected persons or animals.

3. Pathological Waste

Tissues, organs, body parts, human fetus and animal carcasses, blood and body fluids.

4. Sharps

Needles, syringes, scalpels, saws, blades, broken glass, infusion sets, knives, nails and any other item that can cause a cut

5. Pharmaceutical Waste

Expired, unused, spilt and contaminated pharmaceutical products, drugs, vaccines and sera that are no longer required and need to be disposed of appropriately, discarded items used in handling of pharmaceuticals such as bottles or boxes with residues, gloves, masks, connecting tubing and drug vials

6. Genotoxic Waste

cytostatic drugs, vomit, urine, or feces from patients treated with cytotoxic drugs, chemicals and radioactive materials.

Date Developed:


May 2014

Date Revised:



Revision # 01

7. Chemical Waste

Solid, liquid, and gaseous chemicals, for example from diagnostic and experimental work and from cleaning, housekeeping, and disinfecting procedures

8. Waste with high Content of Heavy Metals

Mercury

9. Pressurized Containers 10. Radioactive Waste

Aerosol cans, O2 tanks disused sealed radiation sources; liquid and gaseous materials contaminated with radioactivity; Excreta of patients who underwent radionuclide diagnostic and therapeutic applications; paper-cups, straws, needles and syringes

Cadmium

2. Enumerate the six colors of waste containers used on the first column; give the description of what type of wastes each colored container should contain on the second column and an example of a waste product on the third column. Color of Container

Description

Example

Black

Non-infectious, dry waste

Office wastes like paper (refer to general wastes)

Green

Non-infectious, wet waste (kitchen, dietary, etc.)

Residuals

Yellow

Infectious and Pathological waste

Refer to infectious and pathological wastes

Yellow with Black Band

Chemical waste including those with heavy metals

Refer to chemical wastes and wastes with heavy metals

Orange

Radioactive waste

disused sealed radiation sources; liquid and gaseous materials contaminated with radioactivity; Excreta of patients who Date Developed:


May 2014

Date Revised:



Revision # 01

underwent radionuclide diagnostic and therapeutic applications; paper-cups, straws, needles and syringes

Red

Sharps and pressurized containers

Needles, syringes, scalpels, saws, blades, broken glass, infusion sets, knives, nails and any other item that can cause a cut Aerosol cans, O2 tanks

Date Developed:


May 2014

Date Revised:



Revision # 01

Information Sheet 3.1-6 Principles of Proper Body Mechanics Learning Objectives After reading this Information Sheet, you should be able to: 1. Explain in simple terms and in a brief statement the general principle of practicing proper body mechanics 2. Describe different concepts and examples of practicing proper body mechanics. 3. Appreciate the importance of proper body mechanics in the work place.

Body mechanics is the use of the human body with regards to its structure, function and position in relation other body parts or external factors. Proper body mechanics is the correct use of the body in relation to daily activities and work. It is important for us to practice proper body mechanics since we are going to work with different kinds of people and equipment in different sizes and weight; also to prevent injury not just to us but also to other health care givers and the patient. The correct use of body mechanics is a part of illness prevention and illness prevention and health promotion.

Practicing Body Mechanics •

•

Body mechanics is the efficient, coordinated and safe use of the body to move objects and carry- out the activities of daily living. Good body mechanics is essential to both health care workers and clients to maintain balance, reduce the energy required, reduce fatigue and decrease the risk of injury.

Concepts most helpful to the understanding of body mechanics are those concerned with the effect of gravity and balance.

Date Developed:


May 2014

Date Revised:



Revision # 01

The Effect of the Base of Support and Gravity on Balance

Balance is maintained when the line gravity falls close to the base of support. B, Balance is precarious when the line gravity falls at the edge of the base of support. C, Balance cannot be maintained when the line of gravity falls outside the base of support.

An object is stable when its center of gravity is close to its base of support, when the line of gravity goes through the base of support, and when the object has a wide base of support

Guidelines and Principles Related to Body Mechanics

Action

Rationale

Plan the move or transfer carefully. Free the surrounding area of obstacles and move required equipment near the head or foot of the bed.

Appropriate preparation prevents potential falls and injury and safeguards the client and equipment.

Obtain the assistance of other people or use mechanical devices to move objects that are too heavy.

The heavier an object, the greater the force needed to move the object.

Encourage clients to assist as much as possible by pushing or pulling themselves to reduce your muscle effort. Date Developed:


May 2014

Date Revised:



Revision # 01

Use arms as levers whenever possible to increase lifting power. Adjust the working area to waist level, and keep the body close to the area. Elevate

adjustable

Objects that are close to the center of gravity are moved with the least effort.

beds

and tables or lower the overbed side rails of beds to prevent stretching and reaching. Provide a firm, smooth, dry bed foundation before moving a client in bed or use a pull sheet.

Less friction between the object moved and the surface on which it is moved requires less energy.

Always face the direction of the movement.

Ineffective use of the major muscle groups occurs when the spine is rotated or twisted.

Start any body movement with proper alignment.

Balance is maintained and muscle strain is avoided as long as the line of

Stand as close as possible to the object to be moved.

gravity passes support.

through

the

base

of

Avoid stretching, reaching and twisting, which may place the line of gravity outside the base of support. Before moving an object, increase your stability by widening your stance and flexing your knees, hips, and ankles.

The wider the base of support and the lower the center of gravity, the greater the stability.

Before moving an object, contract your gluteal, abdominal, leg, and arm muscles to prepare them for action.

The greater the preparatory isometric tensing, or contraction of muscles, before moving an object, the less the energy required to move it, and the less the likelihood of musculoskeletal strain and injury.

Date Developed:


May 2014

Date Revised:



Revision # 01

Avoid working against gravity. Pull, push, roll, or turn objects instead of lifting them. Lower the head of the client's bed before moving the client up in bed.

Moving an object along a level surface requires less energy than moving an object up an inclined surface or lifting it against the force of gravity.

Use your gluteal and leg muscles rather than the sacrospinal muscles of your back to exert an upward thrust when lifting.

The synchronized use of as many large muscle groups as possible during an activity increases overall strength and prevents muscle fatigue and injury.

Distribute the workload between both arms and legs to prevent back strain. When pushing an object, enlarge the base of support by moving the front foot forward.

Balance is maintained with minimal effort when the base of support is enlarged in the direction in which the movement will occur.

Likewise, when pulling an object, enlarge the base of support by either moving the rear leg back if facing the object or moving the front foot forward if facing away from the object. When moving or carrying objects, hold them as close as possible to your center of gravity.

The closer the line of gravity to the center of the base of support, the greater the stability.

Use the weight of the body as a force for pulling or pushing, by rocking on the feet or leaning forward or backward.

Body weight adds force to counteract the weight of the object and reduces the amount of strain on the arms and back.

Alternate rest periods with periods of muscle use to help prevent fatigue.

Continuous muscle exertion can result in muscle strain and injury.

Date Developed:


May 2014

Date Revised:



Revision # 01

Self-Check 3.1-3 Principles of Proper Body Mechanics TRUE OR FALSE

This quiz will test how well you understood the Principles of Proper Body Mechanics and is designed in ten (10) items to be completed within an ideal duration of 15 minutes. The following are about body mechanics. Identify they are truestatements or false. Draw a CIRCLE ( ) on Column B if whether the statement is correct and CROSS ( ) if it is incorrect.

A

B

1. Appropriate preparation prevents potential falls and injury and safeguards the client and equipment 2. Avoid working against gravity. Pull, push, roll, or turn objects instead of lifting them. Lower the head of the client's bed before moving the client up in bed 3. Balance is maintained and muscle strain is avoided as long as the line of gravity passes away the base of support. 4. Before moving an object, relax your gluteal, abdominal, leg, and arm muscles to prepare them for action. 5. Ineffective use of the major muscle groups occurs when the spine is rotated or twisted. 6. More friction between the object moved and the surface on which it is moved requires less energy. 7. Moving an object along a level surface requires more energy than moving an object up an inclined surface or lifting it against the force of gravity 8. Objects that are close to the center of gravity are moved with the least effort. 9. The heavier an object, the lesser the force needed to move the object. 10. The wider the base of support and the lower the center of gravity, the greater the stability

Date Developed:


May 2014

Date Revised:



Revision # 01

Self-Check Answer Key Principles of Proper Body Mechanics

A

B

1. Appropriate preparation prevents potential falls and injury and safeguards the client and equipment 2. Avoid working against gravity. Pull, push, roll, or turn objects instead of lifting them. Lower the head of the client's bed before moving the client up in bed 3. Balance is maintained and muscle strain is avoided as long as the line of gravity passes away the base of support. 4. Before moving an object, relax your gluteal, abdominal, leg, and arm muscles to prepare them for action. 5. Ineffective use of the major muscle groups occurs when the spine is rotated or twisted. 6. More friction between the object moved and the surface on which it is moved requires less energy. 7. Moving an object along a level surface requires more energy than moving an object up an inclined surface or lifting it against the force of gravity 8. Objects that are close to the center of gravity are moved with the least effort. 9. The heavier an object, the lesser the force needed to move the object. 10. The wider the base of support and the lower the center of gravity, the greater the stability

Date Developed:


May 2014

Date Revised:



Revision # 01

Information Sheet 3.1-7 Client Safety Equipment Learning Objectives After reading this Information Sheet, you should be able to: 1. Enumerate the different types of equipment to prepare for assisting in client mobility. 2. Differentiate the names and use of the equipment from each other. To finally be able to successfully and efficiently assist the client to move from one position to another, assistive devices are going to be needed.

The incorrect use of these assistive devices can lead to improper handling of the patient and further cause to unnecessary injury and trauma to the patient, you as the health care provider or other persons linked to the care of the patient. This information will help you become more familiarized with the different assistive devices and, therefore, become confident in caring for your patients.

Devices Used in Positioning Clients in Bed Devices

Use

1. Pillow (of different sizes)

Used for support or elevation of a body part.

Date Developed:


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Revision # 01

2. Mattresses

Supports natural body curvatures

a. Standard

Prevents pressure ulcers

b. Egg Crate

3. Bed boards (made of wood and placed under the mattress)

Provides additional support to mattress and improves vertebral alignment.

4. Footboard or

Keeps the feet in dorsiflexion

Posey footguard (a flat panel made of plastic or wood) 5. Sandbag

6. Trochanter Roll

7. Hand Roll

to prevent plantar flexion.

Provides support and shape to body contours Immobilizes Maintains specific body alignment. Prevents external rotation of legs when client is in supine position.

Maintains thumb slightly abducted and in opposition to fingers, maintains fingers in slightly flexed position.

Date Developed:


May 2014

Date Revised:



Revision # 01

8. Hand-wrist splint

9. Trapeze bar

Individually molded for client to maintain proper alignment of thumb; are slightly adducted in opposition to fingers; maintains wrist in slight dorsal flexion. Enables client to raise trunk from bed and to transfer from bed to wheelchair. Allows client to perform exercises that strengthen upper arms.

10.

Side rails

Allows weak clients to roll from side to side or to sit up in bed.

Indications and Support Devices Used in Positioning Clients in Bed Position Fowler's Or Semi-Sitting

Supine or Dorsal Recumbent or Back-lying

Indications

Support Devices Used

allows greater chest expansion and lung ventilation promotes postoperative drainage

place pillows under the head, the small of the back, arms and ankles

promote comfort

place pillows under the head, the small of the back, arms and ankles

footboard

head and shoulders are kept flat to facilitate healing following certain surgeries or anesthetics

Date Developed:


May 2014

Date Revised:

footboard



Revision # 01

facilitates drainage from the mouth prevents aspiration

Sims‘ or Semi prone

reduces pressure over the sacrum and greater trochanter of the hip

place pillows under head, upper

treatments like enema; examinations or treatments of the perineal area

arm and upper leg place sandbag parallel to plantar surface of foot

insertion of suppository promotes comfort while sleeping specially for pregnant women promote comfort good for resting and sleeping

Side-lying or Lateral

promotes good back alignment relieves pressure on the sacrum and heels

place pillows at the back, under the head, upper arm, upper leg and thigh

facilitates drainage from the mouth

promotes drainage from the mouth

Prone or Abdomen-lying

clients recovering from surgery of the mouth and throat allows full extension of the hip and knee joints

Date Developed:


May 2014

Date Revised:

place pillows under the head, abdomen (just below the diaphragm) and lower leg



Revision # 01

Orthopneic facilitates respiration by allowing maximum chest expansion

provides postural drainage basal lung lobe of promotes venous circulation

Trendelenburg 's

Date Developed:


May 2014

Date Revised:

place pillows on over bed table for client to lean on

place pillows under the head, arms and ankles



Revision # 01

Self-Check 3.1-5 Client Safety Equipment Identification Identify the position that is being described by the following items. These are questions that pertain to assistive devices needed in assisting in positioning clients in bed. Write your answers on the box on the right side of each item.

Description

Answer

1. Allows weak clients to roll from side to side or to sit up in bed 2. Enables client to raise trunk from bed and to transfer from bed to wheelchair. Allows client to perform exercises that strengthen upper arms. 3. Individually molded for client to maintain proper alignment of thumb; are slightly adducted in opposition to fingers; maintains wrist in slight dorsal flexion. 4. Keeps the feet in dorsiflexion to prevent plantar flexion. 5. Maintains thumb slightly abducted and in opposition to fingers, maintains fingers in slightly flexed position. 6. Prevents external rotation of legs when client is in supine position. 7. Provides additional support to mattress and improves vertebral alignment. 8. Provides support and shape to body contours, immobilizes and maintains specific body alignment 9. Supports natural body curvatures and prevents pressure ulcers 10.


Date Developed:


May 2014

Date Revised:



Revision # 01

Self-Check Answer Key Client Safety Equipment

Description 1. Allows weak clients to roll from side to side or to sit up in bed 2. Enables client to raise trunk from bed and to transfer from bed to wheelchair. Allows client to perform exercises that strengthen upper arms. 3. Individually molded for client to maintain proper alignment of thumb; are slightly adducted in opposition to fingers; maintains wrist in slight dorsal flexion. 4. Keeps the feet in dorsiflexion to prevent plantar flexion. 5. Maintains thumb slightly abducted and in opposition to fingers, maintains fingers in slightly flexed position. 6. Prevents external rotation of legs when client is in supine position. 7. Provides additional support to mattress and improves vertebral alignment. 8. Provides support and shape to body contours, immobilizes and maintains specific body alignment 9. Supports natural body curvatures and prevents pressure ulcers 10.


Date Developed:


May 2014

Date Revised:

Answer Side rails Trapeze bar

Hand-wrist splint

Footboard or Posey footguard Hand Roll

Trochanter Roll Bed boards Sandbag Mattresses

Pillow



Revision # 01

Information Sheet 3.1-8 Handling of Hospital Equipment Learning Objectives: After reading this information sheet, you should be able to: 1. Identify and enumerate the two most common types of hospital bed. 2. Enumerate the basic parts of the hospital bed. 3. Handle the hospital bed according to its design and as appropriate.

In preparing in assisting in patient mobility, one of the factors that we have to look at before actually handling the patient is to know how to operate the hospital bed. There are different types of hospital beds, but in this learning material we are only going to tackle the two most common types. Read on to know the difference between these two types of bed and how to operate them accurately.

What is a hospital bed? A hospital bed is a special bed that may be needed to care for a person who is ill. Most hospital beds are made of heavy metal with movable parts. The bed has moveable side rails, hand cranks or electric buttons or levers that may be used to change positions of the bed.

Types of Hospital Beds 1.

Manual hospital bed: 



2.

With this bed you need to change bed positions by hand using cranks. If you are unable to do this, you will need to ask someone to help you. The cranks are located at the foot or head of the bed, and you’ll have to pull them up manually. Manual beds may not move to as many positions as an electric bed. The bed may also be lowered to make it easier for you to get in and out of bed. A manual bed may be very difficult for a person who has limited hand or arm strength to use. You may need good hand strength to turn the cranks. A person with a back condition or knee problems may also have trouble. Therefore, proper body mechanics should be strictly observed. A person may need to bend or kneel to use the bed cranks.

Electric hospital bed An electric bed has a motor and a cord to plug into an electrical outlet. 





There is a control pad hooked to the bed or located on the bed itself that may look like a television remote control. Each button on the control may have a picture showing how the bed will move when you push the button. Many people like an electric bed because the positions of the bed can be changed easily. Date Developed:


May 2014

Date Revised:



Revision # 01

Parts of a Manual Hospital Bed

Hip Gatch: this is where the hinges for adjusting the angle of the head of the bed are being moved. It is designed so that the hip joints are positioned approximately on these hinges. Thus, before adjusting the head of the bed, make sure that the patient’s body is properly aligned and positioned on the bed.

Head Crank: this is the pulley system usually located in the outer foot part of the bed that is used to elevate or increase the angle of the head of the bed. Turn this to clockwise to elevate the head; and counter clockwise to decrease the elevation. Knee Gatch: this is where the hinges for adjusting the angle of the foot of the bed are being moved. It is designed in a way that when the crank is adjusted, the knees should also flex. Foot Crank: this is found next to the head crank that is used to adjust the elevation or the angle of the foot of the bed. Height Crank: used to elevate the height of the bed. It is usually located next to the foot crank. Wheels with Lock: the wheels are used to easily transport the bed from one place to another while its locks are used to keep the bed in place. The lock system is usually as easy as stepping on a button or switch every time you want to lock or unlock the wheels. Lock the wheels whenever you are going to perform anything with the patient or if you are going to leave the patient alone. Adjustable Side-Rails: Usually comes in two pairs- one pair at the head part and another at the foot part of the bed. These are raised to prevent the patient from falling from bed. Sometimes they are also used to brace restraints for the patient. However, to refrain from false imprisonment of the patient, one side rail is left unraised. Date Developed:


May 2014

Date Revised:



Revision # 01

Parts of the Electronic Hospital Bed The electronic hospital bed has basically the same parts with the absence, however, of the cranks since it can now be easily used by pushing on buttons in a remote control, a control connected through a cable to the hospital bed or on any bed surface. If there are only two buttons, one button will be used to elevate the head of the bed and the other the foot, while the height of the bed would be adjusted manually through a separate crank. If there are three buttons, then the three functions would be given a corresponding button. If there are four buttons, however, the fourth button would be used to change the inclination of the bed, especially for positioning the patient to trendelenburg or reverse.

Safe use of the Hospital Bed •

Keep the wheels of the bed locked at all times. Unlock the wheels only if the bed needs to be moved.

•

Put a bell and a telephone within reach of the bed. These should be available so the person may call for help when needed.

•

Keep the side rails up. If there is danger of the person falling off the bed, keep the rails up at all times.

•

Never light matches, candles or smoke while in or around the bed. Do not let others smoke or light matches or candles near your bed.

•

Follow the specific manufacturer's instructions for using the bed.

•

Put night lights where needed. Night-lights may help prevent falls.

•

If a footstool is needed for the person the get out of bed, make sure it is strong and stable.

•

Put the bed control pad within easy reach of the bed for the person to adjust positions. Learn to use the control panel, and practice the different positions. Test the bed's hand and panel controls to be sure the bed is working correctly. Some hospital bed controls may be locked so that a person in bed cannot change bed positions themselves. If the bed has this "locking" feature, test it to be sure it is working correctly.

•

Check for cracks and damage to the covering of the all bed controls. If covers are damaged, liquids may get into the controls. This may cause them to stop working, and may cause a fire.

•

Have a professional look at all parts of the bed, as well as the floor beneath and around the bed for dust and lint build-up. These areas should be kept clean.

•

Call the bed manufacturer or another professional if there are burning smells or unusual sounds coming from the bed. Do not use the bed if there is a Date Developed:


May 2014

Date Revised:



Revision # 01

burning smell coming from it. Call if the bed controls are not working correctly to change positions of the bed. •

Check the bed's power cord for damage. It may be crushed, pinched, sheared, cut or worn through. Do not place furniture (such as rocking chairs) away from the cord. Avoid placing or rolling the bed over the power cord.

•

Do not allow clothing, sheets, blankets, books, or anything else to be in contact with a wall outlet. Do not let these items get stuck between the cord and outlet when the bed is plugged in. This may cause a fire, or damage the cord or the plug.

•

Do not place a rug or carpet over the power cord for the bed, or anything else. Carpets and rugs may cause the cord to heat up too much, and lead to a fire. Do not place the cord in a location where people walk, as this may cause falls and damage the power cord.

•

Do not use an extension cord, or a power strip having more than one plug-in outlet. Any damage to these can cause a fire. If you must use an extension cord or power strip, have a professional check it before using it. It will also need to be checked regularly for as long as you use it. Avoid using outlet boxes that more than one cord may be plugged into. If you must use an outlet box, place it where there is no risk of damage or spilling liquids.

•

Plug the power cord from the bed directly into an outlet on the wall. Have a professional check the outlet to see if it is working correctly. The outlet should also be checked to be sure it is the right type for the cord. The prongs (blades) on the plug should be tight. The cord should fit tightly into the outlet. The plug, outlet and wall plate should not be chipped or cracked.

•

When adjusting the head, foot, or any part of the bed, be sure the bed is able to move freely. It should extend to its full length, and adjust to any position. Be sure bed movement does not affect the bed's power cord, plug, or outlet. Hand control and power cords should not be threaded through moving parts of the bed, or through bed rails. Watch the hand control cables and the power cord as you are adjusting the bed. Normal bed movement should not pinch or damage these cords.

Date Developed:


May 2014

Date Revised:



Revision # 01

Operation Sheet 3.1-1 Title

Operate a manual and an electronic hospital Bed

:

Performance Objective: Given two manufacturer’s manual- one for a manual hospital bed and the other an electronic hospital bed, you should be able to properly and safely operate the hospital beds according to instructed positions

Supplies

:

Equipment

:

Manufacturer’s Manual

A manual hospital bed An Electronic Hospital Bed

Steps/Procedure: 1. Gather instructions and relevant materials. 2. Read through the manufacturer’s manuals 3. Follow standard precautions. Check for any discrepancies on the hospital beds. 4. Identify the parts of the beds. 5. Raise the height of the beds to the highest position 6. Raise the head of the manual bed. 7. Raise the foot of the manual bed. 8. Raise the head of the electronic bed. 9. Raise the foot of the electronic bed. 10. Position the bed so that they are in high fowler’s. 11. Check for any discrepancies on the equipment. 12. Complete the operation. 13. Evaluate your performance against the Performance Criteria Checklist. 14. Refer to your trainer for evaluation.

Assessment Method: Practical Demonstration

Date Developed:


May 2014

Date Revised:



Revision # 01

Performance Criteria Checklist 3.1-3 CRITERIA Did you…. 1. Gather instructions and relevant materials?

YES

NO

2. Read through the manufacturer’s manuals? 3. Follow standard precautions and check for any discrepancies on the hospital beds? 4. Identify the parts of the bed correctly? 5. Operate the hospital beds according to prescribed positions? 6. Re-check for any discrepancies on the equipment? 7. Complete the operation by using the correct techniques?

Date Developed:


May 2014

Date Revised:



Revision # 01

Job Sheet 3.1-5 Title

:

Prepare to Assist in Client Mobility

Performance Objective: Given the supplies, you should be able to properly prepare to assist in Client mobility on a case simulation provided by evaluator.

Materials

:

Faucet with running water Hand Soap Paper Towels Sterile Gloves Waste Receptacles Labels for receptacles Hospital Devices Pillow Mattress Sandbag Trochanter roll Trapeze Side rail

Hospital Bed Steps/Procedure: 1. 2. 3. 4. 5. 6.

Gather instructions and relevant materials. Perform Medical Asepsis Perform Surgical Asepsis through Gloving Identify waste receptacles and label them correctly. Identify Hospital devices and describe their uses. Operate the hospital bed as prescribed, make sure to observe proper body mechanics. 7. Report to evaluator for case analysis and oral questioning. 8. Evaluate Performance against Skill Evaluation sheet. 9. Refer to trainer for evaluation.

Assessment Method: Practical Demonstration

Date Developed:


May 2014

Date Revised:



Revision # 01

Republic of the Philippines C ordillera Administrative Region Municipality of La Trinida d

BVS C OLLEGES Km. 5, La Trinidad, Benguet

C BLM Evaluation Inst rument Health Care Services NC II Assisting in Patient Mobility Developed by: Warren J ae M. Sandoval Please tick (/ ) YES if the following contents were succ essfully done and NO if not succ essfully done in the performance of the job of preparing to assist in patient mobility.

Yes

No

Takes standard precautions

MEDICAL ASEPSIS Gathers needed supplies to a sink. Uses the steps provided in the Information Sheet, demonstrate the proper hand washing technique. Ensures to briefly explain important points during the hand washing procedure Implements after-care procedures.

DONNING AND REMOVING GLOVES Gathers needed supplies in a working table. Demonstrates the removing gloves.

proper

methods

of

donning

and

Rationalizes every action that is being performed. Implements after care procedures.

HEALTH CARE WASTE MANAGEMENT Enumerate the different classifications of health care wastes Describe the measures for health care waste management. Identifies the health prescribed color code.

care

waste

according

to

their

HOSPITAL ASSITIVE DEVICES Identify Hospital devices correctly Describes correctly the uses of hospital devices

OPERATION OF HOSPITAL BED Gather instructions and relevant materials. Date Developed:


May 2014

Date Revised:



Revision # 01

Read through the manufacturer’s manuals Follow standard precautions. Check for any discrepancies on the hospital beds. Identify the parts of the beds. Raise the height of the beds to the highest position Raise the head of the manual bed. Raise the foot of the manual bed. Raise the head of the electronic bed. Raise the foot of the electronic bed. Position the bed so that they are in high fowler’s. Check for any discrepancies on the equipment. Practices proper body mechanics

Stop Time: ___________H Evaluators’ Input: _______________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

Date Developed:


May 2014

Date Revised:



Revision # 01

Evidence Plan

Competency Standard

Health Care Services

Unit of competency

Assist in Patient Mobility

n e tti r W

n n io t g n i o it la n u o a rt m ti s i s n s e o h u q mg d e u o n Dr a th

t ro p re ty r a p d ri h T

*Observed strict infection control guidelines

/

/

/

*Practiced patient confidentiality and privacy requirements

/

/

Selected equipment according to prescribed plan of care.

/

/

/

Performed proper medical aseptic technique

/

/

Demonstrated correct sterile technique in donning and removing gloves

/

/

Ways in which evidence will be collected [tick (/) the column]

The evidence must show that the trainee.. • •

•

•

•

• Identified necessary equipment as appropriate for the eventual procedure.

Date Developed:


May 2014

Date Revised:

/

/



Revision # 01

TABLE OF SPECIFICATIONS

Test item distribution

e g d le w o n K la tu c a F

n io s n e h e r p m o C

Patient confidentiality and privacy requirements

6

Infection Control Guidelines

Content/ Objectives

n o ti a c i

s m te i f o r e b m

e g a t n e c r e P

lp p A

n u l a t o T

7

7

20

20 %

10

15

5

30

30 %

Equipment Use and Specifications

6

6

8

20

20 %

Body Mechanics

6

12

12

30

30 %

Total

28

40

32

100

100 %

Date Developed:


May 2014

Date Revised:



Revision # 01

WRITTEN TEST This part of the learning material will test how much you have learned about the entire learning outcome “Prepare to assist with client/patient mobility” under the unit of competency “Assist in Client/ Patient Mobility”. A variation of exam types has been designed for this test, starting from easy to hard. Follow the succeeding instructions for each exam type.

I. TRUE OR FALSE The following test is designed to measure a part of your comprehension regarding the concepts of Patient Rights and Confidentiality, Infection Control, Client Safety Equipment Use and Body Mechanics. Identify whether statements are true or false. Draw a CIRCLE ( ) on Column B if the statement is correct and CROSS ( ) if it is incorrect.

Patient Rights and Confidentiality A

B

1. Without looking at the aspect of monthly income, a patient has the right to be treated with considerate and respectful care. 2. If information is deemed to be harmful to the patient or is medically inappropriate, it cannot be disclosed to an appropriate person. 3. The patient DOES NOT have the right to refuse any treatment, procedure or any life-giving measure as long as the patient is able to decide for himself/ herself. 4. Case discussions, consultations, treatments, and examination are confidential and should be strictly conducted discreetly. 5. All communications (written, spoken, non-verbal) should always be treated as confidential except when a media person is asking for information regarding the patient’s condition.

Infection Control Guideline 6. A sterile object or field cannot become unsterile by prolonged exposure to airborne microorganisms. 7. Do not remove used needles from disposable syringes by hand; and do not bend, break or otherwise manipulate used needles by hand. Date Developed:


May 2014

Date Revised:



Revision # 01

8. Microorganisms move slowly on wet surfaces but very quickly through dry surface. 9. Microorganisms move through space on air currents. 10. Never recap used needles using both hands 11. Practice passing dirty items over clean items or areas, that way, sterility will be preserved. 12. Put on clean gloves just before touching mucous membranes and non-intact skin. 13. The skin can be sterilized via autoclaving for an optimal duration of 15 minutes. 14. Wash immediately after gloves are removed and between patient contacts. 15. When a clean item touches a less clean item, it becomes “dirty,” because microorganisms are transferred to it

Client Safety Equipment Use 16. Pillows are used for support and / or elevation of a body part 17. Mattresses provide additional support to pillows and improve vertebral alignment. 18. The fowler’s position is indicated to facilitate healing following certain surgeries or anesthetics. 19. The orthopneic position facilitates allowing maximum chest expansion.

respiration

by

20. Side rails allow weak clients to roll from side to side or to sit up in bed.

Body Mechanics 21. Balance is maintained when the line gravity falls close to the base of support. 22. Appropriate preparation prevents potential falls and injury and safeguards the client and equipment. 23. Balance cannot be maintained when the line of gravity falls outside the base of support.

Date Developed:


May 2014

Date Revised:



Revision # 01

24. Balance is not maintained and muscle strain is promoted as long as the line of gravity passes through the base of support. 25. More friction between the object moved and the surface on which it is moved requires less energy. 26. Less friction between the object moved and the surface on which it is moved requires less energy. 27. Moving an object along a level surface requires less energy than moving an object up an inclined surface 28. Objects that are far from the center of gravity are moved with the least effort. 29. The heavier an object, the greater the force needed to move the object. 30. When pushing an object, enlarge the base of support by moving the front foot forward. 31. The unsynchronized use of as many large muscle groups as possible during an activity increases overall strength and prevents muscle fatigue and injury. 32.base Imbalance is maintained minimal effort when the of support is enlargedwith in the direction in which the movement will occur. 33. The farther the line of gravity to the center of the base of support, the greater the stability. 34. Body weight decreases force to counteract the weight of the object and reduces the amount of strain on the arms and back. 35. Continuous muscle exertion can result in muscle strain and injury.

Date Developed:


May 2014

Date Revised:



Revision # 01

II.

Multiple-Choice

The following test is a set of items derived from the different contents of the first learning outcome- Prepare to Assist in Client Mobility. Identify what is being asked for by each item. This part will measure how you are going to perform in actual situations and your knowledge about the concepts previously learned. Choose your answers from the selection given after each statement. Place a tick (/) inside the circle of the answer of your choice. 1. Mr. Raul is due for surgery of his appendicitis. The surgeon has explained how the surgery will be done, the risks during and after surgery and the alternative treatment available. What is the best statement to describe the situation? Ο

His surgeon is honoring the patient’s rights by explaining the surgery to be done and including the risks and alternatives.

Ο

It does not have any weight on the client’s condition and is, thus, insignificant.

Ο

The surgeon has done too much for the patient that the patient already has a tendency to get confused.

Ο

None of the above.

2. A nursing attendant observes that Mrs. Lampitoc’s obstetrician hasn’t been changing her gloves for the whole labor period of the mother and finds out that this was because of Mrs. Lampitoc’s poverty. What principle is subjected in this situation? Ο

The patient has the right to know from his physician what his/ her present diagnosis is.

Ο

The patient has the right to refuse any treatment

Ο

The privacy of the patient is very important.

Ο

Without looking at the aspect of monthly income, a patient has the right to be treated with considerate and respectful care.

3. Before Mr. Raul goes to the surgery room for his operation, what should be secured first? Ο

A signed informed consent signifying that the patient knows the surgery to be done, and the risks attached to it.

Ο

An anesthetic to numb him of the pain during surgery.

Ο

A transfer referral to another health care institution

Ο

Hallucinogens to divert his attention and keep him from being anxious.

Date Developed:


May 2014

Date Revised:



Revision # 01

4. You are the nurse taking care of an attempted suicide patient and your colleague who is not involved in your patient’s care asks you about the past medical history of the patient. What is the best thing for you to say? Ο

“Ok, I will let you take a peek at her chart”

Ο

“No, I cannot tell you any information about her since these are private matters.”

Ο

“You’ll have to ask my chief nurse.”

Ο

“You’ll have to write a consent”

5. A patient is complaining that she does not want any student nurses “practicing” with her and asks that only staff nurses care for her. What is the best thing to consider? Ο

The student nurses are competent and thus should not be withdrawn from caring for the patient.

Ο

Honor the request of the patient and let staff nurses care exclusively for her.

Ο

Ask for additional fee for her request.

Ο

Tell the patient to leave and find a better hospital.

6. The patient is in Abatan Hospital and is under severe cardiogenic shock. He needs to be transferred to another institution since Abatan Hospital lacks the needed facilities to support the care for the patient. Which statement is best? Ο

A transfer can only be completed if the receiving institution accepts the patient.

Ο

The patient cannot be transferred unless he settles his fees.

Ο

The patient will be transferred but the health care providers of the referring institution will go with him to continue care.

Ο

There is no correct statement.

7. They are tiny living beings that make their presence known only by their effect. Ο Dwarves Ο Microorganisms Ο Organisms Ο Pathogens 8. These are microbes that are useful to human beings Ο Ο

Eubacteria Microorganisms Ο Non-pathogens Ο Pathogens 9. They are microbes that causes diseases to human. Ο Eubacteria Ο Microorganisms Ο Non-pathogens Ο Pathogens

Date Developed:


May 2014

Date Revised:



Revision # 01

10.

Which of the following is not a classification of microorganisms? Ο Bacteria Ο Cholera Ο Protozoa Ο Virus 11. Which statement is true about the Human Normal Flora? Ο Normal body flora are cells that attack foreign bodies Ο Normal body flora are flowers that normally grow inside the human body Ο Normal body flora are naturally residing microorganisms in the human body. Ο Normal body flora are the same in each part of the body 12. Among the chain of infection, this is the part that causes the disease Ο Causative agent Ο Mode of transmission Ο Portal of exit Ο Reservoir 13. This is a person who will become ill from the entry of pathogens into the body. Ο Causative agent Ο Portal of entry Ο Reservoir Susceptible host 14. It is where the pathogens can survive. Ο Causative agent Ο Ο

Portal of entry Reservoir Ο Susceptible host 15. Which is not a way of transmitting a disease Ο Airborne transmission Ο Contact transmission Ο Droplet transmission Ο Mucosal transmission 16. These are people who have pathogens in their bodies but does not show signs of the disease are called: Ο Carriers Ο Immune Ο Parasites Ο Pathogens 17. This type of waste is suspected to contain pathogens Ο Ο

18.

General Infectious Ο Radioactive Ο Chemical Which is not a kind of infectious waste Ο Laboratory cultures Ο Wastes from autopsies Ο Patient’s feces Ο Wet food residuals Date Developed:


May 2014

Date Revised:



Revision # 01

19.

20.

21.

22.

23.

24.

25.

26.

27.

These are types of wastes that are parts of human body Ο Pathological waste Ο Chemical waste Ο Pharmaceutical waste Ο General waste Which is not considered as a sharp Ο Needle Ο Syringe Ο Pressurized container Ο Blade Which of the following is not a characteristic of haxardous wastes? Ο Toxic Ο Corrosive Ο Potable Ο Reactive Where do you place non-infectious dry wastes? Ο Black container Ο Green container Ο Yellow container Ο Red container Where should infectious wastes go? Ο Black container Ο Green container Ο Yellow container Ο Red container Where should pathological wastes go? Ο Black container Ο Green container Ο Yellow container Ο Red container What kinds of receptacle should radioactive materials be placed? Ο Orange Ο Red Ο Black Ο Green Where should sharps be disposed in Ο Orange Ο Red Ο Black Ο Green Where does non-infectious, wet waste go? Ο Orange Ο Red Ο Black Ο Green

Date Developed:


May 2014

Date Revised:



Revision # 01

28. It is the efficient, coordinated and safe use of the body to move objects and carry out the activities of daily living Ο Aerobics Ο Body mechanics Ο Ergonomics Ο Exercise 29. Provides additional support to the mattress and improves vertebral alignment. Ο Bed board Ο Footboard Ο Hand roll Ο Mattress 30. Used for support or elevation of a body part. Ο Bed board Ο Footboard Ο Hand roll Ο Pillow

Enumeration: list down what is being asked for by the following items in the left column. Write your answers on the right column.

Ten Categories of Health Care wastes

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Ten Assistive Devices

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Two types of Asepsis

1. 2.

Date Developed:


May 2014

Date Revised:



Revision # 01

COMPLETION: A. Identify the bed positions illustrated below and complete the following descriptions stated on the second column. DESCRIPTION. The ___________ position is one of three types where the head is elevated up to 300 to 450. P

P

P

P

____________ is another type among two others which is indicated for difficulty breathing and where the head is elevated to 750-900. P

P

P

P

The ___________ is a type of Fowler’s position where the head is elevated to a minimum of 7 0 to P

P

150. P

P

______________ is also known as back-lying position and is indicated to enhance healing of abdominal wounds or spinal injuries or the administration of general anesthesia. Best for pregnant women, ___________ is a position that provides rest to the back of the patient and relieves pregnant women from the weight of her womb. This is best used to relieve tension and pressure on one side of the body’s bony prominences and is also used to enhance the healing process in certain lung surgeries. This is called the ____________ position. Date Developed:


May 2014

Date Revised:



Revision # 01

The ______________ is best done to patients that has had previous throat or mouth injuries and to also relieve the back from pressure. The ____________ position is best made for patients who are having difficulty breathing such as those with asthma or COPD.

Matching Type: Identify what is being asked for or described by each item. Choose your answers from column B and write them down in Column C. B

A 1. It is the efficient, coordinated and safe use of the body to move objects and carry out the activities of daily living 2. The point at which its mass is centered. 3. The foundation that provides the stability of the object 4. What is being maintained during work by widening the base of support and keeping the line of gravity close to the center?

a. Balance b. Base of Support

2.

c. Body Mechanics d. Center of Gravity e. Pressure Ulcer

4.

Date Developed:


May 2014

Date Revised:

3.

5.

5. Degradation of the skin consequent to stasis in one bed position.


C 1.



Revision # 01

WRITTEN TEST SELF-CHECK I.

TRUE OR FALSE

The following test is designed to measure a part of your comprehension regarding the concepts of Patient Rights and Confidentiality, Infection Control, Client Safety Equipment Use and Body Mechanics. Identify whether statements are true or false. Draw a CIRCLE ( ) on Column B if the statement is correct and CROSS ( ) if it is incorrect.

Patient Rights and Confidentiality A

B

1. Without looking at the aspect of monthly income, a patient has the right to be treated with considerate and respectful care.

O

2. If information is deemed to be harmful to the patient or is medically inappropriate, it cannot be disclosed to an appropriate person.

O

3. The patient has the right to refuse any treatment, procedure or any life-giving measure as long as the

X

patient is able to decide for himself/ herself. 4. Case discussions, consultations, treatments, and examination are confidential and should be strictly conducted discreetly.

0

5. All communications (written, spoken, non-verbal) should always be treated as confidential except when a media person is asking for information regarding the patient’s condition.

X

Infection Control Guideline 6. A sterile object or field can become unsterile by prolonged exposure to airborne microorganisms.

O

7. Do notand remove used needles from syringes by hand; do not bend, break or disposable otherwise manipulate used needles by hand.

O

8. Microorganisms move slowly on wet surfaces but very quickly through dry surface.

X

9. Microorganisms move through space on air currents.

O

10. Never recap used needles using both hands

O

Date Developed:


May 2014

Date Revised:



Revision # 01

11. Practice passing dirty items over clean items or areas, that way, sterility will be preserved.

X

12. Put on clean gloves just before touching mucous membranes and non-intact skin.

O

13. The skin can be sterilized via autoclaving for an optimal duration of 15 minutes.

X

14. Wash immediately after gloves are removed and

O

between patient contacts. 15. When a clean item touches a less clean item, it becomes “dirty,” because microorganisms are transferred to it

O

Client Safety Equipment Use 16. Pillows are used for support and / or elevation of a body part

O

17. Mattresses provide additional support to pillows and improve vertebral alignment.

X

18. The fowler’s position is indicated to facilitate healing following certain surgeries or anesthetics.

X

19. The orthopneic position facilitates allowing maximum chest expansion.

O

respiration

by

20. Side rails allow weak clients to roll from side to side or to sit up in bed.

O

Body Mechanics 21. Balance is maintained when the line gravity falls close to the base of support.

O

22. Appropriate preparation prevents potential falls and injury and safeguards the client and equipment.

O

23. Balance cannot be maintained when the line of gravity falls outside the base of support.

O

24. Balance is not maintained and muscle strain is promoted as long as the line of gravity passes through the base of support.

X

25. More friction between the object moved and the surface on which it is moved requires less energy.

X

Date Developed:


May 2014

Date Revised:



Revision # 01

26. Less friction between the object moved and the surface on which it is moved requires less energy.

O

27. Moving an object along a level surface requires less energy than moving an object up an inclined surface

O

28. Objects that are far from the center of gravity are moved with the least effort.

X

29. The heavier an object, the greater the force needed to

O

move the object. 30. When pushing an object, enlarge the base of support by moving the front foot forward.

O

31. The unsynchronized use of as many large muscle groups as possible during an activity increases overall strength and prevents muscle fatigue and injury.

X

32. Imbalance is maintained with minimal effort when the base of support is enlarged in the direction in which the movement will occur.

X

33. The farther the line of gravity to the center of the base of support, the greater the stability.

X

34.ofBody weightand decreases counteract the on weight the object reducesforce the to amount of strain the arms and back.

X

35. Continuous muscle exertion can result in muscle strain and injury.

O

Date Developed:


May 2014

Date Revised:



Revision # 01

III.

Multiple-Choice

The following test is a set of items derived from the different contents of the first learning outcome- Prepare to Assist in Client Mobility. Identify what is being asked for by each item. This part will measure how you are going to perform in actual situations and your knowledge about the concepts previously learned. Choose your answers from the selection given after each statement. Place a tick (/) inside the circle of the answer of your choice. 1. Mr. Raul is due for surgery of his appendicitis. The surgeon has explained how the surgery will be done, the risks during and after surgery and the alternative treatment available. What is the best statement to describe the situation? Ο

His surgeon is honoring the patient’s rights by explaining the surgery to be done and including the risks and alternatives.

Ο

It does not have any weight on the client’s condition and is, thus, insignificant.

Ο

The surgeon has done too much for the patient that the patient already has a tendency to get confused.

Ο

None of the above.

2. A nursing attendant observes that Mrs. Lampitoc’s obstetrician hasn’t been changing her gloves for the whole labor period of the mother and finds out that this was because of Mrs. Lampitoc’s poverty. What principle is subjected in this situation? Ο

The patient has the right to know from his physician what his/ her present diagnosis is.

Ο

The patient has the right to refuse any treatment

Ο

The privacy of the patient is very important.

Ο

Without looking at the aspect of monthly income, a patient has the right to be treated with considerate and respectful care.

3. Before Mr. Raul goes to the surgery room for his operation, what should be secured first? Ο

A signed informed consent signifying that the patient knows the surgery to be done and the risks attached to it.

Ο

An anesthetic to numb him of the pain during surgery.

Ο

A transfer referral to another health care institution

Ο

Hallucinogens to divert his attention and keep him from being anxious.

Date Developed:


May 2014

Date Revised:



Revision # 01

4. You are the nurse taking care of an attempted suicide patient and your colleague who is not involved in your patient’s care asks you about the past medical history of the patient. What is the best thing for you to say? Ο

“Ok, I will let you take a peek at her chart”

Ο

“No, I cannot tell you any information about her since these are private matters.”

Ο

“You’ll have to ask my chief nurse.”

Ο

“You’ll have to write a consent”

5. A patient is complaining that she does not want any student nurses “practicing” with her and asks that only staff nurses care for her. What is the best thing to consider? Ο

The student nurses are competent and thus should not be withdrawn from caring for the patient.

Ο

Honor the request of the patient and let staff nurses care exclusively for her.

Ο

Ask for additional fee for her request.

Ο

Tell the patient to leave and find a better hospital.

6. The patient is in Abatan Hospital and is under severe cardiogenic shock. He needs to be transferred to another institution since Abatan Hospital lacks the needed facilities to support the care for the patient. Which statement is best? Ο

A transfer can only be completed if the receiving institution accepts the patient.

Ο

The patient cannot be transferred unless he settles his fees.

Ο

The patient will be transferred but the health care providers of the referring institution will go with him to continue care.

Ο

There is no correct statement.

7. They are tiny living beings that make their presence known only by their effect. Ο Dwarves Ο Microorganisms Ο Organisms Ο Pathogens 8. These are microbes that are useful to human beings Ο Ο

Eubacteria Microorganisms Ο Non-pathogens Ο Pathogens 9. They are microbes that causes diseases to human: Ο Eubacteria Ο Microorganisms Ο Non-pathogens Ο Pathogens

Date Developed:


May 2014

Date Revised:



Revision # 01

10.

Which of the following is not a classification of microorganisms? Ο Bacteria Ο Cholera Ο Protozoa Ο Virus 11. Which statement is true about the Human Normal Flora? Ο Normal body flora are cells that attack foreign bodies Ο Normal body flora are flowers that normally grow inside the human body Ο Normal body flora are naturally residing microorganisms in the human body. Ο Normal body flora are the same in each part of the body 12. Among the chain of infection, this is the part that causes the disease Ο Causative agent Ο Mode of transmission Ο Portal of exit Ο Reservoir 13. This is a person who will become ill from the entry of pathogens into the body. Ο Causative agent Ο Portal of entry Ο Reservoir Ο Susceptible host 14. It is where the pathogens can survive. Ο Causative agent Ο Ο

Portal of entry Reservoir Ο Susceptible host 15. Which is not a way of transmitting a disease Ο Airborne transmission Ο Contact transmission Ο Droplet transmission Ο Mucosal transmission 16. These are people who have pathogens in their bodies but does not show signs of the disease are called: Ο Carriers Ο Immune Ο Parasites Ο Pathogens 17. This type of waste is suspected to contain pathogens Ο Ο

18.

General Infectious Ο Radioactive Ο Chemical Which is not a kind of infectious waste Ο Laboratory cultures Ο Wastes from autopsies Ο Patient’s feces Ο Wet food residuals Date Developed:


May 2014

Date Revised:



Revision # 01

19.

20.

21.

22.

23.

24.

25.

26.

27.

These are types of wastes that are parts of human body Ο Pathological waste Ο Chemical waste Ο Pharmaceutical waste Ο General waste Which is not considered as a sharp? Ο Needle Ο Syringe Ο Pressurized container Ο Blade Which of the following is not a characteristic of hazardous wastes? Ο Toxic Ο Corrosive Ο Potable Ο Reactive Where do you place non-infectious dry wastes? Ο Black container Ο Green container Ο Yellow container Ο Red container Where should infectious wastes go? Ο Black container Ο Green container Ο Yellow container Ο Red container Where should pathological wastes go? Ο Black container Ο Green container Ο Yellow container Ο Red container What kinds of receptacle should radioactive materials be placed? Ο Orange Ο Red Ο Black Ο Green Where should sharps be disposed in Ο Orange Ο Red Ο Black Ο Green Where does non-infectious, wet waste go? Ο Orange Ο Red Ο Black Ο Green

Date Developed:


May 2014

Date Revised:



Revision # 01

28. It is the efficient, coordinated and safe use of the body to move objects and carry out the activities of daily living Ο Aerobics Ο Body mechanics Ο Ergonomics Ο Exercise 29. Provides additional support to the mattress and improves vertebral alignment. Ο Bed board Ο Footboard Ο Hand roll Ο Mattress 30. Used for support or elevation of a body part. Ο Bed board Ο Footboard Ο Hand roll Ο Pillow

Enumeration: list down what is being asked for by the following items in the left column. Write your answers on the right column.

Ten Categories of Health Care wastes

1. General Waste 2. Infectious Waste 3. 4. 5. 6. 7.

Pathological Waste Pharmaceutical Waste Sharps Pressurized Containers Wastes with high metal content 8. Chemical Waste 9. Radioactive Waste 10. Genotoxic Waste

Ten Assistive Devices

1. Pillow 2. Mattress 3. Side Rails 4. Trapeze Bar 5. Hand Roll 6. Foot Board 7. Bed Board 8. Trochanter Roll 9. Sand Bag 10. Hand-Wrist Splint

Two types of Asepsis

1. Medical Asepsis 2. Surgical Aspesis Date Developed:


May 2014

Date Revised:



Revision # 01

COMPLETION: A. Identify the bed positions illustrated below and complete the following descriptions stated on the second column. DESCRIPTION. The Fowler’s position is one of U

U

three types where the head is elevated up to 300 to 450. P

P

P

P

High-Fowler’s is another type U

U

among two others which is indicated for difficulty breathing and where the head is elevated to 750-900. P

P

P

P

The Low-fowler’s is a type of U

U

Fowler’s position where the head is elevated to a minimum of 7 0 to P

P

150. P

P

U

U

Supine Position is also known as back-lying position and is indicated to enhance healing of abdominal wounds or spinal injuries or the administration of general anesthesia. Best for pregnant women, Sim’s U

Position is a position that provides U

rest to the back of the patient and relieves pregnant women from the weight of her womb.

This is best used to relieve tension and pressure on one side of the body’s bony prominences and is also used to enhance the healing process in certain lung surgeries. This is called the Side-lying U

U

position. Date Developed:


May 2014

Date Revised:



Revision # 01

The Prone Position is best done to U

U

patients that has had previous throat or mouth injuries and to also relieve the back from pressure. The Orthopneic position is best U

U

made for patients who are having difficulty breathing such as those with asthma or COPD.

B. Identify what is being asked for or described by each item. Write your answers on the space proved after each item. 1. It is the efficient, coordinated and safe use of the body to move objects and carry out the activities of daily living 2. The point at which an object’s mass is centered. 3. The foundation that provides the stability of the object 4. What is being maintained during work by widening the base of support and keeping the line of gravity close to the center?

1. C

2. D a. Balance b. Base of Support c. Body Mechanics d. Center of Gravity e. Pressure Ulcer

5. Degradation of the skin consequent to stasis in one bed position.

Date Developed:


May 2014

Date Revised:

3. B

4. A

5. E



Revision # 01

PERFORMANCE TEST

Specific Instruction for the Candidate Qualifications


Unit of Competency

Assist in Client/ Patient Mobility

General Instructions: Given the necessary equipment, supplies and materials you are required to prepare in assisting in client/ patient mobility following the proper procedures. Perform the said task in accordance with the criteria. Time Duration: 1 hour and 20 minutes Specific Instructions: The following tasks should be accomplished. If you finish before the allotted ti me, you may call the attention of your trainer.

1. Before starting the task, identify important safety practices to be observed. (5 minutes) 2. Prepare and identify materials and equipment needed in assisting client in mobility. (10 Minutes) 3. Using the given supply/ materials and equipment, you should be able to perform the following tasks. a. Identify the patient and the patient’s case (2 minutes) b. Perform the appropriate aseptic technique (5 minutes)

Materials and Supplies Needed: 1. Sink 2. Faucet 3. Paper Towel 4. Soap 4. After this, proceed to the working area and gather needed materials strategically. (10 minutes) 5. Identify the waste containers accordingly using the provided labels: (10 minutes) a. Black b. Green c. Yellow d. Red 6. Identify and check the equipment and materials if they are complete and functioning well: (15 minutes) a. Pillows b. Trochanter rolls c. Sand bags d. Hospital Bed e. Trapeze Bar f. Side Rails g. Foot board 7. Operate the equipment according to its ideal function as instructed by your trainer. (10 minutes) a. Hospital Bed 8. Make sure to practice proper body mechanics while performing. Date Developed:


May 2014

Date Revised:



Revision # 01

9. The questioning will be made while the demonstration is being performed and assessment will be undertaken while tasks are being performed. Make sure to explain significant details of your performance as you are being rated accordingly. (3 minutes) 10. After successfully performing the procedure of preparing in assisting the client in mobility, some additional problems may be given to further test your skills. (10 minutes) 11. Other evidence gathering methods maybe used to address the less critical areas, fill the gaps or confirm judgment that strictly adhere to the Evidence Plan. • • •

12. 13.

Portfolio- Checks the authenticity of the materials presented and the trainee’s work. Demonstration with questioning Oral Questioning Record Assessment result using the prescribe form. Obtain feedback on the assessment result.

 COMPETENT  NOT YET COMPETENT

Date Developed:


May 2014

Date Revised:



Revision # 01

Questioning Tool

Question to Prove the Trainee’s Underpinning Knowledge

Satisfactory Response YES

NO

Extension/ Reflection Questions: 1. What are some safety practices that you should observe before, during and after performing a task? Give at least three 2. What is the significance of gathering materials before proceeding with your tasks? 3. What would be better to use, a bar of soap or a liquid one? Could you explain your answer? 4. Suppose only a bar soap is available, how would you consider it before using it? What should you do with it first before lathering it over your hands? 5. What are the types of wastes that you are going to place on those waste receptacles that you have just identified? Can you give an example for each color? 6. What are the materials that you have just checked (refer to item no. 6 in the Performance Test)? Can you briefly describe how they function? 7. Why is it important for you to know how the hospital bed functions?

Safety Questions 1. When working with patients and equipment, what should you observe to prevent yourself from unnecessary back strain and/or injury? 2. What is the importance of using PPEs in the preparation of your task?

Contingency Questions 1. Suppose a bulk of infectious waste was accidentally place in the black container, what would you do to prevent contamination to health care waste handlers? Date Developed:


May 2014

Date Revised:



Revision # 01

2. If your patient needs to be positioned to low fowler’s position but you have a problem elevating the head of the bed, then what could be a remedy that you can use?

Infrequent Events 1. Let’s say you have performed surgical asepsis, and you are already considered “sterile”. You have unmindfully touched your left hand with the other, how would you consider yourself and what should you do? 2. What if a trochanter roll is needed for your patient but there is none available in your department

Rules and Regulations 1. Supposed you heard your patient arguing with her husband about lack of funds to pay for hospital bills. What should be your reaction? The candidates underpinning knowledge was



SATISFACTORY



NOT SATISFACTORY

Feedback to Candidate: General Comments:

Strengths: Improvements: Candidate’s Signature

Date

Assessor’s Signature

Date

Date Developed:


May 2014

Date Revised:



Revision # 01

REFERENCES Valles, C.R. (2009). Manual of Basic Nursing Procedures. Benguet State University-College of Nursing U

U

Taylor, C.R. et. al (2011). Fundamentals of Nursing: The Art and Science of Nursing Care. 7th Edition. Wolters Kluwer Health- Lippincott Williams & Wilkins U

UP

UP

U

Date Developed:


May 2014

Date Revised:



Revision # 01

TRAINING ACTIVITY MATRIX

Training Activity

Trainee

- Video documentary - Laptop - Speakers - DLP Projector

- OSH procedures

Bulcio, Carlita

-

Information sheet on OSH Procedures

-

Soap Water Sink Paper Towels Sterile Gloves Performance Checklist

-

- Equipment use and specifications

Lilibeth Alyao

-

- Body Mechanics

-

-

Safe handling skills

Venue (Workstation/ Area)

- Information Sheet on Pateint Confidentiality

- Patient confidentiality and privacy requirements

- Infection control guidelines

Facilities/Tools and Equipment

Norie Diamas Leah Matis

Information Sheets Hospital Equipment

Information Sheet on Principles of Body Mechanics Information Sheet on Safe Handling Skills Job Sheets in Assistin in Patient Mobility


Learning Resource Area

2014 8:009:00 am

Learning resource Area

May 27, 2014 Wash Area 8:009:00 am Learning Resource Area Work Station 3: Assist in Patient Mobility

May 27, 2014 8:30 am

Learning Resource Area Lecture Area

Workstation # 3: Assist in Patient Mobility

May 2014

Date Revised:

Ma7 27, 2014 9:00


Developed by: SANDOVAL, Warren

Jae M.

Remarks

May 27,

Date Developed:


Date & Time

Revision # 01

-

-Oral Questionning

Performace Checklist

-Oral Questionning Tool

Trainer’s Resource Area

Prepared By: WARREN JAE M. S ANDOVAL HCS NC II Trainer

Date Developed:


May 2014

Date Revised:


Developed by: SANDOVAL, Warren

Jae M.

Revision # 01

FORM 1.1 SELF-ASSESSMENT CHECKLIST INSTRUCTIONS: This Self-Check Instrument will give the trainer necessary data or information which is essential in planning training sessions. Please check the appropriate box of your answer to the questions below.

BASIC COMPETENCIES CAN I…?

YES NO 

1. Participate in Workplace Communication a.

Obtain and convey workplace information



b.

Participate in workplace meetings and discussions



c.

Complete relevant work related documents

 

2. Work in a Team Environment a. Describe team role and scope



b. Identify own role and responsibility within team



c. Work as a team member

 

3. Practice Career Professionalism a. Integrate personal objectives with organizational goals



b. Set and meet work priorities



c. Maintain professional growth and development



d. Integrate personal objectives with organizational goals



e. Set and meet work priorities



f.




4. Practice Occupational Health and Safety Procedures



a. Identify hazards and risks



b. Evaluate hazards and risks



c. Control hazards and risks



d. Maintain occupational health and safety (OHS) awareness



Date Developed:


May 2014

Date Revised:

Doc ument No. Issued by: Page 29 of 122

Develope d by: SANDOVAL,

Warren J ae M .

Revision # 01

COMMON COMPETENCIES YES

CAN I…?

1. Implement and monitor infection control policies and procedures

NO



a. Provide information to the work group about the organization’s infection control policies and procedures



b. Integrate the organization’s infection control policy and procedure into work practices.



c. Monitor infection control performance and implement improvements in practices.





2. Respond effectively to difficult/ challenging behavior



a. Plan responses



b. Apply appropriate responses



c. Report and review incident/s



3. Apply basic first aid



a. Assess the situation



b. Apply basic first aid techniques c. Communicate details of the incident/event



6. Maintain high standard of patient services

 

a. Communicate appropriately with client/patients b. Establish and maintain good interpersonal relationship with clients/patients



c. Act in a respectful manner at all times d. Evaluate own work to maintain high standard of client/patient services

Date Developed:


May 2014

Date Revised:





Warren J ae M .



Revision # 01

CORE COMPETENCIES YES NO

CAN I…?

1.

2.

3.

4.

5.

Prepare and maintain beds a. Prepare the area for bed making?



b. Perform bed making?



c. Perform aftercare activities of materials and equipment used?



Collect and maintain linen stocks at end-user loca tions a. Collect soiled linen?



b. Distribute clean linen?



c. Maintain linen stock levels?



Assist in client/ patient mobility a. Prepare to assist with client/patient mobility?



b. Assist with client/ patient mobility?



c. Complete client/ patient mobility assistance?



Assist in transporting clients/patients a. Prepare client/patient for transport?



b. Assist in client/patient transport?



c. Perform post-transport procedures?



Assist in bio-psychosocial support care of clients/ patients a. Establish and maintain rapport with client/patient? b. Obtain information regarding the bio-psychosocial needs of the client/patient? c. Assist patient in meeting his bio-psychosocial needs?

6.

  

Handle waste in a health care environment a. Determine job requirements related to handling waste?



b. Identify and segregate waste?



Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

c. Transport and store waste?



d. Conduct quality control activities?



e. Clean up work areas?



U

Prepared by:

WARREN JAE M. SANDOVAL, RN HCS NC II Trainer

Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

CLASS PROGRESS CHART Name:_____________ _____________ ___

Trainer:______ _____________ ____________

Qualification:__ __ _____ __ __ __ _____ __ _

Target Date to Finish:__ __ _____ __ __ __ ____ BASIC COMPETENCIES

NAME OF TRAINEE

E C A L P K R O WN IN IO E T T A A IC P I N U IC M T R M A O P C

eyv n o c d n a n i ta b O . 1

n o ti a m r fo n i ec a l p k r o w

ce la p k r o w in te a icp tir a P . 2

d n s a n s o g si s in ete cu is md

k r o w t st n n a e evl m er u c o tee d l p d e mt o ela C r . 3

d n a le ro M A T E N T E A M N IN O K R R IV O N WE

m a te e b rci e p es o D cs . 1

d n a le ro n w o y ift n e Id . 2

n i h it w yt i il b is n o m p s a re te

er b em m m a te

a s a k r o W . 3

R E E R A C E IC T C A R P

M IS L A N O I S S E F O R P

l a n o sr e p te a r egt In

th i w esv tci ej b o

. 1

ls a o g l a n o ti a iz n a rg o

k r o w te e ms d ei n itr a o et ri S p . 2

t n l e a m n p o io ss el v fe ed o r d p n n i a ta h t in w a ro Mg . 3

L A N O I T A P U C C O E IC T C A R P

Y T E F A S

D N A H T L A E H

E R U D E C O R P

d n a s d r za a h fiy t s n e sk Id ri . 1

d n a s rd a z a h te a u l s k a v s E ri . 2

d n a s rd a z a h l o tr s n o k s C ri . 3

Alyao, Lilibeth G. Bulcio, Carlita G. Diamas, Norie C. Matis, Leah V. Segundo, Ronald M.

Date Developed: Ma y 2014


Date Revised:


Developed b y: Warren J ae M . SANDOVAL, Revision # 01

) l S a H n o (O ti y a t p fe a cu c s o d n in a ta h tl in a a e Mh . 4

ss e n re a w a

COMMON COMPETENCIES

S E R U D E C IN O R R P O D T I N N A O S ME I D C N I A L T O P N E L MO E R L T P N O IM C N IO T C E F

NAME OF TRAINEE

t u o s b eci a i p lo u p o rg lo tr rk n o o w cn e o h t ict o t fe n i n o it 's n a o i rm ta fo iz n i n e a rg id v o e ro h P t . 1

.s re u ed c ro p d n a

l o rt n o c n o i cte f in 's n o it a zi n a gr o e th et ra ge t In . 2

se ci tc a r p k r o w o t n i er u d ce o r p d n a cyi l o p

/ T L U C I F F I D O T Y L E V I T C E F F E D N O P S E R

R O I V A H E B G N I G N E L L A H C

ess n o p s re n a l P . 1



D I A T S R I F C I S A B Y L P P A

n io t a u its e h t ss es s A

es u q i n h etc id a ts r fi isc a b yl p p A

t en id c in e th f o s il a te d te a ic n u m m o C

. 1

. 2

. 3

T N IE T A P F O S D R A D N A T S H IG H S N I E A C T I V IN R A E MS

ts n iet a p tih w lye t a ri p ro p p a et ca i n u m m o C . 1

l a n o sr e p etr n i d o o g st in n ie a t ta n i a p m th i d w n p a i h s sh n li o b ti ta l s a E re . 2

se m ti ll a t a er n n a m l fu tc e p s re a in ct A . 3

Alyao, Lilibeth G. Bulcio, Carlita G. Diamas, Norie C. Matis, Leah V. Segundo, Ronald



Date Revised:



h gi h a in a t in e a ic m rv e to s t rk en o i t wa n p f wo o et rd a a u l d n a v ta E s . 4

CORE COMPETENCIES

NAME OF TRAINEE

S D E B N I A T IN A M D N A E R A P E R P

g n i k a m d e b r o f a re a re a p re P . 1

d e b e k a M . 2

s ite iv tic a er a -cr et f a rm o f er P . 3

S N O I T A C O L

N E IN L N I R A E T S IN -U A D MN D E N T A A T C S E K L C L O O T C S

n e in l eld i so tc el l o C . 1

n e in l n a lec et u b rit si D . 2

lse ve l ck to s n e in l n i ta n i a M . 3

Y IT L I B O M T N IE T A P N I T IS S S A

t en ti a p th i w sit ss a to re a p re P . 1

yt lii b o m t n ei t a p h it yt w lii ts b is o s m A . 2

tyi li b o m t n ei t a p e tee cn l ta p s m is o s C a . 3

rt o p s n a tr G r IN fo T t R n O iet P a S p N e A r R a T p S e N I T rP T N . IS IE 1 S T S A A P

tr o p s n a tr t n iet a p n i t iss s A . 2

rt o p s n a rt t-s o es p r u rm d e fo c er ro P p . 3

L IA C O S O H C Y S P O I B N I T IS S S A

S T N IE T A P F O E R A C T R O P P U S

tr o p p a r in ta in a t mn d e n ti a a p sh il eh b t a h st ti E w

g fo in s d r d ee a ge n r l n a ci o it o a so rm ch o f sy n i -p n i i o ta b e b h Ot

. 1

. 2

t n iet a p e h t

te e d m ect to eir ec d n sa a t s iss d s ee a n e t d n vi eit ro a P p . 3

H T L A E H A T N I N E E M T N S O A R W IV E N L E D E N R A A HC

st n e em ir u eq r b jo e n i rm e et D . 1

et s a w te a egr ge s d n a y ift n e Id . 2

et s a w er to s d n a tr o sp n ra T . 3

Alyao, Lilibeth G. Bulcio, Carlita G. Diamas, Norie C. Matis, Leah V. Segundo, Ronald



Date Revised:



l o tr n co tiy l a u q tc u d n o C . 4

se it iv i ct a

s a re a rk o w p u n ea l C . 5

Ac hievement Chart Health Care Ser vices NC II

Achievement Chart Healthcare Services NC II

nfo ei

sic Ba

Name of Trainee

Alindayo, Janice Alyao, Lilibeth Ben-At, Cristan Biniahan, Samar Bulcio, Carlita Catalino Judy Ann Damitan, Jurist Lee Diamas, Norie Dimuyog, Jerica Matis, Leah Legend: /

Passed

X

Failed

Prepared By: Warren Jae M. Sandoval Trainer

) on ati rm

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TRAINING SESSION EVALUAT ION FORM

INST RUC TIONS

This post-training evaluation instrument is intended to measure how satisfac torily your trainer has done his job during the whole duration of your training. Please give your honest rating by checking on the corresponding cell of your response. Your answers will be trea ted with utmost c onfide ntiality.

y r o t c a f s i / t r a o s o n P U

TRAINERS/INSTRUCTORS

Name of Trainer: _ ______________________________

1

y r o t c fa / s i r i t a a F S 2

/ d o o G

y r e V / d o o G y r e V

e t a u q e d A

3

4

1. Orients trainees about CBT, the use of CBLM and the evaluation system

g in d n a t s t u O

y r o t c fa s i t a S 5



2. Discusses clearly the unit of competencies and outcomes to be attained at the start of every module 3. Exhibits mastery of the subject/course he/she is teaching 4. Motivates and elicits active participation from the students or trainees

  

5. Keeps records of evidence/s of competency attainment of each student/trainees



6. Instill value of safety and orderliness in the classrooms and workshops 7. Instills the value of teamwork and positive work values

   

8. Instills good grooming and hygiene 9. Instills value of time 10. Quality of voice while teaching 11. Clarity of language/dialect used in teaching



12. Provides extra attention to trainees and students with specific learning needs

 

13. Attends classes regularly and promptly

Date Developed:




May 2014

Date Revised:



Warren J ae M .

Revision # 01



14. Shows energy and enthusiasm while teaching 15. Maximizes use of training supplies and materials

  

16. Dresses appropriately 17. Shows empathy



18. Demonstrates self-control

This post-training evaluation instrument is intended to measure how satisfac torily your trainer prepared and fac ilitated your training. Please give your honest rating by chec king on the corresponding cell of your response. Your answers will be trea ted with utmost confidentiality.

PREPARATION / r o o P

y r o t c fa s i t a s n U

1

y r o t c a f / s i r i t a a F S

/ d o o G

2

3

e t a u q e d A

/ d o o G y r e V

y r o t c a f y s i r t e a V S

4

1. Workshop layout conforms with the components of a CBT workshop



2.



Number of CBLM is sufficient

3. Objectives of every training session is well explained



Date Developed:


5



4. Expected activities/outputs are clarified


g n i d n a t s t u O

May 2014

Date Revised:



Warren J ae M .

Revision # 01

DESIGN AND DELIVERY

y r o t c a f is / t r a o s o n P U

y r o t c a f / s i ir t a a F S

1

2


e t a u q e d A / d o o G

3

1. Course contents are sufficient to attain

4

y r o t c a f s i t a S


5



objectives 2. CBLM are logically organized and presented



3. Information Sheet are comprehensive in providing the required knowledge



4. Examples, illustrations and demonstrations help you learn



5. Practice exercises like Task/Job Sheets are sufficient to learn required skills



6. Valuable knowledge are learned through the contents of the course



7. Training Methodologies are effective



8. Assessment Methods and evaluation system are suitable for the trainees and the competency 9. Recording of achievements and competencies acquired is prompt and comprehensive

 

10. Feedback about the performance of learners are given immediately



Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01


TRAINING FA CILITIES/RESOURCES

1 1.


y r o t c fa / s i r i t a a F S

2

3


y r o t c fa y s i r t e a V S

/ d o o G y r e V

4

5



Training resources are adequate

2. Training venue is conducive and appropriate 3. Equipment, supplies, and materials are sufficient 4. Equipment, supplies and materials are suitable and appropriate 5. Promptness in providing supplies and materials

SUPPORT STAFF

   

y r o t / c r fa o s o i P t a s n U

y r o / t c r i a a f F s i t a S

1

2

e t a u q e d A /

y r e V / d o o G

o d o G

y r o t c a f s i t y r a S e V


3

4

5



1. Support Staff are accommodating

Comments/Suggestions:

Ok naman. Nagenjoy kami sa pagtuturo ni sir, pero sana masmabait yung U

nasa tool room. 

Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

BVS C OLLEG ES Km. 5, La Trinidad, Benguet 422-4992

C

E

R

T

I

F

I

C

A

T

I

O

N

TO WHOM IT MA Y CO NC ERN:

This is to certify that Warren J ae M . Sandoval, RN, a trainer/ instructor of HEALTH CARE SERIVICES NC IIin this institution has prepared, submitted and used session plans in all the competencies in Health Care Services NC II. Likewise, he has adopted the requirements of Competency-Based Training under the Unit of C ompetency Maintain Training Facilities through the visual display and use of c omplete set of C ompetency-Based Lea rning Materials in his laboratory with the following forms: a. Learning Style Questionnaire b. Evidence and Proof of Competency c . Self-Assessment d. Session Plans (C omplete Set) e. Summary of Current Competencies f. Trainee C harac teristic s g. Training Needs h. Competency-Based Learning M aterials (Complete Set) This c ertific ation is issued upon the request of Mr. SANDOVAL for any legal best Issued this30th day of May 2014at purposes and intends it may serve him Km. 5 La Trinidad, Benguet, Philippines.

ENGR. KE NDAR A. SOMYDEN

President

MAINTAIN TRAINING FACILITIES

C ONTENT S

Laboratory Lay-out Equipment Maintenance Sc hedule Housekeeping Inspec tion Chec klist Equipment Maintenance Inspec tion C hec klist Waste Segregation Purc hase Request Operational Proc edure Housekeeping Sc hedule Workshop Housekeeping Sc hedule Tag-out Index C ard Breakdown/repair Report Inspec tion Report Work Request Salvage Report Training Certific ates Third party c ertificate

Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

LABORATORY LAY-OUT

Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

EQUIPMENT MAINTENANCE SCHEDULE EQUIPMENT TYPE EQUIPMENT CODE

BP Apparatus (Aneroid) BP 01

LOCATION

Healthcare Laboratory

Schedule for the Month of November U

MANPOWER

ACTIVITIES

Daily

Every Other

Weekly

Day

1. Test-check BP cuff for leaks, holes , and breaks 2.Check for incorrect zero and calibration of sphygmomanometer 3. Check functionality of aneroid sphygmomanometer comparing results to a mercurial sphygmomanometer or the like 4. Test-check equity of the stethoscope’s sounds heard on the earpieces 5. Check the connection of the stethoscopes parts 6. Clean stethoscope with 3% Hydrogen Peroxide solution 7. Wash BP cuff and sun dry

Trainer

Trainer

Trainer

Trainer

P

P

Monthly

Remarks

Day







Trainer

Trainer

Every 15th









Trainer

Prepared by:

WARREN JAE M. SANDOVAL HCS NC II Trainer

Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

BP APPARATUS EQUIPMENT MAINTENANCE SCHEDULE* 1T

8 HOURS

50 Hours

1T

Test-check BP cuff for leaks, holes , and breaks Check for incorrect zero and calibration of sphygmomanometer •

•

•

•

•

Clean stethoscope Check the connection of the stethoscopes parts

Test-check equity of the stethoscope’s sounds heard on the earpieces

100 HOURS Check functionality of aneroid sphygmomanometer comparing results to a mercurial sphygmomanometer or the like

Prepared by: WARREN JAE M. SANDOVAL HCS NC II Trainer

Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

HOUSEKEEPING INSPECTION CHECKLIST Qualification

Healthcare Services NC II

Area/ Section


In- Charge

Healthcare Personnel (Warren Jae M. Sandoval)

YES

NO



    



 

INSPECTION ITEMS 1. Are the tools and equipment returned to their proper places? 2. Are the walls, ceiling, floor and other furniture and fixtures well cleaned? 3. Are all used equipment disinfected? 4. Is all the equipment in good working condition? 5. Are all areas well lighted and ventilated? 6. Is the equipment arranged for the purpose of safety and ease in maintenance? 7. Is all the equipment well clean, in order and arranged for safety and maintenance? 8. Are the tables and chairs properly arranged according to the floor layout? 9. Are all expired materials and non-recyclable damaged items disposed?

Remarks: Inspected by:

Jun A. Sabayton

Date: May 22, 2014


Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

EQUIPMENT MAINTENANCE INSPECTION CHECKLIST Equipment Type

:

BP Apparatus (Aneroid)

Property Code/Number : Location YES

:

Practical Work Area / Healthcare Laboratory

NO

INSPECTION ITEMS



1. Does the gauge pointer drop slowly if the cuff is wrapped around Itself and then inflated till 250?



2. Does the gauge return to zero after the cuff has been deflated?



3. Are the results taken using the aneroid sphygmomanometer synonymous with the results taken using the mercurial Sphygmomanometer?



4. Are the sounds heard from the right earpiece equal to those heard from the left?



5. Are the rubber tubing’s of the stethoscope in place?



6. Is the equipment arranged for the purpose of safety and ease in maintenance?



7. Is the stethoscope and BP cuff free from dust and dirt?

Remarks: Inspected by: Jun A. Sabayton

Date:

Prepared by:

WARREN JAE M. SANDOVAL HCS NC II Trainer

Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

WASTE SEGRAGATION Qualification


Area/ Section

Healthcare Department

In- Charge WASTE SEGREGATION METHOD

GENERAL / ACCUMULATED WASTES

Recycle 1. Papers

Compost

Dispose



2. Cottons, bandages, and cotton sticks



3. Dressing trays



4. Sputum caps



5. Mercurial thermometers



6. Masks



7. Goggles



8. Head caps



9. Straps



10. Splints



11. Slings



12. Bandages



13. Crutches



14. Feeding utensils



15. Linens





16. Pillow and pillow cases





17. Rubber sheet



18. Thermal blanket



19. Kelly pad



20. Rubber ring



Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

21. Patient’s gown



22. Draw sheet



23. Towel, hand towel



24. Bed pan



25. Soap dish

 

26. Urinals 27. Ambu man



28. Ambu baby



29. Plaster


Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

PURCHASE REQUEST BVS COLLEGES Km. 5, La Trinidad, Benguet Department: Section:

Stock Unit No.

Technical

PR. No.:

October 18, 2012

Date:

Electronics

Unit Quantity Cost

Item Description

Total Cost

(Php) (Php)

pcs

Plastic dressing tray (complete with accessories) and alcohol and betadine

3

250

750

pcs

Sputum cap

3

10

30

pcs

Thermometer (digital, axillary)

12

120

1440

pcs

Disposable non-woven fabric hospital clinical surgical medical mask

12

5

60

pcs

Surgical Goggles

3

65

195

pcs

Surgical Cap

12

2

24

pcs

Rubber Bandages

3

100

300

Pcs

Gauze Bandages

3

30

90

pcs

Stainless-Steel Feeding utensils

12

20

240

unit

Caja de Oro Shelves

1

1000

1000

pcs

Stainless-Steel Basin

3

50

150

pcs

Soap dish

3

20

60

pcs

Surgical Plaster

3

25

75

pcs

Adult Brachial Aneroid BP apparatus

3

1500

4500

pcs

Hospital pillow case

6

50

300

Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

pcs

Cotton hand towel

6

20

Grand Total:

120 9334

Purpose: Tools and materials in the practical work area are not enough and some are not functional. Supplies are consumables and are needed to replace. Requested By:

Approved By:

Signature: WARREN JAE M. SANDOVAL PRINTED NAME:

GRACE E. CUYAHON

HCS NC II Trainer

Designation:

Registrar/ Administrative Officer


Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

OPERATIONAL PROCEDURE Equipment Type

Aneroid BP Apparatus

Equipment Code Location


Operation Procedure:

1. Check functionality of stethoscope, earpieces, chest-pieces, bladder, cuff and rubber tubings. 2. Check availability of all parts. 3. Check for protruding parts. 4. Always deflate the bladder when not in use. 5. Wipe the diaphragm or the bell and the earpieces with alcohol. 6. Wipe the rubber tubings with clean water, NOT alcohol or soap. 7. Place all needed materials in the prescribe receptacle.

Prepared by:

WARREN JAE M. SANDOVAL, RN Trainer

Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

HOUSEKEEPING SCHEDULE Qualification


Area/ Section


In- Charge


Schedule for the 2nd Semester, 2012 P

ACTIVITIES

y

Responsible person

y li a D

1. Clean all tools and equipment

Trainee/Utility X Personnel

2. Clean tables and chairs 3. Arrange all tools, equipment, tables and chairs 4. Wash all bed linens, curtains and linen hamper cloths. 5. Disinfect

Trainee/Utility Personnel

unused tools/equipment 6. Disinfect used tools/equipment 7. Dispose all expired materials and nonrecyclable damaged items

P

y r e v E

re h t a o D

ly k e e W

y a r hD et v 5 E 1 P

P

y l th n o M

s k r a m e R

X

Trainee/Utility X Personnel Utility Personnel

X

Trainee/Utility Personnel

X

Trainee/Utility X Personnel Healthcare Personnel

Trainee/Utility X Personnel 9. Clean walls Utility and windows Personnel Trainee/Utility 10. Dispose waste X Personnel 11. Lock storage Healthcare cabinets every X 8. Clean floor

after use

X

Personnel


Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

WORKSHOP HOUSEKEEPING SCHEDULE DAILY TASK

YES

1. Clean all tools and equipment.



2. Clean tables and chairs.



3. Arrange all tools, equipment, tables and chairs.



5. Disinfect unused tools/equipment



6. Disinfect used tools/equipment



7. Clean floor



8. Dispose waste



9. Lock storage cabinets every after use



WEEKLY TASK

YES

1. Wash all bed linens, curtains and linen hamper cloths.



2. Clean walls and windows



MONTHLY TASK

YES

1. Inspect expired materials and non-recyclable damaged items.



2. Clean instructional materials & modules; arrange and put in order



NO

NO

NO

Prepared by:

WARREN JAE M. SANDOVAL, RN Trainer

Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

TAG-OUT INDEX CARD

DESCRIPTION

LOG

DATE

TYPE

SERIAL

ISSUED

(Danger/Caution)

2012-01

10-18-2012

Warning

2012- 02

10-18-2012

Warning

Allow the heater to cool before handling

Warning

Electrical Shock Hazard. Refer all servicing to qualified, trained personnel only.

(System Components, Test reference, etc. Fire Hazard. Do not use in

2012- 03

2012- 04

10-18-2012

10-18-2012

Caution

the presence of flammable Anesthetic gases.

Do not autoclave, gas sterilize, pasteurize or immerse this device in any liquid. Severe equipment damage will result.

2012- 05

2012- 06

10-18-2012

10-18-2012

Warning

No smoking/fire within 50 feet

Warning

The instrument contains electrical circuits, devices and components operating at dangerous voltages.


Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

BREAKDOWN/ REPAIR REPORT Property ID Number: Property Name:

Wheelchair 01

Location:

Practical Work Area / Healthcare Laboratory

Findings

Recommendation

•

Malfunctioning left wheel lock

•

Sent to maintenance for repair

Inspected by: Warren Jae M. Sandoval

Reported to: Engr. Kendar A. Somyden

Date: Oct. 18, 2012

Date: Oct. 18, 2012

Assigned to: Jun A. Sabayton

Received Assignment:

Date: Oct. 18, 2012

Date:

Subsequent Action Taken:

Recommendation:

By Technician

Reported:

Date:

Date:


Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

INSPECTION REPORT Area / Section:


In-Charge:

Healthcare Personnel Warren Jae M. Sandoval

FACILITY TYPE Overbed Table

Nebulizer

INCIDENT

ACTION TAKEN

Detached wheels on the left rear

Sent to maintenance for repair Sent to manufacturer for repair Sent to maintenance for repair Troubleshooting done Sent to maintenance for repair Hinges Lubricated Mended

Unable to switch on

Hospital Bed

Malfunctioning Manual Lever

BP Apparatus

Non-Inflating Cuff

Wheelchair

Malfunctioning left wheel lock

Bedside Table Linen Hamper

Inoperable door Torn hamper

PROGRESS / REMARKS Repaired

Cannot be repaired; replace nebulizer Repaired

Needs replacement Repaired

Repaired Repaired

cloth Reported by:

WARREN JAE M. SANDOVAL U

Signature over Printed Name Date:

May 27, 2014

Prepared by:


Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

WORK REQUEST Unit No.

Description: Over-bed Table

Observation: Detached Wheels on the Left Rear

Date Reported: May 27, 2014 Reported by: Warren Jae M. Sandoval Date completed: May 27, 2014 Sign:

Should be reattached

Activity: Soldering

Spare parts used: None

Unit No.

Description: Nebulizer

Observation: Unable to switch on

Date Reported: May 27, 2014

Should be sent to manufacturer/place of purchase for repair or replacement Activity: Referred to manufacturer for repair

Reported by: Warren Jae M. Sandoval Date completed: May 27, 2014 Sign:


Unit No.

Description: BP Apparatus

Observation: Non-inflating Cuff

Date Reported: May 27, 2014

Should be replaced if the damage is tearing of the cloth part of the cuff Activity: Purchased

Reported by:M. Warren Jae Sandoval Date completed: May 27, 2014 Sign:


Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

Unit No.

Description: Hospital Bed

Observation: Detached Wheels on the Left Rear

Date Reported: May 27, 2014 Reported by: Warren Jae M. Sandoval Date completed:

Should be reattached

Activity: Soldering

May 27, 2014 Sign: Spare parts used: None

Unit No.

Description: Linen Hamper

Observation: Torn Hamper Cloth Should be mended


Activity: Tear Stitched

May Sign:27, 2014 Spare parts used: None

Unit No.

Description: Bedside Table

Observation: Inoperable door Should be repaired

Date Reported: May 27, 2014 Reported by: Warren Jae M. Sandoval Date completed: May 27, 2014 Sign:

Activity: Hinges lubricated

Spare parts used: none

Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

Unit No.

Description: Wheelchair

Observation: Malfunctioning left wheel lock


Activity: Should be repaired

May 27, 2014 Sign: Spare parts used: Wheel Lock

Prepared by:


Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

SALVAGE REPORT Area / Section

:


In-Charge

:


FACILITY TYPE

PART ID

RECOMMENDATION

Short Linens

Short Linen( All parts)

BP Apparatus

Cuff Bulb and Stethoscope Tubing

Store as back-up linen draw sheets Store as back-up bulb and tubing

Reported by:

Date

Signature Over Printed Name

Prepared by:


Date Developed:


May 2014

Date Revised:



Warren J ae M .

Revision # 01

BVS C OLLEGES Km. 5, La Trinidad, Benguet 422-4992

C

E

R

T

I

F

I

C

A

T

I

O

TO WHOM IT MA Y CO NC ERN: This is to c ertify that WARREN JAE M. S ANDOVAL, RNa trainer/instructor of HEALTH CARE SERIVICESNC IIin this institution has been maintaining good housekeeping of the laboratory assigned to him. Likewise, he always prepare his session plans and adopted the requirements of C ompetency-Based Training under the Unit of Competency Maintain Training Facilities through the visual display and acc omplishment of relevant forms in the Facilities Maintenance A rea of his Laboratory with the following forms: a. Housekeeping Schedule b. Equipment Ma intenance Schedule c . Housekeeping Inspec tion C hecklist d. Maintenance Inspection Checklist e. Equipment Rec ord with C ode and Drawing f. Tag-out Bill g. Waste Segregation List h. Breakdown Report i. Work Request j. Salvage Report k. Inspec tion Report I. Operation of Equipment This c ertification is issued upon the request of Mr. SANDOVAL for any legal purposes and intends it may serve him best. Issued this27th day of May 2014 at Km.5 La Trinidad, Benguet, Philippines.

ENGR. KENDAR A. SOMYDEN President

N

SUPERVISE WORK-BASED TRAINING

C ontent s

Training Plan Training Session Evaluation Form Work-Based Training Evaluation Interpretation and Analysis of Program Evaluation Trainer’s Self Evaluation Training Evaluation Form Trainee’s Rec ord Book Trainee’s Progress Sheet OJ T Monitoring Sheet Memorandum of Agreement Office Order of Designation Third Party C ertific ate




Date Revised: Developed by: SANDOVAL, Jae M.

Page 72 of 122

Warren Revision 01

#

TRAINING PLAN HEALTH CARE SERVICES NC II

Trainees’ Training Activity/ Training Mode of Training Task Requirements

Facilities/ Tools and Equipment

Staff

•

• •


• •

•

•

Patient confidentiality and privacy requirements OSH procedures Infection control guidelines Equipment use and specifications Body Mechanics

•

• • • • •

Modular/ SelfPaced Lecture Discussions Demonstrations Role-Play Video Presentation

•

Warren Jae M. Sandoval, RN

• • •

• •

•

Information Sheets PowerPoint Presentations Video presentations Hygiene Kit PPE Sink with faucet and running water Sterile gloves Hospital Assistive Devices Hospital Bed

Venue

Assessment Method

Date and time

Self-check • •

•

Classroom Laboratory/ Simulated Workplace Wash area

Return Demonstration TBA Practical Exercises Oral Questioning

•

• •


•

•

•

Patient confidentiality and privacy requirements OSH procedures Infection control guidelines Appropriate communication skills Equipment use and specifications Safe handling skills

•

•

•

• • • • •

Modular/ SelfPaced Lecture Discussions Demonstrations Role-Play Video Presentation


• • •

• •

•

May 2014

Developed by: SA NDOV A L, Jae M.

Devices Hospital Bed


Date Developed:

Health Care Services NC II Date Revised: Assist in Client. Patient Mobility

•

Information Sheets PowerPoint Presentations Video presentations Hygiene Kit PPE Sink with faucet and running water Sterile gloves Hospital Assistive

Page 74 of 122

Warren Revision 01

#

Self-check • •

•

Classroom Laboratory/ Simulated Workplace Actual Workplace

Return Demonstration Observation Practical Exercises Oral Questioning

TBA

•

•

Complete client/patient mobility assistance

• •

•

•

Patient confidentiality and privacy requirements OSH procedures Infection control guidelines Appropriate communication techniques Safe handling skills

•

•

• • • •

Modular/ SelfPaced Lecture Discussions Demonstrations Role-Play

•


• • •

Video Presentation • •

•

Prepared by:

Information Sheets PowerPoint Presentations Video presentations Hygiene Kit PPE Sink with faucet and running water Sterile gloves Hospital Assistive Devices Hospital Bed

W ARREN JAE M. SANDOVAL, RN HCS NC II Trainer U





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Self-check • •

•

Classroom Laboratory/ Simulated Workplace Wash Area

Return Demonstration Practical Exercises Oral Questioning

TBA

TRAINING SESSION EVALUATION FORM

INSTRUCTIONS This post-training evaluation instrument is intended to measure how satisfactorily your trainer has done his job during the whole duration of your training. Please give your honest rating by checking on the corresponding cell of your response. Your answers will be treated with utmost confidentiality.


TRAINERS/INSTRUCTORS

Name of Trainer: _ ______________________________

1

y r o t c fa / s i r i t a a F S 2

/ d o o G 3


e t a u q e d A 4


y r o t c fa s i t a S 5

1. Orients trainees about CBT, the use of CBLM and the evaluation system



2. Discusses clearly the unit of competencies and outcomes to be attained at the start of every module 3. Exhibits mastery of the subject/course he/she is teaching 4. Motivates and elicits active participation from the students or trainees

  

5. Keeps records of evidence/s of competency attainment of each student/trainees



6. Instill value of safety and orderliness in the classrooms and workshops 7. Instills the value of teamwork and positive work values

    

8. Instills good grooming and hygiene 9. Instills value of time 10. Quality of voice while teaching 11. Clarity of language/dialect used in teaching



12. Provides extra attention to trainees and students with specific learning needs

 

13. Attends classes regularly and promptly



14. Shows energy and enthusiasm while teaching





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15. Maximizes use of training supplies and materials

  

16. Dresses appropriately 17. Shows empathy



18. Demonstrates self-control

This post-training evaluation instrument is intended to measure how satisfactorily your trainer prepared and facilitated your training. Please give your honest rating by checking on the corresponding cell of your response. Your answers will be treated with utmost confidentiality.


y r o t c a f s i t a s n U

1

y r o t c a f / s i r i t a a F S

/ d o o G

2

3

e t a u q e d A

/ d o o G y r e V

y r o t c a f y s i r t e a V S

4

5




2.








DESIGN AND DELIVERY




y r o t c fa s i / t r a o s o n P U

y r o t c a f / is r i t a a F S

1

2

1. Course contents are sufficient to attain objectives



3


y r o t c a f is t a S

4

5



2. CBLM are logically organized and presented



3. Information Sheet are comprehensive in providing the required knowledge



4. Examples, illustrations and demonstrations help you learn



5. Practice exercises like Task/Job Sheets are sufficient to learn required skills

 Document No. Issued by:




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6. Valuable knowledge are learned through the contents of the course



7. Training Methodologies are effective



8. Assessment Methods and evaluation system are suitable for the trainees and the competency 9. Recording of achievements and competencies acquired is prompt and comprehensive

 

10. Feedback about the performance of



learners are given immediately

y r o t c fa s i / t r a o s o n P U

TRAINING FACILITIES/RESOURCES

1 1.


y r o t c a f / is r i t a a F S

2

3

4

5



Training resources are adequate

2. Training venue is conducive and appropriate 3. Equipment, supplies, and materials are sufficient 4. Equipment, supplies and materials are suitable and appropriate 5. Promptness in providing supplies and materials

SUPPORT STAFF


y r o t c a f y is r t e a V S

/ d o o G y r e V

   

y r o t / c r a o fs o i P t a s n U

y r o / t c r i a a f F is t a S


1

2

3




4

5

1. Support Staff are accommodating



Comments/Suggestions:

Ok naman. Nagenjoy kami sa pagtuturo ni sir, pero sana masmabait yung nasa tool U

room.  Document No. Issued by:




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Technical Education and Skills Development Authority BVS COLLEGES U

TRAINEE’S RECORD BOOK

I.D. Trainee’s No.___________

NAME: _______________________________________ QUALIFICATION: HEALTH CARE SERVICES NC II U

TRAINING DURATION: __________________________ TRAINER: ____________________________________





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Instructions: This Trainees’ Record Book (TRB) is intended to serve as record of all accomplishment/task/activities while undergoing training in the industry. It will eventually become evidence that can be submitted for portfolio assessment and for whatever purpose it will serve you. It is therefore important that all its contents are viably entered by both the trainees and instructor. The Trainees’ Record Book contains all the required competencies in your chosen qualification. All you have to do is to fill in the column “Task Required” and “Date Accomplished” with all the activities in accordance with the training program and to be taken up in the school and with the guidance of the instructor. The instructor will likewise indicate his/her remarks on the “Instructors Remarks” column regarding the outcome of the task accomplished by the trainees. Be sure that the trainee will personally accomplish the task and confirmed by the instructor. It is of great importance that the content should be written legibly on ink. Avoid any corrections or erasures and maintain the cleanliness of this record. This will be collected by your trainer and submit the same to the Vocational Instruction Supervisor (VIS) and shall form part of the permanent trainee’s document on file. THANK YOU! Document No. Issued by:




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NOTES:





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BASIC COMPETENCIES

•

Unit of Competency: 1. PARTICIPATE IN WORKPLACE COMMUNICATION

•

•

NC Level II •

Learning Outcome

Task/Activity Required

Date Accomplished

Instructors Remarks •

•

•

•

Obtain and convey workplace information Participate in workplace meetings and discussions Complete relevant work related documents

•

•

•

•

•

•

•

•

Access specific and relevant information

•

Effective questioning , active listening and speaking skills

•

Use appropriate medium

•

Use appropriate nonverbal communication

•

Identify Appropriate lines of communication with supervisors and colleagues •

Use Defined workplace procedures Carry personal interaction Attend Team meetings

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Conduct workplace interactions Ask and respond to questions about simple routine workplace Interpret and implement meetings outcomes Complete range of forms relating to conditions of employment Record workplace data. Use Basic mathematical process Identify errors in recording information on forms/ documents

Complete report requirements to supervisor

___________________

Trainee’s Signature

Trainer’s Signature

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Establish protocols

__________________


Date Developed:

Health Care Services NC II Date Revised:

Clearly express own opinion

Unit of Competency: 2. WORK IN A TEAM ENVIRONMENT •

NC Level II Learning Outcome •

•

•

Describe team role and scope Identify own role and responsibility within team Work as a team member

Task/Activity Required •

•

•

•

•

•

•

Date Accomplished

Instructors Remarks

•

Identify the role and objective of the team Identify team parameters, reporting relationships and responsibilities Identify Individual role and responsibilities within the team environment Identify Roles and responsibility of other team members Identify Reporting relationships within team and external Use effective and appropriate forms of communications Make effective and appropriate

__________________ Trainee’s Signature





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contributions Observe protocols in reporting using standard operating procedures Contribute to the development of team work plans based on an understanding of team’s role and objectives and individual competencies of the members.

___________________ Trainer’s Signature

Unit of Competency: 3. PRACTICE CAREER PROFESSIONALISM

Unit of Competency: 4. PRACTICE OCCUPATIONAL HEALTH AND SAFETY PROCEDURES

NC Level II

•

•

•

Learning Outcome Integrate personal objectives with organizational goals Integrate personal objectives with organizational goals Maintain professional growth and development


•

•

•

• •

•

•

•

Date Accomplished

Instructors Remarks

NC Level II

Pursue Personal growth and work plans Maintain Intra- and interpersonal relationships Demonstrate Commitment to the organization and its goal Prioritize competing demands Utilize resources Follow practices along economic use and maintenance of equipment and facilities

Learning Outcome •

•

•

Identifyopportunities Trainings and career Sought/receive and demonstrate recognitions Obtain Licenses and/or certifications relevant to job and career


in practices.

___________________


Trainer’s Signature Document No. Issued by:


Health Care Services NC II Date Revised: Developed by: SA NDOV A L, Jae M.

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Relevant information about the organization's infection control policy and procedures, and applicable industry codes of practice are accurately and clearly explained to the work group.

•

__________________


Provide information to the work group about the organization’s infection control policies and procedures Integrate the organization’s infection control policy and procedure into work practices. Monitor infection control performance and implement improvements

Information about identified hazards and the outcomes of infection

Date Accomplished

Instructors Remarks

COMMON COMPETENCIES

risk assessments is regularly provided to the work group. •

Unit of Competency: 1. IMPLEMENT AND MONITOR INFECTION CONTROL POLICIES AND PROCEDURES. NC Level II

Opportunity is provided for the work group to seek further information on workplace infection control issues and practices.

Learning Outcome •

•

__________________

___________________


Trainer’s Signature •

May 2014


work practices. Monitor infection control performance and implement improvements in practices.


Date Developed:


Provide information to the work group about the organization’s infection control policies and procedures Integrate the organization’s infection control policy and procedure into

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•

•

Explains accurately and clearly relevant information about the organization's infection control policy and procedures, and applicable industry codes of practice. Provides regular information about identified hazards and the outcomes of infection risk assessments. Provides opportunity for the work group to seek further information on

Date Accomplished

Instructors Remarks

workplace infection control issues and practices. •

•

•

•

•

refers to the appropriate personnel for resolution.

Implements Infection control policy and procedures.

•

Maintains liaison with person responsible for organization-wide infection control. Ensures the Supervisor's coaching supports the individuals/teams are able to implement infection control practices. Adopts work procedures to reflect appropriate infection control practice. Deals with and resolves promptly issues raised through consultation or

•

•

•





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Implements workplace procedures for dealing with infection control risks and hazardous events whenever necessary. Encourages employees to report infection risks and to improve infection control procedures. Promptly investigates infection control hazardous events to identify their cause in accordance with organization policy and procedures. Monitors work procedures to

•

•

•

•

control infection risks to ensure compliance. Reviews and adjusts work procedures are regularly to ensure improvements in infection control practice.

inadequacies in work procedures and infection control measures to designated personnel. •

Provides supervisor feedback to team and individuals on compliance issues, changes in work procedures and infection control outcomes.

•

Provides training in work procedures as required to ensure maintenance of infection control standards. Identifies, corrects and reports May 2014



___________________



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Uses aggregate infection control information reports are to identify hazards, to monitor and improve risk control methods and to indicate training needs.

__________________


Date Developed:


Maintains accurate records of infection control risks and incidents as required.

Unit of Competency: 2. RESPOND EFFECTIVELY TO DIFFICULT/ CHALLENGING BEHAVIOR NC Level II Learning Outcome •

•

Plan and respond to emergencies Report and review incident/s


•

•

Date Accomplished

procedures. •

Instructors Remarks

Plans responses to instances of difficult or challenging behavior to maximize the availability of other appropriate staff and resources. Identifies specific manifestations of difficult or challenging behavior and plans strategies appropriate to these behaviors as required.

•

•

•

Gives priority to safety of self and others in

•

responding to difficult or challenging behavior according to institutional policies and procedures. •

•

Deals difficult or challenging behavior is with prompt, firm and diplomatically in accordance with institutional policies and May 2014



Revision 01

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Reviews incidents with appropriate staff and suggestions appropriate to area of responsibility are made. Uses and participates in debriefing mechanisms and other activities. Soughs advice and assistance from legitimate sources when appropriate.

___________________



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Selects appropriate strategies to suit particular instances of difficult or challenging behavior. Reports incidents according to institutional policies and procedures.

__________________


Date Developed:


Uses communication effectively to achieve the desired outcomes in responding to difficult or challenging behavior.

Unit of Competency: 3. APPLY BASIC FIRST AID •

NC Level II Learning Outcome •

•

•

Assess the situation Apply basic first aid techniques Communicate details of the incident


•

•

•

•

Date Accomplished

Instructors Remarks

•

Identify Physical hazards to self and casualty’s health and safety. Minimized immediate risks to self and casualty’s occupational health and safety (OSH ) by controlling the hazard in accordance with OSH requirements. Assess casualty’s vital signs and physical condition in accordance with workplace procedures. Provided First Aid management in accordance with established First Aid procedures. Reassure casualty is in a caring and calm manner and made comfortable using

•

•

•

•





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available resources. Seek First Aid assistance from others in a timely manner and as appropriate. Monitor and respond to casualty’s condition in accordance with effective First Aid principles and workplace procedures. Accurately record details of casualty’s physical condition, changes in conditions, management response in line with organizational procedures. Finalize casualty management according to his/her needs and First Aid principles. Request appropriate medical assistance using relevant communication media and equipment Accurately convey details of casualty’s condition and management activities to emergency

•

services/relieving personnel Prepare reports to supervisors in a timely manner, presenting all relevant facts according to established company procedures

NC Level II Learning Outcome

•

•

__________________

___________________



•

Communicate appropriately with patients Establish and maintain good interpersonal relationship with patients Act in a respectful manner at all times


•

•

•

•

•

Unit of Competency: 4. MAINTAIN HIGH STANDARDS OF PATIENT SERVICES





•

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Identify and use effective communication strategies and techniques to achieve best patient service outcomes. Responded to complaints in accordance with organizational policy to ensure best service to patients. Deal with complaints in accordance with established procedures Accessed interpreter services as required Take action to resolve conflicts either directly, where a positive outcome can be immediately achieved, or by referral to the appropriate personnel Participate in work team constructively and

Date Accompli shed

Instructors Remarks

collaboratively and demonstrate an understanding of own role. •

•

•

•

•

•

•

•

Establish rapport to ensure the service is appropriate to and in the best interests of patients. Use effective listening skills to ensure a high level of effective communication and quality of service

•

•

Correctly identify and respond to patient concerns and needs responsibly and accordingly established procedures and guidelines

•

Consistently monitor and evaluate effectiveness of interpersonal interaction to ensure best patient service outcomes Demonstrate respect for differences is positively, actively and consistently in all work.

Use techniques to manage and minimize aggression Receive or seek advice and assistance from appropriate sources on own performance Adjust own work, incorporating recommendations that address performance issues, to maintain the agreed standard of patient support

__________________

___________________



CORE COMPETENCIES Unit of Competency: 1. PREPARE AND MAINTAIN BED

Maintain confidentiality and privacy of patients. Demonstrated courtesy




in all interactions with patients, their visitors, careers and family Provide assistance with the care of patients with challenging behaviors in accordance with established procedures


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Date Accompli shed

•

Instructors Remarks

Use personal protective equipment according to institutional policy Adjust bed height is adjusted as necessary Clear of bed surroundings of medical and other equipment before bed is stripped, where necessary Provide patient privacy, comfort and safety at all times Check bed linen for displaced personal items, aids and equipment and place such aids/equipment in appropriate area/container  Strip bed linen where necessary Remove and place clinical waste and soiled linen in appropriate container Clean bed according to established procedures,

•

Prepare Area for Bed Making

•

•

•

•

•

•

•

•

Perform Bed Making

•

Perform after care activities of materials and equipment used

•

•

•





•

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where necessary Place clean bed linen is on bed in accordance with institution procedures Remake existing bed linen, as needed Ask patient whether he/she is comfortable, or if he/she has any preferred bed needs Handle reusable clean bed linen is accordance with institution procedures Clean and disinfect mattresses and pillows, in accordance with established procedures Adjust bed height for occupancy and apply brakes according to bed type Keep beds and equipment/ aids accessible and leave bed ready for occupancy Report damaged and/or faulty beds, equipment mattresses, pillows and linen to appropriate personnel and document accordingly.

•

•


Unit of Competency: 2. COLLECT AND MAINTAIN LINEN STOCKS AND END-USER’S LOCATION NC Level II

Discard soiled linen and clinical wastes according to established protocol Clean and returned cleaning implements to designated storage areas or disposed of appropriately.

Learning Outcome Collect soiled linen

Task/Activity Required Collect soiled linen as scheduled from end user locations Replace soiled linen bag in accordance with institution policies and procedures Transport soiled linen to designated holding area using appropriate equipment and safe handling techniques Carry out collection of soiled linen out in a manner that minimizes the risk of cross contamination and comply with OHS policy and procedures Identify and report hazards to supervisor Follow correctly appropriate procedures for dealing with accidents, including sharp injuries Transport clean linen as scheduled to end- user locations using appropriate

•

•


•

•

•

•

Distribute clean linen





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•

Date Accomplished

Instructors Remarks

•

•

Maintain linen stock levels

•

•

•

•

•

Unit of Competency: 3. ASSIST IN CLIENT OR PATIENT MOBILITY NC Level II

equipment and safe handling techniques Replace linen to ensure adequate supply for users Rotate linen stock and return old stock for reprocessing Maintain optimum stock levels to ensure linen availability Requisite linen to par level quantity Store linen in linen storage facilities and maintain according to institution requirements Maintain linen stock records according to institution requirements Do linen inventory according to institution policies and procedures


Learning Outcome



•

•

•

•



•

•

•





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Confirm requirements for assisting with patient mobility with concerned health personnel and care plan Select equipment according to prescribed plan of care Prepare environment according to established guidelines Explain procedure to patient as required using appropriate communication techniques Carry out patient mobility using safe handling methods and equipment as required Take appropriate action to ensure patient comfort and safety throughout positioning or transfer Undertake

Date Accompli shed

Instructors Remarks

•

Complete client/ patient mobility assistance

•

•


Unit of Competency: 4. ASSIST IN TRANSPORTING CLIENTS/PATIENT

communication with patients during movement according to established procedures. Move patient to prescribed position and concerned health personnel are informed accordingly Clean equipment in accordance with established procedures Report equipment’s working condition immediately in accordance with established procedures


Prepare client/patient for transport


•


•

•





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Confirm transportation requirements with appropriate health care personnel Explain transport procedures to patient as required Make preparations for the safe and efficient transport of the patient as per instructions Ready equipment for transportation according to requirements and check to

Date Accomplished

Instructors Remarks

ensure that it is clean, complete and functional

Assist in client/patient transport

•

•

•

Perform post-transport procedures

•

•

Transport patient to designated location in accordance with established procedures Adjust equipment to ensure patient comfort and safety with minimal risk to self Bring patient to designated location and reported to appropriate health care personnel

•

Trainee’s Signature:___________________________

Trainer’s Signature:____________________________

Clean equipment in accordance with established Document No. Issued by:



procedures Return Equipment according to standard operating procedures Immediately report the working condition of equipment in accordance with established procedures.


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Unit of Competency: 5. ASSIST IN BIO-PSYCHOSOCIAL SUPPORT CARE OF PATIENTS

•


Establish and maintain rapport with client


•

•

•

Date Accomplished

Instructors Remarks

Make initial contact with patient care and its appropriate time according to the care plan and / or established procedures Demonstrate courtesy in all communication with patients and staff in the workplace Initiate interpersonal exchanges with patient as appropriate Develop communication and maintained for effective

•

•

Obtain information regarding the BioPsychosocial Needs of the patient

•




•


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relationship with patients Generate trust and confidence of patient consistently in all of the relevant work activities that are undertaken Maintain Confidentiality and privacy of patient consistently Respect Patient’s rights and roles in decisionmaking

Obtain patient information from the family/ significant others and concerned health personnel Determine and recognize patient bio-

•

•

Assist patient in meeting his bio-psychosocial needs

psychosocial care needs Confirm scope, nature and frequency of patient support needs with patient and appropriate health personnel as required Report patient information as appropriate and conform with ethico-moral, legal, professional and institutional requirements Provide comfort and safety

emotional discomfort to patients and with minimum risk to self Provide assistance in emergency situations according to prescribed protocol

•

Trainee’s Signature ______________________ Trainer’s Signature:______________________

•

measures according to the care plan and direction of the health professional Provide assistance and support with minimum physical and

•





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Unit of Competency: 6. HANDLE WASTE IN A HEALTH CARE ENVIRONMENT

personal protective equipment in accordance with job requirements, manufactures’ specifications, workplace requirements and relevant legislation

NC Level II Learning Outcome Determine job requirements


Date Accomplished

Instructors Remarks


Review work sheets to determine waste handling requirements Select and obtain appropriate equipment for waste handling tasks and to maximize work effectiveness and efficiency Organize and set Health care sites up to ensure safe, effective and efficient handling of waste in accordance with workplace requirements and

•

•

•

•

•

relevant legislation Identify and manage potential risks and hazards to work in accordance with workplace requirements, OSH, infection control and other relevant legislation Follow reporting identified risks in accordance with workplace procedures Select and fit emergency and

litter in work areas and avoid cross-contamination Frequently monitor waste containers to ensure adequate available containers and to secure containment of waste Empty or replace full waste containers or replace promptly to minimize disruption to the workplace in accordance with policies and procedures and

•

•

•

•

•





Clearly identify and handle hazardous, dangerous and non-conforming waste in accordance with workplace policies and procedures as well as relevant legislation Accurately identify, label and segregate all waste according to waste types in accordance with workplace policies and procedures and relevant legislation Carefully place all sorted waste into correct waste category containers to prevent

•

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job requirements Clearly label segregated waste in accordance with job requirements, workplace policies and procedures and relevant legislation

legislation and workplace requirements

•

Transport and store waste

•

•

•

•

•

•

Conduct quality control activities

Select appropriate transport equipment for waste transport activities to maximize work effectiveness and efficiency and in accordance with workplace policies and procedures and relevant legislation Color-code and label all transport equipment in accordance with workplace policies and procedures and relevant legislation Secure transport loads and not overload according to workplace requirements and relevant legislation Perform waste collection rounds as often as required to minimize waste overflow hazards. Enclose and secure storage areas are in accordance with workplace requirement and relevant legislation Store waste types in accordance with relevant

Clean-up work areas

Inspect and check waste to ensure that it is placed in the correct waste receptacle Inspect and check storage areas to ensure that they are secured in accordance with workplace requirements and relevant legislation Document accurately and promptly all details of quality control activities in accordance with workplace requirements and relevant legislation Clean waste storage sites and all equipment to ensure safe and effective future operation in accordance with company requirements

•

•

Dispose activities of waste from cleaning in accordance with workplace requirements, council requirements and relevant legislation

Trainee’s Signature:___________________________ Trainer’s Signature:____________________________ Document No. Issued by:



•

•


•

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TRAINEE’S PROGRESS SHEET Name: LANGATO, NORIE D.

Trainer:

U

Qualification: Health Care Services NC II

UNITS OF COMPETENCY

TRAINING ACTIVITY •

•

PREPARE TO ASSIST WITH

•

PATIENT MOBILITY •

•

Patient confidentiality and privacy requirements OSH procedures Infection

TRAINING DURATION

Nominal Duration:

DATE STARTED

60 hours

September 3,

September

2013

14, 2013


Date Developed:


960 hours

RATING

TRAINEE’S SIGNATURE

SUPERVISOR’S SIGNATURE

Numerical Rating: 85 %

control guidelines Equipment use and specifications Body Mechanics


DATE FINISHED

WARREN JAE M. SANDOVAL U

May 2014

Date Revised: Developed by: SA NDOV A L, Jae M.

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Adjectival Rating: Competent

N.D.L

W.J.M.S.

•

•

•

ASSIST WITH CLIENT/PATIENT MOBILITY

•

•

•

Patient confidentiality and privacy requirements OSH procedures Infection control guidelines 90 hrs Appropriate communicatio n skills Equipment use and specifications Safe handling skills

Numerical Rating: 92% September 17, 2013


Date Developed:


May 2014


October 12, 2013

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N.D.L

W.J.M.S.

•

•

COMPLETE CLIENT/PATIENT MOBILITY ASSISTANCE

•

•

•

Prepared by:

Patient confidentiality and privacy requirements OSH procedures Infection control guidelines Appropriate communicatio n techniques Safe handling skills

Numerical Rating: 95% 50 hrs

October 12, 2013

October 24, 2013

W ARREN JAE M. SANDOVAL,RN U

HCS NC II Trainer


Date Developed:


May 2014


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N.D.L

W.J.M.S.

INTERPRETATION AND ANALYSIS OF PROGRAM EVALUATION RATER A y r o t c a f s i t a S

y r o t c a f s i / t r s o a o n P U

PREPARATION

1

r / i a F


2

3




4


5



2. Number of CBLM is sufficient









RATER B


y r o t c a f is t a S / ir a F

y r o t c a f is t a s n U

1

2



3

4

1. Workshop layout conforms with the components of a CBT workshop 2.


y r o t c a f s i t a S

5

 









Date Developed:


May 2014


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RATER C

PREPARATION

y r o t / c r a o fs o i P t a s n U

y r o t c a f s i t a S / ir a F


1

2

3

1. Workshop layout conforms with the components of a CBT workshop 2.



y r o t c fa s i t a S

4

5

 



 



Date Developed:


May 2014


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AVERAGE RATINGS

PREPARATION

AVERAGE

1. Workshop layout conforms with the components of a CBT workshop 2. Number of CBLM is sufficient

4- Very Satisfactory

3. Objectives of every training session is well explained 4. Expected activities/outputs are clarified

5- Outstanding

5- Outstanding

4- Very Satisfactory

General Average

4.50

General Interpretation: As shown by the data, it can be concluded that the trainer’s preparation of the training is generally outstanding.

Recommendation/s: In order to enhance the adherence of the health care laboratory to the standard component of a CBT workshop, I dutifully recommend that more equipment should be purchased.

Prepared by:



Date Developed:


May 2014


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SELF-EVALUATION The trainer shall design a self-evaluation questionnaire that he/she shall answer after the conduct of the training. This shall serve as a checklist of what he/she must do.

During the session, did I?

Yes

1. Establish an atmosphere of trust?



2. Encourage participation of the trainees?



3. Assist the trainees when they needed assistance?



4. Consider the feedback of trainees?



5. Remain aware of nonverbal communication?



6. Praise effort?



7. Summarize key points?



8. Vary activities and tasks to aid attainment of competency?



9. Provide opportunities for practice?



10. Achieve the learning objectives?



No

Questions: U

1. Were there any parts of the session which did not run as expected? Why? 2. Did any unexpected problem arise? Did I deal with them correctly? 3. Were the session outcomes achieved? If not, why? 4. Should anything be changed for the next training sessions?

Prepared by: WARREN JAE M. SANDOVAL, RN HCS NC II Trainer


Date Developed:


May 2014


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BVS C olleges Km. 5, La Trinidad, Benguet Telefax No.: (074) 422-4992 Email address: [email protected] 0TU

U0T

Benguet General Hospital Km. 5, La Trinidad, Benguet U

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OJ T C ENT ER/ ADDRESS

ON THE J OB MONITORING SHEET Trainee: DIAMAS, Norie Department: Medical Ward C ourse: Health Care Services NC II Semester: nd2 Sc hool Yea r: 2013 -2014 OJ T Duration:150 hrs U

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UP

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DATE

JOB J OB PER FORMED RESULT C OMMENT S/ RECOMMENDAT ION REMARKS (DAILYTASK) (QUALITY) 12/ 2/14 Assist in Proficient Trainee c ompletes the

Positioning Patient in bed

Monitored by:

proc edure with c onfidence, using the correc t tec hniques and communic ation skills

Noted by:

___________________________ _______________________________ Signature Over Printed Name Signature Over Printed Name Supervisor In-Charge OJ T C oordinator/ Trainer Approved by: MA. C ORAZON B. SOMYDE N Ac ad emic Dean Document No. Issued by:

Date Developed:


May 2014


Page 108 of 122

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MEMORANDUM OF AGREEMENT AS AFFILIATING HOSPITAL

KNOW ALL MEN BY THESE PRESENTS:

This MEMORANDUM OF AGREEMENT AS AFFILIATING HOSPITAL made and entered into the Province of Benguet, Philippines, this 30thday of September, 2013 by and between: LUIS HORA MEMORIAL REGIONAL HOSPITAL with office address at Abatan Bauko Mountain Province, aMD, dulyMHA authorized represented EPIFANIO B. PAGALILAUAN,Jr., , Chief secondary of Hospitalhospital III herein referred toby as the PARTY OF THE FIRST; And BVS COLLEGES, with office address at KM 5 La Trinidad Benguet, a duly recognized Institution by the Department of Education and Technical Educational and Skills Development Authority represented by Engr. KENDAR A. SOMYDEN herein referred as the PARTY OF THE SECOND PART;

WITNESSETH

1. That the PARTY OF THE FIRST PART agrees and allows the affiliation and training of HEALTH CARE SERVICES NC II students of the PARTY OF THE SECOND PART subject to the policies, procedures and guidelines governing Affiliation and Training of students in the Department of Health Agencies and that the Chief of Agency representing the PARTY OF THE FIRST PART in shall be responsibleOrder and liable theseries fullest1996, extentlikewise, any violation of the Provision Administrative No. to –A, in the PARTY OF THE SECOND PART shall strictly comply with the provision of the above Administrative Order and any violation thereof, shall be legitimate ground for the cancellation of the contract.

2. In consideration of the use of the facility as affiliating hospital, the PARTY OF THE FIRST PART may require commensurate institutional fee either monetary or its equivalent in kind that will contribute to the overall hospital development and effective provision of learning environment for students. 3. The term of this contract is from September 30, 2013 to September 30, 2018. IN THE WITNESS WHEREOF, the parties hereto have signed this contract in _____________________ Philippines, this ___________ day of _____________________ 20___.

SIGNATORIES

EPIFANIO B. PAGALILAUAN, Jr., MD, MHA Chief of Hospital III Party of the First Part

CARMELITA O. LUD-AYEN, RN Nurse III (OIC- Chief Nurse)

ENGR.KENDAR A. SOMYDEN President Party of the Second Part

MAY GRACE A. SOMYDEN, RN, RMT Dean, BVSC- School of Midwifery

CONFORMED:

HON. ABRAHAM AKILIT Municipal Mayor

______________________________________________________________________________ ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES PROVINCE OF _________________

) ) S.S

Before me, this ______ day of _________, 2013 Notary Public in and for the _________________________, Philippines personally appeared EPIFANIO B. PAGALILAUAN,Jr.,MD,MHA with Residence Certificate No. ______________ issued at ___________________________________ on _______________________ and ENGR. KENDAR A. SOMYDEN with Residence Certificate No. 06377046 issued at La Trinidad, Benguet on January 30, 2013 both known to me to be the same persons who executed the foregoing instrument and they acknowledged that the same is their free act and voluntary deed. This instrument consisting of two (2) pages, including this page on which this acknowledgement is written, has been signed on each and every page thereof by the parties hereof and their witnesses and sealed with my notarial seal. IN WITNESS, WHEREOF, I have hereunto set my hand, the day, year and place written above.

NOTARY PUBLIC

Doc. No. ____________ Page No. ____________ Book No.____________ Series of 2014_______

BVS C OLLEG ES Km. 5, La Trinidad, Benguet 422-4992

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TO WHOM IT MA Y CO NC ERN:

This is to c ertify that Warren J ae M. Sandoval, RN, a trainer/ instructor of HEALTH C ARE SERIVICES NC II in this institutio n has prepared, submitted and used session plans in all the competencies in Health Care Services NC II. Likewise, he has been preparing formsand ac complished reports on Supervised Work Based Training using the following documents: a. Class Progress C harts b. Trainee Progress Sheet c . Trainee Rec ord Book d. Training Plan (Industry Setting) e. Trainee's Learning Requirements f. List of Tools g. Determining and Validating Trainee's C urrent Competencies h. Compa ring a nd C ross- matching C ompetenc ies i. Prepare Training Facilities for Work-B ased Training j. Trainer Self-Evaluation k. Interpretation and Analysis of Program Evaluation I. Self-Assessment Tools m. OJ T Monitoring Form n. Memorandum of Agreement of Training Institution and Partner Industry This certific ation is issued upon the request of Mr. SANDO VAL for any legal purposes and intends it may serve him best Issued this 30th day of May 2014 at Km. 5 La Trinidad, Benguet, Philippines.

ENGR. KE NDAR A. SOMYDEN

President

C onduc t C ompetenc y Assessment

C ONTENT S

Attenda nce Sheet C ompetency Assessment Results Summary Self-Assessment C ompetency Assessment Agreement Rating Sheets

Date Developed:


May 2014

Date Revised:

Document No. Issued by: Page 122


Warren Jae M.

Revision # 01

113

of

TESDA-SOP-C AC O-07-F23

Tec hnic al Educ ation and Skills Development Authority ASSESSMENTAND CERTIFICATION PROGRAM

ATTENDANCE SH EET

Health Care Servic es NC II

Name of Co mpetenc y Assessment C enter: Date of Assessment: No.

C ANDIDATE’S NAME

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Assessor/ s:

Signature

Assessment Results

TESDA Representative:

_______________________________

______________________________

Signature over Printed Name

Signature over Printed Name

Ac c reditation Number: __________________________________ Signature over Printed Name Accreditation Number:_______________

C AC Manager : ______________________________ Signature over Printed Name

Date Developed:


May 2014

Date Revised:

Document No. Issued by: Page 122


Warren Jae M.

Revision # 01

114

of

TESDA-SOP-CACO-07-F28 REFERENCE NUMBER

To be filled out by the Competency Assessor

COMPETENCY ASSESSMENT RESULTS SUMMARY Candidate’s Name: Assessor’s Name: Title of Qualification / Cluster of Units of Competency

HEALTH CARE SERVICES NC II

Assessment Center:

Date:

The performance of the candidate in the following unit(s) of competency and corresponding methods Unit of Competency 1.

Prepare and Maintain Beds

Satisfactory

Not Satisfactory

Assessment Method Demonstration with Oral Questioning Interview

2.

3.

Collect and Maintain Linen Stocks at End-Users Location

Demonstration with Oral Questioning Interview Demonstration with Oral Questioning

Assist Mobility

Interview 4.

Assist Transporting Patient

Demonstration with Oral Questioning Interview

5.

6.

Assist in Bio-Psychological

Demonstration with Oral Questioning

Support Care of Patients

Interview

Handle Waste in a Health Care Environment

Demonstration with Oral Questioning Interview

Note: Satisfactory Performance shall only be given to candidate who demonstrated successfully all the competencies identified in the above-named Qualification/Cluster of Units of Competency

 Recommendation:

For issuance of NC/COC (Indicate title of COC, if full Qualification is not met)





For submission of additional documents Specify:

For reassessment (pls. specify)

_________________ _________________



Did the candidate overall performance meet the required evidences/standards?

OVERALL EVALUATION



Competent

YE S





Not Yet Competent

General Comments[ Strengths/Improvements needed]

Candidate’s Signature:

Date:

Assessor’s Signature:

Date:

Assessment Center Manager Signature:

Date:

NO

TESDA-SOP-CACO-07-F28

CANDIDATE’S COPY (Please present this form when you file and claim your NC/COC)

To be filled out by the Competency Assessor

COMPETENCY ASSESSMENT RESULTS SUMMARY

Name of Candidate:

Date:

Name of Center:

Date:

Assessment

Assessment Results:

Recommendation:



Competent



For issuance of NC/COC (Indicate title of COC, if full Qualification is not met)





For submission of additional documents Specify:

Not Yet Competent



For re-assessment (pls. specify)

REFERENCE NUMBER Assessed by:

Date:

_____________________________ Name and Signature

Attested by:

Date:

__________________________ Name and Signature

SELF ASSESSMENT GUIDE Qualification:

HEALTH C ARE SERVICES NCII

Project:

PROVIDE HEALTH CARE SERVICES TO PATIENTS

Units of Competency Covered:

• • • • • •

Prepare and Ma intain Beds Collect and Maintain Linen Stocks at End-Users Location Ass is t in Patient Mobil ity Ass is t in Transpo rt ing Patients Assi st in Bio-Psyc ho logical Support Care of Pati ents Handle Waste in a Health Care Envir onment

Instruction: Read each of the questions in the left-hand column of the chart. Place a check in the appropriate box opposite each question to indicate your answer. • •

CAN I? •

Prepare area for bed making*

•

Make up bed*

•

•

Collect soiled linen* Distribute clean linen*

•

Maintain linen stock level*

•

Prepare to assist with patient mobility*

•

Assist with patient mobility*

•

Complete patient mobility assistance*

•

Prepare patient for transport*

•

Assist in patient transport*

•

Perform post transport procedures*

•

Establish and maintain rapport with the patient*

•

NO

Perform after care activities of tools, materials and equipment that I used*

•

•

YES

Obtain information regarding the bio-psychosocial needs of the patient* Provide assistance to meet patient needs as directed by a health professional*

HCSHCS205-1009 HEALTH CARE SERVICES NC II

1

•

Determine job requirements related to waste handling in a health care environment*

•

Identify and segregate waste*

•

Transport waste and store in an enclosed and secured place*

•

•

Conduct quality control activities related to waste handling in a health care environment Clean up work areas in a health care environment

I agree to undertake assessment in the knowledge that information gathered will only be used for professional development purpose and can only be assessed by concerned assessment personnel and may manager / supervisor. Candidate’s signature:

HCSHCS205-1009 HEALTH CARE SERVICES NC II

Date:

2

RATING SHEET Qualification: HEALTH C ARE SERVICES NCII Project: Units of Competency Covered:

PROVIDE HEALTH CARE SERVICES TO PATIENTS • • • • • •

Prepare and Ma intain Beds Collect and Maintain Linen Stocks at End-Users Location Ass is t in Patient Mobil ity Ass is t in Transpo rt ing Patients Ass is t in Bio-Psyc ho logical Suppor t Car e of Patien ts Handle Waste in a Health Care Envir onment

Instruction: Read each of the questions in the left-hand column of the chart. Place a check in the appropriate box opposite each question to indicate your answer. • •

CAN I?

YES

•

Prepare area for bed making*

•

Make up bed*

•

Collect soiled linen*

•

Distribute clean linen*

•

Maintain linen stock level*

•

Prepare to assist with patient mobility*

•

Assist with patient mobility*

•

Complete patient mobility assistance*

•

Prepare patient for transport*

•

Assist in patient transport*

•

Perform post transport procedures*

•

Establish and maintain rapport with the patient*

•

N/A

Perform after care activities of tools, materials and equipment that I used*

•

•

NO

Obtain information regarding the bio-psychosocial needs of the patient* Provide assistance to meet patient needs as directed by a health professional*

HCSHCS205-1009 HEALTH CARE

1 NC II

•

Determine job requirements related to waste handling in a health care environment*

•

Identify and segregate waste*

•

Transport waste and store in an enclosed and secured place*

•

•

Conduct quality control activities related to waste handling in a health care environment Clean up work areas in a health care environment

I agree to undertake assessment in the knowledge that information gathered will only be used for professional development purpose and can only be assessed by concerned assessment personnel and may manager / supervisor. Candidate’s signature:

HCSHCS205-1009 HEALTH CARE

Date:

2 NC II

TM1 Portfolio_HCS NCII.pdf

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