STANDARD 1.0 EXAMINE THE HEALTHCARE COMMUNITY AND THE ROLES AND RESPONSIBILITIES OF THE HEALTHCARE TEAM
1.1   Identify essential functions, similarities, and differences of healthcare facilities (e.g., acute care, long-term care, assisted living, homecare, rehabilitation, and hospice)
1.2   Explain the organizational structure and essential duties, including the delegation process, of the healthcare team within a healthcare facility [e.g., physician, physician’s assistant, RN, LPN, nursing assistant, nurse practitioner, discharge coordinator, home health aide, and therapists (physical, occupational, respiratory)]
1.3   Explain the role of the nursing assistant as outlined in regulatory and professional guidelines [e.g., Omnibus Budget Reconciliation Act (OBRA), Arizona State Board of Nursing Standards of Conduct (R4- 19-814), ethics in the workplace, informed consent, and advanced directives]
1.4   Demonstrate professional work habits and time management skills

STANDARD 2.0 DEMONSTRATE ETHICAL AND LEGAL CONDUCT IN ALL NURSING ACTIVITIES
2.1   Examine ethical and legal issues and the standards for healthcare professions (e.g., nursing code of ethics, facility ethical protocol, and appropriate legal documents)
2.2   Explain state certification and renewal requirements including criminal conduct
2.3   Identify the standards of conduct that the nurse assistant must maintain in his or her daily care of residents
2.4   Examine the effect of personal ethics, morals, and values on nursing services
2.5   Compare and contrast behaviors and practices that could result in malpractice, liability, or negligence
2.6   Explain the Patient’s Bill of Rights (e.g., right to privacy and confidentiality, right to be free from abuse, mistreatment, and neglect, right to be free from restraints, right to make personal choices, right to obtain assistance in resolving grievances and disputes, and security of personal property)
2.7   Comply with legal, regulatory, and accreditation standards or codes such as the Health Insurance Portability and Accountability Act (HIPAA)
2.8   Review methods and protocol for reporting instances or suspicion of abuse, mistreatment, or neglect
2.9   Follow the standards for workers’ rights, harassment, labor, and employment laws

STANDARD 3.0 APPLY STANDARD PRECAUTIONS AND INFECTION CONTROL MEASURES
3.1   Explain the infectious process and modes of disease transmission
3.2   Examine the Center for Disease Control (CDC) and Prevention guidelines related to body substances and Standard Precautions (e.g., respiratory hygiene, exposure incidents, and transmission-based precautions)
3.3   Examine the Occupational Safety and Health Administration (OSHA) guidelines related to body substances and Standard Precautions (e.g., bloodborne pathogens and methods for reducing infection)
3.4   Explain the general principles of asepsis (e.g., clean, medical, sterile, and disinfection)
3.5   Demonstrate the principles of hand hygiene
3.6   Explain the isolation procedures
3.7   Explain and demonstrate the use of Personal Protective Equipment (PPE)

STANDARD 4.0 APPLY PRINCIPLES OF BODY MECHANICS WHEN POSITIONING, TRANSPORTING, TRANSFERRING, AND AMBULATING RESIDENTS
4.1   Examine the effects of prolonged bed rest and/or restricted physical activity (e.g., muscle atrophy, arterial restriction, and body alignment)
4.2   Identify and use different techniques for positioning residents in bed (e.g., side lying, supine, prone, Sim’s, high and low Fowler’s, Trendelenburg, lithotomy, orthopneic, and footboard)
4.3   Identify and use assistive devices and techniques to aid in turning residents (e.g., logroll, draw sheet, and move up in bed)
4.4   Identify and use assistive devices and techniques to aid in ambulating residents (e.g., crutches, cane, walker, wheelchair, dangling, and gait belt)
4.5   Identify and use assistive devices and techniques to aid in transferring residents (e.g., gait belt, mechanical lifts, slide board, lift sheet, and stretcher)
4.6   Assist residents to transfer from bed to chair and chair to bed using pivot and ambulatory techniques
4.7   Assist residents to ambulate with and without a gait belt
4.8   Demonstrate the proper positioning of the resident in a wheelchair
4.9   Assist and care for the resident who is falling or who has fallen
4.10   Apply body mechanics and use safety procedures when positioning, transferring, transporting, turning and lifting residents
4.11   Determine the purpose and procedure for active and passive range of motion exercises
4.12   Identify and the purpose of continuous passive motion (CPM) devices

STANDARD 5.0 PROVIDE BASIC EMERGENCY CARE
5.1   Recognize emergency situations/changes in condition and notify appropriate personnel following protocol (e.g., asphyxia, stroke/TIA, anaphylaxis, seizure, poisoning, fainting, and hemorrhage)
5.2   Demonstrate basic life support (CPR) at the minimum accepted standard of practice (e.g., compression, AED, and breathing techniques)
5.3   Perform standard first aid skills (e.g., hemorrhage, shock, fainting, and burns)
5.4   Perform abdominal thrusts for the choking victim

STANDARD 6.0 EXAMINE HUMAN BODY SYSTEMS FOR COMMON CONDITIONS, DISORDERS, AND CARE
6.1   Describe the characteristics of homeostasis
6.2   Describe major body systems, organs, cell functions, anatomical terms, and tissues (e.g., nervous, connective, muscular, and epithelial)
6.3   Use medical terminology as it relates to body systems and their functions
6.4   Identify the function, structure, common health problems, and age-related changes of the integumentary system (e.g., bruises, skin tears, rashes, decubitus ulcers, shingles, lice/scabies, and gangrene)
6.5   Identify the function, structure, common health problems, and age-related changes of the musculoskeletal system (e.g., arthritis, osteoporosis, fractures, amputations, muscle atrophy, and joint replacement)
6.6   Identify the function, structure, common health problems, and age-related changes of the nervous system (e.g., cerebral vascular accident, Parkinson’s disease, dementia/Alzheimer’s, spinal cord/head injuries, seizures, and multiple sclerosis)
6.7   Identify the function, structure, common health problems, and age-related changes of the sensory system (e.g., cataracts, glaucoma, macular degeneration, hearing loss, and neuropathy)
6.8   Identify the function, structure, common health problems, and age-related changes of the circulatory system (e.g., angina, myocardial infarction, coronary disease, congestive heart failure, and hypertension)
6.9   Identify the function, structure, common health problems, and age-related changes of the respiratory system (e.g., COPD, bronchitis, asthma, TB, pneumonia, and oxygen therapy)
6.10   Identify the function, structure, common health problems, and age-related changes of the gastrointestinal system (e.g., constipation/fecal impaction, gastroesophageal reflux disease, ulcers, hernias, gall bladder disease, diverticulitis, colon cancer, Crohn’s disease, and celiac disease)
6.11   Identify the function, structure, common health problems, and age-related changes of the urinary system (e.g., renal failure, urinary tract infection, incontinence, and kidney stones)
6.12   Identify the function, structure, common health problems, and age-related changes of the endocrine system (e.g., diabetes mellitus and thyroid disease)
6.13   Identify the function, structure, common health problems, and age-related changes of the reproductive system [e.g., BPH, prolapsed uterus, cancer, pregnancy-related conditions, endometriosis, and sexually transmitted disease/infection (STD/STI)]

STANDARD 7.0 COMMUNICATE EFFECTIVELY WITH EACH OTHER AND RESIDENTS AND REPORT MEDICAL INFORMATION USING MEDICAL TERMINOLOGY
7.1   Use medical terminology to interpret and communicate information, data, and observations including sound alike and look alike terms
7.2   Respond effectively to a resident’s behavior in a positive, non-threatening manner
7.3   Observe and describe a resident’s physical and emotional condition changes
7.4   Communicate appropriately with residents who have sensory deficits (e.g., hearing, visual, and cognitively impaired, aphasic, and comatose, and physically and verbally aggressive)

STANDARD 8.0 MEASURE AND RECORD VITAL SIGNS
8.1   Describe purpose, influencing factors (e.g., confused patient, infant, and child) and procedures (e.g., digital, electronic, oral, rectal, axillary, and tympanic) for measuring and recording temperature and reporting abnormal findings
8.2   Describe purpose, influencing factors, and procedures for measuring and recording pulse rate (e.g., radial, apical, carotid, and brachial) and report abnormal findings
8.3   Describe the purpose, influencing factors, and procedures for measuring and recording respiration and report abnormal findings
8.4   Describe the purpose, influencing factors, and procedures for measuring and recording blood pressure and report abnormal findings
8.5   Describe purpose, influencing factors, and procedures for measuring and recording height and weight (e.g., upright/standing, bed, and chair scale) and report abnormal findings
8.6   Describe the purpose, influencing factors, and procedures for measuring and recording oxygen saturation using an oximeter and report abnormal findings
8.7   Identify signs, symptoms, and behavior relative to pain and report abnormal findings
8.8   Record observations of changes in vital signs and report abnormal findings to licensed personnel according to protocol (e.g., tachycardia, bradypnea, arrhythmia, tachypnea, hypertension, and pain)
8.9   Apply noninvasive pain relief measures within the scope of practice and report abnormal findings

STANDARD 9.0 DEMONSTRATE PERSONAL CARE AND GROOMING WITH CONSIDERATION OF CULTURAL AND PERSONAL PREFERENCES
9.1   Describe the purpose and procedure for bathing residents (e.g., complete bed bath, partial bath, tub bath, whirlpool, and shower)
9.2   Provide skin care including back rubs, massage procedures, and frequent turning
9.3   Identify and report skin problems including the four major stages of decubitus ulcers
9.4   Describe the purpose and procedure for perineal care
9.5   Describe the purpose and procedure for catheter care
9.6   Describe the purpose and procedure for oral and dental care
9.7   Describe the purpose and procedure for shampoo and hair care
9.8   Describe the purpose and procedure for nail care
9.9   Describe the procedure for shaving a resident
9.10   Assist residents with dressing and undressing
9.11   Examine the use and care of prosthetic and orthotic devices
9.12   Describe the purpose and procedure for bedmaking (occupied and unoccupied)
9.13   Describe the purpose and methods for pressure reduction (e.g., floating heels and repositioning)

STANDARD 10.0 MAINTAIN A SAFE AND CLEAN ENVIRONMENT FOR RESIDENTS AND OTHERS
10.1   Identify measures to prevent or control workplace violence (e.g., facility policies and procedures and personal safety practices)
10.2   Apply safety precautions related to age of residents (e.g., flooring, bed elevation, shoes/dress, and cords)
10.3   Explain risk management protocols in the healthcare environment (e.g., incident reporting and fall risk)
10.4   Apply emergency procedures (e.g., fire, chemical, biohazard, radiation, and community disasters)
10.5   Maintain equipment to ensure safe use (e.g., cleaning and check safety cords)
10.6   Comply with hazardous labeling requirements, safety signs, and symbols
10.7   Handle and dispose of contaminated and hazardous items according to standards and procedures
10.8   Position call light for easy access (e.g., toileting, ambulating, and pain medication)
10.9   Provide care within the scope of practice for residents receiving oxygen (e.g., securing oxygen, transporting oxygen, oxygen signage, cylinder care, and risks)
10.10   Demonstrate proper handling and safe use of oxygen delivery systems/equipment (e.g., transporting system, nasal cannula, face mask, and removal and application of oxygen)
10.11   Explain how to work with the resident’s family as a source of emotional support for the resident

STANDARD 11.0 APPLY THE PRINCIPLES OF BASIC NUTRITION TO RESIDENT CARE
11.1   Identify principles of nutrition (e.g., essential nutrient groups, My Plate, physiological needs, and serving sizes)
11.2   Identify alternative feeding methods
11.3   Explain optimal nutritional needs for the residents throughout the life span
11.4   Examine therapeutic diets (e.g., liquid, low sodium, diabetic, and high fiber)
11.5   Present meals in the facility
11.6   Restrict and record fluids
11.7   Assist with eating using assistive devices
11.8   Examine dietary concerns associated with age-related problems (e.g., denture problems and reduced sense of taste), situational factors (e.g., depression and dysphagia), and aspects of nursing assistant care (e.g., socialization and comfort foods)
11.9   Identify personal, cultural, religious, and medical conditions leading to variations in the diet
11.10   Ensure that residents receive diets as ordered
11.11   Measure and record nutritional data, including meal percentage, intake, and output

STANDARD 12.0 FACILITATE ACTIVITIES RELATED TO ELIMINATION
12.1   Assist with toileting, (e.g., bedpan, urinal, commode and toilet seat extension, and bladder training)
12.2   Measure, calculate, and record fluid intake and output in ounces and milliliters
12.3   Assist with alternative methods of elimination (e.g., ostomy, urostomy, and Foley catheter)
12.4   Care for a resident who is incontinent
12.5   Care for a resident who is vomiting

STANDARD 13.0 PROVIDE CARE FOR THE PERI-OPERATIVE RESIDENT AND/OR RESIDENT WITH SPECIAL NEEDS
13.1   Determine purpose and procedure for assisting with preoperative care according to protocol (e.g., NPO orders, ID band, and surgical checklist)
13.2   Determine purpose and procedure for assisting with postoperative care per protocol (e.g., ID band, airway maintenance, N/V, and surgical bed)
13.3   Determine purpose and procedure for positioning and caring for residents receiving tube feeding
13.4   Determine the purpose and procedure for caring for residents with feeding tubes
13.5   Determine purpose and procedure for caring for residents with gravity and sump drains
13.6   Examine complications with improper positioning and surgical gravity drains
13.7   Measure and record intake and output
13.8   Determine the purpose and procedure for applying binders
13.9   Determine purpose and procedure for applying support, anti-embolism, and compression stockings
13.10   Determine purpose and procedure for applying and maintaining dressings
13.11   Report status, observations, and resident response to binders, bandages, and dressings
13.12   Follow policy and protocol for appropriate temperature range for heat and cold treatments

STANDARD 14.0 ASSIST WITH ADMISSION, TRANSFER, AND DISCHARGE
14.1   Explain the procedure for admitting a resident
14.2   Explain the procedure for transferring a resident
14.3   Explain the procedure for discharging a resident
14.4   Maintain safekeeping of resident’s belongings and personal possessions according to facility policy

STANDARD 15.0 ASSIST WITH DIAGNOSTIC TESTING AND EXAMINATIONS
15.1   Determine purpose and procedure for collection, labeling, and sending specimens for analysis according to protocol (e.g., sputum, stool, urine, and blood)
15.2   Determine the purpose and procedure for diagnostic testing (e.g., culture and sensitivity, clean the catch, sterile, and 24-hour)

STANDARD 16.0 ASSIST IN IDENTIFYING BEHAVIORAL HEALTH AND CARING FOR MENTAL HEALTH AND SOCIAL SERVICE NEEDS OF RESIDENTS
16.1   Discuss basic human needs of the individual (e.g., throughout the lifespan, including physical, socio-cultural, social service and mental health needs, developmental tasks with aging, mental and behavior changes, and role of the elderly in a community)
16.2   Explain how cultural and spiritual attitudes may influence psychological responses
16.3   Respect and accommodate cultural and spiritual differences
16.4   Modify personal behavior in response to resident behavior
16.5   Determine the purpose and techniques for addressing the needs and behaviors of individuals with dementia, Alzheimer’s, and other cognitive or sensory deficits (e.g., cognitive impairments, anger, depression, and unresponsiveness)
16.6   Describe the special needs of residents with a mental health diagnosis
16.7   Describe special needs of residents in long-term care/alternative care facilities

STANDARD 17.0 CARE FOR DYING RESIDENTS AND THEIR FAMILIES
17.1   Describe the stages of grieving and death and dying process
17.2   Explain the role of hospice in end-of-life care
17.3   Assist with care for the dying resident/patient and support for the family considering physical needs, spiritual, and cultural beliefs
17.4   Determine purpose and procedure for postmortem care (e.g., positioning, respect, dress, and organ donation)