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CCA Competency Assessment Tool Page 1 CCA Curriculum Standards September 2013 Revised May 2014
CCA Student Competency Assessment Tool (CAT)
Student Name: _____________________________________School/Campus________________________
CCA Program Start Date: ____________________________End Date: _____________________________
RN/LPN Supervisor: _____________________________________ Initials _________ Date ____________
RN/LPN Supervisor: _____________________________________ Initials _________ Date ____________
Mentor: ____________________Initials ______ Host Site: ___________________________ Date _______
Mentor: ____________________Initials ______ Host Site: ___________________________ Date _______
Mentor: ____________________Initials ______ Host Site: ___________________________ Date _______
Mentor: ____________________Initials ______ Host Site: ___________________________ Date _______
Mentor: ____________________Initials ______ Host Site: ___________________________ Date _______
Mentor: ____________________Initials ______ Host Site: ___________________________ Date _______
How to Use the Competency Assessment Tool (CAT)
1. Identifying Information
In the blanks provided, please print the student’s full name, school and campus, and the start and end date at the top of the page. RN/LPN supervisors and the mentors must sign their name, initials, and identify the name of the host placement site, and start date of the placement. Please ensure the full name of the host site is identified. Host site is the physical location of the placement site not the organization the site operates under. 2. Assessment of Skills Table
The RN/LPN supervisor must initial beside the skill in the Skills Development column when the student has competently demonstrated a skill during this placement.
The mentor or RN/LPN supervisor must initial during mentorship the appropriate column based on the health care setting (home support, nursing home, or other setting) where the competency was demonstrated.
The notes section throughout the CAT should be used to inform the CCA Program of any reasons why a skill may not have been demonstrated in the placement setting. Alternatively you may place observed only (OO) or not available (NA) next to the skill. The primary instructor may also use the Additional Comment section at the end of the CAT to identify how a skill, if not demonstrated in the placement setting was evaluated.
Definition of Competent: Student consistently demonstrates skills and abilities required to practice safely and ethically in the placement setting1.
Whenever possible and appropriate, skills will be practiced and evaluated in more than one health care setting. Ideally the student will have an opportunity to practice all skills listed in the assessment tool over the complete placement experience. However it is recognized that some skills may only be observed or may not be available in all settings. Skills available for observation only and/or not available in one placement setting may be demonstrated competently in another placement. Skill not demonstrated in any settings will require an explanation by the primary instructor of how the skill was evaluated in the Additional Comment section. 1 Source (modified): Scope of Practice Continuing Care Assistant (CCA) in Nova Scotia, April 2009, page 14
CCA Competency Assessment Tool Page 2 CCA Curriculum Standards September 2013 Revised May 2014
While students have had the benefit of education in classroom and laboratory settings, they have had little experience with persons2 therefore the expectation should be based on entry-level (minimum) competency.
The CCA Program has a new learning outcome: Demonstrate competency in the application of topically applied medicated3 creams, ointments, or drops to skin, eyes, ears, nose, and perineal area4 as defined by an individual care plan. These skills are required to be evaluated by an RN/LPN and subsequently s/he is required to sign off on the CAT that the skills have been demonstrated competently in an approved placement site. This outcome is only required to be signed off in one mentorship placement, as available. 3. Overall Performance
The Skills Development placement experience must be signed by the education provider’s RN/LPN supervisor.
The authorized mentorship placement site representatives are each asked to evaluate the student’s overall performance as satisfactory or unsatisfactory (i.e., whether or not the individual is recommended for hire). An authorized placement site representative is determined by the placement site and can be the mentor, the mentor’s supervisor, or another person the placement site deems appropriate. The placement site may be contacted by the CCA Program Administration to confirm the placement site’s authorized signing representative. At the end of the mentorship, the placement site representative will:
Identify the direct care hours the student spent at the placement site. Identify the host site where the placement took place. Identify if the student’s performance was “Satisfactory or Unsatisfactory”. Sign and date the document and provide his/her title and phone number.
Identifying a student’s performance as Satisfactory indicates the student consistently demonstrated the required entry-level competencies (skills and professionalism) within that mentorship placement site. An “Unsatisfactory” placement should never be a surprise to an educator or a student; please refer to the CCA Student Placement Standards and Guidelines for recommended protocol. Before a placement is signed off as “unsatisfactory”, all reasonable efforts should be made to assist the student’s to have a successful placement. Identifying a student’s performance as Unsatisfactory indicates the student failed to consistently demonstrate the required entry-level competencies (skills and professionalism) within the mentorship placement site and is not an eligible candidate for the CCA Certification Exam. 4. Education Provider’s Final Evaluation
For a student to become a candidate to write the Certification Exam, proof of successful completion of all eligibility requirements must be submitted to the CCA Program Administration by the education provider. Once the student has successfully completed all theory, lab, placements, external certificates and professional behavior rubric the primary instructor signs the CAT acknowledging the student has
2 In the CCA Curriculum Standards persons includes all individuals receiving care in a care setting for example clients, residents, and patients. 3 Includes prescription and over-the-counter (OTC) medicated and non-medicated creams, ointments, or drops 4 Reference: Joint Practice Guidelines for Continuing Care Assistants, Application of Medicated Creams, Ointments, or Drops May 2014
CCA Competency Assessment Tool Page 3 CCA Curriculum Standards September 2013 Revised May 2014
successfully completed the CCA Program at his/her education institution and is eligible to write the Certification Exam. The section for certificate completion may be signed by the certificate instructor or the primary instructor. Students must have completed each certificate and certificates must be current in accordance to its governing body’s regulations before the student is eligible to write the Certification Exam. The CCA Program reserves the right to ask for copies of certificates and completed Professional Behaviour Development Rubrics on a random basis and during the Standards Compliance Assessment process. The CAT must be forwarded to the CCA Program at least three weeks prior to desired exam sitting, before the student is assessed for eligibility to write the exam. If a skill has not been demonstrated during placements it must be indicated how the skill was evaluated in the notes or additional comments sections.
More detailed information regarding the placement standards and guidelines including the expectations of students, placement sites and its staff, and the education provider are provided
in the CCA Placement Standards and Guideline, September 2013 document.
CCA Competency Assessment Tool Page 4 CCA Curriculum Standards September 2013 Revised May 2014
Program Outcome Competencies Assessment of Skill
Skills Dev.
Home Support
Nursing Home
Other Setting
Provide person-centered care in designated care settings. Demonstrate effective communication techniques to reassure and calm specific persons when exhibiting challenging/responsive behaviour.
Demonstrate time management skills following the care plan.
Notes:
Communicate clearly and professionally using a variety of communication media. Demonstrate effective communication strategies and skills when relating to persons, family, and the interdisciplinary team and public.
Demonstrate the documentation of subjective and objective observations using acceptable terminology.
Document on appropriate forms used in designated care settings using acceptable terminology.
Demonstrate an understanding of the effective use of computer technology appropriate for designated care settings.
Notes:
Use appropriate aseptic safeguards in designated care settings. Demonstrate the following:
Hand hygiene
Donning and removal of gown
Donning and removal of gloves
Donning and removal of goggles
Disposal of sharps
Notes:
Apply environmental safety and security measures in designated care settings. Demonstrate strategies to ensure personal safety when persons exhibit challenging/responsive behaviours.
CCA Competency Assessment Tool Page 5 CCA Curriculum Standards September 2013 Revised May 2014
Program Outcome Competencies Assessment of Skill
Skills Dev.
Home Support
Nursing Home
Other Setting
Demonstrate the use of routine practices in the designated care setting.
Demonstrate safety guidelines to follow in a person's home or facility.
Demonstrate emergency procedures in the event of a power/equipment failure, including turning off the system being used and setting up the backup oxygen system.
Identify appropriate reporting of risk factors associated with falls prevention.
Identify appropriate documenting of risk factors associated with falls prevention.
Notes:
Provide appropriate personal care to persons in designated care settings. Demonstrate the following:
Complete bed bath
Partial bed bath
Tub/whirlpool bath
Shower
Demonstrate shaving (face, legs, and underarms) using both an electric and a safety razor.
Female
Male
Demonstrate assisting with dressing and undressing, and care for the person’s clothing.
Demonstrate the following: Oral care
Denture care
Eye glasses and contact lenses care
CCA Competency Assessment Tool Page 6 CCA Curriculum Standards September 2013 Revised May 2014
Program Outcome Competencies Assessment of Skill
Skills Dev.
Home Support
Nursing Home
Other Setting
Hair/wig care
Nail care
Female perineal care
Male perineal care
Hearing aid care
Prosthetic care
Demonstrate cutting of nails on persons who have been assessed by an RN or LPN
Demonstrate skills in skin inspection for integrity issues.
Demonstrate toileting a person using: Bedpan
Urinal
Commode
Demonstrate the use of incontinence devices.
Demonstrate urinary catheter care.
Demonstrate ostomy care.
Demonstrate collection of urine/stool specimens.
Demonstrate safe feeding techniques, including:
In a bed
CCA Competency Assessment Tool Page 7 CCA Curriculum Standards September 2013 Revised May 2014
Program Outcome Competencies Assessment of Skill
Skills Dev.
Home Support
Nursing Home
Other Setting
In a chair
At a table
Demonstrate the use of special needs feeding devices and aids.
Demonstrate measurement and recording of weight using the metric system.
Notes:
Provide housekeeping duties within the care setting. Demonstrate care setting management tasks including the following:
Bed making (occupied)
Bed making (unoccupied)
Laundry
Cleaning Floors
Cleaning Bathroom
Cleaning Kitchen
Cleaning Living or Care Area
Care and Cleaning of Appliances
Garbage disposal including composting and recycling
Notes:
Prepare, cook, and serve meals according to Canada’s Food Guide and based on persons’ needs. Demonstrate safety when preparing meals.
Demonstrate ways to prepare meals with the following in mind:
CCA Competency Assessment Tool Page 8 CCA Curriculum Standards September 2013 Revised May 2014
Program Outcome Competencies Assessment of Skill
Skills Dev.
Home Support
Nursing Home
Other Setting
Special Diets
Food Sensitivities
Feeding Problems
Prepare meals and snacks using a variety of foods, textures, and cooking methods as identified in Schedule A. For examples include tea/coffee, vegetables, meats, eggs.
Serve meals following the persons socially accepted traditions and practices.
Demonstrate safe storage of leftovers including packaging and dating.
Demonstrate safe usage and cleaning of appliances and food preparation surfaces.
Notes:
Use proper body mechanics while performing duties in designated care settings. Demonstrate proper body mechanics principles.
Demonstrate positioning the person in bed and chair.
Demonstrate the use of the following comfort/positioning devices: Hand rolls/grips
Footboard
Bed rails
Pillows
Turning/Lifting Sheets
Demonstrate the correct use of: Sliding Board
CCA Competency Assessment Tool Page 9 CCA Curriculum Standards September 2013 Revised May 2014
Program Outcome Competencies Assessment of Skill
Skills Dev.
Home Support
Nursing Home
Other Setting
Transfer Belts
Transfer Sheets
Demonstrate assisting the person with the following: Getting out of bed
Getting out of the chair
Walking
Transferring to and from a wheelchair
Transferring in and out of a bathtub
Transferring in and out of a shower
Transferring on and off a toilet/commode
Transferring in and out of a car
Transferring using a mechanical lift
Demonstrate range of motion (ROM) exercises.
Notes:
Respond and/or seek appropriate help when any change occurs in persons’ conditions. Demonstrate correct reporting procedures using acceptable terminology when there is a change in person’s behaviour and condition.
Demonstrate correct documentation procedures using acceptable terminology when there is a change in person's behaviour and condition.
Notes:
Respond appropriately to the physiological, psychological, social, cultural and spiritual needs of persons across the life cycle.
CCA Competency Assessment Tool Page 10 CCA Curriculum Standards September 2013 Revised May 2014
Program Outcome Competencies Assessment of Skill
Skills Dev.
Home Support
Nursing Home
Other Setting
Demonstrate respect for the person‘s needs and their spiritual, cultural, moral and ethical values, and life style preferences.
Notes:
Promote healthy lifestyle choices and illness prevention. Demonstrate basic teaching and encouragement strategies appropriate to the CCA’s promotion of client health maintenance.
Notes:
Provide person-centered care within the CCA Scope of Practice and as a member of a health care team. Demonstrate the measurement and recording of temperature, pulse, respiration, blood pressure, and blood oxygen level using appropriate devices.
Demonstrate the application of compression/anti-embolism garments (e.g. stockings, sleeves).
Demonstrate the checking and adjustment of a prescribed oxygen flow rate.
Demonstrate how to remove the oxygen mask/cannula during the delivery of personal care, and reapply it after care.
Demonstrate the accurate collection and recording of vital signs, within practice guidelines.
Demonstrate the application of medicated creams, ointments, shampoos and eye drops, under the continued assessment of an RN/LPN within the practice guidelines.
RN/LPN signature required:
Notes:
Demonstrate appropriate, respectful professional behaviour in all settings Appropriate Behaviour Attitude: Positive, friendly, helpful, courteous, person centered, optimistic, patient, and team oriented attitude when interacting with people and situations.
Appearance: Neat and clean in their appearance; as well as safely attired and respectfully covered in a manner that demonstrates person comfort and team/self-respect.
Integrity: Honest, respectful, ethical, sincere, reliable, empathic, and committed when dealing with people, environment, and technology.
Notes:
Respect for self and others
CCA Competency Assessment Tool Page 11 CCA Curriculum Standards September 2013 Revised May 2014
Program Outcome Competencies Assessment of Skill
Skills Dev.
Home Support
Nursing Home
Other Setting
Communication: Appropriate verbal (written and oral) as well as non-verbal skills; includes such things as voice control, language, message, legal requirements, and media used.
Nonjudgmental: Awareness and respects for differences in opinions, beliefs, and preferences of individuals in all settings.
Caring: Considerate of others, listens attentively, responds appropriately, and is respectful, gentle and compassionate towards person and team.
Team player: Contributes to the group, displays initiative, offers to help, shares the workload, participates in tasks, and is accountable to themselves and the group in all settings.
Notes:
Commitment Time Management: Is punctual, prepared, dependable and able to handle the varying workload by managing time efficiently through prioritizing and multitasking.
Adaptability: Frequently approaches change with a positive attitude, is able to manage changing environments, varying workloads, and works well with a variety of co-workers and persons.
Stress Management: Is aware of and frequently manages his/her triggers, balances work and home life, prioritizes appropriately as well utilizes and continues to develop individual coping skills.
Notes:
Competence Accountability: Appropriately applies knowledge and skills, stays informed of team goals and person status, ask questions, seek guidance, reports issues/changes and advocates when needed.
Continuous Learning: Frequently seeks opportunities to learn, attends in-services and workshops, openly offers/receives and applies feedback, and seeks to continuously improve.
Safety: Demonstrates due diligence, meeting safe work practices by: identify, reporting, documenting, and address safety concerns/issues as needed.
Problem Solving: Employs critical thinking by applying logic and facts to formulate decisions when resolving or addressing issues/situations and continues to develop learned skills.
Notes:
Overall Performance Evaluation
CCA Competency Assessment Tool Page 12 CCA Curriculum Standards September 2013 Revised May 2014
Skills Development Placement This student has completed the 110 hours in a nursing home/home for aged required for Skills Development placement at __________________________________________and based on performance is ready to advance to the next level. Signature of Education Provider’s RN/LPN Supervisor Name _____________________________________Title ________________ Phone_________________ Date _____________________________________
Mentorship Placement: 220 direct care hours with at least 80 hours in a home support agency providing services to DHW persons and 80 hours in a licensed DHW Nursing Home/Home for the Aged. The remaining 60 hours can be in a variety of settings as stipulated in the CCA Program Curriculum Standards. Authorized Placement Site Representative is determined by placement site.
This student has completed ____ hours at _____________________________________________ and based on this experience I would judge her/his performance as Satisfactory at an entry-level or Unsatisfactory. Signature of Authorized Placement Site Representative Name __________________________________________ Title _______________________________ Phone __________________ Date ______________________
This student has completed ____ hours at _____________________________________________ and based on this experience I would judge her/his performance as Satisfactory at an entry-level or Unsatisfactory. Signature of Authorized Placement Site Representative Name __________________________________________ Title _______________________________ Phone __________________ Date ______________________
This student has completed ____ hours at _____________________________________________ and based on this experience I would judge her/his performance as Satisfactory at an entry-level or Unsatisfactory. Signature of Authorized Placement Site Representative Name __________________________________________ Title _______________________________ Phone __________________ Date ______________________
This student has completed ____ hours at _____________________________________________ and based on this experience I would judge her/his performance as Satisfactory at an entry-level or Unsatisfactory. Signature of Authorized Placement Site Representative Name __________________________________________ Title _______________________________ Phone __________________ Date ______________________ This student has completed ____ hours at _____________________________________________ and based on this experience I would judge her/his performance as Satisfactory at an entry-level or Unsatisfactory. Signature of Authorized Placement Site Representative Name __________________________________________ Title _______________________________ Phone __________________ Date ______________________
If you require additional mentorship acknowledgements, please insert a copy of this page in the CAT.
CCA Competency Assessment Tool Page 13 CCA Curriculum Standards September 2013 Revised May 2014
Education Provider’s Final Evaluation Nova Scotia Certificate Completion: Date Signature
Alzheimer Disease and Other Related Dementia Care _________ _________________
WHMIS _________ _________________
Introduction OH&S Act _________ _________________
Standard First Aid/CPR Level C _________ _________________
Food Handler’s Course _________ _________________
CCNS, Palliative Care Front-Line Education _________ _________________
Student Name: ____________________________________________
The above student has completed all the requirements including theory, lab, professional development rubric, and placements and is prepared to write the CCA Certification Exam.
___________________________ ____________________________ CCA Primary Instructor Date
Additional Comments
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