NURSE AIDE ENROLLMENT GUIDE

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1 NURSE AIDE ENROLLMENT GUIDE Thank you for choosing the Nurse Aide certificate program. I. Eligibility to register for the nurse aide course is as follows: 1. Submit a completed and signed Verification of Pennsylvania Residency and Attestation of Compliance with Act 14 Form to the Information and Registration Center. A list of prohibitive offenses is attached. If you have been a resident of Pennsylvania for the last 2 years, complete and submit a PA criminal history record. If you have not been a resident of Pennsylvania for the last 2 years: o Complete and submit the results of your PA criminal history record check. o Complete the FBI fingerprint record check and submit the letter of approval for Nurse Aide training. The procedural process for procuring the FBI report and the letter of approval for Nurse Aide training is attached. If history of criminal offenses, you cannot register until offenses are checked against the list of prohibitive offenses by the nurse aide primary instructor. 2. Submit a copy of your high school transcript or GED scores. 3. Register for MSHT 100. II. After registration, complete requirements as follows: 1. Submit completed physical examination form and lab reports on Thursday, August 6, 2015 from 9:00 a.m. to 12:00 p.m. or on Friday, August 14, 2015 from 9:00 a.m. 11:00 a.m. in the Health Sciences Center (HSC) Room The physical examination form is found in this packet and on the CCBC website. Registration is provisional until satisfactory physical examination form, laboratory reports and/or immunizations, and tuberculin skin test results are submitted. Students cannot begin the nurse aide class unless the physical form with 2-step tuberculin testing and laboratory results have been submitted prior to the first day of class. NOTE: Classes begin on Wednesday of the first week. Monday and Tuesday clinical does not begin until the fifth week.

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3 Welcome to Pennsylvania Access To Criminal History PATCH Helpdesk QUERY-PA ( ) Our current response time for record requests labeled UNDER REVIEW is between two to three weeks from the date the request was made. Thank you for your patience as we process your request. Notarized copies of a Criminal Record Check are authorized for certain types of requests: 1. Employment outside of the United States 2. International Adoption 3. Visa 4. Citizenship 5. Other-Special Circumstances Any request for a notarized copy that is not listed above may be returned to the requestor for clarification. Before requesting a Criminal History for a record expungement or an Access and Review, please read the Terms and Conditions page. Credit Card Users Submit a New Record Check (requires a credit card) Check the status of a Record Check Registered Users - Please Log In Username: Password: Login Bottom of Form Why does PATCH exist? Its purpose is to better enable the public to obtain criminal history record checks. The repository was created and is maintained in accordance with Pennsylvania's Criminal History Information Act contained in Chapter 91 of Title 18, Crimes Code. This Act also directs the Pennsylvania State Police (PSP) to disseminate criminal history data to criminal justice agencies, non-criminal justice agencies and individuals on request. Criminal justice agencies can access all of an individual's criminal history record information (CHRI). Requests made by noncriminal justice agencies and individuals are subject to edit criteria contained in the law. Dispositions Dispositions on most criminal cases can be accessed by reviewing court docket sheets located at the Pennsylvania Judiciary web portal site: Clicking the HELP link on this page will provide information as to how to access the public docket sheets. However, public docket sheet information should not be used in place of a criminal history background check, which can only be provided by the Pennsylvania State Police. Browser Requirements The recommended web browsers for this site are Microsoft Internet Explorer 6.x-11.x using a 32 bit or 64 bit browser. All other web browsers or versions (such as Microsoft Internet Explorer 12 and above, Firefox, Google Chrome, Opera and Safari) are not supported. Web browsers need to accept cookies and have scripting enabled. Ensure that pop-up blockers are disabled. PATCH Helpdesk QUERY-PA ( )

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6 COMMUNITY COLLEGE OF BEAVER COUNTY NURSE AIDE PROGRAM Nurse Aide Program Functional Abilities Certain functional abilities are essential for the delivery of safe, effective care. Students must be able to perform the functional abilities with or without reasonable accommodations. In order to be considered for an accommodation, students must declare with the Supportive Services Office that they have a disability and provide the required medical documentation. 1. Visually observe changes in the resident s status as well as unsafe environmental condition. Must possess visual acuity of: a) near clarity of vision at 20 inches or less and b) far clarity at least 20 feet or more. 2. Hear sounds of spoken verbal communication by residents and staff. 3. Sufficient speech/language ability to convey oral messages in English to residents and to other health team members. 4. Smell odors that indicate changes in the physiological status of the resident or unsafe environmental conditions. 5. Read and cognitively comprehend written course materials, resident care documents, and health care institution policies and procedures. 6. Write utilizing a legible and concise documentation style which is readable and in the English language. 7. Move freely to observe and assist residents and perform emergency care; this includes having full manual dexterity of the upper extremities, including neck and shoulders and unrestricted movements of the lower extremities, back and hips in order to assist in all aspects of resident care. 8. Lift and/or support 50 or more pounds in order to transfer, ambulate, and/or reposition residents safely. 9. Emotional stability sufficient to transfer knowledge from one situation to another, to solve problems, prioritize tasks, and to use long term and short term memory. 4/09

7 COMMUNITY COLLEGE OF BEAVER COUNTY NURSE AIDE PROGRAM STUDENT HEALTH RECORD Section I: To Be Completed by Applicant. NAME: (Last) (First) (Middle) Student ID Number ADDRESS: (Street) (City) (State) (Zip Code) TELEPHONE: DATE OF BIRTH: EMERGENCY CONTACT: RELATIONSHIP TELEPHONE :(Work) (Home) I do hereby authorize Community College of Beaver County to release my medical information to hospital affiliates for the purpose of clinical instruction. Signature Date Section II: To be completed by physician/nurse clinician only. PHYSICAL EXAMINATION: CLINICAL EVALUATION: (WNL) Normal (X) Abnormal (O) Not Examined NOTE: Please comment on any abnormal finding. 1. Height Weight BP Pulse Respiration 2. General Appearance 3. Nutrition 4. Skin and Lymphatics 5. Head 6. Eyes (General) 7. Funduscopic 8. Ears (Canals and Drums) 9. Nose 10. Mouth, Throat 11. Teeth 12. Neck and Thyroid 13. Chest (General) 14. Breasts 15. Lungs 16. Heart 17. Abdomen 18. Genitalia (Hernia) 19. Rectum, Prostate 20. Neurological (Reflexes) 21. Back and Spine 22. Extremities 23. Peripheral Vascular 24. Psychiatric, Emotional

8 Page 2 Section II: (Cont d) To be completed by physician/nurse clinician only. Tests/Immunizations: 1. Two Step Tuberculin Skin Test. First Step: Date of Test Date Read Result mm of Induration Read by: Second Step: Date of Test Date Read Result mm of Induration Read by: Current chest x-ray report is required if other than negative or if provider deems it necessary. Please submit copy of report. 2. Hepatitis B Vaccine and Post Vaccination Testing for Serologic Response. After the series is completed, please submit copy of lab report for a hepatitis titer. Injection Dates: (1) (2) (3) Titer Date:. 3. Diphtheria Tetanus Toxoid (Adult Type TD or single dose of Tdap if not previously received) Date of latest immunization: (Must be current within the last ten years). PROGRAM PARTICIPATION: Does this student have any mental or physical problems or limitations which might affect class attendance or participation in clinical activities? Please refer to the Functional Abilities attachment. Yes No Explain restrictions: Print or Type: Physician/Nurse Practitioner Name Address Telephone Physician/Nurse Practitioner Signature Date Revised 4/11, 3/09

9 COMMUNITY COLLEGE OF BEAVER COUNTY ALLIED HEALTH DIVISION HEPATITIS WAIVER I have not been immunized for Hepatitis B. I realize that I will be responsible for the cost of any testing required should I be injured or experience an accidental needle puncture. I understand that risk is high for health care workers and that neither the clinical agency nor college is responsible should I be exposed. Name (Please Print) Signature Date Student ID Number Reviewed 12/10: L.G.

10 Nurse Aide Additional Program Costs Uniform - A green uniform can be purchased in the College Bookstore. Please order two weeks prior to the first day of class. Jeans and T-shirts are not permitted. You will also need white leather shoes, white socks or hose, and a wristwatch with a second hand. Textbook - See the College Bookstore for details. Transportation - Students are assigned to a clinical facility and are responsible for providing their own transportation. Clinical affiliates include: Friendship Ridge in Beaver. PA Nurse Aide Registry Exam - $102.00

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