APPLICATION PERIOD FOR SUMMER TERM IS May 4 th -June 1 st 2015 FROM 9AM-5PM AT YAMHILL VALLEY CAMPUS BLDG 2. Cost of Class: $475.

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1 Basic Nursing Assistant Yamhill Valley Campus This 155 hour training course is approved by the Oregon State Board of Nursing (OSBN). It consists of 80 hours on-campus classroom and lab and 75 hours of clinical in a long term care facility. Successful completion qualifies individuals to take the Nurse Assistant Competency Evaluation test for state certification as a Nursing Assistant. APPLICATION PERIOD FOR SUMMER TERM IS May 4 th -June 1 st 2015 FROM 9AM-5PM AT YAMHILL VALLEY CAMPUS BLDG 2 Cost of Class: $ Additional Costs: AT LEAST $ Tuition/UAF Fee $125 Non-Refundable Fee $350 (includes textbook, two sets of scrubs, stethoscope, gait belt, background test and drug test. Course tuition or fees are not refundable beyond the second week of class. Other program costs are non-refundable. Oregon State Board of Nursing Test for Certification $106 Fingerprinting for OSBN $52 CPR training & Immunizations- (costs vary) Directions: Submit the following documentation to Renae Burger at Yamhill Valley Campus Bldg 2 Applications will be accepted May 4 th June 1 st from 9am-5pm Only complete applications will be accepted. This is a limited-enrollment consent course only 18 students are accepted on a first come, first served basis. 1. Basic Nurse Assistant Application form (see attached) 2. Proof of Reading Requirement Documentation (copy of unofficial transcript or copy of test scores) showing completion of RD090 or placement in RD115 based upon Chemeketa s ASSET test (score of 40 46) or COMPASS test (score of 80 90). Or proof of completing an Associate degree or higher. Contact the Chemeketa Testing Center at (Salem) or Yamhill Valley campus (McMinnville) to schedule the Reading placement test. 3. Copy of CPR Certification Must be taken within the last six months The only acceptable certification is: American Heart Association, Healthcare Provider Level See for listing of available CPR trainings. We do offer a CPR class at our Yamhill Campus, see attached flyer for details! You can sign up for this CPR class at application time. Non-Credit/Non- financial aid available program. Student responsible for paying all fees. Outside funding available! Job Growers Inc has sponsored many of our students in the past to help with costs associated with the program. For more information on scholarships please contact Pablo Cuauxinque of the McMinnville Job Growers Center at: pcuauxinque@jobgrowers.com Page 1

2 Class Times: June 22 nd July 16 th M/T/W/R/F 8:00am-1:00pm Yamhill Valley Campus Bldg 2 Rm 101A You must be registered for the Basic Nurse Assistant class before June 22nd. You will then have 10 business days from the day your register to pay the fees/tuition or install a payment plan. For more information please contact the business office at / Clinical dates/times: July 20 th - August 12 th M/T/W/R/F 6:00am-11:00am Our clinical location is LifeCare Center of McMinnville Address: 1309 NE 27 th Street McMinnville, OR Website: Mock Skills Days TBA in class Graduation Ceremony August 13 th, :30pm at Chemeketa Yamhill Valley Criminal Background Check & MANDATORY orientation: Tuesday, June 2 nd 2015 Yamhill Valley Campus Bldg 2/room 101A 3:00-4:30pm. Mock skills days are STRONGLY recommended and are for your benefit to practice your skills and help prepare you for the OSBN test for your license. The graduation program is an opportunity for your family and friends to recognize your accomplishments and enjoy cake and refreshments! You will also get your official certificate of completion of the program at this time. Attending graduation does NOT make you a CNA, you must pass the OSBN test and get your license. This test is usually a month after you complete the class. For the class The Dean of Health Sciences shall ensure that all students pass a national criminal history check to be eligible, pursuant to laws governing the clinical site facility, to participate in the program's clinical experience. It is important that you come prepared to the orientation and having already completed your background check. As soon as your application is accepted you will receive notification via your chemeketa gmail address from advanced reporting letting you know your background check is ordered. Renae will give you information at application time. Failure to complete the background check or a background check revealing a disqualifying criminal history will mean you are ineligible for the class. For questions about disqualifying crimes see: For Oregon State Board of Nursing (OSBN) If students have questions about the possibility of denial of certification by the OSBN after they complete this course, they should check with OSBN at before enrolling in this course. Drug Testing Depending upon where you are placed for the clinical experience, and in order to be accepted to the program you will need to pass a drug test. More information will be given orientation night. Page 2

3 Immunizations Technical Standards Course Attendance Time Commitment Students will be required to provide COMPLETE copies of immunization records to the department office by the end of the second week of the class (July 2nd ). (See attached immunization flyer for specific details and due dates.) Students must meet the requirements for the Technical Standards for the Basic Nurse Assistant Program. (See attached.) In order to meet the State Board of Nursing course requirements, students must attend ALL classes. In addition to class attendance, studying/reading for comprehension of content and practice of skills outside of class time is required Attendance at every class meeting, clinical session, and mock skills is required to pass the course! NO EXCEPTIONS OR EXCUSES THERE IS NO MAKEUP TIME SCHEDULED. IF YOU MISS CLASS YOU WILL BE DROPPED FROM THE PROGRAM. Questions? Contact Chemeketa Yamhill Valley campus building 2 at renae.burger@chemeketa.edu Page 3

4 Basic Nurse Assistant/Nursing Technical Standards Introduction Certain functional abilities are essential for the delivery of safe, effective nursing care. These abilities are essential in the sense that they constitute core components of nursing practice, and there is a high probability that negative consequences will result for patient/clients under the care of nurses who fail to demonstrate these abilities. A program preparing students to practice as nursing assistants must attend to these essential functional abilities in the education and evaluation of its students. This statement of the Technical Standards of the Nursing Assistant/Nursing Program at Chemeketa Community College identifies the functional abilities deemed by the Nursing faculty to be essential. Students with disabilities who think they may require accommodation in meeting the Technical Standards of the Nursing Assistant/Nursing Program should contact the Office of Disability Services to discuss the process of identifying reasonable accommodations. This office is located in Building 2, first floor (telephone [voice/tty]). Students should seek accommodation advising as soon as possible so that a plan for accommodation can be in place at the beginning of the nursing course. Applicants seeking admission into the nursing assistant program who may have questions about the technical standards and appropriate reasonable accommodations are invited to discuss their questions with Disability Services. Reasonable accommodation will be directed toward providing an equal educational opportunity for students with disabilities while adhering to the standards of nursing practice for all students. If a student is dissatisfied with Disability Services, they may discuss their concerns with the Executive Dean of Students. ( ) Technical Standards The practice of Nursing requires the following functional abilities with or without reasonable accommodations: 1. Visual ability sufficient to assess patients and their environments and to implement the nursing care plans that are developed from such assessments. Detect changes in skin color or integrity (pale, ashen, grey, or bluish) Collect data from recording equipment and measurement devices used in patient care Detect a fire in a patient area and initiate emergency action Draw up the correct quantity of medication into a syringe 2. Hearing ability sufficient to assess patients and their environments and to implement the nursing care plans that are developed from such assessments. Detect sounds related to bodily functions Detect audible alarms within the frequency and volume ranges of the sounds generated by mechanical systems that monitor bodily functions Communicate clearly in telephone conversations Communicate effectively with patients and with other members of the healthcare team 3. Olfactory ability sufficient to assess patients and to implement the nursing care plans that are developed from such assessments. Detect foul odors of bodily fluids or spoiled foods Detect smoke from burning materials 4. Tactile ability sufficient to assess patients and to implement the nursing care plans that are developed from such assessments. Page 4

5 Detect changes in skin temperature Detect unsafe temperature levels in heat-producing devices used in patient care Detect anatomical abnormalities, such as subcutaneous crepitus, edema, or infiltrated intravenous fluid Detect changes in respiration rate 5. Strength and mobility sufficient to perform patient care activities and emergency procedures Safely transfer patients in and out of bed and assist them with ambulation. Safely control the fall of a patient. Lift or move (turn, position) clients or objects, pull or push objects weighing up to 35 pounds.. Place or access equipment such as intravenous bags that are at shoulder or higher level. Accurately read the volumes in body fluid collection devices hung below bed level Provide equipment and supplies to the client bedside Perform cardiopulmonary resuscitation 6. Motor skills sufficient to perform psychomotor skills integral to patient care Safely dispose of needles in sharps containers Place and maintain position of stethoscope for detecting sounds of bodily functions Manipulate small equipment and containers, such as syringes, vials, ampules, and medication packages, to administer medications 7. Physical endurance sufficient to complete assigned periods of clinical practice. 8. Communicate information in oral and written form effectively, accurately, reliably, and intelligibly to individuals and groups, using the English language. Process information thoroughly and quickly to prioritize and implement nursing care Sequence or cluster data to determine client needs Develop and implement a nursing plan of care for clients in acute, long term, and community settings Report verbally and in writing client data to members of the healthcare team Read, comprehend, and implement medical orders and client information found in the medical record Perform math computations for medication dosage calculations both with and without a calculator 9. Emotional stability to function effectively under stress and emergency situations, to adapt to changing situations, and to follow through on assigned patient care responsibilities. Maintain effective, mature, and sensitive relationships with others Examine and modify one s own behavior when it interferes with others or the learning environment Possess attributes that include compassion, empathy, altruism, integrity, honesty, responsibility, and tolerance 10. Cognitive ability to collect, analyze, synthesize, integrate and recall information and knowledge to make clinical judgments and management decisions that promote positive patient outcomes. Recognize, understand, and interpret required instruction materials including written documents, computer information systems, and non-book resources. Follow universal precautions against contamination and cross contamination with infectious pathogens, toxins, and other hazardous chemicals. Page 5

6 Department of Human Services Administrative Services Division Potentially Disqualifying Crimes For a list of disqualifying crimes that could prevent a student from being eligible for this class, see Oregon State Board of Nursing Administrative Rule: Criminal Conviction History/Falsification of Application Denial of Certification (1) The Board has determined that the following crimes bear a demonstrable relationship to the role of a CNA and will issue a Notice to Deny Certification to an applicant for certification, renewal of certification or for reactivation of certification as a nursing assistant, following the provisions of the Administrative Procedure Act in contested case hearings, to persons who have been convicted as an adult, or found responsible except for mental illness, or adjudicated as a juvenile for the following crimes as set forth in Oregon law or comparable law in other jurisdictions: (a) Aggravated murder, as in ORS and 115; (b) First Degree Manslaughter, as in ORS ; (c) Second Degree Manslaughter, as in ORS ; (d) First Degree Assault, as in ORS ; (e) Second Degree Assault, as in ORS ; (f) First Degree Criminal Mistreatment, as in ORS ; (g) Second Degree Criminal Mistreatment, as in ORS ; (h) First Degree Kidnapping, as in ORS ; (i) First Degree Rape, as in ORS ; (j) Second Degree Rape, as in ORS ; (k) Third Degree Rape, as in ORS ; (l) First Degree Sodomy, as in ORS ; (m) Second Degree Sodomy, as in ORS ; (n) Third Degree Sodomy, as in ORS ; (o) First Degree Unlawful Sexual Penetration, as in ORS ; (p) Second Degree Unlawful Sexual Penetration, as in ORS ; (q) First Degree Sexual Abuse, as in ORS ; (r) Second Degree Sexual Abuse, as in ORS ; (s) Contributing to the Sexual Delinquency of a Minor, as in ORS ; (t) Sexual Misconduct, as in ORS ; (u) Child Abandonment, as in ORS (2) Any individual who applies for certification as a nursing assistant, who has a history of arrests and convictions over an extended period of time, will be issued a Notice to Deny Certification following the provisions of the Administrative Procedure Act in contested case hearings. (3) All other applicants with conviction histories, other than those listed above, including crimes which are drug and alcohol related, will be considered on an individual basis. The following factors will be considered by the Board: (a) Evidence of rehabilitation; (b) The length of time since the conviction to the time of application for certification as a nursing assistant; (c) The circumstances surrounding the commission of the crime which demonstrate that a repeat offense is not likely; and (d) Character references. (4) Any individual who applies for certification as a nursing assistant, and supplies false or incomplete information to the Board on an application for certification regarding the individual's criminal conviction record, may be issued a Notice to Deny Certification under the provisions of the Oregon Administrative Procedure Act in contested case hearings amended 2/9/ , 0020, 0030, 0040, 0050, 0060, 0070, 0080, 0100 amended 11/20/ amended 4/10/ amended 6/20/ amended 2/14/ , , , , , , , , , and adopted 6/17/99 Page 6

7 Basic Nursing Assistant TB Screening and Immunization Requirements Student Name: Directions: Attach this sheet with copies of all required documentation (no originals) and submit as one (1) complete packet to Renae at the department office before the end of the second week of class (July 2 nd ) Incomplete immunization packets will not be accepted! PROGRAM REQUIREMENT TB screening report Screening shall consist of a Mantoux PPD Tuberculin skin test, administered and read within the last year and will not expire during the course of the class. PPD should not be given at the same time as MMR or PPD will have to be repeated in 30 days of MMR being administered. ADDITIONAL INFORMATION Note: Be aware that the results take 48 hours to obtain. The written report of a TB skin test must include the results of the test as read by a health professional Upon entry, those with positive reactions to the skin test, or with a history of known positive reactions, must submit a recent medical evaluation certifying they do not have active infectious tuberculosis. Tetanus and Diphtheria (Td), OR Tetanus, Diphtheria and Pertussis (Tdap) Vaccination within the last 10 years. Measles, mumps, and rubella (MMR) Two (2) doses of MMR vaccine (reported by month and year of each dose) administered at least 30 days apart with first dose on or after the first birthday, OR Physician-documented disease, OR Positive titer (requires blood test) Hepatitis B (HBV) Series of three (3) injections, OR Positive titer (requires blood test) Varicella (chicken pox) One dose if vaccine was received before age 13, OR two (2) doses if vaccine was received after age 13, OR physician-documented disease, OR positive titer (requires blood test) It is recommended that adults receive a single dose of Tdap to replace a single dose of Td. To protect against pertussis, Tdap may be given at an interval shorter than 10 years since receipt of the last dose of Td. Please see PPD Tuberculin skin test instructions above regarding administration of MMR. Be aware that the recommended minimum timeframe between the first and the second injection is one month, and between the second and third injection is five months. NOTE: A minimum of the first injection is required your clinical rotation. Self-reporting is no longer accepted. Page 7

8 ADDITIONAL STUDENT IMMUNIZATION INFORMATION: The Oregon Health Authority has established standards for requirements for health professional student placements in clinical training settings within the State of Oregon. Immunizations include Hepatitis B, Measles, Mumps and rubella (MMR); Tetanus,diphtheria, pertussis (Tdap), and Varicella. Required screenings include tuberculosis.all reports of TB screening and immunization status must be on official records, signedby a qualified healthcare professional, and must be complete before you are eligible to register for the Basic Nurse Assistant course. Exemptions to the requirements for immunizations may be claimed by students for medical or religious reasons. a. Medical exemption requires a written statement signed by an appropriate healthcare professional that identifies the specific contraindication(s) for receiving the immunization(s). b. Religious exemption requires a written statement signed by the student claiming the exemption that they are not immunized because they are an adherent to a religion the teachings of which are opposed to such immunization. IMPORTANT: Students who exempt themselves from the vaccination requirements should be aware that circumstances may arise that would require their exclusion from clinical and/or classroom settings. Also, illness that may result from lack of immunizations may prevent students from attending class or clinical sessions. Either exclusion from clinical and/or class or missed time due to illness may result in an inability to meet course requirements and, therefore, the need to withdraw from the Basic Nurse Assistant program. Disability Accommodations (if requested): Medical evaluations of physical capacity may be necessary to provide information needed to accommodate functional limitations. When needed for this purpose, reports of an examination conducted by a licensed healthcare professional may be required from students. Students requesting accommodations should make an appointment with Rebecca Bolante in the College's Office for Services for Students with Disabilities at Page 8

9 Chemeketa Community College Yamhill Valley Campus Basic Nurse Assistant Application Form Original To be submitted with application materials To apply for the Basic Nurse Assistant course, please submit this signed form with the following documentation during the application period of May 4 th - June 1 st to Renae Burger in Building 2 Chemeketa Basic Nurse Assistant Application Form (this page) Documentation (copy of unofficial transcript or copy of test scores) of completion of RD090 or placement in RD115 based upon the results of Chemeketa s Placement Test OR proof of Associate Degree or higher Copy of current, signed CPR card taken within the last six months Chemeketa only accepts this card : American Heart Association, Healthcare Provider Level NOTE: Incomplete applications will not be accepted. Mandatory Orientation/Criminal Background/Drug Testing Statement I understand that I must attend this mandatory orientation session to receive vital information about the program I certify that I have accessed and read the link to the Oregon State Board of Nursing and Aging and People with Disabilities (APD) regulations and understand that any of the crimes documented here could disqualify me from being eligible for this course. Failure to attend the mandatory orientation/criminal background check session may also disqualify me from the course. I also understand that the Oregon State Board of Nursing may deny my application for certification as a nursing assistant based on the following: The results of my criminal background check My failure to provide complete and truthful information on my application to test I understand that the Oregon State Board of Nursing (OSBN) requires applicants for certification to provide fingerprints in order for OSBN to conduct a national criminal history record check. This will be a part of the process when I apply to test.i also understand that I will be required to undergo a drug test. Confidentiality Statement I understand that maintaining appropriate confidentiality in all settings is imperative. I understand that I am to demonstrate confidentiality of all information at all times. I understand that failure to observe and respect the privacy of any resident in any facility is grounds for immediate dismissal. Signature Student ID # (K#) Printed Name Telephone # Chemeketa gmail address Address City, State, ZIP Page 9

10 DO YOU NEED TO TAKE A CLASS TO FILL THE CPR REQUIREMENT FOR A CHEMEKETA HEALTH CARE PROGRAM?? WE WILL BE OFFERING A HEALTH CARE PROVIDER CPR AND FIRST AID CLASS THAT WILL FILL THAT REQUIREMENT!!! Date of class: June 20 th, 2015 Time: 8am-5pm (if you are more than 5 minutes late you WILL NOT be allowed in the class so plan on being on time) You are given a lunch break and should wear comfortable clothing Location: Yamhill Valley Campus Bldg 2 room 121 Cost: $69.00 Certification: American Heart Association Health Care Provider Level CPR and First Aid Instructor: Bill Schrempp First priority spots will be for our Fall term CNA class, but if there are extra spots we can fill them with public students! Registration will not take place until June, so please Renae Burger at renae.burger@chemeketa.edu for more information! Page 10