MCH 130 Cincinnati State Nurse Aide Training Application & FAQ

MCH 130 Cincinnati State Nurse Aide Training Application & FAQ Cost: 5 credit hours @ $145.30 = 726.50. $100 for the State test. Other fees for admission ($15), facility fee ($45), registration fee ($9), lab and technology fee (37.50). Total $106.50 for other fees.. (Total cost is $933 for the listed items) $75.00 Parking fee is not included. A physical and 2-step TB test is also required. Required books approximately $50.00. You must have your book and workbook for the first day of class. You will also need hunter green scrubs and white shoes for clinical. For Financial Aid questions please call 513-569-1530. Schedules: Please see our web page as many different class schedules are available. Go to www.cincinnatistate.edu/nurseaide. Click on MCH 130 on the Curriculum Tab. PREREQUISITES and Requirements: You should attend a Nurse Aide Training Information Session. Dates and times are posted or you may call 513-569- 1669 for more information. You must be at least 16 years old. A GED is not required. A current State ID or driver s license and a Social Security card are required to be presented on the first day of class and are required on the day of the State test. Please submit a completed application to the Health Professions Building room 312 which includes a current 2 step TB Test and Physical signed by a Physician or Certified Nurse Practitioner and they must include their title. Instructor Consent is given after the application is reviewed for completeness. Other Requirements include the ability to lift and move 50 pounds and perform the duties of a nurse aide safely and according to policies of the College and of the clinical site. Students will use the computer, email and Blackboard in class. The course involves mastery of basic health care terminology and critical thinking skills on the written exams. You must also register with the college as a degree or non-degree seeking student. Please see www.cincinnatistate.edu/nurseaide for more information or call 513-569-1669. Note: Employers will require a CRIMINAL BACKGROUND CHECK and a DRUG TEST. CONSENT to Register for class: Return your completed application to the Health and Public Safety Building Room 312. We will review your application for completeness and, if approved, we will give you consent to register. Please allow one week for review. We will attempt to contact you by the phone number or email that you provided if your application is incomplete. You can register for the MCH 130 class online or inperson per your priority status. REGISTER with the College: Register as a degree seeking or a non-degree seeking student. You must be registered with the college in order to get into the computer system so that consent to register for class can be given. ATTENDANCE: Nurse Aide Training is a State approved program and attendance at all classes is required. If you are late or absent at the beginning of class or miss any of the Curriculum Standards I-VI which count for16 hours of the course you may need to drop the class In person attendance is mandatory for Standards I-IV. Occurrences of tardy, leaving early, or absence anytime during the class may cause dismissal from the program. Opportunities for make-up for 15 or 30 min of missed lecture are limited to two occurrences. Some missed topics may require additional testing. If so -you must pass the test in order for the make-up to count. Lab Skills and clinical cannot be missed. In cases of Acts of God or extreme hardship which can be documented, it may be possible to make up in another class if there is space. Problems in attendance may require a student to drop or withdraw. Students may also be dismissed for violation of the Code of Conduct and Ethics. Type Code of Conduct in the Search box on the Cincinnati State web page. CLINICAL: Clinical experience begins 30 minutes earlier than posted lecture times. You must be on time and in uniform. Uniforms: Hunter Green scrubs and white tennis shoes are required for clinical. Modest attire is a requirement for the classroom. Scrubs are preferred for class and are required for State Testing. BOOKS Required: Nursing Assistant Care- Second Edition, 2013. Hartman Publisher. ISBN 978-1-60425-037-4. & ISBN 978-1-60425-038-1. The cost for both is around $50.00. The book and workbook are required. Workbook completion is part of your grade. State ID and Social Security Card: You will need a correct and current Driver s License or a State ID and a Social Security Card for the State test. Nurse Aide Training Application updated October 28, 2013 Page 1 of 8

COLLEGE RESOURCES COMPASS Test: You are encouraged to take the free COMPASS test before attending Nurse Aide Training. Taking the test is not a requirement. You will receive your scores on completion of the test. The scores will provide valuable information about your readiness to take college classes. For more information, type COMPASS test in the Search box on the Welcome page for Cincinnati StatePathways to Employment: (PTEC) This is a free service that will partner you with a Tutor, Job Coach, Academic Advisor and Employment Specialist. PTEC will partner students with local and regional healthcare employers that are willing to engage with students to discuss job placement. PTEC is located at Super Jobs 1916 Central Parkway, 45214. Contact Regina Macklin at 513.569.4135 or email her at regina.macklin@cincinnatistate.edu o Tutoring for STNA Exam: Our tutor has proven successful working with students to help increase scores on assessment test and can assess your strengths and weaknesses prior to taking the STNA Exam. This individualized approach will help bridge any gaps you may have to be successful on the exam. Contact Charlene McDaniel 513.569.4138 with questions. o National Career Readiness Certificate: This assessment will help our Career Coach determine career goals and preferences; identify any strengths or barriers to a successful career path. After completing the brief assessments participants will be presented with a National Career Readiness Certificate (NCRC) that is nationally recognized by Healthcare employers. (The NCRC is also a pre-requisite for admission into the PNC program if you are interested in pursuing that program). o Career Placement Services: PTEC will provide individualized services that can include job development, resume and cover letter writing, interviewing techniques, soft skills counseling and assistance in performing an effective job search. You can also benefit from working with an experienced Job Placement Coordinator who has established partnerships with numerous healthcare employers and is well known in the community. o Academic Advisor: Educational planning, assistance with exploring certificates and associate degree programs that best match your skills. Resources for students: Health Excel Services Lisa Lucas- 569-1224, English as a Second Language Andrea Cheng- 569-4848 and Disability Services for students with IEPs Vicki 569-1775. For more information about other services call 569-1669- Nurse Aide Training. Appointments: If you wish, you may make an appointment with the Program Coordinator, Mary Meiser, RN @ 513-569-1670 to discuss preparation for the Nurse Aide Training class. I have read the above information about Nurse Aide Training and I will call 513-569-1669 if I have questions. Name Date Nurse Aide Training Application updated October 28, 2013 Page 2 of 8

Frequently Asked Questions Is there Financial Aid for the class? o If you are a degree seeking student in a Program that requires Nurse Aide Training, you may be able to receive financial aid towards your nurse aide training course. o If you wish to take the class alone, you can apply to the college as a non-degree seeking student. Non-degree seeking students do not qualify for the Federal Financial Aid program. o Bills are due by the 2 nd week of the Semester. How long is the class? o All of our classes meet the 75 contact hours required by State and Federal law. (We usually schedule 80+ hours because we don t count the breaks.) o Most common class times: Classes that meet 2 times a week for 4.5 hours each, day or eve. 10-12 weeks depending on holidays. Classes that meet 2 times a week for 3 hours each, morning or afternoon. 14 weeks Classes that meet from 8-3 x 15 week days. 3 weeks When do the classes start? Spring 2014 starts Jan 6, 2014. Open Registration begins Nov 12, 2013. Summer Starts May 5. Open Registration Mar 24, 2014 o You can check our web site for the most current schedules. Check under programs and courses or use the search tool and select the course number MCH 130. o If the class is full (closed) you may go on the waitlist to be notified if/when there is an opening, then check your email daily or go the first day and take a seat if there is a no-show first comefirst served. My physical and TB Test are not done but I need to enroll now. Can I register for class if I haven t turned in my 2 Step PPD (TB) and Physical? o No, you must complete your 2 Step PPD (TB) and physical. Also the Hepatitis B form must be completed before you can register for class. These are required by the State of Ohio in order to go to the clinical setting. WE CANNOT HOLD A SEAT FOR STUDENTS WITH INCOMPLETE PAPERWORK. How long do I have to wait to take my state test? o Your application for testing must be received at least 10 business days before the date that you wish to test. It could be 2 weeks to 1 month based on lab availability and evaluators for testing. o Do I have to take my test right away? The fee for the State test is included in your tuition. It is better to test right away so that you remember the skills and the class content. You have up to 2 years from the date on your certificate to take the state test. What if I need to miss class? Attendance at all classes is required. Absence, coming late or leaving early may mean you have to drop the class. Pick a class schedule that does not conflict with other obligations. Nurse Aide Training Application updated October 28, 2013 Page 3 of 8

APPLICATION CHECKLIST Applicants will be allowed to register during registration upon the completion of the paperwork and priority registration. Permission to register will be granted at the time the paperwork is turned in, however, the applicant will only be able to register via internet or in-person during the college registration schedule. Please follow the instructions below: The following checklist must be completed before enrolling in the NURSE AIDE TRAINING CLASS: MCH 130 5 credit hours. We cannot hold a seat when paperwork is incomplete. Complete, sign and date the Application Form Have the physical form completed by your doctor/nurse practitioner and make certain that the date of the exam is listed and signed by the physician. All blanks on the form must be addressed by the doctor or nurse practitioner and their titles are required. Physicals and TB tests must be less than 12 months old for clinical. Complete a 2-Step PPD Test (tuberculin skin test). Takes 9 days to complete. After the first step is given, you will return in 48-72 hours to have it read. The second step is given 7-14 days after the first step. You will return in 48-72 hours to have the second test read. The two tests cannot be given less than seven days apart and not more than 21 days apart. The Department of Tuberculosis Control (946-7600), 184 East McMillan Avenue offers the tests. The center is open Monday-Friday from 8:30 a.m. 4:00 p.m. The charge is $20.00 for each of the two tests and $40.00 for chest x-ray. No appointment is necessary. No testing on Thursdays. The TB tests must be signed and dated. HEALTH RECORDS MUST BE DATED AND NOT MORE THAN ONE YEAR OLD at the Semester s end. Return to the Health and Public Safety Division (room 312 HPB) with: Completed forms Obtain consent by turning in application to Health and Public Safety Building room 312. Health form, physical and TB tests must be complete in order to obtain consent. Register in person or via the internet for the course (MCH 130) Attend a Nurse Aide Training Orientation. Date and Time will be posted and announced. Classroom, lab and clinical attendance is mandatory for this course according to State Regulations. YOU MUST BE ON TIME FOR ALL CLASSES, LABS AND CLINICALS. YOU WILL NOT BE ADMITTED TO CLASS IF YOU ARE LATE THE FIRST DAY The clinical time is built into the class-scheduled time but start ½ hour earlier and meet at the nursing facility. A passing grade of 75%, no missed work and competency in skills checks is required in order to attend clinical. Once you have registered for the course, if you do not attend the class or do not meet the prerequisites, you will be issued a NO SHOW (NS) GRADE for the course. This may affect your Financial Aid. If you have questions, please call the Nurse Aide Training Program office at 569-1669 for an appointment. Nurse Aide Training Application updated October 28, 2013 Page 4 of 8

PROGRAM EXPECTATIONS AND CONDITIONS As a potential student in the Nurse Aide Training Program at Cincinnati State College, it is important that you are successful in your efforts. Therefore, it is essential that you understand and comply with the conditions of the program. These conditions are taken from the Program Policies and Procedures, which you will receive in their entirety on the first day of class. A current State ID or driver s license and a Social Security card are required to be presented on the first day of class and are required on the day of the State test. The book and the workbook are required on Day 1. Purchase at the bookstore. Hunter green scrubs and white shoes are required for clinical and preferred for class. Purchase at any location selling uniforms. Please keep copies of your physical and records. Student records are kept for 2 years. Please allow 5 business days if you are requesting copies in that 2 year period. You must present your current state ID for copies. Admission Policy (minimum age: 16 years old) I. The applicant must submit: A. A completed application form including signature in appropriate section. If you are sponsored by an employer, the section marked For Sponsoring Agency Only must be completed by the employer. B. The results of a physical exam, completed within the past 12 months. Minimally, the physical exam must indicate that the nurse aide is capable of performing the required skills and is free of communicable disease. C. The results of a 2-Step PPD Test (Tuberculin Skin Test) performed within the past 12 months or an annual update test with proof of an original 2-step. For those with a positive TB test you must have a Chest X-ray with negative results. The physical and TB test must be current for the entire Semester. The TB tests and physical must be current for the entire Semester. D. If you have a significant change in health a new physical with consent will be required. Attendance Policy I. No student may transfer to a different course section after day 2 of the term. II. Attendance is mandatory for all class, clinical and skills lab activities. You will not receive a certificate if you miss any part of the program. We cannot guarantee that you will be able to make up missed time. III. The nurse aide must have attended and satisfactorily completed all required work, including skills in order to go to clinical. A. Missing any time on Day 1 or the Standards I-VI/16 hours will require that the student withdraw. B. If the student misses any other time, the time must be made up in order to receive a certificate. The student maybe required to attend a different class covering the same missed content on a space available basis. If a clinical experience is missed, it must be made up in the next scheduled class if space is available. C. Students frequently missing time, 2 occurrences, or missing an entire class may be required to withdraw. IV. All missed work must be completed within 6o days or an F grade may result. Termination Policy I. In addition to the conditions of the Attendance Policy, a student in the Nurse Aide Program may be terminated for any of the following reasons: A. Grade average of less than 75% or unsatisfactory performance on skills may not go to clinical and may not complete the class. B. Inability to successfully demonstrate skills during lab after 3 tries. C. Unsafe or inappropriate resident care during clinical performance. D. Non-compliance with Nurse Aide Training Program policies. E. Exhibition of behavior that is inappropriate as outlined under the Code of Conduct. Refund Policy I. Cincinnati State students will follow the college regulations as outlined in the catalog/handbook. II. All workforce development students will follow the guidelines set forth by workforce development policy: III. Students who are failing are encouraged to withdraw before the deadline. See Withdrawal Period on the Cincinnati State web page under Important Dates 2013/2014. Signature Date Nurse Aide Training Application updated October 28, 2013 Page 5 of 8

Must read & sign form either taking the shots or sign waiver MCH 130 Cincinnati State Nurse Aide Training Application & FAQ Hepatitis B (Recombinant) Hepatitis, the disease is a viral infection caused by Hepatitis B virus (BV) which causes death in 1-2% of affected patients. Most people with Hepatitis B recover completely; but approximately 5-10% can become chronic carriers for the virus. Most of these people have no symptoms but can continue to transmit the disease to other. Some may develop chronic active hepatitis and cirrhosis. HVB also appears to be a causative factor in the development of liver cancer. Thus immunization against Hepatitis B can prevent acute Hepatitis and also reduce sickness and death from chronic active Hepatitis, Cirrhosis, and Liver Cancer. The Vaccine is produced from highly purified yeast cells. Recombinant HBV is not recommended in the presence of Hypersensitivity to yeast or any component of the vaccine. This vaccine has been extensively tested for safety in chimpanzees and for safety and efficacy in large scale clinical trials with human subjects. A high percentage of healthy people who receive the recommended three doses of vaccine achieve high levels of surface antibody and protection against other agents such as Hepatitis A virus, non-b or other virus known to infect the liver. Full immunization requires three doses of vaccine over a six-month period, although some people may not develop immunity even after three doses. There is no evidence that the vaccine has ever caused Hepatitis B; however, because of the long incubation period, HBV people who have been infected with HBV prior to receiving the vaccine may go on to develop clinical Hepatitis in spite of Immunization. Duration of immunity is unknown at this time. The vaccine is free of association with human blood or blood products and is not recommended for pregnant individuals except in severe need, although risk is unknown at this time. Incidence of possible vaccine side effects is very low. No serious side effects have been reported with the vaccine. A few people do experience tenderness and redness around the site of the injection. Low grade fever may occur, along with rash, nausea, mild fatigue, and back, neck, and shoulder pain. Diarrhea, abdominal cramps and dizziness also have been reported. In some patients, a delayed reaction of up to several weeks after injection may occur resulting in fever, joint pain, rash and nervous and blood system reactions. The possibility exists that more serious side effects may be identified with more extensive use. After reading the above information, please direct questions you may have to your physician and/or nurse. Acknowledgement of Information / Hepatitis B Recombinant Vaccine I have read the Patient Information Statement regarding Hepatitis B recombinant vaccine. My questions have been answered to my satisfaction and I have been given the option to discuss my concerns with my physicians. I understand that the college recommends that I receive the Hepatitis B series of three injections required to produce immunity for my protection, however, as with all medical treatment, there is no guarantee that I will become immune or that I will not experience ad adverse side effect of the vaccine. *I have completed the Hepatitis B vaccine series dates-- 1 2 3 I am in the process of taking the vaccine series (signature) Waiver: I understand that the educational experiences in my program may expose me to blood or other potentially infectious materials and that I may be at risk to acquiring Hepatitis B virus HBV infection. I have been given the opportunity to be vaccinated with HBV. However, I decline HBV at this time I understand that by declining this vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease. If in the future I continue to have occupational exposure to blood or other potentially infectious materials, I want to be vaccinated with Hepatitis B vaccine. *I do not consent to be vaccinated at this time (signature) Nurse Aide Training Application updated October 28, 2013 Page 6 of 8

Application for Admission I plan to enroll in the class for Semester Today s Date Check one of the following: Cincinnati State Student Private Pay Student Facility-Sponsored Student Industry-Training Student PLEASE PRINT ALL INFORMATION CLEARLY * Required by the State * Name as it appears on your State ID or Driver s License: *Full Name Last First Middle *Mailing Address Street City State Zip *Home Telephone Number ( ) *Social Security # *email * Date of Birth * Did you have an IEP (Individualized Education Plan) in high school. Yes No Male or Female (circle) In Case of Emergency Notify Phone Number ( ) Education History: List High School, College or other schools attended including other Nurse Aide Training programs. School City & State Date Started Date Left Reason for Leaving Employment History: List your two most recent positions. Employer City & State Date Started Date Left Reason for Leaving Is your general state of health: Excellent Good Fair I declare the above statements to be correct and that I have read (or have had read to me) and agree to the expectations and conditions included in this form. Signed Date For Private Pay Participants: If you are paying for your own training, you must read the statement below. I am not working in a long-term care facility and have not been offered a job in a job in a long-term facility. Signed: Date For Sponsoring Agency Only: To comply with State Regulations, the following information must be completed. PLEASE PRINT CLEARLY. Name of Facility Contact Person Phone Number ( ) Hire Date Nurse Aide Training Application updated October 28, 2013 Page 7 of 8

Physician completes these sections MCH 130 Cincinnati State Nurse Aide Training Application & FAQ Nurse Aide Training Health Certificate Last Name First Name Middle Address City State Zip Code Employer Employer s Phone Number Essentials of Physical Exam Temperature Respiration Pulse Blood Pressure Weight Height Any pertinent findings: Is this person free of communicable disease? Yes or No (A yes or no answer is required. A check mark or blank will be considered incomplete) Have you noted any emotional or physical condition(s) which might prevent this person from fulfilling his/her duties as a Nurse Aide? Yes or No. (A yes or no answer is required. A check mark or a blank will be considered incomplete.) If so, please describe: PPD Include Signature and TITLE of Provider ( RN, LPN, NP etc) Date of 1 st Step: Date 1 st Step Read: Results mm: by Date of 2 nd Step: Date 2 nd Step Read: Results mm: by Date of last PPD screening: If positive, Chest X-ray Results: After the first step is given, you will return in 48-72 hours and have it read. The 2 nd step is given 7-14 days after the first. You will return in 48-72 hours to have the second test read. The two tests cannot be given less than seven days apart and not more than 21 days apart. The test must be signed and dated by a licensed nurse or health care provider. *Required All spaces must be completed Licensed Professionals must sign with their TITLE *Signature of Physician: Date *Name of Physician: *Name of Practice: *Address & Phone # & Fax: Nurse Aide Training Application updated October 28, 2013 Page 8 of 8