OAR 851-063-0030
Authorized Duties and Standards for Certified Nursing Assistant 1 (CNA 1)
(1)
Under the supervision and at the direction of a licensed nurse, the CNA may provide care and assist clients with the following tasks:(a)
Tasks associated with communication and interpersonal skills:(A)
Answering and placing call signals;(B)
Coaching and mentoring other nursing assistants;(C)
Communicating with clients and co-workers;(D)
Maintaining confidentiality;(E)
Reporting abuse, mistreatment, and neglect; and(F)
Utilizing de-escalation techniques.(b)
Tasks associated with person-centered care.(c)
Tasks associated with infection control and Standard or Transmission Based Precautions:(A)
Assisting with coughing and deep breathing;(B)
Bedmaking and handling of linen;(C)
Caring for the client’s environment;(D)
Handling and disposal of hazardous wastes;(E)
Handling of contaminated materials;(F)
Handwashing and hand hygiene;(G)
Implementing precautions associated with communicable and infectious diseases;(H)
Implementing neutropenic precautions;(I)
Maintaining client cleanliness and grooming; and(J)
Utilizing personal protective equipment.(d)
Tasks associated with safety and emergency procedures:(A)
Implementing bleeding, cervical, hip, and sternal precautions;(B)
Moving and transferring clients;(C)
Transporting clients in wheelchairs and specialized chairs;(D)
Turning and positioning clients;(E)
Using lifts and safe client handling devices;(F)
Turning oxygen on and off or transferring oxygen between wall and tank at pre-established flow rate for stable clients;(G)
Managing hazards in the workplace;(H)
Preventing burns;(I)
Preventing falls; and(J)
Performing cardiopulmonary resuscitation.(e)
Tasks associated with activities of daily living (ADL):(A)
Assisting with nutrition and hydration:(i)
Measuring and recording height and weight;(ii)
Measuring and recording intake and output;(iii)
Positioning clients for nutritional and fluid intake;(iv)
Preventing choking and aspiration;(v)
Preventing dehydration; and(vi)
Thickening liquids; and(vii)
Utilizing techniques for assisting with eating.(B)
Assisting with elimination:(i)
Administering bowel evacuation suppositories that are available without a prescription;(ii)
Administering enemas;(iii)
Assisting with the use of bedpan and urinal;(iv)
Assisting with toileting;(v)
Collecting specimens; sputum, stool, and urine including clean catch urine specimens;(vi)
Providing catheter care including the application of and removal of external urinary catheters;(vii)
Providing ostomy care for established, healthy ostomy including cleaning the ostomy site and emptying the ostomy bag or changing the dressing or ostomy appliance or bag; and(viii)
Providing perineal and incontinence care.(C)
Assisting with personal care:(i)
Bathing;(ii)
Providing comfort care;(iii)
Dressing and undressing;(iv)
Grooming to include: application and care of dentures, eye glasses, and hearing aids.(v)
Nail care for fingernails and toenails of persons with uncompromised circulation;(vi)
Oral hygiene;(vii)
Personal care considerations for persons who have tubes or special equipment;(viii)
Shampooing and caring for hair;(ix)
Shaving; and(x)
Skin Care to include: application of non-prescription pediculicides; application of topical barrier creams and ointments for skin care; maintenance of skin integrity; prevention of pressure, friction, and shearing; and use of anti-pressure devices;(D)
Assisting with positioning devices and restraints;(E)
Assisting with restorative care:(i)
Ambulating;(ii)
Applying, turn on and off, sequential compression devices;(iii)
Assisting with and encouraging the use of self-help devices for eating, grooming and other personal care tasks;(iv)
Assisting with bowel and bladder training;(v)
Assisting with ADL programs;(vi)
Assisting with the use of crutches, walkers, or wheelchairs;(vii)
Assisting with warm and cold therapies;(viii)
Caring for, applying, and removing antiembolus stockings, braces, orthotic devices, and prosthetic devices;(ix)
Elevating extremities;(x)
Maintaining alignment;(xi)
Performing range of motion exercises;(xii)
Reinforcing task sequence by breaking down tasks into small, obtainable steps;(xiii)
Reinforcing the use of an incentive spirometer;(xiv)
Using footboards; and(xv)
Utilizing devices for transferring, ambulation, and alignment.(f)
Tasks associated with collaboration with health care team.(g)
Tasks associated with observation and reporting:(A)
Observing and reporting changes of condition to licensed nurse; and(B)
Measuring and recording:(i)
Temperature, apical and radial pulse, respiration and blood pressure (manual and electronic- forearm, lower leg, thigh, upper arm and orthostatic blood pressure readings);(ii)
Emesis;(iii)
Liquid stool;(iv)
Pain level using a facility approved pain scale;(v)
Pulse oximetry; and(vi)
Urinary output, both voided and from urinary drainage systems.(h)
Tasks associated with documentation.(i)
Tasks associated with end of life care.(2)
The CNA may, as an unlicensed person, provide care as delegated or assigned by a nurse in a CBC setting.(3)
ORS 678.440 (Nursing assistants)(5) defines the term “nursing assistant” as a person who assists licensed nursing personnel in the provision of nursing care. Consistent with that definition, a CNA must either:(a)
Be regularly supervised by a licensed nurse; or(b)
Work under licensed nurse monitoring in a CBC setting or other setting where there is no regularly scheduled presence of a licensed nurse provided there is periodic supervision and evaluation of clients.(4)
Under no circumstance shall a CNA work independently without supervision or monitoring by a licensed nurse who provides assessment of clients as described in OAR 851-063-0030 (Authorized Duties and Standards for Certified Nursing Assistant 1 (CNA 1))(3)(a)(b).(5)
A CNA may accept verbal or telephone orders for medication from a licensed health care professional who is authorized to independently diagnose and treat only when working in the following settings under the specified administrative rule:(a)
When working in Adult Foster Homes, as permitted under OAR Chapter 411, division 50;(b)
When working in Residential Care Facilities, as permitted under OAR Chapter 411, division 54; and(c)
When working in Assisted Living Facilities, as permitted under OAR Chapter 411, division 54.(6)
Standards of Care for Certified Nursing Assistants. In the process of client care the CNA shall consistently:(a)
Apply standard precautions according to the Centers for Disease Control and Prevention guidelines;(b)
Use hand hygiene between episodes of care;(c)
Use appropriate body mechanics to prevent injury to self and client;(d)
Follow the care plan as directed by the licensed nurse;(e)
Use appropriate communication with client, client’s family and friends, and coworkers;(f)
Use alternatives to physical restraints, or apply physical restraints as directed by the licensed nurse;(g)
Determine absence of pulse or respiration, and initiate an emergency response;(h)
Report to the licensed nurse any recognized abnormality in client’s signs and symptoms;(i)
Record observations and measurements, tasks completed, and client statements about condition or care;(j)
Apply safety concepts in the workplace;(k)
Report signs of abuse, neglect, mistreatment, misappropriation or exploitation;(l)
Demonstrate respect for rights and property of clients and coworkers; and(m)
Maintain client confidentiality.
Source:
Rule 851-063-0030 — Authorized Duties and Standards for Certified Nursing Assistant 1 (CNA 1), https://secure.sos.state.or.us/oard/view.action?ruleNumber=851-063-0030.