Documentation for the CNA in Long-Term Care
About the Course
Certified nursing assistants (CNAs) perform basic restorative and nursing services related to safety, comfort, personal hygiene, basic mental health, and the protection of resident rights. A CNA has important responsibilities to the facility where they work and the residents/residents they assist. This chapter explains the role of the CNA in resident documentation of daily care.
Learning Outcomes
Upon completion of the course, the learner will be able to:
- Identify and explain the functions of documentation.
- List requirements for documentation by the CNA.
- Describe the categories of care and types of observations that must be documented.
- Identify CNA documentation that may be used in the long-term care Minimum Data Set.
- Identify information that should be reported to the supervisor.
- Explain the CNA’s role in maintaining the confidentiality of medical documentation.
About the Author
Dr. Robin McCormick DNP, RN has been?a nurse leader for over 23 years in nursing practice, leadership, management, and education. Dr. McCormick earned a Doctor of Nursing Practice (DNP) from Troy University in 2018, a Master’s of Science in Nursing degree from University of South Alabama in 2007, and a Bachelor of Science in Nursing (BSN) degree in 2000 from Troy University. Dr. McCormick has published and presented on topics relevant to?nursing practice and education on the local, national, and international levels. With a passion for improving community health outcomes,?Dr. McCormick has a research focus on mental health, maternal-child outcomes, and?community health. Dr. McCormick strives to develop training that?will?empower individuals and communities to achieve their highest level of health and well-being.
How to Receive Credit
- Read the entire course online or in print which requires a 2-hour commitment of time.
- At the end of the course, answer the Yes/No Affirmation question to indicate that you have completed the educational activity.
- Specific to Florida: A mandatory Final Examination with a passing score of 75% or higher is required. Exam questions link content to the course Learning Outcomes as a method to enhance individualized learning and material retention.
- Provide required personal and payment information.
- Complete the mandatory course evaluation.
- Print your Certificate of Completion.
Resolution of Conflict of Interest
Planners, faculty, and others in control of content (either individually or as a group) have no relevant financial relationships with ineligible companies.
Sponsorship/Commercial Support and Non-Endorsement
It is the policy of Colibri Healthcare, LLC not to accept support from ineligible companies. Furthermore, ineligible companies are prohibited from distributing or providing access to this activity to learners.
Disclaimer
The information provided in this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.
Accreditations and Approvals
Colibri Healthcare, LLC is accredited as a provider?of nursing continuing?professional development?by the American Nurses Credentialing Center's Commission on Accreditation.?
©2023: All Rights Reserved. Materials may not be reproduced without the expressed written permission or consent of Colibri Healthcare, LLC. The materials presented in this course are meant to provide the consumer with general information on the topics covered. The information provided was prepared by professionals with practical knowledge of the areas covered. It is not meant to provide medical, legal, or professional advice. Colibri Healthcare, LLC recommends that you consult a medical, legal, or professional services expert licensed in your state. Colibri Healthcare, LLC has made all reasonable efforts to ensure that all content provided in this course is accurate and up to date at the time of printing but does not represent or warrant that it will apply to your situation nor circumstances and assumes no liability from reliance on these materials. Quotes are collected from customer feedback surveys. The models are intended to be representative and not actual customers.?