About This Book

Tracy M. Christianson, RN, BSN, MN, DHEd, CCNE; Kimberley Morris, RN, BN, MN

About This Book

This open education resource (OER) textbook was designed around the laboratory manual used by the faculty at Thompson Rivers University (TRU) Health Care Assistant program (Christianson, T., & Morris, K., Chardon, J., Flurey, L., & Nordick, L.(2022). TRU Health Care Assistant Program HEAL 1150 Healing 3: Personal Care and Assistance Course Manual. Thompson Rivers University. It was enhanced with resources and materials from other OERs that are noted below.

The OER is founded on best-practices related to the competencies and skills for health care assistant (HCA) students, specifically in HCA programs following the British Columbia Provincial curriculum – Health Care Assistant Program Provincial Curriculum Guide 2015. However, the content covered within this textbook can be applied to most HCA program curriculum and offers students the opportunity to acquire personal care and assistance skills within the parameters of the HCA role. The content helps the student learn the theoretical principles and concepts along with understanding the steps of practical skills required to maintain and promote the comfort, safety and independence of individuals in community and facility contexts.

British Columbia Provincial Curriculum (2015) Educational Outcomes

Perform personal care skills in an organized manner ensuring the comfort and appropriate independence of the client:
- Organize and implement safe care according to client needs. Encourage independence of the client as much as possible.
- Encourage client communication and engagement during personal care. Maintain client privacy and dignity.
- Assist the client with personal hygiene and grooming. Assist the client with movement and ambulation.
- Use aids to promote comfort, relaxation and sleep.
- Take and record vital signs accurately (temperature, pulse, respirations). Assist the client to meet nutritional needs.
- Assist the client with medication.
- Provide specialized, sensitive care for the dying client in line with palliative care principles.
Apply an informed problem-solving process to the provision of care and assistance:
- Assess the client and situation.
- Observe changes in the client’s health status.
- Set priorities or make adjustments to the care process based on client requirements.
- Identify priorities for care within the care plan.
- Utilize appropriate health team members as resources to augment one’s own problem-solving and decision-making.
- Follow the care plan for each client. Conduct care-giving or assisting activities.
- Reflect on and evaluate effectiveness of care or assistance. Carry out recording requirements.
- Utilize creativity when required to adapt care and assistance to a variety of contexts.
Provide personal care and assistance within the parameters of the HCA:
- Comply with legal/employer-defined parameters of practice for HCA roles.
- Collaborate with other members of the health team.
- Use appropriate lines of communication.
- Demonstrate dependability, reliability, honesty and integrity. Safely Adhere to the client’s care plan.
Provide care and assistance in ways that maintain safety for self and others in a variety of contexts:
- Wear safe and appropriate clothing, including identification. Assess the environment prior to commencing care.
- Adjust the environment, as appropriate, to ensure safety and to promote efficiency.
- Organize time and equipment for safety and efficiency.
- Base choices and actions on a sound knowledge of asepsis and body mechanics. Adhere to infection control practices.
- Recognize and make wise choices in situations of potential risk to self or others. Exhibit flexible and adaptable behaviour in a variety of contexts.
- Recognize and respond appropriately to emergency situations.

Adaptations

List of OERs Used:

Alberta Health Services. (2022). Medication Assistance Program (MAP) manual, CC BY-NC-SA licence, adapted with permission.
Alberta Health Services. (2016). Health care aide role in medication assistance: A Companion to the Alberta provincial continuing care Medication Assistance Program (MAP) manual, adapted with permission.
Anderson, R., Rees, G., & McCutcheon, J. (n.d.). Clinical procedures for safter patient care – Thompson Rivers University Edition, CC BY 4.0 licence.
Ernstmeyer, K., & Christman, E. (Eds.) (2021). Nursing skills – Chippewa Valley Technical College. https://wtcs.pressbooks.pub/nursingskills/
Girdi-Papp, M. (2022). Comparative Oral+ENT Biology. Comparative Oral+ENT Biology : Marcos Gridi-Papp : Free Download, Borrow, and Streaming : Internet Archive . Chpt 20 pg 438-450.CC BY 4.0 licence.
Interior Health, Home Support Transformation. (2017). Community Health Worker medication competency program: Course manual. Unpublished with Permission to adapt.
McLain, K., O’Hara-Leslie, E., & Wade, A. (n.d.). Foundations for assisting in home care. Foundations for Assisting in Home Care – Open Textbook (geneseo.edu), CC BY 4.0 licence.
Provincial Infection Control Network of British Columbia [PICNet]. (2014). Infection control quick-reference guide for residential care facilities (Volume 2) [PDF]. PHSA. PICNet Guidelines.

Unit 1

No OER used

Unit 2

Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon

Added “terms to know”
Checklist 1 now Checklist 2.4.1 with no changes to attributions

Provincial Infection Control Network of British Columbia [PICNet]

2.2 – Infections used except ‘vaccinations’
All attributions updated
Eliminated Alcohol based hand rub section

Unit 3

Adapted from Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon

reorganized section to have Musculoskeletal Injuries come after Principles of Body Mechanics.
Added information re: maintaining proper body mechanics, Patient handling injury prevention and Musculoskeletal Injuries (potential health effects, prevention and treatment)
Deleted critical thinking exercises

Foundations for Assisting in Home Care / McLain, Wade, & O’Hara-Leslie

Used “Maintaining Proper Body Mechanics” from Chapter 10 “ Care of the Home and Personal Belongings “ Unit C “Ways to Be Safe and Save Entergy and Time”

Unit 4

Foundations for Assisting in Home Care – Unit B / McLain, Wade, & O’Hara-Leslie

Added “Terms to Know”
Changed “Home Health Aide/Personal Care Aide” to “Health care assistant”
Omitted procedure steps for tasks

Unit 5

Adapted from Occupational therapy Assistant Student Resource – Used “Patient body Positions” from slide #21; notes section and Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon

Some wordsmithing of introductory paragraph and body position descriptions.
Removed information re: children and post-partum women.
Combined descriptions of bed positions from both OERs.
Added pictures of position types.

Bedmaking Procedures adapted from Foundations for Assisting in Home Care / McLain, Wade, & O’Hara-Leslie

Procedures re-organized into a table format with ‘Steps’ and ‘Rationale’ columns.
Rationale added to some steps
Added procedure table re: ‘How to Mitre a Corner” with photos.
Videos added after procedure tables.

Unit 6

Comparative Oral+ENT Biology, Girdi-Papp

Sections on swallowing and dysphagia simplified for the target audience

Foundations for Assisting in Home Care / McLain, Wade, & O’Hara-Leslie

Added “Terms to Know”
Changed “Home Health Aide/Personal Care Aide” to “Health care assistant”
Formatted procedure steps into procedure tables throughout

Unit 7

Much of this unit was adapted from Foundations for Assisting in Home Care / McLain, Wade, & O’Hara-Leslie

Added “Terms to Know”
Added introductory sections: “Normal Urinary Elimination”, “Characteristics of Urine”
Added “Guidelines” for assisting with urinary elimination.
Changed title to “Assisting with Urinary Elimination”
Changed ‘patient’ to ‘client’
Changed “Home Health Aide/Personal Care Aide” to Health Care Assistant.
Added picture of assistive devices (Figure 7.2.2)
Procedures re-organized into a table format with ‘Steps’ and ‘Rationale’ columns.
Added picture of condom catheter and urinary drainage bag (7.2.3,7.2.4)
Added videos for each procedure
Using a Bed Pan
Using a Urinal
Applying a Condom Catheter
Providing Perineal Care with an Indwelling Catheter
Emptying a Urinary Drainage Bag
Added pictures (7.2.5, 7.2.6) depicting drainage bag position and emptying the drainage bag
The statement “if required by care plan” added to procedure step “Lower the bed to its lowest setting and ensure side rails are raised”
Changed “nurses” to “Health care Assistants”

Adapted from Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon “Procedure: Administering a rectal suppository or enema”

Utilized check list 47: Medication Administered Rectally
Changed title to: Procedure: Medication Administered Rectally
Changed “patient” to “client”
Adapted some steps to be appropriate to HCA level
Figure 7.3.7 has been replaced
“Procedure: Changing an Ostomy Appliance (flange and pouch)
Changed “patient” to “client”
Information adapted to level of HCA role

Section 7.5 Ostomies: Adapted from Nursing Skills – Chippewa Valley Technical College

information adapted to level of HCA role
Physical and emotional Assessment; Urostomy care removed

Unit 8

Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon

Omitted learning Objectives 1-3
Added “Terms to Know”
Omitted sub-section 3.23.2
Omitted link to “Interior Health Patient Handling Procedure: One person manual
Omitted link to “Safe Patient Handling Assessment Form from Winnipeg Health Region
Checklist 1 now Checklist 2.4.1 with no changes to attributions
Table 3.7 now Table 8.1.1 with bullet 7 omitted
Checklist 24 now Checklist 8.2.1
Checklist 27 now Checklist 8.3.1
Table 3.5 now Table 8.5.1
Checklist 26 now Checklist 8.6.2
Table 3.4 now Table 8.7.1
Table 3.6 now Table 8.9.1
Updated links for PHSA courses
Updated link for Mobility Decision Support Tool link
Updated link for Lateral Transfer Sliding Board
Changed “residential” to “long-term care
Added the sentence, “In British Columbia, the British Columbia Patient Safety and Learning System is used.”

Foundations for Assisting in Home Care / McLain, Wade, & O’Hara-Leslie

Changed “home health aide/personal care aide” to “HCA”

Unit 9

Section 9.2 Adapted from Chapter 11 “Oxygen Therapy” in Nursing Skills – Chippewa Valley Technical College

Learning objectives deleted
Added 3 sentences Oxygen is considered a medication and, therefore, requires a prescription and continuous monitoring by the RN/LPN to ensure its safe and effective use. As a Health Care Assistant, your role is to provide safe care to clients who are receiving oxygen therapy. Depending on your facility/agency, you may be trained to provide oral suctioning and transfer a client’s oxygen source from a liquid cannister to an oxygen concentrator or portable cylinder

Section titled “Cautions with Oxygen Therapy ” adapted from Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon

Changed ‘patient’ to ‘client’
Table 9.2.1 Oxygen Safety Guidelines for Home and Hospital added in additional information regarding ordering of ABGs “This is not the responsibility of the Health Care Assistant”

Section 9.3

Table 9.3.1 Adapted from Nursing Skills – Chippewa Valley Technical College
Created from information in Chapter 11, section 11.3 “Oxygenation equipment”.
“Patient” changed to “client”
Table 9.3.2 Adapted from Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon
Title changed to “Types of Oxygen Tubing and Equipment
“patient” changed to “client”
Figure 9.3.5 replaced “nasal cannula” figure
Figure 9.3.6 replaced “simple face mask” figure
Figure 9.3.7 replaced figure 5.1
Figure 9.3.10 replaced Figure 5.2
Figure 9.3.11 replaced figure 5.3
Video added: Oxygen Therapy