CNA · Member of the Health Care Team · 5 min read
Care Plans, Assignments and Prioritizing Care
- Explain the purpose of the resident care plan and describe the nurse aide's responsibility to follow it without unauthorized changes.
- Describe how to read assignment sheets, organize a daily workflow, and prioritize urgent resident needs over routine tasks.
- Identify safe practices for requesting assistance, staying within the nurse aide scope of practice, and advocating for resident preferences.
Understanding the Resident Care Plan
The care plan is an individualized guide developed by the healthcare team to meet a resident's specific needs. It outlines clear care goals, required levels of assistance, and any necessary adaptive equipment. Nurse aides are required to review and follow each resident's care plan, checking it before providing care to ensure resident safety. Nurse aides must not change care plan interventions on their own; if a resident refuses care or an intervention cannot be performed safely, respect the refusal or stop the task, keep the resident safe, and report to the nurse.
The care plan provides vital directions for day-to-day physical assistance. It specifies designated transfer methods, such as whether a resident requires a one-person assist, a two-person assist, or a mechanical lift. It also details dietary restrictions, feeding techniques, and fluid requirements. Following these instructions protects the resident from complications such as choking, dehydration, or falls.
While nurse aides do not independently create, modify, or establish the care plan, they contribute significantly to the care planning process. Because nurse aides provide hands-on daily care, they are often the first to notice changes in a resident's condition. Nurse aides share direct observations with the nurse regarding changes in mobility, skin integrity, mood, or appetite. Aides may also participate in interdisciplinary care conferences to share observations about resident routines. These observations and reports help the nurse and the wider care team review and update care plans effectively.
Common mistakes
- Attempting a two-person transfer alone because coworkers are busy, which violates the care plan and creates a severe risk of injury for both the resident and the aide.
- Failing to report a resident's care refusal to the nurse, assuming that simply respecting the refusal is enough without documenting or communicating the missed care.
- Performing an unfamiliar task without proper training or clarification instead of asking the nurse for guidance.
- Altering a care plan routine independently to suit personal workflow rather than getting authorization from the nurse.
Key points
- The care plan is an individualized guide that specifies assistance levels, adaptive equipment, transfer methods, and dietary needs; nurse aides must review and follow it without unauthorized changes.
- Nurse aides contribute to care planning by sharing direct observations regarding resident mobility, skin integrity, mood, appetite, and daily routines with the nurse.
- Assignment sheets must be reviewed at the start of each shift, and any unclear duties or unfamiliar tasks must be clarified immediately with the nurse.
- Immediate safety hazards, emergencies, sudden symptoms (like pain, dizziness, or shortness of breath), and call lights take priority over routine care.
- Nurse aides must request help whenever a task cannot be safely performed alone, never attempting a two-person transfer or unauthorized lift operation alone.
- Nurse aides advocate for residents by honoring choices, respecting care refusals, reporting unmet needs or abuse, and communicating preferences to the nurse.
- The nurse aide's role excludes assessing, diagnosing, interpreting findings, giving medications, adjusting oxygen, and inserting or removing tubes; tasks outside the role must be reported to the nurse.
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Sample lesson: Health Care Team Roles, Scope of Practice and Delegation25 practice questions on this exam
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