ELEMENT 1: IDENTIFY WORK REQUIREMENTS

On completion of this element, you should be able to:

1. Receive, understand and clarify instructions for work schedule and
performance and quality assurance requirements where necessary

RECEIVE, UNDERSTAND AND CLARIFY WORK INSTRUCTION

When you work as a Healthcare Assistant in a healthcare facility, you will
obtain details of your job requirements for your work instructions. These are
usually contained in the workplace documentation, which may include any of
the following:
 Employee manual
 Workplace policies and procedures
 Legislative guidelines
 Occupational Health & Safety requirements
 Manufacturer’s specifications
ELEMENT 1: IDENTIFY WORK REQUIREMENTS

You should use the workplace documentation/information to guide your work

practices. In order to do so effectively, you should:
 Read the documents carefully to fully understand what you are required to
do
 Seek clarification where necessary
 Follow the work instructions and procedures correctly
Work organization sequence may range from receiving instructions, to
carrying out task, to cleaning up task. Work plan may be either written or
verbal and may include the following:
 Preparation of work area
 Selections of tools and equipment
\

Handling of material, tools and equipment

Housekeeping requirements
Work instructions may relate to the following:
Work schedule
Patients in hospitals and long-term care facilities need care
twenty-four (24) hours per day. As such, the day is divided into
three (3) shifts of eight (8) hours, which are called:
Day – 7:00 a.m. to 2:00 p.m.
Evening – 2:00 p.m. to 10:00 p.m.
Night – 10 p.m. to 7 a.m.
In some healthcare facilities, you may be able to work one shift all the time. While in others you
may have to rotate form one shift to another every few weeks. In addition, you may also be
required to work on weekends. Some healthcare facilities may provide a shift differential for
working evenings and nights.
Shifts differential – extra money for working in the evening, night or on the weekends
Work schedule may be carried out in a singular application or in a team situation.
Performance
You will required to carry out several work tasks as a Healthcare Assistant. These will vary form
one work environment to the next, but some of the general duties may include:
 Keeping the patient safe
 Using universal or standard precautions
 Communicating with patient and health team members
 Assisting with patient assessment and care planning
 Taking care of patients’ personal care needs
 Measuring vital signs
 Using special equipment
 Giving special treatments
 Observing patients and reporting findings
It is important for you to understand the scope of the work tasks that you will be
expected to carry out. The term ‘scope of practice’ refers to the skills that you are
legally permitted to perform. You should avoid situations wherein you are
requested to perform work tasks that are outside of your ‘scope of practice’ i.e.
for which you have not been trained.
Quality Assurance Requirements
Quality assurance requirements are necessary in order to have a defined,
repeatable process to adhere to so that you can consistently meet standards for
carrying out your tasks. These requirements may relate to workplace procedures,
work specifications and the use and maintenance of tools and equipment.
Quality Assurance
Quality Assurance – the “checks and balances” involved
ensuring that all work conforms to the standards of quality
established by the profession/industry.
Quality Assurance requirements are usually outlines in
regulations and enforced by the national Nursing Council and the
administration of your healthcare facility. These regulations will
help you to provide better uniformity in the care.
Sometimes, you may need to communicate with your supervisor
so that he/she may clarify any aspect of the instructions that you
might not understand.
Quality Assurance
Clarify – to make something clearer by explaining it in greater
detail
You may seek more detailed explanation on the following:
The exact nature of the work task
The extent of your job responsibilities
To whom you should report
Timeframe for completion of the task
How to deal with certain issues/problems
Asking the right questions can lead to a better understanding of a
problem or situation. Failure to clarify work instructions could
mean that you will be unable to carry out your work tasks
effectively.
ELEMENT 2: PLAN PROCESS TO COMPLETE WORK
On completion of this element, you should be able to:
1. Identify, prioritize and sequence tasks to achieve effective completion of work

IDENTIFY, PRIORITIZE AND SEQUENCE WORK TASKS

You have already learnt about how to identify you work tasks from work instructions.
Having done this, you should then plan and organize your work activities; including
preparing and laying out the work area with the equipment and materials that you need
in order to avoid any back tracking, workflow interruptions or wastage. Each
healthcare facility will have its own way of doing things; so you are to make sure that
you know the procedure and practices of your workplace and adhere to them.
ELEMENT 2: PLAN PROCESS TO COMPLETE WORK
If you are constantly rushing from one task to the next or if you are always rushing to
meet deadlines, this could be a sign that you need to prioritize your work tasks.
Prioritizing is determining what needs to get done and in what order. Here are some
guidelines for you to follow:
 Review your work assignments at the start of each shift/day
 Note the tasks, the urgency of each and the timeframe of completion
 Place the tasks in order of importance on your work schedule or “to do list”
 The tasks that are urgent and important should be completed first
 If any items are added to your list during the workday/shift, place them on your list
and rank them, relative to the other items
 Decide which work tasks will require the assistance of your colleagues or supervisor
and arrange to get the necessary help
Procrastination – the act of postponing or deferring action
In order to be an efficient worker, you should try to avoid
procrastination. You can do this by identifying the work tasks that
you tend to put off as long as possible. When you identify the reason
for procrastination, you can find solutions such as breaking down
large tasks into smaller pieces.
Sometimes priorities may change and so you may need to change
your list and re-prioritize. It might also be helpful to speak to your
supervisor about your list of priorities. Ensure that both of you agree
on which of your work of you work tasks are low and high priority.
Having identified and prioritized your work tasks, you should then
sequence you work tasks so that you can complete them effectively.
ELEMENT 3: SELECT TOOLS AND EQUIPMENT

On completion of this element, you should be able to:

1. Identify and select personal protective equipment
2. Identify and select appropriate tools and equipment for required service

IDENTIFY AND SELECT PERSONAL PROTECTIVE EQUIPMENT

A hazard is considered to be any existing or potential condition in a healthcare
facility that could result in injuries, illness or death to healthcare workers. One
way to eliminate or reduce the risk of harm from hazards is to wear Personal
Protective Equipment (PPE). This includes all clothing and work accessories
designed to create a barrier against workplace hazards.
ELEMENT 3: SELECT TOOLS AND EQUIPMENT
Personal protective equipment that may be used when carrying out work in a healthcare setting
includes:
 Safety goggles/face shields
 Gloves
 Masks
 Gowns
 Shoe covers
 Surgical caps
Some guidance for using personal protective equipment are:
 Changing gloves at appropriate times and disposing of them according to facility policy.
 Wearing mask and eye protection or face shield for procedures that are likely to generate
splashes of blood and other body fluids, this is to prevent contact between pathogens and
mucous membranes.
 Wearing a waterproof gown for procedures likely to produce splashes of blood or other body
fluids. Removing soiled gown as soon as possible and disposing according to facility policy.
 Removing protective equipment before leaving the work area and when a garment becomes
contaminated
 Placing used protective equipment in marked areas or containers when being stored,
washed, decontaminated, or discarded
In order to ensure the greatest possible protection in the workplace, you should:
 Wear PPE properly
 Attend training sessions on PPE
 Care for, clean and maintain PPE
 Inform a supervisor of the need to repair or replace
You should be careful when selecting personal protective equipment, as they will offer
protection from exposure to harmful substances (such as blood and body fluids) that
you may come into contact with as you carry out your job. All PPE (clothing and
equipment) should be of safe design and only those items that meet national standards
should be used.
IDENTIFY AND SELECT TOOLS AND EQUIPMENT
The selection of appropriate tools and equipment for managing the healthcare of your clients is very
important. With the ever-changing technology that is available today, you may feel overwhelmed
when trying to select appropriate equipment. However, as a healthcare worker, you will perform your
job more effectively if you can quickly determine the most appropriate tool/equipment for a particular.
The tools and equipment that you will use while carrying out your job will depend on the type of work
task that is being performed. For example, you will require the following tools/equipment when
 Assisting with a physical examination
 Percussion hammer
 Vaginal speculum
 Nasal speculum
 Opthalmoscope
 Otoscope
 Stethoscope
 Laryngeal mirror
 Measuring vital signs
 Thermometer
 Sphygmomanometer
 Stethoscope
 Assisting with personal care needs
 Scale
 Continence aids
 Toileting aids
 Hair grooming equipment
 Assisting client with mobility
 Wheelchairs
 Other transport devices
 Lifting and transferring aids
It is important that you familiarize yourself with all tools and equipment so that you
can select the appropriate one for the required service. In addition, you should ensure
that you know how to use the tool/equipment correctly. Be sure to read the
manufacturer’s guidelines and instructions before use. when in doubt, do not hesitate to
ask a colleague or your supervisor. You should also check to see all tools and
equipment are in proper working order before use.
ELEMENT 4: DEMONSTRATE SAFE AND EFFICIENT SEQUENCE OF WORK

On completion of this element, you should be able to:

1. Provide service safely and in a logical and efficient sequence
2. Store tools, supplies and equipment hen not in immediate use

PROVIDE SERVICE SAFELY

One major role of all healthcare providers including Healthcare Assistants is to
maintain a safe and work environment. You should always be cautious and
alert in order to prevent any accidents that are related to procedures that you
carry out on a daily basis. It is possible to make mistakes when carrying out
work procedures such as:
 Moving/transferring a client
 Changing a dressing
 Feeding a patient
ELEMENT 4: DEMONSTRATE SAFE AND EFFICIENT SEQUENCE OF WORK

Most healthcare facilities establish rules and procedures that are designed to keep both staff and
clients safe. It is important that you follow the correct procedures and practices when caring for
clients/patients.
Some of the safeguards to prevent errors and ensure that client’s safety include:
 Making sure that the client is properly identified
 Establishing a system of checking and rechecking
 Ensuring that the proper resources are available to carry out your work tasks and knowing how
to use these resources properly
 Ensuring that all tools and equipment are well maintained and in proper working condition
When you are unsure about the correct action to be taken in a particular situation, you should
consult the appropriate written guidelines or a supervisor before proceeding. It is important that
you ensure that all procedures and practices that are implemented by your healthcare facility
comply with government health regulations.
When you work in a healthcare facility, there are several routines that you will
be required to carry out on a daily basis. These include but are not limited to:
 Bathing the patient and providing oral hygiene care
 Changing the patient’s bed linen
 Assisting the patient with mobility
 Keeping the work area clean and preventing the spread of infection
Standard precautions are the infection-control action used for all people
receiving care regardless of their condition or diagnosis. This approach treats
all human blood, body fluids and other potentially infectious materials as if
they were infected with blood-borne pathogens such as hepatitis or HIV.
Standard precautions are designed to reduce the risk of transmission of micro-
organisms from both recognized and un-recognized sources of infection such
as blood, body fluids, secretions and excretions in healthcare facilities.
This means that all healthcare workers follow specific procedures called work practice controls to
prevent the spread of infection. Standard precautions stress hand washing and the use of Personal
Protective Equipment (PPE).
When you follow workplace procedure, they will help you to carry out your work tasks in a logical
and efficient sequence. For example, if you are required to turn and position a client/patient, there
are tasks that are always done before carrying out the procedure such as washing you hands,
identifying the patient and explaining the procedure. These procedures would be the same of you
were preparing a patient for examination, measuring vital signs, bathing or feeding the patient.
With this particular procedure, you would also be required to focus on safety before starting, by
locking the bed wheels, raising the bed to a suitable level and ensuring that the bed rails are up.
The steps for this procedure are listed in sequence. Each facility will have specific methods for
turning and positioning the patient and you should be guided by them. After the procedure is
completed, there are some standard post-procedure tasks such as ensuring that the patient is
comfortable, un-screening the patient ad washing your hands.

STORE TOOLS, SUPPLIES AND EQUIPMENT

An important aspect of maintaining a safe environment is storing all tools, supplies and equipment
upon completions of the various work tasks.
ELEMENT 5: REPORT OUTCOMES
On completion of this element, you should be able to:
1. Give verbal report to appropriate person on completion of service and enter relevant
client details on database

GIVE VERBAL REPORT

Communication among health professionals is usually done through discussion, records
and reports. One of your job responsibilities as a Healthcare Assistant is to provide
accurate verbal reports to your colleagues, supervisor and other health professionals.
Verbal reports use words and can be done orally or in writing.
Oral reports may be used to communicate information about patients. One type of
report is a shift report, which is given by the registered nurse at the start of the shift to
the staff that is about to start working. This report includes:
 Changes in patients’ conditions
 Information about new patients
 Any incidents that occurred to patients
 Feedback on effectiveness of strategies in care plan
ELEMENT 5: REPORT OUTCOMES

This report provides you with information on assignments such as patients that
you will need to care for and procedures that you will be required to perform.
During your shift, you will be required to give oral reports to the supervisor
about procedures that you have completed and observations that you have
made. At the end of the shift, you will summarize your assignment to the nurse
so that the information can be included in the shift report to the staff working
on the next shift.
In addition to oral reports, you were also required to provide written reports.
After you have completed your assessment and the necessary procedures for
patient care, you should enter the relevant information on the records. You
should include:
 All your observations of the patient’s condition
 The care that has been given
 The patient’s response to the care
You should familiarize yourself with the necessary forms that you are required to
complete. When completing these records, you should ensure that you:
 Write legibly
 Use good grammar
 Use standard medical abbreviations only
 Use correct colour ink
 Chart entries in correct sequence
 Make entries brief, objective and accurate
 Write the date and time each entry
 Sign your first initial, last name and title to each entry
 Follow the proper procedure for correcting errors
With time and experience you will learn when to report
observations about patients. If the patient’s condition changes
after you have reported your observations, you should inform you
supervisor again. It is important that you ensure that these reports
are accurate, clear, concise and factual. You should ensure that
the reports meet all legal and organizational requirements.
If your healthcare facility uses computerized records instead of
paper-based records, you should ensure that you know how to
enter and retrieve relevant information. Records that are stored in
a computer database have the advantage of being accessed from a
single location. It is also possible to search through these records
much more quickly than through a large number of paper file
folders. Computers also allow you to use passwords and special
security procedures to prevent unauthorized access to
information.
Many healthcare agencies have developed special policies and procedures to
ensure the confidentiality of client information stored in computers. Here are
some guidelines that you should find helpful:
 You will require a password to access computer files. Do not share this
password with anyone (including other health team members)
 Never leave computer terminal unattended after you have logged on
 Do not leave a client information displayed on the screen where others may
see it
As with other aspects of documentation, failure to observe
confidentiality rules may have legal implications. Be sure to
familiarize yourself with the organizational policies and
protocols pertaining to privacy and confidentiality of client
information.

Properly completed client records enable healthcare workers

who interact with the client at different times to communicate
with each other. Once persons are able to access data on
patient’s condition, they will be better able to plan and
modify the client’s plan of care.
ELEMENT 6: CLEAN UP

On completion of this element, you should be able to:

1. Ensure that unused materials are safely stored at appropriate
area
2. Remove empty containers and waste material from service area
3. Ensure that service area is left clean, safe and secure on
completion
4. Clean, maintain and store tools and equipment
ELEMENT 6: CLEAN UP
CLEAN, MAINTAIN, STORE TOOLS AND EQUIPMENT/STORE UNUSED
MATERIALS
The daily care and cleaning of tools and equipment is an important part of your job and it helps to
contribute to patient’s safety. The cleaning and disinfecting of equipment helps to reduce the
spread of micro-organisms which will in turn help to control infections in the healthcare
environment. This equipment may include:
 Bedpans
 Urinals
 Emesis basins
 Urinary drainage bags
 CPR trolley
 IV stand
 Suction machine
 Patient’s chart
 Patient’s bed
 Oxygen tubes and face masks
 Wheelchairs
 Stretchers
 Thermometer
 Blood pressure machine
It is essential that reusable equipment is cleaned, disinfected and sterilized before use with
another patient. This helps to prevent the transmission of infection from one person to
another. You should clean this equipment properly according to establishment practice and
return the to the appropriate place of use.
Clean tools/equipment
There are several ways to clean tools. These include washing in hot water with soap and/or
detergent added and carefully rinsing in clean water to remove all traces of soap. Detergents
are chemicals that are designed to lift dirt, soils and deposits. However, the do not kill
micro-organisms, but instead help to wash them off. Cleaning the equipment is an important
first step because they cannot be properly disinfected or sanitized until the soil is removed.
.
Disinfection
Disinfection – is the process of eliminating harmful pathogens from equipment and instruments.
A chemical called a disinfectant is used for this procedure. You may be required to disinfect
personal care items such as washbasins, bedpans, and urinals. You may also use disinfectants to
clean wheelchairs and other furniture items. Remember to wash all items before you disinfect
them. The procedure for disinfection depends on the chemicals used. Follow the manufacturer’s
recommendations and the directions of your facility for the use of disinfectants. You should also
wear personal protective equipment such as gloves or gowns that are appropriate for the
procedure.
Sterilization removes all micro-organisms from an item. This process can be completed in an
autoclave, which uses steam and pressure to kill organisms. Gas sterilization is also used in some
healthcare facilities.
Maintain tools/equipment

You are responsible for ensuring that equipment is made safe,

secure and is of suitable standard. The condition of the tools and
equipment used in the healthcare facility affects the quality of
your work and the service you give to your clients. As such, you
should try to keep all equipment in proper working order by
regularly checking to ensure that it is operational and functional.
You need to inspect and clean equipment regularly. Know the
basic care routines your equipment requires. This information can
be obtained from the manufacturer’s operating instructions.
Establish a regular inspection schedule and carry out simple
cleaning and replacements recommended by the manufacturer.
It is very important not only for you to learn to use equipment properly, but also to
recognize the signs that indicate that equipment is not functioning correctly. Form time
to time your checks will reveal equipment faults. Some of the signs that indicate that
equipment is faulty include:
 Breaks in electrical cords
 Sparks
 Smoke
 Electric shocks
 Loose or missing parts
 Unusual noises or smell
All of these equipment faults and malfunctions should be promptly reported to the
appropriate person(s). The faulty equipment should be tagged when it needs repair and
removed from the regular area so that there is no possibility of it being used. You
should ensure that the equipment is not used again until the tag is removed.
Stored tools/equipment

Stored tools/equipment
After you have cleaned and inspected the tools and equipment, it is important that
you safely store them in the appropriate area. This entails:
 Putting away tools and equipment in their proper places
 Ensuring that storage area has shelving and/or racks and covered containers
 Storing all stock according to manufacturer’s instructions
 Storing tools and equipment safely on shelves (away from edges)
 Ensuring that the storage area is positioned to provide protection and security
Smaller items should be in a locked storage area and heavy items should be stored at
low levels. You should store similar items adjacent to each other on either shelves or
bins, which should be clearly marked with their contents.
You should always adhere to your organization’s regulations and policies regarding
the cleaning, maintenance and storage of tools and equipment.
REMOVE WASTE MATERIALS/CLEAN SERVICE AREA

The service areas of a healthcare facility are usually quite busy as both
healthcare staff and clients are involved in a wide range of activities, which
may include registration, examination, interviewing and treatment. Healthcare
facilities should therefore try to create a neat, clean, comfortable and
welcoming environment in these service areas for all clients. As a Healthcare
Assistant, you play an important role in keeping the service areas tidy and
clean.
Some of the specific aspects that you may have responsibility for include:
 Removing waste materials
 Storing unused materials
 Storing tools and equipment
REMOVE WASTE MATERIALS/CLEAN SERVICE AREA

Cleaning the service area prevents the growth of micro-organisms which can cause infections and
diseases. You should be aware of the cleaning requirements of your facility with regards to:
 Where to clean
 How often each area should be cleansed
 The cleaning products to use
 The correct cleaning methods
Remember that you should always wear appropriate Personal Protective Equipment such as
disposable gloves when cleaning as this helps you to avoid direct contact with infectious micro-
organisms. In order to ensure that you use cleaning agents and disinfectants effectively, you should
always read and follow all of the manufacturer’s direction on the label. Some of these instructions
deal with correct dilution as well as storage.
You should ensure that you follow your healthcare facility’s procedures for cleaning and
disinfecting walls, floors and other working surfaces. In addition, it is important that you adhere to
health and safety standards while avoiding damage.
REMOVE WASTE MATERIALS/CLEAN SERVICE AREA

Remove waste materials

Health care facilities generate different types of waste that
require disposal. Much of the waste is hazardous and must
therefore be packaged, transferred, and disposed of properly to
protect both the persons handling it and the environment.
These wastes can be categorized as infectious or noninfectious.
Infectious wastes include human or biological wastes such as
urine, vomit, blood and other body fluids as well as items that
may be contaminated with pathogens. Noninfectious wastes
include toxic chemicals, certain drugs, and flammable wastes.
Some of materials that you may be required to remove include:
 Waste (regular and bio-hazardous)
 Sharps (needles, syringes, razors, blades etc.)
 Soiled linen
 Specimen and specimen containers
Waste should be placed in plastic bags and handled in the following ways:
 Contaminated articles should be enclosed in a sturdy bag (which will not
allow the entry of micro-organisms)
 A single bag can be used if it is sturdy and impervious
 Double bagging should be done if the above conditions are not met
 Garbage and soiled disposable equipment such as tissues and dressings
should be placed in the plastic bag that lines the waste container
 Reusable equipment that is visibly soiled should be placed in a labeled bag
There are separate containers for regular waste (non-infectious
waste) and for bio-hazardous (infectious) waste. Containers for
bio-hazardous waste should have the bio-hazard symbol or be
colour coded red. Learn your facility policy for what is
considered to be bio-hazardous waste and follow the guidelines.
Bio-hazardous waste is stored in special areas until it is removed,
and requires special handling during removal. This type of
handling is very expensive, and storage space is often limited, so
do not place non-hazardous materials in the bio-hazard disposal
containers.
.
There are certain workplace practices that will help to reduce the
exposure to blood-borne pathogens caused by sticks with sharps.
Here are a few important guidelines that you should follow:
Place used disposable syringes and needles, scalpels, blades
and other sharp items in puncture-resistant sharps containers
located as close as practical to the area in which the items were
used. You should place reusable syringes and needles in a
puncture-resistant container for transport to the reprocessing
area.
Avoid over filling the sharps container. Seal the cap when it is
three quarters full. The cap is designed so it cannot be snapped
back off after it is closed. The sealed sharps container is stored
until it can be picked up with the rest of the bio-hazardous waste.
Appropriate containers for sharps should be:
Closable, puncture-resistant, and leak-proof on sides and bottom.
Accessible, maintained upright, and not overfilled.
Coloured red or labeled with the bio-hazard symbol.
Labeled in fluorescent orange or orange-red, with lettering and
symbols in a contrasting colour. Red bags or containers may be
substituted for labels
You should adhere to all standards and health regulations related
to the handling of both infectious and non-infectious waste.
These measures will help to protect you from the potential risks
and hazards.
Keeping the service areas tidy and clean is a continuous
operation. If you take pride in your job as a nursing assistant, you
ill take the time to do this job properly. Any problems that you
encounter while carrying out this job should be reported to the
appropriate person(s) such as your supervisor or colleagues.