HCAD1101 Working As A HCA Module Fall 2017

Health
Aide Care
Provincial
Curriculum
HCAD1101:
Working as aAide
Health Care
Learner Guide
Alberta Health and Wellness
Fall 2017
Copyright
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rights reserved. No part of this publication may be reproduced or transmitted in any form or by
any means, or stored in a database and retrieval system, without the prior written permission of
Alberta Health and Wellness.
Alberta Health and Wellness (2011) Health care aide provincial curriculum. Edmonton, AB,
Canada: Author
Care has been taken to obtain copyright permission to reproduce this material. Any information
that will enable Bow Valley College to obtain copyright clearance for any material not
acknowledged would gladly be received by:
Bow Valley College

345 - 6th Avenue S.E.
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Attn: Director, Learning Resource Services
email: copyright@bowvalleycollege.ca
© Copyright 2011, Alberta Health and Wellness

© 2017, 2016, 2015, 2013, 2012, 2010 Bow Valley College
No part of this material may be reproduced or transmitted in any form or by any means,
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system, without permission in writing from Bow Valley College and Alberta Health and
Wellness.
Table of Contents
Introduction......................................................................................................................................1
Grading Policy.................................................................................................................................4
Module 1: Role of the Health Care Aide.........................................................................................7
Answer Key for Module 1 Exercises.............................................................................................50
Module 2: Legislation...................................................................................................................56
Answer Key for Module 2 Exercises.............................................................................................83
Module 3: Function Effectively as a Team Member....................................................................86
Answer Key for Module 3...........................................................................................................107
Module 4: Environmental Safety.................................................................................................111
Module 5: Client Safety..............................................................................................................146
Module 6: Self Care and Safety...................................................................................................158
References....................................................................................................................................171
Course Review Questions............................................................................................................176
Course Review Answer Keys......................................................................................................189
Lab Procedure Checklist – Hand Washing..................................................................................192
Lab Procedure Checklist – Hand Hygiene using Waterless Hand Sanitizer................................194
Lab Procedure Checklist – Putting on a Disposable Mask..........................................................196
Lab Procedure Checklist – Removing a Disposable Mask..........................................................198
Lab Procedure Checklist - Putting on Non-Sterile Disposable Gloves.......................................200
Lab Procedure Checklist – Removing Gloves.............................................................................202
Lab Procedure Checklist – Gowning...........................................................................................204
Lab Procedure Checklist – Removing a Gown............................................................................206
Lab Procedure Checklist - Body Mechanics when Lifting an Item.............................................208
HCAD1101: Working as a Health Care Aide

Credits: 3 Hours: 45
Prerequisites: none
Co-requisites: none
Introduction
In this course you will learn the key elements that go together to ensure a safe environment for
clients, staff and facility visitors. There is information included in this to assist learners who are
currently working for, or who will be employed by, home care agencies in the future to assist you
in establishing safe work practices in community settings.
Part of creating a safe working environment involves learning to work effectively as part of an
interdisciplinary team. Understanding your roles and responsibilities within a team framework
will assist you to function to the full scope of your job description while providing safe care to
clients. Client’s safety depends on your ability to follow agency policy and procedures and
adhere to client’s Care Plans. This course will assist you to learn and apply these valuable skills.
Creating a safe environment for your clients, as well as staff members, includes being familiar
with and practicing the current standards in infection prevention and control. In addition,
learning to use chemicals in a safe manner and practicing the principles of slips, trips and falls
prevention will ensure that the environment your clients live in is hazard free.
Throughout this course you will be using the Provincial Curriculum Learning Guide, the Lab and
Practicum Skills Checklist, and your Mosby’s Canadian Textbook for Support Workers 4th
edition, and videos.
Read, learn, practice and enjoy.
Required Textbooks
Bow Valley College/Alberta Health and Wellness. (2017). HCAD1101 Course Package.
Calgary: Bow Valley College.
Sorrentino, S. (2018). Mosby’s Canadian textbook for the support worker with workbook
(4th Canadian ed.). Toronto: Mosby or current edition
Sorrentino, S., Remmert, L., Wilk, Mary J., Newmaster, R. Mosby's nursing assistant video skills
4.0 - Learner Version DVD Package, 4th Edition or current edition
See current Booklist in Desire2Learn (D2L)
Other Resources
Work Safe Alberta Best Practices in Occupational Health and Safety in the Health care Industry
http://work.alberta.ca/occupational-health-safety/13568.html
A medical terminology dictionary
Course Learning Outcomes

By the end of this course the learner should be able to:
• Examine concepts of health and wellness and of illness and disability

• Examine health within the context of the Canadian health care system and the Canada
Health Act
• Describe the role, responsibilities, and unique contributions of the HCA to the health of
clients across a variety of workplace settings
• Explain the importance of the helping relationship within the role of the HCA
• Describe the importance of respect for culture and diversity
• Examine health care ethics within the role of the HCA
• Develop skill in self-awareness
• Examine lifelong learning and continuing education within the role of the HCA
• Use terminology related to the HCA role and responsibilities
• Examine the HCA role and responsibility when applying the “ICARE” Model
• Demonstrate knowledge of the legislation that governs health care in Alberta, and how that
legislation relates directly to the HCA role, responsibilities and scope of practice
• Apply the “ICARE” Model to legislation governing the HCA role, responsibilities, and
scope of practice in the province of Alberta
• Describe the importance of interdisciplinary teams within the health care system
• Examine the assignment of tasks to the HCA within the health care team.
• Examine the Care Planning process in facilities and community-based settings
• Examine time management, decision making, and problem solving within the role of the
HCA
• Examine the HCA role and responsibility when applying the “ICARE” Model within the
team Care Planning process
• Examine principles of environmental safety in facilities and in community-based settings
• Examine infection prevention and control principles
• Describe the role and responsibilities of the HCA in preventing the spread of infection
• Examine the HCA role and responsibilities when applying the “ICARE” Model to
environmental safety
• Demonstrate best practice principles for hand hygiene, applying personal protective
equipment, and caring for supplies and equipment
• Examine the principles of client safety
• Examine the HCA role and responsibilities when applying the “ICARE” Model to client
safety
• Examine principles of body mechanics
• Examine personal safety and the impact of personal safety on the HCA in the workplace
• Examine the effects of fatigue on shift workers
• Examine stress, burnout, stress management, and the impact of each on the HCA in the
workplace
• Examine aggression, bullying, harassment, and the impact of each on the HCA in the
workplace
Learning Activities
• A varied format will be used to facilitate learning. Lectures, assigned readings, class
discussions, review exercises and demonstrations will be used.
Course Assessments
Assessment Description Due Date Value
Methods
Midterm Exam Demonstrate knowledge of information 30%
presented in the course up to midterm
Demonstrate competence in carrying out
Lab Skills simulated nursing care for clients in a safe, 10%
Evaluation competent, and professional manner for
hand washing
Lab Skills Demonstrate competence in carrying out
Evaluation simulated nursing care for clients in a safe, 10%
competent, and professional manner for
gowning, gloving, masking
Final Exam Demonstrate knowledge of information
presented in the entire course 50%
Total 100%
Grading Policy
The following values in percentages have been established for the Health Care Aide Program.
GRAD
PERCENTAGE GRADE POINT DESCRIPTION
E
A+ 95-100 4.0 Exceptional
A 90-94 4.0
A- 85-89 3.67 Excellent
B+ 80-84 3.33
B 75-79 3.0
B- 70-74 2.67 Good
C+ 67-69 2.33
C 64-66 2.0
C- 60-63 1.67 Satisfactory
D+ 57-59 1.33
D 50-56 1.0 Minimal Pass
F 0-49 0.0 Fail
A Grade Point Average of 2.0 is required for graduation.
A minimum grade of D / 50% is required to pass this course. However, your program may require a higher grade in this
course for you to progress in the program and to graduate. Please refer to your individual Program Content Guide or
contact your program coordinator for further details.
Marks posted in Desire2Learn (D2L) for assignments, quizzes, exams and final course grades are
unofficial. Official final course grades are posted by the Registrar on the learner transcript.
Grading Guidelines
• A grade point average (GPA) of 2.67 (B-) is required for successful course and program
completion.
• A grade point average (GPA) of 2.67 (B-) is required to demonstrate competency in Lab
Skills evaluations. Learners who do not achieve the required GPA for a skill are allowed to
repeat the evaluation once, and if successful, a final lab skills grade of 70% will be assigned.
Course Policies
The following are the course policies for HCAD1101:
• Reading/exercises are to be done prior to class; learners are expected to come prepared to
discuss materials.
• Learners are expected to bring course materials to class.
• Assignments must be completed by the stated deadlines.
• All course assessments and assignments must be completed to be eligible to pass the course.
Course assessments and assignments are intended to officially evaluate learner
understanding of the course material. These must be completed independently without
collaboration, except for assignments designated as group projects.
• It is the learner’s responsibility to complete and submit all papers and assignments on time.
Please follow the assignment submission directions given to you by your facilitator.
References in your assignments must be recent, i.e. less than five years old.
• Learners participating in group assignments are expected to participate in the group work
and to equally contribute to the assignment. If there is conflict within the group over
individual participation or the equal distribution of work, the facilitator has the right to
intervene and assign individual grades.
• Assignment extensions are at the discretion of the facilitator and must be approved in
writing 48 hours before the date the assignment is due. If an emergency occurs after the
48-hour deadline, extensions may be granted at the discretion of the facilitator. Proof of
emergency may be requested.
• Assignments submitted late will be subject to a five percent reduction of the total grade for
every day past due date, including weekends. ( i.e. if the assignment is three days late,
3 x 5% =15% will be deducted resulting in a maximum letter grade of A)
• Assignments date stamped seven or more calendar days past the due date, without a written
approval for extension will only be able to receive up to the minimum grade for a pass. (i.e.
if an assignment is received seven days late, the maximum letter grade that can be earned is
a C)
• NO rewrites of exams will be allowed
• Mutual respect and professionalism are integral aspects of the Health Care Aide Program,
including this course. Any disruptions to the learning environment such as tardiness, cell
phones and pagers, talking while others are speaking, swearing and inappropriate behaviour
will be perceived as unprofessional. The Health Care Aide Program has clear objectives for
performance, progress and attitude.
• When late or absent, learners must phone their facilitator. When a late or absence involves a
clinical course, the clinical facilitator must be notified as well.
• Learners who miss an exam without prior notification will obtain zero percent (0%) for that
exam.
• Learners in the Health Care Aide Program are allowed to attempt a course up to two (2)
times. Failure to be successful on the second attempt will result in withdrawal from the
program for a period of two semesters, or eight months. Readmission, at that time, will be at
the discretion of the Dean in the School of Health and Wellness.
Academic Honesty
Academic honesty is expected of all learners enrolled at Bow Valley College. Academic
dishonesty is a serious offence and will result in consequences ranging from a reprimand to
expulsion from the college. Please review the Academic Policy in the HCA Program Content
Guide. Successful Completion of the Academic Honesty quiz is required.
Course Content
Module/Topics Week/Date Covered (facilitator
will give dates during first week
of classes)
• Module 1: Role of the Health Care Aide •
• Module 2: Legislation •
• Module 3: Function Effectively as a Team Member •
• Module 4: Environmental Safety •
• Module 5: Client Safety •
• Module 6: Self Care and Safety •
Module 1: Role of the Health Care Aide

This module introduces you to the exciting and challenging role
of being a health care aide (HCA) in the province of Alberta.
You will learn many things about your chosen field of work,
including how we define and determine individual health, the
importance of family and the role it plays in a client’s life; the
importance of promoting client wellness and independence; the
recognition of culture, religion, health beliefs, and personality
on an individual’s response to changes and challenges.
Most exciting of all, you will be introduced to the “ICARE”
Model which has been developed specifically for training health
care aides in Alberta.
Glossary
Word Meaning
Alternative Non-traditional medical treatments such as
healing acupuncture
Balanced Lifestyle addresses physical, emotional,
lifestyle spiritual, social, and learning needs. A
balanced lifestyle is when an individual feeds
balanced in all these areas.
Blood kin People you are related to by bloodlines
Continuity A predictable pattern of events
Denial Refusal to acknowledge or believe facts and
experiences
Frame of The way an individual looks at the world
reference based on past history, family traditions,
education, culture, and religion
Gender Male or female
Interdisciplinar All members of the health care team including
y team the client and the client’s family
Medical model Traditional care based on client diagnosis and
of care treatments
Mental The ability to cope with all of life’s changes
hardiness and challenges
Personal The events of an individual’s life
history
Resilient The ability to positively recover from loss,
change, and disease
Scope of The regulated roles and responsibilities for
practice each member of the health care team
Social model of Providing for all the needs of a client and
care providing a home-like environment
Supervisor The individual whom the HCA reports to. The
supervisor generally is a professional health
care provider; such as a registered nurse or
licensed practical nurse
Trauma Injury caused by accident
Traits Personal characteristics
Section 1
SLO 1.1 Describe the past and current definitions of health in
Canada
SLO 1.2 Explain the health-illness continuum
SLO 1.3 Describe holism and the five dimensions of health
SLO 1.4 Describe the twelve determinants of health
SLO 1.5 Explain the relationship between health and wellness
Learning Activities
• Read “Health and Wellness” in Chapter 4 in the textbook
• Study Figure 4-1 in Chapter 4 in the textbook
• Complete “A. Reflective Exercise: How Balanced is My
Health?” in the Learner Guide
• Study Figure 4-5, the Continuum of Health in Chapter 4 in the
textbook
• Complete “B. Case Studies: Understanding the Continuum of
Health” in the Learner Guide
• Read “Influences on Our Health Beyond Our Immediate
Control: Determinants of Health” in Chapter 4 in the textbook
• Complete “C. Diagram Labelling: The Determinants of
•
Exercises
A. Reflective Exercise: How Balanced is my Health?
To help determine how balanced your personal health is, give
yourself a health mark in each of the five domains: physical,
emotional, social, intellectual, and spiritual. A mark of 1
indicates the lowest possible score in a health dimension and a
mark of 10 means you are as healthy as possible in this
dimension.
• Physical health – You keep your body strong, fit, and
disease-free by living a healthy lifestyle including a good
diet, regular physical exercise, and sufficient rest.
1____2____3____4____5____6____7____8____9____10
• Emotional health – You are able to adjust to the constantly
changing demands of life. You feel confident in most
situations and believe in your own skills and abilities.
1____2____3____4____5____6____7____8____9____10
• Social health – You are able to make and maintain healthy
relationships. You are able to help friends and family
members, as well as ask for help in return when you require
support. You are respectful to others and they respect you in
return.
1____2____3____4____5____6____7____8____9____10
• Intellectual health – You take an active interest in your
surroundings and the people and activities in your
environment. You show an interest in learning new skills
and maintaining old ones. You remain curious about local
and world news and events.
1____2____3____4____5____6____7_____8____9____10
• Spiritual health – You may or may not have a formal

religion that is part of your spiritual life, but if you do have
a religious affiliation, then you try to maintain participation
in it. Spirituality indicates that you have an awareness of
your personal belief system that might include honesty,
trustworthiness, forgiveness, serenity, meditation,
generosity, and caring for others.
1____2____3____4____5____6____7_____8____9____10
Which dimensions of health did you score well in?

Which dimensions did you score lower in? Outline some
actions you can take so you can become healthier in these
areas of your life.
Now that you have scored your own health in these five
dimensions you will be able to understand your clients’ health in
these areas.
B. Case Studies: Understanding the Continuum of Health
Read each Case Study below and then choose the correct
multiple choice answer by referring to the continuum of health
in Figure 4-5, Chapter 4 in the textbook.
• Martha, 29 years old, is very overweight, eats a lot of takeout
food, and rarely exercises. She works nights at a convenience
store so that she does not have to meet as many customers as
she would if she worked during the day and evening. She has
two close friends whom she has known since grade seven, and
maintains close relationships with her family, although she
lives independently. She listens to relaxation tapes and reads
inspirational books. Martha’s health on the continuum is:
• complete health
• good health
• average health
• extreme ill health
• Joe is 66 years old and has been married for 42 years. He has
four children and five grandchildren whom he and his wife
visit several times a year. Joe and his wife play cards and
bowl weekly with other couples. Joe also has personal friends
whom he meets for golf and walks. Joe volunteers for several
community events every year and participates in a weekly
bible study. He describes himself as content and says that if he
were to die today he would die a happy man. Joe’s health on
the continuum is:
• good health
• average health
• poor health
• complete health
• Mary is 88 years old and lives in a continuing care facility.

She becomes upset when there is any environmental noise,
including laughter and music. She no longer recognizes her
family and often cries, stating she wants to go home. The staff
have difficulty getting her to eat and drink enough. Mary is
only strong enough to be up in her wheelchair one or two
hours per day. She has oxygen on at all times. Mary’s health
on the continuum is:
• average health
• poor health
• extreme poor health
• good health
C. Diagram Labeling: The Determinants of Health

Below is a diagram of the determinants of health, organized into
categories.
Social The
Physical Environment Environme Individual
nt
Built Natural Family, Spiritual
Environment Environment friends, and well-being
communities
Safe, clean Green space Health care Values
housing
Pleasant Lack of Leisure Mental
surroundin pollution hardiness
gs
Clean air Birds and Work Individual
animals behaviours
Adequate Clean air Childhood Genetic and
space experiences biological
characteristic
s
Good lighting No
environmental
hazards
In the space beside each circle write the phrase that belongs to
this aspect of health. For example, “clean air” would go beside
“physical environment built.”
• Respects other people’s property

• Talks on phone with sister every week
• No mice in house
• Able to cope with changes to routine and responsibilities
• Good lighting in house
• Snow shovelled off walk
• Attends cooking classes with a friend
• Walks for half an hour three times a week
• Good sewage drainage
• Park and walking paths nearby
• Clean pond or stream
• No smoke from factories
• Works part time
• Attends bible study
• Meditates
• Participates in yoga class
• Believes in being honest
Section 2
SLO 1.6 Explain the concept of health beliefs and factors that
influence health beliefs and behaviours
SLO 1.7 Examine the importance of respecting each
individual’s health care beliefs and behavioural choices
Learning Activities
• Read “Our Beliefs and Experiences Directly Affect our
• Complete “A. True and False: Health Beliefs” in the Learner
Guide
• Read “Respect – The Key to Honouring Health Beliefs and
Individual Choices” in the Learner Guide
• Complete “B. Case Study: Honouring the Client’s Health
Beliefs” in the Learner Guide
•
• Articles
Our Beliefs and Experiences Directly Affect our Health
It is human nature to try to make sense of what is happening to
our health physically, socially, emotionally and spiritually. Each
individual has what is known as a set of “health beliefs.” When
we become ill, or when someone we are in close contact with
becomes ill, we apply our health beliefs to the situation to help
make sense of what is happening. Not all health beliefs are
based on scientific evidence, but they are an important part of
who you are as a caregiver, and how your clients and their
families will interpret what is happening.
Learned Beliefs
Like our religious, ethical, and social beliefs, our health beliefs
are learned. The teaching we receive about health comes from a
variety of sources. Some of these sources are listed below.
Did your mother or grandmother have a saying such as, “Feed a
cold and starve a fever?” When we are raised with these kinds of
sayings they become part of our health belief system. Even
though as adults we may know there is no scientific proof that
we should feed a cold and starve a fever, it has become part of
our frame of reference about common illnesses and our
behaviours may automatically follow that belief.
Family Influences
Social Networks
Friends, families, classmates, work colleagues and people we
share hobbies and activities with become our social networks.
Health beliefs are often formed within social networks. For
example, let’s say that most of your friends have become
vegetarians because they believe eating meat is unhealthy. If you
remain in this social group there is a high likelihood that you
will also become a vegetarian and follow your friends’ health
beliefs about eating meat.
If your friends and family believe in the benefits of physical
fitness and exercise, chances are that you will also adopt this
healthy lifestyle; however, if your friends are all smokers who
eat a lot of “fast food” you are at risk of following the pattern of
your role models.
Community
Communities may be large or small. If we look at Canada as one
large community, we can see some of the direct influence on
health this community has had when shaping individual health
beliefs. In the 1970s Canada began a program called
“ParticipACTION.” This health initiative was designed to
encourage people to get up off the couch, turn off the television,
and do anything active to improve their fitness levels. Many
individuals and families embraced this message and made
changes to their exercise patterns. Another “Canada as a
Community” health guideline came in the form of the Canada
Food Guide. Schools, doctors, health centres, and individuals
have adopted this as the standard for healthy eating in Canada.
The Food Guide is still used today and has become a part of
many health beliefs as a result.
Religion
Religious beliefs often influence health. Individuals of certain
religions do not believe in receiving blood transfusions; other
religions do not allow the consumption of alcohol or carbonated
beverages. These beliefs may prove either helpful or harmful at
various times in an individual’s life. Each client or client
guardian has the right to make decisions based on their
individual religious practices.
Government
The government may set policy or legislation to help create a
healthy environment. As an example, in Alberta, immunizations
are free for infants, children and seniors. This is to encourage
parents to have their children immunized and the elderly to be
immunized. Many people believe in being immunized and take
advantage of these free clinics. Others, however, believe
immunization is harmful and refuse to have their children
immunized. Individuals make choices about this and other
health care initiatives based on health beliefs. Sometimes the
education the government provides is very convincing and
individuals incorporate this information into their health care
beliefs. An example of this would be the smoking reduction
education which has resulted in many people quitting smoking,
and employers providing smoke-free environments so that
individuals are not subjected to second hand smoke.
Exercises
A. True or False: Health Beliefs
Read the statements then circle T for true and F for false.
• Health beliefs are always learned in school. T F
• Health beliefs may come from following your T F
friends’ beliefs.
• All health beliefs are based on healthy T F
choices.
• If the government has a health initiative, all T F
people must participate.
• An individual’s religious beliefs influence T F
health decisions.
• Health beliefs help us make sense of illness. T F
Articles
Respect – The Key to Honouring Health Beliefs and
Individual Choices
A client’s beliefs about health provide meaning for his or her
experience of illness. Personal health beliefs are very strong and
even when health care professionals have given a scientific
explanation for an illness, the origin, and the treatment options,
clients may cling to their own health beliefs to make sense of the
frightening changes to their health.
Health Beliefs May Be Helpful or Harmful
Some health beliefs may be helpful, such as the belief in regular
exercise, the belief that whole foods are better than processed
foods, and the belief in a balanced lifestyle. Other health beliefs
may be harmful. For example, if my grandfather smoked every
day of his life from age 12 and lived to be 92 years old, I may
not believe smoking is harmful. Or, if my grandma always said
to put butter on a burn, this is what I always do.
In the case of harmful beliefs it may be very tempting to jump in
and tell the client he or she is wrong, or to try to prove you know
better. Do not do this. Instead, let a health care professional
know the beliefs the client has shared with you and any
behaviour related to the belief.
Listen with an Open Mind

Client’s health beliefs will have a history attached to them. If
you listen respectfully and with an open mind you may be
privileged to hear the personal history that has become a client’s
health belief. Even if this seems like a very strange practice to
you, you now know that this is a family health belief and it is
your job to be respectful. If you believe that a client’s health
belief is harmful, report your concerns to your supervisor, but
never try to convince the client and/or the client’s family that
they are wrong. Instead, try to find out what experiences resulted
in this health belief and bring this information forward to assist
with care planning with the client, the client’s family, and other
interdisciplinary team members. When providing care, follow
the client’s care plan and respectfully tell the client you will
bring forward their request for alternative treatments.
Exercises
B. Case Study: Honouring the Client’s Health Beliefs
Clifford was 82 years old when he came to live in a long term
care facility. When he was admitted he brought a can of WD-40
(lubricant) with him. Shortly after his admission he was
observed by one of the health care aides to be rubbing this
lubricant into his knees. The health care aide explained he could
not do this and removed the can from his room. When his family
came to visit they brought a new can of WD-40. This can was
also removed from the client’s room. Clifford complained to the
RN when she was applying an ointment used for arthritis to his
knees that this ointment did not work as well as his WD-40.
After several days of hearing these complaints, the RN placed
Clifford’s name on the list to be seen by the doctor.
When the doctor visited, he asked Clifford why he preferred the
WD-40. Clifford explained that everyone in his family used this
product on their arthritic joints and they believed it worked best.
After examining Clifford’s knees and seeing the skin was
healthy, the doctor made a note in the chart that Clifford could
use the WD-40 instead of the ointment that had been ordered for
him.
Reflect on the following questions.
• Should the HCA and other health care team members have
removed Clifford’s WD-40 from his room?
• What opportunity related to health beliefs did the HCA miss
when she first discovered Clifford using the WD-40?
• Were Clifford’s health beliefs honoured?
Section 3
SLO 1.8 Identify factors that affect an individual’s response to
personal illness and disability
SLO 1.9 Describe common personal reactions to illness and
disability
SLO 1.10 Identify common attitudes towards individuals
with illness and disability
Learning Activities
• Read “Illness and Disability” in Chapter 4 in the textbook
• Study Box 4-1 “Common Reactions to Illness and Disability”
in Chapter 4 in the textbook
• Read “Illness and Disability are Personal” in the Learner
Guide
• Complete “A. Case Study: Toby Never Saw It Coming” in the
Learner Guide
• Read “Change and Loss Associated with Illness and
Disability” in Chapter 4 in the textbook
• Read “Health Decisions are Related to Experiences and
Beliefs” in the Learner Guide
• Read “Attitudes of Others Toward Illness and Disability” in
the Learner Guide
• Read the case study “Supporting Mr.Vitale: The Effect of
Serious Illness on Self-Esteem” in Chapter 4 in the textbook
Articles
Illness and Disability are Personal
Factors Influencing a Response to Illness or Disability
There are many different elements to take into account when
examining how individuals respond to illness and disability. In
this article we will take a close look at some of these factors.
What are the elements that disrupt health?
• physical disease
• injury
• mental illness
• terminal disease
• loss
Who is the person experiencing the illness or
disability?
Many individual traits need to be taken into consideration here.
Gender: Is this individual male or female, and does the illness
or disability affect how they view themselves in feminine or
masculine roles or how they view themselves sexually?
Responsibilities: Is this individual a single parent or the parent
who stays home to care for the children? Perhaps she owns her
own business and does not have anyone trained to carry out the
leadership role. This person may be the caregiver for a parent or
older relative.
Finances: This individual may be single and dependent on his
ability to earn money and support himself, or he may be a single
parent with other people who are dependent on him financially.
Diagnosis: An illness or a disability with a slow gradual onset
and development will have a very different impact on an
individual than a disability caused by an accident or sudden
trauma. When an individual is diagnosed with high blood
pressure he or she has an opportunity to adjust to the diagnosis
and take some positive steps to prevent a heart attack; however,
when a person has a spinal cord injury as the result of a car
accident there is no chance of preventing the diagnosis and the
impact it will have on this person’s life.
Mental and physical hardiness: Responses to a sudden change
in physical ability or to a diagnosis of a chronic illness can
depend on how physically fit the individual was before and how
mentally resilient he or she is. Someone who already has
difficulty walking because of arthritis in his knees will not
recover from a broken ankle as well as someone who has no
prior injuries or conditions that will affect his walking ability.
Exercises
A. Case Study: Toby never saw it coming
Toby grew up in Kelowna, British Columbia, and attended
university in Vancouver. Every summer he would ride his 10-
speed bike back to his parents’ home and every fall he would
ride back to university. This was a distance of 6400 kilometres
through the mountains in each direction. After his graduation
from university, Toby moved home and started work in
Kelowna. One day he was riding down a steep hill on his way to
work and a car turned in front of him without warning. Toby and
his bike hit the car and he flew off, hitting his head on the
pavement. Toby was in a coma for three weeks. The doctor
stated that if Toby had not been so physically fit he would not
have survived the accident. After his recovery, Toby had short
term memory problems, seizures, and difficulty being client with
other people. He has continued to work and support himself for
30 years, but he worries about growing older and frailer. His
parents are dependent on him for financial and social support.
He has two long-time friends who both live a long distance
away, and one has chronic health problems of his own.
Use the example of Toby’s experience to complete the matching
questions below.
1. Financial • The ability to recover physically
responsibility from a serious accident
2. Personal • Seizure disorder
responsibility
3. Diagnosis • Need to support himself
4. Physical • Dependent parents

hardiness
5. An element that • Sudden life-changing accident
disrupts health
Articles
Health Decisions are related to Experiences and
Beliefs
Individuals make health decisions based on a number of
different experiences. A person who is injured or not feeling
well might decide to:
• get extra rest or sleep
• buy over-the-counter medications
• increase the amount of times phoned in sick for work
• take a vacation
• talk to a friend or relative
• visit a chiropractor
• visit an alternative healer such as an acupuncturist
• see a medical doctor
• ignore the illness
Some factors that influence these decisions
• previous positive or negative results when seeking medical
help
• family influence and personal health beliefs
• finances
• fear
• religious beliefs
• denial that there is a problem
• intensity of pain
• intensity, duration, and complexity of the illness
A pastor once had two women in his congregation whom he
visited regularly. One, Mrs. Rose, was very frail and had
debilitating arthritis. She could barely lift a phone receiver and
had pain at all times. When the pastor called her or visited she
was always cheerful and wanted to talk about a wide variety of
things happening at home and in the community. Mrs. Rose
always took her pain medication, tried to do the exercises she
had been given, and followed the dietitian’s food chart.
The second lady, Mrs. Boyd, had no specific diagnosis, but
always was feeling “under the weather” when the pastor visited
her. She would focus all of the conversation on herself and her
poor health. She visited the doctor frequently but was never
pleased with what he said or did for her. She bought a lot of
over-the-counter medications and was frequently on the phone
with her pharmacist. When her doctor suggested that she seek
counselling for possible depression, Mrs. Boyd became very
angry and stated she did not believe in that “mumbo-jumbo.”
These two women displayed a wide difference in how they
responded to health concerns. Mrs. Rose displayed an ability to
adapt to the changed situation in her life and respected the
treatments suggested by health care professionals. Mrs. Boyd
became obsessed with her perceived poor health, rejected a
mental health diagnosis made by her doctor, and self-medicated
with over-the-counter medications.
Perhaps these two ladies, like many of us, made health decisions
based on previous experiences, individual personality traits, and
the ability to adapt to changes in their lives caused by illness and
disease.
Illness and Disability Are Not Always Accepted by
Others
Mark O’Brien (July 31, 1949 – July 3, 1999) put it best when he
said, “I want people to think of disability as a social problem . . .
. Everyone becomes disabled unless they die first.”
This quote from a physically disabled poet indicates that it is not
the disease or disability that are the greatest barriers to
individuals; what causes the greatest barriers is the way society,
and individuals within that society, accept an illness or
disability.
Few people intentionally set out to be ill or disabled. Yes, some
people do not eat right or exercise regularly; some people do not
ensure they lead a life in which work is balanced with recreation
and relaxation; and still others refuse to take their medications.
No one expects to have their lives changed in irreversible ways
because of these poor health habits. Even harder to accept is the
sudden change in health experienced by a person who has
focused on being healthy.
Hans was a long distance runner. Every day he set out with his
water bottle and would run five to ten kilometres. He worked at
a job he enjoyed and tried to eat right. One day Hans did not
return from his run and his wife set out to see what was wrong.
She found Hans at the side of the road. His right side was
paralyzed and his wife could not understand his speech. Hans’s
life changed suddenly and unexpectedly. He had had a stroke
and was left with a permanent disability.
Friends who had been supportive following his accident soon
stopped calling and coming over. They did not know what to say
or do during a visit. His employer offered him long term
disability benefits and hired someone else to do his job. Gone
were the family camping and hiking holidays—outings became
difficult because there was no easy access to places Hans wanted
to go, and was embarrassed to have to park in the blue
handicapped parking spaces.
People who had previously greeted Hans in a friendly manner
appeared to be avoiding him.
Hans was left to deal with two problems: first, the sudden
changes in his health and income, and second, the attitude that
friends, family and strangers had toward his disability.
This Case Study illustrates the impact that other people in our
environment can have on our adjustment to illness and disability.
Section 4
SLO 1.11 Define health according to the Ottawa Charter
SLO 1.12 Describe the five principles of the Canada Health
Act
SLO 1.13 Examine federal and provincial roles supporting
the Canada Health Act
SLO 1.14 Describe the concepts of health promotion and
disease prevention
Learning Activities
• Read “The Evolution of Canada’s Health Care System” in
Chapter 2 in the textbook
• Complete the “Fill-in-the-Blanks” questions in Chapter 2 in
the workbook
• Study Box 2-3 “The Principles of Medicare, as Listed in the
Chanda Health Act (1984)” in Chapter 2 in the textbook
• Read “Health Promotion and Disease Prevention” in Chapter
2 in the textbook
• Complete the “True or False” questions in Chapter 2 in the
workbook
• Read “The Ottawa Charter for Health Promotion” at
http://222.who.int/healthpromotion/cnferences/previous/ottaw
a/en/index.html
• Read “People who receive Support Services”
• Read “Working in Facility-Based Settings” in Chapter 3
Section 5
SLO 1.15Describe the role of HCA work
SLO 1.16 Describe the roles and responsibilities of the HCA
in the province of Alberta
SLO 1.17 Describe various types of clients for whom HCAs
provide care
SLO 1.18 Describe the settings where the HCA commonly
works, including community-based and facility-based
settings
Learning Activities
• Read “Support Work Across Canada” in Chapter 1 in the
textbook
• Read “Support Worker Responsibilities” in Chapter 1 in the
textbook
• Complete “A. Matching Question: Understanding
Responsibilities” in the Learner Guide
• Read “Living the ‘ICARE’ Model – Roles and
Responsibilities of Health Care Aides in Alberta” in the
Learner Guide
• Read “People who Receive Support Services” in Chapter 1 in
the textbook
• Read “Home Care” in Chapter 2 in the textbook
• Read “Working in Community-Based Settings” in Chapter 3
in the textbook
• Read “Working in Facility-Based Settings” in Chapter 3 in the
textbook
• Complete “B. Matching Exercise: Care Settings and Client
Groups” in the Learner Guide
• Complete “C. Chart: Comparing Challenges in Care Settings”
in the Learner Guide
Exercises
A. Matching Question: Understanding Responsibilities
Match the tasks outlined below with the HCA responsibility.
1. Personal care • Assisting with simple wound care
2. Housekeeping/ • Providing support to a new mother

home
management
3. Support for • Taking a client for a walk
nurses
4. Family support • Assisting a client to walk to the
dining room
5. Social support • Doing client laundry
Articles
Living the “ICARE” Model: Roles and Responsibilities of
Health Care Aides in Alberta
As a health care aide learner in Alberta, you will be trained in
the “ICARE” Model. This model was specifically developed for
health care aides to highlight the core roles and unique
responsibilities of HCAs in this province.
The Model
Figure 1: ICARE Model
Bringing Meaning to the Model

Figure 2
This is an exciting way to view your roles and responsibilities as
a HCA. At the end of each module you will have an opportunity
to review how the “ICARE” Model relates to the theory and
skills you have just learned.
Exercises
B. Matching Exercise: Care Settings and Client Groups
Beside each client group, write the abbreviation for the care
setting in which a HCA would be working. There may be more
than one correct answer.
CC community care
HC home care
AC hospital care (acute
care)
LT long term care facility
C
GH group home
AL assisted living facilities
__________ older adults
__________ people with disabilities
__________ people with medical problems
__________ people having surgery
__________ people with mental health problems
__________ people needing rehabilitation
__________ children
__________ mothers and newborns
__________ people requiring special care
C. Chart: Comparing Challenges in Work Settings

Complete the chart below using information from Chapter 3 in
the textbook: Box 3-1 “Issues and Challenges Associated with
Working in Home Care” and Box 3-4 “Issues and Challenges
Associated with Working in a Facility.”
Challenges associated with Challenges associated with
working in home care working in a facility
Working alone Part of structured team
List two challenges of working List two challenges of working
alone. as part of a structured team.
1. 1.
2. 2.
Taking direction from a Meeting multiple needs and
variety of health care demands
professionals
When confused about List two strategies that you can
following through on tasks use to meet the challenges of
assigned by a health care multiple needs and demands.
professional, such as a 1.
physiotherapist, always check
with your 2.
_________________________
.
Maintaining professional Maintaining professional
boundaries boundaries
Never confuse a caring The two main responsibilities
relationship with a within your professional role
____________________. are
1.
2.
Client safety Making a facility feel like
home
Two examples of safety The goal is to make the facility
concerns in the client’s home ________________ and
are __________________.
1.
2.
These concerns should be
reported to your supervisor.
Personal safety Shift work
List three challenges to your What impact will working
personal safety when working evenings, nights, and weekends
in home care. have on your life?
1.
2.
3.
Section 6
SLO 1.19 Describe the concept of family
SLO 1.20 Explain the HCA role in assisting families
Learning Activities
• Read “What is Family?” in the Learner Guide
• Read “The HCA Has a Role When Working with Families” in
the Learner Guide
Articles
What is Family?
As society changes so does the definition of family. Below are
several definitions of family, all of which will be useful to you
as you work with individuals of all age groups in a variety of
health care settings.
A Couple
A couple consists of two adults of the opposite or same sex who
share living space and may or may not be legally married.
Traditional or Nuclear Family
This family group consists of one or two parents and their
children living together under one roof. The parent or parents
take responsibility for providing the basic needs of the
dependent children, and teach family and cultural customs and
values. The parents may be of opposite sex or it may be a same-
sex relationship.
Blended family
This may consist of a husband with children from a previous
marriage or relationship and a wife with children from a
previous marriage or relationship. It may also be a same-sex
couple with children. Usually, all of these family members share
a home for at least part of the time, and the parents assume
responsibility for the care of the children and meeting their
needs. Family, cultural, and religious customs are taught, and
family values are modelled by the parents.
Single Parent Family
A single parent family consists of one adult who has the
responsibility of raising dependent children and providing for
their basic needs. This parent may be the mother or the father,
and she or he will teach the family social and cultural traditions
and values.
Multigenerational Family
These families consist of three or more generations of family
members and may be parents, children, grandparents, aunts, and
uncles. The members of the family share living space and all of
the adults play a role in raising the children and teaching them
social, cultural, and family customs.
Extended Family
The extended family consists of blood relatives with a variety of
relationships such as aunts, uncles, cousins, and grandparents
who usually live in close geographical proximity to each other
and are available for social and practical support.
Family is whoever the Client calls Family
Our clients come from a wide variety of backgrounds and each
person has an individual history.
These individuals may be without blood kin because of life
circumstances or because of choice. Therefore, they may refer to
people with no blood or legal ties as family. In this case, the
definition of family takes on one or more of the following
characteristics:
Two or more people who are bound together by time, and who
assume responsibility in some or all of the following areas:
• meeting the physical needs of each other for food, clothing,
shelter
• socialization of children
• affection
• development of family traditions
• modelling of family values
• establishing boundaries for acceptable behaviour
• shared responsibilities
These families may include blood relatives, friends, neighbors,
members sharing a group home, or other significant
acquaintances. To provide emotional and social support, health
care workers must learn to respect the client’s definition of
family. The declaration of family, however, does not indicate
legal status. Only legal guardians may have access to client
records and details of the client’s condition.
The HCA has a Role when Working with Families

Working with clients and their families can be both rewarding
and challenging. One of the most important guidelines to
remember is that our attitudes and behaviours can influence our
relationships with families. If the family believes that you are
critical or judgmental of them and their beliefs and values they
will not trust you to care for their loved one.
Dennie Wolfe from Harvard University tells us: “When working
with families from diverse backgrounds, it is crucial to be a wise
stranger. We must listen, observe, ask questions and be a
learner.” Do not make assumptions about a family based on
gossip or a small amount of knowledge. Make it a rule to always
get to know the family from your own experience and make
decisions based on facts.
Many clients have been cared for by a loved one for months and
years before home care started providing services or the client
came into facility care. The husband, wife, sister, brother,
mother, father, daughter, son, or best friend may have been the
primary caregiver. Now the role is shifting and, although they
may be happy to have help with the care, they still remain very
tied to and committed to the person they have been caring for.
As health care providers we need to find ways of acknowledging
and including family members as a vital part of the care team.
Remember, they know this person best and have shared many
years of experiences. The client and family share common
history. Finding a way of understanding and honouring this
history is an important step to building supportive relationships
with family members.
As a HCA, some of the responsibilities you will have with
family members include:
• assistance with childcare for a mom with a new baby
• meeting with the interdisciplinary team for care
conferences
• getting clients ready for family outings and appointments
• assisting with household tasks
• supporting families whose loved one is dying
• listening respectfully to questions and concerns
• notifying the regulated health care professional of family
concerns and needs when appropriate
There will be other roles and responsibilities associated with
working with families throughout your career. Remember, the
key to making a success of these relationships is to demonstrate
a caring, respectful, and trustworthy attitude.
Section 7
SLO 1.21 Identify the sources of information that describe
the roles and responsibilities of the HCA in Alberta
Learning Activities
• Read Roles and Responsibilities of the Health Care Provider
• Read “Understanding the Purpose of a Policy and Procedure
Manual” in the Learner Guide
• Read “Your Job Description is Linked to Provincial
Legislation” in the Learner Guide
• Complete “A. Case Study: Job Descriptions Can Be
Misleading” in the Learner Guide
Articles
Roles and Responsibilities of the Health Care Provider
Each member of the health care team is specifically trained
and/or educated to perform certain care or support activities in
providing safe, effective and quality care to clients in the health
system. Roles and responsibilities are the services and activities
that an individual is educated and trained to provide while
providing health care. Each individual is responsible to ensure
they have the competency to perform the services and activities
within their roles and responsibilities.
Certain members of the health care team must be licensed to
provide the care they do. This means they must meet certain
standards and regulations outlined by their licensing body
(professional association) to be licensed for practice each year.
They must maintain this standard of practice to continue to
practice as a health care provider. Most regulated health
professionals’ roles and responsibilities are outlined in their
scope of practice, by their licensing body. In some provinces this
scope of practice is legislated.
Because the health care aide in Alberta is not licensed
(regulated) there is not a legislated scope of practice. The HCA
instead functions under a defined set of Alberta competencies
(2001) which makes up the limits of the health care aide’s roles
and responsibilities. It is very important that you know and
understand your roles and responsibilities as a HCA and that you
function competently within them. Your job description helps to
clarify the roles and responsibilities expected of you as an
employee of an agency. Other members of the health care team
will assign you tasks within your roles and responsibilities
which you will be required to carry out safely and competently.
If you are assigned tasks that you are not trained to do or that
you know are not within the HCA’s roles and responsibilities
you need to discuss this with the regulated professional or your
supervisor immediately.
Understanding the Purpose of a Policy and Procedure
Manual
Health care organizations have a written set of policies and
procedures. These policies and procedures may be in print copy
and stored in a binder or they may be electronic copies available
online. Some employers will have both print and electronic
copies available. These policies and procedures are important
guidelines for helping staff complete their jobs in ways that are
acceptable to the organization.
A Policy is:
The “what” of employer operations
A statement that contains the words will or shall which means,
in a legal sense, this is a statement of how something must be
done. An example of this for meeting a client’s nutritional needs
may read as follows: “All clients will be offered three meals and
two snacks in a 24-hour period.” A staff member reading this
knows this is an expectation of the level of care to be provided,
not just a suggestion.
Based on legislation:
• All cases of abuse to clients will be reported according to
the Protection of People in Care Act
• The Policy will be updated on a regular basis and based
on health care and human resources best practice
guidelines
Policies may be written under the following headings:
• Human Resource policy, including information on
bullying, harassment, disciplinary action, benefits, pay
periods, vacation, and seniority
• Health and Safety policies, including emergency
responses, safety occurrence reporting, infection
prevention and control, client and staff safety
• Skilled procedures and who has authority to perform these
procedures
• Job descriptions
• Admission and discharge
• Facility maintenance
• Quality assurance
• Governance – who will make decisions for the
organization
A Procedure is:
The “how” to fulfill the policy
A set of detailed steps to ensure the goal of the policy is reached.
For example, a policy may state that all clients and staff will be
offered the influenza immunization by October each year. The
procedure will list the steps that the organization will follow to
reach this goal.
All staff, including health care aides, need to know where the
policy and procedure manual is kept and how to access it. By
following agency policy and procedure you will be helping to
ensure the health and safety of clients, visitors, co-workers, and
yourself.
Your Job Description is Linked to Provincial
Legislation
When you apply for a job you should always make sure you read
the job description. The title of a position may be misleading,
but a job description will give you a clear description of what
you are being employed to do.
A good job description can be described as a “snapshot” of what
your role and responsibilities will be. Such a job description will
include:
• the title of the position
• the department you will be working for
• who you will report to
• your overall responsibilities
• key responsibilities
In Alberta, the roles and responsibilities of staff members
employed as health care aides is clearly defined by legislation
Acts. Two legislations that specifically impact on the role and
responsibilities of a HCA are the Alberta Government
Organization Act and the Alberta Health Professions Act. These
two legislations describe the role of regulated professional staff
such as registered nurses, registered psychiatric nurses, and
licensed practical nurses, and the roles and responsibilities of
unregulated staff such as health care aides. The Government of
Alberta has made it very clear what the roles and responsibilities
of health care aides in Alberta is.
Employers use these two legislations as well as other
information and guidelines when they design a job for health
care aides in their organization.
It is the employer’s responsibility to write a job description that
clearly defines and describes the roles and responsibilities of
health care aides working for them.
It is the HCA’s responsibility to read and understand the job
description and to work within the defined roles and
responsibilities in the job description.
Exercises
A. Case Study: Job Descriptions Can be Misleading
Read the following job description and answer the questions that
follow.
• Janice applied to work at Thunder Mountain Home Care
Office. The job description was as follows.
Position title: Care and Comfort Companion
Wages: $15.00 to $18.00 per hour dependent on education
and experience
General job description: Assist clients with all aspects of
daily living. Give support and hope to clients, with an
emphasis on holistic care.
Key tasks: Household management, personal care, social and
recreational stimulation
Qualifications: Completion of a Health Care Aide Certificate
from a recognized college preferred. Experience working with
the elderly and a compassionate nature are assets.
Competition closes: When suitable candidate has been
chosen.
Is this a helpful job description?
What else would you have included in this job description?
Section 8
SLO 1.22 Describe quality improvement programs that are
used in health care
SLO 1.23 Identify how a HCA can participate in quality
improvement programs
Learning Activities
• Read “Measuring and Responding to Quality Improvement
Indicators” in the Learner Guide
Articles
Measuring and Responding to Quality Improvement
Indicators
As health care workers we all want the care we provide to be of
a very high quality, and we want the environment that our clients
live in, and that we work in, to be safe and desirable. Although
health care providers and employers always have high quality
care as a goal, sometimes things go wrong and clients, families,
and workers all start to wonder why there are so many falls or
why a particular client sleeps all day long or constantly
complains of pain.
The health care industry started to recognize that there are trends
in incidents and accidents, and patterns in injuries and
complaints from clients, families, and staff. In response to these
trends some standard measuring tools have been developed and
are in use in long term care facilities, home care, and mental
health care facilities.
Minimum Data Sets (MDS)
A Minimum Data Set is a standard tool that is used to assess
clients admitted into long term care, home care, and mental
health care facilities. It focuses on a clinical assessment of a
client in specific areas.
Some of the assessment measurements are:
• mobility
• diet and nutrition
• socialization
• support systems for finances
• pain
• medications
• elimination patterns and problems
The information is entered into a standardized form or MDS
collection tool. This tool can be on paper or on a computer. Each
member of the health care team has the responsibility to
complete his or her area of the form as accurately as possible
and in a timely manner.
MDS data collection tools are started on the day of a client’s
admission and completed by each shift for seven days. After
this, the same amount of information is collected every three
months and annually until the client is discharged.
Resident Assessment Protocols (RAPs)
After all the information is collected and input into a computer
program, a document called a Resident Assessment Protocol
(RAP) is generated by the computer. This document will
indicate if the client is being treated for pain often enough and
effectively enough. It will indicate that the client may be at risk
for falls if they are incontinent or on medications that might
lower their blood pressure and make them dizzy. These are just a
few examples of the kind of information that the RAP may have
on it.
The information from the RAP is used by the interdisciplinary
team to create a Care Plan that will meet the client’s needs for
care and safety.
Your Role as a HCA
Your role as a HCA is to:
• input your observations of the client as directed and
required
• participate in the development of the individual Care Plans
• follow the Care Plans and notify your supervisor when you
are not able to do so
• report and record any changes you observe about the client
Other Quality Improvement Initiatives and Approaches
Many employers have quality improvement teams or
committees. These committees collect the information from
incident reports and a process called an audit and make
decisions about how to prevent further incidents of these types.
There is a high degree of focus on safety.
Examples of Information used from Incident Reports
Falls – When there is an increase in the number of client falls or
injuries from falls, the committee will examine this
information found in safety reports and look for trends in
the incidents such as places where the falls occur, the time
of day they occur, and the environment in which they
occur. Staff may be educated in ways of preventing falls, or
client assessments for fall risks may be improved as the
result of the committee’s quality improvement initiative.
Medication errors - are more common than they should be. The
medication error quality improvement committee will look
at what type of medication errors are being made, how
often, and by whom. Often, staff re-education results from
these audits.
Examples of Regular Audits
Infection prevention and control audits – These occur
especially if there has been a recent outbreak of
gastrointestinal disease or an increase in infections, such as
bladder infection.
Restraint use audits – Most facilities have “least restraint”
policies. This means that instead of confining a client to bed
or a chair, other approaches are used to keep the client safe in
his or her environment. An audit may be done to collect
information on how many client restraints are used in a unit or
facility.
The HCA Role
• Always follow agency policy and procedure for completing
incident reports (sometimes called safety occurrence
reports).
• Complete the MDS data collection sheets accurately, in a
timely manner and as directed.
• Participate as a member of an audit team or a quality
improvement committee if requested to do so by your
employer.
• Participate in ongoing education related to quality
improvement initiatives.
• Follow new policies, procedures or protocols which may be
the result of a quality improvement initiative.
Section 9
SLO 1.24Describe the concept of professionalism and the
attitudes and behaviours that demonstrate
professionalism
SLO 1.25Describe concepts of compassion, caring,
compassionate care, and support
SLO 1.26Describe typical needs of a client including dignity,
independence, the ability to express preferences, and to
be safe from harm
Learning Activities
• Read “Being a Professional” in Chapter 1 in the textbook
• Read “The Goal of Support Work: Compassionate Care” in
• Study Box 1-1 “Statements That Show a Negative Attitude”
in Chapter 1 in the textbook
• Complete “A. Chart: Dressing for Success” in the Learner
Guide
Exercises
A. Chart: Dressing for Success
Review Box 1-2 “Practices for a Professional Appearance” in
Chapter 1 in the textbook and complete the chart below.
Put a checkmark in the appropriate column or columns that
indicate the reason for a dress code regulation. There may be
more than one right answer.
Infectio
Clie Wor n Professi Client
nt ker Prevent onal Dignity
Safe Safet ion and Appear and
Dress Code ty y Control ance Respect
Clean uniform
Clothing and
uniforms that fit
well and is not
revealing
Clean comfortable
shoes
Short hair or hair
pulled back; clean
hair; hair neatly
secured off face
and collar
Light makeup; no
scents
No neck chains,
bracelets, dangling
earrings
No rings
No slogans or
offensive pictures
on t-shirts
Tattoos covered up
Short, clean,
unpolished, natural
fingernails
Section 10
SLO 1.27Describe the holistic approach to working with clients
and their families
SLO 1.28Describe the concept of psychosocial health and the
four factors that influence psychosocial health
SLO 1.29Describe each of the five levels of Maslow’s Hierarchy
of Needs
Learning Activities
• Read “Promoting Client Well-Being and Psychosocial
Health” in Chapter 12 in the textbook
• Read “Maslow’s Hierarchy of Needs” in Chapter 12 in the
textbook
• Complete “A. Case Study: Martha is Sad” in the Learner
Guide
Exercises
A. Case Study: Martha is Sad
Martha lives in a care home in a small prairie town. She has
known most of the other clients in the care home all her life. She
has always loved spending time with friends and family but has
always had a fear of “not fitting in” in social situations.
Martha has arthritis and is no longer able to stand or walk. The
staff use a mechanical lift to transfer her into and out of her
wheelchair. Martha does not like being in the chair because she
thinks others judge her.
Recently, the care home made some renovations and created a
small visiting “nook” in front of some large widows. New
upholstered chairs in a cheery print fabric were purchased and
arranged in the visiting area. Every morning a group of clients
gather in the nook for morning tea and a chat. Martha wished to
join in the tea time, but when she asked the staff to assist her,
they rolled her chair into the visiting area and left her there.
Martha began to cry. She asked to be transferred into one of the
comfortable upholstered chairs so that she could be one of the
group. The staff told her they did not have time to transfer her
and that she could visit just as easily from her wheelchair.
Martha asked to be taken to her room where she closed the door
and cried until it was time to come out for lunch.
• Which of Martha’s needs were not being met?
• physical needs
• safety needs
• need for love and belonging
• self-actualization
• What part of Martha’s history lets us know why she would
not visit from her wheelchair when the other clients were in
upholstered chairs?
• As a caregiver, how would you have met Martha’s needs
differently?
Section 11
SLO 1.30Describe the professional helping relationship and how
it differs from friendships
SLO 1.31Describe the required behaviours that contribute to a
positive helping relationship
SLO 1.32Identify the benefits of the helping relationship to
client health
SLO 1.33Describe characteristics of client-centered care
SLO 1.34Compare concepts of independence, dependence, and
interdependence within the professional helping
relationship
SLO 1.35Describe the relationship between independence and
self esteem
Learning Activities
• Read “Maintaining a Professional Relationship With the
Client” in Chapter 11 in the textbook
• Read “The Benefits of a Client-Centered Helping
Relationship” in the Learner Guide
• Read “Independence, Dependence, and Interdependence” in
• Read “Independence and Self-Esteem” in Chapter 11 in the
textbook
• Complete “A. Identifying Questions: Professional vs. Helping
Relationships” in the Learner Guide
Articles
The Benefits of a Client-Centered Helping Relationship
A helping relationship should be based on a caring and sharing
philosophy in which the client is the centre of everything that
happens. In other words, we do not do things for a client; we do
things with a client.
Independence is the Focus
A client-centered approach always aims at maintaining a client’s
independence no matter what care setting the client may be in.
The caregiver must always ask herself in every situation. “Is
there some way the client can be more involved in this activity?”
Characteristics of a Client-Centered Helping
Relationship
• focus on client needs
• focus on client experiences
• focus on client feelings, ideas, values and input
• client goal-oriented
Focus on Client Needs
When you go to get Mrs. Gibbs ready for the day, she asks if
you can help her make a phone call to her daughter to make sure
she will be on time to take her to a dental appointment. You are
focused on getting Mrs. Gibbs dressed and ready for the
appointment. Nothing seems to be going right. Why? Well, very
likely it is because you are focused on your needs to complete
morning care instead of Mrs. Gibbs’ needs for reassurance.
A helping relationship focuses on client needs first. After that,
the completion of other tasks seems to flow more easily.
Experiences
A helping relationship creates meaningful shared experiences.
One of the most looked-forward-to events for many clients is
mealtime. If you simply set a meal down in front of your client
and then spend the rest of the mealtime talking to other
caregivers or tidying up, then the opportunity to make the meal a
pleasant and shared experience is lost.
If you are working with a home care client, finding ways to
make your visit there a pleasant shared event will bring warmth
and contentment to an otherwise long and lonely day.
Even bath time or other personal grooming tasks are more
productive and energetic if the health care aide finds a way to
involve the client in the process.
Focus on Client Feelings
Imagine if your best friends knew you were frightened of flying
but they bought you a ticket for a helicopter ride for your
birthday. How would you feel? Now imagine that you know
your client never likes to miss his game show at 10am, but you
scheduled his weekly bath for 10am. How would he feel? A
helping relationship centres on knowing a client and his feelings
well, and responding to those feelings in ways that are
supportive and helpful.
Be Client Goal-Oriented
A helping relationship will have a specific direction in which it
is heading. This direction is based on a client care plan. Ideally,
the client has had input into this care plan and understands the
goals and what it will take to meet those goals. The health care
aide should always assist the client in meeting their goals.
Characteristics of a “Helper” in a Helping Relationship
• maintains confidentiality
• shows respect
• asks the client’s opinion
• never enters into a power struggle
• listens to and understands what the client is trying to say
• shows warmth and caring
• understands cultural diversity
• controls his or her own feelings
• is flexible
• involves the client’s family and friends in the client’s day-
to-day experiences
How does the client benefit from a client-centered
helping relationship?
When we involve clients as fully as possible in the day-to-day
decisions and routines of life, the client will:
• Feel confident about the care he is receiving and his
involvement in that care
• Experience the benefits of being heard and understood
• Remain in control of her life
• Know that his past history will be important to the care he
receives now
• Participate in a variety of stimulating activities that
integrate old skills and knowledge with new life
experiences
• Feel recognized and valued as a person of worth
Exercises
A. Identifying Questions: Professional vs. Helping
Relationships
Review Box 11-1 “Professional Helping Relationships Versus
Friendships” in Chapter 11 in the textbook.
Beside each statement circle a P for statements that describe a
professional relationship or an F for statements that describe
friendships.
• Mary works for home care and gives Mrs. P F
Klause a weekly bath.
• Kelly and Jill decided to keep in touch after P F
they graduated from the HCA course.
• Joe dropped by his cousin’s place to help him P F
finish building his garage.
• Matilde charges $16.00 to wash and set Mrs. P F
Bleur’s hair.
• Sherry told Marcia she thinks Marcia is P F
wasting her time watching soap operas.
Marcia just laughed.
• Jim and Ed have been friends for 20 years. P F
Usually they just spend time shooting pool or
watching sports.
• Renee was assigned to give care to Mrs. Lee P F
today.
• When Mrs. Van Horn apologized for being P F
confused and causing extra work, Marvin told
her not to worry about it; he wants her to be
happy with her care.
Section 12
SLO 1.36 Explain the relationship between a client’s coping
skills and how the client may adjust to care
SLO 1.37 Identify the three common client responses
related to adjusting to care
Learning Activities
• Read “The Frail Elderly Experience” in the Learner Guide
• Complete “A. Case Study: Mrs. Logan’s Response to Care” in
the Learner Guide
Articles
The Frail Elderly Experience
Len Fabiano, in his book Breaking Through: Working with the
Frail Elderly, talks about four components that result in an
individual’s ability to adjust to care.
These four components are:
The Individual
Who was this person during her earlier years? It is important to
look at all aspects of the individual to try to fully understand her
personality, belief systems, values, the role work played in her
life, who her friends were, and the importance of family.
Normal Aging Process
This includes the biological changes of aging such as a general
slowing down, and some changes in sight, hearing, and
perception. It also includes the individual’s own attitude to
growing older and how he sees himself and how he believes
others see him. The person’s ability to adapt to changes and
envision the future are part of accepting the process of growing
older.
Effects of Disability
A disability may be physical or mental and includes not only the
diagnosis but also the individual’s ability to cope with the
diagnosis and the response to medical interventions. A change in
body image plays a role here; for example, the person may have
had a stroke and be paralyzed on one side, she may have arthritis
and be unable to hold a spoon or weight-bear, and she may have
lost bladder control and need to wear an adult incontinence
product. Once again she may ask herself, “What do other
people think of me?” Fatigue and pain play a role in an
individual’s ability to adapt to the changes the disability has
brought to her life.
The Individual Response

The response is an unknown and is represented by a question
mark.
Placing these components into an equation helps to us look in a
new way at the frail elderly and their responses to changes in life
and the need for care.
Three common responses to adapting to receiving

care are:
The Adaptive Response
This individual has a personality and inner resources that have
allowed him to adjust to changes and losses in his life. Fabiano
states, “This is the individual that strives to hold onto whatever
quality of life remains, responding positively to the present
circumstances.”
This is the client who will welcome you into her home as a
home care worker or greet you cheerfully in the morning in a
care facility. She will thank you for your work and try to follow
her care plan. These clients are a pleasure to work with.
More challenging are the clients who have responded to the
changes in their lives by adopting the aggressive response or the
apathetic/withdrawn response.
The Aggressive Response
This individual has not accepted the changes in his physical
abilities or the losses in his lifestyle and activities. It is as if the
client is saying: “I have not changed, I am still the man I have
always been and I will fight to prove to myself and others that I
am still that man.” As a result of this attitude, Mr. Fabiano tells
us, that client “attempts to hold onto a lifestyle that no longer
exists, or a way of controlling that lifestyle that is no longer
available.”
This client’s tendency to fight all attempts to assist him makes it
very challenging to form a helping relationship and provide the
care that is required.
The Apathetic/Withdrawn Response
The best way to describe the clients who have adopted this
response is that they appear to be thinking, “There is nothing left
in my world except time.” These clients will be very compliant
and allow family and care providers to tell them what to do and
when to do it. They will not resist care but they also do not
participate in their own care. They may make statements like
“Why do I have to wait so long to die?
Len Fabiano tells us that the aggressive response and the
apathetic/withdrawn response “present a complex dilemma that
requires us to closely examine the individual in order to gain
understanding of the ‘why’ of each response and the ‘how’ to
compensate for it.” He suggests we use the five basic
components of the client-centered model of care.
Consistency – in approach and expectations
Continuity – of past life patterns, likes and dislikes
Respect – of personal values and beliefs
Involvement – in decision-making
Support – to decrease or eliminate those things that impede
quality of life
Understanding who an individual is and attempting to
understand the thoughts and feelings being experienced by this
individual are the most important elements in assisting her to
adjust to changes and challenges in her life.
The work content of this article has been adapted from
Breaking Through: Working with the Frail Elderly by Len
Fabiano and has been used with written permission of the
author.
Exercises
A. Case Study: Mrs. Logan’s Response to Care
Mrs. Logan was 68 years old and had been married for 40 years.
She had no children, but after she was admitted to the care
facility her husband and sister visited often. She would visit with
them briefly then ask them to leave. She refused to play bingo,
participate in social activities or play the piano, although she had
played the piano and organ in church for 30 years. She was
aggressive to the staff when they tried to direct her into activities
or give her personal care. She would not accept assistance with a
bath and insisted on giving herself a “sponge bath.”
The staff and Mr. Logan were very concerned. One day at care
conference the nurse asked Mrs. Logan’s husband and sister if
there was any information they could share that might be helpful
in improving Mrs. Logan’s quality of life. The sister stated,
“Well, you might as well know that my sister does not believe in
leisure. She only played the piano at home to practice for church
services, she would volunteer at bingos for fundraisers, but
would never play for fun, and she does not believe in getting
together with friends to complete projects like baking.”
• Given this information about Mrs. Logan, what do you
believe is her adaptation style to care?
a.an aggressive response
b. an adaptive response
c.an apathetic/withdrawn response
• Based on the sister’s information about Mrs. Logan, put a
checkmark beside activities that Mrs. Logan may be
interested in doing.
___ handing out bingo cards and markers
___ joining the baking club
___ folding facecloths
___ playing the piano for the Sunday service
___ joining in a sing-song
Section 13
SLO 1.38 Distinguish among race, ethnicity, and culture
SLO 1.39Describe concepts of prejudice, discrimination,
stereotyping, and cultural conflict
SLO 1.40 Describe the effects of culture on the client,
family, religion, health beliefs, and communication
SLO 1.41 Identify ways to provide culturally sensitive care
and support
SLO 1.42 Analyze how your own cultural biases and moral
judgments may affect your relationships with clients and
their families
Learning Activities
• Read “Diversity: Ethnicity and Culture” in Chapter 10 in the
textbook
• Read “The Effect of Culture” in Chapter 10 in the textbook
• Read “Providing Culturally Sensitive Care and Support” in
• Complete the questions “Caring About Culture and Diversity”
in Chapter 10 in the workbook
Section 14
SLO 1.43 Explain the purpose of a code of ethics
SLO 1.44 Identify the four principles of health care ethics
SLO 1.45 Describe the principles used to solve ethical
dilemmas
Learning Activities
• Read “Codes of Ethics” in Chapter 8 in the textbook
• Read “The Principles of Health Care Ethics” in Chapter 8 in
the textbook
• Read “Dealing with Ethical Dilemmas” in Chapter 8 in the
textbook
• Complete the review questions at the end of Chapter 8 in the
textbook
Section 15
SLO 1.46 Describe the influence of the HCA’s self-
confidence on the caring behaviours toward others
SLO 1.47 Identify techniques to improve self-confidence
SLO 1.48 Identify the importance of developing self-
awareness
SLO 1.49 Relate self-awareness to role performance and to
the development of helping relationships
SLO 1.50Identify techniques to improve skills in self-awareness
Learning Activities
• Read “Your Self-Confidence Will Influence Your Success” in
the Learner Guide
• Read “The Many Layers of Self-Awareness” in the Learner
Guide
Articles
Your Self-Confidence Will Influence Your Success
Self-confidence is a belief or trust in your own abilities. As a
learner in this program you will be taught many skills that are
required by your employer for you to fulfill your job description.
The goal of learning the theory of care giving, watching
demonstrations of skills, practising skills in the lab, and then
having a chance to apply these skills in a practicum setting is to
ensure that learners build both confidence and competence.
Self-confidence means that you:
• maintain a positive attitude
• value yourself
• believe in your own ability to do well
• compare yourself favourably with others
• accept feedback as helpful and try to make improvements
• ask for help when you need it
Sometimes it is difficult to work as one of a group of learners
and see that some of your classmates seem to be learning how to
give client care more easily and quickly than you. It may be hard
to feel confidence in yourself in all of these new situations.
Remember that your attitude toward yourself and your abilities
will influence your success in your new career.
Techniques for Improving Self-confidence
Use positive self-talk. Practice saying to yourself short phrases
that will remind you that you know how to do something well.
Recognize your strengths. Make a list of all of the skills you do
very well and all of the positive comments you have received
from your facilitator, supervisor or clients.
Recognize your limits. Sometimes a skill is learned in class and
then not used again for many months. If you do not remember
how to complete a skill correctly, do not try it. Instead, review
your course materials and ask the regulated health care
professional to supervise you until you are confident you can
perform the skill correctly.
Speak up. If you have had success when working with a
particular client, speak up and tell others what you did and how
the client responded.
Keep quiet. If you are in a situation in which you do not have
all of the facts, listen and learn. This shows respect for other
people’s knowledge.
Smile. If you look worried and flustered, the client and team
members will not see you as a confident and competent person.
Show an interest in other people. Sometimes taking the focus
off yourself and paying positive attention to others will help you
to relax, which is an important trait of a self-confident person.
The Many Layers of Self-Awareness

Five Key Areas of Self-awareness
Personality: It is important to understand your personality and
how your personality fits with your choices in life. Personalities
are consistent and rarely change, except as the result of disease
processes or traumatic injury. Therefore, it is important to match
your personality to your work and activities. If you like working
independently in quiet surroundings, you are probably more
suited to working with individual home care clients than in a
busy continuing care setting.
Values: What do you value most? Do you value having a routine
and getting things done in a logical order? Do you value
flexibility and “going with the flow?” Do you value being
available for your children’s activities whenever they need you?
These are important questions to ask yourself as you enter into a
career in health care. Many of the jobs are shift-work positions
with an expectation that you will be available to work evenings,
nights, and weekends. You must question which values may help
or hinder your personal and work relationships and make
decisions accordingly. Perhaps a part time or casual position will
fit your lifestyle best at this time.
Habits: Habits are behaviours we repeat automatically. Are you
in the habit of arriving late all the time? Are you in the habit of
using all of your sick time? Are you in the habit of being
organized and preparing your clothing and lunch the night
before? Examine your habits in these areas and others, and
decide if these habits will be a positive or negative influence on
your new job.
Needs: Earlier in this module we examined Maslow’s hierarchy
of needs. Are safety and security your primary needs? If so,
getting to work on time, and doing the best job you can, will be
a priority for you. Are your needs based on socialization and
maintaining friendships? There is nothing wrong with this unless
it starts to become a barrier to your work attendance.
Emotions: Caregiving can be a difficult and emotionally
challenging job. It can also be highly rewarding and gratifying.
It is important to be emotionally self-aware. This means you
understand your own feelings, what causes them, and how they
impact your thoughts and actions. If you become emotionally
upset every time your supervisor corrects your work or each
time a team member or family member or client is rude to you,
then you will be on an emotional roller-coaster all the time. Stop
and ask yourself: “Why is this so upsetting to me? How can I
learn to react differently?”
Improving Skills in Self-Awareness
You have good self-awareness if you
• know your strengths and recognize your personal limitations
• are aware of your feelings and emotions, what causes them,
and why
• understand how your feelings affect your behaviour
• learn from your experiences and mistakes
One of the most important skills in self-awareness is the ability
to recognize which situations and people consistently make us
happy and why they make us happy. In addition, we must
examine which situations and people create stress in our lives
and why. When we take an honest look at these two things, we
are able to make life choices that suit our personalities. As a
result, we experience higher job satisfaction and success.
Section 16
SLO 1.51 Describe societal and technological changes that
require HCA participation in lifelong learning and
continuing education
Learning Activities
• Read “Make Lifelong Learning a Goal” in the Learner Guide
•
Articles
Make Lifelong Learning a Goal
The health care environment is constantly changing. An example
of a major change which has taken place in recent years has
been the introduction of electronic client health records. When
health care staff changed from written documentation to
electronic documentation, the necessity was created for training
the staff to use computers for the day-to-day charting of clients.
There have been many other changes in care philosophy that
have created the need for staff education. An example of a
change in care provision has been the move away from the
medical model of nursing to the social model of nursing. This
meant that many staff who had previously provided personal
care to clients were now expected to provide housekeeping,
cooking, and recreational services. As a consequence, staff
members were provided with in-service education to help them
learn how to fulfil their new roles.
Some staff are not excited about opportunities to learn new skills
or improve old ones. An example of improving on old skills and
knowledge is the approach we now take to infection prevention
and control. Health care workers used to wash their hands for
two minutes at the beginning and end of the shift and when their
hands were soiled. Now, however, we have a better
understanding of how to prevent the spread of infection and we
wash our hands for short periods of time on a more frequent
basis. As health care workers we should be excited about
learning new ways of improving care and safety for our clients
and ourselves.
Ways of participating in lifelong learning
There are many opportunities to participate in ongoing education
for the workplace.
Mandatory Education (annual education)
There are some topics for which all health care workers must
update their skills annually. Your employer will provide the time
and opportunity for you to participate in these in-service
opportunities.
The topics are:
• Infection Prevention and Control
• Back Care
• Food Safety
• Protection of Persons in Care Act
• Fire Safety and Emergency Codes
Some other ways of ensuring your knowledge and
skills are up to date:
Keep a “to-learn” list – This is a list of topics you would like to
know more about. For example, do you want to know more
about diabetes or care plans? Add them to your list and look for
opportunities to learn more about them.
Learn from a coworker – Do you have a co-worker whose
skills in time management impress you? Watch her closely as
you work together and learn from her.
Learn and practice – If you have learned a new skill at an in-
service session or read a journal article about a new skill, then
start practicing it the very next time you work.
Teach others – The time will come when you will be the “old or
experienced staff.” Be sure you are up-to-date in your
knowledge and skills so you can help new staff learn how to
give effective care.
Read – There are many journals containing articles aimed at
health care aides. Take time to read these interesting
publications.
Dream – Perhaps one day you will go back to school and
become a registered nurse or a licensed practical nurse. These
are dreams that could come true for many.
Section 17
SLO 1.52Use terminology related to the roles and
responsibilities of the HCA
Learning Activities
• Review the Glossary at the beginning of this module
• Review “Key Terms” in chapters 1, 2, 3, 4, 8, 10, 11 and 12 in
the textbook
• Complete “A. Matching Exercise: Terms and Definitions” in
the Learner Guide
• Complete “B. Fill in the Blanks: Terminology” in the Learner
Guide
• Complete “C. True and False: Definitions” in the Learner
Guide
Exercises
A. Matching Exercise: Terms and Definitions
This exercise is based on the glossary found at the beginning of
this module.
Match the following terms:
1. Alternative • All members of the health care team,
healing including the client and the client’s
family.
2. Blood kin • The way an individual looks at the
___ world based on past history, family
_ traditions, education, culture, and
religion.
3. Continuity • The events of an individual’s life.
4. Frame of • People you are related to by

reference bloodlines.
5. Gender • The ability to positively recover from
loss, change, and disease.
6. Interdisciplinar • Non-traditional medical treatments
y team such as acupuncture
7. Mental • The regulated roles and
hardiness responsibilities for each member of the
health care team.
8. Personal • A predictable pattern of events
history
9. Resilient • Male or female.
10 Scope of • The ability to cope with all of life’s
. practice changes and challenges.
B. Fill in the Blanks: Terminology

This exercise is based on Key Terms from Chapters 1, 2, and 4
in the textbook.
Choose the word from the right-hand column in the table below
that fits in the blank in the following definitions.
Definition
• Concern for a client’s dignity, preferences, Holism
privacy, and safety is called Confidentiality
_______________________. Scope of
• Respecting and guarding a client’s personal practice
information is referred to as Caring
_____________________________. Homecare
• _______________ is the state of feeling Chronic
worthy, valued, and respected. condition
• _________________ refers to working Health
within the legal limits of the job. promotion
• ____________ provides support services to Dignity
individuals where they live.
• A strategy for improving the health of a
community is ______________.
• A____________________ causes the loss of
physical or mental function.
• Considering all aspects of a client’s life
when planning care is _________.
C. True and False: Definitions

This exercise is based on the Key Terms found in Chapters 6,
10, and 12 in the textbook.
Read each statement then circle T for true or F for false.
• Competence refers to performing a job safely. T F
• Empathy refers to sharing your feelings with T F
the client.
• Respect refers to judging another person. T F
• Self-esteem refers to thinking well of T F
yourself.
• Conduct is your personal behaviour. T F
• Justice means treating people unfairly. T F
• Culture is the characteristics of a group of T F
people.
• Diversity refers to different individuals and T F
cultures living separately from each other.
• Stereotypes are based on facts, not T F
assumptions.
Section 18
SLO 1.53 Apply the “ICARE” Model to the role of the
Health Care Aide.
Learning Activities
• Read “Applying the ‘ICARE’ Model to the Role of the Health
Care Aide” in the Learner Guide
• Complete A. Matching Exercise: “ICARE” Model in the
Learner Guide
Applying the “ICARE” Model to the Role of the Health
Care Aide
Compassionate caring – The number one responsibility of a
health care aide is to care for the clients you work with in a
holistic way. This means that you see the client not as a series of
tasks that must be performed but rather as a person who has
needs in a variety of areas. These needs are physical, emotional,
and spiritual. Compassionate caring means you strive to know
the client as well as you possibly can and allow her to participate
in her own care to whatever level she is able. Promoting
participation and independence must always be a goal.
Compassionate caring involves respect for a client’s cultural,
religious, and health beliefs, and honours the role family plays in
this client’s life.
Accurate observations – How is this client adjusting to care? Is
he adapting to the new lifestyle? Is he angry and aggressive?
Or, does he appear apathetic and withdrawn? Some clients fail to
thrive when they have a series of losses to their health or living
circumstances. A rapid deterioration in their physical and mental
well-being may result. It is important for you to notice any
changes to eating, sleeping, and socialization patterns. In
addition, the client may resent family members when
arrangements have been made for home care services or a move
to a care facility. Observe for difficult relationships between the
client and his friends and family.
Report and record – Always report your observations to your
supervisor. She will help you plan how best to approach the
client and her needs. The health care team needs accurate and
timely information regarding the client’s physical, emotional or
psychological changes. Care planning is done based on these
changes.
Always follow the employer’s policies and procedures for
reporting and recording (documentation).
Ensure client comfort and safety – As you review the
information in this module you will see that there is a number of
ways in which you can ensure a client’s comfort and safety
within your role as a HCA.
One of the most important ways to ensure you client’s safety is
always to work within your roles and responsibilities as a health
care aide. Never complete procedures for which you have not
been trained or to which you have not been assigned. Following
your job description for the HCA position will assist you in
determining your role and responsibilities.
In addition, always follow employer policy and procedures.
Policy and procedures will inform you who is to perform which
tasks, and how they are to be completed. The policy and
procedures will include environmental safety, client safety, and
worker safety.
Keep up-to-date on procedures and equipment usage.
Continuing education including participating in annual
education and in-service education will assist you in being
prepared to give safe, client-centered care.
A client’s comfort and safety are not just related to physical care.
Emotional comfort is also important. By presenting yourself as a
confident caregiver you will build an atmosphere of trust with
your client. Understanding the client, his background, his health
beliefs, and cultural practices are key elements of establishing a
relationship based on trust and respect. This helps to build the
client’s self-confidence which, in turn, leads to an increased
sense of security.
Exercises
A. Matching Exercise: “ICARE” Model
Beside each statement place a “C” for examples of
compassionate caring, an “A” for examples of accurate
observations, an “R” for examples of record and report, or an
“E” for examples of ensuring client safety and comfort.
____ Encouraged the client to talk about his health beliefs

____ Told the supervisor that the client has been crying every
morning
____ Left a message for the dietitian that the client would like
to see her about his menu
____ Asked the client for a list of activities she likes to
participate in
____ Recorded concerns expressed by the client’s family
____ Removed the client from a noisy activity that was
upsetting her
____ Wiped up a spill in the client’s room
____ Got a different dinner from the kitchen for a client who
does not eat pork for religious reasons
____ Noticed that the client had not attended any of his regular
activities today
Answer Key for Module 1 Exercises
Section 1
A. How Balanced is My Health?
There are no right or wrong answers to this exercise.
B. Case Studies: Understanding the Continuum of Health
1. c 2. d 3. c.
C. Diagram Labeling: The Determinants of Health
The Physical Physical Social
Individual Environment Environment Environment
Built Natural
• Respects • No mice in • Park and • Talks on
other house walking phone with
people’s • Good paths sister every
property lighting in nearby week
• Able to house • Clean pond • Attends
cope with or stream cooking
changes to • Snowshovelled classes with
routine and off of walk a friend
responsibilit • Participates
ies • No smoke in yoga
• Walks for from class
half an hour factories
three times • Good
a week sewage
• Works part drainage
time
• Meditates
• Believes in
being
honest
• Attends
bible study
Section 2
A. True and False: Health Beliefs
1. F 4. F
2. T 5. T
3. F 6. T
B. Case Study: Honouring the Client’s Health Beliefs

1. This would depend on the agency’s policy and procedures. If
people are living in a supportive living facility the policies about
personal medications may be quite different from the policies in
a continuing care facility.
2. This would have been an opportunity for the HCA to find
out the history of Clifford’s health beliefs and why he believed
that WD-40 was the best treatment for his arthritis.
3. In the end, because the RN referred Clifford to the doctor and
the doctor took the time to listen, Clifford did have a chance to
tell his story and have his health beliefs honoured.
Section 3
A. Case Study: Toby Never Saw It Coming
1. d 4. a
2. c 5. e
3. b
Section 5
A. Matching Exercise: Understanding Responsibilities
1. d 4. b
2. e 5. c
3. a
B. Matching Exercise: Care Settings and Client Groups
Beside each client group, write the abbreviation for the care
setting in which a HCA would be working. There may be more
than one correct answer.
CC, HC, AC, LTC, AL Older adults
CC, HC, LTC, GH, AL People with disabilities
CC, HC, AC, LTC, GH, AL People with medical problems
AC People having surgery
AC, GH, LTC, CC, HC People with mental health
problems
AC, LTC, HC People needing rehabilitation
HC, GH, AC, CC Children
AC, HC Mothers and newborns
CC, GH, AC, LTC, HC People requiring special care
C. Chart: Comparing Challenges in Work Settings

Challenges associated with Challenges associated with
working in home care working in a facility
Working Alone Part of Structured Team
List two challenges of List two challenges of
working alone. working as part of a
• lonely structured team.
• supervisor not • may feel intimidated
immediately available • must learn to be
confident in role
Taking direction from a • prioritize client needs
variety of health care • be flexible
professionals
When confused about
following through on tasks
assigned by a health care
professional such as a
physiotherapist always check
with your immediate
supervisor.
Maintaining Professional Maintaining professional
Boundaries boundaries
Never confuse a caring • caring
relationship with a • supportive
friendship.
Client safety Making a facility feel like
• electrical hazards such as home
frayed cords cheerful and comfortable.
• unsafe smoking
Personal safety Shift work
• travel to unfamiliar Answers will vary
places
• hazardous weather
• abuse by client or client’s
family
Section 7
A. Case Study: Job Descriptions Can Be Misleading
1. This job description is too vague. What are the aspects of
daily living? Personal care, housekeeping duties? Shopping?
Meal preparation? Medication assistance?
2. Full summary of duties –What is included in household
management?
Is this a union job?
Is there a probationary period?
Are there health benefits?
Some indication of an actual closing date
Section 9
A. Chart: Dressing for Success
C W I P C
l o n r l
Dress Code i r f o i
e k e f e
c
t
i
o
n
P
r
e n
v t
e e D
n s i
t s g
i i n
o o i
n n t
a y
a l a
n A n
d p d
n e p
t r C e R
S S o a e
a a n r s
f f t a p
e e r n e
t t o c c
y y l e t
Clean uniform X X X X
Clothing and uniforms that fit well X X X
and do not reveal a lot of skin
Clean comfortable shoes X X X
Short hair or hair pulled back X X X
Light makeup X X
No neck chains X X
No rings X X X X
No slogans or offensive pictures on t- X X
shirts
Tattoos covered up X X
Section 10
A. Case Study: Martha is Sad
1. c
2. All her life Martha was afraid she would not fit into social
situations.
3. Take the time to put Martha in the chair and allow her to feel
like she belonged to the group.
Section 11
A. Identifying Questions: Professional vs. Helping
Relationships
1. 5. F
P
2. 6. F
F
3. 7. P
F
4. 8. P
P
Section 12
A. Case Study: Mrs. Logan’s Response to Care
• a.
• Handing out bingo cards and markers
Folding facecloths
Playing the piano for the Sunday service
Section 13
A. Caring about Culture and Diversity (exercise in the
workbook)
1. F 6. F
2. F 7. F
3. T 8. T
4. T 9. T
5. T 10.T
Section 17
A. Matching Exercise: Terms and Definitions
• f 6. a
• d 7. j
• h 8. c
• b 9. e
• i 10.g
B. Filling in the Blanks: Terminology
1. caring
2. confidentiality
3. Dignity
4. Scope of practice
5. Home care
6. health promotion
7. chronic condition
8. holism
C. True or False: Definitions
1. T 6. F
2. F 7. T
3. F 8. F
4. T 9. F
5. T
Section 18
A. Matching Exercise: “ICARE” Model
C
R
C
C
R
E
E
C
A
Module 2: Legislation
Introduction
Both the federal government (Government of Canada) and the
provincial government (Government of Alberta) have created
legislation to ensure that the rights and safety of health care
clients and health care workers are protected.
In this module, the legislated Acts that affect both the client and
the health care worker are discussed and related to roles and
responsibilities of the health care aide. By learning about these
acts and applying them to your everyday work, you will ensure
you have done all you can to keep yourself and your clients safe.
The information found in this module is some of the most
important you will learn during your HCA training. The
philosophy of health care is that all health care workers are
responsible for completing their assignments in the safest, most
competent way possible and are accountable for their actions.
By studying and understanding the legislation that guides the
care of residents in Canada, and specifically in Alberta, you will
have a firm foundation on which to base your actions and
decisions made in the provision of care to the clients you serve.
It is your responsibility to be aware of and fully informed about
legislations related to the work you do. You should attend all
information sessions and in-services your employer may offer
when legislation is changed or updated.
These legislations protect both the client and you, the employee.
A competent health care worker is familiar with these
legislations and refers to them regarding client and worker
rights. It is very important that you seek clarification about how
legislation is applied in your workplace and in the care of your
clients. Often, workplace policies and procedures are developed
in response to legislation. A number of health care professionals
on the health care team can assist you with any questions
concerning the interpretation and application of these
legislations.
Glossary
Word Meaning
Activities of Daily tasks that the client would complete
Daily Living for himself if he were not prevented from
(ADL) doing so by a health condition.
Confidentiality No private information about a client or the
client’s care is shared with people who do
not have the right or need to know this
information.
Direct A regulated health care professional is
supervision present while a HCA completes a task.
Hazard Working together with the employer to
assessment determine any unsafe working conditions.
Indirect A regulated health care professional is
supervision confident that a HCA can perform a task
safely and is available if help is needed.
Private guardian A friend, acquaintance or family member
who has been appointed by the court to
make decisions on behalf of a client. These
decisions do not include financial matters.
Public guardian An employee of the government who has
been assigned by the courts to make
decisions on behalf of a client. These
decisions do not include financial matters.
Restricted Health care procedures that have a degree
activities of risk and may only be assigned to HCAs
after specific training, under the
supervision of a regulated health care
professional, and with the permission of
the client or the client’s family.
Rights Choices that individuals are entitled to
make regarding religion, cultural practices,
beliefs, and personal expression. These are
examples of individual rights.
Section 1
SLO 2.1 Describe the purpose of the Alberta Health Professions
Act (AHPA) and the Government Organization Act
(GOA)
SLO 2.2 Explain how the Health Professions Act and the
Government Organization Act affect the HCA’s role and
responsibilities
Learning Activities
• Read “Legislation Related to Regulated and Unregulated
Health Care Workers” in the Learner Guide
• Read “Accepted Definitions for ‘Activities of Daily Living’
and ‘Restricted Activities’ ” in the Learner Guide
• Read “Assignment of Task Checklist” in the Learner Guide
• Read “Accepting or Refusing an Assigned Task” in the
Learner Guide
• Read “Direct and Indirect Supervision” in the Learner Guide
• Complete “Case Study 1: Supervision and Assignment of
Tasks I” in the Learner Guide
• Complete “Case Study 2: Supervision and Assignment of
Tasks II” in the Learner Guide
Articles
Legislation Related to Regulated and Unregulated
Health Care Workers
The Health Professions Act of Alberta
The Health Professions Act of Alberta is the legislation that
regulates health professionals in this province. The Act gives
each group of health professionals the responsibility of setting
their own standards and regulations to be self-governing.
Examples of regulated health care professionals are:
• registered nurses
• registered psychiatric nurses
• licensed practical nurses
• registered dietitians
• registered social workers
• physical therapists
• occupational therapists
• recreation therapists
Health care aides are unregulated workers, not covered by the
Health Professions Act, because the HCA always works under
the supervision of a regulated professional in Alberta. The HCA
should be aware of the Act and must understand the concept of
restricted activities as defined by the Government Organization
Act. Health care aides perform only those restricted activities
that they are assigned and trained to do for each specific client.
The HCA’s employer must approve the assignment of a
restricted activity from the Government Organization Act to
HCAs. There will likely be a policy and procedure identifying
the permitted assignment of such tasks to the HCA by a
regulated health care professional, such as an RN or LPN.
Training for the restricted activity assigned to a HCA can be
provided either by an approved health care aide program or by
an authorized health care professional under the direction of the
employing agency.
The Government Organization Act
The Alberta Government Organization Act (GOA) allows
regulated health care professionals, such as regulated
professional nurses, to assign certain “restricted activities” to
unregulated health care providers such as HCAs.
Restricted activities are those that can only be performed by
appropriately trained and licensed (regulated) professionals and
include activities such as cutting into the skin, inserting items
into the body, and prescribing or administering medications.
In 2003, the College and Association of Registered Nurses of
Alberta, the College of Registered Psychiatric Nurses of Alberta,
and the College of Licensed Practical Nurses of Alberta together
created a formal response to the restricted activities listed in the
Government Organization Act (GOA) to help clarify how
regulated (licensed) and unregulated health care team members
could work within their defined scope of practice, roles and
responsibilities and training to provide care to clients when
restricted activities were part of the care plan. For example,
giving a suppository is considered a restricted activity; however,
under the right circumstances, it can be safely done by a HCA
and it is not feasible to have only RNs and LPNs give
suppositories. The document written by these three professional
nursing colleges (CARNA, CRPNA, and CLPNA) outlines a
collaborative approach for assigning tasks to the HCA that are
outlined as restricted activities.
This document states that regulated health care professionals
must ensure that a HCA has had the proper instruction,
supervised practice, and has the competence to complete the
restricted activities assigned. It is the responsibility of the
regulated health care professional to complete assessment for
clients in their care. Based on the assessment of the client’s
health status, the health care professional can determine if the
HCA can be assigned certain restricted activities as a part of the
client’s care.
If the client’s health status changes and the health care
professional’s assessment indicate that the client’s condition is
not stable, the care plan must change to reflect the current health
status. At this time, the assignment of the restricted activities
assigned to the HCA must be reassessed and reassigned if
appropriate. Each HCA must be individually instructed on how
to manage each restricted activity assigned for each individual
client. The HCA may be taught how to do a restricted activity by
a health care professional for a certain client. However, if the
same HCA is required to do the restricted activity for a different
client, the HCA must be instructed on the restricted activity
based on this new client’s needs. Clients must consent to having
the HCA perform the restricted activity as part of their care plan.
Assisting with this procedure is not a restricted activity. The
HCA may then assist the client or surrogate to complete this task
in ways such as gathering supplies or assisting with preparing
the site for injection.
For example: As a HCA you may be assigned intermittent
catheterizations for Client A as part of their care plan. You must
receive instruction and demonstrate to the health care
professional assigning this task to you that you are aware of how
to perform this task for this client. Then, if you assigned
intermittent catheterizations for Client B, you must also receive
instruction from the regulated health care professional on how to
do the catheterizations for Client B. Do not assume that all tasks
for all clients are the same; they are not, and each client has
individual and unique needs.
Restricted activities can be assigned to HCAs only under very
specific circumstances. The restricted activity or task is
considered part of the routine activities of daily living for an
individual client.
• The HCA is specifically permitted by legislation or
regulation to carry out the restricted activity.
• The HCA has the consent and supervision of a regulated
nurse.
• Regulation is in place indicating how regulated members
supervise unregulated workers, such as HCAs, while
performing the restricted activity.
• The HCA has received instruction and demonstrates
competency in performing the task for a particular client.
• The client will not be at risk if the procedure is performed
by an unregulated care provider.
• The client’s needs are stable, and the restricted procedure is
an established part of the client’s care.
• The outcomes of the restricted procedure are predictable.
• The client and/or the client’s family have been involved in
the development of the care plan and in the assignment of a
restricted procedure to an unregulated care provider.
• The client has been assessed by a regulated health
professional, who will continue to be responsible for the
evaluation and the outcomes of the care provided on an
ongoing basis.
• If healthy and able, the client would perform the restricted
activity for himself or herself, such as self-catheterizations.
Role and Responsibility Alert! If a restricted activity meets all

the above requirements, then that activity could be considered an
activity of daily living for that specific client. The supervisor
could assign this activity to a HCA.
If a HCA has been trained to do a restricted activity for an
individual client, the HCA cannot carry out the same task for
another client without specific training. The HCA must be
trained in the specific task for each individual client.
Accepted Definitions for “Activities of Daily Living” and
“Restricted Activities”
The Alberta Government Organization Act (GOA) sets out
definitions for “activities of daily living” and “restricted
activities.”
Activities of Daily Living (ADLs)
Activities of daily living are activities that individuals normally
perform on their own to maintain their health and wellbeing.
ADLs include:
• Routine and/or invasive self-care activities, including but
not restricted to administering oral medications, removing
slivers and the cleaning of wounds
• Specifically taught procedures, which generally result in
predictable and stable responses, including but not
restricted to catheterization, maintenance of drainage tubes,
and administration of drugs by injection
This is certainly a broader range of activities than what we as
care providers generally think of as activities of daily living. In
fact, ADLs may be more than assisting a client with such
activities as bathing, eating, grooming or toileting. Keeping this
broader definition in mind, ADLs may also include activities
such as oral suctioning, caring for wounds and drainage tubes,
catheterizing, tube-feeding, assisting a client to administer drugs
by injection, and assisting a client to check blood sugars with a
glucometer.
In a specific situation it may be reasonable for a health care
professional to train a HCA who works in home care to assist a
client with an insulin injection, which is considered a restricted
activity under the above-mentioned Acts. For example, a
specific client suffers from diabetes, but the person’s medical
condition is stable and the outcome of giving the insulin is
predictable. A HCA may be trained to assist this specific client
with a pre-filled insulin injection on a daily basis in order for
this client to maintain his/her level of health, independence and
wellbeing. This particular restricted activity is considered to be a
part of this specific client’s ADLs, as defined in the above-
mentioned Acts. The activity is necessary for this client to
maintain his/her level of health, independence and wellbeing.
Note that in this case the insulin syringe has been pre-filled by a
pharmacist and the HCA is assisting and NOT administering the
medication. The HCA assists the client to administer the
injection independently. Breaking the skin barrier is a restricted
activity and therefore the injection is not to be administered by
the HCA.
Restricted Activities
Restricted activities are health care procedures or tasks that are
considered invasive and carry enough risk to clients that they
may not be performed by health care providers in Alberta unless
specifically permitted by legislation or regulation to do so.
The GOA [Schedule 7.1, Section 2 (1)] allows for two
exceptions in which restricted activities that a HCA can perform
do not need to be considered part of a specific client’s ADLs.
Note that for these exceptions a regulated health care
professional must assess the client as being medically stable and
the outcome of the activity being performed must be predictable.
So essentially, before you, as the HCA, perform any restricted
activity for your client, ensure you are covered to perform it by
your employer’s policies and procedures, that it is acceptable for
you to perform the activity for the specific client, you have been
appropriately trained and are competent to perform the activity
and that you follow the client care plan in completing the
activity for the client.
The two exceptions are as follows:
• To insert or remove instruments, devices, fingers or hands
beyond the labia majora. This would, for example, allow
health care professionals to train HCAs to insert vaginal
suppositories.
• To insert or remove instruments, devices, fingers or hands
beyond the anal verge. This would, for example, allow health
care professionals to train HCAs to insert anal suppositories
and administer small-volume enemas and provide bowel care,
including digital rectal stimulation.
Role and Responsibility Alert! The GOA has a list of
restricted activities and the legislation around the assignment of
such tasks. You must follow the direction of the regulated health
care professional in performing these activities and must seek
clarification and direction whenever there is a change in the
client’s condition or circumstances. Often these directions are
found in the client care plan.
Assignment of Task Checklist
When your supervisor assigns a task to you, it is important that
you go through the following checklist. This will ensure that you
are given tasks appropriate to your training and experience, and
that you receive the appropriate supervision while performing
the task.
• Is the task within the legal limits of the role of the HCA?
• Is the task part of your responsibilities as listed in your job
description?
• Do you have the proper training to perform the task
competently? (training can be part of your educational
preparation or can be delivered by health professionals in
the agency that employs you)
• Do you have adequate experience to safely perform the
task, given the client’s condition and needs?
• Do you understand the purpose of the task?
• Can you perform the task safely under the current
circumstances?
• Do you have the right equipment and supplies to safely
complete the task, and do you know how to correctly use
the equipment and supplies?
• Are you comfortable performing the task?
• Do you have concerns about performing the task?
• Is there a client-specific care plan in the home that outlines
the assigned task?
• Did you review the task with your supervisor and the
regulated health care professional and do you understand
what the supervisor expects? Were you given clear
instructions and directions by the supervisor?
• Are you receiving the appropriate type of supervision for
your level of demonstrated competency?
• Were you given clear instructions and directions by the
supervisor or health care professional assigning you the
tasks?
• Do you know where and how to seek assistance in an
urgent situation?
Role and Responsibility Alert! The amount of supervision you
require will depend on your experience, the complexity of the
task, and the client’s condition. The less experience you have
performing a task, the more complex the task, and the more
complex a client’s condition, the more supervision you will need
when performing the assigned task.
Accepting or Refusing an Assigned Task
You have one of two choices when your supervisor or health
care professional assigns a task to you. You can either accept it
or refuse it. Ensure that you go through the “Assignment of Task
Checklist” before you accept an assigned task.
Accepting an Assigned Task
Once you accept an assigned task, you are responsible for your
actions and for completing the task according to your training
and the agency policy and procedure. What you do or fail to do
can harm your client. You are ultimately responsible for your
actions, even if you meant no harm to the client, but caused
harm because of neglect, failure to follow policy or instruction,
failure to follow the care plan or a lack of competency to
perform the task.
• Make sure you know how to perform the task competently
and safely
• Make sure you know why you are performing the task
• Ask for help if you are unsure or have questions or
concerns about what you are required to do
• Communicate what you did and your observations of the
client during the task to your supervisor
• Make sure you document all the facts and client response to
the activities as required
• Notify your supervisor immediately if the client’s condition
has changed since the last time you performed the activity
for them
Refusing an Assigned Task
You must have a good reason to refuse an assigned task, because
refusing to provide care could harm a client. You must not refuse
an assigned task simply because you do not want to do it. This
behaviour could put the client’s health and wellbeing at risk and
could also cost you your job. A HCA may refuse a task under
the following circumstances:
• The task is beyond the legal limits of the role of the HCA
• According to the agency policy, the HCA is not permitted
to do the task
• The task is not in the HCA’s job description
• The HCA is not trained to perform the task
• The HCA does not have the experience to safely perform
the task
• The client’s condition has changed
• The appropriate health care professional is not available to
supervise
• The supervisor’s or health care professional’s directions
and instructions are incomplete or unclear
• The HCA does not know how to use the supplies and
equipment or proper supplies and equipment are not
available
• The supervisor’s or health care professional’s requests are
illegal, unsafe, unethical or against agency policy
• The task could harm the client
Role and Responsibility Alert! If you have concerns and are
hesitant to carry out an assignment or a request from your
supervisor or regulated health care professional, you must
communicate your concerns to your supervisor. You cannot
simply ignore the request.
If the task is within the legal limits of your role and in your job
description, but you do not feel comfortable carrying out the
task, your supervisor or regulated health care professional can
help you in any of the following ways:
• answer your questions
• demonstrate the task and stay with you while you perform
the task or until you feel comfortable and safe in carrying
out the task under indirect supervision
• familiarize you with the supplies and equipment
• observe you performing the task and provide feedback
• set up further training
Direct and Indirect Supervision
Direct Supervision
Health care aides require direct supervision performing assigned
tasks until they can demonstrate competency and are
comfortable in performing the assigned task. This means that the
supervisor or health care professional must be physically present
with the client and directs the HCA while the task is being
performed. Direct supervision is also required in the following
situations:
• the client’s needs are complex
• the client’s condition requires regular assessment and
evaluation
• the task is too complex
• the HCA has not been trained to do the task
• the step-by-step task the HCA is trained to do requires
modifications due to the client’s condition or needs
• the HCA is performing the task on the specific client for the
first time
An example of a situation in which direct supervision by the
supervisor would be necessary is bathing a client who has a
fractured hip or a hip replacement. HCAs receive basic training
in assisting clients to bathe, but do not generally receive training
in how to bathe a client who is recovering from surgery. Such a
client has more complex needs, and the task of bathing this
client is more complex. The HCA’s basic training does not
prepare him or her for giving this type of care.
Indirect Supervision
Health care aides are under indirect supervision once they have
demonstrated competency with a task. This means that the
supervisor is not physically present with the client while the
HCA performs the task, but is accessible if needed for
assistance. Indirect supervision is appropriate when:
• the client’s needs are stable
• the HCA is able to complete the step-by-step tasks that she
is trained to do
In the example of the client who has had recent hip surgery, the
health care aide must be trained to carry out a step-by-step
bathing procedure. When the client’s needs are assessed as
stable, then the supervisor will trust that the HCA can carry out
the task of bathing without the supervisor being physically
present. The HCA can then bathe the client with only indirect
supervision.
Exercises
A. Case Study 1: Supervision and Assignment of Task I
You are employed in home care and have been asked to visit Mr.
Tisdale and change his medicated patch. The patch is placed on
his chest, and the medication in the patch helps relieve his chest
pain.
In your training, you had very little experience giving
medications and your training allowed you to administer only
certain specific medications. You remember having given a
suppository once to a client and eye drops to another client, but
you were never trained to administer medicated patches. You are
informed that changing medicated patches is part of your role as
a HCA.
• What do you do when asked to perform this task?
B. Case Study 2: Supervision and Assignment of Task II

This is your first job in a continuing care facility, and you are
asked to start Mr. Samuel’s tube feed. You have seen nurses do
the tube feeds, but have never assisted with the procedure. In
your training, you remember reading some information about
tube feeds, including the reasons why some clients need to have
tube feeds, and the complications to watch for when a client is
being tube fed.
You remember that a tube is inserted through the stomach or
small intestine so that nutritional supplements can flow through
the tube from a feeding bag. You were trained to position the
client properly for a tube feed, set up the tube feeding
equipment, observe for complications while the tube feed is
being administered, and clean the equipment following the tube
feed.
You are aware that one of your main responsibilities is to
observe and report any concerns to your supervisor such as if the
tube feed is not flowing, if the feeding bag is empty, or if the
client is complaining of any discomfort. You were never trained
in how to ensure that the feeding tube is in proper position in the
stomach or small intestine. You were also not trained in how to
administer the tube feed.
• What do you do when asked to perform this task?
Section 2
SLO 2.3 Describe the Health Information Act (HIA)
SLO 2.4 Explain how the Health Information Act affects the
HCA’s role and responsibilities
Learning Activities
• Read “Learning About the Health Information Act” in the
Learner Guide
• Read “Knowing What Client Health Information You Can
Share” in the Learner Guide
• Complete “Case Study 3: A Request for Client Information”
Articles
Learning about the Health Information Act
What HCAs need to know about the Health Information
Act
The Health Information Act (HIA) sets out rules that govern the
collection, use, and disclosure of health information. These rules
apply to all health care providers operating in the public health
system. Health care providers are allowed to share client
information with other health care workers without the client’s
consent if the information is needed for client care or treatment.
The client’s health information (but usually not the client’s
name) will be used to:
• provide the client with the appropriate health services and
permit the agency to do its job
• educate and train staff and physicians
• evaluate agency services so that the agency can make
improvements to service
• conduct research (approved by the ethics committee)
• monitor community health
• manage health systems to coordinate services and set
priorities
• respond to concerns and review work of staff members and
physicians
What Clients, Family, and Friends need to know about
the Health Information Act
The care centre will let family and friends know where the
client’s room is and how the client is doing in general.
• Informal caregivers will be provided with enough
information in order to care for the client when the client is
discharged home.
• If the client requests no information be released, the right to
privacy will be respected. No information will be released
to family and friends except when required by law.
• Only appropriate or needed information will be released.
Knowing What Client Health Information You May
Share
If a client or a client’s legal guardian believes that health
information has not been kept private and the HIA has not been
followed, the person may file a complaint with Alberta’s
Information and Privacy Commissioner. If it is determined that
the rules have been broken, individual health care workers or the
employer they work for can be fined up to $50,000.
Families will ask health care aides for health information
because of the hands-on role the HCA plays in client care.
Therefore, as a health care aide, it is important that you
recognize what information you can share and how you can
assist the clients’ families when they request detailed
information from you.
Keep the following points in mind when handling these
requests:
• Family members and friends ask questions regarding a
loved one’s health because they are concerned or want to be
helpful.
• All family and friends making information requests should
be treated with respect.
• All family and friends may be given general information
such as where the client’s room is and a general statement
of how he is doing.
• Not all family and friends have the right to detailed
information about a client, the client’s condition, physician
assessment, or test results.
• If visitors are requesting more than general information,
politely refer the visitors to the health care professional in
charge. Ensure that the health care professional is aware
that visitors need to talk to him or her.
• Do not give out information over the telephone and do not
fax information; this is the role of the health care
professional.
• Only the client or the client’s legal guardian has the right to
access the full medical information.
• Although information may be shared among members of
the health care team, the regulated health care professional
decides whether to share information and how much
information should be shared.
Exercises
A. Case Study 3: A Request for Client Information
You are working the afternoon shift in a designated supportive
living facility with another HCA. You are being indirectly
supervised by a nurse from home care. Just after supper, you
receive a phone call from an old friend of Joe, who is one of the
clients. The friend would like an update on the client’s recovery
from recent surgery and would also like to know whether the
client has received any visitors this week.
Which of the following responses would be the most appropriate
for you to make in this situation?
• “The client’s brother has just left because Joe is too tired for
visitors.”
2. “I think you should come in and see for yourself how Joe is
doing.”
• “May I take your name and number? I will have the home
care nurse call you.”
• “I am sorry but I don’t think you have a right to this
information.”
Section 3
SLO 2.5 Describe the Freedom of Information and Protection
of Privacy Act (FOIP)
SLO 2.6 Explain how the Freedom of Information and
Protection of Privacy Act affects the HCA’s role and
responsibilities
Learning Activities
• Read “Some Facts About FOIP” in the Learner Guide
• Read “FOIP is About Confidentiality” in the Learner Guide
• Complete “True and False: The Health Information Act and
FOIP” in the Learner Guide
Articles
Some Facts about FOIP
The Freedom of Information and Protection of Privacy Act
(FOIP) has applied to health care bodies since October 1, 1998.
The purpose of the Act is to make public bodies such as
governments, schools, and health care organizations accountable
for the way that they collect, use, and share information about an
individual.
Basic Principles of the Act
• People have a right to know their own personal information.
2. People have a right to privacy. Only those people who need
to see an individual’s personal information are allowed to do
so.
3. Individuals have a right to request that corrections be made
to the information about them that is in the custody or control
of a public body.
4. Individuals and organizations have the right to request an
independent review of any decision made by a public body
under the FOIP Act.
5. The public has the right to access records held by public
bodies unless otherwise indicated by FOIP.
As a HCA, you will be required to apply the principles of the
Act when providing client care. You must maintain client
confidentiality. A client’s chart is a confidential record. You are
legally and ethically obligated to keep all client information
confidential. Your employer trusts that this information will be
held in strict confidence. Do not give out any information about
a client unless directed to do so by your supervisor.
Note: An individual must give written permission for someone
else to use that individual’s personal information.
FOIP is about Confidentiality
As a HCA, you will be required to apply the principles of the
FOIP Act when providing client care.
You must:
• maintain client confidentiality
• remember that a client’s chart is a confidential record
• know that you are legally and ethically obligated to keep all
client information confidential
• never give out any information about a client unless
directed to do so by your supervisor
• Your employer trusts that this information will be held in
strict confidence
Exercises
A. True and False: The Health Information Act and
FOIP
Read each statement and then circle T for true or F for false.
• A client’s health information can be used to T F
educate and train staff and physicians.
• A care facility is not allowed to disclose the T F
client’s room number to visitors.
• Only the client or the client’s legal guardian T F
has the right to access the client’s full medical
information.
• The FOIP Act states that people have the right T F
to know their own personal information.
• A client’s chart is not part of his confidential T F
information.
Section 4
SLO 2.7 Describe personal directives
SLO 2.8 Explain the effect of personal directives on client care
planning
Learning Activities
• Read “Personal Directives Act (PD)” in the Learner Guide
• Read “Personal Directives Reflect the Client’s Competency
and Wishes” in the Learner Guide
• Complete “A. Reflection Activity: Personal Directive” in the
Learner Guide
Articles
Personal Directives Act (PD)
Your client has the right to make his own decisions unless
directed by a court of law or if under the age of legal consent, in
which case his parent or legal guardian has the right to make
choices or decisions for him. This means that the client has the
right to make decisions about his life and wellbeing, including
the right to choose to live at risk.
The Personal Directives Act became law in Alberta on
December 1, 1997. A personal directive is a document that gives
instructions and/or names an agent to make decisions in the
event the person becomes incapable of making his or her own
decisions. It can be handwritten, typed, or printed on a computer
printer. It must be signed, witnessed, and dated. Making a
personal directive is optional and voluntary in the province of
Alberta.
Instructions in a personal directive can include all personal
matters, except financial matters.
A personal directive deals with:

• medical treatment that an individual wants or does not want
• accommodation (living arrangements)
• who the individual wants to live with
• choices about personal activities, such as those involving
recreation, employment, and education
• any other personal and legal decisions (not financial)
Note: A personal directive cannot be used to request illegal
actions.
Activating a Personal Directive
There is a legal process that needs to be completed before a
personal directive can be used for decisions. Do not act on a
personal directive before checking with your supervisor to
ensure that it has been legally activated.
Family and friends do not automatically have a legal right to
make decisions for a client unless they are named as the agent(s)
in the personal directive or have been court appointed as the
legal guardian.
If a family member or friend who is not named an agent wants
to make decisions on behalf of a client who has an activated
personal directive, the HCA must:
• inform the family member or friend that decisions may
only be made by agents named in the personal directive
• provide general information on the wellbeing of the client
• encourage the family member or friend to bring concerns to
the supervisor
• inform the supervisor of the requests of the family member
or friends
Personal Directives Reflect the Client’s Competency and
Wishes
Client competency can change. When this occurs, any decisions
must be reassessed by the professional care team. If you observe
any change in the client’s competency, report this to your
supervisor so that an assessment may be done and areas of
competency and decision making may be adjusted. Record all
observations and actions in the client chart, according to
employer policy and procedure.
Any competent client has a right to modify or cancel his PD at
any time. You must contact your supervisor for direction if the
client makes this request.
Exercises
A. Reflection Activity: Personal Directive
Review the information you have read about personal directives
and write a personal directive reflecting your wishes.
Section 5
SLO 2.9 Describe the Personal Information Protection and
Electronic Documentation Act (PIPEDA)
Learning Activities
• Read “We Live in an Electronic Age” in the Learner Guide
Articles
We Live in an Electronic Age
With the increased use of electronic money exchange and record
keeping, it has become necessary for the Government of Canada
to pass legislation to help protect the personal information that
has been collected through business transactions. This includes
information obtained by home care agencies and other care
providers as well as information employers have obtained about
employees.
What is Personal Information?
Personal information includes:
• name, race, ethnic origin, religion, marital status, and
educational level
• email address and messages
• age, height, weight, medical records, blood type, DNA
code, fingerprints, and voice print
• income, purchases, spending habits, banking information,
credit/debit card data, loan or credit reports, tax returns
• social insurance number and other identification codes
Individual Rights under the Personal Information
Protection and Electronic Documentation Act
Alberta has both the Freedom of Information and Protection of
Privacy Act (FOIP) and the Health Information Act (HIA) to
protect client health records. However, the Personal Information
Protection and Electronic Documentation Act protects the
information of employees collected as part of the employment
and payroll process.
Under the Act, individuals have the right to:
• see their personal information after submitting a request in
writing
• request that their personal record be corrected if there are
errors
• file a complaint if they are not being granted access to their
records in a reasonable amount of time and at no charge
Unionized employees often seek the assistance of a union
representative when they wish to view their personnel file.
• The information for this article was adapted from A Guide
for Individuals: Your Guide to PIPEDA, April 2009.
Section 6
SLO 2.11 Describe the Protection for Persons in Care Act
(PPICA)
SLO 2.12 Explain how the Protection for Persons in Care
Act affects the responsibilities of the HCA
Learning Activities
• Read “Understanding the Protection for Persons in Care Act
(PPICA)” in the Learner Guide
• Read “Duties and Responsibilities Associated With the
PPICA” in the Learner Guide
• Read “Self-Care If You Are Reported to the PPICA Office” in
the Learner Guide
• Complete “A. True and False: PPICA” in the Learner Guide
• Complete “B. Case Study 4: PPICA” in the Learner Guide
Articles
Understanding the Protection for Persons in Care Act
(PPICA)
Alberta passed the Protection for Persons in Care Act (PPICA)
in 1998 to ensure the safety of people who receive care in
Alberta health care facilities. The Act promotes the prevention
and reporting of abuse of adult Albertans who receive publicly-
funded care or support services. This included people who
receive services form hospitals, nursing homes, lodges, group
homes, facilities and other health care agencies funded to
provide support and care in the province of Alberta. The Act was
updated in 2010 and now includes mental health facilities and
care homes.
Under the terms of the Act, anyone who reasonably believes that
a person in care has been abused must report that abuse to an
appropriate authority. The Act requires you to report abuse only
if you believe a person has been abused. It is not up to you to
investigate whether it is abuse or not. You need to ensure the
safety of your clients and protect them from abuse. Before
reporting abuse, you must ask yourself what a reasonable
caregiver would do in similar circumstances with similar
experience and education. Failure to report suspected abuse can
lead to a fine or imprisonment. You may not report abuse
anonymously; however, your identity will be protected if you do
make a report.
There are several avenues to report abuse; one is to call 1-888-
357-9339 to report abuse/suspected abuse of persons in care,
reporting to the RCMP if the client’s life is in danger or the
alleged abuse is criminal in nature, reporting to a professional
regulating body if the alleged abuser is a licensed health care
provider. For example: CARNA, or reporting to the Mental
Health Client Advocate if the alleged abused is detained in a
care facility or under a community treatment order.
Roles and Responsibilities Alert
As a member of the health care team you are required to
safeguard the client. Many of those you will care for cannot
protect themselves and will need you to advocate for them. If
you are aware of, or reasonably believe abuse has or is
occurring, you MUST report to the appropriate authority, failure
to do so can result in a fine.
Definition of Abuse
Abuse, according to the Protection for Persons in Care Act, is
defined as:
• intentionally causing bodily harm
• intentionally causing emotional harm through such acts as
threatening, intimidating, harassing, humiliating, coercing,
or restricting social contact
• intentionally administering or prescribing medication for an
inappropriate purpose
• subjecting the person in care to non-consensual sexual
contact, activity, or behaviour
• intentionally misappropriating (using wrongly) or
improperly or illegally converting money or other valuable
possessions of the person in care
• intentionally failing to provide adequate nutrition, medical
attention, or other necessities of life without a valid consent
Common Factors That Increase the Incidence of
Abuse
Investigators have identified a number of common factors that
seem to increase the incidence of abuse. They are:
• lack of cooperative teamwork resulting in the client being
caught in the middle
• concerns about family dynamics causing problems for
residents and staff
• failure to report abuse by management
• residents feeling threatened that they will be punished if
they report abuse
Abuse in Care
The most common types of abuse in care are:
• emotional
• financial
The most prevalent abusers are (in the following order):
• service providers
• co-residents
• family
Duties and Responsibilities Associated With the
PPICA
Duties of the Employing Agency
The employing agency also has specific duties listed in the Act.
• Every agency must require that each new employee and new
volunteer provide a criminal record check
• Every agency has a duty to protect the clients from abuse
and to maintain a reasonable level of safety for clients
• Every agency must make sure that all clients, employees,
and service providers are aware of the content and
requirements of the Act
• Employers must have policy and procedure that reflect the
Act
• The employer will conduct an internal investigation separate
from the external investigation
Protection for the Person Reporting Abuse

The Act protects from punishment those persons reporting
abuse. No employer can in any way punish a person or service
provider who makes a report of abuse. The employer can be
fined for punishing a person who makes a report of abuse. Any
person who discontinues or threatens to withdraw care of the
client because abuse has been reported can be fined.
False Reporting of Abuse
The Act attempts to protect persons from false or malicious
reporting of abuse. False or malicious reporting of abuse is a
serious offence with serious consequences. Any person who
reports abuse to cause harm to another or without reasonable or
probable ground that abuse has occurred may be fined.
Self-Care if you are reported to the PPICA Office
It is important to ensure that you seek support and professional
assistance if the stress of undergoing the investigation is
interfering with your ability to function effectively in your
personal and professional life. Most agencies have an employee
assistance program through which a care provider can seek
confidential counseling if required.
Exercises
A. True and False: PPICA
• You can report abuse anonymously. T F
• One of the most common groups of T F
abusers is caregivers.
• Neglect is one type of abuse. T F
• You may lose your job if you report that a T F
client has been abused.
• If you suspect abuse, the most important T F
thing you should do is ensure the client’s
safety.
B. Case Study 4: PPICA

Read the following Case Study and then answer the questions
that follow.
As you are walking down the hallway one day, you pass a
client’s room where the door is partially closed. Suddenly you
hear what sounds like a slap, and the client says, “Ouch, that
hurt.” When you enter the room, the client has some tears on her
cheeks, but the HCA working with her says, “It’s OK. I have
everything under control in here.” When you ask the client
whether she is OK, she just hangs her head and keeps crying.
1. What should your first action be?
• Is this a reportable incident? If so, how do you report the
incident?
• What should you do if you know that the HCA working with
the resident is on probation and could lose her job if there is
one more complaint about her?
Section 7
SLO 2.13 Describe the Adult Guardianship and Trusteeship Act
SLO 2.14 Discuss the effect of the Adult Guardianship and
Trusteeship Act on the role and responsibilities of the
HCA
Learning Activities
• Read “Dependent Adults May Require a Legal Guardian or
Trustee” in the Learner Guide
• Read “Dependent Adults are Members of the Health Care
Team” in the Learner Guide
Articles
Dependent Adults May Require a Legal Guardian or Trustee
In Alberta, a dependent adult is defined as an individual who:
• is 18 years or older
• is continuously or repeatedly unable to safely care for
himself or herself
• has a mental disability caused by a developmental delay,
acquired brain injury, chronic mental illness, or a disease
associated with aging
Guardians and Guardianship Responsibilities
The needs of dependent adults vary from one individual to
another. As the needs and capacities of adults vary, so too do the
responsibilities of the guardian. All guardians, both public and
private, are appointed by the courts.
Private Guardians
A private guardian is an individual who is 18 years of age and
over, usually a friend or relative, who has been appointed by the
court. A private guardian does not need to live in Alberta.
This person must agree to:
• Act in the best interests of the dependent adult
• Encourage the dependent adult to do as much for himself or
herself as the person can
Public Guardian
The Public Guardian is a government official who can act as a
guardian for a dependent adult under the terms of The Adult
Guardianship and Trusteeship Act. Guardianship is handled by
the Office of the Public Guardian, which is part of the Ministry
of Seniors and Community Supports. This office supports
private guardians and assists them in their role.
Both private and public guardians may be responsible for all or
some of the following areas:
• where the dependent adult will live
• social activities
• personal contacts
• employment
• education and training
• licenses and permits
• legal matters that do not include finances
• health care
• daily living routines
Note: A guardian’s responsibility never includes financial
matters.
Trustees and Their Role
Private Trustees
Private trustees are friends or family members who have been
appointed by the court to assume responsibility for a dependent
adult’s financial matters.
Public Trustees
The Public Trustee is a government official who can make
financial decisions on behalf of a dependent adult under the
terms of The Adult Guardianship and Trusteeship Act, if there is
no suitable private trustee available. Trusteeship is handled by
the Office of the Public Trustee, which is part of the Ministry of
Seniors and Community Supports. This office supports private
trustees and assists them in their role.
Role and Responsibility Alert! If there are legal guardians or
trustees in place for clients, there should be a copy of this legal
record on the client’s personal care chart. If you are not sure
who the legal decision maker is for health, personal or financial
matters, you must ensure you clarify this with a health care
professional. It is important for you to ensure you are taking
directions from the appropriate alternative decision-maker for
your client.
Dependent Adults are Members of the Health Care Team
As a member of the health care team, you may be required to
attend family conferences. It is important to know that if a client
is a dependent adult and has a legal guardian, the guardian will
attend the conference on the client’s behalf. It is possible for a
client to be competent to make some decisions in his or her life,
but not all decisions. For example, a client may not be able to
consent to medical procedures because he does not understand
the consequences and risks of the procedure; however, this same
client may be able to decide who he wishes to have visits from
and who he does not want to see.
The Adult Guardianship and Trusteeship Act focuses on the
client’s ability to participate in life decisions. The Act has key
elements that help focus on ability rather than disability. There is
a range of supportive and substitute decision-making options.
Supportive decision making
This allows an adult with capacity to choose a supporter to help
the adult to make decisions in personal matters. The supporter
has access to the client’s personal health information. The client
can discontinue this arrangement at any time.
Co-decision making orders for personal matters
This order takes place when a client has significant cognitive
impairment, but retains the ability to make some decisions with
the assistance of another person.
Specific decision making provisions
When a client has no personal directive or guardian, health care
professionals may need to approach relatives to make specific
decisions on the client’s behalf in emergency or crisis situations.
Temporary guardianship or trustee orders
A court order is required to appoint someone to make decisions
on behalf of an adult who is in danger of death, serious harm, or
financial loss. The court order lasts only 90 days.
Guardianship and trustee orders
These options remain available for adults assessed as incapable,
but there is a more thorough screening process of the applicants
for private guardianship.
It is important that, as part of the health care team, you support
the client in remaining independent in those areas in which he
or she is still able to make choices. In general, the guardian
must be informed of any medication change, treatment change,
upcoming appointments, and change in client condition. The
representative from the Office of the Public Guardian has the
right to review the client’s entire chart. Private guardians must
be referred to the regulated health care professional to have
questions answered about the client’s condition, lab results, and
diagnosis.
– Adapted from Office of the Public Guardian Fact Sheet,
Alberta Seniors and Community Supports, and Adult
Guardianship and Trusteeship Frequently Asked Questions
Information Sheet, Government of Alberta Seniors and
Community Supports.
Section 8
SLO 2.15 Describe the Occupational Health and Safety Act
regarding “working alone” legislation as it relates to the
health care aide’s role and responsibilities
Learning Activities
• Read “Working Alone Safely is a Shared Responsibility” in
the Learner Guide
• Complete “A. Matching Exercise: Working Alone Safely” in
the Learner Guide
Articles
Working Alone Safely is a Shared Responsibility
The Occupational Health and Safety Act defines working alone
as a situation in which an employee is working alone at a
worksite where assistance is not readily available should the
worker become sick or injured or require some other form of
assistance to maintain the worker’s safety.
Health care aides working in home care, group home, or
designated supportive living settings may find themselves
working alone in two of the five categories described in the
Occupational Health and Safety Act.
These categories are:
• employees who travel away from the office to meet clients
• employees who are at risk of violent attack because their
work site is isolated from public view
Hazard Assessment
Both the employer and the employee have a responsibility when
a hazard assessment is being completed. During the hazard
assessment, the employer and the employee work together to
identify unsafe working conditions for the employee who works
alone. During this process, any records of previous unsafe
incidents should be reviewed to ensure that the hazards listed in
the record have been corrected. Then an analysis of the current
working conditions must be made. Input from employees is very
important for the success of the hazard analysis. This also applies
to individuals providing care in facilities where risk is present.
Employees must know how to alert each other for assistance in
case of emergency.
Best Practices for Working Alone
Some best practices that apply to all working alone situations
are:
• proper employee training
• effective communication systems available
• awareness for personal safety
• awareness of how to use the protocols for communication
while working alone or in case of emergency
Proper Employee Training
It is important that all employees be trained in the limits and
scope of their job, as well as in how to handle hazards such as
verbal threats and unpredictable client behaviours. The employee
must review and understand the employer’s policies and
procedures for working alone safely.
Effective Communication Systems
If an employee is working alone, there must be an easily
accessible phone or other communication system that gives
access to an individual designated to assist the employee who is
working alone.
Safe Visit and Travel Plans
Employees who travel from a home base to visit clients in their
own home are at risk while they are travelling and while they are
visiting. Therefore, detailed safe travel and safe visit plans
should be developed.
Safe Travel Plans
Safe travel plans should include:
• properly maintained vehicles
• first aid and emergency supplies
• A travel plan submitted by the employee. In the case of
HCAs travelling to visit rural clients, this would include a
list of the clients and scheduled visit time, as well as
checking in when arriving at and leaving a client’s home.
Safe Visit Plans
These plans may include:
• asking a client’s family to be in attendance during the visit
• assigning two staff members to the client if there is an
identified risk
• meeting the client at an alternative location, such as making
plans to bathe the client at a lodge or care facility if there is
an assessed risk of working alone with a client
• ensuring that there is an effective communication system
and a resource person readily available to you as a worker
• reporting incidents of when the caregiver’s safety was, or
could have been, at risk
Adapted from Working Alone Safely: A Guide for Employers
and Employees, Government of Alberta Employment and
Immigration, 2000
Exercises
A. Matching Exercise: Working Alone Safely
Match the actions in the left column with the corresponding
aspect of working alone safely in the right column.
• ___ The employer and employee • Safe visit
work together to identify potential plan
dangers of working alone.
• ___ Family members may be asked • Employee
to be present during a home care safety
visit. training
• ___ The supervisor calls the • Safe travel
employee at scheduled times. plan
• ___ An employee is instructed in • Defined as
how to protect herself during an “working
aggressive attack. alone”
• ___ An employee submits a detailed • Good
list of the day’s activities to the communic
employer before leaving the office. ation
system
• ___ An employee travels away from • Occupatio

the office. nal Health
and Safety
• ___ This government department • Hazard
developed the “working alone” assessment
legislation.
Section 9
SLO 2.16 Describe the Canadian Charter of Rights and
Freedoms
SLO 2.17 Explain how the Canadian Charter of Rights and
Freedoms affects the HCA’s role and responsibilities
Learning Activities
• Read the article “Basic Human Rights in Canada” in Chapter
9 of the textbook
• Read “Health Care Aides and the Canadian Charter of Rights
and Freedoms” in the Learner Guide
• Complete “A. Case Study 5: A Violation of the Charter” in
the Learner Guide
Articles
Health Care Aides and the Canadian Charter of Rights and
Freedoms
The Charter is long and complicated, but it is of vital importance
that you understand some parts of it when you are working as
part of a health care team. Some of the key rights and freedoms
that pertain directly to your role as a health care aide are
discussed below.
Freedom of Religion
As part of a care team, you must support the clients’ freedom to
practice their faith even if a faith expression is very different
from your own. Most importantly, you must never try to
“convert” a client to your own faith expression or religion. At
times of illness and stress, and during dying and after death,
honouring the religious practices of individual clients and their
families is very important.
Freedom of Thought
Life would be easier if we all thought the same way, but it would
also be much less interesting. Your client may belong to a
different generation than you or have been raised with different
religious, cultural, and social beliefs than yours. This does not
mean that one of you is right and one of you is wrong. What it
does mean is that you, as a trained health care provider, must
never argue with or criticize the client for the way he or she
thinks. Set personal and professional boundaries and listen to the
client in an open and non-judgmental way. Never try to debate
who is right and who is wrong. Share your personal thoughts
only in a general and non-threatening way.
Freedom of Expression
This freedom can apply to many areas of the client’s life, but
one particularly important aspect for health care aides is the
freedom of sexual orientation. Not all of your clients or
coworkers will be heterosexual. This may be uncomfortable for
you, but it is not the HCA role to be judgmental. Each client is
an individual no matter what the person’s social, religious or
sexual orientation may be. As a trained health care provider, you
must first look at each individual as a unique and valuable
person with strengths and weaknesses. Never judge a person on
just one aspect of who the person is, and never try to change that
aspect of the person.
It is easy to say we will honour each person’s rights as they are
guaranteed under the Charter; however, it is sometimes very
challenging to do so. Stop, think, and consider before speaking
or acting when you find yourself assigned to work with a client
whose religious, social or cultural background does not fit with
your own. If you are really struggling with your client
assignments, talk to your supervisor.
Exercises
A. Case Study 5: A Violation of the Charter
Read the following Case Study and answer the questions that
follow.
A First Nations resident named Linda lived in a continuing care
facility. She had several chronic conditions, including partial
blindness. Linda was a Christian; however, she also followed
some of her People’s traditional teachings and practices. Around
her neck she always wore a “medicine bag” which was sacred to
her. Some of the staff were very critical of the medicine bag and
called it “a filthy rag” and a lot of “hokus pokus.” One day when
the staff were giving Linda a bath, they decided to cut the
medicine bag off and throw it in the garbage. Before throwing it
out, they opened the medicine bag and looked inside. Linda
became very upset about the actions of the HCAs and
complained to the nurse. When the staff were asked to explain
why they acted the way they did, they replied that it was “just a
dirty old thing filled with garbage” and that it could “cause
infections.”
1. Which of Linda’s rights and freedoms were violated?
2. Why do you think that the HCAs reacted the way they did
about the medicine bag?
• What would your own reaction to this client’s practices have
been?
Section 10
SLO 2.18Use the terminology associated with the legislation
governing the HCA’s role and responsibilities
Learning Activities
• Complete “A. Fill in the Blanks: Terminology Related to
Legislation” in the Learner Guide
• Refer to the Glossary in this module
Exercises
A. Fill in the Blanks: Terminology Related to Legislation
Fill in the blanks with the correct words from the word list.
Word list: indirect supervision, direct supervision,
confidentiality, private guardian, public guardian, hazard
assessment, restricted activity, activities of daily living, religious
freedom
• If your supervisor is present while you perform an assigned
task, this is an example of _____________________.
• A friend or relative who is appointed by the court to make
decisions on your behalf, but not financial decisions, is called
a ______________________.
3. If the regulated health care professional is available to you
by phone while you perform an assigned task, this is called
_______________________.
• You must maintain ___________________ about client
information.
• Tasks that clients would normally perform for themselves are
referred to as ______________________________.
Section 11
SLO 2.19Describe a caring attitude as it relates to the Alberta
health care legislation
SLO 2.20Describe client observations as they relate to the
Alberta health care legislation
SLO 2.21Describe the importance of accurate recording and
reporting of client changes as governed by Alberta health
care legislation
SLO 2.22Describe ensuring client comfort and safety as they
relate to the legislation
Learning Activities
• Read “Applying the ‘ICARE’ Model to Legislation” in the
Learner Guide.
Articles
Applying the “ICARE” Model to Legislation
One question you should ask yourself each time you learn new
theory in this program is “How can I use this information to
become a skilled HCA?”
One of the ways is to take the information you have learned and
apply it using the “ICARE” Model.
C When you give compassionate care to a client, it is important
to ensure that all of your actions will be helpful and not
harmful. By knowing and following the legislation that guides
the HCA role and responsibilities, you can ensure that you
honour your clients’ individual rights and freedoms in a way
that is personal and meaningful to them. You will encourage
your clients to make decisions for themselves and remain as
independent as possible.
A Accurate observations are vital. The Protection for Persons in
Care Act requires vigilant observation and the Adult
Guardianship and Trusteeship Act require the members of the
health care team to recognize when an individual’s cognitive
ability is changing. The “working alone safely” guidelines of
the Occupational Health and Safety Act make observation of
unsafe or hazardous work conditions mandatory.
R Always report and record in a timely manner. Report and
record any specific care needs of a client based on culture,
religion or social background. Report abuse according to the
Protection for Persons in Care Act and employer policy and
procedure. Remember the Health Information Act and
Freedom of Information and Protection of Privacy Act when
making verbal or written reports. Client confidentiality is
vital.
E Ensure client comfort and safety. Your first obligation at all
times is to ensure client comfort and safety. Share information
only with those people who are official guardians and the
health care team. Prevent and report any suspected or
observed abuse immediately. Always ensure that the client is
safe as a first step in the case of abuse. Understand what is in
a client’s personal directive, and plan care in a way that
honours the client’s wishes after the client is no longer able to
help plan his or her own care.
Answer Key for Module 2 Exercises
Section 1
A. Case Study 1: Supervision and Assignment of Task I
• You are required to tell your supervisor that you have not
been trained in this task and have never administered
medication by application of medicated patches.
• You need to be trained by a health care professional from
the agency. Even after training, you would administer the
medication only under direct supervision until you could
demonstrate competency in performing that task on that
particular client.
• You must check agency policy regarding the types of
medications that HCAs are allowed to administer.
B. Case Study 2: Supervision and Assignment of Task II
• Inform your supervisor of the tasks that you feel
comfortable doing and request adequate training in the
tasks that you cannot do because you have no training or
experience in them.
• Ask your supervisor to demonstrate the task and then to
observe you doing the task until you feel comfortable and
safe in performing the task under indirect supervision.
• Ask your supervisor to observe you performing the task
and to provide feedback.
• Ask your supervisor to set up further training in tube
feeding. The agency must arrange to have health care
professionals provide training and direct supervision until
the HCA can demonstrate competency in the following
procedures: checking the feeding tube position,
administering tube feedings, and flushing of feeding tubes
and bags. After the HCA has demonstrated that she is
competent in these procedures, she can perform them under
indirect supervision unless the client’s condition becomes
unstable or the tube feeding procedure is changed.
Section 2
A. Case Study 3: A Request for Client Information
You are working the afternoon shift in a designated supportive
living facility with another HCA. You are being indirectly
supervised by a nurse from home care. Just after supper, you
receive a phone call from an old friend of Joe, who is one of the
clients. The friend would like an update on the client’s recovery
from recent surgery and would also like to know whether the
client has received any visitors this week.
Which of the following responses would be the most appropriate
for you to make in this situation?
1. “May I take your name and number? I will have the
home care nurse call you.”
Section 3
A. True and False: The Health Information Act and FOIP
1. T 4. T
2. F 5. F
3. T
Section 6
A. True and False: PPICA
1. F 4. F
2. T 5. T
3. T
B. Case Study 4: PPICA
1. Your first action should always be to ensure client safety. If
you believe that the HCA providing care slapped this client, then
do not leave the client alone. Quietly ask the other caregiver to
leave or stay in the client’s room until the care is complete.
2. If you have reasonable grounds to believe that abuse has
happened, you must report the abuse. Call the toll-free number
to make the report to the government office and follow your
employer’s policy and procedure for reporting abuse.
Remember, never allow yourself to be talked out of or
threatened out of making the report if you believe abuse has
occurred.
3. Your responsibility is to the client’s safety. Although you may
feel sorry for the other staff member, your first duty is always to
the client. It is up to your manager to determine the action to
take with the staff member after the internal investigation has
been completed and policy and procedure have been followed.
Section 8
A. Matching Exercise: Working Alone Safely
1. g 5. c
2. a 6. d
3. e 7. f
4. b
Section 9
A. Case Study 5: A Violation of the Charter
1. The client’s freedom of religion was violated. In addition, her
right to privacy was violated. The staff had no right to look
into the medicine bag. It was personal and sacred.
2. It appears that the HCAs did not understand the traditional
First Nations religious practices, and perhaps were prejudiced
against this woman. In addition, they may not have accepted
that this client practiced parts of two different religions.
3. Answers will vary
Section 10
A. Fill in the Blanks: Terminology Related to Legislation
1. direct supervision
2. private guardian
• indirect supervision
• confidentiality
• activities of daily living
Module 3: Function Effectively as a Team Member

A vital role of the HCA is being a contributing member of the
health care team. The HCA learns valuable information during
client care and shares that information with other members of
the health care team, contributing to a safe plan of care for the
client. Documenting on the client chart, reporting to supervisors,
and participating in team meetings are all communication
methods by which client information is shared. As a member of
the health care team, the HCA must work closely with clients
and families, be organized, and be able to make decisions and
solve problems, keeping the client as the central focus of all care
decisions.
Glossary
Word Meaning
Accountable To be able to justify and take
responsibility for something, someone,
or actions
Chronic A health condition that requires ongoing
condition health treatment over a long period of
time
Collaborate To willingly work together
Competent Having knowledge and ability to perform
a skill successfully
Diversity Difference; variety
Intimidate To create fear through the force of
personality or authority
Palliative care Health care focusing on reducing
symptoms of disease and promoting
comfort and quality of life
Pandemic Spread throughout the world
Personality A resistance between two or more people
conflict because of a difference in personalities
Regulated A health professional who meets the
health education and training requirements of a
professional regulatory body to obtain a license to
practice a certain profession
Restricted A care activity that can only be
activity performed by a health professional who
has received the training and
demonstrated competence
Team A group of people working together
towards a common purpose
Section 1
SLO 3.1 Describe the concept of team and the goal of a health
care team
SLO 3.2 Describe trends in health care that have increased the
need for care providers to work in teams
Learning Activities
• Read the article “What is a Team?” in the Learner Guide
• Read the article “Trends in Health Care” in the Learner Guide
• Complete “True and False: Working in a Team” in the Learner
Guide
Articles
What is a Team?
A team is a group of people working together for a common
purpose. A team may consist of members with similar skills,
experience and knowledge, but often includes members with
different skills, knowledge, and varying levels of expertise.
Team members often have skills that complement each other.
This helps to contribute to the diversity and strength of the team.
A team may work together for a long period of time (Boards of
Governors that plan the business of a company) or a short period
of time (planning the Christmas party at work). It is common for
a team to come together when the tasks to be completed or
problems to be solved are complex.
The purpose of a team is to combine the knowledge, skill, and
experience of team members to achieve a common goal. Each
member of the team has a role to play in the achievement of the
goal. If one person conducted all of the tasks that are required to
reach the same goal as the team, it is likely that the goal would
not be reached or not be achieved to the same degree as if it
were completed by a team.
Teamwork is based upon trust. Trust is developed when each
member:
• commits to the plan
• is accountable for their actions
• is responsive to the needs of the team
Trends in Health Care
Health care is in a continuous state of change. Research
produces new knowledge that changes the way health care is
practiced. The following list describes some of the major trends
influencing health care today.
Advances in technology - Ongoing research and developments
in technology have changed the way clients are treated in
hospitals. New surgical procedures have decreased hospital stays
and improved ways to diagnose illness. Hospitals are also
starting to adopt new technologies to maintain electronic health
records and charting systems. This means that physicians’
orders, laboratory results, and nursing notes may all be recorded
electronically.
Focus on safety - Since the groundbreaking report from the
Institute of Medicine was released in 1999, health care has been
focusing on various communication practices that translate into
a safer health environment for clients:
• communicating using clear communication strategies
• sharing client information among all health care
professionals
• managing health care providers’ workloads
• preventing disruptions and interruptions during nursing
tasks
People are living longer - As the life expectancy of the
population continues to increase, people with chronic conditions
are living longer and will require more health care during their
lifetimes.
Chronic illness - People can live for many years with chronic
conditions such as diabetes and heart disease but also experience
complications that require treatment and ongoing management.
Shorter hospital stays - Advances in technology and
procedures mean that clients don’t need to be in the hospital as
long as used to be the case. Once discharged from hospitals,
many clients are cared for at home by their families or by
community nurses and health care staff. This helps to decrease
hospital costs, but increases the need for knowledgeable and
experienced health care professionals in the community.
Cultural and ethnic diversity - The influx of immigrants from
countries around the world into Canada means that health care
professionals require knowledge of a variety of cultures, their
customs, and health issues that affect various ethnic groups.
Threat of pandemic illness - The world has been exposed to
new health threats such as AIDS, SARS, deadly strains of
influenza, and antibiotic-resistant organisms. As these new
illnesses arise, it is critical to be well-prepared in preventing the
spread of organisms and infection from one person to another,
and from clients to health care professionals.
Exercises
A. True and False: Working in a Team
• A team is a group of people who carry out tasks T F
to achieve a common goal.
• A team works together only for a short period of T F
time.
• The skills of team members do not usually T F
complement each other.
• Shorter life spans and longer hospital stays are T F
growing trends in health care.
• Health care teams consist of members from a T F
variety of health disciplines.
Section 2
SLO 3.3 Describe the role and unique contribution of health
care team members
SLO 3.4 Describe the importance of the client and family as
collaborative members of the health care team
SLO 3.5 Identify the goal of teamwork in health care
Learning Activities
• Read “Roles and Unique Contributions of Health care Team
Members” in the Learner Guide
• Read “The Importance of Client and Family as Part of the
Health care Team” in the Learner Guide
• Read “The Goal of Teams in Health Care” in the Learner
Guide
• Complete “A. Matching Exercise: Professional Roles” in the
Learner Guide
• Complete “B. Questions” in the Learner Guide
Articles
Roles and Unique Contributions of Health Care Team
Members
Each member of the health care team contributes by bringing
unique knowledge, skill, and experience that contribute to
achievement of client goals. Understanding the role of each
member helps the HCA to know how they best fit into the health
care team. The following health professions are all regulated and
have legally defined roles and scopes of practice:
Physician (Dr): A doctor who is qualified to practice medicine
Advanced Nurse Practitioner (NP): Registered nurse with
advanced education and clinical experience that integrate
diagnosing, treating health problems, and prescribing
medications into his/her nursing practice.
Registered Nurse (RN): A nurse who works to enhance the
health of the client, whether the client is an individual, a family,
a community or a population. RNs focus on the whole client
from biophysical, emotional, cultural, spiritual, psychological,
and social points of view.
Licensed Practical Nurse (LPN): A nurse with a scope of
practice separate from the registered nurse. LPNs are frontline
nurses with a focus on caring for individuals, families, and
communities.
Registered Psychiatric Nurse (RPN): A regulated nurse who
works primarily with clients who have a mental illness or
psychiatric disorder.
Respiratory Therapist (RT): A therapist who provides care to
clients to address respiratory issues.
Physiotherapist (PT): Works with clients to improve and
maintain physical mobility and independence, manage pain, and
improve overall fitness and health.
Occupational Therapist (OT): Trained in physical and mental
health to help clients to recover from illness or injury and return
to regular living activities such as work, caring for oneself, or
enjoying leisure activities.
Pharmacist: Focuses on medication therapy for clients. Their
expertise lies in medications, how they work, how they should
be used, and how they will best benefit the client.
Dietitian (RD): Regulated health professional with specialized
education in food, diet, and nutrition.
Recreation Therapist (RT): Works with clients with illnesses
or disabilities to improve their health and quality of life through
leisure and recreation.
Social Worker (SW): Works with individuals, families, and
groups to deal with issues in their lives related to relationships,
illness, disability, poverty, unemployment, and substance abuse.
Speech Language Pathologist (SLP): An individual who
assists clients with speech and swallowing issues.
Figure 1. The Health Care Team
The Importance of Client and Family as Part of the

Health Care Team
Members of a health care team work together to achieve goals of
the client. It is important to include the client when setting goals
for their health. When clients participate in their own health care
planning, they experience higher satisfaction and an improved
quality of life.
The client may have views of health and values that are different
from those of the health care team. Health care team members
must put their own health beliefs and values aside and develop
the plan of care with the client’s values in mind. Including the
client in health care goals allows him/her to bring his/her own
knowledge, experience, and skill to the health situation.
In many cases, family members are active members of the health
care team. Family members are often involved in the care of the
client during a period of illness. Families hold a unique
perspective because they know the client as a whole person and
not as a set of health issues. Including the family in the care
planning for a client reassures the client that his/her best
interests are important to the health care team.
The Goal of Teams in Health Care
As the face of health care changes, teams are needed to plan and
provide safe, specialized, and efficient care for the client. It is
internationally recognized that a comprehensive assessment of a
client is required as a necessary part of health care provision.
Health care clients require a team of health care professionals to
manage their health. For example, a client with high blood
pressure may need to consult with the following members of the
health care team:
• a physician for prescriptions to manage the client’s blood
pressure
• a pharmacist to discuss side effects from medications
• a nurse to monitor blood pressure
• a dietitian to talk about nutritional requirements and weight
management strategies
In order for the health care team to be effective, each of the
health professionals must work together and share their
knowledge of the client’s health situation, collaborate by solving
problems and making decisions, and share responsibility for the
plan of care for the client to achieve the common goal of the
client’s optimal level of health.
Exercises
A. Matching Exercise: Professional Roles
Match the health care professional with the role they play on the
health care team.
1. ____ Social worker • Provides client care from biophysical,
social, and cultural points of view
2. ____ Recreation • Assists the client with tools to live
therapist independently in their home
3. ____ Registered • Includes the client in group
nurse socialization activities
4. ____ Occupational • Teaches the client about their
therapist medications
5. ____ Pharmacist • Treats client health issues and
prescribes medications
6. ____ Nurse • Helps the client to apply for extra
practitioner funding while they are out of work
due to illness
B. Questions
Answer the following questions.
• Why is it important to include the client as part of the health
care team?
• What must the HCA do when the client’s values are different
from their own?
• What can the family contribute as part of the health care
team?
Section 3
SLO 3.6 Examine the benefits and challenges of working on a
team
SLO 3.7 Describe teamwork in facilities and community
settings
Learning Activities
• Read “Benefits and Challenges of Working on a Team” in the
Learner Guide
• Read “Health care Teams in Hospitals and Community
Settings” in the Learner Guide
• Complete “A. Benefits and Challenges of Teamwork” in the
Learner Guide
• Complete “B. “Case Study: Mr. Saddleback” in the Learner
Guide
Articles
Benefits and Challenges of Working on a Team
Working on a team is a skill that comes naturally to some people
and must be learned by others. When working toward a common
goal, it is important to understand how you can best meet the
needs of the team, and perform your role to the best of your
abilities.
Benefits of Working on a Team
• Better decisions can be made when all members of the team
share their knowledge, skills, and experience.
• Problem-solving is more effective than if one person were
to attempt to solve the problem on their own.
• When team members collaborate, or work together, a
positive environment is created for both the team and the
client. Your knowledge of how the client manages self-care
is an important contribution to the overall health and
quality of life of the client.
• Sharing information about the client with the team
contributes to safer client care. For example, when you
share information regarding a client who is having
difficulties transferring from the bed to the wheelchair, the
health care team can support you and the client by
enhancing his/her exercise routine during physiotherapy,
and by adding a handrail to the bed to help the client during
the transfer. Withholding this information and having the
client continue to transfer with difficulty from the bed to
the wheelchair continues a situation in which the client may
be injured.
• Communication between team members is improved when
team meetings are held and unique knowledge of the client
is shared. For example, if the family would like the client to
eat one home-cooked meal each day, the team can decide
how to accommodate this wish in a way that benefits the
client and that works with the tasks of team members.
• Knowledge, experiences, and perspectives are shared with
all members of the health care team. As a HCA, sharing
knowledge about the daily care of a client allows other
health professionals who have less contact with the client
(such as a pharmacist or dietitian) gain a broader
understanding of the client.
• A trusting environment is created when team members
share information and work together to solve problems that
promote the quality of life for the client. Team members
gain a sense of trust when all members take responsibility
and complete their tasks while following the plan
developed as a team.
• Team members support each other during difficult times.
For example, if a client’s health is deteriorating, team
members are available to support not only the client and
his/her family, but all team members involved in the care of
the client.
As much as there are benefits to teamwork in health care,
there can also be challenges. Understanding the challenges
can help to prepare team members for possible conflict
situations and ways to work through conflict to maintain a
positive environment.
Challenges to Working on a Team
• Each team member has a unique role with boundaries that are
assigned to that role. Each institution has policies and
procedures that outline the parameters each team member,
including the HCA, must work within. Each regulatory body
outlines a scope of practice under which team members must
abide. It is important that each member work within their
professional boundaries, and only perform tasks that are
permitted by their profession, employer job description, and
facility policies.
• Team members need to be flexible to meet the overall needs
of the team in meeting the client goals. If the client does not
want to have a bath in the morning, then routines may have to
be adjusted so the client’s health goals can still be met. This
may require rescheduling of client care, recreation activities
or meal times.
• Disagreements between team members should be expected.
Team members make decisions to support the goal, but
sometimes errors in judgment happen. If you are having
difficulties working with another team member, it is
important to do the following:
• approach the team member with your concern in a
constructive manner
• take responsibility for your actions
• listen to the perspectives of others
• discuss issues as they arise
• involve the team leader/supervisor when necessary by
discussing the issue and help to come up with a solution
• The role of the HCA on the health care team is as important
as the role of the physician, registered nurse, physiotherapist
and other regulated health professionals. At times, the HCA
may feel intimidated by the authority and expertise held by
other members of the health care team. But information
shared by the HCA with the team is critical in determining
the Care Plan for each client. Since the HCA spends the most
time with the client, it is important to share client information
with the team.
Health care Teams in Hospitals and Community
Settings
Clients require a team of health care professionals to manage
their care. It requires coordination, collaboration, and
communication among all members to ensure the client receives
the care required. Health care Teams are critical because one
health care professional cannot provide all of the care needs of
the client. Different teams exist in the hospital and community
settings, but each has a common goal - to provide the client with
the best care.
Health care Teams in Hospitals
In hospitals, there are different types of teams depending upon
the hospital, the type of unit, and the client. Each requires the
coordination of health care services from various health care
professionals to provide around-the-clock care.
Medical-Surgical Teams - These teams consist of health
professionals who prepare the client for surgical procedures,
treat the client following surgery, and prepare the client to go
home after surgery. The team consists of the surgeon, nursing
staff, client and family, and various specialists as required during
the client’s hospital stay.
Rehabilitation Teams - Some clients require extended hospital

stays for rehabilitation due to surgical procedures or to medical
events such as a stroke or a heart attack. Rehabilitation teams
consist of the physician, nursing staff, and rehabilitation staff
such as physical, occupational and recreation therapists as well
as speech-language pathologists. Often, if there is a longer
hospital stay, social workers and dietitians become involved.
Long Term Care (continuing care) Teams - Clients in a long
term care facility are often there for months or years under the
care of a physician and nursing staff. Family conferences are
held every few months after admission, and then at regular
intervals throughout the year to ensure the client’s health and
quality of life are being managed as the client and family
wishes. These clients require a health care team that touches
every facet of their lives including financial assistance,
pharmacy assistance, recreation and leisure, and nursing to
provide assistance with everyday living. Rehabilitation
therapists are often a part of the team to maintain or improve
strength and mobility.
Palliative Care Teams - These teams include specially trained
health professionals who help to manage disease symptoms,
prevent and relieve suffering, and improve the client’s quality of
life. The palliative care team consists of physicians, nurses,
pharmacists, and spiritual advisors who specialize in promoting
quality in the end stage of life. Key considerations are pain
management and counseling to help the client and family deal
with issues related to death. The palliative care team works with
the existing health care team, including the client and family.
Health Care Teams in the Community
In a community setting, health care providers collaborate to
provide health services to the clients who require care in their
homes, assisted living facility or in an outclient clinic. Since it is
more common for clients to complete the recovery process in
their own homes, the community health care team has expanded
to include team members similar to those in hospital settings. In
the community, care is often provided from home care staff or
through a day support program.
Home Care (Community Care) Team – The home care team
includes the same health care professionals found in hospitals. A
case manager, usually a registered nurse, coordinates the care
required by physicians, nurses, pharmacists, rehabilitation staff,
dietitians, social workers, and the client and family. With the
exception of the team working in assisted living facilities and
lodges, members of the home care team do not meet as often as
those in a hospital, but do communicate through verbal and
written reports as well. Documentation from each member of the
home care team is critical for the team to function well.
Day Support Program Team – Clients who require
socialization or recreation activities benefit from the use of a day
support program. The team often includes a recreation therapist
who coordinates the client’s activities with required programs
such as physical therapy and occupational therapy. A day
support team will also include nursing case management (when
required), and support workers from nursing and other health
disciplines.
Exercises
A. Benefits and Challenges of Teamwork
Read the following statements and choose if it describes a
benefit or challenge to working on a team.
• Mr. Smith does not agree that his wife should have a bath
today.
• The dietitian asks the HCA how often Mr. Sanderson
brushes his teeth.
• The HCA tells the LPN that Mr. Jones had difficulty
transferring into his wheelchair this morning.
• The HCA asks the dietitian if Mrs. Taylor took her
medication today.
• The registered nurse insists that the HCA use four
washcloths when providing morning care.
• The HCA is nervous about telling her supervisor that her
client won’t eat.
• The physiotherapist brings a custom-fitted wheelchair for
Mrs. Shelley.
• The physician orders a medication to help the client sleep
through the night.
• The social worker and family member do not have the same
idea for the client goal.
• Two HCAs help each other when their coworker is sick.
B. Case Study: Mr. Saddleback
Read the following Case Study and answer the questions that
follow.
Mr. Saddleback is an elderly man who was admitted
yesterday to a long term care facility. Prior to his
admission, he was living alone in his home with the help of
home care. Mr. Saddleback’s health has been getting worse.
He has had trouble breathing and he has fallen three times
in the past week. He has cuts and bruises on his left
shoulder, both knees, and lower legs. Mr. Saddleback says,
“My shoulder hurts when I try to put my shirt on.” In the
morning, the dietitian greets Mr. Saddleback and asks what
he would like for breakfast. He states, “I don’t eat
breakfast, just coffee, please.”
• Which members of the health care team should get
involved in the care for Mr. Saddleback? What part of Mr.
Saddlebacks’ current health situation could these members
address?
• Who would be a reliable source of information about Mr.
Saddleback’s health history?
Section 4
SLO 3.8 Differentiate between direct and indirect supervision
in a facility and in a community-based setting
SLO 3.9 Identify team members who can assign tasks to the
HCA
Learning Activities
• Read “Direct and Indirect Supervision in Facility and
Community-Based Settings” in the Learner Guide
• Read “Assigning Tasks to the HCA” in the Learner Guide
• Complete “A. Supervision Questions: Direct or Indirect” in
the Learner Guide
Articles
Direct and Indirect Supervision in Facility and
Community-Based Settings
HCAs working in facilities and community-based settings are
commonly supervised by an RN or an LPN. Depending on the
work setting, a HCA may work under the direct or indirect
supervision of his/her supervisor. The table below compares
direct and indirect supervision in both a facility and a
community-based setting.
Direct Indirect
Facility The regulated The regulated
Supervisor is a regulated nurse is with the nurse is on site
health professional, most client and and available to
often a Registered Nurse supervises the monitor and
(RN), a Registered HCA while the supervise when
Psychiatric Nurse (RPN) task is being required.
or a Licensed Practical performed.
Nurse (LPN).
Community-based The regulated The regulated
setting nurse is with the nurse is
Supervisor is a regulated client in his/her available for
health professional, most home or in a day- consultation, but
often a Registered Nurse support setting, may not be
(RN) or a Licensed and supervises the actually on site
Practical Nurse (LPN). HCA while the while the task is
task is being being
performed. performed.
Assigning Tasks to the HCA
In Alberta, any regulated health professional can assign tasks to
the HCA. Usually, the HCA will be assigned tasks from a
regulated nurse – an RN, an RPN or an LPN. Assigned tasks are
most commonly related to a client’s daily care.
Exercises
A. Supervision Questions: Direct or Indirect
Read each statement and then circle D for Direct Supervision or
I for Indirect Supervision.
• The RN explains how to change Mr. Killarney’s D I
dressing on his hand.
• The HCA competently performs a care task in D I
the client’s home setting.
• After administering medications, the HCA D I
contacts the supervisor to report that the client
had difficulty swallowing.
• After watching the demonstration, the HCA D I
shows the supervisor how to apply a medicated
cream.
Section 5
SLO 3.10Identify factors that affect decisions about assigning
care activities to the HCA
SLO 3.11Describe the role and responsibility of the HCA during
assignment of care activities
Learning Activities
• Read “Factors Affecting Decisions about Assigning Care
Activities” in the Learner Guide
• Read “Role and Responsibility of the HCA during
Assignment of Care Activities” in the Learner Guide
• Complete “A. Fill in the Blanks: Care Activities” in the
Learner Guide
Articles
Factors Affecting Decisions about Assigning Care
Activities
There are specific factors that determine if care activities can be
assigned to a HCA.
According to the Government Organization Act (GOA), the
HCA can be assigned to carry out a “restricted activity” for a
client if the activity meets all of the following criteria:
• the client is medically stable and the restricted activity is
part of the routine activities of daily living for that client,
and the outcomes are predictable
• the HCA is legally permitted to carry out the restricted
activity
• the HCA has the consent and supervision of the regulated
nurse
• regulations exist that outline how a regulated professional
supervises unregulated workers
• the HCA has received instruction and demonstrates the
competence to perform the restricted activity for that client
• the client is not at risk when the HCA performs the
restricted activity
• the client and/or family have been involved in the Care
Planning and in the assignment of the HCA to a restricted
activity
• the client is assessed on an ongoing basis by a regulated
health professional
• if the client had the ability, he/she would perform the task
him/herself
Role and Responsibility of the HCA during
Assignment of Care Activities
When taking on the assignment of restricted activities, you are
contributing to the efforts of the health care team. As a team
member, you are responsible and accountable for the care you
provide. Before performing any care activity or restricted
activity, ensure that you consider each of the following
statements:
• It is legal for me to perform the task
• The task is in my job description
• I have been trained to perform the task
• I know why the task is to be completed
• I have the experience to perform the task safely
• The current conditions in the environment are safe for me to
perform the task
• I have the proper equipment and supplies, and know how to
use them
• I am confident in performing the task
• If I have concerns about performing the task, I will contact
my supervisor
• I understand the expectations of my supervisor in
performing the task
• I am receiving appropriate supervision for my experience

with the task and the current situation
• If I feel the situation is unsafe, or the client may be harmed,
I can refuse an assigned task
• If I do not feel competent to carry out the task, even if I
have performed the task previously, I will contact my
supervisor
Exercises
A. Fill in the Blanks: Care Activities
Fill in the blanks in each of the statements below related to the
assignment of care activities to the HCA.
• A restricted activity can be performed by the __________ if
the client is medically ____________.
• Once the HCA has been ____________ by the RN, the
HCA can perform the restricted activity.
• The ___________ and/or __________ must participate in
the Care Planning process and agree to assign a HCA to
perform a ___________ activity.
• A HCA can perform a restricted activity if it does not place
the client at _________.
• A ________________________ may be assigned to a HCA
if the client outcomes of the task are _____________.
• A HCA can ____________ to perform a care activity if the
surrounding environment is unsafe.
• To perform a restricted activity, the HCA must receive
_____________ based upon the HCA’s level of experience.
• It is the role of the supervisor to ___________ the HCA
how to perform the restricted activity.
Section 6
SLO 3.12Identify the steps of the Care Planning process in
facilities and in community-based settings
SLO 3.13Describe the function of the client Care Plan
SLO 3.14Describe the HCA’s contributions to the health care
team in the Care Planning process
SLO 3.15Compare objective and subjective data
Learning Activities
• Read “The Care Planning Process in Facilities” in Chapter 14
in the textbook
• Read “The Care Planning Process in Community Settings” in
• Read “Your Role in the Care Planning Process” in Chapter 14
in the textbook
• Complete the review exercises for Chapter 14, #1 to 4 in the
textbook
• Complete the workbook exercises for Chapter 14, #18 to 20,
#21 to 28, #33 to 38
Section 7
SLO 3.16Describe verbal reporting in a facility and in a
community-based setting
SLO 3.17Identify guidelines for providing a verbal telephone
report to a supervisor
Learning Activities
• Read “Verbal Reporting” in Chapter 14 in the textbook
• Read “Client Records or Charts” in Chapter 14 in the
textbook
• Complete the review exercises for Chapter 14, #5 to 10 in the
textbook
• Complete the workbook exercises for Chapter 14, #1 to 17
and #29 to 32
Section 8
SLO 3.18 Describe the concept of time management
SLO 3.19Identify the importance of setting goals to manage
time
SLO 3.20Describe ways to save time and stay organized in the
workplace
Learning Activities
• Read “Time Management” in Chapter 7 in the textbook
• Complete the workbook exercises for Chapter 7
• Complete “A. True and False: Measuring Goals” in the
Learner Guide
Exercises
A. True and False: Measuring Goals
• A goal does not have to be measurable. T F
• Setting goals for more than ten tasks is T F
appropriate.
• Dividing a goal into smaller parts can make it T F
more achievable.
• A clear goal is one that is specific, gives T F
direction, and is focused.
• The statement “I need to do laundry” is a T F
measurable goal.
Section 9
SLO 3.21Describe decision-making as it relates to the role of
the HCA in the workplace
SLO 3.22Identify three skills that help improve decision-making
including focus, flexibility, and decisiveness
Learning Activities
• Read “Decision Making” in Chapter 7 in the text
• Complete “A. Definitions: Decision-Making” in the Learner
Guide
• Complete “B. Matching Questions: Decision-Making” in the
Learner Guide
Exercises
A. Definitions: Decision-Making
Define the following terms using the materials you read from the
textbook:
• Focus
• Flexibility
• Decisiveness
B. Matching Questions: Decision-Making

Match the following terms:
1. ____ Focus • “We decided on this plan, so let’s try it first.”
2. ____ Flexibilit • “Mrs. Peters has to leave the unit at 9:00
y a.m., so Mr. Saunders’ bed will have to
wait.”
3. ____ Decisive • “I can clean the sink or dust the table. Where
ness would you like me to start?”
Section 10
SLO 3.23Identify positive behaviours when working with
colleagues
SLO 3.24Identify positive behaviours when working with
clients and their families
Learning Activities
• Read “Positive Behaviours when Working with Colleagues”
• Read “Positive Behaviours when Working with Clients and
Families” in the Learner Guide
• Complete “A. Questions: Positive Behaviours” in the Learner
Guide
Articles
Positive Behaviours when working with Colleagues
When working with colleagues on a health care team, each
member brings their personality, skill, knowledge, and
experience to meet a common goal. It is an expectation that all
team members work collaboratively, even when there are
differences of opinion, or factors such as stress or personality
conflicts come into play. Whatever the situation, there are
certain behaviours and actions that help to promote a positive
team experience:
• Listen to what team members are saying
• If you are unsure of what team members are saying, ask
questions to clarify the information
• Do not interrupt team members
• Share your knowledge of the client and the situation with
other team members
• Verify what other team members are saying
• Include all team members in the decision-making process
• Be flexible when making changes to the Care Planning
process
• Stay focused on the overall team goals
Positive Behaviours when working with Clients and
Families
Clients and families are an integral part of the Care Planning
process. Your care and communication with the client and
family help to build trust and promote a partnership with the
client, family, and the whole health care team. When working
with clients and families, the following behaviours and actions
will help to promote the client and family as part of the health
care team:
• Listen to the client’s and family’s concerns
• Clarify and verify the information given to you by the
client and family members
• Share the information with appropriate members of the
health care team
• Be flexible when providing care
• Be accountable to the client. Perform client care when you
say you will. If you need to make changes to the original
plan, explain the situation and discuss alternate plans with
your client.
Exercises
A. Questions: Positive Behaviours
Read the following statements and determine if they
demonstrate positive behaviours by circling Y (yes) for positive
behaviours and N (no) if they are not.
• The HCA cleans the client’s kitchen as the Y N
client describes how sad she is that her
daughter is moving away.
• The HCA gives the client a bath on the day that Y N
was planned with the client.
• The HCA states, “I don’t want to hear about Y N
your schedule. There is nothing I can change to
help you.”
• The HCA describes how the client fell to the Y N
supervisor and to the family.
• The HCA asks, “Can you tell me again the plan Y N
for Mrs. Dempster’s meals?”
Section 11
SLO 3.25Identify types of workplace problems that may occur
in facilities and community-based settings
SLO 3.26Describe the problem-solving process including
identifying the problem, analyzing the problem, and
devising a plan
Learning Activities
• Read “Workplace Problems in Facility and Community
Settings” in the Learner Guide
• Read “Problem Solving” in Chapter 7 in the textbook
• Complete the review exercise for Chapter 7, #9 in the
textbook
• Complete the workbook exercise for Chapter 7, #13
• Complete “A. Case Study: Mr. Clarke” in the Learner Guide
Articles
Workplace Problems in Facility and Community
Settings
There are a number of problems related to teamwork that could
occur in the workplace, both in facility and community-based
settings. The HCA should be aware of potential conflict
situations, anticipate client needs, and respond to all situations
by listening and involving the client in solutions whenever
possible, and reporting all outcomes to the supervisor.
Facility Settings
Working with different staff members in a busy environment
with clients with chronic conditions and their families, all of
whom who are experiencing stress, it is not surprising that
workplace problems may arise numerous times during each
shift. These problems can be related to the following:
• facility issues (e.g. the building is unusually cold)
• staff issues (e.g. two staff members called in sick and
there are no replacements)
• client and family issues (e.g. one family is upset over the
care a client is receiving and another client refuses to take
her medications)
Regardless of the setting or the issue, the HCA must be
professional, address issues in a positive and effective manner,
or refer the issue to the regulated health care professional to be
addressed. Promoting and participating in positive teamwork is
everyone’s responsibility.
Community Settings
The work setting in the community is unique, as the HCA often
works in a client’s home without the assistance of other staff.
The HCA, the client, and family members can experience
problems related to the client’s health or have questions about
the care the client is receiving. Family members often become
stressed from the responsibilities related to taking care of their
family member. Just as in a facility, the HCA must report
problems encountered to the team or supervisor. Depending on
the issue, it may only need to be documented in the client chart,
or it may be something that requires contacting the supervisor by
phone for immediate assistance.
Exercises
A. Case Study: Mr. Clarke
Read the Case Study, then number the statements in the correct
order to solve this problem.
The recreation therapist visits Mr. Clarke’s family. The family
asks the therapist if Mr. Clarke can participate in a woodworking
project on Thursday afternoons. Mr. Clarke is scheduled for
physiotherapy sessions Thursday mornings and the HCA knows
that he is usually very tired afterwards. The family tells the HCA
how much Mr. Clarke loves woodworking. What can the HCA
do?
_______ Mr. Clark attends an afternoon physiotherapy session
on Wednesday.
_______ The HCA explains the situation to the supervisor.
_______ The physiotherapist talks to the client about changing
the session to another day.
_______ The supervisor explains the situation to the
physiotherapist.
_______ The recreation therapist includes Mr. Clarke in the
woodworking session on Thursday afternoon.
_______ The HCA talks to the client about the problem.
Section 12
SLO 3.27Use terminology related to functioning effectively as a
team member
Learning Activities
• Complete “A. Matching Exercise: Glossary Terms” in the
Learner Guide
Exercises
A. Matching Exercise: Glossary Terms
Using the glossary in the Learner Guide and key terms in
Chapter 8 in the textbook, match the following terms:
1. ____ Care Plan • Differences; varieties
2. ____ Restricted • Working together
activity
3. ____ Diversity • Take responsibility for care provided
4. ____ Subjective • A document describing the care a client
data requires
5. ____ Accountabl • Having the knowledge and skill to
e complete a task successfully
6. ____ Objective • Information reported by the client that
data cannot be seen by others
7. ____ Collaborate • Task performed by a regulated health
professional
8. ____ Competence • Information seen through observation and
detected by using the senses
Section 13
SLO 3.28Describe the concept of compassionate caring within
the team care planning process.
SLO 3.29Describe client observations that impact the team care
planning process.
SLO 3.30Describe the importance of recording and reporting
client changes related to the team Care Planning process.
SLO 3.31Describe methods to support the team care planning
process.
Learning Activities
• Read the article “Applying the ‘ICARE’ Model to
Functioning Effectively as a Team Member” in the Leaner
Guide
Articles
Applying the “ICARE” Model to Functioning
Effectively as a Team Member
So, now that you have new theory on functioning effectively as
a team member, you can ask the question, “How can I use this
information to become a competent HCA?”
One of the ways is to take the information you have learned and
apply it using the “ICARE” Model.
C – When working as a team member, providing compassionate
care for a client means following the plan of care set out by the
team in order to reach the health goals set for the client.
Including the client’s and family’s preferences within the care
planning process respects the client’s dignity and promotes
independence. Compassionate care includes listening to,
acknowledging, and valuing the input and uniqueness of all
members of the team.
A – When providing care, information collected by performing
accurate observations is important information to share with the
health care team. Sharing observations helps the team to make
informed decisions about client care and contributes to client
safety.
R – Reporting to the supervisor and team members about the
care you provided, or information the client and family has
shared, is a valuable contribution to the health care team in
providing safe client care. Accurate recording on the client chart
provides critical information for other health care members
about the client’s health status at any given moment.
Documenting in the client chart is a legal requirement, and holds
the HCA accountable for the care provided.
E – Ensuring comfort, support, and safety means following the
plan of care determined by the health care team. Ensure client
safety by sharing your experience and client knowledge with the
health care team, and by performing care activities and restricted
activities competently when assigned. It is important to
participate as part of the team following agency policies and
procedures, to take initiative to get things done, and to
contribute to the overall goal achievement of the team.
Answer Key for Module 3

Section 1
A. True and False Exercise
• T
• F*
• F**
• F***
• T
* 2. A team can be long term or short term
** 3. Members’ skills do complement each other, making them
valuable to the team
*** 4. Longer lifespan and shorter hospital stays are part of
the growing health care trend
Section 2
A. Matching Exercise
1. f 4.
b
2. c 5.
d
3. a 6.
e
B. Questions
• The client must be included to set the plan of care that the
client will be willing to work towards. If the team plans
care that the client does not agree with, then the client is
not motivated to commit to the plan.
• When values between the client and the HCA are different,
the HCA must remain focused on the client’s needs, and put
aside his/her own feelings and values.
• Families contribute information about the client as a
person. They can contribute knowledge that affects the care
the client requires, and what the client is able to
accomplish. This helps the team make better decisions
about planning care for the client.
Section 3
A. Compare the Benefits and Challenges of Teamwork
1. 6.
Challen Challeng
ge e
2. 7.
Benefit Benefit
3. 8.
Benefit Benefit
4. 9.
Challen Challeng
ge e
5. 10.
Challen Benefit
ge
B. Case Study: Mr. Saddleback

• Registered nurse (breathing, cuts and bruises), LPN
(breathing, cuts and bruises), dietitian (nutrition, no
breakfast), physician (poor health, breathing, shoulder pain
and falls), physiotherapist (sore shoulder, recurring falls),
occupational therapist (assist with dressing techniques and
assess for or provide assistive device for recurring falls).
• The home care team, the client, and the client’s family.
Section 4
A. Compare Direct Vs. Indirect
• D
• I
• I
• D
Section 5
A. Fill in the Blanks
• A restricted activity can be performed by the HCA if the
client is medically stable.
• Once the HCA has been supervised by the RN, the HCA
can perform the restricted activity.
• The client and/or family must participate in the Care
Planning process and agree to assign a HCA to perform a
restricted activity.
• A HCA can perform a restricted activity if it does not place
the client at risk.
• A restricted activity may be assigned to a HCA if the
client outcomes of the task are predictable.
• A HCA can refuse to perform a care activity if the
surrounding environment is unsafe.
• To perform a restricted activity, the HCA must receive
supervision based upon the HCA’s level of experience.
• It is the role of the supervisor to train the HCA how to
perform the restricted activity.
Section 8
A. True and False Questions: Measuring Goals
• F*
• F**
• T
• T
• F**
*
* 1. A goal must be measurable to make it realistic and
achievable.
** 2. Do not set more than ten goals or it becomes difficult to
focus on the tasks required to meet those goals.
*** 5. “I need to do one load of laundry this afternoon” is a
specific and measurable goal.
Section 9
A. Definitions: Decision Making
Focus - Concentrate on the client and the task at hand when
making a decision. Do not get distracted by other clients or
situations.
Flexibility - Be adaptable and keep the client as the main
focus when making decisions.
Decisiveness - Once a decision is made, commit to that
decision.
B. Matching Questions: Decision-Making
1. b
2. c
3. a
Section 10
A. Questions: Positive Behaviour
• N
• Y
• N
• Y
• Y
Section 11
A. Case Study: Mr. Clarke
• Mr. Clark attends an afternoon physiotherapy session on
Wednesday.
• The recreation therapist includes Mr. Clarke in the
woodworking session on Thursday afternoon.
• The HCA explains the situation to the supervisor.
• The supervisor explains the situation to the physiotherapist.
• The physiotherapist talks to the client about changing the
session to another day.
• The HCA talks to the client about the problem.
Section 12
A. Matching Question: Glossary Terms
Using the glossary in the Learner Guide and key terms in
Chapter 8 in the textbook, match the following terms:
1. 5.
d c
2. 6.
g h
3. 7.
a b
4. 8.
f e
Module 4: Environmental Safety
Introduction
The HCA is responsible for identifying, managing, and
preventing potential environmental hazards in facilities and
community-based settings. The HCA identifies the dangers that
can cause risk for client harm, manages environmental hazards
to minimize harm, and performs actions to prevent risk of harm.
This module highlights how the HCA can identify, manage, and
prevent various environmental hazards. When the HCA correctly
identifies, manages, and prevents hazards, environmental safety
is achieved for the client.
Glossary
Word Meaning
Air quality A term used to describe the characteristics of
air including the smell, taste, clarity, and
temperature.
Ergonomic The science of designing a job, job equipment,
s and workplace to fit the worker. For example,
a desk chair with adequate back support.
Feces The waste matter eliminated from the bowels.
The medical term for stool.
Non-skid A surface designed or produced to prevent or
reduce skidding or slipping. Rubber bottoms
on shoes are non-skid because they prevent
the wearer from slipping or skidding on a
smooth or wet surface.
Pest Any unwanted insect, bug or rodent.
REACT An acronym used to help a health care worker
remember what to do if a fire occurs:
R = Remove those in immediate danger
E = Ensure the doors and windows are closed
A = Activate the fire alarm
C = Call the fire department (911)
T = Try to extinguish the fire only if safe to
do so
Riser A mechanical recliner chair. Also known as a
recliner lift chair, the riser recliner has a mechanical
handset that lifts the chair up and down.
Soiled A piece of linen or clothing that has blood,
laundry vomit, urine, or feces present is considered
soiled.
Urine Liquid waste produced in the kidneys and
discharged from the body. Commonly referred
to as “pee.”
Water A term used to describe the characteristics of
quality water including the smell, taste, clarity, and
temperature.
Section 1
SLO 4.1 Describe environmental hazards and hazard
assessment as they apply to the HCA roles and
responsibilities
SLO 4.2 Describe the WHMIS system as it applies to health
care
SLO 4.3 Identify the dangers of slips, trips, and falls in
facilities and community-based settings
SLO 4.4 Describe strategies for the prevention of slips, trips,
and falls
Learning Activities
• Read “Environmental Hazards and Hazard Assessment” in the
Learner Guide
• Read “Handling Hazardous Materials” (WHMIS) in Chapter
22 of the textbook
• Complete “True or False: WHMIS” in the Learner Guide
• Read “Identifying the Dangers of Slips, Trips, and Falls in
Facilities and Community-Based Settings” in the Learner
Guide
• Read “Risks Associated With Riser Recliners” in the Learner
Guide
• Read “Think about Safety: Measures to Prevent Falls among
Older Adults and Others at Risk” in Chapter 19 of the
textbook
• Complete “Case Study 1: Mrs. Abbott’s House” in the Learner
Guide
Articles
Environmental Hazards and Hazard Assessment
Environmental hazards can be defined as anything in the
environment that can cause risk of accident or injury. Hazards
within the environment can include loud noise, bright or dim
lighting, poor indoor air quality, poor water quality, and poor
ergonomics.
Loud noises can cause future hearing problems and include
repeated loud banging, loud music, and screaming.
Environments that are too bright can cause headaches or visual
problems, and dim lighting can cause trips and falls. Poor indoor
air quality includes air that has an unusual smell, is cloudy, too
cold, and/or too hot. Poor water quality includes water that has
an unusual taste, is cloudy or discoloured, too cold and/or too
hot. Poor ergonomics includes an absence of equipment or
problems with equipment that cause harm. For example, the
client has a bed that cannot be raised up and the HCA has to
bend over to help a client move in bed. Bending over may cause
the HCA to hurt his or her back.
A hazard assessment is a way of determining whether there are
hazards in the environment that can harm anyone, including the
client, a HCA, family members, visitors or anyone else who may
come into the area. One method for the HCA to perform a
hazard check is by asking the following questions:
• Is anyone being harmed due to noise, lighting, air quality,
water quality, or ergonomics in my work environment?
• Could anyone be harmed due to noise, lighting, air quality,
water quality or ergonomics in my work environment?
If the answer to either of these questions is yes, then the role and
responsibility of the HCA is to immediately inform the regulated
health care professional.
Exercises
A. True and False Questions: WHMIS
• Compressed gas may explode when dropped. T F
• Poisonous material will improve illness. T F
• Corrosive material can cause burns to skin. T F
• Flammable material may catch fire if exposed to T F
cold temperatures.
Articles
Identifying the Dangers of Slips, Trips and Falls in
Facilities and Community-Based Settings
A slip or a trip can lead to a fall. Anyone can fall but the risk
increases with age. Every year, one in three Canadian seniors
falls at least once, and approximately 20% of these falls lead to
death. Almost half of the falls among seniors happen at home. In
facilities and community-based settings, the bathroom, stairs,
living areas, and floors are particularly dangerous areas that can
cause slips, trips, and falls.
Bathroom hazards include:
• water combining with soap to make surfaces slippery
• tubs without a secure bath mat
• tubs without a handrail
Stair hazards include:
• lack of handrails
• poor lighting
• items left on the stairs
Living area hazards include:
• general clutter
• phone and electrical cords
• scatter mats
• freshly waxed floors
• spills on the floor
Hazards outside the facility include:
• lawn hoses lying on the ground
• items left by postal and delivery employees
• walkways filled with leaves or ice
Risks Associated With Riser Recliners

A riser recliner is a mechanical recliner chair. Also known as a
lift chair, the riser recliner has a mechanical handset that lifts the
chair up and down. When the chair is lifted up, the person sitting
in the chair can get out of the chair with less strength than would
be needed to push himself out of a regular armchair. The riser
recliner is becoming more popular with senior citizens because
it increases their independence in getting in and out of a chair.
Unfortunately, there have been serious incidents and risks
associated with riser recliners. A senior in 2008 lost his balance
when his chair was lifted to an upright position. When he lost
his balance, he fell and hit his head, later dying in hospital. An
eight-year-old boy in 2000 became trapped in the riser recliner’s
electrically operated lifting and reclining mechanism after
crawling underneath. He activated the seat’s motor, and a metal
bar crushed his throat.
Riser recliners may become unbalanced, causing the user to trip
and fall. Therefore, recliner risers should be checked regularly to
identify signs of instability. Riser recliners need to be an
appropriate distance from the wall so the recliner may fully
recline.
Individuals with balance difficulties are required to have another
person as a standby to ensure the user does not lose balance
when the chair is lifted to an upright position or the user is
standing away from the chair.
Children should be supervised around the riser recliner chair at
all times to ensure that they do not get injured.
Exercises
B. Case Study 1: Mrs. Abbott’s House
The HCA makes a home visit to Mrs. Abbott, a 92-year-old
female who lives on her own. As the HCA walks up the steps of
Mrs. Abbott’s home, she notices ice patches on the steps, but she
holds onto the rail to walk up the steps. Once inside, the HCA
notices Mrs. Abbott’s cane by the front door and sees the non-
skid tip. While showing the HCA around her home, Mrs. Abbott
wears non-skid shoes and her reading glasses. The main floor is
completely covered in hardwood flooring with throw rugs in the
hallway, living room, and kitchen. When the HCA enters the
bathroom, she notices a grab bar in the bathtub, but no bath mat.
While walking to the kitchen, she steps over a phone cord. In the
kitchen, the HCA notices a wet spill on the floor.
Answer the following questions regarding the Case Study:
• What safety measures did the HCA notice on her visit to
Mrs. Abbott?
• What were the safety issues that the HCA noticed on her
visit to Mrs. Abbott that could cause a fall or other harm?
Section 2
SLO 4.5 Describe safety guidelines when using electrical
equipment
SLO 4.6 Explain household management safety, including
guidelines for dealing with pest infestations, linen
washing, and light housekeeping
SLO 4.7 Describe the HCA role and responsibilities in
environmental emergencies such as fire and electrical
hazards, including REACT
SLO 4.8 Describe guidelines for emergency preparedness
Learning Activities
• Read “Accident Risk Factors” in Chapter 22 of the textbook
• Read “Household Management Safety” in the Learner Guide
• Complete “Matching Question: Identifying the Pest” in the
Learner Guide
• Read “Preventing Fires” in Chapter 22 of the textbook
• Read “Evacuating” in Chapter 22 of the textbook
• Read “Box 22 Important Points about Evacuating in the Event
of a Fire” in Chapter 22 of the textbook
• Read “REACT” in the Learner Guide
• Complete “Putting Tasks in Order: Reacting to a Fire
Emergency” in the Learner Guide
• Read “Community Emergencies” in the Learner Guide
• Complete “True and False: Reacting to Community
Emergencies” in the Learner Guide
Articles
Household Management Safety
One role of the HCA is to assist the client to keep a clean,
healthy, and safe home. This article identifies ways in which the
HCA can successfully perform this role by discussing how to
deal with pest infestations, linen washing, and light
housekeeping.
Pest Infestations
A pest can be any unwanted insect, bug or rodent. If not
destroyed, pests can cause harm and/or illness. The pests that are
identified on the following chart include head lice, scabies, bed
bugs, and mice. The chart contains helpful information that the
HCA can use if a pest infestation occurs.
• the “What is it?” column discusses the specific type of pest
• the “What do they look like?” column gives a description of
the pest
• the “How do you know?” column provides the signs and
symptoms of the specific pest
• the “How is it spread?” column tells how the pest can spread
• the “Prevention and control” column gives advice on how to
prevent the pest from spreading
• the “Treatment” column gives the common method used to
destroy or get rid of the pest
Pest What is it? What do they look like? How do you know? How is it spread? P
c
Head lice Parasitic insects that feed on The egg is oval-shaped and A person complains of a • Direct contact with the hair of an infected •
human blood yellow or white in colour. tickling feeling in the hair or person, i.e. using the same comb or
• Can be found on the on the scalp or an itchy scalp. wearing the same hat
head, eyebrows, and The louse is the size of a • Lice do not hop or fly; they crawl. •
eyelashes sesame seed, has six legs, and
• Found in two forms: is tan to white in colour.
egg/nit or louse.
•
Scabies Human itch mite that Tiny microscopic eight-legged A person could complain of Direct skin contact, or by sharing personal •
burrows into the upper layer wingless insect that cannot be the following: items such as clothing or bed sheets
of the skin seen by the eye. • Linear itchy rash,
primarily itchy at night.
• Reddened pimple-like rash
Symptoms can take up to two
weeks to appear and a person •
can be contagious prior to s
showing symptoms. p
t
c
w
h
d
h
•
Bed Bugs Blood-sucking insect that Oval-shaped, flat body with A person could complain of: • From sleeping in a bed that has bed bugs •
cannot fly or jump short head; similar looking to • Itchy red marks on their and travelling in infected clothing.
an apple seed skin • Bed bugs can also live in wooden bed
• Brown spots on mattress frames and furniture
sheets, bed frame or walls
Mice Two common types of mice: House mouse: Has large ears A person may complain of Mice enter into buildings when the colder •
house mice and deer mice and is light brown to dark grey hearing scratching sounds in weather arrives.
with a lighter colour on his the walls or finding
belly droppings, urine, and holes in •
the walls.
Deer mouse: Brown or grey
with a white belly. The •
underside of the tail is white.
•
•
Washing Linens and Clothing

Soiled laundry refers to linens or clothes that have urine, feces,
vomit or blood present. Soiled laundry should be handled as
little as possible to prevent the spread of germs. Before touching
soiled laundry, the HCA should wear waterproof gloves for
protection from body fluids. To minimize touching soiled
laundry, do not sort the clothes until after they are cleaned. Hold
soiled linen away from your uniform and clothes and place it
directly into the soiled laundry hamper. Do not place it on floors
or other surfaces.
Washing clothes in hot water cleans the clothes and decreases
the risk for spreading germs. When clothes are to be washed in
hot water, they should be washed with a detergent in water at
least 71⁰C (160⁰F) for 25 minutes. For drying clothes, high heat
is recommended to further decrease the amount of harmful
germs. Read the drying instructions on each garment’s label.
Use caution when using high water and drying temperatures.
If cold water is used for washing soiled clothing, then bleach
should be used with the detergent. Very soiled clothing needs to
be soaked in lukewarm water and stains scrubbed out by hand.
Bleach should not be needed in every load if the laundry is done
in a person’s own home. Always read instructions on bleach and
detergent bottles to see how much is required. Always read
clothing washing labels to ensure that it is safe to use bleach on
an article of clothing. All client clothing must be handled in a
respectful manner.
Wear gloves for washing heavily soiled linens and clothes and
wash your hands.
Light Housekeeping
Different clients will have different standards of neatness and
cleanliness. One way to handle different standards is to show
respect for the client by asking the client where he or she would
like the items put. Consult clients prior to putting items away or
moving them as the client may want the items where they are.
The HCA performs only the housekeeping tasks identified on
the Care Plan. In order to encourage and maintain an
independent client, never do chores that the client can do.
Safety tips associated with cleaning include:
• keeping all chemical products out of sight and out of reach of
children in a secure cupboard
• closing the caps on cleaning product containers, even if you
are only setting them down for a moment
• storing household cleaners in their original containers and
making sure there are labels on all of them
• always reading the label before using a specific cleaner
• asking for help if you are unsure about the instructions on the
label
• never mixing cleaners together, because some mixtures can
produce harmful gases
• opening windows to let in fresh air when cleaning, to prevent
poor air quality
• wearing rubber gloves to protect yourself from chemicals and
bacteria when using strong cleaners or when small areas of
human waste are present
Tasks associated with the bathroom include:

• cleaning sink and counters – Use hot soapy water with a
capful of bleach or disinfecting household cleaning solution
such as Lysol. Use a clean cloth and clean countertops and
sinks by wiping thoroughly in all surface areas.
• cleaning mirrors
• cleaning and disinfecting toilets and tubs – Using proper
cleaning solutions, wipe all surfaces thoroughly including
rim and base of toilet.
• changing towels
• cleaning the floor by sweeping and vacuuming before
washing with a mop or by hand
• removing garbage – Clean and wipe out garbage can before
replacing bag.
• vacuuming rugs and mats thoroughly
Tasks associated with the kitchen include:
• washing and drying dishes before putting them away
• cleaning the sink after washing the dishes
• cleaning counters and walls behind the counter
• cleaning the tops of the fridge and stove
• cleaning the kitchen floor by sweeping or vacuuming it
before washing it with a mop
• removing old garbage and putting a new garbage bag into
the bin
Tasks associated with the bedroom or living room include:
• picking up any garbage on the floor
• changing bedding covers
• dusting furniture and electronic equipment
• removing accumulated household garbage or other waste
Exercises
A. Matching Exercise: Identifying the Pest
Match the pest to the description.
1. ____ head lice • I invade buildings in colder months.
2. ____ scabies • I can be found on eyebrows.
3. ____ bed bugs • I like to hide under the skin.
4. ____ mice • I like to live in mattresses.
Articles
REACT
REACT is an acronym commonly used in facilities to help staff
members to remember what to do when a fire is discovered.
E = Ensure doors and windows are closed
A = Activate the alarm
T = Try to extinguish the fire if safe to do so
By using the REACT acronym, the HCA is reacting to a fire
emergency.
Exercises
B. Putting Tasks in Order Questions: Reacting to a
Fire Emergency
Number the following actions from 1 to 5 to show the order of
steps a HCA should take if he or she discovers a fire.
_____ Try to extinguish the fire if safe to do so
_____ Ensure that the doors and windows are closed
_____ Call the fire department (911)
_____ Remove those in immediate danger
_____ Activate the alarm
Articles
Community Emergencies
Community emergencies can include fires, floods, and gas leaks,
contamination of food and/or water supplies, and outbreaks of
disease.
The role of the HCA is to attempt to ensure the client’s safety by
following employer policy and procedures and community
disaster plans. Once the client is safe, the HCA must always
notify the supervisor of the situation so that further instructions
can be received.
How does the HCA keep the client safe during a fire?
• remove those in immediate danger
• ensure the doors and windows are closed
• call the fire department (911)
• if possible, try to extinguish the fire
• basically following the REACT principles, but without
activating the alarm because most community settings do
not have an alarm to activate
• as you are taking the client out of the building, knock on the
neighbors’ doors, yelling “FIRE!”
• if the client lives in a house, notify the client’s neighbors
that there is a fire
• do not re-enter the building once you are out
How does the HCA keep the client safe during a flood?
• remove the client from the flooded area
• if it is safe to do so, ensure that the power and natural gas in
the area are shut off
• avoid any downed power lines and avoid standing in water,
which may contain glass and metal fragments
• Return to the home only when told to do so. Upon returning
into the home, do so in daylight so that no lights need to be
turned on.
How does the HCA keep the client safe during a gas leak?
• remove the client from the home if you smell gas or a
“funny odour”
• notify the gas company or the fire department
How does the HCA keep the client safe during a tornado?
• take the client into the basement as that is the safest place
• if there is no basement or the client cannot get into the
basement, take the client into a room that has no windows,
such as a bathroom or a closet
• once safely in the room that has no windows, cover yourself
and the client with a blanket, sleeping bag or mattress to
protect the client’s and your face and head
How does the HCA keep the client from a contaminated food
or water supply?
• throw away any item of food that is suspected of being
contaminated
• check expiry dates on dairy, meat, and poultry products
• when cooking with meat, poultry or fish, cook until the
product has no pink flesh showing
• clean the knives, counters, and cutting boards with hot water
and soap immediately after use
• while preparing a meal, do not use the same cutting board to
prepare raw meat, poultry or fish and vegetable products
• cover, date, and refrigerate leftovers
• if the water is contaminated or suspected of being
contaminated, use bottled water for drinking, cooking,
cleaning, and mouth care
How does the HCA keep the client safe during disease
outbreaks?
• if a pandemic disease outbreak occurs, keep the client
confined to his or her home as much as possible because
this will reduce the likelihood that the client will become
infected with the disease
• wash your hands and the client’s hands frequently and
thoroughly
• be vigilant about cleaning frequently touched items in the
client’s home
• do not go to the client’s home if you are ill
• visitors to the home may enter the home only if they are not
sick; encourage them to wash their hands
Exercises
C. True and False Questions: Reacting to Community
Emergencies
• To keep clients safe during a tornado, move them T F
to a room with windows.
• If water is suspected of being contaminated, the T F
tap water will be safe to use.
• If a gas leak is suspected, remove the client from T F
the home.
Section 3
SLO 4.9 Describe three types of microorganisms
SLO 4.10 Explain the concept of normal flora
SLO 4.11Identify various routes of transmission of
microorganisms
SLO 4.12 Describe infection and common signs of infection
SLO 4.13 Describe the triangle of infection
Learning Activities
• Read “Micro-organisms,” “Types of Micro-organisms,” and
“Normal Flora” in Chapter 23 of the textbook
• Complete “Matching Exercise: Microorganisms” in the
Learner Guide
• Read “Table 23-1: Modes of Transmission of Micro-
organisms” in Chapter 23 of the textbook
• Complete “Fill in the Blanks Questions: Routes of
Transmission” in the Learner Guide
• Read “Box 23-2: Signs and Symptoms of Infection” and
“Focus on Older Adults: Signs and Symptoms of Infection” in
Chapter 23 of the textbook
• Read “Triangle of Infection” in the Learner Guide
• Complete “Questions: Infection” in the Learner Guide
Exercises
A. Matching Exercise: Microorganisms
Match the term to the description.
1. ___ Bacteria a. Microbes that can cause infection
__
2. ___ Viruses b. Microbes that have a protective shell
__ called a spore coat
3. ___ Fungi c. Survive by destroying harmful
__ bacteria
4. ___ Normal Flora d. Microbes that do not cause disease
__
5. ___ Non-pathogen e. Live only on organic matter
__
6. ___ Pathogen f. The common cold is an example of
__ this
Articles
Triangle of Infection
Microorganisms are everywhere: in the air, on our bodies, and
on everything we touch. Some microorganisms need very
specific conditions in which to grow and mature enough to be
transmitted, but most thrive in an unclean environment. That is
why it is important to keep the physical care environment clean.
Not all microorganisms are harmful or disease-producing. In
fact, the body needs many to function. An infection occurs when
harmful microorganisms, also called pathogens, get into your
body and make you ill. Most microorganisms that infect humans
prefer a moist, dark, and warm environment in which to grow.
Kitchens, bathrooms, and laundry rooms are ideal locations for
the growth of microorganisms. Another warm, undisturbed place
on which microorganisms can flourish is dirty equipment.
The body of an animal or a human being provides the most ideal
environment for microorganisms to live and grow because they
provide a warm, moist, and dark environment.
Three factors must be present for microorganisms to spread: a
source, a route of transmission, and a susceptible host. (Note
that the textbook refers to the routes of transmission as modes of
transmission.) If one of these factors is missing, the
microorganism will not spread or be transmitted. To prevent the
spread of infection, you need to be aware of the sources of
harmful microorganisms and the way that they are transmitted.
Figure 1. Triangle of infection
Sources of Infections
All infections need a source that harbors microorganisms
capable of causing disease and illness. These microorganisms
are also called pathogens. There is a variety of sources from
which a person can become infected. The source of infection can
be found in vomit (emesis), feces (stool), and respiratory
secretions, and also in the blood system, in wounds, and in other
body fluids.
The Susceptible Host
The host is the living body or organism that microorganisms
attack. Whether or not the host gets sick depends on how well
the host’s body can fight off the microorganisms. A susceptible
host is one that lacks resistance to a particular pathogenic
organism.
To prevent the host from getting sick, the body’s immune system
or the defenses of the host must be stronger than the
microorganisms. Harmful microorganisms can enter a
susceptible host in the following ways:
• by being inhaled
• through open skin wounds or cracks
• by being eaten
• through mucous membranes when the eyes, nose or mouth
have been touched
• by being bitten by a rodent or insect
Examples of susceptible hosts are:
• infants, especially if not being breastfed
• people who do not get enough nutrition in their diet
• people taking medications
• people having chemotherapy
• people who have just had surgery
• people who have devices in their body, such as shunts, or
who have transplanted organs
• people who are under stress
• people who do not get enough sleep
• people who are dehydrated
• people with a weakened immune system (e.g. HIV/AIDS)
Exercises
B. Fill in the Blanks: Routes of Transmission
Fill in the correct route of transmission. One answer may be
used twice.
• ________________ occurs when touching an infected person.
• Coughing and sneezing are examples
of____________________.
• The least common means of transmission in health care is
______________.
• ____________ occurs when touching a contaminated object.
C. Questions: Infection
Answer the following questions.
• Identify three signs and symptoms of infection.
• Identify three types of susceptible hosts.
• Identify three types of sources of infection.
Section 4
SLO 4.14 Describe factors that increase the risk of infection
SLO 4.15 Describe infection prevention and control
SLO 4.16 Identify routine immunizations for staff and
clients
SLO 4.17 Describe infections associated with the health
care environment and the factors that increase the risk of
infection
SLO 4.18 Explain the development of multidrug-resistant
organisms
SLO 4.19 Describe blood-borne and body fluid pathogens
and how they are transmitted
SLO 4.20 Describe guidelines for routine practices and
transmission-based precautions
SLO 4.21 Describe infection prevention and control
guidelines as they apply to the HCA role and
responsibilities
Learning Activities
• Read “Box 23-3: Factors That Increase the Risk of Infection”
in Chapter 23 of the textbook
• Read the article “Infection Prevention and Control” in the
Learner Guide
• Read “Vaccinations” in Chapter 23 of the textbook
• Read “Factors That Increase the Risk of Infection for Health
Care Workers” in the Learner Guide
• Read “Box 23-4: Twelve Ways the Support Worker Can Break
the Chain of Infection” in Chapter 23 of the textbook
• Complete “Identification: Risk of Infection” in the Learner
Guide
• Read “Multidrug-Resistant Organisms” and “Box 23-1
Multidrug-Resistant Organisms: C. difficile, MRSA, and
VRE” in Chapter 23 of the textbook
• Read “Blood-Borne Pathogens” in the Learner Guide
• Read “Table 23-2: Communicable Illnesses and Diseases:
Care and Immunization” in Chapter 23 of the textbook
• Complete “Identification: Available Immunizations” in the
Learner Guide
• Complete “Fill in the Blanks: Organisms and Pathogens” in
the Learner Guide
• Read “Box 23-6: Medical Asepsis Measures You Should
Follow,“ “Box 23-7: Standard Practices,” “Box 23-8:
Transmission-Based Precautions,” and “Box 23-9: General
Rules for Transmission-Based Practices” in Chapter 23 of the
textbook
Articles
Infection Prevention and Control
Infection prevention and control is the term used for any
measure used to prevent and control the spread of harmful
microorganisms. The following measures prevent infection and
control the spread of harmful microorganisms:
• Immunizations/vaccinations – protect clients, staff, and
family from viruses that cause influenza and hepatitis.
Clients wishing to garden require tetanus shots to protect
them from microorganisms found in the soil.
• Clean technique – ensures that the staff member does not
introduce microorganisms while performing client care.
• Hand hygiene – employees’ and visitors’ hands are the
number one source of microorganisms. Hand hygiene refers
to the use of hand sanitizers as well as hand washing.
• Standard and transmission-based precautions – these are
routine practices that each health care worker should
automatically use to prevent the spread of microorganisms.
They include hand washing, cleaning and sanitizing
equipment, and handling linen and garbage according to the
Infection and Prevention Control guidelines outlined by
your employer.
Factors That Increase the Risk of Infection for Health Care
Workers
Health care workers are at a high risk for getting infections
because they are in constant contact with sources from which a
person can become infected. Sources of infection can be found
in vomit (emesis), feces (stool), blood, and other body fluids.
Factors that increase the health care worker’s risk of infection
include the following:
• the health care worker already has an illness
• the health care worker has cuts or openings on his/her skin
• the health care worker works with dirty equipment
• the health care worker is under uncontrolled stress or
extreme fatigue
• the health care worker works in close contact with an
infected individual
• the health care worker does not wash his or her hands
• the health care worker does not follow standard or
transmission-based precautions
Precautions for Health Care Workers
Health care workers can take a number of precautions to
minimize the risk of infections.
• Always consider the following as potential sources of
contamination and infection:
• blood and all body fluids, secretions, and excretions
• non-intact skin and mucous membranes
• hands, as they carry microorganisms
• surfaces that are exposed to a lot of touching and use
such as door handles, taps, treatment areas, countertops,
and equipment
• Eat well, get proper rest, exercise
• If you have an open area such as a cut on your body, cover
the cut with a bandage and wear disposable gloves.
• Keep your immunizations up to date including the yearly
flu shot, hepatitis B series, tetanus, and rubella.
• If you have an infection that could spread to clients, you
should not work until the infection is gone. If you feel
unwell and are experiencing a fever, a new cough, or a
cough that does not go away, vomiting, diarrhea, or a new
rash, you must stay at home until you are well.
• Always wash your hands before and after performing tasks
to prevent the spread of microorganisms.
Exercises
A. Identification Questions: Risk of Infection
Read each statement and then circle D for a situation that could
decrease the risk of infection and I for a situation that could
increase the risk of infection.
• The HCA did not get enough sleep prior to the D I
start of her shift.
• The HCA has a cut on her finger. D I
• The HCA washes his hands frequently D I
throughout his shift.
• The HCA has a cough and does not feel well at D I
the beginning of the shift.
• The HCA regularly eats foods that have lots of D I
vitamins and minerals.
Articles
Blood-Borne Pathogens
Blood-borne pathogens are harmful viruses and include hepatitis
B, hepatitis C, and human immunodeficiency virus (HIV).
Exposure to blood-borne pathogens and body fluids occurs as a
result of the following:
• needle stick injuries
• cuts from sharp objects contaminated with an infected
client’s blood such as used needles
• blood or body fluids from an infected person coming into
contact with the mucous membranes of your eyes, nose or
mouth
• contact on open skin with an infected client’s blood
• sharing items such as needles, utensils or toothbrushes with
an infected person
• contact with body fluids such as feces, urine, and vomit
• unprotected sexual contact
Role and Responsibility of HCA
All health care providers have the responsibility to protect
themselves and others in the environment from blood-borne
pathogens. By using routine practices while giving care to
clients, the health care worker will avoid contact with harmful
viruses. All care for all clients must follow the routine practices
which include:
• frequent hand washing including washing hands before and
after using disposable gloves
• wearing disposable gloves if there is a risk of coming into
contact with blood or other body fluids
• wearing other personal protective equipment such as gowns
and eye shields if there is a risk of splashing your face or
clothing with blood or other body fluids
• following the employer IPC guidelines for cleaning up a
blood or body fluid spill
• disposing of dressings or linens saturated in blood or body
fluids in a biohazard bag
• disposing of used sharps (needles)in a biohazard container
• following the employer’s policies and procedures for
cleaning reusable medical equipment
First Aid for HCAs Who Have Sustained a Needle-Stick
Injury or Body Fluid Splash to the Eye
One of the most frequent contacts with body fluids is through
the accidental poke (stick) with a sharp object which has come
into contact with a client’s blood. Needles used for injections
and other procedures are referred to as sharps.
Prevention of needle-stick injuries includes the following:
• dispose of needles and other sharp objects used in client
care in a biohazard container designed for that purpose,
immediately after use
• do not scoop up paper and other garbage from the client’s
bedside without checking carefully to see if there is a sharp
that has been left there
If you receive a needle-stick injury:
• wash your hands with soap and water
• report it to the regulated health care professional
immediately
• report to an emergency department within one hour
• follow all Infection Prevention and Control guidelines
pertaining to this injury
• complete all documentation required by the agency’s policy
and procedures
A body fluid splash to the eye can occur when a piece of tubing
containing client’s blood spurts the blood into your eye, a blood
vessel is injured causing a blood spurt, or the contents of a
container holding blood or other body fluids splashes into your
eye. Body fluids such as urine can be splashed into a worker’s
eyes while emptying a bedpan, catheter bag, or performing
personal care. Body fluid splashes can be avoided by wearing
eye goggles or eye shields if there is any potential for the fluids
to splash into the eye.
If you sustain a blood or other body fluid splash:
• use the employer eye wash station or gently running
lukewarm water and flush the eye for 10-15 minutes
• report the incident to the regulated health care professional
• report to emergency
• follow all Infection Prevention and Control guidelines
pertaining to this incident
• complete all documentation required by the agency’s policy
and procedures
Exercises
B. Identification Questions: Available Immunizations
Identify whether the disease listed has an immunization
available.
Illness Immunization Available
(Yes or No?)
• Influenza
• Hepatitis B
• Hepatitis C
• HIV
C. Fill in the Blanks: Organisms and Pathogens

• The two most common multidrug-resistant organisms are
_______________ and ____________.
• Blood-borne pathogens include the following three viruses:
___________, _______________, and __________________.
Section 5
SLO 4.22 Describe the concept and purpose of clean
technique
SLO 4.23 Describe the principles of hand hygiene and
guidelines for proper hand hygiene
SLO 4.24 Describe the purpose and guidelines for wearing
non-sterile gloves
SLO 4.25 Describe the purpose and use of personal
protective equipment related to infection prevention and
control, including masks, protective apparel, eye
protection and face shields
SLO 4.26 Describe the procedure for putting on, removing,
and disposing of personal protective equipment (PPE)
SLO 4.27 Describe the management of waste products in
SLO 4.28 Describe the procedure for bagging bio-hazardous
waste items
SLO 4.29 Explain the care of supplies and equipment,
including cleaning, disinfection, and sterilization
SLO 4.30Demonstrate best practices in hand hygiene, applying
PPE and caring for supplies and equipment
SLO 4.31 Use appropriate terminology related to
environmental safety
SLO 4.32 Describe the concept of compassionate caring in
relation to environmental safety
SLO 4.33 Describe observations related to environmental
safety
SLO 4.34 Describe the importance of recording and
reporting related to environmental safety
SLO 4.35 Describe methods to support client safety and
comfort related to environmental safety
SLO 4.36 Apply knowledge and follow best practice
principles in a lab setting while demonstrating hand
hygiene, applying personal protective equipment, and
caring for supplies and equipment
Learning Activities
• Read “Medical Asepsis” in Chapter 23 of the textbook
• Read “Hand Hygiene,” “Box 23-5 When to Practise Hand
Hygiene,” “Hand Washing”, “Using Waterless Alcohol-Based
Hand Rubs,” and “Focus on Home Care: Hand Hygiene” in
• Read “Best Practice for Hand Hygiene” in the Learner Guide
• View the video clip “Performing Hand Hygiene”
• Read “Wearing Gloves” in Chapter 23 of the textbook
• Read “Protective Measures” including “Wearing Masks and
Respiratory Protection,” “Wearing Protective Apparel,”
“Wearing Eye Protection and Face Shields” in Chapter 23 of
the textbook
•
•
• Read “Box 23-10: Order for Putting on and Taking off a Full
Set of Personal Protective Equipment” in Chapter 23 of the
textbook
• View the video clip “Using Personal Protective
Equipment”
• Read “Management of Waste Products in Facilities and
• Read “Disposing of Sharps” in Chapter 23 of the textbook
• Complete “Identification: Proper Waste Disposal” in the
Learner Guide
• Read “Bagging and Disposing of Waste Items” in Chapter 23
of the textbook
• Read “Care of Supplies and Equipment” including
“Cleaning,” “Disinfection,” and “Sterilization” in Chapter 23
of the textbook
• Review “Key Terms” at the beginning of Chapter 23 in the
textbook
• Review the glossary at the beginning of this module in the
Learner Guide
• Read “Basic Needs and Transmission-Based Precautions” in
• Read the article “Applying the ‘ICARE’ Model to
Environmental Safety” in the Learner Guide
• Complete the workbook exercises for Chapter 23, “Preventing
Infection.”(Omit Question 65)
• Complete multiple choice questions in “Module Review” at
the end of this section in the Learner Guide
• Participate in the Lab Skills Procedures for hand hygiene and
applying personal protective equipment. Prior to the lab,
review the following skills as outlined in Chapter 23: “Hand
Washing,” “Removing Gloves,” “Box 23-10 Order for Putting
on and Taking off a Full Set of Personal Protective
Equipment,” “Wearing a Mask,” and “Donning and Removing
a Gown”
Articles
Best Practice for Hand Hygiene
Research has found that using alcohol-based hand rubs is more
effective than hand washing for getting rid of harmful
microorganisms. In the same study, hand washing was found to
be more effective than alcohol-based hand rubs when getting rid
of visible dirt or body fluids. So, the recommendation is to use
alcohol-based hand rubs at all times, except when hands are
visibly soiled. When hands are visibly soiled, hand washing is
suggested.
Management of Waste Products in Facilities and
Health care facilities generate a large amount of waste. These
wastes can be divided into three categories: general wastes,
biohazardous wastes, and hazardous wastes. In order to dispose
of wastes correctly, the HCA needs to be able to distinguish
between different types of waste.
General wastes are regular wastes such as food, paper, paper
towels, and items that are not saturated with blood or body
fluids.
Biohazardous wastes are blood and human wastes and items
that are saturated with blood and body fluids. For example, a
paper towel that has been used to wipe up a blood spill, but is
not saturated with blood, would be disposed of in the regular
waste container. If the paper towel is saturated or soaked with
blood, this would be considered a biohazard waste and would
need to be disposed of in a biomedical container (yellow
garbage bag).
Hazardous wastes are wastes such as batteries, broken glass,
and some radioactive materials. The agency policy will give you
directions on how and where to store such items for disposal.
WHMIS (Workplace Hazardous Material Information System)
products also fall into this category.
Types of Wastes Examples Disposal Methods
General wastes •Food General container
• Paper Regular black or green
• Paper towels garbage bag
Goes to regular landfill
Biohazardous Blood Colour-coded (yellow or
wastes Used needles red) government-
Scalpels approved puncture-
Suture needles resistant sharps container
Body tissue Colour-coded yellow
Lab cultures garbage bags
Items saturated Each employer will have
with blood and policy and procedures of
body fluids who collect sharps
containers, where all
biohazard waste is
stored, and who will pick
it up for disposal.
All biohazard wastes
will be collected and
incinerated.
Hazardous Broken glass Agency containers for
wastes Batteries hazardous waste
Radioactive Taken to special landfill
material
Products
covered under
WHMIS
Exercises
A. Identification Questions: Proper Waste Disposal
This exercise gives you practice in identifying both regular
waste products and biohazardous waste products and identifying
the appropriate disposal method for each. Put an “X” to show
which disposal method is appropriate. The first one is done for
you.
Waste Product Regular Biohaz Biohazar
Garbage ard d Sharps
Bags Containe
rs
1. Syringe with needle X
attached
2. Paper towels dripping
with blood
3. Paper towels with a small
amount of blood
4. An incontinence pad (not
dripping)
5. Microbiological
specimens
6. Unused medications
7. Blood-filled tubing from a
suction container
8. Used masks and gloves
9. Intravenous tubing set
with bag attached (not
blood tubing)
1 Used tissues
0.
1 Hair from shaving
1.
Articles
Applying the “ICARE” Model to Environmental Safety
Remember the “ICARE” theory.
C = Compassionate Caring
A = Accurate Observation
R = Report and Record
E = Ensure Client Comfort, Support, and Safety
By applying the “ICARE” model to environmental safety, the
HCA carries out the essential roles and responsibilities of the
health care aide.
Compassionate Caring
Through compassionate caring, the HCA attempts to ensure that
the client is safe in his or her environment. The HCA does this
by doing the following:
• identifying environment hazards in facilities and
community-based settings
• identifying the dangers of slips, trips, and falls in facilities
and community-based settings
• identifying strategies to prevent slips, trips, and falls in
• applying safety guidelines when using electrical
equipment
• applying safety guidelines when managing household
responsibilities in community-based settings
• responding effectively in emergency situations
• following infection prevention and control guidelines
Accurate Observations
The HCA makes accurate observations to determine whether
clients are safe in their environment. The HCA does this by
doing the following:
• performing a hazard assessment of the client care
environment
• using the Care Plan to identify environmental safety
hazards that the health care team needs to be aware of
• ensuring the Care Plan reflects appropriate disposal of
wastes
Report and Record
The HCA reports and records in a timely and accurate way to
ensure that clients are safe in their environment. The HCA does
this by doing the following:
• following employer policies and procedures and
community disaster plans
• notifying the regulated health care professional in charge
of all emergency situations or transmission-based
outbreaks so that further instructions can be received
• notifying the regulated health care professional in charge
of potential or real environmental hazards observed in
• documenting environmental safety concerns accurately to
communicate to other health care staff
Ensure Client Comfort, Support, and Safety
The HCA ensures the client’s comfort and support and protects
the client from environmental hazards by taking the following
actions:
• following standard and transmission-based precautions
• wearing appropriate personal protective equipment
• encouraging all visitors to wear appropriate personal
protective equipment
• following agency policy on cleaning, disinfecting, and
sterilizing equipment
• removing clients from potential hazards or emergency
situations
Lab Skills Procedures
Lab Procedure: Hand Washing
Action Reason
• Assemble equipment: Safe, efficient completion of
• soap the task
• paper towels
• garbage receptacle
• Remove your watch and Protects clothing and jewelry
ring, and push your sleeves and allows proper cleaning of
up. all surfaces of the hand,
including the wrist
• Run lukewarm water. Hot water dries out hands and
is not needed to achieve
cleanliness.
• Wet hands and apply soap Bar soap harbours bacteria as
from a dispenser. it remains wet after use.
• Rub surfaces of hands The friction of rubbing the
together for at least 15 surfaces of the hands together
seconds. loosens dirt and organisms
• Rub wrist. that may be present.
• Rub palms together.
• Interlace fingers and rub
the spaces in between
fingers.
• Rub the fingertips of each
hand against the palm of
the other hand.
• Rub the backs of hands,
thumbs.
• Rinse all surfaces of the Washes soil off of hands and
hand under running water into the sink
with the fingertips pointing
down.
• Pat hands dry with a paper Prevents chaffing of the hands
towel. caused by rough towel rubbing
on skin
• Dispose of wet towels in the Avoids recontamination of
garbage by dropping them hands
in without touching the
receptacle.
• Use a dry paper towel to Avoids recontamination of
shut off the water. hands
• Apply hand lotion as Prevents skin breakdown
needed.
Lab Procedure: Hand Hygiene Using Waterless Hand

Sanitizer
Action Reason
• Pour 3 to 5 ml, or a quarter- This method of hand hygiene
sized amount, of waterless is fast and easy, especially
hand sanitizer into the palm between glove changes and
of your hand. when there is no visible
soiling.
• Rub hands together ensuring Ensures the cleansing of all
that all surfaces are covered areas of the hands
with the hand gel.
• Rub palms together.
• Interlace fingers and rub
the spaces in between
fingers.
• Rub the fingertips of each
hand against the palm of
the other hand.
• Rub the backs of hands
and wrists.
• Rub hands until they are dry Allows time for the sanitizer
– about 30 to 60 seconds. to work
CAUTION: Alcohol-based
waterless hand sanitizers are
flammable when wet.
Lab Procedure: Putting on a Disposable Mask

View the Illustrations in Figure 20-11 in Chapter 20 of the
textbook.
Action Reason
• Perform hand hygiene by Infection prevention and
washing your hands with control
soap and water or by using
hand sanitizer.
• Avoiding touching the part Keeps breathing surface clean
of the mask that will touch
your face, pick the mask up
by the ties.
• Grasping the edges of the Fasten the upper ties over the
mask, place it over your ears and tie them behind your
nose and mouth. head.
• Tie the lower strings behind Ensures a tight fit
your neck ensuring the
bottom of the mask is
securely under your chin.
• Mold the metal band across Ensures a proper fit
your nose to create a tight
fit.
• Perform hand hygiene.
Lab Procedure: Removing a Disposable Mask

Action Reason
washing your hands with control, and worker safety
hand sanitizer. Put on clean
gloves if needed.
• Remove the mask in this Avoids exposure to the
order: contaminated inner surface of
• Untie the lower strings. the mask
• Untie the top strings.
• Hold the top strings and
pull the mask away from
the face.
• Bring the strings together
folding the moist inner
surface of the mask to the
inside.
• Hold the mask by the Avoids contamination of the
strings and discard it into health worker and
the garbage receptacle environment
avoiding touching the
receptacle.
washing your hands with control, and worker safety
hand sanitizer after
disposing of the mask.
Lab Procedure: Putting On Non-Sterile Disposable

Gloves
Action Reason
• Perform hand hygiene by In case the glove tears, your
washing your hands with hands are clean if they come
soap and water or using into contact with the client or
hand sanitizer prior to the client’s belongings.
putting on the gloves.
• Check gloves for rips and Protection of health care
tears before putting them on worker
• Grasp the glove by the cuff Gloves are clean but not sterile,
and place it on one hand and so they may be touched by
follow this procedure for the your clean hands as you put
second hand. them on.
Lab Procedure: Removing Gloves
textbook.
Action Reason
• Ensure that your soiled Worker safety; infection
gloves touch only each prevention and control
other and never touch your
skin.
• Grasp the glove just below Prevents spread of infection
the cuff with the gloved and contamination of clean
fingers of your opposite skin
hand.
• Pull the glove down over Keeps the contamination
your hand, allowing it to inside the glove
turn inside out as you do
this.
• Hold the glove you have
removed in your still-gloved
hand.
• Insert the fingers of your Avoids touching the
un-gloved hand under the contaminated surface of the
cuff of the remaining glove glove
• Pull the glove down over Contains contaminated
your hand and the removed surfaces inside the glove
glove, allowing the glove to
turn inside out as you do so.
• Drop both gloves into the Ensures proper disposal of
garbage, ensuring you do soiled protective equipment
not come into contact with
the receptacle.
• Perform hand hygiene. Removes any contamination
of hands as the result of the
procedure
Lab Procedure: Gowning

textbook.
Action Reason
• Perform hand hygiene. Prevents the spread of
microorganisms
• Put on the gown. Prevents the transfer of
• Open the gown without microorganisms between your
shaking it or touching it to uniform and the gown
your uniform. Provides a protective cover for
• Put on the gown. Ensure your uniform
that it covers your
clothing completely from
front and back. Ensure
that you do not
contaminate the outside of
the gown.
• Fasten the neckties and
overlap the gown at the
back to fasten the waist
ties.
Lab Procedure: Removing a Gown
Action Reason
• Untie the neck and waist ties. Prevents the spread of
microorganisms
• Remove the gown by grasping Prevents the spread and
it at the neck or shoulders and transfer of microorganisms
pulling the gown forward. from the gown to your
hands or uniform.
• Slide the gown off your This is done without
shoulders using a shrugging touching the outside of the
motion. gown, preventing
contamination of hands.
• Turn the gown inside out To contain the contaminated
surface and prevent contact
with soiled area of gown
• Roll up the gown and discard it Ensures that if the gown is
in the appropriate container. saturated with blood or
body fluids it is disposed of
in a biohazard waste
container. If it is not
saturated with body fluids it
is disposed of in a garbage
pail.
Section 1
A. True and False Questions: WHMIS
• T
• F*
• T
• F**
2. * It will cause illness.
4. ** Flammable material may catch fire if exposed to hot
temperatures.
B. Case Study 1: Mrs. Abbott’s House
• What safety measures did the HCA notice on her visit to Mrs.
Abbott?
front rail
grab bar in the bathtub
cane had a non-skid tip
client was wearing non-skid shoes
• What unsafe measures did the HCA notice on her visit to Mrs.
Abbott that could cause a fall or other harm?
ice patches on the front steps
throw rugs
no bath mat in the tub
wet spill on the kitchen floor
phone cord on the floor
unstable riser recliner
client wearing reading glasses while walking throughout the
home
Section 2
A. Matching Exercise: Identifying the Pest
1.
b
2. c
3. d
4. a
B. Putting Tasks in Order Questions: Reacting to a Fire
Emergency
__5__ Try to extinguish the fire
__2___ Ensure that the door(s) is (are) closed
__4___ Call the fire department
__1__ Remove those in danger
__3___ Activate the alarm
C. True and False Questions: Reacting to Community
Emergencies
• F*
• F*
*
• T
* You would move them to a room without windows.

** Use only bottled water.
Section 3
A. Matching Exercise: Microorganisms
1. 4.
b c
2. f 5.
d
3. e 6.
a
B. Fill in the Blanks Questions: Routes of Transmission

• direct contact transmission
• droplet transmission
• vector borne transmission
• indirect contact transmission
C. Questions: Infection
• Answers will vary. See “Signs and Symptoms of Infection”
and “Focus on Older Adults: Signs and Symptoms of
Infection” in Chapter 20.
• Answers will vary. See the article “Triangle of Infection.”
• Answers will vary. See the article “Triangle of infection.”
Section 4
A. Identification Questions: Risk of Infection
• I
• I
• D
• I
• D
B. Identification Questions: Available Immunizations

• Yes
• Yes
• No
• No
C. Fill in the Blanks: Organisms and Pathogens

• The two most common multidrug-resistant organisms are
MRSA and VRE.
• Blood-borne pathogens include the following three viruses:
hepatitis B, hepatitis C, and HIV.
Section 5
A. Identification Questions: Proper Waste Disposal
Waste Product Regular Biohaz Biohazar
Garbage ard d Sharps
Bags Containe
rs
1. Syringe with needle X
attached
2. Paper towels dripping X
with blood
3. Paper towels with a small X
amount of blood
4. An incontinence pad (not X
dripping)
5. Microbiological X
specimens
6. Unused medications X
7. Blood-filled tubing from X
a suction container
8. Used masks and gloves X
9. Intravenous tubing set X
with bag attached (not
blood tubing)
1 Used tissues X
0.
1 Hair from shaving X
1.
Module 5: Client Safety
Introduction
The HCA is responsible for a client’s overall safety. This module
addresses how the HCA can minimize risks and harm from
accidents and injuries when caring for the client. It also focuses
on the role of the HCA following accidents and injuries.
Glossary
Word Meaning
Defend in place “Defend in place” philosophy refers
philosophy to the practice of not evacuating
clients unless absolutely necessary,
but using the fire zones in a building
and placing people behind fire doors
or in their rooms.
Gap protector Small attachable padded board that
fits between two side rails and turns
the two side rails into one
Geriatric/Geri chair A specially designed chair that
allows for proper positioning of the
client who does not fit well or is not
safe in a wheelchair; sometimes used
as an intervention for client safety.
When the geri-chair tray is attached,
the client is prevented from getting
up on his/her own.
Incident/Accident report A report that is filled out after an
incident or accident occurs.
Personal right to risk A written agreement between a
client and the health care team to
give the client the right to participate
in a behaviour that may place the
client at risk. For example, eating
sweets instead of the prescribed
diabetic diet.
Padded side-rails Padded side-rails are long padded
boards that are put inside against the
side rails, closest to the client.
Policy of least restraint Policy that states that restraints
should be used only when all non-
restraint interventions have been
unsuccessful. When using restraints,
the least restrictive restraint is to be
used and only used to keep the client
safe from harm.
Protection of Persons in The Act is designed to stop or
Care Act prevent abuse of people who live in
or receive services from hospitals
and community care, or who live in
continuing care, lodges, group
homes, mental health facilities and
other such facilities.
REACT An acronym used to help a health
care worker remember what to do if
a fire occurs:
R = Remove those in immediate
danger
E = Ensure that the doors and
windows are closed
T = Try to extinguish the fire if safe
to do so
Section 1
SLO 5.1 Describe the concept of client safety
SLO 5.2 Describe client factors that increase the risk of
accidental injury
SLO 5.3 Describe strategies to promote client safety, including
the use of a call bell and client identification
SLO 5.4 Identify factors that increase risk for falls among the
elderly
SLO 5.5 Describe strategies to prevent falls among the elderly
SLO 5.6 Describe actions to take when a client falls
Learning Activities
• Read the Introduction at the beginning of Chapter 22 of the
textbook
• Read “Accident Risk Factors” in Chapter 22 of the
textbook
• Read “Identifying the Client” in Chapter 22 of the textbook
• Read “Using the Call Bell” in Chapter 22 of the textbook
• Read “Think about Safety: Risk Factors for Accidents and
Falls in Older Adults” in Chapter 22 of the textbook
• Read “Preventing Falls and Injuries” in Chapter 22 of the
textbook
• Read “Think about Safety: Measures to Prevent Falls
among Older Adults and Others at Risk” in Chapter 22 of
the textbook
• Read “What to Do When a Client Falls” in the Learner
Guide
• Read “Creating a Safe Workplace”, including: “Employers’
and Supervisors’ Responsibilities”, “Employees’
Responsibilities”, and “Report of Incident and Injury: in
• Complete “Case Study: Mr. Smith Falls” in the Learner
Guide
Articles
What to Do When a Client Falls
Falls happen and it is the responsibility of the HCA to know
what to do when a client falls in a facility or community-based
setting. During your orientation to a facility or community-based
setting, read the policy and procedure manual which outlines
what you should do if a client falls. When a client falls and you
cannot remember the policy and procedure, the guidelines listed
here will help you address the client needs.
Falls in a facility
• Always stay with the client. The client will be frightened
and will need somebody there to keep her calm and to
prevent further harm.
• Ask the client if she is hurt, and if so, where the pain is.
• Press the emergency call bell in the room; if there is no
emergency call bell, yell for help.
• While waiting for another person to respond, cover the
client with a blanket and reassure her that help will arrive
soon.
• Whoever responds to the emergency call bell or yells for
help is to contact the regulated health care professional in
charge.
• The regulated health care professional in charge will assess
the client for any injuries and determine whether it is safe
to move the client. If it is determined to be safe, only then
can the client be moved.
• Once it is safe to get the client up, do so by moving the
client off the floor using a mechanical lift.
• When getting the client up, ensure that the client goes right
into bed or to a chair.
• Once the client is safely in bed or in a chair, ensure that the
call bell is within the client’s reach.
• Document the fall in the client’s chart; include a description
of what happened, using accurate details. Include the time
and the action performed by the HCA.
• Complete an Incident/Accident/Occurrence form (this form
can be called an incident form, safety occurrence form or
an accident form). This is a form filled out by the first
person who finds the fallen client. The form is used to
ensure that all the correct people are notified of the fall and
to determine further tasks that can be taken to prevent the
fall from happening again. The incident/accident form
does not blame or put blame on the HCA or other
health care workers for the client’s fall.
Falls in a community-based setting
• Always stay with the client. The client will be frightened
and will need somebody there to keep him calm and to
prevent further harm.
• Ask the client if he is hurt, and if so, where the pain is.
• Call 911 or the emergency number to have an ambulance
come to the community-based setting.
• While waiting for the ambulance, cover the client with a
blanket and reassure him that help will arrive soon.
• Contact the regulated health care professional in charge for
further directions following the employer’s policy and
procedure.
• Document the fall in the client’s chart. Write a description
of what happened, using accurate details. Include the time,
and the actions performed by the HCA as per the
employer’s policy and procedure.
• Complete an Incident/Accident/Safety Occurrence form as
per the employer policy and procedure.
Exercises
A. Case Study: Mr. Smith Falls
You are a HCA walking down the hallway in a lodge (a
community-based setting) when you hear moans for help
coming from Mr. Smith’s room. You find 88-year-old Mr. Smith
on the floor beside his bed. He is wearing pyjamas, and has
socks on his feet. From the doorway, you can see Mr. Smith’s
cane on the bathroom floor.
• As the HCA who first finds Mr. Smith on the floor, what do
you do?
• What are two potential reasons for why Mr. Smith fell?
Section 2
SLO 5.7 Describe the philosophy of least restraint
SLO 5.8 Describe strategies to support the least restraint
philosophy
SLO 5.9 Compare three types of restraints
SLO 5.10Describe legal implications for the HCA and other care
providers with the use of restraints
SLO 5.11Describe guidelines regarding use of restraints
SLO 5.12Identify alternatives to restraints and safety measures
for using restraints
Learning Activities
• Read “Least Restraints” in the Learner Guide
• Read “Box 22-1 Alternatives to Restraints” in Chapter 22
of the textbook
• Read “Types of Restraints” in Chapter 22 of the textbook
• Read “Using Bed Rails” in Chapter 22 of the textbook
• Complete “Matching: Match the Restraint” in the Learner
Guide
• Read “Legal Implications When Using Restraints” in the
Learner Guide
• Read “Restraints and How to Avoid Them” in Chapter 22
of the textbook
• View video clip “Using Restraints and Alternatives”
• Read “Guidelines Regarding the Use of Restraints” in
• View Video Clip “Following Restraint Safety Precautions”
• Read “Think about Safety: Measures for Using Restraints”
in Chapter 22 of the textbook
Articles
Least Restraints
Least restraint policy is a policy that a facility follows that states
all preventive methods must be tried on a client before the
decision is made to use restraints. Before determining different
methods to try on a client, an assessment and analysis are
performed on the client’s behaviour. This assessment and
analysis is carried out by the regulated health care professional.
If a restraint is determined to be needed, then “least restraint
policy” also states that the least restrictive restraint be used.
Restraints are used only for the client’s safety and NOT for the
convenience of the staff. There are specific guidelines for how
often a client is to be monitored and checked when a restraint is
used, consent is required before a restraint can be used, and a
restraint may only be used if ordered by a physician and outlined
in the Care Plan. Inappropriate use or application of a restraint,
or use of one when the client has not been properly assessed or
indicated, can be considered as abuse.
Exercises
A. Matching: Match the Restraint
Identify whether the following items are physical, environmental
or chemical restraints. (the different types of restraints may be
used as answers more than once)
1. ___ Mitt restraint Physical restraint
__
2. ___ Sleeping pill Environmental restraint
__
3. ___ Bed rail Chemical restraint
__
4. ___ Belt restraint
__
5. ___ Locked room
__
6. ___ Geriatric chair
__
Articles
Legal Implications when using Restraints
When using restraints, it is necessary for the HCA to be aware of
the Protection of Persons in Care Act (PPICA). Knowledge of
the Act means that the HCA understands his or her responsibility
for ensuring client safety when restraints are used.
Background on PPICA
Under the terms of the Act, anyone who reasonably believes that
a person in care has been abused must report this to an
appropriate authority. The Act requires you to report abuse if
you believe a person has been abused. It is not up to you to
investigate whether or not abuse has occurred. You need to
ensure the safety of your clients and protect them from abuse.
Before reporting abuse, you must ask yourself what a reasonable
caregiver would have done in similar circumstances with similar
experience and education. Failure to report suspected abuse can
lead to a fine. You may not report abuse anonymously; however,
your identity will be protected if you do make a report.
The toll-free phone number for reporting abuse is: 1-888-357-
9339
Definition of abuse when applying restraints
Abuse when applying restraints is defined as follows:
• intentionally causing bodily harm by using a restraint
• intentionally causing emotional harm by using a restraint;
threatening to use a restraint
• intentionally administering or prescribing medication
(chemical restraint) for an inappropriate purpose
• subjecting the person in care to non-consensual sexual
contact, activity or behaviour by applying a restraint
inappropriately
• theft of a client’s money or valuables while the client has
restraints applied
• Intentionally failing to provide adequate nutrition, medical
attention or other necessities to a client who has restraints
applied. This includes failure to release the restraint and
reposition the client at least every two hours, or more
frequently if indicated by the Care Plan.
Common themes that increase the incidence of abuse
Investigators have identified these common themes that seem to
increase the incidence of abuse:
• lack of co-operative teamwork resulting in the client being
caught in the middle
• concerns about family dynamics causing problems for
residents and staff
• failure to report abuse by management
• residents feeling threatened that they will be punished if
they report abuse
Protection for the person reporting abuse
The Act protects from punishment those persons reporting
abuse. No employer can in any way punish a person or service
provider who makes a report of abuse. The employer can be
fined for punishing a person who makes a report of abuse. Any
person who discontinues or threatens to withdraw care of the
client because abuse has been reported can be fined.
For further details regarding Protection of Persons in Care Act
(PPICA), go to the Legislation Module in the Course One
course.
Section 3
SLO 5.13Describe common causes of poisoning in clients in
SLO 5.14Describe actions when poisoning is suspected
SLO 5.15Identify the common causes of burns in clients in
SLO 5.16Describe strategies to prevent burns
SLO 5.17Describe actions to take when a client is burned
SLO 5.18Describe suffocation and carbon monoxide poisoning,
and safety measures to prevent suffocation and carbon
monoxide poisoning
Learning Activities
• Read “Preventing Poisoning” and “What to Do If You
Suspect Poisoning” in Chapter 22 of the textbook
• Read “Preventing Burns,” “Care of Client with Burns,” and
“Think about Safety: Measures to Prevent Burns” in
• Read “Preventing Suffocation,” “Carbon Monoxide
Poisoning,” and “Safety Measures to Prevent Suffocation in
Adults” in Chapter 22 of the textbook
• Complete “True and False: Preventing Poisoning and
Burns” in the Learner Guide
Exercises
A. True and False: Preventing Poisoning and Burns
• The HCA should give the client sips of cold T F
milk if poisoning is suspected.
• Oven cleaner can cause chemical burns. T F
• Water temperature in a tub should be checked T F
prior to assisting the client with a bath.
• Carbon monoxide is blue in colour when it is in T F
the air.
Section 4
SLO 5.19Describe common equipment accidents, including
electrical cords and oxygen tanks
SLO 5.20Describe safety measures to prevent equipment
accidents
SLO 5.21Describe causes of fires in facility and community-
based settings
SLO 5.22Describe safety measures to prevent fires
SLO 5.23Describe actions to take during a fire and evacuation,
including the use of REACT
SLO 5.24Describe personal right to risk
SLO 5.25Describe the importance of managed risk agreements
within the Care Plan
SLO 5.26Use terminology related to client safety
SLO 5.27Describe the concept of compassionate caring within
client safety
SLO 5.28Describe client observations related to client safety
SLO 5.29Describe the importance of recording and reporting
client changes related to client safety
SLO 5.30Describe methods to support client safety
Learning Activities
• Read “Preventing Accidents With Equipment” in Chapter
22 of the textbook
• Read “Think about Safety: Measures to Prevent Equipment
Accidents” in Chapter 22 of the textbook
• Read “Think about Safety: Measures for Using Oxygen
Equipment Properly” in Chapter 22 of the textbook
• Read “Preventing Fires” in the Learner Guide
• Read “Fires and the Use of Oxygen” in Chapter 22 of the
textbook
• Read “Focus on Home Care: Fire Safety” in Chapter 22 of
the textbook
• Read “What to Do During a Fire” in Chapter 22 of the
textbook
• Read “Focus on Home Care: Being Prepared for a Fire” in
• Read “Think about Safety: Fire Prevention Measures” in
• Read “Using a Fire Extinguisher” in Chapter 22 of the
textbook
• Read “Types of Extinguishers” in Chapter 22 of the
textbook
• Read “Evacuating” and “Box 22-2 Important Information
about Evacuating in the Event of a Fire” in Chapter 22 of
the textbook
• Read “REACT” in the Learner Guide
• Read “Fire Evacuation in a Community-Based Setting” in
the Learner Guide
• Read “Managed Risk Agreements” in the Learner Guide
• Read “The Importance of the Managed Risk Agreements
Within the Care Plan” in the Learner Guide
• Review “Key Terms” at the beginning of Chapter 22
• Read “Applying the ‘ICARE’ Model to Client Safety” in
the Learner Guide
• Complete the workbook exercises for Chapter 22
• Complete the multiple choice questions in the module
review at the end of this Learner Guide
Articles
REACT
REACT is a commonly used acronym in facilities to help staff
members remember what to do when a fire is discovered.
E = Ensure the doors and windows are closed
C = Call 911 or the fire department
T = Try to extinguish the fire if safe to do so
The REACT acronym helps HCAs to respond to a fire
emergency in a manner that fulfills their role of promoting client
safety. The REACT steps do not have to be followed in the order
shown here. The HCA may provide safety by ensuring that
doors and windows are closed, and evacuate clients from
immediate danger. The fire may happen so quickly that the HCA
may pick up the fire extinguisher and put a small fire out before
activating the fire alarm.
If a fire occurs in a hospital or nursing home, clients are not
evacuated unless absolutely necessary. Instead, the “defend in
place” philosophy is followed. “Defend in place” is a philosophy
of not evacuating clients unless absolutely necessary. Instead,
fire zones in a building are used; clients are placed behind fire
doors, in hallways or in their rooms; and the sprinkler systems
are relied on to assist in extinguishing the fire. Keeping clients
safe behind doors reduces the risk of smoke inhalation.
If an evacuation is necessary, the preferred method is to move
clients from one area of the building to another area in the
building—usually on the same floor. Moving clients to the other
side of the building is often the quickest way to remove many
clients from the danger of smoke and fire.
Fire Evacuation in a Community-Based Setting
The role of the HCA is to attempt to ensure the client’s safety by
following employer policy and procedure, and community
disaster plans. Once the client is safe, the HCA must always
notify the supervisor of the situation so that further instructions
can be received.
How does the HCA keep the client safe during a fire?
• the HCA is to remove those in immediate danger
• ensure the doors and windows are closed
• call the fire department (911)
• if possible, try to extinguish the fire
• basically follow the “REACT” principles, activate the alarm
if one is present.
• as you are taking the client out of the building, knock on the
neighbors’ doors, yelling “FIRE!”
• if the client lives in a house, notify the client’s neighbors
that there is a fire
• do not re-enter the building once you are out
Managed Risk Agreements
Managed Risk Agreements are created to minimize a behaviour
that places a client at risk, manage the high-risk behaviour, and
prevent it from harming the client and others in the same
environment. Managed risk agreements are put in place to allow
for personal right to risk. If a client chooses to participate in
behaviours that are not helpful to their health, or out of line with
facility or agency policy, a managed risk agreement can be used
to manage the risk.
Client high-risk behaviours can include the following:
• Smoking
• Drinking alcohol
• Not taking prescribed medication
• Not following prescribed diet plan
Although a client may engage in some independent behaviours
that could put his health and safety at risk, a negotiated balance
between such behaviour and its possible effects on other
individuals in the facility needs to be found. A Managed Risk
Agreement acts as a negotiation between the client, or client’s
guardian, and the facility. The behaviour that places a client at
risk and the consequences are discussed. An agreement or
formal plan is written up by the regulated health care
professional in charge. The Managed Risk Agreement identifies
the high risk behaviour and the agreements made surrounding it.
Once created, the Managed Risk Agreement is signed by the
client, or client’s guardian, and the regulated health care
professional in charge and is put into the client’s Care Plan.
The Importance of the Managed Risk Agreements within the
Care Plan
Managed Risk Agreements are kept in the client’s Care Plan in
order to communicate the agreement to all individuals providing
care to the client. If a client does not follow the Managed Risk
Agreement, the HCA is to immediately notify the regulated
health care professional in charge for further directions. A copy
of the agreement is given to the client, client’s guardian, or both.
Always check employer policy and procedure regarding
managed risk agreements.
Applying the “ICARE” Model to Client Safety

Remember the “ICARE” Model
C = Compassionate caring
A = Accurate observation
R = Report and record
E = Ensure client comfort, support, and safety
By applying the “ICARE” Model to environmental safety, the
HCA carries out his/her roles and responsibilities.
Compassionate caring related to client safety is a role that the
HCA performs. Compassionate caring means that the HCA
strives to ensure the client’s safety by preventing harm or injury.
The HCA does this by doing the following:
• describing client factors that increase the risk of accidental
injury in facilities and community-based settings
• identifying the factors in facilities and community-based
settings that increase risk for falls for elderly clients
• identifying and implementing strategies to prevent falls and
accidents
• ensuring that the call bell is within the client’s reach
• applying safety guidelines when using electrical equipment
• following the “least restraint” policy
• using safety measures when applying restraints
• responding competently to emergency situations
Accurate observations enable the HCA to determine if the client
is safe from accidents or risk of harm. The HCA makes accurate
observations by following these guidelines:
• performing frequent checks on clients who are restrained
• observing for factors in facilities and community-based
settings that increase the risk for falls for elderly clients
Report and record is the responsibility of the HCA to ensure that
the client is safe. The HCA does this by taking these steps:
• following employer policy and procedure and community
fire protocols
• activating emergency services (calling 911) appropriately
for emergencies
• following the Care Plan to check for Managed Risk
Agreements
• notifying the regulated health care professional in charge of
all emergency situations or any broken Managed Risk
Agreements
• notifying the regulated health care professional in charge of
potential or real environmental hazards observed in facilities
and community-based settings
• accurately documenting safety concerns to communicate to
other health care staff
• reporting and recording actions taken to monitor a client in
a restraint and any issues related to the use of the restraint
Ensuring client comfort, support, and safety helps to protect the

client from environmental hazards. The following measures are
taken by the HCA:
• following the Protection of Persons in Care Act
• attempting all alternatives to applying restraints
• using least restrictive restraint
• performing skin care regularly to clients who have restraints
on
• performing safety measures to prevent burns and
suffocation
• following agency policy on caring for equipment
• removing clients from potential hazards or emergency
situations
• following agency policy and procedures related to restraints,
water temperature checks, chemical storage, care and use of
equipment, management and prevention of client falls
• removing items that may be hazardous to client safety

Section 1
A. Case Study: Mr. Smith Falls
1. Stay with the client
• Call/press emergency call bell for help
• Put a blanket on the client and give reassurances
• Notify the regulated health care professional in charge
• Once it is safe to do so, move the client into the bed by
using a mechanical lift
• Document the accident/incident in the client’s chart, and
complete an accident/incident/occurrence form
2. Mr. Smith was wearing socks, which tend to be slippery on
floors, and his cane was in the bathroom out of his reach.
Section 2
A. Matching: Match the Restraint
1. a
2. c
3. b
4. a
5. b
6. b
Section 3
A. True and False: Preventing Poisoning and Burns
• F
• T
• T
• F
Module 6: Self Care and Safety

Introduction
The HCA is responsible for his/her own health and safety in
order to provide and maintain safe care for clients. The health
and safety of the HCA directly influences client care because
you must care for yourself first before you can care for others.
This module covers topics on how the HCA can stay healthy and
safe.
Glossary
Word Meaning
Aggressive Aggressive behaviour is the action of an
behaviour individual or group of individuals towards an
employee or group of employees that is
intended to intimidate, offend, or humiliate.
Bullying Repeated aggressive behaviour
Fatigue Fatigue is the inability or unwillingness to
continue effective performance of a mental
or physical task due to a feeling of weariness,
tiredness or lack of energy.
Medical alert A type of bracelet that provides emergency
bracelet medical information about the person
wearing it
Modified work A situation in which, after an injury, the
program worker slowly progresses back to work.
Tasks and number of working hours are
slowly increased.
Personal Personal hygiene refers to the cleanliness
hygiene level of your body; the cleaner your body, the
higher the level of cleanliness.
Rehabilitation To restore health after an incident, illness or
accident
WCB claim The application form a worker fills out in
order to get funding under the WCB
Workplace Workplace harassment is illegal and includes
harassment any unwelcome verbal, written or physical
behaviour that slanders or shows hatred
towards a person on the basis of race, sex,
colour, culture, religion, sexual orientation,
age or disability.
Section 1
SLO 4.1 Describe body mechanics, the purpose of body
mechanics, and guidelines for proper body mechanics
SLO 4.2 Describe the role and function of the Workers’
Compensation Board
SLO 4.3 Describe the role and function of the Occupational
Health and Safety Legislation
SLO 4.4 Describe the HCA role and responsibilities in
following the principles of body mechanics
SLO 4.5 Practice the principles of body mechanics
Learning Activities
• Read “Body Mechanics” in Chapter 25 of the textbook
• Read “Think about Safety: Guidelines for Good Body
Mechanics” in Chapter 25 of the textbook
• Read “Role and Function of the Workers’ Compensation
Board” in the Learner Guide
• Read “Occupational Health and Safety Legislation” in
• Read “HCA Role and Responsibilities in Following the
Principles of Body Mechanics” in the Learner Guide
• Complete “A. True and False Questions: Posture” in the
Learner Guide
• Read “Figure 25-1, Figure 25-2, Figure 25-3” in Chapter 25
of the textbook
• Read “Body Mechanics When Lifting an Item” in the
Learner Guide
• Perform Lab Skills Procedure “Body Mechanics when
Lifting an Item” in the Learner Guide
Articles
Role and Function of the Workers’ Compensation Board
(WCB)
The WCB is an organization that is not a government
department; instead, it is funded by employers/companies. The
organization was formed to provide cost-effective disability and
liability insurance to employees by compensating injured
workers for lost income, health care, and other costs incurred
due to work-related injury.
The WCB is a no-fault insurance system in which injured
workers are able to receive benefits for work-related injuries no
matter whose fault it is. However, not all injured workers are
covered under the WCB. The injured worker only gets covered
if the company he/she works for has paid into the WCB
insurance.
The goal of the WCB is to help injured workers return to their
jobs. The WCB accomplishes its goal by offering rehabilitation
to the injured worker and by offering modified work programs.
A modified work program looks at the injured worker and
determines how much he/she can realistically work and tells the
employer how much time the injured worker can work. For
example, a modified work program for an injured worker might
include only working two days a week instead of five.
When a worker gets injured he or she fills out a
claim/application form that the employer provides. The benefits
that the injured worker gets are determined on whether the claim
is accepted or rejected.
HCA Role and Responsibilities in Following the Principles of
Body Mechanics
The HCA Role and Responsibilities
As a health care aide, your role is to:
• Use proper body mechanics to ensure you do not injure
yourself while moving objects or assisting a client with
care activities
• Assess the work environment for hazards prior to the move
and ensure that the environment is safe and clear of
obstacles
• Assess yourself and the object to be moved prior to the
move, and obtain assistance to help move objects you have
assessed as too heavy to lift or move alone
• Work smartly and efficiently by using proper body
mechanics in all situations
• Observe your work environment for situations that prevent
you from using proper body mechanics and report these
situations to your supervisor
• Maintain your safety, and the safety of staff assisting you
and the client, by consistently using proper body mechanics
when providing client care
• If injured on the job, it is the responsibility of the HCA to
notify the supervisor immediately in order to have the
claim filled out
Exercises
A. True and False Questions: Posture
• Bend at your knees and hips and squat when T F
lifting or putting objects down.
• When a person is standing with good posture, the T F
shoulders are forward.
• The WCB is a government department. T F
• Lying down and sitting also require good body T F
alignment.
Lab Skills Procedures

Lab Skills Procedure: Body Mechanics When Lifting
an Item
Action Reason
• Determine if assistance is Half of all back pain is
needed prior to lifting an associated with lifting too
item. much weight.
• Place both feet flat on the This position keeps the body
floor, with one foot slightly balanced.
in front of the other.
• Slightly bend both knees Allows the muscles in legs to
and, if the item is on the do the lifting.
floor, squat down.
• Squeeze stomach muscles This position protects the
and tuck buttocks so that back.
spine is in alignment.
• Hold head so that eyes are Prevents neck sprain.
looking straight ahead.
• Maintain weight to be lifted Reduces lower back sprain.
as close to body as possible.
• Prevent twisting when Prevents injury to back.
lifting.
•
Section 2
SLO 4.6 Identify personal safety measures when driving to and
from work and when visiting clients in community-based
settings
SLO 4.7 Identify appropriate clothing and accessories to
maintain personal safety in the workplace
SLO 4.8 Describe appropriate personal hygiene for the
workplace
Learning Activities
• Read “Promoting your Personal Safety” and “Think about
Safety: Personal Safety Measures” in Chapter 22 of the
textbook
• Read “Appropriate Clothing and Accessories to Maintain
Personal Safety in the Workplace” in the Learner Guide
• Read “Appropriate Personal Hygiene for the Workplace” in
the Learner Guide
• Complete “A. Identification Questions: Appropriate or
Inappropriate” in the Learner Guide
•
Articles
Appropriate Clothing and Accessories to Maintain Personal
Safety in the Workplace
To maintain personal safety in the workplace, only appropriate
clothing and accessories are to be worn. By wearing appropriate
clothing and accessories, risk of self-injury or potential for harm
is minimized. In addition to the information provided, also refer
to agency policy for further details because uniforms or casual
clothing may be required to be worn in the work setting.
Appropriate clothing worn in facilities or in community-
based settings
• To prevent clothes from getting caught in equipment or
pulled by clients, clothes should not be oversized or loose.
For example, no big/baggy pants or t-shirts.
• To prevent clients from getting sexually aroused, no tight
clothes or clothes revealing majority of skin are to be worn.
For example, no halter tops or low-cut tank tops, no above-
the-knee shorts, and no mini-skirts.
• To prevent the spread of viruses and bacteria, work clothing
and shoes must be clean and kept clean. For example, work
clothes must be washed after each wear.
• A way to prevent the spread of viruses and bacteria to your
loved ones is to change out of work clothing and shoes as
soon as possible after the shift finishes. Work clothes
should never be worn to run errands before or after work,
such as to the grocery store.
• Another way to prevent the spread of viruses and bacteria is
to avoid wearing shirts with long sleeves. If cold, sweaters
are acceptable, but must be able to be removed prior to
giving client care.
• Shoes must be clean and intact. The heels must be flat or a
medium walking height with a non-skid bottom. All work
shoes must have closed toes and heels.
Appropriate accessories to maintain personal safety in
facilities or community-based settings
• Only a plain flat wedding band may be worn. No other
rings are permitted because they could easily scratch a
client. Another reason is that dirt and germs can build up
and hide in the ring, causing a potential risk for spread of
infection.
• Small studded earrings are allowed, but dangly earrings are
not. Dangly earrings can be easy pulled by a client, causing
harm to the HCA.
• A thin neck chain with pendant can be worn only if kept
under the top. If the chain is visible, it too can be pulled by
the client, causing harm to the HCA.
• The only type of bracelet allowed is a medical alert
bracelet.
• A watch with a second hand may be worn on the top or
wrist. If worn on the wrist, wristwatches are to be removed
prior to giving direct client care.
Appropriate Personal Hygiene for the Workplace
Personal hygiene refers to the cleanliness level of your body; the
cleaner your body and hair, the higher the level of cleanliness.
When a person suffers from low personal hygiene, or low level
of cleanliness, this can be offensive to others. The goal of the
HCA is to achieve the highest cleanliness level possible. To
achieve this, the HCA should:
• not wear perfume or colognes
• only wear unscented deodorant and hand lotion
• apply unscented deodorant prior to putting on work clothes
• wear cosmetics only in minimal amounts
• Keep nails clean and trimmed. Artificial or long nails are
not allowed. No nail polish may be worn.
• keep hair clean, controlled, neatly off the face and collar,
and in a style that cannot compromise client safety
• keep beards and moustaches clean and neatly trimmed or
be clean-shaven
• ensure adequate oral hygiene to prevent offensive breath
odour
• monitor yourself for other offensive or harsh odours such
as lingering cigarette smoke, excessive body odour, etc.
Exercises
A. Identification Questions: Appropriate or Inappropriate
Read each statement and then circle A for appropriate or I for
inappropriate.
• The HCA is wearing her new diamond A I
engagement ring.
• The HCA goes home after work and changes out A I
of her work clothes after making supper.
• The HCA has trimmed artificial nails that are A I
kept clean.
• The HCA is wearing perfume to which the client A I
is allergic.
Section 3
SLO 4.9 Describe fatigue
SLO 4.10Identify the factors that contribute to fatigue
SLO 4.11Describe the effects of fatigue on role performance
and safety for clients and self
SLO 4.12Describe strategies for preventing fatigue
Learning Activities
• Read “Fatigue and How it Happens” in the Learner Guide
• Read “Effects of Fatigue on Role Performance and Safety
for Self and Clients” in the Learner Guide
• Read “Strategies for Preventing Fatigue” in the Learner
Guide
• Complete “Case Study: Fatigue” in the Learner Guide
Articles
Fatigue and how it Happens
Fatigue is the inability or unwillingness to continue effective
performance of a mental or physical task due to a feeling of
weariness, tiredness or lack of energy. A common
misunderstanding is that fatigue and drowsiness mean the same
thing, but fatigue is different than drowsiness. Drowsiness is
feeling the need to sleep, while fatigue is a lack of energy and
motivation.
Various factors have been identified that cause nurse fatigue and
they fall under three categories: professional factors, personal
factors, and environmental factors.
Professional Factors
• total number of hours worked per week
• working more than one shift within a 24-hour period
• working with a decreased number of staff
• working while sick
Personal Factors
• working extra jobs
• working overtime by choice
• additional responsibilities of home and family
• not sleeping an average of six to eight hours within a 24-hour
period
• overall poor physical and mental health
• unhealthy lifestyle choices; poor diet and smoking habits;
lack of exercise
Environmental Factors
• noise
• room temperature
• air quality
•
Effects of Fatigue on Role Performance and Safety for
Clients and Self
HCA fatigue has been linked to unintentional harmful effects
while working that may result in one or a combination of the
following negative outcomes related to safety for clients and
self.
•
Safety for Clients
• inability to focus and pay attention to a task at hand
• delayed reaction time
• decreased judgment
• increased risk for medication errors
• decreased ability to communicate
• decreased ability to get along with coworkers
• decreased ability to notice changes to client’s health
Safety for Self
• increased risk for injury inside and away from the workplace
• increased risk for addictive behaviour
• increased risk for obesity
• increased risk for depression
• increased risk for short term illness
• increased risk for long term illness
• reduced motivation
Strategies for Preventing Fatigue
Here are some tips for preventing fatigue:
• get adequate, regular, and consistent amounts of sleep each
night (six to eight hours)
• eat a healthy, well-balanced diet and drink plenty of water
(two litres) throughout the day
• exercise regularly (30 minutes three times a week)
• learn relaxation methods
• maintain a reasonable work and personal schedule
• schedule time away from work to rest and relax
• limit the amount of drinking fluids that contain caffeine
• avoid alcohol, nicotine, and drug use
Exercises
A. Case Study: Fatigue
Debbie is a 35-year-old single mother of three who works full
time as a HCA. Debbie works five eight-hour shifts per week
and every month tries to pick up two eight-hour overtime shifts.
She drinks eight cups of coffee a day and smokes half a package
of cigarettes per day. Debbie exercises three times a week, eats a
balanced diet, and tries to sleep between six and eight hours a
night.
• Which factors mentioned in the case study can cause
fatigue?
• Which strategies mentioned in the case study can prevent
fatigue?
Section 4
SLO 4.13Describe the concept of stress
SLO 4.14Describe the common causes of stress
SLO 4.15Identify the physical, emotional, and behavioural signs
of stress
SLO 4.16Describe the effects of stress across the five
dimensions of health
SLO 4.17Identify factors that can influence an individual’s
response to stress
SLO 4.18Describe defense mechanisms
SLO 4.19Describe strategies that can be used to manage stress
SLO 4.20Describe “burnout”
SLO 4.21Identify the signs and symptoms of “burnout”
SLO 4.22Determine personal stress management strategies
•
Learning Activities
• Read “Stress” in Chapter 7 in the textbook
• Read “Sources of Stress” in Chapter 7 in the textbook
• Read “Box 7-1: Physical Signs and Symptoms of Acute
Stress” and “Box 7-2: Physical Signs and Symptoms of
Chronic Stress” in Chapter 9 in the textbook
• Read “Box 7-3 Emotional and Behavioural Signs and
Symptoms of Stress” in Chapter 7 in the textbook
• Read “Table 7-1 Stress Can Affect All Dimensions” in
• Read “Responses to Stress” in Chapter 9 in the textbook
• Read “Defence Mechanisms” in Chapter 9 in the textbook
• Read “Job Burnout” in Chapter 9 in the textbook
• Read “Time Management” in Chapter 9 in the textbook
• Read “Box 9-4: Calming Yourself When Feeling Stress” in
• Read “Setting Smart Goals” in Chapter 9 in the textbook
• Read “Box 9-5: Meditation” in Chapter 9 in the textbook
• Read “Planning Your Life and Your Work” in Chapter 9 in
the textbook
• Complete “A. Case Study: Personal Stress Management
Strategies” in the Learner Guide
•
•
•
•
•
Exercises
A. Case Study: Personal Stress Management Strategies
Answer the following questions. There are no wrong answers!
1. What causes you stress?
2. How do you recognize signs of stress in yourself?
• What type of stress management strategies do you currently
use?
• After reading Chapter 9, what type of stress management
strategies do you think would work for you?
Section 5
SLO 4.23Describe aggressive behaviours, including bullying, in
SLO 4.24Describe effective responses to aggressive behaviour,
including bullying
SLO 4.25Describe workplace harassment
SLO 4.26Identify strategies for responding to workplace
harassment
SLO 4.27Describe the HCA role and responsibilities in
following the employer policy and procedures regarding
aggression, bullying, and workplace harassment
SLO 4.28Use terminology related to self-care and safety
Learning Activities
• Read “Aggressive Behaviours and Bullying in Facilities and
• Read “Workplace Harassment” in the Learner Guide
• Complete “Case Study: Workplace Harassment” in the
Learner Guide
• Complete “Matching Question: Identify the Correct Term” in
the Learner Guide
• Complete the multiple choice practice questions that follow
this module
•
Articles
Aggressive Behaviours and Bullying in Facilities and
Aggressive behaviour is the action of an individual or group of
individuals towards an employee or group of employees that is
intended to intimidate, offend or humiliate. Bullying is different
from aggressive behaviour. Aggressive behaviour usually
involves a single act, whereas bullying involves repeated attacks
that create an on-going pattern of behaviour.
Bullying behaviour creates a negative environment and can
cause risk of harm to the targeted person or group of people. It is
possible for a supervisor to bully an employee, but the most
common form of workplace bullying occurs between employees.
There are actions that a HCA can take if he or she feels bullied
in the workplace.
It is the role and responsibility of the HCA to follow employer
policy and procedures regarding aggression and bullying.
Examples of aggressive behaviour and bullying include:
• being unnecessarily criticized
• being blamed without reason
• being treated differently from the rest of the employees
• being sworn at
• being put in isolation from other employees
• being shouted at
• being humiliated
• being constantly monitored without appropriate reason
How bullying affects people:
• high levels of stress
• financial problems due to missing work
• low levels of self-esteem
• emotional distress
• lack of sleep
• digestive problems
Actions that can be taken to prevent or stop bullying:
• recognize that you are being bullied
• realize that you are not the source of the problem
• recognize that bullying is about control and has nothing to do
with your performance
• confront the bully and calmly discuss the behaviour that you
consider aggressive
• keep a diary that describes when, where, who, and what are
involved with the bullying behaviour
• discuss the bullying issues with the supervisor
• if the supervisor is the bully, take your concerns to the union
• if the union is unable to help, take your concerns to the
Human Resources department
• when confronting the bully, one communication method that
can be used is PEER
PEER is an acronym for four steps to use in communicating
with a bully or anyone with whom you are having conflict.
P stands for presenting the problem; explain the problem
as you see it
E stands for explaining how the problem makes you feel
E stands for the effect the problem has on your ability to
do your work
R stands for resolving the problem; explain that you want
to resolve the problem and what would resolve the
problem for you
Workplace Harassment
Workplace harassment is illegal and includes any unwelcome
verbal, written or physical behaviour that slanders or shows
hatred towards a person on the basis of race, sex, colour, culture,
religion, sexual orientation, age or disability. A negative work
environment results from harassment, and interferes with an
employee’s work performance. Anyone in the workplace might
participate in harassment – a supervisor, co-worker, client,
and/or client’s family member.
Examples of workplace harassment

• use of racially offensive words
• comments about a person’s skin colour
• negative statements about a religious belief
• negative statements about a person’s age
• negative statements about a person’s culture
• negative statements about a person’s size, shape, social
status, sexual orientation, education or appearance
Strategies for responding to workplace harassment
• review workplace policy and procedures for dealing with
harassment
• using the PEER method of communication, let the person
know which behaviour is making you feel uncomfortable
• if confronting the individual is not possible, write a letter to
that person explaining which behaviour makes you
uncomfortable
• if the behaviour continues, report the incidents of harassment
to the supervisor
• keep a journal or diary of all the incidents that have been felt
as harassment; include dates, times, and witness names if
applicable
• if harassment continues, find out who handles workplace
harassment policy at your workplace, and file a complaint
• if harassment continues, file a formal complaint with the
Canadian Human Rights Commission
It is the role and responsibility of the HCA to follow employer
policy and procedures regarding workplace harassment.
Exercises
A. Case Study: Workplace Harassment
Read the Case Study and then answer the questions that follow.
Lisa is a HCA of Asian descent who goes to visit her client (Mr.
Willhite) in the community. While assisting Mr. Willhite with
his care, the client makes Chinese jokes that make Lisa feel
uncomfortable.
• What are Lisa’s choices when dealing with the harassment?
• Lisa decides to discuss her feelings with her client. What
should she say to Mr. Willhite?
•
B. Matching Question: Identify the Correct Term
• Match the description from the right column with the
correct term on the left column.
1. Aggressive • Repeated unwanted behaviour
behaviour
2. Bullying • HCA can wear this on their wrist
3. Fatigue • Wearing a clean uniform is an

example of this
4. Medical alert • Type of application form
bracelet
5. Modified work • Illegal type of behaviour
program
6. Personal • To offend someone
hygiene
7. Rehabilitation“I am feeling too tired” is an
•
example of this
8. WCB claim • To restore health after an accident
9. Workplace • “After my injury, I started back to

harassment work part time” is an example of
this
Section 1
A. True and False: Posture
• T
• F
• F
• T
Section 2
A. Identification Questions: Appropriate or Inappropriate
• I
• I
• I
• I
Section 3
A. Case Study: Fatigue
• Single mother, works full time, works extra shifts, drinks
eight cups of coffee and smokes half a package of
cigarettes/day
• Exercises three times a week, eats a balanced diet, and tries
to sleeps between six and eight hours a night
Section 4
B. Case Study: Personal Stress Management Strategies
There are no wrong answers to questions 1 to 4.
Section 5
A. Case Study: Workplace Harassment
• Lisa’s choices include: ignoring the client, confronting the
client, leaving the client, and reporting to her supervisor.
• Lisa would use the PEER method of communication; state the
behaviour that the client is doing (i.e., telling Chinese jokes),
explain how the jokes make her feel, explain how it impacts
her ability to do her job, and that she would like to have the
issue resolved so that she can continue her job.
B. Matching Question: Identify the Correct Term

1. f 6.
c
2. 7.
a h
3. 8.
g d
4. 9.
b e
5. i
References
Acronym Finder. (n.d.). What does REACT stand for? Retrieved

October 10, 2009, from
http://www.acronymfinder.com/Remove-Those-in-Danger,-
Ensure-Door-Is-Closed,-Activate-
Alarm,-Call-Fire-Dept,-Try-to-Extinguish-Fire-(REACT).html
Alberta College of Pharmacists. (2009). Pharmacist and
pharmacy facts. Retrieved October 28, 2009. from
https://pharmacists.ab.ca/nPublic/PharmacistPharmacyFact
s.aspx
Alberta Physiotherapist Association. (n.d.). What is
physiotherapy? Retrieved October 28, 2009, from
http://www.albertaphysio.org/admin/contentx/default.cfm?
PageId=8636
Allen & Bacon. (2004). Introduction to helping relationships.
Retrieved December 21, 2009, from
http;//www.allongman.com/helpingprofessions
American Association of Nurse Anesthetists. (2005, May 10).
Advisory opinion 5.1: Client safety: Fatigue, stress and
work schedule effects. Retrieved November 28, 2009, from
http://www.aana.com
Buckley, L.L, Caple, C., & Pravikoff, D. (November 2009).
Hand Hygiene. In Evidence-Based Care Sheet series.
Glendale, CA: CINAHL Information Systems. Retrieved
February 16, 2010, from CINAHL Plus with Full Text
database.
Canadian Association of Social Workers. (2009). CASW
presents the social work profession. Retrieved October 28,
2009, from http://www.casw-acts.ca/
Canadian Nurses Association. (2007). Framework for the
practice of registered nurses in Canada. Retrieved October
28, 2009, from
www.cna-aiic.ca/CNA/documents/pdf/publications/RN_Fra
mework_Practice_2007
Centers for Disease Control and Prevention. (2003). Exposure to
blood: What health care personnel need to know.
[Brochure]. Retrieved from
http://www.cdc.gov/ncidod/dhqp
Centers for Disease Control and Prevention. (2008). Head lice:
Fact sheet. Retrieved October 17, 2009, from
http://www.cdc.gov/lice/head/factsheet.html
Centers for Disease Control and Prevention. (2008). Head lice:
Prevention & control. Retrieved October 17, 2009, from
http://www.cdc.gov/lice/head/prevent.html
Centers for Disease Control and Prevention. (2008). Lice.
Retrieved October 17, 2009, from
http://www.cdc.gov/lice/index.html
Centers for Disease Control and Prevention. (2008). Scabies:
Prevention & control. Retrieved October 17, 2009, from
http://www.cdc.gov/scabies/prevent.html
Symptoms. Retrieved October 17, 2009, from
http://www.cdc.gov/scabies/symptoms.html
Treatment. Retrieved October 17, 2009, from
http://www.cdc.gov/scabies/treatment.html
Centers for Disease Control and Prevention: Office of Health
and Safety. (2002). Guidelines for laundry in health care
facilities. Retrieved October 10, 2009, from
http://www.cdc.gov/od/ohs/biosfty/laundry.htm
Clatterbuck, S. (2003). Quality in long term care: From quality
assurance to performance improvement. Retrieved
December 17, 2009, from Caring Newsletter, Spring 2003,
at http://findarticles.com/p/articles/
College and Association of Registered Nurses of Alberta.
(2004). Prescribing and distributing guidelines for nurse
practitioners. Retrieved October 28, 2009, from
http://www.nurses.ab.ca/Carna-Admin
College and Association of Registered Nurses of Alberta.
(2005). Medication administration: Guidelines for
registered nurses. Retrieved November 2, 2009, from
http://www.nurses.ab.ca
College of Dietitians of Alberta (n.d.). About registered
dietitians and registered nutritionists. Retrieved October
28, 2009 , from
http://www.collegeofdietitians.ab.ca/app/about.aspx
College of Licensed Practical Nurses of Alberta (2008). LPNs in
Alberta. Retrieved October 28, 2009 from
http://www.clpna.com/BecomeanLPN/LPNsinAlberta/tabid
/68/Default.aspx
College of Nurses of Ontario. (2009, June). Restraints. Retrieved
November 11, 2009, from
http://www.cno.org/docs/prac/41043_Restraints.pdf
Commonwealth of Virginia. (2006, May 16). Department of
Human Resource Management - Policies and Procedures
Manual. Workplace Harassment. Retrieved November 26,
2009, from
http://www.dhrm.state.va.us/hrpolicy/policy/pol230Workpl
aceHarassment.pdf
Egan, Kelly J. & Katon, Wayne J. (1987). Responses to illness
and health in chronic pain clients and healthy adults. The
American Psychosomatic Society, Inc. 470-481. Elsevier
Source Publishing Co. Inc.
Ellingson, L.E. (2002). Communication, collaboration and
teamwork among health care professionals. Communication
Research Trends, 21, (3) 1-44. Retrieved February 13,
2010, from http://cscc.scu.edu/html/trends/v21/v21_3.pdf
Escape Consult Mobiltex Pte Ltd. (2005). Health care facilities
need evacuation plans. Retrieved November 16, 2009, from
http://www.escapeconsult.com/000007.html
Euroscooters. (2006). Guide to riser recliner chairs. Retrieved
http://www.disabled-world.com/artman/publish/article_619
.shtml
Fabiano, L. ( 1999). Breaking through: Working with the frail
elderly. Port Perry, Ontario, Canada: FCS International.
Family Counselling Centre of Brant. (n.d.). Solutions
Newsletter: Harassment in the workplace. Retrieved
http://www.familycounsellingcentrebrant.com/files/408593
6294896818.pdf
Federal Communications Commission. (2008, January 8).
Understanding workplace harassment. Retrieved
http://www.fcc.gov/owd/understanding-harassment.html
Government of Alberta. (2007). Recreation therapist. Retrieved
http://www.alis.gov.ab.ca/occinfo/Content
Government of Alberta. (2009). Protection for Persons in Care:
Safeguarding vulnerable adults. Retrieved November 11,
2009, from
http://www.seniors.gov.ab.ca/CSS/persons_in_care/PPIC_B
rochure.pdf
Government of Alberta. (2009). Residential services - Seniors
and community supports. Retrieved November 11, 2009,
from
http://www.seniors.gov.ab.ca/housing/continuingcare/slas/r
esidentialservices.asp#s25
Health Canada. (2006). Seniors and aging - Preventing falls in
and around your home. Retrieved October 17, 2009, from
http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/life-vie/fp-pc-eng.php
Health Canada. (2009). Effective control of bed bugs. Retrieved
http://www.hc-sc.gc.ca/cps-spc/pubs/pest/_pnotes/bedbugs-
punaises-lits/index-eng.php
Health Canada. (2009). Effective control of rats and mice.
http://www.hc-sc.gc.ca/cps-spc/pubs/pest/_pnotes/rats/inde
x-eng.php
Health Canada. (2009). Environmental and workplace health.
http://www.hc-sc.gc.ca/ewh-semt/occup-travail/work-
travail/index-eng.php
Health Canada. (2009). House and yard - Safe summer fun.
http://www.hc-sc.gc.ca/hl-vs/securit/season-saison/summer-
ete/index-eng.php
Health Canada. (2009). Lindane shampoo - Pediculicide.
http://www.hc-sc.gc.ca/dhp-mps/prodpharma/applic-
demande/guide-ld/label-etiquet-pharm/lindanes-eng.php
Heathfield, S.M. (n.d.). What is the purpose of a team?
http://humanresources.about.com/od/teambuilding/f/teams_
purpose.htm
Hosley, J., & Molle, E. (2006). A practical guide to therapeutic
communication for health professionals. St. Louis, MO:
Saunders Elsevier.
House cleaning checklist: Do you need one? (2009). Retrieved
http://www.easyhousecleaningtips.com/House-Cleaning-
Checklist.html
Hwang, S. W. (2005). Bed bug infestations in an urban
environment. Retrieved October 19, 2009, from Centers for
Disease Control and Prevention: Emerging Infectious
Diseases website:
http://www.cdc.gov/ncidod/eid/vol11no04/04-1126.htm
Lewis, S. M., Heitkemper, M. M., & Dirksen, S. R. (2006).
Medical-surgical nursing in Canada: Assessment and
management of clinical problems (First Canadian ed.).
Toronto, ON: Elsevier Canada.
National Pediculosis Association. (n.d.). FAQs - I've got you
under my skin. Retrieved October 17, 2009, from
http://www.headlice.org/faq/scabies.htm
Nolan, M. R., Davies, S., Brown, J., Keady, J., & Nolan, J.
(2003). Beyond “person centered” care: A new vision for
gerontological nursing. International Journal of Older
People 13, 3a 45-53.
Nursing Organizations Alliance. (2006). Principles of fatigue
that impact safe nursing practices. Retrieved November 27,
2009, from http://www.aorn.org
Palliative Care (2009). In Wikipedia. Retrieved November 1,
2009, from http://en.wikipedia.org/wiki/Palliative_care
Petera, K. (2006). Self-awareness. Retrieved December 28,
2009, from
http://www.more-selfesteem.com/self_awareness.htm
Pryce, A. (2005). Responses to illness. Retrieved 29 October,
2009, from
http://www.staff.city.ac.uk/apryce/responses.htm
Recliner risers: Comfort to live. Freedom to move. (n.d.).
Retrieved October 11, 2009, from http://www.stander.com
Registered Nurses Association of Ontario. (2006). Client
centered care. Retrieved November 1, 2009, from
http://www.rnao.org/Storage
Scabies pictures.What does scabies look like? (n.d.). Retrieved
http://www.naturalscabiesremedy.com
Sinclair, K. (2006). Improve your self-awareness for personal
growth. Retrieved October 14, 2009, from
http://ezinearticles.com/?Improve_Your-Self-Awareness-
For-personal-Growth HYPERLINK
"http://ezinearticles.com/?Improve_Your-Self-Awareness-
For-personal-Growth&id=36825"HYPERLINK
For-personal-Growth&id=36825"& HYPERLINK
For-personal-Growth&id=36825"id=36825" HYPERLINK
For-personal-Growth&id=36825" HYPERLINK
For-personal-Growth&id=36825"id=36825...
Smith, S. F., Duell, D. J., & Martin, B. C. (2004). Clinical
nursing skills: Basic to advanced skills (6th ed.). Upper
Saddle River, NJ: Pearson Prentice Hall.
Smith, S. F., Duell, D. J., & Martin, B. C. (2004). Facilitator's
resource manual and checklists for clinical nursing skills:
Basic to advanced skills (6th ed.). Upper Saddle River, NJ:
Pearson Prentice Hall.
Society of Alberta Occupational Therapists. (2007). Just what is
occupational therapy? Retrieved October 28, 2009, from
http://www.saot.ca/OT.htm
Sorrentino, S. A., Wilk, M. J., & Newmaster, R. (2009). Mosby's
Canadian textbook for the support worker (2nd Canadian
Edition). Toronto, ON: Elsevier Canada.
Sorrentino, S. A., Wilk, M. J., & Newmaster, R. (2009). Mosby's
Canadian textbook for the support worker (2nd Canadian
ed.). Toronto, ON: Elsevier Canada.
State of Washington. (2008, April). Workplace bullying: What
everyone needs to know. Retrieved November 29, 2009,
from
http://www.lni.wa.gov/Safety/Research/Files/Bullying.pdf
Stowkowski, L. (2004). Trends in nursing: An opportunity for
nurses. Topics in Advanced Practice Nursing eJournal, 4,
(1). Retrieved from
http://www.medscape.com/viewarticle/466711_13
Tazim, V., McConnell, H., Tait, A., & Gerolas, E. (July 2002).
Client centered care. The Registered Nurses Association of
Ontario. Toronto, Ontario.
The Business Research Lab. (2007). Toleration of workplace
bullies. Retrieved November 28, 2009, from
http://www.busreslab.com/policies/badpol7.htm
Wong, A. S. J. (2003). Knowing myself: Prerequisites of honesty
and courage. Retrieved December 28, 2009, from
http://www.vtaide.com/lifeskills/knowself.htm
Workers' Compensation Board - Alberta. (2009). Did you know?
Retrieved November 20, 2009, from
http://www.wcb.ab.ca/public/did_you_know.asp
Workers' Compensation Board - Alberta. (2009). Who we are
and what we do. Retrieved November 20, 2009, from
http://www.wcb.ab.ca/public/about_us.asp
Course Review Questions
Module 1 Review
• A holistic care approach for a client includes:
• family, friends, community, religion
• career, sports, recreation, rest
• physical, emotional, social, intellectual, spiritual aspects
• free choice, living at risk, independence
• Self-esteem means:
• the ability to learn from mistakes
• being popular with clients and co-workers
• being well groomed and following the employer’s dress
policy
• thinking well of yourself and having others think well of
you
• Lifelong learning contributes to:
• client safety
• family comfort
• time off
• confidence and competence
• When Mary asked her client if there are any special days or
events she likes to celebrate, Mary was showing an interest
in her client’s:
• culture
• religion
• health beliefs
• dietary restrictions
• When Julio enrolled in a course to help him understand his
clients with a diagnosis of dementia better, he was:
• participating in lifelong learning
• ensuring he would get a promotion
• making a learning plan
• showing an interest in cultural diversity
• Muriel found a used needle left at a client’s bedside. She
did not know what to do with it. One place she could have
looked for this information was:
• the client’s electronic chart
• the policy and procedures manual
• her job description
• the MDS tracking record
• Miguel grew up believing he should put butter on a burn.
This is an example of:
• cultural diversity
• a stereotype
• a health belief
• health promotion
• Burton always walks into a room with his head up, a smile
on his face, and a plan of action. Burton is demonstrating
the traits of:
• good self-esteem
• self-motivation
• client-centered care
• self-actualization
• Sonja has made a plan to evaluate all aspects of her life and
make changes that are good for her overall health. She will
be looking at herself based on:
• her cultural background
• her job description
• the determinants of health
• the layers of self-esteem
• Tilley has no blood kin but has a large group of friends, one
of which is her legal guardian. Tilley is part of:
• a traditional nuclear family
• an extended family
• a blended family
• a self-defined family
Module 2 Review
• Your supervisor has assigned to you the task of starting a
tube feed. She is going to watch you do the procedure. This
is an example of:
• indirect supervision
• direct supervision
• change of role and responsibilities
• new task instruction
• When you are assigned a task, you can refuse the
assignment when:
• you are too busy to do any more work
• the client’s condition is stable
• a new staff member wants a chance to do the
procedure
• you have never done this task for this client before and
have not received instruction on this task which is a
restricted activity
• An activity is restricted when:
• there is a degree of risk involved
• the task is non-invasive
• the doctor has decided it is a restricted activity
• supplies to complete the procedure are expensive
• Health care aides are unregulated health care workers who
work under the direction of:
• the client’s family or legal guardian
• the president of the care facility
• the regulated health care professional
• the Health Care Aide Professional Association
• The Health Information Act ensures that:
• the family can always get the client’s full medical
history
• if the client does not wish to have any health
information disclosed, this wish will be respected
• all health care organizations in the community
automatically receive all clients’ information
• a client is given a copy of his chart when he is
discharged from the hospital
• When a request for information on a client’s condition is
made, the responsibility of the HCA is to:
• refer the person making the request to the health care
professional in charge of client care
• tell the person making the inquiry to call back and
make an appointment to talk to a nurse
• explain that this is not your area of responsibility and
there is nothing you can do to help
• ask to see proof of guardianship and, if this is the legal
guardian, give this person the client’s chart to read
• As a HCA, you must keep client information confidential
because:
• some information on the chart may not be correct
• you have a legal and ethical obligation to maintain
confidentiality
• the client may define confidentiality differently than
you
• a client does not have the legal right to know about his
or her personal information
• A client may not make a personal directive if:
• he is under the age of 18
• he is mentally competent
• he is physically disabled
• he is married
• An agent named in a personal directive must:
• have a medical background
• live in the same province as the client
• be a relative or spouse of the client
• agree to act as the agent for this client
• Which of the following decisions is not a part of the
personal directive?
• where the client would like to live
• who the client would like to associate with
• financial decisions made by the client
• medical treatments the client will accept
• The Protection for Persons in Care Act is designed to
protect:
• home care clients
• clients seen in emergency rooms
• clients receiving treatment in a walk-in clinic
• clients who live in care facilities
• One of the most common types of abuse in care is:
• physical
• religious
• financial
• sexual
• Upon witnessing abuse, the first thing a HCA should do is:
• ensure that the client is safe
• investigate what has happened
• document the incident in the client’s chart
• problem-solve with the abuser
• A public guardian:
• is assigned to each client who comes into care
• is appointed by the court
• is chosen by the client or client’s family
• works for the Government of Canada
• One employee responsibility when working alone is to:
• have a friend to text when in trouble
• refuse to travel alone in a car
• never take a lunch or coffee break
• follow a safe visit plan
Module 3 Review
• What is a team?
• an individual who asks others for advice to achieve a goal
• an individual who works toward achieving a client goal
• group of people who work together towards a common goal
• group of people who work separately toward their part of a
goal
• What do individuals contribute to a team?
• knowledge, experience, skill
• willingness to learn
• flexibility and kindness
• desire to change opinions
• Which of the following is a health care trend?
• ongoing research
• cultural diversity
• acute illness
• longer hospital stays
• A health care team member who works with clients to
improve their strength is what type of health professional?
• registered nurse
• physiotherapist
• recreation therapist
• social worker
• Why is it important to include the client in the Care
Planning?
• client will direct the plan of care
• to follow the values of the health care team
• to determine who will be on the health care team
• the client is more likely to participate
• Which of the following describes subjective data?
• reddened area
• swollen ankle
• painful stomach
• clear discharge
• Which of the following describes a benefit of working on a
health care team?
• sharing knowledge and experience helps to plan for safe
client care
• when team members disagree, the team does not continue
working together
• sharing information can be difficult when people on the
team do not get along
• team members can plan their own client plans individually
without discussing it with the team
• The HCA is assigned to a care activity for which she has
been taught the skill. What is the next step for the HCA?
• complete the skill under indirect supervision
• refuse to complete the skill
• perform the skill under direct supervision
• demonstrate competence by performing the skill on
another client
• Which of the following is a rule of documentation?
• always write using a red pen
• never sign your name in the chart
• use white-out to cover a mistake
• document care given after you have completed care
• What type of information would be included on an
“Activity of Daily Living” flow sheet?
• client’s hygiene
• client’s blood pressure
• an accident involving the client
• client’s food intake
Module 4 Review
• WHMIS stands for which of the following?
• Workplace Hazardous Materials Information System
• Workplace Hurtful Message Information System
• Workplace Hazardous Mould Information System
• Workplace Hurtful Mould Information System
• What does this WHMIS symbol stand for?
• Compressed gas
• Corrosive material
• Poisonous and infectious material
• Flammable and combustible material
• What does this WHMIS symbol stand for?
• Compressed gas
• Corrosive material
• Poisonous and infectious material
• Flammable and combustible material
• What does the “R” in “REACT” stand for?
• Remember to call 911
• Remove those in danger
• Remove the fire extinguisher
• Remember to gather valuables
• Which of the following pests is largest in size?
• A head louse
• A scabies mite
• A bed bug
• A mouse
• The triangle of infection includes which of the following
parts?
• Host, route, and source
• Host, illness, and source
• Host, method, and source
• Host, precaution, and source
• Which of the following activities is part of hand hygiene?

• Vaccinations
• Sterilization
• Disinfection
• Hand washing
• Which of the following diseases is transmitted by blood-borne
pathogens?
• Hepatitis A
• Hepatitis B
• Influenza
• MRSA
• Identify the correct order for putting on personal protective
equipment.
• Goggles, gloves, gown, and mask
• Gloves, gown, mask, and goggles
• Mask, goggles, gown, and gloves
• Gown, gloves, mask, and goggles
• Which of the following terms refers to soiled linen?
• Disposable waste
• Odorous waste
• Biohazardous waste
• Sharps disposable waste
Module 5 Review
• Which of the following factors would increase the risk of
accidental injury?
• client wears eyeglasses
• client does not smoke in bed
• client refuses to wear eyeglasses
• client uses a cane when walking in the hallway
• Identify the strategy that a HCA could use to prevent a
client from falling.
• encourage the client to get long shoelaces
• place the call bell out of the client’s reach
• keep the bed in the highest position
• turn on night lights in hallways
• Which strategy supports the “least restraint” philosophy?
• interrupt the client’s sleep every hour
• provide a calm and quiet environment for the client
• put a mitt restraint on only one of client’s hands
• apply a belt restraint when client is in the wheelchair
• Which restraint is an example of an environmental
restraint?
• bed rails
• alarmed door
• mitt restraints
• waist restraints
• Which of the following actions is a safety measure required
when a client has a restraint applied?
• apply restraints when client is on the toilet
• use bed sheets to tie client to the wheelchair
• remove the restraint from the client every four hours
• check the restraint and client every 15 minutes
• Which of the following measures is a strategy to prevent
burns?
• allow the client to smoke in bed
• test the temperature of the bathwater before putting the
client into the water
• avoid applying sunscreen creams to the client’s skin
• encourage the client to wear loose-fitting clothing when
he cooks
• What is the first thing the HCA should do when a client in a
community setting has a serious burn?
• call 911
• call the client’s doctor
• apply oil to the burn
• apply hot compresses
• Which of the following measures is a strategy to prevent
electrical equipment accidents?
• keep electrical equipment close to water
• follow employer policies and procedures
• hold the cord when removing it from an outlet
• keep electrical equipment on when not using it
• The “R” in “REACT” stands for which of the following?
• remember to call 911
• remove those in danger
• remove the fire extinguisher
• remember to gather valuables
• A Managed Risk Agreement is an agreement between
which people?
• client and her health care team
• client and her daughter
• client and her spouse
• client and her son
Module 6 Review
• When carrying objects, how should they be held?
• close to the body
• away from the body
• above the body
• behind the body
• WCB is an abbreviation for which of the following?
• Workers’ Cash Bureau
• Workers’ Claim Benefits
• Workers’ Custom Benefits
• Workers’ Compensation Board
• Which type of bracelet is the HCA allowed to wear?
• charm bracelet
• tennis bracelet
• friendship bracelet
• medical alert bracelet
• Which type of shoe would be the most appropriate for the
HCA to wear?
• open-toe high-heeled shoes
• running shoes
• flip flops
• sandals
• Which of the following is not a strategy to prevent fatigue?
• eat a balanced diet
• drink plenty of water
• exercise three times a week
• drink plenty of caffeinated coffee
• Drowsiness and fatigue mean the same thing.
• true
• false
• Prolonged or severe stress can lead to which of the following?
• burn out
• bullying
• happiness
• lack of control
• Denial is an example of which of the following?

• meditation
• calming exercise
• defence mechanism
• positive support mechanism
• Being sworn at is an example of bullying.
• true
• false
• Refusing to work with somebody because they are not from
the same culture as you is an example of which of the
following?
• workplace harassment
• defence mechanism
• job burnout
• fatigue
Course Review Answer Keys

Module 1 Review Answer Key
1. c 6. b
2. d 7. c
3. d 8. a
4. a 9. c
5. a 10.d
1. a 9. d
2. d 10. c
3. a 11. d
4. c 12. c
5. b 13. a
6. a 14. b
7. b 15. d
8. a
1. c 6.
c
2. a 7.
a
3. 8.
b c
4. 9.
b d
5. 10.
d a
1. a 6.
a
2. 7.
c d
3. 8.
d b
4. 9.
b c
5. 10.
d c
1. c 6.
b
2. 7.
d a
3. 8.
b c
4. 9.
b b
5. 10.
d a
1. a 6.
b
2. 7.
d a
3. 8.
d c
4. 9.
b b
5. 10.
d a
Lab Procedure Checklist Table of Contents
Lab Procedure Checklist – Hand Washing..............................192

Lab Procedure Checklist – Hand Hygiene using Waterless Hand
Sanitizer...................................................................................194
Lab Procedure Checklist – Putting on a Disposable Mask......196
Lab Procedure Checklist – Removing a Disposable Mask......198
Lab Procedure Checklist - Putting on Non-Sterile Disposable
Gloves......................................................................................200
Lab Procedure Checklist – Removing Gloves.........................202
Lab Procedure Checklist – Gowning.......................................204
Lab Procedure Checklist – Removing a Gown........................206
Lab Procedure Checklist - Body Mechanics when Lifting an
Item..........................................................................................208
Lab Skills Checklist: Environmental Safety
Learner Last Name: _________________________ Learner
First Name: _______________________ ID Number:
____________
Lab Procedure Checklist – Hand Washing
Handwashing: Lab S U Practic S U Facilitat
Action Date um
Date
• Assemble
equipment:
• Soap
• Paper towels
• Garbage
receptacle
• Remove your watch,
and push your
sleeves up.
• Run lukewarm water.
• Wet hands and apply
soap from a
dispenser.
5. Rub surfaces of
hands together for at
least 15 seconds.
a. Rub the backs of
hands and wrists.
b. Interlace
fingers and rub the
spaces in between
fingers.
c. Rub palms
together.
d. Rub all hand
surfaces,
fingertips, and
thumb of each
hand against the
palm of the other
hand. Get under
the fingernails.
6. Rinse all surfaces of

the hand under
running water with
the fingertips
pointing down.
7. Pat hands dry with a
paper towel.
• Dispose of wet towels
in the garbage by
dropping them in
without touching the
receptacle.
• Use a dry paper towel
to shut off the water
• Apply hand lotion as
needed

____________
Lab Procedure Checklist – Hand Hygiene using
Waterless Hand Sanitizer
Hand Hygiene using Lab S U Practic S U Facilit
Waterless Hand Date um
Sanitizer: Date
Action
• Pour 3 to 5 ml of
waterless hand
sanitizer into the
palm of your hand.
• Rub hands together
ensuring that all
surfaces are
covered with the
hand gel.
• Rub palms
together.
• Interlace fingers
and rub the
spaces in
between fingers.
• Rub the
fingertips of
each hand
against the palm
of the other
hand.
• Rub the backs of
hands and wrists.
• Rub hands until
they are dry –
about 30 to 60
seconds.

____________
Lab Procedure Checklist – Putting on a Disposable
Mask
textbook.
Putting on a Lab S U Practic S U Facilit
Disposable Mask: Date um
Action Date
• Perform hand
hygiene.
• Pick mask up by the
ties, avoiding
touching the part of
the mask that
touches face.
• Fasten the upper ties
over the ears and tie
behind head.
• Tie lower strings
behind neck
ensuring the bottom
of the mask is
securely under chin.
• Mold the metal band
across nose to create
a tight fit.
• Perform hand
hygiene.
____________
Lab Procedure Checklist – Removing a Disposable
Mask
Removing a Lab S U Practicu S U Facilit
Disposable Mask: Date m Date
Action
• Wash your hands
and put on clean
gloves if needed.
• Remove the mask
in this order:
• Untie the lower
strings.
• Untie the top
strings.
• Hold the top
strings and pull
the mask away
from the face.
• Bring the strings
together folding
the moist inner
surface of the
mask to the
inside.
• Hold the mask by
the strings and
discard it into the
garbage receptacle
avoiding touching
the receptacle.
____________
Lab Procedure Checklist - Putting on Non-Sterile
Disposable Gloves
Putting on Non- Lab S U Practicu S U Facilit
Sterile Disposable Date m Date
Gloves:
Action
• Perform hand
hygiene by
washing your
hands with soap
and water or using
hand sanitizer
prior to putting on
the gloves.
• Check gloves for
rips and tears
before putting
them on
• Grasp the glove
by the cuff and
place it on one
hand and follow
this procedure for
the second hand.

____________
Lab Procedure Checklist – Removing Gloves
textbook.
Removing Gloves: Lab S U Practicum S U
Action Date Date
• Ensure that your soiled
gloves touch only each
other and never touch
your skin.
• Grasp the glove just
below the cuff with the
gloved fingers of your
opposite hand.
• Pull the glove down over
your hand, allowing it to
turn inside out as you do
this.
• Hold the glove you have
removed in your still-
gloved hand.
• Insert the fingers of your
un-gloved hand under the
cuff of the remaining
glove
• Pull the glove down over
your hand and the
removed glove, allowing
the glove to turn inside
out as you do so.
• Drop both gloves into the
garbage, ensuring you do
not come into contact
with the receptacle.
• Wash your hands.
____________
Lab Procedure Checklist – Gowning
textbook.
Gowning: Lab S U Practicu S U Facilit
Action Date m Date
• Perform hand
hygiene.
• Put on the gown.
• Open the gown
without shaking it
or touching it to
your uniform.
• Put on the gown.
Ensure that it
covers your
clothing
completely from
front and back.
Ensure that you do
not contaminate
the outside of the
gown.
• Fasten the neckties
and overlap the
gown at the back
to fasten the waist
ties.
____________
Lab Procedure Checklist – Removing a Gown
Removing a Gown: Lab S U Practicu S U Facilit
Action Date m Date
• Untie the neck and
waist ties.
• Remove the gown
by grasping it at
the neck or
shoulders and
pulling the gown
forward.
• Slide the gown off
your shoulders.
• Turn the gown
inside out to
contain the
contaminated
surface.
• Roll up the gown
and discard it in the
appropriate
container. Do not
touch uniform with
soiled gown.
Lab Skills Self Care and Safety

____________
Lab Procedure Checklist - Body Mechanics when
Lifting an Item
Body Mechanics when Lab S U Practic S U Facili
Lifting an Item: Date um
Action Date
• Determine if assistance is
needed prior to lifting an
item.
• Place both feet flat on the
floor, with one foot slightly
in front of the other.
• Slightly bend both knees
and, if the item is on the
floor, squat down.
• Squeeze stomach muscles
and tuck buttocks so that
spine is in alignment.
• Hold head so that eyes are
looking straight ahead.
• Maintain weight to be lifted
as close to body as possible.
• Prevent twisting when
lifting.
Pass_______ Redo_______
Facilitator_______________________________________
_______

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Health

Bow Valley College

© Copyright 2011, Alberta Health and Wellness

HCAD1101: Working as a Health Care Aide

Read, learn, practice and enjoy.

See current Booklist in Desire2Learn (D2L)

Course Learning Outcomes

• Examine concepts of health and wellness and of illness and disability

• Module 4: Environmental Safety •

• Module 5: Client Safety •

• Module 6: Self Care and Safety •

Module 1: Role of the Health Care Aide

• Spiritual health – You may or may not have a formal

Which dimensions of health did you score well in?

• Mary is 88 years old and lives in a continuing care facility.

C. Diagram Labeling: The Determinants of Health

• Respects other people’s property

Listen with an Open Mind

4. Physical • Dependent parents

2. Housekeeping/ • Providing support to a new mother

Bringing Meaning to the Model

C. Chart: Comparing Challenges in Work Settings

The HCA has a Role when Working with Families

The Individual Response

Three common responses to adapting to receiving

The Many Layers of Self-Awareness

4. Frame of • People you are related to by

B. Fill in the Blanks: Terminology

C. True and False: Definitions

____ Encouraged the client to talk about his health beliefs

B. Case Study: Honouring the Client’s Health Beliefs

C. Chart: Comparing Challenges in Work Settings

Role and Responsibility Alert! If a restricted activity meets all

B. Case Study 2: Supervision and Assignment of Task II

A personal directive deals with:

Protection for the Person Reporting Abuse

B. Case Study 4: PPICA

• ___ An employee travels away from • Occupatio

Module 3: Function Effectively as a Team Member

Figure 1. The Health Care Team

The Importance of Client and Family as Part of the

Rehabilitation Teams - Some clients require extended hospital

• I am receiving appropriate supervision for my experience

B. Matching Questions: Decision-Making

Answer Key for Module 3

B. Case Study: Mr. Saddleback

Risks Associated With Riser Recliners

Washing Linens and Clothing

Tasks associated with the bathroom include:

2. ____ scabies • I can be found on eyebrows.

3. ____ bed bugs • I like to hide under the skin.

4. ____ mice • I like to live in mattresses.

C. Fill in the Blanks: Organisms and Pathogens

Lab Procedure: Hand Hygiene Using Waterless Hand

Lab Procedure: Putting on a Disposable Mask

Lab Procedure: Removing a Disposable Mask

Lab Procedure: Putting On Non-Sterile Disposable

Lab Procedure: Gowning

* You would move them to a room without windows.