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General Information

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Provide Name of Company*

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Core Competency Quiz

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COMPETENCY #1

To have knowledge of the agency’s mission, policies, and procedures.

As a Medicare-certified agency, we accept patients for hospice care when their prognosis is 12 months or less.*

True

False

For patients on the hospice benefit, we pay for their medical equipment.*

True

False

For patients on the hospice benefit, we pay for medications related to the terminal illness.*

True

False

For patients on the hospice benefit, we never pay for radiation or chemotherapy.*

True

False

Medicare and MediCal pay us a fixed amount for each home visit.*

True

False

Hospice patients are required to sign advance directives such as a living will, Durable Power of Attorney for Health Care, or Do Not Resuscitate form.*

True

False

Where would you find our agency’s personnel policies?*

What is the Mission Statement of Mission Hospice & Home Care?*

COMPETENCY #2

To be familiar with and knowledgeable about the issues involved in death and dying, and to be effective in communicating with patients, families, and the public about these issues.

Hint: there are 10 terms & 9 definitions.

Advanced Directive
Durable Power of Attorney for Health Care
Euthanasia
Hospice
The Medicare medical requirement for eligibility for hospice admission
Palliative Care
End of Life Option Act (ELOA)
Prognosis
Terminal illness
Palliative sedation

An illness that will, if it follows its normal course, eventually cause death.*

Written instructions concerning the provisions of health care, to be followed in the event the individual is incapacitated at the time a health care decision must be made.*

Death caused by the deliberate action of someone other than the patient, with the intention of ending the patient’s life.*

A person who is terminally ill with a prognosis of 6 months or less to live if the disease follows its normal course.*

California's End of Life Option Act (ELOA) allows a terminally ill patient to request a drug from his or her physician that will end the patient’s life. Patients who choose to end their lives in this way, and who follow the steps in the law, will not be considered to have committed suicide.*

A foretelling of the outcome of a disease; a forecast of the outcome of a disease.*

The use of high doses of sedatives to relieve extremes of physical distress, for the purpose of addressing unmanageable suffering during the final days of the patient’s illness.*

A document that includes designation of one or more individuals to make health care decisions on behalf of an incapacitated patient.*

Provides an extra level of physical, emotional, and spiritual support to improve quality of life for people with serious, life-limiting illness who are not ready for hospice.*

Name two of the common signs or symptoms of approaching death.*

Does California have a law that allows physician-assisted suicide?*

COMPETENCY #3

To recognize one’s own attitudes, feelings, values, and expectations about death and the individual, cultural, and spiritual diversity existing in these beliefs and customs.

Write one or two sentences about your own attitudes about death and dying. If possible, touch on how your attitudes have altered since being associated with Mission Hospice & Home Care.*

COMPETENCY #4

To have a general understanding of palliative care and pain and symptom management.

Pain is always an accompaniment to a cancer diagnosis.*

True

False

Pain medication doses should only be given when the patient has pain they cannot tolerate.*

True

False

Palliative care may include radiation therapy and blood transfusions.*

True

False

If a patient takes pain medication such as morphine early in the illness, they may develop a tolerance that would mean pain medication would not work later when the pain is worse.*

True

False

Symptoms that hospice care frequently addresses are pain, nausea, anxiety, constipation, and shortness of breath.*

True

False

There are very few cases in which the hospice team cannot manage a patient’s pain.*

True

False

COMPETENCY #5

To have a general understanding of grief and bereavement.

Anticipatory grief is just as valid and important as grief occurring after the patient dies.*

True

False

Grief and depression are exactly the same.*

True

False

Medicare guidelines require that we offer our support to the bereaved for only six months.*

True

False

Our regular bereavement services are free of charge.*

True

False

Bereavement care is mostly listening.*

True

False

Becoming the bereaved’s friend is one of the most caring and professional things we can do.*

True

False

Children grieve like adults but for a shorter period of time.*

True

False

Signs or symptoms of high-risk grief are normal and should not unduly concern us.*

True

False

We can give bereaved families the names of at least three outside professionals and three community agencies, if needed.*

True

False

COMPETENCY #6

To understand how to manage stress of hospice work.

Which of the following are positive responses to stress?*

A walk on the beach

Having several drinks at the end of a hard day

Talking it out with someone

Writing in a journal

Having a massage

Seeing a counselor

Keeping a bright face and not talking about your stresses

Name two things Mission Hospice & Home Care provides to help employees with the stresses of hospice work.*

COMPETENCY #7

To have the ability to work effectively as a team member, to understand the roles of other team members and office staff, and to utilize each others’ expertise.

Name the team member whose job it is to:

Take referrals:*

Visit patients and families with existential concerns:*

Clean patients, provide bed baths, change diapers, change linens:*

Order gloves, diapers, and other patient care supplies:*

Assign Direct Care Volunteers to patients and families:*

Help patients and families complete advance health care directives, make funeral arrangements, and find caregivers:*

Take calls in the office from patients and families who have medical concerns:*

Coordinate grant proposals and solicitations for donations to Mission Hospice & Home Care:*

Bill Medicare:*

See that bereavement follow-up is done for family members:*

Send physician surveys and discharge summaries after a patient’s death:*

Mark the four “core disciplines” that are required to participate in care planning.*

Medical Social Workers

Direct Care Volunteers

Physicians

Patient care coordinators

Dieticians

Home Health Aides

Nurses

Spiritual Counselors and other counselors

Physical Therapists

Pharmacists

List two things that a Medical Social Worker might do with/for a patient or family*

List two things that a Spiritual Counselor might do with/for a patient or family*

List two things that a Direct Care Volunteer might do with/for a patient or family*

COMPETENCY #8

To have good listening skills and to understand concepts of active listening.

List one way you show that you are listening actively to another person*

In a situation in which you wish to offer empathetic, reflective listening, which of the following responses would be useful?*

“Let’s talk about pleasant things.”

“You sound very tired.”

“That happened to me too.”

“That must be very frustrating.”

“So, what I would do is…”

“It sounds as though you don’t feel much hope.”

“It’s all for the best.”

“That must be very disappointing. Would you like to talk more about it?”

“You’ll feel better soon.”

The way in which you ask a question can make a difference in how it is answered. An open-ended question will invite the client to give you more information. Which of the questions below are open-ended?*

Tell me about your relationship with your brother.

Tell me about your mother.

How has your illness affected you?

What has been the most difficult for you recently?

What are your favorite holidays?

Are you afraid of dying?

How many times have you been in the hospital?

How has the experience in the hospital been for you?

What is the difference between an open-ended and a closed-ended question?*

Describe empathetic listening.*

PAIN ASSESSMENT COMPETENCY EXAM

Pain exists whenever the patient says it does.*

True

False

All pain has an identifiable cause.*

True

False

Pain tolerance varies from patient to patient.*

True

False

Pain tolerance varies from one time to another in a particular patient.*

True

False

If a patient has a positive placebo response (pain relief), the pain was probably imaginary.*

True

False

The nurse, not the patient, is the expert on a patient’s pain.*

True

False

Pain behaviors or facial expressions of pain are very reliable indicators of the presence of pain in any patient.*

True

False

The best source of assessment information is usually the patient’s family.*

True

False

I will assess pain at each visit primarily by observing the patient’s attitude.*

True

False

When using a numeric pain scale, if the rating given is “4 to 5,” that is what I will write on the visit note.*

True

False

If the patient reports a pain level of 4, I will:*

If the patient reports a new pain, I will:*

BASIC SAFETY COMPETENCY

The percentage of people who have back pain at some time in their life is:*

10-20%

35-45%

60-80%

Which of these could cause spinal pain?*

All of the below

Slouching at your desk

Holding the phone between your ear and shoulder

Turning to the side and lifting at the same time

A basic principle of back safety is to lift with your:*

Hands

Head

Leg muscles

Another basic principle of back safety is to lift with:*

Gusto

No rotation

Exhalation

Stretching exercises and staying in shape can help to prevent back injury.*

True

False

The natural curves of the spine allow even distribution on the vertebrae and muscles of the back.*

True

False

You can safely lift heavier weights down from a height than up from the floor.*

True

False

Sitting is a stressful position for the back.*

True

False

For safe lifting, bend at the waist.*

True

False

When carrying, it is safest to hold objects close to your body.*

True

False

TRAINING EXERCISE – PERSONAL INVENTORY – PROFESSIONALISM/BOUNDARY ISSUES

This exercise is to encourage your active thinking about boundary issues. Please indicate when you think each behavior on the part of a health care professional would be OK.

Accepting cash, or equivalent, as a gift for personal use.*

Always OK

Sometimes OK

Never OK

Buying gifts for individual patients or families.*

Always OK

Sometimes OK

Never OK

Sharing information a client reveals in a support group with his/her physician.*

Always OK

Sometimes OK

Never OK

Inviting patients or families to join you in activities or parties outside of work.*

Always OK

Sometimes OK

Never OK

Meeting with a client who comes to you in crisis after you have transferred the case to a peer.*

Always OK

Sometimes OK

Never OK

Sharing personal information about yourself with patients or families.*

Always OK

Sometimes OK

Never OK

Sharing personal problems with patients or families.*

Always OK

Sometimes OK

Never OK

Giving an update to a neighbor on the medical condition of a football star’s son.*

Always OK

Sometimes OK

Never OK

Sharing information about one patient/family with another patient/family.*

Always OK

Sometimes OK

Never OK

Giving out your cell phone number to patients or families.*

Always OK

Sometimes OK

Never OK

Calling in on days off to check on how your patient is doing.*

Always OK

Sometimes OK

Never OK

Loaning money or personal belongings to patients or families.*

Always OK

Sometimes OK

Never OK

Tuberculosis Control

Tuberculosis (TB) is passed through the air when a person with active TB coughs, speaks, or sneezes.*

True

False

The concentration of droplets in a room is higher, and therefore more likely to cause infection, if the room is poorly ventilated.*

True

False

Touching the surfaces in a room where a TB patient has coughed can cause transmission of TB.*

True

False

It depends on the length of time between the coughing and the touching of the surface

A person with a weakened immune system (e.g., someone with AIDS/HIV, or someone on chemotherapy) is at greater risk for getting active TB.*

True

False

It is okay for a healthcare worker to provide care to a client if they have NOT had a Mantoux/PPD test (or, for those who historically have a positive skin test, a chest x-ray.)*

True

False

If you have a latent TB infection, you are infectious to others.*

True

False

Symptoms of active TB include a productive, persistent cough that lasts more than three (3) weeks; bloody sputum; weakness; fatigue; weight loss; fever; loss of appetite; night sweats.*

True

False

If a person with active TB does not complete the full course of treatment with medication, there is a risk of producing a drug-resistant strain of TB.*

True

False

Multi-drug resistant (MDR) TB has a 100% cure rate.*

True

False

If you visit a patient who is suspected or known to have active TB, you can wear any mask you have available.*

True

False

End of Life Option Act

Who can use this option? Mark all that apply.*

Patient must be 18 years or older and be a resident of California

Have a terminal illness. A physician must determine that the disease cannot be cured or reversed and is expected to result in death within six months.

Have the capacity to make medical decisions.

Not have impaired judgment due to mental disorder.

Have the ability to take the drug at the time they want to take it.

The patient must take the drug if he or she requests a prescription.*

True

False

If a patient is too weak to speak for him or herself, but told a family member they want to take advantage of the ELOA, the family member can request a prescription on the patient’s behalf.*

True

False

A volunteer cannot pick up the ELOA prescription for the patient.*

True

False

Volunteers are required to support patients who elect to exercise their rights under the End of Life Option Act.*

True

False

If the patient is too weak, family or staff can give medication to a patient who wants a cup placed to his or her mouth.*

True

False

Which of these topics can a volunteer discuss with a patient? Mark all that apply.*

The medications available for ELOA, and how they work.

The mental stability of the patient and assessment tests to evaluate in order to be a candidate for ELOA.

The involvement of family and how they can be in on the conversation with the doctors.

The patient’s emotions and thoughts on ELOA, and how this affects the patient and loved ones.

We Honor Veterans

Veterans account for 25% of all deaths in the United States.*

True

False

Most Veteran deaths are in VA facilities because it’s easy for Veterans to access the benefits they’ve earned and are entitled to receive.*

True

False

Mission Hospice is partnering with We Honor Veterans Hospice program to:*

Ensure that patients who are Veterans receive appropriate, high quality services provided by skilled staff.

Ensure that care teams communicate with our Veterans honestly and effectively.

Help coordinate transitions across the VA and other community settings of care.

All Veterans have similar needs, so it is not important to know in which war, or in what branch someone has served.*

True

False

If you are visiting a patient and notice a Certificate of Honor, or photo of the patient or their family member in a military uniform, it’s best not to say anything because Veterans are trained not to talk about how they feel, and it may upset them.*

True

False

Signature – Core Competency Quiz*

Please sign your name below

Blood Borne Pathogen Quiz

All fields are required. You may save this form at anytime and come back to the area you want to continue.

Healthcare workers most often become exposed to Hepatitis B, Hepatitis C and HIV through accidental needlesticks.*

True

False

HIV poses a greater risk to healthcare workers than Hepatitis B or Hepatitis C because it is transmitted more easily.*

True

False

Most people infected with the Hepatitis B virus do recover and clear the infection.*

True

False

Most people infected with Hepatitis C become chronically infected.*

True

False

People infected with HIV usually experience symptoms in two weeks.*

True

False

Fortunately, there are vaccines to prevent both Hepatitis B and Hepatitis C.*

True

False

Hepatitis B virus, Hepatitis C virus and HIV spread most easily through contact with blood.*

True

False

You can be exposed to bloodborne pathogens at work if blood or other infectious material splashes on your broken skin or mucous membranes.*

True

False

Most needlestick injuries occur when disposing of needles, giving medications, drawing blood or handling trash or dirty linens.*

True

False

The Hepatitis B vaccine is very effective only if the series is completed.*

True

False

Standard Precautions means wearing gloves when having direct contact with any patient.*

True

False

Standard Precautions incorporates features of both Universal Precautions and Body Substances Isolation practices to protect you against the risk of bloodborne pathogens as well as pathogens from moist body substances.*

True

False

After removing gloves, you need to wash your hands only if you touch the outside of the gloves.*

True

False

It is always good practice to know whether your patient has a bloodborne pathogen that could be an infection risk, so you can take proper infection precautions.*

True

False

You do not need to wear gloves when handling dirty linens unless the linens are contaminated with blood.*

True

False

If you happen to find a needle, it is ok to just throw it in the garbage as long as you put the protective cap back on the needle.*

True

False

Nearly one-third of all sharps injuries occur during the disposal process.*

True

False

According to research, safety precautions such as handling all blood and body fluids as though infectious, using PPE when needed, and handling sharps carefully will decrease your risk of exposure to bloodborne pathogens.*

True

False

If your skin is punctured by a contaminated sharp, wash the area with soap and water or a diluted mixture of bleach and water, if available*

True

False

Most needle sticks that puncture the skin result in a blood infection.*

True

False

It is good precautionary practice to never touch a patient if you know that they are infected with AIDS or hepatitis.*

True

False

If you are accidentally stuck by a sharp, or get contaminated blood or body fluids on broken skin or splashed on mucous membranes, it is best to immediately contact the Mission Hospice triage nurse.*

True

False

Consent*

I have read and understand the training Handbook, Bloodborne Pathogens: a Sharper Image (Featuring Sharps Safety Device). I have also completed and passed the comprehensive quiz related to this training.*

Signature (Blood Borne Pathogen Quiz)*

Handwashing Competency Certification

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Can you identify times when hand washing is required?*

Yes

Additional comments

Performance Evaluation: Alcohol-Based Handrub

Apply palm full of the product in a cupped hand covering all surfaces*

Satisfactory	Unsatisfactory

Rub palm to palm*

Satisfactory	Unsatisfactory

Right palm over left dorsum with interlaced fingers and vice versa*

Satisfactory	Unsatisfactory

Palm to palm with fingers interlaced*

Satisfactory	Unsatisfactory

Backs of fingers to opposing palms with fingers interlocked*

Satisfactory	Unsatisfactory

Rotational rubbing, backward & forward with clasped fingers of right hand in left palm and vice versa*

Satisfactory	Unsatisfactory

Rotational rubbing, backward & forward with clasped fingers of right hand in left palm and vice versa*

Satisfactory	Unsatisfactory

Performance Evaluation: Soap and Water

Using warm running water, wet hands and wrists (back and front)*

Satisfactory	Unsatisfactory

Apply enough soap to cover all hand surfaces*

Satisfactory	Unsatisfactory

Rub hands palm to palm*

Satisfactory	Unsatisfactory

Right palm over left dorsum with interlaced fingers and vice versa*

Satisfactory	Unsatisfactory

Palm to palm with fingers interlaced*

Satisfactory	Unsatisfactory

Backs of fingers to opposing palms with fingers interlocked*

Satisfactory	Unsatisfactory

Rotational rubbing of left thumb in right palm and vice versa*

Satisfactory	Unsatisfactory

Rotational rubbing, backward and forward with clasped finger of right hand in left palm and vice versa*

Satisfactory	Unsatisfactory

Rinse hands with water*

Satisfactory	Unsatisfactory

Dry hands thoroughly with single use towel*

Satisfactory	Unsatisfactory

Use towel to turn off faucet*

Satisfactory	Unsatisfactory

Dispose without touching garbage receptacle*

Satisfactory	Unsatisfactory

Signature (Handwashing Competency Certification)

Evaluator Name*

First Last

Evaluator signature*

CAPTCHA

Competency Quizzes

General Information

Core Competency Quiz

COMPETENCY #1

COMPETENCY #2

COMPETENCY #3

COMPETENCY #4

COMPETENCY #5

COMPETENCY #6

COMPETENCY #7

COMPETENCY #8

PAIN ASSESSMENT COMPETENCY EXAM

BASIC SAFETY COMPETENCY

TRAINING EXERCISE – PERSONAL INVENTORY – PROFESSIONALISM/BOUNDARY ISSUES

Tuberculosis Control

End of Life Option Act

We Honor Veterans

Blood Borne Pathogen Quiz

Handwashing Competency Certification

Performance Evaluation: Alcohol-Based Handrub

Performance Evaluation: Soap and Water

Peninsula Office

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