2022 - 2023
Florida Department of Education
Curriculum Framework 

Program Title:	Nursing Assistant (Acute and Long Term Care)
Program Type:	Career Preparatory
Career Cluster:	Health Science

Secondary – Career Preparatory	
Program Number	8417210	
CIP Number	0317060201	
Grade Level	9-12 	
Standard Length	3 credits	
Teacher Certification	Refer to the Program Structure section.	
CTSO	HOSA: Future Health Professionals	
SOC Codes (all applicable) 	31-1014 -- Nursing Assistants
31-9099 -- Healthcare Support Workers, All Other	
CTE Program Resources 	http://www.fldoe.org/academics/career-adult-edu/career-tech-edu/program-resources.stml	

Purpose 

This program offers a sequence of courses that provides coherent and rigorous content aligned with challenging academic standards and relevant technical knowledge and skills needed to prepare for further education and careers in the Health Science career cluster; provides technical skill proficiency, and includes competency-based applied learning that contributes to the academic knowledge, higher-order reasoning and problem-solving skills, work attitudes, general employability skills, technical skills, and occupation-specific skills, and knowledge of all aspects of Health Science career cluster. 

This course is designed to prepare students for employment as nursing assistants SOC Code- 31-1014 (Nursing Assistants) in nursing homes, hospitals, or other health care facilities.

The content includes, but is not limited to, interpersonal skills, medical terminology, legal and ethical responsibilities, safe and efficient work, gerontology, nutrition, pet-facilitated therapy, health and safety including Cardio-pulmonary Resuscitation (CPR) – heart saver level, and employability skills.

Additional Information relevant to this Career and Technical Education (CTE) program is provided at the end of this document.

Program Structure

This program is a planned sequence of instruction totaling three credits. The two credit Health Science Core (Health Science Anatomy & Physiology 8417100 and Health Science Foundations 8417110) is required as a prerequisite for all programs.  Secondary students completing the two required courses will not have to repeat the core in postsecondary.  

To teach the courses listed below, instructors must hold at least one of the teacher certifications indicated for that course.

The following table illustrates the secondary program structure:

Course Number	Course Title	Teacher Certification	Length	SOC Code	Level	Graduation Requirement	
8417100	Health Science Anatomy and Physiology	ANY HEALTH OCCUP G (See DOE approved list)	1 credit	31-9099	3	EQ	
8417110	Health Science Foundations		1 credit	31-9099	3		
8417211	Nursing Assistant 3 	REG NURSE  7 G 
LPN 7 G*
PRAC NURSE @7  %7%G (Must be a Registered Nurse)	1 credit	31-1014	3		
(Graduation Requirement Abbreviations- EQ= Equally Rigorous Science, PA= Practical Arts, EC= Economics)

* The LPN 7 G district issued certification is a practical nurse. A practical nurse can only be utilized as an instructor of the CNA training program when they are supervised by the program coordinator, which must be a registered nurse. Please refer to F.A.C. 64B9-15.005 for requirements.

Regulated Programs

This program is regulated by the Florida Board of Nursing.

Successful completion of this program from an approved school prepares the student for certification for employment as a Nursing Assistant, in accordance with Chapter 464.203, Florida Statutes.  To be approved, this program must be supervised by a registered nurse and follow the faculty qualifications set forth in 64B9-15.005 (3) (a) F.A.C. 

New programs must be approved by the Board of Nursing, Department of Health prior to enrolling students.

Those students who satisfactorily complete an approved course are eligible to apply to take the national nursing assistant examination being utilized in Florida, in accordance with Chapter 464.203, F.S.  This program includes both Acute and Long Term Care.

In accordance with 64B9-15.005 (4) (c) F.A.C., students will perform nursing skills in the clinical and simulated laboratory settings under the supervision of a qualified instructor. The clinical instruction ratio for program instructor to student is 1 to 15 for students caring directly for residents or clients.

In accordance with 64B9-15.006 (2) F.A.C., The standardized curriculum shall require a minimum of 80 hours of classroom and 40 hours clinical instruction. The clinical instruction shall include at least 20 hours of long term care clinical instruction in a licensed nursing home

In accordance with 64B9-15.006 (3) F.A.C., Prior to any direct contact with a resident, a training program shall require that a student receive a minimum of 16 hours of classroom instruction in communication and interpersonal skills; infection control; safety/emergency procedures, including the Heimlich maneuver; promoting residents’ independence; and respecting residents’ rights.

According to Section 400.211, F.S., persons who are enrolled in, or have completed, a state approved nursing assistant training program may be employed by a licensed nursing facility for a period of four months. However, the certification requirements must be met within four months of such initial employment.

Common Career Technical Core – Career Ready Practices

Career Ready Practices describe the career-ready skills that educators should seek to develop in their students.  These practices are not exclusive to a Career Pathway, program of study, discipline or level of education.  Career Ready Practices should be taught and reinforced in all career exploration and preparation programs with increasingly higher levels of complexity and expectation as a student advances through a program of study. 

1. Act as a responsible and contributing citizen and employee. 

2. Apply appropriate academic and technical skills. 

3. Attend to personal health and financial well-being. 

4. Communicate clearly, effectively and with reason. 

5. Consider the environmental, social and economic impacts of decisions. 

6. Demonstrate creativity and innovation. 

7. Employ valid and reliable research strategies. 

8. Utilize critical thinking to make sense of problems and persevere in solving them. 

9. Model integrity, ethical leadership and effective management. 

10. Plan education and career path aligned to personal goals. 

11. Use technology to enhance productivity. 

12. Work productively in teams while using cultural/global competence. 

Standards

After successfully completing this program, the student will be able to perform the following:

Standards 1-27 encompass the Health Science Core: 

01.0	Analyze and interpret an overview of the human body, including organization and chemical process.
02.0	Apply correct medical terminology relating to body structure and function within a real-world application.
03.0	Evaluate cells and tissues microscopically and macroscopically and relate their specialized functions.
04.0	Analyze the integumentary system in relation to health and disease.
05.0	Analyze the skeletal system in relation to health and disease.
06.0	Analyze the muscular system in relation to health and disease.
07.0	Analyze the nervous system in relation to health and disease.
08.0	Analyze the endocrine system in relation to health and disease.
09.0	Analyze the cardiovascular/circulatory system in relation to health and disease.
10.0	Analyze the lymphatic and immune systems in relation to health and disease.
11.0	Analyze the respiratory system in relation to health and disease.
12.0	Analyze the digestive system in relation to health and disease.
13.0	Analyze the urinary system in relation to health and disease.
14.0	Analyze both the male and female reproductive systems in relation to health and disease.
15.0	Identify and explain factors relating to genetics and disease.
16.0	Evaluate and apply the principles of disease transmission and control to real-world scenarios.
17.0	Demonstrate knowledge of the healthcare delivery system and health occupations.
18.0	Demonstrate the ability to communicate and use interpersonal skills effectively.
19.0	Demonstrate legal and ethical responsibilities.
20.0	Demonstrate an understanding of and apply wellness and disease concepts.
21.0	Recognize and practice safety and security procedures.
22.0	Recognize and respond to emergency situations.
23.0	Recognize and practice infection control procedures.
24.0	Demonstrate an understanding of information technology applications in healthcare.
25.0	Demonstrate employability skills.
26.0	Demonstrate knowledge of blood borne diseases, including HIV/AIDS.
27.0	Apply basic math and science skills.

Standards 28-39 encompass competencies specific to Nursing Assistant:

28.0	Use verbal and written communications specific to nurse assisting.
29.0	Demonstrate legal and ethical responsibilities specific to nurse assisting.
30.0	Perform physical comfort and safety functions specific to nurse assisting.
31.0	Provide personal patient care.
32.0	Perform patient care procedures.
33.0	Apply principles of nutrition.
34.0	Provide care for geriatric patients. 
35.0	Apply the principles of infection control specific to nursing assisting. 
36.0	Provide biological, psychological, and social support.
37.0	Perform supervised organizational functions, following the patient care plan.
38.0	Assist with restorative (rehabilitative) activities. 

2022 - 2023
Florida Department of Education
Student Performance Standards
Health Science Core: 

The first two courses in this program are referred to as the Health Science Core and consist of the courses Health Science Anatomy & Physiology (8417100) and Health Science Foundations (8417110). To ensure consistency whenever these courses are offered, the standards and benchmarks for the health science core have been placed in a separate document. 

You can access the course outline, standards, and benchmarks by visiting this link:
https://www.fldoe.org/core/fileparse.php/20062/urlt/health-sci-core-secondary-2223.rtf

The two credit core is required as a prerequisite for all secondary programs except for Practical Nursing and Pharmacy Technician.  Secondary students completing the two required courses will not have to repeat the core in postsecondary.  When the recommended sequence is followed, the structure allows students to complete at specified courses for employment or remain for advanced training or cross-training.  

Course Title: 	Health Science Anatomy & Physiology 
Course Number: 	8417100
Course Credit:	1

Course Description:
This course is part of the secondary Health Core consisting of an overview of the human body, both structurally and functionally with emphasis on the pathophysiology and transmission of disease.  Medical terminology is an integral part of the course.

The course Anatomy and Physiology (2000350) or Anatomy and Physiology Honors (2000360) may be substituted for the course Health Science Anatomy & Physiology (8417100).   

The course Health Science Anatomy & Physiology (8417100) is designated as an equally rigorous (EQ) science credit.

Course Title: 	Health Science Foundations 
Course Number: 	8417110
Course Credit:	1

Course Description:
This course is part of the Secondary Health Core designed to provide the student with an in depth knowledge of the health care system and associated occupations.  Emphasis is placed on communication and interpersonal skills, use of technology, ethics and the development of critical thinking and problem solving skills.  Students may shadow professionals throughout the course.  

2022 - 2023
Florida Department of Education
Student Performance Standards

Course Title: 	Nursing Assistant 3  
Course Number: 	8417211
Course Credit:	1

Course Description:

This is a course designed to prepare the student to provide/assist with all aspects of activities of daily living for the adult patient in both hospital and nursing home settings.  The course, which is taught by a registered nurse, includes didactic instruction, skills practice in the laboratory and clinical experience.  Emphasis is also placed on the development of communication, interpersonal, problem solving and critical thinking skills.

Upon successful completion, the student is eligible to apply to sit for the Florida State Certified Nursing Assistant exam which qualifies as industry certification.  

CTE Standards and Benchmarks	
28.0	Use verbal and written communications specific to nurse assisting. - The student will be able to:	
28.01	Obtain specified data from patient and family.	
28.02	Utilize verbal and written information to assist with the patient's plan of care. 	
28.03	Demonstrate use of the communication system.	
29.0	Demonstrate legal and ethical responsibilities specific to nurse assisting. – The student will be able to:	
29.01	Discuss and demonstrate legal and ethical behavior within the nursing assistant scope of practice including role limitations in Florida.	
29.02	Describe the purpose of the chain of communication to resolve conflict.	
29.03	Follow policies and procedures affecting the health, safety, and well-being of patients.	
29.04	Demonstrate safe standards of patient care including prevention and quality of care 	
29.05	Exhibit behavior supporting and promoting patients’ and/or residents' rights.  	
29.06	Recognize potential for and prevention of medical errors.	
29.07	Practice the proper procedures to follow regarding medical errors.	
29.08	Follow policies and procedures affecting the health, safety, and well-being of patients.	
29.09	Recognize and report signs of substance abuse.	
29.10	Demonstrate the understanding of vulnerable population abuse and reporting procedures per agency.	
29.11	Recognize that a C.N.A. must self-report any crimes they’ve been involved in within 30 days of the offense in accordance with (FS 456.0727(1) w).	
29.12	Define Omnibus Budget Reconciliation Act (OBRA).	
29.13	Define Minimum Data Set (MDS).	
30.0	Perform physical comfort and safety functions specific to nurse assisting. - The student will be able to:	
30.01	Implement appropriate regulatory and accrediting agency patient safety guidelines.  	
30.02	Maintain safe patient units, equipment, and a comfortable environment.	
30.03	Maintain service areas on the units including supplies and equipment. 	
30.04	Observe, report, and record changes in the patient's behavior as needed, including mental awareness. 	
30.05	Demonstrate adjustment of bed and side-rails according to facility policy.	
30.06	Demonstrate and assist patient to dangle.	
30.07	Demonstrate lifting, supporting and transferring patients from bed to chair, bed to bed, and bed to stretcher, including the use of the various assistive devices and equipment while utilizing proper body mechanics and patient safety measures	
30.08	Demonstrate the proper use of a gait/transfer belt in both transfer and ambulation.	
30.09	Assist patient in ambulation, including the use of crutch, cane, or walker.	
30.10	Demonstrate the proper wheelchair safety techniques and assist patient as needed with use.	
30.11	Apply supportive devices as directed (e.g., footboard, over-bed cradle, alternating pressure mattress).	
30.12	Assist patient with care and use of prosthetic/orthotic devices.	
30.13	Describe emergency procedures utilized in the clinical area(s) and the role of the nursing assistant in these procedures.	
31.0	Provide personal patient care. - The student will be able to:	
31.01	Perform bed bath; observe and report changes in a patient including skin and level of consciousness.	
31.02	Assist with shower or tub bath, including the use of specialty tubs or prepackaged disposable-bagged bath.	
31.03	Administer back rub with bath and as needed.	
31.04	Assist patient with hair care utilizing sink, tub, shower, bed or shower cap.	
31.05	Demonstrate the use of a safety and/or electric razor to shave the patient.	
31.06	Demonstrate how to groom patient, including hair, skin, foot, hand and nail care.	
31.07	Assist with and/or administer oral hygiene including denture care.	
31.08	Assist patient to dress.	
31.09	Assist patient with toileting using various types of restorative and rehabilitative equipment.	
31.10	Assist patient with use of bedpan (standard and fracture)	
31.11	Assist with bowel and bladder training.	
31.12	Assist and/ or provide perineal care.	
31.13	Empty, measure and record urinary output and/or drainage.	
31.14	Demonstrate application and use of a leg bag, leg strap and dignity bag.	
31.15	Monitor and assist with the drainage of urostomy bags and colostomy bags.	
31.16	Assist patient with both donning and doffing prosthesis and brace.	
31.17	Assist patient with meals.	
31.18	Describe the relationships of body systems when providing patient care.	
31.19	Recognize abnormal signs and symptoms of common diseases and conditions when providing patient care.	
32.0	Perform patient care procedures. - The student will be able to:	
32.01	Demonstrate ability to accurately measure, record and report vital signs. 	
32.02	Assist with the admission of a patient and/or resident.	
32.03	Assist with the admission, transfer, and discharge of a patient and/or resident.	
32.04	Maintain patient-belongings list.	
32.05	Make unoccupied/occupied bed.	
32.06	Provide passive range-of-motion exercises.	
32.07	Apply anti-embolic hose and sequential compression devices.	
32.08	Understand and demonstrate proper collection of routine, timed urine and clean catch urine specimens.	
32.09	Record fluid intake and output (I&O).	
32.10	Observe, record, and report patient's emesis.	
32.11	Monitor and provide urinary catheter care and drainage systems.	
32.12	Assist with ostomy care including emptying or changing ostomy bags that do not adhere to the skin.	
32.13	Collect stool specimen.	
32.14	Assist with the collection of a sputum specimen.	
32.15	Assist the nurse with care of the patient with complex medical needs.  	
32.16	Assist patient to apply binders.	
32.17	Care for patient in skin and skeletal traction.	
32.18	Assist with pre-operative and post-operative patient care.	
32.19	 Reinforce dressings under the supervision of the RN/LPN.	
32.20	Obtain and record an apical pulse.	
32.21	Provide cast care and/or pin care.	
32.22	Provide care for eyeglasses, artificial eyes, and contact lens.	
33.0	Apply principles of nutrition. - The student will be able to:	
33.01	Identify nutrients and food groups. 	
33.02	Develop a basic food plan.	
33.03	Describe special diets.	
33.04	Check patient's diet tray for accuracy.	
33.05	Monitor and document Nutritional Intake.	
33.06	Identify and implement regional, cultural and religious food guidelines/preferences.	
33.07	Demonstrate knowledge of the need for thickened liquids and fluid consistency.	
33.08	Identify methods of maintaining fluid balance including encouraging and restricting fluids.	
34.0	Provide care for geriatric patients. - The student will be able to:	
34.01	Identify and assist with methods and procedures to prevent pressure ulcers. 	
34.02	Identify and assist with methods to prevent falls in the elderly. 	
34.03	Identify and assist with safety principles as related to the elderly.	
34.04	Describe general characteristics, particular needs, and age related changes of the elderly.	
34.05	Identify attitudes and living habits that promote positive mental and physical health for the elderly.	
34.06	Distinguish between fact and fallacy about the aging process.	
34.07	Apply reality orientation techniques and validation therapy unless it is contraindicated by the patient diagnosis.	
34.08	Recognize and respond appropriately to symptoms of common diseases, including dementia, depression/suicide and Alzheimers.	
34.09	Provide and involve patients in diversional activities.	
34.10	Identify common alterations in elderly patient behavior.	
34.11	Provide care for patients with special needs (e.g., impaired hearing, impaired vision, immobility, impaired body functions, cognitively impaired (dementia)).	
34.12	Demonstrate awareness of common behaviors in drug use and abuse in the elderly.	
34.13	Report concerns to the nurse and appropriate authorities related to drug use and abuse in the elderly patient.  	
34.14	Identify the need for community resources and services available to the elderly and their caregiver.	
34.15	Identify components of the grief process. 	
34.16	Demonstrate an understanding of end of life care, hospice and palliative care.	
35.0	Apply the principles of infection control specific to nursing assisting. - The student will be able to:	
35.01	Discuss transmission-based precautions.	
35.02	Identify the chain of infection.	
35.03	Provide care for patients with infectious diseases applying the principles of "Standard Precautions" utilized with all patients as well as special procedures required.	
35.04	Apply the proper use of personal protective equipment (PPE) for all types of isolation including donning and removing PPE appropriately.	
35.05	Follow isolation procedure with food tray, PPE, and other supplies/equipment.	
35.06	Collect specimen from patient in isolation.	
36.0	Provide biological, psychological, and social support. - The student will be able to:	
36.01	Discuss family roles and their significance to health.	
36.02	Respond to patient and family emotional needs.	
37.0	Perform supervised organizational functions, following the patient care plan. – The student will be able to:	
37.01	Organize and prioritize patient-care assignments.	
37.02	Complete assignments accurately and in a timely manner.	
38.0	Assist with restorative (rehabilitative) activities. - The student will be able to:	
38.01	List the purposes of restorative (rehabilitation) program.	
38.02	Assist patient with specified restorative (rehabilitation) needs.	
38.03	Assist patients/residents to reach the optimum level of independence.	

Additional Information

Laboratory Activities

Laboratory investigations that include scientific inquiry, research, measurement, problem solving, emerging technologies, tools and equipment, as well as, experimental, quality, and safety procedures are an integral part of this career and technical program/course. Laboratory investigations benefit all students by developing an understanding of the complexity and ambiguity of empirical work, as well as the skills required to manage, operate, calibrate and troubleshoot equipment/tools used to make observations. Students understand measurement error; and have the skills to aggregate, interpret, and present the resulting data. Equipment and supplies should be provided to enhance hands-on experiences for students.

Academic Alignment

Secondary Career and Technical Education courses are pending alignment to the B.E.S.T.  (Benchmarks for Excellent Student Thinking) Standards for English Language Arts (ELA) and Mathematics that were adopted by the State Board of Education in February 2020.  Academic alignment is an ongoing, collaborative effort of professional educators that provide clear expectations for progression year-to-year through course alignment. This initiative supports CTE programs by improving student performance through the integration of academic content within CTE courses.  

Florida Standards for English Language Development (ELD)
English language learners communicate for social and instructional purposes within the school setting. ELD.K12.SI.1.1 

English Language Development (ELD) Standards Special Notes:
Teachers are required to provide listening, speaking, reading and writing instruction that allows English language learners (ELL) to communicate for social and instructional purposes within the school setting.   For the given level of English language proficiency and with visual, graphic, or interactive support, students will interact with grade level words, expressions, sentences and discourse to process or produce language necessary for academic success. The ELD standard should specify a relevant content area concept or topic of study chosen by curriculum developers and teachers which maximizes an ELL’s need for communication and social skills. To access an ELL supporting document which delineates performance definitions and descriptors, please click on the following link: http://www.cpalms.org/uploads/docs/standards/eld/SI.pdf.
For additional information on the development and implementation of the ELD standards, please contact the Bureau of Student Achievement through Language Acquisition at sala@fldoe.orgg 

Special Notes

Students completing this program and the course Home Health Aide 3 have met the requirements for, and may be known as, Patient Care Assistants.

Following the completion of Health Science 1 and Health Science 2, the student is eligible to take the National Health Care Foundation Skill Standards Assessment with instructor approval and the completion of a portfolio.

This program meets the Department of Health’s education requirements for HIV/AIDS, Domestic Violence and Prevention of Medical Errors.  Although not a requirement for initial licensure, it is a requirement for renewal, therefore the instructor may provide a certificate for renewal purposes to the student verifying these requirements have been met.

If students in this program are seeking a licensure, certificate or registration through the Department of Health, please refer to 456.0635 F.S. for more information on disqualification for a license, certificate, or registration through the Department of Health. 

Career and Technical Student Organization (CTSO)

HOSA: Future Health Professionals is the intercurricular career and technical student organization providing leadership training and reinforcing specific career and technical skills. Career and Technical Student Organizations provide activities for students as an integral part of the instruction offered.

Cooperative Training – OJT

On-the-job training is appropriate but not required for this program.  Whenever offered, the rules, guidelines, and requirements specified in the OJT framework apply. 

Accommodations

Federal and state legislation requires the provision of accommodations for students with disabilities as identified on the secondary student’s Individual Educational Plan (IEP) or 504 plan or postsecondary student’s accommodations’ plan to meet individual needs and ensure equal access. Accommodations change the way the student is instructed. Students with disabilities may need accommodations in such areas as instructional methods and materials, assignments and assessments, time demands and schedules, learning environment, assistive technology and special communication systems. Documentation of the accommodations requested and provided should be maintained in a confidential file.

In addition to accommodations, some secondary students with disabilities (students with an IEP served in Exceptional Student Education (ESE)) will need modifications to meet their needs.  Modifications change the outcomes or what the student is expected to learn, e.g., modifying the curriculum of a secondary career and technical education course.  Note: postsecondary curriculum and regulated secondary programs cannot be modified.

Some secondary students with disabilities (ESE) may need additional time (i.e., longer than the regular school year), to master the student performance standards associated with a regular course or a modified course.  If needed, a student may enroll in the same career and technical course more than once.  Documentation should be included in the IEP that clearly indicates that it is anticipated that the student may need an additional year to complete a Career and Technical Education (CTE) course.  The student should work on different competencies and new applications of competencies each year toward completion of the CTE course.  After achieving the competencies identified for the year, the student earns credit for the course.  It is important to ensure that credits earned by students are reported accurately.  The district’s information system must be designed to accept multiple credits for the same course number for eligible students with disabilities.

Additional Resources

For additional information regarding articulation agreements, Bright Futures Scholarships, Fine Arts/Practical Arts Credit and Equivalent Mathematics and Equally Rigorous Science Courses please refer to:
http://www.fldoe.org/academics/career-adult-edu/career-tech-edu/program-resources.stml