Please locate and continue to fill and sign the following training/guideline forms in your staff binder.
Person-Centered Thinking
It is important that you become familiar with each client you work with. Knowing pertinent information about an individual could save their life. You will be given full training on each individual that you work with as well as the opportunity to ask questions for further understanding. This happens during your shadow shifts, as you are provided training and insight to the individual’s life and support needs (including medical needs, etc.).
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E-Signature | Intent To Sign
TNS uses an electronic paperwork system that allows staff the ease-of-use to complete paperwork directly and securely from their smart phones. This form provides consent for TNS and it’s staffing core to use electronically typed signatures via electronic devices.
The form also provides a confidentiality | privacy agreement & staff commitment to protecting sensitive information.
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DSPD | DHS Code of Conduct
DHS & DSPD expect that each TNS employee has the opportunity to review and sign their Code of Conduct.
Although it is included in your legal forms packet, click on the link below to access & review the Code of Conducts.
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Medication Training
If medication supports are needed with a client that you support, it is pertinent that you understand the details of their medication and always remember the 5 rights below.
5 Rights of Medication
– Right Person
– Right Medication
-Right Dose
-Right Time
-Right Route
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30-Day Training
TNS Staff are required to complete the following trainings within 30 days of employment:
- Job Descriptions
- Duties & Responsibilities
- Policies & Procedures
- Money Management Policy
- Human Rights
- Non-disclosure | Non-compete
- Chain of command
- Incident Reporting
- APS Reporting
- Prevention of Choking
- Introduction to Person’s with Disabilities
- Notification Of a Lost Client
- What Makes a Good Employee
- Orientation to Seizure Disorders
- Quality Management Plan
- Attesting that you were given the opportunity to ask questions about anything you may not have understood and have received adequate answers to your questions.
Orientation to Seizure Disorders – Known and not known to have seizures
Not many people know how to react when observing somebody having a seizure. Although quite common, seizures are not something people are typically used to seeing in person.
There are many different types of seizures. The most common example is a grand mal seizure, which features violent muscle contractions and a loss of consciousness. Other types of seizures are less apparent and may include lip smacking, staring, loss of awareness, unusual finger motions or repetitive chewing or swallowing. Fundamentally, seizures are a result of abnormal electrical discharges in a small region or broadly distributed throughout the brain, almost like an abnormal surge of electrical activity. The clinical manifestation of this activity is dependent on which part of the brain is involved.
There are some very simple things one can do to ensure the safety of the individual having a seizure. A few simple interventions can lead to a significant reduction in the possibility of injury from a seizure.
Ensure their safety
When witnessing somebody having a seizure, take note of the surroundings and position. If the person is sitting or standing, help lower them to the ground. Often, turning them on to their side will help to keep their mouth and airway open. Try to move away any easily mobile objects that they may strike or potentially fall on them.
Do not try to restrain the person in any way, as this can cause more injury. It is important to keep in mind that your own safety is a consideration, as well. Often, a very violent convulsion or fall can lead to injury in those trying to assist. Refrain from placing objects in the person’s mouth, as this may lead to oral injury or injury to you. Most seizures are self-limiting and will stop on their own. Remain by the person’s side until the seizure has stopped. Staying calm always helps ease panic from others less familiar with the situation. After the seizure has stopped, try to provide reassurance that the person is in a safe place, as they may be confused for a bit of time after.
Seek medical attention
The second goal is to seek appropriate medical attention. If it is the first time the individual has had a seizure, seek immediate emergency medical attention by calling 911. Also, make note of how long the seizure lasted and relay this information to the first responder.
Many people with epilepsy have a rescue plan in place, so make sure to follow and execute this plan as needed.
Seizures can be frightening, but remembering these tips will help you provide the right care for the individual.
Documenting a seizure includes the following: Date & Time of the incident, last doctor’s appointment, duration of the active phase (length of the seizure), last meal intake, and other observations (sounds, movements the individual made).
KEY POINTS
- Individuals with a known seizure disorder have a written seizure protocol contained in his or her “Getting To Know You” file.
- Epilepsy is: a neurological disorder marked by sudden recurrent episodes of sensory disturbance, loss of consciousness, or convulsions, associated with abnormal electrical activity in the brain. It is sometimes referred to as a seizure disorder
- If a seizure lasts more than five minutes or the designated length of time indicated in the person’s seizure protocol, or if one seizure follows another without a return of consciousness, you should call 911.
- Some seizures can be controlled with medication. In the instance an individual with known seizure medication forgets to take preventative medicine, and a seizure occurs, follow their seizure protocol, contact your supervisor and document the incident.
- If an individual has a seizure and has never had one before, contact and seek emergency personnel immediately.
- Tonic-Clonic (Grand Mal) Seizure:
- A grand mal seizure causes a loss of consciousness and violent muscle contractions. It’s the type of seizure most people picture when they think about seizures.
- A grand mal seizure — also known as a generalized tonic-clonic seizure — is caused by abnormal electrical activity throughout the brain. Usually, a grand mal seizure is caused by epilepsy. But sometimes, this type of seizure can be triggered by other health problems, such as extremely low blood sugar, a high fever or a stroke.
- Many people who have a grand mal seizure never have another one and don’t need treatment. But someone who has recurrent seizures may need treatment with daily anti-seizure medications to control and prevent future grand mal seizures.
- Absence (Petit Mal) Seizures
- There are two types of absence seizures that may look a bit different. Both types of seizures are short, and people often don’t notice them at first. They may come and go so quickly that no one notices anything wrong. Or observers may mistake the symptoms for simple daydreaming or not paying attention.
- Typical Absence Seizures
- These seizures are the most common.
- The person suddenly stops all activity. It may look like he or she is staring off into space or just has a blank look.
- The eyes may turn upwards and eyelids flutter.
- The seizures usually last less than 10 seconds.
- Atypical Absence Seizures
- These absence seizures are called atypical because they may be longer, have a slower onset and offset, and involve different symptoms.
- The seizure still starts with staring into space, usually with a blank look.
- There is usually a change in muscle tone and movement. You may seeBlinking over and over that may look like fluttering of the eyelids
- Smacking the lips or chewing movements
- Rubbing fingers together or making other hand motions
- An atypical absence seizure lasts longer, up to 20 seconds or more.
- There are two types of absence seizures that may look a bit different. Both types of seizures are short, and people often don’t notice them at first. They may come and go so quickly that no one notices anything wrong. Or observers may mistake the symptoms for simple daydreaming or not paying attention.
- Complex-Partial (‘Temporal Lobe’ or ‘Psychomotor’) Seizure
- Now called focal onset impaired awareness seizures, are the most common type for adults who have epilepsy (a disorder that affects brain cells). They’re usually harmless and only last a minute or two. But they can be strange or worrying — both for the individual and anyone who’s with them.
- Seizures are brought on by surges of electrical energy in the brain. With a complex partial seizure, the surge happens only on one side and in a specific area. It’s called “partial” because only one part of the brain is affected.
- During this type of seizure, the individual may not be able to control their movements or talk. Afterward, they may not remember at all.
- Anyone can have a complex partial seizure, and doctors don’t always know why they happen. They’re often related to a type of epilepsy called temporal lobe epilepsy. They also may be more common in people who have had a stroke or head injury or who have other health problems, like an infection in their brain or a tumor.
- Simple-Partial Seizure
- Simple-Partial seizures can be subtle. But some external symptoms can occur and be seen by someone watching. These symptoms will not always occur, as each seizure and person is different.
- Some external symptoms may be:
- emotions changing abruptly without cause
- laughing or crying for no reason
- a jerk or spasm of a single part of the body, usually a leg or arm
- difficulty speaking or speaking in non-sensible ways
- The person having the seizure will not lose consciousness or awareness of their surroundings. Most of the symptoms associated with simple partial seizure are internal and only noticed by the person having the seizure. These symptoms may include:
- changes in how something might taste, feel, look, or sound
- distorted vision of items around you or of your own body
- smelling an odd odor
- tingling sensation in parts of your body, usually the arms or legs
- goosebumps
- feeling like there are butterflies in your stomach
- dizziness
- seeing flashing lights
- feeling afraid or extremely happy suddenly for no reason
- a feeling of deja vu
An ‘aura‘ is the term that some people use to describe the warning they feel before they have a tonic clonic seizure. An epilepsy ‘aura‘ is in fact a focal aware seizure. Focal aware seizures are sometimes called ‘warnings’ or ‘auras‘ because, for some people, a Focal aware seizure develops into another type of seizure.
Symptoms of a seizure (not all symptoms are listed and can vary dramatically depending on the individual)
- Muscle tightening
- Unusual head movements
- Blank stares
- Eyes moving from side to side
- Numbness
- Tingling
- Skin crawling (like ants crawling on the skin)
- Hallucinations- seeing, smelling, or hearing things that are not there
- Pain or discomfort
- Nausea
- Sweating
- Flushed face
- Dilated pupils
- Rapid heart rate/pulse
- Changes in vision
- Feeling déjà vu (feeling like current place and time have been experienced before)
- Changes in mood or emotion
- Unable to speak for a short while