cna skills sim kit: focus on sensory impairment scenario guide

CNA Skills Sim Kit:

Focus on Sensory Impairment

Scenario Guide

CNA Skills Sim Kit: Focus on Sensory Impairment

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Table of Contents

Scenario Guide Components 4

Scenario Structure 5

Scenario One – Dressing and Grooming 6

Pre-Brief 8

Scenario 12

Debrief 13

Sources 15

Scenario Two – Ambulation 16

Pre-Brief 18

Scenario 22

Debrief 24

Sources 26

Scenario Three – Feeding Assistance 27

Pre-Brief 29

Scenario 33

Debrief 35

Sources 37


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This Skills Sim Kit will focus on three different sensory impairment scenarios: dressing and grooming a patient with a sensory impairment, ambulating a patient with a sensory impairment, and assist feeding a patient with a sensory impairment.

Scenario Guide Components The scenario guide is composed of the following components. Approximate times are included.

Scenario Title Approximate Time

One Dressing and Grooming Pre-Brief 20 minutes Scenario 20 minutes Debrief 20 minutes

Two Ambulation Pre-Brief 20 minutes Scenario 20 minutes Debrief 20 minutes

Three Feeding Assistance Pre-Brief 20 minutes Scenario 20 minutes Debrief 20 minutes Total 3 hours


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Scenario Structure Each Scenario contains an Overview, Pre-brief, Scenario, and Debrief.

Scenario Sections

Each scenario follows the sections described below:

OVERVIEW Each scenario begins with an OVERVIEW of scenario objectives, materials needed, preparation instructions, and a brief patient description.

PRE-BRIEF The PRE-BRIEF activity is intended to capture participants’ attention and prepare them for the scenario. During this activity, participants are introduced to the topic of the scenario.

SCENARIO The SCENARIO activity in each scenario varies in its script and topic. Participants will be playing the role of nursing assistant and patient using simulation products.

DEBRIEF Every scenario ends with a DEBRIEF activity intended to briefly review the scenario’s main points and the feelings of the participants.


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Scenario One – Dressing and Grooming

Scenario Objectives After completing this scenario, participants will be able to: • Verbalize empathy for a patient with a sensory impairment • Safely assist a patient with a sensory impairment through dressing and grooming

Scenario Materials

Activity Materials Preparation Approximate class time

PRE-BRIEF • Dressing and Grooming Pre-Brief Student Worksheet

• Dressing and Grooming Pre-Brief Student Worksheet – Answer Key

• Dressing and Grooming Scenario Guidelines and Expectations

1. Print/photocopy Dressing and Grooming Pre-Brief Student Worksheet and Dressing and Grooming Scenario Guidelines and Expectations (one per participant)

20 minutes

SCENARIO Skills Sim Kit Component: • Hearing impairment simulator • Sensory impairment gloves

Environmental Props: • Bed or chair • Gait/transfer belt • Hand sanitizer/sink • Shirt with buttons (size may vary depending on

students) • Pull on pants (size may vary depending on students) • Tie shoes (optional) • Grooming supplies (your choice of hairbrush,

toothbrush/toothpaste, etc.)

1. Prepare area as stated in the Scenario Setup

20 minutes

DEBRIEF • Dressing and Grooming Debrief Instructor Resource

1. Optional: Display questions to students on a projector or print/photocopy Dressing and Grooming Debrief Instructor Resource

20 minutes

Scenario Overview The purpose of this simulation is to understand the impact that sensory impairment has on dressing and grooming as well as how to assist a patient with a sensory impairment.


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Scenario Roles This scenario is designed to simulate the roles of both nursing assistant and patient. If time allows, the scenario may be repeated and the roles may be reversed for optimal learning of empathy and skill. Assign two students to the following roles: • Patient

• Nursing assistant

Scenario Setup The setting is a long-term care facility. Ensure that there is a sink and/or hand sanitizer by the entrance to patient’s room. Position the patient to be sitting prior to and after dressing and grooming. Place the gait/transfer belt in the room. Help the patient with putting the Hearing Impairment Simulator over their ears and the Sensory Impairment Gloves on their hands. Dressing and grooming supplies should be in the room.

Patient Description Name: Mr. or Mrs. Kelly Dutton (title based on preferred gender of student in patient role)

Age: 89

History of Present Illness: Mr./Mrs. Kelly Dutton is a long-term care resident who has impaired hearing and peripheral neuropathy. They are a one assist.


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Pre-Brief 20 minutes

Purpose:

To understand the impact that sensory impairment has on dressing and grooming, as well as how to assist a patient with a sensory impairment.

Materials:

• Dressing and Grooming Pre-Brief Student Worksheet

• Dressing and Grooming Pre-Brief Student Worksheet – Answer Key

• Dressing and Grooming Scenario Guidelines and Expectations

Facilitation Steps:

1. Distribute the Dressing and Grooming Pre-Brief Student Worksheet to participants prior to the scenario. You can also have them complete the pre-brief independently prior to the day of the scenario.

2. Review answers to the Dressing and Grooming Pre-Brief Student Worksheet.

3. Review the Dressing and Grooming Scenario Guidelines and Expectations for the scenario.

4. Orient participants to the scenario area and products.

5. Assign the roles designated in the scenario.

6. Set the patient up with the Hearing Impairment Simulator and Sensory Impairment Gloves.

7. Have the patient sit in a chair.

8. Give the scenario report to both students before beginning scenario.


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Name: _____________________________________ Class: ___________________________

Dressing and Grooming Pre-Brief Student Worksheet

Complete the scenario preparation questions.

1. What are symptoms of neuropathy?

a. Stiffness

b. Numbness

c. Inflammation

d. Rash

2. What is presbycusis?

a. Age-related hearing loss

b. Unilateral hearing loss

c. Trauma induced hearing loss

d. Complete hearing loss

3. What is the best way to communicate with someone with hearing loss?

a. Use sign language or an interpreter

b. Speak as loud as you can without shouting

c. Face the person and speak clearly

d. Speak at a faster rate than usual

4. What aspect of dressing would someone with neuropathy struggle with?

a. Tying shoes

b. Buttoning shirt

c. Putting on socks

d. All of the above


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Dressing and Grooming Pre-Brief

Student Worksheet – Answer Key

1. What are symptoms of neuropathy?

a. Stiffness

b. Numbness

c. Inflammation

d. Rash

2. What is presbycusis?

a. Age-related hearing loss

b. Unilateral hearing loss

c. Trauma induced hearing loss

d. Complete hearing loss

3. What is the best way to communicate with someone with hearing loss?

a. Use sign language or an interpreter

b. Speak as loud as you can without shouting

c. Face the person and speak clearly

d. Speak at a faster rate than usual

4. What aspect of dressing would someone with neuropathy struggle with?

a. Tying shoes

b. Buttoning shirt

c. Putting on socks

d. All of the above


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Dressing and Grooming Scenario Guidelines and Expectations

(Based on the INACSL Standards of Best Practice: Professional Integrity)

When you come to the simulation, please be:

• Organized and prepared

• Accountable for one’s role and responsibilities

• Collaborative, supportive, nonintimidating, and respectful

• Able to share expertise and/or experiences in a safe, nonjudgmental manner

• Calm, compassionate, and creating a sense of trust

• Honest, mindful, and sensitive to cultural differences and ethical issues related to the simulation-based experience

• Aware of a safe learning environment

It is important that you follow the standards of practice, principles, and ethics of your profession.

Roles

You will be assigned the role of either the patient or the nursing assistant. As the patient, you are to gain empathy for those with a sensory impairment throughout the scenario. As the nursing assistant, you are to safely assist your patient, who has a sensory impairment, with dressing and grooming. This includes correct prompting and education.

Confidentiality Agreement

This simulation requires confidentiality of the performances and scenario content. By signing below, I agree to be a participant in this simulation. I understand that the content of this simulation is to be kept confidential to maintain the integrity of the learning experience. I also understand that it is unethical for me to share information in any way regarding student performance with persons outside this simulation.

Name (printed) ______________________________ Signature ______________________________


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Scenario 20 minutes

After assigning roles, read the following report to students.

Report: Mr. or Mrs. Kelly Dutton (title based on preferred gender of student in patient role) is an 89-year-old long-term care resident who has impaired hearing and peripheral neuropathy. They are a one assist.

Allow students time to gather their thoughts before starting. Remind students not to prompt one another and to stay within their roles. The “patient” is to follow the “nursing assistant’s” directions and may discuss what he/she is feeling. The “nursing assistant” is to assist the “patient” with dressing and grooming.

Note: The scenario should be paused if any real-life safety issue occurs. Once the issue is addressed, the scenario can continue. Roles can be reversed so that both students can experience the simulator.

Scenario Events and Expected Actions: State Event Expected Actions of Patient Expected Actions of Nursing Assistant

One Introduction • Acknowledges nursing assistant • States identifiers

• Knocks, washes hands • Identifies self • Explains purpose for presence • Identifies patient

Two Dressing • Follows nursing assistant’s prompts

• Attempts to dress self with assistance

• Obtains gait/transfer belt • Prompts and assists to don shirt and pants around

ankles • Ensures proper footwear (assists with donning of

shoes if applicable) • Places gait/transfer belt on patient • Uses gait belt to stand patient • Prompts and assists to don pants • Removes gait/transfer belt on patient

Three Grooming • Follows nursing assistant’s prompts

• Attempts to groom self with assistance

• Provides and sets up grooming supplies • Prompts and assists grooming • Cleans up grooming supplies

Four Closing • May thank nursing assistant • Asks if anything else is needed before leaving • Leaves patient safe (call light, rails, etc.) • Washes hands before leaving


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Debrief 20 minutes

Purpose:

To reflect on and discuss the scenario experience.

Materials:

• Dressing and Grooming Debrief Instructor Resource

Facilitation Steps:

1. Review debriefing rules a. Confidentiality

i. Scenarios are to be kept confidential to maintain the integrity of the learning experience

ii. It is unethical to share information in any way regarding student performance with persons outside the scenario

b. Safe space i. This is a safe, non-discriminatory

learning environment for constructive feedback

2. Work through the debriefing questions on the Dressing and Grooming Debrief Instructor Resource as a group.

3. Praise the students for their efforts.


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Dressing and Grooming Debrief Instructor Resource

Group Questions 1. Describe the objectives that you were able to achieve.

2. Which objectives were you unable to achieve (if any)?

3. Which objectives did you do well?

4. If you were able to do this again, how would you handle the situation differently?

Patient Questions 1. How did you feel throughout the simulation experience?

2. What part of the simulation was the most challenging?

Nursing Assistant Questions 1. How did you feel throughout the simulation experience?


Ending Questions 1. What are your main take-away points of this simulation?

2. Is there anything else you would like to discuss?


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Sources Craven, R. F. (2017). Fundamentals of Nursing: Human Health and Function. Wolters Kluwer.

International Nursing Association for Clinical Simulation and Learning (2016). INACSL Standards of Best Practice: Simulation. Retrieved from https://www.inacsl.org/inacsl-standards-of-best-practice-simulation/

National Institute on Aging. (2018). Hearing loss: A common problem for older adults. Retrieved from https://www.nia.nih.gov/health/hearing-loss-common-problem-older-adults

https://www.inacsl.org/inacsl-standards-of-best-practice-simulation/

https://www.nia.nih.gov/health/hearing-loss-common-problem-older-adults


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Scenario Two – Ambulation

Scenario Objectives After completing this scenario, participants will be able to: • Verbalize empathy for a patient with a sensory impairment • Safely ambulate a patient with a sensory impairment

Scenario Materials

Activity Materials Preparation Approximate

class time

PRE-BRIEF • Ambulation Pre-Brief Student Worksheet • Ambulation Pre-Brief Student Worksheet –

Answer Key • Ambulation Scenario Guidelines and Expectations

1. Print/photocopy the Ambulation Pre-Brief Student Worksheet and Ambulation Scenario Guidelines and Expectations (one per participant)

20 minutes

SCENARIO • Provider’s Orders Skills Sim Kit components: • Macular Degeneration Glasses

Environmental Props: • Gait/transfer belt • Hand sanitizer/sink • Chairs (2-3) • Small item to place on floor as obstacle

1. Print/photocopy the Provider’s Orders (one per participant)

2. Prepare area as stated in the Scenario Setup

20 minutes

DEBRIEF • Ambulation Debrief Instructor Resource 1. Optional: Display questions to students on a projector or print/photocopy the Ambulation Debrief Instructor Resource

20 minutes

Scenario Description The purpose of this simulation is to demonstrate the impact that sensory impairment has on ambulation and how to ambulate a patient with a sensory impairment.


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Scenario Roles This scenario is designed to simulate the roles of both nursing assistant and patient. If time allows, the scenario may be repeated and the roles may be reversed for optimal learning of empathy and skill. Assign two students to the following roles:

• Patient


Scenario Setup The setting is a long-term care facility. A sink and/or hand sanitizer should be by the entrance to patient’s room. The patient will be positioned sitting in a chair. The gait/transfer belt should be placed in the room. Place the Macular Degeneration Glasses on the patient. Place the remaining chairs and small item(s) as obstacles in the area that the patient will be ambulating.

Patient Description Name: Mr. or Mrs. Morgan Williams (title based on preferred gender of student in patient role)

Age: 77

History of Present Illness: Mr./Mrs. Morgan Williams is a long-term care resident who has severe macular degeneration. They are a one assist.


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Purpose:

To understand the impact that sensory impairment has on ambulation and how to ambulate a patient with a sensory impairment.

Materials:

• Ambulation Pre-Brief Student Worksheet • Ambulation Pre-Brief Student Worksheet –

Answer Key • Ambulation Scenario Guidelines and

Expectations

Facilitation Steps:

1. Distribute the Ambulation Pre-Brief Student Worksheet to participants prior to the scenario. You can also have them complete the pre-brief independently prior to the day of the scenario.

2. Review answers to the Ambulation Pre-Brief Student Worksheet.

3. Review the Ambulation Scenario Guidelines and Expectations for the scenario.

4. Orient the participants to the scenario area and products.

5. Assign roles designated in the scenario.

6. Set the patient up with the macular degeneration glasses and have them sit in the chair.

7. Give the scenario report to both students before beginning the scenario.


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Name: ___________________________ Class: ___________________________

Ambulation Pre-Brief Student Worksheet


1. What is macular degeneration?

a. Deterioration of the central part of the retina

b. Damage to the optic nerve due to increased pressure in the eye

c. Clouding of the central portion of the lens

d. Injury to the anterior eye

2. What is a cause of macular degeneration?

a. Bacteria

b. Genetics

c. Trauma

d. Diabetes

3. How does age-related macular degeneration influence gait?

a. Gait is faster

b. Longer strides are taken

c. Gait is slower

d. Balance is steady

4. A patient with macular degeneration is at risk for which of the following safety concerns?

a. Trauma

b. Burns

c. Infection

d. Falls


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Ambulation Pre-Brief Student Worksheet – Answer Key

1. What is macular degeneration?

a. Deterioration of the central part of the retina

b. Damage to the optic nerve due to increased pressure in the eye

c. Clouding of the central portion of the lens

d. Injury to the anterior eye

2. What is a cause of macular degeneration?

a. Bacteria

b. Genetics

c. Trauma

d. Diabetes

3. How does age-related macular degeneration influence gait?

a. Gait is faster

b. Longer strides are taken

c. Gait is slower

d. Balance is steady

4. A patient with macular degeneration is at risk for which of the following safety concerns?

a. Trauma

b. Burns

c. Infection

d. Falls


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Ambulation Scenario Guidelines and Expectations











Roles

You will be assigned either the patient or nursing assistant role. As the patient, you are to gain empathy for those with a sensory impairment. As the nursing assistant, you are to safely ambulate your patient with a sensory impairment. This includes correct prompting and education.





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Scenario 20 Minutes

After assigning roles, read the following report to students.

Report: Mr. or Mrs. Morgan Williams (title based on preferred gender of student in patient role) is a 77-year-old long-term care resident who has severe macular degeneration. They are a one assist and need to be ambulated, as tolerated, twice daily.

Allow students time to gather their thoughts before starting. Remind students not to prompt one another and to stay within their roles. The “patient” is to follow the “nursing assistant’s” directions and may discuss what he/she is feeling. The “nursing assistant” is to assist the “patient” with ambulation.



One Introduction • Acknowledges nursing assistant

• States identifiers

• Verifies orders • Knocks, washes hands • Identifies self • Explains purpose for presence • Identifies patient

Two Gait/Transfer belt • Follows nursing assistant’s prompts

• Obtains gait/transfer belt • Ensures proper footwear • Places gait/transfer belt on patient

Three Ambulation • Follows nursing assistant’s prompts

• Ambulates with simulator on

• Places cane on strong side • Instructs patient on how to walk with the cane • Ambulates patient while holding onto gait/transfer

belt • Prompts patient to return to room

Four Return to chair • Follows nursing assistant’s prompts

• Assists and prompts patient to sit • Removes gait belt

Five Closing • May thank nursing assistant • Asks if anything else is needed before leaving • Leaves patient safe (call light, rails, etc.) • Washes hands before leaving


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Provider’s Orders Date Time Orders

Today 0700 Ambulate as tolerated BID with one assist-------------------

-------------------------------------------Dr. Mary Thompson

NAME: Morgan Williams

MRN: 8965325

Age: 77 years


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Debrief 20 minutes

Purpose:


Materials:

• Ambulation Debrief Instructor Resource

Facilitation Steps:

1. Review debriefing rules • Confidentiality

• Scenarios are to be kept confidential to maintain the integrity of the learning experience

• It is unethical to share information in any way regarding student performance with persons outside the scenario

• Safe space • This is a safe, non-discriminating


2. Work through the debriefing questions on the Ambulation Debrief Instructor Resource as a group.



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Ambulation Debrief Instructor Resource












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Varadaraj, V., Mihailovic, A., Ehrenkranz, R., Lesche, S., Ramulu, P. Y., & Swenor, B. K. (2017). Gait Characteristics of Age-Related Macular Degeneration Patients. Translational vision science & technology, 6(4), 14. doi:10.1167/tvst.6.4.14




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Scenario Three – Feeding Assistance

Scenario Objectives After completing this scenario, participants will be able to: • Verbalize empathy for a patient with a sensory impairment • Safely assist with feeding a patient with a sensory impairment and impaired swallowing

Scenario Materials

Activity Materials Preparation Approximate class time

PRE-BRIEF • Feeding Assistance Pre-Brief Student Worksheet

• Feeding Assistance Pre-Brief Student Worksheet – Answer Key

• Feeding Assistance Scenario Guidelines and Expectations

1. Print/photocopy Feeding Assistance Pre-Brief Student Worksheet and Feeding Assistance Scenario Guidelines and Expectations (one per participant)

20 minutes

SCENARIO • Provider’s Orders Skills Sim Kit Component: • Glaucoma Glasses • Sensory Impairment Gloves

Environmental Props: • Table • Chairs • Variety of foods – shapes, sizes, textures • Plate • Spoon • Food tray (optional) • Drink with straw • Clothing protector • Hand sanitizer/sink

1. Print/photocopy the Provider’s Orders (one per participant)

2. Prepare area as stated in Scenario Setup

20 minutes

DEBRIEF • Feeding Assistance Debrief Instructor Resource

1. Optional: Display questions to students on a projector or print/photocopy the Feeding Assistance Debrief Instructor Resource

20 minutes

Scenario Description The purpose of this simulation is to demonstrate the impact that sensory impairment has on eating, and how to assist in feeding a patient with a sensory impairment and/or impaired swallowing.


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Scenario Roles This scenario is designed to simulate the roles of both nursing assistant and patient. If time allows, the scenario may be repeated and the roles may be reversed for optimal learning of empathy and skill. Assign two students to the following roles:

• Patient


Scenario Setup The setting is a long-term care facility. A sink and/or hand sanitizer should be available. The patient will be sitting at a table. Place plated food, drink, and spoon in front of the patient (a food tray is ideal, but optional). Place a food identification slip by the food that contains patient’s name and diet. Glaucoma Glasses, Sensory Impairment gloves, and a clothing protector should be worn by the patient.

Patient Description Name: Mr. or Mrs. Jamie Berg (title based on preferred gender of student in patient role)

Age: 82

History of Present Illness: Mr./Mrs. Jamie Berg is a long-term care resident who has glaucoma and peripheral neuropathy caused from cancer treatment. They need assistance at mealtimes due impaired vision and impaired sensation. Mr./Mrs. Berg is on a regular diet per order.


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Purpose:

To review the knowledge needed for completion of the scenario.

Materials:

• Feeding Assistance Pre-Brief Student Worksheet

• Feeding Assistance Pre-Brief Student Worksheet – Answer Key

• Feeding Assistance Scenario Guidelines and Expectations

Facilitation Steps:

1. Distribute the Feeding Assistance Pre-Brief Student Worksheet to the participants prior to the scenario. You can also have them complete the pre-brief independently prior to the day of the scenario.

2. Review answers to the Feeding Assistance Pre-Brief Student Worksheet.

3. Review the Feeding Assistance Scenario Guidelines and Expectations for the scenario.

4. Orient the participants to the scenario area and products.

5. Assign the roles designated in the scenario.

6. Set the patient up with the Glaucoma Glasses and Sensory Impairment Gloves and have the patient sit at the table.

7. Give the scenario report to both students before beginning the scenario.


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Name: ___________________________ Class: ___________________________

Feeding Assistance Pre-Brief Student Worksheet


1. What is peripheral neuropathy?

a. Nerve damage to the hands and feet

b. Brain damage causing weak extremities

c. Nerve death in the spinal cord

d. Spinal disorder that weakens nerves

2. Glaucoma is an eye disease that causes damage to which part of the eye?

a. Retina

b. Lens

c. Optic nerve

d. Cornea

3. How does glaucoma affect vision?

a. Peripheral vision decreases

b. Central vision decreases

c. Difficulty seeing objects at a distance

d. Loss of sight in one eye

4. What are safety concerns with someone with peripheral neuropathy?

a. Falls

b. Burns

c. Injuries

d. All of the above


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Feeding Assistance Pre-Brief Student Worksheet – Answer Key

1. What is peripheral neuropathy?

a. Nerve damage to the hands and feet

b. Brain damage causing weak extremities

c. Nerve death in the spinal cord

d. Spinal disorder that weakens nerves

2. Glaucoma is an eye disease that causes damage to which part of the eye?

a. Retina

b. Lens

c. Optic nerve

d. Cornea

3. How does glaucoma affect vision?

a. Peripheral vision decreases

b. Central vision decreases

c. Difficulty seeing objects at a distance

d. Loss of sight in one eye

4. What are safety concerns with someone with peripheral neuropathy?

a. Falls

b. Burns

c. Injuries

d. All of the above


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Feeding Assistance Scenario Guidelines and Expectations











Roles

You will be assigned either the patient or nursing assistant role. As the patient, you are to gain empathy for those with a sensory impairment. As the nursing assistant, you are to safely assist with feeding your patient with a sensory impairment. This includes correct prompting and education.





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Scenario 20 minutes

Prior to beginning the scenario (but after assigning roles), read the following report to students.

Report: Mr./Mrs. Jamie Berg (title based on preferred gender of student in patient role) is a long-term care resident who has glaucoma and peripheral neuropathy caused from cancer treatment. They need assistance at mealtimes due impaired vision and impaired sensation. Mr./Mrs. Smith is on a regular diet per order. They request to feed themselves as much as possible.

Allow students time to gather their thoughts before starting. Remind students not to prompt one another and to stay within their roles. The “patient” is to follow the “nursing assistant’s” directions and may discuss what he/she is feeling. The “nursing assistant” is to assist the “patient” with feeding themselves.



One Introduction • Acknowledges nursing assistant • States identifiers

• Verifies dietary orders • Washes hands • Identifies self • Identifies patient • Matches food tray/diet with patient

Two Feeding prep • Acknowledges nursing assistant • States identifiers

• Verifies dietary orders • Washes hands • Identifies self • Identifies patient • Matches food tray/diet with patient

Three Feeding assistance

• Follows nursing assistant’s prompts

• Attempts to feed self as much as possible with simulator

• Assists patient with eating • Reminds patient to take small bites, not to rush,

and to chew thoroughly. • Offers drink

Four Closing • May thank nursing assistant • Wipes mouth if able

• Wipes mouth and cleans area • Asks if anything else is needed before leaving • Leaves patient safe • Washes hands before leaving


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Provider’s Orders Date Time Orders

Today 0700 Regular Diet----------------------------------------------------

---------------------------------------------Dr. Mary Thompson

NAME: Jamie Berg

MRN: 8965325

Age: 82 years


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Debrief 20 minutes

Purpose:


Materials:

• Feeding Assistance Debrief Instructor Resource

Facilitation Steps:

1. Review debriefing rules • Confidentiality

• Scenarios are to be kept confidential to maintain the integrity of the learning experience

• It is unethical to share information in any way regarding student performance with persons outside the scenario

• Safe space • This is a safe, non-discriminatory


2. Work through the debriefing questions on the Feeding Assistance Debrief Instructor Resource as a group.



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Feeding Assistance Debrief Instructor Resource












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Hu, C. X., Zangalli, C., Hsieh, M., Gupta, L., Williams, A. L., Richman, J., & Spaeth, G. L. (2014). What do patients with glaucoma see? Visual symptoms reported by patients with glaucoma. The American journal of the medical sciences, 348(5), 403–409. doi:10.1097/MAJ.0000000000000319



cna skills sim kit: focus on sensory impairment scenario guide

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