Feeding Assistant Training Program

Classroom Content 

Preceptor 

Materials/Techniques Utilized 

Duration 

Feeding Techniques Taught/Provided 

45 minutes 

The role of the Feeding Assistant (FA) & Introduction to the FA program. 

• FAs do not provide nursing care, they provide assistance with eating and drinking to reduce unplanned weight loss and incidence of dehydration 

Instruction requirements & Supervision of FAs 

• Must work under the direction and supervision of a RN or LPN 

• Cannot feed residents with complicated feeding problems or receiving thickened liquids,  care plan  process for determination if a FA can be utilized  

Promotion of good nutrition and hydration  

•  Therapeutic Diets, dietary restrictions, special diets  

• Recognition of individual preferences/needs 

• Factors which effect nutrition  (including swallowing problems, chewing problems, tooth loss, dentures, pain, diminished sense of smell, taste and vision, disease process, emotional concerns, end of life issues, constipation, etc) 

Importance of Hydration/Fluid Balance 

• Clear liquids 

• Full liquids 

• Thickened liquids  

Director of Staff Development 

Lecture, discussion 

Handouts, written materials 

Duration 

Safety/Emergency Procedures Taught 

1 hour 

Environmental safety & preventing accidents 

• Identify and report promptly potential hazards to residents safety (including wrong meal tray, food temperatures, spills unsafe equipment, etc) 

• Resident emergencies requiring immediate action (including seizures, bleeding, choking, etc) 

Fire, RACE, use of extinguisher 

Performing the  abdominal thrust 

• Conscious victim 

• Chest thrusts for obese victim 

FA role in an emergency 

Lecture, discussion, demonstration and return demonstration  

Handouts, written materials 

Duration 

Assistance with Feeding/Hydration Taught 

2 hours 

The dining atmosphere 

Verify that the resident is prepared for mealtime, (has dentures, glasses, HA, positioning) 

Meal service/Distribution of meals 

• Efficiency and timely distribution 

• Accuracy 

• Menu and alternatives 

• Examples of assistance  

           Cueing 

           Assisting resident who is blind or visually impaired 

                 Use of adaptive equipment such as lipped plates, divided plates,    

                                       straws, special utensils 

                 Identifying items and location                                                                   

• Examples of assistive devices and adaptive equipment 

• Examples of promoting independence 

Feeding a resident, steps to take 

        Specific feeding techniques:    

               Hand over hand techniques 

               Verbal cueing 

               Tactile cueing 

               Compensatory strategies including: alternating food / liquid,  checking /   

                         observing for pocketing,  positioning / chin tuck 

               Offering food in bite size pieces 

               Alternating type of food offered considering resident preference 

        Environmental modification:  table height, lighting, posture / positioning,    

                         noise /distractions 

Feeding the cognitively impaired resident 

Serving supplementary nutrition 

Providing fresh drinking water 

Conclusion of a meal 

Measuring intake 

Lecture, discussion, demonstration and return demonstration  

Handouts, written materials 

Duration 

Infection Control  

Practices Taught 

1 hour 

Infection Control definition and basic principles 

Chain of infection 

Medical asepsis, practices to promote asepsis 

Standard precautions 

Hand washing exercises and competency 

Correct handling of food, separation of clean/dirty items, clothing protectors 

Temperatures – do not blow on food to cool 

Lecture, discussion, demonstration and return demonstration 

Handouts, written materials 

Duration 

Patient Behavior and Staff Responses Taught 

45 minutes 

Appropriate responses to resident behavior 

Know your resident 

Dealing with resident behavior 

Problematic Resident behaviors at meal time 

Lecture, discussion and role playing 

Duration 

Resident Changes in Condition/Reporting to Licensed Staff Responsibilities Taught 

45 minutes 

Observations of residents 

Recognizing abnormal signs and symptoms 

Nursing staff will assess and treat, FA may observe and report to nurse 

Recognize and report abnormal signs and symptoms (including: SOB, breathing changes, Pain, color changes, drowsiness, changes in appetite, difficulty chewing , changes in LOC,  new drooling, eyes watering, facial grimacing, coughing, gurgling, attempts to clear his or her throat, can’t produce a voice or only whispers, states something is stuck in throat, or feels fullness in throat) 

Report incidents regarding your residents to the nurse (including any event that does not fit the routine, loss of dentures, glasses, broken teeth, accidents, injuries, theft, resident pocketing food, change in behavior or physical condition, any complaints, falls, residents on the floor etc) 

Lecture and discussion 

Handouts, written materials 

Duration 

Communication/Interpersonal Skills Taught 

1 hour 

Elements of Communication 

How to be a good communicator 

• Verbal and Non-verbal communication 

• Barriers to effective communication 

• Sensory impairment 

• How to be a good listener 

• Communicating with a hearing impaired resident 

• Communicating with residents with decreased sight 

• Communicating with the resident who has difficulty speaking 

• Communicating with residents with memory loss and cognitive impairment  

• Communicating with team members, record keeping, measuring intake 

Lecture, discussion, role playing and demonstration 

Handouts, written materials 

Duration 

Resident Rights/Staff Responsibilities Taught 

45 minutes 

Residents rights defined, regulations and information 

Residents have the right to… (Bill of Rights) 

Behavior that maintains the resident rights 

Residents right to be free from abuse, signs of abuse, examples of abuse and reporting of abuse 

Residents rights at meal time (actions that promote/violate residents rights)   

Promoting dignity during meals  

Lecture, discussion and role play 

Handouts, written materials 

Clinical Practices 

Preceptor 

Observations 

Duration 

Feeding Techniques Provided/Observed 

15 min. 

Demonstrations of: 

• The role of the Feeding Assistant (FA) 

• Taking direction and supervision from the RN/LPN 

• Recognition that FAs do not provide nursing care, they provide assistance with eating and drinking  

• Cannot feed residents with complicated feeding problems or receiving thickened liquids 

• Promotion of good nutrition and hydration 

• Recognition of therapeutic diets, dietary restrictions, special diets  

• Recognition of individual preferences/needs 

• Factors which effect nutrition  (including swallowing problems, chewing problems, tooth loss, dentures, pain, diminished sense of smell, taste and vision, disease process, emotional concerns, end of life issues, constipation, etc) 

• Awareness of importance of Hydration/Fluid Balance 

• Recognition of fluid needs, including clear liquids and thickened liquids  

Director of Staff Development 

Validation of skill competency will be based on: 

• Direct observation  

• Skill demonstration 

• Test questions and open ended questions asked during training 

Duration 

Safety/Emergency Provided/Taught 

15 min. 

 Abdominal thrust critical steps competency validation 

Demonstrations of: 

• Identify and report promptly potential hazards to residents safety (including wrong meal tray, food temperatures, spills unsafe equipment) 

• Reporting resident emergencies requiring immediate action (including seizures, bleeding, choking, etc) 

• Steps to take in case of a Fire, RACE, use of extinguisher 

• Awareness of FA role in an emergency 

Validation of skill competency will be based on: 

• Direct observation  

• Skill demonstration 

• Test questions and open ended questions asked during training 

Duration 

Assistance with Feeding/Hydration Observed 

1 hr. 

Feeding a Resident critical steps competency validation  including: 

• Checking the 5 C’s:  1) correct resident 2) correct eating and adaptive equipment 3) correct diet 4) correct fluids 5) charting 

• Preparation of tray 

• Maintaining dignity of resident 

• Assisting resident to feed self, encouraging  

• Completion of meal 

• Attention to the dining atmosphere 

• Verify that the resident is prepared for mealtime (dentures, glasses, HA, positioning, etc) 

• Meal service/Distribution of meals 

• Accuracy, efficiency and timely distribution 

• Menu and alternatives 

• Examples of assistance  

• Examples of assistive devices and adaptive equipment 

• Examples of promoting independence 

• Feeding a resident, steps to take 

• Feeding the cognitively impaired resident 

• Serving supplementary nutrition 

• Providing fresh drinking water 

• Measuring Intake competency 

Validation of skill competency will be based on: 

• Direct observation  

• Skill demonstration 

• Test questions and open ended questions asked during training 

Duration 

Infection Control Practices Observed 

15 min. 

Hand washing critical steps competency validation 

Infection Control principles followed including: 

• Steps that break the chain of infection, including hand washing 

• Uses practices to promote asepsis 

• Attention to standard precautions, including hand hygiene  

• Correct handling of food, separation of clean/dirty items, clothing protectors 

Temperatures – do not blow on food to cool 

Validation of skill competency will be based on: 

• Direct observation  

• Skill demonstration 

• Test questions and open ended questions asked during training 

Duration 

Patient  Behavior and Staff Responses Observed 

30 min. 

Demonstrate appropriate responses to resident behavior including:  

• FAs know the residents that they are feeding, likes and dislikes, conversation starters 

• Dealing with aggressive, combative, and resistive resident behavior 

• Problematic behaviors at meal time 

• Recognizes the needs of cognitively, visually and hearing impaired residents 

• Utilizes good communication skills 

Validation of skill competency will be based on: 

• Direct observation  

• Skill demonstration 

• Test questions and open ended questions asked during training 

Duration 

Resident Changes in Condition/Reporting to Licensed Staff Responsibilities Taught 

15 min. 

Demonstrates immediate reporting of changes observed including:  

Recognize and report abnormal signs and symptoms (including: SOB, breathing changes, color changes, drowsiness, pain, changes in appetite, difficulty chewing , changes in LOC,  new drooling, eyes watering, facial grimacing, coughing, gurgling, attempts to clear his or her throat, can’t produce a voice or only whispers, states something is stuck in throat, or feels fullness in throat) 

• Report incidents regarding your residents to the nurse (including any event that does not fit the routine, loss of dentures, glasses, broken teeth, accidents, injuries, theft, resident pocketing food, change in behavior or physical condition, any complaints, falls, residents on the floor etc) 

Validation of skill competency will be based on: 

• Direct observation  

• Skill demonstration 

• Test questions and open ended questions asked during training 

Duration 

Communication/Interpersonal Skills Observed 

15 min. 

Demonstration of the elements of good communication: 

• Verbal and Non-verbal communication 

• Barriers to effective communication 

• Sensory impairment 

• How to be a good listener 

• Communicating with a hearing impaired resident 

• Communicating with residents with decreased sight 

• Communicating with the resident who has difficulty speaking 

• Communicating with residents with memory loss and cognitive impairment  

• Communicating with team members, record keeping, measuring intake 

Validation of skill competency will be based on: 

• Direct observation  

• Skill demonstration 

• Test questions and open ended questions asked during training 

Duration 

Resident Rights/Staff Responsibilities Observed 

15 min. 

 Demonstration of actions that maintain and promote resident rights, choice, dignity, independence  

Recognition of residents right to be free from abuse, signs of abuse, examples of abuse and reporting of abuse 

Residents rights at meal time (actions that promote/violate residents rights)   

Promoting dignity during meals  

Validation of skill competency will be based on: 

• Direct observation  

• Skill demonstration 

• Test questions and open ended questions asked during training