Related Experiment Video
Updated: Feb 7, 2026

Using Retinal Imaging to Study Dementia
Published on: November 6, 2017
Developing a Training for Certified Nursing Assistants to Recognize, Communicate, and Document Discomfort in
Vanessa Rodriguez1, Joann P Reinhardt, Ruth Spinner
1Vanessa Rodriguez, MD, is assistant professor, Icahn School of Medicine at Mount Sinai Hospital, New York. Joann P. Reinhardt, PhD, is director of research, The New Jewish Home, New York. Ruth Spinner, MD, CMD, is associate medical director, The New Jewish Home, New York. Sharon Blake, RN, is nurse manager, The New Jewish Home, New York.
Abstract:
Nursing home residents with advanced dementia experience significant symptom burden and may be unable to articulate their needs. Observational tools, such as the Pain Assessment in Advanced Dementia (PAINAD) scale, are available to evaluate changes in behavior that may signify discomfort or pain. Studies proposing a short and effective curriculum, primarily for certified nursing assistants (CNAs) on how to use and incorporate the PAINAD in daily patient care, are scarce. This performance improvement project involves the design and implementation of a training curriculum for CNAs for using the PAINAD and discusses barriers to be considered for further projects. Certified nursing assistant perceptions of their experience with the training and the use of the tool were also assessed with a brief evaluation. Seventy-three initial PAINAD forms were completed along with 52 follow-up PAINAD forms. A paired t test (N = 52) showed a significant decrease in the PAINAD scores from initial (mean, 6.06) to follow-up (mean, 1.85) (P < .001), suggesting a reduction of patient discomfort. The process of collecting and examining these data was meant to reinforce the identification and reduction of behavioral distress through the application of this tool. The training was perceived as effective and the tool as easy to use, indicating it can be incorporated into daily care responsibilities of CNAs.
Related Concept Videos
Role of Communication in the Nursing Process III: Evaluation and Documentation
Guidelines for Nursing Documentation I
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
Formats for Nursing Documentation
Nursing Assessment Form:
• A nursing assessment form is a foundational document that captures detailed patient data from physical assessments and nursing histories.
• It includes patient demographics, medical history,...
Documentation of Nursing Diagnosis
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
Guidelines for Nursing Documentation II
Timely documentation is crucial to ensure continuity of care for patients. Any delays in recording or reporting medical information can result in medical errors and even adverse patient outcomes. From medication administration to diagnostic test results, every detail must be accurately and promptly documented to provide the best possible care for patients.
Dementia
The progression of dementia is generally gradual....

