Requirements for NATCEPs

4132.2 - Requirements for NATCEPs (Rev. 1, 05-21-04) (S&C01-20) 4132.2A - Hours of Training (Rev. 1, 05-21-04) A NATCEP must consist of a minimum of 75 clock hours of training in order to be approved by the State. The State has the discretion to require additional hours of training. NOTE: Transporting residents is the only nursing home service that does not require the use of nurse aides with 75 hours of training. It was never the intent that transporting residents by driving a van or pushing a wheelchair would require 75 hours of nurse aide training. However, transferring residents, for example from bed to wheelchair, from wheelchair to the toilet or bath does require the services of a nurse aide who has completed the NATCEP. 4132.2B - Restrictions on Activities of Students in a NATCEP (Rev. 1, 05-21-04) The State should not approve a program unless it ensures that: • Students do not perform any services for which they have not trained and been found proficient by the instructor; and • Students providing services to residents are under the general supervision of a licensed nurse or an RN. 4132.2C - Instructor Qualifications (Rev. 1, 05-21-04) The training of nurse aides must be performed by or under the general supervision of a registered professional nurse who possesses a minimum of 2 years of nursing experience, at least one year of which must be in the provision of long-term care facility services. Instructors of nurse aides must have completed a course in teaching adults or have experience in teaching adults or supervising nurse aides. In a facility-based program, the training of nurse aides may be performed under the general supervision of the Director of Nursing, who is prohibited from performing the actual training. Other individuals may supplement the instructor. Following are examples of those who might be useful in a NATCEP: • RNs; • Licensed practical/vocational nurses; • Pharmacists; • Dietitians; • Social workers; • Sanitarians; • Fire safety experts; • Nursing home administrators; • Gerontologists; • Psychologists; • Physical and occupational therapists; • Activities specialists; • Speech/language/hearing therapists; and • Resident rights experts. The program may utilize individuals from fields other than those listed as examples if needed to meet the planned program objectives for a specific unit. Supplemental personnel must have a minimum of one year of experience in their fields. The State may require that these individuals be, where applicable, licensed, registered, and/or certified in their field. 4132.2D - Minimum Curriculum Requirements (Rev. 1, 05-21-04) The objective of NATCEPs is to enable nurse aides to provide quality services to residents. Therefore, a NATCEP must contain at least these minimum curriculum requirements for it to be approved. The State may also specify additional areas to be included. Within the minimum 75 hours of training, at least 16 hours must be devoted to supervised practical training. Supervised practical training is defined as training in a laboratory or other setting in which the student demonstrates knowledge while performing tasks on an individual under the direct supervision of an RN or LPN. A program must also include at least 16 hours of classroom instruction prior to a trainee’s direct involvement with a resident. This instruction must include the following: • Communication and interpersonal skills; • Infection control; • Safety/emergency procedures, including the Heimlich maneuver; • Promoting residents’ independence; and • Respecting residents’ rights. The curriculum must also include training in the following areas: 1. Basic nursing skills: a. Taking and recording vital signs; b. Measuring and recording height and weight; c. Caring for the residents’ environment; d. Recognizing abnormal changes in body functioning and the importance of reporting such changes to a supervisor. Some examples of abnormal changes are: • Shortness of breath; • Rapid respiration; • Fever; • Coughs; • Chills; • Pains in chest; • Blue color to lips; • Pain in abdomen; • Nausea; • Vomiting; • Drowsiness; • Excessive thirst; • Sweating; • Pus; • Blood or sediment in urine; • Difficulty urinating; • Frequent urination in small amounts; • Pain or burning on urination; and • Urine has` dark color or strong odor. e. Caring for residents when death is imminent. 2. Personal care skills: a. Bathing; b. Grooming, including mouth care; c. Dressing; d. Toileting; e. Assisting with eating and hydration; f. Proper feeding techniques; g. Skin-care; and h. Transfers, positioning, and turning. 3. Mental health and social service needs: a. Modifying aide’s behavior in response to resident’s behavior; b. Awareness of developmental tasks associated with the aging process; c. How to respond to resident behavior; d. Allowing residents to make personal choices, providing and reinforcing other behavior consistent with the resident’s dignity; and e. Utilizing resident’s family as a source of emotional support. 4. Care of cognitively impaired residents: a. Techniques for addressing the unique needs and behaviors of individuals with dementia (Alzheimer’s and others); b. Communicating with cognitively impaired residents; c. Understanding the behavior of cognitively impaired residents; d. Appropriate responses to the behavior of cognitively impaired residents; and e. Methods of reducing the effects of cognitive impairments. 5. Basic Restorative Services - The nurse aide should be able to demonstrate skills which incorporate principles of restorative nursing, including: a. Training the resident in self-care according to the resident’s abilities; b. The use of assistive devices in transferring, ambulation, eating, and dressing; c. Maintenance of range of motion; d. Proper turning and positioning both in bed and chair; e. Bowel and bladder training; and f. Care and use of prosthetic and orthotic devices. 6. Residents’ Rights - The nurse aide should be able to demonstrate behavior that maintains residents’ rights, including but not limited to: a. Providing privacy and maintenance of confidentiality; b. Promoting the resident’s right to make personal choices to accommodate their needs; c. Giving assistance in resolving grievances and disputes; d. Providing needed assistance in getting to and participating in resident and family groups and other activities; e. Maintaining care and security of resident’s personal possessions; f. Providing care which maintains the resident free from abuse, mistreatment, and neglect, and reporting any instances of such treatment to appropriate facility staff; and g. Avoiding the need for restraints in accordance with current professional standards. 4132.2E - Competency Evaluation Component (Rev. 1, 05-21-04) All NATCEPs must contain competency evaluation procedures that meet the requirements specified in §4132.3. 4132.2F - Prohibition of Charges (Rev. 1, 05-21-04) No nurse aide who is employed by, or who has an offer of employment from, a facility on the date on which the aide begins a NATCEP may be charged for any portion of the program (including any fees for textbooks or other required course materials). If an individual who is not employed or does not have an offer to be employed as a nurse aide becomes employed by or receives an offer of employment from a facility not later than 12 months after completing a NATCEP, the State must provide payment for costs incurred in completing the program on a pro rata basis during the period in which the individual is employed as a nurse aide.