Unlicensed Assistive Personnel Training Program

PURPOSE: This rule requires hospitals to have a personnel training policy that requires unlicensed health care personnel who provide direct patient care under the delegation and supervision of a registered nurse to complete the Unlicensed Assistive Personnel (UAP) Training Program, which shall be used to prepare individuals for employment in hospitals. This program shall be designed to teach the knowledge and skills that will qualify students to perform uncomplicated nursing procedures and assist in direct patient care. PUBLISHER’S NOTE: The secretary of state has determined that publication of the entire text of the material that is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here. (1) Hospitals may only employ or contract with a staffing agency for unlicensed assistive personnel (UAP) in accordance with this rule. (2) The hospital training policy for UAPs shall include the following minimum standards: (A) The curriculum of the UAP Program shall consist of a standard plan of instruction to include: 1. A minimum of seventy-five (75) hours of classroom instruction; 2. Computer or paper-based learning modules that provide documentation of completion may be substituted for up to sixty (60) hours of classroom time; 3. Comparable certified medical assistant training from an accredited medical assistant program may be substituted for up to fifty (50) hours of classroom time of comparable subject matter; 4. A minimum of one hundred (100) hours of clinical practicum; and 5. Curriculum content of the program shall include procedures and instructions on basic patient care skills including but not limited to the areas of— A. The Role of the UAP (ethics, law, team member communication, observation, reporting, documentation, medical terminology); B. Patient/Client Rights (Health Insurance Portability and Accountability Act (HIPAA), privacy, confidentiality, advanced directives, abuse and neglect, age specific care, cultural diversity, pain management, restraint-free care, end-oflife care, death and dying, do not resuscitate (DNR) orders, post-mortem care); C. Vital Signs; D. Quality (basic human needs: age specific cognitive/ psychological/social needs, activities of daily living, ambulation, positioning, personal care, elimination and toileting, nutrition, hydration, feeding, bed making); E. Infection Control (universal precautions, bloodborne pathogens, safe needle devices, aseptic technique, hand washing, gloving, isolation); F. Skin Care (wound care, pressure ulcers, and prevention); and G. Safety (cardiopulmonary resuscitation (CPR), allergies, fall prevention, environmental safety issues, fire/electrical, hazardous materials transportation safety information (HAZMAT), emergency procedures, body mechanics); (B) The clinical practicum of one hundred (100) hours shall start after the student has enrolled and started the course curriculum; (C) Skill validation and knowledge verification is to be used SENIOR SERVICES to determine student competence; and (D) Annual in-service training also shall occur as required by 19 CSR 30-20. (3) Hospitals shall not be required to meet the UAP training requirements if an employee demonstrates competency in the content areas required by this rule; in the duties specific to their job and the patient population assigned and— (A) Is enrolled in a professional or practical nursing education program and has or will complete within ninety (90) days a fundamentals of nursing course; or (B) Was a professional nursing or practical nursing licensure candidate who failed to pass the state licensure examinations in the past three (3) years; or (C) Is certified as a nursing assistant as defined in section 198.082, RSMo; or (D) Has documentation of current registration as a certified nursing assistant in another state that meets the requirements listed in 42 CFR 483.151 and 483.152 (April 2012) which are incorporated by reference in this rule and are published by the U.S. Government Printing Office, 710 North Capitol Street, NW, Washington, DC 20401. This rule does not incorporate any subsequent amendments or additions; or (E) Has documented experience as a nurse assistant, emergency medical technician, or surgical technician in the past three (3) years; or (F) Has proof of completion of a patient care technician training program which meets the curriculum requirements of this rule or UAP training program in Missouri or another state which meets the requirements of this rule within the last three (3) years; (G) Has completed a professional or licensed practical nursing program outside the United States and is awaiting the licensure examination in this country; or (H) Has proof of certification as a patient care technician. (4) The hospital training policy for UAPs shall meet the following faculty qualifications and responsibilities: (A) A registered professional nurse shall be designated as the course coordinator and shall be responsible for all aspects of the course, and must supervise all classroom and clinical instruction; (B) Instructors shall hold a current license or temporary permit to practice as a registered professional nurse in Missouri or in another Nurse Licensure Compact state and have a minimum of two (2) years of nursing experience in an acute care, long-term care, or ambulatory surgery facility within the prior five (5) years, or an experience as a clinical faculty member in a nursing program within the prior five (5) years. An instructor’s nursing license shall not be under current disciplinary action; (C) A clinical supervisor’s or preceptor’s nursing license shall not be under current disciplinary action; and (D) UAPs who have satisfied the training requirements of this rule and Licensed Practical Nurses may assist with the clinical practicum under the direction of the course coordinator. (5) A hospital or ambulatory surgical center that provides training for UAPs shall meet the following training site requirements: (A) Provide designated space sufficient to accommodate the classroom teaching portion of the course or have a written agreement with another acute care hospital, an area vocational-technical school, a high school offering a health service occupation program, a community college, or a provider agency to provide the classroom portion of the course; (B) Provide on-the-job clinical practicum or have a written agreement with one (1) or more hospitals or ambulatory surgical centers in their vicinity to do so; (C) Assess and review the program and outcomes of any training provided by another facility to ensure that all of the requirements of this rule have been met; (D) Maintain, either electronically or on paper records of course completion and competency for a minimum of three (3) years. Records shall be signed and dated by the course coordinator and each of the instructors and clinical supervisors verifying classroom time, clinical time, and competency for each student; and (E) Provide a signed copy of the course completion and competency record to the student, that includes the elements in subsection (5)(D) of this rule. (6) The UAP training shall be completed within one hundredeighty (180) days of employment for any individual who is hired as a UAP. Quality and Safety curriculum shall be covered within ninety (90) days of employment. A UAP shall not work in direct patient care, except as part of their supervised practicum, until the entire UAP training requirements have been met. AUTHORITY: section 197.287, RSMo Supp. 2023.* Original rule filed Jan. 31, 2008, effective Sept. 30, 2008. Amended: Filed Dec. 31, 2013, effective Aug. 30, 2014. ** Emergency amendment filed May 22, 2023, effective June 6, 2023, expired Dec. 2, 2023. Amended: Filed May 22, 2023, effective Nov. 30, 2023. *Original authority: 197.287, RSMo 2000, amended 2017. **Pursuant to Executive Order 21-07, 19 CSR 30-20.125, section (6) was suspended from April 2, 2020 through May 1, 2021. Pursuant to Executive Order 21-09, 19 CSR 30-20.125, section 197.287, RSMo was suspended from April 2, 2020 through December 31, 2021 and section (6) was suspended from October 13, 2021 through December 31, 2021.