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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 17. BUSINESS, OCCUPATIONS, AND PROFESSIONALS |
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Chapter 17-93. HOME HEALTH AIDES |
Section 17-9327. HOME HEALTH AIDE TRAINING PROGRAM CURRICULUM
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9327.1Core training requirements include:
(a) Cardio-pulmonary resuscitation (CPR) – basic life support (BLS) for Healthcare Providers;
(b)First aid;
(c) The role of nursing assistive personnel;
(d) Client rights and privacy;
(e) Legal and ethical duties, including recognition, prevention, and reporting of abuse or neglect;
(f) Care sensitive to culture, religion, national origin, gender identity, and sexual orientation;
(g) Interpersonal communication;
(h) Receiving delegation and working as a member of the health care team;
(i) Basic safety skills;
(j) Infection prevention, including standard precautions;
(k) Delegated nursing functions including:
(1)Taking and documenting vital signs, intake and output, and other routine observations;
(2)Measuring and documenting the client’s height and weight; and
(3) Recognizing, reporting, and documenting abnormal changes in behavior or body functions;
(l) Basic restorative skills, including safe transfer, ambulation, maintaining range of motion, and positioning;
(m)Personal care skills, including but not limited to bathing, feeding, hydration, skin care, dressing, grooming, and toileting;
(n)Caring for the client’s environment;
(o) Promoting the client’s independence;
(p)Measures for ensuring safety of clients at risk which include but are not limited to:
(1)Cognitive impairment;
(2)Sensory deficits or impairments;
(3)Communication limitations;
(4)Altered level of consciousness; and
(5)Agitation or combativeness;
(q)Working with agitated or combative clients, including techniques useful in the prevention of abuse;
(r)Prohibition on use of restraints;
(s)End of life care;
(t)Supporting individuals with cognitive, intellectual or developmental disabilities;
(u)Supporting individuals with behavioral problems;
(v)Basic emergency procedures;
(w)Preventing fatigue and burn-out;
(x)Types of abusive behavior; and
(y)Requirements of reporting incidents.
9327.2Training requirements specific to the role of the HHA shall include:
(a)Tasks and responsibilities of an HHA;
(b)Implementation of a plan of care;
(c)Legal and ethical considerations for an HHA;
(d)Respect for client property;
(e)Personal and community safety for an HHA;
(f)Delegated nursing functions:
(1)Basic restorative skills, including transfers, ambulation, range of motion, and positioning, that are appropriate for the home setting;
(2)Assisting with self-administration of medication;
(3)Administering an enema;
(4) Care of ostomy including skin and changing appliance;
(5)Administering oxygen therapy; and
(6) Medication administration following medication aide certification;
(g)The foundations for working with the home care client, the family, and significant others of the client and home care team members, including:
(1)Family dynamics;
(2)Communication with the client, the client’s family, and significant others in the home setting;
(3)Dealing with barriers to communication in the home;
(4)Communication with the home care team;
(5)Maintaining relationships with the client, the client’s family, and significant others;
(6)Understanding basic human needs; and
(7) Individual, family, and cultural differences;
(h)Foundations for a safe client environment, including:
(1)General home safety;
(2)Infection prevention in the home;
(3)Fire safety in the home setting;
(4) Emergencies in the home setting;
(5)Home care considerations, including:
(A)Food and nutrition, meal planning, and meal preparation;
(B)Housekeeping, laundering, and food shopping;
(C)Maintenance of a clean, safe, and healthy environment; and
(D)Use and care of medical equipment in the home; and
(6)Simple procedures such as non-sterile dressings; and
(i)Understanding and working with various client populations in home care settings including:
(1)Introduction to infant and child care;
(2)Mental and physical disabilities;
(3)Chronic illness and disease conditions;
(4) Caring for the terminal client in the home;
(5)The elderly client; and
(6) Proper use of assistive devices, such as lifts, prosthetic, and orthotic devices.
9327.3The training program for an HHA using Board-approved model curriculum shall provide a minimum of:
(a)One hundred twenty-five hours (125) of didactic and clinical training consisting of sixty-five (65) hours of classroom instruction, twenty (20) hours of laboratory, and forty (40) hours of clinical; or
(b)Thirty-two hour (32) of didactic and clinical training in a certified nursing assistant (CNA) bridge course consisting of sixteen (16) hours of classroom and laboratory, and sixteen (16) hours of clinical.
9327.4Each training program’s curriculum shall prepare trainees to practice as required in § 9315 prior to any direct contact with a client.
9327.5Each training program shall report to the Board for approval of any proposed change in its curriculum prior to the implementation of the change.
9327.6Each training program shall have a sufficient number of qualified instructors to meet the purposes and objectives of the program.
9327.7The training program shall be coordinated by a registered nurse with:
(a) A current, unencumbered license issued by the District of Columbia;
(b)At least two (2) years of experience as a registered nurse; and
(c)Clinical experience in the practice setting that he or she is coordinating.
9327.8The program coordinator’s responsibilities shall include, but not be limited to:
(a)Ensuring that the curriculum is coordinated and implemented in accordance with this chapter;
(b)Establishing job descriptions stating the responsibilities of the instructors;
(c)Ensuring that each instructor meets the qualifications specified in this chapter;
(d)Ensuring that each student is properly supervised during the student’s clinical experience; and
(e)Ensuring that each clinical preceptor evaluates the student’s performance and provides the evaluation results to the clinical instructor.
9327.9The training programs for HHAs shall be performed by a licensed nurse who is:
(a) Licensed as a registered nurse in the District of Columbia and has a minimum of two (2) years of current clinical experience in the clinical practice setting in which he or she teaches; or
(b) Licensed as a practical nurse in the District of Columbia and has a minimum of three (3) years of current clinical experience in the home or residential settings.
9327.10A licensed, qualified health professional as listed in D.C. Official Code § 3-1201.02 (2012 Supp.) who has a minimum of two (2) years of experience may offer training to HHAs in non-nurse related content.
9327.11The following conditions shall be met when clinical preceptors are used:
(a)The criteria for selecting a clinical preceptor shall be in writing and shall include the following:
(1) The method of selecting clinical preceptors;
(2) The plans for orientation of clinical preceptors;
(3) The clinical objectives or outcomes of the preceptorship; and
(4) A system for monitoring and evaluating the preceptor’s learning experiences.
9327.12There shall be a written agreement between the preceptor and the training program specifying the following:
(a)The clinical objectives or outcomes; and
(b)The system used for monitoring and evaluating the trainee’s learning experiences.
9327.13The clinical instructor shall:
(a)Retain responsibility for the trainee’s learning experiences and meet periodically with the clinical preceptor and the trainee to monitor and evaluate the trainee’s learning experiences; and
(b) Be readily available, either directly or by a communication device, when preceptors are in the clinical area.
9327.14The clinical preceptor shall have:
(a) A minimum of two (2) years of experience as a licensed nurse or HHA;
(b)Experience providing direct client care during the five (5) years immediately preceding the date of the written agreement between the preceptor and the training program;
(c) A philosophy of health care congruent with that of the HHA program; and
(d) Current knowledge of practice at the HHA level.
9327.15Each clinical instructor and preceptor shall be licensed or certified in the District of Columbia.
9327.16Clinical instruction shall be offered in the setting in which the HHA shall work.
9327.17The ratio of clinical instructors to trainees in clinical areas involving direct care of clients shall:
(a) Be based upon the client acuity level, skill level of the trainee, and the clinical setting; and
(b)Not exceed one (1) instructor or preceptor to two (2) HHAs.
9327.18Each clinical instructor and preceptor’s qualifications shall be documented in the official records of the program and shall be available for review by the Board.
9327.19Each clinical instructor shall be responsible for:
(a) Assisting in the development, implementation, and evaluation of the purpose, philosophy, and objective of the training program;
(b) Helping to implement and evaluate the curriculum;
(c) Facilitating preceptor participation in the program and evaluating the progress and retention of preceptors in the program;
(d) Giving guidance to preceptors;
(e) Evaluating preceptor achievement in the program;
(f) Providing for preceptor and peer evaluation of his or her teaching effectiveness; and
(g) Participating in continuing nursing education programs to improve his or her competence in areas of responsibilities.