3204 NURSE AIDE TRAINING PROGRAM CURRICULUM

3204.1 Each nurse aide training program shall provide one hundred twenty (120) hours of training for each nurse aide trainee before he or she may be certified as a nurse aide.

3204.2 Each nurse aide training program shall include training in the following areas:

1. (a) Forty-five (45) hours of classroom instruction;
2. (b) Thirty (30) hours of clinical laboratory practicums; and
3. (c) Forty-five (45) hours of nursing home practicums.

3204.3 Each nurse aide training program shall prepare each nurse aide to do the following:

1. (a) Communicate and interact with residents, families, and other members of the health team;
2. (b) Demonstrate sensitivity to resident's emotional, social, and mental health needs;
3. (c) Assist residents with self-care deficits while promoting functional independence;
4. (d) Help to ensure and protect the resident's rights; and
5. (e) Observe, report, and document the conditions and changes relating to the residents' physical and psycho-social well-being.

3204.4 Each nurse aide training program shall use as the primary textbook a long term care publication approved by LTCA. The program's instruction may be enhanced by using audio-visual, training aids, and additional medical textbooks and journals.

3204.5 Each nurse aide training program's curriculum shall require at least sixteen (16) hours of training in the following areas prior to any nurse aide's direct contact with a resident:

1. (a) Communication and interpersonal skills;
2. (b) Infection control;
3. (c) Safety/emergency procedures;
4. (d) Promoting resident's independence;
5. (e) Respecting resident's rights;
6. (f) Basic nursing skills:
7. (1) Taking and recording vital signs;
8. (2) Measuring and recording height and weight;
9. (3) Caring for the resident's environment;
10. (4) Recognizing abnormal signs and symptoms of common diseases and conditions;

(5) Caring for residents when death is imminent;

(g) Personal care skills, including but not limited to:

(1) Bathing;

(2) Grooming, including mouth care;

(3) Dressing;

(4) Toileting;

(5) Assisting with eating and hydration;

(6) Proper feeding techniques;

(7) Skin care; and

(8) Transfer, positioning, and turning;

(h) Mental health and social service needs:

(1) Modifying aide's behavior in response to resident's behavior;

(2) Identifying developmental tasks associated with the aging process;

(3) Behavioral management by reinforcing appropriate behavior and reducing or eliminating inappropriate behavior;

(4) Allowing the resident to make personal choices, providing and reinforcing other behavior consistent with the resident's dignity;

(5) Using the resident's family as a source of emotional support;

(i) Care of cognitively impaired residents:

(1) Techniques for addressing the unique needs and behaviors of individuals with dementia (Alzheimer's and others);

(2) Communication with cognitively impaired residents;

(3) Understanding the behavior of cognitively impaired residents;

(4) Appropriate responses to the behavior of cognitively impaired residents;

(5) Methods of reducing the effects of cognitive impairments;

(j) Basic restorative services:

(1) Training the resident in self care according to the resident's abilities;

(2) Use of assistive devices in transferring, ambulation, eating, and dressing;

(3) Maintenance of range of motion;

(4) Proper turning and positioning in bed and chair;

(5) Bowel and bladder training;

(6) Care and use of prosthetic and orthotic devices; and

(k) Resident's rights:

(1) Providing privacy and maintenance of confidentiality;

(2) Promoting the resident's rights to make personal choices to accommodate their needs;

(3) Giving assistance in resolving grievances and disputes;

(4) Providing needed assistance in getting to and participating in resident and family groups and other activities;

(5) Maintaining care and security of resident's personal possessions;

(6) Providing care which maintains the resident free from abuse, mistreatment, and neglect and the need to report any such instance to appropriate facility staff; and

(7) Maintaining the resident's environment and care to avoid the need for restraints.

3204.6 No nurse aide employed by a nursing facility which participates in the medicaid program shall be charged for any portion of the nurse aide training course, including any fees for textbooks or other required course materials.

3204.7 Each nurse aide training program shall report any proposed changes in its curriculum to the LTCA, prior to their implementation for approval.

SOURCE: Final Rulemaking published at 38 DCR 2008 (April 5, 1991).