1. A. Curriculum content. The curriculum shall include classroom, skills laboratory, and clinical instruction in the following:

   1. 1. Initial core curriculum. Prior to the direct contact with a client, a student shall have completed a total of at least 24 hours of instruction. Sixteen of those hours shall be in the following five areas:

      1. a. Communication and interpersonal skills.
      2. b. Infection control.
      3. c. Safety and emergency procedures, including dealing with obstructed airways and fall prevention.
      4. d. Promoting client independence.
      5. e. Respecting clients' rights.

   2. 2. Basic skills.

      1. a. Recognizing changes in body functioning and the importance of reporting such changes to a supervisor.
      2. b. Measuring and recording routine vital signs.
      3. c. Measuring and recording height and weight.
      4. d. Caring for the client's environment.
      5. e. Measuring and recording fluid and food intake and output.
      6. f. Performing basic emergency measures.
      7. g. Caring for a client when death is imminent.

   3. 3. Personal care skills.

      1. a. Bathing and oral hygiene.
      2. b. Grooming.
      3. c. Dressing.
      4. d. Toileting.
      5. e. Assisting with eating and hydration, including proper feeding techniques.
      6. f. Caring for skin, to include prevention of pressure ulcers.
      7. g. Transfer, positioning, and turning.

   4. 4. Individual client's needs, including mental health and social service needs.

      1. a. Modifying the nurse aide's behavior in response to the behavior of clients.
      2. b. Identifying developmental tasks associated with the aging process.
      3. c. Demonstrating principles of behavior management by reinforcing appropriate behavior and causing inappropriate behavior to be reduced or eliminated.
      4. d. Demonstrating skills supporting age-appropriate behavior by allowing the client to make personal choices, and by providing and reinforcing other behavior consistent with the client's dignity.
      5. e. Utilizing the client's family or concerned others as a source of emotional support.
      6. f. Responding appropriately to the client's behavior including aggressive behavior and language.
      7. g. Providing appropriate clinical care to the aged and disabled.
      8. h. Providing culturally sensitive care.

   5. 5. Care of the cognitively or sensory (visual and auditory) impaired client.

      1. a. Using techniques for addressing the unique needs and behaviors of individuals with dementia (Alzheimer's and others).
      2. b. Communicating with cognitively or sensory impaired clients.
      3. c. Demonstrating an understanding of and responding appropriately to the behavior of cognitively or sensory impaired clients.
      4. d. Using methods to reduce the effects of cognitive impairment.

   6. 6. Skills for basic restorative services.

      1. a. Using assistive devices in transferring, ambulation, eating, and dressing.
      2. b. Maintaining range of motion.
      3. c. Turning and positioning, both in bed and chair.
      4. d. Bowel and bladder training.
      5. e. Caring for and using prosthetic and orthotic devices.
      6. f. Teaching the client in self-care according to the client's abilities as directed by a supervisor.

   7. 7. Clients' rights.

      1. a. Providing privacy and maintaining confidentiality.
      2. b. Promoting the client's right to make personal choices to accommodate individual needs.
      3. c. Giving assistance in resolving grievances and disputes.
      4. d. Providing assistance necessary to participate in client and family groups and other activities.
      5. e. Maintaining care and security of the client's personal possessions.
      6. f. Promoting the client's rights to be free from abuse, mistreatment, and neglect and the need to report any instances of such treatment to appropriate staff.
      7. g. Avoiding the need for restraints in accordance with current professional standards.
   8. 8. Legal and regulatory aspects of practice as a certified nurse aide including consequences of abuse, neglect, misappropriation of client property, and unprofessional conduct as set forth in § 54.1-3007 of the Code of Virginia and 18VAC90-25-100.
   9. 9. Occupational health and safety measures.
   10. 10. Appropriate management of conflict.
   11. 11. Observational and reporting techniques.
   12. 12. Substance abuse and opioid misuse.

2. B. Unit objectives.

   1. 1. Objectives for each unit of instruction shall be stated in behavioral terms that are measurable.
   2. 2. Objectives shall be reviewed with the students at the beginning of each unit.

Statutory Authority

§§ 54.1-2400 and 54.1-3005 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 30, Issue 10, eff. February 27, 2014; amended, Virginia Register Volume 32, Issue 26, eff. September 21, 2016; Volume 37, Issue 17, eff. May 12, 2021.