Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: This proposed amendment amends subsection
(2)(A) to reclassify UAP Program curriculum content, amends subsection (2)(D)
to correct an obsolete rule reference, amends subsection (3) (F) to exempt
hospitals from complying with certain UAP training requirements if the
employees can prove completion of patient care technician training programs,
adds a new subsection (3)(H) to exempt hospitals from complying with certain
UAP training requirements if the employees have proof of certification as a
patient care technician, and amends section (6) to extend the UAP training
completion deadline from ninety (90) days to one hundred-eighty (180) days and
requires quality and safety curriculum to be completed within ninety (90) days
of employment.
(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 pro-vide 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-of-life 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, blood-bornepathogens, 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 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 an-other 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 hundred-eighty (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.
*Original authority: 197.287, RSMo
2000.
