Current through Reg. 49, No. 38; September 20, 2024
Each facility must develop, implement and maintain
effective training programs of orientation, training, and continuing in-service
education to develop the skills of its staff, including all new and existing
staff; individuals providing services under a contractual arrangement; and
volunteers, consistent with their expected roles. Effective November 28, 2019,
a facility must determine the amount and types of training necessary based on a
facility assessment as specified at § 554.1931 of this subchapter
(relating to Facility Assessment) and as described in § 554.1001 of this
chapter (relating to Nursing Services) .
(1) As part of orientation and annually, each
employee must receive instruction regarding:
(A) Human Immunodeficiency Virus (HIV), as
outlined in the educational information provided by the Texas Department of
State Health Services Model Workplace Guidelines. At a minimum the HIV
curriculum must include:
(i) modes of
transmission;
(ii) methods of
prevention;
(iii) behaviors related
to substance abuse;
(iv)
occupational precautions;
(v)
current laws and regulations concerning the rights of an acquired immune
deficiency syndrome/HIV-infected individual; and
(vi) behaviors associated with HIV
transmission which are in violation of Texas law;
(B) restraint reduction and the prevention of
falls through competency-based training. Facilities also may choose to train on
behavior management, including prevention of aggressive behavior and
de-escalation techniques;
(C)
activities that constitute abuse, neglect, exploitation, or misappropriation of
resident property as set forth at § 554.601 of this chapter (relating to
Freedom from Abuse, Neglect and Exploitation);
(D) procedures for reporting incidents of
abuse, neglect, exploitation, or misappropriation of resident property;
and
(E) dementia management and
resident abuse prevention.
(2) Each registered nurse, licensed
vocational nurse, and nurse aide (nurse assistant) who provides nursing
services must receive at least one hour of training each year in caring for
people who have dementia.
(3)
Nursing staff, licensed nurses, and nurse aides must receive annual in-service
training which includes components, appropriate to their job responsibilities,
from one or more of the following categories:
(A) communication techniques and skills
useful when providing geriatric care, such as skills for communicating with the
hearing impaired, visually impaired and cognitively impaired; therapeutic
touch; and recognizing communication that indicates psychological
abuse;
(B) assessment and nursing
interventions related to the common physical and psychological changes of aging
for each body system;
(C) geriatric
pharmacology, including treatment for pain management and sleep
disorders;
(D) common emergencies
of geriatric residents and how to prevent them, for example, falls, choking on
food or medicines, injuries from restraint use; recognizing sudden changes in
physical condition, such as stroke, heart attack, acute abdomen, and acute
glaucoma; and obtaining emergency treatment;
(E) common mental disorders with related
nursing implications; and
(F)
ethical and legal issues regarding advance directives, abuse and neglect,
guardianship, and confidentiality.
(4) Facilities with pediatric residents must
comply with the following:
(A) Facility staff
must be trained in the use of pediatric equipment and supplies, including
emergency equipment and supplies.
(B) Facility staff must receive annual
continuing education dealing with pediatric issues, including child growth and
development and pediatric assessment.
(5) Minimum continuing in-service education
requirements are listed in subparagraphs (A)-(B) of this paragraph. Attendance
at relevant outside training may be used to satisfy the in-service education
requirement. The facility must keep in-service records for each employee
listed. The minimum requirements are:
(A)
licensed personnel--two hours per quarter; and
(B) nurse aides--12 hours annually. For the
purpose of this paragraph, a medication aide is considered a nurse aide and
must receive the same continuing in-service education. This in-service
education does not qualify as continuing education units required for renewal
of a medication aide permit.
(6) A rural hospital participating in the
Medicaid Swing Bed Program as specified in § 554.2326 of this chapter
(relating to Medicaid Swing Bed Program for Rural Hospitals) is not required to
meet the requirements of this section, if the swing beds are used for no more
than one 30-day length of stay per year, per resident.
(7) Effective November 28, 2019, the facility
must also include as part of its mandatory training the following topics:
(A) effective communications for direct care
staff;
(B) rights of the resident
and the responsibilities of a facility to properly care for its residents as
set forth in Subchapter E of this chapter (relating to Resident
Rights);
(C) standards, policies,
and procedures for the facility's infection prevention and control program, as
set forth in § 554.1601 of this chapter (relating to Infection Control);
and
(D) behavioral health training,
as set forth in § 554.904 of this chapter (relating to Behavioral Health
Services).
