216 R.I. Code R. 216-RICR-40-05-22.7 - Requirements Pertaining to Nursing Assistant Training Programs

22.7.1 Application for and Approval of Training Programs

A. Approval of training programs shall be granted for two (2) years, if the program is found to meet the requirements of this Part, and such approval may be renewed biennially unless approval has been sooner revoked or suspended.

B. Any person desiring to conduct a training program for the preparation of individuals to provide nursing assistant services shall apply to the Department for approval by submitting a completed application on forms provided by the Department accompanied by documentation pertaining to no less than the following:

1. Evidence of support and fiscal administration accountability;

2. Sources and locations of potential students, faculty, classrooms, conference rooms, clinical laboratory for practical experience and other resources;

3. Names and qualifications of instructors;

4. Copy of the curriculum including provisions for the practical experience;

5. Written statements of purpose, philosophy and objectives;

6. Organization with clearly defined authorities and responsibilities and a chart showing the relationships and channels of communication of the program to other agencies, programs, etc.;

7. Practical experiences related to areas of instruction of the didactic segment of the program; and

8. Written policies and procedures pertaining to the nursing assistant training program.

C. The application fee for a training program certification shall be as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title). Any nursing assistant training program within a facility administered and operated by the State of Rhode Island shall be exempt from this fee.

1. Nursing Assistant Training program sites that are not inspected by the Board within four (4) weeks of approval by the Board, will be inspected by the Department.

D. Standards for Nursing Assistant Training Program Approval

1. The nursing assistant training program shall consist of no less than one hundred twenty (120) clock hours including no less than forty (40) hours of practical training integrated with the classroom topics and under supervision in accordance with the definition of "supervision" in § 22.3(A)(22) of this Part.

a. Online nursing assistant training programs may offer the required eighty (80) hours of didactic training via the Internet. The forty (40) hours of practical training shall be provided by the employing facility.

2. A nursing assistant training program conducted in a health care facility shall be completed within ninety (90) days.

3. Paperwork and scheduling required for a candidate to sit for the State Nursing Assistant examination shall be prepared by the nursing assistant training program, and testing scheduled with the testing provider within ten (10) days after the applicant's completion of the program. The nursing assistant training program is required within that time to file an application for nursing assistant license with the Department, and is required to contact the testing provider to schedule a date for testing.

4. The course of instruction shall be designed to prepare students to perform all the nursing assistant duties listed in §22.12.1 of this Part. At least sixteen (16) hours of classroom instruction shall be required prior to a trainee's direct involvement with patients. Such instruction shall be consistent with the curriculum outline of §22.12.2 of this Part.

E. Personnel

1. Program Coordinator

Each nursing assistant training program shall have a coordinator who shall be responsible for the management of the instructional and practical portions of the program. The program coordinator must be a registered nurse with a minimum of two (2) years of nursing experience, one (1) of which must be in the provision of long term care services; and must have documented evidence of teaching and/or appropriate supervisory experience. Directors of nursing in nursing facilities are prohibited from performing actual training, but may supervise clinical training.

2. Instructors

Competent resource personnel from various areas of the health field may participate as program instructors at the discretion of the program coordinator. Such personnel may include: licensed registered nurses (RNs)/practical nurses (LPNs) with one (1) year of nursing experience, dietitians; pharmacists; or physical therapists. Instructors shall have completed a course in teaching adults or have experience in teaching adults, or supervising nursing assistants, and shall have at least one (1) year of experience in their respective fields.

F. Policies and Procedures

1. Each nursing assistant training program shall have available for students written policies pertaining to no less than the following:

a. Admission, re-admission, retention, dismissal and course completion requirements;

b. The identification of the resource facilities for the practical experience in a long-term care or appropriate acute care facility;

c. Management of any unique online program issues, such as internet and equipment access;

d. The supervision requirement of nursing assistants in all settings in accordance with the definition of "supervision" in this Part; and

e. Such other provisions as may be deemed appropriate.

f. Licensed Nursing Assistant training programs shall submit all required documentation for students who have successfully completed a nursing assistant training program within one (1) month to the Department or shall be subject to disciplinary action in accordance with §22.10.1 of this Part.

G. Resources and Facilities

1. Each nursing assistant training program shall have resources/facilities consistent with the philosophy, purposes, objectives and policies of the nursing assistant program. Such resources/facilities shall include no less than:

a. Classroom, offices, and conference rooms accessible to and adequate for the number of students;

b. Sufficient instructional materials to meet the needs of students and instructor, including clinical supplies;

c. Furnishings of appropriate size and numbers as may be required for the instructional program and for the number of students;

d. An adequate number of service resources to provide the kinds of practical learning experiences as required to meet the curriculum objectives;

e. Adequate financial support to implement and operate the nursing assistant program;

f. Compliance with all applicable licensing laws and regulatory requirements.

2. Online nursing assistant training programs must ensure that each student enrolled in the program has internet connection, a computer and/or laptop with a webcam, microphone, and speakers to complete the course(s).

H. Curriculum

The objectives of the nursing assistant training program shall be consistent with 42 C.F.R. § 483.152 incorporated at § 22.2 of this Part and the curriculum outline of §22.12.2 of this Part and shall promote the provision of quality health care services by nursing assistants who are able to perform competently the duties listed in §22.12.1 of this Part.

I. Evaluation of Curriculum

1. A systematic plan for on-going evaluation of the curriculum shall be established and include evaluation provisions pertaining to no less than:

a. The implementation of the curriculum design;

b. The relationship of the curriculum to current needs of patients in health care facilities and current standards of practice;

c. Revisions and/or modifications of curriculum as may be necessary based on evaluation data, unique online students' requests, and/or other Federal and State requirements.

J. Examinations

1. An examination shall be administered that tests the knowledge and competency of a person to carry out the duties of a nursing assistant as defined in these Regulations.

2. The nursing assistant program shall determine a person's skill, knowledge levels, and competency through a manual skills (practical) examination. Such examination shall test no less than the following:

a. Communication and interpersonal skills;

b. Infection control;

c. Safety emergency procedures;

d. Promotion of patients' independence;

e. Respecting patients' rights;

f. Basic nursing skills;

g. Mental health/social service needs;

h. Care of cognitively impaired patients;

i. Basic restorative services.

3. In addition, the nursing assistant program shall test specific manual skills as set forth in §22.12.1 of this Part. Where appropriate, skills demonstration shall be performed on a real patient, or "pseudo-patient," but shall not be performed on a mannequin.

K. Standards for Medication Aide Training Program Approval

1. Medication aide training programs shall be offered by a college or university that is approved by an appropriate accrediting authority. Correspondence courses and on-line learning programs shall not be approved.

2. Approval of a medication aide training program shall be granted for two (2) years, if the program is found to meet the requirements of this Part, and such approval may be renewed biennially unless approval has been sooner revoked or suspended.

3. Training programs for medication aides that are approved by the Department shall include the following components:

a. Require written documentation for entry into the medication aide training program from a director of nursing or an administrator at an adult day services program, nursing facility, or assisted living residence licensed in Rhode Island;

b. A minimum of forty-five (45) hours of classroom instruction in a medication administration training program that includes theoretical and practical instruction;

c. Skills demonstration, performed within one (1) year of successful completion of the medication aide training program, under the supervision of a registered nurse and approval of a registered nurse in the employing facility;

d. Written guidelines, policies, and procedures that define the specific tasks the medication aide shall be expected to perform;

e. A stipulation of how the medication aide's competency is to be assessed (i.e., examination and practicum).

L. Curriculum for a Department-approved Training Program for Medication Aides

1. Training programs for medication aides that are approved by the Department shall include, but not be limited to, the following course content:

a. Legal constraints;

b. Dose forms;

c. Laxatives, vitamins, cold and cough remedies, and other over-the- counter drugs;

d. Psychiatric medications;

e. Antidiabetic and antiemetic drugs;

f. Asthma and chronic obstructive pulmonary disease (COPD);

g. Hormones (including steroids);

h. Antibiotics;

i. Systems of measurement and medical abbreviations;

j. Anti-Parkinson drugs and muscle relaxers;

k. Cardiac drugs;

l. Seizures and pain;

m. Communication techniques;

n. Security and safety of drugs;

o. Glossary of terms;

p. Drug orders;

q. Over-the-counter and legend medications;

r. Common side effects of drugs;

s. Drug administration preparation;

t. Prescribers;

u. Directions for use;

v. Commonly-used abbreviations and symbols;

w. Number of dosage units;

x. Strengths and systems of measurement;

y. Routes of administration;

z. Frequency of administration;

aa. Interpreting directions for use;

bb. Infection control procedures;

cc. Patient instruction;

dd. Calculations and conversions;

ee. Administration of topical medications;

ff. Patient monitoring of health indicators;

gg. "Five rights" of medication administration: right patient, right drug, right dose, right time, and right route of administration;

hh. Proper documentation in patient medication records;

ii. Accurate administration of the appropriate quantity of drug product.

M. Personnel for a Department-approved Training Program for Medication Aides

1. All instructors in a Department-approved training program for medication aides shall be licensed pharmacists (R.Ph) with no less than a bachelor's degree in pharmacy. Provided, however, pharmacist instructors may engage competent resource personnel from other health fields, such as nursing, to deliver discrete lectures in their area(s) of expertise.

2. Instructors shall have completed a course in teaching adults or have experience in teaching adults and shall have at least one (1) year of experience in their respective fields.

N. Unless otherwise stated, the provisions of § 22.7 of this Part pertain to both classroom and online nursing assistant training programs.

Notes

216 R.I. Code R. 216-RICR-40-05-22.7

Adopted effective 5/21/2022
Amended effective 2/1/2023