NCDPI HIGH SCHOOL APPROVED NURSE AIDE TRAINING (NAT) PROGRAM STANDARDS

NCDPI HIGH SCHOOL APPROVED NURSE AIDE TRAINING (NAT) PROGRAM STANDARDS Authoritative Sources for Nurse Aide I Training Program Standards: Code of Federal Regulations Title 42, Chapter 4, Part 483 NC State Law Chapter 151E Article 15 Memorandum of Understanding, NC Division of Health Service Regulation, 8-24-1989 Standard #1 FACULTY AND ENROLLMENT 1.01 Teachers must be approved by the NCDPI/HSE/Nurse Aide office per 42CFR483.152 and Division of Health Service Regulation. Registered Nurse, with unencumbered license, licensed to practice in North Carolina, minimum of two years work experience as a registered nurse, and RN must have completed a course in teaching adults, experience in teaching adults, or experience in supervising nurse aides. 1.02 Faculty must be adequate for the enrollment of the Nurse Aide class. Ten (10) is the absolute enrollment limit for one teacher with one section/class of Nursing Fundamentals course number HN43. This ratio applies to the learning laboratory, didactic, and clinical experience. 1.03 Teacher attendance. Nursing Fundamentals RN teacher must have general supervision of the class 100% of the time. Refer to document regarding teacher attendance for Nursing Fundamentals located in Standard #1 folder on the Nurse Aide and Related Endorsement Courses (NARE) Moodle PLC. Standard #2 NAT AND ENDORSEMENTS COURSES MUST FOLLOW SCOPE AND SEQUENCE 2.01 Health Science Education scope and sequence MUST be followed as outlined in the Career and Technical Education Essential Standards in regard to course content, sequence and satisfaction of recommended prerequisites. Evidence of compliance must be available. 2.02 Curriculum and assessment materials. Current curriculum materials for Health Science I, Health Science II, and Nursing Fundamentals must be utilized. Curriculum materials for HS I and HS II are located on HSE Moodle PLC. Nursing Fundamentals materials are located on the NARE Moodle PLC. 2.03 Course prerequisite compliance for Nurse Aide training. Nurse Aide Training Summary (NATS) Part I must be completed for each Nursing Fundamentals nurse aide candidate as documentation of HSE course prerequisites compliance. 2.04 Public Health Fundamentals HN45 and Fundamentals of Gerontology HN44 are adopted endorsement courses that may be taken before or after Nursing Fundamentals. HS I and HS II are required prerequisites and Nursing Fundamentals is very strongly recommended. Information on these courses is located on the NARE Moodle. Standard #3 TRAINING LABORATORY 3.01 Simulated resident care unit, as outlined by DHSR equipment/supply list must be readily available to students for skill acquisition, refinement, and retention. A. Simulated resident care unit includes bed, hanging curtains with 360 privacy, bedside stand or functional equivalent, bedside chair, over bed table in an area of at least 100* square feet for one bed and 80* square feet per bed for a two bed unit. *This is state minimum for residents in LTC. Additional space is needed for sound teaching and learning. It is highly recommended that there be five (5) feet of space between the sides/foot of the bed and the curtains. B. Hanging curtains must be substantial and functional. NCDPI NURSE AIDE TRAINING PROGRAM STANDARDS Page 1 of 6

C. Sink in the training laboratory must be functional with hot and cold running water. The sink must be of adequate size to accommodate hand washing without the hands touching the sides of the sink. 3.02 D. Training laboratory safety guidelines must be posted in the training lab. Equipment and Supplies as per DHSR regulations must be readily available to students for skills acquisition, refinement, and retention. A. Equipment and Supplies required for nurse aide training must comply with requirements of NC DHSR. Equipment/Supply List located in the Standard #3 folder on the NARE Moodle PLC. 4.01 B. Consumable supplies adequate, organized, easily accessible for instruction and practice. C. Equipment must be functional, safely stored, and easily accessible for instruction and practice. D. Digital pictures of the resident unit, equipment, and supplies must be submitted to the NCDPI Nurse Aide Training office upon request. Standard #4 NAT PROGRAMS MUST ASSURE SKILLS ACQUISITION A. B. Students must demonstrate with 100% skills competency ALL curriculum skills in the training laboratory prior to direct resident contact. Code of Federal Regulations Title 42, Chapter 4, Part 483. It is strongly recommended that the NAI training program utilize formative assessment during classroom and training laboratory instruction per NC FALCON. https://center.ncsu.edu/nc/course/category.php?id=10 Nurse Aide Training Summary (NATS) Part II must be completed in blue or black ink as attestation that each curriculum skill has been demonstrated competently as determined by the approved RN Nurse Aide instructor. The completed NATS Part II must become a part of the NA student's individual record. NATS document located in Standard #4 folder on the NARE Moodle PLC. 4.02 4.03 C. D. E. NATS Part II documentation must be kept current during skills acquisition time. NATS Part II must be totally completed PRIOR to direct hands on care of patients. NATS Part II is a legal document showing proof of skill proficiency and must be completed in blue or black ink. Curricular skills performance sheets are used in the lab for skill acquisition. A. Teacher must teach from the most current curriculum skills performance sheets available. Look in the Standard #4 folder for the most current curriculum skills. B. ONE set of curricular skills must be kept in the CLASS FILE for each section of nurse aide students taught. Students need a set of curriculum skills performance sheets during training. However, the students' curriculum skills sheets may be given to the students after the course and should not be kept in each students file. C. Students must be given a score in the grade book for demonstration of skills proficiency. National Nurse Aide Assessment Program (NNAAP) skills. It is the expectation that all Nursing Fundamentals students who complete approved training take the NNAAP examination. A. NNAAP Skills in the NC Nurse Aide I Candidate Handbook must NOT be taught as the standard of care. Curriculum skills, which are the standard of care, MUST be taught first. B. NNAAP skills must be used in competency evaluation preparation. NNAAP skills represent minimal competence; not the standard of patient care. Standard #5 CLINICAL TRAINING 5.01 Nurse Aide Student Preparation for Clinical (Other than skills acquisition) A. Required immunizations and other preparation required by the host medical facility completed PRIOR to clinical experience. NCDPI NURSE AIDE TRAINING PROGRAM STANDARDS Page 2 of 6

5.02 5.03 B. If drug screening and/or background checks are required, a written LEA approved policy should be in place to assure findings are treated in an equitable manner. A document entitled Nurse Aide I Training Healthcare Industry Requirements dated 6-4-2012, prepared by state CTE staff should be used as a reference. C. Consider IEPs and communicate closely with exceptional children department to accommodate learning needs as much as possible. Identification of Clinical Facilities for Nurse Aide Training A. Clinical facilities used for nurse aide training must be approved by the DPI/Nurse Aide Training office. LTC facilities on Centers for Medicaid and Medicare Services (CMS) sanction will not be approved. B. Changes in clinical sites MUST be reported to the DPI/Nurse Aide Training office immediately. Schedule for Nurse Aide Training Clinical Experience (Time of day) A. Nurse aide training must be scheduled at a time that allows for adequate clinical experiences. Morning classes provide better personal care opportunities to apply nurse aide skills. 5.04 B. Afternoon classes should be avoided if at all possible. If afternoon classes are scheduled, care must be taken to assure adequate skill application opportunities for students. C. The original clinical rotation schedule (in DAILY increments) including absent notations and other teacher comments must be maintained and kept for three years as a part of the CLASS FILE. Clinical summary sheet that reflects which clinical option(s) were used must be maintained and kept for three years as a part of the CLASS FILE. (See Standard 8.02 Class File) Clinical Experience - Emergency Action Plan A. Emergency action plan for students to follow when a student on the clinical floor needs immediate (stat) assistance must be developed and taught to nurse aide students prior to clinical. This must be evidenced by documentation. When writing the plan assume the teacher is assisting another student thus not IMMEDIATELY available. B. It is highly recommended that the RN teacher have emergency contact information for each student and for appropriate school administrators. 5.05 Supervision of Nurse Aide Students A. Direct, continuous, on-unit supervision of 10 or less nurse aide students by one RN teacher. Documentation of same by clinical schedule. B. Completion of 40 hours of long term care as outlined in one of the four clinical options.* * Clinical options and summary document on NARE Moodle PLC. C. Students must demonstrate proficiently, the subset of skills required by DHSR/CARE in the clinical area. RN teacher must document the same on the NATS Part 3. D. RN nurse aide teacher must assure that nurse aide students do not perform tasks for which they are not trained. E. The RN teacher MUST read documents related to supervision of nurse aide students located on the NARE Moodle PLC. Teachers must be knowledgeable of the NCBON Decision Tree as it related to making assignments to ULP. F. It is highly recommended that students not be allowed to take or use cell phones or other electronic devices in the clinical area. Standard #6 CERTIFICATE OF COMPLETION AND NNAAP TESTING 6.01 Teacher MUST complete a certificate of completion of nurse aide training AFTER all nurse aide training requirements are met. The certification requires notarization. Original goes to student, copy stays in student file. 6.02 Teacher must assist students as they complete the online NNAAP application to test. Be very careful with the distribution of the training program number! NCDPI NURSE AIDE TRAINING PROGRAM STANDARDS Page 3 of 6

6.05 Teacher and LEA administration should consider and offer In-Facility NNAAP Testing if at all possible. 6.06 6.07 criterion added 3-14-14 Standard #7 NAT TEACHERS MUST UITLIZE NURSE AIDE TRAINING RESOURCES 7.01 Teacher must be competent in accessing nurse aide training resources on the NARE Moodle PLC and be able to demonstrate the ability to efficiently access the information contained therein. Moodle accounts that are not used in 60 days will be dropped automatically by the Moodle system. 7.02 Teacher must have/use a current hardcopy of NC NNAAP Nurse Aide I Candidate Handbook produced by Pearson VUE. Standard #8 CLASS AND STUDENT TRAINING RECORDS 8.01 Individual file OR individual section of a notebook must be kept for each student completing nurse aide training per instructions for student records. A. Nurse Aide Training Summary (NATS) Parts 1 through 7 for Nursing Fundamentals and a copy of the Certificate of Nurse Aide Training Completion. C. Other documents such as travel permission forms and student contracts MAY be kept in the student s folder. Any documents other than the NATS and a copy of the Certificate of Completion are OPTIONAL. DO NOT house background check records or drug screen results. 8.02 8.03 D. A. Clinical Preparation Sheet highly recommended but optional B. Hardcopy of the APPROVED training application C. Original clinical rotation schedule (in daily increments) including absent notations and other teacher comments D. Clinical summary sheet that reflects which clinical option(s) were used E. Record of all teacher absences and "RN face to face make up" documentation if needed. F. Instruct students who have a complaint regarding NNAAP testing to complete the complaint form generated by the DPI Nurse Aide office and send the completed complaint to the NCDPI Nurse Aide Specialist for processing. NNAAP reports will be emailed to the local CTE Director or Designee by PearsonVue. It is the responsibility of the CTE Director to share reports with NAT teachersand to notify the NCDPI Nurse Aide Trianing Office if the email address of the CTE Diretor or designee changes. NCDPI office will notify PearsonVue of the change. Do NOT retain photocopies of Social Security Cards or Drivers Licenses! Historically speaking, this practice was done at a time when HSE teachers were the final competency evaluators. This is no longer the case therefore SS cards and DLs must not be retained. Class file must be prepared and kept for each section/class of nurse aide training. Summary print outs for each marking period of the course that reflects curriculum content topics, grades and student attendance G. ONE SET of the curriculum skills performance sheets used during the class H. ONE COPY of the NC Nurse Aide I Candidate Handbook used during review for testing. Training Records Security A. Student records and class files must be secured in a locked file cabinet. B. Retain class and student records for THREE years. Destroy outdated records per HIPAA guidelines. NCDPI NURSE AIDE TRAINING PROGRAM STANDARDS Page 4 of 6

Standard #9 REAPPLY FOR APPROVED STATUS ANNUALLY 9.01 Nurse Aide Training Program Approval A. Each high school nurse aide training program must submit a program application each year that approved nurse aide training status is desired. B. Approved status for a high school training program is in effect for a period of one year but can be revoked if federal/state requirements of nurse aide training are not met. C. D. E. Each initially approved training program is issued a nurse aide training (NAT) number. The NAT is permanently assigned to that particular training program but will be rendered inactive if the program loses approved status. The training program number must be used for on-line NNAAP registration only by candidates who have completed nurse aide training. Students who do not complete nurse aide training may take the NNAAP exam but, NOT via the same eligibility route as nurse aide training completers and must NOT use the training program number. If a training program in withdrawn from Approved Status the previously assigned training program number must not be used during the time the school is not approved. F. Official statement from DHSR 8-8-2012 email time stamp 9:12am. It is the expectation of the Division of Health Service Regulation, which regulates nurse aide training and licenses nursing homes, that students who are training to be nurse aides are doing so through an approved program. Our federal regulations mandate specific information regarding the training of nurse aides and have stipulations for students in the clinical setting. In order to monitor compliance with these federal mandates, it is our expectation that all high school programs training nurse aides obtain approval from the NCDPI Nurse Aide office. If the student does not complete the high school course and later decides to challenge the Nurse Aide Competency Exam, it is still expected that the class was an approved program. Kathy B. Turner Manager, Center for Aide Regulation and Education Division of Health Service Regulation 2709 Mail Service Center Raleigh, NC 27899 9.02 Nurse Aide Training Program Changes A. The approved training program faculty and/or administration are responsible for notifying the nurse aide office immediately when NAT program changes occur. B. Such changes include but are not limited to: faculty, clinical sites, location changes, school schedule changes that affect nurse aide training, program coordinator, principal, and CTE Director. Standard #10 PROGRAMS MUST BE REVIEWED BY DHSR DESIGNEE 10.1 Approved training programs must allow announced and unannounced program reviews by the NCDPI Nurse Aide Program Consultant. On-site program review visits are required every two years. Nurse Aide training program Approved Status can be withdrawn at any time if federal/state requirements of nurse aide training are not met. 10.2 NAT programs are encouraged to perform self-evaluation reviews each year using this standards document as the evaluation tool. Revised by Agnes Moore, NCDPI Nurse Aide Training Consultant, 9-21-2011, 6-28-2012, 9-17-2013, 3-14-2014 Reviewed by Kathy Turner, DHSR CARE Manager, 9-22-2011 @ 4:10pm email, 6-28-2012 @ 4:43 PM Reviewed by Daniel R. Smith, NCDPI, SCC Section Chief, 10-11-11, 6-29-2012 NCDPI NURSE AIDE TRAINING PROGRAM STANDARDS Page 5 of 6

Revised by Agnes Moore, NCDPI Nurse Aide Training Consultant, 5.01C and 5.03 C added 11-19-2012 Items related to Allied Health Science II interpretation of the Standard removed. 7-5-2013awm Reviewed by Dan Smith 7-5-2013 after AHSII items removed. NCDPI NURSE AIDE TRAINING PROGRAM STANDARDS Page 6 of 6