A health care provider may employ a student as a nurse aide after the student has completed 16 hours of classroom training in the topics in subd. 2.
, and if the student is a full-time permanent employee, and is enrolled in an approved training program. The training program shall provide the health care provider with verification that the program has provided the instruction specified in subd. 2.
The program shall provide notification to students sponsored by Medicaid-certified nursing facilities that the students are not responsible for any costs associated with training, including deposits for textbooks or supplies used.
(c) Clinical setting.
Before a student performs any client-related services, the RN primary instructor shall determine that the student has been trained and found proficient in providing those services. The training program shall ensure all of the following:
Access to a clinical setting approved by the department that is adequate to meet the needs of the program.
Clinical settings shall be in compliance with state and federal law. The program designee or primary instructor and the health care provider with whom the program has contracted are responsible for verifying that the clinical facility is in compliance with state and federal law. This verification shall be documented in the program's files and shall be available during the evaluation process.
The agreement between the program and the clinical setting shall be reviewed and renewed annually by the department and upon any change of facility or school administration. A copy of the agreement shall be submitted to the department.
During classroom and lab instructions, students shall be oriented to the various forms used to document resident information. Instructors shall supervise documentation on the appropriate flow sheets and forms during the clinical rotation.
Before a student begins a clinical rotation, the primary instructor shall evaluate and document that the student successfully demonstrated the ability to perform a skill.
Students may not give hands-on care to a resident who is not assigned to the student unless the student is under the direct supervision of the primary instructor.
Students who are under the general supervision of the primary instructor may be paired, during the student's clinical rotation, with nurse aides who are employed by the health care provider.
Students shall maintain safe practices, infection control and respect resident rights at all times.
Students shall demonstrate knowledge regarding their assigned residents' diagnoses and identified needs.
Students and instructors shall wear clothing that is in compliance with program policy and that is appropriate for performing resident care. The clothing shall include a nametag that designates the name of the nurse aide training program and the person's status as a student or instructor.
The scheduled clinical hours shall provide experiences that meet expected outcomes outlined in the program curriculum.
A health care facility may serve as the site of clinical instruction for up to 2 nurse aide training programs at the same time, except that the department may decide to allow more than 2 programs at a single health care facility on a case-by-case basis in conjunction with the facility's administrative staff.
The program shall not be used as a substitute for staff orientation or staff education programs.
An adequate number of primary instructors in the clinical setting to provide safe and effective supervision and assistance of students.
Primary instructors shall not function in another role while supervising students in the clinical setting.
A ratio of 6 to 8 students per instructor is considered to be adequate in most circumstances.
The primary instructor shall evaluate and document that a student demonstrated successfully the ability to perform a skill before the student begins a clinical rotation.
The primary instructor shall make all student clinical assignments with the approval of the health care provider. The instructor shall complete a review of each resident's chart to retrieve pertinent information needed by the students to provide the required cares. Care plan information shall be reviewed at the beginning of each clinical experience and shall include new orders or changes in each resident's status.
A student's assignment shall be shared with the clinical setting to which the student is assigned before the student arrives at the clinical setting.
Each student shall be given an individual assignment. More than 2 students shall not be assigned to the same resident at the same time.
i. Care of clients with varied levels of care needs.
ii. The opportunity to be evaluated on organizational skills and time management.
The RN primary instructor is responsible for supervising the clinical performance of each LPN program trainer.
(d) Nursing home-based program.
Training of nurse aides may be performed under the general supervision of the director of nursing for a facility; however, the director of nursing may not act as the primary instructor or as a program trainer. Instructors shall not be involved in more than one role while supervising students in the clinical area.
The training program shall maintain a list of the skills and a summary of the knowledge that a student will complete by the end of the training program.
On the list of skills, the primary instructor shall verify, by initialing and dating each individual skill, that the student has satisfactorily performed that skill. When a student has satisfactorily completed all required skills and competencies and attained the necessary knowledge, as well as achieved the stated course completion criteria, the trainee qualifies to enter a competency evaluation program.
The primary instructor shall provide a copy of the student's performance record to the student at the conclusion of the student's training.
(f) Record retention.
The training program shall retain all records required by this section for a period of at least 3 years after a student completes the training program.
DHS 129.07 History
History: CR 08-042
: cr. register November 2008 No. 635, eff. 12-1-08; correction in (1) (e) 1. h. made under s. 13.92 (4) (b) 7.
, Stats., Register November 2008 No. 635
; renumbering in (2) (c) 2. g. made under s. 13.92 (4) (b) 1.
, Stats., Register November 2008 No. 635
Standards for nurse aide competency evaluation programs. DHS 129.08(1)
The examiner conducting the clinical competency program of a student shall be an RN with at least one year experience caring for the elderly or chronically ill of any age.
The RN examiner will give each student instructions for the written or oral evaluation component. After the student's written or oral evaluation has begun, the RN may designate another person to proctor the written or oral evaluation.
The competency evaluation program shall develop a pool of test questions that addresses all 6 content areas and their components under s. DHS 129.07 (1)
. The test questions shall include enough questions to form 3 separate and complete examinations.
The competency evaluation program shall develop written and oral examinations from the pool of test questions. The content of the written and oral examinations shall reflect the content and emphasis of the training program approved by the department.
The competency evaluation program shall provide students with written and oral examinations in English. If the student will be working in a provider setting in which the predominant language is other than English, the program may not refuse to test in the language that is predominant in that work setting.
The competency evaluation program may develop an oral examination for nurse aides with limited literacy skills. To do so, the program shall adapt the written examination for oral testing. The oral examination shall cover the same subject areas included in the original written examination adapted for oral testing, and shall include a component to determine the aide's ability to read basic, objective, job-related information, such as reading a client's name band or a client's flow sheet.
A minimum of 50 written or oral questions shall be asked in each examination. The questions shall cover at least the 6 care areas under s. DHS 129.07 (1)
and shall be selected randomly from the following areas:
A minimum of 4 questions in the area of interpersonal communication and social interaction.
A minimum of 7 questions in the area of basic nursing skills. Of these 7 questions, at least one question shall address each of the following areas:
Observation, reporting and documentation of changes in client status and services furnished.
Recognizing and reporting change of client condition and status to supervisor.
A minimum of 5 questions in the area of client rights. Of these 5 questions, at least one question shall address each of the following areas:
To successfully complete the written or oral portion of the competency evaluation program, the student shall obtain satisfactory scores as identified in par. (f)
The competency evaluation program shall develop a pool of skill demonstration scenarios. There shall be a sufficient number of skill demonstration scenarios to measure the individual's ability to perform the required job tasks. Skills demonstration scenarios shall be randomly selected from the pool of skills to be demonstrated. The care areas of interpersonal communication and social interaction shall be integrated throughout the skills demonstration scenarios.
The skills demonstration shall consist of a demonstration of at least 5 randomly selected items drawn from a pool consisting of the tasks generally performed by nurse aides. This pool of skills shall include all skills listed in s. DHS 129.07
The criteria for successful completion of a competency evaluation program shall include the passing scores in all required skills.
To be included on the registry under s. DHS 129.09
, a student shall successfully pass a Wisconsin-approved nurse aide competency evaluation examination within one year of completing an approved nurse aide training program. If a person fails to pass any component of the competency evaluation examination, the individual need only retake the failed component. The person may retake the component failed as many times as needed within the one-year time period. The competency evaluation program shall ensure that each repeat examination shall differ in content from any examination previously taken by the individual.
(5) Program operation.
The competency evaluation program shall maintain all of the following standards in operating the program:
Reasonable accommodations for students with handicapping conditions.
An adequate number of examiners to provide safe and effective supervision and assistance.
Assurance that examiners do not test students they have trained.
Skills demonstration exercise portions of the examination are conducted at a ratio of one examiner to one student.
Competency evaluation facilities that are adequate to meet the needs of the testing program.
Retention of all records required under this section for a period of at least 3 years.
A system to prevent unauthorized disclosure of the pool of test questions and the results of the individual competency evaluations.
DHS 129.08 History
History: CR 08-042
: cr. register November 2008 No. 635, eff. 12-1-08; correction in (2) (g) made under s. 13.92 (4) (b) 7.
, Stats., Register May 2011 No. 665
Content of the registry.
The department shall maintain information about a person on the registry, including:
The person's eligibility for employment in a department-approved or licensed health care provider.
The date the aide completed a competency evaluation program, if applicable.
The dates, if any, that indicate the aide's employment status.
The 2 character alphabetic postal code of any state other than Wisconsin in which a finding of abuse, neglect, or misappropriation has been placed on the registry against the aide.
Any finding of abuse or neglect of a client or misappropriation of a client's property made by the department under s. 146.40 (4r) (b)
, Stats., or, if appealed, by a hearing officer under s. 146.40 (4r) (d)
, Stats., and a brief rebuttal statement provided by the affected nurse aide under s. 146.40 (4r) (e)
, Stats., if the nurse aide disputes the finding.
The department or the department's contractor shall place an individual's name on the registry within 30 days after an individual has satisfactorily completed the competency evaluation program.