NEW JERSEY REGISTER
VOLUME 34, NUMBER 14
MONDAY, JULY 15, 2002
RULE ADOPTION

LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
STATE BOARD OF NURSING
HOMEMAKER-HOME HEALTH AIDE TRAINING PROGRAM;
HOME CARE AND HOSPICE CARE
TRAINING PROGRAMS


Adopted Amendment: N.J.A.C. 13:37-14.4

Adopted New Rule: N.J.A.C. 13:37-14.5

Adopted Recodification with Amendments: N.J.A.C. 13:37-14.5 to 14.14 as 14.6 to 14.15.

Proposed: July 2, 2001 at 33 N.J.R. 2241(a).

Adopted: October 16, 2001 by the Board of Nursing, Maris Lown, President.

Filed: June 13, 2002 as R.2002 d.220, without change.

Authority: N.J.S.A. 45:11-24.

Effective Date: July 15, 2002.
Expiration Date: January 13, 2005.

Federal Standards Statement

A Federal standards analysis is not required because the adopted amendments are governed by N.J.S.A. 45:1-3.2 and 45:11-50 and are not subject to any Federal requirements or standards.

Full text of the adoption follows:

<< NJ ADC 13:37-14.4 >>

13:37-14.4 Homemaker-home health aide training program

(a) (No change.)

(b) A homemaker-home health aide training program shall consist of at least 76 hours, to include 60 hours of classroom instruction and 16 hours of clinical instruction in a skills laboratory or patient care setting, covering topics outlined in (d) below and N.J.A.C. 13:37-14.5. The student-to-instructor ratio for classroom instruction shall not exceed 30 students to one classroom instructor.

(c) (No change.)

(d) The curriculum for a homemaker-home health aide training program shall include instruction in:

1. The role of unlicensed assistive personnel in nursing care settings, including:

i. Long term care, acute care, subacute, outpatient services, rehabilitation centers, home care agencies, assisted living and hospice;

ii. The role, responsibilities and scope of practice of the registered nurse;

iii. The role, responsibilities and scope of practice of the licensed practical nurse;

iv. The role and responsibilities of the unlicensed assistive personnel; and

v. Legal and ethical considerations for the unlicensed assistive personnel, such as client rights, confidentiality, accountability, legal documentation, eligibility, reporting physical, mental, verbal, emotional and financial abuse, and maintenance of certification including necessity for unlicensed assistive personnel to complete a course, competency testing and criminal background checks;

2. Foundations for working with people, including:

i. Components of communication;

ii. Factors that affect communication;

iii. Barriers to communication;

iv. Enhancing communication;

v. Skills for basic communication;

vi. Communicating with staff members;

vii. Guidelines for communicating with individuals who are visually impaired, hearing impaired, speech impaired, cognitively impaired, experiencing stress or who have transcultural considerations; and

viii. An introduction to human behavior including instruction on understanding basic human needs, understanding mental health, emotional growth and needs throughout a person's lifetime, behavior as a response to stress or unmet needs, responses to changes in health, spiritual needs and reactions to loss, grief and dying;

3. Foundations for a safe client environment, including:

i. Environmental conditions;

ii. Physical conditions including potential hazards and safety measures;

iii. Emotional conditions including potential hazards and protective measures;

iv. Prevention of, and response to, fire and disaster emergencies;

v. Infection control, including the chain of infection, standard precautions, hazardous waste and special concerns regarding tuberculosis (TB), Human Immunodeficiency Virus (HIV) and Hepatitis B;

vi. Body mechanics; and

vii. Medical emergencies, emergency preparedness and guidelines for handling medical emergencies;

4. The musculoskeletal system, including:

i. Overview of anatomy and physiology;

ii. Common conditions and disorders of themusculoskeletal system;

iii. Examples of changes in the musculoskeletal system to report to a nurse; and

iv. Client care procedures related to the musculoskeletal system including exercise, activity and positioning, range of motion, transferring, ambulation, and assistive devices;

5. The integumentary system, including:

i. Overview of anatomy and physiology;

ii. Common conditions and disorders of the integumentary system;

iii. General skin care;

iv. Examples of changes in the integumentary system to report to a nurse; and

v. Client care procedures related to the integumentary system including personal hygiene and positioning;

6. The upper gastrointestinal system, including:

i. Overview of anatomy and physiology;

ii. Common conditions and disorders of the upper gastrointestinal system;

iii. General care including nutrition across the lifespan, factors affecting nutrition, therapeutic diets and alternative nutrition sources;

iv. Examples of gastrointestinal changes to report to a nurse; and

v. Client care procedures related to upper gastrointestinal system;

7. The lower gastrointestinal system:

i. Overview of anatomy and physiology;

ii. Common conditions and disorders of the lower gastrointestinal system;

iii. General care including factors affecting bowel elimination;

iv. Examples of gastrointestinal changes to report to a nurse; and

v. Client care procedures related to lower gastrointestinal system;

8. The urinary system, including:

i. Overview of anatomy and physiology;

ii. Common conditions and disorders of the urinary system, specifically incontinence;

iii. Examples of urinary changes to report to a nurse; and

iv. Client care procedures related to the urinary system;

9. The cardiovascular and respiratory systems, including:

i. Overview of anatomy and physiology;

ii. Common conditions and disorders of the cardiovascular and respiratory systems;

iii. Examples of cardiovascular or respiratory changes to report to a nurse; and

iv. Client care procedures related to cardiovascular and respiratory systems specifically, vital signs, applying antiembolism stockings, assisting the client to use oxygen and positioning the client for circulatory and respiratory comfort;

10. Neurological system, including:

i. Overview of anatomy and physiology;

ii. Common conditions and disorders of the neurological system;

iii. Examples of neurological changes to report to a nurse; and

iv. Client care procedures related to the neurological system, specifically, care needs of a client with cognitive impairment, care of a client with a seizure disorder, care of a client following a stroke and rehabilitation or restorative care;

11. The endocrine system, including:

i. Overview of anatomy and physiology;

ii. Common conditions and disorders of the endocrine system;

iii. Changes to report to a nurse, including hyperglycemia and hypoglycemia and their causes, symptoms and emergency response; and

iv. Client care related to the endocrine system, specifically foot care, skin care and nutrition for a client with diabetes;

12. The reproductive system, including:

i. Overview of anatomy and physiology;

ii. The structure of, function of and age related changes to reproductive organs;

iii. Common conditions and disorders of the reproductive system, specifically sexually transmitted diseases such as gonorrhea, syphilis, herpes and Acquired Immunodeficiency Syndrome (AIDS); and

iv. Examples of changes in the reproductive system to report to a nurse;

13. The immune system, including:

i. Overview of anatomy and physiology; and

ii. Common conditions and disorders of the immune system, such as AIDS, HIV and cancer;

14. Rest and sleep, including:

i. Functions of rest and sleep;

ii. Factors affecting and/or causing sleep disturbances; and

iii. Promoting sleep; and

15. Death and dying, including:

i. Responding to the physical and emotional needs of a client with a terminal illness;

ii. Legal and quality of life issues including the New Jersey Advance Directives for Health Care Act (N.J.S.A. 26:2H-53 et seq.), living wills and "do not resuscitate" orders;

iii. Signs of impending death; and

iv. Post-mortem care of the patient.

(e)-(g) (No change.)

<< NJ ADC 13:37-14.5 >>

13:37-14.5 Home care and hospice care training programs

(a) In addition to the curriculum training requirements of N.J.A.C. 13:37- 14.4(d), the training program for a homemaker-home health aide in home care or hospice care shall include instruction in:

1. The role of the homemaker-home health aide, including:

i. Settings utilizing homemaker-home health aides;

ii. Role of the homemaker-home health aide; and

iii. Legal and ethical considerations for the homemaker-home health aide;

2. The foundations for working with the home care client, the family and significant others of the home care client and home care team members, including:

i. Communication with the client and the client's family and significant others;

ii. Barriers to communication;

iii. Communication with the home care team; and

iv. Maintaining relationships with the client and the client's family and significant others;

3. Foundations for a safe client environment, including:

i. General home safety;

ii. Fire safety;

iii. Personal safety and body mechanics;

iv. Infection control;

v. Emergencies; and

vi. Assistance with medications;

4. Home care considerations, including:

i. Food;

ii. Housekeeping;

iii. Use and care of medical equipment in the home;

iv. Cultural diversity; and

v. Death and dying;

5. Infant and child care, including:

i. Introduction to infant and child care; and

ii. Family dynamics; and

6. The responsibility of an agency to the homemaker-home health aide, including:

i. The supervision to be provided by a registered professional nurse;

ii. The agency's responsibility to comply with Federal and State employment laws;

iii. Mandatory taxes to be withheld by the agency;

iv. In-services provided to the homemaker-home health aide;

v. Job descriptions provided by the agency;

vi. Personnel policies of the agency;

vii. Service policies and procedures of the agency; and

viii. Agency policies on patient and family confidentiality.

<< NJ ADC 13:37-14.6 >>

13:37-14.6 (No change in text.)

<< NJ ADC 13:37-14.7 >>

13:37-14.7 Program coordinator; responsibilities

(a) (No change.)

(b) The program coordinator's responsibilities shall include, but not be limited to, the following:

1.-2. (No change.)

3. Ensuring that each instructor meets the qualifications specified in N.J.A.C. 13:37-14.8;

4.-7. (No change.)

(c) (No change.)

<< NJ ADC 13:37-14.8 >>

13:37-14.8 (No change in text.)

<< NJ ADC 13:37-14.9 >>

13:37-14.9 Homemaker-home health aides; training program requirement

Every applicant for certification as a homemaker-home health aide in this State shall be required to complete a training program approved by the Board of Nursing, except as provided in N.J.A.C. 13:37-14.12 and 14.14. The applicant shall have completed the training program no later than four months after commencing the program.

<< NJ ADC 13:37-14.9 >>

<< NJ ADC 13:37-14.10 >>

<< NJ ADC 13:37-14.11 >>

<< NJ ADC 13:37-14.12 >>

<< NJ ADC 13:37-14.13 >>

<< NJ ADC 13:37-14.14 >>

<< NJ ADC 13:37-14.15 >>

Recodify existing N.J.A.C. 13:37-14.9 through 14.14 as 14.10 through 14.15 (No change in text.)


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