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DHS 129.07(1)(b)8. 8. Recognize the normal physical and psychological changes associated with aging.
DHS 129.07(1)(b)9. 9. Identify the basic principles of nutrition and hydration.
DHS 129.07(1)(b)10. 10. Recognize and report deviations from a client's normal food and fluid intake and output.
DHS 129.07(1)(b)11. 11. Recognize the basic requirements of commonly prescribed therapeutic diets.
DHS 129.07(1)(b)12. 12. Use common measures to promote a client's skin integrity, considering the client's ethnicity, race and age.
DHS 129.07(1)(b)13. 13. Demonstrate appropriate techniques in walking, transferring, positioning and transporting clients.
DHS 129.07(1)(b)14. 14. Recognize and respond appropriately to unsafe environmental conditions, including damp floors, frayed electrical cords and loose hand rails.
DHS 129.07(1)(b)15. 15. Recognize and respond appropriately to emergency situations including following emergency evacuation procedures.
DHS 129.07(1)(b)16. 16. Demonstrate appropriate hand washing techniques.
DHS 129.07(1)(b)17. 17. Understand and use commonly used alternatives to restraints in accordance with current professional standards.
DHS 129.07(1)(b)18. 18. Maintain the safety and cleanliness of client care areas.
DHS 129.07(1)(b)19. 19. Make use of proper isolation technique.
DHS 129.07(1)(b)20. 20. Perform commonly accepted infection control practices, including proper gloving technique and proper disposal of blood and body fluids and secretions.
DHS 129.07(1)(b)21. 21. Make occupied and unoccupied beds.
DHS 129.07(1)(b)22. 22. Measure temperature, pulse and respiration.
DHS 129.07(1)(b)23. 23. Measure a client's weight and height.
DHS 129.07(1)(b)24. 24. Record objective information.
DHS 129.07(1)(b)25. 25. Apply nonprescription ointments to unbroken skin areas.
DHS 129.07(1)(b)26. 26. Recognize the general effects of prescribed routine medications.
DHS 129.07(1)(b)27. 27. Recognize therapeutic interventions and specialized non-pharmacological pain control interventions.
DHS 129.07(1)(b)28. 28. Assist with care of clients when death is imminent.
DHS 129.07(1)(b)29. 29. Assist with post-mortem care.
DHS 129.07(1)(b)30. 30. Maintain the safety and cleanliness of areas where food is stored.
DHS 129.07(1)(c) (c) Personal care skills. The program shall include the theory of and practice in basic personal care skills, including bathing, mouth care, grooming, dressing, toileting, and assistance with eating, hydration and skin care. A nurse aide shall demonstrate the ability to do all of the following:
DHS 129.07(1)(c)1. 1. Give a complete or partial bed bath to a client and assist a client in taking a bath or a shower.
DHS 129.07(1)(c)2. 2. Provide care of the client's perineal area.
DHS 129.07(1)(c)3. 3. Apply appropriate oral hygiene practices when assisting a client with oral hygiene, including caring for the client's dentures.
DHS 129.07(1)(c)4. 4. Care for a client's nails, hair and skin.
DHS 129.07(1)(c)5. 5. Shave and shampoo a client, including applying nonprescription medicated shampoos.
DHS 129.07(1)(c)6. 6. Dress and undress a client.
DHS 129.07(1)(c)7. 7. Prepare a client for meals.
DHS 129.07(1)(c)8. 8. Assist in feeding a client, including helping a client use adaptive devices and feeding utensils and encouraging a client to eat nutritionally balanced meals.
DHS 129.07(1)(c)9. 9. Assist a client with bowel and bladder elimination.
DHS 129.07(1)(d) (d) Basic restorative services. The program shall include the theory of and practice in providing restorative services. Basic restorative services include the application of assistive devices for ambulation; eating and dressing; maintenance of range of motion through appropriate exercises; proper turning and positioning both in bed and chair; proper transferring techniques; bowel and bladder training; and care and use of prosthetic devices such as hearing aids, artificial eyes and artificial limbs. A nurse aide shall demonstrate the ability to do all of the following:
DHS 129.07(1)(d)1. 1. Recognize the importance of bowel and bladder programs.
DHS 129.07(1)(d)2. 2. Recognize the method for maintaining and improving musculoskeletal functioning by promoting joint mobility, body alignment and movement, including being able to do all of the following:
DHS 129.07(1)(d)2.a. a. Position clients by use of pillows, towel rolls, padding and footboards.
DHS 129.07(1)(d)2.b. b. Perform simple range of motion exercises.
DHS 129.07(1)(d)2.c. c. Assist clients in the use of crutches, walkers, wheelchairs, canes, prostheses and appliances.
DHS 129.07(1)(d)3. 3. Transfer clients safely and according to principles of patient care ergonomics and with proficiency in use of available equipment that is used to transfer clients.
DHS 129.07 Note Note: Equipment used to transfer clients includes, but is not limited to, mechanical lifts, friction reducing devices; wheelchairs and gait belts.
DHS 129.07(1)(d)4. 4. Reinforce breathing exercises, including coughing and deep breathing.
DHS 129.07(1)(d)5. 5. Help clients use hearing aids and visual aids.
DHS 129.07(1)(e) (e) Rights of clients.
DHS 129.07(1)(e)1.1. The program shall provide instruction on the principles of and requirements relating to clients' rights. The nurse aide shall demonstrate an understanding of all of the following obligations:
DHS 129.07(1)(e)1.a. a. Providing privacy for clients in treatment, living arrangements and personal care needs.
DHS 129.07(1)(e)1.b. b. Maintaining the confidentiality of client health and personal records.
DHS 129.07(1)(e)1.c. c. Allowing clients to make personal choices to accommodate the clients' needs.
DHS 129.07(1)(e)1.d. d. Providing help clients need in getting to and participating in activities, including client and family group meetings.
DHS 129.07(1)(e)1.e. e. Maintaining the personal possessions of clients in good and secure condition.
DHS 129.07(1)(e)1.f. f. Interacting with clients without abusing or neglecting the clients.
DHS 129.07(1)(e)1.g. g. Interacting with clients without misappropriating the clients' property.
DHS 129.07(1)(e)1.h. h. Immediately reporting to appropriate facility or agency staff every instance of abuse or neglect of a client or misappropriation of a client's property as defined in s. DHS 13.03 (1), (12), and (14).
DHS 129.07(1)(e)2. 2. The nurse aide shall demonstrate behavior that recognizes that clients have rights and that the aide respects those rights. The nurse aide shall do all of the following:
DHS 129.07(1)(e)2.a. a. Demonstrate respect and concern for each client's rights, preferences and awareness of age, color, disability, family status, financial status, gender, marital status, race, sexual orientation, and ethnic, cultural, social, generational and religious differences.
DHS 129.07(1)(e)2.b. b. Show respect for cultural, ethnic and religious food preferences.
DHS 129.07(1)(e)2.c. c. Recognize what constitutes abuse of clients and demonstrate an understanding of how to interact with clients without abusing them or without appearing to abuse them.
DHS 129.07(1)(e)2.d. d. Demonstrate prevention and intervention skills with combative clients that balance appropriate client care with a need to minimize the potential for injury to the aide and others.
DHS 129.07(1)(e)2.e. e. Recognize the role of state and federal regulatory agencies in licensing or otherwise approving providers and in investigating complaints of abuse of client property.
DHS 129.07(1)(e)2.f. f. Demonstrate an understanding of the process by which a client or staff member may file a complaint on behalf of a client and seek redress for a perceived violation of client rights.
DHS 129.07(1)(e)2.g. g. Recognize the role of client advocacy groups as client resources.
DHS 129.07(1)(e)2.h. h. Demonstrate awareness of how to file a complaint with the department regarding operations within the provider setting.
DHS 129.07(1)(f) (f) Dementias. The program shall include instruction about dementia and specific techniques for meeting the basic needs of clients with dementia. The nurse aide shall demonstrate an understanding of all of the following:
DHS 129.07(1)(f)1. 1. The nature of dementia, including the cause, course and symptoms of the impairment. The effects that brain changes have on the person's moods, abilities and functioning.
DHS 129.07(1)(f)2. 2. The effects on the client of staff verbal and nonverbal communication with the client and means of modifying these communications and approaches to facilitate effective interaction between clients and staff.
DHS 129.07(1)(f)3. 3. The feeding and fluid intake problems associated with dementia and the specialized techniques for addressing those problems.
DHS 129.07(1)(f)4. 4. The effect of the environment on clients with dementia and the appropriate environmental stimuli to use with those clients to reduce stress and maximize normal functioning and how to incorporate strategies that preserve function and prevent excess disability.
DHS 129.07(1)(f)5. 5. Possible causes of dementia related symptomatic behavior changes, specifically focusing on understanding behavior as an attempt to communicate unmet needs and then how to address the unmet need including an understanding of how pain impacts behavior.
DHS 129.07(1)(f)6. 6. Ways to help the person with dementia continue meaningful involvement in his or her day, the importance of structure and routine and the incorporation of the person's life story and past interests, routines, tastes, values and background.
DHS 129.07(1)(f)7. 7. The stress involved for the client, family and nurse aide in caring for a client with dementia and techniques for coping with this stress and ways to address the person with dementia's core needs of having self-esteem boosted, being useful, giving and receiving love, and caring for self and others.
DHS 129.07(2) (2) program operation.
DHS 129.07(2)(a)(a) Class setting.
DHS 129.07(2)(a)1.1. Programs shall ensure that classrooms and lab facilities are adequate to meet the needs of the program, based on the number of students enrolled and how the classroom space is used. Programs shall ensure that classroom and skills labs have adequate temperature controls, clean and safe conditions, adequate space to accommodate students, adequate lighting, and all training equipment needed, including audiovisual equipment and any equipment needed for simulating resident care. Lab equipment shall be in the skill lab at all times necessary for demonstration, practice, and student demonstration. Any area designated as a classroom or lab in a facility-based program shall be an area that is not designated for resident care.
DHS 129.07(2)(a)2. 2. The program shall have qualified faculty members for both the classroom and the skills portion of the program.
DHS 129.07(2)(a)3. 3. The program shall have reasonable accommodations for students and prospective students with disabilities.
DHS 129.07(2)(b) (b) Program standards for training programs.
DHS 129.07(2)(b)1.1. A training program shall include at least 75 training hours as required under 42 CFR 483.152 (a). At least 16 of those 75 training hours must be in a clinical experience in a clinical setting as required under 42 CFR 483.152 (a) and approved by the department. The first 16 hours of training shall be provided in a classroom setting before a student has direct contact with clients. Tours of a facility, including observations of clients and day-to-day facility activities, may be incorporated into the classroom hours. Competency evaluation under s. DHS 129.08 and provider orientation may not be counted toward meeting the 75-hour minimum requirement.
DHS 129.07(2)(b)2. 2. The program shall cover all of the following during the first 16 hours of classroom training:
DHS 129.07(2)(b)2.a. a. Communication and interpersonal skills.
DHS 129.07(2)(b)2.b. b. Infection control.
DHS 129.07(2)(b)2.c. c. Safety and emergency procedures.
DHS 129.07(2)(b)2.d. d. Promoting residents' independence.
DHS 129.07(2)(b)2.e. e. Residents' rights.
DHS 129.07(2)(b)3. 3. 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.
DHS 129.07(2)(b)4. 4. 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.
DHS 129.07(2)(c) (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:
DHS 129.07(2)(c)1. 1. Access to a clinical setting approved by the department that is adequate to meet the needs of the program.
DHS 129.07(2)(c)1.a. a. 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.
DHS 129.07(2)(c)1.b. b. 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.
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.