Annual In-Service Education for LTC

1 Brought to you by the Maine Health Care Association 2019 NOTE: Necessary amounts and types of training will be based on facility assessment. The adequacy of the In-Service Education program is measured not only by documentation of hours of completed In-Service Education , but also by demonstrated competencies of staff in consistently applying the interventions necessary to meet residents needs. The training must be consistent with the expected roles of these individuals and include the following topics: Available Resource Annual In-Service training Area HIPAA & HITECH Compliance provide fundamental privacy and security training for all staff. Include relevant information from the Omnibus Rule. DeWitt Ross Stevens In Service Education Communication effective communications for direct care staff. Requires facilities to include effective communications as a mandatory training for direct care personnel.

2 Areas to include: a. Anticipating the residents' needs b. Minimize problems c. Speak and listen effectively d. Learning to follow up effectively e. Handle complaints successfully f. Be caring, conscientious, team-oriented and pro-active. LTC Ombudsman Education Module Resident Rights and Facility Responsibilities Requires facilities to ensure that staff members are educated on the rights of the resident and the responsibilities of a facility to properly care for its residents as set forth in the regulations under subsection Resident Rights. NCLER Signs of Abuse Neglect Maine DHHS Resource Site Abuse, Neglect, and Exploitation Requires facilities, at a minimum, to educate staff on activities that constitute abuse, neglect, exploitation, and misappropriation of resident property, and procedures for reporting these incidents. Abuse prohibition practice Education should include: a.

3 Appropriate interventions to deal with aggressive and/or catastrophic reactions of residents. b. How staff should report their knowledge related to allegations without fear of reprisal. c. How to recognize signs of burnout, frustration and stress that may lead to abuse; and d. What constitutes abuse, neglect and misappropriation of resident property. QAPI Implementation Checklist CNA Inservice Facilitators Guide Medline QAPI Toolkit QAPI Requires facilities to include mandatory training as a part of their QAPI and infection prevention and control programs that educate staff on the written standards, policies, and procedures for each program. CDC Infection Control Resource Page Infection Prevention training FAQ Infection Control The regulation does not say training must occur every year but the facility must have a program in place to investigate, control, and prevent infections.

4 This requires some type of training of new staff and ongoing training . Centers for Disease Control (CDC) has the following guidelines: a. Isolation Precautions b. Standard precautions Facility AssessmentDetermine who you serveTrain those that serveAccess competence following trainingReassess areas of opportunityAnalyze DataPrepare for next yearAnnual In-Service Education for LTC CMS mandates that facilities must complete a performance review of every nursing home employee at least once every 12 months and must provide regular In-Service Education based on the outcome of these reviews. For CNAs this Education must be no less than 12 hours per year, address areas of weakness as determined in nurse aides performance reviews, and for nurse aides providing services to individuals with cognitive impairments, also address the care of the cognitively impaired. Brought to you by the Maine Health Care Association 2019 CDC LTC Prevention Tools c.

5 Transmission based precautions FDA Most Common Foodborne Illnesses Florida Department of Health Resource Guide Prevention of Foodborne Illness Education , training , and monitoring of all staff and volunteers involved in food service, as well as establishing effective infection control and quality assurance programs help maintain safe food handling practices. AHCA NCAL Toolkit Holland Hart Presentation on Compliance Ethics Compliance and Ethics Requires the operating organization for each facility to include training as a part of their compliance and ethics program. Requires Annual training if the operating organization operates five or more facilities. Coming Soon! Maine Dementia Care Partnership Change Package Alz Assoc. Recommendations for LTC CARES Program Dementia Management Requires dementia management and resident abuse prevention training to be a part of 12 hours per year In-Service training for nurse aides.

6 Maine Behavioral Health Workforce Advancing States LTC Ombudsman Bx Guide Behavioral Health training Requires facilities to provide behavioral health training to its entire staff, based on the facility assessment at (e). a. Appropriate interventions to deal with aggressive and/or catastrophic reactions of residents; b. How staff should report their knowledge related to allegations without fear of reprisal; c. How to recognize signs of burnout, frustration and stress that may lead to abuse, and d. What constitutes abuse, neglect and misappropriation of resident property. OSHA e-Tools Workplace Safety (OSHA) Process for Protecting Workers: Ergonomics that includes providing management support; involving employees; identifying problems; implementing solutions; addressing reports of injuries; providing training ; and evaluating ergonomics efforts. a. Resident Lifting and Repositioning b.

7 Activities Other than Resident Lifting and Repositioning c. Fire Protection and Emergency Evacuation d. Haz Mat e. PPE f. Sexual Harassment and Professional Communication Assistive Devices/Equipment Hazards training of staff, residents, family members and volunteers on the proper use of assistive devices/equipment is crucial to prevent accidents. It is also important to communicate clearly the approaches identified in the care plan to all staff, including temporary staff. It is important to train staff regarding resident assessment, safe transfer techniques, and the proper use of mechanical lifts including device weight limitations. Wisconsin EP Toolkit AHCA NCAL Resource Page Emergency Preparedness: Pursuant to section (m)(2, the facility must train all employees in emergency procedures when they begin to work in the facility, periodically review the procedures with existing staff, and carry out unannounced staff drills using those procedures.)

8 CMPRP Tool for Staff Competency Assessment Other as identified by Facility Assessment (not an exclusive list): a. Activities of Daily Living b. Catheter Care and Urinary Tract Infections c. Constipation d. Falls e. Feeding Residents f. Nutrition and Hydration g. Pain Care h. Range of Motion i. Sensory and Communication Impairments j. Skin Care and Pressure Ulcer Prevention k. Toileting Programs l. Urinary Incontinence m. Wandering and Elopement Risk In-Service training curriculum for nurse aides: Brought to you by the Maine Health Care Association 2019 Facilities must have in place and permanently maintain an In-Service training program for nurse aids that is appropriate and effective based on the nurse aide evaluation or the facility assessment. The training may be in-person, webinar based, or supervised practical training hours. Must be no less than 12 hours per year.

9 training should include: o Dementia management and resident abuse prevention. o Care of cognitively impaired for nurse aides providing services to individuals with cognitive impairments. o Adequacy of training will be measured by demonstrated competencies through written exam and/or in consistently applying the interventions in a lab or clinical setting. o The facility must track attendance at the required trainings. o nurse aides may include individuals who provide nursing or nursing-related services to residents through an agency or under contract with the center, excluding licensed health professionals, registered dietitians, or someone who volunteers to provide such services without pay. nurse aides do not include those who serve residents only as paid feeding assistants. Adapted from CMS Code of Federal Long-Term Care Regulations, Title 42, Part 483, CMS, 1999: 42 C _____