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PDFWAC 388-71-0911

What are the competencies and learning objectives for the core competencies of basic training?

Long-term care worker basic training includes core competencies that describe the behavior and skills that a long-term care worker must exhibit when working with clients and the learning objectives associated with each competency as follows:
(1) Regarding communication:
(a) Communicate effectively and in a respectful and appropriate manner with clients, family members, and care team members;
(b) Recognize how verbal and nonverbal cues impact communication with the client and care team;
(c) Engage and respect the client through verbal and nonverbal communication;
(d) Listen attentively and determine that the client, when able, understands what has been communicated;
(e) Recognize and acknowledge clients' communication including indicators of pain, confusion, or misunderstanding;
(f) Utilize communication strategies to deal with difficult situations; and
(g) Recognize common barriers to effective communication and identify how to eliminate them;
(2) Regarding long-term care worker self-care:
(a) Identify behaviors, practices, and resources to reduce stress and avoid burnout;
(b) Recognize common barriers to self-care and ways to overcome them; and
(c) Recognize aspects of a long-term care worker's job that can lead to stress and burnout, common signs and symptoms of stress and burnout; and the importance of taking action to practice self-care to avoid burnout;
(3) Regarding the competency of effective problem solving, use effective problem solving skills to:
(a) Explain why it is necessary to understand and utilize a problem solving method;
(b) Implement a problem solving process/method; and
(c) Identify obstacles to effective problem solving and ways to overcome them;
(4) Regarding the competency of client rights and dignity, take appropriate action to promote and protect a client's legal and human rights as protected by federal and Washington state laws including:
(a) Protect a client's confidentiality, including what is considered confidential information, to whom a long-term care worker is allowed or not allowed to give confidential information, and how to respond if a non-care team member asks for confidential information;
(b) Promote client's dignity and privacy, and encourage, and support a client's maximum independence when providing care;
(c) Maintain a restraint-free environment, including physical, chemical, and environmental restraints. Use common, safe alternatives to restraint use; and
(d) Protect and promote the client's right to live free of abuse, neglect, abandonment, and financial exploitation;
(5) Regarding the competency of recognizing indicators of abuse and understanding the mandatory reporting requirements, recognize the signs of abuse and report suspected abuse, abandonment, neglect, and financial exploitation:
(a) Describe long-term care worker's responsibilities as a mandatory reporter as defined in RCW 74.34.020 through 74.34.053; and
(b) Identify common indications of abuse, abandonment, neglect, and financial exploitation;
(6) Regarding the competency of client directed care, take appropriate action when following a client's direction regarding his or her care:
(a) Describe a long-term care worker's role in client directed care including determining, understanding, and supporting a client's choices;
(b) Describe the importance and impact of client directed care on a client's independence, self-determination, and quality of life;
(c) Identify effective problem solving strategies that help balance a client's choice with personal safety; and
(d) Report concerns when a client refuses care or makes choices that present a possible safety concern;
(7) Regarding the competency of cultural sensitivity, provide culturally appropriate care:
(a) Describe how cultural background, lifestyle practices, and traditions can impact care; and
(b) Use methods to determine and ensure that these are respected and considered when providing care;
(8) Regarding the competency of body mechanics, utilize current best practices and evidence-based methods of proper body mechanics while performing tasks as outlined in the care plan;
(9) Regarding the competency on fall prevention:
(a) Identify fall risk factors and take action to reduce fall risks for a client; and
(b) Take proper steps to assist when a client is falling or has fallen;
(10) Regarding the competency of skin and body care, use personal care practices that promote and maintain skin integrity:
(a) Explain the importance of observing a client's skin, when to observe it, and what to look for including common signs and symptoms of skin breakdown;
(b) Identify risk factors of skin breakdown;
(c) Observe skin at pressure point locations and report any concerns;
(d) Describe what a pressure ulcer is, what it looks like, and what actions to take if a client appears to be developing or develops a pressure ulcer;
(e) Describe current best practices that protect and maintain a client's skin integrity including position changes when sitting or lying for extended periods, and proper positioning and transfer techniques;
(f) Implement current best practices that promote healthy skin including hygiene, nutrition, hydration, and mobility; and
(g) Identify when to report skin changes and who to report them to;
(11) Regarding the competency on long-term care worker roles and boundaries, adhere to basic job standards, expectations, and requirements and maintain professional boundaries:
(a) Identify when, how, and why to obtain information from appropriate sources about a client's condition or disease for which they are receiving services, and describe how to use this information to provide appropriate, individualized care;
(b) Describe a client's baseline based on information provided in the care plan and explain why it is important to know a client's baseline;
(c) Identify changes in a client's physical, mental, and emotional state through observation;
(d) Report changes from baseline and concerns to the appropriate care team member(s);
(e) Identify basic job standards and requirements (such as coming to work on time) and describe how maintaining these standards are critical to a client's safety and well-being;
(f) Explain the purpose of a care plan and describe how it is created, used and modified;
(g) Use a client's care plan to direct a long-term care worker's job tasks and any client directed care tasks;
(h) Identify what is required of a long-term care worker, as described in WAC 388-71-0946, prior to performing a nurse-delegated task;
(i) Describe the role of a care team and a long-term care worker's role in the care team;
(j) Describe professional boundaries and the importance of maintaining them; and
(k) Identify signs of unhealthy professional boundaries, barriers to keeping clear professional boundaries, and ways to avoid or eliminate them;
(12) Regarding the competency on supporting activities of daily living, perform required personal care tasks to the level of assistance needed and according to current best practices and evidence-based guidelines:
(a) Demonstrate, in the presence of a qualified instructor, all critical steps required for personal care tasks including but not limited to:
(i) Helping an individual walk;
(ii) Transferring an individual from bed to wheelchair;
(iii) Turning and repositioning an individual in bed;
(iv) Providing oral care;
(v) Cleaning and storing dentures;
(vi) Shaving a face;
(vii) Providing fingernail care;
(viii) Providing foot care;
(ix) Providing a bed bath;
(x) Assisting an individual with a weak arm to dress;
(xi) Putting knee-high elastic stockings on an individual;
(xii) Providing passive range of motion for one shoulder;
(xiii) Providing passive range of motion for one knee and ankle;
(xiv) Assisting an individual to eat;
(xv) Assisting with peri-care;
(xvi) Assisting with the use of a bedpan;
(xvii) Assisting with catheter care;
(xviii) Assisting with condom catheter care; and
(xix) Providing medication assistance;
(b) In the process of performing the personal care tasks, use proper body mechanics, listen attentively, speak clearly and respectfully while explaining what the long-term care worker is doing, incorporate client preferences, maintain privacy and dignity, support the client's level of ability, and assure his or her comfort and safety;
(c) Appropriately utilize assistive device(s) specified in the care plan;
(d) Describe any safety concerns related to each task and how to address the concerns;
(e) Demonstrate an understanding of bowel and bladder functioning, including factors that promote healthy bowel and bladder functioning, and the signs, symptoms, and common causes of abnormal bowel and bladder function; and
(f) Identify the importance of knowing a client's bowel and bladder functioning baseline and when to report changes;
(13) Regarding the competency on food preparation and handling, plan and prepare meals using a basic knowledge of nutrition and hydration, incorporating any diet restrictions or modifications, and prevent food borne illness by preparing and handling food in a safe manner:
(a) Describe how nutrition and hydration can impact a client's health;
(b) Plan, shop, and prepare meals for a client according to the guidelines of good nutrition and hydration, incorporating any dietary requirements and restrictions from the care plan and client preferences;
(c) Describe common signs of poor nutrition and hydration, and when to report concerns and who to report concerns to;
(d) Understand that diet modification is required for certain health conditions, including dysphagia, and describe how to identify diet modifications required for a client;
(e) Recognize when a client's food choices vary from specifications on the care plan, describe when to report concerns and who to report them to;
(f) Describe what causes food borne illness, the risks associated with food borne illness and examples of potentially hazardous foods;
(g) Describe appropriate food handling practices, including:
(i) Avoiding cross contamination from one food to another;
(ii) Safe storage requirements for cooling of leftover foods, including:
(A) Depth;
(B) Types of containers and temperatures;
(C) The need to maintain food at proper temperatures to limit bacterial growth; and
(D) Safe food storage and holding temperatures for both cold and hot foods;
(iii) Best practices for thawing and re-heating food; and
(iv) Using clean gloves (if possible), and clean utensils when preparing food;
(h) Describe the importance and correct procedure for cleaning and disinfecting food contact surfaces; and
(i) Describe why a long-term care worker with certain types of illnesses, symptoms, or both must not prepare food;
(14) Regarding the competency of medication assistance, appropriately assist with medications:
(a) Identify what a long-term care worker is allowed and not allowed to do when assisting with medications as described in chapter 246-888 WAC;
(b) Define terms related to medication assistance including prescription drugs, over the counter medications, and as needed (PRN) medications, medication side effects, and drug interactions;
(c) Identify common symptoms of medication side effects and when and to whom to report concerns;
(d) Store medications according to safe practices and the label instructions;
(e) Describe, in the proper sequence, each of the five rights of medication assistance; and
(f) Identify what to do for medication-related concerns, including describing ways to work with a client who refuses to take medications, identifying when and to whom to report when a client refuses medication or there are other medication-related concerns, and identifying what is considered a medication error, when to report a medication error, and who to report it to;
(15) Regarding the competency of infection control and blood-borne pathogens including HIV/AIDS, implement best practices to prevent and control the spread of infections:
(a) Identify commonly occurring infections, ways that infections are spread, and symptoms of infections;
(b) Describe the purpose, benefit, and proper implementation of standard precautions in infection control;
(c) Implement current best practices for controlling the spread of infection, including the use of hand washing and gloves;
(d) Demonstrate proper hand washing and putting on and taking off gloves;
(e) Identify immunizations that are recommended for adults to reduce the spread of virus and bacteria;
(f) Describe laundry and housekeeping measures that help in controlling the spread of infection;
(g) Describe proper use of cleaning agents that destroy micro-organisms on surfaces;
(h) Describe what blood-borne (BB) pathogens are and how they are transmitted;
(i) Identify the major BB pathogens, diseases, and high-risk behaviors for BB diseases;
(j) Identify measures to take to prevent BB diseases;
(k) Describe what to do if exposed to BB pathogens and how to report an exposure;
(l) Describe how HIV works in the body;
(m) Explain that testing and counseling for HIV/AIDS is available;
(n) Describe the common symptoms of HIV/AIDS;
(o) Explain the legal and ethical issues related to HIV including required reporting, confidentiality and nondiscrimination; and
(p) Explain the importance of emotional issues and support for clients and long-term care workers;
(16) Regarding the competency on grief and loss, support yourself and the client in the grieving process:
(a) Define grief and loss;
(b) Describe common losses a client and long-term care worker may experience;
(c) Identify common symptoms associated with grief and loss;
(d) Describe why self-care is important during the grieving process; and
(e) Identify beneficial ways and resources to work through feelings of grief and loss;
(17) Long-term care workers who complete DSHS approved basic training meet the training requirements for adult family homes in RCW 70.128.250;
(18) Long-term care workers who complete DSHS-approved basic training meet the four hours of AIDS education as required by the department of health for the home care aide requirement in WAC 246-980-040; and
(19) Regarding the competency on identifying indicators of hearing loss, which may be part of the basic training or population specific hours:
(a) Identify common symptoms associated with hearing loss; and
(b) Identify what to do for hearing loss related concerns, including describing ways to communicate with a client who is experiencing hearing loss and identifying when and to whom to report when a client's hearing ability changes.
[Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0911, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0911, filed 12/20/12, effective 1/20/13.]
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