| (a) Staff member training shall be in accordance with §301.331
of this title (relating to Competency and Credentialing).
(1) A hospital administrator, or administrator's designee,
shall:
(A) ensure that services are provided by staff members
who are operating within their scope of their license, credentialing,
job description, or contract specification, and in accordance with
applicable state law and rule, including 25 TAC Chapter 415, Subchapter
F (relating to Interventions in Mental Health Services);
(B) define competency-based expectations for each hospital
staff position and ensure each staff member receives initial training
before the staff member assumes responsibilities required by the hospital
and annually throughout the staff member's employment with the hospital;
(C) provide hospital staff live, interactive, instructor-led
electronic or face-to-face training competency-based training; and
(D) require all staff members to demonstrate required
competencies delineated in §301.331(a)(3)(A) of this title, including:
(i) identifying, preventing, and reporting abuse and
neglect of patients and unprofessional or unethical conduct in the
hospital, as defined by Texas Health and Safety Code §161.131
(relating to Definitions);
(ii) identifying, preventing, and reporting abuse,
neglect, and exploitation as follows, in accordance with Texas Health
and Safety Code §161.133 (relating to In-service Training):
(I) residential staff must receive eight hours of training;
(II) training must be conducted in person, and not
through teleconferencing, web-based video conferencing, or other technology;
(III) a hospital must ensure all new employees receive
training on abuse, neglect, and exploitation; and
(IV) a hospital may provide abuse, neglect, and exploitation
training to staff or may choose to contract with an outside entity
to provide the training;
(iii) preserving and protecting dignity and rights
of a patient in accordance with 25 TAC Chapter 404, Subchapter E (relating
to Rights of Persons Receiving Mental Health Services); and
(iv) preserving and protecting confidentiality of a
patient's information in accordance with Texas Health and Safety Code
Chapter 611 or Chapter 241, Subchapter G, as applicable, 42 CFR Part
2, and 45 CFR Parts 160 and 164.
(2) All registered nurses (RNs), licensed vocational
nurses (LVNs), and unlicensed assistive personnel (UAP) shall receive
training in:
(A) monitoring for patient safety in accordance with §568.67
of this chapter (relating to Protection of a Patient);
(B) infection control in accordance with §510.41(d)
of this title (relating to Facility Functions and Services); and
(C) the hospital's mandatory overtime policy required
by §568.63(k) of this chapter (relating to Nursing Services).
(3) An RN and LVN shall receive training in the process
for reporting concerns regarding the adequacy of the staffing plan,
as described in §568.63(h) of this chapter.
(4) A staff member routinely providing treatment to,
working with, or providing consultation about a patient who is younger
than 18 years of age shall receive training in the aspects of growth
and development (including physical, emotional, cognitive, educational
and social) and the treatment needs of patients in the following age
groups:
(A) early childhood (1-5 years of age);
(B) late childhood (6-13 years of age); and
(C) adolescent (14-17 years of age).
(5) A staff member routinely providing treatment to,
working with, or providing consultation about a patient diagnosed
with co-occurring psychiatric and substance-related disorders (COPSD)
shall receive training in substance-related and addictive disorders.
(6) A staff member routinely providing treatment to,
working with, or providing consultation about a geriatric patient
shall receive training in the social, psychological, and physiological
changes associated with aging.
(7) In accordance with Texas Health and Safety Code §572.0025(e),
a pre-admission screening professional (PASP) shall receive at least
eight hours of pre-admission screening and intake training, as described
in subsection (c) of this section.
(8) In accordance with Texas Health and Safety Code §572.0025(e),
a staff member whose responsibilities include conducting the hospital's
intake process for a patient shall receive at least eight hours of
pre-admission screening and intake training, as described in subsection
(c) of this section.
(9) A staff member who may initiate an involuntary
intervention shall receive training in and demonstrate competency
in performing such interventions in accordance with 25 TAC Chapter
415, Subchapter F (relating to Interventions in Mental Health Services)
prior to performing such interventions.
(b) A staff member providing direct patient care shall
maintain certification in a course developed by the American Heart
Association, the American Red Cross, or the Health and Safety Institute
in recognizing and caring for breathing and cardiac emergencies. The
course shall teach the following skills appropriate to the age of
the hospital's patients:
(1) rescue breathing, with and without devices;
(2) airway obstruction;
(3) cardiopulmonary resuscitation; and
(4) use of an automated external defibrillator.
(c) Pre-admission screening and intake training. The
pre-admission screening and intake training required by subsections
(a)(7) and (8) of this section shall provide instruction to staff
members regarding:
(1) assessing, interviewing, and diagnosing an individual
with a mental illness and an individual diagnosed with COPSD;
(2) obtaining relevant information about the patient,
including information about finances, insurance benefits and advance
directives;
(3) explaining, orally and in writing, the patient's
rights described in 25 TAC Chapter 404, Subchapter E (relating to
Rights of Persons Receiving Mental Health Services);
(4) explaining, orally and in writing, the hospital's
services and treatment as they relate to the patient;
(5) informing the patient in writing of the existence,
telephone number, and address of the protection and advocacy system
of the state of Texas; and
(6) determining whether the patient comprehends the
information provided in accordance with paragraphs (3) - (5) of this
subsection.
(d) Frequency of training. A hospital shall provide
the training described in subsection (a) of this section, periodically,
as follows.
(1) A staff member shall receive the patient rights
training required by subsection (a)(1)(D)(iii) of this section:
(A) before assuming responsibilities at the hospital;
and
(B) annually throughout the staff member's employment
or association with the hospital.
(2) A staff member shall receive the training in identifying,
preventing, and reporting abuse and neglect of patients and unprofessional
or unethical conduct required by subsection (a)(1)(D)(i) of this section
annually throughout the staff member's employment or association with
the hospital, as set forth in Texas Health and Safety Code §161.133.
(3) A staff member shall receive the training required
by subsections (a)(1)(D) and (a)(2) - (5) of this section:
(A) before assuming responsibilities at the hospital;
and
(B) annually throughout the staff member's employment
or association with the hospital.
(4) A staff member shall have the certification required
by subsection (b) of this section:
(A) before assuming responsibilities at the hospital;
or
(B) not later than 30 days after the staff member is
hired by the hospital if another staff member who has such certification
is physically present and on-duty on the same unit on which the uncertified
staff member is on-duty.
(5) A pre-admission screening professional (PASP) shall
receive the training required by subsection (a)(7) of this section:
(A) before the PASP conducting a pre-admission screening;
and
(B) annually throughout the PASP's employment or association
with the hospital.
(6) A staff member shall receive the training required
by subsection (a)(8) of this section:
(A) before conducting the intake process; and
(B) annually throughout the staff member's employment
or association with the hospital.
(7) A staff member shall receive the training required
by subsection (a)(9) of this section at the intervals described in
25 TAC Chapter 415, Subchapter F .
(e) Documentation of training.
(1) A hospital shall document that a staff member has
successfully completed the training described in subsection (a) of
this section including:
(A) the date of the training;
(B) the length of the training session; and
(C) the name of the instructor.
(2) A hospital shall maintain certification or other
evidence issued by the American Heart Association, the American Red
Cross or the Health and Safety Institute that a staff member has successfully
completed the training described in subsection (b) of this section.
(f) Performance in accordance with training. A staff
member shall perform the staff member's responsibilities in accordance
with the training and certification required by this section.
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