TRAINING GUIDELINES AND PROGRAM DESCRIPTIONS
Table of Contents
The Training Guidelines and Program Description Chapter contains two sections. For easy access to each section, hit “Ctrl+click” on the subheading below to go directly to that section.
OVERVIEW
SECTION ONE: Table Of Contents – Training Matrix Guidelines
SECTION TWO: Table of Contents – Program Descriptions
Overview
Training Guidelines and Program Descriptions
The American Nurses Association “Public Health Nursing: Scope and Standards of Practice”1 practice guidelines describe the standards of practice, standards of professional performance and provide measurement criteria for public health nursing care. These standards of public health nursing practice are meant to guide, define, and direct health professional nursing practice in all settings.
In order to remain consistent and in alignment with these nationally recognized standards of public health nursing practice, the Department for Public Health Administrative Reference “Training Guidelines and Program Descriptions” chapter provides specific training guidance and program overviews for the clinical and community health services provided in local health departments.
One of the standards of Professional Performance which specifically relates to training and competencies, Education, states “The public health nurse attains knowledge and competency that reflects current nursing and public health practice.”
The measurement criteria for this standard include the following guidelines:
The public health nurse:
· Participates in ongoing education activities to maintain and enhance the knowledge and skill necessary to promote the health of the population.
· Seeks experiences to develop and maintain competence in the skills needed to implement policies, programs, and services for populations.
· Identifies learning needs based on nursing and public health knowledge, the various roles the nurse may assume, and the changing needs of the population.
· Identifies changes in the statutory requirements for the practice of nursing and public health.
· Maintains professional records that provide evidence of competency and lifelong learning.
· Seeks experiences and formal and independent learning activities to maintain and develop clinical and professional skills and knowledge.
Additional measurement criteria for the Advanced Practice Public Health Nurse include:
The advanced practice public health nurse:
· Uses current research findings and other evidence to expand nursing and public health knowledge, enhance role performance, and increase knowledge of professional issues.
1 American Nurses Association (2007), Public Health Nursing: Scope and Standards of Practice. Silver Spring, MD: Nursesbooks.org.
SECTION ONE: Training Matrix Guidelines
Abstinence Education 1
Adult Preventive 1
Arthritis 1
Asthma Program 1
Breastfeeding Peer Counselor Program 2
Cancer (KY Women’s Cancer Screening Program) 2
Cardiovascular Health Program 2
Child Fatality Review 3
Diabetes 3
Family Planning 4
Folic Acid 4
Genetics 5
HANDS 5
Home Health 6
Immunizations 7
Lead 7
Nutrition 8
Oral Health 8
Physical Activity 9
Prenatal 8
Reportable Disease 9
Resource Persons 9
School Health: Clinical Services 11
School Health: Coordinated Services 11
Sexually Transmitted Disease and HIV/AIDS 11
Tobacco Use Prevention and Cessation 13
Tuberculosis 13
Vital Statistics 16
Well Child Pediatrics 16
WIC 16
SECTION TWO: Program Descriptions
Cancer (KY Women’s Cancer Screening Program) 17
Child Fatality Review and Injury Prevention 21
Diabetes 25
EPSDT Outreach 27
Family Planning Program (Title X) 33
Genetics Program 41
HANDS (Health Access Nurturing Development Services) 42
Healthy Start 48
Hepatitis (Adult Viral Hepatitis Prevention Coordinator) 51
HIV/AIDS Branch 52
HIV/AIDS Care Coordinator Program 56
Home Health 58
Home Visiting 60
Immunization Program 62
K-STRIPE Program (KY State and Regional Infection Prevention and Epidemiology) 75
Laboratory Services 78
Lead (Childhood Lead Poisoning Prevention Program) 85
Newborn Metabolic Screening Program 90
Oral Health Program 93
Preconception/Folic Acid Guidelines 99
Prenatal Program 104
Preventative Services Protocols 110
Reportable Diseases 121
ROR Program (Reach Out and Read) 123
Resource Person Services 125
School Health: Clinical 127
School Health: Coordinated 130
STD Control Program 131
TB Prevention and Control Program 135
Well Child 140
WIC Program 143
WIC Farmers Market Program (FMNP) 146
WIC Breasfeeding Peer Counselor Program 154
Fair Hearing Procedures 155
TRAINING MATRIX GUIDELINES*
/Abstinence Education
/Adult Preventive
/Arthritis
/Asthma Program
Description / Provide education to decrease early sexual activity and teen pregnancy. / Provides for age-appropriate health screening or services. / Provides self-help, Arthritis Aquatics, classes for individuals in the community with arthritis. / Provides public and professional asthma education and awareness,in order to decrease asthma morbidity and mortality and improve the quality of life for people with asthma in KY.
Target / Adolescents age
10 – 19. / Adults 21 and above needing access to preventive health services. / Persons with self reported or MD diagnosed arthritis. / All people with asthma in Kentucky
Category / I.B. / I.B. / I.B. / I.B.
Laws, Regs / Title V,
PL 104-193 / KRS 211.180
Funding
Sources / Federal – CDC / State General & Local / Local Funding / Federal – CDC funding
Cost Center / 837 / 810 / 856 / 722
Staff Req. / Recommend experience with adolescents. / Direct care MD, APRN, PA or RN.
Support: LPN & other appropriately trained health professionals. / RN’s Health Education, Program Coordinators, lay people who are trained. / Varies with level of services: certified asthma educator, RN, health educator
Training Req. / A-H Compliant with curricula abstinence education definition as defined by law PL 104-193 / RNs must complete a DPH approved training / LHD staff must complete DPH approved training. / New Nurses – Asthma 1-2-3 one hour training – Optional for clinic nurses. Module will be on TRAIN in the fall, 2010 Experienced Nurses – Asthma Educator Institute – Optional Contact Asthma Program Mgr.
Competencies / Under Development
Reporting / Semi and annual progress report in approved format / PSRS / Annual progress report in approved format. / CDC
Special Projects
References / CCSG
Division / DWH / PQI / Chronic Disease Branch / PQI / Chronic Disease Branch / PQI
* KEY:
Category I.A. = Core service, required by statute or regulation.
Category I.B. = Preventive service for specific populations from appropriated funds.
Category II. = Local option service, provided after mandated services are assured.
TA = Trust and Agency (fees)
GF = General Fund
EHMIS = Environmental Health Management Information System
RS = Registered Sanitarian
CCSG = Core Clinical Service Guide
TRAINING MATRIX GUIDELINES*
(continued)Breastfeeding Peer Counselor Program
/KY Women’s Cancer Screening Program
/Cardiovascular Health Program
Description / Provides paraprofessional, peer to peer breastfeeding information and support to pregnant and breastfeeding mothers on the WIC Program. / Provides breast & cervical cancer screening & follow-up services to promote optimal outcomes for women. / Provides public & professional awareness, community education, quality improvement & community mobilization to reduce the incidence & complications of cardiovascular disease.Target / WIC Program participants who are pregnant or breastfeeding. / All women under 250% of federal poverty guidelines. / All Kentuckians at risk for CVD with special emphasis on school age youth, women, rural & the African American populations.
Category / I. B. / I.B. / I.B.
Laws, Regs / KRS 214.554,
P.L. 101-354,
P.L. 101-183, and
P.L. 101-340.
Funding Sources / Federal WIC Breastfeeding Peer Counselor Grant funding to selected agencies / Federal - CDC, State General Fund. / Federal – CDC funding for special projects.
Cost Center / 840 / 813 / 832
Staff Req. / Peer Counselors must have breastfed at least one baby for six months and previously been or currently are a WIC participant.
See further information under the Breastfeeding Peer Counselor Program Description in this section. / MD, APRN, or PA recommended. RN with cancer screening certification.
Nurse Case Manager: (APRN, RN, or LPN) / Varies with level of services: nurse, RD or certified nutritionist, &/or health educator.
Training Req. / Peer Counselor - Must complete 12 modules of Loving Support Through Peer Counseling. Must have 4 hours continuing education every year. Must attend the WIC Program Peer Counselor Meetings.
Supervisor – Must have completed Loving Support Through Peer Counseling supervisory training. Must attend WIC Program Peer Counselor Meetings. / Cancer screening training with preceptorship in CBE, Bimanual exam and Pap. Annual update.
If nurse has a lapse of one (1) year in providing either service, she/he must contact DPH to determine training needs. / Varies with level of services provided.
Competencies / Under Development
Reporting / Breastfeeding Peer Counselor Program / PSRS, Special KWCSP reports / Special project reports
References / Loving Support Through Peer Counseling (USDA Required Curriculum), WIC and Nutrition Manual, AR / CCSG / CCSG
Division / MCH / DWH / PQI
* Refer to front page for a Key to Categories and Abbreviations.
TRAINING MATRIX GUIDELINES*
(continued)Child Fatality Review
/Diabetes**
Description / Multidisciplinary review of child deaths to identify preventable factors. / Provides a variety of diabetes prevention and control efforts. Since funds are not sufficient to support implementation of all aspects of the program statewide, the program is implemented at four levels of activity:Level 1: Provides/coordinates public awareness activities
Level 2: Provides/coordinates public awareness and group educational programs that target behavior change (specifically, comprehensive diabetes self-management training)
Enhanced Level 2: Provides/coordinates public awareness, group educational programs, professional education activities and community mobilization/community change activities to reduce the incidence and complications of diabetes.
Level 3: All of the above activities within a region plus projects of state-level significance
Target / Unexpected or unexplained deaths of children < 18 years of age. / Kentuckians with or at risk for diabetes.
Category / I.B. / I.B.
Laws, Regs / KRS 211.684
Funding Sources / Core Public Health Block Grant / Federal – CDC and State General.
Cost Center / 818 / 809, 841
Staff Req. / LHDs are required to have a representative on the local team. / Clinical/DSMT providers: RN, RD or certified nutritionist
Community service providers: Varies with level of service. Certification as a diabetes educator (CDE) preferred for Levels 2 ½ and above.
Training Req. / Recommend MECAN series of online modules and grief counseling modules via TRAIN / Clinical providers: Initial diabetes training modules available through the American Association of Diabetes Educators (AADE). Contact the Diabetes Program staff at (502) 564-7996 to obtain access to these training modules. A minimum of bi-annual updates required.
DSMT providers: On-line modules from AADE, in person and observation training available through the Diabetes Program. Contact the Diabetes Program staff at (502) 564-7996 to obtain access to these trainings. A minimum of bi-annual updates required.
Level 3 staff may have additional requirements as determined by KDPCP.
Community: Varies with level of service.
Competencies / Under Development / Contact Diabetes Program Staff for Diabetes Self-Assessment Competency Tool
Reporting / Coroner Reports & Vital Statistics. / PSRS, Catalyst Diabetes
References / AR / CCSG
Division / MCH / PQI
* Refer to front page for a Key to Categories and Abbreviations.
** Diabetes Centers of Excellence (DCOE) staff must follow DCOE guidelines if different from above.
TRAINING MATRIX GUIDELINES*
(continued)
Family Planning
/Folic Acid
Description / Provide FDA approved methods of birth control & counseling to reduce unplanned & mistimed pregnancies. / Provides multivitamins with 0.4 mg. of folic acid & counseling to prevent neural tube defects.Target / Priority to families
< 100% poverty. / Women of childbearing age.
Category / I.B. / I.B.
Laws, Regs / Federal Title X PL 91-572 / KRS 200.703
Funding Sources / Federal Title X and MCH Block. / KIDS NOW Tobacco Settlement Funds
Cost Center / 802 / 802
Staff Req. / Medical: MD, APRN or PA.
Counseling: RN, LPN or appropriately trained health professional. / Nurses, nutritionists, dietitians, health educators or physicians may provide counseling.
Training Req. / Mandatory Initial Orientation for all new staff:
· “Inspiring Staff about Family Planning”: TRAIN #1015638;
· OPA’s “Title X Orientation”: http://www.cardeaservices.org/training/txor/index.html.;
· WEBCAST “Mandatory Reporting of Child/Adult Abuse, Neglect, Violence and Human Trafficking per Kentucky Statute” TRAIN #1028362.
Mandatory Annual:
· MDs, APRNs, RNs, and LPNs - 3.0 hours of training or contact hours each fiscal year; Support staff - one training each fiscal year.
· MODULE “Kentucky State Laws Regarding Mandatory Reporting & Human Trafficking”: TRAIN #1034386.
*The Annual Family Planning Training Calendar (approved and distributed by the Family Planning Program) lists all family planning trainings available for family planning staff each fiscal year. / Folic Acid training module
TRAIN #1017232
Competencies / Under Development
Reporting / PSRS / PSRS
References / CCSG / CCSG
Division / DWH / DWH
* Refer to front page for a Key to Categories and Abbreviations.
TRAINING MATRIX GUIDELINES*
(continued)
Genetics
/HANDS
Description / Regional outreach services to provide genetic counseling, diagnosis & education. / Voluntary home visits to support at risk parents during prenatal period & up to child’s second birthday.Target / Anyone with a suspected genetic risk. / Pregnant women (first time parents) & their infants & toddlers.
Category / I.B. / I.B.
Laws, Regs / KRS 211.690
Funding Sources / For selected sites.
Federal – MCH Block, State General / Phase I Tobacco Settlement and Federal Medicaid
Cost Center / 802 / 853
Staff Req. / RN Coordinator, works with UK or UL genetic team / Coordinator: RN, SW or other professional
Supervisor: Licensed RN/SW
Family Support Worker: high school diploma or GED
Parent Visitor: RN, SW or other professional
RN/SW Visitor: RN or SW
Training Req. / Periodic training updates / Mandatory core, curriculum and advanced training along with annual basic wrap around hours
Basic computer training recommended
Competencies / Under Development
Reporting / PSRS / HANDS web-based system
References / CCSG / CCSG
Division / MCH / MCH
* Refer to front page for a Key to Categories and Abbreviations.
TRAINING MATRIX GUIDELINES*
(continued)
Home Health
Description / Provides intermittent health & health related services to patients in their place of residence under MD prescribed plan of treatment.Target / Anyone referred from a physician in need of service as described in 902 KAR 20.081.
Category / II.
Laws, Regs / 902 KAR 20.081, Medicare, Medicaid, CHFS Licensure, HIM-11, HIM-15.
Funding Sources / Medicare, Medicaid, insurance & private pay
Cost Center / 861 through 868
Staff Req. / RN coordinator (full time). Additional qualified & licensed staff as needed.
Training Req. / Home health nurses will receive on the job training as applicable to their position. Other training may be provided by the Kentucky Home Health Association or other organizations when workshops are available.
Training includes:
1. Must Demonstrate clinical competency
2. Medicare and Medicaid home health guidelines regarding qualifications and covered home health services
3. Medicare Home Health Advance Beneficiary Notices and notice of Medicare Non-Coverage
4. Patient Rights and Confidentiality, acceptance of patients for services
5. Medicare Conditions of Participation, Medicare PPS & ICD-9 coding
6. State licensure requirements for home health agencies
7. Role of other disciplines in home health (Aide, PT, ST, OT, MSW)
8. Completion of OASIS (Start of Care, Transfer, Resumption of Care, Follow-up, Significant Change in Condition, and Discharge)
9. Completion of Plan of Treatment, Clinical documentation guidelines
10. Use of point of entry software system if applicable
11. Scheduling visits, Recording physician verbal orders & On-Call responsibilities
12. Supervision of Home Health Aides
13. Coverage, guidelines and all other home health payer sources/programs such as EPSDT Special Services, Model II Waiver, Home and Community Based Waiver
14. Outcome Based Quality Improvement & Quality Management
15. Infection Control/Risk Management in the home setting
Home Health Aides - Minimum of 12 hours in-service annually.
Home health aides must have completed a nurse’s aide course and received certification. In lieu of the aide certification, the home health agency may provide the training which includes 75 hours of classroom training and 16 hours of supervised practical training. The training must follow regulations per Federal Register, Title 42, Chapter IV, Part 484 Home Health Services. The home health agency must conduct a competency evaluation (by a Registered Nurse) and performance review of each aide no less frequently than every 12 months. In addition, the aide must receive at least 12 hours of in-service training during each 12-month period.
Competencies / Under Development
Reporting / HH Billing System
References
Division / AFM
* Refer to front page for a Key to Categories and Abbreviations.