12VAC5-391-350. Home attendant services.

A. Services of the home attendants may include, but are not limited to:

1. 환자의 (i) 일상생활 활동 지원; (ii) 보행 및 처방된 운동 지원; (iii) 적절한 교육과 역량을 갖춘 경우 기타 특수 업무 지원;

2. Assisting with oral or topical medications that the patient can normally self-administer Administration of normally self-administered drugs in a patient's private residence as allowed by § 54.1-3408 of the Virginia Drug Control Act (Chapter 34 (§ 54.1-3400 et seq.) of Title 54.1 of the Code of Virginia);

3. 치료 계획에 따라 생체 징후를 측정하고 기록합니다;

4. 체액의 섭취량과 배설량을 측정하고 기록하는 것;

5. 환자의 신체 상태, 행동 또는 외모의 변화에 대해 의료진에게 기록하고 보고하는 것;

6. 의료 기록에 서비스 및 관찰 내용을 기록하는 것; 및

7. 주요 업무 외에도, 추가 교육 및 역량 입증을 통해 자격을 갖춘 경우, 주 정부 지침에 따라 수행할 수 있는 기타 업무를 수행합니다.

B. 서비스의 최초 제공 전에, 가정 간병인은 해당 환자의 간병을 담당하는 적절한 의료 전문가로부터 환자의 간병에 관한 구체적인 서면 지시를 받아야 합니다.

C. 가정 간병인은 환자의 치료를 담당하는 해당 의료 전문가의 감독 하에 근무하여야 합니다.

D. 가정 간호사를 감독하는 책임 간호사는 환자의 집을 필요에 따라 자주 방문해야 하며, 최소한 2주에 한 번 이상 방문해야 합니다. 각 방문의 결과는 의료 기록에 기록되어야 합니다.

E. 가정 간병인을 위한 관련 직무 교육 또는 훈련은 연간 최소 12 시간으로 구성되어야 합니다. 직무 교육은 현장 감독과 병행하여 진행될 수 있습니다.

F. Home attendants shall be able to speak, read and write English and shall meet one of the following qualifications:

1. 간호사 면허 취득을 위한 호스피스 교육 프로그램을 성공적으로 이수한 자;

2. 버지니아 주 간호사 협회(Virginia Board of Nursing)에서 승인한 호스피스 간호 보조 교육 프로그램을 성공적으로 이수했습니다.

3. 버지니아주 간호위원회에서 발급한 간호조무사 자격증이 있어야 합니다;

4. Be successfully enrolled in a nursing education hospice program preparing for registered nurse or practical nurse licensure and have currently completed at least one nursing course that includes clinical experience involving patient care;

5. Have satisfactorily passed a competency evaluation that meets the criteria of 42 CFR 484.36 (b); or

6. Have satisfactorily completed training using the "Personal Care Aide Training Curriculum," dated 2003, of the Department of Medical Assistance Services. However, the training is permissible for volunteers only.

12VAC5-391-430. 약국 서비스.

A. All prescription drugs shall be prescribed and properly dispensed to the patient according to the provisions of Chapters 33 (§ 54.1-3300 et seq.) and 34 (§ 54.1-3400 et seq.) of Title 54.1 of the Code of Virginia and the regulations of the Virginia Board of Pharmacy, except for prescription drugs authorized by § 54.1-3408 of the Drug Control Act, such as epinephrine for emergency administration, normal saline and heparin flushes for the maintenance of IV lines, and adult immunizations, which may be given by a nurse pursuant to established protocol.

B. Home attendants may assist only with those topical and oral medications that the patient would normally self administer normally self-administered drugs in the patient's private residence as allowed by § 54.1-3408 of the Virginia Drug Control Act (Chapter 34 (§ 54.1-3400 et seq.) of Title 54.1 of the Code of Virginia). Any other drug shall be administered only by a licensed nurse or physician assistant.

C. The hospice program shall develop written policies and procedures for the administration of infusion therapy medications that include, but are not limited to:

1. Developing a plan of care;

2. Initiation of medication administration based on a prescriber's order and monitoring of the patient for response to the treatment and any adverse reactions or side effects;

3. 약물 치료 시작, 변경 또는 중단에 대한 처방자의 결정에 영향을 미칠 수 있는 가정 환경과 관련된 모든 요인에 대한 평가;

4. Communication with the prescriber concerning assessment of the patient's response to therapy, any other patient specific needs, any significant change in the patient's condition;

5. Communication with the patient's provider pharmacy concerning problems or needed changes in a patient's medication;

6. Maintaining a complete and accurate record of medications prescribed, medication administration data, patient assessments, any laboratory tests ordered to monitor response to drug therapy and results, and communications with the prescriber and pharmacy provider;

7. Educating or instructing the patient, family members, or other caregivers involved in the administration of infusion therapy in the proper storage of medication, in the proper handling of supplies and equipment, in any applicable safety precautions, in recognizing potential problems with the patient, and actions to take in an emergency; and

8. Initial training and retraining of all hospice program staff providing infusion therapy.

D. The hospice program shall employ a registered nurse who holds a current active license with the Virginia Board of Nursing, has completed training in infusion therapy and has the knowledge, skills, and competencies to safely administer infusion therapy to supervise medication administration by staff. This person shall be responsible for ensuring compliance with applicable laws and regulations, adherence to the policies and procedures related to administration of medications, and conducting periodic assessments of staff competency in performing infusion therapy.