EKG Technician Training in Virginia

The state’s Department of Professional and Occupational Regulation does not have formal EKG technician training and/or certification requirements in Virginia. The local Board of Nursing has been tasked with establishing and enforcing the regulations that do affect allied health professionals. Individuals who want to work as a technician in the cardiac care unit may need to complete nurse aide certification (CNA) and training that addresses common responsibilities associated with providing care to patients who have various heart conditions.

Delegation Regulations

Healthcare facilities in the United States require that assistive personnel be supervised by nurses who are responsible for delegating tasks and who assume full responsibility for the health outcomes that result from the care that is provided by unlicensed personnel. There is a tremendous amount of liability associated with cases where medical personnel are suspected of negligence and it is imperative for administrators to develop procedures and protocols that ensure the competency of staff members and protect the health and well-being of patients. Although state regulations do not directly address the EKG technician, most employers classify the profession as an unlicensed branch of assistive personnel that is subject to the rules and regulations that govern the delegation of nursing tasks.

According to state regulations (18-VAC-90-20), the term ‘delegation’ is defined as the authorization by a nurse to an unlicensed person to perform selected nursing tasks and procedures. An ‘unlicensed person’ means an appropriately trained individual, regardless of title, who receives compensation, who functions in a complementary or assistive role to the nurse in providing direct patient care or carrying out common nursing tasks and procedures, and who is responsible and accountable for the performance of such tasks and procedures. In order for a task to qualify for delegation, the following criteria must be met…

1) Assessment of the client population to be served

2) Analysis and identification of nursing care needs and priorities

3) Establishment of organizational standards to provide for sufficient supervision

4) Communication of the delegation plan to the staff

5) Identification of the educational and training requirements

6) Documentation of competencies

7) Provision of resources for appropriate delegation

8) Task requirements…

    • can be safely performed
    • does not jeopardize…
      • health
      • safety
      • welfare
    • nurse retains accountability
    • within scope of practice
    • client-specific communication
    • a name tag clearly identifies an unlicensed person
    • do not require the exercise of independent nursing judgment
    • do not require complex observations or critical decisions
    • frequently recur in the routine care of the client
    • do not require repeated performance of nursing assessments
    • utilize a standard procedure
    • have predictable results

Nurses have a lot of responsibility when delegating tasks to unlicensed personnel and they are required to assess the training, skills and experience of the unlicensed person and verify the competency of the unlicensed person in order to determine which tasks are appropriate for that unlicensed person and the method of supervision required.

Tasks that cannot be delegated include the nursing assessment, problem identification, and outcome evaluation requiring independent nursing judgment; counseling or teaching except for activities related to promoting independence in personal care and daily living; coordination and management of care involving collaboration, consultation and referral; emergency and nonemergency triage; administration of medications except as specifically permitted by the Virginia Drug Control Act; and circulating duties in an operating room. The tasks that are most often delegated to a technician working in the cardiac care unit involve things like electrocardiogram administration, Holter monitoring, telemetry, vital sign collection, medical record documentation, procedure preparation, and administrative tasks.

Education and Training Requirements

Individuals who want to become an EKG technician in Virginia will most likely be required to complete training and a competency examination. While some facilities offer in-house programs that are tailored to the specialty, others may expect applicants to become a certified nurse aide (CNA) before working in the cardiac care unit. In order to have the state enter someone in the CNA registry, the individual must complete a training program and pass the competency exam. Although some colleges and universities have begun offering EKG technician certificate programs, these may not be required by an employer and it is important for aspiring technicians to verify applicant requirements with local employers before enrolling in such a program.

Enhancements in state and federal quality of care initiatives have increased the amount of accountability that administrators have when ensuring the competency of a technician. This has caused facilities to begin providing hiring preference to applicants who have at least a 2-year degree in an allied health profession or prior patient care experience in a generalized area of practice. Individuals who are having a difficult time competing for job openings may want to work as an assistant or aide for a few years to help strengthen their resume.

State Contact Information

Virginia Department of Health

Phone:         (804) 367-2102
Alternate:   (804) 367-2104
Email:          OLC-Inquiries@vdh.virginia.gov

Virginia State Seal9960 Mayland Dr., Ste. 401     Henrico, VA 23233

Virginia Board of Nursing

Phone:         (804) 367-4515
Fax:             (804) 367-4455
Email:          nursebd@dhp.virginia.gov

9960 Mayland Dr., Ste. 300     Henrico, VA 23233

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