EKG Technician Training in Washington

The Department of Licensing has not yet enacted legislation that creates EKG technician training and certification requirements in the state of Washington. The Health Department has expectations for the medical assistant and nursing assistant that may require compliance. Since there is no law that specifically identifies competency standards for an EKG technician, an employer may choose to adopt their own unique employment expectations and training protocols. Those planning to pursue this career path should inquire with facilities directly.

Delegation Regulations

A technician is most commonly classified as an unlicensed assistive person (UAP) who must work under the supervision of a registered nurse who assumes responsibility for ensuring the competency of unlicensed personnel and the appropriate delegation of patient care tasks. This system establishes accountability for delivery of care and protects the health and safety of patients. Rules and regulations affecting the delegation of tasks are found in Chapter 246-840-910:990 of the Washington Administrative Code. According to this piece of legislation, a nurse is required to decide if a task is appropriate to delegate based on the elements of the nursing process which includes the assessment, planning, implementing, and evaluating of patient care. In order to qualify for delegation, a task must be within the delegating nurse’s area of responsibility and must be able to be performed properly and safely.

Prior to delegation the nurse must…

1) Assess the patient’s nursing care needs

2) Determine the patient’s condition is stable and predictable

3) Analyze the complexity of the nursing task

4) Determine the required training or additional training needed by the assistant

5) Assess the level of interaction required

6) Verify that the nursing assistant…

    • is currently registered or certified
    • has completed basic caregiver and core delegation training
    • has a certificate of completion
    • is willing and able to perform the task in the absence supervision

Accountability is an important topic when providing care to patients in all types of medical settings. In most cases, it is the responsibility of the registered nurse to assess the patient, evaluate assistant competency, and accept accountability for the health outcomes that result from delegation. WAC 246-840-970 states that the nurse delegator retains overall accountability for the nursing care of the patient despite the fact that the task becomes the responsibility of the nursing assistant. Within the cardiovascular department, a technician is commonly responsible for the administration of electrocardiogram, telemetry, Holter monitoring, medical history documentation, vitals collection, and procedure preparation.

Education and Training Requirements

The competency requirements for becoming an EKG technician are highly dependent on the expectations of the local employer. If an aspiring technician is required to become a certified nursing assistant or medical assistant then they will need to complete a state approved training program, pass a competency exam, and submit a personal statement that attests to the individual’s physical and mental status, lack of impairment due to chemical dependency, history of lost credentials, history of action by the Department of Social and Health Services, felony convictions, privileges that have been lost or limited, disciplinary actions, and history of professional liability claims.

Although some colleges and universities have begun offering certificate programs for an EKG technician, it is important to verify that the program has been approved by the state and is accepted by the employer prior to enrolling. Many organizations have developed their own training programs that are designed to orient individuals to the needs of the employer and to give them the knowledge and skills they need to be successful. These in-house programs also prepare employees for the certification exams that need to be passed before providing care.

State Contact Information

Washington Department of Health

Phone:         (360) 236-4700
Fax:             (360) 236-4818
Email:          hsqa.csc@doh.wa.gov

Washington State SealTown Center 2, 111 Israel Rd. SE     Tumwater, WA 98501

Washington Board of Nursing

Phone:         (360) 236-4700
Fax:             (360) 236-4738
Email:          nursing@doh.wa.gov

Town Center 2, 111 Israel Rd. SE     Tumwater, WA 98501

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