Med Prep Chapter 1 Review – The Nursing Assistant in Long-Term Care – Flashcards

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Long term care: long term care facilities provide 24-hour skilled care for people who are no longer eligible for hospital care, but are unable to be cared for at home...assists people with ongoing, chronic medical conditions, and is usually given for an extended period of time Skilled care: skilled care is medically necessary care given by a skilled nurse or therapist Assisted living: in assisted living facilities, residents are generally more independent, staff are available to provide whatever daily care the resident needs...residents in assisted living do not usually need skilled care Home health care: home health care is care that takes place in a person's home Adult daycare: adult daycare is given at a facility during daytime working hours, generally adult daycare is for people who need some help, but who are not seriously ill or disabled Inter-generational care: with this type of care, the young and the elderly are able to spend their days together Acute care: acute care is given in hospitals and ambulatory surgical centers, it is for people who require care for illnesses or injuries or for shorts stays after surgery Subacute care: subacute care can be given in a long-term care facility or a hospital, it is used for people who need less care than for an acute illness but a higher level of care and observation than is given in long-term care Outpatient care: outpatient care is usually given for less than 24 hours, it is for people who have had treatments or surgery and need short-term skilled care Rehabilitation: rehabilitation is care given by a specialist or a team of specialists to help improve function after an illness or injury Hospice care: hospice care is for people who have approximately six months or less to live

Medicare: medicare is a health insurance program for people who are 65 years of age or older, as well as those who are disabled or ill and cannot work Medicaid: medicaid is medical assistance for low-income people REMINDER: Medi"care" is for people who need to be cared for, Medic"aid" is for those people who need a little aid, just need a little bit of help

The majority of residents are over the age of 65, the majority are female and the majority are Caucasian, coming from a hospital or other facility

Most nursing assistant care covers the activities of daily living such as bathing, skin, nail, and hair care, walking, eating and drinking, mouth care, dressing, transferring, and using the bathroom. Examples include: - serving trays and feeding residents - helping residents dress and undress - bathing residents - shampooing hair - shaving residents - bedmaking - tidying residents' living areas - measuring vital signs, including temperature, pulse, respiration, blood pressure and observing and reporting pain levels - helping residents with toiling needs - assisting with mouth care - giving back rubs - observing and reporting changes in residents' conditions - reporting residents' complaints to the nurse - helping residents move safely around the facility - caring for equipment Nursing assistants DO NOT: - administer medication, insert or remove tubes, give tube feedings or change sterile dressings

This is the basic stuff: - be neatly dressed and groomed - do not discuss personal problems or situations with residents - be on time when you are scheduled to work - avoid unnecessary absences - never leave your job early without permission - do not report to work under the influence of drugs or alcohol - keep a positive attitude - do not gossip or speak badly about co-workers or bosses - speak politely to all persons in the facility - address residents, family members and visitors in the way they wish to be addressed - do not curse or use inappropriate language - keep all residents information confidential - follow all facility policies and procedures - report concerns or problems to your supervise - meet and maintain all educational requirements - ask questions when you do not understand something - be honest - accept constructive criticism gracefully and learn from it - do not accept tips or gift from residents, their families, or other visitors - be loyal to your facility

Again, the basic stuff: - patient and understanding - honest and trustworthy - conscientious - enthusiastic - courteous and respectful - empathetic - dependable and responsible - humble and open to growth - tolerant - unprejudiced

- keep your uniform clean, neat and pressed - bathe or shower every day, wear deodorant or anti-perspirant - brush your teeth at least twice a day - avoid using strongly-scented items, such as perfume, cologne, after-shave, body washes, body creams and lotions, hair spray and fabric softeners - keep your hair neatly tied back and away from your face - keep beards trimmed and neat-looking - apply makeup lightly or use none at all - keep nails short, filed and clean, follow facility policy regarding nail polish - do not wear artificial nails - keep shoes and laces clean - wear as little jewelry as possible

Resident and Family: residents make choices about their care, they help plan their care and their family and friends may help with these decisions, and may share vital information about the resident with the care team including their health and medical record, personal preferences, rituals, and routines Nurse: a nurse assesses residents, creates the care plan, monitors progress and gives treatments Registered Nurse: a person who has graduated from a state-licensed nursing program (2-4 years) and has passed a national examination Licensed Practical Nurse: a person who has graduated from a state-licensed nursing program (1-2 years) and has passed a national examination Advanced Practice Nurse: an advanced practice nurse is a registered nurse who has completed training at the graduate level as a certified nurse practitioner, nurse anesthetist, nurse midwife, or clinical nurse specialist Physician: a doctor diagnoses disease or disability and prescribes treatment, has graduated from medical school after first receiving a bachelor's degree Medical Social Worker: a medical social worker helps with social needs such as helping residents find compatible roommates and counseling and financial assistance Physical Therapist: a physical therapist gives therapy in the form of heat, cold, massage, ultrasound, electricity, and exercise to muscles, bones, and joints to improve blood circulation, promote healing, ease pain and help the resident regain mobility Occupational Therapist: an occupational therapist works with people who need help with activities of daily living, they evaluate a resident's ability to do these activities and adaptive devices may be ordered to help Registered Dietitian: a registered dietitian assesses nutritional status and plans a care program, creates diets for residents with special needs which can improve health and help manage illness Speech-Language Pathologist: a speech language pathologist or speech therapist teaches exercises to help the resident improve or overcome speech problems, also evaluates a person's ability to swallow food and drink Activities Director: the activities director plans activities, such as bingo or special performances to help residents socialize and stay physically and mentally active REMINDER: "You can sit there and stare if you're not going to come Zumba with us!!!" :) Nursing Assistant: nursing assistans do assigned tasks, such as taking a resident's temperature or giving personal care

REMINDER: "Look lady, I just wanna know who the HMFIC (head mo fo in charge) is" ;)

When planning care, nurses have to decide which tasks to delegate to others. This includes nursing assistants. Delegation means transferring authority to a person for a specific task. The Five Rights of Delegation are: "Right Task" "Right Circumstance" "Right Person" "Right Direction/Communication" "Right Supervision/Evaluation" REMINDER: You were asked this in clinicals with Colin in the pediatric ward...You thought they were the patient rights, but these are different...Remember how the RN was administering medication to the little girl, and all the questions he had to ask her before you gave her a teddy bear :)

Holistic Care: holistic care is caring for the whole person, including their physical needs as well as other needs including social, emotional, intellectual and spiritual Resident Focused Care: this style of nursing care focuses on the resident and hit or her family, it is based upon a partnership between the residents, their families and their caregivers, choices made by residents and their families are honored by caregivers whenever possible, families are encourage to participate in the actual care, healthcare providers and caregivers share useful and accurate information with residents and families Team Nursing: a registered nurse has the role of the team leader in this method, assignments are made, care is given and the team members report to the team leaders throughout the day Primary Nursing: with this method, a registered nurse gives much of the daily care to residents, this type of care allows for a closer relationship between the nurse and the residents, the nursing team exchanges information about the resident throughout the day while working toward shared goals Functional Nursing: staff provide care to large members of residents during each shift using this method, each member of the care team is given one or more specific tasks to complete for a large number of residents, for example, one team member is assigned to measure vital signs on all residents in the unit while another completes all of the daily weights, this type or care is not as organized as other methods, stay may not have enough time to accurately observe each resident and changes in a resident's condition may be overlooked REMINDER: Think of the tasks you were asked to perform in clinicals. You were given a clipboard and a pen and asked to record the vital signs of all forty patients on the rehab floor...After that, you were asked to feed three residents and then looked for residents to shower. Finally, you were asked to administer fresh ice water to the entire ward.

All facilities have manuals outlining policies and procedures. A policy is a course of action to be taken every time a certain situation occurs. The policy manual has information about every facility policy. A procedure is a specific method, or way, or doing something. The procedure manual has information on the exact way to complete every procedure, for example there will be a procedure for giving a resident a bed bath. REMINDER: You have your skills book that you read off of every single day...Think of the skills book as the procedure manual. With the skills book you were taught how to record vital signs, how to measure input and output, etc...Then think of the policies as your little things, like keeping the bed in the lowest resting position, as maintaining a "need to know basis" for HIPPA, and knowing that "wrinkles kill".

Inspections are done to make sure long term care facilities and home health agencies are following state and federal regulations. Inspections are done periodically by the state agency that licenses facilities. These inspections are called surveys and may be done more often if a facility has been cited for problems. Inspections may be done less often if the facility has a good record. Surveys study how well the staff cares for its residents. They interview residents and families and observe the staff's interactions with residents and the care given. They review resident charts and observe meals.

1. Describe long term care 2. Whom does Medicare insurance cover? 3. Who makes up the majority or residents in long term care facilities, men or women? 4. List ten common nursing assistant tasks 5. What are three tasks that nursing assistants do not usually perform? 6. List ten ways a nursing assistant can show professional behavior 7. List each of the ten qualities in learning objective 7. 8. Describe ten grooming guidelines for nursing assistants 9. Who is the most important part of the care team? 10. Choose four members of the care team and describe the roles they play 11. Define the chain of command 12. List the "Five Rights of Delegation" 13. Give a brief description of the four methods of nursing care 14. What is a policy? What is a procedure? 15. When surveyors visit a facility, what do they study and observe? 16. When a surveyor asks a nursing assistant a question she does not know the answer to, how should she respond?