MNA Working in Long Term Care Chapter 1

Long Term Care Centers  Board and Care Homes Can be in a home setting Can be part of a nursing facility SUPPORTIVE CARE Meals, housekeeping, laundry, transportation, medication reminders

Long Term Care Centers  Assisted Living Residence Home like setting, apartment like Provides housing, personal care, health care, social activities. Assistance with ADL. Residents

Long Term Care Centers  Nursing Centers Require continuous care LTCF Licensed Staff Provide: medical, nursing, dietary, rehab care recreation and social services, laundry and housekeeping Residents

Long Term Care Centers  Nursing Centers Skilled Nursing Facilities SNF More complex care provided

Purposes and Goals of Nursing Centers Promote Physical and Mental Health Eat properly Exercise Prevent communicable disease Treat chromic illness Rehab or restorative care

Purposes and Goals of Nursing Centers Promote Physical and Mental Health Eat properly and Exercise Do as much for themselves as possible Encourage appetite Quality of life

Purposes and Goals of Nursing Centers Promote Physical and Mental Health Prevent Communicable Diseases Disease spread from one person to another Hand washing

Purposes and Goals of Nursing Centers Promote Physical and Mental Health Treat chromic illness Slow or gradual onset No cure acute illness Sudden onset Should recover

Purposes and Goals of Nursing Centers Promote Physical and Mental Health Rehab or restorative care Return to highest possible level off functioning Begins on admission Entire staff involved

OTHER SERVICES provided by Nursing Centers Hospice Alzheimer’s Unit Rehab and Sub-acute care

Accreditation JCAHO Standards and practices Improves quality of care Yearly review

Nursing Center Organization Owned by person or corporation Local, state and federal regulations Must have a medical director Nursing is a major department

Organizational Structure ADMINISTRATOR DO ENVIRONMENTAL SERVICES DO FINANCE PAYROLL DO NURSING - RN Floor Charge Nurse - RN Shift Supervisor - RN HOUSEKEEPING RN LPN Nursing Assistant

Registered Nurse 2 year degree - Associate 4 year degree - Bachelors Assess, plan, implement, evaluate nursing care Must pass Licensing exam Must continue education DO NOT Diagnose

Licensed Practical Nurse LPN (Also called LVN) month Program Community College or Technical School Must pass Licensing exam Must continue education Under the supervision of an RN

Nursing Assistant 75 hour program Required by the Omnibus Budget Reconcilation Act of 1987 (OBRA) 59 classroom, 16 hours clinical Must pass a state exam to be placed on registry Must continue education Under the supervision of an RN, LPN

Nursing Assistant State Exam Written exam – 75 questions Performance exam – 5 skills Must be taken within one year of course completion 3 attempts

Nursing Care Functional Nursing Tasks and jobs Team Nursing Team led by RN Delegation based on staff ability and patient need Primary Nursing Primary RN is responsible for Total Care

Health Care Team Activities Coordinator Dentist Dietician Lab Tech Physical Therapist Pharmacist Respiratory Therapist Podiatrist Social Worker Radiology Tech

Payments Private Insurance Group Insurance Medicare Medicaid Health care payment program sponsored by the federal govt and operated by the states. Available to low income, blind, disabled, elderly Federal health care insurance program for 65 or older

Payments DRG – Diagnosis Related Groups Managed Care - Limits

Review Helping persons return to their highest physical and mental functioning is called? rehabilitation

Review Persons in a LTCF are referred to as ? residents

Review Which facility provides 24 hour nursing care? Nursing center (LTCF)

Review When does rehab start? On admission

Review What is the nursing center goal or purpose? Promote Physical and Mental Health

Review Who is the person “in charge” in a health care facility? Administrator

Review Who is the person in charge of the nursing department? DON

Review A health care program for the dying person is ? Hospice

Review An illness with slow, gradual onset, usually no cure is called? chronic

Review Who would qualify for Medicaid? Low income, blind, disabled, elderly

Review Doctors are part of the nursing team. True or False

Review Nursing assistants often supervise others. True or False

Review Medicare is for persons age 65 and older. True or False

Review All nursing centers must be JCAHO accredited. True or False

Review DRG are used to control the cost of health care. True or False

Review Residents are often encouraged to work at the LTCF to lower the cost of their health care. True or False

Review Nursing assistants must pass a state exam in order to be put on the state registry True or False

Review What is ADL? Activities of Daily Living

Questions??