1. Lesson 2 Resident Rights

2. Lesson Objectives 1.Explain the importance of Resident Rights 2.Describe the key components/areas that are Resident Rights and the Nursing Assistant’s obligation to protect them 3.Demonstrate ways to protect Resident Rights 4.Explain and cite examples of abuse, neglect, invasion of privacy, false imprisonment and misappropriation of resident property 5.Explain the NA’s responsibilities related to reporting and responding to incidents of abuse, neglect misappropriation of resident property

3. Omnibus Budget Reconciliation Act - OBRA OBRA - law passed by the federal government in 1987 that includes minimum standards for nursing assistant training, staffing requirements, resident assessment instructions, and information on rights for residents.

4. OBRA Cont….. The Omnibus Budget Reconciliation Act (OBRA) Sets minimum standards for NA training (75 hours) Requires competency exam for NAs Requires regular in-service training for NAs (12 hours annually) Establishes state registry of NAs Sets standards that instructors must meet to train NAs

5. Resident Rights Numerous rights identified in the OBRA law that relate to how residents must be treated while living in a facility; they provide an ethical code of conduct for healthcare workers. See page 15 in book

6. Protecting Resident Rights IMPORTANT: NA’s are responsible for protecting residents and preventing abuse and neglect. Abuse: Willful infliction of injury, unreasonable confinement, intimidation, or punishment resulting in physical harm, pain, or mental anguish Neglect: failure to take reasonable caution or care

7. Protecting Resident Rights: Privacy Avoid unnecessary exposure Mail should be opened by resident unless permission is given otherwise Knock and ask permission to enter room Privacy for visits and phone calls

8. Protecting Resident Rights: Confidentiality Avoid workplace gossip Practice HIPAA (Health Insurance Portability and Accountability Act) regulations Federal law that protects the privacy of Personal Health Information (PHI) https://www.youtube.com/watch?v=KhF6v_WQOlo

9. Protecting Resident Rights: Right to be involved in personal care Always explain procedures Allow choices if possible (Ex: clothing, food, etc.) Respect right to refuse care Report refusal of care to nurse

10. Protecting Resident Rights: Report and Document Use honesty and accuracy when both reporting and documenting information Immediately notify supervisor of abuse, neglect,and/or misappropriation of funds or property misappropriation: misuse of property belonging to someone else (theft/destruction) Notify nurse at the time questions and concerns arise Report changes in condition to nurse

11. Types of Abuse: Physical Physical Abuse - Any unwanted physical contact with a resident even if no physical injury occurs Can result in both criminal and civil legal action Assault: Threatening to touch a person without their permission Battery: Touching a person without permission

12. Types of Abuse: Sexual Sexual Abuse - Rape, fondling, sexual advances/comments toward a resident

13. Types of Abuse: Mental/Psychosocial Abuse Mental/Psychosocial Abuse - Careless, thoughtless, tactless, and insensitive actions Examples: See page 16

14. Types of Abuse: Verbal/Financial Verbal Abuse - Use of words or statements that speak badly of sneer at, criticize, or reprimand a resident. Financial Abuse - Misuse or theft of funds or property belonging to a resident.

15. Signs and Symptoms of Abuse Signs (objective) - Bruising, swelling, redness, welts, bite marks or unusual marks, fractures, dislocations, burns, etc Symptoms/Observations (subjective): Mood/behavior changes, anxiety, withdrawn, complaints of pain, fear, guarding without complaint

16. Neglect/Negligence Active Neglect - the purposeful failure to provide needed care, resulting in harm to a person. Passive Neglect - the unintentional failure to provide needed care, resulting in physical, mental, or emotional harm to a person. Negligence - actions, or the failure to act or provide the proper care, that result in unintended injury to a person. Involuntary seclusion - the separation of a person from others against the person’s will.

17. Neglect/Negligence Examples of Neglect: failure to perform an equipment safety check Leaving a resident in a potentially dangerous situation Performing a task not in the CNA’s scope of practice Failure to report a significant change in a resident’s condition. Damaging or losing a resident’s personal property Lack of assistance to resident when needed. Ex: Not answering a call light

18. Signs/Symptoms of Neglect Signs: Pressure ulcer, dehydration, weight loss Symptoms: unclean, soiled bedding/clothing, unanswered call lights, wrong clothes, no glasses/hearing aids, uneaten food,no water available, etc.

19. Involuntary Seclusion Involuntary Seclusion - The separation of a person from others, from his/her room, or confined against the person’s will.

20. Misappropriation Misappropriation - Misuse of property belonging to someone else. (Theft/ Destruction) Financial Abuse is considered misappropriation of a person’s money.

21. Signs/Symptoms of Misappropriation Signs: Anger, sadness, fear Symptoms: Missing items, comments from resident or family

22. Informed Consent - The resident gives permission to give care after having been informed of potential negative outcomes Consent is given when entering a health-care facility. Can be a simple “yes” or “no” or a gesture such as a nod Right to decide who touches and when he/she may be touched Important Term to Know

23. Reporting Abuse, Neglect, and Misappropriation 1.Follow facility policy 2.Discuss situation with supervisor. 3.Put everything in writing. 4.Supervisor will contact appropriate members of the healthcare team to investigate. 5.NA’s are obligated to protect resident. 6.Any WITNESSED incidents MUST be reported. 7. ISDH will investigate any report of abuse. 8. Be sure informed consent is used. 9. If found guilty of abuse/ misappropriation, CNA License will be FOREVER revoked. If found guilty of negligence, CNA certification can be suspended for up to 5 years.

24. Other Legal Issues Slander - (Intentional or Unintentional) Making false and damaging statements about someone. Example: Implying or suggesting a resident has a mental illness.

25. Other Legal Issues (Cont….) Invasion of Privacy Not pulling privacy curtain/ closing door during personal care. Not keeping resident covered during personal care. Handling resident’s personal belongings without permission. Releasing private information without resident’s consent. Reading resident’s mail. Listening to resident’s private phone/personal conversations. Giving personal care in front of visitors Failing to knock when entering room

26. Other Legal Issues (Cont…..) False Imprisonment - the unlawful restraint of someone which affects the person’s freedom of movement; includes both the threat of being physically restrained and actually being physically restrained.

27. Make sure you know the answers to the review questions!!