1. 1 The Nursing Assistant in Long-Term Care 2. Describe healthcare settings Nursing assistants have a very important job and many career opportunities. Your work will make a difference in the lives of many people. Facts about long-term care (LTC): Long-term care facilities provide 24-hour skilled care. Long-term care assists people with ongoing, chronic medical conditions. Other terms for LTC facilities include the following: nursing homes, nursing facilities, skilled nursing facilities, extended care facilities

2. 1 The Nursing Assistant in Long-Term Care 2. Describe healthcare settings REMEMBER: The LTC facility is the resident’s home. The resident’s room must be treated with respect.

3. 1 The Nursing Assistant in Long-Term Care 2. Describe healthcare settings Think about this question: How would you feel if someone touched your personal belongings or moved your things around without asking?

4. 1 The Nursing Assistant in Long-Term Care 3. Explain Medicare and Medicaid Medicare is a health insurance program for people who are 65 or older who are under 65 but are disabled and cannot work Medicare will only pay for care that it deems medically necessary.

5. 1 The Nursing Assistant in Long-Term Care Transparency 1-1: Facts about Medicare and Medicaid Medicare Medicare is for people 65 or older and people under 65 who are disabled and cannot work. Part A helps pay for care in a hospital or skilled nursing facility or for care from a home health agency or hospice. Part B helps pay for doctor services and other medical services and equipment. Part C allows private health insurance companies to provide Medicare benefits. Part D helps pay for medications prescribed for treatment. Medicaid Medicaid is a medical assistance program for low-income people. People qualify based on income and special circumstances.

6. 1 The Nursing Assistant in Long-Term Care Transparency 1-2: Residents in LTC Facilities Residents in LTC facilities Over 88% are over 65. Over 71% are female. More than 85% are Caucasian. About 1/3 come from a private residence. Over 64% come from a hospital or other facility.

7. 1 The Nursing Assistant in Long-Term Care 5. Describe the nursing assistant’s role Common nursing assistant tasks include: Serving trays and feeding residents Helping residents dress and undress Bathing, shaving, and shampooing residents Bedmaking Tidying living areas Measuring vital signs, including temperature, pulse, respiration, blood pressure and observing and reporting pain levels

8. 1 The Nursing Assistant in Long-Term Care 5. Describe the nursing assistant’s role Common nursing assistant tasks include (cont’d.): Helping residents with toileting Assisting with mouth care Giving back rubs Observing and reporting changes in conditions and complaints Helping residents move safely around facility Caring for equipment

9. 1 The Nursing Assistant in Long-Term Care 5. Describe the nursing assistant’s role Tasks which nursing assistants usually do not perform include: Giving medications Inserting or removing tubes Giving tube feedings Changing sterile dressings

10. 1 The Nursing Assistant in Long-Term Care 5. Describe the nursing assistant’s role REMEMBER: Nursing assistants can have different titles, such as nurse aide, patient care technician, health care assistant, etc.

11. 1 The Nursing Assistant in Long-Term Care 6. Discuss professionalism and list examples of professional behavior Understanding how to be professional is a key step to success for a nursing assistant. Professionalism has to do with behaving properly on the job.

12. 1 The Nursing Assistant in Long-Term Care 6. Discuss professionalism and list examples of professional behavior As a nursing assistant, you must practice the following professional behavior: Be neatly dressed, groomed, and clean. Do not discuss personal problems with residents. Be at work on time and avoid unnecessary absences. Never leave work early without permission. Do not report to work under the influence of drugs and/or alcohol Keep a positive attitude. Do not gossip about co-workers.

13. 1 The Nursing Assistant in Long-Term Care 6. Discuss professionalism and list examples of professional behavior Professional behavior for nursing assistants (cont’d.): Be polite and respectful. Address residents and visitors in the way they wish to be addressed. Do not curse. Keep resident information confidential. Follow procedures and policies. Report problems to your supervisor. Maintain educational requirements.

14. 1 The Nursing Assistant in Long-Term Care 6. Discuss professionalism and list examples of professional behavior Professional behavior for nursing assistants (cont’d.): Ask questions when you do not understand something. Be honest and document carefully. Accept and learn from constructive criticism. Do not accept tips or gifts. Be loyal to your facility and be a good role model.

15. 1 The Nursing Assistant in Long-Term Care 6. Discuss professionalism and list examples of professional behavior REMEMBER: Whenever you are unsure about care, be sure to ask questions or to review the policy manual about policies or procedures you do not understand.

16. 1 The Nursing Assistant in Long-Term Care 7. List qualities that nursing assistants must have Think about these questions: The best nursing assistants have certain traits. As you review these traits, ask yourself, “Do I have these traits?” and, “Is there a way I can better develop them?”

17. 1 The Nursing Assistant in Long-Term Care 7. List qualities that nursing assistants must have Nursing assistants should be: Patient and understanding Honest and trustworthy Conscientious Enthusiastic Courteous and respectful

18. 1 The Nursing Assistant in Long-Term Care 7. List qualities that nursing assistants must have Nursing assistant traits (cont’d.): Empathetic Dependable and responsible Humble and open to growth Tolerant Unprejudiced

19. 1 The Nursing Assistant in Long-Term Care 7. List qualities that nursing assistants must have Think about these questions: Choose one of the qualities that nursing assistants must have. Can you imagine a situation on the job where that quality is needed? Can you describe a time that you used that quality in a previous job, or in your personal life?

20. 1 The Nursing Assistant in Long-Term Care 8. Discuss proper grooming guidelines Making a good first impression is very important, and proper grooming is an essential part of making a good first impression. Do these things to be properly groomed: Keep uniform clean and neat. Bathe and wear deodorant every day. Brush teeth at least twice a day. Avoid strongly-scented items. Keep hair neatly tied back.

21. 1 The Nursing Assistant in Long-Term Care Do these things to be properly groomed (cont’d.): Keep beards trimmed and neat. Apply makeup lightly. Keep nails short, filed, and clean. Do not wear artificial nails. Keep shoes and laces clean and in good condition. Wear as little jewelry as possible, except for a simple waterproof watch and identification badge. 8. Discuss proper grooming guidelines

22. 1 The Nursing Assistant in Long-Term Care REMEMBER: Keep in mind that residents may be allergic to certain scents. Heavy perfumes or scents should be avoided. This is an important part of meeting residents’ needs. 8. Discuss proper grooming guidelines

23. 1 The Nursing Assistant in Long-Term Care 9. Define the role of each member of the care team The care team consists of many members who each play a different role. The resident is at the center of the care team. Members of the care team include: Resident and resident’s family Nurse (RN, LPN or LVN) Advanced practice nurse Physician Medical social worker

24. 1 The Nursing Assistant in Long-Term Care Members of the care team (cont’d.): Physical therapist Occupational therapist Registered dietitian Speech-language pathologist Activities director Nursing assistant 9. Define the role of each member of the care team

25. 1 The Nursing Assistant in Long-Term Care REMEMBER: The resident is the most important member of the care team. 9. Define the role of each member of the care team

26. 1 The Nursing Assistant in Long-Term Care Transparency 1-3: Chain of Command

27. 1 The Nursing Assistant in Long-Term Care 11. Explain “The Five Rights of Delegation” When planning care, nurses must decide which tasks to delegate to others. “The Five Rights of Delegation” are the following: Right Task Right Circumstance Right Person Right Direction/Communication Right Supervision/Evaluation

28. 1 The Nursing Assistant in Long-Term Care Consider these questions before accepting a delegated task: Do I have all the information I need to do this job? Are there questions I should ask? Do I believe that I can do this task? Do I have the necessary skills? Do I have the needed supplies, equipment, and other support? Do I know who my supervisor is, and how to reach him/her? Have I told my supervisor of my special needs for help and support? Do we both understand who is doing what? 11. Explain “The Five Rights of Delegation”

29. 1 The Nursing Assistant in Long-Term Care REMEMBER: Asking questions and asking for help when you need it will allow you to provide the best possible care. 11. Explain “The Five Rights of Delegation”

30. 1 The Nursing Assistant in Long-Term Care Think about this question: What could happen if you did not understand something you were asked to do, but did not ask for help? 11. Explain “The Five Rights of Delegation”

31. 1 The Nursing Assistant in Long-Term Care 12. Describe four methods of nursing care The nursing profession takes a holistic approach to caring for residents, meaning caring for the whole person. This includes his or her physical needs as well as other needs, such as social, emotional, intellectual, and spiritual. Meeting all of these needs will improve the residents’ quality of life.

32. 1 The Nursing Assistant in Long-Term Care 12. Describe four methods of nursing care Over the years, the nursing profession has seen many changes. Many types of nursing care have been used at facilities. Each facility chooses the type that provides the best care for their residents. Definitions for the different types of nursing care follow.

33. 1 The Nursing Assistant in Long-Term Care 13. Explain policy and procedure manuals All facilities have manuals outlining policies and procedures. These two manuals are usually kept together. The procedure manual serves as a guide if you want to review the steps in a procedure.

34. 1 The Nursing Assistant in Long-Term Care 13. Explain policy and procedure manuals REMEMBER: You should always ask questions or consult the policy manual or procedure manual when you are unsure of something.

35. 1 The Nursing Assistant in Long-Term Care 14. Describe the long-term care survey process Inspections are done by the state agency that licenses facilities to make sure that facilities are following state and federal regulations. These inspections are called surveys. Inspections are done more often if a facility has been cited for problems. If the facility has a good record and has not been cited, inspections are done less often.

36. 1 The Nursing Assistant in Long-Term Care 14. Describe the long-term care survey process The survey process includes the following: Inspections are done periodically. Surveyors observe and interview residents and staff to find out how well residents’ needs are being met. Nursing assistants should answer any questions asked by surveyors to the best of their ability. If a nursing assistant does not know the answer to a question, he should say so and then find out.

37. 1 The Nursing Assistant in Long-Term Care 14. Describe the long-term care survey process As previously mentioned, the Joint Commission is an independent, not-for-profit organization whose standards focus on improving the quality and safety of care provided. The Joint Commission’s surveys are separate from state inspections.

38. 1 The Nursing Assistant in Long-Term Care 14. Describe the long-term care survey process REMEMBER: If a you are asked questions by surveyors during a survey and do not know the answer, be honest. Never guess. Tell the surveyor that you do not know the answer, but will find out as quickly as possible. Then check with your supervisor.