MNAWorking 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 FacilitiesSNF

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 HealthEat 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 - RNHOUSEKEEPING

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)

•12 -18 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??