1.01
-
Upload
melodiekernahan -
Category
Education
-
view
63 -
download
0
Transcript of 1.01
Unit ANurse Aide Workplace FundamentalsEssential Standard 1.00Understand the range of function, legal and ethical responsibilities of the nurse aide within the healthcare system. Indicator 1.01Understand healthcare facilities and organizational structure with focus on LTC.
11.01 Nursing Fundamentals HN43
Understand Understand healthcare healthcare facilitiesfacilities and and organizational organizational structure with structure with focus on focus on LTCLTC. .
FF YY II - - Intentional RepeatIntentional Repeat
There is intentional repeat of some HSII There is intentional repeat of some HSII course content in Nursing Fundamentals. course content in Nursing Fundamentals.
Repeating course content distributes Repeating course content distributes learning over time and increases long learning over time and increases long term memory. term memory.
Academic and skill competence must be Academic and skill competence must be maintained at a maintained at a very high level for direct very high level for direct resident careresident care. .
21.01 Nursing Fundamentals HN43
BRAIN STORMBRAIN STORM
3
ThinkThinkWhere do you think Nurse Aides work? Where do you think Nurse Aides work?
ActActRaise your hand and share your Raise your hand and share your thoughts!thoughts!
1.01 Nursing Fundamentals HN43
Provide care for individuals of all Provide care for individuals of all ages with a broad range of health ages with a broad range of health problemsproblems
51.01 Nursing Fundamentals HN43
HospitalsHospitals
HospitalsHospitalsServices varied and extensiveServices varied and extensive
• DiagnosticDiagnostic• TherapeuticTherapeutic• MedicalMedical• SurgicalSurgical• EmergencyEmergency
61.01 Nursing Fundamentals HN43
So what does So what does DiagnosticDiagnostic mean?mean?
7
Remind me from HSII…Remind me from HSII…
Pertaining to the Pertaining to the IdentificationIdentification of of a medical condition or disease as a medical condition or disease as determined by a physician. A determined by a physician. A statement of what is wrong with a statement of what is wrong with a resident. resident.
1.01 Nursing Fundamentals HN43
So what does So what does TherapeuticTherapeutic mean?mean?
8
aaaand….aaaand….
Pertains to treating, Pertains to treating,
fixingfixing, or correcting a , or correcting a medical or surgical medical or surgical problemproblem
1.01 Nursing Fundamentals HN43
So what does So what does MedicalMedical mean? mean?
9
• Pertaining to the science of treatment that Pertaining to the science of treatment that includes drugs, diet, exercise and other includes drugs, diet, exercise and other non-surgical means.non-surgical means.
aaaaaaaand ….aaaaaaaand ….
1.01 Nursing Fundamentals HN43
Surgical …
10
Pertains to the treatment of injury, Pertains to the treatment of injury, deformity, and disease by manual deformity, and disease by manual
and and instrumental instrumental operationsoperations. .
1.01 Nursing Fundamentals HN43
So what does So what does EmergencyEmergency mean?mean?
11
and last but not least….
Sudden occurrence of a Sudden occurrence of a serious and urgent nature serious and urgent nature that demands immediate that demands immediate attention.attention.
1.01 Nursing Fundamentals HN43
Stick diagnostics
12
Open your mouth and say aaaaaanswer
DiagnosticDiagnostic TherapeuticTherapeutic MedicalMedical SurgicalSurgical EmergencyEmergency
1.01 Nursing Fundamentals HN43
BRAIN STORMBRAIN STORM
13
ThinkThinkConsider situations that are Consider situations that are NOT NOT emergenciesemergencies that may be considered that may be considered emergencies by some people.emergencies by some people.
ActActRaise your hand and share your Raise your hand and share your thoughts! Wait to be called on.thoughts! Wait to be called on.
1.01 Nursing Fundamentals HN43
So what does So what does AcuteAcute mean?mean?
15
OK so…..remind meOK so…..remind me
• An acute illness has a An acute illness has a sudden onsetsudden onset from from which the resident is expected to recover.which the resident is expected to recover.
• Acute therapy is Acute therapy is short-termshort-term medical medical treatment, usually in a hospital, for patients treatment, usually in a hospital, for patients having an acute illness or injury or recovering having an acute illness or injury or recovering from surgery.from surgery.
1.01 Nursing Fundamentals HN43
ChronicChronic means…. means….
16
Then…Then…
• A chronic illness has slow or gradual on set, for A chronic illness has slow or gradual on set, for which there is no known cure, the illness can be which there is no known cure, the illness can be controlled and complications prevented.controlled and complications prevented.
• Chronic care is medical and nursing services that Chronic care is medical and nursing services that focus on long term care of people with chronic focus on long term care of people with chronic diseases or conditions, either at home or in a diseases or conditions, either at home or in a medical facility. It includes measures specific to the medical facility. It includes measures specific to the problem, as well as others to encourage self-care, problem, as well as others to encourage self-care, promote health, and prevent loss of function. promote health, and prevent loss of function.
1.01 Nursing Fundamentals HN43
What does What does TerminalTerminal mean? mean?
17
An illness from which An illness from which the resident is not the resident is not expected to recover and expected to recover and will die. will die. Residents with terminal Residents with terminal illnesses are given illnesses are given PalliativePalliative (comfort) (comfort) care instead of curative care instead of curative care.care.
1.01 Nursing Fundamentals HN43
Acute
18
Open your mouth and say aaaaaanswer
AcuteAcute ChronicChronic TerminalTerminal PalliativePalliative
1.01 Nursing Fundamentals HN43
LONG TERM CARE FACILITIESLONG TERM CARE FACILITIES
Referred to as:Referred to as:•Extended care facilitiesExtended care facilities•Skilled care facilitiesSkilled care facilities•Nursing homesNursing homes•CCRC – continuing care CCRC – continuing care retirement community (includes retirement community (includes skilled nursing)skilled nursing)
191.01 Nursing Fundamentals HN43
LONG TERM CARE FACILITIESLONG TERM CARE FACILITIES
Provide healthcare services to Provide healthcare services to individuals unable to care for individuals unable to care for themselves:themselves:
• elderly personselderly persons• disabled or handicapped disabled or handicapped
personspersons• people with chronic illnesspeople with chronic illness
201.01 Nursing Fundamentals HN43
Long term care…Have we got it?
Let’s check and see
22
Stick diagnostics
Student Name A
Student Name B
1.01 Nursing Fundamentals HN43
ADULT CARE HOMES / HOMES FOR THE AGEDADULT CARE HOMES / HOMES FOR THE AGEDHHOMES FOR THE OMES FOR THE AAGED GED LLICENSE ICENSE (HAL)(HAL)
Formerly called:Formerly called:
•Rest home Rest home •Assisted livingAssisted living
231.01 Nursing Fundamentals HN43
ADULT CARE HOMES / HOMES FOR THE AGED
Types:•Family Care Home Family Care Home – – serves 2-6 unrelated serves 2-6 unrelated personspersons•Adult Care Home Adult Care Home – – serves 7 or more serves 7 or more unrelated personsunrelated persons•Group Home Group Home – – for developmental disabled for developmental disabled adultsadults•Multi unit housing with servicesMulti unit housing with services
241.01 Nursing Fundamentals HN43
ADULT CARE HOMES / HOMES FOR THE AGEDADULT CARE HOMES / HOMES FOR THE AGED
• Assists resident with medication Assists resident with medication administrationadministration
• Assists with personal care, dressing, or Assists with personal care, dressing, or groominggrooming
• Provides three meals a dayProvides three meals a day• Provides housekeepingProvides housekeeping• 24 hour supervision24 hour supervision
251.01 Nursing Fundamentals HN43
HOMES FOR THE AGED
• Monitored byMonitored by Adult Home Specialist within County Adult Home Specialist within County Department of Social Department of Social Services. Do most of complaint investigations. Services. Do most of complaint investigations.
26
• Licensed and Licensed and inspected by inspected by
1.01 Nursing Fundamentals HN43
Homes for the AGEDHave we got it?
Let’s check and see
27
Stick diagnostics
1.01 Nursing Fundamentals HN43
What are other names for homes for the aged?What are other names for homes for the aged?
How much medical supervision is given in HAs?How much medical supervision is given in HAs?
What agency issues licenses to HAs?What agency issues licenses to HAs?
What agency monitors HAs?What agency monitors HAs?
HOME CARE AGENCIES
Provide care in the Provide care in the homehome for people for people needing health services, needing health services, but not hospitalizationbut not hospitalization
281.01 Nursing Fundamentals HN43
HOME CARE AGENCIESHOME CARE AGENCIES
Services provided include:Services provided include:
29
• Nursing / CNA / PCANursing / CNA / PCA• Physical therapyPhysical therapy• Occupational therapyOccupational therapy• Speech therapySpeech therapy• Social servicesSocial services• Nutritional and food servicesNutritional and food services• Respiratory therapyRespiratory therapy• Homemaker servicesHomemaker services
1.01 Nursing Fundamentals HN43
Home Care AgenciesHave we got it?
Let’s check and see
30
Stick diagnostics
Student Name A
Student Name B
1.01 Nursing Fundamentals HN43
HEALTHCARE FACILITY HEALTHCARE FACILITY ORGANIZATIONAL STRUCTUREORGANIZATIONAL STRUCTURE
• Displays Displays chain of commandchain of command• Shows Shows lines of authoritylines of authority• Identifies health care Identifies health care
worker’s positionworker’s position• Identifies immediate Identifies immediate
supervisorsupervisor
311.01 Nursing Fundamentals HN43
HEALTHCARE FACILITY HEALTHCARE FACILITY ORGANIZATIONAL STRUCTUREORGANIZATIONAL STRUCTURE
• Responsible for provision of safe Responsible for provision of safe and adequate care at a reasonable and adequate care at a reasonable costcost
• Makes facility policiesMakes facility policies• Delegates management to an Delegates management to an
administratoradministrator
Governing bodyGoverning body = (Board of Directors)
321.01 Nursing Fundamentals HN43
HEALTHCARE FACILITY HEALTHCARE FACILITY ORGANIZATIONAL STRUCTUREORGANIZATIONAL STRUCTURE
Department headsDepartment heads– Have specific areas of responsibilitiesHave specific areas of responsibilities– Supervise department staffSupervise department staff
• FinanceFinance• Ancillary servicesAncillary services• NursingNursing
331.01 Nursing Fundamentals HN43
HEALTHCARE FACILITHEALTHCARE FACILITY Y ORGANIZATIONAL STRUCTUREORGANIZATIONAL STRUCTURE
Medical DirectorMedical DirectorSupervises medical staff Supervises medical staff activitiesactivities
• PhysiciansPhysicians• ResidentsResidents• InternsInterns
341.01 Nursing Fundamentals HN43
HEALTHCARE FACILITY ORGANIZATIONAL STRUCTURE
Director of Nursing and Director of Nursing and Assistant DONAssistant DON
• Supervises nursing staff Supervises nursing staff activitiesactivities
• Responsible for safe Responsible for safe nursing carenursing care
• Registered nursesRegistered nurses
351.01 Nursing Fundamentals HN43
HEALTHCARE FACILITY ORGANIZATIONAL STRUCTURE
Nursing supervisorNursing supervisor• Assists director of nursingAssists director of nursing• Licensed nurseLicensed nurse• Assigned areas of responsibilityAssigned areas of responsibility• Assigned to specific shiftAssigned to specific shift
361.01 Nursing Fundamentals HN43
HEALTHCARE FACILITY HEALTHCARE FACILITY ORGANIZATIONAL STRUCTUREORGANIZATIONAL STRUCTURE
Charge Nurse Charge Nurse –Has specific areas of Has specific areas of
responsibilityresponsibility–Responsible for resident Responsible for resident
care in specific areacare in specific area
371.01 Nursing Fundamentals HN43
HEALTHCARE FACILITY HEALTHCARE FACILITY ORGANIZATIONAL STRUCTUREORGANIZATIONAL STRUCTURE
Charge Nurse Charge Nurse Supervises staff in specific Supervises staff in specific areaarea
• Registered nurses (RNs)Registered nurses (RNs)• Licensed practical nurses Licensed practical nurses
(LPNs)(LPNs)• Nurse aides (NAs)Nurse aides (NAs)
381.01 Nursing Fundamentals HN43
LTC Healthcare organization structure…
Have we got it?Let’s check and see
39
Stick diagnostics
1.01 Nursing Fundamentals HN43
LTC FACILITIES REGULATIONLTC FACILITIES REGULATION
40
Federal Level
State Level
1.01 Nursing Fundamentals HN43
41
Federal Level
• Federal agency that works Federal agency that works with state agencieswith state agencies
• Runs two national care Runs two national care programsprogramsMedicareMedicareMedicaidMedicaid
1.01 Nursing Fundamentals HN43
42
Federal Level
• Helps pay for health care Helps pay for health care including nursing home careincluding nursing home care
• Sets quality standards for Sets quality standards for long term care facilitieslong term care facilities
• Nursing homes must be Nursing homes must be certified to receive Medicare certified to receive Medicare and Medicaid fundsand Medicaid funds
1.01 Nursing Fundamentals HN43
43
Federal Level
Nursing Home Compare for Consumers http://www.cms.gov/CertificationandComplianc/Downloads/consumerppt.pdf
•Five Star rating systemFive Star rating system•Quality of care informationQuality of care information•Characteristics of nursing homesCharacteristics of nursing homes
1.01 Nursing Fundamentals HN43
LTC FACILITIES REGULATIONLTC FACILITIES REGULATION
44
State Level
Two Sections of DHSR:Two Sections of DHSR:
•Nursing Home Licensure and Certification Section•Health Care Personnel Registry Section
1.01 Nursing Fundamentals HN43
LTC FACILITIES REGULATION
45
Nursing Home Licensure and Nursing Home Licensure and Certification SectionCertification Section•Determines location and number of nursing homes Determines location and number of nursing homes needed in NCneeded in NC•Issues licenses to nursing homes giving permission Issues licenses to nursing homes giving permission to operate and provide careto operate and provide care•"Surveyors" conduct inspections to find out whether "Surveyors" conduct inspections to find out whether the nursing home meets federal rulesthe nursing home meets federal rules
Routine inspections take place in nursing homes Routine inspections take place in nursing homes that receive payment through Medicare and that receive payment through Medicare and Medicaid every 9 to 15 monthsMedicaid every 9 to 15 months
Surveys take three days on averageSurveys take three days on average
1.01 Nursing Fundamentals HN43
LTC FACILITIES REGULATION
46
Responsibilities of the nurse aide during the survey process
• Provide quality careProvide quality care• Protect residents rightsProtect residents rights• Provide for resident and personal safetyProvide for resident and personal safety• Keep center clean and safeKeep center clean and safe• Conduct yourself in a professional Conduct yourself in a professional
mannermanner• Demonstrate good work ethicsDemonstrate good work ethics• Follow center policies and proceduresFollow center policies and procedures• Answer surveyor questions honestly Answer surveyor questions honestly
and completelyand completely
1.01 Nursing Fundamentals HN43
LTC FACILITIES REGULATION
47
LTCs can be put on LTCs can be put on
““SANCTION”SANCTION” because because of:of:
• Substandard careSubstandard care• CMPCMP – – CCivil ivil MMoney oney PPenaltyenalty
1.01 Nursing Fundamentals HN43
LTC FACILITIES REGULATIONLTC FACILITIES REGULATION
CMP-Civil Money PenaltyCMP-Civil Money Penalty
48
• Fines collected as a result of Fines collected as a result of nursing home violationsnursing home violations
• Fines are redirected back in the Fines are redirected back in the nursing home industry to improve nursing home industry to improve the quality of carethe quality of care
• In NC – Win A Step Up is funded by In NC – Win A Step Up is funded by CMP CMP
1.01 Nursing Fundamentals HN43
LTC FACILITIES REGULATION
49
Health Care Personnel Registry Health Care Personnel Registry SECTIONSECTION
There are two branches:There are two branches:1.1. Investigations BranchInvestigations Branch
2.2. Center for Aide Regulation and Center for Aide Regulation and Education (CARE) BranchEducation (CARE) Branch
1.01 Nursing Fundamentals HN43
LTC FACILITIES REGULATIONLTC FACILITIES REGULATION
50
Health Care Personnel Registry SECTIONHealth Care Personnel Registry SECTION
InvestigationsInvestigations BRANCH BRANCH responsible for:responsible for:
1.1. Health Care Personnel RegistryHealth Care Personnel Registry2.2. Receiving reports from health care Receiving reports from health care
facilitiesfacilities3.3. Unlicensed health care worker Unlicensed health care worker
investigationsinvestigations4.4. Listing "Pendings" and "Findings" Listing "Pendings" and "Findings"
on the Nurse Aide I and Health Care on the Nurse Aide I and Health Care Personnel RegistriesPersonnel Registries
1.01 Nursing Fundamentals HN43
LTC FACILITIES REGULATION
51
Health Care Personnel Registry SECTION
CCenter for enter for AAide ide RRegulation and egulation and EEducation ducation (CARE) (CARE) BRANCH is BRANCH is responsible for responsible for 1.1.Nurse Aide I Registry, training and competency Nurse Aide I Registry, training and competency programsprograms2.2.Medication Aide Registry and competency Medication Aide Registry and competency programsprograms3.3.Geriatric Aide Registry and trainingGeriatric Aide Registry and training4.4.Feeding assistant training curriculumFeeding assistant training curriculum5.5.Providing registry access and listing Providing registry access and listing verificationverification
1.01 Nursing Fundamentals HN43
LTC FACILITIES REGULATION
52
NC New Organizational Vision Award
~NC NOVA~http://www.ncnova.org/index.html
NC Special State License that honors excellence in the workplace for people employed by home care agencies, adult care homes, and nursing homes.
1.01 Nursing Fundamentals HN43
LTC FACILITIES REGULATION
53
NC New Organizational Vision Award
NC NOVA facilities have the following: 1.Well trained staff, satisfied and loyal workers helping families by caring for their loved ones;2.Stronger links among workers, residents, families, and management;
1.01 Nursing Fundamentals HN43
LTC FACILITIES REGULATION
54
NC New Organizational Vision Award
NC NOVA facilities have the following: 3.Chances for staff to better their skills and advance their careers;4.Stable, quality worker available now and for the future.
1.01 Nursing Fundamentals HN43
LONG TERM CARE REGULATIONS – SO WHAT?
55
Nurse AidesNurse Aides must must provide provide good care good care and and comply with comply with state and federal state and federal and regulations.and regulations.
1.01 Nursing Fundamentals HN43
Consequences of inappropriate actions by the Nurse Consequences of inappropriate actions by the Nurse Aide Student or CNAAide Student or CNA
Name of the Nurse Aide will be listed on the Health Care Personnel Registry for a "pending" allegation or substantiated allegation "finding(s)".
561.01 Nursing Fundamentals HN43
Consequences of inappropriate actions by the Nurse Consequences of inappropriate actions by the Nurse Aide Student or CNAAide Student or CNA
Nursing homes and other facilities must access the NC DHSR Health Care Personnel Registry before they hire unlicensed staff. Listings include:•Name of the Nurse AideName of the Nurse Aide•Nature of the finding or allegationNature of the finding or allegation•Status of the investigationStatus of the investigation•Listings on the NC Health Care Personnel Registry will also be Listings on the NC Health Care Personnel Registry will also be listed on the National Practitioner Data Banklisted on the National Practitioner Data Bank
571.01 Nursing Fundamentals HN43
58
NPDB-HIPDB – National Practitioner NPDB-HIPDB – National Practitioner Data Bank / Healthcare Integrity and Data Bank / Healthcare Integrity and Protection Data BankProtection Data Bank
• Nurse Aides Nurse Aides are considered are considered “practitioners”“practitioners”• Substantiated negative “Findings” for nurse Substantiated negative “Findings” for nurse
aides will appear in this national data bank!aides will appear in this national data bank!
http://www.npdb-hipdb.hrsa.gov/
1.01 Nursing Fundamentals HN43
Consequences of inappropriate actions by Consequences of inappropriate actions by the Nurse Aide Student or CNAthe Nurse Aide Student or CNA
Deficiencies may be cited against the LTC where the Nurse Aide is employed
591.01 Nursing Fundamentals HN43
Prevent Problems Prevent Problems
• Good resident careGood resident care• Given with a good heartGiven with a good heart• Using Good standardsUsing Good standards• Each and every dayEach and every day• Equals a Equals a GREAT CNA GREAT CNA who has nothing to who has nothing to
fear and everything to gain. fear and everything to gain.
601.01 Nursing Fundamentals HN43