Nursing Assistant Care Chapter 1-4 Questions and Answers

Nursing Assistant Care Chapter 1-4 Questions and Answers Long-Term Care (LTC) care for persons who require 24-hour care and assistance. Length of Stay the number of days a person stays in a healthcare facility Terminal Illness an illness or injury for which there is no reasonable expectation of recovery Chronic being long-lasting and recurrent or characterized by long suffering Diagnosis identifying the nature or cause of some phenomenon or medical condition determined by a doctor ONLY Assisted Living a residence for people who require some help with daily care, but who need less care than a long-term care facility offers Home Health Care provides nursing, therapy, personal care or housekeeping services in the patient's own home Adult Daycare care given at a facility during daytime hours; generally for people who need some help but are not seriously ill or disabled. Acute Care Level of health care, generally provided in hospitals or emergency departments, for sudden, serious illnesses or trauma Skilled Care medically necessary care given by a skilled nurse or therapist. Subacute Care care given to people who have had an acute injury or illness or problem resulting from disease. This care given in a nursing home or a hospital and is for people who need a higher level of care and observation than some long-term care facilities can give Outpatient care care usually provided for less than 24 hours for persons who have had treatments or surgery requiring short-term skilled care. Rehabilitation care given in facilities or homes by a specialist. Physical, occupational, and speech therapists restore or improve function after an illness or injury. Hospice Care treatment of the terminally ill in their own homes, or in special hospital units or other facilities, with the goal of helping them to die comfortably, without pain Health Maintenance Organizations (HMOs) both health care delivery systems and types of health insurance. Provide preventive health care for a fee that is usually fixed and prepaid. The disadvantage is that you must use only HMO-affiliated providers or pay it yourself if out of network Preferred Provider Organizations (PPOs) client chooses from a list of contracted providers. using non-contracted providers increases the client's out of pocket costs Managed Care "Cost control strategies" A system that combines the financing and the delivery of appropriate, cost-effective health care services to its members. Catheters a thin flexible tube inserted into the body to permit introduction or withdrawal of fluids or to keep the passageway open Dementia a slowly progressive decline in mental abilities, including memory, thinking, and judgment, that is often accompanied by personality changes Policy a standing plan that indicates the general course of action that should be taken in response to a particular event or situation Procedure a series of steps taken to accomplish a task Cite to find a problem through a survey Joint Commission formally the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), is a not-for-profit organization that evaluates and accredits different types of healthcare facilities The Centers for Medicare & Medicaid Services (CMS) formally known as the Health Care Finance Administration (HCFA), is a federal agency within the Health and HumanServices Dept. that runs Medicare an Medicaid Medicare A program added to the Social Security system in 1965 that provides hospitalization insurance for the elderly and permits older Americans to purchase inexpensive coverage for doctor fees and other health expenses. Medicaid a federal and state assistance program that pays for health care services for people who cannot afford them or special needs Culture Change Term given to the process of transforming services for elders so that they are based on the values and practices of the person. Pioneer Network a small group of professionals working in long term care that began meeting in 1997 to share ideas and create a new vision for the future of long-term care The Eden Alternative • A new response to cultural change and living arrangements William and Judy Thomas aim to de-institutionalize long term care, increase well-being in residents, encourage late-life development • "Three Plagues" o Loneliness: Provide companionship with other friends, children and animal o Helplessness: Provide opportunity to partake in one's own care or the care of others o Boredom: Involve residents in meaningful and unpredictable activities and event Medicare Part A The part of the Medicare program that pays for hospitalization, care in a skilled nursing facility, home health care, and hospice care. Medicare Part B The part of the Medicare program that pays for physician services, outpatient hospital services, durable medical equipment, and other services and supplies. Medicare Part C Medicare Managed Care Plans (formally Medicare Plus (+) Choice Plan) was created to offer a # of healthcare services in addition to those available under Part A & Part B. The CMS contracts w/ managed care plans or PPO's to provide Medicare benefits. A premium similar to Part B may be required for coverage to take affect Medicare Part D prescription drug reimbursement plans offered to Medicare beneficiaries Joint Commission Survey a process undergone at least every 3 years in which performance in areas such as patient rights, treatment, and infection prevention are all graded. HIPPA Health Insurance Portability and Accountability Act - 1996- written to protect the privacy of health info., 2 parts: Title I- health ins reform; Title II- provides rights for the transfer of electronic health care data. Administration and Simplification Standards (Title II) put privacy and security mechanisms in place to ensure personal health info is kept confidential Activities of Daily Living (ADLs) personal care tasks a person does every day to care for him- or herself; include bathing, dressing, caring for teeth and hair, toileting, eating and drinking, and moving around. Empathy the ability to identify with someone else and understand that person's situation of feelings because of personal experience Sympathy sharing the feelings of others (especially feelings of sorrow or anguish) feeling sorry for someone Tact consideration in dealing with others and avoiding giving offense conscientious Thorough; careful 6 Principles of Care Dignity, Safety, Independence(allow them to make decisions), Privacy(tactful), Infection Control(wash hands), Communication Nursing Assistant (NA) a person who has passed a nursing assistant training and competency evaluation program; performs delegated nursing tasks under the supervision of a licensed nurse (ie taking temps and providing assistance with ADL's) must have at least 100 hours of training per CA law Registered Nurse (RN) Health care professional who has completed a course of study at an accredited school of professional nursing (at least 2 yrs) and has passed an examination administered by a State Board of Nursing Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) licensed nurse who has completed one to two years of education; LPN/LVN administers medications, gives treatments, and may supervise daily care of residents Physician or Doctor (MD or DO) 4 years of education. diagnose disease or disability and prescribe medication and treatment Physical Therapist (PT) A professional who is devoted to improving a person's physical abilities through activities that strengthen muscular control and motor coordination. They have obtained either a Masters or doctoral degree Occupational Therapist (OT) help resident to compensate for disabilities and to help adapt so they can perform (adls) activities of daily living Assistive or Adaptive devices Devices used to help a person compensate for a disability. Often used by occupational therapists., Devices which help residents perform ADL's. Speech Language Pathologist (SLP) A trained therapist who provides treatment to help a person develop or improve articulation, communication skills, and oral-motor skills, Also helps children with speech errors and/or those with difficulties in language patterns. These professionals are licensed or certified. Registered Dietitian (RD) "a professional trained in foods and the management of diets (dietetics) who is credentialed by the Commission on Dietetic Registration based on completing a bachelor of science degree from an approved program, receiving clinical and administrative training, and passing a registration examination." Medical Social Worker (MSW) helps with social needs , support services, counseling, & financial assistance advice. These professionals generally hold Masters in Social Work Activities Director Plans activities for residents to help them socialize and stay physically and mentally active. Explain a Nursing Assistants role Feeding, Toileting, ambulation, maintaining a clean and safe environment, encouraging eating an drinking, stocking supplies, Making beds, dressing residents, giving back rubs, oral care. Charting writing down important information and observations about residents Professional of or relating to a job Personal concerning or affecting a particular person or his or her private life and personality...(the opposite of professional) Professionalism how to behave while at work, the ability to handle problems and criticism gracefully and maturely Professional Relationship with residents Maintaining a positive Attitude, Completing on the assigned tasks, Keeping information confidential, Being Polite and Cheerful (even if you are not), Not discussing Personal Problems, no Profanity, Listening to resident, addressing my proper prefix, never giving or accepting gifts, always explaining care given, Following sanitation practices, NA's must be... Compassionate, Honest, Tactful, Conscientious, Dependable, Respectful, Unprejudiced, Tolerant Liability the state of being legally obliged and responsible Scope of Practice legal description of what a specific health professional may and may not do Care Plan a written plan for each resident created by a nurse or doctor; outlines the steps taken by the staff to help the resident reach his or her goals Nursing Process Systematic problem-solving method by which nurses individualize care for each client. The five steps of the nursing process are assessment, diagnosis, planning, implementation, and evaluation. The Five Rights of Delegation 1) right circumstance 2) right task assigned to the right person 3) the right health care provider using 4) the right direction (clear, concise, correct, complete, communication) 5) the right supervision Ethics the principles of right and wrong that guide an individual in making decisions Laws society's values and standards that are enforceable in the courts Omnibus Budget Reconciliation Act (OBRA) an act passed in 1987 to improve the quality of life for people who live in long-term care facilities by making sure that residents receive a certain standard of care, law that regulates the education and cerification of nursing assistants in acute care and long term care facilities Minimum Data Sheets (MDS) a part of the U.S. federally mandated process for clinical assessment of all residents in Medicare or Medicaid certified nursing homes. This process provides a comprehensive assessment of each resident's functional capabilities and helps nursing home staff identify health problems, Must be completed within 14 days of admission and again each year. Residents Rights A list of the rights and freedoms guaranteed to all residents regardless of their illness or behavior, 1. Quality of life. 2. Services and activitis to maintin a high level of wellness. 3. The right to be fully informed about rights and services. 4, The right to participate in own care. 5. Right to make independent choices. 6. Right to privacy and confidentiality, dignity, respect and freedom, right to security of possessions. Right to complain, the right to visits. Neglect The act of harming person by failing to provide needed care Active Neglect purposely harming a person physically, mentally, or emotionally by failing to provide needed care Passive Neglect unintentionally harming a person physically, mentally, or emotionally by failing to provide needed care Negligence careless neglect, often resulting in injury Malpractice professional wrongdoing that results in injury or damage Abuse physical or emotional harm to someone Physical Abuse any treatment, intentional or not, that causes harm to a person's body; includes slapping, bruising, cutting, burning, physically restraining, pushing, shoving, or rough handling. Psychological Abuse emotionally harming a person by threatening, scaring, humiliating, intimidating, isolating, insulting, or treating him or her as a child; also includes verbal abuse. Verbal Abuse oral or written words, pictures, or gestures that threaten, embarrass, or insult a person. Assault a threatened or attempted physical attack by someone who appears to be able to cause bodily harm if not stopped Battery an assault in which the assailant makes physical contact Sexual Abuse any sexual act that happens without consent Financial Abuse the act of stealing, taking advantage of, or improperly using the money, property, or other assets of another Domestic Violence violence or physical abuse directed toward your spouse or domestic partner or family Workplace Violence abuse of staff by residents or other staff members; can be verbal, physical, or sexual. Involuntary Seclusion separating a person from others against his or her will; keeping the person confined to a certain area or away from his or her room without consent Sexual Harassment Any unwelcome behavior of a sexual nature. Substance Abuse any unnecessary or improper use of chemical substances for nonmedical purposes Mandated Reporter are professionals who, in the ordinary course of their work and because they have regular contact with children, disabled persons, senior citizens, or other identified vulnerable populations, are required to report (or cause a report to be made) whenever financial, physical, sexual or other types of abuse has been observed or is suspected, or when there is evidence of neglect, knowledge of an incident, or an imminent risk of serious harm NATCEP Nurse Aide Training and Competency Evaluation Program, part of OBRA that sets minimum requirements for nursing assistants for training and testing Ombudsman a legal advocate for residents who visits the facility, listens to residents, and decides what course of action to take if there is a problem. PHI Protected Health Information., info about a patient's past, present, or future physical or mental health or payment for health care that can be used to identify the person. Advance Directive A legal document that makes known a person's wishes about health care and life-support measures. Living Will A document that indicates what medical intervention an individual wants if he or she becomes incapable of expressing those wishes. Durable Power of Attorney for Health Care a signed and dated legal document that appoints someone to make the medical decisions for a person in the event he or she becomes unable to do so DNR a legal document, usually signed by the patient and his physician, which states that the patient and his physician, which state that the patient has a terminal illness and does not wish to prolong life through resuscitation efforts (do not resuscitate)