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Chapter 37,38,39

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Assisted Living

residential care setting where adult patients rent a small 1 bedroom & can receive personal care services like bathing, dressing, admin of meds

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Chapter 37,38,39 - Details



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Assisted Living
Residential care setting where adult patients rent a small 1 bedroom & can receive personal care services like bathing, dressing, admin of meds
Settings serve the older adult population & mentally or physically disabled person & offers a wide variety of services
Pallitiave care
Comfort care earlier in an illness or disease process (broader population for hospice
Adult Daycare
Services are community based programs, to meet the needs of functionally or cognitively impaired adults through supervised health care & social & recreational activities
Hospice care is provided for terminally ill patients as end of life approaches
Activities Of Daily Living (ADLs)
Daily routine of hygiene, dressing & grooming, toileting, eating and ambulation
Quality Of Life
An individual's overall well-being & feeling of physical, social, & spiritual happiness
Long- Term Care
Array of services an individual may find necessary to help in meeting various personal care needs
Diagnosis- Related Groups (DRGs)
This system is based major diagnostic categories & pays a set rate (according to diagnosis)
Home Health Care
Enables individuals of all ages to remain in the comfort & security of their home while recieving care
Telehealth Services
Allows for patients & care providers interactions & monitoring through the use of telephones, computers, televisions, and two way monitors
Restorative Nursing Care
Basic concepts of physical therapy for maintenance of functional mobility and physical activity
Minimum Data Set (MDS)
Provides a system for assessment of each resident's functional, medical, mental, & psychosocial status upon admission and after
Residential Assessment Instrument (RAI)
Comprehensive tool that includes the minimum data set, resident assent protocols & guidelines for functional assessment of residents
Functional Assessment
The assessment of functional status of the patient, which is the ability of individual to perform normal, expected, or required activities of daily living
Skilled Nursing Care
The provision of care by a team of trained and/ or licensed health care providers
Subacute Unit
Institutional setting that's less expensive than acute care; a bridge between acute care & long term care
Program pays for home care services to indigent & low income people of all ages
Instrumental Activities Of Daily Living (IADLs)
Complex daily tasks; shopping, using the phone, assistance with meds, tube feeding, oxygen therapy
A process where by a professional associate or nongovernment agency grants recognition to a school or institution for demonstrated ability in a special area of practice or training
Process in which an individual or institution, agency, or educational program is evaluated & recognized as meeting certain predetermined standards
Continuing Care Retirement Community (CCRC)
A complete range of housing & health care accommodations, from independent living to 24 hr nursing care (usually good health & need little assistance)
Is a federal program that requires agencies to be certified as meeting the federal conditions of participation ( 65 yrs or older, disabled, or have end stage renal disease & under the care of a licensed physician)
Omnibus Budget Reconciliation Act (OBRA 1987)
Obra defines requirements for the quality of care given to the residents & many aspects of the institution life ( nutrition, staffing, qualifications required of personnel e.t.c)
Any loss or abnormality of psychological, physical, or anatomic structure or function
The loss of ability to participate in one or more major life activities as a result of mental, emotional, or physical impairments
Functional Limitations
Any loss of ability to perform tasks or activities of daily living
Chronic Illness
A chronic illness generally refers to a condition or state that lasts for 3 moons or longer
An increase in the seriousness of a disease or disorder; marked by the greater intensity in the signs and symptoms being treated
Commission on Accredition of Rehabilitation Facilities
A nonprofit private, international standard-setting & accreditation body whose missions to promote & advocate
Comprehensive Rehab Plan
Care within 24 hours of admission & have it ready for review & revision by rehab team within 3 days of admission
Physicians specializing in physical medicine or rehab
Multidisciplinary Rehab Team
Discipline- specific goals, clear boundaries between discipline
Interdisciplinary Rehab Team
Identify individuals goals & features a combo of expanded problem solving beyond the boundaries of individual discipline
Transdisciplinary Rehab Team
A blurring of boundaries between discipline as well as cross-training & flexibility to minimize duplicate of effort toward individual goal attainment
Family-Centered Care
A philosophy that a recognizes the pivotal role of the family in the lives of children with disabilities or other chronic conditions
Posttraumatic Stress Disorder (PTSD)
Mental health condition related to the experiencing of or witnessing of traumatic even outside the normal range of human experience
Spinal Cord Injury (SCI)
An injury in which the spinal cord undergoes compression by fracture or displacement of vertebrae
Traumatic Brain Injury (TBI)
From mild concussion to more devastating kind that renders injured people comatose for the remainder of their lives
Pediatric Rehab Nursing
Is a specialty practice that also continues to expand within the field of rehab for children
Gerontologic Rehab Nursing
A specialty practice that focuses on the unique requirements of older adult rehab patients
What did community based care lead to?
Increased number of acutely ill patients and change in home health care.
What is needed for HMO ( insurance to cover home care)
Patient must be homebound meaning unable to travel or lots of effort to travel to and from appointments
What determines how often and how long home visits are?
Depending on the services need can be as often as twice daily or monthly
What does home health care preserve?
Individual independence, integrity, and keeps families together.
What are the different prospective view from home health?
Official comprehensive health care, Patient compassionate care, Family keeping families together, provider challenges all discipline involved to provide excellent care.
BBA 1977
Balanced Budget Act
Interim Payment System
What are agencies classified as?
Tax status (profit or non profit), Location (freestanding or institution), Governance ( private or public)
PICC line care?
Peripherally Inserted Central Catheter
What does the use of technology do?
Allows patient care outside of the traditional inpatient settings
What does the social worker do?
Provide assistance with patients emotional, financial, and household problems.
How does a social worker help nurses?
Social workers do more patient home needs and that allows the nurse more time to perform nursing interventions
What does pet care have to do with home health?
Provide pet care " Durable Power Of Attorney For Pet Care" (special pet services like transportation to the vet.
Total Parenteral Nutrition
What are three of the most common if IV therapy?
Antibiotics, Hydration, Total Parenteral Nutrition (TPN)
What has the list of IV meds grown to include?
Analgesics,Chemotherapeutic agents, Hormones, Antiemetic agents
What are some of the services Home Health offers to follow the basic Medicare services?
Skilled Nursing, Physical Therapy, Speech-language Therapy, Occupational Therapy, Medical Social Service, Home Health Aide
Who does the LVN/LPN provide care under?
A RN who is also responsible for the development of the care plan
What are four major goals of skilled nursing services?
Restorative: returning previous, Improvement: achieving better health, Maintenance: preserving current health, Promotion: teaching health and prevent recurring illness
What is crucial for nurses caring for patients in home health?
Reliability, communication, ongoing assessment and reinforcement of the care plan accepting different culture plans.
Who makes the initial admission and evaluation for home health after a referral?
The RN within 24-48 hours unless nursing care is not needed right away the physical therapist may do it
When is discharge and planning done?
Discharge for home care, as in hospitals, begin with admission when patient goals or other criteria are met the discharge begins
What are three major goals to improve quality in home health?
Structural: overall organization, Process: care delivery, Outcome: results of patient care
What is the standard of care for many illness?
Management and control rather than cure
What does acuity mean
How sick a patient is
When is there a need for long term care?
When a patient is not capable of meeting daily needs independently, perhaps because of a physical or psychological impairment
Culture is a system of what?
Values, beliefs, and practices that guides a persons behavior
Define Ethnicity?
Is a persons identification with a certain ethnic group ( based on shared traditions, physical characteristics, origin, language, religion and food
Who is majority of the elderly living at home?
Women because the age expectancy is higher for women then men
Program of All-Inclusive Care for the Elderly
Whats is Respite Care?
Rescue Care to give family members or caregivers a break
Who usually attends adult daycare?
Adults over 75 or disabled adults
National Center for Assisted Living
What does CCRC offer?
Apartments, townhomes, detached dwellings or a combination
What does the nursing interventions depend on in CCRC?
Functional abilities of the elder adult
What is the reward for nursing working long term care for CCRCs?
The opportunity of working with patients over a long time frame
Whats does a subacute unit mainly focus on?
Rehabilitation and shorter length of stay than long term care
Who does ICU care for?
Patients conditions who are so critical they would have not survived
What is some of the most common care in subacute care?
Physical rehab, Stroke rehab, wound care, Recovery from hip fracture
What does Long-Term care mostly provide?
24 hour care and usually to adults 65 or older
What are most common disorders or illness in long term care?
Cardiovascular disease, Hypertension, Depression, Dementia, Type 2 diabetes
What are some other reasons other than illness why an older adult might enter long term care?
Cognitive impairment, incontinence, assistance with ADLs, Alzheimer's, safety
Interdisciplinary Care Planning
Omnibus Budget Reconciliation Act
What's the window for legal administration for meds in longterm care?
2 hours: 1 hour before scheduled time or 1 hour after scheduled time
What does restorative nursing assistance forces on?
Basic concepts of physical therapy to maintain functional mobility and physical activity
Health Care Financing Administration
What are some positive outcomes of OBRA?
Empowerments of residents, reduce or eliminate restraints, improve staffing
How did the OBRA law effect nursing?
Expand the role of LVN/LPN and required facilities to use greater numbers of licensed nursing staff
What does MDS provide?
A system for assessment of residents functional, medical, mental, psychological status upon admission and after
What are RAPS?
Assessment guides that are address common clinical problems such as delirium, falls and urinary incontinence