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Long Term Care Books

Nursing Care Plans for Long Term Care
Restorative Nursing Care Plans
Care Area Assessment
Director of Nursing Book
Long Term Care Forms
Activities Care Plans
Infection Control for Long Term Care
Long Term Care Inservices
MDS Coordinator Book
Social Service Care Plans
Nursing Policy Long Term Care
Quality Assurance for Long Term Care

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Nursing Care Plan Conference

The entire nursing care plan team, members from the Nursing, Social Services, Activities, Dietary, and Restorative departments participate in writing nursing care plans for residents.

The MDS Coordinator writes the nursing care plans, leads the nursing care plan meeting, and oversees participation from the other long term care facility departments: Social Services – Behavior, Mood, and Cognitive care plans; Dietary – Nutrition, Dehydration, and Tube Feeding care plans; Activities – Activity care plan; Restorative Nursing – care plans on any Restorative Nursing programs such as Ambulation, Range of Motion, and training in improving ADLs.

A productive nursing care plan meeting has input from each department and team discussion of the resident’s needs. Issues related to Late-loss ADLs, Falls, Restraints, Skin breakdown, Psychotropic medications, and Weight loss are discussed, and effective interventions are implemented and documented.

Compliance with Pressure Ulcer Guidelines

Posted by LTCS on May 16, 2012

Assess skin on day one of admission, and immediately implement care planning for any resident at risk for pressure ulcer.

Correctly identify the type and stage of pressure ulcer, and describe well.

Include repositioning and nutritional interventions in care planning.

Track the healing progress of pressure ulcers, and alter the nursing care plans and treatment when needed.

Implement facility forms and policies to assure comprehensive documentation and monitoring of skin status.

Write care plans interventions for residents who need cues, reminders, and teaching on repositioning.

The surveyor guidelines refer to several clinical resources for recognized standards of practice for the prevention and management of pressure ulcers.

Read more about skin care assessment and treatment.

Compliance with Pressure Ulcer Guidelines

Coding Section E of the MDS 3.0

Posted by LTCS on May 16, 2012

The intent of section E is to assess the presence and frequency of behavioral symptoms and their impact on the resident and others, and to assess the presence of psychosis.

Verbal and physical behaviors are examined as well as their impact on the resident and others.

Social Service care plans and Nursing care plans that may be triggered from section E include:

Abusive, Physically

Abusive, Verbally

Hoards Objects

Refuses to Eat / Drink

Resists Care

Socially Inappropriate Behavior

Wandering

Withdrawal from Care / Activities

Read more about section E of the MDS 3.0, significant changes, care area assessments, quality indicators, RUG IV categories, and skilled charting.

Section E Behavior of the MDS 3.0

Spotlight on the National Council on Aging

Posted by LTCS on May 16, 2012

Founded in 1950, The National Council on Aging (NCOA) is a nonprofit organization with the goal of providing a voice for older Americans. They also work to bring together nonprofit organizations, businesses, and government agencies concerned with senior issues.

NCOA’s Stated Social Impact Goals for 2020

Improve the health of 4 million older adults with multiple serious health problems through participation in cost-effective evidence-based programs.

Make self-care an integral part of U.S. health care for people with multiple chronic conditions.

Improve the financial well-being of 5 million low-income and vulnerable older adults by providing comprehensive, integrated services that significantly increase their income and/or reduce their expenses.

Strengthen and protect major public programs (especially Medicare, Medicaid, Social Security, and the Older Americans Act) for disadvantaged and vulnerable older adults.

NCOA sites include Benefits Checkup, Home Equity Advisor, and the Center for Healthy Aging.

NCOA National Council on Aging

Defining and Reporting Abuse

Posted by LTCS on May 9, 2012

Considering the amount of turnover in long term care staffing and the level of caregiver stress, being vigilant for signs of resident abuse is vital.

Careful hiring and screening practices will help protect residents.

Educating staff members is also an essential part of prevention.

Abuse is defined as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish.

Federal and state regulations are very specific about the facility’s responsibility in preventing, investigating, and reporting abuse.

These include policies and procedures for: Screening potential employees. (Reference checks from past or current employers, Checks with licensing boards and registries, Criminal background checks)

Defining and Reporting Abuse

Read more about topics of interest to the DON in long term care in the book Director of Nursing Book and int the book Nursing Policy for Long Term Care.

Find more resources for Nursing Assistant training in the book Long Term Care Inservices.

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Nursing Care Plans

Nursing care plans are blueprints for residents’ entire care needs, and direct the actions of all health care team members. Written nursing care plans are usually arranged into the three parts of Care Plan Problem, Care Plan Goal, and Care PlanInterventions.

Nursing care plan problem statements are traditionally based on a nursing diagnosis. The nursing diagnosis is a problem that nurses can identify and treat. Medical diagnoses can be part of the nursing care plan problem statement, but not the actual problem itself. The most commonly used nursing diagnoses are the ones approved by NANDA, the North American Nursing Diagnosis Association, and are grouped by functional health patterns.

The nursing care plan goal can be to prevent a potential problem from occurring, to maintain a present status or level of functional ability, or to resolve a currently existing problem. Goals are usually stated in terms of an action the resident will perform.

Nursing care plan interventions describe specific actions taken by the staff to achieve the stated goal, and are based on standards of clinical practice. Like the goals of nursing care plans , interventions need to be specific, measurable, appropriate, and realistic. Interventions are worded in terms of what the staff will do to assist the resident to meet the stated goals for the problem.

Evaluation of nursing care plans is an ongoing activity that examines the problem itself, the goals, and the interventions to determine if they are still applicable or if changes to the care plan need to be made.

Read more about how to write nursing care plans in any of our nursing care plan books or on the care plan consult page.

Information on International Orders, Billing to Facility, and Volume Discounts

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