A long term care admission or baseline nursing care plan must be as comprehensive as possible. A head to toe assessment is the only way to make sure the gathering of information is complete.
This begins with the first interaction between the nurse and the resident. It is about seeing, hearing, and touching – Looking at the resident, talking to the resident, and using palpation when needed.
Long term care facilities must develop and implement a baseline care plan for each resident within 48 hours of admission.
The guidelines state the 48 hour baseline care plan must include “the instructions needed to provide effective and person-centered care of the resident that meet professional standards of quality care,” including, but not limited to: initial goals based on admission orders, physician orders, dietary orders, therapy services, social services, and PASARR recommendation, if applicable.
According to the regulations, facilities may develop a comprehensive care plan in place of the baseline care plan if the comprehensive care plan meets all of the requirements for the baseline care plan outlined in the surveyor guidelines.
In order to assure all of the requirements of the guidelines are met, LTCS Books recommends that the facility develops and implements a comprehensive care plan within 48 hours of admission.
Enhanced barrier precautions (EBP) are now required by CMS for residents with chronic wounds or indwelling medical devices during high-contact resident care activities regardless of their multi drug-resistant organism (MRDO) status.
The new guidelines list the specific chronic wounds and high-contact resident care activities.
Required Measures for EBP are: Gloves and gown prior to the high-contact care activity, change PPE before caring for another resident, face protection if performing activity with risk of splash or spray.
The LTCS book Infection Control Program for Long Term Care has been updated to reflect the new guidelines.