1.03 presentation

102
Understand Understand residents’ residents’ rights rights , advocacy, and , advocacy, and grievance procedures. grievance procedures. Unit A Nurse Aide Workplace Fundamentals Essential Standard 1.00 Understand the range of function, legal and ethical responsibilities of the nurse aide within the healthcare system. Indicator 1.03 Understand residents’ rights, advocacy, and grievance procedures. 1 1.03 Nursing Fundamentals

Transcript of 1.03 presentation

Understand Understand residents’ residents’ rightsrights, advocacy, and , advocacy, and grievance procedures. grievance procedures.

Unit A Nurse Aide Workplace FundamentalsEssential Standard 1.00 Understand the range of function, legal and ethical responsibilities of the nurse aide within the healthcare system. Indicator 1.03 Understand residents’ rights, advocacy, and grievance procedures.

11.03 Nursing Fundamentals

Residents’ RightsResidents’ Rights

Nursing Fundamentals 7243 21.03

Nursing Fundamentals 7243 3

Basic Human RightsBasic Human Rights

– Protected by ConstitutionProtected by Constitution– Laws clarify these rights:Laws clarify these rights:

• Right to be treated with Right to be treated with respectrespect• Right to live in Right to live in dignitydignity• Right to Right to pursue a meaningful lifepursue a meaningful life• Right to be Right to be free of fearfree of fear

1.03

Nursing Fundamentals 72434

Basic Human RightsBasic Human Rights

Behaviors that infringe on human Behaviors that infringe on human rights:rights:

• addressing residents as childrenaddressing residents as children• using demeaning nicknames for using demeaning nicknames for

residentsresidents• leaving door open during bathleaving door open during bath• threatening a resident with harmthreatening a resident with harm

1.03

Nursing Fundamentals 7243 5

• Ethical and legal basisEthical and legal basis• States have adopted or States have adopted or

codified these rights into lawcodified these rights into law• Posted in facilityPosted in facility• Distributed on admission in Distributed on admission in

many facilitiesmany facilities

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 6

Residents have the right to:Residents have the right to:

1.1.Be treated with Be treated with consideration, respect, consideration, respect, and full recognition of and full recognition of personal dignity.personal dignity.

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 7

Residents have the right to:Residents have the right to:

2.2.receive care, treatment, receive care, treatment, and services which are and services which are adequate and in adequate and in compliance with rulescompliance with rules

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 8

Residents have the right to:Residents have the right to:

3.3.receive a statement of receive a statement of services and chargesservices and charges

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 9

Residents have the right to:Residents have the right to:

4.4.have on file the attending have on file the attending physician’s proposed physician’s proposed schedule of medical schedule of medical treatment.treatment.

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 10

Residents have the right to:Residents have the right to:

5.5.privacyprivacy

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 11

Residents have the right to:Residents have the right to:

6.6.Be free from mental and Be free from mental and physical abuse, and free physical abuse, and free from restraint (except in an from restraint (except in an emergency)emergency)

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 12

Residents have the right to:Residents have the right to:

7.7.receive reasonable receive reasonable response to all requestsresponse to all requests

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 13

Residents have the right to:Residents have the right to:

8.8.associate and associate and communicate privatelycommunicate privately

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 14

Residents have the right to:Residents have the right to:

9.9.manage financial affairsmanage financial affairs

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 15

Residents have the right to:Residents have the right to:

10.10.private visits from private visits from spousespouse

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 16

Residents have the right to:Residents have the right to:

11.11.privacy in the resident privacy in the resident room. Personal items room. Personal items should not be searched.should not be searched.

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 17

Residents have the right to:Residents have the right to:

12.12.present grievances and present grievances and recommend changesrecommend changes

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 18

Residents have the right Residents have the right NOTNOT to: to:

13.13.perform services for the perform services for the facilityfacility

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 19

Residents have the right to:Residents have the right to:

14.14.retain, store, and use retain, store, and use personal clothing and personal clothing and possessionspossessions

OBRA 1987 Residents’ Bill of Rights

1.03

1.03 Nursing Fundamentals 7243 20

Nursing Fundamentals 7243 21

Residents have the right to:Residents have the right to:

16.16.be notified if the facility be notified if the facility is given a provisional is given a provisional licenselicense

OBRA 1987 Residents’ Bill of Rights

1.03

Nursing Fundamentals 7243 22

Behaviors That Uphold Residents’ Rights

• Address as Mr., Mrs., or Miss unless Address as Mr., Mrs., or Miss unless asked to use a specific nameasked to use a specific name

• Never withhold social responsivenessNever withhold social responsiveness• Never ignore residentsNever ignore residents• Make eye contactMake eye contact

1.03

Nursing Fundamentals 7243 23

Behaviors That UpholdBehaviors That UpholdResidents’ RightsResidents’ Rights

–Make eye contactMake eye contact–Allow to complete sentences prior to Allow to complete sentences prior to

leaving roomleaving room–Don’t shut or slam door to quiet Don’t shut or slam door to quiet

residentresident–Never threaten or intentionally hurtNever threaten or intentionally hurt

1.03

Nursing Fundamentals 7243 24

Behaviors That UpholdBehaviors That UpholdResidents’ RightsResidents’ Rights

• Encourage socialization (meal-time)Encourage socialization (meal-time)• Assist to activities/meetings/churchAssist to activities/meetings/church• Participate in planned activitiesParticipate in planned activities• Help with phone calls, cards, mailHelp with phone calls, cards, mail

1.03

Nursing Fundamentals 7243 25

Behaviors That Uphold Behaviors That Uphold Residents’ RightsResidents’ Rights

• Explain care you plan to give Explain care you plan to give • Observe safety precautionsObserve safety precautions• Obtain proper consent after identifying Obtain proper consent after identifying

residentresident

1.03

1.03 Nursing Fundamentals 7243 26

1.03 Nursing Fundamentals 7243 27

Nursing Fundamentals 7243 28

Behaviors That Uphold Behaviors That Uphold Residents’ RightsResidents’ Rights

• Sit when feeding a residentSit when feeding a resident• Offer a clothing protector; do NOT Offer a clothing protector; do NOT

automatically place clothing protector automatically place clothing protector on the resident prior to eatingon the resident prior to eating

• Give resident centered, not task Give resident centered, not task centered carecentered care

1.03

Nursing Fundamentals 7243 29

Behaviors That Uphold Behaviors That Uphold Residents’ RightsResidents’ Rights

• Address resident in a dignified wayAddress resident in a dignified way• Listen to what resident has to sayListen to what resident has to say• Converse with resident in an adult Converse with resident in an adult

mannermanner• Respect resident’s privacyRespect resident’s privacy

1.03

Nursing Fundamentals 7243 30

Behaviors That Uphold Behaviors That Uphold Residents’ RightsResidents’ Rights

• Adult residents must be treated as adults. Give age appropriate Adult residents must be treated as adults. Give age appropriate care.care.

• Age-appropriate considerations:Age-appropriate considerations:– Style of dressStyle of dress– Hair style and groomingHair style and grooming– Recreational activitiesRecreational activities– Social activitiesSocial activities

1.03

Nursing Fundamentals 7243 31

Age Appropriate CareAge Appropriate CareGuidelinesGuidelines

• Don’t ignore or humor residentDon’t ignore or humor resident• Explain what care you are going to giveExplain what care you are going to give• Promote resident independencePromote resident independence• Treat resident as you would want to be Treat resident as you would want to be

treated treated

1.03

Nursing Fundamentals 7243 32

Age Appropriate CareAge Appropriate CareGuidelinesGuidelines

Encourage resident to make choices:Encourage resident to make choices:•select clothing to wearselect clothing to wear•select books to readselect books to read•select television programs to watchselect television programs to watch

1.03

Nursing Fundamentals 7243 33

Age Appropriate CareAge Appropriate CareGuidelinesGuidelines

Encourage resident to make choices:Encourage resident to make choices:•select food and nourishmentsselect food and nourishments•select activities of interestselect activities of interest•select friendsselect friends

1.03

Nursing Fundamentals 7243 34

Age Appropriate CareAge Appropriate CareGuidelinesGuidelines

• Recognize value of past experience Recognize value of past experience (validate the resident)(validate the resident)

• Praise age appropriate accomplishmentsPraise age appropriate accomplishments• Encourage adult behaviorEncourage adult behavior

1.03

Nursing Fundamentals 7243 35

Right to be Free from Right to be Free from RestraintRestraint

• Under Under OOmnibus mnibus BBudget udget RReconciliation econciliation AAct 1987 ct 1987 (OBRA)(OBRA), ,

• residents have a right to be free residents have a right to be free from restraints. from restraints.

1.03

Resident RestraintsResident Restraints

Nursing Fundamentals 7243 361.03

Nursing Fundamentals 7243 37

Facts Regarding RestraintsFacts Regarding Restraints

RESTRAINTSRESTRAINTSrestrict restrict

voluntary movement voluntary movement or behavioror behavior

CHEMICALCHEMICAL PHYSICALPHYSICAL

1.03

Nursing Fundamentals 7243 38

Facts Regarding RestraintsFacts Regarding Restraints

Physical RestraintsPhysical Restraints

also known as • postural supportspostural supports

• protective devicesprotective devices1.03

Nursing Fundamentals 7243 39

Facts Regarding RestraintsFacts Regarding Restraints

1.03

Restraint:Restraint:

Any manual method, physical or Any manual method, physical or mechanical device, material, or mechanical device, material, or

equipment attached or next to the equipment attached or next to the resident’s body that the individual resident’s body that the individual

cannot remove easily, which restricts cannot remove easily, which restricts freedom of movement or normal freedom of movement or normal

access to one’s bodyaccess to one’s body

Nursing Fundamentals 7243 40

Facts Regarding RestraintsFacts Regarding Restraints

IN THE PAST!IN THE PAST!

• Restraints commonly used to Restraints commonly used to safeguard residents who wander, safeguard residents who wander, prone to falls, are violet, at risk of prone to falls, are violet, at risk of hurting themselves, or pulling tubes hurting themselves, or pulling tubes outout

• Abuse of restraints led to new Abuse of restraints led to new restrictions and laws on use of restrictions and laws on use of restraintsrestraints

1.03

Nursing Fundamentals 7243 41

Facts Regarding RestraintsFacts Regarding Restraints

1.03

Tucking in top Tucking in top sheetsheet so tightly so tightly that resident that resident cannot movecannot move

NEVERNEVER

Nursing Fundamentals 7243 42

Facts Regarding RestraintsFacts Regarding Restraints

1.03

Placing wheelchair Placing wheelchair so close to a wall so close to a wall that the wall that the wall prevents resident prevents resident from getting out from getting out of chairof chair

Nursing Fundamentals 7243 43

Facts Regarding RestraintsFacts Regarding Restraints

1.03

Pulling up full Pulling up full side rails to side rails to prevent patient prevent patient from voluntarily from voluntarily getting out of getting out of bedbed

Nursing Fundamentals 7243 44

Facts Regarding RestraintsFacts Regarding Restraints

1.03

Restraints MUST Restraints MUST not be usednot be usedfor conveniencefor convenienceor discipline or discipline

Nursing Fundamentals 7243 45

Facts Regarding RestraintsFacts Regarding Restraints

1.03

Unnecessary use of restraint is Unnecessary use of restraint is

FALSE FALSE

IMPRISONMENTIMPRISONMENT

Nursing Fundamentals 7243 46

Facts Regarding RestraintsFacts Regarding Restraints

1.03

Acceptable Reasons for Use of Restraints: Acceptable Reasons for Use of Restraints:

Temporarily for life threatening medical Temporarily for life threatening medical conditionsconditions

Brief periods to allow medical treatment Brief periods to allow medical treatment to proceed if there is documented to proceed if there is documented evidence of resident or legal approval of evidence of resident or legal approval of treatmenttreatment

Nursing Fundamentals 7243 47

Facts Regarding RestraintsFacts Regarding Restraints

1.03

Acceptable Reasons for Use of Restraints Acceptable Reasons for Use of Restraints When alternatives to restraints are not When alternatives to restraints are not effective, however, and the physician effective, however, and the physician orders restraints, it becomes essential for orders restraints, it becomes essential for the nurse aide to know the risks involved the nurse aide to know the risks involved in caring for these residents.in caring for these residents.

Nursing Fundamentals 7243 48

Facts Regarding RestraintsFacts Regarding Restraints

1.03

Types of acceptable physical restraints if Types of acceptable physical restraints if ordered appropriatelyordered appropriately

•Side rails on a bedSide rails on a bed

• Special chairs such as geriatric chairsSpecial chairs such as geriatric chairs

• Lap cushions or lap trayLap cushions or lap tray

• Vests and jacket restraintsVests and jacket restraints

• Safety belt restraintsSafety belt restraints

• Soft ties for wrist and anklesSoft ties for wrist and ankles

Nursing Fundamentals 7243 49

Facts Regarding RestraintsFacts Regarding Restraints

1.03

Restraint-free facility:Restraint-free facility:

Restraints are not used for Restraints are not used for any reason and not kept in any reason and not kept in the facilitythe facility

Restraint AlternativesRestraint Alternatives

Nursing Fundamentals 7243 501.03

Nursing Fundamentals 7243 51

Restraint AlternativesRestraint Alternatives

1.03

Restraint alternative:Restraint alternative:

Interventions used instead of Interventions used instead of using restraintsusing restraints

Nursing Fundamentals 7243 52

Restraint AlternativesRestraint Alternatives

Using friends, family, volunteers or resident directed care provider

1.03

Nursing Fundamentals 7243 53

Restraint AlternativesRestraint Alternatives

Interesting activities and diversions Interesting activities and diversions such as games, movies or music such as games, movies or music distract residentsdistract residents

1.03

Nursing Fundamentals 7243 54

Restraint AlternativesRestraint Alternatives

Answering call signal promptlyAnswering call signal promptly

1.03

Nursing Fundamentals 7243 55

Restraint AlternativesRestraint Alternatives

Exercise and outdoor activitiesExercise and outdoor activities

1.03

Nursing Fundamentals 7243 56

Restraint AlternativesRestraint Alternatives

Consistent reality orientation or Consistent reality orientation or validation and staff assignmentsvalidation and staff assignments

1.03

Nursing Fundamentals 7243 58

Restraint AlternativesRestraint Alternatives

Barriers such as STOP SIGNS Barriers such as STOP SIGNS posted on doors discourages posted on doors discourages confused residents from confused residents from wandering into the areawandering into the area

1.03

Nursing Fundamentals 7243 59

Restraint AlternativesRestraint Alternatives

PartialPartial bed rails prevent residents bed rails prevent residents from rolling out of bed while from rolling out of bed while allowing them freedom to get up allowing them freedom to get up if they wish toif they wish to

1.03

Nursing Fundamentals 7243 60

Restraint AlternativesRestraint Alternatives

Positioning devices and wedges such as Positioning devices and wedges such as wedge cushions placed in wheelchairs wedge cushions placed in wheelchairs to prevent forward slidingto prevent forward sliding

1.03

Nursing Fundamentals 7243 61

Restraint AlternativesRestraint Alternatives

Furniture such as low beds, rocking chairs, or recliners

1.03

Nursing Fundamentals 7243 62

Restraint AlternativesRestraint Alternatives

Easy –release belts reminds Easy –release belts reminds resident of safety but the resident resident of safety but the resident can release if desiredcan release if desired

1.03

Nursing Fundamentals 7243 63

Restraint AlternativesRestraint Alternatives

Floor cushion or pads next to the Floor cushion or pads next to the bed – decreases injuries if a bed – decreases injuries if a resident does fall when getting resident does fall when getting out of bedout of bed

1.03

Nursing Fundamentals 7243 64

Restraint AlternativesRestraint Alternatives

Electronic warning devices on beds, Electronic warning devices on beds, wheelchairs, and doors alert staff if wheelchairs, and doors alert staff if patient gets up without help*patient gets up without help*

1.03

1.03 Nursing Fundamentals 7243 65

SKILLSKILL 1.03A1.03AApply Personal Electronic Apply Personal Electronic

Warning DeviceWarning Device

Training Lab AssignmentTraining Lab AssignmentEngage in the Skill Acquisition Process for:Engage in the Skill Acquisition Process for:

Nursing Fundamentals 7243 66

The Last Resort!The Last Resort!

Occasionally, alternatives do not work and restraints are ordered.

1.03

Nursing Fundamentals 7243 67

Using RestraintsUsing RestraintsOrdered by the physician…Ordered by the physician…• when necessary to treat a medical when necessary to treat a medical symptom or provide emergency symptom or provide emergency medical treatmentmedical treatment• choice of restraint based on choice of restraint based on multidisciplinary evaluation for the multidisciplinary evaluation for the least restrictive measureleast restrictive measure

1.03

Nursing Fundamentals 7243 68

Using RestraintsUsing Restraints

Safety Measures Safety Measures and Considerations and Considerations

When When APPLYINGAPPLYING RestraintsRestraints

1.03

Nursing Fundamentals 7243 69

Using RestraintsUsing RestraintsSafety measures and Considerations APPLYING Restraints:

•Use reassurance in an attempt to Use reassurance in an attempt to calm agitated residentscalm agitated residents

1.03

Nursing Fundamentals 7243 70

Using RestraintsUsing RestraintsSafety measures and Considerations APPLYING Restraints:

Be sure there is a physician’s Be sure there is a physician’s order for restraint use and that it is order for restraint use and that it is in the care plan before applying in the care plan before applying restraintrestraint

1.03

Nursing Fundamentals 7243 71

Using RestraintsUsing RestraintsSafety measures and Considerations APPLYING Restraints:

Use the correct type of restraint and Use the correct type of restraint and apply according to manufacturer’s apply according to manufacturer’s directions and only after you have directions and only after you have received instructions in its usereceived instructions in its use

1.03

Nursing Fundamentals 7243 72

Using RestraintsUsing RestraintsSafety measures and Considerations APPLYING Restraints:

Secure enough assistance to apply Secure enough assistance to apply restraints quickly to avoid injuryrestraints quickly to avoid injury

1.03

Nursing Fundamentals 7243 73

Using RestraintsUsing RestraintsSafety measures and Considerations APPLYING Restraints:

Attach restraints to bed frame Attach restraints to bed frame (immovable part of bed), not to (immovable part of bed), not to side rails or other parts of the bedside rails or other parts of the bed

Leave an 8 inch tailLeave an 8 inch tail

1.03

Nursing Fundamentals 7243 74

Using RestraintsUsing RestraintsSafety measures and Considerations APPLYING Restraints:

Use slip knot to tie restraint for Use slip knot to tie restraint for quick releasequick release

1.03

Nursing Fundamentals 7243 75

Using RestraintsUsing RestraintsSafety measures and Considerations APPLYING Restraints:

Protect bony areas and skin by Protect bony areas and skin by padding them prior to applying padding them prior to applying restraintrestraint

1.03

Nursing Fundamentals 7243 76

Using RestraintsUsing RestraintsSafety measures and Considerations APPLYING Restraints:

Adjust restraint so that it allows Adjust restraint so that it allows some movement, but is secure some movement, but is secure and comfortable – place open and comfortable – place open flat hand between the resident flat hand between the resident and the restraint for restraints and the restraint for restraints around the torso.around the torso.

1.03

Nursing Fundamentals 7243 77

Using RestraintsUsing RestraintsSafety measures and Considerations APPLYING Restraints:

Make sure breasts or Make sure breasts or skin are not caught in skin are not caught in the restraint.the restraint.

1.03

Nursing Fundamentals 7243 78

Using RestraintsUsing Restraints

Safety Measures Safety Measures and Considerations and Considerations AFTERAFTER Restraints Restraints

are appliedare applied

1.03

Nursing Fundamentals 7243 79

Using RestraintsUsing RestraintsSafety measures and Considerations AFTER Applying Restraints:

Be sure resident Be sure resident NEEDS are METNEEDS are MET

1.03

Nursing Fundamentals 7243 80

Using RestraintsUsing RestraintsSafety measures and Considerations AFTER Applying Restraints:

Special attention must be paid Special attention must be paid to basic needsto basic needs

• Elimination- Elimination- assist in assist in toiletingtoileting

• Hydration – Hydration – offer fluidsoffer fluids

1.03

Nursing Fundamentals 7243 81

Using RestraintsUsing RestraintsSafety measures and Considerations AFTER Applying Restraints:

Call signal must be in reach and the resident’s signal for help must be answered immediately (STAT)

1.03

Nursing Fundamentals 7243 82

Using RestraintsUsing RestraintsSafety measures and Considerations AFTER Applying Restraints:

Check on resident Check on resident

every 15 minutesevery 15 minutes

1.03

Nursing Fundamentals 7243 83

Using RestraintsUsing RestraintsSafety measures and Considerations AFTER Applying Restraints:

Every 15 minutes:Every 15 minutes:

Pulse, color, and temperature Pulse, color, and temperature of any restrained extremityof any restrained extremity

1.03

Nursing Fundamentals 7243 84

Using RestraintsUsing Restraints

Safety measures and Considerations AFTER Applying Restraints:

Every 15 minutes:Every 15 minutes:

Breathing of resident with Breathing of resident with vest (torso) restraintvest (torso) restraint

1.03

Nursing Fundamentals 7243 85

Using RestraintsUsing RestraintsSafety measures and Considerations AFTER Applying Restraints:

Every 2 hours:Every 2 hours:

Remove restraint for 10 Remove restraint for 10 minutes and reposition residentminutes and reposition resident

1.03

Nursing Fundamentals 7243 86

Using RestraintsUsing RestraintsSafety measures and Considerations AFTER Applying Restraints:

In an emergency, notify supervisor immediately via call bell, stay with the resident, and loosen restraint.

1.03

Nursing Fundamentals 7243 87

Using RestraintsUsing RestraintsEMERGENCY EXAMPLES:EMERGENCY EXAMPLES:

•Unable to detect a pulse in extremityUnable to detect a pulse in extremity

•Extremity cold, pale, blue-tinged, gray, red, Extremity cold, pale, blue-tinged, gray, red, purple in colorpurple in color

•Resident complains of pain, discomfort, Resident complains of pain, discomfort, numbness, or tingling in restrained partnumbness, or tingling in restrained part

•Breathing is impaired with vest or safety belt Breathing is impaired with vest or safety belt restraintrestraint

•URGENT!!! TAKE ACTIONURGENT!!! TAKE ACTION1.03

Nursing Fundamentals 7243 88

Using RestraintsUsing RestraintsObservations and reporting should Observations and reporting should include:include:

• Color and condition of skin under Color and condition of skin under restraintrestraint

• Pulse rate, color and temperature of Pulse rate, color and temperature of skin in restrained extremityskin in restrained extremity

1.03

Nursing Fundamentals 7243 89

Using RestraintsUsing RestraintsObservations and reporting should Observations and reporting should include include (continued):(continued):

• Any complaints about restrained partAny complaints about restrained part• Red or injured skin areas under Red or injured skin areas under

restraintrestraint• Respiratory rate and color of skin with Respiratory rate and color of skin with

vest and safety belt restraintsvest and safety belt restraints

1.03

1.03 Nursing Fundamentals 7243 90

SKILLSKILL 1.03B1.03BApply RestraintsApply Restraints

Training Lab AssignmentTraining Lab AssignmentEngage in the Skill Acquisition Process for:Engage in the Skill Acquisition Process for:

Resident AdvocatesResident Advocates

Nursing Fundamentals 7243 911.03

Nursing Fundamentals 7243 92

Resident AdvocatesResident Advocates

1.03

What does an advocate do?What does an advocate do?•Plead cause of anotherPlead cause of another•Resolve grievancesResolve grievances•Protect resident’s rightsProtect resident’s rights

Nursing Fundamentals 7243 93

Resident AdvocatesResident Advocates

1.03

Advocates can be:Advocates can be:• You and your co-workersYou and your co-workers• Member of resident’s Member of resident’s

family/support systemfamily/support system• Resident’s guardianResident’s guardian• OmbudsmanOmbudsman

Nursing Fundamentals 7243 94

Resident AdvocatesResident Advocates

1.03

Ombudsman Program - History The national network of long term care ombudsman programs was established in response to the many problems found in nursing homes. The program was first introduced in 1971 as part of President Nixon’s eight-point plan to improve nursing home conditions. This plan established several demonstration ombudsman projects, funded and supervised in the beginning through the U.S. Public Health Service.

In 1973, administration responsibility for these projects was transferred within the Department of Health, Education and Welfare to the Administration on Aging, within the Office of Human Development Services. By 1975, all state agencies on aging were invited to submit proposals to promote effective statewide ombudsman programs. Money was then made available for this voluntary state program.

The Long Term Care Ombudsman Program has been in existence in North Carolina since 1976.

A favorable response to the ombudsman program led to its formal adoption in the 1978 Amendments to the Older Americans Act. The Older Americans Act (federal law) requires that each state establish and maintain a Long Term Care Ombudsman Program to advocate on behalf of residents in nursing and adult care homes (rest homes, assisted living). In 1989, the North Carolina General Assembly enacted legislation for the Long Term Care Ombudsman Program (G.S. 143B-181.15-25) which incorporated federal mandates in the Older Americans Act for the Program and clearly define the roles and responsibilities of the state and regional long term care ombudsmen. In North Carolina, the State Long Term Care Ombudsman Program is located in the Department of Health and Human Services, Division of Aging and Adult Services. The Regional Long Term Care Ombudsman Programs are housed in the 17 Area Agencies on Aging. Last updated June 2, 2010 LTC Ombudsman Program

Nursing Fundamentals 7243 951.03

Nursing Fundamentals 7243 96

Resident Right to Resident Right to Voice GrievancesVoice Grievances

1.03

• Regarding services furnishedRegarding services furnished• Regarding services not furnishedRegarding services not furnished• With respect to behavior of othersWith respect to behavior of others• Nurse aide must report grievances to Nurse aide must report grievances to

supervisorsupervisor

Nursing Fundamentals 7243 97

Facility policy components for resident grievance

1.03

1.1. AcknowledgmentAcknowledgment2.2. Prompt attempt to resolvePrompt attempt to resolve3.3. Resident kept apprisedResident kept apprised

Nursing Fundamentals 7243 98

Resident Council: Advisory Group

1.03

Nursing Fundamentals 7243 99

Resident Council: Advisory Group

1.03

Provides opportunity for discussionProvides opportunity for discussionRecommendations may be made for:Recommendations may be made for:

• Facility policiesFacility policies• Decisions regarding activitiesDecisions regarding activities• Exploration of concernsExploration of concerns• Resolving grievances Resolving grievances

Nursing Fundamentals 7243 100

Resident Council: Advisory Group

1.03

• Gives residents a voice in facility Gives residents a voice in facility operationsoperations

• MembersMembers– residentsresidents– facility staff members to include facility staff members to include

Nurse AidesNurse Aides– representatives from communityrepresentatives from community

The Bottom Line

Nursing Fundamentals 7243 1013.01

Resident has a right to voice grievances without fear of retaliation or discrimination!

Understand Understand resident’s rightsresident’s rights, , advocacy, and grievance procedures. advocacy, and grievance procedures.

102

ENDEND 1.031.03

1.03 Nursing Fundamentals