Lesson 1: The Roles of the Various Disciplines within the Nursing Facility
Lesson 2: The Various Clinical Conditions, Including Alzheimer’s disease, of LTC Residents
Lesson 3: Resident Admission, Assessment and Medical Terminology
Lesson 1: The Roles of the Various Disciplines within the Nursing Facility
- Discuss the relationships among the Administrator,
The Medical Director, and the Director of Nursing in a nursing home
Nursing homes are not acute care facilities. However, responsibility regarding efficient patient care and safety is just as essential as acute care facilities because health care law enforcement do make nursing homes liable for negligence or malpractice. Consequently, a strong administrative structure is mandatory. Modern nursing homes administration consists of an administrator, medical director and director of nursing. Their and responsibilities are distinct yet they collaborate in enduring efficiency within the organization
A nursing home administrator‘s role encompasses supervision of staff, planning activities and programs for the organization; developing strategies for performance improvement, monitoring progress and disturbances as well as maintaining adequate care standards in every department in the organization. In order to function effectively there must be astute leadership skills; open communication and a very businesslike approach towards management of the facility. Importantly, this position is very demanding. As such, some administrators across the country ere targeted for poor management skills. Due to the high turnover in nursing homes it is very important that administrators keep abreast with changing and current trends in the nursing home business (Townshend & Davis, 2003).
The nursing home medical director functions as leader and manger, but in a different capacity from the nursing home administrator. According to Medicare regulations a physician serves as medical director in skills nursing facilities. He/she is responsible for all medical care executed within the facility. Passage of the Nursing Home Reform Act of 1987, AMDA subsequently in 1991 approved roles and responsibilities for nursing home medical directors (Townshend & Davis, 2003).
It specifically outlined four leadership roles inclusive of physician leadership whereby the physician is responsible for all care and clinical practice conducted in the facility. The second role relates to Patient Care-Clinical Leadership whereby the medical director is executes clinical and administrative strategies to guide the facility towards efficient evidenced based care practices. Role three embraces quality of care in relation to assisting the administrator and director of nursing in adhering to protocols that ensure patient safety and very high quality of care (Townshend & Davis, 2003).
He/she also helps the administrator assess and manage risks within the organization. Role four allows the nursing home medical director to take responsibility for educating staff, information dissemination and executing communication programs. This role may extend outside the boundaries of the facility into the community where it is located (Townshend & Davis, 2003).
Duties of a director of nursing include developing and implementing nursing policies and procedures with the underlying motive of ensuring securing patients’ safety by preventing accidents in the environment. Act as support for human resource in selecting the most appropriate nursing staff for employment. He/she is mainly responsible for managing nursing staff employed by the organization making sure that the skills needed for executing efficient nursing care are available and they are current (Townshend & Davis, 2003).
Nursing homes directors of nursing are expected to monitor nurses’ conduct and make recommendations for promotion or skills upgrade. In cases of litigations the director is expected to testify in court as a trial witness. Importantly, he/she has to be exceptionally knowledgeable about the facility’s accident risks and work closely with the nursing home medical director and administrator to resoles accident risks relation to both residents and staff. Along with these duties the nursing home director is required to regularly asses nursing care needs of each patient and adjust care plans according to current evaluations. These findings must be communicated to the physicians in a timely and professional manner (Townshend et.al, 2003).
In concluding this discussion concerning the relationships among the nursing home administrator, medical director, and the director of nursing it is clear that while the role are distinct and do not overlap they are supportive. Precisely, the medical director who is a qualified physician has four unique functions as leader/manager within the organization. They related significantly to professional education and clinical practice efficiency. The nursing home administrators’ role requirement manages of the entire organization’s physical structure as it relates to budget and financial stability. The nursing director is concerned with quality of patient care from the evidence based nursing perspective.
- Nursing home activities related to personal satisfaction, social contacts, creative expression, recreation, and/or spiritual gratification
Personal satisfaction activities.
Personal satisfaction actives are related to allowing residents to make up their beds; select linen that they prefer to be placed on their beds; arrange lockers, drawers and closets interact with other residents they feel comfortable relating to
Social contacts
Encourage visits from relatives/significant others; provide interaction with groups in the facility though playing of games such as cards, dominoes, bingo,
Creative expression
Residents are encouraged to engage in handicraft such as knitting, sewing; hat designing; coloring drawing and painting. Kills such as singing; speaking; playing musical instruments and reciting are explored and allowed full expression at concerts held in the facility.
Recreation
This takes the form of watching movies as a group; mild exercise programs; relocating to the activity room to see a show or listening to a performance and celebrating residents birthday with a cake gathering. Tours outside of the facility are conducted for residents who are more capable of mobility.
Spiritual gratification
Residents are allowed to practice their form of religious culture by either praying; signing or meditation. Religious organizations are encouraged to visit and render prayers for members who are residents of the nursing home.
Lesson 2: The Various Clinical Conditions, Including Alzheimer’s disease, of LTC Residents
My name is Nerisa. As far as I can remember I was born on the 5th of June 1934, which should make me about 79 years old and my sex they say is female. I live here in this nursing home for 5 years now because the doctors said that I was in the early stages. It is great that I can remember my date of birth, age, sex and where I am because many of my friends younger than me whom live here cannot remember what they ate this morning neither where they are. I was the principal of a High School in New Jersey for several years before moving into the position of District Superintendent.
I live here with friends who can help me remember a little longer. My children and grandchildren have their own lives and I do not want to impose on them since I have lived a great life with a wonderful careful. Here they label places so we cannot get lost. I am not there yet because I remember here I am and whose I am. I help out my friends who get lost and bring it to the attention of administration. You see I can still apply my management skills even though I was diagnosed. I do not know when they will find a cure for this disease. There are so many new diseases for which there are no cures. However, here is a great place. The people are adorable and staff always happy to help.
Three non- three non-Alzheimer’s dementia diseases.
Senile dementia
This conduction is a natural consequence of aging when neurons become worn and do not function as they were during youth. It is more or less classified as forgetfulness and difficulty in recalling recent facts, but person often remember stories from their youth or childhood accurately (Townshend et.al, 2003).
Frontotemporal lobar degenerations,
These occur mainly as two types aphasia syndromes affecting speech and the next produces behavior changes inclusive of personality dysfunctions; apathy, disturbances in planning and ability to become organized. This dementia occurs often after a stroke or diabetic hypoglycemic coma (Townshend et.al, 2003)
Vascular disorders dementia
These occur along with Lewy bodies, from hydrocephalus, Parkinson’s dementia being secondary to the dementia. In these cases disease process initiate the dementia unlike a stroke or coma and many patients were born with the brain irregularities. They occur in young people (Townshend et.al, 2003).
Lesson 3: Resident Admission, Assessment and Medical Terminology
- Explanation for why a nursing home administrator needs to understand the nuances of clinical care (terminology, practices, professional requirements, etc.).
The nursing home manager’s work environment is the nursing home and its nuances of clinical care are the substance of his/her management from a physical perspective. While it is not necessary for him/her to directly execute nursing care because the medical director and director of nursing roles’ are commissioned with specific responsibility for this task; however, at least basic nursing knowledge is essential, especially, when planning the budget.
If a directive is passed down from the medical director to purchase more beds since patient flow is increasing in the medical unit; as administrator he/she will have to clarify necessity of the cost before simply extending funds towards this expenditure. The hospital administrator will have to understand how increasing medical unit beds will bring more income or offset costs the organizations has to carry for the venture.
First medical unit patient requirements, compulsory expenditure will have to be calculated based on knowledge of health conditions of patients in this unit. As such, a nursing home administrator needs to understand the nuances of clinical care; terminology, practices, professional requirements for interpreting many decisions director of nursing and medical director make from time to time.
Definitions and example
a. Uniform Data Set is a system used for designed evaluating health care information within a specific health care setting. An example is the electronic health record system
b. ADL-Activities of daily living including bathing, eating and resting
c. Physical and Chemical Restraints devices used by nursing home facility administration for ensuring safety of disruptive residents. They include medication, bed rails and bed straps
d. Automatic Stop Order is used hen medications prescribed many become unnecessary in cases of pain or specific symptom that subsides such as fever.
e. Antipsychotic Drug a group of psychiatric medications used to manage psychosis e.g zyprexa
f. Specialized Rehabilitative Services used hen patients need additional rehabilitation services specific to their condition. For example, physical therapy; speech therapy
g. Nosocomial Infection is a hospital acquired infection or one the resident as not admitted with e.g urinary tract infection with indwelling catheter
h. Generic Drug is a drug that is comparable to a brand name such as pantoprazole and the generic being Prevacid, Inhibitol, Zoton; Monolitum or Helicid
Complete the following statements
a. Nursing hours per patient day are established by the _Medicaid_______________.
b. The person responsible for the implementation of resident care policies, as required by OBRA, is _Adminstrator__________________.
c. A licensed pharmacist must review the drug regimen of each resident at least ____Twice___________.
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d. An inactive medication having no physical healing effect is called impotent/expired drug_____________________.
e. A comprehensive assessment of a resident’s functional capacity begins with taking a history__________________________________.
References
Townshend, J. Davis, W., & Haacker, R. (2003). Principles of health care administration.
Publicare.
Abstract
This document contains responses for lessons one to three. They encompass analyses of roles pertaining to distinct disciplines within the nursing facility; various clinical conditions, including Alzheimer’s disease, of LTC residents and resident admission, assessment and medical terminology.
