Hospitals and Nursing Centers



Hospitals and Nursing Centers



Key Abbreviations


ALR Assisted living residence


DON Director of nursing


HMO Health maintenance organization


LPN Licensed practical nurse


LVN Licensed vocational nurse


PPO Preferred provider organization


RN Registered nurse


SNF Skilled nursing facility



Objectives



• Define the key terms and key abbreviations listed in this chapter.


• Describe hospitals and long-term care centers.


• Describe the persons cared for in long-term care centers.


• Describe the members of the health team and nursing team.


• Describe 5 nursing care patterns.


• Describe the programs that pay for health care.


• Explain your role in meeting standards.


• Explain how to promote PRIDE in the person, the family, and yourself.



Key Terms













Hospitals and long-term care centers provide health care. Staff members use their knowledge and skills to meet the person’s needs. The person is always the focus of care.



Hospitals


Hospitals provide emergency care, surgery, nursing care, x-ray procedures and treatments, and laboratory testing. They also provide respiratory, physical, occupational, speech, and other therapies.


People of all ages need hospital care. They have babies, surgery, physical and mental health disorders, and broken bones. Some people need hospital care when dying.


Persons cared for in hospitals are called patients. Hospital patients have acute, chronic, or terminal illnesses.




Long-Term Care Centers


Some persons cannot care for themselves at home but do not need hospital care. Long-term care centers are designed to meet their needs. Care needs range from simple to complex. Medical, nursing, dietary, recreation, rehabilitation, and social services are provided.


Persons in long-term care centers are called residents. They are not patients. This is because the center is their temporary or permanent home.


Most residents are older. They may have chronic diseases, poor nutrition, memory problems, or poor health. Not all residents are old. Some are disabled from birth defects, accidents, or disease. Hospital patients are often discharged while still recovering from illness or surgery. Some residents recover and return home. Others need nursing care until death.


Long-term care centers meet the needs of:



• Alert, oriented persons. They know who they are, where they are, the year, and the time of day. They have physical problems. Disability level affects the care required. Some require complete care. Others need help with daily activities.


• Confused and disoriented persons. They are mildly to severely confused and disoriented. Some cannot remember names or dates. Others do not know who or where they are. They cannot dress or feed themselves. Sometimes the problem is short-term. Some persons have Alzheimer’s disease and other dementias. Confusion and disorientation are permanent and become worse (Chapter 30).


• Persons needing complete care. They are very disabled, confused, or disoriented. They cannot meet any of their own needs. Some cannot say what they need or want.


• Short-term residents. These people need to recover from illness, surgery, fractures, and other injuries. Often they are younger than most residents. They usually recover and return home.


• Persons needing respite care. Some people cared for at home go to nursing centers for short stays. This is respite care. Respite means rest or relief. The caregiver can take a trip, tend to business, or simply rest. Respite care may be from a few days to several weeks.


• Life-long residents. Birth defects and childhood injuries and diseases can cause disabilities. A disability occurring before 22 years of age is called a developmental disability. It may be a physical impairment, intellectual impairment, or both. The person has limited function in at least 3 of these areas: self-care, understanding or expressing language, learning, mobility, or self-direction. The person needs life-long assistance, support, and special devices. Some nursing centers admit developmentally disabled children and adults.


• Residents who are mentally ill. Behavior and function are affected. In severe cases, self-care and independent living are impaired. Some persons also have physical illnesses.


• Terminally ill persons. Some are alert and oriented. If in a coma (Chapter 6), they cannot respond to what people say to them. But they may still feel pain. Terminally ill persons may need hospice care. The goal is quality end-of-life care for persons who are dying.




Assisted Living Residences


An assisted living residence (ALR) provides housing, personal care, support services, health care, and social activities in a home-like setting for persons needing help with daily activities. ALR residents may need help with taking drugs and with bathing, dressing, elimination, and eating. Many have problems with thinking, reasoning, and judgment.


Mobility is often required. The person walks or uses a wheelchair or motor scooter. The person is able to leave the building in an emergency. Stable health also is required. The person needs limited health care or treatment.


A home-like, secure setting is provided. Residents have 24-hour supervision and 3 meals a day. They have laundry, housekeeping, transportation, social, recreational, and some health services. Services are added or reduced as the person’s needs change.


Some ALRs are part of nursing centers or retirement communities. Others are separate facilities. ALRs must follow state laws and rules.



Nursing Centers


A nursing center (nursing facility, nursing home) provides health care services to persons who need regular or continuous care. Licensed nurses are required. Medical, nursing, dietary, recreation, rehabilitation, and social services are provided.


Skilled nursing facilities (SNFs) provide complex care for severe health problems. They are part of hospitals or nursing centers. SNF residents need time to recover or rehabilitation. Others never go home.


Some nursing centers and hospitals provide subacute care. Subacute care is complex medical care or rehabilitation when hospital care is no longer needed. Often called patients, they may have nervous system injuries, bone or joint surgeries or injuries, or wounds that are not healing. Short stays are common.


The Omnibus Budget Reconciliation Act of 1987 and “Residents’ Rights” are discussed in Chapter 2.




Alzheimer’s Units (Dementia Care Units)


An Alzheimer’s unit is designed for persons with Alzheimer’s disease and other dementias (Chapter 30). Such persons suffer increasing memory loss and confusion. Over time, they cannot tend to simple personal needs. Often they wander and may become agitated and combative. The unit is usually closed off from other parts of the center. The closed unit provides a safe setting where residents can wander freely.



Organization


A hospital has a governing body called the board of trustees or board of directors. The board makes policies. It makes sure that safe care is given at the lowest possible cost. Local, state, and federal laws are followed.


An administrator manages the agency. He or she reports directly to the board. Directors or department heads manage certain areas (Fig. 1-1).


image
FIGURE 1-1 Sample organizational chart of the nursing department.
(LPN—licensed practical nurse; LVN—licensed vocational nurse; RN—registered nurse.)

Nursing centers are usually owned by an individual or a corporation. Some are owned by county or state health departments. The U.S. Department of Veterans Affairs (Veterans Administration; VA) also has nursing centers.


Each center has an administrator. Department directors report to the administrator. Nursing centers have nursing, therapy, and food service departments. They also have social service, activity, and other departments.


Hospitals, nursing centers, and other health care agencies must follow local, state, and federal laws and rules. This is to ensure safe care.



The Health Team


The health team (interdisciplinary health care team) involves the many health care workers whose skills and knowledge focus on the person’s total care. Some members of the health team are described in Table 1-1, p. 4. The goal is to provide quality care. The person is the focus of care.



TABLE 1-1


Health Team Members
































































Title Description
Activities director Assesses, plans, and implements recreational needs.
Audiologist Tests hearing; prescribes hearing aids; works with persons who are hard-of-hearing.
Cleric (clergyman; clergywoman) Assists with spiritual needs.
Clinical nurse specialist Provides nursing care and consults in a nursing specialty. Geriatrics, critical care, diabetes, rehabilitation, and wound care are examples.
Dietitian and nutritionist Assesses and plans for nutritional needs; teaches good nutrition, food selection, and preparation.
Licensed practical/vocational nurse (LPN/LVN) Provides direct nursing care, including giving drugs, under the direction of an RN.
Medical or clinical laboratory technician Collects specimens and performs laboratory tests on blood, urine, and other body fluids, secretions, and excretions.
Medication assistant-certified (MA-C) Gives drugs as allowed by state law under the supervision of a licensed nurse.
Nurse practitioner Plans and provides care with the health team; does physical exams, health assessments, and health education.
Nursing assistant Assists nurses and gives care; supervised by a licensed nurse.
Occupational therapist registered (OTR) Assists persons to learn or retain skills needed to perform daily activities; designs adaptive equipment for daily living.
Physical therapist (PT) Assists persons with musculo-skeletal problems to restore function and prevent disability.
Physician (doctor) Diagnoses and treats diseases and injuries.
Podiatrist Prevents, diagnoses, and treats foot disorders.
Radiographer/radiologic technologist Takes x-rays; processes film for viewing.
Registered nurse (RN) Assesses, makes nursing diagnoses, plans, implements, and evaluates nursing care; supervises LPNs/LVNs and nursing assistants.
Respiratory therapist (RT) Assists in treating lung and heart disorders; gives respiratory treatments and therapies.
Social worker Deals with social, emotional, and environmental issues affecting illness and recovery; coordinates community agencies to assist patients, residents, and families.
Speech-language pathologist Evaluates speech and language and treats persons with speech, voice, hearing, communication, and swallowing disorders.

Modified from Bureau of Labor Statistics, U.S. Department of Labor: Occupational outlook handbook, 2012-2013 edition.

Related posts:

  1. Assisting With End-of-Life Care
  2. Assisting With Fall Prevention
  3. Assisting With Safety
  4. Assisting With Exercise and Activity

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Nov 5, 2016 | Posted by in MEDICAL ASSISSTANT | Comments Off on Hospitals and Nursing Centers

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