Long Term Facility Case Study

Hello Dr. Ullom, majority of the long term care facilities are under staffed. There is usually one registered nurse in charge to manage a 240 bed facility, with LPN's  and nursing assistance. I feel that these patients would benefit from having one RN to every six -eight patients with a nursing assistance. Not only would this benefit the patient but the nurse as well. Patient are placed in long term care facility with a certain problem, but ends up with additional condition such as UTI, MRSA, pressure ulcers, and etc. These issues are related to poor care they receive because of unstaffing. I'm not placing blame on the LPN or nursing assistance, but with a RN and low nurse to patient ratio, they will receive better care.

A patient is admitted to your surgical center for minor surgery that involves a breast biopsy under local anesthesia. The surgeon has previously informed the patient of the surgery risks, options, desired outcomes, and possible complications. A staff member brings the surgical permit form to the patient for her signature. The patient readily states that she knows about the surgery and has no additional questions. She signs the form with no hesitation.

Roles of Administrator and Case Managers in this facility vs. roles of Administrator and Case Manager in other facilities

Long term care facilities use Joint Commission Accreditation as a benefit to show the quality and commitment to the health care organization. A long term care facility that is Joint Commission accredited will have a more appealing look to reimbursement centers and to the patient and families that they care for. Having this accreditation is also a risk management tool. The likelihood of a bad outcome is reduced if a facility is accredited by the Joint Commission. There is a team put together to come up with accreditation standards and to make sure facilities stay compliant with these standards. Performance is evaluated to ensure standards are followed.

Long term care (LTC) settings provide a vast variety of services that range from convalescent care, respite stays and skilled rehabilitation services which includes: skilled nursing, physical, occupational or speech therapy. LTC includes a broad spectrum of services that are designed to meet the varying needs of geriatric individuals and other adults with functional restrictions. The services rendered in this setting are designed to support individual needs from assistance with activities of daily living, medication management, cognitive and behavioral health support and limitations secondary to acute to chronic medical conditions. The care bestowed not only assists individuals with maintaining or improving their physical functioning, it

Boscart. V. M., Bowers, B., Brown, M., & McGilton, K.S. (2014). Making tradeoffs between the reasons to leave and reasons to stay employed in long-term care homes: Perspectives of licensed nursing staff. International Journal of Nursing Studies,51(6). 917-926.dpo:10/1016/j.ijnurstu.2013.10.015

Issues with long term care services include employee turnover, regulation, employee communication and especially payment for services. Legal concerns associated with long-term care are the rise of population who will eventually need it. The demand for long-term care services are going to explode as the population ages and more people are living longer with chronic conditions. But the main questions still remains, who will pay for these services and how will they be delivered? When I say this I’m referring to the actually facilities themselves, will there be space for patients when the time

I chose a learning plan topic that would increase my nursing practice competency as a senior nursing student, would be relevant to my placement setting, would build on my knowledge obtained from completing NSE417 – Nursing Practice IV class and NSE407 – Nursing: Professional Issues and Trends class, and was approved by my Primary Preceptor and Faculty Advisor (FA). With a global trend of an increasing senior population and having a placement in a nursing home, it was important to choose a learning plan that focused on the challenges and trends in senior safety. My Overarching goal for my learning plan was to expand my knowledge and critical thinking skills related to expertly assessing and managing elder frailty in a long-term care setting by Tuesday, March 1, 2016. By completing this learning plan, I have fulfilled and demonstrated the College of Nurses of Ontario (CNO)’s Continuing Competency Standard by performing a self-assessment of my knowledge, developing and implementing a learning plan, and evaluating the outcomes of the plan (CNO, 2002). Ultimately, the goal is to enhance geriatric care at my placement setting and advance my competency in delivering safe, ethical, competent client-centred care.

The character Dorothy said in The Wonderful Wizard of Oz, “there is no place like home” (Baum, 1960, p. 45). Sadly, many of our elderly live in Long Term Care Facilities (LTCF). The transition from living in their own homes, to living in a LTCF, can be a traumatic experience. Poor adaptation to a LTCF may cause depression, malnutrition and significantly reduce the lifespan of the elder. Thus, it is imperative, that nurse’s recognize this promptly.

The necessity for long-term care is increasing which will require additional training and education for health care personnel, family members, and patients. Family members can have peace of mind knowing their family member will gain confidence in learning how to become accustomed to his or her new life while maintaining a quality continuum of care during and after treatment for physical, mental, or age associated illnesses.

More than 5 million Americans currently have dementia in the United States and this number is projected to rise to between 8 and 13 million by 2050 (Alzheimer’s Association, 2015). Dementia is known to become more prevalent with age, increasing from 5 to 10 percent in people over 65 years of age to almost one half of people over the age of 85 (Alzheimer’s Association, 2015). Although family members provide the majority of care for people with dementia, increasing needs over time often lead to placement in a long-term care setting. Dementia is the most common reason for entry into long-term care facilities (Zimmerman, 2013) and nearly 90% of persons with dementia will have at least one stay at a nursing home in their lifetime (Grunier, 2007).

With today’s technology and the specialized skills of doctors, nurses, and therapists, patients who need long term care of acute problems can obtain these services at institutions known as postacute care providers. One type of facility that falls under this title is the Long Term Acute Care Hospital (LTACH) (Munoz-Price, 2009, p. 438). This paper will discuss services provided by LTACHs, the role of the Chief Nursing Officer (CNO) in these facilities, and Medicare reimbursement effected by patient satisfaction surveys.

The continuum of institutional long-term care is for patients whose needs are not adequately met in a more community-based setting. It is for individuals who need more dependency. There are two ends of the continuum of institutional long-term care spectrum. On the one end there are the individuals that may only need basic personal or custodial care (Shi & Singh, 2015, p. 399). An example of personal and custodial care can include help with walking, bladder training, or just helping with bathing. On the other end there are the individuals that may need more round the clock care with nursing or specialized services along with the basic needs (Shi & Singh, 2015, p. 399).

This paper will review the many aspects of long-term care problems and many challenges there are within Long-Term care. We will look at rising costs within long-Term Care, patient abuse, will look at the quality of life, shortages of nurses and demand that the elderly are putting on the medical field. The type of care that Long-Term Care had been giving to its patients and the changes within Long-Term Care.

Upon entering the facility as a new employee, new director, and new to long term care, each day is inundated with unfamiliar tasks, responsibilities, and knowledge base. Laziness and failure is a huge misconception of the nursing home staff. This is a very specialized area of nursing; as a matter of fact, instead of working a