According to the Nursing Home Reform Act of 1987, nursing homes are required to meet or exceed a number of standards in order to receive funding from government organizations. Each state may have additional care guidelines that must be met as well. It is important to always research nursing homes before placing a loved one in their care, because even if standards are in place, quality nursing care is not always guaranteed.
Personal Care Plan
Nursing homes are required by law to accommodate the needs of each individual patient. Personal care plans may include important nursing needs, dietary requirements, medications and special physical or emotional concerns. In addition, the plan may include prescribed therapy, orders from the doctor and individual toileting and hygiene orders. Nursing home staff and the family of the patient meet regularly to update the plan to accommodate necessary changes.
Staff
Nursing homes must strive to maintain a sufficient number of certified nursing assistants and licensed nurses to accommodate the number of patients in the facility. Homes must clearly post the current number of nursing staff directly in charge of patient care. If staff shortages occur, they must be quickly resolved in order to provide optimal care for the patients in the facility.
Infection Control
By law, nursing homes must have a plan for prevention of the spread of disease or illness, and infection control. Frequent hand washing must be practiced and for those working directly with patients, hands must be washed between caring for each patient in order to prevent the spread of infection. Nursing homes must also report any cases of communicable diseases to local and state health authorities and all staff must be tested for tuberculosis.
Medications
Because many nursing home residents require medications to maintain their health or treat illness, nursing staff are required to follow the physician's orders noted for the ordering and administration of medications to each patient noted in the personal care plan. Nurses must keep a detailed log of when each medication is given, changes in doctor's orders, and refill requirements, along with noting any refusal to take medications.
Food and Nutrition
Each nursing home resident must be offered nourishing foods each day that meet individual dietary requirements and nutritional needs. Nursing homes must serve a minimum of three meals a day at regular intervals with a time span not to exceed 14 hours between breakfast and the evening meal. Snacks must be offered at bedtime unless physician's orders state differently. All food served must meet proper temperature requirements at all times.
Toileting and Incontinence
Nursing home residents are often unable to control their bladders and sometimes bowel functions due to certain medical conditions. Nursing home staff must remind and assist incontinent residents in using the toilet at regular times and as needed. When accidents occur, it is required that residents be cleaned promptly to control odor, infection, and to avoid embarrassment of the resident.
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