Biology Forums - Study Force

Which option(s) reflect a scenario that violates the Nursing Home Reform Act of 1987? Choose all that are correct.
 
  1. The resident falls during a physical therapy session, despite being attended by two staff members.
   2. The nursing assistant is overheard telling a resident, If you don't eat, I won't take you down to play dominoes this afternoon.
   3. The nursing staff routinely leave doors open when getting residents up to bedside commodes.
   4. If a resident attempts to get out of bed, a soft vest restraint is applied.
   5. The patient is not consulted prior to a change in medical treatment.

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How does the need to assess resident/patient changes and potential problems differ between the long-term care facility and an acute care facility?
 
  1. They are the same.
   2. There is a need for greater assessment skills in acute care because patients are so sick.
   3. There is a need for greater assessment skills in long-term care because of the lack of direct physician contact with residents.
   4. There is a lesser need for good assessment in long-term care because the residents are old and just waiting to die.

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How has the decreased use of restraints affected fall rates in long-term care facilities?
 
  1. It has not changed.
   2. It has increased, but injuries have not.
   3. It has decreased.
   4. Both fall rates and injury rates have increased.

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The resident of a long-term care facility is unable to ambulate without maximal assistance. The patient is restless and frequently attempts to get out of bed. What is the appropriate nursing action?
 
  1. Use four-point restraints to prevent the resident from getting up alone.
   2. Use sedation to keep the resident from attempting to get up.
   3. Move the resident to a room near the nursing station for closer observation.
   4. Inform the family that they need to hire a sitter to keep the resident safe.

2, 3, 4, 5
Rationale: This act provides for the right to privacy, to participate in resident and family groups, freedom from physical restraints, and to self-determination, among other rights. A patient fall, when adequately attended, may occur without being abuse, mistreatment, or neglect.

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3
Rationale: While it is true that acute care patients are sicker, there is also availability of consults both with other nurses and with physicians. The long-term care nurse does not have ready consult available and the physician may not have as good a working knowledge of the resident. Nursing home residents are not just waiting to die.

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2
Rationale: In settings in which restraints are seldom used, rates of falls increase, but the incidence of long-term injuries has not changed, supporting interventions that avoid the use of restraints if possible.

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3
Rationale: Moving this resident to a room where closer observation is possible is the least restrictive approach to providing safe care. The second best option would be use of a sitter, but the nurse cannot shift all accountability for the resident's safety to that person.

I hope they're paying you for this lol