LONG TERM CARE AND SUB-ACUTE REHABILITATION

Ashley Benjamin, RN

INTRODUCTION¢ Ashley Benjamin, RN

¢ Staff Development Coordinator and Assistant Director of Nursing at Holt Senior Care and Rehab Center

¢ Additional Information:� Member of the National Association of Directors of

Nursing (NADONA)� Capital Area Health Alliance (CAHA)� Capital Area Community Nursing Network (CACNN)� Certified CNA Train-the-Trainer

BRIEF OVERVIEW OF THE LONG TERMCARE AND SUB-ACUTE REHAB FIELD

¢ LONG TERM CARE� The patients are usually referred to as residents due to the fact

that they reside in the facility as their home.¢ SUB-ACUTE REHAB NURSING CARE

� Depending on the specific facility, the patients are usually referred to as residents, guests, clients, etc. due to the fact that the facility is their temporary home.

� Sub-Acute Rehab length of stay is resident-specific based on their nursing needs, therapy goals, discharge setting requirements, etc.

¢ ASSOCIATIONS THAT SUPPORT SPECIFICALLY THE LONG TERM CARE AND SUB-ACUTE REHAB SETTING� Healthcare Association of Michigan (HCAM)

� American Healthcare Association (AHCA)

� National Association of Directors of Nursing Association (NADONA)

ROLE AND STRUCTURE OF NURSING

¢ QUALITY CARE MEASURES AND EVIDENCED BASED PRACTICE

¢ THE GOVERNING AGENCIES¢ The Regulatory body of the State of Michigan¢ Centers for Medicare and Medicaid Services (CMS)¢ Occupational Safety Health Administration (OSHA)¢ Food and Drug Administration (FDA)¢ Center for Disease Control (CDC)¢ State surveyors have oversight and perform annual surveys

¢ 5-STAR RATING ¢ SUB-ACUTE REHAB UNIT AND LONG TERM CARE

UNITS HAVE A VARIETY OF DIFFERENT PRIMARY DIAGNOSES AND MEDICAL COMORBIDITIES

¢ REHAB NURSING CARE SPECIALIZES IN WOUND CARE AND HEALING BUT MANAGES AN IMMENSE DIVERSITY OF RESIDENT CONDITIONS

¢ SPECIFIED LONG TERM CARE UNIT FOR DEMENTIA-FOCUSED CARE

VAST VARIETY OF DISEASE MANAGEMENTINCLUDING BUT NOT LIMITED TO:

� Orthopedic � Cardiovascular � Respiratory� Diabetes � Oncology � Neurology� Skin/ Wound� Pain Management� Palliative Care � Infectious Diseases

THE ROLE OF THE NURSEIN LONG TERM CARE

¢ Medication Administration and Management¢ EMR¢ Post–Acute Rehab ¢ Wound Care & Vacs¢ Pain Management ¢ EKG Machine Use ¢ PICC Lines and Ports¢ IVs¢ TPN¢ Bladder Scanner Use¢ Tracheostomy Care

THE ROLE OF THE NURSEIN LONG TERM CARE CONTINUED

¢ Physical Assessment¢ Documentation¢ Partnership and Communication with

Attending Physicians¢ Laboratory and Radiology Interpretation¢ Infection Control and Prevention¢ Leadership, Management, and Coaching of Staff¢ Responder for Critical Resident Situations such

as Cardiac Arrest, Respiratory Distress, Choking, etc.

¢ Collaboration with Specialized Services such as Dialysis, Cardiologists, Infectious Disease, etc.

NURSING COLLABORATION ANDINTERDISCIPLINARY TEAM APPROACH

¢ THERAPY SERVICES� PHYSICAL THERAPY� OCCUPATIONAL THERAPY� SPEECH LANGUAGE PATHOLOGY

¢ SOCIAL WORK¢ DIETARY SUPPORT¢ LIFE ENRICHMENT

NEW NURSE MENTORSHIP ANDON-BOARDING

¢ General Orientation¢ CNA Orientation with Nurse Participation¢ Nurse Classroom Orientation¢ Floor Training With Preceptor(s)¢ Follow-Up Classroom Orientation¢ Performance Competency¢ Continued One-on-One Meetings¢ Support of Fellow Staff Including the Entire Nurse

Management Team¢ Routine/Ongoing Staff Meetings and Educational

Sessions¢ Competency-Based Learning

WHY I CHOSE LONG TERM CARE AND SUB-ACUTE REHAB

¢ ONGOING RELATIONSHIP BUILDING WITH THE RESIDENTS AND FAMILIES¢ IN SUB-ACUTE REHAB, RESIDENT PROGRESS AND SUCCESSFUL OUTCOMES ARE OFTEN

OBSERVED FROM THE START TO FINISH OF A REHAB STAY¢ LONG TERM CARE OFTEN ALLOWS FOR THE DEVELOPMENT OF A CLOSE BOND WITH

THOSE THAT ARE CARED FOR DURING THEIR FINAL JOURNEY¢ COMMUNITY INVOLVEMENT¢ QUANTITY OF EMPLOYEES IS OFTEN LESS THAN SOME COMPARATIVE NURSING

WORKPLACES WHICH PROMOTES A “FAMILY FEEL” AND UNITY ¢ EMPLOYEE RECOGNITION¢ DIVERSE SKILL FAMILIARITY AND ROUTINE USE¢ NURSING AUTONOMY

ADVANTAGES OF LONG TERM CARE AND SUB-ACUTE REHAB

¢ ADMINISTRATION TEAM AND EMPLOYEES HAVE A PERSONAL RELATIONSHIP AMONGST EACH OTHER

¢ STAFF FEEDBACK AND IDEAS ARE SIGNIFICANT ¢ OPPORTUNITY FOR STAFF-FOCUSED EVENTS¢ TEAMWORK AND UNITY¢ ENHANCED COMMUNICATION¢ VARYING SHIFT OPPORTUNITIES¢ OPPORTUNITY FOR GROWTH AND CAREER ADVANCEMENT¢ INDIVIDUALIZED AND SMALL GROUP EDUCATION¢ ENCOURAGEMENT OF CONTINUED EDUCATION (BOTH

FORMAL EDUCATION AND CEUs)¢ TUITION REIMBURSEMENT ¢ STUDENT LOAN FORGIVENESS¢ CONTINUITY OF RESIDENT CARE¢ RESIDENT SATISFACTION AND POSITIVE OUTCOMES¢ DIRECT AFFECT IN THE LIVES OF THOSE SERVED

QUESTIONS?