General Knowledge
Prior to a resident going on a LOA or when sending a resident to the hospital, these 2 forms need to be completed and included in your documentation.
What is bed hold and ombudsman form
Standard precautions apply to these individuals.
What is all residents regardless of diagnosis?
When administering a narcotic medication to a resident, you should make sure you document in the narcotic book at this time.
What is immediately upon removing the medication from the cart.
This must be performed before and after every resident during med pass.
What is hand hygiene?
During survey, if you don't know an answer, the best response is to do this.
What is say "I am not sure, but will find out and get back to you"
A resident on your shift begins to develop a cough and is c/o a headache. You should do this important step to prevent the spread of infection.
What is start the resident on quarantine droplet/contact precautions?
Weekly skin documentation must include updates on existing wounds, not just this phrase.
What is “no new skin issues/conditions”?
This task needs to be completed prior to leaving the medication cart
What is lock the medication cart and hide the screen?
Any significant change in a resident’s condition must be documented and followed by this required action.
What is notification of the provider and/or family?
A resident develops a new onset of diarrhea on your shift. To prevent the spread of infection you should do this.
What is start the resident on contact precautions?
If you have a question on what should be included in documentation, information can be found in the area of the facility.
What is the documentation expectations book in every nursing office on every household.
With the exception of oral medications, all medications and treatments must be administered in this type of location.
What is a private area
This action should be completed if you notice a tear in a bubble of the narcotic card.
Compare the pill with the description of the pill on the medication card. Two nurses should then destroy the medication. It is never acceptable to tape in medications in ANY card - this can lead to medication errors and narcotic diversion.
Enhanced barrier precautions are used to prevent the spread of this.
What are MDROs?
pain location, pain rating, pain description, what caused the pain/when did it start, what has helped ease the pain in the past, what non-pharm interventions were offered prior to the medication.
This task needs to be completed after completion of steroid nebulizer and inhaler medication.
What is have the resident rinse and spit their mouth?
Name the action steps you should take when you find a resident has fallen on the floor.
Assess the resident (vitals, neuros, injury, etc), interventions as needed, interview resident (ask what they were doing), assist back to bed or wheelchair if safe, update family, update physician, chart
This is the single most important way to prevent the spread of infection
What is hand hygiene?
Foul smelling or cloudy urine is not a valid indication for initiating antibiotics. This clinical guideline helps determine when it is appropriate to start antibiotics for suspected urinary tract infections in long-term care residents.
What is Loeb criteria. Will also accept the following symptoms:
NO indwelling catheter:
• Acute dysuria
or
• Fever (>37.9oC [100oF] or a 1.5oC [2.4oF] increase above baseline temperature)
and at least one of the following:New or worsening:
• Urgency
• Frequency
• Suprapubic pain
• Gross hematuria
• Costovertebral angle tenderness • Urinary incontinence
WITH indwelling catheter (Foley or suprapubic):
• At least one of the following:
• Fever (>37.9oC [100oF] or a 1.5oC [2.4oF] increase above baseline temperature)
• New costovertebral tenderness
• Rigors
• New onset of delirium
Failing to perform this step on multi-dose vials and liquids can lead to use beyond safe timeframes and increased risk of contamination.
What is not labeling/open dating medications