Lesson

Kitchen Etiquettes

Medication Management

• Identify the right resident.
• Verify the right medication.
• Verify the indication for use.
• Make sure it’s the right time.
• Check the right route.

• Secure keys: Always keep the keys to medication storage in your possession. Avoid leaving them inside drawers or easily accessible areas.
• Lock medication storage: Ensure that the medication cabinet or storage area is locked at all times when not in use. This prevents unauthorized access and safeguards the medications.
• Safeguard access codes: Properly secure access codes for medication boxes with combination locks. Unauthorized personnel should not have access to these codes to prevent medication misuse or theft.
• Double lock Narc box: Store narcotics or controlled substances separately in a dedicated Narc box. Implement an additional lock or mechanism to provide double locking protection.
• Restrict resident access: Residents should not have access to medication storage or be provided with access codes. This helps maintain the security and integrity of the medications and prevents any potential risks or misuse.

• Practice hand hygiene: Before administering any medication, ensure to wash your hands thoroughly or use hand sanitizer to maintain proper hygiene.
• Provide water for the resident: Offer water to the resident when administering medication, ensuring they have an adequate supply to take their medication comfortably.
• Verify medications with eMAR: Always compare the medication you are administering with the information on the electronic Medication Administration Record (eMAR) to avoid any assumptions and ensure accuracy.
• Promptly document medication administration: Chart the medication administration on the appropriate documentation system immediately after administering the medication.
• Check extra medication box for missing meds: If a medication is not found in the designated storage, check the extra medication box. If it is still unavailable, contact the pharmacy (phone number provided on the wall) for further assistance.
• Request refills for low quantity PRN meds: When the quantity of “as needed” (PRN) medications reaches five or fewer pills, contact the pharmacy to request a refill.
• Transfer medication storage keys to incoming staff: When you finish your shift, ensure that you pass on the keys to the medication storage area to the incoming staff member to maintain proper accountability and security.
• Avoid popping pills into the medication box: Refrain from pre-loading or popping out pills into the medication box in advance to ensure accurate administration and prevent medication errors.
• Observe medication intake by the resident: Ensure that the resident takes their medication while you are present, and do not leave medication unattended on the table to minimize the risk of missed doses or errors.
• Seek guidance from the registered nurse if uncertain: If you have any doubts or concerns about medication administration, always seek guidance from the registered nurse to ensure the safety and well-being of the resident.

TB Isolation and Reporting

Here are some important points regarding TB isolation and reporting:

1. Testing for TB: Timely and accurate testing for TB is crucial for identifying infected individuals and initiating appropriate treatment. Regular screening and testing help protect both individuals and the community.
2. Report to the Nurse: If you observe signs and symptoms of TB in someone, it is important to report it promptly to the nurse or healthcare provider. They can take appropriate measures to evaluate the individual and initiate the necessary interventions.
3. Signs and Symptoms of TB: Common signs and symptoms of TB include persistent coughing, especially if accompanied by coughing up blood (hemoptysis), prolonged fever, fatigue, weight loss, night sweats, and chest pain. These symptoms can indicate active TB disease and require medical evaluation.
4. Isolation Precautions: Individuals with suspected or confirmed active TB should be placed in appropriate isolation rooms specifically designed for airborne precautions. These rooms help contain the airborne infectious particles and prevent transmission to others in the healthcare setting.
5. Follow Infection Control Measures: Healthcare providers should adhere to strict infection control measures when caring for individuals with TB. This includes using personal protective equipment (PPE), such as N95 respirators, gloves, gowns, and eye protection, to minimize the risk of exposure.

By promptly reporting suspected cases of TB and following proper isolation precautions and infection control measures, healthcare providers can effectively protect both themselves and other patients from the transmission of TB.

Blood Spill Cleanup

Here are the steps to take when dealing with a blood spill:

1. Clean According to Policy: Follow the established policy and procedures of your healthcare facility or organization for cleaning up blood spills. Adherence to proper protocols is essential to maintain a safe environment.
2. Treat All Blood as Contaminated: Assume that all blood is potentially contaminated with infectious agents. Handle it with caution and use appropriate protective measures.
3. Use Personal Protective Equipment (PPE): Wear the necessary PPE, such as gloves, protective eyewear, and a gown, to protect yourself from direct contact with the blood and minimize the risk of exposure.
4. Use EPA-Approved Disinfectant: Use an Environmental Protection Agency (EPA)-approved disinfectant specifically designed for bloodborne pathogens. Follow the manufacturer’s instructions on dilution ratios and contact time to effectively disinfect the affected area.
5. Dispose in a Leakproof Container: Collect any contaminated materials, such as used cleaning materials or absorbent materials used for containing the spill, in a leakproof biohazard bag or container. Dispose of it according to local regulations and facility policies for the disposal of biohazardous waste.

Surfaces and Equipment

Here are some important guidelines to follow regarding surfaces and equipment:

1. Clean Between Use and People: Surfaces and equipment should be cleaned thoroughly between each use and between different individuals. This helps remove dirt, debris, and potential contaminants.
2. Use Disposable Items If Infection is Known: Whenever possible, disposable items such as needles, lancets, razors, and scalpels should be used, especially when there is a known infection. This reduces the risk of cross-contamination between individuals.
3. Disinfect After Each Use: After cleaning, surfaces and equipment should be properly disinfected to kill any remaining microorganisms. Use an appropriate disinfectant solution recommended for healthcare settings and follow the manufacturer’s instructions for effective disinfection.
4. Needle, Lancet, Razor, Scalpel Safety: Sharps, such as needles, lancets, razors, and scalpels, should be handled with extreme caution to prevent accidental needlestick injuries or cuts. Proper disposal in puncture-resistant containers specifically designed for sharps is essential to ensure safety.
5. Regular Maintenance and Inspections: Equipment should be regularly inspected, maintained, and serviced to ensure proper functioning and cleanliness. Follow manufacturer guidelines for maintenance and cleaning protocols.

Airborne Precautions

Here are some key points to understand about airborne precautions:

• Infectious agents such as Mycobacterium tuberculosis, varicella-zoster virus (chickenpox), and measles are known to spread through airborne transmission.
• Airborne infectious agents are typically small and can remain suspended in the air for extended periods, making them capable of being inhaled by others.
• Special isolation rooms, often referred to as negative pressure rooms, are used for patients requiring airborne precautions. These rooms are designed to prevent the contaminated air from spreading to other areas of the healthcare facility.
• Hospitalization is often necessary for patients requiring airborne precautions to ensure appropriate isolation and containment of the infectious agent.
• Healthcare providers and visitors entering the airborne isolation room should follow specific precautions, including wearing respiratory protection (such as N95 respirators) and other personal protective equipment (PPE) to minimize the risk of exposure.

Contact Precautions

Here are some key points to consider regarding contact precautions:

• Infectious agents like Methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C. diff), and Norovirus require contact precautions due to their ability to spread through direct contact with infected individuals or contaminated surfaces.
• To break the chain of infection, it is essential to use gowns and gloves when encountering individuals or environments that may be contaminated.
• Gowns serve as a barrier, covering both the healthcare worker’s clothing and preventing direct contact with infectious agents.
• Gloves act as a protective barrier for the hands, preventing the transmission of microorganisms from contaminated surfaces or infected individuals.
• Properly covering hands and clothing with gloves and gowns helps prevent the spread of infectious agents and protects both healthcare workers and patients.

Droplet Precautions

Here are some important points to remember regarding droplet precautions:

• Infectious agents, such as those causing whooping cough, pertussis, COVID-19, influenza, and meningitis, can spread in small droplets produced when an infected person coughs, sneezes, talks, or breathes.
• It is crucial to use a mask, particularly a surgical mask, to prevent the inhalation of respiratory droplets containing infectious agents.
• When in public or in situations where there is a risk of exposure, it is important to refrain from close contact with others to minimize the spread of droplet-borne infections.
• Avoid sharing equipment, such as utensils, drinking glasses, or personal items, as they can serve as vehicles for transmission.
• Handle linens and other potentially contaminated materials with care, following proper infection control guidelines, to prevent the spread of infectious agents.

Gowns, Masks and Eyes Protection

Gowns:

Gowns are worn for specific purposes to provide protection for both the wearer and others. Here are some key points regarding the use of gowns:

• Gowns should be worn only once and disposed of properly after use.
• They protect not only the wearer’s arms and uniform but also prevent the transfer of infectious agents to other surfaces or individuals.
• Gowns are particularly important when there is a risk of contact with blood, body fluids, or other potentially infectious materials.
• They act as a barrier against respiratory droplets and can help prevent the transmission of infectious agents present in human saliva.
• If you are in close proximity to someone who coughs or sneezes, wearing a gown can shield you from any potential sprays or droplets.
• It is recommended to wear gowns when providing care or having close contact with individuals who are suspected or confirmed to have an infectious condition.

Masks:

Masks are essential in preventing the spread of respiratory droplets and protecting both the wearer and others. Here are diverse types of masks and their purposes:

• Surgical Masks: These masks protect the wearer’s nose and mouth from large respiratory droplets, splashes, or sprays. They are also effective in preventing the wearer from spreading respiratory secretions to others.
• N95 Respirators: These masks offer a higher level of filtration and are designed to provide a tight facial seal. They are particularly effective in filtering out small airborne particles, including certain infectious agents. N95 respirators are commonly used by healthcare workers in high-risk situations.

Eye Protection:

Eye protection, such as goggles or face shields, is important in preventing the transmission of infectious agents through the eyes. Here’s why eye protection is crucial:

• Infectious agents can enter the body through the mucous membranes of the eyes.
• Goggles or face shields create a physical barrier, preventing respiratory droplets or other infectious materials from reaching the eyes.
• Eye protection is especially recommended in situations where there is a substantial risk of exposure to respiratory droplets, such as during close contact or when performing procedures that generate aerosols.

Correct Technique for Applying Gloves

Here’s a step-by-step guide on how to apply gloves:

1. Perform hand hygiene by washing your hands thoroughly with soap and water or using an alcohol-based hand sanitizer.
2. Take one glove and slide your non-dominant hand into it, ensuring that your fingers are fully inserted.
3. With the gloved hand, grasp the cuff of the second glove and carefully slide your opposite hand into it. Avoid touching the exterior of the gloves with bare skin.
4. Interlace your fingers and adjust the gloves to ensure a snug fit without restricting movement or causing discomfort.
5. Inspect both gloves for any tears, holes, or other signs of damage. If any defects are detected, replace the gloves with a new pair.
6. Remember, gloves are not a substitute for hand hygiene. It’s important to wash your hands thoroughly with soap and water after removing the gloves to further reduce the risk of contamination.

Hand Hygiene Guidelines

Here are some key moments when hand hygiene is recommended:

1. Before touching your face, especially your eyes, nose, or mouth.
2. Before applying lip gloss, makeup, or any facial products.
3. After using the restroom, including both urinal and toilet use.
4. Before and after eating meals or handling food.
5. After cleaning activities, such as wiping surfaces or handling cleaning chemicals.
6. Before putting on gloves, such as when providing medical care or handling hazardous substances.
7. After removing gloves to avoid cross-contamination.
8. After assisting with personal care activities for others, such as helping with bathing or changing diapers.
9. When in doubt about the cleanliness of your hands, it is always better to err on the side of caution and practice hand hygiene.

Waterless, Alcohol-Based Hand Rub Techniques

1. Follow the instructions provided by the manufacturer for the specific hand rub product.
2. Dispense an adequate amount of the solution onto the palm of your hand.
3. Rub your hands together, ensuring that you cover all surfaces and fingers with the hand rub.
4. Continue rubbing your hands together until the solution has completely dried. This usually takes about 20 seconds.
5. Do not rinse or dry your hands with water or a towel after using the alcohol-based hand rub.

Hand Washing Technique

1. Wet your hands thoroughly.
2. Apply an ample amount of soap to your hands.
3. Rub your hands together vigorously for at least 20 seconds, making sure to cover all surfaces.
4. Rinse your hands thoroughly with running water.
5. Dry your hands using a paper towel or an air dryer.
6. Use a clean towel to turn off the faucet and avoid recontamination of your hands.

Chain of Infection

It consists of several components:

1. Infectious Agent: This refers to the microorganism or pathogen that causes the infection, such as bacteria, viruses, fungi, or parasites.
2. Reservoir: The reservoir is the source or habitat where the infectious agent lives and multiplies. It can be humans, animals, insects, or the environment.
3. Exit Portal: The exit portal is the route through which the infectious agent leaves the reservoir. It can be respiratory secretions, bodily fluids, skin lesions, or feces.
4. Transmission Means: This refers to the mode of transmission by which the infectious agent is transferred from the reservoir to the susceptible host. It can occur through direct contact, droplet transmission, airborne transmission, vector-borne transmission (via insects), or through contaminated objects (fomites).
5. Entry Portal: The entry portal is the route through which the infectious agent enters the susceptible host. It can be through the respiratory tract, digestive system, broken skin, mucous membranes, or other openings in the body.
6. Susceptible Host: The susceptible host is an individual who is at risk of developing an infection when exposed to the infectious agent. Factors that may increase susceptibility include a weakened immune system, underlying health conditions, age, or other predisposing factors.

Congratulations! Now that you have successfully completed the assigned lesson, please complete the assigned quizzes

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The Assisted Living Bill of Rights is intended to be a guide to how residents are treated *

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The Bill of rights must be given to the resident before starting services. *

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If a resident asks to access his file, the answer is no. *

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Residents can come and go freely from the facility. *

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Resident’s Council

Resident Council:

A resident council is a forum for residents to voice their opinions, concerns, and suggestions regarding their living conditions and the operation of the assisted living facility. The council serves as a platform for residents to discuss issues of common interest, collaborate with facility management, and advocate for their rights and well-being. Resident councils may have regular meetings, elect representatives, and work in partnership with the facility administration to address resident concerns, improve services, and enhance the overall quality of life within the facility.

Assisted living facilities should support the formation and functioning of resident councils, providing them with the necessary resources, guidance, and a platform to express their collective voice. Resident councils promote resident empowerment, involvement in decision-making processes, and a sense of community within the facility.

Person Centered Care

In a real-life situation, person-centered care means:

1. Respect for Autonomy: The healthcare team respects and supports the individual’s right to make decisions about their own care. They involve the person in discussions and decisions related to their treatment options, care plans, and daily routines. The person’s choices and preferences are honored to the greatest extent possible, allowing them to actively participate in their own healthcare journey.
2. Individualized Care Planning: The care plan is developed collaboratively, considering the person’s unique needs, goals, and circumstances. The healthcare team works closely with the person and their family members to identify their specific healthcare requirements, preferences, and priorities. The plan considers not only the person’s physical health but also their emotional, social, and spiritual well-being.
3. Communication and Shared Decision-Making: Open and honest communication is vital in person-centered care. Healthcare providers actively listen to the person’s concerns, questions, and feedback, creating a safe and supportive environment for dialogue. They provide clear information about the person’s condition, treatment options, and potential risks and benefits. Together, the person and their healthcare team engage in shared decision-making, collaboratively determining the most appropriate course of action.
4. Emotional and Psychosocial Support: Person-centered care recognizes the importance of addressing the person’s emotional and psychosocial needs alongside their physical health. Healthcare providers offer empathy, compassion, and emotional support, acknowledging the person’s feelings, fears, and anxieties. They consider the person’s social connections, cultural background, and personal beliefs, ensuring that care is sensitive to their individual context.
5. Continuity and Coordination: Person-centered care focuses on delivering coordinated and seamless care across different healthcare settings and providers. There is a strong emphasis on effective communication and collaboration among healthcare professionals, ensuring that the person’s care is well-integrated and consistent. The person is empowered with the necessary information and resources to navigate their healthcare journey effectively.

By embracing person-centered care, healthcare providers strive to create a therapeutic relationship built on trust, respect, and shared decision-making. This approach acknowledges the person as an active participant in their own care, promoting their autonomy, dignity, and overall well-being.

Concerns and Complaints

Assisted living residents have the right to voice their concerns and file complaints if they are dissatisfied with their care or living conditions. Here are important aspects related to concerns and complaints:

1. File a Complaint: Residents have the right to file a complaint regarding any aspect of their care, treatment, or living conditions that they believe is inadequate, unsafe, or violates their rights. This can include concerns about staff behavior, facility policies, quality of care, cleanliness, or any other issue affecting their well-being. Assisted living facilities should have a formal process in place for residents to submit complaints.
2. Know Contact Information: Residents should be provided with clear information about whom to contact and how to file a complaint. Assisted living facilities should make sure residents are aware of the appropriate channels for reporting concerns, such as a designated staff member, ombudsman, or regulatory agency. This information should be easily accessible and communicated to residents in a manner that they can understand.

By ensuring that residents can file complaints and providing them with the necessary contact information, assisted living facilities empower residents to have a voice in their care and living conditions. It promotes transparency, accountability, and continuous improvement in the quality of care and services provided.

Records

Records management and privacy are crucial aspects of protecting the rights and confidentiality of individuals in assisted living facilities. Here are key points related to records:

1. Information Kept Private: Assisted living residents have the right to expect that their personal information and records will be kept private. This includes their medical records, personal details, and any other confidential information. Assisted living facilities have a responsibility to establish policies and procedures to ensure the security and confidentiality of residents’ records.
2. Refusal to Release Information: Residents have the right to refuse the release of their information to outside parties. This means that their consent is required before any personal or medical information is shared with external individuals or organizations, unless there are legal obligations or specific circumstances that require disclosure.
3. Contacted if Records Requested: If someone requests access to a resident’s records, the resident should be informed and contacted before any information is released. This ensures that residents are aware of who is requesting their records and have an opportunity to provide consent or seek clarification before any disclosure occurs.
4. Access to Records: Residents have the right to access their own records. This includes the right to review and obtain copies of their medical records and other relevant documents. Assisted living facilities should have procedures in place to facilitate residents’ access to their records, ensuring transparency and enabling residents to actively participate in their own care.

By upholding these principles, assisted living facilities protect residents’ privacy and ensure that their personal information is handled securely and confidentially. Respect for residents’ rights to refuse information release, being contacted about record requests, and having access to their own records empowers residents and supports their involvement in their own care.