Download - Proxy caregiver workshop pp2013 2
PROXY CAREGIVER WORKSHOP
OWNERS, ADMINISTRATORS AND EXECUTIVE DIRECTORS
DEFINE THE ROLE OF THE PROXY CAREGIVER
DEFINE LICENSED HEALTHCARE FACILITIES VS. LICENSED RESIDENTIAL FACILITIES
STATE THE DIFFERENCES BETWEEN PERSONAL CARE AND HEALTH MAINTENANCE SERVICES/ACTIVITIES
DISCUSS THE KEY COMPONENTS OF AN INFORMED CONSENT FOR PROXY CARGIVERS
BE ABLE TO INTEGRATE PROXY CAREGIVERS INTO FACILITY OPERATIONS
DISCUSS THE COMPONENTS OF A BACK-UP PROXY CAREGIVER SERVICE PLAN
DISCUSS WITH POTENTIAL OR CURENT RESIDENTS HOW PROXY CAREGIVERS ARE USED IN THE FACILITY
IDENTIFY THE TRAINING REQUIREMENTS FOR PROXY CAREGIVERS
DISCUSS THE TRAINING REQUIREMENTS FOR PROXY CAREGIVERS THAT ADMINISTER MEDICATIONS TO SPECIFIC RESIDENTS
EXAMINE AN EXAMPLE OF A MEDICATION ADMINISTRATION CURRICULA THAT CAN BE USED TO TRAIN PROXY CAREGIVERS
IDENTIFY MEDICATIONS THAT ARE PROHIBITED FROM BEING GIVEN BY A PROXY CAREGIVER
DISCUSS THE DIFFERENCES BETWEEN PROXY CAREGIVER AND MEDICATION AIDE
SERVICES THAT ARE REQUIRED BY RESIDENTS
PERSONAL CARE
SERVICES
EATING, BATHING,
GROOMING, DRESSING
ACTIVITIES OF DAILY LIVING
TRANSFERS, TOILET USE,
EATING, BATHING, BED
MOBILITY
HEALTH MAINTENANCE
ACTIVITIESHB 1040
UNLICENSED PERSON
QUALIFIED THROUGH TRAINING;
KNOWLEDGE AND SKILLS; COMPETENCY
BASED
TRAINED BY A LICENSED HEALTHCARE
PROFESSIONAL
HEALTH MAINTENANCE ACTIVIITES
WRITTEN INFORMED CONSENT BASED ON PHYSICIAN ORDERS
PLAN OF CARE
A PROXY CAREGIVER IS AN UNLICENSED PERSON WHO HAS BEEN DETERMINED QUALIFIED TO HAVE THE NECESSARY KNOWLEDGE AND SKILLS ACQUIRED THROUGH TRAINING BY A LICENSED HEATHCARE PROFESSIONAL TO PERFORM DOCUMENTED HEALTH MAINTENANCE ACTIVITIES INCLUDING SPECIALIZED PROCEDURES, FOR AN INDIVIDUAL WITH A DISABILITY WHO HAS DELEGATED TO THE DESIGNATED PROXY CAREGIVER THE PERFORMANCE OF SUCH HEALTH MAINTENANCE ACTIVITIES THROUGH EXECUTION OF A WRITTEN INFORMED CONSENT BASED ON WRITTEN PHYSICIAN ORDERS BY THE INDIVIDUAL WITH A DISABILITY OR LEGAL GUARDIAN
HEALTH MAINTENANCE ACTIVITIES ARE THOSE LIMITED ACTIVITIES THAT, BUT FOR A DISABILITY, A PERSON COULD REASONABLY BE EXPECTED TO DO FOR HIMSELF OR HERSELF.
SUCH ACTIVITIES ARE TYPICALLY TAUGHT BY A LICENSED HEALTHCARE PROFESSIONAL OR CAN BE TAUGHT DIRECTLY TO THE RESIDENT.
DOES NOT INCLUDE ACTIVITIES THAT REQUIRE COMPLEX OBSERVATIONS OR CRITICAL THINKING.
CAN BE SAFELY PERFORMED AND HAVE REASONABLY PRECISE, UNCHANGING DIRECTIONS; AND HAVE OUTCOMES OR RESULTS THAT ARE REASONABLY PREDICTABLE.
WHAT IS MEANT BY “COMPETENCY-BASED
TRAINING”?
TRAINING THAT IS TIED TO AN INDENTIFIED SET OF SKILLS
AND KNOWLEDGE REQUIRES INDEPENDENT
DEMONSTRATION AND DOCUMENTATION
ACCEPTABLE LEVEL OF PERFORMACE OF A TASK OR
ACHIEVEMENT OF AN OUTCOME
WRITTEN EVIDENCE OF SATISFACTORY
PERFORMANCE ON INITIAL AND ANNUAL SKILLS
COMPETENCY DETERMINATIONS
UTILIZE CHECKLIST DEVELOPED BY DCH OR LICENSED HEALTHCARE
PROFESSIONAL
TEST THE KNOWLEDGE AND OBSERVATION OF THE SKILLS
NECESSARY TO DO THE SPECIFIC HEALTH MAINTENCE
ACTIVITY IN ACCORDANCE WITH STANDARDS OF CARE
COMPETENCY BASED SKILLS CHECK-OFFS
HEALTH MAINTENANCE ACTIVITIES ARE TAUGHT BY AN ATTENDING
PHYSICIAN, REGISTERED NURSE, PHYSICIAN ASSISTANT, ADVANCED
PRACTICE NURSE, PHARMACIST
OR DIRECTLY TO THE RESIDENT
HIMSELF/HERSELF
THESE HEALTH MAINTENANCE ACTIVITIES ALLOW RESIDENTS TO REMAIN IN THEIR LIVING ENVIRONMENT OF CHOICE ONCE THEIR CARE REQUIREMENTS GO BEYOND PERSONAL CARE SERVICES
LICENSED HEALTHCARE PROFESSIONALS
NOT ALLOWED UNDER PROXY CAREGIVER REGULATIONS
COMPLICATED WOUND CARE
IV MEDICATION ADMIN
CENTRAL LINES
INITIAL DOSES OF IM OR SQ MEDICATIONS
WHERE CAN PROXY CAREGIVERS BE EMPLOYED?
RESIDENTIAL FACILITES--YES
• PCHs AND ALFs
• COMMUNITY LIVING ARRANGEMENTS
• RESIDENTIAL DRUG ABUSE TREATMENT
EDUCATION PROGRAMS
• TRAUMATIC BRAIN INJURY FACILITES
PRIVATE HOME CARE PROVIDERS
HEALTHCARE FACILITIES--NO
• HOSPITALS
• RESIDENTIAL MENTAL HEALTH FACILITIES
• NURSING HOMES
• MEDICARE-CERTIFIED HOME HEALTH AGENCIES
EXAMPLES OF HEALTH MAINTENANCE ACTIVITIES
CATHETER CARE
MEDICATION ADMINISTRATION
BLOOD GLUCOSE MONITORING
RANGE OF MOTION
EXAMPLES OF HEALTH MAINTENANCE ACTIVITIES
SPLINT APPLICATION
SIMPLE DRESSING CHANGE
OSTOMY CARE
HOW ARE PROXY CAREGIVERS HIRED?
FACILITY FOLLOW FACILITY HIRING
PROCEDURE
APPLICATION, CRC, TB SCREENING
DRIVING RECORD, IF APPROPRIATE
ORIENTATION
COMPETENCY BASED TRAINING
DOCUMENTATION IN FILE
RESIDENTCRC, TB SCREENING, DRIVING
RECORD
EVACUATION PROCEDURES
ENSURE THERE IS A PROCEDURE IN PLACE TO PROTECT OTHER RESIDENTS FROM HARM BY PROXY CAREGIVERS NOT UNDER THE CONTROL OF THE FACILITY
DOCUMENTATION IN FILE
WHAT HAPPENS WHEN THE PROXY CAREGIVER CANNOT PROVIDE SERVICES?
ILLNESS
FAMILY EMERGENCY
CHILL ILL
INCLEMENT WEATHER
CAR TROUBLE
PROXY CAREGIVERS VS CERTIFIED MEDICATION AIDES
ASSISTED LIVING FACILITIES
• ASSIST WITH OR SUPERVISE SELF-ADMINISTRATION OF MEDICATIONS TO RESIDENTS THAT ARE CAPABLE OF SELF-ADMINISTRATION. CANNOT ADMINISTER MEDICATIONS
• CAN PERFORM OTHER HEALTH MAINTENANCE ACTIVITIES
• MEDICATION AIDES
PERSONAL CARE HOMES• CAN ADMINISTER MEDICATIONS
IF PROPERLY TRAINED
• CAN PERFORM ADDITIONAL HEALTH MAINTENANCE ACTIVITIES
• CAN ASSIST/SUPERVISE MEDICATIONS TO RESIDENTS THAT CAN SELF-MEDICATE
WHAT SYSTEMS MUST BE IN PLACE TO IMPLEMENT A PROXY CAREGIVER PROGRAM
POLICY/PROCEDURE
PHYSICIAN ORDERS
INFORMED CONSENT
PLAN OF CARE
TRAINING CURRICULA
SKILLS CHECK-OFFS
POLICIES AND PROCEDURES
SCOPE OF THE HEALTH MAINTENANCE ACTIVITIES THAT ARE
PERFORMED BY THE PROXY CAREGIVERS
NOTIFICATION PROCEDURES THAT WILL BE UTILIZED WHEN THE PROXY CAREGIVER OBSERVES A CHANGE IN THE RESIDENT’S CONDITION THAT MAY NEED FURTHER EVALUATION/TREATMENT
THERE IS A CHANGE IN THE PLAN OF CARE
SAFETY AND SECURITY PRECAUTIONS (CRC, TRAINING)
THE MANNER IN WHICH PROXY CAREGIVERS ARE SUPERVISED; FREQUENCY OF RE-EVALUATIONS
BACK-UP PROXY CAREGIVERS; QUALIFICATIONS OF THE LICENSED HEALTHCARE PROFESSIONALS
MANNER IN WHICH RESIDENTS CAN CHANGE PROXY CAREGIVERS
ADMISSION AGREEMENT
AFTER JANUARY 8, 2013, MUST STATE WHETHER FACILITY ALLOWS PROXY CAREGIVERS
IF PROXY CAREGIVERS ARE ALLOWED, THEN MUST STATE WHETHER OR NOT THERE WILL BE ANY ADDITIONAL CHARGES
MEDICATION POLICIES/PROCEDURES REQUIREMENTS
ADDRESS PROCEDURES FOR RECEIVING MEDICATIONS
RECONCILING MEDICATIONS RECEIVED AGAINST THOSE ORDERED
MEDICATION STORAGE
PROCEDURES FOR MANAGING MEDICATIONS
PROCEDURES FOR DISCONTINUED MEDICATIONS
PROCEDURES FOR DISPOSAL OF MEDICATIONS
TRAINING REQUIREMENTS
TRAINING CURRICULA DEVELOPED BY A LICENSED HEALTHCARE PROFESSIONAL THAT ENSURES THAT THE PROXY CAREGIVER DEMONSTRATES THE HEALTH MAINTENACE ACTIVITY CORRECTLY AND SAFELY
LEARNING OBJECTIVES THAT RELATE SPECIFICALLY TO THE HEALTH MAINTENANCE ACTIVITY TO BE PERFORMED
CONTENT KNOWLEDGE AND SKILLS THAT ARE REQUIRED TO ACCOMPLISH THE LEARNING OBJECTIVES
LEARNING OBJECTIVES THAT WILL BE UTILIZED TO PROVIDE INSTRUCTION ON KNOWLEDGE AND SKILLS REQUIRED
SATISFACTORY AND INDEPENDENT COMPLETION OF THE REQUIRED SKILLS COMPETENCY CHECKLIST RELATED TO THE SPECIFIC ACTIVITY TO BE PERFORMED BEFORE AN APPROPRIAELY TRAINED LICENSED HEALTHCARE PROFESSIONAL
TRAINING REQUIREMENTS
SKILLS COMPETENCY CHECKLIST FORMS MUST INCLUDE ALL THE REQUIRED
INFORMATION SET FORTH IN THE REGULATIONS AND REQUIRED BY THE SPECIFIC RESIDENT
SATISFACTORY EVIDENCE OF ROUTINE EVALUATIONS OF CONTINUED SKILLS COMPETENCIES BY AN APPROPRIATELY LICENSED HEALTHCARE PROFESSIONAL AT LEAST ANNUALLY IF NOT ASSESSED MORE FREQUENTLY AS SPECIFIED ON THE WRITTEN PLAN OF CARE
A SCORE OF 75% OR GREATER ON THE TEST OF FUNCTIONAL HEALTH LITERACY (TOFHLA) USED AS AN ASSESSMENT TOOL TO INDIVIDUALIZE NECESSARY TRAINING FOR THE SPECIFIC SKILLS
MEDICATION ASSISTANCE RECORD
NAME OF THE RESIDENT
ANY KNOWN ALLERGIES
NAME, TELEPHONE NUMBER OF THE HEALTHCARE PROVIDER
THE NAME, STRENGTH AND SPECIFIC DIRECTIONS OF EACH MEDICATION
TIME/DATE MEDICATIONS ARE TAKEN OR REFUSED
MEDICATION RESOURCES FOR PROXY CAREGIVERS
CHANGES IN RESIDENT CONDITION
CHANGES IN RESIDENT’S MEDICATIONS
CHANGES IN RESIDENT’S PLAN OF CARE
CHANGES IN HEALTH MAINTENANCE ACTIVITIES
INTRODUCE CONCEPT TO MEDICAL DIRECTOR,
PHYSICIANS AT QA MEETING
DISCUSS THE CONCEPT OF “AGING IN PLACE”
DEVELOP POLICIES TO ADDRESS SAFETY,
TIMELY NOTIFICATION AND DOCUMENTATION,
AA
INTRODUCE PROXY CAREGIVERS CONCEPT
TO RESIDENTS/FAMILIES
AND STAFF
DISCUSS HOW PROXY CAREGIVERS WILL BE
UTILIZED IN THE FACILITY
FEES FOR HEALTH MAINTENANCE ACTIVITIES
QUESTIONS