Current through Register Vol. 35, No. 18, September 24, 2024
Each resident shall receive care based upon individual
needs.
A. Hygiene:
(1) Each resident shall be kept comfortably
clean and well groomed.
(2) Beds
shall be made daily, with a complete change of linen to be provided as often as
necessary, but at least once a week.
(3) Residents shall have clean clothing as
needed to present a neat appearance and to be free of odors. Residents who are
not bedfast shall be dressed each day, in their own clothing, as appropriate to
their activities, preferences, and comforts.
B. Decubiti prevention: Nursing personnel
shall employ appropriate nursing management techniques to promote the
maintenance of skin integrity and to prevent development of decubiti filed in
the resident's clinical record, except as provided in this section.
(1) Verbal orders: Verbal orders from
physicians or dentists may be accepted by a nurse or pharmacist, or, in the
case of verbal orders for rehabilitative therapy, by a therapist. Verbal orders
shall be immediately written, signed and dated by the nurse, pharmacist or
therapist on a requirement may be waived if:
(a) facility has made unsuccessful good faith
effort; and
(b) the health and
environment department determines residents will not be endangered;
or
(c) staffing is sufficient to
meet residents' needs.
(2) Nursing personnel shall provide care,
including proper hydration, designated to maintain current functioning and to
improve the resident's ability to carry out activities of daily living,
including assistance with maintaining good body alignment and proper
positioning to prevent deformities.
(3) Each resident shall be encouraged to be
up and out of bed as possible, unless otherwise ordered by a
physician.
(4) Any significant
changes in the condition of any resident shall be reported to the nurse in
charge or on call, who shall take appropriate action.
C. Rehabilitative measures: Residents shall
be assisted in carrying out rehabilitative measures initiated by a
rehabilitative therapist ordered by a physician, including assistance with
adjusting to any disabilities and using any prosthetic devices.
D. Tuberculosis retesting: Resident's shall
be retested for tuberculosis infection based on the prevalence of tuberculosis
in the community and the likelihood of exposure to tuberculosis in the
facility.
E. Nourishment:
(1) Diets: Residents shall be served diets as
prescribed by a physician.
(2)
Adaptive devices: Adaptive self-help devices shall be available to residents
assessed as capable of using such devices and these residents shall be trained
in their use to contribute to independence in eating.
(3) Assistance: Residents who require
assistance with food or fluid intake shall be helped as necessary.
(4) Food and fluid intake and diet
acceptance: A resident's food and fluid intake and acceptance of diet shall be
monitored and documented, and significant deviations from normal eating
patterns shall be reported to the nurse and either the resident's physician or
dietician as appropriate.
