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Providing effective care and assessing risk factors that cater to the unique needs of the complex older adult population residing in a skilled nursing facility can be a challenge. This certificate will inform nurses and others working in a skilled nursing facility with the strong foundation necessary to provide quality, competent, and safe care to the older adult, all while working within regulatory guidelines as a member of the diverse healthcare team. Nurses or other health care personnel who complete this 16-course certificate program will have a better understanding of the skills necessary to provide care that improves the quality of life for the older adult.
New or seasoned direct care, licensed staff working in a skilled nursing facility. Other members of the care team including therapists, certified nursing assistants, and qualified medication aids. Nurses working in acute care and home care may also benefit from this certificate.
15 hours of online video lectures and patient demonstrations.
HEP and patient education resources to use with your patients.
Case-based quizzes to evaluate and improve clinical reasoning.
Regulatory Environment in the Skilled Nursing Facility Part 1keyboard_arrow_downCourse
This chapter will review newly revised Federal Regulation being called the “Mega Rule.” Utilizing the federal regulation to implement clinical practice in the nursing home can be daunting, so this section will share strategies to grasp concepts and implement practice. The nurse should be aware of evidenced-based standards related to passing medication in the long-term care setting. This section will explore the concept of resident voice and resident-centered care and understanding how to embed this philosophy in clinical practice.
Compliance with the revised regulations will depend on the facility’s ability to formulate a facility risk assessment. This chapter will identify ways to conduct a risk assessment and utilize this information to assure compliance in staffing education, staffing patterns and resident care decisions.
Regulatory Environment in the Skilled Nursing Facility Part 2keyboard_arrow_downCourse
This chapter will review the survey process, surveyor probes and determination of scope and severity. Avoiding citations is often tied to adequate and appropriate documentation so the session will cover basic components of good clinical documentation. This section will also provide tips on how nursing leaders can provide an environment that will ease the stress of the survey process on staff.
Review Occupational Safety and Health Agency (OSHA), labor laws, state regulations related to nursing homes, hospital readmission initiatives, and Medicare regulations. Compliance of practices related to these agencies is important to the overall survival of the facility. Basic understanding and what clinical practice these rules affect is important to overall regulatory compliance.
The Nurse's Role With Frail Older Adults Part 1keyboard_arrow_downCourse
This chapter will provide an overview of long-term care within the continuum of care. Nursing staff will review the importance of policies, regulations, and payment systems for patients who reside in long-term care. Additional discussion will focus on palliative and hospice care in the long-term care setting.
This chapter will describe the demographics, common characteristics of nursing home residents, and a discussion of payment mechanisms for long-term care. There is also a review of quality of care and access to long-term care with a synopsis of positive culture change occurring within long-term care.
This chapter will focus on normal aging changes and the common geriatric conditions that nursing staff are required to assess and manage. Older adults commonly have multiple chronic conditions that contribute to complex and challenging care. The focus of this chapter will be on nursing’s support of functional ability and quality of life for residents.
The Nurse's Role With Frail Older Adults Part 2keyboard_arrow_downCourse
This chapter will focus on the nurse's role in provision of person-centered care and individualized care planning. It will also discuss the nurse's role within the interdisciplinary team. Nurses will be required to examine their personal attitudes related to aging and to recognize and diminish ageism within the long-term care setting.
Essential elements of person-centered care as they relate to quality of life in long-term care will be emphasized. Ethical principles will be defined, and common ethical problems will be reviewed including decision making capacity, informed consent, autonomy, and advance care planning. Ongoing strengths and challenges related to the nurseï¿½s role in long-term care will be reviewed.
Supervision Skills: Directing the Nursing Assistant Part 1keyboard_arrow_downCourse
It is important to understand the language of supervision and to clearly understand what is meant by supervision of resident care being delivered by CNAs. This section will review the traits important for the Licensed Nurse to possess and practice to improve their supervision skills.
Reviewing studies completed asking CNAs how they want to be supervised and what motivates them will assist the Licensed Nurse in identifying strategies that will work to assure CNAs are performing at their best. These strategies can be adapted to the work environment the Licensed Nurse is supervising during a normal work shift.
Supervision Skills: Directing the Nursing Assistant Part 2keyboard_arrow_downCourse
Auditing performance of the CNA the Licensed Nurse is supervising is an important part of ensuring quality resident care. This section will provide strategies on auditing and monitoring as the nurse is performing nursing tasks. This section will review the strategies inherent in Management By Walking Around. These strategies can also assure that resident’s care is being provided in an environment without abuse or neglect.
Once performance deficiencies are identified, it is part of the Licensed Nurse’s responsibility to correct the issue to assure resident safety and satisfaction. The skill and strategies that are needed to provide the CNA staff with appropriate correction will be presented. These actions will take the CNA staff to a higher level of performance and will decrease the effort needed by the Licensed Nurse when supervising that same task.
Identifying and Preventing Common Risk Factors in the Older Adultkeyboard_arrow_downCourse
Health promotion activities can improve quality of life, prevent disease, and improve functional capacity for the older adult. This chapter will define health promotion and disease prevention through screening recommendations. The U. S. Preventive Services Task Force (USPSTF) and Healthy People 2020 will be discussed.
Remaining physically active and maintaining proper nutrition can prevent disease and disability. How the nurse can promote health through increased physical activity and healthy nutrition will be discussed, and screening recommendations will be noted.
Assessing the environment for any safety concerns can prevent injuries in the elderly. Knowing how medications interact and providing a thorough assessment of how errors can be made in the regimen is imperative. How the nurse can promote health through identifying safety issues and potential for medication errors because of polypharmacy will be discussed, and screening recommendations will be noted.
Nurses should provide education on smoking cessation and avoidance of alcohol overuse to improve outcomes in patients. Nurses should also be aware of signs of neglect in order to intervene appropriately. How the nurse can promote health through identifying alcohol and tobacco use and factors that put the older adult at risk for potential abuse and neglect will be discussed, and screening recommendations will be noted.
Immunizations can prevent disease in older adults, and mental health is an essential aspect of holistic care. How the nurse can promote health by providing appropriate immunizations and mental health screening will be discussed, and screening recommendations will be noted.
For nurses to promote health and prevent disease, they need to understand what factors put an older adult at risk. How the nurse can encourage health through identifying the factors that cause heart disease, as well as screening and preventative measures that can be implemented to reduce the risk of complications will be discussed. Other chronic illnesses, such as breast cancer, colorectal cancer, osteoporosis, and thyroid disease, will also be identified along with screening recommendations.
Nurses want their patients to be independent in managing their chronic conditions. This chapter will describe some strategies the nurse can employ to assist the older adult in managing their care independently.
Physiological Changes and Assessment of the Older Adult Part 1keyboard_arrow_downCourse
Nurses need to have an awareness of issues specific to the aging population so they can advocate and provide quality care. An overview of why specialized geriatric care is necessary to improve older adult outcomes will be addressed. Theories of aging, gerontological nursing, and roles of the gerontological nurse will be discussed.
Cardiovascular and pulmonary issues are common in the older adult, and the nurse needs to be aware when changes in the system need intervention. Anatomical and physiological changes in aging and their significance in the cardiovascular and pulmonary systems will be discussed. Basic assessment parameters relevant to the system will be reviewed.
Increasing rates of chronic disease and deterioration with advancing age require greater vigilance by the nurse to differentiate pathology that needs intervention from “normal” aging processes. To discover abnormalities and judge relevance for a patient takes knowledge of the physiology of each body system. Anatomical and physiological changes in the renal and genitourinary system that occur with aging will be discussed along with basic assessment parameters.
Problems with eating and with the gastrointestinal tract can affect the older adult’s quality of life. Changes in aging specific to the oropharyngeal and gastrointestinal systems will be discussed along with basic assessment parameters.
Changes in the ability of the older adult to move around can affect the ability to perform the activities of daily living needed for independence. Anatomical and physiological changes in aging and their significance in the musculoskeletal and integumentary systems will be discussed. Basic assessment parameters relevant to the system will be reviewed.
Being able to adequately sense the world around them is essential to people's safety and well-being. Normal anatomical and physiological changes in aging of the nervous and sensory systems will be discussed, along with an evaluation of the endocrine system. Assessment parameters of these systems will be reviewed.
Changes to the blood cells and the structure and function of the reproductive tract are issues that can often be overlooked yet are essential aspects to monitor as the individual ages. Changes to the hematopoietic and reproductive systems will be discussed.
Physiological Changes and Assessment of the Older Adult Part 2keyboard_arrow_downCourse
Performing a thorough physical assessment of the older adult is imperative to ward off complications and provide interventions that improve quality of life. Having a basic knowledge of common chronic illnesses and age-related changes also plays an essential role in the physical exam. This chapter will provide a demonstration of how to give an assessment of the top half of the body, including head, eyes, ears, nose, mouth, throat, lungs, and upper extremities of the older adult. Common age-related factors and chronic illness related to each body system will also be mentioned to help the nurse differentiate normal from abnormal findings in order to provide appropriate interventions.
Performing a thorough physical assessment of the older adult is imperative to ward off complications and provide interventions that improve quality of life. Having a basic knowledge of common chronic illnesses and age-related changes also plays an essential role in the physical exam. This chapter will provide a demonstration of how to give an assessment of the older adult for the bottom half of the body, including the heart, abdomen, lower extremities, and neurological systems. Common age-related factors and chronic illness related to each body system will also be mentioned to help the nurse differentiate normal from abnormal findings in order to provide appropriate interventions.
Performing a head-to-toe physical exam is an important aspect of decreasing complications and improving the well-being for the older adult. In addition, providing a comprehensive assessment can assist the nurse in gathering more information that is imperative to the holistic care of the older adult. In this chapter, comprehensive assessments for factors such as functional status, pain, spirituality, cognition, and psychological condition will be identified.
Nursing Delegation in the Skilled Nursing Facilitykeyboard_arrow_downCourse
This chapter defines nursing delegation and the difference between delegation and assignment. Nursing delegation is often part of a state’s Nurse Practice Act. The content will explore how to find any legislated nurse delegation limitation that may be important to defining nurse delegation tasks in the facility. Reviewing the delegation model will clarify the components necessary to protect the nurse leader, the licensed nurse delegator, and the delegatee.
This chapter defines the roles of the nursing leader, the licensed nurse, and the delegatee to assure the delegation process is effective. Understanding these roles will assure the delegated task is completed properly, therein protecting the safety of a facility’s residents.
The content will review what is classified as a delegated task and how to determine if delegation to a licensed or unlicensed person is appropriate. An important part of this section is understanding how to developing job descriptions to guide consistent delegation roles and responsibilities. A consistent delegation process is important in resident protection.
An important part of the delegation process is to determine the competency-based training that will be necessary to carry out the delegation of a task and the performance of that task. This requires the knowledge to develop job descriptions that clearly delineate responsibilities. Once the delegated tasks are determined, it is imperative that employee training match these responsibilities.
This chapter reviews an example of what an action plan for performance improvement will entail. This template for action can be utilized by the individuals to evaluate the facility’s present nursing delegation process or to begin development of a new nursing delegation process.
Medication Administration in the Skilled Nursing Facility Part 1keyboard_arrow_downCourse
This chapter will review the Federal Regulation the nurse should be aware of when passing medication in the long-term care setting. This will include a review of how the survey process determines the nurse’s compliance with these regulations. Hand hygiene and other infection prevention strategies will also be noted.
This chapter will review the routes of medication delivery and the administration best practice for each route. The session will review the challenges and the importance of following resident identification procedures in the long-term care setting.
The content of this chapter will review the general principle involved in oral administration of medication including buccal and sublinqual administration techniques. The demonstration will include the challenges of this type of administration in the long-term care setting. Injection administration principles will be reviewed with demonstration intramuscular and subcutaneous injections.
Medication Administration in the Skilled Nursing Facility Part 2keyboard_arrow_downCourse
This chapter will review the general principles for rectal, eye drops/ointments, and inhalation administration. The demonstration of application of eye medication will stress the importance of infection control principles, care of the eye, and appropriate timing when more than one drop or more than one eye medications is required.
This chapter will review the components that are required for proper labeling of medication for administration in the nursing home. The items on the label will be reviewed as they relate to safe administration practices. Basic storage guidelines for common medications will be examined in addition to the nurse’s responsibility if the integrity of the medication has been compromised due to inappropriate storage or labeling.
When administering medication, it is part of the nurse’s responsibility to be astute to practices that may cause medication errors. This chapter will inform nurses about their role in improving the quality of safe medication practices, and reporting errors.
Nurse Performance of Treatments in the Skilled Nursing Facility Part 1keyboard_arrow_downCourse
This chapter will physically demonstrate the performance of topical treatments including the application of ointments and creams. The importance of professional data collection, assessment and documentation is part of these procedures.
This chapter will demonstrate the performance of dressing changes, and review best practices for maintaining staff and resident safety.
Nurse Performance of Treatments in the Skilled Nursing Facility Part 2keyboard_arrow_downCourse
This chapter will explain the importance of oxygen and how it is used as a medication. Examples of how and why a physician may order an oxygen treatment on a patient will be reviewed.
Nursing-ordered treatments are often used to monitor acute changes in the condition of a resident. These nursing-driven orders may include checking vital signs, behavior monitoring and other nursing interventions. Examples of these will be shared as along with documentation principles.
This chapter will explain the importance of monitoring the effectiveness of medical treatment and nursing interventions so that early detection of lack of improvement can be identified and reported. Examples will be given of how treatments meant to monitor efficacy can prevent unnecessary hospitalization or resident dissatisfaction.
The Nurse’s Role: Communication and Teaching Skills in Long-Term Care Part 1keyboard_arrow_downCourse
This chapter will provide an overview of communication strategies for use with frail older adults, and their families. It includes a rationale for essential communication and an overview of the process of communication. Factors that influence communication in long-term care including attitudes and beliefs about aging are reviewed.
The effects of normal aging changes as well as cognitive and functional changes will be discussed. Common communication challenges, assessment methods, interventions, and effective responses to improve communication with frail older adults will be included in this chapter.
The Nurse’s Role: Communication and Teaching Skills in Long-Term Care Part 2keyboard_arrow_downCourse
This chapter will focus on planning and implementing effective teaching strategies for use with frail older adults. The chapter will include an assessment of unique teaching challenges in long-term care and implementation of strategies to create individualized teaching plans. Health literacy will be defined with a review of its significance in teaching and learning.
The effects of health literacy as it relates to teaching and learning with older adults will be discussed. Health literacy will be defined and its impact on older adults will be examined. Universal precautions are recommended to enhance communication and teaching sessions.
This chapter will focus on choosing written or visual handouts appropriate for the individual’s ability to read and comprehend. Materials that compensate for decline in sensory or cognitive processing in older adults will be discussed and demonstrated.
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Amy Lee, MPT, OCS
Physical Therapy Central
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Outpatient Physical Therapy & Rehabilitation Services
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Grant R. Koster, PT, ATC, FACHE
Vice President of Clinical Operations, Athletico Physical Therapy
Do I get CEU credit?
Each course is individually accredited. Please check each course for your state and discipline. You can receive CEU credit after each course is completed.
When do I get my certificate?
You will receive accredited certificates of completion for each course as you complete them. Once you have completed the entire Certificate Program you will receive your certificate for the program.
Each course is individually accredited and exact hours will vary by state and discipline. Check each course for specific accreditation for your license.
Do I have to complete the courses in order?
It is not required that you complete the courses in order. Each Certificate Program's content is built to be completed sequentially but it is not forced to be completed this way.
How long do I have access to the Certificate Program?
You will have access to this Certificate Program for as long as you are a subscriber. Your initial subscription will last for one year from the date you purchase.
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