Nurses who work for nursing homes obide by specific codes.
A CFR, or code of regulations, are specific care standards and expectations given to the care of the elderly within nursing homes. Nursing homes that obtain Medicare and Medicaid for the care of such individuals must abide by these regulations. According to the California Advocates for Nursing Home Reform, it is the nurse's obligation to maintain the health of an individual, unless it is absolutely impossible to do so medically or the individual refuses treatment.
Patient Needs
Nursing home staff must accommodate the patient.
Staff working within a nursing home must accommodate the needs of the resident. For example, 42 CFR 483.15 (e) maintains that any resident living within a nursing home has the right to accommodations that fits the needs of that individual. The needs of the resident can include room arrangements, nutrition of the resident and helping the resident in daily activities.
Staff and Care
Nurses should develop a care plan for every resident.
There must be an adequate amount of nurses and staff for each resident within a nursing home. Nurses must assess each resident's functional capacity (e.g., the ability to bathe, dress or the need for medications) and develop a care plan catered to the resident's needs.
Resident Deterioration
If a resident no longer has the capacity to function on her own, a nurse should help with toileting assistance. A resident may not be able to control her bladder or reach the bathroom. Helping with toileting is necessary to prevent the development of pressure sores, physical harm from falls and other skin conditions. If pressure sores develop, according to 42 CFR 483. 25, the necessary steps to heal and prevent infections from occurring should be taken.
Feeding and Hydration
Food provided should be healthy and nutritious.
Residents who are capable of feeding themselves, no matter how long it takes to eat, should remain able to do so. The enforcement of feeding tubes should be avoided unless medically necessary. Foods provided for residents must be nutritious, as well as catered to any special dietary needs of residents. Foods provided for residents include snacks. Residents should be provided with fluids to prevent dehydration. Dehydration in residents that is severe can lead to death.
Infection & Disease
Illnesses can easily spread in nursing homes. A disease prevention program should be developed to organize the prevention of diseases and infections. Staff should wash hands after coming into contact with residents. Any infections that are identified on a resident should be promptly treated.
Other Concerns
Physicians should see residents regularly.
A resident must be attended by a physician of her choosing or by a representative of the resident. Title 42 CFR 483.40 (c) specifies that a physician should see a resident once a month, unless more visits are required. Since accidents in nursing homes are a concern, a nursing home environment should be free of hazards. Other care should be given to a resident, including dental, hearing and vision care.
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