Long Term Care > Final Exam > Flashcards

Final Exam Flashcards

(47 cards)

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1
Q

What type of care is offered in supportive housing?

A

Daily personal care, 24 hour availability of PSW’s, meals

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2
Q

What type of care is offered in retirement homes?

A

Light housekeeping help, meals, generally low levels of care, availability of 24 hour support staff

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3
Q

What type of care is offered in long term care homes?

A

High level of care, meals, may include activities of daily living, availability of 24 hour nursing care

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4
Q

What are the accommodation type differences in supportive housing, retirement and LTC homes?

A

Supportive: Shared living in a home like setting, not more than 5-6 ppl per home
Retirement: Ranges from shared living to bachelor, one or two bedroom apartments
LTC: Predominantly private or semi-private rooms. Older homes may have 4 bed ward rooms

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5
Q

Who owns and manages Supportive housing, retirement homes, and LTC?

A

Support: Building management can vary, services managed by non-profits
Retirement: Private corporations, non-profit (in a few cases)
LTC: Municipal governments, non-profits, or private corporations

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6
Q

What are the 3 governing legislations of the 3 types of homes?

A

Supportive: Housing Services Act, 2011
Retirement: Retirement Homes Act, 2010
LTC: Long Term Care Homes Act, 2007

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7
Q

What is the cost difference of the three home types?

A

Supportive: Rental costs vary according to market rent ($600-$1200/month) and subsidies available in some places. Government assistance too through Ministry of community and social services
Retirement: Vary depending on room type and care level and no government subsidy available
LTC: Co-payment structure, government can subsidize accommodation to the basic rate for those who qualify, the care is funded by the MOHLTC so only paying for the accommodations

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8
Q

Can medications be administered in retirement homes?

A

Yes they can but may be an extra charge. According to the Act, meds must be securely stored, Narcs kept under double lock, record of administration must be maintained, and errors must be reviewed.

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9
Q

What four things are required for a retirement home resident to have their meds administered?

A
  1. Need a valid prescription
  2. Informed consent by resident or their POA
  3. Staff training under specific protocols under DPRA
  4. Documentation requiring accurate records of admin
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10
Q

Do the regulations for group homes address provision of care of med administration?

A

No they don’t

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11
Q

How old is the typical LTC home resident?

A

Mid to late 80’s

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12
Q

What percentage of ppl in LTC have some form of cognitive impairment?

A

90%

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13
Q

What sort of things are charged as extras to a LTC resident?

A

Hairdressing, cable TV, internet, transportation

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14
Q

What are the requirements to be admitted to a LTC home?

A

Age over 18, health status must include a condition that requires assistance that cannot be managed at home, assessment by LHIN or similar organization, must have care needs, availability in home is needed, need to qualify for funding or be able to pay, and behavioral considerations must be thought of depending on the home

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15
Q

What is the capitation model for LTC?

A

Pharmacy services for LTC are provided by community of LTC pharmacies. They get paid a fee per bed capitation. The rates have been decreasing every year so the only way to remain profitable is through volume of patients

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16
Q

What happens with meds not covered by ODB for LTC residents?

A

They are charged to the resident with a dispensing fee

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17
Q

IS there a copayment charged to LTC residents for their meds?

A

NO

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18
Q

Is medscheck at home allowed to be billed for retirement home residents?

A

No

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19
Q

How long do pharmacies servicing LTC homes need to be open?

20
Q

What does DONPC stand for?

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A

Director of Nursing and Personal Care

21
Q

Who needs to meet to evaluate medication management system on a quarterly basis?

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A

Medical Director, the administrator, the DONPC, and the pharmacy services provider

22
Q

How often does an interdisciplinary team meet to evaluate the effectiveness of medication management?

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A

Quarterly so every 3 months

23
Q

What rule must be followed in regards to administration of a new drug to a LTC resident?

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A

Medical directives must be reviewed whenever their condition is assessed and all directives must be individualized to their specific condition and needs

24
Q

What is typically kept in an emergency drug box?

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A

Meds required for the immediate comfort of patients, and meds to reduce risk of need for hospitalization

25
What is a monitored dosage system?
Providing meds in unit dose or multi dose packaging to reduce the risk of administrative error
26
What are examples of unit dose packaging?
Blister cards with one med in each slot of 28-35 days or cold sealed or heat sealed cards
27
What is multi dose packaging?
Strip packaging like from PacMed
28
How many meds can be packaged into one multi-dose pouch and what is done with hazardous and cytotoxic meds?
5 is the limit. Hazardous meds are packaged separately in a pouch and are labelled with instructions to handle carefully, do not crush, and that its hazardous
29
Can residents in LTC administer their own meds?
Only if the prescriber approves and the resident is deemed capable
30
What does STS stand for?
Special Tablet System (Tray)
31
What is written on the header bag for strip packs?
Resident suite number, packaging date, physician, pharmacy name, address and phone #
32
What is labelled on each strip in strip packaging?
Name and location of resident, date and time of administration, brand and generic name of meds, description of meds, quantity of meds in each pack, prescription number
33
Which meds do not go in strip packaging?
Monitored drugs like narcs and controlled, non-oral meds like inhalers, eye drops, and topicals, oral liquids, PRN meds, titrated or range doses (e.g.1-2), refrigerated meds, meds that stay in OG packaging for light or moisture sensitivity
34
How many pouches does pacvision verify per minute?
40-60
35
How do digital pens work?
The doctor writes orders on a special digital paper with the digipen and as soon as he docks the pen it gets automatically sent to the pharmacy
36
What is a medication review form?
Provides a summary of all current doctor's orders for review and reauthorization by the physician. must be completed q3months in the nursing home setting and a copy is kept in the home and in the pharmacy
37
What are the 8 main roles of pharmacy techs in LTC?
1. Medication dispensing 2. Patient care support 3. Record keeping 4. inventory management 5. medication review 6. collaboration with healthcare teams 7. regulatory compliance 8. quality assurance
38
What does the clinical consultant pharmacist do in LTC?
Provides on site services by visiting homes on a weekly to monthly basis. Involved in education, narcotic disposal, audits, and committee meetings
39
How many meds might a nurse administer in a single med pass?
300-400
40
Which meds have a longer half life in the elderly so are given less frequently?
Digoxin, phenytoin, and diazepam
41
Which meds must be dosed more frequently?
Acetaminophen usually TID to QID, Salbutamol inhaler, levodopa/carbidopa
42
What is the role of an RN in LTC?
Often management or supervisory role, responsible for clinical assessment of residents and development of care plans, often coordinates efforts of other team members, can administer meds in some settings if needed, processing of prescriber orders, and provides info on all aspects of a residents care
43
What is the role of a physician in LTC?
Visits on weekly to monthly basis. Attends annual patient care conference with patient/family member and other members of multi disciplinary team
44
What is role of RPN in LTC?
Primarily responsible for administration of meds, processing physician orders, some patient assessment, may supervise in retirement settings, can provide info on difficulty in administering meds to residents or their response to meds
45
What is role of PSW in LTC?
Day to day care of residents. Assist with bathing, hygiene, toileting, dressing, feeding, etc. and can provide info on difficulties with providing care (behaviours, continence, mood)
46
What is the role of Unregulated Care providers in LTC?
Trained by nurses to administer meds primarily in retirement or group home settings. Must be supervised by RN or RPN, can only perform controlled acts if delegated and the act is considered a routine act of daily living and is stable dosing (eg. if insulin needs to be adjusted based on BG, that isn't stable)
47
How many residents might one RPN be responsible for administering meds to?
25-40 patients in one unit
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