Cal. Code Regs. Tit. 22, § 72315 - Nursing Service-Patient Care
(a) No patient shall be admitted or accepted
for care by a skilled nursing facility except on the order of a
physician.
(b) Each patient shall
be treated as individual with dignity and respect and shall not be subjected to
verbal or physical abuse of any kind.
(c) Each patient, upon admission, shall be
given orientation to the skilled nursing facility and the facility's services
and staff.
(d) Each patient shall
be provided care which shows evidence of good personal hygiene, including care
of the skin, shampooing and grooming of hair, oral hygiene, shaving or beard
trimming, cleaning and cutting of fingernails and toenails. The patient shall
be free of offensive odors.
(e)
Each patient shall be encouraged and/or assisted to achieve and maintain the
highest level of self-care and independence. Every effort shall be made to keep
patients active, and out of bed for reasonable periods of time, except when
contraindicated by orders of a licensed health care practitioner acting within
the scope of his or her professional licensure.
(f) Each patient shall be given care to
prevent formation and progression of decubiti, contractures and deformities.
Such care shall include:
(1) Changing position
of bedfast and chairfast patients with preventive skin care in accordance with
the needs of the patient.
(2)
Encouraging, assisting and training in self-care and activities of daily
living.
(3) Maintaining proper body
alignment and joint movement to prevent contractures and deformities.
(4) Using pressure-reducing devices where
indicated.
(5) Providing care to
maintain clean, dry skin free from feces and urine.
(6) Changing of linens and other items in
contact with the patient, as necessary, to maintain a clean, dry skin free from
feces and urine.
(7) Carrying out
of physician's orders for treatment of decubitus ulcers. The facility shall
notify the physician, when a decubitus ulcer first occurs, as well as when
treatment is not effective, and shall document such notification as required in
Section 72311(b).
(g) Each patient requiring help in eating
shall be provided with assistance when served, and shall be provided with
training or adaptive equipment in accordance with identified needs, based upon
patient assessment, to encourage independence in eating.
(h) Each patient shall be provided with good
nutrition and with necessary fluids for hydration.
(i) Measures shall be implemented to prevent
and reduce incontinence for each patient and shall include:
(1) Written assessment by a licensed nurse to
determine the patient's ability to participate in a bowel and/or bladder
management program. This is to be initiated within two weeks after admission of
an incontinent patient.
(2) An
individualized plan, in addition to the patient care plan, for each patient in
a bowel and/or bladder management program.
(3) A weekly written evaluation in the
progress notes by a licensed nurse of the patient's performance in the bowel
and/or bladder management program.
(j) Fluid intake and output shall be recorded
for each patient as follows:
(1) If ordered
by the physician.
(2) For each
patient with an indwelling catheter:
(A)
Intake and output records shall be evaluated at least weekly and each
evaluation shall be included in the licensed nurses' progress notes.
(B) After 30 days the patient shall be
reevaluated by the licensed nurse to determine further need for the recording
of intake and output.
(k) The weight and length of each patient
shall be taken and recorded in the patient's health record upon admission, and
the weight shall be taken and recorded once a month thereafter.
(l) Each patient shall be provided visual
privacy during treatments and personal care.
(m) Patient call signals shall be answered
promptly.
Notes
Note: Authority cited: Sections 1275, 100275 and 131200, Health and Safety Code. Reference: Sections 1262.7, 1275, 1316.5, 131050, 131051 and 131052, Health and Safety Code.
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