Utah Admin. Code 432-300-13

Current through Bulletin 2024-20, October 15, 2024

Section R432-300-13 - Nursing Care

(1) Each Type N facility licensee shall provide nursing care services to meet the needs of residents.

(2) The licensee shall ensure nursing practice is in accordance with the Utah Nurse Practice Act 58-31b.

(3) Licensees are responsible to:

(a) direct the implementation of physician's orders;

(b) develop and implement an individualized care plan for each resident within seven calendar days of admission, and direct the delivery of nursing care, treatments, procedures, and other services to meet the needs of the residents;

(c) review and update the health care needs of each resident in the facility at least every 6 months;

(d) develop resident care plans according to the resident's needs and the physician's orders;

(e) review each resident's medication regimen as needed and immediately after medication changes to ensure accuracy;

(f) ensure that nursing notes describe the care provided including the resident's response;

(g) supervise staff to ensure they perform restorative measures in their daily care of residents;

(h) teach and coordinate resident care and rehabilitative care to promote and maintain optimal physical and mental functioning of the resident; and

(i) plan and conduct documented orientation and in-service programs for staff.

(4) The licensee shall:

(a) develop and maintain a current health services policy and procedure manual that is to be reviewed and updated at least annually;

(b) ensure the manual is accessible to any staff and is available for review by the department; and

(c) ensure the health services policies and procedures address the following:

(i) bathing;

(ii) positioning;

(iii) enema administration;

(iv) decubitus prevention and care;

(v) bed making;

(vi) isolation procedures;

(vii) blood sugar monitoring procedures;

(viii) telephone orders;

(ix) charting;

(x) rehabilitative nursing;

(xi) diets and feeding residents;

(xii) oral hygiene and denture care;

(xiii) medication administration;

(xiv) Alzheimer's or dementia care;

(xv) universal precautions and blood-borne pathogens; and

(xvi) housekeeping and cleaning procedures.

(5) The licensee shall ensure compliance with each of the following regarding bowel and bladder care:

(a) each resident's care plan includes measures to prevent and reduce incontinence;

(b) each resident is assessed to determine the resident's ability to participate in a bowel and bladder management program;

(c) an individualized plan for each incontinent resident begins within two weeks of the initial assessment;

(d) the licensed nurse documents a weekly evaluation of the resident's performance in the bowel and bladder management program; and

(e) fluid intake and output is recorded for each resident and evaluated at least weekly when ordered by a physician or nurse.

(6) The licensee shall ensure:

(a) staff are trained in rehabilitative nursing;

(b) rehabilitative nursing services for residents who require such services are provided and documented daily;

(c) rehabilitative nursing services include the following:

(i) turning and positioning of residents as per physician's or nurse's orders;

(ii) assisting residents to ambulate;

(iii) improving resident's range of motion;

(iv) restorative feeding;

(v) bowel and bladder retraining;

(vi) teaching residents self-care skills;

(vii) teaching residents transferring skills; and

(viii) taking measures to prevent secondary disabilities such as contractures and decubitus ulcers, which are stiffening joints and skin ulcers.

Utah Admin. Code R432-300-13

Amended by Utah State Bulletin Number 2017-22, effective 10/17/2017

Amended by Utah State Bulletin Number 2023-10, effective 5/9/2023