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PROXY CAREGIVER WORKSHOP

OWNERS, ADMINISTRATORS AND EXECUTIVE DIRECTORS
DEFINE THE ROLE OF THE PROXY CAREGIVER

DEFINE LICENSED HEALTHCARE FACILITIES
VS. LICENSED RESIDENTIAL FACILITIES

STATE T...
DISCUSS THE KEY COMPONENTS OF AN
INFORMED CONSENT FOR PROXY
CARGIVERS

BE ABLE TO INTEGRATE PROXY CAREGIVERS
INTO FACILITY...
DISCUSS WITH POTENTIAL OR CURENT
RESIDENTS HOW PROXY CAREGIVERS ARE
USED IN THE FACILITY

IDENTIFY THE TRAINING REQUIREMEN...
EXAMINE AN EXAMPLE OF A MEDICATION
ADMINISTRATION CURRICULA THAT CAN BE
USED TO TRAIN PROXY CAREGIVERS

IDENTIFY MEDICATIO...
SERVICES THAT ARE REQUIRED BY RESIDENTS

PERSONAL CARE
SERVICES

ACTIVITIES OF DAILY
LIVING

EATING, BATHING, G
ROOMING, D...
UNLICENSED PERSON

TRAINED BY A
LICENSED
HEALTHCARE
PROFESSIONAL

QUALIFIED THROUGH
TRAINING;
KNOWLEDGE AND
SKILLS; COMPET...
A PROXY CAREGIVER IS AN UNLICENSED
PERSON WHO HAS BEEN DETERMINED
QUALIFIED TO HAVE THE NECESSARY
KNOWLEDGE AND SKILLS ACQ...
HEALTH MAINTENANCE ACTIVITIES ARE THOSE LIMITED ACTIVITIES
THAT, BUT FOR A DISABILITY, A PERSON COULD REASONABLY BE EXPECT...
WHAT IS MEANT BY
“COMPETENCY-BASED
TRAINING”?

 TRAINING THAT IS TIED TO
AN INDENTIFIED SET OF
SKILLS AND KNOWLEDGE

 RE...
COMPETENCY BASED SKILLS
CHECK-OFFS

 WRITTEN EVIDENCE OF
SATISFACTORY PERFORMANCE ON
INITIAL AND ANNUAL SKILLS
COMPETENCY...
HEALTH MAINTENANCE
ACTIVITIES ARE TAUGHT BY AN
ATTENDING
PHYSICIAN, REGISTERED
NURSE, PHYSICIAN
ASSISTANT, ADVANCED
PRACTI...
NOT ALLOWED UNDER PROXY CAREGIVER REGULATIONS
INITIAL DOSES OF IM
OR SQ MEDICATIONS

COMPLICATED WOUND
CARE

CENTRAL LINES...
WHERE CAN PROXY CAREGIVERS BE EMPLOYED?

RESIDENTIAL FACILITES--YES

•
•
•

PCHs AND ALFs
COMMUNITY LIVING ARRANGEMENTS
RE...
EXAMPLES OF HEALTH MAINTENANCE ACTIVITIES
BLOOD GLUCOSE
MONITORING

RANGE OF MOTION
CATHETER CARE
MEDICATION
ADMINISTRATIO...
EXAMPLES OF HEALTH MAINTENANCE ACTIVITIES

SPLINT APPLICATION

SIMPLE DRESSING
CHANGE

OSTOMY CARE
HOW ARE PROXY CAREGIVERS HIRED?

FACILITY
FOLLOW FACILITY HIRING PROCEDURE
APPLICATION, CRC, TB SCREENING
DRIVING RECOR...
WHAT HAPPENS WHEN THE PROXY CAREGIVER CANNOT PROVIDE
SERVICES?

ILLNESS

INCLEMENT WEATHER

FAMILY
EMERGENCY

CAR TROUBLE
...
PROXY CAREGIVERS VS CERTIFIED MEDICATION AIDES

ASSISTED LIVING FACILITIES
•

•
•

ASSIST WITH OR SUPERVISE SELFADMINISTRA...
WHAT SYSTEMS MUST BE IN PLACE TO IMPLEMENT A PROXY CAREGIVER
PROGRAM

 POLICY/PROCEDURE
 PHYSICIAN ORDERS
 INFORMED CON...
POLICIES AND PROCEDURES

 SCOPE OF THE HEALTH MAINTENANCE ACTIVITIES THAT ARE
PERFORMED BY THE PROXY CAREGIVERS
 NOTIFIC...
ADMISSION AGREEMENT
 AFTER JANUARY 8, 2013, MUST STATE
WHETHER FACILITY ALLOWS PROXY
CAREGIVERS

 IF PROXY CAREGIVERS AR...
MEDICATION POLICIES/PROCEDURES
REQUIREMENTS

 ADDRESS PROCEDURES FOR RECEIVING MEDICATIONS

 RECONCILING MEDICATIONS REC...
TRAINING REQUIREMENTS
 TRAINING CURRICULA
DEVELOPED BY A LICENSED HEALTHCARE PROFESSIONAL
THAT ENSURES THAT THE PROXY CAR...
TRAINING REQUIREMENTS
 SKILLS COMPETENCY CHECKLIST FORMS MUST INCLUDE ALL THE REQUIRED
INFORMATION SET FORTH IN THE REGUL...
MEDICATION ASSISTANCE RECORD
 NAME OF THE RESIDENT
 ANY KNOWN ALLERGIES
 NAME, TELEPHONE NUMBER OF
THE HEALTHCARE PROVI...
MEDICATION RESOURCES
FOR PROXY CAREGIVERS
CHANGES IN RESIDENT
CONDITION

CHANGES IN RESIDENT’S MEDICATIONS
CHANGES IN RESIDENT’S PLAN OF CARE
CHANGES IN HEALTH MAIN...
INTRODUCE CONCEPT
TO MEDICAL
DIRECTOR, PHYSICIA
NS AT QA MEETING

DISCUSS THE
CONCEPT OF “AGING
IN PLACE”

DEVELOP POLICIE...
FEES FOR HEALTH
MAINTENANCE ACTIVITIES
QUESTIONS
Alfreda Bivins
RN Consultant

678-576-8790

alfreda@fivestarresourcegroup.com
Proxy caregiver workshop pp2013 2
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Proxy caregiver workshop pp2013 2

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In 2011, the state of Georgia passed House Bill 1040 which allows unlicensed caregivers to perform "health maintenance activities" after receiving competency based training. This presentation is an overview of this new level of caregiver, the proxy caregiver.
For more information: http://fivestarresourcegroup.com/proxy-caregiver-training.php

Published in: Health & Medicine, Technology
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  • Introduction
  • OBJECTIVES
  • OBJECTIVES
  • OBJECTIVES
  • OBJECTIVES
  • SERVICES THAT ARE REQUIRED BY RESIDENTS
  • CHARACTERISTICS OF A PROXY CAREGIVER PROGRAM
  • OFFICIAL DEFINITION OF A PROXY CAREGIVER
  • COMPETENCY BASED; INDIVIDUALIZED TRAINING BASED ON THE NEEDS OF THE RESIDENT
  • HOW IS COMPETENCY BASED TRAINING ACHIEVED?
  • LICENSED PRACTICAL NURSES; CERTIFIED NURSES ASSISTANTS OR MEDICATION AIDES ARE NOT INCLUDED
  • ACTIVITIES THAT ARE NOT ALLOWED BY A PROXY CAREGIVER
  • IDENTIFY WHERE PROXY CAREGIVERS CAN WORK
  • ACTIVITIES ALLOWED TO BE PERFORMED BY PROXY CAREGIVERS
  • ACTIVITIES THAT CAN BE PERFORMED BY PROXY CAREGIVERS
  • FACILITY VS RESIDENT HIRED REQUIREMENTS
  • PROXY CAREGIVERS HIRED BY THE RESIDENT; BACK –UP PLAN
  • PROXY CAREGIVERS VS MEDICATION AIDES
  • REGULATORY REQUIREMENTS FOR A PROXY CAREGIVER PROGRAM
  • MEDICATION POLICIES AND PROCEDURE REQUIREMENTS
  • TRAINING CURRICULA
  • TRAINING CURRICULA
  • MEDICATION ASSISTANCE RECORD
  • RESOURCES WRITTEN FOR LICENSED PROFESSIONAL ARE NOT APPROPRIATE; CAN BE USED FOR TEACHING
  • CHANGES IN RESIDENT CONDITION; IMPACT ON PLAN OF CARE
  • HOW TO IMPLEMENT A PROXY CAREGIVER PROGRAM
  • RISK MANAGMENT
  • CHARGES; FEES FOR ADDITIONAL SERVICES
  • Transcript of "Proxy caregiver workshop pp2013 2"

    1. 1. PROXY CAREGIVER WORKSHOP OWNERS, ADMINISTRATORS AND EXECUTIVE DIRECTORS
    2. 2. DEFINE THE ROLE OF THE PROXY CAREGIVER DEFINE LICENSED HEALTHCARE FACILITIES VS. LICENSED RESIDENTIAL FACILITIES STATE THE DIFFERENCES BETWEEN PERSONAL CARE AND HEALTH MAINTENANCE SERVICES/ACTIVITIES
    3. 3. DISCUSS THE KEY COMPONENTS OF AN INFORMED CONSENT FOR PROXY CARGIVERS BE ABLE TO INTEGRATE PROXY CAREGIVERS INTO FACILITY OPERATIONS DISCUSS THE COMPONENTS OF A BACK-UP PROXY CAREGIVER SERVICE PLAN
    4. 4. DISCUSS WITH POTENTIAL OR CURENT RESIDENTS HOW PROXY CAREGIVERS ARE USED IN THE FACILITY IDENTIFY THE TRAINING REQUIREMENTS FOR PROXY CAREGIVERS DISCUSS THE TRAINING REQUIREMENTS FOR PROXY CAREGIVERS THAT ADMINISTER MEDICATIONS TO SPECIFIC RESIDENTS
    5. 5. EXAMINE AN EXAMPLE OF A MEDICATION ADMINISTRATION CURRICULA THAT CAN BE USED TO TRAIN PROXY CAREGIVERS IDENTIFY MEDICATIONS THAT ARE PROHIBITED FROM BEING GIVEN BY A PROXY CAREGIVER DISCUSS THE DIFFERENCES BETWEEN PROXY CAREGIVER AND MEDICATION AIDE
    6. 6. SERVICES THAT ARE REQUIRED BY RESIDENTS PERSONAL CARE SERVICES ACTIVITIES OF DAILY LIVING EATING, BATHING, G ROOMING, DRESSIN G TRANSFERS, TOILET USE, EATING, BATHI NG, BED MOBILITY HEALTH MAINTENANCE ACTIVITIES HB 1040
    7. 7. UNLICENSED PERSON TRAINED BY A LICENSED HEALTHCARE PROFESSIONAL QUALIFIED THROUGH TRAINING; KNOWLEDGE AND SKILLS; COMPETENCY BASED HEALTH MAINTENANCE ACTIVIITES WRITTEN INFORMED CONSENT BASED ON PHYSICIAN ORDERS PLAN OF CARE
    8. 8. A PROXY CAREGIVER IS AN UNLICENSED PERSON WHO HAS BEEN DETERMINED QUALIFIED TO HAVE THE NECESSARY KNOWLEDGE AND SKILLS ACQUIRED THROUGH TRAINING BY A LICENSED HEATHCARE PROFESSIONAL TO PERFORM DOCUMENTED HEALTH MAINTENANCE ACTIVITIES INCLUDING SPECIALIZED PROCEDURES, FOR AN INDIVIDUAL WITH A DISABILITY WHO HAS DELEGATED TO THE DESIGNATED PROXY CAREGIVER THE PERFORMANCE OF SUCH HEALTH MAINTENANCE ACTIVITIES THROUGH EXECUTION OF A WRITTEN INFORMED CONSENT BASED ON WRITTEN PHYSICIAN ORDERS BY THE INDIVIDUAL WITH A DISABILITY OR LEGAL GUARDIAN
    9. 9. HEALTH MAINTENANCE ACTIVITIES ARE THOSE LIMITED ACTIVITIES THAT, BUT FOR A DISABILITY, A PERSON COULD REASONABLY BE EXPECTED TO DO FOR HIMSELF OR HERSELF. SUCH ACTIVITIES ARE TYPICALLY TAUGHT BY A LICENSED HEALTHCARE PROFESSIONAL OR CAN BE TAUGHT DIRECTLY TO THE RESIDENT. DOES NOT INCLUDE ACTIVITIES THAT REQUIRE COMPLEX OBSERVATIONS OR CRITICAL THINKING. CAN BE SAFELY PERFORMED AND HAVE REASONABLY PRECISE, UNCHANGING DIRECTIONS; AND HAVE OUTCOMES OR RESULTS THAT ARE REASONABLY PREDICTABLE.
    10. 10. WHAT IS MEANT BY “COMPETENCY-BASED TRAINING”?  TRAINING THAT IS TIED TO AN INDENTIFIED SET OF SKILLS AND KNOWLEDGE  REQUIRES INDEPENDENT DEMONSTRATION AND DOCUMENTATION  ACCEPTABLE LEVEL OF PERFORMACE OF A TASK OR ACHIEVEMENT OF AN OUTCOME
    11. 11. COMPETENCY BASED SKILLS CHECK-OFFS  WRITTEN EVIDENCE OF SATISFACTORY PERFORMANCE ON INITIAL AND ANNUAL SKILLS COMPETENCY DETERMINATIONS  UTILIZE CHECKLIST DEVELOPED BY DCH OR LICENSED HEALTHCARE PROFESSIONAL  TEST THE KNOWLEDGE AND OBSERVATION OF THE SKILLS NECESSARY TO DO THE SPECIFIC HEALTH MAINTENCE ACTIVITY IN ACCORDANCE WITH STANDARDS OF CARE
    12. 12. HEALTH MAINTENANCE ACTIVITIES ARE TAUGHT BY AN ATTENDING PHYSICIAN, REGISTERED NURSE, PHYSICIAN ASSISTANT, ADVANCED PRACTICE NURSE, PHARMACIST LICENSED HEALTHCARE PROFESSIONALS OR DIRECTLY TO THE RESIDENT HIMSELF/HERSELF THESE HEALTH MAINTENANCE ACTIVITIES ALLOW RESIDENTS TO REMAIN IN THEIR LIVING ENVIRONMENT OF CHOICE ONCE THEIR CARE REQUIREMENTS GO BEYOND PERSONAL CARE SERVICES
    13. 13. NOT ALLOWED UNDER PROXY CAREGIVER REGULATIONS INITIAL DOSES OF IM OR SQ MEDICATIONS COMPLICATED WOUND CARE CENTRAL LINES IV MEDICATION ADMIN
    14. 14. WHERE CAN PROXY CAREGIVERS BE EMPLOYED? RESIDENTIAL FACILITES--YES • • • PCHs AND ALFs COMMUNITY LIVING ARRANGEMENTS RESIDENTIAL DRUG ABUSE TREATMENT EDUCATION PROGRAMS • TRAUMATIC BRAIN INJURY FACILITES HEALTHCARE FACILITIES--NO • • • • HOSPITALS RESIDENTIAL MENTAL HEALTH FACILITIES NURSING HOMES MEDICARE-CERTIFIED HOME HEALTH AGENCIES PRIVATE HOME CARE PROVIDERS
    15. 15. EXAMPLES OF HEALTH MAINTENANCE ACTIVITIES BLOOD GLUCOSE MONITORING RANGE OF MOTION CATHETER CARE MEDICATION ADMINISTRATION
    16. 16. EXAMPLES OF HEALTH MAINTENANCE ACTIVITIES SPLINT APPLICATION SIMPLE DRESSING CHANGE OSTOMY CARE
    17. 17. HOW ARE PROXY CAREGIVERS HIRED? FACILITY FOLLOW FACILITY HIRING PROCEDURE APPLICATION, CRC, TB SCREENING DRIVING RECORD, IF APPROPRIATE ORIENTATION COMPETENCY BASED TRAINING DOCUMENTATION IN FILE RESIDENT CRC, TB SCREENING, DRIVING RECORD EVACUATION PROCEDURES ENSURE THERE IS A PROCEDURE IN PLACE TO PROTECT OTHER RESIDENTS FROM HARM BY PROXY CAREGIVERS NOT UNDER THE CONTROL OF THE FACILITY DOCUMENTATION IN FILE
    18. 18. WHAT HAPPENS WHEN THE PROXY CAREGIVER CANNOT PROVIDE SERVICES? ILLNESS INCLEMENT WEATHER FAMILY EMERGENCY CAR TROUBLE CHILL ILL
    19. 19. PROXY CAREGIVERS VS CERTIFIED MEDICATION AIDES ASSISTED LIVING FACILITIES • • • ASSIST WITH OR SUPERVISE SELFADMINISTRATION OF MEDICATIONS TO RESIDENTS THAT ARE CAPABLE OF SELFADMINISTRATION. CANNOT ADMINISTER MEDICATIONS CAN PERFORM OTHER HEALTH MAINTENANCE ACTIVITIES MEDICATION AIDES PERSONAL CARE HOMES • • • CAN ADMINISTER MEDICATIONS IF PROPERLY TRAINED CAN PERFORM ADDITIONAL HEALTH MAINTENANCE ACTIVITIES CAN ASSIST/SUPERVISE MEDICATIONS TO RESIDENTS THAT CAN SELFMEDICATE
    20. 20. WHAT SYSTEMS MUST BE IN PLACE TO IMPLEMENT A PROXY CAREGIVER PROGRAM  POLICY/PROCEDURE  PHYSICIAN ORDERS  INFORMED CONSENT  PLAN OF CARE  TRAINING CURRICULA  SKILLS CHECK-OFFS
    21. 21. POLICIES AND PROCEDURES  SCOPE OF THE HEALTH MAINTENANCE ACTIVITIES THAT ARE PERFORMED BY THE PROXY CAREGIVERS  NOTIFICATION PROCEDURES THAT WILL BE UTILIZED WHEN THE PROXY CAREGIVER OBSERVES A CHANGE IN THE RESIDENT’S CONDITION THAT MAY NEED FURTHER EVALUATION/TREATMENT  THERE IS A CHANGE IN THE PLAN OF CARE  SAFETY AND SECURITY PRECAUTIONS (CRC, TRAINING)  THE MANNER IN WHICH PROXY CAREGIVERS ARE SUPERVISED; FREQUENCY OF RE-EVALUATIONS  BACK-UP PROXY CAREGIVERS; QUALIFICATIONS OF THE LICENSED HEALTHCARE PROFESSIONALS  MANNER IN WHICH RESIDENTS CAN CHANGE PROXY CAREGIVERS
    22. 22. ADMISSION AGREEMENT  AFTER JANUARY 8, 2013, MUST STATE WHETHER FACILITY ALLOWS PROXY CAREGIVERS  IF PROXY CAREGIVERS ARE ALLOWED, THEN MUST STATE WHETHER OR NOT THERE WILL BE ANY ADDITIONAL CHARGES
    23. 23. MEDICATION POLICIES/PROCEDURES REQUIREMENTS  ADDRESS PROCEDURES FOR RECEIVING MEDICATIONS  RECONCILING MEDICATIONS RECEIVED AGAINST THOSE ORDERED  MEDICATION STORAGE  PROCEDURES FOR MANAGING MEDICATIONS  PROCEDURES FOR DISCONTINUED MEDICATIONS  PROCEDURES FOR DISPOSAL OF MEDICATIONS
    24. 24. TRAINING REQUIREMENTS  TRAINING CURRICULA DEVELOPED BY A LICENSED HEALTHCARE PROFESSIONAL THAT ENSURES THAT THE PROXY CAREGIVER DEMONSTRATES THE HEALTH MAINTENACE ACTIVITY CORRECTLY AND SAFELY  LEARNING OBJECTIVES THAT RELATE SPECIFICALLY TO THE HEALTH MAINTENANCE ACTIVITY TO BE PERFORMED  CONTENT KNOWLEDGE AND SKILLS THAT ARE REQUIRED TO ACCOMPLISH THE LEARNING OBJECTIVES  LEARNING OBJECTIVES THAT WILL BE UTILIZED TO PROVIDE INSTRUCTION ON KNOWLEDGE AND SKILLS REQUIRED  SATISFACTORY AND INDEPENDENT COMPLETION OF THE REQUIRED SKILLS COMPETENCY CHECKLIST RELATED TO THE SPECIFIC ACTIVITY TO BE PERFORMED BEFORE AN APPROPRIAELY TRAINED LICENSED HEALTHCARE PROFESSIONAL
    25. 25. TRAINING REQUIREMENTS  SKILLS COMPETENCY CHECKLIST FORMS MUST INCLUDE ALL THE REQUIRED INFORMATION SET FORTH IN THE REGULATIONS AND REQUIRED BY THE SPECIFIC RESIDENT  SATISFACTORY EVIDENCE OF ROUTINE EVALUATIONS OF CONTINUED SKILLS COMPETENCIES BY AN APPROPRIATELY LICENSED HEALTHCARE PROFESSIONAL AT LEAST ANNUALLY IF NOT ASSESSED MORE FREQUENTLY AS SPECIFIED ON THE WRITTEN PLAN OF CARE  A SCORE OF 75% OR GREATER ON THE TEST OF FUNCTIONAL HEALTH LITERACY (TOFHLA) USED AS AN ASSESSMENT TOOL TO INDIVIDUALIZE NECESSARY TRAINING FOR THE SPECIFIC SKILLS
    26. 26. MEDICATION ASSISTANCE RECORD  NAME OF THE RESIDENT  ANY KNOWN ALLERGIES  NAME, TELEPHONE NUMBER OF THE HEALTHCARE PROVIDER  THE NAME, STRENGTH AND SPECIFIC DIRECTIONS OF EACH MEDICATION  TIME/DATE MEDICATIONS ARE TAKEN OR REFUSED
    27. 27. MEDICATION RESOURCES FOR PROXY CAREGIVERS
    28. 28. CHANGES IN RESIDENT CONDITION CHANGES IN RESIDENT’S MEDICATIONS CHANGES IN RESIDENT’S PLAN OF CARE CHANGES IN HEALTH MAINTENANCE ACTIVITIES
    29. 29. INTRODUCE CONCEPT TO MEDICAL DIRECTOR, PHYSICIA NS AT QA MEETING DISCUSS THE CONCEPT OF “AGING IN PLACE” DEVELOP POLICIES TO ADDRESS SAFETY, TIMELY NOTIFICATION AND DOCUMENTATION, AA INTRODUCE PROXY CAREGIVERS CONCEPT TO RESIDENTS/FAMILIES AND STAFF DISCUSS HOW PROXY CAREGIVERS WILL BE UTILIZED IN THE FACILITY
    30. 30. FEES FOR HEALTH MAINTENANCE ACTIVITIES
    31. 31. QUESTIONS
    32. 32. Alfreda Bivins RN Consultant 678-576-8790 alfreda@fivestarresourcegroup.com
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