Tasks the QMA is PROHIBITED from performing.
Assess a resident's condition. Call a physician. Take a physician's written or verbal order. Administer medic... [Show More] ation by injection. Administer any medication inhalation treatment OTHER than a metered dose inhaler. Administer medication per nasogastric tube. Instill irrigation fluids of any type including, but not limited to, colostomy, catheter and enema, EXCEPT a commercially packed prepared disposable enema. Administer a treatment that involves an advanced skin condition, including Stage II, III, and IV decubitus ulcers.
The QMA Scope of Practice
Observe and report to licensed nurse. Measure and document vital signs. Administer regularly prescribed meds which the QMA has been trained to administer only after personally preparing the meds to be administered. Initiate oxygen per nasal cannula or non sealing mask only in an emergency. Obtain oxygen saturation using oximeter. Administer, apply physician ordered oral, ophthalmic, otic, nasal, vaginal and rectal meds. Crush and administer meds if such preparation is appropriate per manufacturer or physicians order. Alter capsules if prescribed to be administered in this altered manner by the physician. Count, administer, and document controlled substances. Administer meds per G-tube or J-tube. Administer previously ordered PRN meds only if authorization is obtained, then the QMA must chart resident symptoms indicating the need for the med and time symptoms occurred, Chart that the facility nurse was notified the symptoms of the resident and that permission was granted to administer med, obtain permission each time the resident needs the med, ensure that the resident's record is soigné do by the LPN or RN who gave the permission for the PRN meds. Apply topical meds to minor skin conditions such as dermatitis, scabies, pediculosis, fungal infection, psoriasis, eczema, first degree burn, stage I decubitus ulcer. Administer meds via metered dose inhaler. Conduct hemoccult testing and report result to licensed nurse. Provide site care and apply dressing to a healed G-tube or J-tube site (ordered). Empty and change colostomy bag. Instill a commercially disposable enema (120 ml or 4.5 ozs) after the resident has been assessed by the nurse. Administer a sitz bath if ordered by a physician. Apply cold, dry compress as directed by nurse or physician. Conduct diabetic urine testing. Collect fecal or urine specimens as ordered by physician. CHART CHART CHART anything the QMA see, hears, or smells and document what is reported to the Q by the resident.
Negligence
The omission or neglect of any reasonable precaution, care or action. Residents are protected from health care negligence or malpractice by a law called Duty of Care.
Malpractice
Any improper or injurious practice, or any unskillful or faulty medical or surgical treatment.
The Six Rights of Medication administration
Right Medication. Right Dose. Right Resident. Right Route. Right Time. (1hr before or 1 hr after). Right documentation.
Initial Steps
Obtain info from licensed nurse about resident's needs abilities, limitations, and known allergies. Gather supplies and equipment. Knock on resident's door. Identify yourself. Explain procedure to the resident. Wash your hands or use antiseptic foam or gel. Wear gloves to maintain Standard Precautions as necessary.
Final Steps
Observe resident for any immediate reaction to med or procedure. Assure the resident is in a comfortable position. Make sure call light is within resident's reach. Remove supplies and discard of medication cups/disposable supplies. Thank resident. Remove gloves. Wash hands. Document meds administered or procedure preformed. Report any abnormalities to the nurse.
Sundowning
Increased confusion and restlessness in late afternoon, evening, and night.
Hand washing
Lather all areas of hands and wrists, rubbing vigorously for at least 10 seconds.
Putting on Gloves
Remove one glove by grasping the outer surface just below the cuff with the other gloved hand.
Isolation Precautions
Airborne-pathogens are transmitted on dust particles in air currents examples are TB, chickenpox, measles.
Droplet-pathogens are transmitted in droplets when a person coughs, sneezes or talks examples pneumonia, influenza, scarlet fever.
Contact-pathogens are transmitted by direct contact (skin-to-skin) with the resident or indirect contact with surfaces or care items in the resident's environment examples scabies, conjunctivitis, impetigo.
Hepatitis
Contagious disease of the liver caused by a virus and spread by exposure to infected blood, sexual contact or fecal/oral contact. Symptoms are flu like. Severe infection can cause permanent liver damage and death. Types A, B, C, D, E
Tuberculosis
Chronic bacterial infection that usually affects the lung but may affect other parts of the body such as the kidneys, bones, and the brain. TB is spread through the air in droplets from sputum of persons with active disease. Symptoms include fever, loss of appetite, fatigue, productive cough and night sweats.
Acquired ImmuneDeficiency Syndrome
Results from infection with the Human Immunodeficiency Virus (HIV) which destroys the body's ability to fight infection. Virus is spread thru infected blood and body fluid. Early symptoms are flu like followed by a symptom free period which can last many years (one to ten or more). No cure is known, however, new meds and treatments show promise.
Methicillin Resistant Staphylococcus Aureus (MRSA)
Bacteria that no longer responds to antibiotics normally used to treat staphylococcal infections. It is spread on the hands of health care workers. To prevent spread follow Standard Precautions.
Vancomycin Resistant Enterococcus
(VRE)
Bacteria that no longer responds to the antibiotic Vancomycin. It is spread on the hands of health care workers. Use Standard Precautions to prevent spreading.
Body Mechanics/Resident Safety
Place a pillow against the headboard when moving a resident up in bed. [Show Less]
