SECTION 310:675-9-1.1. Nursing and personal care services

(a)   The facility shall ensure that resident rights are respected in the provision of care.

(b)   Basic nursing and personal care shall be provided for residents as needed.

(1)   Nursing care shall include, but not be limited to:

(A)   Encouraging residents to be active and out of bed for reasonable time periods.

(B)   Measuring resident temperature, blood pressure, pulse and respirations at least once every thirty days and more frequently if warranted by the resident's condition, with the results recorded in the clinical record.

(i)   Measuring resident weight at least once every thirty days and more frequently if warranted by the resident's condition, with the results recorded in the clinical record.

(ii)   Measuring resident pain whenever vital signs are taken and more frequently if warranted by the resident's condition, with the results recorded in the clinical record.

(C)   Offering fluids, and making fluids available, to maintain proper hydration.

(D)   Following proper nutritional practices for diets, enteral and parenteral feedings and assistance in eating.

(E)   Providing proper skin care to prevent skin breakdown.

(F)   Providing proper body alignment.

(G)   Providing supportive devices to promote proper alignment and positioning.

(H)   Turning bed residents every two hours or as needed, to prevent pressure areas, contractures, and decubitus.

(I)   Performing range of motion exercises in accordance with individual assessment and care plans.

(J)   Ensuring that residents positions are changed every two hours or as needed when in a chair and are toileted as needed.

(K)   Establishing and implementing bowel and bladder programs to promote independence, or developing toileting schedules to promote continence.

(L)   Performing catheter care with proper positioning of bag and tubing at all times.

(M)   Recording accurate intake and output records for residents with tube feedings or catheters.

(N)   Assessing the general mental and physical condition of the resident on admission.

(O)   Updating the assessment and individual care plan when there is a significant change in the resident's physical, mental, or psychosocial functioning.

(P)   Recognizing and recording signs and symptoms of illness or injury with action taken to treat the illness or injury, and the response to treatments and medications.

(2)   Personal care shall include, but not be limited to:

(A)   Keeping residents clean and free of odor.

(B)   Keeping bed linens clean and dry.

(C)   Keeping resident's personal clothing clean and neat.

(D)   Ensuring that residents are dressed appropriately for activities in which they participate; bedfast/chairfast residents shall be appropriately dressed and provided adequate cover for comfort and privacy.

(E)   Ensuring that the resident's hair is clean and groomed.

(F)   Providing oral hygiene assistance at least twice daily with readily available dental floss, toothbrush and dentifrice. A denture cleaning/soaking device and brush shall be available and maintained for each resident as needed.

(G)   Keeping toenails and fingernails clean and trimmed.

(c)   The facility shall assist the resident in securing other services recommended by a physician such as, but not limited to, optometry or ophthalmology, audiology or otology, podiatry, laboratory, radiology or hospital services. The administration shall, through social services or other means, assist each resident desiring or needing medical related services.

[Source: Added at 9 Ok Reg 3163, eff 7-1-92 (emergency); Added at 10 Ok Reg 1639, eff 6-1-93; Amended at 23 Ok Reg 156, eff 10-6-05 (emergency); Amended at 23 Ok Reg 2415, eff 6-25-06]