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Restorative Programs

The safety perspective

By Rita Frieder, RN, LNHA

Research has shown that a large majority of nursing home residents are at risk for premature functional loss and institutionally induced dependency. Residents who progress from health, to pathology, to impairment end up requiring an alteration in the type and amount of nursing care required. Early examination, evaluation and intervention can prevent many of these functional losses.

Helping residents avoid decline and attain/maintain functional abilities requires an active facility-wide restorative program. Restorative nursing is not just administered by the restorative personnel. It is a program that can also be provided by CNAs, volunteers and other staff trained in restorative care. All departments in a facility can and should be a part of the restorative program.

Needlestick injuries can be caused by products such as hypodermic needles, blood collection needles and IV stylets and can expose healthcare workers to a number of bloodborne pathogens, including Hepatitis B, Hepatitis C and HIV/AIDS. 2

What are restorative programs?

According to the MDS 3.0, "Restorative services are programs under the direction and supervision of a licensed nurse and are provided by nursing staff. Although therapists may participate in designing the initial program, members of nursing staff are still responsible for the overall coordination and supervision of restorative nursing programs."1

Restorative programs promote the resident's ability to adapt and adjust to living as independently and safely as possible. This concept actively focuses on achieving and maintaining optimal physical, mental and psychosocial functioning. Functional decline can lead to depression, withdrawal, social isolation and the physical complications of immobility, such as incontinence and pressure ulcers.1

Which residents should be part of a restorative program?

All residents in a facility could, and probably should, be involved in restorative programs. Section O of the MDS 3.0 states that a resident may begin a restorative program when he or she is admitted to the facility with restorative needs (but is not a candidate for formalized rehabilitation therapy), when restorative needs arise during the course of a longer-term stay or in conjunction with formalized rehabilitation therapy. Generally, restorative nursing programs are initiated when a resident is discharged from formalized physical, occupational or speech rehabilitation therapy.1

How can restorative programs assist with safety measures?

About one out of 10 falls among older adults result in a serious injury, such as a hip fracture or head injury, that requires hospitalization. Falls are the leading cause of injury deaths among older adults and they're preventable. Many restorative nursing programs can assist with improving the resident's lower extremity strength, balance and overall mobility. Residents who are non-weight-bearing or unable to ambulate independently are great candidates for restorative programs.

Let's take a look at the components of restorative nursing programs. Like any other nursing program, restorative programs require a team approach to be successful.

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