There are six in-service sections. They will each be presented for you to review and followed by a short quiz.

The purpose of this course is to illustrate examples of Abuse and Exploitation. The goal is to help you recognize signs of patient abuse or exploitation. Any abuse or exploitation perpetrated by any DCHC Staffing employee will result in immediate termination and be reported to the proper authorities. For additional details see DCHC Staffing Policy for Prevention of Abuse and Neglect in your employee handbook.

 

Physical abuse is “the use of physical force that may result in bodily injury, physical pain, or impairment.” This includes striking, hitting, beating, shoving, pushing, shaking, slapping, kicking, pinching, and burning. In addition to these, utilizing drugs or physical objects to restrain a patient or forcing them to eat or drink against their will is also classified as physical abuse.

As healthcare providers, we must diligently assess our patients for signs of physical abuse, document these signs, and report them to the appropriate individuals. Signs of physical abuse include:

• Bruises, black eye, lacerations, restraint (rope marks).
• Broken bones, sprains, dislocations, internal injuries, cuts, punctures, or untreated injuries.
• Laboratory findings of medication overdose or underutilization.
• Sudden change in patient’s behavior.
• Caregiver’s refusal of visitors.
• Patient reports physical abuse.

Sexual abuse is classified as any sexual act without consent or with someone incapable of giving consent to sexual acts. Sexual acts can include unwanted touching, rape, sodomy, coerced nudity, or sexually explicit photography.

As healthcare providers, we must diligently assess our patients for signs of sexual abuse, document these signs, and report them to the appropriate individuals. Signs of emotional abuse include:

• Bruises around the breasts or genitals.
• Unexplained vaginal or anal bleeding.
• Unexplained genital infection or venereal disease.
• Torn, stained, or bloody underwear.
• Patient reports sexual assault.

Emotional or psychological abuse is the infliction of anguish, pain, or distress through verbal or nonverbal acts including harassment, verbal assaults, threats of harm or restraint, intimidation, humiliation, and isolation. We may mistake simple arguments or disagreements as innocent but they can be signs of a larger problem.

As healthcare providers, we must diligently assess our patients for signs of emotional abuse, document these signs, and report them to the appropriate individuals. Signs of physical abuse include:

• Patient becomes non-communicative, withdrawn, or non-responsive.
• Patient becomes emotionally agitated.
• Unusual behavior like thumb-sucking, biting, and rocking.
• Patient reports emotional abuse.

Neglect is a major problem, especially with frail and elderly patients. As people age, activities of daily living become more difficult. The decline in the ability to function independently can lead to neglect

As healthcare providers, we must diligently assess our patients for signs of neglect, document these signs, and report them to the appropriate individuals. Signs of neglect include:

• Dehydration, malnutrition, untreated bed sores, or poor personal hygiene.
• Unattended or untreated health problems.
• Unsafe living conditions.
• Unsanitary living conditions from lack of housekeeping.
• Patient reports neglect.

Abandonment is when a patient is left or deserted. Abandonment can happen when the patient is stranded at a facility or their residence which could put them at risk. Abandoned patients may be confused, unable to call for assistance, or left without money or a phone.

As healthcare providers, we must diligently assess our patients for signs of abandonment, document these signs, and report them to the appropriate individuals. Signs of neglect include:

• Patient has been deserted at a hospital, a nursing facility, or their home.
• Patient has been left at a shopping center or public place.
• Patient reports abandonment.

Financial exploitation includes theft, misuse, or concealment of funds, property, or assets of a vulnerable person. Financial abuse includes forgery, use of a patient’s ATM/Credit Card without authorization, theft of cash or checks, or coercion of signing a contract or will.

As healthcare providers, we must diligently assess our patients for signs of financial abuse, document these signs, and report them to the appropriate individuals. Signs of neglect include:

• Disappearance of funds or valuable possessions.
• Transfer of patient assets.
• Bank account changes including unexplained withdrawals or the addition of a new signer.
• Changes to a will or financial documents.
• Discovery of a patient’s forged signature.

Skin Care

The skin is an organ. It’s the largest organ in the human body. The top layer of the skin is called the epidermis. It is important to keep the epidermis hydrated since the skin becomes weaker and thinner as we age and becomes more prone to tearing and bruising. Caregivers must follow the prescribed skin care plan outlined in a patient’s Individual Service Plan (ISP).

Bathing

The room should be comfortably warm. Water temperature should be checked often. The bathing supplies, including towels, should be gathered, readily available, and close to the tub/shower. When bathing, safety is critical, but it is important to allow the patient to have as much control of the process as possible without compromising their safety.

Privacy

During bathing, it is important to allow the patient to have as much privacy as possible without compromising their safety. Safety must come first during the bathing process. If the patient objects to this process, it is critical to speak with your case manager to fix any bathing issues.

Resistance

If a patient is resistant to a bath or shower, it might make sense to give them a “bird bath.” To effectively give a patient a “birdbath,” use a warm soapy washcloth. Only disrobe the parts of a patient’s body that are being washed. This can make bathing longer, so be patient.

Assessment

It is important to check for changes to your patient’s skin during bath time. You should look for breaks in the skin and rubbed areas between fingers and toes, under the arms, and under the breasts. Barrier cream is a good tool to protect the skin

 

Skin Care

The skin is an organ. It’s the largest organ in the human body. The top layer of the skin is called the epidermis. It is important to keep the epidermis hydrated since the skin becomes weaker and thinner as we age and becomes more prone to tearing and bruising. Caregivers must follow the prescribed skin care plan outlined in a patient’s Individual Service Plan (ISP).

Bathing

The room should be comfortably warm. Water temperature should be checked often. The bathing supplies, including towels, should be gathered, readily available, and close to the tub/shower. When bathing, safety is critical, but it is important to allow the patient to have as much control of the process as possible without compromising their safety.

Privacy

During bathing, it is important to allow the patient to have as much privacy as possible without compromising their safety. Safety must come first during the bathing process. If the patient objects to this process, it is critical to speak with your case manager to fix any bathing issues.

Resistance

If a patient is resistant to a bath or shower, it might make sense to give them a “bird bath.” To effectively give a patient a “birdbath,” use a warm soapy washcloth. Only disrobe the parts of a patient’s body that are being washed. This can make bathing longer, so be patient.

Assessment

It is important to check for changes to your patient’s skin during bath time. You should look for breaks in the skin and rubbed areas between fingers and toes, under the arms, and under the breasts. Barrier cream is a good tool to protect the skin

 

How to Protect Against Infection

1. Handwashing is the most important way to prevent infection.
2. Gloves should always be worn when interacting with a patient with an infection.
3. Gloves should be worn when washing clothes, cleaning the house, or working with a patient.
4. Gloves should be discarded after each contact.
5. If a glove tears during contact, remove gloves, wash hands, and replace gloves.

Proper removal of gloves

1. Peel the glove away from your body, pulling it inside out.
2. Hold the glove you just removed in your gloved hand.
3. Peel off the second glove by putting your fingers inside the glove at the top of your wrist.
4. Turn the second glove inside out while pulling it away from your body, leaving the first glove inside the second.
5. Properly dispose of used gloves.

Additional Safeguards

• Masks are optional but should be worn when a patient has a respiratory infection.
• Bio-hazardous waste is anything that comes out of the patient’s body and needs proper disposal.
• Should you accidentally poke yourself with a needle:
  
  • Wash the affected area immediately.
  • Squeeze the affected area to force it to bleed.
  • Apply proper First Aid.
  • Seek medical attention if necessary.

Homecare Safety

1. Confirm with the patient before visiting for the first time.
2. Make sure you know where you’re going.
3. Always carry an extra set of keys.
4. Lock valuables in the trunk of your car, or if allowed, bring them in with you.
5. Always keep your car windows closed and doors locked.
6. Always wear shoes in the consumer’s home unless asked otherwise.
7. Never touch any animals in the consumers’ home.
8. If you ever spot a gun in the consumer’s home, alert your supervisor immediately.
9. Be very careful when lifting or moving your consumer. Lift with your legs and bend with your knees.
10. Apply all commonsense safety measures.

HIPAA

HIPAA stands for the Health Insurance Portability and Accountability Act.

HIPAA Laws are designed to protect the Patient. HIPAA provides restrictions against sharing a patient’s medical and identifying information. Even a Patient’s family is not allowed access to a patient’s records. If you think there has been a violation of your patient’s right to privacy, even by a patient’s family member, you should call the office and ask for the HIPAA Compliance Officer.

DCHC Staffing will provide you with all the background and medical information you need to care for your patient properly. You must remember that all patient information is confidential and should not be shared with anyone. If you are unsure whether information can be shared, it is best not to share until you have spoken with DCHC Staffing