Clinical Surveillance Resources

When it comes to resident care, your role is to see the bigger picture and to put systems in place that not only protect your residents but also promote their best possible function. Preventing and identifying medical errors and adverse events is imperative for facility leaders. Using the latest technologies to synthesize resident care outcome data -- in complement with implementing proper bedside and clinical decision-making protocols -- are part of a strong clinical surveillance system that bolsters quality assurance. Find out what you need to know and how your facility can take evidence-based steps to improve care. 

  • National Palliative Care Clinical Practice Guidelines Updated (11/18)

    By National Consensus Project for Quality Palliative Care - November 01, 2018

    New national palliative care clinical practice guidelines seek to ensure the millions of people living with serious illness, such as heart failure, lung disease and cancer, have access to vital care that can help meet their needs. The guidelines promote improved access to palliative care, which is focused on giving patients and their caregivers relief from the symptoms and stress of serious illness, is based on need, not prognosis, and can be provided along with disease-focused treatment.

    The Clinical Practice Guidelines for Quality Palliative Care, 4th edition calls for a seismic shift in the delivery of this specialized care by urging all health care professionals and organizations to integrate it into the services they provide to people living with serious illness. The guidelines also include tools, resources and practice examples to help with implementation. 

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  • Wound Management Best Practice Intervention Package (11/18)

    By National Nursing Home Quality Improvement Campaign (11/18) - November 01, 2018

    Note: The package is home health-focused and may need tweaking for long-term care.


    This package brings together evidence-based practices and tools from leading expert organizations, such as Wound, Ostomy, and Continence Nurses Society (WOCN); National Pressure Ulcer Advisory Panel (NPUAP); International Skin Tear Advisory Panel (ISTAP); and Centers for Medicare & Medicaid Services (CMS).

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  • Toolkit for CDI Prevention and Management in Long Term Care (11/18)

    By National Nursing Home Quality Improvement Campaign - November 01, 2018

    New toolkit alert from the National Nursing Home Quality Improvement Campaign:


    The Minnesota Department of Health's toolkit for C. diff infection (CDI) prevention and management in long-term care includes resources in six topic areas: prepare, detect, contain, clean, prevent, and educate.

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  • CMS Will Conduct Focused Dementia Care and Focused Schizophrenia Surveys in FY 2019

    By CMS - October 25, 2018
    Focused Dementia Care Surveys: FY2019, CMS plans to have federal contract surveyors conduct additional focused dementia care surveys in some states. Due to concerns about facilities using an inappropriate process to diagnose residents with schizophrenia, we also expect to conduct a limited number of surveys focused on this issue.
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  • Influenza: How to Prevent or Minimize Outbreaks

    By Caralyn Davis, Staff Writer - October 25, 2018

    Through Oct. 13, influenza activity remained low across the United States. However, the Centers for Disease Control and Prevention (CDC) expects flu outbreaks to increase in the coming months. Avoiding and minimizing flu outbreaks not only protects residents and staff, it protects the facility as well given the laser focus on infection prevention and control that state surveyors have had during the first year of the Long-term Care Survey Process (LTCSP).

    Directors of nursing services (DNSs) can work with the interdisciplinary team, residents, and families to reduce the risk of influenza transmission and minimize any outbreaks that occur. Limiting transmission requires a bundled approach, including the following steps:

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  • Study: Treating Delirium With Antipsychotic Meds May Not Be Best Option (10/18)

    By National Institute on Aging - October 25, 2018

    NIH-funded clinical trial suggests reconsidering current strategies to treat delirium.

    Critically ill patients in intensive care units (ICUs) did not benefit from two antipsychotic drugs used to treat delirium, according to a large clinical trial funded by the National Institute on Aging, part of the National Institutes of Health. The multi-site team that conducted the trial found no evidence that treatment with antipsychotic medicines — haloperidol or ziprasidone — affected delirium, survival, length of ICU or hospital stay or safety. The findings from the Modifying the Incidence of Delirium USA (MIND USA) study were published online Oct. 22, 2018 in The New England Journal of Medicine.

    “This is strong evidence from what we consider a ‘gold standard’ clinical trial showing that these two antipsychotics don’t work to treat delirium during a critical illness,” said NIA Deputy Director Marie A. Bernard, M.D. “Antipsychotics have often been used to treat delirium. The evidence from this study suggests the need to reexamine that practice.” Bernard is also NIA’s senior geriatrician.

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  • Free AHRQ Antibiotic Stewardship Training: Is It Right for Your Facility?

    By AHRQ - October 24, 2018

    While F881 (antibiotic stewardship program) citations remain low overall compared to other citations nationwide, as of Oct. 15, 2018, QCOR data, F881 is now the 10th most-cited new F-tag with a severity level of F or above. -Staff

    Register now to attend a one-hour webinar that explains how long-term care facilities can run an effective antibiotic stewardship program by joining a free, 12-month national project. Beginning in December, the AHRQ Safety Program for Improving Antibiotic Use will provide participating long-term care facilities with antibiotic use guidelines, expert coaching, online education, improvement tools and patient education materials to help prevent harms associated with antibiotics, such as Clostridium difficile. Participants also have the opportunity to earn continuing education credits. 

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  • Infection Control: CDC Study on Candida auris in Healthcare Facilities (10/18)

    By CDC - October 01, 2018
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  • Nursing Home Compare Claims-based Measures Technical Specifications Updated (9/18)

    By CMS - September 24, 2018
    Revision: September, 2018 This update contains the specifications for the Number of Hospitalizations per 1,000 Long-Stay Resident Days measure, which is claims-based and risk-adjusted. This update also revises the MDS items included in the risk-adjustment models for the short-stay, claims-based quality measures, as well as the coefficients for the models.
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  • Hand in Hand Training Course Update (9/18)

    By CMS - September 14, 2018
    Section 6121 of the Affordable Care Act of 2010 requires CMS to ensure that nurse aides receive regular training on caring for residents with dementia and on preventing abuse. CMS, supported by a team of training developers and subject matters experts, created this training to address the need for nurse aides’ annual in-service training on these important topics.

    The mission of the Hand in Hand training is to provide nursing homes with a high-quality training program that emphasizes person-centered care in the care of persons with dementia and the prevention of abuse.
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  • Do you report C difficile data to NHSN? (9/18)

    By NNHQIC - September 06, 2018
    CMS, the CDC, and the Quality Innovation Network Quality Improvement Organizations encourage nursing homes to continue to track and report C. difficile data to NHSN. These data inform national work on patient safety and are valuable for individual nursing home quality improvement projects, including C. difficile prevention and antibiotic stewardship.
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  • New Dementia Care and Psychotropic Med Tracking Tool: NNHQIC Seeks Pilot Testers (9/18)

    By NNHQIC - September 06, 2018

    The National Nursing Home Quality Improvement Campaign (NNHQIC) seeks pilot testers for a new Dementia Care and Psychotropic Medication Tracking Tool. This Excel-based tool will track information for individuals living with dementia AND any resident for whom psychotropic medications are prescribed.  It will support and prompt individualized care, document key processes, and provide information to identify opportunities and drive improvement. Interested organizations please send a message to to request additional information on participating in the pilot test.

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  • Antibiotic Stewardship: Fluoroquinolones and Black Box Warning Update (9/18)

    By CDC - September 06, 2018

    The U.S. Food and Drug Administration (FDA) Recently Strengthened its Black Box Warning About Fluoroquinolone Use

    Appropriate fluoroquinolone prescribing is important for patient safety. A recent study published in Clinical Infectious Diseases reports that fluoroquinolones are commonly prescribed for conditions when antibiotics are not needed at all, or when fluoroquinolones are not the recommended first-line therapy.

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  • SNF Uses AHRQ Toolkit to Boost Residents' Health Literacy Skills

    By AHRQ - August 22, 2018

    Occupational therapists (OTs) at Greenwich Woods Rehabilitation and Health Care Center improved their ability to assess and implement health literacy interventions for patients by 36 percent after a 6-week workshop that featured AHRQ’s Health Literacy Universal Precautions Toolkit. The workshop was administered to OTs, OT assistants, and other therapy and rehabilitation staff at the 217-bed skilled nursing facility in Greenwich, Connecticut.

    Improving OTs’ ability to provide information that patients can readily understand and use in their daily lives is an important aspect of their overall rehabilitation, according to Virginia Koenig, who has a clinical doctorate in occupational therapy. Dr. Koenig is an academic fieldwork coordinator at Touro College, New York, and developed and administered the intervention at Greenwich Woods. 

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  • ACIP 2018 - 2019 Flu Vaccine Recommendations UPDATED (8/18)

    By CDC - August 20, 2018

    Update: ACIP Recommendations for the Use of Quadrivalent Live Attenuated Influenza Vaccine (LAIV4) — United States, 2018–19 Influenza Season
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