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. 

  • New CDC Infection Control Training (9/19)

    By CDC - August 31, 2019

     

    We are pleased to announce the launch of the Environmental Cleaning and Personal Protective Equipment courses, the latest in a series of 11 new infection control training courses. These courses are part of the new States Targeting Reduction in Infections via Engagement (STRIVE) curriculum intended for the infection prevention team, hospital leaders, clinical educators, nurse and physician managers, environmental services managers, all patient care staff, and patient/family advisors. Additional courses will be launched in the coming months. 

    These training courses were developed by national infection prevention experts led by the Health Research & Educational Trust (HRET) for the Centers for Disease Control and Prevention (CDC).

    All courses are free and offer continuing education (CE).

     

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  • AHRQ Study: Adverse Events in LTC Residents Transitioning From Hospital Back to NF (8/19)

    By AHRQ - August 12, 2019

    Transitions from hospitals to long-term care facilities are associated with safety hazards. This prospective cohort study identified adverse events in the 45 days following acute hospitalization among 555 nursing home residents, which included 762 discharges during the study period. Investigators found that adverse events occurred after approximately half of discharges. Common adverse events included falls, pressure ulcers, health care–associated infections, and adverse drug events. Most adverse events were deemed preventable or ameliorable. The authors conclude that improved communication and coordination between discharging hospitals and receiving long term-care facilities are urgently needed to address this patient safety gap. A previous WebM&M commentary discussed challenges of nursing home care that may contribute to adverse events.


    Transitions from hospitals to long-term care facilities are associated with safety hazards. This prospective cohort study identified adverse events in the 45 days following acute hospitalization among 555 nursing home residents, which included 762 discharges during the study period. Investigators found that adverse events occurred after approximately half of discharges. Common adverse events included falls, pressure ulcers, health care–associated infections, and adverse drug events. Most adverse events were deemed preventable or ameliorable. The authors conclude that improved communication and coordination between discharging hospitals and receiving long term-care facilities are urgently needed to address this patient safety gap. A previous WebM&M commentary discussed challenges of nursing home care that may contribute to adverse events.
    Transitions from hospitals to long-term care facilities are associated with safety hazards. This prospective cohort study identified adverse events in the 45 days following acute hospitalization among 555 nursing home residents, which included 762 discharges during the study period. Investigators found that adverse events occurred after approximately half of discharges. Common adverse events included falls, pressure ulcers, health care–associated infections, and adverse drug events. Most adverse events were deemed preventable or ameliorable. The authors conclude that improved communication and coordination between discharging hospitals and receiving long term-care facilities are urgently needed to address this patient safety gap. A previous WebM&M commentary discussed challenges of nursing home care that may contribute to adverse events.

    Transitions from hospitals to long-term care facilities are associated with safety hazards. This prospective cohort study identified adverse events in the 45 days following acute hospitalization among 555 nursing home residents, which included 762 discharges during the study period. Investigators found that adverse events occurred after approximately half of discharges. Common adverse events included falls, pressure ulcers, health care–associated infections, and adverse drug events. Most adverse events were deemed preventable or ameliorable. The authors conclude that improved communication and coordination between discharging hospitals and receiving long term-care facilities are urgently needed to address this patient safety gap. A previous WebM&M commentary discussed challenges of nursing home care that may contribute to adverse events.


    Transitions from hospitals to long-term care facilities are associated with safety hazards. This prospective cohort study identified adverse events in the 45 days following acute hospitalization among 555 nursing home residents, which included 762 discharges during the study period. Investigators found that adverse events occurred after approximately half of discharges. Common adverse events included falls, pressure ulcers, health care–associated infections, and adverse drug events. Most adverse events were deemed preventable or ameliorable. The authors conclude that improved communication and coordination between discharging hospitals and receiving long term-care facilities are urgently needed to address this patient safety gap. A previous WebM&M commentary discussed challenges of nursing home care that may contribute to adverse events.


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  • Updated CDC Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings (7/19)

    By CDC - July 29, 2019
    Please note that nursing homes are one of the applicable healthcare settings listed by the CDC.
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  • Q&A: Do any of your facilities have residents who are quadriplegic that utilize motorized wheelchairs and leave the facility campus in their motorized chair to go to nearby stores or activities?

    By Cody Campbell, LNFA - July 23, 2019
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  • QIO-Developed Trauma-Informed Care Resources (7/19)

    By MQIO Program - July 15, 2019

    Purpose of these resources This is a comprehensive, but not all inclusive, list of resources that may be helpful for nursing homes as they work to ensure that residents who are trauma survivors receive culturally competent, traumainformed care in accordance with professional standards of practice and accounting for residents’ experiences and preferences in order to eliminate or mitigate triggers that may cause re-traumatization of the resident (per §483.25(m) requirement that will be implemented beginning November 28, 2019).

    Who should use these resources? Nursing home leadership teams may assign responsibility to a person, such as a social worker, to review the resources below, identifying those that might be helpful for a) leadership, staff, and/or resident/family education, or b) behavioral/emotional care policy or program development or revision. 

    Why this is important? The included resources provide information that will help nursing homes to build capacity among interdisciplinary team members to deliver holistic resident care, being sensitive to how a range of experiences over the resident’s life may relate to their current physical, emotional, and behavioral health status. Trauma is common throughout human experience, and we need to respond with empathy and understanding. Providing trauma informed care can help staff to avoid re-victimization of those who have survived trauma and create an environment where the individual feels safe and secure. 

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  • CDC Health Literacy Resources (6/19)

    By CDC - June 25, 2019
    Includes education and training tools.
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  • OIG Audit Finds Staff Didn't Always Comply With Care Plan for Residents With UTI at One NF (6/19)

    By OIG - June 19, 2019

    Princeton Place Did Not Always Comply With Care Plans for Residents Who Were Diagnosed With Urinary Tract Infections (A-06-17-02002)

    Princeton Place did not always provide services to Medicaid-eligible residents diagnosed with UTIs in accordance with their care plans, as required by Federal regulations. Specifically, Princeton Place staff did not always document that they monitored the residents' urine appearance at the frequencies specified in their care plans. Princeton Place did not have policies and procedures to ensure that its staff provided services in accordance with its residents' care plans. As a result of Princeton Place not following residents' care plans, the residents were at increased risk for contracting UTIs and for incurring complications from UTIs, including requiring hospitalization.

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  • CDC Infection Control Interactive Graphic Novel for Environmental Services (EVS) Personnel (6/19)

    By CDC - June 19, 2019

    EVS personnel play a critical role in preventing the spread of germs and healthcare-associated infections

    EVS and the Battle Against Infection” is an interactive graphic novel illustrating the important role of EVS personnel in the prevention of healthcare-associated infections. The online version of the training tool features real-world infection prevention and control scenarios and allows participants to choose options that affect the outcome of the story. 

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  • CDC Interactive Training: Reducing HAI Transmission Risk (6/19)

    By CDC - June 19, 2019

    Healthcare professionals are the first line of defense against healthcare-associated infections (HAIs) and the spread of germs in healthcare settings. CDC now offers a new online interactive infection control training, “Let’s Talk Patient Safety: Reducing HAI Transmission Risk,” to help healthcare professionals identify infection risks and prevent the spread of HAIs. The training provides free continuing education for healthcare professionals, including nurses, physician assistants, medical assistants, health educators, and other clinicians. (0.1 CEU and 0.6 CNE).

    The free online training can be completed anywhere. It has two modules and takes approximately 30 minutes to complete the entire training.

    Module 1: “What’s the Risk?” 

    This interactive module transports healthcare professionals into a scenario where they must identify infection risks and take action to protect patients, colleagues, and visitors. 

    Module 2: “Chain of Infection” 

    This story-based interactive module challenges professionals to break the chain of infection in a busy healthcare environment and educates them on the consequences of not following infection prevention and control recommendations.

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  • Early Identification of Sepsis in Nursing Facilities: Opportunities and Hurdles Recorded Webinar/Slides (6/19)

    By NNHQIC - June 19, 2019

    Please join Christine LaRocca, MD and the National Nursing Home Quality Improvement Campaign to learn more about sepsis, who is at risk and the signs and symptoms for early detection. In addition, we will:

    ·        Review examples of sepsis screening tools commonly used in hospital settings;

    ·        Learn what tools to use while recognizing the limitations of sepsis screening tools in the nursing home population; and

    ·        Understand the elements of evidence-based treatment for optimal outcomes.

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  • Abuse and Neglect of Medicare Beneficiaries: OIG Targets SNFs (6/19)

    By OIG - June 12, 2019

    The Department of Health and Human Services Office of Inspector General issued two new reports that address the identification, reporting and investigation of incidents of potential abuse and neglect of our nation's most vulnerable populations, including seniors and individuals with developmental disabilities. OIG issued an early alert in 2017 based on the preliminary findings of this work. Our resulting work, released in June 2019, identify thousands of Medicare claims that indicate abuse and neglect of beneficiaries, including beneficiaries in skilled nursing facilities. If you suspect someone is the victim of abuse or neglect, contact law enforcement immediately.

    Reports:

    CMS Could Use Medicare Data To Identify Instances of Potential Abuse or Neglect 

    Incidents of Potential Abuse and Neglect at Skilled Nursing Facilities Were Not Always Reported and Investigated

     

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  • AHRQ’s Hospital-Based Re-Engineered Discharge Program Adaptable to SNFs (5/19)

    By AHRQ - May 19, 2019
    An AHRQ-funded toolkit designed to improve the hospital discharge process can be adapted for use in skilled nursing facilities (SNFs), according to a study published in the Journal of Nursing Care Quality. Researchers tracked the implementation of AHRQ’s Re-Engineered Discharge (RED) toolkit over 18 months at four short-stay SNFs in the Midwest. They evaluated whether the RED toolkit could help involve family members and caregivers with patient-focused discharge plans; reconnect patients quickly to primary care providers; and educate patients at discharge about their health condition, medications and other chronic health needs. While staff capacity and corporate-level policies may limit adoption of some components, transitional care processes such as RED can be adapted for SNFs to improve discharges, researchers concluded. 
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  • CDC C. difficile Naming Convention Change (5/19)

    By National Nursing Home Quality Improvement Campaign - May 19, 2019

    The CDC has begun using Clostridioides difficile instead of Clostridium difficile to refer to the bacterium that commonly causes infectious diarrhea.

    The change followed a decision early last year by the Clinical and Laboratory Standards Institute (CLSI).

    Given that laboratories and medical publications may be transitioning to the new name, the National Nursing Home Quality Improvement Campaign is making the transition when using the full name. However, the abbreviated form C. Diff is still applicable.

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  • CDC Training: Legionella Water Management Programs (5/19)

    By CDC - May 02, 2019
    Preventing Legionnaires’ Disease: A Training on Legionella Water Management Programs (PreventLD Training)
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  • OIG Assessment of Nursing Home Deficiency Trends Finds Need for Improvement (5/19)

    By OIG - May 02, 2019

    Trends in Deficiencies at Nursing Homes Show That Improvements Are Needed To Ensure the Health and Safety of Residents (A-09-18-02010)

    In this data brief, we analyze nursing home deficiencies that were identified by State survey agencies (State agencies) across the Nation for calendar years 2013 through 2017 (review period). This data brief offers the Centers for Medicare & Medicaid Services (CMS) and other stakeholders (e.g., State agencies and nursing home management) insight into deficiency trends at nursing homes nation-wide. It also complements our previous report on State agencies' verification of correction of nursing home deficiencies.

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