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One in four nursing assistants and one in five home health aides report that they are actively looking for another job. That’s a lot of unhappy employees.
This turnover comes at a high price for facilities. It costs an estimated $2,200 to replace a nursing assistant or home care worker, according to the Recruitment and Retention Guide For Employers by PHI (formerly the Paraprofessional Healthcare Institute).
Moreover, frustration in the workplace can be contagious; unsatisfied staff members have a negative impact on residents and their peers alike.
There are books and guides devoted to programs for staff retention. Better hiring processes, rewards systems, and staff training can yield positive returns for facilities—but overhauling an entire program can feel daunting for busy nurse managers.
Here are four simple ways to promote staff retention, starting right where you are.
Through the first four months of fiscal year (FY) 2020, F881 (Antibiotic Stewardship Program) is the 46th most cited F-tag nationwide. That’s up from 49th overall in FY 2019, according to the Quality, Certification, and Oversight Reports (QCOR) from the Centers for Medicare & Medicaid Services (CMS). This possibly increased scrutiny occurred as CMS issued the November 22, 2019, Quality, Safety, and Oversight (QSO) memo QSO-20-03-NH, which highlighted the importance of antibiotic stewardship programs and announced a new training, Development of an Antibiotic Stewardship Program for Nursing Home Providers, and a new resource list to support antibiotic stewardship compliance as part of a package of actions designed to assist nursing homes to improve their entire infection prevention and control program.
“The requirement for nursing homes to have an antibiotic stewardship program that includes antibiotic use protocols, a system to monitor antibiotic use, and education for prescribers, residents/representatives, and nursing staff—and that is reviewed annually and as needed—became effective on November 28, 2017, as part of the Phase 2 rollout of the revised Medicare/Medicaid requirements of participation,” says Deb Patterson Burdsall, PhD, RN-BC, CIC, FAPIC, an infection prevention and control consultant and faculty member at the Association for Professionals in Infection Control and Epidemiology (APIC) in Arlington, VA.
The Centers for Medicare & Medicaid Services (CMS) makes clear that nursing homes should have a sexual expression/intimacy program that supports sexually intimate relationships when possible. Specifically, F607 (Develop/Implement Abuse/Neglect, etc. Policies) in Appendix PP of the State Operations Manual states:
The facility must have and implement written policies and procedures to prevent and prohibit all types of abuse, neglect, misappropriation of resident property, and exploitation that achieves (but is not limited to):
Here are critical steps for establishing a viable sexual expression/intimacy program for residents:
Medication is a critical component of resident care. Since the October 2018 start of fiscal year (FY) 2019, at least 11 potentially medication-related citations have been included among the top 60 most frequently cited survey issues, according to the Quality, Certification, and Oversight Reports (QCOR) at the Centers for Medicare & Medicaid Services (CMS). These include the following:
Key Medication-Related Citations Since the Start of FY 2019 …
Ranking of the Frequency of Citations Nationwide
F-tag Number and Description
F689 (Free of Accident Hazards/Supervision/Devices)
F761 (Label/Store Drugs and Biologicals)
F758 (Free From Unnecessary Psychotropic Medications/PRN Use)
F755 (Pharmacy Services/Procedures/Pharmacist/ Records)
F759 (Free of Medication Error Rates of 5% or More)
F757 (Drug Regiment Is Free From Unnecessary Drugs)
F756 (Drug Regimen Review, Report Irregular, Act on)
F760 (Residents Are Free of Significant Medication Errors)
F697 (Pain Management)
F881 (Antibiotic Stewardship Program)
F661 (Discharge Summary)
* May or may not be medication-related.
Optimizing the use of consultant pharmacists can help the director of nursing services (DNS) improve patient care, suggests Bri Palowitch, PharmD, BCGP, senior director of development for the American Society of Consultant Pharmacists (ASCP) in Alexandria, VA. The following five areas are a good place to start:
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