Risk Management

In a SNF, there are a lot of moving pieces, a lot to manage, and a lot can go wrong. Mitigating the risk of adverse events is a daily task. From care systems review and root cause analysis to anticipatory management, the resources below are designed to help you do just that. Protect your staff and residents now before you have to pick up the pieces after the fact. 

  • Register for Free Jan. 24 QIN-QIO Webinar: All Cause Harm Prevention in Nursing Homes Applying Strategies from the New CMS Change Package (1/19)

    By QIN-QIOs - January 03, 2019
    One-third of SNF residents experience an adverse or temporary harm event, and the majority of those are preventable. As part of CMS’s focus on raising awareness of nursing home safety and to support safer nursing home care across the nation, CMS and the Quality Innovation Network National Coordinating Center released a new resource: a Change Package to prevent all cause harm in nursing homes. The Change Package is a compendium of successful practices of high-performing nursing homes, illustrating how they prevent harm while honoring each resident’s rights and preferences. 

    Please join us to learn more about the development of the Change Package and how you can use it to improve the quality of life and quality of care for those living in nursing homes and other long-term care settings. Registration is required
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  • Nursing Home Compare Claims-based Measures Technical Specifications Plus Appendix Updated (12/18)

    By CMS - December 07, 2018

    Nursing Home Compare Claims-based Measures Technical Specifications -Update December 2018  plus Appendix


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  • Infection Prevention and Control Audits: Start with Hand Hygiene

    By Caralyn Davis, Staff Writer - November 26, 2018

    Nursing homes can have the most beautiful policies and procedures for infection prevention and control in the world, but if staff aren’t following through on them, they are a waste of paper, notes 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.

     

    “So monitoring and auditing infection prevention processes in the facility is a critical component of quality care,” says Burdsall. “Unfortunately, the focus on infection prevention has not always been well-supported because infection surveillance, monitoring whether proper supplies are available and used correctly, and watching whether staff are performing hand hygiene and correctly using personal protective equipment all take time, which means the effort costs money.”

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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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  • Nursing Home Staff Influenza Vaccinations Still Lag Behind Other Settings (9/18)

    By CDC - September 28, 2018

    Health care personnel working in long-term care settings, the majority of whom work as assistants or aides, have lower influenza vaccination coverage than do health care personnel working in all other health care settings, which puts the elderly in long-term settings at increased risk for severe complications for influenza. Implementing workplace strategies shown to improve vaccination coverage among health care personnel, including vaccination requirements and active promotion of on-site vaccinations at no cost, can help ensure health care personnel and patients are protected against influenza. 


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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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  • Nursing Home Compare & PBJ Updates: Long-stay Resident Hospitalization Rate to Be Added to NHC / Five Star; Non-Nursing Staff for PBJ to Be Posted; Health Inspection Freeze to End (6/18)

    By CMS - June 22, 2018
    • In October 2018, the long-stay hospitalization measure will be posted on the Nursing Home Compare website as a long-stay quality measure. In the spring of 2019, this quality measure will be included in the Five Star Quality Rating System.  Additionally, in July 2018 we will update the other claims-based quality measures reported on the Nursing Home Compare website.
    • To increase transparency, CMS will begin posting the number of hours worked by other staff (i.e., non-nursing) in July 2018. Facilities are required to submit hours for all other staff as listed in Table 1 of the PBJ Policy Manual. We will also distinguish between hours submitted for direct employees and contract staff. 
    • In October 2019, CMS will resume posting the average number of citations per inspection for each state and nationally. CMS is monitoring outcomes of the new inspection process and plans to resume health inspection rating calculations (i.e., end the freeze) in the spring of 2019. CMS will communicate more details about this prior to its implementation.



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  • 13 Best Practices to Prevent High-Scope Citations for F686 (Skin Integrity)

    By Jessica Kunkler, MA, Staff Writer - June 19, 2018

    Since the new Long-Term Care Survey Process (LTCSP) launched on November 28, 2017, 702 citations have been given for F686 (Skin Integrity). 22% of those tags are a G scope or above. Many of the citations are for:

    ·         Failure to provide care to treat and/or prevent worsening pressure ulcers

    ·         Failure to prevent facility-acquired pressure ulcers

    ·         Failure to develop and/or follow the care plan

    ·         Failure to ensure accurate assessment, obtain treatment orders, or communicate with other professional staff

    ·         Failure to prevent infection of wounds

    Widespread pressure ulcer issues are no surprise when facilities don’t have proper protocols in place for prevention, early identification, and treatment, according to Wendy DeCarvalho, MS, BSN, RN, DNS-CT, Director of Nursing for Scotia Village in North Carolina. As a DNS and clinical nurse consultant in long-term care facilities nationwide, DeCarvalho has worked to improve Quality Measures, including those for pressure ulcer rates. “If the staff doesn’t have protocols in place, pressure ulcers often go unchecked, untracked, and untreated,” she says. She recommends the following best practices.

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  • Fall Prevention: It’s Easy to Miss What You’re Not Looking For

    By Linda Shell, DNP, MA, RN, DNS-CT - June 19, 2018
    Does this sound familiar? Mary, an 87-year-old memory care resident and recurrent faller, has another fall in her room. A housekeeper spots her lying on the floor. Staff members rush to help. Alarm, floor mat, low bed? What will it be this time? The nurse completes an incident report and an intervention is care planned. The same scenario with Mary repeats itself over and over. She falls, a new intervention fails, her family grows concerned, staff members become frustrated, and the resident and facility are at risk.
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  • Q&A: Does anyone have a procedure for destruction of unused and/or discontinued narcotics?

    By AADNS Network - June 19, 2018
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  • NIH HerbList App (6/18)

    By NIH - June 17, 2018
    App offers easy access to scientifically backed information on herbs and herbal products.
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  • NIOSH Training for Nurses on Shift Work and Long Work Hours (6/18)

    By CDC - June 07, 2018
    The purpose of this online training program is to educate nurses and their managers about the health and safety risks associated with shift work, long work hours, and related workplace fatigue issues,. The training program will also relay strategies in the workplace and in the nurse’s personal life to reduce these risks
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  • Resident Prioritization Tool

    By CMS and Telligen - April 10, 2018
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  • Step Up Your GDR Game Part 1: Team-Building is Critical

    By Caralyn Davis, Staff Writer - April 10, 2018
    In the second quarter of 2017, 15.5 percent of long-stay nursing home residents received an antipsychotic medication as measured by the publicly reported MDS-based quality measure (QM), Percent of Residents Who Received an Antipsychotic Medication (Long-Stay). That represents a 35 percent decrease in the national prevalence since the fourth quarter of 2011, according to the most recent data from the National Partnership to Improve Dementia Care in Nursing Homes.
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  • The Importance of a Thorough Investigation: What You Need to Know

    By Emily Royalty-Bachelor, Staff Writer - April 10, 2018
    As a director of nursing services or an administrator of a long-term care facility, you naturally hope that the day-to-day care, services, and activities that happen within the facility proceed without incident. However, despite precautions and oversight, reportable incidents do indeed occur. That’s why it is imperative that, when they do, you have policies and procedures in place to conduct a thorough investigation and that you implement processes to prevent similar incidents from occurring again.
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