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Nursing Home Compare Claims-based Measures Technical Specifications -Update December 2018 plus Appendix
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.”
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:
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.
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.
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 Help@nhQualityCampaign.org to request additional information on participating in the pilot test.
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.
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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