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Nursing Home Survey Findings: Infection Control, Dialysis, and Antipsychotic Medications

This article discusses the findings of a nursing home survey in 2014, highlighting increased problem areas in infection control, dialysis, and antipsychotic medications, as well as decreased problem areas in pressure ulcers and incontinence. It also mentions oddities observed in nursing homes and provides a list of the most commonly cited deficiencies. Readers are encouraged to audit their own facilities for similar practices and make necessary changes.

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Nursing Home Survey Findings: Infection Control, Dialysis, and Antipsychotic Medications

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  1. Nursing Home Survey Findings Fall Region Forums - 2014 Doug Beardsley VP Member Services Care Providers of Minnesota

  2. Many similar trends, but a few new ones • Increased Problem Areas: • Infection Control • Dialysis • Antipsychotic Medications • Physician Responses to Pharmaceutical Recommendations • Drug Storage

  3. Many similar trends, but a few new ones • Decreased Problem Areas: • Pressure Ulcers • Incontinence • Reporting of Suspected Abuse • Policies regarding reporting of suspected abuse

  4. Many similar trends, but a few new ones • Oddities: • Posting of Staff Hours • Dialysis focus • Expired Nurses licenses • Failure to act/respond to issues in the Resident Council Minutes • Providing notice of new roommate • Call lights not within reach

  5. Average Number of Deficiencies per Survey

  6. What is being cited during Nursing Home surveys?

  7. Current Nursing Home survey deficiencies issued in 40% or moreof surveys F441: Infection Control • Infection control program • Staff infection control breaches • Resource – QIS Infection Control List

  8. Current Nursing Home survey deficiencies issued in 30% - 40% of surveys F282: Qualified Staff F329: Unnecessary Drugs F371: Kitchen Issues

  9. Current Nursing Home survey deficiencies issued in 30% - 40% of surveys F282: Qualified Staff • Staff not performing their job consistent with the directives of the Care Plan or facility policies and procedures.

  10. Current Nursing Home survey deficiencies issued in 30% - 40% of surveys F329: Unnecessary Drug • Antipsychotics remain the major focus • Also sleep medications, antidepressants, & prn • Resource – QIS Unnecessary Meds Pathway

  11. Current Nursing Home survey deficiencies issued in 30% - 40% of surveys F371: Kitchen Stuff • Cleanliness and upkeep of the kitchen • Infection control (hand washing/gloving) • Proper cooling of food for storage • Steam table food temps during meal • Dishwasher temperatures • Resources – Food Cooling Poster and Training Sheet QIS Kitchen/Food Service Observation Form

  12. Current Nursing Home survey deficiencies issued in 20% - 30% of surveys F309: Highest Practicable Level F431: Storage of Drugs F323: Accidents & Supervision F279: Care Plans F428: Monthly Med Review

  13. Current Nursing Home survey deficiencies issued in 20% - 30% of surveys F309: Highest Practicable Level • Pain • Dialysis • Hospice • Positioning • Etc. • Resources – QIS Resident Interview QIS Dialysis Critical Elements form

  14. Current Nursing Home survey deficiencies issued in 20% - 30% of surveys F431: Storage of Drugs • Expired Meds • Multi-Use Vials not dated when opened • Temperatures • Unsecured meds

  15. Current Nursing Home survey deficiencies issued in 20% - 30% of surveys F323: Accidents & Supervision • Falls • Alarms • Siderails

  16. Current Nursing Home survey deficiencies issued in 20% - 30% of surveys F279: Care Plans • Ineffective or nonexistent approaches to identified or observed patient care needs or issues • Dialysis

  17. Current Nursing Home survey deficiencies issued in 20% - 30% of surveys F428: Monthly Med Review • Consultant Pharmacist missed something • Physician failed to act on Consultant Pharmacists recommendations

  18. Take-Aways: • Look at the examples provided • Audit your nursing home to determine if you have similar deficient practices • Make changes, and re-audit!

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