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Post-Acute Care is obliged to deliver care that provides better outcomes, in a shorter period of time, all while ensuring that patient safety is in the forefront.  We are responsible for increasing efficiencies without sacrificing safety.

There are a lot of tools available for use to help guide efficiencies.  We have previously discussed and reviewed how communication across the continuum of care is an important factor for patient safety.  As length of stay shortens, it becomes vitally important to ensure the accuracy of information which is passed on to the next care setting and provider.

Let’s examine the Nursing Care Center National Patient Safety Goals established by that The Joint Commission for 2020.

  • Identify Resident Correctly: The gold standard for patient identification is name and date of birth.  However, you may be in a facility that does not have residents wearing identification arm bands.  There is also the possibility that residents may be cognitively impaired and unable to accurately answer those simple questions.  If you approach a resident and ask, “Are you Mrs. Smith?”  A cognitively impaired individual may nod, smile, and be agreeable, when in fact you have just made a patient ID error. Each facility is challenged with ensuring that all care providers are able to easily identify all residents receiving medications and other treatments.  Each facility should use at least two ways to identify patients or residents.
  • Use Medications Safely: Recognize that residents who take anticoagulants are at greater risk for injury and ensure this is communicated to all care providers who would need to know. Accurate medication reconciliation could not be more important, we are charged with recording and passing along correct information about a patient’s or resident’s medications. Many patients may use more than one pharmacy which means they could easily duplicate medicines if not reconciled prior to discharge.  At time of discharge, ensure that the patient understands the importance of bringing their up-to-date list of medicines with them every time they visit the doctor.
  • Prevent Infection: Good hand hygiene prevents spread of infection. It would be easy to set up surveillance of staff to observe their compliance with hand hygiene practices, and good information to share with them.  Ensure that you are following proven guidelines to prevent infections from MDROs, indwelling Foley catheters, and blood infections from central lines.
  • Prevent Residents from Falling: Identify the residents that are at higher risk for falling and implement protocols that are proven to help decrease falls. Again, pay close attention to any resident who is at higher risk for injury from a fall, such as someone taking anticoagulants.  Pay close attention to patients and residents who are taking medications that may make them weak, dizzy, or sleepy.  Take actions to identify and prevent falls in these individuals.
  • Prevent Bed Sores: Identify those residents that are at higher risk for developing decubitus. Implement protocols or programs designed to decrease the incidence of bed sores.  Establish a routine recheck process to examine those residents at risk.

The easiest way to determine if you have made progress is to track and trend events.  Use the information to make system wide changes and address processes.  It’s known that any safety error could delay discharge or transition to next level of care.  Safety errors could require a hospital readmission.  It’s important to your patients and residents, their families, and your staff to address safety concerns and be able to show sustained improvement.

 

Resource: The Joint Commission Accreditation; Nursing Care Centers  www.jointcommission.org