Pandemic Nursing is a new term that describes nursing care that is rushed, physically overwhelming, and emotionally draining and provided to an onslaught of critically ill patients. There are numerable contributing factors and adverse results related to Pandemic Nursing. I have witnessed firsthand in the halls of long-term care facilities and recognize the toll this environment is having on the nurses. The frantic, adrenalin pumping reaction to the disaster of the day, coupled with total exhaustion. Working in a Pandemic Nursing environment is a direct threat to patient safety. Is your facility working under Pandemic Nursing conditions? To assess the risk, answer these questions: Is the pace of work hectic? Is the station and records frequently disorganized? Have there been financial strains on the facility? Is there a shortage of staff? Has the nurse-to-patient ratios fluctuated higher? Has the level of care the patients require increased? Is the facility having difficulty recruiting and retaining staff? Add to this list of struggles the increased daily workload of, continuous donning of PPE, increased discharges and emergencies, isolated and depressed patients and constant testing and swabbing. Unfortunately, the results of practicing Pandemic Nursing are bad patient outcomes. A recent article by the Institute for Safe Medication Practices reported an increase of serious increased medication errors coupled with a trend by nurses to try
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Annual Surveys resume, are you ready? Surveyors have returned to facilities after the licensure and certification surveys were suspended early into the pandemic when nursing homes closed their doors to visitors. AHCA visits in 2020 only focused on complaints and infection control issues. Many facilities have not had an annual licensure & certification survey since 2019 and nurses suffering from “Pandemic Nursing” may not be prepared to be scrutinized. One Director of Nursing recently admitted “He was particularly concerned about the many opportunities for serious medication errors when providing what he called “pandemic nursing” care—the rushed, physically overwhelming, and emotionally draining care provided to an onslaught of critically ill patients.” During the past year staff may forget the details or get used to taking short cuts just to get their job done. While facility staff are still dealing with COVID19 and ever-changing priorities they must be ready when the annual inspection returns to the building We must recognize that human factors and working in healthcare during a pandemic can easily lead to medication errors. A perfect storm for serious medication errors is created by: The hectic pace and disorganization of “pandemic nursing” The constantly under-resourced healthcare environment High nurse-to-patient ratios due to staffing shortages The exhausting and continuous donning of PPE The need for any available nurse, not necessarily the
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Long-term opioid therapy can cause harm ranging in severity from constipation and nausea to opioid use disorder and overdose death. Certain factors can increase these risks, and it is important to assess and follow-up regularly to reduce potential harms. Long term care facility healthcare professionals including nurses, physicians and administration should educate patients and families regarding the harms of opioid therapy. All healthcare professionals have an obligation to assess factors that can increase patient’s risk for harm. Ask your patient about concerns and determine any harms they may be experiencing such as: nausea or constipation, feeling sedated, breathing interruptions during sleep and craving more opioids than prescribed or difficulty controlling use. Patients that have become addicted to opioids require the drugs to avoid painful withdrawal. Withdrawal symptoms from opioids may include drug craving, anxiety, insomnia, abdominal pain, vomiting, diarrhea, and tremors. Tapering plans should be individualized but in general the following apply: Go Slow, Consult with specialists and provide support. Prescribers must educate those patients that have higher dosage and higher risk. Prior to prescribing opioids, prescribers are required to consult with the E-Force clearing house and review the patients history of opioid use. High Morphine milligram equivalent (MME) per day scores that exceed 50 MME/day identify patients who would benefit from closer monitoring, reduction or tapering of opioids, prescribing
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$20 Billion in New Phase of Provider Relief Funding On October 1st, U.S. Dept. of Health and Human Services (HHS) announced additional funding for Assisted Living and Mental Health facilities. The $20 Billion dollars considers financial losses and changes in operating expenses caused by the coronavirus. Providers can begin applying for funds from October 5, 2020 through November 6, 2020. According to HHS Secretary Alex Azar, “This new round helps ensure that we are reaching America’s essential behavioral health providers and takes into account losses and expenses relating to coronavirus.” HHS has already issued over $100 billion in relief funding to providers through prior distributions. Still, HHS recognizes that many providers continue to struggle financially from COVID-19’s impact. They also recognize constraints such as the stay-at-home orders and social isolation have been particularly difficult for American’s that live in assisted living facilities. Eligibility Providers who previously received or rejected Provider Relief Fund payment. Providers that have already received payments of approximately 2% of annual revenue from patient care may submit more information to become eligible. Behavior Health providers. Healthcare providers that began practicing Jan. 1, 2020 through March 31, 2020 Payment Methodology Applicants that have not yet received Relief Fund payments of 2% of patient revenue will receive a payment that, when combined with prior payments, equals 2% of
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Making Insulin More Affordable for People with Medicare More than 3.3 million people with Medicare use one or more of the common forms of insulin every day. Unfortunately, the cost of insulin has nearly tripled over the past ten years, from about $100 to $300 a vial, and out-of-pocket costs for the drug for people with Medicare can significantly fluctuate from month to month, making budgeting and management of a person’s diabetes more difficult. Starting October 15, 2020, people with Medicare will be able to enroll in a Medicare drug plan that offers insulin for no more than a $35 copay for a month’s supply. Coverage will begin on January 1, 2021. While all plans that are participating in Medicare’s new “insulin savings model” guarantee that your cost-sharing is capped at $35 for a month’s supply of insulin, some plans may offer even lower copays. Participating plans cover different types and brands of insulin, and it’s important to check each plan’s formulary to find out your exact cost, starting in the deductible phase, and going through the initial coverage, and coverage gap phases of your Medicare drug benefit. By enrolling in a participating plan, people with Medicare may save hundreds of dollars per year on your out-of-pocket costs for insulin, and you’ll always know exactly what you’ll be paying each
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As you begin to educate your residents regarding the open enrollment period to review and select their Part D plans, Partner Care Pharmacy has useful tools to share. Also, Starting October 15, 2020 Medicare beneficiaries will be able to enroll in a Medicare drug plan that offers insulin for no more than $35 copay per month. For those residents currently on insulin therapies it is important to review that coverage. Go to this website Medicare.gov/plan-compare to log-in and compare Part D plans. Have your list of medications available before you log-in. Click the links below for Medicare Part D resources Open Enrollment Video Medicare Open Enrollment flyer – English Medicare Open Enrollment flyer – Spanish 2021 Insulin Saving Model – FAQ
