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
F 883 Guidance to Surveyors 483.80(d) Influenza and pneumococcal immunizations The intent of this regulation is to: Minimize the risk o resident acquiring, transmitting, or experiencing complications from influenza an pneumococcal disease by ensuring that each resident: Is informed about the benefits and risks of immunizations: and Has the opportunity to receive the influenza and pneumococcal vaccine(s), unless medically contraindicated, refused or was already immunized Ensure documentation in the resident’s medical record of the information/education provided regarding the benefits and risks of immunization and the administration or the refusal of or medical contraindications to the vaccine(s). Please see the Flu Vaccine Toolkit and Pneumococcal Disease Toolkit for forms and resources.
TAG REGULATION OLD TAG F554 Self-Admin Meds F176 F694 IV Fluids F328 F697 Pain Management F309 F755 Pharmacy Services F425,F431 F756 Drug Regimen Review F428 F757 Unnecessary Drugs F329 F758 Psychotropic Meds F329,F428 F759 Med Error Rate F332 F760 Significant Med Errors F333 F761 Label/Storage Drugs F431 F773 Notify of Lab Results F504,F505 F881 Antibiotic Stewardship new F882 Infection Preventionist new F883 Immunizations F334 F945 Infection Control Train new
5 Tips to reduce Med Errors More than 60% of medication errors are caused by poor communication. The first step in reducing medication errors should be promoting effective communication among physicians, pharmacists and nurses. When in doubt, nurses need to be confident and ask questions. A quick call to the pharmacy can be a valuable resource for nurses to clarify a doctor’s order. The Joint Commission and the Institute for Safe Medication Practices have published a list of high-alert medications. These high risk medications include potassium chloride, insulin, IV pain drugs and blood thinners. Errors can occur at any point in the healthcare system. Acknowledging that errors happen, learning from them and working to prevent future errors is a shift from blame and punishment to analysis of causes of errors and making changes to improve. 5 tips for long-term care facilities Know the 5’R’s Inform patients of the reason for all medications Work as a team with doctors and pharmacists Be confident in questioning medication orders Report medication errors Right Time Right Patient Right Medicine Right Dose Right Route
Attached are a few tools to use in educating your nursing staff regarding your facility’s antibiotic stewardship program.