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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EFFECTIVE OCT. 1, 2018 Facilities that are found non-compliant will have their Medicare Payment reduced 2%. Drug Regimen Review Quality Measure – At the Beginning of the Stay the following questions will be asked: Did a complete drug regimen review identify potentially clinically significant medication issues? Did the facility contact the physician or designee by midnight of the nest calendar day and complete prescribed/recommended actions in response to the identified potential clinically significant medication issues? At the End of The stay the following question will be asked: Did the facility contract and complete the physician or designee prescribed/recommended actions by midnight of the next calendar day each time potential clinically significant medication issues were identified since the Admission? (This Quality Measure will affect the FY 2020 payment determination and subsequent years) Medication reconciliation is the formal process in which health care professionals partner with patients to ensure accurate and complete medication information transfer with the patient from one care level to another. Patients admitted to a hospital have a 50% chance that a medication error will occur. Many adverse drug events (ADE) occur as a result of poor communication between health care professionals and patients or caregivers when they are admitted to the hospital, change rooms within the hospital, are discharged to a skilled nursing facility and discharged home to the
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On October 1, 2018, data will be collected to ensure that medication reconciliation is also completed at the time of admission. The new Quality Measure – Drug Regimen Review, will evaluate the percentage of resident stays in which drug regimen review was conducted at time of admission and if facility staff followed up with the physician before midnight the next calendar day. Facilities that are found non-compliant will have their Medicare Payment reduced 2%. Skilled nursing facilities are required to reconcile patient medications prior to discharge back to the community. F661 – Discharge Summary states “Facility staff must compare the medications listed in the discharge summary to medications the resident was taking while in the facility. Any discrepancies must be assessed and resolved, and resolution documented in discharge summary with rationale.” The Advancing Excellence “Medications at Transitions and Clinical Handoffs” (MATCH) toolkit incorporated experiences and lessons learned from staff of facilities that have implemented MATCH. The toolkit helps facilitate a review and improvement of current practices to strengthen the process and improve patient safety. The World Health Organization has developed a Standard Operating Protocol for Medication Reconciliation and assuring medication accuracy in transitions in care. To write your policy and start your program, click the link below:
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