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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All long term care facilities are required to have an effective immunization program that reflect current standards of practice. Receipt of vaccinations is essential to the health and well-being of long-term care residents. Influenza outbreaks place both the residents and staff at risk of infection. If your facility does have an outbreak, the CDC offers the following guidance. Flu Vaccines must be offered to patients October 1st through March 31st. Facilities are encouraged to promote 100% staff participation in flu shots to prevent outbreaks. Got to www.flu.gov for useful information and resources for your Influenza Vaccination Program. The following forms can be used for education, promotion and documentation of your facility’s Immunization Program. CLICK HERE for the CDC Long-Term Care Toolkit for valuable information. INFLUENZA VACCINE INFORMATION SHEET (English) INFLUENZA VACCINE INFORMATION SHEET (Spanish) POSTER/FLYER 65 YEARS+ (English) POSTER/FLYER 65 YEARS+ (Spanish) POSTER/FLYER HEALTHCARE WORKER (English) POSTER/FLYER HEALTHCARE WORKER (Spanish) Sample Consent Form
Pneumococcal Disease According to F883, Immunizations for pneumococcal pneumonia the requirements have five aspects: The resident is provided education regarding the benefits and potential side effects of the vaccination The facility must offer each resident pneumococcal immunizations unless the immunization is medically contraindicated, ore the resident’s immunization status is current The resident, or resident’s legal representative, has the right to refuse the vaccinations Each eligible resident is administered the pneumococcal vaccine (unless refused or contraindicated or the resident has already been immunized) The facility must document that education was provided and that the resident either received the vaccine or, if not received, that the vaccine was refused or medically contraindicated or the resident had already been immunized Make sure your facility policy includes all five requirements and that the resident’s medical record documents patient education, offering the vaccine, administering the vaccine. Two pneumococcal vaccines are recommended for adults: PCV13, Prevnar13 and PPSV23, Pneumovax 23. One dose of PCV13 is recommended for adults 65 years and older who have not previously received PCV13. For patients who have not received any pneumococcal vaccine or with unknown vaccination history, give 1 dose of PCV13, and administer 1 dose of PPSV23 at least 1 year later. Once a dose of PPSV23 is given at age 65 or older, no additional doses of PPSV23 should be
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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.
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