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7/17/2013 |
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In This Issue
• Review Emergency Plans
• Fall Prevention
• Latest News & Blog Posts
• Featured Author - Rein Tideiksaar |
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Review and Update Emergency Plans with Operational Changes
Long-term care providers around the nation have experienced the impact of challenging economic times. Many communities including skilled nursing homes, assisted living facilities and independent senior living properties have been forced to downsize elements of operations, resulting in the reassignment of personnel, redistribution of staff responsibilities, elimination of positions, closing of facilities and consolidation of other aspects of facilities management. |
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Some of these changes may have occurred quickly while the operation was under a great deal of pressure to maintain quality of care while dealing with the reality of decreased census and revenue. When changes occur, it is essential to review and update your community’s emergency plans to help ensure that the changes have been incorporated into these essential documents.
Keeping emergency procedures and disaster preparedness/emergency management plans up to date is an essential element of your facility’s Life Safety compliance program. LTC communities of all types commonly develop and maintain comprehensive plans to address a variety of emergency situations ranging from routine power failures to disaster scenarios requiring complete facility evacuation. In some cases, these response protocols and associated documents are required by regulation while in others, facilities have developed comprehensive written contingencies including plans, policies and procedures designed to help control potential losses and minimize risk exposure.
It is not uncommon for surveyors to review these types of plans during the course of an assessment and find that information is out of date or not applicable due to significant changes that have occurred within the facility or parent corporation. These changes can include the following:
Operational Changes
• Expansion
• Downsizing
• Consolidation
• Merger
Facility Changes
• Floor plan changes
• New construction
• Demolition
• Remodeling
• Temporary structures
• Elimination of beds/facilities
Personnel Changes
• New employees
• Promotion
• Demotion
• Elimination of position
• New assignment/position
• Re-assignment to a new location within a campus or organization
• Retirement
• Departure from company/organization
Personnel Contact Information Changes
• Phone numbers (home phone and cell)
• Pager number
• E-mail address
• Home address
Community Resources Personnel Changes-Primary Contacts
• Fire Department
• Police/Law Enforcement
• Emergency Medical Services
• County Emergency Management Agency
• Utility Companies-electric, gas, water, cable system, etc.
• Contractors-construction, electrical, plumbing, board-up service, etc.
Community Resources Contact Information Changes
• Phone numbers (business phone and cell)
• Pager number
• E-mail address
• Business Address
The usefulness of a written plan, policy or procedure is premised on the relevancy and applicability of its information. While a great deal of information contained in these documents does not typically change, dynamic information can be subject to change on a frequent basis. To help ensure that your facility’s written emergency contingencies are kept up-to-date, it is recommended that these documents be reviewed and date-stamped in accordance with the following guidelines:
• At minimum on an annual basis
• Following operational changes
• Following facility changes
• Following personnel changes
• Following community resources changes
• Any time it appears practical to review and update
Significant changes in the operation of LTC communities as well as sectors of local emergency services (fire department, law enforcement, police, etc.) due to economic factors is likely a trend we will continue to see for quite some time. It is essential to review and update all elements of your emergency contingencies including written documents as well as your overall risk management program to help ensure the accuracy and reliability of all information after these changes have occurred.
Pedagogy’s author, Stan Szpytek, is a fire service / safety professional with more than thirty (30) years of emergency service, loss control and asset protection experience. Mr. Szpytek is a former deputy fire chief / fire marshal of a metropolitan Chicago area fire protection district. As a safety consultant and a founding partner of Fire and Life Safety, Inc. (FLS), Mr. Szpytek has developed a firm that provides its clients with a variety of proactive safety solutions that are designed to identify and eliminate risks subsequently decreasing an organization’s operating costs and increasing levels of emergency preparedness, as well as write for Pedagogy Inc. Mr. Szpytek has written a class on Positive Fire and Life Safety Practices that is sure to keep healthcare facilities on top of their fire safety practices.
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Fall Prevention
Falls are a leading cause of injury in elders. As a result, family caregivers often become worried about an elder’s safety when they start to fall. This is especially the case when the elder is living alone at home.
Frequent falls often lead family members to conclude that living at home is no longer safe for their Dad (or Mom*) and closer supervision in a nursing home setting maybe a better option to prevent falls.
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In fact, one of the most common reasons for nursing home placement in this country (by family members) is for the problem of falling.
Family caregivers, thinking that their loved one is safe, are often surprised to get a call from the nursing home in the middle of the night, telling them that their Mom has fallen and is injured. Families frequently ask: ‘How could this have happened?’ ‘I thought that the nursing home staff would provide a safe place for my Mom and not let falls occur’. In response, caregivers start to question their decision about placing Mom in the nursing home and, even, start to feel guilty about it.
Nursing homes are not necessarily ‘bad places’. Elders in nursing homes are at great risk of falling due to a variety of chronic health conditions and medications that negatively impact on their ability to walk and balance safely. But how do you know that the care your Dad is receiving in the nursing home is suitable or far from ideal in helping to avoid falls?
*[Going forward, ‘Dad’ will apply to both genders]
Warning Signs
There are several warning signs to look out for that may indicate that the nursing home is failing:
• Emotional or Physical Changes. Be concerned if your Dad is not functioning as usual or has become withdrawn and uncommunicative. This could be a sign of an underlying health problem or over medication. If you notice unexplained bruises or skin tears, this may be an indication of poor balance (bumping into walls and furnishings), and even, falling episodes that you may not even know about.
• Unanswered Questions. Ask staff and your Dad’s nursing aide to explain anything you find worrisome. If staff are unable to answer your questions, or refuse to discuss your Dad’s care, this is a bad sign and suggests that care may be suboptimal. Questions, such as, ‘Dad is having trouble with her balance and has had several falls recently, what is the plan? or ‘Are my Dad’s medications causing her to become confused and lose balance?’ should always have a credible answer. If staff answer you by stating: ‘Don’t worry, poor balance and/or falling is normal for old people’, this is of concern.
• Staff Concerns. Are nurses available to assist your Dad with her everyday activities (walking, getting in/out of bed safely, toileting, etc.)? Is your Mom being rushed by staff or does she have plenty of time to complete her activities. Many falls are caused by rushing. Additionally, having consistent staff (who knows your Dad’s health problems and needs) is important. If you sense that staff are not being attentive to your Dad’s needs or that no one on the staff seems to know your Dad, it may be time to address the issue with the Director of Nursing.
• Unanswered Call Lights. Sometimes loved ones will complain that: 'I waited and waited for the nurse or someone to help me to the bathroom, but nobody came’ ‘So I got up on my own and lost my balance.' Find out for yourself if your Dad is getting caregiver assistance in a timely manner. Push your Dad’s call button. If there is a long delay in responding to your call (or no response at all), then bring up your concerns to the nursing staff.
• What About Restraints? Are physical restraints being used to keep your Dad safe? Routine use of restraints does not lower the risk of falls or fall injuries. They should NOT be used as a fall prevention strategy. Restraints can actually add to the risk of fall-related injuries and deaths. Limiting an elder’s freedom to move around leads to muscle weakness, poor physical functioning, and increased risk of falling.
How Can Families Help?
Here are 5 steps that families can take to help prevent falling:
• Ask about the nursing home’s fall prevention program. What is their plan to keep your Dad safe? Some common interventions to ask about include one-on one assistance with activities (such as walking to and from the bathroom), lowering bed heights, placing the call bell within easy reach while in bed, providing canes or walkers to help with balance, removing clutter and other environmental hazards, non-slip footwear and ‘close observation’ (during daytime hours, moving your Mom to an area close to the nursing station where nurses can keep a close eye on her).
• Ask what you can do as a family caregiver to help the nurses. For instance, during visits, monitoring your Dad to make sure that she’s not off balance. If you notice or observe any changes, immediately report these to the nursing staff.
• Ask if the nursing home staff has assessed your Mom after each fall to identify and address risk factors and treat any underlying conditions. The staff should update you and keep you informed about any changes in your Dad’s health.
• Ask the doctor to review your Dad’s medications on a regular basis for safety. The use of certain medications can cause dizziness, impaired balance and coordination, and increase the risk of falls.
• Ask about exercise and walking programs to help your Dad stay fit. Lack of leg strength and poor balance are common causes of falling. Physical activity is almost always a good idea, it can lead to greater flexibility, strength and balance, which helps to avoid falls. As previously mentioned, limiting a person’s movement and freedom (to prevent falls) can actually contribute to falls.
Pedagogy’s author, Rein Tideiksaar Ph.D., PA-C (or Dr Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, NJ, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician's assistant. He has been active in the area of fall prevention for over 30 years, and has directed numerous research projects on falls and has developed fall prevention programs in the community, assisted living, home care, acute care hospital, and nursing facility setting. Dr. Tideiksaar has written a class on Managing Falls to help educate health care providers in fall prevention and management.
To view the original article, Click Here
To view the classes we offer in fall prevention forLong Term Care and Home Health education, click below
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Featured Author: Rein Tideiksaar
Rein Tideiksaar
Ph. D., PA-C,
Rein Tideiksaar, PhD, PA-C, or Dr. Rein as he is commonly referred to, is the president of Fall Prevent, LLC, Blackwood, New Jersey, a consulting company that provides educational, legal, and marketing services related to fall prevention in the elderly.
Dr. Tideiksaar is a gerontologist, which is a health care professional who specializes in working with elderly patients, and a geriatric physician's assistant. He has been active in the area of fall prevention for over thirty years.
He has directed numerous research projects on falls and has developed fall prevention programs in the community, assisted living, home care, acute care, and nursing facility settings. He has as authored several books devoted to the topic of fall prevention.
To view a full biography for Rein Tideiksaar, click below.
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