Post Acute Care is obliged to deliver care that provides better outcomes, in a shorter period of time, all the while ensuring that patient safety is in the forefront. We are responsible for increasing efficiencies without sacrificing safety.
There are a lot of tools available for use to help guide efficiencies. We’ve previously discussed and reviewed how communication across the continuum of care is an important factor for patient safety. As length of stay shortens it becomes vitally important to ensure accuracy of information that is passed on to the next care setting and provider. While accountability across the transitions to ensure a successful partnership is vital, it is equally important to look at patient safety events which contribute to patient injury.
Let’s examine the patient safety goals that The Joint Commission has identified for 2018 in the post acute setting.
- Identify resident correctly: The gold standard for patient identification is name and date of birth. However, you may be in a facility that does not have residents wearing identification arm bands. There is also the possibility that residents may be cognitively impaired and unable to accurately answer those simple questions. If you approach a resident and ask, “Are you Mrs. Smith?” A cognitively impaired individual may nod, smile, and be agreeable, when in fact you’ve just made a patient ID error. Each facility is challenged with ensuring that all care providers are able to easily identify all residents receiving medications and other treatments.
- Use medications safely: Recognize that residents who take anticoagulants are at greater risk for injury and ensure this is communicated to all care providers who would need to know. Accurate reconciliation of medications could not be more important. Many patients may use more than one pharmacy which means they could easily duplicate medicines if not reconciled prior to discharge.
- Prevent infection: Good hand hygiene prevents spread of infection. It would be easy to set up surveillance of staff to observe their compliance with hand hygiene practices, and good information to share with them. Ensure that you are following proven guidelines to prevent infections from MDROs, indwelling Foley catheters, and blood infections from central lines.
- Prevent residents from falling: Identify the residents that are at higher risk for falling and implement protocols that are proven to help decrease falls. Again, pay close attention to any resident who is at higher risk for injury from a fall, such as someone taking anticoagulants.
- Prevent bed sores: Identify those residents that are at higher risk for developing decubitus. Implement protocols or programs designed to decrease the incidence of bed sores. Establish a routine recheck process to examine those residents at risk.
The easiest way to determine if you’ve made progress is to track and trend events. Use the information to make system wide changes and address processes. It’s known that any safety error could delay discharge or transition to next level of care. Safety errors could require a hospital readmission. It’s important to your residents, their families, and your staff to address safety concerns and be able to show sustained improvement.
Resource: The Joint Commission Accreditation; Nursing Care Centers www.jointcommission.org