Nursing Homes Risk Management Plan
For the majority of nursing homes, ensuring the safety of patients is essential. Besides making sure that a particular nursing home achieves high levels of clinical care, patient injuries present significant financial and reputation implications (Buckinx et al., 2018). It should be noted that hip fractures are one of the most common patient fall-related injuries in nursing homes and therefore, their prevention is one of the most common challenges (Gulka et al., 2020). Despite the efforts that have been made through education and other activities, the impact on patient falls in the United States of America and Canada has been insignificant (Bondevik et al., 2017). It stems from the fact that are negligible nursing home interventions that have been put in place to prevent patient falls. The majority of the patients suffer from dementia and are more likely to fall (Bor et al., 2017). The overemphasis on falls as a standard of quality care in nursing homes has contributed to unintended consequences, for example, increased immobility which is a risk factor for more falls. Therefore, the current study revolves around the “Continuum Program” which is a risk management plan for Grisworldhomecare.
According to the Continuum program, event reporting is important in an organization since it creates a platform for organizational reporting of exposure to risk with the aim of detecting, reporting, tracking and determining the trend patterns of any actual or potential leading adverse patient outcomes or property damage. Additionally, the plan aims at reducing potential deleterious patient outcomes or damage to property and reducing the financial burden of claims. In the continuum program, a risk manager has a unique role in the sense that he reports analysis data and recommends the actions that should be taken to the quality assurance department as well as the department that is involved in the organization to assess the event. The sentinel events have to be reported to the relevant government agencies following set regulatory requirements. Within healthcare organizations, it is the responsibility of the risk manager to report any events following specified regulatory requirements and reporting timeframe.
Griswold homecare has stipulated risk management plans for patient falls at the organization. Some of the most common causes of patient fall include vision changes, balance issues, new medications, chronic health conditions, cognitive impairment, poor home safety measures and fall prevention programs (Grisworldhomecare, n.d.). It should be noted that vision changes can have an impact on both depth perception and peripheral vision. It means that clients with declining vision can oversea objects that can cause them to trip and fall (Grisworldhomecare, n.d.). Also, poor judgement and depth perception might lead a client to miss to grab on an object causing them to fall. The risk mitigation plan for Grisworldhomecare entails ensuring that professional care providers can help in carrying out activities that require a sharp vision, for example, driving a car or manoeuvring around a cluttered house. Body balance is essential when conducting activities of daily living such as shifting body weight from one foot to another or making one part of the body handle a significant amount of the body weight (Buckinx et al., 2018). The activities include walking up the stairs and walking into a bathtub. Homecare encourages their clients to seek help from family members of the healthcare providers since it only takes two seconds of loss of balance for an elderly person to end up in a rehabilitation centre for a fractured bone over months.
Additionally, the continuum program requires the risk manager to carry out orientation programs for the new employees, volunteers and any contracted staff as well as the regular employees at least yearly. The programs focus on raising awareness of the risk exposures of client falls and the latest risk prevention strategies. The in-service training of the healthcare workers should be conducted based on the monitoring and trending patterns of patient fall or upon request from one of the employees. There should be continuous education of the staff on the needed preventative measures and risk aversion or exposure. Similarly, Griswold homecare recommends the education of the patients and their families on homecare. They also recommended that once risk factors for a fall are identified, there is a need to ensure that a fall prevention program is in place.
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Some of the agencies and organizations which regulate the provision of healthcare in nursing homes entail the Center for Medicaid and Medicaid Services (CMS), the Foods and Drugs Administration, Occupational Safety and Health Administration (OSHA) and Food and Drugs Administration (FDA). The role of the FDA is that it is oversight of drugs, vaccines, medical devices, and blood products and it provides the rules for testing, conducting clinical trials and the requirements and regulations for approval of new products. Patient falls are sometimes caused by drugs, for example, drugs that are likely to lead to dizziness and patient falls. It is the responsibility of the FDA to monitor the side effects of drugs and safety and make sure that the healthcare industry is informed of the risks associated with the use of certain drugs. CMS works closely with healthcare organizations such as nursing homes to ensure that older adults received efficient, cost-effective and safe healthcare services. OSHA ensures that workplace safety requirements are adhered to, for example, the removal of hazards that can lead to patient falls.
Compliance with the MIPPA-approved accrediting body, American Society of Healthcare Risk Management (ASHRM) Standards is necessary. It is worth noting that the risk management program that is designed for the current study follows the ASHRM standards. However, the ASHRM recommends a ten-step evidence-based intervention which plays a significant role in ameliorating patient falls. The intervention entails screening for patient falls, carrying out a detailed fall assessment and gait and balance screening when it is necessary, and a customized fall prevention program for all the patients. It should be noted that reassessing the fall risk as well as fall prevention programs has been instrumental in making sure that there is a proactive approach to reducing falls among the ageing population.
Recommendation and Conclusion
In conclusion, patient safety in nursing homes is essential as it reduces poor patient outcomes, financial burden and reduced number of insurance claims. The continuum program follows all compliance standards. To ensure that the suggested program is successful, there is a need to carry out documentation audits followed by monthly reports of falls with the documents being shared amongst all the members of staff. I am proposing the sitter policy. Currently, Grisworldhomecare does not provide every patient with a sitter. The department of nursing should provide the sitter which means developing a nurse technology off the floor for purposes of sitting.
Bondevik, G. T., Hofoss, D., Husebø, B. S., & Deilkås, E. C. T. (2017). Patient safety culture in Norwegian nursing homes. BMC Health Services Research, 17(1), 424. https://doi.org/10.1186/s12913-017-2387-9
Bor, A., Matuz, M., Csatordai, M., Szalai, G., Bálint, A., Benkő, R., Soós, G., & Doró, P. (2017). Medication use and risk of falls among nursing home residents: A retrospective cohort study. International Journal of Clinical Pharmacy, 39(2), 408–415. https://doi.org/10.1007/s11096-017-0426-6
Buckinx, F., Croisier, J.-L., Reginster, J.-Y., Lenaerts, C., Brunois, T., Rygaert, X., Petermans, J., & Bruyère, O. (2018). Prediction of the Incidence of Falls and Deaths Among Elderly Nursing Home Residents: The SENIOR Study. Journal of the American Medical Directors Association, 19(1), 18–24. https://doi.org/10.1016/j.jamda.2017.06.014
Grisworldhomecare, G. (n.d.). Fall Prevention Program & Risk for Falls Care Plan. Griswold Home Care. Retrieved July 7, 2022, from https://www.griswoldhomecare.com/blog/2015/october/fall-prevention-program-risk-for-falls-care-plan/
Gulka, H. J., Patel, V., Arora, T., McArthur, C., & Iaboni, A. (2020). Efficacy and Generalizability of Falls Prevention Interventions in Nursing Homes: A Systematic Review and Meta-analysis. Journal of the American Medical Directors Association, 21(8), 1024-1035.e4. https://doi.org/10.1016/j.jamda.2019.11.012
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