Question

1. How could LTC settings prepare better for patient safety issues? ( 100 words unique essay

2. What role does the NH administrator have in preparing for patient safety issues?( 100 words unique essay )

Answer 1

Long term care centres ( LTC) render services to patients recovering from surgery, trauma or actue illness. Services of LTC vary from long term acute care to intensive rehabilitation services. Increasing number of the patient population with patients becoming frail and complex condition due to comorbidities makes it difficult for nurses to examine and address issues related to patient safety. Hazards that are documented in older patients consist of medication error, falls, delirium, healthcare associated infection such as indwelling catheter related Infection.

Preparation towards patient safety issues can be done by the following measures:

1. Assessment - various assessment tools are available to assess the risk of patient safety. Assessment will help the facility to identify the reasons or practices that commonly leads to patient safety issues. Individualized assessment for safety is performed can also give an input about the need of nursing care required to prevent safety issues.

2. Supervision and leadership- there should be appointment of safety champions, conduct patient safety leadership rounds etc so that the nurses as well the senior nurses supervise, improvise and support nurses towards patient safety.

3. Changing the working culture - a)acknowledgement of high risk activities sone through thorough assessment with the help of adequate tools helps the organization to evaluate the causes hindering patient safety.

B) No blame environment helps the nurses as well as nursing leaders to report about errors or near Miss incidents without the fear of being blamed or punished for inadequate patient safety.

C) collaboration - collaboration of all ranks, disciplines and specialist should work together towards achievement of patient safety.

D) Organization commitment - the organization should make availability of adequate resources, support the nurses and commit towards patient safety .

4. Training and skill development - ongoing nursing education should be provided about taking care of patient on long term care, care of elderly, address on dementia, Alzheimer's, late life depression etc. Focus of education and training should be on skills required to improve care and promote patient safety.

5. Recording and reporting - various measures, tools and documentation of events related to patients safety should be done appropriately. Safety briefing increased the awareness and alertness of the Frontline nurses and help nurses to develop a culture of safety.

Role of Nursing Home (NH) administrator -

NH administrator are an indespensible asset to the long term healthcare system. Role of NH administrator are as follows:

1. Evaluation of elderly residents needs - the NH administrator should have in depth knowledge about the physical, psycho social and psychological impact of elderly patient. Knowledge asses the needed nursing care, medication needed and nursing rehabilitation needs. NH administrator should make the tools and checklist available in the LTC to assess the needs of elderly with regard to patient safety.

2. Advocate - NH administrator act as a liason between the patients, staff and doctors. They must ensure quality care for patient with optimum coordination and communication with nursing staff and doctors. Incase of any patient safety issues, the NH administrator should act as an advocate for the patient considering the other health care workers in the LTC facility.

3. Management of nursing home-made the NH administrator manages the smooth functioning of the LTC setting. Management begins with recruitment of knowledgeable and skillful nursing personnel, doctors etc. The nursing staff should be monitored continuously for their performance of task, keep continuously training their skills and take action if needed. Staff member health, insurance and benefits should also be taken care of to promote staff retention and optimal function. Any incidents or near miss incidents related to patient safety if found any should be reported, discussed upon and solution should be sought.

4. Financial monitoring - NH administrator take care of financial responsibility by using various accounting and payroll software which helps in managing the bugets for the LTC. If nursing staff is not care of financially, it may lead to improper nursing skills provided which may affect patient safety.

5. Complying with Central and state procedures- Central and state procedure consist of by-laws, protocols and other legal formalities that contribute to the quality of care provided in LTC. Various insurance and schemes such as Medicare, Medicaid and other governmental health grants can be considered and availed by complying Central and state procedure. They also help LTC with problem solving strategy and variations of measures that can be implemented to promote patient safety.