Patient and resident safety is vital in every healthcare setting, and nursing homes are no exception. In the context of long-term care, nursing home safety tips are a great way to stay in compliance with federal regulations and navigate the staffing crisis more effectively.
Nursing home safety refers to the measures, practices, and policies in place to protect residents from potential harm, promote their well-being, and meet their emotional, physical, and mental health needs. It involves creating a nursing home environment where residents are secure and protected from hazards, accidents, and abuse or neglect.
Seniors residing in nursing homes are vulnerable, with many facing safety issues due to age, mobility limitations, and cognitive decline. This is why caregivers must fully understand nursing home safety tips to minimize unnecessary risks. Here we will mention the top safety concerns regarding seniors in nursing homes and tips for preventing unfortunate incidents.
1. Tips on Proper Medication Management
Polypharmacy is a serious problem in long-term care, as seniors are often medicated with five or more different medications per day. Unfortunately, this has become a common occurrence in most nursing homes.
Studies show that 91% of residents take more than five medications daily, with 74% taking more than nine medications per day. Polypharmacy has been associated with adverse clinical outcomes, such as cognitive impairments, falls, fractures, adverse drug events (ADEs), and drug interactions.
Some nursing home safety tips to address polypharmacy include:
- Regular medication reviews: Here, physicians, pharmacists, and nursing home staff should collaborate to evaluate the appropriateness and effectiveness of each medication while considering factors like dosage, duration, and potential side effects of other medications.
- Cautious deprescribing: Deprescribing is the discontinuing or tapering off of medications that are no longer necessary or may be causing harm. This is something that nurses must do with extreme caution and only upon consultation with the resident’s physician. By carefully assessing the risk-benefit ratio of each medication, nursing homes can determine which drugs can be safely discontinued or reduced in dosage. Of course, such changes should always be accurately recorded in the facility’s senior care software.
- Patient-centered care: Involving the family of residents and the residents themselves is especially crucial during transfers, as one must ensure they have the complete list of medications the resident was prescribed. Also, engaging residents in discussions about their medications, potential side effects, and treatment goals will result in more informed decisions and encourage residents to be more proactive in managing their health.
- Organize medications list in a long-term care EHR: Long-term care EHRs are indispensable tools in modern healthcare. They provide easy access to essential patient information and improve internal and external communication with pharmacies. Nursing home software, such as EHRs, plays a vital role in managing residents’ complex medication regimens, as they ease the medication review process, and they can also offer drug interaction warnings.
2. Tips for Preventing Falls
Falls are a significant safety issue in nursing homes, affecting the health and well-being of many residents. It is estimated that around half of all nursing home residents experience a fall each year, and some experience frequent falls.
These incidents can have serious consequences, including injuries, hospitalizations, poorer quality of life, or even death. By understanding the factors associated with an elevated risk of falls, nurses can implement some nursing home safety tips to better prevent them. Factors include the following:
- Previous falls: Residents who have experienced falls in the past are at a higher risk for future falls. A history of falls may indicate underlying issues, such as balance or mobility problems, that need to be addressed to prevent further incidents.
- Use of assistive walking devices: While assistive devices like canes and walkers are designed to help seniors maintain their mobility, their use may also indicate an increased risk of falls due to instability, muscle weakness, or balance issues.
- Wandering: Wandering behavior, often seen in residents with cognitive impairments such as dementia, can contribute to an elevated risk of falls. Disorientation, confusion, and agitation can lead to unsafe situations and increase the likelihood of falls.
- Parkinson’s disease: Seniors with Parkinson’s disease are at a higher risk for falls due to muscle rigidity, postural instability, and gait disturbances, which are common symptoms of the condition.
- Dizziness: Dizziness, whether caused by medical conditions, medications, or dehydration, can affect balance and coordination, increasing the risk of falls. Proper assessment and management of dizziness in nursing home residents are essential for fall prevention.
- Polypharmacy: Polypharmacy can contribute to an increased risk of falls due to the negative side effects that result from using multiple medications, like dizziness, drowsiness, or confusion, leading to instability and falls.
- Use of sedatives, antipsychotics, or antidepressants: Certain medications, such as sedatives, antipsychotics, and antidepressants, can further increase the risk of falls due to their potential side effects, including drowsiness, impaired balance, and slowed reaction times.
To reduce the likelihood of falls and their negative impacts, nursing homes should keep in mind the following tips:
- Balance, gait, and strength training: Exercises targeting balance, gait, and strength can help improve residents’ physical abilities, reducing their risk of falls. Such training can be offered individually or in group settings under the guidance of trained professionals.
- Individualized or group physical therapy: Physical therapy can address specific mobility or balance issues, tailoring interventions to each resident’s unique needs.
- Tai Chi: This gentle form of exercise emphasizes balance and coordination, and studies have shown it to be effective in reducing falls among seniors.
- Environmental modifications: Ensuring a safe living environment is crucial for fall prevention. This includes proper lighting, clutter-free walkways, grab bars, and non-slip flooring.
- Nursing home safety awareness: Educating residents and staff about potential fall hazards within the nursing home can encourage proactive measures to maintain a safe environment.
- Correcting vitamin D deficiency: Vitamin D deficiency is associated with an increased risk of falls. Ensuring adequate vitamin D levels through supplementation or dietary changes can help mitigate this risk.
- Minimizing the number of medications: Regular medication reviews and collaboration with healthcare professionals can help remove polypharmacy and the risks associated with multiple medications.
- Decreasing the use of psychotropics, anti-anxiety, anti-depressants, and sedatives: Reducing medications that can contribute to dizziness, drowsiness, or impaired balance can significantly lower the risk of falls among nursing home residents.
- Treating vision and hearing impairments: Addressing vision and hearing impairments can help improve residents’ spatial awareness and balance, reducing the likelihood of falls.
- Correcting arrhythmia: Certain types of arrhythmia can cause dizziness and fainting, increasing the risk of falls. Proper medical management of arrhythmias is essential for fall prevention.
- Managing foot and footwear issues: Ill-fitting or inappropriate footwear and foot problems like bunions can contribute to instability and falls. Ensuring residents wear supportive, properly fitted footwear and addressing any foot-related issues can help reduce fall risks.
3. Tips for Preventing Elder Abuse
- Physical abuse: This involves the intentional use of force or violence against a resident, resulting in injury, pain, or impairment. Examples include hitting, slapping, pushing, or improper use of restraints.
- Psychological abuse: Also known as emotional or verbal abuse, psychological abuse involves causing emotional pain, distress, or anguish through verbal or non-verbal actions. This can include humiliation, intimidation, threats, or isolation from social activities.
- Financial abuse: This occurs when someone illegally or improperly uses a resident’s funds, assets, or property without their consent. It can involve theft, forgery, or exploitation of a resident’s financial resources.
- Sexual abuse: This involves any non-consensual sexual contact or activity with a resident. This can include unwanted touching, sexual assault, or forced participation in sexually explicit materials or conversations.
- Neglect: Neglect is the failure to provide necessary care, assistance, or protection to a resident, resulting in harm or the risk of harm. This can mean the inadequate provision of food, water, shelter, medical care, or personal hygiene, as well as failure to ensure a resident’s safety or prevent accidents.
As a way to prevent elder abuse in nursing homes, congress passed the Nursing Home Reform Act of 1987, a landmark piece of legislation establishing quality-of-life rights for nursing home residents. The act was passed in response to growing concerns about the mistreatment and neglect of elderly and vulnerable individuals in nursing homes. The act aimed to improve the quality of care provided in nursing homes and to protect the rights of residents.
Unfortunately, the reality is that elder abuse often goes unnoticed, ignored, or disregarded by nursing home staff, making it more challenging to discover and address abuse. Caregivers and families of seniors, though, can help prevent elder abuse in their facilities by keeping the following tips in mind:
- Listening to older adults to understand their challenges and provide support: This can include providing emotional support and counseling as well as practical assistance with tasks such as managing medications and arranging transportation.
- Reporting abuse or suspected abuse to local adult protective services, long-term care ombudsman, or the police: Reporting abuse or suspected abuse is critical to preventing elder abuse. Doing so can help stop the abuse and ensure the abuser is held accountable.
- Educating staff on how to recognize and report elder abuse: This can help to ensure that abuse is identified and reported as soon as possible and that appropriate action is taken to prevent further abuse.
- Learning how the signs of elder abuse differ from the normal aging process: The signs of elder abuse differ from the normal aging process. Nursing home staff who learn the differences can help identify potential abuse and ensure appropriate action is taken, preventing further abuse of residents.
- Checking in on older adults who may have few friends and family members: Doing so can help to prevent social isolation, which can be a risk factor for elder abuse.
- Supporting over-burdened caregivers: This can include help from friends, family, or local relief care groups, as well as adult day care programs, counseling, and outlets intended to promote the emotional well-being of the caregiver.
- Encouraging and assisting persons (either caregivers or older adults) having problems with drug or alcohol abuse in getting help: Substance abuse can be a risk factor for elder abuse, and addressing it can help to prevent elder abuse from occurring.
4. Tips for Smooth Care Transitions
Effective communication is necessary for smooth care transitions between nursing homes and hospitals. Meanwhile, poor communication is a significant barrier to safe and effective care transitions, which can lead to serious negative consequences for nursing home residents.
Poor communication can also impact resident care when residents are discharged from a hospital with incomplete or inaccurate information about their diagnosis, tests, treatments, and recommendations. This can lead to confusion and misunderstandings among nursing home staff, residents, and their families, as well as delays in appropriate care and rehospitalizations.
So what nursing home safety tips can be implemented during resident care transitions?
- Effective transitional care management practices: This involves developing strategies and protocols for transitioning residents between nursing homes and hospitals. This can include creating a comprehensive care plan that outlines the resident’s needs and goals, ensuring that necessary medical information is accurately shared between healthcare providers, and identifying potential barriers to effective care transitions.
- An efficient senior care software: With the help of technology, nursing homes can streamline communication, documentation, and information sharing among healthcare providers. Senior care software can help nursing homes manage resident data, including medication lists, diagnoses, and care plans. An efficient senior care software can also help nursing homes to reduce the risk of medication errors and other adverse events by providing access to real-time data, such as lab results and medication orders.
5. Tips for Infection Control
Infections in nursing homes have become a pressing issue that affects the health and safety of millions of elderly residents each year. One of the most common infections in these settings is the catheter-associated urinary tract infection (UTI), which poses a unique set of challenges for both patients and healthcare providers.
UTIs are alarmingly common among nursing home residents, with nearly 2 million infections occurring annually in these settings. UTIs are particularly associated with the use of catheters, which are often necessary for elderly residents with mobility or continence issues. The high rate of UTIs in nursing homes is a cause for concern, as it not only affects the quality of life of the residents but also puts a strain on healthcare resources.
Diagnosing UTIs in nursing home residents can be especially challenging due to communication barriers, chronic genitourinary symptoms, and comorbidities. Given the high prevalence of UTIs and other infections in nursing homes, these facilities must implement strict infection control measures.
Some key components of an effective infection control program include proper hygiene practices, the appropriate use of catheters, and vigilant monitoring of residents for signs of infection. In addition to these, other nursing home safety tips concerning infection control are:
- Addressing training and accountability for infection preventionists: Infection preventionists play a critical role in maintaining infection control standards in nursing homes. Ensuring these professionals receive adequate training and are held accountable for their actions can significantly improve a facility’s overall infection control practices. Regular assessments, continuing education programs, and performance evaluations can help infection preventionists stay up-to-date with the latest guidelines and best practices, ultimately leading to better nursing home resident outcomes.
- Encouraging alliances with hospital-based infectious disease specialists: These specialists can provide nursing homes with valuable resources and the expert guidance they need. They can offer advice on infection control protocols, assist with outbreak management, and provide staff training on infection prevention measures. By working together, nursing homes and hospitals can create a collaborative approach to infection control, resulting in improved patient and resident care and reduced risk of infection outbreaks.
- Strengthening reporting requirements: Implementing stringent reporting requirements for nursing homes can help track infection rates, antibiotic use, and other related data. By clearly understanding these trends, healthcare providers can identify areas that need improvement and develop targeted interventions to address them. Mandatory reporting of infection rates to local and state health departments can also increase transparency, allowing for more effective monitoring of nursing homes’ infection control practices. Furthermore, sharing this data with the public can encourage nursing homes to maintain high infection control standards to safeguard their reputation.
- Involving local and state health departments in infection control efforts: Local and state health departments can provide valuable assistance in infection control efforts for nursing homes. Nursing homes can access additional resources, training, and expert guidance by collaborating closely with these agencies. Health departments can also monitor infection control practices within nursing homes, identify gaps, and recommend improvements. In addition, they can facilitate the sharing of best practices among nursing homes, fostering a culture of continuous improvement in infection control.
By following the above nursing home safety tips, long-term care leaders can ensure that their residents receive the best care, resulting in better outcomes.
Order of Evacuation in A Nursing Home: How It Works
Having discussed some of the safety concerns regarding seniors in nursing homes, we can now look at the order of evacuation in a nursing home. So what exactly does a written evacuation plan entail? Generally speaking, these nursing home safety tips on evacuation should include the following:
- A designated chain of command: It’s essential to have a clear hierarchy in place so that everyone knows who is responsible for making decisions in the event of an emergency.
- Procedures for evacuating patients and residents: This should include details on how patients will be moved, where they will be taken, and who will be responsible for transporting them.
- Information on transportation and communication: Evacuation plans should include details on how patients and residents will be transported and how communication will be maintained during the evacuation.
- Identification of potential hazards: Healthcare facilities and nursing homes should conduct regular assessments to identify potential hazards and take steps to mitigate them.
- Protocols for staff training and drills: All staff members should be trained on the evacuation plan and drills regularly to ensure that everyone is prepared in an emergency.
- Protocols for returning to the facility: Evacuation plans should also include procedures for returning patients and residents to the facility once the emergency has passed.
In the United States, Federal law requires healthcare facilities and nursing homes to have written evacuation plans on hand. These plans are designed to ensure that patients, residents, and staff members can be safely evacuated in the event of an emergency.
Written evacuation plans are critical to emergency preparedness for healthcare facilities and nursing homes. Not only do they help to protect the health and safety of those who reside in these facilities, but they are also required by law. By creating and implementing a comprehensive evacuation plan, nursing homes and other healthcare facilities can help ensure the safety and well-being of their patients, residents, and staff members.
Contact us here if you would like to improve resident safety by using long-term care EHR.
What Nurses and Resident Families Should Know About Nursing Home Fire Safety
Nursing home fire safety is important to families, as they want to ensure that their loved ones residing in nursing homes are safe. While nursing homes must have certain fire safety measures in place, families can also play a role in increasing the safety of their loved ones by checking on the building’s maintenance, evacuation plan, safety systems, and staff-to-patient ratio.
Since nursing homes are required to have fire safety procedures in place, it is important for staff members to plan, train, and practice nursing home safety tips and procedures to ensure the safety of residents and that families feel that nursing homes are safe.
Some key steps that nursing home staff should take to promote fire safety are:
- Develop a comprehensive fire safety plan: Having an effective order of evacuation in a nursing home means having a plan in place that outlines procedures for evacuation, fire suppression, and notification of emergency services. The plan should also identify fire hazards and provide guidelines for fire prevention.
- Train staff members: All staff members should be trained on the nursing home’s fire safety plan. This includes education on properly using fire extinguishers, evacuation routes, and emergency procedures. Staff members should also receive regular refresher training to ensure that they are prepared in case of a fire and understand the fire safety regulations for nursing homes.
- Practice fire drills: Regular fire drills should be conducted to ensure that staff members are prepared and that evacuation procedures are effective. These drills should be conducted at various times of day and in different locations throughout the nursing home.
- Install and maintain fire safety equipment: The nursing home should have fire alarms, smoke detectors, and sprinkler systems installed and maintained to ensure they are working properly. Staff members should regularly check these systems to ensure they function correctly.
- Plan for residents with special needs: Nursing home staff members should develop a plan for residents with special needs, such as those who require a wheelchair or oxygen. This plan must include procedures for evacuation and assistance during a fire.
- Review and update the fire safety plan: The nursing home’s fire safety plan should be reviewed and updated regularly to ensure it remains effective. Staff members should also receive ongoing education on fire prevention and safety.
Nursing home staff members play a critical role in promoting fire safety and ensuring the safety of residents, and they can help promote a safe and secure environment for all their residents by developing a comprehensive fire safety plan.
Nursing Home Safety Tips Related to Regulations
Nursing homes are regulated at both the federal and state levels to ensure quality care and safety for residents. The Centers for Medicare and Medicaid Services (CMS) oversee quality standards, health care delivery systems, and long-term services in nursing homes and enforce federal regulations. However, state governments may also regulate nursing homes with more stringent requirements than the federal government.
Unfortunately, some nursing homes fail to meet quality standards due to abuse, neglect, understaffing, or a lower quality of care. Failure to implement some of the nursing home safety tips we mentioned can lead to a negative reputation and impact occupancy, as potential residents and their families may choose other facilities with better reputations.
To stay in compliance with regulations, nursing homes should research state regulations and ensure that they are meeting the domains for Medicare and Medicaid reimbursement. It is also important to consider closing down services until compliance is achieved, as non-compliance can result in fines and penalties. Using an intuitive and state-of-the-art long-term care software system for managing facility and resident documentation can also help ensure compliance with regulations.
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