It is important for physicians, staff, and families to find creative ways for residents to stay on the move.
Around the country, nursing homes trying to protect their residents from the coronavirus eagerly await boxes of masks, eyewear and gowns promised by the federal government. But all too often the packages deliver disappointment — if they arrive at all.
McKnight’s Long-Term Care News asked nursing home leaders what they were doing to “help keep spirits up” during the coronavirus pandemic and, boy, did they tell us.
Nearly 500 providers, in fact, opened up to share what their favorite coping mechanisms are.
The most popular answers culled from the McKnight’s COVID-19 flash survey last weekend involved free food for staff, dress-up or theme days, flexible work hours, and increased communication with staff members.
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Researchers say the Reducing Avoidable Facility Transfers (RAFT) model was shown to “substantially” decrease emergency department (ED) trips from three skilled nursing facilities. Moreover, the SNFs “also recorded a reduction in some acute health care utilization.” The model aims “to bring closer monitoring of a resident’s care plan and more expert clinical evaluations in order to prevent unnecessary hospitalizations for those in long term and post-acute care.”
In this recent article from Provider magazine, Betty Halvorson, RN, encourages providers to evaluate the current level of care their facilities are producing and to ask themselves, “Is this care evidence-based?”
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Research conducted by AHCA/NCAL in 2019 shows that SNFs that employ at least one American Nurses Credentialing Center (ANCC) Board certified RN performed higher on average on SNF VBP performance scores.
The average 2017 SNF VBP performance score across the nation was 34.4. For SNFs with at least one RN who has been ANCC Board certified in gerontological nursing, the average SNF VBP performance score was 44.2. The net result is that these SNFs get higher Medicare Part A reimbursements.
- Fewer survey deficiencies
- Fewer IJ citations
- Lower rehospitalization rates
- Lower rates of off-label use of antipsychotics
- Higher CMS 5-Star ratings
The ANCC offers certification in gerontological nursing – the gold standard in demonstrating clinical excellence in geriatric patient care. ANCC is the world’s largest and most prestigious nurse credentialing organization and a subsidiary of the American Nurses Association. Less than one percent of America’s RNs are board certified in gerontological nursing.
To help RNs prepare for the certification exam, AHCA/NCAL offers an online course called Gero Nurse Prep. RNs who complete the course earn 30 nursing contact hours and experience a 96% pass rate on the ANCC certification exam on the first try. Gero Nurse Prep students see a whopping 24 percent average increase between their pre- and post-test scores.
Gero Nurse Prep is flexible. RNs study online at their own pace and have one year from the time they enroll to complete their Gero Nurse Prep coursework.
AHCA/NCAL Gero Nurse Prep provides tremendous value at the $690 AHCA/NCAL member price. That’s $23 per contact hour for outstanding nursing education that makes a measurable difference on so many fronts. For RNs pursuing Board certification through ANCC, there is an additional and separate cost of $395.
Injuries, infections, behavioral incidents and family insistence often drive hospital admissions among nursing home residents, and a new study finds many of those transfers may be unavoidable.
Among the most difficult challenges facing skilled nursing centers today is ensuring that staff are adequately trained to care for their increasingly frail and medically complex residents. While training requirements are included in the initial phase of the final rule, and much more substantially in Phase 3, training and competency are more than a survey compliance issue.
Providing compassionate person-centered care for frail elders, many with severe cognitive and/or physical disabilities, requires staff to be well trained in understanding and addressing a range of resident needs and behaviors. Basic nursing and nurse assistant training provides a necessary starting point, and “caring” goes a long way, but even the most well-intended of us can benefit from training that builds upon knowledge and practice in eldercare.
Training requirements already included in the new regulations and survey relate to abuse and neglect for all staff, in-service training for nurse assistants on dementia management and abuse prevention, care of those with cognitive impairments, and training of feeding assistants. Training in these areas is essential to prepare staff to better understand the needs of those who are most vulnerable and/or difficult for caretakers to understand.
Phase 3 of the final rule will substantially increase the emphasis on training and competency with requirements relating to communication, resident rights, infection control, compliance, and ethics—especially in regard to person-centered care, behavioral health, and Quality Assurance and Performance Improvement. These specific areas are accompanied by the general training requirement that staff are trained to care for all resident needs identified in the facility assessment.
With competency requirements in these areas a year away (Nov. 28, 2019), nursing centers need to begin designing and implementing a systematic training program today. A combination of training methods is encouraged, including in-person instruction, web-based training, and/or supervised practical training.
Due to the steady evolution in resident care needs and treatment, training is required for both new and existing staff.
For nurse assistants, in-service training of at least 12 hours per year is expected to reflect an assessment of their knowledge and skills and how well they know the resident population. To determine the adequacy of in-service training, providers will be required to demonstrate competencies, not just completion of in-service hours.
Many nursing centers will require investment in training specific to the growing frailty and complexity of the long-stay resident population and the higher acuity of post-acute residents. High staff turnover and shortages of nursing staff with the necessary qualifications to take care of today’s elders will continue to be a challenge. Training programs must therefore be ongoing and sustainable so that they continue and evolve as resident needs change and staff capabilities change.
Balancing these training needs with caring for residents is a daunting task. That said, investments in staff training can make caretaking less challenging and more rewarding for staff members. These not only lead to greater staff satisfaction and retention, but the commitment to excellence will not go unnoticed by residents and families.
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This New Directions in Healthcare podcast reports on what some public health officials are calling a plague of loneliness and its medical consequences.