Missouri Long-Term Care Information Update

Entire Series Now Available for Download!

The Health Quality Innovation Network’s free 9-week education series is now available for download on our Resource Center. Download the topic(s) that you want to focus on in your facility or download the entire series and work through all nine weeks.

The five short, concentrated evidence-based talking points in each week can easily be included in daily stand-up meetings to increase staff knowledge on relevant topics. The program is designed to empower nursing home staff with practical knowledge to foster a safer environment and decrease preventable emergency room visits and hospital readmissions.

We’d appreciate your feedback on this education series. Please share your experience in using the content and materials offered in the Nursing Home Stand-Up Series.

HQIN is presenting an educational series tailored for nursing home stand-up meetings, aimed at decreasing preventable emergency room (ED) visits and hospital readmissions. HQIN is sending out talking points that can be included in daily stand-up meetings to increase staff knowledge on relevant topics like effective communication, adverse drug events and infection prevention. The program is designed to empower nursing home staff with practical knowledge to foster a safer environment.

This week is the final week of the series. This week’s strategies include Purposeful Conversations. Below is an overview of information and resources.

• Purposeful conversation refers to intentional and meaningful communication that serves specific objectives or goals. It goes beyond casual chitchat and aims to achieve specific outcomes.
  Print and discuss with the team the following resource, Go to the Hospital or Stay Here. Social services staff or nurses can use this decision guide to facilitate clear and informative conversations of a resident’s choice to “Go to the Hospital or Stay Here.”
• Do all of your residents have a documented advanced directive? Review which residents are a full code, and which are a Do Not Resuscitate (DNR). Discuss how staff know which residents are DNR and what the current process is to communicate this to all staff.

Print and discuss Education on CPR for Residents/Patients and their Representatives with the clinical team to guide conversations when providing education for residents and their family.

Advanced directives should be reviewed upon admission, quarterly, and if a change in condition would warrant it. Use this Advance Care Planning Tracking Form to assist with tracking these reviews.

• It is often helpful to involve the physician or healthcare provider, in addition to the resident and their family, in purposeful conversations during care plan meetings. You may want to have an ad hoc care plan meeting if a decline in condition is noted.  Discuss with the team the importance of being proactive with change in condition. Consider inviting the physician or nurse practitioner to participate in a care plan meeting to participate in difficult conversations.

Print and discuss A Patient’s Guide to Serious Illness Conversations from the Institute for Healthcare Improvement to guide these conversations.

• Advanced care planning for vaccinations is a best practice. The Planning for COVID-19 Care Conversation Tool can assist with having purposeful conversations centered around vaccinations upon admission and at quarterly care plan meetings. Print and share the same resource with the admissions and clinical care plan team and discuss how it can be incorporated into current practice.

HQIN is presenting an educational series tailored for nursing home stand-up meetings, aimed at decreasing preventable emergency room (ED) visits and hospital readmissions. HQIN is sending out talking points that can be included in daily stand-up meetings to increase staff knowledge on relevant topics like effective communication, adverse drug events and infection prevention. The program is designed to empower nursing home staff with practical knowledge to foster a safer environment.

This week’s strategies include Falls. Below is an overview of information and resources.

• Talk about environmental hazards that may contribute to a resident falling.
  How many can your staff name (wet floors, poor lighting, incorrect bed height, improperly fitting wheelchair, poor shoes, or resident needs such as the need to use bathroom, items not in reach, call bell not in reach)?
  Print the Environmental Safety resource and review with your team, then post it for other staff members to have for reference. Create a Falls bulletin board to display educational resources to reduce falls for your team.

• How many times have you seen a resident try to stand, transfer or walk unassisted? It takes a team, working together, to reduce falls.
  If you see a resident that looks unsafe, let someone know. Purposeful rounding can be conducted by anyone (housekeeping, dietary, maintenance, nursing, social services, activities and volunteers) who is “walking” in the facility.
  Print the Falls Prevention resource and share with team members, then post it for others to reference.

• What are the 4 P’s to reduce fall risk? Pain. Potty. Positioning. Possessions. Implementing purposeful rounding for all staff can significantly reduce fall risk.
  Print and post the following resource on The 4 P’s of Reducing the Risk of Falls and discuss them in depth with your staff. Also, download these 4 P’s Cards that can be cut out and shared with staff.

• It is time to talk about engagement and sleep hygiene. Improving mobility, psychosocial well-being and sleep hygiene has been shown to reduce fall risk.
  Print and post Simple Strategies to Prevent Falls: Engagement and Sleep Hygiene for your team. Discuss ways your team can improve sleep for your residents.

• Who is tracking falls in your facility and are they including it as part of QAPI? Is there a system of sharing information on falls and letting all members of the team know the facility’s fall data?
  Designate a “falls champion” today and continue to find great information on fall reduction to share with your team. Charts and graphs can be great to share! Download the Health Quality Innovation Network (HQIN) Nursing Home Falls Tracking Tool and implement it into your team processes.