LTC NAC Chat

In this fifth episode of the Deep Dive into MDS 3.0 Quality Measures podcast series, AANAC curriculum development specialist, Jane Belt, MS, RN, QCP, RAC-MT, RAC-MTA, discusses two long-stay antianxiety/hypnotic medication MDS 3.0 Quality Measures—the Prevalence of Antianxiety/Hypnotic Use and the Percent of Residents Who Used an Antianxiety or Hypnotic Medication.

In this podcast, AANAC curriculum development specialist, Jessie McGill, RN, RAC-MT, RAC-MTA, will discuss two antipsychotic medication-related measures, the short-stay measure—Percent of Residents Who Newly Received an Antipsychotic Medication, and the long-stay measure—Percent of Residents Who Received an Antipsychotic Medication. McGill will discuss the rationale, what is the numerator, denominator, the exclusions, covariates as well as a possible action plan for greater success.

In this third episode of the Deep Dive into MDS 3.0 Quality Measures podcast series, AANAC curriculum development specialist, Jane Belt, MS, RN, QCP, RAC-MT, RAC-MTA, discusses two more long stay measures, Percent of Residents Whose Need for Help with Activities of Daily Living Has Increased and Percent of Residents Whose Ability to Move Independently Worsened.

Deep Dive into MDS 3.0 Quality Measures: Episode 002 - Pressure Ulcers

In this podcast, Jane Belt, MS, RN, QCP, RAC-MT, RAC-MTA, AANAC curriculum development specialist, starts off a new podcast series called "Deep Dive into MDS 3.0 Quality Measures." These monthly podcasts will feature one or two of the Quality Measures (QMs) and delve into the details about each measure and what actions may prove helpful as the NAC and other members of the IDT work to improve or maintain their results.

For our first podcast, Jane discusses two long-stay measures—Falls With Major Injuries and Prevalence of Falls. For each measure, Jane describes the rationale, what is the numerator, denominator, the exclusions, and covariates, as well as a possible action plan for greater success.

MDS Item Sets Breakdown

The Waivers NACs Need to Know

Personal protective equipment (PPE) is currently a topic of discussion on a global level. The COVID-19 pandemic has brought infection control procedures and the use of PPE under intense scrutiny, especially in long-term care. On a daily basis, we hear about the shortcomings of PPE supply and use, along with the lack of proper infection control in healthcare. Do not let the negative publicity paralyze you. As a leader, it is imperative to analyze what occurs in the facility and find ways to improve. By investigating competency and compliance, directors of nursing or other nurse leaders, such as infection preventionists, can improve PPE utilization in their facilities.

History of PPE

Since Leonardo DaVinci invented the first respirator to prevent contamination from chemical warfare in the 16th century, healthcare personnel (HCP) have been attempting to protect themselves from illness (Segal, 2016). As understanding of pathogens increased, PPE have evolved in response. PPE as we know it today originated in the 1970s when the Centers for Disease Control and Prevention (CDC) published the manual Isolation Techniques for Use in Hospitals. In the 1980s, PPE use intensified due to the human immunodeficiency virus (HIV) pathogen, which led to universal precautions being introduced in 1985 to prevent the transmission of infection. In addition to the gowns and gloves already being utilized, facemasks and eye shields were implemented to protect mucous membranes. In 1989, the Occupational Safety and Health Administration (OSHA) proposed a rule on occupational exposure to bloodborne pathogens. The rule on bloodborne pathogens was then finalized and published in 1991. The CDC issued an isolation guideline in 2007 which addressed PPE, including the donning and doffing procedures (Segal, 2016).

 

Transmission-Based Precautions and PPE

The route a pathogen spreads (air, droplets, contact, or a combination of these) dictates the transmission-based precautions that are appropriate. Once the type or types of transmission-based precaution have been selected, the PPE that will provide a barrier specific to that route of transmission is used to protect the HCP and resident. PPE may consist of face masks or respirators, gowns, gloves, face shields, and goggles.

Due to the current pandemic, the CDC issued the Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings, which were updated on May 18, 2020. This guidance states facilities should use transmission-based precautions for residents with suspected COVID-19 or test-based positive results; it includes the use of gloves, gowns, face masks, goggles, and, in some cases, a N95 mask or respirator.

 

PPE competency

Merriam-Webster defines competency as the quality or state of having sufficient knowledge, judgment, skill, or strength. In other words, competence is based on performance and whether the HCP can properly complete the job or task. In order to achieve competency, the HCP must be educated regarding both the purpose and the procedures.

OSHA requires that each HCP know the following regarding PPE:

When it is necessary

What kind is necessary

How to properly put it on, adjust, wear, and take it off

The limitations of the equipment

Proper care, maintenance, useful life, and disposal of the equipment

In general, when observing an HCP for PPE competency, the observer should make sure the staff member is performing hand hygiene correctly, correctly determining which type of PPE to use, and donning and doffing each type of PPE correctly and in the right sequence. Below is a breakdown of what the observer should look for regarding each type of PPE to determine competency.

Type of PPE

Competence

Gloves

· Don/doff in correct sequence

· Doff inside of resident room

· Doff gloves without touching clean hand

· Discard correctly

Gown

For the last several years, the AAPACN conference has started with a special session planned by the AAPACN Board of Directors and intended to celebrate the members and to give them an opportunity to provide feedback directly to the board members. With the conference transitioning to a virtual format this year, this Spotlight on You Session transitioned as well into a two-part podcast series with AAPACN Chair-elect, Jill Snow, MBA, BSN, RN-BC, CHC, and AAPACN Immediate Past-chair, Stephanie Kessler, CPC. Joining the conversation is AAPACN Vice President of Curriculum Development, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT.

In part one, Jill, Stephanie, and Amy discuss the LTPAC Nurse Heroes initiative, how AAPACN advocates for its membership, and why they are proud to be LTPAC nurses. Originally part of the conference, we are happy to make this conversation available to all AANAC and AADNS members.

How to Catch Up on MDS Assessments