Ensuring Resident Safety

While striving to meet our day-to-day goal of providing each resident with the best care possible, the growing demands on long-term care (LTC) facilities imposed by federal regulations present many challenges, from complying with the F-Tags outlined in the Centers for Medicare & Medicaid Services (CMS) State Operations Manual to anticipating the requirements of “meaningful use” of certified electronic health records in nursing homes. But it’s important to remember that these regulations help safeguard residents’ personal rights, dignity, and wellbeing. This issue of Annals of Long-Term Care: Clinical Care and Aging^® (ALTC) includes two articles that emphasize resident safety. 

In the first article, “Identifying and Managing Long-Term Care Residents With Criminal or Correctional Histories: Preliminary Analysis of One Facility’s Experience”, Robert Gibson, PhD, JD, and Rebecca Ferrini, MD, MPH, CMD, discuss the issue of protecting residents’ rights while creating a safe and nonthreatening environment for others. Although all people have the right to be free from discrimination, F-Tag 224 requires facilities to identify residents whose personal histories may render them at increased risk of abusing others and to develop intervention strategies to prevent abusive behavior. As Drs. Gibson and Ferrini note, this task is “difficult even for forensic experts, much less nursing home staff.” The authors conducted a study at their LTC facility that led them to develop several resources for identifying risk of abusive behavior in residents with criminal histories and strategies for monitoring these residents and ensuring the safety of staff and other residents. For example, the authors provide a simple algorithm that compares residents’ physical ability with cognitive ability that may assist staff with identifying residents who are most likely to both formulate and act on criminal intentions.

Having a robust health information technology (HIT) system is another way to protect residents’ safety. As Elizabeth Babalola, MPH, and colleagues discuss in our second article, “Building a Health Information Technology Infrastructure in Long-Term Care”, HIT can improve individualized resident care and reduce unnecessary rehospitalization, medication errors, and other negative outcomes associated with fragmented systems of documenting and sharing health information across multiple care settings. The authors identified several barriers to HIT implementation in their study and discuss a relatively low-cost program that may help medical directors prepare for the imminent requirements of widespread HIT adoption in LTC.

In this issue, you will also find the next article in our Ask the Expert series, which sheds light on how dietitians are progressively being integrated into interdisciplinary care teams via CMS policies and clinical practice guidelines. As we gain greater understanding of nutrition’s role in the physiology of aging, dietitians represent the keenest pair of eyes on a resident’s nutritional status, ensuring that special diets are prescribed judiciously and that adverse food–medication interactions are avoided.

This issue also contains a tip sheet on screening for and managing pressure ulcers, the first of many Geriatrics Evaluation and Management Tools provided by the American Geriatrics Society (AGS). In the AGS Viewpoint, AGS President Wayne McCormick, MD, MPH, explains how geriatric healthcare providers can use these resources in clinical practice and what our readers can expect to see from the AGS in future issues.

Last but not least, please join me in welcoming the following individuals to ALTC’s editorial advisory board: Steven R. Gambert, MD; Barney Spivack, MD, CMD; Colleen Christmas, MD; Edmund Duthie, MD; Andrew Dentino, MD; and Kenneth Shay, DDS, MS. These individuals previously served on the editorial advisory board of ALTC’s sister publication, Clinical Geriatrics^®. To provide primary care physicians with the latest clinical information and tools to care for the growing geriatric population, Clinical Geriatrics^®  has been integrated into Consultant^® , a peer-reviewed primary care journal. We invite you to check out the new Clinical Geriatrics^®  to access online exclusive content, breaking news, blogs, and archived content at www.consultant360.com/geriatrics.

We hope that you enjoy the articles and resources in this month’s issue. As always, we appreciate your feedback. Please e-mail your comments to our associate editor, Allison Musante, at amusante@hmpcommunications.com.

Thank you for reading!