National Patient Safety Goals aim to improve nursing home care

Texas nursing homes are notoriously overcrowded and understaffed. This provides a perfect recipe for medical malpractice and health care errors and mistakes that can spell disaster for already at-risk patients.

The Joint Commission is an accrediting agency for health care facilities, including nursing homes and skilled nursing facilities (SNFs). Its overall goal is to raise the bar on the quality of care provided by accredited facilities. One of the ways it does this is through annual National Patient Safety Goals.

As a former hospital administrator, I know that these efforts get the attention of hospital leaders and make a difference in the quality of care provided to all patients.

The 2020 National Patient Safety Goals became effective in July 2020. Here are some of the goals.

Goal: Improve the accuracy of patient and resident identification.

I bet many people think this one is needless and borderline absurd. You may be surprised to learn, though, that there are many errors in this area.

Painter Law Firm recently handled a case on behalf of a patient at a Houston, Texas area nursing home. She had the same last name as a different patient who needed a surgical debridement procedure. The surgeon and staff were in a hurry and literally got the first patient with that last name and brought her to the operating room. There were multiple failures that day, but it subjected this hearing-impaired elderly lady to an unnecessary surgery.

This National Patient Safety Goal requires physicians and nursing home staff to use at least two methods to identify the patient or resident before providing care, treatment, and services. This could be, for example, name and birthdate.

Goal: Improve the safety of using medications.

This focuses on the numerous nursing home patients and residents who are on long-term anticoagulation therapy. This type of medical therapy is frequently prescribed for patients with atrial fibrillation, deep vein thrombosis (DVT), pulmonary embolism, and certain heart implants.

The challenge with anticoagulation medications is that they must be carefully managed within narrow windows to prevent harm. This requires substantial staff time and attention to proper dosing and monitoring.

This goal aims to improve face-to-face patient education to make sure that they understand the risks involved in anticoagulation therapy and comply with physician orders. The goal also mandates that nursing homes use approved protocols and practice guidelines to begin and maintain anticoagulant therapy, and develop policies and procedures for responding to adverse drug events. Additionally, to avoid complex dosing problems, The Joint Commission requires using prefilled syringes or premixed infusion bags when they are available.

Goal: Maintain and communicate accurate patient and resident medication information.

This goal highlights the importance of a nursing function called medication reconciliation. It simply means that when a patient is admitted, the nursing staff needs to obtain a complete list of medications and supplements that the patient is already taking.

This must be documented in the medical record, so the attending physician and other consulting doctors can avoid prescribing new medications that may be contraindicated or that would interfere with those that the patient is already on.

You can improve your own patient safety by maintaining your own list of medications and supplements, which you can bring to any emergency room, doctor’s visit, or hospital or facility admission.

Goal: Reduce the risk of patient and resident harm resulting from falls.

Patient falls are considered sentinel or never events, yet they still happen. Statistics show that a typical nursing home reports 100–200 falls a year! Some of these falls are caused by poor staffing, or residents not being able to wait for assistance when they need to go to the bathroom or to get out of bed.

This goal requires nursing homes to assess the patient’s fall risk, implement interventions to reduce the risk, and provider patient education.

Goal: Prevent health care-associated pressure injuries.

Pressure injuries, bedsores, decubitus ulcers—whatever you call them, they’re a sad, and often, preventable condition. Many medical experts of pressure injury that we’ve worked with have said that the best way to treat bedsores is to prevent them. The strain on the body and nutritional requirements to heal severe bedsores are often too much for elderly patients to endure.

This goal requires nursing homes to assess and periodically reassess each patient’s pressure injury risk and to create and document action plan to protect from any identified risks. To comply with this goal, facilities will need written policies and procedures, including how and when to perform initial assessments and reassessments, and mandating use of standardized risk assessment tools such as the Braden’s Scale or Norton Scale.

Additionally, the goal requires documented actions to protect against patient pressure injuries by maintaining and improving tissue tolerance to pressure, which can be done through repositioning, specialized beds, and medical ointments, and reducing external mechanical forces like friction, which can cause skin damage.

If you or someone you care for has been seriously injured because of poor nursing home care, then contact a top-rated Houston, Texas medical malpractice lawyer for help in evaluating your potential case.

Robert Painter
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Robert Painter

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm Medical Malpractice Attorneys in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him for a free consultation and strategy session by calling 281-580-8800 or emailing him right now.