Wild
The 6 Quality indicators we monitor are?
1.Has fallen in last 30 days
2.Worsening pressure ulcers stage 2 – 4
3.Antipsychotics usage without diagnosis
4.Has pain
5. Worsened Pain
6 .Restraint
What are the 4Ps?
Pain, Position, Placement, and Personal Needs
As a non-nurse what do you when you see any changes in the skin of the resident
Any changes in the skin colour, texture, new bruises, new cuts are to be reported to registered staff.
As a nurse when do you do a referral to BSO?
When you see a new or worsened expression (responsive behaviour), new admission with expressions, antipsychotic medication added to resident for the purpose of expressions.
Pain assessments should be done for all of the residents.
True or falls
True, pain assessments should be done
for all of the residents.
The purpose of Quality Board and Continous Quality Improvement Committee is?
Quality Improvement. To compare ourselves to the highest of health care standards and prove that we meet them all or identify where we can improve.
Falls huddles are conducted on ________
Falls huddles are conducted on Tuesdays
As a nurse, when do you change the dressing?
When fluid has expanded and beyond the eorylio pad and is leaking into the border of the dressing.
The edges have rolled comprising of viral and bacterial barrier.
What is considered appropriate use of anti-psychotic medications without diagnosis?
According to HQO, Schizophrenia, Schizoaffective disorder, Huntingtons disease, and or hallucinations and delusions are appropriate.
What are the non-pharmaceutical pain management interventions?
Acupuncture, massage, TENS, music therapy, physiotherapy, cold and heat application, visualization, counselling, psychotherapy and aromatherapy.
You can contribute to the Quality Indicators?
Simply follow the correct practices of:
1.Following the care plan
2.Accurate documentation
3.Reaching out to the home area leaders in case of doubt
As a nurse what do we after a fall?
Assess resident, get vitals, call for post fall huddle, complete risk management, referral to physio, document and inform the POA as needed.
How can the pressure ulcers be prevented?
1.Appropriate skin care
2.Turning and repositioning
3.Hydration and nutrition
Can you list 3 common responsive behaviours (personal expressions)
Wandering (exploring), calling out (vocal expression), exit seeking. Best practice interventions: assess for hunger, thirst, pain and toileting needs. What are they trying to say?
What is PPS score?
PPS score is Palliative Performance Scale.
What is HQO?
Health Quality Ontario is now part of Ontario Health, an agency created by the Government of Ontario with a mandate to connect and coordinate our province’s health care system to help ensure that Ontarians receive the best possible care. Our Home’s Quality Indicators can be found on the HQO website.
How can we prevent and manage falls?
•4Ps
•Comfort rounds
•Clean up spills immediately
•Ensure there is a “Wet Floor” sign in place after mopping
•Remove broken equipment or furniture
•Keep call bells and frequently used items within residents’ reach
•Apply brakes to beds, wheelchairs and walkers
•Ensure there is a clear path from residents’ bed to bathroom
•Ensure residents are wearing proper footwear
•Provide Falls prevention tip sheet to residents/families upon admission
As a nurse, how do you manage skin tears by ___
1. Cleanse
2. Classify wound
3. Apply 3M Tegaderm absorbent clear acrylic dressing.
What is our corporate benchmark for antipsychotic medication use without a diagnosis and where do we stand?
Corporate benchmark is 17.3%
Our home is at 8.86% as of May 2023.
What does a pain assessment include?
Ensure the pain assessment includes the following:
a. The reason for the assessment;
b. L – Location of the resident’s pain;
c. P – Provoking factors (What makes the pain better? What makes the pain
worse?);
d. Q – Quality of the pain described (dull, aching, burning?);
e. R – Radiation of the pain (does it extend to another area?);
f. S – Severity rated by the numeric scale or the PAINAD;
g. T – Timing (Is it constant or intermittent? What time of day is the pain
occurring?);
h. U – What effect does the pain have on the resident? Are there other
symptoms (nausea, vomiting, fatigue)? Are there any behaviours
suspected as being the result of pain (striking out, refusal of care or
depression/withdrawal, etc.)? What is the sedation scale from 1-5?
i. V – What are the resident goals? Values?
j. History of pain and how the pain has been managed.
Where can the reports on quality indicators be found?
The reports on Quality Indicators can be found in Insights tab in PCC
Where is the falls kit placed in the home and what all can be found in it?
The falls kit is placed in every nursing station.
Usually falls kit includes clip alarms, bed alarms, chair alarms, IR lights, hip protectors, anti-skid socks and falls mats
How do we prevent pressure ulcers?
1.Use correct products
2.Barrier creams
3.Proper surfaces
4.Turning and re-positioning
5.Hydration/nutrition
Can you list examples of hallucinations and delusions?
Hearing and talking to someone that is not there.
Believing a doll is a real live baby.
What is the corporate benchmark for has pain indicator and what is our score as of May 2023
Corporate bench mark is 5.50 and we were at 15.50%.