Hcs 451: A Brief Note On Risk Management In Long Term Care

Risk Management
Lynda Villicana
HCS/451
March 19, 2013
Barbara Smith
Risk Management Risk management in long term care creates many different and sometimes conflicting ideas. The general consensus is that risk management is the steps taken by an organization to prevent the possibility of a loss or injury. It is the responsibility of every employee to assist with minimizing the risk of harm. There are five basic steps to identifying and managing risks.
1. Identify the problem
2. Decide who might be harmed and how
3. Evaluate the risks
4. Record the findings
5. Review the assessment and update as needed
In this organization a continuous quality improvement committee meets every morning to go over every new patient, patients that are due for their quarterly or annual review, and any patients that have had any issues over the last 24 hours. The committee works together
to come up with a plan to best care for the patient, which includes safety measures that are put into place to keep each patient free from harm. Patients that have been put onto the fall prevention program are frequently reevaluated to make sure the program is working for them or if there are minor adjustments that need to be made for their individual needs. The committee is also able to identify and track any new infections, look for patterns, and come up with a plan to help illuminate the issue.
There are several possible risks that could be found in the long term care arena. The possible risk could have a negative impact on the organization and its stakeholders if preventative measures are not put into place. Three of these possible risks are falls, employee injuries, and urinary tract infections.
Patient falls is one of the most common possible risks. Even though patients have the right to fall, it is the organizations responsibility to keep each patient safe from harm. A fall with serious injury could have a negative impact on the organization if the family was to claim that the organization did not protect their loved one or caused their loved one harm. There are several reasons that a patient could fall and several ways to help prevent falls from happening.
Reasons for falls:
Defective equipment
Safety measures not in place
Improper lifting technique or device
Slippery surface
Preventing falls:
Fall assessment done upon admission
High risk patients placed on a fall prevention program
Transfer assessment done by therapy upon admission
Cleaning up spills immediately and put non-slip surfaces in the bathroom/shower room.
Employee injury is another common risk in long term care. Stress plays a huge factor in employee injuries. Long term care is a very stressful environment and if precautions are not used an employee could get hurt.
Causes for employee injury
Stress
Over worked and tired
Improper lifting techniques
Faulty equipment
Slippery surfaces
Ways to prevent employee injury:
Follow OSHA guidelines
Monitor work load
Transfer/lifting trainings
Increase moral
Urinary tract infections are an ongoing issue in long term care that requires constant education and monitoring. It is one of the most common facility acquired illnesses in long term care and can become very costly. Any kind of infection can put the elderly that already have compromised immune systems at risk.
Causes for urinary tract infections:
Lack of hydration
Improper hand washing
Infection control
Poor peri care
Prevention of urinary tract infections:
Offer water every two hours
Wash hands before and after working with a patient
Use gloves properly
Provide good peri care every time the patient is changed
The reduction of any and all risks in long term care is dependent on the ongoing education that employees receive throughout the year and accountability. Education is a key factor in risk prevention. In-services are held on a weekly basis to keep all employees up to date on any changes or new policies and procedures within the organization. Monthly staff meetings are also held to make sure the staff is well informed and are able to provide feedback. Safety meetings are held once a month to go over any new safety issues and employee injuries. The safety team invites all injured employees to the meeting to explain what happened and come up with a plan to prevent further injuries from happening in the same way.
Assessments are done on every patient upon admit, including a fall risk assessment.
The patient is assessed and if there is a high risk the patient is put on a fall prevention program. This consists of fall mats put next to their bed, alarms being place in the chair and bed, and frequent monitoring. The alarms alert the staff that a patient at risk is trying to get up. The policy states that every patient has the right to fall but it is the organization responsibility to prevent injury. This requires all staff to be alert and on their toes to any alarms going off and respond immediately.
Risk management takes the effort of all employees in the organization, it’s a team effort. Identifying risks and continually assessing them will help minimize the chance of any patient or employee getting injured or harmed. Continuous education is mandatory in risk management and is the best way to keep all employees informed of any changes to policies or procedures. Every organization must follow OSHA guideline for providing a safe work environment. Together as a team we can reduce
risk.

References
Kapp, M. B., & Makert, R. J. (1990, Winter). Legal risk-management programs in nursing homes: Who has them and do they work?. Hospital & Health Services Administration,
Vol. 35(No. 4), Page
Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com/docview/206718555?accountid=35812
DiNatale, Paola., Granger, Brad., (2010, March). Demystify risk management in nursing homes. McKnight’s Long-Term Care News & Assisted Living. Retrieved from
http://www.mcknights.com/demystify-risk-management-in-nursing-homes/article/164835/