November 23, 2010
Marci Pederson, RN, BSN, Nurse Educator/Consultant, Avera Education & Staffing Solutions
F431 Pharmacy Services
F280 - Comprehensive Care Plans was the 9th most cited regulation as a deficiency during 2009 in long term care facilities in South Dakota. There were 18 deficiencies written for F280. This regulation says,
“483.10(d)(3) The resident has the right to -- unless adjudged incompetent or otherwise found to be incapacitated under the laws of the State – participate in planning care and treatment or changes in care and treatment.
483.20(k)(2) A comprehensive care plan must be---(i) Developed within 7 days after the completion of the comprehensive assessment; (ii) Prepared by an interdisciplinary team, that includes the attending physician, a registered nurse with responsibility for the resident, and other appropriate staff in disciplines as determined by the resident’s needs, and, to the extent practicable, the participation of the resident, the resident’s family or the resident’s legal representative; and (iii) Periodically reviewed and revised by a team of qualified persons after each assessment.”
When becoming familiar with this regulation we need to keep in mind the whole picture and how the resident’s comprehensive care plan fits in this picture.
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November 1, 2010
Marci Pederson, RN, BSN, Nurse Educator/Consultant, Avera Education & Staffing Solutions
Reader Questions
Dear Ms. Pederson:
I write to you regarding the proper way to empty a male urinal. It may sound trivial but there is nothing I can find on the proper way to empty the urinal in a semi-private room and the toilet has no mechanism to facilitate their rinsing. I'd appreciate a moment of your time and will give credence to your opinion or policy.
Thank you,
RN, BSN
Clinical Resource Manager
Dear RN, BSN:
Thank you for your email and question. Before answering your question, I confirm that it is difficult to find something specific regarding what to do with emptying and cleaning a male urinal when the patient/resident is in a semi-private room. I did some searching on the CDC website and reviewed the federal regulations’ Guidance to Surveyors. Based on your description of the environment, I would make the following comments to answer your question.
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October 1, 2010
Marci Pederson, RN, BSN, Nurse Educator/Consultant, Avera Education & Staffing Solutions
F431 Pharmacy Services
F431 Pharmacy Services was the 8th most cited regulation as a deficiency during 2009 in long term care facilities in South Dakota. There were 19 deficiencies written for F431.
This regulation says,
“483.60(b) Service Consultation. The facility must employ or obtain the services of a licensed pharmacist who—
(2) Establishes a system of records of receipt and disposition of all controlled drugs in sufficient detail to enable an accurate reconciliation; and
(3) Determines that drug records are in order and that an account of all controlled drugs is maintained and periodically reconciled.
483.60(d) Labeling of Drugs and Biologicals. Drugs and biologicals used in the facility must be labeled in accordance with currently accepted professional principles, and include the appropriate accessory and cautionary instructions, and the expiration date when applicable.
483.60(e) Storage of Drugs and Biologicals.
(1) In accordance with State and Federal laws, the facility must store all drugs and biologicals in locked compartments under proper temperature controls, and permit only authorized personnel to have access to the keys.
(2) The facility must provide separately locked, permanently affixed compartments for storage of controlled drugs listed in Schedule II of the Comprehensive Drug Abuse Prevention and Control Act of 1976 and other drugs subject to abuse, except when the facility uses single unit package drug distribution systems in which the quantity stored is minimal and a missing dose can be readily detected.”
This regulation covers three main areas of interest:
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September 10, 2010
Marci Pederson, RN, BSN, Nurse Educator/Consultant, Avera Education & Staffing Solutions
F309 Quality of Care
F309 Quality of Care was the 7th most cited regulation as a deficiency during 2009 in long term care facilities in South Dakota. There were 21 deficiencies written for F309.
F309 states, ““Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.”
There are a couple of points in the Guidance to Surveyors to be aware of, and they are:
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July 21, 2010
Marci Pederson, RN, BSN, Nurse Educator/Consultant, Avera Education & Staffing Solutions
F514 Clinical Records
F514 titled Clinical Records was the 6th most cited regulation as a deficiency during 2009 in long term care facilities in South Dakota. There were 24 deficiencies written.
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July 2, 2010
Marci Pederson, RN, BSN, Nurse Educator/Consultant, Avera Education & Staffing Solutions
F253 Housekeeping and Maintenance
South Dakota long term care facilities had 28 deficiencies cited for F253 in 2009. It ranks number five in the top ten deficiencies for long-term care facilities in South Dakota.
F253 states, “Housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior”
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June 3, 2010
Marci Pederson, RN, BSN, Nurse Educator/Consultant, Avera Education & Staffing Solutions
Celebrating Success
I am grateful to be a part of Avera Education & Staffing Solutions. Today I returned to my office from a nursing home feeling joyful! I have worked with this facility the past three years by providing mock surveys, updating policies and procedures, and assisting with their post-survey plans of correction. This week I had the privilege of being present during their survey to lend support.
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May 1, 2010
Marci Pederson, RN, BSN, Nurse Educator/Consultant, Avera Education & Staffing Solutions
Federal Regulation - F371 Sanitary Conditions
F371 had 36 deficiencies cited in South Dakota long-term care facilities in 2009. It ranks number four in the tiop ten deficiencies for long-term care facilities in South Dakota.
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March 31, 2010
Marci Pederson, RN, BSN, Nurse Educator/Consultant, Avera Education & Staffing Solutions
Federal Regulation - F323 Accidents and Supervision
F323 states, “The facility must ensure that – The resident environment remains as free of accident hazards as is possible; and each resident receives adequate supervision and assistance devices to prevent accidents.”
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February 25, 2010
Marci Pederson, RN, BSN, Nurse Educator/Consultant, Avera Education & Staffing Solutions
Regulations Update
Let’s look at this regulation and the Guidance to Surveyors. F281 states, “(3) The services provided or arranged by the facility must—(i) Meet professional standards of quality”. Professional standards of quality mean accepted standards of clinical practice and can apply to any professional discipline. Because many of us reading this newsletter are in nursing, we may refer more to that clinical area of expertise.
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Janaury 22, 2010
Marci Pederson, RN, BSN, Nurse Educator/Consultant, Avera Education & Staffing Solutions
Regulations Update
Starting this month I will have a regulations update every month in the new Solutions Blog. Check in regularly for other blog entries from our consultants.
My topic this month is regulation F441—Infection Control. This regulation has tremendous importance for our long-term care residents. According to the Guidance for Surveyors, “Infections are a significant source of morbidity and mortality for nursing home residents and account for up to half of all nursing home resident transfers to hospitals.
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