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AMDA's 2015 Annual Conference


C38 - Making Adverse Events Work For You


Mar 21, 2015 11:00am ‐ Mar 21, 2015 12:30pm


Credits: None available.

Standard: $24.00

Description

Accreditation Statement: AMDA – The Society for Post-Acute and Long-Term Care Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement: AMDA – The Society for Post-Acute and Long-Term Care Medicine designates this Internet Enduring Material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

ABPLM Designation Statement: This Internet Enduring Material has been pre-approved by the American Board of Post-Acute and Long-Term Care Medicine (ABPLM) for a total of 1.5 management hours toward certification as a Certified Medical Director (CMD) in post-acute and long-term care medicine. The CMD program is administered by the ABPLM.  Each physician should claim only those hours of credit actually spent on the activity.

Session Description:
The presentation will provide an innovative approach to using adverse events and the evaluation of them using root cause analysis, to optimize function and physical activity among residents, minimize the risk of delirium through mobilization, and use care strategies that prevent exacerbation of behavioral symptoms to improve clinical outcomes and quality of life of the resident. The presenters will provide an overview of challenges and opportunities in skilled nursing facilities to decrease adverse events, specifically falls, skin trauma, pressure ulcers, and delirium. These include the multiple comorbidities of residents, balancing resident rights and engaging them (i.e., motivate them) in preventive activities, knowledge of staff, resources within settings, and regulatory support and encouragement to prevent and decrease these events. The presenters will also describe a philosophy of care, entitled Function Focused Care, which when implemented into settings can decrease adverse events and optimize function and physical activity among residents without exacerbating behavioral symptoms. Finally, this session will provide challenging resident case examples including residents who are resistant to care, unable to follow more than simple single step commands, or those who refuse to engage in functional or physical activity and demonstrate how to overcome those challenges. Three minute video coaching sessions will be shared as well as addition educational and assessment resources.

Learning Objective(s):

  • Discuss the opportunities and challenges associated with decreasing falls, skin trauma, pressure ulcers and delirium in skilled nursing facilities.
  • Perform a root cause analysis of an adverse event (fall, skin tear/pressure ulcer, delirium) in a skilled nursing facility resident.
  • Explain how to maintain resident rights and prevent adverse events when residents refuse to engage in preventive behaviors known to decrease risk of these events.
  • Describe the four step approach to integrate Function Focused Care into their settings.

Speaker(s):
Barbara Resnick, PhD, CRNP
Elizabeth Galik, PhD, CRNP

Disclosure(s):
None

Reference(s):
1.The Health and Retirement Study. The Health and Retirement Study. http://hrsonlineisrumichedu/indexphp?p=xgetstarted. 2010.
2.The Medicare Current Beneficiary Survey. The Medicare Current Beneficiary Survey. http://wwwcmsgov/Research-Statistics-Data-and-Systems/Research/MCBS/indexhtml?redirect=/MCBS. 2011.
3.Congressional Budget Office. Rising Demand for Long-Term Services and Supports for Elderly People. Available at:  www.cbo.gov. Last accessed January, 2014. 2013.
4.American Association of Homes and Services for the Aging ASHA, Assisted Living Federation of American, National Center for Assisted Living, and National Investment Center for the Seniors Housing & Care Industry,. Overview of Assisted Living,. http://wwwalfaorg/Mall/StoreHomeasp?MODE=VIEW&STID=1&LID=1&PRODID=16. 2009.
5.The National Center for Health Statistics Data Brief No. 91. Data from the 2010 National Survey of Residential Care Facilities. http://wwwahcancalorg/ncal/resources/Pages/ResidentProfileaspx). 2010.
6.Zimmerman S, Anderson, WL, Brode, S, Jonas, D, Lux, L, Beeber, AS, Watson, LC, Viswanathan, M, Lohr, KN, Sloane, PD, . Systematic Review:  Effective characteristics of nursing homes and other residential long-term care settings for people with dementia. . Journal of the American Geriatrics Society, . 2013; 61: 1399-409.
7.Frytak J, Kane, RA, Finch, MD, Kane, RL, Maude-Griffin, R. Outcome trajectories for assisted living and nursing facility reisdents in Oregon. Health Services Research. 2001; 36(1): 91-111.
8.Resnick B, Galik E. Assisted Living versus Nursing Facility Residents:  Differences and Similarities Over Time under review.
9.Resnick B, Galik E, Gruber-Baldini A, Zimmerman S. Testing The Impact of Function Focused Care in Assisted Living. Journal of the American Geriatrics Society 2011; 59(12): 2233-40.
10.Chung G. Understanding nursing home worker conceptualizations about good care. . The Gerontologist 2012; doi 10.1093/geront/gns 117(www.ncbi.nlm.nih.gov/pubmed/22936538).
11.Galik E, Resnick B, Hammersla M, Brightwater J. Optimizing Function and Physical Activity among Nursing Home Residents with Dementia: Testing the Impact of Function Focused Care. The Gerontologist In press.
12.Resnick B, Galik E, Gruber-Baldini AL, Zimmerman S. Implementing a restorative care philosophy of care in assisted living: pilot testing of Res-Care-AL. . Journal of the American Academy of  Nurse Practitioners, . 2009; 21(2): 123-33.
13.Nazir A, Mueller, C,  Perkins, A,  Arling, G, . Falls and Nursing Home Residents With Cognitive Impairment: New Insights into Quality Measures and Interventions. Journal of the American Medical Directors Association,. 2012; 13(9): 819-23.
14.Falls and Fall Risk Clinical Practice Guideline. American Medical Directors Association Clinical Practice Guideline. 2009.
15.Lapane K, Quilliam, BJ, Chow, W,  Kim, M, . The association between pain and measures of well being among nursing home residents. Journal of the American Medical Directors Association, . 2012; 13(4): 344-9.
16.Morrison RS, Magazine J, Gilbert M, Koval KJ, McLaughlin MA, Orosz G, et al. The relationship between pain and opioid analgesics on the development of delirium following hip fracture. J Gerontol Med Sci. In Press.
17.Kim S, Park E, Kim, S, Nakagawa, S, Lung, J, Choi, JB, Ryu, Woo, S, Min, TJ, Shin, HP, Kim, K, et al, . The Association Between Quality of Care and Quality of Life in Long-Stay Nursing Home Residents With Preserved Cognition. Journal of the American Medical Directors Association, . 2014; 15(3): 220-5.
18.Rao A, Chou A, Bursley, B, Smulofsky, J, Jezequel, J,. Systematic Review of the Effects of Exercise on Activities of Daily Living in People With Alzheimer's Disease. American Journal of Occupational Therapy 2014; 68(1): 50-6.
19.Resnick B, Galik, E, Gruber-Baldini, A, Zimmerman, S, Understanding Dissemination and Implementation of a New Intervention in Assisted Living Settings: The Case of Function Focused Care. Journal of Applied Gerontology In press.
20.Galik E, Resnick B LN, Gruber-Baldini A,. Testing the Feasibility and Impact of Function Focused Care for Assisted Living in Residents with Dementia Under review
21.Galik EM, Resnick B, Gruber-Baldini A, Nahm ES, Pearson K, Pretzer-Aboff I. Pilot Testing of the Restorative Care Intervention for the Cognitively Impaired. Journal of the American Medical Directors Association. 2008; 9(7): 516-22.
22.Resnick B, Gruber-Baldini A, Galik E, Pretzer-Aboff  I, Russ K, Hebel J, et al. Changing the philosophy of care in long-term care: Testing of the restorative care intervention. The Gerontologist 2009; 49(2): 175-84
23.Beck C, Heacock P, Mercer S, Doan R, O'Sullivan P, Stevenson J, et al. Sustaining a best-care practice in a nursing home. J Health Qual 2005; 27(4): 5-16.
24.Parrish M, O'Malley K, Adams R, Adams S, Coleman E. Implementation of the care transitions intervention: sustainability and lessons learned. . Prof Case Manage. 2009; 14(6): 282-93.
25.Glasgow RE, Toobert DJ, Hampson SE, Strycker LA. Implementation, generalization and long-term results of the "choosing well" diabetes self-management intervention. Patient Educ Couns. 2002; 48(2): 115-22.
26.Schnelle JF, Alessi, CA, Simmons, SF, Al-Samarrai, NR, Beck, JC & Ouslander, JG. Translating clinical research into practice:  A randomized controlled trial of exercise and incontinence care with nursing home residents.  . Journal of the American Geriatrics Society. 2002; 50: 1476-83.
27.Gregson J, Foerster S, Orr R, Jones L, Benedict J, Clarek B, et al. System, environment and policy changes:  Using the Social Ecological Model as a framework for evaluating nutrition education and social marketing programs with low income audiences. Journal of Nutrition Education. 2003; 33: S4-S15.
28.Bandura A. Self-efficacy: The Exercise of Control. New York, New York: W.H. Freeman and Company.; 1997. 29.Resnick B, Galik E, Vine, E,   . Translation of Function Focused Care to Assisted Living Facilities.  . Family and Community Health 2014; 37(2): 101-65.1.The Health and Retirement Study. The Health and Retirement Study. http://hrsonlineisrumichedu/indexphp?p=xgetstarted. 2010. 2.The Medicare Current Beneficiary Survey. The Medicare Current Beneficiary Survey. http://wwwcmsgov/Research-Statistics-Data-and-Systems/Research/MCBS/indexhtml?redirect=/MCBS. 2011. 3.Congressional Budget Office. Rising Demand for Long-Term Services and Supports for Elderly People. Available at:  www.cbo.gov. Last accessed January, 2014. 2013. 4.American Association of Homes and Services for the Aging ASHA, Assisted Living Federation of American, National Center for Assisted Living, and National Investment Center for the Seniors Housing & Care Industry,. Overview of Assisted Living,. http://wwwalfaorg/Mall/StoreHomeasp?MODE=VIEW&STID=1&LID=1&PRODID=16. 2009. 5.The National Center for Health Statistics Data Brief No. 91. Data from the 2010 National Survey of Residential Care Facilities. . http://wwwahcancalorg/ncal/resources/Pages/ResidentProfileaspx). 2010. 6.Zimmerman S, Anderson, WL, Brode, S, Jonas, D, Lux, L, Beeber, AS, Watson, LC, Viswanathan, M, Lohr, KN, Sloane, PD, . Systematic Review:  Effective characteristics of nursing homes and other residential long-term care settings for people with dementia. . Journal of the American Geriatrics Society, . 2013; 61: 1399-409. 7.Frytak J, Kane, RA, Finch, MD, Kane, RL, Maude-Griffin, R. Outcome trajectories for assisted living and nursing facility reisdents in Oregon. Health Services Research. 2001; 36(1): 91-111. 8.Resnick B, Galik E. Assisted Living versus Nursing Facility Residents:  Differences and Similarities Over Time under review. 9.Resnick B, Galik E, Gruber-Baldini A, Zimmerman S. Testing The Impact of Function Focused Care in Assisted Living.  . Journal of the American Geriatrics Society 2011; 59(12): 2233-40. 10.Chung G. Understanding nursing home worker conceptualizations about good care. . The Gerontologist 2012; doi 10.1093/geront/gns 117(www.ncbi.nlm.nih.gov/pubmed/22936538). 11.Galik E, Resnick B, Hammersla M, Brightwater J. Optimizing Function and Physical Activity among Nursing Home Residents with Dementia: Testing the Impact of Function Focused Care. The Gerontologist In press. 12.Resnick B, Galik E, Gruber-Baldini AL, Zimmerman S. Implementing a restorative care philosophy of care in assisted living: pilot testing of Res-Care-AL. . Journal of the American Academy of  Nurse Practitioners, . 2009; 21(2): 123-33. 13.Nazir A, Mueller, C,  Perkins, A,  Arling, G, . Falls and Nursing Home Residents With Cognitive Impairment: New Insights into Quality Measures and Interventions. Journal of the American Medical Directors Association,. 2012; 13(9): 819-23. 14.Falls and Fall Risk Clinical Practice Guideline. American Medical Directors Association Clinical Practice Guideline. 2009. 15.Lapane K, Quilliam, BJ, Chow, W,  Kim, M, . The association between pain and measures of well being among nursing home residents. Journal of the American Medical Directors Association, . 2012; 13(4): 344-9. 16.Morrison RS, Magazine J, Gilbert M, Koval KJ, McLaughlin MA, Orosz G, et al. The relationship between pain and opioid analgesics on the development of delirium following hip fracture. J Gerontol Med Sci. In Press. 17.Kim S, Park E, Kim, S, Nakagawa, S, Lung, J, Choi, JB, Ryu, Woo, S, Min, TJ, Shin, HP, Kim, K, et al, . The Association Between Quality of Care and Quality of Life in Long-Stay Nursing Home Residents With Preserved Cognition. Journal of the American Medical Directors Association, . 2014; 15(3): 220-5. 18.Rao A, Chou A, Bursley, B, Smulofsky, J, Jezequel, J,. Systematic Review of the Effects of Exercise on Activities of Daily Living in People With Alzheimer's Disease. American Journal of Occupational Therapy 2014; 68(1): 50-6. 19.Resnick B, Galik, E, Gruber-Baldini, A, Zimmerman, S,   . Understanding Dissemination and Implementation of a New Intervention in Assisted Living Settings:  The Case of Function Focused Care. Journal of Applied Gerontology     In press. 20.Galik E, Resnick B LN, Gruber-Baldini A,. Testing the Feasibility and Impact of Function Focused Care for Assisted Living in Residents with Dementia Under review 21.Galik EM, Resnick B, Gruber-Baldini A, Nahm ES, Pearson K, Pretzer-Aboff I. Pilot Testing of the Restorative Care Intervention for the Cognitively Impaired. Journal of the American Medical Directors Association. 2008; 9(7): 516-22. 22.Resnick B, Gruber-Baldini A, Galik E, Pretzer-Aboff  I, Russ K, Hebel J, et al. Changing the philosophy of care in long-term care: Testing of the restorative care intervention. The Gerontologist 2009; 49(2): 175-8423.Beck C, Heacock P, Mercer S, Doan R, O'Sullivan P, Stevenson J, et al. Sustaining a best-care practice in a nursing home. J Health Qual 2005; 27(4): 5-16. 24.Parrish M, O'Malley K, Adams R, Adams S, Coleman E. Implementation of the care transitions intervention: sustainability and lessons learned. . Prof Case Manage. 2009; 14(6): 282-93. 25.Glasgow RE, Toobert DJ, Hampson SE, Strycker LA. Implementation, generalization and long-term results of the "choosing well" diabetes self-management intervention. Patient Educ Couns. 2002; 48(2): 115-22. 26.Schnelle JF, Alessi, CA, Simmons, SF, Al-Samarrai, NR, Beck, JC & Ouslander, JG. Translating clinical research into practice:  A randomized controlled trial of exercise and incontinence care with nursing home residents.  . Journal of the American Geriatrics Society. 2002; 50: 1476-83. 27.Gregson J, Foerster S, Orr R, Jones L, Benedict J, Clarek B, et al. System, environment and policy changes:  Using the Social Ecological Model as a framework for evaluating nutrition education and social marketing programs with low income audiences. Journal of Nutrition Education. 2003; 33: S4-S15. 28.Bandura A. Self-efficacy: The Exercise of Control. New York, New York: W.H. Freeman and Company.; 1997. 29.Resnick B, Galik E, Vine, E,   . Translation of Function Focused Care to Assisted Living Facilities.  . Family and Community Health 2014; 37(2): 101-65.
 

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