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Staffing Ratios In Long Term Care Facilities Are Unsafe
Few would dispute that safe nurse staffing ratios are necessary. As nurses across the country rally for safe nurse-patient ratios on their units, long term care (LTC) facilities -- also known as nursing homes -- and skilled nursing facilities (SNF) seem forgotten.
Federal law has few requirements for nurse staffing in long term care facilities. The Nursing Home Reform Law of 1987 requires these facilities to have:
A registered nurse eight consecutive hours, seven days a week
Licensed nurses 24 hours a day
Otherwise “sufficient” nursing staff to meet residents’ needs
Federal standards haven't updated since the Reform Law was implemented over 30 years ago. The standards in place aren't adequate to ensure a competent, safe workplace.
Credit to: By: Portia Wofford
Federal law has few requirements for nurse staffing in long term care facilities. The Nursing Home Reform Law of 1987 requires these facilities to have:
A registered nurse eight consecutive hours, seven days a week
Licensed nurses 24 hours a day
Otherwise “sufficient” nursing staff to meet residents’ needs
Federal standards haven't updated since the Reform Law was implemented over 30 years ago. The standards in place aren't adequate to ensure a competent, safe workplace.
Credit to: By: Portia Wofford
Why is this important?
The Heavy Workload
SNF and LTC are no longer just for geriatric residents. Residents enter facilities sicker, the acuity level has increased, and the role of the facilities has expanded. LTC and SNF care for patients with higher-level nursing and rehabilitation needs, including
Tracheostomies
Complex wound care
TPN
Assisted ventilation
JP drains
Life vests
IV medications
Medically complex residents bring an increase of residents with psychiatric diagnoses and multiple comorbidities. Under the ongoing Centers for Medicare & Medicaid initiative to reduce rehospitalizations -- the Patient-Driven Payment Model (PDPM) -- facilities are likely to treat higher acuity residents. In a typical eight-hour shift, a nurse is expected toPass meds at least twice per shift (within a two-hour time frame)
Monitor blood sugars and give insulin
Check vital signsManage certified nursing assistants Watch mealtimes, Perform wound care
Receive and transcribe physician's orders,Complete incident,reports,Complete.documentation
Arrange transportation, diagnostic testing, and schedule appointments
Ensuring their residents are safe and cared for and notifying physicians and family members of any concerns are additional tasks to a long list of duties!
Credit to: By: Portia Wofford
SNF and LTC are no longer just for geriatric residents. Residents enter facilities sicker, the acuity level has increased, and the role of the facilities has expanded. LTC and SNF care for patients with higher-level nursing and rehabilitation needs, including
Tracheostomies
Complex wound care
TPN
Assisted ventilation
JP drains
Life vests
IV medications
Medically complex residents bring an increase of residents with psychiatric diagnoses and multiple comorbidities. Under the ongoing Centers for Medicare & Medicaid initiative to reduce rehospitalizations -- the Patient-Driven Payment Model (PDPM) -- facilities are likely to treat higher acuity residents. In a typical eight-hour shift, a nurse is expected toPass meds at least twice per shift (within a two-hour time frame)
Monitor blood sugars and give insulin
Check vital signsManage certified nursing assistants Watch mealtimes, Perform wound care
Receive and transcribe physician's orders,Complete incident,reports,Complete.documentation
Arrange transportation, diagnostic testing, and schedule appointments
Ensuring their residents are safe and cared for and notifying physicians and family members of any concerns are additional tasks to a long list of duties!
Credit to: By: Portia Wofford