Help! New grad nervous about LTC state inspection!

Specialties Geriatric

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Specializes in Home Health, PDN, LTC, subacute.

New to nursing/LTC and nervous about the coming state inspection. We have a great facility, 95% rating in the past, but need some tips about what they are looking for. I'm not positive I can handle the med pass in the correct time frame, but what about wound care? What were your experiences with the state? Thanks in advance.:uhoh21:

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state wants to make sure you are following the 5R's with med passes, knocking on the door and privacy for inj. and FSBS. With wound care they want to make sure you are following the order, changing gloves between old and new dressing and privacy. ALWAYS make sure you tell the resident what you are doing and why. Plus, knock, introduce yourself. Also with med pass, make sure you are waiting the proper amount of time between puffs of inhalers and eye gtts and between different inhalers/gtts. Hope this helps.

Jaime

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Wash hands /use hand sanitizer inbetween pts. Lock your med cart whenever you turn your back to it. If you don't know an answer to a question tell them "I will find out for you" then check with a manager. If you have to do a direct observation such as wound care, check your policy first. Stay calm, take your time, and if you make a mistake tell them that you would like to start over. If you start over begin again with handwashing. Have a drug book on the cart so if they ask a question about a med and you are not sure you can look it up. And never use delay tactics such as " i just did the treatment" the DPH are not fools and it will only irritate them. Just remember that whenever DPH is in the building everyone will be tense so just stay calm and you will do great.

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Specializes in med/surg,CHF stepdown, clinical manager.

Answer call lights! They have been known to go into a room and see how long it takes for the light to be anwsered. Make sure water is within reach of all residents. Make sure all call lights are within reach of the residents. Make sure all residents that have to be repositioned every 2 hours are repositioned.......they will look! They have also been know to time briefs and come back and see if the resident has been changed. Make sure all bedpans and urinals are labeled with the residents room number or name, whatever your facility policy. No resident personal stuff in shared bathrooms. No medications or treatments left in the resident rooms. Make sure the rooms are neat and beds are made. All men and women have been shaved. All resident fingernails are trim and clean, hair combed. (No 'bedhead') All tubing is labeled with a date. Your applesauce on your med cart is dated. Residents should have an area where they can make a private phone call. (We were cited on this, residents used the phone at the nursing station. Now we have portable phones just for the residents to use.) The residents food should be the proper temp, not too hot or too cold. Make sure you follow your facility's policies.

The Activity department can be a big help entertaining the 'problem' residents and keeping them busy.

This is all I can think of off the top of my head. Good Luck!! We expect our annual survey any day now so I know what you are going through. I have been in LTC for almost 7 years. It is very stressful when the state is in. Oh, and don't give them more information then they ask for. They will quote you and often take it out of contex!

Again, good luck!

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We are not trying to freak you out. Many of us have been through surveys and have received tags for what we have mentioned. BTW never, ever, ever give your opinion. Example " They got the pressure ulcer because they were not turned". You would be shocked on how many employee's actually say such a thing. You would not be the apple of your Administrators eyes.

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We just had our state inspection last week, and some of the things we got tagged on:

One nurse did not lock the med cart when she walked into the resident's room to give meds

One table in one of our small dining rooms was not level

Three residents complained about not having their call lights answered promptly (it doesn't have to happen while state is there, just having the resident complain about it happening in the past is enough for a tag)

One count of "verbal abuse" because a CNA who was repeatedly called by a resident who is Alzheimers and always thinks her diaper needs changing told the resident "It was just changed five minutes ago" (no bad tone of voice or anything).

I hope this helps. Just remember, noone is perfect and you will be tagged on SOMETHING no matter what you do. As long as nothing is below a "D" rating you will be OK, just expect to have to make some plans of correction after it is all said and done with.

Good luck!!!

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Another thing to remember, your facility has a 95% rating, this is a good thing. The inspectors know that this is a good facility and the staff are professionals.

Surveyors understand EVERYONE is on edge and trying to be perfect. If you make a mistake tell them you did so and make the correction, provided it's not a biggie (like not washing your hands before doing a treatment, or changing your gloves). Also, talk to them....small chit-chat. They know your probaly scared out of your wits about making a mistake. I've only been through two state inspection's, and on both times the inspectors told me "We're not out to get you." They have a job to ensure public safety, it's nerve wracking, tense, and it can seem like the worst time of your career. We have all been through it and we all know exactly how you feel.

But like every else has posted, think a little ahead and remember your training. Now as far as trying to relax.....well, that's easier said than done, but try to relax. But above all........BREATH!!!

Taking a few deep breaths will help more that you know.

Just to let you know....where I'm at, two surveys ago they had 15 tags (ouch!), the first one I went through we got 5 (all of them no harm), the last one we just went through......2 (unfortunatly one was mine.....I forgot to announce myself :o ....)

Best of luck

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I didn't see this posted......make sure your GT tubes are flushed as ordered.

Bags should be changed q24 hours, labeled, dated and timed.

If you keep a syringe at the bedside, after flushing, remove the plunger from the outer portion.... I suppose they're thinking that the syringe will hold water if you don't separate the pieces.

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triple post...sorry ..............slow loading page.

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triple post.....sorry. page loaded verrrrry slow.

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Specializes in Gerontology, Med surg, Home Health.

MeanBird...it's not only new nurses who stress over state DPH survey. I've been a nurse since 1982 and get more stressed out every year. Part of the reason is the survey is way more stressful if you're management and therefore considered responsible for everyone else and the other part is how much surveys have changed. NONE of the facilities around here got zero deficiency surveys...even the ones who have for years. The average number of citations in this state is 10. It's almost like they think we work in an ICU...at least the surveyors who came to my facility acted like we were working in one.

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I want to cry. We had the stat inspection this morning. I didn't lock the med cart when I walked into the resident's room pass meds. Will I get fine? Is there any punishment?

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