DOH survey

[ktwlpn]

Can I just get some love? It's just been AWFUL!!! Everyone is freaking out, snapping at each other, we're all agitated and worn out.I doubt this year's results will really be any worse then any others-we usually do well but I guess I tend to blackout just how upsetting and exhausting the process truly is....such drama.The focus seems to be our incident reports and what a mess it is-was one done? If so,where is it? If not, why not? They are telling us now to do incident reports on stuff we have NEVER done them on ,ever.We always have a handful hanging out on our desk- pending notification of the docs,usually. Every doc has requirements for when we can call them,where to call them on which days, it's stooopid.I bet THAT changes....

[fairyluv]

Sotty kt- sometimes when you click a topic you are led to the last page, not the first- and by that time the topic has already taken a dive off the cliff. I feel your pain about IRs. I'd rather eat a worm than fill one out. But I have to say I have never in all my years even heard of a surveyor asking to SEE them? I've always known them to be internal, risk control forms not to be shared, not to be mentioned in the chart, etc. As a long time MDS nurse, this makes me wonder if it happens in every state? Once, I charted that I tried to explain safety to a woman that I charted "Had had about 50 falls in the past year. I talked to her about why it is in her best interest to use the call light, because the risk of her breaking a hip with so many falls is just going to rise, and I also explained to her the real effects of a hip fracture. She agreed with me to use the call bell every time she wanted to use the bathroom". The DON saw this note, SCREAMED at me at the top of her voice, in front of the whole unit: "She has NOT had FIFTY falls- and WHY did you chart that!?". I told her I has scanned the care plan, I noticed about 50 falls, and thought that mentioning such a large number might encourage the patient to use the call bell. DON told me to "Take that note OUT of the chart! You're going to cause a survey!". She made me rewrite the note on a new (blank) NN, then told everyone before me to rechart, as well. I then counted the actual falls recorded in the CP for the last year. My bad! There were only 46. Ugh. So, this post about surveyors wanting IRs confuses me- that episode with Psycho leads me to believe even more that IRs were created to be private? I dunno.

isn't that illegal to make you re-write your note and make everyone esle do there's to. that is unreal.

[miasmom]

And all these posts make want we want of long term care. Sigh. Done to long.

[ktwlpn, LPN]

I,too was under the impression that IRs were for in house use but this survey they have been a focus. They wanted to see every one for each documented incident and ,of course ,many had mysteriously disappeared somewhere and who know's where? They get shuffled all over the building and I have seen a co-worker who was working a double come to relieve me carrying an IR in her hand to complete regarding an incident that occurred early in her previous shift on the other unit where she had been working.

Doesn't EVERY nurse in LTC know you complete an IR for any bruise, skin tear or fall? Isn't that a universal policy? Have you ever done one for chest pain, choking, symptomatic hypoglycemia? Get ready for that,I think that is the direction it's heading.

[sallyrnrrt, ADN, RN]

i was just thinking the same thing yesterday, aned like you cape cod, i spend majority of my time with my staff on the floor,residents, and working with families......i try to teach by example, but sometimes !

[mlbluvr]

isn't that illegal to make you re-write your note and make everyone esle do there's to. that is unreal.

Only on so many levels.

[sallyrnrrt, ADN, RN]

my surveyors always review the IRs, sometimes to just make sure our fall preventon system or risk mgt. system is in place...... then sometimes they review certain incidents......

[mlbluvr]

I,too was under the impression that IRs were for in house use but this survey they have been a focus. They wanted to see every one for each documented incident and ,of course ,many had mysteriously disappeared somewhere and who know's where? They get shuffled all over the building and I have seen a co-worker who was working a double come to relieve me carrying an IR in her hand to complete regarding an incident that occurred early in her previous shift on the other unit where she had been working. Doesn't EVERY nurse in LTC know you complete an IR for any bruise, skin tear or fall? Isn't that a universal policy? Have you ever done one for chest pain, choking, symptomatic hypoglycemia? Get ready for that,I think that is the direction it's heading.

Every day as MDS nurse, I've always made it my habit to collect and make copies of the daily IRs to put into my personal 'stash'. Why? So I'd always have a documented reason to either prove or disprove the need for a change of status assessment- some surveyors are really anal about that if they can't find anything else to complain about. This is why I wondered why I've never heard of a surveyor asking about an IR- so many IRs seem to disappear, yet in my case they were all just sitting there in a notebook?

[NurseGuyBri]

Our incident reports are to remain private.... HOWEVER... last survey we were caught in a hard spot and our corporate ordered that we release them for that patient. So we did. Baaaaaad idea. Ended up in IDR and lost over what should have been a "D" and ended up a "G"

[CapeCodMermaid, RN]

In Massachusetts, the DPH can look at anything they want. The IRs are not part of the medical record so family members and attorneys cannot look at them.