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There are two ways that the staff at Agape Hospice have identified cases of medication diversion by employees. One involved patients reporting less medication in the bottle than listed on the label. Another involved a nursing home hospice patient who was receiving pain medication on an as-needed basis but was running out of pills before the nurse's next visit.
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This is the second of two-part series about best practices in palliative care programs.
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A family member's statement that "Dad's pain is really helped by methadone rather than hydrocodone," should serve as a red flag for any hospice nurse, says Debbie Williams, RN, CHPC, administrator of Agape Hospice in Minden, LA. Any time a family member or friend of the patient is naming specific drugs to bring into the house, you should be suspicious of drug diversion, she says.
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Pressure ulcer education is pretty straightforward for nurses who want up-to-date clinical information that will help them select the best interventions to prevent pressure ulcers and the best treatments to help their patients with ulcers, says Terri Edmiston, RN, MSN, clinical manager for Parkview Hospital Home Health and Hospice in Huntington, IN.
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The Indiana Pressure Ulcer Initiative's collaborative effort to share education and tools to improve the risk identification, prevention, and treatment of pressure ulcers included more than 160 home health agencies, hospitals, and nursing homes. With the focus on education and sharing best practices among the providers, members of the 15-month first phase of the initiative posted some impressive results that contributed to a drop in reported pressure ulcers throughout the state.
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An Indiana initiative to reduce pressure ulcers throughout all areas of health care has resulted in a reduction of bedsores at more than 160 organizations participating in the project.
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Nurses at Sullivan County Community Hospital Home Health and Hospice in Sullivan, IN, don't spend time looking for a copy of the Braden Scale, documentation checklists, pressure ulcer intervention guidelines, or teaching tools. They just pick up a pre-packaged envelope and go.
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Establishing a relationship with a nursing home is not an easy task, especially because the staff members of both organizations don't necessarily understand how the other works.
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Of the 1.4 million Americans receiving hospice care, 319,200 reside in nursing homes.
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One of the challenges to providing hospice care in a nursing home is identifying all of the regulations that govern each organization and, in some cases, might conflict with each other.
