I am a brand new director of nursing services. What processes and systems do I need to monitor regularly?
To ensure residents receive high-quality care, the DNS must oversee clinical and resident systems, as well as performance within those systems.
By providing oversight of clinical and resident systems, the DNS enables a timely response to budding issues and can forestall the need for more complex interventions.
To prepare a comprehensive list of what a DNS should be monitoring, begin by checking to see if the facility has policies and procedures that outline systems or processes that must be monitored and, if so, how frequently. To help keep on track, it is best to have a master schedule with all the tasks.
Some examples of systems that should be monitored daily might include: staffing, incidents/accidents, 24-hour reports, drug regimen review compliance and infection tracking. Other systems likely require weekly monitoring. These may include wound tracking, resident weights, medication management and restraint use.
Monthly monitoring could include gradual dose reductions of psychotropic medications, tracking and trending of falls and infections, MDS submission timeliness, CASPER report reviews, medication cart reviews, staff education compliance and pharmacy consultation reviews.
Once you have populated this initial list, supplement it with any audits and reviews that are being done. If the facility has initiated corrective actions to remedy any past deficiencies, those also should be added to the comprehensive list.
By taking the time to organize an inventory of systems monitored, the DNS can develop a plan to provide the ongoing, and vitally important, oversight needed.
From the September 2019 Issue of McKnight's Long-Term Care News
