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In the previous posts we started talking about how nursing home and hospital surveyors investigate issues surrounding incontinence in nursing homes. I continue that discussion here.

Another element to investigations is interviews.

Interviews: During the review and investigation the surveyor will be conducting interviews with the resident, family or responsible party when possible. These interviews will help identify:

  1. Involvement in care plan development including defining the approaches and goals, and whether interventions reflect preferences and choices;
  2. Awareness of the existing continence program and how to use devices or equipment;
  3. If timely assistance is provided as needed for toileting needs, hydration and personal hygiene and if continence care and/or catheter care is provided according to the care plan;
  4. If the resident comprehends and applies information and instructions to help improve or maintain continence;
  5. The presence of urinary tract-related pain, including causes and management;
  6. If interventions were refused, whether consequences and/or other alternative approaches were presented and discussed; and
  7. Awareness of any current Urinary Tract Infections (UTI), history of UTIs, or perineal skin problems.

 

Interviews of the nursing assistants will be conducted to determine if they:

  1. Are aware of, and understand, the interventions specific to this resident (such as the bladder or bowel restorative/management programs);
  2. Have been trained and know how to handle catheters, tubing and drainage bags and other devices used during the provision of care; and
  3. Know what, when, and to whom to report changes in status regarding bowel and bladder function, hydration status, urine characteristics, and complaints of urinary-related symptoms.

It is best for the nursing home surveyor to interview the direct care staff first rather than the Director of Nursing or other administrative staff. This allows the surveyor to see if the “front-line” staff, who provide the care, are knowledgeable about what is needed for each resident. The physician, medical director, charge nurse, director of nursing, and other administrative staff can be interviewed also, but many times the most valuable interviews come from the direct care staff.

We will continue this in the next post.

Be safe and informed!

JL

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One Response to “Nursing Home Surveyors Look At Urinary Incontinence in Nursing Homes – Part 3”

  1. Chicago Nursing Home Lawyer Blog Says:

    Nursing Home & Hospital Surveyor… is excited to exchange links with the Chicago Nursing Home Lawyer Blog.

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