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(solution) Hi. I need to write reaction or reflection paper. I don't need to


Hi. I need to write reaction or reflection paper. I don't need to write a summary about it.

You can briefly describe the topic in general but you are expected to critically assess a problem or solution within the reading and describe as reactions to or reflections of the reading. (good, bad, eye opening, questions you may have, etc.).

The majority of these reaction or reflection papers should focus on this.

This paper should be Two pages. Double spaced. 12-point Times New Roman font, 1 inch margins. It must be complete page in length.


INPERSPECTIVE DON?S CORNER by Betty MacLaughlin Frandsen, RN, NHA, MHA, CDONA/LTC, C-NE Hidden cameras N ewspaper headlines shocked readers

 

recently by declaring that 14 nursLong-term care facilities

 

ing home workers from one New

 

that keep the lines of

 

York facility near Albany were arrested and

 

communication open

 

charged with neglect. Eight others were arbetween residents and

 

rested in a Western New York nursing home.

 

families and that respect

 

These actions resulted from the use of hidden

 

their rights will go far in

 

cameras installed with consent of residents?

 

preventing abuse and

 

family members. Attorney General Andrew

 

other inappropriate actions

 

Cuomo reported conducting a six-week

 

concerning residents.

 

investigation using all necessary tools to watch

 

over the vulnerable who cannot advocate for

 

themselves.1

 

In the Albany area facility, hidden cameras revealed

 

the following: At a glance... ? Staff often left residents in the same position

 

for an entire shift, failing to turn and position an

 

immobile resident.

 

? Nurses failed to administer medication and

 

treat bed sores.

 

? Staff failed to check for incontinence or change

 

undergarments for long periods of time.

 

? Staff falsified medical records to conceal this

 

neglect.

 

? A physician?s assistant created a false record of

 

an annual physical that was never performed. In all, six licensed practical nurses (LPNs) and

 

seven certi?ed nurse aides (CNAs) were charged

 

with felony ?rst-degree multiple counts of falsifying

 

business records and misdemeanor willful violation

 

of public health law. The physician?s assistant was

 

charged with one count.1

 

The Western New York investigation revealed

 

similar ?ndings:

 

? Staff routinely failed to properly transfer a

 

resident in and out of bed. Instead of using a

 

mechanical lift with assist of two caregivers, 48 ? JUNE 2010 they put the resident at risk of injury through

 

other methods.

 

? One aide failed to provide range of motion

 

therapy.

 

? Two LPNs failed to administer insulin, failed to

 

provide skin and wound treatment, and failed to

 

check vital signs.

 

? The employees falsified medical records to

 

conceal the neglect and mistreatment.1 Falsifying business records is a Class E felony

 

punishable by up to four years in prison. The other

 

charges are misdemeanors with varying maximum

 

prison terms of up to one year.1

 

WWW.LTLMAGAZINE.COM DON?S CORNER

 

INPERSPECTIVE While this ?sting? operation may catch

 

many by surprise, use of hidden cameras

 

and similar ?ndings are not new. Consider

 

these other cases:

 

? In Texas, first-degree felony abuse

 

charges were filed against a nurses?

 

aide captured by a hidden camera

 

striking a woman to get her out of her

 

wheelchair and then throwing her into

 

bed. The resident, paralyzed from a

 

stroke, also suffered from dementia. When the facility failed to act on

 

complaints from her husband, stating

 

the woman ?could not identify her

 

abuser,? he took action and installed

 

the camera.2

 

? In Ventura County, California, a family

 

noticed unexplained bruises on their

 

70-year-old loved one admitted to

 

the facility following a stroke. Family

 

notified administrators, but there was

 

no investigation. The family set up a

 

hidden camera and captured what

 

they could not believe. A CNA was

 

seen slapping the resident, violently

 

bending her fingers, wrists, and neck,

 

and pulling her by her hair. An investigation showed the nursing home

 

knew this was a problem employee.

 

Other families had complained of

 

suspected abuse, and one named the

 

CNA in writing, but she was allowed

 

to continue to work with residents.

 

The family was awarded $7.75 million

 

by a jury after facility owners refused

 

to settle out of court for $500,000.3

 

? In an Illinois nursing home, seven

 

patients were admitted who had

 

criminal backgrounds after the facility

 

failed to conduct background checks.

 

Two deaths resulted from neglect,

 

and cameras showed mentally ill patients were out of control and elderly

 

residents lived in fear. Two workers

 

and three patients were arrested,

 

and the administrator?s license was

 

suspended.4 to meet the needs of residents.

 

? Staff falsely documented that the

 

care was provided.

 

? Staff members intentionally abused

 

or neglected residents.

 

? Staff failed to report what they saw

 

others do or fail to do. ? Administration did not adequately

 

investigate family concerns. In each case, the installation of hidden

 

cameras was the vehicle by which neglect

 

and abuse was substantiated. In most of

 

the examples, family members ?rst tried In our examples several key things happened:

 

? Staff failed to provide care designed

 

www.ltlmagazine.com/readerservice

 

WWW.LTLMAGAZINE.COM LONG-TERM LIVING ? 49 INPERSPECTIVE

 

to work with administration to gain resolution, but when they

 

perceived they were not heard, they resorted to other means.

 

None of us want to believe that our sta? could be involved

 

in neglect or abuse, but we must remain vigilant in overseeing

 

resident care. Attorneys and investigators are waiting to step

 

in to right these wrongs, and the lesson for us is clear: As nurse

 

leaders we must take all possible steps to prevent similar occurrences from happening in our settings, and we must make time

 

to listen to our residents and their family members. Once they

 

have shared their concerns, it is imperative that we follow up

 

until they agree that they are satis?ed with our response.

 

The Centers for Medicare & Medicaid Services (CMS) provides us with guidelines to help us organize our protocols and

 

direct our sta?. F-223 Abuse states, ?The resident has the right

 

to be free from verbal, sexual, physical, and mental abuse, corporal

 

punishment, and involuntary seclusion.? This means residents are

 

not subjected to abuse by anyone, whether they are sta?, other

 

residents, consultants, volunteers, agency personnel, family

 

members, legal guardians, friends, or any other individuals.

 

F-224 Treatment of Residents & their Property addresses mistreatment and neglect. The following de?nitions apply:

 

? Abuse?The willful infliction of injury, unreasonable

 

confinement, intimidation, or punishment with resulting

 

physical harm, pain, or mental anguish or the deprivation

 

by an individual of goods or services necessary to attain or

 

maintain physical, mental, and psychosocial well-being.

 

? Neglect?failure to provide goods and services necessary

 

to avoid physical harm, mental anguish, or mental illness.5 F-226 Policy & Procedure on Abuse instructs us to develop

 

and implement written policies and procedures containing the

 

following seven components:

 

1. 2. 3. 4. Screening?Potential employees must be screened for

 

a history of abuse, neglect, or mistreatment through attempts to obtain information from previous/current employers, appropriate licensing boards and registries, and law

 

enforcement agencies who conduct criminal background

 

checks.

 

Training?Employees must receive orientation and ongoing education on dealing with aggressive and/or catastrophic reactions of residents; reporting knowledge of

 

allegations; and recognizing signs of burnout, frustration,

 

and stress that could lead to abuse and explanation of

 

what is considered abuse and neglect.

 

Prevention?Procedures should provide information to

 

residents, families, and staff on how to report concerns,

 

incidents, and grievances without fear of retribution; how to

 

identify, correct, and intervene in situations where abuse or

 

neglect are most likely to occur; and state the importance

 

of giving feedback.

 

Identification?Procedures must instruct staff in identify- 50 ? JUNE 2010 DON?S CORNER 5. 6. ing events needing investigation, such as suspicious bruising,

 

patterns, or trends.

 

Protection?Procedures must explain how to immediately

 

protect residents from harm while an investigation is conducted.

 

Reporting/response?Procedures should guide reporting of

 

alleged or substantiated incidents to appropriate agencies,

 

require corrective actions based on investigation results,

 

and include reporting action by a court of law that indicates

 

an employee is unfit for service to the appropriate agency,

 

registry, or licensing authority. Also consider what changes to

 

make to prevent future occurrences.5 Whether the individuals in our examples receive prison sentences or not, they will no longer work in nursing homes. Careers

 

of many years were ended by bad choices and bad actions. In the

 

long run, future residents will be protected from the substandard

 

care delivered by these individuals.

 

Any facility without a policy on use of cameras in resident areas

 

should develop one, with input from legal counsel. By following

 

CMS guidelines for abuse and neglect prevention, nursing homes

 

will establish a foundation for protecting residents from negative

 

events. Reporting of inappropriate behavior must be the facility

 

standard. Families should be listened to, even if they previously

 

reported what administration deemed to be unsubstantiated

 

complaints.

 

Administration in our examples, for whatever reason, failed to

 

protect their residents. Nursing homes that establish open lines

 

of communication and feedback with residents and families, and

 

that respect their rights will go far in preventing inappropriate

 

activity from happening. They may, in fact, avoid the arrival of

 

hidden cameras in their own neighborhood. ?

 

Betty MacLaughlin Frandsen RN, NHA, MHA, CDONA/LTC, C-NE, has more than

 

30 years of experience in long-term care as a Director of Nursing, Administrator, and Regional Consultant. She is currently Vice President of Education and

 

Regulatory Affairs for AANAC. To send your comments to the editor, please e-mail

 

mhrehocik@vendomegrp.com. References

 

1. Twenty-Two Arrested in Hidden Camera Nursing Home Probe, April 1, 2010. Available at:

 

www.consumeraffairs.com/news04/2010/04/ny_nursing_homes.html

 

2. Rosenfeld, J. Hidden Camera Catches Nursing Home Worker Abusing Paralyzed Stroke Patient.

 

Available at www.nursinghomesabuseblog.com/2010/01/articles/nursing-home-abuse-1/

 

hidden-camera-catches-nursing-home-worker-abusing-paralyzed-stroke-patient/

 

3. Jeffcoat, M. Hidden Camera Evidence Helps Jury Measure Damages at $7.75 Million Dollars,

 

February 18, 2010. Available at: www.southcarolinanursinghomelawyerblog.com/2010/02/

 

hidden_camera_evidence_helps_j.html

 

4. Two Surefire Ways to Catch Nursing Home Abuse with Hidden Cameras. Available at: www.

 

spygearco.com/blog/index.php/two-surefire-ways-to-catch-nursing-home-abuse-withhidden-cameras/

 

5. The Long Term Care Survey (September 2009 Edition). Published by American Health Care

 

Association, Washington D.C. WWW.LTLMAGAZINE.COM Copyright of Long-Term Living: For the Continuing Care Professional is the property of Vendome Group LLC

 

and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright

 

holder's express written permission. However, users may print, download, or email articles for individual use.

 


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