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  • Quality Improvement Programming

    Quality Improvement Programming

    Fall Prevention and Intervention: Anticipation of Resident Needs

    Theracore’s Fall Prevention and Intervention Program has been implemented in numerous nursing facilities with a resultant unprecedented 50% reduction in fall occurrences within 6 months of program implementation and 75% reduction within one year of implementation. The goal of this program is to prevent all avoidable falls through application of systems and processes toward the timely implementation of interventions that effectively anticipate resident need to prevent fall occurrences. They implement specific policies and procedures and mentor facility staff in the clinical assessment of the resident and the factors contributing to the fall occurrence. From this point they work with the falls team to develop appropriate care plan interventions and assess these interventions for their effectiveness in preventing additional occurrences. Systems that ensure staff accountability to the interventions according to the residents care plan are also implemented.

    Restorative Nursing

    “Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being in accordance with the comprehensive assessment and plan of care”. Theracore assists skilled nursing facilities by establishing and training nursing staff on restorative nursing programs for each reimbursable category of resident care and function. Additionally, we implement all of the necessary clinical documentation and processes according to the requirements of the RAI manual as necessary for coding on the MDS. We assist the facility in the development of processes that effectively monitor the residents’ response to the restorative programs , determine when modification is necessary or when referral back to therapy for skilled.

    Dysphagia Management and Restorative Dining:

    The goal of this program is to ensure that residents maintains acceptable parameters of nutritional status; receive a therapeutic diet when there is a nutritional problem; and that residents are provided with sufficient fluid intake to maintain proper hydration and health. This program requires collaboration between speech therapy, nursing and dietary to identify and actively assess residents at risk for swallowing and aspiration issues. Dysphagia Management includes intensive CNA training and monitoring of compliance with therapeutic diet recommendations and feeding techniques. Review of URI occurrences in addition to the Casper Report to identify residents who have experienced weight loss and/or UTI occurrences is critical as these quality measures can reflect an underlying/undetected swallowing problem

    • Reduce the risk of aspiration by ensuring good airway protection and efficient oral motor functioning
    • Ensure that caregivers are well versed on the signs and symptoms indicative of potential aspiration
    • Ensure good communication between Speech , Dietary and Nursing to maintain resident safety during all forms of intake( meals, snacks and medications)
    • Ensure consistent carryover of safe feeding techniques by caregivers for residents dependent in feeding
    • Enhance resident’s quality of life by ensuring that they are placed on the least restrictive diets and consistencies

    Service is indicated and create a system where therapy and restorative communicate regularly so as to prevent avoidable functional decline of the long term care resident.

    Wound Care Management/Prevention:

    This program is designed for therapy participation as part of the interdisciplinary team in the prevention and treatment of wounds. Wound prevention is largely addressed by therapy’s involvement in bed and wheelchair positioning and the provision of staff training to ensure consistent carryover of resident positioning techniques. The goal of Therapy in wound care treatment is as follows:

    • Improve skin integrity issues and address factors contributing to poor integrity
    • Promote the normal healing process of open wounds
    • Identify factors that enhance or promote wound healing and intervene accordingly
    • Assess on an ongoing basis the effectiveness of pressure relieving devices
    • Minimize the risk of infection
    • Ensure that caregivers have the knowledge necessary to maintain resident skin integrity

    Contracture Management and Prevention:

    This program incorporates a variety of neuro-motor techniques and principles to address the physical mechanisms that contribute to the development of contractures. In addition to these techniques orthotics can either be fabricated or prescribed to accommodate deformities and/or prevent the development or worsening of deformities. Additional goals of this program are:

    • Achieve optimal positioning of joints and limbs
    • Ensure maintenance of good skin integrity
    • Ensure ability of staff to maintain proper resident hygiene
    • Improve and maintain resident comfort
    • Implement restorative programs that maintain available range of motion and prevent worsening of existing contractures