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TitleOlder Persons Services Research Report
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Total Pages92
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Page 1

OLDER PERSONS SERVICES Nursing and Midwifery Quality Care-Metrics

June 2018


Older Persons Services
Research Report

Page 46

Nursing and Midwifery Quality Care-Metrics OLDER PERSONS SERVICES46

Mobility, dexterity and rehabilitation

48. Pre-admission/pre –morbid and current functional status is assessed and recorded

49. Care plans demonstrate Enabling supports, strategies, aids and assistive devices are
appropriately to promote independence within functional capacity

Activities (physical, social, recreational and sensory)
Social/engagement (family-centred/included, social engagement and support)

50. The individuals interests and hobbies are documented on admission

51. Four monthly regular review

52. The care plan demonstrates evidence of the individual’s involvement in the development of
their social activity plan.

53. There is evidence of individual’s participation in the social activity plan.

Wound care

54. Regular inspections and skin care are performed in a MDT approach in collaboration with
individual and family

55. Modifiable risk factors associated with poor wound healing e.g. malnutrition, continence,
mobility are identified and managed

Medicines administration

56. The Individual’s prescription documentation provides details of individual’s legible name,
unique identifier.

57. The Allergy Status is clearly identifiable on the front page of the prescription chart and/or
medication administration.

58. All prescribed medication are administered or have an omission code entered and
appropriate action taken.

59. The individual’s surrounding environment is free of unsecured prescribed medicinal

60. The Frequency of Administration is as prescribed.

Medicines prescribing

61. There is evidence of medication reconciliation on admission or transfer.

62. There is evidence of 4 monthly review of medicines.

63. The complete prescription is legible with correct use of abbreviations.

64. The minimum dose interval and/or 24 hour maximum dose is specified for all “as required” or
PRN drugs.

65. Discontinued medicines are crossed off, dated and signed by prescriber.

66. The Generic name is used for each drug unless the prescriber indicates a branded drug and
states ‘do not substitute’.

MDA Medicines

67. MDA Medicines are checked & signed at each changeover of shifts by nursing staff (By
member of Day staff & Night Staff).

68. Two signatures are entered in the MDA Medicines Register for each administration of an
MDA Medicine.

69. The MDA Medicines cupboard is locked.

70. A designated nurse holds MDA keys separate from other medication keys.

Page 47

OLDER PERSONS SERVICES Nursing and Midwifery Quality Care-Metrics 47

Medicine storage and custody

71. A registered nurse when on duty is in possession of the keys for Medicinal Product Storage.

72. All Medicinal products are stored in a locked cupboard/room and trolleys are locked and
secured as per local policy.

73. Up-to-date suitable medication formulary is available on all Medicine Trolleys.

Responsive behaviour support

74. An assessment is carried out on Responsive Behaviours on admission.

75. Four monthly regular review.

76. The responsive care plan incorporates a communication strategy and other psychosocial
interventions specific to the individual.

77. There is evidence of PRN psychotropic medication is evidenced to be given as a last resort
only after a review has taken place and employment of non-pharmaceutical interventions
are included.

78. A record of all PRN Psychotropic Medication administered is maintained.

Safeguarding vulnerable adults

79. Safeguarding vulnerable adults procedures are well publicised, easy to access and at an
appropriate level to promote understanding.

80. Easily accessible information is available to the older person of their rights to be free from
abuse and supported to exercise these rights, including access to advocacy.

81. Risk assessments relating to vulnerable adults have been carried out in consultation with the
vulnerable person, their family, advocates and the multidisciplinary team and documented
in care plan.

End of life and palliative care

82. Individual’s end-of-life care preferences are identified and documented with ongoing
engagement every 4 months or as per local policy

83. A comprehensive care plan for end of life including spiritual needs and symptom
management is evident.

84. The individuals resuscitation status is clearly documented

Infection control

85. All invasive medical devices are managed in accordance with local policy / Care bundle e.g.
Peg, Catheter, Cannula, TPN, Tracheostomy.

86. Infection and sepsis alert /status are recorded in the nursing / medical record.

87. Environmental hygiene audits are complete at a minimum of 6 monthly intervals.

88. Hand hygiene audits are completed at a minimum of 6 monthly intervals.

89. The unit/ward area and individual bed space is clean and clutter free.

Person experience

90. Consistent delivery of care against identified needs is evident.

91. What is important to the individual is known and documented in care plan.

92. Observed that each individual has an opportunity to be alone when receiving visitors when
requested (residential settings).

93. Individual reports a timely response to their call bell.

94. A process in place to anonymously survey patients experiences as per local policy.

Page 92

Nursing and Midwifery Quality Care-Metrics OLDER PERSONS SERVICES

JUNE 2018

Office of the Nursing and Midwifery Services Director

Clinical Strategy and Programmes Directorate

Health Service Executive

Dr. Steevens’ Hospital

Dublin 8


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