The Ministry of Health’s Inspection and Advisory Committee on Nursing Homes recently gave owners and operators of these establishments a few tips on how they can improve their level of care and service to the elderly.
The occasion was a two-and-a-half hour workshop on Monday, March 12, in the Queen Elizabeth Hospital’s auditorium.?? The session was aimed at bringing them in line with the regulations, standards and procedures set out by the Ministry to address any issues relating to owners and operators of homes and to heighten awareness of the role of the Environmental Health Inspectorate.
Co-ordinator of the Committee, Angela Crawford, told participants that the typical health care process included the way they scheduled appointments in order to avoid "bundling"; the way in which medication was dispensed; how patients were admitted; reporting lab or X-ray results; developing treatment plans; investigating food-borne diseases and outbreaks and accessing the public health nurse when vaccinations are to be administered.
Those in attendance heard from a number of professionals including, an environmental health officer, a drug inspector, public health nurse, social worker and a representative from the Town and Country Planning Development Office who advised the owners on the Change of Use process which was needed to convert residential homes into nursing homes.
Brian Greene, Environmental Health Officer attached to the St. Phillip Polyclinic, informed participants about the need to dispose of medical waste correctly, particularly needles and syringes – not in PET bottles but in appropriate containers, designed to safely house sharp objects. He also advised against placing them in the garbage for the Sanitation Service Authority to collect.
"Some owners get the plastic bottles and drop the needles in there along with the syringes, I’ve seen it. When you have medical waste, it must be transported to the appropriate facility, bring it down to the QEH and they will dispose of it properly," Mr. Greene said. The role of the Environmental Health Officer, he explained, was to go into nursing homes, talk to the nurses and operators in order to find out what health issues they had and how best to address them. They also look at liquid and solid waste disposal, epidemiological control, and water safety, as well as the safety of the nursing home for patients and workers.
One of the challenges the Advisory Committee faced, was the dispensation of medication. Drug inspector, Trevor Richards, complained that the drug registers at some of these institutions were not up to date. Also, some medications were stored in hot areas such as in the kitchen, which rendered them of little or no use to patients since many of them were temperature sensitive. Mr. Richards added, that a number of nursing homes kept discontinued medication too long, preferring to hold on to them to use on other patients at a later stage.
Expired stock was another issue, mainly cough syrup and vitamins, which were kept long past the expiration dates. The Drug Inspector implored operators to refrain from transferring medication from their original containers into other receptacles, since this, too, could be a dangerous practice.
Attendees were also advised by the committee to inform the Ministry of Health via letter, about any patient deaths, whether private or part of the Alternative Care of the Elderly Programme. Accidents and behavioural matters should be reported to the Chief Medical Officer and social workers at the Geriatric Hospital, respectively, he said.
Assistant Nutrition Officer with the National Nutrition Centre, Beverly Stanford, told participants that proper care must be paid to patients’ nutrition. She said the committee gathered information through three processes – documentation, interviews and observation.
Mrs. Stanford noted that nursing homeowners and operators needed to pay attention to a number of areas including a patient’s appetite; if he or she needs a special diet; whether they are lactose intolerant or have any food allergies; have difficulty swallowing due to dementia or stroke; or whether there was a need for assisted feeding.