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Nursing Home Self-assessment of Implementation of Emergency Preparedness Standards
- Sandi J. Lane, Elizabeth McGrady
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- Journal:
- Prehospital and Disaster Medicine / Volume 31 / Issue 4 / August 2016
- Published online by Cambridge University Press:
- 23 May 2016, pp. 422-431
- Print publication:
- August 2016
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- Article
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Introduction
Disasters often overwhelm a community’s capacity to respond and recover, creating a gap between the needs of the community and the resources available to provide services. In the wake of multiple disasters affecting nursing homes in the last decade, increased focus has shifted to this vital component of the health care system. However, the long-term care sector has often fallen through the cracks in both planning and response.
ProblemTwo recent reports (2006 and 2012) published by the US Department of Health and Human Services (DHHS), Office of Inspector General (OIG), elucidate the need for improvements in nursing homes’ comprehensive emergency preparedness and response. The Center for Medicare and Medicaid Services (CMS) has developed an emergency preparedness checklist as a guidance tool and proposed emergency preparedness regulations. The purpose of this study was to evaluate the progress made in nursing home preparedness by determining the level of completion of the 70 tasks noted on the checklist. The study objectives were to: (1) determine the preparedness levels of nursing homes in North and South Carolina (USA), and (2) compare these findings with the 2012 OIG’s report on nursing home preparedness to identify current gaps.
MethodsA survey developed from the checklist of items was emailed to 418 North Carolina and 193 South Carolina nursing home administrators during 2014. One hundred seventeen were returned/“bounced back” as not received. Follow-up emails and phone calls were made to encourage participation. Sixty-three completed surveys and 32 partial surveys were received. Responses were compared to data obtained in a 2010 study to determine progress.
ResultsProgress had been made in many of the overall planning and sheltering-in-place tasks, such as having contact information of local emergency managers as well as specifications for availability of potable water. Yet, gaps still persisted, especially in evacuation standards, interfacing with emergency management officials, establishing back-up evacuation sites and evacuation routes, identification of resident care items, and obtaining copies of state and local emergency planning regulations.
ConclusionNursing homes have made progress in preparedness tasks, however, gaps persist. Compliance may prove challenging for some nursing homes, but closer integration with emergency management officials certainly is a step in the right direction. Further research that guides evacuation or shelter-in-place decision making is needed in light of persistent challenges in completing these tasks.
,Lane SJ .McGrady E Nursing Home Self-assessment of Implementation of Emergency Preparedness Standards . Prehosp Disaster Med.2016 ;31 (4 ):422 –431 .
CHAPTER 17 - Anaesthesia service provision for maternity services
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- By Vishal Uppal, Glasgow Royal Infirmary, Elizabeth McGrady, Glasgow Royal Infirmary
- Edited by Tahir Mahmood, Philip Owen, Sabaratnam Arulkumaran, Charnjit Dhillon
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- Book:
- Models of Care in Maternity Services
- Published online:
- 05 July 2014
- Print publication:
- 01 November 2010, pp 159-170
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- Chapter
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Summary
This chapter describes the level of service required from anaesthesia departments providing services for obstetric units. In addition to clinical duties, consultant anaesthetists are involved in teaching, training, administration, research and audit. The Obstetric Anaesthetists' Association (OAA) and the Association of Anaesthetists of Great Britain and Ireland (AAGBI) jointly published Guidelines for Obstetric Anaesthesia Services. These guidelines aim at developing national standards for maternity care. A clear line of communication from the duty anaesthetist to the on-call consultant should be assured at all times. All obstetric departments should provide and regularly update clinical protocols, which should be readily accessible. Obstetric units with an anaesthesia service should have a nominated consultant responsible for training in obstetric anaesthesia and there should be induction programmes for all new members of staff, including locums. There should be an audit programme in place to audit anaesthetic complication rates, such as accidental dural puncture.