2 Severely Injured After Crash in Framingham, Massachusetts

Two people have been hospitalized with severe injuries after a crash witnesses say involved two vehicles and a pedestrian Friday evening in Framingham, Massachusetts.

According to witnesses, a pickup truck ran into the back of the white SUV and hit a man who was on the sidewalk.

Fire officials confirmed that one patient had been airlifted to Beth Israel Deaconess Medical Center in Boston, and that another had been transported to the same hospital on the ground. Both sustained injuries that may be life-threatening.

Rainy Ferriere looked outside when she heard the crash.

“I saw two guys in the truck and they start yelling at one guy who was on the ground,” she said. ‘They start hitting the guy and kicking.”

Ferriere says from what she saw, the two men from the truck had something against the man who was hit.

“The way the guys in the truck reacted – like hitting the guy and saying a lot of bad words – I felt like they had something with this guy,” she explained.

Witnesses tell necn the two men from the truck took off on foot. Police began a search of the area and, with information from neighbors, tracked them down to a house a block away.

Some took pictures as one was taken into custody, and witness video shows a dog being sent in.

“They actually just surrounded,” said Alexandrea White. “They were yelling to come out with their hands up. No shots were fired. They were armed and ready to go, though, if something did happen.”

“There was cops all around. Guns already pointing. We figured something was happening,” said Tashali Little. “Some guy in a Lakers jersey came out and he walked out with his hands up, and he was really calm, put something down, and they took him into custody right away.”

State police sent K-9 and CSI units to assist Framingham Police in the search near the intersection of Grant Street and Howe Street.

At this point, there is no official word on what happened.

Stay with necn as this story develops.

Source: NECN

Nursing Home Negligence

Falls in Nursing Homes

Litigators who work with cases involving long term care know how significant the issue of falls can be. Falls are the leading cause of injury and death by injury in adults over 65. Approximately half of the 1.6 million nursing home residents in the U.S. fall each year, and a report by the Office of the Inspector General found that about 10% of Medicare skilled nursing residents experience a fall resulting in significant injury; and, more than 1/3 of hospital falls result in injury. In the rehab setting, rates are often higher – for example, fall rates among stroke patients have been shown to be very high. Immobility and falls can lead to poor outcomes.

Fear of falling is defined as a geriatric syndrome. It not only occurs in older adults who have fallen, but in those with impaired mobility and is associated with decreased physical ability and depression. Care of older adults requires that clinicians be aware of the myriad of issues related to falls including knowledge of this syndrome, increased risk and interventions needed to prevent injury related to falls.

Just about every resident in a long term care setting, including assisted living and sub-acute rehab, is at risk for falling. Between medications, functional and medical issues and advancing age, older adults in most settings are prone to falling.

There are well established standards of care related to fall prevention; but, as I continue to review records related to issues like falls, I am amazed at how often these basic standards are not being practiced. The basics of a fall prevention program include assessment and ongoing reassessment of risk, ensuring a safe environment, medication review, providing therapy as needed, individualized interventions, and staff education.

Basic nursing practice includes assessment, planning (Care plan), putting interventions in place and then evaluating outcomes to determine if those interventions are appropriate and effective. Assessment includes completing fall risk assessments on admission and then as needed. Very often, the fall risk assessments completed by nurses in LTC are inaccurate. The tools utilized in long term care typically include these risk factors: history of falling, use of ambulatory aids, gait/balance issues, medications, secondary diagnoses (i.e. diabetes) and mental status. Care planning is the next step in nursing care - it is the standard of care that as the resident’s status changes, assessments and care plans must be updated, and often, are not. For example, with each fall, there should be updates, or if there is a new diagnosis, i.e. stroke, or worsening dementia, updated interventions should be put into place, with ongoing evaluation of effectiveness.

Care planning and interventions very often are generic and not individualized. For example, a toileting schedule that includes only after meals and before bedtime may not be appropriate. If a resident has issues with constipation or incontinence, this may lead to the need for more frequent toileting to prevent falls. The “make certain call bell is within reach” for residents with dementia is an example of a generic intervention. Older adults with dementia may not recognize a call bell or remember to use it. The debate about use of bed and chair alarms go on – they are a part of an individualized care plan, not a solution to preventing falls. Often, I see delays in putting interventions in place, i.e. with the resident who is incontinent NOT being put on a toileting plan immediately. The other common issue I see when reviewing records is the lack of updating care plans as the resident’s status changes – with every fall, with worsening dementia, physical decline, or new medical diagnosis (i.e. Parkinsonism).

Nurses reviewing records need to pay attention to the MDS, risk assessments, care plans and Interdisciplinary notes with attention to where the standard of care is not being met.
... See MoreSee Less

6 days ago  ·  

View on Facebook