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First storm of season proves hazardous on roads

Winter weather wrapped itself around the Berkshires on Monday for the first time this season, causing power outages and making for a treacherous morning commute while giving off December vibes.

Snow, sleet and freezing rain from a coastal storm near Boston began falling by daybreak, leaving about an inch of frozen precipitation on area roads before ending by noon. The wintry mix caused numerous accidents, mostly fender benders and vehicles sliding off the road. None of the accidents involved serious injury, according to local and state police.

Nevertheless, local towing services were busy, with R.W.’s Inc. in Lee responding to 12 accidents on the Massachusetts Turnpike.

“Our first call was for a two-car accident at the Lee-Becket line, and it was non-stop after that,” said Bill Brunell, R.W.’s co-owner .

The worst motor vehicle mishap occurred shortly after 11 a.m. on Old Cheshire Road in Lanesborough, when an oil delivery truck from O’Connell Oil Associates flipped on its side near Camp Mohawk.

The driver, who wasn’t identified, suffered minor injuries and was taken to Berkshire Medical Center as a precaution, according to company officials.

“I was outside moving my vehicles when I heard the truck crash,” said Camp Mohawk’s owner, Dave Schulman. “Considering what happened, [the driver] was very lucky.”Only a small amount of diesel fuel from the truck’s gasoline tank leaked out, and it was cleaned up by highway crews, according to eyewitness reports from the scene.

“I was outside moving my vehicles when I heard the truck crash,” said Camp Mohawk’s owner, Dave Schulman. “Considering what happened, [the driver] was very lucky.”Only a small amount of diesel fuel from the truck’s gasoline tank leaked out, and it was cleaned up by highway crews, according to eyewitness reports from the scene.

O’Connell’s officials wouldn’t confirm how much fuel leaked. Company employees spent the afternoon pumping fuel from the overturned tanker into another vehicle so that the tanker could be righted and towed away.

Lanesborough police did not return phone calls seeking information on what caused the accident.

While Berkshire residents scrambled to find their ice scrapers and snow shovels from last winter, local highway crews were ready to salt, sand and plow — six weeks before winter officially begins.

“We were all set and had trucks on the road by 5:30 a.m.,” said Jeffrey Vincent, superintendent of Lenox’s Department of Public Works. “We made sure we had enough vehicles ready to deal with this [storm].”

Local cities and towns generally gear up for winter weather by Nov. 1, and Sheffield was no exception.

“Our town highway department had plows ready to go,” said Town Administrator Joseph Kellogg. “You never know when winter weather will begin.”

Utility crews from National Grid and the Western Massachusetts Electric Co. were kept busy as gusty winds knocked down tree limbs, causing scattered power outages throughout the county, according to officials from both companies.

Despite the head-start to winter, local skiers will have to curb their enthusiasm about an early beginning to the downhill season. Ski area officials said Monday they hope their resorts will be operational by early December, with Jiminy Peak Mountain Resort in Hancock shooting for its traditional opening by Thanksgiving weekend.

“The second we get sustained 32-degree temperatures, we’ll start making snow,” said Betsy Strickler, Jiminy’s director of marketing.

“We have a month to go before we open,” said George Jervis, owner of Bousquet Ski Area in Pittsfield. “We’re not going to make snow when it’s 55 degrees.”

The forecast for today calls for a high of 45, with a 30 percent chance of rain and/or snow. High temperatures are projected to be near 50 for the rest of the week.

Source:  Berkshireeagle.com


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.
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7 days ago  ·  

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