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Snow storm slips into Boston area, rush hour turns into longer mess

METRO BOSTON – Boston and neighboring communities were caught by surprise yesterday as a storm system that was forecast to move out of the area suddenly reversed course, dumping several inches of snow, causing more than 100 mostly minor accidents, and snarling traffic through rush hour and late into the evening.

Commuters in and around Boston reported long delays in their evening commutes, in many cases leaving them stopped in traffic or barely moving for an hour or more. At Logan Airport, aviation officials reported delays of up to a half hour on many flights.

Forecasters said as much as 4 inches of snow was expected to accumulate in Boston by this morning.

Across the region, the storm blindsided residents and municipal officials alike. A top Boston public works official said the department was caught off guard by the change in the weather in the afternoon, leading to a delay in some streets being salted during the slippery commute.

Josh Wilson, 32, a photographer from Stoughton, got in the car about 2 p.m. with his wife, Maura, for a trip to take pictures at Walden Pond in Concord. They got as far as Canton, one town over, before the conditions and traffic forced them to divert to a restaurant for a late lunch.

On the trip home, the 3-mile journey from the 99 Restaurant to their home took two hours and 15 minutes.

“It was literally a parking lot, and we just sat on Route 138 for two hours just to get from Canton to the Shaw’s less than 3 miles away,’’ Wilson said. “There were no accidents. People were just spinning off the roads. The roads were horrendous. I’ve never seen anything like it.’’

Elmo Baldassari, Boston’s deputy commissioner of public works, said the department was surprised by a change in the National Weather Service forecast. He said the forecast had originally called for “light flurries,’’ but then turned into a “coating to half an inch of snow’’ at 3 p.m. By 7 p.m., the forecast called for up to 3 inches.

Some public works trucks went out at 1 p.m. to treat bridges and hills that normally get icy first. Later in the afternoon, as conditions worsened, the department scrambled to mobilize extra crews, along with some contracted equipment, to try to get ahead of rush-hour traffic. But some crews “got locked up in traffic with everyone trying to get home,’’ Baldassari said.

Shortly after 6 p.m., he said, the city had more than 100 trucks salting the streets. But by then, about 100 accidents had been reported, police said.

“There are multiple multiple-car accidents and cars getting stuck across the city,’’ said David Estrada, a police spokesman. “It’s all over the city.’’

Meteorologists blamed an unusual jet stream pattern. “The [storm] systems come up off the coast, and usually they’re caught in the jet stream and keep flowing out to the mid-Atlantic,’’ said Bill Simpson of the National Weather Service in Taunton. “But in this case, it stalled for a day and looped back.’’

Motorists slid into accidents yesterday on snow-slicked roadways around Eastern Massachusetts, but no fatalities were reported, State Police said.

A Boston Fire Department ladder truck was responding to a multiple-vehicle accident about 7 p.m. when it slid on Kilsyth Road and struck another car. No one was hurt, but both vehicles were damaged, said Steve MacDonald, a Fire Department spokesman.

Several Boston public schools buses were delayed by an average of more than an hour as road conditions worsened yesterday afternoon, said Matthew Wilder, a spokesman.

As of 11 p.m. yesterday, Gloucester and Sandwich announced that public schools will be closed today, according to WBZ-TV. Scituate public schools will have a two-hour delay.

The snow was not expected to taper off until 5 a.m., Simpson said.

Elsewhere, trouble spots included the intersection of Route 213 and Interstate 495 in Methuen, the intersection of I-495 and Interstate 95 in Mansfield, the intersection of Route 128 and I-95 in the Peabody-Danvers area, and I-495 in the Merrimack Valley, a State Police spokesman said.

The snow fell more heavily and posed bigger problems on the South Shore and the Cape. Chatham registered a foot of snow at 10:22 p.m. yesterday. The Weather Service warned that the wet snow, combined with gusty north winds, could bring down tree branches and power lines in Barnstable County.

Quincy police responded to about 40 calls reporting minor snow-related accidents by 3 p.m., with most involving cars sliding into each other on slick roads, Sergeant Richard Gilmore said.

“It’s been crazy,’’ he said. “The phones have been ringing off the hook.’’

In Kingston, a school bus was sideswiped by a car sliding on an icy road, the Fire Department said. The bus was dropping off about 15 students at Landing Road and Maple Street about 2:30 p.m. when a car turned the corner too quickly, said Deputy Fire Chief Mark Douglass.

No one was injured, and the students were released into the custody of a school official, he said.

David Balerna, owner of Midway Café in Jamaica Plain, said that the snow made his seven-minute commute yesterday take 47 minutes. “I actually called the city of Boston today and said, ‘What’s it going to take for you people to realize that the roads out here are like a skating rink?’ ’’ he said.

Balerna, who was tending bar last night, said the conditions hurt his business, and patrons who did make the trek out to the Washington Street establishment had horror stories to tell.

One patron, Susan Shannon, a nurse, said she saw an MBTA bus strike a parked car on South Huntington Avenue earlier that afternoon. No one was hurt, but the accident blocked the busy artery.

“It took me an hour and a half to go less than 2 miles,’’ she said “It’s out of control out there. I mean they should have been salting beforehand.’’

Shannon said she called the mayor’s office and was told that trucks were out salting, but she did not see any until after 7 p.m.

“We’re a New England city,’’ she said. “We’re supposed to be used to snow.’’

Source:  Boston.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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