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State Police Offer Safety Tips for Driving Amid Snow and Ice

Pulpit rockWith the potential for significant snowfall to hit parts of the state this weekend, the Massachusetts State Police remind motorists of several basic strategies to stay safe in snowy weather. Please remember the following tips this weekend and throughout the coming months:

  • Take Note of the Local Forecast:  The State Police encourage motorists to take note of local forecasts and plan accordingly for adverse weather conditions.  Motorists are reminded that they can dial 511 on their cell phones for current traffic and road conditions on Massachusetts Highways.
  •  Vehicle Preparation:  With a forecast of inclement weather, motorists should ensure that their vehicles are well maintained and properly equipped for winter driving.  Motorists should check the fluid levels of their vehicles, particularly washer fluid and anti-freeze, to make sure that they are at adequate levels.  Tires should be inspected to ensure that they are properly inflated and have sufficient tread depth.  Motorists should equip their vehicles with a snow shovel, ice scraper, jumper cables, flares, a flashlight and some warm clothing and blankets.  Additionally, motorists are reminded to completely clear their vehicles of snow and ice prior to driving, including all lights, for visibility.  Clearing vehicles of snow and ice enhances the safety of all motorists by providing an unobstructed view to the operator and prevents snow and ice from flying off vehicles at high speeds and posing a hazard to others on the road. Motorists should also carry a charged cellular phone.
  • Reduce Speed:  Anticipate delays.  Most snow- and ice-related crashes are caused by spin-outs and vehicles sliding off the road because they are travelling at speeds too great for the road and weather conditions.  Posted speed limits are set for driving under optimal, dry conditions.  If road and weather conditions are adverse, motorists should operate at a speed well below the posted limit.
  • Leave Extra Space Between Vehicles:  Under optimal driving conditions, motorists should leave at least one car length for every ten miles per hour between them and the vehicle in front of them.  If the road and weather conditions are adverse, that distance should be significantly increased in order to afford for increased stopping distances.
  • Black Ice:  Transparent ice may form on the roadway.  If you notice ice forming on any objects, assume that it is forming on the road surface as well. Bridges are usually the first surfaces to freeze. Drive slowly and, if possible, avoid driving on iced-over surfaces.
  • Buckle Up:  Ensuring everyone in your vehicle is properly restrained is the single most effective thing that motorists can do to keep themselves and their loved ones safe on the roads.
  • Dial 911 in Roadway Emergencies:  In any weather conditions, motorists who become disabled or encounter an emergency on the roadways should dial 911 on their cellular phones to immediately be connected to a State Police Communications Center. Motorists should always be aware of their location, noting the route they are traveling on and the number of the exit they most recently passed.

Source: mass.gov


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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5 days ago  ·  

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