Spanish Cove Retirement Village, located in Yukon, Oklahoma, is a valued partner in the Telligen QI Connect™ network. Spanish Cove has nearly 200 staff members and includes assisted living, independent living and long-term care.
Jacki Dunlap, BSN, RN, Director of Nursing, has been with Spanish Cove for 19 years and has been in her current role for the past seven years. She is proud of her facility’s strong Quality Assurance and Performance Improvement (QAPI) program and says that the residents have always been the “why” behind their quality improvement efforts to provide the best care. Quality Assurance/Infection Preventionist Tracy Guerra, LPN, has enjoyed a long career in nursing and long-term care. She is proud to have assisted in implementing two quality improvement programs that have made a difference for resident safety at Spanish Cove.
Implementing Positive Change
Enhanced Barrier Precautions Program
Guerra sought to improve processes for residents with enhanced barrier precautions (EBP) and made prescriptive changes that resulted in positive outcomes. First, staff education was a main focus. At in-service trainings, EBP education was provided and team members took a quiz to test for knowledge. MDS Nurse Liz Guzzardo helped create education and quizzes to assist aides’ understanding in proper charting and definitions were placed at each kiosk so that staff had easily accessible materials to reference. Spanish Cove staff watched the Centers for Disease Control and Prevention (CDC)’s enhanced barrier precautions video and were given pocket guides to help identify EBP.
As a result of this education, a team member questioned the use of cloth gait belts on residents with EBP. This prompted Spanish Cove to switch to using vinyl gait belts for those residents which are more easily cleaned. This individual was rewarded for their quality improvement suggestion and all residents have benefited from this positive process update.
In addition, the Spanish Cove team holds a daily meeting to review referrals and identify residents with pre-existing conditions that may require EBP. If there is no information available about a resident’s EBP status, they rely on nurse assessments and skin evaluations to determine if EBP should be implemented (e.g., if a resident has an open wound, the team begins using EBP). To help easily recognize which residents are under EBP, purple dots are placed on respective doors, a flag is added to the resident chart and care plans are updated to reflect the resident’s status. “Admissions nurse Heather Pawnee and unit manager Savanna Pearce are a huge help in making sure communication on new admits is passed on regarding EBP. All of these people are a part of our QAPI program and are involved in completing our performance improvement projects,” said Dunlap.
Finally, Spanish Cove ensures that every single resident room is properly stocked with personal protective equipment (PPE) in an easily accessible bin, which helps with compliance and following proper EBP protocols.
What are enhanced barrier precautions? Read about frequently asked questions from the CDC.
Fall Prevention Program
A little over a year ago, Guerra organized a fall prevention program to help team members more easily identify which residents were at higher risk for falls. A gold star is placed on residents’ doors who may need extra assistance, have additional call lights, require support with accessing items in their room or need help getting up to move around. Signage reading, “CALL, DON’T FALL!” was added and additional signage in bathrooms helps further identify residents who may need extra care. Assistant Director of Nursing Heather Tinsley reviews the fall prevention program initiatives with all new hires, and staff are required to attest that they understand the program and its goals. “Our residents benefit from this,” Guerra shares. “When our staff are better educated, the residents are safer.”
The Spanish Cove team utilizes the performance improvement project (PIP) process and revamped it for their facility with the help of Telligen’s quality improvement facilitator, Micki Reyman. “Micki helps tackle the PIP process and provides support on what is doable. She asks important questions that push us beyond the base level to dive deeper,” said Guerra. Dunlap adds, “We are so appreciative to Micki as she helps us with each PIP. We love that she is flexible and available even with our crazy schedule. Thank you to Telligen for being a great resource.”
Culture at Spanish Cove
Spanish Cove works hard to provide a positive experience with quality improvement at the core. Admissions and discharge nurse, Heather Pawnee, LPN, is proud of the team at Spanish Cove. She shares that they go above and beyond and usually double the state required number of staff. Spanish Cove boasts longevity amongst team members and uses staffing agencies when needed to ensure the best care for residents. Leadership support is evident throughout the building, and upper management is always willing to step in. “Being short staffed isn’t an option,” said Pawnee.
“We have an all-hands-on-deck approach to any issues that arise so we can be proactive versus reactive,” explains Dunlap. “We take staffing very seriously and hire the right people so that our programs can be followed. We are very fortunate to have Debbie Wesley, MSN, RN, in our corporate compliance role. She stays on top of new regulations and creates policies faster than anyone can blink. She is involved in all of our processes and is a tremendous help to all of us.”
“When we all follow through and use a team approach, our residents and families benefit the most. I love that when we say a team approach, we mean all CNAs, housekeeping, safety, floor nurses, therapy and administrative staff. No one knows the residents and families better than our CNAs and floor nurses.”
