Q: A resident reports that a staff member has mistreated them. What steps should be taken?
A: When an allegation of abuse is reported actions should be taken to comply with the Elder Justice Act, state regulations and facility policy. General best practices include:
- Remain calm, acknowledge their concern, and gather details (description of event(s), staff member’s name or physical description). Assess the resident, including performance of a head-to-toe skin assessment, obtain vital signs, and obtain the resident’s statement.
- Protect the reporting resident and other residents by increasing supervision for the resident and removing the staff member from resident care areas. Obtain the staff member’s statement then suspend per facility policy.
- Notify the charge nurse, DON, and the administrator and follow the facility’s incident reporting and grievance reporting procedure. Notify the residents’ representative, the physician, the police, and follow state regulations for the initial reporting requirements to the appropriate state agencies.
- Complete an incident report to initiate the investigation. Document the resident assessment in the medical record. Nursing should document every shift during the investigation regarding any physical or emotional changes in the resident such as skin changes, new behaviors, changes in meal intake or participation in activities. Social Services should also follow up with the resident x 3 days and document findings in the medical record. Social Services should consult psychiatric consulting services.
- Update the care plan regarding the allegation and what interventions are initiated to protect the resident during the investigation and any new interventions in response to the resident’s physical or emotional status. Additionally, add any new interventions put in place to prevent reoccurrence.
- The investigation should include interviews of other residents that the alleged perpetrator has had access to and other staff members that have worked recently. Interviews should be completed on interviewable residents by the Social Services department or as designated, and skin assessments should be completed on residents who are non-interviewable by a licensed nurse within 48 hours or per facility policy. Review the staff member’s employee file and recheck the licensure and abuse registry per state guidelines.
- Re-educate all staff on the abuse policy, any policy revisions, and any pertinent information or gaps identified during the investigation.
- The 5-day report will need to be submitted in accordance with state regulatory reporting requirements for communicating the investigation findings.
Proactive assists nursing home providers with abuse prevention training and program review, investigations, and reporting compliance. Contact us to learn more.
Written By:
Melisa Brandenburg
Clinical Consultant
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