Specific results for criterion where corrective actions are required Where a standard is rated partially attained (PA) or unattained (UA) specific corrective actions are recorded under the relevant criteria for the standard. The following table contains the criterion where corrective actions have been recorded. Criterion can be linked to the relevant standard by looking at the code. For example, a Criterion 1.1.1.1: Service providers demonstrate knowledge and understanding of consumer rights and obligations, and incorporate them as part of their everyday practice relates to Standard 1.1.1: Consumer Rights During Service Delivery in Outcome 1.1: Consumer Rights. If there is a message data to display” instead of a table, then no corrective actions were required as a result of this audit. “no Criterion with Audit Evidence Finding Corrective action desired outcome Rating required and timeframe for completion (days) Criterion 1.3.6.1 PA Low Monitoring forms available for use One resident returned from hospital following a fall with Ensure risk include; fluid balance, continence diary, a diagnosis of postural hypotension. There is no assessments are The provision of monthly blood pressure and weight evidence of blood pressure monitoring on return to the reviewed with services and/or monitoring, nutritional food and fluid facility, post medication review. The short term care changes to health interventions are monitoring record, two hourly turning plan does not identify the residents falls risk. The status. Ensure consistent with, and chart, Iowa pain monitoring too, resident is on regular and required’ pain relief. monitoring tools ‘as contribute to, neurological observations and There is no documentation/monitoring of the reflect the resident’s meeting the behaviour chart. Five of six care plans effectiveness of pain relief for breakthrough pain as current clinical consumers' reviewed reflected current needs. recorded in the progress notes. status. assessed needs, There is an improvement required and desired around the use of assessment and outcomes. monitoring tools to reflect the resident’s 90 days health status.
Specific results for criterion where corrective actions are required Where a standard is rated partially attained (PA) or unattained (UA) specific corrective actions are recorded under the relevant criteria for the standard. The following table contains the criterion where corrective actions have been recorded. Criterion can be linked to the relevant standard by looking at the code. For example, a Criterion 1.1.1.1: Service providers demonstrate knowledge and understanding of consumer rights and obligations, and incorporate them as part of their everyday practice relates to Standard 1.1.1: Consumer Rights During Service Delivery in Outcome 1.1: Consumer Rights. If there is a message “no data to display” instead of a table, then no corrective actions were required as a result of this audit. Criterion with desired outcome Rating Audit Evidence Finding Corrective action required and timeframe for completion (days) Criterion 1.3.6.1 The provision of services and/or interventions are consistent with, and contribute to, meeting the consumers' assessed needs, and desired outcomes. PA Low Monitoring forms available for use include; fluid balance, continence diary, monthly blood pressure and weight monitoring, nutritional food and fluid monitoring record, two hourly turning chart, Iowa pain monitoring too, neurological observations and behaviour chart. Five of six care plans reviewed reflected current needs. There is an improvement required around the use of assessment and monitoring tools to reflect the resident’s health status. One resident returned from hospital following a fall with a diagnosis of postural hypotension. There is no evidence of blood pressure monitoring on return to the facility, post medication review. The short term care plan does not identify the residents falls risk. The resident is on regular and ‘as required’ pain relief. There is no documentation/monitoring of the effectiveness of pain relief for breakthrough pain as recorded in the progress notes. Ensure risk assessments are reviewed with changes to health status. Ensure monitoring tools reflect the resident’s current clinical status. 90 days
AuditSummary_PRMS_CommunicatePublish_000000915007.docx