1st Quarter In-Service Training

Omicron TOP 10 FACTS!

What Do You Need to Know?

 

1. Omicron may appear similar to the FLU or COMMON COLD. If you experience any symptoms notify your physician and your Galaxy Home Care supervisor.

2. Omicron is very contagious much more than previous COVID variants.

3. Omicron is less deadly than the Delta variant.

4. Omicron some symptoms are similar to previous variants and may include:

·      HIGH fever

·      SEVERE headache

·      may or may not have a loss of taste/smell

·      chills

·      cough

·      sore throat

·      as it progresses some people experience shortness of breath.

.      According to the CDC, symptoms may develop within 2-10 days after initial exposure.

5. An individual can spread COVID 19 even before showing symptoms.

6. If you hear your client has COVID-19 symptoms or tested positive, notify your Galaxy Home Care supervisor immediately.

7. DO NOT under any circumstances, report to your client’s home if you or a family member is feeling unwell or if you have tested positive. Notify your Galaxy Home Care supervisor.

8. COVID-19 RAPID TESTS ARE NOW AVAILABLE FOR PUBLIC PURCHASE in pharmacies such as CVS, Riteaid, Walgreens, and online! Click on this link to order tests online https://ihealthlabs.com/ 

9. Continue to wear a mask to work and avoid large public gatherings.

10. Continue to wash your hands regularly. This is the #1 way to protect yourself.

 

 

The best way to avoid COVID-19 infection is by:

·      Practice good handwashing techniques!

·      Avoid touching your eyes, nose, and mouth with unwashed hands

·      Wear a face mask and gloves when you touch or have contact with the patient’s blood, stool, or body fluids, such as saliva, sputum, nasal mucus, vomit, and urine.

·      When removing gloves after coming into contact with bodily fluid or soiled surfaces/objects, immediately wash hands or use hand sanitizer.

·      Avoid sharing household items with the client (dishes, glasses, towels, phones, etc.)

·      Clean “high-touch” surfaces (counters, tabletops, doorknobs, etc.) every day

What must you do?

If you, your family member, client, or anyone you may have had recent contact with are sick and suspect infection of COVID-19: 

·      you should remain at home

·      notify your physician

·      contact your Galaxy Home Care office by calling   215.588.5068 

·      if you must cough or sneeze yourself, do it in clean tissue, throw it in the trash, and then immediately wash your hands.

What Is OSHA?

Occupational  Safety and Health Act of 1970 (OSHA) was created to stop workers from being killed or hurt at work.  This act also created an organization (OSHA), which makes sure each workplace meets safety and health standards.

OSHA also provides information, training, and assistance to workers and employers.

Health care organizations are required to follow all rules and regulations outlined by OSHA.

What Are Bloodborne Pathogens?

Bloodborne pathogens are infectious microorganisms in human blood that can cause disease in humans. These pathogens include but are not limited to, hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). Needlesticks and other sharps-related injuries may expose workers to bloodborne pathogens. Workers in many occupations, including first responders, housekeeping personnel in some industries, nurses, and other healthcare personnel, all may be at risk for exposure to bloodborne pathogens.

See the video below that can explain OSHA regulations in the healthcare industry.

       

Is COVID-19 considered a bloodborne pathogen by OSHA ?

YES, all employers must report to the CDC all confirmed cases of COVID-19.

·      COVID-19 can be identified as a recordable illness if an employee is infected as a result of performing their work.

Contact Galaxy Home Care office staff if you are in need or running out of Personal Protective Equipment, such as:

o   gloves

o   masks

o   face shields

o   gowns

o   soap/sanitizer

or any other equipment you might need.

Tuberculosis: Signs and Symptoms

Tuberculosis (TB) is a disease caused by bacteria that are spread through the air from person to person. If not treated properly, TB disease can be fatal.
 

TB bacteria most commonly grow in the lungs and can cause symptoms such as:

o   A bad cough that lasts 3 weeks or longer

o   Pain in the chest

o   Coughing up blood or sputum (mucus from deep inside the lungs)

Other symptoms of TB disease may include:

o   Weakness or fatigue

o   Weight loss

o   No appetite

o   Chills

o   Fever

o   Sweating at night

Galaxy Home Care evaluates your risk for TB through our yearly questionnaire based on the following risk factors and above symptoms:

·    If you feel you may be at risk for developing TB according to the above infographic and/or if you are experiencing any of the above symptoms, please inform your Galaxy Home Care supervisor and schedule an immediate visit with your physician. If you feel your client may be at risk or demonstrate symptoms, please notify your Galaxy Home Care supervisor for an immediate evaluation.

·      What Is HIPAA?

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its regulations restrict all Galaxy Home Care employee's abilities to use and disclose protected health information (PHI). All PHI MUST be kept confidential.

 

What Is Protected Health Information?

Protected health information means information that is collected by Galaxy Home Care and relates to the physical or mental health condition of a patient, the provision of health care to a patient, or payment for the provision of health care to a participant, and there is a reasonable basis to believe the information can be used to identify the patient. Protected health information includes information about persons living or deceased.

Some examples of PHI are:

• Patient’s medical record number
• Patient’s demographic information (e.g. address, telephone number)
• Information stored in patient’s medical file at the place of residence and/or office
• Images of the patient
• Conversations a care provider has about a patient’s care or treatment with other nurses and caregivers
• Information about a patient in a Galaxy Home Care computer system or a health insurer’s computer system
• Any health information that can lead to the identity of an individual or the contents of the information can be used to make a reasonable assumption as to the identity of the individual.

 

It is Galaxy Home Care’s policy to comply fully with HIPAA's requirements. That means all staff members who have access to PHI must comply with HIPAA. For the purposes of this plan, the workforce includes:

o   employees,

o   volunteers,

o   interns,

o   board members

and any other individuals whose work performance is under the direct control of Galaxy Home Care, whether or not they are paid by Galaxy Home Care.
All staff members must comply with all applicable HIPAA privacy and information security policies.

If after an investigation you are found to have violated the organization’s HIPAA privacy and information security policies, you will be subject to disciplinary action up to and including termination and/or further legal ramifications if the infraction requires it.

HIPAA is a law. The government gave the Department of Health and Human Services (HSS) the responsibility to enforce HIPAA. Care providers who do not protect patients’ privacy, by following the law may be fined as much as $250,000 and/or go to jail for up to 10 years.

·     Examples of HIPAA violations:

1. The Aide's Plan of Care is lost on your way to the patient's home. This document contains the patient's name as well as other confidential, protected information. Keep all patient-protected information secure!

2. A neighbor of the patient asks how she is doing and you say "she is stronger today". The correct response in this situation would be "you need to stop by and ask her how she is". Do not divulge information even to neighbors.

3. You fax patient notes to the office, but they accidentally go to the wrong fax number.

4. You tell your family all about the patient you take care of for Galaxy Home Care.

·      Watch the below helpful video tips for all field staff members:

·     What can you do?

Keep any patient information confidential and share it only with those who are involved in patient care.

 

If any violation happens, you must notify the agency right away.

• Recognizing Type and Signs of Abuse

·      PHYSICAL ABUSE

Physical abuse is perhaps the most obvious and is usually easier to detect than other forms of abuse. The most common types of physical abuse are:

o   Assault — hitting, shaking, pushing, shoving, kicking, burning, choking, scratching, rough-handling, cutting, biting, physically confining, or forcibly confining or restraining into a room, a chair, or a bed;

o   Forcibly feeding or not providing enough food;

o   Forcibly medicating, over-medicating or withholding prescribed medication;

o   Any sexual activity with an adult who is unable to understand or give consent;

o   Inflicting pornography, voyeurism, exhibitionism, etc.;

o   Control of an adult through the use of threats or intimidation or through the abuse of a relationship of trust;

o   Prolonged intervals between an injury and the treatment;

SIGNS OF PHYSICAL ABUSE

o   Cuts, scrapes, burns, puncture wounds, marks indicating use of restraints;

o   Bruises, discoloration, swelling;

o   Stiffness & Difficulty moving(trouble walking or sitting). The client may have been injured internally or suffered broken bones with no external signs;

o   Genital infections or pain in the groin area;

o   Frequent changes in doctors.

Ask the client what happened. Do they have a reasonable explanation for the injury? Does it make sense, or do the injuries lead you to a different conclusion?

·      PSYCHOLOGICAL ABUSE

There are varying degrees of psychological/emotional abuse. Often, this type of abuse is difficult to detect, particularly if you do not witness interactions between the abuser and the client. The most common types of psychological abuse are:

o   Threatening clients (threatening to physically harm clients, threatening to take away their rights, threatening to sell their property, threatening to place them in confinement, threatening to take the clients’ power to make choices, etc.);

o   Humiliating clients or treating them like children with malicious intent;

o   Verbal abuse, insults, name-calling;

SIGNS OF PSYCHOLOGICAL ABUSE

o   Helplessness;

o   Hesitation to talk openly;

o   Agitation and/or trouble sleeping;

o   Withdrawal and/or depression;

o   Implausible stories;

o   Fear in the presence of the caregiver;

o   Constant deferral to the caregiver, including waiting for the caregiver to answer a question that was posed to the client;

o   Decision-making by the caregiver without deferring or consulting with the client;

o   Client not accepting/allowing visitors.

·      FINANCIAL ABUSE

o   Withholding money belonging to the client;

o   Forcing a client to sell or give property or money away;

o   Stealing money from a client;

o   Borrowing money from a client without consent (if consent can even be provided) and/or failing to repay it.

  

·      SIGNS OF FINANCIAL ABUSE

o   The client cannot explain the disappearance of funds in the bank account OR personal property;

o   The client is suddenly spending a great deal of money;

o   The client is unable to pay his or her bills;

o   The caregiver does not give the resident an opportunity to speak for him or herself;

o   The caregiver gives conflicting accounts of incidents reported by the others (i.e.incidents reported by the resident, family members, friends, neighbors, other health care professionals);

o   The caregiver has drug or alcohol problems;

o   The caregiver’s affection is inappropriate (flirtations, coyness, or other indications that there may be an inappropriate sexual relationship).

·      NEGLECT

Whether intentional or unintentional, any time clients are left in an unsafe environment or they are not receiving proper care, they are being neglected:

o   Withholding treatment (failing to administer medications, failing to provide physical therapy when needed, not taking to doctor’s appointments, etc.);

o   Failing to provide assistance with Activities of Daily Living (e.g., toileting, bathing, transferring, eating, etc.), when necessary;

o   Failing to ensure proper diet or withholding food;

o   Abandoning the resident;

o   Failing to provide basic needs - food, clothing, shelter, medicine, medical aids not properly or timely administered.

SIGNS OF NEGLECT

o   Malnourishment;

o   Dehydration;

o   Weight loss;

o   Not receiving proper medical care (under or over medicated, missing doctor’s appointments, etc.);

o   Lacking necessary medical aids (walker, wheelchair, hearing aid, dentures, etc.);

o   Inadequate and/or inappropriate clothing;

o   Inadequate and/or inappropriate supervision;

o   Extreme filth of person or surrounding;

o   Pest/rodent infestation;

o   Offensive odors;

o   Inadequate heat, fuel, electricity, refrigeration;

o   Untreated physical or mental health problems;

o   Abandonment;

o   Dilapidated housing condition;

o   Soiled bedding.

·      What Can You Do? - REPORT
As a health care professionals working with elderly clients, you have an excellent position to observe and report abuse or neglect. It is our legal responsibility to observe for signs of abuse and/or neglect and report it. You must report all cases of suspected abuse to your Clinical Manager first.

Do not approach the family and confront them about any incidents of abuse. Report facts and relay those to your Clinical Manager.

Galaxy Home Care Clinical Manager will investigate and contact PA Elder Abuse Hotline.

Critical Incidents 

1.   Death (other than by natural causes);

2.   Serious injury that results in emergency room visits, hospitalizations, or death;

3.   Unplanned Hospitalization except in certain cases, such as hospital stays that were planned in advance;

4.   Provider or staff misconduct, including deliberate, willful, unlawful, or dishonest activities;

5.   Abuse, which includes the infliction of injury, unreasonable confinement, intimidation, punishment, mental anguish, or sexual abuse of a participant including but not limited to the following:

§  Physical abuse is defined as a physical act by an individual that may cause physical injury to a participant;

§  Psychological abuse, defined as an act, other than verbal, that may inflict emotional harm, invoke fear, or humiliate, intimidate, degrade or demean a participant;

§  Sexual abuse defined as an act or attempted act, such as rape, incest, sexual molestation, sexual exploitation, or sexual harassment and/or inappropriate or unwanted touching of a participant;

§  Verbal abuse, defined as using words to threaten, coerce, intimidate, degrade, demean, harass, or humiliate a participant;

§  Neglect, which includes the failure to provide a participant the reasonable care that he/she requires, including, but not limited to, food, clothing, shelter, medical care, personal hygiene, and protection from harm.

6.   Seclusion, which is the involuntary confinement of an individual alone in a room or an area from which the individual is physically prevented from having contact with others or leaving, is a form of neglect;

7.   Exploitation, which includes the act of depriving, defrauding, or otherwise obtaining the personal property from a participant in an unjust, or cruel manner, against one’s will, or without one’s consent, or knowledge for the benefit of self or others;

8.   Restraint, which includes any physical, chemical, or mechanical intervention that is used to control acute, episodic behavior that restricts the movement or function of the individual or a portion of the individual’s body. Use of restraints and seclusion are both restrictive interventions, which are actions or procedures that limit an individual’s movement, a person’s access to other individuals, locations, or activities, or restrict participant rights;

9.   Service interruption, which includes any event that results in the participant’s inability to receive services that place his or her health and or safety at risk. This includes involuntary termination by the provider agency and failure of the participant’s backup plan. If these events occur, the provider agency must have a plan for temporary stabilization;

10. Medication errors that result in hospitalization, an emergency room visit or other medical intervention.

11. Diseases listed in the PADOH List of Reportable Diseases,  an occurrence of a disease on the Pennsylvania Department of Health List of Reportable Diseases. www.health.state.pa.us. An incident report is required only when the reportable disease is initially diagnosed;

12. Law enforcement activity  is reportable in the following situations:

§  An individual is charged with a crime or is the subject of a police investigation that may lead to criminal charges.

§  An individual is the victim of a crime, including crimes against the person or his property.

§  An individual is the victim of a crime, including crimes against the person or his property.

§  An on-duty employee who is charged with an offense, a crime or is the subject of an investigation while on duty.

§  A crisis intervention involving police/law enforcement personnel.

§  A citation is given to an agency staff person for a moving violation while transporting individuals in a private vehicle;

13. Missing person where a consumer is considered missing when they are out of contact with staff for more than 24 hours without prior arrangement or if they are in immediate jeopardy when missing for any period of time. A person may be considered in ''immediate jeopardy'' based on the person's personal history and may be considered ''missing'' before 24 hours elapse. Additionally, it is considered a reportable incident whenever the police are contacted about an individual or the police independently find and return the individual, or both, regardless of the amount of time the person was missing;

14. Misuse of funds as an intentional act or course of conduct, which results in the loss or misuse of an individual's money or personal property. Requiring an individual to pay for an item or service that is normally provided as part of the individual support plan is considered financial exploitation and is reportable as a misuse of funds.

15. Rights violation is an act that is intended to improperly restrict or deny the human or civil rights of an individual including those rights which are specifically mandated under applicable regulations. Examples include the unauthorized removal of personal property, refusal of access to the telephone, privacy violations, and breach of confidentiality. This does not include restrictions that are imposed by court order or consistent with a waiver of licensing regulations;

16. Suicide attempts were intentional and voluntary attempts to take one's own life. A suicide attempt is limited to the actual occurrence of an act and does not include suicidal threats.

·      COMPLAINTS & GRIEVANCE

Patients can freely voice complaints and recommend changes without being subject to coercion, discrimination, reprisal, or unreasonable interruption of care, treatment, and services.

Any difference of opinion, dispute, or controversy between a patient or family/caregiver or patient representative and Galaxy Home Care concerning any aspect of services or the application of policies or procedures will be considered a grievance.

The Administrator will be informed of situations that may damage good patient relations and will be committed to maintaining a consistently high level of patient relations. This grievance procedure will be included in the Patient Rights and Responsibilities document given to each patient upon admission.

1. The person receiving the complaint will discuss, verbally and in writing, the grievance with the Clinical Manager who will investigate the grievance. They will make every effort to resolve the grievance to the patient's satisfaction

2. If the grievance cannot be resolved to the patient's satisfaction, the patient or his/her representative is to notify, verbally or in writing, the Administrator.

3. All complaints will be logged, tracked, trended, and filed for performance improvement.

·      WHAT CAN I DO?

You can call 215-588-5068 and report the incident to Clinical Manager over the phone

or 

you can report on your timesheet as "Change in Patient Condition" as "YES".

And then provide details of an incident to the best of your ability.

 

·      WHAT HAPPENS NEXT?

Clinical Managers will be assigned to investigate the incident, grievance, or complaint.

If this is a critical incident the agency will file it with the EIM system, and a Certified Investigator may come out to the patient's house to further investigate. 

The agency takes all grievances and complaints seriously. We try our best to work with families and resolve them to the best of our ability.

 

How does it work at Galaxy Home Care?

Galaxy Home Care will have a proactive quality management program focusing on reducing negative trends in quality, liability exposure, and client satisfaction, as well as improving processes.

Galaxy Home Care maintains an integrated quality management program (QMP) which incorporates a focus on client independence, along with issues, plans, and goals for all the various programs and client types we serve. This is achieved by performing ongoing assessments of quality outcomes with intervention when needed, education and services to employees regarding new initiatives and regulations, and evaluation of client satisfaction to identify areas of risk. The focus of our efforts can be described in a single question we hope to answer: " Are we meeting the needs of the community we serve?"

The ODP philosophy embedded in the document "Everyday Lives" is pertinent to the majority of clients served by Galaxy Home Care. Therefore, the performance improvement assessments required by ODP will be applied to all clients.

The following are evaluated within the QMP:

o   Quarterly performance reviews

o   Incident Management

o   Satisfaction surveys and Grievance reviews

o   Program objectives and goals, with action planning

o   Satisfaction Survey results with corrective action

o   Timeliness of ISP (specific to ODP)

o   Percent of consumer satisfaction with complaint resolution

o   Infection control logs

o   Chart review results

o   The overall Quality Management Program is reviewed, at minimum, every three years but maybe modified more frequently to meet the standards of the various programs.

Outcomes of the data analysis and review of issues that occur will be utilized when planning educational programs for the year.

Outcomes of the QMP can be sorted by program so that Specific Program data results can be obtained and reviewed separately.

WHAT ARE WE WORKING ON?

Galaxy Home Care is currently working on the following Quality Assurance Milestones:

1.   Infection Prevention

§  COVID-19 Awareness;

§  Proper & Frequent Handwashing;

§  Use of Masks during COVID-19;

§  Use of Gloves when providing care;

§  Bag Technique for LPN

2.    Real-Time Data Collection and Analysis

§  Visit Time-In/Time-Out

§  GPS Analysis

§  Data submission with Sandata preferred data aggregator for PA DOH

WHAT CAN I DO?

·      Follow recommended training provided through inservice

·      Report any incidences, grievances, and complaints occurring in the client's home. 

·      Report any potential client issues that you think may happen in the future (e.g., the client almost ran away and you think it will happen again, etc.).

·      Tell us how you are doing in your work with your client!

·      If there are any improvements that you think can be made to better Galaxy Home Care, please communicate them to your direct supervisor.

·      Wash your hands often with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.

Soap and water are preferred if hands are visibly dirty.