Long-Term Care Survey Alert

An INR of 9 or greater even without bleeding can spell IJ if you don't do this.

If you're looking for a blueprint for what not to do, consider these specific examples of potential IJ citations provided in the survey interpretive guidelines.

"Failure to assess or respond appropriately for a resident taking warfarin who had an elevated INR of 9 or greater with or without bleeding, or the elevated INR persisted without assessment/follow-up." "Failure to recognize developing serotonin syndrome (e.g., confusion, motor restlessness, tremor) in a resident receiving a SSRI, leading to the addition of medications with additive serotonin effect or medication to suppress the symptoms."

"The facility did not clean and disinfect the glucometers before or after use and/or did not use new glucometer lancets on residents who required blood sugar monitoring."

"The facility failed to restrict a staff member with a documented open, draining and infected skin lesion that was colonized with MRSA from working without adequately covering the area, resulting in MRSA transmission and infection of one or more residents under that staff person's care."