Promoting Mobility and Reducing Falls by Individualizing Care and Eliminating Alarms
Lead Presenter: Joanne Rader, RN, MN, PMHNP, Pioneer Network co-founder, who led restraint elimination efforts, is an expert in understanding behavior as communication, the importance of proper mobility and seating devices, and is the author of Bathing Without a Battle.

Do you have so many bed and chair alarms going off that they cause alarm fatigue and agitation among residents, families and staff? Alarms provide a false sense of security and actually contribute to"iatrogenic" decline of residents because they limit mobility, adversely affect body systems, and isolate residents from social engagement. The best fall prevention strategies rely on knowing residents so you can anticipate their needs, and exercise activity that improves core strength, balance, and gait. Residents are more vulnerable to falls with injury when alarms discourage residents' movement and lead staff to tune out the volume of noise. Hear from one home's interdisciplinary team about how they transformed their nursing home from being a Special Focus Facility because of too many resident falls and their excessive use of alarms to a virtually alarm free facility. How did they do it?They used an individualized approach, with consistent care teams who know each resident and anticipate their needs and routines. Working with their occupational therapist, they used assistive devices with residents to aid mobility. In daily huddles they used Interact's Stop and Watch to identify and address residents' risk for falls and opportunities to prevent falls. Now their nurses have more time for care and leadership because they are not spending time conducting fall investigations. CNAs have fewer call bells to answer because they know what residents need before they even have to ask. Learn how to promote mobility, reduce falls, and eliminate alarms, using a team approach to assessment and care planning to individualize care.

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Individualizing Dining: New Practice Standards
Featuring: Carmen Bowman, MHS, who facilitated the CMS and Pioneer Network's Creating Home in the Nursing Home II: A National Symposium on Culture Change and the Food and Dining Requirements and the subsequent Pioneer Network Food and Dining Clinical Standards Task Force.

Now that you've asked residents what they'd like to eat and when, as part of the MDS Customary Routines, how do you honor their choices, especially when there may be medical risks to consider? Hear interdisciplinary nursing home teams -physicians, nurses, dietitians, speech therapists, and CNAs – describe how they work with medical issues like swallowing and diabetes to liberalize diets in accordance with residents' life-long routines and preferences, while mitigating risks such as weight loss and choking.Learn about new standards of practice for dining that emphasize "Real Food First" by honoring residents' life-long food and dining preferences through interdisciplinary assessment and care planning. These new Dining Practice Standards, agreed to by twelve national clinical standard-setting associations, support individualized care and self-directed living versus traditional diagnosis-focused treatment for people living in nursing home. The New Dining Practice Standards reflect evidence-based research available to-date as well as current thinking,and recognize that individualizing dining avoids the medical risks for residents related to loss of appetite that occur when preferences are not honored. The presenters will describe how the new dining standards relate to the MDS sections on customary routines, nutrition, and therapy, and how they work together in relation to the QIS resident interviews and critical elements, and the surveyor guidelines on choice in eating at F Tags 242 and 325.

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