Tuesday, May 20, 2008

F281: Professional Standards of Quality Care


Services provided or arranged by the facility must meet professional standards of quality.


All services performed in the facility must conform to generally accepted standards of clinical practice. These standards may come from textbooks, current journals, position statements by such organizations as ADA, AMDA, ANA, etc., or clinical practice guidelines published by AHCPR.

Common Reasons for Citing F281:

Improper disposal of controlled substances

Failure to secure controlled substances

Leaving medications at bedside

Failure to assess for dehydration issues

Failure to carry out physician orders

Failing to add new interventions after a fall

No care plans or lack of care plan review for resident care issues

Not monitoring or assessing dialysis access site

Failing to date multidose vials when first opened

Pre-pouring of medications

Improper documentation of medication administration


Frequent education is necessary to make sure that nursing staff understand the standards to which they should be practicing under. Explanation of rationales is vital in this aspect. Working alongside nurses during medication passes is a useful technique for ensuring compliance with this tag and has the potential to improve staff morale if carried out in an appropriate manner. Having generic care plans available for frequently missed areas of care is another useful idea. Frequently missed areas include safe smoking, constipation, weight loss, hydration, fluid restriction, accident prevention and falls, skin breakdown, and hemodialysis.

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