Blossom View Nursing Home

L to R front row, seated: Larissa McMullen, Activities Assistant; Shirley Warren, RN, Director of Nursing; Karen Bonomo, RN; Michele Allman, LMSW, Director of Social Work; Jennifer Parker, CNA.

L to R back row, standing: Nancy Tourje, Administrator; Joann McGregor, ADC, Director of Activities; Sandy MacLaughlin, RN; Kristie DeBadts, LPN; Kelly Bacon-Turreli, LPN.

CQI Success

Blossom View Nursing Home in Sodus, New York is one of the New York State nursing homes working with IPRO in the Nursing Home Quality Initiative (NHQI) 8th SOW.

Assessing the chronic pain QM rates and pain management program, Blossom View recognized there was room for improvement. The first step in the quality improvement (QI) process was the pulling together of an interdisciplinary team. The team gathered to identify and assess the effectiveness of staff's understanding and recognition of residents' pain levels, comfort needs, and treatment plans. Additional interventions include:

weekly interdisciplinary pain management meetings;
internet research into non-pharmacological approaches to manage pain;
enhanced policies, procedures, and review of pain screening, assessment, and tracking forms;
provision of interdisciplinary staff education programs including traditional/non-traditional and non-pharmacological pain management approaches (i.e. attentive touch, guided imagery, music and massage therapy); and
community involvement (i.e. local Girl Scout troop making and donating rice packs to be used as potential hot/cold packs).

Ongoing focused attention and review include:

Pre-admission review of residents' pain history, and securing pre-admission pain management guidance and/or prescription;
Residents are started on routine medications as well as additional prn doses to manage pain "24/7;" and
Close monitoring of individual pain levels, appreciating that "pain is what the resident says it is."

The results of Blossom View's efforts are undeniable. They began the NHQI project above both the New York State and national averages for chronic pain. However, by the third quarter of the project, Blossom View's chronic pain QM fell below both benchmarks. Their experiences with post-acute care pain management virtually mirrored that of their chronic pain statistics.

Blossom View continues to sustain the gains they made in both chronic and post-acute care pain management. Blossom View notes staffs' enhanced knowledge of pain management has drilled down to positive resident level outcomes. They note residents' independently practicing relaxation techniques and guided imagery, obvious reduction in the use of pain medications by residents, and a decrease in unpredictable behaviors. This is yet another example of how cohesive interdisciplinary teams can make a difference in the quality of life for our elders.