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Healthcare Inspection – Patient Care Concerns at the Community Living Center, Hampton VA Medical Center, Hampton, Virginia
OIG conducted a review at Senator Mark Warner’s 2015 request to assess complaints about the delivery of care at the community living center (CLC), Hampton VA Medical Center (facility), Hampton, VA. We substantiated that CLC staff did not consistently have competency validation completed for the care of residents (a term commonly used for patients in a CLC) with suprapubic catheters. We substantiated that CLC staff failed to carry out some physician orders for catheter irrigation. We substantiated that CLC staff did not consistently document checks for well-being and skin assessments. We did not substantiate that CLC staff failed to weigh residents, take vital signs, offer morning care, or address residents’ dining assistance needs. We did not substantiate that CLC staff made residents wait for care. We could not substantiate that weekend staff were not keeping the same routines for the residents or that residents were not informed of special events. We substantiated that in the past, residents had to go to the facility barbershop to be shaved. We found that resident call lights could be turned off at the nurses’ desk. Biomedical staff reconfigured the system so that a call light could only be shut off at a resident’s bedside. We could not substantiate that CLC staff left medications at a resident’s bedside and later tried to give the resident another dose that was still sitting at his bedside. We did not substantiate that CLC staff were not routinely cleaning or sanitizing durable medical equipment. We substantiated that procedures were not followed and an appropriate mattress was not obtained in a timely manner. We recommended the Facility Director ensure CLC staff have competency assessments and validations completed for care of residents with suprapubic catheters, CLC staff carry out physician orders, CLC staff conduct and document resident checks for well-being, skin assessments, and activities of daily living assistance, and procedures are followed for obtaining special care beds and mattresses.
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-------Army sergeant and Paralympian: "I'm so grateful military nurses put up with me." for Thursday, 11 May 2017 from Military Health System in Washington, D.C., United States
VAOIG - Administrative Investigation Advisory - Alleged Misuse of Position, VA Central Office (VACO), Washington, DC from Veterans Affairs Office of Inspector General (OIG) from Washington, D.C., United States
The Department of Veterans Affairs, Office of Inspector General (OIG) independently reviews allegations and conducts administrative investigations generally concerning high-ranking senior officials and other high profile matters of interest to Congress and the Department. While these reviews and investigations may result in the issuance of a formal report, they can also lead to the issuance of an administrative advisory to VA senior leadership. Advisories have been issued instead of reports if allegations are substantiated but no recommendations are made or are unsubstantiated during the course of the investigation and there is a need to notify VA leadership of the investigative results.
OIG’s intention is to maintain transparency with veterans, Congress, and the public by releasing information related to administrative investigative work completed by OIG. As other administrative investigation advisories are completed, they will be available on our website if they are not prohibited from public disclosure.
You may view and download these administrative investigation advisories by clicking on the link to our webpage at https://www.va.gov/oig/publications/administrative-investigation-advisories.asp. The individual advisory may also be accessed by selecting the weblink below.
VA OIG Administrative Investigation Advisory – Alleged Misuse of Position, VA Central Office (VACO), Washington, DC (16-00932-203)This service is provided to you at no charge by Veterans Affairs Office of Inspector General (OIG).
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Army sergeant and Paralympian: "I'm so grateful military nurses put up with me."Retired Lt. Gen. Patricia Horoho (left) shares the spotlight with Sgt. Elizabeth Marks in March at the Rayburn House Office Building in Washington, D.C., after Marks was inducted into the U.S. Army Women’s Foundation Hall of Fame. (Courtesy photo)
As a combat medic in Iraq, the work of Army Sgt. Elizabeth Marks included interactions with other medics but not with nurses. As a wounded warrior who worked relentlessly to be declared fit for duty, became an elite swimmer in the process and fought her way back after nearly dying from a lung ailment, her interactions with nurses have been plentiful.
“Maybe it’s because I’m in the medical field, but I don’t like to be a patient,” Marks said. “So I’m terrible. I’m an ornery, ornery patient. I’m so grateful military nurses put up with me.”
Marks suffered severe hip injuries during a deployment to Iraq in 2010. First hospitalized at Landstuhl Regional Medical Center, Germany, she was sent to the Warrior Transition Unit at Brooke Army Medical Center in Fort Sam Houston, San Antonio. Her case manager was Guillermo “Bill” Leal Jr., who became a nurse after retiring from the Army as a master sergeant in 1994.
“I know the Army, I know nursing, and I know people,” said Leal, who was a Special Forces medic when he was on active duty. “I don’t think there’s any other job better for me anywhere else than to be a nurse in the WTU.”
Marks underwent several painful surgeries and exhaustive rehab. She applied twice to the Physical Evaluation Board for a ruling of fit for duty, or FFD. Twice, she was denied.
Leal “was the first person who made me realize nursing is a field where you can really impact lives beyond hands-on patient care,” Marks said. “I was so scared I’d have to leave the Army, and he knew I didn’t want to. I talked to him every day. He believed in me when a lot of other people didn’t.”
Marks heard a lot of messages about the things she would no longer be able to do. But Leal sent a different message, namely that the wounded warrior wasn’t crazy for wanting to stay in the military.
Marks started swimming in January 2012 to regain strength. Within six months, she got cleared for duty – and also landed a spot in the U.S. Army World Class Athlete Program. Leal celebrated by giving her a flag with the initials FFD and WCAP.
Marks moved to Fort Carson, Colorado, in September 2012 to train. Two years later, she flew to the U.K. with plans to compete in the inaugural Invictus Games. By the time her plane landed, she inexplicably was having trouble breathing.
At Papworth Hospital in Cambridge, England, the medical staff suspected a respiratory infection and put her into a medically induced coma and onto the extracorporeal membrane oxygenation, or ECMO, life support machine. She was transported to Landstuhl and was in a coma for almost a month.
At Landstuhl, “I was ready to be out of the ICU before I could even sit up on my own. I was ready to be out of the ICU before I could form full sentences,” Marks recalled. “So I would sit up in bed and try really hard to move, but I just didn’t have the strength.
The nurses saw how badly she wanted to make progress. They urged her along with little things like moving her into a chair. “Those little things were huge to me,” Marks said.
Amazingly, she was back in the pool by the end of 2014. Her winning streak continued, culminating in gold and a world record in the 100-meter breaststroke during the 2016 Paralympics in Rio de Janeiro, and bronze in the 4x100 medley relay. She also received the ESPN television network’s Pat Tillman Award for Service, the first active-duty soldier to receive the award.
Another nurse, retired Lt. Gen. Patricia Horoho, inspired Marks to mentor other wounded warriors. Horoho was the U.S. Army surgeon general and commanding general of the U.S. Army Medical Command from 2011 to 2016.
“She has been extremely supportive and encouraging,” said Marks, who met Horoho in 2012 when competing in her first Warrior Games. “One of the reasons I stay in the military is because I want to be that support and encouragement for someone else.”
Marks called Horoho a true advocate for wounded warriors. “She believes there is still a purpose for us, that we have value,” Marks said. “She understands that just because we’re injured, or altered, doesn’t mean we’re out of the fight.”Read More ...
Military nurses honored during ceremony at Defense Health Headquarters
(l-r) Maj. Gen. Dorothy Hogg, Air Force deputy surgeon general and chief of the Air Force Nurse Corps; Army 1st Lt. Kelsey Lane, Ft. Belvoir Community Hospital; Air Force 2nd Lt. Jeffery Reimer, Ft. Belvoir Community Hospital; Navy Lt. Cmdr. Melissa Troncosco, student nurse and Ph.D. candidate at the Uniformed Services University of the Health Sciences; Army Sgt. Elizabeth Marks, winner of a gold medal in swimming at the 2016 Paralympic Games in Rio; and Navy Rear Adm. Colin Chinn, acting deputy director for the Defense Health Agency, took part in a cake cutting during a ceremony honoring military nurses during National Nurses Week at the Defense Health Headquarters in Falls Church, Virginia, May 9, 2017.Maj. Gen. Dorothy Hogg, Air Force deputy surgeon general and chief of the Air Force Nurse Corps; Army 1st Lt. Kelsey Lane, Ft. Belvoir Community Hospital; Air Force 2nd Lt. Jeffery Reimer, Ft. Belvoir Community Hospital; Navy Lt. Cmdr. Melissa Troncosco, student nurse and Ph.D. candidate at the Uniformed Services University of the Health Sciences; Army Sgt. Elizabeth Marks, winner of a gold medal in swimming at the 2016 Paralympic Games in Rio; and Navy Rear Adm. Colin Chinn, acting deputy director for the Defense Health Agency, took part in a cake cutting during a ceremony honoring military nurses during National Nurses Week at the Defense Health Headquarters in Falls Church, Virginia, May 9, 2017.
The Military Health System has joined in recognition of National Nurses Week, with continues through May 12, as a way to spotlight the contributions military nurses make to readiness and care of service members, retirees, and their families.Read More ...
May is better speech and hearing monthU.S. Air Force Thunderbirds maintenance professionals, wearing hearing protection, watch Thunderbird 5 taxi out during the Wings of Freedom Open House and Air Show performance, Altus Air Force Base, Oklahoma. Auditory injury is an invisible condition that is often viewed as an unavoidable, acceptable consequence of military service, but service-related hearing loss is largely preventable. Most hearing protection, if worn properly during noise-hazardous conditions, is effective in preventing hearing loss. (U.S. Air Force photo by Master Sgt. Stan Parker)According to the National Institutes of Health, approximately 36 million American adults report hearing loss and between 6 and 8 million people have some form of language impairment. Service members and veterans are at a greater risk of hearing injury than the general public.
The Veterans Benefits Administration reports that tinnitus and hearing loss are the top two service-connected disabilities for U.S. military veterans, and tinnitus is the most common service-related disability among recent veterans.
May is National Better Speech and Hearing Month and a time to recognize the effect of hearing loss and speech disorders on individual wellness.
The military first introduced audiology care as it resulted from the need to rehabilitate troops with hearing loss who returned from World Wars I and II.
"As Better Hearing and Speech Month is recognized nationally during the month of May, it is important to note the role the military played in the origin and evolution of the audiology and speech-language pathology professions," said Army Lt. Col. Kristen Casto, audiology staff officer for the Office the Army Surgeon General.
"The genesis of both specialties resulted from the collaborative efforts to rehabilitate troops returning from World Wars I and II with hearing loss, and resultant communication disorders."
Strategies for the prevention, identification, and rehabilitation of hearing loss and communication disorders have evolved since WWII and the Department of Defense has robust prevention and treatment programs to maximize service member hearing readiness and beneficiary hearing health.
Current auditory research initiatives are advancing the ability to predict auditory performance in operational environments, to maximize the function of advanced hearing protection and communication devices, and pharmacological strategies for preventing hearing loss. Defense Health Agency speech-language pathology research focuses on the mitigation of swallowing, voice, and language disorders.
Studies are also being conducted to identify early indicators of hearing loss, so that measures to prevent hearing loss and tinnitus can be implemented early.
Auditory injury is an invisible condition that is often viewed as an unavoidable, acceptable consequence of military service, but service-related hearing loss is largely preventable. Most hearing protection, if worn properly during noise-hazardous conditions, is effective in preventing hearing loss.
Off-duty noise exposure can cause hearing loss as well including loud music, motorcycles, lawn mowers, and power tools can cause permanent hearing loss.
Disclaimer: Re-published content may have been edited for length and clarity. Read original post.
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