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Proactive Planning

With winter fast approaching us, have you done an elopement drill? CMS’s definition of elopement is when a resident leaves the premises or a safe area without appropriate supervision. Elopement drills are held to help prepare all staff to systematically search for a resident who is missing or has eloped. An elopement drill should be performed annually or more frequently if recommended by the Quality Assurance Performance Improvement Committee. Prior to the drill, a staff person or resident will be assigned to function as the missing resident. This staff member or resident will be assigned to a location in or out of the facility. All staff will be alerted that an elopement has occurred. Staff should be assigned areas to search and a designated time to report back to the person coordinating the drill. An elopement drill log will be kept which notes a list of participants; the length of time it took to locate the eloped individual; and the time the drill was conducted. The results of the elopement drill will be submitted to the Quality Assurance Performance Improvement Committee for review and recommendations. Results of the drill should be reviewed and evaluated to determine the need for additional staff training or a revision in the policy and procedure. This is also a good time to review the policy relevant to elopement. Does it require that a full body assessment be completed by a nurse, physician, or physician extender immediately following retrieval of the resident? Does the policy specify who is responsible for investigating the elopement and determine a root cause? Non-goal-directed wandering requires a response in a manner that addresses both safety issues and an evaluation to identify root causes. A resident wandering about the facility aimlessly may indicate that the resident is bored, anxious, lonely, depressed, thirsty, hungry, experiencing pain, or needs toileted. The interdisciplinary team can work together to identify changes needed to help maintain the resident’s safety when wandering. The resident at risk should have interventions in the care plan to address the potential for elopement. Does the staff know where to look if a resident is an elopement risk? While wander, door, or building alarms can help to monitor a resident’s activities, staff must respond to them in a timely manner. Are the alarms being tested and receiving the proper maintenance? Facility policies that clearly define the mechanisms and procedures for assessing or identifying, monitoring, and managing residents at risk for elopement can help to minimize the risk of a resident leaving a safe area without the facility’s awareness. It is everyone’s responsibility to understand the facility’s disaster and emergency preparedness plan to locate a missing resident.

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