Improving Long-Term Care Admissions Policy: A Voice of Change Thirty minutes before the evening shift change and you get the call. A new admission is coming to your facility. The patient is reported to have high acuity, requires intravenous antibiotics, and has a diagnosis of chronic pain. In some healthcare settings this would be considered a typical new patient admission. However, for rural long-term care facilities there is a risk of significant complications. In an environment where registered nurses only need to be in the facility eight hours in a twenty-four-hour period, significant complications can occur during hospitalizations that require certain specialty care specific to the RN. Ineffective discharge planning between any healthcare facility can be detrimental to patient care. To provide adequate care, long-term care admissions must be well thought out and explicit tasks performed before the patient's arrival. There should be a smooth transition between facilities to promote continuity of care (LaMantia, Scheunemann, Viera, Busby-Whitehead & Hanson, 2010). If discharge planning is inadequate, patient health and safety may be compromised. For example, scheduled drug regimens, such as antibiotics and controlled medications, must be available in a timely manner. Most long-term care facilities do not support an on-site pharmacy. Additionally, many pharmacies require original scripts before filling controlled medications. If shelter orders are inadequate or cannot be fulfilled within the appropriate time frame, the shelter facility may not be able to meet critical needs. I have experienced this firsthand on more than one occasion. The most recent ones in the middle of the article reinforce quality nursing practice. When nurses take an active role in protecting patients, we do what nursing does best, we care. Reference Kirsebom, M., Wadensten, B., & Hedstrom, M. (2013). Communication and coordination during the transition of older people between nursing homes and hospitals still needs improvement. Journal of Advanced Nursing, 69, 886—895. DOI: 10.1111/j.1365-2648.2012.06077.x.vLaMantia, M., Scheunemann, L., Viera, A., Busby-Whitehead, J., & Hanson, J. (2010). Interventions to improve transitional care between nursing homes and hospitals: a systematic review. Journal of the American Geriatrics Society, 58(4), 777—82.Tjia, J., Bonner, A., Briesacher, B., McGee, S., Terrill, E., & Miller, K. (2009). Treatment discrepancies during the transition from a hospital to a skilled nursing facility. Journal of general internal medicine, 24(5), 630-635.