Prevention Is Key in Long-Term Care: Strong DONs Don’t Wait to React

Hey boo hey. Let’s talk facts.

In long-term care, the biggest problems rarely “just happen." Falls don’t magically occur overnight.

Pressure injuries don’t suddenly pop up. A choking episode isn’t random bad luck. These events are almost always tied back to one thing:

👉 Prevention wasn’t activated.

And as a Director of Nursing, that reality doesn’t scare you…it empowers you.

Because when prevention is your culture, your building feels different. Staff move differently.

Residents receive care differently. Surveyors even talk to you differently. They can feel when a facility is proactive versus panicking.

💜 When Prevention Isn’t in Place, These Events Aren’t Surprises — They’re Patterns

📌 You receive an admission on Friday, and by Monday there’s a Stage 2 pressure injury. Why? Ask yourself — were preventative measures in place such as:

• Turning & repositioning on arrival?

• Elevation of heels?

• Pressure-relief cushion?

• Barrier cream?

• Braden on admission?

If prevention isn’t activated immediately, the wound isn’t “new. "Prevention simply wasn’t started.

📌 You admit someone on Friday, and by Saturday they’ve transferred to the hospital with a fracture. Why?

Was the transfer method verified?

Were fall precautions added on Day 1 — not later?

Were staff educated immediately upon admission?

📌 You admit a resident on Tuesday, and by Wednesday there’s a choking incident. Why?

Was the diet order followed?

Was swallow risk reviewed?

Did staff know the texture before feeding?

None of these incidents are shocking. They are predictable outcomes when a facility reacts after something happens instead of preventing before it does.

🔎 This isn’t a staffing issue. This is a prevention system failure — and it begins at admission.

🛑 Prevention Is Not Extra Work — It Protects Everyone

When prevention is NOT a priority, your days look like this:

• Constant investigations

• Endless incident reports

• Pressure wound claims

• IDT meetings in crisis mode

• Angry families

• Documentation clean-up

  
  

That’s exhausting leadership. And exhausted leadership has no time to develop a team.

When you build prevention systems, your day becomes:

• Coaching

• Auditing

• Rounding

• Teaching

• Planning

• Recognizing wins

• Leading with intention

• 
  

👉 Prevention doesn’t create more work. It removes the work that drains you.

💜 Prevention Is a System, Not a Slogan

Strong facilities don’t just “hope for the best.” They:

✔ Implement day-one prevention during admissions

✔ Teach in real time while rounding

✔ Review risks before the weekend

✔ Track patterns (same shifts, same residents, same errors)

✔ Follow through — consistently

If prevention isn’t part of your daily workflow, it’s just a beautiful idea that won’t save you when something goes wrong.

🩺 Prevention Protects Residents AND Your License

Every fall prevented… every wound avoided… every choking episode that never happened…

…protects:

• your residents

• your team

• your license

• your survey outcome

• your facility’s reputation

• 
  

💥 Prevention is care, and prevention is protection.

💬 Leadership Tip

Great DONs aren’t defined by how fast they fix a crisis — but by how few crises they have. Your culture should say:

“We don’t wait to act. We anticipate.”

💜 Lead With Prevention, Lead With Love

When you lead with prevention, you build a team that:

• thinks ahead

• protects residents

• reduces risk

• trusts systems

• takes pride in outcomes

• makes your job less stressful

And a facility that prevents is a facility that thrives.

Lead with love.

Lead with systems.

Lead with prevention.

💜 Lead with Love,

Yourfavnurseleader

Bilquis Ali