Improving admission policy in long-term care: a voice of change Thirty minutes before the evening shift change and you receive the call. A new admission is on the way to your establishment. The patient is reported to be in very serious condition, requiring intravenous antibiotics and diagnosed with chronic pain. In some healthcare settings, this would be considered a typical new patient admission. However, in rural long-term care settings, the risk of complications is considerable. In a context where registered nurses are only required to be present in the facility for eight hours in a twenty-four hour period, significant complications can arise during admissions requiring certain specialized care specific to the registered nurse. Ineffective discharge planning between healthcare settings can harm patient care. To provide appropriate care, long-term care admissions must be well thought out and explicit tasks completed before the patient arrives. 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 safety and health may be compromised. For example, scheduled medication regimens, such as antibiotics and controlled medications, must be available in a timely manner. Most long-term care facilities do not have an on-site pharmacy. Additionally, many pharmacies require original scripts before prescribing controlled medications. If admission orders are inadequate or cannot be fulfilled in a timely manner, the admitting institution may not be able to meet critical needs. I have experienced this several times. The newest o...... middle of article ......essentially reinforces the practice of quality nursing care. When nurses take an active role in patient advocacy, we do what nurses do best: we care. ReferenceKirsebom, M., Wadensten, B. and Hedstrom, M. (2013). Communication and coordination during the transition of older people between nursing homes and hospital still needs to be improved. 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. and Miller, K. (2009). Medication discrepancies during transitions from hospital to skilled nursing facility. Journal of General Internal Medicine, 24(5), 630-635.