Scare Up Some Halloween Fun at Your Facility

Has Halloween crept up on you? Don't be spooked! We have lots of ideas to help you create a memorable celebration at your facility.

Have a pumpkin decorating contest
Talk to local farmers in your area to see if they would be willing to donate small pumpkins for a pumpkin decorating contest. Gather interested participants and provide them with an array of non-toxic paints, markers and other decorative elements (while some residents might still possess the dexterity needed to carve a pumpkin with a knife, paints and markers are a safer choice). Have residents vote for their favorite pumpkin and award a prize to the winner. 

Show a scary movie
Your residents might enjoy watching spooky movies that were popular when they were younger. Many of these movies are available on DVD at your local library. Alfred Hitchcock films, such as Psycho, The Birds and Rear Window, are sure to be crowd pleasers. For additional ideas, click here to view the American Film Institute's "100 Years…100 Thrills" list.

Celebrate with healthy treats
Traditional Halloween goodies are packed with sugar, making them a bad choice for your diabetic residents. The American Diabetes Association suggests swapping out candy for beloved fall flavors, such as low-sugar apple and pumpkin goodies, broth-based soups and vegetarian chili.

How are you celebrating Halloween at your facility? Head over to our Facebook page and tell us!

How Hurricane Sandy Affected East Coast LTC Facilities

The American Health Care Association has been in contact with LTC facilities on the East Coast that were affected by Hurricane Sandy and has these preliminary findings to report:

• About 900 residents were evacuated from facilities in New Jersey 
• 180 nursing home residents were moved from a facility in Long Island to one in Nassau County that was unaffected by the storm 
• Nursing homes in Westerly, Rhode Island and Waterbury, Connecticut also chose to evacuate their residents

To learn more, click here. 

NY DOH Issues Guidance To LTC Facilities On Preparing for Hurricane Sandy

With Hurricane Sandy barreling toward the East Coast, the New York Department of Health (DOH) has issued storm guidelines for healthcare facilities in the state.

The agency emphasizes that facilities should focus on making plans for residents who are dependent upon electrical equipment, including ventilators, dialysis units and oxygen concentrators.

They also recommend the following:

• Check that generators are functioning properly 
• Ensure that your facility has adequate fuel
• Make sure that you have adequate food and water supplies 

To learn more, click here. 

Aspirin May Extend Survival for Colon Cancer Patients

Aspirin's benefits have long been touted, and now it appears that we can add another one to the list. A new study in the New England Journal of Medicine reports that aspirin can help prolong the lives of colon cancer patients - specifically, patients whose tumors had a mutated form of the PIK3CA gene.

Of the patients with the mutated gene who took aspirin, 97 percent were alive five years after receiving their colon cancer diagnosis. Only 76 percent of those with the mutation who didn't take aspirin were alive.

Colon cancer is the third leading cause of cancer-related deaths in the United States when men and women are considered separately. When they are grouped together, it is the second leading cause of cancer deaths.

To learn more, click here.

Green Tea Tied to Reduced Digestive System Cancers in Older Women

A study of more than 69,000 Chinese women found that older women who regularly drink green tea might have slightly lower risks of developing digestive system cancers.

The women, who drank green tea at least three times a week, were 14 percent less likely to develop colon, stomach or throat cancer.

The researchers also refer to "strong evidence" from other animal and human studies that seemed to point to green tea having the potential to fight cancer.

Green tea is considered safe in moderate amounts, but the tea and its extracts do contain caffeine, which some people need to avoid. Green tea also contains small amounts of Vitamin K, which can interfere with warfarin and other drugs that prevent blood clots. Older people are encouraged to talk to their doctors before using green tea as a health tonic.

To learn more, click here.

Fight Infections with Hand Hygiene

Infections are a major problem in long-term care facilities, with an estimated 1.6 to 3.8 infections per resident occurring annually. These infections account for up to half of all nursing home resident transfers to hospitals.¹

Infectious organisms can be transmitted either through direct contact (e.g., skin to skin) or indirect contact (for example, through air, water or inanimate objects).¹ One of the easiest and most effective ways to halt infections is through proper hand hygiene. 

Depending on the situation, hand hygiene can include either washing the hands with soap and water or using an alcohol-based hand sanitizer. According to the CDC, alcohol-based hand sanitizers are appropriate for use when hands are not visibly soiled and before having direct contact with residents.² 

In addition to establishing hand hygiene policies and procedures for your employees, you might also want to consider placing hand sanitizer in high-traffic areas of your facility, where interaction among staff, residents, family members and guests can increase the likelihood of germ transmission. Hand sanitizers are also now available in convenient touch-free dispensers, which can be mounted on stands and placed throughout the building. Touch-free dispensers have been shown to increase hand hygiene compliance by 20.8 percent.³ 

Your ProMed territory manager is ready to talk to you about creating a comprehensive hand hygiene program! Give us a call at (800) 648-5190 or visit us online at www.promedsupply.com.

References
1 Centers for Medicare and Medicaid Services. State Operations Manual. Appendix PP – Guidance to Surveyors for Long Term Facilities (Rev. 70, 01-07-11). Available at: http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf. Accessed August 16, 2012. 

2 Centers for Disease Control and Prevention. Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR.2002;51(RR-16). 

3 Larson EL, Albrecht S, O'Keefe M. Hand hygiene behavior in a pediatric emergency department and a pediatric intensive care unit: comparison of use of 2 dispenser systems. Am J Crit Care. 2005 Jul;14:304-11; quiz 312. 

Falls: Which Residents Are At Risk?

Falls can happen in a split second. While they can’t always be prevented, it’s important to know which of your residents are at an increased fall risk.

According to the CDC, residents are more likely to fall if they have the following traits^1:

•   Have muscle weakness and walking or gait problems (these residents account for almost a quarter of all falls in nursing homes)
• Take medications, including sedatives and anti-anxiety drugs
• Have difficulty moving from one place to another
• Have poor foot care or poorly fitting shoes
• Use walking aids improperly or incorrectly

Environmental risks, including wet floors, poor lighting, incorrect bed heights and improperly fitted or maintained wheelchairs, can also contribute to falls.

The CDC recommends implementing a fall prevention strategy that includes a combination of medical treatment, rehabilitation and environmental interventions that should be undertaken at the organizational, staff and resident levels. To learn more, click here.

Reference

1 Centers for Disease Control and Prevention. Falls in Nursing Homes. Available at: http://www.cdc.gov/HomeandRecreationalSafety/Falls/nursing.html. Accessed October 8, 2012. 

Study: Residents Successfully Taking Risperdal Should Stay On It

Despite a recent push by regulators and LTC groups to reduce the use of antipsychotics in nursing homes, researchers are cautioning that taking residents off Risperdal might actually do more harm than good.

The study, published in the New England Journal of Medicine, noted that when dementia care residents were switched from taking Risperdal to taking a placebo, they were twice as likely to relapse compared to residents who remained on the medication. Additionally, the researchers found that the rates of side effects or death were not any higher in those who continued taking Risperdal.

To learn more, click here.

Get to Know Your Support Surfaces

		Support Surface	Type of Support*	Description
		Solid foam	Static	Porous polymer material that conforms according to applied weight
		Gel-infused foam	Static	Provides the support and conformity of foam with the addition of gel that allows for rapid heat dissipation and better breathability
		Convoluted foam (i.e., channel-cut or "egg crate" foam)	Static	Cuts in the supportive foam create a pressure-reducing, anti-shear surface
		Gel	Static	Semisolid (can range from soft to hard) with elastic, pressure-redistributing properties
		Alternating pressure mattresses and overlays	Dynamic	Provides pressure redistribution by cycling through loading and unloading via inflation and deflation
		Low air loss	Dynamic	Provides a flow of air to assist in managing the skin’s heat and moisture

Gel and foam and air, oh my! There are a lot of support surfaces on the market and it can be tricky to match your residents with the product that best fits their needs. We created the chart above to help you weigh your options.¹ Keep in mind that these components can bused alone or in combination. 

* Static pressure redistribution devices are non-powered devices that may be indicated when a resident is at risk for pressure ulcer development or delayed healing. Dynamic pressure reduction surfaces are powered devices that are indicated if a resident can't move into a variety of positions without placing weight on a pressure ulcer, if their weight completely compresses a static device that otherwise maintains its original integrity or if they have a pressure ulcer that is not healing as expected and it is determined that the pressure could be contributing to the delay.


Reference
1 National Pressure Ulcer Advisory Panel. Terms and Definitions Related to Support Surfaces. Available at: http://www.npuap.org/wp-content/uploads/2012/03/NPUAP_S3I_TD.pdf. Accessed October 3, 2012.

Norovirus Mortality, Hospitalizations Linked to Low Staffing Levels

A new report has linked low staffing levels and negative outcomes related to norovirus outbreaks in long-term care facilities.

Researchers at the University of Chicago studied 308 nursing homes that reported a total of 407 norovirus outbreaks to the National Outbreak Reporting System (NORS) between January of 2009 and December of 2010. They found that facilities with lower nurse-hour-to-bed ratios were most at risk for increased mortality and hospitalizations during norovirus outbreaks. An increase in mortality during outbreak periods was limited to homes with less than 0.75 daily registered nurse (RN) hours per bed.

Residents older than 90 experienced the greatest increase in hospitalization and mortality during the norovirus outbreaks.

to learn more, click here.

FDA Encourages Healthcare Providers to Contact Patients Who Received Injectables from NECC in Wake of Fungal Meningitis Outbreak

The FDA is recommending that medical professionals reach out to any patient who was administered an injectable product distributed by the New England Compound Center (NECC). This comes on the heels of a fungal meningitis outbreak being tied to steroids distributed by the NECC.

At this point, the fungal meningitis has been traced to injections of  methylprednisolone acetate as well as triamcinolone acetonide. NECC has issued a recall of all of its products (to view the list of affected products, click here).

Since the outbreak began, the FDA has has been conducting an ongoing investigation into contamination at  NECC, which is located in Framingham, Massachusetts. As a result of this investigation, they have recommended that healthcare professionals retain NECC products, secure them and withhold them from use. They are also advising them to follow up with any patient who received an injectable drug from NECC and asking them to be on the lookout for symptoms of possible infection, including fever, swelling, increasing pain, redness, warmth at the injection site, chest pain, drainage from the surgical site, visual changes and redness or discharge from the eyes. If patients notice any of these symptoms, they should contact a healthcare provider immediately.

At this time, the FDA is not urging patient follow-up for those who received non-injected NECC drugs, such as lotions, creams, suppositories and eye drops not used in conjunction with surgery.

To learn more and stay up to date on any new developments, click here.

Breast Cancer Myths Debunked

In honor of October being National Breast Cancer Month, we're taking a look at some breast cancer myths that were debunked in an article on Health.com.  Some of them might surprise you!

Myth: Family history is the biggest risk factor for breast cancer.
Fact: The vast majority of women who have breast cancer have no family history.

Myth: Most breast lumps are cancerous.
Fact: About 80% of lumps found in breasts are benign.

Myth: All women have a one-in-eight chance of getting breast cancer.
Fact: Risk of developing breast cancer actually rises as we age. A woman who is in her 30s has about a one-in-233 chance. This rises to one-in-eight by the time she reaches 85.

Myth: Small-breasted women have a lower risk of breast cancer.
Fact: There's no connection between breast size and developing breast cancer.

Myth: Breast cancer presents in the form of a lump.
Fact: You should be alert for other signs of breast cancer, including swelling, skin irritation or dimpling, breast or nipple pain, nipples turning inward, discharge and redness, scaliness or thickening of the nipple or breast skin.

The article addresses 25 common myths and we've only addressed a few of them. Click here to read the article in its entirety.

Generic Version of Wellbutrin Pulled Off the Market

The FDA has asked Teva Pharmaceuticals to pull its generic version of the popular antidepressant Wellbutrin  XL 300 mg off the market after discovering that the generic version releases its key ingredient faster than the original drug.

The generic version, Budeprion XL 300 mg, was pulled after hundreds of reports that the drug did not work or caused side effects including headaches, anxiety and insomnia.

There are four other generic versions of Wellbutrin XL 300 mg that have been approved by the FDA.

To learn more, click here.

FDA Approves Actemera for Earlier Stages of RA

The FDA has widened the approved use of rheumatoid arthritis drug Actemera to include patients who are in earlier stages of treatment for the disease. Previously, Actemera was approved for patients who were not helped by use of TNF inhibitors (such as Humira and Embrel).

To learn more, click here.

Healthcare Sector Adds 43.5K Jobs in September

According to new data from the Bureau of Labor Statistics (BLS), the healthcare sector added 43,500 jobs in September 2012. Of those jobs, 5,700 were at skilled nursing facilities.

In the past year (ending in September 2012), healthcare has added a total of 294,000 jobs, up 2.1 percent over the previous year.

To view the full report from the BLS, click here.

CDC Launches Online Healthcare-Acquired Infection Tracking Tool

The CDC's National Healthcare Safety Network (NHSN) has launched a new online tracking tool designed to help nursing homes monitor healthcare-acquired infections, or HAIs. HAIs are a serious problem in the long-term care setting with staggering statistics¹:

• 1 to 3 million serious infections occur every year in long-term care
• As many as 380,000 residents die every year from the HAIs they contract
• Infections are one of the most common reasons that residents are admitted to hospitals 

By using the tracking tool, the CDC expects that nursing homes will be better able to identify problems, implement preventive measures and monitor their progress in halting infections. Right now, the tracking tool is available to record data on C. difficile, MRSA and other drug-resistant infections as well as urinary tract infections. In addition to capturing data, the online tool also offers access to forms, protocols, training information and additional resources for preventing HAIs. Facilities can begin using the program by enrolling here. 

The NHSN's website notes that submitted data will be used to help gauge progress toward meeting national HAI reduction goals. To learn more, click here.

Professional Medical offers a complete line of infection prevention products, including the new CaviWipes1^™, which are effective in killing 99.9% of bacteria, viruses and fungi in one minute. To learn more, contact your ProMed territory manager, visit us at online at www.promedsupply.com or give us a call at (800) 648-5190.
Reference
1 Centers for Disease Control and Prevention National Healthcare Safety Network. Tracking Infections in Long-term Care Facilities. Available at: http://www.cdc.gov/nhsn/LTC/index.html. Accessed September 26, 2012.

Study: Tomatoes May Lower Stroke Risk

According a new study published in the journal Neurology, eating tomatoes can help reduce your risk of a stroke. Why? They contain a powerful antioxidant, lycopene, that promotes brain health.

According to Jouni Karppi, the study's author, "A diet containing tomatoes...a few times a week would be good for our health. However, daily intake of tomatoes may give better protection." The study noted that cooked tomatoes seem to offer better protection than raw.

To learn more, click here.

Botox, Oral Drugs Both Effective in Treating Incontinence in Women

Researchers at Loyola University in Chicago have found that both Botox injections and oral drugs known as anticholinergics are effective in reducing urinary incontinence in women.

Women in the study were divided into two groups. One group received Botox injections in their bladders as well as a placebo pill. The other group received a daily oral anticholinergic. On average, the women who were treated with Botox reduced the daily frequency of their incontinence episodes by 3.3 For the anticholinergic group, this figure was 3.4. Overall, 27 percent of women who received the Botox treatment and 13 percent of the women taking the anticholinergics saw their symptoms resolve completely.

Both groups also reported quality of life improvements.

To learn more, click here.

90% of Seniors Happy with Medicare Part D

According to a new survey, about 90 percent of seniors are happy with Medicare's prescription drug program. This includes seniors who have dual eligibility for both Medicare and Medicaid. Seniors with dual eligibility typically have multiple chronic illnesses and make up a large percentage of nursing home residents.

The 90 percent satisfaction rate has risen 12 percentage points over Medicare Part D's seven-year life.

Medicare Recipients Choose Nursing Homes Over Hospices for End-of-Life Care

According to a new study, nearly one-third of Medicare beneficiaries choose to stay in nursing homes over hospices for end-of-life care because Medicare doesn't cover room and board at hospices.

The study's authors believe that Medicare's nursing home benefits should cover palliative and hospice care: "Perhaps having Medicare pay concurrently for post-acute SNF care and hospice services for the same condition could allow earlier incorporation of palliative care for these medically complex patients."

To learn more, click here.

CDC: Cancer Patients, Survivors Need the Flu Vaccine

October is National Breast Cancer Awareness Month - and it's also the beginning of fall, when flu starts to crop up.

While cancer patients and survivor are not more likely to get the flu, they are at an increased risk of complications if they do, including pneumonia, hospitalization and even death. The CDC recommends that cancer patients and survivors get the flu vaccine (they should receive the shot, not the nasal spray).

Cancer patients and survivors are also advised to contact their healthcare providers immediately if they experience flu-like symptoms.

To learn more, click here.

Medicare Hospital Readmission Fines Begin Today

Beginning today, Medicare will start to fine nearly two-thirds of hospitals that have high numbers of patients readmitted within 30 days for heart attacks, heart failure and pneumonia. On average, the penalties will costs hospitals about $125,000 a year.

The fines are currently capped at 1 percent of a hospital's Medicare payments for the first year, but they will eventually rise to 3 percent under the Affordable Care Act.

To learn more, click here.