ProMed New Year Closure Reminder

ProMed will be closed Tuesday, December 31 and Wednesday, January 1 to celebrate the arrival of 2014. Orders that were placed by noon on Friday, December 27 will be delivered by Friday, January 3.

If you have any questions or concerns, please contact our Customer Care team at (800) 648.5190.

Happy New Year!

Don't Be SAD: Identifying and Treating Seasonal Affective Disorder

Winter can cause even the most buoyant spirits to sink. It's cold outside, the sun disappears earlier and many people find themselves staring at the same four walls day in and day out. It's a dreary situation indeed – but for many people, perhaps including your residents, it's far more serious than a case of the winter blues. Seasonal affective disorder, or SAD, occurs repeatedly at the same time of year, typically beginning in the fall and ending in spring. Although rare, some people experience the opposite – they become depressed when spring or summer roll around.

Causes

Despite extensive research, the exact causes of SAD are unknown. According to the Mayo Clinic, it's likely that, as with many other mental health conditions, genetics, age and a person's natural chemical makeup play a role in developing the disorder. Being female, living far from the equator and having a family history of SAD are also risk factors for developing the condition.1

Other causes are thought to include1:

• Melatonin levels. Melatonin, a natural hormone, plays a role in sleep patterns and moods. When the seasons change, the melatonin balance can be disrupted.
• Circadian rhythm. Fall and winter bring with them a reduced amount of sunlight. This can upset the body's circadian rhythm, or internal clock, which tells a person when they should be awake or sleeping. This disruption can lead to depression.
• Serotonin levels. Serotonin is a brain chemical (neurotransmitter) that affects mood. Reduced sunlight can cause serotonin levels to drop, leading to depression.

Symptoms

SAD is a cyclic condition, which means that symptoms come back and go away at the same time every year. Symptoms include1:

• Depression
• Hopelessness
• Anxiety
• Loss of energy
• Social withdrawal
• Oversleeping
• Loss of interest in activities
• Changes in appetite (especially a craving for high-carbohydrate foods)

Symptoms might start out mild and grow worse as the season progresses. If left untreated, SAD can lead to suicidal thoughts or behavior, social withdrawal and substance abuse.1

Diagnosis

In order to receive a diagnosis of SAD, individuals need to have experienced depression and other symptoms for at least two consecutive years, and during the same season each year. Those periods of depression also need to have been followed stretches of time without depression. Finally, there must be no other explanations for the change in mood or behavior.1

Treatment

There are a number of available treatments for residents who are experiencing SAD. Common treatments for SAD include phototherapy (also known as light therapy), psychotherapy and medication.1

During light therapy, the affected person sits several feet away from a specialized box designed to expose users to bright, outdoor-like light. Light therapy has few side effects, is easy to use and appears to cause a change in the brain chemicals linked to mood.1 For light therapy to be effective, SAD sufferers should be exposed to a 10,000-lux (about the intensity of the sun at dawn) light source for 30 to 45 minutes a day.2

Even though SAD is thought to be related to biochemical processes, mood and behavior can also complicate symptoms of the disorder. Psychotherapy can be beneficial for identifying and changing negative thoughts and behaviors as well as learning healthy ways to cope with SAD and manage associated stress.1

Finally, a doctor might choose to treat someone with SAD with antidepressants such as bupropion (Wellbutrin XL), paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac and Sarafem) and venlafaxine (Effexor).1

Altering your facility's environment to combat SAD

While severe SAD might require treatment with medication, there are a number of ways to make your facility a more welcoming place for those suffering from the disorder. For starters, try opening blinds, pulling back curtains and trimming any tree branches that block sunlight from entering the facility. Sunshine appears to boost mood, so encourage residents to sit in sunny rooms. Exposure to outdoor light is also highly beneficial, even if just for short periods of time.

Physical exercise can also relieve stress and anxiety. Make sure that there are abundant opportunities to get up and move around your facility, even if it's just taking a few laps up and down the hallways.

While SAD can hit residents hard, simple adjustments to the environment, combined with other treatment options, can help ease the depression and anxiety associated with this disorder.

References
1 MayoClinic.com. Seasonal affective disorder (SAD). Available at: http://www.mayoclinic.com/health/seasonalaffective-disorder/DS00195. Accessed December 27, 2013.

2 The Harvard Medical School Family Health Guide. A SAD story: seasonal affective disorder. Available at: http://www.health.harvard.edu/fhg/updates/Seasonal-affective-disorder.shtml. Accessed December 27, 2013.

ProMed Holiday Closure Reminder

Professional Medical will be closed on Tuesday, December 24 and Wednesday, December 25 in honor of Christmas. We will also be closed Tuesday, December 31 and Wednesday, January 1 to celebrate the new year. Orders that are placed by noon on Friday, December 27 will be delivered by Friday, January 3.

If you have any questions or concerns, please contact our Customer Care team at (800) 648.5190.

Navigating the Holidays with Diabetes

With the holidays approaching, many of your residents are likely making plans to spend time at home with their families. For residents with diabetes, this will bring the added challenge of navigating meals served at festivities. Family members who are unaccustomed to preparing food for diabetic loved ones might also be unsure of their specific nutritional needs.

Luckily, there are resources available to help ease worry over holiday meals. You might want to share the following strategies (courtesy of the CDC) for sticking to a healthy diabetic meal plan with your residents and their families:

• Eat a healthy snack before a party to avoid overeating.
• Choose smaller portions.
• Ask beforehand what food will be served so that you can see how it fits into your meal plan.
• Choose low-calorie drinks such as sparkling water, unsweetened tea and diet beverages.
• Alcohol should only be consumed with a meal and should be limited to one drink a day for women and two for men.
• Choose fresh fruit instead of pies, cakes and other fat- and sugar-laden desserts.
• Watch out for sauces such as a gravy and sugar glazes that can add calories to otherwise healthy foods.
• Focus on friends, family and activities instead of food.

Residents should also make sure that they have any items that they might need during their time away from the facility, including blood glucose monitoring supplies and a glucagon emergency kit for those who use insulin.

To learn more, click here.

OIG Releases Its Top Management and Performance Challenges

The Office of the Inspector General (OIG), a branch of the Department of Health and Human Services (HHS), has released its annual list of management and performance challenges. According to the OIG, this list reflects "continuing vulnerabilities that OIG has identified for HHS over recent years as well as new and emerging issues that HHS will face in the coming year."

The 10 challenges identified by the OIG are:

1. Overseeing the health insurance marketplaces
2. Transitioning to value-based payment for health care
3. Ensuring appropriate use of prescription drugs in Medicare and Medicaid 
4. Protecting the integrity of an expanding Medicaid program 
5. Fighting fraud and waste in Medicare Parts A and B
6. Preventing improper payment and fraud in Medicare Advantage 
7. Ensuring quality of care in nursing facilities and home- and community-based settings 
8. Effectively using data and technology to protect program integrity 
9. Protecting HHS grants and contract funds from fraud, waste and abuse
10. Ensuring the safety of food, drugs and medical devices 

To learn more about each of these challenges, click here. 

FDA Scrutinizing Antibacterial Soaps

On Monday, the FDA issued a proposed rule that would take closer look at antibacterial hand soaps and body washes to determine if they provide benefits beyond those of “plain” (non-antibacterial) soaps. The FDA notes that there is currently no research that supports these soaps being any more effective at preventing illness.

The agency is also concerned that chemicals commonly contained in these soaps, such as triclosan and triclocarban, might carry unnecessary risks, such as bacterial resistance to antibiotics and hormonal effects.

The FDA is proposing that manufacturers of antibacterial soaps be required to provide more substantial data that demonstrates the safety and effectiveness of antibacterial soaps. The agency is asking consumers, clinicians, environmental groups, scientists, industry representatives and others to weigh in on this proposal in the next 180 days, so it will be some time before a final rule is issued.

We want you to know that ProMed offers a complete range of hand soaps that do not contain triclosan, including DermaKleen. Our knowledgeable sales team is ready to meet with you to discuss your needs and help you select the best products for your facility.

We will continue to monitor the progress of this proposed rule and keep you updated.

For additional information  from the FDA, please click here.

Christmas Movie Word Scramble

Test your knowledge of holiday movies by reading the clues below and then unscrambling the name of the movie. Be sure to print out this page, make copies and share them with your residents during your holiday party! If you get stumped, the answers can be found below.

1. This 1946 film was directed by Frank Capra and features an angel named Clarence Odbody.

SIT A LFENWURDO EILF

2. This 1983 comedy is based on a short story from Jean Shepherd’s book In God We Trust, All Others Pay Cash.

A MISTRASCH TORYS

3. In this 1988 comedy, Bill Murray puts his spin on a classic character created by Charles Dickens.

DEGROCSO

4. Starring Bing Crosby and Fred Astaire, this 1942 musical takes place at an inn that is only open on holidays.

DOLIHAY NIN

5. The Griswold family is back for more hilarious misadventures in this 1989 film starring Chevy Chase.

SAMRISTCH NOTIVACA

6. This 1954 musical features a popular song-and-dance team belting out tunes by Irving Berlin.

EHWTI SIRMASTCH

7. Set in London and released in 2003, this romantic comedy chronicles the love lives of eight very different couples.

EOLV YALTUACL

8. This film, based on a book by Doctor Seuss, has been released in both live action and animated formats.

WOH EHT CHINRG EOTSL SMATRISCH

9. In this 1990 film, a young boy is inadvertently left behind while his family takes a trip to Paris and must protect his home against intruders.

MOHE NOELA

10. Buddy, a human who was raised as one of Santa’s elves, is the hero of this 2003 comedy.

LEF

Answers
1. It’s a Wonderful Life 2. A Christmas Story 3. Scrooged 4. Holiday Inn 5. Christmas Vacation 6. White Christmas 7. Love Actually 8. How the Grinch Stole Christmas 9. Home Alone 10. Elf 

OSHA: Heavily Soiled Linens Are Not Regulated Waste

OSHA has confirmed that LTC facilities and other healthcare providers are not required to dispose of contaminated linen as "regulated waste" and that OSHA's regulatory standard governing regulated waste is not meant to apply to linens that are laundered and reused.

OSHA examined the issue after it was brought to the agency's attention by the Association for Linen Management (ALM) and American Reusable Textile Association (ARTA). They were concerned about the practice of placing heavily soiled linens in red bags, which is a sign to laundry operators that the bags must go to a waste department for disposal.

Rather than placing the linens in red bags, the ALM recommends that facilities place heavily soiled linens in impermeable bags so that they do not leak on the way to the laundry.

ALM noted that some facilities place linens contaminated by residents with C. diff in the red bags because they believe the infection is so virulent that the linens must be destroyed rather than washed. This is not the case, according to the ALM. Instead, the linens can be laundered using the requirements set by CMS.

To learn more, click here.

CDC Releases Statistics on LTC Services Provided in U.S.

According to "Long-Term Care Services in the United States: 2013 Overview," which was released by the CDC's National Center for Health Statistics, about eight million people in the U.S. received long-term care services in 2012.

According to the study, these individuals were served by the following regulated long-term care providers:

• 22,200 assisted living and similar residential care communities 
• 15,700 nursing homes 
• 12,200 home health agencies
• 4,800 adult day services centers
• 3,700 hospices

The researchers divided the U.S. into five sectors for the study. They found that in four of the five sectors, the majority of providers were for-profit, although the majority of adult day services providers tended to be nonprofit. 

To learn more and read the complete report, click here. 

CMS: Hospice Medication Claims Will Face Increased Scrutiny

CMS announced that Medicare claims for hospice medications will face heightened scrutiny from the agency in light of widespread inappropriate claims.

Medications for hospice patients should by and large be billed to Medicare Part A, with Medicare Part D only covering drugs that are needed for reasons unrelated to residents' terminal conditions. CMS believes that this guidance has been misinterpreted, resulting in Part D paying out $12.9 million in hospice claims for analgesics. These claims typically came from for-profit, new and/or rural hospice providers and half of the claims were for individuals receiving hospice care in nursing facilities.

To help remedy this, CMS plans to place prior authorization requirements on all hospice medication claims.

To learn more, click here.

Antacid Use Tied to Vitamin B12 Deficiency

A new study suggests that popular antacid drugs, such as those used to treat gastric reflux and peptic ulcers, can contribute to a serious vitamin B12 deficiency.

The study found that people who are diagnosed with the deficiency are more likely to be taking proton-pump inhibitors (PPIs) and histamine 2 receptor antagonists (H2RAs) compared to those not diagnosed with the deficiency. The researchers explained this is because the body absorbs vitamin B12 with the help of stomach acid.

A vitamin B12 deficiency can lead to people becoming tired, weak, constipated and anemic. When left untreated, it can also lead to nerve damage and dementia.

Common PPIs include omeprazole (Prozac), esomeprazole (Nexium) and lansoprazole (Prevacid). H2RAs include cimetidine (Tagamet), famitodine (Pepcid) and ranitidine (Zantac).

The researchers' findings suggest that the drugs should be used for as short a time as possible and at the lowest dose that is still effective.

To learn more, click here.

Could Your Facility's Beds Contribute to Entrapment?

Entrapment can happen in the blink of an eye and its consequences can be serious, even fatal. Between January 1, 1985 and January 1, 2013, the FDA was notified of 901 incidents of people becoming caught, trapped, entangled or strangled in healthcare beds. Of these incidents, 531 resulted in death, 151 led to nonfatal injuries and 220 required staff to intervene in order to prevent injuries. The majority of the individuals were frail, elderly or confused.1

To help combat entrapment, the FDA and Hospital Bed Safety Workgroup collaborated to draft guidance for healthcare facilities on developing bed safety programs. The guidelines recommend using a multi-faceted approach that includes evaluating bed design, performing clinical assessment and monitoring, meeting the needs of vulnerable residents and seeking input from product manufacturers as well as facility staff.2

Here are some questions to ask yourself when evaluating the beds in your facility for
entrapment risk:

• "Are some components worn?" For example, do rails wobble, have the rails been damaged, is the mattress softer than it should be? These can increase entrapment risk.
• "Does the bed still have its original parts?" Many beds that are currently in use do not have their original mattresses or bed rails. The risk of entrapment is increased if there are gaps or spaces between the components of the bed system, which can happen when pieces are replaced or removed.
• "Have I contacted my supplier to see if any entrapment-preventing accessories are available?" These could include mattresses, rails and other accessories.
• "Is the mattress the correct size for the bed?" Not all beds and mattresses are interchangeable.

The FDA has a number of resources available on preventing entrapment at your facility.To view them, click here.

References
1 U.S. Food and Drug Administration. Hospital Beds. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/GeneralHospitalDevicesandSupplies/HospitalBeds/default.htm . Accessed December 4, 2013. 

2 U.S. Food and Drug Administration. Hospital Bed System Dimensional and Assessment Guidance to Reduce Entrapment. Available at: http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/
ucm072729.pdf. Accessed December 4, 2013. 

Santa Claus Goes Global

Here in the United States he's known as Santa Claus, but the jolly man in the red suit takes on many different names and roles around the world. We dug into Santa Claus traditions around the world to give you a leg up during holiday trivia contests (or help you come to rescue when there's a lull in Christmas party conversation!). 

The Netherlands: Known as Sinterklaas, the Dutch version of Santa reportedly lives in Spain during the off season. He takes a steamboat to Holland in mid-November and spends three weeks delivering gifts to good children. Naughty children don't get presents, though. Instead, according to legend, Sinterklaas kidnaps them and takes them back to Spain! 

Italy: La Befana is a friendly holiday witch who delivers goodies to children on either Christmas or Epiphany (January 6). Unlike Santa, she prefers wine over milk and cookies and Italian parents often leave her a glass to enjoy during her stop. A Santa Claus figure, known as Babbo Natale, is also becoming more popular in Italy.

Russia: Ded Moroz, or Grandfather Frost, looks a lot like the Santa we know in the U.S., but he also carries a magical staff and travels with his granddaughter Sengurochka, or Snow Girl. The pair plan New Year's Eve parties for Russian children and hand out gifts.

Mexico: While Santa Claus does travel to Mexico to hand out gifts, they're also distributed by El Niño Dios (Baby Jesus). Depending on the region, either Santa or El Niño Dios may brings the bulk of the gifts.

Sweden: Jultomten, Sweden's answer to Santa Claus, is actually a hybrid of Santa, Julbocken (a Swedish Christmas goat) and a garden gnome. Jultomten visits homes on Christmas Eve and asks "Are there any good children here?" before unloading gifts from his pack. 

Australian Company Develops Electronic Brief

Simavita, a medical device company in Australia, has developed an electronic brief that can help caregivers efficiently determine when an incontinent resident needs to be changed as well as monitor their voiding patterns.

To use the brief, caregivers place an electronic sensor on a disposable pad in the brief. Simavita says it is especially useful during the first 72 hours that a resident is in a facility and can generate a "live bladder chart" that includes information on what triggers urinary discharge, such as changes in position, and the timing and frequency of voiding. This information can be used to develop a care plan.

To learn more, click here.

AHCA Members Close to Antipsychotic Reduction Goal

The American Health Care Association (AHCA) reports that their members are close to meeting the Quality Initiative goal of reducing antipsychotic use in nursing homes by 15 percent. As of the end of the second quarter of 2013, that number stands at 13 percent.

The 13 percent reduction means that an estimated 19,600 residents have been weaned off of antipsychotics. More than 3,600 AHCA member facilities, or about 47 percent of those reporting data, have already reached the goal.

To learn more, click here.

Dementia, Alzheimer's Onset Slowing

Researchers have found that education, better prevention and treating high blood pressure appear to be delaying the onset of signs of dementia and Alzheimer's disease. Lower blood sugar levels and regular exercise also appear to be slowing the onset of the diseases, according to the studies, which were published in the New England Journal of Medicine. 

To learn more, click here.

Deck the Halls, Don’t Contribute to Falls

As you get ready to break out your facility’s Christmas tree, take a second to review your decorating plans and ensure they won’t contribute to resident falls. According to the CDC, around 1,800 nursing home residents die from fall-related injuries every year.1

Ask yourself the following questions as you deck your halls:

• “Could our residents trip over these decorations or have trouble maneuvering around them with a walker or cane?” 
• “Am I adding any decorations to our banisters or hand rails that would make it difficult for residents to get a firm grip?”
• “Are our light cords tucked away from areas where residents walk? If the cords must cross hallways, are they secured with duct tape?”
• “Am I keeping my eyes open for any decorations that have fallen to the ground, creating a fall risk?” 
• “Do I have a trash can near where we are opening presents so that we can quickly dispose of paper and bows before residents trip over them?” 
• “Do our throw rugs have non-slip backings?” 
• “Do any of our decorations have flashing or pulsing lights on them that could cause residents to become disoriented and fall?” 

You should also stress the importance of safe decorating to your staff. Every year, about 6,000 people find themselves in the emergency room being treated for falls sustained while decorating.2 The majority of these falls came while people were on ladders, roofs, furniture (including step stools), stairs and porches.

Professional Medical can help you develop a comprehensive fall prevention strategy. To learn more, contact your ProMed territory manager or give us a call at (800) 648-5190.

References
1 Centers for Disease Control and Prevention. Falls in Nursing Homes. Available at: 
http://www.cdc.gov/HomeandRecreationalSafety/Falls/nursing.html. Accessed December November 20, 2013. 

2 Centers for Disease Control and Prevention. Study: Fall-Related Injuries During the Holiday Season, United States, 2000-2003. Available at: http://www.cdc.gov/media/pressrel/fs041210.htm. Accessed November 20, 2013.  

ProMed Holiday Closure Notice

Professional Medical will be closed Tuesday, December 24 and Wednesday, December 25 in honor of Christmas. Orders that are placed by noon on Friday, December 20 will be delivered by Friday, December 27.

We will also be closed on Tuesday, December 31 and Wednesday, January 1 in honor of the new year. Orders that are placed by noon on Friday, December 27 will be delivered by Friday, January 3.

If you have any questions or concerns, please contact our Customer Care team at (800) 648.5190.

Happy holidays from ProMed!

Gobble Up Some Thanksgiving Trivia

Looking for a fun way to pass Thanksgiving afternoon? Print out this post, distribute it to your residents and test their knowledge of Thanksgiving! (If they get stumped, the answers are at the bottom.)

1. What was the first department store to host a Thanksgiving parade?

2. Who is the Greek goddess of corn?

3. What part of the turkey is saved and snapped as a superstitious good luck custom?

4. Who was the first President of the United States to pardon a turkey?

5. Which two football teams played each other in the first Thanksgiving Day game, held in 1934?

6. What is the name of the flap of skin that hangs from a turkey’s neck?

7. Yes or no: Do all turkeys gobble?

8. What is a baby turkey called?

9. Which state produces the most cranberries?

10. The Mayflower was not originally built to be a transportation vessel. What was its original purpose?

11. What was the name of the pilgrim leader who organized the first Thanksgiving feast?

12. Which eating utensil was absent at the first Thanksgiving meal – the knife, spoon or fork?

13. Who wanted the turkey to be the national bird of the United States? Hint: His face can be found on U.S. currency.

14. What is the average weight of a turkey purchased for Thanksgiving dinner?

15. How long did the first Thanksgiving celebration last?

Answers:

1. Gimbel’s Department Store in Philadelphia. 2. Demeter. 3. The wishbone. 4. Harry Truman. 5. The Chicago Bears and Detroit Lions. 6. The wattle. 7. No. The male turkeys gobble, but the females make clicking noises. 8. A poult. 9. Wisconsin. 10. The Mayflower was built to be a merchant ship to carry wine. 11. Governor William Bradford. 12. The fork. The pilgrims ate with knives, spoons and their fingers. 13. Benjamin Franklin. 14. 15 pounds. 15. Three days. 

Antibiotics Show Promise at Eradicating Colonies of CRE

According to a new study, a powerful antibiotic has been shown to be effective at eliminating colonies of carbapenem-resistant Enterobacteriaceae, or CRE, in asymptomatic carriers.

During the study, 152 patients in an Israeli hospital were either given oral gentamicin, oral colistin, a combination of the two, or no antibiotics. The antibiotics had an average 44 percent success rate in eradicating CRE colonization. Of the two drugs, colistin performed better, at 50 percent. Among the control group, only 7 percent of patients had their CRE colonization eradicated.

Eradicating the colonies of CRE also improved mortality rates. The mortality rate was 17 percent among patients whose CRE was eradicated and 49 percent among others.

The CDC has warned that about half of all people with CRE bloodstream infections die. The agency has identified CRE as an urgent public health threat and named nursing facilities among the settings at highest risk.

To learn more, click here.

Study: One-Quarter of Seniors Haven't Discussed End-of-Life Care Preferences

A new survey from the Pew Research Group found that almost one-quarter of seniors over 75 have not written down or talked to anyone about their end-of-life care preferences. The study also found that 30 percent of people who described their health as "fair" or "poor" have not conveyed their wishes either.

However, there have been improvements in other areas. Back in 1990, only 16 percent of people had put their wishes down in writing, whether it was in an informal letter or a legal document. Today, that figure is at 35 percent.

To learn more, click here.

ProMed Order Cutoff Reminder

We wanted to remind you that our deadline for placing an order for delivery by Wednesday, November 27 was today at noon. Orders that are placed with ProMed from here on out will be delivered the week of December 2.

Additionally, our office will be closed on Thursday, November 28 and Friday, November 29 to allow our employees to celebrate Thanksgiving with their families.

We wish you and your team a safe and happy Thanksgiving! If you have any questions or concerns, please contact our Customer Care team at (800) 648-5190.

Study: Satisfaction, Outcomes Improved When Shift Handovers Done at Bedside

A new study has found that nurses can reduce errors and improve resident satisfaction by doing shift handovers at the bedside rather than at nurses' stations.

Care is more efficient and accurate when both the incoming and outgoing nurse can visually assess the resident, according to the study. The residents also report feeling less anxious and more engaged in their care when nurses did bedside meetings at shift changes.

To learn more, click here.

Study: Doctors' Refusal to Prescribe Generic Medications Costing Medicare Millions

According to a new analysis from ProPublica, Medicare is wasting hundreds of millions of dollars every year because a relatively small number of doctors refuse to allow expensive name-brand medications to be substituted with less-pricey generics.

The researchers found that just 913 doctors, including internists, family medicine and general practice physicians cost Medicare an extra $300 million in 2011 by disproportionately prescribing name-brand drugs. The doctors each wrote at least 5,000 prescriptions per year, including refills.

ProPublica also found that 48 percent of these doctors had financial ties to the pharmaceutical industry and received at least $1,000 for speaking, consulting and other promotional purposes.

There's can be a vast difference between the price of a name-brand drug and a generic. Crestor, for example, costs more than $6 per pill while its leading generic costs as little as 20 cents.

To learn more, click here.

OSHA Training Deadline for New Hazard Standard is December 1

In May of 2012, the Occupational Safety and Health Administration (OSHA) announced that changes would be coming to its Hazard Communication Standard. The goal of the changes was to improve worker understanding of the hazards associated with chemicals in the workplace.

There are three major changes being made to the standard:

• Hazard classification. Chemical manufacturers and importers will be required to determine the hazards of the chemicals they produce or import. 
• Labels. Chemical manufacturers and importers must provide a label that includes a signal word, pictogram, hazard statement and precautionary statement for each hazard class and category related to the product.  
• Material safety data sheets (MSDS). A new MSDS format is being implemented that requires 16 specific sections, ensuring consistency in the way information is presented. 

The first deadline related to these changes is rapidly approaching. By December 1, 2013, employers are required to train their employees on the changes that are being made. However, it’s important to remember that distributors may continue to ship products labeled under the old system until December 1, 2015.

OSHA believes that the changes to the standard will enhance understanding of hazards, especially for low- and limited-literacy workers. They also expect that it will reduce confusion in the workplace, facilitate safety training, result in safer handling and use of chemicals and provide workers with quicker and more efficient access to MSDS information.

To learn more about the new standard and download training materials, click here.

Please Help Us Help Mike Kellenberger!

One of ProMed's very own, longtime sales rep Mike Kellenberger, lost his home in yesterday's tornado in Washington, Illinois. We have taken up a donation to help Mike, his wife, Michelle, and their six children.

We hope that friends of ProMed will consider making a donation. Any amount is appreciated and will help the Kellenberger family rebuild their lives.

To learn more or make a donation, please click here.

Five Strategies for Combating Flu At Home

You take all of the recommended steps to keep flu from spreading in the facility where you work, but what about your home?

The following five strategies can help you defend your house against the flu: 

1. Keep your home's relative humidity level at 40 to 60 percent. Low humidity levels can contribute to the flu virus's survival. 
2. Invest in a germicidal UV light. These gadgets can inactivate microorganisms such as bacteria and viruses. 
3. Purchase an air purifier. Air purifiers can remove the smallest microbes from the air, reducing harmful airborne germs. 
4. Disinfect surfaces. This will physically remove germs from surfaces. Look for EPA-registered disinfectants. 
5. Wash linens. The flu virus can live for several hours on surfaces and even longer on porous materials like towels, washcloths, blankets and linens. Wash your linens in hot water and dry them on a hot setting. 

To learn more, click here. 

Study: Oral Health Problems Could Be As Common and Serious As Falls, Incontinence

According to a new study out of the Netherlands, oral healthcare is poised to become as serious a health problem as falls, incontinence and mobility limitations among the elderly.

Interestingly, problems have worsened because of advances in dental care that have allowed more elderly people to keep their teeth. This means that these people are now at greater risk for developing gum disease and other oral health care issues, which can lead to diabetes and heart disease.

The researchers noted that seniors, especially those in LTC facilities, suffer from a wide array of negative consequences tied to poor oral care.

To learn more, click here.

Study: Singing Show Tunes Can Combat Dementia

It might be time to break out your Phantom of the Opera soundtrack.

A new study has found that singing show tunes can help combat dementia. During the four-month study, the participants, who had dementia, were divided into two groups. The first group sang along with classic show tunes during three 50-minute sessions per week. The second group just listened to the songs.

At the end of the study, the researchers found that the singing group's performance on cognitive tests had improved. The listening group did not show improvement. The researchers said that the results indicate that singing is an effective form of therapy for those with moderate to severe dementia.

The type of music sung is important, the researchers added. Familiar songs, such as show tunes, might activate the brain by sparking memories.

To learn more, click here.

Get a Good Night’s Sleep with ProMed

ProMed has everything that you need to help your residents have sweet dreams!

Studies have shown that as people age, they tend to have a harder time falling asleep and more trouble staying asleep. They also tend to be less satisfied with the sleep they are getting and more tired during the day. A number of behavioral modifications can help with this, including cutting back on caffeine, trying to go to bed at the same time each evening and reducing the amount of time spent napping.1 A sleep-conducive environment can also help residents relax and fall asleep more quickly. ProMed stocks a complete line of products to help you create comfortable, homelike sleeping spaces.

We offer:

• Bathroom safety products to assist with nighttime toileting 
• A complete range of beds, including bariatric offerings 
• Blankets and linens, ranging from lightweight coverlets to thick, warm comforters 
• CPAP machines and accessories 
• Fall prevention items, including alarms, bedside mats and rails 
• Furnishings and casegoods to create an attractive living environment 
• Incontinence management products to keep residents dry and comfortable throughout the night
• Lifts and slings to help caregivers easily maneuver residents in and out of bed 
• Mattresses in both dynamic and static pressure-relieving designs 
• Pillows in foam, polyester fiberfill and disposable styles 

Your ProMed territory manager is ready to help you create soothing, comfortable sleeping environments for your residents. To learn more, reach out to your territory manager, give us a call at (800) 648-5190 or visit us online at promedsupply.com.

Reference 
1 National Sleep Foundation. Aging and Sleep. Available at: http://www.sleepfoundation.org/article/sleep-topics/aging-and-sleep. Accessed October 11, 2013. 

Data: Nursing Homes Most Dangerous Workplaces in America

According to new data from the Bureau of Labor Statistics (BLS), nursing homes had the highest rates of workplace injury and illness in 2012.

The incidence rate for illness and injury in private sector nursing and residential care facilities was 7.3 percent in 2012. State-run nursing homes reported an even higher rate of 13 percent. Of all the illness and injury rates reported by the BLS, this was the only one to reach double digits. By comparison, the figure for construction workers was only 3.6 percent.

Many of the reported injuries occurred while workers were moving residents, highlighting the importance of a safe lifting program.

To learn more, click here.

ProMed Thanksgiving Closure Notice

Professional Medical will be closed Thursday, November 28 and Friday, November 29, 2013 in honor of Thanksgiving.

Orders placed by noon on Friday, November 22 will be delivered by Wednesday, November 27. Orders placed after noon on Friday, November 22 will be delivered the week of December 2.

If you have any questions or concerns, please contact our Customer Care team at (800) 648-5190. Thank you!

CMS Corrects Coding Examples in RAI Manual

CMS has corrected some therapy coding examples in the newly released MDS 3.0 Resident Assessment Instrument (RAI) Manual.

The corrected examples appear on pages 3, 5 and 6 of Chapter 3, Section O. Corrections were also made to the Chapter 3 flowchart addressing ADLs and the Section O change table on page G-7 of Section G.

To learn more and access the corrections, click here.

Study: Younger People More Likely to Save for LTC

A new study has found that younger people are becoming more informed about their long-term care needs and are more likely to be saving for the future needs than older Americans.

The survey, which involved more than 2,000 people, found that 36 percent of people between 18 and 34 years old were saving for future long-term care needs. On the other hand, only 21 percent of people between 45 and 54 said they were saving.

The younger respondents were also less likely than other groups to believe that Medicare, Medicaid and other insurance would cover their long-term care needs.

To learn more, click here.

Tips to Avoid a Fall This Fall (and All Year Round)

Every year, one out of every three adults 65 years and older will fall. These falls can cause moderate to severe injuries, including hip fractures, head traumas and the risk of early death.1 The good news is that falls are largely preventable. The following list was created to help keep both you and your residents safe from fall risks.

Diet and fluids

• Good nutrition, keeping fluid levels up and exercising are all important for maintaining health and reducing fall risk. 

Vision 

• Have your eyes checked annually
• Give your eyes time to adjust to the change in light when going from a well-lit room to a dimmer one and vice versa 

Physical environment 

Ask yourself the following questions when inspecting a resident room:

• “Is the bed adjusted to an appropriate height for the resident – not too high or too low, and with the wheels immobilized?”
• “Is there a non-skid area where the resident exits the bed?”
• “Is the call light within reach?”
• “Is the lighting sufficient for the resident to see obstacles without glare?” 
• “Is the furniture at the right height and equipped with armrests to support the resident?”
• “Is the toilet at the proper height for easy use?” 
• “Is the tub area equipped with handrails and non-skid surfaces?” 
• “Is the rug that is put down to keep floors dry in winter secure enough to not trip residents?”

Devices 

• Be aware that residents can injure themselves while attempting to get free from restraints. 
• Falls can occur as a result of a resident climbing over bed rails, especially full rails. The injuries that are sustained are often much worse due to the increased height of the fall.

Footwear

• Shoes with a thinner rubber sole or rough leather sole accommodate both carpeting and tile. 
• Leather soles can cause a person to slip on a slick floor. 
• Rubber soles can cause a person to “stick” on carpet. 
• Athletic shoes with thick rubber soles can cause a halting walk on thick carpeting and prevent a true sense of impact on the bottom of the feet. 

To download a printable version of this checklist, click here.

Professional Medical’s complete fall prevention line contains a number of products to help you combat falls in your facility, including revolutionary SAFEHIP AirX hip protectors and the low-profile FlatMat. To learn more about these and other products, contact your ProMed territory manager, visit us online at promedsupply.com or give us a call at (800) 648-5190.

Reference
1 Centers for Disease Control and Prevention. Falls Among Older Adults: An Overview. Available at: http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html. Accessed October 7, 2013.

Study: Animal Therapy Helps Delay Dementia Symptom Progression

A new study has found that interacting with therapy animals can slow down the progression of dementia symptoms in nursing home residents.

The study, which was conducted in Germany and Switzerland, placed 65 residents into two groups. One of the groups received 10 weekly sessions of animal therapy while the other group did not. At the end of the study period, the researchers found that agitation/aggression and depression had significantly increased in the group that did not receive animal therapy. Those symptoms remained steady in the group that had interacted with the animals.

To learn more, click here.

10 Fun Halloween Facts

Halloween has a long and colorful history! Why not share these tidbits with your residents during your facility’s celebration this year?

1.  It’s hard to imagine jack-o’-lanterns being carved out of anything but pumpkins, but the tradition actually began in Ireland with large turnips and potatoes. Irish immigrants brought the tradition to America, home of the pumpkin, where carvers found that the large orange fruit made for a perfect jack-o’-lantern.  
2. Halloween can trace its roots back 2,000 years to a Celtic celebration called Samhain, which means “summer’s end.” The Celts believed that Samhain was a time when the dead could walk among the living.
3. According to the National Retail Federation, nearly 158 million consumers will participate in Halloween activities this year. On average, they’ll spend $75.03 on decorations, costumes, candy and other Halloween-related fun.
4. Trick-or-treating originated on All Souls’ Day during the Middle Ages, when poor people in Great Britain would beg for soul cakes, a sweet-bread treat, and pray for dead relatives in return. American children began trick-or-treating in the 1800s, but the focus was more on pranks than candy. By the 1950s, the focus had switched to costumes and family fun.
5. According to an Irish legend, jack-o’-lanterns are named for a man called Jack who could not go to Heaven or Hell and was forced to walk the earth forever with only a coal from hell to light his lantern.
6. Humans aren’t the only ones getting in on the Halloween fun. The National Retail Federation reports that approximately $330 million will be spent on Halloween costumes for pets this year.
7. Black and orange are the colors most commonly associated with Halloween. Orange represents the autumn harvest, while black is tied to death and darkness.
8.  The modern-day Halloween game of bobbing for apples is thought to be derived from Roman celebrations of Pomona, the goddess of fruit trees.
9.  According to the National Confectioners Association, three-quarters of Americans say that chocolate is their favorite Halloween treat.
10. While many of us enjoy Halloween, there’s a word for people who have an extreme, intense or irrational fear of Halloween – samhainophobia.

From our team to yours, have a safe and happy Halloween!

Best Practices: Perineal Skin Care

It's crucial that your staff provide great care to your residents' delicate perineal skin to avoid potentially serious skin conditions. We recommend reviewing the following steps with your staff as a refresher course on providing quality care. Materials needed: Disposable washcloths/wipes, towels, linens, underpads, perineal cleanser, barrier cream and gloves Step 1: Wear gloves and use wipes to remove heavy soiling prior to perineal care. Then remove or discard gloves and wash your hands. Place a protective underpad under the resident's buttocks. Cover the resident with linens and raise them to only expose the perineum. Wash your hands and put on clean gloves for perineal care. Step 2: Using a washcloth or wipe, apply perineal cleanser sparingly. Gently wipe the perineal area, wiping from "clean" urethral to "dirty" rectal area to avoid contamination. Step 3: If an indwelling catheter is present, hold and support the catheter tubing to one side to avoid traction or unnecessary movement during the procedure. When cleaning the urethral area, gently spray and wipe the catheter tubing from the urethra outward for about three inches of tubing. Keep the drainage bag below the level of the bladder. Step 4: Turn the resident on his side. Spray a wipe with perineal cleanser and gently wipe the remaining area, including the rectum and buttocks, without returning to the urethral area. Appropriately and gently cleanse from clean to dirty areas, leaving the entire area clean and dry. Step 5: Apply a moisture barrier to the buttocks and peri area. Step 6: Remove the soiled linens and place them in an appropriate receptacle. Leave the resident in a position of comfort. Registered promedsupply.com customers can access and download our exclusive in-service guides at any time by clicking on Education and selecting Product In-Service Guides on the website. Not a registered user? Just give us a call at (800) 648-5190 and one of our Customer Care Professionals will be happy to get you set up.

Congratulations, Laura Kuhn!

Congratulations to ProMed copywriter Laura Kuhn! She tied the knot with Nathan Underhile on October 19.

Report: Not Taking Meds as Prescribed Leads to Increased Nursing Home Admissions

According to a new report, about 100 million Americans are not taking their medications as prescribed, leading to an uptick in unnecessary deaths, hospitalizations and nursing home admissions.

Failure to take medications as prescribed is associated with about 40 percent of nursing home admissions among residents with type 2 diabetes, according to the report. People who have multiple chronic medical conditions are of particular concern because they often take many medications.

This noncompliance will cause costs to skyrocket and health outcomes to deteriorate, the report added.

To learn more, click here.

Match Your Residents with the Right Incontinence Products

The sheer volume of incontinence management products on the market can make it a challenge to find the perfect fit for your residents. We’ve put together the following chart to help make it easier for you. Keep in mind that CMS recommends considering incontinence, gender, fit and ease of use when selecting an absorbent product.¹

Type of Product	Absorbency	Good For
Briefs	Moderate-Ultimate	·        Bedridden residents       ·        Overnight use       ·        Heavy to complete     urinary incontinence       ·        Bowel incontinence
Pull-Ups	Super-Ultimate	·        Ambulatory residents       ·        Light to severe     urinary incontinence       ·        Bowel  incontinence
Pads and male guards	Moderate-Ultimate	·        Added absorbency inside     regular undergarment     or pull-ups       ·        Used as a system with     reusable pants
Liners	Moderate-Ultimate	·        Moderate to severe     urinary output       ·        Bedridden residents       ·        Ambulatory residents
Belted undergarments	Light-Heavy	·        Occasional accidents       ·        Frequent changes
Underpads	Moderate-Ultimate	·        Open airing       ·        Bed and furniture protection

ProMed recently made a number of upgrades to our incontinence management products to benefit both the resident and the caregiver. Our Embrace™ Adult Skin Caring Underwear with Leakage Barrier now features a comfort stretch panel that hugs the body like real underwear, creating a comfortable, dignified wearing experience. Additionally, our Embrace™ Adult Skin Caring Underwear is now packaged in 100-count cases to save valuable storeroom space and reduce ordering frequency. Both of these products also have updated packaging.

We’ll soon be introducing the Embrace™ Skin Caring Stretch FlexRight Brief, which has a fully breathable stretch panel that creates a natural, discreet fit and moves with the resident. These briefs have standardized sizing that allows you to stock fewer products, freeing up valuable storage space and saving caregiver time. Be sure to watch LTC Connection for future announcements on this product!

To learn more about our complete line of incontinence management products, contact your ProMed territory manager, give us a call at (800) 648-5190 or visit us online at promedsupply.com.

Reference

1 Centers for Medicare and Medicaid Services. State Operations Manual. Appendix PP – Guidance to Surveyors for Long Term Care Facilities (Rev. 70, 01-07-11). Available at: http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf. Accessed October 10

Buy 10 FlatMats, Get One Free!

We're having a fall management special! For a limited time, when you buy 10 or more FlatMats at $112.95 each, you'll get one FREE! To receive this deal, use promo code FMATB10G1 when you check out online or reference it when you place your order over the phone. To learn more, give us a call at (800) 648-5190. 

Happy National Consultant Pharmacist Week!

National Consultant Pharmacy Week begins tomorrow, October 15 and runs through October 18. The celebration is sponsored by the American Society of Consultant Pharmacists (ASCP), the only international professional society devoted to optimal medication management and improved health outcomes for older individuals.

To learn more, click here.