Study: Real-Time Video Can Aid in Physical Therapy Progress

Researchers in South Korea have found that stroke survivors can achieve greater progress in physical therapy by incorporating real-time video into their sessions.

The real-time video is part of a computer program that records video footage and provides real-time feedback on how well the resident is performing the physical therapy activities.

During the experiment, two groups of residents (an experimental group and a control group) took part in therapy three times a week for 30 minutes. The experimental group utilized the real-time video component. At the end of the experiment, the experimental group outperformed the control group in gait velocity, stride length and "timed up and go" tests, despite being outperformed in these areas by the members of the control group before the study.

To learn more, click here.

How to Shut Out Rain-Out

What springs to mind when you think of wintertime annoyances? Snow, surely. Cold temperatures. A lack of sunlight. For those who work in long-term care, oxygen concentrator rain-out is likely on the list as well.

Rain-out refers to the condensation that develops and collects in oxygen tubing when a humidifier is being used. As warm, humid, oxygenated air travels down the tubing, moisture condenses and collects when it hits cooler areas of the tubing, typically in the section of tubing that sits on the floor. This moisture, which is a breeding ground for bacteria and can lead to respiratory infections, eventually makes its way out of the tubing and into the resident’s nose.

Rain-out worsens in the winter because floors tend to be colder during this time of year. It is also more likely to occur when long oxygen tubing is used. For example, 50 feet of tubing allows the oxygen to come in contact with the cold surface for a longer period of time than 25 feet of tubing.

The following tips can help you curb rain-out in your facility:

• Eliminate the humidifier, if feasible.
• If a humidifier is used, fill the bottle with room temperature or cool water.
• Shorten the tubing length or use hooks or straps to elevate the tubing off the floor.
• Use tubing that features an in-line water trap, which collects water and prevents it from being passed on to the resident. It should be located in the tubing near the cannula end to achieve the best results.
• Place the concentrator in a shaded, larger and well-ventilated room. This will prevent a buildup of heat from the sun or other heating sources.
• Keep the machine at least eight inches from the wall to provide adequate ventilation. You should also make sure that the air intake filter is kept clean.
• Make sure there are no leaks, kinks or weak connections in the tubing.

Professional Medical offers all of the tools you need to develop an effective respiratory care program at your facility. To learn more, contract your ProMed territory manager or give us a call at (800) 648-5190.

Researchers Propose Redefining Fever

Researchers funded by the Agency for Healthcare Research and Quality (AHRQ) are recommending that each resident in a long-term care facility have a documented "mean normal temperature" in their records. Any temperature one degree or more above that documented temperature would qualify as a fever.

According to the researchers, "In agreement with past studies, the current study found that the normal non-illness temperature in the study population was lower than the often-quoted 98.6 degrees Fahrenheit, suggesting that the definition of fever should be lower as well."

To learn more, click here.

Are You Fully Stocked for Flu Season?

The CDC predicts that the current flu season will continue on for some time and worsen in many locations before coming to an end. If an outbreak occurred in your building today, would you have everything you need to fight back?

We encourage you to examine the chart below, which was created based on CDC recommendations, to ensure you’re not caught empty-handed when illness strikes. 

CDC Recommendation	ProMed Product Solutions
“Wear a facemask (e.g., surgical or procedure mask) upon entering the resident’s room. Remove the facemask when leaving the resident’s room and dispose of the facemask in a waste container. If resident movement or transport is necessary, have the resident wear a facemask if possible.”	Our N95 particulate respirators meet CDC guidelines for fluid resistance and TB exposure control and provide respiratory protection for your entire staff.            We also offer basic procedure masks to protect your residents, staff and visitors.
“Perform hand hygiene before and after touching the resident, after touching the resident’s environment or after touching the resident’s respiratory secretions, whether or not gloves are worn. Gloves do not replace the need for performing hand hygiene.”	GelRite Instant Hand Sanitizer contains 65 percent ethyl alcohol and kills 99.9 percent of harmful bacteria, making it the perfect choice for healthcare use.           DermaKleen is a soft antimicrobial hand cleanser. It kills bacteria on contact while softening, conditioning and moisturizing skin.
“Wear gloves if hand contact with respiratory secretions or potentially contaminated surfaces is anticipated. … [Change] gloves and gowns after each resident encounter and performing hand hygiene.”	We offer gloves in nitrile, stretch synthetic, synthetic, latex and powder-free poly formulations.                        Super Sani-Cloth Germicidal Disposable Wipes meet CDC, OSHA and CMS Tag F441 guidelines for disinfection of contaminated surfaces. They are effective against Influenza A, the most prominent strain this year, among numerous other microorganisms. The wipes are also available in bleach and alcohol-free formulas.
“Wear a gown if soiling of clothes with a resident’s respiratory secretions is anticipated.”	Our isolation gowns feature elastic cuffs for a more secure fit under gloves. They’re made from high-quality spunbonded polypropylene.
“Administer the current season’s influenza vaccine to unvaccinated residents and healthcare personnel as per current vaccination recommendations.”	ProMed’s safety syringes are ideal for flu vaccines and medication delivery.

To read the CDC’s complete guidance, click here.

ProMed also stocks products to help ill residents manage their flu symptoms, including facial tissue, electrolyte drinks and disposable bedside bags.

Professional Medical has everything you need to develop a comprehensive flu prevention and management strategy. To learn more, contact your territory manager, give us a call at (800) 648-5190 or visit us online at promedsupply.com.

Reference

1 Centers for Disease Control and Prevention. Interim Guidance for Influenza Outbreak Management in Long-Term Care Facilities. Available at: http://www.cdc.gov/flu/professionals/infectioncontrol/ltc-facility-guidance.htm. Accessed January 22, 2013. 

Study: Families Interfere with End-of-Life Care

According to a survey conducted in Canada and France, a majority of LTC professionals believe that relatives of dying residents interfere with end-of-life care.

When asked whether they agreed with the statement "family members tend to interfere in the care of residents at the end of life," 50 percent of respondents said "somewhat agree" and 22 percent said "strongly agree."

According to follow-up interviews, the LTC professionals believe that residents' families something exhibit "problematic behaviors" and create "dysfunctional situations" when their loved ones are dying.

The researchers hypothesized that cultural differences between caregivers' approach to end-of-life care and families' expectations could help explain the responses.

To learn more, click here.

CDC Launches New LTC Infection Control Website

The CDC has launched a new website to help long-term care facilities meet their infection control goals. The site offers information for clinicians, infection control coordinators and residents.

Topics on the site include, among others:

• Antibiotic stewardship
• Dialysis safety
• Hand hygiene 

Users will also find links to to the CDC's National Healthcare Safety Network and other resources that the CDC developed in partnership with the Advancing Excellence in America's Nursing Homes Campaign. 

Click here to access the site.

Shingles Tied To Higher Likelihood of Stroke, Heart Attack

A new study has found that having shingles while young increases a person's risk of heart attack or stroke later in life.

Shingles, which presents as a painful rash, lies dormant in the nerve roots of anyone who has had the chicken pox.

During the study, researchers found that people aged 18 to 40 who had had shingles were more likely to have a stroke, warning stroke or heart attack later in life.

Other findings included:

• People under 40 were 74 percent more likely to have a stroke if they had shingles 
• The sane group 2.4 times more likely to have a warning stroke if they had shingles
• People under 40 were 50 percent more likely to have a stroke if they had shingles

The researchers urged anyone who has had shingles, especially younger people, to be screened for stroke risk factors. 

To learn more, click here.

Be Skin Smart This Winter

The weather outside has certainly been frightful lately – and it can do a number on the already-delicate skin of your residents. As we age, our skin is likely to become drier due to the natural loss of oil glands, which help keep skin soft. Combine this with the dry air created by indoor heating and you have the perfect recipe for dry, flaking or cracking skin.

What can you do to keep your residents – and yourself – comfortable?

Here are eight ideas:

1. Ask your supplier or a dermatologist which products they would recommend to deliver extra moisture to skin that is battered by the winter elements.
2. Moisturize resident skin more often with a product that creates a protective layer on the skin to help retain moisture, such as Embrace Skin Repair Cream.
3. If residents will be going outside, apply sunscreen to their faces and hands (if they're exposed). Winter sun, especially when combined with glare from snow, can damage skin.
4. The skin on our hands is thinner and contains fewer oil glands, which makes it harder to keep hands moisturized in the winter. When your residents go outside, make sure they're wearing gloves (and remember that wool gloves can cause irritation to the skin).
5. If residents come back into the building wearing wet socks or gloves, remove them immediately to reduce the likelihood of itching, cracking, sores or even eczema flare-ups.
6. Consider placing several small humidifiers throughout the building. These put more moisture into the air, which helps prevent skin dryness.
7. To keep residents' feet moisturized, seek out a lotion that contains petroleum jelly or glycerin, such as Embrace Moisturizing Hand & Body Cream.
8. Keep in mind that super-hot baths and showers can break down the lipid barriers in the skin, leading to moisture loss.

ProMed's exclusive Embrace skin care line is designed to provide best-in-class care to delicate skin. To learn more, contact your ProMed territory manager, give us a call at 800.648.5190 or click here.

Flu Season Update

According to the CDC, 40 states are currently reporting widespread flu activity. To be considered widespread, flu activity needs to be reported in more than 50 percent of a state's geographic regions.

In the past week, the proportion of deaths attributed pneumonia and influenza increased and moved above the epidemic threshold for the first time this season.

There have been 3,745 laboratory-confirmed influenza-related hospitalizations since October 1, 2013. The highest hospitalization rates are among those 65 older and children younger than five years old. This is typical of most flu seasons.

The most common strain of flu this year is Influenza A, or H1N1. After causing a pandemic in 2009, H1N1 has established itself in the human population and is no longer referred to as swine flu. In fact, it's become so common that it was included in this year's vaccine. This is the first season that H1N1 has circulated at high levels since the pandemic in 2009.

Typically, the flu continues to spread in January and peaks either in January or February before tapering off. The CDC expects that the flu season will continue for some time, especially in parts of the country that are seeing recent increases in flu and those that have yet to experience significant activity

The CDC emphasizes that anyone aged six months or older who has not received a flu shot should get one now.

To learn more, click here. 

Congress Urged to Help Keep Holocaust Survivors Out of LTC Facilities

A group of experts has urged Congress to make an effort to keep Holocaust survivors out of institutional long-term care facilities because they can trigger post-traumatic stress disorder for the survivors.

Instead, the Holocaust Survivors Foundation USA and The Generation After Inc. urged Congress to help survivors receive home care so that they could live out their lives in the comfort of their own homes.

According to the experts who presented to the Senate Special Committee on Aging, being confined and receiving instruction or orders from uniformed personnel can trigger highly disturbing memories or PTSD in survivors. Routine events such as visiting the shower room or being asked to fill out paperwork can also be triggers. These effects are often worse for residents with dementia, they added.

However, providing home care for the survivors has its own set of challenges since these individuals tend to have more complex medical needs than average seniors.

To learn more, click here.

Five Wintertime Concerns for Seniors

Winter can be unpleasant for just about anybody, but seniors face a special set of risks this time of year. According to A Place for Mom, the following are five hazards of winter that seniors and their caregivers should keep an eye out for the following:

1. Snow, cold and ice. Winter weather can cause seniors to fall and make driving hazardous. Cold temperatures can also lead to hypothermia and frostbite. According to the CDC, seniors account for more than half of annual hypothermia deaths. 
2. Social isolation. The weather conditions listed above can cause seniors to withdraw and not leave their homes. Family and friends can help alleviate this by visiting loved ones or arranging transportation for them through the local senior center. 
3. Flu. Seniors are especially susceptible to the flu because they have weakened immune systems. The flu vaccine and proper hand hygiene can help ward it off. 
4. Seasonal Affective Disorder (SAD). Many people get the blues during the winter due to a decrease in daytime light. Be sure to open blinds and curtains to take advantage of what light there is and consider investing in a light therapy system. 
5. Sundowners Syndrome. Sundowners Syndrome, which manifests as increased memory loss, confusion, agitation and even anger during the evening hours, can be exacerbated during winter because of the decrease in daytime light. Establishing a routine, opening curtains and blinds and creating a relaxing environment can help prevent or minimize this. 

To learn more, click here.

FDA Asks Healthcare Professionals to Stop Prescribing Combination Drug Products Containing More Than 325 Mg of Acetaminophen

On January 14, the FDA recommended that healthcare professionals stop prescribing and dispensing combination drug products that contain more than 325 milligrams (mg) of acetaminophen.

According to the agency, there is no data that shows taking more than 325 mg of acetaminophen per dosage unit provides additional benefits that outweigh the risk for liver injury. They also note that limiting the amount of acetaminophen consumed will reduce the risk of severe liver injury from inadvertent overdose, which can lead to liver failure, liver transplant and death.

The FDA is recommending the following:

• That healthcare providers consider prescribing combination drug products that contain 325 mg or less of acetaminophen 
• That pharmacists call prescribers to discuss a product with a lower dosage of acetaminophen when they receive a prescription containing more than 325 mg of acetaminophen
• That prescribers always consider the amounts of both acetaminophen and opioid components when making individual dosing determinations

To learn more, click here. 

Great New Products for the New Year!

2014 is bringing great new products from Professional Medical! We've listened to your requests and feedback and added a number of items to our already-great product lineup. We're confident that they will help you meet your goal of providing the best possible care to your residents.

All of these products will debut in coming weeks:

Embrace® Skin Caring Stretch FlexRight® Briefs feature standardized sizing that allows you to stock fewer products, freeing up valuable storage space, saving caregiver time and reducing your costs. The fully breathable stretch panels on the briefs create a comfortable fit that moves with the resident. The brief will initially be available in M/R and L/XL sizes, with a bariatric size arriving later in 2014.

Embrace Anti-Itch Skin Protectant with Calamine & Menthol soothes skin and promotes healing. Zinc oxide forms a barrier that helps prevent and heal skin irritations related to urine, diarrhea, perspiration, drainage and leakage, minor burns and cuts and scrapes.

Embrace Antifungal Skin Protectant with Breathable Barrier treats and helps prevent athlete's foot, ringworm, jock itch and other superficial skin infections. It also helps to relieve itching, cracking, scaling and discomfort related to these conditions.

The CareSens® N Blood Glucose Monitoring System provides the convenience of a no-code meter with the rapid, reliable test results you need – all from a small 0.5 μ blood sample. We also offer the CareSens N Voice®, which has all of the great features of the CareSens N with an added "talking" function.

Our Compliance® String, Mobile and Flex Alarms have been updated and now offer an "always-on" feature that eliminates caregivers needing to remember to turn on the alarms. The Flex Alarm is also compatible with existing nurse call systems as well as our universal chair and bed sensors, seat belt systems and floor sensor pad.

Embrace Stretch Synthetic Exam Gloves and Compliance Synthetic Exam Gloves are now packaged in 150-count boxes that reduce order frequency and free valuable storage space while fitting in existing glove box holders.

To learn more, contact your ProMed territory manager, give us a call at (800) 648-5190 or visit us online at www.promedsupply.com.

Welcome Visitors (But Not Their Germs)

With flu season in full swing, it's crucial that everyone entering your facility perform proper hand hygiene. Nursing home staff, residents and visitors should all work together to kick germs to the curb.

Who, what, when?

The CDC recommends that residents take a proactive role in encouraging their guests to practice good hand hygiene while at the facility. Residents, guests and staff should clean their hands1:

• Before preparing or eating food
• After using the restroom
• After blowing their noses, coughing or sneezing
• Before touching their eyes, nose or mouth
• After touching surfaces that could be contaminated with germs, including bed rails, bedside tables, doorknobs, remote controls and the telephone

Additionally, staff members at long-term care facilities should clean their hands before donning gloves (gloves alone aren’t enough to halt the spread of infection), after removing gloves and every time they enter a resident room.1

Many facilities have found that placing pump-top bottles of hand sanitizer just inside the entrance to the building along with a flyer asking guests to sanitize their hands is a great way to help keep germs from entering the building. These bottles and signs can also be placed in other common areas of the facility where guests and residents are likely to congregate.

Soap or sanitizer?

The CDC recommends that hands are washed with soap and water whenever they look dirty, after using the bathroom and before eating or preparing food. Alcohol-based hand sanitizers are appropriate when there is no visible dirt on the hands or when soap and water are not available. Keep in mind that hand sanitizers should contain between 60 and 95 percent alcohol.

Reference
Centers for Disease Control and Prevention. Hand Hygiene Saves Lives: A Patient’s Guide. 
Available at: http://www.cdc.gov/handhygiene/PDF/CDC_HandHygiene_Brochure.pdf. Accessed January 13, 2014. 

Flu Season Peak Approaching

According to the CDC, 35 states are reporting widespread flu activity. To be considered widespread, flu activity needs to be reported in more than 50 percent of a state's geographic regions. The most severe activity is in the South and Southwest.

According to the CDC, this year's flu season is less severe than last year's and is fairly typical. The only thing out of the ordinary is that the most common strain of flu this year is H1N1. After causing a pandemic in 2009, H1N1 has established itself in the human population and is no longer referred to as swine flu. In fact, it's become so common that it was included in this year's vaccine.

Typically, the flu continues to spread in January and peaks either in January or February before tapering off.

To learn more, click here.

Medicare Reimbursement Cuts Extended to 2023

Under the federal budget deal that was created in December, LTC providers will fave two additional years of reduced Medicare reimbursements. The 2 percent reduced reimbursements, which were implemented in 2013 originally set to expire in 2021, have now been extended to 2023. The extension was implemented as a means to offset increased spending while other programs receive relief from sequestration cuts.

To learn more, click here.

Study: Tired Nurses More Likely to Regret Clinical Decisions

A new study has found that tired nurses are more likely to regret decisions they make on the job.

The study, which was conducted by researchers at the University of Illinois-Chicago College of Nursing and University of Michigan-Ann Arbor, involved quizzing more than 600 critical care nurses about their sleep routines, clinical decision-making and levels of fatigue and daytime sleepiness.

The researchers found that nurses who reported fatigue, sleep loss, daytime sleepiness and insufficient recovery between shifts were more likely to report "decision regret," which happens when an expected or hoped-for clinical outcome doesn't happen, leading nurses to doubt their choices.

To learn more, click here.

FDA Scrutinizing Antibacterial Soaps

In December, the FDA announced that it plans to take a 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.

What you need to know now:

• Under the FDA's proposal, manufacturers of antibacterial soaps would be required to provide more substantial data to demonstrate the safety and effectiveness of antibacterial soaps.
• The proposed rule would only cover consumer-grade antibacterial soaps and body washes that are used with water. It would not apply to antibacterial soaps that are designed for use exclusively in healthcare settings or alcohol-based hand sanitizers or hand wipes.
• The agency is asking consumers, clinicians, environmental groups, scientists, industry representatives and others to weigh in on this proposal in the next 180 days.

At this point, the FDA's proposal is preliminary and the agency has not officially recommended that anyone discontinue use of antibacterial soaps.

ProMed will continue to closely monitor this issue and share any updates with you. You should also know that our DermaKleen antibacterial hand soap does not contain triclosan or triclocarban. Our territory managers are ready to help you choose the ideal product for your needs as well as address any concerns you might have. To connect with us, give us a call at (800) 648-5190 or visit us online at promedsupply.com.

To learn more, click here.

Stay Skin Smart This Winter

Cold weather can zap the moisture right out of skin, leaving it dry, itchy and flaky. Your residents' skin, just like yours, needs extra TLC during the winter to keep it soft and supple.

There are two main factors that affect skin during the winter: a lack of moisture in the air and colder temperatures. When there is less moisture in the air, the water that skin naturally produces to protect and seal itself evaporates more easily, causing skin to become dry and cracked. Skin that is exposed to the cold winter air is vulnerable to conditions like frostbite and pernio, a painful inflammation of the small blood vessels in response to sudden warming from cold temperatures.1

Luckily, there are a number of simple steps you can take to protect your residents' delicate skin from winter weather, including:

• Ask your supplier which products they would recommend to deliver extra moisture to skin that is battered by the elements. Some products, including Embrace Moisturizing Cleanser & Skin Protectant with Breathable Barrier, can perform a number of skin care functions, eliminating the need for multiple products.
• Moisturize resident skin frequently with a product that creates a protective layer on the skin to help retain moisture, such as Embrace Skin Repair Cream or Embrace Moisturizing Hand & Body Cream.
• If residents will be going outside, apply sunscreen to their faces and hands and make sure they are wearing hats, mittens and scarves to protect their skin from the cold. If their clothing gets wet, change it as soon as possible. Damp clothing can lead to skin breakdown, itching, sores and eczema flare-ups.
• Consider placing several small humidifiers throughout the building. These put more moisture into the air, which helps prevent skin from becoming dry.

Professional Medical's exclusive Embrace skin care line can help you provide top-notch year-round skin care to your residents. To learn more, contact your territory manager or give us a call at (800) 648-5190.

Reference

1 The Mayo Clinic. Simple Self-care Steps Can Ensure Healthy Skin, Even During Winter Weather. Available at: http://129.176.211.24/medical-edge-newspaper-2011/nov-25b.html. Accessed January 6, 2014. 

CNAs Most Likely to Have C. diff on Their Hands

A new study has found that, among healthcare workers, CNAs are the most likely to have C. diff spores on their hands after providing routine care to an infected person.

During the study, the researchers examined caregivers' hands after they came into contact with infected patients in a hospital infection control unit. The caregivers observed protocols including wearing disposable gowns and full-length sleeves and gowns.

The researchers found that approximately one-quarter of the workers had spores on their hands after providing care. They noted that the spores were more likely to be found after high-risk contact, such as rectal exams or changing bed linens. Since these tasks are frequently performed by CNAs, it could explain their higher likelihood of having C. diff on their hands.

Below is the reported likelihood for each type of caregiver to have C. diff spores on their hands:

• CNAs: 42 percent
• Physicians: 23 percent
• Nurses: 19 percent 

The researchers stressed that their results emphasize the importance of proper hand hygiene. 

To learn more, click here. 

Nuts Linked to Longer Life

Looking for a filling snack that could have the side benefit of prolonging your life? Reach for a handful of nuts.

According to researchers from Brigham and Women's Hospital and Harvard Medical School, people who consume nuts regularly are less likely to die from a variety of diseases, including cancer, heart disease and respiratory diseases.

The researchers found that people who eat nuts seven or more times a week experience a 20 percent lower death rate after four years than people who do not eat nuts. They also found that nut eaters tend to be leaner, more physically active and less likely to smoke. During the study, the researchers asked specifically about how often the participants consumed almonds, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios or walnuts.

Previous research has found that nuts are high in unsaturated fats, protein, vitamins and antioxidants that are thought to be linked to a decreased risk for heart disease.

To learn more, click here.