Why Do We Do That On Halloween?

Have you ever wondered how Halloween traditions such as trick-or-treating, carving pumpkins and dressing in costume got started? We have the answers!

Why do kids trick-or-treat on Halloween?

Trick-or-treating originated on All Souls' Day during the Middle Ages, when poor people in Great Britain would beg for soul cakes, described as a sweet-bread treat, and promise to pray for the donor's 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.

Why do we carve pumpkins?

The tradition of carving pumpkins began in Ireland, where turnips were hollowed out, carved into a representation of a human face and illuminated with a candle. Children commonly carried these "turnip lanterns" door to door to represent the dead when begging for soul cakes. 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.

Why do we wear Halloween costumes?

Hundreds of years ago, people believed that ghosts could come back to the earthly world on Halloween. To avoid being recognized by these ghosts when they left their homes at night, they would wear scary masks that they believed would make the ghosts mistake them for fellow spirits. The tradition has evolved over the years and now many costumes are more fun and less frightening.

Does your facility have any special Halloween traditions? We'd love for you to share them with us – and your colleagues in long-term care – on our Facebook page!

Research: Hearing Aid Adjustment Helps Residents Enjoy Music More

According to researchers at the University of Colorado Boulder, nursing home residents enjoy music more if their hearing aids are adjusted before it's played.

The researchers found that current hearing aid technology makes it easier to follow conversations, but distorts music. These hearing aids use a technology called wide dynamic range compression, which boosts softer sounds while providing less amplification to loud sounds. This technology isn't ideally suited for listening to music, which commonly uses multiple volume levels during a single song. Instead, a hearing aid that boosts volume across the board is a better fit.

Many modern hearing aids can be adjusted to perform this way (it's actually the way many older models functioned). The key is that clinicians know to make the adjustment before residents listen to music.

To learn more, click here.

Today Is World Stroke Day

October 29 is World Stroke Day. Established by the World Stroke Organization in 2006, this day was designed to help spread public awareness of stroke risks and prevalence.

Stroke is the fourth most common cause of death in the U.S. The American Heart Association and American Stroke Association encourage everyone to learn the F.A.S.T. stroke warning signs, which are:
F: Face drooping
A: Arm weakness
S: Speech difficulty
T: Time to call 911

Additional signs of a stroke include sudden trouble seeing, dizziness, confusion, severe headache and weakness on one side of the body.

To learn more about World Stroke Day, click here.

Report: Increase Flu Vaccine Compliance By Requiring Unvaccinated Workers To Wear Masks

According to a new report, making unvaccinated healthcare workers wear face masks is a highly effective way of increasing flu vaccine compliance.

A new rule put into place in New York state during the 2013-'14 flu season required unvaccinated workers to wear masks while flu was deemed prevalent in the state. The rule is being credited with increasing flu vaccine compliance in the state from 60.5 percent to 87 percent, with some facilities reporting 98 percent compliance.

To learn more, click here.

Report: Falls Top Reason for LTC Lawsuits

According to a new report, falls continue to be the number one reason for lawsuits against skilled nursing and other LTC facilities.

The report, which was issued by an insurance company, stated that falls accounted for 41.5 percent of closed professional liability claims against nonprofit skilled facilities between 2012 and 2013. However, this figure was actually down from nearly 44 percent for the time period between 2007 and 2011.

Falls greatly surpassed the second most common reason for lawsuits, pressure ulcers, which represented just 17.5 percent of closed claims.

The most common allegations of reasons for falls were failure to monitor, improper care and unsafe environment.

To learn more, click here.

Canadian Researchers Develop One-Hour Test for Sepsis

A new test developed in Canada could reduce the time needed to diagnose sepsis to just one hour. The current time needed for a sepsis diagnosis is 24 to 48 hours.

The diagnostic test, which would look for a specific gene signature, has not yet been developed, but the technology for it exists. According to the developers, the test could work by a resident providing a blood sample that is then tested through technology including mass spectrometry. If the gene signature is found, it would indicate that sepsis will develop and organ failure will follow.

To learn more, click here.

CDC Updates PPE Requirements for Ebola Patient Care

The CDC recently updated its guidance on the personal protective equipment, or PPE, to be used by healthcare workers managing patients with the Ebola virus. The agency now recommends the following:

• An N95 respirator in combination with a surgical hood and full face shield or a PAPR with a full face shield, helmet or headpiece
• A disposable fluid-resistant or impermeable gown that extends to at least the mid-calf or a coverall without an integrated hood
• Two pairs of disposable nitrile examination gloves with extended cuffs 
• Disposable fluid-resistant or impermeable boot covers that extend to at least mid-calf or disposable shoe covers 
• A disposable fluid-resistant or impermeable apron that covers the torso down to the mid-calf level (this is only necessary when caring for Ebola patients who are vomiting or have diarrhea) 

Additionally, the CDC noted that all healthcare workers involved in caring for Ebola patients must receive repeated training and have demonstrated competence in performing all Ebola-related infection control practices and procedures.

To read the complete guidance, click here.

Get Ready for Flu Season 2014

The CDC has released its guidance for the 2014-’15 flu season, which could begin at any time and last until as late as May. The agency recommends that healthcare facilities implement five core infection prevention strategies to halt the spread of flu.

The flu vaccine

The CDC recommends that everyone over the age of 6 months, including all healthcare workers and nursing home residents, receive a flu shot unless contraindicated. This year’s flu shot is designed to protect against the main flu viruses that research suggests will cause most of the season’s illnesses. It takes about two weeks after vaccination for flu antibodies to begin developing and providing protection, so the vaccine should be administered as soon as it is available.

Implement respiratory hygiene and cough etiquette 

Respiratory hygiene and cough etiquette should be observed by all healthcare workers as well as all visitors, both at their arrival and throughout the duration of their visits. The CDC recommends posting visual alerts, such as signs and posters, at the entrance and throughout the facility containing information on how and when to perform these procedures. Supplies such as hand sanitizer, tissues and masks should also be readily available for staff, residents and visitors.

Monitor and manage ill healthcare workers 

Healthcare workers who develop a fever and respiratory symptoms should be instructed not to report to work. If they are already at work, they should stop all resident-care activities, don a facemask and notify their supervisor and infection control contact. The ill worker should not return to work until at least 24 hours after they no longer have a fever (without the use of fever-reducing medicines).

Adhere to infection control precautions

When caring for a resident with the flu, all healthcare workers should observe standard precautions, droplet precautions and exercise caution when performing aerosol-generating procedures (such as bronchoscopy, sputum induction, elective intubation and extubation).

Implement environmental and engineering infection control measures

Standard cleaning and disinfection procedures should be performed in all settings within the facility, including resident-care areas in which aerosol-generating procedures are performed. When feasible, consider installing engineering controls that reduce or eliminate exposure, such as curtains that can be drawn between residents in shared areas.

For additional details on the CDC’s recommendations, click here.

ProMed stocks all of the products you need to fight the spread of flu and other infections in your facility, including:

• Hand hygiene products and dispensers
• Isolation products 
• Linen bags designed to handle infectious waste
• Surface disinfectants 

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

Ebola Resources for LTC

There are a lot of questions surrounding the recent Ebola outbreak. We've assembled the following list of links to help you find the answers you need both for yourself and your residents.

• CDC Ebola Update 
• Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Virus Disease in U.S. Hospitals
• WHO Global Alert and Response for Ebola 
• CNN's Coverage of the Ebola Outbreak
• Information for Ohioans from the Ohio Department of Health
• Ebola Updates from the White House

Report: Average Per-Day Rate for LTC Now $280

According to a new report, the average per-day rate for a nursing home is at $280 and is expected to rise to $284 by the end of the year. This represents a 3.6 increase over last year.

The report was conducted by California-based commercial real estate brokerage Marcus & Millichap, who said their findings show that the economy has turned a corner and that improvements in the housing market (namely, residents being able to access funds previously tied up in their homes) have also created favorable conditions for long-term care communities.

To learn more, click here.

Study: Increased Hospice Services Lead to Decreased Hospitalizations

According to a new report, increasing hospice services at nursing homes can reduce hospital admissions among all residents, including those not enrolled in hospice.

The researchers found that for every 10 percent increase in hospice expansion at a facility, the risk of hospitalization decreased 5.1 percent for non-hospice residents and 4.8 percent for residents enrolled in hospice.

According to the study's authors, their findings "shed light on nursing home end-of-life care delivery, collaboration among providers and cost benefit analysis of hospice care."

To learn more, click here.

Positioning Solutions from ProMed

Gone are the days of a "one-product-for-all-needs" mentality when it comes to positioning cushions. Today, there's a product for every situation.

We created the list below to help you select the perfect cushions for your residents’ individual requirements. All of these cushions are available from ProMed.

• Foam wheelchair cushions are inexpensive, lightweight, provide even support and are available in multiple densities.
• Gel wheelchair cushions provide excellent pressure redistribution and are very comfortable. 
• Gel/foam hybrid cushions combine the benefits of foam and gel cushions. 
• Air flotation (inflated cell) cushions can be inflated to the resident’s specific needs and can be modified to help relieve pressure sores. They are waterproof and will not bottom out when inflated properly. 
• Lap positioners provide upper torso support and can help assist with upper body alignment. They also serve as a gentle reminder to residents to stay seated.
• Abductor (pommel) cushions hold the legs slightly apart to help keep a resident’s hips and knees properly aligned and reduce forward sliding. They can also be used to help prevent hip dislocation following surgery.
• Wedge cushions offer improved posture and slide control.

To learn more, contact your ProMed territory manager, give us a call at 800.648.5190 or visit us online at promedsupply.com.

Do You Have a Cold or Allergies?

As the weather turns cooler, many of us start to sniffle and wheeze. Is it a cold or seasonal allergies?

According to the Mayo Clinic, while common colds are caused by viruses, seasonal allergies are an immune system response triggered by an allergen, such as ragweed. Colds can typically be relieved with rest, pain relievers and OTC remedies. Seasonal allergies, on the other hand, can be eased with OTC or prescription antihistamines, nasal steroid sprays and decongestants and avoiding allergens where possible.

The Mayo Clinic also assembled the chart below to help you examine your symptoms and get to the root of your discomfort.

Symptom	Cold	Allergies
Cough	Usually	Sometimes
Aches and pains	Sometimes	Never
Fatigue	Sometimes	Sometimes
Itchy eyes	Rarely	Usually
Sneezing	Usually	Usually
Sore throat	Usually	Sometimes
Runny nose	Usually	Usually
Stuffy nose	Usually	Usually
Fever	Rarely	Never

Study: Men Moving Into Memory Care at a Faster Rate than Women

According to new information from a large senior referral service, men are moving into memory care units at a 14 percent faster rate than women.

The referral service, A Place for Mom, also found that men in memory care are 30 percent more likely than women to be combative and are also more likely to wander.

In response to this trend, care providers are being trained on how to manage aggressive behavior and are also tailoring activities to appeal to men.

To learn more, click here.

Columbia University Study: Nursing Home Infections on the Rise

Researchers at the Columbia University School of Nursing and the RAND Corporation found that the rate of nursing home infections greatly increased between 2006 and 2010. Specifically, the researchers found that:

• The prevalence of viral hepatitis increased 48 percent
• MDRO prevalence increased by 18 percent
• Pneumonia prevalence increased by 11 percent
• The prevalence of urinary tract infections, septicemia and wound infections increased as well

The authors noted that further research is needed to determine the cause of the trend. In the meantime, they recommend that potential residents and their families seek out facilities with strong infection practices, including protocols to limit catheterizations, easy access to hand sanitizer and isolation rooms for infected residents. 

To learn more, click here. 

CMS: Hospices Can Keep Using Contract Nurses

In a memo dated October 3, CMS announced that hospices may continue to rely on contract nurses due to the ongoing nurse shortage that leaves them understaffed.

The memo states that under normal conditions, only direct hospice employees should provide "core services" such as nursing. However, exceptions can be made when facilities face "extraordinary circumstances," such as the current nursing shortage.

CMS added that when contract nurses are used, the hospice must maintain professional, financial and administrative responsibility for the services.

To read the memo, click here.

Let's Design a Custom Dispensing Solution

Has your facility considered custom chemical dispensing systems as a way to solve environmental hygiene challenges? They're designed to help your staff create a sparkling, homelike environment while saving space and money.

Benefits of custom dispensing systems include:

• They work with concentrated chemicals that offer significant cost savings (some as much as 50 percent) and take up less valuable storage space.
• The can be mounted both horizontally and vertically to work with any available space.
• They're easily modifiable to meet changing requirements.
• They can be configured to include multiple stations for both bottle and bucket fill.
• Configurations are available for food service, warewashing, laundry, housekeeping and more.

Professional Medical's territory managers have been trained to help you create a custom dispenser system for your facility. To learn more about available options as well as our high-quality cleaning products, call 800.648.5190 or visit us online at promedsupply.com.

CDC Issues Ebola FAQs

In the wake of the first confirmed case of Ebola in the United States, the CDC has issued a new document titled "What You Need to Know about Ebola."

Facts about the disease that are listed in this document include:

• A person infected with Ebola can't spread the disease until symptoms appear, which is typically 8 to 10 days after exposure. Symptoms include fever, severe headache, muscle pain, vomiting, diarrhea, stomach pain and unexplained bleeding or bruising. 
• Ebola is spread through direct contact with blood and other body fluids, including urine, feces, saliva, vomit, sweat and semen as well as through objects that have been contaminated with these body fluids. It is not spread through the air, water or food. 
• While there is no FDA-approved vaccine for Ebola, the CDC recommends individuals protect themselves through regular hand hygiene, by avoiding the body fluids of people who are sick, refraining from handling items that may have come into contact with a sick person's blood or body fluids and not touching the body of someone who has died of Ebola. 
• If you have traveled to an area where Ebola outbreaks are happening, you might be at risk of developing the disease if you had direct contact with blood or body fluids of someone who has the disease, touched bats or nonhuman primates (or their blood, fluids or raw meat), went into hospitals where Ebola was being treated or touched the body of a person who died of Ebola. 
• If you traveled to an area where Ebola outbreaks are occurring, you should check for signs and symptoms for 21 days. You should also call your doctor to have your risk level evaluated. 
• If you get sick after coming back from an area with an Ebola outbreak, get medical care right away. The CDC recommends calling ahead to the hospital so that they can adequately prepare for treating you. 

To view and download the FAQs, which are presented in a convenient PDF, click here.

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.