Indiana Seniors: Exempt LTC Facilities from Liquor Permits

A group of Indiana seniors is pushing for legislation that would exempt nursing homes and other LTC facilities from having to obtain liquor permits or pay excise taxes in order to serve alcohol to residents. 

The residents took up the cause after their facility was cited by state inspectors for violating the law. 

The Indiana Health Care Association supports the effort, adding that nursing homes shouldn't be held to the same rules as restaurants. Dennis Neary, IHCA's legislative and public affairs director, was quoted as saying, "This is a nursing home, not a nursing bar and grill." 

To learn more, click here. 

Study: People Who Feel Younger Live Longer

Need another excuse to not act your age?

Researchers in London have found that older people who felt three or more years younger than their chronological age had a lower death rate compared to those who felt their age or older. They also discovered that self-perceived age can affect assessments of health, physical limitations and well-being in later life.

The authors studied data from 6,489 people who averaged 65.8 years old but felt an average of 56.8 years old. They found that the mortality rates during an average follow-up of 99 months were 14.3 percent in adults who felt younger, 18.5 percent in those who felt about their age and 24.6 percent in adults who felt older than their actual age. There was a strong relationship between self-perceived age and cardiovascular death.

To learn more, click here.

Study: Anticholinergic Use Tied to Dementia

According to a new study, a higher use of anticholinergic medications can be linked to an increased risk of developing dementia. An anticholinergic is a substance that blocks the neurotransmitter acetylcholine in the central and peripheral nervous system.

Many medications, including some available over the counter (such as sleep aids), have strong anticholinergic effects, the researchers found. The most commonly used medications in the study of 3,600 seniors were tricyclic antidepressants such as doxepin, first-generation antihistimanies such as chlorpheniramine (Chlor-Trimeton) and antimuscarinics for bladder control such as oxybutynin (Ditropan).

According to the research, those who took at least 10 mg/day of doxepin, 4 mg/day of diphenhydramine or 5 mg/day of oxybutynin for more than three years would be at an increased risk of developing dementia.

To learn more, click here.

Now Available: Embrace and Compliance Flushable Wipes

Two exciting new products are now available from brands you know for their superior performance and great value. ProMed’s exclusive Embrace® and Compliance® Flushable Washcloths are made of natural biodegradable fibers that disperse just like toilet paper during flushing. They’re the perfect addition to your skin care regimen!

Additional features:

• Biodegradable
• Dispersible
• Safe for sewers and septic systems when used as directed
• Latex- and alcohol-free
• Contain skin-softening aloe
• pH balanced and hypoallergenic

The wipes are comparable to Cottonelle FreshCare Flushable Cleansing Cloths, DUKAL Flushable Wet Wipes, Dynarex Flush Away Flushable Wipes, Medline ReadyFlush Biodegradable Flushable Wipes, PDI Hygea Flushable Cleansing Cloths and TENA Flushable Washcloths.

Contact your ProMed territory manager to learn more about the new wipes! You can also give us a call at (800) 648-5190 or visit us online at promedsupply.com for additional information.

Product Safety Alert: Baxter Acetic Acid Irrigation

Baxter Healthcare has received reports of customers mistakenly using the 0.25 percent Acetic Acid Irrigation (ProMed item number 020-2F7184) when the use of a different Baxter irrigation product was intended. If an error is made and the wrong product is used, the potential for an adverse event to occur is high.

In the wake of these reports, Baxter has decided the update the product label of the 0.25 percent Acetic Acid to better differentiate it from the product labels of Sterile Water for Irrigation and 0.9 percent Sodium Chloride for Irrigation.

In the meantime, Baxter is asking that facilities carefully read product labels prior to use.

If you have any questions, please contact Professional Medical at (800) 648-5190.

Study: Rural Nursing Homes Do Better with One RN Per Four CNAs

According to a new study, rural nursing homes provide better care when they hit a staffing ratio of one full-time registered nurse for every four CNAs.

The researchers found that rural facilities who hit this ratio "significantly improved" their composite scores for long-stay residents. The score took into account a number of individual quality indicators, such as pressure ulcer and UTI prevalence.

The reasons for this are not immediately clear, the researchers noted. They did observe that increasing RN hours resulted in fewer physical restraints and that increasing CNA hours improved pressure ulcer and ADL outcomes.

To learn more, click here.

Wrap Your Residents In Warmth This Winter

The weather outside might be frightful, but ProMed is ready to help you keep your residents warm and cozy this winter. We’ve created a Textile and Linen Solutions catalog that features specially selected items to help you meet your goal of delivering great care while remaining budget-conscious. To download and view the catalog, click here.

Be sure to check out the following chill-chasing items:

• Woven and ribbed blankets and spreads in a spectrum of colors
• Quilted spreads in both solid colors and stylish prints
• Bath blankets to keep residents warm and protect modesty

You might also be interested in the following everyday essentials featured in the catalog:

• Premium, standard and knitted sheets
• Reusable and disposable pillows with non-woven or vinyl bodies
• Premium and standard white terry in multiple weights
• Colored terry for color-coding by use, department or resident
• Generously cut clothing protectors in terrycloth and flannel
• Reusable underpads in a variety of absorbencies
• Related items such as mattresses, laundry carts and hampers

To learn more about our comprehensive Textiles and Linen product category, contact your ProMed territory manager, give us a call at 800.648.5190 or visit us online at promedsupply.com.

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, take a look at the references below.

References
1 U.S. Food and Drug Administration. Hospital Beds. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/GeneralHospitalDevicesandSupplies/HospitalBeds/default.htm. Accessed January 19, 2015.

2 U.S. Food and Drug Administration. Hospital Bed System Dimensional and Assessment Guidance to Reduce Entrapment. Available at: http://www.fda.gov/RegulatoryInformation/Guidances/ucm072662.htm. Accessed January 19, 2015.

CDC: Flu Vaccine Only 23 Percent Effective This Year

According to new data released by the CDC, this year's flu vaccine is only 23 percent effective at preventing medical visits associated with seasonal flu. The vaccine is typically between 10 and 60 percent effective.

The CDC said these findings indicate that physicians should be aware that all hospitalized patients and all outpatients who are at high risk for flu complications should be treated as soon as possible with one of three available influenza antiviral medications if the flu is suspected, regardless of whether or not the patient has been vaccinated.

Individuals who are high risk for complications include:

• Children and infants
• Pregnant women
• Senior citizens
• People with disabilities
• People with heart conditions
• Travelers and people living abroad 

To learn more, click here.

Incontinence Products: Change When Wet or Change When Needed?

Do you change your residents' incontinence management products as soon as they're wet, or only when it's necessary? Many of today's products are made using advanced technology that allows a single brief to hold multiple voids without sacrificing resident comfort or skin health.

Facilities using the "change when wet" strategy change a brief as soon as the wetness indicator shows that any wetness is present. The "change when needed" strategy, on the other hand, calls for changing the product only when two to three fingers' width of wetness is shown on the indicator. Of course, if fecal matter is present, the brief is changed right away.

The "change when needed" strategy is a guideline rather than a hard and fast rule. Caregivers should use their experience with an individual resident to determine whether it would be a good fit for that person. When used correctly, this strategy can reduce the number of changes per day that a resident has to endure, which in turn helps promote resident dignity.

This strategy is especially beneficial for nighttime changes. Research has found that residents who spend less of the night asleep are more likely to nap during the day, are at a higher risk for falls and are at risk of shorter survival. Additionally, when residents are exposed to room-level light in the middle of the night, their circadian rhythms can shift, further upsetting their sleep patterns.1

Extended-use and overnight absorbent products offer a higher total capacity, which can reduce the number of changes needed at night. A high-capacity product, combined with the "change when needed" strategy, can equal a peaceful night for the resident.

Your ProMed territory manager can help you develop a protocol that fits your residents' individual needs. To learn more, contact your territory manager, give us a call at (800) 648-5190 or visit us online at promedsupply.com.

Reference
1 Martin JL, Ancoli-Israel S. Sleep Disturbances in Long-Term Care. Clin Geriatr Med. Feb 2008;24(1):39-vi.

Avoid Oxgen Concentrator Rain-Out This Winter

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.

Why Your Facility Needs Lifts

Safe lifting programs benefit everyone in your facility, from residents to caregivers and management. Numerous studies have shown that mechanical lifts are a key component of these programs and are preferable to training caregivers to use body mechanics because lifting adult residents is inherently unsafe.

If you haven’t yet invested in mechanical lifts for your facility, we invite you to consider the following benefits they provide.

Benefits for residents:

• Improved quality of care, safety, comfort and satisfaction
• Reduced risk of falls, being dropped, friction burns and dislocated shoulders
• Reduced likelihood of skin tears and bruises

Benefits for caregivers:

• Reduced risk of injury
• Improved job satisfaction and morale
• Pregnant caregivers can work longer
• Staff can work to an older age
• Caregivers have more energy at the end of their shifts
• Less daily pain and muscle fatigue
• Previously injured caregivers are less likely to be re-injured

Benefits for employers:

• Reduced number and severity of staff injuries
• Lower workers’ compensation medical and indemnity costs
• Improved resident safety
• Reduced lost and restricted workdays
• Less overtime and sick leave
• Improved recruitment and retention of caregivers
• Fewer resources required to replace injured staff

As a general rule, one full-body lift should be provided for every eight to 10 non-weight-bearing residents and one stand-up lift should be provided for every eight to 10 partially-weight-bearing residents.1

Concerned about cost? Research has shown that the monetary investment in lifting equipment and training can be recovered through reduced workers’ compensation expenses and costs associated with lost and restricted work days.

If you’re updating your safe lifting program, we encourage you to review the Sample Lift Program Policy and Guide that we recently added to our website. You can find this guide, which is based on OSHA recommendations, under Clinical Documentation on the product pages that feature lifts.

Whether you’re looking to purchase your first lifts or replace aging equipment, your ProMed territory manager is here to help. To connect with us, 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/National Institute for Occupational Safety and Health. Safe Lifting and Movement of Nursing Home Residents. Available at: http://www.cdc.gov/niosh/docs/2006-117/pdfs/2006-117.pdf. Accessed January 7, 2015.

Study: Nursing Home Occupancy Steady, Independent Living Rises Again

According to new information from the National Investment Center for Seniors Housing & Care, occupancy rates for nursing homes held steady in the fourth quarter of 2014 while the rate for independent living continued to increase.

The nursing home occupancy rate was reported as 88.3 percent and assisted living was 89 percent. Independent living grew 0.4 percentage points from the previous quarter to reach 91.3 percent.

To learn more, click here.

Study: Insulin Nasal Sprays Help Ease Alzheimer's Symptoms

Newly published research demonstrates that taking a man-made form of insulin nasal spray improves memory and cognition in people with mild to moderate Alzheimer's disease. 

The researchers found that subjects who took the nasal spray for 21 days showed significant improvement in being able to retain and process verbal and visual information in the short term. Improvements were even seen in people who have the APOE-e4 gene, which has been historically resistant to other therapies and interventions. 

Insulin has been shown to play a part in memory processes and regulating blood sugar. Nasal insulin sprays have the benefit of allowing insulin to reach the brain without creating a blood sugar imbalance. 

To learn more, click here. 

Researchers: New Antibiotic Could Be Valuable Weapon Against MRSA

According to new research, a recently discovered type of antibiotic could be a "silver bullet" of sorts against potentially fatal infections that are common in LTC facilities. It could also potentially be a breakthrough in the fight against antibiotic-resistant bacteria.

The antibiotic, called teixobactin, has the ability to rapidly clear infections. It attacks substances in the cell walls of harmful bacteria. Other antibiotics target bacterial proteins. Bacteria such as MRSA can begin producing different proteins, making them resistant to drugs. The researchers say it is highly unlikely that bacteria will become resistant to teixobactin.

Teixobactin is only effective against bacteria that have a cell wall, so it won't work on infections such as E.coli.

Although it could be two years before human trials with teixobactin begin, the researchers said they are excited about the implications of their work.

To learn more, click here.

Study: Failure to Administer Meds, Inadequate Supervision Tied to UTIs

Researchers have found that lapses in nursing care are significantly linked to the incidence or urinary tract infections, or UTIs.

The researchers found that there are seven categories of care linked to UTI incidence. The categories with the strongest correlation were failure to administer medications and lack of adequate supervision. These two categories accounted for 40 percent of the variance in the perfect of residents with UTIs.

The information the researchers studied was culled from Nursing Home Compare data and New Jersey state survey data.

To learn more, click here.

Start the New Year with a Perfect Survey

Does having a perfect survey in 2015 top your list of resolutions? If so, ProMed can help make that goal a reality.

Compliance Solutions: For the Perfect Survey Every Day, our exclusive Web-based survey preparation tool, is available at no charge to dedicated ProMed customers. The site will help you prepare for both the traditional and QIS survey and includes access to:

• The actual forms that surveyors use
• Exclusive tips from industry veterans
• Resources for tracking your survey preparedness
• Case studies to help you address how you would handle specific challenges in your own facility
• And much more!

New information is added on a monthly basis and the site is regularly updated to reflect updates from the Centers for Medicare & Medicaid Services (CMS).

To learn more and register for Compliance Solutions: For the Perfect Survey Every Day, contact your ProMed territory manager or give us a call at (800) 648-5190.

Study: Outdoor Exercise Promotes Energy, Happiness for Middle-Aged Women

If you're a middle-aged woman and you've resolved to exercise more in 2015, researchers have a recommendation for you: head outdoors.

A small Canadian study found that women in their 50s and 60s who exercised outdoors exercised for longer and seemed to be happier than those who exercised indoors. The outdoor exercisers also showed a decrease in depressive symptoms and increased activity levels outside of the exercise sessions. The study's control group of women who exercised indoors didn't see a change in their general activity levels.

The study's senior author said that similar results have been shown in studies involving younger women.

To learn more, click here.