Study: Anticholinergics Increase Fall Risk In Older Men

A new study published in the Journal of the American Geriatrics Society found that older men who take specific commonly used medications have a higher risk of being injured in a fall.

The medications in question are those that have anticholinergic effects, which block the part of the brain that passes messages between nerve cells. These drugs are commonly prescribed to older people to help alleviate bladder problems, depression, psychosis, insomnia and respiratory problems. They can cause blurred vision, increased heart rate, sedation and confusion.

Interestingly, the researchers noted that the use of these drugs did not increase risks for women.

To learn more, click here.

Keep Residents Cool This Summer

The heat is fully cranked up here in Chicagoland! Are you taking steps to prevent heat-related emergencies at your facility? We assembled the following list to help you make sure you have all your bases covered. 

Make sure your building is summer-ready 

• Make sure that the temperature in your facility is safe and comfortable.
• Keep residents indoors in the air conditioning during heat waves.
• Close blinds or curtains to keep direct sunlight from entering rooms.
• Turn off unneeded lights (they emit heat).
• Use extra circulating fans to keep to keep air moving within your facility. Avoid using fans directed at individuals when the ambient temperature exceeds 100° F.

Be ready for anything 

• Many states issue Hot Weather Bulletins. Monitor the television or radio for important local heat-related announcements and be sure to follow your state's protocols during warm weather.
• Review your facility's emergency disaster plan. It should include:
• Up-to-date emergency telephone numbers
• Contingency plans in case the facility's air-conditioning system goes out
• An evacuation plan in case residents need to be moved to a "cooling center
• Be aware of the outdoor heat index (a measurement of what the hot weather "feels like") and take appropriate precautions.
• Remember that exposure to full sunshine can increase the heat index by up to 15 degrees.

Keep residents hydrated

• Consider establishing a hydration station in the facility, where water and other fluids are always available to residents and staff.
• Encourage residents to drink plenty of fluids. Water and fruit or vegetable juices are best.
• Offer residents extra fluids at regular intervals.
• Popsicles or freeze-pops are another alternative to fluids.
• If the resident has a fluid restriction, ask the physician for specific orders during hot weather.
• Avoid caffeine or sodas because these cause a person to lose more body fluid.

Analysis: Healthcare Workers Feel Jobs are Meaningful

According to a new analysis from PayScale, a compensation data website, many jobs that rank high both in terms of pay and meaningfulness are in the healthcare industry.

Eighty-two percent of healthcare practitioners felt their jobs were meaningful. This group includes individuals such as registered nurses, surgeons, specialized doctors, technicians and educators. This group also earned the highest median annual pay out of the 24 groups analyzed at $83,500 per year.

Seventy-eight percent of healthcare support workers, a group that includes home health aids, nursing aides, therapists and medical assistants, reported that their jobs were meaningful. Their median annual pay was $33,800.

To learn more, click here.

Keep Your Residents Safe in the Bathroom

According to the CDC, roughly 1,800 older adults living in nursing homes die every year from fall-related injuries. Those who fall and survive are still likely to suffer injuries that result in permanent disability and a reduced quality of life.1

Many of the falls that occur each year happen in the bathroom, with the majority involving injuries occurring in or around the tub or shower and on or near the toilet.2 To help combat bathroom falls, the CDC recommends making environmental changes that allow residents to move around more safely.1 Such modifications could include installing grab bars and raised toilet seats, among other bathroom safety tools.

ProMed stocks a complete suite of bathroom safety products to protect your residents and give you peace of mind, including:

• Portable commodes
• Raised toilet seats
• Shower and bath chairs
• Bath lifts
• Handheld shower sprayers
• Grab bars
• Tub rails
• Bath steps

To learn more about any of these products, contact your ProMed territory manager, give us a call at (800) 648-5190 or visit us online at promedsupply.com. We’re ready to help you create a comprehensive fall prevention plan!


References
1 Centers for Disease Control and Prevention. Falls in Nursing Homes. Available at: http://www.cdc.gov/HomeandRecreationalSafety/Falls/nursing.html. Accessed July 2, 2015.

2 Centers for Disease Control and Prevention. Nonfatal Bathroom Injuries Among Persons Aged ≥ 15 Years – United States, 2008. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6022a1.htm. Accessed July 2, 2015.

Study: Eye Drops Might Help Clear Cataracts, Reduce Need for Surgery

Researchers at the University of California, San Diego, have found that eye drops that contain a natural chemical could help seniors avoid cataract surgery.

The chemical, lanosterol, was shown to help prevent clumping of protein in the eyes that can lead to obstructed vision. The six-week study found that applying lanosterol drops to dogs with age-related cataracts decreased lens cloudiness and reversed the course of the disease.

The researchers noted that the drops likely won't clear up dense cataracts and that more research is needed before human trials could begin.

To learn more, click here.

Report: Nursing Home Employee Salaries Continue to Rise

A new report found that salaries for nursing home employees continue to increase. The "Nursing Home Salary & Benefits Report 2015-2016," which is published by the Hospital & Healthcare Compensation Service with an endorsement from LeadingAge, reported the following average salaries:

• Executive directors: $171,008 (up 2 percent over last year) 
• Administrators: $119,197 (up 2.5 percent) 
• Assistant administrators: $96,380 (up 1.68 percent) 
• DONs: $93,290 (up 1.5 percent) 
• Assistant DONs: $69,003 
• Nursing supervisors: $66,109 (up 3.24 percent, the largest jump this year) 
• CNAs: $11.84 per hour (for-profit facilities) or $11.89 (non-profit facilities) (up 1.95 percent) 

To learn more, click here. 

Tips for Protecting Diabetic Feet This Summer

While it might feel great to kick off your shoes and feel the grass beneath your feet during the summer, it's important that people with diabetes remember they're more prone to foot-related complications and continue to take measures to prevent them.

Here are four tips to protect diabetic feet during the summer:

1. Forget the flip-flops. While flip-flops and other sandals allow feet to feel cooler, they're not supportive. Instead, consider a breathable, well-fitted athletic shoe that offers both support and comfort.
2. Don't overlook small cuts and scrapes. Many diabetics underestimate the havoc that can be wrought by a scrape, open blister or superficial cut. Diabetes lowers the body's natural defense against bacteria, thereby opening the door for cellulitis to set in. This infection can quickly spread into the bloodstream from a seemingly small wound on a foot or leg. Diabetics are a higher risk for cellulitis than non-diabetics.
3. Keep skin clean and dry. Fun at the pool and beach or any activity that results in sweating can result in extra skin moisture, which in turn can lead to an overgrowth of skin fungus and potentially an athlete's foot infection. If the infection makes its way into the foot skin through cracks and fissures, cellulitis can result.
4. Control blood sugar. When blood sugar is normal, the potential for foot complications is significantly lower. In the summer, this might mean saying no to the barbeque, pie, ice cream and other warm-weather goodies that pop up at celebrations.

Study: Cognitive Impairment Worsens Faster in Women

A new study out of Duke University found that women with mild cognitive impairment that can lead to Alzheimer's tend to deteriorate faster than their male counterparts.

The researchers studied 400 men and women in their mid-70s with mild cognitive impairment and followed up with them over the course of eight years. They administered a test called the Mini-Mental State Examination and determined that thinking and memory deteriorated twice as fast in women as in men.

The researchers stressed that their findings demonstrate the importance of making gender-specific Alzheimer's research a priority.

To learn more, click here.

Sanitize Your Hands on the Go

Summer is filled with picnics, fairs and time spent outdoors. These pastimes are great fun, but they can also be breeding grounds for germs. To protect yourself and your residents, slip bottles of alcohol-based hand sanitizer into your bag before heading outdoors.

For maximum efficacy, make sure that the sanitizer you’re using has an alcohol concentration of between 60 and 95 percent. Studies have shown that sanitizer in this concentration range is more effective at killing germs than non-alcohol based sanitizers and those with a lower concentration of alcohol.1

The proper application of hand sanitizer should take 20 to 30 seconds – don’t rush it! To ensure you’re getting optimum performance from your product, follow these steps2:

1. Apply a palmful of sanitizer to your cupped hand. 
2. Rub your hands palm to palm. 
3. Rub your right palm over the back of your left hand, then switch hands. 
4. Interlace your fingers and rub your palms together again. 
5. Interlock your fingers and rub them on the opposing palms.
6. Clasp your left thumb in your right palm and rub it in a rotational motion, then switch hands.
7. Clasp the fingers of your right hand together and rub them backward and forward on the palm of your right hand, then switch hands. 
8. Wait until the sanitizer is dry on your hands before resuming activities. 

While they’re great in a pinch – say, when you’re outdoors and there are no sinks available for washing hands – keep in mind that hand sanitizers might not be as effective as soap and water when hands are visibly dirty or greasy.1 If this is the case, be sure to wash your residents’ hands as soon as you return to the facility.

To learn more about the hand sanitizing options available from ProMed, as well as the other products in our comprehensive skin care line, contact your ProMed 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. Show Me the Science – When to Use Hand Sanitizer. Available at: http://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html. Accessed June 24, 2015.

2 World Health Organization. How to Handrub? Available at: http://www.who.int/gpsc/5may/How_To_HandRub_Poster.pdf. Accessed June 24, 2015.

HHS Proposes Major Changes to Improve Nursing Home Care

On July 13, the Department of Health and Human Services announced a proposal that would make "major changes to improve the care and safety of the nearly 1.5 million residents in more than 15,000 long-term care facilities or nursing homes that participate in the Medicare and Medicaid programs," according to a statement from the department.

Many of the proposed changes build upon improvements nursing homes have already made since 1991, the last time the conditions for participating in Medicare and Medicaid received a major update.

The changes include:

• Making sure that staff are properly trained on caring for resident with dementia as well as in preventing elder abuse.
• Ensuring nursing homes consider the health of residents when making decisions on the kinds and levels of staffing their facilities need to properly care for residents.
• Ensuring staff members have the right skill sets and competencies to provide person-centered care and that the care plan developed takes the resident's goals of care and preferences into consideration.
• Improving care planning, including discharge planning for all residents, with involvement of the facility's interdisciplinary team and consideration of the caregiver's capacity, giving residents information they need for follow-up and ensuring that instructions are transmitted to any receiving facilities or services. 
• Allowing dietitians and therapy provides the authority to write orders in their areas of expertise when a physician delegates the responsibility and state licensing laws allow it. 
• Requiring nursing homes to provide greater food choices for residents while also providing flexibility. 
• Update the nursing home's infection prevention and control program, including requiring an infection prevention and control officer and an antibiotic stewardship program that includes antibiotic use protocols and a system to monitor antibiotic use. 
• Strengthening rights of nursing home residents, including placing limits on when and how binding arbitration agreements may be used. 

To learn more, click here.

Pack a "Senior Summer Survival Kit" to Fight the Heat

It's shaping up to be a hot weekend here in Illinois! Is your facility ready? If you haven't already, we recommend creating "Senior Summer Survival Kits" to help your residents and loved ones cope with the hot weather. 

These kits are low-cost and easy to assemble. Examples of contents include: 

• A reusable water bottle to encourage proper hydration
• Copies of all prescriptions and health insurance cards
• Phone numbers of healthcare providers and information about any health conditions
• Sunscreen (at least SPF 30) to prevent serious burns
• Hand-held fans 

Happy Friday from our team to yours! 

CMS: Fraud Payment System Identified $820M in Improper Payments in Three Years

CMS announced that their Fraud Prevention System identified or prevented $820 million in improper payments during its first three years.

The Fraud Prevention Service, or FPS, was launched in 2011. In 2014 alone, the system identified $454 million in inappropriate payments, which resulted in administrative actions against 2,000 providers. These actions included having billing privileges revoked or being referred to law enforcement, among other consequences.

CMS has plans to ramp up FPS in the future. The agency wants to use the system to identify early leads for intervention for Medicare Administrative Contractors as well as to stop claims for medical review by Recovery Audit Contractors prior to payment.

To learn more, click here.

Let Us Help You Achieve a Perfect Survey

Have you exhausted all of your go-strategies for boosting your facility’s survey results? Maybe it’s time for a fresh perspective. ProMed is ready to help!

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.

Catheterization: What, How and When?

Generally speaking, urinary catheters are used to drain urine from the body. The three primary types of urinary catheter are indwelling, intermittent and external. We created the following chart as a brief overview of these three catheter types, including how they work and when they can appropriately be used.1,2

Type:  Indwelling (Foley) catheter

How It Works  

• Left in the bladder 
• Collects urine and empties it into a drainage bag 
• May be inserted through the urethra or directly into the bladder via a small hole in the belly (urostomy)
• A small inflated balloon on the end of the catheter prevents it from sliding out (the balloon is deflated before removal)

When Is It Used?

• For both short and long periods of time
• When residents have acute urinary retention or bladder outlet obstruction 
• For accurate measurement of urinary output in critically ill residents 
• During and following select surgeries
• When residents require prolonged immobilization
• Following spinal cord injuries
• To improve comfort during end-of-life care

Type: Intermittent catheter 

How It Works  

• Inserted into the bladder only when urine needs to be drained and then removed  

When Is It Used?

• For short-term use, such as after surgery

Type: External (condom) catheter  

How It Works 

•  For male use only
• A condom-like device is placed over the penis
• A tube connected to the catheter leads to a drainage bag  

When Is It Used?

• Typically used when residents have seriously functional or mental disabilities, such as dementia, rather than urinary retention problems

The CDC cautions that indwelling catheters should only be used for appropriate indications and left in place only as long as needed. They should never replace proper nursing care for incontinent residents.2

Catheters are available in several different materials, such as silicone and latex, and with multiple features. Your highly trained ProMed territory manager is ready to help you select the exact catheters to meet your residents’ need. To get started, contact your territory manager, give us a call at (800) 648-5190 or visit us online at promedsupply.com.

Sources

1 U.S. National Library of Medicine: MedlinePlus. Urinary catheters. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/003981.htm. Accessed June 16, 2015.

2 Centers for Disease Control and Prevention. Guideline for Prevention of Catheter-associated Urinary Tract Infections, 2009. Available at: http://www.cdc.gov/hicpac/cauti/02_cauti2009_abbrev.html. Accessed June 15, 2015.

Congratulations, Dave Starke!

Congratulations to Dave Starke and his wife, Ashley, on the arrival of their daughter, Sophie Grace! Sophie was born on July 8. She weighs 7 lbs, 15 oz and is 20 inches long. Both baby and mama are healthy! Congratulations to the Starke family

Bill Requiring On-Duty RNs at All Times Draws Support

The "Put a Nurse In the Nursing Home" bill introduced by Rep. Jan Schakowsky of Illinois would require nursing homes to have a registered nurse on duty 24/7. It's drawn support from the Coalition of Geriatric Nursing Organizations, Consumer Voice and, most recently, the American Nurses Association.

Supporters of the bill believe that it would:

• Improve the quality of care nursing home residents receive
• Ensure the safety of residents in a way that isn't possible with the current eight-hour-per-day on-duty requirement 
• Allow the RN time to create care plans and evaluate and treat residents who were recently discharged from the hospital or are at risk for readmission

To learn more, click here.

IMPORTANT NOTICE: SDS File Update

In response to OSHA’s Revised Hazard Communication Standard, a component of which requires manufacturers to streamline existing Material Safety Data Sheets (MSDS) to a standardized Safety Data Sheet (SDS) format, ProMed has begun collecting and posting new SDS files for you to download for your facility records. According to OSHA, the information contained in the SDS is largely the same as the MSDS, but now it is presented in a consistent, user-friendly, 16-section format.

OSHA requires that employers update their hazard communication program as necessary by June 1, 2016 and provide additional employee training for newly identified physical or health hazards as needed.1

ProMed is gathering and posting SDS sheets on our website as they become available from manufacturers. Due to the volume of this conversion, not all SDS files have yet been received and posted. We will include a monthly update in LTC Connection alerting you to the new SDS files we have received and posted on the site.

If you are in immediate need of a specific file that has not yet been posted online, please contact our Customer Care team at (800) 648-5190 and we will be happy to assist you.

To view and download the updated SDS files, please take the following steps:

1. Go to promedsupply.com
2. Log on to the site. (If you do not have existing login credentials, please call our Customer Care team at (800) 648-5190 to obtain them.)
3. On the right-hand side of the page, under the Search box, click on the blue “Download SDS forms” link. This will bring you to the SDS landing page. 
4. On the SDS landing page, SDS files are organized by ProMed item number. To locate the file you need, you can either scroll through the list of files or use the Search box at the top of the list to quickly locate a specific product.
5. Click on the file name to open the file. The files are in PDF format. Once they are opened, they can be printed or saved to your computer. 
6. For added convenience, SDS files are also posted under the “Specifications/SDS” tab on individual product pages.  

If you have any questions at all, please reach out to your ProMed territory manager or give us a call
at (800) 648-5190.

Reference
1 Occupational Safety & Health Administration. Hazard Communication Standard Final Rule. Available at: https://www.osha.gov/dsg/hazcom/HCSFactsheet.html. Accessed June 30, 2015.

The Other SAD: Summer-Onset Seasonal Affective Disorder

When you think of seasonal affective disorder, chances are you associate it with the shorter, darker days of fall and winter. However, for about 10 percent of people with the disorder, the onset of spring and summer can trigger symptoms. Experts aren't exactly sure why this happens, but longer days and increasing heat and humidity could play a role.

Symptoms of summer-onset seasonal affective disorder, also known as summer depression, include:

• Anxiety
• Trouble sleeping
• Irritability
• Agitation
• Weight loss 
• Poor appetite
• Increased sex drive

Symptoms might start out mild and become more severe as the season progresses. 

While it's not uncommon to feel down, people who are depressed for days at a time and lack the motivation to do activities they normally enjoy should see a doctor. 

To learn more, click here. 

Think Sun Safety This Fourth of July

Before you head outside with your residents this Fourth of July weekend, make sure you have a sun safety plan in place!

We recommend taking the following steps:

• Ask residents' families to purchase sunscreen, sunglasses, water bottles and hats for their loved ones. Ensure that the residents' names are written on the items.
• Encourage residents to wear lightweight pants and long-sleeved shirts to protect them from the sun's rays.
• Medications and some medical treatments can make residents more susceptible to sunburns. The nursing department should make a list of all sun-sensitive residents.
• Residents should be encouraged to come indoors periodically to cool off and prevent sunburn.

Once you have a sun safety plan in place, get outside and celebrate Independence Day!