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Wednesday, February 22, 2017

New guidelines for managing influenza outbreaks in long-term care facilities

The Centers for Disease Control and Prevention have released new guidelines related to managing influenza outbreaks in long-term care facilities for the 2016-2017 flu season.
Influenza is easily introduced into a nursing home by newly admitted residents, health care workers and loved ones who are visiting their relatives. Prevention is important as the transmission of such viruses can make residents severely or fatally ill.
The CDC makes the following recommendations:
·        Influenza vaccination should be provided routinely to all residents and health care workers of long-term care facilities, and when there is a suspected outbreak
·        Implement daily active surveillance for respiratory illness among ill residents, health care personnel and visitors to the facility
·        Implement Standard and Droplet Precautions for all residents with suspected or confirmed influenza
·        Be Aware of the Possibility of a Drug-Resistant Virus
·        Consider additional measures to reduce transmission among residents and health care personnel1
To read the full CDC report click on the following link: http://bit.ly/2kM7pWN
1 Interim Guidance for Influenza Outbreak Management in Long-Term Care Facilities. (2017, February 02). Retrieved February 21, 2017, from https://www.cdc.gov/flu/professionals/infectioncontrol/ltc-facility-guidance.htm

Friday, February 17, 2017

Canadian Seniors at Risk: New study warns against harmful prescription medication use, offers new strategies for improvement


Seniors use more prescription drugs than any other age group in Canada. Approximately 67% of seniors take five or more prescriptions drugs a year and 25% take ten or more prescriptions. Furthermore, it is projected that as many as half of the medications given to seniors are administered incorrectly or are over-prescribed, which can lead to harmful drug reactions and interactions. 1 In addition, many of these drugs have either not been studied extensively for this age group or have not been formally approved to treat the conditions for which they have been prescribed. In other words, some of these medications are prescribed to seniors without any concrete evidence that they are safe or effective and, sometimes, even when they are known to be risky. One example is antipsychotics, which have known adverse effects, but which are still often prescribed to patients with dementia. 2

In her study, “Improving Prescription Drug Safety for Canadian Seniors,” Nicole Bernier examines the unsafe and inappropriate use of prescription drugs by seniors and provides some possible solutions to the problem. 1 Although there are many joint educational initiatives that have been started by professionals, advocacy groups, and health authorities, Bernier posits that improving prescription drug safety among seniors will require more systematic change  from national bodies, such as Health Canada, provincial and territorial health ministries, as well as local health authorities. Such a strategy should include a revision of the drug approval process, tracking newly marketed drugs that are prescribed to seniors, and reporting adverse drug reactions.  Health providers should have access to in-depth information on their patients’ medical histories and to clinical decision-making tools which would allow them to conduct independent research into off-label prescription drug use. Canadian provinces and territories should also be mandated to update their prescribing guidelines on a regular basis, require medications reviews, and to provide coverage or alternative nonpharmacological therapies and interventions.

Much more can and needs to be done in order to protect seniors and to address this health issue for our increasingly aging population.
To see the full Institute for Research on Public Policy (IRPP) study, visit: http://irpp.org/research-studies/study-no61/
1.    
1 1 Bernier, Nicole F. “Improving Prescription Drug Safety for Canadian Seniors.” IRPP. Jan. 12th 2017. Accessed February 2017 from http://irpp.org/research-studies/study-no61/

2 2 Maust, D. T., Kim, H. M., Seyfried, L. S., Chiang, C., Kavanagh, J., Schneider, L. S., & Kales, H. C. (2015). Antipsychotics, other psychotropics, and the risk of death in patients with dementia: number needed to harm. JAMA psychiatry, 72(5), 438-445. Accessed February 2017 from http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2203833

Wednesday, February 15, 2017

Report calls on government to invest more in long-term care and aging population

A 2017 report compiled by the Canadian Association for Long Term Care (CALTC) states that the Trudeau government needs to invest more in order to make improvements to the care provided to seniors in long-term care facilities.
CALTC points to statistics that show that the number of seniors age 65 and older will rise by 25% by 2036, and the number of seniors 80 and over will double between 2011 and 2036. New data also shows seniors entering long-term care suffer from more chronic conditions than their predecessors. For example, 87% of residents are affected by Alzheimer's or other dementias. This number is expected to double by 2031.1
Some of their recommendations to the government include:
  • Set aside a portion of its infrastructure fund to modernize and rebuild older long-term care homes and build new ones
  • Mandate and invest in a standardized data system for long-term care homes to measure resident satisfaction, quality of care and financial performance
  • Encourage Canadians to save for their care needs later in life by developing a Seniors Care Savings Plan or allowing Canadians to use existing savings to pay for their care needs when they can no longer live at home.
Click here to read the full report: http://bit.ly/2ljYuei
1 Canadian Association for Long Term Care. Caring for Canada’s Seniors. February 2, 2017. Retrieved from http://www.oltca.com/OLTCA/Documents/Reports/CaringForCanadasSeniors_CALTC.PDF

Wednesday, February 08, 2017

New resource informs staff and long-term care residents’ families on sexuality

Despite portrayals of sexuality in popular media that are tied to youth and beauty, sexual desire does not necessarily fade with age. The need for intimacy and affection is still important to many residents living in long-term care facilities and sexuality is linked to their overall wellbeing and quality of life. However, this topic is a challenging one for many staff and family members, who may have trouble openly discussing the needs of residents in their care.
To help the families of people living in residential care and staff to be more informed about sexuality, researchers from the Australian Centre for Evidence Based Aged Care at La Trobe University have developed a new guideline called “Sexuality and people in residential aged care facilities: A guide for partners and families”.
Some of the issues covered in this resource include:
  • The importance of sexuality in old age
  • Sexuality and living in a long-term care facility
  • Sexuality and dementia
  • Sexual behaviours and their impact
  • How a facility, such as a nursing home or assisted living facility, can be supportive of the expression of sexuality
Click here to download a free copy: http://bit.ly/2kmRABZ

Wednesday, February 01, 2017

New Gerontology Resources for APRN Preceptors and Students

The Gerontological Advanced Practice Nurses Association (GAPNA) has launched a new toolkit that is designed to make geriatric and gerontological content accessible to those working with and caring for older adults, including advanced practice registered nurses, students, preceptors, and educators.
The toolkit has two sections:
1) Gerontological Resources for Healthcare Management
·        Gerontological and Geriatric Assessment
·        Specialty Assessments
·        Mental Health
·        Cognitive Assessment
·        Dementia Assessment and Management
·        Gerontological Pharmacology
·        End-of-Life Issues
·        Nursing Home Issues
·        Role Issues
·        Legal Issues
2) Preceptor Resources
·        Preceptor Preparation for Role
·        Suggested Readings for Clinical Preceptors
·        National Standards for Nurse Practitioner Competencies
·        Student Geriatric Clinical Site Examples
For more information, or to register and download a copy of the new 2017 toolkit, visit their website here: http://bit.ly/2jvZD2I

Wednesday, January 25, 2017

Infection Prevention and Control Assessment Tool for Long-term Care

Healthcare-associated infections (HAIs) are infections that patients acquire during the course of receiving treatment for other conditions within a healthcare setting.

It is estimated that the rates of HAIs in personal care homes range from 1.8 to 13.5 per 1,000 patient care days. Such infections can significantly increase overhead costs to an organization(1)
. The risk of infection is high in long-term care because residents are already at risk. Pre-existing conditions, medical procedures, touching contaminated surfaces, or even holding a loved one’s hand can lead to contamination. However, infection can also spread easily when healthcare workers do not follow proper hand hygiene(2).

To help prevent instances of and to mitigate costs of healthcare-associated infections, the CDC has posted a new tool for assessing infection control programs and practices in nursing homes and other long-term care facilities. This tool is particularly beneficial for health centers to use in their own self-assessment procedures.

To access this tool, click here: http://bit.ly/2j5LskO

For more information on healthcare-associated infections in Canada , visit: http://bit.ly/2j5HfxG

(1) IPAC. (December 2016). Infection Prevention and Control (IPAC) Program Standard. Retrieved on January, 16, 2017, from http://ipac-canada.org/photos/custom/CJIC/Vol31No4supplement.pdf

(2) Public Health Agency of Canada (2013). Report on the State of Public Health in Canada, 2013: Infectious Disease- the Never-ending Threat. Retrieved on January 15, 2017, from http://www.phac-aspc.gc.ca/cphorsphc-respcacsp/2013/infections-eng.php#footnote17

Wednesday, January 18, 2017

Fighting the Blues: Depression in Long-term Care

This past Monday, January 16th, was Blue Monday – supposedly the most depressing day of the year. However, for many residents who have recently moved into long-term care facilities, every day is a “blue” day.

Moving into a nursing home or residential care setting can be a very difficult experience for some individuals. Some common pervasive thoughts that many people experience after moving into a long-term care facility include:
  • This is the end of the road
  • There is no hope
  • I’m losing my independence
  • I’m going to lose the support of my family and friends
Along with the transition to long-term care, a resident may be dealing with complicated health problems, be on a number of different medications and have experienced other recent losses in their life. These factors put them at a higher risk for developing depression, especially in the first couple of months after moving.

Early detection of depression is critical to treatment, so healthcare professionals must be vigilant in screening for depression. Tools such as the Geriatric Depression Scale, a short test which uses simple questions and answers, can be used to monitor mood1.

The Geriatric Depression Scale can be accessed here: http://bit.ly/2iIT7jX

For more information on depression in long-term care, visit the J.W. Crane Memorial Library’s research guide here: http://libguides.lib.umanitoba.ca/depression-longtermcare

1Depression in long-term care. (n.d.). Retrieved January 16, 2017 from http://www.baycrest.org/educate/mental-health/depression/depression-in-long-term-care