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Wednesday, April 16, 2014

AHRQ Policy Innovations featuring Long-Term Care

This month’s issue on policy innovations from AHRQ features initiatives and quality tools meant for long-term care facilities and staff.  Overall, the issue includes 2 policy innovations and 3 quality tools, but those of significant interest are:
Long-Term Care Facilities Cede Control of Immunization Policies to Regional Pharmacy, Significantly Increasing Influenza Vaccination Rates Among Workers: This policy innovation, part of the RISE (Raising Immunizations Safely and Effectively) program saw 14 LTC facilities give over control of their immunization policy to a local pharmacy.  The facilities collaborated with the pharmacy to enforce standardized policies to boost the immunization rate.  The program improved immunization rates significantly, with an estimated Health People 2020 goal of 90% of LTC staff.
Improving Quality Outcomes for an Aging Population: Alzheimer’s Treatment in Long-Term Care: This quality tool aims to improve quality of life for residents with Alzheimer’s Disease in Long-Term Care.  The tool includes a variety of instruments that look at updating guidelines, improving diagnosis and updating best practice treatment.  Information on managing Alzheimer’s Disease includes pharmacological and non-pharmacological treatments. 
On-Time Quality Improvement Manual for Long-Term Care Facilities: The purpose of this quality tool is to ease efficiency and improve workflow of CNA’s in Long-Term Care facilities, which improve overall quality of life for the residents.  The tool provides an introduction to quality improvement strategies, (such as integration of documentation and reporting), and assists in the implementation process.  It is a practical approach to Quality Improvement, aimed at LTC stakeholders, nursing home leaders and nursing home personnel responsible for quality improvement.
For more information on this month’s issue on policy innovations in long-term care, please visit

Monday, April 14, 2014

Canadian Foundation for Healthcare Improvement Collaborative: Reducing Antipsychotic Medication Use in Long Term Care

Successful recipients of the initiative, Reducing Antipsychotic Medication Use in Long-Term Care will receive funding as well as coaching from the Canadian Foundation for Healthcare Improvement (CFHI) staff to help implement a program to support non-pharmacological methods for behavioural issues in people with dementia.  Two Winnipeg Regional Health Authority managers, with the help of the EXTRA Program for Healthcare Improvement, designed an initiative to make staff aware of which residents may benefit from  non-drug therapies to treat behavioral issues, and consequently remove these residents from medication which improved their overall quality of life.  The program they devised will direct this initiative.

For more information on the project and the prospectus, please visit

Friday, April 11, 2014

AHRQ Webinars: Long-Term Care

AHRQ is hosting 3 free webinars this spring and summer on issues facing long-term care.  The second webinar, to take place April 23rd, is on the use of Improving Patient Safety in Long-Term Care Facilities Training Modules.  "The webinar developed for nurses and staff educators in Long-Term Care facilities, will feature effective engagement strategies to train staff to recognize and report changes in a nursing home resident's condition." Registration is free, but space is limited.  To register and for more information on the webinar, please visit 

Upcoming webinars include:

June 18th, Communicating Change in a Resident's Condition
August 13th, Falls Prevention and Management

Wednesday, April 09, 2014

Choosing Wisely Canada: 5 Things Physicians and Patients should question

For the past 2 years, the American Choosing Wisely campaign (see previous posts about Choosing Wisely here and here) has achieved tremendous success, and last week the initiative moved to Canada.  The first ever Choosing Wisely Canadian campaign includes a list of 5 things physicians and patients should question, produced with the assistance of the Canadian Geriatrics Society.  This list is specifically targeted to physicians working with older adults and to elderly patients.  It was compiled by a small group of council members from the Canadian Geriatrics Society, who reviewed the best available evidence and made recommendations to ensure delivery of high-quality medical care.  This years’ list includes the following recommendations:
1.       Don’t use antimicrobials to treat bacteriuria in older adults unless specific urinary tract symptoms are present.
2.       Don’t use benzodiazepines or other sedative-hypnotics in older adults as first choice for insomnia, agitation or delirium.
3.       Don’t recommend percutaneous feeding tubes in patients with advanced dementia; instead offer oral feeding
4.       Don’t use antipsychotics as first choice to treat behavioural and psychological symptoms of dementia.
5.       Avoid using medications known to cause hypoglycemia to achieve hemoglobin A1c <7.5% in many adults age 65 and older; moderate control is generally better.
For more information on these recommendations and to learn more about the Canadian Choosing Wisely campaign, please visit

Monday, April 07, 2014

Late-Life Depression

A new website on late-life (geriatric) depression from Baycrest, a global leader in developing and providing innovations in aging and brain health.
Headquartered on a 22-acre campus in Ontario and fully affiliated with the University of Toronto, Baycrest is the global leader in developing and providing innovations in aging and brain health - See more at:
Headquartered on a 22-acre campus in Ontario and fully affiliated with the University of Toronto, Baycrest is the global leader in developing and providing innovations in aging and brain health - See more at:

The site is aimed at older adults, their families, friends, and caregivers. It provides an introduction to depression, and stories, videos, and resources on signs and symptoms, diagnosis and treatment.

Wednesday, April 02, 2014

Supporting staff working with people who challenge services

Supporting Staff working with people who challenge services is a guide for employers to better equip their staff and organizations in dealing with the different care needs of residents.  It was developed by Skills for Care in partnership with staff, families and organizations who work with adults with different support needs such as older people with dementia, people with mental health and personality conditions, and those with learning disabilities who have particularly complex needs and/or are labelled as challenging (such as autism).
The guide is intended as a support tool to instigating a strategic policy that supports an effective workplace development program.  Building a knowledgeable, effective workplace will  ensure confidence within an organization and to its staff, reducing the impact that challenging behavior may have.
There are 5 sections to the report:
·         Section 1 Introduction and purpose of the guide
·         Section 2 Organisational action: This section looks at approaches an organization can take to ensure a supportive workplace, such as designing staff structures that work, recruiting the right staff and implementing support to staff to ensure good retention levels.
·         Section 3 Building workforce skills and knowledge: discusses how to recognize challenging behavior and solutions for combatting it.  It link to outside resources, like papers, reports, tools and websites that may help.   It also looks at how families can be important partners to an organization.
·         Section 4 Using learning tools and resources: This section includes information on what to look for when selecting a learning module, coach or trainer.
·         Section 5 Specialist approaches additional considerations for working with different people: This section provides greater insight into the medical reasons for challenging behaviours and links to outside resources for more specialized information.
For more information on challenging behaviours in Long-Term Care, don’t forget to check out our Current Perspectives on Behaviour in Long-Term Care.

Monday, March 31, 2014

D.E.A.R. Dental Elder Abuse Response and Oral Hygiene Instructions for Caregivers

Over 4 million Canadians require some kind of assistance when performing dental hygiene practices.  As a result of this alarming statistic, Dr. Natalie Archer of the Toronto dental clinic Archer Dental, has created a video to encourage awareness of proper dental hygiene techniques and provides tips to health care assistants, nurses and caregivers.  The video demonstrates best practice approaches for cleaning dentures, partial dentures, tooth brushing and advice when dealing with difficult residents.  By demonstrating these practices on actual patients, Dr. Archer provides hands-on advice to proper techniques in care.  The instructions are easy to follow and appropriate for all levels of education.

Dr. Archer also developed the D.E.A.R. (Dental Elder Abuse Response) project, which aims to bring awareness to proper dental care for older adults and its links to elder abuse.  This initiative is a joint project of Archer Dental, the Canadian Centre for Elder Law, and the National Initiative for Care of the Elderly (NICE). So far, the project has created brochures and tools for dental professionals. For more information on the project, please visit