Clinical Practice Guidelines

The American Geriatrics Society in conjunction with the British Geriatric Society have formally published Clinical Practice Guidelines:  Prevention of Falls in Older Persons (2010).  We at HHQI were fortunate enough to have this group summarize their fall prevention recommendations from their May 2009 meeting for the HHQI Fall Prevention Best Practice Intervention Package published in July 2010.  This allowed HHQI participants early insight and early implementation of these recommendations to prevent patient falls. 

To read the final guidelines, go to:  http://www.americangeriatrics.org/health_care_professionals/clinical_practice/clinical_guidelines_recommendations/2010/

FDA Drug Safety

FDA recommends against the use of propoxyphene by all patients.  This includes Darvon, Darvocet, and all generic forms.  The FDA reports propoxyphene causes “serious toxicity to the heart, even when used at therapeutic doses…resulting in prolonged PR interval, widened QRS complexes and prolonged QT intervals”.  Even though propoxyphene relieves mild to moderate pain, the benefits are outweighed by the risk of interruption of cardiac electrical activity.

To read the entire article including suggested guidelines for healthcare professionals and patients currently taking propoxyphene products, go to http://www.fda.gov/Drugs/DrugSafety/ucm234338.htm

Process Based Quality Improvement (PBQI)

Did you know new quality reports to supplement the currently available OBQI and OBQM reports are available?  These focus on specific best practices in high risk, high volume, and problem areas for home health agencies. 

To see the video presentation, go to:

http://www.youtube.com/user/CMSHHSgov#p/search/4/hNno1GIVAPA

Care Transitions

We are gearing up, gathering information and getting excited about the Cross Settings II BPIP. This cross-settings package will focus on self-management and will be available on January 28, 2011. I came across this blog the other day and really thought the information presented was valuable and relevant to the topic at hand. Check it out: http://abytesgen01.securesites.net/howard_gleckman/2010/11/the-importance-of-care-transit.html

November is also Family Caregivers Months

National Family Caregivers (NFC) Month is organized annually by the National Family Caregivers Association (NFCA) as a time to thank, support, educate and empower family caregivers. NFCA represents more than 50 million Americans who care for loved ones with chronic illness or disability, or the frailties of old age. The theme for National Family Caregivers Month 2010 is “Reach Out for Help”.

In the month of November, National Family Caregivers Association (NFCA) has several opportunities for caregivers, including a teleclass on medication mishaps, a Webinar on managing finances, and a free caregivers toolkit and planner. Learn more at https://www.thefamilycaregiver.org.

The Advancing Excellence Nursing Home Campaign also has several resources available. The tools are available in the “For Participants” area of the Advancing Excellence website under “Consumers” or by visiting http://www.nhqualitycampaign.org/star_index.aspx?controls=consumerActionPlan.

A tip sheet for residents and family members is available at:   http://www.nhqualitycampaign.org/files/Tip%20Sheet%20Formatted.pdf.

November is American Diabetes Month

Our next Best Practice Intervention Package (BPIP) will be released on January 28. This Cross Settings II BPIP will focus on chronic disease and self-management.  Patients with one of more chronic diseases are more likely to wind up back in the hospital. One of the most common of these chronic diseases is diabetes. Spread the word, November is American Diabetes Month. There are endless resources available from the American Diabetes Association. A great resource you can share with your patients is this Holiday Survival Guide from the ADA. (Great timing!) Another great resource is a self-management tool for patients with diabetes. To view this tool, login to your HHQI account here: www.homehealthquality.org/hh/extranet.

Hand-off Communication Solutions

By now, we all understand that communication between healthcare providers is key in improving the quality of care our patients receive.  It’s imperative we know a patient’s allergies and diagnosis before we assume the responsibility of their care, but what about the not so obvious information?  If we go into a patient’s home with more detailed knowledge of the patient’s previous hospitalization experience, not only would it make our jobs easier and the patient care safer, it would also give the patient confidence in his / her care during this transitional period.

Joint Commission Center for Transforming Healthcare is addressing ways to improve communication during the hand-off. To read more about this project, go to the following link:  http://www.centerfortransforminghealthcare.org/

Transitions to Home Care Getting More Attention

Did you attend the Optimizing Home Health in Care Transitions Summit in Philadelphia last week? If not, read a summary article quoting Dr. Steven Landers and Dr. David Wenner (HHQI Medical Director) here or go to www.homehealthquality.org and go to the bottom of the page to find the link under “HHQI Campaign News”. Thanks to Dr. Landers and Dr. Wenner for continuing to advocate for those in home health!

Centers for Disease Control and Prevention (CDC) Focus on Preventing Falls

Does it feel at times that you have tried everything possible to keep your patients safe from falls only to walk into their homes and trip over their pet or a rug?  The CDC has recently published new guidelines focusing on preventing falls for the public (http://www.cdc.gov/Features/OlderAmericans/). 

In addition to Prevention and Safety Tips for in the home, the CDC has also provided brochures and posters in English, Spanish, and Chinese for your patients as well as Podcasts and Fact Sheets for your staff.

As our patients and their families are becoming more computer savvy, are you referring them to the Web sites developed for the general public by reliable sources (CDC is one of the best).  If not, it may be time to start.  One way or the other we need to reach our patients and help them understand the importance of preventing falls.  Although preventing a fall may not increase their quality of life, it will most definitely prevent decreasing it.

Joint Commission Launches Fall Prevention Campaign

Our partners at the Joint Commission recently launched a national campaign to help Americans reduce the risk of falling. The new education campaign, which is part of The Joint Commission’s award-winning Speak Up™ program, recognizes that falls are a serious problem. Statistics from the Centers for Disease Control and Prevention (CDC) show that falls are the second leading cause of injury-related deaths for people ages 65 and older, and are the most common cause of injuries and hospital admissions among the elderly.

The new Speak Up™ campaign offers tips and actions that will help people reduce the risk of falling, whether at home or in a medical facility. Among the topics are:

• Taking care of your health—this includes exercise to improve strength and balance, staying hydrated, having an eye exam regularly and talking to your doctor about any side effects from medications that might cause drowsiness or confusion.

• Taking extra precautions—simple actions such as turning on the lights when entering a room, keeping walkways clear, using handrails on stairs, and wearing proper shoes can make a difference.

• Making small changes to your home—using motion sensors or timers for lights, placing nightlights in bedrooms and bathrooms, removing throw rugs, and applying non-slip decals on stairs and in bathtubs to reduce the risk of falls. Home care agencies, personal care and support agencies, or community programs may be available to help you accomplish these tasks if you are older or disabled.

• Taking extra precautions in the hospital or nursing home, for example, people in health care facilities should use the call button to ask for help to get out of bed or go to the bathroom, wear non-slip socks, lower the height of the bed and bed rails, and tell the nurse or doctor if medicine is making you feel dizzy or sick.

You can learn all about the Speak Up program by clicking here (http://www.jointcommission.org/PatientSafety/SpeakUp/ ). On the Web page, you can download brochures and even order free fall prevention brochures available in an easy-to-read format and in Spanish.

We are very appreciative that the Joint Commission is sharing this life-saving information with HHQI National Campaign participants. Thank you!