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One thing that is becoming more prevalent is healthcare consumers becoming more aware. The Internet has a wealth of information for consumers, and  sorting through and making use of that information is how each of us can be more active in directing our own healthcare. Healthwatch MD put out a video on the concept of patient as part of the healthcare team. No longer is the team just the doctor and nurses, now it is everyone, doctors, nurses, social workers, clergy, therapists, family and patients, to name just a few. Take a few moments to watch Dr. Leigh Hamby, chief medical officer for Piedmont Healthcare, discuss this concept.

Hospital Safety: You are Part of Your Healthcare Team

Remember, to be your own advocate!

JL

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Effective pain recognition and management requires a continuous facility-wide commitment to every resident’s comfort, to identifying and addressing barriers to managing pain, and to addressing any misconceptions that residents, families, and staff may have about managing pain. As discussed previously, nursing home residents are at high risk for having pain that may affect function, impair mobility, impair mood, or disturb sleep, and diminish quality of life. The onset of acute pain may indicate a new injury or a potentially life-threatening condition or illness. It is important, therefore, that a resident’s reports of pain, or nonverbal signs suggesting pain, be evaluated.

Care plans for pain should be developed and the resident’s needs and goals as well as the cause, type, and severity of pain are needed to develop an adequate and appropriate plan of care for pain management. It is also important to consider treating the underlying cause, where possible in order to remove the cause of the pain. Understanding the underlying causes of pain is an important step in determining optimal approaches to prevent, minimize, or manage pain. Addressing those underlying causes may permit pain management with fewer analgesics, lower doses of analgesics and narcotics, or the use of medications with a lower risk of serious adverse consequences.

Certain factors may affect the recognition, assessment, and management of pain. For example, residents, staff, or practitioners may misunderstand the indications for, and benefits and risks of, opioids and other analgesics; or they may mistakenly believe that older individuals have a higher tolerance for pain than younger individuals, or that pain is an inevitable part of aging, a sign of weakness, or a way just to get attention. Other challenges to successfully evaluating and managing pain may include communication difficulties due to illness or language and cultural barriers, stoicism about pain, and cognitive impairment.

It is a challenge for the nursing staff to assess and manage pain in individuals who have cognitive impairment or communications difficulties. Some individuals with advanced cognitive impairment can accurately report pain and/or respond to questions regarding pain and others cannot. Those who cannot report pain may exhibit nonspecific signs such as grimacing, increase in confusion or restlessness or other distressed behavior. Effective pain management may decrease distressed behaviors that are related to pain. However, these nonspecific signs and symptoms may reflect other clinically significant conditions such as delirium, depression, or medication related adverse consequences, instead of, or in addition to, pain. To distinguish these various causes of similar signs and symptoms, and in order to manage pain effectively, it is important for facility nurses to evaluate the resident in detail, to confirm that the signs and symptoms are due to pain. Nursing assistants may be the first to notice a resident’s symptoms; therefore, it is important that they too are able to recognize a change in the resident and the resident’s functioning and to report the changes to a nurse for follow-up. Family members or friends may also recognize and report when the resident experiences pain and may provide information about the resident’s pain symptoms, pain history and previously attempted interventions. Other staff, e.g., dietary, activities, therapy, housekeeping, who have direct contact with the resident may also report changes in resident behavior or resident complaints of pain.

Nurses and other healthcare practitioners should look for interventions that are resident specific since the cause of pain is different for each person. Staff should try to prevent and minimize pain that is anticipated to occur due to a process or procedure. Non-pharmacological interventions should also be planned and implemented to complement the use of pharmacological interventions.

Remember – be your own advocate!

JL

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I found an interesting article from Prevention’s List-Maker’s Get Healthy Guide book. It is so interesting and something many people don’t think about. I want to share it here with you.

An average adult can touch as many as 30 objects within a minute, including germ-harboring, high-traffic surfaces such as light switches, doorknobs, phone receivers, and remote controls. At home, you do all that you can to keep the germs at bay. But what happens when you step out the door to go to dinner, do some grocery shopping, or visit the doctor’s office? Know where germs are most likely to lurk, as you’ll find out here.

Restaurant Menus

Have you ever seen anyone wash off a menu? Probably not. A recent study in the Journal of Medical Virology reported that cold and flu viruses can survive for 18 hours on hard surfaces. If it’s a popular restaurant, hundreds of people could be handling the menus–and passing their germs on to you. Never let a menu touch your plate or silverware, and wash your hands after you place your order.

Lemon Wedges

According to a 2007 study in the Journal of Environmental Health, nearly 70% of the lemon wedges perched on the rims of restaurant glasses contain disease-causing microbes. When the researchers ordered drinks at 21 different restaurants, they found 25 different microorganisms lingering on the 76 lemons that they secured, including E. coli and other fecal bacteria. Tell your server that you’d prefer your beverage sans fruit. Why risk it?

 Condiment Dispensers

It’s the rare eatery that regularly bleaches its condiment containers. And the reality is that many people don’t wash their hands before eating, says Kelly Reynolds, PhD. So while you may be diligent, the guy who poured the ketchup before you may not have been, which means his germs are now on your fries. Squirt hand sanitizer on the outside of the condiment bottle or use a disinfectant wipe before you grab it. Holding the bottle with a napkin won’t help; napkins are porous, so microorganisms can pass right through, Reynolds says.

Restroom Door Handles

Don’t think you can escape the restroom without touching the door handle? Palm a spare paper towel after you wash up and use it to grasp the handle. Yes, other patrons may think you’re a germ-phobe–but you’ll never see them again, and you’re the one who won’t get sick.

Soap Dispensers

About 25 percent of public restroom dispensers are contaminated with fecal bacteria. Soap that harbors bacteria may seem ironic, but that’s exactly what a recent study found. “Most of these containers are never cleaned, so bacteria grow as the soap scum builds up,” says Charles Gerba, PhD. “And the bottoms are touched by dirty hands, so there’s a continuous culture feeding millions of bacteria.” Be sure to scrub hands thoroughly with plenty of hot water for 15 to 20 seconds–and if you happen to have an alcohol-based hand sanitizer, use that, too.

Grocery Carts

The handles of almost two-thirds of the shopping carts tested in a 2007 study at the University of Arizona were contaminated with fecal bacteria. In fact, the bacterial counts of the carts exceeded those of the average public restroom. Swab the handle with a disinfectant wipe before grabbing hold (stores are starting to provide them, so look around for a dispenser). And while you’re wheeling around the supermarket, skip the free food samples, which are nothing more than communal hand-to-germ-to-mouth zones.

Airplane bathrooms

When Gerba tested for microbes in the bathrooms of commercial jets, he found surfaces from faucets to doorknobs to be contaminated with E. coli. It’s not surprising, then, that you’re 100 times more likely to catch a cold when you’re airborne, according to a recent study in the Journal of Environmental Health Research.

Doctor’s office

A doctor’s office is not the place to be if you’re trying to avoid germs. These tips can help limit your exposure.

  • Take your own books and magazines (and kid’s toys, if you have your children or grandchildren with you).
  • Also pack your own tissues and hand sanitizers, which should be at least 60% alcohol content.
  • In the waiting room, leave at least two chairs between you and the other patients to reduce your chances of picking up their bugs. Germ droplets from coughing and sneezing can travel about 3 feet before falling to the floor.

I’ve always thought I was careful, but this list gives me more ideas to protect myself! I hope it gives you ideas to protect yourself too!

JL

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Today I want to share with you some important information about bloodborne pathogens. This bloodborne pathogens infographic is provided to us courtesy of Compliance and Safety. This is just one of many things a Nursing Home and Hospital Surveyor looks at when surveying a health facility. Of course, the risk of exposure to bloodborne pathogens is quite high in a health facility. Safety procedures and processes are important to not only protect the staff but also the resdients/patients. You can see how it is higher in certain healthcare areas when compared to others. – JL


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