Resources for Physicians

‘Nightmare’ Bacteria Spreading in Nursing Homes, Hospitals

heidi Hospital Discharge, Resources for Physicians Comments Off on ‘Nightmare’ Bacteria Spreading in Nursing Homes, Hospitals

Untreatable and hard-to-treat infections from CRE germs are on the rise among patients in medical facilities. About 18 percent of long-term acute care hospitals and about 4 percent of short-stay hospitals in the United States had at least one CRE infection during the first half of 2012, warns the Centers for Disease Control and Prevention (CDC).

Read entire story here.

Health Care Providers Can:

  • Know if patients in your facility have CRE.
    • Request immediate alerts when the lab identifies CRE.
    • Alert the receiving facility when a patient with CRE transfers, and find out when a patient with CRE transfers into your facility.
  • Protect your patients from CRE.
    • Follow contact precautions and hand hygiene recommendations when treating patients with CRE.
    • Dedicate rooms, staff, and equipment to patients with CRE.
    • Prescribe antibiotics wisely.
    • Remove temporary medical devices such as catheters and ventilators from patients as soon as possible.


Recommended Guidelines

The CDC’s 2012 CRE Toolkit provides CRE prevention guidelines for doctors and nurses, hospitals, long-term acute care hospitals, nursing homes, and health departments. It gives step-by-step instructions for facilities treating patients with CRE infections and for those not yet affected by them.

Patients Benefit From In-Home Pulmonary Rehabilitation

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Benefits of home-based therapy include stronger clinical outcomes, reduced emergency care need, and increased compliance to physician’s orders.

Do you care for patients who have COPD, chronic lung disease, or who have conditions that make it hard for them to breathe? Your patients may benefit from a pulmonary rehabilitation program that comes to their door. These programs are often provided by skilled home health agencies. Patients who receive specialized treatment in their home have better clinical outcomes and a reduced need for emergency care.

Pulmonary rehabilitation is an intervention that can combine exercise, education, and behavior modification strategies in an effort to minimize symptoms and improve quality of life. A multidisciplinary program is individually tailored to optimize a patient’s physical and social functioning and increase their autonomy. Patients are taught how to manage their symptoms and reach their maximum functioning level. Read more

Medications that Send Seniors to the ER

heidi Medicare Patient News, Resources for Physicians Comments Off on Medications that Send Seniors to the ER

These four medicines account for nearly 50 percent of emergency department
visits for adverse drug events in Medicare patients.

The Institute for Safe Medication Practices maintains a list of high-alert medications—medications that can cause significant patient harm if used in error. These include medications that have dangerous adverse effects, but also include look-alike, sound-alike medications, which have similar names and physical appearance but completely different pharmaceutical properties. The Beers criteria, which define certain classes of medications as potentially inappropriate for geriatric patients, have traditionally been used to assess medication safety. However, the newer STOPP criteria (Screening Tool of older Person’s inappropriate Prescriptions) have been shown to more accurately predict ADEs than the Beers criteria, and are therefore likely a better measure of prescribing safety in the elderly.

Though there are specific types of medications for which the harm generally outweighs the benefits, such as benzodiazepine sedatives in elderly patients, it is now clear that most adverse drug events [ADEs] are caused by commonly used medications that have risks, but offer significant benefits if used properly. These medications include antidiabetic agents (e.g., insulin), oral anticoagulants (e.g., warfarin), and antiplatelet agents (such as aspirin and clopidogrel). Together, these four medications—which are not considered inappropriate by the Beers criteria—account for nearly 50% of emergency department visits for ADEs in Medicare patients. Focusing on improving prescribing safety for these necessary but higher-risk medications may reduce the large burden of ADEs in the elderly to a greater extent than focusing on use of potentially inappropriate classes of medications. – Agency for Healthcare Research and Quality

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