Using RN Continuing Education as a Weapon Against Rising Costs and Threats to Quality

The “Using RN Continuing Education as a Weapon Against Rising Costs and Threats to Quality” webinar on Tuesday, March 18, from 2-3pm EST will focus on how the current LTC environment can be improved by an intentional, comprehensive continuing education program for RNs that prepares them to achieve Board Certification.

The modest investments LTC facility administrators have made in this program have had a positive impact on the LTC RN workforce, their effectiveness on the job, and their RN turnover rate in a LTC environment characterized by rising acuity of LTC patients, tighter reimbursements, and more stringent regulations. Administrators are finding that the benefits of this program to their residents and financial bottom line far outweigh its costs.

Using RN Continuing Education as a Weapon Against Rising Costs and Threats to Quality
Register here

Learning Objectives:

  1. Correlate the attainment of RN board certification with standards of clinical excellence
  2. Explore the relationships between comprehensive education,  RN retention, and overall quality of care outcomes
  3. Provide data supporting the business case of comprehensive RN education and professional development investment


Heidi Keeler
Assistant Professor
University of Nebraska Medical Center

Catherine Bevil
University of Nebraska Medical Center

Its a complimentary webinar with no registration fees required. Register here..

Issues in Long Term Care

In 2010, 40 million Americans were age 65 or older. By 2050 that number is expected to jump to 88 million. Among these older citizens, only three in 10 will never receive long-term care services. The majority will get such care—though not necessarily in a nursing home or assisted living facility. The current definition of long-term care includes services provided in the home by family members or paid caregivers. Adult day-care is also considered a form of long-term care.

The cost will be huge. In addition to the increase in the number of people over 65, the number of people 85 and older is also predicted to jump dramatically. This is the “frail elderly” group most likely to need long-term care. In 2010 there were 5.5 million of these older people, but by 2050 there will likely be 19 million.


These demographic shifts raise two questions. How will the nation decide to pay for that care? Will it be given in different ways and settings?

66% of people 65 and older can’t pay for even a year in a nursing home.

The demand for long-term care services will explode as the population ages and more people live longer with chronic conditions. Who will pay for these services and how will they be delivered?

Read more here….



ANCC Board Certified Nurses get $200 off on registration rates. It gives you opportunity to connect with your peers, participate in expert-led, hands-on sessions and learn about the newest nursing standards and best practices in health care. You can also choose your educational track. Don’t miss this exceptionally precious offer. Register now and  and get your $600 special registration rate!



A New Role For Skilled Nursing in Long Term Care

When I was a medical resident at Boston City Hospital, a large, public, inner city hospital, I began wondering whether hospitals sometimes caused as many problems as they cured. Over and over, I saw older patients admitted with one disease such as pneumonia or a heart attack, who ended up falling and breaking a bone or getting a blood clot from being confined to bed. So I did a study in which I measured how often older people became confused, stopped eating, developed incontinence, or fell while they were in the hospital. I tried to separate out those cases in which the new symptom could be plausibly related to the admitting diagnosis: for example, someone who was hospitalized with a stomach ulcer would normally stop eating during the initial treatment, and someone with a stroke might well be confused. Then I compared the rates at which people over 70 developed these unexpected complications with the rates at which younger people developed them. Finally, I speculated that each of these problems might trigger a cascade of adverse events: a patient who became incontinent might have a catheter placed in his bladder, which in turn might cause a urinary tract infection; a patient who got confused might be physically restrained and his immobility might lead to a blood clot.


What I found was that among the 502 patients I examined, a startling 41% of those over 70 developed 1 or more of the 4 problems I was interested in compared to only 9% of the younger group—and these were all problems that could not clearly be related to the acute illness for which the patient was being treated. It made me question whether hospitals were a safe place for older patients.

Read more here


Murriel Gillick, “Barking Up the Wrong Tree”,

Sedentary Lifestyle Increases Risk for Heart Failure

We are all aware of the risks of heart disease: diet, exercise, smoking, lipid levels, stress, genetics, etc. Now, research is showing us more specifically to what these lifestyle risks relate. A recent study published in the Journal Circulation: Heart Failure, found that a high sedentary lifestyle increased the chance of having heart failure, as much as 1.34 times that of a low sedentary lifestyle.

Heart Failure

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Similarly, the study found that lower levels of physical activity were also related to heart failure, as much as 1.52 times as likely to get heart failure that those with high levels of physical activity. It is crucial to stress the importance of healthy, active lifestyle for all, to the individual’s highest ability, to protect the heart from disease. This evidence can be used as a motivator to discourage sedentary behaviors.

Young DR, Reynolds K, Sidell M, Brar S, Ghai NR, Sternfeld B, et al. Effects of physical activity and sedentary time on the risk of heart failure. Circ Heart Fail. 2014 Jan 1;7(1):21-7.

For more on this study, see:

Music to reduce stress and anxiety for coronary heart disease patient

Individuals with coronary heart disease often suffer from severe distress, putting them at greater risk for complications, including sudden cardiac death. It is therefore important that the care of people with coronary heart disease focuses on psychological as well as physiological needs. Music interventions have been used for many years to reduce anxiety and distress and improve physiological responses such as heart rate and respiratory rate in medical patients.

This review is an update of a previous Cochrane review from 2009 which suggested that music interventions may have a beneficial effect on anxiety and physiological responses in people with coronary heart disease but the quality of the evidence was not strong and the clinical significance unclear.

Music to reduce stress and anxiety

For this review, we searched for additional trials on the effect of music interventions on stress and anxiety in people with coronary heart disease. We searched for studies published up until November 2012 as well as ongoing studies until November 2012. We considered all studies in which any form of participation in music (e.g. listening to music, singing, playing music) was compared with any form of standard treatment and included persons with confirmed coronary heart disease. We identified four new trials for this update.

This review includes 26 trials with a total of 1369 participants. The trials were small in size. The findings suggest that listening to music may have a beneficial effect on systolic blood pressure and heart rate in people with coronary heart disease. Listening to music also appears to be effective in reducing anxiety in people with myocardial infarction, especially when they are given a choice of which music to listen to. Listening to music may also reduce pain and respiratory rate. However the size of the effects on pain and respiratory rate is small. Therefore, its clinical importance is unclear. Finally, listening to music appears to improve patients’ quality of sleep following a cardiac procedure or surgery. We found no evidence of effect for depression or heart rate variability, and inconsistent results for mood. No adverse effects of music interventions were reported. The majority of the studies examined the effects of listening to pre‐recorded music. More research is needed on the effects of music interventions offered by a trained music therapist. Overall, the quality of the evidence is not strong thus the results should be interpreted with caution.

Read the complete story here

Cochrane Database of Systematic Reviews,”Music to reduce stress and anxiety for people with coronary heart disease“.

Smart Hiring Practices Improves Nurse Retention

The turnover rate for long-term care nurses is far higher than the national average, but facilities can improve retention by adjusting human resources practices, a top workforce researcher said in a McKnight’s webcast Thursday.

While it is no secret that long-term care operators see high turnover rates, the hard numbers show just how serious the issue is, said Frederick Morgeson, Ph.D., of Michigan State University. The national turnover rate for all professions is about 4.5 years, while the rate for registered nurses in long-term care is about a year, according to Morgeson. Organizations with 150 nurses could face between $1.25 million to $2 million a year in the costs of losing nurses, he said.


Providers should consider the recruitment messages they are sending and how these can sow the seeds of future turnover, he said. For example, if a job posting promises opportunities for relocation or career advancement, this could effectively address nurses’ desire for professional growth — the lack of which they often cite as a source of dissatisfaction, according to Morgeson. However, if a provider cannot actually deliver on this promise, the company is likely to attract and hire an applicant who will go on to be unhappy and leave the job.

Read more here

Tim Mullaney, Staff Writer,”Improved nurse retention begins with smart hiring practices“.

Cure or Treatment for Dementia by 2025

The NY Times didn’t cover it; neither did the Washington Post or the Wall Street Journal. But the BBC made a big deal of the G8 “dementia summit,” hosted by the UK just a month ago. Representatives from the research world, the pharmaceutical industry, and the Organization of Economic Development, along with government health leaders, met to discuss what to do about Dementia.

Almost all the members of the G8 took the conference seriously: the UK, Canada, France, Germany, Italy, Japan, and Russia each sent their top health representative. The US didn’t send the Secretary of Health and Human Services or an assistant secretary. The US sent the “acting assistant secretary for planning and evaluation” in the Department of Health and Human Services. This says it all: the US didn’t regard this conference as a priority.

What is Dementia?

  • It is an umbrella term that describes about 100 diseases in which brain cells die on a huge scale.
  • All damage memory, language, mental agility, understanding and judgement.
  • Alzheimer’s disease is the most common form, affecting 62% of those living with dementia.
  • It gets worse with time and eventually people are left completely dependent on carers.
  • It is incurable

Dementia across the Globe

Dementia across the globe

Read more here..


Murriel Gillick, “The Latest War”,