Skin is the largest organ of the human body; yet, while people talk about “kidney failure” or “heart failure,” practitioners or others seldom refer to “skin failure.”
According to Jeffrey Levine, MD, AGSF, CMD, CWSP, a New York-based physician and frequent speaker and author on wound care, “skin failure should be considered as a diagnosis in advanced chronic illness as well as in situations when patients are approaching death.” This is consistent with the recognition that many chronic illnesses worsen over time and increase the likelihood of comorbidities and decreased functional status.
Gary Kelso of Mission Health Services talks about how his skilled nursing facilities have learning circles each day to help staff know the residents. As a result, Mission’s staff turnover rates are below the national average.
Commander Mark Kelly, retired captain in the U.S. Navy and husband of former Congresswoman Gabrielle Giffords, talks about the important role that team work plays in his wife’s rehabilitation.
Dr. Joyce Black, Associate Professor at the UNMC College of Nursing, and faculty contributor to Gero Nurse Prep, was recently recognized for both clinical and advocacy expertise.
Objectives:
Compare and contrast the patient risk factors for pressure ulcer development that match support surface characteristics used for prevention
Explain the benefits to use of a low air loss or microclimate management surface, an alternating pressure surface and a continuous low pressure surface for the treatment of pressure ulcers
Describe how to determine if the support surface is working
Describe how to develop an algorithm for the facility to use support surfaces
We are engaged in a battle to reduce the unnecessary use of antipsychotics to control behavior in our long term care facilities, favoring the use of behavioral interventions instead. Turns out that our struggles in this effort are not unique to the United States.
Nearly two out every five European elders who suffer from dementia are being given antipsychotic drugs, a new study has found. Click HERE to read more.
2014 NNFA/NALA Fall Convention
September 16, 2014 | Booth #71
La Vista Conference Center
12520 Westport Parkway
I-80 Exit #442
La Vista, NE.
402-331-7400
Special Offer!
We are offering $100 off the course fee to people who will visit the GNP booth#71 and get the code at GNP booth#71 during the convention. The offer will be valid from September 16, 2014 and expires on December 31, 2014.
Geriatrics would be a good deal easier if every older person suffered from just one medical condition. But most elderly people have more than one chronic disease and the older they are, the more chronic conditions they are likely to have. Since “multiple chronic conditions” is a mouthful, researchers coined the term “multimorbidity,” an only slightly less awkward way of expressing what is probably one of the most critical features of geriatric existence. It’s so critical because the best medical treatment, known as “evidence-based medicine,” is founded on studies of patients who don’t have multimorbidity at all. They are generally perfectly healthy except for the single disease being studied. So when we tell a patient that “studies show’ that blood pressure should be below 140 and that the best medication to take if the blood pressure is elevated is a diuretic, we mean that if the only problem is high blood pressure, then taking the diuretic is the best way to lower the risk of bad outcomes such as strokes and heart attacks. But if the patient also has another chronic condition, say Parkinson’s disease, which is being treated with the medication L-dopa (Sinemet), then giving that patient a diuretic to lower blood pressure could backfire—long before any heart attacks or strokes were prevented, the patient might fall down (both L-dopa and diuretics contribute to sudden falls in blood pressure when a person stands up) and break a hip. Simply assuming it makes sense to apply multiple guidelines to a patient with multiple problems can result in medication lists a mile long that cost a fortune and that cause more problems than they solve. So multimorbidity is a big deal in geriatrics. Now, for the first time, multimorbidity is getting the attention it deserves.
Image Source: Google Images
A couple of years ago, the American Geriatrics Society set up a task force to develop an approach to multimorbidity for physicians. This group generated a report that lays out the basic principles that should underlie care for a patient with multiple chronic conditions. And a recent symposium brought together physicians and researchers from a variety of backgrounds to come up with strategies for generating a better evidence base, for designing new guidelines, and for carrying out appropriate systematic reviews for patients with multimorbidity. The results of the symposium are published as 3 articles along with an editorial in the April issue of the Journal of General Internal Medicine.
