It’s 9:00AM and you are headed to your patient’s room where he and his family await news on the results of a recent test. Despite being optimistic, the outcome is not what anyone wanted. How prepared are you to communicate with your patient and his family on this? Would you like to be able to support the patient with empathy? Would you like to have the skills to develop a treatment plan at this critical moment?
A FREE online training module “SPIKES – A Six-Step Protocol for Delivering Bad News” will provide you with the tools you need to enhance your confidence. Videos are provided that demonstrate the application of this protocol and you will also be able to see patient/family reaction when news is delivered in an insensitive manner versus using the protocol. This online resource is available 24/7 and provides 1.0 contact hour under ANCC criteria.
The University of Nebraska Medical Center College of Nursing Continuing Nursing Education is accredited with distinction as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
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?
Pressure ulcers – commonly called bedsores — are a big problem in the United States. More than 2.5 million U.S. residents develop pressure ulcers every year, with about 60,000 people dying each year from pressure ulcer complications.
Today is International Stop Pressure Ulcer Day, a day dedicated to bringing awareness to the causes and ways to prevent pressure ulcers.
“This is not just a problem for patients and their families, but also health facilities,” said Joyce Black, Ph.D., associate professor in UNMC’s College of Nursing, who is recognized as a national expert in pressure ulcers. “The government won’t reimburse for Medicare and Medicaid expenses if patients get pressure sores.”
Pressure ulcers can develop in as little as three hours as a result of sitting or lying too long in the same position, she said. Those who are bedridden are most at risk, including those in hospitals and long term care facilities like nursing homes. It can happen in the home as well.
“Ulcers develop quickly depending on how hard the surface is that you’re on and how much fat padding a person has,” Dr. Black said. “Thin, frail individuals develop them more quickly.”
She said pressure ulcers develop due to pressure on the soft tissues when patients don’t move or continuously slide down in a chair. The blood in the area stops and the tissue dies. Most problems with ulcers occur on the buttocks, tailbone and the heel of the foot.
Tips on prevention and treatment
Dr. Black has these tips for preventing and treating minor pressure ulcers.
Sit or lay in different position, walk if you can.
Stay off the sore spot until the pain or red or purple color goes away.
Put a pillow under the calf of the leg to keep the heel off of the bed.
Don’t rub the skin. It may tear.
Keep skin clean. The healthier you can keep skin the less chance of skin breakdown.
Make sure diapers get changed.
Turn individuals every three hours if they are on a good mattress. Every two hours if mattress is thin, frayed or worn.
Cover wound with dressing or apply topical antibiotic to keep wound clean.
Ask what the facility is doing to reduce or prevent bed sores and if you can help.
Ask how they are turning your loved one to get them off their back (individual should be turned on their sides-family members can help).
Ask what kind of mattress the patient is sleeping on. An old spring mattress with an inch padding is not adequate. Family may be well advised to go to a bedding store and get two inches of memory foam so there is more padding on the bed.
Make sure the patient is eating a well-balanced meal (not junk food).
New Feature! Check out the latest at Gero Nurse Prep! We have prepared a demo site to help you decide if Gero Nurse Prep is right for you. The demo contains a sampling of choice topics, and was constructed with the look and feel of the full course.
The risk for developing cataracts, a leading cause of impaired vision and blindness, is higher among individuals using statins as compared with nonusers, according to the results of a recent propensity score–matched cohort study.
Previous studies on the link between this popular class of drugs used to lower cholesterol levels and cataracts have yielded mixed results.
For their analysis, Jessica Leuschen, MD, Wilford Hall Ambulatory Surgery Center and San Antonio Military Medical Center, San Antonio, Texas, and colleagues reviewed data from 2003 to 2010 from the medical records of patients enrolled in a military healthcare system.
Patients were split into two groups based on prescription refills during fiscal year 2005: statin users and nonusers. Statin users were defined as those who had taken statins for at least 90 days, and nonusers were individuals who had never used a statin throughout the course of the study.
Leuschen J, Mortensen EM, Frei CR, Mansi EA, Panday V, Mansi I. Association of statin use with cataracts: a propensity score-matched analysis. JAMA Ophthalmol. 2013 Sep 19. doi: 10.1001/jamaophthalmol.2013.4575. [Epub ahead of print]