I never thought hip protectors did any good. Now a study proves me right!

BOSTON, July 24 — Hip protectors designed to lessen the impact of falls among older adults do not appear to reduce the incidence of hip fractures, researchers here found.

In a large clinical trial, nursing home residents actually had a higher rate of hip fracture when wearing foam-covered polyethylene pads than when unprotected (3.1% versus 2.5%, P=0.70), reported Douglas P. Kiel, M.D., M.P.H., of Harvard and Hebrew SeniorLife, and colleagues, in the July 25 issue of the Journal of the American Medical Association.

The results confirm “the growing body of evidence that hip protectors are not effective in nursing home populations,” they wrote.

There are some conflicting points in this article and it’s hard to follow the process used in this study. The bottom line was simple though: Hip protectors don’t protect hips.

This is a good idea.

Senator Charles Grassley is proposing a new “watch list” for nursing homes that aren’t meeting federal health and safety standards. “That would include nursing homes that yo-yo in and out of compliance by using grace periods to correct deficiencies, but only then on a temporary basis,” Grassley says. “We never seem to get consistency of safety and quality at these nursing homes.”

The public would be better able to judge whether a nursing home is the right place for their loves one if a “watch list” disclosed which homes aren’t up to snuff, according to Grassley. “It’s kind of a right to know approach,” Grassley says. Sanctions against nursing homes are often withdrawn before they go into effect because the homes are given time to correct deficiencies, according to Grassley, so the public often never knows of serious health and safety violations.

“The fixes that turn out to be only patches mask permanent problems,” Grassley says. “The whole situation warrants a watch list that would identify the nursing homes that repeatedly fall out of compliance.”

We all know how these places manage to get by with this Plan of Correction bulloney. Everything is made to look good but in the long term, nothing changes. Repeat offenders should be red flagged.

Working with certain populations of people, in our line of work, can be very dangerous. We expect it from those patients who are mentally ill. BUT we should not endure threats and abuse from our own PEERS.

Is this a case of Aides Gone Wild??

I don’t want to comment too much on this; but I can say that this is the result of very bad management.

Just go read the article!

Identity theft of nursing home residents. And the CNA’s who committed these crimes.

A federal grand jury has indicted 17 people, most native Kenyans, for allegedly stealing the identities of hundreds of nursing-home residents and filing false tax returns in their names.

The conspiracy, which began in February 2005, sought more than $13.1 million in fraudulent returns from the federal government and 27 states, U.S. Attorney John Wood said Thursday at a news conference.

The defendants allegedly stole the identities of more than 300 people, most from the Kansas City area.

“Identity thieves are using more complex and sophisticated methods to commit their crimes,” Wood said.

Some involved in the conspiracy used their positions as certified nursing assistants to gather personal information, which they passed to others who prepared the returns, authorities said.

“It’s not hard to get identity information in an institutional setting,” said Assistant U.S. Attorney Curt Bohling. “They might have a chart with their name and Social Security number on it, which is all you need.”

The grand jury Wednesday returned the 18-count indictment under seal. Federal agents Thursday arrested 10 of the defendants. Officials said three others were believed to be in Kenya, and four remained fugitives in the United States.

Those charged include: Loretta Wavinya, 30; Ervin Somba, 26; Edwin Nyumu Sila, 25; Lillian Nzongi, 26; Moses Ndubai, 33; and Bernard Nyemba, 39, all of Kansas City; Vincent Niagwara Ogega, 23, of Independence; Aaron Mutavi, 28, of Overland Park; Kenneth Njagi, 31, of Lenexa; Mary Gitiha, 25, of San Francisco; Ernest Kangara, 40, of Santa Rosa, Calif.; Paul Kilungya Nyumu, 41, address unknown; and Karingithi Gotonga Kamau, whose age and address were unknown to prosecutors.

No commentary needed on this. It’s wrong. And we need to think about ways to keep SSN’s and other pertinent info out of the hands of those who might have reason to steal the name of someone else.

It’s all in the technique?

Working together to reduce the occurrence of pressure ulcers in patients throughout various care settings, members of the New Jersey Hospital Association’s Pressure Ulcer Collaborative have reported a 70 percent reduction in the incidence of new pressure ulcers after nearly two years of applying shared best practices and preventive techniques.

Each year, pressure ulcers, commonly known as bed sores, affect more than 1 million patients and residents in nursing homes and hospitals nationwide. Costs associated with pressure ulcer treatment exceed $1.3 billion. More importantly, the human toll of pain, depression, altered self-image, infection and increased mortality is immeasurable.

The NJHA Collaborative, which first met more than 22 months ago to develop and share standardized preventive strategies, is comprised of 150 hospitals, nursing homes and home care agencies. The 70 percent reduction in the incidence of pressure ulcers was reported from data that was tracked from September 2005 through May 2007.

Everyone knows the dangers of pressure sores; the time and effort and costs to clear them up is very high. And we also know for the most part, pressure sores are preventable.

So what special techniques were used?

Common improvement techniques used by staff at hospitals, nursing homes and home care settings alike included: complete skin evaluation within eight hours of admission; evaluation of the risk of skin breakdown using the internationally respected Braden scale; implementation of preventive strategies, such as proper positioning and use of assistive devices; and ongoing observation of the condition of patients’ skin, particularly for those identified as being at high risk for developing a pressure ulcer.

That’s IT?? This is good old fashioned nursing care. If we did this more and provided decent and ethical staff, pressure sores would be a thing of the past.

A Boston MA nursing home will have a special unit for gay and lesbian residents.

The Chelsea Jewish Nursing Home Foundation in Boston is slated to build a new $26 million facility with specialized units, including one 10-bedroom section “for elderly residents who are lesbian, gay, bisexual, and transgender,” Barry Berman, the executive director told the Boston Herald. “Someone could feel comfortable putting up a picture of their partner without someone snickering at them or ostracizing them.”

The unit will be named the Elsie Frank House, after the late mother of out gay Congressman Barney Frank, a Democrat who represents the Boston suburban area that includes Newton. She was an advocate for LGBT rights and low-income housing for older people.

I’m not inclined to think this is a bad idea, but the “snickering” could still happen, from the staff if they are not respectful of resident rights. Do other nursing homes have similar units?

Falls usually occur during change of shift times or at night. Both of these times we see a lack of supervision in nursing homes. Staffing patterns for third shift do not take into consideration the fall risks associated with the residents. And change of shift is when the aides are off the units getting report. I don’t know when these falls happened, but I do suspect it was during these prime fall risk hours.

The Health Department has ordered the Park View Nursing Home, in Providence, to immediately correct the inadequate staffing that led to repeated falls by a patient.

The patient, who suffered three injuries in 11 falls between October and the end of May, was declared in “immediate jeopardy” late last month and moved to another floor in the nursing home.

Four other residents were found to have fallen multiple times because they lacked supervision. One suffered a fractured hip and elbow and cuts to his face that required stitches. Another resident was hospitalized with a hip fracture.

The Health Department also ordered Park View, at 31 Parade St., to hire an independent “quality monitor” to advise the home on meeting state and federal laws, file twice-monthly progress reports, and seek department approval before admitting any new patients.

Those orders remain in effect, but the immediate-jeopardy finding was rescinded Tuesday after a survey team found that the nursing home had fixed all conditions that carried a risk of immediate harm, said Raymond Rusin, director of facilities regulation. The quality monitor is now working with the nursing home on making improvements, which must be complete by Aug. 13, he said.

“This is primarily about accidents and prevention of accidents. We cited staffing,” Rusin said.

Good. The more pressure a state can place on a nursing home, to increase staffing, the better off the residents will always be.

Margaret Vaccaro, Park View administrator, said the nursing home has brought its staff up to acceptable levels. She said she expected to be in full compliance with regulations by July 28, if not sooner.

“Most of our severe deficiencies have been corrected,” Vaccaro said. “The most important part was getting the staffing up, and everything else flows from that.”

Now that is the quote of the day- that last sentence. Too bad all nursing homes don’t get it.