Caring for Patients with Mesothelioma


Mesothelioma is a rare and aggressive cancer most often caused by a long-ago occupational exposure to asbestos, typically striking those in the retirement stage of life.

Although there is no definitive cure — and a diagnosis is met with considerable gloom and doom — recent therapeutic advances have begun extending lives significantly, raising the importance of a primary caregiver at home.

Instead of the past cancer prognosis of 6-18 months to live, some patients today are surviving two, three, four or more years after finding a mesothelioma specialty center that uses a multidisciplinary approach to treatment.

Taking care of a mesothelioma patient might seem like a daunting task, but it also can be a richly rewarding experience if provided the necessary tools. Understanding the cancer is important.

Pleural mesothelioma, the most common type, begins in the thin membrane surrounding the thoracic cavity. It stems from inhaling microscopic asbestos fibers, which become lodged in the lining around the lungs. They slowly cause inflammation and scarring, and eventually lead to cancer several decades later.

Early symptoms may include tightness of the chest, a persistent dry cough and strained breathing patterns. The later stages of disease can be debilitating, often making the simplest of tasks impossible without a caregiver at home. An uncertain future only adds stress to the patient and family.

A mesothelioma caregiver might be dealing with medical and legal professionals, remembering medications and treatments, managing appointments and financial affairs. In the latter stages, the caregiver could be feeding and bathing the patient, too.

The caregiver can become overwhelmed, struggling to maintain his or her own life. To improve patient care, there are some important things a caregiver should remember.

Here are a few:

  • The better you feel, the better care you will provide. So take care of yourself physically and mentally. Even with a demanding schedule, find the time to recharge your own batteries. Eat right.
  • Accept help from others. Ask for it, too. Too often, a caregiver tries to go it alone, and becomes worn down. It may seem admirable to spend every last minute alongside your spouse, but that often backfires. Let other family members or friends help with daily chores and provide a break.
  • Explore alternative or complementary therapies. Think outside the box. It might seem odd, but homeopathic treatments like herbs and anti-oxidants can sometimes help. Mind-body therapies, such as yoga, and even energy therapies, including music, can help, too.
  • Talk to others dealing with the same rare disease. Join a support group. Those in the group may understand your questions better than a nurse or doctor would. It also takes away the isolation that a caregiver often feels. The Mesothelioma Center has a support group that meets by phone monthly to discuss various topics.

“Sometimes, I think caregivers are the forgotten casualties in all this,” said Linda Chitwood, who has been her husband’s mesothelioma caregiver in southeast Virginia for eight years. “There is such a range of emotions you have to go through. And it can be terribly isolating if you’re not careful. You have to take care of yourself, too, if you want to be a good caregiver.”

If you’re interested in reading more about her and her husband’s journey, she detailed it in her 2012 book, “Fear 2 Faith: Our Journey Through Mesothelioma.” It contains their highs and lows, as well as the heartaches and heartwarming experiences.

Learn What Fall Prevention Can Do For You


Imagine it: you’re a caregiver in a nursing home facility, administering medication to one of your patients. It’s evening and the building has quieted down for the most part; many residents have already turned in for the night. As you finish with your patient and are gently closing the door behind you, you hear it. At first it’s a muffled thud – a sound you can’t quite place – and then it’s a throaty moan from down the hall. Your heart accelerates and fills with panic. You dart in the direction of the noise, desperate to find its source. When you finally arrive, you find a resident on the floor, tears of pain streaming down cheeks, bruises already blooming. You’re terrified and heartbroken as you kneel down to the floor and shout over your shoulder for backup.

Perhaps this is a scenario you dread of experiencing as a caregiver to the elderly – or perhaps it’s one you’re already familiar with. Whatever the case, falls in nursing homes is a looming and near-constant threat. It is estimated that 75% of patients experience a fall at some point. Injuries from falls can be devastating, and the facility often pays the price when they occur.

There have certainly been various types of fall protection plans that facilities have implemented over the years, such as walking programs or the use of companions. The use of call systems  is another idea that works in theory, though they fail to provide accurate and consistent fall intervention.


An Advanced Fall Protection Plan

Now imagine it: you’re assisting one of your patients when your pocket buzzes from your cell phone. You check it and receive an alert that one of your other residents is at risk of falling. It tells you which resident and which room number, so you pace quickly down the hall and find your patient fiddling around in his or her bed. You ask how you can help.

This advanced fall intervention technology is not just a whimsical thought – it’s an actual monitoring system brought to you by Hello Nurse. Our system is the only one of its kind that has the ability to notify caregivers of possible issues before the incident can occur.


How the System Works

Installation of the Hello Nurse system simply involves placing one pressure pad on a resident’s bed or chair. Each Receiver can monitor up to 30 residents at a time, and when someone is attempting to rise, an alert will automatically signal. These alerts can be sent to a pager or cell phone, providing immediate details to staff members that include the patient’s room number and name.

And one of the best parts is that the Hello Nurse system is always on and monitoring for specific events on residents. Because the technology works independently of facilities’ IT systems and does not require the use of Wi-Fi, caregivers can rely on it to constantly be effective. And since it operates on a pager system, the alerts are always instantaneous.  

The many benefits of a fall prevention system far outweigh the fear of a resident experiencing a traumatic – and potentially life-threatening – fall. Don’t let yourself or your facility live with that fear anymore. Look to Hello Nurse for more information and ways to learn about our product. Help is always on the way.

The Effects Of Falls – And How Plans Can Work to Prevent Them


As healthcare providers in the geriatric field well know, falls sustained by the elderly are extraordinarily hazardous. The CDC has actually reported that between 50 percent and 75 percent of residents in nursing homes fall every year – a staggering percentage. Not only do these statistics mean horrible things for elderly residents: they can also prove exceedingly negative for the facility itself.

While accidents can and do happen, preventing falls in nursing homes is exceptionally important today. This prevention is about more than providing good care to the people in your facility’s care. It’s also a necessity to ensure that your facility will not fall victim to negative consequences that occur following a fall. Consider these three possibilities that commonly affect facilities after a fall:


  1. Legal Backlash: In the best-case scenario of a fall incident – one in which the resident who falls does not sustain a serious injury – the staff members and facility must still handle the repercussions of the accident. In addition to paperwork and reports that inevitably detract time away from caretakers’ additional patients and duties, there is a potential for lawsuits and legal action from the resident, their family, or local or federal authorities. Aside from the actual fall itself, litigation is probably the last thing a facility wants to confront, as legal involvement can be a lengthy process and incredibly pricey.
  2. Repercussions to the Facility: Additional backlash to falls include both a decrease in of your facility ratings and poor survey results for the facility as a whole. These can ultimately affect your facility’s ability to continue working with residents, their families, and other members of the public.
  3. Additional Work for the Staff: Again, in the best-case scenario of a fall, the patient who suffers will still be required to receive additional care and monitoring after the incident to ensure it won’t happen again. Unfortunately, in a more serious fall, the resident could possibly be injured for life, which would necessitate another level of medical attention. For a facility that may already be understaffed, this adds additional pressure to its staff members.

Along with the harm caused to elderly residents in general, this brief list further illustrates how harmful nursing home falls can be. What this does not represent, however, are the number of deaths that these falls cause every year – which is around 1,800 according to the CDC.   

So what can be done to address this – and to address common causes of falls in the elderly? There are three key ways you can take action and work to prevent falls in nursing home:


  1. Carry Out A Risk Assessment: It’s important for caretakers to understand that there is not a single issue that causes falls in the elderly. Typically, falls occur because of a multitude of factors, so it is necessary to complete a risk assessment of each patient in order to determine whether he or she is a fall risk. Resources such as this guide from MedScape can assist caretakers in monitoring for signs of a potential fall in order to prevent the incident before it ever occurs.
  2. Create a Fall Protection Plan: Once residents are assessed, it’s time to take the next step in addressing any issues. Is the patient taking a high-risk medication? Are they experiencing continence issues? Do they exhibit a fluctuating mental status? If the assessment has determined that a resident is, in fact, in danger of a fall, then these are the type of factors that caretakers can look into adjusting in order to reduce that risk. Even though it might take time, it’s important to create an individualized fall protection plan for each resident who might be under threat of future injury. This additional time will make up for the aftereffects of a fall that impact everyone involved.
  3. Build A Culture of Safety: A nursing home facility must cultivate a culture of safety for both their staff members and their residents. Potential action plans include creating a fall prevention team and appointing staff to fill leadership positions. This team can work together to instate a system with regulations and procedures for the rest of the staff to follow. By creating accountability and strict rules on safety, caretakers can learn to work together and rely on one another to better secure and monitor their residents.
  4. Invest in monitoring tools that can alert staff to a possible fall before it occurs. No prevention plan is 100 percent foolproof, unfortunately. However, modern technology can provide staff with the extra resources they need to truly begin preventing falls in nursing homes. Hello Nurse, for example, can be set up to send out direct alerts to caregivers, facilitating a quicker response time when a resident is at risk of suffering from a fall. Our monitoring system is just one example of the tools available today that are designed to truly address falls before they ever occur – and in this case, it truly is an example of technology to the rescue!

Falls have a history of plaguing the nursing industry as a whole. However, they do not have to be part of your own facility. To continue to learn about fall prevention, we recommend reading about things that do – and do not – help to prevent falls. It also never hurts to research the best ways to instate your own plan and methods. And remember – help is on the way!

Remembering To Remember: Caring For Patients With Alzheimer’s


Both the holiday season and the transition into a new year tends to revolve around nostalgia and fondly reminiscing on the seasons of our past. But what if you had no recollections of these previous periods? What if these warm memories simply eluded you?

 This is the tragic state of affairs for nearly 50% of nursing home residents in the U.S. who live with Alzheimer’s disease. It’s estimated that around 5.3 million Americans suffer from this disease, and that 1 in 3 seniors will die of Alzheimer’s or another form of dementia. Sadly, it is the only disease among the top 10 causes of death in America that cannot be prevented, cured or even slowed.

Due to the severity of this condition, it’s vital that facilities work to enhance the quality of life for both the patients and their caregivers in nursing homes today. Doing so can help staff provide the best care possible, even as facilities work to overcome staffing issues in busy modern nursing homes. We recommend the following for facilities looking to improve Alzheimer’s care in 2016:

Review the disease’s stages with staff members. Al nursing facility caregivers need to be properly prepared to handle the three major stages of Alzheimer’s care: early-stage caregiving, middle-stage caregiving, and late-stage caregiving. There are different expectations for each stage, as well as different patterns of behavior that residents are likely to exhibit during each stage. For instance, in the early stages, a patient might still exhibit independence and not necessarily show outward signs of the disease. In the late-stages, however, the patient might need assistance with even the most basic of functions, such as eating or swallowing. Understanding and clearly laying out the responsibilities of a nurse and of staff members during each stage will help your facility provide better care.

Help busy, frustrated staff accept the patient’s condition. Alzheimer’s disease, particularly in the more advanced phases, can be incredibly frustrating to deal with, even for the most experienced nurses. Many residents may even get combative and overwhelmed – projecting anger onto those around them. This is relatively normal, and should not be entirely reflective of the patient. Facility caregivers must also remember that people dealing with dementia often feel isolated and alone. Of course, good staff members will know this – but open communication with management, reminders about this fact, and resources for caregivers taking the full brunt of this stressful burden can go a long way in addressing the stress it creates in a facility’s nursing staff. It also gives management a chance to remind staff about good caregiving practices in these situations (i.e. accept that these behaviors are part of the disease and attempt to work through them; do not argue or convince a resident; try to both be the one in charge and treat your patient with compassion).

Know your resources. It’s not uncommon for caregivers and staff who work with multiple Alzheimer’s patients to experience occupational burnout – especially when more than one of your facility’s residents exhibits difficult behaviors. It’s incredibly helpful for your staff to know that there is help out there for you. For example, there are groups specifically designed for caregivers dealing with dementia that provide advice and support. Even if a staff member just needs to vent to someone else who deals with the same issues, it can be helpful to reach out so that you can get encouragement and feel less overwhelmed. Encourage your staff to find groups in your area that they can meet with, or even online forums to contribute to – it may very well be what makes their new year at work more productive and manageable.

Alzheimer’s will remain one of the constant diseases prevalent in nursing home facilities. Make sure that you, your facility, and your staff continue to be connected to both information and help when it comes to caring for patients with this and other forms of dementia. And remember, if you need additional help monitoring these specialized conditions, feel free to contact us with questions on how Hello Nurse can help.

6 Fun & Seasonal Activities for Assisted Living (That Your Staff Can Plan!)


The day-to-day responsibilities of operating an assisted living facility can sometimes feel more burdensome than rewarding – particularly if the facility is understaffed. As a staff member, it’s easy to get dragged into an unstimulating routine of caring for your patients. Now that the holiday season is here, though, our traditions of decoration and celebration could give facility staff the perfect opportunity to recharge – all while benefiting their residents!

Not only do holiday decorations brighten up a facility – but organizing fun activities for assisted living residents can also be a simple way to breathe some excitement back into the job. Plus, by bringing a bit of holiday cheer into the facility, staff can create a happier environment for residents, and therefore provide better quality care!

Even better, holiday decorating doesn’t need to rob too much time from the schedule. Here are a few seasonal suggestions for great activities you can put together for your residents:  

  • Start A Baking Club. Gathering residents who can safely work in the kitchen and allowing them to try their hands on a fun recipe or two is a great way to empower them. Depending on your facility, you can organize and have a baking day weekly, biweekly, or monthly – whatever will suit your staff and residents best. Some great ideas to make around the holidays could be eggnog cookies, a classic fruitcake, or even gingerbread cutout cookies that residents can personalize.
  • Throw A Hot Toddy Social. Invite residents to gather in a common area and serve up delicious hot toddies. You could even make it a themed event and celebrate December as the month Prohibition ended. Play some Sinatra records, or some tunes by the Andrews Sisters, to complete the perfect afternoon in your facility.
  • Plan A Holiday Trivia night. Put on a trivia night this month and invite residents to play as teams. Be sure to ask holiday themed questions (and don’t forget to include Hanukkah, Kwanzaa,and New Year’s!) that will not only fit the theme of the season, but which will have residents using their noodles!
  • Organize An Afternoon to Record Memoirs. Giving residents the opportunity to sit down and tell some of their favorite – and maybe even secret! – stories is an excellent way to engage their minds and to help them build relationships and friendships among their community members. By recording these tales, you can also provide a wonderful gift for their families.
  • Start A Walking Club. Keeping your residents fit can certainly be a challenge. If you don’t already have one in place, a Walking Club could be an easy way to encourage people to start healthy habits by making it a social event. The benefit to this idea is that you can continue it year-round (and while it won’t necessarily help to prevent a fall, it will certainly help to keep your residents a little healthier!).
  • Put On A Reading Series. Another great way to engage residents without having to resort to the television is by reading aloud to them. Have one of your staff members choose a seasonal book to read from and start a series – read a couple chapters every day, or every few days. Encourage this staff member(s) to be lively and interactive with the residents and turn it into a fun event.  

As you can see, while it’s tempting to make the holidays a momentous celebration, organizing facility events doesn’t have to be complicated or costly. They can even serve as a way to avoid burnout in staff and idleness in residents; because of this, we recommend thinking of of holiday ideas as a way of providing quality care, rather than as an annoyance. So go ahead, use these ideas or brainstorm your own, and make this holiday season at your assisted living facility the best one yet!

4 Ways To Give Your Facility A Competitive Edge


Operating a nursing home facility is a complex business. Staying compliant and cost-effective is a challenge in itself, particularly when combined with the need to remain patient-focused. It can be a difficult balancing act to ensure you are running a successful business – which includes keeping your staff happy – while still providing high quality care.

But it can be done! Here are a few ideas to consider that should help improve the processes you already have in place, and thereby help you build a stronger business and care model overall:

  • Communicate with residents. It sounds incredibly simple, but communicating with the residents in your facility is very important if you hope to improve care. Currently a number of experts are calling to shift the old culture of nursing homes to a new one that would emphasize encouraging both facility staff and family members to have a dialogue with their elderly patients. “Rather than assuming they need one thing, a better idea would be to simply ask them,” states Atul Gawande, author of Being Mortal. A simple question could be all it takes to boost resident satisfaction – as well as patient care.
  • Engage with their families. Involving residents’ family members is another simple trick that can help improve the success of a facility. As discussed in a previous post, the quality of a facility’s care efforts is very important to families as they choose a home for their aging relatives. But in addition to care, families are also interested in accommodating visiting policies, as well as the facility’s overall guest environment. If relatives are encouraged to visit and share meals or activities with patients, then resident satisfaction will likely improve – and so will the reflection on and reviews of your facility.
  • Restructure your care model (if possible). Depending on your facility’s budget, this may be a difficult goal to achieve, but new versions of nursing homes are starting to take hold across the country. One of the biggest differences between these new facilities  and traditional facilities is that patients have private rooms and staff can concentrate care on small groups of residents, rather than distributing generic care to a multitude of patients. If you cannot afford to restructure, then it’s important to take a strong marketing approach by highlighting the advantages your facility offers that others do not. By sharing information on how you provide quality care and work with other healthcare providers, you can increase your competitive edge in the industry.
  • Implement modern care assistance technology. One of the best ways to better your facility is to invest in competitive technology that will improve the quality of your care. For example, wireless patient monitoring systems are able to collect data on residents and send warning signs to staff before an injury can occur. When incidents and reports are prevented, patients receive better care and facilities receive better reviews and reputations.

Overall, running a good business and prioritizing patients can – and should – go hand-in-hand. When you implement strategies that boost both goals, you should be able to see success.

To learn more about an easy way to invest in your facility, be sure to download our brochure and to explore the benefits of Hello Nurse’s own wireless monitoring technology tool.

Why They Care: What Motivates Nursing Home Staff Today?


Working in a care facility today is growing more and more difficult for the caregivers and nurses who have risen to meet the challenge of providing care for an aging population. Right now, nursing homes must prepare for the day when the Baby Boomers require the help of professional caregivers. At the same time, ongoing changes within the healthcare field in general mean that facilities are constantly experiencing fluxes in industry rules, budgets, and even staffing demands. Add in the fact that consumers today are quick to look for signs of neglect – whether intentional or accidental – and it’s easy to see that caregiving staff today have been given quite a headache to manage.

So why do they do it? Despite the fact that many facilities are vastly understaffed and nurses often report that they feel underpaid, these brave individuals continue to come to work and find the silver lining in what is truly an incredibly stressful job. For them, working within the industry is not just rewarding – it’s beneficial on a personal level. Here’s how:

The job helps to keep them prepared for their daily life. Many individuals currently have an elderly family member involved in their lives somehow – whether that be a grandparent, a parent, an aunt or uncle, or an older friend. By working in a nursing home, nurses have the ability to witness and work with the aging process firsthand. The result? They are often able to give better recommendations to relatives or friends about what to do to address their own aging needs. This ability to provide advice – and even to help friends and loved ones navigate the nursing home system during an incredibly stressful time – is a very valuable skill that staff can use to benefit the people in their lives outside of work as well as within it.

The job helps to make them comfortable. Many caregivers will testify that working in a nursing home can help them grow more comfortable with the idea of the aging process. After all, growing older is almost a universal fear. It’s something that everyone thinks about eventually – it’s something that worries many people, too. It can feel particularly daunting and highly isolating if someone does not know exactly what may happen to them over time. As a geriatric caregiver, though, individuals have the opportunity to help patients face these obstacles. This allows staff to demystify the aging process – thereby removing a major source of this fear.

They enjoy (aspects of) the nursing home environment. While they face many challenges within their facilities, many nurses or caregivers who work in a care facility prefer this type of environment over other caregiving settings, such as a hospital. Care facilities give staff members a chance to grow familiar with the residents they care for. The possibility of building relationships can certainly make the job easier, particularly as staff learn how to work with each patient individually. The ability to build a repoirte – instead of being forced to simply treat a patient and send them home – allows staff to enjoy connecting with another human being. And in many cases, this is what the staff in a care facility want! After all…

Caregiving allows nurses to work with a population that needs their help. With over 1.4 million men and women residing in nursing care facilities, it’s clear that the need for caregivers is not going anywhere. Ultimately, working with the elderly can be rewarding simply because it is a job that requires kind act after kind act. It calls on staff to provide comfort and support to another human being. And for many nurses and caregivers, meeting this need – and taking up the mantle of treating consumers as an extended family member – is what brings them the greatest level of satisfaction at work.

Unfortunately, as changes in the industry continue to impact nursing homes, even these benefits of working in a care facility cannot always prevent caregiver burnout or other serious problems. Ultimately, it’s just as important to provide staff with tools that will make their jobs easier, from EHR usage to the implementation of patient monitoring technology. The right tools will allow staff to continue to focus on their reasons for working in the industry, instead of possible reasons to leave it.

呼叫系统落伍,现代科技涌入— — 在看护机构防止跌倒


您的机构已经用过居民启动呼叫系统吗? 如果是这样,你并不孤单。许多长期照护机构曾经有可能投资于呼叫系统以增加安全和提升的消费者对其运作的意见。

今天,然而,普通护士呼叫系统已经被证明并不总是对居民病患最有效也是最实用的工具。现在许多人对于呼叫系统反应度是强烈皱眉 — — 并不是积极主动 — — 针对跌倒安全的预防方法。 并在系统的地方,越来越多的行产业领导者选择使用一个新的现代安全工具,更有可能向居民提供他们需要的安全与保护: 自动监督。


呼叫系统确切地的问题是什么? 曾经是一个长期照护机构有展望的工具,居民启动呼叫系统已经不能持续地提供保护和援助当居民可能需要在紧急情况下,尤其是涉及跌倒。


更重要的是,经由呼叫系统并不能帮助预防跌倒放在第一位。这是不能被忽视的需要。疾病控制和预防中心目前报告说”介于一半和四分之三的养老院居民每年跌倒”和”约有 10%至 20%的养老院居民跌倒造成严重伤害”。更糟的是,每年约 1,800 位在养老院的老年人因跌倒造成死亡。这仅只是在养老院里的数字 — — 这一数字不包括那些缺乏全国性监督的辅助生活或其他照料类型。

这数字是太高了 — — 单单以呼叫系统是无法解决预防跌倒的需求。




what families look for in assisted living为所爱的年长者选择长期照护的机构并不容易。





当新的居民患者或居民患者家人经过你的大门时,他们不只是观看环境 — 他们会专注于他们的感官。

高功能、 组织护理设施往往要更安静及不混乱。

频繁的、 大声的广播都是一种警讯 — 消费者期望一个更现代的通信系统,和会注意到它是否产生不愉快的气氛。

对于阿尔茨海默氏症和老年痴呆症的老年人,嘈杂的环境可能会对居民患者有特别的压力 — 他们的亲人知道这一点,也会根据此来选择一家养护院。


真相有关于”老人体味”(也称为壬烯醛的身体气味)是: 它是自然的老化过程中,没有人需应该为此事感到羞愧。

然而,这些气味会因为尿片未更换, 皮肤感染和不经常的沐浴而加剧其味道。




但事情已经改变。让访客于凌晨2点来访, 虽然它可能不是明智的,因你居民患者的访客应该会觉得他们可以来来去去,参与活动,并与他们所爱的人一起进餐。

如果你将探视时间限制在一个时段里,居民患者家人会想,”探视以外的时间居民患者的情况如何?” 和可能会怀疑当居民患者访客不在时候的职员配置水平和护理的质量下降。


你的社区文化说明了关于在您的机构的生活的型态。尤其是,注意你的员工相互之间以及与居民患者之间是如何交互作用的。当护士不知道居民患者的名字,可能会以粗厉的语气对居民患者和其他居民患者说话,或反之亦然 — 居民患者家人可能假设工作人员并不是以他们为最优先。




他们会想知道什么样的科技系统装置在你的机构,以防止可以预防的事件,例如褥疮、 跌倒、 感染,和更多的问题。

如果你不准备回答这些问题,那是一个警讯 – 幸运的是,如果你正在积极寻找这些问题的答案,帮助是咫尺可及的。




Image courtesy Wikimedia Commons




极为重要的是要为你的居民患者设置有一个结构化的皮肤保健的方案, 这样你就可以避免一些常见的缺失:


你会惊讶有多少机构采购预算水平乳液、 沐浴乳、 肥皂和洗发水。投资于高质量的产品对于采购决策者是重要的 — 老年皮肤不同于 30 岁的皮肤,应以不同样的方式来照顾。

老年人的皮肤处于退化阶段。便宜的护肤产品通常并不具酸硷值平衡功能且以酒精作为一种主要成分。这就象是一个配方作为给干燥的皮肤、容易眼泪、 皮肤破裂,褥疮和/或溃疡等。

与您的供应中心协调员和管理员购买护肤品,此应为特别设计专为医疗保健应用 — 和确保他们在每个时段随时可供应。



许多长期照护的社区做到正确地使用护肤产品,但并不应用于居民患者洗完澡后 — 这是适用任何种类的洗剂或产品的理想时间。

很多机构还在使用会阴冲洗以预防患者使用便盆的感染。然而,即使会阴冲洗不是”非冲洗”种类, 很多照护之家并没有在使用冲洗后立即清洁该便盆。

甚至有的用抗菌肥皂来替代会阴冲洗 — 这又是另一种造成皮肤干燥和后续并发症。






最后,作为一名养护院的管理员,你应该每周检查你的员工对于居民患者的皮肤报告— 如果这些报告有被完整的纪录。

找出第3-4 阶段压力领域的高频率,看看您的机构对于皮肤保健的检修是否已过期。此外,为所有你的居民患者使用 Bradens 计量器预测压疮风险,无论他们的病史如何。


使用床垫旨在促进愈合。使用居民患者患者的监测技术,以密切留意居民患者患者发生褥疮及溃疡的高风险。藉由改进您的员工为护对居民患者的皮肤护理程序,此即保护您的机构 — 无论在在财务和法律的层面。



你认为导致养护院居民患者损伤主要因素是什么? 如果答案是跌倒,那你就猜对了!

当在你的社区老年居民患者跌倒,损伤的严重程度可从轻微擦伤到头部严重创伤,甚至死亡。更令人担忧的是,你可以装置最有效的居民患者患者监测系统以减少跌倒的风险 — 但如果你没有设置回应的方案,跌倒的后果可能打击到你的机构的底线,偿还和病人满意度指标。

AHRQ 已经发展一个 “什么是跌倒有效应对的战略” 全面审查 — 有多少的这些程序是已经在你居民患者社区里实施?


只要居民患者跌倒,护理人员应立即来评估情况。居民患者不应尝试起床或移动直到护士评估完毕。这种评估应包括测量生命迹象,问居民患者如果他或她有没有疼痛 (和严重的情形,从 1-10 范围内),以及检查有瘀伤、 擦伤、 割伤或者任何类型的出血。为手臂和腿部的运动范围也应进行评估,以确保没有脱臼。


如有必要 (及居民患者是能够站立或坐起来),护理人员应于评估后适用急救。而即使骨折的迹象并不明显,如果护士怀疑居民患者可能有骨折情形时应该执行X光片的照射。如果病人是仍然无法移动,应该用担架或救护车于运输居民患者至适当的救护机构。当然,所有这些活动和评估结果都应记录在居民患者的档案中 — 并应通知他们的家人。


如果没有发生骨折情形,护理人员应在跌倒以后几天监测居民患者健康 — 尤其是最初评估时没有察觉对因跌倒造成行为或伤害等在的任何变化。



最后,一旦居民患者是在稳定的条件和所有即将发生的健康问题都得到适当的处理。养护院工作人员应评估跌倒发生的原因和制定计划以防止未来的跌倒 — 它新科技投资到警报护理人员当居民患者开始移动,移除障碍,重组某些元素,使环境更安全。



养护院董事应彻底检讨 AHRQ 跌倒回应准则 — 和如果当前资源不允许工作人员的结构改变、 护适通将提供给您及时的帮助。

5 件事无法避免养护院的跌倒事件……有一件事可以做到


每年,典型 100 床养护院报告有 100-200 起跌倒,此根据美国疾病预防控制中心(CDC)的资料。当然,那些数字仅仅只是来自那些已经报告。

这些跌倒并不是一种”滋扰”— 每年近 2000 名养护院居民患者因跌倒而死亡。10 至 20%的所有养护院跌倒的居民患者造成严重的损害。

更不用说,护养院处理跌倒的成本 — 在时间、 资源、 直接成本 (比如,居民患者损伤治疗) 和间接成本 (比如从跌倒所引起的诉讼)。


长期的医疗决策者注意: 这些预防策略并不被证明可以预防老年人跌倒:

1比1 的同伴

当居民患者的跌倒风险评估表明他们处于高风险的跌倒时,一些养护院分配那居民患者 “1:1 的同伴”— 在任何时候都是与居民患者患者一起的护士或照护人员。根据 2010 年的护理管理论文,虽然,不只是这种策略使护理人员效率低下 — 1:1 的同伴并不能预防跌倒。例如,一名 82 岁的居民患者患者仍然跌倒当护士正在为他准备茶的同时。



研究显示,维生素 D 具有很小,但对老年人的骨质密度的积极影响。然而,很多人断然做出结论,维生素 D 可预防老年跌倒 — 事实并非如此。

虽然维生素 D 可能减少跌倒受伤的严重性,研究表明它并不是可以防止跌倒。 2014年Lancet糖尿病及内分泌发表文章总结了一项研究 在29,535 人跨越 20 随机控制试验中,发现使用维生素 D 补充剂并不减少跌倒的机率达 15%以上 — 在统计学差上的差异极度微小。


这个常识是正确的吗? 如果你提高病人的床栏杆,他们因此不能离开他们的床上 — 并造成跌倒。

然而,研究显示恰恰相反,据年龄与老化 2002年论文。床栏杆不仅提高因跌倒及缠绕栏杆所造成的伤害,更是增加他们也可能会连结到恶化搅拌、 恐惧和谵妄患者。事实上,不论是否加高床栏杆有50% 到 90%的病人跌倒是从医院病床发生。





甚么事做到预防养护院的跌倒?物理束缚永远不应该用于养护院跌倒预防策略。根据疾病控制和预防 (CDC) 的中心,他们不做预防养护院跌倒或摔伤。其实,使用束缚可以增加跌倒相关的损伤和死亡的风险。他们也可以导致肌肉无力和物理功能丧失。


  • 跌倒后立即评估患者的风险已指出危险因素及治疗的基本条件。
  • 教育工作人员对跌倒的危险因素。
  • 检视处方和分析这些药物的潜在风险。
  • 改变养护院的环境。
  • 提供居民患者髋关节垫
  • 教育居民患者有关跌倒的危险因素

对高风险居民保持密切关注,设施可以形成整体跌倒预防战略的基础。它是一项大工作 — 但帮助是咫尺可及的。




平均而言,在养护院一年的费用是91,000 美元。这引出了一个问题: 长期护理机构应该做些甚么事情帮助居民们和他们的家庭降低他们的成本,如果有的话? 在 twitter 推特社交网络上,我们从一个护士那里得到的一个反应是一个特别伤脑筋的问题: 在她工作的养护院里每个房间有四名居民患者,每 20-25 名居民患者仅配有一名护士。


护理人员负担过重的后果具有重要意义: 降低病人的满意度和护理质量的问题。事实上,宾夕法尼亚大学的研究人员最近调查发现,37%的护士在养护院里感觉工作倦怠,(相比,22%的护士在其他设置中); 在47%的养老院护士说,他们的工作量对于他们的病人状况导致了重大的改变, (相比其他设置 21%)。

连接来自医疗保险与医疗补助服务中心的压力 (CMS) 经由通过”质量”以保持一流成果指标以便获取最大的偿还,养护院及熟练的护理领导者应如何对抗护士和照护人员的职业倦怠问题?


照护人员压力可以几种形式表现出 — 藉由认知他们,你将会在您的设施更好以确定和解决工作人员效率低下,。如果你没有能力或才能注意到这些症状,考虑进行员工满意度调查或个别访谈,准确地判断你工作人员之间的压力水平。


  • 抑郁、沮丧和烦躁不安
  • 精神和身体疲劳问题
  • 对于小问题的过度反应
  • 集中力有困难
  • 增加不健康的习惯,如饮酒、 吸烟,或暴饮暴食
  • 忽略或未能完成重要任务

在照护人员之间的压力与职业倦怠可产生无数的影响,无论就个人和专业上。错过药物剂量或配药错误。居民患者跌倒可能会被忽略,延迟回应注意或追踪等。需要被翻身的居民患者没有定时做到,从而导致褥疮的昂贵治疗 (或诉讼)。你还冒着失去你的照护人员的风险, 由于他们转至其他的机构,从而导致人力的减少。这样的职员紧张状态是你可以承受的吗?






当然,倦怠的工作人员在你对人员配置的方法上还可能显示出多更大的问题。重新审视你的时程表是否一致 (不一致的任务可能对照护人员造成不便),时间的调度和/或增加你的护士对居民患者的比例, 给与照护人员更多的影响。


员工识别方案是可以减少倦怠、 积极加强期望和优先事项,并为员工成功创造机会的超级工具。一个企业对于随着时间推移居民患者健康自然下降,确认成功,无论多么小的成就,可以有巨大的士气鼓舞。



由于新的护理技术,很多占用看护时间的任务现在可以自动执行。温度、 空气质量和居民患者室内照明现在可以依照每个人喜好自动调整。可以安装无线监控解决方案来衡量居民患者跌倒的风险,当像跌倒或尿失禁的事件确实发生的时候,用于提醒工作人员。药房机器人可以用于简化处方填充和交付过程。




在健康护里面,于此基于质量偿还的时代 — 如果建议给医疗保险和医疗补助服务 (CMS) 的改变获得通过,长期护理机构会有更多鼓励投资于其居民患者的保健改善。这些建议改变已于上周向白宫会议提出且相关于年长护理机构将在未来几十年保持竞争力。

一旦实施,这项立法应该有对一大部分的美国人有重要和积极的影响。有 1 亿 2500 万老人、 残疾人士、 或低收入的美国人目前参加医疗保险和医疗补助计划。在该国的 15,000 长期护理设施中的所有居民患者,多数都是医疗保险和医疗补助的受益者。

当一个家庭决定要把心爱的人安置在长期的护理机构时,他们投入对该机构的极大信任 — 相信他们所爱的人的健康、 安全和生活质量将会是该机构工作人员, 从行政级别一路到入门级护理助理等的高度优先事项。但长期护理机构究竟应如何操作这些新法规的改变呢?


年长者护理领导人多年来一直面临采用新科技的压力,但这些新变化,自 1991 年以来的第一个主要对 CMS 参与更新 — 旨在巩固健康护理科技信息和其他病人的护理增强功能作为一个优先事项。

具体来说,熟练的护理机构将面临更严格的规则,使用电子健康记录 (Ehr),可以帮助健康提供者降低成本和节省时间纪录病人的健康情形。以前,熟练的护理机构未列入补贴方案,旨在激励 EHR 用法。现在,机构将有可能获得所有在线的最大的激励 — 即是由CMS 付款。

然而,它是重要的是注意到,这些建议修改均只是 — 建议。因此很自然,很多病人的宣传组织正在努力进一步改进这些法规。LeaderAge 中心老化服务技术 (CAST) 是其中之一。他们正在推广行动要求供应商提供更高科技的设备。

集团的执行董事,Majd Alwan 博士说: “从技术角度来看,我们将提倡为 CMS 来确定奖励措施,确保所有供应商,包括较小和农村供应商,有正确的健康工具到位,以及积极参与有意义的健康信息交流.


提议的新法规超越医疗技术。其他就 CMS 付款在提案中的包括所需的变化:

  • 更大家庭参与护理规划和出院规划进程;
  • 强化感染控制协定;
  • 减少使用药物如抗生素和抗精神病药物,努力减少再次入院;
  • 更多顾问药师参与在发展对居民患者的药物治疗计划; 和
  • 改善用餐的标准 — 具体地说,提供广泛的更高的质量,本地成分的食品。

这些新建议条例应被视为不造成对长期护理和熟练的护理机构的负担,而是”大家帮帮忙吧”对病人护理的改进策略。无论是电子病历使用,病人监督技术、 更好的饭菜或更多的以证据为基础的药物治疗方案,所有这些潜在规则有着相同的目标 — 改善居民患者和他们的家庭生活。



居民跌倒是对养护院工作人员和管理员面临的特殊挑战。他们频繁地发生,对于居民患者的生活质量及机构的运作可以有重大的影响。根据 CDC,有140 万65 岁或更年长者住在养护院里 — 预计到2030年养护院65岁以上人口预计将达到 300 万。CDC 老人跌倒统计资料可以清楚看到,跌倒对于年长者是相当大的危险:

  • 根据有100 床规模养护院报告每年约有 100 和 200 起的跌倒, 有更多跌倒的事件事没有被报告的;
  • 养护院的居民患者平均每人每年有2.6 次跌倒;
  • 35%的跌倒发生于居民患者不能走路;
  • 大约有 10%至 20%的跌倒造成严重伤害,有2%至6%造成骨折;
  • 每年大约有 1800 名的养护院居民患者因跌倒导致死亡。

跌倒幸存者往往患有残疾和抑郁、 无助,和隔离伴随跌倒的恐惧。养护院设施治疗这些居民患者和他们的跌倒的影响, 对非致命跌倒每起通常面对超越 7,300 美元的费用。平均每年每名居民患者的平均2.6 跌倒,这些费用迅速升级,可能会严重影响机构的运作。


幸运的是,保健设施可以使用技术来改进跌倒干预和预测。电子健康记录 (EHRs) 的执行可以加强跌倒预测,但是有很多改进的余地。养护院的人口不断增加和照护人员对居民患者的人数比例预计减少,机构必须采用新技术以帮助减轻他们的工作量,并确保最佳可能的病人护理。


此类系统甚至可以用于改进您的电子健康记录 。资料会被这些感应器提取用于产生报告,使它更容易识别模式和预防高危患者跌倒。此资料将添加到设备的预测和预防电源。通过实施这些系统,行政管理者可以节省几千美元的成本,并确保其居民患者更高的生活质量。