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| Sebelius: Criticisms of Five-Star Quality Rating System Need to Be Addressed |
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 Kathleen Sebelius, Secretary of the Department of Health and
Human Services, acknowledged on March 16 that although the Five-Star Quality Rating System is an important tool for consumers, criticisms about its shortcomings need to be addressed.
Speaking at the National Council on Aging and The American Society on Aging annual conference in Chicago, Sebelius said "We need to have some standards; they need to be clear, need to be accurately measured and if everyone ends up being excellent or everyone ends up being failing, so be it. But somehow this sort of bell curve seems to have some inherent flaws."
Critics of the rating system have complained about regulators assigning predetermined percentages of facilities either "excellent" or "failing" grades. Sebelius commented, "The last thing we want to do is have an arbitrary bell curve just for the sake of having a system."
To learn more, click here. To view the original blog entry, click here.
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The following is an excerpted article from the debut issue of Embrace. Want to learn more? Simply subscribe to Embrace! Subscriptions are free and signing up is a snap – just visit promedsupply.com and click on the "Subscribe Now" link.
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| UTI Problems? Consider Treating the Environment, Not Just the Resident |
By Linda McConnell, RN
Having been a nurse in long-term care for more than 10 years, I have seen my fair share of urinary tract infections. Gram-negative bacteria such as E. coli, Proteus mirabilis and Klebsiella pneumoniae are just some of the usual culprits. Tracking and trending can become exhausting and overwhelming at times. Proper staff training and education and even making rounds to ensure these things are being performed properly do not guarantee an actual decrease in the number of residents with UTIs.
UTIs in the geriatric population
Identifying a UTI in the geriatric population in and of itself can be difficult. Geriatric residents do not always have the common symptoms associated with a UTI. They can exhibit increased confusion, behavioral symptoms and even balance problems leading to increased fall risk, but might not complain of actual discomfort from dysuria or the typical lower back pain. Diagnosis can be overlooked if based solely on the classic symptoms.
Complications from UTIs, especially in the elderly, can be devastating. Residents face problems with dysuria, frequency, fever, dehydration and even possible hospitalization from urosepsis. The evolution of antibiotic-resistant bacteria is also a huge problem for repeat infections due to the use of multiple antibiotics.
Look to the environment for answers
If the problem of urinary tract infections seems to be a routine dilemma in your facility, I suggest that you consider treating your environment, not just the resident. Residents at our facility had been experiencing UTIs whose origins left me puzzled. I obtained cultures of our shower chairs and whirlpool after properly sanitizing the devices with the sanitizer we had always used. The results were astonishing. The culture results showed the presence of three gram-negative bacteria.
Once the problem was identified, we implemented a change in our view of UTI prevention. The first thing we did was change the sanitizing agent we were using, fearing that the bacteria that were present had become resistant to the previous product. The next steps were to educate the staff on the proper use of the new agent and reeducate them on how to properly sanitize the shower chairs and whirlpool between each resident.
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