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  • The Health of Your Staff is Important

    The Health of Your Staff is Important

    When it comes to infection prevention in long-term care facilities, the discussion usually focuses on the residents. The last thing any facility wants is an outbreak of illness. What about infection prevention for the nursing staff, though? They are exposed to many of the same germs and are often exposed to blood and other bodily fluids on a regular basis. It’s important to ensure that nursing staff follow proper safety procedures and have access to the tools they need to stay safe.

    A study published in the American Journal of Infection Control revealed that 80% of ambulatory care nurses do not adhere to standard precautions for infection prevention. The research focused on 9 standard precautions and asked 116 ambulatory care nurses to self-report their adherence to these precautions. The precautions included practices such as washing hands after removing gloves, avoiding recapping needles, and wearing a face-mask when being exposed to air-transmitted pathogens.

    While the study focused on ambulatory care nursing, the same precautionary measures should be considered by all nursing staff, regardless of specialty. Even if a resident doesn’t have an obvious infection or illness, it is important to follow all standard safety procedures in order to avoid the transmission of undiagnosed pathogens. Standard precautions include hand hygiene, safe injection practices, cough etiquette, and use of gloves, gowns, and masks.

    Another point of safety is the proper disposal of bodily fluids as it may harbor unknown pathogens. Care must be taken by nursing staff to avoid any splash-back or spattering as it is being emptied into the service sink. The Apollo Service Sink Splash Guard, The Shield™ Splash Guard, was designed to be a barrier between infectious waste and nursing staff and be part of the PPE system. It installs easily to any service sink and can be cleaned and disinfected in place.

    The health and safety of your nursing staff is just as important as your residents. When you are evaluating the safety practices and procedures of your staff, consider investing in The Shield™ Splash Guard as an additional tool to provide an extra level of protection. By helping your staff stay healthy, you also keep your residents healthy.

  • Recommendations for Properly Cleaning Your Bathing Area

    Recommendations for Properly Cleaning Your Bathing Area

    A clean bathing area is a safe bathing area. Long-term care facilities know the importance of a clean facility and the dangers that micro-organisms can pose to residents. Since the bathing area is a shared environment where bacteria, viruses, and other pathogens can readily spread from one resident to another, it is especially important that it be cleaned and disinfected regularly and thoroughly. Here are some recommendations for cleaning your bathing area so that you can be confident that it is a safe place free from pathogens.

    Have a written process and proper documentation

    One of the challenges that LTC facilities face is the constant rotation of staff. Some may clean bathing areas better than others; some may do more while others do less. By having a written and documented process of disinfection of tubs and bathing areas, you will reduce the chances of something being forgotten or skipped. Since every staff member will follow the same guidelines and “sign off” on their work, the bathing area will stand a better chance of being cleaned the right way every time.

    Be mindful of stagnant water

    The Centers for Medicare & Medicaid Services expects Medicare-certified healthcare facilities to have water management policies and procedures to reduce the risk of growth and spread of Legionella and other opportunistic pathogens in building water systems. An industry standard1 calling for the development and implementation of water management programs in large or complex building water systems to reduce the risk of Legionella was published in 2015 by American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE). In 2016, the CDC and its partners developed a toolkit to facilitate the implementation of this ASHRAE Standard.

    To pose a health risk, Legionella first has to grow (increase in numbers). Then it has to be aerosolized so people can breathe in small, contaminated water droplets. Legionella can grow in many parts of building water systems that are continually wet, and certain devices can then spread contaminated water droplets.

    The prescribed use of most bathing systems and showers includes draining and cleaning and chemical disinfecting after each use. These steps address the risk of Legionella growth as outlined by the CDC. It should be noted, that the chemical disinfection step does not directly kill Legionella. However, chemical cleaning and disinfecting with appropriate products does address the development of biofilm, scale and sediment growth, all of which provide environments supportive of Legionella survival and growth.

    If your building water management protocol includes periodic flushing of fixture water sources (sinks, showers, toilets, etc.), your bathing system should be a part of that protocol. This would be a preventative measure against stagnant water in building plumbing lines if your bathing system is used infrequently.

    Residents may self-infect

    Residents bring significant amounts of pathogens to their baths. The micro-organisms then circulate in the water and enter the body through any natural openings or a cut or wound. To help combat these types of infections, consider investing in a bathing system that incorporates UV water purification.  These systems use ultraviolet light to purify the bath water during the bath, for a cleaner bathing environment.  A study by the medical college of Pennsylvania showed the tremendous amount of bacteria bathers bring to their own bath and proved the efficacy of UV light at purifying the bathwater.  In a clinical study by Apollo Corporation, long-term care residents bathed in bathing systems protected with the Remedy® Ultraviolet Water Purification System is designed to keep bathwater clean between residents.

    Follow manufacturer guidelines

    It’s important to follow the recommended cleaning and disinfecting procedures from the tub manufacturer so that you can be confident that your staff’s procedures are effective. Some bathing systems have integrated cleaning and disinfecting systems that automatically mix the disinfectant concentrate with the appropriate amount of water.  So it is critical that you use cleaners and disinfectant that are of the right concentration for your bathing equipment.

    In Summary

    The health of your residents is top priority. It is essential that you do everything you can  to minimize the risk of disease and illness. It’s important to understand that bathing areas, shower rooms and restrooms have an increased risk to spread infections from one resident to another unless you take the necessary precautions. By having a detailed cleaning procedure, being mindful of areas where stagnant water may breed bacteria, and properly cleaning bathing equipment, your residents can enjoy a better and healthier quality of life.

  • Tips for Bathing People with Alzheimer’s or Dementia

    Tips for Bathing People with Alzheimer’s or Dementia

    At some point in your career as a caregiver in a long-term care facility, you will need to care for someone who has Alzheimer’s or dementia. Caring for someone who may phase in and out of cognitive understanding is probably one of the hardest things you will do as a caregiver. After all, the resident will probably feel very uncomfortable as someone else undresses them or washes their body. Then to complicate things, with a lack of memory or focus, the situation can go from bad to worse. However, by following some simple advice and using best practices, this daunting challenge may result in an enjoyable experience for both you and your resident.

    Setting Up the Bathing Area

    In a previous blog post, we discussed ways to enhance the bathing experience for your residents. In summary, create a relaxing atmosphere with dimmed lights, soft music or sound-proofed room, and turn your bathing area into a spa. If you have an Advantage End-entry Spa from Apollo, you can also prepare the spa by filling the Rapid Fill™ Reservoir ahead of time. This will allow you to rapidly fill the tub so that the resident isn’t sitting in a cold empty tub for more than 60-90 seconds. It’s also important to never leave a person unattended.

    The other advantage of the Advantage End-entry Spa is that residents can easily get in and out using the Level Glide™ Transfer System. No hoists or dangerous methods for helping them in and out so that they are relaxed and safe during the entire bathing time.

    During the Bath

    Depending on the condition of the resident with Alzheimer’s or dementia, allow them to do as much on their own as possible. Remember, they probably once cared for themselves and still want to maintain as much independence as possible. This will help them retain a feeling of dignity and self-worth.

    It may also help to lay a towel across their shoulders so they don’t feel so exposed. Also, talk about a variety of things to help pass the time so that their mind can focus on something else while you assist with their bathing.

    After the Bath

    Once the bath is complete, be sure to dry them completely in order to avoid rashes and infections. Remember to also dry especially between the folds of skin.

    In Conclusion

    Bath time can be scary for someone with Alzheimer’s or dementia. By creating a relaxing atmosphere and being respectful at all times, the bathing experience can be something they look forward to and brighten their day.

  • How to Turn a Bath into a Bathing Experience Your Residents will Love

    How to Turn a Bath into a Bathing Experience Your Residents will Love

    When it comes to bath time in a long-term care facility, sometimes it can be seen as a chore for both staff and residents. There is a lot of work that goes into helping someone take a bath, especially if the bather has limited mobility or needs extra help. While the primary purpose of bathing is to maintain good hygiene, LTC facilities are beginning to recognize the additional benefits of spa bathing for its therapeutic qualities and to give residents an opportunity to relax. So, how do you turn bath time into an enjoyable spa experience?

    Create a Quiet Atmosphere

    The first step is to examine the environment of your bathing area. A stark and sterile room that is cold and uninviting will keep residents on edge. By creating a warm and soothing environment, residents will feel at home and find it easier to focus on feeling comfortable. Ideally, the room should be decorated in warm colors and the lights turned down to a moderate level. If it all possible, the room should also be sound-proofed so that external noises do not interfere with the bathing experience. Some additional enhancements to try would be aromatherapy, soft music, and warm towels.

    The Right Spa Makes a Difference

    Getting in and out of the spa tub can be the most difficult part of the bathing experience. For those with limited mobility, this is the most scary and humiliating aspect of bath time as staff members need to be more hands on to provide assistance. As such, a standard spa bathing tub is not appropriate.

    The best solution to create an enjoyable and relaxing spa bathing experience is to use an end-entry bathing system such as the Advantage™ End-Entry Seated Bathing System from Apollo Corporation. Because it makes getting in and out of the spa tub significantly easier with its patented Level Glide™ Transfer System, residents don’t have to face the daunting challenge of scary hoists or lifts just to get in the bathtub.

    In addition to making entrance to the tub easier, the Advantage™ Bathing System provides a therapeutic bathing experience. It can be configured as an air spa or whirlpool spa. The continuous flow of warm water will help soothe aches and pains and increase blood circulation. Other benefits of hydrotherapy include healing of sore or injured tissue, improved sleep, and an increased general sense of well-being.

    In Conclusion

    If you want your residents and staff to enjoy their bath time, then consider taking the time and effort to transform your bathing room into a spa room. With warm inviting colors, soft music, aromatherapy, and a spa bathing system that is easy to use, your residents will be happier, healthier, and look forward to their bath time.

    More on what separates a bath from a wipe-down: A Bed Bath Is Not a Bath. The case underneath all of it is Seniors in Care Deserve a Real Bath.

  • Person-Centered Care Makes the Difference

    Person-Centered Care Makes the Difference

    Over the years, healthcare providers have endeavored to change healthcare practices and develop new methodologies that benefit the person being cared for. Weiner & Ronch described this shift as an effort to make “long-term care less about care tasks and more about caring for people and the relationships between people.”1

    Person-centered care includes (but is not limited to) personhood, maximizing choice, comfort, and organizational support. It is about providing care in such a way that residents feel honored and valued, and are not just another number or task to be checked off. Personal preferences should be taken into account so that residents feel that they have a say in their daily activities. In order to accomplish a system of true person-centered care, there must be support from administration and all levels of staff.

    In order to determine what methods or systems could be developed to accomplish person-centered care, the Oregon Health & Science University Hartford Center of Geriatric Nursing Excellence partnered with 9 long-term care facilities. In this article, we will look at some of the changes and outcomes that resulted from this partnership.

    Personalized Bathing

    One of the facilities endeavored to implement person-centered care into their bathing routine. They changed their bathing methods so that they could implement a “bathing success portfolio” that detailed what worked well and what did not work well. A unique portfolio was created for each resident so that in the event of a staffing change, the assisting care provider would be able to implement the same routine and procedures for the bath. In the process of creating the bathing success portfolio, they realized that the bathing experience was more important than the act of bathing itself.

    Flexible Meal Systems

    Another long-term care facility changed their entire meal system to be flexible so that it could accommodate personal dining choices and meal times. For example, the facility extended the breakfast availability window by an additional two hours. This allowed residents to wake up and eat when it was convenient for them. The facility also began cooking meals to order with kitchen crew becoming wait staff. This allowed residents to choose their own food from a menu and have it freshly prepared. Now, residents get a choice of when, where, and what to eat. The end result was a high satisfaction level among staff and residents, and food waste was eliminated almost entirely.

    In Summary

    Person-centered care is the future for long-term care facilities. Instead of residents being just another check box on a long list of things to do, systems and routines can be developed in order to make the lives of residents better and create a more positive atmosphere for everyone.

    Sources

    1Weiner, A.S., & Ronch, J.L. (2003). Culture change in long-term care. Binghamton, NY: The Haworth Social Work Practice Press. P 13

    Person-centered care shows up at bath time more than almost anywhere else. See Seniors in Care Deserve a Real Bath and When a Resident Refuses a Bath.

  • The Importance of Documenting Resident Bathing

    The Importance of Documenting Resident Bathing

    If it has not been charted, it has not been done. This adage has been drilled into the minds of healthcare workers and for good reason. So much of a healthcare facility’s reimbursement for services provided is directly linked to what is charted in the patient record. Even though bathing is not a Medicare reimbursed service, if improperly documented or neglected completely, there may be negative consequences.

    Why Is Documentation So Important?

    CMS (Centers for Medicare and Medicaid Services) surveyors will be interested in your facility’s compliance with ROP (Requirements of Participation). Per the ROP, bathing falls into the area of residents’ rights and patient-centered care. Patients have the right to make choices about their daily routine, and bathing preferences are included. As such, this information must be documented.

    Low scores from the ROP could affect the star rating of a facility. This information is available to the public and influences physician referrals as well as potential clients choosing one facility over another. Therefore, baths must be documented giving concrete proof that services have been provided.

    How to Properly Document Bathing Info

    Simply clicking a check mark to confirm that a bath has been given is not enough. For a bath to meet the requirements of resident’s rights, there are steps that must be taken and documented. McKnight’s Long-Term Care News highlights these essential details that must be ascertained.

    Firstly, the resident’s preferences must be determined by assessment within 48 hours of admission to the facility. These preferences must then be updated quarterly or when there is any change in the resident’s status. These resident preferences need to be notated and accessible to all staff members who are providing care. Resident’s preferences would include bathing frequency, time of day, type of bath, and water temperature preferred. These bathing preferences, as well as when baths are provided, should be a regular part of the documentation process.

    In Summary

    Documenting your residents’ bathing preferences and your follow-through is vital for providing high quality care and for achieving a high score on the ROP survey. By ensuring that your staff members are trained in proper documentation procedures, delivering patient-centered care will be much more efficient.

    Having the proper bathing equipment, knowing how to use it and keeping it in good working order is also integral to providing an effective and pleasing bathing experience that will exceed residents’ expectations. Whirlpool spa bathing systems from Apollo Corporation provide the best in caregiver-assisted hygiene.  An enjoyable and relaxing hydrotherapy bath also provides a broad range of therapeutic health benefits. Contact us for more information and discover how we can help make bathing a competitive advantage in your facility.

    Documenting what happened at bath time is easier when the bath is worth documenting. See Seniors in Care Deserve a Real Bath.

  • Minnesota Veterans Adult Day Care Center

    Minnesota Veterans Adult Day Care Center

    The Minnesota Department of Veterans Affairs offers a unique program, with the goal to keep veterans in their own homes. View the video above of a November 2013 broadcast on KSTP 5 Eyewitness News to learn more about the Minnesota Veterans Adult Day Center, where a spa room offers bathing as a service to veterans and their families.

    The bathing system highlighted in the news clip (2m, 5s) is an Apollo Advantage™ Series Whirlpool Bathing System, which features a patented ultraviolet water purification system for enhanced infection control.

  • Impactful “Dementia Experience”

    Impactful “Dementia Experience”

    At the 2014 National LeadingAge Convention, attendees could participate in a “Virtual Dementia Tour®” provided by Second Wind Dreams®, where one could experience, to a certain extent, the challenges people with dementia face in their daily lives.  A group of Apollo staff jumped into participating, to gain better insight on what the “dementia experience” is like, from a first-hand perspective.

    Understanding Patients Needs

    Prior to entering the experience area, participants donned glasses that simulated macular degeneration and reduced peripheral visions (studies have linked vision impairment as a contributing factor to dementia onset), put on thick gloves to simulate reduced touch sensory perception and hand dexterity, had inserts put into their shoes that poked the soles of the feet, creating a prickly sensation similar to neuropathy symptoms, and put on headphones that emanated a barrage of loud, distracting background noise.  The sounds were everyday occurrences but the volume simulated the reduced ability of dementia sufferers to focus on specific sources such as the voice of a person with whom one is conversing.  The combined effect of these stimulatory devices profoundly disrupted our senses that most of us take for granted.

    A facilitator quickly read a series of what would normally be easy to follow instructions.  However, the noise generated by the headphones significantly hindered one’s ability to comprehend these instructions.

    After listening to the instructions, participants were left alone to complete the ordinarily simple daily tasks.  Each member of our group reacted differently; one got frustrated and walked out of the experience center, one mumbled frustrated comments under her breath and virtually “shut down,” unable to approach the tasks.  Another member of our group fumbled through partial completion of what he thought he was supposed to do and then moved on to his best guess at the remaining tasks.  I completed what I could, then wandered about the area trying, with little success, to identify items in the area I “thought” might have been mentioned in the instructions.

    For those of you who deal with dementia residents on a daily basis, our reactions to the exercise probably sound familiar. At the end of the exercise we were debriefed to help us learn from the experience.  We learned that dementia sufferers require eye contact from someone directly in front of them to help them see who is speaking to them and to stay focused, that they respond best to instructions given in simple, short sentences.  Those suffering from dementia greatly benefit when given the opportunity to confirm their understanding, and they need others to be cognizant of their compromised eyesight, especially peripheral vision. We also gained new insight and empathy for the victims of dementia and the impact that sensory impairment has on their lives.  We can only imagine how reduced cognitive health combines with these disabilities and the impact on one’s quality of life.

    Assisting Dementia Patients in Senior Care Facilities

    As Apollo specializes in bathing, we discussed how the challenges in serving the needs of those who live with dementia might affect the bathing process, and how Apollo systems may better support residents and their caregivers as they cope with dementia.  Our spas always position the resident so they have a full view of the room and the caregiver to facilitate a sense of control and security during the bath.  The Level Glide™ Transfer System is designed to back residents into the system, thus allowing staff to maintain eye contact and vocalize short, easy-to-understand instructions to residents to alleviate anxiety in the process and to facilitate a face-to-face conversation during the bath.

    We actively discourage spa room planners from adding distractions like televisions which interfere with the resident’s ability to hear the caregiver and discourage social interaction.  The sound of the whirlpool itself emits a lower frequency of sound than air spas, helping residents to isolate conversation with the staff from background noise.Studies have demonstrated the physical therapeutic benefits to the extremities, circulatory system, skin health, and more, as well as support cognitive health through induced relaxation, improved blood flow and endorphin production and other restorative benefits.

    In all, this experience helped us better understand Apollo’s role in the care of those coping with dementia and opportunities for further improvements in the future. We encourage everyone in our industry to take part in an educational virtual experience and gain greater insight into the dementia experience and opportunities for superior care of those who need it most.

    To learn more about the Virtual Dementia Tour® through Second Wind Dreams®, visit https://www.secondwind.org