TIP OF THE WEEK
Take purple ulcers seriously on people with darkly pigmented skin
The National Institute for Health and Clinical Excellence’s (NICE, United Kingdom) 2001 guidelines discuss the connection between purplish/bluish areas and pressure damage in relation to people with darkly pigmented skin. However, the etiology is the same for all skin types, regardless of pigmentation (Bethell 2003b).
Further controversy arises over ”purple” ulcers, which are often classified as stage 1 (Torrance 1983, Lyder 1991, Dailey 1992, Witkowski 1993) or even ignored. However, Dailey (1992) described the increasing number of patients admitted with ”purple” ulcers as purple-red, ecchymotic – an effusion of blood under the skin causing discoloration – pale ecchymotic, or bruised. The skin may be intact or the epidermis ”brushed”off, exposing a discolored area. These can rarely be reversed. Biopsy specimens of the purple lesions demonstrate hemorrhage and early gangrenous changes (Witkowski 1993).
Purple ulcers appear to be treated less seriously than they should be, especially in patients with darkly pigmented skin where they are clinically difficult to identify (Dailey 1992, Witkowski 1993). Both authors suggest that the main problem is the lack of recognition of the serious nature of these ulcers. However, it is vital that practitioners be aware that the purple patch is the end stage of non-blanching erythema and signifies a full-thickness skin loss, and take appropriate action.
RESOURCE SPOTLIGHT
Pressure Sore Brochure for Residents and Families
This brochure, provided by Ohio KePRO in partnership with the Ohio Department of Health and the Ombudsman office, provides information about what all residents and families need to know about pressure sores.
To order, click here and select “Nursing Home” in the drop-down box. Then, scroll to the bottom and add the Workforce Retention Resource CD-ROM to your cart. Finally, proceed to checkout. All resources in the Ohio KePRO Shopping Bag are free of charge to Ohio healthcare providers. Please allow 10 business days to process your request.
IN THE NEWS
A WIKIPEDIA-STYLE SITE FOR MEDICAL INFORMATION?
March 29, 2007 -- Cleveland Plain Dealer -- Think of it as a librarian with a stethoscope. Four doctors at the Cleveland Clinic are drawing international attention with a medical version of Wikipedia, the popular online encyclopedia that anyone can edit. This version is called Ask Dr Wiki. The public can access it, but the information is pretty technical and healthcare professionals are the biggest users. Read more >>
AETNA EXPANDS DOCTOR PRICE INFORMATION
March 28, 2007 -- United Press International -- Beginning in April, patients can find information on the cost, clinical quality and efficiency information of doctors in Houston; Atlanta; Richmond, Va.; Oklahoma City; and Tulsa, Okla. Read more >>
WAL-MART AND PARTNERS CREATE HEALTH-IT RESEARCH CENTER
March 28, 2007 -- Information Week -- Wal-Mart on Wednesday joined up with the University of Arkansas and Blue Cross Blue Shield to create a new research center to investigate ways of improving health care delivery through IT. Wal-Mart is donating $1 million over five years to fund the new Center for Innovation in Health Care Logistics, which will be located at the university.
Read more >>
REPORT: OHIO BIG SPENDER FOR NURSING HOME CARE
April 2, 2007 -- Cincinnati Business Journal -- Ohio is increasing its investment in at-home care for seniors with disabilities, but it still spends more per capita on nursing home care than 41 states, the Scripps Gerontology Center at Miami University reports.
A doubling in the older severely disabled population calls for critical changes, researchers say. Read more >>
NURSING HOMES ADDING REHABILITATION SERVICES
April 2, 2007 -- Akron Beacon Journal -- With billions of dollars at stake, nursing homes across the nation are rushing to reinvent themselves to compete with hospitals and affiliated rehabilitation facilities for short-term, higher-paying patients. They are spending hundreds of millions of dollars on renovations and additions and new features such as aromatherapy, brightly colored decor, spacious therapy gyms and Internet cafes to try to create a new, warmer, less institutional image. Read more >>
OHIO KEPRO EVENTS
CANCELLED: COMMUNITY OF PRACTICE CONFERENCE CALLS
The remaining community of practice conference calls have been cancelled. This includes further discussions about pressure ulcers (April 17+19, 2007), pain (April 24+26, 2007), and restraints (May 1+3, 2007).
For more information, please contact the Nursing Home Team at 1-800-385-5080
SMOKING CESSATION IN OHIO TELECONFERENCE
In Collaboration with The American Heart Association and The Ohio Department Of Health
- Discuss prevalence of tobacco use in Ohio
- Review how to provide tobacco cessation assistance to patients using the Ohio Tobacco QUIT-LINE (1-800-QUIT-NOW)
- Describe the quit kits and patient referral process using fax referral forms
- Summary, questions, and answers
Who should attend: Physicians, Senior Leaders, Case Managers, Advanced Practice Nurses, Nurse Managers, Staff Nurses, Respiratory Therapists, Pharmacists, Quality Improvement staff, Social Workers, and all others interested.
Click here to register and download the flyer
INDUSTRY EVENTS
PRESSURE ULCERS: THE POWER OF PREVENTION AND EARLY DETECTION
A workshop series presented by American Medical Technologies in support of the Advancing Excellence in America’s Nursing Homes Campaign. April 18-26, 2007 in locations throughout Ohio. Registration one week in advance is required. Register now
2007 DQA QUALITY FORUMS FOR NURSING HOMES
In April and May, the Ohio Division of Quality Assurance (DQA) is presenting one-half day quality forums to discuss current issues with Nursing Home Administrators, Directors of Nursing and Maintenance Supervisors (limited to two participants per facility, advanced registration is required). The quality forums will include the following topics: GPRA goals/restraint use guidelines, MRSA in LTC, LTC updates, enforcement updates, and life safety code updates.
Dementia: The Emerging Epidemic, A support group meeting for family, friends, and caregivers
May 10, 2007, 7:00pm to 8:30pm, Courtyard by Marriott, Springfield, OH.
Call OMH, Rita Brown at 937-525-3000 to register before May 3, 2007.
Dementia: The Emerging Epidemic Training for Professionals
May 11, 2007, 8:30 p.m. to 4:30 p.m., The Ohio Masonic Home, Springfield, OH.
Call OMH, Rita Brown at 937.525.3000 to register before May 4, 2007.
Navigating the MDS Through the Ohio Medicaid Reimbursement System
Ohio Department of Job and Family Services
June 11, 2007 or August 23, 2007
Call Cheryl Robertson at (614) 466-9088 for more information.
Medicare Learning Network: Learning resources and products for the healthcare professional.
Alzheimer’s Association Training Events
Case Western Reserve University School of Medicine Courses
Ohio Department of Health, Technical Assistance Program – New Programs
Ohio Health Care Association Events
An archive of The Nursing Home Weekly Update is available on our Web site. Click here >>
