QIO NHQI Weekly Update :: April 11, 2008  

 

TIP OF THE WEEK

Guideline.gov approach to bathing persons with dementia

 

Bathing can be a challenging task for some nursing home residents, particularly those with a degree of cognitive impairment. The National Guidelines Clearinghouse has compiled extensive, evidence-based guidance for Bathing Persons with Dementia. Below is an excerpt from the “Caregiver Approach” portion of the guideline.

CAREGIVER APPROACH

Many caregivers possess intuitive skills with which to assist in understanding and caring for persons with dementia. There are, however, many skills that can be learned by staff motivated to provide quality care to all individuals who may require assistance in performing activities of daily living.

  • Shifting the caregiver's perspective from task focused to person focused is one way to change the psychosocial environment under which successful bathing process can occur (Hoeffer et al., 1997; Schindel, 1998) (Evidence Grade = C).
  • Understanding the individual and their behavior is crucial for staff to be able to provide safe care and prevent aggression (Farrell Miller, 1997; Hoeffer et al., 1997) (Evidence Grade = C).
  • Knowledgeable caregivers will preserve the dignity of the individual by (Farrell Miller, 1997; Kovach & Meyer-Arnold, 1997; Sloane et al, 1995) (Evidence Grade = D):
    • Giving choices
    • Knowing personal preferences (i.e., time, day, type of bath)
    • Allowing for privacy
    • Providing same gender caregiver if possible
    • Keeping directions simple, one step, to reduce the amount of stimuli
    • Adjusting their schedule to the individual
    • Giving adequate time for the bath so the person does not feel hurried
    • Encouraging use of the person's abilities whenever possible
  • Knowledgeable caregivers need to display the following skills (Sloane et al., 1995; Schindel Martin, 1998) (Evidence Grade = D):
    • Patience
    • Flexibility
    • Sensitivity
    • Gentleness
    • Creativity
    • A genuine interest in older persons

The grading schema used to make recommendations in this evidence-based practice protocol is:

  1. Evidence from well-designed meta-analysis
  2. Evidence from well-designed controlled trials, both randomized and nonrandomized, with results that consistently support a specific action (e.g., assessment, intervention, or treatment)
  3. Evidence from observational studies (e.g., correlational descriptive studies) or controlled trials with inconsistent results
  4. Evidence from expert opinion or multiple case reports

 

 

RESOURCE SPOTLIGHT

 

Bathing Tip Sheet
This change idea sheet, created by the Arkansas Accord, is a crosswalk that connects individualized care (i.e., culture change) to regulatory F-Tags.

 

 

IN THE NEWS

 

CMS RELEASES REGULATION MODERNIZING DIALYSIS CENTERS

April 3, 2008 -- CMS -- The Centers for Medicare & Medicaid Services (CMS) released a final rule that will modernize the Medicare conditions for coverage for the nation’s dialysis centers and promote higher quality of care for patients receiving dialysis. | Final rule (PDF)

 

INSOMNIA PROLONGS DEPRESSION IN THE ELDERLY

April 4, 2008 -- Sleep -- Study published in the Sleep Journal suggests that insomnia is a perpetuating factor for late-life depression. | Journal Article

 

 

INDUSTRY EVENTS

 

NAVIGATING THE MDS THROUGH THE OHIO MEDICAID REIMBURSEMENT SYSTEM

May 1, 2008, 8:30 a.m. to 4:45 p.m. ET

Speakers: Claire Spellmire, RN, BSN, and Karen Jennings, LNHA, MHA, from the Case Mix Section, Bureau of Long Term Care Facilities, Office of Ohio Health Plans.

Cost: Free

 

For more information or to register, call Cheryl Robertson at (614) 466-9088.

Space is limited to two per facility.

 

Cuyahoga Community College Spring ’08 Continuing Education
Schedule for Gerontology Professionals

 

Health Policy Institute of Ohio: Regional Meetings on the Ohio Family Violence Prevention Project

Medicare Learning Network: Learning resources and products for the healthcare professional.

 

Alzheimer’s Association Training Events

 

AOPHA Events

 

Case Western Reserve University School of Medicine Courses

 

Ohio Department of Health, Technical Assistance Program – New Programs

 

Ohio Health Care Association Events

 

 

 

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