Category Archives: Health & Wellness Information

WHO’s World Hand Hygiene Day In Conjunction With Fight Antibiotic Resistance – It’s In Your Hands

SAVE LIVES: Clean Your Hands

WHO’s global annual call to action for health workers


SAVE LIVES: Clean Your Hands 5 May 2017 – Fight antibiotic resistance – it’s in your hands

The WHO’s calls to action are:

  • Health workers: “Clean your hands at the right times and stop the spread of antibiotic resistance.”
  • Hospital Chief Executive Officers and Administrators: “Lead a year-round infection prevention and control programme to protect your patients from resistant infections.”
  • Policy makers: “Stop antibiotic resistance spread by making infection prevention and hand hygiene a national policy priority.”
  • IPC leaders: “Implement WHO’s Core Components for infection prevention, including hand hygiene, to combat antibiotic resistance.”

Every 5 May, WHO urges all health workers and leaders to maintain the profile of hand hygiene action to save patient lives. Being part of the WHO SAVE LIVES: Clean Your Hands campaign means that people can access important information to help in their practice. This year Pr Pittet and three leading surgeons explain why hand hygiene at the right times in surgical care is life saving.

 

 

Le 5 mai de chaque année, l’OMS exhorte tous les travailleurs et responsables de santé à maintenir haut le profil de la promotion des bonnes pratiques d’hygiène des mains afin de sauver la vie de patients. Faire partie de la campagne Pour Sauver des Vies: l’Hygiène des Mains signifie que soignants et collaborateurs de santé peuvent accéder à des informations importantes pour améliorer leurs pratiques. Cette année, le Pr Pittet et trois chirurgiens de renommée internationale expliquent pourquoi l’hygiène des mains au bon moment au cours des soins chirurgicaux sauve des vies.

 

5 Moments for Hand Hygiene

The My 5 Moments for Hand Hygiene approach defines the key moments when health-care workers should perform hand hygiene.

This evidence-based, field-tested, user-centred approach is designed to be easy to learn, logical and applicable in a wide range of settings.

This approach recommends health-care workers to clean their hands

  • before touching a patient,
  • before clean/aseptic procedures,
  • after body fluid exposure/risk,
  • after touching a patient, and
  • after touching patient surroundings.

 

 

 

 

 

 

For further Information on WHO My 5 Moments for Hand
Hygiene visit:
To download hand hygiene reminder tools for the workplace visit:
To access WHO hand hygiene improvement tools and resources for use
all year round visit:
To see the latest number of hospitals and health care facilities which
have signed up to support the campaign visit:

 

Home Health Care Information for Both Physicians and Patients

What is Home Health Care?

At its basic level, “home health care” means exactly what it sounds like – medical care provided in a patient’s home. Home health care can include a range of  care given by skilled medical professionals, including skilled nursing care, physical therapy, occupational therapy and speech therapy. Home health care can also include skilled, non-medical care, such as medical social services or assistance with daily personal activities provided by a highly qualified home health aide.

As the Medicare program describes, home health care is unique as a care setting not only because the care is provided in the home, but the care itself is “usually less expensive, more convenient, and just as effective” as care given in a hospital or skilled nursing facility.

When we say “home care” a common thought is senior care.  However; in  today’s society wellness draining diagnosis occur in every age group. Some of the more chronic, long-term illnesses greatly benefit from receiving home health care vs extended stays in acute care facilities and other health care in-patient services depending upon individual living situations and over-all health conditions.

Who qualifies for Home Health Care?

Each individual must contact their insurance provider to inquire about this skilled care provided within their home.  There may be co-pays per visit, limitations of the number of visits per episode and per calendar year, there may additional stipulations and should be understood by the patient and their families prior to discussing with a Medicare enrolled Physician.

To be eligible for Medicare home health services a patient must have Medicare Part A

and/or Part B.

To  be eligible for Home Health Care Services: (1)

  • Be confined to home.
  • Need Skilled Services.
  • Be Under the Care Of a Medicare -enrolled Physician.
  • Receive Services Under a Plan Of Care Established and Reviewed by a Physician and Have Had a Face-to-Face Encounter With a Physician or Allowed Non-Physician Practioner (NPP).  Care Must Be Furnished By or Under Arrangements Made by A Medicare-Participating Home  Home Health Agency (HHA).
  • Patient Eligibility—Confined to Home
    Section 1814(a) and Section 1835(a)
    of the Act specify that an

    individual is considered
    confined to the home” (homebound) if the following two criteria are met:
    First Criteria: One of the Following must be met:
    1. Because of illness or injury, the individual needs the aid of supportive devices such as crutches, canes, wheelchairs, and walkers; the use of special transportation; or the
    assistance of another person to leave their place of residence
    2.  Have a condition such that leaving his or her home is medically contraindicated.

    Second Criteria Both of the following must be met:
    1. There must exist a normal inability to leave home.
    2. Leaving home must require a considerable and taxing effort.

     

     

    Home Health Aids May Be Included In the Home Health Care Assessment and Assigned To Assist With Personal Care – Activities of Daily Living  (ADL’s), Bathing, Feeding, Dressing, and Walking.

    To learn more about Home Health Care Nursing and being treated in the home environment, listen to Linda Jablonski, MS, BSN, RN-BC – Director of Nursing Home Health.   Click on the C.diff. radio logo below to listen to the podcast.

    cdiffRadioLogoMarch2015

 

 

 

 

 

Sources:

(1) CMS  (article se1436)  https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/se1436.pdf

MD Peer Exchange Focus On Clostridium difficile Infections

mdmag

Courtesy of MDMag .com

MD Magazine

 

 

Listen and View Panelists:  Peter L. Salgo, MD; Erik Dubberke, MD; Lawrence J. Brandt, MD; Dale N. Gerding, MD; and Daniel E. Freedberg, MD, MS,

Topic of discussion:  Understanding Why Clostridium difficile Infections (CDI) Occur In the Community

The second video the panelists discuss:

The Pathophysiology of Clostridium difficile Infection (CDI)  and Its Impact On the Gastrointestinal System.

See more at: http://www.mdmag.com/peer-exchange/clostridium-difficile-infections/understanding-why-clostridium-difficile-infections-occur-in-the-community#sthash.r4Z6jNwk.dpuf

 

 

Bridging Collaboration Between Patients and Healthcare Providers to Reduce Hospital-Acquired Infections

cdiffRadioLogoMarch2015

C. diff. Spores and More” Global Broadcasting Network
will host a special episode on their live radio program (cdiffradio.com)
airing on Tuesday, January 24, 2017 at 1:00 pm EST featuring world-renowned
infectious disease expert, Dr. Hudson Garrett Jr., Global Chief Clinical Officer for Pentax Medical-Hoya Corporation and Chairperson of the Clinical Education Committee
for the C Diff Foundation.

This special episode, Bridging Collaboration Between Patients and Healthcare Providers to Reduce Hospital-Acquired Infections (HAI’s),  will feature a robust discussion on the patient’s role in preventing healthcare associated infections, an overview of medical device hygiene and infection control, the importance of antibiotic stewardship, and applications of evidence-based infection control measures across the entire healthcare continuum of care.

“Healthcare continues to become more and more complex as the acuity and needs of the patient changes along with the correlating technologies. Patients and Healthcare Providers must work together to mitigate the risk for Healthcare Associated Infections and other adverse events,” says Dr. Garrett.

C. diff. Spores and More ™“ spotlights world renowned topic experts, research scientists, healthcare professionals, organization representatives, C. diff. survivors, board members, and their volunteers who are all creating positive changes in the
C. diff.
community and more.

Through the interviews, the C Diff Foundation’s mission connects, educates, and empowers listeners worldwide.

Questions received through the show page portal will be reviewed and addressed  by the show’s Medical Correspondent, Dr. Fred Zar, MD, FACP,  Dr. Fred Zar is a Professor of Clinical Medicine, Vice HeZarPhotoWebsiteTop (2)ad for Education in the Department of Medicine, and Program Director of the Internal Medicine Residency at the University of Illinois at Chicago.  Over the last two decades he has been a pioneer in the study of the treatment of Clostridium difficile disease and the need to stratify patients by disease severity.

 

Take our show on the go…………..download a mobile app today

www.voiceamerica.com/company/mobileapps

healthwellnesshealth (2)

Clorox Healthcare, Sponsor of C. diff. Spores and More Global Broadcasting Network

CloroxHealthcare_72

Partners In Hope For the Holidays Worldwide

Have you or a loved one has been affected by a catastrophic illness or in the fight of combating a C.diff. infection, or any long-term illness?

This holiday season might not feel like the “most wonderful time of the year.”

Instead of joy, one may be struggling with sadness or anxiety trying to understand that  spending the holidays in the traditional, old fashion ways is a challenge. There may be worries about money, time, or energy to partake in the holidays.

There are ways to help make the most of the holiday season.

Begin with setting realistic goals, starting new holiday traditions, and calling for help when it is needed most are the first steps in helping to cope. Below are several tips from mental health experts that will be useful to anyone while fighting any illness.

Set Realistic Goals: This may not be the best holiday but with a positive outlook, and the support of family and friends, one can still make the most of it. Adapting to setbacks after or during an illness can cause stress, anxiety, and sadness. Try to be realistic about gift-giving and affordability and what can be done around the holidays, and share your thoughts with friends and family. Being honest about feelings and the present circumstances can help you better cope and give everyone the chance to have a better understanding. Make time to have a conversation will be very beneficial. Enjoy sharing the holidays, make  precious moments into wonderful memories.

Start New Traditions: If you are celebrating the holidays away from your own home or away from loved ones, start a new tradition to help yourself and your family adjust to the changes. Activities like singing holiday songs or reading books aloud can help you maintain a positive outlook. Trying something new can create positive results. The new traditions will help create something special.

Surround Yourself with Support: The holidays can be a difficult for adults and children. When an individual is feeling down, lacking energy, in pain, combating an infection of any kind – one tends to isolate themselves. Do the best to avoid too much alone time, and talk to someone about how you are feeling. You are not alone and there are local numbers available in all areas to call for confidential crisis counseling and emotional support.

CONTACT USA (CUSA) is a network of crisis intervention helpline centers across the nation providing help by telephone and online chat for those in need of help.   http://www.contact-usa.org/programs.html

Treat Yourself with Care: It is important to pay attention to your own needs and feelings. Doing so will help you cope with stress caused by the holidays. If you are a parent or caregiver, it is important for you to take care of your needs first. Then you will be better able to take care of those who depend on you.

Reach Out for Help: Recovery takes time after any illness – it is common to feel a lot of different emotions – anger, sadness, anxiety, confusion, guilt, and bitterness during and after suffering from a long term illness.

Take it one-day-at-a-time………. live life in the moment and take it one step at a time.

A Collaboration Between LifePoint Health and Duke University Health System Successful At Driving Down Hospital-Acquired Infection Rates

Clinch Valley Medical Center has demonstrated its commitment to putting patients first and keeping quality front and center.

Clinch Valley Medical Center (CVMC) today announced that it has been named a Duke LifePoint Quality Affiliate. This designation recognizes hospitals within the LifePoint Health system that have enrolled in the LifePoint National Quality Program and succeeded in transforming their culture of safety and achieving high standards of quality care, performance improvement and patient engagement.

“LifePoint’s operations are defined by our mission of Making Communities Healthier and our relentless pursuit of quality”

“Our hospital is committed to establishing safe, reliable, high-quality standards of care to ensure that members of our community can be confident in the service and care they receive when they come through our doors,” said Peter Mulkey, chief executive officer of Clinch Valley Medical Center. “Earning the esteemed Duke LifePoint Quality Affiliate designation further demonstrates our dedication to putting our patients and their families first, and I am so grateful for the hard work of each and every member of our team who has helped us reach this milestone.”

CVMC is a 175-bed hospital that has served people in the Richlands, Va., community and surrounding areas for more than 75 years. To achieve Duke LifePoint Quality Affiliate designation, the CVMC team worked to implement a number of best practices and launch new initiatives to engage patients and families, enhance patient safety and improve quality care.

For example, the CVMC leadership team instituted daily executive patient safety rounding to ensure that leaders at every level of the organization engage with staff, physicians, patients and families about quality and patient safety. CVMC also implemented bedside shift reporting to help ensure clear communication, reduce the risk of errors and maintain consistency of care during shift changes. Bedside shift reporting is an effective method for transferring information from one provider to another, while also involving the patient in discussions about their health, progress and treatment plan.

Additionally, CVMC implemented a Safety Collaborative designed to help prevent potential healthcare-acquired conditions. As a result of this effort, the hospital has achieved zero incidences of central line-associated blood stream infections (CLABSI), clostridium difficile (C. diff), Methicillin-resistant Staphylococcus aureus (MRSA), and post-operative infections, among other conditions, in the last 12 months.

“CONGRATULATIONS!”

CVMC also established a community collaboration called the “Bridge Program” to help reduce readmissions. The program connects patients with various community resources and support to help ensure a smooth transition from the hospital to the home setting.

“LifePoint’s operations are defined by our mission of Making Communities Healthier and our relentless pursuit of quality,” said David Dill, president and chief operating officer of LifePoint Health. “By becoming a Duke LifePoint Quality Affiliate, Clinch Valley Medical Center has demonstrated its commitment to putting patients first and keeping quality front and center.

As only the third LifePoint facility in the country to earn designation to date, it has set the bar high for our hospitals that will follow in its footsteps along this quality journey.”

The LifePoint National Quality Program was created through a collaboration between LifePoint Health and Duke University Health System.

When hospitals enroll in the program, they begin working with Duke and LifePoint quality coaches to evaluate and strengthen their quality programs and processes.

Following an initial evaluation, the hospital creates a plan and begins to deploy changes that will help it achieve quality improvement benchmarks and establish long-term solutions to sustain its results.

In addition to evaluating common quality care and patient safety metrics, the LifePoint National Quality Program focuses foundation elements required to sustain quality care, including committed leadership, systems to ensure continuous performance and process improvement, and a culture dedicated to safety. Duke LifePoint Quality Affiliate designation denotes those hospitals that achieve a broad range of criteria in each of these areas and demonstrate a capacity to continuously measure and improve what they do.

About Clinch Valley Medical Center

Clinch Valley Medical Center in Richlands, Va., is a 175-bed acute care hospital, which offers comprehensive cancer services; specialty care for the heart, lungs and vascular system; emergency services; inpatient and outpatient physical rehabilitation; sleep studies; skilled nursing; pediatrics; obstetrics and advanced diagnostics. More information is available at www.clinchvalleymedicalcenter.com.

About LifePoint Health

LifePoint Health  is a leading healthcare company dedicated to Making Communities Healthier®. Through its subsidiaries, it provides quality inpatient, outpatient and post-acute services close to home. LifePoint owns and operates community hospitals, regional health systems, physician practices, outpatient centers, and post-acute facilities in 22 states. It is the sole community healthcare provider in the majority of the non-urban communities it serves. More information about the company can be found at www.LifePointHealth.net

 

To read the article in its entirety please click on the following link:

http://www.businesswire.com/news/home/20161012005331/en/Clinch-Valley-Medical-Center-Named-Duke-LifePoint

 

Coders and Clinical Documentation Improvement (CDI) Specialists Find Changes Regarding Coding Superbug Infections Dynamic As the Pathogens Themselves

A study published in the American Journal of Infection Control determined that one of these superbugs, clostridium difficile (c. diff) contributed to an increase in hospital costs of approximately 40 percent per case, or an average of $7,286.

For coders and clinical documentation improvement (CDI) specialists, the nuances and changes regarding coding superbug infections remain as dynamic as the pathogens themselves.

Medication resistance, and especially antibiotic resistance, can be a challenging issue in the coding world.

The bacteria in question include:

enterococcus
staphylococcus
klebsiella
acinetobacter
pseudomonas
enterobacter

In this article, we will examine a few of the recent coding guideline changes related to superbug infections, resistance, and new guidelines when infections are acquired in the hospital.

A Growing Cost Concern

The nuances of coding the superbugs can have a significant impact on revenue streams – especially if these infections are contracted during a hospital stay.

A study published in the American Journal of Infection Control determined that one of these superbugs, clostridium difficile (c. diff) contributed to an increase in hospital costs of approximately 40 percent per case, or an average of $7,286.

Costs were even higher for patients contracting renal impairment ($8,942), immunocompromised status ($8,692), and concomitant antibiotic exposure ($8,545).

Given the high cost of these cases and risk factors for contamination, ensuring correct identification, coding, and nationwide tracking of superbug infections is critical.

New Zika Codes and C-diff, MRSA Codes

A quick look at the Zika virus illustrates just one example of how superbugs can be rapidly introduced to the coding scene. Unknown to U.S. coders only one year ago, the

ICD-10 code set now contains Zika codes.  Zika will come in as a CC and impact reimbursement for healthcare providers.

A92 Other mosquito-borne viral fever
A92.5 Zika virus disease
Zika virus fever
Zika virus infection
Zika NOS

Also, effective Oct. 1, 2016, the 2017 updates include codes for c. diff and MRSA as hospital-acquired infections (HACs).

The addition of c. diff and MRSA to the HAC list marks a big potential impact for providers. Hospital-acquired infections are particularly difficult to treat, manage, and code.

Superbugs Common for Immunocompromised Patients

Most patients who contract superbugs are already immunocompromised due to cancer, long-term medication protocols, extended inpatient admissions, or other factors.

A common scenario involves patients who undergo surgical procedures and then develop MRSA infections. These painful infections quickly spread to other organs and body systems, requiring progressively stronger narcotics.

Also, since the immune systems of these patients are already compromised due to surgery and the underlying condition, superbugs build powerful resistance to medications, and such cases often become increasingly harder and more costly to treat. The progression of infection in these cases must be carefully noted and coded to ensure proper reimbursement.

Coding Medication Resistance

Coders should assign all available ICD-10 codes to reflect medication resistance. There are ICD-10 codes for resistance to 22 different types of medications, including codes for resistance to multiple medications, which might certainly be applicable in the scenario described above. This is a new change in 2016, so it’s important that coders are aware of it.

Reporting these resistant infections corrections is crucial for statistical purposes, and for tracking the superbugs across the U.S.

While the codes for medication resistance don’t impact the DRG, they are usually high-dollar cases with long lengths of stays. Resistance codes are Z codes.

Here are three coding steps to take:

  • Identify the infection/type of bacteria.
  • Assign a Z code to describe the resistance (e.g. resistance to antimicrobial drugs – Z16.10-Z16.39).
  • If the patient has been on a lot of antibiotics, this should also be coded.

Supporting documentation for coders to review includes all culture reports, physician progress notes, medication administration records, and any other ancillary testing used to identify resistance. Today, coders must rely on physician documentation to code a medication resistance. Since resistance codes do not impact the DRG, a coding query is not applicable.

However, we expect future guidance from the Centers for Medicare & Medicaid Services (CMS) to open the door for CDI and coding queries for cases in which resistance occurs, but is not documented by the physician.

More on MRSA

Because MRSA is so resistant to treatment, there are most certainly added precautions and costs with MRSA patients. For MRSA to be coded as an active infection and HAC, it would have to be proven that the patient contracted MRSA while in the hospital, leading to a CC. Hospital-acquired versus present-on-admission is a very important distinction in MRSA cases.

However, MRSA should also be picked up by the coder if the patient is a carrier. Carrier status is usually designated by a note in the chart. Z codes should be used for:

  • Carrier status (Z22.32 – Carrier or suspected carrier of methicillin-resistant staphlyococcus aureas)
  • Colonization status
  • Personal history

MRSA is the only one of the organisms that has a specific code that identifies both the bacteria and the antibiotic it’s resistant to (B95.62—MRSA infections as the cause of diseases classified elsewhere).

Superbugs Hit Outpatients Too

Outpatients are not immune to superbugs, and this is an area where coders need some heightened awareness. For example, a patient may enter through the emergency department (ED) for a urinary tract infection and be prescribed a standard antimicrobial. However, following the ED visit, the urinary culture may test positive for E. coli. The physician must be notified and a stronger antibiotic prescribed for the patient.

These scenarios present unique challenges for coders, as the microbiology culture is usually posted a few days later, after the case has been coded. Coders can’t code the bacteria unless the ED physician goes back and makes an addendum to ED report or progress note – which is not common practice and only happens in a few cases.

A Final Word

For inpatients with hospital-acquired superbug infections, no matter how they may have been contracted, the hospital’s costs for treatment of the infections are not payable under CMS guidelines.

Therefore, it’s important that physicians, CDI specialists, and coders go the extra mile to identify, document, treat, and code these infections as early as possible.

 

To read this article in its entirety – click on the link below:

http://www.icd10monitor.com/enews/item/1709-coding-the-superbugs-keeping-up-with-change