MDS
Most of you know this but….
Wounds that were obtained in the hospital do not affect our quality measures initially. However, after 100 days, the wound will count against us if we have not healed it.
CMS Makes Updates to Nursing Home Care Compare and Five Star
Drop Third Cycle Standard Surveys from the Nursing Home Care Compare Health Inspection Rating
Beginning July 2025, CMS will no longer use the three most recent standard surveys and will only use the two most recent standard surveys for the health inspection rating calculation. CMS notes that this change is related to the continued standard survey backlogs. CMS will continue to use a three-year lookback period for complaint and infection control inspections to calculate the health inspection rating.
Unrealistic staffing rules get a reality check – McKnight’s Long-Term Care News
“That’s the message the Centers for Medicare & Medicaid Services just got from a federal judge in Iowa, who did what many skilled care operators had been hoping for: He hit pause on the most unrealistic parts of the staffing mandate. The 24/7 RN requirement and rigid nurse staffing rule minimums are now off the table — at least for now.…”
End of Days for Benadryl (diphenhydramine)?
- FDA approved in 1946, before rigorous medication testing standards
- Other countries have taken action to limit diphenhydramine’s availability by making it available by prescription only: Germany, Netherlands, Sweden.
- Crosses the blood-brain barrier to block histamine in the CNS.
- Histamine is a neurotransmitter.
- Acts to block neurotransmitter effect of histamine within the CNS leading to sedation, drowsiness, and psychomotor impairment, urine retention,
- Increases risk of dementia and global cognitive impairment
- Half-life in elderly can be up to 18 hours.
- Due to long half life it can lead to daytime sedation, poor concentration, reduced memory, reduced sensory-motor performance.
- May impair driving performance as much or more than alcohol
- CSACI position statement: Newer generation H1-antihistamines are safer than first-generation H1-antihistamines and should be the first-line antihistamines for the treatment of allergic rhinitis and urticaria – PubMed
- Insomnia
- Fall asleep faster but sleep quality if not good.
- Decreases REM sleep
- Reduces deep sleep (slow wave sleep)
- tolerance can develop
- increased risk for falls, urine retention, constipation, cognitive impairment,
- Urticaria / hives
- Second generation antihistamines (cetirizine, loratidine) are recommended first line agents for urticaria. They are equally effective with fewer side effects.
- Cetirizine is approved for treatment of chronic idiopathic urticaria
- Noted to enhance the sedative and hypnotic effects of benzodiazepines.
Is It Really Time to Say Goodbye to Benadryl? | MedPage Today
Diphenhydramine: It is time to say a final goodbye – World Allergy Organization Journal
We believe that diphenhydramine has reached the end of its life cycle, and in its class of therapies is a relatively greater public health hazard. We recommend it should no longer be widely prescribed or continue to be readily available over the counter.
Diphenhydramine: It is time to say a final goodbye – World Allergy Organization Journal
Healthcare Associated Infections and Antibiotic Resistance
CDPHE introduced the HAI/AR program led by Dr. Chris Czar MD.
Mission: To prevent health care-associated infections and control the spread of
emerging antimicrobial-resistance threats in all health care settings in Colorado
through surveillance, containment and response, infection prevention, and
antimicrobial stewardship
Wildfire Smoke and Facility Preparedness
Please be sure that we are prepared for any type of natural disaster but especially the possibility of a fire.
- Ensure fie drills and other natural disaster drill are up to date and that we are prepared for such incidents.
- Ensure communication methods and protocols are reviewed.
- Ensure we know who our partners are and who/how to contact for each partner organization.
How Wildfire Smoke Affects Your Body | Wildfires | CDC
CDPHE – Colorado.gov/AirQuality
CDPHE – Colorado.gov/AirQuality