At the conclusion of the session, the participant will be able to accomplish the following:

• Describe the burden of multidrug-resistant organisms (MDROs).
• Describe challenges to preventing MDRO transmission in nursing homes.
• Define Standard Precautions, Enhanced Barrier Precautions, and Contact Precautions.
• Identify which residents and activities meet criteria for Enhanced Barrier Precautions.
• Discuss best practices for implementing Enhanced Barrier Precautions.

The U.S. Department of Health and Human Services published a new Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics - PDF. Individual patients, as well as the health of the public, benefit when opioids are prescribed only when the benefit of using opioids outweighs the risks.  But once a patient is on opioids for a prolonged duration, any abrupt change in the patient’s regimen may put the patient at risk of harm and should include a thorough, deliberative case review and discussion with the patient. The HHS Guide provides advice to clinicians who are contemplating or initiating a change in opioid dosage.

“Care must be a patient-centered experience. We need to treat people with compassion, and emphasize personalized care tailored to the specific circumstances and unique needs of each patient,” said Adm. Brett P. Giroir, M.D., assistant secretary for health. “This Guide provides more resources for clinicians to best help patients achieve the dual goals of effective pain management and reduction in the risk for addiction.”

Clinicians have a responsibility to coordinate patients’ pain treatment and opioid-related problems. In certain situations, a reduced opioid dosage may be indicated, in joint consultation with the care team and the patient. HHS does not recommend opioids be tapered rapidly or discontinued suddenly due to the significant risks of opioid withdrawal, unless there is a life-threatening issue confronting the individual patient.

Compiled from published guidelines and practices endorsed in the peer-reviewed literature, the Guide covers important issues to consider when changing a patient’s chronic pain therapy. It lists issues to consider prior to making a change, which include shared decision-making with the patient; issues to consider when initiating the change; and issues to consider as a patient’s dosage is being tapered, including the need to treat symptoms of opioid withdrawal and provide behavioral health support. 

EVS personnel play a critical role in preventing the spread of germs and healthcare-associated infections

“EVS and the Battle Against Infection” is an interactive graphic novel illustrating the important role of EVS personnel in the prevention of healthcare-associated infections. The online version of the training tool features real-world infection prevention and control scenarios and allows participants to choose options that affect the outcome of the story. 

Healthcare professionals are the first line of defense against healthcare-associated infections (HAIs) and the spread of germs in healthcare settings. CDC now offers a new online interactive infection control training, “Let’s Talk Patient Safety: Reducing HAI Transmission Risk,” to help healthcare professionals identify infection risks and prevent the spread of HAIs. The training provides free continuing education for healthcare professionals, including nurses, physician assistants, medical assistants, health educators, and other clinicians. (0.1 CEU and 0.6 CNE).

The free online training can be completed anywhere. It has two modules and takes approximately 30 minutes to complete the entire training.

Module 1: “What’s the Risk?” 

This interactive module transports healthcare professionals into a scenario where they must identify infection risks and take action to protect patients, colleagues, and visitors. 

Module 2: “Chain of Infection” 

This story-based interactive module challenges professionals to break the chain of infection in a busy healthcare environment and educates them on the consequences of not following infection prevention and control recommendations.

Please join Christine LaRocca, MD and the National Nursing Home Quality Improvement Campaign to learn more about sepsis, who is at risk and the signs and symptoms for early detection. In addition, we will:

·        Review examples of sepsis screening tools commonly used in hospital settings;

·        Learn what tools to use while recognizing the limitations of sepsis screening tools in the nursing home population; and

·        Understand the elements of evidence-based treatment for optimal outcomes.

Purpose of Review

To assess adverse events of antidepressants in the treatment of major depressive disorder in adults 65 years of age or older.

Key Messages

In people 65 years of age or older:

• Serotonin norepinephrine reuptake inhibitors (SNRIs) (duloxetine and venlafaxine) cause adverse events more often than placebo and most likely lead to discontinuation of therapy during treatment of up to 12 weeks.
• Selective serotonin reuptake inhibitors (SSRIs) (escitalopram and fluoxetine) most likely cause adverse events at a similar frequency to placebo therapy but still may lead to discontinuation of therapy during treatment of up to 12 weeks.
• Duloxetine most likely increases the risk of falls over longer treatment (<24 weeks)
• Adverse events contributing to discontinuation of therapy were rarely reported in a way that allowed clear characterization of what adverse events to expect.
• Few studies compared other antidepressants to placebo or to each other, or reported other outcomes. Trial data were sparse, and trials were short in duration, underpowered, and studied low doses of antidepressants. Observational studies had limitations related to their design. Long-term, rigorous comparative studies are needed.