• CDC Infection Prevention and Control Assessment (ICAR) Tool for Nursing Homes Preparing for COVID-19 UPDATED (11/20)

    Monday, November 23, 2020 | CDC

    Infection Control Assessment and Response (ICAR) tools are used to systematically assess a healthcare facility’s infection prevention and control (IPC) practices and guide quality improvement activities (e.g., by addressing identified gaps).

    This tool is an update to the previous ICAR tool for nursing homes preparing for COVID-19. Notable changes as of November 20, 2020 include:

    • Additions to reflect updated guidance such as SARS-CoV-2 testing in nursing homes
    • Increased emphasis on the review of Personal Protective Equipment (PPE) use and handling
    • Addition of sections to help guide a video tour as part of a remote TeleICAR assessment or in-person tour of a nursing home
    • Addition of an accompanying facilitator guide to aide with the conduction of the ICAR and create subsequent recommendations for the facility

    This updated ICAR tool is a longer but more comprehensive assessment of infection control practices within nursing homes. Due to the addition of example recommendations to aid the facilitator during the process of conducting an ICAR, the facilitator guide version of the tool appears even longer. Facilitators may decide whether to use the tool in its entirety or select among the pool of questions that best fit their jurisdictional needs and priorities as part of quality improvement efforts.

    Read more
    Comments (0)
  • Residents With Acute Respiratory Symptoms? CDC Testing and Management Considerations When SARS-COV-2 and Influenza Co-Circulate (11/20)

    Monday, November 23, 2020 | CDC
    This document contains practices that should be considered when SARS-CoV-2 and Influenza viruses are found to be co-circulating based upon local public health surveillance data and testing at local healthcare facilities.
    Read more
    Comments (0)
  • CMS Podcast: Nursing Home Series for Front Line Clinicians and Staff (11/20)

    Thursday, November 19, 2020 | CMS

    The Centers for Medicare & Medicaid Services (CMS) is releasing the first episode in a series of short podcasts for frontline nursing home staff “CMS Beyond the Policy”.

    This edition is titled “Nursing Home Series for Front Line Clinicians and Staff.” Dr. Shari Ling, Deputy Chief Medical Office for The Centers for Medicare and Medicaid Services and geriatrician is joined by David Wright, Director of the Quality Safety & Oversight Group to discuss training and infection control practices in nursing homes to help combat the spread of coronavirus disease 2019 (COVID-19).

    Read more
    Comments (0)
  • CDC STRIVE Infection Control Trainings (11/20)

    Wednesday, November 18, 2020 | CDC

    The following CDC infection control training courses are part of the new States Targeting Reduction in Infections via Engagement (STRIVE) curriculum intended for the infection prevention team, hospital leaders, clinical educators, nurse and physician managers, environmental services managers, all patient care staff, and patient/family advisors.

    These training courses were developed by national infection prevention experts led by the Health Research & Educational Trust (HRET) for the Centers for Disease Control and Prevention (CDC).

    All courses are free and offer continuing education (CE).

    The STRIVE curriculum will include over forty individual training modules grouped into 11 courses that focus on Foundational and Targeted infection prevention strategies. 

    Foundational Infection Prevention Strategies

    · Competency-Based Training 

    · Hand Hygiene 

    · Strategies for Preventing HAIs 

    · Environmental Cleaning 

    · Personal Protective Equipment 

    · Patient and Family Engagement – WB4226

    · Building a Business Case for Infection Prevention – WB4227 

      Targeted Infection Prevention Strategies

      • Catheter-Associated Urinary Tract Infection (CAUTI) – WB4222
      • MRSA Bacteremia – WB4228
      • Central Line-Associated Blood Stream Infection (CLABSI) – WB4229
      • C. difficile Infection (CDI) – WB4230
      Read more
      Comments (0)
    • AHRQ Evidence-Based Practice: Interventions for Breathlessness in Patients With Advanced Cancer (11/20)

      Wednesday, November 18, 2020 | AHRQ
      This report is from the Agency for Healthcare Research and Quality.

      Main Points

      For patients with advanced cancer:

      • Airflow interventions (fans) were more effective for improving breathlessness compared with usual care or sham.
      • Bilevel ventilation (a form of noninvasive positive pressure ventilation) was more effective than standard supplemental oxygen for improving breathlessness.
      • Acupressure/reflexology were more effective than usual care or sham for improving breathlessness.
      • Neither behavioral/psychoeducational interventions alone nor activity/rehabilitation interventions alone were more effective than usual care for improving breathlessness. However, multicomponent nonpharmacological interventions that combined these, with integrative medicine interventions, were more effective than usual care for improving breathlessness.
      • Opioids were not more effective than placebo or anxiolytics for improving breathlessness or exercise capacity; most of these studies in advanced cancer were of exertional breathlessness. Studies on opioids showed no differences in effectiveness between different doses or routes of administration for improving breathlessness.
      • Anxiolytics were not more effective than placebo for improving breathlessness.
      • Both nonpharmacological and pharmacological interventions led to adverse event-related dropouts in a small percentage of patients.

      Structured Abstract

      Objectives. To assess benefits and harms of nonpharmacological and pharmacological interventions for breathlessness in adults with advanced cancer.

      Data sources. We searched PubMed®, Embase®, CINAHL®, ISI Web of Science, and the Cochrane Central Register of Controlled Trials through early May 2020.

      Review methods. We included randomized controlled trials (RCTs) and observational studies with a comparison group evaluating benefits and/or harms, and cohort studies reporting harms. Two reviewers independently screened search results, serially abstracted data, assessed risk of bias, and graded strength of evidence (SOE) for key outcomes: breathlessness, anxiety, health-related quality of life, and exercise capacity. We performed meta-analyses when possible and calculated standardized mean differences (SMDs).

      Results. We included 48 RCTs and 2 retrospective cohort studies (4,029 patients). The most commonly reported cancer types were lung cancer and mesothelioma. The baseline level of breathlessness varied in severity. Several nonpharmacological interventions were effective for breathlessness, including fans (SMD -2.09 [95% confidence interval (CI) -3.81 to -0.37]) (SOE: moderate), bilevel ventilation (estimated slope difference -0.58 [95% CI -0.92 to -0.23]), acupressure/reflexology, and multicomponent nonpharmacological interventions (behavioral/psychoeducational combined with activity/rehabilitation and integrative medicine). For pharmacological interventions, opioids were not more effective than placebo (SOE: moderate) for improving breathlessness (SMD -0.14 [95% CI -0.47 to 0.18]) or exercise capacity (SOE: moderate); most studies were of exertional breathlessness. Different doses or routes of administration of opioids did not differ in effectiveness for breathlessness (SOE: low). Anxiolytics were not more effective than placebo for breathlessness (SOE: low). Evidence for other pharmacological interventions was limited. Opioids, bilevel ventilation, and activity/rehabilitation interventions had some harms compared to usual care.

      Conclusions. Some nonpharmacological interventions, including fans, acupressure/reflexology, multicomponent interventions, and bilevel ventilation, were effective for breathlessness in advanced cancer. Evidence did not support opioids or other pharmacological interventions within the limits of the identified studies. More research is needed on when the benefits of opioids may exceed harms for broader, longer term outcomes related to breathlessness in this population.

      Read more
      Comments (0)
    • CMS Urgent Call to Action: Staff, Managers Should Complete QSEP Nursing Home COVID-19 Training (11/20)

      Tuesday, November 17, 2020 | CMS

      Agency thanks nursing homes whose staff have completed free CMS training, but urges remaining homes to take advantage of this resource

      The Centers for Medicare & Medicaid Services (CMS) is publicly recognizing the 1,092 nursing homes at which 50% or more of their staff have completed CMS training designed to help staff combat the spread of coronavirus disease 2019 (COVID-19) in nursing homes. CMS applauds these facilities for taking this critical step to equip their staff with the latest information regarding infection control, vaccine distribution, and other topics.

      There are 125,506 individuals from 7,313 nursing homes who have completed the training. This represents approximately 12.5% of the approximately one million nursing home staff in the country. With today’s announcement, CMS is calling on nursing homes to take action, urging them to require their staff to take this free training, as part of the Trump Administration’s continued efforts to keep nursing home residents safe.

      “We’ve provided nursing homes with $20 billion in federal funding, millions of pieces of PPE, free testing machines and supplies, and significant technical assistance and on-the-ground support,” said CMS Administrator Seema Verma. “Ultimately, the ownership and management of every nursing must take it on themselves to ensure their staff is fully equipped to keep residents safe. With coronavirus cases increasing across the country and infection control identified as a major issue, we encourage all nursing homes to take advantage of this no-cost opportunity to train their staff.”

      The training includes multiple modules, with emphases on topics such as infection control, screening and surveillance, personal protective equipment (PPE) usage, disinfection of the nursing home, cohorting and caring for individuals with dementia during a pandemic. CMS developed this training in consultation with the Centers for Disease Control and Prevention (CDC) and expert stakeholders, and announced the training on August 25, 2020. For anyone interested, the training is free to access on a public CMS website; instructions on how to create an account and take the training are available at qsep.cms.gov/welcome.aspx.

      Read more
      Comments (0)
    • CMS Alert Addressing Holiday Celebrations (11/20)

      Tuesday, November 17, 2020 | CMS

      In advance of the approaching holiday season, the Centers for Medicare & Medicaid Services (CMS) is urging nursing home staff, residents and visitors to follow established guidelines for visitation and adherence to the core principles of infection prevention. These guidelines include remaining six feet apart from individuals, wearing a face covering, and limiting the number of visitors in the nursing home at any one time. Adherence to these principles is critical in preventing the spread of the coronavirus disease 2019 (COVID-19) in America’s nursing homes. While the holiday season is typically a time for family and friends to gather, CMS implores staff, residents and visitors to exercise extreme caution this year. 

      “The approaching holiday season remains fraught with danger for the vulnerable residents of America’s nursing homes,” said Administrator Seema Verma. “They have already endured loss and loneliness to a degree that would have been unthinkable before this year began, but they and their families – along with facilities themselves – must not let their guard down over the holiday season, especially with a safe and effective vaccine so close to reality.”

      The agency understands the emotional and mental health impact that separation from loved ones during the pandemic has caused. In September, CMS provided guidance for how residents can safely receive visitors in the nursing home. With the holiday season approaching, residents will want to spend more time with their loved ones, and CMS is recommending that facilities find innovative ways of recognizing the holidays without having parties or gatherings that could increase the risk of COVID-19 transmission (e.g., virtual parties or visits).

      CMS also acknowledges that some residents may want to leave the nursing home temporarily to visit with family and friends for the holidays, or for other outings.  A resident has the right to leave the nursing home, and CMS urges that extra precautions be taken to help reduce the spread of COVID-19, which poses an elevated danger to the health of nursing home residents.  Nursing homes should double down on infection control and adhere to testing requirements.

      Extra precautions taken now will help to ensure that our loved ones stay healthy and safe for the short amount of time remaining until a safe and effective vaccine becomes available.  Leaving the nursing home could increase a resident’s risk for exposure to COVID-19. The risk may be further increased by factors such as a resident’s health status, the level of COVID-19 in the community (e.g., cases or positivity rate), or attendance at large gatherings. Residents are encouraged to discuss these and other risks with their family and nursing home staff.  Nursing homes should educate residents and families of the risks of leaving the facility, the steps they should take to reduce the risk of contracting COVID-19, and encourage residents can stay connected with loved ones through alternative means of communication, such as phone and video communication. 

      Read more
      Comments (0)
    • Considerations for Use of SARS-CoV-2 Antigen Testing in Nursing Homes (10/20)

      Tuesday, November 17, 2020 | CDC
      This document provides a summary of considerations for use of SARS-CoV-2 (the virus that causes COVID-19) antigen testing in nursing homes and is intended for nursing home providers and state and local public health departments.

      Also see: Guidance for SARS-CoV-2 Point-of-Care Testing

      Read more
      Comments (0)
    • CMS COVID-19 Nursing Homes Best Practices Toolkit and New QIN-QIO Virtual Assistance UPDATED (11/20)

      Sunday, November 15, 2020 | CMS

      New tool provides innovative solutions for states and facilities to protect our nation’s vulnerable nursing home residents during emergency

      CMS has released a new toolkit (updated 11/22/20) developed to aid nursing homes, Governors, states, departments of health, and other agencies who provide oversight and assistance to these facilities, with additional resources to aid in the fight against the coronavirus disease 2019 (COVID-19) pandemic within nursing homes. The toolkit builds upon previous actions taken by the Centers for Medicare & Medicaid Services (CMS), which provide a wide range of tools and guidance to states, healthcare providers and others during the public health emergency. The toolkit is comprised of best practices from a variety of front line health care providers, Governors’ COVID-19 task forces, associations and other organizations, and experts, and is intended to serve as a catalogue of resources dedicated to addressing the specific challenges facing nursing homes as they combat COVID-19.

      “The coronavirus presents a unique challenge for nursing homes. CMS is using every tool at our disposal to protect our nation’s most vulnerable citizens and aid the facilities that care for them. This toolkit will support state, local leaders and nursing homes in identifying best practices to protect our vulnerable elderly in nursing homes” said CMS Administrator Seema Verma.  

      The toolkit provides detailed resources and direction for quality improvement assistance and can help in the creation and implementation of strategies and interventions intended to manage and prevent the spread of COVID-19 within nursing homes. The toolkit outlines best practices for a variety of subjects ranging from infection control to workforce and staffing. It also provides contact information for organizations who stand ready to assist with the unique challenges posed by caring for individuals in long-term care settings. Each state was involved in the creation of this toolkit, resulting in a robust resource that may be leveraged by a variety of entities serving this vulnerable population.

      Additionally, CMS has contracted with 12 Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) to work with providers, community partners, beneficiaries and caregivers on data-driven quality improvement initiatives designed to improve the quality of care for beneficiaries across the United States. The QIN-QIOs are reaching out to nursing homes across the country to provide virtual technical assistance for homes that have an opportunity for improvement based on an analysis of previous citations for infection control deficiencies using publicly available data found on Nursing Home Compare.

      Read more
      Comments (0)
    • CMS Will Retire Nursing Home Compare Tool and Fully Transition to Care Compare on December 1 (11/20)

      Sunday, November 15, 2020 | CMS
      CMS will retire the original Compare Tools on December 1st. Use Medicare.gov’s Care Compare to find and compare health care providers.

      In early September, the Centers for Medicare & Medicaid Services (CMS) released Care Compare on Medicare.gov, which streamlines our eight original health care compare tools.  Since then, you’ve had the opportunity to use and familiarize yourself with Care Compare while having the option to use the original compare tools, too.  You’ve also been able to share feedback from a survey directly on Care Compare and we’ve received lots of great feedback so far.

      The eight original compare tools – like Nursing Home Compare, Hospital Compare, Physician Compare – will be retired on December 1st, ending this transition period. If you haven’t been using Care Compare, we urge you to:

      ·  Use Care Compare on Medicare.gov and encourage people with Medicare and their caregivers to start using it, too. Go to Medicare.gov and choose “Find care”.

      ·  Update any links to the eight original care tools on your public-facing websites so they’ll direct your audiences to Care Compare.

      Care Compare offers a new design that makes it easier to find the same information that’s on the original compare tools. It gives you, patients, and caregivers one user-friendly place to find cost, quality of care, service volume, and other CMS quality data to help make informed health care decisions.

      Now, instead of having to search through many compare tools, with just one click on Care Compare, you’ll find easy-to-understand information about nursing homes, hospitals, doctors, and other health care providers.

      Please remember that when we retire the 8 original compare tools, you will still be able to find information about health care providers and CMS quality data on Care Compare, as well as download CMS publicly reported data from the Provider Data Catalog on CMS.gov.  Fully transitioning to these tools does not change how CMS measures quality. In addition, we’ll continue to make improvements to Care Compare and the Provider Data Catalog based on stakeholder and consumer feedback now and in the future. 

      Read more
      Comments (0)
    1 of 2 Next