Health
UKIAH, Calif. – Ukiah Valley Medical Center is proud to announce that it has received the Nurses Improving Care for Healthsystem Elders (NICHE) designation.
This designation signifies UVMCs dedication and commitment to excellence in providing care for the elderly in Mendocino county.
According to Vice President for Patient Care Heather Van Housen, “The NICHE designation demonstrates our leadership and commitment to meeting and exceeding the special care needs of older adults in the communities we serve.”
Van Housen also said that to achieve the NICHE designation the nursing leadership team, herself included, completed a six-week course on how to build the infrastructure needed to support our aging population.
“Our next step in the process,” said Van Housen, “is to evaluate how we currently care for elders and make quality improvements where needed.”
Once the evaluation has taken place the nursing staff is then educated on best practices for caring for elders in varying situations.
“Our goal is to educate our nursing team and care providers on the age-related changes of the older adult,” saidd Kristen Marin, director of education. “Being compassionate and empathetic towards elders is part of the training to enhance our team’s communication skills with our elderly patients, including their support persons and family members. This is just as important as their clinical skills and will help us provide excellent care for our older patients.”
Eugene Lewis of Ft. Bragg, a recent patient at UVMC, felt that the nursing team was great. “They anticipated all of my needs – the team knew what they were doing. I received great care.”
New treatment methods are also being introduced to patient care for treating certain conditions.
“We will be introducing massage, music, and essential oils therapies to help treat delirium,” said Lindsey Spencer, director of acute care services. “The evaluation we are conducting on our current care methods for our elder patients will also give us an opportunity to adjust care plans to provide new and alternative treatment methods that best meet the needs of each individual patient.”
“UVMC shows a tremendous commitment to meet the most critical challenge of our times - quality care of older adults,” said Liz Capezuti, PhD, RN, FAAN, NICHE director.
Likewise, Dr. John W. Rowe, professor in successful aging, New York University College of Nursing said, “UVMCs dedication to drive continuous improvement processes and enhance care marks them as leaders in the field.”
NICHE is the leading nurse-driven program designed to help hospitals improve the care of older adults.
The vision of NICHE is for all patients 65-and-over to be given sensitive and exemplary care. The mission of NICHE is to provide principles and tools to stimulate a change in the culture of healthcare facilities to achieve patient-centered care for older adults.
NICHE, based at NYU College of Nursing and comprised of almost 450 hospitals and healthcare facilities throughout North America, engages hospitals and their affiliates in achieving and sustaining the NICHE designation.
NICHE designation demonstrates a hospital's organizational commitment and continued progress in improving quality, enhancing the patient and family experience, and supporting hospitals’ efforts to serve their communities.
For more information visit www.nicheprogram.org .
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MISSOULA, Mont. – Each year more than 1,000 people die from heat stroke in the United States.
Long thought to be the product of dehydration, traditional prevention and treatment of heat related illness has been to drink more water.
More recent research has proven that, while proper hydration is important, the key step to preventing heat stroke is to recognize when one is working too hard for the given environment and slowing down or stopping.
“One can absolutely suffer and even die from heat stroke even when properly hydrated,” said Dr. Brent Ruby, Director of the Center for Work Physiology and Exercise Metabolism at The University of Montana. “Prevention of heat stroke starts with recognizing our own limits while being active in hot environments. Our bodies are sending us signals to slow down and stop; we just have to know when to say when.”
The first stage of heat related illness is heat cramps with symptoms including painful muscle aches.
The next stage is heat exhaustion with symptoms such as headache, nausea, dizziness, weakness, irritability, thirst and heavy sweating.
Without taking steps to cool down, heat exhaustion can quickly progress to heat stroke when the body becomes overwhelmed by heat and is unable to regulate its core temperature.
Symptoms of heat stroke include, sweating stops and the victim may become confused, lose consciousness, and have seizures. Heat stroke is a medical emergency that may result in death.
“In cases of HRI (heat related illness) that are developed during exertional heat stress, the individual is working too hard for the environment they are in and likely thinks – if I can stay hydrated, I will be fine,” explained Ruby. “But, that’s the wrong thinking. Even aggressive hydration strategies that attempt to match fluid loss one-to-one will not prevent the HRI. Knowing when to stop is the crucial step in prevention of heat stroke.”
Dr. Brent Ruby, Ph.D., FACSM is Director of the Montana Center for Work Physiology and Exercise Metabolism (Montana WPEM) at the University of Montana and a fellow of the American College of Sports Medicine (ACSM).
Dr. Ruby’s research interests include nutritional strategies during ultra-endurance work/competition, muscle metabolism during and after exercise, the use of stable isotope tracers for the measure of water turnover and energy expenditure, and issues surrounding heat stress during arduous work.
Differentiating WPEM from other labs, Ruby created a solar powered, mobile lab that allows controlled laboratory research to be meshed with raw field data to draw scientific conclusions.
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Activating an enzyme known to play a role in the anti-aging benefits of calorie restriction delays the loss of brain cells and preserves cognitive function in mice, according to a study published in the May 22 issue of The Journal of Neuroscience.
The findings could one day guide researchers to discover drug alternatives that slow the progress of age-associated impairments in the brain.
Previous studies have shown that reducing calorie consumption extends the lifespan of a variety of species and decreases the brain changes that often accompany aging and neurodegenerative diseases such as Alzheimer’s.
There is also evidence that caloric restriction activates an enzyme called Sirtuin 1 (SIRT1), which studies suggest offers some protection against age-associated impairments in the brain.
In the current study, Li-Huei Tsai, PhD, Johannes Gräff, PhD, and others at the Picower Institute For Learning and Memory, Massachusetts Institute of Technology, and Howard Hughes Medical Institute, tested whether reducing caloric intake would delay the onset of nerve cell loss that is common in neurodegenerative disease, and if so, whether SIRT1 activation was driving this effect.
The group not only confirmed that caloric restriction delays nerve cell loss, but also found that a drug that activates SIRT1 produces the same effects.
“There has been great interest in finding compounds that mimic the benefits of caloric restriction that could be used to delay the onset of age-associated problems and/or diseases,” said Luigi Puglielli, MD, PhD, who studies aging at the University of Wisconsin, Madison, and was not involved in this study. “If proven safe for humans, this study suggests such a drug could be used as a preventive tool to delay the onset of neurodegeneration associated with several diseases that affect the aging brain,” Puglielli added.
In the study, Tsai’s team first decreased by 30 percent the normal diets of mice genetically engineered to rapidly undergo changes in the brain associated with neurodegeneration. Following three months on the diet, the mice completed several learning and memory tests.
“We not only observed a delay in the onset of neurodegeneration in the calorie-restricted mice, but the animals were spared the learning and memory deficits of mice that did not consume reduced-calorie diets,” Tsai explained.
Curious if they could recreate the benefits of caloric restriction without changing the animals’ diets, the scientists gave a separate group of mice a drug that activates SIRT1.
Similar to what the researchers found in the mice exposed to reduced-calorie diets, the mice that received the drug had less cell loss and better cellular connectivity than the mice that did not receive the drug.
Additionally, the mice that received the drug treatment performed as well as normal mice in learning and memory tests.
“The question now is whether this type of treatment will work in other animal models, whether it’s safe for use over time, and whether it only temporarily slows down the progression of neurodegeneration or stops it altogether,” Tsai said.
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Heart attack or heart failure patients may have a high risk of death or re-admission for a month or longer after leaving the hospital, researchers said at the American Heart Association’s Quality of Care and Outcomes Scientific Sessions 2013.
“The risks of death and re-hospitalization can extend well beyond 30 days after discharge, the time period used by the federal government for measuring hospital performance,” said Kumar Dharmarajan, M.D., M.B.A., lead author of the study and a fellow in cardiology at Columbia University Medical Center in New York City, and visiting scholar at Yale University in New Haven, Conn. “Post-discharge care may be improved when aligned to the periods of greatest risk for patients.”
Researchers examined Medicare data on patients discharged for heart failure (878,963) and heart attack (350,509) and found:
- Within the first year, 41.8 percent of heart failure patients died and 70.3 percent were re-hospitalized.
- Within the first year, 25.9 percent of heart attack patients died and 50.5 percent were re-hospitalized.
- The risk of re-hospitalization after heart failure took more than a month (43 days) to decline 50 percent from its peak level after discharge.
- In the month after a heart attack, the likelihood of death is 21 times higher and the likelihood of hospitalization is 12 times higher than among the general Medicare-age population.
- In the month after hospitalization for heart failure, the likelihood of death is 17 times higher and the likelihood of hospitalization is 16 times higher than among the general Medicare-age population.
“In the weeks after hospital discharge, your risk of death, re-hospitalization and other complications is very high,” Dharmarajan said. “If you feel ill, take it seriously and contact your health care provider.”
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