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A national chain of home care agencies found through a quality assurance report that one in 11 new home care patients enters the system with pressure ulcers. The report, published in the September issue of the Journal of the American Geriatrics Society, raises concerns about the quality of routine skin care measures for older adults in hospitals and nursing homes and points out the need for better wound care.
More than 3,000 home care patients from 14 states were examined as part of the study, 65% of whom had been discharged from a hospital or nursing home. About 9% already had pressure ulcers at the time of their first home care visit. Of those, roughly a third had two or more pressure ulcers, while three-fourths had advanced-stage ulcers.
The report also revealed that patients who began home care after being released from a nursing home or hospital were more likely to have pressure ulcers than other patients. Fifty-four percent of those with pressure ulcers received pressure-reducing mattresses or other devices on admission to the facility, and only 18% of those at risk received pressure reduction. Other risk factors for pressure ulcers included functional impairment, incontinence, and previous ulcers.
Most ulcers were being managed by wound care products, including dry or wet-to-dry gauze dressings. The researchers recommended educational and quality improvement efforts to ensure that home care providers have the knowledge and skill to assess and manage these potentially dangerous wounds.
Three Internet health organizations announced in October that they were forming a coordinating committee to collaborate on ethical conduct codes. The committee has a goal of ensuring a system of e-health codes that is understandable to the public and that uses a common terminology. The organizations involved in this committee are:
• Hi-Ethics (Health Internet Ethics), a coalition of 20 of the most widely used U.S.-based consumer health Internet sites and information providers;
• The Health on the Net Foundation, a not-for-profit portal for medical and health-related information based in Geneva, Switzerland;
• The Internet Healthcare Coalition’s e-Health Ethics Initiative. The Internet Healthcare Coalition is a Washington, DC-based nonprofit organization. Its initiative aims to provide a forum for the development of a universal set of ethical principles for health-related Web sites.
The first step of the collaboration will be the development of a common glossary of definitions and terms for verification and compliance efforts. E-health consumers should be able to easily compare security and privacy statements using universal descriptions. The common terminology will be used by the three organizations when communicating future developments. The groups hope their efforts may set domestic standards and may eventually lead to cooperation on an international level.
A Michigan osteopathic physician agreed to pay the government $2 million to settle allegations that he and a corporation he controlled overcharged the Medicare and Medicaid programs, the Justice Department announced on Dec. 27. The settlement resolves various allegations under the False Claims Act against Donald Dreyfuss, DO, in connection with services provided from 1992 to 1996 to nursing home and hospice patients in the Detroit area.
The settlement was announced by Assistant Attorney General David Ogden of the Justice Department’s Civil Division and Saul Green, U.S. Attorney for the Eastern District of Michigan. Dreyfuss billed Medicare and Medicaid for provision of physician services to nursing home patients. The Justice Department alleges that the services were not provided or were not medically necessary, or the complexity of the services was exaggerated. It was also alleged that in connection with a hospice, Dreyfuss certified that patients were eligible for Medicare or Medicaid services when they were not.
A two-year independent study has found that frail seniors who wore HipSavers hip protector underwear were considerably less likely to experience a hip fracture than their less frail counterparts who didn't wear the undergarment.
The study, reported in a recent issue of Advances for Occupational Therapy Practitioners, examined a high-risk group from the Elder Service Plan of the East Boston Neighborhood Health Center. Of those who wore HipSavers, none experienced a hip fracture, compared to a 4.3% hip fracture rate in a group at less risk that did not wear the undergarment, even though the frail group had a historic rate of twice as many previous hip fractures and experienced five times the frequency of falls as did the lower risk group.
HipSavers are U.S. Food and Drug Administration-approved underwear incorporating a soft, thin pad over each hip bone to absorb and dissipate the impact of a fall. For more information about HipSavers, visit www.hipsaver.com.