News/Blog

Nutrition Administration and Ventilator Weaning in Long-Term Acute Care

Ernest Health, which includes Laredo Specialty Hospital, recently was recognized nationally for its work in nutrition management and administration for patients being weaned from ventilators in its long-term acute care hospitals (LTACHs).

The initiative, which was introduced and led by Cindy Tew, Ernest Health’s Director of Clinical Programs and Resources, and Anne Woodbury, Registered Dietitian Nutritionist at Utah Valley Specialty Hospital, won the 2017 Quality Achievement Award from the National Association of Long Term Hospitals.

“We wanted to see if we could track specific nutritional indicators that could positively influence patients being weaned from ventilators,” Tew says. In particular, the team wanted to find if the level of protein provided to a ventilated patient had any effect on the success of weaning the patient off the ventilator.

“Mechanical ventilation is a life-saving procedure that’s used to support patients who are recovering from critical illnesses or injuries,” Woodbury explains. “Patients who require prolonged mechanical ventilation need specialized medical assistance in healing and weaning from ventilator dependence, and nutrition plays a critical role in this.”

A team of Ernest Health dietitians led by Tew and Woodbury created a nutritional tracking form to collect data from its LTACH hospitals to monitor tube feeding tolerance and nutrition administration. That data was collected from patients who had been on a ventilator longer than 96 hours and were in respiratory failure.

After two years of collecting data from 204 patients, the team found more successful ventilator weaning results when a patient could tolerate 1.6-2.0 grams of protein each day.

“Data of this nature has never been recorded before, so we’re optimistic about the potential impact of our findings,” Tew says. “These are promising results not only for our patients, but for other post-acute hospitals to consider for their patients as well.”

Ernest Health’s LTACH hospitals will continue to collect data and measure protein intake values to substantiate significance with a larger data pool of patients being weaned from ventilators. The intent is to publish the results in the future for other post-acute hospitals to consider.

Read More

Don’t Let Driving Distractions Wreck Your Summer Vacation

Distracted driving is a growing – and dangerous – recurring event in the United States. Distracted driving is any activity that takes your eyes off the road, hands off the wheel, or mind off driving.

A study through the National Institutes of Health found that drivers eat, reach for the phone, text, or otherwise take their eyes off the road about 10 percent of the time. This behavior can endanger the drivers, passengers and bystanders.

Distracted driving can include a myriad of activities, including:

  • Texting
  • Talking on a cell phone
  • Looking at a GPS system
  • Eating or drinking
  • Grooming
  • Talking to passengers
  • Adjusting the radio
  • Reaching for items elsewhere in the car

Probably the most alarming distraction of all is text messaging because it requires visual, manual, and cognitive attention from the driver. Five seconds is the average time someone’s eyes are off the road while texting. When traveling at 55 mph, that’s enough time to cover the length of a football field blindfolded.

With summer vacations in full swing, many of us will be driving to our destinations. Let’s remove our distractions and pay attention to road. The simplest and most effective way to do this is to turn off your cell phone when you turn on the car ignition. It’s simple.

Read More

Communicating with a Family Member in Critical Care

Sometimes it’s hard enough to say what we mean. So what do we do if we have a family member in critical care? Rest assured, communicating is an important part of the healing process for your loved one as well as your family.

Here are 5 tips to help you out:

  1. Even if your loved one is on a ventilator, he or she will most likely be able to hear you. Speak in a calm, clear manner in a normal tone of voice. There’s no need to speak loudly. Read your family member a favorite poem, book, or prayer. If the staff says it’s OK, you could even play some music.
  2. Use short, positive statements. Reassure your loved one that you’re there, and that everyone is taking good care of him or her. Help orient your family member to the surroundings by sharing the date, day of week and time of day. Help describe the noises in the room.
  3. It’s OK to acknowledge that your family member may be experiencing discomfort. You can help by explaining what is going on, “That tube is helping you breath.” Remind your loved one that this is just temporary and helping him or her to get better.
  4. Don’t ask questions that can’t be answered. Make it simple. Suggesting hand gestures to communicate may be helpful. For example, a thumbs up or thumbs could indicate pain level. A small dry erase board may also be helpful in communicating as well. You could write words that your family member could point to, or possibly your loved one can write a few words as well.
  5. Human touch goes a long way. Ask the hospital staff first, but holding a hand or touching your family member gently is a great way to express your love and concern.

If you’re unsure about the best way to communicate, don’t hesitate to ask a member of the hospital staff for help. If one way doesn’t seem to be working, there likely will be another way that can be more effective.

Read More

6 Things to Expect When Your Loved One is in Critical Care

It’s difficult to imagine a loved one being ill or injured enough to require critical care. But being prepared for what to expect can help you manage the situation.
Here are 6 important things to know:

  1. You have an experienced team on your side. The hospital staff that’s caring for your loved one is highly trained and prepared to treat the sickest – and most medically complex – patients. From the physicians and nurses to the respiratory therapists and dietitians – they all are specially trained to care for your loved one.
  2. The tubes and equipment in a critical care unit can be intimidating. But, they all have a role and purpose in providing your loved one with the intensive healthcare that he or she needs. The healthcare team will be able to explain the role of any equipment to help you better understand what it happening.
  3. Information overload can – and most likely will – occur. Everything will be new to you from the equipment and noises to the procedures and health professionals. Take a deep breath. Once you get your bearings, think of how you can best keep track of information. Write in a notebook. Keep notes on your phone. Jot down items like key information, questions you want to ask, purpose of treatments, and names of hospital personnel.
  4. Expect peaks and valleys. Critical care can be a bumpy ride. Some days will be better than others. As much as possible, try to be patient and keep perspective.
  5. Talk to your loved one. Communicating with your loved one is important for not only him or her, but for your entire family. Often patients can hear while in critical care. Speak calmly and clearly, and make short, positive statements. Hold your loved ones hand or touch them gently if a member of the healthcare team says it’s OK.
  6. Take care of yourself. It may be a long road to your loved one’s recovery, so be sure to take time to do things like sleep, eat, and shower. Don’t be afraid to leave the room for a bit. The healthcare team will be there 24/7 to provide care.
Read More

5 Benefits of Walking

There’s nothing quite like a good walk. It doesn’t require a gym membership or a bunch of equipment, and often gets you into the great outdoors.

It’s also very good for you, both physically and mentally. Indeed, all of the benefits of walking would make for a long list, but here are five main benefits that can inspire you to lace up your walking shoes and get moving.

1. Walking Improves Your Mood

You know how it is at the end of a long, trying day. You get home and are looking for something to help take the edge off a little bit. And a great way to do just that – is by taking a walk.

Studies show that walking affects our nervous system, so that we’ll feel a decrease in anger and hostility. Furthermore, walking outside exposes you to sunlight, which helps you cope with Seasonal Affective Disorder.

2. Walking Combats the Effects of Too Much Sitting

It has become clear in recent years that prolonged sitting has many negative health effects, including the damage it causes to leg arteries. But one study showed that taking even three, five-minute walks a day can reverse this damage.

If your job entails prolonged sitting, it’s helpful to take a short break every hour and go for a quick stroll.

3. Walking Boosts Your Immune System

We’ve already mentioned how great walking is as a stress-reliever, but it also improves your circulation, and helps give you a sense of overall calm. In turn, these factors boost your immune system – which helps your body fight diseases; from the common cold, up to more serious health problems.

Walking has even been shown to lessen menopause symptoms for older women.

4. Walking Lowers Your Risk of Chronic Disease

We’ve already touched on the positive impact walking has on your immune system and fending off diseases, but it’s worth a closer look:

  • Walking lowers your blood sugar levels and your overall risk for diabetes (according to the American Diabetes Association).
  • Another study showed that regular walking lowered blood pressure, and may significantly reduce the risk of stroke.
  • Studies also show that those who walked regularly, and met minimum physical activity guidelines had a lowered risk of cardiovascular disease.

5. Walking Helps Improve Your Creativity

The research is in: Walking and other physical activities will improve your creativity and help you find solutions – like those often faced at work –  to tricky problems. A study showed that walking produced twice as many creative responses in participants that walked, than those who were sitting for long periods.

Read More

What is Occupational Therapy?

When it comes to health and rehabilitation professions, occupational therapists are truly a valuable resource.

Occupational therapy helps people optimize their ability to accomplish daily activities, through improving life skills following an injury or physical impairment. But there’s much more to occupational therapy than meets the eye – and in honor of National Occupational Therapy Month – let’s take a closer look.

What Do Occupational Therapists Do?

An occupational therapist works with people of all ages who are in need of specialized assistance because of physical, social, developmental, or emotional impairments. The occupational therapist helps patients lead more independent and productive lives by using daily activities such as self-care, work, play, and leisure as part of the therapeutic process.

A primary goal of an occupational therapist is to help patients improve their ability to carry out daily tasks. The occupational therapist will assess the patient’s home and work environment, and provide recommendations for how to adapt and lead a better quality of life. In short, occupational therapists help people with injuries, illnesses, and disabilities to live better lives.

What are Some Common Occupational Therapy Services?

  1. Occupational therapists often work with children with disabilities to help them participate fully in school and social activities.
  2. An occupational therapist may help someone who is recovering from an injury to regain needed day-to-day skills.
  3. The occupational therapist may provide support for older adults who are going through cognitive and physical changes.
  4. Occupational therapists will also do individualized evaluations, provide a customized rehabilitation plan, and ensure that outcomes are met throughout the rehabilitation process.
  5. While occupational therapists will sometimes directly treat injuries, they focus more often on helping the patient improve his or her life skills, while also incorporating adaptive tools that are sometimes created by the therapist.

Where Do Occupational Therapists Work?

An occupational therapist may work in a variety of settings, including: rehabilitation hospitals, nursing facilities, acute-care hospitals, outpatient clinics, home health, school systems, industry settings, and more. The types of places where an occupational therapist may work are growing annually.

In honor of National Occupational Therapy Month, we would like to thank all occupational therapists for what they do to help rehabilitate patients. We understand and appreciate the unique services that you provide!

Read More

National Doctors’ Day

The world of medicine was changed forever on March 30, 1842, with the first documented use of anesthesia during surgery.

While the accomplishments of doctors has continued to evolve  – and amaze – since then, March 30 remains a special day in the world of medicine. After all, it’s now considered National Doctors’ Day – a day to recognize physicians and their countless contributions to society and their communities.

The first observance of National Doctors’ Day was in 1933, in Winder, Georgia. The wife of a local doctor wanted to have a day to honor physicians, and with the help of others, sent greeting cards and placed flowers on the graves of deceased doctors. Today, the red carnation is considered the symbolic flower for Doctors’ Day.

In 1991, President George H. Bush signed a bill that made National Doctors’ Day a day of celebration in the United States.

We’ll celebrate by giving thanks to the incredible doctors in our Inpatient Rehabilitation Facilities and Long-Term Acute Care Hospitals. In both settings, our physicians are an integral part of the team that works with patients and their families to deliver the highest quality care possible.

Former Polish Prime Minister Eva Kopacz – who’s also a physician – wonderfully described the role of doctors as “a special mission, a devotion,” while saying that it called for “involvement, respect, and willingness to help all other people.”

Let’s all help celebrate National Doctors’ Day by giving physicians in our community a sincere word of thanks for their long hours, hard work, and constant care.

You can also observe this special day by using #NationalDoctorsDay to post on social media.

 

Read More

The Role of Social Workers in the Long-Term Acute Care Setting

There’s no better time than now to highlight the role of social workers in the Long-Term Acute Care (LTACH) Setting. March, after all, is National Social Worker Month.

But the importance of the role and function of social workers in a LTACH is worthy of attention year-round. A social worker is a vital member of any health care team and serves in many different capacities, including as a liaison between the patient and the care community.

Let’s take a closer look:

Social Workers in the LTACH

  • Making the Transition
    The social worker helps the person entering a long-term acute care facility to help them make a transition to the LTACH from an acute care hospital. Once the patient is in their new setting at the LTACH, the social worker continues to see that his or her needs are met, and that they are participating in planning for continued care now and in the future.
  • Identifying Resources
    Social workers help patients identify resources to meet their individual needs. They also serve as the patient’s advocate in dealing with insurance providers to secure the most comprehensive coverage possible.
    In fact, serving as the patient’s advocate is one of the most important roles.
  • Working with Patients’ Families
    A social worker in an LTACH setting spends much of their time with a patient’s family and friends, and must always be aware of factors that have an impact on the patient’s well-being.
    Patients and families deal with many aspects of a specific illness, including learning more about it, the diagnosis, and the steps in the recovery process. A social worker helps them deal with each step that hopefully leads to a safe recovery.
  • A Wide Range of Tasks
    Typical duties for social worker may include: interaction with potential residents and their families, pre-admission and discharge planning, and assessment and completion of the part of the minimum data required for each patient.

The LTACH social worker will also:

  • Contact and utilize community resources on the resident’s behalf.
  • Ensure that the social and emotional needs of each patient are met.
  • Promote the maximum level of independence for each resident.
  • Participate fully in resident care planning as part of an interdisciplinary team.

In all cases, the social worker provides a physical environment that is supportive while fostering a positive self-image for residents through social contact, independence, and decision-making opportunities.

Read More

A Heart Attack’s Effect on the Brain

It’s estimated that someone suffers a heart attack approximately every 40 seconds in the United States – or about 720,000 people each year. While many heart attack victims recover and resume their normal lives, others have to deal with lingering physical effects, such as changes in the brain.

Specifically, heart attacks and other forms of heart failure can cause a loss of gray matter in the brain, and a decline in mental processes.

What Happens During a Heart Attack

A heart attack occurs when blood that brings oxygen to the heart is cut off, or severely reduced. Coronary arteries that supply blood to the heart can narrow because of fat buildup and other substances. When an artery breaks, a clot forms around the substance and blood flow is restricted to the heart muscle.

Oxygen and the Brain

The brain needs adequate oxygen to function normally. Research has shown that brain cells begin to die when oxygen levels drop significantly low for several minutes or longer. After an extended period, a permanent brain injury may occur. This type of injury is known as an anoxic brain injury, or also cerebral hypoxia.

There are four types of anoxia – with each potentially leading to brain damage – including stagnant anoxia, in which an internal condition (such as a heart attack) blocks oxygen-rich blood from reaching the brain.

Cognitive Issues Associated with Heart Attacks

A recent study by Sweden’s Lund University said that half of all heart attack survivors experience memory loss, attention problems, and other cognitive issues. Lasting effects on the brain’s mental functions could even lead to possible dementia.

Brain scans done in similar studies showed that heart disease and heart failure might lead to losses of gray matter in the brain that are important for a variety of cognitive functions, which in turn lead to issues such as:

  • Memory Loss
    Most people who suffer an anoxic brain injury experience some short-term memory loss. The hippocampus, the part of the brain responsible for learning new information, is extremely sensitive to a lack of oxygen.
  • Anomia
    Anomia refers to difficulty in using words, or processing the meaning of words. The patient may not remember the right word, or use a word out of context.
  • Poor Performance in Executive Functions
    Executive functions include reasoning, processing information, judgment, etc. For instance, the patient may become impulsive and indecisive.
  • Visual Issues
    Patients also may have trouble processing visual information.

Treatment

Immediate treatment is essential when dealing with cerebral hypoxia. The sooner the normal oxygen supply is restored to the brain, the lower the risk of brain damage. The type of treatment depends on the cause of the anoxic injury and may include:

  • Breathing assistance via mechanical ventilation and oxygen.
  • Controlling the heart rate and rhythm.
  • The use of medicines such as phenytoin, phenobarbital, valproic acid, or general anesthetics.

The patient’s recovery depends on how long the brain lacked oxygen. The patient might have a full return to function if the oxygen supply to the brain was blocked only for a short time. The longer a person lacks this oxygen supply, the higher the risk for serious consequences, including death, and severe brain injury.

Read More

10 Things to Know if Your Loved One is On a Ventilator

For patients who are unable to breathe on their own, mechanical ventilation is used to provide life-sustaining oxygen. Ventilation is a process that requires the diligent care of a medical team and a weaning process.

If you have a family member or loved one on a ventilator, here are some things you should know:

1. What is a Ventilator?

A ventilator is a machine that supports breathing, and is used mainly in a hospital or rehabilitation setting. Medical issues or conditions that make it hard for the patient to breathe necessitate that a ventilator is used to aid the breathing process.

2. How Does a Ventilator Work?

A ventilator helps get oxygen into the lungs of the patient and removes carbon dioxide (a waste gas that can be toxic). It is used for life support, but does not treat disease or medical conditions.

3. Who Needs a Ventilator?

Many conditions, such as pneumonia, COPD, brain injuries, and strokes require the use of a ventilator. If you have a loved one with a disease or condition that impairs their lung function, a ventilator will be employed. The use of a ventilator is also common when someone is under anesthesia during general surgery. A patient may not even know they were connected to a ventilator after the completion of the surgery or medical procedure.

4. Risks of Being on a Ventilator

Patients on ventilators run a higher risk of developing pneumonia because of bacteria that enters through the breathing tube. It can also make it difficult for them to cough and clear airways of irritants that can cause infections.

5. Eating While on a Ventilator

The breathing tube will prevent the patient from eating normally, so a different tube that provides nutrients, may be inserted into their vein. Patients who are on long-term ventilation may require a feeding tube directly inserted into the nose or mouth, or through a hole made in the stomach.

6. When Sedation is Used

Sedation is often used for patients on long-term ventilation, although there’s plenty of debate in medical circles concerning the over-use of sedation. The use of sedation often depends on the patient; a patient who is calm during normal life is usually calm on a ventilator while in an ICU unit.

7. A Ventilator Restricts Your Movement

A patient’s activity and movement are significantly limited while on a ventilator. While they may be able to sit up in bed or in a chair, their mobility is otherwise limited.

8. Your Care Will Involve a Team Approach

The medical team that closely monitors patients on a ventilator includes: doctors, nurses, respiratory therapists, X-ray technicians, and more.

9. Will the Ventilator be Painful?

There’s usually little or no pain when on a ventilator.

10. Ventilator Weaning Process

Weaning is the process of taking someone off of a ventilator, so that they may begin to breathe on their own. The process usually begins with a short trial, in which they’re still connected to the ventilator, but allowed to breathe on their own. The ventilator is removed once it’s clear that the patient can breathe on their own.

Read More