Journal of Gerontological Nursing

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A study funded by the Agency for Healthcare Research and Quality has found that patients ages 30 to 74 who took atypical antipsychotic agents such as risperidone (Risperdal®), quetiapine (Seroquel®), olanzapine (Zyprexa®), and clozapine (Clozaril®) had a rate of sudden cardiac death twice that of people who did not take these medications and similar to the death rate for patients taking typical antipsychotic agents, including haloperidol (Haldol®) and thioridazine (Mellaril®).

The study, published in the New England Journal of Medicine, examined medical records from the Tennessee Medicaid program and identified data on patients prescribed atypical antipsychotic drugs, including the number of prescriptions they received, the dosage, and the number of days supplied. The researchers concluded that atypical antipsychotic drugs, which are frequently prescribed off label for symptoms such as agitation, anxiety, psychotic episodes, and obsessive behaviors, are not a safer alternative to typical antipsychotic drugs in preventing death from sudden cardiac causes. In this study, the risk of death increased with higher dosages of the drugs taken.

Source.“Use of Atypical Antipsychotic Drugs Increases Risk of Sudden Cardiac Death in Adults.” (2009, January 14). Retrieved January 26, 2009, from http://www.ahrq.gov/news/press/pr2009/antipsychpr.htm.

A newly discovered link between inflammation and Alzheimer’s disease may be the key to the development of novel therapeutics for this disease. Research at the Roskamp Institute in Florida focused on inflammation—long been known to accompany Alzheimer’s disease—and abnormal deposits of the protein amyloid, which accumulate in the brain of those with Alzheimer’s disease and also trigger an inflammatory response. This inflammatory response is thought to be detrimental to nerve cells, eventually causing their destruction.

The Roskamp research revealed that inflammation can lead to the production of more amyloid, and the researchers found that a specific receptor on the nerve cell surface, known as CXCR2, is an interface between inflammation and new amyloid production. As specific inflammatory molecules contact CXCR2, a signal is generated, which results in increased amyloid production. The presence of the abnormally occurring amyloid, therefore, contributes to its own reproduction through the inflammatory response it triggers.

By genetically “knocking out” CXCR2, the researchers were able to reduce the amount of amyloid in various laboratory models. In addition, by using drugs that specifically block the CXCR2 receptor, the researchers showed that a decrease in amyloid production is possible and could open a new door for therapeutic interventions.

Source.“Roskamp Institute Identifies New Class of Drugs to Treat Alzheimer’s Disease.” (2008, December 16). Retrieved December 31, 2008, from http://www.medicalnewstoday.com/articles/133283.php.

A University of Iowa survey of 1,071 nursing home social service directors and an examination of state legislation show that qualifications of nursing home social workers vary significantly in part because of low federal standards and inconsistent state laws. Despite the important responsibilities nursing home social workers have, 10 states do not address qualifications for such employees, and seven state codes do not appear to comply with federal standards. Twenty-one states require a social work degree; most others require a 4-year degree, but not in social work. In fact, the study found that only half of nursing home social workers have a degree in social work, and 20% do not have a 4-year degree. In addition, two thirds of nursing home social workers reported they do not belong to a related professional organization, and only 38% are licensed in social work. For-profit nursing homes were found to be 31% less likely to hire a degreed social worker.

Other inconsistencies were found related to:

The results of the national survey will be published in the Journal of the American Medical Directors Association.

Source.“Study Shows Need for Standardizing Nursing Home Social Workers’…

© Istockphoto.com

© Istockphoto.com

Alarming Data About Sudden Cardiac Death

A study funded by the Agency for Healthcare Research and Quality has found that patients ages 30 to 74 who took atypical antipsychotic agents such as risperidone (Risperdal®), quetiapine (Seroquel®), olanzapine (Zyprexa®), and clozapine (Clozaril®) had a rate of sudden cardiac death twice that of people who did not take these medications and similar to the death rate for patients taking typical antipsychotic agents, including haloperidol (Haldol®) and thioridazine (Mellaril®).

The study, published in the New England Journal of Medicine, examined medical records from the Tennessee Medicaid program and identified data on patients prescribed atypical antipsychotic drugs, including the number of prescriptions they received, the dosage, and the number of days supplied. The researchers concluded that atypical antipsychotic drugs, which are frequently prescribed off label for symptoms such as agitation, anxiety, psychotic episodes, and obsessive behaviors, are not a safer alternative to typical antipsychotic drugs in preventing death from sudden cardiac causes. In this study, the risk of death increased with higher dosages of the drugs taken.

Source.“Use of Atypical Antipsychotic Drugs Increases Risk of Sudden Cardiac Death in Adults.” (2009, January 14). Retrieved January 26, 2009, from http://www.ahrq.gov/news/press/pr2009/antipsychpr.htm.

Inflammation Findings Pique Interest in New Class of Alzheimer’s Drugs

A newly discovered link between inflammation and Alzheimer’s disease may be the key to the development of novel therapeutics for this disease. Research at the Roskamp Institute in Florida focused on inflammation—long been known to accompany Alzheimer’s disease—and abnormal deposits of the protein amyloid, which accumulate in the brain of those with Alzheimer’s disease and also trigger an inflammatory response. This inflammatory response is thought to be detrimental to nerve cells, eventually causing their destruction.

The Roskamp research revealed that inflammation can lead to the production of more amyloid, and the researchers found that a specific receptor on the nerve cell surface, known as CXCR2, is an interface between inflammation and new amyloid production. As specific inflammatory molecules contact CXCR2, a signal is generated, which results in increased amyloid production. The presence of the abnormally occurring amyloid, therefore, contributes to its own reproduction through the inflammatory response it triggers.

By genetically “knocking out” CXCR2, the researchers were able to reduce the amount of amyloid in various laboratory models. In addition, by using drugs that specifically block the CXCR2 receptor, the researchers showed that a decrease in amyloid production is possible and could open a new door for therapeutic interventions.

Source.“Roskamp Institute Identifies New Class of Drugs to Treat Alzheimer’s Disease.” (2008, December 16). Retrieved December 31, 2008, from http://www.medicalnewstoday.com/articles/133283.php.

Qualifications of Nursing Home Social Workers Vary State to State

A University of Iowa survey of 1,071 nursing home social service directors and an examination of state legislation show that qualifications of nursing home social workers vary significantly in part because of low federal standards and inconsistent state laws. Despite the important responsibilities nursing home social workers have, 10 states do not address qualifications for such employees, and seven state codes do not appear to comply with federal standards. Twenty-one states require a social work degree; most others require a 4-year degree, but not in social work. In fact, the study found that only half of nursing home social workers have a degree in social work, and 20% do not have a 4-year degree. In addition, two thirds of nursing home social workers reported they do not belong to a related professional organization, and only 38% are licensed in social work. For-profit nursing homes were found to be 31% less likely to hire a degreed social worker.

Other inconsistencies were found related to:

  • Qualifications. Homes with more than 120 beds are required by federal law to employ a full-time social worker, but anyone with a bachelor’s degree in any human service field—not necessarily social work—and 1 year of supervised experience in the field is considered qualified.
  • Loopholes in state laws. In Colorado, for-profit nursing homes in rural areas do not have to hire a qualified social worker if they advertise for a week in a local paper without success. In Indiana, social services can be provided by a member of the clergy who completes a 48-hour course and consults with a social worker.
  • Salaries. Full-time salaries in some regions are as low as $15,000 per year, while others exceed $60,000.

The results of the national survey will be published in the Journal of the American Medical Directors Association.

Source.“Study Shows Need for Standardizing Nursing Home Social Workers’ Credentials.” (2009, January 5). Retrieved January 26, 2009, from http://www.medicalnewstoday.com/articles/134421.php.

Hospice Benefits Acknowledged in Statement

Acknowledging that patient demographics, treatment protocols, and public attitudes about health care have changed since the 1982 inception of the Medicare Hospice Benefit, the National Hospice and Palliative Care Organization, along with several national leadership organizations, have issued a consensus statement regarding principles of hospice care and protection of the benefit. One of the top issues is payment policy, acknowledging that payment reforms should be incremental, based on adequate data analysis, and undertaken carefully.

Other recommendations in the consensus statement include:

  • Congress should change the current Medicare payment system for hospice to reduce payments per day as the length of the episode increases. The revised payment system should include a payment adjustment to reflect hospices’ higher costs associated with patient death at the end of the episode.
  • The Secretary of the U.S. Department of Health and Human Services should direct the Office of the Inspector General to investigate the prevalence of financial relationships between hospices and nursing facilities that may represent a conflict of interest and influence admissions to hospice, differences in patterns of nursing home referrals to hospice, and the appropriateness of hospice marketing materials.
  • As a condition of payment, the Secretary should require that hospices report information on all visits provided to the hospice patient on hospice claims, including length of visit.
  • The Secretary should change cost reports to reflect new data on hospice claims, add new data fields to capture the full range of hospice revenues to provide a more accurate picture of hospices’ financial performance, and increase the accuracy of cost report data through audits or other processes so that these data can be used in setting, adjusting, or rebasing payments, as warranted.

The complete consensus statement is available at http://www.nhpco.org/i4a/pages/Index.cfm?pageID=5803.

Source.“National End-of-Life Organizations Release Consensus Statement on Hospice, the Medicare Hospice Benefit, and Key Issues for the Future.” (2009, January 8). Retrieved January 26, 2009, from http://www.medicalnewstoday.com/articles/134838.php.

Auto Workers Shift Gears, Merge into Nursing

If the body is indeed a machine, then students in the Henry Ford Health System’s nursing recruitment program will have no problem working in their new industry. In partnership with Oakland University, Henry Ford developed the program to help displaced auto workers seeking a career change, as well as to address the national nursing shortage.

© Henry Ford Health System

© Henry Ford Health System

Oakland University offered places for up to 100 displaced auto workers to qualify for a pre-nursing program. Those who completed the prerequisites and who met the grade requirements then started the first nursing class in September 2008 at Henry Ford. Fifty-one students are currently enrolled in the program.

Students move through the year-round program as a group and are scheduled to graduate in August 2010 with a bachelor’s degree in nursing. After completing the RN licensure examination, they could have a job waiting for them at Henry Ford.

Henry Ford is donating classroom, laboratory, and clinical space and is paying the cost of clinical instructors for two clinical courses.

Source.“Goodbye Assembly Line, Hello Nursing.” (2009, January 9). Retrieved January 27, 2009, from http://www.henryford.com/body.cfm?id=46335&action=detail&ref=914.

10.3928/00989134-20090301-07

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