Tag Archives: protection

AT HOME WITH MOM

 

Mom always had a huge garden on the farm. She grew potatoes, tomatoes, lettuce, peas, onions, green beans, sweet corn, pickles, cucumbers, strawberries, gooseberries, raspberries, and blackberries. There was a bed of asparagus along the fence, and rhubarb plants in another area. A peach tree and an apricot tree grew along the path to the chicken house. We used to say that if we couldn’t grow it, we didn’t eat it.

When Dad retired from farming in 1968, he and Mom moved to a house in Decatur. The house was on a quiet street, not far from a small shopping center. The property backed up to the baseball fields of a high school. The backyard was perfect for a garden. Dad trucked in a load of good, black dirt.

Mom and Dad lived in that house for many years. Then Mom’s mind began to fail. It was as if a computer in her brain had a short in it. Once she tried defrosting a frozen chicken by putting it in the bedroom closet instead of in the refrigerator. She was storing the object in an inappropriate place, an early sign of Alzheimer’s disease.

Another time, Dad had driven Mom to the beauty shop just a few blocks away. He told her to call him when she was finished at the beauty shop, and he would pick her up. He was sitting in his big Lazy Boy chair next to the front window when he saw Mom walking past on the sidewalk. By the time he got up to go outside to get her, she had disappeared. Vanished. Dad called the police, and they came to help search for Mom. They found her around the corner about half a block. She was sitting in a Burger King! Getting lost in familiar places is another early sign of Alzheimer’s disease.

Sometimes when they left the house to visit relatives, she would become frantic at dusk. She thought they needed to get home to put the screen in the door of the chicken house so the foxes would not eat the chickens. That was the routine we had when we lived on the farm, but that was years ago. This was another sign of Alzheimer’s disease.

Mom could still dress herself. She could still cook. Since Dad was in good health and living in the house with her, Mom was able to continue living in their house. Without Dad, she would have needed in-home care or an assisted living facility. She died suddenly at age eighty-one.

If you have a family member who needs in-home services, call American Home Health at (630) 236-3501. The agency can provide round-the clock nursing care by Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Certified Nursing Assistants (CNAs). Our service area covers fifteen counties in Northern Illinois including Cook, Lake, McHenry, Boone, Winnebago, Ogle, Lee, DeKalb, DuPage, Kane, Kendall, LaSalle, Grundy, Will, and Kankakee. American Home Health is licensed by the State of Illinois and accredited by the Joint Commission.

For further information, go to www.ahhc-1.com, or call (630) 236-3501.

—By Karen Centowski

CARJACKINGS SKYROCKET IN CHICAGO

If you live in Chicago or the collar counties, you are probably accustomed to the huge number of shootings or homicides that occur in the city. Now another crime, carjacking, has surged to its highest numbers in at least ten years, according to a Chicago Tribune article printed December 29, 2017.

Although the vast number of shootings and homicides tended to be concentrated on the South and West sides, carjacking occurred throughout the city, often in trendy neighborhoods and downtown. Among the 967 victims of carjacking in Chicago in 2017 were ordinary citizens, an off-duty police officer, and a Lyft driver.

What is carjacking? Merriam-Webster defines it as “the theft of an automobile from its driver by force or intimidation.” The word “carjacking” is actually a combination of car + hijack + ing. According to Merriam-Webster, the word was first used in 1991.

Thieves often use force, threatening the drivers with a gun or knife, to rob their victims of their money and their vehicles. Sometimes the thieves then use the vehicles in drive-by shootings, smash-and-grab burglaries, and other crimes. Sometimes they might just go for a joy ride in the car and abandon it on a city street.

What methods do criminals use to steal the cars? One method is called “bump-and-run.” The criminals intentionally drive their car into the rear of the victim’s car. When the driver gets out of his car to survey the damage and exchange insurance information, the criminals threaten the victim with a weapon, jump into the car, and drive away.

Darren Reboletti, a Lyft driver, was dropping off his Lyft passenger around 1:30 A.M. on December 20, 2017 on the South Side of Chicago when he felt another car bump into his brand-new Jeep Cherokee from behind. When he got out to check the damage, someone from the other car jumped into his Jeep. Reboletti tried to pull the thief out of the Jeep, but the thief kicked him, swore at him, and threatened to kill him. Reboletti backed off, and the thief drove away in his 2017 Jeep. The second vehicle, a blue Ford Exposition, also fled.

Another method is distraction. The criminals place a $20.00 bill under the windshield wiper of a parked car. When the driver gets out to retrieve the $20.00 bill, the thieves jump into the car and drive away.

A third method is armed robbery. On December 18, 2017, an off-duty Chicago police officer was sitting in his personal car two blocks from police department headquarters on the South Side. Two men approached the officer’s car. One man tapped on the passenger’s side window to distract the officer. The other man, Carlos Hendricks, age 18, went to the driver’s side, pulled a gun, and demanded the car. According to the Chicago Tribune article “Police: Charges filed against man shot while carjacking off-duty Chicago cop near headquarters,” the officer fired one shot and hit Hendricks in the abdomen. Hendricks was taken to Northwestern Memorial Hospital. The other suspect ran away and remained at large as of December 19. A gun belonging to Hendricks was recovered from the scene.

—By Karen Centowski

HOW TO PREVENT DRIVING-RELATED INJURIES

One of the hazards of providing home healthcare is the daily challenge of driving to and from the client’s home. In Winter, the streets may be snow-packed or icy. In Spring, roads may be flooded. Even under ideal conditions, driving can be challenging.

OSHA, the Occupational Safety and Health Administration, has published an overview of hazards in home healthcare at https://www.osha.gov. The article states that home healthcare workers “have little control over their work environment which may contain a number of safety hazards. These hazards include bloodborne pathogens and biological hazards, latex sensitivity, ergonomic hazards from patient lifting, violence, hostile animals and unhygienic and dangerous conditions. In addition, if their daily work schedule requires them to provide care for multiple patients, they face hazards on the road as they drive from home to home.”

The National Institute for Occupational Safety and Health has published six Fact Sheets to assist in reducing home healthcare workers’ risk for injury and illness. Publication Number 2012-122 focuses on preventing or reducing driving related injuries. The Fact Sheet addresses behaviors and conditions which contribute to car accidents. These include distracted driving, aggressive driving, failure to use a seatbelt, driving while tired or under the influence of drugs or alcohol, poor weather conditions, and poorly maintained vehicles.

What can you do to protect yourself? The OSHA Fact Sheet lists the following things employees should do to prevent driving-related injuries:

  • Use seatbelts.
  • Stop the vehicle before using a cell phone.
  • Avoid distracting activities such as eating, drinking, and adjusting radio and other controls while driving.
  • Avoid driving when over-tired.
  • Use detailed maps to determine your route before you leave, or use a GPS.
  • Have the vehicle checked and serviced regularly.
  • Keep the gas tank at least a quarter full.
  • Carry an emergency kit containing a flashlight, extra batteries, flares, a blanket, and bottled water.

—By Karen Centowski


To see a video about distracted driving, go to Distracted Driving Presentation at https://www.youtube.com/watch?v=zfknB9CZiA8.

WHAT’S THE WORST TELEPHONE SCAM?

Lady On the Phone

You are sitting at the kitchen table having a cup of coffee when the telephone rings. Almost by instinct, you answer it. The chances are high that it is not someone you know. More likely, this is some sort of telephone scam.

Telephone scams occur year around. Some originate from within the United States. Other calls are made from foreign countries. The callers are using computer generated lists of phone numbers to contact potential victims. They don’t know you or care about you. Their motive is to separate you from your money or personal information such as your credit card number or Social Security number.

In recent years, scammers have utilized phone calls to unsuspecting individuals to try to get access to personal computers. Their goal is to take over your computer so they can make changes to your settings that could leave your computer vulnerable. They may ask for your credit card number so they can bill you for phony services or things you could get elsewhere for free. They may try to trick you into installing malware that could steal sensitive data such as user names and passwords. These scams are described in detail in another article on this blog called “COMPUTER TECH SUPPORT SCAMS.”

Perhaps you have received a call from a man who tells you that your son has been arrested in Rockford and needs bail money. He wants you to send $500 to Rockford by Western Union. However, your son is sitting in your house watching television. Another scam!

There’s a scam called the Grandparent Scam. A con artist, pretending to be a grandchild of the victim, calls the grandparent. The “grandchild” says he desperately needs money or he’ll be evicted. He asks the grandparent to wire transfer money.

Have you ever received a phone call from someone who tells you that you have won one of five valuable prizes? The caller will put the shipping and handling charges on your credit card. All you have to do is give the caller your credit card number. Another phone scam! Never give your credit card number to a stranger who calls you.

Perhaps you have received a call offering you a “free” or “low cost” vacation. These “free” vacations may have hidden costs or may never take place, even after you have paid.

Be careful about calls for charitable causes such as urgent disaster relief. This is a common scam. If you want to donate, call a recognized organization such as the Red Cross.

Many times you will answer the phone and hear a recorded message instead of a live person. This is a robocall. Recorded messages that are trying to sell you something are illegal unless you have given the company permission to call you. Hang up! If you respond by pressing any number, you may get even more robocalls.

So, what’s the worst telephone scam? You decide. Avoid these and other phone scams by registering your home and cell phone numbers with the Do Not Call Registry online or by calling 1-888-382-1222.

—By Karen Centowski

Documentation Made Easy

Charting

The Basics

Right Chart: Check that you have the correct chart before writing.

Penmanship: All your documentation is to be legible so anyone can read it. If you have poor penmanship, begin to print. Your printing will make it easier to read your notes. Now that your nursing notes are legible, let’s talk about the basics. Use permanent black ink pen. Other colors do not copy well.

Date and Time: Date and time every entry. The date should include the year; the time should indicate am or pm or be in military time. Don’t chart in blocks of time such as 0700 to 1500. This makes it hard to determine when specific events occurred.

Client’s history (including unhealthy conditions or risky heath habits such as scalp lice, smoking, failure to take prescribed medication, specific non-compliance issues and events, etc.) A client’s history is usually reflective of trends and may offer valuable hints about what to expect in the future.

Subjective Information: It is important that you chart any subjective information. Document what you hear, what the client says, what the caregivers say, comments to you about how they feel, feelings of anxiety or depression, etc. Use direct quotes and place quotation marks around the quote. Chart a client’s refusal to allow a treatment or take a medication. Be sure to report this to your immediate supervisor and the client’s physician and document your calls.

Objective Information: Chart your observations, what do you see, vital signs, hard data such as any and all assessment information. It is especially important to document changes in health status such as the emergence of a productive cough, difficulty in breathing or changes in vital signs from their baseline. Did you address: mental status, functional status, mobility, cognitive ability, speech? Oftentimes when you are in the home every day you forget that the people reading your notes do not know the client so you need to show them on paper.

Interventions: Document any actions that you did in response to any of your observations and the client’s response to your actions. These responses to your interventions are commonly called client outcomes. Chart the time you gave a medication, the route you gave it and the client’s response. If a medication is a PRN, chart the reason it was given and the client’s response to the medication (did it give the desired effect). Chart precautions, preventive measures used as well as any safety measures enacted, such as bed rails.

Client outcomes: Chart the client’s response to your interventions, including those that are deviations from what you expected. For example: if a client is in pain, observe and document how that pain is experienced both objectively (what you see) and subjectively (what you hear). Record where the pain is and the level of intensity or severity (use a pain scale to do that). Record the medication and the backrub you give to relieve the pain and whether or not those actions were effective, i.e., did the pain persist, recur, or go away?

Document the client, family member or significant other’s actual response (verbal or non-verbal) to any aspect of care provided even if you were not the one providing it. Doing so indicates that you have evaluated the results of care. It is perfectly acceptable to chart the client’s verbal responses in the record as long as you use quotation (“) marks. Non-verbal responses should be described in as much detail as possible.

Make sure your documentation reflects the nursing process and your professional capabilities. Chart completely, concisely and accurately (“Tell it like it is.”). Write clear sentences that get right to the point. Use simple, precise words. Don’t be afraid to use the word “I.”

Be sure to record your full name, credentials and job title in the required section on documentation forms. Some forms will ask you to record your initials as well. Your signature must be in cursive writing so a word of final caution: do take the time to sign your name legibly.

Beyond The Basics

Client Education and Instruction: Other information that needs to be recorded in the medical record includes any education or instructions you give to the client, his family or significant other. Anytime there is a new medication or treatment the client, family member and other personnel must be educated and informed. Documentation of these actions is required. Include the fact that you informed the client/caregiver of the new order; chart the education of dosage, actions, side effects and schedule; chart that you made changes on the medication administration record or task sheets (if applicable); chart how you were able to communicate the new orders to other nursing personnel responsible for the client’s care, document your communications regarding the new orders to the office.

Check Off Sheets: In some instances a preprinted, standardized check off form may be used where all you have to do is check off or initial what you have done. The only time you may have to write any notes is when something is specific or unique to this particular client, something that can’t be included on a standardized check off form. Remember: if you do not check off items, it means that legally the care was not done.

Phone Calls: We don’t often think about phone calls, but they can contain certain information for which we have obligations such as advice that we may give to a client or a phone order that we may take from a doctor. To protect yourself in these kinds of phone conversations, a detailed summary of your conversations is charted in the client record.

Details of each call should include:

  1.  Date and time of the call
  2. Caller’s name, position or credentials, call back phone number and address
  3. Reason for the call, request, complaint
  4. Your response to the call, advice you gave, protocol you followed (if applicable)
  5. Others that you notified as a result of the call
  6. Your name and credentials
  7. If taking doctor’s orders, transcription of the orders word for word and documentation that you read the orders back for verification.

More Do’s to Make Charting Successful

  • Chart as soon as possible after giving care; don’t wait to chart until the end of your work day. Chart often enough to tell the whole story.
  • If you remember an important point after you’ve completed your documentation, chart the information with a notation that it’s a “late entry.” Include the date and time of the late entry.
  • Chart all of the details relating to visits by physicians or other members of the health care team such as the teacher, therapist, case worker, dietician, social worker, etc. Describe the purpose of the visit, the name of the visitor, the time spent with the client and the outcome of the visit.
  • If you don’t give a medication, circle the time and document the reason for the omission.
  • If information on a form such as a flow sheet doesn’t apply to your client, write NA (not applicable) in the space provided.
  • Use only commonly used or approved abbreviations and symbols. Refer to the procedure manual for a list of approved abbreviations. When in doubt spell out the words. Remember many medications have similar names but very different actions.
  • When documentation continues from one page to the next, sign the bottom of the first page. At the top of the next page, write the date, time and “continued from previous page.” Make sure each page contains the client’s identifying information, date and year.
  • Re-read your documentation. You need to paint a picture of the client. Pretend you know nothing about the client. Then read your notes and see if your notes are capable of making you see the client as he/she really is.

-By Janet Fulfs, President

Note: First published on American Home Health's news, October 2011.

The Single Most Important Reason to Practice Good Hand Hygiene

Hand Hygiene

What is the single most important reason for healthcare workers to practice good hand hygiene?

  1. To remove visible soiling from hands
  2. To prevent transfer of bacteria from the home to the hospital
  3. To prevent transfer of bacteria from the hospital to the home.
  4. To prevent infections that patients acquire in a health care setting.

While all answers are good reasons to practice good hand hygiene. Improved adherence to hand hygiene has been shown to terminate outbreaks in facilities, reduce the transmission of antimicrobial resistant organisms and reduce the overall infection rate.

 

Drugs Influencing the Respiratory System

Medications and Respiratory System

  1. Corticosteroids

    These drugs produce an anti-inflammatory effect. Used to reduce mucous secretions, swelling and inflammation. Used in conjunction with bronchodilators to open airways in conditions such as asthma and COPD.

    Examples: Flovent, Solumedrol, Azmacort, Decadron

    Side Effects: Masks infections, hyperglycemia, slow wound healing.

  2. Beta Agonists

    These are drugs having an affinity for the Beta 2 receptors sites. These sites are found primarily in bronchial and vascular smooth muscles producing bronchial relaxation and arterial dilation to skeletal muscles.

    Used to relieve bronchoconstriction, for short term treatment of acute exacerbations, and long term treatment to control symptoms. Used for nocturnal symptoms.

    Examples: Alupent, Serevent, Proventil

    Side Effects: Tachycardia, headache, angina, muscle tremors