American Association for Respiratory Care's

Spring 2004

Editor
George Gaebler, MS Ed, RRT, FAARC
Dept. of Respiratory Care, Rm. 516
University Hospital
750 E. Adams St.
Syracuse, NY 13210
(315) 464-4490
FAX (315) 464-4497
gaeblerg@upstate.edu

Chair
Melinda Gaylor-Childress, MEd, RRT
Director Training and Accreditation
Advanced Lifeline Services Inc

10503 Timberwood Circle, Suite 215
Louisville, KY
502-426-1958, ext. 122, 502-426-2337 (fax)
melinda.g@alsvents.com

 

In This Issue...

Notes from the Chair Melinda Gaylor-Childress, MEd, RRT
Web Page Ideas Melinda Gaylor-Childress, MEd, RRT
Update Your E-mail Address Online Melinda Gaylor-Childress, MEd, RRT
Authors Needed! Melinda Gaylor-Childress MEd, RRT
Open Door Forum: Skilled Nursing Facilities/Long-Term Care
Using a Dry Port for Your Foam Cuff Trachs Tom Castle
Depression in the Elderly
Long Term Care Section Members
Section Connection
 
 
 
 

AARC Education Section Bulletin

Notes from the Chair

by Melinda Gaylor-Childress, MEd, RRT

The Long Term Care Section has enjoyed an exciting beginning to 2004. Our new memberships are consistently climbing and we are retaining our existing members as well. We have also seen some significant changes to our section. We have a new name, for starters, and an updated section web site on AARC Online, which debuted on March 1. It is imperative that you visit our LTC site and sign up for the section e-mail list. It's the best, fastest way for all of us to communicate and stay in touch.

If you have not yet provided the AARC with your e-mail address, please do, so that you can receive a quarterly e-mail alert for each new issue of the Bulletin on the web site. In addition, your suggestions for additional links and submissions of shared policies/forms will be greatly appreciated as we continue to update and improve the content on the site. In short, everyone's participation is needed to make our section a success.

Over the past few months, we have also been working to develop a recognition program for long-term care respiratory programs similar to the AARC's Quality Respiratory Care Recognition (QRCR) program for acute care hospitals. I hope to see this program fully implemented in 2005. I would like to thank each of you that contributed to the discussions that took place on the section e-mail list. And special thanks to Terry Volsko and Gene Gantt, who reviewed every draft.

On another note, the MDS 3.0 (proposed April 3, 2003) is now in the testing phase. The timeline for completion is pending. Additional information on skilled nursing homes is available from Medicare.

I hope you find this Bulletin informative. As always, George Gaebler, our Bulletin editor, and I welcome any articles that highlight respiratory care in LTC. Your feedback is also appreciated. If you would like to see particular issues covered in future Bulletins please e-mail Melinda Gaylor-Childress.

[Top]


AARC Education Section Bulletin

Web Page Ideas

by Melinda Gaylor Childress MEd, RRT

As you may already know, the LTC web site on AARC Online has been completely revamped. A big part of the effort was focused on updating the site to include resources on policies, procedures, professional contacts, regulations, links and reimbursement information. If you know of a resource that could benefit your colleagues in the section, please e-mail your suggestion to Melinda Gaylor-Childress. I would particularly like to request sample policies that can be shared in a PDF format, such as:

  • Trach Care Policies
  • Pressure Alarm Setting Policies
  • Supply Change Out Frequency
  • Trach Tube Change Out Policies

I also would like to create a LTC Resource Directory with the names and contact information for section members who would be willing to serve as expert resources in various areas of long-term care for fellow members. If you are willing to act as a resource person who will answer questions from other members about policies, equipment, procedures, etc., please complete this form (LINK TO FORM, which is in the file labeled “LTCSpring04FORM.doc”) and e-mail it to Melinda Gaylor-Childress. This information will be posted as a link on the section web site. We appreciate your participation!

[Top]


AARC Education Section Bulletin

Update Your E-mail Address Online

by Melinda Gaylor-Childress, MEd, RRT

With more and more information being shared via e-mail, it's never been more important for you to have a valid e-mail address on file with the AARC. Please update your information on the AARC web site.

We also encourage all members to subscribe to the section e-mail list. Then you can send e-mails to the entire group by using the list's e-mail address.

Updating your e-mail information with the AARC and the section is the only way to ensure that you are getting the full benefits of both AARC and section membership. As of Jan. 15, 2004, the LTC Section had 337 total members, but only 228 (67%) had e-mail addresses on file.

[Top]


AARC Education Section Bulletin

Authors Needed!

by Melinda Gaylor-Childress MEd, RRT

More members must step up and volunteer to provide Bulletin articles for this Bulletin to be most beneficial to members. There is no better way to share information and experiences with our peers. To that end, I would like to request articles on various topics of interest in long-term care. Here's a suggestion to help you get started: write a patient success story highlighting care delivered in your facility.

The best way to report patient success stories is to do a regular “case study” in which you identify the patient by initial rather than name (such as “Mr. G” or Mrs. S”). Tell us why the patient came to your facility, the treatment the patient received, how the disease progressed, and most specifically, how respiratory therapists were involved in this patient's care. We can also run patient photos, but only with a written release on file before publication. If the patient agrees to provide a photograph, simply prepare a document for signature by the patient or parent, in the case of a child, with the following statement: I hereby give permission for my photo (my child's photo) to be published in the Long Term Care Bulletin published by the American Association for Respiratory Care. Then have them list their name and address under the statement.

You can mail or e-mail your photos to me (high resolution images only, please), along with the release statement. (See top of this issue for my mailing address.) If you'd like the picture returned, please include a statement to that effect. Otherwise, just e-mail your articles to Melinda Gaylor-Childress. The copy deadlines for upcoming Bulletins appear in the Section Connection area at the end of this issue.

Sharing your success stories through the Bulletin is a great way to highlight your facility and the wonderful work you are doing to care for patients in the long-term care setting!

[Top]


AARC Education Section Bulletin

Open Door Forum: Skilled Nursing Facilities/Long-Term Care

Did you know the AARC represents our interests in long-term care to the Centers for Medicare and Medicaid Services (CMS) on a regular basis? They do — every time CMS holds an Open Door Forum for Skilled Nursing/Long-Term Care. These regular meetings provide organizations like the AARC opportunities to gain direct access to leaders in CMS. The Association sends a representative to listen to the presentations and ask questions pertinent to our area of care. The AARC also welcomes questions from Association members, so if you have a question you'd like to pose to CMS, e-mail it to Section Chair Melinda Gaylor-Childress. She'll send it on to the appropriate representative, and then get back to you with the response.

[Top]


AARC Education Section Bulletin

Using a Dry Port for Your Foam Cuff Trachs

by Tom Castle, Director of Respiratory Care, Washington Terrace Health Services, Ogden, UT

Inevitably, when using the pressure adaptor supplied with a foam cuff trach, moisture invades the cuff. Even when there is an HME in place, the moisture finds its way in. Those of you who have worked with foam cuffs before know that the manufacturer recommends aspiration of the cuff to prevent breakdown of the foam and cuff that could lead to foam aspiration. Deflating the cuff is an aspiration risk in itself.

Aspirating the cuff every eight hours can become quite tedious. Some institutions prefer to require aspiration every 12 hours. As this task is not always a high priority with all therapists, it might occasionally be missed. In that case, the build up of moisture and secretions in the foam can cause it to become stiff, and the seal may end up compromised, thus leading to a need to prematurely change the trach tube.

Most of the time, this is not a problem in the ICUs and acute care areas. The patient population usually does not need a tracheostomy tube in place for extended periods. The problem is more frequent, however, when the patient ends up in long-term care. And that's also when the possibility of extra tube changes can affect the cost per patient day.

To avoid many of the consequences that arise from using a “wet” pressure port, try a dry gas port kit. This equilibrates the pressure in the foam cuff with the ventilator pressure, using pre-humidified gas. The foam maintains its resilience longer and there is less risk of foam breakdown. Following that line of thinking, it seems that there would be less need for cuff aspiration. The adapter fits into the inspiratory limb of the vent circuit between the outlet port of the ventilator and the humidifying device. Then a pressure line is run along the circuit to the port for the cuff. There are kits available from the manufacturer, but the parts can be found in most respiratory care supply catalogs.

[Top]


AARC Education Section Bulletin

Depression in the Elderly

As respiratory therapists, our patients' physical health is our chief concern. But physical health is often impacted by mental health, and according to the American Mental Health Association, elderly people are at particular risk. Consider the following statistics on depression in older Americans:

  • More than 58% of older Americans think depression is a normal part of aging.
  • Some six million Americans, mostly women, are affected by late-life depression. Only 10%, however, ever receive treatment.
  • Chronic illnesses like diabetes, stroke, heart disease, cancer, Alzheimer's disease, Parkinson's disease, arthritis, and, yes, chronic lung disease, can trigger depression in the elderly.
  • The suicide rate among older adults is 50% higher than that of the general population. As many as two-thirds of these suicides are attributed to undiagnosed or untreated depression.

What can we do to help our elderly patients cope with depression? One of the best ways is to get them involved in fun activities like exercise sessions, social gatherings or instructional classes. These activities help patients to get moving and to interact with others, which helps protect against the feelings that lead to depression. So, consider how you can get involved in promoting these activities in your facility. By promoting better mental health for your patients, you'll be helping to improve their physical health as well.

[Top]


AARC Education Section Bulletin

Long Term Care Section Members

The following members either joined or renewed their membership in the section between January 1 and March 18. (A big “thumbs up” to the state of Washington!)

ALASKA

  • Joy A Adams
CALIFORNIA
  • Margaret Gasperino, RRT
  • Rebecca Anne Mabry
FLORIDA
  • Nancy Ann Courtney
  • Carlene Newman
  • David J. Rappa
  • Abigail S Robinson
IDAHO
  • Kevin Davis, RRT
ILLINOIS
  • Toni Marie Frey, RRT
INDIANA
  • Cynthia Miller
  • Maurice D. Miller
KANSAS
  • Karen Staudenmier
KENTUCKY
  • Melinda Jean Gaylor Childress
LOUISIANA
  • Maria M Wooldridge, RRT
MASSACHUSETTS
  • Charles M. Peterson
  • Wayne T. Stone
MAINE
  • Charles W. Kettell
MINNESOTA
  • Marcia Lynn Jaeger
NORTH CAROLINA
  • Nettie Patricia Cuervo
  • Thomas V. Frye
  • Merry Mounce, RRT, CRT, CPFT
NEBRASKA
  • Marcia J. Wyrens
NEW JERSEY
  • Estela Dimagiba, CRT
  • Mary Christine Loring
  • J. Brian Lynch
  • Rajeshri Rana
NEW YORK
  • Alicia B. Aldridge
  • Steven Daves
  • Elizabeth Pisano
  • Abdul Aziz Rashad
  • Meghan Sharp, RRT
  • James Williams
  • Julia Wright Sile
OHIO
  • Richard Almasy
  • Michael David Brockhoff
  • Robert L. Chatburn
  • Meritta Eby
  • Renee Lawson
OREGON
  • Douglas Lowther, RRT, CPFT
  • Carol Lee Raynor
  • Kimberly Kaye Tiba
PENNSYLVANIA
  • Erick H. Cooper
  • Hope Smolin
SOUTH CAROLINA
  • Lisa J. Runciman
TEXAS
  • John S. Sabo
UTAH
  • David Clooten, CRT
  • Jullie McBratney, RRT
WASHINGTON
  • Frank Acosta, CRT
  • Andrew J. Alder
  • Tamara Cohen, RRT, CRT
  • James Darville, RRT
  • Shelley Beth Dove, RRT
  • Vernon Earhart, CRT
  • Lisa Fincher, RRT
  • Ilja Holubec, CRT
  • Solange Johnson, CRT
  • Dean Kerr, CRT
  • Terryl E. Lee, CRT
  • Conchita Lim, RRT
  • Karen Lindgren, CRT
  • Gary Lynch, RRT
  • Monita L. Mattes, RRT
  • T. Kyle McDowell
  • Carla Mitchell
  • Carrie Moore, CRT
  • Benjamin Muzzey, RRT
  • Gary Nichols
  • Christie Nolan, RRT
  • Zaideh Onjang, CRT
  • Rick Painter, CRT
  • Lyudmila Petrovskaya
  • Joyce Randrup, RRT
  • Joanne Reed, CRT
  • Donald Robley
  • David Rose
  • Christine Savage
  • Anna Shtelen, CRNA
  • Thomas Suarez, CRT
  • Glen Vaughn, CRT
  • Paulette Wold, CRT
  • George Zayko, CRT
WISCONSIN
  • Janet E. Anderson
  • James P. Lewis
FOREIGN
  • Martina Boegel
  • Franco Pallini

[Top]


AARC Education Bulletin

Section Connection

Specialty Practitioner of the Year: Submit your 2004 nominations online.

Recruit a new member: Know an AARC member who could benefit from section membership? Direct them to section sign up. It's the easiest way to add section membership to their overall membership package.

Section e-mail list: Start networking with your colleagues via the section e-mail list.

Bulletin Deadlines: Winter Issue: December 10; Spring Issue: March 10; Summer Issue: June 10; Fall Issue: September 10.

[Top]