Nicholasville Nursing and Rehabilitation is so excited to share resident Henry Marcum’s Success Story!

Mr. Marcum came to Nicholasville Nursing and Rehabilitation after sustaining a broken knee and required occupational and physical therapy to rehabilitate. He was unable to get out of bed by himself due to weakness. He was also restricted to avoiding weight bearing on his effected leg, so this really limited what he could do. He progressed from non-weight bearing to partial weight bearing, and then finally weight bearing as tolerated! He is now using a walker for standing and walking in the therapy gym. This has been a long road for Mr. Marcum, but he has worked VERY hard and is now getting ready to discharge to his apartment. Way to go, Henry! Congratulations to you and your Care Team on your success!

Residential communities for older adults may combine nursing, assisted living, and independent living lifestyles. Each community may face different risks and decide to put in place less restrictive or more restrictive protocols.

To help protect friends and family members who live in these communities, get vaccinated. CDC has also issued updated recommendations for visitations at post-acute facilities. These recommendations align with the Centers for Medicare and Medicaid Services (CMS)external iconexternal icon guidance for visitations under various circumstances.

Learn more about the risks among people who live in nursing homes or long-term care facilities and about CDC’s guidance for preventing the spread COVID-19 infection in nursing homes.

There is no way to ensure you have zero risk of getting the virus that causes COVID-19.  So, it is important to understand the risks and know how to reduce your risk as much as possible if or when you do resume some activities, run errands, and attend events and gatherings.

While it is generally safest to implement universal use of source control for everyone in a healthcare setting, the following allowances could be considered for individuals who are up to date with all recommended COVID-19 vaccine doses (who do not otherwise meet the criteria described above) in healthcare facilities located in counties with low to moderate community transmission. These individuals might choose to continue using source control if they or someone in their household is immunocompromised or at increased risk for severe disease, or if someone in their household is not up to date with all recommended COVID-19 vaccine doses.

• HCP who are up to date with all recommended COVID-19 vaccine doses:
  • Could choose not to wear source control or physically distance when they are in well-defined areas that are restricted from patient access (e.g., staff meeting rooms, kitchen).
    • They should wear source control when they are in areas of the healthcare facility where they could encounter patients (e.g., hospital cafeteria, common halls/corridors).
• Patient Visitation:
  • Indoor visitation (in single-person rooms; in multi-person rooms, when roommates are not present; or in designated visitation areas when others are not present): The safest practice is for patients and visitors to wear source control and physically distance, particularly if either of them are at risk for severe disease or are unvaccinated.
    • If the patient and all their visitor(s) are up to date with all recommended COVID-19 vaccine doses, they can choose not to wear source control and to have physical contact.
    • Visitors should wear source control when around other residents or HCP, regardless of vaccination status.
  • Outdoor Visitation: Patients and their visitors should follow the source control and physical distancing recommendations for outdoor settings described on the page addressing Your Guide to Masks.
• Residents who are up to date with all recommended COVID-19 vaccine doses in Nursing Homes in Areas of Low to Moderate Transmission:
  • Nursing homes are healthcare settings, but they also serve as a home for long-stay residents and quality of life should be balanced with risks for transmission. In light of this, consideration could be given to allowing residents who are up to date with all recommended COVID-19 vaccine doses to not use source control when in communal areas of the facility; however, residents at increased risk for severe disease should still consider continuing to practice physical distancing and use of source control

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html.

“I entered skilled nursing as a Certified Nursing Assistant (CNA). During this role, I developed love and compassion for the elderly. It gave me an opportunity to learn who each of these people were, hear their stories, and listen to the words of wisdom they often imparted to me. They encouraged me to continue to grow and make a difference in long-term care. As I continued in my healthcare journey, there were various leaders who believed in me and continued to provide opportunities and experiences. I continued to grow from one role to the next all while expanding my education of the field. I am thankful for each role that I’ve held through the years. Each member of the nursing team is important and needed, but the role of a CNA is invaluable. They are the backbone of the long-term care industry. They are often the unsung heroes that become more like family to a Resident than a caregiver. We honor and give gratitude to those CNA’s that answer the call every single day and make unmeasurable impact.”

CEO, Bernie McGuinness

The Pfizer-BioNTech and Moderna COVID-19 vaccines are messenger RNA vaccines, also called mRNA vaccines. Learn more about Pfizer-BioNTech and Moderna COVID-19 vaccines, including who can get them, doses, and ingredients.

How mRNA COVID-19 Vaccines Work

To trigger an immune response, many vaccines put a weakened or inactivated germ into our bodies. Not mRNA vaccines. Instead, mRNA vaccines use mRNA created in a laboratory to teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what helps protect us from getting sick from that germ in the future.

1. First, mRNA COVID-19 vaccines are given in the upper arm muscle. After vaccination, the mRNA will enter the muscle cells. Once inside, they use the cells’ machinery to produce a harmless piece of what is called the spike protein. The spike protein is found on the surface of the virus that causes COVID-19. After the protein piece is made, our cells break down the mRNA and remove it.
2. Next, our cells display the spike protein piece on their surface. Our immune system recognizes that the protein does not belong there. This triggers our immune system to produce antibodies and activate other immune cells to fight off what it thinks is an infection. This is what your body might do if you got sick with COVID-19.
3. At the end of the process, our bodies have learned how to help protect against future infection with the virus that causes COVID-19. The benefit is that people get this protection from a vaccine, without ever having to risk the potentially serious consequences of getting sick with COVID-19. Any side effects from getting the vaccine are normal signs the body is building protection.

mRNA COVID-19 Vaccines Have Been Rigorously Evaluated for Safety

COVID-19 vaccines are safe and effective.

mRNA COVID-19 vaccines have been held to the same rigorous safety and effectiveness standards as all other types of vaccines in the United States. The only COVID-19 vaccines the Food and Drug Administration (FDA) makes available for use in the United States (by approval or emergency use authorization) are those that meet these standards.

While COVID-19 vaccines were developed rapidly, all steps have been taken to ensure their safety and effectiveness.

mRNA Vaccines Are Newly Available to the Public, but Have Been Studied for Decades

Researchers have been studying and working with mRNA vaccines for decades. Interest has grown in these vaccines because they can be developed in a laboratory using readily available materials. This means vaccines can be developed and produced in large quantities faster than with other methods for making vaccines.

mRNA vaccines have been studied before for flu, Zika, rabies, and cytomegalovirus (CMV). As soon as the necessary information about the virus that causes COVID-19 was available, scientists began designing the mRNA instructions for cells to build the unique spike protein into an mRNA vaccine.

Future mRNA vaccine technology may allow for one vaccine to provide protection against multiple diseases, thus decreasing the number of shots needed for protection against common vaccine-preventable diseases.

Beyond vaccines, cancer research has used mRNA to trigger the immune system to target specific cancer cells.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html

What You Need to Know

• COVID-19 vaccines are available for everyone ages 5 years and older at no cost.
• Vaccines were paid for with taxpayer dollars and will be given free of charge to all people living in the United States, regardless of insurance or immigration status.
• COVID-19 vaccination is an important tool to help stop the pandemic.
• CDC recommends you get a COVID-19 vaccine as soon as you can.

Be Aware of Scams

If anyone asks you to pay for access to a COVID-19 vaccine, you can bet it’s a scam. Don’t share your personal or financial information if someone calls, texts, or emails you promising access to a vaccine for an extra fee.

COVID-19 vaccination providers cannot:

• Charge you for a vaccine
• Charge you directly for any administration fees, copays, or coinsurance
• Deny vaccination to anyone who does not have health insurance coverage, is underinsured, or is out of network
• Charge an office visit or other fee to the recipient if the only service provided is a COVID-19 vaccination
• Require additional services in order for a person to receive a COVID-19 vaccine; however, additional healthcare services can be provided at the same time and billed as appropriate

COVID-19 vaccination providers can:

• Seek appropriate reimbursement from the recipient’s plan or program (e.g., private health insurance, Medicare, Medicaid) for a vaccine administration fee
  • However, providers cannot charge the vaccine recipient the balance of the bill.

Anyone in the United States Can Get Vaccinated

The federal government is providing vaccines free of charge to everyone 5 years and older living in the United States, regardless of their immigration or health insurance status.

CDC does not require U.S. citizenship for individuals to receive a COVID-19 vaccine. Jurisdictions (state, tribal, local, and territorial) cannot add U.S. citizenship requirements or require U.S. citizenship verification as a requirement for vaccination.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/vaccines/no-cost.html

Nicholasville Nursing and Rehabilitation is excited to share resident Carl Dickerson’s Success Story! 

Carl is a Marine Corps Veteran who was admitted to our community on May 17th following a lengthy hospital stay for abdominal surgery. He was unable to ambulate or complete activities of daily living tasks without extensive assist. He was eager to regain his independence and worked daily with Physical and Occupational Therapy to address his deficits in balance, safety awareness, endurance, and overall strength. He was so eager to regain his independence, he was noted to be completing exercises on his own in the evenings per our Care Team. He is now able to ambulate over 100 feet with his rolling walker and is completing all activity of daily living tasks without assistance. Carl is nothing short of a miracle and 3 weeks later is discharging to his own apartment in Lexington, KY. We are so proud of his hard work and wish him continued good health and independence in his new apartment. Congratulations to Carl and his Care Team on their success! 

KEY POINTS

• In 2020, countries reported on average, about half of essential health services were disrupted -WHO “pulse survey“external icon
• Pursue telehealth as an alternative to face-to-face healthcare services, commonly used pre-pandemic, to:
  • Reduce unnecessary exposure to COVID-19,
  • Help mitigate the spread of the virus, and
  • Reduce surges in hospitals and clinics.

This guidance document is developed to encourage healthcare providers to explore ways of meeting the essential healthcare needs of the community using innovative telehealth modalities and technologies; and expand the use of telehealth in the care of patients, and telemedicine in the care of COVID-19 and other non-COVID-19 patients.

WHAT IS TELEHEALTH?

Telehealth is remote patient care and monitoring. It allows direct transmission of a patient’s clinical measurements from a distance to their healthcare provider and may or may not be in real time. The telehealth session may also be facilitated by a Healthcare Professional (to other healthcare professionals), Village Health Volunteer -VHV, a Community Health Worker -CHW visiting the patient, or by the patient him/her-self, a parent or a legal guardian. Telehealth can be any combination of healthcare services including telemedicine. Some healthcare specialties default to “referring to all of such services” as telehealth. “TeleCOVID-19” care is Telemedicine.

Examples of Telehealth Care include:

• Screening for COVID-19, testing recommendations, and guidance on isolation or quarantine
• General health care (i.e. wellness visits, blood pressure control, advice about certain non-emergency illnesses, like common rashes)
• Non-emergency follow-up clinics
• Prescriptions for medication
• Nutrition counseling
• Mental health counseling
• Physical therapy exercise
• Teleradiology
• Tele-intensive care (in infectious disease hospitalizations)
• Telemedicine

Telehealth  decreases contact with healthcare facilities, other patients, and healthcare staff in order to reduce the risk of COVID-19 spread in the community.

Generally, Telehealth Modalities include:  

• Synchronous: Real-time telephone or live audio-video interaction, typically with a patient, using a smartphone, tablet, or computer.
  • For example: In some cases, peripheral medical equipment (e.g., digital stethoscopes, otoscopes, ultrasounds) can be used by another health care provider (e.g., nurse, medical assistant) physically with the patient, while the consulting medical provider conducts a remote evaluation.
• Asynchronous:The provider and patient communication does not happen in real time.

For example, “store and forward” technology allows messages, images, or data to be collected at one point in time and interpreted or responded to later. Patient portals can facilitate this type of communication between provider and patient through secure messaging. Other examples of telehealth modalities developed/used by American College of Obstetricians and Gynecologistsexternal icon include:

1. Live, two-way (or real-time) synchronous audio and video allows specialists, local physicians, and patients to see and hear each other in real-time to discuss conditions e.g. via phone or computer (also defined above).
2. Store-and-forward, also referred to as “asynchronous telemedicine,” sends medical imaging such as X-rays, photos, ultrasound recordings, or other static and video medical imaging to remote specialists for analysis and future consultation (also defined above).
3. Remote patient monitoring collects personal health and medical data from a patient in one location and electronically transmits the data to a physician in a different location for use in care and related support.
4. mHealth is a general term for self-managed patient care using mobile phones or other wireless technology and does not necessarily involve monitoring by a physician. It is most commonly used to deliver or reinforce patient education about preventive care and provide medication reminders, appointment reminders, and other essential self-care steps that patients should undertake to maintain their optimal obstetric health.

WHAT IS TELEMEDICINE?

Telemedicine is the use of electronic information and telecommunication technology to get needed health care while practicing physical distancing.  This encourages meaningful use of patient health measures to help guide the engagement of patient in care.

Telemedicine goals for Developing Countries should includeexternal icon, but not be limited to:

• Remote diagnosing and teleconsulting* system. Data (including signals and images) are locally (patient-side) acquired and stored, and then forwarded to the main hospital, where physicians can analyze those data. The remote (physician-side) hospital will then send back the diagnosis.
• Remote diagnosis performed with patient assisted by nurses. If no physician is in the neighborhood: such a situation typically occurs in rural locations of developing countries, and in some cases a preliminary diagnosis is locally performed by the aid of a decision support system (DSS).
• Remote monitoring system. The patient is monitored in the remote location, his/her signals are continuously acquired, forwarded to the main hospital, and possibly, locally analyzed by a DSS. Alarms are remotely detected and transmitted back to the patient-side. The monitoring system can be managed and locally controlled by a physician or by a nurse.
• Remote intervention system. The patient enters the operating room, the intervention is performed through a local (patient-side) robot that is remotely controlled by a physician in the main hospital. The remote intervention requires that some local assistance is performed by a physician or by a nurse.
• Remote education (e-learning) system. Students or caregivers (mostly physicians, nurses, and technicians) attend classes taught from remote academic institutions, and possibly by a bi-directional communication interact with the teacher by making up questions. Remote education can be locally assisted by a local tutor, during and/or after the classes.

*Note: Teleconsulting, i.e., expert second opinion, is performed among physicians, where a non-specialist physician requires a remote consultation with one or more specialist physicians: typically, such a situation occurs in emergency centers of rural locations or in minor hospitals of developed countries, or in any location of developing countries.

POTENTIAL LIMITATIONS OF TELEHEALTH

Adaptations to telehealth may need to be considered in certain situations where in-person visits are more appropriate such as:

• Due to urgency, a person’s underlying health conditions, or the fact that a physical exam or laboratory testing is needed for medical decision making.
• If sensitive topics need to be addressed, especially if there is patient discomfort or concern for privacy.
• Limited access to technological devices (e.g., phones, tablets, computers) or connectivity. This may be especially true for those living in rural settings.
• When healthcare workers or patients may be less comfortable with using the technology, and may prefer an in-person visit.
• When virtual visits are not readily accepted in lieu of in-person visits by healthcare workers or patients.

To learn more, please visit https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/telehealth-covid19-nonUS.html

Nicholasville Nursing and Rehabilitation is proud to share resident Kathy Durham’s Success Story!

Kathy has been a resident of this center since February of 2019 and was previously using a manual w/c for all mobility.  She was unable to propel the w/c due to L UE hemiplegia from a previous CVA, requiring assistance from our Care Team to move about the building.  A power w/c was donated to the community, and Kathy was the prime candidate to receive the power w/c, as it would increase her overall I, and reduce her need to rely on our Care Team to move as she desired. She was educated on how to use the power w/c and is now able to independently mobilize throughout the community, increasing her overall quality of life. Congratulations to Kathy and her Care Team on their success! Keep up the great work!

The federal government is committed to ensuring that residents and staff in long-term care (LTC) settings, such as nursing homes, assisted living, residential care communities, group homes and senior housing, have access to COVID-19 vaccines to receive primary series and booster shots. For additional examples of LTC settings, see COVID-19 Vaccine Access in Long-Term Care Settingsexternal icon.

The goal is to continue to protect those who are disproportionately affected by COVID-19—especially residents of LTC settings. All LTC settings that request assistance accessing COVID-19 vaccines for their residents and staff will receive the support they need.

Many LTC providers have already identified strategies and partnerships to obtain and administer COVID-19 vaccines for residents and staff. These include:

• Working with established LTC partners and retail pharmacy partners
• Coordinating with state and local health departments

Long-term care providers are encouraged to consider the option that works best for their residents and staff when coordinating access to COVID-19 vaccines, either in the local community or on-site. Additional details on these options are available on the pages linked below.https://www.cdc.gov/vaccines/covid-19/long-term-care/pharmacy-partnerships/administrators-managers.htmlhttps://www.cdc.gov/vaccines/covid-19/long-term-care/pharmacy-partnerships/jurisdictions.html

Additional Information COVID-19 Vaccination Recommendations

COVID-19 vaccination is recommended for all people ages 5 years and older in the United States for the prevention of COVID-19. COVID-19 vaccines currently approved or authorized by FDA are highly effective in preventing serious outcomes of COVID-19, including severe disease, hospitalization, and death. Efforts to maximize the proportion of people in the United States who are fully vaccinated against COVID-19 remain critical to ending the COVID-19 pandemic. At present, people with moderately to severely compromised immune systems should receive an additional dose of mRNA COVID-19 vaccine after the initial 2 doses.

CDC now recommends that certain people receive a COVID-19 booster shot. For more information, visit Who is Eligible For a COVID-19 Vaccine Booster Shot?

In addition, COVID-19 vaccines may now be administered along with other vaccines. This includes simultaneous administration of the COVID-19 vaccine and other vaccines such as the flu vaccine on the same day, as well as coadministration within 14 days. For more information, see Interim Clinical Considerations for Use of COVID-19 Vaccines.

To learn more, please visit https://www.cdc.gov/vaccines/covid-19/long-term-care/pharmacy-partnerships.html.

During National Nurses Week, take time to celebrate the founder of modern nursing, Florence Nightingale! Her endeavors to improve the aspect of healthcare has greatly shaped the quality of care by nurses in the 19th and 20th centuries. 

Currently, there are nurses all around the world putting their lives on the line to help stop the spread of COVID-19. It’s clear that Florence Nightingale’s impact on healthcare also helped pave the way for modern-day nurses and healthcare professionals to follow suit.

“With nurses around the world on the front lines of a global pandemic, it’s a poignant time to reflect on how Nightingale’s legacy laid the groundwork for their heroic work in hospitals today.” Says Greta Westwood, CEO of the Florence Nightingale Foundation. “She never took no for an answer – anything was possible.”

Also known as “The Lady with the Lamp”, Florence Nightingale started her nursing career in London, and later became appointed as the head nurse of the 1854 Crimean War. Nightingale’s passion and determination set her apart from others and got her the famous nickname “Lady with the Lamp” for checking on her patients via lamplight during the war. Not only did she care for her patients’ health, but she also often wrote letters to soldiers’ loved ones on their behalf.

The “Angel of the Crimea” made it her goal to lower death rates by improving hygiene practices in hospitals. She created numerous patient services that improved each patient’s quality of care while admitted in the hospital. She oversaw “invalid’s kitchen” where she set out food plans for patients that had dietary requirements. She also secured a laundry area so patients could have clean bed sheets and towels.

After the Crimean War, Nightingale wrote a book called Matters Affecting the Health, Efficiency and Hospital Administration of the British Army to share her observations and experiences while tending wounded soldiers. In 1857, the War Office’s administrative department was completely reconstruction due to Nightingale’s book and her experiences during the Crimean War, reforming several military hospitals that were under very poor conditions. (History.com Editors 2009)

In August of 1910, Nightingale became ill and was battling with heart failure. She died a week later at her home in London, bringing her life to an end at 90 years old. (History.com Editors 2009) Two years after her death, the Florence Nightingale Medal was created by the International Committee of the Red Cross, dedicated to be given to exceptional nurses every 2 years. In 1965, International Nurses Day was also created, residing on Nightingale’s birthday to continue celebrating her accomplishments. (Alexander 2018)

Despite her unexpected death, her legacy continues to live on at the Florence Nightingale Museum, which is located at the exact same spot of the original Nightingale Training School for Nurses. The museum holds over 2,000 artifacts to memorialize the mother of modern nursing. (History.com Editors 2009)

Florence Nightingale’s legacy is important to note during significant time for nurses courageously fighting on the frontlines during the pandemic. Notes Westwood, “Florence would be so proud of what nurses have managed to achieve during the pandemic.” (Haynes 2020)

References:

https://time.com/5835150/florence-nightingale-legacy-nurses/

http://history.com/topics/womens-history/florence-nightingale-1https://www.womenshistory.org/education-resources/biographies/florence-nightingale