SaferCare Texas

Author: safercaretexas

DISPOSE YOUR PERSCRIPTON DRUGS CORRECTLY. YOU COULD SAVE SOMEONE’S LIFE.

Often times, consumers are not always familiar with the process of disposing expired, unwanted, or unused medications. As a result, they will attempt to bring these medications back to the pharmacy or the provider’s clinic for disposal. However, these sites are not able to take back the medication once it leaves the premises due to concerns of contamination. This increases concern of unwanted prescription medications left in the house, which allows for other individuals to have access to it such as family and friends. Based on the National Survey on Drug Use and Health in 2015, it was seen that most abused prescription drugs were acquired by family and friends from home.

Reasons why unused medication may be a danger to your family and friends:

  • Up to 92% of patients with opioid prescriptions do not use their entire prescription1
  • Up to 77% of patients do not store their opioid prescriptions in a locked container1
  • One in four teenagers misuse/abuse a prescription drug at least once in their life2
  • Drug overdose involving any opioid prescriptions have increased to 47,600 deaths in 20173

Accordingly, National Prescription Drug Take Back Day was established by the U.S. Drug Enforcement Administration (DEA) to occur twice a year (usually in April and October) for the safe disposal of prescription drugs including opioids. This is a free public event that offers proper medication disposal services to consumers at various authorized collection sites throughout the nation. Consumers should also know that there are ‘no questions asked’ when dropping off mediations at these sites. This service aids in the reduction of accidental or intentional misuse of unneeded medications as well as entrance into the environment.

The goal of this national event is to “provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications.”

If consumers are not able to attend the national event or there are no DEA-registered collection sites in the area, there are other safe disposal methods of medications:

Permanent collection sites4

    • There are permanent collections sites which may be located in retail pharmacies or law enforcement facilities
    • These sites may have a medication disposal kiosk or drop-off box where you can dispose of the medication at the consumer’s convenience
    • Google Maps
      • Search “drug drop off near me” in Google, you will find drug disposal sites near you
      • Learn more

Proper home disposal4

  • Mix the medicine (do not crush tablets/capsules) with an inedible substance (i.e. dirt, cat litter, or used coffee grounds
  • Place the mixture in a sealed container (i.e. plastic bag)
  • Throw the sealed container in your household trash
  • Remove all personal information on the prescription label of the empty bottle before disposal
  • Follow specific disposal instructions on a drug’s label or the patient information that accompanies the medication—and don’t flush the drugs down the toilet

By using available resources and appropriate methods to dispose of prescription medications, this offers a safer community and environment for everyone.

Additional information can be found at: https://takebackday.dea.gov/and www.fda.gov.

 

References:

1.    Bicket MC, Long JJ, Pronovost PJ, Alexander GC, Wu CL. Prescription Opioid Analgesics Commonly Unused After Surgery: A Systematic Review. JAMA Surg. 2017;152(11):1066-1071. doi:10.1001/jamasurg.2017.0831

 

2.    National Study: Teen Misuse and Abuse of Prescription Drugs Up 33 Percent Since 2008, Stimulants Contributing to Sustained Rx Epidemic. https://drugfree.org/newsroom/news-item/national-study-teen-misuse-and-abuse-of-prescription-drugs-up-33-percent-since-2008-stimulants-contributing-to-sustained-rx-epidemic/.

 

3.    Overdose Death Rates | National Institute on Drug Abuse (NIDA). https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates.

4.    Research C for DE and. Safe Disposal of Medicines – Disposal of Unused Medicines: What You Should Know.https://www.fda.gov/drugs/resourcesforyou/consumers/
buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm.

Nutrition Literacy and Patient Safety: Could this impact your patients?

As a registered dietitian, I know that the misunderstanding of basic nutrition or medical nutrition therapy can have major consequences for patient outcomes. I have seen the link between nutrition literacy and patient safety many times. Some of the more memorable encounters include:

  1. A newborn infant admitted near death because her mother did not know that crushed chips in soda placed in a bottle was not a nutritionally sound diet for infants. Chips and soda were typical foods for the mother.
  2. Another mother caused her child to fail-to-thrive due to her obsession with a fat-free diet. She was literally starving her child of much needed fat and calories for normal growth and development.
  3. One man living with diabetes, who was post-op toe amputation from complications due to poor blood sugar control, had taken his insulin at 8am but had not yet eaten breakfast. When I went to his home at 10am to check on him, I inquired about a potential low blood sugar reaction and he pulled open a drawer of candy. Instead, he should have eaten within a half hour of taking his insulin to keep his blood sugar stable and to prevent future complications.
  4. A grandmother with morbid obesity was homebound and bedbound with good family support but chronic readmissions. I was checking on her post-discharge from the hospital and was pleased to find a wide variety of fruits and vegetables in her refrigerator. When I inquired from her granddaughter why they were all still in the package, she replied, “The dietitian at the hospital told us we needed to buy more fruits and vegetables…but, we don’t know what to do with them.”
In all of the scenarios described and many more throughout the world, people may not understand basic nutrition principles to thrive, stay healthy and well, or prevent medical complications. 
 

EatRight, LiveRight, FeelRight

This year’s theme for National Nutrition Month® is EatRight, LiveRight, FeelRight! Sounds like an easy concept. However, people are limited in capacity to achieve these aspirations by their level of nutrition literacy. Nutrition literacy requires skills and capabilities empowering people to be food and health literate. These concepts also raise the questions do people have adequate access to nutritious foods and knowledge about food for proper selection or skills for preparation?

Nearly one billion people living in the world today are hungry on a daily basis, and over thirty percent of the world’s population experiences malnutrition in one form or another (World Food Program, 2018). The burden of malnutrition falls most heavily on girls and women who make up nearly two-thirds of this statistic (World Hunger, 2016). Babies born to mothers who are malnourished are at greater risk for low birth weight, which further places the baby at risk for early mortality, under five years of age. In the United States (U.S.), 40 million people are “food insecure” or lack access to healthy foods. This includes more than 12 million children. Malnutrition in children is the biggest contributor to childhood mortality, opening the door to opportunistic infections by inhibiting the effectiveness of the immune system (World Hunger, 2016).

However, good nutrition and access to healthy foods are not only essential for maternal and child health outcomes but for all populations. Good nutrition is important for prevention and management of chronic conditions such as obesity, heart disease, diabetes, and some types of cancer. Additionally, proper nutrition is one aspect of preventing obesity, which is a major health risk globally and in the United States. While the importance of good nutrition is well understood by clinicians, putting nutrition recommendations into practice can be very challenging for many families. For example, some places in the United States, labeled “food deserts,” lack healthy food that is affordable for the families that live there or sometimes lack healthy food entirely (USDA, 2009). Additionally, these neighborhoods frequently have more fast food restaurants and convenience stores that only sell unhealthy food options (USDA, 2009). Those living in low income neighborhoods generally have to travel further to access a supermarket, and 2.3 million households live more than one mile from a supermarket and do not have transportation (USDA, 2009). As a result, disparities exist in achieving the goal to EatRight, LiveRight, FeelRight!

Additionally, nutrition literacy causes health barriers without regard to socioeconomic status. Even the most affluent of households suffer from chronic diseases or complications related to poor nutrition literacy. Previously, public health promotion strategies have focused on nutrition education but have not been successful in changing dietary intake (Vidgen, 2016). Explicitly supporting and building food literacy infrastructure may more effectively address the self-efficacy people need to navigate the current food system and make healthy food decisions (Vidgen, 2016). Promoting National Nutrition Month®, the Academy of Nutrition and Dietetics recommends multi-faceted interventions to address poor food and nutrition literacy. Registered Dietitians receive specific training to help people navigate food and nutrition, complex phenomena made up of multiple factors of environment and lived experience, empowering people to eat healthy and reducing disease risk among populations. The Academy also supports advocacy for nutrition policy to help correct environmental, knowledge/skill and access barriers therefore, create a culture where everyone can EatRight, LiveRight, FeelRight!

If you are struggling with health literacy or have questions about the topic, feel free to contact us or read our resources for more information. 

References

  • US Department of Agriculture. (USDA). (2009). Access to affordable and nutritious food: measuring and understanding food deserts and their consequences. Washington, DC: Report to Congress.
  • Vidgen HA (editor) (2016) Food Literacy: Key Concepts for Health and Education. London: Routledge.
  • World Food Program (2018). Zero Hunger. Retrieved from http://www1.wfp.org/zero-hunger
  • World Hunger (2016). Women and Hunger Facts. Retrieved from https://www.worldhunger.org/women-and-hunger-facts/

Written by Teresa Wagner, DrPH, MS, CPH, RD/LD on March 14, 2019

COMMUNICATION BETWEEN HEALTH CARE PROFESSIONALS IS KEY

A friend recently began experiencing physical symptoms and was hospitalized, tests were run, and a quite serious condition was discovered. He was discharged from the hospital with referrals to several specialists to pursue a course of treatment. Expressing frustration, he and his wife shared with me that they felt as if they were starting over with each new individual practitioner. They failed to recognize any organized communication or coordination between those practitioners. Following their care journey has reminded me of the benefits of an integrated team approach to care over the more traditional parallel practice model of care.

Parallel Practice Care vs. Integrative Care

In a parallel practice model of care, independent healthcare practitioners share a common patient. Each practitioner performs their role, within their scope of practice with the patient.1 Though communication may occur between these practitioners, it is typically rather informal and may not be evident to the patient and patient care givers. These often ad-hoc care teams typically have no assigned leader or case manager to ensure that information is transferred between practitioners and the patient efficiently. This approach to care often fails to integrate the patient and care givers as a part of the care team. Of the 251,454 deaths per year in America attributed to medical error,2 up to eighty percent of those medical errors are associated to communication errors.3

Integrative care consists of an interprofessional team of practitioners providing a seamless continuum of care. Each practitioner, the patient and their care givers contribute knowledge and skills to develop a shared plan of care.4 This patient-centered approach to care recognizes the importance of communication within and across the care team which includes the patient and their care givers. It can range from care teams that meet with the patient to discuss plans of care, or teams coordinated by an assigned team leader or case manager. Integrative teams are typically non-hierarchical, focused on treating the whole person, valuing the contributions that each practitioner, staff member and patient bring to the team.

Supporting an Integrative Healthcare Model

As a practitioner in the field of mental health, I have had the opportunity to practice within both parallel practice and integrative models of care. I personally found the integrative model of care a much more satisfying practice experience. My friend and his wife fortunately have made their way into an integrative care practice. Though struggling to accept and adjust to a serious medical condition, they report renewed hope in being a part of an interprofessional patient-centered practice, where they feel an integral part of the team.

If you have any questions about these types of healthcare models or would like more information, the SaferCare Texas team is here to support you. You can reach us at 817-735-7633 or by email.

References

  1. Boon, H. Verhoef, M. O’Hara, D. Findlay, B. (2004) “From Parallel Practice to Integrative Health Care: A Conceptual Framework.” BMC Health Services Research, 4(1):15.
  2. Makary, M. and Daniel, M. (2016) “Medical Error the Third Leading Cause of Death in the US” British Medical Journal, 353:i2139.
  3. Joint Commission on Accreditation of Healthcare Organizations. (2012) “Joint Commission Perspectives” 32(8).
  4. Boon et. al.

Written by David Farmer, PhD, LPC, LMFT on February 26, 2019

Workplace violence: Harm to patients and caregivers is preventable

What is Workplace Violence?

The CDC National Institute for Occupational Safety and Health (NIOSH) defines workplace violence as “violent acts (including physical assaults and threats of assaults) directed toward persons at work or on duty.2

The U.S. Department of Labor defines workplace violence as an action (verbal, written, or physical aggression) which is intended to control or cause, or is capable of causing, death or serious bodily injury to oneself or others, or damage to property. Workplace violence includes abusive behavior toward authority, intimidating or harassing behavior, and threats.3

“Personal boundary violation is not part of our job description. That statement is powerful because boundary setting is a part of our job,” said an emergency department nurse. “If we fail to establish and maintain personal boundaries, then we’ve compromised the safe and therapeutic environment in which we’re able to truly care and advocate for our patients. We have an obligation to stand up against that which is unsafe, and I believe that ending nurse abuse is critical.”

That’s how my conversation began with an emergency department nurse who experienced on-the-job violence. She is just one of thousands of nurses and other care providers who have been harmed by patients while at work.

The American Nurses Association (ANA) #EndNurseAbuse movement is one example of how many national organizations are taking a stance and trying to shed light on this important issue. Another is the Joint Commission who issued a Sentinel Event Alert to bring more awareness to the seriousness of the issue and outline seven actions every healthcare setting must implement to create safer workplaces. (Read the alert and see the infographic at https://www.jointcommission.org/sea_issue_59/).1

Our role as caregivers is to establish a trusting relationship with patients and when that relationship is compromised after an assault, we may be left with a lasting fear for our personal safety. When you walk into a patient’s room, you enter with a sense of confidence. But this type of event jars that confidence. Getting back to the level of how it felt pre-assault takes a long time and may require long-term support systems that healthcare facilities may not have in place.

illustrated humans acting out at each other

The Safety Issue

Workplace violence impacts personal and patient safety in many ways. From a personal safety and performance perspective, some are obvious such as increased absenteeism and decreased productivity. The entire team is also impacted by lower morale, reduced creativity and communication that is hindered by fear. Workplace violence also creates a threat to maintaining a healthy, safe and supportive workplace for healthcare providers and patients.

According to the Occupational Safety and Health Administration, 75% of nearly 25,000 workplace assaults reported annually occur in healthcare and social service settings. But we know that number is grossly underreported because only about 30% of nurses report violent incidents. Abusive physical and verbal conduct is not part of anyone’s job and has no place in healthcare settings. It’s not okay, and really is a big deal…for the caregiver, for the organization and for society. Report it if it happens to you. Tell someone if you see it happen. Let’s do everything we can to stop it and prevent it. The next victim could be you or me!

We are Here to Help

SaferCare Texas is committed to improving health care for all Texans. If you would like one of our experts to speak to you and your peers regarding Workplace Violence in a Healthcare Environment, please call us today at 817-735-7633.

References:

  1. The Joint Commission. Physical and verbal violence against health care workers. Sentinel Event Alert, 2018;59.
  2. The Joint Commission. Behaviors that undermine a culture of safety. Sentinel Event Alert, 2008;40.
  3. The Joint Commission. The essential role of leadership in developing a safety culture. Sentinel Event Alert, 2017;57.

Written by Lillee Gelinas, MSN, RN, CPPS, FAAN on January 9, 2019