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Incontinence Support Blog

Holistic Kidney Health

Posted by Caleb Bartlett

Feb 22, 2017 3:43:45 PM

 As a survivor of spinal cord injury for almost twenty-three years I have been blessed with very good kidney health. Sadly, many of those in a similar situation have not been as fortunate. I recognize that not all conditions have the same cause and not everyone reading this may have a spinal cord injury, but considering that most of the readers of this blog are using or are affiliated with the Men’s Liberty product in some way kidney health was a good topic to tackle. Kidney health starts with hydration. With the constant availability of soft drinks, energy drinks, teas, and other beverages filled with sugar and sugar substitutes that tease our brain’s pleasure centers it’s easy to think we are hydrating when we aren’t. This month I am going to give a few simple (and cost-effective) methods to hydrate properly and prolong the life and cleanliness of your kidneys. 

If you have ever cleaned the filter on a fish tank or air conditioner you know how the smallest particles can build to a nasty mess over time. As you go about your daily life the blood pumped through your body not only carries nutrients, but removes the impurities that are rejected by cells to maintain health. Bacteria, uric acid, heavy metals, salts, and other toxins make their way to the kidneys where they are filtered, drained into the bladder, and washed away when you urinate. When the body lacks the proper balance of fresh water the blood and kidneys must work harder to push those toxins out. Think about it… what moves faster through a straw, a milkshake or, well… water? So how do you get a proper hydration cycle?
  1. Give your kidneys a much-needed break. Oftentimes we are conscious about what we eat, but not what we drink. Read the label. Sugar, aspartame, artificial flavors, sweeteners, and chemicals you can’t pronounce should be removed from your diet. Coffee and tea are acidic and the caffeine they contain will dehydrate you regularly.
  2. Drink natural things. Water, herbal teas, freshly juiced fruits and veggies. If you have been diagnosed with sand in your kidneys water with lemon and cranberry juice low in sugar regularly will help greatly.
  3. Observe your body. When do you urinate most during the day? If you have paralysis, does your sitting position or laying down effect how you urinate? Do you have difficulty when it’s very hot or very cold? Share this with your doctor.
  4. Watch what you eat. Eat simple foods. Find healthy proteins and vegetables and stop fast food and snack foods like chips and cookies.
  5. Move around. Avoid a sedentary existence as much you possibly can. Get your blood pumping and moving those impurities from your body.
Kidney infections are nothing to play around with. An ounce of prevention is worth a pound of cure. If you need to make a lifestyle change, do it. Sure, that sugar-sweet soft drink tastes good and gives a happy feeling, but isn’t a long life and good health better that a few moments of satisfied taste buds? Best of luck, and take care of your body.

Thanks for reading.

Topics: doctors visit, urinary tract infections, Guest Blogs, incontinence, Kidney Health

The Pros of Probiotics

Posted by Mens Liberty

Sep 16, 2014 1:00:00 PM

Hello friends and readers! Just the other day we received the new issue of PN magazine and as I was looking through it, I stumbled upon an article about the pros of taking probiotics. I’m sure some of you already take probiotics on a regular basis, but what you may not know is how beneficial they can be in helping to prevent Urinary Tract Infections (UTI).

Following spinal-cord injury (SCI) a person may often experience a neurogenic bladder, which requires catheterization or other urinary devices to help drain the bladder. This can introduce unwanted bacteria into the bladder that can lead to a urinary tract infection.

For those of you who live with SCI, UTI’s are a constant and lifelong threat. In fact a staggering 80% of individuals with SCI will develop bladder infections over their lifetime. As a result of these infections, a person is often put on antibiotics and in some cases they can be on these antibiotics for a long time.

However, there is a downside to this; prolonged and repeated use of antibiotics can actually increase the risk of UTIs by:

  • Developing bacteria that are resistant to drugs, causing repeated infections.
  • Destroying good bacteria in your gut, comprising your immune system.
  • Destroying the protective shield of good bacteria that line your urethra. When antibiotics are used for long periods of time, this protective shield is stripped away or replaced by less effective organisms.

So how exactly could probiotics help prevent UTIs? For starters, “good” and “bad” bacteria live in our gastrointestinal, urinary, and respiratory tracts. Although it may seem odd, both kinds of bacteria are necessary to maintain optimal health. Probiotics contain “good” bacteria, Lactobacillus acidophilus and bifidobacterium bifidum, just to name a few. The probitoics help to restore and maintain the natural bacterial environment to make it hard for “bad” bacteria to cause infection.

Now just to make things clear, regularly taking probiotics will not completely prevent the reoccurrence of UTIs, but studies do show that it did seem to reduce the potential for reoccurrence. Since UTIs are the second most common infection in the body, prompt millions of hospital visits per year and cause billions of dollars in unnecessary healthcare costs annually; taking probiotics as a preventative measure sure wouldn’t hurt.

But they’re quite a few probiotics on the market, all claiming to be the latest and greatest. So here is what to look for when picking a probiotic:

  • A minimum of eight billion active bacteria cultures.
  • Should contain lactobacillus acidophilus and bifidobacterium bifidus.
  • If you have a bladder infection or want to prevent one it should contain lactobacillus rhamnosus and lactobacillus fermentum.
  • Consider buying freeze-dried probiotics as they keep the flora dormant until it enters your body.
  • Keep it stored in the fridge.

So did you find this post helpful, informative, or interesting? Let us know in the comment section below.

As always have a great week and we will see you next time!

Get Started

Sources:

Chan, A. (2011, April 15). Probiotics Could Help Prevent Urinary Tract Infections. Retrieved September 10, 2014, from http://www.livescience.com/13747-good-bacteria-prevent-urinary-tract-infection.html

James, K., & Smith, J. (2014, September 1). The Pros of Probiotics. PN Mag, 22-23.

Topics: urinary tract infections

Infection Prevention and You

Posted by Mens Liberty

Oct 28, 2013 3:00:00 PM

International Infection Prevention Week (IIPW) ended last week, but that doesn’t mean we can slack off for the next 358 days. Let’s stick with the mission statement developed by APIC: 365 days of commitment, 7 days of focus. In fact, we would like to take a moment to give a shout out to the Association for Professionals in Infection Control and Epidemiology (APIC) and Eloquest Healthcare Inc.  Both of these organizations are making great strides in order to reduce the number of infections contracted by healthcare patients.

Infection Infographic

Topics: Caregiving, healthcare professionals, urinary tract infections, hospital acquired infections, Eloquest

Mythbusters: Urinary Tract Infections

Posted by Mens Liberty

Oct 22, 2013 3:00:00 PM

This week is International Infection Prevention Week and to kick things off we are going to dispel some common myths about Urinary Tract Infections (UTIs) and expose the facts. Before we dive into these myths, let’s talk about just how common it is to contract a UTI.

Urinary tract infections are the second most common type of infection in the body, accounting for 8.1 million visits to health providers each year. To put a $ sign on it, a recent study published in Infection Control Today found that ER visits for UTIs contributed to $4 BILLION in unnecessary healthcare costs annually. Dozens of other studies tell us that urinary tract infections are the most common type of hospital-acquired infection and most hospital-acquired UTIs happen after urinary catheterization.

So what causes a UTI? Are women more susceptible them men to contracting a UTI? Does cranberry juice really cure UTIs? I’m sure you’ve heard various answers to these questions. Well, we are here to tell you the facts. But don’t feel bad if you’ve had it wrong, some of this was news to me too!

Myth: UTIs only happen after having sex.

Fact: Sexual intercourse is the number one cause of UTIs. However, it isn’t the only cause. Other causes of UTIs include wiping from back to front, holding in your urine for extended periods of time, and catheters or tubes place in the urethra and bladder.

Myth: UTIs are a sign of bad hygiene.

Fact: You don’t get a UTI from having bad hygiene of sleeping with somebody who doesn’t shower every day. You (and our partner) can be squeaky clean and still contract a UTI.

Myth: Men don’t get UTIs.

Fact: Bacteria do not discriminate between sexes. Although it’s certainly rarer for men to contract a UTI, only 12% of men claim to have had a UTI in their lifetime compared to 50% of women. Women have a much shorter urethra then men, which means that bacteria has a much shorter journey into the bladder, resulting in higher infection rates. However, for men, the likelihood of getting a UTI increases with age.

Myth: Cranberries, cranberry juice, or cranberry products can cure UTIs.

Fact: Cranberry juice contains the active ingredient, cranberry proanthocyanidins or PACs, that helps prevent bacterial growth in the bladder. You can drink cranberry juice to help prevent a bladder infection. But don’t rely on cranberry products as a cure if you have already contracted a UTI. It won’t hurt, but it won’t help significantly more than drinking plenty of water. Only an antibiotic will cure an established UTI.

Myth: Taking a low-dose antibiotic every day is a good way to prevent UTIs.

Fact: Daily antibiotics can be effective but pretty quickly you’ll discover that the bacteria have become resistant to them. Plus, this is a good way to give your body something it doesn’t need. Prevention of UTIs typically doesn’t require antibiotics. The scientific community now knows how to standardize and dose cranberry PACs in dietary supplements at 36mgs of PAC once a day to properly maintain a clean urinary tract. Increasing antibiotic resistance is a chief concern and initiative of both the WHO (World Health Organization) and the CDC (Center for Disease Control).  Antibiotics are for treatment, and frequent use can lead to antibiotic resistance. It's better to maintain a clean urinary tract with ellura, lots of water and other simple protections.

Have you heard other myths regarding UTIs that I may have missed or do you have a question? Leave it in the comments section and I will respond or address it in our next blog. As always, thanks for reading!

Topics: urinary tract infections, hospital acquired infections

Seniors reusing incontinence products!

Posted by Sarah Woodward

Aug 15, 2013 11:55:00 AM

It seems that US Seniors aren't exactly alone in not having their incontinence products (i.e. diapers) covered by the government or insurance. It's the same situation in our northern neighbour, Canada.

Absorbent products go by a lot of names these day – adult diapers, briefs, pads, male guards and pull ups, just to name a few. Whatever the brand, there are some basic commonalities. Absorbent products are made up of hydrophilic materials like paper pulp which absorb urine and a hydrophobic external layer like nylon to hold the moisture inside and prevent leaks.

The price of most superabsorbent pads is between $0.44 and $0.86 per unit. Pads should be changed an average of 4-6 times a day, meaning that the annual expenditure for an incontinent man using pads could be as high as $4,402. Because absorbents aren’t covered by insurance, these costs are borne almost exclusively by the individual user.

So I understand the impulse to try and make your pad last a little longer and to save a little of that money. But sadly diapers are generally only designed to absorb around 16 ounces of fluid in a single episode and most do very poorly during a second urination.

But in Canada, Jack O'Neill is on a mission to change all that.

Orange Line

Jack O'NeillPORT COLBORNE - Jack O’Neil is disgusted that low-income seniors are forced to put their dignity aside to feed themselves.

The longtime seniors advocate says some seniors on fixed incomes in Port Colborne have to choose between buying groceries or incontinence products.

“Depending on the level of incontinence, people can spend more than $150 a month on these things,” he said.

“I know some people try to use them again or even wash them and it’s not healthy.”

O’Neil met with Welland MPP Cindy Forster Monday morning to deliver a petition with more than 1,300 signatures from residents of Port Colborne and doctors from across Ontario calling for government funding for incontinence products for low-income seniors.

“I think it’s an important issue,” Forster said. “Seniors don’t have enough money to live on. Many live below the poverty line as singles and even couples. This is another example of the need for supports for low-income seniors.”

She intends to bring the petition to Queen’s Park when the Ontario legislature resumes Sept. 9. Health Minister Deb Matthews will have 24 sessional days, or six weeks, to respond in writing.

Forster, a former nurse, said trying to reuse incontinence products or leaving the same pair on for expended periods can lead to rashes, bladder infections, skin breakdowns and serious skin infections.

Roseanne Western, administrator at Niagara Region’s Gilmore Lodge seniors home in Fort Erie, said in a phone interview that almost 90% of seniors living in regional senior care facilities have incontinence issues.

“It’s just something that happens as we age,” she said. “We experience a loss of muscle tone, so (people) lose a lot of control of bowel and bladder functions. Those muscles are not as strong or working as well (as they used to).”

She said the region’s homes receive funding for the products, but she empathizes with seniors who have to buy their own.

“It’s definitely an issue,” she said. “They are expensive and it’s quite a cost for them.”

At Shoppers Drug Mart on Niagara St. in Welland a package of 16 Depends Undergarments cost $23.99. The brands Max Protection undergarments are the same price, but come with 10 in a package.

Find Out About  Diaper Alternatives!

 

Original article published in Well and Tribune CA - http://www.wellandtribune.ca/2013/07/15/seniors-reusing-incontinence-products

Topics: Interesting Articles, proactive patients, diaper alternatives, urinary tract infections

7 Medical Procedures You May Not Need...

Posted by Sarah Woodward

Jul 19, 2013 10:20:00 AM

You're facing minor surgery, and your doctor orders routine preoperation tests. Do you get them?

You're a senior with insomnia. Prescription sleeping pills are OK, right? You see an ad for a screening to detect a potential stroke. Good idea?

Probably not, the experts say. All three are among the unnecessary or potentially harmful tests and treatments identified by 17 key medical specialty societies, which recently, in Washington, released their lists of questionable procedures as part of the Choosing Wisely campaign.

That campaign, set up by the nonprofit American Board of Internal Medicine (ABIM) Foundation, began in 2012 when nine medical societies first offered their lists of unnecessary treatments.

Consumer Reports is a partner in the Choosing Wisely campaign, and John Santa, M.D., who directs that group's health ratings, says, "We know Americans believe more health care is better, and all prevention is good." But, he stresses, "waste and overuse is a major issue — and it's frequent across all medical disciplines."

Christine K. Cassel, president and chief executive of the ABIM, says the Choosing Wisely campaign is "about the right care at the right time for the right patient."

Here are seven overused tests or treatments commonly prescribed for people age 50-plus that experts now say you probably don't need if you're healthy.

1. Recommendation: Avoid routine presurgery tests for eye and other low-risk surgeries (American Society for Clinical Pathology and American Academy of Ophthalmology).

Men and women facing elective surgery — eye, foot and cosmetic operations, as well as biopsies — routinely undergo unnecessary blood and other tests. "You need to ask: Why do I need these tests?" says Lee Hilborne, M.D., an official with the clinical pathology society. Cataract patients, for example, often get an EKG, blood work and a chest X-ray, says William Rich, M.D., of the ophthalmologists group. "They're paying for tests we don't think are necessary," he says. Average costs run $300 to $400.

Danger: Aside from the cost, a few test results come back abnormal even though the patient is fine — causing anxiety and further tests that could delay the surgery.

Exception: A patient with a severe heart condition or symptoms that could be heart-related should have a presurgery EKG.

Diabetic patients need a blood glucose test and those on diuretics should have a potassium test.

2. Recommendation: Don't take prescription sleeping pills as the first choice for insomnia (American Geriatrics Society).

Insomnia is very common in older people, but experts say seniors should avoid some widely prescribed sleeping pills, such as Restril and Ambien. Instead, talk to your doctor about other therapies, such as counseling to improve sleep patterns through lifestyle changes.

Danger: Meds called sedative-hypnotics, including benzodiazepines, double the risk of falls and hip fractures, leading to hospitalization and death in older adults, according to several large studies.

"It's not entirely clear why; it may be there's some carryover the next day," says Cathy Alessi, M.D., president-elect of the American Geriatrics Society.

Exceptions: For seniors, prescription sleeping pills (sedative-hypnotics) should be reserved for anxiety disorders or severe alcohol withdrawal after other therapies have failed.

3. Recommendation: Don't get a screening test for carotid artery disease unless you have symptoms (American Academy of Family Physicians).

Companies provide screenings for carotid artery stenosis — the narrowing of arteries that can lead to strokes — but unless you have symptoms, don't get scanned. "The scientific evidence is very clear that more people are harmed than helped by having this test, and we advise against it," says Glen Stream, M.D., board chair of the family physicians group.

Danger: Screening someone with no symptoms of carotid artery disease could lead to further tests and even surgery, which carries increased risk of stroke.

Exception: If you've had a transient ischemic attack (TIA) or ministroke, you may need a diagnostic test.

4. Recommendation: Talk to your doctor about not having a urinary catheter. If a catheter must be used, have it removed as soon as possible (Society of Hospital Medicine).

One in five hospital patients has a catheter, but about half don't need one. Sometimes they're used for incontinence or the convenience of the patient or health care staff.

"Don't get a catheter put in. But if you have to have one, get it out as quickly as you can," says John Bulger, an official with the society that represents hospital physicians. While patients hate it, wetting the bed or intermittent catheterization is far preferable to the continuous use of a catheter, he adds.

Danger: Urinary tract infections from catheters are more prevalent the longer a catheter is in place. Urinary tract infections are the most common hospital-acquired infection, and can be fatal. About 13,000 people a year die as a result of infections from catheters, a study found.

Exceptions: If you have surgery, you may need a catheter. Guidelines call for its removal the next day.

5. Recommendation: Skip the annual Pap test (American College of Obstetricians and Gynecologists and American Academy of Family Physicians).

If you're under 65, get a screening every three years. After 65, if you've had several normal Pap tests, you can stop having them.

"Pap smears annually are a waste of money," says Gerald F. Joseph, M.D., of the OB/GYN group. "In average-risk women, studies show no advantage to annual screenings over those performed at three-year intervals."

Danger: False positive results cause anxiety for patients.

Exception: If you've had cervical cancer or cervical disease, continue annual Pap smears. Cervical cancer is caused by the Human Papillomavirus (HPV), which is transmitted through sexual relations.

6. Recommendation: Don't use testosterone for erectile dysfunction (American Urological Association).

A number of TV ads and men's clinics are pushing this remedy, but most men should skip testosterone supplements if their testosterone levels are normal.

"Anecdotally, we know a lot of prescriptions are being written for testosterone for men with normal testosterone," says Daniel A. Barocas, M.D., assistant professor of urologic surgery at Vanderbilt University Medical Center. But he says the prescription doesn't work for erectile dysfunction.

Danger: Testosterone does not affect the ability to get an erection. It enhances libido or sex drive but not performance. It also reduces fertility and may make prostate cancer blossom. Prostate cancer thrives on testosterone. Gels can irritate the skin; injections can increase red blood cells.

Exception: If you have other symptoms of low testosterone, including loss of muscle mass and body hair, talk to your doctor to see if hormone testing is right for you.

7. Recommendation: Don’t order a blood test for creatinine or upper-tract imaging for patients with an enlarged prostate (American Urological Association).

Most men after age 50 have enlarged prostates, which result in urination that disturbs sleep and a weaker urine stream.

Danger: Even routine tests are not risk-free. Patients spend time and money and may get false positive readings, leading to other tests. CT scans mean radiation exposure.

Exception: Tell your doctor about blood in the urine, pain with urination or urinary retention.

The full list is available at ChoosingWisely.org.

Topics: doctors visit, medical research, healthcare professionals, urinary tract infections, Medicare

I’m All Stressed Out! 7 Tips for Managing Stress from Men's Liberty

Posted by Mens Liberty

Apr 18, 2013 4:06:00 PM

Recently, a good friend of ours spent 15 days in the hospital with multiple areas of “severe sepsis” (infections) that had spread from a UTI (urinary tract infection). Our friend spent 9 of those days on a ventilator after surgically removing the most critical of the infections. His situation was truly life-threatening – all from a simple UTI…

No matter how scary hospital stays are for a patient, they can create 4 times the amount of stress for the caregivers. After all, they are the ones still trying to balance the day-to-day living. Plus, they now have the added worry of a loved ones’ health and life, how they’re going to pay for it, who’s going to work to make the money to pay the bills, who’s taking care of the children and feeding the pets, did the stove get turned off… and the list goes on and on. Sound or feel familiar?

Stress comes from three areas in our lives. Physical stress is like sitting or standing for long hours, or incurring injuries to our body. The caregiver and the patient are experiencing that type of stress. Emotional stress comes from our fast-paced life and the overwhelming feelings of despair and fatigue.

Chemical stress is environmental. We may or may not have control over chemical stressors, such as smoking, abuse of over-the-counter drugs, poor diet, and excessive sugars and caffeine. They put our body in an altered chemical state that clearly is not balanced for a healthy person.

Too much of all or part of these stresses can wear you down and make you sick, both physically and mentally.

So, where to start?

First off, control is an illusion. No one can fully control the amount of stress they might feel from any given situation. However, we can do our very best to manage it.

Here are our 7 tips to manage stress.

  1. The first tip is to accept that there are events that you can’t control.
  2. Keep a positive attitude and avoid a negative mental avalanche. It’s possible to be objective and positive at the same time. You can be realistic about the situation and still believe that you are resilient and will come out on the other side just fine.
  3. When you feel stress starting to take over, consciously halt the stress energy. You can do it! When feeling overwhelmed, take a brief walk. And definitely don’t drive aggressively. The last thing you need is a road rage incident…
  4. As much as drinking a good cocktail might sound, avoid alcohol - same with drugs and smoking. These activities chemically stress your body and lower your immune system
  5. Take a moment to do something pleasurable. This is one of the hardest tips to follow. Why? Because, we feel guilty. Remember that list in the very beginning; it’s still there in your head. It hasn’t magically disappeared. But if you don’t stop and create some time for yourself and a happy activity, you aren’t giving your body and mind a moment to rest and re-create its’ energy.
  6. Sleeping is another aspect of slowing the body down to recover from stressful situations. Most Americans are sleep deprived normally. Stress can easily interrupt healthy sleep patterns, so it takes being extra vigilant and making sure you get enough for your body to function.
  7. Remember to eat healthy. Yes, it’s easy to grab a burger on the way to the hospital.  Try and avoid that temptation. Take the time to have good meals. No one needs your immune system going down, and then you can’t be available for others.

And here is a bonus tip for you:

Seek social support. Text your friends. Call them. See them. The concept of “Tend and Mend” is the act of using existing and new friendships to create a venting solution and a balanced approach to any situation. And they say laughter is a great stress reliever!

You can clearly feel and see that stress directly affects your health. So, take care to preserve your own health and well-being and not to compromise it as you are giving care to others!

Now here’s what I do. I take a deep breath and go out and play with the puppy that someone forgot to feed!

 

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Topics: Caregiving, urinary tract infections, hospital acquired infections

Cutting Hospital Readmissions with Men's Liberty

Posted by Sarah Woodward

Dec 7, 2012 9:58:00 AM

Here is some great new information out recently from Stephen Jencks, MD, MPH.


Dr Jencks is the lead author of the New England Journal of Medicine study on the cost of readmissions to the American healthcare system. He says hospitals must look beyond the four walls of their facilities to reduce readmissions. That’s great news for us because we talk to WAY TOO MANY guys who ricochet back and forth between hospitals and home health care due to urinary tract infections. Reducing infections and readmission rates go hand in hand!

Speaking recently in Florida, Dr Jencks expanded on his previous work to convince attendees that the best way to cut hospital readmissions was to build relationships within the local community.

“The idea that it is not just that the patient leaves the hospital and goes into the community. It’s that information leaves the hospital and goes to the community, and that information comes back to the hospital from the community. This is feedback. This is how you improve what you do when you send a patient out. And if you are not securing that feedback, it’s going to be really hard to make the discharge more effective and better, yet the truth is that relatively few organizations have a systematic way of getting that feedback from nursing homes, physicians, home-health agencies and hospice.”

“On the other end, the same increasing complexity of information flow is here. You have the patient going back to the emergency service and you have information going with the patient from the home health agency or the skilled nursing facility or from the family.  And you have feedback coming from the emergency room to the organization that sent the patient, and that information may come back with the patient. Suddenly, the emergency room is now in an active dialog with the nursing home or the home-health agency or community nursing. This is a partnership. And partnerships with community organizations are emerging out of attention to readmissions. There are conversations going on between nursing homes and hospitals that weren’t going on five years ago.”

The biggest lesson is not to look at readmission as a black and white issue.  “Discharges are not something written in stone. In fact, in readmissions, the best way to reduce bad outcomes is to reduce exposure to the risk of bad outcomes,” i.e. reducing exposure to things like indwelling catheters will cut initial infection rates AND readmissions.

describe the imageFor partner organizations, “it’s not enough to put people in the back of the ambulance at 11 o’clock in the evening and shove them to the emergency room with a slip of paper pinned to them that reads, “Please diagnose and treat.”

“Understanding community is not new for hospitals. What is new is the need for partnerships within that community. The community shifts from where people flow in out to a set of partners you actively work with. That’s an enormous challenge for some hospitals. My personal suspicion is the hospitals’ ability to succeed with that challenge is going to be the difference between hospitals that really succeed over the next 10 years and those that find that it’s all too much for them.”

We’re rooting for hospitals, nursing homes, home health agencies, patients and families as they make this transition and we look forward to supporting the reduction of urinary tract infections by introducing the healthier alternative, Men’s Liberty.

Have you experienced a catheter-associated UTI recently? Looking for a healthier option that gets you out of the hospital and back out in the world living life to the fullest? See if Men’s Liberty could work for you!

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Topics: urinary management, doctors visit, hospital errors, urinary tract infections, nursing, hospital acquired infections

Using Medicare’s paying power to change hospital behavior

Posted by Sarah Woodward

Oct 18, 2012 9:42:00 AM

The idea was sound; the execution was a little shaky.

If you’re anything like me, you have been seeing a lot in the news lately about medical errors and hospital acquired infections and how expensive this problem is becoming. If not, don’t worry, I turn off my TV during election season too!

Fortunately, I get to catch up on the highlights online, without most of the ads. One article caught my eye last week and I wanted to share. It’s a report on a recent study published in the Annals of Internal Medicine. In 2008, there was a lot of hullaballoo when Medicare and Medicaid published a new rule saying that they were no longer going to pay hospitals for treating preventable hospital acquired infections. The goal was to give hospitals and doctors a financial incentive to reduce their infection rates. It made sense to me; draining my bank account has always been a pretty good incentive for me to change my shopping habits!

But perhaps unsurprisingly to the health care professionals out there, this isn’t working out quite like they had planned. A recent analysis from the University of Michigan showed that hospitals are not correctly identifying infections in their coding/billing systems so that they can continue to get paid!

“For all adult hospital stays in Michigan in 2009, eliminating payment for [urinary tract] infections decreased hospital pay for only 25 hospital stays (0.003% of all stays).” This drastically underestimates the number of people who get infections. The CDC estimates that 560,000 catheter-associated urinary tract infections (CAUTIs) occur annually and leads to an estimated 13,000 attributable deaths each year.  

Doctor in Hospital

When this program was originally announced, Medicare expected savings of $20 million annually and Medicaid estimated a further savings on their side of $35 million over 5 years. The savings was expected to come from reduced reimbursements for ten “never events” including UTIs and pressure ulcers. It is now clear that this is NOT going to happen without a major change within hospital systems.

“The policy was well intended but its financial savings from non-payment for catheter-associated UTIs are negligible because of the data used to implement the policy,” says author Jennifer Meddings, MD, MSc, an assistant professor in the Department of Internal Medicine, Division of General Medicine at U-M Medical School.

But why should this matter to you? There are lots of reasons, but the top three are below:

  1. You or someone you know may be at risk of a UTI right now. Over half a million patients develop a catheter-associated urinary tract infection (CAUTI) in a U.S. hospital each year.

  2. You’re paying for it. The Government funds Medicare and Medicaid through my and your taxes. We are continuing to pay top dollar for lower quality care.

  3. It’s about to get worse. Effective 2015, Medicare is going to start penalizing hospitals with high infection rates. Sounds like a good idea, right? The problem is that they are using data that we already know is wrong. In effect, this new policy is going to disproportionately penalize hospitals who are declaring their infections correctly and allow hospitals that skirt the system to benefit even more. That hardly sounds fair, does it?

The best thing we can do as consumers is insist that hospitals report their infection rates honestly so that patients can make informed decisions and know what they’re getting for their money! So the next time you’re in the hospital, stay away from the Foley. Ask for alternatives and make your infection concerns known to the doctors and nurses. Demand better!

(And just a little shameless self promotion to the men reading this, there are better urinary management options out there. An indwelling catheter isn’t always the best answer –talk to your doctor about alternatives like Men’s Liberty.)

 

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Topics: urinary management, bladder control, external catheter for men, spinal cord injury, urinary tract infections, nursing, hospital acquired infections

Are you turning into Nurse Ratched? Nurse Burnout & Infections

Posted by Sarah Woodward

Oct 8, 2012 10:56:00 AM

Caregiver burnout is a well documented phenomenon and it is something we’ve talked about here in this blog. Well intentioned, hardworking, dedicated cargivers struggle on a daily basis to provide the best possible care and quality of life to their loved ones. It's overwhelming, emotionally draining and physically exhausting. Well, it turns out that it applies to nurses just as much – and we have the study to prove it!


A new article in the American Journal of Infection Control, by Jeannie Cimiotti RN et al., shows that there is a “significant association between patient-to-nurse ratio and urinary tract infections.” According to the authors, if Pennsylvania hospitals reduced burnout by 30% they would have 4,006 fewer urinary tract infections and see an annual cost saving of $3.3 million.

Cimiotti and her colleagues looked at data from over 7,000 nurses working in 161 hospitals in Pennsylvania. On average, each nurse cared for 5.7 patients and more than 30% of nurses reported job related burnout. Overall, 16 of every 1,000 patients acquired an infection; and the single most common infection was urinary tract infections. They also discovered that the addition of a single patient per nurse increased infection rates by a full point per thousand.

“Fewer infections were seen in hospitals in which nurses cared for fewer patients… [at least in part because] high nurse burnout [is] associated with heavier patient caseloads.” The authors suggested one possible explanation, saying: “the cognitive detachment associated with high levels of burnout may result in inadequate hand hygiene practices and lapses in other infection control procedures.”

The lesson: We need to invest more in reducing nurse burnout and patient caseloads. Investing more in staffing, education, performance feedback and support services will pay dividends throughout the system.

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One of the study's authors, Dr. Linda Aiken suggested that "it's a great time for hospitals to implement evidence-based staffing standards." The good news is that there are some pioneering states leading the charge. In California, the legislature has established minimum requirements for safe staff ratios. A supporting study funded by the Agency for Healthcare Research and Quality (AHRQ), discovered that hospitals with an effective nurse-to-patient ratio had lower rates of adverse patient outcomes (just like the study we looked at above).

Urinary tract infections are only one of many types of hospital acquired infections (HAI) which can be linked to nurse burnout. HAIs kill nearly 100,000 people every year. There’s usually a lot of hand-wringing when these kinds of statistics get published and lots of new transformative initiatives that never seem to go anywhere. One question the healthcare industry has had trouble answering is why simple solutions – like washing your hands or using newer, better products like Men’s Liberty – don’t always get implemented.

And just maybe, this is one of the reasons – health care professionals like nurses are suffering under the crushing weight of a  “do more with less” philosophy that is literally killing people.

What do you think?

 

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Topics: urinary management, external catheter for men, Caregiving, urinary tract infections, nursing