What is new in 2008

Delirium and Acute Problematic Behavior

Problematic behavior and delirium are common in both the short-stay and long-term residential facility populations. Although disease or organ dysfunction may cause or affect behavior, disruptive or problematic behavior itself is not an illness or disease and it should not be viewed or managed as such. Instead, problematic behavior and altered mental function are symptoms or syndromes (collections of signs and symptoms) needing careful evaluation and thoughtful management. These are complex issues with diverse potential causes. A systematic approach allows them to be handled effectively most of the time and serves the best interests of both patients and facilities. Following the steps in this guideline should permit facilities and their staff and practitioners to optimize their approach to these issues. This replaces the 1996 Altered Mental States guideline.

Order Information:
Product Code: CPG2-7
Member Price: $20
Non-member Price: $30
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Updated Pressure Ulcers in the Long Term Care Setting CPG

The updated guideline is evidence based and incorporates the revised federal guidance to surveyors on pressure ulcers (Tag F314) including:

• risk factors
• infection
• pain management
• treatments based on the wound characteristics
• the resident’s rights to refuse one or more aspects of pressure ulcer care

The guideline also includes the updates for staging according to the 2007 National Pressure Ulcer Advisory Panel (NPUAP).  This guideline removes practices that were experientially based (that is, have no evidence to support that practice) and moves to true evidence-based medicine. Additionally, the CPG discusses such controversial areas as photographic documentation, nutritional interventions, reverse staging, risk assessment tools, debriding of wounds, selection of ulcer care products and support surface options, treatments such as negative pressure wound therapy, incontinence as a causative factor, and much more.

This updated CPG combines AMDA’s previous two CPGs--Pressure Ulcers and Pressure Ulcer Therapy Companion. 

Order Information:
Product Code: CPG2-12
Member Price: $20
Non-member Price: $30
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Diabetes Management in the Long Term Care Setting

Type 2 diabetes is a chronic metabolic condition that increases in prevalence with age. Macrovascular and microvascular complications of diabetes cause serious morbidity and mortality. Diabetes is common in the LTC setting, where functional disabilities and multiple comorbidities increase the complexity of diabetes management.

A comprehensive approach to diabetes management, as in this guideline, can improve glycemic control and reduce the risk of complications. Such a comprehensive approach includes careful attention to diet and activity levels (when feasible), the use of oral medications, the use of insulin or other injectable therapies, and management of cardiovascular risk factors where appropriate. However, intensive treatment of diabetes may not be appropriate for all individuals in the LTC setting. To improve quality of life, diagnostic and therapeutic decisions should take into account the patient’s cognitive and functional status, severity of disease, expressed preferences, and life expectancy. This guideline recommends processes that, if implemented, should help LTC facilities to systematically manage and improve the care of residents with diabetes. This is the 2008 update to the original 2002 guideline.

Order Information:
Product Code: CPG15
Member Price: $20
Non-member Price: $30
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Guide to CPT Coding, Reimbursement and Documentation in Long Term Care

Updated for 2008, this handy pocket guide provides a description of the latest coding changes and coding modifications, including the 2006 new and revised nursing home and domiciliary codes. The booklet also lists the new time parameters that were ascribed to nursing facility codes. Topics include home visit services, care plan oversight services, consultation services as well as vignettes of situations where the various codes are applicable, and frequently asked questions on non-phyician practicioners, consultation services, hospice, discharge issues, assisted living, and subacute care. The guide also provides definitions for commonly used terms in coding such as "new and established patient", "concurrent care", and "nature of prescribing problem". Your purchase also includes a pocket-sized folding card that you can quickly reference anywhere at anytime!*

*pocket size coding book does not include clinical examples or FAQs

Order Information:
Product Code: CPT3 Member Price: $25
Non-member Price: $35
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