What Was New in 2006

Antithrombotic Therapy in the Long-Term Care Setting, is a succinct and practical reference guide designed to fill an important void in thrombi and thromboemboli reference materials. Drawn from evidence-based and best practices this tool kit helps practitioners quickly find answers to questions they face every day such as:

• What is the best antiplatelet regimen to prevent myocardial infarction or ischemic stroke?
• What is the safest way to begin, titrate and monitor warfarin therapy for a frail elderly patient?
• Which patients are at greatest risk for deep vein thrombosis (DVT), and what are the best regimens to prevent and treat DVT?
• What adjustments to antiplatelet or antithrombotic therapy are needed when a patient has an invasive procedure or major surgery?

Filled with easy to read tables, this is a one-of-a-kind office reference guide. Contents Include:

• Overview of Antithrombotic Therapy in Specific Conditions in the Long-Term Care Setting
• Special Consideration in the Use and Monitoring of Antithrombotic Medications in the Long-Term Care Setting
• Approved Indications and Cautions for Antithrombotic Medications
• Sample Policies and Guidelines for the Use of Antithrombotic Therapy in the Long-Term Care Setting

The guideline incorporates evidence-based guidelines and expert opinion from several specialty organizations, including the American College of Chest Physicians American College of Cardiology, American Heart Association, and the American Stroke Association. To assure the accuracy and applicability of the information contained in the toolkit the authors collaborated with experts in geriatric cardiology, warfarin risk assessment, prevention of deep vein thrombosis, peri-procedural anticoagulation, heparin-induced thrombocytopenia, pharmacology and the practice of long term care medicine.

LTCANT1
Introductory Price
$110.00 members, $150.00 non-members

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Prepare your team and residents for flu season with the "Immunizations in the Long Term Care Setting" toolkit.

Take the lead in initiating and implementing activities to address and prevent influenza and pneumococcal disease in LTC facilities. With the Immunizations in the Long-Term Care Setting Toolkit, you'll:

• Learn how to boost vaccination compliance among both residents and staff;
• Find out what the barriers are and learn strategies for overcoming them;
• Get an overview of federal regulations;
• Learn processes for managing influenza outbreaks in LTC facilities;
• Go beyond standard flu preparedness plans and learn additional steps you can take to ensure your facility is prepared; and
• Receive the accompanying CD-ROM containing full versions of tools for easy access and customization, as well as the DVD inservice.

You can separately order the 18 minute DVD, Influenza Immunization and the Health Care Worker and hear firsthand from healthcare workers why they get immunized. This peer-to-peer emotionally moving DVD is perfect for your next staff in-service.

LTCIMM2
$60.00 for AMDA members, $100.00 for non-members

Influenza Immunization and the Health Care Worker (18 minute in-service on DVD)
IMM-DVD
$25.00 for AMDA members, $50.00 for non-members

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Just Released — 3 New Toolkits
Dementia, Depression, and Falls & Osteoporosis — Most health care practitioners and organizations are aware of AMDA's clinical practice guidelines (CPGs). But are you familiar with the AMDA Toolkits that walk you through each step of implementing a specific CPG. If you need assisistance to implement CPGs in your facility, these complete packages are a must have. Order Today.

Clinical Practice Guideline: Sleep Disorders in the Long Term Care Setting - Published 2006

Sleep problems are extremely common among residents of long-term care facilities. Sleep disturbance and its behavioral consequences in patients with dementia are a common reason for admission to long-term care. Data suggests that age-related sleep changes, medical conditions common among older people, medications that affect sleep, substance use, and factors related to the long-term care facility environment all contribute to the prevalence of sleep difficulties in the long-term care population. Most patients with sleep disorders in the long-term care setting can be appropriately assessed and treated without specialist referral using a stepwise approach that emphasizes nonpharmacologic techniques and that uses a combination of pharmacologic and nonpharmacologic therapies if the latter alone are unsuccessful. The sleep disorders clinical practice guideline focuses on the evaluation and management of sleep disorders that are secondary to chronic medical conditions or environmental issues. Most sleep disorders in the long-term care setting fall into this category. Outcomes that may be expected from the implementation of this guideline include better awareness and understanding of sleep disorders among patients and caregivers, proper utilization of pharmacologic sleep agents, greater acceptance of individualized scheduling (i.e., enabling patients to get up, go to bed, and eat meals at times of their choosing rather than at institutionally established times), reduction in the frequency of daytime drowsiness, increased levels of participation in activities, enhanced quality of life, improved physical and cognitive function and fewer falls, reduction in nighttime disruptive behavior caused by sleep problems, reduction in distressed daytime behavior in patients with dementia, decline in geriatric psychiatry referrals for evaluation of behavioral problems related to sleep disorders, increased participation in rehabilitation programs and better rehabilitation outcomes and increased job satisfaction among caregivers.

$20.00 for AMDA members, $30.00 for non-members.
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Clinical Practice Guideline: Gastrointestinal Disorders in the Long Term Care Setting - Published 2006

Although aging has relatively minimal effects on GI function, age-related changes can cause or contribute to several GI disorders. For example, oral changes (e.g., decreased taste sensation, decreased saliva production) can cause poor appetite, with associated weight loss. Aging can result in impaired function of the gastric mucosal barrier and increased risk of peptic ulcer disease. Patients residing in long-term care facilities typically have numerous concurrent conditions and use numerous medications that may complicate the assessment and treatment of GI disorders. GI disorders may also be caused or exacerbated by a variety of medical conditions that are more prevalent with age. Fecal impaction and dehydration are sentinel events that may indicate a patient has or is at high risk for a GI disorder. In addition, the presentation of many GI disorders in older people is atypical. For example, GERD may present as dysphagia, asthma, recurrent aspiration pneumonia, or even cough. It is important for members of the interdisciplinary team in the long-term care setting to realize the impact that GI disorders can have on patients’ quality of life. These conditions can prevent patients from participating in activities, hinder their mobility, disrupt their sleep, and cause them to become socially isolated. The G.I disorders guideline focuses on the gastrointestinal (GI) disorders most commonly seen in the long-term care population. The following outcomes may be expected from implementation of this clinical practice guideline; reduced incidence of some acute GI disorders and greater stability of chronic GI disorders; appropriate use of medications to treat GI disorder; appropriate use of acute care facilities to assess and treat GI disorders if indicated ; appropriate use of specialist referrals and invasive testing in the management of GI disorders; reduced morbidity, mortality, and incidence of complications (e.g., fecal impaction, dehydration) of GI conditions and improved palliative care outcomes in residents with poor prognosis.

$20.00 for AMDA members, $30.00 for non-members.
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Recommendation for Completing Death Certificates - Published 2006

New for 2006, the Recommendations for Completing Death Certificates are designed to assist physicians through the often complicated process of completing a death certificate. The guidelines include information on understanding the legal definition of death; the roles held by physicians, coroners, medical examiners, and nonphysician practitioners during the process of pronouncing and certifying death; and in-depth information about properly completing the cause of death.

$15.00 for AMDA members, $20.00 for non-members.
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Product Updates

Updated for 2006, this guide provides a description of the latest coding changes and coding modifications, including the 2006 new and revised nursing home and domiciliary codes. Topics also include home visit services, care plan oversight services, as well as vignettes of situations where the various codes are applicable, and, frequently asked questions on nonphysician practitioners, 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.

$25.00 for AMDA members, $35.00 for non-members.
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Tool Kit for Managing Attending Physicians - Revised 2006

This kit addresses a range of needs from a basic level of acknowledgement to the very structured level of a formal application for professional services. It will assist the facility and medical director with verifying the qualifications of each attending physician that wishes to serve as a member of the attending physician’s staff and make a decision to grant or deny the right to practice in the facility, and a tool to develop and communicate to the community-based attending physicians.

$50.00 for AMDA members, $65.00 for non-members.
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AMDA Model Medical Director Agreement and Supplemental Materials: Medical Director of a Nursing Facility - Revised 2006

This model agreement contract package is intended to serve as a guide for agreements for medical director services for nursing facilities. The complete package includes a model agreement between the medical director and the nursing facility; performance requirements and the roles and responsibilities of a medical director; AMDA’s statement on compensation for medical director services; and CMS requirements for medical directors. The newly revised package also includes information relevant to the updated Medical Director 501 FTag and Stark II prohibition on physician self-referral. (Published 1999; Revised 2003, 2006)

$25.00 for AMDA members, $35.00 for non-members.
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