Clinical Tools and Products














Clinical Practice Guidelines in the Long-Term Care Setting

AMDA’s CPGs have become the standard care process in the long-term care setting. AMDA CPGs can reduce: costs, avoidable transfers, and risk of survey penalty and litigation. Most importantly, AMDA CPGs can improve: patient outcomes and safety of staff, facility, and patients. With the implementation of MDS 3.0 and the new Care Area Assessment (CAA), facilities will need to show they are using evidence based and expert endorsed resources. Appendix C in the new MDS Manual references the AMDA CPGs. CMS State Operations Manual references AMDA CPGs.

AMDA Guidelines emphasize key care processes and are organized for ready incorporation into facility-specific policies and procedures to guide staff and practitioner practices and performance. CPG implementation follows the medical care process of recognition, assessment (root cause analysis), treatment (based on assessment), and monitoring. Be able to make the case for unavoidable situations and conditions. Know that you can better manage a condition. Know that you can provide quality care for your residents!

AMDA’s Clinical Practice Guideline Steering Committee reviews any AMDA guidelines that are three years old to determine if it remains current. If a guideline is currently listed, it is considered to be clinically accurate and up-to-date despite its publication date.

AMDA has published the following Clinical Practice Guidelines specifically for use in long-term care settings:

Don't forget AMDA's
CPG Implementation Manuals,
a great accompaniment to the CPGs.
Click here to view the full list.

Each guideline is presented in a user-friendly format and contains an introduction explaining the purpose, development process, and terminology; a step-by-step narrative text that covers definition, recognition, diagnosis, treatment, and monitoring of the condition discussed; and an algorithm that summarizes the steps involved in addressing the condition.

These guidelines were developed by interdisciplinary workgroups using a process combining evidence and consensus-based thinking, and have been reviewed by national organizations and individual experts. They are applicable to members of the long-term care interdisciplinary team including physicians, nurses, consultant pharmacists, and others.

Guidelines may be ordered individually or as a full set; multiple copies of each individual guideline are also available.

All CPGs are the same price.

Member Price: $32.00 each
Non Member Price: $42.00 each

For guideline updates, guideline grading and to discuss implementation challenges, go to CPGNews.org.

¥ - Electronic/Digitial Products - Purchasers of electronic products will receive an email containing a user name and password allowing access to their online digital product(s). Access to digital products are available once the order has been processed (within 48 hours).

For a complete listing of AMDA resources, follow this link.


Full Set of CPGs - Electronic Format ¥ New!

  1. Evidence based, up to date information at your fingertips
  2. Available when you need it – 24 hours a day, 7 days a week
  3. Quicklinks to charts, tables and figures within CPGs
  4. References linked to official websites giving you additional details without having to search
  5. Instant updates to the CPGs with the latest advisories and changes in medical protocols
  6. Research and find your answers in a flash
  7. Offering the same in-depth information as our hard copy versions, e-CPGs are available for both PC and Mac, and can output digital editions for iPad, and coming soon, iPhone. Digital editions can have embedded web links, allowing you to jump to pages, tables, and references that enrich your experience, bringing the product to life. Readers can use the search facility to explore the e-CPG, finding relevant key words and phrases, and have the ability to delve further into any page. When readers see something that they want to highlight or bookmark for future reference they can do so by using the notes or bookmark options, they can even choose to send their typed notes to their email address so their thoughts are never lost.

    AMDA offers all e-subscribers hard copy CPGs at a discounted rate of $10 per CPG (email ca@amda.com for special product code). e-subscription is good for one year from date of purchase. Renewals must be done within 30 days of subscription ending.

AMDA’s CPGs have become a standard in care processes in Long-Term Care. With the implementation of MDS 3.0 and the new Care Area Assessment (CAA), facilities will need to show they are using evidence based and expert endorsed resources. Appendix C in the new MDS Manual references the AMDA CPGs. CMS State Operations Manual references AMDA CPGs.

Did you know that AMDA’s CPGs can reduce: costs, avoidable transfers and risk of survey penalty and litigation?

Most importantly, AMDA’s CPGs can improve: patient outcomes and safety of staff, facility & patients.

CPG implementation follows the medical care process of recognition, assessment (root cause analysis), treatment (based on assessment) and monitoring. Be able to make the case for unavoidable situations and conditions. Know that you can better manage a condition. Know that you can provide quality care for your residents!

Your online subscription will give you unlimited access to AMDA’s 22 guidelines focused on the Long-Term Care (LTC) patients and environment. AMDA Guidelines emphasize key care processes and are organized for ready incorporation into facility-specific policies and procedures to guide staff and practitioner practices and performance. They are developed specifically to address population and practice of LTC facility.

For Corporate Member Pricing, please call the Clinical Affairs Department at 410-740-9743 to receive your corporate member rate/code.

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Multi-User Electronic Clinical Practice Guidelines (e-CPGs) Subscriptions

Your facility and/or organization can subscribe to AMDA’s e-CPGs and ensure that all relevant staff have access to CPGs created specifically for the Long-Term Care Setting. Multi-User subscription plans are ideal for facilities and organizations that require multiple people to access AMDA’s Clinical Practice Guideline library electronically through one account which allows concurrent usage. Multi-User Subscriptions are by far the most cost effective option.

The same information available in AMDA’s CPGs NOW available in an electronic format:
Benefits of a Multi-User Subscription:
Unlimited access to AMDA’s 22 guidelines
focused on the Long-Term Care (LTC) patients and environment.
  • Administrative privileges. Manage up to 100 users in your group (Varies based on Pack chosen i.e. 1-10, 1-25, 1-50, or 1-100)
  • Collaborate. Quick links to charts, tables and figures within CPGs; when readers see something that they want to highlight or bookmark for future reference they can do so by using the notes or bookmark options
  • Mobile. Evidence based, up to date information at your fingertips; available when you need it 24 hours a day, 7 days a week
  • Content. Digital editions have embedded web links, allowing you to jump to pages, tables, and references that enrich your experience, bringing the product to life giving you additional details without having to search
  • Improve workflow. Find answers and solve problems anytime, anywhere with instant updates to the CPGs with the latest advisories and changes in medical protocols
  • Transform teamwork. Learn as a team; Research and find your answers in a flash

Frequently Asked Questions:

  • Login information can be found on your order confirmation email which contains your purchased downloadable product(s) and login information.
  • E-subscription is good for one year from date of purchase.
  • Renewals must be done within 30 days of subscription ending.

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Clinical Practice Guidelines: Complete Set of CPGs

Includes 22 guidelines (one copy of each current CPG).

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Clinical Practice Guideline: Acute Change of Condition (© 2003, last reviewed 2012)

In the long-term care setting a primary goal of identifying acute change of conditions (ACOC) is to enable staff to evaluate and manage a patient at the facility and avoid the transfer to a hospital or emergency room (ER). To achieve this goal, the facility's staff and practitioners must recognize an ACOC and identify its nature, severity, and cause(s). The approach to recognition, assessment, treatment, and monitoring of ACOCs proposed in this guideline should result in better management of these events and fewer transfers to hospitals and other acute-care settings.

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For additional information, visit the Clinical Corner on Acute Change of Condition.

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Clinical Practice Guideline: Altered Nutritional Status (© 2011)

Weight has emerged as a principal screening and monitoring indicator in LTC because it is easy to measure and the measurement is reasonably accurate and reproducible, noninvasive, acceptable to most patients, and relatively inexpensive to obtain. Among patients who remain in LTC for at least 2 years, 50 - 60% experience weight change; equal numbers of patients gain and lose weight.

The guideline offers a structured approach to the recognition, assessment, treatment, and monitoring of altered nutritional status (ANS) that acknowledges the ethical implications of this condition for patients, their families, and the staff of LTC facilities. It is intended that this guideline be helpful to those who develop and determine institutional policies and procedures and the survey processes at the federal and state levels.

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For additional information, visit the Clinical Corner on Nutrition & Hydration.

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Clinical Practice Guideline: Anemia (© 2007, last reviewed 2012)

Anemia is common in the long-term care setting, with a prevalence ranging from 34 - 60%, increasing with each decade of life over age 70. Anemia often goes unevaluated or is inadequately evaluated in the frail elderly. Studies suggest the importance of treating anemia to improve patients’ overall health and prevent certain comorbid conditions.

This CPG focuses on the recognition and management of anemia that may improve patient function, outcomes, and overall quality of life, as well as reduce healthcare costs.

Outcomes that may be expected include:

  • Comprehensive evaluation of the causes of anemia when appropriate;
  • Better recognition and more appropriate management of anemia;
  • Improvement in patients’ functional status, cognitive function, exercise performance, and quality of life;
  • Reduced morbidity and mortality; and
  • Reduced medical-care costs as a result of a reduced need for blood transfusions.

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Clinical Practice Guideline: Common Infections (© 2011)

Infections are a significant source of illness and death in the long-term care (LTC) setting. It is estimated that between 1.6 million and 3.8 million infections occur annually among patients in LTC facilities. Infections account for up to half of all transfers from LTC facilities to hospitals and result in an estimated 150,000 - 300,000 hospital admissions annually. Numerous studies indicate that pneumonia, urinary tract infections, and skin and soft-tissue infections account for nearly 75% of all infections acquired in the LTC setting. This guideline focuses on management of the four most common types of infections occurring in long-term care - urinary tract, respiratory, gastrointestinal, and skin infections. The guideline also discusses infection control, colonization versus true infection, and antibiotic resistance in long-term care facilities.

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For additional information, visit the Clinical Corner on Infection Control.

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Clinical Practice Guideline: COPD Management (© 2010)

Chronic obstructive pulmonary disease (COPD) causes more than 80,000 deaths annually and is the fourth leading cause of death in the United States after heart disease, cancer, and stroke. In contrast to other major chronic diseases, prevalence of and mortality from COPD are increasing. Recognition, assessment, treatment, and monitoring of COPD in the long-term care setting can be challenging.

Expected outcomes from implementing this guideline may include earlier identification and better differential diagnosis of COPD, better symptom control, increased patient function in activities of daily living and participation in social activities, decreased anxiety and depression caused by shortness of breath and other COPD symptoms, more appropriate use of oxygen therapy and medications to treat COPD - resulting in improved resource utilization, decreased patient care costs, reduction in rates of viral and bacterial infections in COPD patients, reduction in the frequency of hospital transfers in acute exacerbations of COPD, better understanding of when and how to initiate palliative care, and enhanced comfort care for patients with end-stage COPD.

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Note: To earn AMA PRA category 1 credit, see the CME insert included with this CPG or go to www.amdacmedirect.com/copd.

For additional information, visit the Clinical Corner on Chronic Obstructive Pulmonary Disease (COPD).

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Clinical Practice Guideline: Dehydration and Fluid Maintenance (© 2009, last reviewed 2012)

This CPG offers a structured approach to the recognition, assessment, treatment, and monitoring of dehydration and fluid and electrolyte imbalances and acknowledges the ethical implications of this condition for patients, their families, and the staff of long-term care facilities. It provides educational components such as how to differentiate between dehydration and fluid and electrolyte imbalance, how to document varieties of fluid and electrolyte imbalance, and how to manage hydration issues in those with end-stage and terminal illnesses. It also provides a step-by-step approach to address the condition with a corresponding treatment algorithm.

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For additional information, visit the Clinical Corner on Nutrition & Hydration.

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Clinical Practice Guideline: Delirium and Acute Problematic Behavior (© 2008, last reviewed 2012)

Problematic behavior and delirium are common in short-stay and long-term residential facility populations. Although disease or organ dysfunction may cause or affect behavior, disruptive or problematic behavior is not an illness or disease and 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 facilitates effective management and serves the best interests of both patients and facilities. Following the steps in this guideline should enable staff and practitioners to optimize their approach to these issues.

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For additional information, visit the Clinical Corner on Delirium and Acute Problematic Behavior.

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Clinical Practice Guideline: Dementia (© 2012)

Dementia, a disorder characterized by progressive decline in multiple areas of cognitive function, causes a range of cognitive, mood, behavioral, and functional impairments. Optimal management of dementia involves the entire interdisciplinary team, with practitioners playing an important leadership role. This guideline offers a systematic approach to the recognition, assessment, treatment, and monitoring of patients with dementia. Implementing this guideline should help LTC facilities:

  • Identify patients at risk for new or progressive dementia;
  • Manage dementia symptoms, consequences, and complications effectively and appropriately;
  • Identify the nature and causes of dementia in patients;
  • Identify and manage potential sources of excess disability;
  • Minimize preventable complications and functional decline;
  • Respond appropriately to the changing needs of patients with dementia;
  • Make appropriate environmental and staffing modifications to maximize patient dignity, comfort, and safety; and
  • Improve the understanding of staff, family members, and caregivers about dementia and respond appropriately to their concerns.

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For additional information, visit the Clinical Corner on Dementia.

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Clinical Practice Guideline: Depression (© 2011)

Depressive symptoms are common among older adults and can have a major effect on their quality of life. It has been estimated that between 12 and 16% of older adults living in long-term care facilities have major depression and 50% may have a minor depressive disorder.

This tool assists the interdisciplinary care team through a process of recognition, diagnosis, treatment, and monitoring of depression in the longterm care facility resident. It includes an expanded section on pharmacology and strategies to assist in diagnosing and managing depression.

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For additional information, visit the Clinical Corner on Depression.

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Clinical Practice Guideline: Diabetes Management (© 2011, currently in revision)

Residents of long-term care (LTC) facilities who have diabetes often take multiple medications and who experience frequent infections, high rates of cardiovascular complications, dehydration, hospitalizations, hyperosmolar states, and physical and cognitive disability.

A comprehensive approach to diabetes management may improve glycemic control and reduce the progression of existing complications that result in morbidity and premature mortality. This guideline recommends processes that should help LTC facilities systematically manage and improve the care of residents with diabetes.

Potential benefits associated with the implementation of this guideline include:

  • Earlier identification of diabetes and its complications;
  • Better documentation of, and rationale for, patients' personal goals and decision-making processes regarding their disease and its treatment;
  • A decline in the rate of hypoglycemic and hyperglycemic events;
  • A decline in the frequency of infection, electrolyte imbalance, and dehydration;
  • A decline in the rate of progression of diabetic complications;
  • A reduction in emergency room visits and hospitalizations caused by uncontrolled diabetes;
  • A reduction in direct and indirect patient care costs as a result of more appropriate resource utilization;
  • Improved monitoring and treatment protocols; and
  • Improved staff education and awareness of this complex progressive disease.

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For additional information, visit the Clinical Corner on Diabetes.

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Clinical Practice Guideline: Falls and Fall Risk (© 2011)

This tool guides physicians, other practitioners, and staff in assessing and managing individuals who have a recent history of falls or who are at risk of falling. This guideline will help identify ways to modify some of the risk factors for falls, as well as identify ways to adjust the patient's environment to minimize the risk of injury due to falls. Nursing facility patients fall for various reasons and there are many age-related factors that contribute to a greater risk of falling. This guideline will help identify ways to modify some of the risk factors for falls, as well as identify ways to adjust the patient's environment to minimize the risk of injury due to falls.

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For additional information, visit the Clinical Corner on Falls & Fall Risk.

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Clinical Practice Guideline: Gastrointestinal Disorders (© 2006, last reviewed 2012)

Although aging has relatively minimal effects on gastrointestinal (GI) function, age-related changes can cause or contribute to several GI disorders. 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 concurrent conditions and use numerous medications that may complicate the assessment and treatment of GI disorders. GI disorders may be caused or exacerbated by a variety of 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 a cough. These conditions can prevent patients from participating in activities, hinder their mobility, disrupt their sleep, and cause them to become socially isolated. This guideline focuses on 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.

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Clinical Practice Guideline: Health Maintenance (© 2012)

Health maintenance in long-term care settings incorporates systemic, proactive approaches that promote patients’ physical, emotional, psychological, cognitive, and functional integrity. Early detection and prevention of illness may reduce morbidity and mortality in the elderly.

Standard published guidelines for preventive care may be insufficient when applied to populations such as the frail, institutionalized elderly. Implementation of individualized preventive care measures may represent an opportunity to improve longevity or quality of life for frail elders. This clinical practice guideline focuses on primary prevention, to the extent that it is feasible and beneficial in the frail elderly long-term care population.

Outcomes that may be expected from the implementation of this clinical practice guideline include the following:

  • Improved health and well-being of patients,
  • More appropriate resource utilization,
  • A reduction in the number of patients who receive inappropriate interventions or care,
  • An increase in the number of patients who receive appropriate interventions and care,
  • Facilitation of patient-centered care goals (i.e., goals that are appropriate to patients’ needs and wishes),
  • Improved awareness among health care providers and facility staff of appropriate preventive health interventions for patients in the LTC setting,
  • Better-informed patients and patients’ families or advocates, with more appropriate expectations about patients’ care goals, and
  • Improved quality outcomes and reporting to government and other agencies.

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Clinical Practice Guideline: Heart Failure (© 2010, currently in revision)

Heart failure is one of the most common reasons for new or recurrent hospitalizations among persons over 65 years of age. Considerable progress has been made during the past decade in providing symptomatic relief for such patients. By implementing the processes and practices outlined in this guideline, and by keeping up with new recommendations for managing heart failure as they emerge, the interdisciplinary care team can improve the quality of life for patients with heart failure in the nursing facility.

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Note: To earn AMA PRA category 1 credit, see the CME insert included with this CPG or go to www.amdacmedirect.com/heartfailure.

For additional information, visit the Clinical Corner on Heart Failure.

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Clinical Practice Guideline: Osteoporosis and Fracture Prevention (© 2009, last reviewed 2012)

The aging process, the postmenopausal state, low calcium intake, lack of physical activity, and other risk factors predispose the elderly to low bone mass. Most elderly nursing facility patients have age-related changes in bones, resulting in a lower than normal bone mass. This tool will guide the physician in the recognition, diagnosis, and management of patients with osteoporosis or patients who are at risk for osteoporosis.

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For additional information, visit the Clinical Corner on Osteoporosis.

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Clinical Practice Guideline: Pain Management (© 2012)

Pain is common in the LTC setting. As many as 80% of LTC patients have at least one condition associated with pain. Although disorders that can cause pain become more common with increasing age, pain itself is not a normal part of aging.

This guideline outlines many of the myths and misperceptions about pain and discusses the barriers to effective pain management and offers steps for overcoming these barriers.

This CPG is not intended to be a comprehensive treatise on all possible types of pain or on all evaluations, interventions, or medications for pain. Rather, it should serve as a foundation for a systematic approach to the recognition; assessment; treatment; and monitoring of pain in LTC care patients. It is also hoped that, in some cases, it should be possible to anticipate and prevent pain from occurring.

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For additional information, visit the Clinical Corner on Pain Management.

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Clinical Practice Guideline: Parkinson's Disease (© 2010)

Parkinson’s Disease (PD) is a progressive, degenerative neurologic disorder. Although there is no known cure for PD, treatment can often prolong the patient’s life, improve mobility and function, and enhance dignity and quality of life. Early detection of PD is essential to effective treatment.

Understanding all the manifestations of the disease; the importance of basic, competent primary nursing and medical care; the roles of various disciplines, therapies, and specialties; and the concept of realistic goal setting for the individual patient are essential to effective treatment of PD. Effective treatment should be multifaceted, taking into consideration the patient’s physical, spiritual, social, and emotional needs and concerns, as well as those of the family.

Potential benefits associated with the implementation of this guideline include:
  • Better management of PD, allowing patients to maintain their highest practicable physical, mental, and psychosocial function;
  • Greater individualization of care;
  • Better documentation of, and rationale for, patients' personal goals and decision-making processes regarding their disease and its treatment;
  • More appropriate pharmacologic therapy for PD;
  • More appropriate practitioner participation in the care of the patient with PD;
  • Improved patient and family satisfaction with care;
  • More appropriate resource utilization;
  • Improved treatment and monitoring protocols;
  • Improved staff education and awareness of this complex progressive disease; and
  • More appropriate and timely referral to palliative care and hospice.

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Note: To earn AMA PRA category 1 credit, see the CME insert included with this CPG or go to www.amdacmedirect.com/parkinsons.

For additional information, visit the Clinical Corner on Parkinson's Disease.

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Clinical Practice Guideline: Pressure Ulcers (© 2008, last reviewed 2012)

This guideline includes updates for staging according to the 2007 National Pressure Ulcer Advisory Panel (NPUAP).  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.

The 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; and
  • The resident’s rights to refuse one or more aspects of pressure ulcer care.

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For additional information, visit the Clinical Corner on Pressure Ulcers.

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Clinical Practice Guideline: Sleep Disorders (© 2007, last reviewed 2012)

Sleep problems are common among residents of long-term care (LTC) facilities. 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 LTC population. The CPG focuses on the evaluation and management of sleep disorders that are secondary to chronic medical conditions or environmental issues.

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;
  • 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.

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For additional information, visit the Clinical Corner on Sleep Disorders.

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Clinical Practice Guideline: Stroke Management and Prevention (© 2011)

Survivors of an acute stroke who are transferred to a long-term care facility need a multidisciplinary assessment and treatment plan that lowers risk for post-stroke complications, helps to optimize physical and cognitive function, and reduces the risk of stroke recurrence. This guideline will help the facility care team individualize its approach to stroke evaluation, treatment, and prevention and reach shared decisions about care that consider the patient's physical and cognitive status, prognosis, goals of therapy. It includes an assessment of the benefits, burdens, and alternatives to evaluations, tests, and treatments. Caregiving staff will learn how to respond and with whom to communicate when they recognize the signs and symptoms that may signal an acute stroke or stroke complications.

Stroke management falls into three categories of urgency

  • Acute stroke (a medical emergency that should be addressed immediately);
  • Post-stroke; and
  • Stroke prevention.

The steps in this guideline are relevant in the context of those categories. These differences are reflected in the text by the use of color-coded labels.

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For additional information, visit the Clinical Corner on Stroke Management and Prevention.

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Clinical Practice Guideline: Transitions of Care (© 2010)¥

Transitions of care involves the movement of a patient between care settings and the transfer of information with them to facilitate a seamless continuum of care and to enable patients’ wishes to be followed - no matter where in the continuum of care they are. This is an important issue, as care for today’s elderly people is more complex than ever. It may involve a wide variety of care settings over time including community-based care, home care, hospital care, sub-acute care, rehab, skilled nursing care, assisted living, and hospice. As an elderly person gets sicker or gets better, he or she may move from setting to setting, such as from a hospital to a nursing home or rehabilitation facility or from home to an assisted living facility. It is important that these transitions of care between settings are handled smoothly and effectively.

This guideline will help to ensure smooth transitions of care. It is available as a free download at https://www.amda.com/members/flashpapers/papers/TOC/.

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For additional information, visit the Clinical Corner on Transitions of Care.

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Clinical Practice Guideline: Urinary Incontinence (© 2012)

Urinary incontinence is one of the most common conditions among residents of LTC care facilities, affecting about 55% of all such residents. The prevalence of urinary incontinence increases with age. Women are affected more than men. Although urinary incontinence is increasingly prevalent with age, it is not a normal part of aging.

Urinary incontinence can adversely affect patients’ dignity and can contribute to depression, embarrassment, and social isolation. The annual cost of managing urinary incontinence in LTC care facilities is estimated at $5.5 billion.
Outcomes that may be expected from the implementation of this clinical practice guideline include the following:

  • Better identification of individuals who have a reversible urinary incontinence problem.
  • More individualized approaches to urinary incontinence management.
  • More effective targeting of staff resources to urinary incontinence management.
  • Minimization of inappropriate use of diapers and catheters.
  • Reduction in significant complications of urinary incontinence and urinary catheters.

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For additional information, visit the Clinical Corner on Urinary Incontinence.

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