You go to the hospital to get well, right? Of course, but did you know that you can get infections in the hospital while you are being treated for something else?

Time in the hospital can put you at risk for a healthcare-associated infection (HAI), such as a blood, surgical site, or urinary tract infection.

Every day, patients get infections in healthcare facilities while they are being treated for something else. These infections can have devastating emotional, financial, and medical effects. Worst of all, they can be deadly.

Healthcare procedures can leave you vulnerable to germs that cause HAIs. These germs can be spread in healthcare settings from patient to patient on unclean hands of healthcare personnel or through the improper use or reuse of equipment.

These infections are not limited to hospitals. For example, in the past 10 years alone, there have been more than 30 outbreaks of hepatitis B and hepatitis C in non-hospital healthcare settings such as

• outpatient clinics,
• dialysis centers, and
• long-term care facilities.

5 Tips for Patients [Video – 2:32]

Protect yourself and your family from harmful germs that can cause infections

• Keep your hands clean. Regular hand cleaning is one of the best ways to remove germs, avoid getting sick, and prevent spreading germs.
• Take antibiotics only when your provider thinks you need them. Ask if your antibiotic is necessary. If you take antibiotics when you don’t need them, you’re only exposing yourself to unnecessary risk of side effects and potentially serious infections in the future. If you do need antibiotics, take them exactly as they’re prescribed.
• Watch for signs of infection and its complications, like sepsis. Get care right away—don’t delay.
  • Tell your doctor if you think you have an infection, or if your infection is not getting better or is getting worse.
• Watch out for life-threatening diarrhea caused by C. difficile. If you have been taking an antibiotic, tell your doctor if you have 3 or more diarrhea episodes in 24 hours.
• Get vaccinated against flu and other infections to avoid complications.

Sepsis is the body’s extreme response to an infection. It is a life-threatening medical emergency. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death. Learn more about sepsis.

Be a safe patient in the hospital

• Tell your doctors if you have been hospitalized in another facility, have recently received health care outside of the United States, or have recently had an infection.
• Ask your healthcare provider what they and the facility will do to protect you and your family from an antibiotic-resistant infection.
  • If you have a catheter, ask daily when it can be removed.
  • If you are having surgery, ask your doctor how they prevent infections. Also, ask how you can prepare for surgery to reduce your infection risk.
• Keep your hands clean. Make sure everyone cleans their hands before touching you. Remind healthcare personnel and your visitors to clean their hands.
• Let your doctors check you for resistant germs if needed. Hospitals need to screen patients if they’re exposed, and this helps protect you and those around you.
• Understand that if you have a resistant bacteria, healthcare providers may use gowns and gloves when caring for you.
• Allow people to clean your room while you’re in the hospital, even when it feels inconvenient for you.
  • Environmental services workers are the people who clean patient rooms in the hospital, and they are important members of the healthcare team.
  • Allowing them to clean and disinfect your room helps keep you safe by reducing your risk of developing an infection—don’t say, “come back later.”

To learn more, please visit https://www.cdc.gov/HAI/patientSafety/patient-safety.html.

Dementia: Not an Inevitable Part of Aging

A recent survey revealed that nearly half of adults aged 40 years and older think they will likely develop dementia, such as Alzheimer’s disease.¹

The truth is dementia is not a normal or inevitable part of typical brain aging. It is also important to remember that as we get older, it is common to experience some cognitive decline with typical brain aging, such as subtle changes in memory, thinking, and  reasoning. For example, you might not immediately remember where you left your car keys, but you can find them when retracing your steps, or you can’t think of the name of a person you just met; however, you remember meeting them. These subtle changes can be frustrating and should not be bad enough to affect your daily life.

Modifiable Risk Factors and Alzheimer’s Disease and Related Dementias

Modifiable risk factors are the lifestyle and behaviors that can reduce or increase a person’s chances of developing a disease. For example, there are modifiable risk factors that could reduce your risk of Alzheimer’s disease and related dementias (ADRD), slow its progression, or increase your risk of ADRD. Most modifiable risk factors for ADRD are related to cardiovascular disease and other chronic health conditions. They include hypertension, not getting enough physical exercise, obesity, diabetes, depression, smoking, hearing loss, and binge drinking. Maintaining a healthy lifestyle and managing related chronic conditions is good for your overall physical health, facilitates and improves brain health, and may help decrease the risk of dementia or slow its progression.

Common Risk Factors Among Adults 45 Years and Older

A new CDC study examined how common these eight risk factors (hypertension, not getting enough physical exercise, obesity, diabetes, depression, smoking, hearing loss, and binge drinking) were among adults 45 years and older: ² 

• Nearly 50% had high blood pressure or did not meet the aerobic physical activity guideline.
• Adults with cognitive decline were more likely to report at least 4 factors (34%) than those without cognitive decline (13%).
• 34% of adults who reported cognitive decline—worsening confusion or memory loss in the previous year—had at least 4 risk factors compared with 13.1% of those without cognitive decline.
• 9% of adults with no risk factors reported cognitive decline while 25% of those with at least 4 risk factors reported cognitive decline.
• Several modifiable risk factors were more common among African American, Hispanic, and American Indian or Alaska Native populations than other races and ethnicities.

Older African Americans have twice the incidence and prevalence of ADRD and higher burdens of chronic disease, like hypertension, than non-Hispanic White Americans.³

Ways to Improve Your Brain Health

There is encouraging scientific news despite these risk factors: nearly 40% of all ADRD may be prevented or delayed.⁴ Since ADRD takes years to develop, there are opportunities to develop and maintain healthy lifestyle habits that could reduce your risk of ADRD or slow its progression. It is never too late to break old habits and start new ones.

This healthy lifestyle habits list consists of some things you can do and some things you should try to limit or avoid.

Things You Can Do: 

• Get Active and Maintain a Healthy Weight—Regular physical activity is important for good health and combined with a healthy diet can lead to a healthy weight.

• Manage Blood Sugar—Learn how to manage your blood sugar if you have diabetes.
• Prevent and Manage High Blood Pressure—Tens of millions of adults in the United States have high blood pressure, and many do not have it under control. Learn the facts.
• Prevent and Correct Hearing Loss—Make sure to talk to a hearing care professional to treat and manage hearing loss.
• Find Support—Depression is not just having “the blues” or the emotions we feel when grieving the loss of a loved one. It is a medical condition that can be treatable.

Things You Should Try to Limit or Avoid:

• Binge Drinking—If you drink, do so in moderation. Learn about alcohol use and your health.
• Smoking—Quitting smoking improves your health and reduces your risk of heart disease, cancer, lung disease, and other smoking-related illnesses.

To learn more, please visit https://www.cdc.gov/aging/publications/features/dementia-risk-reduction-june-2022/index.html.

Happy Healthcare HR Professionals Week! Boyd Nursing and Rehabilitation is thrilled to spotlight our HR superhero, Sherry Vanhorn! Get to know Sherry:

I have worked in a business office setting in LTC for over 37 years. I have been at Boyd Nursing and Rehabilitation Center for 25 years. I have been married for 38 years to the love of my life. As an HR Manager, I have gained experience with a variety of duties. Being involved in payroll and orientation of employees has allowed me to help employees with new hire questions and also assist employees with matters related to leaves, retain, benefits and other payroll issues. Also I am the receptionist so I meet a lot of family members and vendors daily. Being the first contact of the community, I always try to be polite and helpful to them. This position has made me a better person and has made may days uplifting by developing relationships with family members, Care Team members, and managers.

We appreciate you, Sherry, and the MAGIC you provide to all of our Care Team members! Thank you for your HR leadership to our community!

There are four types of influenza viruses: A, B, C, and D. Influenza A and B viruses cause seasonal epidemics of disease in people (known as flu season) almost every winter in the United States. Influenza A viruses are the only influenza viruses known to cause flu pandemics (i.e., global epidemics of flu disease). A pandemic can occur when a new and different influenza A virus emerges that infects people, has the ability to spread efficiently among people, and against which people have little or no immunity. Influenza C virus infections generally cause mild illness and are not thought to cause human epidemics. Influenza D viruses primarily affect cattle and are not known to infect or cause illness in people.

Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus: hemagglutinin (H) and neuraminidase (N). There are 18 different hemagglutinin subtypes and 11 different neuraminidase subtypes (H1 through H18 and N1 through N11, respectively). While more than 130 influenza A subtype combinations have been identified in nature, primarily from wild birds, there are potentially many more influenza A subtype combinations given the propensity for virus “reassortment.” Reassortment is a process by which influenza viruses swap gene segments. Reassortment can occur when two influenza viruses infect a host at the same time and swap genetic information. Current subtypes of influenza A viruses that routinely circulate in people include A(H1N1) and A(H3N2). Influenza A subtypes can be further broken down into different genetic “clades” and “sub-clades.” See the “Influenza Viruses” graphic below for a visual depiction of these classifications.

This graphic shows the two types of influenza viruses (A and B) that cause most human illness and that are responsible for flu seasons each year. Influenza A viruses are further classified into subtypes, while influenza B viruses are further classified into two lineages: B/Yamagata and B/Victoria. Both influenza A and B viruses can be further classified into clades and sub-clades (which are sometimes called groups and sub-groups.) Note that this graphic is an example, and currently circulating influenza clades and subclades may differ from those presented here.

Influenza Vaccine Viruses

Current seasonal flu vaccines are formulated to protect against influenza viruses known to cause epidemics, including: one influenza A(H1N1) virus, one influenza A(H3N2) virus, one influenza B/Victoria lineage virus, and one influenza B/Yamagata lineage virus. Getting a flu vaccine can protect against these viruses as well as additional flu viruses that are antigenically similar to the viruses used to make the vaccine. Information about this season’s vaccine can be found at Preventing Seasonal Flu with Vaccination. Seasonal flu vaccines do not protect against influenza C or D viruses or against zoonotic (animal-origin) flu viruses that can cause human infections, such as variant or avian (bird) flu viruses. In addition, flu vaccines will NOT protect against infection and illness caused by other viruses that also can cause influenza-like symptoms. There are many other viruses besides influenza that can result in influenza-like illness (ILI) that spread during flu season.

To learn more, please visit https://www.cdc.gov/flu/about/viruses/types.htm.

Boyd Nursing and Rehabilitation is pleased to recognize Mrs. Deborah Thompson’s Success Story!

Deborah came to the Boyd community for rehab following a neurological event that left her with significant weakness, limited mobility, and an inability to perform basic activities of daily living. After just a few weeks of therapy services and nursing care, Deborah made a remarkable recovery! She regained her mobility using an assisted device and the ability to perform self-care activities with minimal assistance. Upon discharge, Mrs. Thompson successfully returned to her home and community living thanks to the care she received at Boyd Nursing and Rehab. Congratulations to Deborah and her Care Team on their success!

Who should get a flu vaccine this season?

Everyone 6 months and older should get a flu vaccine every season with rare exceptions. Vaccination is particularly important for people who are at higher risk of serious complications from influenza. A full listing of people at Higher Risk of Developing Flu-Related Complications is available.

Flu vaccination has important benefits. It can reduce flu illnesses, visits to doctor’s offices, and missed work and school due to flu, as well as make symptoms less severe and reduce flu-related hospitalizations and deaths.

Different flu vaccines are approved for use in different age groups.

• There are several flu shots approved for use in people as young as 6 months old and older, and two are approved only for adults 65 years and older.
• Flu shots also are recommended for pregnant people and people with certain chronic health conditions.
• The nasal spray flu vaccine is approved for use in people 2 years through 49 years of age. People who are pregnant and people with certain medical conditions should not receive the nasal spray flu vaccine.

There are many vaccine options to choose from.

• For people younger than 65 years, CDC does not recommend any one flu vaccine over another.
• For adults 65 years and older, there are three flu vaccines that are preferentially recommended for people 65 years and older. These are Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine. If none of the three flu vaccines preferentially recommended for people 65 and older is available at the time of administration, people in this age group can get any other age-appropriate flu vaccine instead.

The most important thing is for all people 6 months and older to get a flu vaccine every year.

If you have questions about which flu vaccine to get, talk to your doctor or other health care professional. More information is available at Who Should and Who Should NOT Get a Flu Vaccine.

Who Should Not Receive a Flu Shot:

Different influenza (flu) vaccines are approved for use in people in different age groups. In addition, some vaccines are not recommended for certain groups of people. Factors that can determine a person’s suitability for vaccination, or vaccination with a particular vaccine, include a person’s age, health (current and past) and any allergies to flu vaccine or its components. More information is available at Who Should and Who Should NOT get a Flu Vaccine.

Are any of the available flu vaccines recommended over others?

Yes, for some people. For the 2022-2023 flu season, there are three flu vaccines that are preferentially recommended for people 65 years and older. These are Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant  flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine. This recommendation was based on a review of available studies which suggests that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines. There is no preferential recommendation for people younger than 65 years.

What if a preferentially recommended flu vaccine is not available?

If none of the three flu vaccines preferentially recommended for people 65 years and older is available at the time of administration, people in this age group should get any other age-appropriate flu vaccine instead.

Special Consideration Regarding Egg Allergy

People with egg allergies can receive any licensed, recommended age-appropriate influenza (flu) vaccine (IIV4, RIV4, ccIIV4, or LAIV4) that is otherwise appropriate. People who have a history of severe egg allergy (those who have had any symptom other than hives after exposure to egg) should be vaccinated in a medical setting, supervised by a health care provider who is able to recognize and manage severe allergic reactions. Two completely egg-free flu vaccine options are available: Flublok Quadrivalent recombinant flu vaccine and Flucelvax Quadrivalent cell-based flu shot.

Get vaccinated before flu season starts

It takes about two weeks after vaccination for antibodies that protect against flu to develop in the body.

When should I get vaccinated against flu?

For most people who need only one dose of flu vaccine for the season, September and October are generally good times to be vaccinated against flu. Ideally, everyone should be vaccinated by the end of October. Additional considerations concerning the timing of vaccination for certain groups of people include:

• Most adults, especially those 65 years and older, and pregnant people in the first or second trimester should generally not get vaccinated early (in July or August) because protection may decrease over time. However, early vaccination can be considered for any person who is unable to return at a later time to be vaccinated.
• Some children need two doses of flu vaccine. For those children it is recommended to get the first dose as soon as vaccine is available, because the second dose needs to be given at least four weeks after the first. Vaccination during July and August also can be considered for children who need only one dose.
• Vaccination during July and August also can be considered for people who are in the third trimester of pregnancy during those months, because this can help protect their infants for the first few months after birth (when they are too young to be vaccinated).

To learn more, please visit https://www.cdc.gov/flu/prevent/vaccinations.htm.

How do I know if I have the flu?

Your respiratory illness might be influenza (flu) if you have fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and/or fatigue. Some people may have vomiting and diarrhea, though this is more common in children. People may be sick with flu and have respiratory symptoms without a fever. Flu viruses usually cause the most illness during the colder months of the year. However, flu can also occur outside of the typical flu season. In addition, other viruses can also cause respiratory illness similar to flu. So, it is impossible to tell for sure if you have flu based on symptoms alone. If your doctor needs to know for sure whether you are sick with flu, there are laboratory tests that can be done.

What kinds of flu tests are there?

A number of tests are available to detect flu viruses in respiratory specimens. The most common are called “rapid influenza diagnostic tests (RIDTs).” RIDTs work by detecting the parts of the virus (antigens) that stimulate an immune response. These tests can provide results within approximately 10-15 minutes but may not be as accurate as other flu tests. Therefore, you could still have flu, even though your rapid test result is negative. Other flu tests called “rapid molecular assays” detect genetic material of the flu virus. Rapid molecular assays produce results in 15-20 minutes and are more accurate than RIDTs.

In addition to RIDTs and rapid molecular assays, there are several more accurate flu tests available that must be performed in specialized laboratories, such as hospital and public health laboratories. These tests include reverse transcription polymerase chain reaction (RT-PCR), viral culture, and immunofluorescence assays. All of these tests require that a health care provider swipe the inside of your nose or the back of your throat with a swab and then send the swab for testing. Results may take one to several hours.

How well can rapid tests detect flu?

During a flu outbreak, a positive rapid flu test is likely to indicate flu virus infection. However, rapid tests vary in their ability to detect flu viruses, depending on the type of rapid test used, and on the type of flu viruses circulating. Also, rapid tests appear to be better at detecting flu in children than in adults. This variation in ability to detect viruses can result in some people who are infected with flu having a negative rapid test result. This situation is called a false negative test result. Despite a negative rapid test result, your health care provider may diagnose you with flu based on your symptoms and their clinical judgment.

Will my health care provider test me for flu if I have flu-like symptoms?

While your doctor may test you for flu, not everyone who goes to the doctor with flu-like symptoms will be tested. After evaluating you, your doctor may choose to diagnose you with flu without the need for testing based on your symptoms and his or her own clinical judgement.

Please visit diagnosing flu for more information.

Difference Between Flu and COVID-19

Influenza (Flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a coronavirus named SARS-CoV-2, and flu is caused by infection with influenza viruses. You cannot tell the difference between flu and COVID-19 by symptoms alone because some of the symptoms are the same. Some PCR tests can differentiate between flu and COVID-19 at the same time. If one of these tests is not available, many testing locations provide flu and COVID-19 tests separately. Talk to a healthcare provider about getting tested for both flu and COVID-19 if you have symptoms.

Can I have flu and COVID-19 at the same time?

Yes. It is possible to have flu as well as other respiratory illnesses including COVID-19 at the same time. Health experts are still studying how common this can be.

Is there a test that can detect both flu and COVID-19?

Yes. There is a test that will check for seasonal flu type A and B viruses and SARS-CoV-2, the virus that causes COVID-19. This test is being used by U.S. public health laboratories for surveillance purposes. Testing for these viruses at the same time will give public health officials important information about how flu and COVID-19 are spreading and what prevention steps should be taken. The test will also help public health laboratories save time and testing materials, and possibly to return test results faster.

The Food and Drug Administration (FDA) has given CDC an Emergency Use Authorization for this new test. Initial test kits were sent to public health laboratories in early August 2020. CDC will continue to manufacture and distribute these kits.

More information for laboratories is available.

To learn more, please visit https://www.cdc.gov/flu/symptoms/testing.htm.

Influenza is primarily a community-based infection that is transmitted in households and community settings. Each year, 5% to 20% of U.S. residents acquire an influenza virus infection, and many will seek medical care in ambulatory healthcare settings (e.g., pediatricians’ offices, urgent-care clinics). In addition, more than 200,000 persons, on average, are hospitalized each year for influenza-related complications. Healthcare-associated influenza infections can occur in any healthcare setting and are most common when influenza is also circulating in the community. Therefore, the influenza prevention measures outlined in this guidance should be implemented in all healthcare settings. Supplemental measures may need to be implemented during influenza season if outbreaks of healthcare-associated influenza occur within certain facilities, such as long-term care facilities and hospitals [refs: Infection Control Measures for Preventing and Controlling Influenza Transmission in Long-Term Care Facilities].

Influenza Modes of Transmission

Traditionally, influenza viruses have been thought to spread from person to person primarily through large-particle respiratory droplet transmission (e.g., when an infected person coughs or sneezes near a susceptible person). Transmission via large-particle droplets requires close contact between source and recipient persons, because droplets generally travel only short distances (approximately 6 feet or less) through the air. Indirect contact transmission via hand transfer of influenza virus from virus-contaminated surfaces or objects to mucosal surfaces of the face (e.g., nose, mouth) may also occur. Airborne transmission via small particle aerosols in the vicinity of the infectious individual may also occur; however, the relative contribution of the different modes of influenza transmission is unclear. Airborne transmission over longer distances, such as from one patient room to another has not been documented and is thought not to occur. All respiratory secretions and bodily fluids, including diarrheal stools, of patients with influenza are considered to be potentially infectious; however, the risk may vary by strain. Detection of influenza virus in blood or stool in influenza infected patients is very uncommon.

Fundamental Elements to Prevent Influenza Transmission

Preventing transmission of influenza virus and other infectious agents within healthcare settings requires a multi-faceted approach. Spread of influenza virus can occur among patients, HCP, and visitors; in addition, HCP may acquire influenza from persons in their household or community. The core prevention strategies include:

• administration of influenza vaccine
• implementation of respiratory hygiene and cough etiquette
• appropriate management of ill HCP
• adherence to infection control precautions for all patient-care activities and aerosol-generating procedures
• implementing environmental and engineering infection control measures.

Successful implementation of many, if not all, of these strategies is dependent on the presence of clear administrative policies and organizational leadership that promote and facilitate adherence to these recommendations among the various people within the healthcare setting, including patients, visitors, and HCP. These administrative measures are included within each recommendation where appropriate. Furthermore, this guidance should be implemented in the context of a comprehensive infection prevention program to prevent transmission of all infectious agents among patients and HCP.

To learn more, please visit https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm.

Boyd Nursing and Rehabilitation would like to recognize Ms. Shirley Morrison as our latest resident success story!

Ms. Morrison was admitted following a complicated hospitalization. When she was first evaluated by therapy, her health was compromised and she needed help with balance and mobility, strengthening, activity tolerance, and self-care deficits. With the help of physical and occupational therapy services, she learned compensatory strategies and adaptive techniques in addition to an individualized exercise plan to regain independence! Congratulations, Shirley! We are very proud of your progress and happy to have assisted you along the way!

Steps to take if you get flu

1. If you get very sick, are pregnant, or are 65 years or older, or are otherwise at high risk of flu-related complications, call your doctor. You might need antiviral drugs to treat flu.
2. Stay at home and rest.
3. Avoid close contact with well people in your house so you won’t make them sick.
4. Drink plenty of water and other clear liquids to prevent fluid loss (dehydration).

When caring for people who have flu:

• Avoid being face-to-face with the sick person. If possible, it is best to spend the least amount of time in close contact with a sick person.
• When holding sick children, place their chin on your shoulder so they will not cough in your face.
• Wash your hands often and right way.
• If soap and water are not available, use an alcohol-based hand rub.
• Make sure to wash your hands after touching the sick person. Wash after handling their tissues or laundry.

Emergency Warning Signs of Flu Complications

People experiencing these warning signs should obtain medical care right away.

In Children:

• Fast breathing or trouble breathing
• Bluish lips or face
• Robs pulling in with each breath
• Chest pain
• Severe muscle pain (child refuses to walk)
• Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
• Not alert or interacting when awake
• Seizures
• Fever above 104 degrees Fahrenheit that is not controlled by fever-reducing medicine
• In children younger than 12, any fever
• Fever or cough that improve but then return or worsen
• Worsening of chronic medical conditions

In Adults:

• Difficulty breathing or shortness of breath
• Persistent pain or pressure in the chest or abdomen
• Persistent dizziness, confusion, inability to arouse
• Seizures
• Not urinating
• Severe muscle pain
• Severe weakness or unsteadiness
• Fever or cough that improve but then return or worsen
• Worsening of chronic medical conditions

These lists are not all-inclusive. Please consult your medical provider for any other symptom that is severe or concerning.

To learn more, please visit https://www.cdc.gov/flu/treatment/caring-for-someone.htm.