Welcome to the Care Homes page

If you’d like to see something here about medicines which is currently missing, please use the “Contact us” link at the top of the page or e-mail ghccg.swyapc@nhs.net.

Infections

Urinary Tract infection: diagnostic tools for primary care from PHE flowcharts (updated  Sept 2019) describes when to send for urine cultures and when to consider a UTI in adults >65 years, women <65 years and in children.  The flow chart for adults >65 has been updated to reflect NICE guidance on managing catheter-associated UTIs.

The form to complete and send to the GP if an older resident has a suspected urinary tract infection will be updated once national guidance has been updated.

Out of hospital management of UTIs in elderly patients

Good hydration in six parts:

Part 1 – The Urinary System

Part 2 – Spotting the sign of dehydration

Part 3 – Improving Hydration

Part 4 – Medicines, kidneys and urine

Part 5 – Urinary tract infection (UTI)

Part 6 – Improving hydration through structured drinks rounds

To dip or not dip

 

‘To Dip Or Not To Dip’ has a network of health and social care professionals who are improving the management of UTI in older people in care settings throughout the UK. To join this community email Elizabeth Beech (National Project Lead Healthcare Acquired Infection and Antimicrobial Resistance NHS Patient Safety Team, NHS Improvement)

elizabeth.beech@nhs.net

Twitter:

@elizbeech and #ToDipOrNotToDip

 

See also the Antimicrobial Guidelines for Primary Care .

 

Public Health England has issued ‘Guidelines on the management of outbreaks of influenza-like illness in care homes’ Influenza-like_illness_in_care_home_2018

 

Public Health England has issued guidance about infection control in residents with Candida auris.

SAFE USE OF EMOLLIENT SKIN CREAMS TO TREAT DRY SKIN CONDITIONS

Take care when using creams to treat dry skin conditions as they can easily dry onto clothing, bedding and bandages making them more flammable.

Watch this video and share it with your family or carer:

 Skin creams, sometimes known as emollients are used by many people every day to help manage different dry skin conditions such as eczema, psoriasis and ichthyosis.

The creams are easily transferred from skin onto clothing, bedding and bandages.  Tests and research have shown that the dried-on cream makes the fabric more flammable and the resulting fire burns quickly and intensely, resulting in serious injury or death.

It’s important for anyone using these creams to avoid any naked flame.

If you use an emollient or skin cream to treat a dry skin condition, please follow this advice.

Avoid smoking

Do not smoke, use naked flames or get near to anything which may cause a fire whilst wearing clothing or a bandage that has been in contact with skin creams.

If this is not possible, you must take steps to ensure you are safe when you smoke or use naked flames. For example, by using a flameless lighter or e-cigarette, and removing long sleeved or baggy clothing before using a gas hob.

Change and wash clothes and bedding

Change and wash your clothes and bedding frequently to reduce the build-up of skin cream. However, remember that whilst washing your clothing and bedding even at high temperatures might reduce the build-up, it does not remove it completely and the danger may remain.

Keep cream off furniture

Be careful to make sure the skin cream does not get onto the fabric of armchairs or other furniture, cushions and blankets. Be aware that the cream can transfer from your skin onto the fabric of furniture when you are sitting or lying on it.

Tell relatives and carers

Tell your relatives or carers about your treatment and ask how they can help you to reduce the risk. Download the leaflet  for them.

For HEALTHCARE PROFESSIONALS

Ensure patients and their carers understand the fire risk associated with the build-up of dried emollient residue on clothing and bedding and can take action to minimise the risk.

When prescribing, recommending, dispensing, selling, or applying an emollient, instruct patients not to smoke, cook or go near any naked flames or heat source (gas, halogen, electric bar or open fire) whilst wearing clothing or dressings that have been in contact with emollients. If the patient cannot do this advise on measures to do so safely (e.g use safety lighters or e-cigarettes; remove long sleeved or loose clothing before cooking; put on a thick uncontaminated shirt, overalls or apron, move chairs further away from the open fire or other heat source)

Be aware that washing clothing or bedding at a high temperature may reduce emollient build up but does not totally remove it – it is important to minimise risk in additional other ways (as above).

Watch the video above and share it with your patients or customers.

Report any fire incidents associated with the use of emollients to the Yellow Card Scheme

For complex cases contact the local fire and rescue service for advice and support.

Further information is available here.

                                                                         

 

 

 

 

 

BBC News Health has again highlighted the dangers of using preparations for dry skin whilst smoking or using naked flames.

 

Wound Management

The wound management formulary has been developed by the Joint Wound Management Formulary Group.

Please click the link to navigate to the relevant sections of the wound formulary.

 

                                                                                     

Insulins

Newsletter about concern regarding high strength insulin:

UPDATED MARCH 2017 newsletter_concerns re high strengths insulins and withdrawing insulin

A patient safety alert has been issued about the risk of severe harm and death resulting from withdrawing insulin from pen devices. This notes that

56 incidents have been reported which were associated with withdrawing insulin from insulin pens or refill cartridges.

Extracting insulin from pen devices or cartridges is dangerous and should not happen.

Safer administration of insulins is included in the key therapeutic topic from NICE on Safer Insulin Prescribing.

 

Managing Medicines in Care Homes

From NICE: Guideline  on Managing Medicines in Care Homes.

Quality standard  – Medicines Management in Care Homes.

Flow chart – Managing Medicines in Care Homes.

Some things to think about when considering covert administration of medicine

Some things to consider when crushing tablets or opening capsules.

Therapeutic options for patients unable to take solid oral dosage forms

 

Some useful websites

British Geriatrics Society

 

Advice on diamorphine and Intrasite gel

The CD Accountable Officer is aware of the unlicensed use of Intrasite gel and diamorphine injection in certain settings.

The decision to use this would be a clinical judgement for the individual prescriber.

In all cases, if this is the chosen treatment, both the person administering the treatment, and the patient, must be  aware of its unlicensed status. There must also be a full audit trail for the use of the diamorphine (including destruction details of any part ampoules that may have been discarded).