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Two MRSA Categories Defined

When you think of methicillin-resistant Staphylococcus aureus (MRSA) infections, you probably think of patients with weakened immune systems, who acquired their infections in the hospital or a long-term care facility. However, the Centers for Disease Control (CDC) now differentiates between MRSA infections acquired in healthcare facilities (HA-MRSA) and those acquired in the community (CA-MRSA).


CA-MRSA infections are acquired by persons who have not been hospitalized within the past year and have not had a medical procedure (such as dialysis, surgery, or catheter placement). These infections usually present as skin infections, such as pimples and boils, and frequently occur in otherwise healthy people (


The CDC estimates that 25% to 30% of the American population is colonized with staphylococcus, and approximately 1% is colonized with MRSA. To prevent the spread of staphylococcus and MRSA infections, the CDC recommends:


* Keep cuts and scrapes clean and covered with a bandage until healed.

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* Avoid contact with other people's wounds or bandages.


* Avoid sharing personal items, such as towels or razors.


* Wash hands thoroughly with soap and water or an alcohol-based sanitizer.



Act Now for Your Tomorrow

By now everyone knows we face a healthcare crisis: With the ever-increasing nursing shortage, who is going to care for the ever-increasing elderly and disabled patient population? For anyone who wishes to have a global understanding of the issues and solutions to the long-term care needs of these patients, the National Commission on Nursing Workforce for Long-Term Care's final report, Act Now for Your Tomorrow, is a "must read." The document includes an analysis of future patterns and trends and identifies best practices for recruiting and retaining a workforce to care for patients with long-term needs. The document is available at


Guide to Clinical Preventive Services

When patients ask how often they should have check-ups or screening tests, you can give them the latest guidance from the U.S. Preventive Services Task Force. Since 1998, the Agency for Healthcare Research and Quality (AHRQ) has sponsored a panel of primary care and prevention experts to develop recommendations for clinical preventive services. Now their recommendations are available as a pocket guide, The Guide to Clinical Preventive Services (2005; AHRQ publication no. 05-0570). The guide is available for free in print and electronic versions:


* Print copy: Call the AHRQ Publications Clearinghouse at 1-800-358-9295.


* Downloadable copy:


* PDA program:



Tools to Support Hospice Certification and Recertification

Two new tools to help clinicians improve certification and recertification documentation for hospice patients are available at: Each tool is a 1-page documentation guide, which will help clinicians focus their documentation:


* Documentation Tool: "Suggestions for Improved Documentation to Support Medicare Hospice Services" for use in initial certification.


* Recertification Tool: "Appropriate Clinical Factors to Consider During Recertification of Medicare Hospice Patients."



Additional information about using the tools can be found in Cahaba GBA's newsletter, Medicare: A Newsline (June 2005, vol. 12, no. 9, p. 114).


Is Your Patient Ready to Quit Smoking?

Despite the known adverse effects of smoking, 40 million Americans continue to smoke, even though 4 of 5 smokers would like to quit. Do you have a patient who is ready to quit? The National Cancer Institute can help you help your patient with two resources:


* Web site: includes multiple resources, including a step-by-step plan for preparing to quit, actually quitting, and staying quit.

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* Hotline: Patients can get advice and support in English or Spanish by calling 1-877-44UQUIT or 1-877-448-7848.



Nurses Hear the Cry of the Poor

According to the International Council of Nurses (ICN), poverty causes ill health and "nurses have a vital role in reducing poverty and its impact on health and well-being" ( The ICN suggests ways that nurses can help eliminate poverty, including:


* Advocate for the hungry and lobby against poverty;


* Partner and network with groups working to eliminate poverty.



Web sites that facilitate advocacy and networking to end poverty and hunger include:


* Bread for the World:




* Oxfam:



Create the World You Wish to See

Have you ever wished you could give your congressional representative a piece of your mind about a nursing or healthcare issue? Have you ever wanted to make the public aware about the effect of a health-care regulation or policy? If so, you are interested in advocacy. An American Nurses Association (ANA) Web site ( makes advocacy easy. Click on "Federal Advocacy," and a host of advocacy resources are at your fingertips, including:

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* Current health-related legislation in Congress and an analysis of how each proposed bill affects nursing and healthcare.


* Instant e-mail access to your representatives, obtained by entering your zip code, with suggested letters and talking points on important current nursing and healthcare issues.


* An RN Activist Toolkit, including tips on writing to the media, contacting your federal and state representatives, and lobbying.


* Application to be an official liaison from the ANA to your congressional representatives.



How You Can Help Our Home Care and Hospice Colleagues Affected by Hurricane Katrina

We are concerned for our colleagues who work in the homes and communities that are affected or demolished by Hurricane Katrina. From all of us atHome Healthcare Nurseand our publisher, Lippincott Williams and Wilkins, we extended our love and support to everyone involved. There are several ways we can help with donations and support specially targeted for home care and hospice.


Ongoing Home Care Information and Links for Providers and Volunteers

The Louisiana Association for Home-care has placed important facts and ways to help on its Web site The Web sites has links to house and employ people and other ways to help.


Hurricane Katrina Homecare Recovery Fund and Recover Center

The home care associations of Louisiana (HCLA), Mississippi (MAHC), and the Home Care Association of Alabama have collaborated to open the recovery fund and recovery center, both aimed at assisting home care employees and their agencies.


The Hurricane Katrina Homecare Recovery Fund is a 501-C3 corporation that allows tax-deductible donations. All funds received will be focused solely on helping the home care employees in the affected areas. Donations can be made at Checks to the account can be made to the Hurricane Katrina Homecare Recovery Fund and mailed to:


Hurricane Katrina Homecare Recovery Fund


223 East Main St.


New Iberia, LA 70560


Hurricane Katrina Homecare Recovery Center (HKHRC) Opens

The Hurricane Katrina Homecare Recovery Center opened today in New Iberia, Louisiana. The 2000-sq.-foot office, 110 miles west of New Or-leans, is providing work space at no cost to displaced home care agencies to maintain and reconstitute their businesses electronically. Along with necessary office furniture, equipment, computers, high-speed internet access, phone lines, and a receptionist, the Center will host visits for Palmetto GBA assistance and possible CMS visits. Public health and disaster response specific to home health will be provided to agencies by RBC Limited of New York, the recognized national expert in home care disaster response.


The National Association for Home Care and Hospice Task Force

NAHC is coordinating the industry's response to the devastation. NAHC President Val J. Halamandaris appointed Barbara Citarella, President of RBC Limited and NAHC Vice President for Regulatory Affairs, Mary St. Pierre to co-chair this Hurricane Relief effort otherwise known as HRTF. Updates can be accessed at


The Task Force advises individuals from the home care community interested in working in an affected State should contact Ms. Citarella at RBC Limited ( Barbara will take their name, profession, phone number(s), email address, agency name and identify any specialized training a person has.


National Hospice and Palliative Care Organization (NHPCO)

NHPCO is serving as a conduit for the release of assistance grants from the National Hospice Foundation to state organizations coping with this disaster. Monetary donations also are being accepted by the National Hospice Foundation to provide assistance to hospice and palliative care providers. These gifts will be distributed through coordinated efforts with state hospice and palliative care organizations and other providers.


Gifts may be made online at or by check payable to National Hospice Foundation (make a notation of "Hurricane Relief Efforts" on the check) and send to:


National Hospice Foundation


Attn: Hurricane Relief Effort


Department 929


Alexandria, VA 22334-0929


Organizations wishing to offer staff support or supplies should contact Andy Duncan at NHPCO, 703-837-3145 or, to indicate what resources they are able to offer.