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Question: With all the snow and cold weather this winter, it's been difficult for many of our elders to get outside much. We've suggested that they sit in a sunny spot, near a window, where they can spend time soaking up Vitamin D! Generally, they will ask for a sweater or blanket to avoid becoming chilled. Please review hypothermia in the elderly.

Reply: Thanks for submitting our first question, timely too! We'll do an overview first . . . 

Question: While networking with other facilities, a question arose about possible safety defects in patient lifters. The question had to do with the mechanism that holds the sling pin in place breaking, causing the sling to drop to the floor. Will the nurse consultants research this?

Reply: QINC reviewed the Manufacturer and User Facility Device Experience Database (MAUDE) at the Federal Drug Administration. The majority of reports for 2000 indicated improper maintenance of equipment or improper use of equipment as the cause of accidents with this device. To prevent injury to residents or caregivers, thoroughly check your equipment on a regular basis and provide routine and special maintenance according to manufacturer's guidelines. A maintenance log indicating the device was checked and any maintenance performed is an easy way to document these safety efforts. Make sure your staff is properly trained in the use of equipment.

Question: Our facility is considering replacing our dishwasher. Do you have any information on the chemical sanitizing models?

Reply: Dishes washed in a chemical sanitizer model dishwasher require a longer time to air dry since the water temperature utilized in the final rinse is lower than that of the hot water models. The chemical sanitizers can use colder water in the final rinse since the dishes are not sanitized by hot water temperature. To avoid a citation, you must allow sufficient time for the dishes to air dry before storing them. Do not store wet dishes . Possible solutions include providing more counter space on the clean side of the drain board to allow all dishes to air dry, or increasing the water temperature of the final rinse, as the use of hotter water will decrease drying time.

Question: Please clarify the interpretation of F368 relative to making evening snacks available for residents.

Reply: With regard to evening snacks, Federal Regulations state that all residents must be offered nourishing bedtime snacks from the basic food groups. It does not meet the requirement to simply have the snacks available for consumption. Nutritional adequacy and level of satisfaction with the snack will be determined by resident interview, observation, and record review of overall nutritional status of the residents.