The Texas Quality Matters website was developed by the Center for Policy and Innovation (CPI) at the Texas Department of Aging and Disability Services (DADS). This website will direct you to a variety of resources and initiatives. Texas Quality Matters will be our way to provide information to you.
The Texas Department of Aging and Disability Services, in collaboration with TMF Quality Innovation Network Quality Improvement Organization (QIN-QIO), is presenting the TRAIN initiative statewide in an effort to reduce the inappropriate use of antipsychotic medications in Texas nursing facilities.
In order to establish a baseline measure of antipsychotic use across the state, we have developed this short eight question survey for you to complete regarding the current practices in your nursing facility. This survey is 100% anonymous and will not be used to single out any specific facility's practices. We would greatly appreciate it if you would take a few minutes to fill out the survey.
The survey will be open for entry from 8/8/2014 through 9/18/2014. Please click on the link below and answer the questions to the best of your ability. If you choose to participate in this survey, we ask that you also complete a follow-up survey that will be conducted in September 2015. Thank you for providing us with the information we need to tackle this issue.
TRAIN Survey: https://www.surveymonkey.com/s/CLMYMM3
DADS staff, in collaboration with TMF Quality Improvement Organization (QIO) staff and other stakeholders, is developing a statewide project to reduce the use of antipsychotic medications in nursing homes. The TRAIN (Texas: Reducing Antipsychotics In Nursing homes) project will also address pain management in residents with dementia, identify alternative strategies for managing behaviors associated with dementia and explain the survey implications of F-tags 309 and 329.
Phase I of the TRAIN project will consist of a day-long training session, offered in various locations across the state in July and September 2014. In addition to the educational presentations provided during each session, providers will be offered the opportunity to sign-up for individualized assistance and support targeting their facility’s specific needs.
Phase II of the project will be the provision of individualized assistance and support to facilities, provided by members of an interdisciplinary team. Team members may include any of the following:
Dates and locations for the remaining Phase I Training sessions are being evaluated. The plan is to hold four more trainings in October. Once the dates and locations are finalized, information on this site will be updated and notices sent out through Gov Delivery.
This continuing nursing education activity was approved by the Texas Nurses Association, an accredited approver by the American Nurses Credentialing Centerâ€™s Commission on Accreditation.
In April 2014, the mandatory requirements for reporting communicable diseases were updated to include Carbapenem Resistant Enterobacteriaceae (CRE) and Multi-drug Resistant Acinetobacter (MDRA). While there are many species of Enterobacteriaceae, only CRE-Ecoli and CRE — Klebsiella are on the list of notifiable conditions. The full list of notifiable conditions is available on the Department of State Health Services (DSHS) website http://www.dshs.state.tx.us/idcu/investigation/conditions/.
Any lab finding of CRE-Ecoli, CRE-Klebsiella or MDRA must be reported immediately regardless of the site of infection, even with colonization or surveillance cultures. Reports should be submitted immediately to the local health department or to DSHS using the facility’s standard reporting form or DSHS’s EPI 2 form: http://www.dshs.state.tx.us/idcu/investigation/forms/. Consultation with the local health department or reporting jurisdiction is necessary to identify the best method for reporting notifiable conditions after hours, during holidays or on weekends.
Each facility should have policies in place to ensure appropriate infection prevention precautions are initiated once a case of CRE or MDRA is identified, even if infection control staff is not on-site. In addition, the facility should ask the laboratory to save the isolates for 3 months to allow for identification of any related cases through DNA fingerprinting.
For more information, contact your local health department or
Jessica Ross, CIC
Infectious Disease Control Unit
Department of State Health Services
On December 20, 2013, the Texas Department of State Health Services (DSHS) issued an influenza health alert. Influenza is now widespread across the state, and influenza-like illness activity continues to increase. The DSHS Health Alert is available at http://www.dshs.state.tx.us/news/releases/20131220.aspx.
While most people recover from influenza within one to two weeks, others may develop significant complications that can lead to hospitalization and even death. In most years, people over the age of 65, pregnant women, young children and people with chronic health conditions are most at risk for complications. This year the prevailing H1N1 strain is causing severe illness in otherwise healthy mid-aged adults.
Immunization is the single best method for preventing influenza and reducing the risk of complications. It is not too late to get the flu vaccine, and DSHS recommends everyone over the age of 6 months be vaccinated, especially healthcare workers to prevent transmission to others. The prevailing strain is contained in this year's vaccine.
Antiviral treatment, when started within 48 hours of the onset of illness, may reduce the risk of complications and death, while possibly shortening the length of hospitalization. According to DSHS, antiviral treatment is recommended for anyone with confirmed or suspected influenza who is:
Other resources for further information regarding influenza and the influenza vaccine include:
Centers for Disease Control and Prevention (CDC) Seasonal Flu page
Texas Department of State Health Services
Department of Aging and Disability Services -- Texas Quality Matters
Tell Us What You Think
Updated: August 8, 2014