A Model for Implementing a Vitamin D3 Regimen in a Skilled Nursing Facility
|Michael Gloth F1*, Jennifer Coates2, Kim Adams3 and Elizabeth Hidlebaugh4|
|1Department of Medicine, Johns Hopkins University School of Medicine, USA|
|2Moorings Park Healthy Living, The Center for Healthy Living, Naples, Florida, USA|
|3Department of Nursing, The Chateau, Moorings Park, The Center for Healthy Living, Naples, Florida, USA|
|4Medical Student, St. George’s University School of Medicine, The Center for Healthy Living, Naples, Florida, USA|
|Corresponding Author :||Michael Gloth F, MD
Associate Professor of Medicine
Johns Hopkins University School of Medicine
Chief Medical Officer, Moorings Park Healthy Living, USA
E-mail: [email protected]
|Received April 09, 2014; Accepted June 13, 2014; Published June 16, 2014|
|Citation: Gloth FM, Coates J, Adams K, Hidlebaugh E (2014) A Model for Implementing a Vitamin D3 Regimen in a Skilled Nursing Facility. J Gerontol Geriat Res 3:160. doi:10.4172/2167-7182.1000160|
|Copyright: © 2014 Gloth FM et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Purpose: To describe a process for implementing widespread Vitamin D3 supplementation in a skilled nursing home setting that didn’t require laboratory assessment and was acceptable in a state regulatory environment.
Methods: After a discussion with state officials, a chart review of all long-term care residents in a nursing home (The Chateau at Moorings Park) was conducted to identify risk factors noted in a review of medical literature for vitamin D deficiency. Data were also collected on whether or not the patient had been given a Vitamin D deficiency diagnosis, treated with Vitamin D and what dosage, and if there were 25-OH Vitamin D serum level evaluations.
Results: Seventy resident charts were reviewed. Thirty-two men and 38 women comprised the cohort evaluated. Hours of sunlight per day (60%), menopause (54%), and muscle weakness (69%) were found to be the most common risk factors present in this population and every patient met at least one risk factor. Also, four patients had a Vitamin D deficiency diagnosis and twenty patients were taking Vitamin D.
Conclusion: A screening process without facility-wide laboratory testing for Vitamin D status was acceptable to state regulators. All nursing home patients in this cohort were at risk for Vitamin D deficiency even though they may have had access to the sunshine outdoors. A process for facility-wide Vitamin D supplementation was successfully developed that was acceptable to state officials without requiring laboratory assessment of vitamin D status from every resident. Even so, the process was inconvenient and time-consuming. If these findings are replicated in other facilities, it may be reasonable recognize a sufficiently high risk of vitamin D deficiency in nursing homes and accept facility-wide vitamin D supplementation. Our report supports such a practice while not compromising the principles of individualized medical care in the nursing home environment.