alexa A Model for Implementing a Vitamin D3 Regimen in a Skilled Nursing Facility
ISSN: 2167-7182

Journal of Gerontology & Geriatric Research
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Research Article

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
Tel: 239-430-6387
Fax: 239-430-6365
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.

Abstract

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.

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