Author Affiliations:

Dr. Kettl is Clinical Professor of Psychiatry, Penn State College of Medicine, Hershey, PA, and on staff at Lancaster General Hospital, Lancaster, PA.

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As people age, physical problems may increase but sexuality remains an active interest. It is estimated that approximately 60% of normal older persons have an interest in maintaining sexual activity.1 In a survey of men age 60-69 years, 52% had attempted sexual intercourse in the previous four weeks.2 Today, nursing home staff and administrators recognize that sex

Author Affiliations:

Dr. Stefanacci served as a CMS Health Policy Scholar
for 2003-2004. He is Director of the Center for Medicare Medication Management and the Geriatric Health Program at the Mayes College of Healthcare Business &
Policy, University of the Sciences, Philadelphia, PA.

Dr. Spivack is Associate Clinical Professor of Medicine, Columbia University, New York, NY; Consultant in Geriatric Medicine, Greenwich Hospital, Greenwich, CT;
and Medical Director, LifeCare, Inc., Westport, CT.

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When Medicare was created in 1965, the a

Increasing Influenza Immunization for Long-Term Care Facility Staff Using Quality Improvement

Kelly L. Sand, MPP, Joanne Lynn, MD, MA, MS, Barbara Bardenheier, MPH, MA, Hsien Seow, BS, and David A. Nace, MD, MPH

OBJECTIVES: To improve staff immunization rates for influenza in long-term care facilities (LTCFs).

DESIGN: A quality improvement project

SETTING: LTCFs ranging in size from 50 to 2,000 beds.

PARTICIPANTS: Staff members at facilities.

MEASUREMENTS: Change in staff influenza immunization rate.
RESULTS: