Newsletter for Paradigm 97
January 7, 2007
Our NEW website...... http://paradigm97.blogspot.com/
Guess you were wondering just what happened to me. Well, both Marlene and I had computer failures ! After several expensive trips by a tech, I ended up with a new one....e-machine 5212. Love it. Newsletters will be regular again.
Another note........we will be TEN YEARS old this January 10, 2007 ! AOL members go to the chatroom for the Birthday celebration, ok?
MISSION STATEMENT
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
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| Metabolic Syndrome: The Silent Epidemic Serious condition is linked to obesity, lack of exercise By Kathleen Zelman, MPH, RD/LD WebMD Weight Loss Clinic - Feature Reviewed By Louise Chang, MD Call it a silent epidemic. An estimated one in four adults is afflicted with the condition known as metabolic syndrome, and many of them don't even know it. Obesity and lack of exercise are key components of this dangerous condition, which puts you at risk of developing serious health problems. That makes metabolic syndrome yet another reason to adopt healthier eating and exercise habits. What Is Metabolic Syndrome? According to the National Cholesterol Education Panel, if you have at least three of the following characteristics, you're classified as having metabolic syndrome:
The clustering of these traits has been linked to an increased risk for heart disease, diabetes, heart attack, and stroke. And the more of them you have, the greater your risk. Studies have shown that people with metabolic syndrome are at triple the risk for heart disease, heart attack, or stroke than those without the risk factors. Further, those with metabolic syndrome have a quadrupled risk of developing diabetes. It's very important to "know your numbers'': your cholesterol levels, blood pressure, blood sugar, and triglyceride levels. That's because even someone who is only mildly overweight -- but who carries the extra fat around their middle and has mild high blood pressure and elevated blood sugar -- is at risk. Most people with metabolic syndrome also have insulin resistance. That means the body does not properly use insulin, the hormone that regulates blood sugar levels. An estimated 86% of people with diabetes also have metabolic syndrome. What Causes It? A diet high in unhealthy fats, sugars, and calories along with a lack of regular physical activity can certainly contribute to the risk factors for metabolic syndrome. The actual causes of metabolic syndrome may be many, but researchers lean toward insulin resistance as the underlying problem. Overweight people tend to develop a resistance to insulin -- a hormone that regulates blood sugar levels, pushing sugar into the body's cells, where it is used for energy. When you're resistant to insulin, blood sugar isn't effectively delivered into the cells. That leads to high blood-sugar levels in the bloodstream, which is one of the symptoms (and causes) of type 2 diabetes. A Growing Problem A recent study in the Archives of Internal Medicine suggests that metabolic syndrome is on the rise, especially among adults in their mid-30s. Researchers found that the young adults with metabolic syndrome had gained fat around their midsections and were much less physically active in their 30s, compared to their teen years. The researchers also noted that more men were diagnosed with the condition than women in this age group. According to the National Cholesterol Education Program, some 24% of young adults over 20 have metabolic syndrome. That number swells to 44% by age 50. An Ounce of Prevention To lower your odds of developing the risk factors of metabolic syndrome, make sure your eating plan is full of fruits, vegetables, whole grains, and low-fat dairy. It makes perfect sense that the new dietary guidelines for Americans recommended three servings of whole grains each day. Studies have shown that whole grains can lower the risk of heart disease and certain cancers -- and now you can add metabolic syndrome to that list. Eating whole grains can improve insulin sensitivity and reduce the risk of metabolic syndrome, according to a study published Diabetes Care. Whole-grain carbohydrates, fruits, and vegetables tend to be absorbed slowly by the body and help normalize blood sugar. And wine lovers can rejoice; a glass or two per day is good for your health. The new dietary guidelines condone it -- and so does a study suggesting that a glass or two of wine may actually lower a person's risk for developing metabolic syndrome. Moderation is key, though. The health benefits become risks if you overindulge and drink more than one or two glasses of wine a day. Stay Active Many studies have documented the effectiveness of physical activity along with a healthy diet. One study in the Archives of Internal Medicine found that exercise and weight loss helped to reduce blood pressure and improve insulin sensitivity in people with metabolic syndrome. Exercise helps burn fat (especially around the waist), increases "good" cholesterol, and lowers blood pressure, according to a study published in the American Journal of Preventive Medicine. And a study in the Journal of the American College of Cardiology found that fitness helps reduce the risk factors for metabolic syndrome by lowering "C-reactive protein" -- a marker for a person's risk of heart attack and stroke. Researchers found that fit people had lower C-reactive protein levels in their blood and a lower risk of heart disease-related complications than people who were not fit. So add preventing metabolic syndrome to the long list of benefits that can result from a healthy diet and regular physical activity. Source: http://onhealth.webmd.com |
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FORGOTTEN HISTORY
01/02/07
Contact Hour Credit Changes to 60 minutes = 1 CH
The American Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC). As required by new ANCC criteria, on January 1, 2007, as of January 1, 2007, ANA will provide 60-minute contact hours and will no longer provide 50-minute contact-hour credit for continuing nursing education. According to ANCC, "This change brings greater consistency with the accreditation processes of other disciplines and increases the understanding and intuitiveness of the awarding of contact hours." To estimate the number of contact hours for an educational activity, total the minutes of didactic or clinical experience and evaluating the activity and divide by 60. For example, 60 minutes=1 CH, 150 minutes=2.5 CH, etc.
If you need information about re-certification or re-licensure CH requirements, please contact your certification board or state board of nursing. For questions about ANA’s change to a 60-minute contact hour, please e-mail valerie.restifo@ana.org.
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"Can Electronic Medical Record Systems Transform Health Care?" by Richard Hillestad and colleagues from Health Affairs' September/October 2005 issue attracted 40,263 pageviews in 2006, and the medical bankruptcy Web Exclusive by David Himmelstein and colleagues from February 2005 continued its high readership, adding 39,262 pageviews in 2006 to its over 70,000 pageviews from 2005, thus surpassing 100,000
readings of the paper.
The complimentary access to the top 25 papers from 2006 runs through January 19, 2007. Health Affairs subscribers have complete access to the full 25-year online archive, including all current content. http://healthaffairs.org/blog/2007/01/04/25-most-read-papers-from-2006/
Please remember that the REUTERS' articles are good for 30 days only
The focus on eliminating penile foreskin stems from previous immunologic studies demonstrating that it contains large concentrations of HIV-target cells, such as macrophages, Langerhans, and CD4+ cells.[1] Therefore, it is plausible that the removal of these HIV-target cells could reduce the risk that exposure to the virus would result in transmission. Recently, the first randomized, single-blinded, controlled trial (RCT) to assess this strategy showed a significant reduction in rate of HIV infection.[2] Findings from this trial have raised both hope and concern about use of the procedure. http://www.medscape.com/viewarticle/547113?src=mp
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Cognitive Behavioral Therapy Should Be First-Line Insomnia Treatment — Behavioral approaches for the treatment of chronic insomnia are effective, produce longer-lasting effects than medication, and should be used as first-line treatment, a large review suggests.
The results of the study, which included more than 2029 patients from 37 treatment studies conducted between 1998 and 2004, consistently found treatments such as cognitive behavioral therapy (CBT) and relaxation were effective for primary insomnia as well as insomnia associated with some medical conditions and, to a lesser extent, some psychiatric illnesses.
"CBT is an effective therapy [for insomnia], but it is underutilized, largely because there is a misperception by clinicians that it takes too much time to implement. But the fact is, there are some CBT methods that can be efficiently integrated into clinical practice that do not take an undue amount of a practitioner's time," the study's lead author, Charles Morin, PhD, from Université Laval, in Québec, told Medscape. http://www.medscape.com/viewarticle/547586?src=mp
| Most primary care physicians intend to use the recently approved human papillomavirus (HPV) vaccine in clinical practice, a new study reveals. In addition, about two thirds of women patients reported they were likely to get the vaccine. Sherri Sheinfeld Gorin, PhD, from Columbia University in New York City, presented her findings here at the 134th annual meeting of the American Public Health Association. "There is very little known about physician awareness of HPV DNA testing and intention to vaccinate," Dr. Sheinfeld Gorin told attendees. "We wanted to examine awareness of HPV testing, guidelines, and screening practices among primary care physicians who are working, particularly working in underserved communities." ******************************* To be able to read all of the following....just log in to the NYTimes......it is free. People with ruptured disks in their lower backs usually recover whether or not they have surgery, researchers are reporting today. The study, a large trial, found that surgery appeared to relieve pain more quickly but that most people recovered eventually and that there was no harm in waiting. And that, surgeons said, is likely to change medical practice. The study, published in The Journal of the American Medical Association, is the only large and well- designed trial to compare surgery for sciatica with waiting. The study was controversial from the start, with many surgeons saying they knew that the operation worked and that it would be unethical for their patients to participate in such a study. http://www.nytimes.com/2006/11/22/health/22spine.html?_r=1&th&emc=th&oref=login The Spine Patient Outcomes Research Trial (SPORT): A Randomized Trial (JAMA) The Spine Patient Outcomes Research Trial (SPORT) Observational Cohort (JAMA) ***************************** The following was sent in by Debbieann (OneAcre454@Msn.com) Thanks ! Earlier today, the National Labor Relations Board (NLRB) issued rulings that restrict nurses' freedom to join together for a voice at work, by expanding the definition of " supervisory" and who qualifies as a "supervisor." There's little doubt that these rulings strike a blow against quality care in hospitals by making it harder for us to stand up for our patients. Cincinnati. "Almost all of us have been given charge duties at one time or another. That certainly doesn't mean we have any management authority. If we did, we'd decide to put more nurses on staff so we can take better care of our patients!" (Read more on the NLRB ruling here: http://nurseactioncenter.org/ct/31LKNwn1DPIv/) Cathy Singer wrote"So let's get started! Tell-a-friend about Nurse Alliance email updates and join in building our RN-driven organization": http://nurseactioncenter.org/nursealliance_seiu/join-forward.html?domain= nursealliance_seiu&r=YpLKNwn1Squd& Thanks for joining together with us, Cathy Singer-Glasson, RN Nurse Alliance &r=YpLKNwn1Squd& . RNs need a unified voice now more than ever. Joining together in the Nurse Alliance gives us a voice in our hospitals, our communities, and our state and federal legislatures. ****************************** This was sent in by BAcello... in order to read it, you must "join". It is free. United States: The Rise Of Electronic Evidence From Duane Morris LLP preserved. The destruction of such data can lead to serious adverse evidentiary inferences, as illuminated by a very recent case. The case of Easton Sports v. Warrior Lacrosse involves the movement of an employee from one company to another and the allegation that he misappropriated trade secrets and confidential business information from his first employer. A federal magistrate in Michigan recently was called upon in the case to decide whether and to what extent sanctions should be awarded with respect to the failure to preserve certain electronic evidence. http://www.mondaq.com/article.asp?articleid=44160&email_access=on ************************** Acute abdominal pain is a common presenting complaint in older patients. Presentation may differ from that of the younger patient and is often complicated by coexistent disease, delays in presentation, and physical and social barriers. The physical examination can be misleadingly benign, even with catastrophic conditions such as abdominal aortic aneurysm rupture and mesenteric ischemia. Changes that occur in the biliary system because of aging make older patients vulnerable to acute cholecystitis, the most common indication for surgery in this population. In older patients with appendicitis, the initial diagnosis is correct only one half of the time, and there are increased rates of perforation and mortality when compared with younger patients. Medication use, gallstones, and alcohol use increase the risk of pancreatitis, and advanced age is an indicator of poor prognosis for this disease. http://www.aafp.org/afp/20061101/1537.html ************************************* Work Related Fatigue and Recovery: The Contribution of Age, Domestic Responsibilities, and Winwood, Peter C., - Conclusions: Unpredictable internal shift rotations, including night duty, which are traditional and typical in nursing, are inimical to maintaining nurses' health. More creative approaches to rostering for nurses working multiple shifts are a necessary step towards reducing wastage from the profession due to chronic work-related fatigue. Younger nurses in particular, may need more support than is currently recognized if they are to be retained within the profession... 2jkkh5hqq4q0s.victoria **************************** The Evolving Role of the Acute Care Nurse Practitioner in Critical Care Current Opinion in Critical Care Howie-Esquivel, et al. - The newest nurse practitioner role is the acute care nurse practitioner...The role of acute care nurse practitioners in critical care is increasing worldwide. Most countries are experimenting with this latest nurse practitioner as an extended-role healthcare provider with many potential benefits to patients and their families, as well as the healthcare system... htm;jsessionid=F8bpbKjFkdvQxRbymMhjwYprFmXgPyrzlmLNCJ0pwq1VPxzjg6JW!2030273863!-9 49856145!8091!-1 ******************************* The United States' aging, overweight population is fueling demand for personal trainers skilled at prodding the out-of-shape of all ages to get fit. Within a few years, one expert predicts, the standard for personal fitness trainers will be a bachelor's degree and certification from an accredited ************************** Oxygen Monitor Fails to Help Doctors Detect Birth Risks New York Times - United States ... and the chairman of obstetrics and gynecology at the University of Texas Southwestern Medical ... had never been proved more effective than a trained nurse with a ... ******************************* KXAN 36 Austin, Fri, 24 Nov 2006 1:42 PM PST Gardasil Vaccine Could Prevent Cervical Cancer The federal government recently approved a breakthrough drug that prevents most cases of cervical cancer, which kills 10 American women every day. The vaccine also fights the HPV virus, which is sexually transmitted. ************************************* WCBS-TV New York, Wed, 22 Nov 2006 8:37 AM PST Hidden Cameras Lead To Nursing Home Arrests Hidden cameras were put in a Queens nursing home - and have led to the arrest of nine people for patient neglect. An investigation by the state attorney general's office said among those arrested at the Hollis Park Manor nursing home were the medical ********************************** Thank you, Laura (Laregis@AOL.com) Preoperative Verification Process PATIENT SAFETY As part of the Universal Protocol for Preventing Wrong Site, Wrong Procedure and Wrong Person Surgery™, staff should ensure that all relevant documents and studies are available before the procedure. If there is missing information or discrepancies, they must be addressed before starting the procedure. The preoperative verification process should ensure that the documents have been reviewed and are consistent with each other, the patient’s expectations, and the team’s understanding of the intended patient, procedure, site, and implants, if applicable. ***************************** Treatment Of Anemia Associated With Chronic Renal Failure, Including Patients On Dialysis And Patients Not On Dialysis BETHESDA, MD -- The U.S. Food and Drug Administration notified healthcare professionals of a newly published clinical study showing that patients treated with an erythropoiesis- stimulating agent (ESA) and ... OpenDocument&id=D82277BEB625E4E185256E3700509F48&c=&count=10 ******************************* Go a little plum crazy in the morning for a big antioxidant boost. Plum pancakes? It may sound peculiar, but plums are a rewarding addition to your breakfast choices. Berries may boast the most antioxidant power, but plums win hands down over grapefruit, oranges, and even purple grapes. Toss a handful of dried plums onto your cereal or into your pancake batter before cooking and enjoy with a glass of orange juice. The vitamin C in the juice will help you absorb the iron in the plums. Find delicious plum and berry recipes with RealAge Smart Search. After berries, plums are one of the fruits that have the highest levels of antioxidants -- about 23 milligrams (mg) per half cup. A half cup of cherries serves up the same amount. And plums offer up additional nutrients, such as potassium, magnesium, iron, fiber, and vitamin A. Your body uses antioxidants to neutralize nasty molecules that contribute to aging and chronic diseases, such as diabetes, cancer, and heart disease. You can get antioxidants from a variety of fruits, vegetables, beverages, and even dark chocolate. In this study, coffee and black and green teas also were found to have high levels of antioxidants. Reference: Phenolic acids in berries, fruits, and beverages. Mattila, P., Hellström, J., Törrönen, R., Journal of Agricultural and Food Chemistry 2006 Sep 20;54(19):7193-7199. ******************************* Is channel surfing your primary fitness activity each day? Watch out -- it may make you fat. In study after study, all that TV-time has been shown to increase the risk of obesity. Not only does couch time take away from time spent walking, gardening, and playing with the dog, but also researchers suspect that the commercials could be influencing you to make poor eating choices. Hide the remote, cancel the cable, do whatever it takes to avoid an unfit fate. It's prime time for you. Each hour you log in front of the tube leads to 144 fewer steps taken per day. The average American watches 4 hours a day -- that's almost 580 fewer steps taken toward the goal of 10,000 that many fitness experts recommend for optimal health. TV is associated with obesity, there's no doubt about that. Less certain is exactly how hours spent watching American Idol or backlogged episodes of Lost saved on your TiVo can make you fat. So what can you do? Limit TV viewing to no more than 2 hours per day, and cut back on other sedentary activities, such as computer use, reading, and resting. Commit more free time -- at least 30 minutes a day -- to being active. Walk at the mall, play catch with your kids, or clean the house. Reference: low-income housing. Bennett, G. G., Wolin, K. Y., Viswanath, K., Askew, S., Puleo, E., Emmons, K. M., American Journal of Public Health 2006 Sep;96(9):1681-1685. ******************************* ATLANTA, Georgia (AP) -- Taking vitamin D cut the risk of pancreatic cancer nearly in half, according to a new study that is being called the first to show such a benefit. Vitamin D protects against colorectal and breast cancer, earlier studies have found. And lab and animal studies show it stifles abnormal cell growth and curbs formation of blood vessels that feed tumors. "I've been converted from a skeptic about a role of vitamin D in preventing cancer to a believer that there's something there," said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society. Taking 450 international units (IUs) of vitamin D -- about the standard dose in most multivitamins -- reduced the risk of pancreatic cancer by 43 percent, according to researchers at Northwestern and Harvard universities who led the latest study. There was no significant added benefit from taking more than that amount. But there was decreased benefit from taking less: Taking 150 to 300 IUs a day reduced the risk of pancreatic cancer by just 22 percent, the researchers found. http://www.cnn.com/2006/HEALTH/09/14/pancreatic.vitamind.ap/index.html ************************************** LANSING, Michigan (AP) -- Michigan girls entering the sixth grade next year would have to be vaccinated against cervical cancer under legislation backed Tuesday by a bipartisan group of female lawmakers. The legislation is the first of its kind in the United States, said Republican state Sen. Beverly Hammerstrom, lead sponsor. The vaccine was approved by the Food and Drug Administration in June for use in girls and women and has been hailed as a breakthrough in cancer prevention. It prevents infections from some strains of the sexually transmitted human papilloma virus, which can cause cervical cancer and genital warts. ******************************* (I didn't choose to have this section changed to double spacing.....tried to fix.....) Ten ways to catch a Liar J.J. Newberry was a trained federal agent, skilled in the art of deception detection. So when a witness to a shooting sat in front of him and tried to tell him that when she heard gunshots she didn't look, she just ran -- he knew she was lying. How did Newberry reach this conclusion? The answer is by recognizing telltale signs that a person isn't being honest, like inconsistencies in a story, behavior that's different from a person's norm, or too much detail in an explanation. While using these signs to catch a liar takes extensive training and practice, it's no longer only for authorities like Newberry. Now, the average person can become adept at identifying dishonesty, and it's not as hard as you might think. Experts tell WebMD the top 10 ways to let the truth be known. http://www.webmd.com/content/article/127/116573.html ********************************** Nurse Practitioners and staff working in general dermatology may be interested in the well written four page case study, Diagnostic Dilemmas: Bullous Pemphigoid. The case has an introduction, continues with the results of the physical examination, proceeds to a discussion of the findings and finishes with a treatment plan. The article profiles “a 75-year-old, aphasic Chinese woman presented to the authors' wound clinic with a 6-week history of widespread blisters and erosions.” Wounds 18(6) 2006. http://www.medscape.com/viewarticle/540392?src=mp **************************** Good carbs versus bad carbs: Do you know the difference? Carbohydrates have gotten a bad rap, and that's a shame. Eat the right kind of carbs -- the low-glycemic index (GI) kind -- and you'll lose weight and lower both LDL and total cholesterol. Eat the wrong kind and . . . well, your heart suffers the consequences. GI index refers to how quickly starches break down and affect your blood sugar. Opt for low-GI lentils, beans, bran cereal, and high-fiber fruits and veggies to reach your lighter, heart-healthier goals. Don't be swayed by low-carb diets. You need carbs to supply your body with energy, fiber, B-vitamins, magnesium, and other important nutrients. Completely eliminating carbs from your diet isn't healthy. Instead, go for low-GI carbs, the kind your body digests slowly, to help keep your blood sugar steady. You'll stay full longer, have more consistent energy, and feel better overall. a different diet, but calorie intake was the same (women 1,400 calories a day, men 1,900). The diets varied in their percentage of protein, high-GI carbs, and low-GI carbs. After 12 weeks, all groups lost weight, but the people who got the most calories from low-GI carbs also lowered their LDL and total cholesterol levels. The people in the high protein/fewer carbs (mostly high-GI carbs) group experienced an increase in LDL and total cholesterol levels. Ouch! Reference: overweight and obese young adults: a randomized controlled trial. McMillan-Price, J., Petocz, P., Atkinson, F., O'neill, K., Samman, S., Steinbeck, K., Caterson, I., Brand-Miller, J., Archives of Internal Medicine 2006 Jul 24;166(14):1466-1475. ************************************* From omega-3 fatty acids to flavonoids, the ingredients in foods you eat every day may be potent weapons in the battle against disease. Once-forbidden foods like chocolate, nuts, and wine made headlines in 2004 for their potentially healthy benefits, and new research suggests that the key to avoiding heart disease or cancer may be found in the cupboard rather than the medicine cabinet. But the secret may not lie in a single wonder food. Instead, researchers say that variety may really be the spice of (long) life. To get your plate in order, WebMD asked the experts for their top picks from this year's newsmakers. http://www.webmd.com/solutions/sc/womans-guide-healthy-heart/heartfelt-diet ************************************ Six serious symptoms Like red-light warnings on the dashboard, the human body sends out a flare when something's awry. Chest pain, shortness of breath,dizziness -- those are some familiar medical symptoms.But other problems can creep up on you, too -- aches and pains, lumps and bumps. When are they important, when are they not? In his book, Your Body's Red Light Warning Signals, Neil Shulman, MD, provides a head-to-toe owner's manual for the human body. His book lists hundreds of medical symptoms that could mean life or death, or serious disability. *********************************** Sytematic Review of Medical Errors in Pediatric Patients Medical error has received a great deal of attention in recent years. The phrase "medical error" is an umbrella term given to all errors that occur within the healthcare system including mishandled surgery, diagnostic errors, equipment failures, and medication errors (MEs). Medical error is a large problem in the UK and the US, in both primary and secondary care, and policy initiatives have been implemented to reduce it.[1-5] MEs are probably one of the most common types of medical error. In the US, it has been estimated that MEs kill 7000 patients a year.[1] In UK hospitals, the incidence and consequences of MEs seem similar to those reported in the US: prescribing errors occur in 1.5% of prescriptions, and administration errors occur in 3-8% of nonintravenous doses given.[6,7] Much of the research into MEs and their prevention has been performed in facilities that care primarily for adults. Information on the incidence of MEs in pediatrics is scarce. Pediatrics poses a unique set of risks, predominantly because of wide variation in body mass, which requires doses to be calculated individually based on patient age, weight or body surface area, and clinical condition. This increases the likelihood of errors, particularly dosing errors.[8] In addition, dosage formulations are often extemporaneously compounded to meet the need for small doses in these patients, and there is a lack of information on pediatric doses and indications.[9] http://www.medscape.com/viewarticle/549356 *********************************** Basic Vital Signs Help Predict Amoxicillin Failure in Pediatric Pneumonia Patients. NEW YORK (Reuters Health) Dec 26 - For children with severe pneumonia in limited-resource settings, initially monitoring the basic vital signs and blood oxygen saturation of children treated with amoxicillin for at least 12 hours can help determine who is most likely to fail this treatment and require other therapy, a study shows. "In situations where monitoring blood oxygen saturation is not possible, then following basic vital signs for 24 hours is advisable," Dr. Linda Y. Fu of Children's National Medical Center, Washington, D.C., who led the study, told Reuters Health. "Our findings are most applicable in areas of the developing world that rely on the World Health Organization (WHO) case management guidelines for the treatment of pneumonia," she added. The findings are based on information gathered from 857 children aged 3 to 59 months with WHO- defined severe pneumonia who were treated with oral amoxicillin. "A recent clinical trial found oral amoxicillin to be acceptable for the treatment for WHO-defined severe pneumonia," Dr. Fu noted. "As with any treatment, there will be children on amoxicillin therapy who will be less likely to respond than others." http://www.medscape.com/viewarticle/549912 ************************************ Ever been so mad you could spit? Your lungs may have something to say about that. Although lung function naturally declines with age, recent research suggests it may decline faster in perpetual hotheads than in even-tempered sorts. Next time you're seething, try this on-the-spot cool down: Close your eyes, relax your muscles, and imagine yourself far away from what's making you so mad. Then, breathe deeply. Here's another one to try . . .In one recent study, men who scored highest in hostility also performed poorly on three tests of lung function -- both at the beginning of the study and during follow-up visits years later. Scientists believe that strong negative emotions may provoke inflammation and alter hormone function, both of which can knock the wind out of your lungs' sails. Also, the kind-of-bad feeling that piggybacks anger often goes hand-in-hand with smoking and inactivity, two of the biggest known breath-takers around. Next time you turn into a snarling Tasmanian devil, employ a chill-out strategy. Don't have one? Try this: Take a deep breath and scrunch up every muscle in your face as hard as you can. Now, slowly exhale and release those muscles one-by-one. If you don't feel lighter after that, try looking in the mirror when you do it!
*************************** Grab a banana and say bye-bye to Parkinson's disease? Researchers say it could be so. Bananas are rich in vitamin B6 -- and very early research suggests that high levels of B6 may protect against Parkinson's. Still, the news is not something to go bananas over just yet. The benefit applied only to smokers in the most recent study. But bananas and B6 do your body good in many other ways. Here's an example . . . Vitamin B6 -- along with folate and B12 -- helps reduce levels of homocysteine, an amino acid. That's good for your ticker, because too much homocysteine in the blood appears to up heart disease risk. Parkinson's disease, a progressive neurological disorder that causes muscles to become rigid and shake uncontrollably. B6 intake was highest were 50 percent less likely to develop the brain disorder over a nearly 10-year period, compared to smokers who consumed the least amount of the vitamin. And although all three members of the nutrient trio help lower homocysteine, only B6 intake -- not folate or B12 -- translated into reduced rates of Parkinson's, suggesting the B vitamin may lower disease risk by some mechanism unrelated to the lowering of homocysteine. What's smoking got to do with it? Oddly enough, nicotine may actually protect nerve cells in some way, and B6 may help out in that process. Here's another way that bananas can do a body good . . .
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HUMOR SECTION
dition, but I wouldn't worry about it."
"Really, Doc?" the patient replied. "Well, if you had a
slight heart condition I wouldn't worry about it either."
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
A website offering free CEU s: http://www.medscape.com/cmecenterdirectory/nurses
Pharmacists - 1.0 ACPE continuing education credits for pharmacists (0.1 CEUs)
- DNR in the OR and Afterwards
- Emergent Presentation and Treatment of Influenza in Children
- Antithrombotic Therapy in ACS: From STEMI Presentation to Follow-up -- A Clinician's Perspective
- COPD: Which Treatment Is Right for My Patient
- The Long-term Treatment of Bipolar Disorder: Managing the Maintenance Phase
- Highlights of the Transcatheter Cardiovascular Therapeutics 2006
- Female Sex, Age, Severity Predict Poor Outcomes in Ventilator-Associated Pneumonia
- Moderate Exercise May Lower Risk for Breast Cancer in Postmenopausal Women
- Emergent Presentation and Treatment of Influenza in Children
- COPD: Which Treatment Is Right for My Patient
Always on the lookout for interesting websites / links. Please send them to:
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Medical Recalls
http://www.fda.gov/medwatch/safety/2006/safety06.htm#Evra
the US.
The following code words have been recommended for standardization and have been adopted by a number of hospitals and long-term care facilities. For those who are not familiar with them, they are (NOTE: MESSAGE CONTINUES BELOW LIST):
- Code Red: Fire
- Code Blue: Medical emergency - adult
- Code White: Medical emergency - pediatric
- Code Pink: Infant abduction
- Code Purple: Child abduction
- Code Yellow: Bomb threat
- Code Gray: Combative person
- Code Silver: Person with a weapon and/or hostage situation
- Code Orange: Hazardous material spill/release
- Code __________ (specify): Missing resident/possible elopement
- Code Triage Internal: An internal disaster
- Code Triage External: An external disaster.
(Please note: This list was originally developed for acute care, and there is no code word for resident elopement. Facilities using the list may wish to add this term to their code list by using "code brown" or another term that has not been designated on the list above. Be aware that other health care workers, such as physicians and EMS may be in your facility when a code is called. Avoid confusion by changing the designation of the colors listed above.)
http://en.wikipedia.org/wiki/Hospital_emergency_codes"
FDA Approves New Treatment for Type 2 Diabetes
FDA has approved the first in a new class of drugs called DPP-4
inhibitors for treating type 2 diabetes...
http://www.accessdata.fda.gov/psn/transcript.cfm?show=59#1
Cardiovascular Risk with Erythropoietic Agents FDA is warning health care professionals that patients treated with erythropoietic agents may have an increased risk of cardiovascular
complications if the dosing recommendations in the labeling are exceeded...
http://www.accessdata.fda.gov/psn/transcript.cfm?show=59#2
Caution on Neuropsychiatric Events with Tamiflu Roche Laboratories has alerted healthcare professionals about neuropsychiatric events that have occurred in influenza patients taking
Tamiflu... http://www.accessdata.fda.gov/psn/transcript.cfm?show=59#3
Fatal Overdoses with Effexor Wyeth is alerting healthcare professionals about the risk of fatal
overdoses occurring in patients taking Effexor and Effexor XR...
http://www.accessdata.fda.gov/psn/transcript.cfm?show=59#4
Change in iPledge Program for Isotretinoin The iPledge program is a risk management program to reduce the possibility of fetal exposure to the acne drug isotretinoin, which can cause serious birth defects if taken during pregnancy... http://www.accessdata.fda.gov/psn/transcript.cfm?show=59#5
Warning on Avastin and Brain-Capillary Leaks Genentech is alerting healthcare professionals about two new safety issues for Avastin, a drug used to treat certain colorectal and lung cancers...
http://www.accessdata.fda.gov/psn/transcript.cfm?show=59#6
Preventing Dosage Errors with Diastat AcuDial The Institute for Safe Medication Practices recently warned about potentially fatal dosing errors when using Diastat AcuDial...
http://www.accessdata.fda.gov/psn/transcript.cfm?show=59#7
What Women Need to Know about Silicone Gel-Filled Breast Implants Patients may be asking about FDA's recent decision to approve the marketing of certain silicone gel-filled breast implants...
http://www.accessdata.fda.gov/psn/transcript.cfm?show=59#8
Roche notified healthcare professionals of a correction to a Dear Healthcare professional letter issued on November 13, 2006. The original letter referenced changes to the PRECAUTIONS Section of prescribing information for Tamiflu about post marketing reports of self-injury and delirium with the use of Tamiflu in patients with influenza. The prescribing information that accompanied the letter contained an incorrect dosing chart for the Standard Dosage of Tamiflu Oral Suspension for prophylaxis of influenza in pediatric patients. The chart incorrectly specified twice daily instead of once daily dosing under "Recommended Dose" for 10 days. Healthcare professionals should discard the incorrect version of the package insert included in the November 13 mailing and refer to the new dosing chart included in the December 26 letter.
NURSING HINTS CORNER
on an infusion pump and getting an unintended repeat of that same number (i.e., pump recorded 366
mL per hour, not 36 as intended). The reporting facility had uncovered 11 similar double key
bounce events within the past 2 years—all involving different nurses working in various
patient care units who felt certain that they had pressed the number key just once. This problem differs
from an accidental double keying error in which a number or letter key is accidentally pressed twice.
To further investigate double key bounces and double keying errors, we asked you to send us examples of similar problems. One nurse reported that she had programmed a propofol infusion to run at 25 mL per hour. Fortunately, before she left the patient’s room, she noticed that the pump was actually delivering 225 mL per hour. She thought she had pressed the number “2” key too long, causing a double key bounce in the same manner that a depressed computer key might run a string of numbers. Unfortunately, when she tested the pump by holding the key down longer than usual, she had difficulty recreating the error.
angle rather than standing directly in front of it. Another reporter was also able to replicate double key
bounce errors by partially depressing the number keys to a shallow depth. Pumps involved in the
reports so far include: Alaris SE pump (formerly Signature Edition GOLD Infusion
System), SIGMA 8000, and SIGMA 6000+ infusion pumps (from Sigma International). Some nurses
also reported that distracting background noise prevented them from hearing the two audible beeps,
one for each digit registered on the pump, when any keying error occurred. Some hospitals may be
experiencing keying errors without recognizing them as hazards. Nurses may notice the programming
discrepancy and simply correct it without reporting the event, believing they caused the error by
inadvertently pressing the key twice. If nurses recognize that the pump itself contributed to the
mistake, they may still just “accept” the phenomenon as typical for high-tech medical devices. Nurses
also may not notice an error if the higher infusion rate did not result in patient harm. ECRI, an impartial
health services research company, has begun testing various pumps for double key bounce and
double keying capability.
Thanks to your additional reports about this problem, FDA is also now investigating the problem. So
please continue to report events to ISMP at ismpinfo@ismp.org so we can help
ECRI and FDA fully examine the issue. Until we know more, be alert to this risk and take action to
detect and manage keying errors as suggested in checkitout!
Checkitout !!
The following recommendations may help prevent or quickly detect double key bounce or double keying errors.
Proper stance. When programming pumps, stand squarely in front of the keypad (ideally with the pump at eye level for best visibility) to facilitate proper depth of depressing each key.
Verify screen displays. When programming pumps or changing settings, always compare the patient’s prescribed therapy on the medication administration record, original order, or bar code device, to the displayed pump settings for verification before starting or restarting an infusion.
Independent double check. Require an independent double check of pump settings by another practitioner before starting or changing infusions with hospital-selected high-alert drugs.
Listen and look. Keep pump tones functional on all pumps and focus on listening to the number of beeps while programming IV pumps; each beep should correspond to a single digit entry. Before leaving the patient’s room, actually look at the IV tubing drip chamber to see if the observed rate of infusion looks faster or slower than expected.
Dose alerts. Use smart infusion pumps with activated dosage error reduction software that will alert when safe doses and infusion rates have been exceeded. This will help detect most double key bounces and double keying errors before the infusion begins. Keep in mind, some hospitals may not have added alerts to the pump library for IV solutions that are dosed by infusion rate alone (e.g., TPN), or nurses may not always use the dose alert features.
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THOUGHT FOR THE DAY
among those who don't.
--Frank A. Clark, writer (1911- )
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