Newsletter for Paradigm97
April 3, 2007
Our website...... http://paradigm97.blogspot.com
PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype.
2) a philosophical and theoretical framework of a scientific school or
discipline within which theories, laws, and generalizations, and the
experiments performed in support of them, are formulated.
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.
Members, please take the time.to drop in to the AOL Paradigm97 chatroom which is
"manned" by GingerMyst for 45 min on Tuesday evenings: 9 pm EST, 8 pm CST, 7 pm MST,
6 pm PST (Please note that these are actially the same time)
The Paradigm97 chatroom is always there....door open, lights on, waiting for visitors
to come in. Check your Buddy List.....and invite your nursing friends in for a little chat
Let me know if you want others involved e.g. prospective new members.
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SNIPPETS
(Another JCAHO offering)
Medication errors related to potentially dangerous abbreviations
One of the major causes of medication errors is the ongoing use of potentially dangerous abbreviations and dose expressions.Underlying factors contributing to many of these errors are
illegibleor confusing handwriting by clinicians and the failure of health care providers to
communicate clearly with one another. Because medication safety and the identification,
prevention and timely reporting of medication errors are of primary importance to the Joint Commission, this issue of Sentinel Event Alert specifically addresses medication
errors related to the use of dangerous abbreviations and dose expressions used in prescribing medications.
Despite repeated warnings for more than 25 years by the Institute for Safe Medication Practices (ISMP)--and other organizations--about the dangers associated with using certain
abbreviations when communicating medication information, the practice of using these dangerous abbreviations continues, increasing the potential for patient harm. "Symbols and abbreviations are frequently used to save time and effort when writing prescriptions and documenting in patient charts," says Darryl S. Rich, Pharm.D., M.B.A., FASHP,
associate director, Surveyor Development and Management, JCAHO. "However, some
symbols and abbreviations have the potential for misinterpretation or confusion."
Examples of especially problematic abbreviations include "U" for "units" and "µg" for "micrograms." When "U" is handwritten, it can often look like a zero. There are numerous case reports where the root cause of sentinel events related to insulin dosage has been the
interpretation of a "U" as a zero. Using the abbreviation "µg" instead of "mcg" has also been the source of errors because when handwritten, the symbol "µ" can look like an "m". The use of trailing zeros (e.g., 2.0 vs. 2) or use of a leading decimal point without a leading zero
(e.g. .2 instead of 0.2) are other dangerous order writing practices. The decimal point is sometimes not seen when orders are handwritten using trailing zeros or no leading zeros. Misinterpretation of such orders could lead to a 10-fold dosing error. "To minimize the potential
for error and to maximize patient safety, prescribers need to avoid such specifically dangerous abbreviations and phrases," Dr. Rich says.
ISMP issues wake-up call
Following the tragic death of an infant due to the misinterpretation of a prescription for morphine, ISMP recently issued a wake-up call to health care institutions reminding them of the
dangers of utilizing certain dangerous abbreviations and dose expressions. (1) "ISMP and others have advocated abandoning the use of these abbreviations and expressions for almost three decades," says Michael Cohen, D.Sc., M.S., FASHP, president, ISMP. "ISMP has also
stressed that it is equally important to avoid these dangerous abbreviations and dose expressions in other communications such as computer-generated labels, Medication
Administration Records (MARs), labels for drug storage bins/shelves, preprinted orders and protocols, and pharmacy and prescriber order entry screens." A table of dangerous abbreviations and dose expressions most often associated with misinterpretation and patient harm (as reported to the USP-ISMP Medication Errors Reporting Program) may be obtained from the ISMP website at www.ismp.org.
In addition, NCC MERP (National Coordinating Council for Medication Error Reporting and Prevention) in 1996 issued "Recommendations to Correct Error-Prone Aspects of Prescription Writing" (2) and U.S. Pharmacopeia in 1997 issued "Recommendations for
Prescription Writing," (3) which discuss ways organizations can avoid medication errors and minimize risks to patients.
Risk reduction strategies
Though new technologies such as computerized order entry systems are being
introduced into health care, it is estimated that currently less than 5 percent of U.S. physicians utilize these systems and write their prescriptions electronically. The related costs and
training issues are most often cited as reasons why organizations do not adopt these new technologies. However, by moving toward electronic prescribing systems, organizations can most certainly minimize medication errors, including those related to poor handwriting, thus
drastically reducing the risks to patients and the costs associated with drug-related morbidity and mortality. (4) Realizing that most health care organizations will not be able to implement this new, costly technology in the near term, JCAHO has identified some cost efficient and effective risk reduction strategies that any health care organization can adopt:
a.. Develop a list of unacceptable abbreviations and symbols that is shared with all prescribers.
b.. Develop a policy to ensure that medical staff refer to the list, and take steps to
ensure compliance.
c.. Establish a policy that if an unacceptable abbreviation is used, the prescription order is verified with the prescriber prior to its being filled.
Recommendations
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Examples of correct and incorrect use of decimal points and zeros:
Correct Incorrect
2. or 2 2.0
0.2 .2
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The Joint Commission requires that medication orders have "the degree of accuracy, completeness, and discrimination necessary for their intended use" (JCAHO standard IM.3 in
all manuals). Standard IM.3 also requires the use of standardized abbreviations, acronyms and
symbols. Use of confusing and dangerous abbreviations is not consistent with the intent of this standard. Furthermore, hospitals are to assess/review orders in the medical record for "presence, timeliness, legibility, and authentication," and see that "action is taken to
improve the quality and timeliness of documentation that impacts patient care" (IM.7.10 in the Comprehensive Accreditation Manual for Hospitals). This should be done as part of the quarterly medical record review that hospitals undertake for record completeness and
authentication. As part of the review, standard IM.7.10 clearly requires that legibility be addressed as well as completeness and authentication.
In addition, MS.8.2.3 (Comprehensive Accreditation Manual for Hospitals) requires that data regarding "accurate, timely and legible completion of patient's medical records" be specifically addressed in the privileging and credentialing program, and that this
data must not only be aggregate data, but how specific physicians do compared to the norm. Failure to do so can result in multiple Type I recommendations, even if not part of a Medication Use Evaluation or Performance Improvement program. Multiple Joint Commission standards
require legibility of physician orders and that hospitals take appropriate action to improve the legibility of physician orders. Finally, standard TX.3.5.2 (Comprehensive Accreditation Manual for Hospitals) requires pharmacists to review all medication orders and to contact the prescriber, if questions arise. In order to achieve compliance with these standards, strategies to reduce the inappropriate use of dangerous abbreviations need to be taken, such as those
identified in this alert's risk reduction strategies.
References
1.. ISMP Medication Safety Alert!, May 2, 2001, www.ismp.org.
2.. "Recommendations to Correct Error-Prone Aspects of Prescription Writing," NCC MERP Council Recommendation, adopted Sept. 4, 1996, at www.nccmerp.org (under Council Recommendations).
3.. "Recommendations for Prescription Writing, " USP Quality Review, No. 57, Jan. 1997, www.usp.org (search keyword "abbreviations").
4.. Electronic Prescribing Can Reduce Medication Errors, white paper from the Institute for Safe Medication Practices, www.ismp.org.
Published for Joint Commission accredited organizations and interested health care professionals, Sentinel Event Alert identifies specific sentinel events, describes their common underlying causes, and suggests steps to prevent occurrences in the future.
During the on-site survey of accredited organizations, JCAHO surveyors assess the organization's familiarity with and use of Sentinel Event Alert information. Accredited organizations are expected to:
a.. Review and consider relevant information, if appropriate to the organization's services, from each Sentinel Event Alert.
b.. Consider information in an alert when designing or redesigning relevant processes.
c.. Evaluate systems in light of information in an alert.
d.. Consider standard-specific concerns.
e.. Implement relevant suggestions or reasonable alternatives or provide a reasonable explanation for not implementing relevant changes. Failure to do so will result in a type I
recommendation.
Setting the Standard for Quality in Health Care
Joint Commission
Sentinel Event Hotline (630) 792-3700
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INTERESTING READING
Please remember that the REUTERS' articles are good for 30 days only
Finding it harder to do what you once did easily? Check your multivitamin. If your arms
start to feel like wet noodles after carrying groceries, pushing the vacuum, or
doing a normal workout, you may be low on magnesium. Your muscles require this mineral to function properly, yet two-thirds of us don't get enough. Meet your daily intake
with whole grains, nuts, leafy greens, and a multivitamin/mineral supplement that includes magnesium. More findings about magnesium . . . RealAge Benefit: Getting enough magnesium (400 milligrams per day for women, 333 milligrams for men) can make your RealAge as much as 0.9 years younger.
Your body needs magnesium to power your muscles (and your heart, nerves, and bones, too) and when you don't have enough, it shows. In one study, older adults who had the lowest magnesium levels also did the worst on strength tests, a risky combination that invites accidents
and threatens the heart. The reason? Without enough magnesium, your body struggles to carry out physical tasks, which pushes up your heart rate and can leave you gasping for oxygen. Gaps in your diet are largely to blame.
Here's what you can do about it: On your next trip to the supermarket, fill your basket with bran or shredded wheat cereal, brown rice, nuts, whole-grain breads, and leafy greens --
all are rich in magnesium. And to back up your improved diet, take a daily multivitamin/mineral
supplement that contains at least 100 milligrams of magnesium.
References: Magnesium and muscle performance in older persons: the In CHIANTI study. Dominguez, L. J., Barbagallo, M., Lauretani, F.,, Bandinelli, S., Bos, A., Corsi, A. M., Simonsick, E. M., Ferrucci, L., American Journal of Clinical Nutrition 2006 Aug;84(2):419-426.
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All that tension inside you? It's on the surface, too. When your life is a pressure cooker,
your skin pays the price. Stress throws off the skin's ability to recover, so scratches or
scrapes stick around longer. And your skin may be more easily inflamed by scratchy
wool sweaters, adhesive bandages, cold weather, or dry, itchy skin conditions like
psoriasis or eczema. What unknots you on the inside helps calm your skin side too --
a quiet walk, a little yoga, soothing music. But if that's not doing the trick, take this psoriasis assessment and get personalized advice on red, itchy, flaky skin. Stress appears to
interfere with the normal barrier function of skin, making it more susceptible to skin
disorders. This response was noted in a study on skin irritation, in which sticky tape was
applied and then removed from the forearms of participants. The skin of people who
were highly stressed took longer to recover than the skin of people who were not tense.
That's a good reason to find a mind/body relaxation method that works for you -- whether
it's meditation, knitting, or rhythmic running. References: Psychological stress perturbs epidermal permeability barrier homeostasis: implications for the
pathogenesis of stress-associated skin disorders. Garg, A., Chren, M.
M., Sands, L. P., Matsui, M. S., Marenus, K. D., Feingold, K. R.,
Elias, P. M., Archives of Dermatology January 2001;137(1):53-59.
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Hospitals Made Less Safe When Individuals Blamed
The Capital Times :: EDITORIAL :: A10
Wednesday, November 15, 2006 (yes, this is old, but good) SUZANNE GORDON
Wisconsin officials believe they've done the right thing by charging Madison nurse Julie Thao with a felony for making a fatal medication error at St. Mary's Hospital last July. "The circumstances of the case go well beyond a simple mistake," contends Mike Bauer of the Department of Justice.
Indeed they do. Which is why pressing charges against a veteran nurse is going to make hospitals less safe. Thao worked on a labor and delivery unit until she was fired four months ago. For 15 years, she had, by all accounts, been an exemplary RN. Yet she accidentally
delivered a powerful painkiller, rather than penicillin, to a young woman who was giving birth. The anesthetic stopped Jasmine Gant's heart, causing her death (although hospital staff were able to save baby)
Contrary to the theory of individual blame now being pursued by prosecutors, this terrible
tragedy confirms what a 1999 report by the Institute of Medicine found -- that medical errors are usually the result of system failures.
http://www.nursingadvocacy.org/news/2006/nov/20_captimes.html#gordon_section
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Women With Thrombophilic Defects on Oral Contraceptives Have
Higher VTE Risk
February 13, 2007 (Groningen, the Netherlands) - Women with hereditary
deficiencies of protein S, protein C, or antithrombin are at higher risk of venous thromboembolism (VTE) from combined oral contraceptives (COC) than women without such deficiencies, according to a retrospective family cohort study [1].
to our knowledge, to address the multicausality of VTE in COC-using women, including all the known thrombophilic defects and deficiencies," van der Meer said.
http://www.medscape.com/viewarticle/552153?sssdmh=dm1.247632&src=nldne
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More Data Support Switching to Aromatase Inhibitors in Early Breast Cancer
February 13, 2007 - Further data to support switching to an aromatase inhibitor (AI)
instead of continuing with tamoxifen in postmenopausal women with early breast cancer comes from a mature analysis of the Intergroup Exemestane Study (IES), published online
February 13 in the Lancet....
http://www.medscape.com/viewarticle/552135?sssdmh=dm1.247632&src=nldne
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FDA Staffer Urges Scrutiny of Lilly Drug WASHINGTON (Reuters) Feb 13 - Eli Lilly
and Co.'s antipsychotic medication Zyprexa carries risks that call for closer safety monitoring
by the U.S. Food and Drug Administration, an FDA whistleblower told Congress on Tuesday.
FDA scientist Dr. David Graham said there were concerns about weight gain from Zyprexa
and diabetes. Other antipsychotic medications also warrant closer scrutiny, he added.
http://www.medscape.com/viewarticle/552152?sssdmh=dm1.247632&src=nldne
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WHO Backs Glaxo's Rotariz for Mass Vaccination LONDON (Reuters) Feb 13 - GlaxoSmithKline Plc's vaccine Rotarix, designed to prevent gastroenteritis caused by rotavirus
in children, has been endorsed as suitable for use by U.N. agencies by the World Health Organization. The British-based drugmaker said on Tuesday it was the first such vaccine to
win so-called prequalification status from the international health body. The move certifies the vaccine's quality, safety and efficacy, allowing agencies like the Pan American Health Organisation, UNICEF and others to use it in mass vaccination programs.
http://www.medscape.com/viewarticle/552150?sssdmh=dm1.247632&src=nldne
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Increased Risk of Infection and Mortality After Blood Transfusion for
CABG Patients - A new study has shown that patients who receive blood transfusions
while hospitalized for coronary artery bypass graft (CABG) surgery are more likely to develop an infection after surgery and are at a greater risk of death than those who do not receive a blood transfusion [1].
These findings, say investigators, could help shed light on why women fare worse after surgery
than men. As women receive more blood transfusions than men, primarily because of their lower hemoglobin or hematocrit levels, this might explain the difference in death rates
between the sexes following CABG.
http://www.medscape.com/viewarticle/549791?sssdmh=dm1.234442&src=nldne
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This article was sent in by BAcello (Barbara) who wrote: "I sincerely
believe that many nurses need to learn how to properly manage
treatment refusals. They think hey have fulfilled their responsibility if they have documented the refusal and written something like "refuses bath"on the care plan. They often do not notify the physician, and they seldom try other creative ways of getting the resident to accept the treatment. I have been preaching about this forever, and although this rather lengthy article is gross, it is a good example of why the aforementioned is not sufficient
nursing intervention. I think this is an excellent article to use for teaching nurses about notifications and managing refusals" Barbara
URL: http://www.firstcoastnews.com/printfullstory.aspx?storyid=71819
Woman Treated For Maggot-Infested Wounds EVANSVILLE, Ind. (AP) -- A resident of a
long-term care facility had maggot-infested wounds so advanced that skin peeled off her legs
when a hospital emergency room nurse removed her clothing, state inspectors found.
Riverwalk Communities, which has a history of violating nursing home standards,
could face state action for the woman's care, said Jennifer Dunlap, a spokeswoman for the
State Department of Health.
"He indicated he soaked her right foot in warm water for 45 minutes and bugs/cockroaches were crawling out of the house slipper. Upon removing the house slipper, he indicated the skin came off of the right foot and toes," the report said. When the nurse removed the woman's pants, the material pulled the skin off the woman's legs, from the knees to the
ankles, according to the report.
The state's survey report found, among other things, that Riverwalk officials had failed to notify the woman's physician when she refused his prescribed treatment. While residents can refuse treatment, "that does not absolve the facility from protecting the resident," said Michelle Motta,
Vanderburgh County's long-term care ombudsman.
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The Older Nurse in the Workforce......does Age Matter? In this article
of the Six articles, we concentrate on a different but increasingly important component of the RN workforce - the growing proportion of older RNs.
http://www.medscape.com/viewarticle/521375?sssdmh=dm1.235588&src=top10# ************************************
Palm Beach Post wire services Wednesday, February 28, 2007LOS ANGELES - In what some are hailing as the most important development in HIV therapy in a decade, two new classes of drugs havebeen found to block virus replication in patients who have become resistant to existing drugs, researchers said Tuesday.The two new classes, called integrase inhibitors and CCR5 inhibitors, doubled the number of patientsin a group of studies whose infections could be brought under control, researchers said at the Conference on Retroviruses and OpportunisticInfections.This is "a pivotal moment" for patients who have become resistant to most AIDS drugs, said Dr. Eric Daar ofHarbor-UCLA Medical Center.Daar, who was not involved in the research, estimated that about 20percent of his patients are resistant to the existing classes of drugs.http://www.palmbeachpost.com/search/content/nation/epaper/2007/02/28/a2a_HIV_0228.html ************************************
Texas, take care of nurses the way they care for us. Limiting the RN-to-patient ratios in hospitals saves lives. Imagine, being alone and sick in the hospital. It's a frightening and stressful experience, but you can always count on one person to be at your bedside: the registered nurse. RNs are on the front lines of our medical system, and every family in the state will eventually rely on their care.That is why a coalition of Texas lawmakers has joined with the National Nurses Organizing Committee and introduced the Texas Hospital PatientProtection Act of 2007, which will significantly improve patient safety in our hospitals with enhanced standards for nurses and stronger protections for patients.The sad fact is that Texas nurses do not have the support they need to do their job. We're seeing an exodus of RNs from the hospital bedside because of hazardous working conditions and dangerously unsafe assignments that are not up to national standards.This must change. Right now, for example, hospitals can assign an RN an unlimited number of patients to care for, meaning they don't have the time to assess and properly care for any of them. This problem is particularly acute because patients who stay in hospitals today are much sicker and have more complex medical treatments and drugs requiredthan in pastyears... (Florida, is not any better)http://www.chron.com/disp/story.mpl/editorial/outlook/4591290.html ***************************** ***
End-of-life care, palliative care, hospice, death and dying; these are terms that many advanced practice nurses deal with in our work lives.We know that planning carefully for this stage of life can bring about comfort and satisfaction despite the inevitable outcome. Many of us may be workingwith adults who are planning for the future for themselves or older family members. Although end-of-life care may not be an overt goal in planning, comfort and quality of life usually are. Patients and families look to advanced practice nurses for information, resources,advice, and support during this time of decision making. Learn about the Nursing Home Quality Monitor, which provides a state-by-state breakdown of nursing homes that are likely to provide better-qualitycare and those that provide poorer-quality care. Topics in AdvancedPractice NursingeJournal 6(4) 2006http://www.medscape.com/viewarticle/548968?src=mp
To check out your knowledge of Business etiquette......try this site:www.etiquetteexpert.com/eti_quiz.htm ( I found several surprises when Itook the test. ********************************
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Much Wider Use of M.R.I.'s Urged for Breast Exam By DENISE GRADYTwo reports call for greatly expanded use of M.R.I. scans but radiologists are not equipped for more demand...
http://www.nytimes.com/2007/03/28/health/28mri.html?th&emc=th
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Hospitals set standards for wristband use The Business Journal of Phoenix - March 2, 2007 by Angela Gonzales The Business Journal
Imagine getting rushed to the hospital and, in the frenzy of your heart attack, a nurse slaps on a yellow wristband. The yellow bands have different meanings depending on the hospital. In some, they mean "do not resuscitate." This actually happened to a patient in Pennsylvania. Luckily, another nurse caught the mistake in time for doctors to save the patient's life.
http://phoenix.bizjournals.com/phoenix/stories/2007/03/05/story7.html?
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WASHINGTON (Reuters) -- An antibiotic often used in hospital intensivecare units to treat serious staph infections resistant to other medicines may cause a sometimes-fatal bleeding condition, researchers said Wednesday. A study in the New England Journal of Medicine linked the antibiotic vancomycin to a disorder called thrombocytopenia. It is associatedwith abnormal bleeding and marked bya decrease in blood platelets....Vancomycin, in use for about three decades, can be used to treat infections in many parts of the body, and is seen as the drug of choice for serious staphylococci infections that are resistant to most other antibiotics. It can have other serious side effects, including hearing and kidney damage.The study's senior researcher, Dr. Richard Aster of the Medical College of Wisconsin in Milwaukee and the Blood Center of Wisconsin's Blood Research Institute,said the findings should not reduce use of vancomycin, which he said remains an important life-saving drug for certain patients.http://www.cnn.com/2007/HEALTH/02/28/antibiotic.blood.reut/index.html
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Wits Scientists invent cutting-edge medicine Independent Online - Cape Town,South Africa One method he has invented, the wafer delivery system, will minimise the use of injections and deliver medicine into the body almost immediately, ...http://www.iol.co.za/index.php?set_id=14&click_id=117&art_id=vn20070331121412544C365335
<<<<<<>>>>>>
CME/CEU
Those that are free and otherwiseNursing Spectrum's CE address is now: www.nurse.com
A website offering free CEUs: http://www.medscape.com/cmecenterdirectory/nurses
This site is loaded with CE/CME offerings......http://www.medscape.com/nurses/ce
A huge offering of CEUs for LPNs and RNs. ......for$24.99
https://nursing.advanceweb.com/Common/CE/Main.aspx
Medical Adherence: America's "Other Drug Problem". Introduction:The Challenge of Adherence http://www.medscape.com/viewprogram/6450?src=mp 0.75 ceu's
Genital Warts: Best Practices for Diagnosis and Management Twenty million people in the United States have HPV but are largely unaware because genital warts, the most common clinical manifestation, are not recognized. http://www.medscape.com/viewprogram/6385Nurses - 1.2 nrs (0.6 hrs.are in the area of pharmacology)
This CE is for Pharmacists Understanding Migraine http://www.medscape.com/viewprogram/6095?src=mp
Aspirin Found to Reduce Esophageal Cancer Risk in Barrett's (CME/CE) SEATTLE --Aspirin and other NSAIDs decrease the risk of progression of the most aggressive form of Barrett's esophagus to esophageal cancer, researchers here reported.
http://www.medpagetoday.com/HematologyOncology/OtherCancers/dh/5167
Vitamin D Insufficiency in Patients with End Stage Renal Disease: the Role and Effect of Vitamin D analogues on Survival CME/CE 0.9 hrs03/30/2007
What impact do vitamin D analogues have on survival in patients with secondary hyperparathyroidism? Join Drs. Craig Langman, Francesca Tentori, and Csaba Kovesdy as they discuss. http://www.medscape.com/viewprogram/6857?sssdmh=dm1.259168&src=nlcmealert
Improving Adherence in Childhood and adolescent ADHD CME/CE03/30/2007 0.4 hrs
Find out what 3 of the top experts in ADHD recommend to improve treatment outcomes for kids with ADHD, and why it's important.
http://www.medscape.com/viewprogram/6884?sssdmh=dm1.259175&src=nlcmealert
Making the Difficult Diagnosis: Detecting Autism in a Toddler CME/CE03/30/2007 1.5 hrs Autistic disorders can be detected in toddlers, and early intervention is in increasing demand. Learn how to respond to anxious parents and the best approach to this challenging diagnostic problem. http://www.medscape.com/viewprogram/6876?sssdmh=dm1.259175&src=nlcmealert
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WEBSITES/LINKS
Always on the lookout for interesting websites / links.Please send them to: RNFrankie@bellsouth.net A - Z Guide onHealthTopicsWEBSITES/LINKS
http://www.webmd.com/a_to_z_guide/health_topics.htmRozalfaro's website (Roz)
http://www.alfaroteachsmart.com/Raconte's website (Geneviève)
http://www.solutionsoutsidethebox.net,I am not certain...but probably most of us and all our information isat this website. "Believe it" !!! Zabasearch:http://www.zabasearch.com/
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HUMOR
(If anyone has ever tried Medical Transcription, this is typical. Can become very difficult)HUMOR
We were thoroughly confused. While transcribing medical audiotapes, myco-worker came upon the following garbled diagnosis: "This man haspholenfrometry"."
Knowing nothing about that particular condition, she double-checked with the doctor.
After listening to the tape, he shook his head."This man," he said, translating for her, "has fallen from a tree."
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MEDICAL RECALLS/ NOTICES
FDA and Bristol-Myers Squibb notified healthcare professionals of Clinical Studies/Special Populations sections of the prescribing information for Baraclude. The revised labeling is the result of a case report in which a human immunodeficiency virus (HIV) variant containingthe M184V resistance substitution was documented during Baraclude treatment for chronic hepatitis B virus(HBV) infection in an HIV/HBVco-infected patient who was not simultaneously receiving highly active antiretroviral therapy (HAART). Current treatment guidelines recommend Baraclude as an option for treatment of HBVin the HIV/HBV co-infected adult patient who does not qualify for HAART. Healthcare professionalsare advised that when considering therapy with Baraclude in an HIV/HBVco-infected patient not receiving HAART, the risk of developing HIV resistance cannot be excluded based on current information.MEDICAL RECALLS/ NOTICES
http://www.fda.gov/medwatch/safety/2007/safety07.htm#Baraclude
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FDA notified healthcare professionals and patients that Novartis has agreed to discontinue marketing Zelnorm, a drug used for the short-term treatment of women with irritable bowel syndrome with constipation andfor patients younger than 65 years of age with chronic constipation. FDA analysis of safety data pooled from 29 clinical trials involvingover 18,000 patients showed an excess number of serious cardiovascular adverse events, including angina, heart attacks, and stroke, in patients taking Zelnorm compared to patients given placebo. http://www.fda.gov/medwatch/safety/2007/safety07.htm#Zelnorm ~~**~**~**~**~**~**~**~**
NURSING HINTSSorry Next Time
Used with permission from 1,001 Nursing Tips & Timesavers,ThirdEdition, 1997, p. 49, Springhouse Corporation/www.springnetcom ~*~*~*~*~*~*~*~*~*~*~*~*~*~
ADVERTISEMENTS
From the members
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From the members
This ad is from Decubqueen @aol.com (Gerry)......Accu-Ruler Accurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford. Free Shipping with first order when you mention Paradigm97.Visit us at http://www.accu-uler.com
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This ad is from: GShort @AOL.com (Gwen) These are great little cakes! http://www.delightful greeting cakes.com/worlds greatest.php
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NEW MEMBERS
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Please send the prospective members'screen names with first names to me: RNFrankie@bellsouth.net
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Membership BIO Committee...(if you haven't sent in your BIO....Please send it to the appropriate section below) : Check by your screen name's first letter.........If you have any questions...feel free to write either the Bio/Profile person or myself. Be very glad to help you.
BCK131 @AOL.com (Chris) A thru B section,
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Paradigm 97Co-Founders:
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DISCLAIMER:
The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the links and information provided by our members.The articles and websites are not personally endorsed by the editors, nor do the articles necessarily reflect our opinions.
Sent in by MJSolon@AOL.com(Melva)
Write me.....offer suggestions for theNewsletter/ share articles, etc. Frankie
(rnfrankie@bellsouth.net)
ADDRESS CHANGES
NOTICE: I attempt to send newsletters to your current email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the e-mail address until you contact me with an updated e-mail address; I have no way to reach you without a corrected-mail address.... Remember most ISPs do not send the updated e-mail address.You could always send me your home number.......lol So pleasesend your new name/address to rnfrankie@bellsouth.net
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EDITORIAL STAFF:
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EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868@AOL.com(Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com(Miriam), and Schulthe @AOL.com (Susan)
Membership BIO Committee...(if you haven't sent in your BIO....Please send it to the appropriate section below) : Check by your screen name's first letter.........If you have any questions...feel free to write either the Bio/Profile person or myself. Be very glad to help you.
BCK131 @AOL.com (Chris) A thru B section,
Dick515 @AOL.com (Eileen) C thru D section,
GALLO RN @AOL.com (Sue) E thru I section,
rnfrankie @bellsouth.net (Frankie) J thru K section,
Jntcln @AOL.com(Janet) L thru M section,
GALLO RN @AOL.com (Sue) N thru Q section,
Schulthe @AOL.com (Susan) R thru T section,
Sandy1956 @AOL.com (Sandy) U thru Z section.
Paradigm 97Co-Founders:
MarGerlach@AOL.com (Marlene) rnfrankie@bellsouth.net (Frankie)
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DISCLAIMER:
The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the links and information provided by our members.The articles and websites are not personally endorsed by the editors, nor do the articles necessarily reflect our opinions.
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THOUGHT FORTHE DAY
THOUGHT FORTHE DAY
Sent in by MJSolon@AOL.com(Melva)
Anger or hatred is like a fisherman's hook.
It is very important forus to ensure that
we are not caught by it.-
DalaiLama
It is very important forus to ensure that
we are not caught by it.-
DalaiLama
Write me.....offer suggestions for theNewsletter/ share articles, etc. Frankie
(rnfrankie@bellsouth.net)
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