Cepheid Xpert MRSA/SA Blood Culture Assay for Use with the GeneXpert Dx System:
ISSUE: The firm received increasing numbers of complaints for false negative MRSA results when compared to MRSA positive results received from culture methods. All Cepheid MRSA/SA Blood Culture Assay products have a potential of generating infrequent rates of false negative MRSA results, which could result in incorrect treatment or delay of care for patients with MRSA infection.
BACKGROUND: This test is used to detect methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus aureus (SA) DNA directly from patient positive blood culture determined to be Gram Positive Cocci in Clusters (GPCC) or Gram Positive Cocci in singles (GPC) by Gram stain.
RECOMMENDATION: On July 1, 2010, the company issued a press release and sent its customers a revised Corrective Action Notice letter instructing them not to report the MRSA negative result when a MRSA negative/SA positive result is generated on the Cepheid MRSA/SA Blood Culture Assay. Instead, customers were instructed to conduct further antimicrobial susceptibility testing to determine the MRSA result. The MRSA positive/SA positive results generated on the Cepheid MRSA/SA Blood Culture Assay can still be reported. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm218038.htm
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Slim-30 Herb Supplement: Undeclared Drug Ingredient
ISSUE: FDA lab analysis of Slim-30 Herb Supplement distributed by the company was found to contain undeclared N-Desmethyl Sibutramine and traces of Sibutramine. Sibutramine is an FDA-approved drug used as an appetite suppressant for weight loss. The FDA has not approved this product, therefore the safety and effectiveness of the product is unknown. This product poses a threat to consumers because Sibutramine is known to substantially increase blood pressure and/or pulse rate in some patients and may present a significant risk for patients with a history of coronary artery disease, congestive heart failure, arrhythmias or stroke.
BACKGROUND: Slim-30 Herb Supplement is marketed as a Natural Herb for Weight Loss. Slim-30 Herb Supplement is packaged in plastic bottles containing 30 capsules per bottle and bears UPC 8 31457 005009 2. The affected lot/code being recalled is 032009. The product was sold to distributors and retail stores nationwide and China and via internet sales. No illnesses or injuries have been reported to the company to date in connection with this product.
RECOMMENDATION: Consumers should not consume the Slim-30 Herb Supplement and should return it immediately to the place of purchase for a full refund.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm219463.htm
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Que She Herbal Supplement: Undeclared Drug Ingredients
Capsules widely sold on Internet sites as weight loss supplement
ISSUE: FDA warned consumers and healthcare professionals that Que She, marketed as an herbal weight loss supplement, contains unlisted and active pharmaceutical ingredients that could harm consumers, especially those with cardiovascular conditions. These active pharmaceutical ingredients also may interact with other medications and result in a serious adverse event.
BACKGROUND: Que She, advertised as “Slimming Factor Capsule” and as “an all-natural blend of Chinese herbs,” has been widely distributed on Internet sites such as the Bouncing Bear Botanicals website, and at retail outlets, including Sacred Journey in Lawrence, Kansas.
FDA analysis of Que She found that it contains:
fenfluramine – a stimulant drug withdrawn from the U.S. market in 1997 after studies demonstrated that it caused serious heart valve damage
propranolol – a prescription beta blocker drug that can pose a risk to people with bronchial asthma and certain heart conditions
sibutramine – a controlled substance and prescription weight loss drug, sibutramine was the subject of a recent study whose preliminary findings showed an association between sibutramine use and increased risk of heart attack and stroke in patients who have a history of heart disease
ephedrine – a stimulant drug that is legally marketed over-the-counter for temporary relief of asthma but can pose a risk to people with certain cardiovascular conditions.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm218439.htm
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Angiotensin Receptor Blockers (ARBs): Ongoing Safety Review for Cancer Risk
ISSUE: A recently published study - a meta-analysis combining cancer-related findings from several clinical trials - suggested use of ARBs may be associated with a small increased risk of cancer.
BACKGROUND: ARBs are used in patients with high blood pressure and other conditions. Brand names include Atacand, Avapro, Benicar, Cozaar, Diovan, Micardis, and Teveten.
The meta-analysis included data from over 1,000 patients in several long-term, randomized, controlled clinical trials evaluating ARBs for which adverse events related to cancer were captured during the study. The mean duration of follow-up ranged from 1.7 to 4.8 years.
The study reported the frequencies of new cancer occurrence to be 7.2% for patients receiving ARBs compared to 6.0% for those not receiving ARBs (risk ratio = 1.08, 95% Confidence Interval: 1.01-1.15). No statistically significant difference in cancer deaths was noted.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm219185.htm
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LIFEPAK 20 and LIFEPAK 20e External Defibrillator/Monitors by Physio-Control Inc.: Class I Recall Due To Power Supply Failure
ISSUE: A failure on the power supply assembly can result in either "No DC power" or "No DC or AC power". A failure of DC (battery) power can result in the inability to deliver defibrillation therapy if the device will not turn on using DC (battery) power and no AC (line) power is available.
BACKGROUND: The LIFEPAK 20 and LIFEPAK 20e defibrillator/monitor is designed for use by trained medical personnel in hospitals and clinic settings to monitor patient heart rhythms and to treat patients experiencing cardiac arrest. Approximately 42,943 devices were distributed worldwide between September 16, 2002 and September 27, 2007. These devices were manufactured from July 31, 2002 to September 19, 2007.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm217980.htm
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Coumadin 1 mg Tablet Blister Packs: Recall
Bristol-Myers Squibb determined that some of the tablets, over time, may not meet specification for isopropanol. Isopropanol is used to maintain the active ingredient, Coumadin, in the crystalline state, and could affect the therapeutic levels of the active ingredient. A decrease of active ingredient may increase the risk of clots which could lead to heart attack or stroke, and if there is too much active ingredient, there is an increased risk of bleeding.
ISSUE: The following lot numbers are included in this recall: Physician Sample Blister Packs: Lot# 9A48931A, 9A48931B, 9A48931C, expiration January 2012; HUD Blister Pack: Lot# 8F34006B, 8K44272A, 8K46168A, 9F44437A and 9K58012B with expiry dates between June 2011 and November 2012.
BACKGROUND: The recall only involves Coumadin 1 mg tablet blister-packs distributed in the U.S. This recall does not involve Coumadin 1 mg supplied in bottles or any other strengths and dosage forms of the product. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm218955.htm
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Arava (leflunomide): Boxed Warning - Risk of Severe Liver Injury
ISSUE: FDA is adding information on severe liver injury to the Boxed Warning of Arava (leflunomide) a drug used to treat rheumatoid arthritis - to highlight the risk of severe liver injury in patients using this drug and how this risk may be reduced. FDA previously required a Boxed Warning stating that leflunomide was contraindicated in pregnant women, or women of childbearing potential who were not using reliable contraception.
BACKGROUND: The decision to add information on severe liver injury to the Boxed Warning was based on FDA’s review of adverse event reports which identified 49 cases of severe liver injury, including 14 cases of fatal liver failure, between August 2002 and May 2009. In this review, the greatest risk for liver injury was seen in patients taking other drugs known to cause liver injury, and patients with pre-existing liver disease.
RECOMMENDATIONS: The information on severe liver injury being added to the Boxed Warning states:
Patients with pre-existing liver disease should not receive leflunomide.
Patients with elevated liver enzymes (ALT greater than two times the upper limit of normal) should not receive leflunomide.
Caution should be used in patients who are taking other drugs that can cause liver injury.
Liver enzymes should be monitored at least monthly for three months after starting leflunomide and at least quarterly thereafter.
If the ALT rises to greater than two times the upper limit of normal while the patient is on leflunomide – leflunomide should be stopped, cholestryamine washout begun to speed the removal of leflunomide from the body and follow-up liver function tests conducted at least weekly until the ALT value is within normal range.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm218912.htm
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CONSTELLATION Vision System: Recall
ISSUE: Alcon initiated the recall after it identified both software and hardware problems which have been associated with unexpected system loss of power (shutdowns), unintended system error messages, unresponsive touchscreens, and system setting and infusion performance problems. These events may cause eye injuries, including blindness.
BACKGROUND: The Alcon CONSTELLATION Vision System is an ophthalmic microsurgical system used by eye surgeons to perform various types of eye surgery. All model and catalog numbers are affected by this recall and are listed in the FDA Recall Notice. These devices were manufactured and distributed from September 1, 2008 through April 30, 2010. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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Air- or Gas-Pressurized Spray Devices: Risk of Air or Gas Embolism
ISSUE: FDA has received reports of air or gas embolism occurring during or immediately after application of hemostatic drug or biological products using air- or gas-pressurized sprayers. These adverse events appear to be related to use of spray devices inconsistent with the approved product labeling and instructions for use. In some reports the device was used at higher than recommended pressure or at a distance too close to the surface of the bleeding site. Although rare, the reports describe air embolisms that are life threatening and include one fatality.
BACKGROUND: The manufacturers of all fibrin sealants licensed in the U.S. have updated the Warning and Precautions sections of the labels of EVICEL, Tisseel and ARTISS to emphasize the risk of air embolism and the need to use the recommended ranges of pressure and distance. The labeling of the spray devices and non-fibrin hemostatic drug or biological products also includes information on recommended pressures and distances.
RECOMMENDATIONS: Clinicians using air- or gas-pressurized spray devices for application of hemostatic drug or biological products should:
Use the applicator, spray set, and pressure control device or regulator as recommended in the labeling or Information For Use of the hemostatic agent.
Use an air or gas pressure setting within the range recommended by the manufacturer of the sprayer.
Ensure that distance between the spray head and the tissue surface is not less than the minimum recommended by the manufacturer of the sprayer.
Monitor blood pressure, pulse, oxygen saturation and end tidal CO2 for signs of an air or gas embolism.
Make sure the regulators are maintained properly and checked for safe performance regularly.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm218530.htm
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Qualaquin (quinine sulfate): New Risk Evaluation and Mitigation Strategy - Risk of serious hematological reactions
ISSUE: Due to continued reports of serious side effects in patients using Qualaquin "off-label" for night time leg cramps, FDA has approved a risk management plan to warn against the use of this drug for such unapproved uses. Qualaquin should not be used for night time leg cramps. Qualaquin use may result in serious and life-threatening hematological reactions, including serious bleeding due to thrombocytopenia, and hemolytic-uremic syndrome/ thrombotic thrombocytopenic purpura, which in some cases may result in permanent kidney damage. In some patients, adverse reactions result in hospitalization and death.
BACKGROUND: Qualaquin is only FDA-approved for the treatment of uncomplicated malaria caused by the parasite Plasmodium falciparum, primarily in travelers returning from malaria-endemic areas. However, the majority of Qualaquin's use in the United States is for the treatment or prevention of night time leg cramps.The product labeling states that the risks associated with the use of Qualaquin in the absence of evidence of its effectiveness for treatment or prevention of nocturnal leg cramps outweigh any potential benefits.
The risk management plan (REMS) requires that patients be given a Medication Guide explaining what this medication is and is not approved for, as well as the potential side effects of this drug. In addition, the REMS requires that the manufacturer issue a Dear Health Care Provider Letter warning of the risk of serious and life-threatening hematologic reactions.
RECOMMENDATION: Healthcare professionals should discuss with patients the warning signs of thrombocytopenia, such as easy bruising, severe nose bleeds, blood in the urine or stool, bleeding gums, and the appearance of unusual purple, brown, or red spots on the skin. Patients are encouraged to read the Medication Guide given to them at the pharmacy before starting Qualaquin and each time they get a refill. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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Vialipro Dietary Supplement: Recall- Undeclared Drug Ingredient ISSUE: Good Health, Inc. is conducting a voluntary recall after an FDA lab analyses found that the product tested from certain batches of Vialipro contain Sulfoaildenafil, an analogue of Sildenafil, an FDA-approved drug used as treatment for male Erectile Dysfunction (ED) making this product an unapproved drug. The undeclared ingredient may pose a threat to the consumer because the interaction of the analogue with some prescription drugs (such as nitroglycerin) may lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take other prescription drugs. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm219580.htm
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Advair Diskus (fluticasone propionate and salmeterol inhalation powder): Stolen Product Warning
ISSUE: Certain Advair Diskus inhalers stolen from a distribution warehouse in 2009 have been found in some pharmacies. The safety and effectiveness of the stolen inhalers cannot be assured and they should not be used.
The lot numbers, doses, and quantities of the stolen Advair Diskus inhalers are:
Lot 9ZP2255 - NDC 0173-0696-00, Advair Diskus 250/50, 60 Dose, Exp: Sep 2010 (14,400 inhalers)
Lot 9ZP3325 - NDC 0173-0697-00, Advair Diskus 500/50, 60 Dose, Exp: Sep 2010 (11,200 inhalers)
BACKGROUND: Advair Diskus (fluticasone propionate and salmeterol inhalation powder) is an inhaler used to treat patients with asthma and chronic obstructive pulmonary disease. The products were reported stolen in August 2009 from a GlaxoSmithKline warehouse near Richmond, Va. The inhalers found recently were the first from the stolen lots to be found in commerce. However, more stolen product may still be on the market and the FDA continues to aggressively investigate the matter.
RECOMMENDATION: Patients who have products with these lot numbers should immediately stop using them, contact GlaxoSmithKline’s Customer Response Center at 888-825-5249, and follow-up with their physician or pharmacist to obtain a proper replacement.
Pharmacists and wholesalers who find Advair Diskus inhalers bearing these lot numbers should remove them from shelves and contact the FDA’s Office of Criminal Investigations (OCI) at 800-551-3989. The agency also is asking for the public's help in reporting any information regarding these inhalers, including suspicious or unsolicited offers for the Advair Diskus lots in question, to OCI or by visiting the OCI website. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts
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Evamist (estradiol transdermal spray): Drug Safety Communication - Unintended Exposure of children and pets to topical estrogen ISSUE: FDA notified healthcare professionals and patients that it is reviewing reports of adverse effects from Evamist, an estrogen hormone used to reduce hot flashes during menopause. Children unintentionally exposed to the drug through skin contact with women may experience premature puberty. Female children may experience nipple swelling and breast development. Male children may experience breast enlargement.
BACKGROUND: Evamist is a topical product, sprayed on the skin on the inside of the forearm between the elbow and the wrist. FDA is currently reviewing reported adverse events and is working with the company to identify any factors that may contribute to unintended exposure. The Agency will update the public when this review is complete. FDA and the company are also evaluating ways to minimize the risk.
RECOMMENDATION: Patients should make sure that children are not exposed to Evamist and that children do not come into contact with any skin area where the drug was applied. Women who cannot avoid contact with children should wear a garment with long sleeves to cover the application site. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts
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Cubicin (daptomycin): Drug Safety Communication - Risk of Eosinophilic Pneumonia
ISSUE: FDA notified healthcare professionals and patients about the potential for developing eosinophilic pneumonia during treatment with Cubicin (daptomycin), an intravenous antibacterial drug indicated for use in treatment of serious skin infections and bloodstream infections. Eosinophilic pneumonia is a rare but serious condition where a type of white blood cell (eosinophil) fills the lungs. Symptoms of eosinophilic pneumonia include fever, cough, shortness of breath, and difficulty breathing. Eosinophilic pneumonia may lead to progressive respiratory failure and is potentially fatal if not quickly recognized and appropriately managed.
BACKGROUND: FDA has reviewed published case reports of Cubicin-associated eosinophilic pneumonia and conducted a review of post-marketing adverse event reports from the FDA's Adverse Event Reporting System. FDA's review identified 7 cases of eosinophilic pneumonia between 2004 and 2010 that were most likely associated with Cubicin. Based on these reviews, FDA determined that eosinophilic pneumonia can be associated with Cubicin use and requested that the manufacturer of Cubicin include this information in the Warnings and Precautions and Adverse Reactions, Post-Marketing Experience sections of the drug label.
RECOMMENDATION: Healthcare professionals should closely monitor patients being treated with Cubicin for eosinophilic pneumonia. Patients receiving Cubicin should immediately contact their healthcare professional if they develop a new or worsening fever, cough, shortness of breath, or difficulty breathing. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm220499.htm
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Cook brand Ciaglia Blue Rhino/Ciaglia Blue Dolphin Percutaneous Tracheostomy Introducer Sets and trays. Sets and Trays contain Covidien 6PERC or 8PERC Shiley Tracheostomy Tube
Issue: FDA notified healthcare professionals that Cook initiated a voluntary recall of certain lots of Ciaglia Blue Rhino/Blue Dolphin Percutaneous Tracheostomy Introducer
Sets/Trays that contain Covidien 6PERC or 8PERC Shiley Tracheostomy Tube due to the product’s cuff not holding air. The voluntary recall only affects lot numbers noted in the press release at link below.
Background: The defect is a result of leaks in the pilot balloon inflation assembly. If a cuff does not hold air, ventilation will be adversely affected since the ability to generate positive pressure in the airway could be compromised by lack of cuff seal. This could result in a sudden decrease in the amount of oxygen in the blood or a sudden increase in the amount of carbon dioxide in the blood, especially if the patient requires assisted mechanical ventilation and could result in serious injury, including death.
Recommendation: Cook has mailed a detailed Customer Notification letter to each customer who has received an affected lot number of these devices. Customers should review product in inventory and current use to identify product from the affected lot codes. Healthcare professionals may report adverse events or quality problems experienced with the use of this product to the FDA’s MedWatch Adverse Event Reporting program either online by regular mail or fax. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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Miracle Mineral Solution (MMS): Product as consumed produces a potent bleach ISSUE: FDA warned consumers not to consume or use Miracle Mineral Solution, an oral liquid solution also known as "Miracle Mineral Supplement" or "MMS." The product, when used as directed, produces an industrial bleach that can cause serious harm to health. The product instructs consumers to mix the 28 percent sodium chlorite solution with an acid such as citrus juice. This mixture produces chlorine dioxide, a potent bleach used for stripping textiles and industrial water treatment. High oral doses of this bleach, such as those recommended in the labeling, can cause nausea, vomiting, diarrhea, and symptoms of severe dehydration.
BACKGROUND: MMS is distributed on Internet sites and online auctions by multiple independent distributors. MMS claims to treat multiple unrelated diseases, including HIV, hepatitis, the H1N1 flu virus, common colds, acne, cancer, and other conditions. The FDA is not aware of any research that MMS is effective in treating any of these conditions. MMS also poses a significant health risk to consumers who may choose to use this product for self-treatment instead of seeking FDA-approved treatments for these conditions.
RECOMMENDATIONS: Consumers who have MMS should stop using it immediately and throw it away. The FDA advises consumers who have experienced any negative side effects from MMS to consult a health care professional as soon as possible. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts
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Afluria (CSL Ltd.) Influenza Virus Vaccine: Label Change - Risk of Fever and Febrile seizure
ISSUE: FDA updated the Warnings and Precautions sections of the Prescribing Information for Afluria to inform healthcare professionals that the Afluria vaccine has been associated with an increased incidence of fever and febrile seizure among young children reported in Australia, mainly among those less than 5 years of age.
BACKGROUND: FDA announced the approved vaccines for the 2010-2011 influenza season in the United States. The brand names and manufacturers for the upcoming season’s vaccines are: Afluria, CSL Limited; Agriflu, Novartis Vaccines and Diagnostics; Fluarix, GlaxoSmithKline Biologicals; FluLaval, ID Biomedical Corporation; FluMist, MedImmune Vaccines Inc.; Fluvirin, Novartis Vaccines and Diagnostics Limited; and Fluzone and Fluzone High-Dose, Sanofi Pasteur Inc.
The available data suggest that the increased rates of fever and febrile seizure are only associated with the Southern Hemisphere formulation of CSL’s vaccine. The available data regarding the safety of other influenza vaccines for children used in the Southern Hemisphere do not suggest an increased rate of fever or febrile seizure. FDA is requiring CSL Limited to conduct a study of Afluria in children to obtain additional information regarding the febrile events that were seen in the Southern Hemisphere. CSL Limited will not be supplying the United States with the 0.25 milliliter single-dose, prefilled syringes, which are used in very young children. The 0.5 milliliter single-dose, prefilled syringes and 5 milliliter multi-dose vials will be distributed.
RECOMMENDATION: Vaccines for the 2010-2011 influenza season are approved by FDA for the prevention of influenza in children, adolescents, and adults, including the elderly. There are several vaccines approved by FDA available in both nasal spray and injectable (“shot”) forms. Because the influenza viruses that cause people to get sick can change, each year's vaccine may be different from the previous year. Therefore, it is important to get the influenza vaccine every year. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts
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Nutraloid Labs ejaculoid XXTREME and stimuloid II: Undeclared Drug Ingredient ISSUE: FDA notified consumers that lab analysis of lots of ejaculoid XXTREME and stimuloid II found that the products, sold as dietary supplements, contain sulfoaildenafil, similar to sildenafil, which is an active ingredient of an FDA-approved drug for male erectile dysfunction, making these products unapproved drugs. This active drug ingredient is not listed on the product labels and may interact with nitrates found in drugs such as nitroglycerin and may lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take nitrates.
BACKGROUND: The recalled products were distributed in black plastic bottles to distributors and via internet sales. The company press release contains specific lot numbers and additional recall information. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts
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GammaGard Liquid, Immune Globulin Intravenous (Human)
Baxter BioScience and FDA notified healthcare professionals of a market withdrawal being conducted as a precautionary measure due to an increased number of adverse event reports of allergic reactions associated with two lots of the product.
GammaGard Liquid is indicated for the treatment of primary immunodeficiency disorders associated with defects in humoral immunity. See the Market Withdrawal Notice for information on affected lots. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm214497.htm
Sunday, August 15, 2010
Saving the Day by Genevieve M Clavreul (Raconte)
Saving the Day: When Off-Duty Nurses Get Called to Help
By Geneviève M. Clavreul, RN, Ph.D. SUMMER IS HERE and many of us look forward to having time off to relax, recharge our batteries, spend time with family and friends, or just plain escape from the daily grind of our nursing responsibilities. Nursing is one of those careers that doesn’t stop when the workday ends. If a nurse hears that ominous request over the airplane’s intercom — “is there a doctor or nurse onboard?” — a shiver or excitement or dread runs down the spine. A nurse is accustomed to answer a plea for help.
I still remember that sun-drenched beach in Martinique, where a colleague and I had decided to attend an international conference on women and HIV. I love Martinique, a little taste of home as French is spoken and many touches of France greet you at every turn; needless to say I was happy to attend a conference held in such a tropical locale. Thursday rolled around and my colleague and I took a day off from the rigors of the conference, along with a multitude of conference delegates. As the day leisurely progressed, our revels were interrupted by screams for help from near the water’s edge.
One would think that with a beach full of nurses and doctors, the woman in need of help would have been inundated. On the contrary, few responded. Everyone assumed someone else would answer the pleas for help. That afternoon’s emergency was quite the subject of discussion at that evening’s meet-and-greet. Many wondered how so many could stand idly by and ignore the screams. Others questioned the ethics of answering or ignoring the call, while others took a more jaundiced approach with the rationale that they were “on holiday and not on call.” Some of the delegates rationalized they “didn’t speak French.”
This adventure in Martinique taught me that even while on vacation, one might be called upon to render aid — and not to assume that someone else will help.
Two more times in my lifetime I’ve been called to render aid to a person in need while off-duty. The first was early in my career as an LPN when my kids and I were on a picnic in Topeka, Kansas, where my husband was stationed during the Vietnam War. Dusk was falling. We were piled in the car driving home from the park when a frantic woman threw herself in front of our station wagon forcing me to come to an abrupt stop. As I would learn, this woman had been trying for quite some time to get people to stop and help her mother, who was having a heart attack. Desperate, she threw herself on the hood of a passing car, which as luck would have it was mine. I helped resuscitate her mother and waited with her for the ambulance to arrive. That evening as I drove home my children buzzed with excitement at having our day take such an unexpected turn.
Who could forget that call that wafted through the cabin of our cross-country flight asking if there was any medical personnel onboard? We see the “is there a doctor or nurse in the house?” scene played out on television or in the movies, often with dramatic flair and occasionally for laughs, but it takes on a whole new meaning when that call goes out in real life.
We were over North Carolina when the flight crew asked that a doctor or nurse to report to the forward cabin. I was sound asleep, but my daughter, who was awake and observing the scene unfold, nudged me awake when she heard an older woman identify herself as a retired school nurse to a flight attendant.
I offered to help and as fate would have it, the emergency was minor. The passenger’s vitals were monitored and she stayed hydrated until we landed at Dulles Airport where paramedics were waiting. I recalled noticing this passenger earlier while we waited in the terminal to board. At the time I told my daughter that this lady appeared to have had one too many. Later she confirmed this to me adding that she’d also taken Valium to help “take the edge off.”
Vacation is best defined as “leisure time away from work devoted to rest or pleasure.” Just how we chose to use those days off can differ widely from person to person. Some take a trip to the Grand Canyon while others take a “stay-cation,” the term coined to describe individuals relaxing at home and possibly taking day trips. Some nurses choose to use that time to continue their practice by helping others in need, such as volunteering with Doctors without Borders, Operation Smile or at a local clinic.
Whatever vacation is right for you, keep in mind that nurses are among that select group of individuals that fate sometime calls upon to handle an emergency situation. If this should happen to you during your vacation remember that this experience too becomes woven into your vacation experience and can make for some great storytelling later.
Geneviève M. Clavreul RN, Ph.D., is a healthcare management consultant who has experience as a director of nursing and as a lecturer of hospital and nursing management. She can be reached at gmc@solutionsoutsidethebox
By Geneviève M. Clavreul, RN, Ph.D. SUMMER IS HERE and many of us look forward to having time off to relax, recharge our batteries, spend time with family and friends, or just plain escape from the daily grind of our nursing responsibilities. Nursing is one of those careers that doesn’t stop when the workday ends. If a nurse hears that ominous request over the airplane’s intercom — “is there a doctor or nurse onboard?” — a shiver or excitement or dread runs down the spine. A nurse is accustomed to answer a plea for help.
I still remember that sun-drenched beach in Martinique, where a colleague and I had decided to attend an international conference on women and HIV. I love Martinique, a little taste of home as French is spoken and many touches of France greet you at every turn; needless to say I was happy to attend a conference held in such a tropical locale. Thursday rolled around and my colleague and I took a day off from the rigors of the conference, along with a multitude of conference delegates. As the day leisurely progressed, our revels were interrupted by screams for help from near the water’s edge.
One would think that with a beach full of nurses and doctors, the woman in need of help would have been inundated. On the contrary, few responded. Everyone assumed someone else would answer the pleas for help. That afternoon’s emergency was quite the subject of discussion at that evening’s meet-and-greet. Many wondered how so many could stand idly by and ignore the screams. Others questioned the ethics of answering or ignoring the call, while others took a more jaundiced approach with the rationale that they were “on holiday and not on call.” Some of the delegates rationalized they “didn’t speak French.”
This adventure in Martinique taught me that even while on vacation, one might be called upon to render aid — and not to assume that someone else will help.
Two more times in my lifetime I’ve been called to render aid to a person in need while off-duty. The first was early in my career as an LPN when my kids and I were on a picnic in Topeka, Kansas, where my husband was stationed during the Vietnam War. Dusk was falling. We were piled in the car driving home from the park when a frantic woman threw herself in front of our station wagon forcing me to come to an abrupt stop. As I would learn, this woman had been trying for quite some time to get people to stop and help her mother, who was having a heart attack. Desperate, she threw herself on the hood of a passing car, which as luck would have it was mine. I helped resuscitate her mother and waited with her for the ambulance to arrive. That evening as I drove home my children buzzed with excitement at having our day take such an unexpected turn.
Who could forget that call that wafted through the cabin of our cross-country flight asking if there was any medical personnel onboard? We see the “is there a doctor or nurse in the house?” scene played out on television or in the movies, often with dramatic flair and occasionally for laughs, but it takes on a whole new meaning when that call goes out in real life.
We were over North Carolina when the flight crew asked that a doctor or nurse to report to the forward cabin. I was sound asleep, but my daughter, who was awake and observing the scene unfold, nudged me awake when she heard an older woman identify herself as a retired school nurse to a flight attendant.
I offered to help and as fate would have it, the emergency was minor. The passenger’s vitals were monitored and she stayed hydrated until we landed at Dulles Airport where paramedics were waiting. I recalled noticing this passenger earlier while we waited in the terminal to board. At the time I told my daughter that this lady appeared to have had one too many. Later she confirmed this to me adding that she’d also taken Valium to help “take the edge off.”
Vacation is best defined as “leisure time away from work devoted to rest or pleasure.” Just how we chose to use those days off can differ widely from person to person. Some take a trip to the Grand Canyon while others take a “stay-cation,” the term coined to describe individuals relaxing at home and possibly taking day trips. Some nurses choose to use that time to continue their practice by helping others in need, such as volunteering with Doctors without Borders, Operation Smile or at a local clinic.
Whatever vacation is right for you, keep in mind that nurses are among that select group of individuals that fate sometime calls upon to handle an emergency situation. If this should happen to you during your vacation remember that this experience too becomes woven into your vacation experience and can make for some great storytelling later.
Geneviève M. Clavreul RN, Ph.D., is a healthcare management consultant who has experience as a director of nursing and as a lecturer of hospital and nursing management. She can be reached at gmc@solutionsoutsidethebox
August Paradigm Bytes Newsletter
PARADIGM BYTESNewsletter for Paradigm 97
August 15, 2010
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.
Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.
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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SNIPPETS
Presenting two nurses for whom we owe a great deal of respect:
Loretta Ford, a pioneer in shaping the role of NPs In 1965, nurse leader Loretta Ford collaborated with physician Henry Silver in developing a model for the pediatric nurse practitioner with a focus on health and wellness. Their first training program aimed to ensure the NP was competent, safe and acceptable to patients. Since then, Ford has seen the number of NPs grow to 150,000 in the U.S. Nurse.com
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Lystra Gretter: Public Health Advocate and Professional Reformer By David Yates
When Lystra Eggert Gretter was inducted into the Michigan Women's Hall of Fame in 2004, she was honored for her "tireless" efforts in promoting nursing as a respectable profession in the late 19th and early 20th centuries. Gretter made many contributions to nursing. She shifted the model of nursing education from a one-year apprenticeship to a three-year academic pursuit. She created nurse-run hospital wards instead of allowing nursing students to run them. Gretter cut the work day to 8-hour shifts, to afford nurses and students more time to study and recreate. She wrote what is believed to be the first standardized textbook for nursing education and created one of the first professional nursing libraries. And Gretter was a founding member, at the end of the 19th Century, of groups that later became the American Nurses Association and the National League for Nursing. She established an early visiting nurses association. Noting that the public perception of nursing was that of "women's work," Gretter lobbied for more political power, including aligning nursing with suffragettes who sought the vote. And Gretter was "the moving spirit behind the creation of "The Florence Nightingale Pledge," an oath of ethics that many graduating nursing students still make today. Gretter also worked to advance public health generally. She established tuberculosis hospitals, lobbied for in-home nursing care and became a vocal public health advocate for Detroit's burgeoning poor and immigrant population. She also successfully introduced the first state-wide health inspections of school children and a free maternity/infant care clinic in Detroit. more...
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MEDICAL NEWS
Secretary Sebelius Announces Funding for Nurse Practitioner Led Clinics
On June 16, 2010, Secretary Sebelius announced the release of $15,000,000 for the operation of 10 nurse managed health clinics which will support the education and training of nurse practitioners.
Nurse managed health centers staffed by nurse practitioners; provide comprehensive primary health care services to populations living in medically underserved communities. According to Joanne Pohl,Professor at the University of Michigan School of Nursing and nurse managed center consultant, ”Nurse managed health centers provide high quality, cost effective primary care to vulnerable populations in
many communities across the country. This funding will increase access to primary care as well as additional nurse practitioner training sites at a time when millions more will need access.”
http://www.aanp.org/NR/rdonlyres/5304E868-224A-4627-8604-44A1ABEFBB6D/0/NurseManaged.pdf
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Anti-AIDS Gel cuts in half women's chances of Infection Researchers are reporting a breakthrough against AIDS. A vaginal gel containing an AIDS drug cut in half a woman's chances of getting HIV from an infected partner.
The results need to be confirmed, and scientists disagree about whether this amount of protection is enough to justify using the gel now. But it is the first hope of protection for women if their partners refuse to use condoms.
Results of the South African study are being presented at the International AIDS Conference in Vienna and were published online Monday by the journal Science.
"It's the first time we've ever seen any microbicide give a positive result that you could say was statistically significant," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases....
http://www.aolhealth.com/condition-center/hiv/aids-gel-reduces-infection-rate?icid=main|htmlws-main-n|dl1|link4|http%3A%2F%2Fwww.aolhealth.com%2Fcondition-center%2Fhiv%2Faids-gel-reduces-infection-rate
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Hospitals' infection-prevention measures don't correlate with outcomes Data from the Surgical Care Improvement Project show that publicly reported measures implemented by hospitals to prevent postsurgical infections do not correlate with actual post-operation infection rates. "So many other things [that we don't measure] happen to a patient in the health care setting that can influence outcomes," an expert said. http://tinyurl.com/27jqfhu
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AORN supports Pennsylvania's signing of HB 1641 requiring perioperative RN during surgery As advocates for patient safety in the operating room, the Association of periOperative Registered Nurses, (AORN), announced support for Pennsylvania Governor Ed Rendell's signing of HB 1641 requiring the presence of a circulating nurse in certain operating rooms. The bill, signed into law on June 16, applies to any hospital or class C ambulatory surgical facility.
http://www.news-medical.net/news/20100619/AORN-supports-Pennsylvanias-signing-of-HB-1641-requiring-perioperative-RN-during-surgery.aspx
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
Preventing deep venous thromboses (DVTs) and pulmonary emboli (PEs) is one of the constant challenges facing nurses specializing in critical care.
Lisa M. Soltis, MSN, APRN, CCRN-CSC, CCNS, cardiovascular/critical care clinical nurse specialist at Wake Med Health and Hospitals, Raleigh, NC, described the two-pronged approach her organization has taken to prevent DVTs and PEs over the past year.
"One group was evaluating some adverse drug events and non-therapeutic results with patients on anticoagulation therapy, so we decided to look at our medication regimens for DVT prevention," she said. "The second work group developed a prophylaxis advisor with risk stratification of patient circumstances." ...
http://nursing.advanceweb.com/Features/Articles/Preventing-DVTs-Pulmonary-Emboli-2.aspx
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The following is a very important safety advisory......re: poorly attached labels on syringes causing potentially serious problems, including needlesticks. Please view an important safety advisory about "Needlestick injury due to label issue with Lovenox Unit Dose injection" posted on the Web site. http://www.ismp.org/newsletters/acutecare/articles/lovenox_alert_v5_layout_1.pdf
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Japanese Women Extend Life Expectancy to a new high TOKYO (AP) -- Japanese women are expected to live almost 86 1/2 years, topping the world longevity ratings for the 25th straight year, the government reported Monday.
The statistics for 2009 compiled and published by the Ministry of Health, Labor and Welfare showed both Japanese women and men extended their average life expectancy to new records - 86.44 years for women and 79.59 years for men. Average life spans rose by almost five months for women and nearly four months for men compared to the previous year. ... http://hosted.ap.org/dynamic/stories/A/AS_JAPAN_LIFE_EXPECTANCY?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2010-07-26-13-22-45
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RANDOM FACT: Individual orcas can be identified by their dorsal fins and saddle patches. These characteristics are unique for each orca just as human fingerprints are all different.
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The Answer Sheet - Good, bad news on U.S. Children Even before the U.S. economic troubles of the late 1990s, the child poverty rate had increased in this decade, affecting nearly one-fifth of American kids, according to a new report released today on the well-being of American kids
The annual KIDS COUNT Data Book compiled by the nonprofit Annie E. Casey Foundation and released today also shows the following: *New Hampshire, Minnesota, and Vermont rank highest in child well-being across a number of indicators. *Arkansas, Louisiana, and Mississippi rank the lowest. *Virginia ranks 16th, Maryland ranks 25th. The District is not ranked. ... http://voices.washingtonpost.com/answer-sheet/health-1/good-and-bad-news-about-child.html
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Modest weight loss may curb urine leakage (Reuters 7/26) - Overweight women with bladder-control problems can often improve those symptoms if they lose even a modest amount of weight, a new study suggests.
Excess weight, particularly in the abdomen, is one risk factor for urinary incontinence, and studies have found that shedding those extra pounds can help prevent the problem or reduce symptoms. However, it has not been known exactly how much weight women need to lose in order to see a significant improvement in symptoms. ... http://www.reuters.com/article/idUSTRE66P5KJ20100726
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Disabling the off switch: Wall Street Journal and Boston Globe on hospital errors March 16, 2010 -- Recent reports in The Wall Street Journal and The Boston Globe discuss efforts to address potentially lethal hospital errors, with each piece using as its main example a case in which nurses did not spot a problem until it was too late and a patient died. It is very helpful for the public to hear that nursing (just like medicine) is so important to patient care that such problems can mean the difference between life and death. And we commend the journalists responsible for both of these pieces, which provide serious, thoughtful discussion of some important issues, including systemic factors beyond the nurses' control. But neither piece consults nurses to the extent it should, considering that the problems addressed are primarily nursing ones, and the effect is to undervalue nursing expertise and possibly to suggest that nurses report to physicians in providing the relevant care. ... http://www.truthaboutnursing.org/news/2010/mar/16_errors.html
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RANDOM FACT: The Hawaiian alphabet only has 12 letters.
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Will you lose more pounds at a bigger diet center? For every additional 10 people signed up at a clinical center for a weight loss trial, the average person loses half a percent more weight, the study found.
Dr. Arne Astrup of the University of Copenhagen in Denmark and his colleagues delved into a database of 22 weight-loss centers across five countries, gathered in a previous large clinical trial.
Each center served between 4 and 85 men and women, and all of the more than 600 total participants were instructed to follow a nutritionally balanced diet of 800 to 1,000 calories a day. (Typical recommendations for non-dieters range from 1,600 to 2,400 calories per day, depending on gender, age, and level of activity.) http://www.reuters.com/article/idUSTRE6614R620100702?feedType=nl&feedName=ushealth1100
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Brain patterns may be signs of mental illness risk British scientists believe they have found specific patterns of brain activity in children and young people which could be signs or "markers" of those who will later go on to develop mental illnesses such as schizophrenia.
Researchers from Nottingham University, who presented their study at the Forum for European Neuroscience in Amsterdam, said the patterns suggest it may be possible in future to identify those at risk of becoming ill before they develop symptoms. ... http://www.reuters.com/article/idUSTRE66414D20100705?feedType=nl&feedName=ushealth1100
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Unique Protein Source Snuffs Out Wrinkles Ahhh, soy. It's a love-it-or-hate-it kind of food. But maybe you would grow to adore tofu, tempeh, and edamame if you knew this: It could help you look younger.
Yep. Eating lean, nutritious soy foods may help smooth fine wrinkles and buoy your skin's snap-back qualities, according to recent research. Those are two big victories for face freshness.
Reference: Oral intake of soy isoflavone aglycone improves the aged skin of adult women. Izumi, T. et al., Journal of Nutritional Science and Vitaminology (Tokyo) 2007 Feb;53(1):57-62.
http://www.realage.com/tips/unique-protein-source-snuffs-out-wrinkles?eid=7197&memberid=4687812
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RANDOM FACT: The density of Saturn is so low that if you were to put it in a giant glass of water it would float. The actual density of Saturn is 0.687 g/cm3 while the density of water is 0.998 g/cm3. At the equator Saturn has a radius of 60,268 ± 4 km – which means you would need an extremely large glass of water to test this out.
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Frozen blood a source of stem cells, study finds Frozen blood from stored samples can be used to make cells resembling stem cells, researchers said on Thursday -- opening a potential new and easier source for the valued cells.
They used cells from blood to make induced pluripotent stem cells or iPS cells -- lab-made cells that closely resemble human embryonic stem cells but are made from ordinary tissue. ... http://www.reuters.com/article/idUSTRE6604SI20100701?feedType=nl&feedName=ushealth1100
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Good Insulin Injection Practices From the healthcare professional's perspective, patient adherence to the treatment regimen in diabetes management is essential to achieving optimal glycemic control.
Good injection practices, such as injection technique, site rotation and proper needle use, are as important to glucose control as are the type and dosage of insulin.1
Over time, some patients often develop their own injection techniques, which may be less attentive to professional guidelines and standards for what has become commonplace activity.
Consequently, assessment of injection technique is paramount to evaluating the need for re-education on recommended practices to help them understand that changes to injection technique may alter insulin absorption. ... http://nursing.advanceweb.com/Features/Articles/Good-Insulin-Injection-Practices-2.aspx
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The Relationship between Workplace Stress and Depression in Nurses Imagine this workplace situation: an overcrowded unit in an overcrowded and understaffed hospital. Patients constantly need your attention, and yet your documentation and other tasks make it hard to keep up. And the doctors and nurse managers are slow to respond when you need them, because they are also stretched to the limit.
Now imagine yourself working in that place, day after day after day. What is your mood like? You might be stressed out. You might be angry. And according to two recently released studies, you might be much more prone to depression than nurses and health care workers in other types of health care facilities, especially the less crowded ones. ...
http://www.nursezone.com/nursing-news-events/more-features.aspx?articleid=34420
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Study identifies best tests to predict Alzheimer's Combining a specific imaging test of the brain with a memory recall test appears to be the best predictor so far of Alzheimer's disease, U.S. researchers said on Wednesday.
The findings were culled from a large, ongoing study testing various brain imaging tests and biomarkers that aims to identify which patients with cognitive problems will progress to Alzheimer's disease. ... http://www.reuters.com/article/idUSTRE65T6DW20100630?feedType=nl&feedName=ushealth1100
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90 % in USA get too much sodium; 5 foods blamed. June 24, 2010 -- Five high-sodium foods -- not all of them salty tasting -- are a big reason why nine in 10 Americans get way too much sodium every day.
New CDC data show that only 9.6% of U.S. adults limit their daily sodium intake to recommended levels. Where's all that sodium coming from? From salt, mostly. But only 10% of it comes from our shakers. An estimated 77% comes from sodium in processed or restaurant foods.
"All food categories contribute to sodium intake. But grains and meat -- the foods we eat most -- contribute the most sodium," Elena V. Kuklina, MD, PhD, senior service fellow at the CDC's division of heart disease and stroke prevention, tells WebMD. ... http://www.webmd.com/hypertension-high-blood-pressure/news/20100624/90-percent-in-us-get-too-much-salt-5-foods-blamed http://www.webmd.com/diet/slideshow-salt-shockers
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RANDOM FACT: A crocodile cannot stick its tongue out.
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Suggestions to reduce impact of anesthesia care on global warming Inhaled anesthetics widely used for surgery—particularly the anesthetic desflurane—make a measurable contribution to global warming, according to a study in the July issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).
http://www.news-medical.net/news/20100702/Suggestions-to-reduce-impact-of-anesthesia-care-on-global-warming.aspx
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Olive oil, Mediterranean diet modify expression of atherosclerosis-related genes
Everyone knows olive oil and a Mediterranean diet are associated with a lower risk for cardiovascular disease, but a new research report published in the July 2010 print issue of the FASEB Journal offers a surprising reason why: These foods change how genes associated with atherosclerosis function.
http://www.news-medical.net/news/20100701/Olive-oil-Mediterranean-diet-modify-expression-of-atherosclerosis-related-genes.aspx
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MabCure's test detects ovarian tumors in blood (Reuters) - An experimental test that uses antibodies to detect ovarian tumor cells in the blood correctly identified 16 of 17 women who had the cancer, a Belgian company said on Tuesday.
MabCure Inc said its monoclonal antibodies threw up no false positives -- meaning none of them incorrectly identified the blood of healthy women as carrying tumors.... http://www.reuters.com/article/idUSTRE66R00E20100728?feedType=nl&feedName=ushealth1100
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RANDOM FACT: Thirty-five percent of the people who use personal ads for dating are already married.
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BOSTON (Reuters) - When someone collapses suddenly, mouth-to-mouth rescue breathing may not be necessary and could lower the chances of survival, researchers said in two studies on Wednesday that found chest compression alone is enough. The findings add to evidence that the simpler approach works best during cardiopulmonary resuscitation, or CPR.
"Chest compression alone is at least as good, at least as beneficial," Dr. Thomas Rea, medical program director for King County Emergency Medical Services in Washington state and chief author of one of the studies, said in a telephone interview. ... http://www.reuters.com/article/idUSTRE66R5RJ20100728?feedType=nl&feedName=ushealth1100
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Six Questions to Protect Elderly Patients This week, Pam Belluck reported in The Times on the risk that elderly patients may become confused and delirious while in the hospital. Here she offers advice on how to prepare when an elderly patient is headed to surgery or a hospital stay. About a third of patients over age 70 experience hospital delirium, and the consequences can be serious, delaying a patient’s recovery and even leading to placement in a nursing home. Elderly patients who experience delirium are also more likely to develop dementia later on, and more likely to die sooner than patients who do not become delirious. ... http://well.blogs.nytimes.com/2010/06/24/six-questions-to-protect-elderly-patients/
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RANDOM FACT: In England, the Speaker of the House is not allowed to speak.
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These foods aren't just for Hippies and Health Nuts You can't open a magazine without being bombarded with information about superfoods like tofu, sardines and flaxseed. We know they're nutritional powerhouses, but it can be daunting to muster up the courage to try such exotic nibbles. Why eat goji berries, which sound like they were named after a Smurf, or drink almond "milk" when you can pour yourself a bowl of cereal topped with skim milk and a few familiar strawberries? As it turns out, these superfoods pack an even bigger punch than the healthy items normally stocked in your kitchen, and they actually taste pretty darn good, too.... http://www.ivillage.com/these-foods-aren-t-just-hippies-and-health-nuts/4-b-212149?nlcid=hr|06-25-2010|
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Welcome to: Be Tenacious, the campaign created by TENA, in alliance with HealthyWomen, the nation's leading health information source for women, and six-time Olympian Anne Abernathy, to help women live life fully, with or without bladder control issues. Be Tenacious encourages women to be more http://www.tena.us/women/betenacious
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Study finds welfare cuts can cost lives (Reuters) - Radical cuts in social welfare spending by governments intent on reducing budget deficits can cost lives as well as cause economic pain, according to a study published on Friday.
British researchers found that levels of social spending in Europe are strongly associated with risks of premature death, particularly from diseases linked to wealth and social circumstances such as heart attacks and alcohol-related illness. ... http://www.reuters.com/article/idUSTRE65N6PS20100624?feedType=nl&feedName=ushealth1100
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Heparin might still look like the same old heparin, but it's not! Deborah J. Brouwer, RN, CNN
Two years ago, voluntary recalls of heparin sodium injection in vials occurred. The heparin lots were recalled due to a high incidence of allergic-type reactions. The U.S. Food and Drug Administration (FDA) website recall listed the following adverse patient reactions: abdominal pain, burning sensation, chest pain, diarrhea, dizziness, drug ineffectiveness, dyspepsia, dyspnia, erythema, flushing, headache, hyperhidrosis, hypoesthesia, hypotension, including profound and refractory hypotension [italics added], increased lacrimation, loss of consciousness, malaise, nausea, pallor, palpitations, paresthesia, paresthesia (oral), pharyngeal adema, restlessness, vomiting/retching, stomach discomfort, tachycardia, thirst, trismus, and unresponsiveness to stimuli. The recall stated that reports of profound and refractory hypotension usually occur within the first few minutes of bolus administration. ... http://www3.interscience.wiley.com/cgi-bin/fulltext/123356483/HTMLSTART?CRETRY=1&SRETRY=0
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RANDOM FACT: Mount Rushmore is perhaps the most impressive rock formation carved by men. It was made by Gutzon Borglum and took just 14 years to carve it.
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Guidelines on uncomplicated urinary tract infections are difficult to follow: perceived barriers and suggested interventions Urinary tract infections (UTI) are among the most common health problems seen in general practice. Evidence-based guidelines on UTI are available, but adherence to these guidelines varies widely among practitioners for reasons not well understood. The aim of this study was to identify the barriers to the implementation of a guideline on UTI perceived by Dutch general practitioners (GPs) and to explore interventions to overcome these barriers....
http://www.biomedcentral.com/1471-2296/11/51
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New osteoporosis treatment approved for postmenopausal women American Pharmacists Association, 06/28/2010 The safety and efficacy of Prolia were demonstrated in FREEDOM, a 3–year, randomized, double–blind, placebo–controlled, Phase III trial. In the study, the drug reduced the incidence of vertebral, nonvertebral, and hip fractures in postmenopausal women 60 to 91 years old with osteoporosis Free full text .... http://www.pharmacist.com/AM/Template.cfm?Section=Pharmacy_News&template=/CM/ContentDisplay.cfm&ContentID=23563
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The Aged Mouth: An Insight Raina A et al. -- Oral health and function is frequently distorted in the elderly As oral physicians, an awareness of the extreme diversity and multifarious presentations that may affect the aged is essential. This paper intends to review some of the myriad oral conditions that afflict the old. It also intends to highlight the need for exercising caution in dealing with the geriatric population. Read this article in The Internet Journal of Geriatrics and Gerontology
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This was sent in by BAcello (Barbara) Thank you
The American Nurses Association (ANA) and co-publisher National Nursing Staff Development Organization announced this month the release of Nursing Professional Development: Scope and Standards of Practice, the long-awaited update of a key resource. Last updated in 2000, the revised edition, reflects the complex and rapidly developing factors that influence its current and future practice: globalization, dynamic practice
environments, evidence-based practice, and the technologies of nursing and health care. For more information and ordering, go to www.nursesbooks.org
While Nursing Professional Development: Scope and Standards of Practice is a reference guide and primarily for practicing nurses and nursing faculty and students, it is also an essential source for others in related areas of professional development, healthcare providers, researchers, and scholars, along with those involved in funding, legal, policy, and regulatory activities. http://tinyurl.com/273vdbf
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Eat These "Top 3" Antioxidant-Rich Veggies Anyone who's been to the Saturday farmers market knows there are a lot of veggies out there to choose from. But do you know which ones are richest in antioxidants? A recent study of close to 30 different types of veggies put these three at the top of the list: broccoli, beets, and bell peppers (the red kind). Yep, the top-notch veggies all start with B. Makes it easier to remember, doesn't it? ... Reference: Cellular antioxidant activity of common vegetables. Song, W. et al., Journal of Agricultural and Food Chemistry 2010 Jun 9;58(11):6621-6629.
http://www.realage.com/tips/eat-these-top-3-antioxidant-rich-veggies?eid=7204&memberid=4687812
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Bad Blood: Reports highlight global abuse of nurses -- Recent news reports reveal that many nurses around the world confront high levels of abuse from patients and colleagues. On February 4, the OneIndia web site posted an unsigned item from ANI, the South Asian news agency, about an Australian study published in the U.K.-based Journal of Clinical Nursing that found not only that most nurses had been physically assaulted at work, but that many nurses considered violence to be "just part of the job." That short piece does a good job of conveying the magnitude of the problem and of highlighting nursing research, though it might have dug a little deeper about why nurses may view abuse that way, and it might have clarified that lead study author "Dr. Rose Chapman" is a nurse with a PhD, not a physician. ... http://www.truthaboutnursing.org/news/2010/feb/25_abuse.html
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Top 5 Suspected Everyday Carcinogens in the American Cancer Society's Scary New Report
July 15) -- Some carcinogens you already know and fear: cigarettes, asbestos, smoked meat.
But what about the ones you've never even heard of? That's the crux of a new report from the American Cancer Society (ACS), which rounds up 20 "suspected carcinogens" the organization would like to see studied more extensively.y 15) -- Some carcinogens you already know and fear: cigarettes, asbestos, smoked meat.
But what about the ones you've never even heard of? That's the crux of a new report from the American Cancer Society (ACS), which rounds up 20 "suspected carcinogens" the organization would like to see studied more extensively. (check out #5)
http://www.aolnews.com/surge-desk/article/top-5-suspected-everyday-carcinogens-in-american-cancer-societys-scary-new-report/19556272?icid=main|htmlws-main-n|dl1|link3|http%3A%2F%2Fwww.aolnews.com%2Fsurge-desk%2Farticle%2Ftop-5-suspected-everyday-carcinogens-in-american-cancer-societys-scary-new-report%2F19556272
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HUMOR SECTION
After putting her children to bed, a mother changed into old slacks, a droopy, faded blouse and proceeded to wash her hair. As she heard the children getting more and more rambuctious, her patience grew thin.
At last she threw a towel around ther hair and stormed into their room, putting them back to bed with stern warnings.
As she left the room, she heard her 3-year old ask with a trembling voice, "Who was that?"
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The first-time father , beside himself with excitement over the birth of his son, was determined to do everything right.
"So, tell me, nurse, " he asked as his family headed out the hospital door, "What time should we wake the little guy in the morning?"
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
Remember!! Write me for the full page of CEUs......RNFrankie@AOL.com
Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursingspectrum.com /
Free CEs http://www.myfreece.com/welcome.asp
https://nursing.advanceweb.com/CE/TestCenter/Main.aspx
www.MEDCEU.com
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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
Back issues of the newsletter are available at: http://www.ismp.org/Newsletters/nursing/backissues.asp.
Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell)
Founder, Forum for Shared Governance info@sharedgovernance.org www.sharedgovernance.org
Decubqueen's website: www.accu-ruler.com
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.nationalnurse3.blogspot.com/
RNs launch a national safe staffing campaign http://www.1199seiu.org/media/magazine/sept_2007/safe_staffing.cfm
H.R. 2123, The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007
http://www.washingtonwatch.com/bills/show/110_HR_2123.html
Board Supports Your Right to Refuse An Unsafe Assignment: Nurse Practice Act cites three conditions for patient abandonment http://findarticles.com/p/articles/mi_qa4102/is_200408/ai_n9450263
The Nursing Site http://thenursingsite.com .
http://www.snopes.com
http://www.solutionsoutsidethebox.net/ Raconte's website
http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3
National Do Not Call Registry
If you're buying a used car, it is recommended having a mechanic inspect it first. And screen the car's VIN through the free database at carfax.com/flood
This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Critical Thinking is More Than Problem Solving
Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/
Good Insulin Injection Practices on ADVANCE for Nurses
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MEDICAL RECALLS
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I have had to post the medical recalls separately. The list for this month was extensive. Please take the time to check the warnings out. One person stated that a member of her family had been given one of the medications listed-- which could have resulted in a nasty pneumonia...
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NURSING HINTS CORNER
To improvise an ice pack, try using the kitchen appliance that seals a meal into a plastic bag. Fill a large-sized bag with ice and seal it. Apply this pack to the affected area. The ice will melt, but the pack remains cool, with no leakage.
Place the bag of water (after cleaning thoroughly) in the freezer and you have an ice pack ready for the next injury. You can make a few in various sizes and keep in the freezer. Sherri Sener, RN, BSN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.133, Springhouse Corporation/www.springnetcom.
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ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.Visit us at http://www.accu-ruler.com/.
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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
WELCOME TO:
Our newest member: libby.smith@bellsouth.net (Libby) July 13, 2010
jeluciano@gmail.com (Jacquie) June 12, 2010
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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number....lol So please send me your new name/address, ok? RNFrankie@AOL.com
OLD ADDRESS: springns88@AOL.com changed to: springns88@yahoo.com (Barbara)
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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)
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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (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 hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
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THOUGHT FOR THE DAY
Propaganda is persuading people to make up their minds
while withholding some of the facts from them.
--Harold Evans
Hope to see you online or write me !
RNFrankie@AOL.com
August 15, 2010
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.
Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.
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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SNIPPETS
Presenting two nurses for whom we owe a great deal of respect:
Loretta Ford, a pioneer in shaping the role of NPs In 1965, nurse leader Loretta Ford collaborated with physician Henry Silver in developing a model for the pediatric nurse practitioner with a focus on health and wellness. Their first training program aimed to ensure the NP was competent, safe and acceptable to patients. Since then, Ford has seen the number of NPs grow to 150,000 in the U.S. Nurse.com
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Lystra Gretter: Public Health Advocate and Professional Reformer By David Yates
When Lystra Eggert Gretter was inducted into the Michigan Women's Hall of Fame in 2004, she was honored for her "tireless" efforts in promoting nursing as a respectable profession in the late 19th and early 20th centuries. Gretter made many contributions to nursing. She shifted the model of nursing education from a one-year apprenticeship to a three-year academic pursuit. She created nurse-run hospital wards instead of allowing nursing students to run them. Gretter cut the work day to 8-hour shifts, to afford nurses and students more time to study and recreate. She wrote what is believed to be the first standardized textbook for nursing education and created one of the first professional nursing libraries. And Gretter was a founding member, at the end of the 19th Century, of groups that later became the American Nurses Association and the National League for Nursing. She established an early visiting nurses association. Noting that the public perception of nursing was that of "women's work," Gretter lobbied for more political power, including aligning nursing with suffragettes who sought the vote. And Gretter was "the moving spirit behind the creation of "The Florence Nightingale Pledge," an oath of ethics that many graduating nursing students still make today. Gretter also worked to advance public health generally. She established tuberculosis hospitals, lobbied for in-home nursing care and became a vocal public health advocate for Detroit's burgeoning poor and immigrant population. She also successfully introduced the first state-wide health inspections of school children and a free maternity/infant care clinic in Detroit. more...
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MEDICAL NEWS
Secretary Sebelius Announces Funding for Nurse Practitioner Led Clinics
On June 16, 2010, Secretary Sebelius announced the release of $15,000,000 for the operation of 10 nurse managed health clinics which will support the education and training of nurse practitioners.
Nurse managed health centers staffed by nurse practitioners; provide comprehensive primary health care services to populations living in medically underserved communities. According to Joanne Pohl,Professor at the University of Michigan School of Nursing and nurse managed center consultant, ”Nurse managed health centers provide high quality, cost effective primary care to vulnerable populations in
many communities across the country. This funding will increase access to primary care as well as additional nurse practitioner training sites at a time when millions more will need access.”
http://www.aanp.org/NR/rdonlyres/5304E868-224A-4627-8604-44A1ABEFBB6D/0/NurseManaged.pdf
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Anti-AIDS Gel cuts in half women's chances of Infection Researchers are reporting a breakthrough against AIDS. A vaginal gel containing an AIDS drug cut in half a woman's chances of getting HIV from an infected partner.
The results need to be confirmed, and scientists disagree about whether this amount of protection is enough to justify using the gel now. But it is the first hope of protection for women if their partners refuse to use condoms.
Results of the South African study are being presented at the International AIDS Conference in Vienna and were published online Monday by the journal Science.
"It's the first time we've ever seen any microbicide give a positive result that you could say was statistically significant," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases....
http://www.aolhealth.com/condition-center/hiv/aids-gel-reduces-infection-rate?icid=main|htmlws-main-n|dl1|link4|http%3A%2F%2Fwww.aolhealth.com%2Fcondition-center%2Fhiv%2Faids-gel-reduces-infection-rate
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Hospitals' infection-prevention measures don't correlate with outcomes Data from the Surgical Care Improvement Project show that publicly reported measures implemented by hospitals to prevent postsurgical infections do not correlate with actual post-operation infection rates. "So many other things [that we don't measure] happen to a patient in the health care setting that can influence outcomes," an expert said. http://tinyurl.com/27jqfhu
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AORN supports Pennsylvania's signing of HB 1641 requiring perioperative RN during surgery As advocates for patient safety in the operating room, the Association of periOperative Registered Nurses, (AORN), announced support for Pennsylvania Governor Ed Rendell's signing of HB 1641 requiring the presence of a circulating nurse in certain operating rooms. The bill, signed into law on June 16, applies to any hospital or class C ambulatory surgical facility.
http://www.news-medical.net/news/20100619/AORN-supports-Pennsylvanias-signing-of-HB-1641-requiring-perioperative-RN-during-surgery.aspx
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
Preventing deep venous thromboses (DVTs) and pulmonary emboli (PEs) is one of the constant challenges facing nurses specializing in critical care.
Lisa M. Soltis, MSN, APRN, CCRN-CSC, CCNS, cardiovascular/critical care clinical nurse specialist at Wake Med Health and Hospitals, Raleigh, NC, described the two-pronged approach her organization has taken to prevent DVTs and PEs over the past year.
"One group was evaluating some adverse drug events and non-therapeutic results with patients on anticoagulation therapy, so we decided to look at our medication regimens for DVT prevention," she said. "The second work group developed a prophylaxis advisor with risk stratification of patient circumstances." ...
http://nursing.advanceweb.com/Features/Articles/Preventing-DVTs-Pulmonary-Emboli-2.aspx
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The following is a very important safety advisory......re: poorly attached labels on syringes causing potentially serious problems, including needlesticks. Please view an important safety advisory about "Needlestick injury due to label issue with Lovenox Unit Dose injection" posted on the Web site. http://www.ismp.org/newsletters/acutecare/articles/lovenox_alert_v5_layout_1.pdf
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Japanese Women Extend Life Expectancy to a new high TOKYO (AP) -- Japanese women are expected to live almost 86 1/2 years, topping the world longevity ratings for the 25th straight year, the government reported Monday.
The statistics for 2009 compiled and published by the Ministry of Health, Labor and Welfare showed both Japanese women and men extended their average life expectancy to new records - 86.44 years for women and 79.59 years for men. Average life spans rose by almost five months for women and nearly four months for men compared to the previous year. ... http://hosted.ap.org/dynamic/stories/A/AS_JAPAN_LIFE_EXPECTANCY?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2010-07-26-13-22-45
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RANDOM FACT: Individual orcas can be identified by their dorsal fins and saddle patches. These characteristics are unique for each orca just as human fingerprints are all different.
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The Answer Sheet - Good, bad news on U.S. Children Even before the U.S. economic troubles of the late 1990s, the child poverty rate had increased in this decade, affecting nearly one-fifth of American kids, according to a new report released today on the well-being of American kids
The annual KIDS COUNT Data Book compiled by the nonprofit Annie E. Casey Foundation and released today also shows the following: *New Hampshire, Minnesota, and Vermont rank highest in child well-being across a number of indicators. *Arkansas, Louisiana, and Mississippi rank the lowest. *Virginia ranks 16th, Maryland ranks 25th. The District is not ranked. ... http://voices.washingtonpost.com/answer-sheet/health-1/good-and-bad-news-about-child.html
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Modest weight loss may curb urine leakage (Reuters 7/26) - Overweight women with bladder-control problems can often improve those symptoms if they lose even a modest amount of weight, a new study suggests.
Excess weight, particularly in the abdomen, is one risk factor for urinary incontinence, and studies have found that shedding those extra pounds can help prevent the problem or reduce symptoms. However, it has not been known exactly how much weight women need to lose in order to see a significant improvement in symptoms. ... http://www.reuters.com/article/idUSTRE66P5KJ20100726
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Disabling the off switch: Wall Street Journal and Boston Globe on hospital errors March 16, 2010 -- Recent reports in The Wall Street Journal and The Boston Globe discuss efforts to address potentially lethal hospital errors, with each piece using as its main example a case in which nurses did not spot a problem until it was too late and a patient died. It is very helpful for the public to hear that nursing (just like medicine) is so important to patient care that such problems can mean the difference between life and death. And we commend the journalists responsible for both of these pieces, which provide serious, thoughtful discussion of some important issues, including systemic factors beyond the nurses' control. But neither piece consults nurses to the extent it should, considering that the problems addressed are primarily nursing ones, and the effect is to undervalue nursing expertise and possibly to suggest that nurses report to physicians in providing the relevant care. ... http://www.truthaboutnursing.org/news/2010/mar/16_errors.html
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RANDOM FACT: The Hawaiian alphabet only has 12 letters.
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Will you lose more pounds at a bigger diet center? For every additional 10 people signed up at a clinical center for a weight loss trial, the average person loses half a percent more weight, the study found.
Dr. Arne Astrup of the University of Copenhagen in Denmark and his colleagues delved into a database of 22 weight-loss centers across five countries, gathered in a previous large clinical trial.
Each center served between 4 and 85 men and women, and all of the more than 600 total participants were instructed to follow a nutritionally balanced diet of 800 to 1,000 calories a day. (Typical recommendations for non-dieters range from 1,600 to 2,400 calories per day, depending on gender, age, and level of activity.) http://www.reuters.com/article/idUSTRE6614R620100702?feedType=nl&feedName=ushealth1100
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Brain patterns may be signs of mental illness risk British scientists believe they have found specific patterns of brain activity in children and young people which could be signs or "markers" of those who will later go on to develop mental illnesses such as schizophrenia.
Researchers from Nottingham University, who presented their study at the Forum for European Neuroscience in Amsterdam, said the patterns suggest it may be possible in future to identify those at risk of becoming ill before they develop symptoms. ... http://www.reuters.com/article/idUSTRE66414D20100705?feedType=nl&feedName=ushealth1100
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Unique Protein Source Snuffs Out Wrinkles Ahhh, soy. It's a love-it-or-hate-it kind of food. But maybe you would grow to adore tofu, tempeh, and edamame if you knew this: It could help you look younger.
Yep. Eating lean, nutritious soy foods may help smooth fine wrinkles and buoy your skin's snap-back qualities, according to recent research. Those are two big victories for face freshness.
Reference: Oral intake of soy isoflavone aglycone improves the aged skin of adult women. Izumi, T. et al., Journal of Nutritional Science and Vitaminology (Tokyo) 2007 Feb;53(1):57-62.
http://www.realage.com/tips/unique-protein-source-snuffs-out-wrinkles?eid=7197&memberid=4687812
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RANDOM FACT: The density of Saturn is so low that if you were to put it in a giant glass of water it would float. The actual density of Saturn is 0.687 g/cm3 while the density of water is 0.998 g/cm3. At the equator Saturn has a radius of 60,268 ± 4 km – which means you would need an extremely large glass of water to test this out.
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Frozen blood a source of stem cells, study finds Frozen blood from stored samples can be used to make cells resembling stem cells, researchers said on Thursday -- opening a potential new and easier source for the valued cells.
They used cells from blood to make induced pluripotent stem cells or iPS cells -- lab-made cells that closely resemble human embryonic stem cells but are made from ordinary tissue. ... http://www.reuters.com/article/idUSTRE6604SI20100701?feedType=nl&feedName=ushealth1100
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Good Insulin Injection Practices From the healthcare professional's perspective, patient adherence to the treatment regimen in diabetes management is essential to achieving optimal glycemic control.
Good injection practices, such as injection technique, site rotation and proper needle use, are as important to glucose control as are the type and dosage of insulin.1
Over time, some patients often develop their own injection techniques, which may be less attentive to professional guidelines and standards for what has become commonplace activity.
Consequently, assessment of injection technique is paramount to evaluating the need for re-education on recommended practices to help them understand that changes to injection technique may alter insulin absorption. ... http://nursing.advanceweb.com/Features/Articles/Good-Insulin-Injection-Practices-2.aspx
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The Relationship between Workplace Stress and Depression in Nurses Imagine this workplace situation: an overcrowded unit in an overcrowded and understaffed hospital. Patients constantly need your attention, and yet your documentation and other tasks make it hard to keep up. And the doctors and nurse managers are slow to respond when you need them, because they are also stretched to the limit.
Now imagine yourself working in that place, day after day after day. What is your mood like? You might be stressed out. You might be angry. And according to two recently released studies, you might be much more prone to depression than nurses and health care workers in other types of health care facilities, especially the less crowded ones. ...
http://www.nursezone.com/nursing-news-events/more-features.aspx?articleid=34420
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Study identifies best tests to predict Alzheimer's Combining a specific imaging test of the brain with a memory recall test appears to be the best predictor so far of Alzheimer's disease, U.S. researchers said on Wednesday.
The findings were culled from a large, ongoing study testing various brain imaging tests and biomarkers that aims to identify which patients with cognitive problems will progress to Alzheimer's disease. ... http://www.reuters.com/article/idUSTRE65T6DW20100630?feedType=nl&feedName=ushealth1100
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90 % in USA get too much sodium; 5 foods blamed. June 24, 2010 -- Five high-sodium foods -- not all of them salty tasting -- are a big reason why nine in 10 Americans get way too much sodium every day.
New CDC data show that only 9.6% of U.S. adults limit their daily sodium intake to recommended levels. Where's all that sodium coming from? From salt, mostly. But only 10% of it comes from our shakers. An estimated 77% comes from sodium in processed or restaurant foods.
"All food categories contribute to sodium intake. But grains and meat -- the foods we eat most -- contribute the most sodium," Elena V. Kuklina, MD, PhD, senior service fellow at the CDC's division of heart disease and stroke prevention, tells WebMD. ... http://www.webmd.com/hypertension-high-blood-pressure/news/20100624/90-percent-in-us-get-too-much-salt-5-foods-blamed http://www.webmd.com/diet/slideshow-salt-shockers
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RANDOM FACT: A crocodile cannot stick its tongue out.
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Suggestions to reduce impact of anesthesia care on global warming Inhaled anesthetics widely used for surgery—particularly the anesthetic desflurane—make a measurable contribution to global warming, according to a study in the July issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).
http://www.news-medical.net/news/20100702/Suggestions-to-reduce-impact-of-anesthesia-care-on-global-warming.aspx
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Olive oil, Mediterranean diet modify expression of atherosclerosis-related genes
Everyone knows olive oil and a Mediterranean diet are associated with a lower risk for cardiovascular disease, but a new research report published in the July 2010 print issue of the FASEB Journal offers a surprising reason why: These foods change how genes associated with atherosclerosis function.
http://www.news-medical.net/news/20100701/Olive-oil-Mediterranean-diet-modify-expression-of-atherosclerosis-related-genes.aspx
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MabCure's test detects ovarian tumors in blood (Reuters) - An experimental test that uses antibodies to detect ovarian tumor cells in the blood correctly identified 16 of 17 women who had the cancer, a Belgian company said on Tuesday.
MabCure Inc said its monoclonal antibodies threw up no false positives -- meaning none of them incorrectly identified the blood of healthy women as carrying tumors.... http://www.reuters.com/article/idUSTRE66R00E20100728?feedType=nl&feedName=ushealth1100
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RANDOM FACT: Thirty-five percent of the people who use personal ads for dating are already married.
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BOSTON (Reuters) - When someone collapses suddenly, mouth-to-mouth rescue breathing may not be necessary and could lower the chances of survival, researchers said in two studies on Wednesday that found chest compression alone is enough. The findings add to evidence that the simpler approach works best during cardiopulmonary resuscitation, or CPR.
"Chest compression alone is at least as good, at least as beneficial," Dr. Thomas Rea, medical program director for King County Emergency Medical Services in Washington state and chief author of one of the studies, said in a telephone interview. ... http://www.reuters.com/article/idUSTRE66R5RJ20100728?feedType=nl&feedName=ushealth1100
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Six Questions to Protect Elderly Patients This week, Pam Belluck reported in The Times on the risk that elderly patients may become confused and delirious while in the hospital. Here she offers advice on how to prepare when an elderly patient is headed to surgery or a hospital stay. About a third of patients over age 70 experience hospital delirium, and the consequences can be serious, delaying a patient’s recovery and even leading to placement in a nursing home. Elderly patients who experience delirium are also more likely to develop dementia later on, and more likely to die sooner than patients who do not become delirious. ... http://well.blogs.nytimes.com/2010/06/24/six-questions-to-protect-elderly-patients/
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RANDOM FACT: In England, the Speaker of the House is not allowed to speak.
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These foods aren't just for Hippies and Health Nuts You can't open a magazine without being bombarded with information about superfoods like tofu, sardines and flaxseed. We know they're nutritional powerhouses, but it can be daunting to muster up the courage to try such exotic nibbles. Why eat goji berries, which sound like they were named after a Smurf, or drink almond "milk" when you can pour yourself a bowl of cereal topped with skim milk and a few familiar strawberries? As it turns out, these superfoods pack an even bigger punch than the healthy items normally stocked in your kitchen, and they actually taste pretty darn good, too.... http://www.ivillage.com/these-foods-aren-t-just-hippies-and-health-nuts/4-b-212149?nlcid=hr|06-25-2010|
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Welcome to: Be Tenacious, the campaign created by TENA, in alliance with HealthyWomen, the nation's leading health information source for women, and six-time Olympian Anne Abernathy, to help women live life fully, with or without bladder control issues. Be Tenacious encourages women to be more http://www.tena.us/women/betenacious
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Study finds welfare cuts can cost lives (Reuters) - Radical cuts in social welfare spending by governments intent on reducing budget deficits can cost lives as well as cause economic pain, according to a study published on Friday.
British researchers found that levels of social spending in Europe are strongly associated with risks of premature death, particularly from diseases linked to wealth and social circumstances such as heart attacks and alcohol-related illness. ... http://www.reuters.com/article/idUSTRE65N6PS20100624?feedType=nl&feedName=ushealth1100
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Heparin might still look like the same old heparin, but it's not! Deborah J. Brouwer, RN, CNN
Two years ago, voluntary recalls of heparin sodium injection in vials occurred. The heparin lots were recalled due to a high incidence of allergic-type reactions. The U.S. Food and Drug Administration (FDA) website recall listed the following adverse patient reactions: abdominal pain, burning sensation, chest pain, diarrhea, dizziness, drug ineffectiveness, dyspepsia, dyspnia, erythema, flushing, headache, hyperhidrosis, hypoesthesia, hypotension, including profound and refractory hypotension [italics added], increased lacrimation, loss of consciousness, malaise, nausea, pallor, palpitations, paresthesia, paresthesia (oral), pharyngeal adema, restlessness, vomiting/retching, stomach discomfort, tachycardia, thirst, trismus, and unresponsiveness to stimuli. The recall stated that reports of profound and refractory hypotension usually occur within the first few minutes of bolus administration. ... http://www3.interscience.wiley.com/cgi-bin/fulltext/123356483/HTMLSTART?CRETRY=1&SRETRY=0
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RANDOM FACT: Mount Rushmore is perhaps the most impressive rock formation carved by men. It was made by Gutzon Borglum and took just 14 years to carve it.
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Guidelines on uncomplicated urinary tract infections are difficult to follow: perceived barriers and suggested interventions Urinary tract infections (UTI) are among the most common health problems seen in general practice. Evidence-based guidelines on UTI are available, but adherence to these guidelines varies widely among practitioners for reasons not well understood. The aim of this study was to identify the barriers to the implementation of a guideline on UTI perceived by Dutch general practitioners (GPs) and to explore interventions to overcome these barriers....
http://www.biomedcentral.com/1471-2296/11/51
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New osteoporosis treatment approved for postmenopausal women American Pharmacists Association, 06/28/2010 The safety and efficacy of Prolia were demonstrated in FREEDOM, a 3–year, randomized, double–blind, placebo–controlled, Phase III trial. In the study, the drug reduced the incidence of vertebral, nonvertebral, and hip fractures in postmenopausal women 60 to 91 years old with osteoporosis Free full text .... http://www.pharmacist.com/AM/Template.cfm?Section=Pharmacy_News&template=/CM/ContentDisplay.cfm&ContentID=23563
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The Aged Mouth: An Insight Raina A et al. -- Oral health and function is frequently distorted in the elderly As oral physicians, an awareness of the extreme diversity and multifarious presentations that may affect the aged is essential. This paper intends to review some of the myriad oral conditions that afflict the old. It also intends to highlight the need for exercising caution in dealing with the geriatric population. Read this article in The Internet Journal of Geriatrics and Gerontology
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This was sent in by BAcello (Barbara) Thank you
The American Nurses Association (ANA) and co-publisher National Nursing Staff Development Organization announced this month the release of Nursing Professional Development: Scope and Standards of Practice, the long-awaited update of a key resource. Last updated in 2000, the revised edition, reflects the complex and rapidly developing factors that influence its current and future practice: globalization, dynamic practice
environments, evidence-based practice, and the technologies of nursing and health care. For more information and ordering, go to www.nursesbooks.org
While Nursing Professional Development: Scope and Standards of Practice is a reference guide and primarily for practicing nurses and nursing faculty and students, it is also an essential source for others in related areas of professional development, healthcare providers, researchers, and scholars, along with those involved in funding, legal, policy, and regulatory activities. http://tinyurl.com/273vdbf
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Eat These "Top 3" Antioxidant-Rich Veggies Anyone who's been to the Saturday farmers market knows there are a lot of veggies out there to choose from. But do you know which ones are richest in antioxidants? A recent study of close to 30 different types of veggies put these three at the top of the list: broccoli, beets, and bell peppers (the red kind). Yep, the top-notch veggies all start with B. Makes it easier to remember, doesn't it? ... Reference: Cellular antioxidant activity of common vegetables. Song, W. et al., Journal of Agricultural and Food Chemistry 2010 Jun 9;58(11):6621-6629.
http://www.realage.com/tips/eat-these-top-3-antioxidant-rich-veggies?eid=7204&memberid=4687812
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Bad Blood: Reports highlight global abuse of nurses -- Recent news reports reveal that many nurses around the world confront high levels of abuse from patients and colleagues. On February 4, the OneIndia web site posted an unsigned item from ANI, the South Asian news agency, about an Australian study published in the U.K.-based Journal of Clinical Nursing that found not only that most nurses had been physically assaulted at work, but that many nurses considered violence to be "just part of the job." That short piece does a good job of conveying the magnitude of the problem and of highlighting nursing research, though it might have dug a little deeper about why nurses may view abuse that way, and it might have clarified that lead study author "Dr. Rose Chapman" is a nurse with a PhD, not a physician. ... http://www.truthaboutnursing.org/news/2010/feb/25_abuse.html
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Top 5 Suspected Everyday Carcinogens in the American Cancer Society's Scary New Report
July 15) -- Some carcinogens you already know and fear: cigarettes, asbestos, smoked meat.
But what about the ones you've never even heard of? That's the crux of a new report from the American Cancer Society (ACS), which rounds up 20 "suspected carcinogens" the organization would like to see studied more extensively.y 15) -- Some carcinogens you already know and fear: cigarettes, asbestos, smoked meat.
But what about the ones you've never even heard of? That's the crux of a new report from the American Cancer Society (ACS), which rounds up 20 "suspected carcinogens" the organization would like to see studied more extensively. (check out #5)
http://www.aolnews.com/surge-desk/article/top-5-suspected-everyday-carcinogens-in-american-cancer-societys-scary-new-report/19556272?icid=main|htmlws-main-n|dl1|link3|http%3A%2F%2Fwww.aolnews.com%2Fsurge-desk%2Farticle%2Ftop-5-suspected-everyday-carcinogens-in-american-cancer-societys-scary-new-report%2F19556272
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HUMOR SECTION
After putting her children to bed, a mother changed into old slacks, a droopy, faded blouse and proceeded to wash her hair. As she heard the children getting more and more rambuctious, her patience grew thin.
At last she threw a towel around ther hair and stormed into their room, putting them back to bed with stern warnings.
As she left the room, she heard her 3-year old ask with a trembling voice, "Who was that?"
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The first-time father , beside himself with excitement over the birth of his son, was determined to do everything right.
"So, tell me, nurse, " he asked as his family headed out the hospital door, "What time should we wake the little guy in the morning?"
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
Remember!! Write me for the full page of CEUs......RNFrankie@AOL.com
Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursingspectrum.com /
Free CEs http://www.myfreece.com/welcome.asp
https://nursing.advanceweb.com/CE/TestCenter/Main.aspx
www.MEDCEU.com
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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
Back issues of the newsletter are available at: http://www.ismp.org/Newsletters/nursing/backissues.asp.
Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell)
Founder, Forum for Shared Governance info@sharedgovernance.org www.sharedgovernance.org
Decubqueen's website: www.accu-ruler.com
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.nationalnurse3.blogspot.com/
RNs launch a national safe staffing campaign http://www.1199seiu.org/media/magazine/sept_2007/safe_staffing.cfm
H.R. 2123, The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007
http://www.washingtonwatch.com/bills/show/110_HR_2123.html
Board Supports Your Right to Refuse An Unsafe Assignment: Nurse Practice Act cites three conditions for patient abandonment http://findarticles.com/p/articles/mi_qa4102/is_200408/ai_n9450263
The Nursing Site http://thenursingsite.com .
http://www.snopes.com
http://www.solutionsoutsidethebox.net/ Raconte's website
http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3
National Do Not Call Registry
If you're buying a used car, it is recommended having a mechanic inspect it first. And screen the car's VIN through the free database at carfax.com/flood
This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Critical Thinking is More Than Problem Solving
Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/
Good Insulin Injection Practices on ADVANCE for Nurses
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I have had to post the medical recalls separately. The list for this month was extensive. Please take the time to check the warnings out. One person stated that a member of her family had been given one of the medications listed-- which could have resulted in a nasty pneumonia...
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NURSING HINTS CORNER
To improvise an ice pack, try using the kitchen appliance that seals a meal into a plastic bag. Fill a large-sized bag with ice and seal it. Apply this pack to the affected area. The ice will melt, but the pack remains cool, with no leakage.
Place the bag of water (after cleaning thoroughly) in the freezer and you have an ice pack ready for the next injury. You can make a few in various sizes and keep in the freezer. Sherri Sener, RN, BSN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.133, Springhouse Corporation/www.springnetcom.
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ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.Visit us at http://www.accu-ruler.com/.
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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
WELCOME TO:
Our newest member: libby.smith@bellsouth.net (Libby) July 13, 2010
jeluciano@gmail.com (Jacquie) June 12, 2010
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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number....lol So please send me your new name/address, ok? RNFrankie@AOL.com
OLD ADDRESS: springns88@AOL.com changed to: springns88@yahoo.com (Barbara)
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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)
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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (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 hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
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THOUGHT FOR THE DAY
Propaganda is persuading people to make up their minds
while withholding some of the facts from them.
--Harold Evans
Hope to see you online or write me !
RNFrankie@AOL.com
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