What does your patient safety brochure really say about safety?
Most patient safety advocates agree that educated patients are the safest patients. The concept is clear: patients who know what to expect will be more aware of potential risks and errors. What is less clear is exactly how organizations educate patients and their caregivers about their role in safety and encourage their contributions. At a minimum, most healthcare providers attempt to involve patients in safety by distributing a handout or brochure that covers general safety tips and encourages patients to speak up about the hazards they may encounter. The emphasis is usually on actions patients can take to help ensure their safety. Unfortunately, the impact of patient safety brochures has not been well studied. While these have the potential to reduce errors, a recent analysis1 of five leading national patient safety brochures suggest that they may also result in unintended consequences that can compromise patient safety efforts. The study was conducted with participants from academic, clinical, administrative, and consumer settings who had been promoting or researching patients' perspectives on, and contributions to, safety. Based on this analysis, we have put together questions and recommendations to help you design or improve the patient safety brochures that you distribute to patients. Although many nurses do not directly participate in the development of patient safety brochures, all nurses can still benefit from reviewing the assessment questions and recommendations
in Table 1. Nurses are typically the most visible healthcare practitioners to hospitalized patients, so they are in the best position to discuss safety with patients, reinforce the safety messages in a safety brochure, and respond to patients' concerns about safety. Reference: 1) Entwistle VA, Mello MM, Brennan TA.
Advising patients about patient safety: current initiatives risk shifting responsibility. Jt Comm J Qual Patient Saf. September 2005; 31(9):483-94.
What the Study1 Shows Recommendations Is the safety information well defined?
Most safety tips are broad-based and generalized. Patients who are ill are less likely to act on vague safety tips, such as “Ask questions.”
Patients are more likely to heed advice if the instructions are clear and concise, such as “Make sure your name is spelled correctly and your birth date is correct on the bracelet applied to your wrist when you are admitted.”
Is the basis for the safety tips provided? Many times, the basis for the safety tips are not provided. Recommendations without a rationale represent missed opportunities to broadly educate patients about safety issues in healthcare.
Safety tips should clearly explain why specific actions are recommended and the desired outcome or goal of the recommendations. Knowing the reason for a safety tip also helps patients remember it and use it.
Are the safety tips prioritized? Participants in the study noted that the sheer number of tips in a handout may overwhelm patients because they cannot act on all of them. Tell patients which safety tips are most important based on likely impact on their safety during hospitalization.
Does the safety brochure specify what the organization is doing to enhance safety?
A long list of safety tips for patients alone may imply that patients are the only ones looking out for their safety. Describe how patient participation contributes to what the organization is already doing to ensure safety, to reassure patients that their safety is not in their hands, alone.
Are patients advised how to report hazards and errors? Patients and families may observe or perceive risks during the course of care that healthcare providers may not notice. But some patients are not comfortable telling their direct caregivers about these risks, yet they would like to make the organization aware of them.
Tell patients several ways they can report safety problems, including avenues that bypass their direct caregivers, such as telephone hotlines, safety suggestion boxes, surveys, and patient advocate rounds. Also include information about rapid response teams, if available.
Is the patient safety brochure written from the patient’s perspective?
According to the study’s authors, safety handouts are often written from the provider’s perspective.
Learn about the predominant concerns and self-perceived information needs of the patient community served before creating/reviewing the brochure. Test the contents of the brochure with patients before finalizing the design.
Do the safety tips require patients to check or challenge healthcare providers? Advice that requires checking and challenging providers may be particularly problematic for patients, who may fear being labeled as difficult if they speak up. Staff also may be less inclined to interact with patients who challenge them, potentially worsening safety risks. Include some safety tips that do not require patients to check and challenge providers.
Create an environment that demonstrates respect for the patient’s assertiveness regarding safety and encourages patients to speak up about safety.
Does the brochure shift responsibility for safe care from the provider to the patient?
Patients may perceive the safety tips in the brochure as inappropriately shifting responsibility for safe care from the healthcare provider to the patient, particularly if there’s little evidence that the healthcare provider is also taking steps to improve safety.
Be clear about the key initiatives that the organization has implemented or is planning to implement to protect the patient’s safety while providing healthcare services.
Do staff reinforce the safety tips and offer patients support in carrying them out?
Healthcare providers are not likely to discuss the safety tips in the brochure with patients and encourage them to participate unless organizational leaders value and reinforce this behavior. As noted by one study participant: “Systems aren’t set up to have you involved…you have to bully your way in to be a partner… and you’re really not a partner, you’re an imposition at that point. And patients feel that.”
All staff should know the safety tips offered in their organization’s patient safety brochure and
be fully conversant with patients about their meaning and implementation. Beyond distributing
advice in safety brochures, organizations need to build the infrastructure required to ensure that patients’ contributions to error prevention are encouraged and met with appropriate responses.
ISMP Medication Safety Alert! Nurse Advise-ERR® (ISSN 1550-6304) ©2007 Institute for Safe
Medication Practices (ISMP).
Monday, October 11, 2010
October 11, 2010
PARADIGM BYTES
Newsletter for Paradigm 97
August 11, 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
(Thank you, Sandy Summers) THIRTY SEVEN PHYSICIANS---NO NURSES !!!! September 2010 -- As the 2010-2011 U.S. television season starts, there appears to be no major nurse character on any regular prime time broadcast show for the first time in more than 40 years. In part that is because so many of the health-related shows from last year have left the air, including all of the shows that premiered in 2009, notably NBC's generally helpful nurse drama Mercy, but also CBS's physician-centric Three Rivers and Miami Medical, which did each have one recurring nurse character. Other departures had little effect on the portrayal of nursing, including the ends of the long-running Scrubs (ABC), which had shed its lone nurse character the prior season, and FX's nip-tuck, which never had a significant nurse character. The one returning show that did have a nurse character, ABC's Private Practice (premieres Sept. 23), killed him off at the end of last season, when nurse midwife Dell Parker died from a car crash, just after giddily announcing that he had been admitted to medical school. The dominant hospital shows, Fox's House (Sept. 20) and ABC's Grey Anatomy (Sept. 23), still have no nurse characters as they start their seventh seasons. There appear to be just two new shows with any real health care focus: ABC's Body of Proof (October), which stars Dana Delany as an elite surgeon-turned-medical examiner, and ABC's Off the Map (mid-season), a new product from Grey's creator Shonda Rhimes about five young physicians who work to save the poor at a remote clinic in South America. We see no nurse characters anywhere, though there are conflicting signals about whether one minor character on Off the Map is a nurse or physician. Leaving aside that mid-season character, of the five health-related prime time broadcast shows that are slated to start seasons this year, regular physician characters appear to outnumber nurse characters by roughly 37 to 0. Of course, nurses will not be completely absent from the small screen, since non-regular season cable shows Nurse Jackie (Showtime) and HawthoRNe (TNT) will return for third seasons in 2011. And there is even a nurse character on A&E's new summer police drama The Glades, which will return next year (though she is carrying on Dell's Hollywood dream by attending medical school). But given the dominance of the broadcast shows, which attract millions more viewers to many more episodes, the television landscape will remain dominated by programs that reinforce the false notion that physicians provide all important health care.Fall 2010 TV Preview http://www.truthaboutnursing.org/news/2010/sep/fall_preview.html
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MEDICAL NEWS
Nurses, PAs, Physicians Share in Federal Grants to Enlarge Primary Care Workforce HHS Secretary Kathleen Sebelius on Wednesday (9/29/10) announced federal grants worth $320 million to fund health programs aimed at strengthening the primary care workforce. A portion of the grants will be used to train nurse practitioners and advance practice nurses and establish 10 nurse-managed clinics to serve at-risk populations. (of course most of the money is for the physicians, however see below:(
Two of the grants announced yesterday ( 9/29/10) are aimed at nursing. Twenty-six schools of nursing will receive $31 million to increase full-time enrollment in primary care nurse practitioner and nurse midwife programs. This grant will translate into more than 1300 student stipends of $22,000 per year for up to 2 years, leading to 600 new, fully trained nurse practitioners and nurse midwives by 2015.
The other grant is a nod toward the professional autonomy that nurses seek. HHS will spend $14.8 million to launch 10 nurse-managed health clinics providing primary care and wellness services to underserved or vulnerable populations. Such centers will be associated with a school, college, university, department of nursing, federally qualified health center, or independent nonprofit health or social services agency. HHS expects that these nurse-managed clinics will serve 94,000 patients as well as train 900 advanced-practice nurses. ... http://www.medscape.com/viewarticle/729609
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PARIS (Reuters) - Police seized about 10 metric tons of counterfeit medicines and arrested 80 people in a sweep across eastern Africa, international police agency Interpol said on Thursday.
The operation, which Interpol coordinated under the umbrella of the World Health Organization (WHO) over the last two months, included the arrest of suspects involved in the manufacture, trafficking and sale of fake medical products.
Production and sale of counterfeit drugs is on the rise in rich and poor countries especially Africa, where counterfeit medicines are commonly available to treat life-threatening conditions such as malaria, tuberculosis and HIV/AIDS. http://www.reuters.com/article/idUSTRE67P35720100826?feedType=nl&feedName=ushealth1100
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FROM THE MEMBERS
This was sent in by Wendy:
Hi all,
I am at a life care planning conference at the Disney Contemporary Resort two monorail stops from the Magic Kingdom in Orlando. I want them to get a bazillion emails on their disgraceful act banning a colleague from using her ADA-approved mobility device,a Segway, in the park or in the hotel. She has a neuromuscular condition and has used it for independent mobility for three years in the US and Japan without any problem or incident.
She came to this conference and had calls and visits and intimidating conversations from Disney employees immediately. They gave her a scooter after two days of this and told her she had to use it, but she was unable to get out of her room with it because she could not each the door--she had to call for help. She cannot turn to see behind her to back it up safely, but can rotate on a dime in her Segway.
The ADA allows businesses to ban transportation aids if they would substantially disrupt business operations or impact safety. Since Disney uses Segways in the park and in the hotels, safety clearly isn't a valid issue; they said their employees are "trained" but I doubt they have more expertise than she does. There is obviously no impact on business model.
The scooter makes her less independent and the harassment is certainly not what one would expect from "the happiest place on earth." Please go to disneyworld.com and hit "contact us" to let them know how you feel. And please feel free to share this email. Tweet, Facebook, press, go for it.
Wendie Howland RN MN CRRN CCM CNLCP 866-604-9055 toll-free
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
How to lose weight easily Part 1: Just walk an extra 500 steps every day. Part 2: Trim a mere 100 calories from one meal each day (that's roughly equivalent to eating one less tablespoon of butter, drinking three fewer sips of soda, or leaving three or four bites at a meal). Pretty simple, right?
In a study, overweight people who were coached to do exactly that ended up doing big favors for their waistlines. Not just because they removed a few extra calories from their day, but because embarking on this simple plan inspired them to make even bigger changes. They turned into overachievers, cutting 300 calories a day from their diets and walking an extra 1,450 steps per day. That translates into shedding about a pound every 10 days or so. And it was their commitment to baby steps that really got the ball rolling. Reference: A small-changes approach reduces energy intake in free-living humans. Stroebele, N. et al., Journal of the American College of Nutrition 2009 Feb;28(1):63-68.
http://www.realage.com/tips/get-skinnier-with-these-2-small-changes?eid=7221&memberid=4687812
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Evaluation of interventions to reduce catheter-associated bloodstream infection: Continuous tailored education versus one basic lecture This study evaluated the impact of 2 models of educational intervention on rates of central venous catheter–associated bloodstream infections (CVC-BSIs). ... http://www.ajicjournal.org/article/PIIS0196655309009456/abstract?rss=yes
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RANDOM FACT: The Gateway Arch in St. Louis is a structure known as a catenary curve, the shape a free-hanging chain takes when held at both ends, and considered the most structurally-sound arch shape. The span of the Arch legs at ground level is 630 feet, the same as its height.
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Nurse researchers examine impact on patient safety, treatment outcomes and the bottom line.
Hospitals and healthcare systems face increasing pressure to provide safe care and good quality outcomes; patient acuity is on the rise and reimbursement rates are going down, according to a paper from the American Nurses Credentialing Center (ANCC). Research shows effective nurse staffing can significantly reduce the risk of adverse events and improve quality of care.
"[A] growing body of evidence suggests ... quality; cost of care; safety; length of stay; readmissions; patient, physician and staff satisfaction; turnover and vacancy rates - all of which have an impact on operational and financial performance - are linked to staffing," Kathy Douglas, MHA, RN, wrote in a 2008 ANCC report.1 ...
http://nursing.advanceweb.com/south-eastern-tn-nc-sc-ms-al-ga-journal-articles/Regional-Articles/Features/Studying-Staffing-Levels.aspx
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Which nut is Tops for Clearing Arteries? Nuts certainly are great for heart health. But which nut should you choose if you want to make the most progress against heart disease: walnuts, almonds, or pecans?
Kind of a trick question, according to a recent review of the literature. A body of nut research suggests that just about any nut will help lower bad cholesterol and improve the balance of bad to good cholesterol as well. ... http://www.realage.com/tips/which-nut-is-tops-for-clearing-arteries?eid=7211&memberid=4687812
Reference: Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials. Sabate, J. et al., Archives of Internal Medicine 2010 May
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RANDOM FACT: It has been estimated that during the feeding season in Antarctica, a full grown blue whale eats about 4 million krill per day (krill are small shrimp-like creatures), that's 3600 kg or 4 tons every day for 6 months. Having laid down a layer of fat from this feeding activity, they then starve for several months.
RANDOM FACT: The blue whale’s heart is the size of a small car.
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Costs spike when terminally ill leave hospice: study BOSTON (Reuters) - The cost of care for terminally ill cancer patients who stopped hospice care was nearly five times higher than for patients who stayed with it, according to a study. This is particularly important given the latest evidence that patients who die in ICUs and hospitals experience far more physical and emotional distress than patients who die at home with hospice," said Elizabeth Bradley, professor of public health at Yale.
"For decades, we have seen better outcomes for patients and families who use hospice, but here we also find clear evidence that leaving hospice is also costly financially."
The research team evaluated data from more than 90,000 patients with cancer who were served by 1,384 hospices between 1998 and 2002. ... http://www.reuters.com/article/idUSTRE68R60Y20100928?feedType=nl&feedName=ushealth1100
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(Reuters 9/27) Exercise has lasting benefits for older women Older women with thinning bones who exercise regularly have sustained improvements in their balance and walking speed that may protect them from fractures and even extend their lives, new research shows. http://www.reuters.com/article/idUSTRE68Q5O320100927?feedType=nl&feedName=ushealth1100
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RANDOM FACT: The Cathedral of Notre Dame covers 8,500 square yards. When it was completed in the Middle Ages, the entire population of Amiens (the city it is located in), about 10,000 people, could attend the same service.
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LONDON (Reuters) - British scientists have found the first direct evidence attention deficit/hyperactivity disorder (ADHD) is a genetic disorder and say their research could eventually lead to better treatments for the condition.
Researchers who scanned the gene maps of more than 1,400 children found that those with ADHD were more likely than others to have small chunks of their DNA duplicated or missing. Anita Thapar, a professor psychiatry at Cardiff University who led the study, said the findings should help dispel the myths that ADHD is caused by bad parenting or high-sugar diets.
"This is really exciting because it gives us the first direct genetic link to ADHD. Now we can say with confidence that ADHD is a genetic disease and that the brains of children with this condition develop differently to those of other children," she told reporters at a briefing about the findings. http://www.reuters.com/article/idUSTRE68S5UD20100930?feedType=nl&feedName=ushealth1100
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Here's a pleasant little pastime that takes about 5 minutes to do each day but could make you up to 5 years younger if you're faithful to it: drinking tea.
In a Chinese study, the cells of enthusiastic tea drinkers showed about 5 fewer years' worth of wear and tear compared with the cells of people who drank little tea. The enthusiastic tea drinkers averaged 3 or more cups of green or oolong tea daily, while the group that showed more signs of cell aging averaged less than a cup. The researchers looked specifically at the study participants' telomeres to see how much their cells had aged. ... http://www.realage.com/tips/do-this-for-5-minutes-get-5-years-younger?eid=7213&memberid=4687812
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Ten drugstore products doctors don't recommend: We spoke with physicians, dermatologists, surgeons and dentists and here are the 10 drugstore purchases that they say they would never buy:
http://www.walletpop.com/blog/2010/10/07/10-drugstore-products-doctors-do-not-recommend/?icid=main%7Chtmlws-main-n%7Cdl3%7Csec1_lnk1%7C176798
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RANDOM FACT: Dalmatians are born without spots.
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New therapy promising against metastatic melanoma Approximately 60,000 new cases of melanoma, will be diagnosed in the U.S. in 2010. The disease, which is the most serious type of skin cancer, accounts for about 10,000 deaths each year. That's according to the American Cancer Society. And although melanoma is treatable when caught early, after it spreads to other parts of the body, a patient is usually given a grim diagnosis of less than a year to live.
Now a study in the New England Journal of Medicine reports a new drug treatment may help some of these patients live longer. ... http://pagingdrgupta.blogs.cnn.com/2010/08/26/new-therapy-promising-against-metastatic-melanoma/
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High-Alert Medications Medication errors can present a profound risk to patient safety; however, the potential for harm can vary depending on the medication involved.
The Institute for Safe Medication Practices (ISMP) provides a list of drugs and drug categories that, when misused, can cause serious patient harm or death.1
One category of drugs on the high-alert medications list is chemotherapy. Chemotherapy agents are listed due to their potential for toxicity as a result of their narrow therapeutic window, meaning there is often little difference between a lethal and therapeutic dose. The complexity of chemotherapy dosing cycles and the regimens and protocols utilized provides an increased opportunity for errors when prescribing, preparing, dispensing and administering these medications. ...
http://nursing.advanceweb.com/florida-information/Regional-Articles/Features/High-Alert-Medications.aspx
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RANDOM FACT: A one-minute kiss burns 26 calories.
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Moral obligations of nurses and physicians in neonatal end-of-life care The aim of this study was to explore the obligations of nurses and physicians in providing end-of-life care. Nineteen nurses and 11 physicians from a single newborn intensive care unit participated. Using content analysis, an overarching obligation of creating the best possible experience for infants and parents was identified, within which two categories of obligations (decision making and the end of life itself) emerged. ... Nursing Ethics http://nej.sagepub.com/content/17/5/577.abstract
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Dare we speak of ethics? Attending to the unsayable amongst nurse leaders There is increasing emphasis on the need for collaboration between practice and academic leaders in health care research. However, many problems can arise owing to differences between academic and clinical goals and timelines. In order for research to move forward it is important to name and address these issues early in a project. ... Nursing Ethics http://nej.sagepub.com/content/17/5/566.abstract
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RANDOM FACT: Captain Kangaroo won five Emmy awards.
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Courage and nursing practice: A theoretical analysis This article aims to deepen the understanding of courage through a theoretical analysis of classical philosophers’ work and a review of published and unpublished empirical research on courage in nursing. The authors sought answers to questions regarding how courage is understood from a philosophical viewpoint and how it is expressed in nursing actions. ... http://nej.sagepub.com/content/17/5/551.abstract
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Surgery prevents breast cancers in high-risk women (Reuters) - Women with mutations in the well-known BRCA1 or BRCA2 genes who have their breasts and ovaries removed are much more likely to survive than women who do not get preventive surgery, U.S. researchers said on Tuesday.... http://www.reuters.com/article/idUSTRE6801WS20100901?feedType=nl&feedName=ushealth1100
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Proposed diabetes test misses most cases; Study (Reuters Health) - A new proposed diabetes test could miss millions of cases of diabetes and pre-diabetes and also over-diagnose black Americans if it was used as a screening tool, suggests a new study. ... http://www.reuters.com/article/idUSTRE67U4RS20100831?feedType=nl&feedName=ushealth1100
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Handy Hint #1: Did your sweater shrink in the wash? Try this how to and helpful hint for around the house. Add 2 cups salt into a gallon of water. Soak your sweater in it overnight. Your sweater should be back to its original size.
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Malaria comes courtesy of gorillas, DNA study shows WASHINGTON (Reuters) - Malaria appears to have jumped to humans from gorillas, and the parasite may have spread globally from a single gorilla to a single human, researchers reported on Wednesday. ...
http://www.reuters.com/article/idUSTRE68L4PV20100922?feedType=nl&feedName=ushealth1100
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Brain protecting enzyme may fight Alzheimer's CHICAGO (Reuters) - Restoring levels of a nerve-protecting enzyme offers a new approach to developing treatments for Alzheimer's disease, U.S. researchers said on Wednesday. ... http://www.reuters.com/article/idUSTRE68L5M520100922?feedType=nl&feedName=ushealth1100
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Save the Earth... it's the only planet with chocolate!!!!
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RANDOM FACT: In the seventh month of fetal life the adrenal glands, located just above the kidneys, are about the same size as the kidneys. At birth they are slightly smaller, and they continue to shrink throughout life. By the time a person reaches old age, the adrenals are so small they can hardly be seen.
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Regenerative Medicine: In the last few years there has been a lot of talk about growing human body parts. One of the most interesting aspects of this, is growing body part back on a living person. ... http://aboutfacts.net/Science183.html
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RANDOM FACT: The Mona Lisa has no eyebrows.
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Neonatal Encephalopathy, Cerebral Palsy, and Causation: A Look at the Evidence From the Perspective of a Defense Legal Nurse Consultant Medical malpractice cases involving allegations of birth injury and resulting in cerebral palsy are among the most complex, costly, and fiercely litigated. The four elements of a medical malpractice case are reviewed with an emphasis on causation. An overview of neonatal encephalopathy in the term infant, cerebral palsy, and types of evidence reviewed when formulating causation arguments is presented from the perspective of a defense legal nurse consultant. ...
Newborn and Infant Nursing Reviews
Volume 10, Issue 3, September 2010, Pages 124-128
Legal Issues
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B758X-50VN3DB-8&_user=10&_coverDate=09%2F30%2F2010&_rdoc=8&_fmt=high&_orig=browse&_origin=browse&_zone=rslt_list_item&_srch=doc-info(%23toc%2312938%232010%23999899996%232292759%23FLA%23display%23Volume)&_cdi=12938&_sort=
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Genetics Soon to Be Part of Nursing Practice The goal of this program is to provide nurses with information related to the implications of genetic and genomic science on health and nursing practice. http://ce.nurse.com/CE479/Genetics-Soon-to-Be-Part-of-Nursing-Practice/
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HUMOR SECTION
A man and a woman -who had never met before- found themselves in the same sleeping compartment of a train. After the initial embarrassment, they both managed to get to sleep; the woman on the top bunk, the man on the lower.
In the middle of the night the woman leaned over and said, "I'm sorry to bother you but I'm awfully cold and I was wondering if you could possibly pass me another blanket."
The man, with a glint in his eye, responded, "I've got a better idea...let's pretend we're married."
"Why not?" giggled the woman.
"Good," he said. "Now, go get your own blanket."
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
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
CE: Electronic Medical Record & HIPAA Violations (with podcast option!)
Nurses must prevent individuals without the need to know from accessing protected information.
http://nursing.advanceweb.com/Continuing-Education/CE-Articles/Electronic-Medical-Record-HIPAA-Violations.aspx
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Genetics Soon to Be Part of Nursing Practice The goal of this program is to provide nurses with information related to the implications of genetic and genomic science on health and nursing practice. http://ce.nurse.com/CE479/Genetics-Soon-to-Be-Part-of-Nursing-Practice/
Where do nurses go for help? A qualitative study of coping with death and dying CME
International Journal of Palliative Nursing
http://www.mdlinx.com/nursing/newsl-article.cfm/3313423/ZZ5603146585149290157159/?news_id=467&newsdt=092910
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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/
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MEDICAL RECALLS
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INOMAX DS Drug-Delivery System: Class I Recall - Risk of Interruption of Drug Flow Ikaria, Inc. notified healthcare professionals of a Class I Recall of the INOMAX (nitric oxide) Drug-Delivery System. There is a potential for failure of a pressure switch which may have an impact on the administration of INOMAX for inhalation to patients. Risks to the patient may include interruption of drug flow due to an empty cylinder, and/or the time taken to switch to a replacement system. An interruption or delay in the administration of INOMAX therapy may cause:
Worsening of low blood oxygen level (hypoxemia)
Low blood pressure (hypotension) and/or
Increase in blood pressure in the pulmonary arteries (pulmonary hypertension)
Death
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm223746.htm
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Infant sleep positioners: Risk of Suffocation FDA and the Consumer Product Safety Commission (CPSC) issued a warning not to use Infant sleep positioners. In the last 13 years, the federal government has received 12 reports of babies known to have died from suffocation associated with their sleep positioners. Most of the babies suffocated after rolling from the side to the stomach.... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts
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Fisher-Price announced a recall of more than 10 million tricycles, toys and high chairs over safety concerns, including some reports of injuries. Consumer Product Safety Commission Chairwoman Inez Tenenbaum said manufacturers need to ensure their products' safety before they reach consumers, but praised the company for "taking the right steps by agreeing to these recalls and offering consumers free repairs or replacement." http://www.washingtonpost.com/wp-dyn/content/article/2010/09/30/AR2010093001285.html?hpid=moreheadlines
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Avandia (rosiglitazone): REMS - Risk of Cardiovascular Events
FDA notified healthcare professionals and patients that it will significantly restrict the use of the diabetes drug Avandia (rosiglitazone) to patients with Type 2 diabetes who cannot control their diabetes on other medications. These new restrictions are in response to data that suggest an elevated risk of cardiovascular events, such as heart attack and stroke, in patients treated with Avandia.
BACKGROUND: Avandia is in a class of drugs known as thiazolidinediones, or TZDs. It is intended to be used in conjunction with diet and exercise to improve glucose (blood sugar) control in patients with Type 2 diabetes mellitus. Rosiglitazone also is available in combination with other diabetes medications, metformin under the brand name Avandamet or glimepiride under the brand name Avandaryl. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm226994.htm
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BagEasy Manual Resuscitation Devices by Westmed, Inc.: Class 1 Recall Westmed, Inc. is initiating a nationwide recall of 24,384 units of BagEasy Manual Resuscitation Devices. The BagEasy device have been found to have a potential for disconnection at the retention ring of the patient port manifold. Disconnection causes the unit to be inoperable, which potentially could result in treatment delays while another unit is obtained or technician switches to a different method of resuscitation. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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Valcyte (valganciclovir hydrochloride) Label Change: Possible overdose in pediatric patients FDA is notifying healthcare professionals of new pediatric dosing recommendations for Valcyte (valganciclovir hydrochloride) oral tablets and oral solution. FDA has determined that adding an upper limit of 150 mL/min/1.73 m2 to the creatinine clearance calculated using the Schwartz formula for the determination of pediatric doses can help prevent the potential for Valcyte overdosing in children with low body weight, low body surface area, and below normal serum creatinine. If the calculated pediatric dose of Valcyte exceeds 900 mg, a dose of 900 mg should be administered to the child. The dosing calculation can be found in the Drug Safety Communication. Be aware of possible valganciclovir overdose in pediatric patients with low body weight, low body surface area, or below normal serum creatinine.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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Octagam (Immune Globulin Intravenous (human) 5% Liquid Preparation: Market Withdrawal - Risk of Thromboembolic Events Octapharma USA and FDA notified healthcare professionals that, effective immediately, Octapharma is initiating a voluntary market withdrawal of ALL lots of Octagam currently in the US market. Octapharma has determined, through consultation with the public health authorities at FDA, that until a root cause of the previously reported thromboembolic events can be determined and the problem corrected, the most prudent course of action is to suspend further administration of octagam. Customers are asked to immediately quarantine the use of these lots and to contact Octapharma’s Customer Service Department to arrange for product return. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm223968.htm
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Epogen and Procrit (epoetin alfa): Recall - Particulate Matter in Vials Amgen and FDA notified healthcare professionals that certain lots of Epogen and Procrit (Epoetin alfa) vials are being recalled as a precaution, because the vials may contain extremely thin glass flakes (lamellae) that are barely visible. The potential serious adverse events resulting from the use of a sterile injectable product with particulates by the intravenous route include embolic, thrombotic and other vascular events (e.g., phlebitis), and by the subcutaneous route include foreign body granuloma, local injection site reactions, and increased immunogenicity. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm227225.htm
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Similac Powder Infant Formulas: Recall The voluntary recall affects milk- and soy-based formulas distributed in the United States, Puerto Rico, Guam, and some Caribbean nations. At least 12 of the recalled products were provided to families through the federal government’s Women, Infants, and Children (WIC) health and nutrition program. FDA is reassuring caregivers and families whose babies may have consumed recalled products that drinking the formula will not cause long-term health problems.
ISSUE: Possibility of the presence of a small common beetle in the product. The FDA has determined that while the formula containing these beetles poses no immediate health risk, there is a possibility that infants who consume formula containing the beetles or their larvae, could experience symptoms of gastrointestinal discomfort and refusal to eat as a result of small insect parts irritating the GI tract. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm226954.htm ~~**~~**~~**~~**~~**~~
NURSING HINTS CORNER
Go with the flow Next time you are taking a blood sample from a patient and the flow stops, loosen the tourniquet momentarily. If the tourniquet is too tight, it may impede arterial blood flow. Releasing pressure this way usually starts the blood flowing again.. Bertha L. Clarke, RN, CED, BSN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.145,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
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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
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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
They say my world is somber and drear.
To me, it is warm and joyous, and stars shine
in the dark that cannot be seen by day.
Helen Keller
Write to me with your hints, suggestions, articles. I would love to hear from you...... Frankie
RNFrankie@AOL.com
Newsletter for Paradigm 97
August 11, 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
(Thank you, Sandy Summers) THIRTY SEVEN PHYSICIANS---NO NURSES !!!! September 2010 -- As the 2010-2011 U.S. television season starts, there appears to be no major nurse character on any regular prime time broadcast show for the first time in more than 40 years. In part that is because so many of the health-related shows from last year have left the air, including all of the shows that premiered in 2009, notably NBC's generally helpful nurse drama Mercy, but also CBS's physician-centric Three Rivers and Miami Medical, which did each have one recurring nurse character. Other departures had little effect on the portrayal of nursing, including the ends of the long-running Scrubs (ABC), which had shed its lone nurse character the prior season, and FX's nip-tuck, which never had a significant nurse character. The one returning show that did have a nurse character, ABC's Private Practice (premieres Sept. 23), killed him off at the end of last season, when nurse midwife Dell Parker died from a car crash, just after giddily announcing that he had been admitted to medical school. The dominant hospital shows, Fox's House (Sept. 20) and ABC's Grey Anatomy (Sept. 23), still have no nurse characters as they start their seventh seasons. There appear to be just two new shows with any real health care focus: ABC's Body of Proof (October), which stars Dana Delany as an elite surgeon-turned-medical examiner, and ABC's Off the Map (mid-season), a new product from Grey's creator Shonda Rhimes about five young physicians who work to save the poor at a remote clinic in South America. We see no nurse characters anywhere, though there are conflicting signals about whether one minor character on Off the Map is a nurse or physician. Leaving aside that mid-season character, of the five health-related prime time broadcast shows that are slated to start seasons this year, regular physician characters appear to outnumber nurse characters by roughly 37 to 0. Of course, nurses will not be completely absent from the small screen, since non-regular season cable shows Nurse Jackie (Showtime) and HawthoRNe (TNT) will return for third seasons in 2011. And there is even a nurse character on A&E's new summer police drama The Glades, which will return next year (though she is carrying on Dell's Hollywood dream by attending medical school). But given the dominance of the broadcast shows, which attract millions more viewers to many more episodes, the television landscape will remain dominated by programs that reinforce the false notion that physicians provide all important health care.Fall 2010 TV Preview http://www.truthaboutnursing.org/news/2010/sep/fall_preview.html
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MEDICAL NEWS
Nurses, PAs, Physicians Share in Federal Grants to Enlarge Primary Care Workforce HHS Secretary Kathleen Sebelius on Wednesday (9/29/10) announced federal grants worth $320 million to fund health programs aimed at strengthening the primary care workforce. A portion of the grants will be used to train nurse practitioners and advance practice nurses and establish 10 nurse-managed clinics to serve at-risk populations.
Two of the grants announced yesterday ( 9/29/10) are aimed at nursing. Twenty-six schools of nursing will receive $31 million to increase full-time enrollment in primary care nurse practitioner and nurse midwife programs. This grant will translate into more than 1300 student stipends of $22,000 per year for up to 2 years, leading to 600 new, fully trained nurse practitioners and nurse midwives by 2015.
The other grant is a nod toward the professional autonomy that nurses seek. HHS will spend $14.8 million to launch 10 nurse-managed health clinics providing primary care and wellness services to underserved or vulnerable populations. Such centers will be associated with a school, college, university, department of nursing, federally qualified health center, or independent nonprofit health or social services agency. HHS expects that these nurse-managed clinics will serve 94,000 patients as well as train 900 advanced-practice nurses. ... http://www.medscape.com/viewarticle/729609
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PARIS (Reuters) - Police seized about 10 metric tons of counterfeit medicines and arrested 80 people in a sweep across eastern Africa, international police agency Interpol said on Thursday.
The operation, which Interpol coordinated under the umbrella of the World Health Organization (WHO) over the last two months, included the arrest of suspects involved in the manufacture, trafficking and sale of fake medical products.
Production and sale of counterfeit drugs is on the rise in rich and poor countries especially Africa, where counterfeit medicines are commonly available to treat life-threatening conditions such as malaria, tuberculosis and HIV/AIDS. http://www.reuters.com/article/idUSTRE67P35720100826?feedType=nl&feedName=ushealth1100
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FROM THE MEMBERS
This was sent in by Wendy:
Hi all,
I am at a life care planning conference at the Disney Contemporary Resort two monorail stops from the Magic Kingdom in Orlando. I want them to get a bazillion emails on their disgraceful act banning a colleague from using her ADA-approved mobility device,a Segway, in the park or in the hotel. She has a neuromuscular condition and has used it for independent mobility for three years in the US and Japan without any problem or incident.
She came to this conference and had calls and visits and intimidating conversations from Disney employees immediately. They gave her a scooter after two days of this and told her she had to use it, but she was unable to get out of her room with it because she could not each the door--she had to call for help. She cannot turn to see behind her to back it up safely, but can rotate on a dime in her Segway.
The ADA allows businesses to ban transportation aids if they would substantially disrupt business operations or impact safety. Since Disney uses Segways in the park and in the hotels, safety clearly isn't a valid issue; they said their employees are "trained" but I doubt they have more expertise than she does. There is obviously no impact on business model.
The scooter makes her less independent and the harassment is certainly not what one would expect from "the happiest place on earth." Please go to disneyworld.com and hit "contact us" to let them know how you feel. And please feel free to share this email. Tweet, Facebook, press, go for it.
Wendie Howland RN MN CRRN CCM CNLCP 866-604-9055 toll-free
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
How to lose weight easily Part 1: Just walk an extra 500 steps every day. Part 2: Trim a mere 100 calories from one meal each day (that's roughly equivalent to eating one less tablespoon of butter, drinking three fewer sips of soda, or leaving three or four bites at a meal). Pretty simple, right?
In a study, overweight people who were coached to do exactly that ended up doing big favors for their waistlines. Not just because they removed a few extra calories from their day, but because embarking on this simple plan inspired them to make even bigger changes. They turned into overachievers, cutting 300 calories a day from their diets and walking an extra 1,450 steps per day. That translates into shedding about a pound every 10 days or so. And it was their commitment to baby steps that really got the ball rolling. Reference: A small-changes approach reduces energy intake in free-living humans. Stroebele, N. et al., Journal of the American College of Nutrition 2009 Feb;28(1):63-68.
http://www.realage.com/tips/get-skinnier-with-these-2-small-changes?eid=7221&memberid=4687812
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Evaluation of interventions to reduce catheter-associated bloodstream infection: Continuous tailored education versus one basic lecture This study evaluated the impact of 2 models of educational intervention on rates of central venous catheter–associated bloodstream infections (CVC-BSIs). ... http://www.ajicjournal.org/article/PIIS0196655309009456/abstract?rss=yes
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RANDOM FACT: The Gateway Arch in St. Louis is a structure known as a catenary curve, the shape a free-hanging chain takes when held at both ends, and considered the most structurally-sound arch shape. The span of the Arch legs at ground level is 630 feet, the same as its height.
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Nurse researchers examine impact on patient safety, treatment outcomes and the bottom line.
Hospitals and healthcare systems face increasing pressure to provide safe care and good quality outcomes; patient acuity is on the rise and reimbursement rates are going down, according to a paper from the American Nurses Credentialing Center (ANCC). Research shows effective nurse staffing can significantly reduce the risk of adverse events and improve quality of care.
"[A] growing body of evidence suggests ... quality; cost of care; safety; length of stay; readmissions; patient, physician and staff satisfaction; turnover and vacancy rates - all of which have an impact on operational and financial performance - are linked to staffing," Kathy Douglas, MHA, RN, wrote in a 2008 ANCC report.1 ...
http://nursing.advanceweb.com/south-eastern-tn-nc-sc-ms-al-ga-journal-articles/Regional-Articles/Features/Studying-Staffing-Levels.aspx
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Which nut is Tops for Clearing Arteries? Nuts certainly are great for heart health. But which nut should you choose if you want to make the most progress against heart disease: walnuts, almonds, or pecans?
Kind of a trick question, according to a recent review of the literature. A body of nut research suggests that just about any nut will help lower bad cholesterol and improve the balance of bad to good cholesterol as well. ... http://www.realage.com/tips/which-nut-is-tops-for-clearing-arteries?eid=7211&memberid=4687812
Reference: Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials. Sabate, J. et al., Archives of Internal Medicine 2010 May
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RANDOM FACT: It has been estimated that during the feeding season in Antarctica, a full grown blue whale eats about 4 million krill per day (krill are small shrimp-like creatures), that's 3600 kg or 4 tons every day for 6 months. Having laid down a layer of fat from this feeding activity, they then starve for several months.
RANDOM FACT: The blue whale’s heart is the size of a small car.
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Costs spike when terminally ill leave hospice: study BOSTON (Reuters) - The cost of care for terminally ill cancer patients who stopped hospice care was nearly five times higher than for patients who stayed with it, according to a study. This is particularly important given the latest evidence that patients who die in ICUs and hospitals experience far more physical and emotional distress than patients who die at home with hospice," said Elizabeth Bradley, professor of public health at Yale.
"For decades, we have seen better outcomes for patients and families who use hospice, but here we also find clear evidence that leaving hospice is also costly financially."
The research team evaluated data from more than 90,000 patients with cancer who were served by 1,384 hospices between 1998 and 2002. ... http://www.reuters.com/article/idUSTRE68R60Y20100928?feedType=nl&feedName=ushealth1100
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(Reuters 9/27) Exercise has lasting benefits for older women Older women with thinning bones who exercise regularly have sustained improvements in their balance and walking speed that may protect them from fractures and even extend their lives, new research shows. http://www.reuters.com/article/idUSTRE68Q5O320100927?feedType=nl&feedName=ushealth1100
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RANDOM FACT: The Cathedral of Notre Dame covers 8,500 square yards. When it was completed in the Middle Ages, the entire population of Amiens (the city it is located in), about 10,000 people, could attend the same service.
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LONDON (Reuters) - British scientists have found the first direct evidence attention deficit/hyperactivity disorder (ADHD) is a genetic disorder and say their research could eventually lead to better treatments for the condition.
Researchers who scanned the gene maps of more than 1,400 children found that those with ADHD were more likely than others to have small chunks of their DNA duplicated or missing. Anita Thapar, a professor psychiatry at Cardiff University who led the study, said the findings should help dispel the myths that ADHD is caused by bad parenting or high-sugar diets.
"This is really exciting because it gives us the first direct genetic link to ADHD. Now we can say with confidence that ADHD is a genetic disease and that the brains of children with this condition develop differently to those of other children," she told reporters at a briefing about the findings. http://www.reuters.com/article/idUSTRE68S5UD20100930?feedType=nl&feedName=ushealth1100
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Here's a pleasant little pastime that takes about 5 minutes to do each day but could make you up to 5 years younger if you're faithful to it: drinking tea.
In a Chinese study, the cells of enthusiastic tea drinkers showed about 5 fewer years' worth of wear and tear compared with the cells of people who drank little tea. The enthusiastic tea drinkers averaged 3 or more cups of green or oolong tea daily, while the group that showed more signs of cell aging averaged less than a cup. The researchers looked specifically at the study participants' telomeres to see how much their cells had aged. ... http://www.realage.com/tips/do-this-for-5-minutes-get-5-years-younger?eid=7213&memberid=4687812
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Ten drugstore products doctors don't recommend: We spoke with physicians, dermatologists, surgeons and dentists and here are the 10 drugstore purchases that they say they would never buy:
http://www.walletpop.com/blog/2010/10/07/10-drugstore-products-doctors-do-not-recommend/?icid=main%7Chtmlws-main-n%7Cdl3%7Csec1_lnk1%7C176798
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RANDOM FACT: Dalmatians are born without spots.
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New therapy promising against metastatic melanoma Approximately 60,000 new cases of melanoma, will be diagnosed in the U.S. in 2010. The disease, which is the most serious type of skin cancer, accounts for about 10,000 deaths each year. That's according to the American Cancer Society. And although melanoma is treatable when caught early, after it spreads to other parts of the body, a patient is usually given a grim diagnosis of less than a year to live.
Now a study in the New England Journal of Medicine reports a new drug treatment may help some of these patients live longer. ... http://pagingdrgupta.blogs.cnn.com/2010/08/26/new-therapy-promising-against-metastatic-melanoma/
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High-Alert Medications Medication errors can present a profound risk to patient safety; however, the potential for harm can vary depending on the medication involved.
The Institute for Safe Medication Practices (ISMP) provides a list of drugs and drug categories that, when misused, can cause serious patient harm or death.1
http://nursing.advanceweb.com/florida-information/Regional-Articles/Features/High-Alert-Medications.aspx
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RANDOM FACT: A one-minute kiss burns 26 calories.
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Moral obligations of nurses and physicians in neonatal end-of-life care The aim of this study was to explore the obligations of nurses and physicians in providing end-of-life care. Nineteen nurses and 11 physicians from a single newborn intensive care unit participated. Using content analysis, an overarching obligation of creating the best possible experience for infants and parents was identified, within which two categories of obligations (decision making and the end of life itself) emerged. ... Nursing Ethics http://nej.sagepub.com/content/17/5/577.abstract
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Dare we speak of ethics? Attending to the unsayable amongst nurse leaders There is increasing emphasis on the need for collaboration between practice and academic leaders in health care research. However, many problems can arise owing to differences between academic and clinical goals and timelines. In order for research to move forward it is important to name and address these issues early in a project. ... Nursing Ethics http://nej.sagepub.com/content/17/5/566.abstract
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RANDOM FACT: Captain Kangaroo won five Emmy awards.
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Courage and nursing practice: A theoretical analysis This article aims to deepen the understanding of courage through a theoretical analysis of classical philosophers’ work and a review of published and unpublished empirical research on courage in nursing. The authors sought answers to questions regarding how courage is understood from a philosophical viewpoint and how it is expressed in nursing actions. ... http://nej.sagepub.com/content/17/5/551.abstract
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Surgery prevents breast cancers in high-risk women (Reuters) - Women with mutations in the well-known BRCA1 or BRCA2 genes who have their breasts and ovaries removed are much more likely to survive than women who do not get preventive surgery, U.S. researchers said on Tuesday.... http://www.reuters.com/article/idUSTRE6801WS20100901?feedType=nl&feedName=ushealth1100
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Proposed diabetes test misses most cases; Study (Reuters Health) - A new proposed diabetes test could miss millions of cases of diabetes and pre-diabetes and also over-diagnose black Americans if it was used as a screening tool, suggests a new study. ... http://www.reuters.com/article/idUSTRE67U4RS20100831?feedType=nl&feedName=ushealth1100
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Handy Hint #1: Did your sweater shrink in the wash? Try this how to and helpful hint for around the house. Add 2 cups salt into a gallon of water. Soak your sweater in it overnight. Your sweater should be back to its original size.
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Malaria comes courtesy of gorillas, DNA study shows WASHINGTON (Reuters) - Malaria appears to have jumped to humans from gorillas, and the parasite may have spread globally from a single gorilla to a single human, researchers reported on Wednesday. ...
http://www.reuters.com/article/idUSTRE68L4PV20100922?feedType=nl&feedName=ushealth1100
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Brain protecting enzyme may fight Alzheimer's CHICAGO (Reuters) - Restoring levels of a nerve-protecting enzyme offers a new approach to developing treatments for Alzheimer's disease, U.S. researchers said on Wednesday. ... http://www.reuters.com/article/idUSTRE68L5M520100922?feedType=nl&feedName=ushealth1100
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Save the Earth... it's the only planet with chocolate!!!!
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RANDOM FACT: In the seventh month of fetal life the adrenal glands, located just above the kidneys, are about the same size as the kidneys. At birth they are slightly smaller, and they continue to shrink throughout life. By the time a person reaches old age, the adrenals are so small they can hardly be seen.
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Regenerative Medicine: In the last few years there has been a lot of talk about growing human body parts. One of the most interesting aspects of this, is growing body part back on a living person. ... http://aboutfacts.net/Science183.html
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RANDOM FACT: The Mona Lisa has no eyebrows.
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Neonatal Encephalopathy, Cerebral Palsy, and Causation: A Look at the Evidence From the Perspective of a Defense Legal Nurse Consultant Medical malpractice cases involving allegations of birth injury and resulting in cerebral palsy are among the most complex, costly, and fiercely litigated. The four elements of a medical malpractice case are reviewed with an emphasis on causation. An overview of neonatal encephalopathy in the term infant, cerebral palsy, and types of evidence reviewed when formulating causation arguments is presented from the perspective of a defense legal nurse consultant. ...
Newborn and Infant Nursing Reviews
Volume 10, Issue 3, September 2010, Pages 124-128
Legal Issues
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B758X-50VN3DB-8&_user=10&_coverDate=09%2F30%2F2010&_rdoc=8&_fmt=high&_orig=browse&_origin=browse&_zone=rslt_list_item&_srch=doc-info(%23toc%2312938%232010%23999899996%232292759%23FLA%23display%23Volume)&_cdi=12938&_sort=
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Genetics Soon to Be Part of Nursing Practice The goal of this program is to provide nurses with information related to the implications of genetic and genomic science on health and nursing practice. http://ce.nurse.com/CE479/Genetics-Soon-to-Be-Part-of-Nursing-Practice/
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HUMOR SECTION
A man and a woman -who had never met before- found themselves in the same sleeping compartment of a train. After the initial embarrassment, they both managed to get to sleep; the woman on the top bunk, the man on the lower.
In the middle of the night the woman leaned over and said, "I'm sorry to bother you but I'm awfully cold and I was wondering if you could possibly pass me another blanket."
The man, with a glint in his eye, responded, "I've got a better idea...let's pretend we're married."
"Why not?" giggled the woman.
"Good," he said. "Now, go get your own blanket."
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
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
CE: Electronic Medical Record & HIPAA Violations (with podcast option!)
Nurses must prevent individuals without the need to know from accessing protected information.
http://nursing.advanceweb.com/Continuing-Education/CE-Articles/Electronic-Medical-Record-HIPAA-Violations.aspx
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Genetics Soon to Be Part of Nursing Practice The goal of this program is to provide nurses with information related to the implications of genetic and genomic science on health and nursing practice. http://ce.nurse.com/CE479/Genetics-Soon-to-Be-Part-of-Nursing-Practice/
Where do nurses go for help? A qualitative study of coping with death and dying CME
International Journal of Palliative Nursing
http://www.mdlinx.com/nursing/newsl-article.cfm/3313423/ZZ5603146585149290157159/?news_id=467&newsdt=092910
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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/
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MEDICAL RECALLS
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INOMAX DS Drug-Delivery System: Class I Recall - Risk of Interruption of Drug Flow Ikaria, Inc. notified healthcare professionals of a Class I Recall of the INOMAX (nitric oxide) Drug-Delivery System. There is a potential for failure of a pressure switch which may have an impact on the administration of INOMAX for inhalation to patients. Risks to the patient may include interruption of drug flow due to an empty cylinder, and/or the time taken to switch to a replacement system. An interruption or delay in the administration of INOMAX therapy may cause:
Worsening of low blood oxygen level (hypoxemia)
Low blood pressure (hypotension) and/or
Increase in blood pressure in the pulmonary arteries (pulmonary hypertension)
Death
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm223746.htm
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Infant sleep positioners: Risk of Suffocation FDA and the Consumer Product Safety Commission (CPSC) issued a warning not to use Infant sleep positioners. In the last 13 years, the federal government has received 12 reports of babies known to have died from suffocation associated with their sleep positioners. Most of the babies suffocated after rolling from the side to the stomach.... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts
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Fisher-Price announced a recall of more than 10 million tricycles, toys and high chairs over safety concerns, including some reports of injuries. Consumer Product Safety Commission Chairwoman Inez Tenenbaum said manufacturers need to ensure their products' safety before they reach consumers, but praised the company for "taking the right steps by agreeing to these recalls and offering consumers free repairs or replacement." http://www.washingtonpost.com/wp-dyn/content/article/2010/09/30/AR2010093001285.html?hpid=moreheadlines
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Avandia (rosiglitazone): REMS - Risk of Cardiovascular Events
FDA notified healthcare professionals and patients that it will significantly restrict the use of the diabetes drug Avandia (rosiglitazone) to patients with Type 2 diabetes who cannot control their diabetes on other medications. These new restrictions are in response to data that suggest an elevated risk of cardiovascular events, such as heart attack and stroke, in patients treated with Avandia.
BACKGROUND: Avandia is in a class of drugs known as thiazolidinediones, or TZDs. It is intended to be used in conjunction with diet and exercise to improve glucose (blood sugar) control in patients with Type 2 diabetes mellitus. Rosiglitazone also is available in combination with other diabetes medications, metformin under the brand name Avandamet or glimepiride under the brand name Avandaryl. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm226994.htm
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BagEasy Manual Resuscitation Devices by Westmed, Inc.: Class 1 Recall Westmed, Inc. is initiating a nationwide recall of 24,384 units of BagEasy Manual Resuscitation Devices. The BagEasy device have been found to have a potential for disconnection at the retention ring of the patient port manifold. Disconnection causes the unit to be inoperable, which potentially could result in treatment delays while another unit is obtained or technician switches to a different method of resuscitation. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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Valcyte (valganciclovir hydrochloride) Label Change: Possible overdose in pediatric patients FDA is notifying healthcare professionals of new pediatric dosing recommendations for Valcyte (valganciclovir hydrochloride) oral tablets and oral solution. FDA has determined that adding an upper limit of 150 mL/min/1.73 m2 to the creatinine clearance calculated using the Schwartz formula for the determination of pediatric doses can help prevent the potential for Valcyte overdosing in children with low body weight, low body surface area, and below normal serum creatinine.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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Octagam (Immune Globulin Intravenous (human) 5% Liquid Preparation: Market Withdrawal - Risk of Thromboembolic Events Octapharma USA and FDA notified healthcare professionals that, effective immediately, Octapharma is initiating a voluntary market withdrawal of ALL lots of Octagam currently in the US market. Octapharma has determined, through consultation with the public health authorities at FDA, that until a root cause of the previously reported thromboembolic events can be determined and the problem corrected, the most prudent course of action is to suspend further administration of octagam. Customers are asked to immediately quarantine the use of these lots and to contact Octapharma’s Customer Service Department to arrange for product return. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm223968.htm
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Epogen and Procrit (epoetin alfa): Recall - Particulate Matter in Vials Amgen and FDA notified healthcare professionals that certain lots of Epogen and Procrit (Epoetin alfa) vials are being recalled as a precaution, because the vials may contain extremely thin glass flakes (lamellae) that are barely visible. The potential serious adverse events resulting from the use of a sterile injectable product with particulates by the intravenous route include embolic, thrombotic and other vascular events (e.g., phlebitis), and by the subcutaneous route include foreign body granuloma, local injection site reactions, and increased immunogenicity. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm227225.htm
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Similac Powder Infant Formulas: Recall The voluntary recall affects milk- and soy-based formulas distributed in the United States, Puerto Rico, Guam, and some Caribbean nations. At least 12 of the recalled products were provided to families through the federal government’s Women, Infants, and Children (WIC) health and nutrition program. FDA is reassuring caregivers and families whose babies may have consumed recalled products that drinking the formula will not cause long-term health problems.
ISSUE: Possibility of the presence of a small common beetle in the product. The FDA has determined that while the formula containing these beetles poses no immediate health risk, there is a possibility that infants who consume formula containing the beetles or their larvae, could experience symptoms of gastrointestinal discomfort and refusal to eat as a result of small insect parts irritating the GI tract. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm226954.htm ~~**~~**~~**~~**~~**~~
NURSING HINTS CORNER
Go with the flow Next time you are taking a blood sample from a patient and the flow stops, loosen the tourniquet momentarily. If the tourniquet is too tight, it may impede arterial blood flow. Releasing pressure this way usually starts the blood flowing again.. Bertha L. Clarke, RN, CED, BSN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.145,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
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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
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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
They say my world is somber and drear.
To me, it is warm and joyous, and stars shine
in the dark that cannot be seen by day.
Helen Keller
Write to me with your hints, suggestions, articles. I would love to hear from you...... Frankie
RNFrankie@AOL.com
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