Newsletter for Paradigm 97
December 13, 2010
Wishing you a wonderful Christmas and Holiday Season.
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
Everything you wanted to know about HEMP and were afraid to ask For thousands of years, up until 1883, hemp was the world’s largest agricultural crop, from which the majority of fiber, fabric, soap, lighting oil, paper, incense, and medicines were produced.
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Because hemp seeds contain all the essential amino acids necessary for health, it was a primary source of essential food oil and protein for humans and animals. The oil from hemp seeds has the highest percentage of essential fatty acids and the lowest percentage of saturated fats.
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An acre of hemp produces more paper than an acre of trees. Paper made from hemp lasts for centuries, compared to 25-80 years for paper made from wood pulp. The US Declaration of Independence was written on hemp paper. Although industrial hemp contains less than 1% of THC, the psychoactive component of marijuana, it was forced from the market in the late 19th century by a campaign launched by newspaper magnates who also held controlling shares in the paper mill and cotton industry.
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In 1937, Congress passed the Marijuana Tax Act which effectively halted hemp production in the United States. It was briefly overridden during the Second World War when overseas supplies dried up but the campaign, called Hemp For Victory, was quickly withdrawn after the war.
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In 1941, the Ford motor company produced an experimental automobile with a plastic body composed of 70% cellulose fibers from hemp. The car body could absorb blows 10 times as great as steel without denting. The car was also designed to run on hemp fuel. Because of the ban on both hemp and alcohol the car was never mass produced.
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Hypertensive Crisis: Cardiology in Review Hypertension is a common chronic medical condition affecting over 65 million Americans. Uncontrolled hypertension can progress to a hypertensive crisis defined as a systolic blood pressure >180 mm Hg or a diastolic blood pressure >120 mm Hg. Hypertensive crisis can be further classified as a hypertensive urgency or hypertensive emergency depending on end-organ involvement including cardiac, renal, and neurologic injury. The prompt recognition of a hypertensive emergency with the appropriate diagnostic tests and triage will lead to the adequate reduction of blood pressure, ameliorating the incidence of fatal outcomes. Severely hypertensive patients with acute end-organ damage (hypertensive emergencies) warrant admission to an intensive care unit for immediate reduction of blood pressure with a short-acting titratable intravenous antihypertensive medication. Hypertensive urgencies (severe hypertension with no or minimal end-organ damage) may in general be treated with oral antihypertensives as an outpatient. Rapid and short-lived intravenous medications commonly used are labetalol, esmolol, fenoldopam, nicardipine, sodium nitroprusside, and clevidipine. Medications such as hydralazine, immediate release nifedipine, and nitroglycerin should be avoided. Sodium nitroprusside should be used with caution because of its toxicity. The risk factors and prognosticators of a hypertensive crisis are still under recognized. Physicians should perform complete evaluations in patients who present with a hypertensive crisis to effectively reverse, intervene, and correct the underlying trigger, as well as improve long-term outcomes after the episode. (The full article is to be purchased after registration.. )http://journals.lww.com/cardiologyinreview/Abstract/2010/03000/Hypertensive_Crisis.10.aspx
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MEDICAL NEWS
Haiti's cholera part of old pandemic: CDC (Reuters) - The cholera epidemic that has killed 1,110 people and sickened thousands in Haiti is part of a 49-year-old global pandemic and likely was brought to the Caribbean country in a single instance, scientists said on Thursday.
But that was all it took to set off the epidemic, with an already weak sanitation system thrown into chaos by a devastating earthquake in January, the U.S. Centers for Disease Control and Prevention and the Pan American Health Organization said.
The epidemic in the poorest country in the Western Hemisphere could easily worsen and cholera could linger there for years, they said.
Many Haitians blame U.N. troops for bringing the sometimes deadly bacterial disease to the island nation, where 1.5 million people are still displaced after the earthquake. Anti-U.N. riots have disrupted efforts to fight the raging outbreak. ... http://www.reuters.com/article/idUSTRE6AH46U20101118?feedType=nl&feedName=ushealth1100
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U.S. doctors still too cozy with drug industry (Reuters) Doctors in the United States are still too cozy with drug companies, although they have managed to break some of those ties, U.S. researchers said on Monday.
The team at Harvard University and Massachusetts General Hospital did a national survey of 1,900 primary care doctors in 2009 about their contacts with drug companies.
They found 84 percent reported some type of relationship with drug companies, compared with 94 percent in 2004. ... http://www.reuters.com/article/idUSTRE6A75BR20101108?feedType=nl&feedName=ushealth1100
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
Cutting the Pediatric Insulin Error Rate: An online learning module completed by pediatric nurses cut insulin administration errors by more than 80%, according to investigators at the University of California, San Francisco (UCSF), Medical Center. All of the hospital's 283 pediatric nurses underwent training with the three-part module. Before implementation of the training, the mean error rate was 5.2 errors per patient; after implementation, it was 0.86 errors per patient. The effect of the training on insulin administration errors was maintained over at least six months. ...
http://journals.lww.com/ajnonline/Fulltext/2010/11000/ Cutting_the_Pediatric_Insulin_Error_Rate.11.aspx
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Preventing polypharmacy in older adults: Polypharmacy refers to the effects of taking multiple medications concurrently to manage coexisting health problems, such as diabetes and hypertension. Too often, polypharmacy becomes problematic, such as when patients are prescribed too many medications by multiple healthcare providers working independently of each other. Also, drug interactions can occur if no single healthcare provider knows the patient’s complete medication picture.
Among older adults, polypharmacy is a common problem. Currently, 44% of men and 57% of women older than age 65 take five or more medications per week; about 12% of both men and women take 10 or more medications per week. These agents include both prescription and over-the-counter (OTC) preparations, such as vitamin and mineral supplements and herbal products. ... http://www.americannursetoday.com/Article.aspx?id=7132&fid=6852
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The following is very important info for all nurses...whether hospital based or Home health based. As most of us know, pressure ulcers can be found anywhere on a bed bound person....including the ears
The National Pressure Ulcer Advisory Panel has redefined the definition of a pressure ulcer and the stages of pressure ulcers, including the original 4 stages and adding 2 stages on deep tissue injury and unstageable pressure ulcers.
A stage I pressure ulcer presents as intact skin with non-blanchable (becoming white with one's finger pressure) redness of a localized area, usually over a bony prominence. Darkly-pigmented skin may not have visible blanching; its color may differ from the surrounding ... http://www.woundeducators.net/profiles/blogs/pressure-ulcer-stages
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RANDOM FACT: Although Americans eat about the same amount of calories (3,400 a day) as they did in 1910, the average weight has increased due to lack of exercise.
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Antibiotic benefits slight in kid's ear infections (Reuters) The benefits of treating kids' ear infections with antibiotics may not always outweigh the costs in side effects and dollars spent, suggests a new review of more than 100 studies on the topic.
Children in the U.S. receive antibiotics for acute ear infections more often than for any other illness. All this medicating contributes to an estimated $2.8 billion dollars, or $350 per child, spent annually to treat the condition.
"We found that antibiotics did offer a modest benefit in treating ear infections in children, but they were also associated with an increased risk of side effects, such as rash and diarrhea," lead researcher Dr. Tumaini R. Coker of the University of California, Los Angeles, told Reuters Health in an e-mail. ... http://www.reuters.com/article/idUSTRE6AH0FG20101118?feedType=nl&feedName=ushealth1100
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Is your laptop cooking your testicles? NEW YORK (Reuters Health) - Whoever invented the 'laptop' probably didn't worry too much about male reproductive health. Turns out, unsurprisingly, that sitting with a computer on your lap will crank up the temperature of your nether regions, which could affect sperm quality.
And there is little you can do about it, according to the authors of a study out today in the journal Fertility and Sterility, short of putting your laptop on a desk. The researchers hooked thermometers to the scrotums of 29 young men who were balancing a laptop on their knees. They found that even with a lap pad under the computer, the men's scrotums overheated quickly.
"Millions and millions of men are using laptops now, especially those in the reproductive age range," said Dr. Yefim Sheynkin, a urologist at the State University of New York at Stony Brook, who led the new study. ...
http://www.reuters.com/article/idUSTRE6A457320101108?feedType=nl&feedName=ushealth1100
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(Even in my worst "bad" year, J & J have me beat in experiencing a "bad" year)
NEW YORK (Reuters) - Johnson & Johnson and Millennium Pharmaceuticals are recalling thousands of vials of the cancer drug Velcade sold in Europe, the United States, Japan and Malaysia after receiving reports of white particles seen floating in vials of the medicine.
The particles were found in batches of the drug distributed between January and June of this year. They have been identified as a polyester-like material related to a component of the manufacturing process performed by a contract manufacturer for Millennium, which is now a unit of Japan's Takeda Pharmaceutical Co.
Velcade, known chemically as bortezomib, is approved to treat multiple myeloma and relapsed mantle cell lymphoma. It is sold by Millennium in the United States and by J&J unit Janssen-Cilag in Europe and the rest of the world. ...
http://www.reuters.com/article/idUSTRE6AH5XR20101118?feedType=nl&feedName=ushealth1100
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How to undo neck pain In this age of computer keyboards and late-night Web surfing, you may be no stranger to neck pain. So here's what you do if you want it to get better: strength train those muscles. A new study reveals that toning and strengthening the problem areas may be the best way to keep your neck feeling loose and lovely.
Oh, My Aching . . . Neck pain -- technically dubbed trapezius myalgia -- is a common complaint of computer lovers. So Danish researchers recently set out to find a good solution. ... Reference: Effect of contrasting physical exercise interventions on rapid force capacity of chronically painful muscles. Andersen, L. L. et al., Journal of Applied Physiology 2009 Nov;107(5):1413-1419. http://www.realage.com/tips/how-to-undo-neck-pain?eid=7201&memberid=4687812
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Scientists turn patches of human skin into blood Got blood? Future patients who need transfusions for surgery and cancer treatments could get it from a patch of their own skin.
Canadian researchers took the huge step of transforming adult human skin directly into blood, as detailed in the Nov. 7 issue of the journal Nature. That should provide a desperately needed new source of blood for not only surgical and cancer patients, but also for patients suffering from blood disorders such as anemia.
The new method looks far more promising than trying to convert embryonic stem cells into blood. That approach has disappointed so far because of inefficiencies in converting the stem cells into mature cell types for transplantation. In addition, that method produces embryonic blood cells that can't be transplanted into adults. ... http://www.msnbc.msn.com/id/40058974/ns/health-health_care/
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Another Lawsuit Filed Following DePuy Hip Implant Recall Illinois Nursing Home Abuse Blog (blog) Our Chicago nursing home lawyers at Levin & Perconti are closely following the developments of the situation as many nursing home residents in the ...
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RANDOM FACT: Lemons are thought to have originated in the wild both in China and India and have been in existence for at least 4,000 years. They were taken to the Middle East between 400 and 600 BC and then to the Mediterranean where food historians say they have been in cultivation from as early as the first century AD.
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Everolimus Shown Effective for Rare Benign Brain Tumor Patients with subependymal giant-cell astrocytomas (SEGA) associated with the tuberous sclerosis complex who were treated with everolimus (Afinitor) showed "marked reductions" in tumor volume and no new lesions, researchers said.
Volume reductions of at least 30% were seen in 21 of 28 patients in the six-month trial, with nine patients achieving tumor shrinkage of 50% or more, reported David Neal Franz, MD, of Cincinnati Children's Hospital, and colleagues. ... http://www.medpagetoday.com/HematologyOncology/OtherCancers/23146
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Nurses Keep It Clean When it comes to infection control, patient acuity is the main difference between a hospital operating room and an ambulatory surgery center (ASC). In an ASC, the patient is expected to return home safely following recovery from anesthesia. Once the patient leaves the facility, ASC staff has little to no control over the condition of the patient's incision.
"That's the most challenging aspect of infection control in the ambulatory setting," said Bobbie Kendrick, RN, CNOR, CIC, the OR director at Lakeland Surgical & Diagnostic Center (LSDC) in Lakeland, FL.
Another difference between hospital ORs and ASCs, especially as it relates to infection control, is that ASC staff often wear more than one hat. "Typically, someone is designated as an infection control officer [at an ASC]," Kendrick said, "but the intensity of the program may vary by facility because infection control is not this person's sole responsibility."
http://nursing.advanceweb.com/Features/Articles/Nurses-Keep-It-Clean.aspx
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RANDOM FACT: The kiwi fruit has its origins in China's Yangtze River valley. The fruit has been around for over 700 years and was a favourite in the courts of the great Khans.
In the early 1900s, New Zealand missionaries took the seeds from kiwi fruit home where the plant was named for the indigenous bird. Plants were later sent to the United States, Italy, South Africa and Chile.
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Zap the Aging Effects of Stress in 14 minutes Few things speed the aging process like chronic stress. It's like adding fuel to an already capable fire. So take a few minutes to undo the damage.
In a small study of middle-aged women, all it took was 14 minutes of vigorous exercise each day to protect cells from the aging effects of stress. You could knock that out with just a brisk mile-and-a-half walk each day. Reference: The power of exercise: buffering the effect of chronic stress on telomere length. Puterman, E. et al., PLoS One 2010 May 26;5(5):e10837.
http://www.realage.com/tips/reverse-aging-relieve-stress-intense-workout?eid=7231&memberid=4687812
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(this isn't nursing related, but wanted to share) The Amazon Rainforest represents over half of the planet's remaining rainforests, and it comprises the largest and most species-rich tract of tropical rainforest in the world.
And it's dying.
An intense months-long drought through November drained the mighty Negro river -- a tributary of the Amazon -- to its lowest since records began in 1902, drying up the network of water that is the lifeblood of Brazil's huge Amazonas state.
What are the consequences?
This is the second such drought in five years. If this pattern of more extreme weather continues it would reduce rainfall over the remaining forest, creating a vicious cycle that would turn much of the Amazon into a savannah-like state by 2100. Ecologists and climatologists say there may come "a tipping point" after which the death of the forest becomes self-sustained by higher temperatures, dwindling rain levels and destructive fires.
Accounting for more than half of the world's remaining rainforest, the Amazon's trees are a vital global air conditioner, helping to keep the world cool by soaking up atmospheric carbon totaling about 2 billion tons each year.
When they die or wither, as they did in large numbers during the 2005 drought, they become part of the global-warming problem by releasing carbon.
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'Spiral' CT scans reduce smoker deaths: U.S. study WASHINGTON (Reuters) - Dr. Claudia Henschke was delighted with the news -- a trial of 53,000 people had shown that screening smokers and ex-smokers for lung cancer can save lives, something she has been trying to prove for 10 years.
The study sponsored by the U.S. National Cancer Institute is the first to show that people can be screened for lung cancer, akin to mammograms for breast cancer and tests for colon and prostate cancer.
"Nothing has ever shown a 20 percent decrease in mortality in this disease ever before. This is huge," said Regina Vidaver, executive director of the National Lung Cancer Partnership.
The researchers said their findings could save thousands of lives. Lung cancer kills 1.2 million people a year globally and it will kill 157,000 people in the United States alone this year, according to the American Cancer Society. ... http://www.reuters.com/article/idUSTRE6A33UB20101105?feedType=nl&feedName=ushealth1100
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Reduced weight gain tied to the Mediterranean diet NEW YORK (Reuters Health) - People who follow a diet typical of the Mediterranean region might dodge the added pounds that often come with aging, hints a new Spanish study.
However, the researchers can't be sure if it was the diet itself or related healthy behaviors that were responsible for staving off the weight.
The Mediterranean diet is generally rich in fish, fruits, vegetables, legumes and cereals, while low in red meats and dairy. Previous research has uncovered benefits for its followers, including protection from cardiovascular disease and diabetes, as well as weight loss among those who are already overweight or obese.
Yet doubts continue to linger over the potential caloric costs of the diet's high fat content, largely in the form of olive oil, noted lead researcher Juan-Jose Beunza of the University of Navarra. ...
http://www.reuters.com/article/idUSTRE6A34V420101104?feedType=nl&feedName=ushealth1100
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Med Notice: Needleless Pre-filled Glass Syringes: Stakeholder Advisory - Compatibility Problems with Needleless Intravenous Access Systems Reports Received on Adenosine and Amiodarone Products FDA is notifying healthcare professionals, especially those working in emergency and critical care settings, of reports of compatibility problems when certain needleless pre-filled glass syringes are used with some needleless intravenous (IV) access systems. These syringes may malfunction, break, or become clogged during the process of attempting to connect to needleless IV access systems. Most of the reports have been related to pre-filled needleless glass syringes that contain adenosine, often when attempting to connect to some pin activated needleless IV access systems. Adenosine is a cardiac drug that is administered when a patient has a rapid or irregular heart rhythm in an attempt to return their heart rhythm to normal. Adenosine must be injected rapidly into the blood stream in emergency situations and this failure could delay treatment.
In some cases where an attempt is made to connect to pin activated needless IV access systems, the syringe may cause the pin to break thus clogging the syringe, or damaging the IV tubing and/or the needleless connector and requiring reestablishment of a new intravenous access. These failures can cause a delay in administration of the medication, which could potentially result in serious harm to patients. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm234219.htm
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IV Acetaminophen Wins Approval-- in Surgery, General Surgery The FDA has approved an intravenous form of acetaminophen for relieving pain and fever after surgery, according to the drug's manufacturer.
Cadence Pharmaceuticals indicated that it would market the product, with a trade name of Ofirmev, as a treatment for post-surgical pain for patients who would normally receive IV medications.
The company noted that its product is the only nonopioid, non-NSAID medication approved for treating pain and fever currently available in intravenous form.
The FDA's approval was based on clinical trials involving a total of 1,020 adult and 355 pediatric patients -- including two trials evaluating the IV acetaminophen for pain relief and a third trial that tested the product's antipyretic effect. ... http://www.medpagetoday.com/Surgery/GeneralSurgery/23123
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RANDOM FACT: Did you know Chess is the most popular game in the world (although some people will say Monopoly)? It is commonly believed to have originated in India some 1500 years ago!
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Retinal implant trial helps blind see shapes: (Reuters) - Scientists have developed an eye implant that allowed three blind patients to see shapes and objects within days of treatment in a trial and say the device could become routine for some kinds of blindness in five years. ...
http://www.reuters.com/article/idUSTRE6A200C20101103?feedType=nl&feedName=ushealth1100
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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 backs Roche's Tamiflu as the first option in flu French researchers said that providers should consider Tamiflu as the first choice of treatment for flu instead of combining it with Relenza. During the flu pandemic, combining the two drugs was perceived to be a feasible method of preventing the emergence of drug-resistant flu viruses, but the study found that the combined drugs were less effective at fighting the flu than Tamiflu alone. ... http://www.reuters.com/article/idUSTRE6A15UD20101102
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Researchers have identified three models of comprehensive primary care that have the best potential for improving outcomes among elderly patients with multiple chronic conditions, while also lowering costs. The models incorporate a team-based approach and offer services including comprehensive assessment and care coordination. The Sun (Baltimore)/Picture of Health blog
http://www.reuters.com/article/idUSTRE6A27DO20101103?feedType=nl&feedName=ushealth1100
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RANDOM FACT: Less than 3 percent of the water on earth is fresh water. Approximately 1.6 percent is usable.
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Sip this juice for clearer arteries Whether beside oatmeal or eggs, this breakfast favorite is sure to help keep your arteries squeaky clean: orange juice.
In a study of men, those with a high intake of vitamin C -- as well as berries and other fresh fruit -- experienced significantly less thickening of their carotid arteries compared with the low fruit-and-C group. Reference: Vitamin C consumption is associated with less progression in carotid intima media thickness in elderly men: a 3-year intervention study. Ellingsen, I. et al., Nutrition, Metabolism, and Cardiovascular Diseases 2009 Jan;19(1):8-14 http://www.realage.com/tips/sip-this-juice-for-clearer-arteries?eid=7198&memberid=4687812
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Sepsis is tied to a higher risk for cognitive problems in elderly Older adults who were hospitalized for severe sepsis were three times more likely to develop cognitive problems than counterparts who were admitted for other conditions, researchers found. The study also showed that sepsis patients were at higher risk of having at least one new physical impairment, such as difficulty in walking or bathing, following their hospitalization. Los Angeles Times/Booster Shots blog (10/26)
http://www.latimes.com/health/boostershots/la-heb-sepsis-20101026,0,5629320.story?track=rss
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Sepsis a 'Hidden Public Health Disaster' http://www.healthleadersmedia.com/content/QUA-258276/Sepsis-a-Hidden-Public-Health-Disaster Older hospitalized patients who survive sepsis develop lasting, moderate to severe cognitive impairment and functional disability at 3.3 times the rate of patients hospitalized for other reasons, according to a report from University of Michigan researchers.
http://jama.ama-assn.org/cgi/content/abstract/304/16/1787?ijkey=661aa4ebaa1d7bfac061c6b1fce02e29b419b14b&keytype2=tf_ipsecsha
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New CPR is spelled C-A-B For years, anyone learning CPR -- emergency resuscitation -- was taught the "ABC": Check the airway for blockages, give breaths, then circulate the blood. New guidelines issued Monday by the American Heart Association turn that alphabet on its head, punctuating a shift that has led emergency responders to emphasize compression of the chest over all else when treating victims of cardiac arrest.
The new catch-phrase is "C-A-B" -- as in start pushing on the chest before doing anything else. The AHA guidelines also uphold a 2008 recommendation that untrained responders call 911 but then forget rescue breathing completely, and simply press on the victim's chest until help arrives.
http://www.cnn.com/2010/HEALTH/10/18/cpr.rules.heart.association/index.html
http://www.heart.org/HEARTORG/CPRAndECC/Science/ Guidelines/Guidelines_UCM_303151_SubHomePage.jsp
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RANDOM FACT: The Amazon River is so wide that from its mouth pours one-fifth of all the moving fresh water on Earth. Its discharge runs at 7,200,000 cubic feet of water per second; greater than the next ten largest rivers combined!
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Post-traumatic stress ups heart disease risk in vets U.S. military veterans who have post-traumatic stress disorder -- a condition marked by severe anxiety, sleep disruptions, hyperarousal and impaired concentration -- have double the risk of dying and a greater risk of developing cardiovascular disease, researchers said on Wednesday.
Study results, presented at the scientific sessions of the American Heart Association meeting held in Chicago this week, suggest that doctors should provide early and aggressive evaluation and treatment of cardiovascular risk factors in patients with the disorder.
"This study for the first time appears to point to the mechanism for the cardiovascular part of that excess mortality risk: accelerated atherosclerosis," said Dr. Naser Ahmadi, a researcher at the Greater Los Angeles Veterans Administration Medical Center. ... http://www.reuters.com/article/idUSTRE6AG60R20101117?feedType=nl&feedName=ushealth1100
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You could be putting a stranglehold on coffee's health perks by stirring in the wrong stuff. So consider these rules: no nondairy creamer, and go easy on the sweet stuff.
In a recent small study, sugar and nondairy creamers seemed to undo a big chunk of the health benefits of drinking coffee by binding up the good-for-your-body antioxidants in the brew.
Coffee's Good Stuff In the small study, coffee drinkers sipped instant joe three different ways -- black, with a little whole milk, or with sugar and nondairy creamer. Blood tests then showed that levels of chlorogenic acids (CGAs) -- antioxidants in coffee that may play a role in the brew's beneficial impact on diabetes risk and more -- were different across the groups. ... Reference: Nondairy creamer, but not milk, delays the appearance of coffee phenolic acid equivalents in human plasma. Renouf, M. et al., Journal of Nutrition 2010 Feb;140(2):259-263 http://www.realage.com/tips/health-benefits-of-coffee-non-dairy-creamer?eid=7224&memberid=4687812
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Sip this sweet, creamy drink to curb appetite Here's a creamy treat that can help knock both your appetite and calorie count straight to the ground: a fruit-and-yogurt smoothie.
But not just any old fruit-and-yogurt smoothie. Pick a recipe filled with fiber and protein. Research shows that a fiber-and-protein-rich snack at midmorning keeps appetite under control, so you eat a smaller lunch later -- a good 274 calories smaller! ... Reference: Short-term appetite-reducing effects of a low-fat dairy product enriched with protein and fibre. Lluch, A. et al., Food Quality and Preference 2010;21(4):402-409. http://www.realage.com/tips/best-appetite-suppressant-yogurt-smoothie?eid=8549&memberid=4687812
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Top 10 Most Costly, Frequent Medical Errors
By: Cheryl Clark, for HealthLeaders Media, August 11, 2010
Avoidable medical errors added $19.5 billion to the nation's healthcare bill in 2008, according to a claims-based study conducted by Millman, Inc. on behalf of the Society of Actuaries (SOA). The report lists the 10 most expensive errors in healthcare settings.
Most of that amount, $17 billion, was the cost of providing inpatient, outpatient and prescription drug services to individuals affected by medical errors, says Jim Toole, chairman of SOA. "While this cost is staggering, it also highlights the need to reduce errors and improve quality and efficiency in American healthcare."
The report listed the 10 most expensive types of errors in 2008, the number of errors, the cost per error, and the total cost. The first five make up 55% of the total error costs.
The list is as follows:
1. Pressure ulcers—374,964 errors, $10,288 per error and $3.858 billion total.
2. Postoperative infections—252,695 errors, $14,548 per error, $3.676 billion total.
3. Mechanical complication of a device, implant or graft—60,380 errors, $18,771 per error, $1.133 billion total.
4. Postlaminectomy syndrome—113,823 errors, $9,863 per error, $1.123 billion total.
5. Hemorrhage complicating a procedure—78,216 errors, $12,272 per error, $960 million total.
6. Infection following infusion, injection, transfusion, vaccination—8,855 errors, $78,083 per error, $691 million total.
7. Pneumothorax—25,559 errors, $24,132 per error, $617 million total.
8. Infection due to central venous catheter—7,062 errors, $83,365 per error, $589 million total.
9. Other complicaitons of internal (biological) (synthetic) prosthetic device, implant and graft—26,783 errors, $17,233 per error and $462 million total.
10. Ventral hernia without mention of obstruction or gangrene—53,810 errors, $8,178 per error and $440 million total.
http://www.healthleadersmedia.com/content/QUA-254873/Top-10-Most-Costly-Frequent-Medical-Errors
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HUMOR SECTION
Although I had arrived 20 minutes early for my one o'clock doctor's appointment, I watched patient after patient disappear into the various rooms. Now, I know things happen, and that more serious issues are typically dealt with first, so I was able to accept that those coming in after me were seen first, But when I was still sitting in the waiting room 1 1/2 hours later, I'd had enough and had become pretty irate.
Fortunately, as I got up and went to the receptionist, I calmed down enough to handle it without anger.
Instead I calmly said, "I know my son's appointment was for one o'clock. Can you tell me if that was a.m. or p.m.?"
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Before I could enroll in my company's medical insurance plan, I needed to fill out a questionnaire. As expected, the form was very thorough, leaving nothing to chance.
One question asked, "Do you think you may need to go to the emergency room within the next three months?" was the final straw.
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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 /
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https://nursing.advanceweb.com/CE/TestCenter/Main.aspx
This site was sent in by FNPMSN@aol.com (Cindy) http://cmepain.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 ISMP 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
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.nationalnurse3.blogspot.com/
RNs launch a national safe staffing campaign http://www.1199 seiu.org/media/magazine/sept_2007/safe_staffing.cfm
The Nursing Site http://thenursingsite.com .
http://www.snopes.com (to verify truthfulness of rumors)
http://www.solutionsoutsidethebox.net/ Raconte's website
http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3
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
http://www.alfaroteachsmart.com/articles.htm (Rozalfaro@AOL.com)
Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/
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MEDICAL RECALLS *
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Hyland’s Teething Tablets: Recall - Risk of Harm to Children FDA notified consumers that Hyland’s Teething Tablets is being recalled because the tablets may pose a risk to children. The tablets are manufactured to contain a small amount of belladonna, a substance that can cause serious harm at larger doses. For such a product, it is important that the amount of belladonna be carefully controlled. FDA laboratory analysis has found that Hyland’s Teething Tablets contain inconsistent amounts of belladonna. ... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts
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Octopus Nuvo Tissue Stabilizer: Recall - Potential for Device Fracture Medtronic informed healthcare professionals of a recall of the Octopus Nuvo Tissue Stabilizer due to the potential that a component of the device could fracture during use. The resulting potential hazards are that fragments of the component could fall into the patient’s chest cavity and/or damage the heart tissue. Medtronic has received two reports of device failure occurring during patient use, which required retrieval of device fragments from the surgical wound. ... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm231937.htm
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Triton Pole Mount Infusion Pump by WalkMed: Recall - Potential Door Open Alarm Problem WalkMed Infusion LLC notified healthcare professionals of a nationwide recall of the Triton Pole Mount Infusion Pump, serial numbers 001 through 500 and serial numbers TR1401 through TR 2559, manufactured and sold before June 2010. If the pump door is not closed and latched per the instructions for use located on the side of the pump and in the operator manual, the pump door open alarm may not alert the user to this condition. It is then possible for the pump mechanism not to be engaged and a gravity feed flow condition to exist if the pump operator has not checked tube set for flow prior to starting the pump. This could result in over infusion of medication. http://www.fda.gov/Safety/MedWatch/SafetyInformation/Safety AlertsforHumanMedicalProducts/ucm233014.htm
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Propoxyphene: Withdrawal - Risk of Cardiac Toxicity Sold as Darvon, Darvocet, and generics FDA notified healthcare professionals that Xanodyne Pharmaceuticals has agreed to withdraw propoxyphene, an opioid pain reliever used to treat mild to moderate pain, from the U.S. market at the request of the FDA, due to new data showing that the drug can cause serious toxicity to the heart, even when used at therapeutic doses. FDA concluded that the safety risks of propoxyphene outweigh its benefits for pain relief at recommended doses. FDA requested that the generic manufacturers of propoxyphene-containing products remove their products as well. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm234389.htm
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GnRH Agonists: Label Change - Increased Risk of Diabetes and Cardiovascular Disease (update) This new information warns about increased risk of diabetes and certain cardiovascular diseases (heart attack, sudden cardiac death, stroke) in men receiving these medications for the treatment of prostate cancer. Healthcare professionals should evaluate patients for risk factors for these diseases and carefully weigh the benefits and risks of using GnRH agonists before determining appropriate treatment for prostate cancer. Patients who are receiving treatment with GnRH agonists should undergo periodic monitoring of blood glucose and/or glycosylated hemoglobin (HbA1c). Healthcare professionals should also monitor patients for signs and symptoms suggestive of development of cardiovascular disease and manage according to current clinical practice.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm230359.htm
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NURSING HINTS CORNER
Covering pacemaker wires: We routinely care for patients with pacemaker wires. The wires are taped to the patient's abdomen, so we had to come up with a way to keep the tips of the wires aseptic. We solved the problem by protecting the tips with rubber needle covers from syringes. they fit snugly and don't irritate the patient's skin. Judy Gilmore, RN.
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.156, 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:
gloriagracia59@yahoo.com (Gloria) October 30, 2010
sugarp40@yahoo.com (Ronda) November 26, 2010
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NOTICE:
I attempt to send notices to your email addresses on file and if the notices 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
When you get to the end of your
rope, tie a knot and hang on.
Franklin Delano Roosevelt (1882-1945)
Hope to see you online..... Frankie
RNFrankie@AOL.com
