Newsletter for Paradigm 97
January 12, 2011
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
Catheter/tubing misconnections remain a serious problem in healthcare. Earlier this year, we learned of another fatal event. A 19-month-old child who was receiving treatment for a chronic gastrointestinal disorder died at a pediatric care center. A suspension of QUESTRAN (cholestyramine) was accidentally given via a central line intravenous catheter instead of through an enteral feeding tube.
In May 2010, another report was published about an incident where barium sulfate was administered to a 17-month-old child via the superior vena cava during an upper gastrointestinal study (Soghoian S, Hoffman RS, Nelson L. Unintentional IV injection of barium sulfate in a child. Am J Health-Syst Pharm. 2010;67: 734-36). The patient had a central venous catheter (CVC) in place for antibiotic therapy. As the procedure began, approximately 3 mL of barium sulfate was injected into the CVC, which was mistaken as the child’s gastrostomy tube. Fortunately, no respiratory distress or other major problems developed, and the child was discharged 4 days later.
Luer connector systems, common to many healthcare catheters, tubes, administration sets, extension sets, and syringes, have been at the heart of many catheter/tubing misconnections.
One of the most commonly reported problems is that some manufactured enteral catheters still have
ports that only accept parenteral administration sets and syringes. So, even if a liquid medication is prepared in an oral syringe, the medication must be transferred to a parenteral syringe for administration,
risking the accidental administration of the drug via a parenteral line.
Below are examples of the type of events associated with catheter/tubing misconnections reported to
the ISMP Medication Errors Reporting Program (MERP), all of which we’ve described in past
ISMP newsletters:
Peripheral IV infusions connected to epidural lines; and epidural solutions connected to peripheral
IV lines; Vinca alkaloids (e.g., vinCRIStine) in a syringe given via an intrathecal catheter; IV tubing connected to the inflation balloon port of an endotracheal tube or tracheostomy tube; Sequential compression device tubing or pneumatic blood pressure cuff tubing attached to the
port of an IV administration set. Oxygen tubing connected to port of an IV administration set;
Breast milk accidentally administered intravenously into neonates; Bladder irrigation solutions given
IV, or TPN solutions administered via a foley catheter port. An enteral nutrition container spiked with an IV administration set resulting in administering the enteral solution intravenously.
Topical solutions intended to be used with the V.A.C. (Vacuum Assisted Closure) Instill System
(used for wound healing) prepared in “IV” bags that accommodate IV tubing which could be inadvertently connected or attached to an IV catheter or line. Albuterol meant for continuous inhalation set-up using an IV bag and tubing that is accidentally administered intravenously. The International Organization for Standardization (ISO) has been working on a standard (ISO/IEC/FDIS 80369-1, “Small-bore connectors for liquids and gases in healthcare applications”) that will make various healthcare catheter connections and associated tubing sets or syringes incompatible with one another. The standard will include connectors for the flow of gases, enteral feedings, liquid medications via an intravenous route, gastric tube, limb cuffs (e.g., sequential compression devices, pneumatic tubes to blood pressure cuffs), urological access (e.g., bladder irrigation), and neuraxial access (e.g., epidural, intrathecal, intracranial). In addition, the current Luer connector standard (ISO 594) will be updated.
Designs for the connectors for enteral tubes and catheters, as well as containers, administration sets,
and syringes, are expected to be finalized by early 2011, with clinical testing by manufacturers
accomplished during the standards development process. As part of the new enteral standard, a female
Luer connector will not be present on feeding tubes, except for the inflation balloon that anchors some long-term use feeding devices. A final version of the standard standard should be completed by
2013. Although compliance with the standard will be voluntary, product vendors should have revised devices available soon after that.
On July 9, 2010, the US Food and Drug Administration (FDA) sent a letter (www.fda.gov/downloads/
MedicalDevices/ResourcesforYou/ Industry/UCM218631.pdf) to product manufacturers, healthcare practitioners, and hospital purchasing departments, which offered advice regarding the prevention of
catheter/tubing misconnections, which are similar to recommendations you will find in the checkitout!
column to the right, starting on page 1. FDA also mentioned that the agency is considering recognizing
the ISO/IEC/FDIS 80369-1 standard when it is published, due to the significant impact it will likely have
on the safety of these devices. If this happens, the FDA will provide guidance to manufacturers regarding
issues such as whether there will be a set period of time for currently marketed devices to come into compliance and the effect of the standard on new devices. The standard will be a much-welcomed addition toward improved patient safety. Coupled with additional safety measures found in the checkitout! column, we are optimistic that patient harm from tubing misconnections will be greatly reduced.
checkitout!
Follow these recommendations to prevent catheter/tubing misconnections.
Perform a Failure Mode Effects Analysis (FMEA) to identify the various types of catheters and connectors used in your organization. Identify the possibility for misconnections, assess the potential
frequency and severity of misconnections, and address process changes that need to be made. Be sure to include frontline staff who use the equipment.
Provide education to staff before using new tubes, catheters, or connectors. Include discussion about possible sources of errors uncovered during the risk assessment and steps to avoid these errors. Also, use tubing misconnections in simulation training during orientation and annual safety competencies.
(Go to www.fda.gov/downloads/MedicalDevices/Safety/AlertsandNotices /UCM134873.pdf for examples.)
Limit the staff who are allowed to connect or disconnect tubing from medication devices to licensed healthcareprofessionals who have been educated and are knowledgeable about the serious risks associated with misconnections.
During orientation include prohibitions to connecting/disconnecting tubing so all hospital staff are aware of who may perform this task.
Always trace from the source to the connection port to verify attachments before connecting or reconnecting tubing, and/or administering drugs or solutions. This action is particularly important, as awareness of each tube’s location and insertion site is easily lost if tubing is obscured by protective coverings, bedclothes, and sheets. Adjust lights or use flashlights if necessary.
Recheck connections and trace all tubes and catheters to sources upon patient transfer and hand offs.
Never attempt to force or use a makeshift connection that does not fit easily and securely into an access port.
Affix labels on lines near insertion sites if the patient has more than one connection to a port of entry into the body (e.g., IV, arterial, umbilical, enteral, epidural, bladder balloon port, tracheostomy
balloon port).
Avoid using a dual channel pump for infusions via different routes of administration. For example, use
pumps for epidural infusions that look different than pumps for IV infusions, if available. Label the epidural pump as “EPIDURAL ONLY.”
Place pumps on opposite sides of the bed when administering infusions via different routes of administration; when possible, do not keep them next to each other or place them on the same pole.
Use equipment the way it is intended to be used. For example, only use yellow-lined tubing without
injection ports for epidural infusions and only use oral syringes for oral medications.
Always hang infusion bags with labels facing out so they can be read. Make sure labels are on the same side of the infusion that includes any other important preprinted information.
Do not use parenteral syringe pumps to administer breast milk enterally; nasogastric tubes should
only connect to oral syringes via syringe extension sets (e.g., CORFLO by Corpak Medsystems).
Limit the frequency of disconnecting and reconnecting tubing (particularly IV tubing) to reduce the risk
of misconnections and infections.
EMAIL: nursing@ismp.org.
Report medication errors to ISMP at 1-800-FAIL-SAF(E).
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FROM THE MEMBERS
The following was sent in by oneacre454@msn.com (Debbie) : " I decided to join with two other RNs and we are being accredited by ANCC to be a provider of nurse competency job training skills for specialty. We will have simulated labs. Do you feel there is a market for this? My target market is 1199. New York State Nurses' Association, new grad's, and possibly nurses returning to the field. It will be a weeks' course and the cost range will be reasonable. When a nurse wants to change specialty they are told you have to have experience. So where do they acquire competencies? Also looking for nurses who work in the education dept of a hospital". oneacre454@msn.com (Debbie) If you have ideas suggestions, or are interested in learning further, please write her. Feel free to write me, and I will forward your e-mail.
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
Brain scans predict which dyslexics will read (Reuters) Sophisticated brain scans accurately predicted which teens with dyslexia would learn to read within three years, a finding that could lead to better ways to treat the common learning disability, researchers said on Monday.
By looking for a specific pattern of brain activity in teens with dyslexia, the researchers predicted with 90 percent accuracy which students would learn to read. "This gives us hope that we can identify which children might get better over time," Dr. Fumiko Hoeft of Stanford University School of Medicine, whose study appears in the Proceedings of the National Academy of Sciences, said in a statement. ... http://www.reuters.com/article/idUSTRE6BJ52R20101220?feedType=nl&feedName=ushealth1100
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(This was sent in by Laregis (Laura) thank you ! ) This link is to a TV news program. The scanner rubs by the back pocket of a guy or purse of a woman and scans in credit card information. It shows a symbol of 3 semi circles one right over the other that you should look for on your cards. These are the cards that are at risk for being scanned. My cards do not bear that symbol. The scanners could be ordered on line by any consumer, and were available just in time for Christmas. http://www.wreg.com/videobeta/?watchId=8ba6f8fc-90a2-4711-90ea-1884ec348310
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To slash your stroke risk by 80 percent, there are just five simple health habits to keep in mind: Walk every day, maintain a healthy weight, avoid cigarette smoke, enjoy alcohol only in moderation, and eat as nutritiously as you can. Some of these you probably already do. But tack on the missing items and your stroke risk drops dramatically.
The Golden Health Rules In a large study of men and women in their fifties, those who most adhered to these five basic health habits were 80 percent less likely to have an ischemic stroke -- the most common type of stroke. Specifically, these study participants exercised about 30 minutes a day and had BMIs below 25, and their diet mainstays were fruit, veggies, whole grains, and lean protein. Also, the women had no more than one alcoholic drink a day; the men, no more than two. Reference: Primary prevention of stroke by healthy lifestyle. Chiuve, S. E. et al., Circulation 2008 Aug 26;118(9):947-954. http://www.realage.com/tips/5-habits-that-stop-strokes?eid=7245&memberid=4687812
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The Story of Nurse Licensure The evolution of nurse licensure is representative of the heroic efforts of nurses to enhance the value and impact of the nursing profession. This literature review presents a historical account of the advancement of nursing through the nurse licensure process. ... Unfortunately, Purchase is required for the full article.
Nurse Educator: January/February 2011 - Volume 36 - Issue 1 - pp 16-20
doi: 10.1097/NNE.0b013e3182001e82
http://journals.lww.com/nurseeducatoronline/Abstract/2011/01000/The_Story_of_Nurse_Licensure.9.aspx
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(Please take the time to read this article...very interesting)
Pain Assessment in People with Intellectual or Developmental Disabilities
Chronic pain is a significant public health problem in the United States. One in four adults—an estimated 76.2 million Americans—reports having had pain that lasted more than 24 hours, while one in 10 reports pain that lasted a year or longer.2,3
Research has shown that people with intellectual or developmental disabilities have markedly higher rates of both acute and chronic medical conditions than do people in the general population.4 For example, a study by Minihan of 229 people institutionalized with "mental retardation" found that 99% had at least one chronic medical condition requiring follow-up care (for example, cardiovascular conditions, diabetes, ulcers, chronic otitis media, progressive renal failure).5 A Swedish study found that the hospital admission rate of people with developmental disabilities was threefold that of the general population, according to Carr and Owen-DeSchryver.4 Because people with such disabilities tend to have multiple comorbidities and often require more surgical and other medical procedures, the prevalence of pain is also likely to be higher (see Table 1).6 Yet these individuals are often undertreated for pain—or not treated for it at all—because health care professionals either don't know how to assess their pain or don't recognize that certain nonverbal behaviors can be expressions of pain. ... http://journals.lww.com/ajnonline/Fulltext/2010/12000/Pain_ Assessment_in_People_with_Intellectual_or.24.aspx
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Dietary Reference Intakes for Vitamin D Caution Against Excess : Internal Medicine News WASHINGTON – Daily doses of 600 international units of vitamin D and between 700 and 1,300 mg of calcium are enough for most children and adults in the United States and Canada, according to a report on new dietary reference intakes issued by the Institute of Medicine. These new dietary reference intakes for calcium and vitamin D (http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D.aspx) should provide "greater assurance that widespread vitamin D deficiency is not a public health problem," Dr. Steven Clinton, a member of the IOM committee that issued the report. Committee members spoke at a Nov. 30 press briefing. ... http://www.internalmedicinenews.com/newsletter/internal-medicine-news-e-newsletter/singleview40514/dietary-reference-intakes-for-vitamin-d-caution-against-excess/b97c9dbe1f.html
*********************** Your Own Best Friend: Benefits of Self-Compassion
Cost of Low Self-Compassion Self-compassion is essentially extending compassion to the self for one’s failings, inadequacies and experiences of suffering. Chronic patterns of low self-compassion can have significant effects on people not only psychologically, but also physically, and which what prompted one nurse researcher to begin exploring the correlation between self-compassion and levels of stress.
“People with less self-compassion and more negative feelings toward self can have higher levels of stress hormones pouring into the body,” says Lois Howland, RN, DPH, associate professor in the Hahn School of Nursing and Health Science at the University of San Diego. “These chronic high levels of stress can create poor health outcomes, including lower cognitive function, suppressed immune function and poor sleep, and this can affect a nurse’s ability to function in a job.”
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Lab change may affect CARBOplatin dosing. FDA alerted the oncology community about a potential dosing problem with CARBOplatin due to changes in the way labs are measuring serum creatinine. By the end of 2010, all US laboratories will use the new standardized Isotope Dilution Mass Spectrometry (IDMS) method to measure serum creatinine. The IDMS method appears to underestimate serum creatinine values compared to older methods when the creatinine values are relatively low (e.g., about 0.7 mg/dL). Measurement of serum creatinine by the IDMS-method could result in an overestimation of the glomerular filtration rate (GFR) in some patients with normal renal function. If the total CARBOplatin dose is calculated based on IDMS-measured serum creatinine using the Calvert formula, the dose could be higher than desired and result in drug-related toxicity. To avoid toxicity, FDA recommends capping the dose of CARBOplatin for desired exposure (area under the curve [AUC]) if a patient’s GFR is estimated based on serum creatinine measurements using the IDMS method. Specific recommendations appear on the FDA website at:www.fda.gov/AboutFDA/CentersOffices/CDER/ucm228974.htm.
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RANDOM FACT: 42 percent of American professionals say they are "regularly" forced to cancel vacation plans.
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If you want to banish belly fat, you've gotta do something fairly counterintuitive: eat. Yep, that's right. Don't starve yourself. Eat. Research shows that dieting too intensely or tracking every morsel too closely creates the perfect conditions for adding belly fat, not subtracting it.
Don't Mess with Stress A new study tracked the tension levels of 121 female dieters for 3 weeks and showed some concerning results. Those who followed a strict low-cal eating plan -- consisting of prepackaged meals totaling 1,200 calories a day -- experienced a significant rise in their levels of the stress hormone cortisol. And that can spell big trouble when it comes to belly management. Cortisol tells your body to store more calories in your midsection, exactly where you don't want it. On top of that, feeling stressed-out can make sticking with any weight loss plan feel darn near impossible. Reference: Low calorie dieting increases cortisol. Tomiyama, A. J. et al., Psychosomatic Medicine 2010 May;72(4):357-364. http://www.realage.com/tips/get-rid-of-belly-fat-wing-it?eid=7245&memberid=4687812
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RANDOM FACT: More than 25 million vertebrate animals are used in testing in the United States each year — including monkeys, chimpanzees, beagles and other dogs, cats, rabbits, mice, birds, farm animals, and still other sentient beings. After the experiments conclude, essentially all of the animals who have survived the research are killed. (always remember to buy make-up that is NOT animal tested)
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Hospitals Begin to Require BSNs, Aren’t Waiting on BSN in 10 Legislation
As more hospitals seek the American Nurses Credentialing Center’s coveted Magnet recognition, a recent but quiet trend has been slowly making its way into the nursing world: hospitals are requiring their nurses to either return to school for their bachelor’s degrees or have a BSN before applying.
Hospitals are not waiting for the outcome of the highly publicized “BSN in 10” bills — S4051/A2079B in New York and S620 (nee S2529)/A3768 in New Jersey — that are still awaiting closure in both legislatures, it seems, and are taking it upon themselves to get the ball rolling.
http://news.nurse.com/article/20101018/NATIONAL01/310180001
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Nursing Homes are seeking to end the stupor Instead of treating behavioral problems with antipsychotic drugs, the Ecumen chain of 15 homes is using strategies including aromatherapy, massage, music, games, exercise and good talk. The state is helping out.
The aged woman had stopped biting aides and hitting other residents. That was the good news. But in the North Shore nursing home's efforts to achieve peace, she and many other residents were drugged into a stupor -- sleepy, lethargic, with little interest in food, activities and other people.
"You see that in just about any nursing home,'' said Eva Lanigan, a nurse and resident care coordinator at Sunrise Home in Two Harbors, Minn. "But what kind of quality of life is that?" http://www.startribune.com/lifestyle/health/111326224.html?elr=KArks7PYDiaK7DUHPYDiaK7DUiD3aPc:_Yyc:aU6:iPhD_oD3aPc:i_kchO7DUr
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RANDOM FACT: More than 50 percent of U.S. workers don't use all of their paid vacation time; 30 percent say they don't even take half.
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Public Toilets or the Supermarket? See Where the Most Germs Linger For example, did you know you're better off touching a toilet seat than a public handrail? Or the bedspread in a hotel than the remote control? You'll never think of germs the same way again!
http://www.ivillage.com/public-toilet-gym-which-harbors-more-germs/4-b-299771?nlcid=wh|12-14-2010|
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Air Pollution tied to babie's ear infection risk (Reuters Health) - Babies and toddlers who live in areas with moderate air pollution may have a higher risk of middle-ear infection than those breathing cleaner air, a Canadian study suggests.
The findings, reported in the journal Epidemiology, do not prove that air pollution itself was the cause. But if it is, that would allow parents to influence their kids' risk of infection by moving to a place with better air.
Middle-ear infections, also called otitis media, are common among young children, with those younger than 2 being most susceptible. They are caused by a viral or bacterial infection, and usually arise after a child has had a cold, sore throat or other upper-respiratory tract illness.
Earlier studies have suggested that air quality can play a role in young children's vulnerability to middle-ear infections; exposure to second-hand smoke, for instance, has been linked to an increased risk. But little research has looked at the relationship between outdoor air quality and ear aches. ... http://www.reuters.com/article/idUSTRE6B162I20101202?feedType=nl&feedName=ushealth1100
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HANDY HINT: If you've been yanking on a cork in a wine bottle and it just simply won't budge, here's a quick tip: Take a hot, wet towel and wrap it around the neck of the bottle. The heat will cause the glass to expand a little so the cork will pop right out.
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Communication Between Nurses and Unlicensed Assistive Personnel in Nursing Homes: Explicit Expectations Journal of Gerontological Nursing Vol. 36 No. 12 December 2010 By Elena O. Siegel, PhD, RN; Heather M. Young, PhD, RN, FAAN
Effective communication is at the core of quality improvement efforts. This study identified and explored the written guidelines for what, how, and when nurses and unlicensed assistive personnel (UAP) are expected to communicate regarding residents’ status and care needs. Documents from six nursing homes were analyzed for this descriptive study, from which two primary themes emerged. First, extensive and explicit guidelines were identified for UAP-to-nurse communication, in comparison to few corresponding guidelines for nurses. Second, written guidelines for UAP communication were identified in multiple documents, with variations across sites in the situations requiring communication, the level of detail, and the format for how UAP-to-nurse communication should occur (i.e., verbal, written). This study raises the issue of the extent to which explicit organizational structures and written guidelines support and reinforce nurses’ scope of practice, the translation of UAP role expectations into actual practice, and the effectiveness of communication to promote quality care. http://www.jognonline.com/view.asp?rID=66669
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The Perfect snack for weight control: Want to stay faithful to your diet or lose more weight? Eat a handful of nuts when you get the munchies. Despite their high fat and calorie count, nuts are the perfect diet food. Research shows that people who eat nuts lose more weight and are more likely to stick to their weight loss plans than people who don't nibble on this ultrasatisfying munchy. Nuts boost weight loss efforts in three ways. First, they satisfy hunger, helping people to eat less later. Second, research shows that eating nuts helps people burn more calories at rest. And finally -- because of how the body digests them -- nuts might actually deliver fewer calories than you think (in fact, fewer calories per serving than nutrition labels suggest). Reference: Nuts and healthy body weight maintenance mechanisms. Mattes, R. D., Dreher, M. L., Asia Pacific Journal of Clinical Nutrition 2010;19(1):137-141. http://www.realage.com/tips/healthy-snacks-for-weight-loss?eid=7241&memberid=4687812
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Nurse's Roles in Diabetes Prevention, Education, and Care Considered an epidemic by public health officials, diabetes affects more than 23 million Americans, or nearly 8 percent of the Unites States population. And more than 5 million of those affected do not know that they have the disease.
New cases of diabetes mellitus are expected to double by 2050 and will affect 21 percent of the U.S. population, added Alice Poyss, RN, PhD, APN-BC, clinical associate professor at the Drexel University College of Nursing and Health Professions in Philadelphia. ... http://www.nursezone.com/nursing-news-events/more-news.aspx?articleid=35792
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HANDY HINT: Electric bulbs get dirty just like everything else, and that makes them less efficient. By simply dusting them with a microfiber cloth, they'll give off 50% more light so your rooms will be lighter and brighter.
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Brain scans accurate at spotting autism: U.S. study (Reuters) - U.S. researchers are closing in on an accurate test for autism, a finding that could lead to earlier diagnosis and treatment.
The test, which uses conventional magnetic resonance imaging or MRI machines, detected 94 percent of individuals with a high-functioning form of autism, they reported on Thursday.
"These results are the best yet in the search for a biological basis in terms of being able to distinguish those with and without the disease," said Nicholas Lange of Harvard Medical School, who directs the Neurostatistics Laboratory at McLean Hospital in Belmont, Massachusetts.... http://www.reuters.com/article/idUSTRE6B10Y420101202?feedType=nl&feedName=ushealth1100
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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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J&J heartburn worsens as Mylanta joins the recall list (Reuters) - Johnson & Johnson's consumer-product distress worsened on Wednesday as the company recalled 12 million bottles of over-the-counter Mylanta and almost 85,000 bottles of its AlternaGel liquid antacid.
J&J said the actions, which it described as "wholesale and retail level" recalls, were taken because the presence of small amounts of alcohol from flavoring agents was not noted on product packaging.... http://www.reuters.com/article/idUSTRE6B105420101202?feedType=nl&feedName=ushealth1100
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Curb Two Health Risks with this One Protein: Reduce cancer risk and control cholesterol with one protein choice? Maybe so, if that protein is salmon.
Salmon -- and other fatty fish like trout and herring -- may help boost blood levels of good cholesterol. But here's the kicker. That same heart-healthy act could slash the risk of several different types of cancer as well. So warm up the broiler and slice some lemon.
HDL and Cancer A recent review of several studies revealed that the risk of certain cancers -- including lung, colon, prostate, and breast -- may be affected by HDL levels. In the studies, the risk of these cancers took a nosedive in people with bountiful levels of the good-for-you kind of cholesterol. Seems the inflammation dampening that results from high HDL may also help discourage the survival, growth, and spread of various tumor cells.
References: Baseline and on-treatment high-density lipoprotein cholesterol and the risk of cancer in randomized controlled trials of lipid-altering therapy. Jafri, H. et al., Journal of the American College of Cardiology 2010 Jun 22;55(25):2846-2854.
Low high-density lipoprotein cholesterol and chronic disease risk marker or causal? Robinson, J. G., Journal of the American College of Cardiology 2010 Jun 22;55(25):2855-2857.
http://www.realage.com/tips/hdl-cholesterol-levels-lower-ldl-cancer-risks?eid=7240&memberid=4687812
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Protect your kidneys with this pill: The reasons to get your daily dose of the sunshine vitamin just keep piling up. The newest? Kidney protection.
In a study, men who worked outdoors regularly -- and got the most sun -- were 24 to 38 percent less likely to develop renal cell cancer compared with men who got the least sunshine. Experts suspect the link is vitamin D, available in pill or solar-made form.
The Powers of D Vitamin D is produced in your skin after just 10 to 20 minutes of sun exposure. ... http://www.realage.com/tips/renal-cancer-prevention-vitamin-d?eid=8556&memberid=4687812
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How Punching a clock helps your heart: If you just can't seem to break away when your shift ends, make it a mandate for your heart.
The paperwork can wait. Your heart can't. Research shows that people who log lots of overtime may be more likely to experience a heart attack or other signs of serious heart problems. Scary stuff, yeah?
The Work:Life Balance And it turns out that the added risk didn't necessarily boil down to lifestyle. For the people who routinely put in 3 to 4 hours of overtime every day and were more likely to have ticker troubles, ... http://www.realage.com/tips/workaholics-signs-of-a-heart-attack?eid=8556&memberid=4687812
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RANDOM FACT According to the U.S. Department of Agriculture, dandelions are more nutritious than broccoli or spinach, contain more cancer-fighting beta-carotene than carrots, and are a rich source of calcium, iron, magnesium, potassium, thiamine, riboflavin, lecithin, and dietary fiber!
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HUMOR SECTION
I was nervous the night my husband and I brought our three young sons to an upscale restaurant for the first time. My husband ordered a bottle of wine with the meal. When the waitress brought it, our children became quiet as she began the ritual uncorking.
She poured a small amount for me to taste, and then our six-year-old piped up, "Mommy usually drinks a lot more than that!"
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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
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 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.thebreastcancersite.com/clickToGive/home.faces?siteId=2
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 Critical Thinking: Not Usually Rapid Fire
Should Clinical Courses Get a Letter Grade?
Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/
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MEDICAL RECALLS
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Micromedics, Inc. Surgical Sealant dispensers, Nasal Septal Buttons, and Otological Ventilation Tubes: Class 1 Recall- Weak or Open Seals These medical products are contained in sterile pouches that have weak or open seals. These products could become or have been contaminated due to compromise in sterility. This can cause serious adverse health consequences and/or death. Surgical Sealant Dispenser – Instrument for the application of two liquids ; Micromedics Nasal Septal Button – Used for nonsurgical closure of an opening in the septum of the nose ; Otological Ventilation Tubes – Implants designed to provide ventilation to the middle ear space through the eardrum (tympanic membrane). Used when there is there is a chronic failure of the tube that connects the middle ear to the nose (Eustachian tube) and when the problem does not respond to conventional therapy.
Date Recall Initiated by firm March 15, 2010. These products were distributed from February 15, 2010 through March 4, 2010. For specific model and lots numbers please view the Medical Device Recall. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm234602.htm
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Sigma Spectrum Infusion Pump Model 35700: Class 1 Recall: Risk of Over-Infusion FDA notified healthcare professionals of the class 1 recall of the SIGMA Spectrum Infusion Pump Model 35700. These units may fail suddenly, causing inaccurate flow conditions during use, ranging from back flow to over-infusion, including free flow. The pump does not issue an alarm when this occurs. These conditions could result in serious injury or death. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm233747.htm
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VITEK 2 Gram Negative Susceptibility Cards Containing Piperacillin/Tazobactam ( TZP): Recall - Incorrect Test Results bioMérieux, Inc. VITEK 2 Gram Negative Susceptibility Cards that contain Piperacillin/Tazobactam are reporting incorrect results for testing the susceptibility of E. coli and K. pneumoniae to this drug. For E. coli, both falsely-resistant and falsely-susceptible results have been reported; for K. pneumoniae, only falsely resistant results have been observed. Incorrect results could potentially lead to patients being inappropriately treated with Piperacillin/Tazobactam, which could cause serious injury or death. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm233405.htm
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Fresenius Kabi LLC, Red Blood Cell (RBC) Exchange Sets used on AS104 Blood Cell Separation Devices: Class I Recall Use of the recalled product has led to removal of greater amounts of red blood cells than intended, resulting in hemodilution. 255 units are subject to this recall, including Red Blood Cell (RBC) Set (catalog number 9007601), lot numbers WKT252, YLT061, ZCT011, and ZGT052, manufactured from October 1, 2007 to July 30, 2010.
Red Blood Cell (RBC) Set (catalog number 9007601) is used for depletion or exchange of red blood cells during therapeutic apheresis procedures, when blood is removed from the patient and separated into its component parts, on the Fresenius AS 104 Blood Cell Separator Device. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm237707.htm
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Abbott Glucose Test Strips: Recall: False Low Blood Glucose ResultsFDA and Abbott Diabetes Care notified healthcare professionals and patients of a recall of 359 different lots of glucose test strips marketed under the following brand names: Precision Xceed Pro, Precision Xtra, Medisense Optium, Optium, OptiumEZ and ReliOn Ultima. The problem relates to a defect that inhibits sufficient absorption of blood into the test strip. Strips exposed to warm weather or prolonged storage may be more likely to provide a false result. Test strips with lot numbers that have been recalled may give falsely low blood glucose results, which can lead patients to try to raise their blood glucose when it is unnecessary, or to fail to treat elevated blood glucose due to a falsely low reading. Both scenarios pose risks to health. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm237910.htm
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ev3 NanoCross .014" OTW PTA Dilatation Catheter: Class 1 Recall There is potential for cracking or breaking during use. Cracking or breaking of the catheter shaft can result in the inability to inflate or deflate the balloon, and can result in separation of catheter components and potential embolization catheter fragments. Catheter failure may lead to unplanned intravascular or open surgery, significant vasospasm, prolonged tissue ischemia, injury, infarct, bleeding and/or death. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm238291.htm
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Dexamethasone Sodium Phosphate Injection, 4 mg/mL, 30 mL Multiple Dose Vial: Recall due to Particulates in Product American Regent and FDA notified healthcare professionals of the nationwide recall of specific lots of Dexamethasone Sodium Phosphate Injection, USP 4 mg/mL, 30 mL Multiple Dose Vial because some vials of these lots either contain particulates or have the potential to form particulates prior to their respective expiration dates. The recalled lots are listed in the firm's press release: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm238104.htm
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Sodium Bicarbonate Injection, USP, 7.5% and 8.4%, 50 mL. single Dose Vials --Recall American Regent and FDA notified healthcare professionals of the nationwide recall of specific lots of Sodium Bicarbonate Injection, USP, 7.5% and 8.4%, 50 mL Single Dose Vials because some vials of these lots contain particulates. Potential adverse events after intravenous administration include damage to blood vessels in the lung, localized swelling, and granuloma formation. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm238323.htm
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Arrow Intra-Aortic Balloon (IAB) Catheter Products: Class 1 Recall
The Arrow Ultra 8 Intra-Aortic Balloon Catheters (IABS) 8 FR 30CC and 40CC Universal and Arrow Intra-Aortic Balloon (IAB) Catheter with a Fiber Optic Sensor and a Measurement System are recalled because the catheters can become stuck in the sheath. When the IAB catheter becomes stuck, the user is unable to move the IAB catheter forward or backward, causing delay in therapy, bleeding or arterial injury. http://wcms.fda.gov/FDAgov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm238408.htm
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B. Braun addEASE Binary Connector: Class I Recall -Stopper Fragments May Enter Bag When the addEASE binary connector is inserted into a partial additive bag (PAB) stopper, fragments of the stopper may enter the bag, resulting in a small amount of visible particles in the solution. The particles can potentially enter a patient’s body and lead to serious adverse health consequences, such as pulmonary embolism, stroke, or heart attack. These issues could result in serious injury or death. (The addEASE is used to transfer fluid between a partial additive bag (PAB) and a drug vial) http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm235283.htm
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HiRes 90K Cochlear Implant Device: Recall - Malfunction Advanced Bionics (AB) announced that it will voluntarily recall its HiRes 90K cochlear implant device and is retrieving all unimplanted devices in distribution. This action is being taken in response to two confirmed instances where the product experienced a malfunction requiring explantation. These recipients experienced severe pain, overly loud sounds and/or shocking sensations at 8-10 days after initial activation of their device. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm235009.htm
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NURSING HINTS CORNER
Here is another way to get rid of those seemingly indelible ink spots that adorn your uniform pockets-- the products of uncapped pens. Just saturate the spot with hairspray, then wash your uniform with your usual detergent. The result is a truly "spotless" uniform/scrub. Cheryl Diorio, LPN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.216, 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:
JLedwitch@briangriner.com (John) November 8, 2010
Rocket1225@gmail.com Ricky December 17, 2010
jFordhodges@gmail.com (Jo) December 28, 2010
rassatt@gmail.com (Deann) December 28, 2010
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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number....lol So please send me your new name/address, ok? RNFrankie@AOL.com
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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
“No person was ever honored for what he received. He
was honored for what he gave.”
Calvin Coolidge.
Hope to hear from you..... Frankie
RNFrankie@AOL.com
