January Paradigm 97 Newsletter:

PARADIGM BYTES
Newsletter for Paradigm 97
January 12, 2012

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

Contact: Lauren Wilson, Communications Director
2468 Rayburn House Office Building Washington DC 20515
Phone: (202) 225-8885 Fax: (202) 226-1477 www.house.gov/ebjohnson

CONGRESSWOMAN EDDIE BERNICE JOHNSON INTRODUCES THE NATIONAL NURSE ACT OF 2011, HR 3679

Washington, DC – (Friday, December 16) – Yesterday, Congresswoman Eddie Bernice Johnson (D-TX) introduced the National Nurse Act of 2011, HR 3679. The bill, co-led by Congressman Peter King (R-NY), has garnered eighteen original co-sponsors. It would designate the Chief Nurse Officer of the U.S. Public Health Service as the “National Nurse for Public Health.”
The National Nurse would function alongside the Surgeon General and focus on health promotion, improving health literacy, and decreasing health disparities.

“The National Nurse Act of 2011 is an important piece of legislation that would establish a focal point for promoting health and disease prevention. There are currently 3.4 million nurses, making the demographic the largest sector of healthcare workers in the United States.

“As the first registered nurse in Congress, I believe that having a National Nurse focused on prevention activities will help reduce illnesses and decrease the costs for care and services,” said Congresswoman Johnson.

The National Nurse Act of 2011 is currently endorsed by dozens of prominent nursing organizations and key stakeholders.

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U.S. Representative Eddie Bernice Johnson is the highest-ranking Texan on the House Committee on Transportation & Infrastructure and a senior member of the Science Committee. She represents the 30th Congressional District of Texas, which, includes Downtown Dallas, Fair Park, Oak Lawn, Turtle Creek, Old East Dallas, Pleasant Grove, & South Oak Cliff; all of Balch Springs, DeSoto, Hutchins, Lancaster & Wilmer and parts of Cedar Hill, Duncanville, Ferris, Glenn Heights and Ovilla.



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INTERESTING READING

Please remember that the REUTERS articles usually good for only 30 days

522 Million People Could Have Diabetes By 2030, Experts Say Many Cases Still Preventable
GENEVA - The International Diabetes Federation predicts that at least one in 10 adults could have diabetes by 2030, according to its latest statistics.
In a report issued on Monday, the advocacy group estimated that 552 million people could have diabetes in two decades' time based on factors like aging and demographic changes. Currently, the group says that about one adult in 13 has diabetes.
The figure includes both types of diabetes as well as cases that are undiagnosed. The group expects the number of cases to jump by 90 per cent even in Africa, where infectious diseases have previously been the top killer. Without including the impact of increasing obesity, the International Diabetes Federation said its figures were conservative. ... http://www.huffingtonpost.ca/2011/11/14/522-million-people-could-_n_1091753.html?ncid=webmail1#s446200&title=Diabetes

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Quiz Time
An important advance in treating combat-related pain during patient military evacuation flights is:
a. use of morphine
b. use of nonsteroidal anti-inflammatory drugs
c. use of Reiki
d. use of regional anesthesia
(Answer at end of Newsletter)
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ED nurses continue to be victims of workplace violence, according to new report
The latest data from the “Emergency Department Violence Surveillance Study,” an ongoing survey study from the Emergency Nurses Association (ENA), show rates of physical violence and verbal abuse against nurses did not decrease from May 2009 to January 2011. In the 12 months from January 2010 to January 2011, more than half (53.4%) of nurses reported experiencing verbal abuse and more than one in ten (12.9%) reported experiencing physical violence over a seven-day period compared with 54% reporting verbal abuse and 11% reporting only physical violence in the first year of the study. The study also found that reporting policies (especially zero-tolerance policies) were associated with a lower odds of physical violence and verbal abuse. Read the ENA press release. and the report.
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HHS Unveils MLR Rule Dec 02, 2011

The Department of Health and Human Services today released its final medical loss ratio rule. The rule will ensure that health insurance companies spend at least 80 percent of consumers' health insurance premiums on medical care rather than on income, overhead and marketing expenses.
The Hill: "Insurance plans will soon have to give consumers more information about how their premium dollars are spent,
even if the spending meets new federal requirements. The disclosure requirements were included in final regulations on
the healthcare reform law's medical loss ratio (MLR) provision. The Health and Human Services Department finalized
its MLR rules Friday" (Baker, 12/2). There are some links to the interim rule & other info with the article.........
http://www.kaiserhealthnews.org/Daily-Reports/2011/December/02/mlr-rule.aspx

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Frequent red meat eaters at higher risk of stroke (Reuters Health) - A high-protein diet might benefit health in some ways, but depending on what kind of protein a person consumes, it could raise their stroke risk too, suggests a large new study that finds eating lots of red meat ups the likelihood of having a stroke while poultry lowers it.
"The main message from this paper is that the type of protein or the protein package is really important for the risk of stroke. We have to consider protein in the context of the foods," said Dr. Frank Hu, a professor at the Harvard School of Public Health and one of the authors of the study. ...
http://www.reuters.com/article/2012/01/11/us-redmeat-stroke-idUSTRE80A20O20120111?feedType=nl&feedName=ushealth1100
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By MedPage Today Staff
Published: December 30, 2011
Injections That Are 'Soft as Silk' Silk Needle Threaded With Medicines

Instead of the "pinch" of a hypodermic needle to administer drugs, tiny biodegradable needles made of silk protein could be used to deliver precise doses painlessly, researchers suggested.
An engineering group described in Advanced Functional Materials how the microneedles could be made at room temperature and pressure with a water-based process, which wouldn't destroy sensitive biologic medications.
Even large-molecule drugs could be mixed with the silk protein solution, and adjusting the conditions under which they dried determined short or extended release of the medication.
Because the tip of the needles penetrate the skin without reaching nerves, they would be painless to use, the researchers noted.
"This is a very flexible technology that can be scaled up or down, shipped and stored without refrigeration and administered as easily as a patch or bandage," one of the researchers said in a press release. "We believe the potential is enormous."
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Spools and Tails May Be Keys to Schizophrenia Tx
Postmortem studies of brain tissue from patients with schizophrenia have revealed alterations of gene expression relating to low levels of histone acetylation – a finding that could open up new ways of treating the disease itself and not just the devastating symptoms.
Histones are intracellular proteins that serve as structural spools for DNA to wind around, forming chromatin, with "tails" that regularly undergo chemical modifications such as acetylation and methylation.
These epigenetic changes can determine which genes are activated and which are repressed, explained Elizabeth Thomas, PhD, of the Scripps Research Institute in La Jolla, Calif.
In a series of PCR assay experiments, the researchers found alterations in histone acetylation in the promoter region of several genes that have been linked to schizophrenia. They then studied the effects of a histone deacetylase inhibitor on mouse brain tissue, and found a reversal of the abnormal gene expression.
If the use of a histone deacetylase inhibitor such as valproic acid is found to have similar effects in the human brain, the effects could be normalization of histone acetylation patterns and gene expression, the researchers wrote in Translational Psychiatry.

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RANDOM FACTS: Fortune cookies actually originated in Japanese culture. You would find more Japanese-owned restaurants that served the still very popular American adaptation of Asian cuisine before WWII. When large populations of the Japanese-American citizens were put into internment camps, the fates of their restaurants were turned over to Chinese-Americans, and so we associate the famous cookie with the Chinese.

Bonus Fact: Actual Chinese cuisine is much different than what Americans know as Chinese food. However, the success of American-Asian food has necessitated vocational schools in China to teach potential immigrants the art of the cuisine. For example, Egg Foo Young is unheard of in traditional Chinese cuisine.
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Study Examines Changes in Resting Heart Rate Over Time Although resting heart rate (RHR) has been long known to be associated with cardiovascular risk, change in RHR over time has not been well studied. A new paper from Norway published in JAMA demonstrates that an increase in RHR over 10 years helps predict the risk of all-cause and ischemic heart disease (IHD) death.
Javaid Nauman and colleagues analyzed data from 46,410 Norwegian adults without known cardiovascular disease who had their RHR measured at baseline and at 10 years. ...
http://www.forbes.com/sites/larryhusten/2011/12/21/study-examines-changes-in-resting-heart-rate-over-time/
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RANDOM FACT: Levi Strauss arrived in California during the Gold Rush trying to sell canvas tents to miners. However, he soon
learned that what the prospectors needed most was pants, and so he turned his tent business into a pants business;
eventually using imported denim in place of canvas.
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Bonus Fact: In 2005, an original pair of Levi's--aged more than 115 years--were sold to a collector for $60,000.
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A Taste of Nursing Research: An Interactive Program Introducing Evidence-Based Practice and Research to Clinical Nurses Abstract
Developing and implementing a program to introduce clinical nurses to research and evidence-based practice (EBP) should spark interest and participation. In this article, the authors describe and evaluate a staff development initiative not only to introduce the principles of EBP and research but also to give nurses the opportunity to participate in the research process and development of EBP questions.
http://journals.lww.com/jnsdonline/Abstract/2011/11000/A_Taste_of_Nursing_Research__An_Interactive.18.aspx

Brown, Christine R. BSN, RN, CCRN; Johnson, Ann S. BSN, RNC, NNP-BC; Appling, Susan E. MS, CRNP
Journal for Nurses in Staff Development - JNSD:
November/December 2011 - Volume 27 - Issue 6 - p E1–E5
doi: 10.1097/NND.0b013e3182371190
Articles: Online Only
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High lead exposure linked to hearing loss in youth
(Reuters Health) - Teens exposed to higher-than-normal levels of lead are more likely to have trouble hearing, suggests a new study that links the hearing problems to lead levels well below those considered "safe" by current standards.
But other heavy metals weren't clearly tied to hearing problems, researchers said. And with lead, the report found only a small proportion of adolescents had blood concentrations that might be linked to hearing loss.
"It looks like the levels in the blood of most kids are very low and people are avoiding (heavy metals)," said study author Dr. Josef Shargorodsky, from the Massachusetts Eye and Ear Infirmary and Brigham and Women's Hospital in Boston. ...

http://www.reuters.com/article/2011/12/22/us-high-lead-hearing-loss-idUSTRE7BL1T720111222?feedType=nl&feedName=ushealth1100
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Breast implants need lifetime of care: experts (Reuters) - The Internet and women's magazines are filled with enticing adverts for breast implant surgery, but experts and regulators have varying views on how long they last and possible risks.
The implants now at the centre of a worldwide health scare came from the now-defunct French company Poly Implant Prothese (PIP) and appear to have an abnormally high rupture rate. That risk, though typically low, is present in all implants. ... http://www.reuters.com/article/2011/12/27/us-breast-implants-idUSTRE7BQ0EC20111227?feedType=nl&feedName=ushealth1100
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Siemens recalls clinical pregnancy tests (Reuters) - Siemens has recalled 15 batches of clinical pregnancy tests because some of them incorrectly showed a positive result, a spokesman for the company said on Friday.
He said the recall affects several hundred hospitals around the world, which were told as early as mid-December to destroy pregnancy tests from the batches. Until the cause of the malfunction has been found, Siemens will not be supplying any such tests, he said.

http://www.reuters.com/article/2011/12/30/us-siemens-recall-idUSTRE7BT0CN20111230?feedType=nl&feedName=ushealth1100
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Analysis: Court tests liability of healthcare executives (Reuters) - After decades in relative obscurity, a legal doctrine that holds corporate officers liable for company wrongdoing is finding its way back into some high-profile healthcare prosecutions.
The "responsible corporate officer" doctrine allows for prison terms of up to one year for misdemeanor violations of the Federal Food, Drug and Cosmetic Act, but typically defendants have received only probation.
Recently, however, the government has sought to reinvigorate the doctrine, and some executives are facing stiffer penalties than they had ever imagined.
On Tuesday, the Department of Health and Human Services will seek to convince a federal appeals court to uphold a 12-year exclusion from government business for three former executives of Purdue Pharma. The executives had pleaded guilty in 2007 to a misdemeanor for misbranding the painkiller OxyContin. ...

http://www.reuters.com/article/2011/12/06/us-health-legal-idUSTRE7B50NA20111206?feedType=nl&feedName=ushealth1100
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Medtronic settles U.S. probe over doctor kickbacks
(Reuters) - Medtronic Inc has agreed to pay $23.5 million to settle allegations that it paid kickbacks to doctors to encourage them to use its pacemakers and defibrillators, the U.S. Justice Department said on Monday.
The company was accused of seeking physicians to participate in studies and registries and paying doctors fees of between $1,000 to $2,000 per patient for information and data collected as long as they used Medtronic's devices, according to the Justice Department.
Medtronic caused false claims to be submitted to the federal healthcare programs Medicare and Medicaid, the Justice Department said. The settlement resolves two whistleblower lawsuits against the company. ...

http://www.reuters.com/article/2011/12/13/us-medtronic-kickbacks-idUSTRE7BC2GV20111213?feedType=nl&feedName=ushealth1100
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The New York Times: Report Finds Most Errors At Hospitals Go Unreported
Hospital employees recognize and report only one out of seven errors, accidents and other events that harm Medicare patients while they are hospitalized, federal investigators say in a new report (Pear, 1/6).
http://tinyurl.com/6makzby The 42 page study can be downloaded from: http://oig.hhs.gov/oei/reports/oei-06-09-00091.pdf (I don't think this is an accurate report....what do you think?)
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USA Today: Workplaces Ban Not Only Smoking, But Smokers Themselves
As bans on smoking sweep the USA, an increasing number of employers — primarily hospitals — are also imposing bans on smokers. They won't hire applicants whose urine tests positive for nicotine use, whether cigarettes, smokeless tobacco or even patches (Koch, 1/5).
http://tinyurl.com/729eovy
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Emergency Hospitalizations for Adverse Drug Events in Older Americans. A study in the New England Journal of Medicine found that 67% of emergency hospitalizations related to adverse drug events were caused by four medications or mediation classes alone or in combination: warfarin,insulins, oral antiplatelets, and oral hypoglycemic agency. Adverse drug events are important preventable causes of hospitalization in older adults, however nationally representative data on adverse drug events is scarce ...

http://www.nejm.org/doi/full/10.1056/NEJMsa1103053
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RANDOM FACT: Rather than wring every dime he could out of the popular "Matrix" movie series, Keanu Reeves signed away his back-end deal for the two sequels to the films' special-effects and costume-design teams -- an act of benevolence that cost him many millions.

Bonus Fact: Named after his uncle, Henry Keanu Reeves, the actor's first name roughly translates to "cool mountain breeze" in Hawaiian.

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HUMOR SECTION

The shopkeeper was dismayed when a brand new business much like his own opened up next door and erected a huge sign which read BEST DEALS.

He was horrified when another competitor opened up on his right, and announced its arrival with an even larger sign, reading LOWEST PRICES.

The shopkeeper was panicked, until he got an idea. He put the biggest sign of all over his own shop- it read...... MAIN ENTRANCE



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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........

Go to www.sharedgovernance.org for access to a just released, free continuing education module about shared governance, written by Robert Hess, Forum’s founder, and Diana Swihart, Forum advisory board member. Please follow me on Twitter as DrRobertHess.

Pay Only $34.99 for a full year of CONTACT HOURS

www.nurse.com for CNE offerings.

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.

This is an excellent nursing site, check it out: http://nursingpub.com/

This information has recently been updated and is now available.
Draft Guidance for Industry: Use of Nucleic Acid Tests on Pooled and Individual Samples from Donors of Whole Blood and Blood Components, including Source Plasma, to Reduce the Risk of Transmission of Hepatitis B Virus (PDF - 168KB)


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

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

Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/

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MEDICAL RECALLS
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CareFusion AVEA Ventilator: Recall - Failure May Lead to Lack of Ventilation
FDA notified healthcare professionals of a class I recall of CareFusion AVEA Ventilators. The AVEA ventilator can develop a failure where the ventilator activates a false extended high peak alarm, opens the safety valve and stops ventilating. Without health care professional intervention, patients may suffer life-threatening injury or death.
The AVEA ventilator is intended for continuous breathing support for the care of neonatal through adult patients who require mechanical ventilation. These ventilators are used in hospitals and other health care institutions. The recalled ventilators were manufactured between March 1, 2009 and June 30, 2011. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm285063.htm
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Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants: Drug Safety Communication - Use During Pregnancy and Potential Risk of Persistent Pulmonary Hypertension of the Newborn Including Celexa (citalopram); Lexapro (escitalopram); Prozac, Sarafem, Symbyax (fluoxetine); Luvox, Luvox CR (fluvoxamine); Paxil, Paxil CR, Pexeva (paroxetine); Zoloft (sertraline); Viibryd (vilazodone)

FDA notified healthcare professionals and the public on the use of selective serotonin reuptake inhibitor (SSRI) antidepressants by women during pregnancy and the potential risk of a rare heart and lung condition known as Persistent Pulmonary Hypertension of the Newborn (PPHN). The initial Public Health Advisory in July 2006 on this potential risk was based on a single published study. Since then, there have been conflicting findings from new studies evaluating this potential risk, making it unclear whether use of SSRIs during pregnancy can cause PPHN.
FDA has reviewed the additional new study results and has concluded that, given the conflicting results from different studies, it is premature to reach any conclusion about a possible link between SSRI use in pregnancy and PPHN. FDA will update the SSRI drug labels to reflect the new data and the conflicting results.
BACKGROUND: SSRIs are marketed under various brand and generic drug names, and are used to treat depression and other psychiatric disorders. There are no adequate and well-controlled studies of SSRIs in pregnant women.
PPHN occurs when a newborn baby does not adapt to breathing outside the womb. Newborns with PPHN may require intensive care support including a mechanical ventilator to increase their oxygen level. If severe, PPHN can result in multiple organ damage, including brain damage, and even death.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm283696.htm


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NURSING HINTS CORNER

X marks the spot. Locating pedal and posttibial pulses can be time-consuming. After I find them, I use a felt-tip pen to mark and X over a palpable pulse and a D over a pulse that is detectable by a Doppler ultrasound stethoscope only. This not only helps the nurse on the next shift, but it also allows us to determine quickly if the pulse has worsened or improved. Christine Ozoro, RN, BSN.

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.119, Springhouse Corporation/www.springnetcom.

~**~~**~~**~~**~~**~~ 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. So please send me your new name/address, okay? 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

The bitterest tears shed over graves are for words left
unsaid and deeds left undone.

Harriet Beecher Stowe, Author

Drop me a line.... Frankie
RNFrankie@AOL.com

Answer to Quiz Time:

Correct answer: d. Regional anesthesia is now used to manage combat-related pain during air transport to the next level of care and for postoperative pain. Regional analgesia is a preventive strategy that yields improved analgesia, outcomes, and patient satisfaction.