PARADIGM BYTES Newsletter for Paradigm 97 May 11, 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. ***~~~***~~~***~~~*** SNIPPETS Nurses and Substance Abuse Anne Heuser, R.N. LNCC Happy Nurses Week to all. To celebrate and recognize nurses this week at my hospital, we had many presentations; from Mary Kay to SPAN. SPAN is a program through NYSNA which assists nurses who are struggling with substance abuse. Through reaching out to this organization, the addicted nurse can receive help and support and may not have to lose their license. Let’s not remain silent on this epidemic anymore. Let’s be proactive and take a hard look at ourselves and our colleagues. The SPAN presentation I attended really touched my heart. The presenter talked about substance abuse issues with nurses and our individual struggles. Maybe it is you or a colleague…. It reminded me of how human and affected we are. Please follow the below link to learn more. http://www.nysna.org/images/pdfs/span/span_spg12.pdf It would be really great to have more contributors to the SNIPPET column. Please contact me if you are interested, write to:. RNFrankie@AOL.com. ~~**~~**~~**~~**~~**~~ FROM THE MEMBERS The following is from MarGerlach (Marlene) who writes: I totally agree with the concept of sitting down for a patient "consultation"/whatever is a much better way to do it than standing. Puts you on their level and you do not give the impression of being intimidating, superior, disinterested or hurried. You surely appear much more interested in them if you are willing to sit down with them . When I was going through chemo 19 years ago, my oncologist was a total love! After the usual checkup, he would lean way back in his chair, put his hands behind his head and sincerely ask "What else can I do for you today?" "What do you need?" "Do you need to talk about anything?" That meant so much to me that he was willing to take as much time as I needed. ***************************** The following is a well written editorial by one of our members; this was written for Nurse's Week of May 6 through May 12. Please read and enjoy The quiet—and not-so-quiet—courage of nurses. The Best People I Know The more I learned about what nurses did, the more I felt nursing was a good choice: the work changed constantly and was important. (I did think about becoming a physician for about a minute—but the education was long and costly, and the profession seemed not nearly as exciting by Cherry Ames standards.) ... Kennedy, Maureen Shawn MA, RN ( AKA shawn.kennedy@wolterskluwer.com ) http://journals.lww.com/ajnonline/Fulltext/2012/05000/The_Best_People_I_Know.1.aspx ; ~~**~~**~~**~~**~~**~~ MEDICAL NEWS U.S. cites Assurant unit over health premium hike (Reuters) - U.S. officials on Monday cited two health insurers for excessive premium increases, under consumer protection rules of President Barack Obama's healthcare reform law that could soon be nullified by the Supreme Court. The Department of Health and Human Services called on Assurant Inc's Time Insurance Co and Bedford Park, Illinois-based United Security Life and Health Insurance Co to either offer rebates to customers in six states or rescind premium hikes ranging up to 24 percent. ... http://www.reuters.com/article/2012/04/16/us-usa-healthcare-insurers-idUSBRE83F1B020120416?feedType=RSS&feedName=healthNews ~~**~~**~~**~~**~~**~~ INTERESTING READING RANDOM FACT: The Dalai Lama of Tibet, Tenzin Gyatso, is both the spiritual leader and head of the state of Tibet. Born on July 6, 1935, he was just 2 years old when he was recognized as the reincarnation of the 13th Dalai Lama, Thubten Gyatso. He took the throne at age 4 and became a monk at age 6. Bonus Fact: The Dalai Lama has a range of pastimes including meditating, gardening, and repairing watches. ************************** Discussing Death With Pediatric Patients: Implications for Nurses Communicating about end-of-life issues with a pediatric patient and their families can be difficult and uncomfortable for many nurses. The purposes of this article are to provide nurses a foundational overview of the child's understanding of death through the lens of awareness, development, and experience and to provide effective ways for nurses to implement this knowledge as they approach the topic of death with patients and their families. ( the full article price is 14 USD.........one can register and receive articles for the year.) http://www.pediatricnursing.org/article/PIIS0882596311007068/abstract?rss=yes ***************************** The '5 S's': Easing baby pain after vaccine shots For most parents - even the strongest believers in the benefits of vaccines - anticipating how their newborns' facial expressions will turn from curious to shock before they burst into tears from the needle stick, can make the next well-baby check-up something they would love to skip. But doctors at Children's Hospital of the King's Daughters in Norfolk, Virginia, have found an easy way - actually five easy ways - to help calm a baby's pain (and anxiety), without any medication. It's called the "5 S's": swaddling (tightly wrapping a baby in a blanket almost like a burrito), side/stomach position, shushing sounds, swinging and sucking. If babies were doing four out of five of these "S's," they would usually stop crying within 45 seconds after the shot, according to a new study published in the journal Pediatrics. ... http://thechart.blogs.cnn.com/2012/04/16/the-5-ss-easing-baby-pain-after-vaccine-shots/ ************************** Doctors call for end to five cancer tests, treatments (Reuters) - In a move that threatens to further inflame concerns about the rationing of medical care, the nation's leading association of cancer physicians issued a list on Wednesday of five common tests and treatments that doctors should stop offering to cancer patients. The list emerged from a two-year effort, similar to a project other medical specialties are undertaking, to identify procedures that do not help patients live longer or better or that may even be harmful, yet are routinely prescribed. As much as 30 percent of health-care spending goes to procedures, tests, and hospital stays that do not improve a patient's health, according to a 2008 analysis by the nonpartisan Congressional Budget office. ... http://www.reuters.com/article/2012/04/04/us-cancer-idUSBRE83305020120404?feedType=RSS&feedName=healthNews *********************** RANDOM FACTS: (1) The word "toast" is a wish of good health. It started in ancient Rome, where a piece of toasted bread was dropped into wine. (2) The word alcohol is derived from the Arabic word 'al-kuhl', meaning "finely divided", in reference to the distillation process. ***************** How Added Sugar In Diet Leads To Obesity, Diabetes - New Clues About Fructose A new animal study published on Monday in the Proceedings of the National Academy of Sciences, offers new clues about the mechanism through which a diet high in fructose, such as from added sugar and high fructose corn syrup, may contribute to the development of obesity and diabetes. Previous studies have already shown that fructose intake from added sugar is linked with the epidemic rise in obesity, metabolic syndrome, and nonalcoholic fatty liver disease. Metabolic syndrome is a group of risk factors that raises a person's risk for diabetes, heart disease, stroke, and other health problems. It currently affects more than one in four Americans. There is also evidence that fructose intake causes features of metabolic syndrome in animals and humans. This suggests, for instance, if you compared two diets of similar calorie intake, the one with more fructose, as opposed to more starch, will lead to greater accumulation of fat around organs and higher insulin resistance. ... http://www.medicalnewstoday.com/articles/242259.php ************************* Atrial fibrillation plays role in later dementia Dr. Koon Teo, lead author from the Population Health Research Institute at McMaster University in Ontario, noted that dementia, admission to long term care facilities, and loss of independence, occurred in 34 percent of atrial fibrillation patients as compared to only 26 percent who did not have the heart arrhythmia. During the study, researchers reviewed data from two randomized controlled trials, including ONTARGET and TRANSCEND, which involved more than 31,000 patients. Participants were at least 55 years old and came from 733 medical centers in 40 countries. About 70 percent were men. All had heart disease or diabetes, with some organ damage from the diseases. ... http://www.dailyrx.com/news-article/atrial-fibrillation-plays-role-later-dementia-17736.html (how many of us have thought about Afib in this context?) ********************* Five uses for Vegetable oil besides cooking: KEY LOCK HELPER Does the lock on your front door never want to give up your house key? Try wiping your key down with some vegetable oil. It acts as a lubricant, helping the key to get into the lock more freely. HAIR MOISTURIZER You can use vegetable oil as a deep conditioning treatment. Just take about half a cup of oil and warm it at 50% power in the microwave until it's just above room temperature. Massage the vegetable oil into your hair, shampoo and then rinse. CAR CLEANER Whether you are trying to get rid of the brake dust that accumulates on your tires and hub caps, or the bugs, dirt or pollen that always stick to your car's grill and wind shield, skip the special auto cleaners and use vegetable oil instead. Pour a tiny bit onto a paper towel or a rag, and wipe down these surfaces. The vegetable oil helps wipe the gunk away while creating a car-safe coating that future debris won't stick to. NON-STICK SHOVELS With all the spring/summer gardening and yard work, you can use vegetable oil to coat your shovels and trowels. This helps prevent dirt from clumping on your tools. You can also do this trick to your lawnmower blades so grass doesn't stick to them. If you are in a pinch, you can also coat the "working parts" of your hand tools with vegetable cooking spray. SEASON YOUR POTS AND PANS This might not be the most groundbreaking of tips, but you can use vegetable oil to season a new skillet. A light coating of vegetable oil helps protect the pan. Although there are very many different ways to season it, this is my preferred: After washing the pan for the first time, rub a little bit of vegetable oil over the surface of the pan and the sides. You don't have to worry about the bottom. ***************** Implementation of Evidence-Based Practice Susan L. Adams PhD, RN Laura Cullen MA, RN, FAAN Expectations for evidence-based healthcare are growing, yet the most difficult step in the process, implementation, is often left to busy nursing leaders who may be unprepared for the challenge. Selecting from the long list of implementation strategies and knowing when to apply them are a bit of an "art," matching clinician needs and organizational context. This article describes an application-oriented resource that nursing leaders can use to plan evidence-based practice implementation in complex healthcare systems. Nurses in leadership positions have responsibility for provision of evidence-based healthcare that meets the expectations of patients, families, regulators and others.1-3 Research shows that use of evidence is inconsistent. Basic practices from hand hygiene to early ambulation are difficult to implement. Nursing leaders are expanding use of evidence-based care delivery to improve patient and organizational outcomes by developing the infrastructure, defining the processes, strategically planning for implementation, and reporting results. http://www.nursingcenter.com/evidencebasedpracticenetwork/JournalArticle.aspx?Article_ID=1323359 JONA: Journal of Nursing Administration April 2012 Volume 42 Number 4 Pages 222 - 230 ************************* Progesterone might relieve menopause symptoms..(Reuters Health) - A hormone called progesterone helps reduce how frequently and how severely women experience hot flashes and night sweats after menopause somewhat, according to a new study."There are certainly some people for whom estrogen is not an appropriate therapy and other people who wish to avoid it for other reasons. And progesterone offers a choice," Hitchcock, a researcher at the University of British Columbia, told Reuters Health. Estrogen had been a popular hormone therapy to treat menopausal symptoms until some large studies raised concerns about a possible increased risk of stroke and cancer among women who were taking it (see Reuters Health reports of October 19, 2010 and January 31, 2011). Progesterone has been used in hormone replacement therapy to treat menopausal symptoms, but it is typically thought of as an add-on to estrogen therapy to help protect the uterus from abnormal thickening. It is approved by the Food and Drug Administration to for that use, and for abnormal menstrual bleeding symptoms. ... http://articles.chicagotribune.com/2012-04-25/lifestyle/sns-rt-us-progesterone-menopausebre83o13l-20120425_1_menopausal-hot-flashes-progesterone *********************** FDA approves the Glaxo Cancer drug Votrient (Reuters) - U.S. regulators gave the nod to GlaxoSmithKline Plc's Votrient for a type of sarcoma on Thursday, following a positive advisory panel vote last month. The U.S. Food and Drug Administration approved the pill for people with soft-tissue sarcoma who have already received chemotherapy. Soft-tissue sarcoma is a rare but aggressive form of cancer that afflicted about 11,000 Americans last year, 4,000 of whom died from the disease, according to the National Cancer Institute. The cancer begins in the muscles, fat or other tissues. http://www.reuters.com/article/2012/04/26/us-glaxosmithkline-idUSBRE83O0O220120426?feedType=RSS&feedName=healthNews *************************** Informatics & the Future of Nursing Practice Technology is being integrated into every area of healthcare. What does that portend for nursing? From meaningful use to accountable care, healthcare trends are transforming nurses' roles, responsibilities and career trajectories. Key to being part of this change is nursing informatics. The field has already begun to flourish. The American Nurses Association has developed standards for nursing informatics. The American Organization of Nurse Executives has endorsed principles to enhance clinical outcomes by leveraging technology. Another guidepost is the Technology Informatics Guiding Education Reform (TIGER) Initiative Foundation, which recommends educators adopt informatics competencies for all levels of nursing education and practice, and reform the nursing curriculum by integrating healthcare information technology. Achieving success in developing nursing informatics will also require collaboration between hospital executives, nursing leaders, nursing management, nursing staff and nursing schools. ... http://nursing.advanceweb.com/Features/Articles/Informatics-the-Future-of-Nursing-Practice.aspx ; ***************************** Pendulum Swing We were all taught that the period of a pendulum is proportional to the square root of the length of the line suspending the weight - i.e., the longer the pendulum, the slower it swings. You are probably wondering what class this was in. Well it’s not important; just read, click and enjoy. Harvard students built a device with a series of 15 pendulums in a row, each one slightly longer than its neighbor, then set them in motion and filmed the result. The resulting patterns in this short video are fascinating to watch: http://sciencedemonstrations.fas.harvard.edu/icb/icb.do?keyword=k16940&pageid=icb.page80863&pageContentId=icb.pagecontent341734&state=maximize&view=view.do&viewParam_name=indepth.html#a_icb_pagecontent341734 ******************* Implantable Cardioverter Defibrillator Therapy in Adults With Congenital Heart Disease Who Is at Risk of Shocks? Background—The value of implantable cardioverter defibrillators (ICDs) in adults with congenital heart disease (CHD) is unknown. We investigated the long-term outcome after ICD implantation and developed a simple risk stratification score for ICD therapy. ... http://circep.ahajournals.org/content/5/1/101.full?WT.mc_id=EMxj02x20120427xL1 *********************** Periodontal disease...... An American Heart Association expert committee of cardiologists, dentists and infectious disease specialists found no conclusive scientific evidence that periodontal disease causes atherosclerotic heart disease or stroke, and that treating gum disease prevents heart disease or stroke. Risk factors that gum and heart disease have in common, including smoking, age and diabetes, may be the reasons why the diseases often occur in the same person. To download a PDF of the study, which appeared in the AHA journal Circulation. ... http://circ.ahajournals.org/content/early/2012/04/18/CIR.0b013e31825719f3.abstract ************************ RANDOM FACT: When threatened, the hairy frog, or 'horror frog,' intentionally breaks its own bones to produce claws that protrude from its toe pads. (Yee Gods and little fishes !!! ) ************* Thank you, Cherie (ckppk) for this great hint: Berries are delicious, but they're also kind of delicate. Raspberries in particular seem like they can mold before you even get them home from the market. There's nothing more tragic than paying $4 for a pint of local raspberries, only to look in the fridge the next day and find that fuzzy mold growing on their insides. Well, with fresh berries just starting to hit farmers markets, we can tell you that how to keep them fresh! Here’s a tip I’m sharing on how to prevent them from getting there in the first place: When you get your berries home, prepare a mixture of one part vinegar (white or apple cider probably work best) and ten parts water. Dump the berries into the mixture and swirl around. Drain, rinse if you want (though the mixture is so diluted you can't taste the vinegar,) and pop in the fridge. The vinegar kills any mold spores and other bacteria that might be on the surface of the fruit, and ... Voila! Raspberries will last a week or more, and strawberries go almost two weeks without getting moldy and soft. So go forth and stock up on those pricey little gems, knowing they'll stay fresh as long as it takes you to eat them. ***************** Another excellent article from AJN....I agree wholeheartedly with the premise. Please send in your opinions about this topic, I know there is a lot of discussion about 12 hour shifts, esp when they are back to back with no real rest between. Long Work Hours for Nurses Roxanne Nelson But is working 12 consecutive hours in a high-stress setting that's physically, mentally, and emotionally demanding a good idea? And should we be helping students to get used to the idea earlier despite the evidence that long hours affect patient safety and nursing judgment? ... http://journals.lww.com/ajnonline/Fulltext/2012/05000/Long_Work_Hours_for_Nurses.16.aspx ************************ (The following was sent to me by Sandy Summers, thank you. I consider the hospital's actions wimpy- just because a surgeon is deprived of an expected income and throws a tantrum, they cave.) To quickly summarize, Amanda Trujillo is an RN, MSN, earning a doctoral degree, who took the time to educate her patient about the omplications of having a transplant. The patient decided she'd rather go to hospice, so Amanda put in for a referral, at the request of the patient. Next morning the surgeon threw a fit over the canceled surgery and demanded she be fired. (!) The extremely weak and pathetic nurse managers at Banner Health Del E. Webb in Sun City Arizona fired her and she was reported to the board of nursing for what--doing her job--being a good nurse? So the board has been dithering with Amanda's license forever as she's been out of work because no one will hire her when her license is under investigation. I'm trying to find out the latest on this incredible injustice rooted in ignorance about who nurses are and what they really do to save lives and improve patient outcomes. Further reading here: http://vdutton.posterous.com/94287821 *********************** Aspirin tied to lower lung cancer risk in women (Reuters Health) - In a new study of more than 1,200 Asian women, those who took aspirin at least a couple of times a week had a much lower risk of developing lung cancer -- whether or not they had ever smoked. The findings, which link regularly taking aspirin to a risk reduction of 50 percent or more, do not prove lung cancer. There may be other explanations for the connection. But the study backs up a number of previous ones linking regular aspirin use to lower risks of certain cancers, including colon, prostate and esophageal cancers. Still, experts say it's too early to recommend widespread aspirin use for cutting cancer risk. ... http://www.reuters.com/article/2012/04/23/us-aspirin-cancer-idUSBRE83M0ZQ20120423?feedType=RSS&feedName=healthNews ******************* Social media policies from 196 health care facilities http://www.socialmediagovernance.com/policies.php?f=4#axzz1oY5XsZj9 ******************* RANDOM FACT: The Pacific Ocean, the world's largest water body, occupies a third of the Earth's surface. The Pacific contains about 25,000 islands (more than the total number in the rest of the world's oceans combined), almost all of which are found south of the equator. ************* (This was sent in by Marlene...Thank you) Learn Sarver Heart Center's Continuous Chest Compression CPR Every three days, more Americans die from sudden cardiac arrest than the number who died in the 9-11 attacks. You can lessen this recurring loss by learning Continuous Chest Compression CPR, a hands-only CPR method that doubles a person’s chance of surviving cardiac arrest. It’s easy and does not require mouth-to-mouth contact, making it more likely bystanders will try to help, and it was developed at the University of Arizona College of Medicine. (Video) http://medicine.arizona.edu/spotlight/learn-sarver-heart-centers-continuous-chest-compression-cpr ************************** Dissolvable Heart Artery Stents Appear Safe in Study ; Biodegradable stents might lower risk of heart attack, Japanese researchers suggest MONDAY, April 16 (HealthDay News) -- New long-term research now suggests that fully biodegradable stents are safe to use in heart arteries. Reporting in the April 16 issue of Circulation, Japanese researchers said a 10-year study has shown the biodegradable Igaki-Tamai stent, made of a cornstarch-based material, dissolves into the artery wall, leaving no permanent foreign material in an artery and reducing the occurrence of an in-stent blood clot. According to the study, survival rates from all causes was 87 percent and rates of major heart-related complications were similar to those seen with metal stents. Stents, the tiny mesh tubes inserted into heart arteries to keep open and allow blood to flow to the heart, are far from fail-safe. New blockages can -- and do -- occur. So scientists have been trying to develop new stents, including ones coated with blood-thinning medications. Metal stents, sometimes coated with drugs, remain in the body where they can reclog. The Igaki-Tamai stent, developed by Kyoto Medical Planning Co., is used in nine European Union countries and Turkey to treat peripheral artery disease, or blocked arteries in the legs. It is not used to treat blocked heart arteries in any country.... http://consumer.healthday.com/Article.asp?AID=663804 ************************* RANDOM FACT: A mouthful of seawater may contain millions of bacterial cells, hundreds of thousands of phytoplankton and tens of thousands of zooplankton. *********** HIV Raises Anal Cancer Risk in Women, Study Says ; Findings indicate gay men aren't only ones who need screening MONDAY, April 16 (HealthDay News) -- Women with HIV are at increased risk for anal cancer, a new study finds. Researchers at Montefiore Medical Center in New York City looked at 715 HIV-infected women and found that 10.5 percent had some form of anal disease and about one-third of those women had precancerous disease. "Anal cancer was widely associated with HIV-infected men who have sex with men. But now, this study reveals anal precancerous disease in a high proportion of women with HIV," Dr. Mark Einstein, director of clinical research in the division of gynecologic oncology and a professor at Albert Einstein College of Medicine, said in a Montefiore news release. ... http://consumer.healthday.com/Article.asp?AID=663729 ******************* RN whistle-blowers summon moral courage If only whistle-blowing were as simple as taking a deep breath and making a lot of noise. In reality, any nurse who, according to the profession’s ethical obligations, detects wrongdoing and decides to pursue all avenues necessary to correct it probably is facing a grueling and complicated task. Whistle-blowing is much like being alone in the wilderness, said John S. Murray, RN, PhD, FAAN, a member of the American Nurses Association’s Center for Ethics and Human Rights Advisory Board. As an officer in the Air Force, he raised ethical concerns about academic and research practices in his workplace. He was reassigned. Colleagues shunned him. ... http://news.nurse.com/article/20120402/NATIONAL01/104020020 ; (I equate the whistle blowing by nurses with the Good Samaritan act protection for nurses). ******************** Nanostars Deliver Cancer Drugs Direct To Nucleus Scientists at Northwestern University in the US have developed a simple, specialized, star-shaped gold nanoparticle that can deliver drugs directly to the nucleus of a cancer cell. They write about their work in a paper published recently in the journal ACS Nano. Senior author Dr Teri W. Odom, said in a statement released on Thursday: "Our drug-loaded gold nanostars are tiny hitchhikers." "They are attracted to a protein on the cancer cell's surface that conveniently shuttles the nanostars to the cell's nucleus. Then, on the nucleus' doorstep, the nanostars release the drug, which continues into the nucleus to do its work," she added. ... http://www.medicalnewstoday.com/articles/243856.php ************************* Fake cancer drug surfaces again from overseas It is just about the worst kind of fraud you can imagine -- fake cancer drugs, not much more than a vial of water with a drug label on it. CBS News previously reported on this, but it's happened again: A number of clinics received counterfeit vials of cancer drugs. CBS News chief investigative correspondent Armen Keteyian has traced the source overseas. This week, the Food and Drug Administration alerted healthcare professionals that 120 vials of fake Altuzan -- which contained no active ingredient -- had entered the U.S from distributors in the U.K. after being purchased from wholesalers in Turkey. ... http://www.cbsnews.com/8301-18563_162-57409553/fake-cancer-drug-surfaces-again-from-overseas/ ~~**~~**~~**~~**~~**~~ HUMOR SECTION The district attorney was cross-examining the murderess on the witness stand. "And so after you had poisoned the coffee and your husband sat at the breakfast table partaking of the fatal dosage, didn't you feel any qualms? Didn't you feel the slightest pity for him knowing that he was about to die and was wholly unconscious of it?" "Yes," she answered. "Come to think of it...there was just a moment when I sort of felt sorry for him." "And, when was that?" "When he asked for the second cup." ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ While visiting Annapolis, a lady tourist noticed several students on their hands and knees assessing the courtyard with pencils and clipboards in hand. "What are they doing?" she asked the tour guide. "Each year," he replied with a grin, "the upperclassmen ask the freshmen how many bricks it took to finish paving this courtyard." When they were out of earshot of the freshmen, the curious lady asked the guide: "So, what's the answer?" The guide replied: "One." ~~**~~**~~**~~**~~**~~ 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. Complete Your CE Now-Less than $6 per hour ANCC & State Board approved ; Instant certificates - no waiting No tests required (excluding Florida) ; High-quality, evidence-based course material http://advprjo61.securesites.net/CMEResource20111012Nurse.php ---------- 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/ ! ~~**~~**~~**~~**~~**~~ WEBSITES/ LINKS Always on the lookout for interesting websites / links. Please send them to: RNFrankie@AOL.com. Sentinel Events.........Joint commission. http://www.jointcommission.org/sentinel_event.aspx This is an excellent nursing site, check it out: http://nursingpub.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 Decubqueen's website: www.accu-ruler.com http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2 http://www.nationalnurse3.blogspot.com/ H.R. 2123, The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007 http://www.washingtonwatch.com/bills/show/110_HR_2123.html Board Supports Your Right to Refuse An Unsafe Assignment: Nurse Practice Act cites three conditions for patient abandonment http://findarticles.com/p/articles/mi_qa4102/is_200408/ai_n9450263 The Nursing Site http://thenursingsite.com . http://www.snopes.com http://www.solutionsoutsidethebox.net/ Raconte's website http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3 National Do Not Call Registry If you're buying a used car, it is recommended having a mechanic inspect it first. And screen the car's VIN through the free database at carfax.com/flood This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm Metric conversion calculators and tables for metric conversions http://www.metric-conversions.org/ ******************************************************* ******************************************** * MEDICAL RECALLS * ******************************************* ****************************************************** There are many more recalls in medicines...please check them out at : http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm299000.htm?source=govdelivery Also, more important to know recalls....please check them out at: http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm301838.htm?source=govdelivery Acetylcysteine Solution, USP, 20%, packaged in 3 x 30 mL vials per carton, Rx only; NDC 0054-3026-02; Item # 0233-53-1877093. Recall # D-1278-2012 CODE Lot #1877093, Exp. Date 06/30/2013 RECALLING FIRM/MANUFACTURER Ben Venue Laboratories Inc., Bedford, OH, by letters on December 19, 2011, by press release on February 2, 2012 and letters dated February 3, 2012. Firm initiated recall is ongoing. REASON Presence of Particulate Matter; glass particle identified during review of retain samples. VOLUME OF PRODUCT IN COMMERCE 4,911 cartons DISTRIBUTION Nationwide **************************** GE Responderand, Responder Pro, Cardio Life, Cardio Vive, Cardiac Science Powerheart, and Nihon-Kohden Automated External Defibrillators (AEDs): Class I Recall - Defective Component Affected Models include: Powerheart 9300A, 9300E, 9300P, 9390A, and 9390E CardioVive 92532, 92533 CardioLife 9200G and 9231 GE Responder and Responder Pro Nihon-Kohden AEDs FDA notified healthcare professionals and medical care organizations of the Class 1 recall of the listed AEDs which contain a component that may fail unexpectedly due to a defect. If the component were to fail during a rescue attempt, the AED may not deliver defibrillation therapy, causing serious adverse health consequences, including death. The unit’s self test may not detect the failure or impending failure of the component. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm294538.htm ************************* Victrelis (boceprevir) and Ritonavir-Boosted Human Immunodeficiency Virus (HIV) Protease Inhibitor Drugs: Drug Safety Communication - Drug Interactions FDA notified healthcare professionals that the Victrelis drug label has been revised to state that co-administration of Victrelis (boceprevir), a hepatitis C virus (HCV) protease inhibitor, along with certain ritonavir-boosted human immunodeficiency virus (HIV) protease inhibitors, is not recommended. The findings of a drug-drug interaction study and clinical trial showed that co-administration increased of the possibility of reducing the effectiveness of the medicines, permitting the amount of HCV or HIV virus in the blood to increase. Ritonavir-boosted HIV protease inhibitors include ritonavir-boosted Reyataz (atazanavir), ritonavir-boosted Prezista (darunavir), and Kaletra (lopinavir/ritonavir). FDA notified healthcare professionals and patients that drug interactions between the hepatitis C virus (HCV) protease inhibitor Victrelis (boceprevir) and certain ritonavir-boosted human immunodeficiency virus (HIV) protease inhibitors (atazanavir, lopinavir, darunavir) can potentially reduce the effectiveness of these medicines when they are used together. A drug interaction study showed that taking boceprevir (Victrelis) with ritonavir (Norvir) in combination with atazanavir (Reyataz) or darunavir (Prezista), or with Kaletra (lopinavir/ritonavir) reduced the blood levels of the HIV medicines and boceprevir in the body (see Data Summary below). FDA will be updating the Victrelis drug label to include information about these drug interactions. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm291144.htm ~~**~~**~~**~~**~~**~~ NURSING HINTS CORNER Spot check Here is another way to get rid of those seemingly indelible ink spots that adorn your pockets-- the products of uncapped pen points. Just saturate the spot with hairspray, then wash with your usual detergent. The result is a truly "spotless" (scrub)/ uniform. Cheryl Diorio, LPN. Spotless suggestion For spotless shoes, try wiping them with an alcohol prep pad. This removes dirt and smudges instantly. Kathryn L. R. Bowling, Capt., USAF, NC Shoe biz Now that you shes are clean, what about the laces? To clean them, place them in a bowl or jar of warm water and add some dishwasher detergent. Agitate the laces in the solution, let them soak for 1 or 2 hours, then rinse and sir-dry. Your laces will be white and as clean as your shoes. Janet Widman, RN Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, pp. 216 and 217, 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/. ~~**~~**~~**~~**~~**~~ NEW MEMBERS Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com WELCOME TO: hollie_lynne@yahoo.com April 27, 2012 Ctaryane@media.com (Cyndi) April 28, 2012 ~~**~~**~~**~~**~~**~~ NOTICE: I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number....lol So please send me your new name/address, ok? RNFrankie@AOL.com OLD ADDRESS: Gingermyst@AOL.com NEW ADDRESS: lglnrse@gmail.com (Anne) ~~**~~**~~**~~**~~**~~ EDITORIAL STAFF: lglnrse@gmail.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan) ~~**~~**~~**~~**~~**~~ PARADIGM 97 CO-FOUNDERS: MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie) ~~**~~**~~**~~**~~**~~ 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. ~~**~~**~~**~~**~~**~~ THOUGHT FOR THE DAY I am a most unhappy man. I have unwittingly ruined my country. A great industrial nation is now controlled by its system of credit. We have come to be one of the worst ruled, one of the most completely controlled and dominated Governments in the world -- no longer a government by free opinion, no longer a government by conviction and the vote of the majority, but a government by the opinion and duress of a small group of dominant men. -- Woodrow Wilson 1919 Hope to see you online... even better e-mail me .... Frankie RNFrankie@AOL.com