PARADIGM BYTES
Newsletter for Paradigm 97
June 15, 2014
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
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.
***~~~***~~~***~~~***
TWO SNIPPETS
What are the Pitfalls of working the Night shift?
Night shift nurses will tell you that the benefits go far beyond the extra pay. Sure, you may be able to work the night shift part-time and make a full-time salary, due to the shift differential bonus. But you may also find the pace is less frantic without doctors making rounds, housekeepers rolling carts down the hallways, and family members popping in and out of patient rooms. Time and time again, we’ve heard nurses say their favorite part of working the night shift is being able to focus on pure patient care, without the usual daytime distractions. But there are pitfalls to this shift as well. Adjusting to the Night Shift Perhaps you’ve read about the body’s internal “clock” and how your natural circadian rhythm is regulated by the 24-hour cycle of sunlight and darkness. This day-to-night cycle is involved in hormone production, body temperature regulation, brain wave activity, and the natural urges to sleep and eat. When it is disrupted by a pattern of working nights and sleeping in the daytime, it can lead to a syndrome known as shift work disorder. This disorder is characterized by fatigue, difficulty sleeping or excessive sleepiness, headaches, irritability, or lack of concentration. To get around these potential pitfalls, night shift nurses have to make it a priority to get enough sleep. Many say they do this by coming home from work in the morning and going right to bed. Others find they can best balance work with family life by splitting up sleep time into two sessions, perhaps sleeping while the kids are at school, getting up when they come home, then taking a nap just before going to work in the evening. Specialists in sleep medicine advise shift workers to get the best rest by being as consistent as possible with the hours they’re asleep and awake. This means continuing with your workday pattern even on your days off. ...
***~~~***~~~***~~~***
FROM A MEMBER
The following article was referred to in Linda's (Jenxl) response:
Routine Mammograms Found Not Helpful for Most Women Over 70
FRIDAY, March 21, 2014 (HealthDay News) -- Mammogram breast cancer screenings for women aged 70 and older may cause more harm than good, according to a large new study.
The screenings don't decrease the number of advanced breast cancer cases diagnosed in these older women. But the tests can lead to overtreatment in a large number of women and put them at risk from the harmful side effects of breast cancer treatment, the researchers said.
The researchers examined data from the Netherlands, where a mammogram breast cancer screening program was extended in 1998 to include women up to age 75. The study included more than 25,000 women, aged 70 to 75, who were diagnosed with breast cancer between 1995 and 2011. ...
Initially, Linda wrote me: "Mmmmm found this interesting as I had 7 weeks of 5 days a week radiation. This is the first & only time I've heard this. I'll have to go back to Sarah is.
"It has been clear for some time that women in whom the disease has not spread to the lymph nodes in the armpits will not benefit from radiotherapysee who ," Sarah Darby told Reuters Health.
"It's been unclear what the benefit is for women with one, two or three positive lymph nodes," she said. ...
In a letter to a physician friend, she wrote: "
"I know there is much on the internet that is not true but was wondering your take on the paragraph below. There was another snipet that said 'it has been long recognized that there is no benefit to radiation for women who had breast cancer with no lymph involvement.' Have you heard that? "
The physician answered: " Yes, I have heard of that study, and controversy remains about that topic. It is difficult to recommend for or against mammography in that age range without additional information. I personally use family history, patient history (such as was there ever an abnormal mammogram in the past), other medical history, and patient desire when making this recommendation. It certainly is not a black and white science, and (like insurance) is something of a statistical thing. In any event, I'm happy to go over this and more with you at any time.
Regards,
Regards,
Will
~~**~~**~~**~~**~~**~~
INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
FDA approves first implantable wireless device with remote monitoring to measure PAP in certain heart failure patients
On May 28, the U.S. Food and Drug Administration (FDA) approved the CardioMEMS HF System, which measures the pulmonary artery pressures (PAP) and heart rates of patients with New York Heart Association (NYHA) Class III heart failure who have been hospitalized for heart failure in the previous year. The device allows health care professionals to monitor patients remotely. ...
************
Study: Obesity rate continue to climb worldwide
Worldwide, there has been a significant increase in rates of obesity and overweight in both adults (28% increase) and children (up by 47%) in the past 33 years, with the number of overweight and obese people rising from 857 million in 1980 to 2.1 billion in 2013, according to an analysis from the Global Burden of Disease Study 2013, published in The Lancet. ...
********************
J&J suspends sale of device used in fibroid surgery
(Reuters) - Johnson & Johnson suspended worldwide sale of its device used in fibroid surgery amid concerns over its potential to spread undetected cancer beyond the uterus.
The company said it is suspending the sale of its power morcellators until their role in fibroid treatment is better understood and redefined by the medical community.
The action follows a Food and Drug Administration advisory on April 17 that discouraged doctors from using laparoscopic power morcellators to remove fibroids because of a risk of worsening an often-hidden cancer. (r.reuters.com/dug68v)
"Ethicon morcellation devices have always included cautions in their instructions for use about the potential spread of malignant tissue," J&J wrote in a letter to customers, a copy of which is available with Reuters. ...
1/3:
Insect repellants reduce sunscreen’s SPF by up to 1/3.
Insect repellants reduce sunscreen’s SPF by up to 1/3.
3:
Children get an average of three times more exposure than adults.
Children get an average of three times more exposure than adults.
1.2 million:
Number of new cases of skin cancer diagnosed each year in the U.S.
Number of new cases of skin cancer diagnosed each year in the U.S.
1:
Melanoma kills one person every hour.
Melanoma kills one person every hour.
2:
One blistering sunburn can double a child's lifetime risk of developing skin cancer.
One blistering sunburn can double a child's lifetime risk of developing skin cancer.
85% to 95%:
Concrete, sand, water, and snow reflect 85% to 90% of the sun’s UV rays.
Concrete, sand, water, and snow reflect 85% to 90% of the sun’s UV rays.
Source: http://sunsafetyalliance.org/
*******************
A guideline titled, "Class II Special Controls Guideline: Nucleic Acid-Based In Vitro Diagnostic Devices for the Detection of Mycobacterium tuberculosis Complex in Respiratory Specimens" has recently been posted. This document was developed to support the reclassification of nucleic acid-based in vitro diagnostic devices for the detection of Mycobacterium tuberculosis complex (MTB-complex) in respiratory specimens from class III into class II. These devices are intended to be used as an aid in the diagnosis of pulmonary tuberculosis. http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm357617.htm
*****************
Nurse Investigator Group Develops Plan to Increase Nurse Time in Patients’ Rooms
After an internal investigation showed that nurses spent only two-and-a-half to three hours on patient care during a 12-hour shift, and that much of their time was spent on activities that could be done by other staffers, Novant Health brought together a group of nurses to further investigate the issue and find a solution, Becker’s Hospital Review reports.
The nurse investigator group identified four major activities that accounted for most of nurses’ time away from patients’ rooms: including finding supplies; obtaining medications; care planning; and preparing paperwork required for admitting patients. Novant, based in Winston-Salem, North Carolina, then set a goal of having nurses spend 70 percent of their time in a patient's room, reducing the amount of time spent on these tasks. ...http://feedproxy.google.com/~r/INQRI/~3/vHK4HRXwmoc/nurse-investigator-group-develops-plan.html?utm_source=feedburner&utm_medium=email
The nurse investigator group identified four major activities that accounted for most of nurses’ time away from patients’ rooms: including finding supplies; obtaining medications; care planning; and preparing paperwork required for admitting patients. Novant, based in Winston-Salem, North Carolina, then set a goal of having nurses spend 70 percent of their time in a patient's room, reducing the amount of time spent on these tasks. ...http://feedproxy.google.com/~r/INQRI/~3/vHK4HRXwmoc/nurse-investigator-group-develops-plan.html?utm_source=feedburner&utm_medium=email
************************
U.S. measles cases reach highest level in 20 years.
Between Jan. 1 and May 23, there were 288 confirmed measles cases across the country, the highest number in the first five months of a year since 1994, CDC officials said Thursday. Ohio recorded the largest number of measles cases at 138, followed by California and New York
********************
California lawmakers reject bill requiring labeling on GMO foods
(Reuters) - (This May 28 story was corrected in the seventh paragraph to delete erroneous reference to a genetically modified wheat)
California lawmakers on Wednesday rejected a bill that would require labels on foods made with genetically modified organisms (GMOs), the second time in two years such legislation has failed to take hold in the state.
Proponents of the bill had sought to make California the second state in the country after Vermont to require GMO labeling, but the measure failed to pass the state Senate by two votes.
Democratic Senator Noreen Evans, the bill's author, was planning to push a reconsideration vote on Thursday before the end of the legislative session.
The bill would require all distributors who sell food in California to label the product if any of the ingredients have been genetically engineered. The labeling law would exclude alcohol and food sold at farmers markets. ...
***********************
The following was sent in by Barbara (BAcello). Thank you Barbara !
******************************
In the United States, hospital patients get an estimated 722,000 infections each year. That’s about 1 infection for every 25 patients. Infections that patients get in the hospital can be life-threatening and hard to treat. Hand hygiene is one of the most important ways to prevent the spread of infections.
Healthcare providers should practice hand hygiene at key points in time to disrupt the transmission of microorganisms to patients including: before patient contact; after contact with blood, body fluids, or contaminated surfaces (even if gloves are worn); before invasive procedures; and after removing gloves (wearing gloves is not enough to prevent the transmission of pathogens in healthcare settings). For a full list of hand hygiene indications, please see the recommendations in the Hand Hygiene Guideline 
.
.
Horses that seem wild today (such as Mustangs) are actually feral horses, usually descendants of horses that were imported to America from Spain in the sixteenth century. The only true wild horse is the Asian Wild Horse.
RANDOM FACT: There are nearly 160 distinctive breeds and types of horses around the world, but the Arabian horse is unique in that it is the purest of all of the breeds.
RANDOM FACT: There are nearly 160 distinctive breeds and types of horses around the world, but the Arabian horse is unique in that it is the purest of all of the breeds.
Bonus Fact: After horses became domesticated around 4000 B.C., many Indo-European cultures regarded horses as a supreme sacrifice to their gods and often ritually entombed horses.
Famous owner/horse partnerships that helped change world history include Alexander the Great and his horse Bucephalus ("ox head"), El Cid and Babieca ("stupid"), and Napoleon and Marengo (named after a battle) who after its death, had its skeleton displayed in London.
********************
Researchers: Timely cervical cancer screening trumps test type
Boston University researchers wrote in the Annals of Internal Medicine that all three approaches to cervical cancer screening -- a standalone HPV test, cotesting with a Papanicolaou test and a Pap test only -- can adequately detect cervical cancer. They said while more discussion is needed on screening tests and intervals, it is important to remember that most cervical cancers are found in women who have had no recent screening. ...
Boston University researchers wrote in the Annals of Internal Medicine that all three approaches to cervical cancer screening -- a standalone HPV test, cotesting with a Papanicolaou test and a Pap test only -- can adequately detect cervical cancer. They said while more discussion is needed on screening tests and intervals, it is important to remember that most cervical cancers are found in women who have had no recent screening. ...
Study: Heart risks differ for systolic, diastolic hypertension
An analysis of health records for more than 1 million residents of England found that higher systolic blood pressure was linked to greater risk of bleeding strokes and stable angina while higher diastolic pressure was associated with greater risk of abdominal aortic aneurysm. Even with current drugs, the lifetime cardiovascular risks of patients with hypertension were greater than those of a person with normal blood pressure. The findings were published in The Lancet. ...
An analysis of health records for more than 1 million residents of England found that higher systolic blood pressure was linked to greater risk of bleeding strokes and stable angina while higher diastolic pressure was associated with greater risk of abdominal aortic aneurysm. Even with current drugs, the lifetime cardiovascular risks of patients with hypertension were greater than those of a person with normal blood pressure. The findings were published in The Lancet. ...
*****************
Hypertonic solution in pediatric bronchiolitis helps reduce hospital admissions
U.S. researchers looked at 408 children under age 2 who were sent to the emergency department for viral bronchiolitis and found that those who received hypertonic saline solution had a 51% lower chance of being admitted to the hospital than patients who were given normal saline. The use of hypertonic saline was also associated with a shorter average length of stay at 3.16 days compared to 3.92 in the normal saline group, according to the study in the journal JAMA Pediatrics. ...
U.S. researchers looked at 408 children under age 2 who were sent to the emergency department for viral bronchiolitis and found that those who received hypertonic saline solution had a 51% lower chance of being admitted to the hospital than patients who were given normal saline. The use of hypertonic saline was also associated with a shorter average length of stay at 3.16 days compared to 3.92 in the normal saline group, according to the study in the journal JAMA Pediatrics. ...
******************
Congress can help resolve the primary care shortage in the U.S. by reauthorizing and fully funding nurse practitioner residencies in primary care clinics, writes David Vlahov, dean of the University of California at San Francisco School of Nursing. Many studies have shown that NPs perform as well as doctors in terms of clinical outcomes and patient satisfaction for most primary care concerns, and they can be trained faster than physicians, Vlahov added. The Examiner (San Francisco)(4/10)
***************************
Variceal bleeding, HIV may raise risks for portal vein thrombosis
A study in the journal Hepatology found that patients with idiopathic portal hypertension who also have HIV or who experienced variceal bleeding at diagnosis were at greater risk of developing portal vein thrombosis. The study shows that portal vein thrombosis can be a frequent complication, researchers said. Healio (free registration)(6/3) ...
A study in the journal Hepatology found that patients with idiopathic portal hypertension who also have HIV or who experienced variceal bleeding at diagnosis were at greater risk of developing portal vein thrombosis. The study shows that portal vein thrombosis can be a frequent complication, researchers said. Healio (free registration)(6/3) ...
***********************
Surviving heart attack in middle age carries heavier burden for women
Middle-aged women had lower scores in physical functioning, mental health and quality of life a year after suffering a heart attack than their male counterparts, a study showed. Prior to the initial heart attack, women were more likely than men to be obese, suffer from depression, and have diabetes, a history of stroke or a chronic lung condition. The findings were presented at the American Heart Association meeting. HealthDay News(6/2) ...
Middle-aged women had lower scores in physical functioning, mental health and quality of life a year after suffering a heart attack than their male counterparts, a study showed. Prior to the initial heart attack, women were more likely than men to be obese, suffer from depression, and have diabetes, a history of stroke or a chronic lung condition. The findings were presented at the American Heart Association meeting. HealthDay News(6/2) ...
************************
Laura Bolton PhD; Sue Girolami BSN, RN, CWOCN; Jennifer Hurlow GNP-BC, CWCN Pressure ulcers add a heavy personal and medical burden to medical care, causing patients mental anguish and pain, limiting normal activities, extending hospital stays, and increasing the risks of infection and death. More than 90% of pressure ulcers are caused by medical error, and at a cost of more than $3.8 billion per year (according to 2008 statistics), they rank among the most costly U.S. medical errors reported. ...
*********************
Researchers analyzed 28 studies involving 3,428 patients who survived an ICU stay and found that 23% of them showed symptoms of post-traumatic stress disorder one to six months following discharge. "Our meta-analysis confirms that a large proportion of patients who survive an ICU stay will suffer PTSD symptoms, which are associated with worse health-related quality of life. Further research should focus on PTSD screening, prevention and treatment in this vulnerable patient population," researcher Dr. Thiti Sricharoenchai said. The findings were presented at the annual meeting of the American Thoracic Society. HealthDay News(5/19)
***********************
HINT: Do you remember being taught that in a nursing home that they use denture cleaning tablets (like Efferdent) to clean resident's dirty fingernails? They put one in warm water in a little basin and let it fizz away and soak the crud from under the fingernails. Especially good as we all know that they "occasionally" get stool under their nails. It loosens the dirt and then it is easily cleared away with a very soft brush if necessary. Clean and odor free with no discomfort.
*********************
|
Answer at end of newsletter:
Americans are the No. 1 consumers of ice cream worldwide, eating 48 pints of ice cream per person every year on average.
Immigrants at Ellis Island were served ice cream as part of the welcoming to America.
About nine percent of all the milk produced by U.S. dairy farmers is used to produce ice cream.
Vanilla is the most popular flavor, accounting for 20-29% of overall sales of ice cream with chocolate coming in a distant second.
The Library of Congress possesses a copy of a recipe for vanilla ice cream used by Thomas Jefferson written in Jefferson�s own hand. President George Washington allocated a total of $200 on ice cream purchases during the hot summer of 1790.
Charles E. Minches of St. Louis, Missouri is said to have invented the ice cream cone in 1904 at the World's Fair in St. Louis when he filled a pastry cone with two scoops of ice cream.
(www.chicagonow.com)
Thank you, Barbara (BAcello)
Minnesota bans anti-bacterial chemical from soaps
MINNEAPOLIS (AP) — It's widely used nationwide as a germ-killing ingredient in soaps, deodorants and even toothpaste, but it's being banned in Minnesota.
Gov. Mark Dayton on Friday signed a bill to make Minnesota the first state to prohibit the use of triclosan in most retail consumer hygiene products. The Minnesota House and Senate passed it earlier last week because of health and environmental concerns about the chemical. The ban isn't due to take effect until Jan. 1, 2017, but one of its lead sponsors, state Sen. John Marty, predicted Monday that the odds are good that most manufacturers will phase out triclosan by then anyway. "While this is an effort to ban triclosan from one of the 50 states, I think it will have a greater impact than that," Marty said. ...
Minnesota bans anti-bacterial chemical from soaps
MINNEAPOLIS (AP) — It's widely used nationwide as a germ-killing ingredient in soaps, deodorants and even toothpaste, but it's being banned in Minnesota.
Gov. Mark Dayton on Friday signed a bill to make Minnesota the first state to prohibit the use of triclosan in most retail consumer hygiene products. The Minnesota House and Senate passed it earlier last week because of health and environmental concerns about the chemical. The ban isn't due to take effect until Jan. 1, 2017, but one of its lead sponsors, state Sen. John Marty, predicted Monday that the odds are good that most manufacturers will phase out triclosan by then anyway. "While this is an effort to ban triclosan from one of the 50 states, I think it will have a greater impact than that," Marty said. ...
********************
Ten body parts that you may not know the name:
How many of these did you know?
The canthus is where the upper and lower eyelids meet.
The rasceta are the lines on the inside of your wrist.
The purlicue is the space between the thumbs and the forefingers.
The columella nasi is the space between your nostrils.
A morton's toe is a second toe that is longer than the big toe -- do you have one?
A minimus is your little toe or finger.
The space between your eyebrows is known as the glabella.
The lunula, is the white, crescent-shaped part of the nail.
The groove between the nose and the middle of the lips is the philtrum.
The popliteal, is of or relating to the back part of the leg behind the knee joint
The rasceta are the lines on the inside of your wrist.
The purlicue is the space between the thumbs and the forefingers.
The columella nasi is the space between your nostrils.
A morton's toe is a second toe that is longer than the big toe -- do you have one?
A minimus is your little toe or finger.
The space between your eyebrows is known as the glabella.
The lunula, is the white, crescent-shaped part of the nail.
The groove between the nose and the middle of the lips is the philtrum.
The popliteal, is of or relating to the back part of the leg behind the knee joint
Resembling or having the form of the buttocks is known as a natiform. (We're not sure when knowing that will ever come in handy, but if it does ... you're welcome.)
************************
Thank you, Laura (Laregis) for this article.
Increasing Both Nurse and Doctor Staffing Levels Can Reduce Patient Mortality in ICUs – but Nurses Are Key
A new study in the International Journal of Nursing Studies finds that higher staffing levels for doctors and nurses in intensive care units (ICUs) are associated with higher survival rates for patients at high risk for death. The report, titled “Nurse staffing, medical staffing and mortality in Intensive Care: an observational study,” examines whether the number of nurses, doctors, and support staff affected the survival chances of critically ill patients in both the ICU and the hospital, HealthCanal reports.
Researchers reviewed information on nearly 40,000 patients from 65 ICUs in the United Kingdom. Among the findings, higher numbers of nurses per bed were associated with higher survival rates, and the number of nurses had the greatest impact on patients at a high risk of death when compared to other medical staffing levels....
Researchers reviewed information on nearly 40,000 patients from 65 ICUs in the United Kingdom. Among the findings, higher numbers of nurses per bed were associated with higher survival rates, and the number of nurses had the greatest impact on patients at a high risk of death when compared to other medical staffing levels....
******************************
Short sleepers need less sleep (unfortunately, I am not one of this type)
You know those people who claim they can get by on less than six hours of sleep a night? Turns out ABC says a few of them might be onto something. And we mean a few. "They never use an alarm clock, they rarely yawn, don't need caffeine, and no naps."
NPR reports so-called "short sleepers" make up a very small percentage of the population. "If you think you're one, you're probably kidding yourself. ... With just five or six hours' sleep, they're more energized than regular sleepers."
And less sleep isn't hurting these "short sleepers."
"All day long they are very active. They are very optimistic. They are go-getters."
A husband-and-wife team of scientists at the University of California, San Francisco, is studying the genetics of sleep and "short sleepers."
Dr. Ying-Hui Fu has discovered less than 1 percent of the population is biologically capable of comfortably running on six hours of sleep or less. ...
NPR reports so-called "short sleepers" make up a very small percentage of the population. "If you think you're one, you're probably kidding yourself. ... With just five or six hours' sleep, they're more energized than regular sleepers."
And less sleep isn't hurting these "short sleepers."
"All day long they are very active. They are very optimistic. They are go-getters."
A husband-and-wife team of scientists at the University of California, San Francisco, is studying the genetics of sleep and "short sleepers."
Dr. Ying-Hui Fu has discovered less than 1 percent of the population is biologically capable of comfortably running on six hours of sleep or less. ...
*******************
Word Origins:
Back of beyond -- What Australians call the "outback" and Americans the "sticks", the Scots call "back of beyone", meaning very far away indeed. "Beyond," in turn,comes from the Old English word beyeondan, meaning "from the farther side."
Threshold -- The "threshold" of a house is the point at which a door meets the outside world. The word "threshold" is vey old in English, dating back to a time when most speakers of the language farmed and their front doors opened onto the threshing floor, where grain was separated by treading or trampling on it.
eunoia -- A medical term, not much used, that means that a person is in normalmental health, "eunoia" comes from a Greek phrase meaning "good thinking" or beautiful thought." It is the shortest word in the English language containing all five vowels.
***************************
Connection between Nurse Staffing and Patient Outcomes Can Be Made in All Hospital Clinical Areas with Expanded Measures
(2-page pdf) Press release from the American Nurses Association.
(2-page pdf) Press release from the American Nurses Association.
*******************
Word Origins:
Peach-- The "peach" tree, a relative of the almond, is a native of Central Asia. The Romans called it Persicum malum, or "Persian apple," which was shortened over time to persicum. This became pesca in Italian and peche in French. English borrowed the word from the latter language, pronouncing it to rhyme not with "mesh" but with "beech."
Acorn-- The very old word "acorn" has been linked, incorrectly, to the oak tree with the imagined eymology "oak-horn," "horn" meaning mast or fruit. Instead, the word derives from the same ancient Indo-European root that gives us our word "acre," which originally meant a unit of open country. The fruit of the trees that grew wild in that country, such as oak and beech, were called aecern, "acorns," in Old English.
~~**~~**~~**~~**~~**~~
HUMOR SECTION
(Thank you, Marlene for this good one)
This happened to an Englishman in France who was totally drunk.
The French policeman stops his car and asks the gentleman if he has been drinking.
With great difficulty, the Englishman admits that he has been drinking all day, that his daughter got married in the morning to a French man, and that he drank champagne and a few bottles of wine at the reception and quite a few glasses of single malt there after.
Quite upset, the policeman proceeds to alcotest (breath test) him and asks the Englishman if he knows under French Law why he has just been arrested.
The Englishman answers with humour: No! But do you know that this is a British car and that my wife is the driver... on the other side???
*********************************
The Englishman answers with humour: No! But do you know that this is a British car and that my wife is the driver... on the other side???
*********************************
On a curvy mountain highway late one night, my dad was complaining about the car behind us. "That guy must be drunk!" he said. "Every time I move over to let him pass, he slows down. When I get back on the road, he gets closer and stays on my tail."
A few minutes later, the car turned on a set of flashing blue lights. Coming up to our window, the officer said, "Sir, I'd like you to take an alcohol test. You've been swerving on and off the road for the last fifteen minutes!"
*** ************************************************************
A few minutes later, the car turned on a set of flashing blue lights. Coming up to our window, the officer said, "Sir, I'd like you to take an alcohol test. You've been swerving on and off the road for the last fifteen minutes!"
*** ************************************************************
A woman in a supermarket is following a grandfather and his badly behaved 3 year-old grandson. It's obvious to her that he has his hands full with the child screaming for sweets, biscuits, you name it. Meanwhile, Grandpa is working his way around, saying in a controlled voice, "Easy William, we won't be long . . . easy, boy."
Another outburst and she hears the grandpa calmly say, "It's okay, William, just a couple more
minutes and we'll be out of here. Hang in there, boy"
At the checkout, the little terror is throwing items out of the cart and Grandpa says again in a controlled voice, "William, William, relax buddy, don't get upset. We'll be home in five minutes, stay cool, William."
Very impressed, the woman goes outside where the grandfather is loading his groceries and the boy into the car. She says to the elderly man, "It's none of my business, but you were amazing in there. I don't know how you did it. That whole time you kept your composure, and no matter how loud and disruptive he got, you just calmly kept saying things would be okay. "William is very lucky to have you as his grandpa."
Another outburst and she hears the grandpa calmly say, "It's okay, William, just a couple more
minutes and we'll be out of here. Hang in there, boy"
At the checkout, the little terror is throwing items out of the cart and Grandpa says again in a controlled voice, "William, William, relax buddy, don't get upset. We'll be home in five minutes, stay cool, William."
Very impressed, the woman goes outside where the grandfather is loading his groceries and the boy into the car. She says to the elderly man, "It's none of my business, but you were amazing in there. I don't know how you did it. That whole time you kept your composure, and no matter how loud and disruptive he got, you just calmly kept saying things would be okay. "William is very lucky to have you as his grandpa."
"Thanks," said the grandpa, "but I'm William. The little sh*t's name is Kevin."
~~**~~**~~**~~**~~**~~
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 Dr Robert Hess.
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 Dr Robert Hess.
Pay Only $34.99 for a full year of CONTACT HOURS
www.nurse.com for CNE offerings.
www.nurse.com for CNE offerings.
Free CEs http://www.myfreece.com/welcome.asp
This site was sent in by FNPMSN@aol.com (Cindy) http://cmepain.com/ !
~~**~~**~~**~~**~~**~~
WEBSITES/ LINKS
This is an excellent nursing site, check it out:http://nursingpub.com/
Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell) Founder, Forum for Shared Governance
info@sharedgovernance.orgwww.sharedgovernance.org
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
Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Metric conversion calculators and tables for metric conversions
*******************************************************
********************************************
*
MEDICAL RECALLS
*
*******************************************
******************************************************
Soliris (eculizumab) Concentrated Solution for IV Infusion by Alexion: Recall - Visible Particulates
Alexion Pharmaceuticals, Inc. announced that it is initiating a voluntary recall of certain lots of Soliris (eculizumab) 300mg/30 mL concentrated solution for intravenous infusion. The administration of particulate, if present in a parenteral drug, poses a potential safety risk to patients in two general areas: immune reaction and blood clots. Particulates could cause blockage of flow of blood in vessels, which could be life-threatening. The single affected Soliris lot is #10007A. Although these lots currently remain in specification, Alexion is including the following remaining lots, which were produced with the same process component during vial filling, within the scope of the U.S. recall: 10002-1, 00006-1, 10003A, 10004A, 10005A, 10005AR, 10006A and 10008A.
BACKGROUND: Soliris is approved as a treatment for patients with paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS), two ultra-rare and life-threatening disorders. Alexion and its distributors typically ship Soliris to healthcare providers in small quantities, which are timed to individual patient infusions, with the product being consumed before more is shipped. As product from the identified lots was last shipped on October 30, 2013, there is anticipated to be little, if any, material from these lots still remaining in commercial distribution.
*************
Medical Device Safety and Recalls: Fresenius NaturaLyte Liquid Bicarbonate Concentrate (Part Number: 08-4000-LB)
The U.S. Food and Drug Administration has issued a recall for the NaturaLyte Liquid Bicarbonate Concentrate, 6.4 Liter Bottle (Part Number: 08-4000-LB). The product may develop higher than expected bacteria levels during its shelf life. Lab testing identified the bacteria as Halomonas (species 1, 2, 3), a gram negative bacteria typically found in water with high salt concentration. The FDA has received one report of death and two reports of injury that may be related to use of this product. The use of affected product may cause serious adverse health consequences, including sepsis, bacteremia, and death. ... http://www.fda.gov/MedicalDevices/Safety/ListofRecalls/ucm399124.htm
*********************
Gemstar Docking Station by Hospira, Inc: Class I Recall - Potential for Error or Failure to Power Up
Hospira, Inc., announced today a nationwide medical device correction of the GemStar Docking Station (list number 13075), used in conjunction with the GemStar infusion pump. When the docking station is used in conjunction with a GemStar Phase 3 pump (List 13000, 13100 or 13150) the potential exists for the GemStar Phase 3 pump to fail to power up while connected to the docking station. When a GemStar Phase 3 (List 13000, 13100 or 13150) or GemStar Phase 4 pump (List 13086, 13087 or 13088) is used in conjunction with both a docking station and an external battery pack accessory (List 13073), there is a possibility that the GemStar pump will display error code 11/003 and give an audible alarm, indicating excessive input voltage from the external sources. If the GemStar pump detects what is perceived to be more than 3.6 Volts as measured on the external voltage input, the pump will stop the infusion. This will trigger an audible alarm and the device will display alarm code 11/003.
If a GemStar fails to power up or the 11/003 error code stops an infusion, a delay of therapy may occur. A delay or interruption in therapy has a worst case potential to result in significant injury or death.
BACKGROUND: The GemStar Docking Station is a separately sold accessory to the GemStar infusion pump and provides an alternate power source to the GemStar pump. The products impacted by these issues are identified in a table in the Firm Press Release. http://go.usa.gov/kM9d
******************
Fisher and Paykel Healthcare, Ltd., Infant Nasal CPAP Prongs
A recall has been issued for the Fisher and Paykel Healthcare, Ltd., Infant Nasal CPAP Prongs. Fisher and Paykel Healthcare received 24 reports in which the device has malfunctioned. There were zero injuries and zero deaths. The firm received reports of the affected prongs detaching from the nasal tubing during use, especially when mucous and/or moisture are present. When the affected prongs detach from the nasal tubing, therapy is likely to be interrupted. This may cause low blood oxygen (hypoxemia). The detached prongs may enter an infant’s mouth and present a potential risk of choking and airway obstruction. The use of the affected product may cause serious adverse health consequences, including death. For more information, please see http://www.fda.gov/MedicalDevices/Safety/ListofRecalls/ucm398631.htm
~~**~~**~~**~~**~~**~~
ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-Ruler Accurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.
~~**~~**~~**~~**~~**~~
NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
Wendy.baker@sgmc.org (Wendy) June 5, 2014
~~**~~**~~**~~**~~**~~
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. So, be certain to let me know when you change your address. RNFrankie@AOL.com
change of my email:
From: bahudson@iceinternet.com
~~**~~**~~**~~**~~**~~
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)
~~**~~**~~**~~**~~**~~
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
"The welfare of each is bound up in the welfare of all.”
- Helen Keller
Hope to hear from you..... Frankie
