PARADIGM BYTES
Newsletter for Paradigm 97
August 16, 2007
Please note that I have returned to AOL as of yesterday ! Bellsouth did not work for me at all. So my new address is: RNFrankie@AOL.com.
Newsletter for Paradigm 97
August 16, 2007
Please note that I have returned to AOL as of yesterday ! Bellsouth did not work for me at all. So my new address is: RNFrankie@AOL.com.
Our website...... http://paradigm97.blogspot.com/
PARADIGM DEFINED:
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.
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.
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.
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.
~~**~~**~~**~~**~~**~~
. Please drop in ...the AOL chatroom is "manned" by GingerMyst for 45 min on Tuesday evenings: 9 pm EST, 8 pm CST, 7 pm MST, 6 pm PST Now, the Paradigm97 chatroom is always there....door open, lights on, waiting for visitors to come in. Check your Buddy List.....and invite your friends in for a little chat Let me know if you want others involved. Now that I am on AOL, I can attend, also.
~~**~~**~~**~~**~~**~~
SNIPPETS
JCAHO Issue 10 - August 30, 1999
Blood Transfusion Errors: Preventing Future Occurrences
Since the Joint Commission began tracking sentinel events more than "There should be blue ribbon panels set up to find optimal ways to develop a system for patient identification."
James B. Battles, Ph.D., co-principal investigator, a medical event reporting system for transfusion medicine three years ago, the Accreditation Committee of the Joint Commission's Board of Commissioners has reviewed 12 cases related to transfusion errors. For each of the events reviewed, a root cause analysis was completed.
Ten of the cases resulted in patient deaths while in two of the cases the patients recovered. Also, 11 of the cases were hemolytic reactions, while one was an infectious reaction. Eleven of the transfusion reactions took place in a general hospital with eight occurring in high-risk areas: the operating room, emergency room or intensive care unit, or during resuscitation. One of the 12 cases was in a long term care organization.
Incomplete patient/blood verifications were identified as at least one of the causes of eight of the 12 cases. Three of the 12 cases involved the handling or processing of blood samples or blood units for more than one patient at the same time in the same location. In all but one case (contaminated platelets), there were multiple failures to follow established procedures, usually involving the verification of patient identity and correct blood unit for that patient.
The Joint Commission learned of eight of the 12 cases through self-reporting. Three events were reported by state or federal regulatory agencies, and the Joint Commission learned about one case through media coverage.
Risk Factors
The processes involved in blood transfusion exhibit virtually all of the factors recognized to increase the risk of an adverse outcome:
a.. Variable input (The patients have different blood types.)
b.. Complexity (This includes the technical aspects of crossmatching as well as administering and monitoring the effects of blood.)
c.. Inconsistency (Despite efforts to clearly define procedures within a hospital, there is no standardization across all hospitals.)
d.. Tight coupling (When steps in a process happen so closely together, if there is a failure in one step there is little opportunity
for intervention. It is difficult to interrupt the sequence of the process, especially in an emergency room, operating room or intensive care unit.)
e.. Human intervention (This is in processes that require a higher level of consistency than is reasonably achievable by health care workers without computer support.)
f.. Tight time constraints (This occurs especially in an emergency room, operating room or intensive care unit.)
Root Causes Identified
Root causes fell into six general areas:
a.. Patient assessment such as incomplete patient/blood verification. "When an order for a transfusion occurs, a dedicated team should manage the entire process."
Kathleen Sazama, M.D., J.D., chair of accreditation program committee, American Association of Blood Banks
Patient assessment such as the signs and symptoms of a transfusion reaction not being recognized.
b.. Care planning such as no informed consent for a transfusion.
Laboratory procedures such as multiple samples crossmatched at the same time or a crossmatch being started before the order was received.
c.. Staff-related factors such as insufficient orientation and training or insufficient staffing levels.
d.. Equipment-related factors such as blood for multiple operating room patients being stored together in the same refrigerator.
Information-related factors such as incomplete communication among caregivers or patient identification band, specimen label or blood label errors.
Suggested Strategies for Reducing Risk
The organizations that experienced the sentinel events offered the following risk reduction strategies:
a.. People-focused actions that included in-service training on transfusion-related procedures and revising the staffing model.
b.. Process redesign issues such as revising the patient identification band procedures; revising patient/blood verification procedures; revising and implementing new informed consent procedures; discontinuing processing of multiple samples; or discontinuing the use of the room number as the patient identifier.
c.. Technical system redesign efforts such as enhanced computer support or new patient identification band system.
d.. Environmental redesign issue such as discontinuing use of an operating room refrigerator for multiple blood units or adding laboratory workstations.
In addition, the Joint Commission suggests the following actions:
a.. Prohibiting simultaneous crossmatching of multiple patients by the same technologist.
b.. Not using the patient's room number to identify blood samples or transfusion units.
c.. Considering the use of "unique" identification bands for patients receiving blood transfusions.
d.. Introducing a computerized verification step into the process.
Experts' Recommendations
Experts as well as Joint Commission standards emphasize that health care organizations should have unique patient identifier processes in place. This would be a way to take human fallibility out of the equation, says Kathleen Sazama, M.D., J.D., a professor of pathology and laboratory medicine at MCP Hahnemann University in Philadelphia.
Sazama says organizations should use a hand-held bar code reader to read both bar coded wristbands on every patient and a bar code identifier on the tag of the components. If the bar code reader fails to confirm the identity between the wristband and the tag, then the health care worker cannot proceed with the transfusion.
James B. Battles, Ph.D., a professor of medical education for the University of Texas Southwestern Medical Center, Dallas, says bar coding can help but he believes there still is not a good patient identification system in place. He says a major effort needs to be made to study the problem and find the best method.
http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_10.htm
. Please drop in ...the AOL chatroom is "manned" by GingerMyst for 45 min on Tuesday evenings: 9 pm EST, 8 pm CST, 7 pm MST, 6 pm PST Now, the Paradigm97 chatroom is always there....door open, lights on, waiting for visitors to come in. Check your Buddy List.....and invite your friends in for a little chat Let me know if you want others involved. Now that I am on AOL, I can attend, also.
~~**~~**~~**~~**~~**~~
SNIPPETS
JCAHO Issue 10 - August 30, 1999
Blood Transfusion Errors: Preventing Future Occurrences
Since the Joint Commission began tracking sentinel events more than "There should be blue ribbon panels set up to find optimal ways to develop a system for patient identification."
James B. Battles, Ph.D., co-principal investigator, a medical event reporting system for transfusion medicine three years ago, the Accreditation Committee of the Joint Commission's Board of Commissioners has reviewed 12 cases related to transfusion errors. For each of the events reviewed, a root cause analysis was completed.
Ten of the cases resulted in patient deaths while in two of the cases the patients recovered. Also, 11 of the cases were hemolytic reactions, while one was an infectious reaction. Eleven of the transfusion reactions took place in a general hospital with eight occurring in high-risk areas: the operating room, emergency room or intensive care unit, or during resuscitation. One of the 12 cases was in a long term care organization.
Incomplete patient/blood verifications were identified as at least one of the causes of eight of the 12 cases. Three of the 12 cases involved the handling or processing of blood samples or blood units for more than one patient at the same time in the same location. In all but one case (contaminated platelets), there were multiple failures to follow established procedures, usually involving the verification of patient identity and correct blood unit for that patient.
The Joint Commission learned of eight of the 12 cases through self-reporting. Three events were reported by state or federal regulatory agencies, and the Joint Commission learned about one case through media coverage.
Risk Factors
The processes involved in blood transfusion exhibit virtually all of the factors recognized to increase the risk of an adverse outcome:
a.. Variable input (The patients have different blood types.)
b.. Complexity (This includes the technical aspects of crossmatching as well as administering and monitoring the effects of blood.)
c.. Inconsistency (Despite efforts to clearly define procedures within a hospital, there is no standardization across all hospitals.)
d.. Tight coupling (When steps in a process happen so closely together, if there is a failure in one step there is little opportunity
for intervention. It is difficult to interrupt the sequence of the process, especially in an emergency room, operating room or intensive care unit.)
e.. Human intervention (This is in processes that require a higher level of consistency than is reasonably achievable by health care workers without computer support.)
f.. Tight time constraints (This occurs especially in an emergency room, operating room or intensive care unit.)
Root Causes Identified
Root causes fell into six general areas:
a.. Patient assessment such as incomplete patient/blood verification. "When an order for a transfusion occurs, a dedicated team should manage the entire process."
Kathleen Sazama, M.D., J.D., chair of accreditation program committee, American Association of Blood Banks
Patient assessment such as the signs and symptoms of a transfusion reaction not being recognized.
b.. Care planning such as no informed consent for a transfusion.
Laboratory procedures such as multiple samples crossmatched at the same time or a crossmatch being started before the order was received.
c.. Staff-related factors such as insufficient orientation and training or insufficient staffing levels.
d.. Equipment-related factors such as blood for multiple operating room patients being stored together in the same refrigerator.
Information-related factors such as incomplete communication among caregivers or patient identification band, specimen label or blood label errors.
Suggested Strategies for Reducing Risk
The organizations that experienced the sentinel events offered the following risk reduction strategies:
a.. People-focused actions that included in-service training on transfusion-related procedures and revising the staffing model.
b.. Process redesign issues such as revising the patient identification band procedures; revising patient/blood verification procedures; revising and implementing new informed consent procedures; discontinuing processing of multiple samples; or discontinuing the use of the room number as the patient identifier.
c.. Technical system redesign efforts such as enhanced computer support or new patient identification band system.
d.. Environmental redesign issue such as discontinuing use of an operating room refrigerator for multiple blood units or adding laboratory workstations.
In addition, the Joint Commission suggests the following actions:
a.. Prohibiting simultaneous crossmatching of multiple patients by the same technologist.
b.. Not using the patient's room number to identify blood samples or transfusion units.
c.. Considering the use of "unique" identification bands for patients receiving blood transfusions.
d.. Introducing a computerized verification step into the process.
Experts' Recommendations
Experts as well as Joint Commission standards emphasize that health care organizations should have unique patient identifier processes in place. This would be a way to take human fallibility out of the equation, says Kathleen Sazama, M.D., J.D., a professor of pathology and laboratory medicine at MCP Hahnemann University in Philadelphia.
Sazama says organizations should use a hand-held bar code reader to read both bar coded wristbands on every patient and a bar code identifier on the tag of the components. If the bar code reader fails to confirm the identity between the wristband and the tag, then the health care worker cannot proceed with the transfusion.
James B. Battles, Ph.D., a professor of medical education for the University of Texas Southwestern Medical Center, Dallas, says bar coding can help but he believes there still is not a good patient identification system in place. He says a major effort needs to be made to study the problem and find the best method.
http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_10.htm
~**~~**~~**~~**~~**~~
Medical News
After a drug ingredient from China killed dozens of Haitian children a decade ago, a senior American health official sent a cable to her investigators: find out who made the poisonous ingredient and why a state-owned company in China exported it as safe, pharmaceutical-grade glycerin.
The Chinese were of little help. Requests to find the manufacturer were ignored. Business records were withheld or destroyed. The Americans had reason for alarm. "The U.S. imports a lot of Chinese glycerin and it is used in ingested products such as toothpaste," Mary K. Pendergast, then deputy commissioner for the Food and Drug Administration, wrote on Oct. 27, 1997. Learning how diethylene glycol, a syrupy poison used in some antifreeze, ended up in Haitian fever medicine might "prevent this tragedy from happening again," she wrote.
The F.D.A.'s mission ultimately failed. By the time an F.D.A. agent visited the suspected manufacturer, the plant was shut down and Chinese companies said they bore no responsibility for the mass poisoning.
Ten years later it happened again, this time in Panama. Chinese-made diethylene glycol, masquerading as its more expensive chemical cousin glycerin, was mixed into medicine, killing at least 100 people there last year. And recently, Chinese toothpaste containing diethylene glycol was found in the United States and seven other countries, prompting tens of thousands of tubes to be recalled.
The F.D.A.'s efforts to investigate the Haiti poisonings, documented in internal F.D.A. memorandums obtained by The New York Times, demonstrate not only the intransigence of Chinese officials, but also the same regulatory failings that allowed a virtually identical poisoning to occur 10 years later. The cases further illustrate what happens when nations fail to police the global pipeline of pharmaceutical ingredients.....
http://www.nytimes.com/2007/06/17/health/17poison.html?_r=1&th=&adxnnl=1&oref=slogin&emc=th&adxnnlx=1182110156-WVaLeik2p0HH0tks09FLCA
Medical News
After a drug ingredient from China killed dozens of Haitian children a decade ago, a senior American health official sent a cable to her investigators: find out who made the poisonous ingredient and why a state-owned company in China exported it as safe, pharmaceutical-grade glycerin.
The Chinese were of little help. Requests to find the manufacturer were ignored. Business records were withheld or destroyed. The Americans had reason for alarm. "The U.S. imports a lot of Chinese glycerin and it is used in ingested products such as toothpaste," Mary K. Pendergast, then deputy commissioner for the Food and Drug Administration, wrote on Oct. 27, 1997. Learning how diethylene glycol, a syrupy poison used in some antifreeze, ended up in Haitian fever medicine might "prevent this tragedy from happening again," she wrote.
The F.D.A.'s mission ultimately failed. By the time an F.D.A. agent visited the suspected manufacturer, the plant was shut down and Chinese companies said they bore no responsibility for the mass poisoning.
Ten years later it happened again, this time in Panama. Chinese-made diethylene glycol, masquerading as its more expensive chemical cousin glycerin, was mixed into medicine, killing at least 100 people there last year. And recently, Chinese toothpaste containing diethylene glycol was found in the United States and seven other countries, prompting tens of thousands of tubes to be recalled.
The F.D.A.'s efforts to investigate the Haiti poisonings, documented in internal F.D.A. memorandums obtained by The New York Times, demonstrate not only the intransigence of Chinese officials, but also the same regulatory failings that allowed a virtually identical poisoning to occur 10 years later. The cases further illustrate what happens when nations fail to police the global pipeline of pharmaceutical ingredients.....
http://www.nytimes.com/2007/06/17/health/17poison.html?_r=1&th=&adxnnl=1&oref=slogin&emc=th&adxnnlx=1182110156-WVaLeik2p0HH0tks09FLCA
***********************
From the NYT---------- free registration required:
IN BID FOR BETTER CARE, SURGERY WITH A WARRANTY
Author: Reed Abelson Source: The New York Times, 05/17/07
Sent in by K. Ullman......thank you
A hospital group in central Pennsylvania is taking a radical approach to surgery, reports The New York Times. Geisinger Health System "essentially guarantees its workmanship, charging a flat fee that includes 90 days of follow-up treatment," writes the Times. Under Geisinger's program, which focuses on elective heart bypass surgery, "the hospital charges a flat fee for the surgery, plus half the amount it has calculated as the historical cost of related care for the next 90 days," reports the Times. Rather than billing for any additional hospital stays, Geisinger absorbs the extra cost -- which typically runs from $12,000 to $15,000. Since the program began in February of last year, "patients have been less likely to return to intensive care, have spent fewer days in the hospital and are more likely to return directly to their own homes instead of a nursing home," the Times reports. www.nytimes.com
IN BID FOR BETTER CARE, SURGERY WITH A WARRANTY
Author: Reed Abelson Source: The New York Times, 05/17/07
Sent in by K. Ullman......thank you
A hospital group in central Pennsylvania is taking a radical approach to surgery, reports The New York Times. Geisinger Health System "essentially guarantees its workmanship, charging a flat fee that includes 90 days of follow-up treatment," writes the Times. Under Geisinger's program, which focuses on elective heart bypass surgery, "the hospital charges a flat fee for the surgery, plus half the amount it has calculated as the historical cost of related care for the next 90 days," reports the Times. Rather than billing for any additional hospital stays, Geisinger absorbs the extra cost -- which typically runs from $12,000 to $15,000. Since the program began in February of last year, "patients have been less likely to return to intensive care, have spent fewer days in the hospital and are more likely to return directly to their own homes instead of a nursing home," the Times reports. www.nytimes.com
~~**~~**~~**~~**~~**~~
FROM THE MEMBERS
This announcement is from Raconte @AOL.com (Genevieve) Please check out the website !
FROM THE MEMBERS
This announcement is from Raconte @AOL.com (Genevieve) Please check out the website !
The National Registered Nurses Professional Association (NRNPA) is a professional organization for the Registered Nurse. Founded in 2007 by RNs who wanted an organization that the professional nurse could join that fostered the ideals of professionalism, and that helped nurses help each other develop, share, and fine-tune their skills to help one another shine the light of excellence of this time-honored profession. Advocate, Promote and Reform, three simple but powerful words are the core priniciples of this grassroots organization. The NRNPA is a professional organization formed by RNs for RNs join us in the adventure!
For more information call Geneviève at 626-844-7812, email her at Clavreul@nrnpa.org or visit our website at www.nrnpa.org <http://www.nrnpa.org> . You can also read more about the Geneviève¹s ³spin² on all things nursing by visiting her blog at www.thenurseunchained.com.
For more information call Geneviève at 626-844-7812, email her at Clavreul@nrnpa.org or visit our website at www.nrnpa.org <http://www.nrnpa.org> . You can also read more about the Geneviève¹s ³spin² on all things nursing by visiting her blog at www.thenurseunchained.com.
~~**~~**~~**~~**~~**~~
INTERESTING READING
Please remember that the REUTERS articles are good for 30 days only
INTERESTING READING
Please remember that the REUTERS articles are good for 30 days only
Nocioceptive Pain
Nocioceptive pain occurs from real or impending tissue damage, either to the viscera or the soma. Nocioceptive, somatic pain usually occurs due to real or impending damage to bone, muscle, skin, or connective tissue. Somatic pain is most commonly described as localized,aching, or throbbing. Nocioceptive visceral pain usually occurs due to real or impending damage to the thoracic, abdominal, or pelvic organs (i.e. heart, liver, bowel). Visceral pain is often described as deep, cramping, referred, aching, or gnawing (Griffie, McKinnon, Berry, &
Heidrich, 2002).
Nocioceptive pain occurs from real or impending tissue damage, either to the viscera or the soma. Nocioceptive, somatic pain usually occurs due to real or impending damage to bone, muscle, skin, or connective tissue. Somatic pain is most commonly described as localized,aching, or throbbing. Nocioceptive visceral pain usually occurs due to real or impending damage to the thoracic, abdominal, or pelvic organs (i.e. heart, liver, bowel). Visceral pain is often described as deep, cramping, referred, aching, or gnawing (Griffie, McKinnon, Berry, &
Heidrich, 2002).
Neuropathic Pain
Alternatively, neuropathic pain occurs from damage to peripheral or central nervous tissues or from distorted processing of pain. Examples of neuropathic pain include peripheral neuropathies, neuralgias, phantom limb pain, and spinal cord injuries. It is often described as burning, piercing, lacerating, and pricking (Griffie, McKinnon, Berry, & Heidrich, 2002).
Acute Pain versus Chronic Pain
Acute pain is relatively brief and diminishes as healing occurs. Chronic pain is usually subdivided into either malignant or non-malignant pain (McCaffery & Pasero, 1999). Chronic non-malignant and chronic malignant pain may be either nocioceptive or neuropathic depending upon its origin and dissemination. For example, a patient may experience visceral, nocioceptive pain from liver metastasis, but may also be experiencing neuropathic pain from chemotherapy induced neuropathy. Additionally, a person with chronic pain may have exacerbations of acute pain, known as breakthrough pain.
Nocioceptive versus Neuropatic Pain
Nocioceptive Pain: Somatic: localized, aching, throbbing Visceral: deep, cramping, aching, referred, gnawing
Neuropathic Pain: burning, piercing, lacerating, pricking
Alternatively, neuropathic pain occurs from damage to peripheral or central nervous tissues or from distorted processing of pain. Examples of neuropathic pain include peripheral neuropathies, neuralgias, phantom limb pain, and spinal cord injuries. It is often described as burning, piercing, lacerating, and pricking (Griffie, McKinnon, Berry, & Heidrich, 2002).
Acute Pain versus Chronic Pain
Acute pain is relatively brief and diminishes as healing occurs. Chronic pain is usually subdivided into either malignant or non-malignant pain (McCaffery & Pasero, 1999). Chronic non-malignant and chronic malignant pain may be either nocioceptive or neuropathic depending upon its origin and dissemination. For example, a patient may experience visceral, nocioceptive pain from liver metastasis, but may also be experiencing neuropathic pain from chemotherapy induced neuropathy. Additionally, a person with chronic pain may have exacerbations of acute pain, known as breakthrough pain.
Nocioceptive versus Neuropatic Pain
Nocioceptive Pain: Somatic: localized, aching, throbbing Visceral: deep, cramping, aching, referred, gnawing
Neuropathic Pain: burning, piercing, lacerating, pricking
Quality of Pain
Pain descriptors such as aching, throbbing, burning, piercing, shooting, boring, tearing or crushing can also give clues to the origins of pain. Remember, somatic pain is most commonly described as localized, aching and throbbing. Visceral pain is often described as deep, cramping, referred, aching or gnawing. Neuropathic pain is often described as burning, piercing, lacerating and pricking. Qualifying the patient's pain allows you and your team to determine the appropriate analgesic or adjuvant to request to be prescribed.
********************************
See those beads of sweat dripping onto the control panel of your exercise machine? That's a good sign for your colon. Exercise helps keep your colon healthy, but moderate-to-vigorous exercise -- the kind that gets you winded and makes you perspire -- may be particularly important. It can help slow down the growth of colon cells, which is a good thing; slower growth means a lower risk of cancer. So be kind to your colon by sweating to the oldies -- or to whatever it is you like to sweat to -- for at least 30 minutes a day. Bump it up to over 40 minutes or more and you'll do even better. You know that exercise can stave off deadly diseases, from diabetes to cancer. So what are you waiting for? Get moving! Walking is hard to beat if you're just getting started. Aim for a brisk 30 minutes at least 5 days a week and when that gets easy, increase the time and intensity to keep your body challenged. Even better, add some weight work and stretching three times a week.
The protective effects of exercise on colon health seem to be greater in men than in women, but the overall health benefits for both genders are overwhelming. Other things you can do to keep your colon healthy: Make sure your daily diet contains adequate calcium (1,200 milligrams) and vitamin D (400 international units), get plenty of fiber, and limit red meat intake to no more than once per week. References: Effect of a 12-month exercise intervention on patterns of cellular proliferation in colonic crypts: a randomized controlled trial. McTiernan, A., Yasui, Y., Sorensen, B., Irwin, M. L., Morgan, A., Rudolph, R. E., Surawicz, C., Lampe, J. W., Ayub, K., Potter, J. D., Lampe, P. D., Cancer Epidemiology, Biomarkers & Prevention 2006 Sep;15(9):1588-1597.
***********************************
Think you're a multitasking wiz? That may be why your memory's slipping." The more things you do at once, the less likely you are to remember any of them. Sometimes that's no biggie -- if you're flipping through a catalog and watching a sitcom, who cares?
Pain descriptors such as aching, throbbing, burning, piercing, shooting, boring, tearing or crushing can also give clues to the origins of pain. Remember, somatic pain is most commonly described as localized, aching and throbbing. Visceral pain is often described as deep, cramping, referred, aching or gnawing. Neuropathic pain is often described as burning, piercing, lacerating and pricking. Qualifying the patient's pain allows you and your team to determine the appropriate analgesic or adjuvant to request to be prescribed.
********************************
See those beads of sweat dripping onto the control panel of your exercise machine? That's a good sign for your colon. Exercise helps keep your colon healthy, but moderate-to-vigorous exercise -- the kind that gets you winded and makes you perspire -- may be particularly important. It can help slow down the growth of colon cells, which is a good thing; slower growth means a lower risk of cancer. So be kind to your colon by sweating to the oldies -- or to whatever it is you like to sweat to -- for at least 30 minutes a day. Bump it up to over 40 minutes or more and you'll do even better. You know that exercise can stave off deadly diseases, from diabetes to cancer. So what are you waiting for? Get moving! Walking is hard to beat if you're just getting started. Aim for a brisk 30 minutes at least 5 days a week and when that gets easy, increase the time and intensity to keep your body challenged. Even better, add some weight work and stretching three times a week.
The protective effects of exercise on colon health seem to be greater in men than in women, but the overall health benefits for both genders are overwhelming. Other things you can do to keep your colon healthy: Make sure your daily diet contains adequate calcium (1,200 milligrams) and vitamin D (400 international units), get plenty of fiber, and limit red meat intake to no more than once per week. References: Effect of a 12-month exercise intervention on patterns of cellular proliferation in colonic crypts: a randomized controlled trial. McTiernan, A., Yasui, Y., Sorensen, B., Irwin, M. L., Morgan, A., Rudolph, R. E., Surawicz, C., Lampe, J. W., Ayub, K., Potter, J. D., Lampe, P. D., Cancer Epidemiology, Biomarkers & Prevention 2006 Sep;15(9):1588-1597.
***********************************
Think you're a multitasking wiz? That may be why your memory's slipping." The more things you do at once, the less likely you are to remember any of them. Sometimes that's no biggie -- if you're flipping through a catalog and watching a sitcom, who cares?
But if you're hunting for flights on the Internet while talking on the phone and listening to the radio, well, good luck -- both the flight info and the conversation will probably be a blur. The solution's obvious: When something is important, be single-minded. To sharpen your recall of new information -- whether it's health instructions, vital dates, or learning how to work your new cell phone -- make it easy for your mind to absorb it. Limit distractions and focus on the matter at hand, not three other things as well. If other tasks keep popping into your head, stop and jot them down on a notepad. Then go back to what's really important. It's a good bet that this time it will stick with you. References: Modulation of competing memory systems by distraction. Foerde, K., Knowlton, B. J., Poldrack, R. A., Proceedings of the National Academy of Sciences of the United States of America 2006 Aug
1;103(31):11778-11783.
*******************************
This is an advertisement.......but looks interesting
Catheter Navigation without the Use of Fluoroscopy Utilizing advanced computer-based technology in real time, the EnSite® System facilitates electrophysiology procedures with 3-D graphical displays of cardiac structures and arrhythmias. View animated demo.
http://www.medscape.com/files/infosite/sjm/ensite.html?src=0_nl_mp_tad
1;103(31):11778-11783.
*******************************
This is an advertisement.......but looks interesting
Catheter Navigation without the Use of Fluoroscopy Utilizing advanced computer-based technology in real time, the EnSite® System facilitates electrophysiology procedures with 3-D graphical displays of cardiac structures and arrhythmias. View animated demo.
http://www.medscape.com/files/infosite/sjm/ensite.html?src=0_nl_mp_tad
*********************************
From Exceptional nurse @aol.com :
UK Research reveals prejudice against people disclosing impairments
A new report commissioned by the Disability Rights Commission (DRC), Disclosing Disability: Disabled students and practitioners in social work, nursing and teaching, has found that the risks of disclosing unseen disabilities and health conditions in the teaching, nursing and social work professions are compounded by the stigma attached to them.Source and further information at
(http://www.drc.gov.uk/newsroom/news_releases/2007/drc_disclosure_research.aspx)
UK Research reveals prejudice against people disclosing impairments
A new report commissioned by the Disability Rights Commission (DRC), Disclosing Disability: Disabled students and practitioners in social work, nursing and teaching, has found that the risks of disclosing unseen disabilities and health conditions in the teaching, nursing and social work professions are compounded by the stigma attached to them.Source and further information at
(http://www.drc.gov.uk/newsroom/news_releases/2007/drc_disclosure_research.aspx)
***********************
CONFIRMED: YOUR DAUGHTER IS MERCK'S GUINEA PIG
NewsWithViews.com - Merlin,OR,USA ...
On March 15, 2007, the bomb dropped on a cable network show which quickly made the Internet media; see full important column here. Diane M. Harper, a researcher who worked on this vaccine has revealed that it has NOT been tested on young girls and "worst case" scenario: increased cervical cancer rates. As I covered in my February 8th column, Merck needs cash badly. The lawsuits over another "safe" product of theirs, VIOXX, could bankrupt them and they know it; one verdict here. At between $320 - $400 per shot per girl in the U.S., then the world, you can see why Merck has spent millions buying the favors of members of
the state legislatures. http://www.newswithviews.com/Devvy/kidd256.htm
NewsWithViews.com - Merlin,OR,USA ...
On March 15, 2007, the bomb dropped on a cable network show which quickly made the Internet media; see full important column here. Diane M. Harper, a researcher who worked on this vaccine has revealed that it has NOT been tested on young girls and "worst case" scenario: increased cervical cancer rates. As I covered in my February 8th column, Merck needs cash badly. The lawsuits over another "safe" product of theirs, VIOXX, could bankrupt them and they know it; one verdict here. At between $320 - $400 per shot per girl in the U.S., then the world, you can see why Merck has spent millions buying the favors of members of
the state legislatures. http://www.newswithviews.com/Devvy/kidd256.htm
*********************
Pelvic Floor Muscle Training Exercises and Adjunctive Therapies For the treatment of Stress Urinary Incontinence in Women: a Systematic Review Background: Stress urinary incontinence (SUI) is a prevalent and costly condition which may be treated surgically or by physical therapy. The aim of this review was to systematically assess the literature and present the best available evidence for the efficacy and effectiveness of pelvic floor muscle training (PFMT) performed alone and together with adjunctive therapies (eg biofeedback, electrical stimulation, vaginal cones) for the treatment of female SUI.
***************************
Statins: Morning or Evening Dosing Study Summary
This literature review investigated the chronobiologic effects of morning vs evening administration of statins on low-density lipoprotein cholesterol (LDL-C). Based on the 7 clinical trials reviewed, simvastatin demonstrated a significant low-density lipoprotein cholesterol (LDL-C) percentage reduction when administered in the evening, compared with morning administration. Although not significantly significant, the authors also noted a trend favoring evening statin administration with lovastatin, pravastatin, and rosuvastatin. Atorvastatin appears to decrease LDL-C regardless of the time administered. The authors were not able to identify any clinical studies involving the optimum time for administering fluvastatin.
Viewpoint
The National Cholesterol Education Program Adult Treatment Panel III advocates statins as first-line therapy for lowering LDL-C levels.[1] Given that cholesterol is biosynthesized in the early morning hours,[2] the US Food and Drug Administration (FDA) has recommended evening administration for statins with shorter half-lives (lovastatin 2 hours, simvastatin <>http://www.medscape.com/viewarticle/552756?src=mp
**********************************
Can you drink your way to a better workout with super-oxygenated bottled water?
Although the performance-boosting pitch for pumped-up H2O is intriguing -- who doesn't want getting fit to feel like a walk in the park? -- several studies have failed to show any benefit from drinking oxygen-rich water before, during, or after exercise. No increased stamina, no improvement in heart rate, no speedy recovery time. So save your money and just turn on the tap.
Oxygenated waters can have up to 10 times more oxygen than regular bottled water, but that's the only claim that holds up. For starters, since oxygen doesn't dissolve well in water, most of it fizzes out shortly after you twist off the cap. (Think of how bubbles escape from a soda can when you pop the top.) Then there's this fact of life: Very little of the extra oxygen will make it from your gut to your bloodstream, because your intestines aren't great at transferring gases.
So what's with your neighbor who insists he runs faster after downing a bottle of high-test H2O? It's the placebo effect at work, not anything in the water. References: The effects of oxygenated water on exercise physiology during incremental exercise and recovery. Willmert, N., Porcari, J. P., Foster, C., Doberstein, S., Brice, G., Journal of Exercise Physiology Online, 2002 Nov;5(4):16-21.
Mind over body. Porcari, J., Foster, C., ACE FitnessMatters, May/June 2006, pp. 12-13.
"Oxygenated" water and athletic performance. Piantadosi, C. A., British Journal of Sports Medicine 2006 Sep;40(9):740-741; discussion 740-741. Epub 2006 Jul 19.
*************************************
Haven't seen your waistline in a few years? Eat more oranges.
Here's why. Apple-shaped people (who carry extra pounds around their middles) are at higher risk of obesity, heart disease, and diabetes. All of these drain the body's stores of vitamin C. Why? This antioxidant helps fight the cellular damage that comes with these problems. So help your body help you by packing in more oranges, papayas, bell peppers, and other C-rich fruits and veggies. It's the new way to eat skinny. Ever see a rusty pipe? That same process -- called oxidation -- goes on in your insides, but in this case, it damages cells, not metal. Conditions like obesity, heart disease, and diabetes accelerate the process, "rusting" cells throughout your body, including those lining your blood vessels. And the thicker you are around the middle, the more "rusty" you're likely to be.
The best solution for reducing this damage is to lose weight -- especially around your middle. But losing belly bulge is easier said than done.
Now researchers have discovered that hourglass-shaped people have higher blood levels of vitamin C than apple-shaped people. They aren't sure why, but they're investigating some likely theories. One is that men and women who have a low waist-to-hip ratio may eat lots of vitamin C-rich fruits and veggies and take vitamins. A second possibility is that those shaped like an hourglass are healthier and not as likely as their apple-shaped peers to be obese or have ailments like heart disease and diabetes that "rust" tissues and gobble up vitamin C.
Megadosing on vitamin C won't make you slim, but eating a low-fat, high fiber diet that includes lots of C-rich produce may not only help protect your body from excessive cell damage, but also give you a good shot at getting -- and keeping -- a svelte figure. References: Plasma ascorbic acid concentrations and fat distribution in 19,068 British men and women in the European Prospective Investigation into Cancer and Nutrition Norfolk cohort study. Canoy, D., Wareham, N., Welch, A., Bingham, S., Luben, R., Day, N., Khaw, K. T., The American Journal of Clinical Nutrition 2005 Dec;82(6):1203-1209.
***********************************
Report: More than five million living with Alzheimer's
WASHINGTON More than five (m) million Americans are living with Alzheimer's disease. That's a ten percent increase since the last Alzheimer's Association estimate five years ago. http://www.kcbd.com/Global/story.asp?S=6250503&nav=CcXH
Although the performance-boosting pitch for pumped-up H2O is intriguing -- who doesn't want getting fit to feel like a walk in the park? -- several studies have failed to show any benefit from drinking oxygen-rich water before, during, or after exercise. No increased stamina, no improvement in heart rate, no speedy recovery time. So save your money and just turn on the tap.
Oxygenated waters can have up to 10 times more oxygen than regular bottled water, but that's the only claim that holds up. For starters, since oxygen doesn't dissolve well in water, most of it fizzes out shortly after you twist off the cap. (Think of how bubbles escape from a soda can when you pop the top.) Then there's this fact of life: Very little of the extra oxygen will make it from your gut to your bloodstream, because your intestines aren't great at transferring gases.
So what's with your neighbor who insists he runs faster after downing a bottle of high-test H2O? It's the placebo effect at work, not anything in the water. References: The effects of oxygenated water on exercise physiology during incremental exercise and recovery. Willmert, N., Porcari, J. P., Foster, C., Doberstein, S., Brice, G., Journal of Exercise Physiology Online, 2002 Nov;5(4):16-21.
Mind over body. Porcari, J., Foster, C., ACE FitnessMatters, May/June 2006, pp. 12-13.
"Oxygenated" water and athletic performance. Piantadosi, C. A., British Journal of Sports Medicine 2006 Sep;40(9):740-741; discussion 740-741. Epub 2006 Jul 19.
*************************************
Haven't seen your waistline in a few years? Eat more oranges.
Here's why. Apple-shaped people (who carry extra pounds around their middles) are at higher risk of obesity, heart disease, and diabetes. All of these drain the body's stores of vitamin C. Why? This antioxidant helps fight the cellular damage that comes with these problems. So help your body help you by packing in more oranges, papayas, bell peppers, and other C-rich fruits and veggies. It's the new way to eat skinny. Ever see a rusty pipe? That same process -- called oxidation -- goes on in your insides, but in this case, it damages cells, not metal. Conditions like obesity, heart disease, and diabetes accelerate the process, "rusting" cells throughout your body, including those lining your blood vessels. And the thicker you are around the middle, the more "rusty" you're likely to be.
The best solution for reducing this damage is to lose weight -- especially around your middle. But losing belly bulge is easier said than done.
Now researchers have discovered that hourglass-shaped people have higher blood levels of vitamin C than apple-shaped people. They aren't sure why, but they're investigating some likely theories. One is that men and women who have a low waist-to-hip ratio may eat lots of vitamin C-rich fruits and veggies and take vitamins. A second possibility is that those shaped like an hourglass are healthier and not as likely as their apple-shaped peers to be obese or have ailments like heart disease and diabetes that "rust" tissues and gobble up vitamin C.
Megadosing on vitamin C won't make you slim, but eating a low-fat, high fiber diet that includes lots of C-rich produce may not only help protect your body from excessive cell damage, but also give you a good shot at getting -- and keeping -- a svelte figure. References: Plasma ascorbic acid concentrations and fat distribution in 19,068 British men and women in the European Prospective Investigation into Cancer and Nutrition Norfolk cohort study. Canoy, D., Wareham, N., Welch, A., Bingham, S., Luben, R., Day, N., Khaw, K. T., The American Journal of Clinical Nutrition 2005 Dec;82(6):1203-1209.
***********************************
Report: More than five million living with Alzheimer's
WASHINGTON More than five (m) million Americans are living with Alzheimer's disease. That's a ten percent increase since the last Alzheimer's Association estimate five years ago. http://www.kcbd.com/Global/story.asp?S=6250503&nav=CcXH
*********************************8
New Medical Malpractice Market Opens for Florida Nurses
Insurance Journal - San Diego,CA,USA The Nurse's Service Organization reported in 2005 that Florida had the highest number of malpractice claims in the nation against nurses. ...See all stories on this topic See all stories on this topic http://www.insurancejournal.com/news/southeast/2007/03/23/78052.htm
*********************************
Accutech's "Nurse Friendly" Infant Protection System saves nurses ...
PR-Inside.com (Pressemitteilung) - Wien,Austria Milwaukee, WI - October 2, 2006 - Accutech's "Nurse Friendly" Infant Protection System gives nurses the ability to spend more time caring for infants and ... See all stories on this topic http://www.pr-inside.com/accutech-s-nurse-friendly-infant-protection-r75002.htm
****************************
Jewish-American Hall of Fame Inducts Lillian Wald
Hall Of Fame Magazine - New Bedford,MA,USA
President Ronald Reagan signed a proclamation on March 25, proclaiming the first "National Recognition Day for Nurses" on May 6, 1982. ...See all stories on this topic http://www.hofmag.com/content/view/713/190/
***********************
Thank you to Assemblywoman Aileen Gunther who introduced K367, memorializing the Congress of the United States to encourage the effort to create an Office of the National Nurse, into the New York State
Assembly on March 26, 2007. The bill amassed 50 sponsors before it was sent to the floor of the Assembly and adopted unanimously by all voting members.
The National Nursing Network Organization and Assemblywoman Aileen Gunther's office has put out the following press release:
New York Assemblywoman Brings Oregon Nurse's Vision For National Nurse
One Big Step Forward
The New York Assembly unanimously adopted a resolution Wednesday encouraging the Congress of the United States to create an Office of the National Nurse.
New York Assemblywoman and nurse Aileen Gunther (District 98) brought Oregon nurse Teri Mills' vision to create the office a big step forward with Resolution K367.
"Nurses work to keep patients healthy through preventive, proactive care," Gunther said. "A National Nurse would serve as a valuable counterpart to the U.S. Surgeon General to help raise awareness of preventive health issues while providing community outreach. In addition, there is currently a shortage of nurses in the U.S. and a National Nurse would inspire more young Americans to enter the nursing profession."
Efforts to create an Office of the National Nurse began on May 20, 2005, the day the New York Times published America's Nurse, authored by Mills. The intent of the Office of the National Nurse is to focus Americans on health rather than sickness. Working with state-level coordinators and teams of nurse volunteers from around the nation, a recognized and trusted National Nurse will regularly deliver messages about key health issues to the public and serve as an effective complement to the Office of the Surgeon General.
"This grassroots campaign has energized nurses to become involved in the political process for the first time," Mills said. "Creating a National Nurse is a goal that has united all nurses regardless of specialty, educational background or experience."
Thus far, the campaign has led to the introduction in 2006 of a National Nurse bill in the House of Representatives by Rep. Lois Capps (CA-23), and a great deal of interest among elected legislators. At the close of the 2006 legislative session, the bill had bipartisan support with 42 members of Congress signing on as cosponsors, a remarkable achievement for legislation introduced for the first time.
*****************************
Performance Measurement
Performance measurement is an essential part of any effective patient safety program. Without performance measurement, your organization cannot effectively evaluate policies and procedures, staff performance, operations responsiveness, and organization safety. A few common ways to collect performance data include the following:
http://www.medinfonow.com/min/ct/5/61666/fuwluz/KAAK/112/default.aspx
Performance Measurement
Performance measurement is an essential part of any effective patient safety program. Without performance measurement, your organization cannot effectively evaluate policies and procedures, staff performance, operations responsiveness, and organization safety. A few common ways to collect performance data include the following:
http://www.medinfonow.com/min/ct/5/61666/fuwluz/KAAK/112/default.aspx
***********************
MONEY MATTERS
Why do hospitals spend huge sums on traveling nurses, agency nurses, overtime, job fairs, and recruiters, rather than pay more for those nursing shifts and units that are most difficult to staff? Why is there a type of mythology that exists in health care that minimizes the impact of money on nurses? Why is it that hospitals are willing to spend huge amounts of money on traveling nurses, agency nurses, and overtime rather that simply pay more for those shifts and units that are most difficult to staff? There are so many examples of the fact that increasing salaries increases nurses' willingness to work. The so-called "Baylor Plan" proved that when hospitals paid significantly more for nurses to work weekend shifts, significantly more nurses were willing to work those shifts.
There is ample evidence that significant differentials for night shifts result in significant increases in nurses who are willing to work nights. How can hospitals justify spending enormous amounts of money on advertisements, job fairs, recruiters, and legions of human resource types for the purposes of increasing their nurse employees rather than simply using that money to increase the salaries of the hard to fill positions?
Research by Peter Buerhaus and colleagues indicates that increasing salaries leads to increased labor participation (see related articles in this issue). Further their research reveals that nurses feel that salaries and benefits are a major cause of the shortage. The nurses also believe that salary increases and bonuses are effective in stimulating nurses to increase their amount of work.... Nurs Econ 25(2) 2007 http://www.medscape.com/viewarticle/556413?src=mp
********************
Thanks to Sandy Summers...April 25, 2007 -- Today Katharyn May, RN, DNSc, FAAN, the Dean of the University of Wisconsin at Madison School of Nursing (right), presented a persuasive lecture entitled: "Nurses Do Research? How Nursing's Public Image Obscures Nursing Science." Dean May includes a good deal of material from the Center to support her argument that nursing research and nursing in general is underfunded in significant part because of a lack of public respect for the profession. This 47-minute lecture is free to all. http://videos.med.wisc.edu/videoInfo.php?videoid=244 then complete the free login page.
********************
********************
Don't ever call Beka Serdans a victim. After suffering for more than a decade with a movement disorder called dystonia, the intensive care nurse from New York City is anything but. In fact, since Jan. 2006, Serdans, RN, MS, NP has been a a survivor and true patient advocate, creating Awareness for Dystonia, a neurological condition that presents itself through involuntary movements, tremors and bizarre postures.It is estimated that over 40 million Americans suffer from a movement disorder, the third most common being dystonia, There is no cure for dystonia today. ( Source : _www.life-in-motion.org_ http://www.life-in-motion.org/) ).
For more Information, contact _www.care4dystonia.org_ (http://www.care4dystonia.org/)
For more Information, contact _www.care4dystonia.org_ (http://www.care4dystonia.org/)
*************************
Mallinckrodt Launches Magnacet(TM) Tablets
ST. LOUIS, June 7 /PRNewswire/ -- Mallinckrodt Brand Pharmaceuticals today announced that it is providing a new pain management drug, called Magnacet(TM) (oxycodone HCl /acetaminophen tablets CII). Magnacet is the only available Oxycodone product coupled with 400mg of acetaminophen, a unique dosage that gives physicians flexibility in treating patients with moderate to moderately severe pain.
Magnacet is indicated for the relief of moderate to moderately severe pain. The most frequently observed adverse reactions include lightheadedness, dizziness, sedation, nausea and vomiting. Oxycodone can produce drug dependence of the morphine-type and, therefore, has the potential for being abused.
http://www.redorbit.com/news/health/960008/mallinckrodt_launches_magnacettm_tablets/index.html?source=r_health
ST. LOUIS, June 7 /PRNewswire/ -- Mallinckrodt Brand Pharmaceuticals today announced that it is providing a new pain management drug, called Magnacet(TM) (oxycodone HCl /acetaminophen tablets CII). Magnacet is the only available Oxycodone product coupled with 400mg of acetaminophen, a unique dosage that gives physicians flexibility in treating patients with moderate to moderately severe pain.
Magnacet is indicated for the relief of moderate to moderately severe pain. The most frequently observed adverse reactions include lightheadedness, dizziness, sedation, nausea and vomiting. Oxycodone can produce drug dependence of the morphine-type and, therefore, has the potential for being abused.
http://www.redorbit.com/news/health/960008/mallinckrodt_launches_magnacettm_tablets/index.html?source=r_health
***********************
this is from BAcello (Barbara).......
Senate Bill Would Create Nationwide Background Checks for Long ...SeniorJournal.com - San Antonio,TX,USA June 8, 2007 - A bill was introduced in the Senate today that would prevent those with criminal histories from working within long-term care settings by ...
http://www.seniorjournal.com/NEWS/Politics/2007/7-06-08-SenateBill.htm
Senate Bill Would Create Nationwide Background Checks for Long ...SeniorJournal.com - San Antonio,TX,USA June 8, 2007 - A bill was introduced in the Senate today that would prevent those with criminal histories from working within long-term care settings by ...
http://www.seniorjournal.com/NEWS/Politics/2007/7-06-08-SenateBill.htm
************************
This also is from BAcello (Barbara)
This also is from BAcello (Barbara)
ICN kit aims to show importance of healthy working conditions The International Council of Nurses has developed a kit that health care professionals can use to demonstrate to lawmakers the link between patient safety and work environments. The ICN created the kit in response to finding that work conditions of nurses are deteriorating in many countries, affecting the recruiting and retention of nurses. http://r.smartbrief.com/resp/hedUnilqnvtvzJrAFE
************************
Clarification: In an earlier version of this story, The Associated Press reported that an American Cancer Society doctor favors keeping current vitamin D guidelines of 200 to 600 international units daily.
Dr. Michael Thun now says he misunderstood a reporter's question and holds no position on whether those amounts should be changed. He also said he thinks it's too early to recommend using vitamin D to prevent
cancer.
OMAHA, Neb. - Building hope for one pill to prevent many cancers, vitamin D cut the risk of several types of cancer by 60 percent overall for older women in the most rigorous study yet.
The new research strengthens the case made by some specialists that vitamin D may be a powerful cancer preventive and most people should get more of it. Experts remain split, though, on how much to take.
"The findings ... are a breakthrough of great medical and public health importance," declared Cedric Garland, a prominent vitamin D researcher at the University of California-San Diego. "No other method to prevent
cancer has been identified that has such a powerful impact." http://www.msnbc.msn.com/id/19098606/
Dr. Michael Thun now says he misunderstood a reporter's question and holds no position on whether those amounts should be changed. He also said he thinks it's too early to recommend using vitamin D to prevent
cancer.
OMAHA, Neb. - Building hope for one pill to prevent many cancers, vitamin D cut the risk of several types of cancer by 60 percent overall for older women in the most rigorous study yet.
The new research strengthens the case made by some specialists that vitamin D may be a powerful cancer preventive and most people should get more of it. Experts remain split, though, on how much to take.
"The findings ... are a breakthrough of great medical and public health importance," declared Cedric Garland, a prominent vitamin D researcher at the University of California-San Diego. "No other method to prevent
cancer has been identified that has such a powerful impact." http://www.msnbc.msn.com/id/19098606/
*****************************
American Chronicle: Using Science To Verify Chinese Medicine Alien Sheng June 15, 2007
Though Chinese medicine has been employed as a proficient approach for over 5,000 years, Western scientific evidence continues to question whether this is a logical approach to aid with treatment. Nevertheless, most medical experts of Western medicine would not find improbable claims that qigong preserves fitness by encouraging relaxation and movement, that acupuncture relieves discomfort by inducing the production of neurotransmitters, or that Chinese herbal medicines may perhaps contain powerful biochemical agents.
If you are interested in Chinese medicine, yet are not sure of its effectiveness, you can inspect the various studies that have aided others to reach conclusions about its influence. Chinese medicine practices are purported by many to be very effective, occasionally providing palliative efficacy where the best practices of Western medicine fail, specifically for usual ailments such as flu and allergies, and managing to evade the toxicity of some chemically composed medicines. http://www.americanchronicle.com/articles/viewArticle.asp?articleID=29745
************************
Pressure Ulcer Stages have been Revised by NPUAP
February 2007 - The National Pressure Ulcer Advisory Panel has redefined the definition of a pressure ulcer and the stages of pressure ulcers, including the original 4 stages and adding 2 stages on deep tissue injury and unstageable pressure ulcers. This work is the culmination of over 5 years of work beginning with the identification of deep tissue injury in 2001.
Pressure Ulcer Definition
A pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction. A number of contributing or confounding factors are also associated with pressure ulcers; the significance of these factors is yet to be elucidated. http://www.npuap.org/pr2.htm
**********************
Hospital -Acquired Hyponatremia Why are Hypotonic Parenteral Fluids Still Being Used? CME
Hospital-acquired hyponatremia can be fatal and can cause neurologic impairment in children and adults, with the main contributory factor being the routine use of hypotonic fluids. It is a condition that can be prevented by avoiding the use of hypotonic fluids and identifying high-risk patients.
http://www.medscape.com/viewprogram/7278?sssdmh=dm1.280025&src=nlcmealert
Hospital-acquired hyponatremia can be fatal and can cause neurologic impairment in children and adults, with the main contributory factor being the routine use of hypotonic fluids. It is a condition that can be prevented by avoiding the use of hypotonic fluids and identifying high-risk patients.
http://www.medscape.com/viewprogram/7278?sssdmh=dm1.280025&src=nlcmealert
~~**~~**~~**~~**~~**~~
HUMOR SECTION
THESE ARE ACTUAL EXCERPTS FROM STUDENT SCIENCE EXAM PAPERS:
Charles Darwin was a naturalist who wrote the organ of the
species.
Benjamin Franklin produced electricity by rubbing cats
backwards.
The theory of evolution was greatly objected to because it
made man think.
Three kinds of blood vessels are arteries, vanes and
caterpillers.
The process of turning steam back into water again is
called conversation.
The Earth makes one resolution every 24 hours.
To collect fumes of sulfur, hold a deacon over a flame
in a test tube.
Algebraical symbols are used when you do not know what
you are talking about.
The pistol of a flower is its only protection against
insects.
Dew is formed on leaves when the sun shines down on
them and makes them perspire.
A super-saturated solution is one that holds more than
it can hold.
A triangle which has an angle of 135 degrees is called
an obscene triangle.
When you haven't got enough iodine in your blood you
get a glacier.
For fractures: to see if the limb is broken, wiggle it
gently back and forth.
To remove dust from the eye, pull the eye down over
the nose.
For asphyxiation: apply artificial respiration until
the patient is dead.
When you smell an odorless gas, it is probably carbon
monoxide.
HUMOR SECTION
THESE ARE ACTUAL EXCERPTS FROM STUDENT SCIENCE EXAM PAPERS:
Charles Darwin was a naturalist who wrote the organ of the
species.
Benjamin Franklin produced electricity by rubbing cats
backwards.
The theory of evolution was greatly objected to because it
made man think.
Three kinds of blood vessels are arteries, vanes and
caterpillers.
The process of turning steam back into water again is
called conversation.
The Earth makes one resolution every 24 hours.
To collect fumes of sulfur, hold a deacon over a flame
in a test tube.
Algebraical symbols are used when you do not know what
you are talking about.
The pistol of a flower is its only protection against
insects.
Dew is formed on leaves when the sun shines down on
them and makes them perspire.
A super-saturated solution is one that holds more than
it can hold.
A triangle which has an angle of 135 degrees is called
an obscene triangle.
When you haven't got enough iodine in your blood you
get a glacier.
For fractures: to see if the limb is broken, wiggle it
gently back and forth.
To remove dust from the eye, pull the eye down over
the nose.
For asphyxiation: apply artificial respiration until
the patient is dead.
When you smell an odorless gas, it is probably carbon
monoxide.
~~**~~**~~**~~**~~**~~
CEU SITES---(CME and CE)
Those that are-----Free and Otherwise..........
CEU SITES---(CME and CE)
Those that are-----Free and Otherwise..........
this site is loaded with CE/CME offerings.......check it out.
(I know of several nurses afflicted with RLS.........so , although this
is for Physicians, thought it would be of interest to nurses, also).
Restless Legs Syndrome: Impact, Recognition, and Management CME
Learn about RLS and its negative impact on quality of life, the
relationship between RLS and psychiatric disorders, ways to improve
diagnosis, and treatment approaches in this video-based Spotlight.
http://www.medscape.com/viewprogram/7193?sssdmh=dm1.275471&src=nlcmealert
Pay Only $34.99 for a full year of CONTACT HOURS
http://www.nursingspectrum.com/
Hospital -Acquired Hyponatremia
Why are Hypotonic Parenteral Fluids
Still Being Used? CME
Hospital-acquired hyponatremia can be fatal and can cause neurologic
impairment in children and adults, with the main contributory factor
being the routine use of hypotonic fluids. It is a condition that can
be prevented by avoiding the use of hypotonic fluids and identifying
high-risk patients.
http://www.medscape.com/viewprogram/7278?sssdmh=dm1.280025&src=nlcmealert
is for Physicians, thought it would be of interest to nurses, also).
Restless Legs Syndrome: Impact, Recognition, and Management CME
Learn about RLS and its negative impact on quality of life, the
relationship between RLS and psychiatric disorders, ways to improve
diagnosis, and treatment approaches in this video-based Spotlight.
http://www.medscape.com/viewprogram/7193?sssdmh=dm1.275471&src=nlcmealert
Pay Only $34.99 for a full year of CONTACT HOURS
http://www.nursingspectrum.com/
Hospital -Acquired Hyponatremia
Why are Hypotonic Parenteral Fluids
Still Being Used? CME
Hospital-acquired hyponatremia can be fatal and can cause neurologic
impairment in children and adults, with the main contributory factor
being the routine use of hypotonic fluids. It is a condition that can
be prevented by avoiding the use of hypotonic fluids and identifying
high-risk patients.
http://www.medscape.com/viewprogram/7278?sssdmh=dm1.280025&src=nlcmealert
~~**~~**~~**~~**~~**~~
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send
them to:
RNFrankie@bellsouth.net.
http://www.thebreastcancersite.com/
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send
them to:
RNFrankie@bellsouth.net.
http://www.thebreastcancersite.com/
******************************************************
******************************************
*
MEDICAL RECALLS
*
***************************************
******************************************************
Cosmos Trading, Inc. and FDA notified consumers and healthcare professionals of a voluntary nationwide recall of a supplement product sold under the name Rhino Max (Rhino V Max) in 5-tablet boxes or 15-tablet boxes. Lab analysis by FDA of product samples found the product contains Aminotadalafil, an analogue of Tadalafil, an FDA-approved drug used to treat Erectile Dysfunction (ED). FDA advised that this poses a threat to consumers because Aminotadalafil may interact with nitrates found in some prescription drugs (such as nitroglycerin) and may lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take nitrates. Consumers who have Rhino Max (Rhino V Max) in their possession should stop using it immediately and contact their physician if they experienced any problem that may be related to taking this product. http://www.fda.gov/medwatch/safety/2007/safety07.htm#Rhino
*******************
FDA notified healthcare professionals and consumers of its request that all manufacturers of sedative-hypnotic drug products, a class of drugs used to induce and/or maintain sleep, strengthen their product labeling to include stronger language concerning potential risks. These risks include severe allergic reactions and complex sleep-related behaviors, which may include sleep-driving. Sleep driving is defined as driving while not fully awake after ingestion of a sedative-hypnotic product, with no memory of the event. FDA also requested that each product manufacturer send letters to health care providers to notify them about the new warnings, and that manufacturers develop patient Medication Guides for the products to inform consumers about risks and advise them of potential precautions that can be taken.
http://www.fda.gov/medwatch/safety/2007/safety07.htm#Sedative
*******************************
FDA informed healthcare professionals that Custom Ultrasonics agreed to stop manufacturing and distributing its System 83 Plus Washer/Disinfector and the System 83 Plus Mini-flex Washer/Disinfector, used to wash and disinfect flexible endoscopes, until it brings its manufacturing methods and controls into compliance with FDA requirements. Endoscopes that are not properly cleaned and disinfected can be a source of transmission of pathogens between patients, causing life threatening infections. FDA advised health care providers to discontinue using these products, using an alternative device or following appropriate protocols to manually wash and disinfect the device.
http://www.fda.gov/medwatch/safety/2007/safety07.htm#System83
http://www.fda.gov/medwatch/safety/2007/safety07.htm#Sedative
*******************************
FDA informed healthcare professionals that Custom Ultrasonics agreed to stop manufacturing and distributing its System 83 Plus Washer/Disinfector and the System 83 Plus Mini-flex Washer/Disinfector, used to wash and disinfect flexible endoscopes, until it brings its manufacturing methods and controls into compliance with FDA requirements. Endoscopes that are not properly cleaned and disinfected can be a source of transmission of pathogens between patients, causing life threatening infections. FDA advised health care providers to discontinue using these products, using an alternative device or following appropriate protocols to manually wash and disinfect the device.
http://www.fda.gov/medwatch/safety/2007/safety07.htm#System83
***************************
Alcon Refractive Horizons and FDA notified healthcare professionals and patients of a Class I Recall of the LADAR6000 Excimer Laser System for CustomCornea algorithm for myopia with astigmatism (M3) and myopia without astigmatism (A7). This system is used for LASIK and wave-front guided LASIK treatment for the reduction or elimination of mild to moderate nearsightedness (myopia) and farsightedness (hyperopia) with or without astigmatism or for mixed astigmatism in patients who are 21 years of age or older with documented stability of refraction for the prior 12 months. The product was recalled because use of the Alcon Refractive Horizons CustomCornea algorithm for myopia with and without astigmatism with the LADAR6000 Excimer Laser caused corneal abnormalities ("central islands") and decreased visual sharpness (visual acuity) in patients with myopia with and without astigmatism. These "central islands" may not be correctable with lasers and the decrease in visual acuity may not be correctable with glasses or contact lenses. Patients with questions should call the company at 1-877-523-2784.
http://www.fda.gov/medwatch/safety/2007/safety07.htm#LADAR6000
http://www.fda.gov/medwatch/safety/2007/safety07.htm#LADAR6000
~~**~~**~~**~~**~~**~~
NURSING HINTS CORNER
When treating a patient's sore throat with an anesthetic antixeptic like
NURSING HINTS CORNER
When treating a patient's sore throat with an anesthetic antixeptic like
chloraseptic, you can easily get some of the spray on the tongue. Then the patient's throat may feel better, but he has the discomfort of a numb tongue. [To prevent this from happening] ... , invert the bowl of a teaspoon over the patient's tongue and then spray his throat. The spoon not only protects his tongue from the spray, but also depresses the tongue so you can see the area of the throat that's red and sore.
Used with permission from 1,001 Nursing Tips & Timesavers, Third
Edition, 1997, p. 60 Springhouse Corporation/www.springnetcom.
Used with permission from 1,001 Nursing Tips & Timesavers, Third
Edition, 1997, p. 60 Springhouse Corporation/www.springnetcom.
~~**~~**~~**~~**~~**~~
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.
Visit us at http://www.accu-ruler.com/ .
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.
Visit us at http://www.accu-ruler.com/ .
~~**~~**~~**~~**~~**~~
This ad is from: GShort @AOL.com (Gwen) These are great little cakes !
http://www.delightfulgreetingcakes.com/worldsgreatest.php
This ad is from: GShort @AOL.com (Gwen) These are great little cakes !
http://www.delightfulgreetingcakes.com/worldsgreatest.php
~~**~~**~~**~~**~~**~~
NEW MEMBERS
JudyK0652@hotmail.com (Judy) July 27, 2007
NOTICE: I attempt to send newsletters to your current 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
NEW MEMBERS
JudyK0652@hotmail.com (Judy) July 27, 2007
NOTICE: I attempt to send newsletters to your current 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: rnfrankie@bellsouth.net (Frankie)
NEW ADDRESS: RNFrankie@AOL.com (Frankie)
~~**~~**~~**~~**~~**~~
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)
Membership BIO Committee...(if you haven't sent in your BIO....Please
send it to the appropriate section below) : Check by your screen
name's first letter.........
BCK131 @AOL.com (Chris) A thru B section,
Dick515 @AOL.com (Eileen) C thru D section,
GALLO RN@AOL.com (Sue) E thru I section,
RNFrankie@AOL.com (Frankie) J thru K section,
Jntcln@AOL.com (Janet) L thru M section,
GALLO RN @AOL.com (Sue) N thru Q section
Schulthe@AOL.com (Susan) R thru T section
Sandy1956@AOL.com (Sandy) U thru Z section.
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)
Membership BIO Committee...(if you haven't sent in your BIO....Please
send it to the appropriate section below) : Check by your screen
name's first letter.........
BCK131 @AOL.com (Chris) A thru B section,
Dick515 @AOL.com (Eileen) C thru D section,
GALLO RN@AOL.com (Sue) E thru I section,
RNFrankie@AOL.com (Frankie) J thru K section,
Jntcln@AOL.com (Janet) L thru M section,
GALLO RN @AOL.com (Sue) N thru Q section
Schulthe@AOL.com (Susan) R thru T section
Sandy1956@AOL.com (Sandy) U thru Z section.
~~**~~**~~**~~**~~**~~
PARADIGM97 CO-FOUNDERS:
MarGerlach@AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)
PARADIGM97 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.
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
When will our consciences grow so tender that we will act
to prevent human misery rather than avenge it?
--ELEANOR ROOSEVELT
It is the spirit and not the form of law that keeps
justice alive.
--EARL WARREN
Hope to see you online..... Frankie
(RNFrankie@AOL.com)
THOUGHT FOR THE DAY
When will our consciences grow so tender that we will act
to prevent human misery rather than avenge it?
--ELEANOR ROOSEVELT
It is the spirit and not the form of law that keeps
justice alive.
--EARL WARREN
Hope to see you online..... Frankie
(RNFrankie@AOL.com)
