Saturday, September 6, 2008

PARADIGM BYTES-- September 2008


PARADIGM BYTES

Newsletter for Paradigm 97
September 8, 2008

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/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.

~**~~**~~**~~**~~**~~
Please drop in . the Paradigm97 chatroom is always there....door open, lights on, waiting for you to come in. Check your Buddy List.....and invite your friends in for a little chat. Let me know if you want others involved.
***~~~***~~~***~~~***
SNIPPETS
This piece by Wendie is in response to a website :
http://healthypeople.gov/ by : Penelope Royall, MSW, PT
Wendie A. Howland RN MN CRRN CCM "I am absolutely astonished that your process completely ignores the largest and most respected group of health care givers and educators in the United States: NURSES. I knew about this when I came to this website to leave a comment, and was even more angered when registering-- this is why you will find me, and other nurses, under "OTHER." Shame on you for your blindness (speaking of vision services). As my grandmother used to say, there are none so blind as those who will not see. Look around you.When you go to the hospital for care, your health insurance plan (if you are fortunate enough to have one) doesn't pay for inpatient services for doctor care, it pays because you need nursing care-- you can look it up. Nurses are the ones staffing the clinics and storefront services and public health departments serving the people most in need of help to become healthy. Nurses are doing the teaching, scrounging for the resources, handing out the medications for directly-observed therapy (you can look that up, too), unearthing unhealthy living conditions, identifying malnutrition and abuse in children and elders, supporting new mothers and infants, assessing living quarters. Nurses provide case management services for thousands of injured workers to bring health and recovery after injury-- how much money does that save the insurance industry? Nurses care for children in our schools-- and if you look that up, you'll find that it's not the school nursing of a generation ago, where all the school nurse did was give out aspirins to teens with cramps or bandaids for skinned knees, now that children with tracheostomies, feeding tubes, and serious developmental and physical needs are being mainstreamed. Nurses run clinics for the homeless men and women who need their psych and substance abuse problems dealt with. Nurses run clinics for immigrants with no insurance, food, medicine, or education. Nurses run rehabilitation units for head injured persons and make it possible for people to leave institutional care or live out their lives safely at a lower level of care. Nurses are the heart of hospice care, which is growing in prominence year by year; perhaps your mother or you yourself will benefit by their expertise. Nurse researchers enlighten us all by identifying best practices not merely for in-hospital care, but in every area of human life and function, in every quarter of our land.Now, then. Tell me again, oh Penelope Royall, MSW, PT, that you weren't able to identify ONE nurse with a "familiarity with the purpose of Healthy People or other similar measures of health"? That you couldn't look for a nurse with some fit for your desire for geographic distribution, race, or gender diversity? You couldn't find one nurse with knowledge of health promotion and disease prevention? Something tells me that either you have never been ill, never had a parent hospitalized, or never had a neuropsychiatric evaluation, because your cognitive skills of observation, problem-solving, and higher executive function (in the technical sense of the words) are impaired, as evidenced by the fact that... Well, you couldn't possibly have missed .... nurses.
Healthy People is managed by the Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services
~~**~~**~~**~~**~~**~~
FROM THE MEMBERS

This did not happen to me....it was forwarded to me by a member. She wrote: " We have had enormous trouble with brand new tires. On one recent trip to Austin, we had to drive on a rim for 3 hours in an area we were unfamiliar with late at night because we blew a tire, put on the spare, and it blew out in less than 2 miles. We were trying to get to the WalMart 5 miles down the road to buy new tires before they closed at 9 pm. We did not make it. We left the house with 4 new looking tires and a good spare. We did not make it to our destination that night. We were fortunate, though. People get killed changing tires in Texas............When we found a tire shop that happened to be open at midnight, we bought 2 brand new tires. This was not a discount store. My husband just checked the tires we bought that night, which was about 2 months ago. The date on the tires is from the 17th week of 2006, so our "new" tires were actually over 2 years old when we bought them. At any rate, this report got my attention. It also got my husband's, and he is capable enough to build a car from the ground up. He did not know how to decode the tire dates". http://abcnews.go.com/Video/playerIndex?id=4826897&affil=wfaa ~~**~~**~~**~~**~~**~~
MEDICAL NEWS
According to Lanette Anderson,( http://www.nursetogether.com/tabid/169/itemid/516/Lanette-L-Anderson-MSN-JD-BBA-RN.aspx) nurses can play an important role in the policies shaping the nursing profession today. She states "one of the easiest ways to get started with this endeavor is to seek out and become a member of the nursing association in your local area, the American Nurses Association, or both."
We are proud to present her 3 part series on the importance of the involvement of nurses, both individually and as a profession, in politics and policy development.
~~**~~**~~**~~**~~**~~
INTERESTING READING

Please remember that the REUTERS articles are usually good for only 30 days.
Attn: Psych nurses: NAMI is conducting a survey of individuals living with serious mental illnesses and their family members. Help NAMI understand the real world experiences of individuals who need public mental health services. NAMI is working with TeleSage to conduct an online survey to learn about how well states are providing publicly funded mental health services. .
The survey:
is available online through September 30, 2008;
takes only about 10-15 minutes to complete;
is completely anonymous (NAMI will have no way of identifying you or your family member);
was created in partnership with TeleSage, a leading independent survey technology company.
The results of the survey will be summarized and incorporated into the NAMI report, Grading the States 2009, which will be released in early 2009. To participate in this survey, you must be 18 years or older and have been diagnosed with a serious mental illness or have a family member who has been diagnosed with a serious mental illness (for example, schizophrenia, major depression, bipolar disorder, etc.) Click here for more information and to begin the survey.
******************************
Just had to include this Random Fact: Q: How many times can a flea jump without stopping?
RANDOM FACT... A flea can jump 30,000 times without stopping.
*****************************
In response to the letter received from the Tri Council for Nursing: ( http://www.capitolupdate.org/Newsletter/index.asp?nlid=206&nlaid=1022 ) The NNNO Board of Directors believes the nursing organizations should and do advocate for nurses. The Office of the National Nurse initiative is designed to advocate for the health of Americans. That’s the difference. The fact that nurses are pushing for it and that over 50 international, national, and state organizations are in support indicates that the message resonates with their members, and that nurses are interested in focusing on the health of Americans. At the same time, nurses want safe working conditions, decent salaries, and so forth. There is room for both types of advocacy.... www.nationalnurse.org
******************
Newswise — Hospitals can now identify the most important strengths and weaknesses in their disaster response plans using a new tool from the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality.Ensuring that hospitals are prepared to respond appropriately during any type of disaster situation – manmade or natural – is a priority for HHS. Beginning in September, hospitals participating in the Hospital Preparedness Program, administered through HHS, will be required to provide executive summaries of the results of disaster drills they conduct. AHRQ’s new Tool for Evaluating Core Elements of Hospital Disaster Drills can help hospitals meet this requirement. <> The tool is a series of evidence-based modules that provide standardized checklists to document observations during a disaster drill. Using the observations, hospitals can identify areas for improvement, make appropriate changes and set benchmarks to track those changes over time.... The Tool for Evaluating Core Elements of Hospital Disaster Drills is available on the AHRQ Web site at: http://www.ahrq.gov/prep/drillelements .

******************
RANDOM FACT. Coconuts kill more people in the world than sharks do. Approximately 150 people are killed each year by coconuts. ******************
(Reuters 8/29) - Walking on a treadmill three times a week helped stroke survivors improve their mobility and physical conditioning but also led to a "rewiring" of the brain reflecting these gains, U.S. researchers said on Thursday. "I think it's one of the better pieces of news in a while -- in a long while -- for the stroke survivor," Dr. Daniel Hanley, a neurology professor at Johns Hopkins University School of Medicine in Baltimore who helped lead the study, said in a telephone interview. "Improvement can occur a long time -- meaning months and years -- after the stroke," added Hanley, whose findings were published in the American Heart Association's journal Stroke.
Stroke survivors can be left with paralysis or loss of muscle movement. A stroke can impair a person's gait, reducing one's mobility and fitness and promoting chronic disability.... http://www.reuters.com/article/healthNews/idUSN2829098620080828?feedType=nl&feedName=ushealth1100
********************
This letter caught my attention....... first the question by a nurse in Australia who wrote:

"Cindi, I found an eight year old Infection Control Resource Package. It says that VRE are a very hardy organism and can survive in the environment and on the hands of hospital personnel. It mentions strict adherence to glove wearing but also to handwashing with an ANTISEPTIC agent.We've had only one obs machine for thirty patients. The other one has been in the VRE room for the last six months. This means that quite a few patients are getting their mane meds (most are on antihypertensives) without obs being done. I decided to get the machine out of the VRE room. I took it straight from her room into an outdoor courtyard nobody uses. It took a long time to alcowipe the entire machine and get in all the grooves. When I got to the cuff I couldn't alcowipe the velcro part. I got hot soapy water and washed it in that. Unfortunately the bucket I used is the only one on the ward and is used for discharge cleans. I washed it out several times after using it. Do you think the obs machine will be clean enough? I am aware that buckets are supposed to be dedicated for infectious cleans but we only had the one".
****
Cindi, our newest member answered :
"Ahhhh, you warmed my Infection Prevention and Control heart with this!!!! You are correct - enterococci (either resistant or non-resistant) can live in the environment for prolonged periods of time. It has been cultured from just about anything in the patient environment, and also from "moveable" items such as the obs machines, stethoscopes and narcotic keys. That is why the focus is on meticulous cleaning and meticulous hand hygiene - also the rationale for appropriate PPE when in the patient environment.What you describe regarding your cleaning frenzy certainly would be clean enough (and likely cleaner than it has ever been!!!!) Our policy here is to wipe down any moveable equipment with either alcohol wipes or the accelerated hydrogen peroxide agent we use for general housekeeping if we are unable to dedicate that piece specifically to the isolated patient.Having said that, we should be wiping shared equipment between each and every patient (back to that nice to know who's positive but you betcha there are some unidentified ones out and about premise). Your actions with the bucket are sufficient". Cindi ( clwigston@osmh.on.ca)

**********************
TODAY'S RANDOM FACT..Tibet is the highest country in the world. Its average height above sea level is 4500 meters.
**********************
Potent new anti-cancer agents have armed nurses with precision tools in fighting the disease, but they also come with a mandate to learn how they work, about potential side effects, and how to educate patients. The latest wave of cancer treatments, called targeted therapies, broadly fall into two groups: monoclonal antibodies and small molecules. Monoclonals are molecules that are cloned and mass-produced in a lab. They can locate and bind to a cancer cell, marking the cell and inhibiting its growth. Small molecules block enzymes and receptors involved in cancer-cell growth and proliferation. Since the therapies work by interfering with the pathways in which a normal cell becomes a cancer cell, they are less likely to kill surrounding healthy cells than treatments such as radiation and chemotherapy.... http://include.nurse.com//apps/pbcs.dll/article?AID=/20080825/NATIONAL01/108250091/-1/frontpage
*********************** RANDOM FACT... Mosquitos have 47 teeth.
********************
Reuters 8/6 Every U.S. adult could be overweight in 40 years if current trends continue, a study by the Agency for Healthcare Research and Quality says. Weight problems will be most acute among blacks and Mexican-Americans, the study said. Researchers called for a societal effort to improve lifestyles and diets, such as offering more pedestrian-friendly communities and healthier choices from the food industry. http://www.reuters.com/article/wtMostRead/idUSCOL66909620080806
********************
Most Youth With Mental Health Disorders Do Not Receive Recommended Care August 20, 2008 — Concerned that up to 75% of US children and adolescents with mental health disorders do not receive evidence-based treatment, an American Psychological Association (APA) task force is calling for greater dissemination of guidelines among mental health professionals.
Released at the American Psychological Association 116th Annual Convention in Boston, Massachusetts, the report recommends that psychologists — in collaboration with psychiatrists, school psychologists, social workers, and counselors — work to ensure that evidence-based practices for mental health disorders are rapidly disseminated to practitioners and integrated into clinical practice and mental health policies.... http://www.medscape.com/viewarticle/579350
*******************
TODAY'S RANDOM FACT... The most money ever paid for a cow in an auction was $1.3 million.
*****************************
Arsenic in the U.S. Water Supply Linked to Diabetes, Study Says Aug. 19 (Bloomberg) -- Arsenic, a toxic chemical often found at low levels in U.S. public drinking water, may increase the risk of developing diabetes, researchers said.
In the first study of its kind, scientists found Americans with high levels of arsenic in their urine were almost four times more likely to have diabetes than those with trace levels. The risk was apparent at levels generally considered harmless and grew with increasing exposure, according to the study in the Journal of the American Medical Association. The findings follow recent studies on contaminants, including hormones and antibiotics, making their way into U.S. public tap water. While previous research showed chronic exposure to high levels of arsenic could lead to diabetes, the new report is the first to show that even levels that meet U.S. regulations may be dangerous.... http://www.bloomberg.com/apps/news?pid=20601202&sid=atpvvu8kanZ8&refer=healthcare
**********************
In the international literature, the most commonly recommended intervention for managing oral mucositis is good oral care, assuming that nurses have sufficient knowledge and skills to perform oral care correctly. The aim of the present study was to investigate if knowledge and skills about oral care improve when education in oral care is provided to nurses in charge of patients who are at risk of oral mucositis. This intervention study consists of a baseline test on the knowledge and skills of nurses of the haematology wards of two different hospitals. Oral care education sessions were given in one hospital and follow-up tests were performed in both hospitals. Nursing records were examined and observations of nurses performing oral care were made at baseline as well as at follow-up. The results show significant differences in the scores for knowledge and skills before and after the education, whereas there was no difference in scores at the two points in time for the comparison hospital, where no education had taken place. The records test showed no differences at baseline or follow-up for the two groups. Observations showed that nurses who followed the education session implemented the oral care protocol considerably better than those who did not attended. Education in oral care has a positive influence on the knowledge and skills of nurses who care for patient at risk of oral mucositis, but not on the quality of oral care documentation.... http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WF1-4SDNG7B-1&_user=10&_coverDate=05%2F02%2F2008&_rdoc=11&_fmt=high&_orig=browse&_srch=doc-info(%23toc%236781%239999%23999999999%2399999%23FLA%23display%23Articles)&_cdi=6781&_sort=d&_docanchor=&_ct=13&_version=1&_
urlVersion=0&_userid=10&md5=766186da21c059700ee7fea467ad8e9d
***************************
Which fruit is the clear front-runner when it comes to antioxidants? Hint: It’s smaller than a grape and darker than a blueberry. It’s the acai (pronounced "ah-sigh-EE") berry, and it may beat every other fruit or vegetable by a mile. Case in point: The freeze-dried berry has 30 times the disease-arresting anthocyanins of red grapes. Cholesterol, Cancer, and . . .The berries are so nutritious, writes John La Puma, MD, author of ChefMD’s Big Book of Culinary Medicine, that they may help lower bad cholesterol, inhibit inflammation, and fight off arthritis. They may even have cancer-fighting powers. In a lab study, acai berry extract killed between 45 and 86 percent of a sample of human leukemia cells. (Browse La Puma’s book online.) When it comes to acai, we like concentrated powder for its ease of use and wallet-friendly price. The powder’s lots more affordable than the pills or liquid, and you can use it in so many ways! Yogurt, juice, shakes, oatmeal, ice pops? How do you acai? Reference: ChefMD’s Big Book of Culinary Medicine. La Puma, J., New York: Crown Publishers, 2008.
************************
Curls and sit-ups can definitely help tone your abs, but a new study suggests something else might work better. Seems counterintuitive, but working your upper body may be the quickest path to a really sculpted middle. Above-the-Belt ActionIn a study, women did isometric exercises for their stomach, back, shoulders, and arms while researchers measured muscle activity. The results? Shoulder extensions made middle-body muscles contract most -- apparently they work extra hard to stabilize your trunk when your wings are flapping. (Watch this strength-training video to learn how building 5 extra pounds of muscle could burn 26 pounds of fat in a year.) Full-Body FitnessSome more ways to get your midsection -- and whole body -- into mint condition:
Roll out the ball. For strong core muscles and better balance, do tummy and back toners on an exercise ball. Follow these simple steps.
Add resistance. Use weights or resistance bands for extra burn. Use this tool to create a 20-minute workout with or without equipment.
This quick 30-minute workout for arms, back, and shoulders sculpts areas that some DVDs barely touch. No aerobics here -- it uses a blend of yoga and Pilates to target those areas, delivering focused strengthening right where we all need it.

********************* Another superfruit you may not know: (Try something different. Add a little lychee to your fruit salad. Not only will it add an exotic tickle for your taste buds, but it will tickle your ticker, too. When scientists recently measured the heart-helping polyphenol content of fruits popular in France, lychees were bested only by strawberries.Grapes came in third. http://www.realage.com//ct/tips/6183 ) ************************ RANDOM FACT... Worcestershire Sauce is basically an Anchovy ketchup. . ************
(Reuters) - Keeping a food diary -- a detailed account of what you eat and drink and the calories it packs -- is a powerful tool in helping people lose weight, U.S. researchers said on Tuesday.
The study involving 1,685 middle-aged men and women over six months found those who kept such a diary just about every day lost about twice as much weight as those who did not The findings buttressed earlier research that endorsed the value of food diaries in helping people lose weight. Companies including Weight Watchers International Inc use food diaries in their weight-loss programs. http://www.reuters.com/article/healthNews/idUSN0741885020080708?feedType=nl&feedName=ushealth1100
*************************
RANDOM FACT.. It took 20,000 men 22 years to build the Taj Mahal. .
*********************
People recover faster after surgery for ankle fracture if they are given a cast or splint that can be removed to let them exercise the ankle, than if their foot is placed in an immobilising plaster cast. If the fracture is stable, then encouraging them to walk soon after surgery is also beneficial. However, increased activity does increase the chance of experiencing problems with the surgical wound. These conclusions are published in a systematic review included in the latest update of The Cochrane Library.Ankle fracture is one of the most common fractures of the lower limb, especially in young men and older women. In about half of the cases, the broken bone requires surgery to realign the bones, and then the lower leg and foot are placed in a cast to immobilise and protect the area.The problem with immobilisation is that it can lead to pain, stiffness, weakness and swelling in the ankle. A team of Cochrane Researchers therefore looked to see whether there was evidence that using removable casts or splints can improve outcome.The researchers found only limited evidence, but current research indicated that removable casts or splints which allow the ankle to be exercised soon after surgery reduced pain and increased mobility when compared to using a traditional plaster cast. But early exercise on the ankle also led to increased (albeit mainly minor) adverse events, such as problems with the surgical wound and changes in skin sensation.“Getting a patient to exercise soon after surgery has significant benefits, but the increased risks to the wound show that you need to make sure that a person can do this safely before supplying them with a removable cast or splint instead of a standard cast,” says Christine Lin, who works at the Musculoskeletal Division of The George Institute for International Health, Australia.Lin CWC, Moseley AM, Refshauge KM. Rehabilitation for ankle fractures in adults. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD005595. DOI: 10.1002/14651858.CD005595. pub2.
Cochrane Bone, Joint and Muscle Trauma Group.
*********************
RANDOM FACT... The temperature of Earth near the center, is thought to be at least 7,000 degrees Fahrenheit (3,870 Celsius).
*********************
(Sorry, not sure where I got this.....probably from the list serve)
There's little guidance regarding the frequency of vital signs. Surprising when you consider how much we do them. I found recommended frequencies, not based on evidence. For first 24 hours post admission from ED or ICU: 4/24 obs Following first 24 hours for next 3 days: QID After 4 days if clinically stable: Daily Non-acute patient on the ward: Daily (if assessed clinically stable) 1999Frequency of Vital Signs There is only limited information regarding the frequency with which patient observation should be undertaken and much of this is based on surveys of nurses, clinical practice reports and expert opinion.Surveys of nurses have shown that many admit to carrying out frequent vital sign measurements on patients they believed did not require them, and that they had become a routine procedure unrelated to perceived individual patients needs.2006. The optimal frequency of vital sign measurement has yet to be elucidated, mainly because it has received limited attention.27 The few studies that have evaluated a reduction in vital sign frequency report only superficial change during the care of a specific group of patients. Thus, to date, the frequency of vital signs in clinical practice is based on either expert opinion or tradition rather than research evidence.27 Hence, the importance of our study is that it puts into question the specific role of rigorous vital sign determination. It is our experience that repeatedly frequent vital signs did not contribute to earlier recognition of adverse outcomes resulting in transfers to the ICU and, more significantly, did not alter survival.
In conclusion, we recommend that routine frequent vital sign determination might not be needed for all patients, and the frequency of measurement should at least be Q8H and not more often. In addition, the clinical practice of utilization of vital signs should be individualized to each patient; this will not only lead to a more efficient allocation of nursing resources but also will increase patient privacy and satisfaction.
****************
This was sent in by BAcello (thank you): [Free registration required........worth reading]
United States: Employers Must Make Meal And Rest Breaks Available To Non-Exempt Workers;From Fenwick & West LLP http://www.mondaq.com/news.asp?e=1&a=64018
*****************
RANDOM FACT... Raindrops can fall as fast as 20 mph.
*****************
Concentrated Immunotherapy feasible in High=Risk Pediatric sarcoma Stimulating the immune system after chemotherapy shows promise in treating children with high-risk sarcoma, researchers said...
http://www.medpagetoday.com/HematologyOncology/OtherCancers/tb/10369
*****************
(Reuters 8/4) - Governments and health communities need to ramp up male circumcision to prevent HIV infection, particularly in vulnerable countries in eastern and southern Africa, researchers and advocates said on Monday.
Three studies were cut short in 2006 after they showed strong evidence that male circumcision could prevent HIV infection, but very little effort has been made to push for more men to go under the knife, they told a conference on AIDS in Mexico City.
"This is a call to action... to call for male circumcision. It's been two years and still there is not enough money, focus to scale up effort and more needs to be done," said Dvora Joseph, head of the HIV department at Population Services International, a U.S.-based nonprofit organization.... http://www.reuters.com/article/healthNews/idUSN0463420080805?feedType=nl&feedName=ushealth1100
**********************
RANDOM FACT... On average, you'll spend a year of your life looking for misplaced objects.
~~**~~**~~**~~**~~**~~
HUMOR SECTION
Subject: credit card debt Cancel your credit card before you die..........

Now some people are really stupid!!!! Be sure to cancel your credit cards before you die This is so priceless, and so, so easy to see it happening, customer service being what it is today.
A lady died this past January, and Citibank billed her for February and March for their annual service charges on her credit card, and added late fees and interest on the monthly charge. The balance had been $0.00 when she died, but now is somewhere around $60.00. A family member placed a call to Citibank. Here is the exchange :
Family Member: 'I am calling to tell you she died back in January.'
Citibank : 'The account was never closed and the late fees and charges still apply.'
Family Member : 'Maybe, you should turn it over to collections.'
Citibank : 'Since it is two months past due, it already has been.'
Family Member : So, what will they do when they find out she is dead?'
Citibank : 'Either report her account to frauds division or report her to the credit bureau, maybe both!'
Family Member : 'Do you think God will be mad at her?'
Citibank: 'Excuse me?'
Family Member : 'Did you just get what I was telling you - the part about her being dead?'
Citibank : 'Sir, you'll have to speak to my supervisor.' Supervisor gets on the phone:
Family Member : 'I'm calling to tell you, she died back in January with a $0 balance.'
Citibank : 'The account was never closed and late fees and charges still apply.'
Family Member : 'You mean you want to collect from her estate?'
Citibank : (Stammer) 'Are you her lawyer?'
Family Member : 'No, I'm her great nephew.' (Lawyer info was given)
Citibank: 'Could you fax us a certificate of death?'
Family Member : 'Sure.' (Fax number was given )
After they get the fax : Citibank : 'Our system just isn't setup for death. I don't know what more I can do to help.'
Family Member : 'Well, if you figure it out , great! If not, you could just keep billing her. She won't care.'
Citibank: 'Well, the late fees and charges do still apply.' (What is wrong with these people?!?)Family Member : 'Would you like her new billing address?'
Citibank : 'That might help...'
Family Member : ' Odessa Memorial Cemetery , Highway 129, Plot Number 69.'
Citibank : 'Sir, that's a cemetery !'
Family Member : 'And what do you do with dead people on your planet???
(Priceless!!)
~~**~~**~~**~~**~~**~~
CEU SITES---(CME and CNE)
The above are FREE

~~**~~**~~**~~**~~**~~
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to: RNFrankie@AOL.com.
http://www.snopes.com/ Please use this site to verify rumors.

the National Nurse's website: http://nationalnurse.org/

http://safestaffingsaveslives.org/ Register your opinion on safe staffing, please

This site has passed the Snopes.com test
http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3

How ethical are you? Take the Quiz: http://jobs.aol.com/quiz/ethics?ncid=AOLCOMMjobsDYNLprim0001&icid=200100397x1207917944x1200447018

************************
Information on mesothelioma is available at theMesothelioma Applied ResearchFoundation web site at _ http://www.marf.org/_ (http://www.marf.org/ )

http://listserv.acor.org/archives/mesothelioma.html
************************
Xlylitol (a sugar substitute) is in sugar-free gum and is deadly to your dog. Causes the blood sugar to drop precipitously.....and the dog dies within hours. http://www.snopes.com/critters/crusader/xylitol.asp

*****************************
********************************************
*
MEDICAL RECALLS
*
*******************************************
*****************************
FDA informed healthcare professionals of two new cases of progressive multifocal leukoencephalopathy (PML) in European patients receiving Tysabri monotherapy for multiple sclerosis for more than one year. PML, which is usually fatal, is a known risk of Tysabri treatment, but previous cases in patients with multiple sclerosis were seen in combination with other immunomodulatory therapies. Approximately 39,000 patients have received treatment with Tysabri worldwide, with approximately 12,000 patients receiving treatment for a least one year. No new cases have been seen in the US, where about 7,5000 patients have received the drug for greater than one year and approximately 3,300 patients have received the drug for at least one and one-half years. In the U.S., Tysabri is available only to patients with relapsing multiple sclerosis or Chron's disease who are enrolled in the risk minimization plan called the TOUCH Prescribing Program. Under this program, every Tysabri-treated patient is closely monitored and followed for the occurrence of PML and other serious opportunistic infections. While the two patients who developed PML were on monotherapy, the FDA still believes that Tysabri monotherapy may confer a lower risk of PML than when Tysabri is used together with other immunomodulatory medications. Prescribing information for Tysabri will be revised to include information informing prescribers and patients that cases of PML have occurred in patients taking Tysabri as monotherapy. Healthcare professionals should continue to monitor patients for sign and symptoms of PML. Additionally, Tysabri should not be infused if PML is suspected. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Tysabri2
**************************
FDA informed healthcare professionals that the Agency is investigating a report from the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) trial of a possible association between the use of Vytorin and a potentially increased incidence of cancer. Vytorin is a combination product of simvastatin and ezetimibe used to decrease the production of cholesterol by the liver and inhibit the absorption of cholesterol in the intestine to reduce LDL-cholesterol levels and reduce the risk of cardiovascular events. Recently, FDA obtained preliminary results from the SEAS trial. The clinical trial tested whether lowering LDL-cholesterol with Vytorin would reduce the risk of cardiovascular events in individuals with aortic stenosis. A lower overall cardiovascular risk was not found with Vytorin. However, there was an additional observation that a larger percentage of subjects treated with Vytorin were diagnosed with and died from all types of cancer combined when compared to placebo during the 5-year study. FDA anticipates receiving a final SEAS study report in about 3 months and the Agency's review and evaluation of the clinical trial data and other relevant information should take approximately 6 months. FDA will communicate its conclusions and recommendations at that time. Healthcare professionals and caregivers should continue to monitor patients taking Vytorin and report side effects from the use of this drug to the Agency.
http://www.fda.gov/medwatch/safety/2008/safety08.htm#ezetimibe2
*************************
Pacific Consolidated Industries, LLC, and FDA notified healthcare professionals of the Class I Recall of the Mobile Oxygen Storage Tank manufactured and distributed between January - March 2007, because the device's pressure gauge may rupture and may catch fire as a result of hydraulic fluid present in the pressure gauge tubing. The mobile oxygen storage tank is used in military aircraft for treating wounded patients and in disaster areas to quickly supply oxygen to patients. Facilities with the Mobile Oxygen Storage Tank should keep the device in quarantine until arrangements are made to ship the device back to the manufacturer. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Pacific

~~**~~**~~**~~**~~**~~
NURSING HINTS CORNER
This is really a good nursing hint: leg elevation: Critical for lower leg/foot wounds.
I recommend the dual position bed wedge product. In Health Living catalog, item 22176 and costs $17.99. For an extra $ 7.99, you can get a removable cover. It has egg crate material on blue foam base. 1-800-800-0100
~~**~~**~~**~~**~~**~~
ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.Visit us at http://www.accu-ruler.com/.
~~**~~**~~**~~**~~**~~
This ad is from: GShort @AOL.com (Gwen) These are great little cakes ! http://www.delightfulgreetingcakes.com/worldsgreatest.php
~~**~~**~~**~~**~~**~~
This ad is from Wendie (The Inservice guru)
The eLifeCard can save your life when seconds count! Carry this life-saving card in your wallet in case of emergency at home, at work, at school, traveling, or on vacation! NEW online estate planning system membership makes it possible for you to buy, upload, change and securely store your health care directive, allergies and medication lists, emergency contacts, and more. Exceptional package of other benefits. Give yourself and your family the gift of peace of mind. For FREE information, email name & phone number. All responses kept confidential and answered promptly. Wendie Howland, CEO Miracle Group TFN Affiliate #10136 508-564-9556 (office) 915-990-1367 (fax) whowland1@mac.com www.thefoundationnetwork.com
~~**~~**~~**~~**~~**~~
NEW MEMBERS

Welcome to:

CLWigston@osmh.on.ca (Cindi) 8/22/08

losroundtree@yahoo.com (Carlos) 9/4/08

Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
~~**~~**~~**~~**~~**~~
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, okay? RNFrankie@AOL.com
No address changes this month

~~**~~**~~**~~**~~**~~

EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), 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 intellect has little to do on the road to discovery. There comes a
leap in consciousness, call it Intuition or what you will,
the solution comes to you and you
don't know how or why.

Albert Einstein


Hope to see you online..... Frankie

No comments: