PARADIGM BYTES
Newsletter for Paradigm 97
February 12, 2010
**We actually had snow here in southern Georgia.... the first time in 40 years !
**Notice: Paradigm97 had a birthday January 20, 2010; We are now 13 years old.
PARADIGM DEFINED: 1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.
PARADIGM DEFINED: 1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.
MISSION STATEMENT
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
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SNIPPET
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
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SNIPPET
The Right Foot Care and Wear By Jon Vonhof, RN
Take a look at the footwear of your fellow nurses. What do you see — besides dirty shoes? My hospital experience has shown me that many nurses wear shoes that should have been tossed long ago.
Todd Phillips, an ED RN, estimates 25 percent of his fellow nurses wear worn-out shoes. He says, “nurses are aware of their feet from being on them all the time and having limited moments to rest or ‘prop them up’ during a shift.”
Todd Phillips, an ED RN, estimates 25 percent of his fellow nurses wear worn-out shoes. He says, “nurses are aware of their feet from being on them all the time and having limited moments to rest or ‘prop them up’ during a shift.”
RN Margaret Silebi echoes, “I can say for certain that nurses don’t pay attention to footwear. Some ED nurses still wear the first pair they bought. There seems to be pride in the bloodstains and battle scars — the stories the shoes tell.”
With each step you walk, your feet are subjected to a force of two to three times your body weight. Each foot hits the ground around 800 times with every mile walked. No matter how long your shift, good, comfortable shoes and proper foot care will make that time on your feet easier.
Tips for Shoe Care
The variety of footwear worn by nurses includes walking shoes, running shoes and clogs. Buy shoes based on comfort and usability. This means slip-proof outersoles that are resistant to chemicals and acids, and leather or fabric that can be cleaned of blood and other fluids. Slip-on styles eliminate laces that come untied and can catch on stools, gurneys and IV poles. Clogs may be comfortable, but the addition of a sling back-strap makes them safer.
It’s easy to keep your feet and shoes fresh by sprinkling a small amount of powder or baking soda on your feet or into your shoes to control odor. A spray of Lysol into each shoe is another option. This is especially important if you do not wear socks. If your shoes get stinky, wash them with soap and water and let them dry naturally. After they have dried, give each shoe a couple of shots of Lysol. Do not put your shoes in the dryer.
With each step you walk, your feet are subjected to a force of two to three times your body weight. Each foot hits the ground around 800 times with every mile walked. No matter how long your shift, good, comfortable shoes and proper foot care will make that time on your feet easier.
Tips for Shoe Care
The variety of footwear worn by nurses includes walking shoes, running shoes and clogs. Buy shoes based on comfort and usability. This means slip-proof outersoles that are resistant to chemicals and acids, and leather or fabric that can be cleaned of blood and other fluids. Slip-on styles eliminate laces that come untied and can catch on stools, gurneys and IV poles. Clogs may be comfortable, but the addition of a sling back-strap makes them safer.
It’s easy to keep your feet and shoes fresh by sprinkling a small amount of powder or baking soda on your feet or into your shoes to control odor. A spray of Lysol into each shoe is another option. This is especially important if you do not wear socks. If your shoes get stinky, wash them with soap and water and let them dry naturally. After they have dried, give each shoe a couple of shots of Lysol. Do not put your shoes in the dryer.
Check your shoes occasionally for a loss of structure and support, and general wear and tear. The most common breakdown is in the mid-soles, which results in your foot rolling to one side or the other. This indicates it’s time for new shoes.
It's All in the Fit
Without properly fitting shoes, your feet will encounter many problems. Too loose, and your feet will slide around creating friction. Too tight causes excessive pressure. Both can change the biomechanics of your foot strike, which in turn affects gait and throws off stride and balance. This stresses tendons and ligaments. If feet and toes are pinched in too-tight shoes, blood circulation is reduced and you’ll endure aches or pain. When trying on shoes, walk in them for a while to be sure they are comfortable and do not have any pressure points. Shoes should conform to the shape of your feet. Make sure the shoes flex comfortably in the forefoot and there are no irritating seams inside.
Without properly fitting shoes, your feet will encounter many problems. Too loose, and your feet will slide around creating friction. Too tight causes excessive pressure. Both can change the biomechanics of your foot strike, which in turn affects gait and throws off stride and balance. This stresses tendons and ligaments. If feet and toes are pinched in too-tight shoes, blood circulation is reduced and you’ll endure aches or pain. When trying on shoes, walk in them for a while to be sure they are comfortable and do not have any pressure points. Shoes should conform to the shape of your feet. Make sure the shoes flex comfortably in the forefoot and there are no irritating seams inside.
When Did You Last Replace Your Insoles?
Insoles provide extra support and/or cushioning. The typical insoles that come with shoes are of little value. If in doubt, take them out, and if they easily fold in half and are thin, replace them. Replacement insoles offer better heel support, shock absorption, and reduced friction. Some have a better arch support that helps those with flat feet.
The right insoles can make a big difference in the overall fit and comfort of our footwear. But insoles are not made to last forever. Check them occasionally for breakdown and replace them when necessary. There are two common types of insoles available: viscous polymer and foam. The polymers are a great choice for those wanting additional cushioning. Foam insoles are lightweight and inexpensive but offer less shock absorption.
Do you need orthotics? Their purpose is to maintain the foot in a functionally correct position and cure lower extremity ailments. Typically prescribed by a podiatrist or orthopedist, orthotics are medical devices custom made from cast impressions of your feet. A properly fit orthotic will support the body’s natural movements and reduce the demands placed on the muscles when the body is out of alignment. The result is less work by the muscles, meaning less fatigue and fewer injuries.
Insoles provide extra support and/or cushioning. The typical insoles that come with shoes are of little value. If in doubt, take them out, and if they easily fold in half and are thin, replace them. Replacement insoles offer better heel support, shock absorption, and reduced friction. Some have a better arch support that helps those with flat feet.
The right insoles can make a big difference in the overall fit and comfort of our footwear. But insoles are not made to last forever. Check them occasionally for breakdown and replace them when necessary. There are two common types of insoles available: viscous polymer and foam. The polymers are a great choice for those wanting additional cushioning. Foam insoles are lightweight and inexpensive but offer less shock absorption.
Do you need orthotics? Their purpose is to maintain the foot in a functionally correct position and cure lower extremity ailments. Typically prescribed by a podiatrist or orthopedist, orthotics are medical devices custom made from cast impressions of your feet. A properly fit orthotic will support the body’s natural movements and reduce the demands placed on the muscles when the body is out of alignment. The result is less work by the muscles, meaning less fatigue and fewer injuries.
The Joy of Socks
Socks perform four basic functions: cushioning, protection, warmth and absorption of moisture off the skin. The fabric and weave will determine how well they do. Most socks come in three fabrics or blends — cotton, wool and synthetics. Cotton provides no wicking or insulating properties and should be avoided. Wool blends are comfortably warm in winter and cool in summer. Synthetic fabrics, such as CoolMax and Olefin, wick moisture away from the skin.
Hose do not breathe well. Support socks or hose promote circulation and can relieve tired aching legs and swelling. If you usually go sockless or wear hose, give socks a try. The cushioning and warmth on a long busy shift will help your feet survive. Several times a year, check your socks for threadbare areas under the heels and forefoot and for holes in the toes. If you find these, toss the socks and buy new ones.
Socks should fit snugly without sagging or being stretched too tight. If they are too large, they’ll bunch up and cause skin irritation while socks too small can constrict circulation.
Socks perform four basic functions: cushioning, protection, warmth and absorption of moisture off the skin. The fabric and weave will determine how well they do. Most socks come in three fabrics or blends — cotton, wool and synthetics. Cotton provides no wicking or insulating properties and should be avoided. Wool blends are comfortably warm in winter and cool in summer. Synthetic fabrics, such as CoolMax and Olefin, wick moisture away from the skin.
Hose do not breathe well. Support socks or hose promote circulation and can relieve tired aching legs and swelling. If you usually go sockless or wear hose, give socks a try. The cushioning and warmth on a long busy shift will help your feet survive. Several times a year, check your socks for threadbare areas under the heels and forefoot and for holes in the toes. If you find these, toss the socks and buy new ones.
Socks should fit snugly without sagging or being stretched too tight. If they are too large, they’ll bunch up and cause skin irritation while socks too small can constrict circulation.
Foot Massage — You Can Do it Yourself!
Massage helps increase circulation, reduce swelling and release tight, overworked muscles back to their optimum condition. When muscles are relaxed and receiving better circulation, they are stronger and tolerate higher levels of abuse with less pain and breakdown. Tight muscles lead to strains and soft-tissue injury. Chronic tightness can cause muscle and connective tissue injury and inflammation, resulting in biomechanical imbalances, back pain, Achilles tendonitis and plantar fasciitis. This is where massage can help.
To do a self-massage of your feet, start by warming your feet in a bath or with warm, moist towels. Cross one leg over the other with the sole facing you. Use both thumbs to massage in a deep, circular motion, working small areas at a time. Work from toes toward your heel, and then to your ankle. Use various movements and pressure to find what feels best. All movement, and pressure, should be toward the heart — moving the old “stagnated” blood back to your heart. The use of massage oil or creams helps with the kneading of the skin and softens dry heels and calluses at the same time. If possible, have a partner massage your feet. For additional tips on massage see the sidebar below, Foot Self-Massage.
Massage helps increase circulation, reduce swelling and release tight, overworked muscles back to their optimum condition. When muscles are relaxed and receiving better circulation, they are stronger and tolerate higher levels of abuse with less pain and breakdown. Tight muscles lead to strains and soft-tissue injury. Chronic tightness can cause muscle and connective tissue injury and inflammation, resulting in biomechanical imbalances, back pain, Achilles tendonitis and plantar fasciitis. This is where massage can help.
To do a self-massage of your feet, start by warming your feet in a bath or with warm, moist towels. Cross one leg over the other with the sole facing you. Use both thumbs to massage in a deep, circular motion, working small areas at a time. Work from toes toward your heel, and then to your ankle. Use various movements and pressure to find what feels best. All movement, and pressure, should be toward the heart — moving the old “stagnated” blood back to your heart. The use of massage oil or creams helps with the kneading of the skin and softens dry heels and calluses at the same time. If possible, have a partner massage your feet. For additional tips on massage see the sidebar below, Foot Self-Massage.
Don't Forget to Moisturize
Because of never-ending hand washings, nurses learn to care for theirs with a good moisturizer. The same goes for feet. Whether wearing hose, socks or going sockless, your feet need care, too. Use creams or lotions to improve the skin’s texture and tone by exfoliating dry and dead skin and allowing newly rejuvenated skin to emerge. The use of a deep-penetrating hydrating cream twice a day will help your feet stay soft and supple by restoring their natural oils.
Pay close attention to your heels and the balls of your feet, two of the places where fissures and calluses typically form. To help the cream work its magic, at bedtime rub in the cream and place plastic wrap over your feet. The wrap seals in the cream to enhance the moisturizing effect. In the morning after showering, use a pumice stone or callus file to buff the skin and reduce calluses. After this buffing, rub in a small amount of cream to keep them soft during the day. Our Feet are Overworked and Under-appreciated
If you have chronic foot problems, or are uncertain what your feet are trying to tell you through their pain, consider consulting a podiatrist or orthopedic surgeon. Listen to your whole body and especially your feet. Be attentive to when the pain begins and what makes it hurt more or less, and be prepared to tell the specialist about the problem, its history, and what you have done to correct it.
Let’s face it, your feet are overworked and under-appreciated. Denise Nash, RN, who works on an extremely unforgiving floor surface reminds us, “Our feet beg us to pay attention to them regularly.” With a good understanding of footwear and feet care, you can make it through your shift feeling good.
Because of never-ending hand washings, nurses learn to care for theirs with a good moisturizer. The same goes for feet. Whether wearing hose, socks or going sockless, your feet need care, too. Use creams or lotions to improve the skin’s texture and tone by exfoliating dry and dead skin and allowing newly rejuvenated skin to emerge. The use of a deep-penetrating hydrating cream twice a day will help your feet stay soft and supple by restoring their natural oils.
Pay close attention to your heels and the balls of your feet, two of the places where fissures and calluses typically form. To help the cream work its magic, at bedtime rub in the cream and place plastic wrap over your feet. The wrap seals in the cream to enhance the moisturizing effect. In the morning after showering, use a pumice stone or callus file to buff the skin and reduce calluses. After this buffing, rub in a small amount of cream to keep them soft during the day. Our Feet are Overworked and Under-appreciated
If you have chronic foot problems, or are uncertain what your feet are trying to tell you through their pain, consider consulting a podiatrist or orthopedic surgeon. Listen to your whole body and especially your feet. Be attentive to when the pain begins and what makes it hurt more or less, and be prepared to tell the specialist about the problem, its history, and what you have done to correct it.
Let’s face it, your feet are overworked and under-appreciated. Denise Nash, RN, who works on an extremely unforgiving floor surface reminds us, “Our feet beg us to pay attention to them regularly.” With a good understanding of footwear and feet care, you can make it through your shift feeling good.
SIDEBAR:
FOOT SELF-MASSAGE
• Bottom of the foot — Place your thumbs on the ball of the foot. Apply pressure to the underside of the foot and slowly move toward the heel.
• Heels — Massage the bottom and sides, applying gentle pressure with your thumbs.
• Toes — Stroke between the toes upward toward the heart.
• Top of the foot — Using your fingers, massage the top of the foot, focusing on the soft points between the bones of the forefoot upward toward the ankle.
• Stroking the foot — Using both hands, place your fingers on the top of the foot and the thumbs underneath. One hand at a time, stroke by sliding your hands upward toward the heart.
This article is from workingnurse.com
FOOT SELF-MASSAGE
• Bottom of the foot — Place your thumbs on the ball of the foot. Apply pressure to the underside of the foot and slowly move toward the heel.
• Heels — Massage the bottom and sides, applying gentle pressure with your thumbs.
• Toes — Stroke between the toes upward toward the heart.
• Top of the foot — Using your fingers, massage the top of the foot, focusing on the soft points between the bones of the forefoot upward toward the ankle.
• Stroking the foot — Using both hands, place your fingers on the top of the foot and the thumbs underneath. One hand at a time, stroke by sliding your hands upward toward the heart.
This article is from workingnurse.com
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FROM THE MEMBERS
The following was sent in by GALLORN@AOL.com (Sue) who writes: " Hi All, I am currently trying to develop my first ED triage nurse course and am conflicted as to how to outline the day. Is it better to talk about process with triage scenerios or to go thru Systems? I am thinking of doing a combo of both but can't decide which would be more effective. Any suggestions would be awesome and very much appreciated. Thanks, Sue " Please send any comments/ suggestions to her, if you can; if not send them to me and I will send them on.
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The following was sent in by Laregis@AOL.com (Laura) who wrote: "Please feel free to pass this on, even if they do not need the service there may be someone who they know could use it now and also for future reference. This is for women undergoing treatment for any type of cancer".
Cleaning for a Reason If you know any woman currently undergoing Chemo, please pass the word to her that there is a cleaning service that provides FREE housecleaning - 1 time per month for 4 months while she is in treatment. All she has to do is sign up and have her doctor fax a note confirming the treatment. Cleaning for a Reason will have a participating maid service in her zip code area arrange for the service. http://www.cleaningforareason.org
Please pass this information on to bless a woman going through cancer treatment. This organization serves the entire USA and currently has 547 partners to help these women. It’s our job to pass the word and let them know that there are people out there that care. Be a blessing to someone and pass this information along.
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FROM THE MEMBERS
The following was sent in by GALLORN@AOL.com (Sue) who writes: " Hi All, I am currently trying to develop my first ED triage nurse course and am conflicted as to how to outline the day. Is it better to talk about process with triage scenerios or to go thru Systems? I am thinking of doing a combo of both but can't decide which would be more effective. Any suggestions would be awesome and very much appreciated. Thanks, Sue " Please send any comments/ suggestions to her, if you can; if not send them to me and I will send them on.
**************************
The following was sent in by Laregis@AOL.com (Laura) who wrote: "Please feel free to pass this on, even if they do not need the service there may be someone who they know could use it now and also for future reference. This is for women undergoing treatment for any type of cancer".
Cleaning for a Reason If you know any woman currently undergoing Chemo, please pass the word to her that there is a cleaning service that provides FREE housecleaning - 1 time per month for 4 months while she is in treatment. All she has to do is sign up and have her doctor fax a note confirming the treatment. Cleaning for a Reason will have a participating maid service in her zip code area arrange for the service. http://www.cleaningforareason.org
Please pass this information on to bless a woman going through cancer treatment. This organization serves the entire USA and currently has 547 partners to help these women. It’s our job to pass the word and let them know that there are people out there that care. Be a blessing to someone and pass this information along.
********
This response from Margerlach (Marlene) was to the following newsletter article:
NEW YORK (Reuters 12/29) - Breast milk can be refrigerated for up to four days without losing its nutritional value or allowing bacteria to build up, a small study suggests.Guidelines on safe storage of breast milk vary somewhat. But in general, it's thought that breast milk can be refrigerated at 39 degrees Fahrenheit for as long as five to eight days, though it should ideally be used within two or three days.... http://abcnews.go.com/Health/wireStory?id=9442401
MarGerlach (Marlene) writes: "Most people freeze it now if they have an excess or need to leave extra with gramma if they go away for a few days. I had a patient who had to have surgery so pumped often pre-op and stored it up in the freezer so her baby would have enough while she was in the hospital and on meds. Just supposed to thaw it at room temp or in frig and not in microwave to avoid losing any nutrients. Did the article mention that possibility? " (not that I noticed)
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This is a continuation of the thread about epidural headaches......... "Call it an epidural, but if a woman has a HUGE headache after an epidural that gets less severe when she lies back down, there has most probably a hole been made and fluid has leaked.....hence a 'spinal headache' has occured....after an epidural". Linda B. Jenkins, RN jenxl@aol.com www.birthprep.com
This was from Wendie (Whowland1@mac.com) who writes : " Actually, by definition, this was not caused by an epidural. She has a spinal headache after a dural puncture associated with epidural medication. This is a complication, not a normal or common effect of epidural medication. I see a lot of epidurals done for pain, usually steroids given around inflamed areas related to disk injury. They are done with fluoroscopy and I have never, ever seen a dural puncture with one. In OB, however, anesthesiologists go in blind, with the result that they sometimes... miss. I guess they figure it's not so important to be accurate with, like, a laboring woman."
Another follow up from Linda (Jenxl@AOL.com) who writes : "Wendie is absolutely right. You know I wrote that as if I were speaking to my students (I'm a Childbirth Educator) rather than the sophisticated group of nurses so should have said it like she said it. Call it what you want, describe it as you will......a dural puncture can result with a huge headache! "
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The following was sent in by a member, Robert Hess, announcing that the Forum for Shared Governance just started an online community. The title is: Shared Governance Bedside Boardroom, at http://netstation.us/sg/ Please help him with his endeavor.....support is the word.
Robert Hess, RN, PhD, FAAN Founder, Forum for Shared Governance (856) 424-4270 (610) 805-8635 (cell) info@sharedgovernance.org www.sharedgovernance
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MEDICAL NEWS
Joint Commission Alert: Preventing Deaths During, After Pregnancy High blood pressure, diabetes, obesity put women at risk
Pre-existing medical conditions such as high blood pressure are putting women at greater risk for death during or shortly after pregnancy, according to a Joint Commission Sentinel Event Alert issued today. The Alert comes as federal and state governments are stepping up efforts to identify the causes of maternal deaths in order to prevent them. The most current statistics from the Centers for Disease Control and Prevention (CDC) show that there are 13.3 maternal deaths per 100,000 live births, well over the target of 3.3 maternal deaths per 100,000 live births set as part of the U.S. government’s Healthy People 2010 initiative. Read the entire news release. Read the Sentinel Event Alert.
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Gallup: Nursing’s Voice Lacks Volume
Academy Initiatives Seek To Achieve Greater Influence
WASHINGTON – Trust and confidence in nurses remains unequivocally high; however, according to a newly conducted Gallup Survey, opinion leaders believe that during the next five to 10 years nurses will have less influence than other stakeholders in health reform. The American Academy of Nursing (AAN), by mobilizing its cadre of 1,600 esteemed Fellows and advancing health policy and practice, is poised to have its voice resonate.
On behalf of the Robert Wood Johnson Foundation (RWJF), findings from the survey, “Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions,” compared nurses’ influence to government officials, patients, physicians, and insurance and pharmaceutical executives. The survey finds that while nurses possess a wealth of knowledge, they don’t have the authority they should in health care systems.
The public historically rates nurses as achieving the highest standards of professional honesty and ethics. And, according to the recent survey, opinion leaders believe nursing’s voice should be heeded concerning issues of health care policy development and management.... http://www.aannet.org/i4a/headlines/headlinedetails.cfm?id=238
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" Brainless Bimbos" -- Today the Evening Telegraph (Dundee, Scotland) ran a short but helpful item about a recent Dundee University (right) study that found stereotypical television images of nurses as "brainless" "bimbos" were discouraging academically advanced primary school students from pursuing the profession. Marjory Inglis's "Put off nursing by TV portrayal" reports that professor of nursing Liz Wilson presented the research at a meeting of the National Health Service -- Tayside's governance committee at King's Cross Hospital. The piece includes quotes from Wilson, and it describes local plans to try to counter the stereotypes. The study results are consistent with those of a 2000 study of U.S. school children by JWT Communications, which found that students got their main impression of nursing from NBC's ER, and that they considered nursing a technical job for girls, one that was unworthy of private school students. We thank Ms. Inglis and the Evening Telegraph for its report on this research, which shows again that fictional media have a powerful effect on views and actions related to nursing. more... www.truthaboutnursing.org/news-alerts/2010/jan/24.html
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National Nurses United Union Launched The 150,000-member-strong National Nurses United was officially launched Dec. 8 at a meeting in Phoenix. The union, an amalgamation of the California Nurses Association/National Nurses Organizing Committee, United American Nurses, and Massachusetts Nurses Association, elected three co-presidents: Karen Higgins, RN; Deborah Burger, RN; and Jean Ross, RN.“We’re ecstatic,” says Ross. “For years we let our differences divide us; now we’re looking at the things that bring us together.”The union pledges to address the following:• Advance the interests of direct care nurses and patients across the U.S. • Organize all direct care RNs “into a single organization capable of exercising influence over the healthcare industry, governments, and employers.” • Promote effective collective bargaining representation to all NNU affiliates to promote the economic and professional interests of all direct care RNs. • Expand the voice of direct care RNs and patients in public policy, including the enactment of safe nurse-to-patient ratios and patient advocacy rights in Congress and every state. • Win “healthcare justice, accessible, quality healthcare for all, as a human right.” One of the group’s first priorities is taking part in the healthcare reform debate, Ross says. “We’re the true voice for the direct-care registered nurse.”NNU is affiliated with the AFL-CIO. The group’s Web site is www.nationalnursesunited.org. To read the rest of the article:
http://news.nurse.com/article/20091209/NATIONAL02/112280005/-1/frontpage
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
Notice: Due to the overwhelming notices of FDA recalled medical related items and other items too numerous to include.....PLEASE go to this website ; I was shocked at the huge number of recalls...food, medicine, equipment ! http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm197795.htm
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NEW YORK (Reuters 1/28 ) - Even a routine heel-stick test can be painful enough for some newborns to trigger an increase in potentially harmful free radicals in the blood.
The findings, published in the journal Pain, do not mean that a single heel stick -- done routinely to test newborns for certain genetic disorders -- will cause harm. But researchers say they do raise concerns about newborns in neonatal intensive care units (NICUs), who undergo many painful procedures each day.
The study underscores the need to ensure that newborns have adequate pain relief during medical procedures, lead researcher Dr. Carlo Bellieni, of the University of Siena in Italy, told Reuters Health in an email. It was once widely thought that newborns essentially do not feel pain from routine medical procedures. Research has proven that belief to be wrong, and guidelines from groups like the American Academy of Pediatrics call on NICUs to do everything they can to limit tiny infants' pain -- including using topical anesthetics and non-drug tactics, like pacifiers dipped in sugar solutions.... http://www.reuters.com/article/idUSTRE60R56U20100128?feedType=nl&feedName=ushealth1100
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Carlsen MH et al. – Because of the large variations observed between otherwise comparable food samples, the study emphasizes the importance of using a comprehensive database combined with a detailed system for food registration in clinical and epidemiological studies. The present antioxidant database is therefore an essential research tool to further elucidate the potential health effects of phytochemical antioxidants in diet.... http://www.nutritionj.com/content/9/1/3
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ICU Nurses, this looks to be an excellent article....let me know your opinion. Implementation and evaluation of a nurse-centered computerized potassium regulation protocol in the ICU- a before and after analysis Hoekstra M et al. – Computerized potassium control, integrated with the nurse–centered GRIP program for glucose regulation, is effective and reduces the prevalence of hypo– and hyperkalemia in the ICU compared with physician–driven potassium regulation....
NEW YORK (Reuters 12/29) - Breast milk can be refrigerated for up to four days without losing its nutritional value or allowing bacteria to build up, a small study suggests.Guidelines on safe storage of breast milk vary somewhat. But in general, it's thought that breast milk can be refrigerated at 39 degrees Fahrenheit for as long as five to eight days, though it should ideally be used within two or three days.... http://abcnews.go.com/Health/wireStory?id=9442401
MarGerlach (Marlene) writes: "Most people freeze it now if they have an excess or need to leave extra with gramma if they go away for a few days. I had a patient who had to have surgery so pumped often pre-op and stored it up in the freezer so her baby would have enough while she was in the hospital and on meds. Just supposed to thaw it at room temp or in frig and not in microwave to avoid losing any nutrients. Did the article mention that possibility? " (not that I noticed)
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This is a continuation of the thread about epidural headaches......... "Call it an epidural, but if a woman has a HUGE headache after an epidural that gets less severe when she lies back down, there has most probably a hole been made and fluid has leaked.....hence a 'spinal headache' has occured....after an epidural". Linda B. Jenkins, RN jenxl@aol.com www.birthprep.com
This was from Wendie (Whowland1@mac.com) who writes : " Actually, by definition, this was not caused by an epidural. She has a spinal headache after a dural puncture associated with epidural medication. This is a complication, not a normal or common effect of epidural medication. I see a lot of epidurals done for pain, usually steroids given around inflamed areas related to disk injury. They are done with fluoroscopy and I have never, ever seen a dural puncture with one. In OB, however, anesthesiologists go in blind, with the result that they sometimes... miss. I guess they figure it's not so important to be accurate with, like, a laboring woman."
Another follow up from Linda (Jenxl@AOL.com) who writes : "Wendie is absolutely right. You know I wrote that as if I were speaking to my students (I'm a Childbirth Educator) rather than the sophisticated group of nurses so should have said it like she said it. Call it what you want, describe it as you will......a dural puncture can result with a huge headache! "
*****************
The following was sent in by a member, Robert Hess, announcing that the Forum for Shared Governance just started an online community. The title is: Shared Governance Bedside Boardroom, at http://netstation.us/sg/ Please help him with his endeavor.....support is the word.
Robert Hess, RN, PhD, FAAN Founder, Forum for Shared Governance (856) 424-4270 (610) 805-8635 (cell) info@sharedgovernance.org www.sharedgovernance
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MEDICAL NEWS
Joint Commission Alert: Preventing Deaths During, After Pregnancy High blood pressure, diabetes, obesity put women at risk
Pre-existing medical conditions such as high blood pressure are putting women at greater risk for death during or shortly after pregnancy, according to a Joint Commission Sentinel Event Alert issued today. The Alert comes as federal and state governments are stepping up efforts to identify the causes of maternal deaths in order to prevent them. The most current statistics from the Centers for Disease Control and Prevention (CDC) show that there are 13.3 maternal deaths per 100,000 live births, well over the target of 3.3 maternal deaths per 100,000 live births set as part of the U.S. government’s Healthy People 2010 initiative. Read the entire news release. Read the Sentinel Event Alert.
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Gallup: Nursing’s Voice Lacks Volume
Academy Initiatives Seek To Achieve Greater Influence
WASHINGTON – Trust and confidence in nurses remains unequivocally high; however, according to a newly conducted Gallup Survey, opinion leaders believe that during the next five to 10 years nurses will have less influence than other stakeholders in health reform. The American Academy of Nursing (AAN), by mobilizing its cadre of 1,600 esteemed Fellows and advancing health policy and practice, is poised to have its voice resonate.
On behalf of the Robert Wood Johnson Foundation (RWJF), findings from the survey, “Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions,” compared nurses’ influence to government officials, patients, physicians, and insurance and pharmaceutical executives. The survey finds that while nurses possess a wealth of knowledge, they don’t have the authority they should in health care systems.
The public historically rates nurses as achieving the highest standards of professional honesty and ethics. And, according to the recent survey, opinion leaders believe nursing’s voice should be heeded concerning issues of health care policy development and management.... http://www.aannet.org/i4a/headlines/headlinedetails.cfm?id=238
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" Brainless Bimbos" -- Today the Evening Telegraph (Dundee, Scotland) ran a short but helpful item about a recent Dundee University (right) study that found stereotypical television images of nurses as "brainless" "bimbos" were discouraging academically advanced primary school students from pursuing the profession. Marjory Inglis's "Put off nursing by TV portrayal" reports that professor of nursing Liz Wilson presented the research at a meeting of the National Health Service -- Tayside's governance committee at King's Cross Hospital. The piece includes quotes from Wilson, and it describes local plans to try to counter the stereotypes. The study results are consistent with those of a 2000 study of U.S. school children by JWT Communications, which found that students got their main impression of nursing from NBC's ER, and that they considered nursing a technical job for girls, one that was unworthy of private school students. We thank Ms. Inglis and the Evening Telegraph for its report on this research, which shows again that fictional media have a powerful effect on views and actions related to nursing. more... www.truthaboutnursing.org/news-alerts/2010/jan/24.html
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National Nurses United Union Launched The 150,000-member-strong National Nurses United was officially launched Dec. 8 at a meeting in Phoenix. The union, an amalgamation of the California Nurses Association/National Nurses Organizing Committee, United American Nurses, and Massachusetts Nurses Association, elected three co-presidents: Karen Higgins, RN; Deborah Burger, RN; and Jean Ross, RN.“We’re ecstatic,” says Ross. “For years we let our differences divide us; now we’re looking at the things that bring us together.”The union pledges to address the following:• Advance the interests of direct care nurses and patients across the U.S. • Organize all direct care RNs “into a single organization capable of exercising influence over the healthcare industry, governments, and employers.” • Promote effective collective bargaining representation to all NNU affiliates to promote the economic and professional interests of all direct care RNs. • Expand the voice of direct care RNs and patients in public policy, including the enactment of safe nurse-to-patient ratios and patient advocacy rights in Congress and every state. • Win “healthcare justice, accessible, quality healthcare for all, as a human right.” One of the group’s first priorities is taking part in the healthcare reform debate, Ross says. “We’re the true voice for the direct-care registered nurse.”NNU is affiliated with the AFL-CIO. The group’s Web site is www.nationalnursesunited.org. To read the rest of the article:
http://news.nurse.com/article/20091209/NATIONAL02/112280005/-1/frontpage
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
Notice: Due to the overwhelming notices of FDA recalled medical related items and other items too numerous to include.....PLEASE go to this website ; I was shocked at the huge number of recalls...food, medicine, equipment ! http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm197795.htm
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NEW YORK (Reuters 1/28 ) - Even a routine heel-stick test can be painful enough for some newborns to trigger an increase in potentially harmful free radicals in the blood.
The findings, published in the journal Pain, do not mean that a single heel stick -- done routinely to test newborns for certain genetic disorders -- will cause harm. But researchers say they do raise concerns about newborns in neonatal intensive care units (NICUs), who undergo many painful procedures each day.
The study underscores the need to ensure that newborns have adequate pain relief during medical procedures, lead researcher Dr. Carlo Bellieni, of the University of Siena in Italy, told Reuters Health in an email. It was once widely thought that newborns essentially do not feel pain from routine medical procedures. Research has proven that belief to be wrong, and guidelines from groups like the American Academy of Pediatrics call on NICUs to do everything they can to limit tiny infants' pain -- including using topical anesthetics and non-drug tactics, like pacifiers dipped in sugar solutions.... http://www.reuters.com/article/idUSTRE60R56U20100128?feedType=nl&feedName=ushealth1100
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Carlsen MH et al. – Because of the large variations observed between otherwise comparable food samples, the study emphasizes the importance of using a comprehensive database combined with a detailed system for food registration in clinical and epidemiological studies. The present antioxidant database is therefore an essential research tool to further elucidate the potential health effects of phytochemical antioxidants in diet.... http://www.nutritionj.com/content/9/1/3
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ICU Nurses, this looks to be an excellent article....let me know your opinion. Implementation and evaluation of a nurse-centered computerized potassium regulation protocol in the ICU- a before and after analysis Hoekstra M et al. – Computerized potassium control, integrated with the nurse–centered GRIP program for glucose regulation, is effective and reduces the prevalence of hypo– and hyperkalemia in the ICU compared with physician–driven potassium regulation....
http://www.biomedcentral.com/1472-6947/10/5/abstract
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RANDOM FACT: Alaska has more caribou than people.
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RANDOM FACT: Alaska has more caribou than people.
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Cervical Cancer: Combined Drug and Radiotherapy Improves Survival Combining drugs and radiotherapy improves the survival chances of women receiving treatment for cervical cancer. These are the conclusions of Cochrane Researchers who carried out the most comprehensive study of the effects of combined drug and radiotherapy in cervical cancer treatment to date.
Cervical cancer is the second most common cancer in women worldwide. Treatments for the disease have changed markedly over the last decade as a result of guidelines issued by the National Cancer Institute (NCI) in 1999, which stated that chemoradiotherapy should be considered as an alternative to radiotherapy. Chemoradiotherapy combines chemotherapy (drug treatment) and x-ray treatment, whereas radiotherapy is just x-ray treatment.
“We saw clear evidence that adding chemotherapy to radiotherapy improves survival, as well as disease free survival,” said Claire Vale, of the Medical Research Council Clinical Trials Unit in London in the UK. “These are effective, affordable treatments that provide a benchmark for other potential treatment approaches.”
The researchers analysed data from 15 trials involving a total of 3,452 women. They found that compared to women who had radiotherapy alone, women receiving chemoradiotherapy were more likely to live for longer after treatment. Five years after receiving treatment, 66 out of every 100 women survived with chemoradiotherapy compared to 60 out of 100 with radiotherapy. In addition, treatment with chemoradiotherapy reduced the chance of the cancer coming back or spreading to other areas. Crucially, their analysis showed that the benefits of chemoradiotherapy were not just restricted to the platinum-based drugs recommended by the NCI.
Based on a small subset of the data, there was also an indication that continuing drug therapy after chemoradiotherapy could improve survival rates even further, although the researchers say more studies are required to confirm this. “We suggest that new trials are needed to find out whether giving extra chemotherapy is better for women with cervical cancer or not,” said Vale.
Full citation: Chemoradiotherapy for Cervical Cancer Meta-analysis Collaboration (CCCMAC). Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: individual patient datameta-analysis. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD008285. DOI: 10.1002/14651858.CD008285.
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To slash your stroke risk by 80 percent, there are just five simple health habits to keep in mind: Walk every day, maintain a healthy weight, avoid cigarette smoke, enjoy alcohol only in moderation, and eat as nutritiously as you can. Some of these you probably already do. But tack on the missing items and your stroke risk drops dramatically. The Golden Health RulesIn a large study of men and women in their fifties, those who most adhered to these five basic health habits were 80 percent less likely to have an ischemic stroke -- the most common type of stroke. Specifically, these study participants exercised about 30 minutes a day and had BMIs below 25, and their diet mainstays were fruit, veggies, whole grains, and lean protein. Also, the women had no more than one alcoholic drink a day; the men, no more than two. (How close are you to your ideal BMI? Find out with this tool.) http://www.realage.com/tips/5-habits-that-stop-strokes
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Cervical Cancer: Combined Drug and Radiotherapy Improves Survival Combining drugs and radiotherapy improves the survival chances of women receiving treatment for cervical cancer. These are the conclusions of Cochrane Researchers who carried out the most comprehensive study of the effects of combined drug and radiotherapy in cervical cancer treatment to date.
Cervical cancer is the second most common cancer in women worldwide. Treatments for the disease have changed markedly over the last decade as a result of guidelines issued by the National Cancer Institute (NCI) in 1999, which stated that chemoradiotherapy should be considered as an alternative to radiotherapy. Chemoradiotherapy combines chemotherapy (drug treatment) and x-ray treatment, whereas radiotherapy is just x-ray treatment.
“We saw clear evidence that adding chemotherapy to radiotherapy improves survival, as well as disease free survival,” said Claire Vale, of the Medical Research Council Clinical Trials Unit in London in the UK. “These are effective, affordable treatments that provide a benchmark for other potential treatment approaches.”
The researchers analysed data from 15 trials involving a total of 3,452 women. They found that compared to women who had radiotherapy alone, women receiving chemoradiotherapy were more likely to live for longer after treatment. Five years after receiving treatment, 66 out of every 100 women survived with chemoradiotherapy compared to 60 out of 100 with radiotherapy. In addition, treatment with chemoradiotherapy reduced the chance of the cancer coming back or spreading to other areas. Crucially, their analysis showed that the benefits of chemoradiotherapy were not just restricted to the platinum-based drugs recommended by the NCI.
Based on a small subset of the data, there was also an indication that continuing drug therapy after chemoradiotherapy could improve survival rates even further, although the researchers say more studies are required to confirm this. “We suggest that new trials are needed to find out whether giving extra chemotherapy is better for women with cervical cancer or not,” said Vale.
Full citation: Chemoradiotherapy for Cervical Cancer Meta-analysis Collaboration (CCCMAC). Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: individual patient datameta-analysis. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD008285. DOI: 10.1002/14651858.CD008285.
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To slash your stroke risk by 80 percent, there are just five simple health habits to keep in mind: Walk every day, maintain a healthy weight, avoid cigarette smoke, enjoy alcohol only in moderation, and eat as nutritiously as you can. Some of these you probably already do. But tack on the missing items and your stroke risk drops dramatically. The Golden Health RulesIn a large study of men and women in their fifties, those who most adhered to these five basic health habits were 80 percent less likely to have an ischemic stroke -- the most common type of stroke. Specifically, these study participants exercised about 30 minutes a day and had BMIs below 25, and their diet mainstays were fruit, veggies, whole grains, and lean protein. Also, the women had no more than one alcoholic drink a day; the men, no more than two. (How close are you to your ideal BMI? Find out with this tool.) http://www.realage.com/tips/5-habits-that-stop-strokes
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RANDOM FACT: Jellyfish are 94-98% water
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Few women with symptoms actually have ovarian cancer (Reuters 1/28) U.S. researchers said only about one in 100 women who have pelvic and bloating symptoms typical of ovarian cancer really have the disease, which could make it difficult to detect the cancer early. Researchers said the study "argues for a cautious approach to the use of symptom patterns to trigger extensive medical evaluation for ovarian cancer."... http://www.msnbc.msn.com/id/35131894/ns/health-cancer/
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Look at what we can look forward to in our old age !! LOL thanks for this, MJSolon (Melva) (HealthDay News) -- Despite the warnings that being overweight will kill you, a new Australian study finds that overweight adults over the age of 70 are less likely to die over a 10-year period than their normal-weight peers.
The study, published Jan. 28 in the Journal of the American Geriatrics Society, conflicts with research that suggests that being overweight contributes to a long list of health problems, including heart disease.... http://news.yahoo.com/s/hsn/20100129/hl_hsn/over70andoverweightmayaddyearstolife
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RANDOM FACT: A quarter of the bones in your body are in your feet.
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This was sent in by MJSolon@AOL.com (Melva) Thank you. Last fall, a Thai study revealed the first glimmers of hope for an HIV vaccine. Over a three year period, the risk of infection for the 16,000 vaccinated dropped by 31 percent. After such a promising start, additional trials and studies with both adults and children are necessary to learn about this critical vaccine. ... Tell America's leading research institutions to continue to research an HIV/AIDS vaccine and include children in their studies >>
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This interesting article is from Kurt Ullman.......thank you, Kurt.
Heart Attack Victims Who Have ECGs in the Field Experience Shorter Time-to-Treatment; Outcomes for STEMI Patients Improve with Early Treatment Intervention
National guidelines have been set to achieve door-to-balloon time (D2B) is less than 90 minutes to improve outcomeNational guidelines have been set to achieve door-to-balloon time (D2B) is less than 90 minutes to improve outcomes for patients with STEMI. The purpose of this study is to see if a more aggressive approach utilizing prehospital ECGs could improve reperfusion times.s for patients with STEMI. The purpose of this study is to see if a more aggressive approach utilizing prehospital ECGs could improve reperfusion times. http://www3.interscience.wiley.com/journal/122577019/abstract?CRETRY=1&SRETRY=0
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Bruising on Torso and Other sites helps Identify Pediatric Trauma Due to Abuse NEW YORK (Reuters) - In toddlers and small children, bruising on the torso, ear, or neck is suggestive of abuse, according to the developers of a new child abuse screening tool. In infants younger than 4 months, they say, bruising anywhere may be suspicious for abuse.
Dr. Mary Clyde Pierce, from Children's Memorial Hospital, Chicago, and her colleagues were able to create a decision rule that is 97% sensitive and 84% specific in identifying child abuse in bruised youngsters up to four years old.... http://www.medscape.com/viewarticle/713505
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Few women with symptoms actually have ovarian cancer (Reuters 1/28) U.S. researchers said only about one in 100 women who have pelvic and bloating symptoms typical of ovarian cancer really have the disease, which could make it difficult to detect the cancer early. Researchers said the study "argues for a cautious approach to the use of symptom patterns to trigger extensive medical evaluation for ovarian cancer."... http://www.msnbc.msn.com/id/35131894/ns/health-cancer/
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Look at what we can look forward to in our old age !! LOL thanks for this, MJSolon (Melva) (HealthDay News) -- Despite the warnings that being overweight will kill you, a new Australian study finds that overweight adults over the age of 70 are less likely to die over a 10-year period than their normal-weight peers.
The study, published Jan. 28 in the Journal of the American Geriatrics Society, conflicts with research that suggests that being overweight contributes to a long list of health problems, including heart disease.... http://news.yahoo.com/s/hsn/20100129/hl_hsn/over70andoverweightmayaddyearstolife
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RANDOM FACT: A quarter of the bones in your body are in your feet.
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This was sent in by MJSolon@AOL.com (Melva) Thank you. Last fall, a Thai study revealed the first glimmers of hope for an HIV vaccine. Over a three year period, the risk of infection for the 16,000 vaccinated dropped by 31 percent. After such a promising start, additional trials and studies with both adults and children are necessary to learn about this critical vaccine. ... Tell America's leading research institutions to continue to research an HIV/AIDS vaccine and include children in their studies >>
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This interesting article is from Kurt Ullman.......thank you, Kurt.
Heart Attack Victims Who Have ECGs in the Field Experience Shorter Time-to-Treatment; Outcomes for STEMI Patients Improve with Early Treatment Intervention
National guidelines have been set to achieve door-to-balloon time (D2B) is less than 90 minutes to improve outcomeNational guidelines have been set to achieve door-to-balloon time (D2B) is less than 90 minutes to improve outcomes for patients with STEMI. The purpose of this study is to see if a more aggressive approach utilizing prehospital ECGs could improve reperfusion times.s for patients with STEMI. The purpose of this study is to see if a more aggressive approach utilizing prehospital ECGs could improve reperfusion times. http://www3.interscience.wiley.com/journal/122577019/abstract?CRETRY=1&SRETRY=0
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Bruising on Torso and Other sites helps Identify Pediatric Trauma Due to Abuse NEW YORK (Reuters) - In toddlers and small children, bruising on the torso, ear, or neck is suggestive of abuse, according to the developers of a new child abuse screening tool. In infants younger than 4 months, they say, bruising anywhere may be suspicious for abuse.
Dr. Mary Clyde Pierce, from Children's Memorial Hospital, Chicago, and her colleagues were able to create a decision rule that is 97% sensitive and 84% specific in identifying child abuse in bruised youngsters up to four years old.... http://www.medscape.com/viewarticle/713505
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RANDOM FACT: In the game Monopoly, the properties are named after streets in Atlantic City.
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"Brown Tumor" a mass of fibrous tissue containing hemosiderin pigmented macrophages and multinucleated giant cells, replacing and expanding part of a bone in primary hyperparathyroidism.
"Brown Tumor" a mass of fibrous tissue containing hemosiderin pigmented macrophages and multinucleated giant cells, replacing and expanding part of a bone in primary hyperparathyroidism.
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Elbow5995@AOL.com Barb writes "It's rare, but associated with hyperparathyroidism. To remember the constellation of sx with this disease state, the following is helpful: painful bones, renal stones, abdominal groans, and psychic moans. :) Does this patient have chronic renal insufficiency? Or, she may have hypercalcemia secondary to malignancy. If she is on a thiazide diuretic, this may also be a culprit".
I wrote: "Hypercaliphylaxis": The deposition of calcium d/t hyperparathyroidism. If on the trunk-- is fatal. If on the limbs, amputation usually prevents further depositions. The surgeons would remove all four parathyroids.......but that procedure didn't improve the problem as far as I know. Have seen several cases during my stint in Med-surg--- very painful for the patient.....blackens and is as hard like a rock. One patient's pannas (she was very large) was completely hardened. The wound post surgery was huge...requiring 8 to 10 ABD pads plus gauze, etc. Thanks to a very dedicated daughter who changed her dressings twice a day. When the wound was much smaller, a wound vac was used. The patient was a diabetic and on dialysis. The wound was actually healed. It seemed to me that this happened most commonly with diabetics on dialysis"
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RANDOM FACT: The 57 on Heinz ketchup bottles represents the number of varieties of pickles the company once had.
Elbow5995@AOL.com Barb writes "It's rare, but associated with hyperparathyroidism. To remember the constellation of sx with this disease state, the following is helpful: painful bones, renal stones, abdominal groans, and psychic moans. :) Does this patient have chronic renal insufficiency? Or, she may have hypercalcemia secondary to malignancy. If she is on a thiazide diuretic, this may also be a culprit".
I wrote: "Hypercaliphylaxis": The deposition of calcium d/t hyperparathyroidism. If on the trunk-- is fatal. If on the limbs, amputation usually prevents further depositions. The surgeons would remove all four parathyroids.......but that procedure didn't improve the problem as far as I know. Have seen several cases during my stint in Med-surg--- very painful for the patient.....blackens and is as hard like a rock. One patient's pannas (she was very large) was completely hardened. The wound post surgery was huge...requiring 8 to 10 ABD pads plus gauze, etc. Thanks to a very dedicated daughter who changed her dressings twice a day. When the wound was much smaller, a wound vac was used. The patient was a diabetic and on dialysis. The wound was actually healed. It seemed to me that this happened most commonly with diabetics on dialysis"
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RANDOM FACT: The 57 on Heinz ketchup bottles represents the number of varieties of pickles the company once had.
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Organ Trafficking: Global Solutions for a Global Problem The organ trafficking market is on the rise worldwide. Numerous unfortunate stories of networks of brokers, physicians, and hospitals engaged in illegal trade have been featured in high-profile media. The profitable enterprises facilitating these unregulated services exploit the poor in underresourced countries and offer substandard medical care with unacceptable outcomes to the rich recipients. Despite efforts to boost altruistic organ donation and resolutions to curb transplant tourism, their implementation has been compromised. At the same time, the worldwide escalation in the number of patients with kidney failure coupled with a shortage in the supply of organs continues to fuel this trade.... http://www.ajkd.org/article/PIIS0272638609011779/fulltext
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Marrow transplant cures adult sickle cell disease (Reuters) Nine of 10 adult patients given an experimental bone marrow transplant treatment were cured of sickle cell disease, researchers at the U.S. government's National Institutes of Health reported in the New England Journal of Medicine.
If the early results hold, the treatment "could be ideal for patients with severe sickle cell disease," Dr. Miguel Abboud of American University of Beirut Medical Center in Lebanon said in an editorial accompanying the study.
Such transplants already are used to cure children with the disease who have a compatible donor who provides bone marrow. Bone marrow gives rise to blood cells. Destroying a patient's bone marrow and replacing it with healthy marrow from a donor, often a sibling, is considered too risky for adults.... http://www.reuters.com/article/idUSTRE5B853M20091210?feedType=nl&feedName=ushealth1100
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RANDOM FACT: In a 1936 ping pong tournament, the players volleyed for more than two hours on the opening serve.
Organ Trafficking: Global Solutions for a Global Problem The organ trafficking market is on the rise worldwide. Numerous unfortunate stories of networks of brokers, physicians, and hospitals engaged in illegal trade have been featured in high-profile media. The profitable enterprises facilitating these unregulated services exploit the poor in underresourced countries and offer substandard medical care with unacceptable outcomes to the rich recipients. Despite efforts to boost altruistic organ donation and resolutions to curb transplant tourism, their implementation has been compromised. At the same time, the worldwide escalation in the number of patients with kidney failure coupled with a shortage in the supply of organs continues to fuel this trade.... http://www.ajkd.org/article/PIIS0272638609011779/fulltext
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Marrow transplant cures adult sickle cell disease (Reuters) Nine of 10 adult patients given an experimental bone marrow transplant treatment were cured of sickle cell disease, researchers at the U.S. government's National Institutes of Health reported in the New England Journal of Medicine.
If the early results hold, the treatment "could be ideal for patients with severe sickle cell disease," Dr. Miguel Abboud of American University of Beirut Medical Center in Lebanon said in an editorial accompanying the study.
Such transplants already are used to cure children with the disease who have a compatible donor who provides bone marrow. Bone marrow gives rise to blood cells. Destroying a patient's bone marrow and replacing it with healthy marrow from a donor, often a sibling, is considered too risky for adults.... http://www.reuters.com/article/idUSTRE5B853M20091210?feedType=nl&feedName=ushealth1100
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RANDOM FACT: In a 1936 ping pong tournament, the players volleyed for more than two hours on the opening serve.
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Make a stroke less deadly with this Vitamin Having a stroke is a definite life crisis. But what if you could reduce the chances that it'll be deadly?
Enter vitamin D. New research is suggesting that vitamin D may help reduce a person's risk of dying from a stroke -- by as much as 50 percent! ... http://www.realage.com/tips/make-strokes-less-deadly-with-this-vitamin
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RANDOM FACT: A single coffee tree produces only about a pound of coffee beans per year.
Make a stroke less deadly with this Vitamin Having a stroke is a definite life crisis. But what if you could reduce the chances that it'll be deadly?
Enter vitamin D. New research is suggesting that vitamin D may help reduce a person's risk of dying from a stroke -- by as much as 50 percent! ... http://www.realage.com/tips/make-strokes-less-deadly-with-this-vitamin
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RANDOM FACT: A single coffee tree produces only about a pound of coffee beans per year.
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Burn More Fat with These Breakfast Foods: You can give your body a little fat-burning advantage by including items like these in your morning meal: eggs, yogurt, and whole-grain cereal. Breakfast is the most important meal of the day if you're trying to control your appetite and lose weight, but these three items in particular have been credited with extra fat-burning and pound-dropping powers in recent studies.... http://www.realage.com/tips/burn-more-fat-with-these-breakfast-foods
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Provera , Prozac, or Proscar? (sorry, the picture didn't transfer) An order was written for PROVERA (medroxyPROGESTERone)10 mg po daily (see photo below). During order entry, the pharmacist misinterpreted the order as PROZAC(FLUoxetine) 10 mg po daily. The nurse did not detect the error when verifying the order in the electronic medication administration record. The patient eceived one dose of Prozac. The physician discovered the error the next day while he was reviewing the patient’s medication list (which is a highly recommended form of redundancy that has detected many errors). The handwritten order was shown to several nurses, pharmacists, and physicians. Most read the order as Provera but one physician thought it was Prozac. One nurse guessed it was Provera but also said it could be PROSCAR (finasteride). Poor handwriting was a contributing factor, as was the fact that Provera is infrequently prescribed while Prozac is a commonly prescribed drug, perhaps biasing the reader’s interpretation as “Prozac” on the handwritten prescription. Including the indication with this order
Shared MDIs: Can cross-contamination be avoided? Shared MDIs as a cost-saving measure, some hospitals allow respiratory therapy departments to use a single metered dose inhaler (MDI) canister to administer medication to multiple patients. This practice, first described more than a decade ago,1-3 employs a protocol in which the MDI nozzle (mouthpiece) is wiped with an alcohol prep pad and then inserted into a single patient-specific aerosol cloud enhancer (ACE) spacer with a oneway valve before delivering the medication (see Figure 1). Most protocols call for disinfecting the nozzle using an alcohol prep pad after the medication has been delivered.... December 2009 issue of : http://www.ismp.org/Newsletters/nursing/backissues.asp.
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Less is More: Simplified 4-step Algorithm Improves BP Control With Simple Algorithm, 20% More Reached BP Target Feldman explained to heartwire that the Canadian Hypertension Education Program (CHEP) guidelines currently cover 162 recommendations including, for example, a choice of five first-line drugs.
"Hypertension globally is a general-practitioner-based disease; they've got BP guidelines and lots of other guidelines to follow, and we know it's difficult for them to find the time and make the effort to control BP. And patients don't like taking pills either—we know that the more pills they are taking, the more likely they are to stop taking them, and the more switches that occur, the less likely they are to comply."
So the researchers developed the Simplified Treatment Intervention to Control Hypertension (STITCH) algorithm, which consists of four steps: initial use of a low dose of diuretic/ACE-inhibitor or diuretic/angiotensin-receptor blocker (ARB) fixed-dose combination; uptitration of combination therapy to the highest dose; addition of a calcium-channel blocker and up-titration; and addition of a non–first-line antihypertensive agent .... http://cme.medscape.com/viewarticle/590398
Burn More Fat with These Breakfast Foods: You can give your body a little fat-burning advantage by including items like these in your morning meal: eggs, yogurt, and whole-grain cereal. Breakfast is the most important meal of the day if you're trying to control your appetite and lose weight, but these three items in particular have been credited with extra fat-burning and pound-dropping powers in recent studies.... http://www.realage.com/tips/burn-more-fat-with-these-breakfast-foods
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Provera , Prozac, or Proscar? (sorry, the picture didn't transfer) An order was written for PROVERA (medroxyPROGESTERone)10 mg po daily (see photo below). During order entry, the pharmacist misinterpreted the order as PROZAC(FLUoxetine) 10 mg po daily. The nurse did not detect the error when verifying the order in the electronic medication administration record. The patient eceived one dose of Prozac. The physician discovered the error the next day while he was reviewing the patient’s medication list (which is a highly recommended form of redundancy that has detected many errors). The handwritten order was shown to several nurses, pharmacists, and physicians. Most read the order as Provera but one physician thought it was Prozac. One nurse guessed it was Provera but also said it could be PROSCAR (finasteride). Poor handwriting was a contributing factor, as was the fact that Provera is infrequently prescribed while Prozac is a commonly prescribed drug, perhaps biasing the reader’s interpretation as “Prozac” on the handwritten prescription. Including the indication with this order
Shared MDIs: Can cross-contamination be avoided? Shared MDIs as a cost-saving measure, some hospitals allow respiratory therapy departments to use a single metered dose inhaler (MDI) canister to administer medication to multiple patients. This practice, first described more than a decade ago,1-3 employs a protocol in which the MDI nozzle (mouthpiece) is wiped with an alcohol prep pad and then inserted into a single patient-specific aerosol cloud enhancer (ACE) spacer with a oneway valve before delivering the medication (see Figure 1). Most protocols call for disinfecting the nozzle using an alcohol prep pad after the medication has been delivered.... December 2009 issue of : http://www.ismp.org/Newsletters/nursing/backissues.asp.
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Less is More: Simplified 4-step Algorithm Improves BP Control With Simple Algorithm, 20% More Reached BP Target
"Hypertension globally is a general-practitioner-based disease; they've got BP guidelines and lots of other guidelines to follow, and we know it's difficult for them to find the time and make the effort to control BP. And patients don't like taking pills either—we know that the more pills they are taking, the more likely they are to stop taking them, and the more switches that occur, the less likely they are to comply."
So the researchers developed the Simplified Treatment Intervention to Control Hypertension (STITCH) algorithm, which consists of four steps: initial use of a low dose of diuretic/ACE-inhibitor or diuretic/angiotensin-receptor blocker (ARB) fixed-dose combination; uptitration of combination therapy to the highest dose; addition of a calcium-channel blocker and up-titration; and addition of a non–first-line antihypertensive agent
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HUMOR SECTION
This ER medical humor was sent in by Kurt Ullman, one of our new members......who writes:
"Make sure to also follow the links. They are also interesting, especially the one detailing the management of Patients Without Discernible Pathology" ...
http://lifeinthefastlane.com/2010/01/signs-of-imminent-admission/
This is part of the above.......which includes the 4 picosecond rule: The Utopian College of Emergency for Medicine (UCEM) is proud to announce a new policy pertaining to the discipline of peri-departmental medicine. Until now, the softest admissions – such as the Patient Without Discernible Pathology (PWDP) – have been the toughest dispositions.
The introduction of the 4 minute rule had an immediate impact on the rapidity and accuracy of admission/discharge decisions within the realm of the Waiting Room. With this is mind, the UCEM are set to introduce the 4 picosecond rule as part of their tough new front-line strategy in weeding out soft admissions through the diodotic gates. (http://lifeinthefastlane.com/2010/01/ucem-says-no-to-softness/)
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A doctor died and went to Hell. He was met at the gate and asked to stand in a room and wait for Satan. After 4 hours, Satan finally appeared. The doctor was incensed. Poking his watch he said, "How could you keep me waiting so long? I am an important man! I'm a doctor!"
Satan replied, "Doctors are a dime a dozen here in Hell. But I'll tell you what, since you had to wait so long, I will give you a choice of which part of Hell you will spend eternity in."
Satan took the doctor down a hall and said, "Here. I'll be back shortly. You can choose between door #1 and door #2. When I come back, you can let me know where you want to be assigned."
The doctor opened door #1. Inside was an Intensive Care Unit. Blood was spurting, alarms were sounding and patients were coding. A man in the corner extubated himself as a woman in the center fell out of bed. The doctor quickly shut the door,
HUMOR SECTION
This ER medical humor was sent in by Kurt Ullman, one of our new members......who writes:
"Make sure to also follow the links. They are also interesting, especially the one detailing the management of Patients Without Discernible Pathology" ...
http://lifeinthefastlane.com/2010/01/signs-of-imminent-admission/
This is part of the above.......which includes the 4 picosecond rule: The Utopian College of Emergency for Medicine (UCEM) is proud to announce a new policy pertaining to the discipline of peri-departmental medicine. Until now, the softest admissions – such as the Patient Without Discernible Pathology (PWDP) – have been the toughest dispositions.
The introduction of the 4 minute rule had an immediate impact on the rapidity and accuracy of admission/discharge decisions within the realm of the Waiting Room. With this is mind, the UCEM are set to introduce the 4 picosecond rule as part of their tough new front-line strategy in weeding out soft admissions through the diodotic gates. (http://lifeinthefastlane.com/2010/01/ucem-says-no-to-softness/)
****************************
A doctor died and went to Hell. He was met at the gate and asked to stand in a room and wait for Satan. After 4 hours, Satan finally appeared. The doctor was incensed. Poking his watch he said, "How could you keep me waiting so long? I am an important man! I'm a doctor!"
Satan replied, "Doctors are a dime a dozen here in Hell. But I'll tell you what, since you had to wait so long, I will give you a choice of which part of Hell you will spend eternity in."
Satan took the doctor down a hall and said, "Here. I'll be back shortly. You can choose between door #1 and door #2. When I come back, you can let me know where you want to be assigned."
The doctor opened door #1. Inside was an Intensive Care Unit. Blood was spurting, alarms were sounding and patients were coding. A man in the corner extubated himself as a woman in the center fell out of bed. The doctor quickly shut the door,
and said, "My God, I really am in Hell. I'd better check door #2."
Behind door #2 was a Medical Records department. Unfinished charts stretched for miles with notations about delinquent H&Ps. Message slips from managed care case managers filled a swimming pool sized bin, all marked urgent. Inside physicians were dictating as sweat poured off their brows. The doctor shut the door and said, "I don't know which is worse."
Then he noticed another door off to the side. He opened it and inside was a tidy nurses’ station. The nurses were all rushing around. They had 15 patients each...all the patients were on their call lights. They were busily making rounds with the doctors and calling to obtain lab and x-ray results. Starting IVs, hanging IV bags, and finding IV sites all red and swollen.
Behind door #2 was a Medical Records department. Unfinished charts stretched for miles with notations about delinquent H&Ps. Message slips from managed care case managers filled a swimming pool sized bin, all marked urgent. Inside physicians were dictating as sweat poured off their brows. The doctor shut the door and said, "I don't know which is worse."
Then he noticed another door off to the side. He opened it and inside was a tidy nurses’ station. The nurses were all rushing around. They had 15 patients each...all the patients were on their call lights. They were busily making rounds with the doctors and calling to obtain lab and x-ray results. Starting IVs, hanging IV bags, and finding IV sites all red and swollen.
They poured coffee and served donuts purchased with their own money to the physicians. One doctor complained of a stiff neck and a nurse jumped up from her work, and rubbed it for him. "Now this is more like it," the doctor thought as he closed the door.
Satan came strolling back down the hall and said, "Well, which one have you decided on? Door #1, or door #2?" the doctor replied, "Actually, I would like to go behind door #3."
"That's not an option," said Satan.
"But that's the one I want!" said the doctor.
Satan replied, "I'm sorry but you can't go in there. That's the nurse's Hell.
Satan came strolling back down the hall and said, "Well, which one have you decided on? Door #1, or door #2?" the doctor replied, "Actually, I would like to go behind door #3."
"That's not an option," said Satan.
"But that's the one I want!" said the doctor.
Satan replied, "I'm sorry but you can't go in there. That's the nurse's Hell.
~~**~~**~~**~~**~~**~~
CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursingspectrum.com /
Free CEs http://www.myfreece.com/welcome.asp
https://nursing.advanceweb.com/CE/TestCenter/Main.aspx
This site was sent in by FNPMSN@aol.com (Cindy) http://cmepain.com/ !
Sent in by Wendie: Saxe Healthcare Communications announces the latest issues of Safe Practices in Patient Care and Initiatives in Safe Patient Care. Each of these issues contain FREE CE’s for nurses. Just visit www.saxetesting.com. to take the test and obtain your FREE CE.
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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursingspectrum.com /
Free CEs http://www.myfreece.com/welcome.asp
https://nursing.advanceweb.com/CE/TestCenter/Main.aspx
This site was sent in by FNPMSN@aol.com (Cindy) http://cmepain.com/ !
Sent in by Wendie: Saxe Healthcare Communications announces the latest issues of Safe Practices in Patient Care and Initiatives in Safe Patient Care. Each of these issues contain FREE CE’s for nurses. Just visit www.saxetesting.com. to take the test and obtain your FREE CE.
~~**~~**~~**~~**~~**~~
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell)
Founder, Forum for Shared Governance info@sharedgovernance.org www.sharedgovernance.org
Founder, Forum for Shared Governance info@sharedgovernance.org www.sharedgovernance.org
Decubqueen's website: www.accu-ruler.com
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.nationalnurse3.blogspot.com/
RNs launch a national safe staffing campaign http://www.1199seiu.org/media/magazine/sept_2007/safe_staffing.cfm
H.R. 2123, The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007
http://www.washingtonwatch.com/bills/show/110_HR_2123.html
Board Supports Your Right to Refuse An Unsafe Assignment: Nurse Practice Act cites three conditions for patient abandonment http://findarticles.com/p/articles/mi_qa4102/is_200408/ai_n9450263
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.nationalnurse3.blogspot.com/
RNs launch a national safe staffing campaign http://www.1199seiu.org/media/magazine/sept_2007/safe_staffing.cfm
H.R. 2123, The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007
http://www.washingtonwatch.com/bills/show/110_HR_2123.html
Board Supports Your Right to Refuse An Unsafe Assignment: Nurse Practice Act cites three conditions for patient abandonment http://findarticles.com/p/articles/mi_qa4102/is_200408/ai_n9450263
http://www.infoplease.com/ anything and everything answered.
The Nursing Site http://thenursingsite.com .
http://www.snopes.com
http://www.solutionsoutsidethebox.net/ Raconte's website
http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3
The Nursing Site http://thenursingsite.com .
http://www.snopes.com
http://www.solutionsoutsidethebox.net/ Raconte's website
http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3
National Do Not Call Registry
If you're buying a used car, it is recommended having a mechanic inspect it first. And screen the car's VIN through the free database at carfax.com/flood
This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Critical Thinking is More Than Problem Solving Critical Thinking: Not Usually Rapid Fire
Should Clinical Courses Get a Letter Grade?
If you're buying a used car, it is recommended having a mechanic inspect it first. And screen the car's VIN through the free database at carfax.com/flood
This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Critical Thinking is More Than Problem Solving Critical Thinking: Not Usually Rapid Fire
Should Clinical Courses Get a Letter Grade?
Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/
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MEDICAL RECALLS
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http://www.metric-conversions.org/
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MEDICAL RECALLS
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Safesheath CSG Coronary Sinus Guide Hemostatic Introducer System with Infusion Sideport by Thomas Medical FDA and Thomas Medical Products Inc. notified healthcare professionals of a Class I Recall of certain lots of the product, tube-like devices placed into blood vessels to insert pacing or defibrillator wires and catheters into blood vessels. The sheath tip may break off and separate while the sheath is inside a blood vessel. If this occurs, the sheath tip could move through the blood vessel into organs such as the lungs and heart or, less commonly, into arteries. From there, the broken tip could cause a blockage anywhere, including the brain or heart, leading to permanent injury, such as a stroke or heart attack, or even death.
Any adverse events that may be related to use should be reported to the FDA's MedWatch Safety Information and Adverse Event Reporting Program online [at www.fda.gov/MedWatch/report.htm], by phone 1-800-332-1088, or by returning the postage-paid FDA form 3500 [which may be downloaded from the MedWatch "Download Forms" page] by mail [to address on the pre-addressed form] or fax [1-800-FDA-0178]. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm199927.htm
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FDA notified healthcare professionals and patients that the risk of developing progressive multifocal leukoencephalopathy (PML) increases with the number of Tysabri infusions received. This new safety information, based on reports of 31 confirmed cases of PML received by the FDA as of January 21, 2010, will now be included in the Tysabri drug label and patient Medication Guide. Information about the occurrence of Immune Reconstitution Inflammatory Syndrome (IRIS) in patients who have developed PML and subsequently discontinued Tysabri has also been added to the drug label. IRIS is a rare condition characterized by a severe inflammatory response that can occur during or following immune system recovery, causing an unexpected decline in a patient’s condition after return of immune function. Based on the available information, FDA believes that the clinical benefits of Tysabri continue to outweigh the potential risks. Revisions to the drug label and patient Medication Guide, with the continued use of the TOUCH Prescribing Program, are intended to maximize the safe use of Tysabri and the identification of new PML cases. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts
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I am sorry that the following is so very long...but consider it vital to nurses to know :
FDA Announces Class I Recall of Certain Infusion Set Needles Huber needles used in implanted ports to withdraw blood, inject medications, and other solutions The U.S. Food and Drug Administration today announced a Class I recall of Exel/Exelint Huber needles, Exel/Exelint Huber Infusion Sets and Exel/Exelint “Securetouch+” Safety Huber Infusion Sets, manufactured by Nipro Medical Corporation for Exelint International Corporation.
Huber needles are used to access ports implanted under the skin of chronically ill patients for repeated access to veins for the withdrawal of blood and infusion of medication, nutritional solutions, blood products, and imaging solutions. These needles should be designed to penetrate the port without cutting and dislodging any silicone cores (or slivers) from the ports into which they are inserted.
Inspections conducted in October 2009 of Nipro facilities in Japan found that their needles “cored” in 60 to 72 percent of tests. The reason for this coring is related to design and manufacturing processes, which the FDA continues to investigate.
There are more than 2 million units impacted by this recall in distribution nationwide. Recalled needles were manufactured from January 2007 to August 2009
Following hospital reports to the FDA of leakage after accessing the port with a Huber needle (labeled to be non-coring), the agency conducted it own laboratory testing of Huber needles from multiple manufacturers. This testing showed that certain Huber needles produced cores when inserted into ports. However, at this time only needles manufactured by Nipro have shown a high frequency for coring. The agency is continuing its investigation and will update the public if there are new developments.
At this time, the FDA has not received any adverse event reports related to silicone foreign bodies released in patients from Huber needle coring.The agency received only reports of port leakage. However, because it may be very difficult for clinicians to associate adverse patient outcomes with the use of defective Huber needles, there may be under-reporting of events. The agency has issued a letter to manufacturers of other Huber needles to address design and manufacturing concerns.
“The agency’s laboratory work helped determine the coring problem, and we will continue to work with manufacturers to address coring issues as quickly and thoroughly as possible,” said Jeffrey Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health.
The FDA continues to work closely with all 20 manufacturers of Huber needles to understand the potential causes for coring and identify corrective measures. While a more thorough investigation of this situation continues, the FDA recommends that health care professionals consider taking the following precautions, which will be posted on the FDA’s Web site, when accessing implanted ports with Huber needles:
Avoid flushing the syringe when initially confirming needles patency upon accessing the port. If the needle has cored the port, flushing may introduce the core into the patient’s body, and could lead to serious adverse events.
When possible, upon accessing the port, consider aspirating a small amount of blood from the port after septum puncture, then discard the syringe with its contents. This step may recapture the silicone sliver. If the needle becomes clogged when attempting to aspirate, remove the needle, discard it and select a new one.
Watch for signs and/or symptoms that may indicate damage to the port’s septum, such as medication leakage resulting in inadequate therapy delivery, along with tissue, nerve and/or muscle damage; and redness of the surrounding area.
Any adverse events that may be related to use should be reported to the FDA's MedWatch Safety Information and Adverse Event Reporting Program online [at www.fda.gov/MedWatch/report.htm], by phone 1-800-332-1088, or by returning the postage-paid FDA form 3500 [which may be downloaded from the MedWatch "Download Forms" page] by mail [to address on the pre-addressed form] or fax [1-800-FDA-0178]. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm199927.htm
********************************
FDA notified healthcare professionals and patients that the risk of developing progressive multifocal leukoencephalopathy (PML) increases with the number of Tysabri infusions received. This new safety information, based on reports of 31 confirmed cases of PML received by the FDA as of January 21, 2010, will now be included in the Tysabri drug label and patient Medication Guide. Information about the occurrence of Immune Reconstitution Inflammatory Syndrome (IRIS) in patients who have developed PML and subsequently discontinued Tysabri has also been added to the drug label. IRIS is a rare condition characterized by a severe inflammatory response that can occur during or following immune system recovery, causing an unexpected decline in a patient’s condition after return of immune function. Based on the available information, FDA believes that the clinical benefits of Tysabri continue to outweigh the potential risks. Revisions to the drug label and patient Medication Guide, with the continued use of the TOUCH Prescribing Program, are intended to maximize the safe use of Tysabri and the identification of new PML cases. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts
*******************
I am sorry that the following is so very long...but consider it vital to nurses to know :
FDA Announces Class I Recall of Certain Infusion Set Needles Huber needles used in implanted ports to withdraw blood, inject medications, and other solutions The U.S. Food and Drug Administration today announced a Class I recall of Exel/Exelint Huber needles, Exel/Exelint Huber Infusion Sets and Exel/Exelint “Securetouch+” Safety Huber Infusion Sets, manufactured by Nipro Medical Corporation for Exelint International Corporation.
Huber needles are used to access ports implanted under the skin of chronically ill patients for repeated access to veins for the withdrawal of blood and infusion of medication, nutritional solutions, blood products, and imaging solutions. These needles should be designed to penetrate the port without cutting and dislodging any silicone cores (or slivers) from the ports into which they are inserted.
Inspections conducted in October 2009 of Nipro facilities in Japan found that their needles “cored” in 60 to 72 percent of tests. The reason for this coring is related to design and manufacturing processes, which the FDA continues to investigate.
There are more than 2 million units impacted by this recall in distribution nationwide. Recalled needles were manufactured from January 2007 to August 2009
Following hospital reports to the FDA of leakage after accessing the port with a Huber needle (labeled to be non-coring), the agency conducted it own laboratory testing of Huber needles from multiple manufacturers. This testing showed that certain Huber needles produced cores when inserted into ports. However, at this time only needles manufactured by Nipro have shown a high frequency for coring. The agency is continuing its investigation and will update the public if there are new developments.
At this time, the FDA has not received any adverse event reports related to silicone foreign bodies released in patients from Huber needle coring.The agency received only reports of port leakage. However, because it may be very difficult for clinicians to associate adverse patient outcomes with the use of defective Huber needles, there may be under-reporting of events. The agency has issued a letter to manufacturers of other Huber needles to address design and manufacturing concerns.
“The agency’s laboratory work helped determine the coring problem, and we will continue to work with manufacturers to address coring issues as quickly and thoroughly as possible,” said Jeffrey Shuren, M.D., J.D., director of the FDA’s Center for Devices and Radiological Health.
The FDA continues to work closely with all 20 manufacturers of Huber needles to understand the potential causes for coring and identify corrective measures. While a more thorough investigation of this situation continues, the FDA recommends that health care professionals consider taking the following precautions, which will be posted on the FDA’s Web site, when accessing implanted ports with Huber needles:
Avoid flushing the syringe when initially confirming needles patency upon accessing the port. If the needle has cored the port, flushing may introduce the core into the patient’s body, and could lead to serious adverse events.
When possible, upon accessing the port, consider aspirating a small amount of blood from the port after septum puncture, then discard the syringe with its contents. This step may recapture the silicone sliver. If the needle becomes clogged when attempting to aspirate, remove the needle, discard it and select a new one.
Watch for signs and/or symptoms that may indicate damage to the port’s septum, such as medication leakage resulting in inadequate therapy delivery, along with tissue, nerve and/or muscle damage; and redness of the surrounding area.
FDA Announces Class I Recall of Certain Infusion Set Needles (Huber)
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FDA Enforcement Report for Jan. 13, 2009. A total of 55,128 catheters are being recalled due to a possibility that the catheter tubing could separate from the hub/bifurcation of the device. Scroll down the page to see the listing of 48 recallled products http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm197795.htm
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Baxter recently sent an Urgent Device Correction notice to peritoneal dialysis clinicians to help reduce or eliminate overfill, also referred to as Increased Intraperitonal Volume (IIPV), associated with HomeChoice/HomeChoice PRO cyclers. URGENT RECALL: HomeChoice Automated PD System and HomeChoice PRO Automated PD System (Product Codes 5C4471, 5C4471R, 5C8310, 5C8310R)
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Vicks Sinex Nasal Spray - Recall Procter & Gamble and FDA notified consumers of a voluntary recall of three lots of Vicks Sinex Nasal Spray in the United States, Germany and the United Kingdom. The bacteria B. cepacia was found in a small amount of product made at its plant in Gross Gerau, Germany. There have been no reports of illness. However, the bacteria could cause serious infections for individuals with a compromised immune system, or those with chronic lung conditions, such as cystic fibrosis. Consumers should simply discard the affected product as they would any over the counter medicine. Customers who have the affected lots can call P&G for a replacement coupon or refund. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts
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FDA Enforcement Report for Jan. 13, 2009. A total of 55,128 catheters are being recalled due to a possibility that the catheter tubing could separate from the hub/bifurcation of the device. Scroll down the page to see the listing of 48 recallled products http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm197795.htm
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Baxter recently sent an Urgent Device Correction notice to peritoneal dialysis clinicians to help reduce or eliminate overfill, also referred to as Increased Intraperitonal Volume (IIPV), associated with HomeChoice/HomeChoice PRO cyclers. URGENT RECALL: HomeChoice Automated PD System and HomeChoice PRO Automated PD System (Product Codes 5C4471, 5C4471R, 5C8310, 5C8310R)
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Vicks Sinex Nasal Spray - Recall Procter & Gamble and FDA notified consumers of a voluntary recall of three lots of Vicks Sinex Nasal Spray in the United States, Germany and the United Kingdom. The bacteria B. cepacia was found in a small amount of product made at its plant in Gross Gerau, Germany. There have been no reports of illness. However, the bacteria could cause serious infections for individuals with a compromised immune system, or those with chronic lung conditions, such as cystic fibrosis. Consumers should simply discard the affected product as they would any over the counter medicine. Customers who have the affected lots can call P&G for a replacement coupon or refund. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts
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Zyprexa (olanzapine): Use in Adolescents Lilly and FDA notified healthcare professionals of changes to the Prescribing Information for Zyprexa related to its indication for use in adolescents (ages 13-17) for treatment of schizophrenia and bipolar I disorder [manic or mixed episodes]. The revised labeling states that:
Section 1, Indications and Usage: When deciding among the alternative treatments available for adolescents, clinicians should consider the increased potential (in adolescents as compared with adults) for weight gain and hyperlipidemia. Clinicians should consider the potential long-term risks when prescribing to adolescents, and in many cases this may lead them to consider prescribing other drugs first in adolescents.
Section 17.14, Need for comprehensive Treatment Program in Pediatric Patients: Zyprexa is indicated as an integral part of a total treatment program for pediatric patients with schizophrenia and bipolar disorder that may include other measures (psychological, educational, social) for patients with the disorder. Effectiveness and safety of ZYPREXA have not been established in pediatric patients less than 13 years of age. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm198402.htm
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Videx/Videx EC (didanosine): Labeling Revision - Risk of Non-Cirrhotic Portal Hypertension FDA notified healthcare professionals and patients about a rare, but serious, complication in the liver known as non-cirrhotic portal hypertension in patients using Videx or Videx EC (didanosine), a medication used to treat human immunodeficiency virus (HIV) infection. FDA became aware of cases of non-cirrhotic portal hypertension through adverse event reports submitted to FDA's Adverse Event Reporting System. Based on the number of well-documented cases and exclusion of other causes of portal hypertension such as alcohol-related cirrhosis or hepatitis C, FDA concludes there is an association between use of didanosine and development of non-cirrhotic portal hypertension. Because of the potential severity of portal hypertension, including death from hemorrhaging esophageal varices, FDA has revised the Warning and Precautions section of the didanosine drug label to assure safe use of the medication. FDA believes the clinical benefits of didanosine for certain patients with HIV continue to outweigh its potential risks. The decision to use this drug, however, must be made on an individual basis between the treating physician and the patient. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm199343.htm
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Edwards Lifesciences Aquarius Hemodialysis System: Recall FDA notified healthcare professionals of a Class I recall of Hettich Centrifuges with 2050 and 2076 plastic rotors, used in combination with the Mikro 12-24, Mikro 20, Haematokrit 20 and Haematokrit 24 bench top plastic centrifuges. The recall was initiated because the plastic centrifuge rotor may crack, break apart and be forcefully ejected through the plastic centrifuge housing at a high rate of speed. This may result in serious personal injury and damage to the surrounding area.
The device separates the red blood cells from plasma to determine the patient’s hematocrit. These recalled devices were distributed from January, 1999 through November, 2009. Hospitals, clinics and laboratories who have the listed centrifuge/rotor combination should immediately stop using the plastic rotors and contact Hettich to have these affected rotors replaced with metal rotors. The centrifuges can be identified by reading the model number on the front of the instrument or the name tag on the rear of the centrifuge; the rotors have the model numbers 2076 or 2050 stamped on them. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm199202.htm
Section 1, Indications and Usage: When deciding among the alternative treatments available for adolescents, clinicians should consider the increased potential (in adolescents as compared with adults) for weight gain and hyperlipidemia. Clinicians should consider the potential long-term risks when prescribing to adolescents, and in many cases this may lead them to consider prescribing other drugs first in adolescents.
Section 17.14, Need for comprehensive Treatment Program in Pediatric Patients: Zyprexa is indicated as an integral part of a total treatment program for pediatric patients with schizophrenia and bipolar disorder that may include other measures (psychological, educational, social) for patients with the disorder. Effectiveness and safety of ZYPREXA have not been established in pediatric patients less than 13 years of age. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm198402.htm
*****************
Videx/Videx EC (didanosine): Labeling Revision - Risk of Non-Cirrhotic Portal Hypertension FDA notified healthcare professionals and patients about a rare, but serious, complication in the liver known as non-cirrhotic portal hypertension in patients using Videx or Videx EC (didanosine), a medication used to treat human immunodeficiency virus (HIV) infection. FDA became aware of cases of non-cirrhotic portal hypertension through adverse event reports submitted to FDA's Adverse Event Reporting System. Based on the number of well-documented cases and exclusion of other causes of portal hypertension such as alcohol-related cirrhosis or hepatitis C, FDA concludes there is an association between use of didanosine and development of non-cirrhotic portal hypertension. Because of the potential severity of portal hypertension, including death from hemorrhaging esophageal varices, FDA has revised the Warning and Precautions section of the didanosine drug label to assure safe use of the medication. FDA believes the clinical benefits of didanosine for certain patients with HIV continue to outweigh its potential risks. The decision to use this drug, however, must be made on an individual basis between the treating physician and the patient. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm199343.htm
****************
Edwards Lifesciences Aquarius Hemodialysis System: Recall FDA notified healthcare professionals of a Class I recall of Hettich Centrifuges with 2050 and 2076 plastic rotors, used in combination with the Mikro 12-24, Mikro 20, Haematokrit 20 and Haematokrit 24 bench top plastic centrifuges. The recall was initiated because the plastic centrifuge rotor may crack, break apart and be forcefully ejected through the plastic centrifuge housing at a high rate of speed. This may result in serious personal injury and damage to the surrounding area.
The device separates the red blood cells from plasma to determine the patient’s hematocrit. These recalled devices were distributed from January, 1999 through November, 2009. Hospitals, clinics and laboratories who have the listed centrifuge/rotor combination should immediately stop using the plastic rotors and contact Hettich to have these affected rotors replaced with metal rotors. The centrifuges can be identified by reading the model number on the front of the instrument or the name tag on the rear of the centrifuge; the rotors have the model numbers 2076 or 2050 stamped on them. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm199202.htm
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NURSING HINTS CORNER
NURSING HINTS CORNER
Twelve Cranial nerves:
Olfactory-- smell
Optic--vision
Oculometer-- iris and eye movements
Trochlear-- eye movements
Trigeminal-- upper and lower mouth and teeth, forehead, anterior half of scalp
Abducens-- eye movements (lateral)
Facial-- facial expression
Acoustic-- hearing, balance
Glossopharyngeal-- tastebuds on posterior part of tongue, throat sensations, saliva secretions
Vagus-- swallowing, vocal cords, goes to abdominal organs
Accessory-- head and shoulder movements
Hypoglossal-- chewing, speaking, swallowing
Optic--vision
Oculometer-- iris and eye movements
Trochlear-- eye movements
Trigeminal-- upper and lower mouth and teeth, forehead, anterior half of scalp
Abducens-- eye movements (lateral)
Facial-- facial expression
Acoustic-- hearing, balance
Glossopharyngeal-- tastebuds on posterior part of tongue, throat sensations, saliva secretions
Vagus-- swallowing, vocal cords, goes to abdominal organs
Accessory-- head and shoulder movements
Hypoglossal-- chewing, speaking, swallowing
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.32, Springhouse Corporation/www.springnetcom.
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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.
ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.
Visit us at http://www.accu-ruler.com/.
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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
WELCOME TO:
tgosier@smithhospital.com Tammy January 18, 2010
rnpftno_1@bellsouth.net Marilyn January 19, 2010
hayat.barron@gmail.com (Hyat) January 28, 2010
rnpftno_1@bellsouth.net (Marilyn) January 30, 2010
jseward@windstream.net (Judy) February 3, 2010
ChristieRN2008@hotmail.com (Christie) February 3, 2010
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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number....lol So please send me your new name/address, ok? RNFrankie@AOL.com
NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
WELCOME TO:
tgosier@smithhospital.com Tammy January 18, 2010
rnpftno_1@bellsouth.net Marilyn January 19, 2010
hayat.barron@gmail.com (Hyat) January 28, 2010
rnpftno_1@bellsouth.net (Marilyn) January 30, 2010
jseward@windstream.net (Judy) February 3, 2010
ChristieRN2008@hotmail.com (Christie) February 3, 2010
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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number....lol So please send me your new name/address, ok? RNFrankie@AOL.com
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EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)
EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)
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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)
PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)
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DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
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THOUGHT FOR THE DAY
The two greatest obstacles to democracy in the United States are, first,the widespread delusion among the poor that we have a democracy, and second,the chronic terror among the rich, lest we get it.
From Edward Dowling, editor and priest,
Chicago Daily News, July 28, 1941:
THOUGHT FOR THE DAY
The two greatest obstacles to democracy in the United States are, first,the widespread delusion among the poor that we have a democracy, and second,the chronic terror among the rich, lest we get it.
From Edward Dowling, editor and priest,
Chicago Daily News, July 28, 1941:
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