Newsletter for Paradigm97
November 10, 2010
HAPPY THANKSGIVING EVERYONE !!!!
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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SNIPPETS
Nurses' role in Medication Safety choo j., hutchinson a. & bucknall t. (2010) Journal of Nursing Management18, 853–861 Nurses' role in medication safety
Aim To explore the nurse’s role in the process of medication management and identify the challenges associated with safe medication management in contemporary clinical practice.
Background Medication errors have been a long-standing factor affecting consumer safety. The nursing profession has been identified as essential to the promotion of patient safety.
Evaluation A review of literature on medication errors and the use of electronic prescribing in medication errors.
Key issues Medication management requires a multidisciplinary approach and interdisciplinary communication is essential to reduce medication errors. Information technologies can help to reduce some medication errors through eradication of transcription and dosing errors. Nurses must play a major role in the design of computerized medication systems to ensure a smooth transition to such as system. ... http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2834.2010.01164.x/abstract;jsessionid=D24DBB5E0FC93EFF153C857D0DCE46D2.d02t01
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New therapy for metastatic melanoma Approximately 60,000 new cases of melanoma, will be diagnosed in the U.S. in 2010. The disease, which is the most serious type of skin cancer, accounts for about 10,000 deaths each year. That's according to the American Cancer Society. And although melanoma is treatable when caught early, after it spreads to other parts of the body, a patient is usually given a grim diagnosis of less than a year to live. Now a study in the New England Journal of Medicine reports a new drug treatment may help some of these patients live longer.
While looking at genes in cancer patients back in 2002 , scientists found that in 40 to 60 percent of melanoma cases and 7 to 8 percent of all cancers, a protein mutation known as BRAF was present. With this mutation, the protein becomes overreactive, causing cancer cells to grow. When researchers targeted this BRAF mutation with a drug known as PLX4032, it inhibited the mutation, shrinking tumors and slowing the progression of the disease in 81 percent of those treated. ... http://pagingdrgupta.blogs.cnn.com/2010/08/26/new-therapy-promising-against-metastatic-melanoma/
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FROM THE MEMBERS
You can access a free CE credit Webinar on Critical Thinking by one of our members (Roz Alfaro-LeFevre). Roz said over 400 people attended with overwhelming positive responses on evals. This webinar is part of a career development initiative supported by The Johnson & Johnson Campaign for Nursing's Future. To access the webinar content, click here:
Critical Thinking: The Key to Your Success in Nursing | WEB38 > Continuing Education Unit at Nurse.com
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MEDICAL NEWS
WASHINGTON (Reuters) - More than 17,000 doctors and other healthcare providers have taken money from seven major drug companies to talk to other doctors about their products, a joint investigation by news organizations and non-profit groups found. More than 380 of the doctors, nurses, pharmacists and other professionals took in more than $100,000 in 2009 and 2010, according to the investigation released on Tuesday. The report said far more doctors are likely to have taken such payments, but it documented these based on information from seven drugmakers. ... (I believe that a refresher course in Ethics is appropriate, here) http://www.reuters.com/article/idUSTRE69I3PO20101019?feedType=nl&feedName=ushealth1100
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Joint Commission Center for Transforming Healthcare announces hand-off communications solutions Today, the Joint Commission Center for Transforming Healthcare is releasing its second set of solutions, which focus on improving hand-off communications. Miscommunication between caregivers when responsibility for patients is transferred or handed-off plays a role in an estimated 80 percent of serious preventable adverse events.
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LONDON (Reuters) - The United States National Institutes of Health said on Thursday it will share intellectual property rights on some AIDS drugs in a patent pool designed to make treatments more widely available to the poor.
The NIH is the first research institution to join an HIV medicines patent pool launched by UNITAID, a health financing system funded by a tax on airline tickets which was co-founded by Brazil, Britain, Chile, France, and Norway in 2006. ...
http://www.reuters.com/article/idUSTRE68T2Q920100930?feedType=nl&feedName=ushealth1100
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CHICAGO (Reuters) - Drugmaker Wyeth used ghostwriters to play up the benefits and downplay the harm of hormone replacement therapy in articles published in medical journals, U.S. researchers said on Tuesday. Dr. Adriane Fugh-Berman of Georgetown University Medical Center in Washington and colleagues analyzed dozens of ghostwritten reviews and commentaries published in medical journals and journal supplements, many of them using documents from judicial trials.
They said Wyeth, now owned by Pfizer, paid a medical communication company called DesignWrite $25,000 to ghostwrite articles on clinical studies, including four testing low-dose Prempro, the company's combination estrogen-progestin therapy. (Another need for an ethics review) ... http://www.reuters.com/article/idUSTRE6865FQ20100907?feedType=nl&feedName=ushealth1100
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
Thanks, Kurt for bringing this to our attention. (KurtUllman@Sprintmail.com) He writes: "Don't forget to fall back to your local store and get a new battery for your smoke/CO alarm. The stats from the National Fire Protection Association are staggering.
Almost all households in the U.S. have at least one smoke alarm, yet in 2003-2006, smoke alarms were present in only two-thirds (69%) of all reported home fires and operated in just under half (47%) of the reported home fires. (“Homes” includes one- and two- family homes, apartments, and manufactured housing.) Forty percent of all home fire deaths resulted from fires in homes with no smoke alarms, while 23% resulted from homes in which smoke alarms were present but did not operate.
The death rate per 100 reported fires was twice as high in homes without a working smoke alarm as it was in home fires with this protection.
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A Wonderful tool..... this is a great hint. To clean your keyboard...just apply the sticky part of a post-it between the keys. Voila....perfect.
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Copper equipment helps reduce hospital bacteria, study shows Researchers said that using copper for hospital bed rails, tray tables, chairs and other equipment eliminated 97% of hospital bacteria, including 100% of MRSA (methicillin-resistant Staphylococcus aureus). The researchers also aim to determine whether rooms with copper equipment translate to fewer hospital-acquired infections among patients. The Post and Courier (Charleston, S.C.) (free registration)
http://www.postandcourier.com/news/2010/sep/29/copper-found-to-reduce-bacteria
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RANDOM TIDBIT: The only river that flows both north and south of the equator is the Congo. It crosses the equator twice.
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Doctor shortage looming? Use nurses, report says WASHINGTON (Reuters) - Nurses can handle much of the strain that healthcare reform will place on doctors and should be given both the education and the authority to take on more medical duties, the U.S. Institute of Medicine said on Tuesday. ...
http://www.reuters.com/article/idUSTRE69445L20101005?feedType=nl&feedName=ushealth1100
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Astra-Zeneca hunts stem cell cure for eye disorder LONDON (Reuters) - AstraZeneca took its first significant step into regenerative medicine using stem cells on Monday by signing a deal with University College London to develop ways to repair eyesight in people with diabetes. ...
http://www.reuters.com/article/idUSTRE68C15S20100913?feedType=nl&feedName=ushealth1100
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5 Ways Hospitals Will Change Over the Next 10 Years Becker's Hospital Review
"In many hospitals, nurses do the RN work plus most of the nursing assistant work and a little bit of the supply tech work," he says. ...
http://www.beckershospitalreview.com/hospital-financial-and-business-news/5-ways-hospitals-will-change-over-the-next-10-years.html
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Trivia:
Apples have five seed pockets or carpels. Each pocket contains seeds. The number of seeds per carpel is determined by the vigor and health of the plant. Different varieties of apples will have different number of seeds. Newton Pippin apples were the first apples exported from America in 1768; some were sent to Benjamin Franklin in London.
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Add this to your rice to curb all-day appetite Shrink your appetite, your calorie intake, and your pants size with just one little addition to your rice: vegetables.
In a recent study of normal-weight people, mixing vegetables into a plain rice dish at lunch helped people feel fuller for the rest of the day. So much so that they ate way fewer calories at dinner than the folks who had their rice straight up.
Reference: Lowering the energy density of parboiled rice by adding water-rich vegetables can decrease total energy intake in a parboiled rice-based diet without reducing satiety on healthy women. Chang, U. J. et al., Appetite 2010 Jul 21
http://www.realage.com/tips/add-this-to-your-rice-to-curb-all-day-appetite?eid=7217&memberid=4687812
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The Fatigue Factor: Too Many Alarms, Too Little Downtime Critical care nurses must remain vigilant and alert for the slightest changes in patients’ conditions, but unfortunately mistakes can and do happen. A major factor in errors that affect patient care is fatigue — both alarm and physical. But there are solutions to combat the problem that consider the well-being of patients and their caregivers. ... http://news.nurse.com/article/20100906/NATIONAL01/109060005/-1/frontpage
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LONDON (Reuters) - Daily tablets of large doses of B vitamins can halve the rate of brain shrinkage in elderly people with memory problems and may slow their progression toward dementia, data from a British trial showed on Wednesday,
Scientists from Oxford University said their two-year clinical trial was the largest to date into the effect of B vitamins on so-called "mild cognitive impairment" -- a major risk factor for Alzheimer's disease and other forms of dementia.
Experts commenting on the findings said they were important and called for larger, longer full-scale clinical trials to see if the safety and effectiveness of B vitamins in the prevention of neurodegenerative conditions could be confirmed. ...
http://www.reuters.com/article/idUSTRE6875CL20100909?feedType=nl&feedName=ushealth1100
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RANDOM TIDBIT: There are 18 different animal shapes in the Animal Crackers cookie zoo.
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Computer Terms You Should Know
The famous computer scientist Bjarne Stroustrup once said, “There’s an old story about the person who wished his computer were as easy to use as his telephone. That wish has come true, since I no longer know how to use my telephone.”
As technology evolves, advanced computers and other tech devices appear more complicated and intimidating to the average user. In the event of a malfunction, most users who are limited in tech know how dread the call to tech support and frequently lug in their systems to computer stores where professionals can resolve the issue for a hefty price.
As “Sam,” a security engineer and technology expert who wishes to remain anonymous because of his job, explains, “Unfortunately, computers and operating systems are extremely complex devices. It's very easy to be intimidated at the complexity…and they have gotten progressively more complex over the last 20-plus years.” It’s so common apparently that cyberphobia, which the Free Dictionary defines as “the irrational fear of computers and technology,” is a typical occurrence.
Computer knowledge and maintenance
When traveling in a foreign country, it’s always helpful to learn a few everyday words and phrases, and the world of computers is no different. Words such as ‘RAM’ or ‘screenshot’ or ‘cache,’ for example, are common phrases with which average computer users should familiarize themselves.
You can also perform routine maintenance on your computer without getting technical. There are a host of easy-to-use at-home programs available that can help make your computer healthier. Computer Checkup Premium and System Mechanic, for example, help fix and speed up your computer and boost performance.
Popular tech terms
A majority of Americans own computers, yet the average user doesn’t know what ‘URL’ stands for (it’s Uniform Resource Locator, by the way -- a fancy term for an Internet address). Though most users have come a long way since the early days of the digital age when they mistook the CD-ROM drive for a cup holder, many are still baffled by tech-speak. Mastering just a handful of definitions may help users bridge the wide gap between the experts and the rest of us.
Firewall: A part of your network, a firewall allows certain communications to get through while blocking others. As Sam explains, “[Think of] a firewall as a doorman that stands outside your home (computer). It prevents unwanted users from just walking in to your home, and (with Windows 7 and Vista) checks that strangers that snuck into your home are allowed to leave.”
Malware: Malware is a catch-all phrase for viruses, adware and Trojans, which can cause damage to your computer. The best way to prevent malware from infecting your system is to regularly update your anti-virus program.
Cache: Your web cache stores all your web browsing info. You should clear your cache every so often to free up space on your hard drive and help protect your privacy.
RAM: Random-access memory (RAM) is a type of computer memory. “RAM is memory, and hard drive is space. Users often get these two mixed up,” our tech expert, Sam, says. “The best analogy I have is a room: RAM is the height of a room, and hard drive space is the square footage. The greater the ceiling height (RAM), the easier it is to move items (programs) around the floor (hard drive).” When you receive messages that your computer is low on memory, it’s usually time to add more RAM.
CPU: The Central Processing Unit (or more commonly, processor) is basically your computer’s 'brain,' which processes all the information. About.com sums it up best by saying that it’s “responsible for interpreting and executing most of the commands from the computer's hardware and software.”
HTTP and HTTPS: HTTP, or hypertext transfer protocol, is the standard prefix used for website addresses.
HTTPS (Hypertext transport protocol secure), on the other hand, signals that the website you have visited is secure. When browsing bank, credit card or shopping websites online, for example, look for ‘HTTPS’ before entering any sensitive information.
Defrag: As we reported earlier, hard drives eventually become fragmented with daily wear and tear -- meaning that files are scattered and stored in various locations, rather than being neatly lined up on the drive. Hence, it’s important to “defrag” your hard drive, which basically reorganizes the files correctly so your computer can access them more quickly.
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RANDOM FACT: The average cat sleeps about 2/3 of the day (notice that NIGHT is not mentioned)
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Study looks at teens who Self-Embed
Shiels' team found that of about 600 patients of all ages who went to the hospital to have foreign bodies removed from under their skin, 11 patients, or about 1.8 percent, had intentionally inserted the objects. They ranged in age from 14 to 18, and nine were girls.
The 11 teens had other psychological disorders, including depression, bipolar disorder, anxiety disorder, borderline personality disorder or post-traumatic stress disorder, according to the study. ... http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2010/09/07/self-embedding-takes-teen-self-injury-to-the-extreme.html
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RANDOM TIDBIT: There's only one city in the United States named merely "Beach." It is found in North Dakota, which is a land-locked state.
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WASHINGTON (Reuters) - A new kind of test that finds evidence of colon cancer in the stool can also detect pre-cancerous growths, and could potentially be an alternative to colonoscopies, researchers reported on Thursday.
Exact Sciences' new test detected 87 percent of stage I, II and III colon tumors, which can be surgically removed, and found 64 percent of the biggest pre-cancerous growths, the researchers told a meeting of the American Association for Cancer Research. It finds altered DNA that has either turned a cell cancerous, or has started the changes that lead to cancer. ... http://www.reuters.com/article/idUSTRE69R4ZK20101028?feedType=nl&feedName=ushealth1100
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THE NURSE MANAGER'S GUIDE TO HIRING, FIRING AND INSPIRINGAuthor: Hess, Vicki, MS, RN, CSP At A Glance: According to the 2006 Aging Nursing Workforce Survey, 20% of nurse leaders will have retired by 2010 and 75% by 2020, worsening the existing problem of a shortage of nurse leaders. It's important to keep the pipeline filled with new nurse managers and enhance the skills of those less experienced. ... http://www.medinfonow.com/min/ct/2/9781930538924/fuwluz/KAAK/3316/default.aspx
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LONDON (Reuters) - Scientists have discovered a mechanism which raises blood pressure in pre-eclampsia, a potentially deadly condition that can occur in pregnancy, and say their work may help the search for new hypertension drugs.
Researchers at Britain's Cambridge and Nottingham Universities said they had deciphered the first step in the main process that controls blood pressure -- the release of a hormone called angiotensin, from its source protein, angiotensinogen.
"Although we primarily focused on pre-eclampsia, the research also opens new leads for future research into the causes of hypertension in general," said Aiwu Zhou of Cambridge University, whose work was published in the journal Nature. ...
http://www.reuters.com/article/idUSTRE6954NZ20101006?feedType=nl&feedName=ushealth1100
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New Olive Oil Health Powers Revealed You already know that olive oil is chock-full of healthy fats. But here's another reason to cook with it: Olive oil might actually help "turn off" genes that could harm your heart.
In a study, eating a diet with lots of polyphenol-rich olive oil helped suppress genes related to heart-damaging inflammation and oxidation. Quite the modern-sounding health benefit for an oil that's been around since the days of Homer. ... Reference: In vivo nutrigenomic effects of virgin olive oil polyphenols within the frame of the Mediterranean diet: a randomized controlled trial. Konstantinidou, V. et al., FASEB Journal 2010 Jul;24(7):2546-2557.
http://www.realage.com/tips/new-olive-oil-health-powers-revealed?eid=7216&memberid=4687812
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WASHINGTON (Reuters) - Researchers have found a surprisingly quick and apparently safe way to transform ordinary skin cells into both stem cells -- the body's master cells -- and muscle cells. They said on Thursday their method may provide a way to generate tissue in a new science called regenerative medicine, which doctors hope will eventually lead to ways to repair injuries and eventually perhaps even replace whole organs.
Reporting in the journal Cell Stem Cell, Dr. Derrick Rossi of Harvard Medical School and colleagues said they were working on new ways to make induced pluripotent stem cells or iPS cells.
http://www.reuters.com/article/idUSTRE68T58620100930?feedType=nl&feedName=ushealth1100
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Low-Carb Diets Heavy on Meat May Raise Health Risks (HealthDay News) -- A low-carbohydrate diet that derives fats and proteins from vegetable sources rather than meats is probably healthier, new research finds.
Comparing the two types of diets over two decades, researchers found that the low-carb, vegetable-based plan resulted in reduced rates of death from cardiovascular disease and cancer, and a lower rate of all-cause death overall. ... http://consumer.healthday.com/Article.asp?AID=642824
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RANDOM TIDBIT: The Beatles held the Top Five spots on the April 4th, 1964 Billboard singles chart. To date, they're the only band that has ever accomplished that.
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Mental 'exercise' linked to faster dementia progression Mentally active seniors experienced a faster decline in brain function after being diagnosed with Alzheimer's disease compared with those with the disease who were less mentally active, a six-year study showed. The faster rate of decline in cognitive tests suggests that though mentally active older adults may develop dementia later, once they do develop it, they are in a more advanced state of brain damage. ... (This is entirely too much info for me)..... http://www.reuters.com/article/idUSTRE68076720100901
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Kids in the ED: Guidelines Stress Rapid Intervention Children and infants who end up in the ED often require specialized emergency care, yet the majority of children in the U.S. are not cared for in a children’s hospital ED, according to Sally K. Snow, RN, BSN, CPEN, FAEN, the Emergency Nurses Association liaison to the American Academy of Pediatrics Committee on Pediatric Emergency Medicine.
“When kids get sick or injured they can deteriorate rapidly, and you have to be confident in rapid assessment and intervention and know that your facility has the equipment and protocols in place to deliver quality care,” says Snow, who also is trauma program director at Cook Children’s Medical Center, Fort Worth, Texas.... http://news.nurse.com/article/20100830/NATIONAL01/108300001/-1/frontpage
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RANDOM TIDBIT: The king of hearts is the only king without a moustache on a standard playing card.
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U.S. medical programs missing millions of kids: report (Reuters Sept 3) - An estimated five million uninsured children in the United States were eligible for Medicaid or the Childrens Health Insurance Program (CHIP) but were not enrolled in either plan, according to a new report.
The study published on Friday in the journal "Health Affairs" recommended policy reforms and broader efforts to get uninsured children into government medical programs, including the use of income tax data for automatic enrollment.... http://www.reuters.com/article/idUSTRE6820XK20100903?feedType=nl&feedName=ushealth1100
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RANDOM FACT: The first novel ever written on a typewriter was Tom Sawyer.
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A theoretical examination of the rights of nurses Nurses’ duties and patients’ rights have been important foci in nursing. Nurses’ rights legitimate the power and responsibility of the profession. There are few published articles on this subject in the nursing science literature. This article is a theoretical examination of nurses’ rights that aims to structure (i.e. show the internal logic of) those that have been little studied. It is based on the philosophical literature and published research. Nurses’ rights can be divided into: human and civil rights, rights based on health care legislation, professional rights, and earned rights. In this context, professional rights relate to nursing and also to tasks shared with other health care professions. Analyzing nurses’ rights will help to promote these rights, improve nurses’ position both nationally and internationally, and provide possibilities for enhancing patient care. ... http://nej.sagepub.com/content/17/5/628.abstract
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Improving Student Critical Thinking Skills Through a Root Cause Analysis Pilot ProjectThe Essentials of Baccalaureate Education for Professional Nursing Practice provides a framework for building the baccalaureate education for the twenty-first century. One of the exemplars included in the essentials toolkit includes student participation in an actual root cause analysis (RCA) or failure mode effects analysis. To align with this exemplar, faculty at the University of Michigan School of Nursing developed a pilot RCA project for the senior-level Leadership and Management course.... (full text available) http://www.journalofnursingeducation.com/showAbst.asp?thing=64980
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New test can diagnose tuberculosis in under 2 hours Reuters - A new molecular test for tuberculosis made by Cepheid can diagnose TB and detect a drug-resistant form of it far more easily and rapidly than other tests currently available, scientists said on Wednesday.
In a study in the New England Journal of Medicine (NEJM), researchers said that when used on 1,730 patients with suspected TB and suspected drug-resistant TB, the Xpert MTB/RIF test successfully identified 98 percent of all cases.
It also identified 98 percent of patients with a form of TB resistant to rifampin, or rifampicin -- one of the most powerful TB drugs -- and achieved these results in less than two hours.... http://www.reuters.com/article/idUSTRE68071A20100901?feedType=nl&feedName=ushealth1100
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TRIVIA: (This is especially interesting for those of us who have eaten these great litlle "burgers")
White Castle was founded in 1921 in Wichita, Kansas. The name was chosen carefully with “White” signifying purity, and “Castle” signifying strength, stability and permanence.
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Burgers were 5 cents in 1921 and that price was reduced and increased over the next several years. A big jump occurred in December of 1950 when burgers went from 10 cents to 12.
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In 1931, White Castle hired a renowned food scientist from a Big Ten university to run tests to determine the nutritional value of White Castle Sliders. One medical student lived on nothing but White Castle burgers and water for 13 weeks. Studies show conclusively that the student maintained good health.
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The burgers have five holes because they help the patties cook faster and more evenly while eliminating the need to turn them over.
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During World War II, White Castle sold hot dogs and eggs due to meat rationing.
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Coke has been the White Castle beverage of choice since 1921.
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(Thought I would include this ... because this would be another book that I would want to have in my library)
WORLD views on Evidence-Based Nursing Now ranked No. 1 nursing journal!
2009 Journal Citation Reports® (Thomson Reuters, 2010)
WORLDviews on Evidence-Based Nursing™, a quarterly, peer-reviewed, evidence-based nursing journal, provides readers a primary source of information to improve patient care. Each issue contains knowledge synthesis and original articles with best practice applications and recommendations for clinical practice, nursing administration, nursing education and public health care policy. Subscribe today $ 142 personal copies. http://www.nursingsociety.org/Publications/Journals/Pages/worldviews.aspx?utm_source=FY11%20EBD%20promoNKI%20[81910]&utm_medium=email&utm_campaign=FY11%20EBN%20promo!
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RANDOM FACT: 454 U.S. dollar bills weigh exactly one pound.
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National: Hospitals must report intensive care patients’ bloodstream infections to CDC “New regulations may cut down hospital infections” CNN
In the United States, hospital-acquired infections alone afflict almost 2 million patients and kill approximately 100,000 people annually, more than diabetes or influenza and pneumonia. That's according to statistics from the Centers for Disease Control. Beginning next year, Americans will be able to check to see how their hospitals or medical facilities fare when it comes to preventing these types of infections....
http://pagingdrgupta.blogs.cnn.com/2010/08/02/new-regulations-may-cut-down-infections-in-hospitals/
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Dysphagia leads to higher risk of death, longer stays Difficulty swallowing, or dysphagia, leads to a higher risk of death among hospitalized patients as well as hospital stays that are almost double the length experienced by patients without dysphagia, researchers said.... MedPage Today (free registration) http://www.medpagetoday.com/CriticalCare/GeneralCriticalCare/21712
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Choose this protein, Hear better Reconsider that chicken on top of your pasta. This protein choice is music to your mouth and your ears: salmon. Yep, in a large study, people who ate finned food at least twice a week were significantly less likely to develop age-related hearing loss over the 5-year study period. Reference: Consumption of omega-3 fatty acids and fish and risk of age-related hearing loss. Gopinath, B., American Journal of Clinical Nutrition 2010 Aug;92(2):416-421.
http://www.realage.com/tips/choose-this-protein-hear-better?eid=7215&memberid=4687812
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RANDOM TIDBIT: The Mona Lisa has no eyebrows. It was the fashion in Renaissance Florence to shave them off.
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Nutritional supplementation for older people- AbstractSummary: Malnutrition is common in older people and is associated with a number of adverse outcomes. We review the evidence for the effectiveness of nutritional supplementation for older people in the community, in institutional care and following discharge from hospital. Studies in these settings are scarce, often include only small numbers of participants and are of variable quality. The interventions used are heterogeneous and difficult to directly compare. Oral nutritional supplements (sip feeds), dietary fortification, educational programmes, exercise, flavour enhancement and meal setting have all been studied. Evidence for use of oral nutritional supplements as sip feeds in undernourished community-dwelling and institutionalized older people and in those discharged from hospital is currently insufficient to recommend routine use. Flavour enhancement and more sociable meal environments may be beneficial. Further, more methodologically robust research is needed to clarify the effect of these interventions.
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=7911741
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Anorexia Nervosa Abstract: Clinical confidence and coordinated multidisciplinary care can influence the course of anorexia nervosa in children and adolescents. Sicker and younger patients with anorexia nervosa often present first to a paediatrician, requiring early recognition and appropriate management. Paediatric knowledge and skills are also needed to manage the impact of eating disorders on growth and development. This review provides practical guidance on the management of anorexia nervosa for paediatricians, in the areas of assessment, acute management and re-feeding, and long-term monitoring. In the absence of a strong evidence base for some of these recommendations, local protocols based on best practice guidelines can reduce anxiety, increase cooperation and reduce risk. (full text available) http://adc.bmj.com/content/early/2010/10/07/adc.2009.177394.short?rss=1
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Metal Pollution tied to Parkinson's disease NEW YORK (Reuters Health) - People living near a steel factory or another source of high manganese emissions are at higher risk of developing Parkinson's disease, suggests a new study. As many as one million Americans live with the degenerative disease, according to the Parkinson's Disease Foundation. Pesticides from farms have long been suspected of upping the chances of developing Parkinson's, but much less is known about the influences of city living.
"Environmental risk factors for Parkinson's disease have been relatively under-studied, especially in urban areas where the overwhelming majority of Parkinson's disease patients reside," Dr. Brad A. Racette of the Washington University School of Medicine in St. Louis, Missouri, told Reuters Health in an e-mail. ... http://www.reuters.com/article/idUSTRE69Q5DI20101027?feedType=nl&feedName=ushealth1100
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RANDOM TIDBIT: Until the nineteenth century, solid blocks of tea were used as money in Siberia.
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The Nursing and Midwifery Content Audit Tool (NMCAT): a short nursing documentation audit tool johnson m., jefferies d. & langdon r. (2010) Journal of Nursing Management
( The full copy is available for purchase)
Background The Nursing and Midwifery Content Audit Tool (NMCAT) was developed to monitor the quality of nursing documentation.
Methods A health care record audit was conducted on 200 records. Using a time-sampling approach, recent nursing documentation was examined. Inter-rater reliability was determined at 85% agreement between two raters.
Results The NMCAT criteria relating to the recording of the patients’ health status, use of objective information and logical presentation were met to a high level. The patients’ response to treatment or nursing interventions including medications requires attention. The recording of events immediately after they have occurred was limited. The structure of the sentences and language used, restricted the readability of the documentation. The widespread use of local abbreviations, often connected together to form the text, was problematic.
Conclusions The present study provides new audit solutions based on time-sampling approaches and focused evidence-based criteria. The use of language support software and writing coaches to improve the presentation of nursing documentation is recommended.
Implications for Nursing Management The NMCAT is a time-efficient tool available to managers for monitoring the quality of nursing documentation, either at a unit level or across health facilities to demonstrate compliance with quality standards. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2834.2010.01156.x/abstract;jsessionid=B75D6501B612DF7FCFB0DC5CB9D4EEF2.d01t01?systemMessage=Due+to+scheduled+maintenance+access+to+the+Wiley+Online+Library+may +be+disrupted+as+follows%3A+Saturday%2C+30+October+-+New+York+0700+EDT+to+0900+EDT%3B+London+1200+BST+to+1400+BST%3B+Singapore+1900+SGT+to+2100+SGT.
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Pancreatic cancer grows slowly, could be caught WASHINGTON (Reuters) - Pancreatic cancer grows slowly, taking years and even decades to develop, a finding that offers the chance to catch it early and cure it, researchers reported on Wednesday.
They said their findings confirm that one of the most lethal cancers kills not because it spreads like wildfire, but because it does not cause symptoms until it is advanced.
"That provides a large window of opportunity to try to detect the presence of these cancers in the first 20 years of their existence, before they become lethal," said Dr. Bert Vogelstein of Johns Hopkins University in Baltimore, who helped lead the study. ... http://www.reuters.com/article/idUSTRE69Q4JB20101027?feedType=nl&feedName=ushealth1100
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10 Reasons to Give Your Nursing Career a Digital Media Makeover In recent years, the growth of digital and social media have come to influence many aspects of day-to-day life, including our experience in the workplace. Nurses savvy in these new media can take advantage of the new tools that are available and use them for professional growth and development. Check out these fun and clever ways you can use digital and social media to enhance your career! http://jjnursingnotes.com/OCT10/index.html#careers
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Medical groups push to expand heart x-ray NEW YORK (Reuters Health) - More patients could benefit from x-ray scans of their hearts, according to new advice put forth in a report from several medical societies.
But the expanded criteria may be more geared to benefitting medical professionals than patients, according to some experts who say the scans are little more than pretty pictures with a big price tag -- and potentially serious side effects.
Computerized tomography, or CT, scans can help doctors determine whether a patient has heart disease. For instance, they can reveal problems in heart valves or cholesterol plaques that prevent the heart from working properly by blocking its blood supply. ... http://www.reuters.com/article/idUSTRE69O4ST20101025?feedType=nl&feedName=ushealth1100
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RANDOM TIDBIT: Tablecloths were originally meant to be served as towels with which dinner guests could wipe their hands and faces after eating.
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'Natural' statins vary in quality, study finds (Reuters) Red yeast rice supplements, sold as a "natural" alternative to cholesterol-lowering statin drugs, vary widely in how much active ingredient they contain and some are contaminated, U.S. researchers reported on Monday.
Americans thinking they are getting a reliable and safe alternative to prescription drugs should take a closer look, and regulators should consider stricter limits on the products, Dr. Ram Gordon of Chestnut Hill Hospital and the University of Pennsylvania and colleagues said.
They tested 12 commercially available products and found great variation in how much active ingredient each actually contained.
"One-third of the products tested were contaminated with citrinin," they wrote in the Archives of Internal Medicine. Citrinin is a so-called mycotoxin that can alter DNA, which means it could potentially cause cancer. ... http://www.reuters.com/article/idUSTRE69O4XI20101025?feedType=nl&feedName=ushealth1100
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Nurses' perceived barriers to optimal pain management in older patients. Nurses perception of barriers preventing optimal pain management in older adults on acute medical units and the extent to which they perceived they had adopted four evidence-based practices related to pain assessment and management were often incongruent with actual practice. Eliciting reports of pain, offering pro re nata pain relief regularly, utilizing pain assessment tools in patients with cognitive impairment, redesigning documentation tools and processes, making non-pharmacological alternatives accessible, and helping patients and families manage side effects would target the 12 barriers having the biggest impact. ... http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WB4-4VCNF1G-W&_user=10&_coverDate=08%2F31%2F2010&_rdoc=6&_fmt=high&_orig=browse&_origin=browse&_zone=rslt_list_item&_srch=doc-info(%23toc%236700%232010%23999769996%232218765%23FLA%23display%23Volume)&_cdi=6700&_sort=d&_docanchor=&_ct=13&_acct=C000050221&_version=1&_ urlVersion=0&_userid=10&md5=ebc72363a51206ce36d5ffde40d2b407&searchtype=
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RANDOM FACT: The United States once had the highest proportion of young adults with post-secondary degrees in the world. Today, the U.S. has fallen to 12th.
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Pain assessment: state-of-the-art applications from the cognitive–behavioural perspective Behaviour Research and Therapy, Volume 40, Issue 5, May 2002, Pages 547-550
Gordon J. G. Asmundson This brief report highlights some basic issues in pain assessment. This serves to set the stage for the articles that are presented in this issue of the Behavioral Assessment section. Topics covered include an overview of the cognitive–behavioural perspective, consideration of important dimensions for assessment, and a summary of some of the key issues affecting the state-of-the-art. An overview of the articles that follow as well as future research directions are also presented. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6V5W-45FYCTW-6&_user=10&_coverDate=05%2F31%2F2002&_rdoc=1&_fmt=high&_orig=article&_origin=article&_zone=related_art_hover&_ cdi=5797&_sort=v&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_ userid=10&md5=c867d0159b7da2fdd09f492b995f2d60&searchtype=a
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The free Geriatric Pain website shares best-practice tools to support recommendations for good pain assessment and management in older adults. Register today!:
http://www.medinfonow.com/min/pl/12695/fuwluz/KAAK/default.aspx
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(From Rozalfaro...thanks) About Heart Attacks:There are other symptoms of an heart attack besides the pain on the left arm. One must also be aware of an intense pain on the chin, as well as nausea and lots of sweating, however these symptoms may also occur less frequently.
Note: There may be no pain in the chest during a heart attack. The majority of people (about 60%) who had a heart attack during their sleep, did not wake up. However, if it occurs, the chest pain may wake you up from your deep sleep.
If that happens, immediately take the new "quick release" crystal aspirins by Bayer, and swallow them with water. Be certain that you DO NOT LIE DOWN.
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Sepsis leaves long legacy on brain and body Surviving sepsis doesn't mean troubles are over for older adults, who face substantial cognitive impairment and functional disability afterward, according to results from a longitudinal population-based study.
An episode of sepsis boosted the odds of acquiring moderate to severe cognitive impairment 3.3-fold, whereas other types of hospitalizations had no effect, Theodore J. Iwashyna, MD, PhD, of the University of Michigan, in Ann Arbor, and colleagues found. ...
http://www.medpagetoday.com/CriticalCare/Sepsis/22994
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HINT: If you have old paint spots on your windows, you don't need to drag out smelly turpentine. Just apply nail polish remover to the splatters, wait a few minutes and rinse off. They magically disappear!
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In a new study that reviews data collected from people injured during serious crashes, researchers found that those with front airbags were 45 percent less likely to suffer severe kidney trauma.
Specifically, among those injured during car accidents, 3.4 percent of people with front airbags experienced kidney trauma, versus 7.5 percent of those without front airbags, Dr. Bryan Voelzke and colleagues report in the Journal of the American College of Surgeons. ... http://www.reuters.com/article/idUSTRE69P4CN20101026?feedType=nl&feedName=ushealth1100
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Carotid stent has higher stroke risk than surgery CHICAGO (Reuters) - Implanting a device called a stent in neck arteries is more likely to cause a stroke or death than surgically removing life-threatening blockages, U.S. researchers said on Monday.
Both therapeutic procedures are effective," Dr. Louis Caplan of Beth Israel Deaconess Medical Center in Boston and Dr. Thomas Brott of Mayo Clinic in Florida, said in a commentary in the Archives of Neurology. "Both procedures showed a relatively low rate of serious complications. Surgery is superior concerning some outcomes; stenting seems to have advantages in others."
For years, carotid endarterectomy -- in which doctors cut open the neck, scrape away the fatty deposits in the artery and sew it back up -- has been the preferred way to clear dangerous fatty deposits in neck arteries that can cause strokes.
Carotid artery stenting, a newer approach, involves threading a wire mesh coil called a stent in the neck artery to widen the blocked area and capture any dislodged plaque that could travel to the brain and cause a stroke. ... http://www.reuters.com/article/idUSTRE69A4YS20101011?feedType=nl&feedName=ushealth1100 (In my case, the 70% blockage was much too high up, stenting was the only option).
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HINT: Next time you get upset try counting backward from 100. It requires all your concentration, which distracts you from whatever is upsetting you. This trick is also proven to ease anxiety by slowing your pulse and breathing!
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Lilly osteoporosis drug regrows jaw bone: study (Reuters) Eli Lilly and Co's osteoporosis drug Forteo can regrow bone in jaws damaged by severe bone-destroying conditions called osteonecrosis and periodontitis, doctors reported on Saturday.
The research, reported at the annual meeting of the American Society for Bone and Mineral Research in Toronto, suggests that the drug may spur growth in a damaged jaw, the researchers said.
Forteo, known generically as teriparatide, cuts in half the risk of bone fractures in patients with thinning bones by stimulating the growth of new bone. But it is seldom given for more than two years out of fear that long-term exposure might lead to osteosarcoma, ... http://www.reuters.com/article/idUSTRE69F0V520101016?feedType=nl&feedName=ushealth1100
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HUMOR SECTION
Q: What did one vampire say to the other as they were passing the Blood Bank?
A: Let's stop in for a cool one.
An old man said to his buddy, "I hear you are getting married?"
Yep," his friend replied.
"Do I know her?"
"Nope."
"Is she good-looking?"
"Not really."
"Is she a good cook?"
"Naw, she can't cook too well."
"Does she have lots of money?"
"Nope. Poor as a church mouse."
"Well, why in the world do you want to marry her, then?"
"Because she can still drive."
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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/ !
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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
Back issues of the ISMP.org are available at: http://www.ismp.org/Newsletters/nursing/backissues.asp.
The free Geriatric Pain website shares best-practice tools to support recommendations for good pain assessment and management in older adults. Register today!:
http://www.medinfonow.com/min/pl/12695/fuwluz/KAAK/default.aspx
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Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell)
Founder, Forum for Shared Governance info@sharedgovernance.org www.sharedgovernance.org
Decubqueen's website: www.accu-ruler.com
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.nationalnurse3.blogspot.com/
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
The Nursing Site http://thenursingsite.com .
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
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
Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/
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MEDICAL RECALLS*
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Hospira symbiq One-Channel and Two-Channel Infusers: Class 1 Recall Potential for the device to fail to detect air in line at the end of an infusion. Failure to detect air in line may result in the delivery of air to the patient, resulting in serious injury or death. The Symbiq Infusion System is an infusion pump intended for the delivery of fluids, solutions, drugs, agents, nutritionals, electrolytes, blood and blood products via parenteral, enteral, intravenous, intra-arterial, subcutaneous, epidural or irrigation routes of administration. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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Fentanyl Transdermal System: Recall FDA notified healthcare professionals and patients that laboratory testing identified a patch that released its active ingredient faster than the approved specification. An accelerated release of Fentanyl can lead to adverse events for at-risk patients, including excessive sedation, respiratory depression, hypoventilation (slow breathing), and apnea (temporary suspension of breathing). http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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Tylenol 8 Hour Caplets 50 Count: Recall Lot number: BCM155 McNeil is recalling TYLENOL 8 Hour caplets 50 count bottles to the retail level following a small number of complaints of a musty or moldy odor. The uncharacteristic odor is thought to be caused by the presence of trace amounts of a chemical called 2,4,6-tribromoanisole.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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Gadolinium-based Contrast Agents: Class Labeling Change - Risk of Nephrogenic Systemic Fibrosis [Ablavar (gadofosveset trisodium), Eovist (gadoxetate disodium), Magnevist (gadopentetate dimeglumine), Multihance (gadobenate dimeglumine), Omniscan (gadodiamide), Optimark (gadoversetamide injection), Prohance (gadoteridol)]
FDA is requiring changes in the professional labeling for gadolinium-based contrast agents (GBCAs) to minimize the risk of nephrogenic systemic fibrosis (NSF), a rare, but serious, condition associated with the use of GBCAs in certain patients with kidney dysfunction. NSF has not been reported in patients with normal kidney function. Patients at greatest risk for developing NSF after receiving GBCAs are those with impaired elimination of the drug, including patients with acute kidney injury or chronic, severe kidney disease. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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AngioSculpt "EX" PTCA Scoring Balloon Catheter by AngioScore, Inc.: Recall - Risk of Catheter Separation The AngioSculpt EX Percutaneous Transluminal Coronary Angioplasty (PTCA) catheters may become separated during use, and fragments of the catheter may become lodged in coronary arteries. This may result in serious injuries, including death. This recall includes all Part/REF Numbers 2034-XXYY with lot numbers less than F09060003. This product was distributed from January 30, 2009 through December 4, 2009. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm225186.htm
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Heparin Sodium (B. Braun): Recall - Trace Contaminant B. Braun Medical Inc. and FDA notified healthcare professionals of a nationwide recall of certain lots of Heparin Sodium USP Active Pharmaceutical Ingredient (API) sold to B. Braun because testing indicated a trace amount of oversulfated chondroitin sulfate (OSCS) contaminant. These lots were manufactured in 2008 and will be expiring on October 31, 2010 and November 30, 2010. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm231739.htm
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Meridia (sibutramine): Market Withdrawal Due to Risk of Serious Cardiovascular Events Abbott Laboratories and FDA notified healthcare professionals and patients about the voluntary withdraw of Meridia (sibutramine), an obesity drug, from the U.S. market because of clinical trial data indicating an increased risk of heart attack and stroke. ... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts
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Excelsior Medical 5 ml Fill in 6 cc Prefilled Saline Flush Syringes: Recall - Potential loss of sterility Routine internal testing conducted on this product found that some of these syringes may leak and lose sterility. This recall pertains only to syringes with the following product code numbers: E0100-50, 10056-1000, 10056-240, 14056-240, 910056-1000, and S5. Exposure to syringes with a sterility issue could result in systemic infection, which may lead to serious injury and/or death.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm229781.htm
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CareFusion Corporation Alaris PC Units (Model 8015): Recall - Potential for Delay or interruption of therapy Under certain wireless network conditions, a communication error can occur, which freezes the PC Unit screen. This error may result in a delay of therapy and inability to make programming changes to current infusions.
If the communication error occurs during infusion, infusion continues on all channels, as originally programmed, but cannot be modified. When this error occurs, stopping the infusion to make any modification or programming changes causes the PC unit to shut down resulting in a delay or interruption in therapy. This could lead to serious injury and/or death. These devices were manufactured from December 20, 2008 through September 8, 2009 and distributed from December 20, 2008 through June 28, 2010. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts
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NURSING HINTS CORNER
Bright sights Each patient room in our pediatric division has a large wooden animal propped against the wall. The puppies, frogs, bears, and other creatures delight our patients. But ----more importantly--they make an easily accessible board to place beneath a child during a code. Karen Pasley, RN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.87, 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. 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:
Kevinpaige5@windstream.com (Judy) September 29, 2010
bcmims@dhr.state.ga.us (Brenda) October 14, 2010
gloriagracia59@yahoo.com (Gloria) October 30, 2010
5royals@bellsouth.net (Angela) November 5, 2010
stew@smithhospital.com (Stephanie) November 5, 2010
JLedwitch@briangriner.com (John) November 8, 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.... So please send me your new e-mail name and/or address, ok? RNFrankie@AOL.com
OLD: mickunas14 @verison.com NEW: mickunas14@frontier.com
OLD: springns88@AOL.com NEW: springns88@yahoo.com (Barbara)
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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)
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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.
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THOUGHT FOR THE DAY
They say my world is somber and drear.
To me, it is warm and joyous, and stars shine
in the dark that cannot be seen by day.
Helen Keller
Hope to see you online or write me--- would love to hear from you,
RNFrankie@AOL.com
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