August 12, 2012

PARADIGM BYTES Newsletter for Paradigm 97 August 12, 2012 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. ***~~~***~~~***~~~*** SNIPPETS (This excerpt is from Truth About Nursing) America's top RN model? -- Today the Philadelphia Inquirer ran a very good report by Stacey Burling about Hahnemann University Hospital's transition to an all-RN care model, which will mean eliminating the use of nursing assistants. The move, credited to chief executive officer Michael Halter, comes in the wake of a pilot study at the hospital that showed all-RN units had better patient outcomes as well as higher patient and nurse satisfaction. The piece features good expert comment from University of Pennsylvania nursing professor Matthew McHugh, who explains the research showing the benefits to patients and nurses from the use of higher proportions of RNs. The article might also have mentioned that research suggests using higher proportions of RNs does not actually cost much more, and can even save money, when factors like lower complication rates are considered. The report also includes brief comments from two direct care nurses, though it might have gotten more from them on how the move will affect patient care. And the piece should have consulted a nurse manager at the hospital. The piece does rightly include the reactions of the nursing assistants' union, whose representative argues that the move is "union busting" based on a "humbug," though the article includes no support for those claims. We would not expect the report to say so, but this all-RN initiative reminds us of the work of nursing pioneer Lydia Hall, who established an all-RN staff at the Loeb Center at Montefiore Hospital in the Bronx in the 1960's; Hall stressed that all patient care should be provided by professional nurses. On the whole, the Inquirer report is a helpful look at a promising nursing initiative from the same reporter and newspaper responsible for "More nurses, less death," a 2010 piece about a University of Pennsylvania study finding that many lives could be saved if hospitals followed the minimum nurse staffing ratios now required in California. We thank Ms. Burling and the Inquirer for the new report. ... http://www.truthaboutnursing.org/news/2012/feb/hahnemann.html ************************ Sandy Summers, a member, has written a great book on Nursing " Saving Lives"..why the media's Portrayal of Nurses Puts us all At Risk... check it out at: http://www.truthaboutnursing.org ~~**~~**~~**~~**~~**~~ MEDICAL NEWS Joint Commission Center for Transforming Healthcare Releases Tool to Tackle Miscommunication Among Caregivers (OAKBROOK TERRACE, Ill. – June 27, 2012) An estimated 80 percent of serious medical errors involve miscommunication between caregivers when patients are transferred or handed-off. In addition to patient harm, defective hand-offs can lead to delays in treatment, inappropriate treatment, and increased length of stay in the hospital. Today, the Joint Commission Center for Transforming Healthcare is releasing a new Hand-off Communications Targeted Solutions Tool™ (TST) to assist health care organizations with the process of passing necessary and critical information about a patient from one caregiver to the next, or from one team of caregivers to another, to prevent miscommunication-related errors. Ineffective hand-off communication is recognized as a critical patient safety problem in health care. The “hand-off” process involves “senders,” the caregivers transmitting patient information and releasing the care of that patient to the next clinician, and “receivers,” the caregivers who accept the patient information and care of that patient. The Hand-off Communication TST was created to measure the effectiveness of hand-offs within an organization or to another facility, and provide proven solutions to improve performance. Using the tool and the solutions from the Center’s Hand-off Communications Project, health care organizations have reduced readmissions by 50 percent, and have reduced the time it takes to move a patient from the emergency department to an inpatient unit by 33 percent. Health care organizations also reported an increase in patient and family satisfaction; staff satisfaction; and successful transfers of patients. Health care organizations were able to complete their Hand-off Communications Project in approximately four months, using minimal resources. In fact, no staff was added and only minor changes were made to the roles and responsibilities of existing staff. ... http://www.jointcommission.org/center_transforming_healthcare_tst_hoc/ ; ***************** Sebelius announces nursing grant for NC hospital NP training gets $200M boost from HHS HHS Secretary Kathleen Sebelius announced on Monday a $200 million, four-year grant program aimed at increasing the number of advanced practice nurses offering primary care. The grant to five hospitals will be used in the training of nurse practitioners, including nurse anesthetists, nurse specialists and nurse midwives. "With this important initiative, we are putting more advanced practice nurses on the front lines of our health care system and further strengthening and growing our primary care workforce," Sebelius said. News Times (Danbury, Conn.)/The Associated Press (7/30), The Herald-Sun (Durham, N.C.) (free registration) (7/30) http://www.newstimes.com/news/article/Sebelius-announces-nursing-grant-for-NC-hospital-3747082.php ~~**~~**~~**~~**~~**~~ INTERESTING READING Please remember that the REUTERS articles usually good for only 30 days Anastrozole and fulvestrant combination effective in metastatic breast cancer The combination of anastrozole and fulvestrant was more effective than anastrozole alone or sequential anastrozole and fulvestrant for the treatment of hormone receptor-positive metastatic breast cancer in postmenopausal women, according to a study in The New England Journal of Medicine. ... http://www.nejm.org/doi/full/10.1056/NEJMoa1201622?utm_source=BenchmarkEmail&utm_campaign=Weekly_eNewsletter_August_6th_2012&utm_medium=email&; ************************** August is Children’s Eye Health and Safety Month and Cataract Awareness Month. 22.3: According to Prevent Blindness America’s Vision Problems in the U.S. report, more than 22.3 million Americans have cataracts. 40,000: Each year, more than 40,000 people are treated for eye injuries related to sports activities. 8%: About 8% of males and fewer than 1% of females have color vision deficiency. 3,160: Toy weapons, including guns and slingshots, are the toys that cause the most eye injuries in children age 14 and younger, accounting for 3,160 in one year. Source: http://www.preventblindness.org; http://www.preventblindness.org/sites; http://www.preventblindness.org/ FS56_ColorVision.pdf Reprinted with permission from: Production/Electronic Channels Coordinator HealthCom Media 259 Veterans Lane Doylestown, PA 18901 ***************************** Chagas disease, caused by parasites transmitted to humans by blood-sucking insects, has been named “the new AIDS of the Americas” in a lengthy editorial published in PLoS Neglected Tropical Diseases. The authors, several of whom are tropical disease experts from Baylor College of Medicine in Houston, argue that the dangerous spread of Chagas through this hemisphere somewhat resembles the early spread of H.I.V. Chagas is also known as American trypanosomiasis, because the bugs carry single-celled parasites called trypanosomes. (Their best-known relative, spread by tsetse flies in Africa, causes sleeping sickness.) Like AIDS, the authors say, Chagas disease has a long incubation time and is hard or impossible to cure. Chagas infects up to eight million people in the hemisphere, mostly in Bolivia, Mexico, Colombia and Central America. But more than 300,000 of the infected live in the United States, many of them immigrants. The disease can be transmitted from mother to child or by blood transfusion. About a quarter of its victims eventually will develop enlarged hearts or intestines, which can fail or burst, causing sudden death. Treatment involves harsh drugs taken for up to three months and works only if the disease is caught early.... http://www.nytimes.com/2012/05/29/science/spread-of-chagas-is-called-the-new-aids-of-the-americas.html?nl= health&emc=healthupdateema5_20120529 ****************** Monitoring HIV Care in the United States: Indicators and Data Systems Advances in medical treatment have made it possible for people infected with HIV to live longer, healthier lives. The CDC estimates that 1.2 million people live with HIV in the United States, with approximately 50,000 people newly infected each year. People with HIV require continuous access to quality care and treatment for HIV as well as their other health conditions. The White House Office of National AIDS Policy asked the IOM to identify core indicators related to continuous HIV care and access to supportive services, and to monitor the effect of both the National HIV/AIDS Strategy and Patient Protection and Affordable Care Act on improving HIV care. Monitoring HIV Care in the United States: Indicators and Data Systems Morgan A. Ford and Carol Mason Spicer, Editors; Committee on Review Data Systems for Monitoring HIV Care; Institute of Medicine ISBN 978-0-309-21850-4 352 pages 6 x 9 PAPERBACK (2012) **************** FDA PANEL BACKS GILEAD'S TRUVADA TO PREVENT HIV (Reuters) - A U.S. Food and Drug Administration panel of outside experts recommended Gilead Sciences Inc's Truvada as a treatment for preventing HIV infection among people at risk for contracting AIDS, including homosexual and bisexual men. http://tinyurl.com/cq4awbz *********************** RANDOM FACT: Cucumbers are scientifically known as Cucumis sativus and belong to the same botanical family as melons (including watermelon and cantaloupe) and squashes (including summer squash, winter squash, zucchini and pumpkin). Bonus Fact: Fresh extracts from cucumbers have recently been show to have both antioxidant and anti-inflammatory properties. While research in this area must still be considered preliminary--since it's only been conducted on animals in a lab setting--the findings are clear and consistent. *********************** ( This was sent to me by CKppk (Cheri) Thank you !) Berries are delicious, but they're also kind of delicate. Raspberries in particular seem like they can mold before you even get them home from the market. There's nothing more tragic than paying $4 for a pint of local raspberries, only to look in the fridge the next day and find that fuzzy mold growing on their insides. Well, with fresh berries now in the farmers markets, we can tell you how to keep them fresh! Here’s a tip I’m sharing on how to prevent them from getting there in the first place: When you get your berries home, prepare a mixture of one part vinegar (white or apple cider probably work best) and ten parts water. Dump the berries into the mixture and swirl around. Drain, rinse if you want (though the mixture is so diluted you can't taste the vinegar,) and pop in the fridge. The vinegar kills any mold spores and other bacteria that might be on the surface of the fruit, and ... Voila! Raspberries will last a week or more, and strawberries go almost two weeks without getting moldy and soft. So go forth and stock up on those pricey little gems, knowing they'll stay fresh as long as it takes you to eat them. *********************** FDA approves new weight-loss drug On July 17, the U.S. Food and Drug Administration (FDA) approved Qsymia (phentermine and topiramate extended-release) as an addition to a reduced-calorie diet and exercise for chronic weight management. The U.S. Food and Drug Administration today approved Qsymia (phentermine and topiramate extended-release) as an addition to a reduced-calorie diet and exercise for chronic weight management. The drug is approved for use in adults with a body mass index (BMI) of 30 or greater (obese) or adults with a BMI of 27 or greater (overweight) who have at least one weight-related condition such as high blood pressure (hypertension), type 2 diabetes, or high cholesterol (dyslipidemia). BMI, which measures body fat based on an individual’s weight and height, is used to define the obesity and overweight categories. According to the Centers for Disease Control and Prevention, more than one-third of adults in the United States are obese. “Obesity threatens the overall well being of patients and is a major public health concern,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research. “Qsymia, used responsibly in combination with a healthy lifestyle that includes a reduced-calorie diet and exercise, provides another treatment option for chronic weight management in Americans who are obese or are overweight and have at least one weight-related comorbid condition.” Qsymia is a combination of two FDA-approved drugs, phentermine and topiramate, in an extended-release formulation. Phentermine is indicated for short-term weight loss in overweight or obese adults who are exercising and eating a reduced calorie diet. Topiramate is indicated to treat certain types of seizures in people who have epilepsy and to prevent migraine headaches. ... http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm312468.htm?utm_source=BenchmarkEmail&utm_campaign=Weekly_eNewsletter_July_23rd_2012_Copy&utm_medium=email *********************** Second Diet Drug Wins FDA Approval Decision comes with strict guidelines and recommendations for usage. TUESDAY, July 17, 2012 (MedPage Today) — For the second time in as many weeks, the FDA has approved a diet drug — phentermine/topiramate (Qsymia). The two approvals follow a 13-year-long drought in the prescription diet drug pipeline.Formerly known by the brand name Qnexa, the drug was approved for as an addition to a weight-loss program that includes both calorie restriction and exercise. Moreover, the FDA said the drug's use should be limited to in patients with a body mass index (BMI) of at least 30, or a BMI of 27 with at least one other weight-related comorbidity such as diabetes or hypertension. In approving the drug, FDA signaled its intent that the drug's use be tightly controlled. For example, the drug's label will include a number of contraindications, and Vivus, the company that is marketing the drug, will be required to complete 10 postmarketing studies, including a long-term cardiovascular safety trial to assess effects on major events including MI and stroke. ... http://www.everydayhealth.com/diet-nutrition/0718/second-diet-drug-wins-fda-approval.aspx?xid=aol_eh-news_8_20120716_&aolcat=HLT&ncid=webmail27 ***************** Put on your thinking cap … 1,300: The human brain weighs an average of 3 pounds (1,300 to 1,400g). 85%: The cerebrum accounts for 85% of the brain’s weight. 100 billion: Number of nerve cells in the brain 250,000 neurons/minute: Rate neurons multiply during early pregnancy http://science.nationalgeographic.co; http://faculty.washington.edu Reprinted with permission from: Production/Electronic Channels Coordinator HealthCom Media 259 Veterans Lane Doylestown, PA 18901 ***************************** Think Like a Doctor: Doubled Over in Pain Solved! A doctor discovers that clues to a suffering patient's diagnosis have been in the medical chart all along. http://well.blogs.nytimes.com/2012/03/02/think-like-a-doctor-doubled-over-in-pain-solved/?nl=health&emc= healthupdateemb2_20120306 When Doctors Don't Tell the Truth A majority of doctors polled believed that physicians should never lie to patients, but a large number also revealed that they had not been completely honest or transparent over the past year. http://well.blogs.nytimes.com/2012/03/01/when-doctors-dont-tell-the-truth/ tnl=health&emc=healthupdateemb2_20120306 ************************* AAN: New Guideline on How to Best Treat Involuntary Movements in Huntington's Disease A new guideline released by the American Academy of Neurology recommends several treatments for people with Huntington's disease who experience chorea--jerky, random, uncontrollable movements that can make everyday activities challenging. The guideline is published in the July 18, 2012, online issue of Neurology(r),the medical journal of the American Academy of Neurology. (Embargo expired on 18-Jul-2012 at 16:00 ET) Neurology--American Academy of Neurology (AAN) http://www.newswise.com/articles/view/591336/?sc=mwtn ************************** (Please excuse this following "mess" ...all I can say is ...at least it is all there!) Glaxo melanoma drugs beat chemo in pivotal trials (Reuters) - Late-stage trials of two experimental skin cancer drugs from GlaxoSmithKline, each designed to block different pathways used by tumor cells, have found the drugs helped patients with fewer side effects than current chemotherapy. Both drugs, trametinib and dabrafenib, were tested in patients with a mutation in a gene known as BRAF. About half of all melanomas,the deadliest form of skin cancer, have the genetic aberration. Cancer occurs through genetic changes in cells allowing tumor growth factor receptors which activate various pathways, including a protein know as MEK. It is believed that BRAF-mutated melanomas should be particularly dependent on MEK, which is needed to amplify the cancer's genetic signal. ... http://www.reuters.com/article/2012/06/04/us-cancer-melanoma-glaxosmithkline-idUSBRE85308S20120604?feedType= RSS&feedName=healthNews ************** New Biomarker in the Blood May Help Predict Alzheimer's Disease Higher levels of a certain fat in the blood called ceramides may increase a person's risk of developing Alzheimer's disease, according to a study published in the July 18, 2012, online issue of Neurology(r), the medical journal of the American Academy of Neurology. (Embargo expired on 18-Jul-2012 at 16:00 ET) Neurology --American Academy of Neurology (AAN) http://www.newswise.com/articles/view/591338/?sc=mwtn *********************** Slow Gait Tied to Higher Risk of Cognitive Decline Problems walking including slow gait and a short stride are associated with an increased risk of cognitive decline, Mayo Clinic researchers have discovered. (Embargo expired on 18-Jul-2012 at 16:30 ET) Alzheimer's Association International Conference --Mayo Clinic http://www.newswise.com/articles/view/591437/?sc=mwtn ****************** Aging: The Telltale Scent of Old People Old people have a different body odor from younger people, and young people are good at detecting it, researchers say. http://well.blogs.nytimes.com/2012/06/04/the-telltale-scent-of-old-people/ ?nl=health&emc=healthupdateema6_20120605 ******************** Sleep Apnea becomes worse in Winter: Study (Reuters) - Respiration problems in sleep apnea - which causes people to momentarily stop breathing multiple times throughout the night, for seconds to minutes at a time - appear to worsen during the colder months of the year, according to a study from Brazil. changes in weight and seasonal allergies can affect sleep apnea, and researchers writing in the journal Chest wanted to see if weather changes might also have an impact. "More sleep disordered breathing events were recorded in wintertime than in other seasons," wrote study leader Cristiane Maria Cassol from the Universidade Federal do Rio Grande do Sul. ... http://www.reuters.com/article/2012/07/05/us-apnea-idUSBRE86400820120705?feedType=RSS&feedName=healthNews ************************************** Doing the right thing: Pathways to moral courage Issue Date: May 2012 Vol. 7 No. 5 Author: Vicki D. Lachman, John S. Murray, Karen Iseminger, and Kathryn M. Ganske Patient advocacy requires nurses to support and protect their patients. Nurses often find themselves in ethically questionable situations that conflict with their personal and professional morals. Sometimes, speaking out for the patient requires them to demonstrate moral courage—for instance, in the face of conflicting loyalties, in highly charged conflict situations, or when the patient’s rights are being violated. ... http://www.americannursetoday.com/Article.aspx?id=9110&fid=9022#topofpage (Register and take CEU test: http://ananursece.healthstream.com/Pages/Product.aspx?ID=81322d42-7f9f-e111-b22e-0015171c1a75%20&DisplayName=Doing%20the%20Right%20Thing:%20Pathways%20to%20Moral%20Courage ) *********************** 3 New Weight Loss Myths, Busted Who isn't for looking for fresh ways to slim down? The trouble is that, in time, the latest weight loss or diet trick doesn't work anymore -- you get lazy or don't quite remember what the tip was so you follow it in a halfhearted, or even diet-busting, fashion. Here are three current weight loss beliefs that have morphed into myths. http://shine.yahoo.com/healthy-living/3-weight-loss-myths-busted-202700634.html ********************* U.S. FDA checks dictionary on corn syrup vs sugar WASHINGTON (Reuters) - U.S. food and beverage makers who add high-fructose corn syrup to soda, breakfast cereal, and other items will not be able to label it "corn sugar," under a decision by federal officials that frustrated corn processors but won praise from the sugar industry and some health advocates. Both sides say they have consumers' interests at heart and are trying to minimize confusion about the term "sugar." The U.S. Food and Drug Administration, which decides what goes on food labels, has ruled against the corn groups. The agency said calling high-fructose corn syrup "sugar" would mislead people - and could harm them. "FDA's approach is consistent with the common understanding of sugar and syrup as referenced in a dictionary," the agency said in a letter posted on its website late on Wednesday. ... http://www.nlm.nih.gov/medlineplus/news/fullstory_125788.html ****************** HEART Insight: August 2012 - Volume 6 - Issue 3 - p 17–19 doi: 10.1097/01.HEARTI.0000418028.88224.29 Features Loosening the Grip of Post-Stroke Spasticity ABSTRACT: William and Tuye Collins are coming up on an anniversary—though it's one they'd probably rather not have. On the evening of May 10, 2000, Tuye (pronounced TOO-yee) came home from a church gathering to find her husband sprawled on the bedroom floor. He had had a major stroke that severely impaired his ability to speak and swallow. As if being paralyzed on the right side weren't hard enough, his right arm and leg were bent and his right foot frozen in a contracted position. In addition to the discomfort of his limbs frozen in such an unnatural position, William developed muscle cramps and the stiffness that comes with being unable to move around. What William experienced is known as “post-stroke spasticity,” a persistent and involuntary spasm of the muscles that locks limbs, hands or feet into an uncomfortable and disabling contraction. Common examples are a clenched fist or a flexed elbow, or an ankle that doesn't bend well or a foot that turns in. In addition to loss of range of motion or ability to use the affected body part, these spasms may hurt—like a really bad Charley horse. ... http://journals.lww.com/heartinsight/Fulltext/2012/08000/Loosening_the_Grip_of_Post_Stroke_Spasticity.5.aspx?WT.mc_id=EMxj02x20120730xL5 ***************************** Scientists Uncover Gene Variation Linked to Melanoma 'RAC1' mutation found in tumors on sun-exposed skin SUNDAY, July 29 (HealthDay News) -- New gene mutations associated with the development of melanoma have been identified by scientists who conducted what is believed to be the largest DNA-sequencing study of the deadly disease to date. Melanoma accounts for the vast majority of skin cancer deaths. The main cause of melanoma is excessive exposure to ultraviolet (UV) radiation from the sun. The Yale Cancer Center team used DNA-sequencing technologies to analyze 147 melanomas originating on both sun-exposed and sun-shielded sites on patients' bodies. They found a large number of UV-induced mutations in sun-exposed melanomas, but most of these are "passenger" mutations that don't have a functional role in melanoma. ... http://www.nlm.nih.gov/medlineplus/news/fullstory_127722.html ****************************** Rapid H.I.V. Home Test Wins Federal Approval After decades of controversy, the Food and Drug Administration approved a new H.I.V. test on Tuesday that for the first time makes it possible for Americans to learn in the privacy of their homes whether they are infected. The availability of an H.I.V. test as easy to use as a home-pregnancy kit is yet another step in the normalization of a disease that was once seen as a mark of shame and a death sentence. The OraQuick test, by OraSure Technologies, uses a mouth swab and gives results in 20 to 40 minutes. A previous test sold over the counter required a user to prick a finger and mail a drop of dried blood to a lab. Dr. Anthony S. Fauci, the longtime AIDS researcher and director of the National Institute of Allergy and Infectious Diseases, called the new test a “positive step forward” and one that could help bring the 30-year-old epidemic under control. Getting an infected person onto antiretroviral drugs lowers by as much as 96 percent the chance that he or she will transmit the virus to someone else, so testing and treatment have become crucial to prevention. About 20 percent of the 1.2 million infected Americans do not know they have the disease, the Centers for Disease Control and Prevention estimates, and about 50,000 more get infected each year.... http://www.nytimes.com/2012/07/04/health/oraquick-at-home-hiv-test-wins-fda-approval.html **************************************** Quiz Time Which statement about chest tube sizes is correct? a. The larger the French size, the smaller the tube. b. Common tube sizes for adults are 10 to 15 French. c. Smaller tubes are used to drain blood; larger tubes to remove air. d. Larger tubes are used to drain blood; smaller tubes to remove air. (Answer at end of Newsletter) ~~**~~**~~**~~**~~**~~ HUMOR SECTION A doctor that had been seeing an 80-year-old woman for most of her life finally retired. At her next checkup, the new doctor told her to bring a list of all the medicines that had been prescribed for her. As the young doctor was looking through these, his eyes grew wide as he realized she had a prescription for 'birth control pills'. "Mrs. Smith, do you realize these are BIRTH CONTROL pills? "Yes, they help me sleep at night." "Mrs. Smith, I assure you there is absolutely NOTHING in these that could possibly help you sleep!" She reached out and patted the young Doctor's knee."Yes, dear, I know that. But every morning, I grind one up and mix it in the glass of orange juice that my 16-year-old granddaughter drinks. And believe me, it helps me sleep at night." ~~**~~**~~**~~**~~**~~ CEU SITES---(CME and CNE) Those that are-----Free and Otherwise.......... Go to www.sharedgovernance.org for access to a just released, free continuing education module about shared governance, written by Robert Hess, Forum’s founder, and Diana Swihart, Forum advisory board member. Please follow me on Twitter as Dr. Robert Hess. Pay Only $34.99 for a full year of CONTACT HOURS www.nurse.com for CNE offerings. 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/ ! ~~**~~**~~**~~**~~**~~ WEBSITES/ LINKS Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com. This is an excellent nursing site, check it out: http://nursingpub.com/ Back issues of the ISMP newsletter are available at: http://www.ismp.org/Newsletters/nursing/backissues.asp. 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 Metric conversion calculators and tables for metric conversions http://www.metric-conversions.org/ ******************************************************* ******************************************** * MEDICAL RECALLS * ******************************************* ****************************************************** NOTICE: You are encouraged to report all serious adverse events and product quality problems to FDA MedWatch at www.fda.gov/medwatch/report.htm ********* MOOG Medical Devices Group, Curlin Infusion Administration Sets: Class I Recall - Potential for Reverse Flow of Fluid There is a potential for a reverse pump segment in the administration set. This malfunction could reverse the flow of fluid or medicines backwards from what was intended. This may cause blood loss, an under-delivery of prescribed medicines or fluids, or a potential delay in therapy. Use of the affected administration sets may cause serious adverse health consequences, including death. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm306327.htm ************************* Advanced Sterilization Products (ASP) Sterrad Cyclesure 24 Biological Indicator: Safety Communication – Potential Risk of Infection [UPDATED 07/06/2012] The FDA issued a clarification for personnel at facilities that utilize Sterrad sterilizers: The voluntary recall is for only certain lots of Sterrad Cyclesure 24 Biological Indicators. FDA review of ASP data showed that certain lots of Sterrad Cyclesure 24 Biological Indicators cannot effectively monitor the sterilization process throughout a 15-month shelf life. ASP made a change in December 2011 to the materials used to manufacture the product. Product lots manufactured prior to this material change are not subject to the recall. Refer to the list of affected lots found in ASP’s Recall Alert to determine if the product in inventory is subject to this recall. Read the MedWatch safety alert, including a link to the updated FDA Safety Communication, at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm310624.htm ************************* Arrow International, Inc. Multi-Lumen Venous Catheterization Set with Blue FlexTip ARROWg+ard Catheter: Class I Recall --Contains Unlabeled Drug Ingredient The device’s labeling erroneously states that the product “contains no medication,” however, the device contains chlorhexidine and silver sulfadiazine. Additionally, the product’s label is missing the appropriate chlorhexidine contraindication. If a patient with a known or unknown allergy/sensitivity to chlorhexidine or silver sulfadiazine/sulfa drug is exposed to this product, there is the potential for an allergic reaction presenting as a delayed rash, hives or potentially an immediate Type 1, IgE mediated anaphylaxis (loss of blood pressure, bronchospasm and vascular collapse). The product may cause serious adverse health consequences, including death, if used in a patient who is allergic to either chlorhexidine or silver sulfadiazine. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm313721.htm ************************* Leucovorin Calcium Injection (Bedford Laboratories): Recall - Visible Particulate Matter Bedford Laboratories issued a nationwide recall of three lots of Leucovorin Calcium Injection, due to the discovery of visible crystalline particulate matter in a small number of vials. To date, there have been no reports of any adverse events for the lots being recalled. The particulate matter has been identified as active drug substance and not foreign material or contamination. Particulate matter has been recognized as a potential health hazard. Adverse reactions may include vein irritation and phlebitis, clinically occult pulmonary granulomas detected at routine autopsy examination, local tissue infarction, severe pulmonary dysfunction, occlusion of capillaries and arteries, anaphylactic shock and death. ... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm310782.htm ********************************** U.S. health advisers back two new eye treatments (Reuters) - A U.S. Food and Drug Administration panel on Thursday recommended two drugs for combating different forms of vision loss that can lead to blindness among a range of adults, including diabetics and the elderly. The FDA advisory committee of outside experts gave its support to Swiss-based Roche Holding AG's Lucentis eye drug for treatment of diabetic macular edema and Belgium-based ThromboGenics' treatment for viteromacular adhesion, a condition that often develops with aging. The recommendations will now be considered by FDA regulators as they decide whether to approve the two injectable drugs for sale in the United States. ... http://www.reuters.com/article/2012/07/26/us-usa-fda-sight-idUSBRE86P12T20120726?feedType=RSS&feedName=healthNews ~~**~~**~~**~~**~~**~~ 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/. ~~**~~**~~**~~**~~**~~ NEW MEMBERS Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com No new members this issue. ~~**~~**~~**~~**~~**~~ 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 ~~**~~**~~**~~**~~**~~ EDITORIAL STAFF: lglnrse(Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan) ~~**~~**~~**~~**~~**~~ PARADIGM 97 CO-FOUNDERS: MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie) ~~**~~**~~**~~**~~**~~ DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views. ~~**~~**~~**~~**~~**~~ THOUGHT FOR THE DAY "The Bridge you burn is the one you will have to cross later." -Maria Salmon in Words of Wisdon from Pivotal Nurse Leaders. Hope to see you online..... Frankie RNFrankie@AOL.com Quiz Time's Correct Answer: d. Larger chest tubes generally are used to drain blood and transudate while smaller tubes are used for air removal.