Newsletter for Paradigm 97

PARADIGM BYTES Newsletter for Paradigm 97 December 13, 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 AJN, American Journal of Nursing:December 2012 - Volume 112 - Issue 12 - p 15 doi: 10.1097/01.NAJ.0000423491.98489.70 Barriers to Implementing Evidence-Based Practice Remain High for U.S. Nurses Getting past “We've always done it this way” is crucial. Evidence-based practice (EBP), a problem-solving approach to patient care that integrates the best evidence from well-designed studies with clinicians' expertise, patient assessments, and patients' own preferences, leads to better, safer care; better outcomes; and lower health care costs. Yet despite the fact that nurses report that engaging in EBP leads to greater professional satisfaction, nurses in the United States aren't consistently using it. To assess nurses' current readiness and willingness to implement EBP, Melnyk and colleagues at Ohio State University (OSU), Columbus, conducted a descriptive survey of a random sample of 1,015 members of the American Nurses Association. The results showed that only 34.5% of respondents (350) agreed or strongly agreed that their colleagues consistently used EBP in treating patients. Although a majority (76.2%) felt it was important for them to have more education and skills in EBP, most found educational opportunities wanting, as they did access to knowledgeable mentors, resources, and tools needed to use EBP. The two most frequently cited barriers to EBP, however, were a lack of time and an organizational culture that didn't support it—getting past workplace resistance and the constraining power of the phrase, “That's the way we've always done it here.” “There's a resistance that staff nurses are getting from nurse managers and nurse leaders,” says Melnyk. “That's a big problem, because managers are critical for providing the support needed to do this and for providing role models.” Education is a big factor, Melnyk points out. “People educated 20 years ago didn't learn an EBP approach to care,” she says, adding that educators still spend more time teaching students how to do rigorous research than they do teaching them how to use research in practice. “Behavior change is tough,” says Melnyk, who is also dean of the College of Nursing, associate vice president for health promotion, and chief wellness officer at OSU. The key seems to lie in creating a context and support system under which EBP efforts can be sustained. Nurse leaders who want to encourage EBP among their staff, Melnyk says, “need to realize that a one- or two-day workshop isn't likely to cause sustainable change.” To really make it happen, she believes, nurse leaders need to place enough EBP mentors at the bedside who can work hand in hand with clinicians to help them learn these skills and implement them consistently. Melnyk and her colleagues at OSU are currently launching an online continuing education program so that people can access EBP mentorship skills from around the world. Information on the program can be found at http://bit.ly/Ps1pgw.—Laura Wallis Reference: Melnyk BM, et al. J Nurs Adm. 2012;42(9):410–7© 2012 Lippincott Williams & Wilkins, Inc. ~~**~~**~~**~~**~~**~~ MEDICAL NEWS Australia's tobacco marketing laws give retailers a headache (Is this a great idea, or what?) (Reuters) - James Yu, who runs the King of the Pack tobacconist in central Sydney, is indignant about Australia's stringent anti-tobacco laws making manufacturers package cigarettes in drab olive green packs with pictures of ill babies and diseased body parts. The packages, mandatory from Saturday when the laws take effect, make it hard to tell brands apart, complicating deliveries and adding to costs. ... http://www.reuters.com/article/2012/11/30/us-australia-cigarettes-idUSBRE8AT08N20121130?feedType=RSS&feedName=healthNews *************************** Judge orders tobacco companies to admit deception (Reuters) - Major tobacco companies that spent decades denying they lied to the U.S. public about the dangers of cigarettes must spend their own money on a public advertising campaign saying they did lie, a federal judge ruled on Tuesday. The ruling sets out what might be the harshest sanction to come out of a historic case that the Justice Department brought in 1999 accusing the tobacco companies of racketeering. U.S. District Judge Gladys Kessler wrote that the new advertising campaign would be an appropriate counterweight to the companies' "past deception" dating to at least 1964. ... http://www.reuters.com/article/2012/11/28/us-usa-tobacco-idUSBRE8AQ18A20121128?feedType=RSS&feedName=healthNews ******************** J&J says it won't enforce AIDS drug patent in Africa (Reuters) - Generic manufacturers are to be given a free rein to make cheap copies of Johnson & Johnson's HIV/AIDS drug Prezista for sale in Africa and other poor countries. U.S. healthcare group J&J said on Thursday it would not enforce patents, provided generic firms made high-quality versions of the drug - known generically as darunavir - for sub-Saharan Africa and Least Developed Countries. Prezista is a relatively new drug used when patients develop resistance to older antiretrovirals. The need for it was expected to grow rapidly as more patients in Africa stop responding to existing therapies. ... http://www.reuters.com/article/2012/11/29/us-aids-jj-africa-idUSBRE8AS0PN20121129?feedType=RSS&feedName=healthNews ******************** ++++ ANNOUNCEMENT ++++ The Truth about Nursing hands out awards for those who help nursing especially those in the media. This year Wendie Howland, a long-time member of Paradigm97 was awarded. The award was to Wendie Howland, for relentlessly monitoring Help a Reporter Out (HARO) and educating reporters seeking health experts that the better choices for their stories are often nurses, rather than the physicians they seek; Wendie writes "I am astonished and honored to be included in the Truth About Nursing 2011 awards. Please support their work! " Congratulations, Wendie !! ~~**~~**~~**~~**~~**~~ FROM A MEMBER MarGerlach (Marlene) sent this in and wrote: "The article explains why germs are becoming resistant to even the most powerful antibiotics and how we can protect ourselves against the evolving "super bugs". Hope you take a few minutes of your time to read it, and that you find it as informative as I did." http://www.naturalnews.com/022800_antibiotic_antibiotics_infection.html Thank you, Marlene ! ~~**~~**~~**~~**~~**~~ INTERESTING READING Please remember that the REUTERS articles usually good for only 30 days (This article is interesting and informative was presented as a CEU, however, after reading all the nurse's comments, I wouldn't plan to do any more than read the article.). The beat goes on: A pacemaker primer Nearly 400,000 cardiac pacemakers and cardioverter-defibrillators are implanted annually in the United States. In some cases, pacemakers are used as a temporary intervention to support a patient through an acute episode. In other situations, as for patients with permanent conditions that require cardiac pacing, pacemakers are implanted surgically. Whether temporary or permanent,a pacemaker generates an electrical impulse that travels via one or more leadwires, or leads, which in turn stimulate the myo­cardium to depolarize and initiate a contraction. A pacemaker’s primary function is to keep the ventricles beating at a rate that maintains sufficient blood pressure and perfuses all organs adequately. ... http://www.americannursetoday.com/Article.aspx?id=8850& fid=8812#comments ********************* Physiology review: Circulatory system (Now guys, do not assume that this is such basic info, you don't have time to fool with this article. You are very mistaken--it starts off kindergarten but jumps to college level quickly). Chances are that you frequently care for patients with cardiac and circulatory conditions and administer drugs affecting the circulation. This review of the circulatory system increases your knowledge base so you can more efficiently assess patients with signs and symptoms of cardiovascular problems. The circulatory system includes the heart, blood vessels, and regulatory controls (such as the autonomic nervous system, catecholamines, and hormones). Its main function is to deliver oxygen and substrate (glucose) to cells. The circulatory system also transports byproducts of cellular metabolism—66% in the form of carbon dioxide (CO2) to the lungs and the remaining 33% to the kidneys as breakdown products of protein metabolism. Metabolism of oxygen and glucose (cellular combustion) produces heat, which is conducted through the circulation and warms the body. February 2012 Vol.7 No.2 Author: PennyAndrews RN BSN and Nader M.Habashi MD FACP FCCP http://www.americannursetoday.com/Article.aspx?id=8756&fid=8714 ********************* Do you think nurses are responsible for managing poor performers at work? A person wrote the following: Whose Job is it to Manage Poor Performers? (vickihess.com) I was reading about a survey today from Robert Half International about how much time supervisors spend managing poor performers (17%). I hear staff members in many organizations complain about poor performers and their... ******** Another nurse wrote: I don't believe so we have enough on our plate during work if you are referring to a staff nurse's role. Management and HR should do it. I think though the managers should look at first why the person is a "poor performer". Is it because of lack of training or true poor performance or just plain old fashioned laziness? Especially in the nursing field orientation to an area is priceless but it is sometimes skimped on in this day and age due to time and money constraints in an organization. Many times fellow coworker nurses help out the nurse struggling during a shift but we must finish our own work as well. So, Paradigm97 members, what are your thoughts/opinions on this? We have all had to endure this situation- at least once in our careers. Let me hear from you, please. RNFrankie@AOL.com *************** RANDOM FACTS: While gold is currently around $1,700 an ounce, it reached an all-time high in 2011 of nearly $1,800 an ounce. Of course, gold has always been valuable not only as a material resource but also as a commodity. *** Gold is the sixteenth most rare of the chemical elements. Though it is one of the rarest metals, gold was the first to be discovered by man. *** It took half a year for word to reach the Atlantic coast that gold has been discovered in California. The discovery was made in 1848, but John Augustus Sutter and James Marshall tried to keep it a secret. It wasn't until President Polk, in December 1848, announced the discovery that the gold rush of 1949 began. *********** Quiz Time A Clinical Nurse Leader (CNL) program prepares nurses as advanced generalists: True False (Answer at end of Newsletter) Reprinted with permission from: Production/Electronic Channels Coordinator HealthCom Media 259 Veterans Lane Doylestown, PA 18901 **************** Injection Safety: Injection safety is part of the minimum expectation for safe care anywhere healthcare is delivered; yet, CDC has had to investigate numerous outbreaks of life-threatening infections caused by injection errors. Since 2001, at least 150,000 U.S. patients have been negatively impacted by unsafe medical injections. When healthcare providers fail to follow basic infection control practices during injection preparation and administration, patients can be exposed to life-threatening illnesses such as hepatitis and/or bacterial infections. To assist you in covering this important topic, CDC is releasing a digital press kit about the impact of unsafe injection practices in U.S. healthcare settings. The digital press kit includes fact sheets, an infographic, videos and podcasts, and quotes from CDC experts. View DPK [ http://www.cdc.gov/media/releases/2012/dpk-unsafe-injections.html ] In addition, to further educate healthcare providers about safe injection practices, CDC is releasing several new educational pieces today. See: http://www.oneandonlycampaign.org/news/new-tools-help-clinicians-ensure-every-injection-safe ************** Rozalfaro writes: I'm not surprised.... and I agree. Thank you Roz for sending the following: The U.S. health care system wasted $750 billion in 2009. This amount of money could provide health insurance for many—150 million workers, for example—according to the Institute of Medicine (IOM) report, Best Care at Lower Cost. The report identifies deficiencies, such as primary care physicians needing to coordinate with an average of 229 other physicians in a single year to treat Medicare patients, and 75% of hospital patients not knowing the clinician overseeing their care. But it also defines ways to improve heath care, including computing, information science, and connectivity tools that enhance patient–physician communication. The safety and quality of care will improve by applying evidence-based practices and including patients, families, and other caregivers on the care team. The IOM envisions a learning health care system that combines science and informatics, patient–clinician partnerships, incentives, and a culture that promotes continuous improvements. Read Mary D. Naylor's post about the role of nurses in such changes on AJN's blog, Off the Charts, at http://bit.ly/Rpy1BR. AJN The American Journal of Nursing Free Access **************** Simple measures cut infections caught in hospitals Chicago (AP) -- Preventing surgery-linked infections is a major concern for hospitals and it turns out some simple measures can make a big difference. A project at seven big hospitals reduced infections after colorectal surgeries by nearly one-third. It prevented an estimated 135 infections, saving almost $4 million, the Joint Commission hospital regulating group and the American College of Surgeons announced Wednesday. The two groups directed the 2 1/2-year project. Solutions: included having patients shower with special germ-fighting soap before surgery, and having surgery teams change gowns, gloves and instruments during operations to prevent spreading germs picked up during the procedures. ... http://hosted.ap.org/dynamic/stories/U/US_MED_HOSPITAL_LINKED_INFECTIONS?SITE=AP&SECTION =HOME&TEMPLATE=DEFAULT&CTIME=2012-11-28-16-12-15 ************************** Heavy patient workloads for nurses have been associated with poor patient outcomes and low job satisfaction. Yet few states require hospitals to maintain minimum nurse-to-patient ratios, leaving nurses to care for a significant number of patients at a time Link between heavy workloads and poor patient outcomes: Many studies have found that heavier nursing workloads are associated with poor patient outcomes, including more patient deaths, complications, and medical errors.1 For example, one study found that each additional patient added to a nurse’s workload increased mortality within 30 days of admission by 7 percent, and increased the risk of an undetected medical complication leading to preventable death or harm (known as a "failure to rescue") by a similar amount.2 A meta-analysis of 90 studies found that increased registered nurse (RN) staffing was associated with lower mortality on intensive care, medical, and surgical units; reduced risk of hospital-acquired pneumonia, unplanned extubation, respiratory failure,cardiac arrest, and failure to rescue;and shorter lengths of stay for surgical (31 percent) and intensive care unit (ICU) patients (24 percent).3 Other studies have confirmed that higher nurse staffing yields better patient outcomes, including shorter lengths of stay and lower rates of urinary tract infections, upper gastrointestinal bleeding, pneumonia, shock, cardiac arrest, and failure to rescue.4 Negative implications for nurses as well: The study cited above found that each additional patient assigned to a nurse led to a 23-percent increase in the risk of nurse-reported “burnout” and a 15-percent increase in the risk of a nurse being dissatisfied with his/her job.2 Another study found that nurses in states without mandated minimum staffing ratios reported greater levels of burnout,job dissatisfaction, and turnover; these nurses also felt that patients received poorer quality care.5 Few states addressing minimum staffing levels through legislation: Despite the evidence cited above, only a handful of states have any type of legislation related to minimum nurse-to-patient ratios, with most having requirements that address only a specific unit or type of unit (e.g., the operating room or ICU). Legislators remain reluctant to require hospitals and health systems to hire more nurses, particularly with ongoing shortages in many areas. In 2001, there were 264,000 licensed nurses in California (544 working nurses per 100,000 population), compared to a national average of 782 per 100,000; California ranked next to last among the 50 states. ... http://www.nationalnursesunited.org/news/entry/state-mandated-nurse-staffing-levels-lead-to-lower-patient-mortality-and-hi/ (Not certain why the bullets remained despite all my efforts, any suggestions)? ******************** RANDOM FACTS: The human body is an incredible machine. It is an engineering miracle we don't take enough time to appreciate! Man has tiny bones once meant for a tail and unworkable muscles once meant to move his ears. *** And: If 80 percent of your liver were to be removed, the remaining part would continue to function, and eventually the liver would have reconstituted itself to its original size. ******************** Small sachets are big help for clean water in developing world Reuters) - Greg Allgood tears open a small sachet and dumps the powder into a large plastic container filled with brown, murky water. After about five minutes of stirring, clumps of sludge form and sink to the bottom as the water starts to clear. "You let it settle, pour it through a cotton cloth and then you wait 20 minutes and it's ready to drink," said Allgood, the U.S.-based director of Procter & Gamble Co's not-for-profit programme to provide clean water in developing nations and disaster zones. ... http://www.reuters.com/article/2012/11/29/us-water-sachets-idUSBRE8AS08720121129?feedType=RSS&feedName=healthNews ************** Most Women Who Choose Double Mastectomy Don't Need To, Study Shows TUESDAY, Nov. 27 (HealthDay News) -- Almost 70 percent of women with breast cancer who choose to have both breasts removed as a precaution actually have a low risk of developing cancer in the healthy breast, a new study finds. Worry about recurrence -- which is understandable -- typically drives the decision to have the opposite breast removed, said study author Dr. Sarah Hawley, an associate professor of internal medicine at the University of Michigan Health System in Ann Arbor. The procedure is called a contralateral prophylactic mastectomy (CPM). However, that worry can be out of proportion to actual risk, she said. "Our point is that worry about recurrence probably should not drive choice for CPM since this procedure will not reduce the risk of cancer recurrence; it is only going to reduce the risk of developing a new primary in the non-affected breast," she said. ... https://www.nlm.nih.gov/medlineplus/news/fullstory_131705.html *************** How to manage incontinence-associated dermatitis Moisture-related skin breakdown has been called many things-perineal dermatitis, irritant dermatitis, contact dermatitis, heat rash, and anything else caregivers could think of to describe the damage occurring when moisture from urine or stool is left on the skin. At a 2005 consensus conference, attendees chose the term incontinence-associated dermatitis (IAD). IAD can be painful, hard to properly identify, complicated to treat, and costly. It’s part of a larger group of moisture-associated skin damage that also includes intertrigo and periwound maceration. IAD prevalence and incidence vary widely with the care setting and study design. Appropriate diagnosis, prompt treatment, and management of the irritant source are crucial to long-term treatment. ... http://woundcareadvisor.com/how-to-manage-incontinence-associated-dermatitis/ *************** The popularity of dietary supplements continues among adults in the U.S. Consider these facts from a 2011 report from the National Center for Health Statistics: Over 40%: Percent of adults who used dietary supplements between 1988 and 1994 1: Over 50%: Percent of adults who used dietary supplements between 2003 and 2006 The most commonly used dietary supplement is multivitamins/multiminerals. 28%: Percent of women 60 years or older who took supplemental calcium between 1988 and 1994 61%: Percent of women 60 years or older who took supplemental calcium between 2003 and 2006 Source: http://www.cdc.gov/nchs/ ************************* FDA permits marketing of the first hand-held device to aid in the detection intracranial hematomas. The U.S. Food and Drug Administration today allowed marketing of the first hand-held device intended to aid in the detection of intracranial hematomas, using near-infrared spectroscopy. The device, called the Infrascanner Model 1000, can help health care providers identify patients with critical head injuries who need an immediate brain imaging study. Intracranial hematomas occur when blood from a ruptured blood vessel collects within the brain or between the skull and the brain. As blood expands within the brain or in the narrow space between the brain and the skull, the brain becomes compressed. This can produce symptoms such as headaches, vomiting, dizziness, lethargy, weakness in the arm or leg on one side of the body, seizures, or unconsciousness. An intracranial hematoma can be life-threatening if it is not treated immediately. According to the Centers for Disease Control and Prevention, each year about 1.7 million people in the United States experience a traumatic brain injury. The Infrascanner, Model 1000, uses a scanner that directs near-infrared light, a wavelength of light that can penetrate tissue and bone, into the skull. Blood from intracranial hematomas absorbs the light differently than other areas of the brain. The scanner detects differences in light absorption (optical density) and transmits the information wirelessly to a display on a hand-held computer. ... http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm283520.htm ********************* This is from Truth About Nursing's site ---Please check the site out and see why I think we need to support it with $5 to $25. Sandy really accomplishes a lot in demanding the true and correct representation of nurses. One Day in the Life of the Uninsured November 2012 –The new documentary The Waiting Room follows patients and staff in the overcrowded emergency room at Highland Hospital, which serves the poor and working class of Oakland, California. Working with footage shot over just 24 hours, director Peter Nicks takes a good look at how the United States cares for its underinsured residents. The result is a quiet but compelling indictment of our dysfunctional health financing system. We see Highland's staff try, with skill and patience, to help emergency patients with ailments from gunshot wounds or chronic back pain, although what many of them really need is good primary care. ... https://www.truthaboutnursing.org/media/documentaries/waiting_room.html *************** The Evidence is in: RN-to-Patient Ratios Save Lives A major new study led by one of the nation's most eminent nurse researchers provides compelling new evidence that California's landmark RN-to-patient staffing law reduces patient mortality, assures nurses more time to spend with patients, and substantially promotes retention of experienced RNs. "This research documents what California RNs have long known - safe staffing saves lives. We see the effects every day at the bedside in improved patient care, an enhanced quality of life for patients, and nurses able to more safely practice the profession to which we have dedicated our lives," said Malinda Markowitz, RN, co-president of the California Nurses Association, a National Nurses United founding affiliate. CNA/NNU, Sponsor of Law, Cites Major Gains for Patient Safety, RN Shortage CNA/NNU, the nation's largest organization of direct care RNs with 155,000 members, sponsored the California law and has fought off repeated hospital industry attempts to erode it, including a well-chronicled fight with Gov. Arnold Schwarzenegger who sought to roll back the law in late 2004. ... http://www.nationalnursesunited.org/press/entry/the-evidence-is-in-california-rn-to-patient-ratios-save-lives/ ********************** RANDOM FACT: The odds of winning are astronomical: about 175 million-to-1, according to Powerball. And even if you do win, you won't bring home all $550 million. The federal government takes a quarter of the jackpot in taxes, most states take a small share, and some cities even take a slice. That puts the actual cash value of the winnings around $360 million. *** BONUS FACT: If you do win you could fall prey to the "lottery curse". According to Chelmsford wealth counselor Szifra Birke, roughly one-third of lottery winners find themselves in serious financial trouble or bankrupt within five years of turning in their lucky numbers. But I bet most people would be willing to take the risk. ~~**~~**~~**~~**~~**~~ HUMOR SECTION (I read this one before...and enjoyed it too much not to use it again). While visiting Annapolis, a lady tourist noticed several students on their hands and knees assessing the courtyard with pencils and clipboards in hand. "What are they doing?" she asked the tour guide. "Each year," he replied with a grin, "the upperclassmen ask the freshmen how many bricks it took to finish paving this courtyard." When they were out of earshot of the freshmen, the curious lady asked the guide: "So, what's the answer?" The guide replied: "One." ~~**~~**~~**~~**~~**~~ 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 ~~~~~~~~~~~ CE A Perfect Match Preventing Blood Incompatibility Errors Objectives: The goal of this program is to educate nurses and paramedics about blood incompatibility errors and the evidence-based practices to prevent them. After studying the information presented here, you will be able to: List three factors that contribute to blood incompatibility errors Describe blood type compatibility between the donor and recipient Explain the procedure for safely administering blood transfusions This course will be updated or discontinued on or before 10/9/2015 https://ce.nurse.com/ce481/a-perfect-match-preventing-blood-incompatibility-errors/?utm_source=florida-regional-ezine_12-9-12&utm_medium=email&utm_campaign=regionalezinezine ~~**~~**~~**~~**~~**~~ 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/ 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/ 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 If you're buying a used car, it is recommended having a mechanic inspect it first. Screen the car's VIN through the free database at carfax.com/flood Rozalfaro's Website http://www.alfaroteachsmart.com/articles.htm Metric conversion calculators and tables for metric conversions http://www.metric-conversions.org/ ******************************************************* ******************************************** * MEDICAL RECALLS * ******************************************* ****************************************************** Accutron, Inc. Ultra PC% Cabinet Mount Flowmeters for Nitrous Oxide-Oxygen Sedation Systems Model Numbers: Affected Model and Serial numbers are available on the FDA’s website Manufacturing and Distribution Dates: The affected product was manufactured from November 2009 to April 2009 and distributed from November 26, 2008, to June 9, 2011. Intended Use: The Ultra PC% flowmeter is used to control the flow of gases used in nitrous oxide-oxygen sedation systems. Nitrous oxide-oxygen sedation systems are used to sedate patients during certain dental procedures. Recalling Firm: Accutron, Inc. 1733 West Parkside Lane Phoenix, Arizona 85027-1382 Reason for Recall: The flowmeter may continue to release nitrous oxide gas when the oxygen is turned off. When not mixed with oxygen, inhaling nitrous oxide can lead to temporary and permanent brain damage and death. ... http://www.fda.gov/MedicalDevices/Safety/ListofRecalls/ucm324090.htm ********************** Touchscreen for Hospira Symbiq Infusion System, Models 16026 and 16027 Product: Symbiq Infusion System Models and Serial Numbers: 16026 Symbiq One Channel Infuser 16027 Symbiq Two Channel Infuser All serial numbers for these models are potentially affected by this recall. Distribution Dates: All Intended Use: The Symbiq infusion pump is a prescription device used to deliver controlled amounts of medications or other fluids to patients through intravenous, intra-arterial, epidural, and other acceptable routes of administration. The touchscreen is used to control infusion pump settings for patient therapy. Recalling Firm: Hospira Inc., 275 N Field Dr, Lake Forest, Illinois 60045-2579 Reason for Recall: The Symbiq pump touchscreen may not respond to user selection, may experience a delayed response or may register a different value from the value selected by the user. Failure of the touchscreen to respond to user input could result in a delay or interruption in therapy or over delivery or under delivery of medication if the user does not confirm the programmed values on the pump's confirmation screen before starting the infusion. ************************* Atorvastatin Calcium Tablets by Ranbaxy Inc.: Recall - Presence of Foreign Substance On November 9, 2012, Ranbaxy Inc. initiated a voluntary recall of 41 affected lots of Atorvastatin Calcium Tablets (10 mg, 20 mg and 40 mg) which is a solid oral dosage form, to the retail level. The Company is taking this voluntary action as a precautionary measure due to the fact that we cannot exclude the possibility that the affected lots may contain very small glass particles resembling a fine grain of sand (less than 1 mm in size). Because of the size of the particles which may be present in the affected lots it is unlikely to cause a significant safety concern. However, the possibility of adverse experiences arising primarily due to physical irritation cannot be ruled out. The product is used to lower blood cholesterol and is packaged in plastic bottles, as 90 and 500 tablets per bottle. The affected lots of Atorvastatin Calcium Tablets and their respective NDC code, expiration date information can be found in the Firm Press Release. The recall does not affect or relate to the 80 mg dosage strength of Atorvastatin Calcium Tablets. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm329955.htm *************** Mindray A3 and A5 Anesthesia Delivery System: Class I Recall - Gasket Leak FDA notified health professionals of a Class I Recall of the Mindray A3 and A5 Anesthesia Delivery System. The affected devices may have a gasket leak which could cause an interruption of or inadequate patient anesthesia and ventilation, temporary or permanent patient injury, or death. The gasket leak could also cause injury to bystanders and operating room personnel due to exposure from leaking anesthesia gases. The company has identified the cause of the leak as a small step in the gasket surface which may interfere with the full seating of the gasket within the canister. The leak may be identified during the Automatic Circuit Leak and Compliance Test performed at start up and during the Manual Leak Test recommended before each use. The devices were manufactured between May 2011 to March 2012 and distributed between May 31, 2011 to July 15, 2012. The A3 and A5 anesthesia delivery systems are used to administer continuous or intermittent general anesthesia gases and maintain a patient’s breathing during surgery. These devices are used for both pediatric and adult patients. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm330249.htm ************ Isovue (iopamidol injection) Pre-Filled Power Injector Syringes by Bracco Diagnostics Inc.: Recall - Presence of Particulates Bracco Diagnostics Inc. (BDI) is voluntarily initiating a Class I recall of nine (9) lots of Isovue (iopamidol injection) Pre-Filled Power Injector Syringes (Isovue PFS, to be used in combination with Stellant CT Injection Systems) due to the presence of visible particles in syringes observed at the end of standard stability studies on retained samples.These products were distributed to wholesalers and distributors nationwide. BDI has received no reports of adverse events or customer complaints associated with these lots. However, it should be noted that the visible particles in the lots subject to this recall have the potential to cause adverse health consequences. The dates for distribution of the nine (9) affected lots were from January 21, 2010 through May 9, 2012. For a list of products affected see the Firm Press Release. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm329948.htm ~~**~~**~~**~~**~~**~~ 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 WELCOME TO: Tradiewhitey@bellsouth.net (Traci) November 20, 2012 Sterling4@bellsouth.net (Janet) November 20, 2012 Mikeydot@bellsouth.net (Dottie) November 30, 2012 smdmgadawgs@gmail.com (Sonia) November 30, 2012 Nankristin@yahoo.com (Nan) December 6, 2012 ~~**~~**~~**~~**~~**~~ 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. So please send me your new name/address, okay? RNFrankie@AOL.com ~~**~~**~~**~~**~~**~~ 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) ~~**~~**~~**~~**~~**~~ 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. ~~**~~**~~**~~**~~**~~ We may have found a cure for most evils; but it has found no remedy for the worst of them all -- the apathy of human beings. --Helen Keller Would really like to hear from you..... Frankie RNFrankie@AOL.com Correct answer to the Quiz: True. CNL programs at the master’s or post-master’s level prepare nurses to be advanced generalists. A CNL oversees the care coordination and integration of care for a distinct group of patients. Learn more at http://www.aacn.nche.edu/CNC/cnlcert.htm