May 16, 2013 Newsletter

PARADIGM BYTES Newsletter for Paradigm 97 May 16, 2013 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 is from Kurt Ullman, a member--- Thank you, Kurt) Nurses more prone to being bullied than other workers New book Toxic Nursing addresses workplace incivility INDIANAPOLIS — Twice as many nurses as other working Americans have experienced bullying in the workplace. According to a recent study in the Journal of Nursing Management, among 612 staff nurses, 67.5 percent had experienced bullying from their supervisors, while a whopping 77.6 percent had been bullied by their co-workers. Outside the health care industry, just 35 percent of Americans had reported workplace incivility, revealed a recent survey by the Workplace Bullying Institute. Toxic Nursing: Managing Bullying, Bad Attitudes, and Total Turmoil, published by the Honor Society of Nursing, Sigma Theta Tau International (STTI), directly addresses the issue. Written by Cheryl Dellasega, PhD, RN, CRNP, author of Surviving Ophelia and When Nurses Hurt Nurses, and Rebecca L. Volpe, PhD, Toxic Nursing gives nurse managers and administrators the tools they need to defuse conflict and create a positive work environment. Nurse managers and nurse administrators at all levels are frequently confronted by the need to manage employee issues arising from interpersonal relationships, including conflict, cynicism, and unnecessary drama. As a follow-up to When Nurses Hurt Nurses, this book offers concrete strategies for dealing with common employee challenges that nurse supervisors face. “Toxic Nursing is a must-read for nurse managers, nurse preceptors, and new nurses,” said Anita J. Tarzian, PhD, RN, associate professor and program coordinator at the University of Maryland School of Nursing. “Dellasega and Volpe provide a comprehensive toolkit of approaches to address destructive workplace behaviors among nurses. The combination of vignettes based on cases gleaned from blog postings and thorough literature review is novel and effective. It will broaden the reader’s view of bullying, how it harms nurses and those they serve, and what to do about it.” Purchase the book at www.nursingknowledge.org. Toxic Nursing: Managing Bullying, Bad Attitudes, and Total Turmoil By Cheryl Dellasega, PhD, RN, CRNP, and Rebecca L. Volpe, PhD Published by the Honor Society of Nursing, Sigma Theta Tau International ISBN-13: 9781-937554-42-2 Price: US $34.95 Trade paperback, 336 pages Trim size: 53/8 x 73/8 Available at www.nursingknowledge.org/STTIbooks About the authors Cheryl Dellasega, PhD, RN, CRNP, author of When Nurses Hurt Nurses (STTI, 2011), Mean Girls Grown Up (Wiley, 2005), Girl Wars (Simon & Schuster, 2003), and Surviving Ophelia (Perseus, 2001), is a professor of humanities in the College of Medicine and a professor of women’s studies at Pennsylvania State University. As the founder of Club and Camp Ophelia, she has helped girls confront and overcome relational aggression. She has worked clinically as a nurse practitioner and is an international expert on family relationships. Rebecca L. Volpe, PhD, is an assistant professor in the department of humanities in the College of Medicine at Pennsylvania State University. She is also coordinator of the Clinical Ethics Consultation Service for the Penn State Hershey Medical Center. Dr. Volpe earned her PhD from Saint Louis University’s Center for Health Care Ethics and went on to complete a Clinical Ethics Fellowship at California Pacific Medical Center. http://www.nursingknowledge.org/ ~~**~~**~~**~~**~~**~~ MEDICAL NEWS Number of Endorsers Tops 110! for HR 485 (To establish the position of National Nurse for Public Health, to be filled by the same individual serving as the Chief Nurse Officer of the Public Health Service). Support continues to pour in from around the country for H.R. 485, The National Nurse Act of 2013. This past month, the American Federation of State, County, and Municipal Employees (AFSCME) joined over 110 organizations and prominent individuals who have signed on the support letter being delivered to members of Congress. Many chose to vote by email so that they could provide the NNNO with a quick decision regarding support, and several mentioned that the decision was unanimous. If your organization is interested in exploring how to add on to the list of endorsers please contact the National Nursing Network Organization's Board of Directors. ******************* (Please contribute your opinion...the article will give you your rep's name) The American Nurses Association applauds Congresswoman Lois Capps (D-CA) and Congressman David Joyce (R-OH) for introducing the Registered Nurse Safe Staffing Act of 2013 (H.R. 1821). As you know, insufficient nurse staffing can be a life-or-death issue for patients. Federal legislation is needed to ensure that hospitals set upwardly adjustable minimum nurse to patient ratios. The Safe Staffing Bill would require hospitals that participate in Medicare to create staffing committees. Committees would be comprised of a majority of staff nurses and would be responsible for developing and publicly reporting nurse staffing plans for each unit. It would place limits on the practice of “floating” nurses by ensuring that RNs are not forced to work on units if they lack the education and experience in that specialty. The bill also calls for holding hospitals accountable for safe nurse staffing by requiring the development of procedures for receiving and investigating complaints, allowing imposition of civil monetary penalties for knowing violations, and providing whistle-blower protections for those who file a complaint about staffing Please urge your Representatives to support this important piece of legislation today. http://www.rnaction.org/site/R?i=sIoJYvrVn-CszZrPmbnc_w ******************** Residency Program for New Nurses Healthcare professionals across Iowa, led by the Iowa Action Coalition, are pushing for increased residency programs for new nurses. The programs will help new graduates make a successful transition from school to the work force and help keep new nurses from leaving the profession. The Iowa Action Coalition is working on developing a residency program that can be adopted by any hospital or healthcare facility. The program is funded by a grant from the Robert Wood Johnson Foundation. Iowa, along with 19 other states, will receive two-year grants of up to $150,000. Read more: http://thegazette.com/2013/04/17/iowa-hospitals-push-nurse-residency-programs) http://r20.rs6.net/tn.jsp?e=001GPVjCEn9qP_6ZmAvifSMHWsUDyNTe88pGRLgLT30D9NtB-0BL0CBssM5IDRAPBTAVRMmN7zmYFy0Pi8xyQYGsPLlb5ZUTtdWHq0RPa1XM91atorGVV7ILG3oibXthQHmrxirswdrg-YmMPOaGnVH-vf05JNJlPHKJN8WLdjutz1TTAsCa8_VkoHmZB3Pb2t6XeofDyG-tDQ= ~~**~~**~~**~~**~~**~~ INTERESTING READING Please remember that the REUTERS articles usually good for only 30 days Brain 'Pacemaker' May Help Ease Tough-to-Treat Anorexia WEDNESDAY, March 6 (HealthDay News) -- For people suffering from severe, tough-to-treat anorexia, having a biological "pacemaker" implanted in their brain may help ease the disorder, a small new study suggests. The researchers noted that anorexia is the psychiatric disorder with the highest mortality rate and, although therapies exist, not everyone benefits in the long term. The disorder is among the most common psychiatric ills diagnosed among teenage women. Up to 20 percent of patients do not respond to available treatments, which usually focus on behavioral change. The new study examined the effectiveness of an approach called deep brain stimulation (DBS), sometimes called a brain pacemaker. Brain 'Pacemaker' May Help Ease Tough-to-Treat Anorexia ********************* Anorexics Can't Judge Own Body Size: Study THURSDAY, Aug. 23 (HealthDay News) -- People with the eating disorder anorexia have difficulty judging their own body size but are able to size up others accurately, a small new study finds. The study included 25 people with anorexia and 25 people without the disorder who were shown a door-like opening and asked to judge whether they or other people in the room could pass through it. In earlier experiments, people with anorexia felt they could not pass through the door even if it was easily wide enough. In this study, people with anorexia were more accurate at judging whether other people could fit through the door than whether they could. The researchers also found a link between the anorexia patients' ability to fit through the door and their body size prior to becoming anorexic. This suggests that people with anorexia may still think of themselves as having their previous size, said study author Dewi Guardia, of the University Hospital of Lille in France. The study was published Aug. 22 in the journal PLoS One. Anorexics Can't Judge Own Body Size: Study ********************* On April 29, the U.S. Food and Drug Administration (FDA) approved Kcentra (Prothrombin Complex Concentrate, Human) for the urgent reversal of vitamin K antagonist (VKA) anticoagulation in adults with acute major bleeding. Plasma is the only other product approved for this use in the United States; Kcentra doesn’t require blood group typing or thawing, so it can be administered more quickly than frozen plasma. http://healthcommedia.benchmarkmails26.com/c/l?u=2494C69&e=2C4B2E&c=F275&t=0&l=242D6A&email=khDcrWqjAkeIKbHcHZqq5QSXAE%2FMRK6o ********************** Most teens well down road to heart disease, study finds A stunning 80 percent of U.S. teenagers are eating diets that put them on a clear path to heart disease, researchers reported on Monday. They’re eating too much fat, salt and sugar and not eating enough fruits and vegetables, the American Heart Association study found. Just 1 percent ate what the Heart Association considers a perfectly healthy diet. Plus they don’t exercise enough, says Christina Shay of the the University of Oklahoma Health Sciences Center, who led the study. “The far less-than-optimal physical activity levels and dietary intake of current U.S. teenagers, is translating into obesity and overweight that, in turn, is likely influencing worsening rates of high blood pressure, high cholesterol and blood glucose at these young ages,” Shay said in a statement. ... http://vitals.nbcnews.com/_news/2013/04/01/17553021-most-teens-well-down-road-to-heart-disease-study-finds?lite ; **************** Infections Tied to Cognitive Decline A new study adds to the evidence that chronic infection, known to be associated with vascular disease, is also associated with poorer performance on tests of mental ability. Researchers studied 1,625 people in northern Manhattan with an average age of 69, testing them with two well-validated tests of mental acuity. They also tested their blood for “infectious burden” — their degree of exposure to five common viruses and bacteria: cytomegalovirus, herpes 1 and 2, Helicobacter pylori, and Chlamydia pneumoniae. The study appeared online in Neurology. ... http://well.blogs.nytimes.com/2013/03/29/infections-tied-to-cognitive-decline/ ****************** FDA warns of potentially fatal arrhythmias with azithromycin On March 12, 2013, the U.S. Food and Drug Administration (FDA) strengthened the warning for QT interval prolongation and torsades de pointes, a potentially fatal heart rhythm, associated with azithromycin (Zithromax or Zmax). http://healthcommedia.benchmarkmails26.com/c/l?u=21DC719&e=2944BF&c=F275&t=0&l=242D6A&email =khDcrWqjAkeIKbHcHZqq5QSXAE%2FMRK6o ******************* (Since I am so very late with the Newsletter, I am not sure if any of the below still is available. Should be on time in June) National Nurses Week page each day from May 6th to May 12th for details on offers such as: Free CE credits, including a Joanna Briggs Institute Best Practice CE activity Free articles Free Take5 resource on laboratory values related to fluids and electrolytes http://email.lww.com/t?r=1483&c=3517191&l=59027&ctl=46F52C6:B54AB34282EDAD004590D7C92BFD7A5A50CB97921045BA00&; It is not enough to base practice on one research study. A critical analysis of available research, putting the findings in the context of your organization, and adding the perspectives and judgment of clinicians and patients is imperative for true evidence-based practice. New articles have been added to help you in Understanding Evidence-Based Practice. http://email.lww.com/t?r=1483&c=3517191&l=59027&ctl=46F52D4:B54AB34282EDAD004590D7C92BFD7A5A50CB97921045BA00&; ********************* Robotic Surgery Tied to Temporary Nerve Injuries (Reuters Health) - One in 15 people undergoing robot-assisted prostate, kidney or bladder surgery develops a nerve injury related to pressure from positioning on the operating table, a new study suggests. Patients on the table getting those types of robotic surgery need to be tilted steeply - with their head by the floor and their feet in the air - to give the surgeon better traction, researchers explained. "When somebody is in that position, there's a chance they could slide down - it's like a big ramp," said lead author Dr. Tracey Krupski, from the University of Virginia School of Medicine in Charlottesville. "When you slide, you then could be pulling, or having the drag on some of the nerves. It's like a constant pulling on the muscle." Earlier this month, the Food and Drug Administration announced it would be taking a closer look into safety reports regarding da Vinci surgical robots, made by Intuitive Surgical. The robots cost about $1.5 million each. http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTMwNDAxLjE3MjQ4NzQxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDEzMDQwMS4xNzI0ODc0MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3MDYzMTQ2JmVtYWlsaWQ9cm5mcmFua2llQGFvbC5jb20mdXNlcmlkPXJuZnJhbmtpZUBhb2wuY29tJmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&134&&&http://www.nlm.nih.gov/medlineplus/news/fullstory_135431.html ******************** (If someone tries this.........please let me know. It sounds good, but ....) Chinese herbs may reduce hot flashes (Reuters Health) - Women taking a Chinese herbal formula experienced less than half the number of menopausal hot flashes they had before the treatment, according to a new study from Hong Kong. Among women taking an herbal mix called Er-xian decoction (EXD), the frequency of daily hot flashes dropped by 62 percent, compared to a 52-percent drop seen among women taking a placebo. "It's a modest effect, but not a zero effect," said Katherine Newton, a researcher who has studied herbal menopause therapies at the Group Health Research Institute in Seattle. Newton, who was not involved in the research, said she'd want to see more, long-term studies demonstrating that these herbs are safe before she would recommend them to women, but that the current study makes EXD look promising as an alternative menopause treatment. ... http://links.reuters.com/r/ASTCI/UQ6Q6/ZGZPD6/TPPRXR/OFJ8OY/YT/h?a=http://links.reuters.com/r/ASTCI/UQ6Q6/ZGZPD6/TPPRXR/LSQHBQ/YT/h ******************** RANDOM FACT: Why do dimes, quarters and half dollars have notches around their edges, while pennies and nickels do not? The US Mint began putting notches on the edges of coins containing gold and silver to discourage holders from shaving off small quantities of the precious metals. Dimes, quarters and half dollars are notched because they used to contain silver. Pennies and nickels aren't notched because the metals they contain are not valuable enough to shave. ************ Bonus Fact: Why are zero scores in tennis called 'love'? In France, where tennis first became popular, a big, round zero on scoreboard looked like an egg and was called 'l'oeuf,' which is French for 'egg.' When tennis was introduced in the U.S., Americans pronounced it 'love.' ************** (Found this poem, and just had to share it) Not how did he die, but how did he live Not what did he gain, but what did he give? These are the units to measure the worth Of a man as a man, regardless of birth. Not what was his church, nor what was his creed? But had he befriended those really in need? Was he ever ready, with word of good cheer, To bring back a smile, to banish a tear? Not what did the sketch in the newspaper say, But how many were sorry when he passed away? ----Author Unknown---- ******************* This year’s theme is “Patient Safety 7/365: 7 days of recognition, 365 days of commitment to safe care.” Here are some patient safety facts from the World Health Organization (WHO): 1 in 10: As many as one in 10 patients in developed countries is harmed while receiving hospital care. 20: The risk of healthcare-associated infection in some developing countries is as much as 20 times higher than in developed countries. 1.4 million: At any given time, 1.4 million people worldwide suffer from infections acquired in hospitals. 50%: Problems associated with surgical safety in developed countries account for half of the avoidable adverse events that result in death or disability. 1 in 1,000,000: The chance of a traveller being harmed while in an aircraft. 1 in 300: The chance of a patient being harmed during health care. Source: World Health Organization Reprinted with permission from: Production/Electronic Channels Coordinator HealthCom Media 259 Veterans Lane Doylestown, PA 18901 ********************* Chick-fil-A *** In 1946, an Atlanta-area restaurant called the Dwarf Grill began to serve chicken breast sandwiches, which, surprisingly, seems not to have been done elsewhere or earlier. Proprietor Truett Cathy thus holds claim to being the inventor of the treat, which he called "Chick-fil-A," a play on the work "fillet." Cathy established the first restaurant to bear the name in an Atlanta Mall. Today, there are more than 1,500 outlets across the country. ********************* Thank you , Laregis for this great link! She writes: "It's amazing what they are doing these days with these smart phones...." Click: iDoctor http://www.youtube.com/watch_popup?v=r13uYs7jglg ************* Quiz Time When taking clopidogrel, patients who are poor CYP2C19 metabolizers are at increased risk for: a. rhabdomyolysis. b. stroke. c. dyslipidemia. d. lung cancer. Reprinted with permission from: Production/Electronic Channels Coordinator HealthCom Media 259 Veterans Lane Doylestown, PA 18901 (Answer at end of Newsletter) ******************* Fluid and electrolyte imbalances can quickly turn into life-threatening situations and it is critical to be able to recognize subtle signs and symptoms and intervene appropriately. Test your knowledge of fluids and electrolytes by answering the following questions: What are the major organs involved in electrolyte and fluid homeostasis? What medications can cause hypernatremia? What are the recommended treatments for dilutional hyponatremia? What is the relationship between calcium level and phosphorous level? Which medication, commonly given in CCUs, is contraindicated in patients with hypokalemia? Check your answers and learn more by exploring the articles in More Resources. Also, we now have a new collection, Focus On: Fluids & Electrolytes, which includes a variety of articles, CE, and special features all about fluid and electrolytes! http://email.lww.com/t?r=1483&c=3480712&l=59027&ctl=4661F84:B54AB34282EDAD00F9F852C93A3ECCCEBB9E742C260FE2D0&; ******************** The vernal equinox happens every March 20 or 21. RANDOM FACT: "Vernal" is Latin for "spring" and "equinox" is Latin for "equal night." There are two equinoxes every year � vernal and autumnal. Those two days are the only times during the year when the sunrise is due east and the sunset is due west. *** Bonus Facts: Ancient Egyptians built the Great Sphinx to point directly East toward the sunrise on the vernal equinox. Stonehenge in England also marks the position of the rising sun on the vernal equinox. ********************* An Important Step Forward in Addressing the Rare Disease Health Crisis April 23, 2013 (Huffington Post) - We have a health crisis on our hands, and we're finally taking strides to make a difference. The way we are doing so: The Rare Disease Impact Report. http://enews.hcplive.com/c.html?ufl=4&rtr=on&s=lwo0yi,112aj,1qvv,bzse,22yh,6o8t,78ko ********************* White Paper Lists Several Recommendations To Speed Up Orphan Drug Approval April 24, 2013 (Rare Disease Report) - A search of orphan drugs designated by the FDA for the treatment of duchenne muscular dystrophy (DMD) yields 27 drugs. When you repeat the search for approved orphan drugs for the treatment of DMD, zero drugs appear. And that discrepancy was the stimulus for the patient organization Parent Project Muscular Dystrophy (PPMD) to issue a white paper ... http://enews.hcplive.com/c.html?ufl=4&rtr=on&s=lwo0yi,112aj,1qvv,7ns7,ork,6o8t,78ko ********************* No difference in survival rates between teaching and nonteaching hospitals for patients with acute MI A study published in Academic Medicine has found no survival benefit for patients with acute myocardial infarction (MI) who are admitted to teaching hospitals, rather than nonteaching hospitals. Read more. http://healthcommedia.benchmarkmails26.com/c/l?u=242EDCA&e=2BEA28&c=F275&t=0&l=242D6A&email=khDcrWqjAkeIKbHcHZqq5QSXAE%2FMRK6o ********************** Posted: Apr 29, 2013 - Joint Commission Announces Accreditation of DaVita Inpatient Dialysis Units - For the first time, The Joint Commission has awarded Ambulatory Health Care Accreditation to an inpatient kidney care provider DaVita Hospital Services. Denver based DaVita, with nearly 700 sites located in Joint Commission-accredited hospitals across the U.S., is a division of DaVita HealthCare Partners Inc. http://www.jointcommission.org/joint_commission_announces_accreditation_davita_inpatient_dialysis_units/ ************ (If anyone has encountered Naval Corpsmen, as I have, you know their knowledge and their capabilities are excellent) HHS launches nursing program for veterans HHS' Health Resources and Services Administration has introduced a program aimed at training military medics and other veterans with medical backgrounds for careers in nursing. The agency will provide as much as $350,000 each to as many as nine nursing schools annually. The program "helps veterans formalize their skills to get jobs, while strengthening Americans’ access to care," HHS Secretary Kathleen Sebelius said. Nurse.com http://r.smartbrief.com/resp/eudTDrrXoMfJaTkgfDcXdUfCZVrR?format=standard ~~**~~**~~**~~**~~**~~ HUMOR SECTION All of us, at one time or other, have had difficult patients who could never be satisfied. This nurse had such a patient and the patient's doctor was sympathetic with the nurse. He ordered ... soapsuds enema..an enema that the nurse detested. Seeing her face, he asked what was the problem. Once he heard her explanation, he asked her when was her shift over. "1900 hrs", she answered. The doc then ordered the SS enema at HS (Hour of sleep). (what a perfect solution) ~~**~~**~~**~~**~~**~~ 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 Your role in redesigning health care http://email.lww.com/t?r=1483&c=3517191&l=59027&ctl=46F52C8:B54AB34282EDAD004590D 7C92BFD7A5A50CB97921045BA00& Advancing the science of nursing and improving the quality of care: http://email.lww.com/t?r=1483&c=3517191&l=59027&ctl=46F52C9:B54AB34282EDAD004590D 7C92BFD7A5A50CB97921045BA00& ~~**~~**~~**~~**~~**~~ 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/ The Nursing Site http://thenursingsite.com . http://www.snopes.com http://www.solutionsoutsidethebox.net/ Raconte's website http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3 Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm Metric conversion calculators and tables for metric conversions http://www.metric-conversions.org/ ******************************************************* ******************************************** * MEDICAL RECALLS * ******************************************* ****************************************************** Anticoagulant Citrate Phosphate Dextrose Solution, USP (CPD) BLOOD-PACK Unit By Fenwal: Recall - Labeling Issue Identified Fenwal has initiated a voluntary Urgent Product Recall of one lot (FM13A15027) of product code 4R1584, Anticoagulant Citrate Phosphate Dextrose Solution, USP (CPD) BLOOD-PACK unit. Fenwal identified a labeling issue with this batch of Product Code 4R1584 in which the platelet container is incorrectly labeled as “AS-1 Red Blood Cell Adenine-Saline added”. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm350275.htm ******************** Samsca (Tolvaptan): Drug Safety Communication - FDA Limits Duration and Usage Due To Possible Liver Injury Leading to Organ Transplant or Death. FDA has determined that the drug Samsca (tolvaptan) should not be used for longer than 30 days and should not be used in patients with underlying liver disease because it can cause liver injury, potentially leading to liver transplant or death. FDA has worked with the manufacturer to revise the Samsca drug label to include new limitations. BACKGROUND: Samsca is a selective vasopression V2-receptor antagonist indicated for the treatment of clinically significant hypervolemic and euvolemic hyponatremia, including patients with heart failure and Syndrome of Inappropriate Antidiuretic Hormone (SIADH). An increased risk of liver injury was observed in recent large clinical trials evaluating Samsca for a new use in patients with autosomal dominant polycystic kidney disease (ADPKD). http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm350185.htm ******************** Piperacillin and Tazobactam for Injection, USP 40.5 grams: Recall - Precipitation or Crystallization in IV Bag or IV Line Upon Reconstitution Apotex Corp. notified healthcare professionals it is conducting, on behalf of the manufacturer Hospira, Inc., a voluntary nationwide recall of 15 lots of Piperacillin and Tazobactam for Injection, USP 40.5 grams, to the hospital/healthcare provider/user level. The impacted lots may show precipitation/ crystallization in IV bag or IV line after reconstitution. The product can also be identified by NDC number 60505-0773-00 and UPC 360505077304. The product was distributed nationwide in the United States to wholesalers, distributors, HMOs, home infusion and long term care service providers. See Press Release for a list of affected lot numbers Hospira stated that administration of precipitated Piperacillin/Tazobactam in an IV bag or IV line may result in local reactions such as phlebitis, renal impairment, end-organ embolism and ischemia, and/or vasculitis (because the precipitate was visible, its particles may be large enough to cause these adverse events). In addition, the precipitation of the drug may not allow delivering a needed therapeutic dose of piperacillin and tazobactam, thus resulting in inadequate treatment of the targeted infection. This could result in adverse health consequences that could range from transient and minor impairment or complaints to permanent impairment of a body function or permanent damage to a body structure. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm350085.htm ******************** CareFusion Corporation, Alaris PC Unit (Model 8015) with Software Version 9.12 Recall Class: Class I Date Recall Initiated: March 6, 2013 Product: Alaris PC Unit (Model 8015) with Software Version 9.12 This product was distributed from Sept. 21, 2012 through March 5, 2013. Use: The Alaris PC unit (model 8015) is part of the Alaris electronic infusion pump. An electronic infusion pump delivers controlled amounts of medications or other fluids to patients through intravenous (IV), intra-arterial (IA), epidural, and other acceptable routes of administration. Recalling Firm: CareFusion Corporation 3750 Torrey View Court San Diego, California 92130-2622 Reason for Recall: CareFusion has received reports of a communication error on the Alaris PC unit (model 8015) with software version 9.12 when the Alaris EtCO2 module or Alaris SpO2 module is attached. Use of this product may cause serious adverse health consequences, including death. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm349002.htm ************* Potiga (Ezogabine): Drug Safety Communication - Linked To Retinal Abnormalities And Blue Skin Discoloration FDA is warning the public that the anti-seizure medication Potiga (Ezogabine) can cause blue skin discoloration and eye abnormalities characterized by pigment changes in the retina. FDA does not currently know if these changes are reversible. FDA is working with the manufacturer to gather and evaluate all available information to better understand these events. FDA will update the public when more information is available. ... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm349847.htm ************* Eba Multivitamin Supplement By Saratoga Therapeutics LLC: Recall - Allergy Alert On Undeclared Milk Components Saratoga Therapeutics, LLC of North Wales, PA recalled 900 bottles of ebA Multivitamin Supplement because they may contain undeclared milk components – milk protein(s) and lactose. The label lists the product as being free of milk components. People with an allergy or severe sensitivity to milk run the risk of a serious or life-threatening allergic reaction and people who have lactose intolerance run the risk of gastrointestinal symptoms if they consume ebA Multivitamin Supplement. Affected lot numbers include #0912164 expiration date 12/12 and #1110354 expiration date 10/14. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm349706.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 ~~**~~**~~**~~**~~**~~ 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. ~~**~~**~~**~~**~~**~~ THOUGHT FOR THE DAY "Time is the coin of your life. It is the only coin you have, and only you can determine how it will be spent. Be careful lest you let other people spend it for you.” - Carl Sandburg Answer to Quiz Time: Correct answer: b. Drug effectiveness for clopidogrel depends on activation of the drug to an active metabolite by a CYP45O enzyme called CYP2C19. Poor CYP2C19 metabolizers are at increased risk for major cardiovascular events such as heart attack, stroke, and cardiovascular death. Hey, why don't you write? ..... Frankie RNFrankie@AOL.com