Thursday, May 22, 2014

May Newsletter

PARADIGM BYTES

Newsletter for Paradigm 97
May 20, 2014
PARADIGM DEFINED:1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.

Our website...... http://paradigm97.blogspot.com/Please copy, paste, and bookmark it.

MISSION STATEMENT
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
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SNIPPETS
To sleep, perchance to control your dreams
NEW YORK (Reuters) - Nighttime dreams in which you show up at work naked, encounter an ax-wielding psychopath or experience other tribulations may become a thing of the past thanks to a discovery reported on Sunday.
Applying electrical current to the brain, according to a study published online in Nature Neuroscience, induces "lucid dreaming," in which the dreamer is aware that he is dreaming and can often gain control of the ongoing plot.
The findings are the first to show that inducing brain waves of a specific frequency produces lucid dreaming.
For the study, scientists led by psychologist Ursula Voss of J.W. Goethe-University in Frankfurt, Germany, built on lab studies in which research volunteers in the REM (rapid-eye movement) stage of sleep experienced a lucid dream, as they reported when they awoke. Electroencephalograms showed that those dreams were accompanied by telltale electrical activity called gamma waves.
Those brain-waves are related to executive functions such as higher-order thinking, as well as awareness of one's mental state. But they are almost unheard of in REM sleep. Voss and her colleagues therefore asked, if gamma waves occur naturally during lucid dreaming, what would happen if they induced a current with the same frequency as gamma waves in dreaming brains?
When they did, via electrodes on the scalp in a technique called transcranial alternating current stimulation (tACS), the 27 volunteers reported that they were aware that they were dreaming. The volunteers were also able to control the dream plot by, say, throwing some clothes on their dream self before going to work. They also felt as if their dream self was a third party whom they were merely observing.
Voss does not foresee a commercial market in lucid-dreaming machines. Devices currently sold "do not work well," she said in an interview, and those that deliver electrical stimulation to the brain, like the one in her study, "should always be monitored by a physician."
But if the results hold up, the technique might help people suffering from post-traumatic stress disorder, who often have terrifying dreams in which they re-play the traumatic experience. If they can dream lucidly, they might be able to bring about a different outcome, such as turning down a different street than the one with the roadside bomb or ducking into a restaurant before the rapist attacks them.
"By learning how to control the dream and distance oneself from the dream," Voss said, PTSD patients could reduce the emotional impact and begin to recover.
(Reporting by Sharon Begley; Editing by Dan Grebler) By Sharon Begley
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What’s in a name?
Editor’s note: The information below was provided by United States Pharmacopeial Convention (USP). It may be freely reproduced and distributed, for non-commercial use only. The American Nurses Association is a voting member of the USP Convention.
If you eat jelly instead of jam you would get a slightly different version of the same thing. Jelly, jam, and preserves are all made from fruit mixed with sugar and pectin. The difference between them comes in the form that the fruit takes: fruit juice, fruit pulp or crushed fruit, or chunks of fruit respectively. But, not all things that sound and look alike are as easily — or safely — switched.
Look-alike/sound-alike drugs can create increased potential for harm. In fact, inadvertent switches of hydromorphone for morphine, or vice versa, are among the most common and serious errors that can occur between two high-alert drugs. These two medications are considered “high-alert” because they bear a heightened risk of causing significant patient harm. The very real danger of confusing these drugs is the crux of the Stimuli article in the United States Pharmacopeia (USP) Pharmacopeial Forum (March-April 2014), “Name Confusion Between Hydromorphone and Morphine: Safety in Patient Care”.
The article indicates that “[a] recent analysis of wrong-drug errors involving hydromorphone showed that 70% of these mistakes (129 of 185) occurred when hydromorphone was given instead of morphine, or vice versa”, and further observes that “[t]he potential for patient harm may be greatest when the wrong drug is given at the correct dosage for the other drug.” It goes on to describe a variety of risk-control strategies which have been employed to prevent these errors, but which have not been sufficiently effective in preventing patient harm.
What should be done to reduce these medication errors?
One possible solution is to change the name of hydromorphone. Changing the nonproprietary name of a medication is a very rare occurrence, but it has happened before. A nonproprietary name change is considered a last resort for protecting patient safety, and the USP Nomenclature, Safety, and Labeling Expert Committee (NSL EC), which is responsible for USP’s naming decisions, is aware of the significant and prolonged impact this action could have on the healthcare community, industry, and consumers. The article is an effort to stimulate discussion about the seriousness of the reported errors and solicit input on the effects of a name change on practitioners, industry, governmental agencies, and the international community. Should the drug hydromorphone undergo a name change? Are there other innovative ideas that could be effective in reducing medications errors involving hydromorphone and avert the need for a name change?
Who should comment?
Pharmacists, consumers and/or consumer groups, physicians, manufacturers, pharmacy and/or medical students, and the public may all have valuable insights and worthwhile feedback and all are encouraged to share thoughts and comments with the NSL EC by sending comments to dzb@usp.org. Much more detailed information about this challenge is available in the Stimuli article, which can be accessed by registering for the free forum (if not already), clicking on the “ACCESS PF NOW” button, and using the term “Hydromorphone and Morphine” in the search field.
Please, read the article and tell USP what you think.
USP is a global health organization that improves lives through public standards and related programs that help ensure the quality, safety, and benefit of medicines and foods.

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FDA approves first human papillomavirus test for primary cervical cancer screening
The U.S. Food and Drug Administration today approved the first FDA-approved HPV DNA test for women 25 and older that can be used alone to help a health care professional assess the need for a woman to undergo additional diagnostic testing for cervical cancer. The test also can provide information about the patient’s risk for developing cervical cancer in the future.
Today’s approval expands the use of the test to include use as either a co-test or as a primary cervical cancer screening test, however; it does not change current medical practice guidelines for cervical cancer screening. These guidelines are developed, reviewed and modified by groups other than the FDA.
Read the Press Release
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm394773.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
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Here are some facts about child abuse.
6:
State and local agencies receive nearly 6 referrals of child maltreatment every minute.
$124 billion:
Total lifetime cost of child maltreatment each year
8.7 per 1,000 children:
Rate of victimization for boys
9.6 per 1,000 children:
Rate of victimization for girls
1 year:
Children younger than 1 year have the highest rate of victimization.
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Forensic nurses are playing increasingly important roles in coroner and medical examiner's offices.
Working in hospitals in Alaska, Idaho and Oregon, Jennifer Schindell, BSN, RN, F-ABMDI, found it odd investigators didn't come to the hospital more often on cases involving trauma, abuse or neglect.

Here, the officers could have collected evidence from the patient's clothing and other belongings while gathering information such as injuries and patient statements. Also, Schindell wanted someone from law enforcement who was at the crime scene so she could have asked questions to better understand what had happened to her patient.
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Novartis says Signifor LAR drug helps control acromegaly disease
(Reuters) - Swiss drugmaker Novartis said on Monday a final-stage trial of its Signifor LAR therapy allowed for greater disease control in patients with the endocrine disorder acromegaly than existing therapies.
Acromegaly is caused by a benign tumor in the pituitary gland that secretes excess growth hormone, and can lead to the enlargement of body parts, including the hands, feet and facial features.
Worldwide regulatory filings for pasireotide LAR in acromegaly are currently underway based on these results, Novartis said. ...
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Food facts — Here are Centers for Disease Control and Prevention data about foodborne illness.
1 in 6:
About 1 in 6 (or 48 million) people get sick every year from contaminated food.
128,000:
Number of hospitalizations that occur as a result of illness
3,000:
Number of people who die each year from foodborne illness
65:
Compared to other age groups, adults 65 and older are at greater risk for hospitalization and death related to infections from contaminated food.
1:
Salmonella infection causes more hospitalizations and deaths than any other type of germ found in food.

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Why so many C-sections have medical groups concerned
(CNN) -- If you are pregnant, ask your doctor questions about their delivery habits long before you go into labor.
Several studies now suggest doctors may be performing too many cesarean sections. Doctors may be performing them based more out of habit, training, expediency or worry about lawsuits than out of medical necessity, according to the studies.
A surgical birth, while generally safe, does carry more health risks and more expense. If a woman has a C-section once, it also increases the chances she'll need another if she gets pregnant again. Risks go up with each procedure.
The latest information comes from Consumer Reports. The nonprofit ranked hospitals based on the number of C-sections performed at each. Looking at hospital billing records the authors found the number of procedures performed vary wildly -- even at hospitals in the same town.
In Texas, for instance, 15% of births at El Paso's University Medical Center are C-sections; four miles away, at Sierra Medical Center, the rate is more than double that at 37%. ...
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Smoking tobacco emerged from religious ceremonies in the Americas and was probably initially restricted to only shamans, priests, and medicine men.

Ramon Pane, a monk who accompanied Christopher Columbus to the Americas, is usually credited with introducing tobacco to Europe.

Renaissance author Ben Jonson argued that smoking was the "devil's fart."


RANDOM FACT:

Only recently, and mainly in Western countries, has smoking been seen as a serious health hazard. Smoking rates in the United States have dropped by half since 1965, from 42 percent to 26 percent of adults. Smoking in developing countries, however, is rising.
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Bonus Fact:

Within 20 minutes of quitting smoking, a person's blood pressure returns to normal. Within one year, the chance of suffering a heart attack decreases by half.

Tobacco smoking, particularly cigarette smoking, is the single-most preventable cause of the death in the United States.

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Ten body parts that you may not know the name:
How many of these did you know?
The canthus is where the upper and lower eyelids meet.

The rasceta are the lines on the inside of your wrist.

The purlicue is the space between the thumbs and the forefingers.

The columella nasi is the space between your nostrils.

A morton's toe is a second toe that is longer than the big toe -- do you have one?

A minimus is your little toe or finger.

The space between your eyebrows is known as the glabella.

The lunula, is the white, crescent-shaped part of the nail.

The groove between the nose and the middle of the lips is the philtrum.

The popliteal, is of or relating to the back part of the leg behind the knee joint
Resembling or having the form of the buttocks is known as a natiform. (We're not sure when knowing that will ever come in handy, but if it does ... you're welcome.)
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Quiz Time
Which statement accurately describes delirium?
a. It has a slow, progressive, debilitating effect on function.
b. It is a cognitive disturbance of acute onset.
c. It doesn’t affect the sleep-wake cycle.
d. It isn’t helped by family presence.
  
   See correct answer at the end of the Newsletter.
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Cats are North America's most popular pets: there are 73 million cats compared to 63 million dogs. Over 30 percent of households in North America own a cat.
 RANDOM FACTS: On average, cats spend 2/3 of every day sleeping. That means a nine-year-old cat has been awake for only three years of its life.
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Bonus Fact: Every year, nearly four million cats are eaten in Asia. (as far as I am concerned, that was entirely too much information!!!)
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Hint 1: Setting out a bouquet of tulips, daisies, or other pretty spring flowers?
Keep their stems from sagging by removing their leaves and slip each one into a wide plastic drinking straw before adding to your vase. You can use the clear plastic straws or try a mix of pretty colors for an even brighter display of blooms!

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Hint 2: Tip for making peanut butter cookies!

Next time you can save money when you make peanut butter cookies by using a potato masher instead of a fork to press down the dough balls to create their distinctive crisscross pattern in one quick step!

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Hint 3: Potatoes and cauliflower tend to turn brown when boiling or if they sit too long before serving. Keep them white by squeezing a dollop of fresh lemon juice into the cooking water.
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The impact of increased nursing staffing:
An INQRI-funded study on the impact of nursing staffing on hospital performance revealed that increasing the number of registered nurse (RN) hours per patient day increased the quality of patient care. The study looked in particular at patients who were being treated for acute myocardial infarction, pneumonia or heart failure.) For all three conditions, increasing the number of RN hours increased the quality of care. This did not hold true for increasing the number of licensed practical nurse (LPN) or nursing assistant (NA) hours.

The study's authors -- Gestur Davidson, Ira Moscovice and Kathy Belk -- posited that RNs are involved in and directly affect procedures, practices and processes that directly influence patient outcomes. This was the first study into how nurse staffing affects hospital performance on quality metrics used in the Premier Hospital Quality Demonstration project. It is reviewed in a new research brief on the Robert Wood Johnson Foundation website. ...
http://inqri.blogspot.com/2013/12/increased-rn-staffing-hours-are.html
                                                    
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HUMOR SECTION

It was 6 p.m., and I was about to leave the coin laundry where I was employed. My boss called me over and asked if I would mind dropping off someone's laundry on my way home. "It's for my cousin," she apologized, "who's eight months pregnant and can't get out much anymore." I cheerfully agreed and, driving to the address, knocked at the door. A little girl, the sister-to-be, answered.

"Hi, there," I said with a big smile. "Is your mommy home?" Holding up the white bundle of clothes, I explained, "I have a delivery for her."

The child's mouth dropped, and her eyes went wide. "Mom!" She shrieked, "come quick! It's the stork!"

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When my husband and I showed up at a very popular restaurant, it was crowded. I went up to the hostess and asked,
"Will it be long?"

The hostess, ignoring me, kept writing in her book. I asked again, "How much of a wait?"

The woman looked up and said, "About ten minutes."

A short time later, we heard an announcement over the loud-speaker: "Willette B. Long, your table is ready."

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CEU SITES---(CME and CNE)
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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.
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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.orgwww.sharedgovernance.org
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
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
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

 Metric conversion calculators and tables for metric conversions
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MEDICAL RECALLS
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Codman Neuro is informing physicians of this incorrect statement and updating the product's Instructions For Use (IFU). The product's IFU incorrectly noted: "A 2:1 (67% Ethiodized Oil / 33% nBCA) for feeding pedicle injections close to the nidus at high flow rates where venous opacification occurs on contrast injections within 1/2 second." The use of incorrectly mixed product can result in the liquid mixture solidifying too slowly in unintended areas, which may lead to embolization or reflux into arteries and pulmonary vessels. This could result in significant impact to the patient, including neurological deficits, pulmonary emboli and possibly death.
The correct information should have stated: "A 2:1 (67% Ethiodized Oil / 33% nBCA) for Intranidal injections without AV fistulae or high flow rates in order to more deeply penetrate the nidus." Trufill n-BCA is indicated for embolization of cerebral arteriovenous malformations (AVMs) when presurgical devascularization is desired. In October 2013, Codman Neuro identified an incorrect statement in the product's IFU that described suggested mixing ratios for use in certain treatment conditions.
Product is not being removed from the market. Trufill nBCA products associated with the correction notice were manufactured between February 25, 2010 and October, 31, 2013, distributed to hospitals and surgical centers, and include the following product codes (all lots): 631400 (Two 1 gram tubes nBCA) and 631500 (One 1 gram tube nBCA).
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VPRIV (velaglucerase alfa for injection): Recall - Visible Particulate Matter Shire Pharmaceuticals announced a voluntary recall in the United States of one batch, packaged into three lots, of VPRIV due to the presence of visible particulate matter, identified as stainless steel and barium sulfate. The particulate matter was found in a small number of vials in the three packaged lots of VPRIV. A Shire investigation identified the particulate matter root cause as the third party supplier fill finish process.
If infused, there is a possibility of rare but serious adverse events associated with particulate containing barium sulfate.
The following packaged lots were recalled: FEW13-001, FEW13-002, and FED13-006. These lots were distributed nationwide to hospitals, infusion clinics, patients, and home health agencies in the United States and all have the same NDC code (54092-701-04) and same expiration date of 10/15 (Oct 2015).
BACKGROUND: VPRIV is a hydrolytic lysosomal glucocerebroside-specific enzyme indicated for long-term enzyme replacement therapy (ERT) for pediatric and adult patients with type 1 Gaucher disease. VPRIV is supplied as a sterile, preservative-free, lyophilized powder in single-use vials, for intravenous use.
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Calcium gluconate 10 percent Injections by Rx Formulations: Recall - Microbial Contamination FDA notified healthcare professionals to follow up with patients who received calcium gluconate 10% injections made by Rx Formulations, Mesa, Ariz., between Nov. 7 and Dec. 11, 2013. FDA testing confirmed the presence of microbial contamination in lot #778961 of Rx Formulations’ calcium gluconate injection product. The testing identified gram-positive rod bacteria in the product. A contaminated injectable drug can put patients at risk of adverse health consequences and possibly a serious infection.
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ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-Ruler Accurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.
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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
WELCOME TO: alwconglomerate@hotmail.com (Almarine) April 28, 2014
and
anlboat@bellsouth.net (Libby) May 19, 2014
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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address. So, be certain to let me know when you change your address. RNFrankie@AOL.com
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EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)

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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)

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DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
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THOUGHT FOR THE DAY
It is the duty of the patriot to protect his country from its government.
--Thomas Paine
Hope to hear from you..... Frankie

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