PARADIGM BYTES
Newsletter for
Paradigm 97
January 12, 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
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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(The following is an explanation of Truth About Nursing's objectives. If possible, please donate $5 or more to support them in their endeavors. Contact Sandy for instructions about donations.)
As a report by the Institute of Medicine recently stressed, in order for the health care crisis to end, nurses must be a part of the decision-making process. That means more resources and respect. Hospitals exist mainly to provide nursing care, but nurses rarely hold positions of leadership; few nurses serve on hospital boards. Why should any nursing institution be run by anything less than a majority of nurses? Yet that's the status quo in the vast majority of health institutions across the world.
Why does helping people understand nursing matter?
When people think nursing is unskilled loser work, or that nurses exist
to serve physicians, then nurses have a tough time getting the resources
they need to provide good nursing care. Nurses are spread too thinly
because many have been replaced by lesser-educated workers who can't
assess or intervene as nurses can. Decision-makers believe that
non-nurses can perform nursing work because they do not understand the
nature or value of nursing. That leads to poor care--and sadly, even
death.
The Truth About Nursing fights this deadly lack of understanding.
Decision-makers get these wrong ideas from many sources, but especially
by watching, reading and listening to the omnipresent media. The media
constantly tells us that physicians are the only health professionals
whose work matters. Physicians deserve credit for their good work, but
not for the work of nurses. And when physicians get credit for nurses'
work, they get the funding for it too. That's why nursing residencies
only get
$1 for every $375
that physicians residencies get. That's why the NIH gives nursing
researchers only
half of one percent of its budget
, even though nurses work on the cutting edge of health care and make up
the largest body of health professionals.
truthaboutnursing.org
Postoperative recovery in elderly patients:
Implications for respiratory care by Helen M. Sorenson, MA, RRT, CPFT, FAARC
Implications for respiratory care by Helen M. Sorenson, MA, RRT, CPFT, FAARC
The increasing population of older adults will result in an increased amount of surgical procedures being performed on
geriatric patients. The number of elderly (> 65 years) patients who undergo noncardiothoracic surgery is projected to increase from 7 million to 14 million over the next 30 years. Surgery can potentially be debilitating for older adults. While survival may be the ultimate goal, improving quality of life and functional capacity may be far more important to the elderly. Ms. Sorenson outlines in her article how many of the postoperative pulmonary complications can be prevented with advances in medicine, technology, and risk stratification.
Unplanned extubation (UE) can be a devastating event for critically ill patients, with potentially life threatening complications including
airway trauma, bronchospasm, severe hypoxemia, and cardiac arrest. UE can lead to an increased number of ventilator days,
resulting in excessive resource use for patients, and increased risk of litigation for healthcare professionals. Dr. Foster describes methods
to protect against UE including education, quality improvement processes, sedation protocols, physical restraints, and tube securing
methods. ... http://www.accelacommunications.com/microsite/hospital_acquired_uti/Perspectives28.pdf
geriatric patients. The number of elderly (> 65 years) patients who undergo noncardiothoracic surgery is projected to increase from 7 million to 14 million over the next 30 years. Surgery can potentially be debilitating for older adults. While survival may be the ultimate goal, improving quality of life and functional capacity may be far more important to the elderly. Ms. Sorenson outlines in her article how many of the postoperative pulmonary complications can be prevented with advances in medicine, technology, and risk stratification.
Unplanned extubation (UE) can be a devastating event for critically ill patients, with potentially life threatening complications including
airway trauma, bronchospasm, severe hypoxemia, and cardiac arrest. UE can lead to an increased number of ventilator days,
resulting in excessive resource use for patients, and increased risk of litigation for healthcare professionals. Dr. Foster describes methods
to protect against UE including education, quality improvement processes, sedation protocols, physical restraints, and tube securing
methods. ... http://www.accelacommunications.com/microsite/hospital_acquired_uti/Perspectives28.pdf
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MEDICAL NEWS
More Than 30 Nursing Organizations Call for Action in Wake of Newtown Tragedy
More than 30 leading organizations representing registered nurses signed on to a call to action sent today to President Obama, congressional leaders, and leaders of both the National Governors Association and The United States Conference of Mayors that urges swift action to address factors that together will help prevent more senseless acts of violence in the wake of the tragedy in Newtown, Conn. http://www.nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/Call-to-Action-from-the-Nations-Nurses-in-the-Wake-of-Newtown.pdf ;
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FDA approves first subcutaneous cardiac defibrillator
On
Sept. 28, the U.S. Food and Drug Administration (FDA) approved the
first subcutaneously inserted cardiac defibrillator: Subcutaneous
Implantable Defibrillator (S-ICD) System.
An implantable defibrillator is
a small battery-powered device that constantly monitors a person’s
heart rhythm and can deliver a therapeutic dose of electricity to
restore the rhythm when it senses the heart is beating dangerously fast
(tachycardia) or chaotically (sudden cardiac arrest).
Other
implantable defibrillators on the market require a physician to insert
one or more electrical conductor wires, called “leads,” into a vein in
the upper chest and guide them into the patient’s heart. X-ray
fluoroscopy, a real-time imaging method, helps the physician to
visualize the heart and blood vessels to guide the leads to the correct
position.
The Subcutaneous Implantable Defibrillator (S-ICD)
System uses a lead that is implanted just under the skin along the
bottom of the rib cage and breast bone. Because the lead is placed under
the skin rather than through a vein into the heart, a physician can
implant the device without accessing a patient’s blood vessels or heart
and without the need for fluoroscopy.
“The S-ICD System provides
an alternative for treating patients with life-threatening heart
arrhythmias for whom the routine ICD placement procedure is not ideal,”
said Christy Foreman, director of the Office of Device Evaluation at
FDA’s Center for Devices and Radiological Health. “Some patients with
anatomy that makes it challenging to place one of the implantable
defibrillators currently on the market may especially benefit from this
device.” ...
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FROM A MEMBER
INTERESTING READING
The following was sent in by Rozalfaro.After many comments from colleagues, I'm starting a campaign to have "Be on Your Patients' S.I.D.E" (summarized below; applies to all settings) posted on every unit and at every school of nursing. You can download an eye-catching handout free from http://www.alfaroteachsmart.com/handouts.html (Choose Handout #16, S.I.D.E Care Principles). Please download, copy, and share!Be On Your Patients' S.I.D.E.*Use S.I.D.E to remember overarching care principles:S- Safety and comfort. Make safety and comfort top priority.I- Infection prevention. Be alert to infection risks; wash your hands;teach patients to do the sameD- Dignity. Help patients maintain self-respect; ensure privacy.E- Engage and educate. Involve patients and families in making decisions;teach them what they need to know to be independent.For more information S.I.D.E. or coaching on teaching critical thinking (on-site, on the phone, or electonic coaching) simply reply to this email. Rosalinda (Roz) Alfaro-LeFevre teachsmartalfaro@aol.com
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INTERESTING READING
Please
remember that the REUTERS articles usually good for only 30 days
Reprinted with permission from: Production/Electronic Channels Coordinator
HealthCom Media 259 Veterans Lane Doylestown, PA 18901
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Johns Hopkins Malpractice Study: Surgical ‘Never Events’ Occur At Least 4,000 Times per Year Researchers advocate public reporting of mistakes
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Incidence and Severity of Phlebitis in Patients Receiving Peripherally Infused Amiodarone
Abstract
Background: Nurses
noted that the rate of phlebitis was high when intravenous amiodarone
was infused via a peripheral site. Hospital
policy recommends a central vascular catheter,
but this method is often not feasible because the drug is administered
in emergent
situations for short periods.... http://ccn.aacnjournals.org/content/32/4/27.abstract?utm_source=BenchmarkEmail&utm_campaign=Weekly_eNewsletter_August_20th_2012&utm_medium=email
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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.
"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/National Nurses United.
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/
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Nurses Earn Highest Ranking Ever, Remain Most Ethical of Professions in Poll
ANA Urges Policymakers to Listen to Nurses on Health Care Policy, Funding SILVER SPRING, MD —
The public continues to rate registered nurses (RNs) as the most trusted profession according to this year’s Gallup survey that ranks professions based on their honesty and ethical standards.
“This poll consistently shows that people connect with nurses and trust them to do the right thing,” said ANA President Karen A. Daley, PhD, MPH, RN, FAAN. “Policymakers should do the same as they debate crucial budget decisions that will affect health care quality and access for millions of Americans.” ...
http://www.nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/Nurses-Remain-Most-Ethical-of-Professions-in-Poll.pdf
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Code of Ethics for Nurses The ICN Code of Ethics for Nurses, most recently revised in 2012, is a guide for action based on social values and needs.The Code has served as the standard for nurses worldwide since it was first adopted in 1953. The Code is regularly reviewed and revised in response to the realities of nursing and health care in a changing society. The Code makes it clear that inherent in nursing is respect for human rights, including the right to life, to dignity and to be treated with respect. The ICN Code of Ethics guides nurses in everyday choices and it supports their refusal to participate in activities that conflict with caring and healing. [Links to download in numerous languages. 12 pages..] Thank you, Barbara (BAcello) for this article.
http://www.icn.ch/about-icn/code-of-ethics-for-nurses/
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RANDOM FACT: Town laws in the U.S. Midwest in the 1880s were passed prohibiting the sale of ice cream sodas on Sunday. In Illinois, ingenious soda fountain owners got around the law by omitting the carbonated water and serving just the scoop of ice cream and the syrup. They called this a "Sunday Soda." Later the name was shortened to "sunday" and eventually just "sundae."
***
Furthermore, nurses working shifts
of ten hours or longer were up to two and a half times more likely than
nurses working shorter shifts to experience burnout
and job dissatisfaction and to intend to leave the job. Extended shifts
undermine nurses’ well-being, may result in
expensive job turnover, and can negatively affect patient care. Policies
regulating
work hours for nurses, similar to those set for
resident physicians, may be warranted.
http://content.healthaffairs.org/content/31/11/2501.abstract?utm_source=BenchmarkEmail&utm_campaign=Weekly_eNewsletter_November_12th_2012&utm_medium=email
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In the past three decades, the shortage of nurses willing to work in hospitals has been a persistent challenge in the United States. Hiring supplemental registered nurses—nurses on short-term contracts obtained through an external staffing agency—has been common to fill gaps in nurse staffing. But there has been insufficient evidence about supplemental nurse workforce trends to inform workforce policy. To address this concern, we compared qualifications and characteristics of supplemental nurses with those of permanent nurses during 1984–2008. The two groups shared similar education levels in terms of possessing a baccalaureate or higher degree. Supplemental nurses were somewhat less experienced than permanent nurses, averaging fifteen years of experience in 2008 compared to eighteen years for permanent nurses. ... http://content.healthaffairs.org/content/31/11/2510.abstract?utm_source=BenchmarkEmail&utm_campaign=Weekly_eNewsletter_November_12th_2012&utm_medium=email
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Shifting the safety balance for overnight workers
http://www.monash.edu.au/news/releases/show/shifting-the-safety-balance-for-overnight-workers?utm_source=BenchmarkEmail&utm_campaign=AMNT_Electronic_December_2012_House&utm_medium=email
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Quiz Time:
b. Transvenous pacing
c. Noninvasive transcutaneous pacing
d. Biventricular pacing
Answer at end of Newsletter...
****************
RANDOM FACT: The Massachusetts Law School of 1647 required that towns with 50 or more families establish schools or pay a fine of 5 British pounds. Several schools were opened as a result of this law. Although the schools were not the first supported by the public, the law forcing their creation was an important milestone in public education.
*************
Nurses Earn Highest Ranking Ever, Remain Most Ethical of Professions in Poll
ANA Urges Policymakers to Listen to Nurses on Health Care Policy, Funding SILVER SPRING, MD —
The public continues to rate registered nurses (RNs) as the most trusted profession according to this year’s Gallup survey that ranks professions based on their honesty and ethical standards.
“This poll consistently shows that people connect with nurses and trust them to do the right thing,” said ANA President Karen A. Daley, PhD, MPH, RN, FAAN. “Policymakers should do the same as they debate crucial budget decisions that will affect health care quality and access for millions of Americans.” ...
http://www.nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/Nurses-Remain-Most-Ethical-of-Professions-in-Poll.pdf
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Code of Ethics for Nurses The ICN Code of Ethics for Nurses, most recently revised in 2012, is a guide for action based on social values and needs.The Code has served as the standard for nurses worldwide since it was first adopted in 1953. The Code is regularly reviewed and revised in response to the realities of nursing and health care in a changing society. The Code makes it clear that inherent in nursing is respect for human rights, including the right to life, to dignity and to be treated with respect. The ICN Code of Ethics guides nurses in everyday choices and it supports their refusal to participate in activities that conflict with caring and healing. [Links to download in numerous languages. 12 pages..] Thank you, Barbara (BAcello) for this article.
http://www.icn.ch/about-icn/code-of-ethics-for-nurses/
***********************************
RANDOM FACT: Town laws in the U.S. Midwest in the 1880s were passed prohibiting the sale of ice cream sodas on Sunday. In Illinois, ingenious soda fountain owners got around the law by omitting the carbonated water and serving just the scoop of ice cream and the syrup. They called this a "Sunday Soda." Later the name was shortened to "sunday" and eventually just "sundae."
Study: Extended shifts associated with nurse burnout and patient dissatisfaction
"The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction," in November’s
Health Affairs, found that nurses working shifts of 10 hours or
longer were up to two and a half times more likely than nurses working
shorter shifts to experience burnout and job dissatisfaction, and as the
proportion of hospital nurses working shifts of more than 13 hours
increased, patients’ dissatisfaction with care increased. http://content.healthaffairs.org/content/31/11/2501.abstract?utm_source=BenchmarkEmail&utm_campaign=Weekly_eNewsletter_November_12th_2012&utm_medium=email
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Study: Supplemental nurses compared to permanent nurses
Supplemental
nurses and permanent nurses share similar education levels, but
supplemental nurses are slightly less experienced, more racially and
ethnically diverse, and more likely to be male, according to a study in
November’s
Health Affairs. In the past three decades, the shortage of nurses willing to work in hospitals has been a persistent challenge in the United States. Hiring supplemental registered nurses—nurses on short-term contracts obtained through an external staffing agency—has been common to fill gaps in nurse staffing. But there has been insufficient evidence about supplemental nurse workforce trends to inform workforce policy. To address this concern, we compared qualifications and characteristics of supplemental nurses with those of permanent nurses during 1984–2008. The two groups shared similar education levels in terms of possessing a baccalaureate or higher degree. Supplemental nurses were somewhat less experienced than permanent nurses, averaging fifteen years of experience in 2008 compared to eighteen years for permanent nurses. ... http://content.healthaffairs.org/content/31/11/2510.abstract?utm_source=BenchmarkEmail&utm_campaign=Weekly_eNewsletter_November_12th_2012&utm_medium=email
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Shifting the safety balance for overnight workers
An international team of sleep researchers has developed the world’s
first screening tool to help reduce workplace accidents and illnesses,
including cardiovascular disease and cancer, caused by shift work.
Published in the journal Sleep, the new tool will enable health professionals and industry to better understand individual vulnerability to the health and safety impacts of shift work.
This screening questionnaire for a condition known as shift work disorder (SWD) has been developed by researchers from Monash University, and US partners, Harvard Medical School, Brigham and Women's Hospital, and the Henry Ford Hospital.
At least 15 per cent of workers in Australia, the US, and the United Kingdom, and around 23 per cent of workers in Japan are estimated to work outside normal hours, causing significant disruption to their natural sleep-wake schedules. SWD, characterised by extreme sleepiness and/or insomnia, is thought to affect around 10 per cent of shift workers. ...
Published in the journal Sleep, the new tool will enable health professionals and industry to better understand individual vulnerability to the health and safety impacts of shift work.
This screening questionnaire for a condition known as shift work disorder (SWD) has been developed by researchers from Monash University, and US partners, Harvard Medical School, Brigham and Women's Hospital, and the Henry Ford Hospital.
At least 15 per cent of workers in Australia, the US, and the United Kingdom, and around 23 per cent of workers in Japan are estimated to work outside normal hours, causing significant disruption to their natural sleep-wake schedules. SWD, characterised by extreme sleepiness and/or insomnia, is thought to affect around 10 per cent of shift workers. ...
http://www.monash.edu.au/news/releases/show/shifting-the-safety-balance-for-overnight-workers?utm_source=BenchmarkEmail&utm_campaign=AMNT_Electronic_December_2012_House&utm_medium=email
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Quiz Time:
Which type of temporary pacing usually is used for a patient having major cardiac surgery?
a. Epicardial pacing
b. Transvenous pacing
c. Noninvasive transcutaneous pacing
d. Biventricular pacing
Answer at end of Newsletter...
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RANDOM FACT: The Massachusetts Law School of 1647 required that towns with 50 or more families establish schools or pay a fine of 5 British pounds. Several schools were opened as a result of this law. Although the schools were not the first supported by the public, the law forcing their creation was an important milestone in public education.
*************
Sepsis remains a serious problem worldwide. Consider these facts:
6,000,000:
Sepsis kills more than 6 million newborn and small children in the developing world.
Sepsis kills more than 6 million newborn and small children in the developing world.
377:
The number of cases of sepsis per 100,000 people in the U.S. and Europe, higher than stroke, cancer, heart disease, and HIV.
The number of cases of sepsis per 100,000 people in the U.S. and Europe, higher than stroke, cancer, heart disease, and HIV.
91:
In 2011, the U.S. spent $91 million for state-funded research on sepsis, the lower than that for stroke, cancer, heart disease, and HIV.
In 2011, the U.S. spent $91 million for state-funded research on sepsis, the lower than that for stroke, cancer, heart disease, and HIV.
2:
Hospitalizations for sepsis have more than doubled over the last 10 years.
Hospitalizations for sepsis have more than doubled over the last 10 years.
14.6 In 2008:
$14.6 billion was spent on hospitalization for sepsis in the U.S.
$14.6 billion was spent on hospitalization for sepsis in the U.S.
Source: http://world-sepsis-day.org
Reprinted with permission from: Production/Electronic Channels Coordinator
HealthCom Media 259 Veterans Lane Doylestown, PA 18901
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Johns Hopkins Malpractice Study: Surgical ‘Never Events’ Occur At Least 4,000 Times per Year Researchers advocate public reporting of mistakes
After a cautious and rigorous analysis of national malpractice
claims, Johns Hopkins patient safety researchers estimate that a surgeon
in the United States leaves a foreign object such as a sponge or a
towel inside a patient’s body after an operation 39 times a week,
performs the wrong procedure on a patient 20 times a week and operates
on the wrong body site 20 times a week.
The researchers, reporting online in the journal Surgery,
say they estimate that 80,000 of these so-called "never events"
occurred in American hospitals between 1990 and 2010 - and believe their
estimates are likely on the low side.
The findings -
the first of their kind, it is believed - quantify the national rate of
"never events," occurrences for which there is universal professional
agreement that they should never happen during surgery. Documenting the
magnitude of the problem, the researchers say, is an important step in
developing better systems to ensure never events live up to their name. ...
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RANDOM FACTS: There was only one president that was a preacher -- James Garfield.
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Bonus Fact: President Lincoln owned only one home during his lifetime -- in Springfield, Ill.
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RANDOM FACTS: There was only one president that was a preacher -- James Garfield.
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Bonus Fact: President Lincoln owned only one home during his lifetime -- in Springfield, Ill.
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(Reuters) - Health authorities in northeast Thailand
plan to screen people for fluke worms to detect early signs of bile
duct cancer, a deadly disease linked to eating uncooked freshwater fish.
Rivers in northeast Thailand, Vietnam, Laos, Cambodia, the Koreas and China are infested with the tiny parasitic worms which find their way into the human body when seafood is eaten raw.
According
to the World Health Organization, 67 million people are at risk of this
worm and 9 million are infected in Cambodia, Laos and the northeastern
parts of Thailand and Vietnam.
Most of the infected people are men and they can develop bile duct cancer by the time they are 40 or 50. ... (so...while you eat your sushi, remember this article....)
Nursing education
by the numbers
Data from the American Association of Colleges of Nursing show growth in nursing education at all levels and for all roles.
20,301:
The increase in the number of students enrolled in BSN programs from 2010 to 2011
The increase in the number of students enrolled in BSN programs from 2010 to 2011
41.6%:
Percent increase in graduates of Clinical Nurse Leaders programs over 1 year
Percent increase in graduates of Clinical Nurse Leaders programs over 1 year
15.8%:
Percent increase in enrollment in degree-completion programs over 1 year
Percent increase in enrollment in degree-completion programs over 1 year
77:
The number of baccalaureate to doctoral programs in the US
The number of baccalaureate to doctoral programs in the US
184:
The number of doctor of nursing practice programs in 2011, up from 20 in 2006
The number of doctor of nursing practice programs in 2011, up from 20 in 2006
Source: http://www.aacn.nche.edu
Reprinted with permission from: Production/Electronic Channels Coordinator
HealthCom Media 259 Veterans Lane Doylestown, PA 18901
Reprinted with permission from: Production/Electronic Channels Coordinator
HealthCom Media 259 Veterans Lane Doylestown, PA 18901
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(Thank you, Barbara (BAcello)
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Study finds mammograms lead to unneeded treatment
Beer is the second most popular beverage in the world, right behind tea. It's not surprising since beer, in one form or another, has been around since at least 3100 BC where evidence of brewing was found in western Iran. And there are even more fun facts about the golden nectar.
RANDOM FACTS: The first consumer protection law ever written was enacted over beer by Duke Wilhelm IV of Bavaria in 1516. It was a purity law limiting the ingredients of beer to barley, hops and water.
***
Bonus Fact: American
beer is made partially by rice, unlike the beers of other countries.
This was invented to give American beer a lighter taste and tap into the
market of women buyers.
(Thank you, Barbara (BAcello) Promoting Safety: Alternative Approaches to the Use of Restraints | Registered Nurses' Association of Ontario 2012 BOOK 152 Pages free download RNAO has many excellent publications. All meet US standards. http://rnao.ca/bpg/guidelines/promoting-safety-alternative-approaches-use-restraints> *************IRS rules breast pumps, supplies, etc. are now deductible http://tinyurl.com/6gchgun
(Thank you, Barbara (BAcello)
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HINT: Aerosol spray starch isn't just for ironing. It also helps repel dirt
and marks from white canvas tennis shoes! Just lightly mist the fabric
of your sneakers and let it dry completely before the first wear.*****************
Study finds mammograms lead to unneeded treatment
Mammograms have done surprisingly little to catch deadly breast
cancers before they spread, a big U.S. study finds. At the same time,
more than a million women have been treated for cancers that never would
have threatened their lives, researchers estimate.
Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don't need treatment, the study suggests.
It's
the most detailed look yet at overtreatment of breast cancer, and it
adds fresh evidence that screening is not as helpful as many women
believe. Mammograms are still worthwhile, because they do catch some
deadly cancers and save lives, doctors stress. And some of them disagree
with conclusions the new study reached.
But it spotlights a
reality that is tough for many Americans to accept: Some abnormalities
that doctors call "cancer" are not a health threat or truly malignant.
There is no good way to tell which ones are, so many women wind up
getting treatments like surgery and chemotherapy that they don't really
need. http://health.yahoo.net/news/s/ap/study-finds-mammograms-lead-to-unneeded-treatment
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http://www.fda.gov/Drugs/NewsEvents/ucm320924.htm?utm_source=BenchmarkEmail&utm_campaign=Weekly_eNewsletter_October_8th_2012&utm_medium=email
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MP Acute Care Guidelines for Timely Administration of Scheduled Medications
The Institute for Safe Medication Practices (ISMP) developed these Acute Care Guidelines for Timely Administration of Scheduled
Medications after conducting an extensive survey in late-2010 involving almost 18,000 nurses regarding the requirement in the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation Interpretive Guidelines to administer medications within 30 minutes before or after the scheduled time. The nurses who responded to the survey made it clear that changes to drug delivery methods and gradual increases in the complexity of care, number of prescribed medications per patient, and number of patients assigned to each nurse have made the long-standing CMS “30-minute rule” error prone.
Many nurses reported feeling great pressure to take shortcuts to comply with the rule, which have led to errors, some harmful. While delays in administering certain time-sensitive medications can also result in harm, a one-size-fits-all, inflexible requirement to administer all scheduled medications within 30 minutes of the scheduled time is a precarious mandate given that relatively few medications truly require exact timing of doses. ...
https://www.ismp.org/Tools/guidelines/acutecare/tasm.pdf?utm_source=BenchmarkEmail&utm_campaign=Weekly_eNewsletter_December_10th_2012&utm_medium=email
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FDA marks 50 years of Kefauver-Harris amendment
This
year the U.S. Food and Drug Administration (FDA) is marking the
anniversary of the Kefauver-Harris amendment, passed 50 years ago. The
legislation gave FDA weight to require drug manufacturers prove their
products were safe and effective before receiving approval to market
them in the U.S. Before the amendment, drugs could be sold 60 days after
companies filed with the FDA, if the agency did not object, and drug
manufacturers routinely sent new medications to doctors asking them to "
try them out " on their patients. The amendment has its roots in
then-FDA medical officer Frances O. Kelsey’s refusal to approve Kevadon
(more commonly known as thalidomide) for morning sickness during
pregnancy. Thalidomide was later shown to cause serious birth defects.
Senator Estes Kefauver of Tennessee and Representative Oren Harris led
the effort to pass the amendment. ...http://www.fda.gov/Drugs/NewsEvents/ucm320924.htm?utm_source=BenchmarkEmail&utm_campaign=Weekly_eNewsletter_October_8th_2012&utm_medium=email
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MP Acute Care Guidelines for Timely Administration of Scheduled Medications
The Institute for Safe Medication Practices (ISMP) developed these Acute Care Guidelines for Timely Administration of Scheduled
Medications after conducting an extensive survey in late-2010 involving almost 18,000 nurses regarding the requirement in the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation Interpretive Guidelines to administer medications within 30 minutes before or after the scheduled time. The nurses who responded to the survey made it clear that changes to drug delivery methods and gradual increases in the complexity of care, number of prescribed medications per patient, and number of patients assigned to each nurse have made the long-standing CMS “30-minute rule” error prone.
Many nurses reported feeling great pressure to take shortcuts to comply with the rule, which have led to errors, some harmful. While delays in administering certain time-sensitive medications can also result in harm, a one-size-fits-all, inflexible requirement to administer all scheduled medications within 30 minutes of the scheduled time is a precarious mandate given that relatively few medications truly require exact timing of doses. ...
https://www.ismp.org/Tools/guidelines/acutecare/tasm.pdf?utm_source=BenchmarkEmail&utm_campaign=Weekly_eNewsletter_December_10th_2012&utm_medium=email
Beer is the second most popular beverage in the world, right behind tea. It's not surprising since beer, in one form or another, has been around since at least 3100 BC where evidence of brewing was found in western Iran. And there are even more fun facts about the golden nectar.
RANDOM FACTS: The first consumer protection law ever written was enacted over beer by Duke Wilhelm IV of Bavaria in 1516. It was a purity law limiting the ingredients of beer to barley, hops and water.
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HUMOR SECTION
A few years ago the battery in my beat-up VW Beetle had died because I left the lights on overnight. I was in a hurry to get to work on time so I ran into the house to get my wife to give me a hand to start the car. I told her to get into our second car, a prehistoric oversized gas guzzler, and use it to push my car fast enough to start it. I pointed out to her that because the VW had an automatic transmission, it needed to be pushed at least 20mph for it to start.
She said fine, hopped into her car and drove off.
I sat there fuming wondering what she could be doing.
A minute passed by and when I saw her in the rear-view mirror coming at me at about 30 mph, I realized that I should have been a bit clearer with my directions...
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CEU
SITES---(CME and CNE)
Those that
are-----Free and Otherwise..........
Go to www.sharedgovernance.org for access to a free continuing education module about shared governance,
written by Robert Hess, Forum’s founder, and Diana Swihart, Forum advisory board member.
Please follow him on Twitter as Dr Robert Hess.
Go to www.sharedgovernance.org for access to a free continuing education module about shared governance,
written by Robert Hess, Forum’s founder, and Diana Swihart, Forum advisory board member.
Please follow him on Twitter as Dr Robert Hess.
Pay Only
$34.99 for a full year of CONTACT HOURS
www.nurse.com for CNE offerings.
www.nurse.com for CNE offerings.
Free CEs http://www.myfreece.com/welcome.asp
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WEBSITES/ LINKS
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
Forum for Shared Governance
info@sharedgovernance.org www.sharedgovernance.org
Metric conversion calculators and tables for metric conversions
********************************************
*
MEDICAL
RECALLS
*
*******************************************
******************************************************
The
U.S. Food and Drug Administration (FDA) is notifying health care
professionals that the 32 mg, single intravenous (IV) dose of the
anti-nausea drug Zofran (ondansetron hydrochloride) will no longer be
marketed because of the potential for serious cardiac risks. This dose
has been removed from the Zofran drug label. FDA is now working with
the manufacturers of all 32 mg dose ondansetron injectable products
(brand and generic) to voluntarily recall them from the market. These
drugs are sold pre-mixed in solutions of either dextrose or sodium
chloride in plastic containers (See Table 1).
A previous Drug Safety Communication (DSC), issued on June 29, 2012,
communicated that the 32 mg, single IV dose should be avoided due to
the risk of a specific type of irregular heart rhythm called QT interval
prolongation, which can lead to Torsades de Pointes, an abnormal,
potentially fatal heart rhythm.
The 32 mg, single IV dose had been
used to prevent chemotherapy-induced nausea and vomiting. As stated in
the previous DSC, FDA continues to recommend the intravenous regimen of
0.15 mg/kg administered every 4 hours for three doses to prevent
chemotherapy-induced nausea and vomiting. If the calculated
weight-based dose were to exceed 16 mg, the potential for prolonged QT
interval would be greater; therefore, no single intravenous dose should
exceed 16 mg. In addition, oral dosing of ondansetron remains
effective for the prevention of chemotherapy-induced nausea and
vomiting. At this time, there is not enough information available for
FDA to recommend an alternative single IV dose regimen.
FDA anticipates these products (see Table 1,
below) to be removed from the market through early 2013. FDA does not
anticipate that removal of the 32 mg intravenous dose of ondansetron
currently sold as pre-mixed injections will contribute to a drug
shortage of IV ondansetron, as the 32 mg dose makes up a very small
percentage of the current market. According to sales distribution data,
ondansetron IV 32 mg premixed bags accounted for less than 1% of
ondansetron IV sales (vials, bags, etc.) from the manufacturers to
retail and non-retail channels of distribution in the 12-month period
ending in June 2012.1 ...
The U.S. Food and Drug Administration (FDA) is notifying health care professionals, caregivers, and patients about a change to the container and carton labels for heparin products. This label change will require manufacturers of Heparin Lock Flush Solution, USP and Heparin Sodium Injection, USP to clearly state the strength of the entire container of the medication followed by how much of the medication is in 1 milliliter (mL). These modifications will eliminate the need for health care professionals to calculate the total amount of heparin medication in a product containing more than 1 mL, thereby reducing the risk of miscalculations that may result in medication errors. ...
http://www.fda.gov/Drugs/DrugSafety/ucm330695.htm?utm_source=BenchmarkEmail& ; utm_campaign=Weekly_eNewsletter_December_10th_2012&utm_medium=email
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ADVERTISEMENTS
from the members
This ad is from
Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by
nurses, for nurses. Now carrying wound care and first-aid supplies at prices you
can afford.Visit us at http://www.accu-ruler.com/.
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NEW MEMBERS
Please send the
prospective members' screen names and first names to me: RNFrankie@AOL.com
WELCOME TO:
Nankristin@yahoo.com (Nan) December 6, 2012
lvjones@dhr.state.ga.us (Lisa) December 15, 2012
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NOTICE:
I attempt to send
newsletters to your email addresses on file and if the newsletters are rejected
THREE consecutive times, I must then delete the email address until you contact
me with an updated email address; I have no way to reach you without a correct
email address. ... So,
please send me your new name/address, okay? 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
“When one door of happiness closes, another opens;
but often we look so long at the closed door that we do
not see the one which has been opened for us.”
- Helen Keller
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THOUGHT FOR THE DAY
“When one door of happiness closes, another opens;
but often we look so long at the closed door that we do
not see the one which has been opened for us.”
- Helen Keller
Correct answer: a. Epicardial pacing is used only with cardiac surgery patients. Common postoperative complications of cardiac valve surgery and coronary artery bypass surgery include episodic sinus bradycardia, second- and third-degree heart block, and asystole. http://www.americannursetoday.com/Article.aspx?id=9780&fid=9722&utm_source=BenchmarkEmail&utm_campaign=AMNT_Electronic_December_2012_House&utm_medium=email
Would really like to hear from you..... Frankie
