Newsletter for Paradigm 97
June 10, 2010
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
(As a preface to the following from Wendie. She is answering a student nurse who wrote saying that she didn't see any difference between and AA or BSN. What was all the argument about)She writes: "This is one of the most contentious issues in nursing: the level of education needed for a profession. As many of the NN'rs know, I come down squarely on the side of a BS in Nursing or BSN (not a BA or "BAS," whatever that is) as entry-level educational preparation. When I had smaller kids and they asked me a question, I always asked them, "Do you want the short answer or the long one?" Since I can count on the fingers of one hand the number of times they ever said, "Short" and still have enough left over for the Boy Scout salute, here it is again. ::note to self: copy this for cutting and pasting later:: (Disclaimer: Have worked as a staff nurse, inservice/staff development, instructor, NCLEX prep course instructor, case manager in multiple settings, and other stuff too numerous to mention. In short, been around, seen that, done that. Have also been a patient with different levels of caregivers.)
What's a profession? Is nursing a profession? What's the basic educational prep for people you think of as professionals? Would you want your chemistry research done by someone with an associate degree? Your child taught high school math or English? Your income tax advising? Sure, there are good people with lower level education who succeed in life, but don't let that "we all have the same license and sit for the same exam" fool you. Better education makes you better at what you do. There are any number of people who can give you examples of BSNs or MNs who don't know how to take a rectal temp (why does everyone focus on that and bedpans when they think of nursing, anyway?) and marvelous crusty old LPNs who saved the resident's butt one dark and stormy night, but for every single one of those I will see your anecdote and raise you half a dozen godawful errors made by nurses who didn't take the coursework and didn't get exposed to the idea of autonomy in school.
Time: The bachelor's degree takes four years. The associate's degree (AS or ASN) takes ... three and a half, once you count all the prerequisites you're going to have to take before they admit you into the nursing program. And those who say you can work on your BSN while you are working as an RN with an AS don't tell you (and maybe don't know, to be charitable) that many of your course hours from the AS program are not transferrable, so it won't just be a matter of a semester or two or three. AND working as a nurse is HARD, almost as hard as nursing school ... think you'll have the mental, physical, social, and financial energy for more education at the same time? Oh, and in most jurisdictions you can't sit for the LPN exam and work as one while partway thru a AS or BSN program anymore, either.
Job opportunities: Although the old a-nurse-is-a-nurse-is-a-nurse attitude is fortunately fading away, I realize that people who are just starting out have a very incomplete idea of what it means to be a nurse. However, look around the place and see who's working. Are you planning to be older some day? Do you see older nurses working in those entry-level staff or charge positions? If not, where did they all go? Why do you care? Well, suppose you work on a general medical floor and get entranced by cardiac rehabilitation after following a patient who did it. A job comes up in the department, hooray! Oops, BSN only. Or you find your heart drawn to helping underserved women in a public health clinic for high-risk pregnancy. Sorry, BSN only in public health. After five or six years as a staff nurse you have become a resource to new hires and your peers and you realize you have a gift for teaching. You see that a position in staff development has come open, and you are first in line at HR to apply. You got it.... BSN is the minimum. School nursing? BSN. Hurt your back and want to go for a job in case management? BSN. You discover you have a gift for asking, "Why do we do it this way?" and are amazed to find you want to look into jobs in management or nursing research.....BSN minimum. You are starting to get the picture now. Also, many, many practice settings give you a differential for BSN. No, I know, not all, but hey. One more factor.
Growth: The questions in the licensure exams (NCLEX) are developed from errors made in the first year of practice by new grads, and regardless of pass rates from different level programs, anyone in practice can confirm the research: In the first year of work all new grads perform at about the same level as they get their feet under them and get used to the idea of working as an RN. But after that year, the BSNs pull ahead in ways that are related to their higher level of education. Why? Because what we call in the ed biz "psychomotor skills," the things you do with your hands, can be done by anyone with enough practice. Hell, we teach lay people how to do peritoneal dialysis at home or suction tracheostomies. But the understanding of WHY some things are as they are is something you get in better education: more science, more sociology, more psychology, more history, a basic statistics class, exposure to more clinical settings (I doubt if you'll get a full semester in peds, psych, OB, or any public health at all in any AS program) give you the insight to ask better questions and make better decisions".
best
Wendie
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MEDICAL NEWS
Hep C drug achieves 75 percent cure rate: study (Reuters 5/25) The results from the first late-stage Phase III study of telaprevir came in at the high end of expectations for a cure rate of 70 to 75 percent, with slightly lower discontinuation rates due to side effects than previously seen.
Investors cheered the data, sending Vertex shares, which have slumped recently, up 12 percent in after-hours trading. Telaprevir is expected to become a multibillion-dollar drug for Vertex if approved by the U.S. Food and Drug Administration.
Seventy-five percent of patients who received 12 weeks of telaprevir in combination with current standard treatment of pegylated interferon and ribavirin, followed by either 12 or 36 weeks of standard treatment achieved a sustained virologic response, or SVR, which is tantamount to a cure. ... http://www.reuters.com/article/idUSTRE64O6IQ20100525?feedType=nl&feedName=ushealth1100
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Since Johnson & Johnson have done extensive advertising about nursing (for which I have been very grateful), what does that do for us when their reputation is damaged ? Any opinions ?
FDA finds grime at J&J plant, urges use of generics (Reuters 5/5/10) A Food and Drug Administration report released on Tuesday said its inspectors found thick dust and grime covering certain equipment, a hole in the ceiling and duct tape-covered pipes at the Fort Washington, Pennsylvania, facility that made 40 products recalled last Friday.
Inspectors also found raw ingredients contaminated by an unspecified bacteria, a lack of quality control procedures and poor handling of complaints, according to the report dated April 30.
The findings were a further blow to J&J's reputation, as the FDA later on Tuesday urged parents to choose private label alternatives for the over-the-counter medications and said it was weighing possible further regulatory action.
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AACN's Review of the New Healthcare Reform Law (15-page pdf) The American Association of Colleges Nursing’s overview of supported provisions and sections requiring attention. Patient Protection and Affordable Care Act Public Law No: 111-148 Nursing Education and Practice Provisions http://www.aacn.nche.edu/Government/pdf/HCRreview.pdf
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The Evidence is In - California RN-to-Patient Ratios Save Lives With CA Ratios, NJ would have 14%, PA 11% Fewer Deaths Ratios also Boost RN Retention, Increase Time for Patient Care
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.... http://www.calnurses.org/media-center/press-releases/2010/april/the-evidence-is-in-california-rn-to-patient-ratios-save-lives.html
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A new Joint Commission Sentinel Event Alert warns that health care facilities today are being confronted with steadily increasing rates of crime, including assault, rape and murder.
The Alert urges greater attention to the issue of violence and to controlling access to facilities to protect patients, staff and visitors, noting that assault, rape and homicide are consistently in the top 10 types of serious events reported to The Joint Commission.
Caron Wong, Publications and Special Projects Manager, (630) 792-5178 cwong@jointcommission.org
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On Saturday April 24th, 2010, a group of students from the University of New Mexico Physician Assistant program were volunteering at the Indian Pueblo Cultural Center in Albuquerque during the Center’s American Indian Week “Pueblo Days” to offer free voluntary blood sugar tests. The device used to prick the finger to get the blood sample required for testing was meant for single patient use and not for multiple patients. Those who volunteered for testing that day may have been put at risk of contracting infections due to potential exposure to diseases spread by blood contact.
Despite direct faculty supervision, three mistakes were made: They used the wrong device; they were not all properly trained on the device; no records of those tested were kept. (and they didn't change the lancet)
We estimate that 51 to 55 individuals were tested, potentially exposing these people to other's blood. The diseases of greatest concern are Hepatitis B and C although theoretically HIV is also possible. Our best current assessment of the risk of infection is less than a 0.5% risk. Even though the risk is small it is something we are very concerned about it and are taking it seriously. http://contact.health.unm.edu/ ~~**~~**~~**~~**~~**~~
INTERESTING READING
Please remember that the REUTERS articles are usually good for only 30 days
The Nurse's Role as a Patient Advocate Whether calling attention to a potential medication error, helping the rest of the health care team hear a patient’s voice or shaping policy by speaking from first-hand experience, advocating for patients comes naturally to today’s nurses.
“Advocacy is the heart and soul of nursing practice,” said Cindy Zolnierek, RN, MSN, director of practice at the Texas Nurses Association in Austin. “Nurses believe they hold the patients’ safety and care in their hands.” Many nurses give this advocate role little thought, considering looking out for their patients’ well-being part of the job—for instance, reminding a surgeon that he needs to order a different pre-op antibiotic to avoid an allergic reaction or calling attention to the fact a patient lives alone and is not ready for discharge. http://www.nursezone.com/default.aspx *********************** Helicobacter pylori's helical shape helps it colonize the stomach The bacterium Helicobacter pylori, which lives in the human stomach and is associated with ulcers and gastric cancer, is shaped like a corkscrew, or helix. For years researchers have hypothesized that the bacterium's twisty shape is what enables it to survive - and thrive - within the stomach's acid-drenched environment, but until now they have had no proof.... http://www.news-medical.net/news/20100528/Helicobacter-pyloris-helical-shape-helps-it-colonize-the-stomach.aspx
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RANDOM FACT: A giraffe can clean its ears with its 21-inch tongue!
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KCI receives 510(k) clearance to market V.A.C. Therapy System for treatment of VLUs (venous leg ulcers) Kinetic Concepts, Inc. announced today that it has received 510(k) clearance from the Food and Drug Administration to market its proprietary Vacuum Assisted Closure, or V.A.C. Therapy System, for the treatment of venous insufficiency ulcers, also known as venous leg ulcers....
http://www.news-medical.net/news/20100528/KCI-receives-510(k)-clearance-to-market-VAC-Therapy-System-for-treatment-of-VLUs.aspx
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Questions to consider for a solo NP practice Serious thought and planning are required for nurse practitioners who are considering launching their own private practice. It is important to define the practice mission, prepare to take responsibility for more than just patients and figure out how running a business may affect personal relationships. ADVANCE for Nurse Practitioners http://nurse-practitioners.advanceweb.com/Features/Top-Story/Are-You-Ready-for-Ownership.aspx
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Drink This, Not That! features “20 Worst Drinks In America” New York Times bestselling authors David Zinczenko and Matt Goulding are out with the definitive list of the "20 Worst Drinks in America" as featured in the new book Drink This, Not That!—in stores now. The list highlights the country's most calorie-and sugar-laden drinks, everything from flavored waters and juice imposters to beers and margaritas. http://www.news-medical.net/news/20100528/Drink-This-Not-That!-features-e2809c20-Worst-Drinks-In-Americae2809 d.aspx **********************
Cancer care and oncology nursing are headed in a new direction, guided by multiple intertwined factors, including the aging of baby boomers and the longer-term needs of patients with cancer. These factors, coupled with general concerns about the nursing profession and healthcare, including the shortage and costs for care, are creating a challenge for oncology nurses. The challenges evolve their roles as educators, case managers and agents of societal change. ...
http://news.nurse.com/article/20100524/NATIONAL01/105240001/-1/frontpage
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RANDOM FACT: A Boeing 747 airliner holds 57,285 gallons of fuel.
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A whole body MRI scan accurately detected breast tumors that had spread to the bone, even when there were no symptoms, offering a safe way to check patients, Indian researchers said on Thursday. They said whole body magnetic resonance imaging or MRI --
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Croup--Assessment and management Rajapaksa S et al. – This article discusses the key aspects of diagnosing croup and the evidence supporting the different treatment strategies. The assessment of airway, breathing and circulation, focusing on airway, is paramount in treating croup. However, it is important to take care not to cause the child undue distress. In mild to moderate croup, give prednisolone 1.0 mg/kg and review in 1 hour. In severe or life threatening croup, give 4 mL of adrenaline 1:1000 (undiluted) via nebuliser and send immediately to hospital via ambulance. http://www.racgp.org.au/afp/201005/37124
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The Nanotech Gamble: Promise vs Risk Written by Andrew Schneider
Nanotechnology, touted for potential to cure diseases, ease energy woes, and more, is big business. But evidence shows the engineered particles could pose huge rishks. with little being done to enzxure public safety, one expert asks, "Must the bodies stack up first?" First in a 3-part investigative series
http://www.aolnews.com/nanotech/article/amid-nanotechs-dazzling-promise-health-risks-grow/19401235?icid=main|htmlws-main-n|dl1|link1|http%3A%2F%2Fwww.aolnews.com%2Fnanotech%2Farticle%2Famid-nanotechs-dazzling-promise-health-risks-grow%2F19401235
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With two-thirds of adult Americans and a third of children overweight or obese, the need for more activity is dire, health experts said in launching the plan. The plan calls for changes in medical school curricula, local regulations to encourage construction of sidewalks, playgrounds and parks, guidelines for doctors on counseling patients, and a return of organized exercise to school days. ... http://www.reuters.com/article/idUSTRE6424AT20100503?feedType=nl&feedName=ushealth1100
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RANDOM FACT: The tongue is the fastest healing part of the body. (what about the eye?) *****************
Bypass, stents equally safe five years on: study WASHINGTON (Reuters 5/5) - Patients who got heart bypass surgery and those who got their blocked arteries propped open with stents fared equally well five years after their procedures, South Korean doctors reported on Wednesday. The study of more than 2,200 patients showed no difference in death, heart attack or stroke between the two groups, Dr. Duk-Woo Park of Ulsan College of Medicine in Seoul and colleagues reported. The patients all had a serious heart blockage called unprotected left main coronary artery stenosis, which doctors agree needs treatment. But heart surgeons have disagreed about whether stretching the artery open and inserting a wire mesh tube called a stent is as effective as more traditional bypass surgery. ... http://www.reuters.com/article/idUSTRE6445R020100505?feedType=nl&feedName=ushealth1100
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RANDOM FACT: A camel's hump stores fat that the camel uses for energy when food is scarce not water !
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Study Reveals Widespread Fatigue, Risk for Errors with 12-Hour Nursing Shifts
Newswise (press release) — A common practice of successive 12-hour shifts for US hospital nurses leaves many with serious sleep deprivation, higher risk of health problems ...
http://www.newswise.com/articles/study-reveals-widespread-fatigue-risk-for-errors-with-12-hour-nursing-shifts
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Management of beharioral problems in Alzheimer's disease Gauthier S et al. – Alzheimer's disease (AD) is a complex progressive brain degenerative disorder that has effects on multiple cerebral systems. In addition to cognitive and functional decline, diverse behavioral changes manifest with increasing severity over time, presenting significant management challenges for caregivers and health care professionals. Almost all patients with AD are affected by neuropsychiatric symptoms at some point during their illness; in some cases, symptoms occur prior to diagnosis of the dementia syndrome. (required to join) http://www.mdlinx.com/NurseLinx/newsl-article.cfm/3103937/ZZ5603146585149290157159/?news_id=1188&subspec_id=51
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May 25, 2010 -- The latest list of terrible-for-you restaurant food is out, with consumer groups accusing big national chains of packing huge amounts of calories onto unsuspecting diners. “Compared to some of the foods we’re seeing in restaurants now, the Big Mac seems downright dainty,” says Michael Jacobson, executive director of the consumer group Center for Science in the Public Interest (CSPI). The group took aim at nine meals served at popular restaurant chains, noting that many contain far more calories, fat, trans fat, sodium, or sugar in one serving that most adults are supposed to get in a single day. While the recently signed health reform law requires chain restaurants with 20 or more locations to post calorie counts in their menus and on menu boards starting in 2011, Jacobson says restaurants should improve labeling now. ... http://www.webmd.com/food-recipes/news/20100525/group-warns-extreme-restaurant-meals *********************
This was sent in by MJSolon (Melva) Thank you Dr. Nurse? 28 States seek to extend Nurse's powers A nurse may soon be your doctor. With a looming shortage of primary care doctors, 28 states are considering expanding the authority of nurse practitioners. These nurses with advanced degrees want the right to practice without a doctor's watchful eye and to prescribe narcotics. And if they hold a doctorate, they want to be called "Doctor." For years, nurse practitioners have been playing a bigger role in the nation's health care, especially in regions with few doctors. With 32 million more Americans gaining health insurance within a few years, the health care overhaul is putting more money into nurse-managed clinics. (Doctors are fighting it with AMA backing) http://www.aolhealth.com/2010/04/14/dr-nurse-28-states-seek-to-extend-nurses-powers/?icid=main|htmlws-main-n|dl3|link7|http%3A%2F%2Fwww.aolhealth.com%2F2010%2F04%2F14%2Fdr-nurse-28-states-seek-to-extend-nurses-powers%2F
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WASHINGTON (Reuters 5/26) - Sellers of ginseng, echinacea and other herbal and dietary supplements often cross the line in marketing their products, going as far as telling consumers the pills can cure cancer or replace prescription medications, a U.S. government probe found.... http://www.reuters.com/article/idUSTRE64P5MY20100526?feedType=nl&feedName=ushealth1100
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Type 3 Diabetes: Brain Diabetes? Wood L et al. – A relationship between diabetes mellitus (DM) and dementia is undeniable, with numerous studies concluding that DM increases the risk of cognitive decline and dementia, including Alzheimer’s disease (AD). The apparent overlap between DM and dementia has led to the suggestion that AD is not solely a neurologic disorder, but rather a neuroendocrine disorder, with Steen et al coining the term type 3 diabetes to describe this hybrid disease...To date, there are no specific treatments with proven efficacy in the prevention of cognitive decline or AD in patients with DM. ... http://www.uspharmacist.com/content/d/feature/i/1102/c/20754/
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RANDOM FACT: Snickers is the best selling chocolate worldwide, raking in over $2 billion annually.
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A Randomized Study of the Effects of T'ai Chi on Muscle Strength, Bone Mineral Density, and Fear of Falling in Women with Osteoarthritis Rhayun Song, Beverly L. Roberts, Eun-Ok Lee, Paul Lam, Sang-Cheol Bae. The Journal of Alternative and Complementary Medicine. March 2010, 16(3): 227-233. doi:10.1089/acm.2009.0165.
– T'ai chi increased knee extensor muscle endurance and bone mineral density in older women with osteoarthritis, and decreased their fear of falling during daily activities. Further study with long–term follow–up is needed to substantiate the role of t'ai chi exercise in the prevention of fall and its related fracture.... http://www.liebertonline.com/doi/abs/10.1089/acm.2009.0165
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CHICAGO (Reuters 4/14) - A test run of an "artificial pancreas" that monitors blood sugar and delivers both insulin and regulatory hormone called glucagon helped patients achieve near-normal blood sugar levels for more than 24 hours, U.S. researchers said on Wednesday.... http://www.reuters.com/article/idUSTRE63D47V20100414?feedType=nl&feedName=ushealth1100
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RANDOM FACT: Orcas (killer whales), when traveling in groups (AKA pods), breathe in unison.
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All About Osteoporosis: A comprehensive analysis Davis S et al. – Osteoporosis affects more than half of persons older than 50 years. Earlier practice guidelines represented the standard of care but did not adequately address some populations. In 2008, revised guidelines addressed previous concerns. The fracture risk assessment tool (FRAX) helps physicians and patients gain a better understanding of a specific patient’s risk, and clinical experience has highlighted several other risk factors. ...
http://www.musculoskeletalnetwork.com/osteoarthritis/content/article/1145622/1551345
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Eat this bread for a Healthier Smile What you pick from the bread basket might have an impact on your pearly whites. You're probably (hopefully) already grabbing the whole-grain goodies for their fiber and nutrition content. But now here's another reason to be choosy: Whole grains may also help defend against gum disease.... http://www.realage.com/tips/eat-this-bread-for-a-healthier-smile
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Top 10 Qualities of a Great Nurse...
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HUMOR SECTION
An 80-year-old West Virginian hillbilly goes to the doctor for a check-up. The doctor is amazed at what good shape the guy is in and asks, “How do you stay in such great physical condition?”
“I’m from WV and I am a hunter,” says the old guy, “and that’s why I’m in such good shape. I’m up well before daylight and out hunting all day .. I have a beer, and all is well.”
“Well,” says the doctor, “I’m sure that helps, but there’s got to be more to it. How old was your Father when he died?”
“Who said my Father’s dead?”
The doctor is amazed. “You mean you’re 80 years old and your Father’s still alive. How old is he?”
“He’s 100 years old,” says the old Hillbilly “In fact he hunted with me this morning, and then we went to the topless bar for a while and had a little beer and that’s why he’s still alive. He’s A WV man and he’s a hunter, too.”
“Well,” the doctor says, “that’s great, but I’m sure there’s more to it than that. How about your Father’s Father? How old was he when he died?”
“Who said my Granpappy’s dead?”
Stunned, the doctor asks, “You mean you’re 80 years old and your grandfather’s still alive?”
“He’s 118 years old,” says the old Hillbilly
The doctor is getting frustrated at this point, “So, I guess he went hunting with you this morning too?”
“No, Papa couldn’t go this morning because he’s getting married today.”
At this point the doctor is close to losing it.
“Getting married!! Why would a 118 year-old guy want to get married?”
“Who said he wanted to?"
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Sexually Transmitted Diseases: Women Face M… CE594
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Scleroderma: More Than Skin Deep CE588
http://ce.nurse.com/CE588/Scleroderma:-More-Than-Skin-Deep/
What Infectious Diseases Can Providers Expe… CE590
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The Crushing Blow of Crush Injuries CE473
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Activating a Stroke Alert: A Neurological E… CE591
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Safety First: The Joint Commission’s Nation… CE583
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Teaching Tomorrow’s Nurses: What’s Happenin… CE595
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Weight Management: Facts Not Fads CE585
http://news.nurse.com/article/20100430/ALL01/105030015/-1/frontpage
Documentation: Getting it right Conflicting priorities often derail comprehensive chart entries.
http://nursing.advanceweb.com/Continuing-Education/CE-Articles/Documentation-Getting-It-Right.aspx?prg=15 Learning Scope #332 1 contact hour
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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
Back issues of the newsletter are available at: http://www.ismp.org/Newsletters/nursing/backissues.asp.
Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell)
Founder, Forum for Shared Governance info@sharedgovernance.org www.sharedgovernance.org
Decubqueen's website: www.accu-ruler.com
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.nationalnurse3.blogspot.com/
RNs launch a national safe staffing campaign http://www.1199seiu.org/media/magazine/sept_2007/safe_staffing.cfm
H.R. 2123, The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007
http://www.washingtonwatch.com/bills/show/110_HR_2123.html
Board Supports Your Right to Refuse An Unsafe Assignment: Nurse Practice Act cites three conditions for patient abandonment http://findarticles.com/p/articles/mi_qa4102/is_200408/ai_n9450263
The Nursing Site http://thenursingsite.com
The Emergency Email & Wireless Network Alerting us to scams/phishing, etc.
http://www.emergencyemail.org/newsemergency/anmviewer.asp?a=489&z=43
http://www.snopes.com
http://www.solutionsoutsidethebox.net/ Raconte's website
http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3
National Do Not Call Registry
If you're buying a used car, it is recommended having a mechanic inspect it first. And screen the car's VIN through the free database at carfax.com/flood
This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Critical Thinking is More Than Problem Solving Critical Thinking: Not Usually Rapid Fire
Should Clinical Courses Get a Letter Grade?
Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/
Find an address via aerial ! When you enter an address you will see a picture of that place.
There's a little map with a little man on it - you can move the little man up and down the block if you need to. http://www.vpike.com/
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MEDICAL RECALLS
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More than 1 million Infantino baby slings recalled — More than 1 million baby slings made by Infantino were recalled Wednesday after claims linking them to three infant deaths. The Consumer Product Safety Commission said babies could suffocate in the soft fabric slings. The agency urged parents to immediately stop using the slings for babies under 4 months. The recall involves 1 million Infantino "SlingRider" and "Wendy Bellissimo" slings in the United States and 15,000 in Canada. http://www.usatoday.com/news/health/2010-03-24-infantino-baby-sling recall_N.htm
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Ultram (tramadol hydrochloride), Ultracet (tramadol hydrochloride/acetaminophen: Label change Ortho-McNeil-Janssen and FDA notified healthcare professionals of changes to the Warnings section of the prescribing information for tramadol, a centrally acting synthetic opioid analgesic indicated for the management of moderate to moderately severe chronic pain. The strengthened Warnings information emphasizes the risk of suicide for patients who are addiction-prone, taking tranquilizers or antidepressant drugs and also warns of the risk of overdosage. ...
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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Metronidazole injection 500 mg / 100 ml: Voluntary recall due to non-sterility Pharmaceuticals, Inc. announced the voluntary nationwide recall of all lots of metronidazole injection, USP 500mg / 100mL manufactured by Claris Lifesciences and distributed by Sagent due to the discovery of non-sterility in two lots of metronidazole injection.
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Teleflex Medical AQUA+FLEX Hygroscopic Condenser Humidifier (Catalog Number 1570): Recall FDA and Teleflex Medical notified healthcare professionals of a worldwide voluntary recall affecting certain lot numbers of the Teleflex Medical AQUA+FLEX Hygroscopic Condenser Humidifier (HCH) (catalog number 1570), a passive humidifier indicated for use to effectively warm and humidify inspired gas during mechanical ventilation. The 22cm connector on the flex tube may not fit securely within the endotracheal tube (ET) connector. This may result in the product becoming disconnected from the patient ET tube. Device failure is recognizable by the user as an alarm from the ventilator, oxygen sensor or other compatible device to which the AQUA+FLEX tubing is connected. No injuries have been reported to date. (for lot #s) http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm211153.htm
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Baxter International Inc. announced a voluntary recall of all manufactured lots of Hylenex recombinant (hyaluronidase human injection) has been initiated as a precautionary measure due to instances of particulate matter observed in a limited number of vials during routine stability testing. To date, no medical events or customer complaints associated with this issue have been reported. As part of this stability testing for Hylenex recombinant, a limited number of vials were observed to contain small, flake-like particles, identified as glass. The company estimates that there are approximately 3,500 vials in the marketplace.
Baxter is working with the product's NDA-holder, Halozyme Therapeutics, to investigate the root cause of the issue and appropriately address the situation. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts
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FDA and Gyrus ACMI notified healthcare professionals of a Class I recall of Gyrus ACMI Micron Bobbin Vent Tube T, 1.27 mm. This device is implanted for ventilation or drainage of the middle ear. Units of the product in lot number MH136952 have been shipped without being sterilized. This product was manufactured only on December 17, 2009 and distributed only on December 22, 2009. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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NURSING HINTS CORNER
ISMP Nurse Advise-ERR May 2010 Distribute instructions for oral dispenser. Take a look at the oral dispenser that accompanies morphine sulfate oral solution 100 mg/5 mL. The dispensing end of the plunger is pointed rather than flat—a specialty design not typically employed by key US hospital suppliers of oral syringes (e.g., Baxa, BD, B. Braun). It accompanies some liquid products for the purpose of providing a low residual syringe volume after drug delivery. The pointy tip fits into the hub area, pushing out liquid and leaving little behind in the dead space. However, confusion has been reported regarding how to measure liquids—from the end of the pointed tip of the plunger, or from the widest part of the plunger above the pointed tip. Some nurses have been using the tip of the plunger to read the volume against the syringe scale, which is incorrect. All doses should be measured by aligning the widest part of the syringe plunger with the calibrated markings. By measuring from the tip, nurses will administer more than the intended dose. A long-term care consultant pharmacist brought this issue to light when narcotic counts at three different facilities showed remaining volumes different than expected. Residents may have been given higher doses than prescribed if nurses measured the dose by aligning the plunger tip with the calibrated markings on the barrel. The error happened with a generic product, which is no longer on the market; however, Roxane distributes a morphine sulfate oral solution that uses the same syringe. The FDA-approved Medication Guide for the Roxane product has a section under “Patient Instructions for Use” that explains exactly how to use the syringe, and it has a detailed illustration showing how to accurately measure the product (Figure 2, on page 1). Education of nurses, pharmacists, and other healthcare professionals may be necessary if the “Patient Instructions for Use” information is not reaching them. Please pass this information along to nurses who work in areas where morphine 100 mg/5 mL or any other product packaged with this type of syringe is used. The reporter suggested that the company include the syringe diagram on the box flap of the product’s carton; however, the carton may not always reach the nurse. If possible, patient-specific doses should be dispensed from the pharmacy in labeled oral syringes. (hopefully these directions are sufficient; If you need the picture, let me know).
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ADVERTISEMENTS
from the members
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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
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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....You could always send me your Home number....lol So please send me your new name/address, ok? 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
Nurses often have difficulty articulating the essence of what they do. It is so difficult to put into words the often subtle yet profound way that nurses impact lives. It is something that must be experienced, mastered, and emblazoned upon the soul to be truly and deeply understood.
— Donna Wilk Cardillo, RN
A Daybook for Beginning Nurses
Hope to see you online or write me..... Frankie
RNFrankie@AOL.com
