Showing posts with label patient advocates. Show all posts
Showing posts with label patient advocates. Show all posts

Tuesday, March 1, 2011

Helping Patients Understand Their Medical Treatment - Kaiser Health News

An elderly woman sent home from the hospital develops a life-threatening infection because she doesn't understand the warning signs listed in the discharge instructions. A man flummoxed by an intake form in a doctor's office reflexively writes "no" to every question because he doesn't understand what is being asked. A young mother pours a drug that is supposed to be taken by mouth into her baby's ear, perforating the eardrum. And a man in his 70s preparing for his first colonoscopy uses a suppository as directed, but without first removing it from the foil packet.

Each of these examples provided by health-care workers or patient advocates illustrates one of the most pervasive and under-recognized problems in medicine: Americans' alarmingly low levels of health literacy — the ability to obtain, understand and use health information.

Translating Medical Jargon

Some technical terms and what they mean in plain English:

  • "myocardial infarction" (heart attack)
  • "hyperlipidemia" (high cholesterol)
  • "febrile" (feverish)

A 2006 study by the U.S. Department of Education found that 36 percent of adults have only basic or below-basic skills for dealing with health material. This means that 90 million Americans can understand discharge instructions written only at a fifth-grade level or lower. About 52 percent had intermediate skills: They could figure out what time a medication should be taken if the label says "take two hours after eating," while the remaining 12 percent were deemed proficient because they could search a complex document and find the information necessary to define a medical term.

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Wednesday, February 23, 2011

Connected for Life Now Features Ask Mayo Clinic Nurse Line

Family Health Network is excited to announce that its Connected for LifeSM online program for caregivers of aging loved ones will now feature access to Ask Mayo Clinic nurse line.  Seniors who are part of the program will now have 24/7 access to expert health advice from Ask Mayo Clinic registered nurses.  This additional service further enriches the Connected for LifeSM online program which breaks down longstanding barriers to technology use by seniors and helps families stay in touch, monitor, and assist older family members who desire to live healthier and longer at home.

“Mayo Clinic is world renowned for being a leader in medical care, research and education,” said CEO of Family Health Network, Harry Bailes. “Now, in addition to connecting seniors with family members and caregivers, we can offer them access to Ask Mayo Clinic nurse line that represents one of an expanding list of additional resources available through membership in Connected for LifeSM

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Patients find plenty of health information on line, but not all of it is reliable

The Internet has no equal as an information storehouse. The trick is to know how to get right to a source of useful information and not waste time on Web sites that are biased, trying to sell you something or just plain wrong.

Marvin M. Lipman, Consumers Union's chief medical adviser, recalls having a patient who made a Google search and somehow settled on an abdominal aortic aneurysm (a worrisome bulge in the body's main blood vessel) as the logical explanation for his midback pain. No reassuring on Lipman's part eased the patient's apprehension. It took a sonogram to convince him he wasn't at death's door.

Lipman had another patient who was referred to him after her primary-care physician told her she had Graves' disease (an overactive thyroid). She arrived for her appointment armed with computer printouts of useful, accurate information and fully prepared to discuss the pros and cons of treatment options for her problem.

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Drug maker cited for not reporting side effects - Health - Health care - msnbc.com

U.S. health regulators have warned Sanofi-Aventis SA's U.S. unit for failing to submit reports of possible serious side effects in a timely manner.

In a January 28 letter made public on Tuesday, the Food and Drug Administration said an early response from the drugmaker and its "promised corrective actions are inadequate to address the deficiencies."

"We remain concerned that your .... adverse drug experience reporting system has not been fully validated, and may have resulted in inaccurate assessment and untimely submission of 15-day alerts," FDA said.

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Sunday, February 20, 2011

Antiseptic baths 'reduce infection risk' | News | Nursing Times

Using 2% chlorhexidine gluconate cloths for the daily bathing of inpatients, instead of soap and water, reduces the risk of hospital-acquired infections, according to US researchers.

The study found a 64% decrease in the risk of acquiring either MRSA or Vancomycin-resistant Enterococcus. A group of 7,699 general medical patients were bathed daily by healthcare assistants with CHG antiseptic cloths for the duration of their admission, while a control group of 7,102 patients were bathed with soap and water.

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Saturday, February 19, 2011

Traumatic Brain Injury, Legal Nurse Consulting, Law Resources

Legal Nurse Consultants specializing in Traumatic Brain Injury Issues:

Louise Cardillo, R.N. B.S., Cardillo Consultants:"Legal Nurse Consulting firm for ten years. I am a strong liason between attorney's, clients and experts. The strength of all cases is in meticulous attention to detail of medical records and choosing the appropriate expert. This aspect of consulting will bring your cases to closure with damages often above expectation. Experience in this field is critical to the success of working with a Legal Nurse Consultant. In addition, the nurse must have a strong clinical foundation and education.
1190 Honeoye Falls 5 Points Rd.
Honeoye Falls, New York 14472
E-Mail: louLNC@frontiernet.net
http://www.nursingexperts.com/cardillo/

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Brain Injury Association of America:"The Brain Injury Association of America was founded in 1980 by a group of individuals who wanted to improve the quality of life for their family members who had sustained brain injuries. Despite phenomenal growth over the past two decades, the Association remains committed to its grassroots. The Brain Injury Association of America encompasses a national network of more than 40 Chartered state affiliates across the country as well as hundreds of local chapters and support groups. By acting as a clearinghouse of community service information and resources, participating in legislative advocacy, facilitating prevention awareness, hosting educational programs and encouraging research, the Brain Injury Association of America and its affiliates reach the millions of individuals living with the "silent epidemic" of brain injury."
105 North Alfred Street, Alexandria, VA 22314
703-236-6000, fax 703-236-6001
FamilyHelpline@biausa.org
http://www.biausa.org/

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Brain Injury Information Page:"The Brain Injury Information Page provides information about brain injury, concussion, coma and head injury, for TBI survivors, spouses and caregivers. Our goal is to provide education and assistance with the process of diagnosis and proof of brain injury, sometimes called head injury. This page features articles, information and graphics about traumatic brain injury. Our View of Advocacy: We of the Brain Injury Law Group make our living as advocates. But advocacy implies more than being a lawyer. It means dedicating oneself to the community we serve - the survivor, the family member of the survivor, the medical professional. To that end, we have created this home page, to provide information, resources and links, to help you learn and solve the problems you face."
http://tbilaw.com/

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Florida Institute for Neurologic Rehabilitation, Inc. (FINR):"Brain injury and head injury rehabilitation information and resources from The Florida Institute for Neurologic Rehabilitation. FINR helps Brain injury survivors, both children and adult. The Florida Institute for Neurologic Rehabilitation, Inc. (FINR) is dedicated to excellence in the provision of rehabilitation, education and vocational services to both children and adult survivors of brain injury. Through the provision of individualized assessment, restorative service and foundational retraining in behavior, psych-social, cognitive, physical functioning, communication, daily living, education and vocational area, FINR seeks to assist its clients in attaining their maximum level of functioning and quality of life in the most normalized and least restrictive environment."
http://www.finr.net/

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Traumatic Brain Injury Information Page, National Institute of Neurological Disorders and Stroke (NINDS):"Traumatic brain injury (TBI) occurs when a sudden physical assault on the head causes damage to the brain. The damage can be focal, confined to one area of the brain, or diffuse, involving more than one area of the brain. TBI can result from a closed head injury or a penetrating head injury. A closed head injury occurs when the head suddenly and violently hits an object, but the object does not break through the skull. A penetrating head injury occurs when an object pierces the skull and enters the brain tissue. Several types of traumatic injuries can affect the head and brain. A skull fracture occurs when the bone of the skull cracks or breaks. A depressed skull fracture occurs when pieces of the broken skull press into the tissue of the brain. This can cause bruising of the brain tissue, called a contusion. A contusion can also occur in response to shaking of the brain within the confines of the skull, an injury called "countrecoup." Shaken baby syndrome is a severe form of head injury that occurs when a baby is shaken forcibly enough to cause extreme countrecoup injury. Damage to a major blood vessel within the head can cause a hematoma, or heavy bleeding into or around the brain. The severity of a TBI can range from a mild concussion to the extremes of coma or even death. A coma is a profound or deep state of unconsciousness. Symptoms of a TBI may include headache, nausea, confusion or other cognitive problems, a change in personality, depression, irritability, and other emotional and behavioral problems. Some people may have seizures as a result of a TBI."
http://www.ninds.nih.gov/health_and_medical/disorders/tbi_doc.htm

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National Resource Center for Traumatic Brain Injury:"The mission of the National Resource Center for Traumatic Brain Injury is to provide relevant, practical information for professionals, persons with brain injury, and family members. Many of our products were developed by nationally recognized experts. We have more than 20 years of experience developing intervention programs, assessment tools, and investigating the special needs and problems of people with brain injury and their families."
Virginia Commonwealth University's Medical College of Virginia
http://www.neuro.pmr.vcu.edu/

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The Perspectives Network, Inc.:"The Perspectives Network, Inc.'s primary focus is positive communication between persons with brain injury, family members/ caregivers/friends of persons with brain injury, those many professionals who treat persons with brain injury and community members in order to create positive changes and enhance public awareness and knowledge of acquired/traumatic brain injury."
Mailing Address: P. O. Box 121012, W. Melbourne FL 32912-1012
E-Mail Address: TPN@tbi.org
http://www.tbi.org/

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Rehabilitation Research Center (RRC) for Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI):"The Rehabilitation Research Center (RRC) for Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI) conducts research to better understand and improve outcomes after TBI and SCI. Outcomes studied include the functional, vocational, and life satisfaction areas that are important to people with and without disabilities."
Rehabilitation Research Center for TBI & SCI 950 South Bascom Avenue, Suite 2011 San Jose, CA 95128 San Jose, California
phone number is 408/295-9896 Fax the RRC at 408/295-9913, tbisci@tbi-sci.org
http://www.tbi-sci.org/

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TBIchat.org:"Homepage for brain injury survivors & caregivers with pictures, stories, poems, art gallery, message board, question of the week board, homepages, & email lists."
http://www.braininjurychat.org/

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Traumatic Brain Injury LawyerShop:"Traumatic Brain Injury Lawyer Shop is a resource that allows you to find information from lawyers in your area who provide legal services pertaining to traumatic brain injury, TBI, closed head injury, concussion, and coma. While most legal directories offer some information about traumatic brain injury and TBI, the most valuable information comes from an attorney or lawyer who has experience involving traumatic brain injury lawsuits, coma lawsuits, concussion lawsuits or closed head injury lawsuits."
http://www.tbilawyershop.com/

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Traumatic Brain Injury National Data Center (TBINDC):"The Traumatic Brain Injury National Data Center (TBINDC) at Kessler Medical Rehabilitation Research and Education Center is the coordinating center for the research and dissemination efforts of the Traumatic Brain Injury Model Systems (TBIMS) program funded by the National Institute on Disability and Rehabilitation Research (NIDRR). The TBI Model Systems consist of 17 comprehensive systems of care distributed throughout the United States that conduct innovative research and provide “model” care to persons who experience traumatic brain injury. The TBIMS program seeks to improve the lives of persons who experience traumatic brain injury, their families and their communities by creating and disseminating new knowledge about the course, treatment and outcomes relating to their condition."
Traumatic Brain Injury National Data Center c/o Kessler Medical Rehabilitation Research and Education Corp.
1199 Pleasant Valley Way West Orange, NJ 07052
http://www.tbindc.org/

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Prepaid Legal Services: There are many matters that you encounter on a daily basis which have a legal aspect, for instance, motor vehicle accidents and other types of injury claims, estate planning, probate and estate administration, matters pertaining to employment, sale or purchase of real estate, consumer transactions, auto repairs and sales, family and juvenile law, landlord/tenant issues, insurance matters, business, bankruptcy, tax and workers compensation. Literally, everything we do today touches upon the law in one way or another. With Prepaid Legal, you'll receive unlimited phone conversation/consultations on any legal matter at no additional cost.

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See also:

MedMal Consulting:'MedMal Consulting is a Physician owned and operated full-service medical malpractice evaluation and medical negligence consulting support firm. MedMal Consulting has doctors, legal nurse consultants, and medical legal litigation support personnel to assist with every aspect of your medical negligence case. Established in 1992, Dr. Herman and MedMal Consulting have over 18 years of experience in the medical legal field and have assisted in obtaining more than $147 million dollars in verdicts and settlements in medical malpractice cases."
MedMal Consulting, Inc.
P.O Box 391153
Cleveland, Ohio 44139
Phone: (216) 744-8907
Fax:(440) 248-8257
eMail: info@medmalconsulting.com
http://www.medmalconsulting.com/

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Send comments and mail to Andrew Lopez, RN

Last updated by Andrew Lopez, RN on Monday, December 6, 2010

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******************************************************

Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

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Monday, February 14, 2011

Patient Stories May Improve Health, NYTimes.com

The only reservation that he mentioned was the same one all the other patients had — he feared that death would come before the perfect organ.

But during one visit just before he finally got the transplant, he confessed that he had been grappling with another concern, one so overwhelming he had even considered withdrawing from the waiting list. He worried that he would not be strong enough mentally and physically to survive a transplant.

In desperation, he told me, he had contacted several patients who had already undergone a transplant. “That’s what made me believe I’d be O.K.,” he said. “You doctors have answered all of my questions, but what I really needed was to hear the stories about transplant from people like me.”

Patients and doctors have long understood the power of telling and listening to personal narratives. Whether among patients in peer support groups or between doctors and patients in the exam room or even between doctors during consultations, stories are an essential part of how we communicate, interpret experiences and incorporate new information into our lives.

Despite the ubiquitousness of storytelling in medicine, research on its effects in the clinical setting has remained relatively thin. While important, a vast majority of studies have been anecdotal , offering up neither data nor statistics but rather — you guessed it — stories to back up the authors’ claims.

Now The Annals of Internal Medicine has published the results of a provocative new trial examining the effects of storytelling on patients with high blood pressure. And it appears that at least for one group of patients, listening to personal narratives helped control high blood pressure as effectively as the addition of more medications.

Monitoring the blood pressure of nearly 300 African-American patients who lived in urban areas and had known hypertension, the researchers at three-month intervals gave half the patients videos of similar patients telling stories about their own experiences. The rest of the patients received videos of more generic and impersonal health announcements on topics like dealing with stress. While all the patients who received the storytelling DVD had better blood pressure control on average, those who started out with uncontrolled hypertension were able to achieve and maintain a drop as significant as it had been for patients in previous trials testing drug regimens.

“Telling and listening to stories is the way we make sense of our lives,” said Dr. Thomas K. Houston, lead author of the study and a researcher at the University of Massachusetts Medical School in Worcester and the Veterans Affairs medical center in Bedford, Mass. “That natural tendency may have the potential to alter behavior and improve health.”

Experts in this emerging field of narrative communication say that storytelling effectively counteracts the initial denial that can arise when a patient learns of a new diagnosis or is asked to change deeply ingrained behaviors. Patients may react to this news by thinking, “This is not directly related to me,” or “My experience is different.” Stories help break down that denial by engaging the listener, often through some degree of identification with the storyteller or one of the characters.

“The magic of stories lies in the relatedness they foster,” Dr. Houston said. “Marketers have known this for a long time, which is why you see so many stories in advertisements.”

In health care, storytelling may have its greatest impact on patients who distrust the medical system or who have difficulty understanding or acting on health information because they may find personal narratives easier to digest. Stories may also help those patients who struggle with more “silent” chronic diseases, like diabetes or high blood pressure. In these cases, stories can help patients realize the importance of addressing a disease that has few obvious or immediate symptoms. “These types of patients and diseases may be a particular ‘sweet spot’ for storytelling,” Dr. Houston noted.

This particular benefit from stories comes as welcome news not only for patients but also for doctors, who are increasingly reimbursed based on patient outcomes. “There’s only so much the doctor can do, so providers are looking for innovative ways to help their patients,” Dr. Houston said. While more research still needs to be done, the possibilities for integrating storytelling into clinical practice are numerous. In one possible situation, which is not all that dissimilar from popular dating sites, doctors and patients would be able to access Web sites that would match patients to videos of similar patients recounting their own experiences with the same disease.

Dr. Houston is currently involved in several more studies that will examine the broader use of storytelling in patient care and delineate ways in which it can best be integrated. Nonetheless, he remains certain of one thing: Sharing narratives can be a powerful tool for doctors and patients.

“Storytelling is human,” Dr. Houston said. “We learn through stories, and we use them to make sense of our lives. It’s a natural extension to think that we could use stories to improve our health.”

Join the discussion on the Well blog, Healing Through Storytelling.”

Click on the link to read the full story.

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Friday, February 11, 2011

Medical News: Nursing Home Med Errors Vary by Form of Drug - in Geriatrics, General Geriatrics from MedPage Today

Residents in nursing and old age homes are four times as likely to get an incorrect dose of medication if it's in liquid rather than pill form, researchers reported.

In a study in 55 British homes, errors included such things as incorrect measurements and not shaking a suspension, according to David Phillip Alldred, PhD, of the University of Leeds in Leeds, England, and colleagues.

Errors also were more likely with inhalers and other drug formulations, compared with pills or tablets dispensed using a monitored dosage system, Alldred and colleagues reported online in BMJ Quality and Safety.

Monitored dosage systems -- also known as unit dose systems -- consist of a tray or cassette with compartments for one or more doses for a particular day and time and are intended to simplify the administration of medications for staff, the researchers noted.

But such systems can't be used for all medications -- liquids, among others -- and it's not clear that they are safer than delivering drugs from the manufacturer's own packaging, Alldred and colleagues noted.

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

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Thursday, February 3, 2011

CMS Initiative Will Link Incentives With Reduced Infections, Readmissions - California Healthline

CMS is planning a "major multi-year financial commitment" involving Medicare, Medicaid and private insurers that aims to curb hospital-acquired infections and readmissions, according to a confidential draft of a CMS document, Inside Health Reform reports.

The so-called National Patient Safety Initiative -- which is being developed by CMS' innovation center -- would link $70 billion in Medicare funds across 10 years to hospitals' ability to achieve new standardized performance metrics. Under the plan, 6% of hospitals' Medicare payments will be contingent on reporting errors and meeting safety measures, with the proportion of payments increasing to 9% by 2015.

By hiring state contractors, CMS will develop measures and monitor progress, and then use results to determine payments.
Medicaid and private insurance plans that chose to participate in initiative also will link a larger portion of payments to patient safety goals, affordability and patient-centered care.

The innovation center also will fund studies that aim to determine how to disseminate best practices data, and support states and health systems that develop networked learning projects, Inside Health Reform reports (Inside Health Reform, 1/26).

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Nursefriendly, Inc. A New Jersey Corporation.
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Wednesday, February 2, 2011

Impact of a statewide intensive care unit quality improvement initiative on hospital mortality and length of stay: retrospective comparative analysis -- Lipitz-Snyderman et al. 342 -- bmj.com

The US Institute of Medicine highlighted the serious problem of patient safety and importance of evidence based quality improvement initiatives to reduce adverse events.1 Evidence that quality improvement initiatives intended to reduce adverse events result in a measurable impact on other important outcomes, such as mortality and length of hospital stay, is limited. Without this evidence, hospitals and healthcare payers face uncertainty about whether investment in any specific quality improvement intervention will significantly benefit patients and represent a good use of limited financial resources.

The Michigan Health and Hospital Association Keystone ICU (intensive care unit) project, developed by researchers at Johns Hopkins and undertaken by the Michigan Health and Hospital Association, about 80 of its member hospitals, and researchers at Johns Hopkins Medical Institutions, is a recent example of a successful, large scale quality improvement initiative.2 3 4 The project adopted a comprehensive approach to improving patient safety that included promoting a culture of safety, improving communication between providers, and implementing evidence based practices to reduce rates of catheter related bloodstream infections and ventilator associated pneumonia. Evidence based interventions for preventing catheter related bloodstream infections were promoting handwashing, full barrier precautions, skin antisepsis with chlorhexidine, avoiding the femoral site during catheter insertion, and removing unnecessary catheters. Interventions to prevent ventilator associated pneumonia included a mechanical ventilator “bundle” consisting of use of semirecumbent positioning, daily interruption of sedation infusions, and prophylaxis for peptic ulcer disease and deep venous thrombosis.5 The project showed that measures of culture and infection rates in the intensive care unit were substantially improved for up to 36 months after implementing the quality improvement measures.2 4 5 6

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Monday, January 31, 2011

Institute For Safe Medication Practices

Newsletters Professional Development
Consulting Services Self Assessments
Educational Programs Consumers

NEW Standard Concentrations of Neonatal Drug Infusions
FDA and ISMP List of Drug Names with Tall Man Letters
Guidelines for Standard Order Sets
Tool to assess risk in community pharmacy
Quarterly Action Agenda (Free CE)
High-Alert Medication List
Updated Confused Drug Name List
Community Pharmacy Medication Safety Tools and Resources
 
Articles of Interest
List of Products with Drug Name Suffixes
Error-Prone Abbreviation List
Pathways for Medication Safety
ISMP Guidelines
"Do Not Crush" List
Improving Medication Safety with Anticoagulant Therapy
ISMP and Doctor's Digest iPhone app.
More Tools...

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Andrew Lopez, RN
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Monday, January 10, 2011

HealthCare.gov (Healthcare Reform, Affordable Care Act)

Your Rights and Protections Under the Affordable Care Ac... 

Under the new health care law, you will see an end to some of the worst abuses of the insurance industry. New rules will put you – not your insurance company – in control of your health care.…Continue Reading →

Myths vs. Facts: Repeal Would Be Bad for Americans’ Heal... 

You may have read in today’s New York Times that the health care law enacted nine months ago is in jeopardy. Nothing could be farther from the truth. Let’s take these issues one at a time and talk about facts.

Making Living Independently A Reality for People with Di... 

Many Americans with disabilities face challenges in accessing the fundamental right to determine where and how they want to live their lives. Thanks to a new inter-agency partnership, more people living with disabilities will have that choice.


Keeping an Eye on Proposed Premium Hikes  

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Sunday, January 9, 2011

Starve a Cold, Feed a Fever? | Patient Advocate - Kitty Wilde, RN

Do you starve a cold and feed a fever when you’re feeling under the weather? Or is it the other way around?

Good news — starving is never the correct answer.

When you eat a nutritional, well-balanced diet, many other factors fall in place that keep your body functioning optimally. Foods that are rich in nutrients help fight infections and may help to prevent illness. Because a wide array of nutrients in foods — some of which we may not even know about — are essential for wellness, relying on dietary supplements (vitamins and minerals) for good nutrition may limit your intake to just the known nutritional compounds rather than letting you get the full benefit of all nutrients available in food.

Including more raw fruits and vegetables in your diet is the best way to ensure a high intake of antioxidants. And when you cook these super-nutrients, be sure you cook them using as little liquid as possible to prevent nutrient loss.

To read the rest of the article, click on the link above.

See also, patient advocates:
http://www.nursefriendly.com/nursing/consumer.advocate/patient.awareness.orga...
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856-415-9617, (fax) 415-9618

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Wednesday, January 5, 2011

Hospital care easier, faster with standing orders - CNN.com

My patient one day, a spry 80-year-old, started to cough and feel short of breath during a blood transfusion: classic signs of a transfusion reaction. I stopped her IV, but she needed a steroid to bring her breathing back to normal.

Unable to reach her primary physician, we called in a rapid-response team. An ICU doctor, respiratory therapist, two ICU nurses, a nurse anesthetist, and MDs and RNs from the floor all rushed into the room . . . . to authorize giving my patient this one needed drug.

The patient did not need rescuing, just a dose of solumedrol, and I could have given her that dose, without wasting the time and energy of multiple nurses and doctors, if we had a protocol, or "standing order," in place in my hospital for treating transfusion reactions.

A standing order is a kind of treatment algorithm used in hospitals to expedite care. Protocols are designed by doctors and nurses, implemented by nurses, and are typically used either in specific emergencies or to deliver routine care. A protocol for treating low blood sugar is an example of treating an emergency; putting silver nitrate in a newborn's eyes counts as routine.

Protocols make a lot of sense, according to Nancy Foster, vice president for Quality and Safety Policy for the American Hospital Association. The AHA supports the use of standing orders because, Foster says, "Standardization is an effective way to make sure we do the right thing for the right patient at the right time."

To read the complete article click on the above link:
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I'll Never Ration. Not Me. Not I. - NYTimes.com

Opposition to health-care rationing is a little like opposition to growing up. It sounds great. It’s just not very practical.

A society’s resources are always limited. So we have to make choices about what we can afford and what we can’t. Not everyone can afford to own a vacation home — which means vacation homes are rationed. Not everyone can afford to live in towns with excellent public schools — which means that good public education is rationed.

Similarly, we can’t afford to try every feasible medical treatment on every patient. Instead, we make choices. The most obvious form of rationing is the millions of Americans who lack health insurance today. Most of them get less medical care than they need and, in the process, keep down the nation’s total medical bill.

But even those with health insurance experience rationing. How? In many ways.

This country has not spent the money to install computerized medical records, and we suffer more medical errors than many other countries. We underpay primary care doctors, relative to specialists, and we’re left stewing in waiting rooms while our primary-care doctors try to see as many patients as possible. Specialists are usually not paid for time they spend collaborating with doctors in other specialties, and many hard-to-diagnose conditions go untreated. Nurses are usually not paid to counsel people on how to improve their diets or remember to take their pills, and manageable cases of diabetes and heart disease become fatal.

At some point we'll need to accept the fact that we cannot all have every test, every operation, every treatment, every new medicine or see every specialist.

To read the rest of the article, click on the link above:

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Andrew Lopez, RN
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38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

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