Worker fatigue cause of health care mistakes, study finds:"Health care worker fatigue contributed to more than 1,600 incidents reported through the Pennsylvania Patient Safety Reporting System (PA-PSRS), with 37 considered harmful and four resulting in patient deaths, according the Pennsylvania Patient Safety Authority."
http://www.bizjournals.com/pittsburgh/news/2014/06/05/worker-fatigue-cause-of-health-care-mistakes-study.html
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Did you know, the National Nurses in Business Association is one of the few professional nursing organizations for Nurse Entrepreneurs? Nurses in Business?
http://www.nursingentrepreneurs.com/nnba/
Sincerely,
Andrew Lopez, RN
Nursefriendly National Directories
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly
http://www.nursefriendly.com
Showing posts with label patient safety. Show all posts
Showing posts with label patient safety. Show all posts
Tuesday, June 24, 2014
Friday, January 17, 2014
Beyond the Checklist-A Compelling Resource Links Success in Aviation Safety to Patient Safety! @BethBoynton #nurseup
“Beyond the Checklist” A Compelling Resource Links Success in Aviation Safety to Potential for Patient Safety!
November 25, 2013 by @BethBoynton:"Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety is a well-written and well-researched book that makes a compelling case for a collaborative leadership and team development process called Crew Resource Management (CRM). CRM, explained by authors Suzanne Gordon, Patrick Mendenhall, and Bonnie Blair O’Connor was developed by the airline industry following a disturbing pattern of preventable and catastrophic accidents that took place in aviation in the 70s and 80s. The training process with ongoing work contributed to marked improvement in safety. The principles of the process are explained and there are many opportunities for adapting it to healthcare systems. As a specialist in group process consulting and a nurse, I can see great value in this work."
http://www.confidentvoices.com/2013/11/25/beyond-the-checklist-a-compelling-resource-links-success-in-aviation-safety-to-potential-for-patient-safety/
Beth Boynton, RN, MS Consulting Services:"Beth Boynton, RN, MS, Nurse Consultant & Author of award-winning book, "Confident Voices: The Nurses' Guide to Improving Communication & Creating Positive Workplaces". Speaker, trainer, coach, and writer specializing in teaching nurses positive communication and collaboration skills, emotional intelligence, group dynamics & leadership.
Workshops and Speaking
"Whole Systems' work for culture change.
Facilitation of small group process work/teambuilding.
Coaching Nurse Managers & leaders
Change Agent work in preparing staff for culture change initiatives.
P.O. Box 192
Portsmouth, NH 03802-0192
E-mail Address: beth@bethboynton.com
Blogs: http://www.confidentvoices.com
Social Media Twitter: https://twitter.com/#!/BethBoynton
Linkedin: https://www.linkedin.com/pub/beth-boynton/4/979/5b
Facebook: http://www.facebook.com/profile.php?id=1458311533&ref=tn_tnmn
Homepage Address: http://www.bethboynton.com http://www.nursingentrepreneurs.com/boynton
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New!
Discover! "Unconventional Nurse: Going from Burnout to Bliss" Michelle Podlesni, RN @MPodlesni http://unconventionalnurse.com/al/
Discover Martine Ehrenclou, @Med_Writer, Author of "The Take Charge-Patient" http://www.thetakechargepatient.com/
Power Strategies For Nurses:"Do your nursing shifts feel like you’re running full speed ahead on a treadmill that you just can’t stop? http://revolutionarynurse.com/power-strategies-nurses-program-2/
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Did you know? Our team of nurses has been researching, indexing healthcare resources for over a decade? If you have questions, need resources, stop here first and search our index. If we don't have it, ask us
Andrew Lopez, RN
Nursefriendly National Directories
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly
http://www.nursefriendly.com/
November 25, 2013 by @BethBoynton:"Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety is a well-written and well-researched book that makes a compelling case for a collaborative leadership and team development process called Crew Resource Management (CRM). CRM, explained by authors Suzanne Gordon, Patrick Mendenhall, and Bonnie Blair O’Connor was developed by the airline industry following a disturbing pattern of preventable and catastrophic accidents that took place in aviation in the 70s and 80s. The training process with ongoing work contributed to marked improvement in safety. The principles of the process are explained and there are many opportunities for adapting it to healthcare systems. As a specialist in group process consulting and a nurse, I can see great value in this work."
http://www.confidentvoices.com/2013/11/25/beyond-the-checklist-a-compelling-resource-links-success-in-aviation-safety-to-potential-for-patient-safety/
Beth Boynton, RN, MS Consulting Services:"Beth Boynton, RN, MS, Nurse Consultant & Author of award-winning book, "Confident Voices: The Nurses' Guide to Improving Communication & Creating Positive Workplaces". Speaker, trainer, coach, and writer specializing in teaching nurses positive communication and collaboration skills, emotional intelligence, group dynamics & leadership.
Workshops and Speaking
"Whole Systems' work for culture change.
Facilitation of small group process work/teambuilding.
Coaching Nurse Managers & leaders
Change Agent work in preparing staff for culture change initiatives.
P.O. Box 192
Portsmouth, NH 03802-0192
E-mail Address: beth@bethboynton.com
Blogs: http://www.confidentvoices.com
Social Media Twitter: https://twitter.com/#!/BethBoynton
Linkedin: https://www.linkedin.com/pub/beth-boynton/4/979/5b
Facebook: http://www.facebook.com/profile.php?id=1458311533&ref=tn_tnmn
Homepage Address: http://www.bethboynton.com http://www.nursingentrepreneurs.com/boynton
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New!
Discover! "Unconventional Nurse: Going from Burnout to Bliss" Michelle Podlesni, RN @MPodlesni http://unconventionalnurse.com/al/
Discover Martine Ehrenclou, @Med_Writer, Author of "The Take Charge-Patient" http://www.thetakechargepatient.com/
Power Strategies For Nurses:"Do your nursing shifts feel like you’re running full speed ahead on a treadmill that you just can’t stop? http://revolutionarynurse.com/power-strategies-nurses-program-2/
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Did you know? Our team of nurses has been researching, indexing healthcare resources for over a decade? If you have questions, need resources, stop here first and search our index. If we don't have it, ask us
Andrew Lopez, RN
Nursefriendly National Directories
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly
http://www.nursefriendly.com/
Tuesday, December 17, 2013
Patient Safety: A Success Story, (A great example of why nurse intimidation can be lethal) @patiyer #nurseup #nursefriendly
Patient Safety: A Success Story, (A great example of why nurse intimidation can be lethal) #nurseup #nursefriendly:”Prevention of medical errors starts with correct medical orders and diagnosis. When that does not happen, the healthcare team is expected to question orders that are incorrect and don’t make sense. This narration tells the story of a patient injured in a car accident, a failure to diagnose a lung injury, and an order written by a physician that needed to be questioned.”
More about Patricia Iyer:
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New!
Discover! "Unconventional Nurse: Going from Burnout to Bliss" Michelle Podlesni, RN @MPodlesni
http://unconventionalnurse.com/al/
Discover Martine Ehrenclou, @Med_Writer, Author of "The Take Charge-Patient"
http://www.thetakechargepatient.com/
Power Strategies For Nurses:"Do your nursing shifts feel like you’re running full speed ahead on a treadmill that you just can’t stop?
http://revolutionarynurse.com/power-strategies-nurses-program-2/
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Did you know? Our team of nurses has been researching, indexing healthcare resources for over a decade? If you have questions, need resources, stop here first and search our index. If we don't have it, ask us
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Andrew Lopez, RN
Nursefriendly National Directories
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly
http://www.nursefriendly.com/
Monday, November 21, 2011
Patient Left Unrestrained, #Patient Injured. #Nurses Judgement Call, #nursing #malpractice #nursefriendly #epatient #negligence
See also: Medical, Legal Nurse Consultants, Clinical Nursing Case of the Week, Clinical Charting and Documentation, Nurses Notes, Courtrooms, Disability, Discrimination, Employment, Expert Witnesses, Informed Consent, Medical Malpractice, Nursing Practice Acts, Pensions, Search Engines, Torts and Personal Injury, Unemployment, Workers Compensation, Workplace Safety:
Each week a case will be reviewed and supplemented with clinical and legal resources from the web. Attorneys, Legal Nurse Consultants and nursing professionals are welcome to submit relevant articles. Please contact us if you'd like to reproduce our material.
For a free subscription to our publication:
Please send a blank e-mail to: clinicalnursingcases-subscribe@topica.comSummary: The decision to use or not use restraints must be made with caution and good judgement. Their intended purpose must be to protect either the patient or others who may be injured by the patient including the staff caring for the client. The ultimate determination of necessity is left with the physician. Often, the moment to moment necessity is determined by the nurse. In this case a nurse did not feel restraining the patient was necessary. When an injury occurred, the patient sued.
The patient was involved in a motor vehicle accident. A head injury was suffered leaving him in a state of confusion and prone to agitation.
"Each year, an estimated 2 million people sustain a head injury. About 500,000 to 750,000 head injuries each year are severe enough to require hospitalization. Head injury is most common among males between the ages of 15-24, but can strike, unexpectedly, at any age. Many head injuries are mild, and symptoms usually disappear over time with proper attention. Others are more severe and may result in permanent disability." 2
Following the head injury, the patient was visibly confused and frequently became agitated. During the course of his admission, an order for "soft" wrist restraints was obtained and implemented to protect the patient from injury related to mental status (personality) changes.
"Personality Changes-Apathy and decreased motivation. Emotional lability, irritability, depression. Disinhibition which may result in temper flare-ups, aggression, cursing, lowered frustration tolerance, and inappropriate sexual behavior."2
On the day of the incident, the nurse on duty had assessed the patient. In her professional opinion restraints were not needed.
"What Is Restraint?
"Restraint" is physical force, mechanical devices, chemicals, seclusion, or any other means which unreasonably limit freedom of movement. hospital staff may use four types of restraint to restrict patients who are acting, or threatening to act, in a violent way towards themselves or others.
Physical restraint--holding a patient for over five minutes in order to prevent freedom of movement.
Mechanical restraint--using a device, such as 4-point or full sheet restraint, to restrict a patient's movement (excludes devices prescribed for medical purposes).
Chemical restraint--medicating a patient against her will for the purpose of restraint rather than treatment.
Seclusion--placing a patient alone in a room so that she cannot see or speak with patients or staff and the patient cannot leave or believes she cannot leave."3
She based this decision on her observation of the patient's mental, physical state and level of consciousness. It is common procedure and protocol in facilities for patient's to be released from restraints when the danger of violence is felt to have passed.
"How Long May Restraint Continue?
When an emergency no longer exists, the patient should be released. Thus, staff should release a patient who, upon examination, appears calm. The total time which a patient may be restrained is limited:"3
Later in the shift, the same nurse was helping the patient get up. In the course of this maneuver, the patient fell and claimed that an injury was sustained.
A lawsuit would be filed against the facility alleging negligence on the part of the nurse. The patient contended that the removal of the restraints breached standards of care.
In the initial trial, the jury was instructed to view the nurse's role as an "error in judgement." Based on this and on testimony on the proper use of restraints, standards of care, the court found for the facility.
The patient appealed.
Questions to be answered:
1. Was the nurse in error to remove the restraints from a patient when she felt they were no longer needed.
2. Did the removal of the restraints directly contribute to the "injury" that the patient claimed to sustain?
3. Were the standards of care governing restraint use adequately maintained?
The plaintiff's arguments sought to convince the jury that poor judgement was exercised by the nurse. It was contended that removal of the restraints and ambulation of the patient put him in harm's way.
With the patient assessed to be calm, the purpose of the restraints, "to prevent the patient from harming himself or others," had been achieved.
The purpose of the restraints had not been to "keep the patient from falling out of bed." The removal of the restraints then, could not be deemed as negligent. There was no duty of care breached in allowing the calm patient to remain unrestrained.
The order was in place to ambulate the patient when stable. In the nurse's opinion, the patient was ready. Another nurse may not have agreed with her actions. The patient under a different nurse's care might have been kept in restraints. A nurse could have "held off" on the order to ambulate.
There was no causative relationship between removing the restraints and the patient's fall. In carrying out orders for ambulation, the nurse was providing proper nursing care.
It's not difficult to picture a lone nurse with an unsteady patient losing control and having the patient slip away. Would this be a breach of duty owed to the patient?
One could argue that the nurse had no business trying to move a patient by herself. One might also observe the staffing patterns at the time and realize the nurse was doing "the best she could."
The decision to remove the restraints was clearly a nursing decision. Often the decision to use them in the first place lies with the nurse too.
This illustrates the leeway and discretion given nurses when carrying out physician's orders. It also shows the typical catch 22 situation some nurses may find themselves in regarding restraint use.
"Historically, conventional wisdom supported using physical restraints, including bed side rails, to "protect and safeguard" residents. Ironically, little documented evidence exists that restraints prevent falls and risk of injury from falls. Clinical studies demonstrate that restraints, conversely, in some instances, precipitate or exacerbate fall risk."4
Both nurses in the above situation would be acting within their scope of practice. Each would be adhering to standards of care.
For the plaintiff to have a case, it would need to proven that either the removal of the restraints or the ambulation of the patient was premature.
This was clearly not the case. The actions of the nurse were in good faith and exercised reasonable concern for the well being of the patient. The fact that the patient suffered a fall is unfortunate, and reasonably unforseeable.
It can be compared to the actions of a physician when dealing with an acute patient. Depending on which course of treatment that physician chooses, the patient might or might not have a favorable outcome.
In either case, as long as the physician exercises reasonable judgement based on established principles of practice, a finding of negligence is unlikely.
It has been well established that Medicine is not an exact science. Outcomes are not guaranteed when prescribing courses of treatment.
They are the result of standard medical practices and individual patient responses. These responses are not always predictable. Basically, the caregiver can only hope for the best.
The same principle applies to Nursing care. Regardless of how accurate assessments are and how diligently orders are carried out, patients may or may not experience favorable outcomes.
When outcomes are unfavorable, it is the constitutional right of the patient or patient's estate to sue anyone felt to be involved.
The court reviewed the facts of the case and a nursing expert's testimony on restraint use. The appeals court agreed that standards of care had been maintained.
There exists today intense pressure from family members, governmental agencies and regulatory agencies to limit restraint use to "only when absolutely necessary." As soon as they are put in use, the plan of care must include provisions for their removal.
Link Sections:
Head Injuries:
http://www.nursefriendly.com/nursing/directpatientcare/head.injuries.htmEthics:
http://www.nursefriendly.com/nursing/directpatientcare/ethics.htmMechanical & Physical Restraints:
http://www.nursefriendly.com/nursing/directpatientcare/mechanical.physical.re...Medical Legal Consulting Nurse Entrepreneurs
http://www.nursefriendly.com/nursing/ymedlegal.htmSources:
1. RRNL 2 (July 1997)
2. Family Caregivers Alliance Clearinghouse. Revised November 1996. Fact Sheet: Head Injury. Retrieved May 30, 1999 from the World Wide Web: http://www.caregiver.org/factsheets/head_injury.html
3. Mental Health Legal Advisors Committee. No date given. Your Rights in Hospitals Regarding Restraining and Seclusion. Retrieved May 30, 1999 from the World Wide Web: http://www.psychiatry.com/mhlac/basicrights/restraintandseclusion.html
4. Braun, Julie A. & Quish, Clare J. 11/10/98. Illinois Institute for Continuing Legal Education. Physical Restraints And Fall-Related Injuries. Retrieved May 30, 1999 from the World Wide Web: http://www.iicle.com/articles/braun11_10_98b.html
The Uniform Resource Locator (URL) or Internet Street Address of this page is
http://www.nursefriendly.com/nursing/clinical.cases/053099.htmSend comments and mail to Andrew Lopez, RN
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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
Visit our network of sites. Over 150,000 + Nurse Selected, Approved Nursing & Healthcare Resources:
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4nursing.com:"In this Nursing Portal you'll find information on Nursing Jobs, Nursing Schools, Nurse Degrees, CNAs, LPNs, RNs, Travel Nursing, Prescriptions Drugs, Medications, Nursing Associations and much more."
InspirationalNursing.com:"InspirationalNursing.com. Touching Poems, and Inspiring stories that touch the heart and occasionally bring a tear to your eye. Affection, Ambition, Angels In Our Lives, Animals, Babies, Bereavement, Caring, Caring, Children, Christian Stories, Christmas, Computers & The Internet, Death, Dependability, Determination, Dying, Easter, Emergency Medical Services (EMS), End of Life, Etc., Friendship, God's Creatures, Grief, Holiday Thoughts, Honesty, Hospice Poems, etc."
http://www.inspirationalnursing.com
Jocularity.com (Former home to the Journal of Nursing Jocularity (JNJ)):"Nursing & Medical Humor. Find hundreds of jokes and links to sites that will make you smile. Therapeutic Humor Associations, Battle of the Sexes, Bedside Nursing Humor, Brain Teasers, Clowning, Clowns, Therapeutic Humor & Comedy Links, Dental Humor, Emergency Department Humor, General Nursing Humor, Geriatrics, Senior Citizen, etc."
Legalnursingconsultant.com:"This website is intended to be a resource for Legal Nurse Consultants, Attorneys looking to use their services, and nurses looking to enter the field of Legal Nurse Consulting. On our site you'll find a directory of LNCs by state and specialty."
http://www.legalnursingconsultant.com
Nursefriendly.com:"Nationwide Nursing Resources: In this Nursing Portal you'll find information on Nursing Jobs, Nursing Schools, Nurse Degrees, LPNs, RNs, APNs, Nursing Associations and much more."
Nursinga2z.com:"It is our intent for this Alphabetical, A to Z index to be a comprehensive listing (In Progress) of Nursing-related resources on the Internet. It is indexed by Google and fully searchable."
Nursingdiabetics.com:"Welcome to NursingDiabetics.com. Here you will find information on all aspects of Diabetes, a disease that afflicts millions of people world wide. I'll be adding pages as fast as I can research the information so remember to bookmark this page and return."
http://www.nursingdiabetics.com
Nursingdiscussions.com:"This website will be a portal to Nursing Discussion boards throughout the Web. If your site has a discussion board we don't have listed here, please contact us."
http://www.nursingdiscussions.com
Nursingentrepreneurs.com:"Nationwide Nursing resource to nurse entrepreneurs looking to nework and start home based businesses. On it you will find links to small and large business related resources."
http://www.nursingentrepreneurs.com
Nursinghumor.com:"Nursing & Medical Humor. Find hundreds of jokes and links to sites that will make you smile. Therapeutic Humor Associations, Battle of the Sexes, Bedside Nursing Humor, Brain Teasers, Clowning, Clowns, Therapeutic Humor & Comedy Links, Dental Humor, Emergency Department Humor, General Nursing Humor, Geriatrics, Senior Citizen, etc."
Sunday, October 30, 2011
(Nursing's) Most Pressing Concerns About #Healthcare @yoganurse @wwwrnorg #nursing #epatients #patients #nursefriendly
New!I see the most pressing concern in the nursing profession and healthcare is the assurance that the consumer is getting what they are not only paying for, but what they deserve as they put their trust in others to care for them with utmost skill.
Judi S. Brantley, RN BSN MEd. Certified Legal Nurse Consultant, Charleston Medical Legal Consultants, South Carolina Legal Nurse Consultants, Nursing Entrepreneurs, Nurse-Owned Businesses:Charleston Medical Legal Consultants, LLC provides Case Analysis for Medical Malpractice cases. This includes, but not limited to:
Charleston Medical Legal Consultants, LLC
- Inventory for necessary medical records
- Screening for merit
- Identify adherences to/deviations from Standards of Care
- Medical story
- Chronologies with Lexis Nexis CaseMap/TimeMap
- Rendering list of potential defendants
- Educate in medical questions
- Medical Research
- Assist in locating expert witnesses
3575 Maybank Hwy., Suite D192
Johns Island, South Carolina 29455
Email Address: judibrantley@gmail.com
http://www.legalnursingconsultant.com/charleston/******************************************************
Your most pressing concerns with the profession and healthcare: The Healthcare crisis in the US with the costs way out of control.
Larry Snyder, BA, RN, DBA, RN.ORG, SA, Nursing Continuing Education Providers:"Larry Snyder, RN is the Founder and President of RN.ORG®, SA. As a licensed healthcare professional with over 15 years of experience in nursing as well as a computer authority with in-excess of 20 years of experience, he is knowledgeable with the integration of healthcare and computers and sees a strong need for licensed professionals to maintain their license in an easy, convenient, comfortable no stress environment. Larry has worked in various aspects of nursing in many states in both large and small hospitals and has the experience and background to make healthcare and nursing education friendly. Larry also functioned as a consulant at large corporations in various aspects of IT management including CBS Sports, Sportsline.com, Sports.com, Universal Studios, Nickelodeon, Viacom, Flexsys and Monsanto. Larry also has served as an expert witness on several high profile cases throughout the United States sharing his valuable input as an experienced Emergency Room nurse."
Latin America Office (Corporate Offices)
Larry Snyder - RN.ORG®, SA
CR 15A # 10A-03
El Poblado, Medellin, Colombia
Hospital Sales (English) USA: 1-954-369-4556
Hospital Sales (Español - E.E.U.U): 1-860-786-1866
E-mail Address: info@rn.org
Blogs, Social Media (Twitter, Linkedin, Facebook, etc): http://www.facebook.com/MedellinRN
http://www.linkedin.com/pub/dir/Larry/Snyder
http://www.twitter.com/wwwRNorg
Phone number: 954-369-4556
Website: http://www.rn.org
http://www.nursingentrepreneurs.com/snyder/Categories: Emergency Department Nursing, Nursing Continuing Education, Nursing Education
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Your most pressing concerns with the profession and healthcare: Burn out, low-self esteem, nurses do not realize how powerful they are View previous responses: http://www.nursefriendly.com/concerns/
Annette Tersigni RN, Yoga Nursing®:"I am the founder of Yoga Nurse Medical Yoga and Stress Management and am the creator of the enlightening new field of Yoga Nursing® and the Yoga Nursing Institute. Yoga Nursing is the marriage of modern nursing science with the ancient science of yoga. My programs are endorsed by lots of doctors and health care providers as a safe therapy to decrease pain and suffering and help folks to find peace instead of going to pieces. I have dedicated the past 16 years educating people around the world on leading healthier, spiritual lifestyles and with a dose of tough love and loads of laughter helped them to WAKE UP and GET CONSCIOUS NOW.
I am a sought after no barriers heart felt speaker, coach, teacher and writer and am featured extensively in the media including in the Associated Press and on NBC, CBS, Fox News affiliates and have been interviewed on national TV by Arielle Ford as one of America's Experts. I am producing, writing, and acting in several DVD documentary/educational projects: I am training and coaching other nurses, yoga teachers and health professionals throughout the USA and Canada to be Yoga Nursing Therapists and I lead fantabulous Yoga and Juice fasting Makeover Retreats on the magnificent Pyrate laden Crystal Coast of North Carolina. My programs our hip, conscious, filled with hilarious humor, enlightening and designed to inspire and leave a legacy. This is the most prolific, jamming and juicy time of my life and I get to do it all by serving others. SERVING RULES!"
Street Address: 103 short st apt. E
Beaufort, North Carolina, 28516
E-mail Address: theyoganurse@gmail.com
Phone: 252.725.1924
Facebook: http://www.facebook.com/profile.php?id=629639595&v=info
Homepage Address: http://www.yoganurse.com
http://www.nursingentrepreneurs.com/tersigni
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
Visit our network of sites. Over 150,000 + Nurse Selected, Approved Nursing & Healthcare Resources:
For Health Information you can use, Follow, Connect, Like us on Facebook, Google +, LinkedIN, Twitter, StumbleUpon (Most Invites Accepted):
http://www.nursefriendly.com/social/
4nursing.com:"In this Nursing Portal you'll find information on Nursing Jobs, Nursing Schools, Nurse Degrees, CNAs, LPNs, RNs, Travel Nursing, Prescriptions Drugs, Medications, Nursing Associations and much more."
InspirationalNursing.com:"InspirationalNursing.com. Touching Poems, and Inspiring stories that touch the heart and occasionally bring a tear to your eye. Affection, Ambition, Angels In Our Lives, Animals, Babies, Bereavement, Caring, Caring, Children, Christian Stories, Christmas, Computers & The Internet, Death, Dependability, Determination, Dying, Easter, Emergency Medical Services (EMS), End of Life, Etc., Friendship, God's Creatures, Grief, Holiday Thoughts, Honesty, Hospice Poems, etc."
http://www.inspirationalnursing.com
Jocularity.com (Former home to the Journal of Nursing Jocularity (JNJ)):"Nursing & Medical Humor. Find hundreds of jokes and links to sites that will make you smile. Therapeutic Humor Associations, Battle of the Sexes, Bedside Nursing Humor, Brain Teasers, Clowning, Clowns, Therapeutic Humor & Comedy Links, Dental Humor, Emergency Department Humor, General Nursing Humor, Geriatrics, Senior Citizen, etc."
Legalnursingconsultant.com:"This website is intended to be a resource for Legal Nurse Consultants, Attorneys looking to use their services, and nurses looking to enter the field of Legal Nurse Consulting. On our site you'll find a directory of LNCs by state and specialty."
http://www.legalnursingconsultant.com
Nursefriendly.com:"Nationwide Nursing Resources: In this Nursing Portal you'll find information on Nursing Jobs, Nursing Schools, Nurse Degrees, LPNs, RNs, APNs, Nursing Associations and much more."
Nursinga2z.com:"It is our intent for this Alphabetical, A to Z index to be a comprehensive listing (In Progress) of Nursing-related resources on the Internet. It is indexed by Google and fully searchable."
Nursingdiabetics.com:"Welcome to NursingDiabetics.com. Here you will find information on all aspects of Diabetes, a disease that afflicts millions of people world wide. I'll be adding pages as fast as I can research the information so remember to bookmark this page and return."
http://www.nursingdiabetics.com
Nursingdiscussions.com:"This website will be a portal to Nursing Discussion boards throughout the Web. If your site has a discussion board we don't have listed here, please contact us."
http://www.nursingdiscussions.com
Nursingentrepreneurs.com:"Nationwide Nursing resource to nurse entrepreneurs looking to nework and start home based businesses. On it you will find links to small and large business related resources."
http://www.nursingentrepreneurs.com
Nursinghumor.com:"Nursing & Medical Humor. Find hundreds of jokes and links to sites that will make you smile. Therapeutic Humor Associations, Battle of the Sexes, Bedside Nursing Humor, Brain Teasers, Clowning, Clowns, Therapeutic Humor & Comedy Links, Dental Humor, Emergency Department Humor, General Nursing Humor, Geriatrics, Senior Citizen, etc."
Friday, July 8, 2011
When Nurse Make Mistakes (Theresa Brown, RN) - NYTimes.com
By THERESA BROWN, R.N.This year, a Seattle nurse named Kim Hiatt committed suicide. Ms. Hiatt’s death came nearly seven months after she had given an unintended overdose to an infant heart patient, a medical error that was said to have contributed to the child’s death days later.
Ms. Hiatt had been a nurse for 27 years and had often cared for the 8-month-old girl during the child’s stay in the pediatric intensive care unit of her hospital. She had probably drawn up the right dose of the drug hundreds of times in her career. But once, she made a life-changing error. A baby died, and she was suspended, then fired from a profession she loved. And now she’s dead.
Please click on the "VIA" link to read the full article.
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Tuesday, April 26, 2011
amednews: 1 in 3 patients harmed during hospital stay :: April 18, 2011 ... American Medical News
By Kevin B. O'Reilly, amednews staff. Posted April 18, 2011.
One-third of hospital patients experience adverse events and about 7% are harmed permanently or die as a result, according to a study that detected patient safety problems at a far higher rate than other methods.
The study, in April's Health Affairs, echoes two reports issued in November 2010 that showed rates of adverse events hovering near 25% among hospitalized Medicare patients nationwide and at 10 North Carolina hospitals.
The findings draw attention to the safety troubles that have lingered in U.S. hospitals in the 12 years since the Institute of Medicine's headline-grabbing report "To Err is Human." The study cited research estimating that up to 98,000 patients die each year due to preventable medical errors.
"This is one of the best studies that now gives us a sense of how much harm is happening to patients in American hospitals," said Robert Wachter, MD, chief of the medical service at the University of California, San Francisco Medical Center, who was not involved in the research. "There is a tremendous amount of harm befalling patients who are admitted to hospitals and humongous opportunities for improvement."
via ama-assn.org
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Wednesday, March 30, 2011
Hospital worker had deadly blood infection
All Children's Hospital has contacted all the families whose children were exposed to an outpatient therapist who died Monday from a contagious infection that can lead to meningitis.
As they continue to notify staff who may be affected, officials want the public to know the hospital is safe, and the general public is not at risk. However, they do want all of us to be aware of two key facts about the infection that could save lives.
Doctor Juan Dumois, The Director of Pediatric Infectious Diseases at All Children's, has spent the last two days answering questions about a blood infection that likely killed an outpatient therapist. “It’s an organism that we call meningococcal. And this organism has the potential to cause very serious life threatening blood infections and sometimes, once it's in the blood it can get into the brain and that's when we call it meningitis."
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AIM: Adverse event reporting is on the rise
Although the FDA's Adverse Event Reporting System (AERS) database has been in existence since 1969, more than half of the incidents in it were received in the past decade, according to an article published online March 28 in the Archives of Internal Medicine.These 2.2 million events represent a 1.65-fold increase from the prior decade, wrote Sheila Weiss-Smith, PhD, from the University of Maryland School of Pharmacy in Baltimore, and colleagues. "Report volume increased from 2000 to 2010 at a mean annual rate of 11.3 percent,” the authors continued.
AERS is a repository of passively reported adverse drug events designed as a safety net so the FDA can monitor all marketed drugs and detect serious safety problems. Weiss-Smith and colleagues sought to characterize the current reporting patterns.
via cmio.net
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Harmed in the hospital? Should you sue? - CNN.com
Ryan Jeffers finds it hard to believe his daughter, Malyia, went from being a perfectly healthy 2-year-old who loved to dance, sing and entertain to an amputee facing a lifetime of medical care.
"I can't believe something so small turned into something so big," recalls Jeffers, who noticed that his daughter had a fever one Sunday in November.
Malyia's fever continued to climb, and unusual bruises appeared on her cheek; her parents say they rushed her to the emergency room near their Sacramento home. But things did not go as they expected.
The family says that they couldn't get a physician to examine Malyia and that the five-hour wait in the emergency room nearly killed her. Her septic infection worsened as she waited to be seen.
via cnn.com
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The Epidemic of Preventable Medical Harm, HealthcarePSI.org
The Centers for Disease Control reports that 1.7 million people who enter the hospital this year - for any reason - will contract a Hospital Acquired Infection which is completely unrelated to the condition they entered with, and 99,000 of those patients infected will die within the year. Many thousands more will never fully recover.The Sepsis Alliance - a physician group studying the condition - states that 215,000 people die each year from sepsis, a blood stream infection. The Alliance also states that half of those deaths could be prevented if hospitals would identify and treat patients in a timely manner.
In November 2010, the Office of the Inspector General released a damning report stating that every month in US hospitals, 15,000 Medicare patients over the age of 65 are killed by preventable medical harm. That's 180,000 needless deaths a year. Another 45,000 Seniors on Medicare are injured every month, but survive their hospitalization.
The three studies above document more than 386,000 preventable deaths a year in US hospitals - and that's only a small glimpse of a problem that has reached epidemic proportions.
The Institutes of Medicine estimates there are 100,000 documented preventable harm deaths per year, however they also reluctantly admit that only 5%-20% of preventable medical harm incidents are ever documented on patient records. That means their figure is badly underestimated. By how much? You do the math.
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Wednesday, March 23, 2011
Report: Communication Breakdown Leads to Hospital Errors - Health Blog - WSJ
We’ve written about how a small but significant number of health-care workers show disrespect for colleagues, dole out verbal abuse and engage in other unacceptable behavior. Now a new report suggests this kind of poor workplace communication can also contribute to medical errors, even if other preventive steps are being taken.
According to a two-pronged survey of operating-room and critical-care nurses conducted by their professional associations and VitalSmarts, a global training and consulting firm, 85% of 2,383 nurses surveyed said they’d been in a situation where measures put in place to reduce errors – including checklists or hand-off protocols — warned them of a problem that would have otherwise harmed a patient.
That’s the good news. The bad is that 58% of the nurses said they’d been in situations where it was “either unsafe to speak up or they were unable to get others to listen.”
via blogs.wsj.com
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Monday, March 21, 2011
When Nurse Staffing Drops, Mortality Rates Rise: Study
When nurse staffing levels fell below target levels in a large hospital, more patients died, a new study discovered.
The finding may provide guidance in an era of nursing shortages and cost-cutting, in that the focus should shift from cost to patient safety, said the authors of the research, appearing in the March 17 issue of the New England Journal of Medicine.
"Hospitals need to know what their nursing needs are for their patients, and they need to bring staffing into line," said study senior author Jack Needleman, a professor of health services at the School of Public Health of the University of California Los Angeles.
"Patients are entitled to be safe in the hospital and to have care delivered reliably and to have nurses with enough time to make sure they aren't developing avoidable complications with permanent consequences," Needleman said.
via businessweek.com
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Friday, March 11, 2011
FDA takes over Johnson & Johnson's Tylenol plants - Mar. 10, 2011
The government is taking over three Tylenol plants following a blizzard of drug recalls and a Food and Drug Administration criminal investigation into safety issues at the factories.
The FDA and the Justice Department on Thursday took action against McNeil PPC and two of its executives -- its vice president of quality and its vice president of operations for over-the-counter products -- for failing to comply with federally-mandated manufacturing practice.
McNeil, a division of Johnson & Johnson (JNJ, Fortune 500), said it had agreed to put its plants -- one in Las Piedras, Puerto Rico, one in Fort Washington, Pa. and one in Lancaster, Pa., under FDA supervision.
The agreement, known as a "consent decree," is subject to approval by a federal judge in Pennsylvania.
via money.cnn.com
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Safe Staffing Saves Lives - ANA's National Campaign to Solve the Nurse Staffing Crisis
Nurses everywhere rank staffing as their biggest problem. Research shows it is a problem – for patients: Insufficient nurse staffing is linked with poorer patient outcomes, lengthened hospital stays and increased chance of patient death.
ANA’s Solution to Staffing
ANA advocates solving the problem by requiring hospitals to set nurse staffing plans for each hospital unit based on changing conditions:
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Monday, February 28, 2011
Food safety, drug safety, and pregnancy information are among eight new topics included in our survey. | Pew Internet & American Life Project
Health information remains one of the most important subjects that internet users research online. The Pew Internet Project and California HealthCare Foundation have added eight new topics to our national survey measuring internet users’ interest in health information:
- 29% of internet users look online for information about food safety or recalls.
- 24% of internet users look online for information about drug safety or recalls.
- 19% of internet users look online for information about pregnancy and childbirth.
- 17% of internet users look online for information about memory loss, dementia, or Alzheimer’s.
- 16% of internet users look online for information about medical test results.
- 14% of internet users look online for information about how to manage chronic pain.
- 12% of internet users look online for information about long-term care for an elderly or disabled person.
- 7% of internet users look online for information about end-of-life decisions.
via pewinternet.org
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Saturday, February 5, 2011
First aid rules that everyone needs to know, Alax Lickerman, MD, KevinMD.com
First aid is defined as the immediate care given to an acutely injured or ill person. It can literally be life-saving so it behooves all of us to know some basic principles.
What follows are some rules that cover common conditions and general practices:
- Don’t panic. Panic clouds thinking and causes mistakes. When I was an intern and learning what to do when confronted with an unresponsive patient, a wise resident advised me when entering a “code blue” situation to always “take my own pulse first.” In other words, I needed to calm myself before attempting to intervene. It’s far easier to do this when you know what you’re doing, but even if you encounter a situation for which you’re unprepared, there’s usually some good you can do. Focus on that rather than on allowing yourself an unhelpful emotional response. You can let yourself feel whatever you need to feel later when you’re no longer needed.
- First, do no harm. This doesn’t mean do nothing. It means make sure that if you’re going to do something you’re confident it won’t make matters worse. If you’re not sure about the risk of harm of a particular intervention, don’t do it. So don’t move a trauma victim, especially an unconscious one, unless not moving them puts them at great risk (and by the way, cars rarely explode). Don’t remove an embedded object (like a knife or nail) as you may precipitate more harm (e.g., increased bleeding). And if there’s nothing you can think to do yourself, you can always call for help. In fact, if you’re alone and your only means to do that is to leave the victim, then leave the victim.
- CPR can be life-sustaining. But most people do it wrong. First, studies suggest no survival advantage when bystanders deliver breaths to victims compared to when they only do chest compressions. Second, most people don’t compress deeply enough or perform compressions quickly enough. You really need to indent the chest and should aim for 100 compressions per minute. That’s more than 1 compression per second. If you’re doing it right, CPR should wear you out. Also, know that CPR doesn’t reverse ventricular fibrillation, the most common cause of unconsciousness in a patient suffering from a heart attack. Either electricity (meaning defibrillation) or medication is required for that. But CPR is a bridge that keeps vital organs oxygenated until paramedics arrive. Which is why…
- Time counts. The technology we now have to treat two of the most common and devastating medical problems in America, heart attacks and strokes, has evolved to an amazing degree, but patients often do poorly because they don’t gain access to that technology in time. The risk of dying from a heart attack, for example, is greatest in the first 30 minutes after symptoms begin. By the time most people even admit to themselves the chest pain they’re feeling could be related to their heart, they’ve usually passed that critical juncture. If you or someone you know has risk factors for heart disease and starts experiencing chest pain, resist the urge to write it off. Get to the nearest emergency room as quickly as you can. If someone develops focal weakness of their face, legs, or arms, or difficulty with speech or smiling, they may be having a stroke, which represents a true emergency. Current protocols for treatment depend on the length of time symptoms have been present. The shorter that time, the more likely the best therapies can be applied.
- Don’t use hydrogen peroxide on cuts or open wounds. It’s more irritating to tissue than it is helpful. Soap and water and some kind of bandage are best.
- When someone passes out but continues breathing and has a good pulse, the two most useful pieces of information to help doctors figure out what happened are: 1) the pulse rate, and 2) the length of time it takes for consciousness to return.
- High blood pressure is rarely acutely dangerous. First, high blood pressure is a normal and appropriate response to exercise, stress, fear, and pain. Many patients I follow for high blood pressure begin panicking when their readings start to come in higher. But the damage high blood pressure does to the human body takes place over years to decades. There is such a thing as a hypertensive emergency, when the blood pressure is higher than around 200/120, but it’s quite rare to see readings that high, and even then, in the absence of symptoms (headache, visual disturbances, nausea, confusion) it’s considered a hypertensive urgency, meaning you have 24 hours to get the pressure down before you get into trouble.
- If a person can talk or cough, their airway is open. Meaning they’re not choking. Don’t Heimlich someone who says to you, “I’m choking.”
- Most seizures are not emergencies. The greatest danger posed to someone having a seizure is injury from unrestrained forceful muscular contractions. Don’t attempt to move a seizing person’s tongue. Don’t worry—they won’t swallow it. Move any objects on which they may hurt themselves away from the area (including glasses from their head) and time the seizure. A true seizure is often followed by a period of confusion called “post-ictal confusion.” Your reassurance during this period that they’re okay is the appropriate therapy.
- Drowning doesn’t look like what you think it does. For one thing, drowning people are physiologically incapable of crying out for help. In fact, someone actually drowning is usually barely moving at all (I strongly encourage everyone to click on this link to learn more about how to recognize what drowning does look like).
Alex Lickerman is an internal medicine physician at the University of Chicago who blogs at Happiness in this World.
via kevinmd.com
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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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