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	<title>TaleMed</title>
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	<link>http://talemed.com</link>
	<description>The Talent for Medicine</description>
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		<title>How To Be A Well Rested Nurse</title>
		<link>http://talemed.com/travel-nursing/how-to-be-a-well-rested-nurse/</link>
		<comments>http://talemed.com/travel-nursing/how-to-be-a-well-rested-nurse/#comments</comments>
		<pubDate>Tue, 21 May 2013 12:44:21 +0000</pubDate>
		<dc:creator>David McWilliams</dc:creator>
				<category><![CDATA[Travel Nursing]]></category>

		<guid isPermaLink="false">http://talemed.com/?p=541</guid>
		<description><![CDATA[Working rotating shifts makes quality rest a doubly important factor in a nurse’s life. Being well rested will do more than make you feel better; clinical studies have shown that nurses who have gotten proper rest deliver better patient care and commit fewer errors. Dr. Kathy Reid, a research assistant professor at Northwestern University’s School [...]]]></description>
				<content:encoded><![CDATA[<p><a href="http://talemed.com/wp-content/uploads/2013/05/sleeping-nurse.jpg"><img class="alignright size-full wp-image-542" alt="sleeping-nurse" src="http://talemed.com/wp-content/uploads/2013/05/sleeping-nurse.jpg" width="298" height="184" /></a>Working rotating shifts makes quality rest a doubly important factor in a nurse’s life. Being well rested will do more than make you feel better; clinical studies have shown that nurses who have gotten proper rest deliver better patient care and commit fewer errors.</p>
<p>Dr. Kathy Reid, a research assistant professor at Northwestern University’s School of Feinberg Medicine who studies sleep and circadian rhythms in shift workers, provides the following five tips on how rotating shift nurses can get the most out of their sleep and arrive at work fully refreshed.</p>
<p><strong>1. Have good sleep hygiene.</strong> That means sleeping in a dark room that’s quiet and making sure you regulate the temperature of the room. [Editor's note: An eyemask and possibly even ear plugs if you live in a loud daytime environment can be very helpful.]</p>
<p><strong>2. Avoid exposure to bright light as you’re ending your shift or on the way home from work</strong>, as bright light can make you more alert. [Editor's note: Try sunglasses when the sun is rising.]</p>
<p><strong>3. Caffeine is a great intervention.</strong> It takes 30 minutes to kick in, so have some right before you come to work. [Editor's note: Hot teas are better for you than coffee and still have caffeine. Herbal tea can also be very soothing prior to going to sleep for the day after a long night shift.]</p>
<p><strong>4. Take naps</strong>. If you’ve awakened at 7 a.m. and are scheduled to start work again at midnight, it’s well worth it to take a nap in the early evening.</p>
<p><strong>5. Come into your series of night shifts well rested.</strong> You can’t bank sleep, meaning you can’t sleep for 12 hours one night and two hours the next and expect to feel okay. So it’s important to try to be well rested to begin with.</p>
<p>Source: <a href="http://scrubsmag.com/sleep-tips-for-rotating-shift-nurses/" target="_blank">Scrubs</a></p>]]></content:encoded>
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		<title>Treat Every Patient Like Your Mother</title>
		<link>http://talemed.com/travel-nursing/treat-every-patient-like-your-mother/</link>
		<comments>http://talemed.com/travel-nursing/treat-every-patient-like-your-mother/#comments</comments>
		<pubDate>Tue, 21 May 2013 12:42:05 +0000</pubDate>
		<dc:creator>David McWilliams</dc:creator>
				<category><![CDATA[Travel Nursing]]></category>

		<guid isPermaLink="false">http://talemed.com/?p=538</guid>
		<description><![CDATA[She is the breast cancer patient in room 115. She is a grumpy patient, she does not want to eat, and she seems to ask for her pain meds exactly as soon as four hours have passed. You have a big party coming up two weeks from now. You need to get some plans together. What [...]]]></description>
				<content:encoded><![CDATA[<p><a href="http://talemed.com/wp-content/uploads/2013/05/treat-patient-like-mother.jpg.jpg"><img class="alignright size-medium wp-image-539" alt="treat patient like mother.jpg" src="http://talemed.com/wp-content/uploads/2013/05/treat-patient-like-mother.jpg-300x225.jpg" width="300" height="225" /></a>She is the breast cancer patient in room 115. She is a <strong><a title="10 Tips in Dealing with an Angry Patient" href="http://www.nursetogether.com/10-tips-in-dealing-with-an-angry-patient" target="_blank">grumpy patient</a></strong>, she does not want to eat, and she seems to ask for her pain meds exactly as soon as four hours have passed. You have a big party coming up two weeks from now. You need to get some plans together. What can you do as <strong><a title="Compassion and Respect in Nursing Care" href="http://nursetogether.com/compassion-and-respect-in-nursing-care" target="_blank">a nurse to care for her</a></strong>?</p>
<p>Time is running out! You may not see the nurses who are helping with the party for a few days so you need to make some progress on your plans. The nurses’ station which happens to be right across the hall from room 115 is the best place to make your plans since you can hear the call lights from there. Just a few more items and you will have the party plans in good shape.</p>
<p>What about that bald and thin patient in room 115? She can wait a few minutes, can’t she? Yes, she will go home soon and you may never see her again. Does it really matter? You could just close her door and continue with her plans. Maybe she won’t notice. Maybe she will just go to sleep and forget that she called you. You can definitely forget about her as soon as your shift is over.</p>
<p><strong>Longing to Be Normal Again</strong></p>
<p>I urge you to stop and think about that woman in 115. She could be you, she could be me. She could be your mom.</p>
<p>In a matter of weeks she has lost her identity. Her beautiful red hair is gone, her body has changed, and she cannot enjoy the simple things in life like her favorite foods and her favorite activities such as reading and working in her garden. She misses sleeping with her husband. Her favorite sweaters do not fit. She no longer can look forward to getting her hair done and visiting with the ladies at the beauty shop. She misses her dog. She misses her favorite blue robe that is hanging in the bathroom at home.</p>
<p>She does not want to bother you. She is suffering. She wonders if she will die. She feels like you hold the key to the few things that can be done to minimize her agony such as giving her <strong><a title="Pain Management in the Elderly: 7 Things to Consider" href="http://nursetogether.com/pain-management-in-the-elderly-7-things-to-consider" target="_blank">pain medication</a></strong> in four hours although it really only slightly relieved the tearing pain in her mouth for two hours.</p>
<p>Food is her enemy now. Her favorite dinner, lasagna, tastes like tissue paper. Her bones ache. Her stomach seems to be moving and contracting in uncontrollable waves. Getting up to walk the short distance to the bathroom in her room is overwhelming. She hates what she sees in the mirror.</p>
<p>She hates what she has become. She wonders what has caused this sickness and how long will it last. Is this all she has to look forward to for the rest of her days? She longs for the chance to be her normal self again.</p>
<p><strong>Paying Attention</strong></p>
<p>She hears your plans for the party. She hears the irritation in your voice as you ask her why you used your call light. She notices that you do not bring her medication for 30 minutes although she hears you at the nurses’ station making progress on the menu for the party. She notices that you do not make the effort to empty the emesis basin that has been full for two hours. It smells horrible but she hates to ask you to take care of it. She feels like she is a burden and that you do not care about her.</p>
<p>Your patient in room 115 is my mom. Please give her your attention. Please leave your party plans at home. Take the time to read her chart. Investigate the reasons for her discomforts and be able to explain these to her and give her some hope for recovery.</p>
<p>Please give her the <strong><a title="Four Ways to Make a BIG Difference in Patient Care" href="http://nursetogether.com/four-ways-to-make-a-big-difference-in-patient-care" target="_blank">best patient care</a></strong> that you can and show her that she is important and that you will do everything in your power to make her suffering at least a little bit less. Please treat your patient, my mom, as if she were your mom. Your patient is my mom.</p>
<p><strong>“I have a passion for student success and new faculty support.” – </strong><strong>Pam Kersey EdD, MSN, RN (<a href="http://talemed.com/category/nursing/">Nursing</a> Professor)</strong></p>
<p>- See more at: <a href="http://www.nursetogether.com/treat-every-patient-like-your-mother-nurses#sthash.fTjnoekb.dpuf" target="_blank">http://www.nursetogether.com/treat-every-patient-like-your-mother-nurses#sthash.fTjnoekb.dpuf</a></p>
<p>Source: <a href="http://www.nursetogether.com/treat-every-patient-like-your-mother-nurses" target="_blank">Nurse Together</a></p>]]></content:encoded>
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		<title>This One Habit Can Make You a More Valued Employee</title>
		<link>http://talemed.com/travel-nursing/this-one-habit-can-make-you-a-more-valued-employee/</link>
		<comments>http://talemed.com/travel-nursing/this-one-habit-can-make-you-a-more-valued-employee/#comments</comments>
		<pubDate>Tue, 21 May 2013 12:36:04 +0000</pubDate>
		<dc:creator>David McWilliams</dc:creator>
				<category><![CDATA[Travel Nursing]]></category>

		<guid isPermaLink="false">http://talemed.com/?p=532</guid>
		<description><![CDATA[In the healthcare industry, listening is critical. In fact, when patients of a major Los Angeles hospital were asked to list the most important qualities of a good healthcare provider, “good listener” neared the top of the list. But with all the obstacles that come into play in your work environment, listening can be one [...]]]></description>
				<content:encoded><![CDATA[<p><a href="http://talemed.com/wp-content/uploads/2013/05/HClistening.jpg"><img class="alignright size-full wp-image-533" alt="HClistening" src="http://talemed.com/wp-content/uploads/2013/05/HClistening.jpg" width="250" height="182" /></a>In the healthcare industry, listening is critical. In fact, when patients of a major Los Angeles hospital were asked to list the most important qualities of a good healthcare provider, “good listener” neared the top of the list.</p>
<p>But with all the obstacles that come into play in your work environment, listening can be one of the most challenging things to do on a consistent basis. That’s probably why really good listeners are a rare find.</p>
<p>I recently asked participants in a series of workshops to name the “good” and “bad” listeners in their lives. The “good listeners” were typically those categorized as best friends, spouses or current bosses. “Bad listeners” were typically categorized as ex-wives, ex-husbands and prior bosses. Coincidence? I don’t think so.</p>
<p>The better listener you are, the more valuable you become at work (and at home).</p>
<h2><b>Boost your value with these listening tips</b></h2>
<ul>
<li><strong>Focus on the person who’s talking. </strong>It’s easy to get distracted by other patients, your computer screen, the phone or other “to do” items on your list. However, studies show that if you focus on the person who’s talking and truly listen (rather than asking them to repeat themselves or spending time trying to piece together what you <i>think</i> they may have said) you’ll ultimately <i>save yourself time </i>that can be spent on accomplishing other tasks.</li>
<li><strong>Don’t make assumptions</strong>. Ever feel like you know what someone’s going to say, even before they say it? When you work in a service industry, and you talk to people all day every day, it’s tempting to make assumptions about what you <i>think </i>the person may want to know. Ever been wrong? Yeah, it happens to the best of us. Be careful to avoid jumping to conclusions or assuming you know the question before you’ve heard the patient out.</li>
<li><strong>Don’t jump ahead</strong>. Listening can be time consuming and sometimes even frustrating. It’s tempting to want to say, <i>“Could you please just wrap it up?!”</i> However, sometimes the most important pieces of information are revealed at the end of the story. If you’re short on time, try what one doctor described as “guided listening.” Ask questions that lead the talker to the end of their story without making them feel rushed.</li>
<li><strong>Beware of misunderstandings</strong>. Listening is one thing, understanding is another. It’s entirely possible to hear everything that was said and still misconstrue the meaning of the words. Miscommunication is one of the leading causes of conflict. If it doesn’t sound quite right, double check. You may be glad you did!</li>
</ul>
<p>Listening is a crucial part of patient-centered care. Missed details could literally cause life-altering problems. Increase your listening skills and you’ll increase your value in the workplace. Your patients, and your boss, will notice.</p>
<p>Source: <a href="http://career-news.healthcallings.com/2013/04/03/this-one-habit-can-make-you-a-more-valued-employee/" target="_blank">Health Callings</a></p>]]></content:encoded>
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		<title>20 mobile apps for nurses in 2012</title>
		<link>http://talemed.com/travel-nursing/20-mobile-apps-for-nurses-in-2012/</link>
		<comments>http://talemed.com/travel-nursing/20-mobile-apps-for-nurses-in-2012/#comments</comments>
		<pubDate>Wed, 24 Apr 2013 19:22:33 +0000</pubDate>
		<dc:creator>David McWilliams</dc:creator>
				<category><![CDATA[Nursing]]></category>
		<category><![CDATA[Travel Nursing]]></category>

		<guid isPermaLink="false">http://talemed.com/?p=498</guid>
		<description><![CDATA[If you have an iPhone, iPad or other mobile device, you likely have a ton of apps taking up space. While some of those apps are likely tailored for fun (Angry Birds, Words with Friends), there’s no question that you can use your smartphone to serve your nursing career. Of course, when you’re in your [...]]]></description>
				<content:encoded><![CDATA[<p>If you have an iPhone, iPad or other mobile device, you likely have a ton of apps taking up space. While some of those apps are likely tailored for fun (Angry Birds, Words with Friends), there’s no question that you can use your smartphone to serve your <a href="http://talemed.com/category/nursing/">nursing</a> career.</p>
<p>Of course, when you’re in your scrubs and ready to tackle the shift, using mobile apps to get information on drugs to anatomy to conditions is a no-brainer way to better treat your patients and keep reference materials easily accessible. Here’s a look at 20 top clinical apps for nurses in 2012!</p>
<p>Not all of these apps are free, but when you think about the great services they provide—such as keeping you on top of ever-changing medical data—it’s well worth the money.</p>
<p><strong>1. Davis Mobile NCLEX-RN Med-Surg:</strong> If you’re still a student and studying for your boards, this app will give you questions to answer while you’re waiting for the bus, sitting in front of the television or hanging out between classes. The convenience of questions by phone was unheard of only a few years ago. Now you can study in your downtime.</p>
<p><strong>2. Pill Identifier by Drugs.com:</strong> Oh no! Your patient accidentally drop his pills on the floor. Unfortunately, you have no idea which medications they were! When you call the pharmacy for new ones, what will you tell them? Pill Identifier lets you look up pills by their common features to find out which ones you need to reorder.</p>
<p><strong>3. Skyscape Medical Resources:</strong> This app is a great bundle of useful tools for nurses rolled into one. The free version includes comprehensive info on prescription drugs, a medical calculator by specialty, evidence-based clinical information on hundreds of diseases and symptom-related topics and timely content that nurses need to know on-the-go such as journal summaries, breaking clinical news and drug alerts.</p>
<p><strong>4. Instant ECG: An Electrocardiogram Rhythms Interpretation Guide:</strong> With more than 90 high-resolution images of ECGs, this app is perfect for the telemetry nurse who often needs to interpret rhythms. Let’s face it, some of them are just plain tough to remember, and this app makes them easily accessible when you’re stumped.</p>
<p><strong>5. Critical Care ACLS Guide:</strong> In addition to laying out the ACLS algorithms, this app has such helpful information as the rule of 9s for burns, chest X-ray interpretation and 12-lead EKG interpretation. This will come in handy for any nurse who is working in the ICU or other critical care area.</p>
<p><strong>6. Fast Facts for Critical Care:</strong> In keeping with the critical care theme, this app offers even more in-depth knowledge you need when working in a critical unit. Based on the books by Kathy White, this app includes information on managing sepsis, heart failure and 16 classes of critical care drugs.</p>
<p><strong>7. Pocket Lab Values:</strong> Sure, you have the lab values that come along with lab reports nowadays, but sometimes you aren’t at your computer to know the specific values of certain labs. This app helps with that by keeping you up to date on numbers, such as ABGs, lumbar puncture and immunology values.</p>
<p><strong>8. Pocket Body:</strong> Musculoskeletal by Pocket Anatomy: For nursing students, memorizing the names of bones and muscles is often one of the most challenging parts of school. With this app, you will have the names and structures available to study—either on the job or when trying to prepare for that all-important test.</p>
<p><strong>9. Sleep Sounds:</strong> Need to relax? On your lunch break, you can play the soothing sounds of a thunderstorm, the wind or a cat purring to calm your mind and escape from the rigors of the floor. Just don’t get too relaxed—you need to finish your shift!</p>
<p><strong>10. IDdx:</strong> Infectious Disease Queries: This handy reference of more than 250 diseases allows you to type in the symptom of an infectious disease and see a display of all the diseases that contain that symptom. You’re sure to find the reason for your patient’s problem.</p>
<p><strong>11. Harriet Lane Handbook:</strong> If you work in peds, this app is just the one you need. It focuses on the conditions of childhood, how to dose medications for children and immunization schedules. When working with kids, you have to know a different set of rules, and this is the handbook for that.</p>
<p><strong>12. MRSA eGuideline:</strong> MRSA is a big problem in hospitals today, and you need to know the information that’s going to help keep your patients safe from this condition. This app talks about vancomycin dosing, drug information and how to deal with MRSA in infants.</p>
<p><strong>13. Symptomia:</strong> This is another app that allows you to input a symptom, and it will return for you all possible diseases that have that symptom. It includes information on abdominal distention, vertigo and coughing, among other common symptoms.</p>
<p><strong>14. The Color Atlas of Family Medicine:</strong> This app comes with a hefty price tag of $95, but is worth the investment for the full-color pictures on your phone or iPad that show common skin conditions, rashes and other conditions in a glorious multimedia presentation.</p>
<p><strong>15. Anesthesia Drugs: Fast:</strong> If you’re working in the OR or studying to become a nurse anesthetist, this will come in handy for calculating your drug dosages. Simply enter a weight and the proper dose is given to you for a wide range of anesthesia drugs.</p>
<p><strong>16. Med Mnemonics:</strong> We all need help remembering the vast amount of information that comes at us in nursing school and on the job. One of the easiest ways to remember is with mnemonics that help to jog your memory. This app lists all the common aides to studying in a simple format.</p>
<p><strong>17. Heart Murmur Pro:</strong> The Heart Sound Database: Sometimes it’s hard to know what sounds are important when listening to the heart with your stethoscope. This app has a collection of the common and uncommon heart sounds so that you can learn to identify them.</p>
<p><strong>18. palmPEDi:</strong> Pediatric Emergency Medicine Tape for the PICU, OR, ED: When working with children in critical care areas, you need to know the equipment sizes, drug doses and other peds-specific knowledge to act fast. This app puts all of that information on your phone and at your command.</p>
<p><strong>19. Medscape:</strong> This app gives you the latest in medical news right at your fingertips. You can also look up unknown drugs, conditions and procedures directly from the app. The icing on the cake? It’s totally free!</p>
<p><strong>20. Davis’s Drug Guide 2012:</strong> This is the go-to guide for nurses when they want to look up the actions of a medication. This app is a little more pricey than some other apps, but the fact that it is made by Davis and has such a great reputation as a guide for nurses makes it worth the price.</p>
<p>Source: <a href="http://scrubsmag.com/20-mobile-apps-for-nurses-in-2012/">Scrubs</a></p>]]></content:encoded>
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		<title>Another Big Step in Reshaping Health Care</title>
		<link>http://talemed.com/travel-nursing/another-big-step-in-reshaping-health-care/</link>
		<comments>http://talemed.com/travel-nursing/another-big-step-in-reshaping-health-care/#comments</comments>
		<pubDate>Wed, 24 Apr 2013 19:19:41 +0000</pubDate>
		<dc:creator>David McWilliams</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Travel Nursing]]></category>

		<guid isPermaLink="false">http://talemed.com/?p=494</guid>
		<description><![CDATA[Hospitals and health insurers are locking horns over how much health-care providers will get paid under new insurance plans that will be sold as the federal health law is rolled out. The results will play a major role in determining how much insurers will ultimately charge consumers for these policies, which will be offered to [...]]]></description>
				<content:encoded><![CDATA[<p>Hospitals and health insurers are locking horns over how much health-care providers will get paid under new insurance plans that will be sold as the federal health law is rolled out.</p>
<p>The results will play a major role in determining how much insurers will ultimately charge consumers for these policies, which will be offered to individuals through so-called exchanges in each state.</p>
<p>The upshot: Many plans sold on the exchanges will include smaller choices of health-care providers in an effort to bring down premiums.</p>
<p>To keep costs low, the insurers are pressing for hospitals to grant discounts from the rates hospitals usually get in commercial plans. In return, participating hospitals would be part of smaller networks of providers. Hospitals will be paid less by the insurer, but will likely get more patients because those people will have fewer choices. The bet is that many consumers will be willing to accept these narrower networks because it will help keep premiums down.</p>
<p>Tenet Healthcare Corp., one of the biggest U.S. hospital operators with 49 hospitals, Tuesday said it had signed three contracts for exchange plans that would involve either narrow or &#8220;tiered&#8221; networks, in which people pay more to go to health-care providers that aren&#8217;t in the top tier.</p>
<p>Tenet said that in exchange for favorable status in these plans, it granted discounts of less than 10% to the three insurers, which it said were Blue Cross &amp; Blue Shield plans covering 15 of its hospitals, or around 30%.</p>
<p>&#8220;It makes strategic sense for us,&#8221; said Trevor Fetter, Tenet&#8217;s CEO, in an interview. &#8220;There will be a market here, and it&#8217;s important for us, we believe, to participate in that market.&#8221; He said that insurers around the country have approached Tenet to discuss similar plan designs.</p>
<p>Analysts said Tenet&#8217;s disclosures, which came during an earnings call with analysts, are the most explicit from any hospital chain so far about how the negotiations are shaping up. &#8220;It&#8217;s the clearest statement they&#8217;ve gotten about exchange products, pricing and impact,&#8221; said Sheryl Skolnick, an analyst with CRT Capital Group LLC.</p>
<p>Exchange plans will take effect in 2014. In that first year, health plans sold on the exchanges could have 11 million to 13 million enrollees and generate $50 billion to $60 billion in premium revenue, according to an estimate from PwC&#8217;s Health Research Institute, an arm of PricewaterhouseCoopers LLP.</p>
<p>Stonegate Advisors LLC, a research firm that works for health insurers, has been testing clients&#8217; plans with consumers in a mock-up version of an exchange, which is an online insurance marketplace. Marc Pierce, the firm&#8217;s president, says nearly all the products have included limited provider networks.</p>
<p>The tests have found that premiums are the most important factor in consumers&#8217; choices, he said, with more than half typically opting for a narrow-network product if it cost them at least 10% less than an equivalent with broader choice.</p>
<p>Florida Blue, the Blue Cross &amp; Blue Shield plan in the state, will offer plans with a &#8220;tighter, more select group of providers&#8221; in its exchange, said Chief Executive Patrick J. Geraghty in an interview. &#8220;We believe the exchange is going to be driven by price, and therefore we&#8217;re looking for a lower-price option.&#8221;</p>
<p>The insurer has already struck deals for narrow-network plans and will use those same terms for the exchange versions, it said. Florida Blue said it has been winning discounts of 5% to 10% off typical commercial rates from hospital systems, but getting breaks as high as 20% in some cases.</p>
<p>Plans with smaller choices of health-care providers are a big focus for insurers, partly because many other aspects of exchange plans, including benefits and out-of-pocket charges that consumers pay, are largely prescribed by the law, giving them few levers to push to reduce premiums.</p>
<p>&#8220;The need for a smaller network with lower pricing was critical,&#8221; said Juan Davila, an executive vice president at Blue Shield of California, which said it hopes to offer a preferred-provider-organization plan for individuals on the exchange. It would be built around a provider network around 40%-45% of its traditional PPO scope. Mr. Davila said Blue Shield had signed an exchange contract with Tenet but declined to comment on its terms.</p>
<p>So far, insurers and hospitals have sent differing signals on what kinds of discounts the hospitals might grant for the exchange plans, which would vary by market. Publicly traded hospital chains have said they are pressing to get paid approximately what they receive for traditional commercial health insurance.</p>
<p>Some insurers talk about steeper discounts from hospitals. WellPoint Inc. has said it is aiming to pay providers somewhere between Medicaid and Medicare rates, and sees talks trending toward rates close to Medicare. Medicare rates are often substantially lower than commercial prices. An Aetna Inc. official at an investor conference Monday suggested the rates might settle somewhere between Medicare and commercial.</p>
<p>For their part, hospitals have to weigh whether discounts they grant for exchange products pose a risk to the richer pricing they get for traditional commercial health plans, which include those now offered by employers.</p>
<p>Catholic Health Initiatives, a not-for-profit operator of 78 hospitals based in Englewood, Colo., said it is negotiating with insurers about exchange plans in around half of its markets, and insurers are often seeking to craft narrow-network designs.</p>
<p>CHI is taking a &#8220;conservative&#8221; approach and discussing &#8220;very modest discounts in exchange for a narrow-network opportunity,&#8221; said Juan Serrano, a senior vice president, in an interview.</p>
<p>Source: <a href="http://online.wsj.com/article/SB10001424127887323699704578328693720458354.html">Wall Street Journal</a></p>]]></content:encoded>
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		<title>New Joint Commission alert addresses medical device alarm safety in hospitals</title>
		<link>http://talemed.com/travel-nursing/new-joint-commission-alert-addresses-medical-device-alarm-safety-in-hospitals/</link>
		<comments>http://talemed.com/travel-nursing/new-joint-commission-alert-addresses-medical-device-alarm-safety-in-hospitals/#comments</comments>
		<pubDate>Wed, 24 Apr 2013 19:16:05 +0000</pubDate>
		<dc:creator>David McWilliams</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[The Joint Commission]]></category>
		<category><![CDATA[Travel Nursing]]></category>

		<guid isPermaLink="false">http://talemed.com/?p=491</guid>
		<description><![CDATA[(OAKBROOK TERRACE, Ill. – April 8, 2013) The constant beeping of alarms and an overabundance of information transmitted by medical devices such as ventilators, blood pressure monitors and ECG (electrocardiogram) machines is creating “alarm fatigue” that puts hospital patients at serious risk, according to a Sentinel Event Alert issued today by The Joint Commission. The Joint Commission Alert urges [...]]]></description>
				<content:encoded><![CDATA[<p>(OAKBROOK TERRACE, Ill. – April 8, 2013) The constant beeping of alarms and an overabundance of information transmitted by medical devices such as ventilators, blood pressure monitors and ECG (electrocardiogram) machines is creating “alarm fatigue” that puts hospital patients at serious risk, according to a <a href="http://www.jointcommission.org/sea_issue_50/"><em>Sentinel Event Alert </em></a>issued today by <a href="http://talemed.com/category/the-joint-commission/">The Joint Commission</a>.</p>
<p><a href="http://talemed.com/tag/the-joint-commission/">The Joint Commission</a><em> Alert </em>urges leaders at hospitals to take a focused look at this serious patient safety issue. Over a recent four-year period, a U.S. Food and Drug Administration (FDA) database shows that there were more than 560 alarm-related deaths and The Joint Commission’s sentinel event database includes reports of 80 alarm-related deaths and 13 serious alarm-related injuries during a similar period. Patient deaths related to alarms on monitoring devices have also been the focus of national media attention and special reports by the Association for the Advancement of Medical Instrumentation (AAMI) and ECRI Institute. The Joint Commission, AAMI, ECRI Institute and American College of Clinical Engineering also brought together patient safety and <a href="http://talemed.com/category/health-care/">health care</a> experts at a <a href="http://www.aami.org/meetings/summits/alarms.html" target="_blank">2011 summit </a>to seek solutions to problems with medical device alarms.</p>
<p>Alarms are intended to alert caregivers of potential problems, but can compromise patient safety if they are not properly managed. Many patient care areas have numerous alarms and the barrage of warning noises tend to desensitize caregivers and cause them to ignore alarms or even disable them. Other issues associated with effective alarm management include too many medical devices with alarms or individual alarms that are difficult to hear.  Pre-set or default settings also may cause problems because the device sounds a warning even when no action or decision by a caregiver is required. Rather than calling attention to a patient’s needs, these settings may distract caregivers.</p>
<p>These issues vary greatly among hospitals and even within different units in a single hospital. Although there are many variables, the<em> Alert </em>makes it clear that in order to reduce risks related to alarms on medical devices, a series of actions still needs to occur related to people, processes and technology.</p>
<p>“Alarm fatigue and management of alarms are important safety issues that we must confront,” says Ana McKee, M.D., executive vice president and chief medical officer, The Joint Commission. “The recommendations in this <em>Alert</em> offer hospitals a framework on which to assess their individual circumstances and develop a systematic, coordinated approach to alarms. By making alarm safety a priority, lives can be saved.”</p>
<p>The Joint Commission <em>Alert</em> recommends that health care organizations take the following actions, which correspond with recommendations made by both AAMI and ECRI Institute:</p>
<ul>
<li>Ensure that there is a process for safe alarm management and response in areas identified by the organization as high risk.</li>
<li>Prepare an inventory of alarm-equipped medical devices used in high-risk areas and for high-risk clinical conditions, and identify the default alarm settings and the limits appropriate for each care area.</li>
<li>Establish guidelines for alarm settings on alarm-equipped medical devices used in high-risk areas and for high-risk clinical conditions; include identification of situations when alarm signals are not clinically necessary.</li>
<li>Establish guidelines for tailoring alarm settings and limits for individual patients. The guidelines should address situations when limits can be modified to minimize alarm signals and the extent to which alarms can be modified to minimize alarm signals.</li>
<li>Inspect, check and maintain alarm-equipped medical devices to provide for accurate and appropriate alarm settings, proper operation, and detectability. Base the frequency of these activities on criteria such as manufacturers’ recommendations, risk levels and current experience.</li>
</ul>
<p>The Joint Commission <em>Alert</em> also recommends training and education for all clinical care team members on safe alarm management and response in high-risk areas. In addition, organizations should consider how to reduce nuisance alarm signals and to determine whether critical alarm signals can actually be heard in patient care areas. Seeking input from patient care providers, health care engineers, risk managers and information technology professionals, organizations should also establish policies and processes for alarm safety that include the regular review of trends and patterns that reveal improvement opportunities. Finally, the <em>Alert</em> urges organizations to share information about alarm-related incidents, prevention strategies and lessons learned with organizations such as AAMI, ECRI, the FDA and The Joint Commission.</p>
<p>Beyond the <em>Alert</em>, The Joint Commission is considering the possible creation of a National Patient Safety Goal to help health care organizations address this issue. A field review of the proposed Goal occurred in February and the public comments are now under review. The Joint Commission already has numerous accreditation standards in place related to alarm safety. The standards address issues such as leadership, the environment of care, provision of care and staff training and education.</p>
<p>The warning about medical device alarms is part of a series of <em>Alerts</em> issued by The Joint Commission. Much of the information and guidance provided in these <em>Alerts</em> is drawn from The Joint Commission’s Sentinel Event Database, one of the nation’s most comprehensive voluntary reporting systems for serious adverse events in health care. The database includes detailed information about both adverse events and their underlying causes.  Previous <em>Alerts</em> have addressed risks associated with the use of opioids, health care worker fatigue, diagnostic imaging risks, violence in health care facilities, maternal deaths, health care technology, anticoagulants, wrong-site surgery, medication mix-ups, health care-associated infections and patient suicides, among others. The complete list and text of past issues of <em><a href="http://www.jointcommission.org/sentinel_event.aspx">Sentinel Event Alert </a></em>can be found on The Joint Commission website.</p>
<p>Source: <a href="http://www.jointcommission.org/new_joint_commission_alert_addresses_medical_device_alarm_safety_in_hospitals/">The Joint Commission</a></p>]]></content:encoded>
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		<title>Up-to-date vaccination records can help when starting a travel assignment</title>
		<link>http://talemed.com/travel-nursing/up-to-date-vaccination-records-can-help-when-starting-a-travel-assignment/</link>
		<comments>http://talemed.com/travel-nursing/up-to-date-vaccination-records-can-help-when-starting-a-travel-assignment/#comments</comments>
		<pubDate>Wed, 13 Mar 2013 13:03:31 +0000</pubDate>
		<dc:creator>Libby</dc:creator>
				<category><![CDATA[Travel Nursing]]></category>

		<guid isPermaLink="false">http://talemed.com/?p=463</guid>
		<description><![CDATA[Health care workers are sometimes exposed to people who are ill with a vaccine-preventable disease or to contaminated blood and bodily fluids that could result in illnesses. Most health care workers are required to have proof of vaccination or evidence of immunity against several vaccine-preventable diseases to make sure they are protected and to prevent [...]]]></description>
				<content:encoded><![CDATA[<p><img class="alignright size-full wp-image-447" title="adultvaccinationrecords_355px" src="http://talemed.com/wp-content/uploads/2013/03/adultvaccinationrecords_355px.jpg" alt="" width="355" height="135" /></p>
<p><a href="http://talemed.com/category/health-care/">Health care</a> workers are sometimes exposed to people who are ill with a vaccine-preventable disease or to contaminated blood and bodily fluids that could result in illnesses. Most health care workers are required to have proof of vaccination or evidence of immunity against several vaccine-preventable diseases to make sure they are protected and to prevent passing these infections to their patients.</p>
<p>An up-to-date vaccination record helps you and your doctors know if you’re protected against vaccine-preventable diseases. Can’t find your records? You’re not alone. The following tips can jumpstart your search!</p>
<ul>
<li>Check with your current and previous health care providers, including urgent care and public health clinics, or pharmacies where you may have received vaccinations.</li>
<li>Investigate old family albums, baby book or family Bibles.</li>
<li>Contact your college&#8217;s medical services department (student health).</li>
<li>Review your military records.</li>
<li>See if your state has an immunization registry.</li>
<li>Check with your health insurance company to see if it has a record of your vaccinations. Often, medical records are passed from health care provider to insurer and then between insurers if you change medical plans.</li>
</ul>
<p>Source: <a href="http://www.cdc.gov/features/adultvaccinationrecords/?s_cid=fb1976" target="_blank">CDC</a></p>]]></content:encoded>
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		<title>The one Mistake every nurse should never make?</title>
		<link>http://talemed.com/travel-nursing/the-one-mistake-every-nurse-should-never-make/</link>
		<comments>http://talemed.com/travel-nursing/the-one-mistake-every-nurse-should-never-make/#comments</comments>
		<pubDate>Wed, 13 Mar 2013 12:56:00 +0000</pubDate>
		<dc:creator>Libby</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Nursing]]></category>
		<category><![CDATA[TaleMed]]></category>
		<category><![CDATA[Travel Nursing]]></category>

		<guid isPermaLink="false">http://talemed.com/?p=456</guid>
		<description><![CDATA[So I know when you read the title all you could think about was ‘what is it??!’ Anyone who is a nurse or on their way to being a nurse can use this piece of advice! We live in the world of life and death. I don’t think anyone will argue with me on that. [...]]]></description>
				<content:encoded><![CDATA[<p><a href="http://talemed.com/wp-content/uploads/2013/03/nurse-iv-stand.jpg"><img class="alignright size-full wp-image-457" title="nurse-iv-stand" src="http://talemed.com/wp-content/uploads/2013/03/nurse-iv-stand.jpg" alt="" width="298" height="185" /></a>So I know when you read the title all you could think about was ‘what is it??!’ Anyone who is a nurse or on their way to being a nurse can use this piece of advice!</p>
<p>We live in the world of life and death. I don’t think anyone will argue with me on that. We can have many levels of definition when we are asked what a ‘bad day’ really is. In the end, we shoulder a lot of responsibility caring for our patients, and we sure don’t want to make ‘that one mistake’.We’ve all made mistakes. I know I have. Some small, some great, some breath-taking, and some are quite comical. At the end of the day we are all human right? Aren’t we entitle to tripping up once in a while?</p>
<p>I think it has a lot to do with HOW we learned of our mistake sometimes that can determine how that mistake impacts us. In <a href="http://talemed.com/category/nursing/">nursing</a> school I remember a patient of mine having an IV site issue. The nurse caring for him did some adjustments to his IV site. While addressing the IV, she raised the bed up high enough to be close to waist-height (more than likely to lessen the strain on her back while troubleshooting). That particular day it was my big day to hang my first IV. I got to prime the tubing, lock it into the IV pump and then attach it to the patient (I think we all remember that first time). I was nervous as all get out. I had followed the steps prior to entering the room. I rehearsed them in my head before I approached the IV pump. I check and triple checked the tubing. Reviewed the 7 rights, etc., etc.</p>
<p>I successfully hung the med and had it infusing properly with no alarms and no messes! When I was getting read to leave the patients bedside, my nursing instructor asked if I forgot anything? Silently in my head I panicked and retraced all my steps four more times. Check, check, re-check.</p>
<p>I paused before answering no, that everything was fine.</p>
<p>The nursing instructor asked me a second time. I re-traced my steps, 4 more checks over my work. I replied again with an ‘Aye-oh-OK’ response.</p>
<p>This dialogue happened two more times before the patient finally looked over at me and kindly (and jokingly) said, “She’s obviously trying to tell ya something”.</p>
<p>I still for the life of me couldn’t figure it out??</p>
<p>My instructor kindly replies, “Well, good job on the IV, but if Mr. Smith wants to get out of bed to use the restroom or anything else he’s going to have to jump (and maybe fall).”</p>
<p>I looked at the bed – and it was still at waist-height! I got so involved in my task that I forgot that the nurse had raised his bed for that IV site troubleshoot!</p>
<p>I was mortified. I had missed something so basic, so simple, yet SO very important. To this day I tell that story to any and all that will listen. I have never left my patient’s bed at an unsafe height. Every time I leave my patient’s room I always, always, always lower the bed to its lowest setting. The way I learned that lesson has remained engrained in my brain.</p>
<p>I’ve made many more mistakes since then. Some even more comical, and some down right scary. I once entered in the wrong infusion settings for a narcotic medication for a patient. I transposed concentration and total amount of drug settings on the IV pump. Lets just say, thankfully the patient was intubated and the mistake was found quickly.</p>
<p>So back to my original statement : What is the one mistake every nurse shouldn’t make??</p>
<p><em>The mistake that they do not learn from</em>.</p>
<p>Learning from your mistakes is the single most important process of growing and maturing as a practitioner. Not learning from a mistake will set you up to make that same mistake again.</p>
<p>Be sure to learn from all your mistakes, no matter how great or small, your patients will thank you for it.</p>
<div> Source: <a href="http://scrubsmag.com/the-one-mistake-every-nurse-shouldnt-make/" target="_blank">Scrubs Magazine</a></div>]]></content:encoded>
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		<title>10 Best Children&#8217;s Hospitals Rated</title>
		<link>http://talemed.com/travel-nursing/10-best-childrens-hospitals-rated/</link>
		<comments>http://talemed.com/travel-nursing/10-best-childrens-hospitals-rated/#comments</comments>
		<pubDate>Wed, 13 Mar 2013 12:51:52 +0000</pubDate>
		<dc:creator>Libby</dc:creator>
				<category><![CDATA[Health Care]]></category>
		<category><![CDATA[Nursing]]></category>
		<category><![CDATA[TaleMed]]></category>
		<category><![CDATA[Travel Nursing]]></category>

		<guid isPermaLink="false">http://talemed.com/?p=446</guid>
		<description><![CDATA[At children&#8217;s hospitals nationwide, a growing number of very sick children are finding hope in never-before-tried treatments. And the quality of care isn&#8217;t just important to those families, a new poll found that 40 percent of Parents readers have a child who has been treated at a pediatric hospital. We took both routine care and difficult cases [...]]]></description>
				<content:encoded><![CDATA[<p><a href="http://talemed.com/wp-content/uploads/2013/03/l_102049601.jpg"><img class="size-full wp-image-450 alignright" title="l_102049601" src="http://talemed.com/wp-content/uploads/2013/03/l_102049601.jpg" alt="" width="200" height="200" /></a>At children&#8217;s hospitals nationwide, a growing number of very sick children are finding hope in never-before-tried treatments. And the quality of care isn&#8217;t just important to those families, a new poll found that 40 percent of <em>Parents</em> readers have a child who has been treated at a pediatric hospital. We took both routine care and difficult cases into account for our latest survey of children&#8217;s hospitals. Last fall, members of the Children&#8217;s Hospital Association (formerly the National Association of Children&#8217;s Hospitals and Related Institutions) each provided more than 1,000 pieces of information.</p>
<p>We crunched the numbers with guidance from medical advisors, emphasizing treatment-success rates, research studies, and doctors&#8217; experience. Where there was a close call, we gave the edge to hospitals that provide extra TLC for families of outpatients and inpatients: private NICU rooms, play areas that are open 24/7, and music and art therapists to hang out with kids. Whether a child needs a cast for a broken arm or a bioengineered cancer drug, an asthma inhaler or a double lung transplant, these top hospitals have children covered &#8212; and then some.</p>
<h4>1. <span style="font-size: 1em;">The Children&#8217;s Hospital of Philadelphia</span></h4>
<h4><span style="font-size: 1em;">2. Boston Children&#8217;s Hospital</span></h4>
<h4>3. Cincinnati Children&#8217;s Hospital Medical Center</h4>
<h4>4. Children&#8217;s Hospital of Wisconsin, Milwaukee</h4>
<h4>5. Children&#8217;s Hospital Colorado, Aurora</h4>
<h4>6. Children&#8217;s Hospital of Pittsburgh of UPMC</h4>
<h4>7. Texas Children&#8217;s Hospital, Houston</h4>
<h4>8. University of Michigan C.S. Mott Children&#8217;s Hospital, Ann Arbor</h4>
<h4>9. Nationwide Children&#8217;s Hospital, Columbus, Ohio</h4>
<h4>10. Ann &amp; Robert H. Lurie Children&#8217;s Hospital of Chicago</h4>
<p>Source: <a href="http://www.parents.com/health/doctors/best-childrens-hospitals/?page=2" target="_blank">Parents.com</a></p>]]></content:encoded>
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		<title>Hospitals in U.S. Cut Infection Rates in 2011, CDC Says</title>
		<link>http://talemed.com/health-care/hospitals-in-u-s-cut-infection-rates-in-2011-cdc-says/</link>
		<comments>http://talemed.com/health-care/hospitals-in-u-s-cut-infection-rates-in-2011-cdc-says/#comments</comments>
		<pubDate>Wed, 13 Feb 2013 13:07:36 +0000</pubDate>
		<dc:creator>Theresa</dc:creator>
				<category><![CDATA[Health Care]]></category>

		<guid isPermaLink="false">http://talemed.com/?p=415</guid>
		<description><![CDATA[U.S. hospitals reduced some types of deadly and costly infections in 2011, three years after a government initiative to cut hospital-acquired illnesses. Infections stemming from catheters placed in a large vein in the neck, chest or groin to give medication or collect blood declined 41 percent from 2008, the Centers for Disease Control and Prevention said today [...]]]></description>
				<content:encoded><![CDATA[<div  class='wp-caption alignnone' style='width:384px;'><img class=" " title="Center for Disease Control Director Thomas Frieden said &quot;reductions in some of the deadliest health care-associated infections are encouraging, especially when you consider the costs to both patients and the health care system.&quot;" src="http://www.bloomberg.com/image/ix.axsiU6u2U.jpg" alt="Center for Disease Control Director Thomas Frieden said &quot;reductions in some of the deadliest health care-associated infections are encouraging, especially when you consider the costs to both patients and the health care system.&quot;" width="384" height="256" /><p class='wp-caption-text'>Center for Disease Control Director Thomas Frieden said &#8220;reductions in some of the deadliest <a href="http://talemed.com/category/health-care/">health care</a>-associated infections are encouraging, especially when you consider the costs to both patients and the health care system.&#8221;</p></div>
<p>U.S. hospitals reduced some types of deadly and costly infections in 2011, three years after a <a href="http://talemed.com/employer-services/government/">government</a> initiative to cut hospital-acquired illnesses.</p>
<p>Infections stemming from catheters placed in a large vein in the neck, chest or groin to give medication or collect blood declined 41 percent from 2008, the <a title="Open Web Site" href="http://www.cdc.gov/" rel="external">Centers for Disease Control and Prevention</a> said today in a report. Infections following surgery decreased 17 percent since 2008, the CDC said.</p>
<p>The Department of Health and Human Services set a goal in 2008 of reducing the catheter or central line-associated bloodstream infections by 50 percent and surgical site infections by 25 percent, the CDC said in a <a title="Open Web Site" href="http://www.cdc.gov/media/releases/2013/p0211_health_care_infections.html" rel="external">statement</a>. About 1 in 20 patients gets infected each year while receiving medical care, including 41,000 bloodstream infections that strike hospital patients with catheters, the Atlanta-based health agency said.</p>
<p>“Reductions in some of the deadliest health care- associated infections are encouraging, especially when you consider the costs to both patients and the health care system,” CDC Director <a title="Search News" href="http://search.bloomberg.com/search?q=Thomas%20Frieden&amp;site=wnews&amp;client=wnews&amp;proxystylesheet=wnews&amp;output=xml_no_dtd&amp;ie=UTF-8&amp;oe=UTF-8&amp;filter=p&amp;getfields=wnnis&amp;sort=date:D:S:d1&amp;partialfields=-wnnis:NOAVSYND&amp;lr=-lang_ja">Thomas Frieden</a> said in the statement.</p>
<p>CDC uses data from its National Healthcare Safety Network, which collects information from more than 11,500 health-care facilities in the 50 states, Washington, D.C. and Puerto Rico.</p>
<p>The data showed hospitals improved their procedures, reducing catheter-associated bloodstream and surgical site infections at a faster rate than in 2010. In 2010, catheter infections decreased 32 percent from 2008 while surgical site infections declined 7 percent.</p>
<p>Hospitals made a 7 percent reduction in catheter-associated urinary tract infections from 2009, the same percentage as reported in 2010, CDC said.</p>]]></content:encoded>
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