March 27th, 2010 by KevinMD in Better Health Network, Health Policy, Opinion, Research
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When nurses sign out during the end of shift, it’s done so in a quiet setting. Contrast that to medical residents — at least when I was a resident 8 years ago — where pager interruptions during sign out were the norm.
PookieMD compares the situation to the “sterile cockpit” that airline pilots enjoy:
“Pilots have the sterile cockpit–a situation in which, if the plane is below 10,000 feet, only conversation directly relevant to flying is allowed. The rule was developed because take offs and landings are the most likely time a crash will occur, and take offs and landings occur below 10,000 feet. Simple enough, and it saves lives.”
Physicians enjoy no such luxury. Patient discussions with other doctors often take place in distracted settings, under the threat of a pager going off at any time.
Changing this, PookieMD argues, requires a cultural shift. As mentioned earlier, when nurses sign out, it’s sacred time. Doctors need something similar. Studies show that medical errors can arise during the patient hand-off to another physician. Signing out patients in an undisturbed setting may minimize the risk of poor communication, and subsequently, potential mistakes. “Page early and often needs to be replaced with ‘page urgently when appropriate,’” writes PookieMD.
Let’s see if hospital administrators have the courage to make this happen.
*This blog post was originally published at KevinMD.com*
March 27th, 2010 by Medgadget in Better Health Network, News, Research
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The New York Times profiles research by Harvey A. Liu and Kenneth J. Balkus Jr. of the University of Texas at Dallas to create a therapeutic nitric oxide releasing bandage. Nitric oxide can play a significant role in peripheral vasodilation, relaxation of pulmonary vasculature, and other physiological processes, such as penile erection. Therefore, an effective method of delivering this free radical should allow the development of new types of vascular stockings, bandages, and other therapeutic (or recreational) devices.
A snippet from NYT:
As they describe in a paper in Chemistry of Materials, the researchers use a zeolite, an aluminosilicate mineral that has a three-dimensional cage structure. Zeolites have been shown to be able to store and release nitric oxide and other chemicals. They embed the mineral in fibers of a biocompatible polymer, polylactic acid, as they are spun and form a tissue-like mat. The fibers are then infused with nitric oxide; by controlling the porosity of the fibers, the researchers could control the release of the gas.
The researchers say the resulting material could be incorporated into socks for diabetics that would deliver nitric oxide through the skin. It might also prove useful before transplants as a wrapping for organs to help preserve them outside the body for longer.
More from the New York Times…
Abstract in Chemistry of Materials: Novel Delivery System for the Bioregulatory Agent Nitric Oxide
*This blog post was originally published at Medgadget*
March 27th, 2010 by Paul Auerbach, M.D. in Better Health Network, News, Opinion
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In a recent issue of Wilderness and Environmental Medicine (Volume 20, Number 2, 2009), Thomas Welch and colleagues have written an article entitled “Wilderness First Aid: Is There an Industry Standard?” The purpose of their inquiry was to determine if an “industry standard” exists for wilderness first aid training and certification of outdoor adventure and education leaders. To attempt to answer the question, they queried regulatory authorities, national organizations, and school/college groups with regard to their requirements for first aid training of their wilderness trek leaders.
They discovered that 10 or the 22 states with guide licensure programs required any first aid training as a condition of licensure, and none specified a specific course. Of the programs requiring such training, the requirements ranged from a 6-hour standard first aid course to more structured “wilderness first responder” (WFR or “woofer”) certification. Read more »
This post, “Backcountry” Injuries and Wilderness First Aid, was originally published on
Healthine.com by Paul Auerbach, M.D..
March 27th, 2010 by RyanDuBosar in Better Health Network, Health Policy, Humor, News
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Count the pens. News reports said that the president signed healthcare reform into law with either 20 (The New York Times) or 22 pens (Everyone else). The White House posted the ceremony on YouTube so you can count for yourself, starting at 25 minutes into the 27-minute ceremony, when Mr. Obama quips: “This is going to take a little while.”
The pens hits the page 22 times. But there’s only 11 letters in “Barack Obama” (add seven more for his middle name), so he’s clearly having to sign partial letters.
There’s a long history to this practice, which creates historical artifacts and gifts. President Kennedy used his middle name and flourishes to stretch things out. President Lyndon Johnson used 75 pens to sign the Civil Rights Act, with one of the first going to Martin Luther King, Jr., and then key legislators. Here’s a list of who’ll get the 22 pens. (New York Times, Los Angeles Times, TIME, Washington Post)
*This blog post was originally published at ACP Internist*
March 26th, 2010 by Happy Hospitalist in Better Health Network, Humor, Opinion
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From the Tonight Show and the Jay Leno News Service comes this morsel of information about doctors, nurses, patients and hospitals. According to Jay, a Men’s Health poll indicates that 65 percent of men would prefer a sexy nurse over a competent doctor. That’s shocking, but not surprising. I suppose it takes a lot of pressure off the doctors for a perfect hospital outcome. Unless, of course, the nurse happens to be ugly.
I can see it now: In an effort to improve patient satisfaction and reduce malpractice risk, hospitals just need to fire the ugly nurses and keep the hot ones. In fact, as a hospitalist, my malpractice risk depends on it. Forget about all the other quality improvement junk we put ourselves through. I’d put my money on hot nurses any day.
*This blog post was originally published at The Happy Hospitalist*
