Becoming an Advanced Practitioner in Neonatal Nursing

This recently published article discusses the results of a study of the relationship between educational preparation and role development of neonatal nurses.

The aims of this research were to identify

• the educational and working experiences and
• subsequent training needs of graduates of one ANNP course in the UK

The objectives were

• to assess the medium to long-term impact of the training programme on the professional development of the respondents;
• identify potential areas of excellence and
• areas for improvement in this and other training programmes for ANNPs

The results were:

• attention needs to be paid to ongoing professional development particularly the management of professional role relationships among all nurses and between nurses and doctors
• training need to be relevance to clinical practice
• focus on professional role relationships and more effective communication in the clinical setting would be of benefit to all members of multi-disciplinary teams
• greater level of day-to-day support is required for ANNPs, other neonatal nurses and junior doctors if this is to be achieved, especially in clinical settings where there are few ANNPs or the addition of these clinical specialists is relatively new.

Read the full report:
Nicolson P, Burr J, Powell J. Becoming an advanced practitioner in neonatal nursing: a psycho-social study of the relationship between educational preparation and role development.
J Clin Nurs. 2005 Jul;14(6):727-38.

Conscience and Refusing to Deliver Care

Dr. Charo discusses the challenge that clinicians face when torn between their professional obligation to deliver care, and the conflict of that professionalism with her or his own moral inclinations.

Read this perspective
R.A. Charo The Celestial Fire of Conscience — Refusing to Deliver Medical Care N Engl J Med. 2005 Jun 16;352(24):2471-3.

And listen to Dr. Charo's commentary:
An Audio Interview with Professor R. Alta Charo

YSN Library June 20 - June 24

These are the hours that I will be in the Library this week.
Questions, comments, concerns, please email me: janene.batten@yale.edu

Monday 6/20
8:30 - 5:00
Class: 1:00-2:00pm EndNote Basics (TCC Medical Library)

Tuesday 6/21
Call Medical Library for assistance - 737-4065

Wednesday 6/22
8:30 - 5:00
Class: 5:00-6:00pm RefWorks Basics (TCC Medical Library)

Thursday 6/23
Call Medical Library for assistance - 737-4065

Friday 6/24
Call Medical Library for assistance - 737-4065

JCAHO Releases 2006 Patient Safety Goals

JCAHO recently announced its 2006 National Patient Safety Goals, retaining the same six goals from 2005 while adding three new requirements and removing three others.

Additions include

• "New Requirement in all of the programs that "hand-offs" of patients between caregivers be standardized, with particular attention to assuring the opportunity for asking and responding to questions"
• "New Requirement for all types of accredited organizations which provide surgical or other invasive services, specifies that all medications, medication containers and other solutions used in perioperative settings are to be labeled"
• New Goals in other selected programs address the prevention of pressure ulcers and encourage the active involvement of patients and their families in the patient's care as a patient safety strategy

"The following requirements will be retired for all applicable accrediation programs in 2006:

• Elimination of the Requirement to remove concentrated electrolytes (including but not limited to potassium chloride, potassium phosphate, sodium chloride greater than 0.9 percent) from patient care units. This Requirement will continue to exist in relevant accreditation manuals.
• Retirement of a Requirement to ensure free-flow protection on all general-use and patient-controlled analgesia intravenous infusion pumps used in an organization. Compliance with this Requirement has been greater than 99 percent, and equipment manufacturing and availability issues for all health care setting have been satisfactorily resolved."

Full text of the 2006 Goals and Requirements can be found at the JCAHO site.

Oral Bacteria Can Cause Premature Deliveries

A recent study published in the Journal of Clinical Periodontology finds that there is a link between oral bacteria and pre-term deliveries and low birth weight.

The study was conducted with 297 low-income and predominantly African-American women in Alabama who were pregnant for the first time and found that those with high levels of certain oral bacteria had an increased risk of delivering prematurely and having babies with low birth weights. While such bacteria has been previously linked to pneumonia, heart disease, and diabetes, scientists say the new link between gum disease and pre-term delivery is the “strongest” to date. The study’s lead researcher says pregnant women should be encouraged to regularly visit a dentist and maintain good oral hygiene

To find out more, read the study:
Moreu, Gerardo, Téllez, Luís & González-Jaranay, Maximino (2005) Relationship between maternal periodontal disease and low-birth-weight pre-term infants. Journal Of Clinical Periodontology 32 (6), 622-627.

NIH Public Access Policy

As of May 2, 2005, the National Institutes of Health issued its “Policy on Enhancing Public Access to Archived Publications Resulting from NIH-Funded Research” (known as the NIH Public Access Policy). The policy requests that all NIH-funded investigators submit to PubMed Central (PMC) an electronic version of the author’s final manuscript, upon acceptance for publication. This policy applies to any journal articles resulting from research supported in whole or in part with direct costs from NIH. The manuscript is defined as the final version accepted for journal publication and includes all modifications from the publishing peer review process.

The NIH sees this policy as a mechanism to help them not only monitor and archive the output of research funded by NIH, but also ensure the availability of research results for the benefit of the public, health care providers, educators, and scientists.

To assist in understanding this policy the Medical Library has created a web page with information about the Public Access Policy and guides to help you through the process.

Portable Patient Medical Information Storage

Portable USB devices can now be used to store personal medical information. There are several versions including MedicAlert, Med-Info Chip and MedicTag that store general medical information, such as personal identification data, emergency contacts, and even photos. They also store information about prior and present medical conditions, allergies, immunizations, and prostheses. In addition, documents can be scanned into the UBS device, such as EKG results, birth certificates, and X-rays.

The devices are literally a thumb drive that can be plugged into any computer in order to access the medical information. The chip currently is not password-protected, but one developer from Boston University, is working on a dual password system that would allow clinicians to access the information in an emergency but prevent changes from being made. It is thought that having the device password protected would hinder doctors accessing the information in times of emergency.

The device developed in Boston comes in "garish yellow", can hang on your key chain, and sells for around $70 for a single user version, and $100 for a double-user version. The device is perfect for medical emergencies where clinicians can plug it in and retrieve data otherwise unknown about the patient.

The military have employed an Electronic Information Carrier (EIC) that give medics in the field fast access to a patient's history, and do not have the luxury of paper copies of records. Unlike the device developed in Boston, the military use a wireless device that is read by a handheld. In the event that there is no wireless signal, the EIC can be plugged in to the handheld just as the USB device can.

YSN Library June 13 - June 17

These are the hours that I will be in the Library this week.
Questions, comments, concerns, please email me: janene.batten@yale.edu

Monday 6/13
8:30 - 5:00
Class: 5:00-6:00 RefWorks Basics (TCC - Med Library)

Tuesday 6/14
Call Medical Library for assistance - 737-4065
Class: 12:00-1:00 Library 101 Basics of Library Use (TCC - Med Library)

Wednesday 6/15
Call Medical Library for assistance - 737-4065

Thursday 6/16
8:30 - 5:00

Friday 6/17
8:30 - 5:00

Managing Conflict at the End of Life

Great audio article in theis week's NEJM.

M. Gregg Bloche, M.D., J.D., Managing Conflict at the End of Life. N Engl J Med 2005;352(23):2371-3

Read the perspective and listen to the audio.

Dr. Bloche is a professor of law at Georgetown University and a guest scholar at the Brookings Institution, both in Washington, D.C., and an adjunct professor at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore.

YSN Library June 6 - June 10

These are the hours that I will be in the Library this week.
Questions, comments, concerns, please email me: janene.batten@yale.edu

Monday 6/6
8:30 - 3:00

Tuesday 6/7
Call Medical Library for assistance - 737-4065
Class: 5:00-6:00 EndNote Basics (TCC - Med Library)

Wednesday 6/8
8:30 - 5:00

Thursday 6/9
Call Medical Library for assistance - 737-4065

Friday 6/10
8:30 - 5:00

Combined Tetanus, Diphtheria, and 5-Component Pertussis Vaccine

Increasing reports of pertussis among US adolescents, adults, and their infant contacts have stimulated vaccine development for older age groups. A intramuscular 0.5 ml dose of either Tdap or tetanus-diphtheria vaccine (Td) was given to adolescents and adults aged 11 - 64 years.

Conclusions "This Tdap vaccine elicited robust immune responses in adolescents and adults to pertussis, tetanus, and diphtheria antigens, while exhibiting an overall safety profile similar to that of a licensed Td vaccine. These data support the potential routine use of this Tdap vaccine in adolescents and adults."

This is an early release article found in JAMA.
Read the entire article:
Pichichero, Michael E. et al. Combined Tetanus, Diphtheria, and 5-Component Pertussis Vaccine for Use in Adolescents and Adults JAMA published 2 June 2005