Wednesday, April 24, 2013

If you play they will come

We were doing clinical at Hillside today. The residents do love an impromptu piano concert! I'm always happy when we have someone to oblige.

UTAH CNA SCHOOLS, UTAH CNA CLASSES, UTAH CNA TRAINING, TWO WEEK CNA CLASS

Sunday, April 21, 2013

CNA class virtual day

Having fun at CNA class

CNA class Salt Lake City

CNA Salt Lake weekend class

CNA Salt Lake weekend class

CNA Salt Lake weekend class

CNA Salt Lake weekend class 

CNA Salt Lake weekend class

CNA Salt Lake weekend class
Utah CNA class
CNA class Salt Lake
CNA Training Utah

CNA Salt Lake weekend class
Utah CNA class
CNA class Salt Lake
CNA Training Utah

CNA Salt Lake weekend class
Utah CNA class
CNA class Salt Lake
CNA Training Utah

CNA Salt Lake weekend class
Utah CNA class
CNA class Salt Lake
CNA Training Utah

CNA Salt Lake weekend class
Utah CNA class
CNA class Salt Lake
CNA Training Utah
CNA Salt Lake weekend class
Utah CNA class
CNA class Salt Lake
CNA Training Utah
CNA Salt Lake weekend class
Utah CNA class
CNA class Salt Lake
CNA Training Utah
CNA Salt Lake weekend class
Utah CNA class
CNA class Salt Lake
CNA Training Utah
CNA Salt Lake weekend class
Utah CNA class
CNA class Salt Lake
CNA Training Utah
CNA Salt Lake weekend class
Utah CNA class
CNA class Salt Lake
CNA Training Utah

Tuesday, April 9, 2013

Bed Baths: A Necessary (and Embarrassing) Evil

Bed Baths: A Necessary (and Embarrassing) Evil

Laurie Scudder, DNP, NP
Apr 01, 2013

Bed and Shower Baths: Comparing the Perceptions of Patients With Acute Myocardial Infarction

Lopes JL, Nogueira-Martins LA, de Barros AL

J Clin Nurs. 2013;22:733-740

Patients' Perceptions of Bed Baths

Hospitalization, particularly in intensive care, invariably involves a loss of personal space and privacy. Patients experience many invasive and unpleasant procedures. Bed baths may not be the worst of these procedures, but previous studies show that patients view them to be anxiety-provoking.
The purpose of the current study was to compare perceptions of bed and shower baths among patients hospitalized for acute myocardial infarction. The researchers also examined the impact of variables such as patient age, sex, sex of nursing personnel, and previous hospitalizations.

Study Summary

Methods. The study, conducted in Brazil, used a crossover design in which all patients received both treatments, allowing patients to serve as their own controls. Patients who were severely ill, experiencing arrhythmias or ischemic pain, or undergoing invasive procedures at the time of data collection were excluded. Patient perceptions were asked to evaluate both bathing experiences using scales that included responses such as "hygienic/antihygienic," "restful/tiresome," "pleasant/unpleasant," "good/bad," "relaxing/stressful," "necessary/unnecessary," and "independent/dependent." The evaluations occurred at the time of each patient's second bath and again at the time of the second shower bath, typically on the fourth or fifth day of hospitalization. A shower chair was provided and the shower bath occurred without direct assistance, although patients were supervised.
Findings. The sample included 71 patients with an average age of 58.8 years. Patients were more positive about shower baths than bed baths across all variables, and even those who reported negative experiences during bed baths considered the procedure to be necessary and hygienic. Patients who had experienced a previous hospitalization reported more negative perceptions of both bathing experiences. Although sex of the patient did not affect the overall evaluation of bathing, differences in individual scales were found between men and women. Half of the patients in the study indicated that they did not have a preference as to the sex of the person who performed their bath, but those who did have a preference and whose preference was met reported less embarrassment during bathing.

Viewpoint

That bed baths are uncomfortable and embarrassing for patients is certainly not news to nurses. What this study adds, however, is a quantitative description of just how unpleasant and anxiety-provoking the experience is for virtually all patients. All nursing personnel can benefit from the reminder that an everyday and routine part of nursing care is anything but ordinary for our patients. Furthermore, the researchers emphasize that bathing is often done without asking permission, putting nurses in a position of power over the patient.
This study has lessons that should affect practice. First, when possible, patients should be asked whether they have a preference about the sex of the person administering their bath and, if they do express a preference, that preference should be honored. Second, patients commented that the experience of receiving a bed bath engendered feelings of dependency. Lessening that dependency by allowing and encouraging patients to participate in the process may make this necessary procedure somewhat less unpleasant.
 

Monday, April 8, 2013

he Greek island of old age

The Greek island of old age


Stamatis Moraitis
The inhabitants of a small Greek island live on average 10 years longer than the rest of western Europe. So what's the secret to long life in Ikaria?
It could be the fresh air and the friendly, easy-going, open-door lifestyle. It could be fresh vegetables and goat's milk.
It could be the mountainous terrain. Everywhere on Ikaria is up, or down, so getting around keeps you fit.
It could even be the natural radiation in the granite rocks. But Stamatis Moraitis thinks he knows what it is.
"It's the wine," he says, over a mid-morning glass at his kitchen table. "It's pure, nothing added. The wine they make commercially has preservatives. That's no good. But this wine we make ourselves is pure."
Stamatis celebrated his 98th birthday on New Year's Day. He says he's older, but his documents put his date of birth as 1 January 1915. Outside his whitewashed house are his beloved olive trees, his fruit trees, and his vines. He makes about 700 litres of wine a year, he says.
"Do you drink it all yourself?" I ask. "No!" He's shocked at the suggestion. "I drink it with my friends."
Grapes
The wine, and convivial days spent with friends and family, helped make Stamatis a poster-boy for the healing effects of Ikaria. Forty-five years ago, living in the US, he was diagnosed with terminal lung cancer and given nine months to live.

Ikaria

Map showing Ikaria
  • The island, also spelled Icaria, is named after Icarus, the son of Daedalus, who fell into the sea near the island after flying too close to the sun, according to the myth
  • Its population is just over 8,000
  • 2.5 times as many people reach the age of 90 as in the US
By now he has a twinkle in his eye, and is in full flow. It's a story he has dined out on many times, and he clearly doesn't tire of telling it.
"I found my friends in the village where I was born, and we started drinking. I thought, at least I'll die happy."
"Every day we got together, we drank wine, and I waited. Time passed by and I felt stronger. Nine months came - I felt good. Eleven months came - I felt better. And now, 45 years later, I'm still here!"
"A few years ago I went back to the US and tried to find my doctors. But I couldn't find them. They were all dead."
There are lots of stories like this one on Ikaria. Some may well be just stories, but in recent years scientists and doctors have beaten a path to the island not far off the coast of Turkey to find out the real story.
Ikaria
Ikaria got its name from the Greek myth of Icarus who, legend has it, plunged into the sea close to the island when his wax and feather wings melted. For centuries it was known as a health destination because of natural hot springs on the island.
More recently it has been identified as one of a small number of so-called "blue zones" by the author Dan Buettner and National Geographic, where residents enjoy great longevity. Other places include Okinawa in Japan, Sardinia in Italy, and Loma Linda in California.

A life less ordinary

Stamatis Moraitis
  • Born in Evdilos, Ikaria, in 1915
  • Shot in the arm in WWII and escaped to Turkey, then spent time recovering in Chatham, UK, before settling in the US in 1943
  • Met Greek-American wife Alice and had three children, settled in New Jersey and later Florida
  • Established a painting and decorating firm operating in New York, now run by his son
  • Diagnosed with lung cancer in the 1960s, given nine months, returns to Ikaria
  • Says his father was 117 when he died
  • Tends his 200 olive trees, harvests olive oil and produces about 700 litres of red wine a year
  • Wife Elpiniki - known as Alice - dies, in January 2012 aged 84, after 68-year marriage
  • Grandson Christopher now spends a lot of time looking after him, helping with the olive trees
The most comprehensive work on Ikaria has been done by the University of Athens, whose researchers studied islanders aged over 65. On average, the 8,000 residents live 10 years longer than most Europeans and in much better health to the end.
There are many significant factors about the islanders' lifestyle which might contribute to their longevity.
Even compared to a typical Mediterranean diet, Ikarians eat a lot of fish and vegetables, and relatively low levels of meat.
Six out of 10 of people aged over 90 are still physically active, compared with about 20% elsewhere. Most food is cooked in olive oil. Large quantities of wild greens and herbs are gathered from the hillsides for both food and medicinal purposes.
Many older people make a daily brew of mountain tea from dried herbs such as sage, thyme, mint, and chamomile, and sweeten it with honey from local bees. "It cures everything," claims Stamatis.
Many of the wild herbs are used by people all over the world as traditional remedies. They are rich in antioxidants and also contain diuretics which can lower blood pressure.
The researchers believe other elements of lifestyle are also significant.
Rates of smoking are relatively low, mid-day naps are the norm, the pace of life is slow and people socialise frequently with friends and family, drinking moderate amounts of wine.
Extended families give older people an important role in society. Levels of depression and dementia are low.
Stamatis Moraitis: "Here it is clean, you breathe pure oxygen"
Dr Christina Chrysohoou, a cardiologist from the University of Athens who has studied the islanders, says they suffer the same sorts of diseases like cancer and cardiovascular problems as others elsewhere, but later in life.
"Ikaria gives us an opportunity to study why these people enjoy these beneficial effects. We can't avoid these diseases, but they manage to preserve the quality of their life for many years. The mean age for cardiovascular disease is about 55 to 60. In Ikaria it comes about 10 years later."
Future lines of enquiry for the university include geological studies into whether naturally occurring radioactive elements such as radium could have an effect on cancers.
Stamatis with classmates Stamatis, shown here in the early 1920s, was born on the island to which he returned in later life
There is also genetic research which compares islanders with Ikarians who have emigrated and therefore live a different lifestyle.
Meeting some of the oldest islanders makes you appreciate their span of time.
The dining table is laden with delicious Ikarian delicacies. "It's just a little snack," insists Voula, wife of 102-year-old George Kassiotis, as he pulled out his identity card showing his date of birth in 1910 and talked about his early life.
Ikaria
On his sideboard are photos of him in the Greek cavalry in 1931. He fought the Italians in Albania during World War II and later helped build the first metalled road on the island before retiring in 1970.
"I don't eat processed food, I don't smoke and I don't get stressed," says George Kassiotis. "I'm not worried about death. We know that we all are going to go there."
 

Other 'long life' spots

  • Island of Okinawa, Japan
  • Loma Linda, California, US
  • Nuoro province, Sardinia
  • Nicoya Peninsula, Costa Rica
The younger generation seem to be keeping traditions going. We ate another meal at the home of Nikos Karoutsos, a hotel owner in his 50s, and witnessed the sight of many friends and family, popping in for a drink and something to eat.
"We don't have nightclubs or discos," he says, as people chinked glasses filled with red wine poured from large plastic flagons. "The door is always open, there's no need to call and ask to come."
Meanwhile, the teenage children drifted between the table and the computer in the corner to chat on Facebook.
Back at the home of 98-year-old Stamatis Moraitis, we left him up a ladder picking olives from one of his trees.
"I'm happy I can still do it," he says with a laugh. "I feel so much healthier up here."

 

Sunday, April 7, 2013

C difficile Prevention Efforts Increase, but Results Lag

C difficile Prevention Efforts Increase, but Results Lag

Mar 12, 2013
Although healthcare centers have increased their intervention efforts to prevent Clostridium difficile infection (CDI) rates during the past 3 years, they have not experienced equal declines in associated CDI rates, according to a national survey of infection preventionists released March 11 at the Clostridium difficile Educational and Consensus Conference presented by the Association for Infection Control and Epidemiology (APIC).
Although 70% of survey respondents said they have implemented additional interventions since March 2010, only 42% have seen a decline in facility-associated CDI rates; 43% have not seen any decline. In addition, 75% had been performing CDI surveillance before the reporting requirements of the Centers for Medicare & Medicaid Services went into effect in January 2013.
Hiring is not increasing as it should, either: Only 21% of the respondents said they have added prevention staff since March 2010.
"We are encouraged that many institutions have adopted stronger measures to prevent CDI, but as our survey indicates, more needs to be done to reduce the spread of this infection," Jennie Mayfield, BSN, MPH, CIC, APIC president-elect and clinical epidemiologist at Barnes-Jewish Hospital, St. Louis, Missouri, said in a news release. "We are concerned that staffing levels are not adequate to address the scope of the problem."
CDI appears to be on the rise in the United States and is associated with 14,000 deaths each year, according to the Centers for Disease Control and Prevention. CDI, in addition to being potentially life-threatening, also causes diarrhea and other serious intestinal problems.
APIC surveyed its US membership of 14,000 preventionists, including nurses, physicians, public health professionals, and medical technologists, of whom 1087 members responded completely. Those who have not been more aggressive against CDI in the last 3 years most often cited preexisting best-practices programs before 2010.
Practices Vary
Isolation practices vary widely among healthcare facilities, which for this survey included centers for acute care (78%), long-term care (9%), ambulatory care (4%), and other services (9%). Although 42% keep patients with CDI in isolation the entire duration of their stay, 25% keep patients in isolation until treatment has started and no diarrhea has occurred within 48 hours. No national isolation practice recommendation exists.
For patient practices, 77% of respondents said they promote soap-and-water handwashing but also offer alcohol-based hand rubs. "Current opinions regarding the use of handwashing with soap and water instead of [hand rubs] are conflicting," the APIC says in the survey results.
Almost all (92%) respondents said they have increased emphasis on environmental cleaning practices since March 2010, but 64% said they are monitoring efforts only by observation rather than with monitoring technologies, and 14% percent said room cleaning was not monitored. Although 67% said they use bleach for cleaning rooms, only 9% said they have used an emerging disinfectant such as ultraviolet light or vaporized hydrogen peroxide.
Among other findings, 60% had antimicrobial stewardship programs compared with 52% in 2010, 85% of preventionists have participated in educational sessions, and 50% have started patient-education programs.
Most (78%) respondents said they have used the APIC Implementation Guide on CDI to help make improvements.
 

Gloves Are No Substitute for Proper Hand Hygiene

Gloves Are No Substitute for Proper Hand Hygiene

Richard T. Ellison III, MD
Journal Watch 

Abstract and Introduction

Abstract

Healthcare workers frequently neglect hand hygiene when they use gloves.

Introduction

Although the use of latex gloves by healthcare workers (HCWs) can protect against transmission of pathogens, gloves are subject to perforation, and contamination can occur when the gloves are donned or removed. Consequently, WHO guidelines recommend that gloves be changed between patients and that hands be cleaned both before putting on gloves and after removing them. Investigators recently assessed compliance with these guidelines in 56 wards in 15 hospitals in the U.K. that were participating in a larger national study on HCWs' hand hygiene.
Overall, gloves were used in 26% of 7578 HCW hand-hygiene "moments." They were worn in 17% of low-risk contacts (when they would not have been clinically indicated) but were not worn in 25% of high-risk contacts (when they would have been indicated). The rates of hand-hygiene compliance before and after patient contact were 30% and 47%, respectively, when gloves were worn — significantly lower than those observed when gloves were not worn (40% and 52%).

Comment

This study highlights an apparent lack of knowledge among HCWs regarding the need for hand cleaning before and after glove use. Education should be intensified in this area.

References

  • Fuller C et al. "The dirty hand in the latex glove": A study of hand hygiene compliance when gloves are worn. Infect Control Hosp Epidemiol 2011 Dec; 32:1194.
 

Healthcare Workers View Hand Hygiene Reminders Unfavorably

Healthcare Workers View Hand Hygiene Reminders Unfavorably

Joe Barber Jr, PhD
Sep 04, 2012 September 4, 2012 — Healthcare workers do not appear to support being reminded to wash their hands by patients, according to the findings of a cross-sectional study.
Yves Longtin, MD, from Centre Hospitalier Universitaire de Quebec in Quebec City, Canada, and colleagues presented their findings in an article published online September 3 in the Archives of Internal Medicine.
The authors mention that the concept of having patients remind healthcare workers about the importance of hand hygiene has been promoted. "This strategy has been recommended by a large number of organizations and authorities worldwide, including the World Health Organization and the US Centers for Disease Control and Prevention," the authors write. "However, very little is known about [healthcare workers'] views of such programs."
The authors sent anonymous, confidential surveys to the home addresses of 700 healthcare workers in a single institution in 2009 and assessed the views and opinions of the respondents by using a 5-point Likert scale (from 1, strongly agree, to 5, strongly disagree). Of the 277 respondents (41.1% response rate), 29% did not wish to be reminded by patients to wash their hands, 27% believed that this request was beyond the bounds of the patient's role, and 37% did not wish to wear a name badge that prompted patients to remind them about hand hygiene.
Multivariate analysis revealed that the endorsement of patient inquiry was positively associated with the belief that patients could help prevent medical errors (adjusted odds ratio [AOR], 8.4; 95% confidence interval [CI], 3.2 - 22.1; P < .001) and improve healthcare worker hand hygiene compliance (AOR, 6.4; 95% CI, 2.4 - 16.8; P < .001).
Conversely, support for patient inquiry was negatively associated with the concepts that neglecting hand hygiene was inconsequential (AOR, 0.1; 95% CI, 0.02 - 0.5; P = .006), that patient inquiry would be embarrassing (AOR, 0.3; 95% CI, 0.1 0.8; P = .02), and that patient inquiry would question their competency (AOR, 0.4; 95% CI, 0.2 - 1.0; P = .05).
This study was limited by its low response rate, its single-institution nature, and the possibilities of participation and desirability biases.
The authors note that the low rate of endorsement of patient inquiry might be explained by the embarrassment associated with the admitted omission of hand washing. "Similar to their tendency not to disclose minor medical errors, [healthcare workers] may prefer to keep patients in relative ignorance regarding appropriate hand hygiene behavior to avoid delicate situations," the authors write. "Support from HCWs is central to the success of patient participation endeavors, and failure to enlist their open support may undermine the outcome of such programs."
This study was partially supported by the Swiss National Science Foundation for hand hygiene research activities. The authors have disclosed no relevant financial relationships.
Arch Intern Med. Published online September 3, 2012.   

Morning-After Pill Must Be OTC for All Ages, Judge Rules

Morning-After Pill Must Be OTC for All Ages, Judge Rules

Robert Lowes
Apr 05, 2013
In a decision praised by several leading medical societies, a federal judge today ordered the US Food and Drug Administration (FDA) to make an emergency oral contraceptive known as the morning-after pill available to all adolescent girls without a prescription within 30 days.
Previously, the emergency contraceptive formulation of levonorgestrel marketed as Plan B One-Step (Teva Pharmaceuticals), a 1-pill version of Plan B, could be bought over the counter (OTC) by women aged 17 years and older and men aged 18 years and older. Adolescent girls younger than 17 years could obtain the drug and other forms of emergency contraception only by prescription.
An FDA advisory committee in 2011 recommended lifting the prescription requirement, concluding that the morning-after pill could be used safety by all girls of reproductive age, but Health and Human Services Secretary Kathleen Sebelius nixed that idea, saying that 11-year-old girls having periods lacked the maturity to use the drug.
In a suit filed by reproductive rights groups challenging the FDA position, Senior US District Judge Edward Korman in New York City ruled that the government's position on the morning-after pill is "arbitrary, capricious, and unreasonable."
The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Society of Adolescent Health and Medicine immediately applauded the ruling.
"This decision reflects the overwhelming evidence that emergency contraception is safe and effective for all women of reproductive age," the societies said in a press release.
 

Too Shy to Ask for a Wash and Dry?

Too Shy to Ask for a Wash and Dry?

Angela Hewlett, MD, MS
Feb 25, 2013

Do Patients Feel Comfortable Asking Healthcare Workers to Wash Their Hands?

Ottum A, Sethi AK, Jacobs EA, Zerbel S, Gaines ME, Safdar N

Infect Control Hosp Epidemiol. 2012;33:1282-1284

Survey Summary

Can we rely on patients to request handwashing compliance from their caregivers? The answer is probably "no," according to this survey conducted by Ottum and colleagues and published in the December 2012 issue of Infection Control and Hospital Epidemiology. Two hundred patients who were identified as being at risk for various healthcare-associated infections were surveyed to measure patient awareness of these infections. The survey also included several questions about hand hygiene.
Almost all of the survey respondents (99.5%) agreed that healthcare workers are supposed to wash their hands before and after caring for patients. Similarly, 90.5% of respondents felt that they should remind healthcare workers to wash their hands. However, only 64% of patients surveyed reported that they would feel comfortable asking their nurses to wash their hands, and only 54% felt comfortable asking their doctors to wash their hands. Only 14% of patients reported having ever asked a nurse or doctor to wash his or her hands in the past.

Viewpoint

Empowering patients to assist in the hand hygiene compliance of healthcare workers sounds like an excellent idea. However, this survey indicates that although it is almost universally accepted that healthcare workers should wash their hands, patients do not necessarily feel comfortable asking them to do so. The study is limited by the small sample size and single center, but the findings highlight that patient-centered hand hygiene campaigns may need to focus on making patients feel comfortable asking their caregivers to wash their hands, instead of merely emphasizing the importance of performing hand hygiene.
Abstract
 

UTAH CNA JOB OPENING

Hi Carol,
I have 1 ½  (ha ha) opening for SN and HA.  I could use 2 of each, with the goal to make it to full time for both-to start they would be part time. If you know of anyone that is looking for either position-home health and hospice experience would be a plus-send them my way.
Thanks
Donna

Donna Nolder
Director of Nursing




   Salt Lake City Branch
   Office   (801) 261-3023
       Fax       (801) 262-2872

Live Today



Obama Unveils Vast Brain-Mapping Project

Obama Unveils Vast Brain-Mapping Project

10-year initiative, with $100 million funding in 2014, designed to lead to breakthroughs for diseases like Alzheimer's, Parkinson's

By Margaret Farley Steele
HealthDay Reporter TUESDAY, April 2 (HealthDay News) -- The Obama administration unveiled plans Tuesday for a mammoth and unprecedented study of the mysterious inner workings of the human brain.
President Barack Obama, who first cited the need for brain research in his State of the Union address in February, asked Congress to commit $100 million in 2014 for the 10-year project, which will record and map brain circuits in action.
The initiative will involve scientists, government agencies and private foundations teaming up to create a detailed map of the brain, which is composed of billions of neurons, or nerve cells. The hope is the findings will lead to a better understanding of brain disorders such as Alzheimer's, Parkinson's and autism, as well as psychiatric conditions and brain injuries.
The White House said in a statement Tuesday that the goal of the project -- called the BRAIN Initiative, for Brain Research through Advancing Innovative Neurotechnologies -- will be "to revolutionize our understanding of the human mind" and create jobs.
The president told scientists gathered in the White House East Room that the research, which he called one of the administration's "Grand Challenges," has the potential to improve the lives of billions of people worldwide, according to the Associated Press.
"As humans, we can identify galaxies light-years away," Obama said. "We can study particles smaller than an atom, but we still haven't unlocked the mystery of the three pounds of matter that sits between our ears."
The effort will require new tools, not yet available to neuroscientists, that need to be developed to record hundreds of thousands of neurons at once. And, as part of the initiative, Obama was expected to require a study of the ethical and legal implications of such advances in neuroscience, The New York Times reported.
Three government agencies -- the National Institutes of Health, the Defense Advanced Research Projects Agency and the National Science Foundation -- are involved. A working group at the NIH, headed by Cornelia Bargmann of Rockefeller University and William Newsome of Stanford University, will define the goals and develop a multi-year plan.
In a statement, the White House named the private-sector partners as The Allen Institute for Brain Science, the Howard Hughes Medical Institute, the Kavli Foundation, and the Salk Institute for Biological Studies.
Supporters of the initiative said it could have an impact similar to the Soviet Sputnik satellite in the 1950s, when the United States responded with a significant nationwide effort to invest in science and technology, according to the Times.
And scientists hailed the premise.
"Right now, a billion people worldwide suffer from brain disorders and we have very little capacity to prevent them, treat them, or cure them. Making the 'Brain' project a high priority for decades to come should have a very powerful impact on disorders of the human brain," said John Morrison, dean of the Graduate School of Biomedical Sciences at the Icahn School of Medicine at Mount Sinai in New York City.
He added, "It will elevate our capacity to develop prevention strategies, treatment, and cures over the next few decades, with the clearest target being Alzheimer's disease... The neuroscience community is extremely pleased to see the brain put at such a high priority by the White House."
Harry Johns, president of the Alzheimer's Association and a member of the National Alzheimer's Plan Advisory Committee, added, "The Alzheimer's Association applauds the President for underscoring the critical need for research to better understand the mysteries of the brain."
Dr. Raj K. Narayan, director of North Shore-LIJ's Cushing Neuroscience Institute in Manhasset, N.Y., said the "initiative has the potential of turbo-charging neuroscience research. The working group has been given responsibility of developing a strategic plan to use the money effectively. The committee has good leadership and we look forward to their recommendations and hope that these initiatives will bring scientists into closer working relationships with clinicians."
Other experts had welcomed news of the project after Obama's remarks in February.
"This initiative has the potential to revolutionize our understanding of neural circuits, providing the fundamental knowledge that is critical for developing treatments for a host of neurological and psychiatric disorders," said Dr. David Fitzpatrick, scientific director and chief executive officer of the Max Planck Florida Institute for Neuroscience, in Jupiter, Fla.
Dr. Ashesh Mehta, head of the Laboratory of Multimodal Brain Mapping at the Feinstein Institute for Medical Research in Manhasset, N.Y., said the advent of new brain-mapping technologies has brought "an explosion of information in recent years, and the need to coordinate and synthesize this information from the single neuron to the whole brain is upon us now.
"This [the brain project] would not only pave the path toward treating neurological and psychiatric disorders such as Alzheimer's disease, autism, depression and paralysis," Mehta added, "but it will also help us develop better technology."
Scientists hope the effort will have the same wide-reaching effect on brain research and knowledge that the Human Genome Project had on genetics. When it was completed in 2003, the 13-year Human Genome Project had mapped all of the genes in human DNA and cost $3.8 billion.
In his State of the Union remarks, Obama said, "Every dollar we invested to map the human genome returned $140 to our economy. Every dollar."
The White House added a fresh perspective to that Tuesday morning.
"As a result of that daunting but focused endeavor, the cost of sequencing a single human genome has declined from $100 million to $7,000, opening the door to personalized medicine," the statement said.
More information
The U.S. National Institute of Mental Health has more about brain basics.
SOURCES: John Morrison, professor of neuroscience, dean of the Graduate School of Biomedical Sciences, Icahn School of Medicine, Mount Sinai, New York City; Harry Johns, president and CEO, the Alzheimer's Association; Ashesh Mehta, M.D., head of the Laboratory of Multimodal Brain Mapping, Feinstein Institute for Medical Research, Manhasset, N.Y.; Raj K. Narayan, M.D., director of North Shore-LIJ's Cushing Neuroscience Institute, Manhasset, N.Y.; David Fitzpatrick, M.D., scientific director and chief executive officer, Max Planck Florida Institute for Neuroscience, Jupiter, Fla.; April 2, 2013, news release, The White House; The New York Times; Associated Press
Last Updated: April 02, 2013
Health News Copyright © 2013 HealthDay. All rights reserved

Less Salt, More Potassium = Millions of Lives Saved

Less Salt, More Potassium = Millions of Lives Saved

Modest dietary changes would reduce risk of stroke, heart disease, studies confirm

THURSDAY, April 4 (HealthDay News) -- Reducing dietary salt intake and boosting levels of potassium would prevent millions of deaths from heart disease and stroke worldwide each year, according to three new studies.
The new studies, which reviewed prior research, were published online April 4 in the BMJ.
One study examined the findings of 34 clinical trials involving more than 3,000 adults and found that a modest reduction in salt intake led to significant decreases in blood pressure, leading to a reduced risk of heart attack, stroke and heart failure.
Similar findings were reported in another study that reviewed 56 previous studies. It found that reducing salt consumption led to lower blood pressure and a decreased risk of stroke and fatal heart disease in adults.
There was also evidence that reduced salt intake lowered blood pressure in children.
A third study analyzed data from 33 clinical trials that involved more than 128,000 people and found that increased potassium intake reduced blood pressure in adults and reduced their risk of stroke by 24 percent.
Higher potassium intake may also benefit children, but more research is needed, the study authors said.
Potassium is found in most fresh fruits and vegetables and in legumes, such as beans and peas.
The World Health Organization has set a global goal to reduce dietary salt intake to 5 to 6 grams (about one teaspoon) per day by 2025. However, the study researchers and some other experts recommend a further reduction to 3 grams per day.
More information
The U.S. National Heart, Lung, and Blood Institute explains how to reduce your salt intake.
-- Robert Preidt
SOURCE: BMJ, news release, April 4, 2013

UTAH CNA CLASSES
UTAH CNA TRAINING
UTAH CNA SCHOOLS
TWO WEEK CNA CLASSES
TWO WEEK CNA COURSES
SALT LAKE CNA CLASSES
SALT LAKE CNA TRAINING
UTAH CNA CLASSES
UTAH CNA TRAINING
UTAH CNA SCHOOLS
TWO WEEK CNA CLASSES
TWO WEEK CNA COURSES
SALT LAKE CNA CLASSES
SALT LAKE CNA TRAINING
UTAH CNA CLASSES
UTAH CNA TRAINING
UTAH CNA SCHOOLS
TWO WEEK CNA CLASSES
TWO WEEK CNA COURSES
SALT LAKE CNA CLASSES
SALT LAKE CNA TRAINING
UTAH CNA CLASSES
UTAH CNA TRAINING
UTAH CNA SCHOOLS
TWO WEEK CNA CLASSES
TWO WEEK CNA COURSES
SALT LAKE CNA CLASSES
SALT LAKE CNA TRAINING
UTAH CNA CLASSES
UTAH CNA TRAINING
UTAH CNA SCHOOLS
TWO WEEK CNA CLASSES
TWO WEEK CNA COURSES
SALT LAKE CNA CLASSES
SALT LAKE CNA TRAINING
UTAH CNA CLASSES
UTAH CNA TRAINING
UTAH CNA SCHOOLS
TWO WEEK CNA CLASSES
TWO WEEK CNA COURSES
SALT LAKE CNA CLASSES
SALT LAKE CNA TRAINING
UTAH CNA CLASSES
UTAH CNA TRAINING
UTAH CNA SCHOOLS
TWO WEEK CNA CLASSES
TWO WEEK CNA COURSES
SALT LAKE CNA CLASSES
SALT LAKE CNA TRAINING
UTAH CNA CLASSES
UTAH CNA TRAINING
UTAH CNA SCHOOLS
TWO WEEK CNA CLASSES
TWO WEEK CNA COURSES
SALT LAKE CNA CLASSES
SALT LAKE CNA TRAINING

Generational Diversity: Implications for Nurse Staffing

  



Generational Diversity: Implications for Nurse Staffing With four generations of nurses on some teams, managers face new challenges. Up to four generations of nurses may be found working together in some cases, creating new challenges for managers and recruiters.

By Bonnie Clipper, DNP, RN, MA, MBA, CENP, FACHE

It takes an entire team of interdisciplinary professionals working together to provide safe and high quality patient care.
Within that larger team, nursing forms its own teams to collaborate each and every day to make sure their patients' needs are met.
The healthcare environment and the nursing workplace has become more complex than ever and is increasingly dependent upon contributions from each team member to ensure that patients receive the care they require in an efficient and cost effective manner.
Some of the complexity in today's workplace is due to an increase in documentation requirements, inefficient processes and an increasingly diverse workforce.
Dimensions of Diversity
The diversity seen in today's workplace includes a variety of dimensions, such as gender, ethnicity, religion and generational diversity.
Generational diversity is apparent as there are currently four generations in the workplace: the traditionalists (aka: the greatest generation/silent generation/veterans), baby boomers (aka: boomers), Generation X (aka: X'ers) and the millennials (aka: Generation Y, Y'ers, echo boomers).
There is also an emerging generation that remains un-named. Not surprisingly, each generation has its own way of doing things and seeing the world, which is based upon their shared life experiences.
More than ever before, there is a wide range of age groups working side by side within hospitals. This is the first time that there are four generations of workers and three generations of leaders in the same work environment. In any given organization, 20-year-olds through near-80-year-olds may be working in the same department.

This staffing situation is not unique to nursing, or even to healthcare, and it is present in all industries. That span of six decades includes a very diverse group of people, all with different attitudes, expectations, morals, beliefs, values, desires and life experiences.

Generations have a "personality" that is often common to each generational cohort or group,1 but they can't be stereotyped. Also, there are generally some common characteristics that are likely to differ across the generations. Knowing these differences may improve the performance of nursing teams in their pursuit of proving the best patient care possible.
Working Styles


You may be able to tell from experience that there are many different perceptions and expectations of performance and work ethic among each of the generations.
Traditionalists Generally speaking, traditionalists have a strong work ethic and are willing to work hard for the goals of the organization. They work hard to complete a job in a quality manner. They are proud of the product of their hard work and take responsibility for their performance. 
Baby Boomers Overall, boomers enjoy work, often make the choice to "live to work" and put in many hours.  They are personally gratified when they perform well at work. This is also a very competitive cohort by nature that insists that their work is done to the best of their ability and will often beat deadlines. Just like graded assignments, their work is evident in the outcome of whatever it is that they are working on, and this group strives for the "A." 

Generation X'ers
As a cohort, X'ers, generally work because it is a necessity. This group continually strives for optimal work-life balance and looks for the personal benefit of the work that they are doing.  X'ers don't mind working hard, but they typically expect something in return, such as job security, good pay, promotions, flexible schedules, etc. This group is willing to be a team player as long as they like the team and enjoy what they are doing. If the final outcome isn't done as well as it could have been, this group is often un-phased and is willing to just move on to the next task.
Melinnials As a whole, millennials don't need their work to define them, so they can take it or leave it. As a cohort that gets bored easily, they are willing to work hard as long as they perceive an equivalent benefit to them personally, such as career advancement or financial rewards. A good performance by this group means that all of the variables must be in their favor, the right resources, the right team (no conflict among the team as this group prefers group processes/ ecisions) and the right reasons to do it. This generation has difficulty taking accountability for their actions and work; a poor performance is usually not "their fault."
Understanding Each Other
The differences in the level of performance or work ethic can cause conflict and tension in the workplace among coworkers. The reason for this is that each generation may use its own value system as the measurement tool when comparing themselves to their colleagues.

Nurse leaders need to be clear on workplace expectations so that everyone understands the goals, and nurses need to learn how to accept their colleagues' differences in work performance.
This does not mean that you have to accept poor performance, as generational diversity is not an excuse and poor performance should be addressed appropriately.

Nurse leaders should foster the culture of inclusivity and encourage their staff to learn and understand the generational differences that are behind the perceptions of work ethic and performance, so that colleagues can appreciate how the attitude and expectation has been formed.
Understanding breeds acceptance, and acceptance helps teams to function as optimally as possible. This is an opportunity for nurse leaders to use performance improvement as a model to enhance team dynamics as well as to strengthen their own performance as a nurse leader.2 We cannot change each other's formative experiences and attitudes; understanding and acceptance is the best we can do to help us learn to work together.
In order to ensure that all patients receive the highest quality of care possible, it is essential that all team members try to not only understand but also value their colleagues' contributions. It is also helpful to know the strengths and weaknesses of teammates so nurses can manage their own assignments accordingly.   
The goal is not to avoid these, but rather to try to understand them and navigate through them for optimal outcomes, where everyone wins.
Creating a culture of self-awareness, understanding and generational harmony is the best way to allow a team to function cohesively, yet maintain their uniqueness. A high-functioning team that works in an environment where diversity is accepted will promote safe patient care by improving communication and fostering trusting relationships among staff.
References1. Clipper B. (2012) The Nurse Manager's Guide to an Intergenerational Workforce.  Sigma Theta Tau.  Indianapolis, IN.
2. Cherry B, Sullivan DT & Yoder-Wise P.  What Does Leadership in a Diverse Environment Really Mean?  Voice of Nursing Leadership.  2013;11(1): 12-13.
Bonnie Clipper is associate vice president for professional nursing practice and development at St. David's HealthCare in Austin, Tex., and co-chair of the Central Texas Health Industry Steering Committee. She is the author of  The Nurse Manager's Guide to an Intergenerational Workforce.

CNA Class (funny things)

What's different about me? (First day of class game)
5 kids in 4 years
shot a 6X7 30" deer while 9 months pregnant (OK, I think that's weird)
Bit by a monkey
Accidentally froze my puppy to death (OK, don't put be down for a job reference)
I broke my foot in front of 700 people during a band concert (I fell in a hole)
I've pierced my tongue three times (Seriously, stop doing it)
Never seen a Star Wars movie
I'm scared of speed bumps
Have a cat named puppy
Jumped down head first and had to get my eyebrow stitched back on
Went to three different high schools in one year
I take care of a 100 year old lady
Allergic to Fruit Loops
Been engaged for eight years
Punched in the face by Justin Bieber at a ski resort in Park City

UTAH CNA CLASSES
UTAH CNA STUDENTS
CNA TRAINING
CNA TWO WEEK COURSE