HELP in Dealing With Health Insurance Coverage and Appeals
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Consumers Union has a special Web site dedicated to helping consumers understand various healthcare programs, including insurance and coverage issues. A guide that can help you or your patients navigate a health plan's grievance procedure is available at the site:A Consumer Guide to Handling Disputes with Your Employer or Private Health Plan has four sections: 1. Understanding your coverage; 2. appealing through your plan; 3. Getting an independent opinion-external review in your state; and 4. state-by-state external review programs. Visit http://64.224.97.228/i/Health_Care/ for more information.
Does Statin Therapy Put Your Patient at Risk for Rhabdomyolysis?
Combining statins with other drugs such as fibrates, cholesterol inhibitors, and niacin are extremely efficient in the control and management of elevated low-density lipoproteins (LDLs). Because many of these drugs are excreted by the liver and kidneys it is extremely important that home care clinicians pay close attention to test results that measure the patient's liver and kidney function. In addition, assessments should focus on complications such as acute renal failure, hyperkalemia, and rhabdomyolysis.
Source: Federman, D. G, Hussain, F., Walters, J. B. (2001). Fatal rhabdomyolysis caused by lipid-lowering therapy. Southern Medical Journal, 94 ( 10 ), 1023-1026.
Patients on Warfarin Advised Against Drinking Cranberry Juice
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British drug safety experts have advised that patients taking warfarin should limit or avoid drinking cranberry juice because of the risk of hemorrhage. The Committee on Safety of Medicines has received five reports, including one in which the patient died, suggesting the juice and drug interact, and increasing the drug's potency.
The interaction is biologically plausible because cranberry juice contains antioxidants that inhibit cytochrome P450 activity, and warfarin is mainly metabolized by the P450 isoform CYP2C9. "Until this possible interaction between cranberry juice and warfarin has been investigated further, it would be prudent for patients taking warfarin to be advised to limit or avoid drinking cranberry juice," the committee reported.
Source:http://www.medscape.com/viewarticle/461711
Do Not Prefill Syringes With Glargine Insulin
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An issue important to home health relates to prefilling syringes with glargine insulin. The recommendation is... Don't Do It.
"How Long Should Insulin Be Used Once a Vial Is Started?" (Sept. 2003 issue of Diabetes Care) provides an excellent overview of the topic. Concerns about prefilling syringes with glargine are based on a study prefilling syringes from three different manufactures. By day three the Lantus insulin in all syringes visually appeared turbid because of its acid and, additionally, a pH a reaction with the plastic syringe occurs. Prefilling guidelines relative to other insulins:
Aventis... "does not recommend prefilling syringes with Lantus and storing for any period longer than needed for application."
"BD does not recommend any of their syringes be prefilled more than a few minutes in advance of injection."
Source:http://care.diabetesjournals.org/cgi/reprint/26/9/2665.pdf
New Online Resource Advances Community of Ethnic Minority Nurses
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The National Coalition of Ethnic Minority Nurse Associations (NCEMNA) has launched a Web site for the diverse community of ethnic minority nurses. NCEMNA is a coalition that includes the National Black Nurses Association, the National Association of Hispanic Nurses, the Asian American/Pacific Islander Nurses Association, Inc., the National Alaska Native American Indian Nurses Association, Inc., and the Philippine Nurses Association of America, Inc.
The Oncology Nursing Society (ONS) is developing and will maintain the Web site for NCEMNA as a way to support professional development; advocate for culturally competent, accessible, and affordable healthcare; promote professional and educational advancement of ethnic minority nurses; and educate consumers, healthcare professionals, and policy makers on health issues of ethnic minority populations. Visit the newly launched site at http://www.ncemna.org.
Only Charity for Nurses Needs YOUR Help
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Nurses House Inc. is a not-for-profit organization with the mission to help RNs in need. Founded in 1922 as a facility where RNs in need of all types of assistance could stay, the facility was sold in 1959; the proceeds were used to establish a trust that has supported the organization's mission.
Nurses House continues to extend short-term financial assistance to RNs experiencing difficulty due to injury, illness, or disability. In 2002 the organization granted over $100,000 to nurses in need of assistance with rent, mortgage payments, food, utilities, or health insurance. In addition, Nurses House assists the recipient to identify potential sources of long-term assistance and programs.
The organization is currently managed by a voluntary Board of RNs who directs a professional administrative staff. Nurses House is a charitable organization that accepts personal and memorial gifts. All contributions are tax deductible. If you would like to make a contribution or request assistance visit the organization's Web site at http://www.Nurseshouse.org or write to: Susan Fraley, Executive Director, Nurses House Inc., 2113 Western Avenue, Suite 2, Guilderland, NY, 12084-9559, phone: (518) 456-7855.