Med Errors
While nurses are familiar with the five rights of medication administration (right drug, right route, right dose, right patient, right time), do you know the six rights nurses have when administering medications? Nurse Michelle Colleran Cook noted these rights when testifying before the Joint Committee on Health Care:
1. Right to a complete and clear order
2. Right to have the correct drug, route, and form dispensed
3. Right to have access to medication information
4. Right to have policies to guide safe medication administration
5. Right to administer medications safely and identify system problems
6. Right to stop, think, and be vigilant when administering medications
7. -http://www.massnurses.org/News/1999/990600/sixrights.htm
U.S. Teens Vaccine Coverage Lags
The rates for recommended vaccinations lag for many teens, especially for some newer vaccines. The Healthy People 2010 vaccination goals for children ages 13 to 17 have yet to be met. This is especially true for the vaccines for diphtheria, tetanus, pertussis and chicken pox.
Dr. David Katz, director of Yale University School of Medicine's Prevention Research Center, said, "Immunization is on the short list of crowning achievements in the history of disease prevention." Katz also said it isn't surprising that teen vaccination rates lag behind those of younger children. "Young children are more subject to parental control and an easier audience to reach. As new vaccines increase the importance of immunizing adolescents, the need for innovative outreach programs to (reach?) get to this group increases," he said. -Forbes, 8-30-07
HPV Virus Linked to Oral Cancer in Men
The sexually transmitted virus human papillomavirus HPV, which causes cervical cancer in women, is on track to become one of the leading causes of oral cancer in men, according to a new study. Studies suggest oral sex is associated with HPV-related oral cancers. The study by Dr. Maura Gillison of John Hopkins University looked at more than 30 years of National Cancer Institute data on oral cancers.
Previous research established HPV as a primary cause of the estimated 5,600 cancers that occur each year in the tonsils, lower tongue, and upper throat. Gillison pointed toward sex as an explanation for the increase in male upper throat cancers. Research concluded the incidence rates for HPV-related oral cancers rose steadily in men from 1973 to 2004, becoming about as common as those from tobacco and alcohol.
Currently the only available vaccine against HPV is given to girls and young women. Merck plans to seek U.S. Food and Drug Administration approval for the vaccine in men later this year, meaning a government decision would be likely in 2009. -http://www.dallasnews.com/sharedcontent/dws/fea/healthyliving/health/stories/020
Veterans With Traumatic Brain Injuries (TBI)
As many as 20 percent of U.S. combat troops who fought in Iraq or Afghanistan may have had a concussion, and some do not realize they need treatment. Concussion is a common term for mild traumatic brain injury, or TBI. Symptoms of mild TBI can include headaches, dizziness, nausea, light sensitivity, sleep problems, memory problems, confusion and irritability. While the Army knows how to assess and treat more severe brain injuries, it is "challenged to understand, diagnose and treat military personnel who suffer with mild TBI," said Brig. Gen. Donald Bradshaw, chairman of a task force on traumatic brain injury created by the Army surgeon general.
TBI is the signature wound of the war. Reports that troops were not properly treated or diagnosed for the injury have led to improved care. Today, all troops brought to military treatment facilities from a war zone are screened for traumatic brain injury. But troops lacking more outward signs such as bleeding following a blast or other incident might not realize they experienced a concussion. One of the challenges in treating a mild traumatic injury is that it can have some of the same symptoms as post-traumatic stress disorder, such as difficulty sleeping.
The task force identified problems associated with the treatment of troops with traumatic brain injuries, such as inconsistent treatment and documentation, but said some of its recommendations have already been implemented. -http://www.msnbc.msn.com/id/22711522/
Meds and Pregnancy- Knowing the Risks
Healthcare workers need to increase efforts to warn women about the potential risks associated with pregnancy and some prescription drugs that can cause birth defects. Fewer than half of the women taking the medicines did not receive counseling from their healthcare provider about using birth control measures, University of Pittsburgh Medical Center researchers found in a study of nearly 500,000 women.
Medicines that may cause birth defects include some antibiotics, acne medications, cholesterol reducers, anti-seizure drugs, sleep aids, and blood thinners.
Researchers found that internists and family doctors prescribed the highest proportion-48% of the riskier drugs to women of childbearing age, with psychiatrists, dermatologists, and obstetricians/gynecologists far behind.
Research indicated that women on the acne drug isotretinoin, best known by the brand name Accutane, got more pregnancy prevention counseling than anyone else. Women taking statins for cholesterol received the least counseling. Anyone taking isotretinoin is required to use birth control, pass a pregnancy test before each monthly refill and enroll in a national registry. Despite that program, administrators in July reported that more than 120 women became pregnant in the previous year. -MSNBC/Associated Press, 9/17/2007. http://www.msnbc.msn.com/id/20826157/
Revised International Certificate of Vaccination or Prophylaxis Available
In compliance with the International Health Regulations (2005), the Centers for Disease Control and Prevention (CDC) has released a new International Certificate of Vaccination or Prophylaxis (ICVP). All yellow fever vaccines given after December 15, 2007, should be recorded on an ICVP. The ICVP replaces all versions of the International Certificate of Vaccination (ICV) currently in circulation. The CDC requests that all healthcare providers destroy any unused old certificates and begin using the new certificate.
Currently, yellow fever is the only disease under the International Health Regulations (2005) for which proof of vaccination may be required for travelers. Previously issued certificates remain acceptable proof of vaccination against yellow fever as long as the certificate is valid. -CDC website, http://wwwn.cdc.gov/travel/contentIntCertOfVaccination.aspx
-PulseBeats compiled by
Cathy Walker, JCN
Associate Editor