Paula Grech

The Joint Commission's 'Do Not Use' list is a set of medical abbreviations banned in healthcare settings to prevent confusion. Use this quick guide to steer clear of these risky shortcuts! 🙅‍♂️✅ #phlebotomy #phlebotomist #phlebotomyschool #medicalcareer #phlebotomytech

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This is why ALL policing systems, corrections, schools, healthcare and behavioral healthcare staff should have training on proper use of force, physical restraint and ethics training BEFORE they enter their fields. It should be ongoing. It should be updated. It shouldn’t be developed by police, it should be developed by experts! Did you know there is an entire industry dedicated to use of force and physical restraint? They know how to do it, they know how to teach it and they know how to train it. Why? Because in the UK, they don’t tie people to beds. What? How do they deal with violence? They treat it. What? You can’t treat violent ( #tactbook term: disorganized behaviors that are violent). Yes… you can. But it takes time, effort, training and staff resources… oh well we can’t possibly do that… it would cost us the money that we used when cutting all that out because we didn’t think you needed it. I mean nurses and teachers go to school right? They can’t possibly need extra training when they get out. We aren’t a bunch of nutcrackers made in a factory and shoved out to do our jobs. We are people. Caring for other people. In a scary, dangerous world. We need support. Robert F. Kennedy U.S. Department of Health and Human Services (HHS) We need your help. I know I’ve had moments where I didn’t know how to help my combative dementia patient. And had I had the training, I would have been so much more confident. Invest in the training. It will save your organizations, hundeds of nurses and teachers, at a time. Fortune Favors the Prepared TACTBook Doug Melia Keith Butchard MITOL

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Yet another study supporting that pay is NOT a factor for people leaving the #EMS industry and the EMS stafffing shortage. Top 3 reasons for both #EMTs and #Paramedics: 1) stress 2) COVID-19 3) Lack of educational opportunities and educational support. I’ll keep saying it, agencies who cut education to save money…you’re doing more harm than good for your agency. Want people to join and/or stay with your agency…offer a robust educational program and throw your full support behind EMS education! Read the research below for the facts…⬇️ https://lnkd.in/e8YVh2HB

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Quick summary of the latest CDC updates to its opioid prescribing guidelines, including 12 key recommendations and 5 guiding principles to aid in implementation https://lnkd.in/eXMdQTHt #opioids #medication #painmanagement #primarycare

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Updated changes in terminology related to hypertension: Elevated BP in the inpatient setting can be classified as asymptomatic elevated BP versus HTN emergency (elevated BP with signs of new or worsening target-organ damage). Importantly, there is no "hypertensive urgency". The AHA defines elevated inpatient BP as SBP > 130 or DBP > 80 mm Hg. If SBP is < 180 and DBP is < 110 mm Hg, that is asymptomatic elevated BP. If SBP is > 180 or DBP is > 110-120 mm Hg and the patient has no new/worsening target organ damage, that is asymptomatic markedly elevated BP. However, if SBP is > 180 or DBP is > 110-120 mm Hg and the patient does have new or worsening target organ damage, the patient has HTN emergency.  BP related target organ damage includes any harmful effects/injuries to the brain (hypertensive encephalopathy, intracranial hemorrhage, acute ischemic stroke), heart (acute myocardial infarction, unstable angina, acute left ventricular failure with pulmonary edema), large vessels (dissecting aortic aneurysm), kidneys, and the microvasculature (high-grade retinopathy, acute kidney injury, or microangiopathic hemolytic anemia and thrombocytopenia). This can be recalled with the "BARKH" acronym (brain, arteries, retina, kidney, heart).

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Many individuals experiencing DGBI find themselves ensnared in repetitive cycles. Two prevalent patterns merit discussion: 1️⃣ Cycle of Medical Evaluation: Patients consult healthcare providers, undergo various tests, and are informed that no underlying condition is identified—leading to a frustrating cycle of repeat visits. This occurs when patient and provider approach DGBI from a dualistic standard, i.e, either medical or psychiatric. We can break this cycle by understanding these disorders as relating to dysregulation of the brain-gut axis. A p[ositive diagnosis is made using the Rome criteria, not by repeated tests to exclude other disease. 2️⃣ Cycle of Chronic Pain and Mental Health: Individuals suffering from chronic pain may experience associated depression and anxiety. Patient and provider need to understand that chronic pain can produce emotional distress which in turn lowers pain thresholds. It is not "cause and effedt" but a dysregulated control symptom that repeates the cycle. The positive aspect is that there are effective strategies to extend and potentially break these cycles. By addressing the underlying factors and fostering a comprehensive approach to both physical and mental health, we can facilitate enduring relief and improve overall well-being. To learn more, check out our video below: https://lnkd.in/eqqt4aWF #DGBI #PatientCare #Healthcare #Gastroenterology #ChronicPain

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CMS recently released QSO-25-11-NH, which updates guidance for nursing homes to align with new requirements. These include: • Expanded incident reporting protocols under F607 for abuse, neglect, exploitation, and misappropriation of resident property. • Updated Appendix PP of the State Operations Manual to reflect the new regulations. • Enhanced focus on resident rights and facility accountability. It’s critical for nursing home providers to review these changes carefully to ensure compliance and maintain quality care standards. If your team needs support interpreting this guidance or implementing best practices, feel free to reach out—I’m happy to help. 📄 Read the full memo here: QSO-25-11-NH https://lnkd.in/ev66-ifa #Compliance #LongTermCare #RegulatoryUpdates #ResidentRights

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There was no relative increase in rates of high-risk opioid prescribing following the adoption of nurse practitioner independence legislation in six states over two years. https://ja.ma/3VHxxSg

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      Now What Do I Do?   This is the most common question I have been asked in 23 years as an LNC. I am a firm believer in LNC education which takes the RN over the bridge to understand how to apply the RN’s education, skills and experiences and apply them to questions by an attorney.  When the LNC gets their first case to review, it becomes real. She often calls me with the question, “Now What Do I Do?” It may be compared to the new RN opening the sterile kit to perform trach care for the first time.  Just take one step at a time.    Step 1: Know the allegations in your case. Most often the attorney will email or call you regarding a request to review a medical record. He may discuss the allegations in the case with you, provide you with a written summary of the allegation, attach a copy of the intact information or attach a copy of the Complaint. It depends on the stage of the case. If the attorney does not provide the allegations in the case to you, ASK. Otherwise, you have no idea of what to look for when you review the medical record.   Step 2:  Know the medicine including the standards of care for that condition. Use the internet, medical journals, textbooks, and other resources to refresh your knowledge in cases in which you are unfamiliar or even a little “rusty”. A nurse cannot keep current on every condition found in every patient. If the LNC does not know, she knows how to research peer reviewed literature for this information. Keep in mind the time frame of your case, you would not cite SOC written in 2023 for a case which occurred in 2021.   Step 3. Review the medical records. Now the LNC is ready to read the medical records, keeping in mind the allegation, standards of care, and elements to be proved in the case type such as duty, breach of duty, injury, and causation. You may not choose to start at page 1 and read until page 3,000. You may choose to read the discharge summary and then go back to the ER admission or H&P for a before and after snapshot of the case. Each of you will find your process. The take-a-way in this post is…take the first step. BRIDGING LAW AND MEDICINE Kathy G. Ferrell, BS, RN, LNCC

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NDH Drug Quiz Nursing Drug Handbook Quiz! Test your knowledge of drugs and drug administration with questions from the #1 drug guide for #nurses. https://ow.ly/3vJe50UsxHn

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BECOME a CLINICAL NURSE SPECIALIST! Most nurse leaders/C-suite don’t understand what a CNS can do. Once they have them, they strongly support the role. Read more at #NACNS Best decision I ever made - the opportunities are endless. You learn to CREATE them. A truly unique APRN role:)

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3 New Guideline Summaries! *CAUTI *Testicular Cancer *BPH Find them here: https://ow.ly/IMbf50RIh42 Use these guideline summaries to stay up-to-date on current recommendations supported by the latest evidence. #NursingResources #Nurses

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Nursing Degree Fraud   Three Florida nursing schools sold over 7,600 fraudulent diplomas and transcripts for between $10,000 and $15,000 per diploma putting patient safety in question according to federal prosecutors. Unqualified people bypassed the required education and training programs that exist to protect the public from harm.    This is not an isolated incident relating to a specific profession, or even prospective candidates. One of our clients offered pay increases to employees who obtain a Masters degree. Payroll notified the Director of Security that numerous employees are taking online courses and receiving a Masters degree from one specific online college. The Director requested that we look into this matter.   We found that in a matter of minutes that this “college” was not accredited. Further research found that we could receive a “Masters” degree in any field we wanted by sending a resume outlining our experience. Based on the contents of the resume, the “college” determined that our experience equaled the educational experience of a Masters degree. We were awarded a Masters once we paid $500. A Masters degree in minutes. The fraudulent diplomas allowed students to proceed to take the nurse licensing exam. According to prosecutors, many of the individuals were already working in the healthcare field and wanted to explore career opportunities by taking a shortcut. Most of the 7600 individuals with fraudulent diplomas were able to obtain employment in the healthcare field as a nurse. One can only assume that the employer did not follow due diligence in the background investigation process. Candidate qualifications should be verified, and not accepted at face value based on a printout supplied by the candidate. Employers that hired the nurses in question could face serious consequences due to negligent hiring. To follow me, please click: Barb J. Wyskowski, J.D. #SHRM #HR #backgroundcheck #recruiting #LinkedHR #talentsolutions #Recuiters

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📢📢📢 Among med & #BHC providers in a rural mtn west state, greater degree of #integratedcare is associated w/ 🔼 job sat & less emotional exhaustion (part of #burnout). Findings add to the evidence base that #IBH care promotes provider #well-being. ✅ https://lnkd.in/ewk3SZRV

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Your patient coded..."Why are they doing this to me??" The question, "Why are they [the patient] doing this to me?" was my way of teaching other providers the ACLS H's and T's of a code. The H's and T's are the reversible causes of cardiac arrest, which, if caught and treated quickly, can save a patient. H's: 💧 Hypovolemia 🫁 Hypoxia 🧪 Hydrogen ion excess (acidosis) K+ Hypo/Hyperkalemia 🥶 Hypothermia T's: 🫁Tension pneumothorax 🫀Tamponade (pericardial) ☠️ Toxins (overdose) 🩸Thrombosis (PE) 🩸 Thrombosis (MI) How do you figure it out? - Labs - VS - Imaging - Assessment The ACLS team works best when the team leader can work through these items (with input from the other team members) to discover and treat the cause! Attorneys, if you have a case where the patient's code was less than optimal, the case did not go well, and the patient had a bad outcome, make sure you: 1️⃣ Look at the ACLS/AHA guidelines/algorithms for code management at the time of the arrest. 2️⃣ Write specific interrogatories pertaining to the type of cardiac defibrillator used in the hospital so that, if need be, you can request an audit trail of the specific EMR associated with the cardiac monitor (e.g., RescueNet). I just reviewed a case where the entire code sheet was REWRITTEN after the fact. The child died. That is not a good look for providers. Taking my years of nursing experience and putting it to work for attorneys on their medical cases. #ACLS #CPR #rapidresponse #cardiacarrest #medicalmalpractice #trialattorney #CMLC #ICU 📷 credit: Osmosis

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Using a template on your prehospital radio report when notifying the Trauma Center of your pre-arrival can be useful to ensure they get the info they need to prepare. #TraumaEducation #MetrolinaTrauma #Prehospital #TraumaCenter #EmergencyMedicine #EMS #Paramedic #EMT #HEMS #TraumaNurse #EmergencyNurse

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