Latest Comments by NRSKarenRN

NRSKarenRN, BSN, RN Moderator 136,997 Views

Joined Oct 10, '00 - from 'RN Spirit from Philly Burb'. NRSKarenRN is a PI Compliance Specialist, prior Central Intake Mgr Home Care Agency. She has '35+' year(s) of experience and specializes in 'Home Care, VentsTelemetry, Home infusion'. Posts: 27,410 (22% Liked) Likes: 13,578

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  • 12
    TLSpaz, chare, LadyFree28, and 9 others like this.

    In many areas of US, syringe driver pumps are not used on patient care units due to them not being tamper proof. Instead, self contained CADD PCA pump most popular in Philadelphia PA area as allows patient to be ambulatory or move around in bed more freely.

    Examples of syringe driver pumps:


    [IMG]http://allnurses.com/attachment.php?attachmentid=24794&stc=1[/IMG]


    [IMG]http://allnurses.com/attachment.php?attachmentid=24795&stc=1[/IMG]


    [IMG]http://allnurses.com/attachment.php?attachmentid=24796&stc=1[/IMG]

    Some articles of interest

    Syringe driver pump use and setup:

    Syringe Drivers: Setup, Patient Use, Problem solving

    Clinical protocol for the use of syringe drivers in Palliative Care

    Safe practice in syringe pump management

    Guidelines for Syringe Driver Management in Palliative Care


    Overcoming fear of administering last dose pain medication hastening death involves coming to terms with ones immortality, understanding disease process in end stage illness, nursing ethics, end of life care and effective medications for symptom management.

    The Double Effect of Pain Medication: Separating Myth from Reality

    Managing Pain in the Dying Patient

    Managing end-of-life symptoms - American Nurse Today

    ANA 2016: Nurses’ Roles and Responsibilities in Providing Care and Support at the End of Life


  • 4
    Apples&Oranges, SmilingBluEyes, JadedCPN, and 1 other like this.

    Texas nurses who truly feel unsafe staffing can complete Safe Harbor Peer Review form
    documenting conditions that may lead to violation of TX nurse Practice Act.... such submission may incur further employer scrutiny... use with caution.

    What is Safe Harbor Peer Review?
    Safe Harbor is a process that protects a nurse from employer retaliation, suspension, termination, discipline, discrimination, and licensure sanction when a nurse makes a good faith request for peer review of an assignment or conduct the nurse is requested to perform and that the nurse believes could result in a violation of the NPA or Board rules

    The BON has no authority over employment issues, but a nurse does have civil recourse in matters where the nurse’s decision to invoke Safe Harbor was made in good faith, but negative employment action occurred as a result of the nurse's request. A nurse also has whistleblower protections when the nurse reports a facility, physician, or other entity for violations of laws relating to patient care and or illegal acts, such as fraud, see Nursing Practice Act, Section 301.4025 and Section 303.005 and Texas Administrative Code, Rule §217.20 Safe Harbor Peer Review for Nurses and Whistleblower Protections. You may wish to also seek your own legal counsel for advice. The BON cannot provide legal advice, and has no authority in civil matters.



    The Quick Request for Safe Harbor is an abbreviated form to allow a nurse to quickly jot down the key information necessary to invoke Safe Harbor in writing as required by Rule 217.20 at the time the nurse is asked to accept what he/she believes to be an unsafe assignment. Use of the form is not required, but is provided to make safe harbor an easier process for the nurse.


    The Comprehensive Request for Safe Harbor Form is a sample form that may be used to document the more in-depth information that the nurse must commit to writing before leaving the work setting at the end of the work period. The nurse may still supply supporting documents at a later time, however the details of the events surrounding the request must be recorded prior to the nurse leaving the premises. The comprehensive form also includes a fill-in-the-blank format that the peer review committee and CNO or nurse administrator can utilize to document the safe harbor peer review process. Again, this form is not mandatory, but is offered a guide to the process. An entity required to have a peer review plan must have policies and procedures that encompass other aspects both within and beyond the statutes and rules of peer review. In other words, it is not sufficient to use the BON Safe Harbor forms in place of official policies and procedures on nursing peer review.

  • 0

    Pennsylvania is a big state.... where are you planning to live so we can give you ideas of facilities

  • 0

    Section 9.1(a) of ABC-MAP* requires that all prescribers or dispensers, as defined in Section 3 of ABC-MAP, applying for licensure/certification complete at least 4 hours of Board-approved education consisting of 2 hours in pain management or the identification of addiction and 2 hours in the practices of prescribing or dispensing of opioids. Certified registered nurse practitioners (CRNPs) who hold prescriptive authority approval fall within ABC-MAP’s definition of prescribers or dispensers.

    Requirements for initial applicants and additional prescriptive authority approvals
    CRNP applicants seeking prescriptive authority approval on or after July 1, 2017, must document, within one year from issuance of the prescriptive authority approval, that they completed this education either as part of a Board-approved CRNP Program, a stand-alone course from a Board-approved CRNP advanced pharmacology course provider, authorized by Section 21.283(b)(1) of the Board’s regulations, or a continuing education course from a CRNP continuing education provider, listed in Section 21.334 (a) of the Board’s regulations. The 4 hours of Board-approved education needs to be completed only once.

    Where this education is part of the CRNP educational program, verification of completion from the Program may be included within the Verification of Nurse Practitioner Program. Where this education is part of a stand-alone Board-approved CRNP advanced pharmacology course authorized by Section 21.283(b)(1) of the Board’s regulations, verification of completion from the CRNP advanced pharmacology provider may be included within the Verification of Advanced Pharmacology. Where the education is completed as stand-alone opioid education, verification of completion from a CRNP Program, a CRNP advanced pharmacology provider or a CRNP continuing education provider listed in Section 21.334 (a) of the Board’s regulations, may be documented on the Verification of Opioid Education or on a Certificate of Completion that includes the name of the course, the specific number of hours in each of the required content areas and the date completed. The

    Verification forms are available at:
    Application Forms

    Renewals
    In order to renew a prescriptive authority approval for the next renewal period, Section 9.1(a)(2) of ABC-MAP requires that all CRNPs with prescriptive authority approval complete at least two hours of continuing education in pain management, the identification of addiction or in the practices of prescribing or dispensing of opioids. The continuing education requirements of ABC-MAP will count towards the total number of hours of continuing education required for renewal. This two-hour requirement needs to be completed only once per renewal period regardless of the number of prescriptive authority approvals being renewed. This continuing education must be taken from a Board-approved CRNP continuing education provider listed in Section 21.334 (a) of the Board’s regulations and its completion attested to when applying for renewal.

    *The Achieving Better Care by Monitoring All Prescriptions Program Act (ABC-MAP)(also known as Act 124 of 2016), 35 P.S. § 872.3, is available on the Legislature’s website at:
    2�16 Act 124 - PA General Assembly
    Sections 21.283(b)(1) and 21.334 (a) of the Board’s Regulations are available on the Board’s website at: www.dos.pa.gov/nurse

  • 0

    Section 9.1(a) of ABC-MAP* requires that all prescribers or dispensers, as defined in Section 3 of ABC-MAP, applying for licensure/certification complete at least 4 hours of Board-approved education consisting of 2 hours in pain management or the identification of addiction and 2 hours in the practices of prescribing or dispensing of opioids. Certified registered nurse practitioners (CRNPs) who hold prescriptive authority approval fall within ABC-MAP’s definition of prescribers or dispensers.

    Requirements for initial applicants and additional prescriptive authority approvals
    CRNP applicants seeking prescriptive authority approval on or after July 1, 2017, must document, within one year from issuance of the prescriptive authority approval, that they completed this education either as part of a Board-approved CRNP Program, a stand-alone course from a Board-approved CRNP advanced pharmacology course provider, authorized by Section 21.283(b)(1) of the Board’s regulations, or a continuing education course from a CRNP continuing education provider, listed in Section 21.334 (a) of the Board’s regulations. The 4 hours of Board-approved education needs to be completed only once.

    Where this education is part of the CRNP educational program, verification of completion from the Program may be included within the Verification of Nurse Practitioner Program. Where this education is part of a stand-alone Board-approved CRNP advanced pharmacology course authorized by Section 21.283(b)(1) of the Board’s regulations, verification of completion from the CRNP advanced pharmacology provider may be included within the Verification of Advanced Pharmacology. Where the education is completed as stand-alone opioid education, verification of completion from a CRNP Program, a CRNP advanced pharmacology provider or a CRNP continuing education provider listed in Section 21.334 (a) of the Board’s regulations, may be documented on the Verification of Opioid Education or on a Certificate of Completion that includes the name of the course, the specific number of hours in each of the required content areas and the date completed. The

    Verification forms are available at:
    Application Forms

    Renewals
    In order to renew a prescriptive authority approval for the next renewal period, Section 9.1(a)(2) of ABC-MAP requires that all CRNPs with prescriptive authority approval complete at least two hours of continuing education in pain management, the identification of addiction or in the practices of prescribing or dispensing of opioids. The continuing education requirements of ABC-MAP will count towards the total number of hours of continuing education required for renewal. This two-hour requirement needs to be completed only once per renewal period regardless of the number of prescriptive authority approvals being renewed. This continuing education must be taken from a Board-approved CRNP continuing education provider listed in Section 21.334 (a) of the Board’s regulations and its completion attested to when applying for renewal.

    *The Achieving Better Care by Monitoring All Prescriptions Program Act (ABC-MAP)(also known as Act 124 of 2016), 35 P.S. § 872.3, is available on the Legislature’s website at:
    2�16 Act 124 - PA General Assembly
    Sections 21.283(b)(1) and 21.334 (a) of the Board’s Regulations are available on the Board’s website at: www.dos.pa.gov/nurse

  • 0

    Student membership for undergrads is possible for $50.00 fee to verify undergrad status:

    Info:
    •Student Membership: Open to matriculating undergraduate students.

  • 0

    See school discussions here: Student Registered Nurse Anesthetist

  • 0

    Have you visited AN's Nursing Informatics forum

  • 1
    meanmaryjean likes this.

    Check out Aaron's Tracheostomy Page for up to date info on trach care along with the resources section: Surgical Procedures
    Critical pointers: Tracheostomies

    AN's Pulmonary Nursing sectionhas many resources too.

  • 0

    LaSalle Achieve Program Fall 2017 has 3 pages of info about program.

    This link will take you to multiple discussions about program over the years:
    http://allnurses.com/gsearch.php?cx=...chieve+Program

  • 0

    I've been a nurse now 40yrs, last 15yrs in non-bedside position in Home Health. Started planning my retirement 2yrs ago with plans to decrease from FT to 2days wk in about 4 years. Reading allnurses one would assume no one wants bedside positions. In Philly area, BSN push has been on for about 5 years with glut of graduating nurses and not enough hospital/SNF bedside positions available. Five new BSN grads I'd hired into Home Health Central Intake roles all left after that magical first year as able to obtain hospital bedside positions.

    As part of retirement planning, I increased 403b contribution to 10% salary 3 years ago to take advantage of health system match for those over 16years employment getting $.60 for every $1.00 up to 6% salary if making less than $100,000. Paid off all credit cards; use just 1 debit card with monies out of checking account. I rarely go to Starbucks/ Dunkin Donuts/Wawa for Chai tea, instead buy individual sealed Chai + Constant Comment tea bags (my stress relievers) along with Truvia carrying them in separate area in my handbag to cut down on spending. My work pension is anticipated @ $900/mo now --just enough to pay PA state and school Taxes.

    One of my friends continues to work 2days week at age 82 as "keeping her sharp". I would like to volunteer at local library or assisted living activity center as something to keep me busy, rather than have deadlines to meet. All depends on how health insurance plays out over next few years as might need to keep working to pay for insurance cost.

  • 0

    A Sexual Assault Nurse Examiner (SANE) is a qualification for forensic nurses who have received special training to conduct sexual assault evidentiary exams for rape victims. Not all, but many SANE programs are coordinated by rape crisis centers rather than hospitals.

    CAREER INFO: Sexual Assault Nurse Examiners


    Police Laboratory Analysts process the kits
    How are rape kits processed?

    Oregon State Police analysts are working to resolve the growing backlog of rape kits, which has quadrupled since the state shipped kits to a private Utah laboratory in 2016.

    It takes between 8 and 16 hours to analyze a sexual assault forensic evidence kit, or SAFE kit, and each kit passes through the hands of forensic scientists who specialize in biology and DNA analysis.


    The lengthy testing period paired with a limited number of scientists who juggle other casework may have contributed to the growing backlog.


    At the Oregon State Police Forensics Services Division at the Portland Metropolitan Forensic Laboratory in Clackamas, each SAFE kit is passed through several analysts, including biologists who analyze hairs and fibers, and scientists who analyze human DNA like saliva, semen and any other swabs taken from a victim.

  • 12
    poppycat, brownbook, not.done.yet, and 9 others like this.

    In most states, the Department of Health regulates Skilled Nursing Facilities, not board of nursing. Have you notified SNF administrator of these issues.... if they have not been concerned, there should be a corporate DON you should notify. It's not unusual for cash strapped corporations to be late paying bills, especially if reimbursement from Medicare/Medicaid late. If these persons appear unconcerned or hushing up issue, you can file a whistleblower complaint with Dept of Health or state Inspector General hotlines.

    Excellent advice here:
    Preparing to Blow the Whistle: A Survival Guide for Nurses - Medscape requires free registration

  • 0

    PA approved medical marijuana sales last year, at contract stage now. With 75+ kidney stones, my son is hoping this might be of benefit instead of narcotics for renal colic + chronic neuropathic pain he has.

  • 7
    ThePrincessBride, Scottishtape, adventure_rn, and 4 others like this.

    Found at ABC News
    Nurses honor tiny 'graduates' leaving the NICU

    A North Carolina hospital is celebrating babies who are ending their stay in the neonatal intensive care unit.
    The staff at CaroMont Health in Gastonia, North Carolina, honor their tiny patients with a special photo shoot and a graduation cap.
    About six months ago, Nurse Melissa Jordan began the "graduation ceremonies" after she helped care for an infant who spent 62 days in the NICU.
    On the day he was leaving, the baby's parents dressed him up in a "NICU Grad" onesie, which inspired Jordan to continue the tradition.
    "It's an emotional roller coaster for a preemie," Jordan, 28, told ABC News. "One day could be really happy and then another day there can be several setbacks. You have to be there emotionally for the parents and celebrate every single, teeny milestone."




    [IMG]http://a.abcnews.com/images/Lifestyle/HT-Suttonmain1-MEM-170614_4x3_992.jpg[/IMG]

    http://abcnews.go.com/video/embed?id=48037630


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