Arizona nurses gather Tuesday to advocate nurse/patient ratios

HEIDI ROWLEY
Tucson Citizen 

Arizona nurses will gather at the state capitol Tuesday in an attempt to encourage lawmakers to make Arizona the second state in the nation to set minimum nurse to patient ratios.

The Arizona Hospital Patient Protection Act would set minimum ratios for each area of the hospital. For example, one nurse for every patient in an operating room and one nurse for every three patients in pediatrics.

California enacted its minimum staffing ratios in 2002.

Shawn Murray, a Tucson-area nurse for 11 years, went to the rally last year. She hopes this year's rally will get the attention of legislatures who weren't in office then.

"I'm hopeful in that sense maybe we can educate them and let them know what the situation is with the nurses in the hospital," she said.

Many Tucson area hospitals don't have set ratios. Murray, who works in an emergency room but declined to say which one, said the act would put one nurse for every four patients on her floor.

"If we had a 4 to 1 ratio on the floor in the hospital, I would be able to provide 100 percent safe therapeutic, compassionate care to my patients," she said "It's the patients that receive the benefit of safe care."

Without the act, hospitals can create their own ratios, but few do. University Medical Center spokeswoman Katie Riley said the act wouldn't change anything at the hospital because the hospital already voluntarily meets the proposed minimum ratios.

At Tucson Medical Center, spokesman Mike Letson said there aren't set ratios and the staffing numbers are determined by the needs of each patient.

At UPH Hospital at Kino Campus, spokeswoman Sarah Frost said the hospital has one nurse for every two patients in the ICU and 1 to 4 in the medical/surgical unit.

Alison McLeod, who lives in Bisbee but works for a nursing agency that sends her to several Tucson hospitals, said she will always be haunted by the day, five years ago, when one of her patients died. She was the only nurse on the floor and had to leave his bedside to get a medication even though he was in distress.

"Basically there was no one to help me or go get the medication," she said. "You will never forget that, even when they say it's not your fault. That's the type of thing that makes good nurses leave the profession."

The proposed act also provides for whistle-blower and patient advocacy protection. McLeod said she was recently fired from a hospital when she stood up to administrators to advocate for a patient who could not speak for herself.

She worries that other nurses may not speak out.

"If there was a situation that I felt was unsafe in the hospital, I would have mixed feelings on reporting that because I'm not sure my job would be protected," Murray said. "Sure, I could find a job at another hospital, but I would think twice."

A healthy outlook for nursing

By Laura Crimaldi
Sunday, January 11, 2009 - Updated 3d 13h ago


The federal government predicts that education and health services will account for more than three out of every 10 new jobs created in the next seven years - and Fantaba Sheriss, 27, hopes to join that work force as a nurse.

Sheriss, a Roslindale resident who grew up in West Africa, begins part-time studies this month at Bunker Hill Community College. “I want to be a nurse,” said Sheriss. “I’ve always been helping people.”

The move should also help Sheriss achieve her American dream despite a rotten economy. The Bureau of Labor Statistics estimates that jobs for registered nurses will grow by 23 percent, or 587,000 positions, between 2006 and 2016.
 

That growth puts opportunities for nurses among the largest number of new jobs for any occupation.

“We just tripled our capacity and people are just beating down the door to get into the program,” said Les Warren, director of work force development at Bunker Hill.

The college offers day, evening and weekend programs that lead to an associate’s degree and it prepares students to take the national licensing exam. Tuition, supplies and fees cost $11,650 annually for Bay State residents. An average registered nurse’s salary in the Boston area is $70,000, said David Schildmeier of the Massachusetts Nurses Association.

Nurses are not weathering the economic downturn unscathed. Schildmeier said MetroWest Medical Center, Jordan Hospital and Caritas Norwood Hospital laid off nurses last year. Hiring freezes are spreading, but the demand for nurses has not contracted, he said.

Sheriss, a laundry attendant at the Boston Park Plaza Hotel, said she prepared for nursing school by earning a GED last March and enrolling in College Pathways, a college prep course at Action for Boston Community Development.

“They gave me the secret weapon to go to college,” Sheriss said. “They gave me the courage.”

Half of Adults 50 and Younger With Low 10-Year Risk of CVD Have High Lifetime Risk

from U.S. Newswire .. 

To: NATIONAL EDITORS 

Contact: Cathy Lewis of the American Heart Association, +1-214- 706-1396 

American Heart Association rapid access journal report 

Study highlights: 

-- A traditional scoring method to determine the odds of having cardiovascular disease within 10 years may not be sufficient 

for risk estimation. 

-- Most adults 50 years and younger have a low 10-year risk 

because of the importance of age in influencing risk for heart 

disease. 

-- Researchers suggest using a long-term risk estimate for adults 

age 50 and younger in addition to the traditional 10-year risk 

score. 

DALLAS, Jan. 14 /PRNewswire-USNewswire/ -- About half of people 50 years and younger who have a low 10-year or short-term cardiovascular disease (CVD) risk may have a high lifetime risk, researchers report in Circulation: Journal of the American Heart Association. 

Typically, physicians determine patients' risk based on the Framingham Risk Score (FRS), a measure that helps to predict CVD risk during the next 10 years. 

"However, our study's findings suggest that using only the traditional scoring method might be a missed opportunity for prevention," said Jarett D. Berry, M.D., M.S, lead author of the study. 

"One of the limitations of using the traditional method is that most adults who are 50 years and younger have a low 10-year risk. This reflects the importance of age in determining cardiovascular disease risk," said Berry, assistant professor of medicine in the Division of Cardiology at the University of Texas Southwestern Medical Center in Dallas. "We wanted to determine if the addition of a lifetime risk estimate to the 10-year risk estimate would give us a better understanding of which individuals in this age group might have a higher prevalence and progression of undetected atherosclerosis." 

Researchers found long-term risk estimates provide novel information about risk prediction that's not obtained through modifications of the 10-year risk window. For example, adjusting the threshold of "low risk" to less than 5 percent will do little to improve stratification of risk across the remaining lifespan. 

Because of the intuitive nature and distinct features of lifetime risk estimates, researchers sought to combine the 10-year and the lifetime risk window into a single, clinically relevant method of risk stratification. 

Researchers analyzed 10-year and lifetime risk scores for nearly 4,000 people age 50 and younger who had not yet had a heart attack. They found that 91 percent of those 50 and younger were at low risk for CVD, according to the Framingham Risk Score. Among that 91 percent, about half of them had a high lifetime predicted risk. 

"The thickness of the carotid artery and amount of calcium in the coronary artery was significantly greater among those who had low short-term, but high lifetime risk, compared to those with low short- term and low lifetime predicted risk. So, by using many of the same risk factors of the Framingham Risk Score in a lifetime risk model, we reclassified nearly 50 percent of the people who were 'low-risk' by Framingham." 

Using a long-term risk measurement for adults age 50 and younger could be a useful addition to the traditional 10-year risk score, Berry said. 

"We feel that this study emphasizes the role of lifetime risk estimates as a useful adjunct to the 10-year risk estimate. At a minimum, we believe that lifetime risk estimates could be used to communicate risk more effectively to adults younger than 50 with elevated risk factors," he said. 

Nearly 2,400 Americans die of CVD each day, an average of one death every 37 seconds, according to the American Heart Association. Cardiovascular disease claims about as many lives each year as cancer, chronic lower respiratory diseases, accidents and diabetes mellitus combined. 

The National Heart, Lung, and Blood Institute funded portions of the study. 

Co-authors are: Kiang Liu, Ph.D.; Aaron R. Folsom, M.D.; Cora E. Lewis, M.D., M.S.P.H.; J. Jeffrey Carr, M.D., M.S.; Joseph Polak, M.D., M.P.H.; Steven Shea, M.D., M.S.; Stephen Sidney, M.D., M.P.H.; Daniel H O'Leary, M.D.; Cheeling Chan, M.S.; and Donald M. Lloyd- Jones, M.D., Sc.M. Individual author disclosures are available on the manuscript. 

Statements and conclusions of study authors that are published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.americanheart.org/corporatefunding. 

SOURCE American Heart Association 

(c) 2009 U.S. Newswire. Provided by ProQuest LLC. All rights Reserved.

A service of YellowBrix, Inc. 

Fears Grow of Measles Epidemic As Cases Rise

from Lincolnshire Echo .. 

Cases of measles diagnosed by Lincolnshire doctors have doubled in the past year. 

Lincolnshire GPs reported 28 instances of the highly infectious disease in 2008 compared to 15 in 2007 and 17 in 2006. 

New statistics released by the Health Protection Agency show the number of measles cases in England and Wales at their highest for more than a decade. 

And a low uptake of the MMR jab has been blamed for the outbreak. 

Agency spokesman Dr Mary Ramsay said: "A relatively low MMR vaccine uptake over the past decade means that measles is spreading easily among these unvaccinated children. 

"The agency is concerned that we may see measles epidemics take hold. 

"Although MMR coverage is starting to improve, we cannot stress enough that measles is serious and in some cases it can be fatal." 

The combined vaccine against measles, mumps and rubella was introduced in the UK in 1988 to replace single vaccines. 

Parents are invited to vaccinate their youngsters at 13 months and once again before they start school. 

The uptake of the MMR jab declined due to a media furore that followed a 1998 study published in the medical journal The Lancet. 

The study linked the jab to autism and bowel disease. 

And although many studies of the MMR since 1998 have concluded the three-in-one jab is safe, many parents still refuse to vaccinate their children. 

A total of 85 per cent of Lincolnshire's youngsters receive the MMR in line with the national average, but the Department of Health wants this figure increasing to 95 per cent. 

Despite GPs notifying the agency of 28 county measles cases last year, Janine Rayfield, nurse consultant in infectious disease at NHS Lincolnshire, said there were no lab reports to confirm a single case. She said that while GPs might not take mouth swabs from patients in some areas of the country, in Lincolnshire it is routine procedure to confirm a measles case. 

"They might not carry the kit with them on a home visit but they come and collect it later," said Ms Rayfield. 

Retired GP and Lincolnshire representative for the British Medical Association, Dr David Baker, said he could not understand why Lincolnshire GPs had reported 28 measles cases and yet none of them were confirmed by lab tests. 

"Maybe GPs are swabbing and maybe they are forgetting to," he said. 

"It is a case of what is theoretical practice and what is actual practice." 

(c) 2009 Lincolnshire Echo. Provided by ProQuest LLC. All rights Reserved.

A service of YellowBrix, Inc. 

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