Monday, November 16, 2015

Don't Get Stuck!

Sharps injuries?

Sharps injuries are a significant injury and health hazard for health care workers and also result in a number of direct and indirect organizational costs. The Centers for Disease Control and Prevention (CDC) estimates that about 385,000 sharps-related injuries occur annually among health care workers in hospitals. More recent data from the Exposure Prevention Information Network (EPINet™) suggest these injuries can be reduced, as sharps-related injuries in nonsurgical hospital settings decreased 31.6% during 2001–2006 (following the Needlestick Safety and Prevention Act of 2000). However, injuries in surgical settings increased 6.5% in the same period, where adoption of safety devices was limited compared to nonsurgical settings. It has been estimated about half or more of sharps injuries go unreported. Most reported sharps injuries involve nursing staff, but laboratory staff, physicians, housekeepers, and other health care workers are also injured.

Campaign goal and target audience

Reducing sharps injuries first requires that health care workers have a full understanding of the magnitude of the problem. The STOP STICKS campaign focuses on raising awareness which, in turn, prepares and motivates health care workers to make the changes needed to reduce sharps injuries. Change itself requires a shift in the organization's safety culture and use of safer sharps devices and practices, and management support is a critical component of any change initiative.
The STOP STICKS campaign is a community-based information and education program. Its goal is to raise awareness about the risk of exposure to bloodborne pathogens such as HIV, hepatitis B, and hepatitis C from needlesticks and other sharps-related injuries in the workplace. While the campaign materials were developed mainly with operating room and emergency department audiences, the target audience includes clinical and nonclinical health care workers and health care administrators in hospitals, doctor's offices, nursing homes, and home health care agencies.

How the STOP STICKS campaign was developed


The National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC), developed the materials available through this website by conducting a multiyear pilot project in Columbia, South Carolina. Other partners involved with NIOSH in pilot testing this campaign and developing the tools necessary to conduct your own awareness campaign include Palmetto Health Alliance, Dorn VA Hospital, CM Tucker Nursing Care Center, the South Carolina Department of Health and Environmental Control, PHT Services, the Association of Professionals in Infection Control, the University of South Carolina School of Public Health, the South Carolina Nurses Association, and other local Columbia, SC health care employers.
The tools available for conducting your own STOP STICKS campaign are highly customizable so that you can decide which components best fit the needs of your facility. You may choose to conduct a complete campaign, or only use certain components, depending on the needs and resources available at your facility. The STOP STICKS campaign may be presented as a stand-alone initiative, or it may be tied with other initiatives, such as introduction of a new safety device or an annual refresher to remind staff of the hazards associated with sharps injuries.

What is a "safety campaign" and a "communication blitz"?

A safety campaign is a series of strategic communication initiatives designed to convey a consistent key message targeting a safety need. In this sharps injuries campaign, the key message is "STOP STICKS."

The communication blitz is a component of the safety campaign and refers to brief, targeted communication interventions that bring attention to the safety campaign goals. Specifically, the blitzes for the STOP STICKS campaign focus on bloodborne pathogens, exposure prevention methods, equipment evaluation, and proper post-exposure prophylaxis protocols. The blitzes feature posters, newsletters, health and safety fairs, exhibits, and videos, among other communication methods and channels to communicate the campaign message.

STOP STICKS campaign guide and resources

These websites includes guidance on how to prepare blitzesuse templates and other media resources in preparing the blitz materials, implement the blitzes, and evaluate the campaign outcomes. See the full list of campaign resources on the menu at left.

Tuesday, November 10, 2015

I Hate those Videos from the American Heart


We have been teaching CPR, ACLS, and PALS for over 5 years now and I always get the same complaint from many students.  "Why do we have to watch those stupid videos?" 
We know that some of the videos you watch can be boring or repetitive; however, there is a madness behind the methods from the American Heart Association.
A recent student from the
Perelman School of Medicine at the University of Pennsylvania finds "using a video to train members of patients at risk for cardiac arrest in CPR may be just as effective as using the traditional hands-on method with a manikin."
"The findings suggest simplified and more cost-effective approaches may be useful for disseminating CPR education to families of at-risk patients and the general public. The results are being presented during the American Heart Association Scientific Sessions 2015."(Abella, MD, MPhil)
The cardiac arrests in the United States are typically responded and treated by CPR delivered by bystanders, "a fact which has prompted calls for improved CPR education to empower the public to take action."(Abella, MD, MPhil) 
 This typically occurs in Less than 40 percent of bystanders. A few studies have shown that using a video for self-instruction which may include a small inflatable manikin is helpful in remembering the basics of CPR.  However, the cost of such kits is often not affordable by laypersons. Also, since these kits require the use of a manikin, they are limited in their use compared to video-only approaches which can be used to train larger groups.

“Most cardiac arrests take place in the home, where a patient’s best chance of survival is having a family member who knows and can properly administer CPR,” said the new study’s lead author, Audrey L. Blewer, MPH, assistant director for Educational Programs in Penn’s Center for Resuscitation Science, who will present the results. “Traditional training classes involve several hours of group classes and can cost upwards of $100 or more per person. These classes are more commonly used by health professionals, lifeguards and people in other professions where mastery of CPR and certification are necessary. What the new study shows is that for the general public, where cost and time may be more of a concern, using only video instruction may be just as helpful in teaching the basics of CPR as using a hands-on method.”(Abella, MD, MPhil)


In the study, there were more than 1,600 family members of patients identified as being at-risk for a cardiac arrest across eight hospitals were trained in CPR using either the video-only method, or the self instructed method. Six months after training, researchers tested participants to evaluate their long-term retention of properly performing CPR. Results indicated that while there were small differences in the depth of chest compressions among the groups, the overall ability to properly perform CPR was similar. Recent research also suggests the difference in compression depth may be insignificant to a patient’s chance of survival.
“The study has great potential for helping to increase the opportunity for CPR education among the public, and especially for groups of people who may not have access to training programs otherwise,” said senior author, Benjamin S. Abella, MD, MPhil, an associate professor of Emergency Medicine and clinical research director of the Center for Resuscitation Science at Penn Medicine. “Knowing that the manikin may not be necessary for basic training, we could conceivably show CPR training videos in public places, such as a doctor’s waiting room or at the DMV, and they will actually be beneficial in providing this life-saving skill.”(Abella, MD, MPhil)




Reference
Abella, MD, MPhil, B., & Blewer, MPH, A. (2015, November 8). Video-Based CPR Training May be as Valuable as Hands-On Approach, Penn Study Finds. Retrieved November 10, 2015, from http://www.uphs.upenn.edu/news/News_Releases/2015/11/cpr/ 
 

Tuesday, November 3, 2015

Disability gets sexy thanks to a nurse with Crohn's disease


reprinted with the permission of   

www.ExceptionalNurse.com


"Jasmine Stacey, 24, a nurse in the UK has Crohn's disease. 
She underwent surgery to remove part of her intestine when she was 20 years old and needed an ileostomy bag.
Jasmine has launched a new line of luxury lingerie that allows women who also have stoma bags to feel sexy again.
The nurse/designer said she was "inspired to come up with a stylish range of underwear by the lack of seductive garments available for women in her position".
"I want to take the stigma away from having a stoma bag and prove you can still be sexy with underwear. 
"I want to get the message out there that it is not as bad as people think and that young people have stoma bags as well as old people."

"We hope our underwear is stylish without being flimsy and empowers women to feel confident whether they have stoma bags, scars, or simply want more stomach control." 

Tuesday, September 15, 2015

Hospital To Nurses: It's Your Problem; Not Our Problem

Story by 

Daniel Zwerdling NPR Correspondent, Investigations Unit

For years I have been teaching and talking about liability and disability insurance for nurses.  I explain that if you get hurt on the job; most if not all hospitals make it difficult for you to get the help you need as a nurse.  Even if you get on some type of disability; the amount of money you will receive maybe only be around 50-60% of your normal income if you are lucky.  The story below taken from NPR is a great example of how nurses can e lost in the crack and not helped even when simply doing their job.

Daniel presents the case of Terry Cawthorn and Mission Hospital, in Asheville, N.C., which provides a look into how some hospital officials around the country have shrugged off an epidemic.
"Cawthorn was a nurse at Mission for more than 20 years. Her supervisor testified under oath that she was "one of my most reliable employees."   Then, as with other nurses described this month in the NPR investigative series Injured Nurses, a back injury derailed Cawthorn's career. Nursing employees suffer more debilitating back and other body injuries than almost any other occupation, and most of those injuries are caused by lifting and moving patients.   But in Cawthorn's case, administrators at Mission Hospital refused to acknowledge her injuries were caused on the job. In fact, court records, internal hospital documents and interviews with former hospital medical staff suggest that hospital officials often refused to acknowledge that the everyday work of nursing employees frequently injures them. And Mission is not unique. NPR found similar attitudes toward nurses in hospitals around the country.  Documents from Cawthorn's court case tell her story.
It was in the afternoon on her 45th birthday. A large patient had just had a cesarean section, and Cawthorn was helping move her from the gurney onto her bed — a task that nursing employees perform thousands of times every day."  She kind of had one cheek on the bed, one cheek on the stretcher, and we [were] trying to help her," Cawthorn says. To demonstrate, Cawthorn bends her knees and crouches, keeping her back straight. She extends her arms like railings, as though she's holding them out for the patient to grip."  And the second she grabbed on, almost instantaneously I felt like hot tar was just going down my spine, into my butt," Cawthorn says.
By the time she left work that day, she could hardly walk — or drive. Her husband had to lift her out of her car and carry her into their home, and lay her on the floor. Cawthorn could see the birthday flowers and pink cake her family had made on the dining table. "And I'm just on the floor, in tears," says Cawthorn, "in so much pain."
Cawthorn took painkillers and made it back to work the next morning, and reported the injury to her supervisor. Then she hurt her back again barely a week later when she lifted another patient. She injured her back a third time a few days after that. And nine months later, Cawthorn herself became the patient in the hospital where she worked: She had a "lumbar interbody fusion," an operation in which the surgeon built a metal cage around her spine."
"As nurses most if not all of us are covered by State laws that require companies to cover employees' medical bills when they are injured doing their jobs. Companies also have to pay workers' compensation to support injured employees while they're missing work — and missing their paychecks.
But officials at Mission refused to help Cawthorn. According to court documents, the hospital's own medical staff concluded that she was hurt moving patients. But the hospital's lawyer disagreed, arguing that Cawthorn actually hurt her back partly while lifting a dinner casserole out of her oven.
Mission hospital officials also said that as a result of Cawthorn's back injury she was no longer fit to work. Cawthorn and her husband say she was lying in her hospital bed two days after back surgery, when a hospital representative walked into her room and handed her a document. It announced that Mission was terminating her job."  They actually saved themselves the postage," Cawthorn says, looking as if she's about to cry. "And I was so emotionally destroyed. Nursing's not just a job. It's who you are."   As Cawthorn and her husband, Tucker, talk about her painful saga, they're sitting at home in a small town about a 30-minute drive from Asheville. The refrigerator is covered with photos of their family, which show a dramatically different Cawthorn than the woman sitting now at her dining table."
About This Story

This is the third in a series of stories written by Daniel  Zwerdling about the dangers of nursing.

Friday, September 11, 2015

Wednesday, September 2, 2015

Time to Say Goodbye to the IV Pole and Welcome the IVEA

By Helen Taylor



With all of the advancements in infusion technology during the last hundred years, it’s simply astonishing that the IV pole has remained essentially unchanged in design and function during all that time. Top heavy, “tippy”, noisy, awkward, inefficient, for generations the IV pole has been widely viewed as a challenge rather than asset—something to deal with rather than something that actually improves the quality of care.

Finally, however, there’s an alternative. The IVEA is transformative patient-care equipment designed by nurses for nurses to improve mobility, safety, efficiency and storability. The IVEA replaces the IV pole bedside and supports the patient during ambulation. It holds all of the patient’s equipment, including infusion bags and pumps, PCAs, oxygen, chest tubes and catheter bag on a stable platform, and moves easily and securely, promoting early and frequent patient mobility.

The IVEA’s award-winning design is also unique in that it folds and stores easily, reducing clutter in rooms and hallways. This equipment is the brainchild of a former RN, and more than 150 clinicians weighed in on its design. The final result is a piece of equipment that is lightweight yet durable, nimble yet secure—equipment that promises to improve efficiency by eliminating the need to transfer equipment from one device to another and making it possible for one nurse, rather than two or three, to safely ambulate a patient.

The advent of the IVEA couldn’t have happened at a more opportune time. As hospitals experience radical change in healthcare economics, the IVEA offers a means to help improve caregiver efficiency, reduce lengths of stay and improve patient outcomes, thereby improving the bottom line. In light of recent reports on the prevalence of nurse injury and OSHA’s new guidelines for safety enforcement, hospitals are looking for a tool such as the IVEA, specifically designed to improve mobility with less risk of injury for patients and nurses. And with the pronounced shift to more consumer-oriented care, the IVEA’s sleek design has the potential to improve patient satisfaction scores and help hospitals meet the challenges of a more competitive market.

The response from nurses seeing the IVEA for the first time is often, “Wow. I wish I’d thought of that.” In truth, they did. Without extensive clinician input, the IVEA wouldn’t be the product it is: a patient-mobility solution designed to meet the challenges of modern care and finally consign the antiquated IV pole to history.

Learn more about the IVEA at www.iveamobility.com and watch the video.

(video link: https://youtu.be/9uI7DHhv0Jc)

Tuesday, August 25, 2015

5th Leading Cause of Death in America



According to the Center for Disease Control and Prevention; Stroke has dropped from the nation’s fourth-leading cause of death to No. 5.  It is the second time since 2011 that stroke has dropped a spot in the mortality rankings.

What is a Stroke?
A stroke results from a disease process that affects the arteries of the brain. A stroke occurs when a blood vessel bringing blood to the brain gets blocked or ruptures so brain cells don't get the flow of blood that they need. Deprived of oxygen, nerve cells cannot function and die within minutes. When these nerve cells die, the parts of the body they control cannot function either. These devastating effects are often permanent because brain cells cannot be replaced.
Other names for a stroke include:




What are the different types of Strokes?
There are three types of strokes:
  • An Ischemic Stroke is a stroke caused by a blocked artery. This is the most common type of stroke and can sometimes be treated with clot busting drugs.
  • Hemorrhagic Stroke is a stroke caused by bleeding into the brain tissue. This stroke is caused by a ruptured blood vessel.
  • A (TIA), or a Transient Ischemic Attack. 

    What is a TIA?

TIA, or a Transient Ischemic Attack. is also called a “mini stroke” and occurs when a blood clot blocks an artery for a short time. The symptoms of a TIA are like the warning signs of a stroke but they usually last only a few minutes.  About 10 % of strokes are preceded by TIAs and are a very strong predictor of stroke risk. TIAs are a medical emergency and should be treated immediately.


What are the Warning Signs?











Warning signs of a stroke can include:

  • Sudden weakness or numbness of the face arm, or leg, especially on one side of the body.
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause

If you recognize any of these symptoms, act FAST.

  • "F" stands for Face. Ask the person to smile. If the face is droopy on one side, that is a sign of a stroke. Call 9-1-1 immediately.
  • "A" stands for Arm. Ask the person to raise both arms. If one arm drifts down or has no resistance to it that is a sign of a stroke. Call 9-1-1 immediately.
  • "S" stands for Speech. Ask the person to say a simple phrase. If the person's speech is slurred or not able to be understood. Call 9-1-1 immediately.
  • "T" stands for Time.  Diagnosis and treatment of an ischemic stroke must be within 3 hours of the time of onset of symptoms. Call 9-1-1 immediately
Are You Smoking? 















  • Tobacco use is the number one preventable cause of serious illnesses such as heart disease, stroke, lung cancer, and emphysema.
  • An estimated 25.1 million men and 20.9 million women smoke cigarettes. 
           STOP SMOKING NOW!!


Smoking can make cardiovascular disease worse, so if you smoke, you should stop immediately. 


High Blood Pressure (Hypertension)
High blood pressure (BP), is the single most important risk factor for stroke.  Many believe control of high blood pressure is a key reason to decrease the death rates for stroke. 
It is estimated that the prevalence of high blood pressure in adults over the age of 20 is approximately 72 million in the United States alone. 
Up to 95 % of high blood pressure are from unknown causes, but the condition is easily detectable and treatable.
In addition to medications, diet, exercise, and weight loss can assist in controlling your blood pressure.
  •     Please ask to see a dietitian to assist you with healthy diet choice to lower both your blood pressure and cholesterol
  •    Normal blood pressure is 120/80
  •    High blood pressure is 140/90 or higher

High Cholesterol (Hyperlipidemia)
About 36 million American adults have total cholesterol levels above 240 mg/dL. 
  • Normal total cholesterol should be below 200 mg/dL.
  • Normal triglyceride level should be below 150mg/dL.
  • Normal HDL, or good cholesterol, should be 40 mg/dL or higher. 
  • Normal LDL, or bad cholesterol, should be less than 100 mg/dL

In addition to medications, diet, exercise, and weight loss can help control cholesterol levels. 
Diabetes
Diabetes is an independent risk factor for stroke.   Many people with diabetes also have high blood pressure, high cholesterol, and are overweight.  Diabetes is manageable with medications such as insulin, glipizide, and/or glyburide. Diet and exercise can also help manage diabetes. 
Your physician may perform a lab test called a hemoglobin A1C which will let them know how well your diabetes has been controlled in the last 90 days.  
For someone who does not have diabetes, a normal A1C level should range from 4.5% to 6%. Someone who's had uncontrolled diabetes for a long time might have an A1C level above 8%.
When the A1C test is used to diagnose diabetes, an A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes.  For most people who have previously diagnosed diabetes, an A1C level of 7% or less is a common treatment target.   


To learn more about Strokes, signs and symptoms, medications, and how to help a loved one visit http://www.strokeassociation.org/STROKEORG/

Thursday, May 14, 2015

The Value of a Nurse

It was a familiar walk.  One I had made countless times.  Over the years I had entered the Children's hospital Operating Room (OR) on a regular basis to observe and support surgeons during surgery.  It was my job.  I worked for a minimally invasive surgical device company and I loved it.  But, today's trip up to the second floor was not for work.  This time was different. This time I was on the other side of the double doors marked, "Authorized personnel only." They were doors I had walked through many times, but had never been forced to wait behind.   Today would be filled with deja vu and reflection because today the little person walking down the long corridor to the OR was my son.  My little boy. My everything. And I was overcome by emotion.

What must he be thinking?  I was his mommy and I was handing him over to complete strangers in scary masks and hats.  I told him to do whatever they asked and had allowed them to poke him with needles and take him away from me when he was terrified.   As I watched a nurse take my little boy into the OR, I knew what he would see.  Bright lights, computers, a huge anesthesia cart, empty canisters and TV screens.  I pictured him assessing the room and climbing up to the giant operating table.  I wondered if he would be afraid of the scopes lying on the sterile scrub table?  Afraid of the room?  I was relieved he chose his dad to go in with him. Looking him in the eye and seeing his fear was overwhelming me.


I immediately flashed back to work and the first time I had to go into the OR at the children's hospital. It was about two months into my new job and I was excited to see my first major pediatric Urology case. I remember it as clear as yesterday.  The patient was a 12-year old girl with a congenital condition that caused her to manufacture kidney stones like a production line. I would see nothing like it again in a child. I was there to assist with the machine that broke up the stones and removed the fragments from the kidneys. It was a long and tedious process.  The normally two hour surgery was finally aborted after six hours.  What I remember so clearly about this case was that this was the first time that I became acutely aware of the nurses.  Six hours of observing them in the OR that day gave me a whole new appreciation for all the intangible things they do that makes them special. It was the day I noticed them do so many things that I've come to associate with nursing and yet are not in the nursing job description.


While the surgeon was worried about his patient and her kidneys, the nurses were worried about the child and her family.  It was a beautiful balance that exemplified the importance of each of their roles.  While the surgeon was ordering more suction, it was the circulating nurse who noticed the little girl had cold feet and ordered socks.  While the urology nurse was prepping the patient for another access point she took the time to adjust the pillow that was slipping out from under the little girl's head.   When the two hour mark passed, it was the scrub nurse who looked up at the clock and reminded the doctor that the surgery was taking longer than planned and her parents were probably worried. He thanked the nurse and sent someone to update the family.


Sitting in the OR waiting area the vivid events of this day flooded back to me.  In large part because I finally understood.  During our pre-op meetings we saw two doctors and probably five different nurses. It was the nurses who we we interacted with most of the time.  The nurses answered most of our questions and gave us our instructions.  It was the nurses who tried to make my crying child laugh.   The surgeon who came in to speak with us was kind, patient and sweet.   The surgeon smiled at my son and said hello, but she was all business, efficient and serious.  I now understood why.  She did not want to have the image of my son's face and tears in her mind as she tried to find out what was wrong with him.   She needed to be focused on the procedure and the medicine, not on the fear of the child or his family.


I felt blessed that I had seen the OR from the perspective of doctors and nurses. Knowing there would be so many nurses in the room gave me immense comfort. The doctors may have been in charge of overseeing his medical care, but it's the nurses who determined my son's overall experience.  I knew It would be the nurses who made sure his stuffed shark got the same hospital band as my son.  It would be the nurses who made sure his feet were warm and his body comfortable.  They would be the ones transferring him and holding his hand as he fell asleep. And I knew it was the face of a nurse that my son would first see when he opened his eyes from the anesthesia.  It was her arms that would hold him when he freaked out.  Her hands keeping him from pulling the tubes out of his nose and mouth. Her voice telling him it would be ok and that he was safe.  It would be a nurse who would come and get me when he cried for his mommy.


As patients we often see nurses executing the doctors orders. However, it is my hope that the nurses who helped my son in the OR that day know that they did so much more for him.  While their job to help manage the execution of medical care is important,  watching them with my little boy showed me what it is that makes them so valuable.


So, to all the nurses who helped my son, Thank you. Thank you for holding his hand and taking away his fear. Thank you for dealing with the emotion and the pain and crawling into his cot to hold him when he was scared. Thank you for being an extension of mommy when mommy couldn't be there.  Thank you for seeing a child and not another patient. It may have been his Doctor who treated my son as her patient, but it was the nurses who humanized him.   It was the nurses who gave him back his status as my little boy.  You never forgot what really mattered. For that I am eternally grateful.

Written by Heather Conner

Friday, May 8, 2015

New recommendations for treating patients with high blood pressure and cardiovascular disease

Scientific Statement"

March 31, 2015 Categories: Heart NewsScientific Statements/Guidelines



Statement Highlights
  • Three professional organizations have issued a joint statement on treating high blood pressure in people who have been diagnosed with coronary heart disease, stroke or other forms of heart disease.
  • The statement reinforces the goal of reducing blood pressure to under 140/90 in order to reduce the risk of heart attack and stroke.
  • Patients should know their blood pressure, make lifestyle changes to reduce their risk of heart attack and stroke, and work with a physician to safely lower their blood pressure.
This article was published in DALLAS, Texas on  March 31, 2015 .  The American Heart Association came out and discussed a new scientific statement issued jointly by three medical organizations and published in the American Heart Association’s journal Hypertension, which addresses how low healthcare providers should target the blood pressure when treating patients with high blood pressure who also have vascular diseases."The document provides an up-to-date summary on treating hypertension in patients who have both high blood pressure and have had a strokeheart attack or some other forms of heart disease, said Elliott Antman, M.D., President of the American Heart Association and professor of medicine at Harvard Medical School."1

In the article; “The writing committee reinforces the target of less than 140/90 to prevent heart attacks and strokes in patients with hypertension and coronary artery disease,” he said. “This is important since confusion has arisen in the clinical community over the last year regarding the appropriate target for blood pressure management in the general population.”1
The American Heart Association, American College of Cardiology, and American Society of Hypertension have 
issued a joint statement regarding this issue. 
According to this joint statement, "while a target of less than 140/90 is reasonable to avoid heart attacks and strokes, a lower target of less than 130/80 may be appropriate in some individuals with heart disease who have already experienced a stroke, heart attack, or mini-stroke (also called a transient ischemic attack or TIA) or who have other cardiovascular conditions such as a narrowing of leg arteries or abdominal aortic aneurysm."1
The committee states that lowering  a patient's b
lood-pressure can be done safely, and the vast majority of individuals will not experience problems when standard medications are administered correctly. However, the joint statement recommends that healthcare providers use extreme caution in patients with coronary artery blockages, advising that "blood pressure should be lowered slowly, and not strive to decrease the diastolic (lower number) blood pressure to less than 60 mm Hg, particularly in patients more than 60 years old."
The group writing the article and recommendations offer specific, evidence-based recommendations and contraindications to help healthcare providers select which 
anti-hypertensive medications to use in patients with various types of heart disease. 

“In the spectrum of drugs available for the treatment of hypertension, beta-blockers assume center stage in patients with coronary artery disease,” said Clive Rosendorff, M.D., Ph.D., who is the chair of the writing committee, as well as a professor of medicine at the Icahn School of Medicine at Mount Sinai in New York.  He is also the director of graduate medical education at the Veterans Administration in the Bronx.   Beta-blockers not only slow the heart rate and reduce the force of cardiac contraction, both of which reduce the heart’s consumption of oxygen. They also increase blood flow to the heart by prolonging the time between contractions, which is when blood flows into the heart muscle.


Additional Resources:
References
  1.  Association, A. (2015, March 31). New recommendations for treating patients with high blood pressure and cardiovascular disease. Retrieved May 8, 2015, from http://newsroom.heart.org/news/new-recommendations-for-treating-patients-with-high-blood-pressure-and-cardiovascular-disease