WWW.HOSPITALNEWSPAPER.COM HOME SUBSCRIPTION - $36/YEAR APRIL 2013 HOSPITAL H NEWSPAPER Looking for the right employee? Join our Career Guide! Online… PRESORT STANDARD U.S. POSTAGE PAID PERMIT 7246 PHILADELPHIA, PA 19143 CHANGE SERVICE REQUESTED Hospital Newspaper 1 Ardmore Street New Windsor NY 12553 The New Jersey Edition TRINITAS REGIONAL MEDICAL CENTER p16 Hospital of the Month! See page 14 If you are a Hospital employee looking for a mortgage or refinancing contact Sun Home Loans about their Hospital Employee Loan Program and you could WIN AN IPAD! PHX announces an industry first Healthcare Cost Management Loyalty Program p4 Welcome to the 2013 NEW JERSEY LEAGUE FOR NURSING CONVENTION “Nursing: Issues of Our Times” p26-29
Hospitals will find this the place to recognize employees, tell their stories of patient care, market their new technology and promote upcoming events! No one tells the story of local hospitals like Hospital Newspaper!
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WWW.HOSPITALNEWSPAPER.COM HOME SUBSCRIPTION - $36/YEAR APRIL 2013
HOSPITALH NEWSPAPER
Looking for the right employee?
Join our Career Guide!
Online…PRESORT STANDARD
U.S. POSTAGE PAID
PERMIT 7246
PHILADELPHIA, PA 19143
CHANGE SERVICE REQUESTED
Hospital Newspaper 1 Ardmore Street New Windsor NY 12553
The New Jersey Edition
TRINITAS REGIONAL MEDICAL CENTER p16
Hospital of the Month!
See page 14
If you are a Hospital employee looking for a mortgage or refinancing contact Sun Home Loans about their Hospital Employee Loan Program
and you could WIN AN IPAD!
PHX announces an industry firstHealthcare Cost
Management Loyalty Program p4
Welcome to the2013
NEW JERSEY LEAGUE FOR NURSING CONVENTION
“Nursing: Issues of Our Times” p26-29
PAGE 2 April, 2013 Hospital Newspaper - NJ
Hospital Newspaper - NJ April, 2013 Page 3
Premier Healthcare Exchange (PHX), Inc., a leading provider of healthcare
cost management services is extremely excited to announce the release of an
industry first B2B customer loyalty program, the ‘U’ Premier Loyalty Program.
The ‘U’ PLP is designed to provide recognition to the operations people
with whom PHX interfaces with every day at each of our clients. It is
characterized by an all-new integrated, point-based system that delivers
streamlined benefits within a modern loyalty program that incorporates
elements of smart gamification. Because PHX realizes the importance of
customer loyalty and satisfaction, its new ‘U’ PLP reflects their commitment
to foster a long term relationship with their customers and reward them for
their loyalty.
PHX has paired with Badgeville, the #1 gamification platform, to create a
program which draws on proven techniques in social gaming
combined with components from traditional loyalty programs.
The end result is an innovative offering which creates a
compelling user experience that encourages customers to
leverage the PHX library of educational resources and customer
focused tools, thus enabling them to become more proficient at
utilizing the PHX solution suite.
“Industry leaders such as PHX understand that loyalty programs
today must tie directly into the day-to-day behaviors performed
by their customer or employee,” said Kris Duggan, CEO,
Badgeville. “The first healthcare cost management company to
incentivize user loyalty through gamification, PHX has joined the
ranks of world-class B2B businesses that are employing modern
loyalty techniques to drive greater value for their customers.”
Using the customized Behavior Engine provided by Badgeville,
PHX designed a program in which clients achieve recognition based on
their tenure as a client and by completing specific behaviors. These activities
result in accumulated points that can be exchanged for gift cards or a
donation in the client’s name to a qualifying charitable organization.
In return, by participating in the loyalty program, engaged clients will become
more accustom to PHX’s comprehensive suite of services and the benefits
these services provide while being motivated with recognition, achievement
and status dynamics.
“By utilizing the Badgeville Behavior Platform, we have the power to
understand the myriad of behaviors exhibited by our clients across our
service platform and put meaningful rewards in place that recognize the
collective participation of their company. And that’s extremely important to
a customer centric organization like PHX. In fact, the ‘U’ Premier Loyalty
Program gives us a vehicle to provide an innovative, interactive rewards
system for the people we care most about, the experts working in our client’s
operations department. And it’s also a key enabler of the process necessary
for achieving our key business objectives and to maintain alignment with
our mission of delivering healthcare cost management value,” stated
Leo J. Garneau III, PHX, Chief Marketing Officer.
For more information on the strategy utilized to develop the “U” Premier
Loyalty program, please refer to the case study at
http://www.badgeville.com/casestudy/PHX?ref=PHX.
About Badgeville
Badgeville, the #1 gamification and behavior management platform, enables
companies in virtually every industry to influence and measure user behavior.
World-class businesses in more than 20 countries use Badgeville's Behavior
Platform, an award-winning Platform-as-a-Service (PaaS) solution to increase
customer loyalty, user engagement, and employee performance across an
organization's websites, mobile apps and enterprise applications. With over
180 customers, Badgeville brings Game Mechanics, Reputation Mechanics,
and Social Mechanics to industry leaders and innovators including Deloitte,
PHX, EMC, Oracle, Autodesk, Bell Media, NBC, Universal Music, VMware,
and more. Founded in 2010, Badgeville is based in Redwood City, Calif. and
has offices in New York and Europe. (To learn more follow @Badgeville or
visit www.badgeville.com.)
About PHX
Premier Healthcare Exchange (PHX) was incorporated in 2001. The company
provides advanced cost management solutions for health plans that combine
claim processing automation with professional services to deliver a timely,
centralized approach to healthcare cost management. This approach results
in a significant reduction in payment errors, appreciable improvement in the
time needed to bring claims to resolution and in savings that substantially
reduce the healthcare costs of its clients.
Additionally, through its Pay-Plus Solutions™ division, PHX delivers easy,
fast and reliable electronic payments and explanation of payments to
healthcare providers. PPS is the only system designed exclusively for
healthcare that combines banking functions, claim payments and claim
remittance and integrates with traditional paper processes.
PHX solutions are utilized by industry leading insurance companies,
Taft-Hartley Funds, Health Maintenance Organizations (HMOs), Third Party
Administrators (TPAs) and healthcare providers. For the fouth consecutive
year NJBIZ recognized PHX as one of the fastest growing companies in
New Jersey and in 2012 PHX became a four time recipient of the Inc.
500/5000 list of the fast growing private companies in America. Additionally,
PHX received the inaugural “Hire Power” Award from Inc. magazine
recognizing PHX as one of the top job creators over the past three years.
For more information, please visit us at www.phx-online.com.
PHX announces an industry first Healthcare Cost Management Loyalty ProgramLeading healthcare services provider launches innovative customer rewards experience powered by Badgeville
Hospital Newspaper - NJ April, 2013 Page 5
PAGE 6 April, 2013 Hospital Newspaper - NJ
Hospital Newspaper - New Jersey edition - Vol. 11 No. 4 -is published monthly, 12 times a year for $36 per year byBelsito Communications, Inc., 1 Ardmore Street, NewWindsor, NY 12553. Postage Paid at New Windsor, NYand additional mailing offices. Postmaster: Send addresschanges to Hospital Newspaper, 1 Ardmore Street, NewWindsor, NY 12553. No financial responsibility is assumedby this newspaper to publish a display, classified, or legalad or for typographical errors except of reprinting that partof the ad which was omitted or in error. Omissions or errorsmust be brought to the attention of the newspaper duringthe same month of publication.
From left, Michael Fancher, Business Development Manager andSharon Bready, Facility CEO, CareOne LTAC Hospitals, celebrate theopening of the CareOne LTAC at Trinitas Regional Medical Center withGary S. Horan, FACHE, President and CEO of Trinitas.
Trinitas Regional Medical Centerbecomes home to CareOne LTACHospital Unit
provided
If you’d like to reach the health and hospital communities of New Jersey each month,
there is no more cost-effective way than the Hospital Newspaper.
Call Jim Stankiewicz to place your advertisement: 845-534-7500 *219
PAGE 8 April, 2013 Hospital Newspaper - NJ
It’s not just people that make a hospital. The environment—the infrastructure, architecture, and design—also plays
a key role in hospital viability. As the economy recovers, so does the will to invest in hospital facility upgrades and
construction projects, albeit cautiously and on a smaller scale. And with the potential increase in patient load, coupled
with the link between patient satisfaction, outcomes, and payments, facility investments present a long-term opportunity
to make a positive impact on your bottom line.
A 2011 survey found that patient satisfaction is one of the top three concerns of hospital executives. And in October of
last year, the patient satisfaction stakes rose even higher when the Affordable Care Act tied payment cuts to the Hospital
Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Poor HCAHPS scores will cost
hospitals 1% of their reimbursement, a penalty that will grow to 2% in FY 2017. Among other questions, the survey
asks patients to rate their hospital environment according to cleanliness and noise level—which should make facilities
an essential part of every hospital’s reimbursement strategy.
The 2012 Hospital Construction Survey by Health Facilities Management and the American Society of Healthcare
Engineering reported that the majority of hospitals plan to spend more on renovations than new construction, consistent
with the present climate of fiscal restraint. In this patient-centric, tight budget environment, hospitals need to make
prudent decisions and invest in the right projects at the right price.
Although not traditionally associated with facilities management, group purchasing organizations (GPOs), which provide
access to competitive pricing for a variety of contracts for everything from planning to plumbing and from floor mats to
roofing, make a perfect partner for facilities managers and other decision-makers before and during a renovation or
building project.
Hospitals that work with GNYHA Services from the inception of a construction project can present their proposed plan
and gain access to custom-made supply and other contracts. They can also consult a GPO subject matter expert—
who is armed with a background in construction and/or electrical, architecture, etc.—at any or every stage of the
process. In addition, GPO representatives are available to help facilities managers identify savings through suggested
contracts and can create contracts based on specific needs. GPOs are even equipped to become part of a hospital
emergency preparedness plan, helping to arrange access to medical and non-medical supplies and technology.
Hospitals are realizing that their facilities are fundamental to their overall success, affecting everyday but important
issues, such as patient satisfaction and workflow. With well thought out construction plans and a GPO to maximize
savings on supplies, equipment, and services, hospitals can ensure that they are providing an environment that allows
for the highest possible level of care and brings them to the optimal intersection of cost, quality, and outcomes.
Christopher J. O’Connor is Executive Vice President of GNYHA Ventures, Inc., the for-profit arm of the Greater New York Hospital
Association, and President of two GNYHA Ventures companies: GNYHA Services, Inc., an acute care group purchasing organization,
and Nexera, Inc., a healthcare consulting firm. Mr. O’Connor is Chair-Elect of the Association for Healthcare Resource & Materials
Management (AHRMM).
Ask An ExpertAsk An Expert
Christopher J. O’ConnorExecutive Vice President, GNYHA Ventures, Inc.,
President, GNYHA Services, Inc. and President, Nexera, Inc.
Building Patient Satisfaction
Hospital Newspaper - NJ April, 2013 Page 9
Upgrade your bottom line.Facility upkeep is vital to the safety and satisfaction of your patients and employees. �e GNYHA Services facility maintenance portfolio is designed to help hospitals complete successful repair, renovation, and construction projects with reliable suppliers at signi�cant savings.
Repair and renovation don’t have to be DIY. Call GNYHA Services at (212) 246-7100.
555 West 57th St. I New York, NY 10019
PAGE 10 April, 2013 Hospital Newspaper - NJ
Latestinfo fo
r
nurses and
students
By Alison Lazzaro
Valentines Day 2013 was not the usual couples retreat at Bally’s Hotel in Atlantic City
this year. Two-thousand nursing students chose to spend the day at the New Jersey Nursing
Students Inc. 61st Annual Convention. This networking opportunity was themed Kings
and Queens of Hearts: Ace Your Career in Nursing. The year-long diligent planning by a
student run board of nursing students was in full swing on Valentine’s Day.
Eager nursing students began their trip on Wednesday night if they were chosen to
represent their schools as Delegates. The enthusiastic group followed Roberts Rules of
Parliamentary Procedure to conduct business. Thursday was packed with forty-seven
focus sessions on topics from prenatal care to resume workshops, run by the New Jersey
Association of Healthcare Recruiters, to psychiatric-mental health concepts, caring for
the LGBTQ population, political action, and cardiac pharmacology. There was a topic
for every student's unique interest. Simultaneously, a blood drive hosted by the American
Red Cross enabled students to save lives even when they were away from clinical for a day.
Student nurse speakers also discussed the resolutions they prepared in order to present them at the National Student Nurses
Association Convention. NCLEX preparation classes were even available to help students pass after graduation and land
their dream job!
The exhibit hall bustled with NCLEX test preparation organizations, colleges and universities, job opportunities,
uniform sales, and raffle baskets. Students came prepared with resumes and enthusiasm as they professionally greeted
exhibitors. Whether interested in applying to graduate school, ready to face the NCLEX, job searching, or just interested in
seeing what opportunities were available, students were busily networking
throughout the hall.
Thursday night allowed participants to unwind from the long day and
have fun with new acquaintances at the First Night Party. The theme was
"Rodeo Roundup: Lasso in Some Fun" and included Country line dancing
with the western theme. With “Watermelon Crawl” lessons, students came
dressed in cowboy boots to enjoy food and dancing.
Friday closed with the final House of Delegates meeting in which
students prepared speeches to run for a 2013-2014 board position.
Following delegate voting, students could choose to attend a NCLEX
review course or if the exam seemed far away as an underclassman, students could participate in a Disaster Health Services
Response Workshop held by the American Red Cross. The Convention was a huge success and a great way for students
to get more involved in their pre-professional nursing organization.
Nurse’s Viewpoint
Hospital Newspaper Correspondent
61st Annual Convention: Kings and Queens of Hearts: Ace Your Career in Nursing
Hospital Newspaper - NJ April, 2013 Page 11
PAGE 12 April, 2013 Hospital Newspaper - NJ
Two Seton Hall School of Health
and Medical Sciences Internal Medi-
cine residents currently serving their
residency at Trinitas Regional Medical
Center have been awarded Fellow-
ships at two well known metropolitan
medical centers. Nancy Holder, MD,
has received a fellowship in pul-
monary medicine and critical care
medicine from Newark Beth Israel
Medical Center while Amar Sarao,
MD, is the recipient of a fellowship in
critical care medicine at Mount Sinai
Medical Center in New York City.
“Fellowships from these outstand-
ing health care institutions show that
Trinitas Regional Medical Center of-
fers a first-rate residency program,”
said Gary S. Horan, President and
Chief Executive Officer. “I’m proud
to congratulate all who are part of this
fine program.”
Drs. Holder and Sarao join other
Trinitas Regional Medical Center
medical residents who most recently
have received fellowships at presti-
gious national institutions. They are:
Vivek Bansal, MD, who received a fel-
lowship in Endoscopy at Case Western
Reserve University School of Medi-
cine in Cleveland; Mukesh Kumas,
MD, who was awarded a fellowship in
hematology and oncology from Emory
University School of Medicine in At-
lanta, Georgia, and Swaroopa
Yerrabothala, MD, currently doing a
blood transfusion fellowship at Dart-
mouth-Hitchcock Medical Center in
New Hampshire where she will begin
a fellowship in hematology and oncol-
ogy. Over the years, medical residents
at Trinitas have had an impressive
track record of being awarded fellow-
ships at top institutions.
For more information on Trinitas
Regional Medical Center, visit:
www.TrinitasRMC.org or call (908)
994-5138.
Drs. Amar Sarao and Nancy Holder, shown with Dr. Ernest Federici, Director of the InternalMedicine Residency Program (left), and Dr. William Farrer, Associate Director of the Program,join other Trinitas medical residents who have previously received fellowships at prestigiousnational institutions.
Residency Program at Trinitas Regional Medical Center prepares young doctorsfor prestigious fellowships
provided
education & careers
Unique RecruitmentOpportunity
Hospital Newspaper believes that high school students should be informed about potential healthcare careers.
Special career sections will be placed in your local high schools,medical schools, colleges and nursing schools.
This is your opportunity to displayopportunities for:
Faculty/PhysicianNursingAdministrativeSupport PositionsClinical Care
Medical AssistantsCounselorsMedical ImagingDieticians
Educational Partnershiplaunched, allows LourdesNursing Students to earnBachelor’s and Master’sDegrees
Launched in November 2012 through an edu-
cational partnership with Immaculata University
and Camden County College, Our Lady of Lourdes
School of Nursing is currently offering its reg-
istered nurse diploma program with the option to
earn a bachelor of science degree in nursing
(BSN) as well as a master of science degree in
nursing (MSN) on-site at Our Lady of Lourdes
School of Nursing.
This partnership is the result of a three-year
collaboration to provide a seamless transition to
higher education to students, graduates and nurses
within Lourdes Health System.
“To be able to offer the RN to BSN and MSN
degree programs at Our Lady of Lourdes, a main-
stay in South Jersey, ensures that the educational
outlook for the healthcare community in New
Jersey will remain strong,” says Sister R. Patricia
Fadden, IHM, Ed.D., president, Immaculata
University.
Our Lady of Lourdes School of Nursing pro-
vides an educational program that is based on
Christian values, which advocate caring, social re-
sponsibility and service to those in need. The
School is dedicated to providing a learner-cen-
tered environment that develops competent, com-
passionate and knowledgeable professional nurses
for entry into practice.
For more information, please visit our website
at www.lourdesnursingschool.org
Pictured reviewing the educational partner-ship agreement is (l to r): Lisa Easterby, DNP,RN, CNE, dean of Our Lady of LourdesSchool of Nursing; Anne McGinley, PhD,RN, APN, dean of Camden County College’sDivision of Nursing, Health Science andHuman Services; and Sister Ann Heath, IHM,Ph.D., vice president for Academic Affairs atImmaculata University.
provided
PAGE 14 April, 2013 Hospital Newspaper - NJ
Win an iPad!If you are a member of the hospital community, now is your chance to enter
Sun Home Loans and Hospital Newspaper's contest to win a free iPad.
Just to go our website at www.hospitalnewspaper.com and fill in the entry form.
Once you complete it, you will receive an email that requires you to confirm your
email address. Once you do that you are entered. Hospital Newspaper will also
be accepting applications at all conventions that it attends. A total of Five iPads will
be given away so your chances to win are excellent. Sign up today to win today!
www.sunnb.com
Sun Home Loans, Sun National Bank, and Hospital News are not affiliated. All loans subject to approval. Certain conditions and fees may apply. Mortgage financing provided by Sun Home Loans, a division of Sun National Bank, member FDIC. Equal Housing Lender. NMLS #429900
Sun Home Loans, a division of Sun National Bank,
is proud to serve the heroes in our community
who dedicate their lives to serving the rest of us:
doctors, nurses and other hospital employees.
That is why we teamed up with Hospital News to
create the Hospital Employee Loan Program (HELP).
With a competitive mortgage rate and discounted
fees, this program helps our community heroes
purchase new homes or refinance existing homes.
Plus, the program comes with our pledge to get
hospital employees in their new homes by their
contract dates.
Hospital Employee Loan Program
PROGRAM INFORMATION
We understand that the current economic environment has created
challenges to home ownership. Working with our own resources and
Federal government programs we will create a solution that opens
the path to home ownership.
The Hospital Employee Loan Program delivers these advantages:
» A competitive mortgage rate, available specifically for
hospital employees
» Discounted fees
» Personal service from program specialists
» Our pledge to have you in your home by the contract date
COMMUNITY FOCUS
Sun National Bank, a full-service provider of banking products and
services, is dedicated to playing an active part in the communities
we serve. We support a variety of organizations, events and programs
whose goals are to make our neighborhoods a better place to live and
work and improve the lives of those living around us. Hospital News is
the leading provider of local news and information for doctors, nurses
and other hospital staff.
Learn MoreTo find out more about our Hospital Employee Loan Program, email [email protected] or call 973-615-9745 to talk with our program specialist, Steve Testa (NMLS #460176), who will discuss your need and explain how the program could benefit you.
The springtime serves as peak home-buying
season. Even though buyers have a greater advan-
tage than they’ve had in awhile, it’s still easy to
take a wrong, frustrating and – gasp – costly turn.
But don’t worry: The Sun National Bank Hospital
Employee Loan Program (H.E.L.P). provides six
ways to make sure buying a new home proves to
be a success.
Hospital Newspaper and Sun Home Loans teamed
up to create the H.E.L.P. Program. This exclusive
mortgage opportunity provides discounted fees and
low interest rates for firefighters and other members
of the emergency services community. The program
offers unmatched rates, minimal lender fees and
promises to get clients in their new home by the con-
tract date.
1Be prepared: You will need to do a little
homework before you get started looking for
a new home. Make sure that you can locate all
the documents necessary for you to be pre-ap-
proved for a mortgage. You will most likely need
the following: Your two most recent pay stubs, your
last two years W2’s, all of your asset statements,
(checking, savings,401k, stocks, bonds, mutual
funds) and last two tax returns. Sit down and work
up your budget, know how much you want to spend
before you are told how much you can actually
spend.
2Get pre-approved: Call the H.E.L.P.
Program to be pre-approved for your new
mortgage. Without pre-approval, you will
not know what you can afford to buy. This can get
you into a very difficult situation. If you put an
offer on a house without being approved and you
can’t afford it, you might be opening the door to
some very expensive litigation. Call the H.E.L.P.
Program and find out what you can afford to buy.
3Ensure you are working with a real
estate professional: Ask your H.E.L.P.
Program representative if they can recom-
mend a real estate professional to you. It is ex-
tremely important to have a real estate agent that
is working for you and your best interests. A real
estate agent will look out for the best deals in your
market and are there to facilitate the negotiating
process and the transition to your new home.
4Find a good real estate attorney:
A lawyer can help you negotiate the real es-
tate contract and renegotiate it if a home in-
spection finds flaws - or an appraisal deems the
house less valuable than the sales price. A lawyer
also represents your interests at the closing and
does the lion’s share of paperwork and coordination
associated with it.
continued on next page
Sun Hospital Employee Loan program provides six ways to makeyour home purchase a success
Hospital Newspaper - NJ April, 2013 PaGe 15
education & careers
5Make a firm offer: When you see a house you want, you’ll make a verbal offer. If the
seller is interested, your next step is to commit yourself in writing. The written offer, or
contract, is usually drawn up by the seller’s agent, but if you choose to use a buyer’s
agent and real estate lawyer, they can negotiate and review that contract on your behalf. If you
end up negotiating the price of the property, make sure that you check in with your H.E.L.P.
Program representative. You do not want to overbid the price of the property and then not be
able to qualify.
6Get the home inspected: No matter how good a house looks and no matter how
much you love it, you want to be sure it’s sound structurally and in every other way.
If it’s not, you want to know whether the seller will address the issue before you seal the
deal. If not you have to decide whether you want to back out of the deal or take care of the
TRINITAS PROVIDES CRITICAL CARE FOR HEART ATTACK PATIENTSMost direct route “from door-to-balloon” is the goal
When the recommended time-
frame of emergency angioplasty
treatment for a heart attack is only
90 minutes, every minute is crucial.
When a healthcare facility is able to
cut 15 to 20 minutes off its “door-
to-balloon” time, the potential for
saving lives soars.
At Trinitas Regional Medical
Center, that life-saving potential is
realized every time a heart attack
patient is en route. Field assess-
ments of emergency responders
trigger an early call to the Cardiac
Catheterization Lab. The Cath Lab
team calls the Emergency Depart-
ment where doctors can assess the
patient and confirm the diagnosis
immediately upon arrival resulting
in reduced time spent in the
Emergency Room.
Trinitas is one of the only med-
ical centers in New Jersey to offer
this direct line to cardiac care.
Patients experiencing STEMI
(ST segment elevation myocardial
infarction, a heart attack brought on
by a blocked coronary artery) have
traditionally been forced to make a
first stop in a hospital’s ER before
being brought to a cardiac unit for
treatment – a practice the American
Heart Association is lobbying to
change, says Trinitas Mobile ICU
Coordinator Ken Reardon.
“It comes down to doing what’s
in the patient’s best interest,”
Reardon says. “Now when we have
a patient in the field showing
STEMI, EMS responders have a
20-minute head start in notifying
the hospital and the cath lab. They
can perform a 12-lead ECG and
transmit those results [from the
truck] to the hospital and on-call
staff via e-mail and fax, and they
can keep that patient on a stretcher
all the way to the lab.”
Reardon, along with Chairman
of the Department of Emergency
Medicine John D’Angelo, DO,
FAAEM, Fayez Shamoon, MD,
Medical Director of Cardiovascular
Services, and RNs Denise Loneker
and Janice Lynch were among the
key players in helping transform
Dr. Fayez Shamoon, Director of Cardiovascular Services (left), confers with Dr. John D’Angelo,Chairman of the Department of Emergency Medicine, about the life-saving potential of field assess-ments of patients suffering heart attacks caused by blocked arteries, known as STEMI.
Ken Reardon, Coordinator of the Mobile Intensive Care Unit at Trinitas Regional Medical Center,transmits patient care data through a 12-lead EKG directly to the Emergency Department and to thetreating cardiologist through his or her smartphone, a process that speeds heart attack patientsarriving at Trinitas into the cardiac catheterization lab.
Trinitas’ response to STEMI
emergencies. For D’Angelo,
who’d seen the system succeed at
the Florida facility where he
worked before joining Trinitas, the
premise is simple. “Time is mus-
cle,” he says. “Symptom onset
[when a patient experiences chest
pain] to opening the blocked ar-
tery is critical. Our patients need
to recognize signs of a heart attack
and present to the Emergency De-
partment immediately. Every sec-
ond counts—every second we save
means we’re saving heart muscle
and potentially preventing compli-
cations like fluid retention and
shortness of breath.”
In conjunction with the American
Heart Association’s Mission: Life-
line initiative to change the way
STEMI patients are transported, re-
ceived and treated, Trinitas Re-
gional Medical Center is leading the
way in providing more efficient, ef-
fective care when these types of
coronary blockages threaten lives.
The AHA estimates that less than
half of STEMI patients around the
country receive treatment within
their recommended timeframes;
Trinitas is taking the lead among
New Jersey hospitals in changing
that life-or-death trend.
About Trinitas RegionalMedical Center
Trinitas Regional Medical Center
(TRMC), a major center for compre-
hensive health services for those who
live and work in Central New Jersey,
is a Catholic teaching medical center
sponsored by the Sisters of Charity
of Saint Elizabeth in partnership with
Elizabethtown Healthcare Founda-
tion. With 10 Centers of Excellence
across the continuum of care, Trinitas
has distinguished itself in cardiology,
cancer care, behavioral health, renal
care, nursing education, diabetes
management, wound healing and
sleep medicine. For more informa-
tion on Trinitas Regional Medical
Center, visit: www.TrinitasRMC.org
or call (908) 994-5138.
photos provided
Hospital Newspaper - NJ April, 2013 Page 17
Being first with ground breaking technology is a hallmark of Trinitas Compre-hensive Cancer Center, which was the first cancer center in New Jersey to provide patients with the Varian Trilogy radiation therapy system in 2005.
Trilogy’s ultra-precise robotics accurately tracks and adjusts for tumor movements at the moment of treatment, then targets cancer and neurological lesions with sub-millimeter accuracy. No other facility in New Jersey has more experience withVarian Trilogy than Trinitas.
Trinitas was also the first in New Jersey to offer women the new Accuboost radiotherapy technology – a highly effective, non-invasive treatment for breast cancer that is more accurate than standard breast radiotherapy. In addition, Trinitasis a leader in radiosurgery – which uses precisely-focused beams of radiation to treattumors anywhere in the body.
Ground breaking technology, and the expertise to use it - that’s the Trinitas Comprehensive Cancer Center.
TRINITAS CENTERS Behavioral Health • Cancer Care • Cardiology • Diabetes Management OF EXCELLENCE Maternal & Child Health • Renal Services • School of Nursing • Senior Services
Trinitas Regional Medical Center is a Catholic teaching institution sponsored by the Sisters of Charity of Saint Elizabeth in partnership with Elizabethtown Healthcare Foundation.
Look to a ComprehensiveCancer Center that is first tooffer the latest technology…
Clarissa Henson, MDChair of Radiation Oncology
For the Best inCancer CareFor the Best inCancer Care
Look to Trinitas Comprehensive Cancer Center.
PAGE 18 April, 2013 Hospital Newspaper - NJ
Hunterdon Healthcare and Hunterdon Healthcare
Partners were awarded the “Grand Champion” title for
the 7th annual Nextgen Healthcare/Intel Innovation
Award, also known as the Best Practice Award. This
award confirms that Hunterdon Healthcare embraces
a full “meaningful use” implementation of NextGen
applications when managing a business and delivering
quality care to patients.
The term "Meaningful Use" applies to rules for hos-
pitals and providers who are on an Electronic Health
Record ("EHR"). Hunterdon Healthcare utilizes
NextGen as their EHR system. EHR’s provide many
benefits for physicians and their patients, such as:
complete and accurate information and patient em-
powerment. EHR’s facilitate greater access to the in-
formation so physicians can diagnose problems earlier
and improve the health outcomes of their patients.
They also allow information to be shared more easily
among physicians’ offices, hospitals, and across health
systems, leading to better coordination of care.
NextGen Healthcare provides electronic health
records (EHR), financial, and health information ex-
change (HIE) solutions for hospitals, health systems,
physician practices, and other healthcare organizations.
The implementation of NextGen has allowed for sys-
tem expansion and achievement in clinical integration
within the community, as well as ensuring return on in-
vestment for physician practices. Currently, Hunterdon
Healthcare has 199 health providers including physi-
cians and nurses in 48 private and hospital-operated
specialty and primary care practices using NextGen.
Pictured are members of the NextGen team for Hunterdon Healthcare and Hunterdon Healthcare Partners: Back row(left to right): Christopher Simone, Elizabeth Murtha, RN, Alan Revell, Karen Giannattasio, Janice Crawford, RN, LauraKratz, Dawn Tortoriello, Paul Taluba. Middle row (left to right): Jangie Lin, Peggy (Margaret) Sakasitz Valerie LoVerso,Liz (Elizabeth) Verhalen, Pam Anderson, Cheryl Carpenter, Lisa Bosga. Front row (left to right): Christine Bogard, JeanFitzgerald, Glenn Mamary, Wayne Fellmeth, MD.
Hunterdon Healthcare receives Grand Champion Award from Nextgen
provided
Here are just a few ways NextGen has helped Hunterdon Healthcare:
• Hunterdon Healthcare achieved Level 3 Patient Centered Medical Home (PCMH) designation from the National Committee for Quality Assurance (NCQA).
• Implementation of Population Health initiatives to measurably improve the percentage of patients receiving necessary preventative healthcare services.
• NextGen’s Health Information Exchange allows Hunterdon Healthcare to securely share clinical patient data across the practices in their network.
• Improved care team/patient communication with NextGen has resulted in increased patient satisfaction.
Hunterdon Healthcare is committed to continuing to push the boundaries of what is possible with NextGen to streamline workflows, increase revenue and most of all,
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Hospital Newspaper - NJ April, 2013 PAGE 19
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When Clara Memba, RN, of
Bloomfield headed to an 8:30 a.m.
nursing meeting after her overnight
shift at UMDNJ-The University
Hospital on February 4, she thought
the meeting would focus on patient
satisfaction.
Not so.
Instead, James R. Gonzalez,
MPH, FACHE, the hospital’s pres-
ident and chief executive officer
(interim); Theresa Rejrat, RN, MA,
its vice president of patient care
services and chief nursing officer;
and several of Memba’s colleagues
were waiting at the “meeting” to
present her with the Daisy Award—
a prestigious nursing award.
“I am truly honored, proud and
blessed to have such a warm, sin-
cere and compassionate nurse,
Clara Memba, as part of the Uni-
versity Hospital family,” said Jen-
nifer Smith, RN, BSN, MSN, the
hospital’s acting medical-surgical
director who nominated Memba for
the honor and spoke during the sur-
prise award presentation. “She has
always provided the highest stan-
dards of care to patients and their
families while displaying acts of
kindness and empathy.”
The DAISY Award is a national
nursing excellence recognition pro-
gram used by more than 1,200 hos-
pitals across the country. It
recognizes nurses who give com-
passionate bedside care and regu-
larly demonstrate superhuman tasks
that nurses are expected to perform
each day. DAISY Award recipients
are nominated by their peers, pa-
tients or families. They are selected
by their peers, and UMDNJ-The
University Hospital presents the
award to a total of six nurses annu-
ally on a bi-monthly basis.
“We are very lucky to have you
here,” Gonzalez told Memba during
the presentation.
Smith noted that Memba has
been a nurse at UMDNJ-The Uni-
versity Hospital for nearly 10 years.
She was nominated for the Daisy
Award based on her extraordinary
care of and compassion for a dying
patient who desperately wanted to
visit family in Africa one last time.
The patient, however, lacked the fi-
nancial means to do so.
Moved tremendously, Memba
worked with the patient’s friends
and church to raise money to send
the patient to Africa. The patient
died shortly after arriving there.
Memba, who nearly left the room
in shock after realizing that she was
being presented with an award, said
that witnessing her father’s sickness
and subsequent death in 1989 mo-
tivated her to become a nurse. Until
that time, she had been a police of-
ficer in her native Cameroon but
made the career change to honor
her father and to help heal the sick.
Since immigrating to the United
States 16 years ago, Memba has
earned a registered nurse degree
from Bergen Community College
and is pursuing a Bachelor of Sci-
ence in Nursing degree from Jersey
City State University.
“I try to do my job to the best of
my ability every day that I step into
this hospital,” she said through
tears while accepting the award and
talking about her father.
During the award presentation,
Memba received a leather-bound
DAISY Award certificate, a lapel pin,
a unique hand-carved stone sculpture
from Zimbabwe entitled “A Healers
Touch,” and a bouquet of daisies. In
addition, she will be featured on the
DAISY Award Foundation’s web-
site. The unit where she works,
From Police Officer to NurseUniversity Hospital Nurse Recalls Father’s Death in Accepting Award
Clara Memba, RN, (center) was nominated for the DaisyAward by UMDNJ-The University Hospital acting medical-surgical director, Jennifer Smith, RN, BSN, MSN, (l). Membawas recognized by James R. Gonzalez, MPH, FACHE, pres-ident and CEO (interim) (r) during the award presentation.
F-Yellow (surgical), shared in her
award winnings by having cinna-
mon rolls supplied for the unit by
Cinnabon after the presentation.
Created in 2000, the DAISY
Foundation was established by
the family of J. Patrick Barnes,
who died at age 33 of Idiopathic
Thrombocytopenic Purpura (ITP),
an autoimmune disease. The
DAISY Award – an acronym for
Diseases Attacking the Immune
System – was designed by the
Barnes family to honor and recog-
nize the compassion and clinical
skills of the nurses who cared for
him.
The University of Medicine and
Dentistry of New Jersey (UMDNJ)
is New Jersey’s only health sciences
university with more than 6,000
students on five campuses attending
three medical schools, the State’s
only dental school, a graduate school
of biomedical sciences, a school of
health related professions, a school
of nursing and New Jersey’s only
school of public health. UMDNJ
operates University Hospital, a Level
I Trauma Center in Newark, and
University Behavioral HealthCare,
which provides a continuum of
healthcare services with multiple
locations throughout the State.
provided
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PAGE 20 April, 2013 Hospital Newspaper - NJ
Hospital Newspaper - NJ April, 2013 PAGE 21
Darlene Tammara, a teacher at the
Matheny School has been selected as one
of the “Teachers Who Rock” by Greater
Media radio stations WDHA 105.5FM
and WMTR 1250AM, located in Cedar
Knolls, NJ. The stations recognize 24
outstanding teachers in New Jersey for
their important contribution to society.
Each Friday, two winners are announced,
and their stories are read on both stations’
morning shows. Tammara’s name was
announced on Friday, January 25. She
and the other 23 Teachers Who Rock will
be honored at a dinner on April 23 at
Ravello Elegant Weddings & Banquets in
East Hanover, NJ.
The Matheny School is part of the
Matheny Medical and Educational
Center, a special hospital and educational
facility in Peapack, NJ, for children and
adults with medically complex develop-
mental disabilities. Tammara teaches a
transition class, which means she has the
responsibility for instructing older
students in life skills that will help them
after they graduate. Four years ago, she
started the Tea Time Café, a snack bar
managed by Matheny students for Math-
eny employees. Now, in her transition
class, she has her students count money
from Tea Time sales, enter the results on
a special math worksheet and make bank
deposits. The students also work on cler-
ical jobs for Matheny and fill packages
for Operation shoebox, an organization
that sends care packages to U.S. troops
deployed overseas.
Tammara appreciates Matheny’s trans-
disciplinary approach, “where therapists
work in the classroom with teachers.
We all work together. I feel very strongly
about that – it’s such a collaborative
effort.” Her colleagues apparently feel
the same way about Tammara as they
nominated her as Matheny’s educator of
the year for the 2012-2013 school year.
Matheny Teacher recognized by Greater Media Radio Stations
Darlene Tammara uses picture symbols to make a story more understandable to studentDeborah Eike. At left is occupational therapist Debbie Goodheart.
16th Annual Miles for Matheny — Ready to Rollon Sunday, April 21
The 16th annual Miles for Matheny, the Matheny
Medical and Educational Center’s annual fundraiser and
community event, will be held Sunday, April 21, at Lib-
erty Park in downtown Pea pack, NJ. Having grown
from a small wheelchair walk and cycling ride in 1998
to an event that attracts more than 1,500 participants,
volunteers and spectators, Miles brings Matheny stu-
dents, patients, families and friends from the community
together to enjoy a day of camaraderie and fun. “Our
goal,” says Steve Proctor, Matheny president, “has al-
ways been to bring together the children and adults with
disabilities with their able-bodied counterparts in a won-
derful and uplifting day enveloped by the strong com-
munity spirit of our neighbors.”
Activities include:
• The Lu Huggins Wheelchair Walk. Friends
and family members can enjoy walking alongside
more than 100 Matheny children and adults who
“wheel” through the streets of downtown Peapack
to the cheers of community members and other
supporters.
• 5K Road Race: USATF-NJ NBGP 500 point
event. Close to 400 runners will race through the
beautiful Somerset Hills on town and rural roads
in this USATF sanctioned run.
• Cycling Routes. Five different cycling routes
wind through the picturesque countryside,
designed to accommodate cyclists of all levels.
A highly challenging climbing cycle route,
“The Hills of Attrition”, is renowned among
endurance cyclists.
• Kids Fun Run. Children, ages 3-10, enjoy
friendly competition where they all are winners.
And they learn at an early age about “running for
a cause.”
• Nourishment. Participants and supporters can
enjoy the Friends of Matheny’s “Breakfast of
Champions”, along with luncheon refreshments
in the park.
Matheny is a special hospital and educational facility
for children and adults with medically complex devel-
opmental disabilities. All money raised at Miles for Ma-
theny will benefit the Matheny Center of Medicine and
Dentistry, which provides medical, dental and therapy
care to Matheny inpatients and to people with disabili-
ties living in communities throughout New Jersey.
Major sponsors are: Poses Family Foundation, title
Holy Name Medical Center raises Awareness for Haiti Initiative“Make a Difference: Have a Heart, Help Haiti” premier draws 350
Holy Name Medical Center
(HNMC) hosted a premier screen-
ing of Caucus: New Jersey’s “Make
a Difference: Have a Heart, Help
Haiti” on February 13. The public
television program, which features
interviews with Michael Maron,
President/CEO of HNMC, and
David Butler, MD, HNMC Ob/Gyn
and President of the Center for
Rural Development of Milot, was
one component of the evening’s
event, which introduced Holy
Name’s “Hospital for Haiti” initia-
tive and provided an overview of
the Medical Center’s efforts to
enhance the level of patient care at
Hôpital Sacré Coeur in Milot, Haiti.
During the evening, guests
viewed documentary footage about
life in Haiti and learned about the
healthcare and socioeconomic chal-
lenges faced by the people of Milot,
which is located in the northern re-
gion of the country. Mr. Maron and
members of the medical staff who
had made humanitarian trips, includ-
ing Dr. Butler, and Dr. Timothy
Finley and Dr. Alan Gwertzman,
both HNMC anesthesiologists,
shared personal anecdotes about
their experiences. Steve Adubato,
Ph.D., host and producer of Caucus:
New Jersey and One-on-One, pro-
vided commentary, followed by a
question and answer session with the
audience.
Hôpital Sacré Coeur serves
225,000 people in Milot and the
northern Haiti region. It is one of the
area’s few reliable healthcare re-
sources, although the facility and its
technology are 30 to 40 years be-
hind the times. Volunteers from
Holy Name Medical Center are pro-
viding critically–needed medical
care to adults and children at Hôpi-
tal Sacré Coeur. Physicians and
nurses bring equipment, supplies
and pharmaceuticals on every visit,
and provide education to Haitian
healthcare professionals about cur-
rent medical practice. Holy Name’s
administrators and technical em-
ployees work on infrastructure and
systems initiatives, in an effort to
lend organization and leadership.
Mr. Maron captivated the audience
at the beginning of his presentation
with a recording of a beating human
heart. He proceeded to speak of his
Medical Center’s commitment to
Haiti, explaining that “Haiti chose
Holy Name,” rather than the other
way around. “Our hearts were open,
and we listened,” he said. “As an or-
ganization vibrant with faith and a
beacon of light in challenging times,
we chose to act. That is how faith
must be. The minor sacrifices we will
make for Haiti will only make us
stronger and better caregivers here…
It is our responsibility, those who
have benefited from the sacrifices of
others, those of us who have the
means, the strength and the courage
to act… it is our charge to do so.”
Mr. Maron described how the
relationship with Hôpital Sacré
Coeur started with Dr. Butler 20
years ago, and Holy Name’s
founders and sponsors, the Sisters
of St. Joseph of Peace, have had a
consistent presence there. How-
ever, after the devastating earth-
quake of 2010, Holy Name stepped
up its involvement and the staff was
moved to do more. Mr. Maron said
Holy Name’s work in Haiti would
not be a short-term project, but
rather, “HNMC is there for the long
haul, there for the people of Milot,
with the ultimate goal of creating a
reliable, sustainable, healthcare
system.”
Over 350 people were in atten-
dance at February 13th event, in-
cluding benefactors, elected
officials, individuals from the com-
munity at large, and members of the
Holy Name family. Honored guests
included 22 Holy Name employees
and medical staff members who
have volunteered their expertise
and skills at Hôpital Sacré Coeur.
Also present were Angelica Berrie,
President, Board of Trustees of the
Russell Berrie Foundation; Stephen
A. Borg, President of North Jersey
Media Group and Publisher of The
Record; and leaders from The Val-
ley Hospital, St. Barnabas Health-
care System, Mount Sinai Medical
Center, United Water and Bergen
County LINKS.
To learn more about Holy Name
Medical Center’s commitment to
Haiti or to make a charitable dona-
tion to the Hospital for Haiti initia-
tive, visit www.holyname.org or
call the Holy Name Medical Center
Foundation at 201-833-3187.
provided
Michael Maron, President & CEO, Holy Name Medical Center, withchildren of Milot, Haiti.
Online Directory available at www.hospitalnewspaper.com
ARCHITECTURE
Bernstein & Associates, ArchitectsFounded in 1990, Bernstein & Associates,
Architects, specializes in the design and con-struction of hospital and healthcare facilities.Our focus: high-quality design, excellent serv-ice, and client satisfaction.
We have worked for over 100 hospitals andanother 200 private healthcare facilities, acrossthe United States. Our project types have in-cluded all hospital and healthcare servicegroups, including:
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The firm's projects have won design awardsfrom Progressive Architecture, ArchitecturalRecord, and the Architectural Woodworking In-stitute, and have been published in Advance,Health Facilities Management, Medical Technol-ogy Today, Bio/Technology, Progressive Archi-tecture, Architectural Record, Design Solutions,Hospitality Design, Sound and Communication,Contract Design and Hospital Newspaper.
Architectural Services include: program-ming, planning, design, construction docu-ments, bidding and negotiation, andconstruction administration.
The firm also offers sustainable or “green”healthcare design. The firm has a number ofLEED-accredited professionals, has success-fully completed numerous green healthcareprojects, and has published articles on “Green-ing the Healthcare Environment”.
Project Management (or Owner’s Represen-tative Services) is offered as a stand-alone serv-ice through our affiliated project managementcompany, Empire Projects, Inc. (www.empire-projects.com).
FAST & COMFORTABLE PELVIC EXAMSThe Wedgie Pelvic Exam Wedge provides fast,comfortable pelvic exams in the ER, Radiology,and Women's Health.
It is a much more comfortable than using ahard bedpan. The 6" height of the Wedgie liftsthe patient's pelvis significantly higher then abedpan, thus allowing physicians to perform abetter exam. The Wedgie's unique cutout designallows the physicians to maneuver their specu-lum in all directions without interference.
The Wedgie can support patients weighing upto 350 lb. It is made of a medical grade foamand an anti-microbial, anti-bacterial, tear resistant,and stain resistant medical grade vinyl cover.It can be cleaned with standard disinfectantproducts. Optional disposable protective coversand wall holders are available.
Join BlueSteps, the executive career management service of the Association of
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Plymouth Rock Assurance proudly supports the New Jersey Hospital Group by offering all members a special 5% discount on auto insurance. On average, drivers who switch to Plymouth Rock using a group discount save $517 per year!
Plymouth Rock Assurance is a marketing name used by a group of separate companies that write and manage property and casualty insurance in multiple states. Insurance in New Jersey is offered by Plymouth Rock Management Company of New Jersey on behalf of High Point Property and Casualty Insurance Company and their affiliates. Each company is financially responsible only for its own insurance products. Actual coverage is subject to the language of the policies as issued by each company. Group discounts apply to policies written in High Point Property and Casualty Insurance Company. If the discount is not currently applied, it may be added upon request. May not be combined with any other group discounts. Offer available to New Jersey residents only.
Annual average savings based on customers who switched to High Point Property and Casualty Insurance Company using a group discount from January 2010 to April 2012. Your premium may vary due to available discounts, eligibility requirements, driving record, and other factors.
eting name used by a group of separ ark ew Jersey is offered by Plymouth Rock Management Company of New Jersey on behalf of High P
Each company is financially responsible only for its own insur. y and their affiliates age of the policies as issued by each company
it m If the discount is not currently applied,. y. to New Jersey residents only
oint Property and Casualty Insur n customers who switched to High Pailable dary due to avour premium may vY 2.
All rights reserved.. ment Company of New Jersey
agement Company of New Jersey on behalf of High Pance cially responsible only for its own insur
Group discounts apply to policies written in High P. ny May not be combined with any other may be added upon request.
ance Company using a group discount operty and Casualty Insur driving record,, eligibility requirements, iscounts
6679/012013 erved.
anceoint Property f of High PActual. productsoint Property n in High P
mbined with any other
ng a group discount. and other factors ord,
Gary S. Horan, CEO/President of Trinitas Regional Medical Center,receives Professional Society Award
Gary S. Horan, FACHE, of Sea
Girt, President and Chief Executive
Officer of Trinitas Regional Med-
ical Center, received the American
College of Healthcare Executives
(ACHE) Regent’s Award at the an-
nual ACHE breakfast meeting in
Princeton, NJ. Michael Friedberg,
Chairman of the Regent’s Award
Committee (left) and Daniel
Messina, FACHE, Regent for the
National Board of Governors of the
ACHE (right), presented the award
to Mr. Horan.
The Regent’s Award recognizes
ACHE Fellows who serve in a sen-
ior level executive position and
demonstrate success in promoting
the growth of his or her organiza-
tion’s stature in the community.
Recipients of the Regent’s Award
also demonstrate proven leadership
ability, innovative and creative
management, participation in local,
state, or provincial hospital and
health association activities, partic-
ipation in civic/community activi-
ties and projects, and participation
in ACHE activities and interest in
assisting ACHE in achieving its ob-
jectives.
Mr. Horan assumed the post of
Chief Executive Officer and Presi-
dent of Trinitas Regional Medical
Center and its parent organization,
Trinitas Health, in July 2001. Pre-
viously he served as President and
Chief Executive Officer of Our
Lady of Mercy Healthcare System,
Inc., Bronx, New York. He also
served as Vice President of Hospi-
tal Operations for New York Uni-
versity Medical Center, and as
Executive Vice President of St.Vin-
cent’s Medical Center of Rich-
mond, New York.
Mr. Horan is past Chairman of
the Hospital Alliance of NJ as well
as past Chairman of the Greater
NY Hospital Association. He was
elected to the Board of the New
Jersey Hospital Association
(NJHA) in 2010. He serves on the
Board of the Catholic Healthcare
Partnership of New Jersey. In 2007,
Mr. Horan was named a Fellow of
the New York Academy of Medi-
cine. He served as a member of the
Board of Governors of the Ameri-
can College of Healthcare Execu-
tives and is currently an ACHE
Fellow.
In the wider business commu-
nity, Mr. Horan is a recently-named
member of the annual Power 50
Healthcare listing as identified by
NJBIZ which lauded his success
in directing the operations of
Trinitas. He is on the Board of Di-
rectors of the New Jersey Cham-
ber of Commerce, a member of the
Global MBA Advisory Board at
Kean University, and a member of
the Union County College Board
of Governors. In 2012, Mr. Horan
was named Man of the Year by the
Irish Business Association of New
Jersey.
About Trinitas Regional
Medical Center
Trinitas Regional Medical Center
(TRMC), a major center for com-
prehensive health services for those
who live and work in Central New
Jersey, is a Catholic teaching med-
ical center sponsored by the Sisters
of Charity of Saint Elizabeth in part-
nership with Elizabethtown Health-
care Foundation. With 10 Centers
of Excellence across the continuum
of care, Trinitas has distinguished it-
self in cardiology, cancer care, be-
havioral health, renal care, nursing
education, diabetes management,
wound healing and sleep medicine.
For more information on Trinitas
Regional Medical Center, visit:
www.TrinitasRMC.org or call (908)
994-5138.
provided
PAGE 26 April, 2013 Hospital Newspaper - NJ
NEW JERSEY LEAGUE FOR NURSING CONVENTION
"Nursing: Issues of Our Times"
Tropicana Casino & Resort, Atlantic City, NJ
PROGRAM HIGHLIGHTS
(Separate Registration Fee Required for This Program)
“State of Simulation Science: Where We Are and What’s Coming Next?” Presented by
Dr. Susan (Suzie) Kardong-Edgren
Dr. Kardong-Edgren is a recognized international and national thought leader in Simulation and Simulation Research. Dr. Edgren is a consultant for the National Council of State Boards of Nursing landmark study, investigating the substitution of up to 50% simulation for traditional clinical hours. She is a co-PI on a project for the NLN exploring the use of simulation for high stakes testing in nursing education. Register early to attend this knowledge-filled program!!
Keynote Session…
“Don’t Get Sick In July” Dr. Theresa Brown, writer for the New York Times
FOR COMPLETE 2013 CONVENTION BROCHURE: Send email to [email protected] with
your name & mailing address (or) visit our web site at www.NJLN.org
PROFESSIONAL EDUCATION DAY - WEDNESDAY, March 20, 2013 A REGIONAL WORKSHOP FOR NURSE EDUCATORS
CONVENTION – DAY ONE Thursday, March 21st
CONVENTION – DAY TWO Friday, March 2nd
Professional Education Day – March 20, 2013 Convention – March 21 – 22, 2013
Hospital Newspaper - NJ April, 2013 Page 27
PAGE 28 April, 2013 Hospital Newspaper - NJ
SPONSORS Assessment Technology Institute (ATI)
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Thursday, March 21, 2013
8:00 a.m. – 3:30 p.m. Convention Registration Open 8:00 a.m. – 8:45 a.m. GRAND EXHIBITION HALL OPEN (Free Morning Refreshments) 8:45 a.m. – 9:15 a.m. New Jersey Nursing Convention’s Opening Ceremonies 9:15 a.m. – 10:15 a.m. KEYNOTE SESSION (Contact Hours)
Topic: “Pride In The Profession: What’s Great About Nursing” Speaker: Liz Jazweic, RN, President and Founder of Liz, Inc., Oak Lawn, II.
10:30 a.m. – 12:30 p.m. Visit Exhibits & Poster Sessions (Contact Hours) There will be 18 Poster Presentations available for review that highlight current issues in health care. 11:15 a.m. – 12:15 p.m. NEW JERSEY LEAGUE FOR NURSING - 2013 ANNUAL BUSINESS MEETING (Contact Hours) 12:30 p.m. – 2:00 p.m. NEW JERSEY LEAGUE FOR NURSING CONVENTION LUNCHEON (Contact Hours)
Topic: “Let’s Talk About Sex and the Older Woman” Speaker: Dr. Gerti Heider, Associate Professor, UMDNJ School of Nursing
1:00 p.m. – 2:00 p.m. STUDENT TRACK ONLY -- CONTINUING EDUCATION SESSIONS STU1 – TOPIC: Interviewing Techniques & Job Seeking SPEAKER: Claudia Cotarelo, Talent Acquisition and Strategic Recruiter, Atlantic Health System OBJECTIVES: Identify social media, interviewing techniques, searching for a job, and effective resume writing. STU2 – TOPIC: NCLEX Test Tips SPEAKER: Laura Moskaluk , RN, MSN, CNE, Faculty, Middlesex County Vocational and Technical School OBJECTIVES: Review of basis prioritization mnemonic; review of alternate form questions; sample NCLEX style questions 2:15 p.m. – 3:15 p.m. STUDENT TRACK ONLY -- CONTINUING EDUCATION SESSIONS STU3 – TOPIC: Interviewing Techniques & Job Seeking -- (Repeat of STU-1 Topic) STU4 – TOPIC: NCLEX Test Tips – (Repeat of STU-2 Topic) 2:15 p.m. – 3:15 p.m. CONTINUING EDUCATION SESSIONS (Contact Hours) A1-TOPIC: The Transgender Population: The “T” In LGBT SPEAKER: Barbara Chamberlain, PhD, APRN, MBA, President, BJC Consultants OBJECTIVES: Describe the history of the LGBT movement; Compare and contrast the unique needs of the transgender individual; State one victim of transgender hate crimes; Explore the myths surrounding the LGBT population. A2 – TOPIC: A Nurse’s Role in Disasters SPEAKER: Kathe M. Conlon, BSN,RN,CEM MSHS, Burn Disaster & Emergency Preparedness Education Coordinator, St. Barnabas OBJECTIVES: Identify disaster types and implement appropriate nursing interventions for pt. care; Understand evolution of
disaster nursing and its role in modern times; Understand the impact of disasters on nursing practice. A3 – TOPIC: Dealing With Difficult Student Situations SPEAKER: Patricia A. Castaldi, DNP, RN, ANEF, Director, Practical Nursing Program, Union County College OBJECTIVES: Recognize difficult situations that may occur in nursing education setting; Identify effective strategies for
dealing with difficult students; Incorporate principles for the revision and/or development of program policies. A4 – TOPIC: Care Transitions – Partnerships That Work for Patients SPEAKERS: Alyce Brophy, RN, BSN, MPH, President/CEO, Community Visiting Nurses, and
Alyssa Kizun, MSW, LCSW, CCM, Director of Care Management, Somerset Medical Center OBJECTIVES: Identify and discuss the formation, implementation and results of a community collaborative for Care
Transitions utilizing the Coleman Transitions Care Model; Discuss formation of community provider collaborations and the implementation of evidenced based models of care.
3:15 p.m. – 4:15 p.m. CONVENTION WELCOME CELEBRATION (NJLN Scholarship Drawing, Attendee Prize Drawing) 4:15 p.m. – 5:15 p.m. CONTINUING EDUCATION SESSIONS (Contact Hours) B1 - TOPIC: S.O.S. – Support Our Staff and Stop The “Suffering in Silence” SPEAKER: Susan Fisher Brown, RN, Owner of CISM company called S.O.S. Crew Rescue, LLC OBJECTIVES: Describe Critical Incident Stress Management (CISM) and explain the significance of the implementation of
CISM teams within the health care system; Recognize warning signs of Critical Incident Stress that staff might exhibit; Describe the importance and necessity in pre-incident training.
2013 NEW JERSEY LEAGUE FOR NURSING CONVENTION PROGRAM
Hospital Newspaper - NJ April, 2013 Page 29
B2 – TOPIC: Understanding Cultural Diversity – Improving Patient Outcomes: Keys to Providing Culturally
Competent, Congruent, and Sensitive Care SPEAKER: V. Alexandra Hascup, PhD, MSN, RN, CTN, CCES, Asst. Professor, Kean University, College of Nursing OBJECTIVES: Define cultural terms including cultural sensitivity and competency; Develop knowledge of culturally
competent care and behavior strategies that lead to improved patient outcomes; B3 – TOPIC: The Walking Wounded: Consequences of Recurrent Sports Related Head Injuries SPEAKER: Christine Wade, RN, BSN, CRRN, Nurse Manager, Brain Trauma Unit, JFK Johnson Rehabilitation Institute OBJECTIVES: Discuss the effects of head injuries for all ages in sports and repeated injuries; Review how brain injury can be
very subtle and complex at the same time. B4 – TOPIC Everything We Learned in Kindergarten: Arts and Crafts for Simulation SPEAKERS: Pamela J. Hicks, MSN, RN, Skills Laboratory Coordinator, Raritan Bay Medical Ctr./Middlesex County College Susan Ellison, MSN, RNC, CNE, Course Coordinator, Raritan Bay Medical Ctr./Middlesex County College OBJECTIVES: Discuss the creation of environmental props to enhance the realism of the simulation; Demonstrate how to
create a variety of moulage techniques; Identify strategies to integrate moulage into simulation. 5:30 p.m. – 7:00 p.m. Sylvia C. Edge Endowment Campaign Reception Hosted by the Sylvia C. Edge Endowment Board and the New Jersey League for Nursing
Friday, March 22, 2013 8:00 a.m. – 1:00 p.m. Convention Registration Open 8:00 a.m. – 9:30 a.m. Grand Exhibition Hall Open (Free Morning Refreshments ) 8:00 a.m. – 12:00 p.m. EXHIBIT HALL OPEN 8:00 a.m. – 12:00 p.m. POSTER SESSION (Contact Hours) 9:00 a.m. – 10:00 a.m. KEYNOTE SESSION (Contact Hours)
Topic: “Don’t Get Sick In July” Speaker: Theresa Brown, BSN, RN,OCN, Writer and national lecturer, Pittsburgh, PA. 10:15 a.m. – 11:30 a.m. Visit Exhibits & Poster Sessions (Contact Hours) 11:00 a.m. – 12:00 p.m. CONTINUING EDUCATION SESSIONS (Contact Hours) C1 – TOPIC: Adjunct Orientation: The Key To A Successful Academic Year SPEAKER: Nancy Berger, RN, MSN,CNE, Director of Nursing Education, Middlesex County College Nursing OBJECTIVES: Discuss research regarding importance of adjunct orientation in the college/nursing education realm; C2 – TOPIC: Making a Difference in Ghana Through Community Nursing SPEAKER: Michelle L. Foley, MA, RN, CNE, (retired nurse educator) OBJECTIVES: Provide overview of Ghanaian culture; Describe village experiences and its impact on nursing and health care; C3 – TOPIC: Wound Management: Past, Present and Future SPEAKER: Tracey Siegel, MSN, RN, CWOCN, CNE, EdD (c), Program Coordinator, Middlesex County College Nursing OBJECTIVES: Discuss wound healing research and its impact upon nursing practice; Identify factors that affect wound
healing; Review topical therapies and describe appropriate topical therapy based upon wound assessment. C4 - TOPIC: Diabetes: Improving Outcomes, How Sweet It Is SPEAKERS: Dawn Gallagher, RN, CDE, Diabetes Nurse Educator, Somerset Diabetes Ctr, Somerset Medical Ctr. Jackie Plick, RN,BSN,MA,ANP-C,CDE, Diabetes Nurse Educator, Somerset Diabetes Ctr, Somerset Medical Ctr. OBJECTIVES: Review how Diabetes is managed today, including new therapies and education techniques; Discuss
Diabetes Education for the hospitalized patient and preparing them for discharge; Explore the role of the Certified Diabetes Educator as a partner in improving outcomes and wellness.
12:15 p.m. – 1:45 p.m. NEW JERSEY LEAGUE FOR NURSING CONVENTION LUNCHEON (Contact Hours) Topic: “Finding Balance As You Care For Others: Putting Your Oxygen On First” Speaker: Phyllis S. Quinlan, RN-Bc, PhD, Founder, MFW Consultants, Queens County, NY 2:00 p.m. – 3:00 p.m CONTINUING EDUCATION SESSIONS (Contact Hours) D1 - TOPIC: Learning Is Fun: It’s Not Death By Powerpoint and Lecture SPEAKERS: Mary Ann Balut, RN, MSN, APN-C, Raritan Valley Community College; Donna Gray, RN, MSN, CNE, and Kimberly Seaman, RN, MSN, CNE, JFK Muhlenberg School of Nursing OBJECTIVES: Demonstrate active learning pedagogies including audience participation of nurse educators; Evaluation of the
learning process will be provided and remediation strategies discussed; Learner participation in the classroom provides teacher assessment of learning outcomes and prompt feedback for learner.
D2 - TOPIC: Opportunities in Nursing: Beyond the Bedside SPEAKER: Jennifer Lerner, RN, BA, Staff Nurse, Oncology Unit, St. Barnabas Medical Center OBJECTIVES: Discuss many opportunities that exist away from the bedside; Provide current and future nurses with a deeper
knowledge of the healthcare industry and the wide variety of career alternatives.
New Jersey League for Nursing is an approved provider of continuing nursing education by the New Jersey State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.P250-9/11-14.
Speakers have declared that he/she has nothing to disclose. There is no commercial support for this activity. Accredited status does not imply endorsement by NJLN, NJSNA or ANCC of any commercial products or services.
2013 NEW JERSEY LEAGUE FOR NURSING CONVENTION PROGRAM
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BRIEF SUMMARYNitroMist® (nitroglycerin) lingual aerosol Rx OnlyINDICATIONS AND USAGE– NitroMist is indicated for acute relief of an attack or acute prophylaxis of angina pectoris due to coronary artery disease. CONTRAINDICATIONS– PDE5 Inhibitor Use: Administration of NitroMist is contraindicated in patients who are using a selective inhibitor of cyclic guano-sine monophosphate (cGMP)-specifi c phosphodiesterase type 5 (PDE5), as PDE5 inhibitors such as sildenafi l, vardenafi l, and tadalafi l have been shown to potentiate the hypotensive effects of organic nitrates. Severe Anemia: NitroMist is contraindicated in patients with severe anemia. Increased Intracranial Pressure: NitroMist is contraindicated in patients with increased intracranial pressure. Hypersensitivity: NitroMist is contraindicated in patients who have shown hypersensitivity to it or to other nitrates or nitrites. Skin reactions consistent with hypersensitivity have been observed with organic nitrates. WARN-INGS AND PRECAUTIONS– Tolerance: Excessive use may lead to the development of tolerance. Only the smallest number of doses required for effective relief of the acute anginal attack should be used. As tolerance to other forms of nitroglycerin develops, the effect of sublingual nitroglycerin on exercise tolerance, although still observable, is reduced. Hypotension: Severe hypotension, particularly with upright posture, may occur even with small doses of nitroglycerin. The drug should therefore be used with caution in patients who may be volume-depleted or who, for whatever reason, are already hypotensive. Hypotension induced by nitroglycerin may be accompanied by paradoxical bradycardia and increased angina pectoris. The benefi ts of NitroMist in patients with acute myocardial infarction or congestive heart failure have not been established. If one elects to use NitroMist in these conditions, careful clinical or hemodynamic monitoring must be used because of the possibility of hypotension and tachycardia. Hypertrophic Cardiomyopathy: Nitrate therapy may aggravate the angina caused by hypertrophic cardiomyopathy. Headache: Nitroglycerin produces dose-related headaches, which may be severe. Tolerance to headaches occurs. ADVERSE REACTIONS– Headache, which may be severe and persistent, may occur immediately after nitroglycerin use. Flushing, drug rash and exfoliative dermatitis have been reported in patients receiving nitrate therapy. Postural hypotension, as manifest by vertigo, weakness, palpitation, and other symptoms, may develop occasionally, particularly in erect, immobile patients. Marked sensitivity to the hypotensive effects of nitrates (manifested by nausea, vomiting, weakness, diaphoresis, pallor, and collapse) may occur at therapeutic doses. Syncope due to nitrate vasodilatation has been reported. DRUG INTERACTIONS– PDE5 Inhibitors: Administration of NitroMist is contraindicated in patients who are using a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specifi c phosphodiesterase type 5 (PDE5). PDE5 inhibitors such as sildenafi l, vardenafi l, and tadalafi l have been shown to potentiate the hypotensive effects of organic nitrates. The time course and dose dependence of this interaction have not been studied, and use within a few days of one another cannot be recommended. Appropriate supportive care for the severe hypotension has not been studied, but it seems reasonable to treat this as a nitrate overdose, with elevation of the extremities and with central volume expansion. The use of any form of nitroglycerin during the early days of acute myo-cardial infarction requires particular attention to hemodynamic monitoring and clinical status. Antihypertensives: Patients receiving antihypertensive drugs, beta-adrenergic blockers, and nitrates should be observed for possible additive hypotensive effects. Marked orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used concomitantly. Labetolol blunts the refl ex tachycardia produced by nitroglycerin without preventing its hypotensive effects. If labetolol is used with nitroglycerin in patients with angina pectoris, additional hypotensive effects may occur. Aspirin: Coadministra-tion of aspirin and nitroglycerin has been reported to result in increased nitroglycerin maximum concentrations by as much as 67% and AUC by 73% when administered as a single dose. The vasodilatory and hemodynamic effects of nitroglycerin may be enhanced by concomitant administration of aspirin. Tissue-type Plasminogen Activator (t-PA): Intravenous administration of nitroglycerin decreases the thrombolytic effect of tissue-type plasminogen activator (t-PA). Plasma levels of t-PA are reduced when coadministered with nitroglycerin. Therefore, caution should be observed in patients receiving nitroglycerin during t-PA therapy. Heparin: Intravenous nitroglycerin reduces the anticoagulant effect of heparin. Activated partial thromboplastin times (APTT) should be monitored in patients receiving heparin and intravenous nitroglycerin. It is not known if this effect occurs following single nitroglycerin doses. Ergotamine: Oral administration of nitroglycerin markedly decreases the fi rst-pass metabolism of dihydroergotamine and subsequently increases its oral bioavailability. Ergotamine is known to precipitate angina pectoris. Therefore, patients receiving sublingual nitroglycerin should avoid ergotamine and related drugs or be monitored for symptoms of ergotism if this is not possible. USE IN SPECIFIC POPULATIONS– Pregnancy: Pregnancy category C: Animal reproduction and teratogenicity studies have not been conducted with NitroMist or nitroglycerin sublingual tablets. It is also not known whether NitroMist can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. A teratogenicity study was conducted in the third mating of F0 generation female rats administered dietary nitroglycerin for gestation day 6 to day 15 at dose levels used in the 3-generation reproduction study. In offspring of the high-dose nitroglycerin group, increased incidence of diaphragmatic hernias and decreased hyoid bone ossifi cation were seen. The latter fi nding probably refl ects delayed development rather than a potential teratogenic effect, thus indicating no clear evidence of teratogenicity of nitroglycerin. There are no adequate and well controlled studies in pregnant women. NitroMist should be given to a pregnant woman only if clearly needed. Nursing Mothers: It is not known whether nitroglycerin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when NitroMist is administered to a nursing woman. Pediatric Use: The safety and effectiveness of nitroglycerin in pediatric patients have not been established. Geriatric Use: Clinical studies of NitroMist did not include suffi cient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other rep-
orted clinical experience has not identifi ed differences in responses between elderly (greater than or equal to 65 years) and younger (less than 65 years) patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, refl ecting the greater frequencyof decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. OVERDOSAGE– Signs and symptoms of hemodynamiceffects: The effects of nitroglycerin overdose are generally the results of nitroglycerin’s capacity to induce vasodilatation, venous pooling, reduced cardiac output, and hypotension. These hemodynamic changes may have protean manifestations, including increased intracranial pressure with any or all of persistent throbbing headache, confusion, and moderate fever; vertigo; palpitations; tachycardia; visual disturbances; nausea and vomiting (possibly with colic and evenbloody diarrhea); syncope (especially in the upright posture); dyspnea, later followed by reduced ventilatory effort, diaphoresis, with the skin either fl ushedor cold and clammy; heart block and bradycardia; paralysis; coma; seizures; and death. No specifi c antagonist to the vasodilator effects of nitroglycerin is known, and no intervention has been subject to controlled study as a therapy of nitroglycerin overdose. Because the hypotension associated with nitroglycerinoverdose is the result of venodilatation and arterial hypovolemia, prudent therapy in this situation should be directed toward increase in central fl uid volume. Passive elevation of the patient’s legs may be suffi cient, but intravenous infusion of normal saline or similar fl uid may also be necessary. The use of epinephrineor other arterial vasoconstrictors in this setting is not recommended. In patients with renal disease or congestive heart failure, therapy resulting in central volume expansion is not without hazard. Treatment of nitroglycerin overdose in these patients may be subtle and diffi cult, and invasive monitoring may berequired. Methemoglobinemia: Methemoglobinemia has been rarely reported with organic nitrates. The diagnosis should be suspected in patients who exhibit signs of impaired oxygen delivery despite adequate arterial PO2. Classically, methemoglobinemic blood is described as chocolate brown, without color changeon exposure to air. If methemoglobinemia is present, intravenous administration of methylene blue, 1 mg/kg to 2 mg/kg of body weight, may be required.NONCLINICAL TOXICOLOGY– Carcinogenesis, Mutagenesis, Impairment of Fertility: Animal carcinogenicity studies with sublingually administered or lingual spray nitroglycerin have not been performed. Rats receiving up to 434 mg/kg/day of dietary nitroglycerin for 2 years developed dose-related fi brotic and neoplastic changes in liver, including carcinomas, and interstitial cell tumors in testes. At the highest dose, the incidences of hepatocellular carcinomas was 52% compared to 0% in untreated controls. Incidences of testicular tumors were 52% vs 8% in controls. Lifetime dietary administration of up to 1058 mg/kg/day of nitroglycerin was not tumorigenic in mice. Nitroglycerin was found to have reverse mutation activity in the Salmonella typhimurium strain TA1535 (Ames assay). A similar mutation in S. typhimurium strain was also reported for other NO donors. Nevertheless, there was no evidence of mutagenicity inan in vivo dominant lethal assay with male rats treated with oral doses of up to about 363 mg/kg/day or in ex vitro cytogenic tests in rat and dog tissues. In vitro cytogenetic assay using Chinese hamster ovary cells showed no chromosomal aberrations. In a 3-generation reproduction study, rats received dietary nitroglycerin at doses up to about 408 mg/kg/day (males) to 452 mg/kg/day (females) for 5 months (females) or 6 months (males) prior to mating of the F0 generation with treatment continuing through successive F1 and F2 generations. The highest dose was associated with decreased feed intake and bodyweight gain in both sexes at all matings. No specifi c effect on the fertility of the F0 generation was seen. Infertility noted in subsequent generations, however, was attributed to increased interstitial cell tissue and aspermatogenesis in the high-dose males. PATIENT COUNSELING INFORMATION– Interaction with PDE5 Inhibitors - NitroMist should not be used in patients who are using medications for erectile dysfunction such as sildenafi l, vardenafi l, and tadalafi l. These products have been shown to increase the hypotensive effects of nitrate drugs such as NitroMist. Administration - Patients should be instructedthat prior to initial use of NitroMist Lingual aerosol, the pump must be primed by pressing the actuator button 10 times to ensure proper dose priming. If the product is not used for more than 6 weeks, the bottle can be adequately re-primed with 2 sprays. NitroMist is meant to be sprayed on or under the tongue at the beginning of angina or to prevent an angina attack. Treatment with nitroglycerin products such as NitroMist may be associated with lightheadedness on standing, especially just after rising from a laying or seated position. This effect may be more frequent in patients who have consumed alcohol, since alcohol use contributes to hypotension. If possible, patients should be seated when taking NitroMist. This reduces the likelihood of falling due to lightheadedness ordizziness. Headache - Headaches can sometimes accompany treatment with nitroglycerin. In patients who get these headaches, the headaches may indicate activity of the drug. Tolerance to headaches develops. Flushing - Flushing, drug rash and exfoliative dermatitis have been reported in patients receiving nitrate therapy. Container information - The NitroMist bottle should not be forcefully opened. Because NitroMist contains a highly fl ammable propellant (butane),do not have the container burned after use and do not spray directly towards fl ames. While the container is in the upright position, if the liquid reaches the top to middle of the hole on the side of the container, a new supply should be obtained. When the liquid reaches the bottom of the hole, the remaining doses will have less than label content.Manufactured for Akrimax Pharmaceuticals, LLC Cranford, NJ 07016 by Dynamit Nobel GmbH, Leverkusen, Germany Marketed and Distributed by: Akrimax Pharmaceuticals, LLC, Cranford, NJ 07016 USANitroMist is a registered trademark of NovaDel Pharma Inc., used by permission. 141B002 10/2012
* Priming NitroMist: After receiving a new prescription or refi ll, patients should remove the plastic cap, place forefi nger on actuator button, and press 10 times. NitroMist is now primed for 6 weeks and ready to use. If not used for more than 6 weeks, the NitroMist bottle can be adequately reprimed with 2 sprays.
† Store at room temperature (25°C, 77°F); excursions permitted to 15-30°C (59-85°F).