The following first appeared on Sr. Fellow Liz Seegert’s blog, The Human Factor

Amid all of the buzz around Mother’s Day this past weekend, little attention was paid to a study that could potentially save thousands of lives. Researchers from the University of Pennsylvania Perlman School of Medicine found that in 75 percent of cases, automated external defibrillators (AEDs)  are too far away from cardiac arrest victims for the devices to have the best chance at saving lives.

They believe this is an important clue in the quest to improve cardiac resuscitation rates in the United States, which remain at a dismal 10 percent, despite the widespread availability of CPR and AED classes. Chances of survival drop by about 10 percent with each minute that passes without CPR and defibrillation, so survival rates for patients that get shocked six minutes or more after arresting are very low.

Over one million AEDs are available in public buildings — from airports to schools. Yet, as the researchers observed, “they’re not subject to the same FDA regulations as implantable medical devices, it’s unclear exactly where all the devices are, and whether they’re in places where people are most likely to suffer cardiac arrests.” This study looked at whether AED and cardiac arrest victim locations matched up.

Informing the public about the location of these devices is a large part of the challenge. ”Much too much time is wasted trying to find one, senior author Raina Merchant, MD, MS, an assistant professor of Emergency Medicine, said in a press release. Those seconds and minutes are often the difference between life and death.

Over a decade ago, the American Heart Association noted that emergency medical personnel rarely arrive on scene within the critical five-minute window needed to save most lives. Therefore, community training of CPR and AED should augment emergency services until professional help arrives.

Obviously, knowing how to use an AED properly is important, and most devices now include written or even audio instructions. However, none of  this is of any use if a potential rescuer cannot locate the device, or if it’s stored too far away to be useful.

The Penn researchers conducted the “MyHeartMap Challenge”, a crowd sourcing contest that asked Philadelphians to use a special smartphone app to find and map the locations of all of the city’s AEDs. More than 1,500 AEDs in 800 separate buildings were found and tagged. That information will go into a new mobile app to help bystanders easily locate the nearest AED during an emergency.

Additionally, 9-1-1 operators will have these locations available on their computers to help Samaritans find the nearest device as quickly as possible.

This project needs replication in every city, town, and community in the U.S. Perhaps even take it one step further and attach an emergency locator beacon right to the AED location; a user could activate a mobile app that will direct him or her to the exact spot – something that may help to shave crucial time off the process when someone is in an unfamiliar building.

The residents of Philadelphia will surely benefit from this study. It seems to me that the FDA needs to take another look at its AED policy. It’s time for them to provide incentives — or perhaps even mandate if necessary — that other localities map and provide easy access to AED locations too.

There has been some controversy over these devices — the FDA site lists a number of product recalls over the past several years. However an External Defibrillator Improvement Initiative is underway  including a new path to design and engineering best practices.

I just hope they also include best practices to get these devices into the hands of the nearest citizen rescuers.

Follow Liz on Twitter @lseegert and check out her latest article on Women.com –  Your Girlfriends are Good for Your Health

We are in the midst of celebrating International Nurses Week, which culminates on May 12 with the birthday of Florence Nightingale. Although our founding mother of modern nursing would be impressed with the health technology of today, I am sure she would be sorely disappointed by the ongoing invisibility of nurses, which she fought so hard to overcome during her lifetime.

Everyone knows someone who is a nurse. In addition to health clinics and hospitals, we work in your children’s schools, at your workplace, in all branches of military service and in your places of worship. There are more than 3 million registered nurses in the United States alone. But the vast majority of nurses — over 32 million of them — work in other parts of the world.

It is in poor countries and communities, where health needs are greatest and physicians are scarce, that nurses take an even greater role in healthcare delivery, often serving as the sole providers in rural villages or urban slums. For a mother in labor in the mountains of Lesotho in southern Africa or for a child suffering from cholera in Port-au-Prince, Haiti, access to qualified midwives and nurses often means the difference between life and death. We work with patients at every stage in their lives, from birth to death. We deliver babies safely with few if any resources; and we are often the people who are there to make sure that an individual can die in the most dignified and pain free way possible. We know what our patients and communities need.

But although nurses deliver 90 percent of all healthcare services worldwide, they remain largely invisible at decision-making tables in national capitals and international agencies. Their absence constitutes a global health crisis.

In key meetings where global medical and public health experts and international donors map out global health efforts and priorities in prevention and treatment, nurses who provide the vast majority of care are rarely included. The International Council of Nurses has highlighted the severe lack of nurses in leadership positions at the World Health Organization. The WHO human resources annual report of 2008 revealed that over 90 percent of its professional staff are medical specialists; less than one percent are nursing specialists, even though nurses make up over 80 percent of the global healthcare workforce.

At Partners In Health (PIH) we are working with partner organizations and national Ministries of Health to strengthen nursing efforts and raise nursing visibility across the board. We have an incredibly strong, hard-working, and inspiring group of nurses who serve as colleagues and teachers in their home countries, as well as throughout the global community. These are the experts to whom I turn for answers to global health delivery questions.

In Peru, nurses like Dalia Guerra serve as the cornerstone of a program that has achieved the highest cure rates in the world for patients with multidrug-resistant tuberculosis. In Haiti, nurse Beatrice Romela is creating a community of Haitian nurse leaders, and in Rwanda, nurse Manzi Anatole directs a program that is providing mentoring and supervision for nurses at rural health clinics. And at Mamohau Hospital in rural Lesotho, lead midwife Maphaila Mabathoana works tirelessly to make sure women are able to have safe labor and deliveries.

Many of our partners in the United States and around the world have made substantial commitments to nursing. We need more partners like them.

In one of the most innovative initiatives global health nursing has seen, the Dana Farber Cancer Institute has supported the creation of a nursing oncology partnership with Inshuti Mu Buzima (IMB), PIH’s sister organization in Rwanda. Four experienced oncology nurses have committed to working alongside local nurses and physicians at IMB for three-month rotations, creating an unprecedented opportunity for Rwandan nurses to develop the specialized skills and experience needed to raise the quality of oncology care.

In another groundbreaking initiative, Regis College in Massachusetts has partnered with the Haitian Ministry of Health and PIH to tackle the nursing education shortage in Haiti. The partnership has developed a comprehensive three-year master’s program for 12 Haitian nursing faculty members. These nurse leaders will graduate from a public Haitian university with a master’s degree that will enable them to take the lead in educating a future generation of nurses in a country where they’re desperately needed — both to improve the quality of care and to bring essential knowledge and perspectives to the decision-making process.

These long-term, grassroots initiatives are shaping the new face of nursing in global health. With the investment of the global community in nurse training, mentorship, and leadership, we can make enormous strides in strengthening health systems. International Nurses Week is a time of reflection, celebration and hope. I am proud to be part of a strong community of nurses at Partners In Health. If Florence Nightingale saw our nurses providing compassionate care to millions of people in the poorest parts of the world, I think she would be proud as well.

On Sunday, May 6th I was invited to be in conversation with Deborah Jiang Stein, the founder of the UnPrison Project and author of Even Tough Girls Wear Tutus – Inside the World of a Woman Born in Prison published by Cell 7 Media. Ms. Jiang Stein was previously a guest on Healthstyles this past fall.

She opened the conversation directing these questions to the audience and asked them to raise there hands if they knew someone who has been in prison? someone who has an issue with substance use? was adopted or in foster care? All but one person raised their hand.

Deborah Jiang Stein’s book covers many issues. Here’s some gems from her book.

Must be important if it’s hidden. Secret letter reveals heroin-addicted prison mother. Born in prison is a metaphor for all human beings. One in five Americans will be multiracial by 2050. 

Deborah Jiang Stein says  ”My work as a speaker is not a verb. It’s a social justice and spiritual act.” 

This conversation was one of the most heightened one I’d had in years.

Barbara Glickstein is co-director of CHMP.

In searching for the history of how this came about, you can find this exact sentence in almost every post, “In 1953, Dorothy Sutherland of the U.S. Department of Health, Education, and Welfare sent a proposal to President Eisenhower to proclaim a “Nurse Day”..)  That never happened. I tried to find out more about Ms. Sutherland to no avail. Wonder if one of you may know more about her.  There are too many Dorothy Sutherland’s on Facebook and LinkedIn and nothing came up on my Google search.

Fast forward to 1974 when the International Council of Nurses proclaimed International Nurse Day on May 12, Florence Nightingale’s birthday. In 1990, the American Nurses Association decided it should be a whole week  beginning on May 6 and ending on May 12. We now have National Student Nurses Day too.

This is the week you’ll hear about the Gallop Poll results that show when you ask Americans to rate the honesty and ethics of numerous professions nurses make the top of the list every year since except in 2001 when firefighters were included on a one-time basis after 9/11. They’ve been polling since 1976 and the profession of nursing was added in 1999. We’ve come along way baby.

So we’re trusted (that’s good news).  Let’s leverage that trust and our smarts and expertise to get a seat at the policy table and into other stakeholder positions working to create quality and cost-effective health care that is accessible to all Americans.

How about we take action and unite to tell our colleagues and employers to thank us in different way this year and going forward. Tell them (graciously) that you don’t need another pen, water bottle or tote bag with the institution’s name on it. Ask them to use the dedicated budget (plus more $$$) to financially support the work of your state’s Action Coalition and the Campaign for Action to implement the recommendations of the Institute of Medicine’s report on The Future of Nursing.

Now that’s a proclamation I can sign.

Barbara Glickstein is the co-director of the Center.

Source: Florida NP Network

Florida is one of two states in the country that does not permit nurse practitioners to prescribe controlled substances. Imagine being a primary care provider for patients who need an opioid pain medication and having to refer them elsewhere for it. A perfect example of the barriers to access to care that are embedded in laws at the state and federal level. These barriers are costly in time, money, patient suffering and health. Watch this video to its surprising end:

Liz Seegert

CHMP Senior Fellow and journalist Liz Seegert’s latest writings include a piece on cadmium and breast cancer for women.com and another on “Ethnic Elders Online” for New America Media. The latter is becoming a specialized focus for Liz. See her other blog posts on the digital divide and older adults.

Patricia Volland, MSW

"Care coordination" is a new buzz word in the lexicon of health care reform. Most everyone agrees that it will improve clinical outcomes and reduce costs for patients with multiple chronic illnesses and will also help to improve the health care experience of those who are not as sick. Patricia Volland is a social worker, Senior Vice President and Director of the the Social Work Leadership Institute at the New York Academy of Medicine, who is a national leader in care coordination. In recent years, she has also had personal experience and shares her views on it with Healthstyles producer and moderator, Diana Mason, RN. The program airs this morning at 11:00 AM on WXMR-FM (wxmrfm.com, 100.7 FM in upstate NY and Vermont). Click here to listen to the interview: Volland

THE WAITING ROOM is a character-driven documentary that uses extraordinary access to go behind the doors of an American public hospital struggling to care for a community of largely uninsured patients.

CHMP is co-sponsoring two screenings in May of Pete Nick’s THE WAITING ROOM an award-winning film about health care told through individual stories of patients, providers and family members at a public hospital emergency room in Oakland CA. We showed the film at our Envision Health series last November to a riveted audience. If you missed it last November be sure to see it at a screening in May!

MAY 12 – The Schomburg Center in Manhattan – 4pm. There will be a Q&A after the film with Pete Nicks and health experts. There will be preventative health screenings available at the event and a table of healthy snacks.

MAY 19 – Rooftop Films in Brooklyn – 8pm. Along with the film there will be preventative health screenings available at the event and a table of healthy snacks.

Please visit the film’s website for tickets & more information about the film and national social media project:

Theresa is also a paid contributor to the New York Times blog Well.  Her book, Critical Care: A New Nurse Faces Death, Life, and Everything in Between, was released June, 1 2010, by HarperCollins. She has had print pieces in the New York Times “Science Times” section, and in Scrubs Magazine, and Op-Eds on CNN.com, the New York Times, and in the Pittsburgh Post-Gazette.