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APRIL 2013

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! See page 14 Hospital of the Month! TRINITAS REGIONAL MEDICAL CENTER p16

PHX announces an industry first Healthcare Cost Management Loyalty Program p4

13 0 2 e h to t e m o Welc

NEW JERSEY LEAGUE FOR NURSING CONVENTION “Nursing: Issues of Our Times” p26-29


Hospital Newspaper 1 Ardmore Street New Windsor NY 12553



April, 2013

Hospital Newspaper - NJ

Hospital Newspaper - NJ April, 2013

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PHX announces an industry first Healthcare Cost Management Loyalty Program Leading healthcare services provider launches innovative customer rewards experience powered by Badgeville 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.

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

“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

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

Hospital Newspaper - NJ April, 2013

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April, 2013

Hospital Newspaper - NJ




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Gail Hammond helping the communities and the Nurse’s who help all patients! Hospital Newspaper has had the pleasure of being at the beautiful League of Nurse’s convention every year since 2001! There is no better convention and every exhibitor is treated with the utmost professionalism. Nurse’s from the Tri-state are treated to the best educational opportunities available. There is always excitement at the many promotions at the three-day event. Beyond the convention Gail Hammond, Executive Director of NJLN, helps the communities’ that the nurse’s serve. Recently the NJLN donated not only $1,000 to assist in the recovery efforts from Hurricane Sandy, but many others volunteered their time and nursing skills in the recovery. I hope you get the chance the to thank Gail for her years of service. Hospital Newspaper thinks there is no one better! Please share your stories with us: Jim can be reached at 845-534-7500 ext. 219 and via email at






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PHX announces

an industry Healthcare first Cost Manag Loyalty Pro ement gram p4

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Hospital Newspaper - NJ April, 2013

Trinitas Regional Medical Center becomes home to CareOne LTAC Hospital Unit


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

The Sign of Excellence ence in Emergency Medicine edicine® ree Decades for More Than Three


From left, Michael Fancher, Business Development Manager and Sharon Bready, Facility CEO, CareOne LTAC Hospitals, celebrate the opening of the CareOne LTAC at Trinitas Regional Medical Center with Gary S. Horan, FACHE, President and CEO of Trinitas.

A CareOne Long Term Acute Care Hospital is now located at a newlycreated patient unit at the main campus of Trinitas Regional Medical Center. An area that previously housed offices as well as patient rooms has been transformed into a 25 bed modern state-of-the-art long-term acute care patient center. A Long Term Acute Care Hospital (LTACH) is designed to serve patients with complex medical needs that require a lengthier treatment program, usually between 25 – 35 days. Those who meet this clinical profile generally require a variety of care including: telemetry and cardiac monitoring; ventilator weaning/pulmonary management; antibiotic therapy; complex wound care and healing; nutrition services; physical/occupational/speech therapy; social services, and patient education. The CareOne LTACH facility is a separate entity from Trinitas Regional Medical Center; however, CareOne will use many of the ancillary hospital services for which Trinitas is wellknown. As the first LTACH to be licensed by the state, CareOne has had a presence for the past nine years at Raritan Bay Medical Center in Perth Amboy. Its success there was influential in Trinitas Regional Medical Center’s decision to enter into this agreement to rent space to CareOne. “Trinitas Regional Medical Center had a vision to reconfigure office space and a former patient area in a new and meaningful way at our Williamson Street Campus, explains Gary s. Horan, President and Chief Executive Officer. “We realized the value of LTACH services as a supplement to our own patient care services.

Each organization can draw on the strengths of the other in order to achieve a new and exciting level of patient care for our community.” “We look forward to expanding our expertise in the long term acute care environment at our new facility within Trinitas Regional Medical Center,” says Sharon Bready, CareOne LTAC Hospital CEO for both long term acute care hospitals at Raritan Bay Medical Center and now Trinitas Regional Medical Center. “Our new relationship with Trinitas will provide us the opportunity to serve patients from both the local community as well as neighboring areas.” “CareOne and Trinitas are committed to providing superior, multifaceted care in a brilliant new patient care environment, Gary S. Horan concludes. About Trinitas Regional Medical Center Trinitas Regional Medical Center (TRMC), a major center for comprehensive 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 Foundation. 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 information on Trinitas Regional Medical Center, please visit: or call (908) 994-5138.


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April, 2013

Hospital Newspaper - NJ

Ask An Expert Christopher J. O’Connor Executive Vice President, GNYHA Ventures, Inc., President, GNYHA Services, Inc. and President, Nexera, Inc.

Building Patient Satisfaction 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).

Hospital Newspaper - NJ April, 2013

Upgrade your bottom line. Facility upkeep is vital to the safety and satisfaction of your patients and employees. The GNYHA Services facility maintenance portfolio is designed to help hospitals complete successful repair, renovation, and construction projects with reliable suppliers at significant savings. Repair and renovation don’t have to be DIY. Call GNYHA Services at (212) 246-7100.

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April, 2013

fo for n i t s Late es and s

nur dents stu

Hospital Newspaper - NJ

Nurse’s Viewpoint

By Alison Lazzaro

Hospital Newspaper Correspondent

61st Annual Convention: Kings and Queens of Hearts: Ace Your Career in Nursing 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.

Hospital Newspaper - NJ April, 2013

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April, 2013

Hospital Newspaper - NJ

education & careers Residency Program at Trinitas Regional Medical Center prepares young doctors for prestigious fellowships Two Seton Hall School of Health and Medical Sciences Internal Medicine residents currently serving their residency at Trinitas Regional Medical Center have been awarded Fellowships at two well known metropolitan medical centers. Nancy Holder, MD, has received a fellowship in pulmonary 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 outstanding health care institutions show that Trinitas Regional Medical Center offers 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 prestigious national institutions. They are: Vivek Bansal, MD, who received a fellowship in Endoscopy at Case Western Reserve University School of Medicine in Cleveland; Mukesh Kumas, MD, who was awarded a fellowship in hematology and oncology from Emory University School of Medicine in Atlanta, Georgia, and Swaroopa Yerrabothala, MD, currently doing a blood transfusion fellowship at Dartmouth-Hitchcock Medical Center in New Hampshire where she will begin a fellowship in hematology and oncology. Over the years, medical residents at Trinitas have had an impressive track record of being awarded fellowships at top institutions. For more information on Trinitas Regional Medical Center, visit: or call (908) 994-5138.


Drs. Amar Sarao and Nancy Holder, shown with Dr. Ernest Federici, Director of the Internal Medicine Residency Program (left), and Dr. William Farrer, Associate Director of the Program, join other Trinitas medical residents who have previously received fellowships at prestigious national institutions.

Unique Recruitment Opportunity 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 display opportunities for: Faculty/Physician Nursing Administrative Support Positions Clinical Care

Medical Assistants Counselors Medical Imaging Dieticians

Please contact Jim Stankiewicz for more information. tel: 845-534-7500 x219

Hospital Newspaper - NJ April, 2013

education & careers Educational Partnership launched, allows Lourdes Nursing Students to earn Bachelor’s and Master’s Degrees


Pictured reviewing the educational partnership agreement is (l to r): Lisa Easterby, DNP, RN, CNE, dean of Our Lady of Lourdes School of Nursing; Anne McGinley, PhD, RN, APN, dean of Camden County College’s Division of Nursing, Health Science and Human Services; and Sister Ann Heath, IHM, Ph.D., vice president for Academic Affairs at Immaculata University.

Launched in November 2012 through an educational partnership with Immaculata University and Camden County College, Our Lady of Lourdes School of Nursing is currently offering its registered 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 mainstay 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 provides an educational program that is based on Christian values, which advocate caring, social responsibility and service to those in need. The School is dedicated to providing a learner-centered environment that develops competent, compassionate and knowledgeable professional nurses for entry into practice. For more information, please visit our website at



April, 2013

Hospital Newspaper - NJ

Sun Hospital Employee Loan program provides six ways to make your home purchase a success

Win an iPad! The springtime serves as peak home-buying season. Even though buyers have a greater advantage 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 contract date.


Be 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-approved 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.


Get 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.

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 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!

Hospital Employee Loan Program

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.

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


Ensure you are working with a real estate professional: Ask your H.E.L.P. Program representative if they can recommend a real estate professional to you. It is extremely 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.


Find a good real estate attorney: A lawyer can help you negotiate the real estate contract and renegotiate it if a home inspection 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

the leading provider of local news and information for doctors, nurses and other hospital staff.

Learn More To find out more about our Hospital Employee Loan Program, email 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. 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

Hospital Newspaper - NJ April, 2013

education & careers H.E.L.P. Program

continued from previous page


Make 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.


Get 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 repairs yourself.

H.E.L.P. Program clients enjoy unmatched customer service and attentiveness throughout the process - from their initial inquiry - to closing. Working with its own resources and Federal government programs, Sun National Bank develops solutions that open the path to home ownership. Sun National Bank provides a full-range of banking products and services, delivered by experienced bankers. Personal attention merges with world-class service and competitive products that meet the needs of today’s consumers and businesses. Sun National Bank believes that doing business in the community means being a part of it. Whether purchasing a new home or refinancing an existing one, the H.E.L.P. Program is offered exclusively, providing personal service, benefits and rates not normally available to the general public.

“The springtime is the perfect time to buy a home and we make it even easier with aggressive products and programs available to the men and woman who are such an important part of the fabric of our community,” said Steven Testa, an executive vice president with Sun National Bank. “The H.E.L.P Program really got off the ground running and continues to be a success. We are excited about it and look forward in continuing to build our relationship with the hospital community.” To receive more information about the program and its benefits, contact Steven Testa at or call 973-615-9745. Sun National Bank Home Loans and Hospital Newspaper are not affiliated. All loans subject to approval. Certain conditions and fees may apply. Mortgage financing provided by Sun National Bank Loans, Equal Housing Lender.

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April, 2013

Hospital Newspaper - NJ


H of the Month

TRINITAS PROVIDES CRITICAL CARE FOR HEART ATTACK PATIENTS Most direct route “from door-to-balloon” is the goal When the recommended timeframe 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 “doorto-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 assessments of emergency responders trigger an early call to the Cardiac Catheterization Lab. The Cath Lab team calls the Emergency Department 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 medical 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

photos provided

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 assessments of patients suffering heart attacks caused by blocked arteries, known as STEMI.

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 muscle,” he says. “Symptom onset [when a patient experiences chest pain] to opening the blocked artery is critical. Our patients need to recognize signs of a heart attack and present to the Emergency Department immediately. Every second counts—every second we save means we’re saving heart muscle and potentially preventing complications like fluid retention and shortness of breath.”

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 the treating cardiologist through his or her smartphone, a process that speeds heart attack patients arriving at Trinitas into the cardiac catheterization lab.

In conjunction with the American Heart Association’s Mission: Lifeline initiative to change the way STEMI patients are transported, received and treated, Trinitas Regional Medical Center is leading the way in providing more efficient, effective 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 Regional Medical Center Trinitas Regional Medical Center (TRMC), a major center for comprehensive 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 Foundation. 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 information on Trinitas Regional Medical Center, visit: or call (908) 994-5138.

Hospital Newspaper - NJ April, 2013

Page 17

For the Best in Cancer Care

Look to a Comprehensive Cancer Center that is first to offer the latest technology…

Clarissa Henson, MD Chair of Radiation Oncology

Look to Trinitas Comprehensive Cancer Center. eing first with ground breaking technology is a hallmark of Trinitas Comprehensive 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 with Varian 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, Trinitas is a leader in radiosurgery – which uses precisely-focused beams of radiation to treat tumors anywhere in the body. Ground breaking technology, and the expertise to use it - that’s the Trinitas Comprehensive Cancer Center.


Behavioral Health • Cancer Care • Cardiology • Diabetes Management Maternal & Child Health • Renal Services • School of Nursing • Senior Services Sleep Disorders • Women’s Services • Wound Healing & Hyperbaric Medicine

Trinitas Regional Medical Center is a Catholic teaching institution sponsored by the Sisters of Charity of Saint Elizabeth in partnership with Elizabethtown Healthcare Foundation.


April, 2013

Hospital Newspaper - NJ

Hunterdon Healthcare receives Grand Champion Award from Nextgen 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 hospitals 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 empowerment. EHR’s facilitate greater access to the information 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 exchange (HIE) solutions for hospitals, health systems, physician practices, and other healthcare organizations. The implementation of NextGen has allowed for system expansion and achievement in clinical integration within the community, as well as ensuring return on investment for physician practices. Currently, Hunterdon Healthcare has 199 health providers including physicians 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, Laura Kratz, 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, Jean Fitzgerald, Glenn Mamary, Wayne Fellmeth, MD.

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, improve the health of the community.

Hospital of the Month Hospital Newspaper highlights one hospital per month as the centerfold feature. Great way to get information about your facility to interested readers. For more details contact: GENERAL MANAGER

Jim Stankiewicz ( 845-534-7500 ext 219 Scan this barcode with your smart mobile device to see Hospital of the Month examples on

From Police Officer to Nurse

Hospital Newspaper - NJ April, 2013


University Hospital Nurse Recalls Father’s Death in Accepting Award 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 president 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, sincere and compassionate nurse, Clara Memba, as part of the University Hospital family,� said Jennifer Smith, RN, BSN, MSN, the hospital’s acting medical-surgical director who nominated Memba for the honor and spoke during the surprise award presentation. “She has always provided the highest standards of care to patients and their families while displaying acts of kindness and empathy.�

The DAISY Award is a national nursing excellence recognition program used by more than 1,200 hosIt pitals across the country. recognizes nurses who give compassionate bedside care and regularly demonstrate superhuman tasks that nurses are expected to perform each day. DAISY Award recipients are nominated by their peers, patients or families. They are selected by their peers, and UMDNJ-The University Hospital presents the award to a total of six nurses annually 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 University 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 financial 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 motivated her to become a nurse. Until that time, she had been a police officer 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 Science 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 website. The unit where she works,


Clara Memba, RN, (center) was nominated for the Daisy Award by UMDNJ-The University Hospital acting medicalsurgical director, Jennifer Smith, RN, BSN, MSN, (l). Memba was recognized by James R. Gonzalez, MPH, FACHE, president and CEO (interim) (r) during the award presentation.

F-Yellow (surgical), shared in her award winnings by having cinnamon 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 recognize 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.

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April, 2013

Hospital Newspaper - NJ



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Hospital Newspaper - NJ April, 2013


Matheny Teacher recognized by Greater Media Radio Stations 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 developmental 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 Matheny 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 clerical 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 transdisciplinary 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 provided nominated her as Matheny’s educator of Darlene Tammara uses picture symbols to make a story more understandable to student the year for the 2012-2013 school year. Deborah Eike. At left is occupational therapist Debbie Goodheart.

16th Annual Miles for Matheny — Ready to Roll on 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 Liberty 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 students, patients, families and friends from the community together to enjoy a day of camaraderie and fun. “Our goal,” says Steve Proctor, Matheny president, “has always been to bring together the children and adults with disabilities with their able-bodied counterparts in a wonderful and uplifting day enveloped by the strong community 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.

Chuck Matheny and friends in the Lu Huggins Wheelchair Walk at Miles for Matheny 2012.

Start of the 5K race in 2012.

photos provided

• 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 developmental disabilities. All money raised at Miles for Matheny will benefit the Matheny Center of Medicine and Dentistry, which provides medical, dental and therapy care to Matheny inpatients and to people with disabilities living in communities throughout New Jersey. Major sponsors are: Poses Family Foundation, title sponsor; Partlow Insurance Agency; Peapack-Gladstone Bank; Porzio Bromberg & Newman, P.C.; Affinity Federal Credit Union; and WCBS-TV and WCBS Newsradio 880. For more information or to register, log onto or call (908) 234-0011, ext. 260.


April, 2013

Hospital Newspaper - NJ

Consultants Corner Binge-Eating Disorder gets real By Stuart Koman, Ph.D. Although it is the most common eating disorder, binge-eating disorder (BED) has not been officially recognized as a legitimate eating disorder – until now. This spring, when the American Psychiatric Association (APA) publishes the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders, widely known as DSM-5, bingeeating disorder will be among the new additions. The fourth edition, DSM-IV, included binge-eating disorder in its appendix “for further study.” The addition of binge-eating disorder to the manual legitimizes the disorder and gives new hope to those who have it. This is a big deal because: • Nearly half of all states have parity laws that require insurers to cover officially recognized disorders. While insurers have generally covered BED, they may now provide more comprehensive coverage. • DSM is used as a reference for psychiatrists and other healthcare professionals worldwide. Now, they will have common criteria for diagnosing BED. • DSM provides healthcare professionals with the language they need to communicate effectively with patients, their families and insurance companies. Everyone affected by the disorder will now have consistent, shared language to use when discussing BED. • By making BED a legitimate diagnosis, it helps those who have the disorder from a psychiatric perspective, because they are more likely to accept it and to seek treatment. • It should improve research funding. More research would lead to a better understanding of BED, and hopefully to improvements in treatment and recovery. • The extensive research behind DSM-5 gives the manual a great deal of credibility. DSM-5 took more than a decade to produce and includes contributions from more than 1,500 mental health experts. Identifying Binge-Eating Disorder Until now, individuals with binge-eating disorder were typically diagnosed as having EDNOS, which stands for “eating disorders not otherwise specified.” While insurance companies have generally shown flexibility in covering EDNOS patients, the failure to meet medical criteria for a disorder puts coverage in question and may have dissuaded some from seeking treatment. In addition, being categorize with EDNOS can be distressing to many patients. They may have a life-threatening disorder, but the medical limbo of EDNOS makes it not seem like a real eating disorder. Now, those who meet specific criteria will be diagnosed as having binge-eating disorder. While DSM-5 will not officially be published until May, publication available online during a comment period included the following criteria. To be diagnosed with BED, a patient would: • Eat, in a discrete period of time (e.g., within a two-hour period), an amount that is definitely larger than most people would eat in a similar period under similar circumstances. • Feel loss of control over eating during the binge. Those with BED believe they cannot stop eating; they cannot control what or how much they eat. Also, they must have three or more of the following symptoms: • Eat an unusually large amount at one time. It’s difficult to define how much is typically consumed during a binge, but studies show that consumption in the average binge ranges from 2,000 to 5,000 calories. • Eat much more quickly during binges than during normal eating episodes. • Eat until physically uncomfortable and nauseated due to the amount of food consumed. • Eat when depressed or bored. • Eat large amounts of food even when not hungry. • Often eat alone during periods of normal eating, because of feelings of embarrassment about food.

• Feel disgusted, depressed or guilty after binging. • Binge, on average, at least once a week for three months. • Binge in a manner not associated with the recurrent use of inappropriate compensatory behavior. Like others with eating disorders, binge eaters almost always suffer from one or more additional disorders, such as depression. Binge eaters typically become obese over time, but not everyone who is obese has binge-eating disorder. BED has a cognitive aspect lacking in those who are obese and do not have binge-eating disorder. When those who have BED binge, they think about it to the point where it ruins their day. They feel guilty and either do not eat or restrict their eating for the rest of the day. It is important to diagnose BED in those who are obese, because unless it is treated and the patient recovers, any treatment for obesity has the potential to fail over time. If a patient with BED has weight-loss surgery, for example, he or she may continue to struggle with loss of control over eating, especially once the post-operative period of severely limited eating passes. The first step for medical professionals who want to determine if their patients have BED should be to use a screening questionnaire, such as the SCOFF Questionnaire, which is similar to the CAGE Questionnaire used by medical professionals to evaluate alcohol use. There is also a Binge Scale and Night Eating Questionnaire. Combining Therapies As with other eating disorders, successful treatment of binge eating typically requires a combination of therapies. Using these therapies, the prognosis for recovery is usually good. Treatment typically begins by educating patients about their condition, so they are more aware of their eating patterns and can identify triggers that influence how and what they eat. Typically, cognitive-behavioral therapy (CBT) is the most effective treatment. CBT integrates behavior therapy with cognitive psychology and is based on the idea that changing maladaptive thinking can change behavior. The therapist provides information, guidance, support and encouragement. Goals include normalized eating, the reduction or elimination of binging and a reduction in eating behavior triggered by mood and events. Cognitive goals include improving the patient’s self-esteem and weight-related concerns. When patients fail to respond to CBT combined with interpersonal therapy, dialectical behavioral therapy (DBT) is typically used. DBT combines cognitive behavioral techniques for regulation of emotion, and reality testing with distress tolerance, acceptance and mindful awareness. DBT seeks to reduce binging by improving adaptive emotion-regulation skills. Behavioral weight-loss therapy is another option, but many believe that it is best for the patient to recover from BED before addressing weight loss. What works for one individual does not necessarily work for another, so treatment should be based on an in-depth diagnosis and a plan developed by a team, covering medical, behavioral and nutritional care, while also considering co-occurring disorders. Depending on how far the disorder has advanced, in-patient care or residential care may be necessary to help the patient become medically stable and to begin intensive therapy. Insurers have often been resistant to that level of care, but they may be more flexible because of DSM-5. When there are co-occurring disorders – and there are more often than not – it is critical to treat them concurrently. Otherwise, another disorder will likely become more advanced as the patient makes progress with BED. Many in the industry are hopeful insurers will be increasingly supportive of treating co-occurring disorders concurrently because of DSM-5. With the publication of DSM-5, the APA is acknowledging that BED is a real disorder. That’s something that those who have BED have long known. Now that professionals in the field have acknowledged the reality of BED, it should get the attention it warrants as America’s most common eating disorder. Stuart Koman, Ph.D. is President and CEO of Walden Behavioral Care in Waltham, Mass. He can be reached at

Hospital Newspaper - NJ April, 2013

PagE 23

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 screening 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” initiative 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 challenges faced by the people of Milot, which is located in the northern region of the country. Mr. Maron and members of the medical staff who had made humanitarian trips, including 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, provided 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 resources, although the facility and its technology are 30 to 40 years behind the times. Volunteers from Holy Name Medical Center are providing critically–needed medical care to adults and children at Hôpital Sacré Coeur. Physicians and nurses bring equipment, supplies and pharmaceuticals on every visit, and provide education to Haitian healthcare professionals about current medical practice. Holy Name’s administrators and technical employees 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


Michael Maron, President & CEO, Holy Name Medical Center, with children of Milot, Haiti.

way around. “Our hearts were open, and we listened,” he said. “As an organization 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. However, after the devastating earthquake 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 attendance at February 13th event, including benefactors, elected officials, individuals from the community 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 Valley Hospital, St. Barnabas Healthcare 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 donation to the Hospital for Haiti initiative, visit or call the Holy Name Medical Center Foundation at 201-833-3187.

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March, 2013

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Hospital Newspaper - NJ April, 2013

PAge 25

Gary S. Horan, CEO/President of Trinitas Regional Medical Center, receives Professional Society Award

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Gary S. Horan, FACHE, of Sea Girt, President and Chief Executive Officer of Trinitas Regional Medical Center, received the American College of Healthcare Executives (ACHE) Regent’s Award at the annual 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 senior level executive position and demonstrate success in promoting the growth of his or her organization’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, participation in civic/community activities and projects, and participation in ACHE activities and interest in assisting ACHE in achieving its objectives. Mr. Horan assumed the post of Chief Executive Officer and President of Trinitas Regional Medical Center and its parent organization, Trinitas Health, in July 2001. Previously 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 Hospital Operations for New York University Medical Center, and as Executive Vice President of St.Vincent’s Medical Center of Richmond, 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 Medicine. He served as a member of the Board of Governors of the American College of Healthcare Executives and is currently an ACHE Fellow. In the wider business community, 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 Directors of the New Jersey Chamber 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 comprehensive 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 Foundation. 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 information on Trinitas Regional Medical Center, visit: or call (908) 994-5138.

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!

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April, 2013

Hospital Newspaper - NJ


Professional Education Day – March 20, 2013 Convention – March 21 – 22, 2013 Tropicana Casino & Resort, Atlantic City, NJ


“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!!

CONVENTION – DAY ONE Thursday, March 21


Keynote Session… “Pride In The Profession… What’s Great About Nursing” Liz Jazwiec, RN—Best selling author! **********

Continuing Education Sessions & Posters Exhibits of Products & Services **********

Convention Luncheon… “Let’s Talk About Sex and the Older Woman” Dr. Gerti Heider—Woman’s Health Expert! (Earn Contact Hours for All Programs & Posters)

CONVENTION – DAY TWO Friday, March 2nd

Keynote Session… “Don’t Get Sick In July” Dr. Theresa Brown, writer for the New York Times **********

Continuing Education Sessions & Posters Exhibits of Products & Services **********

Convention Luncheon… “Compassion Fatigue: The Price of Caring Too Much” Dr. Phyllis Quinlan— Coach of Energetic Healing ********** (Earn Contact Hours for All Programs & Posters)

FOR COMPLETE 2013 CONVENTION BROCHURE: Send email to with your name & mailing address (or) visit our web site at

Hospital Newspaper - NJ April, 2013

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April, 2013

Hospital Newspaper - NJ

2013 NEW JERSEY LEAGUE FOR NURSING CONVENTION PROGRAM SPONSORS Assessment Technology Institute (ATI) The Wright Choice Agencies Kaplan Test Prep

Thursday, March 21, 2013 8:00 a.m. – 3:30 p.m. 8:00 a.m. – 8:45 a.m. 8:45 a.m. – 9:15 a.m.

Convention Registration Open GRAND EXHIBITION HALL OPEN (Free Morning Refreshments) 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.


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.



Interviewing Techniques & Job Seeking Claudia Cotarelo, Talent Acquisition and Strategic Recruiter, Atlantic Health System Identify social media, interviewing techniques, searching for a job, and effective resume writing. NCLEX Test Tips Laura Moskaluk , RN, MSN, CNE, Faculty, Middlesex County Vocational and Technical School Review of basis prioritization mnemonic; review of alternate form questions; sample NCLEX style questions

2:15 p.m. – 3:15 p.m. STU3 – TOPIC: STU4 – TOPIC:

STUDENT TRACK ONLY -- CONTINUING EDUCATION SESSIONS Interviewing Techniques & Job Seeking -- (Repeat of STU-1 Topic) NCLEX Test Tips – (Repeat of STU-2 Topic)

2:15 p.m. – 3:15 p.m. A1-TOPIC: SPEAKER: OBJECTIVES:

CONTINUING EDUCATION SESSIONS (Contact Hours) The Transgender Population: The “T” In LGBT Barbara Chamberlain, PhD, APRN, MBA, President, BJC Consultants 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. A Nurse’s Role in Disasters Kathe M. Conlon, BSN,RN,CEM MSHS, Burn Disaster & Emergency Preparedness Education Coordinator, St. Barnabas 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. Dealing With Difficult Student Situations Patricia A. Castaldi, DNP, RN, ANEF, Director, Practical Nursing Program, Union County College 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. Care Transitions – Partnerships That Work for Patients Alyce Brophy, RN, BSN, MPH, President/CEO, Community Visiting Nurses, and Alyssa Kizun, MSW, LCSW, CCM, Director of Care Management, Somerset Medical Center 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. B1 - TOPIC: SPEAKER: OBJECTIVES:

CONTINUING EDUCATION SESSIONS (Contact Hours) S.O.S. – Support Our Staff and Stop The “Suffering in Silence” Susan Fisher Brown, RN, Owner of CISM company called S.O.S. Crew Rescue, LLC 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.

Hospital Newspaper - NJ April, 2013


Understanding Cultural Diversity – Improving Patient Outcomes: Keys to Providing Culturally Competent, Congruent, and Sensitive Care V. Alexandra Hascup, PhD, MSN, RN, CTN, CCES, Asst. Professor, Kean University, College of Nursing Define cultural terms including cultural sensitivity and competency; Develop knowledge of culturally competent care and behavior strategies that lead to improved patient outcomes; The Walking Wounded: Consequences of Recurrent Sports Related Head Injuries Christine Wade, RN, BSN, CRRN, Nurse Manager, Brain Trauma Unit, JFK Johnson Rehabilitation Institute 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. Everything We Learned in Kindergarten: Arts and Crafts for Simulation 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 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. 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. 8:00 a.m. – 9:30 a.m. 8:00 a.m. – 12:00 p.m. 8:00 a.m. – 12:00 p.m.

Convention Registration Open Grand Exhibition Hall Open (Free Morning Refreshments ) EXHIBIT HALL OPEN 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. 11:00 a.m. – 12:00 p.m.

Visit Exhibits & Poster Sessions (Contact Hours) CONTINUING EDUCATION SESSIONS (Contact Hours)


Adjunct Orientation: The Key To A Successful Academic Year Nancy Berger, RN, MSN,CNE, Director of Nursing Education, Middlesex County College Nursing Discuss research regarding importance of adjunct orientation in the college/nursing education realm; Making a Difference in Ghana Through Community Nursing Michelle L. Foley, MA, RN, CNE, (retired nurse educator) Provide overview of Ghanaian culture; Describe village experiences and its impact on nursing and health care; Wound Management: Past, Present and Future Tracey Siegel, MSN, RN, CWOCN, CNE, EdD (c), Program Coordinator, Middlesex County College Nursing 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. Diabetes: Improving Outcomes, How Sweet It Is 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. 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 D1 - TOPIC: SPEAKERS:

CONTINUING EDUCATION SESSIONS (Contact Hours) Learning Is Fun: It’s Not Death By Powerpoint and Lecture 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 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. Opportunities in Nursing: Beyond the Bedside Jennifer Lerner, RN, BA, Staff Nurse, Oncology Unit, St. Barnabas Medical Center 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.

Page 29


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Hospital Newspaper - NJ

RESOURCE DIRECTORY ExtEndEd cARE & ASSiStEd livinG dAUGHtERS oF iSRAEl Daughters of Israel is a multi-faceted, stateof-the-art skilled nursing facility offering the most modern and comprehensive services available including: • • • • • •

Sub-Acute Rehabilitation Long-Term, Skilled Nursing Care Alzheimer’s Care Hospice & Palliative Care Respite Stays The Charles Bierman Home Senior Housing with Assistance • The Sarah & Aaron Franzblau Institute for Continuing Education Our team of skilled and dedicated professional staff deliver the highest quality of care for our 300+ residents. Services provided include: round-the-clock professional nursing care; 24hour medical coverage by board-certified geriatricians; on-site synagogue with full-time rabbinical services; a full range of stimulating and innovative recreational activities; on-site beauty salon, barber shop, work activity center, gift shop and coffee shop; spacious dining rooms, auditoriums, lounges and outdoor patio areas. Our sub-acute rehabilitation facility, which functions as a separate unit within the Home, features a spacious gym with state-of-the-art equipment and comfortable recovery suites with luxury amenities. Semi-private and private rooms are available at Daughters of Israel. The facility is covered by Medicare, Medicaid, commercial insurances and private payment. Daughters of Israel is a beneficiary agency of United Jewish Communities of MetroWest, N.J. 1155 Pleasant Valley Way, West Orange, NJ 07052 Contact: Adena Twersky, Director of Admissions Tel: 973-400-3307 Fax: 973-731-8364

HoSPitAlS BERGEn REGionAl MEdicAl cEntER, l.P. Located in Paramus, Bergen Regional Medical Center is the largest hospital in New Jersey dedicated to serving the residents of Bergen County and surrounding communities. With 1000+ beds and 1,500 staff members, the hospital specializes in Behavioral Health Services, which include child and adolescent, adult and geriatric psychiatric treatment. Long Term Care Services provides a scope of services, which far exceeds that offered in a standard nursing home. As a full service accredited medical center, we provide wound care, surgical care, cardiac care, rehabilitation services, respiratory care unit which includes ventilator dependent residents, Korean care services and an acute care unit all under one roof for our residents. The hospital excels in the treatment of substance abuse. The hospital offers detoxification, 21-day rehabilitation program, outpatient services, and treatment for the mentally ill and chemically addicted. Our Acute and Ambulatory Services offers same day surgery, medical and specialty clinics and state-of -the-art operating suites. Tel. 201-967-4000

MEdicAl BillinG Cape Medical Billing (CMB) is your single source billing provider for curing undetected “revenue leakage” that plagues today's healthcare practices. CMB has been in business for 22 years and is uniquely qualified to help your medical practice reverse “revenue leakage” with fast, efficient, innovative and customized billing programs. We offer personalized and cost effective service with 92.9% of charges paid upon the first submission! We accomplish this everyday by utilizing our “state of the art” billing software and paying close attention to critical detail used to match and process data. We also pride ourselves on significantly reducing days in accounts receivable by deploying aggressive and consistent follow-up procedures. Our technology, expertise and personal approach drive our billing practices and produce unparalleled results for our clients. Are you currently doing billing in house and considering outsourcing? No problem, we can integrate our technology with your current EMR software package and help you convert your medical services to consistent cash flow! Our billing specialties: Cardiology, Internal Medicine, Podiatry, Family Practice, General Surgery, Pathology, Infectious Disease, Gastroenterology, OB/GYN, Neurosurgery, Urology, Trauma Surgery, PT/OT, Mental Health and Ambulance. We're the experts...STOP risking your money and profit by collecting it yourself, or utilizing a billing company with less experience. We collect the HARD Stuff and we do it every day! Call for a FREE Billing Analysis to detect and solve your revenue leakage! Contact: Richard Papperman, CEO/President of Cape Medical Billing Office: 609-465-8900 or Sherrii Brentari Director of Sales and Marketing Cape Medical Billing 609-465-8900

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845-534-7500 ext.219 Fax: 845-534-0055

Online Directory available at

Learn What You Must Do To Protect Your Workers' Compensation And Disability Rights! Do Not Make These Mistakes That Can Cost You Benefits

1. You must report the accident or injury as soon as possible, even if you might not lose time from work or need immediate medical care. 2. Report all injuries to all body parts, no matter how minor they may seem. If you do not report it and the injury gets worse over time, the job may deny benefits. 3. Remember, you are entitled to treatment and benefits even if you have previously injured the same body part in a prior accident. Do not let the job tell you different. 4. Your doctor controls the treatment, not risk management. If you need an MRI and the job will not approve it, the experienced attorneys at BAGOLIE FRIEDMAN can fight to get it approved at no cost to you. 5. When you are released from treatment, you may be entitled to money for your injury and disability. You may also collect for repetitive stress, cumulative trauma, cancer, hearing loss & hepatitis. 6. Contact Attorneys Ricky Bagolie or Alan Friedman now for a confidential and free consultation and to discuss your workers' compensation and disability rights. There is no fee if there is no recovery cAll toll FREE 1-866-333-3529 (After Hours / Emergency Number 201-618-0508) BAGoliE FRiEdMAn, llc Workers' compensation & disability Attorneys The Five Corners Building 660 Newark Avenue - Jersey City, NJ 07306 (201) 656-8500 790 Bloomfield Avenue - Clifton, NJ 07012 (973) 546-5414

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Hospital Newspaper - NJ April, 2013

PaGe 31

NO Calibration & NO Drops Icare速 Tonometers for measuring Intraocular Pressure (IOP) with unique, patented rebound technology which enables quick and painless measurement with no drops or air. Quick, easy to use and patient friendly. The technology requires no calibration. From beginning to end the test takes under 60 seconds. Icare速 has over 32,000 satisfied users in over 50 countries.

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April, 2013

Hospital Newspaper - NJ

Calling All Emergency Responders

When every second counts... Count on NitroMist


NitroMist provides fast, effective symptom relief. NitroMist provides a consistent dose with each metered spray.* NitroMist offers secure storage, ensuring potency for up to 36 months from date of manufacture.† Available in 90 & 230 spray bottles. For product samples, patient educational material, and the NitroMist ER Box (Shown), Go to: Now covered on UnitedHealthcare. Check with your GPO for low contract pricing. For additional information, please contact us at BRIEF SUMMARY NitroMist® (nitroglycerin) lingual aerosol Rx Only INDICATIONS 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 guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5), as PDE5 inhibitors such as sildenafil, vardenafil, and tadalafil 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. WARNINGS 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 benefits 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)-specific phosphodiesterase type 5 (PDE5). PDE5 inhibitors such as sildenafil, vardenafil, and tadalafil 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 myocardial 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 reflex 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: Coadministration 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. Tissuetype 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 first-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 ossification were seen. The latter finding probably reflects 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 sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other rep-

Not Actual Size

orted clinical experience has not identified 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, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. OVERDOSAGE– Signs and symptoms of hemodynamic effects: 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 even bloody diarrhea); syncope (especially in the upright posture); dyspnea, later followed by reduced ventilatory effort, diaphoresis, with the skin either flushed or cold and clammy; heart block and bradycardia; paralysis; coma; seizures; and death. No specific 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 nitroglycerin overdose is the result of venodilatation and arterial hypovolemia, prudent therapy in this situation should be directed toward increase in central fluid volume. Passive elevation of the patient’s legs may be sufficient, but intravenous infusion of normal saline or similar fluid may also be necessary. The use of epinephrine or 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 difficult, and invasive monitoring may be required. 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 change on 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 fibrotic 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 in an 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 body weight gain in both sexes at all matings. No specific 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 sildenafil, vardenafil, and tadalafil. These products have been shown to increase the hypotensive effects of nitrate drugs such as NitroMist. Administration - Patients should be instructed that 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 or dizziness. 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 flammable propellant (butane), do not have the container burned after use and do not spray directly towards flames. 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 E Cranford, NJ 07016 by Dynamit Nobel GmbH, Leverkusen, Germany E Marketed and Distributed by: Akrimax Pharmaceuticals, LLC, Cranford, NJ 07016 USA NitroMist is a registered trademark of NovaDel Pharma Inc., used by permission. 141B002 10/2012

*Priming NitroMist: After receiving a new prescription or refill, patients should remove the plastic cap, place forefinger 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). NitroMist is a registered trademark of NovaDel Pharmaceuticals, LLC., used by permission.

©2012 Akrimax Pharmaceuticals, LLC., Cranford, NJ 07016 October 2012 NTR-145T

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