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August, 2013

Hospital Newspaper - NJ

The best-dressed wounds in New Jersey. That’s the beauty of Trinitas.

he Center for Wound Healing & Hyperbaric Medicine at Trinitas Regional Medical Center is New Jersey’s leading comprehensive wound care center. We utilize advanced wound care technologies such as Hyperbaric Oxygen (HBO) Therapy and Vacuum-Assisted Closure (VAC®) negative pressure wound therapy. And we were the first in the state to use Apligraf ® - a living, bi-layered skin substitute. We enjoy healing rates that are consistently above 90%. That’s why so many area hospitals send their most difficult wounds to us. And why Diversified Clinical Services named us a Center of Excellence. This is wound care that goes way beyond bandages. And it’s available right here, right now. Beautiful.

CENTER FOR WOUND HEALING & HYPERBARIC MEDICINE 240 Williamson St., Suite 104, Elizabeth, NJ 07202 908-994-5480 • www.WoundHealingCenter.org TRINITAS CENTERS OF EXCELLENCE

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.

Hospital Newspaper - NJ August, 2013

Clara Maass Medical Center scores top in the state in State Department of Health Hospital Performance Report Clara Maass Medical Center was recognized as a top-performer in the state of New Jersey in providing patients recommended care in four areas: Heart Attack, Pneumonia, Heart Failure and Surgical Infection Prevention, according to a report released Friday, June 28, by the New Jersey state Department of Health. The overall hospital score was 100 percent for Clara Maass Medical Center for patients who are being treated for Heart Attack, Heart Failure, Pneumonia and for patients undergoing Surgical Procedures, ranking it in first place among hospitals in the state and giving it the top score among hospitals in Essex County. In addition, CMMC had an excellent record of patient safety, scoring zero or very low in the number of unsafe incidences involving patients, according to 2011 data examined by the state Department of Health. “We are proud to be recognized for providing outstanding health care to our patients and members of the communities we serve,” said Mary Ellen Clyne, Ph.D., President and Chief Executive Officer of CMMC. “Our physicians and employees maintain a standard of excellence when it comes to patient care and safety and it is through their dedication and hard work that we have achieved this superior record.” The state Hospital Performance Report studies data from all of the hospitals in the state of New Jersey, and also compares their record of performance against the national average. All of the Barnabas Health facilities were among the state’s top performing hospitals, according to the report. The state Department of Health released this statement: “New Jersey hospitals are showing steady progress in advancing quality of care with improved scores on the majority of measures placing our state in the top quartile nationally in health care quality,” said DOH Commissioner Mary E. O'Dowd. “The report is a tool for hospitals to see where they need to improve and gives patients information to help them make more informed health decisions.”

This recent Department of Health Report is not the first time Clara Maass has been recognized for its outstanding patient service. It is one of the most decorated hospitals in the state of New Jersey: Clara Maass Medical Center has won numerous awards and accolades. In 2013, Becker’s Hospital Review named it one of “100 Hospitals with Great Heart Programs.” It is ranked among the 50 Best Regional Hospitals in the New York Metro Area by U.S. News & World Report. In 2013, it also received its third consecutive Grade “A” score in Hospital Safety by the Leapfrog Group, along with a HealthGrades Patient Safety Excellence Award™. HealthGrades awarded Clara Maass an Emergency Medicine Excellence Award. Thomson Reuters named Clara Maass among the top 100 hospitals nationwide in 2012, one of only three hospitals in New Jersey to attain the distinction. In addition, Clara Maass won the Thomson Reuters Everest Award, one of 12 hospitals in the United States to do so. Clara Maass Medical Center was ranked as the second highest in New Jersey for hospital safety by Consumer Reports. It is ranked top in the state for the treatment of Congestive Heart Failure and Heart Attacks by the New Jersey State Department of Health and Senior Services. Located in Belleville, NJ, Clara Maass Medical Center, a Barnabas Health facility, provides a complete continuum of care to residents of northern New Jersey. Clara Maass’ centers and services include The Health and Wellness Center, Nuclear Medicine, The Cancer Center at Clara Maass, Adult Cardiac Services including Diagnostic Services, Cardiac Catheterization, Elective and Emergency Angioplasty and Rehabilitation, The Pain Management Center, The Joint & Spine Institute, a Vascular Center, Same Day Surgery, The Wound Center at Clara Maass, The Center for Sleep Disorders, The Bariatric Surgery Center, Rehabilitation Services, The Eye Surgery Center, Maternity Services and Parent Education, as well as Pediatrics. For a physician referral or more information about Clara Maass, call 1-888-724-7123 or visit www.barnabashealth.org/claramaass.

Page 3

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

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August, 2013

Hospital Newspaper - NJ

Fund-Ex aims to shorten and simplify the financing process By Patrick Harrigan | Syracuse, NY

Todayâ&#x20AC;&#x2122;s medical professionals face a myriad of challenges in their efforts to provide high-quality care. Change has become an industry constant and requires SK\VLFLDQV WR OHDUQ DQG DGDSW RQ WKH Ă&#x20AC;\ Much of the conversation revolves around increased healthcare regulation and compliance requirements. While its long-term effects remain to be seen, the 13,000-page Affordable Care Act promises to bring about considerable change and uncertainty. From a technology standpoint, the push is on to implement EHR systems and demonstrate meaningful use. New HIPAA rules will soon require practices to have policies and procedures in place to ensure that patient health information is secure. Change is also a major theme when it comes to patient interaction. As technology improves and information becomes more accessible, the methods by which patients gather information and interact with care providers will continue to evolve. While increased engagement can ultimately prove valuable as patients take a more active role in their health care, it will also require more time and attention from providers, not to mention DQ LQFUHDVHG ÂżQDQFLDO LQYHVWPHQW In addition, many practitioners still face the day-to-day business challenges of running a practice. Physicians PXVW PDQDJH ÂżQDQFHV FRPPXQLFDWH effectively and delegate responsibility ZKLOH PDLQWDLQLQJ D VWHDG\ Ă&#x20AC;RZ RI SDWLHQWV 6WDII PXVW IHHO IXOÂżOOHG DQG patients must feel comfortable to ensure a positive experience. The frantic pace and ever-expanding task list can often mean that things get overlooked, impacting the long-term health of the practice. Debt can accumuODWH ZKLOH RIÂżFH XSJUDGHV DQG PDQGDWRU\ technology updates can get pushed down the priority list. A medical professionalâ&#x20AC;&#x2122;s WLPH LV DOUHDG\ OLPLWHG DQG ÂżQGLQJ WKH UHVRXUFHV WR VHHN QHFHVVDU\ ÂżQDQFLQJ can seem overwhelming.

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Hospital Newspaper - NJ August, 2013

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August, 2013

Hospital Newspaper - NJ

OUR VIEW

ADVERTISER INDEX Company

Page

Bankers Healthcare Group, inc.

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7, 18

The Federal Patient Protection and Afford-

Those that have gone without insurance

of healthcare services to our economy as

able Care act is scheduled to be implemented

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their new insurance.

members of the community.

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matheny School and Hospital

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Primary care physicians and family doctors

Hospital News will keep you informed as

employer changes and essential health

are expected to receive up to 20% more

changes develop across the industry. As always

benefits for individuals and families.

newly insured patients. There is also an

we welcome your news and thoughts!

Hospital preparations include more staff,

increase of some specialty physicians that

expanded square footage and continued

will gain referral from the additional patients.

20, 22

communication as hospital leaders prepare

Some private physicians are actually be-

for an impact that is yet to be measured.

coming employees of local health system.

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This includes the growth of Medicaid,

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Hospitals preparing for major implementation of the Affordable Care Act

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News in Emergency Medicine About Emergency Medical Associates Emergency Medical Associates (EMA), headquartered in Parsippany, N.J., is a physician-led, physician-owned medical practice that specializes in emergency, hospitalist and urgent care medicine. Dedicated to providing exceptional solutions for the measurable success of our hospital partners, EMA is recognized for clinical excellence, quality service and sustained improved patient satisfaction. For more information, visit www.ema.net, www.facebook.com/EMANews or www.twitter.com/EMANews. Shih presents research to U.S. and International audiences

Stuhlmiller presents poster at Critical Care Transport Medicine Conference David F.E. Stuhlmiller, MD, FACEP, CMTE, presented a poster entitled, "HEMS STEMI Bedside Time: Impact of Medication Changeover Prior to Transport” at the Critical Care Transport Medicine Conference held April 8, 2013, in Austin, Texas. The results of the research concluded a median of 4 minutes (average of 3.5) per infused medication can be saved by HEMS medical crew by not changing over each medication infusion at the bedside of ST elevation myocardial infarction (STEMI) patients. Dr. Stuhlmiller is a partner of Emergency Medical Associates and chairman of the department of emergency medicine at Newton (N.J.) Medical Center.

Amato and Weiner host Workshop at Goryeb Children’s Hospital Continuing Medical Education Conference Drs. Christopher Amato, MD, FACEP, FAAP, and Ethan Wiener, MD, FAAP, presented at Goryeb Children’s Hospital’s 15th Annual Continuing Medical Education Conference held May 31-June 2 at Skytop Lodge, Skytop, Pa. The workshop focused on wound care, basic life support and pediatric advanced life support cases. Dr. Amato also lectured on office preparedness. Dr. Amato is the director of the Pediatric Emergency Medicine Fellowship and an attending pediatric emergency physician at Goryeb Children’s Hospital, Morristown, N.J. He also is the medical director of pediatric advanced life support for Atlantic Health. Dr. Wiener is the associate director of pediatric emergency medicine at the Goryeb Children’s Hospital, Morristown, N.J. Both are partners of Emergency Medical Associates.

Dr. Richard Shih, MD, FACEP, FAAEM, is an active in medical research and education and has traveled extensively to share his findings. Dr. Shih co-authored a case report entitled, “Glycine Induced Hyperammoniemia After Bladder Rupture During Transuretheral Resection of a Bladder Tumor.” The report was published in the Journal of Medical Cases. In addition to co-authoring a case report, Dr. Shih has given various presentations, lectures and was a discussant at various conferences. Presentations: • Oral research presentation entitled, “5 Year Prospective Study: OSCE Evaluations Do Not Correlate with EM Faculty Evaluations” at the 2013 Council of Residency Directors Scientific Assembly in Denver • Poster research presentation entitled, “QTc Prolongation and Torsades in Bupropion Overdose Presenting to U.S. Emergency Departments” at the 2013 American College of Medical Toxicology Scientific Assembly in San Juan, Puerto Rico • Poster research presentation entitled, “Ensuring Equity: Complaints by Race, The Beginning Investigations of MD Complaint Profilers” at the 2013 Society of Academic Emergency Medicine Northeast Regional Meeting held April 3 in Providence, R.I. Dr. Shih gave two lectures at The University of Texas Southwestern Medical Center May 1-2 in Dallas. • Emergency Medicine Journal Club, Discussant • Emergency Medicine Grand Rounds, Cases in Medical Toxicology Dr. Shih gave three presentations at the 2013 New Jersey American College of Emergency Physicians Scientific Assembly Review Course held May 7 in Princeton, N.J. • Ensuring Equity: Complaints by Race, The Beginning Investigations of MD Complaint Profiles • ED Patients Who Complain Are Less Likely To Be Repeat Customers • Dr. Shih and Michael Silverman, MD, presented “2013 Lifelong Learning and Self-Assessment Review Course” Dr. Shih gave three lectures at the Florida Emergency Physicians 13th Annual Symposium on Emergency Medicine Resuscitation of the Critically Ill 2013 held April 14 in Orlando. The lectures were entitled: • Get Up to Speed on New Drugs of Abuse • The Crashing OD: Give ‘Em Fat! • One Pill Can Kill – Practical Approach to Pediatric Poisoning Dr. Shih is residency director for the department of emergency medicine at Morristown (N.J.) Medical Center, and a partner of Emergency Medical Associates.

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PAGE 8

August, 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.

The New Normal: Giving Hospital-Physician Alignment Priority Both the present and the future of healthcare are about care coordination. Given the current environment—its regulatory and financial mandates, patient needs, and technological advancements—hospitals, health systems, and physicians are collaborating more than ever before to help increase care value while improving delivery systems. But whether through physician-hospital organizations (PHOs), accountable care organizations (ACOs), or other arrangements, hospital-physician alignment is a multifaceted cooperative relationship that requires continuous nurturing with clear, strategic practices and goals. Nearly 70 percent of physicians in a 2013 survey expect increased hospital-physician integration in the next one to three years. And they should. There is a substantial incentive to focus on the hospital-physician relationship. In a healthcare delivery system that rewards data sharing as well as cost and quality improvements, physician buy-in is key. Because of their central role in treatment decisions, and their power to decide when to admit and discharge patients, trying to significantly improve quality and outcomes while lowering hospital costs without physician participation may be impossible. Accordingly, hospitals must strengthen physician partnerships. This can entail the challenge of overcoming long-standing competing interests in order to develop an alignment strategy that best fits the organizational culture. The characteristics of a healthy hospital-physician relationship include 1. support for and commitment to change, from senior management down; 2. physician stakeholders actively engaged in hospital governance; 3. adequate staffing, technology, and practices that facilitate alignment; 4. pay models, including incentive compensation programs, developed by the hospital and physicians; 5. established procedures and policies to deal with conflict. While grounded in mutual leadership, resources, and patient-centered goals, hospital-physician alignment should also be mutually beneficial. It should deliver tangible opportunities to lower costs while improving efficiencies. One example is the GNYHA Services Alternate Care Purchasing Platform, which allows physicians affiliated with hospitals and health systems (like those owned, leased, or managed by hospitals or in PHO relationships) to purchase medical and non-medical products at prices typically available only to acute care health systems. Interdependency and teamwork are markers of today’s healthcare environment. Undeniable forces, such as ACOs, bundled payments, health IT requirements, lower reimbursement rates, and quality-based payments, are engendering close hospital-physician collaboration. However, these partnerships are not one-size-fits-all nor can they be forced. Providers must proactively determine their own strategy, based on their needs, their resources, alignment gaps, and the organizational climate. A comprehensive collaborative assessment, start-up plan, and implementation can result in alignment programs that are effective as well as tailored—ones that balance differences, goals, and operational/management capabilities, and provide incentives for continued success. 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 August, 2013

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or nfo f i t s e Lat s and

nursdeents stu

August, 2013

Hospital Newspaper - NJ

Nurseâ&#x20AC;&#x2122;s Viewpoint

By Alison Lazzaro

Hospital Newspaper Correspondent

Mind, Body, Spirit Set an intention If you have ever tried yoga, you will notice that the class begins by setting an intention, or a reason for coming to your mat. This technique allows the yogi to center his or her thoughts and consciously set aside one's own concerns in order direct positive energy to a person or thing. This practice of yoga mirrors holistic nursing. Evidence based practice dating back to Florence Nightengale exemplifies holistic nursing via setting an intention, commitment to self-care, and transcendent presence. Nurses are encouraged to pause for a moment before entering a patient's room, close their eyes, take a deep breath, and direct awareness to someone or something that brings to mind love and compassion. Being fully present in the moment allows nurses to promote a caring and healing interaction. Go through your flow Vinyasa yoga goes through a series of poses while focusing on inhaling and exhaling through flowing movements. Nurses can easily become caught up in the tasks they need to accomplish in the 12-hour work day, but calling to mind that intention and remembering to breath throughout the day can bring back the realization that nursing is about caring for human beings first and foremost. It is also important to care for yourself before you can competently take care of others. Self care is an integral part of holistic nursing. This includes analyzing one's own habits with self-awareness by journaling, meditation, or creating time for reflection. Holistic nursing includes practicing aromatherapy, healing touch, guided imagery, and reflexology to name a few. These methods are backed by the professional American Holistic Nurses Association and American Holistic Nurses Credentialing Corporation. These techniques enrich the scope of nursing practice by treating people's physiological, psychological, and spiritual needs in conjunction with conventional medical therapies. Aromatherapy uses essential oils from plants and herbs to treat physical imbalances. Yogis frequently use lavender and citrus oils to relax deeper. Pre-op and post-op nurses integrate this practice into nursing for relaxation techniques with patients. Healing touch is an energy-based approach to influence healing by restoring harmony and balance. Seal your practice At the end of each yoga class, the student's hard work is acknowledged and sealed with an audible "om." Before sealing your day at work, try to incorporate a holistic technique into your practice. Be mindful of self-care each day because it will expand your capacity to be present and compassionate in nursing. Self-care will rejuvenate your mind, body and spirit and enhance your love of nursing.

Hospital Newspaper - NJ August, 2013

education & careers Hunterdon Healthcare CEO appointed to State Employment and Training Commission by Governor Christie

provided

Robert P. Wise, President and Chief Executive Officer of Hunterdon Healthcare was recently appointed by Governor Chris Christie as a member of the State Employment and Training Commission (SETC). Mr. Wise has chaired the New Jersey Health Care Workforce Council since its inception in December 2010. The Council is a sub-committee of the SETC. The SETC partners with business, employers and job seekers, organized labor, and state and county agencies to set policy, develop plans and evaluate system performance to enhance the workforce for the economic viability of New Jersey. In addition, the SETC identifies and analyzes critical issues relating to workforce readiness and provides policy guidance to the Governor and to state professionals in the fields of employment, training and education; supports innovative programs that advance collaboration among governmental agencies; and, reports to the Governor on the progress that has been made and the issues that must be addressed in the area of employment, training and education. Mr. Wise has been President and Chief Executive Officer of Hunterdon Healthcare since 1990. He also serves as Vice Chairman for Raritan Valley Community College Board of Trustees, is a member of the Rotary Club of Flemington and a member of the State Council on Gender Parity in Labor and Education. He has received numerous awards including; the Hunterdon County Business Leader of the Year Award in 2000, the Distinguished Citizen Award from the Boy Scouts of America in 2001, the Edward J. Ill Excellence in Medicine Award for Outstanding Medical Executive from MDAdvantage Insurance Company of New Jersey in 2006 and the Elks Distinguished Citizenship Award in 2010. He is a founding director of the Hunterdon County Partnership for Health.

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August, 2013

Hospital Newspaper - NJ

HOSPITAL of the Month

St. Joseph’s: Revolutionizing health care. Revitalizing our community. St. Joseph's Healthcare System is proud of its longstanding tradition of patient care service excellence and community advocacy. Since its founding in 1867 by the Sisters of Charity of Saint Elizabeth, St. Joseph’s has continued to redefine the way responsive, compassionate, high quality care is delivered in the region. A recognized leader in the New York Metropolitan Area healthcare industry, St. Joseph’s is the second largest provider of Charity Care in New Jersey, the second largest provider of Medicaid services in New Jersey, and the Passaic Region’s urban safety net hospital. True to the organization’s mission of caring, St. Joseph’s Healthcare System is the anchor of an extensive urban development and beautification project that is transforming its environments for healing and positively impacting the surrounding community and its cityscape. Facilities expansions and renovation projects – components of the largest master facilities investment plan in the history of St. Joseph’s Healthcare System – are focused primarily at St. Joseph’s Regional Medical Center, the hub of the Healthcare System. An academic tertiary care comprehensive medical center in South Paterson, St. Joseph’s Regional Medical Center includes state designated St. Joseph’s Children’s Hospital. Old and underutilized buildings have been razed and replaced with award-winning architecturally significant structures equipped with sophisticated equipment for use by St. Joseph’s highly skilled team of clinical experts. The cornerstone and most extensive project of St. Joseph’s master facilities investment plan is the 183,000 square foot state-of-the-art Critical Care Building opened in October 2011. The impressive structure features separate Pediatric, Adult, and Geriatric Emergency Departments with a total of 88 treatment areas; 12 systemsintegrated operating theaters with pre-operative and post-operative areas; and 56 private rooms in specialized critical care units.

St. Joseph’s high-tech rooftop helipad, fully accessible to even the largest medical and military-style helicopters, tops off the Critical Care Building, expanding expedited ambulance and mobile intensive services, orchestrated through St. Joseph’s centralized 24/7 transfer center. Additional new facilities on the St. Joseph’s Regional Medical Center South Paterson campus include a pediatric and adult ambulatory care center, an outpatient rehabilitation center, an ambulatory radiology and laboratory entrance and reception area, a dedicated women’s and children’s services tower, a main lobby with dedicated waiting areas and high-tech conference center, as well as the ongoing modernization of all patient care areas. Convenient driveways, parking areas, and an adjacent multi-level parking garage enable easy access to St. Joseph’s Regional Medical Center and St. Joseph’s Children’s Hospital services. St. Joseph’s extensive facilities projects have not only revitalized the Regional Medical Center’s campus, they have spurred the actions of community-based investors who are developing medical offices, residential buildings, retail/restaurant space, and a hotel. The New Jersey Business & Industry Association honored St. Joseph’s Regional Medical Center with a 2013 New Good Neighbor Award which recognizes the best and most exciting commercial and industrial development projects in New Jersey based on economic benefit, job creation, architectural merit, and community involvement. St. Joseph’s Healthcare System is proud to set new standards for leading edge healthcare services and community advocacy by providing powerful medicine, revolutionizing healthcare and revitalizing our community. St. Joseph’s Regional Medical Center and St. Joseph’s Children’s Hospital, members of St. Joseph’s Healthcare System, are conveniently located near the Garden State Parkway, Routes 4, 20, 46, and at Exit 58A/Route 80 in South Paterson, NJ. To learn more about the comprehensive programs and services of St. Joseph’s Healthcare System, please visit www.StJosephsHealth.org or call 877.757.SJHS (7547).

Hospital Newspaper - NJ August, 2013

Powerful medicine. For you and your family. St. Joseph’s provides care in every major specialty for hundreds of thousands of patients each year. That’s why we’re in the middle of the most ambitious expansion project in our history— from the new critical care tower in Paterson, to the new ICU and operating suites in Wayne. And our physicians are recognized among the nation’s finest for continuing to push the boundaries of medicine. We remain dedicated to what we do best: delivering advanced care every day on every level. For two reasons. You and your family.

www.StJosephsHealth.org • 877.757.SJHS (7547)

St. Joseph’s Healthcare System • St. Joseph’s Regional Medical Center, Paterson, NJ • St. Joseph’s Wayne Hospital, Wayne, NJ • St. Joseph’s Children’s Hospital, Paterson, NJ • St. Vincent’s Nursing Home, Cedar Grove, NJ • Visiting Health Services of NJ, Inc., Totowa, NJ • Sponsored by the Sisters of Charity of Saint Elizabeth

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August, 2013

Hospital Newspaper - NJ

H.E.L.P. Program helps the hospital community that means so much to us They are the kind and caring faces that treat you for routine check-ups, unexpected trips to the emergency room and, even worse, catastrophic events. They do it under pressure, but always have a smile and soothing words. They are the doctors and nurses that take care of us, often saving lives, at hospitals and healthcare facilities. No matter what, they are always there to help. That’s why Sun National Bank Hospital created the Employee Loan Program (H.E.L.P) and it‘s been a huge success. Sun Home Loans and Hospital Newspaper came together to bring the emergency services community a special mortgage opportunity. Whether purchasing a new home or refinancing an existing one, the Sun Home Loans H.E.L.P. program is offered to members of the hospital community and their families. “We are always looking for programs that benefit our clients and the communities we serve,” said Steven Testa, a Vice President with Sun Home Loans. “This seemed like a natural fit. The men and women who work at hospitals work selflessly every day to take care of our loved ones. They are, indeed, special people. For us, we are just excited to be able to work with them.” Among other things, caring doctors, nurses and their support staffs, protect and promote patients. They prevent illness and injury, advocating for them, their families and communities. Indeed, these men and women are a special breed, tireless and determined. As for the H.E.L.P. program? The enterprising initiative has set itself apart through wonderful customer service with some of the best mortgage rates in the country. Sun National Bank makes that pledge to all of its satisfied clients. The H.E.L.P. program provides discounted mortgage rates designed for hospital employees and pre-qualifications to shop for your next home or refinance. A H.E.L.P. program representative will assist you in making sure the process is cost-effective and works for you and your family. H.E.L.P. Program clients enjoy unmatched customer service and attentiveness throughout the process - from their initial inquiry - through closing. In addition, Sun National Bank provides a full-range of banking products and services, delivered by experienced bankers. Sun National Bank believes that doing business in the community means being a part of it. To receive more information about the program and its benefits, contact Steven Testa at stesta@sunnb.com 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.

Win an iPad! If you are a member of the hospital community, now is your chance to enter Sun Home Loans and Hospital Newspaper's contest to win a free iPad. Just to go our website at www.hospitalnewspaper.com and fill in the entry form. Once you complete it, you will receive an email that requires you to confirm your email address. Once you do that you are entered. Hospital Newspaper will also be accepting applications at all conventions that it attends. A total of Five iPads will be given away so your chances to win are excellent. Sign up today to win today!

Hospital Employee Loan Program

Sun Home Loans, a division of Sun National Bank,

PROGRAM INFORMATION

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.

We understand that the current economic environment has created challenges to home ownership. Working with our own resources and Federal government programs we will create a solution that opens the path to home ownership. The Hospital Employee Loan Program delivers these advantages: » A competitive mortgage rate, available specifically for hospital employees » Discounted fees » Personal service from program specialists » Our pledge to have you in your home by the contract date

COMMUNITY FOCUS Sun National Bank, a full-service provider of banking products and services, is dedicated to playing an active part in the communities we serve. We support a variety of organizations, events and programs whose goals are to make our neighborhoods a better place to live and work and improve the lives of those living around us. Hospital News is the leading provider of local news and information for doctors, nurses and other hospital staff.

Learn More To find out more about our Hospital Employee Loan Program, email stesta@sunnb.com 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.

www.sunnb.com Sun Home Loans, Sun National Bank, and Hospital News are not affiliated. All loans subject to approval. Certain conditions and fees may apply. Mortgage financing provided by Sun Home Loans, a division of Sun National Bank, member FDIC. Equal Housing Lender.

NMLS #429900

Hospital Newspaper - NJ August, 2013

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education & careers Medical education joins Rutgers’ many existing strengths to create a more comprehensive research university that will better serve the people of New Jersey and beyond The new Rutgers University – academically stronger, energized by an expanded mission of medical education – has recently begun. Rutgers University President Robert L. Barchi and leaders across the state welcomed a new era in higher education, as the New Jersey Medical and Health Sciences Education Restructuring Act incorporates most of the former University of Medicine and Dentistry of NewJersey into Rutgers. The restructuring act, which has taken full effect recently, positions Rutgers to assume greater prominence across the state and nation. “For decades, Rutgers has been recognized for outstanding faculty, students and programs in the arts, sciences, humanities, social sciences and professional schools,” President Barchi said. “Combining our many existing strengths with our broader mission of medical education will elevate Rutgers to the ranks of the nation’s finest comprehensive research universities.”

The new Rutgers will: • Offer undergraduate, graduate and professional school students a more complete education, with access to interdisciplinary programs not previously available. • Strengthen public-private partnerships between Rutgers and the health-care industry statewide, nationally and globally. • Create new economic opportunities for New Jersey businesses and residents. • Launch new research initiatives to tackle many of society’s most difficult challenges. In recent months, President Barchi noted, Rutgers faculty and students have begun to form interdisciplinary initiatives in key areas of research, instruction and public service – including neuroscience, medical ethics, public health and precision medicine.

“The people of New Jersey finally have the world-class public university that they deserve, with a commitment to excellence in virtually every facet of higher education,” President Barchi said. “We look forward to the day when Rutgers University is synonymous with research that eradicates disease and enhances medical care, while providing an excellent education each year to tens of thousands of students from all corners of the world. “I’d like to thank Gov. Chris Christie, Senate President Stephen M. Sweeney, Assembly Speaker Sheila Y. Oliver, members of our governing boards and all of the leaders across New Jersey who have made the restructuring of higher education a reality,” President Barchi added. The restructuring act creates Rutgers Biomedical and Health Sciences, which includes all of the schools, centers and institutes that made up UMDNJ except for University Hospital in Newark and the School of Osteopathic Medicine in Stratford. University

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Hospital is now a freestanding institution, but remains the principal teaching hospital for the Newark-based medical and dental schools. The School of Osteopathic Medicine is now part of Rowan University. In addition, Graduate School of Biomedical Sciences programs at Stratford transfer to Rowan University. Rutgers Biomedical and Health Sciences also includes three existing Rutgers academic institutions: the Ernest Mario School of Pharmacy; the Rutgers College of Nursing; and the Institute for Health, Health Care Policy and Aging Research. Established in 1766, Rutgers, The State University of New Jersey, is America’s eighth oldest institution of higher learning and one of the nation’s premier public research universities. Serving more than 65,000 students on campuses, centers, institutes and other locations throughout the state, Rutgers is the only public university in New Jersey that is a member of the prestigious Association of American Universities.

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Hospital Newspaper - NJ

education & careers Congratulations to the Graduates of Bergen Regional Medical Center Psychiatry Residency Program The graduates of the Psychiatry Residency Program at Bergen Regional Medical Center are:

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BACK ROW, L to R: Dr. Asim Rizvi; Dr. Syed Hussaini; Dr. Srikanth Reddy, BRMC attending psychiatrist; Dr. Asghar Hossain, BRMC attending psychiatrist; Dr. Bennett Silver, BRMC Psychiatry Residency Program Director; Dr. Manoj Puthiyathu; Dr. Anatoliy Vasilov FRONT ROW, L to R: Dr. Carolina Mercader; Dr. Fauzia Syed; Dr. Adarezza Ferrer; Dr. Ayme Frometa; Dr. Meaghan Casey

Nine residents finished their final sessions with patients and their last rounds in preparation for graduation for the Psychiatry Residency Program at Bergen Regional Medical Center (BRMC). This residency program, which admits only onepercent of applicants, is one of the most extensive psychiatry residency programs in the county. “Congratulations to our newest group of psychiatry residency grad-

uates and we wish them the best as they begin their new journey as behavioral health care specialists,” said BRMC President Joseph S. Orlando. “As a teaching hospital, Bergen Regional is pleased to provide this service for emerging health care professionals as well as continuing education programs for established health care professionals.” The BRMC Psychiatry Residency Program is designed to give partici-

pants experience in all areas of adult and child psychiatry, the ability to interact with diverse patient populations and establish a foundation of knowledge for future specialization. Residents learn to diagnose and treat all types of psychiatric patients with illnesses ranging from adjustment disorders to more acute conditions. They are provided the opportunity to work with specialists in a variety of fields including child and adoles-

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Dr. Asim Rizvi, Englewood, NJ

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Dr. Syed Hussaini, Hackensack, NJ

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Dr. Manoj Puthiyathu, Hackensack, NJ

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Dr. Anatoliy Vasilov, Highland Park, NJ

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Dr. Carolina Mercader, Leonia, NJ

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Dr. Fauzia Syed, Upper Saddle River, NJ

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Dr. Adarezza Ferrer, Ridgewood, NJ

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Dr. Ayme Frometa, Maywood, NJ

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Dr. Meaghan Casey, Fort Lee, NJ

cent, psychogeriatric, addiction, consultation-liaison, forensic and emergency psychiatry. “This is an outstanding graduating class and it has been a pleasure to see their development as psychiatrists. We wish them all the best with their careers in the behavioral health care field,” said Bennett Silver, MD, Director, Psychiatry Residency Training. Bergen Regional Medical Center is both the largest hospital with 1,070 beds and the largest licensed nursing home in New Jersey. Located at 230 East Ridgewood

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 jim@hospitalnewspaper.com

Avenue in Paramus, NJ, BRMC provides a comprehensive set of quality services including Long Term Care, Behavioral Health Care and Acute Care to the Bergen County community and is a safety net provider for the underinsured and uninsured in the State of New Jersey. Bergen Regional has a full service emergency department, state of the art operating suites and more than 20 ambulatory specialty services available through the BRMC clinic. For more information, call 201.967.4000 or visit www.bergenregional.com.

Hospital Newspaper - NJ August, 2013

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Quick Thinking: St. Joseph’s Wayne Hospital Nurse saves hiker’s life

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Daniel Kline, Vice President, St. Joseph’s Healthcare System, and Site Administrator, St. Joseph’s Wayne Hospital (SJWH), joins Ruth Woudenberg, RN, SJWH, as she is reunited with Robert Landi – the man whose life she helped to save while hiking in January 2013.

It’s not often we have an opportunity to thank someone who saved our life. “Ruth is my guardian angel. Without her, I wouldn’t be here,” says Robert Landi, in a matter of fact tone and with a twinkle in his eyes. The Wyckoff resident pats his new friend, Ruth Woudenberg as he discusses that Sunday in January 2013 when she appeared, as if on cue in his time of need. Ruth fills in the details, recounting the day she came upon Bob, unconscious, laying in the snow at a local nature center. While others called 9-1-1, Ruth, without hesitation, went to Bob’s side, assessing the situation, checking for vitals, and performing cardiac pulmonary resuscitation, chest compressions, until the police arrived with a defibrillator followed by paramedics and an ambulance. Bob was treated with the defibrillator, an automatic compression pump, oxygen and whisked off to a neighboring hospital. “I was just in the right place at the right time with the right skills,” says Ruth, a Registered Nurse in the Ambulatory Services Center at St. Joseph’s Wayne Hospital, adding, “I just reacted, using my training as a nurse.

Congressman Leonard Lance to be Honorary Chair at 20th Anniversary of Matheny’s Arts Access Program Congressman Leonard Lance (NJ-07) will be Honorary Chair of Full Circle 2013: Reflections, the 20th anniversary celebration of the Matheny Medical and Educational Center’s Arts Access Program, to be held November 2 in Matheny’s Robert Schonhorn Arts Center here. Matheny is a special hospital and educational facility for children and adults with medically complex developmental disabilities. Arts Access enables people with disabilities to create fine art, assisted by professional artist-facilitators. Many of the artists in the Arts Access Program cannot speak and do not have control of their hands and arms. But

their minds are intact, and they use unique methods that enable them to overcome their disabilities and express themselves in multiple artistic disciplines. Congressman Lance, who visited Matheny this past January, is cochairman of the Congressional Arts Caucus. He has been a member of the New Jersey Council on the Humanities and a trustee of the Newark Museum and McCarter Theatre in Princeton. The 7th Congressional District includes Peapack-Gladstone as well as other parts of Somerset County, all of Hunterdon County and parts of Essex, Morris, Union and Warren counties.

Arts Access was created in 1993 by the late Robert Schonhorn, former president of Matheny, and Dr. Gabor Barabas, former medical director. The program recently received a $10,000 Challenge America Fast-Track grant from the National Endowment for the Arts to support the 20th anniversary Full Circle celebratory event. Full Circle will include an exhibition displaying original artwork created by artists with disabilities and will feature guest artists who will help participants with disabilities create a culminating multimedia performance piece. FastTrack grants are designed to bring more opportunities for arts engagement to underserved communities.

Congressman Leonard Lance, visiting with Arts Access artist Luis Rodriguez.

I knew he needed assistance. I really didn’t think I’d ever learn more about the man I helped that day.” But Bob had other intentions. Wondering who had done such a great deed, and with dogged determination, Bob was able to find Ruth. He contacted her by telephone one day to thank her. “What a surprise!” acknowledges Ruth, a resident of Hawthorne. “I was so pleased to learn he is doing well. We’ve become great friends and plan to stay in touch. It’s amazing how much we have in common.” Yes, a life saved. St. Joseph’s Wayne Hospital, an acute care community hospital in Wayne, NJ, is a division of St. Joseph’s Regional Medical Center in Paterson, NJ, and a member of St. Joseph’s Healthcare System, which also encompasses St. Joseph’s Children’s Hospital in Paterson, NJ, St. Vincent’s Nursing Home, in Cedar Grove, NJ, and Visiting Health Services of NJ, in Totowa, NJ. For information about the programs and services of St. Joseph’s Healthcare System, sponsored by the Sisters of Charity of Saint Elizabeth, visit us online at www.StJosephsHealth.org, or call 877.757.SJHS (7547).

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Hospital Newspaper - NJ

education & careers Trinitas School of Nursing awards diplomas/degrees to 63 graduates The May 2012 graduates of the Trinitas School of Nursing were awarded their diplomas and their Associate degrees at a ceremony held recently at the main campus of Union County College. In the culturally diverse class of 63 graduates, 57 hail from Essex, Hudson, Middlesex, Monmouth, Morris and Union counties in New Jersey and six from New York. The class, which includes 10 men, is the latest to complete the nursing/Associate Degree program offered at the school which is recognized as one of the largest nursing schools in the nation. This class joins a successful cadre of students who, for more than 20 years, have achieved an average passing rate of 96.5% on their first taking of the National Council Licensure Examination for Registered Nurses (NCLEX-RN). The following new nurses have received their diplomas through the program: Belleville, NJ resident, Cecilia Colón; Bloomfield, NJ resident, Rahel W. Zemicael; Boonton, NJ resident, Jose Crespo; Bronx, NY resident, Rita Okpalanma; Clark, NJ residents, Patricia Alice Radwan and Jacquelyn Umali; Colonia, NJ resident, Caitlin Sweeney; Cranford, NJ resident, Rebecca Flanagan; East Orange, NJ resident, Jessica Gonzalez; Edison, NJ resident, Natalee Nicole Nelson; Elizabeth, NJ residents, Kajal Gandhi, Mukta Gautam Dhakal, Rachel Gomez,

Frantz Martial, Kyoung Moon, John Nivar, Maria Paz, Daiane Resende, Aurora B. Ruizcalderon, Andrea Tinoco, and Luisa Tinoco; Fanwood, NJ resident, Linda Henderson; Fords, NJ resident, Nicholas G. Mwangi; Guttenberg, NJ resident, Diana L. Cuervo; Hillside, NJ residents, Karima Lee and Magelende S. Paviera; Holmdel, NJ resident, Anna Zeldin; Hopelawn, NJ resident, Staci Marie Wandling; Kenilworth, NJ resident, Marta Krajewska; Leonia, NJ resident, Min Ju; Linden, NJ residents, Anna Dragan, Margaret W. Gichuki, Anna Kobylarz, and William D. Lopez-Baylon; Long Valley, NJ resident, Gerard Muench; Metuchen, NJ residents, Marissde Aquino and Adrian Ramos; Mountainside, NJ resident, Alicia Gunther; Newark, NJ residents, Jennifer Cruz and Clara Andreia Lima Maciel; New York, NY resident, Brigitte P. Nkounkou; North Woodmere, NY resident Jessica C. Staco; Perth Amboy, NJ resident, Mariya Vysotskyy; Plainfield, NJ resident, Armand Nguetsop; Queens, NY resident, Shermaine Solomon; Rahway, NJ residents, Lorena Daniela Etienne and Erika Y. Mejia; Roselle, NJ resident Ruthson Noel; Roselle Park, NJ resident, Rena Marie Evans; Scotch Plains, NJ resident, Sharon N. Tagoe; Springfield, NJ resident, Yuliya Markiv; Staten Island, NY residents, Joanna Abella and

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Vanessa Acosta, and Union, NJ residents, Jessica Ann Alberto, Betania P. Dias, Wandy Espinal, Cassandra Fertig, Jennifer Hubbard, Joan Magtoto Intal, Lisa K. Jamurath, Monica Kowalczyk, Lovegem Dizon Santillan, and Mayra Via. The following graduates received Nursing Honors: Cecilia Colón; Jennifer Cruz; Diana L. Cuervo; Lorena Daniela Etienne; Rena Marie Evans; Mukta Gautam Dhakal; Margaret W. Gichuki; Jessica Gonzalez; Anna Kobylarz; Monica Kowalczyk; Karima Lee; Yuliya Markiv; Erika Y. Mejia; Patricia Alice Radwan; Adrian Ramos; Daiane Resende; Lovegem Dizon Santillan; Jessica C. Staco;

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Luisa Tinoco; Mayra Via; Mariya Vysotskyy, and Rahel W. Zemicael. The following awards were also presented at the graduation ceremony: First Scholarship Award, Jessica Gonzalez; Second Scholarship Award, Jessica C. Staco; Third Scholarship Award, Patricia Alive Radwan; Auxiliary Award, Gerard Muench; 2013 Nursing Service Professional Transformation Award, Diana L. Cuervo; Lily Bierstein Memorial Award, Rebecca Flanagan; Gerontological Nursing Award, Jennifer Cruz; Alumni Association Award, Lovegem Dizon Santillan; Curtis Crumbley Memorial Award, Jose Crespo, and Naeisha Massenburg Memorial Award, Mukta Dhakal Gautam.

The National League for Nursing (NLN) Accrediting Commission, Inc. recently granted the Trinitas School of Nursing full continuing accreditation through Fall 2020. The NLN's Board of Commissioners identified the following strengths as pivotal to their decision to grant the extended accreditation through the rest of this decade: NLN's support of the School's designation as an NLN Center of Excellence; the length of employment of the faculty, all of whom hold certification as Certified Nurse Educators (CNE); the School's fostering of excellence among students with English as a second language through its support and Externship programs; the School's nurturing environment for student support that encourages success among the entire student body, and the excellent relationships among the Trinitas Regional Medical Center nursing staff, clinical unit managers, faculty and students. In addition, the Trinitas School of Nursing recently received a renewal of its designation as a Center of Excellence in Nursing Education for its commitment to nursing education excellence among its faculty and student body from the National League for Nursing. The certification initially received for the years 2008 – 2011 has been extended to span 2011 – 2015. For more information on Trinitas Regional Medical Center, please visit: www.TrinitasRMC.org or call (908) 994-5138.

Hospital Newspaper - NJ August, 2013

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Mobile Sleep Lab at Lourdes offers convenient at-home testing for patients with sleep apnea and other sleep conditions Patients of the Neurodiagnostic/Sleep Lab at Lourdes Medical Center of Burlington County now have the option to undergo testing for sleep apnea and other sleep disorders in the comfort of their home via a mobile sleep diagnostic unit, which measures breathing patterns, heart rate and oxygen levels, as well as detects abnormalities during sleep. The Alice PDx portable sleep testing system by Philips Respironics enables patients to be tested outside of the sleep lab without compromising study results. The small, wearable sleep diagnostic device provides easy installation and transforms any bed in a house, hospital, hotel or nursing home into a virtual sleep lab. “We are excited to offer patients this convenient and effective option to help diagnose their sleep disorder,” said Scott Sharetts, MD, Medical Director of the Neurodiagnostic/Sleep Lab at Lourdes Medical Center of Burlington County. “While routine exams and an overnight sleep study are still recommended, at-home sleep tests are viable alternatives that produce essentially the same results.” After a night of sleep, the patient’s data is downloaded and measurements are sent to the sleep laboratory. The lab’s team of sleep experts interpret the results and collaborate

with the patient’s surgeon or physician to diagnose the sleep disorder and help guide a plan of action. While home testing has increased in recent years, the American Academy of Sleep Medicine (ASSM) recommends that an established sleep center manage such testing. In line with these recommendations, the experienced staff of certified physicians and technologists at Lourdes’ comprehensive sleep center oversee at-home testing from start to finish - from instructing patients on how to use the unit to creating a customized treatment plan. Studies show that patients with probable moderate-to-severe obstructive sleep apnea, and no significant co-morbid medical or sleep conditions, can gain a safe, reliable diagnosis from home sleep studies. Advocates of athome testing list numerous benefits such as a more natural sleep environment for patients, less need for retesting and thus, more cost effective, and increased patient satisfaction. Despite an estimated 40+ million Americans suffering from chronic sleep disorders, the vast majority of people never seek help for their affliction. Sleep disorders such as sleep apnea affect many different areas of one’s health, putting added stress on the heart, and can be problematic if left untreated.

“We are hopeful that by eliminating some of the barriers involved with conducting an in-hospital sleep study, such as re-arranging family and work schedules and fear of an overnight stay at the hospital, that more individuals will make their health a priority and

chose at-home testing to address their sleep issues,” added Dr. Sharetts. If you suffer from a sleep disorder, contact your primary care physician or call the Neurodiagnostic/Sleep Lab at (609) 835-3025 for more information or to schedule a consultation.

EMERGENCY MEDICINE UPDATE CME 2013 Conferences 9/23-26 Las Vegas, Nevada

11/4-8 Maui, Hawaii

2014 Conferences 1/20-23 Duck Key, Florida

2/2-7 Turks and Caicos

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4/12-19 7-Day Caribbean Cruise

5/19-22 New Orleans, Louisiana

7/5-12 7-Day Alaskan Cruise

7/21-25 Yosemite, California

8/25-29 Whitefish, Montana

9/15-18 Las Vegas, Nevada

11/13-16 Key West, Florida

12/9-12 Paradise Island, Bahamas

2014 Ultrasound in Emergency Medicine 3/20-21 Las Vegas, Nevada

9/18-19 Las Vegas, Nevada

2015 Tentative Conferences 3/16-19 Las Vegas, Nevada

4/19-24 Turks and Caicos

9/14-17 Las Vegas, Nevada

2016 Tentative Conferences 3/14-18 Las Vegas, Nevada

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August, 2013

Hospital Newspaper - NJ

RESOURCE DIRECTORY ARCHITECTURE

FAST & COMFORTABLE PELVIC EXAMS TSk PRODUCTS

Bernstein & Associates, Architects Founded in 1990, Bernstein & Associates, Architects, specializes in the design and construction of hospital and healthcare facilities. Our focus: high-quality design, excellent service, and client satisfaction. We have worked for over 100 hospitals and another 200 private healthcare facilities, across the United States. Our project types have included all hospital and healthcare service groups, including: Adult Day Care, Alcoholism Treatment Facilities, Ambulatory Surgery Centers, Assisted Living, Cancer Centers, Cardiac Cath, Cardiology, CCU/ICU, Clinics, Coronary Care, Dental, Dermatology, Dialysis Clinics, Doctors Offices, Drug Treatment Facilities, Elder Care, Employee and Student Health Support Services, Emergency Departments, Emergency Preparedness, Endoscopy, ENT, Expert Witness, Group Practices, Hospices, Hospitals, Infectious Disease, Information Systems, Intensive Care, JCAHO Survey, Joint Commission Survey, Laboratories, Master Plans, Medical Offices, Medical Equipment, Medical Libraries, Medical Records, Neurology, Nursing Homes, Ophthalmology/Eye Center, OB/Gyn, Orthopedic, Pain Care Facilities, Pathology, Patient Safety Consulting Services, Pediatric, Pharmacy, Physical Fitness and Sports, PT/OT, Primary Care Programs, Psychiatric, Radiology, Rehabilitation, Senior Citizen Facilities, Sleep Centers, Social Services, Statement of Conditions, Surgical Suites and Ambulatory Surgery Centers, Urgent Care Centers, and USP 797 Consulting Services. The firm's projects have won design awards from Progressive Architecture, Architectural Record, and the Architectural Woodworking Institute, and have been published in Advance, Health Facilities Management, Medical Technology Today, Bio/Technology, Progressive Architecture, Architectural Record, Design Solutions, Hospitality Design, Sound and Communication, Contract Design and Hospital Newspaper. Architectural Services include: programming, planning, design, construction documents, bidding and negotiation, and construction administration. The firm also offers sustainable or “green” healthcare design. The firm has a number of LEED-accredited professionals, has successfully completed numerous green healthcare projects, and has published articles on “Greening the Healthcare Environment”. Project Management (or Owner’s Representative Services) is offered as a stand-alone service through our affiliated project management company, Empire Projects, Inc. (www.empireprojects.com). Bernstein & Associates, Architects - PLLC 1201 Broadway - #803, New York, NY 10001 Contact: William N. Bernstein, AIA Managing Principal Tel: 609-309-7005 Fax: 609-309-7006 wb@bernarch.com NEW YORK - HARTFORD - PRINCETON

The Wedgie Pelvic Exam Wedge provides fast, comfortable pelvic exams in the ER, Radiology, SANE and Women’s Health. It is a much more comfortable than using a hard bedpan. The 6" height of the Wedgie lifts the patient's pelvis significantly higher then a bedpan, thus allowing physicians to perform a better exam. The Wedgie’s unique cutout design allows the physicians to maneuver their speculum in all directions without interference. The Wedgie support patients weighing up to 350 lb. It is made of a medical grade foam and an anti-microbial, anti-bacterial, and stain resistant medical grade vinyl cover. It can be cleaned with standard disinfectant products. Optional: disposable one-time use protective covers and room wall holders are available.

COMMUNICATION SkILLS Aspirin for Your Language Headache! When nurses, administrative staff and technicians speak a different language than patients and their families: •

Patients may not be able to understand simple questions or directions.

• Hospital staff may not be able to give or get important information from caregivers or family members. • Employees may not understand proper protocol and procedures. On your site on your schedule: • Spanish for Healthcare

12 Windsor Drive Eatontown, NJ 07724 www.tskproducts.com Phone: (732) 982-1090 Fax: (732) 389-9044 Email: sales@tskproducts.com

CAREER MANAGEMENT

• Accent Reduction (Pronunciation Improvement) • Communicating Across Cultures

Join BlueSteps today and receive 15% OFF your membership! Visit www.BlueSteps.com and enter Healthcare15% at checkout to get this exclusive discount. Contact info@bluesteps.com to learn more or for assistance getting started!

MED★EXCEL USA Providing Emergency Medicine Excellence for over 20 years EMERGENCY MEDICINE CONTRACT MANAGEMENT Physician Owned and Managed Award winning Customer Relations Program Continuous Quality Improvement Risk Management Innovations Cost Containment Measurable Outcomes EMERGENCY MEDICINE SERVICES CONSULTATION SERVICES Customer Satisfaction TeamBuilding/Staff Development Conflict Mediation ED Systems Analysis PRACTICE MANAGEMENT SERVICES Hospital and Physician Billing/Coding/Auditing/Consultation MED★EXCEL USA

• Business Writing Skills • Sign Language Please contact Marie Buchanan at 800.563.6384 Ext. 249 mbuchanan@medexcelusa.com all inquiries are confidential

• ESL (Basic/Advanced) Connect with Leading Healthcare Recruiters Join BlueSteps, the executive career management service of the Association of Executive Search Consultants Healthcare executives are in demand. Are you being considered for the top leadership jobs? Join BlueSteps today to put your resume and confidential careerprofile at the finger tips of over 8,000 of the world’s top executive recruiters, including hundreds who specialize in healthcare and life sciences recruiting. In addition to a unique connection to the executive search community, BlueSteps also provides a suite of proactive career management tools including: • a free resume review and career consultation • access to the International Executive Search Firm Directory • exclusive information on hundreds of active executive searches • online brand management tools • career management content and events specifically for senior-level executives As a service of the Association of Executive Search Consultants, you can rest assured that your career details will be confidentially and securely managed within BlueSteps. Unlike other mass job boards, only the highest caliber executive search consultants (all members of the AESC) will have access to your BlueSteps profile. Each year, AESC members recruit for over 70,000 of the highest level executive positions globally, many of which are never advertised publically.

CONTRACT/PRACTICE MANAGEMENT SERVICES

...and more Language Directions can help doctors, nurses, technical, and administrative staff to communicate more effectively between each other, patients, and their families

www.languagedirections.com Contact Donna Clark 1-888-554-8848 donna@languagedirections.com

Language D rect ons S

LLC

“Removing language and cultural barriers to effective communication”

Contact Jim Stankiewicz to find out how your organization can be featured in our Resource Directory.

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

Online Directory available at www.hospitalnewspaper.com

HOME MORTGAGES Gateway Funding specializes in mortgage options to the healthcare industry. We understand the nuances involved with obtaining mortgages for physicians, nursing staff, residents, or general staffing. You’re busy, we know it. Your unique, we get it. You need financing for a home, we provide it. One call or email to our experienced, licensed and fully trained loan officers, will put your mind at ease. We can provide No Cost Pre-Approvals prior to looking for a home, and highly competitive rates and fee’s once you do find your dream home!

Frank Mancino, Branch Manager NMLS#133472 3564 Quakerbridge Rd Hamilton, NJ 08620 877-583-3562 fmancino@gatewayfunding.com www.TheMancinoTeam.com

Hospital Newspaper - NJ August, 2013

Page 21

Boomers & Beyond Senior Safety: Always be alert!

The Brother Bonaventure Extended Care Center at

TRINITAS REGIONAL MEDICAL CENTER As a senior citizen, chances of a becoming a victim of crime increases dramatically. You may have a lifetime of experiences, but being aware of your surroundings, staying alert of situations that may make you vulnerable, following your intuition, and watching out for con-games can make all the difference in staying safe. Because many criminals target those victims who are considered vulnerable, it is especially imperative that senior citizens be the “BOSS” (Be Observant, Smart, Safe) whether at home or during their travels. Here are some important safety tips: Safety in the Community – Be alert of your surroundings whether you are in an office building, walking down a street, in a shopping mall, waiting for a bus or driving a vehicle. – Carry your purse close to your body...not dangling by the strap. Never leave your purse in a shopping cart. Never leave your purse unattended. – Place your wallet in the inside coat or front pants pocket. – Wrap a rubber band around your wallet to make it harder to be removed from your pocket. – Do not carry large amounts of cash in your wallet, purse or in your pockets. – Try to sit close to the bus driver or the “exit” while riding public transportation. Safety at Home – Sign up for direct deposit instead of having your social security or other pension checks mailed to your home. And, at many banks, free checking accounts are available to senior citizens. – Be certain that all door locks are functioning properly and install deadbolts on all doors. Make sure windows are locked and cannot be forced open. Secure all basement and attic windows. – Ask for identification from service or delivery people before letting them in. If you are the least bit concerned, call the company to verify. – Always be suspicious of phone solicitors who ask for your personal information such as credit card number, social security number or checking account numbers. Ask them to mail you the information. If they don’t have your address, do not give it to them.

120-Bed Hospital-based Long Term Care Unit • Award Winning Care • Five-Star Quality Rating (Three Stars Overall) from the Centers for Medicare and Medicaid Services • Recipient of the Prestigious “Advisory Standards Designation” from the State of New Jersey • Higher Acuity Care (wound care, IV nutrition, IV antibiotics, pain management) • Post Acute Care • Palliative Care • Rehabilitation Services: Occupational/ Physical and Speech Therapies • Quality of Life Programming (salon, pet therapy, recreation, trips, celebrations)

Featured at a recent open house ceremony following renovations are, left to right: Elizabeth Mayor J. Christian Bollwage; Krishna Garlic, Elizabeth Department of Health; Debby Hall, Administrator of Brother Bonaventure; Gary S. Horan, Trintas' President and CEO; Karim J. Khimani, MD, Medical Director of Brother Bonaventure, and James Lape, FACHE, Senior Vice President for Behavioral Health & Psychiatry, and Long Term Care.

• 24/7 Admissions • Accepts Medicare, Medicaid and most Managed Care • Recently Renovated Facilities

For information and a tour please call: Debby Hall, Administrator (908) 994-7525

655 East Jersey Street Elizabeth, New Jersey 07208 Trinitas Regional Medical Center is a Catholic teaching institution sponsored by the Sisters of Charity of Saint Elizabeth in partnership with Elizabethtown Healthcare Foundation.

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August, 2013

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 www.doigc.org Contact: Adena Twersky, Director of Admissions Tel: 973-400-3307 Fax: 973-731-8364 atwersky@doigc.org

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. www.bergenregional.com 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 rich@capebilling.com or Sherrii Brentari Director of Sales and Marketing Cape Medical Billing sherrii@capebilling.com 609-465-8900

neW pRodUct tecHnologY

WoRKeRS’ coMpenSation HoSpital WoRKeRS Have YoU Been inJURed on tHe JoB?

NO Calibration & NO Drops Icare® 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® has over 32,000 satisfied users in over 50 countries.

Contact: Bob Goldbacher (609) 412-2134 bob@visioninstruments.net

contact Jim Stankiewicz to find out how your organization can be featured in our Resource directory.

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

Online Directory available at www.hospitalnewspaper.com

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

www.bagoliefriedman.com

HQ Location: Cape Medical Billing 5 Locust Lane P.O. Box 670 Cape May Court House, NJ 08210 Office: 609-465-8900 Fax: 609-463-8106 www.capebilling.com

apparatus Campbell Supply company www.campbellsupplyco.com expositions Abilities Expo www.abilitiesexpo.com financial Institutions Healthcare Employees Federal Credit Union www.hefcu.com home care specialists Comprehensive Home Care www.homecarenj.com hospitals Children’s Specialized Hospital www.childrens-specialized.org Matheny Medical & Educational Center www.matheny.org

internet address directory Meridian Health www.meridianhealth.com medical equipment & products TSK Products, Inc. www.tskproducts.com

Hospital Newspaper - NJ August, 2013

PaGe 23

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.

Contact: Bob Goldbacher

(609) 412-2134

bob@visioninstruments.net

PAGE 24

August, 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: www.NitroMistPro.com Now covered on UnitedHealthcare. Check with your GPO for low contract pricing. For additional information, please contact us at info@akrimax.com 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.