|
|
|
A Message from
Bill Stephan, MD, Vice President, Medical Affairs |
|
|
|
As we enter into the busy season of flu, colds and more, I want to thank all of our medical staff in providing the care to their patients that they need and being diligent in prevention efforts. We appreciate your patience and time as we have had to deal with new vaccines and information this year.
Next year we give best wishes to Claudie Maher, Vice President of Hospital Services (retiring in January) and Peter Davis, President and CEO (retiring in July). Both have been long time supporters of our medical staff and should be recognized for their many accomplishments over the years.
I hope everyone can attend our annual physician holiday gathering on December 3rd. I look forward to seeing you there.
|
|
|
Cyrille P. Cucio, MD, Joins SJ Internal Medicine - Riverside
St. Joseph Hospital and SJ Internal Medicine - Riverside welcome Cyrille Cucio, MD, to the medical staff. Dr. Cucio is board-certified in Internal Medicine and Geriatric Medicine.
Dr. Cucio received her medical degree from the University of the East Ramon Magsaysay Memorial Medical Center (UERMMMC) in Quezon City, Philippines.
She completed her residency in Internal Medicine at the University of Connecticut in Farmington, CT, and completed her fellowship in Geriatric Medicine at the State University of New York (SUNY) at Stony Brook in Stony Brook, NY.
Dr. Cucio's clinical interests include preventive medicine, comprehensive care of chronic medical problems and geriatric medicine. She is a member of the American College of Physicians - American Society of Internal Medicine (ACP-ASIM), American Medical Association (AMA) and American Geriatrics Society. She is fluent in English and Pilipino.
Prior to joining SJ Internal Medicine - Riverside, Dr. Cucio provided medical care at Ridge Mills Medical Center in Rome, NY and Queen Village Health Clinic in Camden, NY.
Dr. Cucio is joining SJ Internal Medicine - Riverside, working with new and existing patients. For more information about SJ Internal Medicine - Riverside or to make an appointment with Dr. Cucio, please call SJ Internal Medicine at (603) 595-3614.
|
|
|
Geeta Kulkarni, MD, Board Certified Anesthesiologist
Granite State Anesthesiologists, PA and Granite State Pain Clinic, LLC welcome Dr. Kulkarni to its medical staff. Dr. Kulkarni is board certified in anesthesiology. She received her Bachelor of Medicine and Bachelor of Surgery (MBBS) from Mahatma Gandhi Mission Medical College, Navi Mumbai. She did her residency in Anesthesia from Grant Medical College, Sir JJ Group of Hospitals, Mumbai, India. She graduated from medical school with distinction in Pharmacology and Physiology. She completed a residency with the department of Anesthesia and internship at St. Elizabeth Medical Center in Brighton, MA.
Dr. Kulkarni is fluent in three languages (English, Marathi, and Hindi). She is a member of the American Society of Anesthesiology and Clinical Associate at Tufts University School of Medicine in Boston, MA. Dr. Kulkarni has received numerous honors and awards and has given multiple presentations.
Dr. Kulkarni is accepting new patients in the Pain Clinic by physician referral only. For more information or to make an appointment, please call Granite State Pain Clinic, LLC at 603.882.5058 or visit them on the web at www.granitestatepain.com. |
|
Moushumi Mozumder, MD Joins The Milford Medical Center Staff
SJ Family Medical Center - Milford and St. Joseph Hospital welcome Dr. Moushumi Mozumder to the medical staff. Dr. Mozumder is a board-certified Family Medicine physician. Dr. Mozumder received her medical degree MBBS from Sir Salimullah Medical College in Dhaka, Bangladesh. She completed her residency in Family Medicine at Lutheran Medical Center in Brooklyn, NY, and completed a Fellowship in Geriatric Medicine at New York University Medical Center in New York. Her special clinical interests include geriatrics and women's health. Dr. Mozumder is a publisher author and has done several presentations in the field of gastrointestinal differentiation. In addition to English, she is fluent in Bengali and Hindi. Dr. Mozumder has joined St. Joseph Family Medical Center, Milford, working with new and existing patients. To make an appointment with Dr. Mozumder, please call SJ Family Medical Center- Milford at (603) 673-3014. |
|
Sazia Nowrin, MD, Joins SJ Family Medical - Hudson
SJ Family Medical Center Hudson and St. Joseph Hospital welcomes Dr. Sazia Nowrin, MD to the medical staff. Dr. Nowrin received her medical degree MBBS from Bangladesh Medical College in Dhaka, Bangladesh. She completed her residency in Family Medicine at NH Dartmouth Family Medicine Residency in Concord, NH. Her clinical interests include Women's Health, working with families of all cultures and providing care according to their customs and beliefs, pediatrics, preventive health, adolescent and teen care. In additional to English, Dr. Nowrin is fluent in Bangla, Hindi, and Urdu. Dr. Nowrin is joining St. Joseph Family Medical Center-Hudson, working with new and existing patients. To make an appointment with Dr. Nowrin, please call SJ Family Medical Center- Hudson at (603) 882-6700. |
|
Alok Kumar Sinha, MD Joins the Hospitalist Program at St. Joseph Hospital
St. Joseph Hospital welcomes Dr. Alok Kumar Sinha, MD to the medical staff. Dr. Sinha received his medical degree MBBS from Rangpur Medical College in Bangladesh. As a hospitalist, Dr. Sinha, is a doctor and a member of a growing medical specialty who has chosen a field of medicine that specifically focuses on the care of the hospitalized patient. Before selecting this medical specialty, hospitalists complete specialized education and training. As a key member of the health care team and an experienced medical professional, the hospitalist doctor takes primary responsibility for inpatient care by working closely with the patient's primary care physician. Dr. Sinha is a publisher author and received numerous awards and honors in medical field. In addition to English, he speaks Bengali. For more information about the Hospitalist Program at St. Joseph Hospital, visit our website at www.stjosephhospital.com or call the Hospitalist Office at (603) 882-3000 ext. 63882. |
|
Marsha S. Burns, APRN, Advanced Practice Registered Nurse, Geriatric Nurse Practitioner, Board Certified ANCC
The Roger Dionne, MD, Senior Center at St. Joseph Hospital is pleased to welcome Marsha S. Burns, RN, MSN, GNP-BC, to its medical staff. Ms. Burns received her Master of Science in Nursing-Geriatric Nurse Practitioner from the Massachusetts General Hospital Institute of Health Professions in Boston, MA. She also has a Masters of Science-Anatomy from Boston University School of Medicine. Most recently she completed an Urgent Care Adult, Pediatric and Geriatric Emergency Nurse training from Lawrence General Hospital in Lawrence, MA. As a new Roger Dionne, MD, Senior Center Nurse Practitioner, Ms. Burns will be working with current geriatric providers conducting physical assessments, providing nursing home and assisted living visits and working with specialty clinics. For more information about the Senior Center or to make an appointment with Ms. Burns, please call the Roger Dionne, MD, Senior Center at St. Joseph Hospital at (603) 595.3722. |
|
Ann Girlie Tkaczyk, ARNP, Adult Registered Nurse Practitioner
The Roger Dionne, MD, Senior Center at St. Joseph Hospital is pleased to welcome Ann Girlie Tkaczyk, ARNP, to its medical staff. Ms. Tkaczyk received her Master of Science in Nursing-Family Nurse Practitioner from Rivier College in Nashua, NH and her Bachelor of Science in Nursing from the University of Liceo de Cagayan, Carmen, Cagayan de Oro City, Philippines. As the new Roger Dionne, MD, Senior Center Nurse Practitioner, Ms. Tkaczyk will be working with current geriatric providers conducting physical assessments, providing nursing home and assisted living visits and working with specialty clinics. For more information about the Senior Center or to make an appointment with Ms. Tkaczyk, please call the Roger Dionne, MD, Senior Center at St. Joseph Hospital at (603) 595.3722.
|
Our St. Joseph Hospital Emergency Preparedness (EP&M) Team continues to monitor the status of flu activity. Currently we are getting messages out to staff and patients about receiving vaccines and coordinating the distribution of vaccine received. The biggest challenge we have faced is the daily unknown delivery and supply of the H1N1 vaccine. As more information is available we continue to post updates using our website www.stjosephhospital.com/flu. We have also put together some patient education pieces and distributed them to practices. We will be communicating these updates with medical staff via your office manager and email as news develops.
If you have additional questions please contact Fran Dupuis, Manager, EMS/ Emergency Operations (Ext 66451).
|
St. Joseph Hospital Medical Staff Newsletter is published by Medical Affairs. Please submit ideas, comments, and suggestions to Dr. William Stephan, Vice President, Medical Affairs at (603) 882.3000 ext. 67046, or e-mail wstephan@sjhnh.org. | |
|
|
MDR Bacteria, Nosocomial Infections, and Antibiotic Stewardship |
|
|
|
Appropriate management of antibiotic use in the hospital prevents multi-drug resistance, reduces nosocomial infections and reduces healthcare costs.
The central elements of antibiotic stewardship include:
- When patients have suspected or confirmed infection, treat promptly with appropriate antibiotics targeting the expected pathogens based on our local susceptibility patterns.
- Avoid antibiotic usage in case of colonization rather than infection.
- Obtain appropriate cultures before starting antibiotics whenever possible. Culture results are essential to de-evaluate therapy.
- If cultures do not yield a pathogen in 48-72 hours, consider stopping antibiotics and re-evaluating therapy including doing new cultures. If there is a pathogen isolated, de-escalate therapy based on sensitivities using the least expensive, narrow spectrum drug possible.
- Avoid antibiotics that duplicate anti-bacterial coverage.
Consult Infectious Disease where there are questions about antibiotic selection or for complex situations.
For more information on the topic of antibiotic stewardship, I suggest reviewing Dr. Granok's excellent article in the Winter 2009 Medical Staff Newsletter, entitled What is Antimicrobial Stewardship? |
|
AdminRx Implementation at St. Joe's |
|
|
|
|
What is AdminRx?
AdminRx is an Electronic Medication Administration Record (eMAR) and Bar Coding application that allows clinicians to document medication administration. AdminRx is a McKesson product and is part of HED, St. Joseph Hospital's current nursing documentation application. The goal of this technology is to reduce medication errors at the bedside.
What will AdminRx do for the patient?
Barcode Medication Administration at bedside will give our patients more confidence in the administration of medication and will reduce error rates within our facility, providing a better quality of care for our patients.
What will AdminRx do for physicians/providers?
AdminRx will give providers access to real time medication and IV documentation providing assurance that their patients are receiving the ordered medication and dosage. Potential medication errors will decrease and the documentation of medication administration will be more accurate.
What will AdminRx do for nurses?
AdminRx provide an electronic method of confirming that the correct medication is being given to the correct patient by matching patient bar codes to medication bar codes through AdminRx. The system helps verify that the right drug is being administered to the right patient in the right dose, the right route and at the right time. AdminRx will do away with cumbersome paperwork currently used for medication administration. The printed MAR will be a thing of the past, except during downtime.
How will the Physicians, ARNPs and PAs see the AdminRx data?
Portal has the capability of displaying the electronic MAR in a format that providers can utilize in their delivery of care. The information is available in a report on the Flowsheet Tab in Portal.
Where are we now with Admin Rx?
The AdminRx project officially began in May 2009. The Admin Rx project is a combined effort between the departments of IS, Nursing, Pharmacy, and Nursing Informatics. Currently AdminRx is in the final stages of building and testing. Training for every nurse on 3 North and ICU as well as all per diem nurses is ongoing and will be completed prior to Go Live. There will be phased in Go Live Dates for the Admin Rx Project. The Tentative Go Live Date for 3 North and ICU is January 2010. A staggered implementation for the other units will occur about every four weeks from January 2010 through April 2010.
Questions? Contact Aaron Thibodeau, Manager of Physician Applications at (603) 882-3000 ext.63506 or e-mail athibodeau@sjhnh.org.
|
|
Single Incision Laparoscopic Surgery (SILS) now at St. Joseph Hospital |
|
|
|
The latest technology in laparoscopic surgery has arrived in Nashua! St. Joseph Hospital now offers SILS, or single incision laparoscopic surgery. Instead of requiring multiple incisions that are often associated with traditional laparoscopic surgery that may leave visible scars, the SILS procedure is accomplished through a single incision through the belly button. A single incision lowers the risk of infection because there is only one scar, which is completely hidden by the belly button.
This procedure is ideal for gallbladder removals, but is not for everyone and is not for emergency surgery. Patients have been pleased with both the cosmetic and health results of less incisions. Currently, surgeons Michael Remar, MD, and Sabine Manoli, MD, are performing SILS at St. Joseph Hospital.
|
|
Handwashing: The Beginning of Infection Control |
|
|
|
|
|
Ignaz Semmelweis, an Austrian-Hungarian physician, first demonstrated over 150 years ago that hand hygiene can prevent the spread of disease. Hand hygiene as a practice includes performing handwashing, or using antiseptic handwash, alcohol-based hand rub, or surgical hand hygiene/antisepsis.
Dr. Semmelweis worked in a hospital in Vienna whose maternity patients were dying at such an alarming rate that they begged to be sent home1. Most of those dying had been treated by student physicians who worked on corpses during an anatomy class before beginning their rounds in the maternity ward.
Because the students did not wash their hands effectively between touching the dead and the living (handwashing was an unrecognized hygienic practice at the time) pathogenic bacteria from the corpses regularly were transmitted to the mothers via the students' hands.
The result was a death rate five times higher for mothers who delivered in one clinic of the hospital than for mothers who delivered at another clinic not attended by the student physicians.
In an experiment considered quaint at best by his colleagues, Dr. Semmelweis insisted that his students wash their hands before treating the mothers. Deaths on the maternity ward fell fivefold.
Unquestioned today as the most important tool in the healthcare worker's arsenal for preventing infection, handwashing was not readily accepted in Dr. Semmelweis's era. Indeed, his pleas to make handwashing a routine practice throughout the hospital were largely met with derision. Another 50 years would pass before the importance of handwashing as a preventive measure would be widely accepted by the medical profession. Sanitation is now a standard and thousands of lives have been saved because of Dr. Semmelweis's discovery.
At St. Joseph Hospital, observational studies have been used to monitor our compliance with handwashing. Results are expressed as the percentage of opportunities for handwashing that result in a "wash". The data below represents our results over the last year and a half. There has been significant improvement in physician handwashing rates. Remember to wash before and after each patient contact.
1 Semmelweis I. Etiology, concept, and prophylaxis of childbed fever. Carter KC, ed. 1st ed. Madison, WI: The University of Wisconsin Press, 1983.
|
|
|
|
|
Granite State Anesthesia Announces a New Website for the Pain Clinic |
|
|
|
I would like to take this opportunity to invite you all to visit our new website www.granitestatepain.com. Our team of doctors (Dr. Patel, Dr. Karajgi, Dr. Kumar, Dr. Sudhir, Dr. Burzon and Dr. Kulkarni) provide anesthesia and acute pain services at St. Joseph Hospital and the Surgicenter. We see patients with chronic pain who need injections in the pain clinic everyday of the week in the afternoon. We provide different types of injections to treat a wide variety of painful conditions and nerve problems.You will need a referral from your primary care physician or any specialist such as an orthopedic surgeon, neurosurgeon, who is already treating your pain.In some cases, we may not be able to cure your pain completely, but we will make every effort to decrease your pain and improve your quality of life, so that you can return to your active lifestyle. At Granite State Pain Clinic, we will be persistent and work with you until you feel better.
The common conditions we treat at Granite State Pain Clinic include the following but not limited to:
- Low back pain (lumbar spinal stenosis, Sacroiliac -SI joint dysfunction, Degenerative arthritis-DJD of lumbar spine/facet joint)
- Sciatica (bulging or herniated disc of lumbar spine, lumbar foramen stenosis)
- Neck pain (cervical spinal stenosis, Degenerative arthritis of cervical spine)
- Cervical radiculopathy (herniated or bulging disc in cervical spine, cervical foramen stenosis)
- Trigger points (painful spots in the upper or lower back)
For more information about each treatment, please visit us at our website www.granitestatepain.com. You can also reach us at www.nashuapain.com. Please feel free to write to us at contact@granitestatepain.com for questions and comments.
Dr. Madhankumar Sathyamoorthy (Dr. Kumar)
|
|
MRSA Nasal Surveillance Testing |
|
|
|
Effective October 29, the Clinical Microbiology Laboratory started performing MRSA nasal surveillance screens using the Cepheid Gene Xpert system. This rapid molecular based test utilizes automated real-time PCR (polymerase chain reaction) to detect MRSA DNA. A positive or negative result can be obtained in just over an hour, compared to two days with culture.
Controlling MRSA is a primary focus of hospital infection control programs. This rapid and sensitive test will increase the effectiveness of the prevention and control of MRSA. Testing will be performed 24 hours a day, 7 days a week for inpatients with a 4 hour turn around time. Specimens received from outpatients will be run on day shifts only, 7 days-a-week.
Please contact Nancy Sinclair, Microbiology Supervisor at ext. 67277 with any questions or concerns.
|
|
|
Renovation Updates: Hudson Medical Office Building and Maternal Child Health |
|
|
|
The Hudson Medical Office Building is still underway. Pictured to the right is a photo of the front exterior of the building which is expected to be completed in December. The office building will house SJ Family Medical Center-Hudson, Dartmouth-Hitchcock Hudson, and PT/Lab/Radiology services. Occupants are expected to move into the building in early January.
Other renovations in process include modest renovations on Maternal Child Health. The unit will feature a new "front door/entrance" (similar to 3 South) a new main nurses station, and a new family waiting room with bathroom. The project will be completed by December and is part of a five year plan for facility improvements.
Construction of the Breast MRI reading room was recently completed as well as the opening of the the newly renovated cafeteria.
Watch for more renovation/construction updates in future issues.
|
|
|
N.H. Hospital Association Honors Peter Davis with Highest Recognition |
|
|
|
|
The New Hampshire Hospital Association recently honored Peter B. Davis, FACHE, President and CEO of St. Joseph Hospital, with the James A. Hamilton Founder's Award for outstanding service in healthcare on behalf of the people of New Hampshire. The award is the highest recognition given by the Hospital Association and was presented at the association's 75th Annual Meeting at the Mount Washington Resort Hotel in Bretton Woods.
This year, Peter is celebrating 25 years of service at St. Joseph Hospital, where he has been referred to as a great mentor and champion of clinicians and nurses. His vision developed the hospital's nurse residency program, which is now in its 12th year. The program allows nurses the same opportunity physicians have to experience different clinical areas before making a permanent career choice. Also during Peter's tenure, St. Joseph Hospital founded the state's first dedicated Breast Care Center, the area's most comprehensive Cardiovascular and Diabetes Center and southern New Hampshire's leading Oncology Center. Additionally, during this time St. Joseph Hospital became the first community hospital in New Hampshire to achieve Magnet nursing status. Peter chaired the United Way campaign and Board in Nashua, chaired the Greater Nashua Chamber of Commerce Board, and currently is Chairman of the NH Hospital Association Board and serves as a Member of the American Hospital Association Regional Policy Board.
Peter also served this past year as Chair of the New Hampshire Hospital Association's Board of Trustees, during the transition in leadership of the organization. He gave NHHA's new president, Steve Ahnen, valuable support to lead the association into the future. In his own words, "St. Joseph Hospital is a very special place and it has been my honor to work alongside the most talented and dedicated group of physicians and employees for the past 25 years."
|
|
|
St. Joe's Holds 23rd Annual Charity Golf Tournament |
|
|
|
Bagpipes, kilts, scotch, and glorious weather greeted our players at the St. Joseph Hospital 23rd Annual Charity Golf Tournament. After weeks of rainy weather, it looked like our tournament could be cancelled, but waking up to a sunny and dry day on the morning of July 20 was truly a miracle!
The Scottish theme this year proved to be popular with everyone. Some of our players were great sports and made a colorful entrance dressed for the event in "olde tyme" Scottish golfing attire complete with golf knickers and argyle socks.
A total of 15 St. Joseph Hospital physicians participated and our congratulations to Dr. Jack Crisp for his first place net handicap finish and to Dr. Fred Riester for his second place net handicap finish. It's great to see our physicians equally excelling on the course and the hospital.
|
|
|
Blood Bank Notes |
|
|
|
Did You Know?
A single donor plateletpheresis is now considered a standard platelet dose equivalent to six (6) individual platelet units!
If irradiation is required PLEASE write it in your order.
As You Know....
The platelets must be obtained from the American Red Cross either from Manchester, NH or from Dedham, MA.
Questions? Contact the Blood Bank at ext. 67210.
|
|
|
Exceptional Happens Here - Stories to Share |
|
|
|
We are currently focusing on sharing stories about exceptional care, services or ideas that our medical staff may have.
|
|
|
Physician Practices Now Online! |
|
|
|
The physician practices of St. Joseph Hospital are now online! Each individual practice website includes the hours of operation, contact information, healthcare providers, downloadable forms, and additional practice information. To view this information, visit one of the sites today.
|
|
|
Save the Dates! |
|
|
|
Physician Holiday Celebration - Thursday, December 3rd, 6 p.m., Sky Meadow Country Club.
Quarterly Medical Staff Meeting - Tuesday, December 15th, 6:30 p.m. - CME begins at 5:15 p.m. featuring Dr. Naim Aoun, Pulmonary Hypertension - An Update.
| |
