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To Improve Patient Care, Find the Time
for Research
By Paula Lusardi, RN, PhD, CCNS, CCRN
Advanced Practice Work Group
Research activities are crucial to
improving patient care and generating nursing knowledge. With knowledge,
practice and experience, the advanced practice nurse is ideally situated to
participate in research activities that are tightly linked to clinically
significant patient-care problems.
Historically, research involvement has been
a major component of the clinical nurse specialist role.1 Since the CNS role was
developed in the 1960s, research activities have been mandated by professional
organizations, including the American Nurses Association,2-4 American
Association of Colleges of Nursing5 and AACN.6,7 In addition, research
activities have been galvanized through early research conferences, including
the Western Interstate Commission for Higher Education Regional Program for
Nursing Research Development,8 the Conduct and Utilization of Research in
Nursing Project9 and a burgeoning variety of local, national and international
research conferences. The essential components of the researcher role that are
described in the literature10,11 and the mandate to participate in research
activities make the advanced practice nurse the crucial link between research
and improved patient care.
However, implementing the research role can
be problematic.11,12 The greatest obstacle is the multiplicity of time demands.
The need to ensure quality patient care, provide staff education and participate
in policy, procedure and standard setting, as well as a variety of unit-based
and hospitalwide projects, makes keeping abreast of the latest developments in a
specialty area a daunting task for even the most seasoned APN. As a result,
research activities often take a back seat to other demands.
The best approach may be to integrate
research into daily activities. Of course, the APN's ability to do this depends
on a number of factors, including the organization's commitment to research
activities, the availability of adequate resources, and the APN's personal
commitment and understanding of specific levels of research competencies.
Whether you are a new or experienced APN, the following questions will help you
determine an appropriate level of participation in research activities:
Is your organization ready to have
research conducted?
Organizational readiness is key to the
APN's success in conducting research activities.
Cronenwett12 suggests questions to assess
an organization's readiness. Gawlinski and Henneman13 pose a similar group of
questions that focus on the readiness of the staff nurse and nurse manager. If
you answer "yes" to most of these questions, you have a good start toward
organizational support and unit sophistication for your research endeavors (see
Table).
Is the organization committed to the
resources needed to carry out research activities?
Although the organization and unit may be
committed to nursing research activities, resources must be available to support
them. Cronenwett12 proposes a number of resources that should be in place for
the APN to successfully participate in research activities and nursing
studies-time-clear priorities that include rewards and support for time spent on
research projects or activities; space, both psychological and physical, in
which to think, read and write; secretarial support; adequate library
facilities; necessary equipment and supplies; funds to support computer time,
coding and data entry, printing instruments and travel to present papers; access
to a critical mass of peers who are engaged in research; and time and travel
costs to meet with those who are not in your institution.
What is your desired level of
involvement in research activities? What competencies are needed at basic and
advanced levels?
The APN must understand his or her level of
competence to carry out research activities. McQuire and Harwood11 propose a
tri-level comprehensive, pragmatic and competency-based approach to APN research
involvement. The first level centers on the interpretation and use of research;
the second on the evaluation of practice outcomes; and the third on
participation in collaborative research that generates knowledge from clinically
significant questions and defines optimal nursing interventions.
By using the following guide, the APN can
evaluate the appropriate level of research activities as a function of his or
her abilities, experience and education:
� If you are a new APN, you may want to
focus on the Level I competency, interpretation and use of research. Focus on
incorporating relevant research findings into your practice and assisting others
to incorporate research into individual or unit practice. If you have been in
practice a little longer, you may want to develop programmatic or departmental
research utilization processes.
� If you are somewhat comfortable with
research activities, you may want to focus on the Level II competency,
evaluation of practice. Use existing data to evaluate individual or aggregate
nursing practice and collaborate in conducting evaluation studies. If your
education, experience and interest warrant a more advanced level of research
activities, identify specific outcome criteria and conduct an evaluation study.
� With increasing research sophistication
and peer support, you may focus on the Level III competency, participation in
collaborative research. This level encourages the APN to identify clinically
significant research questions and conclude with collection of outcome data.
What is your personal commitment to the
research role?
A personal commitment to participate in
research activities is crucial to the success of the research role. Inquiry
focused on research activities by CNSs in the mid-1980s suggested a discrepancy
between how much time the CNS wanted to devote to research activities and the
actual time.14 A brief survey at my own institution showed the discrepancy is
similar today. Eisz15 (as cited in Cronenwett12) proposed the following
questions that the APN can ask to assess his or her commitment to the research
role.
� Do I truly value nursing research? In
what ways?
� Will participation in research activities
help me accomplish some of my life goals? Which ones?
� Are there sufficient payoffs for doing
nursing research in my work setting? What are they?
� If I had more time for research-related
activities, what would motivate me to get involved?
� What do my current activities say about
my commitment to nursing research?
� Am I satisfied with my current research
involvement?
What are some practical suggestions to
increase and sustain research activities?
Research activities are a key factor in
evaluating nursing care, improving patient outcomes and generating new nursing
knowledge. With enhanced focus on the importance of research activities,
increasing collaboration with doctorally prepared nurses and acquisition of
Magnet status, APNs understand the need to find time to participate in research
activities. Following are a few practical suggestions to increase the time to
become involved in research activities.
� Decide what you want to do in terms of
research activities and stick to your desires.
� Research always starts with a great idea.
Begin with a clinically significant problem, and focus on theory-driven and
research-based practice issues.16
� Review the literature in your area of
interest. Literature stimulates many other ideas and reveals apparent gaps in
the research.
� Collaborate with peers and a doctorally
prepared nurse. If a university system is nearby, suggest collaboration with a
doctorally prepared faculty member.
� Collaborate with other nurses and
disciplines during research activities.17-19
� Block out regular time on your calendar
to meet with other research colleagues for intellectual stimulation, support and
enthusiastic talk.
� Negotiate for specified hours for
research activities. Determine specified hours or days that will be devoted to
research activities and block out your calendar at those designated times.
� Access funding and research resource Web
sites online, including the AACN site at www.aacn.org > Clinical Practice >
Research.
� Consider continuing your education at the
doctoral or postdoctoral level.
References
1. Riehl JP, McVay, JE. The clinical nurse
specialist: Interpretations. New York, NY: Appleton Century Crofts; 1973.
2. American Nurses Association. Nursing: A
Social Policy Statement. Kansas City, Mo; 1980.
3. American Nurses Association. The Role of
the Clinical Nurse Specialist. Kansas City, Mo; 1986.
4. American Nurses Association. Nursing: A
Social Policy Statement. Washington, DC; 1995.
5. American Association of Colleges of
Nursing. The Essentials of Master's Education for Advanced Practice Nursing.
Washington, DC; 1996.
6. American Association of Critical-Care
Nurses and American Nurses Association. Standards of Clinical Practice and Scope
of Practice of the Acute Care Nurse Practitioner. Washington, DC: American
Nurses Association, 1995.
7. Bell L, ed. Scope of Practice and
Standards of Professional Performance for the Acute and Critical Care Clinical
Nurse Specialist. Aliso Viejo, Calif: AACN; 2002.
8. Krueger J. Utilization of nursing
research: the planning process. J Nursing Admin. 1978;8:6-9.
9. Horsley J, et al. Using Research to
Improve Nursing Practice: A Guide. New York, NY: Grune and Stratton; 1983.
10. McGuire DB, Harwood K. The CNS as
researcher. In: Hamric A, Spross J, eds. The Clinical Nurse Specialist in Theory
and Practice (2nd ed). Philadelphia, Pa: WB Saunders; 1989:169-204.
11. McGuire DB, Harwood K. Research. In:
Hamric A, Spross J, Hanson C, eds. Advanced Nursing Practice: An Integrative
Approach. 2nd ed. Philadelphia, Pa: WB Saunders; 2000:245-278.
12. Cronenwett L. The research role of the
clinical nurse specialist. JONA. 1986;16:10-11.
13. Gawlinski A, Henneman E. Research
utilization in the critical care setting. In: Gawlinski A, Kern L, eds. The
Clinical Nurse Specialist Role in Critical Care. Philadelphia, Pa: WB Saunders;
1994:196-215.
14. Robichaud A, Hamric A. Time
documentation of clinical nurse specialist activities. J Nursing Admin.
1986;16:31-36.
15. Eisz M. Freeing up time for nursing
research. Part I: making the commitment. Momentum. ANA Council of Clinical Nurse
Specialists. 1984;2:1,4.
16. Brown SJ. Direct clinical practice. In:
Hamric A, Spross J, Hanson C, eds. Advanced Nursing Practice: An Integrative
Approach: 2nd ed. Philadelphia, Pa: WB Saunders; 2000:137-182.
17. Sneed N. Collaboration as a means to
achieving the clinical nurse specialist role expectations. Clin Nurs Spec.
1986;1:70-74.
18. Martin J. Implementing the role of the
clinical nurse specialist: one institution's approach. Clin Nurs Spec.
1990;4:137-140.
19. Rehwaldt M, et al. Collaborative
research under the unification model. Nursing Connections. 1991;4:29-35.
Table: Ask yourself
Organizational level
1. Are the basics of safe and effective
nursing care being delivered?
2. Do a majority of your nurses know what
research is?
3. Could a large number of nurses describe
nursing studies that have influenced nursing practice in your institution?
4. Does your setting have an Institutional
Review Board for the protection of human subjects?
5. Is at least one nurse a member of the
IRB? Do you know who he or she is?
6. Does the Department of Nursing have a
process for screening research proposals that affect nursing or nursing care or
assisting in developing these proposals?
7. Is the screening and approval process
clear and efficient enough to encourage nurse investigators to conduct studies
in your institution?
8. Is the commitment to research reflected
in your organization's mission statement, philosophy and goals?
9. Is the commitment to the investigative
function of nurses reflected in the Department of Nursing's philosophy, mission
statement, goals, job description and performance appraisals?
10. Have previous experiences with nurses
doing research established a high level of credibility for nursing studies
within the medical staff, hospital administration, and department of nursing?
11. Do nursing managers see a relationship
between research and current needs of their division or unit?
Division or unit level
1. Does the unit subscribe to a research
journal?
2. Does the unit have a journal club?
3. Are there mechanisms in place for
sharing the results of research studies?
4. Is practice based on research findings?
5. Have any research studies been conducted
in the unit?
6. Is anyone interested in conducting
studies or implementing research-based findings into practice?
The Power of One: Protecting Patient
Privacy Need Not Be a Burden
By Cynthia Janacek, RN, BSN,
CCRN, CC
Ethics Work Group
Routinely, I receive calls about or
encounter visitors who are distant family members, neighbors or friends of my
patients. Our institution's policy regarding patient privacy is to not give out
information over the phone or in person except to a designated patient
spokesperson or family member. However, callers or visitors are often extremely
insistent that information be given to them. They will rephrase a question,
emphasize how close they are to the patient or become angry because they do not
understand the regulations guiding our behavior.
Because we have so much to accomplish in a
day, the need to guard privacy can seem burdensome at times. Documentation, the
sharing of information, talking on the phone with the healthcare team,
discarding reams of paper that contain patient information, and giving report to
our "buddy," charge nurse or at shift change are all just part of the day.
However, any of these activities subject us
to violating Healthcare Insurance Portability and Accountability Act
regulations. A patient's name, medical record number, account number, date of
birth and social security numbers are just some of the individual identifiers
that are protected under HIPAA regulations. Other unique identifiers include
driver's license number, date of admission, device ID number (such as on a
pacemaker or stent), e-mail address, date of death and photographs. As
clinicians, we must be aware of the identifiers and become more accountable in
today's healthcare environment.
Passed in 1996, HIPAA regulations were
instituted in 2000 to require those covered by the act to " train all their
members of its workforce on the policies and procedure with respect to protected
health information" (Federal Register, Volume 65, Number 250, Dec. 28, 2002, pp
82826-82827). Compliance with the training requirement was mandated to be
completed by April 2003. Covered entities are healthcare providers and provider
organizations, including all members of the workforce, whether paid or unpaid,
such as volunteers, students, contractors and physicians.
As a unit educator and an active bedside
practitioner, I have a few easy reminders to guide me in protecting patient
privacy. First, I share only the minimal amount of information necessary to
accomplish a task. The laboratory technician who comes in to draw the patient's
blood does not need to know the family dynamic problems you have been dealing
with all day. The same is true for the hospital volunteer who is also a friend
of the family and who happens to hear you describe your issues with the nurse
who is helping you turn your patient. Closing doors and curtains, clearing
computer screens, and disposing of papers in a timely fashion are always a good
idea.
Second, the AACN Synergy Model for Patient
Care calls for us to serve as patient advocates and moral agents. When
considering sharing information, ask yourself, "Would I want this information
shared about me and does this person need to know?" By answering these
questions, you will be able to safeguard your patient's privacy in a
professional manner.
Our challenge is to be the caretaker of
each patient's privacy and confidentiality. If we ask ourselves the questions
and follow our hospital guidelines, the task of safeguarding information will
not be a burden, but part of being a professional at the bedside.
NTI 2004 Research, Creative Solutions
Abstracts Due Sept. 1
Sept. 1 is the deadline to submit research
and creative solutions abstracts for AACN's 2004 National Teaching Institute and
Critical Care Exposition May 15 through 20 in Orlando, Fla.
Abstracts must be relevant to the care of
acute and critically ill patients or to critical care nursing and must be
noncommercial in nature. The first author must be a nurse holding current AACN
membership. Only completed research and finished projects are eligible, and
abstracts must not have been previously published or presented nationally.
The designated presenters of accepted
abstracts receive a $75 reduction in NTI registration fees. All other expenses
are the responsibility of the presenter, who can be either the first author or a
designate of the author.
In addition, four awards will be presented
for oral research abstracts reflecting outstanding original research,
replication research or research utilization. Each of these awards provides an
additional $1,000 toward NTI expenses.
Following is additional information about
the abstracts:
Research
Abstracts can focus on any aspect of
critical care nursing research, including reports of research studies or reports
of research utilization. Only abstracts of completed projects will be accepted.
Abstracts reporting research studies must address the purpose; background and
significance; methods; results; and conclusions.
Creative Solutions
Abstracts should focus on specific
strategies and practice innovations that are used by nurses to solve difficult,
unique or interesting problems in patient care, nursing practice, nursing
management or nursing education. The creative solution must have been
implemented, with outcomes evaluated. Abstracts must address the purpose of the
project and include a description of the creative solution, as well as
evaluation and outcomes.
Guidelines and resources are now available
online at www.aacn.org > Education > Speaker Material/Information > Call for
Research & Creative Solutions Abstracts. The application will be available
online in July.
Practice Resource Network
Q:
Confronted by the knowledge explosion, how can
nurses ensure that the care they deliver is based on current scientific
evidence?
A:.
Nurses have an obligation to ensure that their clinical practice is based on
science and research. Just like assessment and evaluation, utilizing current
evidence is the standard of practice for acute and critical care nurses. Using
scientific or expert evidence to deliver care for the most vulnerable and
complex patients advances the science of nursing. To meet the expectations of
patients and their families, nurses must find, analyze and use available
information and evidence.
How can nurses close the gap between
research and clinical practice? One way is to look for tools that have been
systematically reviewed to analyze the available science evidence and to make
recommendations based on the quality of that evidence.
For example, AACN's "Protocols for
Practice" present the latest literature, knowledge and scientific evidence and
make practice recommendations based on the strength of that evidence. Each
protocol is written by an expert or experts in a specific area of practice.
To assist in evaluating everyday practices,
recommendations are rated according to the level of information available to
support the devices used and patient care situations. The easy-to-use rating
system uses the following levels:
I. Manufacturer's recommendation only
II. Theory based, no research data to
support recommendation; recommendations from expert consensus group may exist
III. Laboratory data only, no clinical data
to support recommendations
IV. Limited clinical studies to support
recommendations
V. Clinical studies in more than one or two
different populations and situations to support recommendations
VI. Clinical studies in a variety of
patient populations and situation to support recommendations.
Higher levels of evidence allow bedside
nurses to be more confident in validating current practices and in integrating
recommendation into their clinical practice.
In addition, each of the protocols includes
information about the current technology, the accuracy and precision of the
technology, related occupational hazards, ethical considerations, competency
issues, rationale for the practice recommendation and areas for future research.
The protocols can be used:
� As a clinical tool to guide the use of
research at the bedside.
� To educate and teach staff about a
specific technology or patient situations.
� As a clinical reference and continuing
education source.
� As a supplement to unit policy and
procedure.
� As a means to stimulate research at the
bedside.
The AACN Protocols for Practice are
available online at
http://www.aacn.org
> Bookstore > AACN Product Catalog or by calling (800) 899-2226.
If you have a practice-related question,
call AACN's Practice Resource Network at (800) 394-5995, ext. 217, or post your
question online at
http://www.aacn.org
> Clinical Practice > General Practice Information > PRN > InfoLink Discussion.
Public Policy Update
Congressional Nursing Caucus Formed
A bipartisan Congressional Nursing Caucus
has been formed in the U.S. House of Representatives to educate members of
Congress about the nursing profession and how nursing issues affect the delivery
of safe, quality care.
Founded by Reps. Lois Capps (D-Calif.) and
Ed Whitfield (R-Ky.), the caucus was formed after consultation between
congressional leaders and the American Nurses Association. It will conduct
regular briefings to reinforce the important role of nursing in the delivery of
direct and indirect health services throughout the nation.
AACN supports this effort and will identify
opportunities to communicate with legislators as we follow developments.
Voluntary Medical Error Reporting
A bill passed by the House of
Representatives would protect nurses and other healthcare providers from
retaliation for reporting medical errors. In March, the House voted 418-6 to
pass The Patient Safety and Quality Improvement Act (H.R. 663), which would
create patient safety organizations to facilitate anonymous, voluntary reporting
of medical errors.
The PSO, which would be certified by the
Department of Health and Human Services, would analyze the reported errors,
determine causes and develop recommendations intended to reduce medical errors.
Under the bill, any information reported to PSOs would remain confidential. The
approved bill would create new provisions in the Public Health and Service Act,
overseen by the Energy Committee.
The American Hospital Association supports
the voluntary provisions for reporting provided in the bill, while American
Nurses Association says that reporting medical errors should be mandatory, not
voluntary.
Senate Health, Education, Labor and
Pensions Committee Chairman Judd Gregg (R-N.H.) has introduced a similar patient
safety and medical errors bill in the Senate. He was joined by Majority Leader
Bill Frist (R-Tenn.) and Sens. James Jeffords (I-Vt.) and John Breaux (D-La.) in
filing the Patient Safety & Quality Improvement Act of 2003 (S.720) March 27.
Although no hearings are currently scheduled, a committee spokesperson said the
panel might meet on patient safety before marking up the bill.
Many of the bill's provisions enjoy wide
support from both parties. However, Sen. Edward Kennedy (D-Mass.) has objected
to language that establishes liability protections for certain information
related to a medical error to enable healthcare providers to evaluate mistakes.
Kennedy has maintained that such information should be available as evidence for
plaintiffs in malpractice lawsuits. In the 107th Congress, Kennedy introduced
legislation (S 3029) as competition to the GOP bill (S 2590). Both sides cite
Institute of Medicine recommendations on preventing medical errors as the basis
for their positions.
House GOP leaders tied the patient safety
issue to the Health Act (HR 5), a medical malpractice reform bill, passing both
measures on parallel tracks. Whether the Senate will adopt a similar strategy
"remains to be seen," the committee spokesperson said.
Virus Suspected as SARS Agent
The World Health Organization reported that
scientists at the University of Hong Kong have isolated a virus as the causative
agent for Severe Acute Respiratory Syndrome. Canadian researchers released
findings suggesting that the metapneumovirus, a member of the Paramyxoviridae
family, is responsible for SARS, though conclusive determinations have yet to be
made. Work on determining a diagnostic test that can be used clinically is under
way.
SARS is characterized by influenza-like
symptoms, such as fever, myalgias, headache, sore throat, dry cough, shortness
of breath, or difficulty breathing. Some cases have resulted in hypoxia,
pneumonia, acute respiratory distress, and death. Transmission is believed to
occur by exposure to large droplet aerosols through close, direct contact with
persons suffering from SARS.
Healthcare workers have been identified
among the cases and remain a primary at-risk group, secondary to caring and
treating patients with SARS. The use of appropriate infection control measures
such as Airborne and Contact Precautions are strongly urged for individuals
presenting with the listed symptoms. Clinicians are urged to report suspected
cases to their local or state health departments.
JCAHO Report Details Strategies for
Preparedness
The Joint Commission on Accreditation of
Healthcare Organizations recently issued a white paper detailing recommendations
for creating and sustaining communitywide emergency preparedness systems.
The report details more than 40
recommendations for enlisting the community in preparing a local response to
disaster preparedness, focusing participants on key preparedness system
priorities and establishing accountability, leadership and funding. JCAHO
prepared the recommendations in consultation with a 28-member panel that
included representatives from various federal and state agencies, front-line
emergency care providers, emergency preparedness planners and public health and
hospital community leaders.
Nursing Groups Protest Pelvic
Examinations Without Consent
AACN joined 13 other national nursing
organizations in a March 25 letter to the Association of American Medical
Colleges to protest the practice of medical students performing pelvic
examinations without consent on women who are under anesthesia. This practice
was reported in the March 12, 2003, Wall Street Journal article titled "Using
the Unconscious to Train Medical Students Faces Scrutiny." The groups maintain
that individuals, have a right to expect that they will be informed of planned
procedures while they are under sedation; that they will know who will be
performing such procedures; and that they will have the option to decline the
participation of a student or anyone else unrelated to their primary reason for
having the procedure. The letter calls on the AAMC to condemn the practice and
move to have member schools cease the practice immediately.
Thompson Outlines Health Reform
Priorities
Health and Human Resources Secretary Tommy
Thompson says that an overhaul of the nation's healthcare system should include
Medicare reform, as well as changes to Medicaid, assistance for the uninsured,
medical liability reform and improved patient safety in hospitals. Speaking at a
discussion hosted by the Republican Main Street Partnership, Thompson renewed
the administration's call for caps on noneconomic damages in medical malpractice
lawsuits. He also said that HHS is developing a demonstration project that would
allow healthcare providers to offer patients injured by medical errors an
immediate apology and compensation to avoid lawsuits. Injured patients would be
able to reject the offer and file suit.
Thompson also proposed a new program to
assist hospitals in implementing new technologies to better protect patients
against errors.
Public Policy Snapshot
Medical Errors and Patient Safety Facts
According to information provided by the
2003 Health Policy Tracking Service of the National Conference of State
Legislatures:
� Medical errors are the eighth leading
cause of death in the U.S.
� The cost associated with medical errors
in lost income, disability and healthcare costs is as much as $29 billion
annually.
� The most common types of preventable
medical errors were related to technical errors, diagnosis, failure to prevent
injury and medication errors.
� A Harvard survey found that shortages of
nurses and overwork, stress or fatigue of health professionals were among the
leading causes of medical errors.
� Currently, 17 states-Colorado, Florida,
Kansas, Maine, Massachusetts, Nebraska, Nevada, New Jersey, New York, Ohio,
Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas and
Washington-have laws or regulations requiring mandatory reporting of medical
errors or adverse events in hospitals.
Information Online
Nurses for a Healthier Tomorrow
Coalition
AACN is an active member of Nurses for a
Healthier Tomorrow, a coalition of 43 nursing and other healthcare organizations
that have banded together to address the nursing shortage and boost the
attractiveness of nursing as a profession. The spring issue of the NHT
newsletter is now available online. The newsletter includes information on NHT
activities, as well as other nursing-related news. To access, visit
http://www.nursesource.org/NHTNewsletter
to read newsletter.
National Alliance for the Primary
Prevention of Sharps Injury
AACN is a corporate member of the NAPPSI
alliance, a prominent multidisciplinary powerhouse formed to educate and
influence the course of needlestick safety in the healthcare workplace. An
association newsletter that keeps members up to date is available online at
www.nappsi.org/newsletter.php More info:http://www.nappsi.org.
The Latest on Smallpox
IOM Panel Urges Reassessment of Smallpox
Vaccination Plans
An Institute of Medicine committee
established to advise the Centers for Disease Control and Prevention on its
implementation of the nation's smallpox vaccination program has urged the CDC to
continue to make every effort to evaluate the progress and safety as the
vaccination campaign expands to a larger pool of potential recipients.
CDC Recommends Deferring Heart Patients
From Smallpox Vaccinations
The Centers for Disease Control and
Prevention is recommending that people who have been diagnosed with heart
disease be temporarily deferred from receiving the smallpox vaccine while heart
problems in seven vaccinated healthcare workers, one of whom died, are
investigated. The CDC said it will provide states with questions about heart
problems to use in screening volunteers for the vaccine. The precaution was
announced in response to three cases of myocardial infarction, one of which
resulted in death; two cases of angina and two cases of myopericarditis were
reported through the CDC's real-time monitoring system. A total of 25,645 people
have been vaccinated in the civilian program, the agency said.
Smallpox Emergency Personnel Protection
Act Defeated
The Smallpox Vaccination Compensation Fund
Act (H.R. 1463) was defeated in the House of Representatives in March by a vote
of 206 to 184. Nurses won the battle to beat back this unacceptable smallpox
vaccination bill. Now, the fight moves on to the Senate. Along with the American
Nurses Association, AACN does not oppose a smallpox compensation program. AACN
believes legislation must provide adequate education, prescreening, surveillance
and compensation for nurses and other first responders.
Nursing's Agenda for the Future Group
Identifies Priorities for Driving Changes
Changes in the economic value of nursing,
education and delivery models were identified by the members of the steering
committee for Nursing's Agenda for the Future as priorities for driving positive
changes.
The committee met in December to review the
initiative's progress the first year, evaluate the current structure and process
for efficiency, and identify priority work for the coming year.
Steering committee members also discussed
options for a major action plan that would address these priorities to
significantly advance the agenda.
The group seeks to quantify nursing's
contribution to cost and quality of healthcare. Expectations are that the
findings from this research will demonstrate nursing's current and potential
value in reducing the cost of healthcare delivery and will position nurses to
participate in key policy discussions and budget priorities at the local, state
and federal level. Funding strategies are in development, with the goal of
raising half the needed funds for the project within the community of nursing
and half from external sources.
Additional information about Nursing's
Agenda for the Future is available online at
http://www.nursingworld.org/naf.
AACN Legislative Action Center Links
to Legislation and Legislators
Get involved! You can easily track
legislation and contact your elected representatives through AACN's online
Legislative Action Center at www.aacn.org > Public Policy. This tool to enhance
grassroots activism features an "action alert" regarding key legislation, such
as enactment of the Nurse Reinvestment Act, as well as a database of elected
officials, both nationally and by state.
Download or view the status and a brief
summary of pertinent nursing legislation, with information posted within 24
hours of public availability. At the same time, you can connect with elected
officials, agencies and organizations. E-mail members of Congress, the president
and other government officials; find legislators by a ZIP code or name search;
and find out how legislators voted on identified issues. Compose your own
messages or send messages prewritten by AACN.
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