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Vol. 23, No. 10, OCTOBER 2006

Make Influenza Vaccination a Priority for Cardiovascular Patients

Each year, influenza is estimated to cause more than 36,000 deaths and 200,000 excess hospitalizations in the United States. According to the Centers for Disease Control and Prevention, individuals with cardiovascular disease are at high risk for influenza-related complications. Preventing influenza is one of the best, and perhaps least appreciated, opportunities to prevent morbidity and mortality in patients with heart disease. However, people with heart disease receive influenza vaccinations far below national goals for all demographic groups: only one in every three adults with heart disease received influenza vaccination in 2005.

Recognizing the importance of vaccination for people with heart disease, the American Heart Association and American College of Cardiology recommend influenza vaccination as part of disease prevention in persons with coronary and other atherosclerotic vascular conditions.1

What Can Health Professionals Do to Prevent Influenza?
Critical care and advanced practice nurses play a key role in educating patients and providing them with follow up care instructions. Recommendation of flu vaccines as part of cardiovascular patient teaching instructions and standards is one approach. Another strategy is to dialogue with collaborating cardiologists to encourage their participation in providing flu vaccines to cardiovascular patients. Outpatient visits to cardiology practices are a superb opportunity to administer influenza vaccine to millions of adults with cardiovascular disease. Unfortunately, only about one-half of all cardiology practices in the US stock influenza vaccine in their offices. A recent study suggests that the single most effective way to improve influenza vaccination rates among non-elderly adults with heart disease is for cardiology practices to have influenza vaccine available in their offices for patient visits and for cardiologists and cardiovascular nurses to strongly recommend vaccination to their patients during September through January.

Cardiologists who have not administered influenza vaccinations before in their own practices should seriously consider giving them in the 2006-07 influenza season. Physicians and their practice staff should order vaccine now for delivery in fall 2006; they can choose from among three manufacturers, each of which has its own ordering process (Table). In addition, cardiology providers should be aware that, as a direct attempt to increase immunization rates among populations at risk for influenza, many health plans are increasing their reimbursement rates for vaccine administration for the 2006-07 campaign.

Finally, nurses can become knowledgeable about their own risk and participate in flu vaccine campaigns. Health providers are important role models for patients and due to their exposure, should be vaccinated for their own protection and to prevent contagion of their patients.

Be a special part of protecting the 12 million persons in the U.S. with heart disease this year: Vaccinate your patients against influenza!
Prepared by the Influenza Vaccination Group, American Heart Association, June 2006.

The Centers for Disease Control and Prevention has issued posters, flyers and other educational materials healthcare providers can use to promote flu vaccination in the 2006-07 flu season. The materials, which reflect CDC recommendations, are available on the agency’s Flu Gallery Web site at http://www.cdc.gov/flu/professionals/flugallery/index.htm.

Table How to order influenza vaccine

Influenza Vaccine Manufacturers
(alphabetical order)
How to order for the 2006-07 influenza season b,c
GlaxoSmithKline Call Flurix Service Center at (866) 475-8222 (option 1).
Novartis (formerly Chiron) Call (800) 244-7668 (option 2) to receive a list of vaccine distributors
by area.
Sanofi Pasteur Set up a provider account and then place order
at http://www.vaccineshoppe.com.

These are manufacturers of inactivated trivalent influenza vaccine. Live, attenuated intranasal influenza vaccine (FluMist; MedImmune) is not recommended for individuals with cardiovascular conditions.
Providers are encouraged to order in the spring and summer for delivery in fall 2006.
Providers who wish more information about influenza vaccine should contact their local or state public health department.

1. Smith S. et al, AHA/ACC Guidelines for Secondary Prevention for Patients with Coronary and other Atherosclerotic Vascular Disease: 2006 Update. Circulation. 2006;113:2363-2372.

Thank You to Volunteers Reviewing Research Grants and Research and Creative Solutions Abstracts

Research and Creative Solutions Abstracts Review Panel
Nancy M. Albert, RN, CNS, PhD, CCRN, CCNS, CNA, FAHA
Jesus M. Casida, RN, MS, CCRN, APRN
Hatice Y. Foell, APRN, MN, MS, NP
Kristine M. Gaisford, RN, BSN, CCRN
Brenda K. Hardin-Wike, RN, CNS, MS, MSN, CCNS
Linda M. Hoke, RN, MSN, PhD, CCRN
Peggy L. Kirkwood, RN, MSN, NP-C
Teri Lynn Kiss, RN, BSN, MS, CCRN, CFRN, CRN
Diane J. Mick, RN, CNS, APRN, PhD, PhD, CCNS, GNP, NP, RN-BC
Carole Moore, RN, MNSc, CEN
Patricia A. O'Malley, RN, CNS, PhD, CCRN
Valerie Ramsberger, RN, MS, MSN, APRN, APN
Mary Beth Reid, RN, CNS, MS, MSN, CCRN, CEN, CRN
Catherine J. Ryan, RN, CNS, PhD, CCRN, APRN
Joy M. Speciale, RN, MBA, CCRN, CRN
Leslie A. Swadener-Culpepper, RN, CNS, MS, MSN, CCRN, CCNS, CRN
Kimberly M. Tauscheck, RN, BN, BS, CCRN, TNCC, TNS
Judy Trivits Verger, RN, MSN, CRNP
Susan A. Walsh, RN, MN, MS, CCRN, CRN
Charlene A. Winters, RN, CNS, APRN, DNS, ScD, CS, APRN BC, APN, RN-BC
Dolores Curry (staff liaison)
Teresa A. Wavra, RN, MSN (staff liaison)

Research Grants Review Panel
Patricia A. O’Malley, RN, CNS, PhD, CCRN (chair)
Sheila A. Alexander, RN, BN, PhD
Marianne Chulay, RN, DNSc, FAAN
Elisabeth L. George, RN, PhD, CCRN
Linda S. Harrington, RN, CNS, PhD, CPHQ
Christine Hedges, PhD, CCNS, APRN, RN-BC
Linda L. Henry, RN, PhD, CCRN
Kathleen O. Perrin, RN, MSN, PhD, CCRN
Mary Beth Reid, RN, CNS, MS, MSN, CCRN, CEN, CRN
Carolyn S. Reilly, RN, CNS, MN, CCRN, CCNS, APRN
Leslie A. Swadener-Culpepper, RN, CNS, MS, MSN, CCRN, CCNS, CRN
Hilaire J. Thompson, RN, CNS, PhD, ACNP, APRN, CNRN, RN-BC
Dolores Curry (staff liaison)
Joyce C. Hall, RN, MSN (staff liaison)

AACN Resources for Your Practice

“What are other organizations doing about handoff communications?” “Are there any reference materials available to use with ECCO?” Does anyone have a policy for Family Presence during CPR?”

Do you and your colleagues have questions like these? AACN’s comprehensive collection of practice resources may have the answers you’re looking for. Check out these options:

For Nurse Managers or Directors
The Nurses in Healthcare Management and Business Leadership (NIHMBL) listserv is available. The primary audience includes nurse leaders such as charge nurses, managers, and clinical and administrative directors in acute and critical care environments. The purpose of this group is to offer participants a platform where they can interact and discuss issues related to leadership and management affecting acute and critical care. You may join this group at: http://health.groups.yahoo.com/group/NIHMBL/

For ECCO Users/Sites
The purpose of this online support system group is to enhance communication among nurse educators, preceptors, hospital administrators, nurse practitioners and others interested in e-learning. Discussion is focused exclusively on issues of concern to nurse educators including blended learning, case studies, research utilization, role issues, return on investment, effective collaboration, upcoming educational programs and career opportunities. You may join this group at: http://health.groups.yahoo.com/group/ecco_community/

For Chapters
The AACN Chapter listserv was created to enhance communication among chapter leaders and members for networking, sharing best practices and building relationships beyond geographic borders. You may join this group at: http://health.groups.yahoo.com/group/aacnchapterlistserv/

For Advanced Practice Nurses
The Advanced Nursing Practice in Acute and Critical Care (ANPACC) listserv enhances communication among clinical nurse specialists, nurse practitioners, educators, researchers, physicians and others interested in advanced nursing practice in acute and critical care. Discussion is focused exclusively on issues of concern to advanced practice nurses including clinical issues such as patient care problems, ethical dilemmas and case studies; research utilization; role issues; scope of practice; credentialing, certification and licensure; economic, legal and regulatory issues; effective collaboration; upcoming educational programs and career opportunities. The ANPACC listserv was established in 1997 and was initially co-sponsored by the Nursing Section of the Society of Critical Care Medicine (SCCM) and the University of Pennsylvania, School of Nursing. The ANPACC list is currently supported by an unrestricted grant from AACN. You may join this group at http://health.groups.yahoo.com/group/ANPACC/

Want more information? Visit the Practice Resources page at www.aacn.org/aacn/practice.nsf/vwdoc/InFo.

Public Policy Update

Healthcare Coalition Continues to Challenge AMA on Scope of Practice
Nearly 50 organizations, including AACN, were represented at a recent meeting of the Coalition for Patients’ Rights, formed in response to concern regarding the American Medical Association’s Scope of Practice Partnership. AMA formed the partnership to assist various physician organizations facing scope of practice issues by examining the work and qualifications of allied health professionals.

As a founding member of CPR, AACN has been a strong supporter of the group’s efforts. Following several meetings and conference calls since the issue arose, a more formal structure for the organization is planned.

The coalition, which represents more than 3 million healthcare professionals, asserts that the partnership, along with a related AMA resolution, are not only unnecessary but also will impede patient access to quality care. It believes that patients will be negatively impacted if their ability to seek care from advanced practice nurses, psychologists, nurse midwives, chiropractors, and many other licensed, qualified healthcare providers is limited. The coalition also seeks an end to legislation at the state level that would reduce provider options for patients.

The CPR has said any assumption that physician organizations should determine what is best for other licensed healthcare professionals is an outdated line of thinking that does not serve today’s patients. It is inappropriate for physician organizations to advise consumers, legislators, regulators, policy makers or payers regarding the scope of practice of licensed healthcare professionals whose practice is authorized in statutes other than medical practice acts, the coalition contends.

The goal of CPR is to ensure that patients have access to quality healthcare provided by licensed health professionals of their choice.

Caryl Goodyear-Bruch, RN, PhD, a past AACN board member, represented AACN at the meeting.

Additional information about CPR is available at http://www:patientsrightscoalition.org/news/.

Guidelines Recommend Single-Patient Rooms for Certain Units in New Hospitals
Citing mounting evidence that shared hospital rooms contribute to medical errors, higher infection rates, privacy violations and harmful stress for patients, the American Institute of Architects has updated its Guidelines for Design and Construction of Health Care Facilities to recommend single-patient rooms in new medical-surgical and postpartum units.

The guidelines, which are updated on a four-year cycle, were adopted as a regulatory baseline in more than 40 states. The 2006 changes will require adoption by regulators and legislators in individual states. Additional information is available at http://www.aia.org/press2_template.cfm?pagename=release_071906_healthcare.

Reference Guide Helps Providers Bill Medicare forCommonVaccines
The Centers for Medicare & Medicaid Services has published a quick reference guide to help Medicare fee-for-service providers file claims for flu, pneumococcal and hepatitis B vaccines and their administration. Printed copies of the guide, “Quick Reference Information: Medicare Immunization Billing,” will be available this fall. It is available now online at http://www.cms.hhs.gov/MLNProducts/downloads/qr_immun_bill.pdf.

For more information about these and other issues, visit the AACN Web site.

Beacon Award Recipients Represent Excellence in Critical Care

Pictured here are representatives of the hospital units that received the prestigious AACN Beacon Award for Critical Care Excellence 2006-07. They celebrated their achievement during NTI 2006 in Anaheim, Calif.

The Beacon Award recognizes outstanding units that exhibit high quality standards, provide exceptional patient care and maintain a healthy work environment. These award recipients are acknowledged as leaders in critical care by the healthcare community.

In establishing the award, AACN carefully considered a number of factors. To determine whether a critical care unit had earned recognition as a Beacon Award recipient, the unit must have: recognized excellence in the intensive care environments in which nurses work and critically ill patients are cared for; recognized excellence of the highest quality measures, processes, structures and outcomes based upon evidence; recognized excellence in collaboration, communication, and partnerships that support the value of healing and humane environments; and developed a program that contributes to actualization of AACN’s mission, vision and values.

Included in the criteria for achieving a Beacon Award are innovation/excellence in recruitment and retention; education, training and mentoring; evidence-based practice and research; patient outcomes; creating and promoting healing environments;, and leadership and organizational ethics. The award is presented twice yearly.

Interested in applying for the Beacon Award for Critical Care Excellence?

Rhoads 5 Surgical Critical Care
Hospital of the University of Pennsylvania
Philadelphia, Pa.

Norwalk Hospital
Norwalk, Conn.

Hoag Memorial Hospital Presbyterian
Newport Beach, Calif.

Coronary Intensive Care
St. Luke’s Medical Center
Milwaukee, Wisc.

Cardiac ICU
South Jersey Regional Medical Center
Vineland, N.J.

Medical Intensive Care Unit
Clarian Health Partners Indiana University
Indianapolis, Ind.

NorthEast Medical Center
Concord, N.C.

Intensive Care Unit
Munroe Regional Medical Center
Ocala, Fla.

Intensive Care Unit
Baptist Hospital East
Louisville, Ky.

7200 CCU
Duke University Hospital
Durham, N.C.

Medical Intensive Care Unit
University Hospitals of Cleveland
Cleveland, Ohio

Grant Medical Center
Columbus, Ohio

Grant Medical Center
Columbus, Ohio

Inova Fairfax Hospital
Falls Church, Va.

Mount Carmel West
Columbus, Ohio

Harrisburg Hospital
Harrisburg, Pa.

Recipients Not Represented

Neuro ICU, Hoag Memorial Hospital Presbyterian, Newport Beach, Calif.
Coronary Care Unit, The Methodist Hospital, Houston, Texas
Adult Critical Care, Clarian Health/Methodist Hospital, Indianapolis, Ind.
Critical Care Unit, Piedmont Hospital, Atlanta, Ga.
Adult Intensive Care Unit, University Hospitals of Cleveland, Cleveland, Ohio
Medical Intensive Care Unit, Lynchburg General Hospital, Lynchburg, Va.
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