AACN News—March 2009—Association News

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Vol. 26, No. 3, MARCH 2009

NTI 2009 in New Orleans Goes Green

Attending NTI 2009? Expect less paper and more convenient access to information as the premier conference for acute and critical care nurses becomes more eco-friendly.

Digital Access

Enclosed with your registration packet will be a digital treasure trove of conference information on the NTI 2009 ALL-ACCESS CD. This disc will automatically launch when inserted into your computer’s CD-ROM drive,
giving you full search capability in an easy-to-navigate interface.

Using this digital technology, you can access everything you need for the optimal NTI experience. Information on the CD includes:

• Program guide and summaries

• Session schedules

• Preconference and main conference handouts you can print at home and bring with you

• NTI Survival Guide with tips, FAQs, New Orleans travel guide and maps

• ExpoGuide with conference tips, exhibitor list and Exhibit Hall floor plan

• Additional educational information on poster presentations, CEs and highlighted sessions

• First-timer’s information

• Photos and bios of AACN leadership, work groups and speakers

• Links to important areas of the AACN Web site such as the Online Bookstore and AACN journals

Although the Program Guide & Summaries book and the ExpoGuide will also be available in print, they will be smaller in size, have fewer pages and be printed on recycled paper. By offering a blend of digital media and more eco-friendly printed matter at NTI this year, AACN creates a greener conference—and supports the environment at the same time.

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Members On The Move


Joseph Paragas, RN, CCRN, BSN, wrote an article titled “Keeping the Beat With Pulse Oximetry” for the hospital nursing section of the November issue of Nursing2008. He discussed how pulse oximetry works and how to use it properly. Paragas is a critical care nurse in the Trauma/Surgical ICU at Harbor-ULCA Medical Center, Torrance, Calif.

Marie Flordeliza, APRN, BN, MA, CCRN, CRN, FAHA, joined Beth Israel Medical Center, Kings Highway Division, Brooklyn, N.Y., as vice president of patient care services.

Gloria McNeal, PhD, ACNS-BC, APN, FAAN, has been named editor of The ABNF Journal, the official journal of the Association of Black Nursing Faculty, Inc. She is also a fellow in the RWJF Executive Nurse Program; director of the New Jersey Children’s Health Project; and professor and associate dean for Community/Clinical Affairs at the UMDNJ School of Nursing, Newark, N.J.

Scott DeBoer, RN, CCRN, CEN, CFRN, EMT-P, MSN, co-wrote “Puncturing Myths About Body Piercing and Tattooing,” which appeared in the November issue of Nursing2008. He is a flight nurse at the University of Chicago Hospitals, as well as a medical consultant for the Association of Professional Piercers.


Joan Vitello, PhD, RN, FAAN, NEA-BC, was named a “Living Legend” by the Massachusetts Association of Registered Nurses, one of four nurses to be recognized in 2009. The prestigious award honors nurses who have made significant lifetime contributions to the profession of nursing on a state, national or international level. Awardees are nurses whose contributions over the course of their careers serve as an inspiration to other nurses. Vitello was national AACN president in 1994-95.

Mary Holtschneider, RN, BC, BSN, MPA,

NREMT-P, former AACN board member, received the Faculty Excellence in Teaching Award from the Accelerated BSN Class of 2009 at Duke University School of Nursing.

Maria Connolly, PhD, RN, CNE, FCCM, ANEF, dean of the College of Nursing and Allied Health at the University of St. Francis, Joliet, Ill., received the Rush-Presbyterian-St. Luke’s Nurses Alumni Association Distinguished Alumni Award. The award is presented annually to a graduate who has brought distinction to the college through his or her professional accomplishments. Connolly also delivered the distinguished alumna lecture, noting that, “Primary care in the future will be delivered by advanced practice nurses as there will not be enough primary care physicians in the United States.”

Kathy McCarthy, RN, BS, MEd, CCRN, former president of AACN’s Greater Toledo (Ohio) Area Chapter, received a President’s Award from St. Vincent Mercy Medical Center, Toledo, where she has worked for 25 years. She is a staff development coordinator with experience in the Cardiovascular ICU and nursing education. She also uses her own time to conduct CCRN review classes for her fellow nurses.

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Our Healthy Work Environment

By Diane Gorman, RN,BSN,CCRN-CMC

As a new critical care clinical educator in 2004, I knew the AACN Standards for Establishing and Sustaining Healthy Work Environments were essential in developing an environment that would not only optimize patient outcomes but also encourage retention of our facility’s acute and critical care nurses.

In Penn Presbyterian Medical Center’s Coronary Care Unit, we foster a healthy work environment through effective skilled communication. The CCU is a 13-bed unit, staffed with 35+ RNs and ancillary staff, serving the West Philadelphia area and is a tertiary care unit for the South Jersey and surrounding areas. We are known for our excellent cardiac care including the Heart Rescue Program that allows STEMI patients access to a catheterization lab in less than 90 minutes and our Mild Hypothermia Therapy After Cardiac Arrest, which helps improve neurologic function after cardiac arrest. Our newest addition is the tandem ventricular assist device, which gives cardiogenic shock patients a bridge to therapy or transplant.

Our unit is full of activity, and the daily patient turnover rate can be as high as 86 percent. It is therefore very important to maintain a healthy work environment. There are days when the unit is so hectic that nurses are unable to take breaks. It was extremely difficult for a charge nurse, who was caring for her own two-patient assignment, to manage the flow of patients in and out of the unit. Therefore, the nurse manager asked administration for a free charge, which we maintained for a while until budget cuts were made. Through our shared governance council, our manager and administration, we came up with solutions to maintain a free charge whenever possible.

We also encourage new graduate nurses to work in critical care through our Gateway to Critical Care program, an intense six-month orientation. This past year we had a total of 20 new graduates in all four of our critical care areas. Our gateway program graduates in the CCU felt very supported by the biweekly progress conferences where they were able to express concerns and tailor their orientation to their individual needs. In the CCU, the nursing staff and the clinical educator implemented an Intensive Insulin protocol, a CAUTI (catheter associated urinary tract infection) prevention initiative launched system-wide and a CCRN wall of honor, which displays nurses’ certificates to honor those who are certified in critical care.

Effective skilled communication is also demonstrated by including physician leadership in the shared governance meetings where nurses and physicians freely discuss and solve any issues on the unit. We also have coordination rounds, which were implemented house-wide, in an effort to discuss patients in an interdisciplinary manner. Social work, physical and occupational therapy, nutrition and wound care are present on a daily basis to ensure patients receive optimal care.

Evidence-based practice has been a crucial part of the development of new protocols and policies. This has been exciting and also challenging for the staff. It takes good communication to ensure proper adherence to protocols and policies, and the nurses appreciate our unit’s learning environment. We are very thankful for AACN’s Healthy Work Environment Initiative; over the last five years it truly has helped transform our Coronary Care Unit to become one of the best in the Delaware Valley.

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A Message to Congress: ANSR’s Plan to Address the Nursing Shortage

The Americans for Nursing Shortage Relief (ANSR) Alliance recently endorsed a consensus document to stem the tide of the nation’s nursing shortage. AACN is a member of the alliance, which represents a diverse cross-section of healthcare and other related organizations, healthcare providers, and supporters of nursing issues that have united to address this crucial shortage through legislative action.

Following are the alliance’s key recommendations to Congress:

• Build the capacity of nursing education programs and enhance nursing research

• Strengthen the capacity of the national nursing public health infrastructure

• Help retain nurses, with special emphasis on the aging nursing workforce

• Expand recruitment of new nurses with emphasis on those with diverse backgrounds

The ANSR Alliance believes Congress must enact and fund a comprehensive set of initiatives to address nursing challenges and ensure that the nation establishes and maintains an adequate infrastructure of well-qualified nurses. The consensus document outlines programs and evidence-based, cost-effective best practices that address and mitigate the complex factors surrounding the current and future lack of nurses and nursing faculty. These practices will help establish a foundation of available nurses to respond to public health emergencies and to provide quality acute and long-term care to patients in need.

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Get Involved in National Healthcare Decisions Day April 16

AACN, along with other national, state and community organizations, is helping to lead a massive effort to highlight the importance of advance healthcare decision-making – an effort that has culminated in the formal designation of April 16, 2009 as National Healthcare Decisions Day (NHDD).

NHDD organizers are asking interested organizations and individuals throughout the country to help raise awareness about the importance of advance care planning on this special day – and throughout the year. To help realize this goal, they have created a Web site with information and tools for the public to talk about future healthcare decisions and execute written advance directives (healthcare power of attorney and living wills) in accordance with their applicable state laws.

The Web site, www.nationalhealthcaredecisionsday.org, includes tips on how advocates can raise awareness in their communities. In addition to signing up your organization to participate, here are some ways AACN members can promote this important cause:

• First and foremost, lead by example. Be sure you have thoughtfully considered and made your own advance planning healthcare decisions.

• Make sure everyone in your organization is informed about NHDD and ask for their involvement to promote NHDD in your community.

• Provide a link on your organization’s Web site to www.nationalhealthcaredecisionsday.org. It features a variety of information on advance care planning.

• Set up an exhibit about NHDD at your main entrance and offer information about advance care planning.

• Distribute NHDD promotional materials and advance healthcare planning educational brochures at community events and health fairs.

• Partner with your community library to set up a display highlighting books about advance healthcare decision-making and use NHDD promotional resources.

• Partner with local retail businesses by asking them to place a promotional flyer about NHDD in every shopping bag.

• Distribute flyers about NHDD in local physicians’ offices and other strategic locations such as elevators in public buildings.

• Encourage your state leaders to establish a state-sanctioned, secure, online advance directive registry.

• Contact local media (newspapers, TV and radio) and encourage them to write a piece about NHDD and advance healthcare planning.

Although several states have engaged in advance directive awareness events, and numerous organizations have devoted substantial time and money to improving education about advance healthcare planning, only a small percentage of Americans have executed an advance directive. NHDD seeks to address this issue by focusing attention on advance healthcare planning from a variety of directions.

Organizations and coalitions interested in participating are encouraged to sign up at the NHDD Web site. State coordinators are also being recruited to develop statewide networks and outreach activities. For further details, visit www.nationalhealthcaredecisionsday.org

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Bookstore Corner

The Clinical Practice of Neurological & Neurosurgical Nursing, 6th Ed.

The new sixth edition of this award-winning classic prepares its users to deliver expert care in this most challenging nursing specialty. It addresses neuroanatomy, assessment, diagnostic evaluation and management of the complete range of neurological disorders for which nurses provide patient care, including trauma, strokes, tumors, seizures, headaches, aneurysms, infections, degenerative disorders and peripheral neuropathies.

This edition has been thoroughly revised to reflect evidence-based practice standards of care. The book now includes case studies, community nursing sections throughout and increased coverage of normal pressure hydrocephalus, inflammatory demyelinating polyneuropathy and Creutzfeldt-Jakob disease.

Member $90.25
Nonmember $94.95 (#128637)

AACN’s Super Saver promotion features specific products offered at a significant discount.

March is National Brain Awareness Month.

If you care for neuroscience patients, you’ll want to take advantage of the savings on thefollowing titles. These Super Saver prices
are valid through April 30, 2009. All orders must be received or postmarked by April 30 to be eligible for the Super Saver price.

Neuroscience Nursing: A Spectrum of Care, 3rd Ed. (#301514)

Addresses the complicated needs of neuroscience patients and equips providers with in-depth knowledge of neurophysiology, neuroassessment and neuromanagement to help provide the best patient care. This 3rd edition’s carefully refined features enhance the book’s readability, and the new eight-page color insert with 40 plates features important information on neurophysiology, diagnostic scans and disorders such as aneurysms. Readers will find comprehensive information on foundations in neuroanatomy and data collection; thorough discussions of neurologic disorders; management considerations for frequently encountered neurologic conditions; and legal and ethical issues relevant to life care planning for the neuroscience patient.

Regular Price: Member $90.20, Nonmember $94.95
Super Saver Price: Member $84.50, Nonmember $88.95

Trauma Nursing Secrets, Questions and Answers Reveal the Secrets to Safe and Effective Trauma Nursing (#128638)

This book covers trauma nursing from the pre-hospital phase to the trauma resuscitation area, and follows the patient into the intensive care unit and then rehabilitation. Written in a question and answer format, topics include Forensics in Trauma, Thoracic Trauma and Trauma During Pregnancy.

Regular Price: Member $39.85, Nonmember $41.95
Super Saver Price: Member $35.86, Nonmember $37.75

AACN-AANN Protocols for Practice: Monitoring Technologies in Critically Ill Neuroscience Patients (#170695)

“AACN-AANN Protocols for Practice: Monitoring Technologies in Critically Ill Neuroscience Patients” provides clinicians at the point of care with the latest research findings in patient care in a format that is easy to understand and integrate into clinical practice. Each protocol guides clinicians in the appropriate selection of patients; use and application of management principles; initial and ongoing monitoring; discontinuation of therapies orinterventions; and selected aspects of quality control.

Regular Price: Member $92.95, Nonmember $99.95
Super Saver Price: Member $90.20, Nonmember $94.95

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OnlineFirst Brings Publish-Ahead-of-Print Content to AJCC Web Site

As part of its ongoing effort to increase value and make the latest critical care science available as quickly as possible, AACN Publishing announces a new feature on the American Journal of Critical Care (AJCC) Web site: OnlineFirst.

OnlineFirst is AACN’s publish-ahead-of-print program. It enables accepted manuscripts to appear in edited form on the journal’s Web site before those articles appear in print in a future issue. New OnlineFirst articles will appear roughly once a month in the middle of each month. They are fully indexed and searchable on major bibliographic databases such as PubMed.

AACN members receive AJCC as a member benefit. Notifications of new OnlineFirst content will be sent via e-mail.

“With OnlineFirst, AACN can publish high-quality science faster, and clinicians can use that information right away to improve patient care,” said AACN Director of Communications and Strategic Alliances Ramón Lavandero, RN, MA, MSN, FAAN. “The value of AACN’s peer-reviewed journals comes from delivering clinical and scientific content that is both timely and informs best practice at the bedside.”

The first three OnlineFirst articles, dealing with a new model of critical care orientation, electronic surveillance of multidrug-resistant organisms, and an early mobility and walking program for ICU patients, appeared on the AJCC Web site in February. Visit www.ajcconline.org/onlinefirst to read the inaugural OnlineFirst articles in PDF form.

Member or subscriber login is required to view OnlineFirst content; however, abstracts of each article can be viewed by all visitors to the AJCC Web site. Nonsubscribers or nonmembers who wish to be notified of new OnlineFirst content should register their e-mail address at www.ajcconline.org by clicking on “Email Alerts.”

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Share Your Voice: Attend NIWI March 29-31

Looking for a way to influence healthcare legislation? Nurse in Washington Internship (NIWI) provides nurses the opportunity to learn how to influence healthcare through the legislative and regulatory processes. Participants learn from health policy experts and government officials, network with other nurses and visit members of Congress. NIWI is open to any RN or nursing student who is interested in learning more about the legislative process. NIWI 2009 will be held at The Liaison Capitol Hill in Washington, D.C. March 29-31, 2009. For more information visit www.nursing-alliance.org or call (859) 514-9157.

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Scene and Heard

Our Voice at the Table

David Swankin, Esq., AACN Certification Corporation board member and consumer representative; president and CEO, Citizen Advocacy Center, spoke before the Committee on Planning a Continuing Health Care Professional Education Institute, Institute of Medicine (IOM). He said the public simply wants to be assured by the appropriate authorities that their healthcare providers are currently competent to deliver safe, high-quality healthcare services. This was the clear message based on a survey conducted by AARP in May 2007, titled “Strategies to Improve Health Care Quality in Virginia: Survey of Residents Age 50+.” Nearly all (95%) of respondents believe that as a condition of retaining their licenses, healthcare professionals should be required to show they have the up-to-date knowledge and skills needed to provide quality care. Nine in 10 respondents said it is very important for healthcare professionals to be periodically re-evaluated to show they are currently competent to practice safely. More than half incorrectly believe that “being licensed” means healthcare professionals have undergone periodic evaluation and assessment.

Swankin urged the committee to acknowledge that while effective CE courses are one important element in lifelong learning programs, they are not, in and of themselves, a surrogate for assuring current competence. CE is one tool that helps professionals maintain their knowledge and skills and helps prepare them to demonstrate their competence. He asked the committee to reinforce the efforts for stronger regulatory requirements and to call upon professionals to demonstrate their current competence as a condition of relicensure and/or certification renewal.

Mary E. Holtschneider, RN, BSN, BC, MPA, NREMT-P, former AACN board member, represented AACN at the CAMTS Board of Directors Meeting in Minneapolis, Minn. CAMTS is an acronym for the Commission on Accreditation of Medical Transport Systems. The board accredits helicopter, fixed wing and ground programs, and is heavily focused on promoting safety for all aviation-related and medical-related aspects of transport. CAMTS prepared an addendum to the accreditation standards to address fatigue, safety management systems and helipad communications, which was approved in January 2009. These standards have a direct and indirect impact on transport nurses as well those in receiving hospitals, who are often critical care nurses. CAMTS is also undertaking a fatigue study that will likely have a large impact on which shifts are most optimal (8-, 12- or 24-hour) and the safety of working long hours without sufficient breaks. This study will include not only pilots but medical personnel. CAMTS is working diligently to improve safety in this industry, particularly because of the increasing number of EMS-related accidents over the past year.

Caryl Goodyear-Bruch, RN, PhD, CCRN, AACN president, Beth Hammer, RN, MSN, APRN-BC, AACN president-elect, CEO Wanda Johanson, RN, MN, Justine Medina, RN, MS, AACN director of professional practice & programs, and Linda Bell, RN, MSN, AACN clinical practice specialist, attended CHEST 2008 in Philadelphia. This conference is an annual educational event sponsored by the American College of Chest Physicians, one of AACN’s association partners. Goodyear-Bruch attended the ACCP Board of Regents meeting, sharing the table with many physician colleagues. In addition, current and future collaborative initiatives were discussed at a meeting between the leadership of AACN and ACCP and at another meeting with the leadership of AACN, ACCP, the American Thoracic Society and the Society of Critical Care Medicine. Medina attended the Critical Care Institute meeting.

The presidents of all four societies presented a joint educational session: “Healthcare Workforce: Is There a Crisis?,” which included physician workforce shortage data. Each president had an opportunity to respond to the panel. Goodyear-Bruch emphasized the ongoing nursing shortage, which all four societies must address. She said the shortage of healthcare providers cannot be adequately addressed without acknowledging the complexities of our healthcare system, which is regulated by various entities, often with a lack of coordination, inefficiency and fragmentation. She asked how we can deliver the best-quality care with the patient at the center. The answer lies in what the healthcare team can do to meet the needs of patients without professional isolation or silos. Full collaboration of the team of healthcare professionals is needed including efficient use of staff and advanced practice nurses. Further, use of technology such as telehealth is vital to delivering care. There also needs to be clarity about new models of practice to meet the needs of patients.

Our Experts Share Their Knowledge

Beth Martin, RN, MSN, CCNS, ACNP, AACN Certification Corporation chair, spoke at a Region 5 (N.C., S.C.) meeting in Durham, N.C. She discussed healthy work environments, the Beacon Award and certification, and how chapters can promote these initiatives. Linda Thomas, chapter advisory team leader; Susan Helms, RN, MSN, CCRN, PCCN, immediate past AACN Certification Corporation board member, and Holtschneider were also in attendance.

Christie Artuso, RN, MA, CCRN, PCCN, CNRN, AACN Certification Corporation board member, has been on a public speaking tour sharing her insights about stroke, symptoms and actions for public audiences; and presenting stroke lectures for professional audiences. In February, Providence Alaska Medical Center launched a statewide telemedicine stroke program using the REACH system, providing access to stroke care for Alaskans throughout the state. Artuso spent six months designing the program and securing funding. In support of the program, she spoke at the Spenard Lions Club Membership Meeting in Anchorage, the Older Person’s Action Group, Anchorage, and the Rotary Club in South Anchorage on “Stroke – Are You at Risk?” She also gave two presentations to school nurses at the Anchorage School District on “Stroke – Current Trends and Treatments.” Her goal is to increase awareness of stroke signs and symptoms and improve symptom to door time in the ED, leading to improved interventions and treatment options.

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American Association of Critical-Care Nurses Adopts Editorial Manager for Journal Publications

Internet-based system streamlines editorial submission and peer review for American Journal of Critical Care and Critical Care Nurse and reduces time/cost of paper submissions

The American Association of Critical-Care Nurses (AACN) recently adopted Editorial Manager (EM), a Web-based manuscript submission and tracking system, for its publications, the American Journal of Critical Care and Critical Care Nurse.

EM – a product licensed by Aries Systems, Corp., North Andover, Mass. – centralizes data processes to streamline editorial submissions and peer review. The EM system automatically converts submitted manuscripts to PDF files and enables authors to submit manuscripts, check the status of submissions, read comments by reviewers and editors and communicate with editorial staff via the Internet.

EM saves time, allowing authors to submit manuscripts in minutes. By providing automatic e-mail confirmation, the safe and secure online system reduces the cost of manual paper submission sent via postal mail.

Prior to adopting the entirely Web-based electronic system, AACN journal authors submitted multiple copies of paper manuscripts via postal mail, a costly and time-consuming process. Later, authors sent these documents via computer disk and e-mail.

Michael Muscat, AACN’s publishing manager, says, “Our authors, reviewers and editors have been calling for online submissions for some time.” He calls EM a win-win for journal publishing and production and expects the system to simplify submissions for time-strapped manuscript authors.

EM can be accessed through the home page of each journal by visiting www.ccnonline.org or www.ajcconline.org. To access system capabilities, click “Submit a Manuscript” from the gray bars on the left site of the screen, or visit the EM landing pages at www.editorialmanager.com/ccn or www.editorialmanager.com/ajcc.

Authors, reviewers and editors can log on to the EM system to create or update profiles and provide AACN editors with up-to-date contact
information and areas of expertise.

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