AACN News—November 2005—Practice

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Vol. 22, No. 11, NOVEMBER 2005


Sponsored by Philips Medical Systems
Grants Support Studies Relevant at the Bedside

Beginning in January 2006, three AACN grants of up to $10,000 each sponsored by Philips Medical Systems will be awarded to qualified proposals relevant to bedside clinical practice. Each grant supports a nurse who is experienced in research in conducting a clearly articulated study relevant to clinical nursing practice in acute or critical care. Funds may be used for original research or replication of existing research.

Proposals for the first round of funding must be received no later than Jan. 1, 2006. Studies selected should be completed in time for oral and poster presentations at the National Teaching Institute and Critical Care Exposition in May 2007 in Atlanta, Ga. The principal investigator will receive funding for travel, two nights’ lodging and complimentary registration for the NTI.

Other Grants
Applications are also due Jan. 1 for the following grants:
Clinical Inquiry Grant—Annually funds 10 awards of up to $500 each for projects that directly benefit patients and their families.
End-of-Life/Palliative Care Grant—Annually funds two awards of up to $500 each for projects that may include bereavement, communication issues, caregiver needs, symptom management, advance directives or life-support withdrawal.
Evidence-Based Clinical Practice Grant—Annually funds six awards of up to $1,000 each for projects that can include research utilization, quality improvement or outcome evaluation.
AACN Mentorship Grant—Funds one $10,000 award for a project providing research support to a novice researcher.
AACN Critical Care—Annually funds one $15,000 award for projects focused on one or more of AACN’s research priorities.

Additional information about these grants is available online at www.aacn.org > Research > Grants.

Dec. 1 Is Deadline to Submit Nominations for Distinguished Research Lecturer Award

Dec. 1 is the deadline to submit nominations for the 2007 AACN Distinguished Research Lecturer Award. The recipient will present the Distinguished Research Lecture at the NTI 2007 in Atlanta, Ga.

The lecturer receives an honorarium of $1,000, an additional $1,000 toward NTI expenses and a crystal replica of the AACN vision icon. The award is funded by a grant from Philips Medical Systems.

To view a list of past recipients, go to www.aacn.org > Research > Awards & Recognition.

Panel to Review Applications for AACN Research Grants

The Research Grant Review Panel reviews and scores selected proposals submitted for funding by AACN’s large grants program. The following individuals have been appointed to this panel for the 2005-2006 funding cycle:

Sheila A. Alexander, RN, BN, PhD
Alyce S. Ashcraft, RN, PhD, CCRN, CS
Kathy Jo Booker, RN, MS, CCRN
Elizabeth J. Bridges, RN, MN, PhD, CCNS
Patricia A. Crane, RN, ND, PhD
Freda DeKeyser, RN, ND, PhD
Susan Frazier, RN, ND, PhD
Betsy George, RN, PhD, CCRN
Margo Anne Halm, RN, RNP, DSN, PhD, CCRN, RN-BC, FAHA
Linda S. Harrington, RN, CNS, ND, PhD, APRN
Christine Hedges, RN, CNS, ND, PhD, CCRN, CCNS, APRN, RN-BC
Gina M. Maiocco, RN, PhD, CCRN, CCNS
Patricia A. O’Malley, RN, CNS, DSN, PhD, CCRN
Kathleen O. Perrin, RN, MSNc, PhD, CCRN, CRN
Mary Beth Reid, RN, CNS, MN, PhD, CCRN, CEN, CRN, RN-BC
Deanna L. Reising, RN, RN-BC, DNS, ND, PhD, APRN
Mona P. Ternus, RN, CNS, MSN, PhD, CCRN, CRN
Hilaire J. Thompson, RN, CNS, MSN, PhD, ACNP, APRN, CNP, CNRN, NP, RN-BC
Dorothy L. Tullmann, RN, PhD, CCRN
Chris Winkelman, RN, PhD, CCRN, APRN, ACNP-C

Research and Creative Solutions Abstract Review Panel Named

The AACN Research and Creative Solutions Abstract Review Panel reviews, scores and selects abstracts submitted for poster and oral presentation at AACN’s annual National Teaching Institute and Critical Care Exposition. The following individuals have been appointed to this panel for the 2006 NTI, May 20 through 25 in Anaheim, Calif.

Joseph Michael Brookes, RN, BSN
Beverly Ann Carlson, RN, CNS, MS, MSN
Jesus M. Casida, RN, MS, CCRN
Jo Ellen Craghead, RN, MSN, CCRN
Patricia A. Crane, RN, ND, PhD
Richard A Dingwall, RN, AD, CCRN
Lisa A. Falcon, RN, BS, BSN, CCRN, CRN
Roberta A. Fruth, RN, MN, PhD, CNA, CNAA
Kristine M. Gaisford, RN, BS, BSN, CCRN
Kathleen M. Geib, RN, CNS, ND, PhD
Christine Hedges, RN, CNS, ND, PhD, CCRN, CCNS, APRN, RN-BC
Maren R. Johnson, RN, MS, MSN, CCRN, CRN
Dianne R. Junker, RN, CNS, MSN, CCRN
Melanie M. Katz, RN, MSN, CCRN
Michele L. Lanza, RN, BS, BSN, CCRN
Deborah B. Laughon, RN, BN, PhD, CCRN
Lynda C. Liles, RN, MS, CCRN
Julia Lindeman Read, RN, MS
Glenda S. Lister, RN, BN, BS, CCRN, CRN
Angela A. Mann, RN, ASN, AAS, CCRN
Karen M. Marzlin, RN, CCRN, CRN, RN-C
Cathy Mawdsley, RN, MNSc, MS
Cheryl Ann McKay, RN, CNS, MS, MSN, CCNS
Shirlien A. Metersky, RN, MS, MSN, CCRN
Patricia A. Moloney-Harmon
Carole Moore, RN, MS, MSN, CEN
Debra A. Moroney, RN, MS, MSN
Carol A. Puz, RN, BSN, MS, CCRN, CRN
Carolyn S. Reilly
Bradley M. Roberts
Sue E. Sendelbach, RN, CNS, MSN, PhD, CCNS, FAHA
Shyang Yun Pamela Shiao, RN, ND, PhD
Christine L. Sommers, RN, MN, MS, CCRN, CCNS, CRN
Joy M. Speciale, RN, MBA, CCRN, CRN
Michelle A. Speicher, RN, BN, MBA, CCRN
Julie A. Stanik-Hutt, RN, RNP, CNS, MSN, PhD, CCRN, CCNS, CS, RN-BC, ACNP-C
Elaine E. Steinke, MN, PhD, APRN
Leslie A. Swadener-Culpepper, RN, CNS, MS, MSN, CCRN, CCNS, CRN
Linda M. Tamburri, RN, CNS, MS, MSN, CCRN
Kimberly M. Tauscheck, RN, BN, BS, CCRN, CRN
Charlene A. Winters, RN, RN-BC, CNS, DNS, ScD, CS, APRN, APRN-BC, APN
Beth A. Zimmerman, RN, BS, BSN


ANA Code of Ethics: AACN Ethic of Care Mirrors Tenets of Provision 9

Editor’s note: The American Nurses Association’s Code of Ethics for Nurses contains nine provisions that are the foundation of nursing care. The code provides concise statements of ethical obligations and duties to all nursing professionals.1 It is the profession’s ethical standard and commitment to society, and all acute and critical care nurses should practice in accordance with this code. Following is one in a series of articles applying the provisions of the ANA Code of Ethics to critical care nursing practice. This article highlights the ninth provision and its underlying principles.

By John F. Dixon, RN, MSN, CNA, BC
AACN Board Liaison
2004-2005 Ethics Work Group

The ninth provision of the ANA Code of Ethics states:

The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy.

As a professional nursing association, AACN mirrors the tenets of the ANA Code of Ethics Provision 9.

AACN’s values are found in its key statements, beliefs and philosophies. The Ethic of Care, which is its moral orientation, includes three core ethical principles (respect for persons, justice and beneficence) that create a foundation for deliberation and decision making. Within this framework are the AACN Mission, Vision and Values.2 These represent the interrelated and interdependent nature of individuals, systems and society. Values guide the association, individual members, chapters, volunteers and staff in working to promote the Mission and Vision.

AACN’s Values, which have developed and evolved since its inception in 1969, reflect the association’s history, tradition and culture. Today, as the world’s largest nursing specialty organization, AACN remains steadfast in its values that guide, shape and define the strategic direction of the organization. In 1990, AACN’s recognition of the importance of ethics and practice led to the formation of an ethics committee, which eventually evolved into the current Ethics Work Group. The ongoing work of this group and the more recent Beacon Award for Critical Care Excellence program are examples of how AACN affirms these beliefs.

Adding to the ways in which the organization can influence the direction of the professional community, AACN communicates its values in publications, often as the preface, and via its Web site. In addition to serving the needs of more than 400,000 critical care nurses, our Values are shared through public forums and liaisons with other professional associations, both nursing and nonnursing. Through these activities, AACN has multiple ambassador opportunities to assert its voice about the values it considers central to patients, families, nurses, and healthcare.

AACN remains accountable to the integrity of the profession and the practice through its various processes and programs. The organization uses a defined and systematic process for screening new initiatives and evaluating decisions, and assessing their ethical impact. A priority for the organization is to provide nurses with high-quality resources to optimize their contributions. Diligent work in this area has made AACN a recognized leader in quality education.

Each year, the National Teaching Institute and Critical Care Exposition, introduced in 1974, provides thousands of nurses a broad spectrum of learning opportunities, from novice to expert. In addition, AACN offers a multitude of educational resources, in particular the Standards for Acute and Critical Care Nursing Practice, in multiple formats. Most notably, the Essentials of Critical Care Orientation (ECCO) was launched in 2002. This sophisticated, interactive e-learning program provides high-quality, evidence-based information and is now used in more than 400 hospitals nationally and internationally.

Nursing science and evidence-based practice continue to advance through AACN research grants, national collective studies such as the Thunder projects, the Research Work Group and Practice Alerts. AACN recognizes that nursing requires lifelong learning and supports this with scholarships and liaisons with various schools of nursing. AACN’s Synergy Model for Patient Care defines key nurse competencies and patient needs.3 This model is a way to define to society nursing’s contribution by linking nursing practice to patient outcomes that result in safe patient passage along the healthcare continuum.

AACN is responsive to issues within society. Probably the most significant action in this area was the establishment of the AACN Certification Corporation in 1975 and the subsequent development of certification exams. Arising out of studies of practice, the certification exams provide comprehensive credentialing for establishing and maintaining standards of excellence in acute and critical care nursing and afford the public an additional measure of protection. AACN monitors legislation that could affect critical care patients and nurses.

In alliance with other professional organizations, AACN has endorsed legislation such as the Nurse Reinvestment Act and provided testimony on key issues. To assist members in the public policy arena, AACN offers a variety of resources, in particular, position statements. AACN is using its Bold Voice initiative to address three key areas: healthy work environments, palliative and end-of-life care, and staffing and workforce development. In January, AACN released the Standards for Establishing and Sustaining Healthy Work Environments. Consistent with AACN’s belief that work and care environments must be respectful, healing and humane, this document provides evidence of the positive impact that such an environment has on both patients and practitioners.4 Last year, the Ethics Work Group released the 4 A’s to Rise Above Moral Distress handbook and continues to work on key references and tools for members on end-of-life and palliative care issues.5 For more information, go to www.aacn.org > Clinical Practice > Ethics.

AACN’s envisioned future is that it will be universally viewed as the undisputed and indispensable leader of acute and critical care nursing in the United States. Reflecting back on the tenets of Provision 9, AACN is fulfilling these responsibilities and accountabilities through both words and actions. Guided by its key statements, beliefs and philosophies, AACN is creating a solid path to realizing its envisioned future.

1. ANA Code of Ethics for Nurses With Interpretive Statements. Washington, DC: American Nurses Publishing. 2001.
2. American Association of Critical-Care Nurses. Values. . Accessed Sept 29, 2005.
3. AACN Certification Corporation. AACN Synergy Model for Patient Care. Available at http://www.aacn.org/certcorp/certcorp.nsf/vwdoc/SynModel. Accessed Sept 29, 2005.
4. AACN Standards for Establishing and Sustaining Healthy Work Environments. Available at http://www.aacn.org/aacn/pubpolcy.nsf/Files/HWEStandards/$file/HWEStandards.pdf. Accessed Sept 29, 2005.
5. Wavra T. (ed). 4 A’s to Rise Above Moral Distress. American Association of Critical-Care Nurses. 2004.

Practice Resource Network

Disaster Medical Assistance Teams Ready to Respond

Q: As a critical care nurse, I would like to be able to help when a disaster such as Hurricane Katrina occurs. How can I become more involved?

A: One way is to join a Disaster Medical Assist Team (DMAT), a group of professional and support personnel trained to provide medical care during a disaster or other event.1 These teams are part of the National Disaster Medical System (NDMS), a section within the U.S. Department of Homeland Security and the Federal Emergency Management Agency, Response Division. NDMS’s mission is to design, develop and maintain a national capability to deliver quality medical care to the victims of—and responders to—a domestic disaster.1 A DMAT may be deployed to meet regional and nationwide disasters.

DMAT members train together and deploy as a unit. DMATs deploy to disaster sites with sufficient supplies and equipment to sustain themselves for a period of 72 hours. A deployable team consists of 35 members, including physicians, nurses, paramedics, pharmacists and support personnel.1

The team’s mission is to provide medical care at a fixed or temporary medical care site.1 Members of the team must be available for immediate deployment and be capable of working in an austere environment. Responsibilities include triaging patients, providing high-quality medical care and preparing patients for evacuation.1 In some situations, DMATs provide primary medical care and augment overloaded local healthcare staffs.1

Each team has a sponsoring organization, such as a major medical center, public health or safety agency, or nonprofit, public or private organization that signs a memorandum of agreement (MOA) with the Department of Homeland Security.1 DMATs are a national resource that can be federalized.

Four Designations
There are four levels of DMAT teams, designated by their readiness and capabilities.1

Level 1—Fully deployable within eight hours of notification and can be self-sufficient for 72 hours. These are deployed with standardized equipment and supply sets to treat up to 250 patients per day.

Level 2—Not required to be self-sufficient. May be deployed independently if sufficient local resources exist or to supplement a Level 1 team

Level 3—Local response capability only

Level 4—An MOA executed in some stage of development, but no response capability

As part of a DMAT team you are required to maintain appropriate licensure and certification within your discipline. When a DMAT team is deployed, its members are activated as part-time federal employees and their licensures are recognized by all states. They also have the protection of the Tort Claims Act, in which the federal government becomes the defendant in the event of a malpractice claim.1

Other Teams
Following are the other teams within the NDMS section:1
• Disaster Mortuary Operational Response Teams (DMORTs) providing mortuary services
• Veterinary Medical Assistance Teams (VMATs) providing veterinary services
• National Nursing Response Teams (NNRTs) that are available for situations specifically requiring nurses instead of full DMATs. Such a scenario might include assisting with mass chemoprophylaxis (a mass vaccination program) or circumstances that overwhelm the nation’s supply of nurses in responding to a weapons of mass destruction event.
• National Pharmacy Response Teams (NPRTs) similar to NNRTs but where pharmacists, not nurses or DMATs, are needed
• National Medical Response Teams (NMRTs) that are equipped and trained to provide medical care for potentially contaminated victims of weapons of mass destruction

To become a team member you must be accepted by NDMS for temporary employee status. Many of the positions require specialized skills or licensure. The goal for most teams is to fill each position three to four deep to ensure a complete team is always available to meet short notice activation for deployment.

For more information and to locate the team in your area, visit the NDMS Web site. Once you have located a team, you can download and complete the forms, and mail them to the appropriate team leader or administrative officer.

AACN also has a formal statement of understanding with the American Red Cross to help mobilize critical care nurses at times of disaster upon the Red Cross’s request. You can access the statement at www.aacn.org > Public Policy > Position Statements.

1. United States Department of Homeland Security. National Disaster Medical System. What Is a Disaster Medical Assist Team. Available at http://oep-ndms.dhhs.gov/dmat.html. Accessed Sept 29, 2005.

Public Policy Update

Grant to Support Healthcare Improvements
The Robert Wood Johnson Foundation has granted $3 million to the National Quality Forum to support its work to improve American healthcare. The funding will support NQF efforts to standardize healthcare performance measures, reduce disparities in care and otherwise improve healthcare safety and quality.

The NQF is a voluntary consensus standards-setting organization established in 1999 to standardize national performance measures and quality indicators for healthcare and to recommend a national strategy for healthcare performance measurement and reporting, among its other endeavors.

To date, the National Quality Forum has endorsed nearly 200 healthcare performance measures covering the continuum of care, including hospital, ambulatory, nursing homes and home care.

JCAHO Panel to Focus on Information Technology
The Joint Commission on Accreditation of Healthcare Organizations has established a Healthcare Information Technology Advisory Panel to focus attention on the improvement of patient safety and clinical processes as new healthcare information systems are implemented.

The panel, which consists of researchers, physicians, nurses, chief information officers, educators and leaders of healthcare organizations, includes representatives from the Office of the National Coordinator for Health Information Technology, American Health Information Management Association, Agency for Healthcare Research and Quality, Veterans Health Administration and Healthcare Information and Management Systems Society.

Panel members will be asked to recommend ways the Joint Commission’s accreditation process and the widespread use of technology can be used to help re-engineer the delivery of patient care that results in major improvements in safety, quality and efficiency. In addition, panel members will exchange lessons learned and examine topics such as the impact of electronic health records on performance benchmarking and public reporting capabilities.

Report Examines Ethical Caregiving in an Aging Society
A report titled “Taking Care: Ethical Caregiving in Our Aging Society” seeks to increase awareness and offer ethical guidance regarding the care of elderly people who can no longer take care of themselves. Produced by the President’s Council on Bioethics, the report calls attention to the larger social issues of long-term care and attempts to articulate the goals and principles of ethical caregiving.

The council’s recommendations include the establishment of a Presidential Commission on Aging, Dementia, and Long-Term Care.

The report is available at http://www.bioethics.gov/reports/taking_care/index.html

Nurse in Washington Internship Program Set for March

The Nurse in Washington Internship program, which provides nurses the opportunity to learn how to influence healthcare through the legislative and regulatory processes is scheduled for March 12 through 16 in Washington, D.C. AACN endorses this program.

Additional information is available online at http://www.nursing-alliance.org/niwi.htm.

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

Acute and Critical Care Choices Guide to Advance Directives

A new resource to help critical care nurses understand and access advance directive documents for patient education is now available free from AACN.

The Acute and Critical Care Choices Guide to Advance Directives provides historical perspectives as well as the legal, ethical and transcultural principles that guide the preparation of advance directives in the United States. The guide was written by Christine Westphal, RN, MSN, CCRN.

Access the guide at www.aacn.org > Clinical Practice > Ethics.
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