Air Exchange. A Newsletter of the Rocky Mountain Perianesthisia Nurses Association

Transcription

1 Air Exchange A Newsletter of the Rocky Mountain Perianesthisia Nurses Association MISSION: The mission of Rocky Mountain PeriAnesthesia Nurses Association is to unite registered nurses in all phases of perianesthesia/peri-procedural care through education, research, and standards of practice in order to promote quality care for patients, families, and the community... November 1, 2012 Volume 29, Issue 2, Winter 2014 President s Message.... Gold Leaf Application Scholarships Sugarbaker Procedure Retreat in the Rockies Political Action CMTE ASPAN Conference ExSpiron PANAW ICPAN St. Mary Corwin Nurse Grad Inside this Issue President s Message 1 Board of Directors 2 District Report 4 Committee Report 8 Cutting Edge 11 ASPAN News 12 Clinical Practice 13 Perianesthesia Trends 14 Certification 16 Hospital Views 21 Healthstyles 22 Set Sail for Gold Leaf For those of you that have been to National Conference, you ll recall how we anxiously wait to see who will be named component of the year. Is it us? Is it them? How close did we come? When the Gold Leaf is announced there is cheering and smiling, plaques, pictures, and ribbons to obtain. RMPANA did win the Gold Leaf award the year Becky Hoyle was President. But, it was not until this past year that I actually understood what Gold Leaf is truly about and I would like to share this information with each of you. It takes great commitment to win this award and to put together all the information that is required to be a contender. Many before me have organized this process and dedicated mountains of time to it to help improve our RMPANA component. I would be remiss if I did not give recognition and accolades to Becky Hoyle and Valerie Watkins for all the work they have dedicated to streamlining our process and purpose as a component. Working toward Gold Leaf is the strongest way to move our component in the right direction. When a component leader assesses the requirements for Gold Leaf they understand how much purpose this prize has. It is a way to set our bearings; a compass and guide for component improvement. It is a measure of success; a way to define purpose and goals. It is a vision for the future; to reach out and seek the horizon beyond ourselves. We identify growth opportunities and we structure our strategic plan. Gold Leaf has many questions that require detailed answers with accompanying proof. There are over thirty questions that ask about component membership, accomplishments, education, certification and many other things. The Gold Leaf award process aims components in the right direction by requiring examination of ways to gain membership, ensure financial stewardship, along with sharing member recognition, accomplishments and achievements. Beyond our immediate purposes, Gold Leaf also asks: is the component actively engaged in research, scholarship, charity or committee work? With these standards in place, the Gold leaf ensures that we as a component leaders are serving your needs as our members. RMPANA has many things to be proud of as a component and many successes. We have a working strategic plan that the Board of Directors evaluates each year. We have had significant growth over the past several years and are currently 523 members strong, and impressively, almost half of our members are certified in perianesthesia nursing! Additionally, over 40 of our members are involved on various ASPAN committees. Our component features several local, national, and international speakers, who continue to serves our region and others while helping to educate our component and mentor new speakers. And let s not forget our great website, triennial newsletter, and social media endeavors. RMPANA still has areas to improve upon. We have several board assignments that are vacant and we need volunteers to help fill these holes. Communication is key, because scholarship monies and other services are available and very few people requested these in our last year. As a component we have made it easier to obtain scholarship reimbursement for conferences and workshops by changing our policy last year, so get on the web site and get some money! We need to keep encouraging certification and develop new certification coaches. Many of you help your peers get ready for certification. Make it official and become an ABPANC coach. Rocky Mountain PeriAnesthesia Nurses Association is an amazingly strong, vibrant component but we need everyone s assistance to continue to grow. As I said before, Gold Leaf is our compass. We need all hands on deck because it takes many to help hoist the sails. Where will you take us next year? Regina Hoefner-Notz

2 President RMPANA Board of Directors Officers and Committee Chairs Regina Hoefner-Notz MS, RN, CPAN, CPN VP/President Elect/Strategic Planning Marcia Keiser BSN, RN, CPAN Past President/Nominating Valerie Watkins BSN, RN, CAPA Secretary Joanne Forster RN Treasurer/Fundraising JoEtte Krissel RN, BSN, CAPA Historian Nancy O Malley MA, RN, CPAN, CAPA Education Barbara Krumbach MSN, RN, CCRN, CPAN Bylaws Policies and Procedures Sharon Sample RN, CPAN, CAPA Communication/Membership Nicole Babu BSN, RN, CPAN Newsletter Editor/Governmental Affairs Mary Rachel Romero MSN, RN, CPAN, CAPA Website Coordinator Donna Gaul Bobo BSN, RN, CPAN, CAPA Janine Purdy BSN, RN, CAPA Research OPEN Parliamentarian Lynda Marks RN, CAPA District Representative District I Shannyn Steel RN District III Peggy Van Cleve RN, BSN, CAPA District IV Sharon Gleason RN, CAPA District V Sana Zamarripa BSN, RN Honarary BOD Lois Schick MN,MBA, RN, CPAN, CAPA Barbara Godden MHS, RN, CPAN, CAPA Myrna Mamaril MS, RN, CPAN, CAPA, FAAN (Please check our website for member info) PAGE 2 Message from ASPAN Region I Director A I R E XCHANG E Here it comes National Conference in Las Vegas! Believe it or not it s just around the corner and it s in our corner of the world - Region One! I/We would like to extend my/our appreciation to all the volunteers involved in the planning process as well as to those who will be actively involved during the conference. A special thank you to the volunteers, the National Conference committee, Kevin Dill and the National office staff, and the NevPANA Board of Directors. I would like to recognize the following individuals for their involvement during the planning process: Susan O Day MSEd RN CPAN, from Reno NV and conference chairperson, has done an outstanding job. She is both a NevPANA and PANAC member. Region 1 is so very proud of her contribution Deb Ebert BSN RN CCRN CNOR CPAN CAPA has plans for an eventful Vegas style Component Night. Lori Silva RN CCRN CPAN who is ensuring no one at conference gets lost or has unanswered questions by scheduling enough hostesses. A thank-you just doesn t seem to be enough. Please show your support of ASPAN and let s have an outstanding representation of Region 1. Make your reservations, and reserve your time off. If you can t attend the whole conference, please come just for a few days; you won t regret it. If you have never been to a conference please plan on attending the First Timer s presentation which is scheduled for Sunday late afternoon and/or Monday morning. This will give you a great overview and assist you in making sure you don t miss anything you might like to see. This presentation will also be available on ASPAN s website at These are activities the weekend prior to the Opening Ceremonies on Monday April 28: Saturday at Stop by, meet and listen to questions directed at all the candidates for the ASPAN Board of Directors. They will be representing your interests. Sunday Come to the Representative Assembly and have a seat in the gallery. In the morning the candidates will give their speeches and ASPAN will discuss the business items that will be voted on later in the day. It s a great way to know the faces behind the names and hear hot topics that will be emerging for your practice. Sunday night-600pm-900pm- Component Night- dress Las Vegas style and come to Component Night. Remember what happens in Vegas stays in Vegas. Eat, drink and have fun! Bring cash to buy raffle tickets and support your components. Monday- Opening Ceremonies. ABPANC will have their Luncheon for only CPAN or CAPA certified nurses. Come and celebrate your achievement with your collogues. That afternoon starts with educational sessions and then at 1700 the Exhibit Hall opens. There will an assortment of different companies, poster presentations, and silent auction gifts. In the evening, plan to attend the ASPAN Development Reception at the Poolside. It is the premier fundraising event which provides monies for many scholarships offered by ASPAN for its members Tuesday and Wednesday-Many educational sessions and an opportunity to view and listen to poster presentations. Tuesday evening is the President s Reception. A fun night which is a dressy affair with food, drink, lots of dancing and fun. Come and support President Twilla Shrout. Thursday- Rise and shine for an early breakfast. Come to Closing Ceremonies. Meet and hear our next ASPAN President Jacque Crosson s vision for the coming year. Jacque is from Arizona (Region 1) Read the Particulars a conference bulletin published every morning which cover the highlights from the previous day, new activities and announcements. In addition to the Particulars go to the Bulletin Board where announcements are posted. Look for announcements of when your component might be getting together and or picture time. Hope to see you there and let s have some fun! You may even meet Elvis!

3 PAGE 3 AI R EXC HA NG E Valerie Watkins RN, BSN, CAPA Nominating Committee Rocky Mountain PeriAnesthesia Nurse Association Call for Nomination: RMPANA Contribute to Perianesthesia Nursing Practice... as an RMPANA Leader! As Immediate Past President/Nomination Chair, I am looking for RMPANA members interested in running for Treasurer and Vice-President/President-Elect. Job Descriptions are on the RMPANA website or use this link... It is YOUR time. Your professional organization needs your leadership skills and participation. There are other positions and opportunities to get involved. Please contact either Regina Hoefner-Notz RMPA- NA President regina.hnotz@gmail.com or Valerie Watkins, Immediate Past President Valerie@rrwatkins.com Submission Deadline: April 15, 2014 Following selection of nominees, their bios will be posted on the website for review and you will receive an with a Survey Monkey link for voting. JoEtte Krissel RN, BSN, CAPA Treasurer Today I am sending a check to ASPAN for $500 to show our appreciation for all their support with the members of our organization. Check out the ASPAN website if you haven't viewed it for a while. There is a plethora of information relevant to the practice of perianesthesia nursing. The RMPANA component cash reserve is over $80,000 and is kept in a checking account. Since we are financially secure, we are stressing the importance of offering member scholarships. On the website you will find the policy and forms to apply for a variety of scholarships. The board just approved a new form so that most members could receive $100- $250 based on criteria listed. You can submit a scholarship for CPAN/CAPA application, recertification, National Conference and for Retreat in the Rockies. Each RMPANA district also offers scholarship so please avail of these opportunities. Unused scholarship monies get rolled over to the next year s budget. As a side note, my term is over this October. I would really like to talk to anyone that would be interested in being treasurer. Send me an at dkrissel@comcast.net or call me at I will be a hands on mentor for as long as you would need!

4 VO L UM E 2 9, I SS UE 2, W IN T ER PAGE 4 Phyllis Macdonald BSN, RN, CPAN District I, President It has been a very good year for District 1 RMPANA. Our super winter workshop had 138 attendees. We remain true to our mission statement, advances nursing practice through education, research and standards." I have looked on the web and in the Colorado Nurse Newspaper and we are one of only a handful of nursing organizations in this state that provides and promotes education for its membership. The State Board of nursing in Colorado does not require continuing education to renew licenses. Therefore, there aren t many agencies offering continuing education for nurse. As organization supported mostly by volunteers, we should be extremely proud on how we have supported this nursing specialty practice. Here is a list of upcoming education opportunities for us: March 15, 2014, Saturday Spring Perianesthesia Review North Colorado Medical Center, Union Colony Room th Street Greeley, CO (Flyer on the RMPANA website) March 15 th, 2014, Saturday Wake up, It s Spring: The Ortho Connection St Mary s Hospital Saccomanno Education Center, 5 th Floor Conference Room 2635 North 7 th Street Grand Junction CO (SW Corner 7 th & Patterson) (Flyer on the RMPANA website) April 3, 2014, Thursday Monthly Educational Offering* Children s Hospital of Colorado East 16th Ave. Aurora, CO April 5, 2014, Saturday Certification review for CPAN/CAPA exams Parker Adventist Hospital 9395 Crown Crest Blvd Parker, CO April 27-May1,2014 ASPAN National Conference Las Vegas, NV (ASPAN Website) May 8th, 2014, Thursday Monthly Educational Offering* The Medical Center of Aurora 1501 S. Potomac Aurora, CO District Report *There is no fee for the RMPANA Monthly Educational Offering. When I took on the job of president of District I, I really had no idea what I was getting into. My only previous experience was being a Girl Scout leader for 10 years for my daughter s troop and that was where I learned to speak in a public forum for the first time. The current issue of JOPAN has an article titled Life's Lessons of Scouting, Leadership, and Mentorship by Ellen L. Poole which I read this morning and I got to thinking about why I decided to get more involved with District 1 with RMPANA and with ASPAN. After my troop graduated from high school, I needed to find something to fill my time as I was used to being very busy with a full time job, three children and my Girl Scout duties. I started a study group at my job so we could review for the certification exam. This effort prompted me in making an educational power point presentation to support my goals. I started branching out and offered the course to all members of District I. I have conducted this offering annually since then. This has been one of my proudest contribution to our organization. Becoming the president for District I has been one of the most rewarding things I have ever done. I have never been a member of a board let alone being the president. I have never had the experience running a meeting conducted in a parliamentarian manner. I have never had so many people reach out to me asking for my assistance and support. I am glad to have taken this journey of which I see myself performing the role for a while.

5 RMPANA District I has a Facebook page. Please check it out and get connected. We have open dates if anyone is interested in hosting one of the monthly education sessions. Please Rachelle Grant, our new Education chair at rachelle.grant@uchealth.org. Sept Porter Hospital November Open Jan Open Feb Open March Open April Open May Open We need people to get involved on the Board of Directors and on committee. Let me know if you are interested in shadowing any of the meetings or if you have questions on what position you would like to serve on that is suitable. We need several people to volunteer on committees for membership, finance, historical, education and bylaws. These committees will only take a small time commitment from you and you can really be a part of a great organization. If you are interested please contact me via at pjmac142@gmail.com or talk to any board member at our regular meetings. Other Volunteer opportunities: Certification Coach at your hospital or institution for your peers if you are interested I would be willing to assist in your startup. You can volunteer as a certification coach at any time of the year. Fill out the paper work at You must be certified to do this but you can get up to 3 contact hours per year towards your own recertification. Need organization liaison at hospital and free standing surgery center in the area, you would be responsible for posting flyers for the District 1 meetings and for any education flyers that are posted on the RMPANA website at your institution and reminding coworkers about the meeting to increase membership at the meetings. As always feel free to contact me about any of these opportunities. Pjmac142@gmal.com or any of the board members. Here is the list of the Board members information: PAGE 5 Phyllis MacDonald President Shannyn Steele Vice President Tricia Curley Treasurer Sarah Cutright Secretary Dianne Leeth Nominating chair Kathy Anderson Bylaws/policy and procedures chair Rachelle Grant Education CHair Beverly James Membership Chair Lois Schick Historical committee Pjmac142@gmail.com shannysteele@gmail.com curleycolorado@gmail.com Ilyotkd1@aol.com Dianne@danleeth.com Kanders80111@gmail.com rachelle.grant@uchealth.org Bjames715@comcast.net schickles@aol.com Special recognition to: Mary Rachel Romero who is an ASPAN 2014 Excellence in Clinical Practice Nomineeawarding is this April 2014 at National Conference. We are pulling for you Mary. In the future, board meeting times may be utilized on discussing how to conduct a journal club and how to incorporate evidence based practice information. Continue checking your s and get involved. There is a saying out there that if you want to get something done ask a busy person. Please learn that making time for your professional organization will give you many rewards; being busy should not be a barrier. If you are willing to put yourself out there you will be richly rewarded in friendship and fun. Lifelong learning is always a good thing. Thank you for all you do every day and hope to see you at the next meeting.

6 PAGE 6 Peggy Van Cleve RN District III, President District III just completed our "Wake Up, It's Spring" Workshop with 38 attendees and one student with seven great speakers who presented a comprehensive lecture on Orthopedics. Attendees responses were exceedingly positive. Our homemade soup and salad luncheon was a great hit! One lucky gal won the $ scholarship to use for education this year and several won a variety of baskets and GJ Rockies Baseball tickets. We feel blessed to have new information to care for ourselves, family and patients and hope to share our new knowledge with our co-workers. We're looking forward to our Cortez workshop late summer, hopefully, and several will enjoy National Convention in Las Vegas soon. Happy Spring to all! Sharon Gleason RN, CAPA District IV, President March has arrived! We just completed our district s annual workshop last March 15 th at NCMC in Greeley, Colorado. Nancy O Malley and Barbara Krumbach were our guest speakers. In addition to this workshop, we have planned two more educational offerings. The first one is a Journal Club featuring Sleep Apnea tentatively scheduled for June The second workshop will be in the late summer with a focus on Anesthesia agents. We will keep you posted, so watch for blast and educational events through RMPANA. Nursing students will get a significant discount. ASPAN Research Grants Research grants are awarded once a year. Application deadline is April 30th of each year. Grant applicants will be notified of approval or denial by January 1st of the following year. All grant awardees will be acknowledged at the ASPAN National Conference. Research Grants applications and supporting materials must be submitted electronically in their entirety, no exceptions. Please contact ASPAN Director for Research, Kim Noble, PhD, RN, CPAN, at knoble@aspan.org with any questions. Click here to download the Research Grant Application, including instructions and submission form. Save the document to you computer, and your submission to Kim Noble, knoble@aspan.org.

7 PAGE 7 Sana Zamarripa, RN, BSN, CPAN District V, President Hi Everyone, Here the update on District V January 8, 2014, our group enjoyed a presentation by Nancy O'Malley on her medical mission and nursing experiences in Cambodia. We were pleased to have Regina Hoefner-Notz, the RMPANA component president, graced us with her presence as well. During our district meeting, we discussed how we can improve scholarship support for our members. We sponsored Theresa Barajas to attend Retreat in the Rockies last year. We came upon an agreement to offer the scholarship again for this year s retreat. If you are interested in attending the retreat this year and your institution does not provide sponsorship, please our district V officers listed below. We will select a candidate from the requests we receive. We also agreed to allocate $500 to be divided by the number of applicants who interested in attending the ASPAN National Conference in Las Vegas. For those who have never been to the national conference, it is a motivating experience. For community service, we are collecting pajamas for Sweet Dreams, a charity that gives books to foster children and disaster victims. I sent a flyer to district members to serve as flyers for their facilities. We hope to gather many items to donate. We are planning a presentation at Memorial Hospital Central on ostoperative care after a TURP procedure. I will let you know when the date is set. Also we are checking to see if we can have a RMPANA road show educational offering this summer. Please consider becoming an officer for our district. We currently need a vice president who would be rotated into the president slot. Your participation makes our district great! Come and see us at our next meeting. District V Board Members: Bridget Miller RN, treasurer gigi@themillers.com Sandy Haugen, RN education chair styfree451@gmail.com

8 PAGE 8 Committee Report A I R E X C H AN G E Sharon Sample, RN, CPAN, CAPA Bylaws, Policy & Procedure $$ Cash-In On RMPANA Opportunities The RMPANA component sets aside monies each year for members to receive financial assistance to attend National Conference, for nursing degrees tuition, educational workshops, certification, recertification, member recruiter of the year award, and now three new awards: Excellence in Clinical Practice, Outstanding Achievement and Humanitarian Mission. The member scholarship policy and form has been revised, allowing any member attending a seminar to receive a minimum of $ The scholarship and award forms, as well as all corresponding policies can be obtained on RMPANA s web site. Think of at least one colleague you could nominate and recognize for their excellence in nursing practice or their contribution to Perianesthesia nursing. They would receive recognition at Retreat in the Rockies and a $ cash award. Any member who considers participating in a Humanitarian mission should apply for the $ scholarship. Communicate to your nursing students that RMPANA has two $ scholarships available and any member working on an advanced nursing degree has an opportunity to receive a $ scholarship. Keep on recruiting new members; you may receive the $50.00 reward for most recruited this year. Member-get-a-Member Campaign and AWARDS! By Valerie Watkins Congratulation to Regina Hoefner-Notz for being RMPANA Top Recruiter of 2013, she receives a cash award of $50. Here is the list of component recruiters that recruited more than one new member. Keep it up! 3 - Regina Marie Hoefner-Notz, MS, RN, CPAN, CPN 2 - Audrey E Cook, BSN, MS, RN, CPAN, CAPA 2 - Barbara A Godden, MHS, RN, CPAN, CAPA 2 - Barbara J Krumbach, MSN, RN, CNS, CCRN, CPAN 2 - Becki L Hoyle, BSN, RN, CPAN, CAPA 2 - Beverly A James, RN, CPAN, CAPA 2 - Diana L Repasky, RN, CAPA 2 - Janice Elaine Strong, RN, CPAN, CAPA 2 - Sheryl H Greenbury, BN, RN.C, CAPA 2 - Valerie Watkins, BSN, RN, CAPA Invite your colleagues to join ASPAN and RMPANA today and begin enjoying the many benefits of membership. To thank you for your valuable work, prizes are available for members who participate in the campaign. You can obtain ASPAN promotional materials and membership applications by contacting the National Office toll free at or ing dhanisch@aspan.org. Request as many copies as you need! Also check the website for more information. Thank you for your help promoting ASPAN and our vital practice. Membership Chair is currently open. Please let us know if you are interested in joining the team!

9 A I R E X C H A N G E PAGE 9 Barbara Krumbach RN, MSN, CCRN, CPAN Education The RMPANA Education Committee has been busy planning for the 16 th Annual Retreat in the Rockies on October 3-5, 2014 at Snow Mountain Ranch. Mark your calendars now. The flier will be out this summer. On a side note, I am the co-chair of ASPAN s Evidence Based Practice Strategic Work Team (SWT). Over the past several months members of the team have worked with the research committee and the clinical practice committee to critique articles with levels of evidence to update the obstructive sleep apnea practice recommendation and the Unwanted Sedation Practice Guideline. These will go before the ASPAN Board at the national conference in Las Vegas. Once these are approved, they will be incorporated into Standards of Practice Recommendation Guidelines Manual. Have you visited the updated ASPAN EBP web site? If not, log on to the ASPAN site, click on research and then go to the EBP site. The new journal club site has also been updated as. Included on this site is an updated EBP education module on with a description of the FAME levels of Evidence from JBI (Joanna Briggs Institute) as well as the new critique forms to use when you hold a journal club. The critique forms for quantitative, descriptive, cohort/case studies, systematic reviews and qualitative studies are available for your viewing. Each form has a sample article and a completed critique form. You can use these as guides when you conduct a journal clubs in your facilities. These are great article s that affect our practice. Let me know your thoughts on the site. My address is listed on the site. Janine Purdy RN, BSN, CAPA Website rmpana.org Please check our website for contact information on our board members. Click on MEMBERS tab and locate Board of Directors. You will find their addresses. If you would like to serve at the component level, fill out a Willingness to Serve form and let us know the areas you are interested in serving. JoEtte Krissel RN, BSN, CAPA Fundraising I am exploring new products for fundraising at Retreat in the Rockies. One of them is a mock turtleneck long sleeve with the RMPANA logo on the left neckline area. We will continue to sell fleece jackets since this item sold well at previous conferences. If you have other ideas that may interest our attendees, please let me know so we can order them. We always look forward to new ways of generating income for our organization.

10 PAGE 10 Mary Rachel Romero, RN, MS, CPAN, CAPA Governmental Affairs Nursing Community Political Action Committee (PAC) Hello dear readers! Some of you may wonder why ASPAN/RMPANA have a governmental affairs committee and what are its functions. ASPAN is an organization that serves to protect patients and ensuring safety when they undergo procedures. In doing so, we need to be heard on how we implement our practice. We share the same views as other specialty practice group i.e., AORN, AACN, ALNC, ANIA. In order to convince congress to side with our issues, we lobby. Lobbying is the act of attempting to influence decision make by government officials. Most people have a negative opinion of lobbying because they think only rich companies will win. Lobbying does cost money and time. Multiple nursing organization including ASPAN, have supported ANA- Political Action Committee (PAC). By doing so, we have a higher chance of getting our voices heard. Another organization that ASPAN sends liaison to is the members only Nursing Community. This is the political arm endorsed by the American Association of Critical Care Nurses (AACN). The Nursing Community is a coalition of national professional nursing associations dedicated to building consensus and advocating on a wide spectrum of healthcare and nursing issues, including practice, education, and research. The Nursing Community is committed to improving the health and health care of our nation by collaborating to support the education and practice of registered nurses (RNs) and advanced practice registered nurses (APRNs). Collectively, the Nursing Community is comprised of 60 national nursing organizations that represent nearly one million practicing nurses, nursing students, and nursing faculty. The Nursing Community supports the following core principles: A robust and diverse nursing workforce is essential to the health of all Americans. Nurses are an integral part of the healthcare team, are involved in every aspect of care, and are committed to the patient, their families, and the community. The contributions made by the practice and science of nursing are critical to the delivery of high quality, life-saving, preventive, and palliative health care across all care settings, geographic areas, and social determinants of health. The services RNs and APRNs provide are linked directly to the availability, cost, and quality of healthcare services. Affordable, accessible, high quality health care, and improved health outcomes depends upon a model that is patient-centered and comprehensive, which can be achieved through the full complement of expertise gained from broadbased, inter-professional partnerships. Nursing involvement is essential to the development of all aspects of the new healthcare information infrastructure. Nursing data is key to identifying patient outcomes and is essential to identifying required improvements in the delivery of patient care. Recent activities supported by Nursing Community are as follows: a. Nursing Workforce Development Programs (Title VIII of the Public Health Service Act [PHSA]) The Nursing Community discussed the funding level for Title VIII and concluded that if the President s Budget recommends below $251 million, the NC will consult their Congressional Champions to determine if they would support a higher funding level. Should the funding level be an increase, the Community would support that level. b. National Institute of Nursing Research The Nursing Community agreed to request $150 million for NINR. c. Nurse-Managed Health Clinics (NMHCs, Title III of the PHSA) The Nursing Community agreed to request $20 million for NMHCs. References: The Nursing Community. Retrieved from The Nursing Community. Retrieved from

11 PAGE 11 Cutting Edge Sugarbaker Procedure Submitted by Elizabeth Beth Carrier BSN, RN The Sugarbaker procedure, named after Dr. Paul Sugarbaker of MedStar Washington Hospital Center, is a surgery performed for the treatment of rare abdominal cancers. In short, this procedure involves cutting open the abdomen, removing the accessible tumors and organs, followed by soaking the abdominal cavity with a heated chemotherapy elixir agent which treats the remaining tumors the surgeon can t physically remove. This procedure is often thought of as a patient s last hope due to the extensive spread of the cancer and inability to remove all the tumors by hand. This procedure lasts between hours and begins with a large abdominal incision. The surgeon then concentrates on eliminating as much tumor by hand as possible, and removes the abdominal organs from the body cavity. Dr. Sugarbaker often permanently removes organs or spare parts, including the uterus, ovaries, spleen and gallbladder. The peritoneum is often stripped from the pelvis to the diaphragm, with possible removal of the right hemicolon, greater omentum and lesser omentum. Once the organs are removed, the body is filled with three liters of saline and chemotherapy-mitomycin C, and heated to 108 degrees Fahrenheit. The hyperthermic intraperitoneal chemotherapy, also known as Hipec, is to remain in the body cavity for 90 minutes while the surgeon gently shakes the body to allow the agent to slip in every nook and cranny in the cavity. The Sugarbaker procedure has proven effectiveness with rare abdominal cancers, such as appendiceal cancer that has spread to other organs in the abdomen, pseudomyxoma peritonei (cancer of the peritoneal cavity), and peritoneal mesothelioma (cancer linked to asbestos exposure). Survival rate when treating these specific cancers with the Sugarbaker procedure is 50% for at least 5 years. Surgeons are performing this surgery as treatment for other more common types of cancer, such as colorectal and ovarian. However, the true effectiveness and extended survival rates have yet to be extensively proven. As with any invasive procedure, the risks are great and a patient should be thoroughly educated on the possible outcomes. These risks include morbidity during or soon after the procedure (1%), serious post operative complications (12%), such as hemorrhage, lack of nutrition, anastomotic leaks, fistula formation, wound infection, small bowel perforations or obstructions, pancreatitis, neutropenia, and gastric paresis. Other factors to consider include the often extreme cost of the procedure. Few insurance companies cover the double procedure, especially when dubbed experimental in nature for treating colorectal or ovarian cancers. Nursing implications for the Sugarbaker procedure include management of care and close monitoring of the patient to avoid any potential complications. Before surgery, the patient will need an Xray, labs, a CT scan, bowel prep, and emotional reassurance. After surgery, the patient will need to be placed in the intensive care unit for close observation. The post-op/icu nurse will need to manage many lines/drains such as a nasogastric tube, Jackson-Pratt drains, a central line for total parenteral nutrition and lipid administration, possible chest tubes, and Tenckhoff catheter for continued intraperitoneal chemotherapy administration for approximately five days after surgery. Though this procedure is quite invasive and comes with many risks and potential complications, the long term survival rates for the specifically targeted cancers with 50% living 5 more years, and 10-32% surviving 10 years make this last hope procedure a successful one.

12 A I R E X C H A N G E PAGE 12 ASPAN News ASPAN Development Join other RMPANA members at the Dream Walk (which includes a scavenger hunt this year!) and the Poolside Development reception at ASPAN s 33rd national Conference in Las Vegas! ASPAN Development helps to advance the vital practice of perianesthesia nursing. When you support ASPAN, you help bring about many good things. Your contribution goes towards scholarship, awards and to create public awareness and education. Stay tune for announcement on what to wear for the Component Night! Theme: Old Las Vegas

13 PAGE 13 Clinical Practice Question What is the definition of "responsible adult?" "If a patient does not have a responsible adult to accompany him at discharge, what do you suggest? The ASPAN Perianesthesia Nursing Standards, Practice Recommendations and Interpretive Statements do not include a definition of "responsible adult." The dictionary defines responsible as an individual who is able to answer for his conduct and obligations; someone who is trustworthy; someone who knows right from wrong; someone who is accountable. 1 An "adult" is an individual 18 years or older. There are facilities where the word "adult" has been changed to "party" or "person." Determinants of Responsible Adult When determining whether or not an individual can be the responsible adult, age is not the only factor. Sometimes, it is the relationship of the parties. Parents are presumed to have authority to act on behalf of their minor children. A minor who is a parent caring for his/her own child may be the "responsible adult," even if the minor and his/her child live with parents or other adult relatives. The ability to drive is not a prerequisite, although it may be necessary to ascertain whether the mode of transportation is safe for the patient. The patient cannot be the driver after sedation, but taking a taxi when accompanied by a non-driving "responsible party" may be an acceptable option. A blind or deaf person can be the responsible person. Discharge instructions may be carried out through an interpreter. In today's society, many people live alone or are single parents. If the patient's "responsible adult" is a teenage child, you must consult the facility's policy regarding the discharge. It may be reasonable to discharge the patient with a teenager who understands the discharge instructions, and is willing and able to provide the necessary care. Caregiver Support What if the patient is not accompanied by a responsible adult? It is best to verify discharge arrangements prior to the procedure. At the time of admission, ask who will be caring for the patient after discharge, and what transportation arrangements are planned. Make sure the designated caregiver understands that the patient should not be left alone for the first hours, depending on the procedure and the type of sedation. Occasionally, the person driving the patient home is not the designated caregiver. If possible, contact the caregiver to review the discharge instructions and to answer any questions. If the caregiver does not comprehend the discharge instructions, or is unable to perform the tasks necessary to care for the patient, it may be necessary to consult the physician and obtain an order for home healthcare. Occasionally, unaccompanied patients state they have someone to help them at home. Some facilities allow patients to leave via taxi with a physician s order. Consider notifying the caregiver when the taxi leaves the facility. Document the telephone number, the name, and the relationship of the individual. Discharge It may be necessary to obtain an order for the patient to spend the night in the facility (if that is an option). If no alternatives can be identified, the physician may need to cancel the procedure. When discharging a patient to a group home, review the discharge instructions with the group home supervisor. When discharging a patient to assisted living, contact the caregiver to determine what arrangements can be made for overnight care if a family member or friend is not going to be with the patient. With elderly patients, the accompanying spouse may require more care than the spouse having the procedure. When the patient is the spouse's caregiver, determine who else may be available to assist the couple after the procedure. Never hold a patient against his will. False imprisonment is not an option. The patient could file both civil and criminal charges, depending on state laws. Consult the facility risk manager or administrator regarding leaving Against Medical Advice (AMA). AMA departures should be carefully documented in the medical record. References: Merriam-Webster Dictionary. Available at: click here. Accessed June 30, Chinnappa V, Chung F. What Criteria Should Be Used for Discharge after Outpatient Surgery? In: Fleisher L, ed. Evidence Based Practice of Anesthesiology. 2nd ed. Philadelphia, PA: Saunders Elsevier; 2009:

14 VOLUME 29, ISSUE 2, WIN TER 2014 Perianesthesia Trends PAGE 14 PAGE 14 ExSpiron, A Respiratory Motion Monitor By Mary Rachel Romero As perianesthesia nurses, we were taught that there are three areas to observe when assessing for respiratory function: Airway patency, breathing pattern and ventilator depth. We have pulse oximeters and ETCO2 monitors (at least some of us) to help in determining ventilation status. However, oxygen saturation is not an indicator of adequate ventilation and levels decline only after respiratory decompensation has begun (Voscopoulous, 2013). We still count respiratory rate for breathing patterns because cardiac monitors are unreliable. Current Respiratory Monitoring Challenges Ventilation monitoring and pattern assessment is not routine SpO2 values are masked when delivering supplemental oxygen Respiratory rates are not always counted but recorded as 16 bpm Patient specific reactions to opioids are often unrecognized without objective data Apneic events are often unrecognized without subjective data Wouldn t it be nice if we have a monitor that can monitor the depth and rate of respirations? Wait no further, there is a company that has finally develop this product. It is called the ExSpiron and it is FDA approved. Here are some facts and figures: What is it and what does it do? It is a monitoring device that collects continuous, non-invasive minute ventilation data in non-ventilated patients. It measures lung volume against time, generating quantitative metrics for minute ventilation (the amount of air that enters/leaves the lungs every minute), respiratory rate (breaths per minute), and tidal volume (the volume of air in a single breath). Minute Ventilation is the best way to assess respiratory competence. This becomes especially important in patients receiving opioids, anesthetics or sedatives, who are more at risk for respiratory depression. While recent standards call for monitoring ventilation in all post operative patients receiving opioids, the elderly and obese populations may be at increased risk. References: Vacopoulous, C., Brayanov, J., Ladd, D., Lalli, M., et al (2013). Evaluation of a Novel Noninvasive Respiration Monitor Providing Continuous Measurement of Minute Ventilation in Ambulatory Subjects in a Variety of Clinical Scenarios. Analgesia-Anesthesia. 7 (117), 1 The ExSpiron Monitor. Respiratory in Motion. Retrieved from

15 P AG E 1 5 Scenes from ICPAN

16 PAGE 16 Certification New CPAN and CAPA nurses: Congratulations to those who passed their certifications last Fall, 2013 CPAN Barbara Ann Cook - now dually certified Elizabeth Morissette Rowe Anna Elizabeth Denton Marcus Allen Rusch Michelle M. Lieven Wendy Altman-Swift Erin G. Mantych Cheryl Bieber CAPA Tamara L Stewart Kelly Barger Kelly Erica Kaes Bridget Miller Diana Marie Weil Amy Jo Santoro Dual Certification CPAN and CAPA Amanda J. Ford Certification Good luck to those taking the CPAN or CAPA certification this spring. Most likely the registration will be closed by the time you read this (March 10th) Exams are between April 7 and May 31. There is an opportunity to attend a certification review on April 5, a.m. to 5 p.m. at: Parker Adventist Hospital 9395 Crown Crest Blvd Parker, CO For more information check out our website There are many study resources available on the ABPANC website at Certification Handbook Study Reference List Webinar Test Taking Strategies 12-week Study Plan Study Tips Practice Exams Coaches

17 VOLUME 29, ISSUE 2, WIN TER PAGE 17 Education Last March 17th, RMPANA President Regina Hoefner-Notz went to Regis University, her alma mater, and spoke about perianesthesia practice to nursing students. One of our components goal is to increase awareness of perianesthesia practice not just from a professional level. Regina s presentation assisted in garnering interest as well as providing information on what we do as a specialty practice in nursing. Thank you Regina for helping out the next generation in becoming future leaders! Other Conferences AORN Surgical Conference and Expo March 30-April 4, 2014 in Chicago, Illinois NPSF Patient Safety Congress May 14-16, 2014 in Orlando, Florida AACN-NTI Conference May 17-22, 2014 in Denver, Colorado ANCC 2014 Magnet Conference October 8-10, Dallas, Texas

18 PAGE 18 Community Service University of Colorado Hospital Perianesthesia Nurses collected non-perishable food to benefit Foodbank of the Rockies during PANAW. Staff also gave back to the community by offering a Patient and Family Health Education Event. District IV- Service The Quilt of Valor project is completed! While the quilt looks very beautiful, it will never be able to express the gratitude felt by each of us in the protection of our freedom. We are in the decision making process of determining a recipient. It will be one of the three casualties of war in the past eight months from the District IV area. The following is a photo of the quilt with Barb Comstock, its creator, and Vicky Schommer, our Secretary. Thank you Barb, for your talent and dedication to the cause of our troops. 9 News Health fair We are planning to contribute our time to support the 9 News Health Fair, April 26th from 700AM to 1200N in Fort Collins. If you would like to participate, you are welcome to join us. Please send Sharon Gleason or one of the board members and if you are interested in helping out. Hope to see you there. MS Walk Our district is participating in the Northern Colorado Walk MS 2014 on May 10th at Windsor Park. Sign up under Stomp IT Out Team, captain Vicky Schommer. When you join Walk MS you become a critical force in our movement to end MS forever by supporting life-changing programs and cutting edge research. 100,000 people in Colorado and Wyoming are affected by MS. District I Project C.U.R.E Community Project Saturday, April 12, Come join RMPANA District I to do another community project with Project CURE on April 12. Please sign up by ing Nancy O'Malley nancyo44@aol.com

19 P AG E 1 9 Scenes from PANAW University of Colorado Health have always considered PANAW an annual event truly meant to appreciate all their hardworking nurses. It was a whole week affair that started with an inservice followed by sponsored luncheon everyday for the entire week. Support came from the anesthesiologists, CRNAs, AAs, nursing department and Operating Room staff. For extra added fun, we had a photo booth and some giveaways. PANAW is also a time to give back to the community so we had a food drive to benefit Foodbank of the Rockies and a Patient and Family Education Event. The Childrens Hospital NCMC-District IV sent letters and copies of the signed Proclamation from our Governor. We were honored at NCMC with a special surprise each day of the week, which included a catered lunch, Caring every step of the Way lapel pins, foo foo coffee drinks and Outpatient Services (OPS) Memorial Central Hospital St. Mary Corwin

20 PAGE 20 Bedside Story This letter was sent by a nursing student, who was completing her practicum at The Childrens Hospital in Aurora, Colorado, to Regina Hoefner-Notz. I had such a wonderful experience in the PACU and am so grateful to have had the opportunity to do my Senior Practicum there. All the staff were so welcoming and helpful and really encouraged my learning. I had the opportunity to see and do so many new things and I learned more than I have in any other clinical rotation! Not only did my nursing skills grow, but I built the confidence and independence necessary to be successful as a new graduate RN. I've always loved children and have wanted to do pediatrics since before I can remember, but this rotation in the PACU really solidified my desire to work at Children's Colorado. I am very excited to be graduating in May and will apply to the New Grad RN Residency Program. My experience in the PACU (and NICU during my pediatric rotation) will undoubtedly help me succeed as a new grad. I also wanted to write to you about my experience with Renee Lackey. She was such a wonderful preceptor, and did an amazing job of teaching and orienting me. She continually pushed me to think critically, whether in regards to patient care or pain management or airway monitoring. She worked individually with me on my weekly goals and constantly sought out new learning opportunities for me. She is very attentive to her patients and has a strong work ethic. She taught me not just the basic skills of a PACU RN, but to constantly look at the big picture so as to provide the best nursing care possible. She always went the extra mile for her patients, and it was evident in her teaching style that she went the extra mile for her students as well. I am grateful to have learned from her and hope she continues to precept nursing students in the future! Thank you again for your time and allowing me to complete my Senior Practicum in your unit. You really have done a great job as a manager and it's reflected in the work ethic and professionalism of you staff. My experience was exceptional and memorable, and I am very excited for the next step in my journey to become a pediatric RN! Sincerely, Deborah Lillie CU Denver- College of Nursing BSN Student

21 PAGE 21 PAGE 21 Hospital Views A Centura Health Facility 1008 Minnequa Ave Pueblo, CO St. Mary Corwin Hospital PACU Phase I, Endo Manager: Kathy Gabel PAT, Preop, Phase II Manager: Jennifer Chrisman Number of Hospital Beds: 408 licensed beds. Phase I PACU has 8 beds, GI Procedure Room=3, Pre/Post=8, Type of Surgeries: Orthopedic including total hip, knee and shoulder replacements as well as fracture care and arthroscopies. A variety of surgical procedures; minimally invasive procedures such as laparoscopic and Da Vinci robotic assisted hernia repair, cholecystectomies, prostatectomies, and hysterectomies. We also provide cake to patients with spinal surgeries, urological procedures and lithotripsies. PreOp and PACU staff covers pre/post care areas.

22 PAGE 22 Thai Chicken Thighs Healthstyles Love My Crockpot! Recipes from Regina Hoefner-Notz 8 skinless chicken thighs 16 oz jar salsa 1/2 cup peanut butter 2 teaspoons ginger 2 tablespoon soy sauce 2 teaspoons lime juice Put all ingredients in crockpot on low for 6-8 hours and serve over rice. East, East Pot Roast 3-5 lbs chuck roast, boneless pot roast 1 can of Campbell's' cream of mushroom soup 1 packet packet of Lipton's onion soup mix 1/2 cup water Put all ingredients in crockpot. Cook on low for 6-8 hours. Add carrots if you would like to an hour of 2 prior to serving. Makes a great gravy with the soups. Editor s Column Hello RMPANA members and Visitors! Hope you enjoyed this edition of Air Exchange. As your editor, I would like to hear your ideas on how to make this newsletter remarkably interesting. If you would like to be regular contributor, send me an . We can always find ways to create a section. I would like to invite all of you to send interesting articles or commentaries about perianesthesia practices in your respective work areas. We also need write-ups for the following sections: Bedside Stories-Patient-Nurse Relationship Healthstyles-Lifestyle Tips Research-EBP Practices The nest deadline for submission is June 15, Please send your articles or inquiries to maryrachel.romero@yahoo.com. Thank You!