Awakening News. Celebrate PANAW Week! President s Message. Reminders! ISPAN Iowa Society of PeriAnesthesia Nurses. Every job is a selfportrait

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1 ISPAN Iowa Society of PeriAnesthesia Nurses Volume 22, Issue 1 Winter 2008 President s Message Greetings to all ISPAN members, Beth Brown, ISPAN President As I write this letter we are amidst the Holiday Season. Tis the season for religious and family traditions, festive gatherings of family, friends and co- workers and parties brimming with great food and good cheer. We, the members of the ISPAN family, will be soon be celebrating another great season. The week of PANAW (PeriAnesthesia Nurse Awareness Week) is February 4-10, It is a time to celebrate the nursing practice that is unique to our specialty. It is a time to recognize (and to be recognized) for the special presents (presence) we provide to our patients every day of the year. It is a time to hang the PANAW 2008 poster with care, order the gifts and don the ASPAN apparel that is available in the PANAW catalog or on the website at ASPAN.org. It is the time to plan the festivities (great food, of course) in the multitude of workplaces where perianesthesia nurses are employed-ambulatory surgery centers, hospital Phase I and Phase II settings, pain management clinics to name a few. ASPAN is recognized worldwide as the professional organization dedicated to the perianesthesia nursing clinical practice, education and research. Perhaps during the week of PANAW you and your peers can entertain ASPAN membership application, CPAN/CAPA certification or attendance at the ASPAN National Conference in Grapevine, Texas on May 4-8, Each supports the value of perianesthesia nursing in providing the best care for our patients and families. Tis the season. ENJOY the PANAW celebration!!! Sincerely, Beth Brown, BSN,CPAN ISPAN President Happy New Year from the ISPAN Board Reminders! ASPAN 27th National Conference Gaylord Texan Resort and Convention Center Dallas/Fort Worth, TX May 4 8, 2008 Mark your calendars now for your unit to celebrate PANAW, February 4-10th, It s never too early to start planning! Celebrate PANAW Week! Every job is a selfportrait of the person who does it. Autograph your work with excellence. Author Unknown is written by and for ISPAN members. All rights reserved. Copyright 2008

2 Page 2 ISPAN Leadership President: Beth Brown brownb@mercyhealth.com Vice President: Marsha Sabotta pdsabotta@aol.com Secretary: Deb Mueller muelleda@mercyhealth.com Treasurer: Linda Armstrong ams1941@bellsouth.net Immediate Past President: Jennifer Goos goosjs@ihs.org Governmental Affairs Representative: Helen Riedesel hlriedesel@aol.com Newsletter Editor: Sandra Gardner pacurn75@yahoo.com Region II Director Twilla Shrout, MBA BSN RN CAPA J HWY Bunceton, MO (H) (C) (W) ext tshrout@aspan.org tshrout@iland.net Inside this issue ISPAN President Address - Beth Brown... 1 ISPAN Directory... 2 ASPAN 2007 CDI Report - Marsha Sabotta... 3 ASPAN President's Message - Sue Fossum... 4 Region II Director s Report - Twilla Shrout... 4 ASPAN National Conference Information - Sue McDonald... 5 Winter Board Meeting... 5 Methemoglobinemia: Are you ready? - Sandra Gardner... 6 PANAW Week - ASPAN... 6 Committee Corner... 7 Board Meeting Minutes / Fall Deb Mueller... 8 National Conference Welcome - Lori Sanders... 8 Member Spotlight: UIHC Ambulatory Center - BJ Wagner... 9 Invitation to Participate... 9 Pain Management Guidelines - ASPAN Fall Survey Findings - Beth Brown Events Calendar Certification Clips - ABPANC My 2 Worth - Sandra Gardner... Backpage ISPAN Mission Statement As a component of ASPAN, ISPAN formally recognizes the purpose and mission of ASPAN. The Society is committed to maintaining and upgrading the standards of the specialty, and to the promotion of professional growth of its members. Special Kudos to the following ISPAN Members Congratulations to Donna Dolezal, RN who was the recipient of a 2007 ASPAN $1000 scholarship for individuals pursuing a MSN degree. Congratulations to Amy Shinneman, BSN, RN, recipient of a 2007 ASPAN CPAN certification scholarship of $260.

3 Page 3 Page 3 ISPAN Board Members Attend ASPAN s Component Development Institute (CDI) Albuquerque, New Mexico provided a warm and beautiful backdrop for ASPAN s annual Component Development Institute. Perianesthesia nurses from all over the United States gathered September 7-9 for a weekend of learning, networking and fellowship with ASPAN s national and regional leaders. ISPAN was represented this year by Helen Riedesel, Governmental Affairs chairperson and myself, Marsha Sabotta, Vice-president/President Elect. Marsha Sabotta In keeping with ASPAN president Susan Fossum s theme of Advocacy, this year s CDI put the spotlight on Governmental Affairs. Maureen McLaughlin, ASPAN s Governmental Affairs chairperson, addressed the group on Friday evening. Maureen reviewed the legislative process. She reminded us that there are millions of registered nurses and most of us are registered voters. Both Iowa and the national legislatures create laws that impact healthcare practice. We nurses can advocate for our patients when bills are being considered. We have the unique knowledge to help legislators determine what would best benefit patients and nurses who care for them. Nurses must take an active role in determining our practice or others will do it for us. ISPAN is fortunate to have Helen Riedesel as our Governmental Affairs chairperson. If you have an interest or concern about pending legislation and would like to know how to make your voice heard, please contact Helen or any member of the board. ASPAN leaders and Regional Directors reviewed the ASPAN mission and vision. Practices for maintaining components as well as serving and building the membership base were discussed. Each component was represented and each shared ideas for providing great educational opportunities and professional support for our members in keeping with ASPAN s mission and vision. Networking with such dedicated professionals from all over the country is so energizing. & After spending a weekend focused on advocating for the care of our patients and our component members, we closed on Sunday with a talk by Joni Brady on caring for ourselves. ASPAN is studying nurse fatigue and its consequences. CDI attendees filled out a questionnaire on fatigue. Expect to hear more on the study later. This was my third CDI weekend. As always, I came away energized and inspired to serve each of you and all of our patients in the best way possible. Each of you is a professional dedicated to providing the best possible care. You advocate for the strangers placed in your care on a daily basis, a responsibility you stand up for no matter what obstacles you may face. You are not alone. ASPAN and ISPAN are dedicated to supporting you. I am grateful for each of you, my colleagues. Please don t hesitate to contact me or any board member for support. Chances are whatever your concern is, it is a concern for perianesthesia nurses all over. Marsha, Twilla Shrout (Region II Director), and Helen Reidesel at CDI. Region II CDI participants with ASPAN President Sue Fossum (bottom row, 3rd from right) and Regional Director, Twilla Shrout (bottom row, 2nd from right). Coming together is a beginning. Keeping together is progress. Working together is success. ~Henry Ford~

4 Page 4 Sue Fossum, ASPAN President: "Advocacy: Be the Voice" The Hostile Work Environment - Healing Hostility Excerpt (1) Healthcare organizations and nurses have a responsibility to recognize, prevent and intervene in cases of workplace hostility. Nurses must break from the acculturated, negative behaviors we sometimes experience when working together. Situations involving disrespect, questionable work ethics, broken rules and lack of support require a strong voice to hold the responsible individual(s) accountable. Zero tolerance policies should be implemented to support a hostile free work environment. Nurses also need to increase their knowledge and understanding of the issues surrounding workplace hostility. Just as clinical skills are learned and developed, we must learn and develop conflict management strategies to assist us in the identification, intervention and prevention of workplace negativity and hostility. Integrating collaborative conflict management strategies into the daily activities of clinical care can improve patient outcomes, improve retention of nursing staff, and create an environment that optimizes scientific advances through enhancement of effective working relationships. This is the next evolution of healthcare delivery. It is essential that nurses guide and support each other to change destructive thoughts and behaviors. This requires a proactive stand and a mindset of appreciation and respect for our colleagues and the work that we do. As you return to your workplace in the role of active change agent, speak with your supervisors and colleagues about fostering that positive, supportive work environment. Suggest that classes be given or reading material be provided to address dealing with conflict and creating positive environments. Every nurse has the power to eradicate hostile work environments. While acknowledging that we all, at times, feel conflicted in some situations, know that constructive methods and behaviors can be adopted to prevent workplace situations from becoming antagonistic. Speak up for positive change! Be the Voice for yourself and your colleagues. 1. Fossum, S. (2007). The hostile work environment: Speak out - be the voice. Breathline, 27(6), 2-3. Susan Fossum BSN RN CPAN, ASPAN President (916) sfossum@aspan.org or susan.fossum@ucdmc.ucdavis.edu Region II Report Twilla Shrout, Director Another year has passed with many accomplishments for ASPAN. There are now over 13,000 members to be the voice for advocacy. The fall has been a busy time for many component meetings. I am very impressed with the educational information and the dedication of the components to provide this for the membership. Susan s 2 nd quarter report is available from the component president. If anyone would like me to them a copy, just let me know. The 27 th National Conference is not very far away. Make plans now to attend May 4-8 at the Gaylord Texan Resort and Convention Center. The brochures have been mailed, so make your reservations early in order to pick the sessions you want to attend. I received an to disregard the request for the two digit number beginning with EE on the mailing label. This request is on page 19 of the registration brochure. The deadline for the Gold Leaf Award application is February 1 st. Working towards the Gold Leaf Award is a way for the component to showcase the activities directed by the component leadership and its members. Members can submit names for the ASPAN Star recognition program. Just go to the ASPAN website under the Members section go to Awards and scroll down to the ASPAN Star recognition form. Fill out the form and nominate a deserving ASPAN member. PeriAnesthesia Nurse Awareness Week is February 4-10, Gifts are available for purchase online at otherwise the brochure was mailed out to the membership with a recommended order date by January 18 th. Let me know how you plan to celebrate. The ASPAN Scholarship application should be available February 1, The deadline for submission is July 1, Scholarships available are for pursing nursing degrees, National Conference attendance, CPAN/CAPA exam fees, or the Nurse in Washington Internship program. Our grassroots members provide the catalyst for bringing new ideas to the forefront. Please continue to let your important voice be heard! Members feedback and actions stimulate ASPAN to develop new programs and initiatives, leading to enhanced customer service and cohesiveness throughout the organization. I have been fortunate to visit each component and interact with many Region II members during this term. I am amazed by the unique strategies used by component leaders to encourage participation and succession planning, and applaud your ongoing dedication, commitment and efforts. It has been an honor and a pleasure to work together with the members of Region II. Contact information for Twilla Shrout, Region II Director, can be found on p.2 of the Newsletter

5 Page 5 Live Large and Think Big in Texas May 4-8, 2008: ASPAN 27 th National Conference Preview Perhaps by now, you have browsed through the 2008 ASPAN National Conference brochure trying to decide which educational sessions to attend. Conference offers many interesting topics and excellent speakers, so choosing may not be easy! With the many options available, you could earn contact hours during Conference week. In addition to the regular education sessions, contact hours are awarded for participating in the Research Poster Grand Rounds on Tuesday and Celebrate Successful Practices on Wednesday. Several of your peers participated in a Speaker Development Workshop at the 2007 National Conference. After formulating, researching and developing an educational presentation, these colleagues have honed their presentation skills and will offer the topics during Conference. Please support them by attending these presentations and earn some additional contact hours. Seating during the sessions is limited, so come early. Welcome First Time Attendees: The sheer size of National Conference can be a little overwhelming for newcomers. If this will be your first ASPAN Conference, plan to attend one of the two First Timers Orientation sessions. The orientation sessions will help you navigate the syllabus and pocket guide, explain the evaluation forms, preview the social activities and provide an opportunity to meet the ASPAN Regional Directors, who can answer your questions about Conference and ASPAN. If you are interested in sharing a hotel room, information is provided in the brochure to help you find a roommate. Monday, May 5 is CPAN/CAPA Day: All certified nurses are invited to register to attend the CPAN/CAPA Celebration Breakfast held bright and early on Monday morning. Besides offering the certification examinations on Sunday, May 4, ABPANC will present several sessions throughout Conference to help you certify, re-certify, promote certification, and participate in item writing for potential future exam questions. Plan for Some Fun: Your conference brochure includes an Optional Tour booklet. See the many sights of the Dallas/ Fort Worth area and let someone else do the driving! Register for a tour showcasing area museums and attractions, shopping venues and historic sites. The roadside highways will be resplendent with spring wildflowers such as Bluebonnets, Indian Blankets and Brown-Eyed Susans, making the drive to the world renowned wild life conservancy, Fossil Rim, a special treat. ASPAN s National Conference Strategic Work Team has worked hard to bring you an outstanding 2008 National Conference. Our plans for the education sessions, special social events and optional tours are as big as Texas, and we are eager to welcome you to our home state. So come on down, y all, and stay a spell! By: Susan McDonald, RN, CPAN, CAPA 2008 National Conference Strategic Work Team Coordinator Winter Board Meeting ISPAN Board of Directors will meet January 26th, 2008 in Cedar Rapids at the home of Vice President, Marsh Sabotta. ISPAN President, Beth Brown will chair the meeting. The meeting will begin at 8:00 am, barring inclement weather. All ISPAN members are welcome to attend. Call any board member for additional information. Items up for discussion include : PANAW planning Job Description Review National Conference Fall ISPAN Conference Update ISPAN Strategic Planning Membership Budget Review Spring Board meeting date Please plan on joining us. We welcome and value your input and suggestions. See the calendar for the date of our Spring meeting, too!

6 Page 6 Vol. 21 (1) Methemoglobinemia: Are you ready for it? With more and more intubation and endoscopy procedures being done with the assistance of topical numbing sprays, it is not unforeseen that you may encounter an occurrence of methemoglobinemia. This condition can present as a result of a genetic trait or following the use of certain chemical agents. The most common triggering agents are Dapsone (avlosulfon, an antibacterial taken for skin conditions) and benzocaine (1). Although these are the most common, there are links to many oxidizing pharmaceutical agents, including OTC throat lozenges, most local anesthetics, and nitrates (2,3). Methemoglobin is a form of hemoglobin that is incapable of carrying oxygen, leading to a functional anemia and hypoxia. Normal levels of methemoglobin are 1%. The cited incidence of methemoglobinemia varies from cases per 1000, but has been thought to be underreported (4). A common thread in many of the adverse events reported has been multiple or prolonged sprays of benzocaine to mucous membranes. Package directions suggest, but are vague, that the spray should not exceed one second. To this end, some pharmaceutical companies are now packaging topical sprays in metered-dose containers (5). Staff in a procedure-based area should become familiar with the signs of methemoglobinemia. Signs and symptoms advance as the methemoglobin levels rise: 10-20% - mild cyanosis 20-50% - patient dusky, may develop headache, fatigue, tachycardia, weakness, dyspnea, palpitation and/or chest discomfort, blood that appears chocolate in color in lab tubes 50-70% - acidosis, dysrhythmia, coma, hypoxia, and seizures 70+% - fatality (6). Treatment options include oxygen and IV methylene blue, as it converts heme- to the oxygen-carrying form. Doses greater than 7 mg/kg can exacerbate the methemoglobinemia. Inform your patient that the methylene is excreted unchanged, so urine will be blue-green temporarily. Methylene blue is not recommended for the genetic form of the condition, and these patients will need treatment with exchange transfusions and hyperbaric oxygen. Staff involved with benzocaine sprays should become familiar with the signs, symptoms and possible adverse events as treatment is easy and effective if recognized early. References 1. Zosel, A., Rychter, K., & Leikin, J.B. (2007). Dapsone-induced methemoglobinemia: Case report and literature review. American Journal of Therapeutics, 14(6), Grey, T.A. (2004). A PACU crisis: A case study on the development and management of methemoglobinemia. Journal of PeriAnesthesia Nursing, 19(4), Lavergne, S., Darmon, M., Levy, V. & Azoulay, E. (2006). Methemobinglobinuria and acute hemolysis after tetracaine lozenge use. Journal of Critical Care, 21, Kane, G.C., Hoehn, S.M., Behrenbeck, T.R., & Mulvagh, S.L. (2007). Benzocaine-induced methemoglobinemia based on the Mayo Clinic experience from transesophageal echocardiograms. Archives of Internal Medicine, 167(18), Paparella, S. (2005). Topical anesthetic sprays directly associated with a serious, sometimes fatal adverse drug reaction: Methemoglobinemia. Journal of Emergency Nursing, 31(5), Wesley, C. (2006). Responding to methemoglobinemia after bronchoscopy. Nursing2006, 36(12), 64cc1-2. Sandra Gardner, RN, MS, MSN, CPAN Staff Nurse DDC Allen Hospital PANAW Week February 4-10, 2008 ASPAN Press Release The efforts of the nation's more than 55,000 perianesthesia nurses will be recognized February 4-10, PeriAnesthesia Nurse Awareness Week (PANAW) is celebrated annually during the first week of February. This year s theme is Advocacy Perianesthesia Nurses: Be the Voice, and the American Society of PeriAnesthesia Nurses (ASPAN), in conjunction with its 40 chartered Components, will acknowledge the tremendous work that perianesthesia nurses do throughout the year. During PANAW, perianesthesia nurses in hospitals, clinics, and ambulatory surgery centers across the country are encouraged to wear and display official PANAW items to increase the public's awareness of this unique specialty nursing practice. &ASPAN, through its 40 chartered Components, advances nursing practice through education, research and standards. This is done in part by developing standards, providing education, encouraging specialization, and promoting public awareness. The American Society of PeriAnesthesia Nurses is the international professional specialty organization representing the interest of over 55,000 nurses practicing in preanesthesia and postanesthesia care, ambulatory surgery, pain management and special procedure areas.

7 Page 7 Membership Governmental Affairs Join your voice with all of ASPAN! Become an advocate for our patients, our practice, and our profession. Together we will be an influential force for perianesthesia patient safety, public policy, and practice standards. Encourage a colleague to join ASPAN today. Our patients, our practice, and our profession need your voice. ASPAN will provide you direction to become the voice and advocate for all facets of perianesthesia nursing. Joining is easy and can be done online at the ASPAN website: and clicking the Membership tab. Marsha Sabotta and I attended one of Lt. Governor Patty Judge s town hall meetings in August. The Commission on Wellness and Healthy Living made recommendations to put Iowa on the forefront of healthy living. Governor Culver and Lt. Governor Judge have developed "Five Steps toward a Healthy Iowa"- Step One: Remove Unhealthy Food in Schools Step Two: Improve the Health of Iowa's Children Step Three: Encourage More Iowans to Quit Smoking Step Four: Encourage Physical Activity for Seniors Step Five: Promote Prevention Efforts Amongst Iowans Wellness in Iowa can be found at: Retrieved 12/31/07 from: Committee Corner Helen Riedesel, Governmental Affairs Representative Our Financial Snapshot! Checking CEU and Contact Hour Opportunities March 29, Perianesthesia Nursing Conference, Iowa City May 4-8, th National ASPAN Conference, Dallas/Ft. Worth, Texas Savings 10, JOPAN Articles ASPAN Seminars C.D. (2) 8, Finance Total Assets 19, Thank you to Linda Armstrong, ISPAN Treasurer, for providing this information to our members each quarter Important note: ASPAN calculates each contact hour as 60 minutes while the Iowa Board of Nursing calculates each contact hour as 50 minutes. Please be aware of this difference as you submit your totaled contact hours obtained for both your nursing license and CPAN/CAPA certification/recertification. Education

8 Page 8 BOD Minute Highlights Come on down to Texas! Quorum present. Minutes from the July 07 meeting distributed. Reviewed and approved. Treasurer s report submitted dated July 2007-Oct Tax exempt (non-profit) form signed and submitted. Newsletter deadlines as follows: Spring -April 29, Congratulations to Donna Dolezal RN; recipient of ASPAN MSN scholarship and Amy Shinneman BSN, RN; recipient of ASPAN certification scholarship. Governmental Affairs: Iowa Nurses Assoc. Legislative and Policy Day is February 21, 2008, Des Moines. Proclamation for PANAW week will be submitted to the Governor s office for signature. Helen Riedesel and Marsha Sabotta attended the ASPAN leadership conference September 7-9, 2007 in Albuquerque, New Mexico. Report given Leadership conference scheduled for September 5-7; location TBA. Fall Conference reports: 54 pre-registered attendees. ASPAN/ISPAN display board updated. Vendor/Registration packets completed. Black Hawk county food bank is designated charity. Beth Brown to introduce speaker Nancy Strzyzewske. Fall business meeting to include election of officers. Door prizes will be distributed. New Business: Jean Borzwell and Marlene Youngberg (from Red Oak, IA) will attend the 2007 ISPAN Fall Conference with the certificates they won at the 2006 ISPAN Fall Conference. ISPAN membership list with credentials/degrees will be updated by Helen Riedesel. Member gifts to be ordered for PANAW week. Communications from Region II Director & ASPAN President discussed. Region II strategic plan updated (09/07); copy highlights available. Questionnaire to be distributed at conference: RN transport (or not) of patients with epidural catheters Cell phone use by caregivers in OR/PACU information from Twilla Shrout: CDI had over 100 attendees. Pam Windle compiling data on Fatigue in the Workplace. ASPAN council on surgical and periop safety is working on position statement on workplace violence and alarms. Core curriculum due for review Lois Schick and Pam Windle are editing. Beth Brown requested and received The state of post op pain management-a need for improvement document. Will plan to report on at a later date. Gold Leaf application packet to be reviewed in January for possible application. Next meeting: January 2008, time and location TBD. Meeting Respectfully submitted, Deb Mueller RN CPAN October 19, 2007 It may be a little early, but we want to invite you all down, May 4-8, 2008 for a little Texas hospitality! The 2008 ASPAN National Conference will be held at the Gaylord Texan in Grapevine, Texas Grapevine is located smack dab in the middle of the Metroplex, which is the area encompassing Dallas and Ft. Worth There are literally hundreds of things to do and see in these surrounding cities so it would be a great place to bring the entire family for some well needed R&R! The Gaylord Texan is a phenomenal hotel that is built in a similar style to the Gaylord Palms where our 2006 Conference was held. However, it has some great Texas flair. It houses six different full service eateries as well as an ice cream shop for the kiddies (or those of us who still think we are) and a lovely coffee and pastry shop. The hotel also boasts a new wine bar that has an Enomatic system. This works as a kind of wine vending machine that allows you to sample up to 48 different, expensive wines that are normally not sold by the glass. What a fun place to relax with your colleagues! The Metroplex has so many amazing activities that the entire family can enjoy. The hotel offers shuttle service to the Grapevine Mills mall with movie theaters and skate boarding park as well as Grapevine Main Street that has lots of little eclectic shops, tea houses and eateries. The Bass Pro shop is one of the largest sporting good stores around so you or your favorite outdoor enthusiast could get lost there for hours. Also, close by is the Ft. Worth Stockyards. Twice a day, the Stockyards have a simulated cattle drive so you can watch the longhorn cattle amble by while shopping for beautiful western jewelry and decor. However, if you prefer the Dallas area, you could visit the original Neiman Marcus or tour the Sixth Floor museum and Grassy Knoll. If all that doesn't entice you to come on down to Texas, don't forget that the ASPAN National conference is a great place to learn and network with perianesthesia nurses from all over the country. We are honored to host you and look forward to putting on a conference you could really yee-ha over! Ya'll come on down now, ya hear? By Lori Sanders, ASPAN National Conference Strategic Work Team

9 Page 9 Member Spotlight: UIHC Ambulatory Surgery Center Iowa City The new University of Iowa Hospitals and Clinics Ambulatory Surgery Center opened on Monday, March 26, 2007 under the direction of Douglas Merrill, MD. The 44,000-square-foot facility on the fourth level of the Pomerantz Family Pavilion is Iowa City's first full service, multispecialty surgery center. It offers unmatched surgical expertise for this region, where surgeons, who are part of nationally ranked clinical departments, bring their skill to bear on everything from ear tubes to gallbladder removal and hernia repair. Our pre/post nursing staff proudly brings over 150 years of perianesthesia experience to the new unit. The layout is much more spacious than our old one and affords the patients and their families much more privacy and comfort. The ASC also has its own pharmacy, which is a great convenience. We are currently running six operating rooms, with two more slated to open in the near future. There are 29 private pre/post rooms where patients are prepared for, and recover from, their anesthetic/procedure. The nurses station dedicated to orthopaedics is specially equipped for patient monitoring during administration of regional anesthesia. Along with orthopaedics, our patient population includes dermatology, general surgery, gynecology, ophthalmology, otolaryngology and urology services. Happily, our utilization numbers continue to increase monthly. ASC Medical Director, Dr. Doug Merrill reports that the Society for Ambulatory Anesthesia ( has created the SCOR database (SAMBA Clinical Outcomes Registry). This is a web-based database intended to allow ambulatory surgery centers and offices to input their patient data on a daily basis, tracking outcomes in hopes of discovering best practices on a national and local basis. The database will accumulate information about patient co-morbidities and on-site interventions (anesthetic techniques, surgery types, etc.) and will look at how various centers compare with regard to the resulting outcomes. Over the course of time, this will allow individual ASC units and the ambulatory surgery community to determine what techniques work best for which patients. The University of Iowa, NYU at Stoneybrook, and the Cleveland Clinic are currently serving as beta testing institutions to work out the bugs in the system. This stage should be completed by February and a larger group of ASCs, including private centers, will be the next test sites. The online registry will then hopefully be available for participation by all interested sites by the fourth quarter of For more information, check out the web site at: A special thank you to BJ Wagner, RN, BSN, CPAN, CAPA for submitting this member profile. We hope to be spotlighting other member s facilities in the future. Please let the editor know if you are interested in submitting. We re All Ears... The Board wants to be of the most service that we can be to you, the members. The only way we can continue to bring you the information you want is for you to voice your needs and requests. The names and addresses of all the Board members are listed in every newsletter (page 2 of this issue) and we are more than eager to answer any questions, consider any suggestions and comments, or correct any errors that you note for us. Awakening News is published three times a year in the Winter, Spring/Summer, and Fall. Contributions and submissions for publication are always welcome. We also encourage members to submit announcements or notices of interest to Perianesthesia nurses. Deadlines for each upcoming issue is listed in the calendar of events. Submissions can be either in computer or written format. Please contact: Sandy Gardner, Editor, to make a submission or if you have any additional questions.

10 Page 10 The State of Postoperative Pain Management: A Need For Improvement In the year 2000, JCAHO included pain as the fifth vital sign and formulated standards to make pain assessment and management a priority. Advances in analgesics, improvement in medication delivery systems and the development of pain management services have evolved in response to this initiative. However, pain continues to present major challenges to the perianesthesia nurse in the postoperative setting whose patient is more knowledgeable about options for improved pain control. ASPAN, in collaboration with Ortho-McNeil, Inc. recently gathered experts in the field of pain management to address the gap in postoperative pain care. The report provides insight into the current state of postoperative pain management, both in the under management as well as the overly aggressive and unsafe methods of pain control. This report is a national Call to Action to renew efforts to improve the pain experience for our patients. It contains a 10-step action plan that would deter from unsafe or inappropriate medication use. The platform includes the following actions: 1. Elevate postoperative pain management as a priority concern. 2. Expand efforts to educate surgical patients about their rights to effective pain management. 3. Pass the National Pain Care Policy Act of 2007 during the 110 th session of Congress. 4. Double the federal budget for research on pain management. 5. Increase the visibility for pain research both within the NIH research community and with pain advocacy organizations and patient groups. 6. Create the means to share information about best practices in postoperative management. 7. Eliminate the barriers to more effective postoperative pain management for the medically underserved. 8. Develop a curriculum on pain management for the use in medical schools and allied health-care institutions. 9. Immediately implement and increase the funding for professional training on postoperative pain management. 10. Move toward a less invasive, more cost-effective system for delivering acute postoperative pain management in the hospital setting. The report also identifies trends that may influence pain management in the future. Copies of this document are available on the ASPAN website or can be obtained through the ASPAN National Office at 10 Melrose Avenue, Suite 110 Cherry Hill, NJ We Asked, You Responded - Fall Survey Results Beth Brown As ISPAN President, I have recently received numerous communications from ASPAN leadership regarding growing concerns about inappropriate use of electronic communication devices within the patient care areas and RN transport of the patient from the PACU. I distributed a questionnaire at the ISPAN Fall Conference in October to elicit responses from attendees, seeking input to give to Twilla Shrout, Region II Director, that would be somewhat reflective of what s happening in the State of Iowa. Twenty-six responses were returned. To read the entire survey results and comments, please contact me or Sandy Gardner, Newsletter Editor. Is there a concern at your facility about the use of cell phones, lap tops in the OR or at the patient bedside in PACU by anesthesia personnel/surgeon for personal business (such as shopping, buying and selling stock, etc.)? YES 5 NO-17 N/A or UNCERTAIN-4 Is there a policy in place that would prohibit this activity? YES - 2 NO or UNCERTAIN (were not aware of the existence of a policy) - 24 Does an RN transport the patient to the nursing unit after PACU? To the general nursing unit: YES-16 NO-9 Inconclusive-1 To ICU/Telemetry Units: YES-24 NO-1 Inconclusive-1 Does an RN transport patients with epidural catheter in place? (23 total responses) YES - 16 NO-7

11 Page 11 Perianesthesia Events Calendar PANAW 2008 February 4-10, 2008 INA Iowa Nurses Association Legislative & Policy Day ISPAN Spring Board Meeting 2008 Perianesthesia Conference Iowa City 15 th National Evidence Based Practice Conference - Reflections on the Past, Directions for the Future: Implications for Research and Clinical Practice 27th ASPAN National Conference February 21, 2008 Embassy Suites Hotel, Des Moines State Capitol March 28, 2008, Pre-Iowa City Conference Meeting Time/Location: TBA (contact any board member as date approaches) March 29, 2008 Iowa City April 24&25, 2008 Iowa City May 4-8, 2008 Dallas/Ft. Worth, TX, Summer Edition Submission Deadline June 30, 2008 ISPAN Fall Conference 2008 October 20, 2007, Registration begins at 7:30 am Dubuque, IA ASPAN Willingness to Serve ( ) Forms Due October 31st, 2008 Certification Review for PeriAnesthesia Nursing, 2nd Edition By American Society of PeriAnesthesia Nurses, Barbara Putrycus and Jacqueline Ross An ideal way to prepare for CPAN and CAPA certification examinations! This unique review book offers more than 600 questions, with answers and rationales. The text incorporates the nursing process as an organizational framework and covers all of the essential information in the field. It also offers patient-focused scenarios that illustrate critical-thinking approaches. This outstanding review is cross-referenced to the ASPAN Core Curriculum Exam Dates May 4th, 2008 November 1, 2008 Application Deadline 03/04/ /02/2008 Late Application Postmark Deadline (with addl. fees) 03/11/ /08/2008 For more information visit: or write ABPANC at 475 Riverside Dr, 6th Floor, New York, NY, Phone: ABPANC or Fax: Information retrieved from:

12 ISPAN Iowa Society of PeriAnesthesia Nurses Sandra Gardner - Editor 139 Alta Vista Avenue Waterloo, IA Participate! My 2 Worth Notes from the Editor By the time you get this, the politicians will have pulled up stakes and moved to the next primary/caucus state and our phones will be eerily quiet during the evening. No matter how much the mailings, phone calls and knocks on my door interrupt my life, I always try and remind myself how wonderful it is that we have the chance to meet any-and-all candidates and make up our own minds when the time comes to vote. Recent events in both Pakistan and Kenya remind me how much is at stake if we take our democratic system for granted. Our politicians move freely amongst us and we are repeatedly invited to ask questions and be heard. Please do not take that privilege lightly. When it come time, vote. Vote in the caucuses, in the primaries, in the final election. As a group, nurses have a background in many of the issues that are coming to the forefront of the platforms that the parties are developing. Healthcare, women s and children s issues, workplace issues, insurance, minimum wage, education the list could go on. Don t underestimate your political muscle when it comes time to voting. Don t tune it out because it interrupts your favorite TV show or what you are doing at the moment. There is so much more at stake as identified by Rains and Carroll (2000), There has never been a greater need for nurses to get involved in the political and policy process. Nurses are needed to ensure that shrinking resources are best used for the health of the nation, to find ways to provide affordable access to health care for all and to promote the debate about the relationship between broad social factors and health So, when the time comes, read the literature, find out the views of your candidate, and put them on the spot if necessary. Make it your business to know who you are voting for and what they stand for. It s YOU they represent when they move to Washington. Make them remember that! Well, that s my 2 cents-worth. Sandra Gardner, Editor Rains, J. W., & Carroll, K. L. (2000). Journal of Nursing Education, Vol. 39, No.1,