July 2016 The Wisconsin Nurse Page 1

that identified some of Wisconsin’s health care systems that use team-based care to manage patients with hypertension and diabetes. We are also promoting the latest evidence-based practice methods for measuring blood pressure. You can find more about our campaign, “Beyond the 50%,” in this edition.

Please don’t forget to mark your calendars for WNA’s Membership Assembly scheduled for October 20–22, 2016 at the Madison Marriott West. You can find more information about the educational offerings, the annual meeting, and Awards Brunch in the “WNA 2016 Membership Assembly Update.”

I do hope that you can take time to get away for a little rest & relaxation over these next few months. You owe it to yourself. Happy reading!

current resident or

Non-Profit Org.U.S. Postage Paid

Princeton, MNPermit No. 14

VOLUME 2 NUMBER 3JULY 2016

The Official Publication of the Nurses Foundation of Wisconsin, in cooperation withthe Wisconsin Nurses Association. Delivered to you courtesy of the WNA membership.

Executive Director’s Report

Gina Dennik-Champion, MSN, RN, MSHA

Welcome to this edition of WNA’s The Wisconsin Nurse. It has been a busy three months since my last update. I hope you will take time to read about our activities and see how WNA has been visible in the policy, practice, and education arena …feel proud you are a member of WNA!

I would like to call your attention to some very important news …

In April, WNA’s Continuing Education Approval Program (WNA CEAP) received Accreditation with Distinction from the American Nurses Credentialing Center (ANCC). WNA CEAP has held accredited status since the program’s inception in 1975, and we are pleased to receive this honor. We owe many thanks to the WNA CEAP Committee, WNA Education Consultant/WNA CEAP Nurse Peer Review Leader, Mary Kay S. Scheller, and Megan Leadholm, WNA Associate Director.

Beginning September 1, WNA will have a new home. We are moving to an office building on

Walton Commons, approximately three miles from our current location, which is handicapped-accessible and equipped with a spacious conference room and ample parking close to the building. Our suite is on the first floor and has four offices with a large open area as you enter. The task right now is selecting paint colors and flooring so the space is ready to go at the end of the summer. I think you will be pleased with our new location, and we look forward to welcoming you!

Our work continues on the CDC Chronic Disease and Prevention Grant awarded to us by the Division of Health Services Division of Public Health. Our deliverable for this grant year was due June 30, 2016. We have completed our conceptual model: Patient-Centered Team-Based Care for Wisconsin, and we will be reporting on a survey

WNA’s Education, Research, Practice, and Quality Council (Tri-Council) developed a revised position statement regarding Palliative and End-of-Life Care. This work was part of the WNA Position Statement clean-up process that was assigned to the various WNA Councils. The previous position statement was developed in 2003. The members of the Tri-Council conducted a review of the literature and current best-practices related to nurse’s role in the delivery of palliative and end-of-life care. One

issue that was not addressed in 2003 but included in this statement is the recognition and support for a formal approach to advanced care planning.

The Position Statement has served as the impetus in offering a one-day conference entitled, The Nurses Role in Palliative and End-of-Life Care Across the Lifespan which is being planned by WNA’s Tri-Council. The purpose of the conference will address the national and state trends, legal and ethical considerations, best care practices,

and opportunity for table discussion reflecting on the day. The conference will be part of WNA’s Membership Assembly which is scheduled for Thursday, October 20, 2016 in Madison, WI. Please save the date.

The members of the 2016 WNA Tri-Council are as follows: Olivia Schroeder, Chair, Cathy Andrews, Jill Krell, Sue Rees, Stephanie Wanek, and Linda Wlodyga.

The position statement can be found on page 3.

WNA Position Statement on Palliative Care and End-of-Life Care in Wisconsin Approved by the Board of Directors

Mary Kay S. Scheller with the ANCC Accreditation with Distinction plaque.

Wisconsin Nurses Association Updates:Highlights from the WNA Board of Directors March 25, 2016 Meeting. . . . . . . . . . . 2Position Statement Palliative Care and End-of-Life Care in Wisconsin . . . . . . . . . . . . . . 3WNA Membership Assembly 2016 Update. . . . . 6WNA Awards Call for Nominations . . . . . . . . . . . 7WNA Working for You - May 2016 . . . . . . . . . . . . 8WNA Legislative and Regulatory Update . . . . . 12

Mutual Interest Groups (MIGs) Updates:WNA APRN Forum Pharmacology & Clinical Update . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Wisconsin Environmental Health Nurses Coalition (WEHNC) . . . . . . . . . . . . . . . . . . . . . . . . 14Prenatal Environment Health Assessment- Wisconsin Environmental Health Network . . . 15Nurses Foundation of Wisconsin . . . . . . . . . . . .18Membership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Page 2 The Wisconsin Nurse July 2016

THEWISCONSINNURSE

WISCONSIN NURSES ASSOCIATION2016 BOARD OF DIRECTORS

Linda Gobis, PresidentElizabeth Markham, Vice President

Cathy Berry, Treasurer Yvette Egan, Secretary

Suzanne Marnocha, Director-at-LargeTiffany Barta, Director-at-Large

Nicole Faulkner, Director-at-LargeAlex Hetzer, Staff Nurse Representative

Deborah Schwallie, APRN Representative

WISCONSIN NURSES ASSOCIATION STAFFGina Dennik-Champion, Executive Director

Megan Leadholm, Associate Director Brianna Neiderman, Communications and

Membership DirectorTeresa Prattke, Education Program Coordinator

Janine Elliott, Office Coordinator

NURSES FOUNDATION OF WISCONSIN BOARD OF DIRECTORS

SueAnne TeStrake, PresidentPamela Macari Sanberg, Treasurer

Alex Hetzer, WNA Board RepresentativeKristin Haglund, Vice President

Anna Rosen, Secretary Isabelle Garibaldi, Director-at-LargeMalori Hinchen, Director-at-LargeRorey Pritchard, Director-at-LargeTracey Soyring, Director-at-Large

THE WISCONSIN NURSE EDITORIAL STAFFSueAnne TeStrake, Executive Editor

Gina Dennik-Champion, Deputy Executive Editor

Brianna Neiderman, Managing Editor

CONTACT INFORMATIONWisconsin Nurses Association /

Nurses Foundation of Wisconsin6117 Monona Drive, Suite 1

Madison, WI 53716 info@wisconsinnurses.org –

www.wisconsinnurses.org - @wisconsinnursesAmerican Nurses Association

8515 Georgia Avenue, Suite 400 Silver Spring, MD 20910-3492

memberinfo@ana.org - www.nursingworld.org

The Wisconsin Nurse is published quarterly every January, April, July and October by the Arthur L. Davis Publishing Agency, Inc. Subscriber rates are available, 608-221-0383.

For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., 517 Washington Street, PO Box 216, Cedar Falls, Iowa 50613. (800) 626-4081, sales@aldpub.com.

NFW and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement.

Acceptance of advertising does not imply endorsement or approval by the Nurses Foundation of Wisconsin of the products advertised, the advertisers or the claims made. Rejection of an advertisement does not imply that a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. NFW and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of advertisers’ products. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of WNA, or those of the American Nurses Association.

Wisconsin NursesAssociation Updates

The WNA Board of Directors met on Thursday evening March 24, 2016 and Friday March 25, 2016 at the WNA Office.

The highlights of the meeting are as follows:1. ANA Marketing Consultant, Ricki Garrett, met

with the Board on Thursday evening and Friday morning to assist in the development of a Board of Directors-driven membership growth plan. The plan approved by the Board contains the following goals:• Engage Wisconsin Deans and Directors

from Schools of Nursing in identifying and actively supporting, through membership, the impact WNA has on political advocacy and professional development of nurses pre and post-RN licensure.

• WNA’s visibility will increase through theinvolvement of member recruitment of non-members.

• WNA’s purpose and goals will be visiblethroughout Wisconsin and will increase membership.

The WNA Board is very appreciative of ANA’s support and continued guidance as we continue to surpass our membership goals.

2. Approved the appointment of following WNA members to serve on the WNA Awards Committee:

Christina Vik, OnalaskaAnn Wieben, MadisonBrenda Owen, TomahMary Ellen Wurzbach, OshkoshJudith F. Warmuth, MadisonElizabeth Fayram, Cross PlainsAnthony Hermann, LodiAmy Franch, DePereAmanda Rowe, Fitchburg

3. Accepted the report and recommendations submitted by the WNA Finance Committee regarding 2015 Fiscal Year End, and recommendations to adopt the WNA Operating Budget for fiscal year 2016.

4. Approved WNA’s Tri-Council Position Statement on Palliative and End-of-Life Care with suggested edits. You can view the Position Statement on the next page.

5. Referred the application to form a Mutual Interest Group to the appropriate WNA structure, Committee on Appointments, for review and recommendation to the Board.

Highlights from the WNA Board of Directors March 25, 2016 Meeting

Published by:Arthur L. Davis

Publishing Agency, Inc.

www.wisconsinnurses.org

Ricki Garrett, ANA Marketing Consultant

We celebrate National Nurses week–May 6-12. President Reagan signed the first official Nurses Day, May 6th, in 1982, and in 1993 it became a permanent full week celebration. The end of the week celebration coincides with the anniversary of Florence Nightingales’ birthday. We mention this event because it should be recognized not only by nurses, but by everyone across the country. We all have had our paths intersected by nurses at some point in our lives, whether it was on a trip to the hospital, during the birth of a new sibling, or an old friend who became a nurse. There are 100,000 nurses in the state of Wisconsin alone, and in this 3rd edition of “The Wisconsin Nurse,” we would like to thank each and every one of them for their hard work and dedication to nursing. We hope you were able to celebrate your profession during the national week of recognition, whether through your employer, your colleagues, family, or friends. What you do and how you do it does make a difference in the health and wellness of Wisconsin residents. THANK YOU!

SueAnne TeStrake, MSN, RNPresident Nurses Foundation of Wisconsin

How Can You Help WhenDisaster Strikes?

Put Your Skills to work for Wisconsin!

Learn more and sign up at the Wisconsin Emergency Assistance Volunteer Registry (WEAVR)

https://weavrwi.org/

September iS preparedneSS monthRegister on WEAVR for a more prepared Wisconsin.

July 2016 The Wisconsin Nurse Page 3

Wisconsin Nurses Association Updates

Key DefinitionsPalliative Care: Palliative care is specialized

medical care for people with serious illnesses. It focuses on providing clients with relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the client and the family. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment (getpalliativecare.org). Palliative Care is individualized care, set on meeting the unique needs of clients and addressing their specific goals when planning care.

End-of-Life Care: Care that is provided to individuals in the final stages of their life.

Advance Care Planning: A process across time of understanding, reflecting on and discussing future medical decisions, including end-of-life preferences. Advance care planning includes: understanding the health care treatment options, clarifying health care goals, weighing options regarding care and treatment, decision-making regarding the appointment of a health care agent and/or complete an advance directive, communicating wishes and sharing of documents with family, friends, clergy, other advisors, and practitioner and other health care professionals. (Adapted from Honoring Choices Wisconsin)

Position StatementThe quality of care provided is of utmost

concern to nurses individually and the nursing profession collectively. Nurses in all practice settings and roles are faced with quandaries about the provision of humane and dignified care whether at the end-of-life stages or during curative treatment that may require additional interventions to ensure comfort is maintained. Throughout the decades, nurses have been the mainstay of care for the seriously ill persons and their families and have played a vital role in advocating for responsible, competent, compassionate, appropriate and ethically sound care in congruence with the 2015 American Nurses Association Code of Ethics.

Nurses should be adequately prepared to provide competent and compassionate care and

improve the lives of clients and their families. Nursing has a unique opportunity to increase the competencies necessary for meaningful conversations regarding end-of-life decisions and palliative care advocacy. These competencies include creating a culture that goes beyond the institution and into the communities, increasing the awareness regarding advanced care planning that begins with conversations with interprofessional team members (i.e. nurses, physicians, social workers, pastoral care, etc.). In addition, nurses can refer to the ANA position statement “Nursing Care and Do-Not-Resuscitate (DNR) and Allow Natural Death (AND) Decisions (2012) to guide practice and actions for clinical nurses, nurse administrators, nurse educators and nurse researchers, as well as the ANA’s Hospice and Palliative Nursing Scope and Standards of Practice.

The Wisconsin Nurses Association (WNA): I. Supports the education of nurses and

other health care professionals to increase competencies in initiating and participating in meaningful conversations regarding end-of-life choices.

II. Supports the education of nurses and other health care professionals to increase competencies in initiating and participating in meaningful conversations regarding palliative care that focuses on the unique needs of clients, including respecting patient autonomy.

III. Supports the ongoing efforts of nursing organizations to further develop:a) Educational programs (including

interprofessional education)b) Professional partnerships c) Policies d) Standardized guidelinese) Research and quality improvement projects

utilizing evidence-based practicesf) Clinical resources

IV. In congruence with the ANA Position Statement on Euthanasia, Assisted Suicide and Aid in Dying (2013), nurses’ participation in

assisted suicide is a violation of the Code of Ethics for Nurses.

V. Supports continued efforts toward enhancing and enriching the health care system in Wisconsin that offers all persons when they are seriously ill services that meet the individual needs of the person and family, health plans that cover such care, and providers who are well-educated in palliative care and end-of-life care.

References:getpalliativecare.org. (n.d.). Retrieved from https://

getpalliativecare.org/whatis/ Wisconsin Medical Society. (2013). Honoring Choices

Wisconsin: An Initiative of the Wisconsin Medical Society. Glossary and Style Guide. Retrieved from https://www.wisconsinmedicalsociety.org/_WMS/professionalism/hcw/2013/Glossary_and_Style_Guide_FINAL_031513.pdf

Center for Disease Control. (n.d.). Retrieved, from http://www.cdc.gov/aging/advancecareplanning/index.htm

American Nurses Association Code of Ethics for Nurses with Interpretive Statements, 2015. Retrieved from http://www.nursingworld.org / M ain M enu C ategor ies / E thic sSt andards /CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html

American Nurses Association. (2012). Position Statement: Nursing Care and Do-Not-Resuscitate (DNR) and Allow Natural Death (AND) Decisions. Retrieved from http://nursingworld.org/dnrposition

American Nurses Association. (2013). Position Statement: Euthanasia, Assisted Suicide and Aid in Dying. Retrieved from http://nursingworld.org/euthanasiaandseriouslyill

Kass-Bartelmes,B., Hughes,R.& Rutherford, MK. Advance care planning: preferences for care at the end of life. Rockville (MD): Agency for Healthcare Research and Quality, 2003. Research in Action Issue #12. AHRQ Pub No. 03-0018.

Respectingchoices.org. (n.d.). Retrieved from http://www.gundersenhealth.org/respecting-choices

Position Statement Palliative Care and End-of-Life Care in Wisconsin

Page 4 The Wisconsin Nurse July 2016

Governor Scott Walker Signs Specialty

License Plate for Nurse Scholarships into Law

Governor Scott Walker signed 56 bills into law on March 30, 2016 at the Wisconsin State Capitol in Madison. One of which was Assembly Bill 702, a bill that WNA has fought hard for at the capitol. It was signed into law as Wisconsin Act 328.

The law allows for the issuing a specialty license plate for nurses. The proceeds from the license plate will go to a fund called the Wisconsin Nurses’ Education Fund that will be established by the Wisconsin Organization of Nurse Executives. The distribution of funds would be determined by an Advisory Council of the Nurses’ Education Fund comprised of several Nursing Organizations, one of whom will be the Wisconsin Nurses Association.

The Wisconsin Nurses’ Education Fund will create a new funding source for education of Wisconsin nurses, recognize the contribution that Wisconsin nurses make to their communities, and expand awareness of the nursing profession as a career option.

The anticipated cost of the plate is $40.00; there will be a $15.00 issuance fee and $25.00 annual donation to the Wisconsin Nurses Education Fund.

WNA was an active supporter of this legislation through direct communication with legislators and providing testimony to both the Senate and Assembly Committees on Transportation. Copies of the testimony can be found on WNA’s website.

WNA wishes to thank all of our members who contacted their legislator asking for support. Your voice made a difference!

To view Wisconsin Act 328 please go to: docs.legis.wisconsin.gov/document/acts/2015/328.

Wisconsin Nurses Association Updates

Adriana AddisonBarbara AgenJenta AlexanderMariam AliIrina AnKerry AndersonSonya AndersonShannon AngellSari ArcherJill ArnoldAngela ArntzJulie AstrellaTracy AvilaLynda BahdeKaren BalkeCarol BallwegElena BalsoverKatie BaumannLaura BehnkeTammy BellMichelle BornickNicole BraunAlayna BraunKatie BredehornSusan BrightGeorgia BrockwayDonna BroeskeBrittney BuegeTess BurantKristi BurdickMary BurkeRachael Cabral GuevaraTammy CamposKaty CasselColleen ChalgrenStacey ChmielLyndsey ChristensonKatrina ClarkJohn ConcepcionLaura CookDenise Costello-KazikLaura CraigKelly CrumJamie DagostinoJanet DeCoopmanTera DenkLiana DietrichMarcia DobrickJenny DraegerErin DunhamTeresa EdgrenJodie EischJean ErdmanKasandra FlaschLinda FogliaDeborah Frasher

Laura FrazierAmy GanshertMolly GardAndrea GladJulie GliszinskiJennifer GoetschAharon GoodwinCally GorskiJody GraeseSarah GrayMelanie GrayLisa GreenPaige GregarStacey GusmanKeslie HackbarthAudra HaleCarey HalversonJenni HamannBeth HammerKimberly HandDebbie HansenDorrie HansenMeredith HardingEvelyn HarrisAngela HassTaylor HeilRachel HenrichsEmily HerzogKaren HietpasJennifer HoenigNatalie HoffBreanna HollandMelissa HortonVictoria HulbackAmber HussKatie JacobsonKevin JacobyBrenda JarvisCarol JeuckRachel JohnsonVickie JonesDana KatchkaDiane KelleyHolly KempersMarietta KernJody KerzmanAmanda KohlJahoon KooCynthia LarsenSiengthong LassanskeRose LawtonIvy LeasumMichelle LehrJennifer LindnerTeresa LoftsgaardenBreEllen Loughlin

Sarah LowenbergChristine LutzkeElizabeth MaelSarah MagnusonTrudy MaraLisa MartellMegan MathersLinda MathesonMargaret Mc Cabe- SchultzBrooke McCombDionna McFerrinKristin McGuireKatrina McKeeCrisyl McNeirNicole MendollaKelli MeskimenLisa MihlbauerRoberta MontgomeryAddichtra MooreChristine MorganCrystal MorrowLois MummerPamela MyhreTheresa NaultJessica NehringJoanna NellessenLaura NelsonKellie NovakKayla NysethJamie OlafKayla OsterbergLeslie PaceBeth PapeDaniel ParkerKimberly PayetteRichard PetakDonna PetersonAlexandria PollarAndrea PollemaTeresa PulvermacherBonnie PutzKim Rauen-HeidmannAmanda Reda-GoglioElizabeth ReinkeKelly RichardsJulie RichterClair RiveraNicole RobertsAlyssia RoblesStaci RoseColleen RosenbergerNatalie RossMary RossJennifer RouxSarah Roy

Jennafer RuttaLeomarys SantaellaTracy L. Schaetzl, MS, RNBarbara SchellhaassSusan SchleicherBecky SchmidtAlysha ScholzMaureen SchuesslerMarie SchusterAlana SchuttsAndrea SetnikCory SieburgJake SimpsonAshley SkoczynskiJanice SmithTammy SmithAmy StaceyErica SteenTiffany SteffenKristen SteivangDenise StengelKelly StevensChristine StrattonBridget SullivanLaura SwettMegan SyversenRita TenienteFrances TeskieDidia ThompsonAlice ThomsonRebecca TiffaultVirginia TrzebiatowskiLauren TylerNoemi ValentinJamee VanceDeborah Vande ZandeJennifer VernaShannon WagnerDavid WarnerTammy WashingtonAmber WeberCarla WechFonda Maria WeesnerChristine WieseErnise WilliamsSarah WindenDiane WoehlkeBeckysue WolfApril YergesLisa ZaleskiCheryl Zeise-SchmidtDebra ZennerVictoria Zietlow

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For more information, please contact:ManorCare of Pewaukee

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Apply online at jobs.hcr-manorcare.comEOE AA M/F/Vet/Disability

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July 2016 The Wisconsin Nurse Page 5

Wisconsin Nurses Association Updates

The Wisconsin Nurses Association is in its third year of funding to prevent and control hypertension and diabetes from the Wisconsin Department of Health Services and the Centers for Disease Control and Prevention. Of particular interest is the development of a Wisconsin-centric conceptual model for patient-centered team-based care. We need to move from volume-based to value-based care, and team-based care is a critical health care redesign strategy to achieve value-based care.

The WNA has based its work on the definition of patient-centered team-based care originally developed by Naylor, Coburn, and Kurtzman and adopted by the U.S. Institute of Medicine:

“Team-based care is the provision of health services to individuals, families, and/or their

communities by at least two heath providers who work collaboratively with patients and their care givers – to the extent preferred by each patient –

to accomplish shared goals within and across settings to achieve coordinated

high-quality care.”

This working conceptual model is based on science, literature, and evidence. Moreover, it is tempered by the wisdom of collaborating partners in both its development and the review process. The model’s principles and values discussion leans strongly on recent publications from the Institute of Medicine of the National Academies’ Roundtable on Value and Science-Driven Health Care.

The model is strongly patient-centered leading to patient-engagement. It relies on the dynamic interplay of three core elements:

Patient

TeamExpectations

Workforce Diversity

System & Operations

Expectations

Triple Aim of Healthcare TM

Hallmarks of Practice

Core Principles

Patient-Centered Team-Based Care1. Team expectations2. Interprofessional workforce diversity3. Systems and operations expectations

These three core elements are supported and advanced through three external drivers:

1. Core principles2. Hallmarks of Wisconsin practice3. Triple Aim of Health CareTM

Taken together, the three core elements and the three external drivers work harmoniously to support, nurture, guide, and sustain the work of health care teams and the connection of the health system to the community. The elements and drivers are seen as “antecedent conditions” for patient-centered team-based care where processes (published by many sources) inform implementation and improvement. Furthermore, it enables teams to protect and promote patient health and safety; prevent injury and disease; and contribute to healthy people in healthy communities in the places where the people of Wisconsin live, grow, work, learn, and play.

Key messages of the conceptual model are aimed at:

1. Accelerating awareness leading to the adoption of patient-centered team-based care as an important health care redesign strategy in Wisconsin to achieve the dimensions of the Triple Aim of Health Care.TM

2. Providing a fresh look at the principles, practices, components, and dynamics of patient-centered team-based care and the importance of interdisciplinary and interprofessional foundations.

3. Expanding interest in patient-centered team-based care as a redesign strategy to: improve patient safety and health outcomes; reduce/eliminate dissatisfiers in the delivery of care; stimulate payment reform that rewards value-driven over volume-driven care; control health care costs; and improve population health.

4. Sharing a rich set of definitions to inform organizational leaders, professionals, and assistant staff members participating on patient-centered health-care teams.

5. Acknowledging the importance of ongoing dialogue and collaborative leadership by the WNA, its Multidisciplinary Advisory Grant Council, and the Wisconsin Council on Medical Education and Workforce in nurturing “systems thinking” and innovation leading to patient-centered team-based care.

The narrative presents key messages and important contextual information about the working conceptual model. It offers, through the combined thinking of many, a blueprint for thinking and action related to the six components of the model as expressed in Venn diagrams of the model as a whole and its individual components. In addition, the document includes a definition of terms and appendices including the opportunity to “jump start” patient-centered team-based care to prevent and control hypertension.

Next Steps:During January 2016 – April 2016, the WNA

shared the model with stakeholders to identify strengths, weaknesses, and limitations of the working conceptual model. Following this, the working model will be revised and web-published by the WNA in June 2016. WNA will widely disseminate the model to its many collaborating partners for use and improvement by Wisconsin health care organizations, academic centers, and public/community health organizations.

For more information please contact: Gina Dennik-Champion, RN, MSN, MSHA, Executive Director, Wisconsin Nurses Association.

Notice of Vacancy for

NURSE CLINICIAN 2Sand Ridge Secure Treatment CenterMauston, Wisconsin (Juneau County)

Wisconsin’s Departmentof Health Services (DHS), Sand Ridge SecureTreatment Center (SRSTC) in Mauston, is seekingcandidates for the position of Nurse Clinician 2. There arecurrently several vacancies available.

To be considered for this position, you will need to create an account and apply online. For instructions please visit the State of Wisconsin website

at http://wisc.jobs and refer to Job Announcement Code 1600590.The deadline for submitting applications

is June 30, 2016.

EOE

Contact Teresa Harrington, Human Resources Director at 715-684-5020 or t.harrington@

adorayhomecare.org for more information.

NURSE PRACTITIONER – Casual Call Adoray Home Health and Hospice is a not-for-profit organization in existence since 1995, located in Baldwin WI, 40 miles west of Eau Claire along I-94. We are a Home Health & Hospice organization providing health services to our patients in Saint Croix, Pierce, Western Dunn, Polk, Burnett, and Barron counties. We have approximately 300+ volunteers and over 90 employees. Nearly half of our staff possess over 4 years of commitment & service to our mission! Many companies may talk about their culture and how wonderful it is but the proof is in the tenure!QUALIFICATIONS:1. RN dually licensed to practice as an Advance Practice Nurse in WI2. Minimum of three years of nursing experience.3. Current Wisconsin driver’s license.4. Comprehensive knowledge and well-developed skills in medicine and pharmacology, psychology of loss, pain and symptom control and understanding and acceptance of Hospice principles of care5. Ability to work autonomously and make independent judgments6. Demonstrates the ability to relate effectively with physicians, health care professionals, the community, patients, families, and members of the Hospice inter-disciplinary

Pediatric Emergency Department RN’sChildren’s Hospital of Wisconsin is verified as a Level 1 pediatric trauma center by the American College of Surgeons. A minimum of 1 year acute or critical care experience is required- prefer pediatrics ER experience. We have a variety of part time and full time night shift positions. Please apply online www.chw.org/careers Job ID 26009

At Children’s Hospital of Wisconsin, we believe

Kids deserve the bestChildren’s Hospital is a nationally recognized health system dedicated solely to the health and well-being of children. Our reputation draws patients and families from around the country.

If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today. We also have a variety of other RN opportunities throughout our organization.

Page 6 The Wisconsin Nurse July 2016

Wisconsin Nurses Association Updates

WNA’s Membership Assembly will feel a little bit like past WNA Convention and Annual meetings, as it will include a variety of educational offerings over a 3-day span. Membership Assembly will be held on Thursday, October 20 – Saturday, October 22, 2016, at the Marriott West Hotel and Conference Center in Middleton, Wisconsin.

The preliminary schedule for the 2016 Membership Assembly is as follows:Thursday, October 20 – The Nurses Role in Palliative and End-of-Life

Care across the Lifespan – WNA’s Tri-Council members are the conference planners. Presenters will provide information on: the national perspective; description and the value of advanced care planning; the legal and ethical considerations around palliative/EOL care and advanced care planning; interactive session on personal reflections as a means of improving care.

Friday, October 21 – Clinical and Interprofessional Considerations for Patient-Centered Team-Based Care. WNA’s Task Force on Interprofessional Education is partnering with WNA’s Patient-Centered Team-Based Care Grant staff in planning this day-long conference.

The interdisciplinary conference will include an overview of patient-centered team-based care (PCTBC). There will be two concurrent sessions in the afternoon: one will be the clinical application in the identification, treatment, and promotion of patient self-management of patients with hypertension; the second will be the educational considerations related to interprofessional education in a PCTBC setting.

One of the plenary speakers will include Brenda Zieler, PhD, RN, FAAN, A professor of Biobehavioral Nursing and Health Systems at the University of Washington. Dr. Zieler was a contributing member of the Institute of Medicine Report: Measuring the Impact of Interprofessional Education (IPE) on Collaborative Practice and Patient Outcomes.

Friday, October 21 – Wisconsin Faith Community Nurses Annual Conference. WNA’s Mutual Interest Group members, Wisconsin Faith Community Nurse Coalition, are planning the educational offering.

Friday, October 21 – WNA’s Surviving Your First Year. This workshop is for newly graduated RNs and senior nursing students. Content to include: expectations of employers, lab values, ethics, tips on financial survival, delegation review, and an interactive session with newly graduated RNs on perceptions on making it as a new nurse.

Friday, October 21 – Diversity in Nursing – Wisconsin Diversity Assessment Tool (WI-DAT). Presenter, Brent MacWilliams, RN, PhD, ANP-BC, APNP

Friday, October 21 – Reception celebrating the Wisconsin Center for Nursing Ten Year Anniversary.

Saturday, October 22 – National and State Update on the status of the 2016 Elections.

Saturday, October 22 – WNA Awards Brunch. WNA members will be formally recognized for their individual contributions to nursing. Awardees will be presented by members of WNA’s Award Committee.

Saturday, October 22 – WNA Annual Membership Meeting. Members can join virtually and participate in voting on proposed Bylaw changes, listen to reports, and congratulate newly elected leaders.

Speaking of WNA elections, our Nominating Committee is Seeking Nominations for the 2016 WNA Elections. These leadership opportunities consist of seats on the Board of Directors as well as three WNA Councils. The openings are as follows:

Board of DirectorsVice President, Secretary, Staff Nurse, and two Director-at-Large positions

WNA Councils and CommitteesNominating Committee: three positionsTri-Council (Nursing Practice and Quality, Education, and Research): three positionsPublic Policy Council: three positionsWorkforce Advocacy Council: three positions

The Nominating Committee members are Marie Garwood, Gail Hanson Brenner, Pat Keller, Christine Shaw, SueAnne TeStrake, and Donna Warzynski.

The Nomination forms are available on-line on the WNA website at: wisconsinnurses.org/nominations-2016-elections.

Call for References References adopted using the Dialogue Forum process. Members are

encouraged to submit a proposal on an emerging topic impacting nurses that you believe WNA should be promoting. The Reference Committee will review the proposal to determine if it is duplicative of a current WNA Position, meets the guidelines of an emerging topic, or if it conflicts with WNA’s mission, goals, or purpose. The reference proposal application can be found on WNA’s website.

Bylaw ChangesMembers are welcome to submit proposals to modify WNA Bylaws. WNA’s

most recent bylaws can be found on WNA’s website under the About WNA tab. If you wish to receive assistance in drafting a bylaws proposal or if you wish to serve on the Bylaws Committee, please contact Brianna Neiderman, WNA Communication and Membership Director Brianna@wisconsinnurses.org or 608-221-0383 x 207.

WNA Membership Assembly 2016 Update

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Wisconsin Nurses Association Updates

Nominations for WNA Awards are open! Get your nominations in soon, as they will close August 1. Winners will be honored at the Awards Ceremony during Membership Convention on October 20. Below is the list of current awards, with newer ones to come! Submit your nominations at: wisconsinnurses.org/wna-awards-nomination-form

1. Signe Cooper Image of Nursing Award. The recipient of this award is involved in activities that enhance the image of professional nursing and the image of WNA.

2. Vivien DeBack Leadership Award. The recipient of this award is involved in activities that demonstrate innovation in the advancement of the profession.

3. Service to WNA Award. The recipient of this award exhibits outstanding participation in the WNA, including (but not limited to) service through elected office and committee involvement.

4. Community Service Award. The recipient exercises extraordinary contributions to public education, community outreach, and health promotion.

5. Excellence in Nursing Education Award. The recipient of this award demonstrates extraordinary contribution to excellence in nursing education for students and to

WNA Awards Call for Nominationsthe development and implementation of continuing education.

6. Nursing Practice Award. The recipient of this award is involved in activities that demonstrate innovations in patient care; role model for nursing practice; commitment to the practice of professional nurse; and utilization/dissemination of research in practice.

7. Excellence in Nursing Research Award. The recipient of this award conducts original research of relevance to nursing practice and theory development in nursing; serves as principal investigator on externally funded, peer reviewed nursing research projects; generates a substantial record of data-based, referenced publications; delivers invited research presentations at professional/scientific meetings; and communicates nursing research to the general public and the nursing community.

8. Staff Nurse Advocacy Award. This award is given to recognize excellence in individual staff nurses who provide direct patient care in all practice settings and who advocate for their patients. The recipient has demonstrated outstanding advocacy in a clinical setting at the staff nurse level.

9. Advanced Practice Nurse of the Year Award. This award is selected by the WNA APN

Forum. The recipient is employed as an Advanced Practice Nurse, demonstrates expert knowledge and practice in an APN clinical area of nursing, demonstrates involvement and contributions in the areas of patient care, consultation, education, or research and demonstrates leadership within the nursing profession.

10. Political Nurse Award. This award is selected by the Wisconsin Nurses Political Action Committee (WINPAC). The recipient demonstrates involvement in political activities that promote quality of care; acts as a positive role model in his/her use of the political process to advance health care and/or nursing; encourages nurses to become involved in the political process; promotes the education of nurses and consumers in the use of the political process and the value of involvement in governmental affairs; and promotes increased political awareness and involvement within professional organizations.

11. Lillian Mood Award. This award is selected by the Wisconsin Environmental Health Nursing Coalition (WEHNC), a mutual interest group of the Wisconsin Nurses Association (WNA). The recipient is a nurse who demonstrates excellence in incorporating environmental health into his/her practice.

Page 8 The Wisconsin Nurse July 2016

Wisconsin Nurses Association Updates

WNA Working for You – May 2016WNA is working on political advocacy for nurses and patients along with

professional development strategies to support nursing practice, competence, and personal health. Please see the following:

Nurse Workforce Health, Rights, & Safety

Activity

APRN Title Protection

Between now and the November election WNA will be working with the APRN Coalition to inform legislative candidates of the need for title protection for advanced practice registered nurses. More information can be found on WNA’s website under the Advocacy Tab.

APNs

Board of Nursing Rules Revision Update

WNA is tracking the status of Board of Nursing proposed changes to the following Nursing Administrative Rules: N1, N2, N5, N6, N7 and N8. Go to WNA website for info.

RNs

Board of Nursing Rule Revision – N8 (APNPs)

The Board of Nursing has approved changes to N8 and has sent it forward to the Clearinghouse on Administrative Rules. There was a public hearing on March 10, 2016. WNA and others provided testimony supporting the changes but also wanting the physician written collaboration agreement removed.

APNPs

Addressing Workplace Violence

WNA’s legislative proposal was not introduced this biennium. Legislative candidates will be informed on the need for this legislation. To view the proposed language go to WNA’s website and search under the Advocacy tab.

RNs

Healthy Nurses

WNA’s Healthy Nurse Task Force has developed a set of priorities for promoting the health of Wisconsin’s nursing workforce. The Task Force will focus on nurses with hypertension and provide support and strategies for self- management.

RNs

Emerging Role of the Nurse

WNA’s Task Force on the Emerging Role of the Nurse is working on a survey to identify the newer roles of RNs. The end-product will be a compendium of the emerging roles of nurses. Read the Reference Report on WNA’s website under the About WNA tab.

RNs

Telemedicine/ Telehealth

WNA is participating in Task Force to identify regulatory issues for practicing telemedicine

RNs

Continued Competence & WNA Educational Offerings for the remainder of 2016 - WNA’s website under Events tab

Surviving Your First Year - October 21, 2016

Palliative & End-of-Life Care and Nursing 10/20 Madison

Latest Practices in Blood Pressure Measurement webinar

Ready to Vote? Latest update on the National and State Elections - 10/22 Madison

Clinical & Education Considerations for Patient-Centered Team-Based Care – 10/21 - Madison

Northwoods Clinical & Pharmacology Update September

Appropriate Nurse Staffing & Nurse Shortage

Topic Activity

Healthcare Workforce Planning

The Governor’s Health Workforce Academy has been transferred to the Wisconsin Council on Medical Education and Workforce (WCMEW), of which WNA is a member. Focusing on healthcare workforce data, health care delivery design models and integration of behavioral health.

RNs

Patient-Centered Team Based Care

WNA, in conjunction with other healthcare providers, educators, and associations developed a working model “Wisconsin Concentric Model of Patient-Centered Team-Based Care. The model can be viewed along with other info on WNA’s website under Advocacy.

RNs

Interprofessional Education

WNA’s Task Force on Interprofessional Education leading to Team-Based Care is working researching best-practice models of interprofessional education related to team-based care.

RNs

Academic Progression

WNA’s Task Force on Academic Progression is working on an awareness campaign for recruiting and retaining nurse educators. They are working on a white paper that will explore the key issues.

RNs

New RN Grads WNA’s Mentorship Committee is working on a mentorship program.

RNs

Future Nursing Leader

WNA’s Mentorship Committee launched WNA’s Future Nursing Leader Award. Five graduating students received awards Spring 2016.

RNs

Patient Safety/Advocacy

Topic

Prescription drug abuse epidemic

WNA is a member of the Opioid Reduction Task Force formed by the Wisconsin Hospital Association.

RNs

Patient-Centered Team Based Care

WNA received a grant from the Division of Public Health advancing patient-centered team-based care for patients with hypertension and diabetes.

RNs

You Were Represented: March 12, 2016 – May 12, 2016

Topic Audience Location Date

Policy & Practice WNA APRN Forum Board meeting

Madison 3/12

Policy/Practice Attended WI Council on Medical Education & Workforce meeting

Madison 3/15

Practice Task Force meeting on Emerging Role of the Nurse

Call 3/15

Policy Panelist on policy issues regarding nursing education

State Capitol 3/16

Leadership Wisconsin Center for Nursing strategy mtg on sustaining the work of IOM

Waukesha 3/18

Leadership Meeting of the Wisconsin Nursing Coalition

Madison 3/24

Leadership WNA Board of Directors Meeting Madison 3/24-25

Nurse Advocacy WNA Workforce Advocacy Council Meeting

Call 4/5

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July 2016 The Wisconsin Nurse Page 9

Wisconsin Nurses Association Updates

Policy/Advocacy APRN Consensus Meeting – National Council State Boards of Nursing

Chicago 4/5

Nurse Advocacy Presentation on Workplace Violence and Issues for Nursing

Rice Lake 4/6

Policy/Advocacy WI Health Improvement Planning Steering Committee Meeting

Call 4/8

Policy/Advocacy Competitive Wisconsin Meeting Milwaukee 4/12

Policy/Advocacy Board of Nursing Meeting Madison 4/14

Policy/Advocacy WNA Task Force Meeting on Academic Progression

Call 4/14

Education Delegation Issues for Nurses – UW Oshkosh Nursing Students

Oshkosh 4/15

Education Impaired Nursing Practice & Chemical Dependency – UW Madison students

Madison 4/18

Practice Patient-Centered Team-Based Care Conceptual Model (PCTBC) model presentation – WI Collaborative for Health Quality (WCHQ) Planning Cmte.

Webinar 4/18

Policy/Advocacy APRN Coalition Meeting Call 4/18

Practice PCTBC Model presentation - Karen Timberlake is Director of the Population Health Institute

Madison 4/19

Policy/Advocacy Prescription Drug Abuse – Presentation to United Way – Subcommittee

Madison 4/21

Education Policy and Advocacy and WNA’s Role – Edgewood Nursing Students

Madison 4/21

Practice PCTBC model presentation – WCHQ Hypertension QI Committee

Webinar 4/21

Education/Research

Interprofessional Education Task Force Meeting

Call 4/22

Practice/Education WNA Tri-Council Meeting WNA 4/22

Practice PCTBC Model Presentation – Aurora Chief Medical Officer

Milwaukee 4/26

Policy/Advocacy Policy update Aurora Advanced Practice Nurses Council

Milwaukee 4/26

Practice PCTBC Model Presentation – WCHQ Diabetes QI Committee

Webinar 4/27

Policy/Advocacy APRN Policy Update – WNA APRN Conference

Madison 4/28

Practice New best practice guidelines for blood pressure measurement

Madison 4/28

Policy/Advocacy Attended Assoc for Nurse Practitioners Region 5 Policy Meeting

Chicago 4/30

Education Jail & Correctional Health Conference

WI Dells 5/9

Practice PCTBC Model Presentation – Academy of Physician Assistants

Webinar 5/10

Practice Meeting with Wisconsin Hospital Association President

WNA 5/11

Policy/Advocacy Attended Board of Nursing Meeting

Madison 5/12

Policy/Advocacy Attended Medical Society sponsored policy discussion with Russ Feingold

Madison 5/12

For more information go to www.wisconsinnurses.org or info@wisconsinnurses.org

Page 10 The Wisconsin Nurse July 2016

Wisconsin Nurses Association Updates

What:The Wisconsin Nurses Association (WNA) is in its 3rd year of

a chronic disease prevention grant from the Wisconsin Division of Public Health and the Centers for Disease Control. Among other initiatives, WNA is providing an evidence-based training module on blood pressure measurement both in-person and on-demand for Wisconsin registered nurses. The on-demand module is free of charge along with issuing 1.0 of nursing education contact hours.

Why:Cardiovascular disease is the leading cause of morbidity and

mortality in Wisconsin and the United States. It is estimated that approximately only 50% of persons diagnosed with hypertension are adequately managed and controlled. This percentage is likely even lower for vulnerable population groups who struggle with limited resources, low literacy, and limited educational attainment. Because hypertension is a relatively silent disease, patients and family members will often not experience the negative impact until it becomes life-altering. WNA would like to see nurses more engaged in activities, including systems change, that address the prevention and control of hypertension for patients and their caregivers in health care settings and in the broader community. We can do better! It starts with blood pressure measurement!

WNA has identified the “M.A.P. Framework” which has been developed by the American Medical Association. MAP stands for: Measure; Act; Partner. MAP was developed in response to recommendations from Million Hearts®. Million Hearts® is a national initiative with an ambitious goal to prevent 1 million heart attacks and strokes by 2017. The Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services co-lead the initiative on behalf of the U.S. Department of Health and Human Services.

The on-demand educational offering from WNA will focus on blood pressure measurement including preparing nurses to teach their patients self-measurement. Although the educational module will focus on adult measurement, the training can further sustain a pediatric population as it supports awareness for better clinical practice.

Collaborators:This approach to improve measurement has been developed

by the Wisconsin Nurses Association in collaboration with the American Medical Association, Wisconsin Division of Public Health’s Chronic Disease Program, and MetaStar. By working together we can improve health outcomes for patients, populations, and communities.

Knowledge Transfer:The knowledge and skills contained in the educational

offerings is transferable to most health care providers and their assistants. The on-demand offering is easily accessible

on web sites and useable in settings that include, but are not limited to: academe, health care, local health departments, community agencies, and organizations. WNA intends to disseminate this information for use by many.

When:The on-demand program will be available by the end of June on both the

WNA and MetaStar websites. WNA’s website is www.wisconsinnurses.org.

For more information please contact:• BriannaNeiderman,WNADirectorofCommunicationsandMembership

at brianna@wisconsinnurses.org • GinaDennik-Champion,RN,MS,MSHA,ExecutiveDirectorWNA,at

gina@wisconsinnurses.org

Wisconsin Nurses Association Announces Clinical Practice Initiative Beyond the 50%: It Starts with Blood Pressure Measurement

Linda Murakami, presenting at “Beyond the 50%: It Starts with Blood Pressure Measurement”

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July 2016 The Wisconsin Nurse Page 11

Wisconsin Nurses Association Updates

WNA Nurses Day at the Capitol Draws Enthusiasm for Nurses’ Role in Policy-Making

Past ANA President, Rebecca Patton, served as the keynote for WNA’s Annual Nurses Day at the Capitol. Her remarks were very instructive as to the why and how nurses can increase their engagement in the policy arena. This set the tone for the remainder of the day where the over 400 attendees listened, learned, and interacted on a variety of subjects and topics related to health policy. The breakout sessions provided information on environmental considerations in the health care setting, the role of the Board of Nursing, addressing prescription drug and opioid abuse in Wisconsin, and a legislative briefing for attendees who scheduled office visits with their legislator. Feedback regarding the presenters and educational content was very positive. Check back on the WNA Website for more information about the 2016 Conference, and the 2017 Conference on February 28. Here are some photos from the day!

Past ANA President Barbara Nichols and DSPS Secretary Dave Ross

WNA President Linda Gobis and Keynote Speaker Rebecca Patton

Advanced Practice Nurses working in designated

rural and/or health professional shortage areas.

Assist in a DNP student’s research project on

determinants of job satisfaction among advanced

practice nurses working with rural and underserved

populations.

Interested individuals can partake in the survey by

going to this survey link.

https://www.surveymonkey.com/r/WINPSURVEY

Your participation is greatly appreciated!

Who?

Why?

Where?

Needed!Survey Participants

Page 12 The Wisconsin Nurse July 2016

Wisconsin Nurses Association Updates

OverviewThe legislature is responsible for development

of state statutes, which are enacted by the Governor. The statutes are further clarified through the Administrative Rules. In the case of statutes that identify State Statute Chapter 441, it refers to the Board of Nursing. Statue Chapter 227 describes the authority and limitations of any agency or recognized board. The law describes the role of a board or agency to implement or interpret provisions of the statutes and to establish procedures. The board or agency may not impose any standard, requirement, or threshold in a rule or as a license condition unless explicitly required or permitted by statute. The Board of Nursing has the authority to create, maintain, and change Administrative Rules, which are N1 – N9.

The Rule-Making ProcessA rule is created, amended, or repealed

through what is known as a “promulgation process.” Rule promulgations generally take at least 6 months from start to finish, and may take much longer. The purpose of the promulgation process is to ensure that the public and the

WNA Legislative and Regulatory UpdateState of Wisconsin Board of Nursing Working on Changes to the Administrative Code for Nurses

legislature have an opportunity to participate in the rulemaking process and that all perspectives are considered in the development of a final regulation. Rule promulgations may be for either permanent or emergency rules.

The Board of Nursing, like all other agencies, has a specific process that needs to be followed:

• Scope statement – The public notice that the Board intends to begin the development of a permanent rule. This is forwarded to the Legislative Council Rules Clearinghouse

• Draft rule – The initial draft language submitted to the Clearinghouse for review and comment

• Review by the Clearinghouse – The Clearinghouse staff consists of attorneys of the legislature that review the proposed language to ensure it is not in conflict with other rules.

• Public Hearing –The Board of Nursing schedules a public hearing on the proposed draft. The Board reviews input from the

public and the Clearinghouse and may make modifications as a result.

• Governor’s review – The proposed rule or amendments to the rules are reviewed and signed off by the Governor. If there is opposition relayed to the Governor by key groups the Governor can defer the language back to the Board or not authorize continuation in the process.

• Review by legislature – If the draft is approved it is forwarded on to the presiding officers of the appropriate Committee of the Senate and Assembly. The committee has 30 calendar days to review and comment on the rule. If there is opposition, the committee will hold a public hearing and determine if the rule needs to be amended.

• Publication – If there is no opposition the Board files the rule with the Secretary of State. The rule takes effect or is “published” 45-75 days later.

Status of Rules Changes Proposed by the Board of Nursing

Administrative Rule Proposed Change

Rationale Action

N3 – Examining councils on registered nurses and licensed practical nurses

Repeal The Wisconsin Board of Nursing’s examination councils are inactive, and the statutory authority for these councils was repealed in Wisconsin’s 2015-2017 biennial budget. This revision will align the Board’s administrative rules with current practice and the Board’s statutory authority.

5/16/16 Scope Statement submitted

N5 – Renewal of License & N6 – Standards of Practice

N 5 – Repeal N6 – Revise

N5 –Renewal process for licensure and reinstatement to be added to N2 – Licensure. N6 describes standards of practice

1/14/16 – Public Hearing 3/3/16 – Approved by the Governor 3/7/16 – Submitted to Senate and Assembly Health Committees

N7 – Rules of Conduct

Revision to N7.03

The intent of the board of nursing in adopting this chapter is to specify grounds for denying an initial license or certificate or limiting, suspending, revoking, or denying renewal of a license or certificate or for reprimanding a licensee or certificate holder.

10/8/15 – Public hearing 3/4/16 – Governor approval 4/26/16 – Assembly referred to Joint Committee on Administrative Rules 5/3/16 – Senate referred to Joint Committee on Administrative Rules

N8 – Advanced Practice Nurse Prescribers

Various changes

Language can be found on the Advocacy Tab found on the WNA Website.

3/10/16 – Public hearing. 4/6/16 – Final draft rule submitted to Senate and Assembly Committees 5/3/16 – Referred to Joint Committee on Administrative Rules 5/5/16 – Approved by the Governor

July 2016 The Wisconsin Nurse Page 13

Mutual Interest Groups (MIGs) Updates

WNA APRN FORUMPharmacology & Clinical Update

WNA APRN Forum Board of Directors with Dr. Apold Secretary Dave Ross of the DSPS

The 30th annual APRN Forum Pharmacology & Clinical Update was held on April 28th through the 30th. It was held at Madison’s Marriott West. The conference was attended by over 430 APRNs, the majority of who were nurse practitioners.

A highlight of the conference was the keynote address by Dr. Susan Apold PhD, ANP-BC, FAAN, FAANP. She is a Clinical Professor of Nursing at New York University Rory Meyers College of Nursing. Her presentation entitled “Leading from the Center” was very energizing and uplifting.

It provided attendees with strategies for leadership. Dr. Apold believes that leadership skills must be taught in order for the profession of nursing to further its influence in the health care system.

On the opening morning, there was a presentation on appropriate prescribing of opioids as well as a legislative update. In the afternoon, there were numerous workshops including suturing, EKG interpretation, casting and IUD insertion. There were other sessions on diabetes and x-ray interpretations. In the evening, there was an optional presentation that was open to the public on taking a blood pressure correctly. This was part of WNA’s grant from the Department of Health and Human Services on team-based care to improve care related to diabetes and hypertension.

On Friday, in addition to the keynote speaker’s presentation, the exhibition hall opened. The winners of the Mary Barker Scholarship were announced during the noon luncheon (read more on WNA’s website). Secretary Dave Ross, from the Department of Safety and Professional Services (DSPS), addressed the participants. Also, during the luncheon there was presentation on the “State of APRN Practice in Wisconsin.” There

were breakout sessions on a variety of topics. Some of these include atrial fibrillation, end of life symptom management, sepsis, vaginitis, pediatric burns, and managing patient compensation in primary care. In the evening, participants could attend a viewing of the movie, “The American Nurse.”

The final day of the conference offered a new option of a workshop on suturing and in-office procedures. Additionally, there were numerous breakout sessions. A sampling of these sessions includes clostridium difficile, Parkinson’s disease, anxiety, overactive bladder, and nausea/vomiting in pregnancy.

Throughout the conference, there was time for networking with peers, former classmates, and instructors. The initial reviews of the conference were very positive. All feedback is welcome as the planning committee starts to work on next year’s conference on April 6-8 at the new KI Center in Green Bay. We hope to see you there for some excitement in “Title Town!”

Keynote Speaker Dr. Susan Apold, PhD, ANP-BC, FAAN, FAANP:

“Leading from the Center”

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Page 14 The Wisconsin Nurse July 2016

The Wisconsin Environmental Health Nurses Coalition (WEHNC) recommends two websites to direct your questions about environmental health practices, which are:

Health Care Without Harm - https://noharm.org/“Health Care Without Harm is an international

coalition of hospitals and health care systems, medical professionals, community groups, health-affected constituencies, labor unions, environmental health organizations, and religious groups. Together with partners around the world, Health Care Without Harm shares a vision of a health care sector that does no harm, and instead promotes the health of people and the environment.

To that end, they work to implement ecologically sound and healthy alternatives to health care practices that pollute the environment and contribute to disease.

For example, the incineration of medical waste is a leading source of dangerous air pollutants such as dioxin and mercury, and the use of hazardous chemicals indoors may contribute to the high rates of asthma among health care workers. The huge scale of the health care sector worldwide means that unhealthy practices — such as poor waste management, use of toxic chemicals, unhealthy food choices and reliance on polluting

Mutual Interest Groups (MIGs) Updates

Wisconsin Environmental Health Nurses Coalition (WEHNC)

technologies — have a major negative impact on the health of humans and the environment.

The good news is that the health care sector can play a leading role in solving these problems. Due to its massive buying power, and its mission-driven interest in preventing disease, the health care sector can help shift the entire economy toward sustainable, safer products and practices.

Health Care Without Harm is at the center of this work to transform the health sector worldwide, without compromising patient safety or care,  so that it becomes ecologically sustainable and a leading advocate for environmental health and justice.”

Environmental Working Group - http://www.ewg.org/“The Environmental Working Group’s mission

is to empower people to live healthier lives in a healthier environment. With breakthrough research and education, they drive consumer choice and civic action. They are a non-profit, non-partisan organization dedicated to protecting human health and the environment.

Do you know what’s in your tap water? What about your shampoo? What’s lurking in the cleaners underneath your sink? What pesticides are on your food? How about the farms, fracking wells and factories in your local area? Do you know what safeguards they use to protect your water, soil, air

and your kids? Which large agribusinesses get your tax dollars and why? What are GMOs? What do they do to our land and water?

More than two decades ago EWG set out to answer these questions, and more, and to empower you to get to know your environment and protect your health.”

In addition, WEHNC also recommends attendance at the annual state meeting for the Wisconsin Environmental Health Network for health care providers. Typically held in February at UW Madison. The conference is low cost but highly informative.

Nationally, the annual Clean Med conference is held in May at different city each year.

The opportunities to be active and lower exposures has never been better. For example the prenatal environmental health assessment was recently revised and posted by WEHN. The tool was originally created by a nurse, Katie Huffling, MS, RN and promoted by Physicians for Social Responsibility and WEHN. phttps://wehn-intern.squarespace.com/prenatal/

Do you know of any other environmental health conferences for nurses in Wisconsin? Are you interested in learning more about WEHNC? Let us know! Email the WNA office at info@wisconsinnurses.org.

July 2016 The Wisconsin Nurse Page 15

Mutual Interest Groups (MIGs) Updates

Prenatal Environment Health Assessment - Wisconsin Environmental Health Network

Before, during, and after pregnancy, women are exposed to many chemicals that may affect the growing fetus.

FOOD and WATER INFORMATION & ADVICE

Fruits and vegetables Fresh fruits and vegetables are important for a healthy diet. When possible, buy organic and antibiotic-free fruits, veggies, dairy and meat. Pesticides can cause problems with your ability to have a baby, specifically miscarriage & some birth defects.

Fish Fish is healthy for you; try to eat up to 2 meals per week that are low in mercury, such as Pollock, tilapia, and salmon. Buy light tuna, not albacore. Some fish (shark, swordfish, king mackerel or tilefish) are very high in mercury, which can cause problems with your baby’s brain development.

Cooking and storing in plastic

Use glass for storage and microwaving when possible. Try to buy fresh/frozen foods instead of canned. Breastfeed babies when possible. Canned food liners and some plastics contain BPA. BPA is a chemical that interferes with hormones in the body. Do not microwave in plastic, or wash in dishwasher. Don’t reuse disposable plastic.Canned food

Cookware and dishes

Imported pottery or ceramics – also clay, dirt, and paint chips – may contain lead. Lead can damage the brain and nerves, and increase the risk of miscarriage, stillbirth and low birth weight. Eat foods rich in iron (lean red meats, chicken), calcium (dairy and leafy green veggies), and vitamin C (oranges, grapefruits, tomatoes, and green peppers).

Use cast iron cookware instead of Teflon. Teflon is made from a chemical (PFOA) that has been linked to inability to have a baby.

Well water Well water should be tested for nitrates and bacteria, which can make pregnant women and babies sick.

PERSONAL INFORMATION & ADVICE

Smoking and vaping Talk to your doctor about quitting smoking. Smoke chemicals can harm the growing baby: low birth weight, asthma, and/or learning problems.

Antibacterial Use regular soap or hand gels. Avoid antibacterial products that contain triclosan, which promotes “super bacteria” and has hormonal effects.

Personal hygiene Artificial fragrances and other chemicals in soaps, lotions, shampoos and other personal products are linked to reproductive problems, asthma, skin irritation, and cancer. Buy natural or chemical-free when you can.

Clothing and linensWash new clothing, towels and sheets before using them. Use green dry cleaners when possible, or avoid dry cleaning clothes. Chemicals on these items may reduce your ability to have a baby, cause early delivery or stillbirth, affect your nerves, and increase your risk for cancer.

Toxic home remediesDo not use these remedies. Ask your doctor about alternatives to azarcon, greta or pay-loo-ah, and remedies that contain mercury or mercurio. These items may contain heavy metals such as lead or mercury. Lead can cause damage to the brain and nerves, it also increases the risk of miscarriage, stillbirth and low birth weight.

HOME and WORK INFORMATION & ADVICE

Smoke safety Get a detector for both smoke and carbon monoxide, or ask your landlord. Make sure gas stoves and fire places are working properly and are well ventilated. Smoke detectors are very important for preventing smoke inhalation and burns. Carbon monoxide is an invisible gas that is very harmful.

Pesticides inside and out

Pesticides are dangerous for women, babies, and children. They can make it hard to have a baby; cause miscarriage, birth defects, learning disabilities, and even cancers.

Older homes and home improvements

Pipes and paint in some older homes may contain lead, lead can cause damage to the brain and nerves. It also increases the risk of miscarriage, stillbirth and low birth weight.

Dust from paint and building materials can contain lead and other toxins that can cause breathing problems. Choose low-VOC paints.

Radon is a cancer-causing gas that can be found in basements. You can purchase a test kit at a hardware store.

Cleaning supplies

Strong cleaning chemicals, and other products with strong scents like air fresheners, often contain phthalates that can cause health problems, such as thyroid problems, cancer, low birth weight and infertility. Avoid strong smelling chemicals and use alternatives to air fresheners.Air fresheners

Plastic Choose PVC-free plastic materials when you can, or use alternatives such as cloth. PVC plastic (shower curtains, window clings, some toys and teething rings) might contain certain chemicals that can cause cancer and birth defects.

Mercury Use LED lights when possible. Take caution when cleaning up a broken mercury light bulb or ask your landlord to do it. Use electronic thermometers when possible. Mercury exposure can cause problems with how the baby’s brain and nerves develop. Compact fluorescent light bulbs contain mercury.

For more information and resources, go to WEHNonline.org/prenatal and talk to your health care professional

Page 16 The Wisconsin Nurse July 2016

Mutual Interest Groups (MIGs) Updates

Save the DateFaith Community Nurses Annual State

Conference:Chronic Disease Updates: COPD/Smoking

Cessation; Hypertension; Dyslipidemia; Diabetes

Marriott in Middleton on October 21, 2016

Faith Community Nurses Preparation CourseBased on the new curriculum from the

Westberg InstituteAugust 5 & 6, 19 & 20, 2016WNA Office, Madison, WI

Course Fee $400/ New curriculum book $45CEU’s will be awarded.

Contact WNA Website for details.

Faith Community Nursing: Direct Careor “Hands-On” Practice and Glucose Testing

Two frequently asked questions about faith community nursing are:

1. Should faith community nursing be “hands-on” versus “hands-off?”

2. Can faith community nurses (FCNs) do glucose testing?

All nursing practices fall under the legal authority of each state’s Nurse Practice Acts and State Board of Nursing Policies. Scope and Standards of Practice documents reflect the thinking of the nursing profession and provide guidance for nurses in the application of their professional skills and responsibilities. It is up to the nurse who is practicing as an FCN to assess one’s skills, knowledge, and comfort in following any medical orders. Additionally, an employer or setting of practice may limit the scope of practice for the FCN. It is recommended that every FCN have malpractice insurance. The International Parish Nurse Resource Center’s Foundations of Faith Community Nursing course (Documentation

Practices and Legal Aspects modules) offers information and recommendations regarding practice responsibilities.

All of nursing practice is guided by Nursing: Scope and Standards of Practice (American Nurses Association, 2010) available at http://www.nursesbooks.org/Main-Menu/Standards/Nursing-Scope-and- Standards-of-Practice.aspx.

Nurses are also guided by their nurse specialty scope and standards of practice. Faith Community Nursing: Scope and Standards of Practice (American Nurses Association & Health Ministry Association, 2005, 2012) is available at http://www.nursesbooks.org/Main-Menu/Standards/A--G/Faith-Community- Nursing.aspx.

In fact, the faith community nursing certification by portfolio (Registered Nurse-Board Certified (RN- BC) Faith Community Nurse) facilitated by the American Nurses Credential Center is based upon Faith Community Nursing: Scope and Standards of Practice (ANA & HMA, 2012).

Should faith community nursing be hands-on?Even though there are several faith community

nursing interventions that are considered “hands-off,” a skill set that all nurses should have is the ability to do a physical assessment. A thorough physical assessment requires “hands-on” the patient’s body to auscultate breath sounds, assess lymph nodes, palpate pulses, and assess skin turgor, and so on, especially if the patient was recently discharged from a hospital or has a chronic disease. A guide for a head-to-toe physical assessment is available at http://nursinglink.monster.com / benef it s /ar t icles / 18 4 -how-to -perform-a-head-to-toe-assessment.

Can FCN do glucose testing?Diabetes management can be facilitated by

FCN who have received specialized education. Performing a finger-stick for blood glucose testing may be considered part of diabetes management for reasons of demonstration and education. Our goal in demonstration should always be patient self-management and self-efficacy. It is preferred to have the patient demonstrate a finger-stick to the FCN than the other way around.

The FCN needs to possess knowledge of:• Why and when to do glucose testing (the

science behind it)• How to use the glucose meter (testing and

recalibration)• Whattodowiththeresults(interpretation)• What education the client needs (resources

and diary)

• When and where to refer the client(physician-clinic)

• How and where to purchase lancets anddispose of them properly

• Documentation using a standardized nursinglanguage

• Follow-upandfollowthroughfortheclient

It is recommended that the FCN:• Followthe“FaithCommunityNurseVisitation

Guidelines” for Diabetes Assessment available at http://store.churchhealthcenter.org/.

• Haveadditionaleducation regardingdiabetesmanagement or seek guidance from other health care team members, such as diabetic educator, nutritionist, or physician.

• Be familiar with state laws and professionalguidelines regarding practice issues.

• Develop a policy for consistent practice byusing the most recent standards of care and develop a policy for a consistent practice available at http://professional.diabetes.org/admin/UserFiles/0%20- %20Sean/Documents/January%20Supplement%20Combined_Final.pdf.

Regarding glucose testing as a mass screening tool, the American Diabetic Association (2015) suggest that “there is insufficient evidence to conclude that community screening is a cost-effective approach to reduce the morbidity and mortality associated with diabetes in presumably healthy individuals. While community screening programs may provide a means to enhance public awareness of the seriousness of diabetes and its complications, other less costly approaches may be more appropriate, particularly because the potential risks are poorly defined. Thus, based on the lack of scientific evidence, community screening for diabetes, even in high-risk populations, is not recommended.” (Retrieved at http://care.diabetesjournals.org/content/25/suppl_1/s21.full.) A diabetes screening tool is available at http://www.diabetes.org/are-you-at-risk/diabetes-risk-test/. Targeted screenings for individuals with high risk, such as BMI > 25, family history, comorbidities, should include a referral to a physician.

Here are three studies regarding the use of glucose testing and FCNs.

• Austin, S., Brennan-Jordan, N., Frenn, D.,Kelman, G., Sheehan, A., & Scotti, D. (2013). Defy diabetes! A unique partnership with faith community/parish nurses to impact diabetes. Journal of Christian Nursing, 30(4), 238-243.

• Mendelson,S.G.,McNeese-Smith,D.,Koniak-Griffin, D., Nyamathi, A., & Lu, M. C. (2008). A community-based parish nurse intervention program for Mexican American women with gestational diabetes. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 37(4), 415-425.

• Ziebarth, D., Healy-Haney, N., Gnadt, B.,Cronin, L., Jones, B., Jensen, E., & Viscuso, M. (2012). A community-based family intervention program to improve obesity in Hispanic families. Wisconsin Medical Journal, 111(6), 261-266.

Written by Deborah Ziebarth, and edited by Katora Campbell, Maureen Daniels, Sharon Hinton, Susan Jacob, Georgia Oliver, and Lisa Zerull for the International Parish Nurse Resource Center, Church Health Center, Memphis, Tennessee, 2015

July 2016 The Wisconsin Nurse Page 17

Mutual Interest Groups (MIGs) Updates

Mentorship CornerSpring 2016 Future Nursing Leader Award

WNA Board Member, Cathy Berry, presenting Maggie Raske her award at Viterbo.

Marian University Award winner, Aubrey Stucke.

WNA Board President, Linda Gobis, presenting Mollie Merrill her award at UW Oshkosh.

Nominating teacher Barbara Reimer, Award winner Katie Parente, WNA Board Member

Nicole Faulkner, and WCTC School of Health Dean Sandra Stearns.

This May, the Mentorship Committee selected 5 recipients of the WNA Future Nursing Leader Award. The award recognizes outstanding students who embody the ethics and values of nursing and exemplary leadership qualities. It will be given out twice a year to graduating students from the Spring and Fall semesters at the pinning ceremonies. Winners receive a complimentary year of membership in the Wisconsin Nurses Association, along with a hand-picked mentor, and an appointment to a WNA council or committee of his or her choosing. He or she will also receive a certificate and lapel pin presented at their pinning ceremony.

The winners this Spring are: • AubreyStuckefromMarianUniversity• MollieMerrillfromUniversityofWisconsin-Oshkosh• CristinaNazariofromAlvernoUniversity• Margaret(Maggie)RaskefromViterboUniversity• KatieParentefromWaukeshaCountyTechnicalCollege

The Wisconsin Nurses Association congratulates them on their achievements, and is excited to welcome such promising leaders to our organization!

WNA Board Member, Tiffany Barta, presenting Cristina Nazario her award at Alverno College.

•NurseManager–NeonatalIntensiveCare(NICU)•ExperiencedRNsandNewGraduates: PICU, NICU, and Pediatric Inpatient Units •PediatricDialysisandInfusionServices•NeonatalandPediatricTransportService

Page 18 The Wisconsin Nurse July 2016

Nurses Foundation of Wisconsin

On May 14, we held our 2nd Annual NFW Lamplight 5K Run/Walk at Warner Park in Madison. The race was a fundraiser for our foundation to support the nursing workforce in WI by offering scholarships and research grants to nursing students. We started off the event by honoring nurses who passed away through the Nightingale Tribute. The nurses that were honored were:

• SusanFrasier• ClaricePopp• RosalinePolashek• MaryPederson-Steckel• HeidiMcCaulley• DennyThomas

We had 80 people participate, some as runners and some as spirited walkers. Despite the unseasonably cold weather, it was a fun event, with Joe Vande Slunt as our DJ and MC. We thank our sponsors for helping to make the event a memorable one: Magic 98, Wisconsin State Journal, Previant Law Firm, Agnesian Healthcare, Flambeau Hospital, Buffalo Wild Wings, Woodruff Ace Hardware, and Culligan Total Water. We hope to see you all at the race in 2017!

Our second project for this quarter is the review and awarding of nursing scholarships and grant proposals. We will announce the winners in July. We are excited that 5 nurses submitted their applications for consideration.

Check the next edition and WNA’s website for more information on the fall silent cyber auction! Please take time to enjoy the lazy days of summer and make some new memories with those you love.

NFW President, SueAnne TeStrake performing the

Nightingale Tribute The runners at the starting line!

…5 minutes later, the walkers takeoff!

SueAnne TeStrake and Marie Garwood coming up to the halfway point of the walk Nurses finishing the walk with a child in tow!Many thanks to our sponsors!

2nd Annual NFW Lamplight 5K Run/Walk

July 2016 The Wisconsin Nurse Page 19

Membership

SummaryThousands of Wisconsin residents are new

owners of health insurance. For these and many others, it can be a challenge to effectively navigate the formal health insurance and health care systems. Simply having health insurance doesn’t equal understanding how to access providers, effectively or appropriately use health care, or assess health care quality.

Two statewide organizations, Covering Kids & Families (CKF) and Wisconsin Health Literacy (WHL), with support from the Wisconsin Health Information Organization (WHIO) are working to address these gaps. CKF and WHL are focused on helping Wisconsin residents improve their health through increased knowledge about health insurance, accessing care, and how to be an active partner in achieving quality health outcomes.

Through the initiative, Consumer Engagement and Activation through Health Literacy, CKF and WHL are working with a variety of organizations that interact with consumers about their health care including health care clinics and centers, county economic support agencies, insurance carriers and enrollment assisters, and other community resource organizations.

Through these partnerships, the aim of the initiative is to develop and test the effectiveness of educational materials and programs and methods of dissemination, particularly to consumers who are newly insured and other health care consumers who have low literacy skills. The initiative will also strengthen healthcare providers and health insurers in supporting consumers in their emerging role as active partners. Current activities are focused on southeastern and east central Wisconsin, with final products to be made available statewide by Summer 2016.

The outcomes of interest include increased consumer:

Awareness of information resources to support their health care decisions;

Interest in understanding health care quality and costs; and

Ability to make appropriate insurance plan, provider, and healthcare selections

The initiative is funded by WHIO with support from the Wisconsin Department of Health Services. WHIO collects data from health care providers about quality and costs, produces ratings on individual clinics, and is making that information available to providers, insurers, payors and consumers through the website - myhealthwi.org - to help Wisconsin residents make sound decisions about care.

For more information, please contact:• Stephanie Severs, Covering Kids & Families-

Wisconsin (608.261.1455; ssevers@wisc.edu)• SteveSparks,WisconsinHealthLiteracy (608-

257-1655 ext. 2; steve@wisconsinliteracy.org)

Consumer Engagement and

Activation through Health Literacy

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Visit go.wisc.edu/leadershipinpophealth to learn more.

Page 20 The Wisconsin Nurse July 2016