peri-scopenursingnetwork-groupdata.s3.amazonaws.com/aspan/... · report as of august 31, 2014...

At the ASPAN National Conference in April, I had the opportunity to attend the Representative Assembly (RA). One important discussion at the RA pertained to the minimum education level for RN licensing. ASPAN’S recommendation is that the mini-mum entry level for RN licensing should be a BSN. Demands for Education

In October of 2010, The Institute of Medicine released its landmark report on The Future of Nursing, which called for increasing the number of baccalaureate pre-pared nurses in the workforce to 80% by 2020. This evidence based recommendation noted that to meet the demands of an evolving and complex healthcare system and the changing needs of patients, nurses must achieve higher levels of education.¹ The ways in which nurses were previously educated during the 20th century are no longer ade-quate for dealing with the realities of our current health care system. With the healthcare landscape constantly changing, nurses’ roles are evolving. Nurses are being called upon to master technology, manage information systems, as well as collaborate and coordinate care with other health professionals. Many healthcare professions have recognized the necessity for advanced education by requiring a master degree or higher, while nursing continues to discuss and debate entry level for RN licensing. The Value of Advanced Education

My vision of nursing has changed as a result of experiences in pursuing my BSN. While I always be-lieved that nursing could be a transformative process for patients and nurses, as a diploma graduate I was not given the authority or ability to engage in practice changes to improve outcomes. With my BSN, I have a clear vision regarding my role in the workplace and it serves as a springboard for me to consider areas for practice improvement.

The knowledge and experience gained through advanced education empowers nurses to take action in the workplace; to apply knowledge to improve patient care. The process is one that has been transformative for

(Continued on page 3)

Illinois Society of PeriAnesthesia Nurses

Fall 2014 Volume 38 Issue 3

PERI-SCOPE

Inside this Issue

President’s Message Maggie Colabuono BSN RN CPAN CAPA

ILSPAN

Board of Directors Informatics Corner 2 11

Treasurer Report ICPAN News 2 12

Governmental Affairs ASPAN News & Notes 3 13

Vice President Report Education Article 4 14

Scholarship Deadlines Clinical Practice Corner 4 15

District Director Reports Research Project Update 5 15

Research Corner Fall Conference 6 16-17

CPAN®/CAPA® News Membership Page 7 18

ASPAN Regional Director Report 8 Willingness to Participate Form 19

Leadership Development Institute 9 Editorial Comment 19

Member Spotlight 10 ILSPAN Core Purpose 20

Report as of August 31, 2014 Checking account balance $45,692.67 Certificate of deposit $11,199.17 On August 2, 2014, the ILSPAN Audit Committee met to audit the ILSPAN financial records. For information about this audit contact the Treasurer (Information below)

Treasurer’s Report

ILSPAN Board of Directors

President Maggie Colabuono

BSN RN CPAN CAPA 1358 Timberline Drive

Joliet IL 60431 815-725-6459

[email protected]

Vice President/President Elect Mary Higgins BSN, RN, CPAN

847-827-1899 [email protected]

Secretary

Sheri Tadlock BSN RN CAPA 618-539-5711

[email protected]

Treasurer Carla Silzer RN CPAN


Immediate Past President

Wanda Ellenburg MSN MHA RN CPAN


District I Director Rose Ziffra MSN RN CPAN CAPA


District II Director

Kathleen Crowder BSN RN CPAN 217-480-7747

[email protected]

District III Director Jane E. Sieron MSN RN CAPA


Education Chair (ex-officio) Alexis Nicpon BSN RN CPAN


Membership Chair (ex-officio) Fe Castro BSN RN CPAN CAPA


Newsletter Editor (ex-officio)

Jane Reinschmidt BS RN CAPA 847-394-4944

[email protected]

Research Chair (ex-officio) Linda Beagley MS BSN RN CPAN


Web Editor (ex-officio)

Keith Schumacher BSN RN CPAN 217-482-3309

[email protected]

PERI-SCOPE

ILSPAN

Web site

www.ilspan.org

Board and General

Membership Meeting

Minutes can be

found on the web

site

ASPAN

90 Frontage Road

Cherry Hill

NJ 08034-1424

Toll free phone at:

877-737-9696

www.aspan.org

Peri-Scope

Published 3 times a year

Deadlines to submit copy

Winter Issue…….. December 1

Summer Issue..……... April 1

Fall Issue…………...August 15

Send copy to

Jane Reinschmidt

BS RN CAPA

2117 Lake Shore Circle

Arlington Heights IL 60004

[email protected]

mailto:[email protected]








http://www.aspan.org

Governmental Affairs Wanda Ellenburg MSN MHA RN CPAN

uals, improving the health of populations, and low-ering per capita costs.”³

The ACA is moving health care from an episodic treatment and fee for service model to-wards a coordinated model of high performing pro-viders and organizations improving access to quali-ty care, illness prevention, improved safety and co-ordinated services. Health care will see many changes as the ACA achieves its three aims. The creation of ACO organizations is the most notable of the changes.

References

1. Accountable Care Organizations (ACO). Availa-ble at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment /ACO/index.html. Ac-cessed August 15, 2014.

2. US Health Care Facts. Available at http://www.accountablecarefacts.org/facts. Accessed August 15, 2014.

3. Top Questions About ACOs & Accountable Care. Available at http://www.accoutnablecarefacts.org/topten/what-are-the-barriers-and-challenges-such-org. Accessed August 15, 2014.

An internet search on Accountable Care Organizations (ACO) yields many hits with a wealth of information. “Accountable Care Organizations are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare pa-tients.”¹

Providing high quality care without duplicat-

ing services is the goal of an ACO. By providing quality care and spending health care dollars wise-ly, the ACO achieves savings.¹ Medicare shares these monies with the providers in the ACO as an incentive to achieve the goal of timely, high quality care and efficient use of health care resources.

Many health care consumers believe our country’s health care is among the best. Unfortu-nately, the data indicates otherwise. Our life expec-tancy is less than that of other countries. The United States spends more on health care than other coun-tries, yet 46 million Americans are uninsured and services are poorly coordinated. Medical errors re-sult in 99,000 patient deaths in hospitals each year. The Institute of Medicine (IOM) estimate of 1.5 mil-lion preventable adverse drug events yearly is the driving force behind the Health Care delivery reform act.² The Affordable Care Act (ACA) has three aims. “To improve the experience of care for individ-

VOLUME 38 ISSUE 3

(President’s Message continued from page 1) me. I would not have engaged in these activities before completing my degree. I am confident in my ability to change my workplace and to positively contribute to the development of nursing practice. I have become more active at work, recently completing and presenting a nursing research project. I encourage you to pursue your BSN or advanced degree in nursing. Get Involved

Staying connected is critical to succeeding in our perianesthesia profession and keeping our presence strong within healthcare organizations. Being a member of ASPAN and ILSPAN, who support education and professional development, is essential. It is crucial to ensuring that we continue to evolve as nurses, refusing to be satisfied with the status quo. Without participation and commitment, we will lose the power to change our workplace and to positively contribute to the development of our perianesthesia nursing practice. We are each capable of making a difference. All we have to do is take that first step with the help of ILSPAN.

Reference

1. Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press; 2010.

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment%20/ACO/index.html

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment%20/ACO/index.html

http://www.accountablecarefacts.org/facts

http://www.accountablecarefacts.org/facts

http://www.accoutnablecarefacts.org/topten/what-are-the-barriers-and-challenges-such-org



What a gift each of you are! You consistently bring your tal-ents, skills and passion to your patients, families and workplace. With the changes in healthcare and the current economic challeng-es, we need to use the resources and networking of ILSPAN and ASPAN. We need to share the clinical expertise and research that our colleagues possess within our membership area and across the nation. The ILSPAN website, e-blasts and quarterly Peri-Scopes allow our members access to these resource but what of the associ-ates with whom you share your clinical practice? How can they ac-cess these resources? We are seeking a contact person from each institution within the state of Illinois to be the liaison for their peers regarding resources that both ILSPAN and ASPAN can provide. Please contact Mary Higgins at [email protected] for more information. ILSPAN and ASPAN provide scholarships for certification and recertification, humanitarian work, along with local and national conferences fees. ILSPAN has a dynamic research scholarship that can assist financially. The applications for these awards which support professional growth are available on the IL-SPAN website under scholarships and the deadlines are listed on this page. ASPAN is committed to professional excellence and held a LDI (leadership development Institution) seminar in September. The experience was fantastic. Topics ranged from planning a budget, running a board meeting, and recruiting future leaders at both the component and national level. A session on enhancing electronic media for information sharing included electronic newsletters, email blasts, Facebook pages, and websites. Recruiting members to serve in leadership positions is important to the growth of both IL-SPAN and ASPAN. Consider attending a board meeting to see how decisions are made that affect the organization. It is a rewarding experience!

PERI-SCOPE

Deadlines for ILSPAN

Scholarships and Awards

Jan Ridder Excellence in Clinical

Practice Award

Deadline November 15, 2014

Humanitarian Mission

Scholarship

January 1, 2015

CPAN® CAPA® Certification & Recertification

Scholarship

Fall Test Certification &

Recertification Deadline is

January 1, 2015

Recruiter of the Year (ROA)

ROA timeframe is

January to December 2014

for the 2015 Award

2015 ASPAN National

Conference Scholarship

Deadline January 1, 2015

Research Grant Application

Due January 1, 2015

All information is found on the ILSPAN Web site under awards,

scholarships or research tabs.

Mail applications to: Mary Higgins

536 N. 7th Avenue Des Plaines, IL 60016

Email: [email protected]

Vice President’s Report

Mary Higgins BSN RN CAPA

Call for Nominations ILSPAN 2015

Spring Elections

ILSPAN is now accepting nominations for the 2015 ballot.

Board positions to be elected are: Vice-president/

President Elect, Secretary, District I Director and District

III Director.

Fill out the Willingness to Participate form found on page

19 or on line at www.ilspan.org under the “Volunteer” tab.

Job descriptions and committee descriptions can be

found there. Contact any Board member for more infor-

mation. (Contact information on page 2)


http://www.ilspan.org

Summer is almost over and soon we will be

facing the change of seasons to fall, winter and finally

spring. The planning committee for the 2015 ILSPAN

Spring Conference would like you to save Saturday,

March 7 for the spring conference which will be at the

Meridian Banquet in Arlington Heights, Illinois. We

have invited a dynamic ASPAN speaker, Maureen

McLaughlin MS RN CPAN CAPA. She will be pre-

senting a variety of topics, which will be useful in

providing excellent care to our perianesthesia pa-

tients. The day promises to be full of information and

camaraderie with contact hours being awarded.

Breakfast and lunch will be served. Watch for more

information as the seasons change.

I am excited by the number of new members

joining ILSPAN each month in District I. I welcome

you all to ILSPAN and urge you to get involved in

advancing our specialty organization. I encourage

networking and the sharing of best practices between

institutions. We face similar situations every day, and

it is reassuring to know that other institutions encoun-

ter the same challenges and have similar opportuni-

ties as we do. It is helpful to compare solutions and

take recommendations from each other.

ILSPAN Fall Conference was a success last month. It was attended by 49 nurses who enjoyed a wide array of perianesthesia topics. Five boxes of canned goods were donated to the Salvation Army along with collecting 70 dollars in cash donations.

I want to extend a huge thank you to the plan-ning committee and to all those who helped in any way to orchestrate the conference. A special thank

you goes to Sylvia Baker for her expertise which guided me through the process. Sylvia kept me on track and helped me to put it altogether.

District III welcomes two new members this quarter. Let’s be certain we are all encouraging co-workers to join and benefit from our specialty or-ganization.

District I Director Rose Ziffra BSN RN CPAN CAPA

District III Director Jane Sieron MSN RN CAPA

District II Director Kathleen Crowder BSN RN CPAN

This summer brought an opportunity to re-view the business side of ILSPAN. At the August Board of Directors’ meeting we reviewed the IL-SPAN policies and procedures, bylaws and job de-scriptions. The changes to the bylaws must be ap-proved by a vote of the general membership. One of the many things that I learned at this meeting was that opportunities exist for ILSPAN members. Assis-tance abounds in the form of scholarships and grants. For those of you who are considering certifi-cation or recertification, attending an ILSPAN con-ference or ASPAN National Conference, participat-ing in a mission trip or research, I encourage you look at the many ways ILSPAN can assist. If you need any help or information regarding the applica-tion process, please contact me. (Contact infor-mation on page 2)

Research is important to the advancement of perianesthesia nursing and for validating what we do as evidence based. The research by nurses at Memorial Hospital in Springfield on the topic of Visitation in the PACU has been completed. Their research team is now in the process of preparing to publish the results. I look forward to reading about this research in our district. This group was the first to benefit from the ILSPAN Research Grant.

Planning is underway for the ILSPAN Fall Conference which will be held in District II in 2015. There is room for two more planning committee members for this conference. I hope to have the location confirmed soon. If you are interested in helping make this conference a success, fill out a Willingness to Participate Form. (Form found on page 19.

VOLUME 38 ISSUE 3

The terms quality improvement, evidence based practice and research are often used inter-changeably. The reality is all three are different but overlap. Let’s take a look. Quality Improvement (QI)

Commonly used in a business setting, QI is a systematic approach to reduce or eliminate waste, rework and losses in production process.

1

In healthcare, QI is used as a way to develop clini-cal practice based on the principle there is an op-portunity to improve on processes on each occa-sion. I feel certain that many perianesthesia units collect data on a regular basis to evaluate process-es on patient satisfaction and safety measures.

Frequently used is the Donabedian model of structure, process and outcome developed forty years ago.

2 It is essential to complete each of

these three steps. Structure, identifying the prob-lem or issue is the first step. Next is to develop a process to minimize or eliminate the problem. Last-ly, analyzing the outcome or the result of the struc-ture and process completes the cycle. The out-come should be looked at more than once to see if the structure is sustainable. Re-examination also allows an opportunity to reshape or alter the struc-ture to achieve the desired outcome. Research

Burns and Grove define research as “diligent, systematic inquiry or investigation to vali-date and refine existing knowledge and generate new knowledge.”

3 Research has multiple steps:

formation of a research question(s), reviewing the

literature, constructing a framework, applying to and receiving approval from the Institutional Review Board (IRB), data collection, analyzing and drawing conclusions from the results.

Two factors which separate research from QI are the requirement for IRB approval to do the research and publishing the results disseminating the knowledge to others. A third party reviews the proposed research to ensure that the sample popu-lation is kept safe. Prior to the development of IRBs, vulnerable populations, e.g. children, prison-ers, were not protected throughout the research process. Research becomes meaningless if not shared. Telling the story of the process of the re-search and what was discovered during the re-search benefits others only if the story is shared via presentation and/or a published article. Evidence Based Practice (EBP)

What we learn in research is taken to the next step by applying the gained knowledge into practice. EBP is defined by Burns and Grove as “the conscientious integration of best research evi-dence with clinical expertise and patient values and needs in the delivery of quality, cost-effective health care.”

3 Since the 1980s, the Agency for Healthcare

Research and Quality (AHRQ) has worked in identi-fying health topics and the development of practice guidelines for these topics. The AHRQ has devel-oped tools to assess the quality of care that is pro-vided by the evidence-based practice guidelines.

In the next issue we will look at the Jo-anna Briggs Institute website which provides

many benefits for ASPAN members.

References 1. Quality improvement. Available at http://

www.businessdictionary.com/definition/quality-improvement.html#ixzz3A1Ofh4gz Accessed August 10, 2014.

2. Hughes R. Tools and strategies for quality im-provement and patient safety. Available at http://www.ncbi.nlm.nih.gov/books/NBK2682 Accessed on August 10, 2014.

3. Burns N, Grove S. Glossa-ry. The Practice of Nursing Re-

search Conduct, Critique, and Utiliza-tion. St. Louis, MO: Elsevier Saunders;

2005:736, 749.

ILSPAN Research Grant Deadline July 1, 2014

PERI-SCOPE

Looking for All ILSPAN Researchers

ILSPAN is eager to hear about your research

or evidence-based projects on perianesthesia

nursing that are in progress or in the planning

stages. Drop an email to Linda Beagley,

ILSPAN Research Chair.

Contact information on page 2.

Linda Beagley MS BSN RN CPAN

http://www.businessdictionary.com/definition/quality-improvement.html#ixzz3A1Ofh4gz



http://www.ncbi.nlm.nih.gov/books/NBK2682%20%20Accessed%20on%20August%2010

http://www.ncbi.nlm.nih.gov/books/NBK2682%20%20Accessed%20on%20August%2010

E

CPAN®

Christina Anderson Josephine Barcelona Karin Barth Elizabeth Bendinelli Kelly Braun Sheri Brondyke Daphnie Fernandes Andrea Garfinkel Karen Goehl Sandra Griesbaum Melanie Larson Angelique Legrand Linda Louis Rebecca Marschang Mark Moolenaar

Jyoti Naik Nenita Padernal Pamela Pierce Mary Shields Joslyn Smith Juliette Triebe Noel Wojtulewicz

CAPA®

Larry Gnat Mary Iwaszkiewicz Helen McManus Judith Manipon Lea Pearson

VOLUME 38 ISSUE 3

CPAN® and CAPA® News Nursing Passion in Action®

ILSPAN Scholarship

If you are taking the test this fall or if you will recertified this fall be sure to apply for the ILSPAN CPAN® or CA-PA® Scholarship. View information and the policy on the ILSPAN web site, www.ilspan.org > Scholarships > Certi-fication Scholarships, or by sending an e-mail to any Board member. (Contact information on page 2.)

Congratulations to ILSPAN Certified Nurses with 15 to 28 Years Certified.

Total of 671 Years.

CPAN® and CAPA® NEWS

ABPANC Reports: Certification is Helping to Improve Patient Care

Independent studies have proven that Post Anesthesia Care Units with a high-er percentage of CPAN and CAPA nurses have lower rates of central line bloodstream infections. The knowledge gained by studying for certification ex-ams helps to improve patient care.

Those of you who hold our specialty certification know how it has made a difference in your life. Please encour-age others in your unit to join nearly 12,000 CPAN and CAPA nurses who are certified. The next testing oppor-tunity will be spring of 2015.

Start planning now. Resources are available on the ABPANC website at www.cpancapa.org

Eleanor Carlberg CPAN—1986

Anita Deasis CPAN—1986

Mary Janik CPAN—1989

Kim Kraft CPAN—1989

Lisa Mendelson CPAN—1989

Mary Ann Cochran CPAN—

1989; CAPA—1996

Nelia Valera CPAN—1989

Lynn Nadrowski CPAN—1990

Sylvia Baker CPAN—1991

Susan Cramton CPAN—1992

Deborah Rossman CPAN—

1992

Kim Perry CPAN—1994

Kathryn Meier CPAN—1995

Susan Sweeney CPAN—1995

Gwendolyn Hicks CPAN—1995

Evelyn Buscar CPAN—1995

Linda Landers CAPA—1996

Linda Determan CPAN—1997

Maria R. Bell, CPAN—1997

Angela Morris CPAN—1997

Jeanette McAllister CAPA—

1997

Marilyn Harleman CAPA—1997

Joann Quinn CAPA—1997

Christine Johnson CAPA—1997

Debra Golen CAPA—1997

Judith Horvat CAPA—1997

Christine Tilker CAPA—1997

Michelle Nottoli CAPA—1997

Lynn McDermott CAPA—1997

Patricia Moeckel CPAN—1998

Corinn Desmond CAPA—1998

Bella Aggacid CPAN—1998

Mary E. Jones CPAN—1999

Congratulations New ILSPAN Congratulations New ILSPAN

Certified Nurses Certified Nurses

http://www.ilspan.org/

http://www.cpancapa.org

The first weekend in September ASPAN holds the Leadership Development Institute (LDI). The busy, fun filled weekend allows for component leaders to network, share ideas, and learn strategies to grow their components, as well as themselves, profes-sionally. This event is not just for component leaders. Every member interested in learning more about ASPAN and component procedure or becoming a component or ASPAN leader is welcome to attend.

Region 3 was well represented at this year’s LDI in Nashville, Tennessee. The week-end was an interactive learning experience. It was great to spend time with friends made over the years as well as get to know newcom-ers. Friday night, small groups participated in a team building exercise presented by the Re-gional Directors. Each team was instructed to build a bedpan out of paper, straws, rubber bands, and scotch tape. The groups then mar-keted their bedpans. It was an entertaining exercise with much creativity demonstrated.

Educational breakout sessions ad-dressed subjects such as Gold Leaf applica-tions, budget, effective board meetings, using social media, and applying for contact hours. Armi Holcomb and Jacque Crosson spoke about finding the leader in ourselves and oth-ers. The Regional Directors lead a panel dis-

cussion on succession plan-ning where the Directors and attendees shared suc-cessful practices and per-sonal stories regarding re-cruiting the next generation of leaders.

My journey in be-coming a member of the ASPAN Board of Directors started with one person saying that they thought I would be good at the position. I had never con-sidered being on the board but this person plant-ed the seed. Personal contact is important to assure potential candidates feel encouragement and support and know that someone believes in them.

I challenge those of you in leadership positions to plant those seeds of encouragement with up and comers. Your words could be a spark of inspiration. Being a member of a Com-ponent Board or the ASPAN Board is a wonder-ful learning experience. Members give to the organization but receive so much in return. The personal and professional growth, knowledge, professional contacts and wonderful friends I have made will always be with me. There is an effective leader in each of us. I encourage you to consider giving a little of yourself and receive the amazing benefits of being a part of this exciting organization.

Begin plans now for a 2015 PANAW celebration. ASPAN’s 2015 theme is Perianesthesia Nurses: Dedicated Professionals, Passionate Care. During

PANAW, perianesthesia nurses in hospitals, clinics, and ambulatory surgery centers across the country celebrate their roles as partners in caring.

ILSPAN presents an award each year to the perianesthesia unit that demonstrates Educa-tion, Professionalism, and Team Spirit of the perianesthesia unit during PANAW. Submission infor-mation and deadline will be published in the Winter Peri-Scope. The award is presented at the gen-eral membership meeting at the spring conference.

ASPAN Region 3 Director

Tracy Underwood MSN RN CPAN

PERI-SCOPE

Leadership Development Institute

PeriAnesthesia Nurse Awareness Week (PANAW)

February 2-8, 2015

ILSPAN sent five members to the ASPAN Leadership Development Institute (LDI) September 5-7, 2014 in Nashville, TN. Each returned home ener-gized and ready to lead ILSPAN into the future. At the September board of directors meeting they shared highlights from the weekend.

Rose Ziffra, District Director 1, found the team building interactive session to be resourceful. (See details on page 8 in Tracy Underwood’s Region 3 Director’s report.) One of Rose’s many take a-ways from this weekend was that listening is the greatest accomplishment a leader can possesses.

Kathleen Crowder, District Director 2, learned ways to help her transition into her new role. The team building activity in which groups designed and built bedpans was a mechanism to identify the idea-makers or the worker-bees. The activity helped each team come together and resolve differences. Kathleen met ASPAN Region 3 Director, Tracy Un-derwood, who claims that her state components are “the best”. A common theme of membership issues was voiced during the LDI. Kathleen’s learned lesson was that the educational wave of the future is half day seminars, virtual vendors and mixing medical with fun vendors.

Fe Castro, Membership Chairman attended with hopes of learning how to increase membership. She attended a session on budget and learned about

the importance of being insured against risk. Her favorite session was on “Firing up the Keyboard”; a tutorial for the over 50’s group on how to navigate the ASPAN website.

Carla Silzer, Treasurer, also attended the budget meeting and appreciated how personable ASPAN’s CEO Kevin Dill and Treasurer Katrina Bickerstaff were. ASPAN President Jacque Crosson presented the topic of different generations in the workforce—Generalists, Baby boomers, Gen X and Y. Carla learned that knowing your workforce is es-sential in generating effective communication.

Mary Higgins, Vice-President/President-Elect, was interested in the presentation on social media and how it can be both helpful and hurtful. She also learned that here are many methods to hold board meetings including using Skype. Mary particularly enjoyed hearing Kim Noble present “Research Jump Start.” Kim shared how research really isn’t scary and ASPAN is available to help components get started with research.

IF THE LDI SOUNDS INTERESTING AND YOU

WOULD LIKE TO ATTEND NEXT YEAR, CON-

TACT ONE OF THE ILSPAN BOARD MEMBERS.

CONTACT INFORMATION IS FOUND ON PAGE 2.

Notes from 2014 Leadership Development Institute

VOLUME 38 ISSUE 3

ILSPAN Members Rose Ziffra, Carla Silzer, Kathleen Crowder, Fe Castro, Mary Higgins (kneeling) hamming it up.

Photo by Mary Higgins

Terry Booble, MSN, RN, CAPA

Patricia Mertens RN CPAN

Spotlight on ILSPAN Members

Patricia Mertens has been a nurse for twenty-two years. She is a 1992 graduate of Lu-theran Medical Center School of nursing in St. Louis, Missouri and is currently enrolled in a BSN completion pro-gram through Walden University. Patty main-tains a membership in ASPAN and ILSPAN and obtained her CPAN certification in 2012. She feels fortunate to

have attended the ASPAN National Conference in Seattle, Washington in 2011.

Patty currently works in perianesthesia nursing at Memorial Hospital in Belleville, Illinois which is a Magnet hospital. She spent nine years in Phase One Post Anesthesia Care Unit (PACU) and was charge nurse there prior to transferring to the Preoperative Testing Center.

Transferring to another phase of perian-esthesia care has added a new perspective to Patty's understanding of the patient's surgical experience. She has had to adjust from the physical hands on action required in the PACU. The goal now is to work closely with the anesthe-siologist to make certain that the patient is opti-mized for their surgical procedure. Patty is fo-cused, a hard worker and is dedicated to her profession.

Among the numerous committees that Patty has participated in, include: The New Em-ployee Orientation Committee, The Education Committee, The Hand Hygiene Committee, The Quality Improvement Committee and the Unit Practice Council. Patty has also served as a mentor to new employees.

Terry Booble has been working at Adventist Hinsdale Hospital as a Clinical Coordinator in Pre-admission Testing (PAT) for a number of years. She is responsible for patient flow, clinical outcomes and the overall daily operation of the unit. Well-respected by her peers for her leadership and professionalism, Terry is a role model and always strives for excellence. She takes pride in what she does and encourages the staff to give their abso-lute best for every patient. She communicates by listening and then taking action on every oppor-tunity that is presented. The changes that she has introduced are evidence-based, and she measures the success of those changes with both qualitative and quantitative data.

Terry has been instrumental in the inte-gration process of pre-admission testing at Ad-ventist Hinsdale Hospital and Adventist La-Grange Hospital. Together with the team, she looked at the processes, identified clinical varia-tions and developed an efficient, cost effective, evidence based and patient centered care mod-el.

With her leadership, PAT employee en-gagement increased from 75% to 95%. She led her department with 100% NDNQI participation. PAT is one of the top units at the hospital with the highest scores in Culture of Safety Survey and Physician Satisfaction Survey. Terry is the coordinator of the Nursing Care Committee of Adventist Midwest Hospital, and she won the Leadership Award at the 2014 PANAW Celebra-tion. She is both a Clinical Level III nurse and a Certified Ambulatory Perianesthesia Nurse. Terry recently received the Nurse of the Month award at Adventist Hinsdale Hospital.

PERI-SCOPE

In August of 2013 the Office of the National

Coordinator for Health Information Technology

(ONC), indicated that improved care will be the re-

sult of standardization for reporting.1 ONC states,

the key to progress for our future in healthcare re-

form is standardization.1 Electronic documentation

has many positive implications. This includes the

ability to standardize documentation in the periop-

erative setting. This will allow for the collection of

statistics that can translate to care across all peri-

operative settings. Using standardization will also

provide insight into best practices. Currently, limited

use of standardized data documentation practices

and the constraints of IT capabilities impede data

validity and delay the comparisons of quality data

from multiple providers.1 How can we ensure that

the Electronic Medical Record (EMR) is meeting

the needs of our specialty practice while ensuring

standardization? There is no one size fits all for our

scope of practice and each institution has chosen

and developed an EMR based on specific needs.

The types of patients we care for are unique. The

question remains should the documentation be

equally unique? The attempt to standardize docu-

mentation within the EMR is difficult. This can be

related to the workflow processes in our individual

practices or in instances where we have developed

processes deviating from the standard workflows. I

believe from the perspective of data collection and

achieving evidenced based practice, perioperative

documentation of patient care should be standard-

ized. Translating that standardization into the elec-

tronic world is more difficult than anyone could im-

agine.

Documentation Practices

Documentation practices are prescribed by

multiple venues. Many of the governing bodies that

provide recommended practices influence the data

that is documented. For instance ASPAN has de-

veloped standards that provide us with a guideline

for recommended documentation practices.² In ad-

dition, the EMR vendor consults with their subject

matter experts (SME) to develop prescribed content

for documenting a given value. The application is

then turned over to your Clinical Information Sys-

tems administrators who review institutional poli-

cies and procedures to establish documentation

requirements specific to our institutions. The sys-

tem administrators work with management and

staff to develop documentation values. Our docu-

mentation practices should fall within the recom-

mendations of these governing bodies. When re-

sources are not consistent in terminology and prac-

tice, creativity creeps in and we cultivate ways to

meet the needs of our specialty practice and our

institutional policies by tweaking and developing a

“work around”.

Descriptors

For instance let’s review a pulse assess-

ment. This seems easy enough to do, so why is

this so difficult to achieve? The details are in the

descriptors. Terminology or descriptors are not

consistent throughout our practice. Documenting

the heart rate is easy. The pulse is palpated or

auscultated and documented as a numerical value.

When it comes to the description of the pulse, the

details are cloudy. There are thousands of institu-

tions that use multiple resources to determine the

best practice for documenting the description of the

pulse. For instance the term irregular, we all know

what irregular feels like, but how does it translate

into documentation; uneven, erratic, variable, ran-

dom, now and then, intermittent, sporadic, fluctuat-

ing, and abnormal might be a few terms that come

to mind. These terms can all mean the same thing

so how do we ensure they are interpreted the

same way? This is one of the benefits of the EMR.

We have the opportunity to standardize documen-

tation. This would make it easy to collect valuable

data and statistical relevance from documentation

that will make our data actionable. This will guide

us down the path to evidence based practice in the

care of our patients. This is difficult to accomplish

when the terminology and practice are not stand-

ardized.

Ensuring Quality Documentation in the Electronic Medical Record Striving for Standardization: The Details are in the Descriptors

VOLUME 38 ISSUE 3

(Continued on page 12)

Informatics Corner Jamie Danks BSN MSHI RN CNOR

The Danish Association of Anaesthesia, Intensive Care and Recovery Nurs-es is proud to be hosting the 3rd ICPAN congress and would like to invite you to come to Copenha-gen in the late summer 2015.

The aim of the conference is SHAR-ING initiatives in education, research, manage-ment and evidence- based practice and CAR-ING for the perianaesthesia patient: clinical case studies in anaesthesia, post anaesthetic care including paediatric, elderly and surgical specialty groups. Online registration opened mid- Sep-tember 2014 and 1st call for abstracts will open primo October 2014

This will be the first ICPAN congress in the Nordic countries, home of the Vikings and IKEA! Denmark, which introduced Hans Christian Andersen and Lego to the world, is a casual, friendly country with an unparalleled focus on childhood and family life – an appro-priate setting to address issues of post anes-thetic care for our patients. And, as in all Nor-dic countries, English is commonly spoken and spoken well – particularly in beautiful vi-brant Copenhagen, a world class city with im-pressive architecture, parks, museums, res-taurants and, of course, the Little Mermaid. So come to Copenhagen, enjoy what Denmark has to offer and become stimulated and invig-orated by what promises to be an exhilarating congress.

ICPAN CONGRESS ANNOUNCES 2015 CONFERENCE

September 9th

to 12th

2015

(Continued from page 11)

Standardization

How do we develop documentation that will ensure accurate standardized documentation?

This should be included in the planning stages of any EMR.

Teams that are created to develop the EMR should use the following to set a course for stand-

ardization; a strong SME, bedside nurses at the table, ASPAN standards and education and re-

education of staff. Being actively involved in development of the EMR and obtaining buy in from nurs-

ing and management staff alike are crucial to successful development of standard documentation in

the EMR.

References

1. Murphy, K. EHR Standardization Key to Health IT Progress ONC Brief says. EHR Intelligence Website. Available at

http://ehrintelligence.com/2013/08/20/onc-highlights-value-of-ehr-standardization-in-latest-brief Accessed February 14, 2014. 1. American Society of PeriAnesthesia Nurses. Perianesthesia Nursing Standards, Practice Recom-

mendations and Interpretive Statements. 2012-2014. Cherry Hill, NJ: ASPAN; 2012.

PERI-SCOPE

ASPAN Willingness-to-Participate forms are due October 31st.

Sign up for your favorite committee(s) or strategic work team(s).

http://ehrintelligence.com/2013/08/20/onc-highlights-value-of-ehr-standardization-in-latest-brief

ASPAN Resource Development Strategic Work Team (SWT)

This ASPAN SWT works to provide ASPAN members with scholarships for BSN, MSN or Doctorate in Nursing, CPAN® or CAPA® certification or recertification, ASPAN National Conference, Humanitarian Missions and for the Nurse in Washington Internship Program.

Funding for these programs comes from the ASPAN Hail, Honor, Salute program and Silent Auction held in the national conference exhibit hall along with the Dream Walk on Sunday morning during NC. Consider honoring one of your co-workers with a Hail, Honor, Salute, contribute to an item to the Silent Auction or walk in the Dream Walk. Your dona-tion will go a long way to support perianesthesia nurses.

The ASPAN Perianesthesia Nursing Standards,

Practice Recommendations and Interpretive State-

ments 2015-2017 is in the final production stage.

These standards will contain the new ASPAN Pre-

vention of Unwanted Sedation in the Adult Patient

Practice Recommendation and the Position State-

ment on the Nurse of the Future: Minimum BSN Re-

quirement for Practice.

Save the Date

ASPAN 34th National Conference April 26 - 30, 2015

Grand Hyatt San Antonio, San Antonio, Texas

Early Bird Registration Open Until 03/21/15

More information on the ASPAN website at:

http://www.aspan.org/Events/2015-National-Conference

ILSPAN Members apply now for the ILSPAN National Confer-ence Scholarship. Information can be found at www.ilspan.org under the Scholarship Tab.

Registration brochures available from the National Office in De-cember. Save on your registration by doing the early bird regis-tration. There will be opportunities to volunteer at conference for host/hostess or to work in the ASPAN Shoppe. Conference is always a fun time. You could earn 20 to 30 continuing education hours at this conference.

ASPAN Above and Beyond Award

This award honors the recipient for exemplary service to ASPAN and/or their com-ponent. ILSPAN members have been honored with this award—Sylvia Baker and Linda Beagley in 2014. The criteria and ap-

plication is found on the ASPAN website at www.aspan.org. Look under the “Members” tab for Awards and the Above and Beyond infor-mation is in the side menu that ap-pears. It would be great if other IL-SPAN members won in Texas 2015.

VOLUME 38 ISSUE 3

News & Notes

http://www.aspan.org/Events/2015-National-Conference

In the U.S., there are a growing percent-age of chronic pain patients requiring surgery. Pain in this population is likely to be difficult and challenging to manage.

1 In many cases, most

analgesic options have already been maximized, and they are likely to be opioid-tolerant. In addi-tion, new surgical pain may produce opioid-induced hyper-analgesia.

Chronic pain patients require careful evaluation and planning to achieve appropriate acute pain management. The objectives in man-aging acute pain in this complex group of pa-tients are to provide adequate pain relief for the acute surgical event in a safe and timely manner and to meet the patient's expectations.

2 In pre-

paring for surgery, the first step is to identify cur-rent long-term opioid medications, the dosages, routes of administration and the length of time the patient has been using the medication. This information will provide guidance on medication dosing during and after surgery. Multimodal Treatment

Surgical pain has traditionally been viewed as an acute problem, treated mainly with opioids in the recovery room.

2 Research evi-

dence now shows that post-surgical or post-traumatic pain is best treated with a multimodal approach, especially if the pain is severe and long-lived enough to interfere with or impede the recovery process. This multimodal approach may include systemic analgesics, anti-inflammatory agents, local anesthesia with other adjunct medi-cations, use of heat and cold, electric stimulation, drugs applied via cutaneous delivery system and rehabilitation activities. Benefits of multimodal pain management strategies include: reduced pain scores, decreased hospital length of stay, reduced nausea, faster return of bowel function, earlier mobilization, more rapid return of the abil-ity to eat and a minimized stress response to sur-gery in order to facilitate healing. This type of management is particularly important because in our present healthcare system, many surgeries now are being classified as outpatient and length of stay for inpatient is being limited.

2

Intraoperative pain can be variable, and patients on daily chronic opioid maintenance may require up to 20% more of the usual daily opioid

dose.2 In the postoperative period, this popula-

tion is likely to have significantly higher analge-sic requirements and report more intense pain. Intravenous opioids delivered via patient-controlled analgesia (PCA) are the most com-mon approach, beginning as early as the Phase I recovery period. It is common to use PCA with a basal infusion in these patients, and they are less likely to experience over-dosage with a basal infusion rate than opioid naive pa-tients. One Hospital Implements Change

At Adventist Hinsdale Hospital in Hinsdale Illinois, the perianesthesia team de-veloped a protocol for acute pain management in chronic pain patients. Patients come to pre-admission testing one to two weeks before sur-gery for assessment, clearance and education about the surgery. Chronic pain patients are identified by using a screening tool developed by the team. The patients provide information about their pain specialist and all pain medica-tions they are currently taking. The nurse noti-fies the surgeon to obtain a pain consult. All pain management orders are placed by a Pain Specialist pre-operatively to provide timely pain management in the postoperative period. A sticker is placed on the front of the chart as part of a communication tool to all care providers for easy identification of chronic pain patients. For patient safety, all patients with a PCA are sent to the floor with oxygen, capnography and pulse oximeter. This process increased patient satisfaction, decreased length of stay in PACU, facilitated effective communication and collabo-ration between disciplines, resulting in opti-mized patient flow and increased productivity.

References 1. Fisher R, Johnson Q, Reeves-Viets J.

Chronic opioid drug therapy: Implications for perioperative anesthesia and pain man-agement. Missouri Medicine. 2013; 3: 231-235.

2. Quinlan J, Carter K. Acute pain manage-ment in patients with persistent pain. Cur-rent Opinion in Supportive & Palliative Care. 2012; 2:188–193.

Education Article Rose Ziffra MSN RN CPAN CAPA

PERI-SCOPE

Management of Acute Pain in Opioid-Tolerant Patients

ASPAN does not have a clinical path-

way, guideline, or policy regarding the use of

low molecular weight (LMW) heparin or sequen-

tial compression devices (SCDs). Nurses are

aware that deep vein thrombosis (DVT) can

cause increased pain and suffering, increased

financial costs, increased emotional cost, and

decreased surgical outcomes. The Surgical

Care Improvement Project (SCIP) recommends

that mechanical prophylaxis be initiated for most

cases within the 24 hour period prior to and af-

ter surgery.

One article addresses the use of SCDs

in knee arthroplasty surgeries¹. Some research

seems to demonstrate that SCDs are actually

more useful than active motion! Generally, all

patients receive SCD therapy while in the PACU

with the exception of surgical procedures that

SCDs would be contra-indicated (i.e. femoral-

popliteal bypass).

SCIP also recommends that all patients

have pharmacological DVT prophylaxis, with

some exceptions (spinal fusions or patients at

risk for bleeding), in an effort to promote posi-

tive patient outcomes regarding DVTs.

The 2012-2014 Perianesthesia Nursing

Standards, Practice Recommendations and Inter-

pretive Statements states: “ASPAN is a highly

committed advocate for the culture of safety in all

perianesthesia practice settings.”² When address-

ing patient advocacy, this reference explains that

a culture of safety includes several actions,

among those are: “Protecting the patient from

harm through the use of safety tools.”² The use of

SCDs and LMW Heparin products are tools that

help protect the patient from the danger of DVT

formation.

Reference:

1. Journal of the Southern Orthopaedic Assoc. Effect of Sequential Compression Devices on Femoral Venous Blood Flow. Available at: www.medscape.com/viewarticle/444065 Ac-cessed August 21, 2014.

2. Perianesthesia Nursing Standards, Practice Recommendations and Interpretive State-ments. 2012-2014. Cherry Hill, NJ: American Society of PeriAnesthesia Nurses; 2012, 13.

CLINICAL PRACTICE CORNER Sylvia Baker MSN RN CPAN

Research Project Update Wanda Ellenburg MSN MHA RN CPAN

It has been almost four years since we raised the burning question about the impact of family visits in Phase I on the patient and the family. We formulated a research question, completed a literature review, wrote an abstract, received IRB approval, completed a pilot study, received funding from ILSPAN and the Memorial Medical Center Foundation. We gathered data, both quantitative and qualitative. We had a statisti-cian compile the quantitative data. Our research team became immersed in the qualitative data and discov-ered the over-arching theme of “To See with My Own Eyes.” We have presented posters at local ILSPAN conferences, ASPAN 33

rd National Conference in Las Vegas and at Sigma Theta Tau conferences.

Most importantly, the PACU made a practice change allowing family visits in Phase I at 45 to 60 minutes after the patient arrival for all patients and families desiring a visit. It has been ten months since the practice change. The change has been well received by patients, families, nursing staff and physicians. We have the manuscript completed. It will be submitted for peer review among nursing researchers at Memorial Medical Center in Springfield, IL. Our next goal is to submit to a professional journal in October for publica-tion. Be watching as we further disseminate our findings.

VOLUME 38 ISSUE 3

What does ASPAN say about the use of mechanical and pharmacological DVT pre-

vention in the PACU?

http://www.medscape.com/viewarticle/444065

Linda Beagley, Research Chairman speaking with Conference attendee about research in ILSPAN.

Speaker Sandy Alvarez RN MSN CCRN-CMC talks with Carla Silzer.

ILSPAN Fall Conference: Getting in Touch with Your

PeriAnesthesia Practice

PERI-SCOPE

Conference Chairman, Jane Sieron talking with Sylvia Baker, retiring ILSPAN Education Director

Conference Attendees

September 13, 2014

ILSPAN ConI

Fall Conference held at The National Shrine of Our Lady of the Snows Belleville, IL. The conference had 49 in attendance. Door Prizes raised $278 to be donated to a local charity.

Raffle Winners left to right Celeste Wiesner, Jennifer VanDerLeest, Sylvia Baker, Beverly Meis-ter, Janice Willman, Linda Beagley, Mary Higgins. Not pictured Darlene Meyer.

Jan Ridder Excellence in Clinical Practice Award Recipient Sylvia Baker

VOLUME 38 ISSUE 3

ILSPAN Conference Scholarship Winner Insook Ann Kang

Photo

s b

y J

ane R

ein

schm

idt

Sandra Neudahl

Korene Palazzo

Diane Ruch

Kim Sisk

Carla Stainer

Lisa Patrice Theis

Eva Trefonas

Linda Van Buren

Latisha Washington

Jolee Zaagman

Welcome New Members who joined May to September 2014

PERI-SCOPE

District 1

Josephine Begora

Rita Campana

Anna Davies

Bonnie Horton

Yingjie Kielb

Grace Malasig

Judith Manley-Plum

Katrina Marshall

Betty-Ann McGuckin

Catherine Neary

District 2

Elizabeth Ann Collins

Heidi Cook

Janice Willmon

District 3

Tynette Marie Jensen

Elizabeth Smart

ILSPAN BUCKS: Every dollar counts! ILSPAN BUCKS in the amount of $5.00 are awarded for early renewal of your ASPAN/ILSPAN mem-

bership submitting an ILSPAN willingness to participate form, or if you serve as a host for an ASPAN seminar. ILSPAN BUCKS in the amount of $10.00 is awarded for achieving CPAN/CAPA certification for the

first time bringing a non-member to an ILSPAN conference if they join ASPAN/ILSPAN on the spot, submitting articles accepted for publication in the Peri-Scope or a research or evidence based practice poster approved for presentation at the conference.

ILSPAN BUCKS may be redeemed by submitting it with the ILSPAN conference registration form. You cannot use the ILSPAN BUCKS for online registration. ILSPAN BUCKS expire one year from the date it was issued.

RECRUITER OF THE YEAR: It’s not too late! ILSPAN has a Recruiter of the Year Award; given to the member who recruited the highest number of

new members between January 1st and December 31

st. The award is presented at the Spring Conference. To

be considered for the award, a minimum number of three members must be recruited. Be sure that your name

is written as the recruiter in the Membership application form. The recipient of the award will receive one year

free ASPAN/ILSPAN membership.

MEMBERSHIP REPORT Fe Castro BSN RN CPAN CAPA

http://www.google.com/imgres?biw=1119&bih=556&tbm=isch&tbnid=B6vKwhVDwGQZTM:&imgrefurl=http://parenting.leehansen.com/downloads/clipart/autumn/pages/maple-leaves-border.htm&docid=DMFKl2zJ0Br7hM&imgurl=http://parenting.leehansen.com/downloads/clipart/autu

ILSPAN Willingness to Participate Form

Name_____________________________________________________________________

Address___________________________________________________________________

City, State, Zip______________________________________________________________

Home Phone ________________________Cell Phone______________________________

E:mail_____________________________________________________________________

ASPAN Membership #________________________________________________________

Place of Employment_________________________________________________________

Please circle position of interest:

BOD position_________________________

Editor/publication committee

PR/Marketing

Computer networking

Previous experience that will help me: ___________________________________________

My goals for this position:_____________________________________________________

Questions I have:____________________________________________________________

VOLUME 38 ISSUE 3

Volunteer for ILSPAN

Cut out the form below and mail it to Vice President Mary Higgins or log into the web site www.ilspan.org and fill it out and submit on line.

Mail to : Mary Higgins BSN RN CPAN 536 N. 7th Avenue Des Plaines, IL 60016

Editorial Comment Jane Reinschmidt BS RN CAPA

During the past three Januarys, I was privileged to participate in mission trips to the Dominican Re-public. In 2014 I received the gift of seeing where my interventions made a life changing difference for two of the people I was privileged to serve.

Much like what we do in perianesthesia nursing, in mission nursing we provide care and then move to another patient. We go home in the evening (or morning) and know that we made a difference (if we think about it) but there is not often the opportunity to see long term outcomes. As the years go by and we are called on to do more with less, it’s easy to forget how we change and, yes, save lives.

Teaching is another aspect of perianesthesia nursing where knowledge of long term outcomes may not be visible. How many codes had positive outcomes because of the many years I taught CPR and ACLS? I’ll never know. Linda J. Fisher BSN, RN, CPAN knows how it feels to have made a difference. Two years after Linda presented an in-service on lipid rescue one of the nurses who attended was able to identify an occurrence of local anesthetic systemic toxicity (LAST). Her rapid initiation of the lipid rescue protocol saved a life.¹ This nurse took the time to find Linda Fisher and acknowledge that the positive outcome was a result of the class which Linda had taught. Good job, Linda.

Many of you may have noticed a new Peri-Scope column on Informatics. Thanks to author Jamie Danks BSN RN MSHI CNOR, an ILSPAN member, who has volunteered to be a regular contributor to this publication. I hope you find this addition timely and informative. Reference 1. Fisher L. How a JOPAN Article Saved a Patient’s Life. J PeriAnesth Nurs. 2014; 3:173

ILSPAN Illinois Society of PeriAnesthesia Nurses

ILSPAN Humanitarian Mission Scholarship Application Deadline …………………………..January 1, 2015

ILSPAN Research Grant Application Deadline………………………..……………………….January 1, 2015

ILSPAN Winter Virtual Board of Directors Meeting…………………………………………..January 10, 2015

ILSPAN Spring Board of Directors Meeting.. …………...………….……………………………March 6, 2015

ILSPAN Spring Conference, Arlington Heights, IL.……………………………………………...March 7, 2015

ASPAN 34th Conference San Antonio TX……………………………………………….April 26-April 30, 2015

ILSPAN Summer Board of Directors Meeting, Go-to-Meeting…..………………………………July 11, 2015

ILSPAN Fall Board of Directors Meeting, Champaign, IL……………………………………October 9, 2015

ILSPAN Fall Conference, Champaign, IL……………………………………………...……..October 10, 2015

Additional details available on the web sites

www.ilspan.org or www.aspan.org

Looking Ahead………..

ILSPAN Core Purpose The Illinois Society of Perianesthesia Nurses ad-vances nursing practice through education, re-

search, and standards of practice. The Society exists to serve needs of membership at the component level.

Copyright© 2014 Peri-Scope All rights reserved. Reproduction by any means without expressed

permission from ILSPAN is prohibited.

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