Vital Volumes

Indiana Society Of PeriAnesthesia Nurses

Inside this issue

INSPAN Officer info .................... 2

Clinical Practice ......................... 3

Research Corner ....................... 4

Willingness to Participate ........... 5

Willingness to Participate form...6

ABPANC News ........................... 7

Committee Reports ................... 8

INSPAN News ……..…………………….9

Government News ……………..…...10

ASPAN …………………...……………….11

President’s Message Mary Baird MSN, RN, CPAN

Greetings INSPAN Members! I would like to recognize each of you for your part in surviving this historic winter. Thanks to each of you for going the extra mile in planning and coping with the weather to care for our patients and staff. It is true that there is a season for everything! As a gardener, I prepare for each upcoming season. In the fall I cover the roses, wrap the azaleas, and bring other items inside. During this past winter, I longed for the touch and aroma of freshly tilled soil. Even now I relish the warmer temperatures and breezes, as I walk on soggy ground to pick up debris in the yard. It was during such a soggy walk, I found evidence of survival from this hostile winter sprouting plants along the side of the garage. This discovery not only brought me hope but joy. I realize these plants have an advantage based on their vari-ety and location near the house which provided warmth. My question to you as a perianesthesia nurse is where are you professional-ly? Are you wrapped in burlap as my azaleas or are you exposed and vulnera-ble? At this time many of us even those with decades of experience face chal-lenging professional circumstances. Hopefully, not all of these changes have been unanticipated. Like the gardener, most healthcare organizations are preparing and implementing changes. There are times that even the bravest and most dedicated nurse may need inspiration or advice. So, during this springtime of renewal, may each perian-esthesia nurse make the conscious decision to embrace our profession with a renewed prospective and professional energy! Perhaps by attending district meetings to network with fellow nurses or national conference for inspira-tion, direction, and education each nurse can be refueled. Please do not overlook the relevant guidance and support for Perianesthe-sia Nurses by involving yourself in INSPAN/ASPAN. My professional challenge is for each nurse to plant or sow encouragement into the life of the newest member of your perianesthesia department. Then, when next spring arrives you too will be delighted to walk with in the rewards of new professional growth which ultimately impacts patient care! See you at National Convention! Please be sure to visit our table at Compo-nent Night for details on the Indiana Meet and Greet. Please look for further details regarding the Fall Update in September.

March 2014 Volume 4, Issue 1

Vital Volumes Deadlines

June 15th

October 15th

December 15th

Please submit all articles by e-mail

to Charlotte West at

crwest@stvincent.org or

dwills@tds.net

Letter to the Editor

INSPAN loves to hear from YOU! Please

submit news from your district, hospital,

research projects and recognition of fel-

low associates to Charlotte West at

crwest@stvincent.org

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President Mary Baird MSN, RN, CPAN

mary.baird@porterhealth.com

Vice President/President Elect Ruth Boberg BSN, RN, CPAN

rrbberg@tds.net

Secretary Charlotte West BSN, RN, CPAN

crwest@stvincent.org

Treasure Carol Matthews BSN, RN, CPAN, CPN

Past President Kathy Jo Carter MSN, RN, CPAN

Indianapolis District Representative Grace Walke BSN, RN, CPAN

WINSPAN District Representative Lynn Pound RN

Northern District Representative Lorrie Dulla BSN, RN, CAPA

ASPAN Regional Director Tracy Underwood BSN, RN, CPAN

Newsletter Editor Charlotte West BSN, RN, CPAN

19324 Hamilton Boone County Road

Sheridan, IN 46069

crwest@stvincent.org

Phone: 317-582-73335 fax: 317-582-8008

Cell Phone: 317-225-0751

Www.inspan.org

Vital Volumes

Is written by and for INSPAN members.

All rights are reserved.

Copyright 2014

The ASPAN Clinical Practice Committee receives questions from members and non-members interested in clarifying and/or increasing knowledge and understanding of the Perianesthesia practice. Below is one of the frequent questions. This article is reprinted with permission from Alicia Voorhees. Alicia Voorhees, RN, BSN, CPAN, CAPA, PLIV ASPAN Clinical Practice Committee ASPAN Standards & Guidelines SWT

Question(s): Why is it necessary to check the patient’s temperature q hour if they are normothermic on admission, no c/o being cold, no shivers & remain so at d/c? Isn't admission & d/c acceptable?

Answer(s): Great question! There are several points to cover in answering this. First off, the 2012-2014 PeriAnesthesia Nursing Standards, Practice Recommendations and Interpretive Statements Resource 2D “Standards for Basic Anesthetic Monitoring” on p. 107 Sec 5.2 clarifies that “Every patient receiving an-esthesia shall have temperature monitored when clinically significant changes in body temperature are intended, anticipated or suspected”. I’m assuming you are referring to the postanesthesia period not the entire stay per se (ie: preop, phase II) and my answer reflects that.

Normothermic does not always represent clinical changes in status in a timely manner. The best exam-ple of this is urosepsis; patients can develop urosepsis literally in minutes which is why many institutions have adopted policies that require more frequent temperature monitoring even before regulations went into effect. And, of course, if you’re actively warming your patient you want to ensure positive response to that.

More significant to your question is hypothermia; even mild hypothermia may contribute to complica-tions such as surgical site infection (SSI), altered drug metabolism, impaired blood clotting, cardiovascu-lar ischemia, prolonged recovery following surgery, and shivering. Quick temperature drops of as much 1.6°C can occur in even 30 minutes; shivering is actually a very late sign for both ends of the spectrum. Further research reveals that body temperature requires tight monitoring because all general anes-thetics produce a profound dose-dependent reduction in the core temperature triggering cold defenses including arterio-venous shunt vasoconstriction and shivering. Anesthetic-induced impairment of nor-mal thermoregulatory control and the resulting core-to-peripheral redistribution of body heat is the primary cause of hypothermia in most patients. Neuraxial anesthesia also impairs thermoregulatory control, although to a lesser extent than general anesthesia. Prolonged epidural analgesia is also associ-ated with hyperthermia when other causes have been ruled out. Obviously given all of the cardio-respiratory and central effects of the many different types of anesthesia used the evidence is clear that regular monitoring is certainly a prudent practice and has been adopted as a regular Evidence Based Practice (EBP) universally.

Because identifying all of these complications early is an EBP and saves lives, many regulatory and insur-ance agencies have now started rewarding hospitals that are compliant with these recommendations with financial incentives for proving they follow the recommendations by quality assurance monitoring of our documentation.

If you’re patient has remained normothermic at discharge then you have done your job well!

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Clinical Practice Question

33rd ASPAN National Conference

April 27 to May 1, 2014 sev-

eral Perianesthesia nurses

will be traveling to Las Ve-

gas for an exciting confer-

ence. Many opportunities

are available to increase

knowledge with ASPAN,

ABPANC, and general peri-

anesthesia nursing practice.

Be sure to check out these

events:

Representative Assembly

(Sunday): election of na-

tional officers and recom-

mendation discussed

with required vote from

the RA reps

Components Night: Fun

night and networking!

INSPAN members are

asked to dress in black

pants and red t-shirt. The

theme is “Viva Las Vegas”

INSPAN members meet

and greet. A sign will be

posted on the infor-

mation board in the reg-

istration area on the time

and place—usually Mon-

day or Tuesday eve. Ap-

petizers will be availa-

ble—drinks on your own.

Education Session: sit

back an absorb the

knowledge presented at

the various session. You

will not be disappointed.

ASPAN Shoppe: fun and

useful items with ASPAN

logo plus published ma-

terial to help your prac-

tice. 4

Research Corner Kathy Jo Carter MSN, MBA, RN, CPAN

INSPAN Unwanted Sedation Project

You return to the PACU from transporting a patient. In an hour or so, a Rap-

id Response is called to the nursing unit you just left. That sinking feeling

has you wondering if the patient in trouble was yours. “But the patient was

hurting. I couldn’t take her up with a pain number of 8, even if she was

sleepy.” This raises the question, at what point in drive to control pain, do

we back off and let the medicine have a chance to work?

Our SWT spent the last part of 2013 reviewing literature to establish an

evidence base. The literature showed that we under medicate, as well as

over medicate. Where is our middle ground? We reviewed several sedation

scales, two of which are Chris Pasero’s scale (POSS) and Richmond Agitation

and Sedation Tool. These tools can help us prevent the respiratory depres-

sion from opioids, yet still provide pain control. We may see a Practice Rec-

ommendation come out of the RA at conference this year.

Our INSPAN component is talking about a group project to look at unwant-

ed sedation. This would involve the implementation of a sedation scale in

your practice and collaboration with the post PACU nurses for feedback.

The nurse who is not comfortable with administering opioids will benefit

from the use of a tool. Please consider sharing your PACU practice with us.

Do you have a monitor in place to track patient progress after they leave

the PACU? Has evaluation of the data collected led to a practice change?

Kyra and I welcome your participation. Please send your interest to me, kjcarter2009@frontier.com. This project is in the formation stages. My ini-tial thinking is to keep our information focused on the data, so I would ex-pect the data to be submitted without your hospital name. Nausea and vomiting is also a hot topic. If you have any projects going with new ap-proaches to control, please email me or Mary Baird at mary.baird@porterhealth.com.

“We need to adopt a culture of evidence-based

administration, using models of nursing care

delivery that are not based solely on cost saving,

but have been evaluated on robust nursing

research and supported by reality testing from

front-line staff as well as nursing managers.”

– Susan VanDeVelde-Coke (2010). Evidence-Based

Research in Nursing Administration: The Time Is Now.

Nursing Leadership, 23(3). 15-17

Willingness to Participate

INSPAN desires your assistance to enhance our present organizational structure and growth

within our perianesthesia specialty. The INSPAN Nominating Committee is asking you to accept

the challenge of participation at the state level. There are opportunities to serve and participate

as an officer on the board or on a committee. Choosing to get involved will enhance your lead-

ership potential. Listed below are the board positions available. The Board meets 4 times per

year (September, November, March, June)

Attached is the Willingness to Participate/Serve form to submit.

Vice President-President Elect will acquaint himself/herself the duties and responsibilities

of the office of president, so that he/she may serve efficiently when succeeding to the

office. In the absence of the president or in the effect of the president’s inability to

serve, the vice president-president elect shall perform the duties of the president. This

officer will serve as chairperson of the Update Committee. This officer will serve as an

Assembly Representative at National Conference and receive up to $1,500.00 re im-

bursement (Policy # 4-13-1)

Term: One (1) Year

Secretary shall keep or cause to be kept, the corporate books and records of the Compo-

nent (other than financial records). The secretary shall be responsible for giving or

causing to be given, notice to all meetings of members and the Board of Directors, in

accordance with the By-Laws and for keeping the minutes of such meetings, and shall

have a copy of the By-Laws available at all such meetings, for reference. The secretary

shall also keep or cause to be kept, the Articles of Incorporation, the By-Laws, the seal

of the Component, as furnished by ASPAN.+

The secretary shall notify nominees of their election to office or of their appointment to

committees and shall forward pertinent materials to directors, officers, and committee

members as appropriate or necessary. The secretary shall perform all other duties as

may be set forth in the By-Laws, all duties which are custom and practice, incident to

the office of secretary and such other duties as may, from time to time, be assigned by

the Board of Directors.

The secretary shall serve as the official correspondent with ASPAN and shall maintain a

current roster of all members and officers of INSPAN, classified according to category

of membership.

The secretary of INSPAN shall advise the National Headquarters Office, with reasonable

promptness, ANY changes in the Articles of Incorporation or By-Laws of INSPAN which

shall not be consistent with the Articles of Incorporation and By-Laws of ASPAN.

Term: 2 years

Please consider participating or chairing one of the committees listed on the Willingness to Par-

ticipate form. This is your organization supporting the PeriAnesthesia Nursing profession.

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Government Affairs Committee

Strategic Planning Committee

Policy and Procedure Committee

Education Committee

Research Committee

By-laws Committee

Nominating Committee

Publication Committee

Membership Committee

Audit Committee

INDIANA SOCIETY OF PERIANESTHESIA NURSE WILLINGNESS TO PARTICIPATE FORM

(EVEN YEAR ELECTION)

I, _____________________, SUBMIT MY NAME FOR NOMINATION FOR THE FOLLOWING OF-FICE. _______ VICE-PRESIDENT/ PRESIDENT ELECT _______ SECRETARY I DO HEREBY ATTEST THAT I WILL SERVE IF ELECTED TO OFFICE SIGNATURE: ________________________________ PLEASE ENCLOSE A BRIEF AUTOBIOGRAPHICAL SKETCH INCLUDING EDUCATION, NUMBER OF YEARS OF PERIOPERATIVE NURSING EXPERIENCE, PLACE OF EMPLOYMENT, MEMBER-SHIP IN PROFESSIONAL ORGANIZATIONS, AND ANY AWARDS, ACCOMPLISHMENTS, AND HONORS YOU WOULD LIKE TO SHARE WITH US. THIS INFORMATION WILL BE USED TO IN-TRODUCE YOU TO THE INSPAN MEMBERSHIP WHEN THE SLATE OF OFFICERS IS PRESENT-ED. I, ________________________, WOULD BE INTERESTED IN SERVING ON THE FOLLOWING COMMITTEES: _______ PUBLICATION __________ GOVERNMENTAL AFFAIRS _______ BY-LAWS __________ EDUCATION _______ NOMINATING __________ UPDATE _______MEMBERSHIP __________ POLICY AND PROCEDURE _______AUDIT __________ STRATEGIC PLANNING _______RESEARCH __________ HISTORIAN PRINT NAME: ____________________________ SIGNATURE: _____________________________ ADDRESS:________________________________________________ PHONE: _______________ Return Form to: Kathy Jo Carter MSN, RN, CPAN PO Box 67, Frankton, IN 46044 kjcarter2009@frontier.com

May fax forms to: 317-582-8008 Charlotte West BSN, RN, CPAN

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CERTIFICATION NEWS CPAN® / CAPA® Examination Dates There’s never been a better time to get certified. Join more than 11,000 perianesthesia nurses who have become CPAN or CAPA certified. Increase your own personal knowledge and skills for patient care, while enhancing the awareness and respect of perianesthesia nursing. The Spring 2014 Examination schedule is set with the following dates:

Registration Window – Online January 13 – March 10 Examination Administration Window April 7 – May 17 Period for Scheduling Exam Appt. Upon receipt of ATT letter with Prometric through May 15 Deadline for Rescheduling or 31 calendar days before Cancelling Appt. with Prometric scheduled test date

Register early to get the testing date you want and have time to study. ASPAN members receive a $100 discount.

Congratulations to the New CPAN and CAPACongratulations to the New CPAN and CAPACongratulations to the New CPAN and CAPA

Fall of 2013Fall of 2013Fall of 2013

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Tara Beaumont-Colgan RN, CPAN

Rita Govert RN, CPAN

Joy Caton RN, CPAN

Mellissa Hite RN, CPAN

Brenda Toth RN, CPAN

Pamela Parker RN, CAPA

Lora Cooper RN, CAPA

Laura Benkert RN, CAPA

Diana Ritz RN,CAPA

Erin Stader RN, CAPA

Emily Goodman RN, CAPA

Stacie Deutsch RN, CAPA

Research Committee

Kathy Jo Carter MSN, RN, CPAN

INSPAN Past President Networking with other INSPAN members on possible projects; Members are encouraged to contact

Kathy with suggestions. ASPAN research SWT has worked on a proposal for a practice recommendation

on ‘Unwanted Sedation’ - more information to come.

Bylaws/Policy & Procedures

Grace Walke BSN, RN, CPAN Bylaws have been reviewed with no corrections.

Finance Report

Carol Matthews BSN, RN, CPAN

Treasure/Education Chair Stable accounts; Budget for 2013-2014

Education Committee

Carol Matthews BSN, RN, CPAN

Treasure/Education Chair Scholarship funds will be available in September 2014 for completed education July 1, 2013 to June 30,

2014. Encourage members to save receipts and apply for scholarship reimbursement.

Publications/Website

Charlotte West BSN, RN, CPAN

Secretary/Membership/Publication Chair Newsletters will be published 3 times a year. The website is updated monthly or when information is

required. www.inspan.org. Board discussion on redesigning the website.

District Information

WINSPAN: (Lynn Pound) Continue discussion on possible disbanding this district due to lack of par-

ticipation.

Indianapolis of INSPAN: (Grace Walke) Meeting for 2014 are being planned. July 15, 2014 will be

a poster presentations of research, clinical practice. Members are asked to bring posters to present.

Northern: (Mary Baird and Lorrie Dulla): Northern had a meeting March 27th with an educational

offering.

Membership Memo

April membership = 286

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INSPAN Committee Reports

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Celebrations!

The PACU staff at Porter Regional Hospital celebrated PeriAnes-

thesia Week on Monday with bagels, cream cheese, yogurt,

and fruit to get everyone started off with a nutritious breakfast.

Due to the extreme weather conditions on February 5, 2014

the Porter PACU staff postponed the PeriAnesthesia lunch to

February 6, 2014. Regina Wilson-Hackman, Unit Director and

Mary Baird, PACU Educator provided the lunch of sandwiches, chips and sodas. The set up and des-

serts of delicious cakes was supplied by Nilsa Hand, RN (charge nurse); Alexis Olson-Bryant, BSN, RN

BC (Nursing Educator); and Glori Marshal, RN. The PACU nurses present for lunch received verbal

blessing acknowledging and thanking them for their individual contribution to the excellent care in

the PACU. A small gift of hand lotion was given to each PACU staff member.

INSPAN received a proclamation from Governor Mike Pence for PeriAnestheisia Day on February 5,

2014.

March 19, 2014 was Certified Nurses Day™ honors nurses worldwide who contribute to better pa-

tient outcomes through national board certification in their specialty. A registered nurse (RN) li-

cense allows nurses to practice. Certification affirms advanced knowledge, skill, and practice to

meet the challenges of modern nursing. INSPAN and 198 CPAN’s and CAPA’s. Congratulation!!

CPAN 104

CAPA 82

Dual 12

44% of the INSPAN membership has received their certification

INSPAN sent $50 to the American Red Cross, Kokomo, IN to assist the tornado victims. In the area

last fall.

The Pasero book on Pain Assessment and Pharmacologic Management will be sent to the Nursing

School of Valparaiso University library for nursing students. This is in support of future Perianesthe-

sia nurses.

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INSPAN News

Lynn Geberin & Lorrie Dulla John Van Gilder

Indiana Government Information

Senate Bill 222 - Student Athlete Concussions {3/14/2014}

Student athlete concussions. Provides that a high school student athlete who has been removed from

play because of a suspected concussion or head injury may not return to play until at least 24 hours

have passed since the incident. Beginning July 1, 2014, requires football coaches and assistant football

coaches who are coaching individuals less than 20 years of age to complete a course concerning player

safety and concussions at least once during a two year period. Provides civil immunity for football

coaches in certain circumstances.

INSPAN Fall Update 2014 When: September 27, 2014

Where: to be announced

Topic: Surrounding Your Practice with Excellence: Legalities, Standards, & Advocacy

Speaker: Lois Schick MN, MBA, RN, CPAN, CAPA (ASPAN Past President 2008-2009)

May 6—12, 2014: The week celebrates the legacy of Florence Nightingale, a nurse who became famous

for treating wounded soldiers during the Crimean war, and for her work in establishing nursing as a pro-

fession in its own right. Florence was affectionately known as 'The Lady With The Lamp'; she made a lot

of her ward rounds at night whilst carrying a lamp. Florence Nightingale founded a nursing school in

1860, providing the first type of professional nursing establishment in the world.

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INSPAN NEWS

Lois Schick

ASPAN National Conference

ASPAN's 33rd National Conference

Dealing with Challenges:

Winning with Power, Practice & Purpose

Las Vegas Hotel & Casino

April 27 - May 1, 2014

Las Vegas, Nevada

Hope to see you at Component Night and the Indiana Meet and Greet. 2013 pictures at Conference

Component Night Come and enjoy the fun with the Indiana group by wearing a red t-shirt and black pants.

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