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NEWSLETTER

Autumn Issue

ACPAN Newsletter Autumn 2017

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MESSAGE FROM T HE ED I TOR Welcome to 2017 – and it is Easter! Where has the time gone? ACPAN is up and running for the year with seminars held in Victoria, NSW and Qld. At this stage, there are several state vacancies across WA, SA and NSW. If you, or a colleague, have a passion for PACU and Anaesthetic nursing, please get in touch with the board at info@acpan.edu.au who will put you in touch with the relevant state contacts. 2017 is an exciting year in the ACPAN calendar with the biennial ICPAN conference heading down under to Sydney in November. This is an exciting time as Peri-anaesthesia nursing will be celebrated internationally through this conference. If you attend this event, you can earn up to 20 CPD hours. More information is provided within the newsletter. ACPAN is also proud to announce that we are the only Australian member of the International Federation of Nurse Anaesthetists (IFNA). We hope your year has gotten off to a great start and we look forward to seeing you all throughout the year. Melanie Murray ACPAN College Co-Secretary AB O U T US The Australian College of PeriAnaesthesia Nurses (ACPAN) was convened to promote the professional development of perianaesthesia nurses through regular meetings, study days, educational forums, and publication of newsletters. Membership is open to Registered Nurses or Enrolled Nurses working in the specialties of Pre- Anaesthesia Clinic, Anaesthesia, Post Anaesthesia care, Acute Pain and Procedural Sedation. Associate membership is open to others (eg: Representatives of Trade Companies and other Health Professionals) with a genuine interest in the field. JOIN ACPAN NOW

How can you help us influence and advance Perianaesthesia Nursing education and standards in Australia? – Become a member – Be involved in your state branch or national committee – Share your knowledge and ideas with the other members by submitting an article or letter to our newsletter – Take advantage of the education grants available to further your knowledge and be published in our newsletter – Present at state seminars and national conferences – Promote perianaesthesia nursing as a fulfilling career.

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PRESIDENTS R EP O R T We have begun 2017 with a blazing start! The 2017 Clinical Fellowship Program has commenced, ACPAN councils have formed and are busily working towards training pathway development and professional standards research. There have been some membership and website changes to assist our members (stay tuned for a few more exciting changes in the not so distant future). We are bringing our national members and international colleagues the most incredible international conference, ICPAN 1st-4th November- Luna Park Sydney. Oh and also, ACPAN was successful in our application to join the International Federation of Nurse Anaesthetists (IFNA). All before Easter! Not bad for 4 months’ voluntary work from your ACPAN Board. I think we have definitely earned some celebratory Easter chocolate. The 2017 Clinical Fellows are well into their first semester at University. The clinical fellows will be under the expert mentoring of ACPANs Chief Examiner, Dr Paula Foran. Paula is an inspiration to us all who dedicates her waking moments to the advancement of perianaesthesia and perioperative nursing nationally and internationally. Also, we warmly welcome Lyndall Moore into the role of Clinical Fellowship Coordinator. Who better to nurture and support our 2017 clinical fellows but Lyndall who completed her clinical fellowship on 2016. Best of wishes to all our 2017 Clinical Fellows. The curriculum and credentialing council (CCC) has formed a fantastic group of individuals who have embarked on the journey to develop our very own ACPAN Training Pathway. I am so thrilled to see this council come together as education and training is close to my professional heart. There is promise of fantastic initiatives to follow in 2017 and I am certain ACPAN training and education for our members will continue to go from strength to strength with Dr Vera Meeusen leading the charge. The Professional Standards Council (PSC) is making steady progress with background research work to underpin the development of our very own ACPAN Professional Standards. If you have keen interest in professional standards development and review and would like to be part of this council, contact Dr Heather Reynolds. We are thrilled to be working with Heather who has contributed much to evidence based nursing and has extensive clinical research skills experience. The ACPAN Membership Services Council (MSC) continues in striving to improve all aspects of the ACPAN website and membership services and Donna Hopley is doing a sterling job ensuring our members receive the best service possible. The State Presidents (Jodie, Angela, Amy) have been working hard together organising seminars and these efforts are well received by the state members. A big thank you to Donna Hopley stepping in and organising a successful NSW Seminar. I am secretly hoping for a seminar in wonderful Tasmania in the near future which would be an awesome place to visit! Go along to the seminars to support your local presidents and enjoy superb education at low cost. If you want to attend any of the seminars, contact the state presidents on the website. A big shout out to the ACPAN executive (Ellen, Mel and Meg) who continue to work tirelessly behind the scenes leading and shaping our path through 2017 and beyond. Without the efforts of all ACPAN Board members, council and committee members, we would not exist. I am privileged to be part of such a dynamic team who voluntarily strive to deliver the highest level of education, training and standards to our members.

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Finally, ACPAN will play host to the most exciting and awe inspiring international conference for perianaesthesia nurses ICPAN 1st- 4th November 2017, Luna-Park Sydney. The program has just been released on the ICPAN website and I cannot wait for it to come to life. There is a feast of local and international presentations all in the spirit of perianaesthesia nursing. You do not want to miss this conference. Until next time, best wishes and keep striving for excellence in perianaesthesia nursing wherever you may be. Our patients deserve nothing less! Fiona Newman ACPAN College President

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ACPAN BOARD MEMBER S

Executive Fiona Newman President (QLD) Meg Bumpstead Treasurer (VIC) Melanie Murray / Ellen Seib Co-Secretary (WA) / (NSW) Dr Paula Foran Chief Examiner (co-opted) (VIC)

Councils Dr Vera Meeusen Chair - Curriculum & Credentialing Council (QLD) Alison Monger Allyson Johnston Melinda Oliver Sheila Marshall (Rural Coordinator) Lyndall Moore (Fellowship Coordinator) Dr Heather Reynolds Chair - Professional Standards Council (QLD) Kellie Jorgensen Elise Arndell Donna Hopley Chair - Membership Services Council (NSW)

State Presidents

Angela Fraser President - Victoria Jodie Lloyd President - Queensland & Northern Territory Amy Clark President - Tasmania

Vacancy President- Western Australia Vacancy President - New South Wales/ Australian Capital Territory Vacancy President - South Australia

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ACPAN – CALL FOR COMMITTEE & COUNCIL MEMBERS!

We are currently calling for expressions of interest to join our committees or councils, if you are interested please email info@acpan.edu.au for further information.

STATE COMMITTEE MEMBERS

NSW / ACT TAS Vacant – President Bernadette Huang Jane Nichols - ACT Della Blinksell Trute - ACT

Amy Clark - President

QLD/NT VIC Jodie Lloyd – President Kelly Jorgenson Alex Tait Sherice Burgess

Angela Fraser – President Beth Schubel

SA WA Vacant – President Santina Martin Alice Brennan

Vacant - President Jilda Levene

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Council Reports Professional Standards Council (PSC) Work on our new Professional Standards is only in its infancy, but it is exciting to be part of such an inaugural document. Welcome to our new committee members Kelly Jorgensen and Elise Arndell who have enthusiastically embarked on the journey of helping prepare our new Standards. We will have regular meetings that fit our schedules, to discuss and monitor progress in our areas of interest. Please consider joining us to utilise your enthusiasm and skill, so that we can combine our expertise to produce the Standards that meet our needs as an organisation on the world stage. Please express your interest, and we welcome your contribution, however small. Dr Heather Reynolds

Curriculum and Credentialing Council (CCC) Several ACPAN members have shown interest to join the CCC committee. Current members are Alison Johnston (Bega, NSW), Sheila Marshall (St George, QLD) and Dr Vera Meeusen (Chair, Brisbane). We had our first meet & greet in which we discussed our background, work environment and expectations. Both the chair of the CCC and Professional Standards Council (PSC) had a meeting to discuss the framework for the ACPAN Standards which need to be developed. The CCC will spend upcoming months mainly in developing a formal education structure for all perianaesthesia nurses and the Education Standards. If anyone wants to join the committee, you are more than welcome. Dr Vera Meeusen

Membership Services Council (MSC) A shout out to all members that positions on this council are available and needed to share the load. To express your interest in helping out our fantastic Membership Services Council Chair, please email info@acpan.edu.au Donna Hopley

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State Reports

Western Australia WA requires your help! Currently there is only a single committee member in WA and she really needs your help to continue specialty specific education in the state. If you have a passion for recovery and anaesthetic nursing and would like to contribute to yours and your colleagues CPD then let us know! Contact info@acpan.edu.au for more information on committee expectations.

QLD / Northern Territory Queensland committee are presenting their first seminar for 2017 on 22nd April at Redcliffe Hospital. Our topics are:

• Multimodal Analgesia by Dr K Lee; • PPH by Dr K Erinjippuratha; and • Massive Blood Transfusion by Dr Michelle Roets from RWBH.

We are also intending on having workstations for hands on education! Please come and meet the ACPAN committee, find out all the latest ACPAN news and enjoy networking with your colleagues. Morning tea supplied. (3CPD)

Victoria Victoria held a successful seminar on Saturday with 60 members in attendance. There were presentations on Working in Mongolia; MBT in obstetrics; and Anaphylaxis. The event was sponsored by Multigate and Smiths Medical. Keep an eye on your email inbox for registrations details for a half day seminar to be held in Bendigo on 22nd July.

New South Wales/ACT NSW Hunter Seminar The first of the NSW 2017 Seminars was held on Saturday 25th March at The Maitland Hospital. The day saw 25 participants enjoy 6 presentations which included; Perioperative management of the diabetic patient, Brachial plexus blocks; What are they? Why so many variations? What are we supposed to do with them in theatre, recovery and beyond, Airvo versus Thrive High flow oxygen, Aspiration & fasting times? Paediatrics Songs and Stories and finally Which Opioid and why Hydromorphone? Feedback form the evaluations was positive and a great day had by all.

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Many Thanks for your support

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ACPAN CLINICAL FELLOWSHIP

As the peak organisation, representing the professional interests of anaesthetic and post anaesthetic nurses, The Australian College of PeriAnaesthesia Nurses (ACPAN) aims to promote the highest standards of perianaesthetic care, based on available evidence, consultation, and expert consensus. Aligning with this objective, ACPAN has partnered with the University of Tasmania (UTAS) to deliver Australia’s first Clinical Fellowship Program for Registered Nurses. As one component of the ACPAN Clinical Fellowship program, candidates are eligible to complete a Graduate Certificate in Nursing, specialising in Anaesthetics and Recovery Nursing, with our partner UTAS and receive a full scholarship. Our fellowship program is designed for practicing perianaesthesia nurses who would like to demonstrate their advanced specialisation and emerge as clinical leaders in our field of healthcare. The program is suitable for nurses with a minimum of 2 years full-time (or equivalent part-time) anaesthetics and/or PACU experience. To be eligible for the ACPAN Clinical Fellowship Program the following essential criteria must be met:

o Financial Membership of ACPAN,

o Registered Nurse (Div. 1) registered with AHPRA,

o Currently employed in the perianaesthetic area (Anaesthetics and/or PACU), and

o Minimum 2 years full-time (or the equivalent part-time) experience in Anaesthetics and/or PACU. To successfully complete the fellowship program, candidates are required to meet the following requirements:

o Successful completion of Graduate Certificate of Nursing (Anaesthetics and Recovery) through UTAS or equivalent,

o Obtain Adult and Paediatric Advanced Life Support certification,

o Complete a Management of Perianaesthesia Crises course,

o Maintain a logbook of workplace experience (via the ACPAN APP)

o Obtain Multi-source feedback of your performance, and

o Pass the Oral Viva assessment. Duration: Minimum 1 year (maximum 2 years)

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ACPAN GRANTS

ACPAN was convened to promote the professional development of perianaesthesia nurses through regular meetings, study days, educational forums, and publication of newsletters. ACPAN has grown considerably and has an established Education and Research Fund. The ACPAN board extends to members an invitation to apply for grants to attend relevant continuing educational opportunities. These events contribute to providing our patients with optimal care. These grants may relate to a programme of study, a scientific and/or continuing education meeting, research project, or conference presentation/poster. The activity must have content that is relevant to the nursing care of the patient in the perianaesthesia setting. It may relate to perianaesthesia education or clinical practice. 1. The size of the grant is variable, and will depend upon the nature of the activity, available funds, and be up to a maximum of $2,000 per grant. 2. Applications will be accepted until April 30th. Grant applicants will be notified of success or rejection of their application by email by May 14th after ratification at National committee meeting in May. Eligibility for a grant requires 2 years continuous financial membership. For further information about our education and research grants, please go to www.acpan.edu.au and click on the grant link found in the footer section.

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International Federation of Nurse Anaesthesia (IFNA) ACPAN is now a member of IFNA. We are the only Australian specialist organisation to be a member of this international organisation. The following is an extract from their website which provides an overview of the organisation. http://ifna.site/about-ifna/ INTERNATIONAL FEDERATION OF NURSE ANESTHETISTS Founded in 1989, by 11 countries with a specific nurse anesthesia education, the IFNA has 42 country members. MISSION The International Federation of Nurse Anesthetists (IFNA) is an international organisation representing nurse anesthetists serving the public and its members. The mission of the federation is dedicated to the precept that its members are committed to the advancement of educational standards and practices which will advance the art and science of anesthesiology and thereby support and enhance quality anesthesia care worldwide. The IFNA establishes and maintains effective cooperation with institutions that have a professional interest in nurse anesthesia. VISION The International Federation of Nurse Anesthetists (IFNA) is the authoritative voice for nurse anesthetists and nurse anesthesia, supporting and enhancing quality anesthesia care worldwide. As professionals, nurse anesthetists are recognised for their significant contribution to global healthcare as nurses, practitioners, teachers, administrators, researchers and consultants. The IFNA participates in the formulation and implementation of healthcare policy and the recognition of nurse anesthetists as essential and cost-effective health care providers. OBJECTIVES To promote cooperation between nurse anesthetists internationally. To develop and promote educational standards in the field of nurse anesthesia. To develop and promote standards of practice in the field of nurse anesthesia. To provide opportunities for continuing education in anesthesia. To assist nurse anesthetists’s associations to improve the standards of nurse anesthesia and the competence of nurse anesthetists. To promote the recognition of nurse anesthesia. To establish and maintain effective cooperation between nurse anesthetists, anesthesiologists and other members of the medical profession, the nursing profession, hospitals and agencies representing a community of interest in nurse anesthesia. Bylaws and Objectives. FUNCTIONS To promote continual high quality of patient care To serve as the authoritative voice for nurse anesthetists and nurse anesthesia internationally To provide means of communication among nurse anesthetists throughout the world

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To promote the independence of the nurse anesthetist as a professional specialist in nursing To advance the art and science of anesthesiology. The IFNA has developed Standards of Education, Standards of Practice and a Code of Ethics for Nurse Anesthetists. Models of Nurse anesthesia program curriculum have been prepared by the Education Committee. The IFNA previously recognized as Professional Resource Group, is now Affiliate member to ICN (International Council of Nurse) to be the voice for nurse anesthesia internationally. An international study done by Dr. Maura McAuliffe, American CRNA, for the IFNA has demonstrated on its first phase that nurse anesthetists are participating in more than 80% of all anesthesia in the world. They are the sole providers in 60% of the cases.

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ICPAN is coming to Sydney!

As you are aware, there will be no ACPAN conference held in 2017, instead ACPAN are delighted to be hosting the ICPAN – 2017 Conference, 1 - 4 November 2017, Luna Park, Sydney, NSW. Registration is now open for the feature packed event. The program is available here Please note the following dates as can be found on the ICPAN website: http://www.icpan2017.com.au/ ABSTRACT SUBMISSIONS have now closed. POSTER SUBMISSIONS ARE OPEN: Please consider submitting a poster display.

Key Dates: 1st June 2017 – Poster Abstract Submission Deadline 1st June 2017 – Early bird Registration Deadline 1st September 2017 – Accommodation Booking Deadline

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Abstracts for CPD Reading

The global organization of nurses in anesthesia: The International Federation of Nurse Anesthetists (IFNA). Vera Meeusen, Sandy Ouellette, Betty Horton, the IFNA Board of Officers Trends in Anaesthesia and Critical Care xxx (2016) 1e6

World-wide, nurse anesthetists provide anesthesia care in many countries. Because of different historical background responsibilities, tasks and roles vary widely around the world. Established in 1989, the International Federation of Nurse Anesthetists (IFNA) is a global organization representing nurse anesthetists. Each member country is represented in the Council of National Representatives who elect their Board of Officers who manage IFNA on a day-to-day basis. Together with several committees, the IFNA is dedicated to the advancement of educational standards and practices that will advance the art and science of nurse anesthesia and thereby support and enhance quality anesthesia worldwide. The IFNA has relationships with numerous institutions that share the professional interest in nurse anesthesia: International Council of Nurses, World Health Organization, World Federation of Societies of Anesthesiologists (WFSA) and European Society of Anesthesiology. The IFNA-Standards, the Anesthesia Program Approval Process and the IFNA-world congresses are important tools used in the globalization process. Currently, the focus is on a framework and guidelines for Continuous Professional Development, recertification, accreditation and legislation. This is not only important for further development of the profession and the constant improvement of quality anesthesia care but also to become known to the general public.

Respiratory depression detected by capnography among children in the postanesthesia care unit: a cross-sectional study. Melissa L. Langhan, Fang-Yong Li, J. Lance Lichtor First published: 10 July 2016 DOI: 10.1111/pan.12965 Background: Children are at risk for respiratory depression while recovering from anesthesia. Currently, monitoring children in the postanesthesia care unit (PACU) with pulse oximetry is recommended. However, pulse oximetry does not reliably recognize hypoventilation or apnea, particularly in the presence of supplemental oxygen. Capnography is a sensitive monitor of ventilation that is not often used in the PACU. Aim: To determine the frequency of hypoventilation and apnea as detected by capnography among children in the PACU.

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Methods: In a cross-sectional study, capnography monitoring was applied to healthy children of age 1–17 years in the PACU of a tertiary care hospital. Staff was blinded to the capnography monitor; alarms were disabled. Staff provided routine care and monitoring with pulse oximetry to all patients. Vital signs, patient interventions, and medication administration were recorded by a research assistant every 30 s until all monitoring was discontinued by staff. Outcome measures included frequency of hypoventilation and apnea as measured by capnography and oxygen desaturations as measured by pulse oximetry, as well as staff interventions for these events. Results: Data from 194 children were analyzed. Capnography detected hypoventilation or apnea in 45.5% (95% CI 38.5%, 52.5%) of patients. Oxygen desaturations occurred in 19% (95% CI 13%, 24%) of patients. Interventions occurred in 9% (95% CI 5%, 13%) of patients. Patients who received narcotic medications were more likely to experience hypoventilation (OR 2.3, 95% CI 1.02, 5.3) and apnea (OR 2.7, 95% CI 1.1, 7). Hypoventilation was seen more often among children who received supplemental oxygen (OR 3.1, 95% CI 1.1, 12). Conclusions: Hypoventilation and apnea are common among children in the PACU; however, few interventions occur to address these events. Routine monitoring with capnography may improve recognition of respiratory depression and enhance patient safety in the PACU.

Reducing the Incidence of Postoperative Nausea and Vomiting Begins With Risk Screening: An Evaluation of the Evidence Christopher A. Smith & Lisa Ruth-Sahd http://dx.doi.org.libproxy.murdoch.edu.au/10.1016/j.jopan.2015.03.011 Postoperative nausea and vomiting (PONV) is a daily concern for patients and perianesthesia nurses. PONV is experienced by approximately one third of all surgical patients. Identification of patients at risk for PONV through preoperative risk assessment is an effective means in reducing the incidence of PONV. Perianesthesia nurses are positioned to implement such risk assessments by using simplified risk scores to identify moderate to high-risk patients. Risk assessment allows for facilitation of targeted prophylaxis which positively impacts the patients’ surgical outcome and experience. Targeted prophylaxis is efficacious in reducing the institutional incidence of PONV which decreases resource utilization and cost. The perianesthesia nurse is the crucial component in minimizing the PONV in the post-surgical patient. This evaluation of the evidence reveals that preoperative PONV risk screening leads to decreased incidence of PONV for the surgical patient, improves patient satisfaction and reduces postoperative complications. Keywords: PONV; PONV Risk Screening; PACU; Apfel Simplified Risk Score; Targeted prophylaxis; postoperative nausea and vomiting; quality of recovery

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Factors influencing Patient Safety during post-operative handover Monica Rose & Susan Newman AANA Journal, October 2016, Vol 84(5) pp. 329-338. Patient safety continues to be a major concern for healthcare providers and organizations. Handovers, also called handoffs, serve as the transfer of postoperative care from the anesthesia provider to the postanesthesia care unit (PACU) provider. Ineffective handovers result in gaps in care and potential harm to the patient. We conducted a scoping review to identify key factors affecting patient safety during the process of postoperative handovers. We searched empirical literature examining factors associated with patient safety and postoperative handovers in the context of anesthesia, in the Cumulative Index to Nursing & Allied Health Literature, Ovid, Google Scholar, and The Joint Commission websites between January 2004 and March 2014. We excluded obstetric and cardiac anesthesia-related studies. A total of 31 articles met criteria for inclusion in the review. Factors at multiple levels of the Social Ecological Model affecting patient safety and handovers were identified. Intrapersonal factors included individual communication styles; interpersonal factors were related to anesthesia and to PACU provider team dynamics; organizational environmental factors described the dynamic PACU environment; and organizational policy-level factors included emphasizing a culture of patient safety. This scoping review demonstrates a multilevel analysis of factors affecting handovers and patient safety. Keywords: Anesthesia, communication, handovers, patient safety, postanesthesia care unit

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ADVERTISING WITH US

ACPAN is a non for profit organisation and our quarterly newsletter is distributed to RN Clinicians, Educators, Hospitals and to some businesses who are members of ACPAN. ACPAN provides its members with seminars, study days, a national conference and of course this newsletter. This is an ideal medium to market your products to clinicians in the field of perianaesthesia nursing. Your help allows us to provide these services to our members. Advertisers, please send your expression of interest to info@acpan.edu.au for further details regarding your advertising or to obtain our sponsor prospectus.

AUSTRALIAN COLLEGE OF PERIANAESTHESIA NURSES This newsletter is copyright ACPAN and all rights are reserved by ACPAN may not be reproduced in whole or in part without the express written permission of ACPAN and will be subject to the inclusion of an acknowledgement of the source. ACPAN is not responsible for the content within articles published or produced by other parties. Newsletter published April 2017. ACPAN 2017.

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