M N D A K S P A N

News from the Minnesota-Dakotas Society of PeriAnesthesia Nurses

It is more blessed to give than Receive Karissa M Brinkman, RN, BSN

During the third century in the village of Patara, Nicholas, was born and with that the true story of Santa Claus begins (http://www.stnicholascenter.org/pages/who-is-st-nicholas/). Nicholas was raised by wealthy parents who taught him to be a devout Christian and died in an epidemic when Nicholas was very young. However, Nicholas obeyed God and used his whole inheritance to assist the sick, needy, and the suffering. He dedicated his life to serving God and became the Bishop of Myra as a young man. Bishop Nicholas was known for his gener-osity to those in need, his love for children, and his concern for sailor and ships (http://www.stnicholascenter.org/pages/who-is-st-nicholas/).

Bishop Nicholas was persecuted and imprisoned for his faith under the Roman Emperor, Diocletian and re-leased in AD325. On December 6th, AD 343 he died in Myra. The anniversary of his death became a day of celebration, St Nicholas Day, December 6th. Throughout centuries many stories and legends have been told of St Nicholas’s life and deeds that give rise to his extraordinary character, why he is so beloved, and considered a protector and helper of those in needs(http://www.stnicholascenter.org/pages/who-is-st-nicholas/).

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VOLUME 39, ISSUE 3

W INTER 2012

It is more blessed to give than receive—continued from Page 1

As I learned about the true story behind St Nick, I found myself thinking of the many nurses who during the Christmas Season give so much of themselves to help and heal those in need and spread cheer to those who are ill and aren’t with their family’s during the holiday season, while they themselves may be missing out on a family Christmas gathering, a Christmas church service, or a Christmas program to serve those in need. So I would like to take a moment to pause, and say, “thank you” to each and every one of you who give of yourselves so freely during this Christmas Season continuing to be your patients advocate, serving your patients and family’s needs with a compas-sionate heart, all the while helping to spread a little Christmas joy to all the indi-viduals you tenderly care for that won’t be with their family’s this Christmas. May you all have a blessed Christmas, Karissa M Brinkman, RN, BSN MNDAKSPAN President

Fall MNDAKSPAN Conference Recap

Kahler Grand Hotel Rochester, MN

Deb Massey, RN, CPAN

The fall MNDAKSPAN conference was held at the Kahler Grand Hotel in downtown Rochester, MN near the Mayo Clinic. The newly re-modeled conference area was decorated with a patriotic theme that supports our com-munity service project, Opera-tion Mend. The door prizes filled two large tables and were donated by local businesses, vendors, and our perianesthe-sia colleagues. Other displays included a CPAN/CAPA infor-mational table and a MNDAKSPAN and ASPAN ta-ble with informational displays and handouts about our organizations. Our vendors included 3M/Arizant and Dansco Shoes.

Dr Adam Jacob started off our conference with the topic of current evidence and future directions of regional anesthesia. Research has boomed in recent years and is being used more and more. Ultra-sound guided technique vs. blind technique was discussed. Intentionally injecting into the nerve is being researched now also. Regional anesthesia has a large role in the ambulatory surgery setting. The volume of these surgeries has skyrocketed. They have doubled since 1996. The goal is to minimize pain and prevent PONV. Regional anesthesia is not for everyone though because of refusal, patient complexity, untimely offset, as well as safety con-cerns such as falls and insensate extremity. He presented research showing 40% of patients report severe pain 24-48 hours after surgery. Chronic pain is something that we are more aware of these days and is defined as pain lasting greater than 2 weeks after surgery. It may affect up to 25% of pa-tients. Research about cancer recurrence and regional anesthesia was very interesting and Dr Jacob talked about the impaired immunity from Pe-rioperative stress, opioids and general anesthetics. An important considera-tion with regional anesthetics is systemic toxicity treatment to prevent aci-dosis and hypoxia, seizure treatment and cardiac arrest considerations. Rapid lipid emulsion is vital to resuscitation in this situation.

Our first winner of the free pair of Dansco shoes was Traci Smith.

Our next speaker was Susan Cutshall; she gave an overview of what complementary and integrative medicine (CAM) is and how it is being used currently across the nation. She talked about the factors contributing to growth of CAM and integrative medicine. There has been much growth of acupuncture and massage and it’s use at major medical centers across the nation. Spirituality and mind-body medicine is important to consider in the care we provide to our patients. Essential oils are being offered to pa-tients also. This has been shown to reduces nausea, promotes sleep and in-crease feelings of well being. Lavender, peppermint and tangerine are be-ing used at the Mayo Clinic currently. Other modalities used include mas-sage therapy, music, acupressure, guided imagery, hypnoses, reiki, healing touch and the use of nature in healing. She discussed things we can do as nurses in the health care setting. The most important thing for nurses to do is to maintain a loving presence. Holistic health coaching as nurses helps patients reach their self-identified health goals. As we care for our pa-tients, it’s important to remember to care for ourselves. Susan identified how to do a better job of this. Creating resilience is an important practice also. Quease-ease is a product commonly used at her facility. It contains ginger, peppermint, lavender and spearmint essential oils.

Sara Griffith presented on the benefits and challenges of pediatric family centered care in the Perianesthesia setting. She identified benefits to the pediatric patient when incorporating a family centered approach. The ASPAN standards on visitation in the Perianesthesia setting were dis-cussed and the importance of a consistent policy was stressed. There are also benefits to the nurse when a family centered approach is used in the Perianesthesia setting. Challenges include privacy, confidentiality, etc. The benefits include increased satisfaction by family/patient and decreased anxiety. Child-life specialists are being used more and more to assist in this process and are very helpful. Education and communication is important to make sure that all team members are on the same page and the practices are consistent with institutional policies.

Christopher Dietz is a nurse anesthetist and he discussed HIPAA rules to evaluate disclosure of patient information, behaviors necessary to reduce malpractice, and how to ensure patient privacy in our homes and in the Perianesthesia environment. What information is protected and what in-formation isn’t? HIPPA violations and penalties were described. Interest-ing scenarios of breeches in confidentiality were shared and how “bad stuff” happens. Documentation and legal implications of that documenta-tion was addressed. The take away message was to practice within your standards, using correct spelling, approved abbreviations, and with legible handwriting when charting. Every hospital has an approved abbreviation list. Review your nursing practice and monitor your behavior if needed. ( We enjoyed a wonderful meal in an adjoining room and had time to net-work with our fellow nurses. Our second Dansco shoe winner was Carrie Jones. Our first speaker after lunch was Matt Byrne who discussed Web 2.0 and consumer health informatics for the perianesthesia nurse. He started off explaining what informatics is and what it consists of, such as computer sci-ence, cognitive science, information science, and discipline-specific science. He talked about CHI challenges, to include poor health literacy and assess-ing the patient to see what level they are at. Patients tend to not ask for help even when they don’t understand. HON code= health on the net (put acronym/pic) means it’s accurate, trustworthy and readable, etc for health education of the public. A good way to discriminate web resources. Web 2.0 applications. Prezi, Evernote, facebook, etc (pg 2). He compared the differences between Web 2.0 and Web 1.0. Cloud storage is the storing of information non-locally on your device, but on the internet. You are able to access information anywhere at anytime. Social media tips for RN’s, in-cluding being aware of your agencies social media; HIPAA still applies,

privacy is a myth, avoid disparaging remarks about your employer, col-leagues, and patients with with no identifying info. Maintain professional boundaries. There is several state policy initiatives led primarily by MDH and included Minnesota e-Health Initiative. ASPAN has a clinical practice site with additional resources available.

Dr Kopp presented on how to avoid opioid related respiratory events. Risk factors were identified, ongoing efforts to identify patients at risk for OSA, and options for reducing the risk and optimizing the detection of opioid related respiratory depression. People are at risk for about 1 week af-ter anesthesia. She identified patients at risk for a respiratory event. she de-fined apnea (cessation of airflow for > 10 sec), hyponea = tidal volume less than 50% of the awake value for more than 10 sec. Est 24% of obese men and 9% of obese women have sleep apnea. Undiagnosed in > 80%. Types of apnea include obstructive 85-95% and a few are central and a few are mixed. CPAP works well. Recommended to avoid sustained release opioids. Multimodal approach works best, and includes NSAIDS, aceta-minophen, tramadol, ketamine, clonidine, and gabapentin. Described a study done at Mayo Clinic, “Identification of Patients as Risk for Postop-erative Respiratory Complications Using a Preoperative Obstructive Sleep Apnea Screening Tool and Post anesthesia Care Assessment”. Protocols are driven by this research, to include having continuous pulse oximetry af-ter surgery if criteria met.

Our last speaker was Stephanie Madsen, a holistic health coach who addressed holistic healing. She listed self-care ideas to energize/fuel your-self and explore your individuality. The power of intentions including thoughts, words, and behaviors and how they affect us and those around us. Neurolinguistic programming and guided imagery were mentioned; these things can change dramatically your thoughts and actions. She spoke on the power of having a positive attitude. Things to pay attention to in or-der to decrease stress: breathing, sleep, nutrition, exercise, aromatherapy, and complementary and alternative modalities.

At the end of the conference, the winner of the free MNDAKSPAN conference was drawn. The winner was Susan Weir.

Our community service project was to support Operation Mend

which is a collaborative program using the military’s resources with the skills of UCLA Health System for military personnel wounded and disfig-

ured in Iraq and Afghanistan. We had a wonderful display and a volunteer PACU nurse, Capt Traci Smith who is also a service member available to answer questions about operation mend and to collect donations. We were able to collect $800.00 in donations for this cause (including $100.00 do-nation from MNDAKSPAN).

MNDAKSPAN Board Meeting

October 5th, 2012 2:00 p.m.

Kahler Hotel, Rochester

MEETING ATTENDANCE

Karissa Brinkman X Julie Somheil Deb Massey X

Ginny Maruish X Lynn Saari X Susan Poulson X

Mary Olson Paula Fridlund X Deb Moengen X

AGENDA/ITEM DISCUSSION Person responsible/Action items

Minutes Reviewed and approved Deb

Treasurers Report Susan

Old Business

Board members update postion competencies

ASPAN leadership Transition checklist...this a form they designed to use with the transition of duties when they meet with the person assuming their position. It consist of a review of job descriptions specific to position, including current projects and recommendations; communications (to National office, president, BOD); BOD mtgs (attendance, when held, and preparation); additional tools, resources, records, and general

Karissa will send the board a leader-ship transistion checklist to review. All board members are to review and re-turn to karissa by December 1st. Each board member will than keep this in their binder and use this as part of orientation for new incoming mem-bers.

Book donation Each year the component donates a book to a nursing school.chosen from a running list.

Paula will purchase Cecil Drain: A Critical Approach to Perianesthesia

Call for Nominations/ Willingness to serve forms for 2013 Open BOD positions

Open Positions for 2013 are Publications, Director of Education, Secretary, Vice President, President Elect. Voting will completed on-line.

Review of Mission, strate-gic plan, bylaws, and P/P

Updated bylaws were not available for board to review Karissa will send by laws out to board for review

Gold Leaf Award Karissa reviewed some of the areas we are lacking in criteria

CDI update Paula gave an summary of her attendance at the CDI conference. She was Paula

Committee Reports

Governmental Affairs Mary absent. E-Mail read from Mary The board felt that this was quite expensive and in light of financials we would not send a member to the NIWI conference

Certification There are currently 75 CPAN, 30 CAPA and 12 dual certified members. Ginny sent out a letter and a badge holder to replace the pins. There was feedback shared by the board from some members on the badge holders. Vote; The results of the on-line vote was not available. The board moved that making the change to send out badge holders was premature and that there should be pins sent to this quarter”s recipients.

Ginny to send pins to recent certified members. Await the results of the vote for further action.

Membership There are currently 301 members. Paula has created a letter to be sent out to new members. She would like to add all the benefits of membership.

Paula

Public Relations Website; There were issues with the website including the expense of making changes to be $60 each time. Lynn would like to investigate creating a new website. There was support for Lynn to look into further options for our web-site. Newsletter: The next newsletter will be sent out before Christmas. Submis-sions are welcome.

Lynn

Education This conference planning committee has done well on trying to keep cost down. Operation mend will be represented. There are two quilts they will be raffled off and the proceeds will go towards operation mend. A motion was made by Deb Massey to reimburse Tracey Smith (operation mend representative) for registration for the conference. The motion was 2nd by Lynn and all were in favor. A donation was received from ASA for $100. Spring Conference April 6th, 2013 Best Western, Bloomington MOA Planning committee (limit 5 reimbursed)

Deb Massey Motion passed to reimburse registration for operation mend representative.

New Business

Component Membership Fees

Prices effective January 2013 through December 2014. Not another opportu-nity to increase component membership fees again until Jan. 2015. Need to submit price increases by 11-2-12. Discussion to leave membership prices the same.

Karissa No change in fees for mem-berships.

Dates to remember National Conference: Chicago April 14-18 NIWI Sunday Mrch 24th- Tuesday March 26th 2013 Hyatt Regency Washington on Capital Hill Room Rate $235/night with 14.5% tax

A motion was made by Lynn; One national conference registration fee for A registration fee for na-

Respectfully submitted Deb Moengen

Other Business

A motion was made by Lynn; One national conference registration fee for mem-bers who vote in the board of directors election. This vote will be announced at the spring conference. This motion was 2nd by Paula.

A registration fee for national conference. Will be drawn at spring conference.

Review of drawings were as follows; One free conference registration fee for each conference which would total 2 regis-trations given each year.

Meeting adjoined at 5:00 p.m.

Fall Conference Planning Committee: Front Row Left to Right: Deb Massey, Renae Clays, Melissa Hartwig, Karen Peterson-Rucker Back Row Left to Right: Caryl Ewing, Deb Barry , Sheila Nadeau, Kay Padilla, Mary McNab

As a result of the on-line survey last fall, MNDAKSPAN will not send CPAN/CAPA certification pins. The cost of the pins has risen sharply over the last couple of years. MNDAKSPAN strives to be fiscally re-sponsible and listens to its members.

PeriAnesthesia Nurse Awareness Week (PANAW) provides an ideal

opportunity to celebrate and promote our practice throughout the

nation! The 2013 celebration will be held from February 4-10, 2013,

and this year’s theme is PeriAnesthesia Nurses: Compassionate, Caring, Competent.

Browse Resources at : https://www.jimcolemanstore.com/pdf/JC-PANAW13-CAT.pdf

Save the Date MNDAKSPAN Spring Conference April 6, 2012 Best Western Plus Bloomington Right behind the Mall of America Enjoy a weekend of education and shopping with MNDAKSPAN