The American Organization of Nurse Executives (AONE) on July 2 released a toolkit for chief nurse executives and hospital leaders to use as they manage the acquisition and implementation of information systems.

The AONE Toolkit for the Nurse Executive in the Acquisition and Implementation of Information Systems, currently available only to AONE members, is a repository of resources on transition planning, acquisition, implementation, "key learnings," healthcare IT investment, disaster management, contingency planning and nurse informatics credentialing, according to AONE. Resources include Power Point presentations, articles, books and links to useful Web sites.

Utilizing the "identified assumptions" of the previously-released AONE Guiding Principles for Defining the Role of the Nurse Executive in Technology Acquisition and Implementation, a special task force consisting of chief nursing officers and other healthcare directors contributed to the development of the new toolkit.

FDA announced July 1 it is requiring manufacturers to put a "boxed warning" on the prescribing information for the smoking cessation drugs Chantix (varenicline) and Zyban (bupropion) to highlight the risk of serious mental health events when taking these drugs, including changes in behavior, depressed mood, hostility, and suicidal thoughts.

Similar information on mental health events will be required for bupropion marketed as the antidepressant Wellbutrin and for generic versions of bupropion. These drugs already carry a "boxed warning for suicidal behavior in treating psychiatric disorders.

Janet Woodcock, MD, director of the FDA's Center for Drug Evaluation and Research, said healthcare professionals who prescribe Chantix and Zyban should monitor their patients for any unusual changes in mood or behavior after starting these drugs. She added that patients should immediately contact their healthcare professional if they experience such changes.

In addition to the boxed warning, the FDA also is requesting more information in the Warnings section of the prescribing information and updated information in the Medication Guide for patients that further discuss the risk of mental health events when using these products.

Manufacturers also will be required to conduct a clinical trial to determine how often serious neuropsychiatric symptoms occur in patients using various smoking cessation therapies, including patients who currently have psychiatric disorders. FDA's review of adverse events for patients using nicotine patches did not identify a clear link between those medications and suicidal events.

FDA's request for the additional warnings is based on a review of reports submitted to the agency's Adverse Event Reporting System since the time the products were marketed and on an analysis of information from clinical trials and scientific literature.

The analyses revealed some who have taken Chantix and Zyban have reported experiencing unusual changes in behavior, become depressed, or had their depression worsen, and had thoughts of suicide or dying.

In many cases, the problems began shortly after starting the medication and ended when the medication was stopped. However, some people continued to have symptoms after stopping the medication. Also, in a few cases, the problems began after the medication was stopped.

Neither Chantix nor Zyban contain nicotine and some of these symptoms may be a response to nicotine withdrawal. People who stop smoking may experience symptoms such as depression, anxiety, irritability, restlessness, and sleep disturbances.

However, some patients who were using these products experienced the reported adverse events while they were still smoking.

Recommendations for how the Health and Human Services Office of the Secretary will spend $400 million in stimulus funds for patient-centered research, also known as comparative effectiveness research, were released June 29 by the Federal Coordinating Council for Comparative Effectiveness Research (CER).

The report, mandated by the American Recovery and Reinvestment Act, ostensibly is designed to help the HHS Secretary Kathleen Sebelius and lawmakers to improve the quality of care for patients, and provide patients and clinicians the best information possible to make decisions about healthcare.

Additionally, the report also catalogues current federal activities on CER, which had not been previously inventoried; includes a definition of CER; details criteria for determining which research projects should be a priority, and provides a strategic framework to identify gaps and future priorities.

The report, accessible online at www.hhs.gov/recovery/programs/cer, will help to inform Secretary Sebelius' submission of an operational plan for the combined $1.1 billion allocated for patient-centered research, which includes the $400 million allocated to her office. 

The council was charged by congress with the task of identifying key areas of comparative effectiveness research where funding could make the greatest impact to improve health outcomes. The council heard many perspectives, including public input from hundreds of diverse stakeholders, which influenced the entire report.

The council focused on the unique role that the Office of Secretary funds could play in complementing and leveraging funding currently allocated to the Agency for Healthcare Research and Quality, National Institutes of Health, and other government agencies. 

Recommendations include the following:

• It is critically important to be able to share the results of comparative effectiveness research with doctors and patients and make better investments in how information is disseminated.
• Research should focus on the needs of priority populations such as racial and ethnic minorities, persons with disabilities, persons with multiple chronic conditions, the elderly, and children.
• Research should be in specific high-impact health arenas such as medical and assistive devices, surgical procedures, behavioral interventions and prevention.
• Investments should be made in data infrastructure such as linking current data sources to enable answering CER questions, development of distributed electronic data networks and partnerships with the private sector. 

An FDA advisory panel on June 30 recommended lowering the maximum dose of over-the-counter acetaminophen and the recall of some painkillers containing the non-steroidal anti-inflammatory drug (NSAID). 

According to several published reports, the expert panel voted 26-11 to make 1,000 mg doses of acetaminophen available only by prescription, and 24-13 to lower the maximum recommended does to 650 mg. OTC painkillers would be restricted to 325 mg, far less than the maximum of 1,000 mg currently available in drugs such as Extra Strength Tylenol.

The recommendation by the panel follows an FDA report released in May which revealed thousands of cases of severe liver damage (hepatotoxicity) with many as 400 deaths and 42,000 hospitalizations annually from overdoses of acetaminophen, which is considered easier on the stomach than other NSAIDs like aspirin and ibuprofen.

The risk of overdose is increased, the report found, because individuals often mix acetaminophen with other OTC medications containing the drug, such as cold remedies, resulting in dangerously high levels. The panel voted 20-17 not to recommend package size limits for nonprescription versions of the drug, however.

Additionally, following an examination of 11 different drugs containing acetaminophen, the panel voted by the same 20-17 margin in favor of recalling Vicodin, Percocet and five other prescription painkillers that combine narcotics with acetaminophen. If the drugs are kept on the market, the panel voted 36-1 for a "black box" warning, the FDA's strongest advisory, to be added to the drugs' packaging.

The panel voted against recalling NyQuil and other OTC medications that combine acetaminophen with antihistamines and other ingredients to combat cold and flu symptoms like a runny nose.

FDA, which has been warning consumers about acetaminophen overdoses the past 5 years, is not obliged to follow the recommendations of its advisory panels, but it typically does so. A final ruling by the FDA reportedly could take months. 

For more information on acetaminophen and liver damage, click here.   

A DVD that uses American Sign Language and English-based sign language to test for Attention Deficit Hyperactivity Disorder (ADHD) in Deaf and hard-of-hearing adults is now available.

Researchers at the National Technical Institute for the Deaf at Rochester Institute of Technology, Riochester, NY, developed the test in response to the estimated incidence of ADHD in the deaf and hard-of-hearing population being as high as 38 percent.

The Attention Deficit Scales for Adults: Sign Language Version is the first linguistically accessible ADHD assessment instrument designed for deaf and hard-of-hearing adults. It is a computerized sign language version of the original Attention Deficit Scales for Adults published by Santo J. Triolo and Kevin R. Murphy in 1996.

The test uses an interactive interface to present instructions and items in ASL or in English-based sign language, with optional voicing, along with English captions. Clients view and respond to 54 statements such as "I get restless easily" indicating the frequency with which each statement accurately describes them.

Accurate diagnosis of ADHD is important so that appropriate treatment or accommodation can be provided. But existing tests printed in English are not valid for many individuals who typically depend on sign language for accurate communication and whose first language is often not English.

"We are trying to be sensitive to accessibility issues and meet the needs of the community," said Ila Parasnis, a professor in NTID's Department of Research and Teacher Education. "They have complete control over how they see the test items." Parasnis carried out this project with Gerald P. Berent and Vincent J. Samar, also NTID researchers.

The DVD, which works on both PC and Macintosh computers, includes the interactive test software and two manuals for test administration and interpretation of automatically generated test results. The DVD is $149.95 plus shipping and handling and can be purchased by calling NTID at 585-475-6906 V/TTY.

Alex's Lemonade Stand Foundation for Childhood Cancer (ALSF) is seeking applications for as well as the 2009 Nursing Grants cycle, including its new 'A' Award for young researchers.

The deadline for all grant applications is Monday, August 3. 

The A' Award debuts as the foundation's largest grant. It is designed for young researchers with an original childhood cancer project not currently being funded. The award includes access to ALSF's Scientific Advisory Board for periodic consultation and a choice of reference books to enhance the researcher's personal pediatric oncology library.

"We want the best and the brightest researchers to build life-long careers in the pediatric cancer field," says Jay Scott, Alex's dad. Liz Scott, Alex's mom, adds: "As long as there are children with cancer, ALSF will be raising funds and supporting the best research there is, while also attempting to make the lives of children and their families battling the disease better."

The grant applications being accepted are in the following categories:

NEW 'A' Award ($375,000 over 3 years). This grant is designed for young scientists who want to jump-start their career in pediatric oncology research. The ideal candidate has an original project, can demonstrate outstanding mentorship and has a strong future commitment to pediatric cancer investigation.

Mentored Nurse Researcher ($20,000 over 2 years). This grant is designed to support the efforts of beginning nurse researchers to accomplish small research projects.

Intermediate Nurse Researcher ($40,000 over 2 years). This grant is designed to financially support efforts of more experienced nurse researchers to accomplish research projects. Awards may be used to supplement other support in a large project.

Independent Nurse Researcher ($100,000 over 2 years) This grant is designed for an experienced nurse researcher with a career plan that shows commitment to pediatric cancer nursing.

For additional information regarding Alex's Lemonade Stand Foundation's Grant Program and application guidelines, due dates, and how to apply, visit www.AlexsLemonade.org/grants.

About Alex's Lemonade Stand Foundation

ALSF emerged from the front yard lemonade stand of cancer patient Alexandra "Alex" Scott (1996-2004). At the age of 4, Alex announced she wanted to hold a lemonade stand to raise money to help find a cure for all children with cancer.

Since Alex held her first stand, the foundation bearing her name has evolved into a national fundraising movement, complete with thousands of volunteers across the country carrying on her legacy of hope.

To date, the registered 501(c)3 charity has raised more than $25 million, funding more than 100 research projects nationally including, among others, those examining leukemia, brain tumors, neuroblastoma, Wilm's tumor, lymphoma, and osteosarcoma. 

ANA led a contingent of nurses in a demonstration on Capitol Hill June 25, urging congressional action on healthcare reform this year "that will further ANA's goal of guaranteed, affordable, high-quality healthcare for all."

Dozens of nurses from as far away as Florida and New York joined the ANA group in the crowded rally and Town Hall-style gatherings organized by Health Care for America Now, a coalition of which ANA is a member.

In meetings with members of Congress and at the Town Hall forums, nurses spread the word of ANA's core healthcare reform principles, including:

• healthcare is a basic human right;
• a public health insurance plan option must be created to expand choice and control costs; and
• a sufficient and fully utilized nursing workforce is necessary to ensure access to quality care.

"We want to make sure nurses' voices are heard and our perspective is included in the debate as the healthcare reform proposals move forward," said ANA Chief Programs Officer Mary Jean Schumann, MBA, MSN, RN, CPNP. "Nurses are integral to the quality of care and efficiency of our healthcare system. We want to take part in shaping policy and not have policy dictated to us."

The nurses expressed the need to address the current nurse shortage, which is expected to deepen in the coming years, by bolstering programs to recruit more nurses into educational programs and develop more nursing faculty.

As another top priority, the nurses also advocated that Advanced Practice Registered Nurses (APRNs) be allowed to practice to the full extent of their education, training and licensure, saying that APRNs can help alleviate the shortage of primary care health services.

"We have a workforce in the nursing profession that has the training and skills to contribute greatly to the improvements we say we want in our healthcare system - more emphasis on prevention and wellness services, better coordination of care for people with chronic diseases, more education for patients. These are measures that will reduce costs in the long run," said Schumann.

"ANA's participation in this important rally is one way that we can make Congress and the nation aware of what nurses can do."

Read more about ANA testimony before powerful congressional committees June 24-25.

The American Nurses Association (ANA) was on Capitol Hill June 24-25, to testify before two powerful Congressional commitees on healthcare reform.

Donna Policastro, RNP, Executive Director of the Rhode Island Nurses Association, spoke on behalf of ANA June 24 before the the House Ways and Means Committee, "Proposals to Reform the Health System." And on June 25, Kathleen M. White, PhD, RN, CNAA, BC, Chair of the Congress on Nursing Practice and Economics (CNPE) testified on behalf of ANA at Thursday's hearing before the House Committee on Energy and Commerce.

According to ANA, Policastro stressed nurses' willingness to work with policy-makers, industry leaders, providers and consumers to support and advance meaningful healthcare reform.

She thanked the committee for recognizing the need for an integrated and well-resourced national healthcare workforce policy, a system that focuses on wellness and prevention and a high-quality public health insurance option that complements and competes fairly with options offered by private insurers. She also "remarked on the valuable role Advanced Practice Registered Nurses (APRNs) play in primary care, and the importance of recognizing Nurse Practitioners as providers in Medical Homes," ANA said.  

In addition to her leadership role at the Rhode Island Nurses Association, Policastro is also a member of the ANA PAC [Politcal Action Committee] Board of Trustees.

White, during her testimony, emphasized ANA's support for a public health insurance plan, saying it would "provide the peace of mind that is missing from our current healthcare environment. 

"Most importantly, healthcare is a basic human right," White continued. "Individuals and families should have ready access to a restructured health care system that ensures universal access to a standard package of essential healthcare services for all"

White also commended lawmakers for their work to expand Title VIII Nursing Workforce Development Programs to build the nation's nursing workforce, according to ANA.

In addition to her leadership role as chair of the CNPE, White is also an Associate Professor and the Director of the Doctorate of Nursing Practice Program at Johns Hopkins University School of Nursing.

To read Policastro and White's testimony, as well as other recent ANA testimony before Congress in their entirety, click here.

In an effort to help healthcare organizations improve the rate of health care worker influenza vaccinations, the Joint Commission is releasing a free monograph, "Providing a Safer Environment for Health Care Personnel and Patients Through Influenza Vaccination: Strategies from Research and Practice." 

The monograph, which was supported by an educational grant from drug maker sanofi pasteur, is the result of a 10-month collaboration between the Joint Commission, the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC), the CDC, the Society for Healthcare Epidemiology of America (SHEA), and the National Foundation for Infectious Diseases (NFID). 

The monograph includes information about seasonal influenza and the influenza vaccine, barriers to successful programs and strategies for overcoming them, and examples of successful initiatives organizations have used to improve their influenza vaccination rates.  

The Joint Commission received more than 229 submissions from healthcare organizations and a subset of strategy submissions was selected for a panel review. Ultimately, 28 submissions were selected for inclusion in the monograph. The monograph incorporates evidence-based guidelines and published literature to highlight practical strategies and the tools submitted by the healthcare organizations.  

"Healthcare worker flu vaccination rates have been less than optimal for years and the vaccination rate is still below 50 percent. Organizations are eager to find ways to encourage their employees to get vaccinated," says Jerod M. Loeb, PhD, executive vice president, Division of Quality Measurement and Research, the Joint Commission. "The monograph includes strategies that organizations can employ and provides a foundation to improve vaccination rates."

According to the CDC, vaccination coverage of healthcare personnel remains low despite the documented benefits on patient outcomes, staff absenteeism and reducing infections among staff. In addition, increased vaccination rates can reduce costs within healthcare organizations. In 2007, the Joint Commission implemented a new standard in hospitals and long-term care facilities requiring influenza vaccinations be offered to staff and practitioners. 

The American Nurses Credentialing Center's (ANCC) Magnet Recognition Program announced June 23 it has bestowed Magnet designation to the American University of Beirut Medical Center (AUBMC). 

AUBMC is the first healthcare institution in the Middle East and the third facility outside the U.S. to earn Magnet designation for nursing excellence. Only 5 percent of all U.S. hospitals have achieved Magnet status, which is widely held to be the most prestigious peer-reviewed designation in the industry.

"This is an extraordinary achievement that attests to the dramatic changes that have taken place at the AUB Medical Center in recent years, particularly related to nursing services," said Nadim Cortas, vice president for medical affairs and Raja N. Khuri Dean of the Faculty of Medicine, AUBMC. "Having Magnet status recognizes the first rate care we provide our patients today and is a sign of our dedication to offer the best nursing services in the region in the future."

Gladys Mour, assistant hospital director for patient care services, spearheaded the 6-year effort to secure Magnet recognition. "I decided to embark on the Magnet journey the moment I recognized that it would raise the bar of quality to a level of excellence for our patients who deserve the very best," she said.

According to Mour and Cortas, the decision to apply for Magnet status in 2003 marked both the culmination of a long process to rebuild nursing services at the hospital after the 15-year Lebanese civil war, and the beginning of an ambitious campaign to transform the practice of nursing at AUBMC and to set new nursing standards for the region. 

During the Magnet application process, Mouro and colleagues introduced  comprehensive changes to improve nursing practice at the Medical Center that were confirmed by a team of three ANCC appraisers in April. 

"I think the appraisers were impressed, even surprised, by what they saw and heard from our patients and also the physicians," Mouro said. 

AUBMC is the private, not-for-profit teaching center of the Faculty of Medicine of at American University of Beirut, which was founded in 1866, and today has 606 full-time faculty and more than 7,500 students. The 420-bed medical center provides medical, surgical, pediatrics, ob/gyn and psychiatric services.

The Institute for Healthcare Improvement announced an upcoming "Expedition," Preventing Venous Thromboembolism (VTE) in Hospitalized Patients: Risk Assessment, aimed at helping healthcare organizations take decisive action on prevention efforts. 

According to IHI, an Expedition is a new approach created by IHI as a way to help hospitals rapidly implement key components of its Improvement Map through intensive virtual support. An Expedition offers extra help, in the form of expert faculty acting as your guide and support from other organizations who are taking on the same challenge at the same time. 

The Preventing VTE Expedition will take 4 months and the aim is to enable participants to assess all hospitalized patients for VTE risk on admission in order to start needed prophylaxis.

The Expedition will include:

• Send-Off Call to orient all teams, review the route, and provide guidance for specific steps
• Check-In Calls with faculty every two weeks to provide advice and mid-course adjustments
• Ongoing opportunities to share with and learn from all other participating organizations
• Opportunities for periodic check-ins with faculty
• Concluding Call to reflect on the achievement and plot the next climb

The faculty for the Expedition includes Frances A. Griffin, RRT, MPA, Director, IHI; and Gregory Maynard, MD, MSc, Clinical Professor of Medicine and Chief of the division of Hospital Medicine, University of California, San Diego.

The regular rate for the Expedition is $750 per team. Members of IHI's IMPACT leadership program are eligible for a 15 percent discount, and hospitals with fewer than 50 beds can receive a 50 percent discount. There is no charge for members of IHI's Passport membership program. Enrollment begins July 21.

More than 80 percent of hospitals across the U.S. have implemented automated dispensing cabinets (ADCs) as an important part of their drug distribution system, making the evaluation of practices and policies surrounding this technology an essential step in ensuring patient safety.

To help meet healthcare organizations' growing need for assistance in this area, the Institute for Safe Medication Practices (ISMP) has introduced the first Medication Safety Self Assessment for Automated Dispensing Cabinets.

The self-assessment is based on guidelines developed by a national forum of practitioners and vendors with expertise in the safe use of ADCs, which was convened by ISMP.

According to ISMP, the self-assessment is uniquely designed to help the nation's hospitals evaluate their automated dispensing cabinet safety practices, identify opportunities for improvement, and compare their experience with that of hospitals of similar size and demographics.

The assessment contains 12 core elements that support the safe use of ADCs in all clinical settings. Many of the elements represent system improvements and safeguards that ISMP has recommended in response to analysis of medication errors reported to the ISMP Medication Errors Reporting Program, and problems identified during onsite ISMP consultations with hospitals

Healthcare organizations can download a PDF copy of the this latest self-assessment tool from the ISMP Web site at: www.ismp.org/selfassessments/ADC/survey.pdf.

Since safe use of ADCs involves collaboration between many different disciplines and departments, hospitals are being asked to convene multidisciplinary teams to provide a wide range of perspectives for the most complete data set possible, according to ISMP.

ISMP strongly urges hospitals to use the following process to complete the ADC self assessment: 

• Establish a multidisciplinary team. Recommendations for team composition and procedures are contained in the self assessment document.
• Assess organizational use of ADCs through a consensus vote from all team members, after thoroughly investigating the level of implementation of each core element. 
• Confidentially submit data to ISMP. ISMP is a federally certified Patient Safety Organization (PSO). When the self-assessment tool is used for quality improvement purposes and patient safety activities and data are submitted to ISMP, they are considered a patient safety work product and therefore privileged and confidential. Deadline for submission is Dec. 31.
• Compare experience with the aggregate experience of demographically similar hospitals-national data will be available for comparison at the end of the submission period.
• Document progress toward improvement by regularly using the ISMP tool to re-assess the organization's ADC use.

ISMP conducted landmark medication safety self assessments for hospitals in 2000 and 2004. It also has created separate self assessments for medication safety in physician practices and community/ambulatory pharmacies, and the specific areas of bar coding and antithrombotic therapy.

As with its other self assessments, ISMP will use the findings to develop additional educational resources and tools to assist healthcare organizations in improving their medication safety policies and procedures.

For a copy of ISMP ADC guidelines, visit: www.ismp.org/Tools/guidelines/ADC_Guidelines_Final.pdf.

More information on other ISMP self-assessment tools can be found at www.ismp.org/selfassessments/default.asp.

The nonprofit Food For The Poor is adding a medical mission trip to Jamaica in November. The group is seeking doctors, nurses and other medical staff to join them. The largest international relief and development organization in the U.S., Food For The Poor schedules an average of 25 mission trips each year. More than 5,500 people have traveled with the organization, which serves 17 countries in the Caribbean and Latin America.

Medical staff on the Nov. 9-15 trip will serve urban and rural communities in Jamaica, treating such ailments such as hypertension, diabetes, cardiovascular problems, skin conditions and infections. Those on the trip will work in tandem with local medical personnel. Supplies for the trips will be collected by Food For The Poor and will be available when the medical team arrives.

"This is one more way we can meet the needs of the people we serve," said Angel Aloma, executive director. "We have received several inquiries from people moved to use their medical skills to help the needy. More people are expressing an interest in using their free time to help others."

The Government of Jamaica requires permits, which take approximately 6-8 weeks to process. All documents and a $100 non-refundable deposit must be submitted to Food For The Poor by Aug. 3. Depending on professional qualifications or area of interest, a specific list of required documents will be sent.

The cost of the trip per person is $1,800 plus domestic airfare. This includes international round-trip travel from Fort Lauderdale/Miami to Kingston, Jamaica, accommodations, meals, ground transportation and local government registration application fees. A 50 percent deposit is required 60 days prior to departure (Sept. 9), with the balance due 30 days prior to travel (Oct. 9).

For more information, call 1-800-568-8124 or e-mail missions@foodforthepoor.com.

According to the organization, more than 97 percent of all donations to Food For The Poor in 2008 went directly to programs that help those in need, providing nourishing food, housing, necessary medical care, educational materials, support for orphans and the aged, and much more.

FDA is advising consumers to stop using three products marketed over-the-counter as cold remedies because they are associated with the loss of sense of smell (anosmia). Anosmia may be long-lasting or permanent.

The products include:
- Zicam Cold Remedy Nasal Gel;
- Zicam Cold Remedy Nasal Swabs; and
- Zicam Cold Remedy Swabs, Kids Size (a discontinued product).

FDA has received more than 130 reports of loss of sense of smell associated with the use of these three Zicam products. In those reports, many people who experienced a loss of smell said the condition occurred with the first dose; others reported a loss of the sense of smell after multiple uses of the products.

The loss of sense of smell can adversely affect a person's quality of life, of course, and can limit the ability to detect the smell of gas or smoke or other signs of danger in the environment.

"Loss of sense of smell is a serious risk for people who use these products for relief from cold symptoms," Janet Woodcock, MD, director of the FDA's Center for Drug Evaluation and Research (CDER), said in a June 16 press release. "We are concerned that consumers may unknowingly use a product that could cause serious harm, and therefore we are advising them not to use these products for any reason."

FDA has issued Matrixx Initiatives, maker of these Zicam products, a warning letter telling it that these products cannot be marketed without FDA approval.

"Companies have an obligation to the public to demonstrate to the FDA that their products are safe, particularly when there is evidence they may be causing serious adverse events, and they are marketed for minor, self-limiting conditions like the common cold," said Deborah M. Autor, director of CDER's Office of Compliance.

Healthcare professionals (and consumers) are encouraged to report adverse events that may be related to the use of these products to the FDA's MedWatch Adverse Event Reporting program online, by regular mail, fax or phone.
 
Contact MedWatch by phone at 800-FDA-1088; fax 800-FDA-0178; or by U.S. Mail, using FDA Form 3500, at:

MedWatch
5600 Fishers Lane
Rockville, MD 20852-9787

For more information, click here.

The Association for Professionals in Infection Control and Epidemiology (APIC) announced publication of the 3rd edition of the APIC Text of Infection Control and Epidemiology. 

According to APIC, more than 300 infection prevention experts completed the text which "serves as one of the most valuable tools for infection preventionists throughout the world."

The 1,700-page document ($625 for non-members; $475 for APIC members) has been completely revised with more than 120 expanded and enhanced chapters addressing infection prevention in many areas, including ophthalmology, the physician's office and interventional radiology to name a few.

Each peer-reviewed chapter includes an abstract, reference list, international perspectives and additional resources. Each chapter also focuses on the needs of infection preventionists new to the field and then builds on the basic concepts, providing advanced information for more experienced preventionists, according to APIC.

Additionally, the APIC Text has been updated to include the most current regulations, guidelines, technology, research and best practices in the field of infection prevention. It also includes specific information for ambulatory care and long-term care facilities, resources for staffing and training and analysis of new technologies. 

"This was an immense undertaking," said APIC 2009 President Christine J. Nutty, MSN, RN, CIC. "The APIC Text compiles the evidence-based literature in one convenient location and can be used to educate all healthcare personnel on the essentials of infection prevention. It is the definitive, comprehensive, go-to source covering every aspect of infection prevention and control."

APIC will release an online version of the APIC Text in the fall which will be updated regularly and accessible anywhere. Purchase of the APIC Text includes a one-year subscription to the APIC Text Online.  

The American Nurses Association (ANA) announced it believes the best way to achieve its overall health system goal - guaranteed, affordable, high-quality healthcare for all - is through the inclusion of a public health insurance plan option in any healthcare reform legislation.

Citing a June 11 New York Times article, "Doctors' Group Opposes Public Insurance Plan," ANA also said it is deeply disappointed to learn of the American Medical Association's position that private health insurance alone should dictate coverage options for all who don't qualify for existing public plans, such as Medicare.

Following last week's statements by the AMA about a public insurance option, the public was left questioning whether physicians would support such a measure in a health reform bill. Doctors for America subsequently asked physicians directly whether they believed a well crafted public insurance option could be a part of health reform solution.

Within 48 hours, 1,528 responded from 48 states - with an overwhelming 97 percent of respondents voting "Yes" according to the doctor's group. The survey gave doctors two specific answers to choose from: 1) Yes, a well-crafted public insurance option can be part of successful health reform; and 2) No, a public insurance option should be off the table.

According to ANA, a public health insurance plan would expand choices and help protect against potential economic calamity for individuals or families who are not satisfied with their current health coverage, have difficulty paying for their healthcare, or cannot find affordable coverage.

ANA supports President Obama's call for a public plan option, and applauds its inclusion in Senator Kennedy's comprehensive health reform legislation introduced June 9.

"What is lacking in our current healthcare system, driven by for-profit, private insurance companies, is the reliability and predictability of accessible, affordable care. Many people have encountered the unpleasant reality that they can be denied care when they need it most, or lose coverage when they can least afford it," ANA said in a press release.  

"Private insurers can discriminate based on preexisting conditions, health status, gender, age, claims history, or other factors. In addition, in this unstable employment market, the loss of a job often leads to loss of health coverage, as insurance becomes less affordable."

Additionally, ANA said it disagrees with AMA's speculation that a public health insurance plan option would threaten to restrict patient choice by driving out private insurers, as stated in the New York Times article.

"The choice of a public health insurance plan will create a level playing field, where for-profit private plans will have to compete with each other out in the open under fair rules," ANA said. "Patients should be able to see what they're getting so they can make the choice about where they purchase coverage and not receive a surprise from their insurer buried in the fine print when they seek healthcare services."

The economic recession and the emergence of the H1N1 influenza have put additional pressure on emergency departments across the country and emergency nurses are on the front lines of addressing those pressures. 

At the Emergency Nurses Association 2009 Annual Conference, leading emergency nurses from across the nation will discuss best practices and initiatives to improve the quality of emergency care and national emergency preparedness.
 
The conference, with the theme STAT­ [Strengthen, Transform and Transcend], will be held Oct. 8-10 at the Baltimore (MD) Convention Center.
  
According to ENA, the conference will offer presentations, lectures, workshops and interactive courses addressing violence in the emergency department, overcrowding, pediatric emergency patients, disaster management and other clinical education. 
 
An advance agenda with a full listing of sessions is available online at: http://www.ena.org/conferences/annual/2009/AC09AdvanceProgram.pdf.
 
Founded in 1970, ENA is the only professional emergency nurses association in the U.S. It serves as the voice of more than 36,000 members and their patients through research, publications, professional development, injury prevention, and patient education.

Additional information is available at ENA's Web site, www.ena.org. 

While effective communication is necessary for patient safety, it can be inhibited by language, culture, hearing or visual impairment, health literacy, cognitive impairments, and disease or disability.

In addition, racial and ethnic health disparities are linked to poorer health outcomes and lower quality care. As the diversity of our nation continues to grow, there is a need to provide hospitals with more robust guidance to address the needs of the populations they serve.

In response, the Joint Commission is proposing requirements for the Hospital Accreditation Program to advance effective communication, cultural competence, and patient-centered care.

Feedback from nurses regarding the value of the proposed requirements and the ability of hospitals to implement them is important.  At the earliest, any implementation of the proposed requirements would occur in January 2011.

To review and comment on the proposed requirements, please click on the link provided, or copy and paste the link into the address bar of your browser: http://www.JointCommission.org/Standards/FieldReviews/field_ecccpc.

Among the information available on the Web site:

• The proposed requirements
• Instructions for providing feedback via mail, e-mail, or online survey
• A project overview
• Existing Joint Commission standards that support effective communication, cultural competence, and patient-centered care

Comments will be gathered for 6 weeks, beginning June 8.

If you have any questions, contact Christina Cordero, PhD, MPH, Project Manager, Division of Standards and Survey Methods, at 630-792-5845 or ccordero@jointcommission.org.

As a longtime advocate for safe patient handling programs, the American Nurses Association (ANA) applauded recent legislation in Congress "that would help improve patient safety and protect registered nurses and other healthcare workers from debilitating injuries that could force them from their professions."

Specifically, ANA announced June 4 that it "strongly supports" The Nurse and Health Care Worker Protection Act of 2009 (HR 2381), sponsored by Rep. John Conyers, (D-MI), and a House Resolution introduced by Rep. Carolyn McCarthy, (D-NY), who also is an RN.

The bills would reduce musculoskeletal injuries resulting from manually lifting, repositioning and moving patients, said ANA, which cited estimates that 12 percent of the nursing workforce leaves the profession annually due to back injuries and 52 percent complain of chronic back pain. ANA "believes such worker protection measures are crucial to addressing the nursing workforce shortage."

Rep. McCarthy's resolution notes that RNs and other healthcare workers are required to lift and transfer "unreasonable loads, with the average nurse lifting 1.8 tons on an 8-hour shift," and that the U.S. Bureau of Labor Statistics place RNs in the top 10 of all occupations reporting on-the-job injuries resulting in days away from work. according to ANA.

"Considering the critical need to address the current nursing shortage and ensure patient safety, ANA believes it is time to put safe patient handling and movement practices into law instead of relying only on voluntary guidelines," said ANA President Rebecca M. Patton, MSN, RN, CNOR. "ANA's long track record on safe patient handling is solid and strong."

For more than a decade, ANA has supported the use of an Occupational Health and Safety Administration (OSHA) Standard for safe patient handling and movement, rather than voluntary guidelines for healthcare facilities.

Rep. Conyers' bill would accomplish that, according to ANA, and also would expand the standard to healthcare facilities not covered by OSHA. Moreover, the bill would protect all healthcare workers, not RNs at the bedside.

ANA launched its Handle with Care Campaign in 2003 to advocate for policies and legislation that would result in the elimination of manual patient handling. Prompted by the ANA campaign, eight states have enacted safe patient handling legislation. This year, ANA established ANA's Handle with Care Recognition Program to recognize healthcare facilities with a safe patient handling program in place for at least 3 years and meet high standards for program evaluation, planning, policy and training.

In response to the need for expanded monitoring and reporting of healthcare-associated infections (HAIs), the Association for Professionals in Infection Control and Epidemiology (APIC) announced June 3 its support for the use of automated surveillance technologies in the healthcare setting as an essential part of infection prevention and control activities.

Surveillance technologies are computerized systems designed to collect infection data, thereby allowing infection preventionists to rapidly protect patients by identifying and investigating potential clusters of HAIs in real time.

Most healthcare facilities currently use a manual surveillance method that can be limited in scope and is labor intensive. Automated surveillance technologies streamline the review and collection of data, providing a larger amount of information and reducing staff time spent on surveillance and clerical tasks.

The recommendations are published in the APIC position paper, The Importance of Surveillance Technologies in the Prevention of Healthcare-Associated Infections (HAIs).

The APIC position paper outlines many benefits of automated surveillance, including efficient review of infection data, rapid identification of outbreaks, expanded and better-defined infection prevention activities, reduced infection prevention department time spent on surveillance and clerical tasks, improved response to public health issues, assistance with regulatory compliance, and enhanced antibiotic stewardship programs.

"Automated surveillance eases the burden of data management for infection preventionists and allows them to focus on the activities that protect patients, like walking rounds, observing procedures and educating healthcare personnel," said Linda R. Greene, MPS, RN, CIC, lead author of APIC's position paper and director of infection prevention and control at Rochester General Health System. "In addition, it can help hospitals save money by targeting areas for tailored elimination strategies that reduce infections and excess cost."

In a recent survey of APIC members, only one in five had electronic data-mining technology.

"Surveillance of [HAIs] is the cornerstone of effective infection prevention programs, but without automation it consumes a considerable amount of an infection preventionist's time. This limits time spent on what is value-added to the patient - education of healthcare personnel and performance improvement activities," Greene said. "Automated surveillance offers a more efficient and accurate means of obtaining HAI data, provides the opportunity to expand surveillance beyond typical high-risk areas within the healthcare facility and allows infection preventionists to improve prevention practices."

Visit the APIC Web site for more information on Surveillance Technology Resources.

The Medical Musical Group (MMG) Symphony Orchestra and Chorale is seeking nurse participants for two special concerts in November. 

MMG plans twin "Healing for the Nations" concerts in Washington, DC and London, England, raising funds for malaria eradication.

A special Veteran's Day concert in DC will be held at 7 p.m. on Nov. 4, at the Basilica of the National Shrine of the Immaculate Conception. The concert in London will be held at 7:30 p.m. on Nov. 11 at the Central Hall of London in Westminster.

"Because our concerts this year aim at fighting malaria, the United Nations agency Roll Back Malaria Partnership is collaborating with us, and we want to reach out to the maximum number of healthcare musicians to participate in the performances," MMG program coordinator Elizabeth Nunan told ADVANCE.

The Roll Back Malaria Partnership was formed in 1998 by the World Health Organization, UNICEF, the World Bank and the United Nations Development Program.

Physicians, nurses, other personnel, faculty and students, both VA and non-VA, and their families and friends may participate in MMG. If you are a good singer or play well a musical instrument, you may apply, and family members are welcome as companions. To join, complete an online membership application. 

Participants will enjoy elegant amenities, sightseeing and fellowship at a great price, according to MMG. For more information, call 202-797-0700 or e-mail vanmmg@hotmail.com.

Recipient of the Congressional Medal of Honor Society Bob Hope Award, MMG is not a government agency.

Watch MMG's streaming PBS broadcast from the Pentagon streamed at www.medicalmusical.com/wmv/pentagon.wax. Watch a newsclip about "Healing for the Nations" on YouTube at http://www.youtube.com/watch?v=lsqMYhkVQUc
 

Amid concern about the Influenza A, H1N1, "swine flu" pandemic, the Honor Society of Nursing, Sigma Theta Tau International (STTI) is moving its 20th International Nursing Research Congress from Cancun, Mexico, to the Sheraton Vancouver Wall Centre Hotel in Vancouver, Canada.

The July 13-17 conference dates are unchanged.

According to STTI, attendees who have already made hotel reservations at the Moon Palace in Cancun, Mexico, should receive a full refund if cancellations are made at least 7 days prior to the check-in date.

Travelers who have made flight arrangements should contact their specific airline carrier for recommendations regarding changing travel plans, the Honor Society says.

STTI cited CDC and European Centre for Disease Prevention and Control (ECDC) recommendations discouraging all non-essential travel to Mexico for its decision to move the event to Vancouver.

"As nurses, our primary concern is the health and well-being of not only our members and conference attendees, but their families and communities as well," says CEO Patricia E. Thompson, EdD, RN, FAAN. "While no one knows what the situation in Mexico will be like come July, we feel it's best to err on the side of caution - comply with governmental recommendations and move the event to a new location."

"The International Nursing Research Congress is critical to the success of the nursing profession and clinical research worldwide," says STTI President Carol J. Huston, RN, MSN, DPA, FAAN. "The work nurses do and the discoveries we share at the conference help advance nursing and improve the well-being of patients. This enables nurses to better understand health situations like the one we're currently experiencing with" H1N1.

For more information about the Honor Society, visit www.nursingsociety.org. 

The Medical Musical Group (MMG) Symphony Orchestra and Chorale is seeking nurse participants for two special concerts in November. 

MMG plans twin "Healing for the Nations" concerts in Washington, DC and London, England, raising funds for malaria eradication.

A special Veteran's Day concert in DC will be held at 7 p.m. on Nov. 4, at the Basilica of the National Shrine of the Immaculate Conception. The concert in London will be held at 7:30 p.m. on Nov. 11 at the Central Hall of London in Westminster.

"Because our concerts this year aim at fighting malaria, the United Nations agency Roll Back Malaria Partnership is collaborating with us, and we want to reach out to the maximum number of healthcare musicians to participate in the performances," MMG program coordinator Elizabeth Nunan told ADVANCE.

The Roll Back Malaria Partnership was formed in 1998 by the World Health Organization, UNICEF, the World Bank and the United Nations Development Program.

Physicians, nurses, other personnel, faculty and students, both VA and non-VA, and their families and friends may participate in MMG. If you are a good singer or play well a musical instrument, you may apply, and family members are welcome as companions. To join, complete an online membership application. 

Participants will enjoy elegant amenities, sightseeing and fellowship at a great price, according to MMG. For more information, call 202-797-0700 or e-mail vanmmg@hotmail.com.

Recipient of the Congressional Medal of Honor Society Bob Hope Award, MMG is not a government agency.

Watch MMG's streaming PBS broadcast from the Pentagon streamed at www.medicalmusical.com/wmv/pentagon.wax. Watch a newsclip about "Healing for the Nations" on YouTube at http://www.youtube.com/watch?v=lsqMYhkVQUc
 

More than two-thirds of adult Americans agree the U.S. healthcare system needs to put more emphasis on chronic disease preventive care than on treatment, and they are willing to pay higher taxes to fund those programs, according to a new survey by the National Association of Chronic Disease Directors (NACDD).

The survey also found Americans across all income groups believe congress needs to do more to pay for prevention programs.

More than two-thirds (68 percent) don't think congress is doing enough to fund these programs, and 43 percent say they are more likely to vote for candidates who support increased public health spending, the survey found. More than four in five Americans (84 percent) favor public funding for programs to help prevent chronic disease.

According to CDC, chronic diseases are the leading cause of death and disability in the U.S., affecting 133 million Americans, or 45 percent of the population. They are responsible for seven out of every 10 deaths, killing more than 1.6 million Americans every year. In the U.S., 75 cents of every $1 spent on healthcare goes toward the treatment of chronic disease, according to CDC.

"This survey shows Americans believe prevention is the cornerstone to good health, but more funding is needed to achieve a healthy America," said John Robitscher, MPH, NACDD executive director. "More than 50 percent of Americans are not satisfied with the quality of their healthcare, and believe more funding should be allocated to preventive care."

Other NACDD survey findings: 

• 67 percent of Americans are worried about being able to afford necessary healthcare.
• 92 percent of Americans say lack of health insurance is a problem in the U.S.
• 95 percent of Americans say the greater incidence of health problems among Americans with lower incomes is a big problem.
• 83 percent of Americans believe that healthy workers have a strong impact on economic productivity.

The survey, Americans and Public Health: Attitudes Toward Public Funding for Public Health and Chronic Disease, was conducted for NACDD by TSC, a division of Yankelovich, Inc. 

The survey was conducted by telephone within the U.S. between Aug. 21 and 24, 2008, among 1,000 adults (aged 18 and over).  Figures for age, sex, race/ethnicity and region were weighted to ensure reliable and accurate representation of the total U.S. adult population. The margin of error for this study was +/- 3.1 percent.

NACDD was founded in 1988 to link the chronic disease program directors of each state and U.S. territory to provide a national forum. It provides state-based leadership and expertise for chronic disease prevention and control at the state and national level. Further information about NACDD is available at http://www.chronicdisease.org/.

The American Association of Critical-Care Nurses (AACN) launched a major upgrade to the Essentials of Critical Care Orientation (ECCO), dubbed EECO 2.0.

The proprietary e-learning program is a comprehensive introduction to the fundamentals of critical care nursing, providing the theoretical foundation necessary to care for critically ill patients, according to AACN.

Like all AACN e-learning courses, ECCO 2.0 is an easy-to-navigate, interactive Internet-based program. Experts in nursing and nursing education designed the content utilizing the most current adult learning theories.

ECCO provides a total of 69 hours of CE credit and is composed of 10 learning modules, organized using a body systems approach:

• Introduction to Care of the Critically Ill
• Care of the Patient with Cardiovascular Disorders
• Care of the Patient with Pulmonary Disorders
• Basic Hemodynamic Monitoring
• Care of the Patient with Neurological Disorders
• Care of the Patient with Gastrointestinal Disorders
• Care of the Patient with Renal Disorders
• Care of the Patient with Endocrine Disorders
• Care of the Patient with Hematological Disorders
• Care of the Patient with Multisystem Disorders

Modules are comprised of multiple lessons that provide in-depth, interactive content with rich graphics and illustrations that keep learners engaged. Each module addresses the anatomy and physiology of the body system, relevant diagnostic information, and the clinical presentation and management of common disorders for each of the body systems.

"Since its inception in 2002, learners and learning administrators have given us valuable feedback about the content of ECCO and what improvements were needed," said AACN CEO Wanda Johanson, MN, RN.

"For this highly anticipated upgrade, we have responded to these comments by including more interactivity, more case studies and more critical thinking exercises," Johanson continued. "In ECCO 2.0, nurses will find the content they have come to count on, as well as new content we believe makes ECCO a more exceptional orientation program."

For more information on ECCO 2.0 and other AACN e-learning products, call 800-899-2226 or visit www.aacn.org/e-learning.

AACN is the largest specialty nursing organization in the world, representing the interests of more than 500,000 acute and critical care nurses. Its international headquarters are located in Aliso Viejo, CA.  Founded in 1969, the association has more than 240 chapters worldwide. For more information, visit www.aacn.org.