The American Nurses Association (ANA) hailed today’s  Iowa Supreme Court decision affirming Advanced  Registered Nurse Practitioners’ (ARNPs) ability to supervise a certain high-tech X-ray and imaging procedure as a victory for Iowa residents, who will benefit from having broader access and choice in obtaining important health care services.

The appeal to Iowa’s highest court by three nursing organizations was spurred by an Iowa District Court judge’s ruling that supervision of fluoroscopy was not “recognized by the medical…profession as proper to be performed by the registered nurse,” as required by Iowa Nursing Law. Fluoroscopy is a real-time X-ray imaging technique used to guide a variety of diagnostic and interventional procedures. The legal issue involves “scope of practice” – the range of services that nurses are educated and licensed and/or certified to provide.

 “We believe the district court erred in second-guessing the department of public health and nursing board on the adequacy of ARNP training to supervise fluoroscopy,” the Iowa Supreme Court wrote.  “Significantly, nowhere in the voluminous record is there any report of an injury resulting from ARNP-supervised fluoroscopy, although the practice has been ongoing in parts of Iowa for many years. The record affirmatively shows ARNPs have been safely supervising fluoroscopy and are adequately trained to do so…[A]llowing ARNP supervision of fluoroscopy improves access to health care for rural Iowans and helps lower costs.”

ANA President Karen A. Daley, PhD, RN, FAAN, commended the decision for recognizing Iowa ARNPs’ appropriate scope of practice. “In today’s high-demand health care environment, we need nurses and all other health care professionals working to the top level of their capabilities and licenses. The court’s decision will help Iowans get the health care services they need in a timely, efficient, and effective way.”

The Iowa Nurses Association (INA) had initially intervened in the case along with the Iowa Association of Nurse Anesthetists on the side of the Iowa Board of Nursing, which defended its regulation against claims of illegality by the Iowa Society of Anesthesiologists and the Iowa Medical Society.  The Board of Nursing ultimately appealed the decision by the district court that invalidated the Board’s regulations providing educational requirements for ARNPs to order and supervise fluoroscopy, and INA again intervened. 

ANA has supported its state affiliate, INA, in the legal actions. An ANA member, attorney Lynn Boes, represented INA in the appeal.

Senator Ted Erickson’s (R-26) Senate Bill 5, Community-Based Health Care Clinics, was signed into law by Governor Corbett on May 21, 2013. Now Act 10 of 2013, this law provides for the establishment of the Community-Based Health Care Program within the Department of Health, paving the way for certified registered nurse practitioners, certified nurse midwives, clinical nurse specialists and certified registered nurse anesthetists to receive grant funding to provide greater access to health care services.

The Pennsylvania State Nurses Association, representing more than 211,000 registered nurses in Pennsylvania, supported Senate Bill 5 and the inclusion of APRNs within the legislation. These advanced practice registered nurses (APRNs) open, manage and maintain clinics across the Commonwealth. In today’s changing health care environment, APRNs deliver high-quality and cost-effective primary care, and reduce overall health care costs by expanding and improving access to the underserved and uninsured.

“PSNA is proud to be a leading voice for increased patient access to nurse-managed care,” states PSNA Chief Executive Officer Betsy M. Snook, MEd, BSN, RN. “Senator Erickson has been a champion of this vital legislation and we thank him as he stands with nurses during these transformative times. We also applaud Governor Corbett for making this bill a legislative priority.”

The PSNA Board of Directors and staff would like to thank our attendees from this week’s Nursing Awards and Summit. We hope everyone enjoyed themselves and will join us for our Fall Summit: Environmental Health titled “Ecocentric Nursing Practice: Sustaining a Healthy Future in Local to Global Environments”. Watch our site and Facebook for pictures of this week’s events! A special thank you to our host, DeSales University, Center Valley.

The American Nurses Association (ANA) and PSNA applauded today’s vote by the Senate to confirm Marilyn Tavenner, MHA, BSN, RN, as the permanent head of the Centers for Medicare and Medicaid Services (CMS). Tavenner, a former Intensive Care Unit (ICU) nurse, has served as chief executive officer of the Hospital Corporation of America (HCA) and was Virginia’s secretary of Health and Human Resources under former Governor Tim Kaine.

“Tavenner’s nursing expertise, along with her public and private sector experience, will enable her to continue providing the Centers for Medicare and Medicaid Services (CMS) with the leadership needed to guide our health care system during this time of great change,” says ANA President Karen A. Daley, PhD, RN, FAAN. “CMS is an agency that touches the lives of all Americans, through the Medicare, Medicaid, and children’s health insurance programs and other vital functions. With this confirmation vote, CMS is getting a superb leader who understands the need to expand patient access to high quality health care.”

Tavenner joined CMS in February 2010 and became acting administrator in December 2011. Tavenner’s confirmation marks the first time CMS has had a permanent administrator since Mark McClellan resigned in 2006.

The Pennsylvania State Senate has passed Senate Bill 5 – the Community Based Health Care Act. PSNA was successful in having Certified Nurse Practitioners, Clinical Nurse Specialists, Certified Nurse Anesthetists and Certified Nurse Midwives inserted into the bills definitions in order for those APRNs to receive funding through the grant process.

This bill now heads to the Governor’s desk where we expect him to sign it into law. Thank you to our members that wrote, called and advocated on behalf of this important piece of legislation.

The American Nurses Association (ANA) applauds the introduction of federal legislation that empowers registered nurses (RNs) to drive staffing decisions in hospitals and, consequently, protect patients and improve the quality of care.

The Registered Nurse Safe Staffing Act of 2013 (H.R. 1821), crafted with input from ANA, has sponsors from both political parties who co-chair the House Nursing Caucus – Reps. David Joyce (R-OH) and Lois Capps (D-CA), a nurse.

“Nurse staffing has a direct impact on patient safety. We know that when there are appropriate nurse staffing levels, patient outcomes improve. Determining the appropriate number and mix of nursing staff is critical to the delivery of quality patient care,” said ANA President Karen A. Daley, PhD, RN, FAAN. “Federal legislation is necessary to increase protections for patients and ensure fair working conditions for nurses.”

Research has shown that higher staffing levels by experienced RNs are linked to lower rates of patient falls, infections, medication errors, and even death.

And when unanticipated events happen in a hospital resulting in patient death, injury, or permanent loss of function, inadequate nurse staffing often is cited as a contributing factor.

The bill would require hospitals to establish committees that would create unit-by-unit nurse staffing plans based on multiple factors, such as the number of patients on the unit, severity of the patients’ conditions, experience and skill level of the RNs, availability of support staff, and technological resources.

The safe staffing bill also would require hospitals that participate in Medicare to publicly report nurse staffing plans for each unit. It would place limits on the practice of “floating” nurses by ensuring that RNs are not forced to work on units if they lack the education and experience in that specialty. It also would hold hospitals accountable for safe nurse staffing by requiring the development of procedures for receiving and investigating complaints; allowing imposition of civil monetary penalties for knowing violations; and providing whistle-blower protections for those who file a complaint about staffing.

ANA backed a similar staffing bill in the last Congress. This version includes requirements that a hospital’s staffing committee be comprised of at least 55 percent direct care nurses or their representatives, and that the staffing plans must establish adjustable minimum nurse-to-patient ratios.

Additionally, ANA has advocated for safe staffing conditions for the nation’s RNs through the development and updating of ANA’s Principles for Nurse Staffing, and implementation of a national nursing quality database program that correlates staffing to patient outcomes.

To date, seven states have passed nurse safe staffing legislation that closely resembles ANA’s recommended approach to ensure safe staffing, utilizing a hospital-wide staffing committee in which direct care nurses have a voice in creating the appropriate staffing levels. Those states are Connecticut, Illinois, Nevada, Ohio, Oregon, Texas, and Washington.

For more information on ANA’s safe staffing legislative efforts, please visit www.RNAction.org.

PSNA has added a new continuing education offering titled, “Factors Influencing Excellence in Nursing.” As nurses around the globe confront complex changes in health care, they must seek ways to preserve the quality and effectiveness of the care they provide patients and their families. Nurses report the emotional and moral distress they experience as they cope with heavy workloads and time constraints. Many consider leaving the profession. However, others choose to remain in the nursing profession striving to perform extraordinary work despits the obstacles they encounter. In other words, they seek to do good work. This article discusses the concept of good work, particularly as it relates to nursing. Implications for clinical practice will be highlighted. FREE to PSNA members, $10 non-members. Click here to access the article.

The Pennsylvania State Nurses Association (PSNA), the professional association representing 211,000 professional nurses in Pennsylvania, and the PSNA New to Practice Task Force announced that it has added an NCLEX review session to its May 21, 2013 Summit at DeSales University, Center Valley. The two-hour NCLEX review session, in addition to a full-day of continuing education sessions and lunch, is available at a discounted undergraduate rate of $35.

Continue reading →

Boston health officials are dealing with the immediate aftermath of two bombs that exploded near the finish line of the Boston Marathon on the afternoon of April 15, 2013. CDC offers resources that may help local or state health officials prepare for, respond to, and mitigate the health effects of bombings, and other mass casualty events.

Mass Casualty Event Preparedness and Response: CDC’s “Mass Casualty Event Preparedness and Response” website, available at http://emergency.cdc.gov/masscasualties/index.asp, is the primary location for resources for the general public and for health professionals. Public health officials can assist in disseminating the following resources to the audiences who need them.

Information for the General Public: The following resources on the “Mass Casualty Event Preparedness and Response” website offer information for the general public about bombings, and injuries and stress associated with mass casualty events:

• “Preparing for a Bombing: A Common Sense Approach,” available at http://emergency.cdc.gov/masscasualties/preparingterroristbombing.asp
• “After a Bombing: Health and Safety Information for the General Public,” available at http://emergency.cdc.gov/masscasualties/afterbombing.asp
• “Injuries and Mass Casualty Events,” available at http://emergency.cdc.gov/masscasualties/injuriespub.asp
• “Brain Injuries and Mass Casualty Events,” available at http://emergency.cdc.gov/masscasualties/braininjuriespub.asp
• “Coping With a Traumatic Event,” available at http://emergency.cdc.gov/masscasualties/copingpub.asp

Information for Health Professionals: The following resources on the “Mass Casualty Event Preparedness and Response” website offer information for health professionals about treating injuries and stress in patients affected by mass casualty events, as well as other resources for professionals:

Fact Sheets

• “Blast and Bombing Injuries,” available at http://emergency.cdc.gov/masscasualties/blastinjuryfacts.asp
• “Injuries and Mass Casualty Events,” available at http://emergency.cdc.gov/masscasualties/injuriespro.asp
• “After a Bombing: Health and Safety Information for Emergency Providers,” available at http://emergency.cdc.gov/masscasualties/afterbombing-ecp.asp
• “Brain Injuries and Mass Trauma Events,” available at http://emergency.cdc.gov/masscasualties/braininjuriespro.asp
• “Coping With a Traumatic Event,” available at http://emergency.cdc.gov/masscasualties/copingpro.asp

Guidance and Planning Documents

• “Interim Planning Guidance for Preparedness and Response to a Mass Casualty Event Resulting from Terrorist Use of Explosives,” available at http://emergency.cdc.gov/masscasualties/terrorist_explosives.asp
• “In a Moment’s Notice: Surge Capacity in Terrorist Bombings,” available at http://emergency.cdc.gov/masscasualties/surgecapacity.asp

• “Explosions and Blast Injuries: A Primer for Clinicians,” available at http://emergency.cdc.gov/masscasualties/explosions.asp

Data Collection and Planning Tools

• “Medical Record Abstraction Form for Domestic Bombing Events,” available at http://emergency.cdc.gov/masscasualties/bombingform.asp
• “Mental Health Survey Instrument,” available at http://emergency.cdc.gov/masscasualties/mhsurvey-instrument.asp
• “Mass Trauma Casualty Predictor,” available at http://emergency.cdc.gov/masscasualties/predictor.asp
• “Predicting Casualty Severity and Hospital Capacity,” available at http://emergency.cdc.gov/masscasualties/capacity.asp

Training

• “Blast Preparedness and Response Training and Continuing Education,” available at http://www.bt.cdc.gov/masscasualties/blast_training.asp
• “Bombings: Injury Patterns and Care,” available at http://www.bt.cdc.gov/masscasualties/bombings_injurycare.asp
• “Bombings: Injury Patterns and Care: Systems Preparedness” available at http://www.bt.cdc.gov/masscasualties/ppt/bombings_injury_patterns_and_care_systems_preparedness.ppt

Coping with Trauma: The effects of a disaster, terrorist attack, or other public health emergency can be long-lasting, and the resulting trauma can affect those not directly impacted by the disaster. CDC’s “Coping with a Disaster or Traumatic Event” web page, available at http://emergency.cdc.gov/mentalhealth/, lists resources that provide general strategies for promoting mental health and resilience. These materials were developed by various organizations on the basis of experiences in prior emergencies.

Substance Abuse and Mental Health Services Administration (SAMHSA) Disaster Distress Resources: The SAMHSA Disaster Distress Helpline, available at http://disasterdistress.samhsa.gov/, provides 24/7, year-round crisis counseling and support for persons experiencing signs of distress as a result of disaster:

• Call 1-800-985-5990
• Call TTY for deaf/hearing impaired 1-800-846-8517
• Text TalkWithUs to 66746

SAMHSA has additional resources on dealing with disaster at the SAMHSA website, http://disasterdistress.samhsa.gov/.

For More Information

• CDC’s “Mass Casualties: Related Links” web page, available at http://emergency.cdc.gov/masscasualties/resources.asp
• CDC’s “Public Health Resources: State Health Departments,” a state health department website locator, available at  http://www.cdc.gov/mmwr/international/relres.html
• CDC’s National Center for Injury Prevention and Control website, “Injury and Violence Prevention Control,” available at http://www.cdc.gov/injury/

The Centers for Disease Control and Prevention (CDC) protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.

TUBERSOL®,  a product of Sanofi Pasteur Limited, is in shortage nationwide until at least  the end of May 2013. TUBERSOL® is one of two purified-protein derivative (PPD)  tuberculin products that are licensed by the United States Food and Drug  Administration (FDA). The manufacturer notified CDC that 50-dose vials of  TUBERSOL® are unavailable and that the supplies of 10-dose vials will be  limited. This notice advises public health officials, clinicians, and workers  in occupational health and infection control about how to adapt to the  shortage.

Continue reading →