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PERI-SCOPE
ILSPAN
Volume 38 Issue 3
Fall 2014
Illinois Society of PeriAnesthesia Nurses
President’s Message
Maggie Colabuono BSN RN CPAN CAPA
At the ASPAN National Conference in April, I had the opportunity to attend the
Representative Assembly (RA). One important discussion at the RA pertained to the
minimum education level for RN licensing. ASPAN’S recommendation is that the minimum entry level for RN licensing should be a BSN.
Demands for Education
In October of 2010, The Institute of Medicine released its landmark report on
The Future of Nursing, which called for increasing the number of baccalaureate prepared nurses in the workforce to 80% by 2020. This evidence based recommendation
noted that to meet the demands of an evolving and complex healthcare system and the
changing needs of patients, nurses must achieve higher levels of education.¹ The ways
in which nurses were previously educated during the 20th century are no longer adequate for dealing with the realities of our current health care system. With the healthcare
landscape constantly changing, nurses’ roles are evolving. Nurses are being called upon to master technology,
manage information systems, as well as collaborate and coordinate care with other health professionals. Many
healthcare professions have recognized the necessity for advanced education by requiring a master degree or
higher, while nursing continues to discuss and debate entry level for RN licensing.
The Value of Advanced Education
My vision of nursing has changed as a result of experiences in pursuing my BSN. While I always believed that nursing could be a transformative process for patients and nurses, as a diploma graduate I was not
given the authority or ability to engage in practice changes to improve outcomes. With my BSN, I have a clear
vision regarding my role in the workplace and it serves as a springboard for me to consider areas for practice
improvement.
The knowledge and experience gained through advanced education empowers nurses to take action in
the workplace; to apply knowledge to improve patient care. The process is one that has been transformative for
Inside this Issue
(Continued on page 3)
Board of Directors
2
Informatics Corner
11
Treasurer Report
2
ICPAN News
12
Governmental Affairs
3
ASPAN News & Notes
13
Vice President Report
4
Education Article
14
Scholarship Deadlines
4
Clinical Practice Corner
15
District Director Reports
5
Research Project Update
15
Research Corner
6
Fall Conference
16-17
CPAN®/CAPA® News
7
Membership Page
18
ASPAN Regional Director Report
8
Willingness to Participate Form
19
Leadership Development Institute
9
Editorial Comment
19
ILSPAN Core Purpose
20
Member Spotlight
10
PERI-SCOPE
Page 2
Treasurer’s Report
Report as of August 31, 2014
Checking account balance $45,692.67
Certificate of deposit $11,199.17
On August 2, 2014, the ILSPAN Audit Committee met to audit the ILSPAN financial
records. For information about this audit contact the Treasurer (Information below)
ILSPAN Board of Directors
President
Maggie Colabuono
BSN RN CPAN CAPA
1358 Timberline Drive
Joliet IL 60431
815-725-6459
mcbono2004@yahoo.com
Vice President/President Elect
Mary Higgins BSN, RN, CPAN
847-827-1899
higginshouse460016@yahoo.com
Secretary
Sheri Tadlock BSN RN CAPA
618-539-5711
satadlock@hotmail.com
Treasurer
Carla Silzer RN CPAN
708-717-8644
casilzer@att.net
Immediate Past President
Wanda Ellenburg MSN MHA RN
CPAN
217-787-6184
msncpan@yahoo.com
ASPAN
90 Frontage Road
Cherry Hill
NJ 08034-1424
Toll free phone at:
877-737-9696
www.aspan.org
District I Director
Rose Ziffra MSN RN CPAN CAPA
630-856-6657
rose.ziffra@ahss.org
District II Director
Kathleen Crowder BSN RN CPAN
217-480-7747
fyrre@outlook.com
District III Director
Jane E. Sieron MSN RN CAPA
618-398-3447
Jsieron@memhosp.com
Education Chair (ex-officio)
Alexis Nicpon BSN RN CPAN
630-605-4266
ajnicpon@comcast.net
Membership Chair (ex-officio)
Fe Castro BSN RN CPAN CAPA
847-622-9405
feu1977@hotmail.com
Peri-Scope
Published 3 times a year
Deadlines to submit copy
Winter Issue…….. December 1
Summer Issue..……... April 1
Fall Issue…………...August 15
Send copy to
Jane Reinschmidt
BS RN CAPA
2117 Lake Shore Circle
Arlington Heights IL 60004
jane280@comcast.net
Newsletter Editor (ex-officio)
Jane Reinschmidt BS RN CAPA
847-394-4944
jane280@comcast.net
Research Chair (ex-officio)
Linda Beagley MS BSN RN CPAN
630-817-6001
beagley@ameritech.net
Web Editor (ex-officio)
Keith Schumacher BSN RN CPAN
217-482-3309
kesrncpan10@yahoo.com
ILSPAN
Web site
www.ilspan.org
Board and General
Membership Meeting
Minutes can be
found on the web
site
VOLUME 38 ISSUE 3
Governmental Affairs
Page 3
Wanda Ellenburg MSN MHA RN CPAN
An internet search on Accountable Care
Organizations (ACO) yields many hits with a wealth
of information. “Accountable Care Organizations are
groups of doctors, hospitals, and other health care
providers, who come together voluntarily to give
coordinated high quality care to their Medicare patients.”¹ Providing high quality care without duplicating services is the goal of an ACO. By providing
quality care and spending health care dollars wisely, the ACO achieves savings.¹ Medicare shares
these monies with the providers in the ACO as an
incentive to achieve the goal of timely, high quality
care and efficient use of health care resources.
Many health care consumers believe our
country’s health care is among the best. Unfortunately, the data indicates otherwise. Our life expectancy is less than that of other countries. The United
States spends more on health care than other countries, yet 46 million Americans are uninsured and
services are poorly coordinated. Medical errors result in 99,000 patient deaths in hospitals each year.
The Institute of Medicine (IOM) estimate of 1.5 million preventable adverse drug events yearly is the
driving force behind the Health Care delivery reform
act.² The Affordable Care Act (ACA) has three
aims. “To improve the experience of care for individ-
uals, improving the health of populations, and lowering per capita costs.”³
The ACA is moving health care from an
episodic treatment and fee for service model towards a coordinated model of high performing providers and organizations improving access to quality care, illness prevention, improved safety and coordinated services. Health care will see many
changes as the ACA achieves its three aims. The
creation of ACO organizations is the most notable
of the changes.
References
1. Accountable Care Organizations (ACO). Available at http://www.cms.gov/Medicare/MedicareFee-for-Service-Payment /ACO/index.html. Accessed August 15, 2014.
2. US Health Care Facts. Available at http://
www.accountablecarefacts.org/facts. Accessed
August 15, 2014.
3. Top Questions About ACOs & Accountable
Care. Available at http://
www.accoutnablecarefacts.org/topten/what-arethe-barriers-and-challenges-such-org.
Accessed August 15, 2014.
(President’s Message continued from page 1)
me. I would not have engaged in these activities before completing my degree. I am confident in my ability to
change my workplace and to positively contribute to the development of nursing practice. I have become more
active at work, recently completing and presenting a nursing research project. I encourage you to pursue your
BSN or advanced degree in nursing.
Get Involved
Staying connected is critical to succeeding in our perianesthesia profession and keeping our presence
strong within healthcare organizations. Being a member of ASPAN and ILSPAN, who support education and
professional development, is essential. It is crucial to ensuring that we continue to evolve as nurses, refusing to
be satisfied with the status quo. Without participation and commitment, we will lose the power to change our
workplace and to positively contribute to the development of our perianesthesia nursing practice. We are each
capable of making a difference. All we have to do is take that first step with the help of ILSPAN.
Reference
1. Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC:
National Academies Press; 2010.
Page 4
Deadlines for ILSPAN
Scholarships and Awards
Jan Ridder Excellence in Clinical
Practice Award
Deadline November 15, 2014
Humanitarian Mission
Scholarship
January 1, 2015
CPAN® CAPA®
Certification & Recertification
Scholarship
Fall Test Certification &
Recertification Deadline is
January 1, 2015
Recruiter of the Year (ROA)
ROA timeframe is
January to December 2014
for the 2015 Award
2015 ASPAN National
Conference Scholarship
Deadline January 1, 2015
Research Grant Application
Due January 1, 2015
All information is found on the
ILSPAN Web site under awards,
scholarships or research tabs.
Mail applications to:
Mary Higgins
536 N. 7th Avenue
Des Plaines, IL 60016
Email:
higginshouse460016@yahoo.com
PERI-SCOPE
Vice President’s Report
Mary Higgins BSN RN CAPA
What a gift each of you are! You consistently bring your talents, skills and passion to your patients, families and workplace.
With the changes in healthcare and the current economic challenges, we need to use the resources and networking of ILSPAN and
ASPAN. We need to share the clinical expertise and research that
our colleagues possess within our membership area and across the
nation. The ILSPAN website, e-blasts and quarterly Peri-Scopes
allow our members access to these resource but what of the associates with whom you share your clinical practice? How can they access these resources? We are seeking a contact person from each
institution within the state of Illinois to be the liaison for their peers
regarding resources that both ILSPAN and ASPAN can provide.
Please contact Mary Higgins at higginshouse460016@yahoo.com
for more information. ILSPAN and ASPAN provide scholarships for
certification and recertification, humanitarian work, along with local
and national conferences fees. ILSPAN has a dynamic research
scholarship that can assist financially. The applications for these
awards which support professional growth are available on the ILSPAN website under scholarships and the deadlines are listed on
this page.
ASPAN is committed to professional excellence and held a
LDI (leadership development Institution) seminar in September. The
experience was fantastic. Topics ranged from planning a budget,
running a board meeting, and recruiting future leaders at both the
component and national level. A session on enhancing electronic
media for information sharing included electronic newsletters, email
blasts, Facebook pages, and websites. Recruiting members to
serve in leadership positions is important to the growth of both ILSPAN and ASPAN. Consider attending a board meeting to see how
decisions are made that affect the organization. It is a rewarding
experience!
Call for Nominations ILSPAN 2015
Spring Elections
ILSPAN is now accepting nominations for the 2015 ballot.
Board positions to be elected are: Vice-president/
President Elect, Secretary, District I Director and District
III Director.
Fill out the Willingness to Participate form found on page
19 or on line at www.ilspan.org under the “Volunteer” tab.
Job descriptions and committee descriptions can be
found there. Contact any Board member for more information. (Contact information on page 2)
VOLUME 38 ISSUE 3
District I Director
Summer is almost over and soon we will be
facing the change of seasons to fall, winter and finally
spring. The planning committee for the 2015 ILSPAN
Spring Conference would like you to save Saturday,
March 7 for the spring conference which will be at the
Meridian Banquet in Arlington Heights, Illinois. We
have invited a dynamic ASPAN speaker, Maureen
McLaughlin MS RN CPAN CAPA. She will be presenting a variety of topics, which will be useful in
providing excellent care to our perianesthesia patients. The day promises to be full of information and
camaraderie with contact hours being awarded.
District II Director
This summer brought an opportunity to review the business side of ILSPAN. At the August
Board of Directors’ meeting we reviewed the ILSPAN policies and procedures, bylaws and job descriptions. The changes to the bylaws must be approved by a vote of the general membership. One of
the many things that I learned at this meeting was
that opportunities exist for ILSPAN members. Assistance abounds in the form of scholarships and
grants. For those of you who are considering certification or recertification, attending an ILSPAN conference or ASPAN National Conference, participating in a mission trip or research, I encourage you
look at the many ways ILSPAN can assist. If you
need any help or information regarding the application process, please contact me. (Contact information on page 2)
District III Director
ILSPAN Fall Conference was a success last
month. It was attended by 49 nurses who enjoyed a
wide array of perianesthesia topics. Five boxes of
canned goods were donated to the Salvation Army
along with collecting 70 dollars in cash donations.
I want to extend a huge thank you to the planning committee and to all those who helped in any
way to orchestrate the conference. A special thank
Page 5
Rose Ziffra BSN RN CPAN CAPA
Breakfast and lunch will be served. Watch for more
information as the seasons change.
I am excited by the number of new members
joining ILSPAN each month in District I. I welcome
you all to ILSPAN and urge you to get involved in
advancing our specialty organization. I encourage
networking and the sharing of best practices between
institutions. We face similar situations every day, and
it is reassuring to know that other institutions encounter the same challenges and have similar opportunities as we do. It is helpful to compare solutions and
take recommendations from each other.
Kathleen Crowder BSN RN CPAN
Research is important to the advancement
of perianesthesia nursing and for validating what
we do as evidence based. The research by nurses
at Memorial Hospital in Springfield on the topic of
Visitation in the PACU has been completed. Their
research team is now in the process of preparing to
publish the results. I look forward to reading about
this research in our district. This group was the first
to benefit from the ILSPAN Research Grant.
Planning is underway for the ILSPAN Fall
Conference which will be held in District II in 2015.
There is room for two more planning committee
members for this conference. I hope to have the
location confirmed soon. If you are interested in
helping make this conference a success, fill out a
Willingness to Participate Form. (Form found on
page 19.
Jane Sieron MSN RN CAPA
you goes to Sylvia Baker for her expertise which
guided me through the process. Sylvia kept me on
track and helped me to put it altogether.
District III welcomes two new members this
quarter. Let’s be certain we are all encouraging coworkers to join and benefit from our specialty organization.
PERI-SCOPE
Page 6
Linda Beagley MS BSN RN CPAN
The terms quality improvement, evidence
based practice and research are often used interchangeably. The reality is all three are different but
overlap. Let’s take a look.
Quality Improvement (QI)
Commonly used in a business setting, QI
is a systematic approach to reduce or eliminate
waste, rework and losses in production process.1
In healthcare, QI is used as a way to develop clinical practice based on the principle there is an opportunity to improve on processes on each occasion. I feel certain that many perianesthesia units
collect data on a regular basis to evaluate processes on patient satisfaction and safety measures.
Frequently used is the Donabedian model
of structure, process and outcome developed forty
years ago.2 It is essential to complete each of
these three steps. Structure, identifying the problem or issue is the first step. Next is to develop a
process to minimize or eliminate the problem. Lastly, analyzing the outcome or the result of the structure and process completes the cycle. The outcome should be looked at more than once to see if
the structure is sustainable. Re-examination also
allows an opportunity to reshape or alter the structure to achieve the desired outcome.
Research
Burns and Grove define research as
“diligent, systematic inquiry or investigation to validate and refine existing knowledge and generate
new knowledge.”3 Research has multiple steps:
formation of a research question(s), reviewing the
Looking for All ILSPAN Researchers
ILSPAN is eager to hear about your research
or evidence-based projects on perianesthesia
nursing that are in progress or in the planning
stages. Drop an email to Linda Beagley,
ILSPAN Research Chair.
Contact information on page 2.
literature, constructing a framework, applying to and
receiving approval from the Institutional Review
Board (IRB), data collection, analyzing and drawing
conclusions from the results.
Two factors which separate research from
QI are the requirement for IRB approval to do the
research and publishing the results disseminating
the knowledge to others. A third party reviews the
proposed research to ensure that the sample population is kept safe. Prior to the development of
IRBs, vulnerable populations, e.g. children, prisoners, were not protected throughout the research
process. Research becomes meaningless if not
shared. Telling the story of the process of the research and what was discovered during the research benefits others only if the story is shared via
presentation and/or a published article.
Evidence Based Practice (EBP)
What we learn in research is taken to the
next step by applying the gained knowledge into
practice. EBP is defined by Burns and Grove as
“the conscientious integration of best research evidence with clinical expertise and patient values and
needs in the delivery of quality, cost-effective health
care.”3 Since the 1980s, the Agency for Healthcare
Research and Quality (AHRQ) has worked in identifying health topics and the development of practice
guidelines for these topics. The AHRQ has developed tools to assess the quality of care that is provided by the evidence-based practice guidelines.
In the next issue we will look at the Joanna Briggs Institute website which provides
many benefits for ASPAN members.
References
1. Quality improvement. Available at http://
www.businessdictionary.com/definition/qualityimprovement.html#ixzz3A1Ofh4gz Accessed
August 10, 2014.
2. Hughes R. Tools and strategies for quality improvement and patient safety. Available at
http://www.ncbi.nlm.nih.gov/books/NBK2682
Accessed on August 10, 2014.
3. Burns N, Grove S. Glossary. The Practice of Nursing Research Conduct, Critique, and Utilization. St. Louis, MO: Elsevier Saunders;
2005:736, 749.
ILSPAN Research Grant Deadline July 1, 2014
VOLUME 38 ISSUE 3
Page 7
CPAN® and CAPA® News
Nursing Passion in Action®
Congratulations New ILSPAN
Certified Nurses
ILSPAN Scholarship
CPAN®
Christina Anderson
Josephine Barcelona
Karin Barth
Elizabeth Bendinelli
Kelly Braun
Sheri Brondyke
Daphnie Fernandes
Andrea Garfinkel
Karen Goehl
Sandra Griesbaum
Melanie Larson
Angelique Legrand
Linda Louis
Rebecca Marschang
Mark Moolenaar
Jyoti Naik
Nenita Padernal
Pamela Pierce
Mary Shields
Joslyn Smith
Juliette Triebe
Noel Wojtulewicz
CAPA®
Larry Gnat
Mary Iwaszkiewicz
Helen McManus
Judith Manipon
Lea Pearson
Congratulations to ILSPAN Certified
Nurses with 15 to 28 Years Certified.
Total of 671 Years.
Eleanor Carlberg CPAN—1986
Anita Deasis CPAN—1986
Mary Janik CPAN—1989
Kim Kraft CPAN—1989
E
Lisa Mendelson CPAN—1989
Mary Ann Cochran CPAN—
1989; CAPA—1996
Nelia Valera CPAN—1989
Lynn Nadrowski CPAN—1990
Sylvia Baker CPAN—1991
Susan Cramton CPAN—1992
Deborah Rossman CPAN—
1992
Kim Perry CPAN—1994
Kathryn Meier CPAN—1995
Susan Sweeney CPAN—1995
Gwendolyn Hicks CPAN—1995
Evelyn Buscar CPAN—1995
Linda Landers CAPA—1996
Linda Determan CPAN—1997
Maria R. Bell, CPAN—1997
Angela Morris CPAN—1997
Jeanette McAllister CAPA—
1997
Marilyn Harleman CAPA—1997
Joann Quinn CAPA—1997
Christine Johnson CAPA—1997
Debra Golen CAPA—1997
Judith Horvat CAPA—1997
Christine Tilker CAPA—1997
Michelle Nottoli CAPA—1997
Lynn McDermott CAPA—1997
Patricia Moeckel CPAN—1998
Corinn Desmond CAPA—1998
Bella Aggacid CPAN—1998
Mary E. Jones CPAN—1999
If you are taking the test this fall or if
you will recertified this fall be sure to
apply for the ILSPAN CPAN® or CAPA® Scholarship. View information
and the policy on the ILSPAN web site,
www.ilspan.org > Scholarships > Certification Scholarships, or by sending an
e-mail to any Board member. (Contact
information on page 2.)
CPAN® and CAPA® NEWS
ABPANC Reports: Certification is
Helping to Improve Patient Care
Independent studies have proven that
Post Anesthesia Care Units with a higher percentage of CPAN and CAPA
nurses have lower rates of central line
bloodstream infections. The knowledge
gained by studying for certification exams helps to improve patient care.
Those of you who hold our specialty
certification know how it has made a
difference in your life. Please encourage others in your unit to join nearly
12,000 CPAN and CAPA nurses who
are certified. The next testing opportunity will be spring of 2015.
Start planning now. Resources are
available on the ABPANC website at
www.cpancapa.org
PERI-SCOPE
Page 8
ASPAN Region 3 Director
Tracy Underwood MSN RN CPAN
Leadership Development Institute
The first weekend in September
ASPAN holds the Leadership Development
Institute (LDI). The busy, fun filled weekend
allows for component leaders to network,
share ideas, and learn strategies to grow their
components, as well as themselves, professionally. This event is not just for component
leaders. Every member interested in learning
more about ASPAN and component procedure
or becoming a component or ASPAN leader is
welcome to attend.
Region 3 was well represented at this
year’s LDI in Nashville, Tennessee. The weekend was an interactive learning experience. It
was great to spend time with friends made
over the years as well as get to know newcomers. Friday night, small groups participated in a
team building exercise presented by the Regional Directors. Each team was instructed to
build a bedpan out of paper, straws, rubber
bands, and scotch tape. The groups then marketed their bedpans. It was an entertaining
exercise with much creativity demonstrated.
Educational breakout sessions addressed subjects such as Gold Leaf applications, budget, effective board meetings, using
social media, and applying for contact hours.
Armi Holcomb and Jacque Crosson spoke
about finding the leader in ourselves and others. The Regional Directors lead a panel dis-
cussion on succession planning where the Directors
and attendees shared successful practices and personal stories regarding recruiting the next generation
of leaders.
My journey in becoming a member of the
ASPAN Board of Directors
started with one person saying that they thought
I would be good at the position. I had never considered being on the board but this person planted the seed. Personal contact is important to
assure potential candidates feel encouragement
and support and know that someone believes in
them.
I challenge those of you in leadership
positions to plant those seeds of encouragement
with up and comers. Your words could be a
spark of inspiration. Being a member of a Component Board or the ASPAN Board is a wonderful learning experience. Members give to the
organization but receive so much in return. The
personal and professional growth, knowledge,
professional contacts and wonderful friends I
have made will always be with me. There is an
effective leader in each of us. I encourage you to
consider giving a little of yourself and receive the
amazing benefits of being a part of this exciting
organization.
PeriAnesthesia Nurse Awareness Week (PANAW)
February 2-8, 2015
Begin plans now for a 2015 PANAW celebration. ASPAN’s 2015 theme is
Perianesthesia Nurses: Dedicated Professionals, Passionate Care. During
PANAW, perianesthesia nurses in hospitals, clinics, and ambulatory surgery centers across the
country celebrate their roles as partners in caring.
ILSPAN presents an award each year to the perianesthesia unit that demonstrates Education, Professionalism, and Team Spirit of the perianesthesia unit during PANAW. Submission information and deadline will be published in the Winter Peri-Scope. The award is presented at the general membership meeting at the spring conference.
VOLUME 38 ISSUE 3
Page 9
Notes from 2014 Leadership Development Institute
ILSPAN sent five members to the ASPAN
Leadership Development Institute (LDI) September 5
-7, 2014 in Nashville, TN. Each returned home energized and ready to lead ILSPAN into the future. At
the September board of directors meeting they
shared highlights from the weekend.
Rose Ziffra, District Director 1, found the
team building interactive session to be resourceful.
(See details on page 8 in Tracy Underwood’s Region
3 Director’s report.) One of Rose’s many take aways from this weekend was that listening is the
greatest accomplishment a leader can possesses.
Kathleen Crowder, District Director 2,
learned ways to help her transition into her new role.
The team building activity in which groups designed
and built bedpans was a mechanism to identify the
idea-makers or the worker-bees. The activity helped
each team come together and resolve differences.
Kathleen met ASPAN Region 3 Director, Tracy Underwood, who claims that her state components are
“the best”. A common theme of membership issues
was voiced during the LDI. Kathleen’s learned lesson
was that the educational wave of the future is half
day seminars, virtual vendors and mixing medical
with fun vendors.
Fe Castro, Membership Chairman attended
with hopes of learning how to increase membership.
She attended a session on budget and learned about
the importance of being insured against risk. Her
favorite session was on “Firing up the Keyboard”; a
tutorial for the over 50’s group on how to navigate
the ASPAN website.
Carla Silzer, Treasurer, also attended the
budget meeting and appreciated how personable
ASPAN’s CEO Kevin Dill and Treasurer Katrina
Bickerstaff were. ASPAN President Jacque Crosson
presented the topic of different generations in the
workforce—Generalists, Baby boomers, Gen X and
Y. Carla learned that knowing your workforce is essential in generating effective communication.
Mary Higgins, Vice-President/PresidentElect, was interested in the presentation on social
media and how it can be both helpful and hurtful.
She also learned that here are many methods to
hold board meetings including using Skype. Mary
particularly enjoyed hearing Kim Noble present
“Research Jump Start.” Kim shared how research
really isn’t scary and ASPAN is available to help
components get started with research.
IF THE LDI SOUNDS INTERESTING AND YOU
WOULD LIKE TO ATTEND NEXT YEAR, CONTACT ONE OF THE ILSPAN BOARD MEMBERS.
CONTACT INFORMATION IS FOUND ON PAGE 2.
ILSPAN Members Rose Ziffra,
Carla Silzer, Kathleen Crowder,
Fe Castro, Mary Higgins
(kneeling) hamming it up.
Photo by Mary Higgins
Page 10
PERI-SCOPE
Spotlight on ILSPAN Members
Terry Booble, MSN, RN, CAPA
Terry Booble has
been working at Adventist
Hinsdale Hospital as a
Clinical Coordinator in
Pre-admission Testing
(PAT) for a number of
years. She is responsible
for patient flow, clinical
outcomes and the overall
daily operation of the unit.
Well-respected by her
peers for her leadership
and professionalism, Terry
is a role model and always
strives for excellence. She
takes pride in what she
does and encourages the staff to give their absolute best for every patient. She communicates by
listening and then taking action on every opportunity that is presented. The changes that she
has introduced are evidence-based, and she
measures the success of those changes with
both qualitative and quantitative data.
Terry has been instrumental in the integration process of pre-admission testing at Adventist Hinsdale Hospital and Adventist LaGrange Hospital. Together with the team, she
looked at the processes, identified clinical variations and developed an efficient, cost effective,
evidence based and patient centered care model.
With her leadership, PAT employee engagement increased from 75% to 95%. She led
her department with 100% NDNQI participation.
PAT is one of the top units at the hospital with
the highest scores in Culture of Safety Survey
and Physician Satisfaction Survey. Terry is the
coordinator of the Nursing Care Committee of
Adventist Midwest Hospital, and she won the
Leadership Award at the 2014 PANAW Celebration. She is both a Clinical Level III nurse and a
Certified Ambulatory Perianesthesia Nurse. Terry
recently received the Nurse of the Month award
at Adventist Hinsdale Hospital.
Patricia Mertens RN CPAN
Patricia Mertens has
been a nurse for twenty
-two years. She is a
1992 graduate of Lutheran Medical Center
School of nursing in St.
Louis, Missouri and is
currently enrolled in a
BSN completion program through Walden
University. Patty maintains a membership in
ASPAN and ILSPAN
and obtained her CPAN
certification in 2012.
She feels fortunate to
have attended the ASPAN National Conference
in Seattle, Washington in 2011.
Patty currently works in perianesthesia
nursing at Memorial Hospital in Belleville, Illinois
which is a Magnet hospital. She spent nine years
in Phase One Post Anesthesia Care Unit
(PACU) and was charge nurse there prior to
transferring to the Preoperative Testing Center.
Transferring to another phase of perianesthesia care has added a new perspective to
Patty's understanding of the patient's surgical
experience. She has had to adjust from the
physical hands on action required in the PACU.
The goal now is to work closely with the anesthesiologist to make certain that the patient is optimized for their surgical procedure. Patty is focused, a hard worker and is dedicated to her
profession.
Among the numerous committees that
Patty has participated in, include: The New Employee Orientation Committee, The Education
Committee, The Hand Hygiene Committee, The
Quality Improvement Committee and the Unit
Practice Council. Patty has also served as a
mentor to new employees.
VOLUME 38 ISSUE 3
Informatics Corner
Page 11
Jamie Danks BSN MSHI RN CNOR
Ensuring Quality Documentation in the Electronic Medical Record
Striving for Standardization: The Details are in the Descriptors
In August of 2013 the Office of the National
Coordinator for Health Information Technology
(ONC), indicated that improved care will be the result of standardization for reporting.1 ONC states,
the key to progress for our future in healthcare reform is standardization.1 Electronic documentation
has many positive implications. This includes the
ability to standardize documentation in the perioperative setting. This will allow for the collection of
statistics that can translate to care across all perioperative settings. Using standardization will also
provide insight into best practices. Currently, limited
use of standardized data documentation practices
and the constraints of IT capabilities impede data
validity and delay the comparisons of quality data
from multiple providers.1 How can we ensure that
the Electronic Medical Record (EMR) is meeting
the needs of our specialty practice while ensuring
standardization? There is no one size fits all for our
scope of practice and each institution has chosen
and developed an EMR based on specific needs.
The types of patients we care for are unique. The
question remains should the documentation be
equally unique? The attempt to standardize documentation within the EMR is difficult. This can be
related to the workflow processes in our individual
practices or in instances where we have developed
processes deviating from the standard workflows. I
believe from the perspective of data collection and
achieving evidenced based practice, perioperative
documentation of patient care should be standardized. Translating that standardization into the electronic world is more difficult than anyone could imagine.
Documentation Practices
Documentation practices are prescribed by
multiple venues. Many of the governing bodies that
provide recommended practices influence the data
that is documented. For instance ASPAN has developed standards that provide us with a guideline
for recommended documentation practices.² In addition, the EMR vendor consults with their subject
matter experts (SME) to develop prescribed content
for documenting a given value. The application is
then turned over to your Clinical Information Systems administrators who review institutional policies and procedures to establish documentation
requirements specific to our institutions. The system administrators work with management and
staff to develop documentation values. Our documentation practices should fall within the recommendations of these governing bodies. When resources are not consistent in terminology and practice, creativity creeps in and we cultivate ways to
meet the needs of our specialty practice and our
institutional policies by tweaking and developing a
“work around”.
Descriptors
For instance let’s review a pulse assessment. This seems easy enough to do, so why is
this so difficult to achieve? The details are in the
descriptors. Terminology or descriptors are not
consistent throughout our practice. Documenting
the heart rate is easy. The pulse is palpated or
auscultated and documented as a numerical value.
When it comes to the description of the pulse, the
details are cloudy. There are thousands of institutions that use multiple resources to determine the
best practice for documenting the description of the
pulse. For instance the term irregular, we all know
what irregular feels like, but how does it translate
into documentation; uneven, erratic, variable, random, now and then, intermittent, sporadic, fluctuating, and abnormal might be a few terms that come
to mind. These terms can all mean the same thing
so how do we ensure they are interpreted the
same way? This is one of the benefits of the EMR.
We have the opportunity to standardize documentation. This would make it easy to collect valuable
data and statistical relevance from documentation
that will make our data actionable. This will guide
us down the path to evidence based practice in the
care of our patients. This is difficult to accomplish
when the terminology and practice are not standardized.
(Continued on page 12)
PERI-SCOPE
Page 12
ICPAN CONGRESS ANNOUNCES 2015 CONFERENCE
September 9th to 12th 2015
The Danish Association
of Anaesthesia, Intensive
Care and Recovery Nurses is proud to be hosting
the 3rd ICPAN congress
and would like to invite
you to come to Copenhagen in the late summer
2015.
The aim of the conference is SHARING initiatives in education, research, management and evidence- based practice and CARING for the perianaesthesia patient: clinical
case studies in anaesthesia, post anaesthetic
care including paediatric, elderly and surgical
specialty groups.
Online registration opened mid- September 2014 and 1st call for abstracts will open
primo October 2014
This will be the first ICPAN congress
in the Nordic countries, home of the Vikings
and IKEA! Denmark, which introduced Hans
Christian Andersen and Lego to the world, is a
casual, friendly country with an unparalleled
focus on childhood and family life – an appropriate setting to address issues of post anesthetic care for our patients. And, as in all Nordic countries, English is commonly spoken
and spoken well – particularly in beautiful vibrant Copenhagen, a world class city with impressive architecture, parks, museums, restaurants and, of course, the Little Mermaid. So
come to Copenhagen, enjoy what Denmark
has to offer and become stimulated and invigorated by what promises to be an exhilarating
congress.
ASPAN Willingness-to-Participate forms are due October 31st.
Sign up for your favorite committee(s) or strategic work team(s).
(Continued from page 11)
Standardization
How do we develop documentation that will ensure accurate standardized documentation?
This should be included in the planning stages of any EMR.
Teams that are created to develop the EMR should use the following to set a course for standardization; a strong SME, bedside nurses at the table, ASPAN standards and education and reeducation of staff. Being actively involved in development of the EMR and obtaining buy in from nursing and management staff alike are crucial to successful development of standard documentation in
the EMR.
References
1. Murphy, K. EHR Standardization Key to Health IT Progress ONC Brief says. EHR Intelligence
Website. Available at
http://ehrintelligence.com/2013/08/20/onc-highlights-value-of-ehr-standardization-in-latest-brief
Accessed February 14, 2014.
1. American Society of PeriAnesthesia Nurses. Perianesthesia Nursing Standards, Practice Recommendations and Interpretive Statements. 2012-2014. Cherry Hill, NJ: ASPAN; 2012.
VOLUME 38 ISSUE 3
Page 13
News & Notes
Save the Date
ASPAN 34th National Conference April 26 - 30, 2015
Grand Hyatt San Antonio, San Antonio, Texas
Early Bird Registration Open Until 03/21/15
More information on the ASPAN website at:
http://www.aspan.org/Events/2015-National-Conference
ILSPAN Members apply now for the ILSPAN National Conference Scholarship. Information can be found at www.ilspan.org
under the Scholarship Tab.
Registration brochures available from the National Office in December. Save on your registration by doing the early bird registration. There will be opportunities to volunteer at conference for
host/hostess or to work in the ASPAN Shoppe. Conference is
always a fun time. You could earn 20 to 30 continuing education
hours at this conference.
ASPAN Resource Development Strategic Work Team (SWT)
This ASPAN SWT works to provide ASPAN members with scholarships for BSN, MSN or Doctorate in
Nursing, CPAN® or CAPA® certification or recertification, ASPAN National Conference, Humanitarian
Missions and for the Nurse in Washington Internship Program.
Funding for these programs comes from the ASPAN Hail, Honor, Salute program and Silent
Auction held in the national conference exhibit hall along with the
Dream Walk on Sunday morning during NC. Consider honoring
ASPAN Above and Beyond Award
one of your co-workers with a Hail, Honor, Salute, contribute to an
This award honors the recipient for
item to the Silent Auction or walk in the Dream Walk. Your donaexemplary service to
tion will go a long way to support perianesthesia nurses.
ASPAN and/or their component. ILSPAN members
have been honored with
this award—Sylvia Baker
The ASPAN Perianesthesia Nursing Standards,
and Linda Beagley in
Practice Recommendations and Interpretive State2014. The criteria and application is found on the ASPAN
ments 2015-2017 is in the final production stage.
website at www.aspan.org. Look
These standards will contain the new ASPAN Preunder the “Members” tab for Awards
vention of Unwanted Sedation in the Adult Patient
and the Above and Beyond inforPractice Recommendation and the Position Statemation is in the side menu that appears. It would be great if other ILment on the Nurse of the Future: Minimum BSN ReSPAN members won in Texas 2015.
quirement for Practice.
PERI-SCOPE
Page 14
Education Article
Rose Ziffra MSN RN CPAN CAPA
Management of Acute Pain in Opioid-Tolerant Patients
In the U.S., there are a growing percentage of chronic pain patients requiring surgery.
Pain in this population is likely to be difficult and
challenging to manage.1 In many cases, most
analgesic options have already been maximized,
and they are likely to be opioid-tolerant. In addition, new surgical pain may produce opioidinduced hyper-analgesia.
Chronic pain patients require careful
evaluation and planning to achieve appropriate
acute pain management. The objectives in managing acute pain in this complex group of patients are to provide adequate pain relief for the
acute surgical event in a safe and timely manner
and to meet the patient's expectations.2 In preparing for surgery, the first step is to identify current long-term opioid medications, the dosages,
routes of administration and the length of time
the patient has been using the medication. This
information will provide guidance on medication
dosing during and after surgery.
Multimodal Treatment
Surgical pain has traditionally been
viewed as an acute problem, treated mainly with
opioids in the recovery room.2 Research evidence now shows that post-surgical or posttraumatic pain is best treated with a multimodal
approach, especially if the pain is severe and
long-lived enough to interfere with or impede the
recovery process. This multimodal approach may
include systemic analgesics, anti-inflammatory
agents, local anesthesia with other adjunct medications, use of heat and cold, electric stimulation,
drugs applied via cutaneous delivery system and
rehabilitation activities. Benefits of multimodal
pain management strategies include: reduced
pain scores, decreased hospital length of stay,
reduced nausea, faster return of bowel function,
earlier mobilization, more rapid return of the ability to eat and a minimized stress response to surgery in order to facilitate healing. This type of
management is particularly important because in
our present healthcare system, many surgeries
now are being classified as outpatient and length
of stay for inpatient is being limited.2
Intraoperative pain can be variable, and
patients on daily chronic opioid maintenance may
require up to 20% more of the usual daily opioid
dose.2 In the postoperative period, this population is likely to have significantly higher analgesic requirements and report more intense pain.
Intravenous opioids delivered via patientcontrolled analgesia (PCA) are the most common approach, beginning as early as the
Phase I recovery period. It is common to use
PCA with a basal infusion in these patients, and
they are less likely to experience over-dosage
with a basal infusion rate than opioid naive patients.
One Hospital Implements Change
At Adventist Hinsdale Hospital in
Hinsdale Illinois, the perianesthesia team developed a protocol for acute pain management
in chronic pain patients. Patients come to preadmission testing one to two weeks before surgery for assessment, clearance and education
about the surgery. Chronic pain patients are
identified by using a screening tool developed
by the team. The patients provide information
about their pain specialist and all pain medications they are currently taking. The nurse notifies the surgeon to obtain a pain consult. All
pain management orders are placed by a Pain
Specialist pre-operatively to provide timely pain
management in the postoperative period. A
sticker is placed on the front of the chart as part
of a communication tool to all care providers for
easy identification of chronic pain patients. For
patient safety, all patients with a PCA are sent
to the floor with oxygen, capnography and
pulse oximeter. This process increased patient
satisfaction, decreased length of stay in PACU,
facilitated effective communication and collaboration between disciplines, resulting in optimized patient flow and increased productivity.
References
1. Fisher R, Johnson Q, Reeves-Viets J.
Chronic opioid drug therapy: Implications
for perioperative anesthesia and pain management. Missouri Medicine. 2013; 3: 231235.
2. Quinlan J, Carter K. Acute pain management in patients with persistent pain. Current Opinion in Supportive & Palliative
Care. 2012; 2:188–193.
VOLUME 38 ISSUE 3
Page 15
CLINICAL PRACTICE CORNER
Sylvia Baker MSN RN CPAN
What does ASPAN say about the use of mechanical and pharmacological DVT prevention in the PACU?
ASPAN does not have a clinical pathway, guideline, or policy regarding the use of
low molecular weight (LMW) heparin or sequential compression devices (SCDs). Nurses are
aware that deep vein thrombosis (DVT) can
cause increased pain and suffering, increased
financial costs, increased emotional cost, and
decreased surgical outcomes. The Surgical
Care Improvement Project (SCIP) recommends
that mechanical prophylaxis be initiated for most
cases within the 24 hour period prior to and after surgery.
One article addresses the use of SCDs
in knee arthroplasty surgeries¹. Some research
seems to demonstrate that SCDs are actually
more useful than active motion! Generally, all
patients receive SCD therapy while in the PACU
with the exception of surgical procedures that
SCDs would be contra-indicated (i.e. femoralpopliteal bypass).
SCIP also recommends that all patients
have pharmacological DVT prophylaxis, with
some exceptions (spinal fusions or patients at
risk for bleeding), in an effort to promote positive patient outcomes regarding DVTs.
Research Project Update
The 2012-2014 Perianesthesia Nursing
Standards, Practice Recommendations and Interpretive Statements states: “ASPAN is a highly
committed advocate for the culture of safety in all
perianesthesia practice settings.”² When addressing patient advocacy, this reference explains that
a culture of safety includes several actions,
among those are: “Protecting the patient from
harm through the use of safety tools.”² The use of
SCDs and LMW Heparin products are tools that
help protect the patient from the danger of DVT
formation.
Reference:
1. Journal of the Southern Orthopaedic Assoc.
Effect of Sequential Compression Devices on
Femoral Venous Blood Flow. Available at:
www.medscape.com/viewarticle/444065 Accessed August 21, 2014.
2. Perianesthesia Nursing Standards, Practice
Recommendations and Interpretive Statements. 2012-2014. Cherry Hill, NJ: American
Society of PeriAnesthesia Nurses; 2012, 13.
Wanda Ellenburg MSN MHA RN CPAN
It has been almost four years since we raised the burning question about the impact of family visits in
Phase I on the patient and the family. We formulated a research question, completed a literature review,
wrote an abstract, received IRB approval, completed a pilot study, received funding from ILSPAN and the
Memorial Medical Center Foundation. We gathered data, both quantitative and qualitative. We had a statistician compile the quantitative data. Our research team became immersed in the qualitative data and discovered the over-arching theme of “To See with My Own Eyes.” We have presented posters at local ILSPAN
conferences, ASPAN 33rd National Conference in Las Vegas and at Sigma Theta Tau conferences.
Most importantly, the PACU made a practice change allowing family visits in Phase I at 45 to 60
minutes after the patient arrival for all patients and families desiring a visit. It has been ten months since the
practice change. The change has been well received by patients, families, nursing staff and physicians. We
have the manuscript completed. It will be submitted for peer review among nursing researchers at Memorial
Medical Center in Springfield, IL. Our next goal is to submit to a professional journal in October for publication. Be watching as we further disseminate our findings.
PERI-SCOPE
Page 16
ILSPAN Fall Conference: Getting in Touch with Your
PeriAnesthesia Practice
September 13, 2014
Conference Chairman, Jane Sieron talking with
Sylvia Baker, retiring ILSPAN Education Director
Conference Attendees
Speaker Sandy Alvarez RN MSN CCRNCMC talks with Carla Silzer.
Linda Beagley, Research Chairman speaking with
Conference attendee about research in ILSPAN.
VOLUME 38 ISSUE 3
Page 17
ILSPAN Conference Scholarship Winner
Insook Ann Kang
Jan Ridder Excellence in Clinical Practice
Award Recipient Sylvia Baker
ILSPAN ConI
Photos by Jane Reinschmidt
Fall Conference held at The National Shrine of Our Lady of the Snows Belleville, IL. The conference had
49 in attendance. Door Prizes raised $278 to be donated to a local charity.
Raffle Winners left to right Celeste Wiesner, Jennifer VanDerLeest, Sylvia Baker, Beverly Meister, Janice Willman, Linda Beagley, Mary Higgins. Not pictured Darlene Meyer.
PERI-SCOPE
Page 18
Welcome New Members who joined May to September 2014
District 1
Sandra Neudahl
District 2
Josephine Begora
Korene Palazzo
Elizabeth Ann Collins
Rita Campana
Diane Ruch
Heidi Cook
Anna Davies
Kim Sisk
Janice Willmon
Bonnie Horton
Carla Stainer
Yingjie Kielb
Lisa Patrice Theis
District 3
Grace Malasig
Eva Trefonas
Tynette Marie Jensen
Judith Manley-Plum
Linda Van Buren
Elizabeth Smart
Katrina Marshall
Latisha Washington
Betty-Ann McGuckin
Jolee Zaagman
Catherine Neary
MEMBERSHIP REPORT
Fe Castro BSN RN CPAN CAPA
ILSPAN BUCKS: Every dollar counts!
ILSPAN BUCKS in the amount of $5.00 are awarded for early renewal of your ASPAN/ILSPAN membership submitting an ILSPAN willingness to participate form, or if you serve as a host for an ASPAN seminar.
ILSPAN BUCKS in the amount of $10.00 is awarded for achieving CPAN/CAPA certification for the
first time bringing a non-member to an ILSPAN conference if they join ASPAN/ILSPAN on the spot, submitting
articles accepted for publication in the Peri-Scope or a research or evidence based practice poster approved
for presentation at the conference.
ILSPAN BUCKS may be redeemed by submitting it with the ILSPAN conference registration form.
You cannot use the ILSPAN BUCKS for online registration. ILSPAN BUCKS expire one year from the date it
was issued.
RECRUITER OF THE YEAR: It’s not too late!
ILSPAN has a Recruiter of the Year Award; given to the member who recruited the highest number of
new members between January 1st and December 31st. The award is presented at the Spring Conference. To
be considered for the award, a minimum number of three members must be recruited. Be sure that your name
is written as the recruiter in the Membership application form. The recipient of the award will receive one year
free ASPAN/ILSPAN membership.
VOLUME 38 ISSUE 3
Page 19
Volunteer for ILSPAN
Cut out the form below and mail it to Vice President Mary Higgins or log into the
web site www.ilspan.org and fill it out and submit on line.
Mail to : Mary Higgins BSN RN CPAN 536 N. 7th Avenue Des Plaines, IL 60016
ILSPAN Willingness to Participate Form
Name_____________________________________________________________________
Address___________________________________________________________________
City, State, Zip______________________________________________________________
Home Phone ________________________Cell Phone______________________________
E:mail_____________________________________________________________________
ASPAN Membership #________________________________________________________
Place of Employment_________________________________________________________
Please circle position of interest:

BOD position_________________________

Editor/publication committee

PR/Marketing

Computer networking
Previous experience that will help me: ___________________________________________
My goals for this position:_____________________________________________________
Questions I have:____________________________________________________________
Editorial Comment
Jane Reinschmidt BS RN CAPA
During the past three Januarys, I was privileged to participate in mission trips to the Dominican Republic. In 2014 I received the gift of seeing where my interventions made a life changing difference for two of
the people I was privileged to serve.
Much like what we do in perianesthesia nursing, in mission nursing we provide care and then move
to another patient. We go home in the evening (or morning) and know that we made a difference (if we think
about it) but there is not often the opportunity to see long term outcomes. As the years go by and we are
called on to do more with less, it’s easy to forget how we change and, yes, save lives.
Teaching is another aspect of perianesthesia nursing where knowledge of long term outcomes may
not be visible. How many codes had positive outcomes because of the many years I taught CPR and ACLS?
I’ll never know. Linda J. Fisher BSN, RN, CPAN knows how it feels to have made a difference. Two years
after Linda presented an in-service on lipid rescue one of the nurses who attended was able to identify an
occurrence of local anesthetic systemic toxicity (LAST). Her rapid initiation of the lipid rescue protocol saved
a life.¹ This nurse took the time to find Linda Fisher and acknowledge that the positive outcome was a result
of the class which Linda had taught. Good job, Linda.
Many of you may have noticed a new Peri-Scope column on Informatics. Thanks to author Jamie
Danks BSN RN MSHI CNOR, an ILSPAN member, who has volunteered to be a regular contributor to this
publication. I hope you find this addition timely and informative.
Reference
1. Fisher L. How a JOPAN Article Saved a Patient’s Life. J PeriAnesth Nurs. 2014; 3:173
ILSPAN Illinois Society of PeriAnesthesia Nurses
ILSPAN Core Purpose
The Illinois Society of Perianesthesia Nurses advances nursing practice through education, research, and standards of practice.
The Society exists to serve needs of
membership at the component level.
Looking Ahead………..
ILSPAN Humanitarian Mission Scholarship Application Deadline …………………………..January 1, 2015
ILSPAN Research Grant Application Deadline………………………..……………………….January 1, 2015
ILSPAN Winter Virtual Board of Directors Meeting…………………………………………..January 10, 2015
ILSPAN Spring Board of Directors Meeting.. …………...………….……………………………March 6, 2015
ILSPAN Spring Conference, Arlington Heights, IL.……………………………………………...March 7, 2015
ASPAN 34th Conference San Antonio TX……………………………………………….April 26-April 30, 2015
ILSPAN Summer Board of Directors Meeting, Go-to-Meeting…..………………………………July 11, 2015
ILSPAN Fall Board of Directors Meeting, Champaign, IL……………………………………October 9, 2015
ILSPAN Fall Conference, Champaign, IL……………………………………………...……..October 10, 2015
Additional details available on the web sites
www.ilspan.org or www.aspan.org
Be sure to “LIKE”
Illinois Society of PeriAnesthesia Nurses
or ILSPAN on Facebook
ILSPAN is now mobile! Go to www.ilspan.org on your smart
phone browser and keep up with our website on the go.
Copyright© 2014 Peri-Scope All rights reserved.
Reproduction by any means without expressed
permission from ILSPAN is prohibited.