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...prn WINTER 2015 - Vol 23, No. 4
IMPROVING LIVES…THROUGH INCREASING KNOWLEDGE Whether you are the practitioner, nurse, or patient, knowledge is an important element in improving lives. The following short story illustrates the value of knowledge.
Phyllis Gordon, MSN, ACNS, BC
SVN President, 2015-2016
To know is to know that you know nothing. That is the meaning of true knowledge…. - Socrates
SVN’s mission and vision both highlight improving lives through a 3-prong approach that is Think about the world of intertwined – practice, research vascular medicine and nursing and education. Over the years, as you read this story. SVN has addressed all three of these important aspects of A giant ship engine failed. The ship’s owners tried one expert after improving what the vascular nurse and our vascular patients’ another, but none of them could know about their disease and its figure out how to fix the engine. management. For this message, Then they brought in an elderly I want to highlight one leg of the man who had been fixing ships stool – education. since he was a young. He carried a large bag of tools with him, and when he arrived, he immediately went to work. He inspected the engine very carefully, top to bottom. After looking things over, the old man reached into his bag and pulled out a small hammer. He gently tapped something. Instantly, the engine lurched into life. He carefully put his hammer away. The engine was fixed! A week later, the owners received a bill from the old man for ten thousand dollars. “What?!” the owners exclaimed.“He hardly did anything!” So they wrote the elderly man a note saying, “Please send us an itemized bill.”
IN THIS ISSUE - Member News - Nurses at the Table - Finding the Evidence - Research Corner - Continuing Education
SVN...prn Editor
Cristina Sola, BS, RN-BC
management of the disease. The value of the patient knowing the what, why and how of their care to improve his/her own life.
In this issue, I want to focus on education.For many years SVN has developed and revised patient education materials, which consisted of booklets and education sheets. These have recently been revised and available on our website for download or print. An area for SVN to explore is to allow patients direct access to vascular education materials.
gearing up to develop a Vascular Nurse Tool Kit that can be utilized to orient and increase the knowledge of the nurse new to vascular practice. For the future, SVN will need to address the presentation of vascular disease in schools of nursing, as we know; the nurse will meet patients with vascular disease in any type of practice setting. To start this, SVN has developed a position statement on Including Vascular Disease in Nursing Education, published in late 2012 in the Journal of Vascular Nursing and is available on the SVN website under the Resources tab. More recently, SVN has been collaborating on a nursing educational grant project with the Preventative Cardiovascular Nurses Association (PCNA). This project consisted of the presentation of lectures on The Management of Venous Thromboembolism(VTE): A Casebased Approach. Melody Heffline (SVN member) and pharmacist Kelly Rudd presented at the PCNA conference and SVN Convention both in April of this year. Currently, SVN is participating in plans to repeat the presentation to regional groups in designated cities in the U.S.
The Annual Convention has been a major source of increasing the knowledge of the vascular nurse and will continue to be in the future. However, the SVN Board will need to include in The man sent a bill that read: their review of the Strategic Plan, Tapping with a hammer…… $ 2.00 We are extremely excited more innovative formats in the Knowing where to tap…$ 9,998.00 about all of these educational presentation of the convention sessions, such as virtual sessions. endeavors. There is so much Yes, we know there is a price more that SVN can dream Several years ago, thanks to for knowledge, but this story about regarding improving the the hard work of a small group also indicates the quality of knowledge of the vascular nurse of SVN members, four online that knowledge and the value and the vascular patient. As courses were developed and it brings to our practice and to Albert Einstein once noted, “The SVN invested in the process for the management of vascular true sign of intelligence is not these to be available online for disease for our patients. The knowledge but imagination.” We continuing education credit. A value of knowledge also includes will need your help in the future. fifth module on wound care is the quality of the patient’s being developed. understanding about his/her With pleasure, The SVN Education Committee, disease and living a life where the Phyllis Gordon chaired by Chris Owens, is patient takes an active role in the SVN President, 2015-2016
MEMBER news SAYING GOODBYE M. Isobel Green, RN, CNS, CNC, CVN past SVN Treasurer and longtime member recently passed away. Green worked tirelessly to promote vascular nursing and is described consistently as the kindest person who was a pure joy to work with and a tireless promote of SVN. Her SVN colleagues have these memories to share: “ When I first came onto the board, Isobel was the treasurer, and I had the honor of sharing a room with her on occasion. She is from England and would travel with one small carry-on for the whole week. She taught me to pack by rolling my clothes. I still tell that story. “ - Phyllis Gordon
“ Isobel was a wonderful kind and compassionate person who worked very hard in promoting SVN and vascular nursing
NEW BOARD MEMBER internationally. A big loss to the vascular nursing world!” - Marge Lovell “ Isobel was very passionate about vascular nursing and such a wonderful mentor. She will be so missed.” - Debra Kohlman-Trigoboff
“ She was truly a great person. Isobel served as treasurer when I was president and was a pure joy to work with and get to know as a friend. She was a tireless promoter of SVN. We will all miss her.” - Jane Frasca
“ So saddened to hear of Isobel’s passing. She was one of the kindest people I had the pleasure of knowing.”
SVN welcomes Chris Owen, BSN, MSN, RNFA to the Board of Directors. Owen was appointed to the board in November to fill a vacated board position. Board Profile Director (2015-2017) Chris Owen, MSN, ACNP-BC, RNFA Baltimore Washington Medical Center, Maryland Liaison to: Education Committee
- Karen Fitzgerald
Share your favorite memory of Isobel with us on the SVN Facebook page.
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NURSES at the table Submitted by Patty Flanagan MSN, RN-BC SVN Board Liaison to Public Policy & Advocacy Committee It is an honor and a privilege for nurses to advocate for patients as individuals, families and communities. Nursing is a highly respected and trusted profession. Patients and the public value what nurses have to say. Nurses bring to the table real life scenarios to aid in the discussion of healthcare issues. In the day to day care of patients, nurses are good at advocating for individual patient needs. However, patient advocacy goes beyond that. Being involved in decisions that impact the nurse’s patient
population is an important aspect of nursing. Nurses can advocate for patients by being involved in decision-making committees at their place of employment, whether it be in an inpatient or outpatient setting. Nurses can advocate for families by listening to their concerns and needs, identifying the common thread and acting on that need; targeting the appropriate key figures to address the issues and become involved in the decisionmaking process. Communities can be geographic or disease-specific populations. Advocating for communities includes becoming involved in disease-specific organizations,
town boards, zoning boards, and school boards as well as monitoring legislation for health care issues being discussed. Communicating to key figures the issues and their impact on patients, families and communities. Nurses also need to be aware of issues affecting the profession, being aware of issues being discussed at the nurse’s place of employment, nursing organizations and in legislation. Nurses must prepare themselves to take part in the discussions and place themselves in positions of influence to advocate for patients as individuals, families, communities and the nursing profession.
References: 1. Burns, N., Grove, S. Understanding nursing research (5th Ed). 2011. Philadelphia: Elsevier Saunders. 2. S ong, J., Chung, K. Observational studies: cohort and case-control studies. Plast Reconstr Surg: 2010; 126(6): 2234-2242. 3. Framingham Heart Study. Available at: https://www.framinghamheartstudy.org/
Call for JVN Editorial Board Members The Journal of Vascular Nursing is soliciting interested colleagues to apply for an Editorial Board appointment.
Editorial Board members are responsible for editorial review of manuscripts for publication in JVN and for assisting the Editor as assigned. Service on the Editorial Board is for one year to be renewed annually at the Editor’s discretion. Qualifications for appointment consideration include the following: 1. Registered professional nurse. Master’s degree in nursing required. 2. Vascular nursing practice experience in areas of education, practice, administration, or research sufficient to developing considerable expertise in the area. 3. Documented writing ability as evidenced by publication. 4. Membership in SVN for a minimum of one year.
We invite interested colleagues to submit a letter of interest, including your fields of interest and expertise, and current curriculum vitae to the Editor, Cindy Lewis MSN, RN, ACNS-BC, at Cynthia.lewis@aurora. org. All applications will be reviewed.
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Finding the Evidence
“EVIDENCE BASED PRACTICE” Submitted by Debra Kohlman-Trigoboff, RN, MS, ACNP-BO, CVN, SVN Past President
patterns. EPB has been shown to improve patient outcomes, reduce healthcare cost and increase clinician satisfaction3.
the time by medical professionals4; one barrier being the time constraints needed to review and assimilate the data.
Evidence Based Practice (EBP) is an approach to patient care integrating the strongest research evidence, clinical expertise and patient preferences1,2. Utilizing EPB is not only about implementing strong evidence into practice, but it also entails removing harmful or ineffective practice
Keeping current with EBP requires self-direction and spans the lifetime of one’s practice. With busy clinical practice and home schedules, practitioners often find it difficult to keep up with and ultimately implement the EBP recommendations. One study cites EBP is used approximately 55% of
There are multiple medical resources now available online to keep practitioners up-to-date with the current literature. Vincent, et al (2015) has compiled a list of strategies for maintaining currency in research and clinical literature. Please refer to Table 1 below.
Table 1 (Vincent, et al 2015)
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Finding the Evidence
“EVIDENCE BASED PRACTICE” Computerized decision models that assimilate and summarize relevant research evidence linking it through the electronic medical record to a patient’s situation may be the ultimate way to improve clinical care. Though this technique would be ideal, many practices
continued
don’t have access to computerized decision models. More readily available, however are many resources that have already critically evaluated research and have compiled a summary of the critical studies into single documents. Examples of
assimilated and critically evaluated research include clinical practice guidelines, several of which have been developed by SVN members and can be accessed on the SVN website. There are other examples of pre-appraised evidence listed in Table 2 by Vincent, et al (2015).
the patient and have meaningful conversations with the patient and other healthcare professionals. Though many practitioners may have busy home and practice schedules, mastering the plethora
of evidence in the clinical literature can be achieved through the use of internet resources and preappraised clinical evidence to implement and improve clinical practice.
Table 2 (Vincent, et al 2015)
The goal of evidence based practice is quality improvement ensuring implementation of best practices. Many EBP authors stress the importance of individualizing the evidence to
References: 1. S ackett, D, Straus, S, Richardson W, et al Evidence Based Medicine: How to Practice and Teach. EBM 2nd ed, Edinburgh, Scotland: Churchill Livingstone, 2005 2. Straus, S. Evidence-Based Medicine: How to Practice and Teach. EBM. New York, NY. Churchill Livingstone, 2005. 3. M elnyk, B, Fineout-Overbolt, E. Evidence-Based Practice in Nursing and Healthcare. 2nd Ed. Philadelphia: PA: Lippincott Williams & Wilkins, 2011. 4. I nstitute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press: 2001. 5. V incent, D, Hastings-Tolsma, M, Gephart, S, et al. Nurse Practitioner Clinical Decision-Making and Evidence-Based Practice. The Nurse Practitioner, 2015, 40(5): 47-54.
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RESEARCH Corner Barth J, Jacob T, Daha I, et al. Psychosocial interventions for smoking cessation in patients with coronary heart disease.
O`Meara S, Martyn-St James M, Adderley UJ. Alginate dressings for venous leg ulcers.
Benetos A, Rossignol P, Cherubini A, et al. Polypharmacy in the Aging Patient: Management of Hypertension in Octogenarians.
Patnode CD, Henderson JT, Thompson JH, et al. Behavioral Counseling and Pharmacotherapy Interventions for Tobacco Cessation in Adults, Including Pregnant Women: A Review of Reviews for the U.S. Preventive Services Task Force. Ann Intern Med. 2015 Sep 22.
Cochrane Database Syst Rev. 2015 Jul 6; 7:CD006886
JAMA. 2015 Jul 14;314(2):170-180
Blyth A, Maskrey V, Notley C, et al. Effectiveness and economic evaluation of self-help educational materials for the prevention of smoking relapse: randomised controlled trial. Health Technol Assess. 2015 Jul;19(59):1-70.
Dumville JC, Land L, Evans D, et al. Negative pressure wound therapy for treating leg ulcers. Cochrane Database Syst Rev. 2015 Jul 14;7:CD011354.
Ebbert JO, Elrashidi MY, Stead LF Interventions for smokeless tobacco use cessation. Cochrane Database Syst Rev. 2015 Oct 26;10:CD004306.
Gepner Y, Golan R, Harman-Boehm I, et al. Effects of Initiating Moderate Alcohol Intake on Cardiometabolic Risk in Adults With Type 2 Diabetes: A 2-Year Randomized, Controlled Trial. Ann Intern Med. 2015 Oct 13.
McInnes E, Jammali-Blasi A, Bell-Syer SE, et al. Support surfaces for pressure ulcer prevention. Cochrane Database Syst Rev. 2015 Sep 3;9:CD001735.
Cochrane Database Syst Rev. 2015 Aug 19;8:CD010182.
Pursnani A, Massaro JM, D`Agostino RB Sr, et al. Guideline-Based Statin Eligibility, Coronary Artery Calcification, and Cardiovascular Events. JAMA. 2015 Jul 14;314(2):134-41.
Sharma M, Cornelius VR, Patel JP, et al. Efficacy and Harms of Direct Oral Anticoagulants in the Elderly for Stroke Prevention in Atrial Fibrillation and Secondary Prevention of Venous Thromboembolism: Systematic Review and Meta-Analysis. Circulation. 2015 Jul 21;132(3):194-204.
Umpierrez G, Cardona S, Pasquel F, et al. Randomized Controlled Trial of Intensive Versus Conservative Glucose Control in Patients Undergoing Coronary Artery Bypass Graft Surgery: GLUCO-CABG Trial. Diabetes Care. 2015 Jul 15.
Uthman OA, Hartley L, Rees K, et al. Multiple risk factor interventions for primary prevention of cardiovascular disease in low- and middle-income countries. Cochrane Database Syst Rev. 2015 Aug 4;8:CD011163.
Wang D, Liu B, Tao W, et al. Fibrates for secondary prevention of cardiovascular disease and stroke.
Cochrane Database Syst Rev. 2015 Oct 25;10:CD009580.
Williams B, MacDonald TM, Morant S, et al. Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drugresistant hypertension (PATHWAY-2): a randomised, double-blind, crossover trial. Lancet. 2015 Sep 18. pii: S01406736(15)00257-3.
Smyth RM, Aflaifel N, Bamigboye AA Interventions for varicose veins and leg oedema in pregnancy.
Wong GW, Laugerotte A, Wright JM. Blood pressure lowering efficacy of dual alpha and beta blockers for primary hypertension.
Cochrane Database Syst Rev. 2015 Oct 19;10:CD001066.
Cochrane Database Syst Rev. 2015 Aug 26;8:CD007449.
Stead LF, Koilpillai P, Lancaster T Additional behavioural support as an adjunct to pharmacotherapy for smoking cessation. Cochrane Database
Wu L, Norman G, Dumville JC, et al. Dressings for treating foot ulcers in people with diabetes: an overview of systematic reviews.
Syst Rev. 2015 Oct 12;10:CD009670.
Cochrane Database Syst Rev. 2015 Jul 14;7:CD010471.
Janice D. Nunnelee PhD RN Practice and Research Committee
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Continuing ED IAC RESEARCH AWARD PROGRAM: 2016 CALL FOR PROPOSALS The Intersocietal Accreditation Commission (IAC) Research Committee seeks to support innovative and meritorious research relevant to accreditation and quality improvement through its annual IAC Research Award Program. The purpose of the research award is to gain insight into the accreditation process and its value to medicine and society. For complete details about the IAC Research Award Program, including links to published abstracts and manuscripts, visit intersocietal.org/research. For 2016, the IAC Research Committee will award grants up to a maximum of $75,000 (including institutional overhead). Interested individuals are encouraged to submit proposals that advance the IAC Research Committee’s mission of “Strengthening Accreditation through Research”.
IMPORTANT DATES: · Call for Proposals ... 12/1/2015 · Letter of Intent Submission Due ... 3/1/2016 · Notification for Letter of Intent Decision ... 4/2/2016 · Proposal Submission ... 6/2/2016 · Notification of Award ... 9/2016 HOW TO APPLY: For complete submission instructions, please visit intersocietal.org/iac/research_2016.htm. For questions or a variables list, please contact Mary Beth Farrell, MS, IAC Director of Research, at 800-838-2110 or e-mail research@intersocietal.org.
MAYO CLINIC WOUND SYMPOSIUM February 18-20, 2016 Mayo Clinic Rochester, MN Mayo Clinic Wound Symposium will meet the continuing-education needs of wound care providers, from novice to expert. We will provide educational sessions and interactive workshops offering comprehensive wound management strategies (from Basics to high level). This course is for physicians, CNPs, PAs, nurses, podiatrists, physical therapists, dietitians and others who manage skin and wound care patients across the continuum of health care. Register now at: https://ce.mayo.edu/preventivemedicine/content/mayo-clinic-woundsymposium-2016
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