camsn newsletter - canadian association of medical and ... · 02/08/2018  · education corner 6...

CAMSNNewsletter

Don’twaitanylonger!!ApplyforCNACertificationinMedical-SurgicalNursingbySeptember1st

NewCNACodeofEthicsforRegisteredNurses

• Newcontentaddressingmedicalassistanceindying• UpdatedethicsmodelsincludingOberleandRaffinBouchal• Newcontentonadvocatingforqualityworkenvironmentsthatsupportthedeliveryofsafe,compassionateandethicalcare

• Updatedterminologyanddefinitionssuchasadvancedcareplanning,equity,primaryhealthcare,jobaction,medicalassistanceindying,andworkplacebullying.

• Updatedreferences

Hardcopiesofthefull2017editionoftheCodeandthepocketversionwillbeavailableforpurchaseAugust2017.Seemore,includingninee-learningmodules,at:http://www.cna-aiic.ca/en/on-the-issues/best-nursing/nursing-ethics

SPECIALPOINTSOFINTEREST:

Ø NewtoCAMSN?Seepage2Ø Seepage3forthemostup-to-dateinformationabouttheBiennialCAMSNConferenceandtheCall

forAbstractsØ ConsideringgettingyourCNACertificationinMedical-SurgicalNursing?Seepage4forsome

importantdatesØ IfyouareCNACertifiedandhavequestionsabouttherenewalprocess,seepage5Ø TheEducationCorner(EndofLifeCareandArtificialNutrition)providedbyShelleyJolly,RN,B.A.

(Hon),B.S.N.,CHPCN(C),canbefoundonpages6-7Ø Learnaboutfurthercontinuouslearningopportunitiesonpage8Ø Pages9-10includeFeaturedResearch,SepsisPrevention:APopulationHealthApproach,by4th

yearnursingstudentsfromtheUniversityofSaskatchewanØ InterestedinbecomingmoreinvolvedwithCAMSN?Seepage11

The official newsletter for the Canadian Association of Medical & Surgical Nurses

August 2017

Addyourvoicetohelpshapenationalcannabispolicy!

HealthCanadahasaskedtheCanadianNurses’Association(CNA)fornurses’

feedbackontheimpendinglegalizationofnon-medicalcannabis,asoutlinedinBillC-45,AnActRespectingCannabisandtoAmendtheControlledDrugsandSubstancesAct,theCriminalCodeand

OtherActs.YourinputwillinformCNA’sresponsetotheproposedlawandprovideadvicetoHealthCanadaonhowtopreparefor

legalization.

Pleasevisit:http://cna.fluidsurveys.com/s/legalizatio

nofcannabissurvey/langeng/tocompletethe15-minutesurveyby

August14,2017.

AsaRegisteredNurseyourinputisinvaluable.

EXECUTIVECONTACTINFORMATION:

PRESIDENTBrendaLane,RN,MN,DipAdEd,CMSN(C)brenda.lane@viu.caPASTPRESIDENTRobbynPeckford,RN,CNErobbyn.peckford@albertahealthservices.caSECRETARYCrystalCôté,RN,BN,CMSN(C),MSc(Admin)crystal.cote@mail.mcgill.caTREASURERCarolAnnConnors,RN,CNEcconnors@stfx.caCOMMUNICATIONSEstherRees,RN,BScN,CMSN(C)esther.rees@usask.ca2018CONFERENCECOORDINATORLauraNeal,RN,BN,MN,CMSN(C),CDlaura.neal@forces.gc.ca

CanadianAssociationofMedicalandSurgicalNurses

Haveyoueverthoughtaboutjoiningourteam?TheteamofCAMSNExecutivesiscurrentlyinneedofanewPresidentElect.PresidentElect:SucceedstothepresidencyuponexpirationofthePresident’sterm.ExercisesdutiesofthePresidentinthePresident’sabsence.WorksinpartnershipwiththePresident,carryingouttheworkoftheboardandhasdutiesassignedbytheboard.Pleaseforwardyourname,contactinformation,anda250-wordbioandinformationsheetonwhyyouwouldliketojointheCAMSNboardtoEstherRees,ExternalCommunicationsCoordinator(esther.rees@usask.ca)byNov.1st,2017ifyouareinterested.

CAMSNisanassociatememberoftheCanadianNurses’Association

(CNA)

DidYouKnow?IfyouareCMSNcertified,executiveboardmembershipcontributesupto25CLhourstowardsyourcontinuous

learningactivities.Getinvolvedtoday!

OurVisionTobethevoiceofmedicalandsurgicalnursesinCanadaOurMissionMedicalandsurgicalnursesprovidenursingcaretoadultsexperiencingcomplexvariationsinhealth.Theyutilizediverseclinicalknowledgeandskillstocareformultipleacutelyilladultsandtheirfamilies.Theyareleadersatorganizing,prioritizingandcoordinatingcareaswellasworkingwithinterdisciplinaryteams.Thepracticeofmedical-surgicalnursingrequiresapplicationofevidence-basedknowledgeandbestpracticestandardstoprovidequality,safeandethicalcaretoclientsacrossthecontinuumofcare.TheCAMSNnurseadvocates,supportsandpromotestheintegralroleofmedicalandsurgicalnursestothehealthcaresystem.

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CAMSNConference2018

Thankstofeedbackfromourmembers,therewillbenumerousoralpresenters,postersandtopicsincluding,butnotlimitedto:

• PathophysiologyofSepsis• Pharmacology:pain

management,sepsis,heartfailure,medicalmarijuana

• MedicalAssistanceinDying• SplenicInjuries• PelvicFractures• EKGInterpretation• PathophysiologyofWound

Healing:WoundCareComplications(Fistulas)

• LegalDocumentation• Post-opComplications• MentalHealth:Stress

Staytunedforregistrationdetails.Asfurtherconferencespecificsareconfirmed,theywillbesharedvia:

Ø CAMSN’sofficialwebsite(www.medsurgnurse.ca)

Ø CAMSN’sNewslettersØ Facebook(search:CAMSN)

TheCAMSNConferenceCommitteeispleasedtoannouncethenextBiennialConference…

Medical-SurgicalNursing:It’sGettingComplicated

June7th&8th,2018

OttawaConferenceandEventCentreOttawa,Ontario

ItisCAMSN’sdesiretocreatetwodaysfilledwithstimulatinginformationrelevanttothecomplexnatureofmedical-surgicalnursing.NotonlyisCAMSN’sgoaltofocusonthediversehealthchallengesseenonadailybasis,butalsotoprovideeducationonsomeofthenewcontroversialmattersthatarearisinginthe

medical-surgicalnursingworld.

CallforAbstractsØ Areyouanurseeducator,physician,clinicalnursemanager,oranenterostomaltherapistwithaknowledge-basedpresentationrelevanttotheworldofmedicalandsurgicalnursingthatyouwouldliketopresentattheconference?

Ø Areyouamedical-surgicalnursewithaninterestingpracticeorresearchprojectthatyouwouldliketoshareattheconferenceinposterformat?ContacttheCAMSNPresident,BrendaLane,atbrenda.lane@viu.ca.

Deadlineforabstracts:January15th,2018

Encourageyourfriendsandcolleaguestobecome

CAMSNMemberstoensurethattheyreceivethe

discountedconferencefee!

Developconnections.Makenewfriends.JoinacommunityfromacrossCanadathatsharesa

passionformedical-surgicalnursing.

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In2016,44%ofnurseswhoachievedtheirinitialcertificationhadlessthan10years

experience.

CNACertificationProgram

In May 2017, 15 people obtained their initial medical-surgical certification & 6 people

renewed by continual learning across Canada! Congratulations!

TheCanadianNurses’AssociationsharedaLiteratureReviewoutliningthepositiveimpactthatcertificationhashadonpatientoutcomes:

§MortalityRates&FailuretoRescue–Severalstudiesfoundcertifiednurseswereabletorecognizeandrespondtoadeterioratingpatientquickerthannon-certifiednursesandthatcertificationwasassociatedwithdecreasedmortalityandfailuretorescuerates(Cary,2001;Martin,Arenas-Montoya&Barnetty,2015;Kendall-Gallagher,Aiken,Sloane&Cimiotti,201)

§ InfectionControl–Lowerratesofcentrallineassociatedbloodstreaminfectionsassociatedwithhigherratesofcertifiednurses(Boyleetal,2014;William,Lopez&Lewis,2013)

§Falls–Highercertificationrateslinkedwithlowertotalpatientfalls(Boltzetal,2013;Kendall-Gallagher&Blegen(2009);Langeetal(2009)

Certificationrepresentsacommitmenttotheleadingedgeinhealth-carestandards,anditgivesnationalscopetocontinuingcompetenceinitiatives.Whenyouachievecertificationitshowsyourcommitmenttoanationalstandardofprofessionalexpertiseandanin-depthunderstandinginyourareaofnursingpractice.

FALLRegistrationisnowopen!!!June1st–Sept.1stèApplicationwindowtowriteexam&renewbyexamNov.1st-15thèCertificationexamwindow

InitialCertificationè Minimumof3,900hoursofexperienceasaRNinyourspecialtyareaoverthepast5yearsè WrittencertificationexamSeemore,includingtheapplicationprocessat:https://nurseone.ca/en/certification/get-certified

MessagefromthePresident:“Ibelievemedical-surgicalnurseshaveawealthofknowledge,skills,andexperienceworkingwithpeopleexperiencingmanydiversehealthchallenges;andthatinitselfisaspecialty.Havingworkedmycareerinmedical-surgicalnursingIwantedtobringtotheforefrontthatthisisaspecialtythatdemonstratesacommitmenttoexcellence.IwantedtobearolemodelforothernursestowritetheexambecauseIbelieveinthecertificationsopassionatelythatIparticipateintheitem-writingandcompetencydevelopment.Iencouragemedical-surgicalnursestofeelthegreatsatisfactionthatcomeswithpreparationfortheexam;theexcitementofwritingtheexam;andthethrillofsuccess!WearyourCNACertificationpinandshareyourcredentialswithpride.”BrendaLane,RN,MN,DipAdEd,CMSN(C)

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In2016,85%ofnurseswhorenewedtheircertificationhadmorethan16years

experience.

CNACertificationRenewalApplicationwindowtorenewbycontinuouslearningis

currentlyopen!CertificationRenewal

èMinimumof2,925hoursofexperienceasaRNinyourspecialtyareaduringyourcurrent5-yearcertificationtermèDemonstrateadvancedknowledgeofyourspecialtyareathrougheither:•ContinuousLearning–100hoursofcontinuouslearningactivitiesrelatedtoyournursingpracticespecialtyoveryour5-yearcertificationterm•Re-writingthecertificationexam

RenewalByContinuousLearningTheCNACertificationProgramoffersagreatdealofflexibilityregardingtheactivitiesthatyoucancounttowardsyourcontinuouslearninghours.TheCNAhasalsocreatedaneasytouseforminwhichyoucansimplyinputyouractivitiesforsubmission.Optionsforcontinuouslearningactivitiesinclude:- Academiccourses- Conferences,teleconferences,seminars,workshops- CNAcertificationexamdevelopment- CNACertificationMentorshipProgram- Independentstudy- Leadingastudygrouptoprepareforthecertificationexam- Professionalspecialtycommittee/associationmembershiporparticipation

- Presentations,lectures,posters- Preceptorship- Articles,bookchapters,researchprojectsSeemoreat:https://nurseone.ca/en/certification/renewing-your-certification

GeneralGuidelinesforContinuousLearningActivities:• Eachactivitymustrelatetoimprovingknowledgeandskillsinyournursingpracticespecialty(unfortunatelythismeansthattheprimarydutiesinyourjobdescriptiondonotcount).

• Eachactivitymustbecompletedwithinthefive-yearcertificationterm.

• Onecontinuouslearninghourequatestooneclockhour.

• Youmayonlycountcontinuouslearningactivitiesthatare30minutesorlonger.

• Youdonotneedpre-approvalfromtheCNAtocountyouractivities.

• Youmayonlycountthesamecontinuouslearningactivityonceduringthefive-yearterm,unlessit’satahigherlevel(i.e.youcanonlycount“basiclifesupport”onceoverthefiveyears,evenifyoutakeitmorethanonce–butifyoualsotake“advancedlifesupport”thenitwouldcountasasecondactivity).

• ActivitiescompletedoutsideofCanadamaybecounted.

https://nurseone.ca/en/certification/renewing-your-certification/renewal-by-continuous-learning

Ifyouareacertifiednursewhoisduetorenew,butyouareunabletomeettherenewalrequirementsduetopersonalorprofessionalreasons,youcanapplyforinactivestatus.Thisgivesyouathree-yearwindowinwhichtopursueyourcertificationrenewal.

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EducationCorner

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PalliativeCare,asdefinedbytheCanadianpeer-reviewedreferencedresourceThePalliumPalliativePocketbook,is“aphilosophyofcarethataimstorelievesufferingandimprovethequalityoflivinganddyinginthosepatientsdiagnosedwithprogressiveincurableillness,”(Pereira,1-1).Thisincludesaddressingthephysical,psychological,socialandspiritualneedsofboththepatientandtheirfamily.“Itinvolvesoptimizinglivingasfullyaspossibleinthetimeremainingwhilepreparingfordying,”(Pereira,1-1).Asthisauthorexplains,PalliativeCareisnotanexclusiveentitybutanapproachthatcancomplementtreatmentusedtocontroldiseasesuchaschemotherapy,surgery,parentalnutritionandtubefeeds.Thisarticlewillidentifytheareasofconcernoverparentalnutritionandtubefeeds,examiningqualityoflifeforthepatientaswellasthebenefitsandburdensofthistreatmentduringthelaststagesoftheirillness.ThequestionsthatourconsultationteamattheRoyalUniversityHospitaloftenaskswhenreviewingapatientandtheirfamilyunitare:

1. Whatpotentialbenefitsandburdensareknowntothepresenttreatmentplan?2. Areanyoftheburdensofthetreatmentleadingtodiscomfortordistresstothepatient?3. Howdoesthepresenttreatmentplanaffectqualityoflife?4. Areweabletorecommend/modifytheplantomeetthepatient’sandfamily’sphysical,psychological,social

andspiritualneeds?Anumberofourconsultationsinvolveindividualsdiagnosedinthelatestagesofcancerandoftenthefirst

symptomthatthesepatientsexperienceisweightloss.Thisweightlossis“chronic,progressiveandinvoluntary,”(Bozzetti,p.445).Thisconditioniscalledcachexiaandisalsopresentinlatestagecongestiveheartfailureaswellasrenalfailure.Itisaccompaniedby“anorexia(lossofappetite),earlysatiety,fatigueorweakness,chronicnausea,decreasedperformancestatus,andpsychologicaldistressfromchangesinbodyimage,”(Macdonald,p.76).Cachexiaistheresultofnumerousmetabolicderangementsandisdefinedbyanegativeproteinandenergybalanceresultinginthelossofskeletalmusclemass.

Cachexiaassociatedwithlatestagecancerorothernon-malignantdiseasesCANNOTbefullyreversedby

conventionalnutritionalsupport.Itisoftenuncleartotheclinicianastothetimelinetostopnutritionalsupportintheterminallyillpatientsandtheuseoftubefeedsorparentalnutritioninthesepatientshaslongbeenanareaofcontroversyforourpopulation.Attheveryendstagesoflifehowever,theuseofnutritionalinterventionsmaynolongersupportthetreatmentgoalofprovidingenergyandweightgain.Atthispoint,theriskisthattheinterventionofnutritionalsupportmayweighheavilyonthesideofburden,contributingtothepatient’ssufferingduetoincreasednausea,vomiting,edema,pulmonarycongestionand/oraspiration.

Howdoweprovideasmoothtransitionforthosepatientswhereparentalnutritionortubefeedshavegonefrombenefittopotentialburden?

Firstly,asPatriciaFuhrmanstates,“thedifficultyliesinthepatient’sdesires.Conversationsaboutend-of-lifeissuesshouldbeinitiatedearlyinthediagnosticandtreatmentstagesratherthanwaitinguntilthedyingprocesshasbegun,”(p.70).Specialcircumstancessuchasthewishtobepresentforabirthoranniversarymustbeconsiderediflifecanatallbeextendedusingparentalnutrition.Thepatientandfamilyrequireclearcommunicationbothaboutrealisticgoalsofcareandthebody’sresponsetothedyingprocess.Aswell,Fuhrmanindicatesthatanadvancedcaredirectiveshouldbefilledoutandreviewedoftentoensureitiscurrentandup-to-date.

ByShelleyJolly,RN,B.A.(Hon),B.S.N.,CHPCN(C)

EndofLifeCareandArtificialNutrition

EndofLifeCareandArtificialNutrition(Continued)

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Secondly,day-to-dayevaluationbystaffofthepatient’sfunctionalstatusandlabwork,includingalbumin,willindicateindirectlyiftheprocessofprovidingnutritioninthismannerremainseffective.Ifthereisevidencethatthistherapyhasbecomeineffectiveorharmful,informationagainmustbesharedbetweenthemedicalstaffandthepatientorMedicalProxy.Comfortcareshouldbeofferedinordertomaximizequalityoflifeforthepatient.Ideally,atthispointnutritionalsupportcanbewithdrawnandtheprocessofcomfortcareforendoflifemaybegin.

Familymembersoftenworrythatthepatientwillexperiencedistressonceallnutritionalsupportandfluids

arediscontinued.Inreality,mostpatientsattheendoflifedonotexperiencehungerorthirst.Infact,thelackoffoodandfluidscanleadtoamildeuphoria,asenseofwellbeingandevenanalgesiaduetoanincreasedreleaseofendogenousopiates.Parentalnutrition,tubefeedsandintravenousfluidscanmakeedema,ascites,pulmonaryandothersecretions,aswellasdyspneaworse.Discontinuationofmedicationswithanticholinergicsideeffectsandtheadministrationofgoodoralcarehasshowntorelieveanysenseofadrymouth.Ultimately,withholdinghydrationandartificialfeedingattheendoflifereducesthechancesoffluidoverloadandleadsusclosertoprovidingamorecomfortabledeath.

Wecanencouragefamiliestoparticipateinthecareofthepatientduringlastdays.Suggestionsforthe

familyinclude:Allowthepatienttoeatwhattheywantwhentheywantifthepatientisnotathighriskofaspiration.Planinteractionsthatdonotcenteraroundmeals.Read,listentomusicorwatchTVtogether.Reminisce.Massageand/orcuddle.Lastly,iftheyarecomfortable,allowthefamilytoparticipateinsomeofthephysicalcaresuchasmouthcare.

Inconclusion,discontinuationofartificialfeedingcanbeaharddecisionforpatients,familiesortheMedical

Proxytoconsider.Wemustconsiderthepatient’swishesbalancedwithareviewofwherethepatientisinthetrajectoryofthediseaseinadditiontoareviewofthebenefitsandburdensoftreatment.Nursescanfacilitatethechangeingoalsofcarebyprovidingalternativesinfamilyinteractionsthatplacelesssignificanceonfood.Dyinginanaturalstatecanbeacomfortableexperienceforthepatientandavoidstheburdensoffluidoverloadattheendoflife.

Shelley Jolly, RN, B.A. (Hon), B.S.N., CHPCN(C), is a Palliative CareNurseCoordinator for theRoyalUniversityHospitalandtheSaskatoonCityHospitalinSaskatoon,Saskatchewan.ShelleyhasbeenapartofthePalliativeCareTeaminSaskatoonfor27years,firstasanurseonthePalliativeCareUnitatSt.Paul’sHospitalandthenasaNurseCoordinatorforPalliativeServices.

References• Bozzetti,F.,Arends,J.,Lundholm,K.,Micklewright,A.,Zurcher,G.&Muscaritoli,M.,(2009).ESPENGuidelinesonParentalNutrition:Non-surgicaloncology.ClinicalNutrition,(28),445-454.

• Druml,C.etal.,(2016).ESPENguidelineonethicalaspectsofarticlenutritionandhydration.ClinicalNutrition,http://dx.doi.org/10.1016/j.clnu.2016.02.006.

• Emmanuel,L.,Ferris,F.D.,VonGunten,C.F.&VonRoenn,J.H.,(2010).Weightloss.End-of-LifeCareintheSettingofCancer:NutritionandHydration.RetrievedMay18,2010,fromhttp://cme.medscape.com/viewarticle/718781-2

• Emmanuel,L.,Ferris,F.D.,VonGunten,C.F.&VonRoenn,J.H.(2010).Artificalhydration.End-of-LifeCareintheSettingofCancer:NutritionandHydration.RetrievedMay18,2010,fromhttp;//cme.medscape.com/viewarticle/718781-3

• Emmanuel,L.,Ferris,F.D.,VonGunten,C.F.&VonRoenn,J.H.(2010).Helpingfamilyandprofessionalswiththeirneedtogivecare.End-of-LifeCareintheSettingofCancer:NutritionandHydration.RetrievedMay18,2010,fromhttp://cme.medscape.com/viewarticle/718781-4

• Fuhrman,M.P.(2008).NutritionSupportattheEndofLife:ACriticalDecision.Today’sDietitian,10(9),68-73.• Pereira,J.L.,Associates.Thepalliumpalliativepocketbook:apeer-reviewedreferencedresource.1stCdned.Edmonton,Canada:ThePalliumProject;2008.

• Stasser,F.,(2008).Diagnosticcriteriaofcachexiaandtheirassessmentdecreasedmusclestrengthandfatigue.CurrentOpinioninClinicalNutritionandMetabolicCare,(11),417-421.

• Walker,P.&Bruera,E.(2005).Anorexia-cachexiasyndrome.InN.MacDonald,D.Oneschuk,N.Hagen&D.Doyle(Eds.).PalliativeMedicine-Acasebasedmanual,76-87.Oxford,NewYork:OxfordUniversityPress.

EducationCornerContinuousLearning

Opportunities

CanadianFederationofMental

HealthNursesNov.1-3,2017NiagaraFalls,ONwww.cfmhn.ca

CanadianCardiovascularCongress

October21-24,2017Vancouver,BCwww.cccn.ca

37thNationalCAETConference

TurnKnowledgeintoAction:EducationinSpecializedWound,Ostomy&ContinenceCare

May3-6,2018Victoria,BCwww.caet.ca

LegalRisksforNewGradsThursday,September14,2017

11:00:00AMCDT-12:00:00PMCDTCNPSWebinarwww.cnps.ca

“LEADERSHIPandLEARNINGareindispensibletoeachother.”

–JohnF.Kennedy

Deadlinetosubmitabstracts:September1st,2017

www.elsevier.com/netnep-conference

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FeaturedResearch

SepsisPrevention:APopulationHealth

Approach

Background:DakotaSander,DanielleRobertsonandNicoleBoutinwerepartofagroupoffourthyearnursingstudentsfromtheUniversityofSaskatchewancompletingacommunityhealthnursingplacementatParkridgeRehabilitationCentre(PRC),arehabilitationandlongtermcarefacility.PRChasbeenexperiencinganincreaseinsepsisamongsttheirresidentpopulation,resultingintherequirementofhospitalizationfortreatment.TheSaskatchewanMinistryofHealthchallengedPRCtofindwaystodecreasetheprevalenceofsepsisintheirfacility.Duetohealthcarebudgetconstraints,thisfacilityreachedouttotheclinicalgroupoffourthyearnursingstudentstominimizetheeducationalgapamongsttheirmultidisciplinaryteam.ThesethreenursingstudentsnotonlyworkedwiththefrontlinecareprovidersatPRC,buttheyalsoexpandedtheirtargetaudiencetoincludecareprovidersatotherlong-termcarefacilitiesthroughouttheSaskatoonHealthRegion.Thegoaloftheirresearchprojectandpresentationwastohelpenhancethepracticeandknowledgeofthosecaringforvulnerableresidents,specificallyrelatedtothepreventionandearlyrecognitionofsepsis.Throughtheirwork,theyarehopingtoultimatelydecreasetheprevalenceofsepsisamongsttheirtargetpopulation.

Fact:30%ofpeoplewhodevelopsepsiswillnotsurviveandofthosewhodosurvive30%willdiewithinoneyearof

developingsepsis.Inthespanoffourweeks,theyreachedover260frontlinecareproviders,andcreatededucationalbindersforthefutureuseofthefacilities.

HowthePopulationHealthPromotionModelaidedinthedevelopmentofthisproject:ThePopulationHealthPromotionModelwasutilizedinthedevelopmentandimplementationoftheSepsisPreventionProject.Thismodelexplainstherelationshipbetweenpopulationhealthandhealthpromotion.ThePopulationHealthPromotionModelencompassesthreeaspects,the"who,what,andhow,”allofwhichweretakenintoaccountinthedevelopmentoftheSepsisPreventionProject.WHO–Thisprojectaddressedthepopulationatthecommunitylevel,concentratingonParkridgeRehabilitationCentre(PRC),arehabilitationandlongtermcarefacility,aswellasotherlong-termcarecommunitieswithintheSaskatoonHealthRegion.WHAT–TheSocialDeterminantsofHealththatwerefocusedonincludededucation,physicalenvironments,andhealthservices.TheSepsisPreventionProjectaimedatalteringtheseSocialDeterminantsofHealthbyeducatingfrontlinecareprovidersaboutsepsispreventionstrategiessuchasinfectioncontrolandcleantechniqueaswellasearlyidentificationofsepsissothatpromptdiagnosisandinterventionmayoccur.HOW–Thegoalofthisprojectwastostrengthencommunityactionanddeveloppersonalskills.Consideringthatthe“base”ofthePopulationHealthPromotionModelreferstoevidencebaseddecisionmaking,assumptionsandvalues,theSepsisPreventionProjectplacedanemphasisontheimportanceofcollectingaccurate,evidencebasedinformationregardingsepsisasamedicalconditionaswellassepsiswithinlong-termcaresettings.Anumberofreliablesourceswereused,includingpeer-reviewedjournals,interviewswithICUintensivistsaswellasbothleadersandmembersofSepsisInitiativesinvariousacutecaresettings.

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WhatisSepsis?Ø Sepsisisaseriousmedicalconditionresultingfromasystemic,overwhelmingresponsetoaninfection.Theimmune

systemsetsoffaresponsethatinvolveswidespreadinflammation,swellingandbloodclotting.Ø Sepsisislifethreatening!Ø Itcanleadtosepticshock,multipleorgandysfunctionsyndrome(MODS)anddeath,especiallyifitisnotrecognizedearly

andtreatedpromptly.

Barriersinlong-termcareenvironments:Ø Physiciansarenotalwaysonsiteandtheysee

patientsinfrequentlyØ Quickprescribingofantibioticsandtransferringto

acutecareisdifficultØ Moredependentonthecommunicationbetween

theRNsandthedifferentlevelsofcareprovidersregardingconditionchangesoftheresidents

Ø Lackoflaboratorycapabilitiesforappropriateandtimelydiagnostictests

Fact:UrinaryTractInfectionsmakeup40%ofnosocomialinfections

andcanleadtourosepsis.

SepsisPrevention:APopulationHealthApproach(Continued)

Preventioniskeyindecreasingtheprevalenceandimpactofsepsis!Ø Properhandhygiene&aseptictechniqueØ UseofpersonalprotectiveequipmentØ ChangingglovesbetweendifferentproceduresØ Personalhygieneincluding

o Oralcareinthemorning&atnight(especiallyimportantatbedtime)

o PerinealcareØ CatheterCare

o Keepingcatheterbagbelowlevelofbladdero Maintainacloseddrainagesystem

Ø VentilatorCareo Maintainheadofbedat20-45degreeso Suctionusingaseptictechniqueo Providecleantracheostomycarewithouttouching

innercannulaØ Preventing&TreatingPressureUlcers

o Turning&repositioningo Reduceshear,friction&moisture

RecognizingSepsis:Ø AlteredmentalstatusØ Temperature>38degreesor<36degreesCelsius

(ordeviationfrombaseline)Ø Heartrategreaterthan90beatsperminuteØ WBCgreaterthan12orlessthan4Ø Respiratoryrategreaterthan20perminuteØ Watchforsignsofnewedema

References:-Angellini,J.(2016).Financialimplicationsofsepsisprevention,earlyidentification,andtreatment.CriticalCareNursingQuarterly,39(1),51-57.-Bergen,T.(2017,January25th).Personalinterview–SaskatoonHealthRegionCriticalCareRN,ClinicalInstructorUniversityofSaskatchewan.-James,M.(2017,January25th).Personalinterview–SaskatoonHealthRegionSepsisChair,HeadIntensivist-Rees,E.(2017,February1st).Personalinterview–SaskatoonHealthRegionSurgicalRN,ClinicalInstructorUniversityofSaskatchewan.-Smith,P.W.,Bennett,G.,Bradley,S.,Drinka,P.,Lautenbach,E.,Marx,J…Stevenson,K.(2008).SHEA/APICguideline:infectionpreventionandcontrolinthelong-termcarefacility.AmericanJournalforInfectionControl,36(7),504-535.

Authors:DakotaSander,DanielleRobertson&NicoleBoutin–4thYearNursingStudents,CollegeofNursing,UniversityofSaskatchewan,Saskatoon,SK.

Signsandsymptomstomonitorduringmorning/bedtimecare:Ø ChangesinmentalstatusØ Changesinurinecolour/odorØ UsingcleantechniquewhenchangingcatheterbagsØ ProperhandhygieneØ ProperperinealcareØ PersonalProtectiveEquipment–preventingcross

contamination

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WaystobecomemoreinvolvedwithCAMSN…

EducationCornerAnEducationCornerhasbeenaddedtotheCanadianAssociationofMedicalandSurgicalNurses’official

website,www.medsurgnurse.ca,aswellasthequarterlynewsletters.

CAMSN’sgoalistoprovideeducationalpiecesthatbestservetheinterestandlearningneedsofmedical-surgicalnursesacrossCanada.

v DoyouhaveanideaforourEducationCorner?Isthereamedical-surgicaltopicyouwouldliketoknowmoreabout?

v Areyouinvolvedinnursingeducation?Wouldyouliketocontributeaneducationalpiece?Haveyoudonearesearchstudyrelevanttomedical-surgicalnursing?

v AreyouwritingtheMedical-SurgicalCertificationExamandthere’sanareaofnursingincludedinthecompetenciesthatyou’dliketoknowmoreabout?Telluswhatitis!Wecancreateaneducationalpiecetosupportyouinyourexampreparation.

Visit:https://medsurgnurse.ca/education-corner/foraccesstoallofthepreviouspiecesincludedintheEducationalCorner.

FeatureMember

TheCanadianAssociationofMedicalandSurgicalNurseswouldliketofeature

innovativeCAMSNmemberswhoaremakingadifferenceinmedical-surgicalnursing.

IfyouwouldliketobefeaturedinaCAMSNnewsletterand/oronthewebsite,sendusyourworkinitiative(500-750words).

Ifyouwouldliketonominatesomeonetobefeatured,letusknowandwecancontactthem!

ContactUs!

Doyouhaveanideaforournewsletter?DoyouhaveaquestionforCAMSN,oran

upcomingworkshopyouwouldlikesharedwithfellowmembers?

Wewouldloveyourfeedbackandweencourageourmembersto

sharetheirexpertise!

PleasecontactEstherRees,ExternalCommunications

Coordinatoratesther.rees@usask.ca.

VisittheofficialCAMSNWebsite!

www.medsurgnurse.caJointheofficialFacebookgroup!

Search:CAMSN

NextNewsletter:- ComingoutNovember2017- MoredetailsabouttheCAMSNBiennialConference- EducationCorner&MemberQuestion

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