camsn newsletter - canadian association of medical and ... · 02/08/2018 · education corner 6...
TRANSCRIPT
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)[email protected],RN,[email protected]ôté,RN,BN,CMSN(C),MSc(Admin)[email protected],RN,[email protected],RN,BScN,CMSN(C)[email protected],RN,BN,MN,CMSN(C),[email protected]
CanadianAssociationofMedicalandSurgicalNurses
Haveyoueverthoughtaboutjoiningourteam?TheteamofCAMSNExecutivesiscurrentlyinneedofanewPresidentElect.PresidentElect:SucceedstothepresidencyuponexpirationofthePresident’sterm.ExercisesdutiesofthePresidentinthePresident’sabsence.WorksinpartnershipwiththePresident,carryingouttheworkoftheboardandhasdutiesassignedbytheboard.Pleaseforwardyourname,contactinformation,anda250-wordbioandinformationsheetonwhyyouwouldliketojointheCAMSNboardtoEstherRees,ExternalCommunicationsCoordinator([email protected])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,[email protected].
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
VisittheofficialCAMSNWebsite!
www.medsurgnurse.caJointheofficialFacebookgroup!
Search:CAMSN
NextNewsletter:- ComingoutNovember2017- MoredetailsabouttheCAMSNBiennialConference- EducationCorner&MemberQuestion
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