[ARNPCare] July 2014

[ARNP Care Monthly NewsLetter]

Advanced Registered Nurse Practitioner Care
Official Newsletter of ARNPs United of Washington State
Volume 25(5) July 2014
Articles
Jobs
CE
Service Ads
Meetings
Photo of the Month
Ad & Publication Information
Tramadol Switches to Schedule IV on Aug 18, 2014
The Drug Enforcement Administration (DEA) recently issued a final rule to place the drug Tramadol into Schedule IV of the Federal Controlled Substances Act. All pharmacies and dispensers must follow the federal regulations beginning August 18, 2014. Because this drug isn’t included in the Washington State rules, it isn’t required to be reported to the PMP yet. 

The DEA rule becomes effective on August 18, 2014. While it may not be scheduled in Washington State until the end of the year, you should ensure all federal requirements are followed regarding Tramadol becoming a Schedule IV drug.


Home Health Care Planning Improvement Act of 2013

Rep. DelBene has agreed to become a co-sponsor of the Home Health Care Planning Improvement Act of 2013 (H.R. 2504/ S. 1332)! While this is great news we need additional support from our other members of congress. Please communicate with your Members of Congress and voice your support for this important bill. Use this link to contact your Members of Congress to urge them to co-sponsor the Home Health Care Planning Improvement Act of 2013 (H.R. 2504/ S. 1332).

These Members of Congress have co-sponsored the bill:
1st District — Rep. Suzan DelBene [D]
10th District — Rep. Denny Heck [D]
4th District — Rep. Doc Hastings [R]

These Members of Congress have not yet co-sponsored the bill:
Sen. Patty Murray [D]
Sen. Maria Cantwell [D]
2nd District — Rep. Rick Larsen [D]
3rd District — Rep. Jaime Herrera Beutler [R]
5th District — Rep. Cathy McMorris Rodgers [R]
6th District — Rep. Derek Kilmer [D]
7th District — Rep. Jim McDermott [D]
8th District — Rep. David Reichert [R]
9th District — Rep. Adam Smith [D]


Seeking Board of Directors Members for ARNPs United of WA State

We need your help. This October, at the Primary Care Conference, we will hold an election for a new board of directors. 6 BOD positions are open; the old board members have the option for running, as does every AUWS member. The bylaws call for 12 members on the BOD, with 4 of them serving as Board officers – President, Vice-President, Treasurer, and Secretary. The Chair of the Legislative Committee is automatically on the BOD as well (Legislative Committee members meet separately.) Board officers are determined by the board at their January retreat. The term of the service for board members is 2 years. The time involvement is approximately 5-10 hours per month, as we have board meetings every 2 months (which can be attended via conference call) and subcommittee work based on your area of interest.

If you are interested, know someone you would like to nominate, or have any questions about this opportunity to serve Washington’s ARNPs and their clients, please feel free to email tracy at npcentral.net. 
Intimate Partner Violence Study Request for Participants

Intimate partner violence (IPV) is a common illness of both women and men. IPV is pushing, slapping, hitting, punching, yelling and verbal put downs, threats, sexual abuse, withholding food, freedom, money, or other necessities, and stalking. The people involved must have a current or former dating, co-living, or marriage relationship. One in three women and one in four men claim that they have suffered from IPV. The results of IPV for the victims include immediate and ongoing illnesses and injuries that can be very serious. IPV is the leading cause of death in pregnant women. IPV results in mental illness, including post-traumatic stress disorder, and depression. Victims are more likely to abuse alcohol. In fact, many who want to kill themselves, or who cut or injure themselves, have histories of IPV. Chronic health problems from IPV include arthritis, heart disease, migraines, pain syndromes, digestive tract disorders, and sexually transmitted diseases. IPV is one of the leading causes of homelessness among women and children.

When victims seek medical care for IPV-related illness or injury, IPV is not recognized as the cause of their need for care. Victims can go for years before they speak about their abuse even if they have been under medical care for their injuries; tragically, they are often killed before the extent of the danger is recognized. Victims usually do not seek medical care unless their injuries are severe. It is often up to the person who sees victims to figure out how the injuries happened. Nurses are often the first medical professionals that victims meet when they seek care.  Victims often state that if they trust a nurse or doctor they may disclose the abuse. Nurses with advanced degrees such as nurse practitioners (APNs) provide basic medical care to victims. This trend will increase with increasing numbers of nurse practitioners in the U.S. Therefore, APNs must be skilled at helping IPV victims.  

I am a fellow advanced practice nurse and I am conducting a research study on the professional, workplace and personal factors that may affect an advanced practice nurse (APN) who cares for patients who may be experiencing intimate partner violence (IPV). An Institutional Review Board responsible for human subject’s research at The University of Arizona reviewed this research project and found it to be acceptable, according to applicable state and federal regulations and University policies designed to protect the rights and welfare of participants in research.
I would very much appreciate your voluntary participation in my survey to obtain some information about your experiences and background on this important health topic.  This survey, while not offering immediate benefits to you, may help you to clarify your role in IPV treatment as well as help to inform both educational and practice institutions about what APNs need to more effectively treat victims. You will be given a chance to participate in a drawing for one of three $100 gift cards to Amazon if that is legal in your state or territory of residence. Participation in the research study is not required to enter the raffle. Entries are limited to one entry per person subjects under age 18 must have written consent from a parent or lawful guardian, and participation in the raffle is void where prohibited by law.

Since this is a survey of APNs, we ask that you complete this survey only if you are a currently practicing APN or midwife with at least a master’s degree.

https://uarizona.co1.qualtrics.com/SE/?SID=SV_4ILGtYKFuWShVMp

2014 AANP Salute to the States


Tammy Davis receives the AANP State NP Award from 
Nancy Lawton, WA AANP State Rep and Ken Miller, AANP President
Transforming Adolescent Risk Assessment to Eliminate Gaps-in-Care
 
Rapid Assessment for Adolescent Preventive Services (RAAPS) is a standardized, validated risk screening designed especially for the needs of adolescents. The short, 21-item RAAPS survey can be administered within an integrated, cloud-based delivery system or as a stand-alone paper survey. Jennifer Salerno, DNP, CPNP, FAANP, shares the evolution of the RAAPS integrated, cloud-based platform – which was based on her work at the University of Michigan.

Despite the widespread focus on prevention in healthcare today, one area of preventive care remains overlooked.  And the impact of this gap-in-care may surprise you… according to the CDC, a full 75% of mortality in adolescents is a direct result of preventable risk behaviors1.  Organizations such as the AMA, AAP and American Academy of Family Physicians all recommend annual screening of adolescent risk behaviors. But despite these evidence-based recommendations and devastating statistics, teens have been overlooked in our standards of care to date.  And a survey of the American Academy of Pediatric Fellows revealed that fewer than 25% of providers regularly screen teens for risk behaviors2. 
 
RAAPS was developed to overcome some of the most common barriers to adolescent risk screening: time, provider skill and confidence across multiple risk topics, lack of risk-reduction counseling tools - and teen engagement.  As a nurse practitioner working with teens, I understood the need to screen for risky behaviors, but struggled to ask all the “right” questions in a traditional interview style – and had trouble incorporating long health-risk surveys in the appointment time available.
 
I needed a tool that would be more efficient yet just as effective to identify risks negatively impacting adolescent health. I worked with a team of expert clinicians and researchers at the University of Michigan – and we had strong teen involvement every step of the way.  Our collaboration with teens helped to make the RAAPS interface more engaging, and helps teens feel more comfortable answering sensitive questions.  It also led to some innovative features that increase both engagement and effectiveness in the teen population, for example:
·   RAAPS cloud-based survey can be completed in the waiting room in just 5-7 minutes on any device with internet access – like an iPad, or droid tablet (some sites are even using Kindles now!)
·   Audio (recorded with a teen voice) and multi-lingual options are available to help improve health literacy – which is especially important among underserved populations
 
We also added innovative features for healthcare practitioners who use RAAPS to identify risks and provide behavior change counseling:
·    Because the adolescent completes the survey in the waiting room or exam room while waiting to be seen, the impact on workflow is minimal – AND the practitioner can access their completed survey and prepare for risk discussions before they walk in the exam room
·    Evidence-based talking points individualized for each teen’s survey responses are accessible to practitioners to use as a clinical support tool in their discussions with teens across all risk topics 
·    And with the secure system, practitioners can electronically document the risk reduction counseling they provide and receive risk reports on their patient population that are relevant to improving care and tracking outcomes of reduced risk (especially important in our current performance-based culture!)
 
We recently reviewed RAAPS national data of nearly 40,000 surveys completed from 2011-2013, and the results showed significant improvements in some of the “traditional” adolescent risk concerns of tobacco and marijuana use. It also showed that practitioners are making a difference in unsafe driving behaviors including a reduction in texting and driving.  But it’s not all good news, there was a startling increase in teens reporting disordered eating (70% increase!) and carrying a weapon for protection (23% increase).  To learn more download the infographic.
 
With 75% of all deaths in the teen population attributable to preventable risk behaviors – and over 75% of providers failing to standardly screen adolescents for these behaviors, I believe this is an issue that cannot be ignored. I hope you will join me in a call to action to ensure the teens in your population are screened for at-risk behaviors. You have the opportunity to make a real difference!
 
To learn more about the RAAPS innovative approach for engaging teens and improving the effectiveness of risk reduction counseling visit www.RAAPS.org 
 
1 Centers for Disease Control and Prevention [CDC]. (2012).  The youth risk behavior surveillance system - United States 2011. MMWR  61(4).Retrieved from http://www.cdc.gov/mmwr/pdf/ss/ss6104.pdf .
2 American Academy of Pediatrics (AAP) Periodic Survey of Fellows #71, conducted in 2008
New Resource Guide: Legal Aspects of Children’s Health Services

The Northwest Center for Public Health Practice has released a new resource guide, Legal Aspects of Children’s Health Services  to assist professionals working directly with children and their families, or those serving as a resource for referrals or consultations.

Developed in partnership with the Network for Public Health Law Southeastern Region Office, this guide is one in a series of courses and resources funded by the Robert Wood Johnson Foundation to support public health law training.

The guide, which is broken into five parts, provides information about laws and services related to children and adolescents. Topics include: children’s health in the US, health insurance coverage, screening, immunizations, and children with disabilities.

Participants can view or download topic sections individually or as an entire guide. Learn more.
**
 
As a health care professional, you value good judgment, scientific integrity, and a high standard of care. Unfortunately, false or misleading promotion can create a public health risk by misleading you or your patients about the efficacy, risks, and benefits of prescription drugs. As a concerned health care provider, there is an avenue for you to help improve the quality of prescription drug information available to you, your colleagues, and your patients.
 
We’re writing to let you know about a free online CME/CE course aimed at raising awareness of false or misleading prescription drug promotion and its impact on the quality of information available to the public. The Food and Drug Administration’s Bad Ad program recently partnered with Medscape to offer this free course for physicians, pharmacists, nurses, nurse practitioners, and physician assistants. The CME/CE course symbolizes a continued partnership between the FDA and HCPs to protect the public health by ensuring that prescription drug promotion is truthful and not misleading. We hope you’ll find this free, hour-long course to be interesting,  educational, and beneficial, and that you’ll share the link with colleagues so that they may also benefit: http://www.fda.gov/badad 
 
More information about the Bad Ad program is available on our Web site. You can contact the Bad Ad program directly by emailing badad at fda.hhs.gov or calling (855) RX-BadAd.
AUWS BOD Meeting Minutes Summary of 8-Jul-2014

Financial and Membership Update:
There were 26 new members in May, and there are now a total of 58 members. This may be a response to membership renewal mailing sent and/or ability to now renew membership online. A second renewal reminder mailing will be sent.

Legislative update:
CNS rule writing CR101 signed on 4/23/2014. Official rule writing rule-writing workshops held in May. Rules to be presented to nursing commission on 7/11/14 followed by another revision. AUWS stance: Those called ARNPs must meet current criteria for ARNPs. AUWS does not agree with portfolio option to transition from CNS to ARNP.  Maximum of three years grace period to transition from CNS to AUWS.
Nancy Lawton had lunch with the governor and discussed parity issues and suicide prevention continuing education requirements

AUWS website:
The website continues to be revised. Members can now renew online.

Upcoming Elections and Nominations:
Six board members have terms expiring.  It is uncertain at this time which members will be renewing their terms. Call to submit names for potential board members. Annual meeting will be held on Thursday, October 9 at 12:25 at WA state convention center. 


Job Opportunities

Gastroenterology ARNP Position - Seattle, WA
Pacific Medical Centers (PacMed) is a private, not‐for‐profit, multi‐specialty healthcare network in the Puget Sound region. Our 9 convenient locations are staffed by a comprehensive network of more than 160 primary and specialty care professionals who are committed to providing the highest-quality medical care and to developing a compassionate, long-term relationship with each patient we serve. Our personalized, patient-centric system empowers and provides patients with freedom and choices to partner in their care. We provide immediate access to cutting-edge technology, first-class facilities and board-certified specialists, many of whom have been listed as among “Seattle’s Best Doctors.”  We invite you to join our company!

We are seeking an Advanced Registered Nurse Practitioner with three or more years clinical GI practice experience (preferred) to work with our gastroenterology team of four GI physicians and one other ARNP. Specific responsibilities include: initial and follow-up consultations, patient and family education, and coordination of treatment with physicians as needed. Based at our First Hill Clinic with some travel required, the  position will start  in January 2015. The successful candidate will have a proven track record of growth, learning, and self-development. Requirements include Washington  ARNP license, and DEA certificate.

Highlights: • On-site endoscopy suite • Diagnostic imaging center • On-site lab and pharmacy • Internal referral base •   Financially sound and growing organization • Supportive environment • EPIC EMR 

Seattle presents breathtaking scenery, performing arts, exquisite dining, world-class shopping, quality schools and unique attractions. Take advantage of outdoor recreation over four seasons with no state income tax, and you have something to please everyone in your family. PMC’s competitive salary and benefits package will support and enhance a lifelong career. 

For more information, please contact: Deborah Atkins, Medical Staff Recruiter; Toll Free:   888.901.1122; Email: DeborahA at pacmed.org 
NPs Wanted – Olympia and Mt. Vernon

Growing ARNP practice is seeking additional motivated nurse practitioners for an integrative medical practice in Mt Vernon and Olympia Washington. Ability to learn and use critical thinking is more important than past experience. Emphasis in on wellness based medicine. Position is currently 2 days a week at each location and can stay part time or grow into full time at the provider discretion. There is even the option of a beautiful Big Lake Cabin right on the waters edge as part of the compensation package (furnished or unfurnished) if you are relocating. Competitive pay and relaxed work environment make for the perfect place to practice.  Email cv to washwellnesscenter at gmail.com. 

CE Opportunities
Twenty First Annual NWone Fall Conference & Meeting of the Membership
The Affordable Care Act as Opportunity: Advancing the Contribution of Nursing to the Public’s Health
October 1-3, 2014
Seattle Airport Marriott, SeaTac, Washington

Want to learn more about the impact and implications of the Affordable Care Act on nursing practice? Then this is the conference for you! NWone’s fall conference has a line-up of nationally recognized speakers who are experts in the areas of advanced practice nursing, health care workforce, nursing productivity and financial issues associated with labor costs, health care law and issues related to restraint of trade as we attempt to ensure that all nurses work to the top of their license. Speaker line-up includes: 

Peter Buerhaus, PhD, RN, FAAN, a nationally recognized expert in the area of health care workforce and is a prolific researcher in the areas of both nurse staffing and the outcomes of Advance Practice Nursing.
Jack Needleman, PhD, FAAN, is the Professor of Health Services in the Department of Health Services at the UCLA School of Public Health.  Jack is known for his research in the area of nurse staffing and the impact of nurse staffing on patient mortality.  
Joanne Spetz, PhD, is an expert in labor economics, and has published on the impact of nursing ratios in the state of California.  
Tara Isa Koslov, JD, is the Director of the Office of Policy Planning at the Federal Trade Commission and has worked through the FTC to promote fair and equitable competition within the healthcare industry.
Barbara Safriet, JD, is currently a Visiting Professor of Law for the Lewis & Clark Law School after serving as the Associate Dean for Academic Affairs at the Yale Law School.  Her area of expertise is in Health Law & Policy and the Regulation of Health Care Providers.  
David DeLong, PhD, is a Research Fellow at the MIT Age Lab.  His research is focused on the organizational and personal challenges imposed by an aging workforce and is the author of Lost Knowledge: Confronting the Threat of an Aging Workforce. 
Deborah Gardner, PhD, RN, is the Immediate Past Executive Director of the Hawaii State Center for Nursing and a member of the Editorial Board of Nursing Economic$. 
Darcy Jaffe, RN, MSN, is the CNO and VP for Patient Care Services at Harborview Medical Center, a certified Advanced Practice Nurse and a local expert for mental health care and advocacy.
Eileen O’Grady, PhD, RN, is a certified adult nurse practitioner and a certified wellness coach. She is passionate about working with people interested in living a life that they truly want.  
Additionally we will be presenting NWone’s launch of the CAP2 database into the northwest.  CAP2 was developed by the Center for Advancing Provider Practices and is a new national database that examines organizational credentialing practices for both Advance Practice Nurses and PAs while also providing a toolkit with APN job descriptions, orientation tools, and credentialing process tools.  We hope that you will be joining us for this great educational opportunity and also choose to attend our annual Legislative Boot Camp which is offered as a preconference.  To view the full brochure and to register visit www.NWone.org or contact SarahS at wsha.org. 
Pacific Northwest National Advanced Practice in Primary & Acute Care
Save the date for this annual conference by UW CNE. This year it will be October 9-11, 2014. 
Service Ads
Interested in Mentoring the Next Generation of ARNPs?

Pacific Lutheran University in Tacoma, WA is looking for preceptors in the south Puget Sound area for the Family Nurse Practitioner program. Your commitment requires a minimum of 1 day a week for a semester. We need preceptors Fall (Sep to Dec), Spring (Feb to May) and Summer (May to August) semesters. If interested, please contact Dr. Lorena Guerrero at guerrelc at plu.edu or call (253) 535-7374.
*Himalaya Medical Mission
Rachel Frazin, ARNP, MSN is a family nurse practitioner working in Alaska and looking for ARNPs to join her in a medical mission to a very remote part of the Himalaya where Tibetan Buddhists live. They've received no Western health care. 

They will be trekking a week from Kathmandu to get to two villages where we will provide medical care this fall. A description of the trip can be found on her blogsite: volunteersfornepal.blogspot.com.
Meetings
Puget Sound Nurse Practitioners Association

Join us! Puget Sound Nurse Practitioners Association is a non-profit
organization supporting ARNPs in Puget Sound since 1998. We meet
every other month and offer a social hour/networking and a speaker presentation.

Annual dues are $60/$20 for students. $20 per meeting for guests. Apply for membership and find meeting information at http://PSNPA.org


West Sound Advanced Practice Association

Meets the second Thursday of the month. Meetings include networking/dinner/educational session. E-mail Fionafnp at centurytel.net for more information.

Photo of Month

Summer storms beautiful and terrifying at the same time.
photo by Bob Smithing
Ad & Publication Information
ARNP Care Ad Information

Copy deadline is the second Tuesday of the month prior to publication. Ads may be accepted later than this on a space-available basis. Position Available and Continuing Education Ads of less than 66 words are $45, of 66 to 130 words are $75, 131-180 words are $105, and greater than 181 words are $175. Position Available Ads are priced per insertion. Continuing Education Announcements are per offering for up to three (3) consecutive insertions. New Product Announcements per product for one insertion of 130 words or less are $75, more than 130 words are $175. Ad Inserts are $750 for one issue. All ads are subject to space limitations and editing. Call for detailed rate information. Mail copy to ARNP Care, 10024 SE 240th St, #230, Kent, WA 98031. Phone 253.852.9042. Fax 253.852.7725. Email care at nurse.net. 
ARNP Care Editorial Board

Editors:
   Robert T. Smithing, MSN, ARNP, FAANP
   Madeline D. Wiley, MSN, ARNP, FAANP
Contributing Editors:
   Nancy Lawton, MN, ARNP (President)
   Louise Kaplan, PhD, ARNP, FAANP (Legislative Chair)
Production Staff:
   Tracy Kiele, Managing Editor
   Sarah Abid, Production Staff
   NP Central, Publisher

Copyright 2014 NP Central 
ARNPs United of Washington State

Website: www.auws.org
Facebook: facebook.com/ARNPsUnited
Email: au at auws.org
Address: 10024 SE 240th St, #230, Kent, WA 98031
p. 253.480.1035   f. 253.852.7725

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