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Jan 28, 2008 ... Commentary by. Mary Jo Fay, RN, MSN. Lawmakesr pass funding for nursing programs. This space could be yours for only pennies per issue!
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V ol. 9 Issue 4 Vol.

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Information for Denver’s Nursing & Health Care Professionals Locally Published, Owned and Operated Each Week by Metro Publishing LLC

Children’s Hospital practices not only caring, but curing Many hospitals dedicate themselves to treating illnesses and mending injuries. But at The Children’s Hospital, our four-pillared mission includes patient care, education, research and advocacy – a comprehensive approach that provides better treatment, now and in the future. Our academic affiliation with the University of Colorado Denver School of Medicine means our doctors are not only expert clinicians, but also active researchers discovering new treatments and cures. Our physicians practice medicine at The Children’s Hospital while educating the next generation of pediatricians, family practitioners and pediatric specialists, and pioneering research in many fields. “One of the things we want to do is provide the kind of information, from research and clinical

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Ph ysicians pr actice medicine aatt T he Childr en hile Physicians practice Children en’’ s Hospital wwhile educa ting the ne xt ggener ener tricians amil actitioner educating next eneraa tion of pedia pediatricians tricians,, ffamil amilyy pr practitioner actitionerss and pediatric specialists, and pioneering research in many fields. experience, to help the physician on the front lines provide the best care,” says Stephen R. Daniels, MD, PhD, pediatrician in chief and L. Joseph Butterfield Chair of Pediatrics at The Children’s

Hospital. The Children’s Hospital and its affiliates are responsible for virtually all of the pediatric research published in the Rocky Mountain region in the past See Children’s, Page 3

ANA announces presidential endorsement The Clinton Campaign has announced the endorsement of the American Nurses Association (ANA). The ANA represents the interests of the nation’s 2.9 million registered nurses.

Popcorn

“Too many Americans must do without high quality health care, and this country deserves a president that will make health system reform a priority,” said ANA President Rebecca M. Patton, MSN, RN,

by Elizabeth Bussey Sowdal

ell, I have decided that all my present woes and worries can be attributed to one thing. Television. Specifically, all those stupid, stupid decorating shows. I am done with them. Done, I tell you. First off, I blame the current difficulties many of us have had selling our homes on the D.S. (Decorating Shows) phenom. We were lucky and our house sold quickly. But oh my goodness, you should have heard the after the open house critiques – no master suite, no deck, no bedrooms on the first floor, small bathrooms, no spa, neighbors too close, school across the street. After the first open house and the first round of comments I felt like putting notes up. "This house was built in 1937. They thought a bath and a half was fancy enough. They never heard of spa tubs." "You want a deck, build one." "The neighbors are nice. It’s okay that they’re close." "What’s the matter? Do you hate children? What else do you hate? America? God?" "The bed does not go with the house. Laughing Get off of it!" Our real estate agent with thought my note idea was . . Elizabeth . not necessary. And he said I couldn’t hang around and pretend to be a prospective buyer either. Not me and not my sister. He couldn’t stop me from parking the car in See Elizabeth , Page 2

CNOR. “Senator Clinton has shown a commitment to implementing real change in our health care system to ensure high quality, affordable and accessible care. She has also recognized the importance of educating, recruiting and retaining, RNs, and the need to improve the nurse’s work environment which includes addressing safe and appropriate staffing. America’s 2.9 million registered nurses represent the largest group of health care professionals. “We have long advocated for the critically needed reforms vital to the improvement of health care and will use our power in the voting booth to make health care a priority.” “I am honored to have the support of the American Nurses Association,” said Clinton. “We owe nurses a great debt of gratitude for the critical role they play every day in providing quality care. “As President, I will continue to support efforts to attract and retain qualified nurses, especially in rural and urban areas, and to improve working conditions. I look forward to working with America’s nurses to deliver affordable, quality health care to every American.” Clinton has a history of working for America’s nurses. In the Senate, she introduced the Nursing Education and Quality of Care Act, which would expand the number of See ANA, Page 2

Inside Environmental pollution and diabetes may be linked

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programs that address nursing faculty shortages and increase the supply of nurses in rural areas. As part of the Nurse Reinvestment Act, she helped create grants that expanded nurse Magnet hospitals. Clinton also supported increased funding for both Title VII and Title VIII, which help to address the higher education needs of nurses and nursing faculty. Finally, she has supported programs to attract nurses to the field, including efforts to improve the quality of the working environment for nurses. Clinton’s American Health Choices Plan will cover all Americans and improve health care by providing consumers new choices, lowering costs and improving quality. Under Hillary’s plan, Americans who like the insurance they have can keep it and stay with their doctor. But Americans who don’t like the coverage they have will be able to pick from the same set of plans Members of Congress choose for themselves. Under Clinton’s plan, insurance companies won’t be able to deny people

January 28, 2008 coverage for a pre-existing condition and tax credits will ensure that working families never have to pay more than a limited percentage of their income for quality health care. People who change jobs will be able to keep their health care. ANA has been making presidential endorsements since 1984. The endorsement process includes sending a questionnaire on nursing and health care issues to all of the Democratic and Republican candidates, an invitation to all of the democratic and republican candidates for a personal interview and an online survey of ANA’s membership regarding which candidate is most supportive of nursing’s agenda. The ANA is the only full-service professional organization representing the interests of the nation’s 2.9 million registered nurses through its 54 constituent member nurses associations. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.

Environmental pollution and diabetes may be linked Cambridge scientists are advocating additional research into the little understood links between environmental pollution and type 2 diabetes. In the most recent edition of the Lancet, Drs. Oliver Jones and Julian Griffin highlight the need to research the possible link between persistent organic pollutants (POPs, a group which includes many pesticides) and insulin resistance, which can lead to adult onset diabetes. In their commentary, Dr Jones and Dr. Griffin cite peer reviewed research including that of Dr D Lee, et al, which demonstrated a very strong relationship between the levels of POPs in blood, particularly organochlorine compounds, and the risk of type 2 diabetes. “Of course correlation does not automatically imply causation,” says Dr. Jones. “But if there is indeed a link, the health implications could be tremendous. At present there is very limited information. Research into adult onset diabetes currently focuses on genetics and obesity; there has been almost no consideration for the possible influence of environmental factors such as pollution.” Interestingly, in the Lee study an association between obesity and diabetes was absent in people with low concentrations of POPs in their blood. In other words, individuals were more at risk of diabetes if they were thin with high levels of POPs in their blood than if they were overweight but with low levels of POPs. Dr Jones said: “I think research should be carried out to first test the hypothesis that POPs exposure can cause diabetes, perhaps using cell or tissue cultures, so we know for sure if this can occur. Assuming POPs can have this effect, the next step would be to try and develop a method of treatment for those people who might be affected.” POPs came into prominence as effective pesticides with the introduction of DDT in the 1940s. However, many of these chemicals, including DDT, fell out of favour after they were blamed for the declining number of wild birds and other animals (brought to the public’s attention in Rachel Carson’s Silent Spring) and the possible negative human health effects. As the compounds biodegrade slowly, they continue to find their way into the food chain and ultimately into the blood streams of individuals even though many of these toxins were banned many years ago. Additionally, these compounds can persist in body fat for very long periods of time following exposure.

Denver’s Nursing Star

Elizabeth Contin ued frfrom om PPaage 1 Continued

the school parking lot across the street and critiquing the potential buyers – if he knew I was doing it, he didn’t mention it. But that phase of our life is over. The house, Our House, is sold and there are strangers living in it now. They are probably busy painting the woodwork and feeding the koi Fritos. But I don’t care. I’m over it. Completely. The next reason I hate the D.S. is because every episode they show happy, healthy, apparently well adjusted people hemming curtains, whipping up day bed covers from cloth they wove by hand and blithely and tirelessly painting room after room after room a glorious spectrum of colors. Tra-la-la! They make it look quick, easy and effortless. In the week that we have been here at the new house I have personally toted one million and three pounds of books, packed and unpacked and repacked and bagged and stored and donated. My hands are permanently gray from the newsprint which has permeated the poor pores of my paws (tee-hee). And I have painted. Exactly two rooms. I was supposed to do room number three today but I just could not bear the idea. It is not the walls that are my problem, not the thing which has nearly crippled me. It is the "popcorn ceilings." Do they ever mention that on those shows? Except to say to take it off. I decided not to take it off because I have almost more mess than I can deal with right now. If someone so

much as drops a Kleenex I will go screaming right over the edge. The first room I painted and painted and painted. There are two gallons of paint on that ceiling and a great deal of it was applied with a brush in little bitty gentle daubs, which was the only way I could figure out how to do it without losing great swaths of sticky wet popcorn. I went to work the next day and, of course, whined and whined and whined about the terrible time I had with the first ceiling. After eleven and a half hours one of my patients’ visitors said, "For heaven’s sake! Shut up! You have to paint it in one direction! Now go away!" I finished up my work days and by the time my next day off rolled around I was once again able to raise my arms above my shoulders and felt ready to tackle the next room. But tell me, have any of you tried to paint going in one direction? It’s awful. It’s not natural. It is analogous to a grizzly bear walking on it’s hind legs. In stilettos. And it doesn’t actually mean that the popcorn won’t come off. Evidently. So, today I took the day off from painting. I have another day off this weekend and maybe by then I will be ready to go on. The whole house you see, every single room, has popcorn ceilings. Miles and miles of them. Why don’t I just buy a sprayer? Because buying a sprayer, at this point, would be just like giving up. And THAT I won’t do.

Elizabeth Bussey Sowdal and Michael Sowdal have been married 14 years and have six children together. She is a practicing RN and freelance writer.

Question of the Week Did a hospital make the right decision firing a nurse who sweat excessively? According to a CBC article, a Quebec labor ministry tribunal recently backed a hospital’s decision to exclude an overweight nurse from its operating room because she sweated too much. The story stated the nurse, who worked in the OR for five months in 2003, weighed more than 300 pounds. Hospital lawyers argued her excessive sweating could pose an increased bacterial risk for patients. The nurses union grieved the decision and proposed adopting a more flexible schedule and providing special scrubs that would prevent excessive sweating. Do you think the hospital and tribunal acted accordingly? Do you think the nurse was discriminated against because of her weight? How would you feel if the same nurse accompanied you into an operating room setting? Denver’s Nursing Star would like to know your thoughts. Please email your response, along with your name, nursing credentials, city, and contact information to [email protected] or fax it to 720-283-2209.

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Denver’s Nursing Star

January 28, 2008

Children’s

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Published by Metro Publishing, L.L.C. Publisher Steven R. Eldridge [email protected] Editor Crystal Beshear [email protected] News Consultant Dr. Linda Mundorff (Rener) MPH, MSN, ND, RN, NC

W riter s Douglas Walter Sid Goldwell Sarah Sangosti James Coburn Elissa Crocker Mike Lee Lea Terry [email protected] Boar Boardd of Commentar y Martha Collar Eileen Doherty Mary Jo Fay, RN, MS Colleen Folsch Virginia Gillispie Vicki Jenkins Angela Lash, RN, CM Dr. Linda Mundorff (Rener) RN, MPH, MSN, ND Carol Shenold, RN, CIC Sherry L. Ray, CPCC Deresa Claybrook, MS, RHIT Vicki Mayfield, M.Ed., RN, LMFT Classified Ad Advv er tising Annette Deckard [email protected] John G. Smith [email protected] Ad Ser vices Mana Managg er Lisa Ngo [email protected] Accounts Coordinator Gaye Hannan, LPN [email protected] Denver's Nursing Star is published throughout the Denver metro area. With more than 10,000 weekly e-publication readers and more nearly 19,000 online each week, Denver's Nursing Star is the largest health care publication in Colorado.

Opinions expressed in columns and letters to the editor are not necessarily the opinions of employees, ownership of this newspaper or the pub lishing compan publishing companyy.

In Lo ving Memor y of Loving our brother and friend Randall (Randy) I. Eldridge

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decade, as well as several internationally recognized medical milestones including the discovery of toxic shock syndrome and development of new pediatric heart surgery techniques now used around the world. We receive more than $30 million in research funding each year from National Institutes of Health and other government agencies, as well as foundations, local philanthropists and private industry. Current research at The Children’s hospital ranges from improving treatments for diseases such as leukemia, cystic fibrosis and diabetes to developing a new artificial heart pump for kids born with only one ventricle. Our Experimental Therapeutics Program – one of only five west of the Mississippi River – expands cancer

patients’ options for access to new treatments with new combinations of approved drugs, allowing patients to access treatments at Children’s instead of having to travel to another facility. Doctors at The Children’s Hospital are also developing new therapies using umbilical cord stem cells to help regenerate damaged or defective cells,

Page 3 wide variety of childhood illnesses and congenital malformations,” Daniels said. The new Children’s Hospital, located at I-225 and East Colfax Avenue, is part of the first universityaffiliated biosciences park west of the Mississippi River, including 600,000 square feet of research space, two adult hospitals and the University of Colorado’s medical, dental, nursing and pharmacy schools. The Anschutz Medical Campus has been described as a city of its own, where worldclass research meets state-of-the-art facilities for patient care. The close proximity allows doctors to collaborate with their academic colleagues and put scientific discoveries into practice immediately improving children’s lives. “For the first time, we have all of the campus working together across all of the areas we’re interested in,” Dr. Daniels said. “You meet different people and have different interactions, and there are great conference and education facilities. People are excited about working in that environment, and I think that will be an incentive to the kinds of people we want to attract.”

“For the first time, we have all of the campus working together across all of the areas we’re interested in,” said Daniels. potentially unlocking treatments for numerous childhood diseases. Thanks to a $5 million gift from the Gates Frontiers Fund, the Charles C. Gates Regenerative Medicine and Stem Cell Biology program at the University of Colorado Denver School of Medicine will expand its research program to encompass pediatrics. To support the research, The Children’s Hospital will recruit a physician-scientist who will hold a new endowed chair, the Diane G. Wallach Chair in Pediatric Stem Cell Biology. “This research holds great promise for improving our ability to treat a

UCDHSC involved in landmark hemophilia study The University of Colorado at Denver and Health Sciences Center was one of 15 institutions involved in a landmark hemophilia study that has shown significant reductions in the risk of developing joint damage in young children with hemophilia A. The study, which was published in this month’s issue of The New England Journal of Medicine, indicated that infusions of clotting factor VIII used preventively can significantly reduce the risk of young children with hemophilia A developing joint damage associated with joint bleeding. The boys participating in the study

were treated either with prophylactic or regular, continuous infusions to prevent bleeding, or treated at the time of and in response to bleeding known as episodic on-demand treatment. The findings showed that 93 p.c. of boys who received prophylactic treatment had normal joints at age six compared to only 55 p.c. in the episodic treatment group – the strongest medical evidence to date comparing joint outcomes associated with the two forms of treatment. “ Our results show for the first time that prophylaxis, initiated

between six and 30 months of age, is effective at preventing joint bleeds and preserving joint function and structure in young boys with hemophilia A,” said Marilyn Manco-Johnson, MD, principal investigator of the study and director of the Mountain States Regional Hemophilia and Thrombosis Center at the UCDHSC School of Medicine. “ These results provide health care professionals – as well as parents of children with hemophilia A – with solid information to guide optimum treatment.” The multi-center, five year study was in collaboration with the Centers for Disease Control and Prevention and the National Institutes of Health.

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Denver’s Nursing Star

Continued Education February 02/08/07 – 02/10/08 INNER SOUND Tuning Fork Training Intensive Tuning Forks are an effective tool for: Stress Management, Meditation, Relaxation, Regaining Health. A healthy body resonates at its maximum potential because the symphony of its parts are in harmony. Emotional blockages and traumas are stored in the connective tissue of the body in such a way that they dampen the body’s natural resonating frequency. Just as a violin string will come to life when the identical note is struck on a piano, the body’s symphony will come alive when its music is played. Reinstate health and well-being through the power of sound. Dates/Times: Feb. 8, 2008 6:00pm - 9:30pm Feb. 9, 2008 9:00am - 6:00pm Feb. 10, 2008 10:00am - 5:30 pm Location: Coordinator: Drury Inn & Suites Deborah Gotto - 9445 East Dry Creek Road 3741 Tabor Court Englewood, CO 80112 Wheat Ridge, CO. 303694-3400 303-431-7653 or [email protected]. Instructor: Arden Wilken. Cost $295.00. CEU’s – 18. To register online, go to www.healingtouchforanimals.com/ tuningfork.htm Does not include price of Tuning Forks. Tuning Forks will be supplied during the workshop and may be purchased at that time. Contact hours awarded based on 100 % attendance and completion of all practices.

02/19/08 & 02/20/08 Pediatric Advanced Life Support (PALS) Provider Courses Session 1 Date: Tuesday, February 19, 2008 Time: 8:00PM to 4:00PM Instructor: To Be Determined Location: The new Children’s Hospital 2nd Floor Conference Center 13123 E. 16th Avenue; Aurora, CO Session 2 Date: Wednesday, February 20, 2008 Time: 8:00AM to 3:00PM Instructor: To Be Determined Location: The new Children’s Hospital 2nd Floor Conference Center 13123 E. 16th Avenue; Aurora, CO Description: The intended audience for this course includes pediatricians, emergency and

family practice physicians, dentists, hospital pharmacists, registered nurses, respiratory therapists, EMS personnel and other ALS providers who care for pediatric patients. The PALS course will provide the participant with: 1. Information needed to recognize infants and children at risk for cardiopulmonary arrest. 2. Information and strategies needed to prevent cardiopulmonary arrest in infants and children. 3. The cognitive and psychomotor skills needed to resuscitate and stabilize infants and children in respiratory failure, shock, or cardiopulmonary arrest. Continuing Education: Medical: The Children’s Hospital is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Children’s Hospital takes responsibility for the content, quality and scientific integrity of this CME activity. The Children’s Hospital designates this educational activity for a maximum of 13 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity. This activity is being reviewed and credit is pending for up to 13 Prescribed credit hours by the American Academy of Family Physicians. Cancellation and Attendance Policies: Registration fees will be fully refunded if a cancellation is received within three weeks of the course. 50 percent will be refunded up to one week prior to the course, provided a substitute can be found. No refunds will be given after that time or for non-attendance. Attendance at all lectures and stations is required. Certification will not be granted for late arrival, or significant absence during any part of the course. Contact: Starlight Wagner at 303-7242584. You may also email at: [email protected] Cost: Children’s Hospital Staff $190.00 EMS Personnel $200.00 Non-Children’s Hospital Staff $210.00 2006 PALS Text Book (includes Pre-course guide and disk) $40.00 Pre-course guide and disk $10.00 PALS Reference Card $10.00 PALS 2005 Pocket Guideline $15.00 *Children’s Hospital staff need to make departments transfers, for forms contact Starlight at [email protected]. For more information and dates v i s i t www.thechildrenshospital.org.

March 03/04/08 RN IV Refresher Course The RN IV Refresher course is an 8-hour course designed to refresh and update the RN’s skills and knowledge of IV Therapy. This is an excellent course for nurses reentering the health care field! Tuesday, March 4, 2008, 9:00 am - 5:30 pm, $225.00. Seminars held at: Clarion Hotel Denver South, 7770 S Peoria Street, Englewood - (303) 790-7770. Lunch included. Class size is limited, so register early. Registration MUST be received one-week prior to seminar date. Seminar Highlights: Peripheral IV Catheter Topics: Basic anatomy and physiology - Tips & Tricks of PIV (Peripheral IV) starts New devices and their use Identification and prevention of PIV related complications. Central Catheter Topics: Indications for CVADs - Types of CVADs (Central Venous Access Devices) - Nontunneled, tunneled, implanted ports, and PICC catheters Care of central lines Antimicrobial solutions, new dressing materials and stabilization devices - Flushing CVADs - Flush techniques, devices, use of Heparin Implanted port access with safety non-coring needles - Declotting CVADs - Blood collection from CVADs Monitoring CVADs Complications of CVADs Identification, interventions and prevention. Current Standards of Care - RN IV Refresher. Course content based on the INS 2006 Standards of Practice as well as guidelines from the CDC and AVA. Registration fees minus $30.00 will be refunded if cancellation is received at least 5 business days prior to seminar. There is a $30.00 charge to change registration. No refund will be granted for cancellations received less than 5 business days in advance of the seminar. For more information, visit www.cassuttconsulting.com.

03/05/08 & 03/06/08 Neonatal Resuscitation Program (NRP) Instructor Course Session 1 Date: Wednesday, March 5, 2008 Time: 7:30AM

to 5:00PM Instructor: Various Instructors Location: The new Children’s Hospital 2nd Floor Conference Center 13123 E. 16th Avenue; Aurora, CO Session 2 Date: Thursday, March 6, 2008 Time: 7:30AM to 5:00PM Instructor: Various Instructors Location: The new Children’s Hospital 2nd Floor Conference Center 13123 E. 16th Avenue; Aurora, CO Description: Neonatal Resuscitation Program (NRP) Instructor Course - The NRP Instructor Course includes discussion of current scientific information, skills practice and performance checklists, use of slides, DVDROM and DVD/Video. Teaching strategies for NRP implementation will be emphasized. Successful completion of a NRP Provider Course is a prerequisite. AAP Verification is awarded for successful completion of this 2 day course. (CME/AAFP and CNE Credit) To be added to the mailing list to receive a conference brochure, call Kris Smith at 303-724-2867 or send e-mail to [email protected] with Brochure Request in the subject line. Contact: Kris Smit at 303-724-2867. You may also email at: [email protected] Please confirm course availability with Kris, as space is limited for this 2 day . Pre-Registration: PreRegistration is required for this class or event. Status: This class or event is open, with 24 spaces available. For more information visit www.thechildrenshospital.org.

03/17/08 – 03/19/08 Evidence-Based Programs: Research-to-Practice Conference Adam’s Mark Hotel, Denver, Colorado. The purpose of this event is to disseminate science-based information on youth violence, delinquency, and drug prevention programs that are effective. Evidencebased programs will be brought together in one location to provide a first-class conference that offers continuing education and networking opportunities for model evidence-based prevention and intervention programs for youth and their families. A variety of

professionals will attend this event, including but not limited to: individuals involved with any of the Blueprints model and promising programs, individuals interested in pursuing a career in child mental health services and child advocates (such as legislators, judges, probation officers, principals and other school officials, social services employees, community-at-large members and mental health/ substance abuse professionals). Complete conference information and online registration are available at www.blueprintsconference.com.

03/18/08 Pediatric Advanced Life Support (PALS) Renewal Courses Session 1 Date: Tuesday, January 29, 2008 Time: 8:00AM to 1:00PM Instructor: To Be Determined Location: The new Children’s Hospital 2nd Floor Conference Center 13123 E. 16th Avenue; Aurora, CO Description: The intended audience for this course includes pediatricians, emergency and family practice physicians, dentists, hospital pharmacists, registered nurses, respiratory therapists, EMS personnel and other ALS providers who care for pediatric patients. The PALS course will provide the participant with: 1. Information needed to recognize infants and children at risk for cardiopulmonary arrest. 2. Information and strategies needed to prevent cardiopulmonary arrest in infants and children. 3. The cognitive and psychomotor skills needed to resuscitate and stabilize infants and children in respiratory failure, shock, or cardiopulmonary arrest. Cancellation and Attendance Policies: Registration fees will be fully refunded if a cancellation is received within three weeks of the course. 50 percent will be refunded up to one week prior to the course, provided a substitute can be found. No refunds will be given after that time or for nonattendance. Attendance at all lectures and stations is required. Certification will not be granted for late arrival, or significant absence during any part of the course.

Denver’s Nursing Star

January 28, 2008

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Continued Education Contact: Starlight Wagner at 303-724-2584. You may also email at: [email protected] Cost: Children’s Hospital Staff $110.00 EMS Personnel $120.00 Non-Children’s Hospital Staff $130.00 2006 PALS Textbook (includes Precourse guide and disk) $40.00 Pre-course guide and disk $10.00 PALS Reference Card $10.00 PALS 2005 Pocket Guideline $15.00 *Children’s Hospital staff need to make department transfers, contact Starlight for forms at [email protected]. For more information and dates visit www.thechildrenshospital.org.

April 04/22/08 Intravenous Techniques This 8 hour seminar will prepare the MA, RT and other health care professionals to perform peripheral IV access and limited intravenous fluid treatment, utilizing knowledge, skills and competencies required to safely perform such techniques under the supervision of a physician or registered nurse. This seminar will provide lots of hands on practice to allow participants to become familiar and comfortable with equipment involved in IV therapy. Course content based on current INS, AVA and CDC standards. Tuesday, April 22, 2008 9:00 am - 5:30 pm $225.00 Seminars held at: Clarion Hotel Denver South 7770 S Peoria Street, Englewood, CO (303) 790-7770 Lunch included Class size is limited, so register early Registration MUST be received one-week prior to seminar date REGISTER NOW Intravenous Techniques Course Objectives: Discuss legal implications of venipuncture and infusion therapy - Demonstrate understanding of the general anatomy and physiology of the adult circulatory system Name and locate the peripheral veins and arteries of the upper extremities - Demonstrate awareness of the characteristics, which differentiate arteries from veins - Identify approaches to deal with the physiological changes resulting from the aging process - Identify

peripheral veins appropriate for venipuncture - Demonstrate the proper ways of vein distention - List the factors affecting site selection Demonstrate the correct steps in initiating IV therapy Demonstrate the securing of the IV site - Demonstrate the correct procedure for proper infection control and blood borne pathogen safety measures - List and describe the signs and symptoms as well as interventions for complications of IV therapy Calculate the flow rate for a gravity infusion - Demonstrate removal of an peripheral IV. Intravenous Techniques Registration fees minus $30.00 will be refunded if cancellation is received at least 5 business days prior to seminar. There is a $30.00 charge to change registration. No refund will be granted for cancellations received less than 5 business days in advance of the seminar. For more information, please visit www.cassutt consulting.com.

Open LPN IV – Independent Study This 60-hour full IV Certification course will prepare the LPN to perform intravenous therapy and venous blood collection, through peripheral and central venous catheters, utilizing the knowledge, skill and competencies required to safely perform such therapy in accordance with the Colorado Nurse Practice Act. It has been written for the practicing LPN to allow the participant to work at his or her own pace and time. The participant need only attend one day of laboratory instruction and practice. The rest of the course is to be completed on your own time and at your own facility. You must be an LPN who holds an active license without current disciplinary action in Colorado to register for this course and receive the IV-2 authority. This course is approved by the Colorado Board of Nursing Course Breakdown: Independent study - 44 Hours - Laboratory instruction & practicum – 8 Hours - Clinical with preceptor – 8 Hours Total = 60 Hours Section One

– Independent Study Once registration and payment is received we will mail out the independent study modules. Read the course and complete the written tests. You will also need to arrange an RN preceptor at your institution to precept you in the clinical skills. You will have 3 months to complete this section. Section Two – Laboratory Instruction/Practice Once you have completed the self-study modules and quizzes, and arranged a preceptor, you will need to register for a lab instruction day. The laboratory days are held at the Clarion Hotel at Centennial Airport, 7770 Peoria Street, Englewood, CO. They are scheduled once a month on or around the 15th. You need only attend one. Complete the preceptor form, have it signed, then mail or fax the registration for the laboratory practice, the quiz answers and the preceptor form to us. We will email or fax back your scores and a confirmation of registration for the laboratory practice day. Once the self-study modules, quizzes and laboratory instruction/practicum is successfully completed you will need to validate your skills in the clinical setting. Section Three – Clinical skills validation Complete skills validation check off with your preceptor at your facility. Once all of the skills have been successfully demonstrated and signed off, submit by mail the completed validation skills check off with a check or money order made out to the Colorado BON in the amount of $45.00 for the IV-2 authority. You have 3 months from the date of the laboratory practice date to complete this section. Skills to be validated with qualified RN preceptor: Peripheral IV starts on 3 adult clients; Initiation and monitoring of IV fluid administration on 3 clients through peripheral and central venous access devices; Flushes into venous access devices designed to maintain venous patency for 3 clients; Administration of premixed antibiotics via venous access device to 3 clients; Utilization of IV pumps; Peripheral venous blood sampling on 3 clients; Discontinuation of 1 peripheral short device; Documentation of nursing

actions and observations; Sterile dressing change on venous access device; Blood collection from a central venous access device. Registration fee $495.00 plus $45.00 application due to BON upon successful completion Once Independent study course is mailed, there are no refunds. For more information, visit www.cassuttconsulting.com.

Trauma Nursing Core Course (TNCC) The Trauma Nursing Core Curriculum (TNCC), a course designed by the Emergency Nurses Association, teaches a core level knowledge and psychomotor skills associated with the delivery of nursing care to trauma and critically ill patients. Students will be required to test out of 3 psychomotor skills stations and complete a multiple choice written exam. Upon successful completion of the course, certification is awarded by the Emergency Nurses Association and is valid for four years. Upon completion of this course, participants should be able to: * Demonstrate knowledge of pathophysiology as a focus for the signs and symptoms of injury. * Demonstrate appropriate psychomotor skills related to the care of the trauma patient including airway management, spinal immobilization, and resuscitation of the trauma victim. 19 Continuing Education Contract hours are awarded by the Emergency Nurses Association for course completion, regardless of performance on the written exam and skills stations. Full registration fee will be refunded

only if written cancellation is received within 7 days prior to the course. The textbook fee is non-refundable. No refund will be given for non-attendance, although you may send a substitute. The Children’s Hospital reserves the right to cancel this course in the event of an unforeseen circumstance, or if the minimum acceptable registration is not attained 2 weeks prior to the course, with a full refund of the registration fee. Contact: Starlight Wagner at 303-8616336. You may also email at: [email protected]. Cost: TCH Staff and ENA Members: $175.00 Non-TCH Staff: $190.00 Audit Fee (Non-RN or Non-testing participants): $100.00 2000 TNCC textbook: $40.00.

Ultrasonic Guided PICC Insertion Utilizing the Sonosite iLook System Please contact us for additional information at (303) 680-2243. Registration and payment must be received at least one-week in advance of seminar dates. Class size is limited so register early. Learn to place PICC catheters with the Sonosite iLook Ultrasound! Course objectives: Discuss advantages of ultrasonic guided PICC insertion; Review concepts of ultrasound; Review A&P of upper arm; Discuss the features of the Sonosite iLook; Demonstrate visualization of veins and arteries; Practice procedure utilizing “Peter PICCs.” Prerequisite - Should be proficient in the MST (Modified Seldinger Insertion Technique.) For more information, visit www.cassuttconsulting.com.

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FREE OF CHARGE! Email your continuing education information to us at: [email protected] or simply fax it to 720-283-2198!

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January 28, 2008

Denver’s Nursing Star

OPINION Romantic Gift Giving Delights Vs. Disasters Out of the boxx... Commentary by Mary Jo Fay, RN, MSN

Valentine’s Day is right around the corner and whether you’re in a start-up relationship or a long-term love, these tips will keep you either out of hot water Mar Maryy JJoo FFaa y, RN RN,, MSN or up to your eyeballs in deep doo-doo! So choose wisely! You might want to share these with the guys too, if you’re looking forward to a memorable Valentine’s Day … or any other holiday. Do: Do listen when your mate nonchalantly mentions something in passing that they like … from a type of candy to jewelry to that Home Depot specialty tool, the fact that you heard

the idea and put it in your memory banks to pull out perfectly later will usually yield huge brownie points for you in the long-run. Don’t: Assume that what you like for your mate is something they would like … or the surprise you intended may instead surprise you with a long night with a cold shoulder! Do: Ask questions of your mate to clarify specifics of something you have in mind, or that they’ve nonchalantly mentioned. (Even asking for a specific wish list can’t hurt your chances of getting just the right thing. Especially when it comes to size, color, and favorite store.) Don’t: Ever buy a woman an expensive piece of jewelry that you haven’t specifically heard her comment about or unless you make it very clear that you’re totally happy for her to it back for something she may prefer instead. There is nothing like a woman who knows that you just spent a pretty penny on her, but she just can’t stand what you bought. It leaves the both

of you in one tough spot! Do: Find out your mate’s favorite tasty treat and offer it periodically, even in small amounts. Bringing small tidbits when it’s unexpected is not only fun and a nice surprise, it let’s your loved one know that you were thinking of them even when there’s no holiday involved! (And who doesn’t like that?) Don’t: One major exception to this rule is when your mate has informed you that he or she is on a mission to lose weight. Bringing them their favorite sweet under these circumstances can either mean you’re not listening (You? Not listen???) Or else that you’re trying to sabotage their weight loss efforts. And what’s up with that, anyway? Do: Offer gift certificates to your mate’s favorite store or even offer to go shopping together. Don’t EVER: Give a gal things like vacuum cleaners, power scrubbers, or bathroom scales as a gift. (Unless of course, you’re looking to sleep on the couch.) And gals – don’t give your guy a teddy bear or other stuffed creature either. It’s a girl thing – definitely not a guy thing! So don’t try to make it one! DO: If you suspect she’d like lingerie or if you know for certain she loves Victoria Secret, offer to go shopping

Readers inflamed over suggestion that nurses cook, clean Fellow nurses declare idea preposterous; cite educational requirements Editor’s Note: The following letter is in response to Oklahoma’s Nursing Times January 21, 2007 question of the week, “Should nurses be responsible for cleaning and catering to improve standard as was suggested by a medical expert?”

Dear Editor, Nurses are highly trained professionals and we have a shortage of nurses as it is. Expecting them to clean rooms, cook meals and who knows what would be next is ridiculous. Would we expect the same from Physicians? I believe the answer to fixing a problem requires hiring concientious individuals who are willing to perform at top level. The answer is not to have nurses perform at a lesser level. If a nurse is expected to be a cook and be a maid then there is no need to spend the time and effort into their training. I am sure their are nurses out there who would enjoy that type of nursing. So be it, let them work in a private setting and perform the services they find fulfilling, but do not make something mandatory that for many nurses would be a giant step backwords in their profession.

We often do not have the time or the staffing available to provide much more than the most basic, essential nursing care. Gone are the days when each patient recieved a nice alcohol rub to help them drift off to sleep although when I was in nursing school Dear Editor, There may be something worse in we actually had a section on this. I often feel I have accomplished terms of combination of services, but I’d be hard pressed to come up with nearly the impossible if I leave my shift having administered every it! What is this woman thinking? N u r s i n g i s a e v e r - e v o l v i n g medication, provided wound care and profession that demands exceptional ambulated every one, fed those who intelligence, adherence to exact couldn’t feed themselves and that my standards, and compassion. To add patients and I have all survived the more to it would be difficult; to add shift a little bit better than we were cooking/catering and cleaning to it at the beginning of it. Let me now have to cook for them would be unwise; and to add cooking/ catering and cleaning to it would and clean their rooms as well? BAH! take from the time to care for the This Dame, whoever she is, must be living sometime around the turn of patient. If I’m a patient, I definitely want the 20th century. Nurses today - and my physician, my nurse, and any other for decades now - are highly educated, care giver to be focused on delivering trained professionals capable of managing complicated treatments. health care, nothing else. We have given up arranging Sincerely, Lou Masterson, Executive Recruiter flowers and writing letters for our patients in favor of running their Cleveland, Ohio dialysis, their balloon pumps, their ventilators. The suggestion that we might also whip up a nice egg custard Dear Editor, and give the patient rooms a good WHAT????? This is the most asinine dusting is beyond ridiculous! We can only hope that everyone thing that I have ever heard in regard else will see how ridiculous this idea to nursing. Ever, ever, ever heard. Sincerely, Carol Bowers, R.N.C.D. Atlanta, GA

with her. Think of the tons of fun you can have planning on the fashion show once you get home. FOR GOD SAKES DON’T: Buy women lingerie for a gift unless you are absolutely certain that you know she wants something specific AND that you absolutely know her size. Most women realize that a gift of lingerie is really a gift for her man and not her – so you can definitely piss her off with the gesture, and if you are off sizewise, it can be the kiss of death. Besides, some gals don’t even like lingerie, despite her man’s beliefs to the contrary! The Best Advice: Pay attention. It’s usually pretty easy to learn what someone you’re close to likes or dislikes. Just listen and take notes! It will go a long ways towards earning you a special place in your loved one’s heart each time you repeat the pattern!

Mary Jo Fay, RN, MSN, is a relationship expert, columnist, speaker, and awardwinning author of 4 relationship books. She can be reached through her web site at www.TheSevenSecretsofLove.com or by phone at 303-841-7691. is as well. The day I am asked to cook something for a patient other than a nice prune juice and milk of magnesia cocktail or a half pint of milk and molasses enema will be the day I hang up my cap. Oh wait! We don’t wear caps anymore either! That’s right. This is 2008, not 1908. Sincerely, Elizabeth Sowdal, RN Oklahoma City, OK Editor’s Note: Any thoughts and/or responses are welcome and should be sent to [email protected].

Denver’s Nursing Star

Board of Commentary Vicki L. Mayfield, M.Ed., RN, LMFT Martha Collar Eileen Doherty Mary Jo Fay, RN, MS Colleen Folsch Virginia Gillispie, RN, ND Vickie Jenkins Sherry L. Ray, CPCC Linda Mundorff(Rener), RN, MPH, MSN, NDc Carol Shenold, RN, CIC Elizabeth Sowdal, RN Deresa Claybrook, MS, RHIT Licia McCurdy, LPN Angela Lash, RN, CM Opinions expressed in columns and letters to the editor are not necessarily the opinions of employees, ownership of this newspaper or the publishing company.

Denver’s Nursing Star

January 28, 2008

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Nation

Cough, cold medications cause hospital visits states CDC An estimated 7,000 children ages 11 and younger are treated in hospital emergency departments each year because of cough and cold medications, according to a study by the Centers for Disease Control and Prevention. Approximately two-thirds of those incidents were due to unsupervised ingestion (i.e., children taking the medication without a parent?s knowledge). The study was published online today by the American Academy of Pediatrics journal, Pediatrics. This study found that children ages 2 to 5 accounted for 64 percent of all adverse drug events from cough and cold medications, and nearly 80 percent of the events for this age group were from unsupervised ingestions. Among all age groups, 93 percent of the children did not require hospital admission, however, one-fourth needed additional treatment to eliminate the medicine from their bodies.

The CDC researchers reviewed 2004-2005 data from the National Electronic Injury Surveillance System – Cooperative Adverse Drug Event Surveillance (NEISS-CADES) project to describe emergency department visits due to cough and cold medications. “Parents need to be vigilant about keeping these medicines out of their children?s reach,” said Dr. Denise Cardo, director of CDC?s Division of Healthcare Quality Promotion. “They should refrain from encouraging children to take medicine by telling the children that medication is candy.” Cardo also stated that adults should avoid taking adult medications in front of young children. Recently, such products marketed to infants and toddlers less than 2 years old were voluntarily withdrawn from the market due to safety concerns. The safety of these products for children ages 2 to 11 is currently being reviewed by the U.S. Food and Drug Administration.

Lawmakers pass funding for nursing programs, ANA states After months of contentious negotiations, Congress recently passed legislation averting Medicare cuts to advanced practice registered nurses (APRNs) and extending the state children’s health insurance program (SCHIP). The passage of these last remaining bills funds the federal government through the remainder of fiscal year 2008 (which began on October 1, 2007). Congress has left Washington for the holidays. President Bush is expected to sign these bills shortly. The consolidated funding bill (H.R. 2764) includes $156.05 million for the Title VIII nursing workforce development programs, an increase of $6.4 million (4.3 percent) over last year’s funding levels. During negotiations, the President proposed to cut funding by $44 million. Congress also sent to the President separate legislation (S. 2499) that would delay, for six months, a scheduled 10 percent cut in Medicare reimbursement for APRN and Physician services. Instead, this cut will be replaced by a 0.5 percent increase.

Congress will have to revisit this issue again before June 30, 2008, to keep these cuts from reappearing. This bill would also extend SCHIP funding through March 31, 2009, providing enough funds for states to continue to serve their current SCHIP enrollment of about 6 million people. For a more comprehensive summary of the 110th Congress’ first session, please read the upcoming January edition of Capitol Update, http:// www.capitolupdate.org/newsletter/ The ANA is the only full-service professional organization representing the interests of the nation’s 2.9 million registered nurses through its 54 constituent member nurses associations. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public. Please visit the American Nurses Association at www.nursingworld.org for more information.

Parents also should not use products intended for older children to treat young children, and, as stated in the U.S. Food and Drug Administration's mandated label warning, parents should keep all cough and cold medications out of the reach of children. Parents and caregivers should throw away previously purchased products marketed to infants and toddlers age 2 and younger. The over-the-counter cough and cold products examined in this study include these ingredients: decongestants (for unclogging a stuffy nose), expectorants (for loosening mucus so that it can be coughed up),

and antitussives (for quieting coughs). The medications may also have included antihistamines (for sneezing and runny nose) in combination with the ingredients above. The terms on the label could include “nasal decongestants,” “cough suppressants,” “expectorants” and “antihistamines.” For more information on medication safety, visit the CDC?s Injury Prevention Web site at www.cdc.gov/ncipc/factsheets/ poisonprevention.htm. For more information on FDA recommendations on, visit the FDA?s Web site at http:/ /www.fda.gov/consumer/updates/ coughcold011708.html .

SLU researchers show how to stop muscle weakness Severe muscle weakness caused by myasthenia gravis - a highly debilitating autoimmune disorder - can be prevented or reversed by blocking a key step in the immune response that brings on the disease, researchers at the Saint Louis University School of Medicine have found. Myasthenia gravis, which affects about 120,000 Americans, is caused when the immune system produces antibodies that attack and damage acetylcholine receptors, which are mechanisms that play a key role in transmitting the electrical impulses that cause muscles to move and contract. The immune response at the heart of this process is called a complement cascade - a complex chain of chemical reactions in which proteins bind together to attack a cell by punching a hole in it. When acetylcholine receptors are damaged in this way, muscle movement is severely impaired. Using an animal model, the SLU scientists found they could prevent muscle weakness, or restore muscle strength, caused by myasthenia gravis by stopping the complement cascade at a step called C5 – before the series of chemical reactions had finished. They did this by administering an anti-C5 agent, which targets one of the proteins involved in the cascade and thus stops the process. The researchers’ findings are published in a recent edition of the Journal of Immunology ( http://www.jimmunol.org/ cgi/reprint/179/12/8562 ). Henry J. Kaminski, M.D., professor and chairman of the department of neurology and psychiatry at the Saint Louis University School of Medicine, one of the study’s authors, said the findings are promising enough that human clinical trials involving the anti-C5 agent – called eculizumab – are likely within a year. “We believe this therapeutic approach has strong potential for improving the lives of patients with myasthenia gravis,” Kaminski said. “And

if it proves successful there, it could also one day help us find new therapies for other auto-immune disorders, such as rheumatoid arthritis and lupus.” Myasthenia gravis affects approximately 400 per 1 million people. The severe muscle weakness caused by the disease brings a host of other complications, including difficulty breathing, difficulty chewing and swallowing, slurred speech, droopy eyelids and blurred or double vision. By preventing or reversing the muscle weakness, the other symptoms are prevented or reversed as well. Myasthenia gravis can’t be cured, but it is sometimes be treated with surgery to remove the thymus (which plays a role in the immune system) or with various drugs. Surgery often doesn’t bring relief, however, and the medications typically decrease in effectiveness over time or, in the case of immunosupressants and corticosteriods, have severe side effects. In addition to Kaminski, the study’s authors include Yuefang Zhou, Ph.D., and Bendi Gong, Ph.D., both of Saint Louis University; M. Edward Medof, M.D., and Feng Lin, Ph.D., both of the Institute of Pathology at Case Western Reserve University in Cleveland; and Russell Rother, Ph.D., of Alexion Pharmaceuticals in Cheshire, Conn. The research was supported by grants from the National Institutes of Health. Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.