September-October FNPN Newsletter

Good Morning!

We would like to bring you up to date on what’s new in your own backyard of Florida. In this newsletter you will find the following: 

Contents 

• Why should Nurses vote?
• FNPN Elections
• FNPN PAC Update
• Too Little To Late?
• Job Announcement
• Membership update
• Message from AANP
• Education Update
• Around the State and Around the Nation
• News You Can Use

Quote of the Month:
“A vote is like a rifle; its usefulness depends upon the character of the user.”
― Theodore Roosevelt

Why Should Nurses Vote

"We Care We Vote" is our combined nursing organization campaign effort this election year. Our messages must be heard and the only way to do that is if YOU VOTE! 

250, 000 votes, the number of licensed Registered Nurses in Florida and it is a powerful force in any election! This does not take into account family members, retired nurses and friends and supporters of nursing who can stand and vote with us! Nurses are the most trusted profession says the Gallop poll year after year, so take that responsibility and get out and vote.

You became a nurse to make a difference in the lives of your patients. Now, you can make a difference politically as well.

Policymakers at the state and federal levels are making important policy decisions about health care, and those decisions affect your ability to practice as a nurse and to provide health care services to your patients.

Policymakers also make important decisions about the laws, rules and regulations that govern hospitals, nursing homes and other environments where nurses are employed.

Regardless of whether you support the Affordable Care Act, the health care environment is changing. We must ensure that nurses must play a prominent role in the delivery of care.

Florida lawmakers are revising many state laws dealing with state employees.

Budget cuts on the state and federal levels affect programs and services to the elderly, children and low-income. We have an opportunity to become advocates for them by voting for candidates who care for those populations.

Candidates for public office need to be educated about nurses’ issues. There are many new candidates seeking office due to eight-year term limits and redrawing of political district lines.

The sheer number of registered nurses in Florida gives us a strong voice, and politicians will be forced to take notice of nurses and issues important to us. 

FNPN Elections

It is time once again to begin the election process for the Florida Nurse Practitioner Network. This year, our President, Second Vice President in charge of Education and Treasurer Positions will be voted on. On October 15th, a link to vote will be sent to all active members. Please take the time to look at your membership profile on the website http://fnpn.enpnetwork.com/followers, and confirm that your membership is active(full). If you have any questions about your membership, please contact us at floridanpnetwork@gmail.com

FNPN PAC Update

Laureen M. Fleck, PhD,FNP-BC,CDE, Chairperson - Political Action Committee

As voters, we are in a position to support the candidate of our choice by promoting their campaign not only on Election Day but by participation and promotion of the candidate's campaign promises.

Advanced practice nurses in Florida have not been able to practice to the full extent of our scope of practice and education because of political restrictions imposed on us in the House and Senate. 

Our PAC committee will be traveling throughout the state to raise money and participate in fund raising efforts to build OUR VOICE in the Florida political arena. We will also support the candidates that support our issues by monetary contributions to their campaigns. 

We need your help! Money is Power!! A brilliant legislative session is expected and we are closer than ever to reach our goals. We have a lobbyist working with us. We are well informed and networked in Tallahassee. She keeps the constant flow of information current. We cannot achieve our goals with this disruption of policy and politics! Without you, your patients, family and community support we are invisible. Become a member of the FNPN PAC Committee. 

Consider your commitment to our profession. We are ARNPs in private practice, hospital settings, colleges, universities and clinics throughout the state! We are YOU ! 

If each person in our membership donated $10 and asked 5 more people to donate $10 we would be on our way to political success! We have a membership of 4,300 ARNPs in Florida. We are solid, we are YOU!   To  make a contribution please click here

Too Little To Late? 

Submitted by: Nedra Miller MSN, FNP-BC Suncoast Hospice 

The NHPCO is reporting disturbing statistics related to the average length of stay for a patient entering the Hospice benefit. The national average for length of stay is less than 3 weeks. In consideration of this fact, I would imagine that the hospice staff is able to help patient/families achieve a pain-free, peaceful death, but there would have been little, if any time to complete life closure related tasks that someone enrolled in hospice 6 months prior to death would have been able to achieve. I would propose prognosis and estimation life expectancy is a very challenging task, especially for the non-cancer patient, however I would also propose most health care providers are hesitant to refer patient’s earlier due to fear of taking aware a patient’s hope. 

The topic of hospice is a difficult one and only gets easier with practice and knowledge. 

We have all encountered the patient that there just doesn’t seem much else that can be done, well I offer that this may be the time to consider the conversation of Hospice or calling on a Hospice professional to help you determine if that patient is appropriate for hospice. Consider the patient with COPD/CHF who is on their 3rd hospital admission of the year and it’s only February. Consider the spouse who is slowly losing their life partner to diseases like Alzheimer’s, Parkinson’s, Huntington’s chorea or Multiple Sclerosis. Consider that Hospice may provide financial relief by paying for medications and medical equipment needed to keep a patient safe and comfortable in their place of residence. The Hospice team is made up of a team of professional trained compassionate individuals from all disciplines that will support a patient and their family members throughout the dying process in homes, assisted living facilities and nursing homes. What many people are not aware of is that the Hospice team is also made up of devoted volunteers who provide their helping hands to Hospice patient’s in the form of companionship, shopping, dog walking, transportation, haircuts, massage…..the list is as long as the imagination. If you can think it, we can probably make it happen. 

I am confronted regularly with myths about hospice care and services. I hear, “I don’t know how you do what you do.” The only way to dispel these myths is to educate. I invite every health care professional to call their local hospice and ask them the question about hospice that troubles them the most. You may be surprised by what you hear.

Job Announcements! 

Do you know an employer who might find the FNPN Job posting a worthwhile site? If so, please be sure to tell them about the website and the fact that on average 20 or more jobs are posted each month.  The traffic to our website is incredible and we have more and more folks seeking employment through this site than ever before.  Let them know you saw it on the FNPN Website! There have been many new job postings around the state on our web site at www.fnpn.org  for those of you that may have an interest. On our new website, the most recent postings are on the front page. A new feature will allow postings to be visible for 90 days. Please feel free to pass this along to your colleagues who may be interested in it as well, or who may have an interest in finding out more about our network.  For those of you that have found jobs on our website, please be sure to let us know! 

Membership Update

Armando Riera-Membership Chair 

Dear Members, 

In order for us to have our voices heard in Tallahassee, we will need to increase our membership, at the same time working hard to retain current members.   One of our goals this year will be to actively work on recruiting new members to FNPN to make our organization stronger. 

Renewal Reminder-Membership in FNPN runs on an annual basis Jan-Dec. Please renew your membership today. Membership in FNPN can be as a group or individual member.  

Individual members belong and receive many benefits as part of their membership-frequent communication during the legislative session (or special sessions), a paid lobbyist based in Tallahassee, access to posted job opportunities, access to posted upcoming conferences and many more benefits. If you belong to your local NP group you are not an FNPN member until you join FNPN individually, group and individual membership are two separate levels of membership. I encourage you to visit our newly redesigned web page today www.fnpn.org and while you're there you can renew online. 

Group Presidents- please renew today and continue to be an integral part of our growing organization. We value our group members as this creates a vital network of NP groups throughout the state. These groups help disseminate information about trends, issues and changes impacting NP's at the state and national level. As a group member we will also assist with conference planning and obtaining approval for CEU's if offered. We will also assist with promoting your conferences and activities and can provide assistance or link you with support in web design.

FNPN now has several options for membership:

• $70.00 - New Member /Renewing
• $120.00 - 2 Year Membership Special
• $45.00 - Student / Retired Member
• $80.00 - 2 year Membership Student/Retired
• $120.00 - NP Group Member
• $120.00 - Organization Member
• Student Group Membership "First Year Free!" 

To pay by check click here

To pay by credit card click here 

As the Chair of the Membership Committee I am always open to suggestions and new ideas. If you have any questions, please contact me. This year, when joining/renewing, we also ask you to consider ‘bringing a friend’ to the registration table and helping build our organizations to where they should be. With the numbers of Advanced Practice Nurses nearing 15,000 in Florida, we should have a strength that can overcome any push from our medical community. We hope you will let us nurture that side of you if you need it and engage those around you to do the same. Please be sure to contact us should you have questions about legislation, membership, education and more. Our Executive Assistant, Regina, is always available either by phone, computer and even skype! 

Thank you in advance for all your support.

Respectfully,
Armando Riera, MSN, ARNP-BC
FNPN, Membership Committee Chair
ARiera@jhsmiami.org

Message From AANP

Removing Barriers to Advanced Practice Registered Nurse Care: Home Health and Hospice Services
Andrea Brassard AARP Public Policy Institute 

The landmark 2011 Institute of Medicine report, The Future of Nursing, Leading Change, Advancing Health, recommends that advanced practice registered nurses (APRNs) be allowed to certify patients for Medicare payment of home health and hospice services.1 However, Medicare laws and regulations prohibit APRNs from conducting certification for these services. This report shows how removing this barrier would benefit consumers, physicians, and the health care system. To read more click here

AANP Responds to the American Academy of Family Physicians Report

AUSTIN, TX (September 19) -- Angela Golden, President of the American Academy of Nurse Practitioners (AANP), today issued the following statement concerning the report, "Primary Care for the 21st Century: Ensuring a Quality, Physician-led Team for Every Patient," released by the American Academy of Family Physicians: To read more click here 

Education Updates: The following important educational opportunities have been posted for October and November; be sure to check back on our website at www.fnpn.org for additional updates and additions!

NPCPBC   & FNPN 9th Annual Clinical Conference Friday,   October 19 2012 at 7:30am ET in Palm Beach Gardens, FL

Florida   Association of Nurse Anesthetists 2012 Annual Convention Friday,   October 19 2012 at 3:00pm ET in Orlando, FL

CE   Cruise with the Association of NPs in Business Thursday,   November 29 2012 at 12:00pm ET

 

Around the State and Around the Nation 

License Renewal Changes for 2013

The Department of Health, Division of Medical Quality Assurance, would like to announce an exciting new approach to license renewal.

In an effort to streamline processes, MQA will now verify a practitioner's continuing education record in the electronic tracking system at the time of renewal. Practitioners will be able to view their course history in the continuing education tracking system free of charge.

If the practitioner's continuing education records are complete, they will continue the renewal process without interruption.

If the practitioner's continuing education records are not complete, they will be prompted to enter their remaining continuing education hours before proceeding with their license renewal.

As an approved continuing education provider it is now more important than ever for your organization to report course completion credits to the electronic tracking system as quickly as possible. For information regarding all the different reporting options please login to your provider account or contact the CE Broker help desk at 1-877-434-6323 for more information.

The projected release date for the new approach to license renewal is January 2013. For more information please visitwww.CEatRenewal.com you do not need to sign up and pay for CEBroker to manage your CE credits. Just keep great files and know you will have to enter the data if not recorded in your renewal CE page beginning January 2013.

Bottom Line: you do not have to pay to enroll on CEBroker. They offer a free basic service where your Florida CE provider will submit to CE broker for you. If you use that service it will be updated for you in your MQA file. You can keep your own files and update your own at renewal time! Most of the national or out of state CE hrs you gather will need to be self-entered at some point for your license renewal! 

National NP Week 2012 will be held November 11 – 17. 

A resource guide has been prepared to help you plan activities and initiatives that can build awareness of the vital role of the NP as a provider of high-quality, comprehensive, patient-centered care.  The guide contains a wealth of information such as a press release, proclamation, community activities, talking points, guidelines for media interviews, posters that you can download and print for use in your practice site or at community events, as well as radio public service announcements, a letter from AANP President Angie Golden, and other materials that will be helpful in planning fun and informative events.  http://www.aanp.org/images/documents/press-room/npweek2012.pdf 

Have a great week, Let us know what your group is doing to celebrate and recognize National NP Week so it can be shared with colleagues from around the state and let us know how you celebrate National NP Week 2012.  

News You Can Use 

The Florida NP Network has taken the next step to keep our members informed. Keep abreast of changes in your practice around the state and around the nation. You can join us today on Facebook under Florida Nurse Practitioner and Twitter under FloridaNP. We hope to hear from you. 

Vaccine Update for Your Practice?

Like the children of the cobbler, how many ARNP's are current with thier own adult vaccinations?  If you work in a large facility, chances are, your employee Health has you on surveillance and all is well, but those of us in small practices often overlook these vaccinations. So give yourself a check-up and catch-up! 

Important Announcement from DOH Regarding Aspergillus Meningitis Following Epidural Injections

Information from the Department of Health regarding the recent drug recall related to Aspergillus meningitis following epidural back injections.

Based on the latest information from the Centers for Disease Control and Food and Drug Administration, the Department of Health and the Department of Business and Professional Regulation strongly advise all Florida health care facilities and practitioners to stop using any products from the New England Compounding Center (NECC). These products should be pulled from shelves immediately and not used unless the CDC and the FDA make determinations that the products are safe. 

This recommendation is in addition to the recall of three lots of NECC Methylprednisolone Acetate received in Lot Nos. 05212012@68, 06292012@26 and 08102012@51 which should be returned in accordance with FDA recall procedures. These three lots have been associated with Aspergillus meningitis following epidural back injections. These medications are not used for epidural analgesia in labor and delivery.

Any patients known or suspected to have received back injections with NECC Methylprednisolone Acetate from the suspected lots should be evaluated immediately by their health care professional and monitored or treated as necessary. 

The departments have notified all eight Florida facilities who received contaminated Methylprednisolone Acetate, and all suspected lots have been removed. The departments continue to communicate jointly to all other facilities that may have any products from the NECC. Facilities and practitioners should immediately stop using any NECC products until the CDC and the FDA make determinations that the products are safe.

The DOH will continue to update websites at http://newsroom.doh.state.fl.us/ or www.myfloridalicense.com and have set up a toll-free hotline at 1-866-523-7339 for those who may have additional questions. 

Symptoms to look for:

Infected patients have presented approximately one to four weeks following their injections with a variety of symptoms including but not limited to: fever, new or worsening headache, neck pain, nausea and/or new symptoms consistent with a stroke (including weakness on one side of the body and slurred speech). Some of these symptoms may be mild, yet should still be reported to a health care professional immediately.

Department of Business and Professional Regulation Q&A for Facilities 

Q: I have product in my facility from the New England Compounding Center. What do I do with it? 

A: Step One: Identify all product received from the New England Compounding Center.

Step Two: Physically remove the product into a separated area in your facility. Maintain proper storage conditions for each product according to the product label.

Step Three: Verify your inventory using patient records and invoices to ensure that all product received from the New England Compounding Center has been accounted for and separated.

Step Four: Monitor FDA recall information and if necessary, follow all applicable FDA product recall procedures.

Step Five: Maintain product separation until the CDC and the FDA can make determinations indicating that the products are safe for use. 

Q: If I choose to do so, how do I dispose of the product? 

A: Follow FDA product recall procedures or visit www.myforidalicense.com and click on “Our Businesses and Professions.” Select “Drugs, Devices and Cosmetics.” The list of Restricted Prescription Drug Distributor-Destruction establishments is posted on the Drugs, Devices and Cosmetics homepage at http://www.myfloridalicense.com/dbpr/ddc/index.html. 

Disruptive Women in Health Care: Taking health care home

Diana Mason Posted:
08 Aug 2012 06:47 AM PDT

About eight years ago, I was quite ill with what I thought was the flu. When I became even sicker, I realized that it was something else. I called my primary care providers’ office on a Sunday and was told by the physician-on-call to go to the emergency room.  But I decided to go to the primary care office the next morning because I knew too much.

I knew that “hospital-acquired infections” claimed 99,000 lives in 2002 and cost around $30 billion a year. The Centers for Medicare and Medicaid will no longer pay for such infections, leaving it to the hospitals to cover the costs. (Of course, they’ll try to shift these costs to others, whether to private insurance companies or consumers.) Why do we continue to allow needless health care spending when there are other, better options?

Most of us want to heal or die in our own homes – not in a seemingly sterile environment where unseen organisms and errors can kill you.  So home care is a good thing – right? If it is, then why can’t nurse practitioners and physician assistants order home care services for their patients?

The Medicare law includes a provision requiring home care services to be ordered by a physician. This provision is inefficient and costly. My husband is on Medicare and, despite the fact that our nurse practitioner knows when he needs home care, she must get a written referral from a physician. This can delay the referral and put the patient’s health and well-being at risk.

The Home Health Care Planning and Improvement Act (S. 227/H.R.2267) would change this. It would permit nurse practitioners, certified nurse midwives, clinical nurse specialists, and physician assistants to order home care services under Medicare. It has been estimated that this law could save about $235 million over 10 years.

It didn’t get passed this year – but not much legislation is moving in Washington. The provision is part of a larger package that deals with home care policy. I know it’s an election year and everything is being fought over and politicized to score points with “the base”, but we can’t make our health care system safer and more efficient and affordable if federal and state policymakers can’t talk with each other. Maybe legislators should have been delayed from going home or on vacation until they agreed on five ways to improve health care. They could start with changing the Medicare law to allow advanced practice nurses and physician assistants to refer Medicare patients for home care.