WNA Monitor August 25, 2017 WNA News Plan to attend the 4th Annual Northwoods Clinical Practice Update! Friday, October 6, 2017 Nicolet College, Rhinelander, WI Program and registration information will be posted as available at wisconsinnurses.org. Contact [email protected]with questions. Join the Wisconsin APRN Coalition! The Coalition was formed to provide an efficient and effective method and process for assuring the passage of The APRN Modernization Act during the 2017-2018 Legislative Biennium. Join the Coalition for only $50 to support the passage of this important legislation! Learn more here. WNA leads development of Wisconsin APRN Coalition to advance passage of the APRN Modernization Act. The Wisconsin APRN Coalition consists of individual and organizational members supporting passage of the APRN Modernization Act during the 2017-18 Legislative Biennium using grassroots advocacy principles. Achieving passage of the legislation will take volunteers and financial resources that include lobbyist support, creation and distribution of informational materials, website design and maintenance, and a one-day APRN Lobby Day at the Capitol on October 12, 2017. More info on the event and membership. SAVE THE DATE(s)! Starting this September, WNA is hosting a variety of learning opportunities including webinars and conferences, culminating in the Annual Membership Assembly in Green Bay on October 21. Check back in the coming months for more details on those opportunities! Fall Learning Symposium Event Page Keep a look out for more WNA and ANA updates in the Monitor as well as on the website and social media
Nursing Practice, Education, and Research Updates Higher nurse workloads could mean lower hand hygiene compliance.Astudy,publishedintheJournalofHospitalInfection,examinedtheassociationbetweenhandhygienecomplianceandnurseworkloads.Researcherscorrelatedelectronicallymeasuredhandhygienecompliancedata(suchashand-rubactivities)withelectronicallydeterminedworkloaddata(suchasnursingtimeoutput/nursingtimeinput)ataSwitzerland-basedhospital.Theresearchteamalsocalculatedhanddisinfectantuseusingspendingrecordsforoneyear.Readmore.
ANA Seeks Comment on Gender Diversity Draft.TheAmericanNursesAssociationwantspubliccommentonitsproposedpositionstatementNursingAdvocacyforGenderDiversePopulations.ANAis"committedtotheeliminationofhealthdisparitiesanddiscriminationbasedonsexualorientation,genderidentityorexpressionwithinhealthcaresettings,"andinvitesthepublic'scommentsonitsdraft.Deadline:5p.m.ETonSeptember15.Readthestatement.
Understand Unconscious Bias to Promote Health Equity.It'simportantforeveryone,includingandespeciallynurses,tounderstandtheconceptofunconsciousbias.Inafollow-uptoherwebinaronthetopic,CampaigndiversityadviserKupiriAckerman-Barger,PhD,RN,writesaboutthese"beliefs...thatresideoutsideofourawareness,"andhowsuchbeliefscanaffecthealthcareprovidersandthosetheycarefor.Readmore.
NCHWA releases nursing workforce projections and program highlights.TheNationalCenterforHealthWorkforceAnalysis(NCHWA)releasedsupplyanddemandprojectionsforRNs,andlicensedpractical/vocationalnurses(LPNs)in2030.Accordingtothestudy,theU.S.isexpectedtohaveaninequitabledistributionofRNsandLPNsacrossstates.Specifically,sevenstatesareprojectedtohaveashortageofRNsandthirty-threestatesareexpectedtoexperienceashortageofLPNs.NCHWAalsoreleasedaseriesofProgramHighlightsforacademicyear2015-2016,whichsummarizethecharacteristicsandaccomplishmentsoftheBureauofHealthWorkforceprogramsandtheirtrainees.TheSupplyandDemandProjectionsoftheNursingWorkforce:2014-2030reportandtheProgramHighlightsarebothavailableonNCHWA’swebsite.Readmore.
Establishing Clinician Well-Being as a National Priority Burnout Among Health Care Professionals: ACalltoExploreandAddressThisUnderrecognizedThreattoSafe,High-QualityCare.TheUShealthcaresystemisrapidlychanginginanefforttodeliverbettercare,improvehealth,andlowercostswhileprovidingcareforanagingpopulationwithhighratesofchronicdiseaseandco-morbidities.Amongthechangesaffectingclinicalpracticearenewpaymentanddeliveryapproaches,electronichealthrecords,patientportals,andpubliclyreportedqualitymetrics—allofwhichchangethelandscapeofhowcareisprovided,documented,andreimbursed. Readmore.
3 nurses exposed to fentanyl after treating overdose patient at Ohio hospital. ThreenursesatMassillon,Ohio-basedAffinityMedicalCenterfellillandlostconsciousnessaftertreatinganoverdosepatient.Investigatorsbelievethenurseswereexposedtofentanylwhencleaningthepatient'sroom.Thenursesweresuccessfullytreatedwiththeopioidoverdosedrugnaloxone.Fentanylis50to100timesmorepotentthanmorphine.Thedrugissopowerful,individualscanoverdosebysimplytouchingresidualamountsofthesubstance.Readmore.
Are physicians, nurses obligated to protect patients during an active shooter event? Patientsandhospitalstaffhavedifferentperceptionsabouttheriskofactiveshootereventsinhospitals,accordingtoarecentsurveyconductedbytheHartfordConsensus,whichispartofanAmericanCollegeofSurgeons-ledcommitteeformedtoimprovesurvivabilityfrommasscasualtyevents.Learnmore.
Federal Health Policy Updates SAMHSA reports 39% increase in opioid treatment programs since 2003.Thenumberoffederally-approvedopioidtreatmentprograms,whicharequalifiedtodispensemethadoneandbuprenorphineforopioidusedisorders,increased39%between2003and2016,accordingtoanewreportbytheSubstanceAbuseandMentalHealthServices
President signs FDA Reauthorization Act(H.R.2430).ThebillreauthorizesandamendsfourFDAuserfeeprogramsunderwhichcompaniesthatdevelopdrugsandmedicaldevicespartiallypayforpremarketreviewoftheirproducts.Thebillalsoincludesprovisionsintendedtoimprovegenericdrugdevelopmentandhelplowerprescriptiondrugcosts;improvethemedicaldeviceinspectionprocess;andimprovecommunicationaboutabuse-deterrentopioidproducts,amongotherchanges.Learnmore.
CMS proposed rule would cancel three bundled payment models. Theproposedrulewouldcancelthecardiacandsurgicalhipandfemurfracturetreatmentmandatorybundlingpaymentprograms,knownastheepisodepaymentmodels.Italsowouldcancelthecardiacrehabilitationincentivepaymentmodel.TheseprogramshadbeenscheduledtobeginJan.1,2018.TherulealsoproposestorevisecertainaspectsoftheComprehensiveCareforJointReplacementmodel,includingbygivingcertainhospitalsselectedforparticipationintheCJRmodelaone-timeoptiontochoosewhethertocontinuetheirparticipationinthemodel.Learnmore.
Senate health and human services committee holds hearing on expanding EpiPen to individuals.Thelegislationallowingpeoplewithpropertrainingtoadministerdevicesthatcounteractsevereallergicreactionsinemergencies.Thebillwouldallowtrainedindividualstoacquire,maintain,andadministerepinephrineauto-injectorstosomeonetheybelieveisexperiencinganaphylaxis,asevereandpotentiallydeadlyallergicreaction.ItpassedtheAssemblyearlierthisyear.Whilethosewithallergiesoftencarryanepinephrineauto-injector,somepeoplemaynotrealizetheyhaveanallergytoabeestingorothertrigger.WNAhasregisteredinfavorofSB209andAB96.
OCI's approach to cost-sharing reduction payments echoes other states.WisconsinistakingasimilarapproachasotherstateswhenitcomestodealingwiththeuncertaintyoffutureObamacarepaymentstoinsurersthatreduceout-of-pocketcostsforlow-incomeconsumers.Theadministrationalsoplanstomakechangestoitsriskadjustmentmethodologyforstateswherecompaniesincreaseratestoaccountfornotreceivingcost-sharingreductionpayments,whichreduceco-paysanddeductiblesforconsumersmakingbetween100and250percentofthefederalpovertylevel.ThatcouldaffectWisconsin,wheretheOfficeoftheCommissionerofInsurancehasrequestedthatcompaniesfiletheirratesassumingtheywon'treceivethepayments.
Wisconsin hospitals dinged for high readmission rates.Medicarewillpenalize51Wisconsinhospitalsintheupcomingfederalfiscalyearforhavingmoredischargedpatientsreadmittedthanexpectedwithinamonth,accordingtoarecentdataanalysis.About77%ofthe66WisconsinhospitalsthatarepartoftheHospitalReadmissionsReductionProgramwillfacepenaltiesstartingOct.1.TheMedicarereimbursementcutsrangefrom0.02%to2.93%,accordingtodatacrunchedbyKaiserHealthNews.MedicareReadmissionsByState(.csv)
Wisconsin Health Care Best in the Nation.Wisconsinranks#1amongallstatesbasedonquality.Forthesecondtimeinamonth,Wisconsinhealthcarereceivestophonors.TheAHRQqualitymeasuresarecomparedtoachievablebenchmarks,whicharederivedfromthetop-performingstates.AHRQmeasureshealthcarequalityinthreedifferentcontexts:bytypesofcare(suchaspreventive,acute,orchroniccare),bysettingsofcare(suchashospitals,nursinghomes,homehealthorhospice),andcarebyclinicalarea(suchascareforpatientswithcancerorrespiratorydiseases).Theyalsoreportmeasuresbyraceandethnicity.WhileWisconsinshowsstrongoverallperformanceinmostareasof
Wisconsin insurers post profitable first quarter. Asuncertaintycontinuestoroiltheindividualmarket,mostWisconsininsurersboostedtheirprofitsduringthefirstquarterof2017,accordingtoaWisconsinHealthNewsanalysisoffilingswiththeOfficeoftheCommissionerofInsurance.DeanHealthPlan,GroupHealthCooperativeofSouthCentralWisconsin,NetworkHealth,UnityHealthInsurance,WEATrust,WisconsinPhysiciansServiceInsuranceandAriseHealthPlanwereintheblackafterlosingmoneyduringthefirstquarterof2016.SowasCommonGroundHealthcareCooperative,whichearned$2.7million,a6.1percentmargin,afterlosing$3.9millionduringthesameperiodlastyearand$36millionoverallin2016.
Patient Safety and Quality Opioid use, misuse, and overdose in women. TheHHSOfficeonWomen’sHealth(OWH)releasedtheFinalReport:OpioidUse,Misuse,andOverdoseinWomen.Thereportexaminesprevention,treatment,andrecoveryissuesforwomenwhomisuse,haveusedisorders,and/oroverdoseonopioids.Thisnewreportseekstoinformfurtherresearchonopioidsandwomen.Readthereport
40% of hospitalized patients could identify at least 1 breakdown in care, often about medications or clinician communication.Whenaskeddirectly,almost4outof10hospitalizedpatientsreportedabreakdownintheircare.Patient-perceivedbreakdownsincarearefrequentlyassociatedwithperceivedharm,illustratingtheimportanceofdetectingandaddressingtheseevents.Readtheabstract.
AHRQ Annual Report Shows More Americans Have Health Insurance and Receive Safer Care, but Gains Remain Uneven Among Minorities.AHRQ’s2016NationalHealthcareQualityandDisparitiesReportshowsthatthequalityofhealthcarecontinuestoimprovegraduallyeachyear,butgainsremainunevenamongminorities.Someofthebiggestimprovementsareinmeasuresof“person-centeredcare,”suchascommunicationbetweendoctorsandtheirpatients,andthesafetyofmedicalcare,suchasfewercomplicationsamonghospitalpatientswhoweretakinganticoagulantsotherthanwarfarin.Thereportalsoindicatesthatfewerpeoplewereuninsured,as11%ofpeopleunderage65wereuninsuredin2016comparedwith18%in2010.However,mostdisparitiesinhealthcarequalitycontinuedtopersist,withnosignificantimprovementsforanyracialorethnicgroups,especiallypeopleinpoor,low-incomeanduninsuredhouseholdsaswellasblacksandHispanics.Learnmore.
Association of changing hospital readmission rates with mortality rates after hospital discharge.Reducinghospitalreadmissionsisamajorpatientsafetypriority.TheCentersforMedicareandMedicaidServicespolicyofnonpaymentforreadmissionsforcertainconditionshasdecreasedtheirincidence.Learnmore.
AHRQ CAHPS Webcast Now Available: Introducing the CAHPS Cancer Care Survey.Thenewsurveymeasurespatients’experienceswithcancertreatmentinoutpatientandinpatientsettings.ThissurveywasdevelopedbytheAmericanInstitutesforResearchandtheMayoClinic,withfundingfromtheAHRQ,theNationalCancerInstitute,andtheCaliforniaHealthCareFoundation.Webcastspeakersdiscussedthepurposeofthesurvey,developmentandadministrationofthesurvey,andhowtoanalyzesurveyresults.IntroducingtheCAHPS®CancerCareSurvey
Antidepressant use up 65% over 15 years. AntidepressantusebyAmericansaged12andolderincreased65%between1999and2014,accordingtoareportreleasedtodaybytheCentersforDiseaseControlandPrevention.Nearly13%ofAmericansreportedtakingantidepressantsinthepreviousmonthwhensurveyedbetween2011and2014,upfrom7.7%between1999and2002.WhiteAmericansandfemalesweremorelikelytoreportantidepressantusethanmalesandpeopleinotherracialandethnicgroups.Oneinfourpeopletakingantidepressantsreportedusingthemfor10ormoreyears.ThefindingsarefromtheNationalHealthandNutritionExaminationSurvey.Viewthereport.
CDC issues national, state-level data on epilepsy.Anestimated1.2%ofAmericans,including3millionadultsand470,000children,hadactiveepilepsyin2015.That'supfrom2.3millionadultsin2010and450,000childrenin2007.Totalestimatesbystaterangedfrom5,900inWyomingto427,700inCalifornia.Abraindisorderleadingtorecurringseizures,epilepsy"posessubstantialindividualandsocietalburdensthatrequireheightenedpublichealthaction,"theauthorssaid."Asacomplexconditionvaryinginseverityandimpact,itaffectspersonsofallagesandracialandethnicgroups,especiallythosewiththelowestincomes."Viewthereport.
Google’s Machine Learning Looks to Improve Predictions in Health Care.Techgiantteamswiththreeuniversitiestoresearchitsabilitytopredictmedicalevents.ThesamemachinelearningtechnologyGoogleusestoanticipatethenextwordinasearchqueryisinteststoadvancepredictivemodelinginhealthcare,andthetechgiantisteamingupwiththreeuniversitiesthisyeartoresearchitsabilitytodoso.Readmore..
Columbia Study Shows Smoking on the Rise Among Pregnant Women with Depression.Morethanone-thirdofpregnantwomenwithdepressionsmokecigarettescomparedto1outof10pregnantwomenwithoutdepression.Learnmore.
National Adult Immunization and Influenza Summit (NAIIS) publishes white paper on lowering the burden of adult disease through vaccination. ThewhitepaperinBecker'sHospitalReviewistitled"LoweringtheBurdenofAdultDisease,OneShotataTime."Thispaperexaminesbarriershospitalsandhealthsystemsfacewhentryingtoincreaseadultimmunizationrates,aswellasopportunitiesforadvancements,suchasdatatransparencyandimmunizationmeasures.Toaccessthispaper,filloutthisshortform,andacopywillbeemailedtoyoutohelpyourhospitalorhealthsystemworktowardbetteradultimmunizationrates.
Opportunities Promoting transformation in care delivery –OnSeptember27,WCMEWwillsponsoraconference,“TheFutureLandscapeofWisconsin’sHealthCareWorkforce,”whereparticipantswillengageontopicsrangingfrompublicpolicytoproviderretentionandtrainingcliniciansforevolvingmodelsofcaredelivery.TheconferenceisdesignedtobringstakeholdersfromacrossWisconsin’sbusiness,government,educationalinstitutionsandnon-profitareastogethertorecognizetheurgentdemandforcreativeandcross-sectorsolutionstohealthcareworkforcechallenges.Registernow.
New AHRQ Publication Highlights Research on Improving Patient Safety and Reducing Medical Liability. Thepublication,entitledAdvancesinPatientSafetyandMedicalLiability,highlightstheresultsfromanumberofplanninganddemonstrationgrantsaimedatimprovingpatientsafetyandmalpracticeoutcomes,aswellastheenvironmentinwhichthoseoutcomesoccur.In2009,AHRQwasaskedbytheU.S.DepartmentofHealthandHumanServicestospearheadthePatientSafetyandMedicalLiabilityInitiative.Activitiesandfindingsfromtheinitiativehavelaidthegroundworkforfuturepatientsafetyandmedicalliabilityprojects.Amongtopicsincludedinthenewpublication:theroleofthepatientandfamilyinsupportingimprovedcareandpatientsafety;theharmfulimpactofinstitutionalsilencewhenpatientharmoccurs;theuseofdifferenttypesofreportingsystems;andimplementationofdisclosure,apologyandofferprograms.Viewthepublication.
Omega-3 Fatty Acids and Cardiovascular Disease.TheseAHRQpublicationscanhelpcliniciansandpatientslearnabouttheeffectsofomega-3fattyacidsonheartdisease.Omega-3FattyAcidsandCardiovascularDisease:CurrentStateoftheEvidencesuggeststhatinhealthypeople,dietaryintakeoffishoilmayhelplowertheriskofCVDdeathandstroke.Inpeoplealreadydiagnosedoratincreasedriskforheartdisease,evidenceshowedfishoilsupplementsdonotlowertheriskoflongertermheartproblems,suchasheartattackandheartfailure,anddeath.Thecompanionpublicationforpatients,Omega-3FattyAcidsandCardiovascularDisease–AReviewoftheResearchforAdultsmayhelpconsumerstalkaboutthebenefitsandrisksofomega-3fattyacids.Learnmore.
Understanding MIPS: Advancing Care Information (ACI).ACI,whichreplacestheMeaningfulUseprogramisoneoffourcomponentsCMSwillusetomakepaymentadjustmentsunderMIPS.ACIlooksatEHRuseasitrelatestopatientengagementandhealthcarequalityandis25%ofyourMIPSscorefor2017.DownloadthisinfographictolearnmoreaboutACIandanoverviewonscoring.Learnmore.
