July Uro-Gram.Qxd

Volume 31, Number 4 July 2003

Recognizing the Contributions of Associate Members SUNA is one of the ship. These members are not regis- • Are we meeting our associate few professional nurs- tered nurses, but they are equally members’ educational needs? ing organizations that important to the delivery of health • Would our associate members like welcome associate care to our patients. to be more involved in SUNA? members, and we are Teamwork is essential to optimize • How can our associate members proud of this! Years ago health care in today’s evolving world. become more involved in SUNA? when we changed our This work needs to be intradiscipli- • How can we increase associate name from the nary and interdisciplinary. To demon- membership? Donna Brassil American Urological strate the best in nursing care, team- • How can we better recognize our Association Allied work with competency and respect is associates’ contributions? (AUAA) to the Society of Urologic required. Teams see themselves as: These were just a few of the ques- Nurses and Associates (SUNA), it was ✓ having a sense of identity, tions that led us to approve the for- key for us to include our associate ✓ collaborating to achieve the best mation of a task force charged with members in our organizational title. outcome, examining these questions and any Today, our associates comprise ✓ working better and closer during other needs of our associate members. approximately 18% of our member- crisis or stress, By the time you read this, the associ- ✓ being proud of success, ate task force will have been formed ✓ supporting one another during based on a call for volunteers, and tough times, and they will be sharing their recommen- ✓ celebrating one another. dations with us in a few months. Many of us were LPNs, nurse’s This will be my farewell message Call for Abstracts for New aides, or medical technicians prior to to you as President of SUNA for the SUNA Symposium ...... 2 becoming registered nurses. This last 14 months. It has truly been an experience often provides the founda- honor and a privilege to serve in this SUNA Member tion for a nursing career. Being a part role. I am continually impressed to Honored by NAFC...... 3 of a successful team encouraged us to work with such a dedicated and pro- follow the career path. fessional Board of Directors and man- Regional News ...... 4 Assess. Plan. Implement. agement association, Anthony J. Evaluate. How many times have we Jannetti, Inc. Above all, I remain sin- Member Spotlight...... 5 used the nursing process for our cerely impressed with the expertise, patients? Many times, associate mem- dedication, and caring for our Bladder Health Coalition bers’ input into the nursing process patients that is exhibited by each Launched ...... 7 has led to the plan or contributed to SUNA member. I will be “overnight- the evaluation. Our associates have ing” the presidential torch to Marie Preparing for a talents and skills that make a differ- Page, RN, CURN, who will assume her Certification Exam...... 11 ence and contribute to quality health role with the SUNA BOD, beginning a 14-month leadership term, on August Changes in care delivery. At the SUNA Board of Directors 1, 2003. ANCC Criteria ...... 12 (BOD) meeting in March 2003, we Donna F. Brassil, MA, RN, CURN Welcome to discussed our associate member popu- SUNA President New SUNA Members . . . 14 lation. We asked the following questions: Calendar of Events . . . . . 15 Published bimonthly by SUNA under an educational grant from Web site: www.suna.org Pfizer Inc./US Pharmaceuticals Group Uro-Gram July 2003

For some of us the summer months are meant for relaxation. I invite you to take this issue of the Uro-Gram and a glass of iced SUNA Board of Directors tea to your favorite chair and President enjoy. Sally Russell has given us Donna F. Brassil, MA, RN, CURN the first installment in a series of articles on end-of- life care that is definitely worth reading. And make President-Elect sure you read about the new SUNA Annual Marie Page, RN, CURN Symposium focusing on Disorders of the Bladder, Immediate Past President Bowel, and Pelvic Floor, which is scheduled for Jean Lewis, BSN, RN, CNP March 18-20, 2004, in Chicago. Program Chair Evey Kliever Donna Thompson outlines an exciting list of topics Treasurer to be offered there. Anyone wanting to learn about continence, uro- Tamara Dickinson, RN, CURN, CCCN dynamics, or pelvic floor disorders won’t want to miss this event. This issue is also full of articles about our members and our successes Secretary as an organization. I hope you enjoy your summer and this issue of Jeffrey Albaugh, MS, APRN-BC, CUCNS the Uro-Gram. Evey Kliever, MA, RN, CRRN-A, CURN Northeast Regional Director Uro-Gram Editor Lisa Neu, BSN, RN, CRNP-BC [email protected] North Central Regional Call for Abstracts Director Lynn M. Fisher, BSN, RN, CURN for Oral and Poster Presentations

Southeast Regional Director Nancy McFadin Mueller, MA, MSN, RN, CURN

Western Regional Director Joyce Colling, PhD, RN, FAAN

Uro-Gram Editor • Research: qualitative and Evey Kliever MA, RN, CRRN-A, CURN quantitative studies • Challenging case studies SUNA National Office • Clinical approaches/Innovations in Executive Director practice Richard P. Grimes, MEd, CAE • Product evaluation • Continence services Director, Association Services • Urodynamic techniques Cheryl Underhill A statement of financial disclo- Membership Services sure and Ethical Board Approval Coordinator (for research studies) must be Pat Davey included. Abstracts for oral and poster pre- Uro-Gram Managing Editor sentations are invited for the Annual The deadline for submis- Kathleen Thomas Symposium focusing on Disorders sion of abstracts is November of the Bladder, Bowel, and Pelvic East Holly Avenue, Box 56 15, 2003. For instructions on Floor (including pelvic pain, sexual abstract submission contact: SUNA Pitman, NJ 08071-0056 dysfunction), which will be held 1-888-TAP-SUNA / 856-256-2335 National Office, East Holly Avenue, March 18-20, 2004, at the Hyatt Box 56, Pitman, NJ 08071-0056; fax: 856-589-7463 Regency Chicago in Chicago, IL. Web site: www.suna.org 888-TAP-SUNA or (856) 256-2335; email: [email protected] Abstracts may address the following fax (856) 589-7463; [email protected]; or related topics: www.suna.org.

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The Annual Symposium: Omeis Named Continence A New and Innovative Conference Care Champion We have done it! We have created the best forum for new The National Association For Continence (NAFC) Board of ideas and best practices for clinicians who treat patients with Directors recently named Betsy Nielsen Omeis, BSN, RN, as incontinence and bowel dysfunction. Arising from the Multi- NAFC’s 2003 Continence Care Champion among SUNA mem- Specialty Conference on Urinary Continence and the Fall bers. The announcement was made at SUNA’s 2003 Annual Institute, we have taken the best ideas of both and created The Conference in San Antonio in March. Annual Symposium, the focus of which is disorders of the bladder, bowel, and pelvic floor. The grand debut of this all- new conference will be at the Hyatt Regency Chicago on March 18-20, 2004. Each of the three major content tracks (bladder, bowel, and pelvic floor) will incorporate issues specific to special populations, such as children, women, men, elderly, and cultural- ly diverse populations. Consistent with our goal to make this the definitive educational conference for nurses and others involved in treating patients with these disorders, we have retained the most knowledgeable faculty available – individuals known for their ability to easily communicate the state-of- the-art approaches to evaluation and treatment. Some conference highlights include an opportunity to hear Janis Miller, PhD, RNC, talk about “The Wondrous Pelvic Floor;” Peter Sand, MD, and Karen Sasso, MSN, RN, discuss “Injectables for Intrinsic Sphincteric Deficiency;” Diane Smith, Betsy Omeis (right) accepts the 2003 Continence Care Champion MSN, CRNP, give an update on “Pelvic Organ Prolapse: Non- award from Dr. Toni P. Miles. Surgical Approaches;” and Mary Palmer, PhD, RN, share the challenges of treating “Incontinence in the Frail Elderly.” Toni P. Miles, MD, PhD, from the Department of Family Other topics on the schedule include “Physiotherapy of Pelvic Medicine at the University of Texas-Health Sciences Center, Pain Syndromes,” “Irritable Bowel Syndrome,” and “Complex the recipient of the NAFC award in 2001 at the American Cases: Perineal Electrical Stimulation.” This is just a small sam- Academy of Family Physicians (AAFP) Patient Educators ple of what this conference has to offer. Conference, presented the award to Ms. Omeis. The award is Keeping with the tradition of the Multi-Specialty based on a SUNA member’s contributions in the areas of Conference and the Fall Institute, “The Annual Symposium” research, education, and advances in clinical practice specifi- will have a full day of preconference workshops. For beginners cally in the field of incontinence. It is accompanied by an as well as those who need a comprehensive review, Marta unrestricted grant in the amount of $1,500 and is underwrit- Krissovich, MS, RN, NP, CNS, CCCN, will offer a workshop on ten by a grant to NAFC by Eli Lilly & Company. “Bladder Basics” and Dorothy Doughty, MN, RN, FNP, “Betsy has mentored colleagues in the pathophysiology of CWOCN, will present one on “Bowel Basics.” You won’t want urinary incontinence and the value of urodynamics while par- to miss the two sessions on urodynamic studies: “UDS Basics” ticipating in highly recognized research studies, still finding in the morning, and“Advanced UDS” presented by Pat time to promote good urinary health principles to her local O’Donnell, MD, in the afternoon. For those who need an community, “ says NAFC Executive Director Nancy Muller update on pelvic floor rehabilitation, there is a hands-on work- about the award recipient. “Betsy does it all, with aplomb.” shop for you. If you are starting your own practice, sign up for Ms. Omeis works at the University of Texas Health Science the workshop, “Setting Up a Continence Practice/Clinic,” Center San Antonio-Department of Surgery-Division of where you will have an opportunity to problem solve with Urology where she is the Urodynamics Coordinator. Over a people who have successfully started a practice or clinic. decade ago, she created the Urodynamics Center and Pelvic The planning committee consists of an impressive line-up Disorders Center and promoted the concept by leading tours of experts in the field of continence representing all sectors of and speaking publicly about the diagnostic techniques used to the country. They include: Carralee Sueppel, MSN, RN (imme- evaluate the process of emptying the bladder, or micturition. diate past chairperson); Katherine Moore, PhD, MS, RN; Karen Such procedures measure the lower urinary tract function to Sasso, MSN, RN; Peggy Hayn, MSN, CRNP; Besty Nielsen- aid the physician in selecting appropriate treatment options Omeis, BSN, RN; Judy Dutcher, MSN, APRN-BC, CWOCN; and for a patient suffering bladder control or other voiding dys- Cheryl LeCroy, BSN, RN. function difficulties. Beyond urinary incontinence, Ms. Omeis Watch SUNA’s Web site (www.suna.org) and the Uro- has educated peers about testing for interstitial cystitis, anorec- Gram for future announcements about the conference. Mark tal manometry used in cases of fecal incontinence, and behav- your calendar, and we will see you in Chicago! ioral therapy for enuretic pediatric patients. Donna L. Thompson, MSN, CRNP, CCCN “Betsy is deserving in every way of this honor, and I am Conference Chairperson pleased that NAFC can spotlight her professional accomplish- ments with this recognition,” commented SUNA President Donna Brassil, MA, RN, CURN.

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Southeast The Alamo Chapter will hold its 12th Annual Conference in Urology Nursing at the St. Anthony Hotel in San Antonio on October 25. You are invited to attend! The chapter has applied for 7.0 contact hours. Please email me at the address below for more information. The Rocky Mountain Chapter in Denver is also planning a day-long semi- Nancy nar in August. It will be held at the Northeast McFadin Mueller Inverness Golf and Country Club. For more information, contact President Sharon Bretz at 303-410- As we approach summer, a few pro- 9855 grams and chapter activities remain on Lil Hormozdi, president of the Florida Sunshine Chapter, the schedule, and new officers are prepar- reports another great project idea. In August the chapter will ing to begin their transition in several hold a membership drive luncheon targeting the neighboring chapters. I am eagerly looking forward to counties. The chapter’s fall seminar is also in the planning sharing with all of you the fall calendar of stages. Contact Lil at [email protected]. events as it becomes available. I want to introduce you to Carolyn North, who will be The New England Chapter held its assuming the position of Southeast Regional Director in spring conference in Worcester on May August. Carolyn has worked in the urology field since 1972 10. Election of officers was held at that Lisa Neu and has been an active SUNA member since 1982. Carolyn time. Congratulations to Jennifer Reimer, credits her husband Mike, two daughters, and two grandchil- newly elected president-elect, and to Allyson Bodell, who was dren as her strong and steady support throughout her success- elected as treasurer. Doreen Shore will continue her role as ful career. Her hobbies include gardening, walking, country mentor to the chapter’s board of directors. JoAnn Carlson is western dancing, and memory scrapbooking. newly retired from nursing to pursue her role as grandmother. It has been a tremendous honor serving as your regional We are happy for her but will miss her active role in the chap- director. Carolyn can look forward to working with a wonder- ter. The spring meeting was well attended by both members ful group of professionals in the Southeast Region! and industry. This chapter meets the first Tuesday of the month. Contact any of the officers for a schedule of activities. Nancy M. Mueller, MA, MSN, RN, CURN The Washington, DC Chapter held its election in early Southeast Regional Director April. GerrySue Young was elected as president, Susan Talebian [email protected] as vice president, Laila Bailey as secretary, and Marsha Weishaupt as treasurer. A schedule for this chapter was in the North Central works at the time of this submission, including a half-day sem- I am so pleased to have this column inar and the annual Christmas dinner. Contact any of the offi- available to report about the activities of cers for more information. the North Central Region. Once again, The Metropolitan Baltimore Chapter held a meeting on our members have had a very busy spring! June 4. The chapter will continue its full schedule of meetings The Southeast Nebraska Chapter held and spring program, resuming in September. Contact Kristen an evening educational program on April Burns or Nancy Shakelford for more information. This chapter 29 entitled “What PT Can Do For Female meets on the first Wednesday of the month. Urinary Incontinence.” The Mississippi The Central New York Chapter is planning its annual fall Valley Chapter held their annual spring program, which is scheduled for September 27. Contact Lynn Fisher seminar on April 5 in Little Amana, IA. Maureen Kiernan for more information. The program was entitled “A Continuum At the time of submission, dates and other information of Urology Care.” Topics covered the lifespan and included regarding fall programs were unavailable. Please feel free to urinary reflux in the pediatric patient and geriatric urologic contact your nearest chapter officer (this information can be nursing. found in the front of the SUNA membership directory), The Chicago Metro Chapter hosted a 2-day spring semi- Northeast Assistant Regional Director Susan Lipsy, or myself. nar on April 25-26. The program was held at the beautiful Together we can contribute to the growth of our chapters and Hamburger University in Oakbrook, IL. The title of the pro- encourage our members who give so much of themselves to gram was “Urologic Nursing – Chicago Style” and attracted provide programs and activities to our communities and pro- over 100 participants! The Upper Midwest Chapter held their fession. Have a safe and wonder-filled summer! annual “Spring Urology Seminar” in Rochester, MN, on April Lisa Neu, BS, RN, CRNP-BC 12. Topics included superficial bladder cancer, renal cell can- Northeast Regional Director cer, and localized prostate cancer. The all-day program also [email protected] included a session on a complementary therapy: “Music as a Healing Modality.”

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We can be proud of our region as we offer exceptional continuing education programs! Future programs in the region include: • Chicago Metro Chapter — July 16, 2003 (6:30-8:30 pm). Bladder Cancer Dinner Symposium. Location: Greek Town. Contact: [email protected] or 1-888-218-4365. • Southeast Nebraska Chapter — August program (in the planning stages). Contact: Mary Jo Bosworth, 402- Member 666-5546. Member I hope you all have a fun-filled, relaxing summer! Lynn M. Fisher, BSN, RN, CURN North Central Regional Director SpotlightSpotlight [email protected] This column has been created to recognize “behind-the- Western scenes” members of SUNA who contribute to the organization and urologic nursing at the grassroots level. If you I think everyone is getting into the know of a member whose service to SUNA deserves recog- summer mode. Sunny days are certainly nition and would like to highlight his/her contributions here! Since SUNA’s annual meeting, I in this column, please contact Uro-Gram Editor Evey have visited the Portland Chapter. They Kliever ([email protected]). held a dinner meeting with a speaker who presented an interesting talk on “Management of Urologic Problems in I am pleased to “spotlight” Mary Jo Bosworth of the Pregnancy.” On May 24 I visited the new Southeast Nebraska Chapter. Mary Jo joined SUNA in Arizona Chapter and enjoyed a luncheon 1981 and is one of the charter members of her chapter. Joyce Colling meeting featuring a dicussion of “Overactive Bladder Problems.” On June She is currently serving as the chapter president. Mary 19 I visited the Montana Chapter for their first dinner meet- Jo has been involved in urologic nursing for a major part ing, which included a distance learning connection. of her career. She is currently the outpatient surgery The three California chapters – Northern, Central, and manager at The Urology Center, PC, in Omaha, NE. In Southern – are all busy planning for next year’s programs. If this role she coordinates surgery scheduling, assists in you live in any of these areas and don’t get their materials for operating room cases, and provides direct patient care. meetings, contact the following: • Northern: Jan Dryden-Jensen Nine urologists practice at The Urology Center. Prior to ([email protected]) working at The Urology Center, Mary Jo worked at • Central: Kathryn Villarreal ([email protected]) Nebraska Methodist Hospital in med-surg (urology) and • Southern: Dawn Berthiaume (dawn.berthi- the operating room. She was the urology clinician in the [email protected]) operating room. Mary Jo is married and has two grown The Utah Chapter is busy with plans for the Western Regional Meeting to be held in Las Vegas on November 2-6. sons. They will be sending more details soon. The Yakima Valley Mary Jo has worked very hard over the last 2 years Chapter continues with their plans for a major spring meeting to rejuvenate and re-energize the Southeast Nebraska as well a membership drive. Chapter. Under her leadership, the chapter won the All of the chapters need the support and attendance of Most Improved Chapter of the Year Award at this year’s members at meetings. Officers work hard on your behalf to Annual Conference in San Antonio. To recognize her plan meaningful meetings. If you have suggestions for topics or would like to help with a meeting in your area, please con- efforts and dedication, two members of the Southeast tact me or the chapter president in your region. Nebraska Chapter nominated Mary Jo for the Regional I wish each of you a wonderful summer. Member of the Year award. As Regional Director, I have Joyce Colling, PhD, RN, FAAN enjoyed working with Mary Jo! She certainly deserves to Western Regional Director be in the spotlight! [email protected] Lynn M. Fisher, BSN, RN, CURN North Central Regional Director

5 Uro-Gram July 2003 SUNA Represented at End-of-Life Nursing Education Consortium

Nurses spend more time with • Communication, patients who are facing the end of life • Grief, Loss, and Bereavement, than any other member of the health care • Achieving Quality Care at the End-of-Life, and team. Yet studies have shown that many • Preparation and Care for the Time of Death. nurses feel inadequately prepared to pro- Common threads are that: the family is a unit of care; the vide the comprehensive care so impor- nurse has an important role as an advocate for that family tant at the end of life. unit; cultural considerations are important; and there are pop- I had the privilege of representing ulations who must receive special attention as they have been SUNA and three other specialty nursing ignored previously. These populations, such as children, the Sally Russell organizations (Academy of Medical- elderly, the poor, and the uninsured, are seen but not always Surgical Nurses, American Association of considered when planning care for the time surrounding Ambulatory Care Nursing, and Dermatology Nurses’ death. Other threads include financial issues that influence Association) at a 3-day training program in Pasadena, CA, in care and that end-of-life care is not just confined to cancer or January. This program was designed to provide nursing con- to AIDS but is essential across all life. Overriding all these tinuing education providers with information on end-of-life threads is the need for interdisciplinary care, which is essential care and resources to use in integrating end-of-life content in order for quality care to be provided to clients. into continuing education activities. Conducted by a distin- Participants who complete a national ELNEC course spon- guished faculty of researchers, educators, authors, and leaders sored by AACN/City of Hope or Last Acts are considered in the field of palliative care, the entire activity was meaning- ELNEC Trainers and, as such, are considered qualified to teach ful and very moving. ELNEC content to others. For a list of those who have attained From 1997 to 2000, researchers at the City of Hope this certification, visit the ELNEC Web site at National Medical Center in Los Angeles, CA, conducted a pro- www.aacn.nche.edu/elnec. There are other regional train- ject entitled, “Strengthening Nursing Education to Improve er courses held around the country, which are providing what End-of-Life Care.” The research conducted during this project, AACN calls “second generation” trainers, also qualified to which was supported by the Robert Wood Johnson teach end-of-life content to first line providers. Foundation, demonstrated major deficiencies, including lack In future issues of the newsletter, content from each of the of content in nursing texts in end-of-life care, minimal con- nine modules will be shared. Also, look for this content to be tent in nursing curriculum, and reported inadequacy of nurs- provided at our national meetings. The Board of Directors has ing faculty knowledge related to end-of-life content. identified this issue as one that is important to each of our At the same time, in 1997, the American Association of members and, as such, deserves to be included each time we Colleges of Nursing (AACN) hosted a roundtable to discuss have the opportunity to do so. Discussion among the task recommended competencies and guidelines for nursing edu- force, consisting of members of each of the organizations that cation and end-of-life care. Following this roundtable, AACN sponsored my attendance at this training program, is ongoing published a document entitled Peaceful Death: Recommended with the desire to use this information collaboratively in the Competencies and Curricular Guidelines for End-of-Life Nursing future. Care (AACN, 1997). This publication is recognized as a key to Sally S. Russell, MN, RN, BC describing the knowledge and skills needed by nurses to pro- Director of Education vide quality care as well as to providing an outline for inte- Reference grating this content into nursing curriculum. This project also American Association of Colleges of Nursing. (1997). Peaceful death: was funded by a grant from the Robert Wood Johnson Recommended competencies and curricular guidelines for end-of-life Foundation. nursing care. Washington, DC: Author. In 1999, AACN and City of Hope National Medical Center combined efforts to propose a national effort to create nursing education that would meet the recommendations of the “Peaceful Death” document. The activity that I attended was Attention: the culmination of that project – the End-of-Life Nursing Program Coordinators Education Consortium (ELNEC) – which has been repeated eight times. The newly revised Guidelines for Continuing Included in the ELNEC curriculum are nine modules Education Approval Manual is now available from the addressing critical aspects of end-of-life care. These modules SUNA National Office. Some of the criteria have include: changed from the previous edition based on • Nursing Care at the End-of-Life, changes implemented by the ANCC. If you are plan- • Pain Management, ning a meeting and wish to offer contact hours • Symptom Management, through SUNA’s Approver Unit, please request the • Ethical/Legal Issues, new manual by contacting the national office (1- • Cultural Considerations in End-of-Life Care, 888-827-7862, [email protected]).

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Huge Awards for Recruiting New SUNA Members!

e’re excited to offer awards with values of chapter whose members collectively produce the most up to $1,750 to SUNA members who new members over 50. “W recruit new members to the organiza- “This is the most comprehensive and aggressive tion,” says SUNA President Donna Brassil. This year, the membership campaign we’ve ever conducted,” said awards will be structured so that even someone who only SUNA President-Elect Marie Page. “We want 500 new recruits one member will be a winner! members by the end of the year, and we want each Awards are based on recruiting 1 new member, 2 or member to recruit at least one new member.” more, 5 or more, 10 or more, 20 or more, and finally, Visit www.suna.org and follow the links to the the Member Recruiter of the Year Award for the individ- “We’re Everything We Say We Are” Membership ual who recruits the most new members above 20. Also, Campaign to learn more. a special award of $2,500 will be provided to the SUNA

Bladder Health Coalition Launched Bladder Health It was my privilege to attend a breakfast to Coalition Members “kick off” the Coalition for Improved Bladder The Alliance for Aging Research Health in Washington, DC, on March 18, 2003. Spearheaded by the National Association For The American College of Obstetricians and Continence (NAFC), the breakfast meeting includ- Gynecologists ed the following speakers: Nancy Muller (NAFC The American Physical Therapy Association Executive Director); Wanda Jones, DrPH, Deputy Section on Women’s Health Assistant Secretary for Health, Office on Women’s The American Foundation for Urologic Health, U.S. Department of Health and Human Disease Cheryl LeCroy Services; Margo Langstaff (NAFC National Spokesperson); Cheryl Iglesia, MD (American The American Urogynecologic Association Urogynecologic Society); Leroy Nyberg, MD (Director of the National The American Urological Association Institute of Diabetes and Digestive and Kidney Diseases); and Monica Liebert, PhD (Associate Director of Research for the American The Association of Women’s Health, Urological Association). Obstetrics and Neonatal Nursing A very telling remark was made by Dr. Jones, who said she was hav- The International Foundation for Functional ing difficulty explaining to her own staff what incontinence was. If it Gastrointestinal Disorders took her 2 weeks to get her staff to begin to understand, how much longer would it take to raise awareness on Capitol Hill? Men’s Health Network The Coalition’s vision statement is as follows: The Bladder Health The National Association For Continence Coalition is a diverse collaborative group of more than 20 members ranging from national health care provider associations to patient advocacy organi- The National Association of Nurse zations, all of whom are dedicated to heightening awareness about bladder Practitioners in Women’s Health and related pelvic health to public officials, consumers, and the media. The National Institute of Diabetes and Digestive coalition works cooperatively towards legislative, public awareness, clinical and Kidney Diseases practice and outcomes research priorities with an overall purpose of improv- ing bladder and related pelvic health for all Americans. The National Multiple Sclerosis Society The breakfast meeting was very interesting and offered insight into The Simon Foundation for Continence the difficulties in raising awareness as well as the difficulties in garner- The Society for Female Urology and ing increased dollars for research. Follow-up meetings will be held in Urodynamics the future. An afternoon meeting was organized by Eli Lilly and Company to The Society for Women in Urology discuss what could be done in several areas regarding urinary inconti- The Society for Women’s Health Research nence. After a panel presentation by a nurse, a physician, a patient, and a statistician (from a recent NAFC poll), meeting participants broke The Society of Urologic Nurses and Associates into several small groups to create plans for increasing awareness and U.S. Department of Health and Human education (of both providers and consumers). Many great ideas were Services Office on Women’s Health generated and shared. The Wound, Ostomy, Continence Nurses Cheryl LeCroy, BSN, RN Society

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SUNA Corporate Members ACMI Corporation AmeriPath, Inc. Outpatient SIG Astra Tech, Inc. As the new Outpatient SIG leader, I would like to take this AstraZeneca opportunity to introduce myself. My name is Janelle Harris, Aventis Pasteur and I am a geriatric nurse practitioner for the San Francisco Veterans Administration. I have worked in urology for 12 Cook Urological, Inc. years. My career in urology started as a nursing assistant on a Dale Medical Products, Inc. urology unit at the University of Kansas and has brought me through every aspect of urology to my position today at a rural Duraline Medical Products, Inc. clinic providing urology services to veterans. Endocare, Inc. The Outpatient SIG met in San Antonio to discuss issues GYNECARE Worldwide, A Division of Ethicon, Inc. and ideas for the future. I would like to thank Sharla Lee for a Johnson & Johnson Company her service as the leader of this group over the last years. We appreciate the time and energy she devoted to the position! HDIS (Home Delivery Incontinent Supplies I would like to see the Outpatient SIG take on a project Company, Inc.) over the coming months. If you have ideas or thoughts on Hollister Incorporated something we could do as a group, please let me know. One idea that we discussed in San Antonio was the possibility of Humanicare International, Inc. working on training sheets for nurses and associates in the Karl Storz Endoscopy-America, Inc. clinic setting. It seemed to be a common problem that there is Laborie Medical significant turnover of staff in the urology clinic setting. It would be a service to our members to provide written training Life-Tech, Inc. sheets on common issues such as: Zoladex® insertion, Foley Lilly ICOS LLC catheter insertion and removal, etc. If you would like to be Medtronic Urology involved in this type of project or have other ideas that the Outpatient SIG could work on, please contact me Mentor Corporation ([email protected], 707-442-1391). I look forward Merck & Company, Inc. to serving SUNA in this capacity. Novartis Oncology Janelle Harris, NP Outpatient SIG Leader Olympus America, Inc. [email protected] Organon, Inc. Ortho-McNeil Pharmaceutical, Inc. PCI medical inc. Grants Available for Polycystic Pfizer, Inc. Kidney Disease Research Procter & Gamble Pharmaceuticals The Prometheus Group The Polycystic Kidney Disease Foundation is currently accepting applications for 1- or 2-year grants for basic or clin- Rochester Medical Corporation ical research for research on autosomal dominant polycystic Sanofi-Synthelabo Inc. kidney disease (ADPKD) and or autosomal recessive polycystic TAP Pharmaceutical Products, Inc. kidney disease (ARPKD). An extension for a third year is possible. The $65,000 grants will be awarded in December 2003. Thought Technology Ltd. Fellowship awards of $50,000 also are available and will be Tyco Healthcare / Kendall awarded in July 2004. Complete application and guideline UroMed, Inc. information is available online at www.pkdcure.org or by contacting Karla Bredehoeft at the Polycystic Kidney Disease VIVUS, Inc. Foundation at 800-753-2873. Applications are due on or Watson Pharma, Inc. before August 1, 2003. Yamanouchi Pharma America, Inc.

8 20 million men 600,000 prescribing physicians 130 clinical trials

It’s amazing how much a pill can accomplish in 5 years.1

After 5 years, our proven efficacy and safety profile speaks for itself.2 The same holds true for our experience. VIAGRA is proven for erectile dysfunction (ED) in men with a broad range of comorbid conditions—hypertension, hyperlipidemia, diabetes, depression, BPH, and men who have undergone prostate surgery.1,3

PROVEN To learn more, call 1-888-4VIAGRA. Or visit www.viagraMD.com.

The use of VIAGRA and organic nitrates in any form, at any time, is contraindicated. Before treating ED, physicians should consider the impact of resuming sexual activity and the mild and transient vasodilatory effects of VIAGRA on blood pressure. Physicians should carefully consider whether patients with underlying cardiovascular disease or other more unusual conditions could be adversely affected by vasodilatory effects, especially in combination with sexual activity. The most common side effects of VIAGRA were headache (16%), flushing (10%), and dyspepsia (7%). Adverse events, including visual effects (3%), were generally transient and mild to moderate. Please see references and brief summary of prescribing information for VIAGRA (25-mg, 50-mg, 100-mg) tablets on adjacent page. References: 1. Data on file. Pfizer Inc., New York, NY. 2. Padma-Nathan H, Eardley I, Kloner RA, Laties AM, Montorsi F. A 4-year update on the safety of sildenafil citrate (Viagra®). Urology. 2002;60(suppl 2b):67-90. 3. Carson CC, Burnett AL, Levine LA, Nehra A. The efficacy of sildenafil citrate (Viagra®) in clinical populations: an update. Urology. 2002;60(suppl 2b):12-27. Brief summary of prescribing information N-desmethyl sildenafil, was increased 62% by loop and potassium-sparing diuretics and 102% by nonspecific beta-blockers. These effects on the metabolite are not expected to be of clinical consequence. Effects of VIAGRA on Other Drugs In vitro studies: Sildenafil is a weak inhibitor of the cytochrome P450 isoforms 1A2, 2C9, 2C19, 2D6, 2E1 and 3A4 (IC50 >150 µM). Given sildenafil peak plasma concentrations of approximately 1 µM after recommended doses, it is unlikely that VIAGRA will alter the clearance of substrates of these isoenzymes. INDICATION AND USAGE In vivo studies: When VIAGRA 100 mg oral was coadministered with amlodipine, 5 mg or 10 mg oral, to hypertensive patients, VIAGRA is indicated for the treatment of erectile dysfunction. the mean additional reduction on supine blood pressure was 8 mmHg systolic and 7 mmHg diastolic. CONTRAINDICATIONS No significant interactions were shown with tolbutamide (250 mg) or warfarin (40 mg), both of which are metabolized by Consistent with its known effects on the nitric oxide/cGMP pathway (see CLINICAL PHARMACOLOGY), VIAGRA CYP2C9. was shown to potentiate the hypotensive effects of nitrates, and its administration to patients who are using VIAGRA (50 mg) did not potentiate the increase in bleeding time caused by aspirin (150 mg). organic nitrates, either regularly and/or intermittently, in any form is therefore contraindicated. VIAGRA (50 mg) did not potentiate the hypotensive effect of alcohol in healthy volunteers with mean maximum blood alcohol After patients have taken VIAGRA, it is unknown when nitrates, if necessary, can be safely administered. Based on the levels of 0.08%. pharmacokinetic profile of a single 100 mg oral dose given to healthy normal volunteers, the plasma levels of sildenafil at 24 In a study of healthy male volunteers, sildenafil (100 mg) did not affect the steady state pharmacokinetics of the HIV protease hours post dose are approximately 2 ng/mL (compared to peak plasma levels of approximately 440 ng/mL) (see CLINICAL inhibitors, saquinavir and ritonavir, both of which are CYP3A4 substrates. PHARMACOLOGY: Pharmacokinetics and Metabolism). In the following patients: age >65, hepatic impairment (e.g., cir- Carcinogenesis, Mutagenesis, Impairment of Fertility rhosis), severe renal impairment (e.g., creatinine clearance <30 mL/min), and concomitant use of potent cytochrome P450 Sildenafil was not carcinogenic when administered to rats for 24 months at a dose resulting in total systemic drug exposure 3A4 inhibitors (erythromycin), plasma levels of sildenafil at 24 hours post dose have been found to be 3 to 8 times higher (AUCs) for unbound sildenafil and its major metabolite of 29- and 42-times, for male and female rats, respectively, the exposures than those seen in healthy volunteers. Although plasma levels of sildenafil at 24 hours post dose are much lower than at peak observed in human males given the Maximum Recommended Human Dose (MRHD) of 100 mg. Sildenafil was not carcinogenic concentration, it is unknown whether nitrates can be safely coadministered at this time point. when administered to mice for 18-21 months at dosages up to the Maximum Tolerated Dose (MTD) of VIAGRA is contraindicated in patients with a known hypersensitivity to any component of the tablet. 10 mg/kg/day, approximately 0.6 times the MRHD on a mg/m2 basis. WARNINGS Sildenafil was negative in in vitro bacterial and Chinese hamster ovary cell assays to detect mutagenicity, and in vitro human There is a potential for cardiac risk of sexual activity in patients with preexisting cardiovascular disease. Therefore, treat- lymphocytes and in vivo mouse micronucleus assays to detect clastogenicity. ments for erectile dysfunction, including VIAGRA, should not be generally used in men for whom sexual activity is inadvis- There was no impairment of fertility in rats given sildenafil up to 60 mg/kg/day for 36 days to females and 102 days to males, able because of their underlying cardiovascular status. a dose producing an AUC value of more than 25 times the human male AUC. VIAGRA has systemic vasodilatory properties that resulted in transient decreases in supine blood pressure in healthy vol- There was no effect on sperm motility or morphology after single 100 mg oral doses of VIAGRA in healthy volunteers. unteers (mean maximum decrease of 8.4/5.5 mmHg), (see CLINICAL PHARMACOLOGY: Pharmacodynamics). While this Pregnancy, Nursing Mothers and Pediatric Use normally would be expected to be of little consequence in most patients, prior to prescribing VIAGRA, physicians should VIAGRA is not indicated for use in newborns, children, or women. carefully consider whether their patients with underlying cardiovascular disease could be affected adversely by such vasodila- Pregnancy Category B. No evidence of teratogenicity, embryotoxicity or fetotoxicity was observed in rats and rabbits which tory effects, especially in combination with sexual activity. received up to 200 mg/kg/day during organogenesis. These doses represent, respectively, about 20 and 40 times the MRHD on Patients with the following underlying conditions can be particularly sensitive to the actions of vasodilators including VIA- a mg/m2 basis in a 50 kg subject. In the rat pre- and postnatal development study, the no observed adverse effect dose was 30 GRA – those with left ventricular outflow obstruction (e.g. aortic stenosis, idiopathic hypertrophic subaortic stenosis) and mg/kg/day given for 36 days. In the nonpregnant rat the AUC at this dose was about 20 times human AUC. There are no ade- those with severely impaired autonomic control of blood pressure. quate and well-controlled studies of sildenafil in pregnant women. There is no controlled clinical data on the safety or efficacy of VIAGRA in the following groups; if prescribed, this should Geriatric Use: Healthy elderly volunteers (65 years or over) had a reduced clearance of sildenafil (see CLINICAL PHARMACOL- be done with caution. OGY: Pharmacokinetics in Special Populations). Since higher plasma levels may increase both the efficacy and incidence of • Patients who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months; adverse events, a starting dose of 25 mg should be considered (see DOSAGE AND ADMINISTRATION). • Patients with resting hypotension (BP <90/50) or hypertension (BP >170/110); ADVERSE REACTIONS • Patients with cardiac failure or coronary artery disease causing unstable angina; PRE-MARKETING EXPERIENCE: • Patients with retinitis pigmentosa (a minority of these patients have genetic disorders of retinal phosphodiesterases). VIAGRA was administered to over 3700 patients (aged 19-87 years) during clinical trials worldwide. Over 550 patients were treat- Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours in duration) have been ed for longer than one year. reported infrequently since market approval of VIAGRA. In the event of an erection that persists longer than 4 hours, the In placebo-controlled clinical studies, the discontinuation rate due to adverse events for VIAGRA (2.5%) was not significantly patient should seek immediate medical assistance. If priapism is not treated immediately, penile tissue damage and perma- different from placebo (2.3%). The adverse events were generally transient and mild to moderate in nature. nent loss of potency could result. In trials of all designs, adverse events reported by patients receiving VIAGRA were generally similar. In fixed-dose studies, the The concomitant administration of the protease inhibitor ritonavir substantially increases serum concentrations of silde- incidence of some adverse events increased with dose. The nature of the adverse events in flexible-dose studies, which more nafil (11-fold increase in AUC). If VIAGRA is prescribed to patients taking ritonavir, caution should be used. Data from sub- closely reflect the recommended dosage regimen, was similar to that for fixed-dose studies. jects exposed to high systemic levels of sildenafil are limited. Visual disturbances occurred more commonly at higher levels When VIAGRA was taken as recommended (on an as-needed basis) in flexible-dose, placebo-controlled clinical trials, the fol- of sildenafil exposure. Decreased blood pressure, syncope, and prolonged erection were reported in some healthy volunteers lowing adverse events were reported: exposed to high doses of sildenafil (200-800 mg). To decrease the chance of adverse events in patients taking ritonavir, a TABLE 2. ADVERSE EVENTS REPORTED BY ≥2% OF PATIENTS TREATED WITH VIAGRA AND MORE FREQUENT ON DRUG decrease in sildenafil dosage is recommended (see Drug Interactions, ADVERSE REACTIONS and DOSAGE AND ADMINIS- THAN PLACEBO IN PRN FLEXIBLE-DOSE PHASE II/III STUDIES TRATION). Adverse Event Percentage of Patients Reporting Event PRECAUTIONS VIAGRA PLACEBO General N=734 N=725 The evaluation of erectile dysfunction should include a determination of potential underlying causes and the identification of Headache 16% 4% appropriate treatment following a complete medical assessment. Flushing 10% 1% Before prescribing VIAGRA, it is important to note the following: Dyspepsia 7% 2% Patients on multiple antihypertensive medications were included in the pivotal clinical trials for VIAGRA. In a separate drug Nasal Congestion 4% 2% interaction study, when amlodipine, 5 mg or 10 mg, and VIAGRA, 100 mg were orally administered concomitantly to hyper- Urinary Tract Infection 3% 2% tensive patients mean additional blood pressure reduction of 8 mmHg systolic and 7 mmHg diastolic were noted (see Drug Abnormal Vision† 3% 0% Interactions). Diarrhea 3% 1% When the alpha blocker doxazosin (4 mg) and VIAGRA (25 mg) were administered simultaneously to patients with benign Dizziness 2% 1% prostatic hyperplasia (BPH), mean additional reductions of supine blood pressure of 7 mmHg systolic and 7 mmHg diastolic Rash 2% 1% were observed. When higher doses of VIAGRA and doxazosin (4 mg) were administered simultaneously, there were infre- †Abnormal Vision: Mild and transient, predominantly color tinge to vision, but also increased sensitivity to light or blurred vision. quent reports of patients who experienced symptomatic postural hypotension within 1 to 4 hours of dosing. Simultaneous In these studies, only one patient discontinued due to abnormal vision. administration of VIAGRA to patients taking alpha-blocker therapy may lead to symptomatic hypotension in some patients. Other adverse reactions occurred at a rate of >2%, but equally common on placebo: respiratory tract infection, back pain, flu syn- Therefore, VIAGRA doses above 25 mg should not be taken within 4 hours of taking an alpha-blocker. drome, and arthralgia. The safety of VIAGRA is unknown in patients with bleeding disorders and patients with active peptic ulceration. In fixed-dose studies, dyspepsia (17%) and abnormal vision (11%) were more common at 100 mg than at lower doses. At VIAGRA should be used with caution in patients with anatomical deformation of the penis (such as angulation, cavernos- doses above the recommended dose range, adverse events were similar to those detailed above but generally were reported more al fibrosis or Peyronie’s disease), or in patients who have conditions which may predispose them to priapism (such as sick- frequently. le cell anemia, multiple myeloma, or leukemia). The following events occurred in <2% of patients in controlled clinical trials; a causal relationship to VIAGRA is uncertain. The safety and efficacy of combinations of VIAGRA with other treatments for erectile dysfunction have not been studied. Reported events include those with a plausible relation to drug use; omitted are minor events and reports too imprecise to be Therefore, the use of such combinations is not recommended. meaningful: In humans, VIAGRA has no effect on bleeding time when taken alone or with aspirin. In vitro studies with human platelets Body as a whole: face edema, photosensitivity reaction, shock, asthenia, pain, chills, accidental fall, abdominal pain, allergic indicate that sildenafil potentiates the antiaggregatory effect of sodium nitroprusside (a nitric oxide donor). The combination reaction, chest pain, accidental injury. of heparin and VIAGRA had an additive effect on bleeding time in the anesthetized rabbit, but this interaction has not been Cardiovascular: angina pectoris, AV block, migraine, syncope, tachycardia, palpitation, hypotension, postural hypotension, studied in humans. myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, cardiomyopathy. Information for Patients Digestive: vomiting, glossitis, colitis, dysphagia, gastritis, gastroenteritis, esophagitis, stomatitis, dry mouth, liver function Physicians should discuss with patients the contraindication of VIAGRA with regular and/or intermittent use of organic tests abnormal, rectal hemorrhage, gingivitis. nitrates. Hemic and Lymphatic: anemia and leukopenia. Physicians should discuss with patients the potential cardiac risk of sexual activity in patients with preexisting cardiovas- Metabolic and Nutritional: thirst, edema, gout, unstable diabetes, hyperglycemia, peripheral edema, hyperuricemia, hypo- cular risk factors. Patients who experience symptoms (e.g., angina pectoris, dizziness, nausea) upon initiation of sexual activ- glycemic reaction, hypernatremia. ity should be advised to refrain from further activity and should discuss the episode with their physician. Musculoskeletal: arthritis, arthrosis, myalgia, tendon rupture, tenosynovitis, bone pain, myasthenia, synovitis. Physicians should warn patients that prolonged erections greater than 4 hours and priapism (painful erections greater Nervous: ataxia, hypertonia, neuralgia, neuropathy, paresthesia, tremor, vertigo, depression, insomnia, somnolence, abnormal than 6 hours in duration) have been reported infrequently since market approval of VIAGRA. In the event of an erection that dreams, reflexes decreased, hypesthesia. persists longer than 4 hours, the patient should seek immediate medical assistance. If priapism is not treated immediately, Respiratory: asthma, dyspnea, laryngitis, pharyngitis, sinusitis, bronchitis, sputum increased, cough increased. penile tissue damage and permanent loss of potency may result. Skin and Appendages: urticaria, herpes simplex, pruritus, sweating, skin ulcer, contact dermatitis, exfoliative dermatitis. Physicians should advise patients that simultaneous administration of VIAGRA doses above 25 mg and an alpha-blocker Special Senses: mydriasis, conjunctivitis, photophobia, tinnitus, eye pain, deafness, ear pain, eye hemorrhage, cataract, dry may lead to symptomatic hypotension in some patients. Therefore, VIAGRA doses above 25 mg should not be taken within eyes. four hours of taking an alpha-blocker. Urogenital: cystitis, nocturia, urinary frequency, breast enlargement, urinary incontinence, abnormal ejaculation, genital edema The use of VIAGRA offers no protection against sexually transmitted diseases. Counseling of patients about the protective and anorgasmia. measures necessary to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV), POST-MARKETING EXPERIENCE: may be considered. Cardiovascular and cerebrovascular Drug Interactions Serious cardiovascular, cerebrovascular, and vascular events, including myocardial infarction, sudden cardiac death, ventricular Effects of Other Drugs on VIAGRA arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, hypertension, subarachnoid and intracerebral hemorrhages, In vitro studies: Sildenafil metabolism is principally mediated by the cytochrome P450 (CYP) isoforms 3A4 (major route) and pulmonary hemorrhage have been reported post-marketing in temporal association with the use of VIAGRA. Most, but not and 2C9 (minor route). Therefore, inhibitors of these isoenzymes may reduce sildenafil clearance. all, of these patients had preexisting cardiovascular risk factors. Many of these events were reported to occur during or shortly In vivo studies: Cimetidine (800 mg), a nonspecific CYP inhibitor, caused a 56% increase in plasma sildenafil concentrations after sexual activity, and a few were reported to occur shortly after the use of VIAGRA without sexual activity. Others were report- when coadministered with VIAGRA (50 mg) to healthy volunteers. ed to have occurred hours to days after the use of VIAGRA and sexual activity. It is not possible to determine whether these events When a single 100 mg dose of VIAGRA was administered with erythromycin, a specific CYP3A4 inhibitor, at steady state are related directly to VIAGRA, to sexual activity, to the patient’s underlying cardiovascular disease, to a combination of these fac- (500 mg bid for 5 days), there was a 182% increase in sildenafil systemic exposure (AUC). In addition, in a study performed tors, or to other factors (see WARNINGS for further important cardiovascular information). in healthy male volunteers, coadministration of the HIV protease inhibitor saquinavir, also a CYP3A4 inhibitor, at steady state Other events (1200 mg tid) with VIAGRA (100 mg single dose) resulted in a 140% increase in sildenafil Cmax and a 210% increase in Other events reported post-marketing to have been observed in temporal association with VIAGRA and not listed in the pre-mar- sildenafil AUC. VIAGRA had no effect on saquinavir pharmacokinetics. Stronger CYP3A4 inhibitors such as ketoconazole or keting adverse reactions section above include: itraconazole would be expected to have still greater effects, and population data from patients in clinical trials did indicate a Nervous: seizure and anxiety. reduction in sildenafil clearance when it was coadministered with CYP3A4 inhibitors (such as ketoconazole, erythromycin, Urogenital: prolonged erection, priapism (see WARNINGS) and hematuria. or cimetidine) (see DOSAGE AND ADMINISTRATION). Special Senses: diplopia, temporary vision loss/decreased vision, ocular redness or bloodshot appearance, ocular burning, In another study in healthy male volunteers, coadministration with the HIV protease inhibitor ritonavir, which is a highly ocular swelling/pressure, increased intraocular pressure, retinal vascular disease or bleeding, vitreous detachment/traction, para- potent P450 inhibitor, at steady state (500 mg bid) with VIAGRA (100 mg single dose) resulted in a 300% (4-fold) increase macular edema and epistaxis. in sildenafil Cmax and a 1000% (11-fold) increase in sildenafil plasma AUC. At 24 hours the plasma levels of sildenafil were OVERDOSAGE still approximately 200 ng/mL, compared to approximately 5 ng/mL when sildenafil was dosed alone. This is consistent with In studies with healthy volunteers of single doses up to 800 mg, adverse events were similar to those seen at lower doses but ritonavir’s marked effects on a broad range of P450 substrates. VIAGRA had no effect on ritonavir pharmacokinetics (see incidence rates were increased. DOSAGE AND ADMINISTRATION). In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to acceler- Although the interaction between other protease inhibitors and sildenafil has not been studied, their concomitant use is ate clearance as sildenafil is highly bound to plasma proteins and it is not eliminated in the urine. expected to increase sildenafil levels. It can be expected that concomitant administration of CYP3A4 inducers, such as rifampin, will decrease plasma levels of Rev 8, September 2002 sildenafil. Single doses of antacid (magnesium hydroxide/aluminum hydroxide) did not affect the bioavailability of VIAGRA. Pharmacokinetic data from patients in clinical trials showed no effect on sildenafil pharmacokinetics of CYP2C9 inhibitors (such as tolbutamide, warfarin), CYP2D6 inhibitors (such as selective serotonin reuptake inhibitors, tricyclic anti- depressants), thiazide and related diuretics, ACE inhibitors, and calcium channel blockers. The AUC of the active metabolite,

4. The test itself is a multiple choice design with four options for answers. There is only one correct answer so choose the most correct answer. Read the questions carefully and all the answers before choosing. There are no trick questions. Answer all the questions as well as you can since there is no penalty for guessing. The exam is based on national standards of care, not regional. A 70% score is required to pass. Each level of exam is thor- CBUNA’s Examination Preparation oughly reviewed every 3 years. CBUNA and C-Net, our testing agency, is in the process of reviewing the regis- Guide: Your Blueprint to Success tered nurse exam for reliability, validity, and testing fair- You’ve made the decision to become certified. Good for ness. you, but now what do you do? The Certification Board for Certification is an achievable goal with the proper tools Urologic Nurses and Associates (CBUNA) is here to help. We and some pre-planning on your part. CBUNA is available to know the thought of studying for a certification exam can be assist you along the way. Visit our Web site a little overwhelming. But it is doable if you have a plan. (www.cbuna.org) or contact the CBUNA National Office Taking some time in the beginning to lay out your strategy can (856-256-2351) with questions or to request information. help pave the way for success. Working together, we can guide you on your successful quest Listed below are some key points about preparing for the for certification. certification exam and developing your strategy. Jan Giroux, MSN, CURN 1. Your most important first step is to request the CBUNA CBUNA President Examination Preparation Guide from the CBUNA National Office. CBUNA offers three exam prep guides for each level of the certification exam – registered nurse, associate, and advanced practice. The exam prep guide, for the fee of $20, provides an exam blueprint, exam content outline, suggested reading materials, sample questions, lists of drugs used to treat urinary tract diseases, common abbreviations, and a glossary of urologic terminol- ogy. As a reminder, while SUNA’s Urologic Nursing: A Study Guide is a wonderful resource and can be used as The Uro-Gram is an integral part of SUNA’s history. The adjunct study material, it does not follow the certifica- publication originally brought educational articles to the tion exam blueprint. For example, pediatric anomalies members. When it became evident, in 1980, that another and common neoplasms are part of the certification avenue was needed for these articles, the Urologic Nursing exam blueprint but are not covered in Urologic Nursing: A Journal was created. Study Guide. The certification exam blueprint lists the six For 31 years, SUNA members have consistently received major urologic categories that will be covered in the copies of the Uro-Gram. First, the newsletter was published exam and the percentage of examination questions for quarterly and later bimonthly. The Uro-Gram keeps the mem- that specific area. This is a “must have” resource if you bers informed by highlighting association activities, current are planning to sit for your board certification. Visit activities of the Board of Directors, annual reports, and educa- CBUNA’s Web site at www.cbuna.org to learn more tional conferences. about the exam and view the category/content areas and The first issue of the Uro-Gram was published in 1972 by test blueprint. SUNA’s first president, Russell Church. Through the years, a 2. Start early and develop a study plan. Many people, number of people have assumed the responsibility for ensur- including myself, committed to a 6-month prep time. ing the quality of content and on-time publication. Past edi- Review the CBUNA examination prep guide and exam tors include: blueprint and identify areas where you lack knowledge. • Russell Church, CURN (1972-1977) Devote extra study time for these areas. Remember, this • Patti Bates, CURN (1977-1979) is a comprehensive exam. • Janet D’Agostino, RN (1979-1980) 3. For studying purposes, look for selected comprehensive • Nina Bogle, CMAC (1980-1982) texts that meet your learning needs. A nursing text like • Agnes Yost, CURN (1982-1985) Karlowicz’s Urologic Nursing: Principles and Practice, a • David Chaussard, CURN (1985-1987) medical text like Smith’s General Urology, and a lab and • Paula Smith, RN (1987-1992) drug book are some examples. Use the CBUNA suggest- • Marie Wilson, RN, CURN and Glenda Wilkinson, BS, ed reading list as a guide for additional references. RN, CURN, CRLS (1992-2000) Another way to study and practice taking test ques- • Glenda Wilkinson, BS, RN, CURN, CRLS (2000-2001) tions is to utilize the “Getting Ready for Certification” • Evelyn Kliever, MA, RN, CRRN-A, CURN (2001-pre- column in Urologic Nursing. Each issue has several prac- sent) tice questions on various topics, and the answers are pro- We acknowledge their contributions to our membership vided. CBUNA is currently investigating batching ques- with this tribute to their dedication. tions from “Getting Ready for Certification” from past Ardeth S. Hale, CURN(Ret) issues of Urologic Nursing into a CD-ROM to assist in History Committee Chairperson studying for the exam. We will keep you posted! 11 Uro-Gram July 2003 Review of Recent Additions to ANCC Criteria

he American Nurses’ Credentialing Center’s the firm managing the retirement fund acquired it, not the Commission on Accreditation (ANCC-COA), individual him/herself. Vested interest forms should be T through which SUNA receives accreditation to pro- received from speakers in order to determine that “all con- vide and approve activities, engages in a continual quality tinuing education activities are free of bias,” or so that par- improvement process in an effort to make their criteria ticipants know about a speaker’s potential bias and can more appropriate to adult continuing education as well as decide for themselves whether it exists in the presentation. more user-friendly. The revisions occur approximately ANCC states that “all presenters must declare any vested every 2 years, and the most recent ones were to be fully interests” so it is the planning committee who will need to implemented as of February 2003. The revisions included determine whether to have all speakers sign this form, or some significant changes and additions. only those who state they have a vested interest. The most significant revision was a change in the “def- A requirement that has been refined is the one address- inition” of continuing education activities. The previous ing commercial support. There has for some time been a definitions — ED I (which applied to activities that were requirement that commercial support be disclosed to par- instructor driven – or were real-time activities) and ED II ticipants. This is now stated by ANCC as follows: (which applied to learner driven activities – such as inde- In the event that any form of commercial sup- pendent studies) — are no longer used. ANCC-COA deter- port is provided for an education activity, the mined that nursing continuing education activities were provider will maintain control of the educational all based on adult education principles, so there shouldn’t content and disclose to the learners all financial rela- be such a delineation of how that activity takes place. It tionships, or lack of, between the commercial sup- also was becoming more difficult to determine in which porter and the provider or presenters. category an activity belonged, given the proliferation of a. Funds from a commercial source should be in computer and Web-based learning activities that had some the form of an educational grant to the provider of each type of activity in one course. of the education activity and must be acknowl- Those individuals applying to SUNA for approval of edged in printed material and brochures. activities will notice a difference in the application in that b. Arrangements for commercial exhibits will not the description of the activities will need to be more com- influence the planning of or interfere with the plete in order to allow the reviewers to understand what is presentation of education activities to occur. This is necessary in order for the reviewers to be c. Learners will be made aware of the nature of all assured that the activity being approved has the correct commercial support of all education activities. number of contact hours applied to it. d. Education activities are distinguished as sepa- All material for the education activity must now be rate from endorsement of commercial products. described and outlined for the application. For those who When commercial products are displayed, par- have submitted applications in the last few years, this is a ticipants will be advised that approved status as change; before applicants were only required to document a provider refers only to its continuing educa- a representative 3 hours of the activity if it was an all-day tion activities and does not imply ANCC or multi-day activity. This is no longer the case. All educa- Commission on Accreditation endorsement of tion being provided at that activity must be documented any commercial products. and submitted with the application. e. Education activities that present research con- ANCC now requires that promotional materials devel- ducted by commercial companies will be oped for the continuing education activity be submitted designed and presented with scientific objectiv- with the application. Any flier, brochure, or email that is ity. used to promote or advertise the event must be submitted, f. Learners will be informed of any off-label use of and must be reviewed to determine that the correct termi- a commercial product that is presented in edu- nology is used relative to contact hours being applied for. cation activities. Another significant change is a new requirement These are some highlights of the revisions recently regarding vested interest. Vested interest, in this context, instituted by ANCC. If you have questions when you are exists when a speaker has some tie to a corporation that planning your educational activity or preparing to apply could sway his/her presentation to be more positive or to for contact hours through SUNA, please contact the SUNA make statements that could be perceived as promotion of a Approver Unit through the national office (1-888-827- product. Being employed or paid by a corporation or hav- 7862, [email protected]). ing personal stock in that corporation is considered a vest- Sally S. Russell, MN, RN, BC ed interest. Having stock in a corporation that is part of a Director of Education 401K plan, for instance, is not considered vested interest as

12 July 2003 Uro-Gram

ANCC Visits SUNA National Office AHRQ Launches Web-Based The American Nurses’ Credentialing Center’s Quality Measures Resource Commission on Accreditation (ANCC-COA) visited the SUNA National Office on May 6-7, 2003, to audit SUNA’s Approver The Agency for Healthcare Research and Quality (AHRQ) and Provider Units. SUNA’s current period of accreditation recently launched its Web-based National Quality Measures expires in August 2003, and we have applied to renew our Clearinghouse™ (NQMC) – http://www.qualitymeasures. approver and provider of continuing education in nursing sta- ahrq.gov/. The NQMC contains the most current evidence- tus for another period of 6 years. based quality measures and measure sets available to evaluate On May 6 with assistance from SUNA Approver Unit and improve the quality of health care. Users can search the Chairperson Deni von Merveldt, ANCC reviewed and dis- NQMC for measures that target a particular disease/condition, cussed the Approver Unit. Deni did a wonderful job outlining treatment/intervention, age range, gender, vulnerable popula- the process and demonstrated that she truly understands the tion, setting of care, or contributing organization. Users also can criteria. There are a few areas that need minor revisions, but compare attributes of two or more quality measures side by side the overall evaluation was very positive. to determine which measures best suit their needs. In addition, On May 7 the site visitors reviewed and discussed the the site provides material on how to select, use, apply, and inter- Provider Unit. Much time was spent talking about the struc- pret a measure. ture and function of the Provider Unit, which includes SUNA The NQMC builds on AHRQ’s previous initiatives in qual- Education Director Sally Russell; the chairpersons of each of ity measurement and will be part of a larger Web site of quali- SUNA’s national meetings, Jeff Albaugh and Donna ty, clinical information, and decision tool components that Thompson; and Urologic Nursing Journal Editor Jane Hawks. will include the National Guideline Clearinghouse (NGC) at Again, for the most part, the review by ANCC was positive. http://www.guideline.gov. The NQMC and NGC will be Now that the site visit is completed, the site visitors sub- linked for those who wish to coordinate their search for both mit their written report to the Accreditation Review quality measures and guidelines. AHRQ’s quality initiatives Committee, who will review that report and our written self- include the National Healthcare Quality Report and the study. That committee will then make a recommendation to National Healthcare Disparities Report, which will be available ANCC-COA, who will make the final determination of SUNA’s in the fall of 2003. status as a provider and approver. ANCC-COA meets the first weekend in August, so until their decision has been made, SUNA will continue its current accreditation status. Sally S. Russell, MN, RN, BC Director of Education Listen to the Experts from the SUNA 2003 Conference Order Your CD-ROM Today!

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13 Uro-Gram July 2003 Welcome . . . to the following individuals who recently became members of SUNA!

Milagios M. Abellera Anna-Marie Dahlke Angela Ingram Neomi Munoz Laura Singley Britney Allender Ann Marie Daly Sarah Irons Doni Murphy Sylvia E. Sluder Barbara Sue Anderson Kathy Davis Karen Jacopelle Deborah Murry Carla Smith Annette Anguiano Eleanor Davis Gail Jahnke Kathleen M. Muscia Robin G. Smith Eileen B. Anronelli Ivan de Leon Sanford E. Jeames Anne Musgrove Sabrina T. Smith Edna S. Armas Helena Ann DeMoss Mindy Jenson Mark Musmanno Tanya Smith Julie Austin Cynthia L. Dempsey Brandi Jimmie Daphne Myers Wendy Snyder Malinda Babcock Janet S. Dicke Lauraine Johnson Mary Neward Margaret Somers Anne Baechler Bridget Donoghue Carolyn Johnston Victoria Nichols Heather Sorum Denise Bailey Amy Dooley Catherine A. Kavalchick Vivian E. Norrell Carol Southward Tracy Baker Teresa A. Doyle Jackie Kean Debbye Norris Stacy St. Germaine Charllotte E. Ballew Laura Drane Conni Kellish Penny F. Noto Suzann St. Marie Kimberly A. Barres Laura Draper Deborah L. Kelly Dawn Nowak Gail Staley Susan Barten Julie Dreadin Susan Kim Ernestine Nunes Nancy Starr Jennifer Bartholomew Erin Duff Cheryl King Blesilda Nuqui Jean E. Stegle Nannette Baucom Lisa Duffy Juanita King Gretta G. Nusbaumer Lyn Stevens Pam Beckwith Mollie Dvorak Kathy Kinsman Kevin F. O’Connor Shalene Stine Clarissa Bell Debbi Ebner Theresa S. Klopfenstein Patricia O’Hara Dixie Stoutt Arthur Berg Marlo Eldridge Enily Knoll Sue Osborne Lynda Sturdivant Crystal C. Best Ellen Enjada Patricia Knowles Michelle Owens Diana Sullivan Darlene Bewick Beth Ernst Linda Kreft Martha Pacheco Kelly Sykes Jacqueline Bihler Marcia Faber Bobbie Lynn Langan Michelle Passamaneck Parrett Carol Szumlanski Diana Black Cheryl L. Fairweather Jane Lange James E. Parrotto Nicols Tamez Lana Blackburn Jill Fenoglio Colleen Layton Carolle Paul-Blanc Kristi Tanaka Sharon L. Blackburn Ruby Fernandez Vicki Lear Cheryl Paulin Candace N. Taylor Sylvia Blouin Sandi Fisher Tyndall Light Emily A. Perez Linda Tenwalde Valerie Boeldt-Umbright Ruth E. Fitzgerald Richard Lloyd Pamela Pierangeli Amy Thomas Vicki Bohl Julie Foate Sharon Lokaitis Jan Piercy Vona R. Thompson Linda Bolger Irene Fontana Abigail Lopez-Falcon Della Pisor Kristen Toppin Barbara Boone Lorie Fowler Amanda Lucas Wenda Plunkett Vivienne Van Dissel Melanie Boyd Adrienne Franklin Gladys E. Luebke Renita A. Poteat Daisy L. van Opstal Jenna Brand Patricia Frazier Diane Luedtke Katharine M. Prebeck Elaine VanKalker Rhatta Jo Brandt Anna M. Freeman Raul Luna Wenda Preston Chris Varner Marilyn K. Breeze Norma Fritz Diana Macandog Kelly Pu’u-Mendoza Mary Beth Vashro Sandra Brickler Paula Fugett Alice Madden Tiffani Pullen Antonina M. Vaverchak Barbara R. Brooks Lynn Fuhrman Ellen Madden Michaela Purcell Sally Vellenga CeElla L. Brooks Zaleha Fuller Sadie Maestas Karla Putnam Gwen M. Verchota Deborah A. Brown Beth Gagnon Mary Ann Mahoney Luis Quintana Cathy Vicere Siobhan Brown Anne-Marie Gallimore Antoinette Mainillo Mary Rafferty Carol Vignali Marecia Browning Amy Gamez Sally Maliski Nasima Rahimtoola Lorna L. Villanueva Karen Brownlee Marsha Gauthier M. Cheryl Malone Heather Ralston Judy Visockis Sharlene Brunet Annette Gentry Olga Mangold Sabrina Ray Patricia A. Vlcek Anne E. Brzycki Russell Gilbert Theresa Marcotte Susan E. Read Charlene Vogel Jan Bush Kelly Gilmet Rachel Marsh Lisa Resmen Tina Wade Donna Canada Karla Giramonti Rose Martinez Janice Reynolds Deanna Walsh Presentacion D. Cancino Sarah Gonzales Barbara Massey Elaine Richman Sheila Warner Moira Capps Suzanne Goss Mary C. Matule Alyse Ringenberg Tanya Webster Brooke Carpenter Mary Greeno Chuck Mayfield Shelli Ripic Nancy Welke Amy Jill Carr Alissa Grey Chris McCausland Amber Roache-Smith Karen Whitmire Mercy L. Caston Jayne Hague Susan C. McCracken Laurie Robles Gayle G. Wilkins Marcia A. Cate Titia L. Halfen Kathleen M. McDermott Rachel Rockafellow Linda Wilkinson Lisa Ceane Robin Hamilton Wendy McFarland Amanda Roessler Nikki D. Williams Jill Cease Stacie Hankins Shannon Ann McGowan Sandra K. Rosenberg Ellen Williams Tia Chappell Sharon Harris Penney McLaren Peter A. Royek Tra Williams Jacqueline R. Charlie Sandra Harvey Sherry McLaughlin Phillip Rupp Willa Williamson Bernadette M. Chaya Rita Haugen Donna McMillan Rose-Mary Sandy Ruth Ann Williamson Renee Cheal R. Jonathan Henderson Mary McNiff Theresa L. Sawyer Laura Denise Williamson Anita Chelette-Cunningham Mary Beth Hendricks Vicki L. Means Debra J. Sazama Kim Wintersteen Richard V. Ciscia III Cathy Hodges Robin L. Meehan Kimberly Scarborough Judith K. Wolf Deborah A. Coleman Jendirita Nadia Holmes-Zafar Jennifer Melendez Jennifer Schmidt Roxane Wondra Shelly Collins Judith Holzer Marites Meria Annette L. Schneweis Kathy Young Holly Connor Bobbi Honkomp Barbara Miller Sherri Schroeder Jennifer Yurek Tina Cope Andra K. House Kimberly Moen Patricia Schuster Kerry Fitzgerald Zebold Barbara Cornell Edythe E. Hudson Bonnie Moledor Katie Sebastian Katrina Zeigler Laura E. Crowder Kimberly Hughes Jane Monroe Eithne D. Seifert Angie M. Zupan Helen R. Crowe Brandon Humbert Constance L. Moore Fern Serrell Dawn Zwick Margaret M. Cruz Judy Huntee Susan Moore Vicki L. Sherwood Harriet Culver Wendy Hunter Diane Morgan Ruth Shields Opal Cumbee Jean Iler Peter J. Morrison Julie Shiplet Linda M. Curran Maria Delia C. Iloreta Anna Moss Megan Shoemaker Francine D’Alfonso Brenda B. Ingraffia Theresa Muldoon Kathleen J. Simon

14 July 2003 Uro-Gram

September 24-27, 2003 The 5th World Congress on Urological Research. Location: Kensington, London. Contact: +44 (0)20 7940 5540/5555; fax +44 (0) 20 7940 5577; [email protected]; www.britishprostate- SUNA EDUCATION ACTIVITIES group.co.uk/urological-research-congress March 18-20, 2004 October 2-3, 2003 The Annual Symposium focusing on Disorders of the Urodynamics. Location: San Antonio, TX. Sponsor: Bladder, Bowel, and Pelvic Floor. Location: Hyatt Regency Medtronic. Contact: Pat Lee, Education Specialist, 800-227- Chicago, Chicago, IL. Sponsor: SUNA. Contact: SUNA, East 3191 ext. 49486; [email protected] Holly Avenue Box 56, Pitman, NJ 08071-0056; 888-TAP- SUNA; 856-256-2335; fax 856-589-7463; [email protected]; October 2-4, 2003 www.suna.org 16th Annual Urological Excellence Conference. Location: Saint John, NB. Sponsor: Saint John Chapter of the October 22-26, 2004 Urology Nurses of Canada. Contact: www.unc.org SUNA’s 35th Annual Conference. Location: Orlando, FL. Sponsor: SUNA. Contact: SUNA, East Holly Avenue Box 56, October 5-9, 2003 Pitman, NJ 08071-0056; 888-TAP-SUNA; 856-256-2335; fax 33rd Annual Meeting of the International 856-589-7463; [email protected]; www.suna.org Continence Society (ICS). Location: Florence, Italy. Sponsor: ICS. Contact: Euroconventions, [email protected]; SUNA CHAPTER ACTIVITIES www.ics2003.info

September 13, 2003 October 11-12, 2003 Certification Review Course. Sponsor: Chicago Clinical Urodynamic Workshop. Location: Houston, TX. Metro Chapter. Location: Loyola University Medical Sponsor: Life-Tech, Inc. Contact: Clinical Workshops, Life-Tech, Center, Chicago, IL. Contact: Chicago Metro Chapter, Inc., 4235 Greenbriar Drive, Stafford, TX 77477-3995; 281- 1-888-218-4365. 491-6600 ext. 255; 800-231-9841 ext. 255; fax 281-491-6852; [email protected]; www.life-tech.com September 13, 2003 Upper Midwest Chapter Fall Seminar. Sponsor: October 11-12, 2003 Upper Midwest Chapter. Location: Holiday Inn Select, The Nuts and Bolts of Continence Therapy: Learn to Bloomington, MN. Contact: Theresa Lesher, 952-442- Create a Successful Continence Program. Location: 4812. Libertyville, IL. Sponsor: The Nuts and Bolts Clinicians. Contact: [email protected] or 319-683-2739. OTHER ACTIVITIES October 30-November 1, 2003 August 7-8, 2003 Urodynamics “Hands-On” Course. Location: Seoul, Urodynamics. Location: San Antonio, TX. Sponsor: Korea. Sponsor: Laborie Medical Technologies Corp. Contact: Medtronic. Contact: Pat Lee, Education Specialist, 800-227- Kristin Jankowski, Laborie Medical Technologies, 800-522- 3191 ext. 49486; [email protected] 6743; fax 802-878-1122; [email protected]; http://laborie.com/sitemap/education.htm August 22, 2003 Advances in Nursing Care for Prostate Cancer November 1-2, 2003 Management. Location: Los Angeles, CA. Contact: ICPME, Beyond Nuts and Bolts: Pelvic Floor Therapy Level II. 888-864-2763. Location: Libertyville, IL. Sponsor: The Nuts and Bolts Clinicians. Contact: [email protected] or 319-683- September 11-13, 2003 2739. Urodynamics “Hands-On” Course. Location: Vancouver, British Columbia. Sponsor: Laborie Medical Technologies Corp. November 13-15, 2003 Contact: Kristin Jankowski, Laborie Medical Technologies, 800- Urodynamics “Hands-On” Course. Location: Nashville, 522-6743; fax 802-878-1122; [email protected]; TN. Sponsor: Laborie Medical Technologies Corp. Contact: http://laborie.com/sitemap/education.htm Kristin Jankowski, Laborie Medical Technologies, 800-522- 6743; fax 802-878-1122; [email protected]; http://laborie.com/sitemap/education.htm

15 Volume 31, Number 4 July 2003 Presorted Standard U.S. Postage PAID Bellmawr, NJ Permit #58

East Holly Avenue Box 56 Pitman, NJ 08071-0056 856-256-2335 ¥ 888-827-7862 ¥ FAX 856-589-7463 E-Mail: [email protected]

This newsletter is an official publication of the Society of Urologic Nurses and Associates, Inc. Copyright © 2003 by the Society of Urologic Nurses and Associates. All rights reserved. No part of this material may be duplicated or reproduced in any manner without the written permission of the Society of Urologic Nurses and Associates. (ISSN # 1074-8687)

Editor Evey Kliever, MA, RN, CRRN-A, CURN

Visit SUNA’s Web site at www.suna.org

The Society of Urologic Nurses and Associates, Inc. is a professional organization committed to excellence in patient care standards and a continuum of quality care, clinical practice, and research through education of its members, patients, family, and community. Call for Papers SUNA’s 35th Annual Conference October 22-26, 2004 Orlando, FL

The Program Planning Committee is pleased to Each submission will be evaluated by the Program announce a “Call for Papers” for SUNA’s 35th Annual Planning Committee to determine the final selection for Conference. We invite you to submit abstracts for oral the conference program. Send abstracts to: presentation addressing topics related to urologic patient care. Paper presentations must be identified as SUNA National Office basic, intermediate, or advanced. Submissions must East Holly Avenue Box 56 be received by September 30, 2003. Pitman, NJ 08071-0056 856-256-2335 / 888-827-7862 Abstract Form fax 856-589-7463 1. Abstracts must be typed, single spaced on [email protected] 8 1/2” x 11” white bond paper. 2. Abstracts must be in narrative form and not Any questions or concerns may be directed to exceed 300 words. Debbie Hensley, BSN, RN, Annual Conference 3. Title of abstract should appear at the top. Chairperson, at: home 210-497-2766; work 210-567- 4. List primary presenter first, then additional pre- 6865; fax 210-567-4943; [email protected]. senters with credentials (PhD, MA, BSN, RN) below the title. 5. The authors(s) work/home/email addresses and telephone/facsimile numbers should be listed on a separate page.

Published bimonthly by SUNA under an educational grant from Pfizer, Your Partner in Sexual Health