DOCSLIB.ORG

How Well Prepared Are Operating Room & PACU Teams for an MH

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
How Well Prepared Are Operating Room & PACU Teams for an MH Malignant Hyperthermia Association of the Volume 27 Number 4 United States and the North American Fall 2009 Malignant Hyperthermia Registry of MHAUS by Henry Rosenberg, MD MHAUS President How Well Prepared Are Operating Room & PACU Teams For An MH Crisis? There is no doubt that over the past 30 Mortality From MH As A Measure years MH has gone from a virtually un- Of Preparedness known, highly fatal problem to one that One of the goals of MHAUS has been to not is well described in every textbook of an- only provide information about MH to health esthesia, surgery, medicine, and nursing. care professionals and the public but also to Reference to MH can be found, even if it’s assist the anesthesia and nursing communi- just in passing, in the curriculum of most ties to be prepared to act promptly and effec- training programs for health care profes- tively when a crisis arises. We have gener- sionals dealing with surgical patients. Since ally measured success in the management MH is not an extremely common problem, of MH based on declining mortality from MH. it is not surprising that the average physi- However, we realize that we are not aware cian or nurse would not know a great deal of all cases of MH. In some situations we about the intricacies of the syndrome, such might not be called when a patient dies from as its clinical manifestations, the underly- MH because there is an aversion to publiciz- ing pathologic changes and subtleties of ing a bad outcome. treatment. But everyone who has A study published in the very respect- studied some aspect of medicine able journal, Anesthesia and Analgesia, or nursing will be able to know found that the mortality from MH is closer where to find more information to 12% overall based on national data. The about the syndrome and also mortality ranges from 5% when the syn- to understand at the least that it drome occurs in a hospital to 20% when the may be fatal if not identified patient with MH has to be transferred into a and treated with dantrolene hospital. (1) This statistic causes concern, promptly. We would expect but again we questioned whether all those that anesthesia provid- cases called MH were really MH, or just ers and surgeons know a cases of high fever after surgery. Hard to good deal about MH and know since the individual case data are not particularly the steps in presented. treating the syndrome. As part of an epidemiologic study Recent studies provide some disturbing information about MH preparedness. continued on page 3 The Communicator is published four times each year by the Malignant Hyper- thermia Association of the United States (MHAUS) and is made possible by a generous grant from JHP Pharmaceuti- cals, manufacturers of Dantrium®. The Communicator is intended to serve the Notice Something Different In This information needs of MH-susceptible families, health care professionals, and others with an interest Issue Of The Communicator? in MH. EDITOR Well, you should. We have and scientific understanding of MH Brian Kamsoke completely redesigned the front page and related disorders. (The Cana- Editorial Advisory Panel of The Communicator. The new de- dian Malignant Hyperthermia Asso- Scott Schulman, M.D. sign, we believe, is much more styl- ciation closed its doors a few years Henry Rosenberg, M.D., CPE Barbara Brandom, M.D. ish and modern, and incorporates the ago). Cynthia Wong, M.D. “Faces of MH” (the father and son There are, of course, other Lena Sun, M.D. Ronald J. Ziegler image) which is also found on the organizations at work around the Sharon Dirksen, PhD MHAUS exhibit booth that we display globe, most notably the European FOR MHAUS at various meetings, as well as our Malignant Hyperthermia Group Henry Rosenberg, M.D., CPE President website and informational literature. (EMHG). MHAUS works with EMHG Our thanks to Michael J. and other groups, and communi- Ronald J. Ziegler Vice President Barker, President of Integrated cates with medical professionals Marketing Services, Inc., for the new around the world, from South Ameri- Sheila Muldoon, M.D. Vice President, Scientific Development look. ca to Southeast Asia. (MHAUS/NMSIS/Registry) This is the 27th year in which The Communicator remains Stanley Caroff, M.D. we’ve published The Communicator a vital component for distributing Vice President – Director of NMSIS newsletter. The Communicator is information; think of it as the hub of Steven V. Napolitano, Esq. aptly named; it is a primary source a wheel, with the spokes its informa- Secretary of information to medical profession- tion and resources distributed; in its Joseph R. Tobin, M.D. als and MH-susceptibles and their tracks it leaves heightened aware- Treasurer families. But it is not the only source ness and a better understanding of Dianne Daugherty Executive Director of information. MH. MHAUS manages a website Gloria Artist Hotline Coordinator www.mhaus.org and publishes and – The Editor distributes a multitude of informa- Sharon Dirksen, PhD Scientific Officer tional material: podcasts, brochures, pamphlets, videos, and poster. Much Correction Notice Fay Kellogg The article “Calsequestrin1 Fulfillment Administrator of this informational material can be accessed free-of-charge online, and (CASQ1): A New Gene For MH?” Nicole Viera in the summer 2009 issue of The Database Administrator other items, such as the In-Service Communicator (Vol. 27, No. 3, pg Michael Wesolowski Kit, can be purchased for a nominal Public Relations/Project Coordinator fee. 6) should have contained the name of the author Sharon Dirksen, PhD, Malignant Hyperthermia (MH) is an MHAUS is the only organiza- inherited muscle disorder which, when tion in the country (indeed, the only MHAUS Scientific Officer. We triggered by potent inhalation anesthet- apologize for the omission. ics and succinylcholine, may cause a organization in North America) whose life-threatening crisis. The incidence of MH is low, but, if untreated, the mortality mission is to promote optimum care rate is high. Since the advent of the an- tidote drug, dantrolene sodium, and with greater awareness of the syndrome, the mortality rate has decreased. Great ad- vances in our understanding of MH have The mission of MHAUS is to promote optimum care and been made since it was first recognized in the early 1960s, but the nature of the fundamental defect(s) is still unknown. scientific understanding of MH and related disorders. MHAUS advocates that all surgical patients undergoing general anesthesia should receive continuous temperature For more information or for materials on malignant hy- monitoring, that adequate supplies of dantrolene be stocked near the OR perthermia or MHAUS’ programs, call 607-674-7901; write and that thorough family histories be obtained. MHAUS, PO Box 1069, Sherburne, NY 13460; or visit us Copyright 2009 by MHAUS on the Internet at www.mhaus.org. 3 Continued from page 1 the emergency situations were part, because one of the ambula- quite good, but not for MH! Less tory center accrediting agencies than 20% of those handling the require such a drill every year. based on data from the state of crisis performed the key actions But we also know that others do NY from 2001-2005, a higher required to identify and treat MH not know how to develop such than expected mortality (about as opposed to a much higher a drill. Such questions as how 20%) was also identified in cer- percentage for all the other situa- many people need to be involved, tain situations. (2) This data will tions. (3) where does one get expired dan- soon be published in Anesthesia trolene to practice mixing the stuff, and Analgesia. My coauthors MHAUS’ Efforts In Simulation- how does one score the success on the study, Dr. Lena Sun, Dr. Based Education & Training of the drill, does a site require a Guohua Li and Ms. Joanne Brady A word is in order about the use manikin to carry out the drill or is of Columbia University and I will of simulation in training health there an alternative? soon be embarking on an in depth care professionals. Full scale Creation of a program to study of the specific cases that high fidelity manikins that may be assist hospital ORs, ambulatory were labeled MH in order to be programmed to respond to drugs centers and other places where sure that they really were MH and or situations with such physi- MH trigger agents are in use, in not a syndrome resembling MH. ologic responses as blood pres- developing a drill is tops on the sure, heart rate, respiration, even MHAUS project list. Our staff, con- Use Of Simulation Technol- muscle tone, and bleeding have sultants and other volunteers are ogy To Test Preparedness For rapidly become an important part committed to having a guideline Emergencies of training students and health for setting up and carrying out an These studies call into question care professionals. Such simula- MH drill in place soon. our comfort level that MH is recog- tion has been around for a while, So the answer to the ques- nized and treated appropriately in but it has reached the “tipping tion in the headline is that some greater than 95% of cases. Now point”, whereby it will soon be centers are very well prepared, another study looking at MH from a requirement that trainees and but there is still a need for im- an entirely different viewpoint, even experienced clinicians dem- provement. demonstrates that indeed when onstrate their abilities in a simula- faced with a crisis many anesthe- tion center. References: sia providers become confused In the future, we intend for (1) Rosero EB, Adesanyo AO and overwhelmed and do not MHAUS to assist in the develop- et al.
Load more

Recommended publications
  • Itinerary for March 3, 2020
    ITINERARY FOR MARCH 3, 2020 MEMBERS CATCH YOUR BUS & GET TRAINED (8AM – 11AM) Get breakfast with Lobby Day orientation & briefing Bus departure times vary. Contact your NYSNA Rep. Members driving to the event Breakfast served from 9am - 10am and Lobby Day orientation and briefing will be in the Convention Hall at 9am Madison Ave. The New York State Nurses Association is accredited as a provider A Member & Student Bus Drop Off (9AM – 11AM) of nursing continuing professional development by the American Lobby outside Conference Hall Nurses Credentialing Center’s Commission on Accreditation. B NYSNA Member Check-In (8AM - 11AM) Pick up T-shirt and proceed to your first Lobby Appointment. Meet Your Lobby Leader and team This program has been awarded up to six (6.0) contact hours outside the door of the legislator’s office through the New York State Nurses Association Accredited Provider Unit. C Student Check-In (9AM) Get breakfast with Lobby Day orientation and briefing in the Top Tier in the Convention Hall The New York State Nurses Association is accredited by the International Association for Continuing Education and Training D Lobby Visits (9AM – 3PM) “IACET” and is authorized to issue the IACET CEU. Meet your Lobby Team for 1-2 Lobby Visits to advocate for Equitable Healthcare Funding and Safe Staffing to Improve Patient Outcomes.. Check-in through security (multiple entrances underground and The New York State Nurses Association is authorized by IACET to above-ground) to Legislative Office Building or Capitol offer up to .6 CEUs for this program. Convention Hall In order to receive up to 6.0CHs/.6 CEUs all participants are E Lunch Available & Indoor Rally (12PM - 2PM) Enjoy a lunch with your colleagues before or after scheduled Lobby Visits required to attend the entire workshop, complete all in-session NYSNA & legislative leaders address the issues program assignments, complete an evaluation form, complete and return a post-program SurveyMonkey® questionnaire and/or complete and return a post-program checklist, where applicable.
    [Show full text]
  • Diet Shift of Red Belly Pacu Piaractus Brachypomus (Cuvier, 1818) (Characiformes: Serrasalmidae), a Neotropical Fish, in the Sepik-Ramu River Basin, Papua New Guinea
    Neotropical Ichthyology, 12(4): 827-833, 2014 Copyright © 2014 Sociedade Brasileira de Ictiologia DOI: 10.1590/1982-0224-20130212 Diet shift of Red Belly Pacu Piaractus brachypomus (Cuvier, 1818) (Characiformes: Serrasalmidae), a Neotropical fish, in the Sepik-Ramu River Basin, Papua New Guinea Sandra Bibiana Correa1, Ricardo Betancur-R.2, 3, Bernard de Mérona4 and Jonathan W. Armbruster2 Introduction of fish species is a globally widespread practice that causes losses of native species and homogenization of diversity within and across continents. Diet assessments are important tools to depict the ecological function of species introduced into novel ecosystem and possible direct and indirect ecological effects. In this study, we compare the diet of Piaractus brachypomus, a mainly frugivorous Neotropical fish, introduced into the Sepik-Ramu River Basin (Papua New Guinea) nearly two decades ago, to that of similar size individuals from Neotropical populations in the Amazon and Orinoco River basins (South America). In contrast to native populations that feed mainly on terrestrial plants and invertebrates, the diet of introduced P. brachypomus is mainly composed of fish remains and aquatic plants, while terrestrial plants are frequently consumed but in relatively smaller amounts. These findings show that P. brachypomus has an inherently plastic diet that can be adjusted when displaced to a novel geographic area. While trophic plasticity increases the likelihood of a species to establish breeding populations after its introduction, it also reduces our ability to predict negative effects on native species. La introducción de peces es una práctica que se extiende globalmente y que causa perdida de especies nativas y homogenización de la diversidad dentro y entre continentes.
    [Show full text]
  • Taking the Pulse of Nursing Today: a Look at What Makes This Generation
    ALUMNI NEWSLETTER 2018 Taking the Pulse of Nursing Today: A look at what makes this generation Basic BSN graduate Toluwanimi of nursing Olajuyigbe grew up in Nigeria. She believes nursing education will students put her in a unique position to care for people, to create change, and passionate eventually to give back to her home country. [See back cover for more.] LETTER FROM THE DEAN Having doubts about the ability of the next generation to take on the world . is not new. Indeed, Anthony Ashley Cooper (the 7th Earl of Shaftesbury in England), in a speech to the House of Commons on February 28, 1843, ranted, “. a fearful multitude of untutored savages. [boys] with dogs at their heels and other evidence of dissolute habits. .[girls who] drive coal-carts, ride astride upon horses, drink, swear, fight, smoke, whistle, and care for nobody. the morals of children are tenfold worse than formerly.” Laying fears aside For those of us who have been in nursing for a while, if we are honest, we have to admit that we occasionally wonder about the next generation of nurses as well. But we can lay any fears aside! Students still come into nursing to truly make a difference for individuals, families, and communities. Read the following 18 Mary Burman, Dean heartwarming and reassuring stories about what motivates our current students to become nurses. These stories are just a sampling of our students’ stories. We graduate a number of BSN, MS, and DNP students each year from the Fay W. Whitney School of Nursing (see graph).
    [Show full text]
  • Status of ANS in Georgia
    Status of ANS in Georgia Ted Hendrickx Senior Fisheries Biologist Gulf ANS Panel Meeting November 8-10, 2004 www.georgiawildlife.com 1 Georgia www.georgiawildlife.com 2 To Gulf via Mississippi system Atlanta airport •USFWS Atlanta Savannah Port Atlantic • inspectors Brunswick To Gulf www.georgiawildlife.com 3 Georgia Facts • 250+ species of fish have been collected • 20+ species of “exotic” and non-indigenous fish species reported in Georgia – Rainbow trout to Pacu… • 10+ species of “exotic” or nuisance aquatic plants found in GA waters • Other ANS (mussels, inverts, etc) www.georgiawildlife.com 4 Fish • Pacu • Oscar • Grass carp • Red shiner • Asian rice/swamp eel • Tilapia (blue & Mozambique) • Bighead carp • Arowana www.georgiawildlife.com 5 Invertebrates and Others • Asian clam (Corbicula) • Green mussel • Freshwater jellyfish • Crawfish sp. • Lionfish (saltwater) Source: USGS NAS www.georgiawildlife.com 6 Aquatic plants • Hydrilla • Eurasian watermilfoil • Brazilian elodea • Water hyacinth • Giant salvinia • Common salvinia • Alligator weed • Parrot feather www.georgiawildlife.com 7 State Authority • Georgia DNR (WRD) • State Department of – Aquaculture Agriculture registration – Pet trade • “Domestic species” – Food fish sales (dead – Wild Animal licensing or processed) • Exotic species – Pesticide licensing • Commercial (no pets) – State veterinarian – Fish dealer licensing – Processing facilities • Certain exotic – Plant sales (retail & • Native nurseries) www.georgiawildlife.com 8 Georgia Issues • Illegal releases – Intentional
    [Show full text]
  • Stir-Up Regimen There Are Five Steps to the Stir-Up Regimen: Deep Breathing, Coughing, Positioning, Mobilization and Pain Management
    www.NYSPANA.NET Newsletter of the New York State PeriAnesthesia Nurses Association Volume 37 No. 1 March 2015 Back To Basics: Stir-Up Regimen There are five steps to the stir-up regimen: deep breathing, coughing, positioning, mobilization and pain management. One of the most basic and important as- should be sitting, semi-Fowler or side- by 100-300%! Hypoxia should be con- pects of perianesthesia nursing is the stir lying and splinting the incision. The cas- sidered when the patient has hypertension up regimen. It comes after the airway is out cade cough is the best technique for open- from carbon dioxide build up and from the and pain is being assessed. Why is it ing airways and expelling secretions. The effect of hypo-ventilation. An oxygen important? The regimen is the steps taken patient takes a rapid deep breath and saturation of less than 85%, indicates a to prevent atelectasis and venous stasis. coughs multiple times at low lung vol- PaO2 of less than 50mmHg. (Stir-Up) (Stir-Up) umes. This series of small coughs causes airways to compress and improve the ef- Get that airway out, control the pain, Oxygen saturations only tell us how much fectiveness of the cough.(Drain) Forcing cough, deep breath, and move those limbs. oxygen is dissolved on the patient’s he- patients to cough will eventually lead to Hopefully all of this was explained to the moglobin. It is not an indicator of the spontaneous coughing. Sitting or semi- patient before they became your patient! patient’s ventilation status. What causes Fowler’s positioning promotes mainte- Barbara Ochampaugh, RN, BSN, CPAN atelectasis? Post operative patients breathe nance of the patient’s airway, prevents in a shallow, monotonous pattern without aspiration and allows optimal expansion References: sighs.
    [Show full text]
  • Caring for Pediatric Patients in Disasters, Poss
    Caring for Pediatric Patients in Disasters-The Utah Approach Brad Poss, MD, MMM Professor, Department of Pediatrics Associate Dean for Graduate Medical Education University of Utah School of Medicine Medical Director, PICU Primary Children’s Hospital Objectives 1. Participants will understand the unique characteristics of Utah’s Regional Pediatric Emergency Preparedness (PEP) 2. Participants will gain an overview of Federal efforts in PEP 3. Participants will begin to apply lessons learned from recent CDC-Utah PEP Conference on creating pediatric surge to local efforts Primary Children’s Hospital The Child First and Always PCH History • 1911-Children’s ward at LDS Hospital opened by the Primary Association (children’s program) of The Church of Jesus Christ of Latter Day Saints • 1922-The Primary Association opened the LDS Children’s Convalescent Hospital (35 beds) – Primary children began tradition of donating birthday pennies • 1952-Moved to new 70 bed hospital that expanded to 170 beds over time PCH History • 1975-The Church of Jesus Christ of Latter Day Saints created an independent and non-profit healthcare corporation, Intermountain Healthcare including Primary Children’s • 1977-Formal Affiliation with the University of Utah School of Medicine Department of Pediatrics • 1990-Primary Children’ Medical Center moved to present location on the University of Utah. • 2013-Rebranded as Primary Children's Hospital PCH • 289 bed children's hospital, highest acuity score in state of Utah • Admits 65-70% of Pediatric Admissions in the state
    [Show full text]
  • Retention of Nurses in Wyoming
    REETENTIONTENTION OOFF NUURSESRSES IINN WYYOMINGOMING Wyoming Department of Employment R&P Part II in a Series of Publications Related to the Nursing Situation in Wyoming Research & Planning Wyoming DOE August 2008 Contents Page ii A summary of this report is available at Research & Planning’s Nursing Studies website: http://doe.state.wy.us/LMI/nursing.htm Nurse Advisory Committee Cheryl Koski, MN, RN WYOMING BOARD OF NURSING (RETIRED) Mary Beth Stepans, PhD, RN WYOMING BOARD OF NURSING (ASSISTANT EXECUTIVE DIRECTOR) Faith Jones, MSN, RN WYOMING ORGANIZATION OF NURSE EXECUTIVES, POWELL VALLEY HEALTHCARE Toni Decklever, MA, RN WYOMING COMMISSION FOR NURSING AND NURSING EDUCATION Karen Outz, PhD, RN WYOMING DEPT OF HEALTH, PUBLIC HEALTH COMMUNITY AND RURAL HEALTH DIVISION Judy McDowell, MS, RN, CNE NURSE EDUCATORS OF WYOMING Veronica Taylor, RN, MS WYOMING NURSES ASSOCIATION, PRESIDENT Tracy Farris, MS, FNP-C WYOMING ADVANCED PRACTICE, NURSES ASSOCIATION Cindy Rankin, RN, CRRN WYOMING LONG TERM CARE ASSOCIATION Wyoming Department of Employment Research & Planning RETENTION OF NURSES IN WYOMING Wyoming Department of Employment Gary W. Child, Director Research & Planning Tom Gallagher, Manager Prepared by: Edited by: Dr. Mark A. Harris Phil Ellsworth Sylvia D. Jones April Szuch Lisa Knapp Douglas W. Leonard Reviewed by: David Bullard Valerie A. Davis Carol Toups Sara Saulcy Submitted for Publication August 2008 ©2008 by the Wyoming Department of Employment, Research & Planning Research & Planning Wyoming DOE Department of Employment Nondiscrimination Statement The Department of Employment does not discriminate on the basis of race, color, religion, national origin, sex, age, or disability. It is our intention that all individuals seeking services from our agency be given equal opportunity and that eligibility decisions be based upon applicable statutes, rules, and regulations.
    [Show full text]
  • Caring Headlines — March 19, 2020 Debbie’S Photo Gallery
    • Headlines aringMarch 19, 2020 CPACU Skills Day preparing staff to meet the needs of an expanded patient population in the peri-operative setting See story on pages 4-5 Pam Wrigley, RN (right), staffs the eCare Blood Administration station at recent PACU Skills Day training event. Nursing & Patient Care Services Massachusetts General Hospital Debbie Burke Exemplary response to the coronavirus outbreak As the coronavirus (COVID-19) possible environment, and to pro- continues to affect communities tect yourselves, as well. around the world, our MGH Inci- dent Com mand Team has been I want to thank associate chief hard at work overseeing our response nurse, Theresa Gallivan, for the to this rapidly changing situation. great job she’s doing as inpatient operations section chief on our AI want to take this opportunity to Incident Com mand Team. thank everyone for the professional way you’ve stepped up to meet the I ask that you continue to conserve increased demand for care and ser- resources (respirators, masks, per- Debbie Burke, RN vices. sonal protective equipment, and senior vice president for Nursing & Patient precaution gowns); and that you Care Services and chief nurse There’s no way to know how exten- take the time to read daily updates sive the outbreak will be, but I have to stay abreast of changes in prac- the coronavirus page on Apollo for the utmost confidence in all of you. tice and policies. up-to-date information. I know you have the skill and exper­­ tise to ensure our patients receive Please direct any questions to your the highest quality care in the safest managers or supervisors, or go to Debbie Burke In this Issue Raising Awareness about Delirium ....................................9 PACU Skills Day ............................................................................1 Patient Experience Feedback ............................................10 Debbie Burke .........................................................................
    [Show full text]
  • May 2010 U.S
    Non profit Organization MAY 2010 U.S. Postage PAID Microscope is a newsletter written by and for Raleigh, NC 40 Under 40 WakeMed Health & Hospitals Permit NO. 1307 (continued from page 1) What an Employee! the employees of WakeMed. Our goal is to provide employees and friends of WakeMed with the most 3000 New Bern Avenue NEWS FOR EMPLOYEES AND FRIENDS OF WAKEMED Laura Aiken Wake Specialty Physicians - Brier Creek up-to-date news on all of the hospital system’s activi- Raleigh, North Carolina 27610 Patsy Davis, RN, (Surgical Services - OR) ties. The Public Relations department thanks all of the Aiken serves as director of Advocates for was recognized this March as the North Medical Group Welcomes New Physician ADDRESS SERVICE REQUESTED Health in Action (AHA), a collaborative employees who contributed to this publication. Carolina Perioperative Nurse of the Year by WSP - Brier Creek Medical Group is happy to welcome Sara New Raleigh Campus co-created by Aiken in 2007 and formed the North Carolina Council of Perioperative We welcome comments and suggestions on this Rooker, MD. Dr. Rooker will work alongside John Holly, MD, who E Wing and WakeMed by WakeMed, the John Rex Endowment, Registered Nurses. publication and its content. Call (919) 350-8120, e-mail has been with the practice since it opened last year. Dr. Rooker is www.wakemed.org Wake County Human Services and nearly [email protected], or write Microscope, Children’s Hospital Brad Hiatt (Respiratory Care Services) was a family physician who is Board certifi ed in Family Medicine. Most 50 other organizations in Wake County.
    [Show full text]
  • Improving Profitability and Business and Legal Issues
    20th Annual Ambulatory Surgery Centers Conference Improving Profi tability and Business and Legal Issues October 24-26, 2013 • Swissotel - Chicago, Illinois 132 great ASC Executives and Physicians and 87 Sessions with Great Topics Focused on Key Issues for ASCs, State of the Industry, Cost Reduction and Benchmarking, and Key Specialties Thank You to Our Corporate Sponsors • Keynote - A Nansy Bit of Rough - David Feherty, CBS Golf • ASCs 2013 and 2014 - Where Does the Industry Stand, Where Commentator and Best-Selling Author are the Great Opportunities? Nap Gary, Chief Operating Offi cer, Regent Surgical Health, I. Naya Kehayes, MPH, • Keys to Keeping Surgery Centers Profi table Businesses - Robert Managing Principal and Chief Executive Offi cer, Eveia Health Zasa, MSHHA, FACMPE, Managing Partner and Founder, ASD Consulting & Management, Richard N.W. Wohns, MD, JD, Management, Doug Golwas, Senior Vice President Medline MBA, South Sound Neurology, PLLC, Scott Becker, JD, CPA, Industires, Stephen Blake, Chief Executive Offi cer, Central Partner, McGuireWoods LLP, moderated by Bob Woodward, Park ENT & Surgery Center, moderated by Barton C. Walker, Legendary Pulitzer Prize-Winning Journalist/Author and Partner, McGuireWoods LLP Associate Editor, The Washington Post • ASCs, 10 Months and 10 Years Into the Future; Emerging • Washington D.C., The Budgets, Healthcare, America - Bob Business Issues in ASCs - David J. Abraham, MD, The Read- Woodward, Legendary Pulitzer Prize-Winning Journalist/ ing Neck & Spine Center, Linda Ruterbories, RN, ANP, OSC
    [Show full text]
  • Nurse of the New York State Nurses Association
    NEW YORK CITY EDITION | MAY 2016 New York the official publicationnurse of the new york state nurses association Nurses stand with Verizon workers!, p. 4, 7 NYSNA supports Verizon strikers, top to bottom: Anthony Ciampa, RN and NYSNA Second Vice President, with strikers in New York City on April 17; Jalisa Saud, RN, Coney Island Hospital, at the May 5 rally near Wall Street; and striking Verizon workers address the April 13 NYSNA Lobby Day rally. May 6 statewide action for safe staffing, p. 5 2 NEW YORK NURSE MAY 2016 Nurses week: What’s at stake? s I write this column, our Nurses are eloquently expressing their priority bill, the “Safe A Staffing for Quality Care views on the deleterious effects of short Act” (S.782/A.8580-A) – the bill that will set a maximum number of staffing, putting people on high alert. patients a nurse can care for at any one time – is being hotly debated and seriously scrutinized by key in our numbers and in the logic of keting and advertising expenses By Judy Sheridan- legislators. Why is that? the initiative. into the stratosphere. Gonzalez, RN This year, our comprehensive cam- Why do our successful health l They have geometrically NYSNA President paign for passage has intensified: systems plead poverty when it increased their well-paid admin- l involving members through comes to increasing caregiver staff, istrative staff to better “man- Staffing Captain and POA ini- even while they show net profits? age” the hands on caregivers on tiatives, phone calls, legislative Why are some of our facilities whom our patients depend.
    [Show full text]
  • Washington State Aquatic Nuisance Species Committee Report to the 2008 Legislature
    Washington State Aquatic Nuisance Species Committee Report to the 2008 Legislature by the Aquatic Nuisance Species Committee Prepared by Pam Meacham and Allen Pleus Washington Department of Fish & Wildlife December 2007 Formal Citation Aquatic Nuisance Species Committee. 2007. Washington State Aquatic Nuisance Species Committee Report to the 2008 Legislature. Prepared by P. Meacham and A. Pleus Washington Department of Fish and Wildlife. Short Citation ANSC 2007 ACKNOWLEDGEMENTS The ANS Committee would like to extend our appreciation and recognize the contributions made by Joan Cabreza of the US Environmental Protection Agency for her 4-year tenure as Co-chair. The ANS Committee recognizes her many contributions, hard work and dedication to fulfill this role. The ANS Committee would also like to extend our appreciation and recognize the contributions made by Kevin Anderson of the Puget Sound Action Team (now the Puget Sound Partnership). Kevin has been a driving force in the committee, playing a strong leadership role at both the local and regional level. In his position as ANS Coordinator for the Action Team, Kevin has played an important role in obtaining funding for aquatic invasive species and ballast water management. Cover Photos Clockwise from upper left: Dydimo (“rock snot”); New Zealand Mudsnail; Rusty crayfish; Styela clava tunicate; Bullfrog; Nutria; Mitten crab; Purple loostrife; (center) Hydrilla; and Quagga Mussel. ii ANS Committee Report to the 2008 Legislature LEGISLATIVE INTENT RCW 77.60.130 Aquatic Nuisance Species Committee Purpose (1) The aquatic nuisance species committee is created for the purpose of fostering state, federal, tribal, and private cooperation on aquatic nuisance species issues.
    [Show full text]