CNS Communiqué

The CNS Communiqué is an electronic publication of the National Association of Clinical Nurse Specialists. The purpose of this publication is to keep our members updated on the NACNS headquarters news; connect our members with fast-breaking clinical news; and update clinical nurse specialists on state and federal legislative actions.

Issue #42 – January/February 2018

Top Story

How the Tax Bill Might Impact Health Care

Signed into law on December 22, 2017, the tax reconciliation bill, known also as the Tax Cuts and Jobs Act, may be the most consequential health care legislation enacted since the Patient Protection and Affordable Care Act (ACA) in 2010.  Here are a number of the more relevant health-related provisions contained in the bill.

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Headquarter News

NACNS Legislative and Regulatory Toolkit Updated

NACNS’s Leg/Reg Committee has issued an update to the Starter Kit for Impacting Change at the Government Level:  How to Work with Your State Legislators and Regulators.  The toolkit is a series of resources to assist CNSs in advocating for key issues with state and federal policymakers. 

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CNS Core Competencies Revision in Progress

Since its founding in 1995, NACNS has been a leader in articulating CNS practice competencies, educational guidelines and credentialing requirements.  In late 2017, the NACNS Task Force for the Revision of the NACNS Statement on Education and Practice opened the comment period on section two of the draft revised CNS Statement. 

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Malnutrition Task Force Members Disseminating Their Message

While the work of the Malnutrition in the Adult Hospitalized Patient Task Force was completed last year, the members formed a close professional bond and have continued to spread awareness about how CNSs can impact addressing malnutrition as a part of their work.  This dissemination has been funded by Abbott Nutrition and has allowed the task force members to attend professional health care conferences to discuss the importance of identifying and treating malnutrition.

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NACNS Report Highlights Implications for Policy, CNS Education and Practice

More patients than ever are living longer and managing chronic health conditions in their day-to-day lives.  Health costs associated with chronic conditions are skyrocketing and managing patients with chronic conditions requires an understanding of not only the disease process but also self-care actions.  

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Help NACNS Affiliates and CNSs Take Action

Last month the American Medical Association fanned the flames of a settled argument with its call for the creation of a national strategy to oppose legislative efforts that grant full practice authority to non-physician practitioners.  The Clinical Nurse Specialist Institute is creating a special initiative to help NACNS affiliates and CNSs take action and speak out in defense of the CNS role and full practice authority (FPA).

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NICE Network Update

Nursing Infection Control Education

NACNS joined the American Nurses Association and the Centers for Disease Control and Prevention in the Nursing Infection Control Education Network (NICE Network) to develop training programs for real time infection prevention and control, improve adherence to best practice and enhance nurses’ confidence when caring for patients with highly contagious diseases.  As part of our work in the NICE Network, NACNS will host a special workshop on February 28, 2018, the first day of this year’s annual conference in Austin, Texas. 

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Nursing Student Outreach Efforts

In recent years, the NACNS Board of Directors has increased its outreach to nursing students, especially through its work exhibiting and speaking at National Student Nurses Association (NSNA) meetings.

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Upcoming Webinars

Looking for cost-effective, CNS-specific continuing education?  Make sure you check out the 2017-2018 NACNS Webinar Series.

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Affiliate News

California Association of Clinical Nurse Specialists (CACNS)

CACNS continues to be an active vibrant organization and affiliate to NACNS.  Thanks goes out to our President, Paddy Garvin Higgins and our many board members who are dedicated, hardworking volunteers.  

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Missouri-Kansas CNS Affiliate (MO-KAN)

The MO-KAN CNS Affiliate had a productive and exciting 2017.  In an effort to reach CNSs in all of Kansas and Missouri, we launched a new website, changed our name from Greater Kansas City CNS to MO-KAN CNS Affiliate and developed a new logo.

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Oregon Council of Clinical Nurse Specialist (OCCNS)

The OCCNS Stakeholder Group is assisting the Oregon State Board of Nursing (OSBN) in reviewing and revising Chapter 851, Division 54, CLINICAL NURSE SPECIALISTS.  Ruby Jason, Executive Director of OSBN, was interested in assembling a diverse group of CNSs from across the state and working in a variety of practice settings to make recommendations for revising and updating Division 54.

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Washington State Clinical Nurse Specialists

The Washington State Clinical Nurse Specialists affiliate is recruiting members.  We are looking for CNSs who wish to contribute their time to increasing our visibility in Washington State health care.  There are several of us working on credentialing in our facilities; we need to hear from others.  Please contact us at our web site and join us on Facebook.

Association News

Clinical News

Joint Commission Cracks Down on Hand Hygiene

Effective January 1, 2018, The Joint Commission (TJC) will issue citations to health care organizations if during on-site visits surveyors witness an employee fail to follow correct hand hygiene guidelines.  The change is intended to improve health care workers’ compliance with proper hand washing.  

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Innovations and Opportunities for Improving Medication Adherence

Medication adherence is critical to improving chronic disease outcomes and reducing health care costs.  The Centers for Disease Control and Prevention has published a study showing that understanding root causes of medication nonadherence and cost-effective approaches applicable in diverse patient populations is essential to increasing adherence and improving long-term health impact. 

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CDC Opioid Prescribing Guideline Clarification

Several weeks ago, the American Society of Addiction Medicine contacted the Centers for Disease Control and Prevention (CDC) to discuss the persistence of misunderstandings surrounding dosage thresholds in the landmark CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016 (Guideline). 

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Opioid Overdose Medication May Be Effective Either Taken Nasally or Injected

A new study, funded by the Agency for Healthcare Research and Quality, found Naloxone might be similarly effective whether inhaled or injected.  Naloxone blocks the harmful effects of an overdose when taken immediately after an opioid is ingested. 

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New Guidelines to Limit the Spread of Antimicrobial-Resistant Infections

The Center for Disease Control and Prevention estimates more than 2 million people in the United States get drug-resistant infections every year, the majority of which are acquired at health care facilities.  The cost to treat those patients is about $20 billion a year.

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Study Links Severe Hypoglycemia to CV Events

Diabetes patients who had at least one severe hypoglycemic episode had a three-year cumulative incidence of mortality at 28.3% and a 10.8% incidence of coronary heart disease, according to a study in Diabetes Care.  Researchers used a cohort of 1,209 participants and found an association between severe hypoglycemia and all-cause mortality, cancer mortality, cardiovascular mortality and CHD even after adjustments, but found no correlation between hypoglycemia and atrial fibrillation, heart failure, non-CV and noncancerous death, or stroke.

“Texting is Not Permitted” Confusion

The Centers for Medicare & Medicaid Services (CMS) is clearing up recent confusion on what medical providers can text each other.  CMS confirmed care team members are allowed to text patient information over a secure messaging app; however, texting a medical order is still not permitted.

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Biotin (Vitamin B7) May Interfere with Lab Tests

FDA has alerted the public, health care providers, lab personnel, and lab test developers that biotin can significantly interfere with certain lab tests and cause incorrect test results that may go undetected. 

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Federal/State Issues

CHIP Update

January 22nd marked three months and 13 days since Congress allowed reauthorization and long-term funding for the Children’s Health Insurance Program (CHIP) to expire.  As reported in the November/December 2017 CNS Communiqué, Congressional inaction created a dire situation for children, families, and states relying on this successful, bipartisan, health insurance program that covers nearly nine million children.

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Controversial Medicaid Work Requirement Guidelines

One of NACNS’s mainstay health care policy positions is to advocate for equal access to care and services.  During health reform debates, NACNS consistently articulates its values by committing to remove barriers that impede individuals from attaining the necessary quality care to which all persons are entitled.

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Funding Barriers Threaten Successful Mental Health Treatment

The 21st Century Cures Act (Cures), endorsed by NACNS, was signed into law one year ago.  The law included key provisions to oversee mental health and substance use disorder treatment services and to ensure compliance with parity and patient safeguards consistent with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.

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Georgia Panel Backs Broader Powers For APRNs In Rural Areas

A Georgia Senate study committee has recommended that the state allow APRNs broader practice authority if they work in rural, underserved counties.  Under current state law, APRNs in Georgia can prescribe medications only under a collaborative agreement with a physician.


New Resources at the SAMHSA-HRSA Center for Integrated Health Solutions

Some of the best nationwide resources on trauma, suicide prevention, and intimate partner violence are posted on the SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) website.  Trauma, suicide prevention, and IPV are often interrelated issues, i.e., trauma is highly prevalent and a major risk factor for suicide and IPV.

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Medscape Nurse Career Satisfaction Report 2017

In 2017, Medscape, an online journal, invited practicing nurses, including APRNs, LPNs and RNs, from the US to participate in an online survey about compensation and career satisfaction.  10,523 nurses, of whom 567 respondents identified as CNSs, responded to the 2017 survey.

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2017 Gallup Poll® Ranks Nurses as the Most Ethical Profession

For the 16th consecutive year, nurses outpace 21 other professions on honesty and ethics rating, according to The Gallup Poll®

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