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 #41 – November/December 2017

Top Story

Action Alert: Cosponsors Needed for House and Senate Bills Addressing Opioids

The opioid epidemic is taking a toll on individuals, families and communities across the nation.  According to the Centers for Disease Control and Prevention, opioids killed more than 33,000 people in 2015.  Additionally, the Substance Abuse and Mental Health Services Administration estimates 3.3 million Americans over age 12 misused prescription pain relievers in 2016.  Although Congress has increased funding for prevention, treatment and recovery in recent years, a stable, long-term investment is needed to help the hardest hit communities stem the rising tide of this epidemic. 

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Headquarter News

CNS Core Competencies Comment Period Open

NACNS opened the public comment period on its 2017 Draft CNS Core Competencies on November 1.  The NACNS Task Force for the Revision of the NACNS Statement on Education and Practice, a panel of clinical nurse specialist (CNS) experts in education, practice and research, developed the draft competencies since the task force was commissioned in 2015. 

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NACNS Board Adopts Revised Affiliate Agreements

The NACNS Board of Directors approved the revised Affiliate agreements at its October 23 meeting. By the end of November, the NACNS web site will only include active Affiliate members that have adopted the new Affiliate agreements. Contact Laura Huestis if you have questions about the status of your Affiliate or your Affiliate’s agreement.


2018 Annual Conference Registration OPEN

Register today and plan to join NACNS in Austin, Texas for the 2018 Annual Conference at the Renaissance Austin Hotel from February 28 to March 3. 

This year’s theme Putting the Pieces Together: CNSs Bridging the Gaps in Health Care will provide CNSs from across the country a wide selection of sessions that will enhance your skills as an expert clinician and challenge you to engage in new efforts!

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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

Central Indiana Organization of Clinical Nurse Specialists (CIOCNS)

The eighth annual Central Indiana Affiliate fall conference occurred on November 16, 2017.  This year’s theme was Activate your CNS!  Embracing Role Diversity.  Topics included implementation science, APRN legislation activities, CNSs as patient safety officers, and using humor as a strategy for stress.  New this year was a poster exhibition.

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Association News

NEEDED: Volunteers to Update AGCNS Examination

The American Nurses Credentialing Center (ANCC) is seeking content expert test development volunteers to create items (questions) that will update the Adult-Gerontology Clinical Nurse Specialist   (AGCNS) certification examination.  To update the exam, ANCC is hosting an Item Writer Workshop March 22-23, 2018.  This is a virtual, two-day meeting in which volunteers learn how to create questions to appear on a certification exam.  Volunteers then will have 90 days to write and submit approximately 35 new test questions and answers.

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Clinical News

National Study Links Nurses’ Physical and Mental Health to Medical Errors

A new study found that 54% of the 1,790 U.S. nurses responding to a national survey reported sub-optimal physical and mental health.  The research found that depression is common among nurses and is linked to a higher chance they will make medical errors.  The data was generated from a survey offered through nursing organizations and 20 hospitals.  Only responses from clinical practice nurses were included in the study.  The majority of respondents were white women and the average age of participants was 44, which closely resembles the current demographics of the nursing workforce.

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FDA Warning on The Use of Kratom

The Food and Drug Administration (FDA) is warning consumers not to use Mitragyna speciosa, commonly known as kratom, a plant that grows naturally in Thailand, Malaysia, Indonesia, and Papua New Guinea.  FDA is concerned that kratom, which affects the same opioid brain receptors as morphine, appears to have properties that expose users to the risks of addiction, abuse, and dependence.

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Impact of Electronic Sepsis Initiative on Facility–onset Clostridium Difficile Infection

A new, single-hospital study suggests that electronic sepsis screenings and treatment protocols could lead to increased use of certain broad-spectrum antibiotics and healthcare facility-onset (HCFO) C. difficile infection (CDI) rates. The findings were published in the October issue of the American Journal of Infection Control.

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FDA Drug Safety Communication: Careful Medication Management Can Reduce Risks

The Food and Drug Administration (FDA) advises that the opioid addiction medications buprenorphine and methadone should not be withheld from patients taking benzodiazepines or other drugs that depress the central nervous system (CNS).  The combined use of these drugs increases the risk of serious side effects; however, the harm caused by untreated addiction can outweigh risks.

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Federal/Stat Issues

Medicare Graduate Nurse Education Demonstration Increases Primary Care Workforce

Under the Patient Protection and Affordable Care Act, the Centers for Medicare and Medicaid Services  were instructed to provide reimbursement to five sites selected to test the feasibility, effectiveness, and cost of increasing the APRN workforce through Medicare payments to hospitals for the reasonable cost of clinical APRN education.  This activity is the Graduate Nurse Education (GNE) Demonstration, funded at a total cost of $200 million, to study whether the demonstration would:

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States Need Stopgap CHIP Funding

The Children’s Health Insurance Program (CHIP) provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid.  CHIP, along with the Medicaid program, has helped reduce the nation’s uninsured rate for children to a record low of 5%.

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Trump Nominates Former Lilly Exec for HHS Secretary

President Donald Trump announced November 13 that he is nominating Alex Azar to serve as the next secretary of the Department of Health and Human Services (HHS).  Azar is a former Eli Lilly and Co. executive and HHS deputy secretary during President George W. Bush’s administration.  If confirmed, Azar also would take the lead in implementing the president’s campaign promise to dismantle the Affordable Care Act.  Republican lawmakers, as well as some industry trade groups praised the nomination, but several Democrats and health policy experts questioned Azar’s ties to the pharmaceutical sector and raised concerns on whether he can fairly implement measures to lower pharmaceutical profits.


Recent Trends in Baccalaureate-Prepared RNs, 2004-2013: A Longitudinal Study

The proportion of front-line nurses with bachelor’s degrees in U.S. hospitals increased from 44% in 2004 to 57% in 2013.  However, according to a new study, the increase falls short of a national goal to reach 80% percent by 2020.  The former Institute of Medicine, now the National Academy of Medicine,  recommended in its 2010 milestone report, “The Future of Nursing:  Leading Change, Advancing Health,” that 80% of nurses should have at least a BSN by 2020.

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Joint Commission Not Moving Forward with Proposed Telemedicine Standards

Last May, The Joint Commission (TJC) proposed changes to its accreditation standards to account for direct-to-patient telehealth services.  The standards would have required those providers using direct-to-patient telemedicine to confirm the patient’s location so it could pair the patient with a provider who meets licensing requirements and regulations, and to discuss treatment – including the medium (e.g., video, telephone) – during the informed consent process.

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The Controversial Independent Payment Advisory Board

The Patient Protection and Affordable Care Act introduced the idea of an Independent Payment Advisory Board (IPAB).  The Board would be a 15-member panel of appointed officials charged to constrain the undue growth of Medicare costs.  Note that the IPAB only becomes operative if Medicare costs increase by more than a specified target rate for a five-year period as determined by the Center for Medicare and Medicaid Services’ (CMS) actuaries.  If that rate is exceeded, the IPAB submits to Congress recommended measures to reduce Medicare costs.  Congress then has one year either to reject those recommendations by a three-fifths vote or to enact alternatives with similar cost reductions.  If Congress does neither, the recommendations automatically become effective.

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Resources

First, Do No Harm Released by the National Academy of Medicine

The National Academy of Medicine recently released First, Do No Harm – Marshaling Clinician Leadership to Counter the Opioid Epidemic.  The publication was developed to counter the opioid crisis    and states that clinicians are not expected to heal the crisis alone ─ they must work with patients and families, community leaders, elected officials and the business community.  

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Medscape Releases 2017 APRN Compensation Report

Medscape released the results of its 2017 APRN compensation survey.  According to the report, most APRNs saw their compensation continue to grow in 2016, with six-figure pay now the norm across all categories.  The biggest pay hikes belonged to CNSs, who received $102,000 last year, 7.4% more than in 2015.  Certified registered nurse anesthetists and nurse practitioners registered smaller gains, 3.4% and 2.9%, respectively, while compensation for nurse-midwives slipped 1%. More than 3,400 CNSs, nurse practitioners, nurse midwives, and certified registered nurse anesthetists participated in the survey.


Perinatal Quality Improvement Action Brief

The Institute for Perinatal Quality Improvement (PQI) was organized to help perinatal health professionals expand their use of improvement science to eliminate preventable perinatal injuries and deaths.  Recently QPI announced its enhanced website to assist Perinatal QI leaders in:

  • Implementing QI;
  • Keeping staff engaged in QI;
  • Connecting with and learning from other perinatal QI leaders; and
  • Developing QI education and tools.

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