Welcome to the first on-site issue of the 2007 AAHFN Annual Meeting Newsletter! In this issue our roving reporters have highlighted the pre-meeting educational events and the Presidential Address that took place on Thursday, June 28th.
So if you were unable to attend these events, this is your opportunity to stay abreast of the latest meeting happenings!
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Pre-Meeting Workshop on Sleep Apnea |
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"Empowering Nurses to Manage Sleep Apnea in Heart Failure Patients"
Submitted by Bobbi Herron, MS, APRN, BC
With the coming tsunami of Heart Failure (HF), nurses need to specialize in the care of HF patients. 50% of HF patients have sleep disordered breathing (SDB). SDB includes obstructive sleep apnea (OSB), central sleep apnea (CSACSR), hypopnea, and arousal, all which can increase the mortality of these patients. Untreated sleep apnea can cause higher recurrence of problems such as, atrial fibrillation, restless leg syndrome, high blood pressure, and heart failure, to name a few. Thus, it is imperative for HF nurses to be empowered to assess, intervene, monitor, and evaluate the needs for sleep-disordered treatments.
ResMed, a company specializing in sleep apnea, hosted a breakfast presentation at the 3rd Annual AAHFN Meeting for HF nurses. Sara Paul, a nurse practitioner from Hickory NC, specializes in the care of HF patients. She brought the point home by teaching the pathophysiology of sleep apnea and heart failure, the need for device therapy, the advantages of CPAP, BIPAP, AutoPAP, and how to problem solve in order to increase patience compliance. She defined terms used to describe sleep apnea, reviewed the various types of sleep apnea, outlined the diagnosis and treatment, described solutions for troubleshooting positive airway pressure (PAP) therapy, and presented a case study.
Her use of case study helped nurses to visualize the effects of therapy and improvements that sleep apnea devices can make in the quality of life for HF patients. Of particular use to the attendees was the role definition of a HF nurse in comparison to that of the physician role. It is the role of the nurse to work as a detective. The nurse must investigate why the patient is not adhering to the prescribed treatment, and then plan a strategy that makes a way for patients to comply.
After learning the didactic aspects of sleep apnea, nurses then had an opportunity to visit displays and feel first hand the differences between the therapeutic sleep devices. Nurses showed their enthusiasm for the topic and the zest for learning by asking many questions and interacting with one another. They agreed that this presentation was both educational and enjoyable as they interacted with the experts, fellow nurses and handled the sleep apnea devices.
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Pre-Meeting Symposium on Remote Monitoring |
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"Remote Monitoring: New Dimensions in Heart Failure Care for Patients and Clinicians"
Submitted by Nita Meaux, RN, CRNI
Today's symposium "Remote Monitoring in Heart Failure Care for Patients and Clinicians," sponsored by Boston Scientific, was well attended and received. Presenters were Dr. Gregory Ewald, Director, Section of Heart Failure and Cardiac Transplantation Washington University School of Medicine in St. Louis, Missouri and Lynn Shaw, PA-C of Cardiovascular Consultants Medical Group in Walnut Creek, California.
Dr. Ewald made an immediate point about the impact of technology by doing a real time demographics survey. Each attendee was given a remote control and asked to answer specific questions. Within seconds we knew that the audience consisted of 45% ANPs and 45% RNs and that 29% of the attendees work with inpatients while 39% dealt with outpatients. Additional statistics were obtained in the instant survey which set the stage for discussion of how technology can be used to gather information.
Dr. Ewald discussed trials of telemonitoring of patients with implanted CRM devices and identified the need for additional statistics regarding outcomes. Tips regarding implementation of a remote monitoring program included collaboration between clinical care givers, processes for management of incoming data, algorithms or pathways associated with device based data, and integration with EMR.
Lynn Shaw shared case studies relating details of how remote data was used to determine cause and frequency of shocks, as well as rule out perceived shocks. The variety of cases and responses gave a broad view of how remote monitoring can be an adjunct to assessment and treatment.
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Presidential Address |
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Submitted by Rebecca Angerstein, RN, BD, MA, MSN, CCRN, CNS
Robin Trupp, President of the American Association of Heart Failure Nurses presentation entitled "Building the Foundation for Excellence in Heart Failure" was both informative and motivating. Definitions of foundation were discussed but for the purpose of heart failure it was described as the fundamental basics of knowledge. Building a foundation requires a plan, a process, commitment and execution.
The stages of heart failure were described along with recommended therapies based on those stages. The importance of that basic foundation of care required in Stage A continues to Stage D, we simply build on that standard of care foundation as heart failure progresses.
The final common person in the continuum of heart failure care is the nurse. Nurses care for patients across the entire cardiovascular spectrum including transplant and LVAD care, in cath and EP labs, in hospital settings and in preventative care. A survey of nurses revealed over 35,000 nurses consider themselves heart failure nurses.
Foundations for AAHFN were identified: mission, values and integrity. Professional development, relationship and leadership are the pillars of the strengths that allow the foundation to develop and grow. All of these basics lead to excellence where mediocrity and being "good" is no longer good enough.
Excellence for our professional association is measured indirectly. To achieve excellence for AAHFN as an organization we need to: 1) increase awareness, 2) provide research grants and scholarships, 3) develop the "Heart Failure University", and 4) develop Heart Failure Certification. What makes AAHFN's house of excellence a true home are the patients, because they are the heart of what we do.
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Thank you for reading this issue of the Annual Meeting Gazette. Look for upcoming on-site issues which will highlight all of the meeting events and latest news that you won't want to miss!
Sincerely,
AAHFN Annual Meeting Committee
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