Meeting and Committee Highlights October 2016 Through February 2017

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Meeting and Committee Highlights

OCT 2016 – FEB 2017

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Membership

[/vc_column_text][/vc_column_inner][vc_column_inner width=”2/3″][vc_column_text]Membership as of October 9th, 2016 was 255 members. There are over 1000 prospective members in the metro area. Rorie Chinnock, membership chair and President-elect, has been actively sending letters to welcome new members and follow up with any lapsed members.  Ending membership as of February 13th, 2017 is 282 members. We are growing in numbers yet attendance at meetings continues to decline. We are working on a monkey survey to get feedback on what you are looking for in an association. Letter template received from national for periop 101 students. Will look into recruiting from periop 101 groups.[/vc_column_text][/vc_column_inner][/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner width=”1/3″][vc_column_text]

Awards &
Certifications

[/vc_column_text][/vc_column_inner][vc_column_inner width=”2/3″][vc_column_text]Awards were clarified and reduced to four this past year. They are Promising Clinical Star Award, Rising Star Membership, Distinguished Service Award, and Outstanding Perioperative Nursing Practice Award. The awards are based on the previous year service. We will soon be looking at the 2016-2017 nominations. Please consider nominating a deserving individual.  Many members also earned their CNOR during the 2015-2016 year and the chapter purchased CNOR pins for them. If you were not recognized with your pin at a meeting, please contact Mary Mirick at mmmirick@gmail.com. We would love to still recognize your efforts![/vc_column_text][/vc_column_inner][/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner width=”1/3″][vc_column_text]

Bylaws &
Policies

[/vc_column_text][/vc_column_inner][vc_column_inner width=”2/3″][vc_column_text]In the Fall Stereoscope, a proposal was made related to the dissolution of the chapter along with the voting date of January 7th, 2017. The proposal passed that if the association dissolves, all funds in the treasury will be given to the AORN Foundation. Bylaws will be sent for final approval for our Chapter Accountability Standards. More bylaws updates coming from national in the new year.[/vc_column_text][/vc_column_inner][/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner width=”1/3″][vc_column_text]

Community Relations

[/vc_column_text][/vc_column_inner][vc_column_inner width=”2/3″][vc_column_text]October cash donations were sent to Augsburg Women’s Clinic. Our November collection was Toys for Tots. In December, we did a service project, Cooking for Kids, at the RMH within Children’s Hospital, Minneapolis. Then at the January Jam we collected $100 which was split between the Eagan and Coon Rapids Feed My Starving Children locations while several members participated in packing food for needy children across the world.[/vc_column_text][/vc_column_inner][/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner width=”1/3″][vc_column_text]

Education &
Workshops

[/vc_column_text][/vc_column_inner][vc_column_inner width=”2/3″][vc_column_text]October topic was member engagement -1 CEU- presented by Marilyn Westphal. November fall workshop on instrument processing presented by IMS for 5 CEU’s. 3M night was 1 CEU also on instrument processing and the perfect storm. January Jam was mixed topics for 7 CEU’s.  See calendar for future dates of education.[/vc_column_text][/vc_column_inner][/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner width=”1/3″][vc_column_text]

Finance

[/vc_column_text][/vc_column_inner][vc_column_inner width=”2/3″][vc_column_text]Beginning balance $21,063.95 on Oct 8th, 2016. Income from silent auction, fall workshop, Gerten’s fundraiser, basket raffle, and chapter dues. Expenses related to fall workshop. Ending balance $26,221.25 on December 4th, 2016.[/vc_column_text][/vc_column_inner][/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner width=”1/3″][vc_column_text]

Nominating &
Leadership

[/vc_column_text][/vc_column_inner][vc_column_inner width=”2/3″][vc_column_text]Search for candidates to fill the 2017-2018 ballot was successful. Read about the candidates on the posted ballot on page 15. Voting will be at the Saturday morning meeting on May 6th at Children’s Hospital, Mpls.[/vc_column_text][/vc_column_inner][/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner width=”1/3″][vc_column_text]

Legislative

[/vc_column_text][/vc_column_inner][vc_column_inner width=”2/3″][vc_column_text]Out of session for much of this time period. Future discussion will include the health care reform into the new presidency.[/vc_column_text][/vc_column_inner][/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner width=”1/3″][vc_column_text]

Newsletter &
Social Media

[/vc_column_text][/vc_column_inner][vc_column_inner width=”2/3″][vc_column_text]Discussion regarding continuing newsletter with the rebirth of the chapter website: www.aorntwincities.com Will continue printing at least one more year.  We are also on Facebook, Instagram and Twitter. #wearegettingthere[/vc_column_text][/vc_column_inner][/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner width=”1/3″][vc_column_text]

New Business

[/vc_column_text][/vc_column_inner][vc_column_inner width=”2/3″][vc_column_text]Watch for a Monkey survey. Please complete. Expo 2017 coming up in April![/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][vc_column width=”1/3″][vc_widget_sidebar sidebar_id=”main-sidebar”][/vc_column][/vc_row]

Take Off to 2017 AORN Surgical Expo and Conference

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Ready for “Take-Off” to Boston, MA

April 1st through 5th

International AORN Surgical Expo and Conference 2017

By Rorie Chinnock

Chapter 2401 delegates are heading off to Boston from April 1st-5th for the 64th annual conference. The focus is to discover “The Power of You” lead by President Martha Stratton.
As an AORN member, “The Power of You” means you have the right to vote for the officers of our organization locally and nationally. You do not need to go to EXPO to exercise this benefit. For a review of candidates, visit www.aorn.org or read about them in the January AORN Journal.

There will be many speakers, great education, and a “HUGE” exhibit hall. Continuing education will focus on current issues and trends, evidence-based practice and research, and health care initiatives relative to the advancement of perioperative practice.

Representing our chapter are: Rorie Chinnock (delegate chair), Marilyn Westphal, Denise Edelman, Anne Jones, Cheryl Langford, Lynette Marks, Mary Mirick, Michelle Nolander, Leah Van Gorp, and Barb Weiman. Among our delegation are three first time attendees: Denise, Lynette and Leah. Lynette was also our Expo scholarship recipient!

Become involved and join us in Boston! Or get involved in our chapter now and consider being a delegate in 2018 when the EXPO is in New Orleans, March 24-28, 2018.[/vc_column_text][/vc_column][vc_column width=”1/3″][vc_widget_sidebar sidebar_id=”main-sidebar”][/vc_column][/vc_row]

Community Relations Update

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Community Relations Update

By Mary Kay Boell

Last December, twelve pizzas, salads, fruit, cookies and brownies were served at the Ronald McDonald House. Our Chapter continues our involvement with the Cook for Kids Program at Mpls Children’s Hospital. As many of you know, it is designed to help families that are being served at the Ronald McDonald house while their children are receiving treatment and care for major illnesses.

A big shout out and thank you to the following members of our chapter: Marilyn W., Jane O., Anne J., Mary Kay B., Leah V., Cheryl L., Barb W., Sheri D., Rorie C., Eileen S., Denise E., and Mary M. Our involvement at RMH would not be possible without the giving of your time and donation of the food. Thank you!

Our chapter played a role in brightening a child’s life on Christmas morning. We collected 30 toys for the US Marine Corps Toys for Tots. Again, thank you for the donations.
After the January Jam, several AORN members were busy packing meals at Feed My Starving Children. We participated at the Eagan and the Coon Rapids locations.
Marilyn W., her son and his girlfriend, Anne J., Carmel G., Jenny W, her granddaughter and a friend were busy at the Eagan location. At Coon Rapids, Barb W., Kris D., her daughter and granddaughter, Alyce B. her daughter and granddaughter helped pack 145 boxes, which is 31,320 meals! 86 kids will be fed for a year.

Thank you all for giving of your time to make a difference in a child’s life!

Our involvement with our chapter service projects would not happen without our volunteers. Thank you to those who give of their time to make a difference.

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Guarding Against “Normalization of Deviance”

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Guarding Against “Normalization of Deviance”

Presented by Mike Mullane, AORN Expo Speaker
AORN Surgical Expo 2016, Anaheim, CA

Reviewed by Caroline Ness

What kind of team do you want working for you when you take off in an airplane? What kind of team do you want in your work environment? A world class safety and culture, right? Colonel Richard “Mike” Mullane is a retired pilot and astronaut who flew missions with the NASA Space Shuttle program. Mike demonstrated how shorts-cuts in the business model of the space shuttle program were the norm. This culture is what led to the Challenger disaster solid rocket booster failure in 1985 killing all of the crew. This wasn’t an accident; it was a predictable surprise! What led to this predictable surprise? How does this relate to our work environments in health care?

Let’s think about the failures that led to Challenger disaster… Schedule pressures were set up to achieve unattainable goals. Job pressures, budgets, family, relationships, health concerns, financial problems led to safety shortcuts. Conflicting performance results lead to dismissal of options and drift to the easy option to fix things. In the space shuttle failure, the risk analysis drifted to the easy option. The shuttle business model viewed the shuttles as aircraft-like with everything being reused. The program was to be cheap and easy to turn.
The program initially was to have 26 missions per year. The program was never able to achieve that and the most launched missions were 11. The Challenger was the 11th mission! After the Challenger blew up, the business model was changed to 6 to 9 missions. The program drifted to the easy option versus grounding and fixing the assembly process problem. Confirmation bias can occur when testing. There is a predisposition to a resolution that can drive results to a margin that results in false feedback. In the Challenger disaster, the assumption was that the risks associated with the shuttle flight were similar to regular aircraft; therefore, ejection seats were removed. The shuttle crew survived the explosion but had no escape route. They died when the cockpit landed in the water. The crews also had no pressure suits, they wore coveralls. NASA believed the vehicles were as safe as aircraft. They had a “Mission Accomplished Mentality.” This false feedback isn’t absolute; it’s manageable. The repeated success of the missions implied future success. Deviance continued in spite of the risks associated.

So what are the lessons learned from the space shuttle program and how should this drive our decision-making in the health care environment?

Lesson 1: Accountability

  • Live’s depend on your actions.
  • You own what flows from your behavior.
  • Flow to the good.
  • Don’t second guess as there are no “do-overs.”

Lesson 2: Safety is #1

  • Quality is most important.
  • Everything else-budget, schedule, production add “pressures.” These pressures can create priorities to change which causes a “normalization of deviance.”

Lesson 3: Set challenging but attainable goals

  • When you see a problem in which the goal is unattainable, adjust.

Lesson 4: Procedure Compliance should be a religion

  • Documentation for work in hazardous environments is written in blood. Deviance can result in something going wrong.

Lesson 5: Pay Attention

  • Keep your head on a swivel! Is something changing? Be aware of what’s going on, so you can adjust to changes.

Lesson 6: THE FATAL STEP

  • Getting away with it. The first step over a “best practice” is almost always the fatal step.

In order to assure that we don’t fall into the “normalization of deviance,”we must have courageous self-leadership and continuous self-improvement. We can’t be camped out in a comfort-zone. We need to always strive to improve! We aren’t always destined to something. Be doggedly tenacious in improving yourself. As courageous self-leaders you must be laser-focused on the mission! Thinking you can’t do it only to look back and see you can. The scariest thing is advancing your education. Focus on incremental improvement, challenge yourself, set goals! We are all better than we think! Challenging yourself you are also helping to take our teams to the highest level![/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][vc_column width=”1/3″][vc_widget_sidebar sidebar_id=”main-sidebar”][/vc_column][/vc_row]

Patient Safety in the Age of Inattention Science and Solutions

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Patient Safety in the Age of Inattention: Science and Solutions

Presented by Donna A. Ford, MSN, RN-BC, CNOR, CRCST
AORN Surgical Expo, Sunday, Apr 3rd, 2016, Anaheim, CA

Reviewed by Anne Jones

This topic caught my eye because of the ubiquitous nature of personal electronic devices (PEDs)—smartphones, tablets, laptops–in our lives and the safety risk they pose when used while doing tasks that require focus and attention. The risk, in my opinion, is underappreciated by many people, possibly because these devices are so much a part of how we communicate today, receive our news, find information, and more. It’s kind of amazing to have a computer that fits in your hand.

Our presenter pointed out that the considerable upside of this technology is tempered by the fact that some users exhibit almost addictive behaviors related to use of these devices. Use of electronic devices for personal reasons during patient care, can pose a distraction in the health care setting, contributing to the possibility of errors with serious consequences. When added to other distractions–most of them necessary for patient care, such as monitors, pagers, conversation, computers, numbers of personnel, phone calls, the noise level, interruptions, and more–the ability of caregivers to focus decreases, performance suffers, and the potential for error goes up.

Please review AORN’s Position Statement on Managing Distractions and Noise During Perioperative Patient Care, published in 2014, which states, “Distractions and noise that do not serve a clinical function should be minimized.” www.aorn.org. This position statement supports the ongoing work of AORN to describe best practices for the patient care team to promote safe care in the perioperative setting and address some of the human factors implicated in preventable errors. Data on the use of personal electronic devices in the clinical setting for other than patient care seems to be on the rise. AORN states that “Undisciplined use of cellular devices in the OR by any member of the perioperative team may be distracting and affect patient care.”

Ms. Ford cited some research on brain function tells us that the brain receives information constantly and has to sort that information into more relevant or less relevant, organize, determine how to respond, or not, in what order, how many, what to ignore. Does responding to one stimulus mean losing awareness of another, or several? Are these conscious choices, under our control? These all have an impact on our ability to manage distractions and focus on critical tasks.

Undisciplined use of PEDs may become a problem in the clinical setting when caregivers are unable to separate their habits from their work responsibilities. Ms. Ford presented some information based on self-reported addictive behaviors related to their devices, including that more than half of smartphone users say they “couldn’t live without “their devices;  among adults 18-29 years of age, 93% use their phones to avoid “being bored,” and 47% use their phones to avoid others around them. The science on sleep tells us that taking your phone to bed with you can disturb sleep, depriving the brain of time needed to refresh neurons. Good quality sleep improves brain function, especially memory and behavior, essential for the best possible performance in the workplace.

Recommendations for managing use of PEDs, minimizing distractions and interruptions, and promoting patient safety, involve educating staff on the impact of distracted behavior on patient care, promoting a culture of safety including maintenance of no-interruption zones and zones of silence, the concept of situational awareness, strategies to reduce interruptions, distractions, and unnecessary noise, recognition of critical tasks, and the ability to speak up on behalf of the patient.

Organizations have to set and enforce multidisciplinary policies on personal use of mobile devices in the OR reinforcing a code of professional behavior in interacting with these devices, promote a culture of safety to reduce distractions and noise, limit external communication to only what is necessary, allow use of personal devices only outside the work setting on non-work time.

Individuals need to recognize and correct their own behavior related to use of PEDs, avoid contributing to the noise level by being aware of tone of voice and timing of conversations, follow and model routines for safe practices during critical tasks and phases of care, and maintain situational awareness related to patient care needs and to minimize distractions.
Additional information is available on the websites of the Association of Peri-Operative Registered Nurses, the American Association of Nurse Anesthetists, the American College of Surgeons, and the Association for Healthcare Quality Research, the American Nurses Association, and the American Society of PeriAnesthesia Nurses.

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2017 January Jam – Go Clear Award

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Update

Go Clear Award

Presented by Karla Brustad, Medtronic

Karla Brustad extended the electro-surgery presentation talking about the hazards of surgical smoke. For many years, the focus and regulations were regarding laser plume. More research shows that surgical smoke particles are just as hazardous if not more. In a comparison study on smoke condensates from 1 gm of tissue, laser produces smoke equivalent to 3 cigarettes while electro-surgery produces smoke equivalent to 6 cigarettes. The average daily impact of surgical smoke could be as high as 27-30 cigarettes! Also, after 5 minutes of ESU activation the concentration of smoke particles increases from 60,000 to 1,000,000, per cubic foot in the OR and it is that high throughout the entire OR. So our best defense is a good offense…having proper OR ventilation, wearing appropriate PPE, using a smoke evacuation system, and education! The Go CLEAR award is an online education program consisting of a pretest, module, quizzes, and post-test.

CLEAR stands for check, learn, evaluate, assess and report. This program is a partnership between Medtronic and the AORN Foundation. If interested in learning more about Surgical Smoke, 2 CEUs are available free at www.coviden.com/pace/clinical-education/274659.

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2017 January Jam – Recommended Practices for Electro-Surgery and Surgical Smoke

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Update

Recommended Practices for Electro-surgery and Surgical Smoke

Presented by Mario Vai, Medtronic

Mario Vai started this presentation with a review of the basic principles of electricity and electro-surgery, best practices, and patient safety concerns. He differentiated between a monopolar current with the grounding system and the bipolar current with an isolated system. He also discussed advanced surgical hemostasis such as vessel sealing and ultrasonic dissection. Your best practice for safe electro-surgery is to follow the manufacturer’s written instructions. Many questions were asked about tattoos and taping of jewelry with the use of cautery. Red inks in tattoos can contain metal and should be avoided for the placement of the grounding pad. Recommendation for jewelry is to lay it flat and tape it to create a broader dispersal of current. If interested in learning more about Electro-surgery, 2 CEUs are available free through www.coviden.com/pace/clinical-education/273622.

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2017 January Jam – Fetal Therapy

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Update

Fetal Therapy

Presented by Dr. Joseph Lillegard

Dr. Lillegard is a pediatric general and thoracic surgeon at Children’s Hospital. He is also the Medical Director and the Director of Research at the Midwest Fetal Care Center in Minneapolis.

Fetal surgery can either be minimally invasive or an open procedure. Minimally invasive procedures include using ultrasound and fetoscopy. Medical concerns using this corrective technique are twin to twin transfusion and bladder outlet obstruction. Advanced fetal fetoscopy may include congenital defects such as diaphragmatic hernia and CHAOS, which is failure of the upper airway to form the canal around the 10th week of gestation. This leads to laryngeal stenosis and hydrops.

Open fetal surgery includes spina bifida repair around the 26th week of gestation. The early repair is done to decrease the amount of amniotic fluid around the exposed spinal cord and nerve endings, and an overall decrease of having a shunt in patients by 50% and causes reversal of hind brain herniation.

The latest advances in fetal surgery include gene therapy for treatment of inborn errors of the metabolism of the liver. One in 1200 live births needs a liver or a hepatocyte transplantation due to the child missing an enzyme called Tyrosinemia, which leads to FAH deficiency, cirrhosis or cancer of the liver. There are four ways to correct this either by ex-vivo, in-utero gene therapy, large scale production of human hepatocytes, or gene correction. Dr. Lillegard is currently using pigs as his lab models to either return autologous hepatocytes to the model or using gene transfer in-vivo or in-utero to correct the FAH deficiency.

It is a very exciting topic and we will be hearing more about this! Some of you may have caught a documentary on Kare 11 (link on our FaceBook page) that highlighted Dr. Lillegard and how these procedures can help a patient and change not only the patient’s life but the future family life! Awesome presentation!

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2017 January Jam – Fundamentals of UV for Hospital Surface Treatment

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Update

Fundamentals of UV for Hospital Surface Treatment

Presented by Eric Cheng, Clorox Healthcare

Some of you may have met Eric Cheng at the fall workshop vendor fair. He returned to share in more detail the use of UV light technology for hospital surface disinfection. Hospital acquired infections (HAIs) can be life threatening to our patients and cost hospitals millions of dollars. We reviewed the surface viability of microorganisms such as MRSA, C Diff, CRKP, and VRE. Several studies were cited regarding the reduction of these types of microorganisms using this technology. UV is used to supplement manual disinfection not replace it. There are different types of UV light and benefits and limitations. He also discussed selection criteria for your facility and implementation programs. Some members voiced that they have and use the UV system at their hospitals but see lesser use in the Operating Room. If interested in learning more about UV technology, go to www.pfiedlerenterprises.com
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3M Education

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3M Education – November 21st, 2016

by Cheryl Langford, RN, MSN, CNOR

Cori Ofstead, MSPH, President and CEO of Ofstead & Associates was our guest speaker at our fabulous 3M Perioperative Nursing Celebration on Monday November 21, 2016.

Her title to her talk was “Recognizing the potential for a perfect storm: Strategies for improving patient safety with flexible endoscopes.” Some of the factors that contribute to the perfect storm regarding the use of contaminated endoscopes are that there are complicated reprocessing guidelines, non-adherence to guidelines, inability to see pathogens and internal damage with just your eyes, and the ever increasing pressure to do more with less! Reprocessing involves 100 or more steps and many staff who perform these roles don’t like performing manual cleaning, experience physical discomfort, and feel pressure to work quickly while reprocessing, not necessarily performing the correct steps for the correct length of time necessary. One key item to note is that bedside pre-cleaning and manual cleaning removes most of the debris and microbes, and high level disinfection takes care of almost everything else. Sterilization is not required as of yet, but may be in the future.

If you are looking to do some great bedtime reading on infection prevention and endoscopes, check out the many different guidelines that were updated over the past two years from AORN, SGNA, and AAMI. They range in length from 22 pages to 84 pages and each differ a little, but their overall end result is the same; endoscopes that have been properly reprocessed, to include storage, and with some quality control methods in place. All kidding aside, please stay informed about guidelines and instruction for use (IFU) changes, ensure training and competencies are up to date, develop policies and protocols, perform audits, and conduct routine quality checks. Each one of us has a part in improving patient safety and reducing risks associated with flexible endoscopes.

Cori Ofstead has led many studies and can be contacted for more information or questions via email at
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