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2008 Disaster Preparedness and Community Health Committee
Fact Sheet
Download 2008 Resolution [PDF]
2008 House of Delegates Resolution: In Support of Including Disaster Preparedness, Response, and Pre-Certification in Nursing Curricula
- The National Student Nurses' Association (NSNA) has supported disaster preparedness and response related efforts through resolutions in the House of Delegates since 2001.
- Natural disaster events have quadrupled over the last 20 years, primarily floods, cyclones, and storms, and the average number of persons affected per year worldwide has increased to 250 million, causing a humanitarian crisis; and within the NSNA's membership 43% of respondents to the NSNA Disaster Relief Survey reported having experienced a disaster.
- 84% of respondents to the NSNA Disaster Survey who stated that they had participated in disaster relief work felt it enriched their nursing education, yet 57% reported a need for more education in order to perform competently in a disaster relief situation. In addition, 96% felt that disaster preparedness education should be included in undergraduate curricula.
- Nursing students are now required to understand the basic principles of disaster and emergency planning in order to accurately answer questions on those subjects which fall within the category of Safety and Infection Control on the NCLEX-RN®, which accounts for 18-14% of the total NCLEX-RN subject matter.
- National Incident Management Systems (NIMS) basic training (IS-100, IS-200, and IS-700.a courses) for all potential disaster responders is a requirement for states, territories, tribes and local entities as of fiscal year 2006, in order to be deemed NIMS compliant, which is a requirement for agencies to receive federal disaster preparedness funding.
What Can Nursing Students Do?
- Review the articles in Dean’s Notes (pp.1-3) and Imprint (pp. 32-33) that promote the importance of disaster preparedness and pre-certification
- Encourage nursing programs to include disaster preparedness and response material in their planned curricula in order to adequately prepare students for the NCLEX-RN exam;
- Encourage nursing programs to include the National Incident Management Systems (NIMS) training as an elective in their planned curricula;
- Complete the National Incident Management Systems (NIMS) Certificate programs which are available online at no cost. Go to www.fema.gov/emergency/nims/NIMSTrainingCourses.shtm under NIMS Courses, select and then complete the NIMS online IS-100 course, printing the Certificate of Completion when received; select and complete the NIMS online IS-200 course, printing the Certificate when received; and select and complete the NIMS online IS-700.a course, printing the Certificate when received.
- The Disaster Preparedness Committee challenges NSNA members to complete the three basic NIMS training programs online, print their Certifications and bring them to Registration at the 57th NSNA Annual Convention in Nashville, TN from April 15-19, 2009. At registration, NSNA members who completed the NIMS basic training program will be awarded a NIMS Certified ribbon to wear on their name tag and will be recognized at Convention.
Resources:
FEMA’s Incident Command System links to Resources and reference documents on disaster preparedness.
NSNA (2008) Guidelines for Establishing and Implementing Disaster Preparedness, Recovery, and Relief Projects which includes the Go Bag Check List (p. 5) and the Disaster Supply Kit Checklist (pp. 6-7.)
The American Red Cross (www.redcross.org) has information on how to prepare schools and students for disasters, and information for how to prepare your home and family, and how to prepare your workplace and employees.
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2008 Disaster Preparedness and Community Health Committee
Fact Sheet
Download 2008 Resolution [PDF]
2008 House of Delegates Resolution: In Support of Rewriting the Language of the Current Good Samaritan Laws to Cover All Licensed Healthcare Personnel Responding to Emergencies and/or Operating Automatic External Defibrillators
- The 2003 National Student Nurses’ Association (NSNA) House of Delegates supported (p. 12) increased protection for volunteerism by medical personnel caring for the underserved and uninsured.
- Each year 164,000 Americans experience sudden cardiac arrest (SCA) outside of the hospital, and an average of 250,000 Americans across settings.
- On average in the United States, just 6% of SCA victims survive.
- Cardiopulmonary resuscitation (CPR) and early defibrillation with an automated external defibrillator (AED) more than double a victim’s chance of survival.
- Immunity for rescuers does not include licensed nurses in 37 states and 21 states do not have statutes that allow for adequate liability protection for healthcare volunteers during emergencies.
What Can Nursing Students Do?
- Support legislation related to standardizing the language of the current Good Samaritan Laws in all states, the District of Columbia or any territory, possession or dependency of the United States of America to offer immunity for all rescuers who are licensed healthcare personnel;
- Become educated about AED regulations and Good Samaritan Laws and legislation in your state;
- Raise awareness in students, faculty and the community about the effectiveness of yearly workplace training on CPR and the use of AED by trained personnel for sudden cardiac arrest (American Heart Association, 2009.)
Resources:
American Heart Association (2008). AED Implementation Guide.
American Heart Association (2009). Questions and Answers on AED Programs.
The American Heart Association and Occupational Safety and Health Administration Alliance, February, 2008.
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2008 Legislation/Education and Community Health Fact Sheet: Resolution #2
Download 2008 Resolution #2 [PDF]
2008 House of Delegates Resolution: In Support of a Continuum of Medical Care for the Homeless in Order to Prevent Patient Dumping
- Some health facilities have engaged in a practice unfavorably known as ‘homeless dumping’, where patients who are homeless are transported to cities or vicinities that have support services , with the rationale that services might be available to the individual.
- At times homeless individuals have been dropped off in front of a shelter or treatment center that may have limited space available, leaving the person to fend for themselves on the street sometime within the next 24 hours. Although not in acute medical crisis, and therefore not protected under EMTALA regulations, these homeless individuals are at risk for compromised recovery from physical or mental illness or injury on the streets.
- "Respite care" has emerged to describe recuperative or convalescent services needed by homeless individuals with medical problems.
- Respite care has reduced the average number of hospital inpatient days (over a twelve-month period) for its residents to 3.4 days, versus 8.1 days for those who did not receive respite care, which allows for more “timely discharge from the hospital” (Buchanan et al, 2006.)
- Respite care programs have witnessed improvement in their residents’ health, access to healthcare, adherence to medications, income, and housing status.
- Increasing financial pressures on hospitals have caused consolidations and closures, so that the number of emergency rooms is decreasing despite increasing demand for emergency care in many communities.
What Can Nursing Students Do?
- Advocate for a continuum of medical care for the homeless in your state and community, including respite care after hospitalization coordinated between acute care hospitals and community organizations. A list of Respite Centers is available from the National Health Care for the Homeless Council, and other ideas for how to get involved in your state are available from the Respite Care Network;
- Support legislation that protects patients from homeless dumping practices, and provides adequate funding resources for preventative care, emergency care, and alternative discharge destinations for homeless individuals;
- Raise awareness about the effectiveness of respite programs in the United States, as well as the need for federal, state, and local funding of supportive group housing/group respite housing to meet the physical health, mental health, and safety needs of men, women and children who are homeless in America.
- Educate nursing students and discuss with faculty about the requirements, directives, and regulations of the Emergency Medical Treatment and Active Labor Act (EMTALA). Go to the EMTALA website developed by the Centers for Medicare and Medicaid (CMS); the Emergency Nurses’ Association, and www.emtala.com for more information and a compilation of legal and health care regulations involving EMTALA.
Resources:
American Organization of Nurse Executives (AONE) & the American Hospital Association (2009.) The Road to Economic Recovery: A proposal to support health care in America.
American Medical Association (2009.) Virtual Mentor: Refusal of Emergency Care and Patient Dumping.
Institute of Medicine (2006). The Future of Emergency Medical Care in the United States (includes Hospital-based Emergency Care: At the breaking point; Emergency Medical Services: At the crossroads; and Emergency Care for Children: Growing pains.)
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2008 Community Health Committee
Fact Sheet
Download 2008 Resolution [PDF]
2008 House of Delegates Resolution: In Support of Increased Awareness of Oral Assessment and Hygiene and the Need for Appropriate Dental Referrals by Nurses
- The United States Surgeon General declared the status of oral health in the United States a "silent epidemic" and that "no one should suffer from oral diseases or conditions that can be effectively prevented and treated"
- Health People 2010 states that no one can be truly healthy unless he or she is free from the burden of oral and craniofacial diseases and conditions.
- A healthy oral status is a core element for the health and ability to thrive of the patient/client in order to maintain optimal quality of life (McAuliffe, 2007.).
- Conditions such as oral candidiasis, denture stomatitis, denture irritation, hyperplasia and traumatic ulceration may occur as a result of oral neglect. Poor oral hygiene has also been found to be a predisposing factor to chest infections and coronary heart disease (McAuliffe, 2007.)
- Ventilator-acquired pneumonia, one of the predominant nosocomial infections in the health care industry, can be prevented in part by interventions among nursing staff such as appropriate oral hygiene and suctioning of the oral cavity (Augustyn, 2007.)
- The patient/client undergoing treatment for a medical disease may not be receiving care from a dentist for various reasons, such as lack of insurance coverage. The number of dentally uninsured Americans totals more than 100 million (United States Department of Health and Human Services, 2003.)
- The opportunity to assess, educate and refer to a dentist’s care belongs to nurses administering patient care in an office assisting a physician or nurse practitioner or in a hospital.
- Nurses should frequently make oral assessments and implement oral hygiene, including detection of signs and symptoms and difficulties [in performing] oral hygiene procedures” on patients to maintain overall health.
- Oral health of the patient/client will benefit from treatment administered by a multidisciplinary team of nurses, dental hygienists, physicians and dentists (United States Department of Health and Human Services, 2003.)
What Can Nursing Students Do?
- Promote increased awareness among nurses and nursing students about the importance of oral assessment and hygiene as well as appropriate referrals as recommended by the United States Surgeon General and Healthy People 2010;
- Read and discuss with NSNA members in school chapters and state chapters/associations research about the impact that poor oral health has on individual’s physiological health, as well as psychosocial development and quality of life;
- Encourage evidence-based practice by nurses, nursing students, and nurse educators through colleague and peer modeling in both classroom and clinical locations of consistent oral assessment and hygiene, as well as appropriate dental referrals as needed.
Resources:
Augustyn, B. (2007). Ventilator-associated pneumonia: Risk factors and prevention. Critical Care Nurse, 27, 32-39.
U.S. Department of Health and Human Services (USDHHS). Healthy People 2010 (Conference Edition, in two volumes). Washington; 2000 January
McAuliffe, A.(2007). Nursing students’practice in providing oral hygiene for patients. Nursing Standard: Royal College of Nursing, 21 (33).
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2008 Legislation/Education and Community Health Committee
Fact Sheet
Download 2008 Resolution [PDF]
2008 House of Delegates Resolution: In Support of Legislation Against Genetic Discrimination in the Workplace and for Insurance Purposes
- The 1999 National Student Nurses' Association (NSNA) House of Delegates (p. 7) supported genetics education for nurses and nursing students.
- 93% of Americans support genetic testing for research purposes, yet most are afraid to participate; and 92% of Americans are concerned that results of genetic tests could be used in detrimental ways (Genetics and Public Policy Center, 2007.)
- The information gathered by research cannot be used to empower Americans if the public is fearful of misuse of information.
- Three out of four Americans supported in 2008 a law forbidding genetic discrimination by health insurers and employers, but previously there was no national legislation covering genetic testing and privacy.
- There was an executive order prohibiting federal departments and agencies from using genetic information for hiring and promoting purposes that President Clinton signed ; however, the executive order did not apply to the general public.
- On May 21, 2008, President George W. Bush signed into law the Genetic Information Nondiscrimination Act (GINA), which prohibits U.S. insurance companies and employers from discriminating on the basis of information derived from genetic tests.
- The GINA Act protects Americans from discrimination based on information derived from genetic tests. It forbids insurance companies from discriminating through reduced coverage or pricing and prohibits employers from making adverse employment decisions based on a person’s genetic code. In addition, insurers and employers are not allowed under the law to request or demand a genetic test.
- Increased genetic testing makes it more likely that researchers will come up with early, lifesaving therapy for a wide range of diseases with hereditary links, lawmakers said. Genetic testing also will help doctors catch problems early, perhaps leading to preventive treatment and lower costs.
What Can Nursing Students Do?
- Educate NSNA members and faculty about the 2008 Genetic Information Nondiscrimination ACT passes by the 110th Congress and signed into law;
- Support educational programs in nursing curricula that prepare students to offer patient education related to genetic testing, patient confidentiality, and autonomy in the informed consent process;
- Locate your U.S. Representative and his/her contact information (by your zip code) at http://www.house.gov Locate your U.S. Senators and their contact information (by your State) at http://www.senate.gov.
- Write your U.S. Representative and thank them for their support of H.R. 493 (the only nay vote was cast by Rep. Ron Paul of TX); and thank your U.S. Senators* for their unanimous support of the Senate bill (H.R. 493 as amended) which once signed into law, became the Genetic Information Nondescrimination Act of 2008.
Resources:
Association of Women's Health, Obstetric and Neonatal Nurses: Position Statement on Role of the RN in Genetic Testing.
Read, C., Dylis, A., Mott, S., Fairchild, N. (2004). Educational Innovations: Promoting integration of genetics core competencies into entry-level nursing curricula. Journal of Nursing Education, 43 (8).
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2008 Legislation/Education Committee
Fact Sheet
Download 2008 Resolution [PDF]
2008 House of Delegates Resolution: In Support of Increased Awareness of and Evidence-based Research on Bipolar Disorder in the Pediatric Population
- Bipolar Disorder is defined as a "group of mood disorders that include manic episodes, hypomanic episodes, mixed episodes, depressed episodes, and cyclothymic disorder," according to the criteria in the Diagnostic and Statistical manual of Mental Disorders (DSM-IV-TR).
- There has been a 40-fold increase in the diagnosis of Bipolar Disorder in the pediatric population from 1994-2003, with a concurrent 2-fold increase in the diagnosis of Bipolar Disorder in the adult population (National Institute of Mental Health, 2007.)
- There is no single, well-validated screening instrument for the clinical diagnosis of Bipolar Disorder in children, and the diagnosis is complicated by differential presentation of symptoms, comorbid mental health disorders, and physical and psychosocial development (Birmaher, 2007; Moreno,2007; National Institute of Mental Health, 2007.)
- The first-line treatment of Bipolar Disorder is medication, however the pediatric brain is developmentally different from the adult brain and the metabolism of medications differs between these age groups.
- The efficacy and the safety of mood stabilizers and antipsychotic medications, used as front-line treatment for Bipolar Disorder, have not been examined or well-established in the pediatric population.
- Evidence-based data regarding the treatment of children and adolescents with Bipolar Disorder are very limited, yet they are still treated in the same manner as adults.
What Can Nursing Students Do?
- Encourage NSNA members in school chapters and state chapters/associations to collaborate with professional nursing and healthcare organizations to advocate for increased funding toward evidence-based research related to Bipolar Disorder in the pediatric populations;
- Advocate for accurate screening, diagnosis, and treatment of pediatric patients diagnosed with Bipolar Disorder.
Resources:
Birmaher B: Longitudinal course of pediatric bipolar disorder. Am J Psychiatry. 2007, 537-539.
Moreno, C., Laje, G., Blanco, C., Jiang, H., Schmidt, A. & Olfson, M. (2007). National trends in the outpatient diagnosis and treatment of Bipolar Disorder in youth. Archives of General Psychiatry, 64(9), 1032-1039.
National Institute of Mental Health: Child and Adolescent Mental Health.
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2008 Legislation/Education Committee
Fact Sheet
Download 2008 Resolution [PDF]
2008 House of Delegates Resolution: In Support of the American Nurses' Association "Safe Staffing Saves Lives" Campaign
- The 2003 National Student Nurses' Association (NSNA) House of Delegates supported (pp. 4-5) mandatory patient: nurse staffing ratios to maximize patient safety and quality of care, and minimize professional burnout in practicing nurses.
- Staffing is an issue of professional concern because inappropriate staffing can threaten patients’ safety, RN’s [Registered Nurses’] health and safety, and the integrity of the professional’s commitment to patients’.
- Staffing also concerns RNs because the pressures put on them everyday by increasing patient intensity, increasing complexity of care and the fatigue they feel which increases over time.
- Safe staffing provides hospitals with the flexibility of tailoring nurse staffing to the specific needs of patients based on factors including how sick the patient is, the experience of the nursing staff, technology, and support services available to the nurses.
- Complications associated with inappropriate staffing include postoperative respiratory and/or cardiac complications, increased risk for pulmonary failure and re-intubation, and infectious complications (e,g, septicemia) (Clark et al., 2007.)
- In hospitals with high RN staffing, medical patients had lower rates of urinary tract infections, pneumonia, shock, upper gastrointestinal bleeding, and decreased hospital stays (Stanton, 2004.)
- The proposed Registered Nurse Safe Staffing Act would hold hospitals accountable for the development of valid, reliable unit-by-unit nurse staffing plans (ANA , 2008.)
What Can Nursing Students Do?
Resources:
American Nurses’ Association (2008). Principles of Delegation (quick view.)
American Nurses’ Association (2008). Safe Nurse Staffing: Quick Read Resources.
Buerhaus, P., Needleman, J., Mattke, S. & Stewart, M. (2002). Strengthening hospital nursing. Health Affairs, 21(5), 123-132.
Clark, P., Leddy, K., Drain, M., & Kaldenberg, D. (2007). State Nursing Shortages and Patient Satisfaction, More RNs- Better Patient Experiences. Journal of Nursing Care Quality, 22(2), 119-127.
Needleman, J, Buerhaus, P., Mattke, S., Stewart, M. & Zelevinsky, K. (2002). Nursing staffing levels and the quality of care in hospitals. New England Journal of Medicine, 346(22), 1715-1722.
Stanton, M. (2004). Hospital nurse staffing and quality of care. Agency for Healthcare Research and Quality, 14, 1-12.
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2008 Legislation/Education Committee
Fact Sheet
Download 2008 Resolution [PDF]
2008 House of Delegates Resolution: In Support of National Standardized Curricula for Nurse Residency Programs
- The 2006 National Student Nurses' Association (NSNA) House of Delegates supported (p. 1) increased advocacy for improved preceptor programs to create a robust workforce environment within the nursing profession.
- A preceptor, one component of a nurse residency program, provides a period of practical experience and training supervised by a specialist in a particular field.
- Nurses convey an increasing amount of confidence, competence, and mastery of their jobs upon completion of nurse residency programs, as well as feelings of improvement in their ability to organize and prioritize care.
- Published hospital reports cite a noticeable increase in retention rates for new graduates who attend nurse residency programs (Sumner & Cornett, 2007; Thrall, 2007.)
- Negative perceptions of first job experiences may cause nurses to leave their positions, increasing the nursing shortage, and wasting recruitment and retention resources (Bowles & Candela, 2005.)
- Some nurse residency programs consist solely of a standardized curriculum and preceptorship, while other residency programs also include separate mentorships, peer-support components, and educational classes (Robert Wood Johnson Foundation, 2005; Sumner & Cornett, 2007.)
What Can Nursing Students Do?
- Encourage members in NSNA school chapters and state chapters/associations to support the development of national standardized curricula for nurse residency programs;
- Stay engaged as nursing students as proposed curricula changes supporting Nurse Residency Programs evolve in your state Attend NSNA Convention and MidYear Conference programs on Nurse Residency Programs, read and submit articles in Imprint, and encourage faculty to read articles in Dean’s Notes on evidence-based Nurse Residency Programs;
- Encourage faculty members to collaborate with hospital nurse managers to develop standardized curricula for nurse residency programs.
Resources:
Mentoring tomorrow’s nursing leaders through involvement in curriculum development and shared responsibility in quality outcomes, NSNA Student Bill of Rights and Responsibilities and Guidelines for Planning: Shared Governance
Bowles, C., & Candela, L. (2005). First job experiences of recent RN graduates. Journal of Nursing Administration, 35(3).
National Council of State Boards of Nursing (2008). Literature review, Transition to practice regulatory model: The evidence.
Sumner, J. & Cornett, P. (2007). RN residency: Seeking a new paradigm. Patient Safety & Quality Healthcare, March/April.
Ulrich, B., Krozek, C. & Reinsvold, S. (2009). RN residencies for new graduates. Imprint, 56 (1), 25-29;
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2008 Legislation/Education Committee
Community Health Committee
Fact Sheet
Download 2008 Resolution [PDF]
2008 House of Delegates Resolution: In Support of Legislation and Regulation of Toys and Other Products Containing Lead
- Pediatric lead poisoning remains an important preventable public health problem in the United States (U.S.).
- Lead paint on toys has been banned in the U.S. since 1977.
- This ban did not extend to other lead-tainted products marketed to children and lead-based paint has been used as a cost-saving tactic.
- The Consumer Product Safety Commission has not had the resources for adequate inspection of imported toys and other child care items or enforcement of existing rules.
- The 2008 NSNA House of Delegates encouraged the NSNA and constituent members to support current legislation that would regulate companies to make it more difficult to produce and distribute
dangerous products for children in the U.S. (H.R. 4040).
- The 110th Congress agreed to a compromise product-safety bill (H.R. 4040) that would lower lead levels in toys manufactured, distributed, and imported to the United States
and require third-party safety testing before toys are put on the market and then sent the bill to the White House for signature (July, 2008).
- President Bush signed the bill H.R. 4040 into law on August 14, 2008 and it became Public Law 110-314 titled, the Consumer Product Safety Improvement Act of 2008.
What Can Nursing Students Do?
- Become educated on the safety of toys and other child care products that may contain lead and other toxic chemicals for children. Review The Consumer Product Safety
Improvement Act of 2008. To review your own copy go to http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=110_cong_public_laws&docid=f:publ314.110.pdf
- Educate the NSNA members at your school and educate the community about purchasing toys and child care items this holiday season that are safe, healthy, and lead-free.
- Locate your U.S. Representative and his/her contact information (by your zip code) at http://www.house.gov Locate your U.S.
Senators and their contact information (by your State) at http://www.senate.gov.
- Write your U.S. Representative and thank them for their unanimous support of H.R. 4040; and your U.S. Senators* for their support of the Senate bill (H.R. 4040 as
amended) which once signed into law, became the Consumer Product Safety Improvement Act of 2008. * Senators not voting for the bill were Senator DeMint of South
Carolina; Senator Coburn of Oklahoma; and Senator Kyl of Arizona.
- As a National Student Nurses’ Association (NSNA) member, continue to advocate for prohibition and regulation of toys and other products containing lead and other harmful
chemicals that can place the health of U.S. children at risk.
Resources:
U.S. Consumer Product Safety Commission
4330 East West Highway
Bethesda, MD 20814
Toll-free Consumer Hotline: 800-638-2772 (TTY 800-638-8270). Call to obtain product safety and other agency information and to
report unsafe products. Hotline staff may be reached from 8:30 am - 5:00 pm ET. Messages may be left anytime after these hours.
Available 24 hours a day, 7 days a week.
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