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w w w. aknurs e .org THE The Official Publication of the Alaska Nurses Association. Circulation 9,000. Distributed to every Registered Nurse and Licensed Practical Nurse in Alaska. Volume 65, Issue 6 December 2014 / January 2015 Infectious Diseases THE official publication of THE Alaska Nurses Association President’s Letter 3701 E Tudor Rd., Ste. 208 • Anchorage, AK 99507 907.274.0827 • www.aknurse.org Jana Shockman, RN, CCRN-CSC Published bimonthly: Feb., April, June, Aug., Oct., Dec. Materials may not be reproduced without written permission from the Editorial Committee: Contact [email protected] Advertising: [email protected] • 907.223.2801 AaNA Board of Directors • President: Jana Shockman, RN, CCRN-CSC • Vice President: Jane Erickson, ADN, RN, CCRN • Secretary: Phi Tran, MSHS, BSN, RN • Treasurer: Jennifer Hazen, BSN, RN • Staff Nurse Director: Arlene Briscoe, RN-BC • Rural Director: Nelly Ayala, MSN, RN • Greater Alaska Director: Juanita Reese, BA, BSN, RN, CEN • Labor Council Chair (Designee): Donna Phillips, BSN, RN • Directors At Large: Shelley Burlison, RN-BC Janet Pasternak, BA, BSN, RN Paul Mordini, MS, BSN, RN-BC Kimberly Kluckman, RN Yvette Le Sueur, BSN, RN • Student Nurse Liaisons: Leanne Pizzi – UAA Teresa Beitel – Charter College AaNA Labor Council • ChaiR: Donna Phillips, BSN, RN • Vice-Chair: Jana Shockman, RN, CCRN-CSC • SECRETARY: • Treasurer: Jennifer Hazen, BSN, RN • Directors: Arlene Briscoe, RN Lila Elliott, BSN, RN Yvette Le Sueur, BSN, RN Jane Erickson, ADN, RN, CCRN • PAMC BU Rep: Jennifer Hazen, BSN, RN • soldotna BU Rep: Shelley Burlison, RN-BC • KETCHIKAN BU Rep: Susan Walsh, RN • Affiliate Organizations: Alaska Affiliate of the American College of Nurse-Midwives Alaska Home Care & Hospice Association Alaska Association of Nurse Anesthetists Alaska Nurse Practitioner Association Alaska School Nurses Association Alaska Clinical Nurse Specialist Association Author Guidelines for the Alaska Nurse The Editorial Committee welcomes original articles for publication. Preference is given to nursing and health-related topics in Alaska. Authors are not required to be members of the AaNa. format and submission: Articles should be Word documents in 10 or 12 point font, single or double spaced. There is currently no limit on the length of the article. Include the title of the article and headings if applicable. Author’s name should be placed after the title with credentials, organization and/or employer and contact information. Authors must identify potential conflicts of interest, whether of financial or other nature and identify any commercial affiliation if applicable. All references should be listed at the end of the article. Photos are encouraged and may be sent as a .jpg file, as an email attachment or on disc. Photographs send to the Alaska Nurse will become property of the AaNA. We hope that we will be sent copies, not originals, and prefer emailed files. Photos should be provided with a caption and photo credit info and be high resolution. Be sure to double check the spelling, grammar, and content of your article. It is highly recommended that you have a colleague review your article before submission. Prepare the article as a Word document and attach it to an email to andrea@ aknurse.org. You may also mail the article on disc to: The Alaska Nurse, AaNA, 3701 E Tudor Road, Suite 208, Anchorage, AK 99507. If you have any questions, please email [email protected]. 2 Alaska Nurses Association President • Anchorage, AK Last month I was able to attend the Alaska Women’s Summit 2014. One of the sessions that particularly resonated with me was entitled, “Redefining ‘Like a Girl’.”(1) Why is the connotation of doing things “like a girl” not a positive image? For example the statement “you throw like a girl” brings to mind someone who can’t throw the ball very far or very accurately instead of the image of Cat Osterman pitching her way to an Olympic Gold medal. I would like to take this example one step farther and ask you all to consider what it means to “do it like a nurse?” Do you immediately think of Nurse Ratched or maybe “Hot Lips” Houlihan? Or do you think of the four nurses who cared for victims of the 1925 Nome diphtheria epidemic? Or maybe you think of the nurses who carried NICU babies down 15 flights of stairs bagging them as they hurried to evacuate the New York City hospital stricken by Hurricane Sandy. Being a nurse is something that is part of us. It is not merely a job. I don’t know many other occupations that require 12 hour shifts, including nights, weekends and holidays, risk of illness and injury, and the emotional highs and lows that nurses deal with every day. Nurses became the focus of much media attention as America had to deal with the Ebola virus within our shores for the first time. The American healthcare system was caught unaware with outdated PPE and isolation recommendations, and a lack of adequate screening tools to identify patients with exposure to or infection with the Ebola virus. The media exploded with information and misinformation about what Ebola is, how it is spread, and how to protect ourselves. When two nurses in Texas became infected after caring for the first patient in the US with Ebola the immediate response was that they must have done something wrong. The blame game was the talk of the nation as these nurses began the fight for their lives. Nurses and nursing organizations throughout the country mobilized quickly to support the Texas nurses and demand the CDC and the government examine current protocols and standards related to caring for Ebola patients. Nurses led the national conversation discovering gaps in protocols and standards of care. On October 29th, AACN PresidentElect Karen McQuillan discussed member concerns and learnings at an invitation-only White House Ebola meeting. AACN was one of a small group of nursing professional organizations, including ANA and ENA, invited for a dialogue with Ron Klain, Ebola response coordinator, and other officials working on the Ebola response. On November 7th, leaders of the coalition group Nursing Community testified before the Senate appropriations committee and reinforced the critical role that nurses have as front line care providers, deployment of best practices, and educating patients and communities, all to minimize the risk of the Ebola Virus Disease and other emerging diseases in the United States and around the world. Nursing Community is a coalition of 61 professional nursing organizations. This coalition demonstrates the full commitment from national nursing organizations, Inside This Issue 2 3 4 7 8 President’s Letter Open Enrollment A Community Effort: Anti-Vaccines AsNA New Board Members Personal Protection for Eboli 10 11 12 14 15 Cover Photo: The Ebola Virus. CDC/ Cynthia S. Goldsmith T h e o f f i c i a l P u b l i c at i o n o f t h e A l as k a N u r s e s A s s o c i at i o n 2014 Heart Walk Patient Safety Series Part One Viruses: What We Need to Know Nurse Hall of Fame Inductees Calendar of Events w w w. aknurs e .org representing a broad spectrum of care delivery, to engage with all healthcare stakeholders as the nation responds to the Ebola Virus Disease locally and globally. These are just a couple of examples of how nurses have stood up to demand a seat at the table and have provided a voice of reason in the maelstrom of America’s response to Ebola. On the local level I know of nurses that are working within their facilities to establish protocols and plans for dealing with Ebola should it arrive in Alaska. Nurses are training each other about screening and PPE donning and doffing. Nurses are playing a central role in preparations for Ebola. Right now I’m so proud to be a nurse. This is a perfect example of why I’m always encouraging you all to get involved and join the voice of nurses as leaders in America’s healthcare delivery system. I’m proud to belong to the profession that stands up for patients and healthcare providers. The profession that demonstrates heroism in the small things we do every day as well as during a national crisis like Hurricane Sandy. Come on, I dare you to “Do it like a Nurse!” (1) YouTube, Always #LikeAGirl Open Enrollment is on Now for 2015 In an hhs.gov press release, Health and Human Services Secretary Sylvia Burwell stated: “consumers who are renewing their coverage or signing up for the first time will have an opportunity to obtain quality health coverage at a price they can afford. Whether consumers visit the simpler, faster and more intuitive HealthCare.gov or contact the call center, they’re going to find more choices and competitive prices.” The following information is directly from the hhs.gov press release. Open Enrollment for the Health Insurance Marketplace runs through Feb. 15, 2015. Consumers should visit HealthCare.gov to review and compare health plan options and find out if they are eligible for financial assistance, which can help pay monthly premiums and reduce out-of-pocket costs when receiving services. All consumers shopping for health insurance coverage for 2015— even those who currently have coverage through the Marketplace — should enroll or re-enroll between November 15 and December 15 in order to have coverage effective on Jan. 1, 2015. A number of different resources are available to help consumers find Marketplace coverage. They can get more information through HealthCare.gov or CuidadoDeSalud. gov. Consumers can find local help at: Localhelp. healthcare.gov or call the Federally-facilitated Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. Assistance is available in 150 languages. The call is free. The Marketplace includes a Small Business Health Option Program (SHOP), designed to give small businesses new health insurance options and a simpler way to cover their employees. The SHOP is available to small employers with 50 or fewer full-time equivalent employees. Starting tomorrow, November 15, 2014, the SHOP Marketplace will allow qualifying employers to find, compare, purchase, and enroll in 2015 SHOP health and dental coverage entirely online through HealthCare.gov. Employees will be able to view offers of insurance from their employer and enroll online through HealthCare.gov. Small businesses and their employees can get help from the toll-free SHOP Marketplace call center at 1-800-706-7893 or for TTY, call 711. The hours are Monday through Friday, 9 a.m. to 7 p.m. EST. To sign up for individual and family coverage, visit: https://www.healthcare.gov/ apply-and-enroll/. To sign up for small business coverage, visit: https://www.healthcare.gov/ small-businesses/. For more information about Health Insurance Marketplaces, visit: www. healthcare.gov/marketplace. PERSONALIZED CALENDARS EMPLOYMENT OPPORTUNITY Bristol Bay Area Health Corporation www.bbahc.org Great Gift Idea! 9 $ 95 Located in beautiful Southwest Alaska, in the town of Dillingham, BBAHC has many employment opportunites. Come and enjoy the Alaska Native Cultures of the Aleut, Eskimo and Indian. Our town is 2,460 strong and we serve a 44,000 square mile region of 34 villages with a total population of 8000. Personalized Calendars Please contact Human Resources at (907)842-5201 or by email at [email protected] or refer to our website at www.bbahc.org for more information BBAHC is an equal opportunity employer operating under the Alaska Native and American Indian Preference in Hiring provisions of PL93-638. Pre-employment drug screening and a completed background investigation and determination that the applicant meets the eligibility criteria of the Alaska Barrier Crimes Act and, where applicable, the Indian Child Protection Act, are prerequisites to hiring. 907.276.3004 | serviceprint.com 323 East Fireweed Lane, Anchorage, AK T H E A L AS K A N U R S E • D E C E M B E R 20 14- January 201 5 3 A Community Effort: Practices and Information for Communicating with Vaccine-Hesitant Patients A steadily growing number of adults are threatening the peace, health, and well-being of our entire country. They are mothers, fathers, educators, artists, physicians, executives, and entrepreneurs. They work in technology, hospitality, manufacturing, natural resource development, media, and the financial sector. These adults form groups, both unsanctioned and official, to perpetuate their cause. It might sound like I’m describing a type of radicalized political group, but I’m not. Unfortunately, that doesn’t make this group’s ideologies any less alarming or its effects any less dangerous. If the group keeps growing, the health of Americans will become increasingly jeopardized – particularly the health of those most vulnerable in our society. I’m talking for those who belong to and support the cause of the anti-vaccine movement. By not vaccinating themselves 2014 Recommended Immunizations for Children from Birth Through 6 Years Old Shaded boxes indicate the vaccine can be given during shown age range. Notes: • Ifyourchildmissesashot, youdon’tneedtostart over.Justgobacktothe doctorforthenextshot. pB (1-2 TaP, PCV, th MMR (12-15 pB † months) , aricella (12-23 za (yearly, 6 ears)* MMR, a (yearly, 6 ears)* 1 month 2 • Talkwithyourchild’sdoctor ifyouhavequestionsabout thevaccines. 4 6 1 Birth month 12 HepB 15 †, § your new baby and yourself against whooping cough, get a Tdap vaccine towards the end of each pregnancy. Talk to your doctor for more details. PCV PCV PCV IPV IPV• Isyourfamilygrowing?To protectyournewbabyand yourselfagainstwhooping cough,getaTdapvaccine towardstheendofeach Shaded boxes indicate the pregnancy.Talktoyour vaccine can be given during shown age range. doctorformoredetails. f your child misses a shot, you don’t need to start over, ust go back to your child’s doctor for the next shot. Talk with your child’s doctor f you have questions about vaccines. 2 months 18HepB19–23 months RV months months months months months months • Ifyourchildhasany medicalconditionsthatput HepB HepB himatriskforinfectionoris RV RV RV travelingoutsidetheUnited DTaPStates,talktoyourchild’s DTaP DTaP DTaP Hib doctoraboutadditional Hib Hib Hib vaccinestheymayneed. Is your family growing? To protect PCV 4 months 2–3 6 months 4–6 years RV 12 months 15 months 18 months 19–23 months 2–3 years 4–6 years HepB years RV DTaP DTaP DTaP Hib Hib Hib1 PCV PCV IPV IPV DTaP PCV DTaP DTaP Hib PCV IPV IPV IPV IPV Influenza (Yearly)* MMR MMR Varicella Varicella (Yearly)2 MMR MMR Varicella Varicella HepA3 HepA Footnotes: § 1 The State of Alaska distributes PedvaxHib vaccine to enrolled health care providers who provide immunization services to prevent Hib disease. It is 3 dose series recommended at 2 months, 4 months, and 12 months. Formoreinformationvisit See back page FOOTNOTES: * Two doses given at least four weeks apart are recommended for children aged 6 months through 8 years Twoand doses given at least four weeks apart are recommended forfor children moreaged 6 months through 8 years of age who are getting a flu vaccine for the first time and for some other children in this www.cdc.gov/vaccines of age who are getting a flu vaccine for the first2time for some other children in this age group. § information on group.The first dose of HepA vaccine should be Two doses of HepA vaccine are needed for lasting age protection. vaccinegiven between 12 months and 23 months of age. The second dose should be given 6 to 18 months later. HepA vaccination may be given to any child 12 months and older protect HepA. preventable 3 Two doses oftoHepA areagainst needed forChildren lastingand protection. The first dose of HepA vaccine should be given between 12 months and 23 months of age. The second dose should be given 6 to 18 months adolescents who did not receive the HepA vaccine and are at high-risk, should be vaccinated against HepA. diseases and the later. HepA vaccination may be given to any child 12 months andvaccines older to protect against HepA. Children and adolescents who did not receive the HepA vaccine and are at a high risk should be that If your child has any medical conditions that put him at risk for infection or is traveling outside the United States, talk to your child’s doctor about additional vaccines that he mayagainst need. HepA. vaccinated prevent them. Questions?ContacttheAlaska ImmunizationHelplineat [email protected] or1-888-430-4321 e information, call toll free DC-INFO (1-800-232-4636) or visit www.cdc.gov/vaccines 4 2014 Recommended Immunizations for Children from Birth Through 6 Years Old Recommended Immunizations for Children from Birth Through 6 Years Old epB (1-2 13 Recommended Immunizations for Children from Birth Through 6 Years Old ib, Polio, epB (6-18 ib, Polio d Influenza ugh 18 greater than the dangers of long-eradicated diseases. For this reason, parents are choosing to not immunize their children. The threat of mercury that could ruin your child’s brain; the fear of causing autism by vaccinating your children; the potential allergic reactions and adverse reactions; the strain of overloading and weakening the immune system. These are all threats to the health and safety of children that seem much more imminent and likely than the potential to catch an illness that no one has faced for fifty years. Which begs the question: Who has the responsibility to reach out to these parents and community members who are speaking out against vaccines? Who has the responsibility to educate them and lay their unfounded fears to rest? The answer, according to most, is healthcare providers. In fact, the National Vaccine Advisory Committee (NVAC) – which develops standards for both pediatric and adult immunization practice – stresses that all and their children, and encouraging and educating others to do the same, these anti-vaccine proponents are indeed threatening the health of our society. The worst part is that most of them do not believe or understand just how dire the consequences of their actions. I’m certain that a majority of those who repudiate vaccine science do so with good intentions, hoping to protect their families and loved ones from what they believe are the truly harmful substances and devastating adverse effects of immunizations. Any cursory Google search will bring up thousands upon thousands of hits on websites, blogs, and videos claiming to tell the “truth” about the dangers of vaccines. To those who have not studied science, these pseudo-science-backed claims frequently appear legitimate and are frightening. The urge to protect one’s children is strong, and for many it appears that the dangers of vaccines are far By Andrea Nutty T h e o f f i c i a l P u b l i c at i o n o f t h e A l as k a N u r s e s A s s o c i at i o n w w w. aknurs e .org healthcare professionals need to work to ensure that their patients are immunized, regardless of whether the healthcare worker provides vaccines or not. The CDC and NVAC have set forth the following practice standards for all healthcare professionals: • ASSESS immunization status of all your patients at every clinical encounter. • Stay informed. Get the latest CDC recommendations for immunization of adults and pediatric patients. • Implement protocols and policies. Ensure that patients’ vaccine needs are routinely reviewed and patients get reminders about vaccines they need. • Strongly RECOMMEND vaccines that patients need. • Share tailored reasons why vaccination is right for the patient. • Highlight positive experiences with vaccination. • Address patient questions and concerns. • Remind patients that vaccines protect them and their loved ones against a number of common and serious diseases. • Explain the potential costs of getting sick. • ADMINISTER needed vaccines or REFER your patients to a vaccination provider. • Offer the vaccines you stock. • Refer patients to providers in the area that offer vaccines that you don’t stock. • DOCUMENT vaccines received by your patients. • Participate in your state’s immunization registry. Help your office, your patients, and your patients’ other providers know which vaccines your patients have had. • Follow up. Confirm that patients received recommended vaccines that you referred them to get from other immunization providers. The CDC also has resources to assist providers in communicating with patients and patients’ parents who have questions and concerns about vaccines. I strongly recommend viewing these resources, which can be found at www.cdc.gov/vaccines/conversations. These resources are an important reminder that a uniform approach will not work with all of your patients. The CDC offers to following advice to providers: Some patients will prefer anecdotal evidence over detailed scientific evidence, and vice versa. Some patients will pepper you with a long list of questions and will not be easily dissuaded from their anti-vaccine views, while others just need a gentle push towards receiving immunizations. What each patient does need is a provider who is willing to take time out of a hectic schedule to patiently listen to and address (See Anti-Vaccine page 6) — DENALI CENTER — A GOLDEN OPPORTUNITY The Denali Center is hiring for heart. We seek CNAs, LPNs, and RNs toThe provide nursingCenter care in our loving, compassionate environment where Denali is hiring for heart. We seek CNAs, both residents and staff are encouraged to live fully and to learn and grow. LPNs, and RNs home-like to provide nursingpromotes care inhappiness our loving, Our award winning environment by fostering relationships amongst residents, andresidents volunteers. and compassionate environment wherestaff both If thisare is an environment where youfully wouldand feel to at home, visit staff encouraged to live learnplease and grow. our website for a complete list of current openings. Our award winning home-like environment promotes Administrative Assistant Sr. happiness by fostering relationships amongst Supports the Chief Nursing Officer (CNO), Administrators, or members of facility residents, staff and senior leadership teams by providing clerical andvolunteers. administrative services and assistance, requiring the use of judgement and discretion on a periodic basis. If this is an environment where you would feel at home, Administrative Assistant Sr. please visit our website for or members of facility Supports the Chief Nursing Officer (CNO), Administrators, a complete listclerical of current openings. services and senior leadership teams by providing and administrative assistance, requiring the use of judgement and discretion on a periodic basis. TO APPLY VISIT: BANNERHEALTH.COM/CAREERS T H E A L AS K A N U R S E • D E C E M B E R 20 14- January 201 5 5 Anti-Vaccine (continued from page 5) concerns. Providers must keep the conversation going and must show respect for patients’ opinions and questions. It is imperative that the trust the patient has placed in you is not eroded. Unfortunately, it is often the case that addressing concerns and providing evidence in favor of vaccination does not work for the most steadfast of anti-vaccine proponents. In reality, even the best-crafted pro-vaccine messages do not always work. And sometimes, they can be truly harmful. A recent study in the journal Pediatrics, “Effective Messages in Vaccine Promotion: A Randomized Trial” concluded that “Current public health communications about vaccines may not be effective. For some parents, they may actually increase misperceptions or reduce vaccination intention. Attempts to increase concerns about communicable diseases or correct false claims about vaccines may be especially likely to be counterproductive.” Ouch. It would appear that perhaps our “best practices” for getting patients vaccinated are not so great, after all. It seems that some of our patients mistrust in vaccines also extends to a mistrust of healthcare providers, or at the very least that vaccine mistrust often outweighs trust in providers. This does not mean that current recommended practices should be abandoned. As it stands now, the recommendations from the CDC and NVAC are the best practices we have in addressing immunization-hesitant parents and patients. Regardless, it is apparent that more research is needed to develop better “best” practices. For the most dogmatic anti-vaccine patients, the answer to waylaying false beliefs may not lie with the healthcare provider at all. A second study publishing in the journal Pediatrics, “Sources and Perceived Credibility of Vaccine-Safety Information for Parents” found that 6 although healthcare professionals continue to be the most trusted source for vaccinesafety information among the majority of patients and parents, 15% of respondents reported placing “a lot of trust” in family and friends, and 67% of respondents place “some trust” in family and friends. 24% of respondents put “some trust” in celebrities for vaccine-safety information, and 2% trusted celebrities “a lot.” What’s more is that 73% of parents “placed at least some trust in parents who believe that their child was harmed by a vaccine.” Effectively, one anecdotal story by a parent who believes their child was harmed by a vaccine is enough to sow seeds of vaccine doubt in nearly three-out-of-four parents’ minds. The study concluded that “results indicate that different groups of parents seek and trust information from [different sources]. Those who design public T h e o f f i c i a l P u b l i c at i o n o f t h e A l as k a N u r s e s A s s o c i at i o n health efforts to provide evidence-based information must recognize that different strategies may be required to reach some groups of parents who are currently using other information sources. In particular … electronic means of communication and social-networking web sites, newer methods of promulgation should be explored.” Providers and healthcare experts still don’t have all the answers on how to stop the anti-vaccine movement. We should realize though that it is now time to think outside the box. Since parents and patients receive so much vaccinesafety information online today and frequently trust other parents and anecdotal evidence as much as science, websites such as “Voices for Vaccines: Parents Speaking Up For Immunization” (www. voicesforvaccines.org) should be considered as potential tools in practice. The website features a blog (among other resources) that details stories from parents and healthcare providers. There is even a category called “Anti-Vax to Pro-Vax” in which providers and parents share the tales of how they switched from distrusting immunizations to becoming proponents for vaccinations. Other categories include “Teens for Vaccines” and “Natural Parenting” as well as a campaign called “I Vaccinate Because”. It would be delinquent to not consider directing parents and patients to these alternative sources of information. Do you have a story or practice tip to share? How have you helped patients overcome fears of vaccines? I believe that the ability to change minds on vaccines belongs to community members as well as healthcare providers. We need to identify parents and patients within our practice settings who are able to be voices for vaccines and encourage them to speak with friends, family members, and neighbors who may be fearful or questioning of immunizations. Our effort to vaccinate is not just a public and community health effort; it is an effort belonging to our entire community. w w w. aknurs e .org AaNA Welcomes New Board Members By Andrea Nutty The results of the AaNA 2014 Board of Directors Election were presented at the AaNA General Assembly on October 5th. We are proud to welcome three new Board members and one returning Board member. Elected to the Board were Phi Tran, Secretary; Nelly Ayala, Rural Director; Juanita Reese, Greater Alaska Director; and Paul Mordini, Director at Large. Phi Tran, MSHS, BSN, RN was elected as Board Secretary. Phi has 9 years of experience as a nurse and resides in Anchorage, Alaska. Phi is an active duty U.S. Air Force Member and currently works as the Peri-Anesthesia Element Chief of the 673rd Medical Group at Joint Base Elmendorf-Richardson. Phi also has experience as a PACU nurse manager, pediatric clinical nurse, GI clinical nurse, and in med-surg. Phi is an active member of many nursing organizations, including the American Nurses Association and the Society of Air Force Nurses. Phi is fluent in Vietnamese. Nelly Ayala, MSN, RN was elected as Board Rural Director. Nelly has 4 years of experience as a nurse and splits her time between Anchorage, Alaska and rural communities in the Bristol Bay area, where she works as Public Health Nurse III for the State of Alaska. Nelly is a member of many nursing organizations, including the Hispanic Nurses Association and the Sigma Theta Tau Society of Nursing Leaders. She is also a member of the Alaska Public Health Association and was a Ronald McNair Scholar. Her previous experiences include working as a research scientist for the University of Washington and as an advocate for heart health at the Refugee Women’s Alliance. Nelly is passionate about promoting diversity within the field of nursing in Alaska. Juanita Reese, BA, BSN, RN, CEN was elected as Board Greater Alaska Director. Juanita has 4 years of experience as an RN and 23 years of experience as an LPN. Juanita resides in Juneau, Alaska and is employed by Bartlett Regional Hospital in surgical services. Juanita earned her BA in Social Science from the University of Alaska Southeast and her BSN from the University of Texas Medical Branch, where she was president of her class. She holds a certification in emergency nursing and has a passion for patient and nurse advocacy. Paul Mordini, MS, BSN, RN-BC was elected as Director at Large of the Board of Directors. Paul has 30 years of experience as a nurse and lives in Eagle River, Alaska. Paul is employed by the State of Alaska at Alaska Psychiatric Institute, where he works as a Clinical Coordinator. Paul served as a Major in the U.S. Air Force Nurse Corps for 20 years. He has previously served as Vice President of the Board of Directors from 2009 to 2010, and Director at Large from 2006 to 2009 and from 2013 to 2014. During his previous Board service, Paul worked to pass the “No Mandatory Overtime for Nurses” legislation. Paul is the current Chair of the Health and Safety Committee and is focused on advocating for policies and legislation that protect healthcare workers from workplace violence. AaNA extends congratulations to Phi Tran, Nelly Ayala, Juanita Reese, and Paul Mordini; thank you for stepping up to serve your fellow nurses. Each of our new Board members brings varied perspectives and experiences to AaNA, which creates a strong and diverse Board of Directors to work on issues for nurses across the state. What’s in the cloud? Nicotine — Addictive Acetone — Nail polish remover Ultra-fine particles — Asthma Lead — Brain damage Formaldehyde — Embalming fluid E-cigs. Not harmless. Not healthy. Sources: 1. Schripp, T., Markewitz, D., Uhde, E. and Salthammer, T. (2013), “Does e-cigarette consumption cause passive vaping?” Indoor Air, 23: 25–31 2. Williams M, Villarreal A, Bozhilov K, Lin S, Talbot P (2013) “Metal and Silicate Particles Including Nanoparticles Are Present in Electronic Cigarette Cartomizer Fluid and Aerosol” PLoS ONE 8(3): e57987 alaskaquitline.com T H E A L AS K A N U R S E • D E C E M B E R 20 14- January 201 5 7 Personal Protective Equipment: Caring for the Patient with Ebola By Jana Shockman, RN, CCRN-CSC The Centers for Disease Control, (CDC) have updated their recommendations for required personal protective equipment, (PPE). The changes in recommendations reflect the lessons learned from the recent experiences of U.S. hospitals caring for Ebola patients and emphasize the importance of training, practice, competence, and observation of healthcare workers in correct donning and doffing of PPE selected by the facility. Current recommendations for donning PPE now include a buddy system where the care provider is assisted by another care provider, in full PPE, to don PPE with a third trained observer supervising with a written checklist to be sure that there is no skin exposed and that all protocols are followed completely. Prior to donning, the PPE must be visually inspected to ensure that all components are available in the correct size for the caregiver and that the PPE is in good condition. While Ebola is not an airborne pathogen, there is risk that infected body fluids may become aerosolized, therefore The care provider is to change into surgical scrubs or disposable garments and dedicated washable footwear. The care provider performs hand hygiene and begins the donning process. ___________________ the CDC recommends care providers wear and N95 respirator with a full face shield and hood, or a powered air-purifying respirator, (PAPR), with a full surgical hood. ___________________ The CDC recommends that two pairs of gloves be worn. The first, inner, pair of gloves must cover the cuffs of the impermeable gown/ coverall. Wrap the intersection of the gloves and gown with tape or Coban type material to prevent the gloves from sliding or rolling down past the cuffs. Place a second pair of gloves on over the inner pair. ___________________ the integrity of the ensemble is verified by the trained observer. The care provider should be comfortable and able to extend the arms, bend at the waist and go through a range of motions to ensure there is sufficient range of movement while all areas of the body remain covered. ___________________ When beginning the doffing process, engage the trained The care provider dons fluid resistant, impermeable shoe covers. Shoe covers should cover the lower leg so there is no skin exposed between the pant leg of the scrubs and the shoe covers. 8 A full fluid resistant, impermeable gown or coverall must be worn over scrubs. The gown/ coverall must be large enough to allow for unrestricted freedom of movement. After completing the donning process, T h e o f f i c i a l P u b l i c at i o n o f t h e A l as k a N u r s e s A s s o c i at i o n observer to read aloud the protocol for each step of the process and confirm visually that the PPE is removed properly. The trained observer reminds the care provider to avoid reflexive actions, such as touching their face, which could put them at risk. Visually inspect the PPE for any contamination, cuts, or tears prior to removal. If contamination is present, disinfect using and EPAregistered disinfectant wipe, such as Super Sani-wipes, with at least 2 minutes of wet contact time. The buddy may perform this disinfection procedure to the hood and gown that is unreachable by the care provider. Once outer gloves are removed, perform hand hygiene with the disinfectant wipe for 2 minutes. The buddy assists in removal of the PAPR hood. Disposable pieces are disposed of in designated contaminated waste containers and reusable components are placed in designated disinfection containers. ___________________ Buddy assists to remove gown/coverall by pulling gown away from the care provider and carefully gathering or rolling the gown/coverall into a bundle where the outer surface is contained inside the bundle. The bundle and inner gloves are removed as a single unit taking care that the sleeves do not flip or snap from the wearer as they are w w w. aknurs e .org A rewarding career in the northernmost city is closer than you think Now recruiting for the following positions: Samuel Simmonds Memorial Hospital (SSMH) in Barrow, Alaska is a facility unlike most others; it is located in the northernmost city of the United States and serves a population that spans across a region larger than the state of Washington. » Inpatient Med/Surg » RN Case Managers Serving the North Slope, a region that is colored by rich cultural diversity and » RN Phone Advice beauty of the Inupiat people, Samuel Simmonds Memorial Hospital works to » Emergency reserve the health of the region as well as the culture. » LDRP/OP By joining SSMH, you’ll be embarking on the adventurous journey as enriching as it is rewarding. Here you’ll have the unique opportunity to provide healthcare to a vibrant community ready to share its culture and heritage. More than a once in a lifetime opportunity, you’ll provide care in a small community environment, partner with a familial, professional staff, and truly touch—and be touched by—the Inupiat people. It’s an experience you won’t forget. So join us today! visit us: www.arcticslope.org removed. The care provider now sits in a designated chair, lifts a leg and the buddy removes shoe covers one at a time, taking care to keep contaminated surfaces away from the care provider. The care giver performs hand hygiene and the buddy and trained observer inspect the caregiver for any indication of contamination of the surgical scrubs/ disposable garments. If contamination is present immediately notify infection control or occupational health and safety coordinator. Showers are recommended at shift’s end for all healthcare providers spending extended periods of time in the Ebola patient room. Per the CDC, “Comfort and proficiency when donning and doffing are only achieved through repeated practice on the correct use of PPE. Healthcare workers should be required to demonstrate competency in the use of PPE, including donning and doffing while being observed by a trained observer, before working with Ebola patients.” It is also important to remember that as healthcare systems in the United States gain more experience in working with patients infected with Ebola virus disease, these guidelines may continue to evolve. More information regarding donning and doffing PPE can be found at http://www.cdc. gov/vhf/ebola/hcp/procedures-for-ppe.html. For an example of PPE using an N95 mask and a 2 person system, a video demonstration of donning and doffing can be found at http:// www.medscape.com/viewarticle/833907. Phone: 907.852.9204 Mail: PO Box 29, Barrow, AK 99723 Fax: 907.852.3365 | [email protected] Samuel Simmonds Memorial Hospital is an eligible IHS loan repayment site. For more information visit www.ihs.gov NSRH is a Joint Commission accredited facility with 18 acute care beds, 15 LTC beds serving the people of the Seward Peninsula and Bering Straits Region of Northwest Alaska. New hospital now open! Photographs provided by Providence Alaska Medical Center T H E A L AS K A N U R S E • D E C E M B E R 20 14- January 201 5 9 2014 Heart Walk By Janet Pasternak, BA, BSN, RN This year’s Heart Walk event put on by the American Heart Association was the best ever! Over 800 people gathered on the downtown park strip for the fun. The event raised over $190,000 for research and awareness of heart disease and stroke. For the last three years the Alaska Nurses Association has been a supporter of events in Anchorage to promote heart health, disease prevention and stroke. This year we added the Go Red for Women Luncheon for support in addition to the spring Heart Run and fall Heart Walk. At each event we had a table/booth to give out information, to promote visibility of our organization and serve as a first Aid station. We also provided blood pressure screenings. Nursing students from Charter College and UAA helped out with blood pressures and at the same time practiced their new skills. They were a great help! Thank you! At this year’s event our booth provided a new family oriented game for kids. A small kiddy pool filled with water and little yellow rubber duckies floating in it. The objective 10 was for children to scoop out a ducky with a small hand net. Coloring books and crayons were the reward for their efforts. The children had a blast! The water in the pool was provided by handsome firemen who drove up in a pink, breast cancer awareness, fire engine. Needless to say, our booth was the center of attention for quite a while. The Heart Walk is a challenge to raise money for awareness of heart disease and stroke. Corporations or individuals are all invited to come. Some walked in remembrance and in thankfulness of a friend or family member that had experienced heart disease or stroke, others, in support. The American Heart Association is one of the most recognized and respected national organizations that benefits patients and T h e o f f i c i a l P u b l i c at i o n o f t h e A l as k a N u r s e s A s s o c i at i o n nurses both. As nurses we are required to be certified in BLS, a certification that is a direct outgrowth of these money raising events. The money supports research that then determines current and updated recommendations for certifications. If you’ve ever had to do CPR on someone, you are a direct beneficiary of their efforts. The Alaska Nurses Association, in an effort to reach out to its community, supports these organizations. We also support, with your membership dues, other worthy organizations such as the March of Dimes. Our desire is to not only care for our patients but our communities that we live in. Please join us for the coming year’s events and contribute to great causes that we all benefit from! w w w. aknurs e .org Patient Safety Series Part One: 10 Days Without a Father, the Devastation of Medical Errors time had passed. The invisible and voracious cells leftover from the surgery were allowed to uncontrollably proliferate. The miracles of modern medicine sat on a shelf presumably unneeded for a year. Two years of more surgeries, aggressive chemotherapy, and radiation treatments weakened the once strong man. by Carlie Holmberg, RN, CPHQ and Lynette Savage, PhD, RN, CPHQ Difficult Story to Tell: This year on a cold January morning, in a small town in Massachusetts, my father succumbed to the evils of cancer. I lost my mentor, my rock-solid support, and my Daddy. The deep painful ache in my chest is indescribable. The swirling feelings of sadness, anger, and helplessness make it difficult to concentrate. The waves of despair wash over me, making me feel cold and vulnerable. At times the waves drown me making me feel breathless and paralyzed. An Important Story to Tell: Three years ago, an inattentive pathologist made a horrible assumption about what he saw under the microscope. Later, he would unapologetically admit his mistake. He had assured my father and my father’s physicians that the small kidney tumor was benign. He recommended surgical removal of the tumor. No further treatment was necessary because these tumors never return. At the time, it was glorious news to my father and our family. We could breathe again. Twelve months after surgery, three new tumors each larger than the original, were discovered. The original set of pathology slides were sent to Boston for a second opinion. The benign tumor was not benign, it was a treatable cancer. Twelve important months of treatment An Avid Patient Safety Advocate: Before the cancer, my father had become a huge supporter of patient safety initiatives. He scoured the internet and was an unrelenting patient self-advocate. Ten years ago, through his own research and some pressure on his physician to test him, he had discovered his own hemochromatosis. This easily treated blood condition, if left unattended has injurious and sometimes fatal results. My father and I were a dynamic duo. We were like patient safety cheerleaders (minus the cute skirts and pom-poms). Dad could have easily written all of the entries in my blog “Airborne Patient Safety” (airbornepatientsafety.wordpress.com). He fed me volumes of information about patient safety that fueled the flames of my patient safety passion. He was an incredible man. He understood the connection between aviation and patient safety. He had signed copies of Atul Gawande’s The Checklist Manifesto, as well as John Nance’s Why Hospitals Should Fly, and Charting the Course. What would my father want you to know? What would my father want you to do? As a patient, my father would want you to talk about the importance of self-advocacy, researching your own situation, and paying attention to the fact that all healthcare workers are human. Humans are not perfect, they cannot be perfect. He would want you to keep questioning your doctors and healthcare providers until you truly understand. He would want you to tell a healthcare worker to wash their hands before touching you. He would want you to understand your medications. He would want you to teach your loved ones about the dangerous realities in healthcare. He would want you to ask questions and speak-up. As a healthcare provider, my father would tell you that you are the first line of defense in keeping patients, clients, or residents safe. He would want you to follow the National Patient Safety Goals set forth by The Joint Commission (2014). He would encourage you to read the literature through websites such as the Agency for Healthcare Research and Quality [AHRQ] or the National Patient Safety Foundation (AHRQ, 2014; McTiernan, 2014). He would want you to ask questions and speak-up. Saying Good-Bye: The last conversation with my father was over the phone. He was very ill and in pain. At the end of the very brief call he said, “I love ya kid, I’m gonna miss you for a long, long, long time”, he then quickly passed the phone to my mother. Those words echo in my soul. It’s been 310 days without my father. That is a long, long, long time. In the next issue of The Alaska Nurse, Patient Safety Series Part Two – Patient Safety: Is Not the Flavor of the Month. In healthcare in seems we jump from one “hot topic” to the next; a new flavor of the month. The cost of healthcare, preventing hospital acquired infections, readmissions, or ICD-10 coding to name a few. As nurses, we often feel like we are behind before we even understand what is required of us. Then a new topic shows up and we start all over trying to understand. Patient safety and the ramifications are different. References: Agency for Healthcare Research and Quality [AHRQ] (2014). Research summaries for consumers, clinicians, and policymakers. Retrieved from http://www.effectivehealthcare.ahrq.gov/index. cfm/research-summaries-for-consumers-clinicians-and-policymakers/ • Gawande, A. (2011). The checklist manifesto: How to get things right. London: Picador Publishing. • Nance, J. (2008). Why hospitals should fly: The ultimate flight plan to patient safety and quality care. Bozeman, MT: Second River Healthcare Press. • Nance, J. (2012). Charting the course: Launching patient-centric healthcare. Bozeman, MT: Second River Healthcare Press. • McTiernan, P. (2014). Keeping quality and safety front and center. National Patient Safety Foundation. Retrieved from http://www.npsf.org/updates-news-press/ updates/keeping-quality-and-safety-front-and-center-2/ • The Joint Commission (2014). National patient safety goals. Retrieved from http://www.jointcommission.org/standards_information/npsgs.aspx T H E A L AS K A N U R S E • D E C E M B E R 20 14- January 201 5 11 What We Really Need to Know About Viruses away from sick people. Clean and disinfect frequently touched surfaces at home, work, or school. Stay home if you are sick. Cover your cough by coughing into your shoulder or elbow. By Jana Shockman, RN CCRN-CSC Watching the news today is a scary prospect. We are inundated with snippets of information about which ever illness catches the media’s attention and can be sure that we are at the doorstep of a major epidemic. Enterovirus D68, Ebola, MERS, and Influenza have all been in the news recently. In this article we will get back to basics and discuss what we really need to know about viruses. A virus is not a living organism, a virus is a minute infectious particle of nucleic acid, DNA or RNA, but not both. A virus can only be replicated within a living host cell. Because viruses are not living organisms conventional antibiotic therapy is ineffective against them. The strongest weapon we have against viruses are vaccines. Vaccines work by introducing attenuated viruses, inactivated viruses, or recombinant viral DNA antigens to our immune system so that we can develop antibodies to the viruses. Influenza Influenza is the most common life threatening virus that we deal with on a routine basis. Flu season typically starts in October and lasts through March. There can be atypical seasonal flu at other times of the year. According to the State of Alaska Epidemiology website, 471 cases of influenza have been confirmed this season between October 4, 2014 and November 12, 2014. (1) The National Vital Statistics report, in 2011, the most recent year statistics are available for, reports that 53,826 people in the United States died from Influenza and Pneumonia. (2)(5) Symptoms of influenza are fever, cough, sore throat, runny nose or nasal congestion, muscle and body aches, headaches and fatigue. Vomiting and diarrhea can occur and is more common in children with the flu than adults. Symptoms usually last from a few days to two weeks. It can be difficult to differentiate the flu from the common cold, but typically the flu symptoms are more intense than cold symptoms and can result in serious complications that require hospitalization, such as pneumonia. It is important to note that a healthy adult who contracts the flu may be infections beginning 1 day prior to developing symptoms and for 5-7 days after becoming ill. The influenza virus is spread mainly by droplets made when an infected 12 Middle East Respiratory Syndrome (MERS) person coughs, sneezes, or even when speaking. These droplets can contaminate persons up to a distance of about 6 feet.(3) The CDC recommends that all persons aged 6 months and older get annual vaccination for the flu with very few exceptions. There are different flu vaccines approved for people of different ages as well for people with chronic health conditions or pregnancy. Only children under 6 months of age and people with severe, life threatening allergies to the flu vaccine or components in the vaccine are excluded from receiving the flu shot. If a person has an allergy to eggs, history of Guillain-Barre Syndrome, or are currently ill, the recommendation is to consult their doctor before getting the flu vaccine. Once a person is vaccinated against the flu, it takes about 2 weeks for antibodies to develop and provide protection from the flu. (4) There are many myths and misconceptions about the flu vaccine, too many to address here, but two key points to know are: Firstly, you cannot get the flu from the flu shot or nasal spray vaccine. Side effects can include soreness, redness or swelling at the injection site. More generalized side effects can include low-grade fever, headache and muscle aches, probably related to the stimulation of the immune system. And secondly, is that if you don’t get vaccinated at the start of flu season, then it’s not too late. The CDC reports that the vaccine can still be protective even if you are vaccinated in December or later.(6) Other ways to protect yourself from the flu are the tried and true basics, wash your hands or use hand sanitizer frequently. Stay T h e o f f i c i a l P u b l i c at i o n o f t h e A l as k a N u r s e s A s s o c i at i o n The virus that causes MERS is a coronavirus that primarily affects the respiratory system. The symptoms consist of fever, cough and shortness of breath. Occasionally, nausea, vomiting or diarrhea may be present. In 2012 MERS was first reported in Saudi Arabia and Jordan. There was spread of the virus to other countries, but all cases were linked back to countries in and near the Arabian Peninsula. During the 2012 outbreak of MERS, about 30% of people infected developed severe illness and died.(7) MERS is spread through close contact with an infected person. Unlike the Influenza virus there is no vaccine for the MERS Virus. Prevention consists of avoidance, frequent had washing, covering your cough, and cleaning and disinfection of frequently touched surfaces. There is no antiviral treatment for MERS, and treatment of severe illness consists of supportive treatment of symptoms. Enterovirus D68 (EV-D68) EV-D68 is one of a broad group of related viruses that include the viruses responsible for polio; hand, foot, and mouth disease; and viral meningitis. This virus has been known since the early 1960s, but has not been tracked or thought to be a contender for a major outbreak of illness. This virus jumped into the spotlight this year as 47 states and the District of Columbia reported cases of EV-D68 associated with severe respiratory illness. From mid-August to November over 1100 cases were reported, almost all the cases were children. There are a several common viruses that can “EV-D68 like” illness, including RSV. Diagnosis of EV-D68 must be confirmed by laboratory testing. Some children died, though the exact number is unknown. A small cluster of children in Colorado have also had symptoms of paralysis that may, or may not resolve, associated with confirmed infection with EV-D68. Children with a history of asthma w w w. aknurs e .org or wheezing had more severe symptoms than healthy children. There are no currently reported cases of EV-D68 reported in Alaska according to the State of Alaska Epidemiology website.(8) EVD68 cases occur primarily in the summer and fall. The CDC has noted a drop in the number of reported cases and the expectation is that there will be very few if any cases to track over the winter. Ebola The first documented case of Ebola in the United States occurred in the state of Texas this fall. The man, Thomas Eric Duncan travelled to the US from Liberia, arriving in Dallas on September 20th. Four days later Mr. Duncan began to exhibit symptoms and sought care two days later. He was not identified as potential Ebola case, and sent home. He sought care again 2 days later, on September 28th, as his symptoms became more severe. At that time he was identified as a potential Ebola victim and placed in isolation.(9) There has a whirlwind of controversy about why he was not placed in isolation and treatment for Ebola on his first attempt to seek care. Blame has been assigned to the nurse, the computer charting system, physician, and triage processes. The truth of the matter is probably a combination of all these factors and maybe some that haven’t been considered yet. The important point here is that the country learned a lot from this case. Since this case CDC guidelines for screening, intake, recommended personal protection equipment, and standards of care have been updated. Ebola belongs to the virus family Filoviridae, of which there are 3 viruses including the Marburg virus which also causes a hemorrhagic illness. It was first discovered in 1976. There are 5 strains of Ebola, 4 of which are known to cause illness in humans. Zaire, Sudan, Tai Forest (formerly Ivory Coast), and Bundibugyo . The fifth strain Reston Virus caused hemorrhagic illness in monkeys that were housed at the Reston Primate Quarantine Unit in Reston, Virginia.(10) The strain responsible for the 2014 West African outbreak is the Zaire strain. This particular strain is one of the most virulent strains with a 70-90% mortality rate.(11)(12) The reservoir for the virus is suspected to be fruit bats that live in the jungles of western Africa. Humans are thought to become infected by coming into contact with blood, and body fluids from infected animals, especially risky in areas where people eat “bushmeat” (See Viruses page 14) MEMBERSHIP HAS ITS ADVANTAGES Get more out of your Alaska Nurses Association membership with help from First National Bank Alaska. Sign up for an AaNA Employer Advantage checking account to take advantage of the convenient services you want and the exibility you deserve. Have your paycheck directly deposited in an AaNA Employer Advantage account and enjoy: • Free Mobile Banking FNBApp • Free small safe-deposit box (where available) • Free First National Bank Alaska exclusive checks • No-fee money orders • No minimum deposit required to open • And more! You’ll also receive up to $500 off the origination fee of an approved mortgage loan at First National Bank Alaska. Visit your local First National branch to open your account today. FNBAlaska.com (See SART page 14) To Advertise in The Alaska Nurse contact Teresa Bracale [email protected] 907.223.2801 We Offer Assisted Living for Your Patients Apartment style living with 24 hour awake care staff and a RN on-call to triage residents’ needs. Accepting residents 55 and older. Certified for Medicaid CHOICE Waiver and qualifies for most long term care insurances. Assisted Living offering Privacy, Dignity and Individualized Care 2030 Muldoon Road, Anchorage, AK 99504 Phone (907) 338-8708 www.marlowmanor.com T H E A L AS K A N U R S E • D E C E M B E R 20 14- January 201 5 13 w w w. aknurs e .org Two Nurses Inducted into Hall of Fame By Andrea Nutty At the Alaska Nurses Association’s annual General Assembly on October 5, 2014, two Alaskan nurses were inducted into the AaNA Hall of Fame. The ceremony was held during the General Assembly at the Embassy Suites Hotel in Anchorage. Patricia Senner, MS, RN, ANP and the late Kathleen Gettys, BA, BSN, RN were honored for their dedication to the profession of nursing and years of hard work supporting nurses through their leadership positions with AaNA. The AaNA recently mourned the loss of Kathleen Gettys, BA, BSN, RN, who passed away earlier this year on May 18. Over the years, Gettys took on multiple leadership positions at AaNA including Labor Council Director and President of Providence Registered Nurses. She was known as a strong advocate for the professional interests of bedside nurses in Alaska and played an instrumental role in the passage of the “No Mandatory Overtime for Nurses” bill. Gettys spent countless hours over a span of six years meeting the lawmakers and educating them on the risks to both patients and medical staff due to mandatory overtime. The bill finally passed on the last day of the 26th legislative session in 2010. Patricia “Pat” Senner, MS, RN, ANP, began her nursing career in 1982 after she graduated from Catholic University of America in Washington, D.C. and became a family nurse practitioner. For years, Senner worked as a nurse practitioner caring for youth seeking shelter at Anchorage’s Covenant House. Senner served as Executive Director of the AaNA for three years, Board of Directors President, as Chair of the Legislative Committee, and Interim Director of Professional Practice, among other positions. In 2004, Senner received the AaNA Excellence in Service award for her passion, dedication, and leadership on behalf of Alaska’s nurses. “We are honored and thrilled to welcome Pat Senner and Kathleen Gettys into the Alaska Nurses Association’s Hall of Fame,” said Donna Phillips, AaNA Labor Council Chair. “These nurses’ commitment to the profession, to the Association, and to the pursuit of excellence in all that they did and continue to do creates opportunities and better work environments for future Alaskans.” October 5th marked the 61st anniversary of the Alaska Nurses Association’s official incorporation with the Territory of Alaska, and also marked 10 years since the Alaska Nurses Hall of Fame began. The Alaska Nurses Hall of Fame was established in 2003 as part of a celebration of AaNA’s 50th anniversary. Since that time, 10 nurses have been inducted to the Hall of Fame: Catherine (Kitty) Gair, RN; Doris McCarty Southall, RN; Elva Ruth Scott, MEd, BSN, RN; Effie Anderson Graham, PhD, RN; Arnie Beltz, MPH, MN, RN; Elizabeth Berry Fritz, RN; V. Kay Lahdenpera, RN; Patricia “Patti” Hong, RN; and now Patricia “Pat” Senner, MS, RN, ANP and Kathleen Gettys, BA, BSN, RN. The plaques honoring the nurses inducted into the Alaska Nurses Hall of Fame are housed at AaNA’s headquarters in Anchorage. Jana Shockman, AaNA President, and Patricia Senner, Hall of Fame Inductee. 14 T h e o f f i c i a l P u b l i c at i o n o f t h e A l as k a N u r s e s A s s o c i at i o n Viruses (continued from page 14) from bats and monkeys. Once a human is infected and showing symptoms, human to human transmission is rapid and leads to outbreaks. Particularly in countries with poor infrastructure and inadequate public health programs.(12) Ebola is new the United States, but it is a virus that has been studied extensively. The pathophysiology and transmission of Ebola virus disease is well known in the medical and scientific world. Ebola is only spread through direct contact with an infected person’s body fluids, such as blood, urine, saliva, sweat, feces, vomit, breast milk, and semen. Ebola is not spread through the air, or by water. Ebola is not transmitted by mosquitos or other insects.(13) The incubation period of Ebola is anywhere from 2-21 days. Humans are not infectious, meaning that they cannot infect others, with Ebola unless they develop symptoms. A person potentially exposed to Ebola within 21 days and showing no symptoms is not infectious.(14) The initial symptoms of Ebola are very much like the flu and include sudden onset of fever, fatigue, muscle aches, headache and sore throat. The illness then progresses to vomiting, diarrhea, rash, impaired kidney and liver function. Both internal and external bleeding can occur related to the liver dysfunction. (14) There is no preventative vaccine for Ebola, though at least 2 are in the testing process. There are several potential drug therapies for Ebola currently being evaluated, but in actuality treatment for Ebola, like most viral illnesses, is primarily supportive and management of symptoms until the virus runs it’s course. Because of the massive amounts of fluid loss during the acute phase, up to 10L of fluid per day, appropriate fluid resuscitation is a vital part of care of the Ebola patient. (14) This massive loss of fluids due to emesis, diarrhea, and possibly bleeding is a major reason why Ebola is spread so easily from person to person. Extreme measures for personal protection for healthcare workers is essential. Studies of the more than 20 outbreaks of Ebola in Africa show that once barrier protection for healthcare workers is put in place, contraction of Ebola by healthcare workers dropped dramatically.(13) Only 2 people in the US have died from Ebola. A doctor transported to Omaha from Sierra Leone, and Thomas Eric Duncan, the first patient to be diagnosed with Ebola in the US. The two nurses who contracted Ebola while caring for him have made full recoveries, as have the other patients who w w w. aknurs e .org contracted Ebola outside the US, but were treated here. Hospitals throughout the country have had to examine their screening procedures and isolation procedures for infectious patients. America is better prepared to deal with a potential Ebola outbreak now as hospitals implement protocols and algorithms to Identify, Isolate, and Inform, when screening and admitting patients. Patients must have both symptoms, and potential exposure history within 21 days to be ruled in for Ebola isolation. Ebola may never become the feared epidemic that it is in Western Africa but it has certainly taught the American Healthcare system a few things. In responding to the threat of Ebola, we are now better prepared to respond to other potential outbreaks of infectious diseases. The fact is, we are surrounded by viruses. Some are harmless to humans. Some are annoying, like the common cold. Some are potentially lethal, like the flu, HIV, or Ebola. The important thing is that regardless of current media frenzy, we as healthcare providers follow the science, prepare, and follow our calling to provide the best healthcare we can to our stricken patients. 1. Alaska Influenza Surveillance Report. (n.d.). Retrieved November 14, 2014, from http://www.epi.hss.state.ak.us/id/ influenza/influenza.jsp 2. Hoyert DL, Xu JQ. Deaths: Preliminary datafor 2011. National vital statistics reports; vol 61 no 6. Hyattsville, MD: National Center for Health Statistics. 20 3. Flu Symptoms & Severity. (2014, August 13). Retrieved November 10, 2014, from http://www.cdc.gov/flu/about/ disease/symptoms.htm 4. Vaccination: Who Should Do It, Who Should Not and Who Should Take Precautions. (2014, September 26). Retrieved November 10, 2014, from http://www.cdc.gov/flu/protect/ whoshouldvax.htm Calendar of Events Save the Dates! ............................................................................. AaNA Board of Directors Meeting Holiday Schedule December 10, 2014 4:30 to 5:30 pm ............................................................................. AaNA Board of Directors Meeting Holiday Schedule December 10, 2014 5:30 to 6:30 pm ............................................................................. UAA School of Nursing Recognition Ceremony December 14, 2014 ............................................................................. Alaska Public Health Summit January 27-January 29, 2015 AaNA Professional Practice Committee Contact for times: [email protected] ............................................................................. Alaska State Board of Nursing Meeting Jan 21-23, 2015 • The Alaska Board of ........................................................................................... or 907-274-0827 ............................................................................. AaNA Health & Safety Committee 3rd Wednesday of each month 4:30 to 6:30 pm ............................................................................. AaNA Legislative Committee Contact for times: [email protected] or 907-274-0827 ............................................................................. Providence Registered Nurses 3rd Thursday of each month 4 to 6 pm ............................................................................. RN’s United of Central Peninsula Hospital Contact for times: 907-252-5276 ............................................................................. KTN Ketchikan General Hospital Contact for times: 907-247-3828 ............................................................................. AaNA Holiday Open House December 12, 2014 10 am-5pm • AaNA Office 3701 E. Tudor, Suite 208 Anchorage • www.aknurse.org ............................................................................. Hotel Captain Cook www.alaskapublichealth.org Nursing has a listserv that is used to send out the latest information about upcoming meetings, agenda items, regulations being considered, and other topics of interest to nurses, employers, and the public. To sign up for this free service, visit www.nursing.alaska.gov Inquiries regarding meetings and appearing on the agenda can be directed to: Nancy Sanders, PhD RN, Executive Administrator Alaska State Board of Nursing, 550 West 7th Ave, Ste 1500, Anchorage, AK 99501, Ph: 907-2698161 Fax: 907-269-8196, Email: nancy.sanders@ alaska.gov ............................................................................. Contact Hours www.aknurse.org/ Remember to visit: index.cfm/education for frequent updates and information on local nursing contact hour opportunities and conferences! ............................................................................. 5. (2014, July 14). Retrieved November 10, 2014, from http:// www.cdc.gov/nchs/fastats/deaths.htm 6. Misconceptions about Seasonal Flu and Flu Vaccines. (2014, October 22). Retrieved November 10, 2014, from http://www.cdc.gov/flu/about/qa/misconceptions.htm 7. About MERS. (2014, June 4). Retrieved November 10, 2014, from http://www.cdc.gov/coronavirus/mers/about/ 8. (n.d.). Retrieved November 10, 2014, from http:// dhss.alaska.gov/News/Documents/press/2014/ StateUrgesProactiveSteps.Flu.EV-D68_PR_093014.pdf8. 9. Dallas Ebola Patient Thomas Eric Duncan Has Died. (n.d.). Retrieved November 10, 2014, from http://www.npr.org/ blogs/thetwo-way/2014/10/08/354577799/dallas-ebolapatient-thomas-eric-duncan-dies-hospital-says, 10. About Ebola Virus Disease. (2014, October 3). Retrieved November 10, 2014, from http://www.cdc.gov/vhf/ebola/ about.html 11. Emergence of Zaire Ebola Virus Disease in Guinea — NEJM. (n.d.). Retrieved November 10, 2014, from http:// www.nejm.org/doi/full/10.1056/NEJMoa1404505#t=article 12. Ebola - A Growing Threat? — NEJM. (n.d.). Retrieved November 10, 2014, from http://www.nejm.org/doi/ full/10.1056/NEJMp1405314 13. Review of Human-to-Human Transmission of Ebola Virus. (2014, October 29). Retrieved November 10, 2014, from http://www.cdc.gov/vhf/ebola/transmission/humantransmission.html 14. Ebola virus disease. (n.d.). Retrieved November 10, 2014, from http://www.who.int/mediacentre/factsheets/fs103/en/ T H E A L AS K A N U R S E • D E C E M B E R 20 14- January 201 5 15 _bc.indd 1 TAKE THE ROAD LESS SALTED. 2014 MINI Cooper S Countryman ALL4* > > > All Wheel Drive 31 MPG Hwy EPA Est*** MSRP starting at just $27,400 Order yours today. MINI OF ANCHORAGE (888) 984-3380 800 East 5th Avenue MINIANCHORAGE.COM Anchorage, AK 99501 USAA members receive up to $1,000 in savings.† It’s a small token of appreciation from MINI for those who serve in the military. 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