newsletter summer 2012 · 2 the newsletter — † summer 2012, volume 31, number 2 the stage is...

The Newsletter — www.gapna.org 1

Summer 2012 Volume 31, Number 2

A s a clinician, educator,and researcher in the

field of geriatrics, some ofmy most rewarding experi-ences have come fromwatching students developan unexpected interest andcommitment in caring forolder adults during theirclinical rotations. Studentswho develop an interest ingeriatrics describe their abil-ity to make a difference inthe lives of older adults and find that thepatients’ focus on functional and qualityof life outcomes is a good fit withadvanced practice nursing. While I wasinitially ambivalent about the APRNConsensus Model transition to a com-bined adult and gerontological popula-tion focus, it has been my experiencethat this new educational frameworkbrings with it the opportunity to expose agreater number of students to geriatricsthrough focused clinical experienceswith geriatric populations. Not all of thecombined adult gerontological APRN

President’sMessage

NewsletterThe Official Newsletter of the Gerontological Advanced Practice Nurses Association — Founded in 1981

Call for GAPNAFoundation GrantsApplications are due May 16, 2012. Grants are announced in September.

General Eligibility Requirements

• Applicants must be a currentGAPNA member. If you are not acurrent member, please include aGAPNA membership applicationand fee with the grant application.

• Members may apply for more thanone grant.

• Awards are limited to one per personper year.

Applications are available at theFoundation Awards Link on the GAPNAweb site.

students will go on to acareer in geriatrics; howev-er, more students are feelingcompetent in caring forolder adults in these com-bined programs. In addition,some students who wouldnot have been exposed tothe rewards of a career ingeriatrics in adult APRNprograms become passion-ate about the populationand eventually make it the

focus of their professional careers. As a nursing student and a new

nurse, I did not intentionally plan for acareer in geriatrics; however, the olderadults I cared for and the expert teachersand mentors who ignited my interest inthis population helped to focus me on acareer path that I still cherish today. I askour experienced gerontological ad -vanced practice nurses to share theirexpertise, wisdom, and time with thenext generation of students and practic-ing APRNs who may be new to geri-atrics. Your mentorship of the next gener-

Your Vote Counts: Board of Directors Elections SetGAPNA wants to hear from you! You will be seeing ballots for the 2012-2013

Board of Directors election soon. Election ballots will be arriving to your email inboxon May 7 and voting will remain open until May 31, 2012.

Please take a moment to help shape your national leadership team. You will bevoting on the following positions: President-Elect, Secretary, Director at Large, andNominating Committee (2 openings).

We encourage your participation. Let your voice be heard! If you have questions or comments, please contact Katherine Evans at

[email protected]; Candace Harrington at [email protected]; or Colleen Wojciechowski at [email protected]

IN THIS ISSUEConference Preview. . . . . . . . . . 2-3

Award Nominations . . . . . . . . . . . 4

Chapter News. . . . . . . . . . . . . . . 6-9

Committee Updates . . . . . . . . . . 10

ACNP Summit Recap . . . . . . . . . 11

Wound Management . . . . . . . . . 12

Clinical Research Corner . . . . . . 14

Investing in Students and APRNs For Quality Geriatric Care

“Tell me and I forget. Teach me and I remember. Involve me and I learn.” – Benjamin Franklin

ation of gerontological APRNs will helpGAPNA to grow and thrive as a profes-sional organization, and ultimately willimprove the care of older adults, theirfamilies, and caregivers. For students andAPRNs who are new to geriatrics, I askyou to keep an open mind to all of thecareer options in front of you. No matterwhere you practice, you will encounterolder adults in some capacity and yourgeriatric clinical experiences and contin-uing education will make you a morecompetent and well-rounded provider.

continued on page 14

Elizabeth M. Galik

2 The Newsletter — www.gapna.org • Summer 2012, Volume 31, Number 2

The stage is set for GAPNA’s 31stAnnual Conference – Promoting

Clinical Excellence Through Vision,Vitality, and Visibility – September 19-22, 2012, at the Red Rock Hotel andCasino, Las Vegas, NV. The energy andexcitement of Las Vegas is an excel-lent venue for outstanding clinicalcontent and professional networkingfeatured at the Annual Conference.

Most grown-up adventures startwith these five words: Welcome toFabulous Las Vegas. When you’re notwinning in the casino, lounging by thepool, or savoring delicious cuisine,you’ll find that Las Vegas has a varietyof must-see attractions and entertain-ment options to keep you and yourfriends occupied. From thrilling rollercoasters to virtual-reality simulatorrides and erupting volcanoes to waxmuseums, Las Vegas’ attractionsappeal to people of all ages, interests,and budgets.

At the Red Rock Hotel and

Casino, the headquarters hotel forGAPNA’s Annual Convention, youwill enjoy the natural beauty andVegas-style glamour in a peaceful co-existence. Its serene surroundings, dis-tinctive décor, and impeccable stan-dard of service will ensure that yourvisit is unforgettable. Whether admir-ing the panoramic “Strip” view or

awe-inspiring Canyon view from yourroom, unwinding at the expansivepool back yard, trying your luck in thecasino, or relaxing at the 35,000-square-foot spa, Red Rock has a flavorfor all tastes and desires.

To make your stay an even morememorable experience, check out the

Las Vegas hotel deals and spa offeringsavailable at Red Rock Hotel andCasino at www.redrocklasvegas.com.With their special Las Vegas packagedeals you can melt away with a sooth-ing spa treatment or massage, tee offat one of the area’s championship golfcourses, bowl at the amazing RedRock Lanes, or go on an outdooradventure to nearby Red RockCanyon, a wilderness other off-striphotels can’t call their backyard likeRed Rock! Waiting for you on returnare all the lavish amenities of one ofthe premier Las Vegas hotels – finedining for every taste, thrilling Vegascasino gaming, and exciting nightlifeand entertainment. Come see whyRed Rock Hotel and Casino is a cutabove in Las Vegas hotel rooms.

Once known for its all-you-can-eat buffets and bargain shrimp cock-tails, Las Vegas has transformed itselfinto a top culinary destination. Withina decade, Las Vegas has redefined theculinary and wine experience byoffering the most comprehensive col-lection of celebrity chefs and world-

class restaurants, more MasterSommeliers than any other city in theworld, and more wine sold per capitathan in any other destination.

There’s a good reason why LasVegas is called the “EntertainmentCapital of the World.” Since its RatPack days, Las Vegas has been inextri-cably associated with legendaryshows and entertainers. Say “LasVegas” and it’s likely that showgirls inelaborate headdresses and Elvisimpersonators will come to mind.

Today, the Las Vegas entertain-ment scene still has plenty of its classicglamour, but it has evolved to includeso much more. In addition to the icon-ic Las Vegas entertainment staples, thedestination offers a lineup of award-winning magicians, Broadway-caliberproductions, world-renowned concertheadliners, and unique-to-Las Vegasproduction shows.

One of the most fascinatingaspects of Las Vegas is that it is a citythat is constantly changing. Theexcitement of continuous re-inventionand rapid growth has helped LasVegas to achieve popularity, resultingin 37.3 million annual visitors. In2012, visitors will see and experiencemore in Las Vegas than ever before.Don’t miss the action. When planningyour trip to GAPNA’s 31st AnnualConference, request a free visitorsguide at www.visitlasvegas.com

the Non-Stop Entertainment

and Excitement in Las Vegas

GAPNA’s Career Center: Your Opportunity Awaits

Perhaps you know of a friend who is looking to changecareers? Maybe you are contemplating changing posi-

tions or employers? Do you have to move to a new area andcan’t transfer within your current company? Maybe your com-pany has an opening and wants to find a qualified individualto fill the vacancy?

If any of the above questions apply to you, it may be timefor you to visit GAPNA’s Career Center. Simply log onto theGAPNA web site and click the “Career” tab to view currentemployment opportunities. If you would like to post anopportunity, please contact the National Office at 866-355-1392 or send your advertisement to [email protected] for aquick price quote!

The Newsletter — www.gapna.org • Summer 2012, Volume 31, Number 2 3

Fun and Exciting GAPNA FoundationEvents Planned for Annual Convention

Want to have fun while sup-porting a great cause at GAPNAs31st Annual Conference in LasVegas? The GAPNA Foundation hasthree fabulous events planned forthis year’s conference. The first isthe 6th Annual Foundation BestBall Golf Tournament at ArroyoGolf Club. This event does notrequire you to be a good golfer, justwilling to go out and have a lot offun raising money for theFoundation. Family members arealso welcome to participate, so ifyour significant other or another guest wants to play, they aremore than welcome.

The second event is our annual Fun Run/Walk. We encour-age you to come out and participate in this popular event. The lastevent is a fun-filled evening of “cosmic bowling” at the Red RockLanes. The cost includes two games, shoes, pizza, and a drink.

If none of these options appeal to you or if you are in a gen-erous mood, you can also select a cash donation. Remember,your donations are tax deductible and allow the Foundation toprovide scholarships to budding researchers and student schol-ars. Registration will be available early this summer through theconference registration brochure. We hope to see all GAPNAmembers at these enjoyable events!

Debra Bakerjian, PhD, RN, FNPChair, Board of Trustees

[email protected]

GAPNA Research Consults Availableat Annual Conference

Trying to finish up your doctorate? Working on an evi-dence-based project? Having difficulty submitting your researchproposal? Not sure how to go about your first research project?Need someone with experience in research to speak to aboutyour project?

GAPNA sees the need and the Research Committee isinterested in providing you with free consultation and guid-ance. At the 31st Annual Con ference in Las Vegas, GAPNAResearch Committee members will provide one-on-one guid-ance. Email your name, contact info, and a brief description ofthe research/project issue that you would like to discuss [email protected]. Someone with experience in your researcharea will set up a time to discuss your research project with you.You will be contacted and a time selected to meet with a com-mittee member during the Exhibit Hall or lunch on your owntime. GAPNA Research Committee members will have a boothin the Exhibit Hall for you to meet with them. We’re reachingout to you, tell us how we can help you with your research proj-ect.

Valerie Sabol, ACNP-BC, GNP-BCCo-Chair, Research Committee

[email protected]

Margaret Hammersla, MS, CRNPCo-Chair, Research Committee

Approver Unit Seeks VolunteersThe GAPNA Approver Unit approves continuing education

programs for American Nurses Credentialing Center (ANCC)credit. Each GAPNA Chapter may submit one program of up to8 contact hours annually at no charge. Please take advantage ofthis GAPNA member benefit.

The Approver Unit also needs volunteers to review applica-tions, a role named nurse peer reviewer (NPR). NPRs need tohave some background in continuing education and be willingto learn about the ANCC criteria.

Assessing educational objectives is one of the tasks of aNPR. Each application to the Approver Unit must contain edu-cational objectives, defined as learner-oriented outcomes, thatresult from participation in an educational activity. Educationalobjectives describe knowledge and skill acquisition or attitudechanges. They should be measureable and achievable.

Common faults of educational objectives are that they aretoo vague and do not specify learner outcomes in behavioralterms. Some examples of objectives that are vague compared tothose expressed in measureable terms are shown in Table 1.

If you are interested in joining the GAPNA Approver Unit andhoning your education skills, contact Liz Macera [email protected] or Nancy Mandler at [email protected]. Attend our committee meeting at the AnnualConference to learn more.

Liz Macera, PhD, RN, NP-CCo-Chair, Approver [email protected]

Table 1.Educational Objectives

Vague Measurable Terms

To understand atrialfibrillaton.

Describe the pathophysiology of atrialfibrillation.

Handling stress. Compare and contrast two methods ofstress management appropriate to teachpatients with anxiety disorder.

Become familiar withthe POLST form.

Demonstrate a discussion of the POLSTform between a nurse practitioner and apatient.


Nominations Sought for Excellence Awards

GAPNA invites you to submit anomination for one of the followingExcellence Awards. The awards will be announced during the AnnualConference at the Annual AwardsDinner. Self-nominations are invited.Nominations must be received by June1, 2012. Go the GAPNA web site(www.gapna.org) under the “AboutGAPNA” tab and complete the applica-ble nomination form.

GAPNA Chapter ExcellenceAward

The Chapter Excellence Award hon-ors a chapter that best promotes thegoals of the Gerontological AdvancedPractice Nurses Association (GAPNA)through its member relationships, profes-sional activities, and promotion ofadvanced practice gerontological nurs-ing throughout the local, regional,and/or state during the past year. Thewinning chapter will be awarded $250and receive a $100 discount on confer-ence registration for the president orappointed designee for the year that theaward is given.

Eligibility Requirements• The chapter must be officially char-

tered by the GAPNA Board ofDirectors.

• The chapter must be in compliancewith all chapter obligations and ingood standing with the GAPNANational Office.

• The completed application must bereceived by the National Office bythe given deadline.

GAPNA Excellence in ClinicalPractice Award

This award for outstanding clinicalpractice should be given to an individualwho demonstrates a commitment togeriatric clinical practice. This awardshould be for an individual who demon-strates, through the use of geriatric prin-ciples, outstanding geriatric care thatgoes well beyond the traditional servicerole of their profession. The award high-lights clinical practice as an importantelement of the mission of nursing profes-sionals and singles out individuals whoserve as examples of geriatric expertise.

The award recipient must have abroad-based, continuing commitment togeriatric care as reflected in a variety ofprograms and initiatives which areresponsive to medical and social needs

of the geriatric population. This recipientshould be active in furthering geriatriceducation at the local and regional lev-els through precepting, in-services, andeducational presentations.

Examples of the types of experienceappropriate for consideration include,but are not limited to, the following:• Working with geriatric clients• Acting as primary care provider,

consultant, educator, coach, andadvocate

• Utilizing geriatric principles to pro-vide care and treatment

• Meeting multiple needs and re -quests of geriatric clients

• Responding to cultural differences• Acting as an advocate for geriatric

clients• Applying a multidisciplinary ap -

proach in the care of an elder con-sulting other health care providersand additional agencies as required

• Utilizing up-to-date research to sup-port decision making and to im -prove care

GAPNA Excellence inCommunity Service Award

This award for outstanding commu-nity service should be given to an indi-vidual who demonstrates a commitmentto service to the community. This com-mitment should be demonstratedthrough the development of or participa-tion in programs that go well beyond thetraditional service role of their profes-sion. The award highlights communityservice as an important element of themission of nursing professionals, and sin-gles out individuals who serve as exam-ples of social responsiveness on the partof the nursing community.

The award recipient must have abroad-based, continuing commitment tocommunity service as reflected in a vari-ety of programs and initiatives, which areresponsive to community and socialneeds, and which show evidence of atrue partnership with the community.This recipient may be active in volun-teering service to local, national, geri-atric, or specialty nursing groups, whichbenefit the community in which theyserve.

Examples of the types of programsappropriate for consideration include,but are not limited to, the following:• Innovative programs of patient

care/service to disadvantaged com-munities

• Innovative services to the geriatriccommunity

• Educational programs targeted toincreasing the participation of tradi-tionally underrepresented groups

• Leadership focusing communityresources to respond to health needssuch as prevention and health edu-cation, patient care, and social andsupportive services

• Programs aimed at providing nurs-ing students with educational expe-riences in underserved areas toencourage eventual practice in suchcommunities

• Programs developed to meet theneeds of isolated communities, geri-atric communities, or communitieshaving a large geriatric population

• Programs that use the unique assetsand resources to address continuingeducational, economic, and/or sys-temic community problems

GAPNA Excellence inEducation Award

The Award for Excellence inEducation recognizes an individualinvolved in the teaching and/or design ofgerontological nurse practitioner curricu-lum or course content. The faculty mem-ber will demonstrate knowledge of thecare of older adults and the ability totranslate that knowledge to enhance stu-dents’ understanding in innovative ways.The faculty member will encourage andinspire advanced practice students todevelop their excellence in gerontology.In addition to excellence in teaching, thefaculty member will exhibit excellence inpractice and service to the community.

Examples of programs appropriatefor consideration include, but are notlimited to, the following:• Development of a program of

recruitment of students into the GNPprogram of their school

• Development of a new or revisedGNP program

• Implementation of innovative teach-ing in a GNP course

• Development of an academic prac-tice

• Formation of a community partner-ship, which met educational objec-tives while meeting the needs of theolder adult community


GAPNA Excellence inLeadership Award

This award for outstanding leader-ship should be awarded to an individualwho demonstrates a commitment togeriatrics; through direct care, educa-tion, and research. This award should befor an individual who demonstrates thetenacity to advocate, through a variety ofmeans, for geriatric education and carein a variety of settings that goes wellbeyond the traditional service role of theprofession. The award highlights leader-ship as an important element of the mis-sion of nursing professionals and singlesout individuals who serve as examples ofgeriatric expertise.

The award recipient must have abroad-based, continuing commitment togeriatric care as reflected in a variety ofprograms and initiatives which areresponsive to medical and social needsof the geriatric population. This recipientshould be active in furthering geriatricknowledge at the local and regional lev-els through clinical care, education,research, and/or political involvement.

Examples of the types of experienceappropriate for consideration include,but are not limited to, the following:• Excelling in geriatric care

• Innovating clinical practice toenhance the care of geriatric clients

• Creating clinical models that moreefficiently care for geriatric clients

• Leading change (small or large) thatimproves quality of care

• Promoting an environment ofchange

• Excelling at communication andrelationship building

• Energizing others to promote geri-atric care

GAPNA Excellence inResearch Award

This award for research should beawarded to an individual who demon-strates a commitment to research in nurs-ing that benefits the geriatric community.This commitment should be demonstrat-ed through the development of or partic-ipation in research projects that empha-size or go beyond the traditional servicerole of their profession. The award high-lights research as an important elementof the mission of nursing professionalsand singles out individuals who serve asexamples of nursing scientists within thenursing community.

The award recipient must have abroad-based, continuing commitment toresearch as reflected in a variety of pro-

grams and initiatives which are respon-sive to the geriatric nursing community.This recipient may be active in conduct-ing research, mentoring other re -searchers, and contributing to ongoingresearch of other nursing scientists.

Examples of the types of programsappropriate for consideration include,but are not limited to, the following:• Made outstanding contributions to

the science of nursing throughresearch, development of newknowledge in nursing, or to further-ing nursing knowledge throughresearch

• Contributed to the development andtesting of nursing interventions toimprove geriatric nursing care

• Completed research and scholarshipthat informs practice and advancesgeriatric education of advancedpractice nurses

• Provided information that caninform health care policy to improvethe care to the geriatric community

• Demonstrated leadership in re -search in geriatric nursing (conduct-ing research, mentoring, participat-ing in research projects, etc.)

• Demonstrated expertise in researchthrough an earned doctorate or post-doctorate in research

Three Reasons to Visit GAPNA’s Online Library

1. Free CNE Opportunity!Available now in the Online Library, “Geriatric Palliative

Medicine” (1 contact hour). This session is free to everyone!The fields of hospice and palliative medicine are

reaching maturity in the United States. With the graying of thebaby boom generation, the need for clinicians with expertisein both geriatrics and end-of-life care is greater than ever.

2. Annual Conference Content Available Content from GAPNA’s Annual Conference is now

available for sale in the new Online Library. Conference attendees: Access content at no cost (andpurchase CNE for a minimal fee).

Couldn’t make it to the conference, GAPNA member?$30 for regular sessions (CNE included).

Not a GAPNA member? Only $35 for regular sessions.

Visit www.prolibraries.com/gapna for more information.

3. Presidential MinuteGAPNA President, Elizabeth Galik, provides a brief

update on the new Online Library and its benefits.


I f your chapter is looking for a way toengage your membership as well as

attract new members, the StudentMentorship Evening may be an activityyour chapter might like to check out.Today’s health care environment is com-plex and ever-changing and for newnurse practitioners, launching into prac-tice can be a confusing and intimidatingprocess. Although students often receiveguidance and information on gettingstarted in practice while in college,advice and mentorship from practicingclinicians is treasured. The StudentMentorship Evening (SME) brings togeth-er GAPNA chapter members and nursepractitioner students in a fun networkingand informational session and also pro-vides the opportunity for students to bematched with a mentor for their first yearof NP practice.

The Student Mentorship Evening,designed by the Great Lakes Chapter-GAPNA, is a 2-hour event and coversfour main topics related to getting startedin practice. An event flier is sent to areacolleges to invite students (see Figure 1).Students register by contacting theGAPNA chapter secretary or they canRSVP through the chapter’s web site (seeFigure 2). When students arrive, theyreceive a name-tag and are assigned to agroup for ease of rotating through theinformational sessions during theevening. We also offer a chance to win afree GAPNA membership to attendees.At registration, participants can placetheir name and contact information inthe “drawing box” if they are interestedin winning a free membership.

The evening begins with a light din-ner and 30 minutes of networking andsocial time. During this time GLC-GAPNA members welcome and social-ize with students; just prior to starting theinformation session, students are intro-duced to chapter members and are pro-vided contact information and GAPNAmembership information. We arrangethe meeting area to accommodate fiveinformation stations with seating for upto eight participants. Information ses-sions run concurrently and are 20 min-utes in length; a rotation schedule helpsto keep the session running on time (seeTable 1). Handouts, which identify keyissues related to the session topic, areprovided. Presenters keep the sessionslively and interactive rather than a lec-ture style of presentation. Also, it is veryhelpful to have a chapter member who

Energize Your Chapter: Sponsor a Nurse Practitioner Student Mentorship Evening!

TimePractice

AgreementsCertification/

Licensure/DEA Billing/CodingScope of Practice

7:00p-7:30p Welcome Introduction Networking

7:30p-7:50p A B C D

7:50p-8:10p D A B C

8:10p-8:30p C D A B

8:30p-8:50p B C D A

8:50p-9:00p Evaluation Mentor Networking

Table 1.Information Session and Group Rotation

Figure 1.

STUDENT MENTORSHIP NIGHT

Join us for a special session offered by the Great Lakes Chapter of theGerontological Advanced Practice Nurses Association. This interactive session will assist Nurse Practitioner students to launch their career through informative sessions with seasoned NPs.

Topics will include:

• Certification, Credentialing and Licensure• Collaborative Practice Agreements/Contracts/Salary Negotiation• Obtaining NPI and DEA numbers• Billing and Coding for Nurse Practitioner services

SAVE THE DATE:

October 21, 2012

7:00pm-9:00pm

Madonna University, Livonia, MI 48170

Diponio Building

(Northeast corner of Levan and Schoolcraft Roads)

Pizza and refresments will be served


circulates and acts as “timekeeper” toensure the sessions run on schedule.

Toward the end of the evening, thefree GAPNA membership drawing isheld, and the lucky winner isannounced! Participant evaluation andfeedback forms are also collected at theend of the evening (see Figure 3).Evaluation results are reviewed and sum-marized and findings are reported tochapter members at the next quarterlymembership meeting. Participant feed-back has been overwhelmingly positivewith all sessions receiving the highestratings. Typical feedback is summarizedby one attendee: “This was a great men-torship night. I feel more informed andconfident that I will be fine when I go outinto practice, Thank You!” Participantcomments verify the importance andvalue of this event to students and haveencouraged the GLC-GAPNA to contin-ue to offer this event annually. The SMEhas also been a means of recruiting newmembers to the chapter, with severalattendees registering for membership atthe event.

Starting your own SME is easy!Explore with your membership theirinterest in sponsoring a mentorship eventtoday.

Deborah Dunn, EdD, MSN, GNP-BCPresident, [email protected]

Mary Jane Favot, MSN, GNP-BCImmediate Past President, GLC-GAPNA

Judy Wheeler, MSN, GNP-BCSecretary, GLC-GAPNA

Figure 3.

Figure 2.

Great Lakes Chapter

New Nurse PractitionerMentor Request

Name: ______________________________________________

Email address:___________________________ Phone number:______________________

School Affiliation: _____Madonna University_____Michigan State University_____Oakland University_____University of Detroit-Mercy_____University of Michigan_____Wayne State University_____Other__________________________

Anticipated date of graduation: ____________________

Area of study: _____Acute Care Nurse Practitioner_____Adult Nurse Practitioner_____Family Practice Nurse Practitioner_____Gerontological Nurse Practitioner_____Maternal Child Health Nurse Practitioner_____Pediatric Nurse Practitioner_____Psychiatric Nurse Practitioner_____Other ______________________________

Planned area for practice:_____Acute Care_____Nursing home/assisted living_____Outpatient_____Other: _______________________

Area that you anticipate might be most challenging in becoming a full practitoner:_____Certification exam_____Salary/contract negotiation_____Licensure process with state_____Credentialing process with employer_____Billing and coding_____Other: __________________________

City in which you live/plan to practice: ____________________________

Organization at which you plan to practice: _________________________

GLC-GAPNANP Student Membership Evening

Please provide feedback to help us meet your needs!Usefulness of information: Very Somewhat Little

1. Billing and Coding 1 2 32. Certification, Licensure, and Credentialing 1 2 33. Collaborative Practice Agreements Contract & Salary Negotiation 1 2 34. Scope of Practice 1 2 3

Effectiveness of Speakers:1. Billing and Coding 1 2 32. Certification, Licensure, and Credentialing 1 2 33. Practice, Contracts, Salary Negotiation 1 2 34. Scope of Practice 1 2 3

Comments: _______________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

Thank YOU!


Florida GAPNAIt has been a very busy last few months! We had a great

quarterly meeting in Palm Beach Gardens in January. President-Elect Karen Jones made all of the arrangements and gave a veryinteresting talk on “Pseudo Bulbar Affect.” We had great atten-dance and two members stepped up and volunteered to run forthe president-elect and treasurer positions this spring.

We continued to make progress in our plans for our first CEsymposium in Orlando, May 4-5 at Doubletree Hilton, nearOrlando International Airport. We have over 60 registered nursepractitioners and NP students, 18 exhibitors, and will have aproduct theater for Friday evening dinner and Saturday forlunch! This was a challenging undertaking, but CharleneDemers has been an excellent program chair and will be busyon Saturday keeping the program running smoothly and ontime. Marva Edwards-Marshall did a great job on our brochure,and Michelle Lewis is very organized with the registrationprocess. Valerie Bray, Karen Jones, and Lori Cruger will be help-ing man the tables to get everyone signed in.

Deb Hain has worked very hard to get the CE packet toGAPNA for approval and will have help from the registrationcrew handing out the certificates at the end of the symposium.Karen has helped me obtain exhibitors and door prizes. BarbaraPhillips will be timekeeper and photographer. We appreciateand thank all of the supporters of this symposium. You can seewho supported us by looking at our web page. I’ll be busykeeping exhibitors and product theaters organized, not to men-tion keeping everyone fed and watered. Its not easy picking out

the menu. I guess I’ll just have to try each of the hors d’oeuvreson Friday night to make sure I did OK!

Charlene and I went to Tampa in February to speak withrepresentatives of the Gulf Coast Chapter. We all agreed itwould be practical to only have one CE conference per yearand will alternate hosting the event. Some of their members willattend our post-conference meeting to join in the discussion asto what worked and what didn’t. They unanimously decidedthat they would not want to start from scratch in the planningprocess and I am very proud of how well our chapters have sup-ported each other.

We were contacted by the Florida Geriatric Society andinvited them to have a booth at the symposium, which theyaccepted. We will begin talks over the next few months to seeif we can join forces in a project that will benefit the olderadults in our state and are considering promoting awareness ofadvance directives. They will be invited to attend our Augustmeeting in Daytona Beach. I hope to see you in September atGAPNA’s 31st Annual Conference in Las Vegas!

JoAnn FisherPresident

[email protected]

MagnoliaTwo members of the Magnolia Chapter of Gerontological

Advanced Practice Nurses (MagGAPN) – Lisa Byrd PhD, FNP,GNP and Kimberly Ratcliff MSN, ACNP – were appointed bythe governor to the Mississippi Board of Nursing HomeAdministrators. This is a 4-year term to assist with regulatorymatters affecting nursing homes within the state of Mississippi.Congratulations!

continued on page 9

ChapterNews

Washington

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NortheastRegion

SoutheastRegion

WesternRegion

North CentralRegion

402

401

207

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101 102

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206208

301

ChaptersLooking for a CHAPTER NEAR YOU?

ARIZONA (SONORAN)Jean [email protected]

CHICAGOLANDJill [email protected]

NORTHERN CALIFORNIAJulie [email protected]

DELAWARE VALLEYStacy [email protected]

FLORIDA GAPNAJo Ann [email protected]@oslermedical.com

FLORIDA GULF COASTPeggy [email protected]

GEORGIA (ATLANTA)Carolyne [email protected]

LOUISIANA/MISSISSIPPI (MAGNOLIA)Dr. Lisa [email protected]

MARYLANDSusan [email protected]

NEW ENGLANDSusan [email protected]

MICHIGAN (GREAT LAKES)Debra [email protected]

NORTH CAROLINA (TRIAD)Marigold (Margo) [email protected]@aol.com

OHIOBeth [email protected]

TENNESSEE (MIDDLE)Amber [email protected]

TENNESSEE (MIDSOUTH)Regina [email protected]

TEXAS (GULF COAST) - HOUSTONRhonda [email protected]

WISCONSIN (SOUTHEAST)Nancy [email protected]

Interested in Starting a Chapter?

Contact the GAPNA National [email protected] • (866) 355-1392 • Fax (856) 589-7463


Chapter Newscontinued from page 8

Magnolia (continued)MagGAPN encompasses Mississippi, Louisiana, and

Alabama. We cover a large territory and many of our membersmay have difficulty in making the meetings. So we are creatingnew chapters. Louisiana has formed a chapter with TanyaRomanowski as the new president. Congratulations! We plan tostay connected and help our sister chapter have a great start. Weare looking forward to creating a chapter in South Alabamaalso. The kick-off meeting was in Mobile at Zea’s Restaurant onApril 19. If you live in Alabama, consider joining the chapterand invite your colleagues too.

Lisa Byrd, PhD FNP-BC, GNP-BC President

[email protected]

Georgia GAPNAGeorgia GAPNA held its third annual CE conference

“Caring for an Aging Population: An InterdisciplinaryPerspective” at the Nell Hodgson Woodruff School of Nursing,Emory University. For the first time, our chapter partnered withthe Atlanta Regional Geriatric Education Center and the resultwas tremendous! This year’s conference attendees (over 120 ofthem!) included nurses, advanced practice nurses, physicianassistants, physicians, and social workers. The keynote speaker,Joseph Ouslander, MD, presented the Interact2 qualityimprovement program which seeks to improve care transitionsfrom nursing home to hospital – or prevent them from occur-ring at all. Other topics such as “Innovations in CareTransitions,” “Late Life Depression,” “Older Driver,”“Congestive Heart Failure,” “Community Services,” “PalliativeMedicine,” and a “Geriatric Literature Update” were well-received.

Our chapter also held its first quarterly business meeting onMarch 15 at Davio’s. The dinner presentation was on the topicof seizure management.

There are three major upcoming events for the GeorgiaChapter of GAPNA: • We will vote on bylaws changes during April. All members

in good standing are eligible to vote. The link will be avail-able on www.georgiagapna.com

• We will hold online elections in late April-early May. Allmembers in good standing are eligible to vote. The link willbe available on www.georgiagapna.com

• Next quarterly business meeting will be held May 8.Location and other details to be announced on the chapterweb site.

Carolyn K. ClevengerPresident

[email protected]

Delaware Valley The Delaware Valley Chapter collaborated with the

Delaware Nurses Association to provide an 8-hour conferencewith a track focusing on geriatrics. Six of our chapter memberslectured at the conference. Topics included pharmacologyupdate, wound care, delirium, dementia and depression,incontinence, avoiding hospitalization from the nursing home,and palliative care. Over 150 participants from the tri-state area(PA, NJ, DE) attended the conference. Continuing nursing edu-cation and pharmacology credits were awarded. We receivedpositive feedback from the participants regarding the sessions.We were very excited to provide this geriatric update to somany nurses.

We also had our first CE event at Neumann University thisyear on “CHF Management in the Elderly.” This event was wellattended and students from Neumann, Immaculata, and WestChester Universities attended.

Stacey EadiePresident

[email protected]

OhioThe Ohio Chapter of the

Gerontological Advanced PracticeNurses Association is very proud toannounce that our immediate pastpresident, Sandra Jorgensen, waschosen by the American Academy ofNurse Practitioners for the StateAward for Excellence. Sandra was agraduate of the very first MSN GNPclass at the Bolton School of Nursingat Case Western Reserve Universityin 1994. Since graduation, Sandrawas instrumental in achieving titlerecognition for nurse practitioners inOhio. As a certified GNP, she has provided excellent primarycare to older adults in ambulatory, assisted living, skilled, andlong-term care settings. She is a certified wound specialist andprovides management and consultative services for the care ofchronic and acute wounds. She has worked closely with med-ical directors and directors of nursing to enhance the quality ofcare provided in an inner city long-term care institution servingthe needs of minority older adults.

Sandra has been a clinical instructor at the Bolton Schoolfor the past 16 years. In 2006 she was chosen by the studentbody to receive the Award for Excellence in Precepting DNPStudents. For the past 4 years she was the preceptor coordina-tor, an extremely valuable role to faculty in all nurse practition-er programs. As coordinator she cultivated new preceptors,evaluated student performance, and chose sites best suited toensure safe, engaging, and active learning experiences for stu-dents. Sandra’s work has also been acknowledged by the NorthEast Ohio Nurse Practitioner Organization. She served as pres-ident of that organization from 2000-2001. She is an expert inbilling and coding and is a sought-after presenter in that area.

Whether she is providing care to older adults, helping toprepare the next generation of NP care providers, or leading hercolleagues, Sandra performs her job with excellence. She hasmade a difference in Ohio and we are thrilled that she is receiv-ing this honor from AANP.

Evelyn [email protected]

Sandra Jorgensen

CelebrateNational Nurses Week

“Nurses: Advocating, Leading, Caring”

May 6-12, 2012


Health Affairs: The Importance ofSpeaking with a Collective Voice

I was the first recipient of the Health Affairs Scholarship in2010. My attendance at the American Academy of NursePractitioners Summit and Leadership Conference and PublicPolicy Institute was eye opening and stimulating. I found myselfamong APNs who were the “movers and shakers” who hadfought and paved the way for me to be able to practice as anAPN. During the Summit, the Affordable Care Act had not yetpassed and Congress and their staffers were exhausted from latenights burning the midnight oil to move the bill forward. Oneday we were able to listen to live coverage of PresidentObama’s Health Care Summit convening at Blair House whilewe ate our lunch in the Canon Building.

I was coached, given strategies and talking points for myupcoming visits to meet with the Health Legislative Assistantson Capitol Hill. By the end of the Summit, I had made three vis-its to congressional staffers. My first two visits were in the com-pany of several other attendees from California who were alsoat the Summit. Having the support of a group boosted my con-fidence so that I could make my third and final visit of the dayalone. I also had lots of GAPNA support from Anna Treinkman,Charlotte Kelley, and Pat Kappas-Larson. After a long day of lis-tening to speakers, we had a chance to relax and get to knowone another at dinner. I had never been on Capitol Hill previ-ously and the experience was invaluable. As I continue my par-ticipation on the Health Affairs Committee, that initial experi-ence at the ACNP Summit has helped me to understand theimportance of APNs speaking with a collective voice in order tochampion change and ensure quality health care for our elders.

Patricia L. [email protected]

House Calls: Time for APN HomeHealth Orders

The time has come for Congress to pass legislation thatallows advanced practice nurses to order and sign home healthorders. Passing House Bill HR 2267, introduced by Bill Walden(R-OR) and Alyson Schwartz (D-PA), would save Medicaremoney, allow NPs to practice at their full potential, and providecontinuity of care to all home care patients. The currentMedicare law only allows physicians to sign home healthorders, making it difficult to maintain open communicationbetween the NP, who is providing care for the patient, and thehome health agency. This disrupts the NP/patient relationshipby circumventing the orders to a physician, who may have notseen the patient.

High on everyone’s agenda is better patient outcomes andreduction of Medicare spending. Electronic medical records,web-based sharing of health care information, and health caremodels, such as transitional care and medical care homes, arejust a few of the different pilot studies that are being explored toimprove the current health care system. But another way toimprove outcomes and save money may also be in the passingof this major legislation on home health services.

Major reports have been commissioned by the federal gov-ernment to determine ways to save Medicare money. By allow-ing NPs to also sign home health orders (HR Bill 2267)Medicare may appreciate a savings in the range of $91.9 mil-lion dollars over 5 years and $309.5 million over 10 years,according to the Institute of Medicine.

This is a call to action by all NPs who provide care to homehealth patients. Contact your local representative, and voiceyour support for HR 2267. Every NP and every professionalorganization needs to make their voices heard. The currentpractice is inadequate for patients and providers. NPs havefought long and hard to gain our place in the health care field.But the battle is not over. Joining together, we will also claimour place in the home health arena.

Peggy [email protected]

Historical Committee: Preserving GAPNA’s History

The GAPNA Historical Committee continues to work onpreserving the 30-year history of the organization and therole of the GNP. A series on the historical evolution is beingpublished in Geriatric Nursing in the coming months. Thecommittee continues to pursue permanent archival of theGNP historical material. We are communicating with othernursing organizations to determine if there are other attemptsto preserve the history of gerontological nursing. The pio-neers in the field are retiring and the information is at risk tobe lost. The committee welcomes any historical gerontologi-cal nursing material or contacts.

Colleen [email protected]

New Web Site: NIH Clinical Research Trials and YouThe National Institutes of

Health has created a new website, “NIH Clinical Research Trialsand You,” to help people learnmore about clinical trials, whythey matter, and how to partici-pate. From the first cure of a solidtumor with chemotherapy to theuse of nitroglycerin in response toheart attacks, clinical research tri-als have played a vital role inimproving health and quality oflife for people around the globe.

Clinical trials are essential foridentifying and understandingways to prevent, diagnose, andtreat disease. Research has shownthat among the greatest chal-lenges to recruitment of volun-teers is the lack of general knowl-edge about what trials involve, where they are carried out, and who may participate.Visitors to the web site will find information about:

• The basics of clinical trial participation.• Firsthand experiences from actual clinical trial volunteers.• Explanations from researchers.• Links on how to search for a trial or enroll in a research matching program.

In addition, health care professionals can read about evidence-based strategiesfor talking with patients about trials, print audience-tested posters to help promotetrials in clinics and offices, and find other educational materials. Learn more atwww.nih.gov/health/clinicaltrials


Iwould like to start off bythanking the members of

the Health Affairs Com mitteefor awarding me the 2012GAPNA ACNP Sum mitScholarship. I am honoredthe committee felt I wasdeserving of this award.Upon hearing I was thescholarship recipient, Iimmediately began writing alist of questions/concerns totake to Washington, DC. Ithen contacted my Ohio senators, Sen.Sherrod Brown and Sen. Robert Portman.I could not believe it was really that easyto set up a meeting. I have been fairlyactive on the state level; however, I hadmany questions regarding policy on thefederal level. I collected my colleagues’questions/concerns and felt prepared toattend the Summit.

I cannot believe how much I learnedfrom this Summit! Key topics coveredwere “Emerging Models of Care: Lessonsfrom CMS Innovation Center,” “TheCurrent Health Policy Agenda,” “TheConsensus Model,” “State AffiliateViews,” “View from the Hill” by ACNPlobbyist Dave Mason, “Funding forNurse Education (Title VIII),” “MedicaidAPN Access,” and “Home HealthCare/DME Prescriptive Authority.” I par-ticularly enjoyed hearing from DaveMason in regards to general attitudesabout advance practice nurses on “theHill.” Dave helped to calm my fearsabout visiting with senators. I had neverreally thought the senators/representa-tives “work for me.” Another resoundingtheme of this conference was, “if you arenot at the table, you are on the menu.”This sentiment struck a chord as Ithought about nursing, and particularlyAPN’s history. The speakers highlightedthe importance of grassroots organiza-tion and how one person really canmake a difference.

In preparation for my meeting withthe senators, I had done some back-ground work on each one’s stance onhealth care. Nevertheless, I was still verynervous about talking with the staff. I didnot have meetings until noon, so I wasable to get my feet wet tagging along withanother attendee to visit her representa-tives from Florida. Fully prepared, I thenwent to Sen. Portman’s office. I was pleas-antly surprised how well versed the staffwere about advance practice nurses. Iwas armed with folders regarding the

Medicare bill regardinghome health care and dis-cussed its contents with thestaff. I provided personalinstances of patients who didnot receive care appropriate-ly due to the inability of theAPN to prescribe DME/homehealth care. I also discussedfunding for nurse education(Title VIII) and the impor-tance of maintaining currentlevels of funding. I shared

my own experience with student loansand the burden of fiscal responsibility.Overall the meeting went very well, end-ing with the promise to speak with Sen.Portman about possible co-sponsorshipof the Medicare Bill. My visit with Sen.Sherrod Brown was shaky from the start.As I was entering the office, representa-tives from the American MedicalAssociation were coming out. I know theAMA is not against APN’s per se; howev-er, they have been fairly vocal on statelevels limiting APN practice. The stafferwas similarly well versed about APN

roles, but less interested in the Medicarebill or nurse education funding. Thisoffice was not as receptive as Sen.Portman’s and I did not receive as muchpositive feedback as I thought I would. Ifollowed up with Dave Mason after mymeetings and he stated he would circleback to Sen. Portman’s office and requesta meeting with Sen. Brown.

My first attendance at the ACNPSummit was a success. I have alreadydisseminated information I learned at theSummit to my colleagues at workthrough their health affairs committee. Icame away from the Summit with arenewed sense of responsibility to partic-ipate in health care policy. I think it isimportant to improve health care andincrease knowledge about how APNsnot only give excellent care, but alsopromote health wellness. I remain com-mitted to improve access to care on thestate and federal levels and look forwardto everything that comes next.

Meghan Routt, MSN, GNP-BC, [email protected]

ACNP Summit 2012: Policy in Action

Meghan M. Routt


Wound management is a complex process involving identify-ing and addressing etiology, providing systemic support for

healing, and applying appropriate topical therapy. This process isespecially perplexing in the older adult with multiple co-morbidi-ties and the effects of normal aging. Advanced age, however, isnot a contraindication to optimal wound management (Reddy,2008). The first task in wound management in the older adultpopulation is determining the goal of treatment. Not all woundswill heal although many will with appropriate management.Wound healing depends on underlying medical conditions,functional and cognitive status, life expectancy, and ability toadhere to the plan of care (Reddy, 2008). Healing may not be inalignment with the patient’s goals of care or even enhance qual-ity of life. If the goal is not wound healing, the focus should be onquality of life, pain management, prevention of infection, andminimizing dressing change frequency and odor (Reddy, 2008).

EtiologyThe first priority in wound management is identifying and

addressing etiology. Before a treatment plan can be initiated, theunderlying cause of the wound must be determined (Bryant,2012). If the cause of the wound is unrelieved pressure, pressurerelief must be provided to enhance healing. Pressure redistribu-tion can be provided by multiple products on the market: beds,mattresses, seat cushions, boots, shoes, etc. Lower-extremityulcers are usually the result of venous hypertension or arterialinsufficiency (Bryant, 2012). Although these ulcers usually devel-op as a result of minor trauma, they will not heal until the venousinsufficiency is managed with compression wraps or arterial per-fusion is improved.

Incontinence associated dermatitis (IAD), presenting as ery-thema and/or erosion of the skin from urine or stool, cannot beresolved until the skin is protected from further exposure to irri-tants. Regular application of a skin protectant is recommended(Gray et al., 2012). In the presence of yeast or fungal infection inassociation with IAD, an antifungal is required along with the skinprotectant. Topical antifungals alone will not protect the skin fromfurther moisture damage unless they are combined with a protec-tive ointment.

Systemic SupportThe second priority of wound management is providing sys-

temic support for healing. Blood flow, adequate nutrition, and acompetent immune system are essential for wound repair. Ifeither is deficient, a wound will not heal (Kane, 2007). Woundhealing is a cascade of physiologic responses activatedby adequate blood flow providing platelets, whiteblood cells, growth factors, oxygen, and nutri-ents to the wound bed. In the presence ofinadequate blood supply, a wound cannotheal. Revasculari zation is the optimal meansof restoring blood flow but older patients maynot be candidates for surgery. Electrical stimu-lation is an evidence-based physical therapymodality that can increase microcircula-tion and enhance wound healing (Unger,2007).

Nutrition is fundamental to tissuerepair. Carbohydrates, proteins, fat,minerals, vitamins, and fluids arerequired for repair and regenera-

tion. Adequate nutrition is especially important for a person witha wound because as much as 100 g of protein can be lost per daythrough wound exudate (Stotts, 2012). When adequate nutritioncannot be achieved orally, enteral or parenteral nutrition can beused if consistent with the patient’s goals (Dorner, Posthauer,Thomas, and the National Pressure Ulcer Advisory Panel, 2009).There are numerous types of nutritional supplements on the mar-ket today to supply nutrients necessary for wound healing.

Topical TherapiesOnce the wound etiology has been addressed and systemic

support for wound healing is provided, appropriate topical ther-apy can enhance wound healing. The ideal dressing (a) keeps thewound bed moist while keeping the periwound tissue dry, (b)removes exudate but does not desiccate the wound, and (c) pro-vides a barrier against bacteria and particulate matter whileallowing for gaseous exchange. Properly selected dressingsenhance the body’s ability to heal. Creation of the optimal woundenvironment is a benefit of appropriate dressing selection.Appropriate dressings increase healing rates, reduce pain,decrease infection rates, and are cost effective. There is no oneperfect dressing. Parameters that influence topical dressing selec-tion include etiology, location, tissue loss, size, condition ofwound bed, condition of wound edges, volume of exudate, con-dition of periwound, bacterial burden, odor, pain, wound histo-ry, dressing interactions, and patient and caregiver needs(Broussard, 2007; Bryant & Nix, 2007).

Antimicrobial dressings, such as, cadexomer iodine, honey,Hydrofera Blue®, antiseptics, mupirocin, and silver decrease thebacterial bioburden of infected and highly colonized wounds.

Absorptive dressings, such as calcium alginate, hydrofiber,hydrocolloid, and foam absorb drainage without desiccating thewound bed. Hydrofiber and foam dressings absorb drainage andprotect the periwound from maceration.

Hydrogel contributes moisture to the wound bed, as well as,autolytic debridement of necrotic tissue. Hydrogel comes in anamorphous form, sheets, and impregnated gauze.

Deep wounds require packing to fill dead space. HydroferaBlue, calcium alginate, and hydrofiber can be used for packingdeep wet wounds. Cadexomer iodine and honey can be appliedto gauze and packed into deep wounds. Most all categories of

wound products now come impregnated with silverfor an antimicrobial option. Hydrogel may beapplied directly to dry shallow wounds orapplied to gauze for packing dry deepwounds. Hydrocolloids and foam dressings

can be used on wet, shallow wounds or ascover dressings for packed deep, highly

draining wounds.If the goal of care is wound healing

and a wound is not decreasing in size,etiology has been corrected, and sys-temic support provided, advancedwound care modalities may be ini-tiated. Advanced wound caremodalities consist of collagendressings, growth factors, hyper-

baric oxygen, negative pressurewound therapy, and biosyntheticskin substitutes.

Wound Management in Older Adults


Palliative Wound CareIf the etiology cannot be corrected or systemic support can-

not be provided, palliative wound care should be the goal ofcare. Palliative wound care provides comfort and quality of life.This is accomplished through management of odor, drainage,bleeding, pain, and infection. Pain can be reduced with nonad-hesive dressings and infrequent dressing changes. Highlyabsorbent dressings such as hydrofiber and Hydrofera Blueused with foam cover dressings can extend dressing wear timefor several days without negative effects on the wound. Calciumalginate may control bleeding in friable or bleeding wounds.Wound odor is usually caused by bacterial burden, necrotic tis-sue, or saturated dressings. If appropriate, debride necrotic tis-sue with an enzymatic debrider, hydrogel, or sharp debride-ment. Topical antimicrobials, such as silver, iodine, honey, orDakin’s solution will decrease the bacterial load and reduceodor. Target care to the area of most concern to the patient andfamily. Dressing change frequency is not usually as much of aconcern as odor and drainage (Goldberg & Bryant, 2012).

Team ApproachWound management is a complex and multifactorial process.

As with geriatric care, it is best accomplished by a multidiscipli-nary team. Do not hesitate to utilize an interprofessional team forwound management, such as certified wound specialist, dietitian,physical therapist, and pharmacist. Together we can provide bet-ter outcomes and quality of life for our patients with wounds.

Charlene [email protected]

ReferencesBroussard, C.L. (2007). Dressing decisions. In D.L. Krasner, G.T.

Rodeheaver, & R.G. Sibbald (Eds.), Chronic wound care: A clinicalsource book for healthcare professionals (4th ed.) (pp. 249-262).Malvern, PA: HMP Communications.

Bryant, R.A. (2012). Types of skin damage and differential diagnosis. InR.A. Bryant & D.P. Nix, Acute & chronic wounds: current manage-ment concepts (4th ed.). St. Louis, MO: Mosby.

Bryant, R.A., & Nix, D.P. (Eds.). (2007). Acute & chronic wounds: Currentmanagement concepts (3rd ed.) (pp. 391-426). Mosby: St. Louis, MO.

Dorner, B., Posthauer, M.E., Thomas, D., and the National Pressure UlcerAdvisory Panel. (2009). The role of nutrition in pressure ulcer preven-tion and treatment: National Pressure Ulcer Advisory Panel whitepaper. Advances in Skin & Wound Care, 22(5), 212-221.

Goldberg, M.T., & Bryant, R.A. (2012). Managing wounds in palliativecare. In R.A. Bryant & D.P. Nix (Eds.), Acute & chronic wounds:Current management concepts (4th ed.). St. Louis, MO: Mosby.

Gray, M., Beeckman, D., Bliss, D.Z., Fader, M., Logan, S., Junkin, J., …Kurz, P. (2012). Incontinence-associated dermatitis: A comprehensivereview and update. Journal of Wound, Ostomy & ContinenceNursing, 39(1), 61-74.

Kane, D.P. (2007). Chronic wound healing and chronic wound manage-ment. In D.L. Krasner, G.T. Rodeheaver, & G. Sibbald (Eds.), Chronicwound care: A clinical source book for healthcare professionals (4thed.). Malvern, PA: HMP Communications.

Reddy, M. (2008). Skin and wound care: Important considerations in theolder adult. Advances in Skin & Wound Care, 21(9), 424-436.

Stotts, N.A. (2012). Nutritional assessment and support. In R.A. Bryant &D.P. Nix (Eds.), Acute & chronic wounds: Current management con-cepts (4th ed.). St. Louis, MO: Mosby.

Unger, P.G. (2007). The physical therapist’s role in wound management. InD.L. Krasner, G.T. Rodeheaver, & G. Sibbald (Eds.), Chronic woundcare: A clinical source book for healthcare professionals (4th ed.).Malvern, PA: HMP Communications.

On Nursing Excellence (ONE) is producing a film that explores the complex, exciting, and challenging world of being a nursein today’s society. The film will show what it means to be a nurse, the many different roles that nurses play, from the front line tothe board room, and the realities of nursing, its joys and sorrows and the many ways that nurses impact the lives of others.

What It Means to Be a Nurse: New Film Needs Your Support

Needs Addressed by ProjectTremendous change is expected in health

care. By deepening the understanding of nurs-ing, we strive for a future where policymakersand health care leaders make well-informeddecisions, where the public better under-stands the role and value of nurses (beyondTV and news perceptions), where nurses areinspired toward excellence and diversity ofroles, and where others are inspired to join theprofession.

Project HonoringThis film is in honor of Joyce C. Clifford,

PhD, RN, FAAN, for her countless contribu-tions to the profession of nursing; dedicatedalso to DAISY Award Recipients, nurses recog-nized by patients and their peers for goingabove and beyond the call of duty; and tonurses everywhere, recognized or not, whogive so much of themselves to the art and sci-ence of nursing.

Target AudienceThis film is for nurses, health care leaders,

policymakers, payers, patients, their families,and the public at large. This film will be avail-able to professional nursing organizations,hospitals, schools of nursing, news media,and a broad range of audiences for individualand group viewing.

Who We AreOn Nursing Excellence, Inc. (ONE), is a

501(c)3 non-profit organization committed toa strong, healthy, empowered, engaged, andeffective nursing workforce. This organizationis run by nurse leaders who volunteer theirtime to promote the work of nursing. Anyfunds raised beyond covering the cost of thisfilm will go toward similar projects that sup-port ONE’s overall mission and commitmentto promoting and supporting nursing.

Project Oversight CommitteeBonnie Barnes, DAISY Foundation; Carol

Ann Cavouras, MS, RN, CNAA; KathyDouglas, MHA, RN; Karlene Kerfoot, PhD,RN, NEA-BC, FAAN; Karen K. Kirby, MSN,RN, NEA-BC, FACHE; and Ann Van Slyck,MSN, RN, CNAA, FAAN

Your Generous SupportProjects like this cannot happen without

the generous support of individuals andorganizations committed to nurses and nurs-ing. The goal is $80,000 to cover the cost of

this production. The film release is expected inOctober 2012. Please act now. Help furtherthe understanding of nurses through one ofthe following sponsorship levels.

“We are in a time when understandingwho nurses are and what we do is essential toshaping our future. This film explores thepower, the beauty and the expansive roles ofthe Registered Nurse in today’s world.”

Kathy Douglas, MHA, RNFilm Director

Track Film’s Progress www.facebook.com/onnursingexcellence

You Can Help Bring Nursing to theBig Screen

Join the many volunteers and donors whoare making this film possible. Make a taxdeductible donation from yourself or in thename of your favorite nurse or organization.Every dollar helps.

www.OnNursingExcellence.com

Tax Deductible DonationYour generous donations to this effort are tax deductible. Please make checks payable to On

Nursing Excellence. Send to One Bala Avenue, Suite 234, Bala Cynwyd, PA 19004.For more information, contact Kathy Douglas (415-747-2164, [email protected])

or Karen Kirby (610-667-1800 ext. 306, [email protected]).


Depression, HearingImpairment, and HealthLiteracy Influence OlderAdults’ Abilities to Self-Manage their Care

The degree to which elderly patientswith high blood pressure can effectivelyassist in their own care (activation) isinfluenced by a set of measurable fac-tors, according to a new study.Reseachers found elderly persons withhypertension were more likely to beactivated to self-manage their conditionsif they had higher self-ratings of theirown health, higher degrees of health lit-eracy, greater receipt of patient-centeredcare, shorter lengths of stay in long-termcare, and lower levels of depression andhearing impairment.

The researchers suggest that, toimprove patient self-management, clini-cians should seek to expand their reper-toire (and intensity) of patient communi-cations and education methods to meetthe individual’s limitations.

More details are in Gerder, L.M. etal. (2011). Activation among chronicallyill older patients with complex medicalneeds. Challenges to support effectiveself-management. Journal of AmbulatoryCare Management, 34(3), 292-303.

Study Finds PotentiallySuboptimal Use ofAntidepressants for Residentsin Veterans Affairs NursingHomes

Older residents in Veterans AffairsCommunity Living Centers, the equiva-lent of nursing homes, often fail to getoptimal treatment with antidepressant

drugs, concludes a new study. Re -searchers found 25% of the 877 resi-dents with depression did not receiveantidepressant drugs. In addition, 58%of the 654 residents with depression andreceiving antidepressant medicationhad evidence of possible inappropriateuse (most commonly, potential drug-drug or drug-disease interactions).Among the 2,815 residents withoutdiagnosed depression, 42% received atleast one antidepressant drug. De -pressed Black residents were about halfas likely as depressed Whites to experi-ence potential inappropriate use, whiledepressed residents with cancer wereless likely to experience either possibleunderuse or inappropriate use.

For more info, see Hanlon, J.T.(2011). Potential underuse, overuse, andinappropriate use of antidepressants inolder veteran nursing home residents.Journal of the American GeriatricSociety, 59(8), 1412-1420.

Depending on a Woman’sAge, Hysterectomy May Bethe Best Option for ResolvingChronic Pelvic Pain andHeavy Bleeding

Women who suffer from heavy orfrequent uterine bleeding or pelvic painbut do not want hysterectomies do haveother treatment options. Commonuterus-preserving treatments (UPTs)include myomectomy (a surgery toremove uterine fibroids), endometrialablation (a procedure to destroy theuterine lining), and uterine fibroid

embolization (a procedure that stopsblood flow to uterine fibroids). A newstudy finds these options usually providerelief for women who are 40 and older,but not for women younger than that.

For details, see Learman, L.A. (2011).Success of uterus-preserving treatmentsfor abnormal uterine bleeding, chronicpelvic pain, and symptomatic fibroids:Age and bridges to menopause.American Journal of Obstetrics &Gynecology 204(3), 272e1-272e7.

Older Patients with ChronicConditions Have Greater Riskof Problems and Deathfollowing Bilateral KneeReplacement

Patients needing knee replacementsurgery may decide to have both kneesdone at the same time. While certainly acost-saving measure, this surgery mayalso result in increased risk of problemsand death for the patient. Under -standing which patients may be at riskcan help clinicians risk-stratify patientsto determine who will have the best out-comes. A new study has identifiedpatient-related risk factors that increasemorbidity and mortality in thesepatients. Often, those most at risk areolder patients with certain chronichealth conditions.

The researchers analyzed data from1998 to 2007 as part of the NationwideInpatient Survey to identify cases ofbilateral knee replacement surgery.During the time period studied, an esti-mated 206,573 bilateral total kneereplacements were performed. About9.5% of patients developed major com-plications or died while in the hospital.Patients most likely to suffer complica-tions or death were older, male, andWhite. Patients younger than 45 years ofage were half as likely to have a majorcomplication or die than patientsbetween 45 and 64 years of age andone-third as likely to have problems ordie than patients aged 65 to 74.

For more info, see Memtsoudis,S.G. (2011). Bilateral total knee arthro-plasty: Risk factors for major morbidityand mortality. Anesthesia and Analgesia,113, 784-790.

Clinical ResearchCorner

Published an Article Recently?We are looking for GAPNA members who have recently published clinical or research arti-

cles. Let us know the title, publication, volume, and issue number of your article, along with abrief abstract/summary, and we’ll share it with your fellow members in the GAPNA Newsletter.Keep us updated at [email protected]

President’s Messagecontinued from page 1

As a professional organization, GAPNA is dedicated to a future where the compe-tent care of older adults, as delivered by APRNs, will be universally valued and sought.To that end, we must invest in our students and new APRNs who will become our futureleaders in gerontological advanced practice nursing. GAPNA is in the process of simpli-fying and streamlining the application for student membership, reaching out to master’sand DNP students and programs throughout the country about our educational oppor-tunities, and welcoming new members at our Annual Conference by connecting themwith veteran members, committees, and special interest groups.

Our Conference Planning Commit tee, chaired by Pam Cacchione and Dawn MarieBaylis, has planned a fantastic conference for 2012 with more clinical content offerings,and speakers who are national experts in the field of geriatrics. I look forward to seeingall of you in Las Vegas, September 19-22. Please don’t forget to invite a colleague or stu-dent to experience how much there is to learn and love about gerontological advancedpractice nursing.


NewsletterThe Official Newsletter of the Gerontological Advanced Practice Nurses Association — Founded in 1981

PRESIDENTElizabeth Galik, PhD, CRNPUniversity of MarylandSchool of NursingBaltimore, [email protected]

PRESIDENT ELECTMarianne Shaughnessy, PhD, CRNPUniversity of Maryland, BaltimoreSchool of NursingBaltimore, [email protected]

IMMEDIATE PAST PRESIDENTEvelyn Duffy, DNP, GNP/ANP-BC, FAANPCWRU-FPB/School of NursingCleveland, [email protected]

SECRETARYBarbara (Nikki) Davis, MSN, FNP-C, GNP-BCOptum Health, Evercare-ISNPBraselton, [email protected]@gmail.com

TREASURERKathyrne Barnoski, MN, FNP, GNP, BCEvercare PhoenixPhoenix, [email protected]

DIRECTOR-AT-LARGEAlice Early, MSN, ANP-BCBeaumont HospitalDivision of GeriatricsRoyal Oak, [email protected]

DIRECTOR-AT-LARGEPatty Kang, MSN, RN, GNPPermanente Medical Group/Kaiser South SacramentoFairfield, [email protected]

NATIONAL OFFICEMichael Brennan, CMPExecutive [email protected]

Sherry DzurkoAssociation Services [email protected]

East Holly Avenue/Box 56Pitman, NJ 08071Phone: 856-355-1392Fax: [email protected]

Summer 2012 • Volume 31, Number 2

Volunteers NeededInterested in serving on a GAPNA Committee?Learn more by contacting the GAPNA NationalOffice at [email protected] or call 866-355-1392and request a Call for Volunteers form.

2011-2012 Committee ChairsApprover UnitLiz Macera PhD, RN, [email protected] Mandler, [email protected]

AwardsSusan Mullaney, MS, APN, [email protected]

Conference PlanningPamela Cacchione PhD, RN, [email protected]

Dawn Marie Baylis, [email protected]

EducationLaurie Kennedy-Malone, PhD, [email protected]

Barbara Harrison, PhD, [email protected]

Health AffairsAnna Treinkman, MSN, RN, [email protected]

Pat Kappas-Larson, MPH, APN-C, [email protected]

HistoricalKathleen Fletcher, MSN, RN, CS, GNP, [email protected] Keltz, RN, [email protected]

Member ServicesJennifer Serafin, [email protected]

Jo Ann Fisher, MSN, [email protected]

NominatingKatherine Abraham Evans, MSN, RN, [email protected]

Candance Harrington, DNP, A/[email protected]

PracticeJulie A. Roznowski-Olson, RN, GNP, [email protected]

Meghan Routt, MSN, ANP/GNP-BC, [email protected]

ResearchValerie Sabol, ACNP-BC, [email protected]

Margaret Hammersla, MS, [email protected]

Journal Section EditorsLisa Byrd, PhD, RN, [email protected]

Deb Bakerjian, PhD, MSN, RN, [email protected]

Newsletter EditorsDebra [email protected]

Candace Harrington, DNP, A/[email protected]

Web Site EditorsGeorge Smith, MSN, APRN, [email protected]

Carolyn Clevenger, DNP, [email protected]

SPECIAL INTEREST GROUPSAssisted LivingKathy Carroll, MSN, RN, [email protected] [email protected]

Hospice/Palliative CareCarla Tozer, MSN, ANP-BC, GNP-BC, [email protected] Mullaney, MS, APN, [email protected]

House CallsDeb Wolff-Baker, MSN, FNP-BC, [email protected] Brewer, [email protected]

LeadershipPat Kappas-Larson, MPH, APN-C, [email protected]

LTC/Nursing HomeSuzanne Ranselhousen, [email protected] [email protected]

Transitional CareTherese Narzikul, [email protected] Wollman, [email protected]

Please send mail and email address changes to [email protected] Newsletter Deadline: July 5, 2012

Send articles to: [email protected]

Special Thanks to

for their continued support as a Plantinum Corporate Member

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