Concurrent Sessions

Concurrent Session (201)
Family Centered Care in Rehab: Addressing issues and concerns to improve care transitions
Barbara Lutz, PhD RN CRRN

Learning objectives:

  1. Describe salient trends and principles of family-centered care
  2. Discuss issues and concerns that are important to family members
  3. Identify opportunities to improve patient and family outcomes of care during rehab and as patients transition home

Patients receiving rehabilitation care have often experienced a sudden, life-changing disabling illness or injury that has long-term implications for the patient/family unit. The illness event may elicit a crisis response and feelings of grief and loss for both patients and family members. With improved survival rates and shorter inpatient stays for patients experiencing these events, family members are now assuming caregiving tasks that previously were only performed by professional caregivers. Family members need assistance and support to help them deal with the event and assume their new roles and responsibilities. Educating and training family members in the skills they need to provide patient care after discharge is a primary role of rehabilitation nursing. In this presentation, we will discuss trends in family-centered care, describe concerns that are most important to family members as they prepare to assume the caregiving role, and identify opportunities to improve post-discharge outcomes.

Concurrent Session (202)
Spinal Cord Injury and Sexuality

LaTonya Lofton, MD

Learning objectives:

  1. Review the scope of the problem of sexuality after disability.
  2. Discuss physical exam findings used to assess sexual function in a person with SCI.
  3. Discuss treatment options for sexual dysfunction in a person with SCI.
  4. Discuss methods for discussing sexuality with persons with SCI.

Changes in sexual function after a spinal cord injury present a unique set of physical and emotional problems to patients with spinal cord injuries, and rehabilitation professionals are often asked by patients about sexual dysfunction after spinal cord injury. This course will educate rehabilitation nurses on the treatment options for sexual dysfunction and will review guidelines and suggestions for educating patients on this sensitive subject.

Concurrent Session (203)
The Power of One - The Power of All
Donald Kautz, PhD RN CNE CRRN

Learning objectives:

  1. Illustrate the power of each of us to impact patients through our research and evidence-based practice, our leadership and management, and as active members of the rehab team
  2. Apply the lessons from patient and family scenarios to show the power of the team as we assist our patients and families through the rehabilitation process to reintegration into the community

The focus of this inspiring session is to highlight the power of the team in ensuring the best rehab outcomes. Dr. Kautz will share enlightening patient-nurse-team scenarios from a chronic pain clinic, in-patient general rehab unit, and community settings to illustrate the power of one - and all - to produce positive outcomes through our research and evidence-based practice, best practices, our leadership and management, and as active members of the rehab team.

Concurrent Session (204)
Supporting the FIM™ Instrument through Documentation
Pauline Desjarlais, MSN RN CRRN NE-BC

Learning objectives:

  1. Describe the impact of correct documentation on reimbursement
  2. Identify opportunities to rate patient activities to validate the FIM™ instrument

The FIM™ instrument is an integral part of the Inpatient Rehabilitation Facility- Patient Assessment Instrument (IRF-PAI). FIM™ motor and cognitive ratings are used to determine case mix groups (CMGs) and reimbursement. In the hectic shifts of nurses working in acute inpatient rehabilitation units, opportunities to identify and assess patient functional activities are often overlooked. Nurses are not always aware that their assessments affect outcomes and reimbursement. This presentation will review the challenges of narrative and electronic documentation and provide examples of daily activities that can be assessed to validate the assigned FIM™ ratings.

Concurrent Session (301)
The Basics of Research as Best Evidence for Practice

Beverly Reigle, PhD RN

Learning objectives:

  1. Identify credible sources of evidence relevant to nursing practice
  2. Describe approaches the clinician can use to translate research into practice
  3. Explain the importance of using research as best evidence in achieving improved patient outcomes

Quality improvement (QI) and safety initiatives in healthcare are critical to improving patient outcomes. Practice based on research is integral to achieving QI aims and thus better patient outcomes. This session will address the importance of research as a basis for nursing practice and approaches the clinician can use to effectively translate research findings into practice. Using the ACE Star Model as a framework, an understanding of the generation of research, summarization of evidence, and translation of findings will be facilitated. Accessing credible sources such as rigorously conducted systematic reviews and the integration of research-based guidelines and protocols will be highlighted.

Concurrent Session (302)
Life Care Challenges: Medically Complex Injury

Terri Patterson, MSN RN FIALCP CRRN

Learning objectives:

  1. Discuss the challenges of living and aging with a disability and the impact on the individual and their support systems
  2. Identify the issues related to aging with a disability in the current health care system

The session will address the challenges of living and aging with a disability and the impact upon the individual, family, providers, funders and the community. The topics to be presented and discussed will encompass rehabilitation clinical issues, psychological adjustment, coordination of services, access to care across the continuum and financial considerations. Case discussion will address pediatric, adult and geriatric populations in relation to medically complex injuries and disabilities including burn injury, organ transplants, brain injury, gastrointestinal disorders, spinal cord injury, and orthopedic trauma.

Concurrent Session (303)
Caring For Individuals With Open Spina Bifida (Myelomeningocele) and Their Families: Experience and Outcomes

Christine Kinavey, PhD RN CNS

Learning objectives:

  1. Describe the biopsychosocial effects of living with open spina bifida (myelomeningocele)
  2. Describe executive function challenges associated with open spina bifida and their impact on independence
  3. Discuss the role of the advance practice nurse and the multi-specialty clinic in the provision of care to individuals with open spina bifida and their families

This presentation will describe the biopsychosocial impact of open spina bifida (myelomeningocele) throughout the lifespan and the role of the advance practice nurse in developing a program of care for these individuals and their families.

Concurrent Session (304)
Non-Pharmacologic Approach to Pain

Paul Nathenson, RN ND CRRN HNBC

Learning objectives:

  1. Describe the physiology of acute pain including the reflex response and the learned response
  2. Describe the gate theory of pain and the wind up theory of chronic pain by Melzack and Wall
  3. Describe how nutrition and supplements can be used to decrease or eliminate inflammation

The purpose of this presentation is to describe the physiology of the pain response and to discuss how acute pain can become a chronic condition. Two pain theories will be used as a framework for discussion, the gate theory and the wind up theory both by Melzack and Wall. The gate theory is used to explain how therapies like massage and electrical stimulation can be effective. The wind up theory is helpful in explaining how acute pain can transition into a chronic and pathologic condition. The role of an anti-inflammation diet is presented as a means to control pathological inflammation as well as supplements known for their anti-inflammatory properties. Complementary approaches including acupuncture, trigger point therapy, frequency therapy and various touch therapies are reviewed.

Updating the RNF Research Agenda: Methods, Actions and Results
Cheryl Lehman, PhD RN RN-BC CNS-BC CRRN

Learning Objectives:

  1. Review the purpose and practical application of a Delphi research study method.
  2. Compare the current RNF research agenda with the findings of the study.
  3. Critique study findings

The presentation will present an overview of the Delphi study conducted this year to update the RNF research agenda. Available findings will be shared, and input solicited from the attendees.

 

Concurrent Session (401)
Violence in the Workplace

Dianne Ditmer, PhD RN CFN DABFN SANE FACFE

Learning objectives:

  1. Define workplace violence inclusive of horizontal violence and disruptive behaviors according to the National Institute of Occupational Safety and Health and the American Nurses Association
  2. Evaluate current cases and studies, including a report published by The Joint Commission, attributing 24% of sentinel events to poor relationships between staff and disruptive work environments
  3. Develop strategies to increase staff competency in recognition and prevention of disruptive clinical environments with a goal of improved staff retention and clinical outcomes

Consequences of unhealthy work environments go far beyond recruitment and retention of staff. The Joint Commission and Institute of Medicine correlate the effects of violent, disruptive behaviors, including poor teamwork and hostile communication, with an increase in medical errors and poor clinical outcomes. The alarming number of disruptive acts compels us to increase worker and employer awareness of risk factors and to provide strategies for creating a healthy work environment by developing staff competency. Nurses, who are both victims and perpetrators, frequently do not recognize the full continuum and broad definition of workplace violence including horizontal violence. The purpose of this presentation is to identify the types, sources and frequency of violent, disruptive behaviors and offer evidence-based strategies for early recognition and prevention of violence in the healthcare setting.

Concurrent Session (402)
Staging - The Pressure is On: A Look into Documentation and Reporting of Pressure Ulcers

Laurie Crookenden, BS RN CWOCN CRRN

Learning Objectives:

  1. Learners will be able to discuss pressure ulcer stages that are reportable to CMS.
  2. Learners will be able to discuss ways to capture present on admission pressure ulcers.
  3. Learners will explore ways to document and report worsening/ hospital-acquired pressure ulcers.

This session will review the pressure ulcer staging system and the challenges in-patient rehabilitation facilities face as they navigate the waters between documentation of pressure ulcers and reimbursement. Explore the opportunities of admission assessment of skin and capturing “present on admission” pressure ulcers. Learn how to create an atmosphere of pressure ulcer prevention in light of an ever increasing case mix index. Encourage an environment of reporting and documenting worsening and hospital- acquired pressure ulcers for the benefit of learning and improving the prevention strategies employed at your facility. Discuss ways to empower staff to prevent, assess and treat pressure ulcers for the purpose of maximizing reimbursement at your facility.

Concurrent Session (403)
Transition Management for Success

Karen Preston, PHN MS CRRN FIALCP; Donna Williams, MSN RN CRRN

Learning objectives:

  1. Understand key reasons for readmissions and post-discharge problems
  2. Identify various care settings and services that may be used in transitioning patients
  3. Discuss how to prepare the next setting for receiving the patient and how to prepare the patient and family

With increasing emphasis on successfully transitioning patients between settings, case managers play a critical role. It is essential that case managers know the common reasons for transition failure and how to intervene to reduce readmissions and post-discharge problems. This session will explore problem areas in transitions, how to identify the variety of care settings available, and interventions for inpatient and external case managers to use. A case study will be used.

Concurrent Session (404)
Appreciative Inquiry: Changing the Conversation in Healthcare

Natalie May, PhD

Learning objectives:

  1. Understand the development, underlying principles, and 4-D cycle of Appreciative Inquiry (AI)
  2. Adapt the traditional AI process to meet the unique needs of the healthcare setting
  3. Identify the positive core of rehabilitation nursing using the "Discovery" process

Typically in healthcare, our approach is to identify what's wrong and then set out to fix it. We do this with patients, and we do this with our work environments. Appreciative Inquiry turns this approach on its head and asks, "What is working well here? Who are we when we're at our best? How can we get more of that?" The Appreciative Inquiry approach celebrates the best in caregivers, patients, and families. It is energizing, stimulates creativity, and can be done on an individual level or in large groups. Appreciative Inquiry embraces improvement opportunities with optimism. Participants will learn the underlying concepts of Appreciative Inquiry, explore how to adapt them to healthcare & rehabilitation nursing settings, hear examples of transformative change using this process, and engage in a collective discovery of the positive core of Rehabilitation Nursing. We will briefly explore the broader concept of Appreciative Practices in healthcare.

Current Session (501)
Building Successful Research Collaboratives for Healthcare Improvement
Frank Puga, PhD

Learning objectives:

  1. Define improvement science
  2. Describe the role of transdisciplinary teams in improvement science
  3. Discuss the role of the rehabilitation nurse in leading change through the application of improvement science at the bedside

Improvement science is a hybrid field that requires new approaches to conducting research. A relatively new model for clinicians is using transdisciplinary teams for improvement research. This presentation will discuss the adoption of best practices from Team Science in a healthcare improvement research network and the opportunity for rehabilitation nurses to participate in research collaboratives to improve care across settings.

Concurrent Session (502)
Pediatric Rehabilitation in the Intensive Care Unit
Tobias Tsia, MD

Learning objectives:

  1. Describe reasons to advocate for the involvement of rehabilitation services for patients in the intensive care unit
  2. Describe recent studies involving patients with critical care needs who received early access to rehabilitation

Traditionally, bedrest has been recommended for many patients in the intensive care unit. However, recent studies suggest that early rehabilitation, beginning in the critical-care setting, has the potential to improve functional outcomes, reduce complications, decrease length of stay, and reduce healthcare costs.

Concurrent Session (503)
Guilty or Innocent: What Does Your Documentation Show - Did You Safely Discharge Your Patient
Michele Cournan, DNP ANP-BC CRRN

Learning objectives:

  1. Explain why it is essential to document all teaching completed at the time of discharge
  2. Describe how nursing documentation is used in a court room setting

Nurses are caring and compassionate individuals who go to work each day to help others. Lawyers have begun to pursuing claims focusing on the nurse as a highly educated and skilled clinician, with the responsibility to use professional judgment in the course of treatment. At the time of discharge, nurses are responsible to make sure patients know how to safely manage their medications and care at home. The time of discharge may not be the best time to teach patients/families regarding medications or other processes. Failure to teach or to be able to prove that the patient/family received educational materials can lead to medication errors or other safety issues. Documentation is the first line of defense, remember what you were taught in nursing school, "if it wasn't charted, it wasn't done."

Concurrent Session (504)
Performance Measurement & Management
Christine MacDonnell

Learning objectives:

  1. Understand the basic components of performance measurement.
  2. Describe continuous performance improvement major components.
  3. Identify strategies for success in performance measurement and management.

Proving the value of rehabilitation practice is critical in a competitive market of health care dollars. Addressing what results we achieve and the efficiency of that result moves rehabilitation into a competitive advantage.