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News on NANN's Chapters and Educational Offerings and Updates on Proposed CMS Changes and American Nurses Association's 2010 Lobby Day

Section Editor(s): Grazel, Regina

doi: 10.1097/ANC.0b013e3181f08934
NANN Pages
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NANN's Chapters Provide Services

Chapters play an important role in NANN by providing services and support for members at the grassroots level. For the more than 2000 NANN members who belong to a local chapter, the chapters are a source of convenient and inexpensive continuing education and serve as a place for them to connect with other neonatal nurses.

In addition to the work done by chapter leaders, NANN's board of directors and members of the education provider committee continuously seek ways to benefit members through chapter services. A number of sessions at NANN's 2010 annual educational conference will be recorded and offered to NANN chapters for their use. These recordings will be available to chapter members at no charge and will provide opportunities for earning continuing nursing education (CNE) contact hours.

NANN currently has 36 local chapters, including 2 that were chartered in recent months. The Southern Wisconsin Association of Neonatal Nurses was formed in November 2009 with 11 enthusiastic members. The first NANN chapter in Wisconsin, the Southern Wisconsin Association of Neonatal Nurses attracts nurses from the Milwaukee and Madison areas. Led by President Angie Maniaci, the Southern Wisconsin Association of Neonatal Nurses began its journey with a list of ambitious goals. The chapter is off to a great start after holding its first educational meeting. The Central Florida Association of Neonatal Nurses, formed in April 2010, draws members from a 50-mile radius around Orlando. The chapter boasts of 26 founding members—an impressive beginning. It offers continuing education at its quarterly meetings and has even held 1 meeting using video conferencing. Under the leadership of President Carrie Barlow, Central Florida Association of Neonatal Nurses members are already active in the community and have raised money for Transition House, a local charity.

To find a chapter near you or to get information about starting a chapter, go to and click on Chapters under the Membership tab.

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New Educational Offerings Are Available

CNE offerings in NANN's online store. A new function is now available at NANN's Web site. An Online CNE tab has been created in the online store for Web-based learning activities. Just one click will get you to the Understanding Clinical Research learning module, and other offerings are being planned. Visit the online store at

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New Ways to Enhance Knowledge of Developmental Care

* Developmental Care of Newborns and Infants, Second Edition—A comprehensive guide to developmental care, with updated content and expanded chapters, this book is a valuable resource for every NICU and may be used in preparation for the test for the new Developmental Care Specialist designation.

* Developmental Care Specialist designation—The Developmental Care Specialist designation, a new professional development option for nurses and other neonatal care providers, recognizes advanced knowledge and incorporation of developmental care principles into caregiving. The specialist designation is granted upon successful completion of an online test demonstrating expertise in developmental care.

* A series of CNE modules on various developmental care topics will be available online by early September. The modules are independent from the Developmental Care textbook but draw on its content. Learners can pay a nominal fee and receive credit (up to 38 contact hours) for single chapters or for all the chapters at a reduced price. The modules provide an excellent preparation for the test for the Developmental Care Specialist designation.

Visit or call NANN's customer service department at 800-451-3795 for more information about these educational offerings.

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NANN Supports Centers for Medicare and Medicaid Services’ Proposed Changes on Respiratory Care Orders

A number of you participated in NANN's advocacy efforts to have the Centers for Medicare and Medicaid Services (CMS) reconsider its requirement that only physicians be allowed to direct respiratory care services. Although this rule allowed advanced practice registered nurses (APRNs) in all specialties to write respiratory care orders, it also mandated that a “responsible doctor of medicine or osteopathy” co-sign the order. For APRNs in the states that still require a physician “supervision or collaboration” relationship, the policy increased the complexity and eventual cost of providing care and placed patients at increased risk of experiencing delays in therapy and having poorer outcomes.

In April, CMS proposed changes to the rule concerning the Medicare conditions of participation for hospitals relating to the practitioners who may provide rehabilitation services and respiratory care services. CMS asserted that “the process of physician countersignature of orders written by qualified, licensed NPs [nurse practitioners] and PAs [physician assistants], specifically for common hospital services such as rehabilitation and respiratory care services, is burdensome to practitioners (physicians as well as NPs and PAs) and the hospitals that they serve.”

The update concludes, “We are proposing to revise the existing requirements at §482.57 to allow these practitioners, in addition to physicians as currently allowed, to order these services as long as such privileges are authorized by the medical staff and are in accordance with both hospital policies and procedures and CMS-1498-P 659, State laws.”

Please add your voice on this important issue by sending a letter to CMS before October 1 in support of the proposed changes.

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Nurses Advocate for Change: American Nurses Association's 2010 Lobby Day

NANN and NANNP member Karen Q. McDonald, MSN, NNP-BC, recently represented the state of Delaware at the 2010 Lobby Day of the American Nurses Association (ANA) and shares this update.

June 16, 2010, was chosen by the ANA House of Delegates for its 2010 Lobby Day on the theme “When Nurses Talk, Washington Listens.” Lobby Day, a free event open to ANA members and nonmembers alike, was held in conjunction with the ANA's annual House of Delegates conference, which featured opening remarks by President Barack Obama.

The day began with a Capitol Hill orientation and legislative update session at the Washington Hilton. Lobby Day participants were treated to breakfast, greeted by ANA's chief executive officer, Marla J. Weston, PhD, RN, and given their Capitol Hill assignments. Participants were then instructed on the how-tos of lobbying by Kelly Hall, health legislative assistant to Congresswoman Allyson Schwartz (D-PA).

The update session was followed by an overview of federal legislation, conducted by Michelle Artz and Rachel Conant, chief associate director and associate director, respectively, of the ANA Department of Government Affairs. This session focused on the 4 key pieces of legislation for which participants would be lobbying.

The Nurse and Health Care Worker Protection Act of 2009 (H.R. 2381(S.1788 and H. Res. 510). The ANA strongly supports this bill, which recognizes that manual lifting of patients is associated with high rates of injuries for health care workers and encourages strategies to curb this problem.

The Home Health Planning and Improvement Act (H.R. 4993/S. 2814). The ANA strongly supports this bill, which would allow advanced practice registered nurses, nurse practitioners, clinical nurse specialists, certified nurse midwives, and physician assistants to order home health services under Medicare in accordance with state law.

Safe Chemicals Act of 2010 (S. 3209). The ANA supports revisions to the Toxic Substances Control Act passed in 1976. Chemicals that are not required to be tested under the previous act are commonly used in the health care setting as cleaning products, floor strippers, pesticides, sterilizers, disinfectants, and chemotherapeutic agents. A study done by the ANA in collaboration with Physicians for Social Responsibility found that all 20 of the study subjects had at least 24 health care—associated toxic chemicals in their systems. Many of these chemicals are associated with chronic illness and physical disorders. The new bill would include

* requiring chemical companies to develop and make publicly available basic health and safety information for all chemicals;

* requiring chemicals to meet a safety standard that protects vulnerable subpopulations, including pregnant women and children;

* a new program that identifies communities that are “hot spots” for toxic chemicals and takes action to reduce exposures; and

* expedited safety determinations and actions to restrict some of the most dangerous chemicals, such as formaldehyde, lead, and flame retardants.

The Registered Nurse Safe Staffing Act (S. 3491(H.R. 5527). The ANA supports this act, which would require hospitals participating in Medicare to establish a committee with membership comprising at least 55% direct-care nurses or their representatives who would be responsible for publicly reporting unit-by-unit staffing plans. The plans would be required to

* include an adjustable minimum number of RNs;

* include input from direct-care RNs or their representatives;

* be based on patient numbers and the acuity of care needed;

* take into account the level of education, training, and experience of the RN staff;

* take into account the staffing levels and services provided by other health care personnel associated with the care;

* consider staffing levels recommended by specialty nursing organizations;

* account for unit- and facility-level staffing, quality and patient outcome data, and national comparisons when available;

* account for other factors affecting the delivery of care, including unit geography and technology; and

* ensure that RNs are not forced to work in units involving work in which they are not experienced or trained.

Upon conclusion of the morning sessions, participants met with representatives from their home states and districts. The lobbying experience, though exhausting, was exhilarating, and it was rewarding to learn more about legislation that directly affects the care and safety of patients.

© 2010 by The National Association of Neonatal Nurses