Full Update

Transcription

Full Update

Vol. 34/No. 2
Winter 2016
UPDATE
Message from the President
By Debra J. Diaz, CRNA, DNP
I would like to begin by
thanking everyone who
voted in the FANA election.
Member participation in
elections has sadly not been
brisk so to take time out
from your busy schedule is
indeed to be commended.
Our association is one of
the largest in the country
and one of my goals as
President is to increase
member participation. As
Officers of your association,
the FANA Board of
Directors wish to listen to
the ideas you may have to
help accomplish this goal.
This is your association
and it could not continue to
succeed without your input.
The Fall Annual Meeting
in Tampa was one of the
best-participated meetings
and, from a personal
perspective, it was the
best meeting for content
I have attended with the
lectures Mr. Kline gave
and the hands on cadaver
lab at CAMLS. From what
I was told, the lectures that
ran simultaneously with
the ultrasound lectures
were also well received
and the participants felt
they were excellent as well.
Thank you for attending
the Tampa meeting and I
hope to see as many if not
more CRNAs and SRNAs
at the Marco Island Sand &
Surf Anesthesia Symposium
February 18-21, 2016.
During my address one
of the Florida State
Representatives, Rep. Cary
Pigman, came to speak
to the membership. His
speech reviewed how
the process of the Florida
Legislature works. It
reminded me that we all
must be flexible because,
like the legislative process,
the practice of anesthesia
is a fluid one. In order to
remain relevant in today’s
healthcare market and to
provide the best and most
cost-effective anesthesia
care possible, we must
remain flexible. Everyone
is aware that every aspect
of healthcare is dynamic and
ever changing, whether it is
in the delivery of care or in
the administrative aspect.
If a provider is unable to
understand these changes,
he or she runs the risk of
not being able to keep up.
No longer can one say,
“That’s the way we’ve
always done it” and expect
to be able to have the
status quo remain. FANA
continues to provide
continuing education to
keep up with the changes
we are seeing in anesthesia
care, whether it’s in clinical
practice or the business
of anesthesia. Graduate
level education has also
changed to meet the needs
of the public and provide
students who are coming
into the workforce with the
global view they must have
to meet the needs of the
anesthesia care consumers.
After every conference we
offer attendees a chance to
request subjects for future
lectures but I would also ask
anyone who did not attend
to make suggestions as well.
FANA has changed its
practices over time in order
to meet the needs of its
membership as noted in
the strategic plan, which
is a fluid document. In
2006, FANA launched its
website. Since then, the
FANA website has been
updated and reduced costs
by posting the newsletter
on the website instead of
mailing it to each member.
Continued on page 5
2016
DATES TO REMEMBER
Florida Association of
Nurse Anesthetists
JANUARY 2016
CRNA Day
January 18-19, 2016
Tallahassee, FL
FEBRUARY 2016
Third Annual Sand & Surf Anesthesia
Symposium
February 17-21, 2016
Marco Island Marriott
Marco Island, FL
The Florida Association of Nurse Anesthetists
2015-2016 Board of Directors
PRESIDENT-ELECT
John P. McDonough,CRNA, EdD
86479 Meadowfield Bluffs Rd
Yulee, FL 32097-8410
Email: [email protected]
Non-Deductibility
of Lobbying
Expenditures
Disclosure
Statement
In accordance with Section
6033 (e)(2)(A) of the
Internal Revenue Code,
as amended, members of
the Florida Association of
Nurse Anesthetists (FANA)
are hereby notified that an
estimated 17%, or $40.00
of your 2015 state portion
of membership dues has
been allocated to lobbying
activities and therefore
is not deductible as an
ordinary and necessary
trade or business expense.
Winter 2015 • FANA Update
DIRECTORS
Adam Boyd, MSN, ACNP-BC,
CRNA
3999 Chicora Wood Pl
Jacksonsville, FL 32224-7694
VICE PRESIDENT
Erik Rauch, CRNA, DNP, NSPM-C,
DAAPM
3196 65th St N
St. Petersburg, FL 33710-2459
Spencer R. Harvey, CRNA
2989 NW 82nd Ter
Pembroke Pines, FL 33024-3171
Rebecca Lee, DNP, CRNA
3640 Poinciana Ave
Miama, FL 33133-6529
OCTOBER 2016
Annual Meeting
October 14-16, 2016
Renaissance Orlando at SeaWorld
Orlando, FL
SECRETARY/TREASURER
Johanna C. Newman, CRNA,
DNAP
13771 Green Cove Pl
Davie, FL 33325-1244
PRESIDENT
Debra J. Diaz, CRNA, DNP, ARNP
816 NW 11th St, Apt 1201
Miami, FL 33136-3125
William L. Self, CRNA
30 Choctaw Tr
Ormond Beach, FL 32174-4347
Linda L. Wunder, CRNA, PhD
7010 SW 41st Ct
Davie, FL 33314
FASNA PRESIDENT
Jennifer M. Brubaker, SRNA
4990 Key Lime Dr, Unit 207
Jacksonville, FL 32256
PAST PRESIDENT
Gerard T. Hogan, CRNA, DNSc
1306 Osceola Ave
Jacksonville Beach, FL 32250-3110
Committee Chairpersons
EXECUTIVE
Debra J. Diaz, CRNA, DNP, ARNP
816 NW 11th St, Apt 1201
Miami, FL 33136-3125
PEER ASSIST CO-CHAIRS
Erik Rauch, CRNA, DNP, NSPM-C, DAAPM
3196 65th St N
COMMUNICATIONS CO-CHAIRS
Erik Rauch, CRNA, DNP, NSPM-C, DAAPM
3196 65th St N
Jorge A. Valdes, CRNA, DNP
1761 SE 20th Rd
Homestead, FL 33035-1924
Mark Welliver, CRNA, DNP, ARNP
96411 Blackrock Rd
Yulee, FL 32097
Legal Counsel/Lobbyist
GOVERNMENT RELATIONS CHAIR
Jorge A. Valdes, CRNA, DNP
1761 SE 20th Rd
Homestead, FL 33035-1924
MEMBER SERVICES CHAIR
Johanna C. Newman, CRNA, DNAP
13771 Green Cove Pl
Davie, FL 33325-1244
NOMINATING/PACNA
Gerard T. Hogan, CRNA, DNSc
1306 Osceola Ave
Jacksonville Beach, FL 32250-3110
James W. Linn, Esq.
Lewis, Longman & Walker, PA
315 S. Calhoun St, Ste 830
Tallahassee, FL 32301
Business Manager/Headquarters
Tina Kautter, CAE
FANA Headquarters
222 S. Westmonte Dr, #101
Altamonte Springs, FL 32714
Phone: (407) 774-7880
Fax: (407) 774-6440
State Meeting Program Planners
SAND & SURF ANESTHESIA SYMPOSIUM
Marco Island Marriott Resort & Spa
Chair: Bruce Weiner, CRNA, MS
ANNUAL 2016
Co-Chair: Johanna Newman, CRNA, DNAP
Co-Chair: Jorge Valdes
THE UPDATE is the official publication of the Florida Association of Nurse Anesthetists, Inc. Paid advertisements are included
on a space-available basis. For advertising rates, please contact Elaine York at FANA Headquarters at 407-571-1135. The
opinions expressed in the FANA UPDATE are those of the contributors and do not necessarily reflect the views of the
publisher, the FANA Board of Directors, or the Editorial Staff.
Page 2
Communications Committee Report
By Erik Rauch, DNP, CRNA, DAAPM, Communications Committee Co-Chair
A.
ACTIVITIES/ FOLLOW UP OF OLD BUSINESS
1. New FANA website is complete. Continue to
work with Matt Wright at MarketVex to update
and create new content that is appealing and
attractive to members. Goal is to have a onestop shop through the FANA website for all our
members’ needs.
2. Continue to provide updates to the members
through the FANA Facebook page and FANA
Twitter account.
3. Continue Facebook contest to give away a free
FANA meeting registration to both a CRNA
and a SRNA each month based on how many
tags and likes they can accumulate in that onemonth time period. Goal is to hit 1000 “likes”
on Facebook.
4. Continue to work with Steve Birtman as Public
Affairs Director on increasing membership
engagement.
B.
EXPENDITURES
1. Facebook contest – Free registration – Actual
cost to FANA is minimal
2. Advertisement for FANA 2016 Meetings is
undetermined at this time.
C.
NEW BUSINESS
1. Mentor LaTanya Lawrence as a Communication
Committee member in the management of
FANA social media content.
2. Advertisement campaign for FANA 2016
Meetings (Hard mailers, Facebook, Twitter,
text, email).
3. Get Facebook likes up to over a 1000.
4. Wo r k i n g o n o p p o r t u n i t y t o p r o v i d e
transportation for SRNAs to CRNA Day 2016.
CMS Penalty for Failure to Participate in
Physician Quality Reporting System (PQRS)
By Trey Early, CRNA, State Reimbursement Specialist
Many providers have received CMS notice of penalty
for failure to participate in Physician Quality Reporting System (PQRS). It is important for all providers to be aware of
this program and participate if providing Medicare services.
The AANA will provide webinars providing information
and answer your questions. More information is available
on the AANA website.
Will this impact all facilities or groups where I am
employed? This will impact any CRNA who provides
services to a Medicare Part B beneficiary, regardless of
facility or employment. Payment adjustments are based
on Medicare Part B FFS only under the Medicare Physician
Fee Schedule (PFS).
Am I responsible for payment of this penalty or is it
my employer? The penalty affects the provider; however,
the process of collecting and submitting PQRS measures
to CMS may involve a single person, multiple persons,
departments, and/or organizations. CMS does not provide any specifics about responsibility. According to a
CMS QualityNet Help Desk Technician, “the organizational
level will determine for itself persons, departments, or
outside organizations responsible for administering and
maintaining the PQRS Program at their facility/organization. The organization will discuss with all responsible for the
execution of the PQRS Program their role in reporting
successfully as it relates to PQRS.” Ultimately, CRNAs,
billers, coders, and employers are all responsible for
coordinating PQRS efforts.
Is it too late to participate? The notice regarding the
2016 penalty is based on whether the CRNA satisfactorily
reported during the 2014 PQRS reporting year. Therefore,
it is too late for 2014, but it is not too late for 2015. (The
PQRS reporting year is based on a calendar year (January
1 to December 31). A payment adjustment occurs two
years from the reporting year.) A qualified CMS registry
can help for the 2015 reporting year. The AANA has
partnered with PQRSwizard powered by the CECity Registry. For more information about this program please go
to their website: https://aana.pqrswizard.com/default.aspx.
Page 3
FASNA Report
By Ann Miller
FANA held its first College Bowl at
its Annual Meeting in Tampa FL. On
Saturday evening, October 25, all
Florida nurse anesthesia programs
competed against an all-star CRNA
faculty team. Highly experienced
CRNA clinical preceptors represented
the all-star team: President Dr. Debra
Diaz (2016), Kathleen Thibeault, Lori
Schirlie, and Bruce Weiner. In keeping
with the spirited and fun theme,
the all-star team was appropriately
attired in pirate regalia. Playing on
this theme, President Dr. Jerry Hogan
(2015) served as moderatorrrrrrr.
And as expected, he shared the much
expected pirate humor telling many
“Rrrrrrrrrrrrrrrrrrrr” jokes. Each of the six nurse anesthesia
program teams consisted of three to
five students. There were six rounds
of competition in which two teams
raced to be the first to correctly
answer board-type questions asked
by the moderator. The final round
of the College Bowl consisted of
Florida Gulf Coast University (FGCU)
competing against the highly touted
all-star team of Pirates. After an
intense round of battle the FGCU team
emerged victorious! The winning team
members were Erin Bubnick, John
Krall, Supriya Nair, Matt Pratt, and
Travis Rademaker. Congratulations
students and accolades to your school,
Florida Gulf Coast University.
The booty of this epic clash of
cerebral might was a trophy taken
home by the winning team for
bragging rights. Returning next year,
the trophy will be up for grabs by
your school or maybe another team
of CRNA all-stars. Be sure to attend
next year’s Annual Meeting College
Bowl to witness the continuing battle
of student vs. CRNA intellect and
consider putting your knowledge to
the test as a team member. As one
of the many highlights of this year’s
outstanding FANA Annual Meeting
the College Bowl is sure to remain an
annual tradition.
2016 CRNA Day - January 19 in Tallahassee
The 2016 CRNA Day event will be
held on Tuesday, January 19, in
Tallahassee. This is your opportunity
to learn about the issues and speak
directly with legislative leaders about
what CRNAs do and how high quality
anesthesia care can become more
accessible and cost-effective. Most
importantly, CRNA Day gives FANA
members the chance to renew their
relationships with key legislators and
staff, and establish new relationships
among Florida policy makers.
CRNA Day is a one-day event, and
all CRNAs and SRNAs are invited to
attend. Past CRNA Day participants
say the experience was not only
informative and impressive, but they
stated that they wished they had gone
to visit their legislators a long time ago. There is no cost to FANA members
for CRNA Day.
(Click here for hotel information
and to register.)
Page 4
Message from the President
Continued from page 1
We are now looking at live streaming
meetings. This is in response to many
members who stated they could not
get time off at the same time the
meetings are held. We are also utilizing
social media as we never have before.
We have a Facebook page and a
Twitter account. I invite all of you to
like our Facebook page and follow
us @flcrna on Twitter. We have hired
a Public Affairs Director, Stephen
Birtman, and he has been active on
both of these venues. I would like
to have Wi-Fi in the meeting rooms
during the entire meeting. In the past
it has been cost prohibitive but with the
times changing it will be another goal
to see if this can be accomplished in a
cost-effective manner.
Getting involved in your association is
easier than ever. You can now fill out
a Willingness to Serve form online.
Serving on a committee is not difficult
and will not consume a lot of your time.
If you are concerned that you do not
know what some committees entail,
a great deal of knowledge can be
gained at the Annual Fall Leadership
Academy, which the AANA holds in
November annually. The tracks for
professional development this year
were business, state reimbursement
specialist, grassroots advocacy and
public affairs, state president and
president-elect. To help us understand
the legislative aspects of our profession,
there was also a track for federal
political directors and government
relations. I found the information
invaluable and even though I have
been FANA President before, I gained
a lot from this Academy. You no longer
have to feel as though you want to
volunteer but you don’t know how or
what to do. The Board of Directors will
help mentor you in your development.
CRNA Day is coming early this
year because the Legislature is in
session early. It begins in January.
This is another way to get involved.
It is January 18 & 19. If you are
unable to attend, you can promote
FANA’s legislative agenda locally
with your State Senator and State
Representative without leaving your
city. FANA is promoting both the
Ordering and Prescribing Bills, which
are garnering bipartisan support. A
visit to your legislator as a constituent
speaks volumes and you can start a
relationship that will be most helpful
as the legislative session progresses.
The legislators are term-limited so
every eight years we must begin their
education process as to who we are,
what our education and our profession
entails, our safety record, and how we
are beneficial to access to anesthesia
care in the State of Florida.
Since this is my last year as a
Commander in the Reserve Navy
Nurse Corps, I want to take the
opportunity to thank all the Military
CRNAs for their service. I served
both in the Active Duty and Reserve
Component. It is not an easy calling
and there are many sacrifices that are
made by these brave men and women
both at home and overseas. Please
give them your support as well.
Lastly, I want to assure that the
FANA Board of Directors will be the
guardian of the funds you work so
hard for and entrust to FANA with
your membership dues. We will be
judicious in allocating those funds to
make sure that you find value in your
membership.
THANK YOU CRNAs AND SRNAs...
900+ strong on Facebook! Share our page with your peers.
Page 5
FANA Spotlight:
Jonathan Kline, CRNA,
MSNA
We introduce FANA Spotlight, a newsletter shining a
spotlight on a FANA member worthy of recognition for
significant contributions to our profession and/or outstanding achievement. Our first Spotlight is on Jonathan Kline,
CRNA, MSNA. Jonathan is known throughout Florida and
the United States as an expert in regional anesthesia and a
leading instructor of ultrasound guided regional anesthesia.
FANA members have enjoyed some interesting presentations on the topic of regional anesthesia over the past
several years. One CRNA has been not only successful
in clinical practice performing regional anesthesia, but
also teaching others to perform and improve upon these
techniques. Jonathan Kline’s experience, expertise, and
academic contributions to our profession have earned him
this year’s FANA Spotlight.
Jonathan Kline, CRNA, MSNA, began his contributions
to FANA in 2010 with the presentation “Surviving Uncommon Blocks” which focused on lesser-known regional
techniques. Originally intended for students, this presentation also attracted many seasoned nurse anesthetists. He
again presented for FANA in 2012 on ultrasound guidance
in peripheral nerve blocks, which quickly became his forte.
His skills, knowledge, and engaging presentation style have
made him popular not only with FANA meetings but also
throughout the country. In 2013 Kline presented multiple
times for the American Association of Nurse Anesthetists
(AANA) expanding his presentations on ultrasound for
anesthesia providers to include a four-hour presentation
at the AANA Annual Congress in Las Vegas. In 2014 he
presented a well-coordinated didactic and hands-on ultrasound lab at the FANA Sand & Surf meeting on Florida’s
Marco Island. His participation at this year’s Fall FANA
Annual Meeting contributed to drawing a record number of
attendees not only from Florida but also from many other
states. Jonathan Kline’s combined didactic and hands-on
ultrasound workshop was overwhelmingly enjoyed. The
cadaveric presentation led by his colleague Steve Ducker,
MD, CRNA, was also unique and popular.
Kline and his highly skilled faculty at Twin Oaks Anesthesia, a CRNA-led company co-founded with Dr. Deanna
Kline, CRNA, DNP, have inspired and educated CRNAs
all over the United States. As the Director of Education,
Jonathan has expanded Twin Oaks Anesthesia conferences
from two per year in 2010 to nearly a dozen in 2016. The
ultrasound topics now include a comprehensive review of
peripheral nerve blocks (PNBs) and vascular access, advanced ultrasound guided pain management techniques,
and, for the first time in the CRNA community, ultrasound
for critical care providers featuring anesthesia and TTE
(transthoracic echocardiography).
As we have seen at FANA meetings, Jonathan has
set a new standard for excellence in ultrasound learning
at conferences. Combining an organized slideshow with a
simultaneous performance of ultrasound on a volunteer
“patient” truly brings these lectures to life. Real time ultrasonography performed live in front of large crowds has
taken the typical conference presentation to the next level.
The hands-on workshops from Twin Oaks Anesthesia also
provide consolidated learning and help develop hand-eye
coordination, which FANA members have truly appreciated. In addition to his conference presentations and clinical
work, Jonathan has also been active scholarly. He has published five peer-reviewed articles, several of which appear
in the AANA Journal with a focus on anesthesia ultrasound.
Additionally, Kline has recently shared his unique insights
in reliable needle visualization during ultrasound guided
regional and vascular procedures — a simple solution to
steep angle echogenicity loss with any ultrasound system,
based on target depth. Recently published in Anesthesia
eJournal http://anesthesiaejournal.com/index.php/aej/
article/view/39. His discovery helps to refine ultrasound
technique by solving needle location issues
He has also published the first-of-its-kind interactive
digital book called “Peripheral Nerve Blocks and Ultrasound
Guidance for Anesthesia Providers” which can be read on
any Apple device.
The iBook and a complete schedule of courses offered by Twin Oaks Anesthesia is available at: http://www.
twinoaksanesthesia.com/
Spotlight salutes the contributions of FANA member
Jonathan Kline and Twin Oaks Anesthesia to FANA and our
profession. We look forward to his future involvement with
the FANA membership and wish him continued success.
Page 6
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Page 7
FANA Legal Update
By Jim Linn and Glenn Thomas, FANA Legal Counsel
Board of Nursing
The Board of Nursing has been quiet
from a legal perspective. The Board has
discussed legislation affecting the scope
of practice of ARNPs, including SB 210
by Senator Grimsley (which would
allow ARNPs to prescribe controlled
substances under supervision and
protocol, and subject to a negative
formulary), and continues to support
the expansion of prescriptive authority
for ARNPs.
FANA’s legal counsel attend all
meetings of state health care regulatory
boards that affect CRNAs and the
profession of nurse anesthesia. Here is
a summary of recent board meetings
on issues impacting CRNA practice.
Board of Medicine and
Board of Osteopathic
Medicine Joint Committee
on the Office Surgery
At its October meeting, the Joint Board
of Medicine/Board of Osteopathic
Medicine Office Surgery Rule
Subcommittee discussed language
proposed by the Florida Medical
Association (FMA) concerning the
use of anxiolytic drugs in Level I office
surgery. Under the current rule For
several months, representatives from
several OB/Gyn groups have been
attempting to relax rules prohibiting
the use of certain drugs in Level I office
surgery (where only local anesthetics
are used) Level I procedures are
subject to much less regulation than
Level II (conscious sedation) or Level
III (general anesthesia) office surgery.
Basically the OB/Gyns wanted to be
able to use sedation in conjunction with
topical or local anesthetics for Level
I procedures. This initially caused a
rift between the OBs and the Florida
Society of Anesthesiologists (FSA).
In July a compromise was offered
which would have allowed the use
of “minimal sedation” in Level I
procedures and Nalaxone if an opiate
is used. The Joint Committee voted to
approve and recommend the revised
rule to the full Boards. However, when
the Board of Medicine considered
adoption of the language, one Board
member spoke strongly against the rule
change, suggesting that the rule was all
about economic issues at the expense
of patient safety. Hearing that there
may be patient safety issues, one of the
Board’s consumer members expressed
concern as well. What should have
been a routine vote quickly turned
into a patient safety debate. During
the debate, several Board members
requested additional time to consider
the language, given the potential
safety concerns. Other members, who
have served on the Joint Committee
pointed out that the language had
been debated for more than a year
and insisted on a vote. A motion to
approve the language then failed on a
6-6 tie vote, with one member absent.
The Board then voted to table the issue
until the next meeting, where the full
Board will hold another workshop on
the office surgery rule.
The Board has also discussed the RN
licensure compact. For several years,
the Board has been struggling with
whether to support the RN licensure
compact. The Nurse Licensure
Compact (NLC) allows nurses to
have one multistate license, with the
ability to practice in both their home
state and other compact states. Note,
that this is not “reciprocity.” In other
words, nurses from a Compact state
may not practice in other Compact
states unless they obtain a multistate
license. Florida is currently not a
compact state. Twenty-five states have
enacted the original NLC legislation
and several others are considering
legislation. In May, new language was
approved by the National Council of
State Boards of Nursing (NCSBN).
The NCSBN also approved, for the first
time, an APRN Licensure Compact,
which would permit APRNs, including
CRNAs, to obtain a multistate license.
As the language is new, there are not
yet any participating states in the APRN
compact. It should also be noted that
in order to adopt the model APRN
Compact legislation, a participating
state must allow independent practice
for advanced practice nurses —
something Florida does not currently
allow.
Page 8
FANA Legislative Update
By Lori Killinger, Chris Lyon, and Jim Linn, FANA Legislative Counsel
The 2016 Regular Legislative Session
begins on January 12, 2016.
Florida’s economy continues to
generate a large budget surplus over
last year’s state budget of $78.7 billion.
Issues such as education, Medicaid, the
environment and tax cuts are expected to
take center stage in budget negotiations.
Health care issues will continue to
be front and center during the session.
Members of the Florida Senate and
House of Representatives, as well as
Governor Rick Scott, have different
perspectives on various issues. Medicaid
expansion is unlikely to dominate
the session as it continues to be a
flash point of contention. Issues such
as repealing Certificate of Need for
hospitals and increasing hospital
billing transparency also face uncertain
futures.
The House will be led by term-limited
Speaker Steve Crisafulli (R-Merritt
Island) and Speaker Designate Richard
Corcoran (R-Lutz). The Senate will be led
by Senator Andy Gardner (R-Orlando).
The protracted Senate leadership
fight has ended with Senator Joe Negron
(R-Palm City) becoming President of the
Senate in 2017 and 2018, with Senator
Latvala (R-Clearwater) conceding the
race to Negron in exchange for serving
as the powerful Appropriations Chairman
during those years. Yet, the Florida
Senate make-up remains in an uncertain
position due to the fact that all 40
Senators may be up for reelection in
2016 and the makeup of the districts
they represent are far from certain
because they will be drawn by the
courts.
Following is a brief summary of the
legislation of importance to the Florida
Association of Nurse Anesthetists:
ARNPs Ordering Controlled
Substances
SB 152, by Senator Denise Grimsley
(R-Sebring), authorizes ARNPs and PAs
to order medications, including controlled
substances, for administration to patients
in a hospital or ambulatory surgery
center. There is currently no House
companion to the Senate bill. SB 152
has passed unanimously through two of
its three committees of reference. The
legislation has been supported publically
by FANA.
Link to read the proposed
legislation, staff analysis, and vote
sheets: https://www.flsenate.gov/Session/
Bill/2016/0152
SB 946 by Senator Denise Grimsley,
which is a slimmed-down version of SB
152 and provides that a supervising
physician may authorize an ARNP or
PA to order controlled substances for
administration to a patient in a hospital
or ambulatory surgery center. SB 152
has several other provisions and caveats
that are not included in SB 946. SB 946
does not yet have a House companion
and has not received a hearing.
Bill/2016/0946
ARNPs Prescribing Controlled
Substances
SB 210, by Senator Grimsley,
allows ARNPs and PAs to prescribe
controlled substances subject to a
negative drug formulary. The bill includes
other controversial health care issues for
Hospitals and third party payers. SB 210
has not yet been heard in any of its three
committees of reference.
Bill/2016/0210
HB 423, by Rep. Pigman,
(R-Sebring) allows ARNPs and PAs to
prescribe controlled substances under
supervision and protocol but does not
contain the negative formulary found in
SB 210 and SB 676. HB 423 passed
through the first of three committee
references on a 12-1 vote. The legislation
has been supported publically by FANA.
Link to read the proposed legislation,
staff analysis, and vote sheets: http://
www.myfloridahouse.gov/Sections/Bills/
billsdetail.aspx?BillId=55348
To watch the debate: Drag the cursor
forward to 1 hour 29 minutes. http://
thefloridachannel.org/videos/12115house-health-quality-subcommittee/
SB 676, by Senator Grimsley,
contains provisions relating to ARNPs
prescribing controlled substances that are
identical to those in SB 210, discussed
above, but without controversial
provisions in SB 210. SB 676 has not
yet received a hearing.
ARNPs Initiating Baker Act
Examinations
SB 572, by Senator Thad Altman
(R-Rockledge), and HB 325, by Rep.
Daphne Campbell (D-Miami), authorize
ARNPs and PAs to initiate involuntary
examinations under the Baker Act. SB
572 passed unanimously through one of
its three committees of reference while
HB 325 has passed unanimously through
two of its three committees of reference.
Bill/2016/0572
Link to read the proposed legislation,
staff analysis, and vote sheets: http://
www.myfloridahouse.gov/Sections/Bills/
billsdetail.aspx?BillId=55200
Nurse Licensure Compact: For
several years, the Florida Board of
Nursing has been grappling with whether
to support the RN licensure compact.
The Compact allows RNs licensed
in another Compact state to obtain
reciprocal licensure in any other state
that has approved the Compact. Many
questions were asked if this compact
would impact the pay and benefits of
nurses, and various nurse associations
were either supportive of the concept
or were still formulating a position. The
House Select Committee on Affordable
Healthcare Access recently held a
workshop on the issue but no legislation
has yet emerged.
Page 9
FANA Top Ten Articles of 2015
Update from Florida Board of Medicine
(FANA)
http://multibriefs.com/briefs/fana/FANA Eflash-BOM
Update on AAs.pdf
From June 18: The Florida Association of Nurse
Anesthetists prevailed in its opposition to a Petition for
Declaratory Statement filed with the Board of Medicine
last month by an anesthesiologist and two anesthesiologist
assistants. Represented by Lewis, Longman, and Walker,
FANA moved to intervene in the petition, on the grounds
that the petition involved a statutorily delineated area
of practice that was currently exclusive to CRNAs and
anesthesiologists.
The risks of pre-op sedation
(Outpatient Surgery Magazine)
http://www.outpatientsurgery.net/surgical-facilityadministration/patient-management/the-risks-of-pre-opsedation--e-03-10-15
From March 12: Do your providers prescribe a dose of
benzodiazepine to calm a patient’s nerves before surgery?
A study published in a recent issue of JAMA suggests that it
may actually be doing them more harm than good. French
researchers enrolled more than 1,000 elective surgery
patients under the age of 70 who were scheduled for
general anesthesia into three groups. One group received
2.5 mg of lorazepam two hours before surgery. Another
received a placebo. The third received no pre-op sedation.
Research shows brainwave changes
created by nitrous oxide (Medical
Xpress)
http://medicalxpress.com/news/2015-07-revealbrainwave-patients-nitrous-oxide.html
From July 16: Nitrous oxide, commonly known as
“laughing gas,” has been used in anesthesiology practice
since the 1800s, but the way it works to create altered states
is not well understood. In a study published this week in
Clinical Neurophysiology, MIT researchers reveal some
key brainwave changes among patients receiving the drug.
Novel approach may lead to next
generation of anesthetics (Medical
News Today)
http://www.medicalnewstoday.com/releases/288261.php
From Jan. 29: For the first time since the 1970s, researchers
are on the verge of developing a new class of anesthetics.
According to a study published in the February issue of
Anesthesiology, a new approach to identifying compounds
may lead to the next generation of anesthetics.
Do cell phones belong in the operating
room? (Kaiser Health News)
http://khn.org/news/do-cell-phones-belong-in-theoperating-room/
From July 16: Cell phone use is not generally restricted
in the operating room, but some experts say the time for
rules has come. In interviews, many described co-workers’
texting friends and relatives from the surgical suite. Some
spoke of colleagues who hide a phone in a drawer and
check it when they think no one is watching.
Florida home to highest-charging US
hospitals (National Public Radio)
http://www.npr.org/sections/healthshots/2015/06/09/412964072/highest-charging-u-shospitals-are-for-profit-and-concentrated-in-florida
From June 18: Talk about sticker shock: Some U.S.
hospitals charge patients more than 10 times the rates
paid by Medicare. Of the 50 U.S. hospitals with the highest
charges, 49 are for-profit institutions, 20 operate in Florida
and half are owned by a single chain, according to a study
published in the journal Health Affairs. That doesn’t mean
all or even most patients end up paying those charges.
4 Florida hospitals earn top Medicare
rating (Health News Florida)
http://health.wusf.usf.edu/post/4-fl-hospitals-earn-topmedicare-rating?nopop=1#stream/0
From April 23: In an effort to make comparing hospitals
more like shopping for refrigerators and restaurants,
the federal government has awarded its first star ratings
to hospitals based on patients’ appraisals. Many of the
nation’s leading hospitals received middling ratings, while
comparatively obscure local hospitals and others that
specialized in lucrative surgeries frequently received the
most stars.
FDA panel votes unanimously in favor
of Sugammadex (Reuters)
http://www.reuters.com/article/merck-co-fda-idUSL3N13
15ZR20151106#FcmJgS0GDZ4wXrmM.97
From Nov. 19: Merck & Co’s drug to reverse the effects
of muscle relaxants used in surgery is safe and effective
enough to warrant approval, an independent panel to the
U.S. Food and Drug Administration said. The drug, known
chemically as Sugammadex, was developed by Schering
Plough, a rival U.S. drugmaker acquired by Merck in 2009.
Continued on page 11
Page 10
Top Ten...
Optimal mechanical
ventilation strategy
identified for obese
(HealthDay News via
Medical Xpress)
http://medicalxpress.com/news/201505-optimal-mechanical-ventilationstrategy-obese.html
From June 4: For obese patients, the
optimal mechanical ventilation strategy
may be volume-controlled ventilation
with higher positive end-expiratory
pressure and single recruitment
maneuvers, according to a metaanalysis published in the June issue
of Obesity Reviews.
Wisconsin bill could
force facilities to video
surgeries (Outpatient
Surgery Magazine)
http://www.outpatientsurgery.net/
outpatient-surgery-news-and-trends/
general-surgical-news-and-reports/
bill-could-force-facilities-to-videosurgeries--04-24-15
From May 7: Pay no attention to that
camera capturing every move you
make in the OR. Physicians and staff
members in Wisconsin may have no
other choice if a recently drafted bill is
signed into law. The proposal would
give patients the right to insist that
any surgery that involves anesthesia
be captured on video. The “Julie
Ayer Rubenzer Bill” is named after
a Waukesha, Wisconsin, woman
who died after undergoing breast
augmentation surgery in Florida in
2003.
Third Annual Sand & Surf
Anesthesia Symposium
February 18 - 21, 2016
Marco Island Marriott Resort & Spa •
Marco Island, Florida
Visit www.fana.org to register TODAY!
Page 11
AANA Foundation Report
By Kathleen C. Thibeault, MSN, APRN, CRNA
Greetings and Happy Holidays from the AANA Foundation! The AANA Foundation is the philanthropic arm
of the AANA. The mission of the AANA Foundation is to
advance the science of anesthesia through education and
research. To this end, the Foundation provides grants, fellowships, and scholarships for student, graduate, and independent research which pertains to Nurse Anesthesia.
In FY 2015, the Foundation awarded over $252,000 in
Scholarships, Fellowships, Research Grants, and Poster
Presentation Sponsorship. The Foundation also invested
$280,000 in a Post-Doctoral Health Service Research
Fellowship Program. If you do the math, this amounts to
$532,000 in support of Nurse Anesthesia in the past fiscal
year!
The AANA Foundation is donor-driven, so we rely
heavily on your support. We are grateful for donations
large and small – if you have donated in the past year,
look for acknowledgements from the AANA Foundation
and from me, your Advocate. One way to avoid those solicitations for donations is to give proactively to the AANA
Foundation – no amount is too small, and we are grateful
for all your support.
Before I lose your attention, I would like to remind
you of a really easy way to support the AANA Foundation as you go about your holiday shopping. If you are an
Amazon shopper, instead of logging on in the usual way,
log into www.amazonsmile.com, identify AANA Foundation as your Charity of Choice, and 1% of your purchase
will be donated to the AANA Foundation. One percent, as
we all know, really adds up!
Fiscal Year 2015 was an eventful one for the Foundation in many ways. In addition to the above-mentioned
awards, three Florida CRNAs and three Florida SRNAs
were recognized for their individual accomplishments.
MaryKay Thomas, CRNA, was awarded the Janice
Drake Humanitarian of the Year Award. Maureen Bosco,
CRNA, represented Florida in the Anesthesia Pioneers
Forum. Lori Schirle, CRNA, received the FANA Doctoral Fellowship Award. Tracy Chalgren, BSN, SRNA,
received the FANA Student Scholarship. Radhika Patel,
BSN, SRNA, won First Place in the “State of the Science”
Poster Session in the Evidence-Based Practice Category.
Kate Cowap, BSN, SRNA, was selected national Student
Representative to the AANA Foundation.
As the new fiscal year unfolds, several initiatives will
be prioritized. One of these is the expansion of Student
engagement. Last year, the Foundation piloted a Student
Advocate Program. There are currently 10 Student Advocates from across the nation, and the goal is to identify
and mentor an advocate from every Nurse Anesthesia
program. The Foundation will likely seek first-year students to allow adequate time for them to develop in the
role. If you are a student or a program director and would
like more information about the Student Advocate Program, please contact me.
Another priority for the Foundation is the creation of
the Health Services Research Campaign. This HSR campaign will fund research speaking to the safety and costeffectiveness of nurse anesthetists. In addition to implementing the Post-Doctoral Research Fellowship Programs
to be offered at Vanderbilt University and Duke University,
we intend to re-validate the two major studies used regularly by CRNAs and the PACs when meeting with legislators and decision-makers: “No Harm Found When Nurse
Anesthetists Work Without Supervision by Physicians,”
Health Affairs (2010) and “Cost Effectiveness Analysis of
Anesthesia Providers,” Nursing Economic$ (2010).
The AANA Foundation received a generous donation
of $1 Million from the NBCRNA, and hopes to match that
amount through Member Outreach. To learn more about
the Health Service Research Campaign, go to www.aana.
com/myaana/AANABusiness/aanafoundation/Pages/Intro-toHealth-Service-Research.aspx
Just recently, the staff of the AANA Research and
Quality Division published a study in Nursing Economic$ that demonstrated that anesthesia providers differ
among populations of varied socio-economic conditions. After controlling for multiple variables in the correlational analysis, CRNAs were more correlated with the
uninsured, unemployed, Medicaid and Medicaid disabled.
This study illustrates that CRNAs in both urban and rural
environments are more likely to increase access to anesthesia service to the most vulnerable populations. Read
more about this study at: www.aana.com/resources2/research/Pages/NursingEconomics2015.aspx
If you have attended an AANA Meeting lately, you
know that the AANA Foundation likes to keep the “FUN”
in “Fundraising.” Whether at Annual Congress or Assembly of School Faculty, there is sure to be a fun themed
event which entertains while raising much-needed funds
for Nurse Anesthesia research and Education. At every
AANA Meeting, the Foundation holds a Silent Auction
of Treasures, Talents, and sometimes Travel, donated by
CRNAs and friends of nurse anesthesia from across the
nation. At the Third Annual FANA Sand and Surf Symposium, look for an excellent and exciting fundraiser to
benefit the Foundation.
In addition to other fundraising efforts, a further goal
for FY16 is to promote and grow the Friends For Life ProContinued on page 14
Page 12
Page 13
AANA Foundation Report
gram. The Friends For Life Program helps support the
future of the Nurse Anesthesia Profession through meaningful, lasting gifts. Contributions through Friends For Life
help fund and sustain programs that further research and
education in anesthesia. The minimum gift commitment
to join Friend For Life is $25,000. Members may fulfill this
commitment through a cash gift, but there are also many
other ways to meet the commitment – through planned
gifts like bequests as well as beneficiary designations on
life insurance and retirement plans. Friends For Life are
inducted annually in a ceremony at the Opening Ceremonies of the AANA Annual Congress. Florida can proudly claim 12 Friends For Life – among them our current
FANA President, Debra Diaz, past FANA Presidents, past
AANA Presidents, and current AANA Board Member. My
goal as AANA Foundation Advocate is to see that number
increase substantially in the coming year. Please contact
me for more information about this important program.
Once again, as the Focus of the AANA Foundation is
on Education and research, I would like to remind you
of the upcoming deadlines to apply for funds and awards
from the Foundation.
If you would like any information about the AANA
Foundation, its programs or initiatives, please contact me
at [email protected]
I wish you happiness this holiday season, success in
all your endeavors, and I look forward to seeing you at the
Third Annual Sand & Surf Symposium in Marco Island!
Page 14
Florida Nurse Anesthesia Programs
Program Director/Address
Start date/# of students admitted each year
For more information, visit:
Adventist University of Health Sciences
January/25http://www.adu.edu/academics/
Nurse Anesthesia Program
nurseanesthesia
Alescia L. DeVasher Bethea, CRNA, MS, APN, PhD
671 Winyah Drive
Orlando, FL 32803
Barry University
Master of Science in Anesthesiology
Tony Umadhay, CRNA, PhD, MSN
421 N. 21st Avenue
Hollywood, FL 33020
Florida State University - Panama City, FL
Scarlett Hinson, CRNA, DNP
4750 Collegiate Drive
Panama City, FL 32405-1099
January/75http:www//barry.edu
August/24www.pc.fsu.edu
(Program implementation contingent on
SACSCOC approval.)
Florida Gulf Coast University
Thomas Lansden, CRNA, MS
10501 FGCU Boulevard South
Fort Myers, FL 33965
January/25http://www.fgcu.edu
Florida International University
Anesthesiology Nursing Program
Jeffrey Groom, CRNA, PhD
11200 Southwest 8th Street
Suite ACH3-342
Miami, FL 33199
August/25http://cnhs/fiu.edu
University of Miami
August/25http://www6.miami.edu/sonhs/
anesthesia/index.html
Rossana Bizzio, CRNA, MS, ARNP
PO Box 248153
Coral Gables, FL 33124-3850
University of North Florida
Nurse Anesthesist Program
John P. McDonough, CRNA, EdD
1 UNF Drive
Jacksonville, FL 32224
August/25http://www.unfanesthesia.org
University of South Florida
August/30http://www.health.usf.edu/
nursing/academics/nurseSusan Perry, CRNA, PhD
anesthesia
12901 Bruce B. Downs Blvd., MDC 22
Tampa, FL 33612-4766
Wolford College
Lauren K. Corder, CRNA, EdD, ARNP
1336 Creekside Blvd, Ste 2
Naples, FL 34108
February/Octoberhttp://www.wolford.edu
30/40
*All attempts were made to ensure accuracy of the program director, address and contact information.
Page 15

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