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Nursing Ethics: Commitment, compassion, quality care

Nursing Ethics: Commitment, Compassion, Quality Care

October 23-25, 2015

Franklin, TN ♦ Franklin Cool Springs Marriott

Table of Contents

Welcome from the TNA President ................................................................. 3

Welcome from the TNA Executive Director . ......................................................... 5

Welcome from the TASN President. ................................................................ 9

2015 TNA & TASN Conference Schedule . .......................................................... 11

Franklin Cool Springs Marriott Meeting Rooms Map . ................................................. 15

General Announcements . ...................................................................... 16

Keynote Speaker. ............................................................................. 17

Meet the Presenters ........................................................................... 18

2015 Membership Assembly Rules and Information . ................................................. 21

Disclosures to Participants . ..................................................................... 22

Introduction to Robert’s Rules of Order . ........................................................... 23

Proposed 2015–2017 Legislative and Health Policy Statements . ........................................ 25

Tennessee Nurses Political Action Committee (TNPAC) ............................................... 28

TNA District Map ............................................................................. 30

Nightingale Tribute & Memoriam ................................................................. 32

2015 TNA Board of Directors & Staff .............................................................. 33

2015 Slate of Candidates . ...................................................................... 34

Poster Session Abstracts . ...................................................................... 37

TNA Financials . .............................................................................. 46

TNA Area of Interest Form. ...................................................................... 50

TNA Past Presidents .......................................................................... 51

Tennessee Nurses Foundation (TNF) - Mission - Goals - Initiatives ...................................... 52

TNF Board of Trust Roster . ..................................................................... 55

TNA Member Benefits. ......................................................................... 56

TNA 2016 Events . ............................................................................ 58

Printed and Published for the Tennessee Nurses Association by:

Arthur L. Davis Publishing Agency

517 Washington, P.O. Box 216, Cedar Falls, IA 50613

(319) 277-2414

www.tnaonline.org

Published by:

Arthur L. Davis

Publishing Agency, Inc.

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WELCOME ALL!

Nursing Ethics: Commitment, compassion, quality care

Welcome from the TNA President

Billie Sills, MSN, RN, CLNC

I know that many of you have made a huge effort to join us here in Franklin, TN for

the TNA-TASN JOINT CONFERENCE where this year’s theme is “NURSING ETHICS:

COMMITMENT, COMPASSION, and QUALITY CARE”.

During the next three days you will have the opportunity to view ethics and nursing ethics

through the eyes of others and to find out and experience what the world of ethics means

for them. This is a time when we come together to review, reflect, debate and come to

consensus regarding many of the serious challenges facing the nursing profession and

specifically in the state of TN.

Again the public has rated nurses as the most ethical of professions. ANA has identified

2015 as the “Year of Ethics” and thus TNA’s conference is also centered on ethics in

nursing practice. For those of you who have never had the privilege of hearing our keynote

speaker, Faith Roberts, Director of Magnet Professional Practice and Parish Nursing at Carle Medical Center in

Urbana, IL, you are in for a real treat. She will make you laugh, cry, celebrate and reflect on your personal feelings

and understandings of the complex subject we call Ethics. Other presentations will include ethics of advocacy,

situational awareness, a look at the newly revised Code of Ethics, as well as opportunities for interactive problem

solving. A panel of TN legislators will discuss key issues of importance to nurses and our patients. Topping off the

educational opportunities will again include outstanding Poster Presentations.

This is the sixth year we have joined forces with the Tennessee Association of Student Nurses. Combining these two

relevant organizations gives us an exceptional opportunity to interact, mentor, and hear the concerns and dreams of

the new generation of professional nurses who are taking us into the future.

One of the most exciting things about attending the annual conferences is the bringing together of unique ideas

and perspectives we each bring to the meeting. This is nursing’s great strength. Nursing is not just a profession, it

is a community. It has been said that “it takes a village to raise a family”; well it takes a community of dedicated,

compassionate, strategic thinkers to provide a solid foundation for a healthcare system. And that colleagues and

friends, is professional nursing. I look forward to seeing each of you and hearing your thoughts and views, so take

advantage of this opportunity to network, share ideas, make new friends, laugh with old and engage with the next

generation of nurses.

We are Tennessee’s current nurses and Tennessee’s future nurses; we are the voice for professional nurses and the

profession of nursing. When we speak as a unified force…Tennessee listens.

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Nursing Ethics: Commitment, compassion, quality care

Welcome from the Executive Director

Sharon Adkins, MSN, RN

Welcome to the 2015 TNA & TASN Joint Conference, Nursing Ethics: Commitment,

Compassion, Quality Care. Once again, we are excited to be joining the future of nursing –

our students – as we learn together, discuss issues, share our stories and have fun! What

a wonderful opportunity to pass on a bit of our wisdom and experience to students just

beginning the journey that many of us have been traveling a long time.

This year is the ANA Year of Ethics and what better way to mark that than dedicating our

conference to the examination of ethics as it relates to our practice and personal values.

As you look over the program you will see the wide variety of topics and expertise to be

presented. Take full advantage of all that is offered.

The Membership Assembly will do the work of the association… giving direction, setting

priorities, and dealing with issues of importance to our patients and our profession. As in

the past, this is also an opportunity to support the work of TNPAC and TNF by “bidding often and bidding high” in

both the TNF silent auction and the TNPAC live auction…Christmas is just around the corner and what better way to

shop!

Two events are very special, the Welcome reception and the Awards Gala. Be sure to attend, to relax, to celebrate

and to have fun. This year’s conference is a time to re-connect, re-energize, and re-commit to the work before us. It

is a time to engage with others, explore new ideas, and expand our vision for the future. I look forward to spending

these next days with you…my colleagues and friends.

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Welcome from Tennessee Association of Student Nurses

Justin Bowers, BSN, RN

TASN President 2014-2015

Greetings. I would like to welcome everyone to the 2015 TNA and TASN Joint Conference.

For those of you that have not been to a conference, this annual conference is a wonderful

experience. It provides a time to network with peers, an opportunity for learning and

education, and multiple avenues for professional development. Events like these make the

great world of nursing what it is today. I challenge you to take full advantage of everything

that is being offered. If you do, I truly think you will not regret it. If you are a newcomer,

please take advantage of the wealth of information and feel free to reach out to the nurse

veterans that are in attendance. If you are a nurse veteran, please try to reach out to the

newcomers and share your substantial experience and knowledge. Most importantly, enjoy

yourselves. TNA and TASN have planned an exciting weekend that is filled with amazing

activities and some incredible sessions.

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Nursing Ethics: Commitment, compassion, quality care

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Nursing Ethics: Commitment, compassion, quality care

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Nursing Ethics: Commitment, compassion, quality care

General Announcements

Welcome to the 2015 TNA & TASN Joint Conference! Please greet the new members and first-timers and make them

feel welcome. New Members have lavender ribbons and First Time Attendees have turquoise ribbons.

The Tennessee Nurses Political Action Committee, (TNPAC), will host a Legislative panel on Friday from 2:00-

3:30 p.m. in rooms Salon 1-5. This will be a great opportunity for conference participants to dialogue with invited

legislators as well as discuss current issues facing the nursing profession in today’s political climate.

Join us Friday evening between 6:00 – 9:00 p.m. for food and fun during the Welcome Reception and Exhibits. Enjoy

networking time as we all participate in a scavenger hunt and meet and greet exhibitors.

The Tennessee Nurses Foundation Silent Auction opens Friday at 10:00 a.m. in room Mustang\Quarter Horse.

Donations can be dropped off until 11:00 a.m. Saturday morning. The auction will close Saturday at 5:00 p.m.

Your Registration Fee includes a ticket to attend Saturday evening’s TNA Awards Gala. You should have received

the ticket with your name badge. Please bring the ticket with you for admittance to the Gala. Space is limited for

this event, but based upon availability, you may purchase guest Gala tickets for $45 each. Please inquire at the TNA

registration desk for additional tickets. The Tennessee Nurses Foundation (TNF) is proud to sponsor meal tickets

for all registered participants of the Tennessee Association of Student Nurses (TASN). If you are a TASN attendee

and have not received your Awards Gala ticket, please check with the TASN registration desk. Please note: TASN

tickets will be of a different color than TNA’s. Please bring your ticket for admittance to the Gala.

TNPAC will feature the second Annual District Basket Challenge and Auction. Baskets will be on display throughout

the conference. The auction will take place at the end of Membership Assembly on Sunday. All proceeds will support

TNPAC efforts in reaching its 2015 fundraising goal. Please take this opportunity to bid high and often.

On Saturday, the Exhibit Hall is open to all attendees in conjunction with the Schools of Nursing Luncheon. Please

visit the exhibitors and sponsors who support your profession through TNA. The lunch is complimentary for those

registered for the entire conference or for Saturday only, but you must have made a reservation. If you made a

reservation, you should have received a luncheon ticket with your name badge. Please bring your ticket with you for

admittance to the Luncheon. Guest Luncheon tickets may be purchased for $30.00 based on availability.

Sunday morning’s Sunrise Service will be held in room Mustang at 7:00 a.m. Gary Crotty and Wilhelmina Davis will

lead the service and Kathy Denton is providing special music.

For General Sessions held in the Membership Assembly meeting room, please gather near the front of the room.

There is no assigned seating for General Sessions, however; for Membership Assembly business sessions it is

important that you sit in the designated area for members and nonmembers of TNA.

Not a TNA member? Join TNA now and receive $25 off your Full rate annual membership dues. Don’t miss

this opportunity! Many members tell us they are where they are today because of the connections they have

made through TNA.

Your input and opinions help TNA improve conferences for future years. Individual session evaluation forms are

included in your Conference folder. When leaving the Conference, please drop off your completed evaluation form

and Attendance Verification/Certificate form (yellow copy) at the registration desk.

Again, welcome to the 2015 TNA Annual Conference!

Registration Hours

Friday: 10:00 a.m. – 6:00 p.m.

Saturday: 7:00 a.m. – 4:30 p.m.

Sunday: 7:30 a.m. – 10:00 a.m.

VOTE on Sunday

Vote Sunday morning between 7:30 – 9:00 a.m. in room

Quarter Horse. Election results will be announced

during the closing of the Membership Assembly.

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Nursing Ethics: Commitment, compassion, quality care

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Nursing Ethics: Commitment, compassion, quality care

Legal and Ethical Dilemmas:

Walking the Line

2015 Presenters

E-T-C-I-H-S: Unscrambling Ethical

Principles for Nursing Practice

Clare Thomson Smith, JD, MSN, RN,

FAANP

Vanderbilt School of Nursing, Nashville

Suzanne Boswell,

PhD, MSN, RN, CCRA

Clinical Team Lead, CNS;

INC Research

Mary Jo Gilmer,

PhD, MBA, RN-BC, FAAN

Professor of Nursing, Vanderbilt

School of Nursing, Nashville

Professor of Pediatrics, Monroe Carell

Jr Children’s Hospital at Vanderbilt

Director, Pediatric Palliative Care

Research Team

Situational Awareness as Applied to

the Nursing Code of Ethics

Teresa (Tese) M. Stephens, PhD, MSN,

RN, CNE

Director of Undergraduate Programs,

East Tennessee State University

College of Nursing, Johnson City

The Ethics of Self Care

Betsy Kennedy, PhD, RN, CNE

Associate Professor of Nursing and

Director of Faculty Development,

Vanderbilt School of Nursing, Nashville

TNF Session

As the World Turns: Global Health

and the Evolving Role of Nurses

Carol Etherington, MSN, RN, FAAN

Associate Professor of Nursing, Emerita;

Vanderbilt Institute for Global Health,

Nashville

Nurses’ Ethical Responsibility to

Work at the Top of Their License

and Advocate for Their Profession

Karen Hande, DNP ANP-BC,

Assistant Professor, Doctor of Nursing

Program, Vanderbilt School of

Nursing, Nashville

Leslie Hopkins,

DNP, APRN-BC, FNP-BC, ANP-BC

Adult Gerontology Primary Care

Nurse Practitioner Program Director,

Assistant Professor of Nursing,

Vanderbilt School of Nursing, Nashville

Jennifer Kim, DNP, GNP-BC, FNAP

Assistant Professor of Nursing,

Adult/Gerontology Primary Care

NP Program, Vanderbilt School of

Nursing, Nashville

Co-Director, Vanderbilt Center for

Gerontological Nursing Excellence

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Nursing Ethics: Commitment, compassion, quality care

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Nursing Ethics: Commitment, compassion, quality care

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Nursing Ethics: Commitment, compassion, quality care

2015 Membership Assembly Rules & Information

Membership Assembly (MA) General Rules of Order

1. All TNA members may speak. Before addressing

the MA, it is necessary to secure the floor by going

to a nearby microphone. After recognition by the

President, the member shall state his or her name

and district before speaking.

2. Any TNA member may make motions.

3. All motions shall be presented to the President in

writing on the forms provided.

4. TNA members shall be limited to three minutes

when speaking.

5. No member who has already had the floor in debate

on the immediate pending question shall be entitled

to the floor a second time until others who wish to

be heard on the question have had an opportunity

to speak.

6. The voting body shall consist of the Board of

Directors, Past Presidents, and TNA members in

attendance.

7. Only the resolves of resolutions/proposals shall be

acted upon by the MA.

8. The President may suspend the Rules in order to

allow a nonmember to speak.

9. All cell phones, pagers and other devices shall be

silenced throughout meetings during MA.

Guidelines for Discussion on Resolutions/Proposals

1. To facilitate discussion, comments will be limited

to three minutes, and no member may speak more

than once to a question if someone who has not

spoken wishes to do so.

2. Individuals who suggest substantial changes in the

wording of any proposal are asked to submit those

changes in writing before the hearing is adjourned.

3. Sponsors or the Reference Committee may perfect

the resolution/proposal for presentation to the MA

after completion of the hearings.

4. The sponsor may withdraw a resolution/proposal at

any point in the review process.

5. Only the resolves of resolutions/proposals shall be

acted upon by the MA.

Continuing Nursing Education (CNE) Credit

RN participants attending CE sessions will be awarded

contact hours. The procedure is as follows:

1. Complete the CNE Evaluation and leave it in the tray

at the registration desk before you leave.

2. Complete an Attendance Verification of CNE Activity

listing the sessions you attend. Participants must

attend an entire CNE session to receive credit.

3. Detach the yellow copy of the Attendance

Verification form and leave it in the tray at the

registration desk.

4. Retain the white copy for your professional

portfolio.

Registration

Friday: 10:00 a.m. - 6:00 p.m.

Saturday: 7:00 a.m. - 4:30 p.m.

Sunday: 7:30 a.m. - 10:00 a.m.

Conference Badges

All meetings of the conference are open to registered

participants. Exclusive of invited guests, attendance

at any meeting other than the Awards Gala, Welcome

Reception or School of Nurses Luncheon requires the

payment of at least one day’s registration.

The Tennessee Nurses Association appreciates those

who helped develop this event, especially the TNA

Committee on Education members:

Michele Arns

Shirley Brown

Mary Bess Griffith

Karen Hande

Tommie Norris

Tese Stephens

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Nursing Ethics: Commitment, compassion, quality care

Disclosures to Participants

Purpose

Participants will gain a deeper understanding of nursing’s code of ethics and how it shapes practice and the profession.

Objectives

• Discuss how ethical principles impact professional and personal issues.

• Identify best practices in patient care and nursing education.

Contact Hour Credit

Participants at the 2015 TNA & TASN Joint Conference can earn a maximum of 6.0 contact hours for attending.

Official Accreditation Statement

The Tennessee Nurses Association is accredited as a provider of continuing nursing education by the American

Nurses Credentialing Center’s Commission on Accreditation.

Requirements for Successful Completion for Continuing Education Credit

To receive contact hour credit for each session attended, attendees must

• Be seated in the session room no later than five minutes after it has started.

• Remain in the session until the scheduled ending time.

• Complete and submit the Evaluation Form(s) and the Verification of Attendance/Certificate Form listing each

session attended. Turn in the yellow copy before you leave the conference.

Conflicts of Interest

The ANCC has established guidelines whereby all speakers must disclose any affiliations which may cause a conflict

of interest.

A Conflict of Interest occurs when an individual has an opportunity to affect educational content about health-care

products or services of a commercial interest with which she/he has a financial relationship.

No conflicts of interest were disclosed.

Sponsorship

Sponsors have made contributions to Tennessee Nurses Association in support of the 2015 TNA & TASN Joint

Conference: See handout included in the conference packet for a final list.

Non-Endorsement of Products

The Tennessee Nurses Association’s accredited provider status refers only to continuing nursing education activities

and does not imply that there is real or implied endorsement of any product, service, or company referred to in this

activity nor of any company subsidizing costs related to the activity.

Off-label Product Use

This CNE activity does not include any unannounced information about off-label use of a product for a purpose other

than that for which it was approved by the Food and Drug Administration (FDA).

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Nursing Ethics: Commitment, compassion, quality care

Introduction to Robert’s Rules of Order

What Is Parliamentary Procedure?

It is a set of rules for conduct at meetings that allows everyone to be heard and to make decisions without

confusion.

Why is Parliamentary Procedure Important?

Because it’s a time tested method of conducting business at meetings and public gatherings. It can be adapted

to fit the needs of any organization. Today, Robert’s Rules of Order newly revised is the basic handbook of

operation for most clubs, organizations and other groups. So it’s important that everyone know these basic

rules!

Organizations using parliamentary procedure usually follow a fixed order of business. Below is a typical

example:

1. Call to order.

2. Roll call of members present.

3. Reading of minutes of last meeting.

4. Officers reports.

5. Committee reports.

6. Special orders—Important business previously designated for consideration at this meeting.

7. Unfinished business.

8. New business.

9. Announcements.

10. Adjournment.

The method used by members to express themselves is in the form of moving motions. A motion is a proposal that

the entire membership take action or a stand on an issue. Individual members can:

1. Call to order.

2. Second motions.

3. Debate motions.

4. Vote on motions.

There are four Basic Types of Motions:

1. Main Motions: The purpose of a main motion is to introduce items to the membership for their

consideration. They cannot be made when any other motion is on the floor, and yield to privileged,

subsidiary, and incidental motions.

2. Subsidiary Motions: Their purpose is to change or affect how a main motion is handled, and is voted on

before a main motion.

3. Privileged Motions: Their purpose is to bring up items that are urgent about special or important matters

unrelated to pending business.

4. Incidental Motions: Their purpose is to provide a means of questioning procedure concerning other motions

and must be considered before the other motion.

How are Motions Presented?

1. Obtaining the floor

a. Wait until the last speaker has finished.

b. Rise and address the Chairman by saying, “Mr. /Madam Chairman, or Mr. /Madam President.”

c. Wait until the Chairman recognizes you.

2. Make Your Motion

a. Speak in a clear and concise manner.

b. Always state a motion affirmatively. Say, “I move that we ...” rather than, “I move that we do not ....”.

c. Avoid personalities and stay on your subject.

3. Wait for Someone to Second Your Motion

4. Another member will second your motion or the Chairman will call for a second.

5. If there is no second to your motion it is lost.

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Nursing Ethics: Commitment, compassion, quality care

6. The Chairman States Your Motion

a. The Chairman will say, “it has been moved and seconded that we ...” Thus placing your motion before

the membership for consideration and action.

b. The membership then either debates your motion, or may move directly to a vote.

c. Once your motion is presented to the membership by the chairman it becomes “assembly property,”

and cannot be changed by you without the consent of the members.

7. Expanding on Your Motion

a. The time for you to speak in favor of your motion is at this point in time, rather than at the time you

present it.

b. The mover is always allowed to speak first.

c. All comments and debate must be directed to the chairman.

d. Keep to the time limit for speaking that has been established.

e. The mover may speak again only after other speakers are finished, unless called upon by the

Chairman.

8. Putting the Question to the Membership

a. The Chairman asks, “Are you ready to vote on the question?”

b. If there is no more discussion, a vote is taken.

c. On a motion to move the previous question may be adapted.

Voting on a Motion:

The method of vote on any motion depends on the situation and the by-laws of policy of your organization. There

are five methods used to vote by most organizations, they are:

1. By Voice—The Chairman asks those in favor to say, “aye,” those opposed to say “no.” Any member may

move for an exact count.

2. By Roll Call—Each member answers “yes” or “no” as his name is called. This method is used when a record

of each person’s vote is required.

3. By General Consent—When a motion is not likely to be opposed, the Chairman says, “if there is no

objection ...” The membership shows agreement by their silence, however if one member says, “I object,”

the item must be put to a vote.

4. By Division—This is a slight verification of a voice vote. It does not require a count unless the chairman so

desires. Members raise their hands or stand.

5. By Ballot —Members write their vote on a slip of paper; this method is used when secrecy is desired.

There are two other motions that are commonly used that relate to voting.

1. Motion to Table—This motion is often used in the attempt to “kill” a motion. The option is always present,

however, to “take from the table,” for reconsideration by the membership.

2. Motion to Postpone Indefinitely—This is often used as a means of parliamentary strategy and allows

opponents of motion to test their strength without an actual vote being taken. Also, debate is once again

open on the main motion.

Parliamentary Procedure is the best way to get things done at your meetings. But, it will only work if you use

it properly.

1. Allow motions that are in order.

2. Have members obtain the floor properly.

3. Speak clearly and concisely.

4. Obey the rules of debate.

Most importantly, BE COURTEOUS.

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Nursing Ethics: Commitment, compassion, quality care

Proposed 2015-2017 Legislative and Health Policy Statements

Introduction: The Tennessee Nurses Association (TNA) is the professional association representing Tennessee’s

approximately 100,000 registered nurses. This position paper outlines the basic philosophy of the TNA’s

Membership Assembly relative to health care policy which may be addressed by the Tennessee General Assembly

and the U.S. Congress.

Mission: To improve health and health care for all Tennesseans and residents of the state, advance nurse

leaders and the practice of nursing as essential to improvement efforts and transformational change, and

serve as the voice for professional nurses.

The American Nurses Association’s Code of Ethics outlines foundational provisions that frame TNA’s initiatives and

actions.

Vision: TNA supports a transformed health care delivery system that ensures that all Tennesseans and residents

of the state are able to access equitable and affordable essential services when and where they need them. The

transformed system envisioned by TNA is patient-centered, promotes inter-professional collaboration and care

coordination to improve patient outcomes and experiences, primary care and prevention are priorities, value is

emphasized, and there is expanded use of information technology to promote efficiency and effectiveness.

Goals: To realize the vision of a transformed health care delivery system, TNA is committed to ensuring that nurses

can practice to the full extent of their education, training, and experiences for the purpose of improving health and

health care. Therefore, TNA is supportive of initiatives that advance the following goals:

Optimal health system performance, including:

Improved patient care experiences;

Improved population health; and

Reduced per capita cost for health care.

Access to high-quality, affordable and acceptable care for all Tennesseans and residents of the state,

including:

Provision of a standardized package of essential health care services provided and financed by public and private

plans with protection against catastrophic costs and impoverishment; and

Direct access to a full range of professional registered nurses and other qualified providers in a variety of settings

Full practice authority and enhanced participation in the delivery of care and policymaking for all professional

nurses, including:

Support for the Tennessee Board of Nursing as the sole regulatory authority over nursing education and practice;

Adoption of the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education

(2008);

Elimination of financial, regulatory, organizational, and institutional barriers to the practice of professional nursing;

Participation of registered nurses on all local, state, and national health care advisory, policymaking, and

governing boards, committees, and task forces; and

Inclusion of APRNs as licensed independent providers (LIPs) in hospital licensure rules, health plans, and health

care facilities.

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Nursing Ethics: Commitment, compassion, quality care

Assuring an adequate, competent, and diverse nursing workforce to meet current and projected health care

demands, including:

Improved data collection and information infrastructure to inform policymaking, planning, and evaluation;

Promotion of higher levels of education and training through seamless academic progression, inter-professional

education of health professionals, and lifelong learning;

Funding for nursing students and faculty, including loan forgiveness programs; and

Support for nurse safety in the patient care environment, staffing effectiveness plans, whistleblower protection,

and bans on mandatory overtime.

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Nursing Ethics: Commitment, compassion, quality care

2015 TNA Board of Directors and Staff

Billie Sills

MSN, RN, CLNC

President,

Johnson City

Sandy Murabito

MSN, Ed.D, RN

President-Elect

Nashville

Haley Vance

DNP, APN, PNP-

AC

Vice President

Nashville

Julie Hamm

MSN, ACNP-BC

Secretary

Fairview

Mary Bess

Griffith

MSN, RN, CS,

FNP

Treasurer

Union City

Amy Hamlin

Ph.D, MSN, APN,

FNP-BC

Director -

Operations

Ashland City

Deb Chyka

DNP, RN

Director -

Membership

Knoxville

Michele Arns

DNP, FNP-BC

Director -

Education

Sneedville

Sharon Davis

DNP, APRN,

WHNP-BC

Director –

Government

Affairs

Powell

Chaundel Presley

DNP, FNP-BC

Director -

Practice

Lafayette

Connie McCarter

MSN,RN-

BC,CNRN

Representative

– Presidents

Council

Lakeland

TNA Staff

Sharon A. Adkins

MSN, RN

Executive

Director

Barbara Harrell

Executive

Assistant

Wilhelmina Davis

Manager of

Government

Affairs/Lobbyist

Kathy Denton

Manager of

Marketing,

Member

Services/IT

Managing Editor-

Tennessee Nurse

Tracy Depp

Communications

Administrator

Susan Seager

Ed.D, RN,

Education

Administrator

& Nurse Peer

Review Leader

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Nursing Ethics: Commitment, compassion, quality care

Tennessee Nurses Association

2015 Slate of Candidates and Statements

ANA Membership Assembly Representative – vote for one (1)

Carole R. Myers, PhD, RN

District 2

Townsend

Associate Professor

University of Tennessee at Knoxville

Knoxville

American Nurses Association (ANA) Membership Assembly Representative 2013-2015

ANA Delegate 2008-2009, 2010-2011, 2012-2013

Chair of Tennessee Nurses Association (TNA) GOVA committee 2010-present; member 2008-2010

Chair TNPAC 1985-1988, 2007-2010

Nursing Lead and Secretary/Treasurer Tennessee Action Coalition

Fellow American Nurses Advocacy Institute (2011-2012)

Coordinator Graduate Certificate in Health Policy program at the University of Tennessee (UT)

Associate Professor UT: primary teaching responsibilities and research focus include health policy and services; have

joint appointment with Department of Public Health

American Association of Nurse Practitioners (AANP)-Advocate State Award for Excellence (2011)

Stephanie Nikbakht, DNP, PPCNP-BC

District 1

Cordova

APN, Assistant Professor Advanced Practice and Doctoral Studies

University of Tennessee Health Science Center Memphis

Throughout the past 25 years as a nurse, I have listened as ANA active colleagues and professors persuaded,

cajoled and begged nurses to join TNA/ANA and get involved. Politely, I listened and was confident that though I was

too busy, there were plenty of other nurse leaders to handle the issues surrounding our profession. However, while

completing my DNP coursework, certain faculty and course assignments, stimulated my interest in nursing policy

and legislation. I finally realized, without a doubt, that if nurses didn’t speak for themselves, others would do it for us.

Slowly, I have become involved by volunteering on the TNA continuing education committee and am also a volunteer

CCNE evaluator. As a soon-to-be faculty member, I will have the flexibility to become more involved and contribute

to the future of nursing for the next generation.

Ann Schide, MSN, MS, PLNC, BSC, RN

District 4

Ooltewah

Associate Professor

Chattanooga State Community College

Chattanooga

I never wanted an MSN, but had to earn one in order to maintain my status at Chattanooga State, which required

such as I held only a BSN and a specialty the Program needed to be represented. That was 15 years ago! When

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Nursing Ethics: Commitment, compassion, quality care

I graduated with my MSN in 2004, I was proud to be a registered nurse, and more so, an RN with an advanced

degree. The MSN I did not want assisted in renewing my sense of fellowship and experiences. I could claim that

wisdom that comes with age was the turning point from being just a nurse to being A NURSE! However, I was not

at a wise age yet. Currently, I do all that I can to promote the profession of nursing and its need to update past

practices and policies. I wish to extend my current activities with future healthcare professionals to a pursuit in which

I can make a difference in my profession. Qualifications: Service in the U. S. Nurse Corps (1972-1978). I was crosstrained

in all obstetric areas on my first civilian job (1978-1980), an innovative idea back then. Served as a leader in

community education in women’s health and obstetrics in Pensacola, FL and Chattanooga while providing the areas’

only 24/7/365 lactation consultant. These leadership opportunities grew into recruitment to Chattanooga in 1996 to

assist in building and opening the city’s first freestanding women’s hospital (Women’s East Pavilion, now Erlanger

East) while bridging two “parents” who oppose each other in the healthcare market. In 2000, I took a crossroads

opportunity to join academia and never looked back. Currently, I am in pursuit of my Doctorate in Nursing Practice

(DNP). Skills: Microsoft Word, Excel, PowerPoint, and Publisher.

Donna Copenhaver, EdD, MSN, RN

District 15

Eagleville

Assistant Professor of Nursing

Belmont University

Nashville

Secretary – vote for one (1)

Thank you in advance for considering my candidacy for Secretary of the TNA. I am a recent member of the TNA, but

have participated in TNA events and shared their valuable work with the BSN students at Belmont University over

the last 8 years. I am currently working as Assistant Professor of Nursing at Belmont University, and am lead faculty

for Leadership & Management and also teach Evidence Based Practice.

It is imperative that our young professionals learn about the work of the TNA, and become actively involved early in

their professional career. As Secretary of the TNA, I believe I can relate the work and challenges of legislation and

nursing’s scope of practice with our students.

My leadership experience in large organizations includes Past President and Treasurer of Omicron Phi chapter of

Sigma Theta Tau, Certified Instructor Trainer for Facilitative Leadership in Healthcare Organizations, and Coordinator

of the RN/BSN program at Belmont University.

As a licensed Registered Nurse of forty-one years, I remain passionate and enthusiastic about nursing and it’s

impact in healthcare care legislation and ethics. Thank you in advance for considering my request to serve as

Secretary of the Tennessee Nurse’s Association.

Rose Vick, RN, MSN, PMHNP-BC

District 3

Nashville

Faculty

Vanderbilt University School of Nursing

Nashville

I completed my MSN in the Psychiatric Mental Health Nurse Practitioner specialty at Vanderbilt University School of

Nursing in 2007. Following graduation I joined a large cancer center in Louisville, KY to provide psychiatric services

to cancer patients and their families. I returned to Nashville in 2012 to join the faculty at VUSN, and am passionate

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Nursing Ethics: Commitment, compassion, quality care

about educating nurses and advocating for our profession. I’m also working on my PhD in Nursing at the University

of Arizona and look forward to contributing to the field through scholarship. My doctoral studies have contributed to

my interests in policy, advocacy and service. I’m grateful for the support and advocacy that TNA provides and would

like to give back in a service role that utilizes my communication and organizational skills. I would be honored to

serve as secretary for TNA, and look forward to working with each of you to strengthen the voice and influence of TN

nurses as we continue our journey into a changing landscape.

Nominating Committee – vote for three (3)

Karen Hande, DNP, ANP-BC

District 3

Hendersonville

Assistant Professor

Vanderbilt University School of Nursing

Nashville

Hello Fellow TNA Members! It would be my honor to serve as your Nominating Committee Member. I am an adult

nurse practitioner and an assistant professor at Vanderbilt School of Nursing. I have been a dedicated member of

TNA for two years and of ANA since 2004. Originally an oncology nurse and a primary care ANP in MA, CT, and now

TN, I have 16 years of experience dedicated to the profession of nursing. As a member of TNA for two years and

of ANA since 2004, I am keen on the priorities of nursing in our state and nationally. My active role in advocating

for APRN Full Practice Authority, meeting with legislators, and developing forums for nurses to communicate with

key Health Committee Senate and House members speaks to my commitment to advancing the outstanding care

nurses provide to patients in our state. I also have the pleasure of serving on Vanderbilt’s DNP Student Academic

Affairs committee and the DNP Curriculum Committee. My professional roles take priority to serve my colleagues

and school. It would be my privilege to be your Nominating Committee Member to report and be accountable to the

Membership Assembly and the Board of Directors. With stellar organizational skills, I would like to contact any TNA

members that wish to fun for an office. I can skillfully prepare a slate of nominations and elections as established by

the Board of Directors. Thank you for your consideration to allow me to serve you and our TNA fellow members.

Joshua (Josh) Picquet, BSN, RN, CPN

District 2

Knoxville

Nursing Professional Development Specialist – Decentralized

East Tennessee Children’s Hospital (ETCH)

Knoxville, TN

I have been a Nursing Professional Development Specialist (NPDS) for the past three years (formerly known as staff

educator and/or clinical leader) at the unit level for East Tennessee Children’s Hospital. Prior to serving in this role,

I worked as a staff nurse for perioperative services and a clinical manager for pediatric gastroenterology at ETCH.

I have a wide-range of skills after experiencing these different roles as a nurse. Since joining the ANA and TNA

in early 2010, I have been active both at the local and national levels. I am currently chairman of the nominating

committee for District 2. I recently developed and organized a formal survey for our local member list. I plan to have

my certification in Nursing Professional Development by 6/30/15. I have fresh eyes and stay enthusiastic about the

future.

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Nursing Ethics: Commitment, compassion, quality care

Poster Presentation Abstracts

An Action Plan to Improve Communication Between Staff Nurses and Managers

Pamela F. Cherry, DNP-c, RN, CNE

The leadership team in a long-term acute care facility identified that the staff nurses were dissatisfied in communication with their

managers. The problem was identified through a bi-annual employee opinion survey (EOS). The poster presenter proposed the

creation of an action plan by a task force of staff nurses to improve communication with managers. Rosswurm and Larrabee’s

Model for Evidence-Based Practice provided the framework for the project. The task force interviewed their peers using two

questions from the EOS that specifically addressed satisfaction with communication. Based upon findings from the interviews,

the task force members developed an action plan to improve communication between staff nurses and the leadership team.

Strategies in the action plan included monthly staff meetings, quarterly town hall meetings, placement of a suggestion box,

a quiet zone during early morning medication administration, and creation of an inter disciplinary unit shared governance

committee. The leadership team accepted the entire plan and agreed to implement it. Three months after implementation, the

leadership team reassessed the staff nurses using two communication-focused questions from the EOS to determine the impact

of the action plan on communication. Upon completion of the poster presentation, the participants will be able to discuss the use

of Rosswurm and Larrabee’s Model for Evidence-Based Practice to address a non-clinical problem. The project found that the

model can be used successfully to address a non-clinical problem and recommendations include further use of it in additional

non-clinical problems.

Key words: nurse satisfaction, communication, task force, Rosswurm and Larrabbee

Advocating for Staff Nurses: An Innovative Approach for Orientation on Dedicated Education Units

Phillip J. Moore, MSN, RN, FNP-BC

Laurie Acred-Natelson, MSN, RN, NEA, BC

Allie Brown, MSN, RN

Deb Chyka, DNP, MSN, RN

Success with the Dedicated Education Unit (DEU) clinical teaching model is dependent on staff nurses being properly equipped

with tools to promote student learning. Ethics systematizes right and wrong actions. To this end it is ethical for nurse educators to

provide staff nurses with the right tools to work successfully with students while providing quality patient care. In congruence with

ethics in practice, an enhanced orientation process provides guidance through a learning module for staff nurses.

Previously, the DEU staff orientation consisted of face-to-face instruction; yet the current environment warrants a commitment to

provide innovative, cost effective approaches to preparing staff nurses for their role with students. The new learning module for

the DEU staff is made available in hardcopy and/or an electronic format depending on the preference of the clinical partner. Use

of this new process fosters efficient professional development of the staff nurse and minimizes time away from patient care.

Through the use of a visual display and short oral presentation, conference attendees will be introduced to this new process that

has been designed for orienting staff nurses who work on DEU’s. At the completion of this presentation, attendees will be able to;

identify driving forces for product development, describe the new orientation and list ways this product may be adapted for use in

their academic and clinical settings.

AEDS: Where Are They?

Takeitha Chambers, MSN, RN

Kristin Bramlett, BSN, RN

Shanley Brasher, BSN, RN

Paul Flouch, BSN, RN

Katelyn McCormick, BSN, RN

Lindsay Pace, RN

Objectives: The learner will:

• Recognize symptoms of sudden cardiac arrest in non-patient care settings

• Demonstrate appropriate use of the AED in non-patient care settings

Problem Statement: Sudden cardiac arrest affects almost 6,000,000 people in one year. Less than 5% of these people will survive.

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Nursing Ethics: Commitment, compassion, quality care

Purpose: The purpose of this study is to determine if the accessibility and use of AEDS in non-clinical settings within a hospital

improve non-patient outcomes during sudden cardiac arrest.

Method: The study includes review of hospital policies for providing life-saving interventions in non-patient care settings. A

mock code is performed in a non-patient care setting to evaluate staff responsiveness. Also, employee surveys are completed to

evaluate their knowledge of responsibilities during an emergency situation in a non-patient setting.

Findings: Several findings are identified based on the study results. First, the policy is unclear regarding response steps for nonpatient

emergencies. Second, staff is unsure of how to properly use emergency equipment.

Recommendations: Based on the findings of this study, several recommendations have been made. Nursing staff need

additional training on proper use of the AED. Also, non-clinical staff needs to take a basic Heart Savers Course. Finally, it is

recommended that AEDS be installed in non-patient care areas.

APRN Transformational Leadership: Implementation of Advanced Practice Nursing Leadership

Structure within an Academic Medical Center

April Kapu, DNP, APRN, ACNP-BC

Pam Jones, DNP, RN, NEA-BC

To meet the health care drivers of cost-effective, high quality and safe patient care, there has been a rapid growth in the number

of APRNS across multiple clinical settings. More and more APRNs are rising to executive leadership levels, leading APRNs in both

professional and operational practice. Bridging from clinical expert to expert organizational leader can be challenging without role

development, mentorship and structural empowerment.

In 2008, nursing executive leadership of an academic healthcare system recognized the need for specific leadership for APRNs

deployed across multiple settings. Over a 6 year period, APRN clinical experts were placed in leadership roles across the

organization. The leaders were provided education, training and in some cases supportive funding for higher education, beyond

the masters level. The organizational structure that evolved included direct linkage for the APRN leader to the responsible senior

nursing leader and to a centralized office of advance practice for professional practice support. The APRN leadership structure

mirrored the nursing leadership structure and emphasized a collaborative model of APRN, nursing and physician leaders. In 2015,

a detailed analysis was conducted of APRN specific processes, leadership skill, evolvement of the leadership structure, growth of

the APRN programs, APRN perceptions of structural empowerment and APRN associated clinical outcomes.

Breastfeeding as a Protective Factor Against Childhood Obesity

Dereldia Clendening

Ally Johnson

Problem: The prevalence of childhood obesity is increasing in the U.S. and globally. Childhood obesity causes numerous lifethreatening

co-morbid conditions, which is why it is a major area of concern.

Objective: We sought to evaluate original data in order to determine if breastfeeding was protective against childhood obesity.

Methods: The research database CINAHL Complete assisted in determining accurate articles for this specific review of literature.

CINAHL Complete was chosen due to specific correlations with nursing and health journals, as well as its distinguished efforts of

yielding complete full texts from academic journals. Chosen keywords deemed necessary to enter into CINAHL Complete were

“obesity and breastfeeding”, “infant feeding and obesity”, and “exclusive breastfeeding and obesity”. Limitations included in

the results category were only full texts from the years of 2007 to 2015. Only current research articles were used in the literature

review.

Findings: After synthesizing articles on the topic of breastfeeding and a child’s risk for obesity we know that obesity is a

multifaceted disease. Therefore, breastfeeding in infancy cannot be solely linked to protection against obesity. However, there is

evidence that breast-feeding has protective agents against many of the causative factors of obesity.

Recommendations: It is recommended that more research is conducted to study the breakdown of nutritional elements in

formula and breast milk. There is a correlation between early nutrition and obesity but more insight as to which types of foods

parents should feed their infants in order to protect against future obesity is needed.

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Nursing Ethics: Commitment, compassion, quality care

Can It Get Any Worse

Robert E. Spencer, MSN, JD, RN, FNP-BC

Sherrie Spencer, MSQA, BSN, RN

Healthcare providers must be able to understand and manage a complex environment. This simulation explores the preparedness

of students to make critical thinking decisions, extrapolate existing knowledge and formulate a new plan of care based on existing

elements. Variations of existing scenarios allow for utilization of a wide variety of student experiences with each team experience

a different outcome. The poster presentation will be converted from PowerPoint slides with monitor and simulation lab views.

Participants will be asked to engage in discussion concerning scenarios and acuity decisions.

Cardiovascular Disease Promoting Resolution of Disparities

Ashley York, MSN, AGNP-C, WHNP-BC

There are six national priority areas of focus for disparities in the United States according to the National Healthcare Disparities

Report, 2011. This poster focuses on the disparity of promoting effective prevention and treatment of leading causes of mortality

starting with cardiovascular disease. Tennessee is eighth out of the 50 states in heart disease related deaths with West Tennessee

having higher rates of hypertension and strokes. Jackson Tennessee has lower median household income, 16.5% under age 65

in 2012 without health insurance, and 23.7% people are below poverty level. These risk factors seem to correlate with worse

health outcomes. Certain quality measures are tracked by the NHQR associated with cardiovascular disease to help in preventing

and treating cardiovascular disease. Since tracking was initiated inpatients deaths from heart attack has decreased, along with

congestive heart failure admission rates. There are many health awareness programs and legislation to help support prevention

and promotion at the local, state and national level. The Institute of Medicine recommends a multi-level strategy to eliminate

health disparities including implementing patient education fitness programs that are free to the community. This poster is for

awareness of nursing students, nurses and midlevel providers.

Challenges Facing Nursing Education in the 21st Century Rapidly Changing Health Care Environment

Delphine Asonfack Burdick, MSN, RN

Problem: Given the rapidity of changes in the healthcare environment today, nursing education is facing increasing challenges on

bridging the gap between new graduates and practicing nurses. Current research is addressing the need for a redesigned nursing

curriculum as outlined by Patricia Benner and the Institute of Medicine’s report on The Future of Nursing: Leading Change,

Advancing Health, and A Call for Radical Transformation (Benner, Sutphen, Leonard, and Day, 2010).

Objectives: Innovations in nursing education are working towards proving students with deeper learning skills such as:

empowering students with clinical critical thinking skills that enhance their ability to offer high quality care to patients with

higher acuity levels in all healthcare settings, improve cultural diversity proficiency, effective problem-solving abilities, efficient

information technology skills, promoting teamwork and demonstrating competency in collaborating with interdisciplinary

healthcare professionals (Prsybyl, H., Androvich, I., & Evans, J., 2015)

Method: A mixed qualitative and quantitative data collection method. Qualitative data collected from clinical performance surveys

and quantitative data from test scores after incorporating advanced simulations into the curriculum to enhance student’s reflective

skills, clinical judgment, decision making and application of concepts.

Recommendations: 1. Identify presently recommended nursing competencies to guide students’ learning objectives. 2. Integrate

innovative teaching methodology such as advanced simulation using High and Mid-Fidelity simulators into the nursing curriculum

from fundamental courses. 3. Develop training programs for nursing educators designed to address this need.

My poster will be accompanied with PowerPoint presentation. Participants could take notes and ask questions.

Difference in Rate of Preterm Deliveries Among Women with Short Cervix: Observation vs. Inpatient

Linda Billings, DNP, RN

The purpose of this poster presentation is to determine if there is a difference in the rate of preterm deliveries among women with

short cervix, who are admitted for observation (24-48 hours, then sent home on bed rest) and women with short cervix who are

admitted to inpatient status greater than 48 hours. According to the Centers of Disease Control and Prevention, in 2009 preterm

births accounted for 35% of all infant deaths (centers for Disease and Prevention, CDC, 2014). A short cervix places the mother

at risk for a preterm delivery. This is a 5 year retrospective chart review of 66 charts in which pregnant women were admitted to

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Nursing Ethics: Commitment, compassion, quality care

a level 3 obstetrical care unit in Memphis, Tennessee with a diagnosis of a short cervix and delivered less than or equal to 37.6

weeks gestation. Twenty-six were originally admitted as outpatient while 40 were admitted as inpatient. A simple T-test was

performed on those 66 charts. Results were inconclusive indicating the need for further research.

Fast Sepsis – Improving and Management of Severe Sepsis

Patricia Poole, DNPc, MSN, ACNP-C, APRN-BC, CCRN

There are more than 750,000 occurrences of sepsis annually in the US with mortality rate 30-40% for severe sepsis and 50-60%

for septic shock. Septic rates are expected to increase potentially reaching over one million by 2020. In the US a half million

septic patient are evaluated annually in the Emergency Department (ED).

Sepsis is a complex disease with numerous recommended guidelines and bundle treatment regimes. Despite evidence

supporting early goal directed therapy (EGDT), identifying sepsis remains problematic. Efforts must focus on early recognition and

identification of sepsis so aggressive intervention of EGDT can be implemented to decrease patient morbidity and mortality.

The purpose of this pilot project is to develop a rapid nurse-driven sepsis identification and treatment protocol originating in the

ED leading to timely transfer to the critical care unit to meet three and six hour EGDT guidelines. Nursing staff will be educated to

assess, identify, and discern potential pathological disease states. A pretest will assess knowledge of sepsis states followed by a

PowerPoint presentation to include updated sepsis guidelines and the fast sepsis protocol with post testing. The ED nursing and

medical staff will collaboratively identify potential sepsis patients >18 years of age using a sepsis checklist. As potential sepsis

patients are identified, the fast sepsis protocol will be used for prompt intervention with appropriate diagnostic data, intravenous

fluid bolus, and notification of the intensivist team for a fast sepsis protocol admission with urgent transfer to critical care for

further review for EGDT interventions.

Informatics: The Missing Link in Nursing Curriculum

Kathy Putman, MSN, RN

Problem Addressed:

Students enter nursing programs with some knowledge of electronic technology. But often, they do not realize their knowledge

is limited. Additionally, they do not understand that there is more to nursing informatics, than being a nurse who operates a

computer. Therefore, nursing students need a comprehensive introduction to informatics in the healthcare setting.

Objective: To demonstrate how one accelerated BSN program integrated nursing informatics into its curriculum.

Methods: Based on a literature review, the instructor preferred a Hybrid course that did not require a text book, but instead took

advantage of the numerous journals that address nursing information technology.

The TIGER initiative, the ANA standards on informatics were reviewed along with the Quality and Safety Education for Nurses

(QSEN) competencies.

Module I: Information literacy: self-assessment and plan of improvement; introduction and background to nursing informatics,

driving forces. Discussion Board.

Module II: Research: evidence-based practice, data, quality improvement, data bases. Discussion Board

Module III: Administration: teamwork and collaboration: clinical information systems, quality improvement. Discussion Board.

Module IV: Clinical: documentation, patient centered care, safety, quality improvement, point of care technology, electronic

health record, bar coding, electronic security. Discussion Board.

Module V: Education patient centered care, safety, simulation connection, quality improvement.

Outcome:

Students wrote in their weekly discussion board how the course introduced them to new ideas in regards to the subject of

informatics. In the evaluation of the course responding students voiced a new view of information technology.

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Nursing Ethics: Commitment, compassion, quality care

It’s a Little Scar: A Phenomenological Study of Nurses’ Responses Following Direct Involvement in a

Nursing Error

Sheila H. Swift, PhD, RN

Background: Medical errors pose a significant problem in healthcare, and there is sufficient evidence indicating that nurses

involved in a nursing error are emotionally impacted. The patient is the obvious first victim of an error, but the adverse event can

be a traumatic experience for the nurse as well, establishing him or her as a second victim from the same error.

Objective: The purpose of this phenomenological study was to describe the lived experience of nurses as a second victim

following involvement in an unanticipated nursing error.

Methods: A purposeful networking approach was used to recruit participants. In-depth, unstructured interviews were conducted

with 12 currently practicing registered nurses willing to be interviewed about their personal involvement in an unanticipated

nursing error, with or without patient injury. Data analysis included analyzing all transcripts for meaning units and global themes to

develop the overall thematic structure.

Findings: An encompassing central theme of “it’s a little scar” was woven throughout the interviews. Four figural themes

manifested within this central theme: (1) “That was a traumatic experience”; (2) “My god, am I still competent?”; (3) “They did not

treat me bad” – “I am being thrown under the bus”; and (4) “I still think about it.”

Discussion: Regardless of the type of error, the years of experience, the number of years passed since the error, or the type of

patient care unit, participant responses were similar. Findings support that nurses at all experience levels endure internal turmoil

following involvement in a nursing error. Knowledge gained from this study has relevance to nursing education, practice, and

health policy.

The Journey Toward One Medication List

Gwen Holder, MSN, RN-BC

Kelly Cummingham Sponsler, MD, SFHM

Scott Nelson, PharmD, MS

Medication reconciliation is considered best practice and necessary to meet Meaningful Use and National Patient Safety Goal

standards; however, collecting a complete and accurate home medication list is complicated. Differing clinician workflows and

information needs result in multiple, often discrepant medication lists, leading to potential medication errors and/or patient harm.

This poster will describe our two-year journey integrating various tools and lists into a single medication list tool (MLT) used

in outpatient and inpatient settings by nurses, providers, and pharmacists. We will focus on the training and implementation

processes, and highlight lessons learned in the process. Pre- and post-implementation satisfaction surveys showed that inpatient

nurses were satisfied with the new tool. Provider responses to embedding MLT into their workflow (through H&P and reminders

during admission ordering and discharge medication reconciliation) have been either positive (“now I can see the med list from the

nurse”) or neutral.

Despite the initial positive response to MLT from clinicians, there were challenges with adoption. We employed several strategies

to increase adoption, including:

1) Embedding completion indicators on inpatient whiteboards and in electronic forms

2) Granting clinical pharmacists the ability to update MLT

3) Targeting re-education for low performing services

4) Adjusting MLT design to improve user-interface and workflow

Current adherence with the tool is 68.1 %, with many providers and nurses still using other methods to document outpatient

medication lists. We will discuss our journey towards medication reconciliation for every patient at every encounter through

continued enhancements to the tool and integration with user workflows.

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Nursing Ethics: Commitment, compassion, quality care

National Level System Evaluation of Antithrombotic Treatment in Long-Term Care

Jenny Mullen, DNP(c), MSN, FNP

The proposed project will perform a system evaluation on the quality improvement (QI) change project that was conducted by

health care clinicians at a long-term care organization. The QI team objectives were to meet the national policy requirements of:

evidence-based practice (EBP) informatic patient education regarding oral antithrombotic options and risks, and shared-decisions

(SD). The goals of the author’s system evaluation are to: (a) examine whether EBP education and SD met standards at national

levels; and (b) calculate the conversion and correlation with lab monitoring and costs to alternative therapy, which may suggest

a choice was made. After a minimum of 90-days post-QI project, the author will use the Agency for Healthcare Research and

Quality (AHRQ) Evaluation Tool to examine concrete measurable data within the four parameters of Bielecki & Stocki’s (2010)

Systems Theory. This evaluation will determine whether national requirements were met and are being maintained. The project

aims to endorse SD in accordance with: 2010 Patient Protection Affordable Care Act (ACA), Title III Section 3506; the National

Quality Forum Meaningful Use (MU) Incentive Program, Stage One measure 5; and the 2014 National Action Plan for Adverse

Drug Event Prevention (ADEP) regarding patient and family-partners engagement with EBP education and SD. AHRQ (2015)

posited that patients’ satisfaction with SD has improved health outcomes, which in turn increased possibilities of lowering costs.

Alignment with ACA, MU, and ADEP national policies contributes to system performance improvement, and meets qualifications

for establishments seeking recognition as Patient-Centered Medical Homes or Accountable Care Organizations.

*Projected data analysis and results late August/early September of 2015. Poster will be updated with results.

A Nurse Practitioner-Led Heart Failure Education Program for Certified Nursing Assistants in a

Long-Term Care Facility

Jennifer Kim, DNP, GNP-BC, FNAP

Background: Twenty-five percent of all patients with HF who are admitted to long term care (LTC) facilities are readmitted to the

hospital within thirty days. In this clinical project, HF was the facility’s most common admission diagnosis and the most common

diagnosis prompting hospital transfers.

Aim: The purpose of this project was to develop and implement a HF educational program for CNAs working in a LTC facility and

to measure its effect on CNAs’ recognition of HF symptoms and reporting of HF symptoms to supervisory nurses.

Methods: Methods used in this project included: 1) a review of the best available evidence of HF and CNA educational programs

and 2) implementation of nurse practitioner (NP)-led HF educational classes for CNAs. All CNAs took a HF knowledge test before

and after three 20-minute educational sessions. An audit of the facility’s Stop and Watch communication tool was conducted

before, during, and after the educational program to evaluate the program’s impact on CNA reporting of HF residents’ acute

symptoms to supervisory nurses.

Results: Sixty-six CNAs participated in the project. Half of the CNAs (N=33) attended all 3 educational classes. The mean preintervention

HF knowledge score was 78.1% and the mean post-intervention score was 92.5% (95% CI [2.52, 4.76]; p


Nursing Ethics: Commitment, compassion, quality care

Postural Orthostatic Tachycardia Syndrome: Treatment Modalities

Maridith Smith

Mallory Trammell

This research study evaluated the effectiveness of pharmacologic interventions commonly used to manage the symptoms of

Postural Orthostatic Tachycardia Syndrome (POTS). POTS is a challenging health disorder due to a dysfunction of the autonomic

nervous system that affects a division of the population, particularly adolescents.

Patients with POTS experience a sudden onset of an orthostatic tachycardic reaction upon standing and have symptomology

such as headache, fatigue, palpitations, sweating, nausea, syncope, and dizziness (Raj, 2006). Therefore, in order to determine

commonly used treatment methods research was conducted on pharmaceutical studies regarding POTS found in the academic

databases CINAHL and the National Center for Biotechnology Information (NCBI). After reviewing and comparing these studies,

it was determined that Propranolol, midodrine, and DDAVP (Desmopressin) were the most significantly effective in treating

symptoms of POTS in the evaluated patient population. In addition, it was also discovered that pharmacologic treatment was

even more effective when combined with nonpharmacologic interventions such as exercise and diet changes.

In conclusion, the recommendations for further research includes the need for a long-term trial study further evaluating the

medications discovered to effectively manage POTS symptoms. Studies involving a larger sample population of both genders are

also needed.

Pushing Ethical Boundaries Using High-Fidelity Human Patient Simulation: What Would YOU Do?

Patsy E. Crihfield, DNP, APRN, FNP-BC, PMHNP-BC, PMHS

Darel L. Davis, DNP, APRN, FNP-BC, FCN

Inter-professional collaboration is essential to promote high quality patient care. Our purpose was to utilize high fidelity

simulations in portraying ethical dilemmas with Doctor of Nursing Practice (DNP) students at Union University to promote interprofessional

collaboration.

The clinical simulations were performed in our university’s Center for Excellence in Health Care Practice. A blend of students were

assigned to groups and participated within their current scope of practice as nurse practitioners, nurse anesthetists, or nursing

leaders. Faculty portrayed family, friends, or hospital staff throughout the simulations. Two scenarios involving ethical dilemmas

were executed.

The first involved a patient with HIV who experienced anaphylaxis in a primary care office. When the patient’s condition

deteriorated, a conflict developed between a life-partner and a sibling, both claiming to have a valid Durable Power of Attorney for

Health Care.

The second scenario involved a female patient who was being evaluated pre-operatively and the absence of important diagnostic

results. The dilemma resulted from a revelation of the true nature of the procedure and a very hostile surgeon demanding the

patient be taken to surgery.

Debriefing sessions after each simulation allowed students to discuss the ethical dilemmas in great detail and various outcomes

based upon their chosen actions. Students had very positive feedback related to the experiences and the need to collaborate in

order to work through the presenting ethical dilemmas. This experience demonstrated how inter-professional collaboration can be

enhanced by using technology to prepare for difficult clinical situations that may occur in practice.

Spiritual Care Practices of Nurse Practitioners

Darel L. Davis, DNP, APRN, FNP-BC, FCN

Purpose: To gain a better understanding of the spiritual perspectives of NPs in Tennessee, to evaluate the types of nursing

spiritual assessments and interventions commonly used in NP practice, and to determine if relationships exist between spiritual

perspectives and the integration of spiritual care in NP practice.

Review of Literature: Connections between spirituality, better health outcomes, and a positive quality of life have been previously

demonstrated. Patients desire for their providers to consider how spiritual needs affect their overall health. The limited studies

exploring spirituality in NP practice have revealed that NPs rarely assess spirituality or implement spiritual care.

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Nursing Ethics: Commitment, compassion, quality care

Methodology: A sample was recruited via NP email Listservs. Spiritual perspectives were measured using Reed’s Spiritual

Perspective Scale (SPS©). The degree of spiritual care nursing assessment was measured using the Vincensi Spiritual

Assessment Tool (VSAT©). The extent of spiritual care nursing intervention was measured using the Vincensi Spiritual Care

Intervention Tool (VSCIT©). Data were analyzed via descriptive and inferential statistical methods.

Results: Seventy-three NPs completed the survey (N = 73). A significant correlation was found between heightened NP spiritual

perspective (SPS composite scores) and perceived ability to identify and then act upon the spiritual needs of patients (VSAT/

VSCIT composite scores), r (73) = .337, p < .003.

Implications for NPs: Heightened spiritual self-awareness has been shown to enhance spiritual care practices by NPs.

Developing methods to enrich spiritual self-perception throughout NP curricula and through CE offerings appears to be a way to

increase spiritual assessment and spiritual care intervention for patients.

A Statewide Collaboration to Define the Value of the BSN

Teresa M. Stephens, PhD, MSN, RN, CNE

Martha Buckner, PhD

The educational preparation of the nursing workforce in the United States is undergoing a rapid shift toward the Bachelor of

Science in Nursing degree. This shift has been fueled by factors such as the move toward higher levels of quality and safety,

increasing evidence of better outcomes associated with a more highly educated workforce, the Magnet designation movement,

and ultimately the 2010 Institute of Medicine report. The Tennessee Association of Nursing Deans and Directors formed an

RN-BSN sub-committee to work on issues that will improve the opportunities for Tennessee registered nurses with a diploma or

associate degree education to seamlessly move through a high quality curriculum to obtain their BSN degree.

To date, there are no established national standards or best practices guiding the development and delivery of RN-BSN

programs. A large number of registered nurses seeking a BSN combined with employers supporting these efforts have made

this an attractive and lucrative venture for academic institutions. It is imperative that the value of the degree be protected and

supported to achieve the original intentions in the calls for academic progression. This poster will showcase the collaborative

efforts of the subcommittee members to define the value of the BSN from four perspectives: patients, students, employers, and

academic institutions. Participants will view information related to providing quality and accessible completion program while

maintaining the quality and rigor of the educational experience.

Teaching a Systems Approach to MSN Students: An Innovative Quality Improvement Project

Rose Vick, MSN, PMHNP-BC

LeTizia Baxter Smith, MSN, PMHNP-BC

Cynthia Brame, PhD

Vanya Hamrin, DNP, PMHNP-BC

Megan Simmons, DNP, PMHNP-BC

Dawn Vanderhoef, PhD, DNP, PMHNP/CS-BC

Healthcare systems in the United States are fragmented and complex to navigate. It is imperative that advanced practice nurses

understand the complexities of healthcare systems and have the knowledge and skills to effect change. Master’s level educational

programs are poised to educate nurses to transform the healthcare system and improve quality by engaging students in projects

that require systems advocacy. In an effort to graduate students who are skilled to make system level changes, we implemented

and revised a quality improvement (QI) project that: 1) helps students in the PMHNP program develop core competencies;

2) addresses common student challenges, and 3) is based on the tenets of effective cooperative learning and adult learning.

During the second and third semesters of the PMHNP specialty year, students implement the project in their clinical site, thereby

applying concepts to a real-world context. The project involves a formal needs assessment of the agency, implementation and

evaluation of a solution strategy and assessing sustainability and continued QI (CQI). At the end of the 2014 academic year,

faculty identified several barriers to students’ success in the QI project. Instructional revisions implemented in 2015 included

adding a second lecture and a peer-led, faculty-facilitated online discussion board. Outcomes showed that the 2015 student

group that received the changes in instruction had a significant increase in performance, t(92) = 1.66, p = 0.05, d = 0.34, r2 =

0.0289, when compared to the 2014 student group. Long-term benefits of increasing students’ skills for creating system change

will be explored.

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Nursing Ethics: Commitment, compassion, quality care

The Virtual Nurse: Adding Value to Perioperative Experience

Julie Hamm, MSN, BSN, ACNP-BC

Laura Hollis, DNP, RN, CCRN

The purpose of this poster is to understand the impact a virtual nursing role has on different aspects of the perioperative

experience. This poster describes the creation of RN positions to create “virtual” appointments using technology to facilitate

pertinent patient information for anesthesia providers in order to add value to the patient experience and optimize perioperative

patient movement on the day of surgery.

Which Interventions are Most Effective in Treating Blood Glucose Dysregulation Related to

Pregnancy Outcomes?

Nhan L. Dinh

Nicole Becker

Gestational diabetes mellitus (GDM) is a condition experienced by pregnant women who are glucose intolerant; in fact, it is

prevalent in as many as 2.5% of all pregnancies. Due to this high prevalence, many research trials have attempted to discover

effective treatments of this illness. Such experimental treatments have generally been found effective, significantly reducing

perinatal morbidity of infants (Crowther et al., 2005). The authors utilized the online resource CINHAL to research which

interventions are most effective in treating blood glucose dysregulation and how they relate to the pregnancy outcome.

The authors were able to search the database using key terms such as “gestational diabetes,” “diabetes and pregnancy,” and

“interventions and gestational diabetes.” Oral therapies have increased in popularity of late, perhaps due to their lower cost and

easier administration; in addition, patients have demonstrated better adherence to oral hypoglycemic therapy than to traditional

subcutaneous insulin injections. Beginning nutritional counseling in the first trimester of pregnancy greatly reduced the risk of

GDM and its complications, as does watching that expecting mothers do not over-exert themselves for the health of the baby.

A combination of all three – oral insulin therapy, nutritional counseling and moderating activity – seems to be the most effective

prevention that health care team members can recommend to their patients to reduce the risk of GDM and prevent pregnancy

complications.

Future research should examine the relationship between these three factors, as well as investigate the influence of elevated BMI

on adverse pregnancy outcomes of women with GDM.

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TNA PAST PRESIDENTS

*Mrs. Lena A. Warner ................................................................... 1905-1918

*Nina E. Wootton. ...................................................................... 1918-1919

*Myrtle Marion Archer. .................................................................. 1920-1921

*Mrs. Daisy Gould. ..................................................................... 1921-1923

*Mrs. Myrtle E. Blair. .................................................................... 1924-1925

*Abbie Roberts ........................................................................ 1926-1927

*Mrs. Corrine B. Hunn. .................................................................. 1928-1929

*Hazel Lee Goff. ....................................................................... 1930-1932

*Nancy Rice (Nashville). ................................................................. 1933-1935

*Aurelia B. Potts (Nashville). .............................................................. 1936-1937

*Mattie E. Malone (Memphis) ............................................................. 1938-1939

*Lennis Ault (Knoxville) .................................................................. 1940-1942

*Frances H. Cunningham (Memphis). ....................................................... 1942-1944

*Beatrice M. Clutch (Nashville) ............................................................ 1944-1948

*Ruth Neil Murry (Memphis) .............................................................. 1948-1950

*Elizabeth H. Killeffer (Cookeville). ......................................................... 1950-1952

*Violet M. Crook (Union City). ............................................................. 1952-1955

*Catherine M. Sterling (Memphis). ......................................................... 1956-1959

*Vesta L. Swartz (Johnson City) ........................................................... 1960-1961

*Mary Frances Smith (Memphis). .......................................................... 1962-1966

*Dorothy L. Griscom (Memphis) ........................................................... 1966-1969

*Dorothy Hocker (Nashville). .............................................................. 1969-1971

*Mary Evelyn Kemp (Nashville). ........................................................... 1971-1973

*Erline Gore (Nashville) .................................................................. 1973-1975

Patsy B. McClure (Knoxville). ............................................................. 1975-1977

*Emma Lou Harris (Chattanooga). ......................................................... 1977-1979

*Mary Windham (Clarksville). ............................................................. 1979-1981

Annie J. Carter (Nashville). ............................................................... 1981-1983

Margaret Heins (Knoxville). ............................................................... 1983-1985

Virginia Trotter Betts (Nashville). ........................................................... 1985-1987

Margaret Heins (Knoxville). ............................................................... 1987-1989

Frances Edwards (Nashville). ............................................................. 1989-1993

Carol Blankenship (Johnson City). ......................................................... 1993-1995

Sharon Adkins (Nashville). ............................................................... 1995-1997

Peggy Strong (Memphis). ................................................................ 1997-1999

Gary Crotty (Knoxville). .................................................................. 1999-2001

Wanda Neal Hooper (Nashville) . .......................................................... 2001-2003

*Maureen Nalle (Knoxville). ............................................................... 2003-2005

Susan Sanders (Lynchburg) .............................................................. 2005-2007

Laura Beth Brown (Nashville) ............................................................. 2007-2009

Elizabeth H. Smith (Piney Flats). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2009-2011

Lena Patterson (Ooltewah). .............................................................. 2011-2012

Jill S. Kinch (Nashville) (Interim President) ................................................... 2012-2013

*deceased

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Nursing Ethics: Commitment, compassion, quality care

Promotion of Nursing Image Program

The Tennessee Nurses Foundation partners with other organizations to accurately portray the

profession of nursing and to promote a positive image of the profession and nursing.

TNF Grant Review Process

The grant review process will take approximately four to six weeks. If you miss a deadline, your grant

application will not be reviewed until after the next deadline date. If you have questions regarding the grant

application process, contact TNF at tnf@tnaonline.org.

TNF’s Initiatives

TNF’s RN to BSN Scholarship Program

The TNF RN to BSN Scholarship is an educational scholarship for eligible Registered Nurses in the State of

Tennessee who are continuing their education to attain a BSN.

Scholarship applications are reviewed once each year. The deadline is November 1.

Maureen Nalle Memorial Graduate Nursing Scholarship Program

The Tennessee Nurses Foundation supports the education of nurses who are members of the Tennessee

Nurses Association by providing scholarships for those nurses seeking higher education.

Scholarship applications are reviewed once each year. The deadline is November 1.

Nursing Research Grants

The Tennessee Nurses Foundation provides grants to nurses who are members of the Tennessee Nurses

Association engaging in scientific and other research projects focusing on nursing practice.

Grant applications are reviewed twice each year.

Submission deadline dates are the last day of February and August.

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Nursing Ethics: Commitment, compassion, quality care

Leadership Nursing Program

The Tennessee Nurses Foundation provides scholarship opportunities for members of the Tennessee

Nurses Association to participate in a variety of leadership development programs to prepare nurses for an

enhanced role in nursing and community involvement.

In addition, scholarships for nursing students to attend the TNA and ANA Annual Conventions may be

provided.

Grant applications are reviewed twice each year.

Submission deadline dates are the last day of February and August.

Arthur Davis LPN to RN Scholarship Program

The Tennessee Nurses Foundation supports the education of Licensed Practical Nurses by providing

scholarships for those nurses seeking higher education through an accredited LPN to RN nursing program.

Scholarship applications are reviewed once each year. The deadline is November 1.

Edna Mason Memorial TNA Conference Scholarship

The Tennessee Nurses Foundation is pleased to offer a scholarship to attend the TNA Annual Conference.

Visit tnaonline.org for full details.

TNF’s Honor A Nurse Program

The Tennessee nurses Foundation (TNF) welcomes you to publicly recognize a special nurse in your life.

With your $50 tax-deductible donation to TNF, your honored nurse’s name will appear in the Tennessee

Nurse, (a quarterly publication sent to all Registered Nurses in the State of Tennessee), as well as in the

designated “Honor A Nurse” section under the Tennessee Nurses Foundation’s link at www.tnaonline.org. A

photo and brief paragraph may also be submitted to further recognize your honored nurse.

This program is available to honor any Tennessee nurse. Honor a nurse friend, nurse family member,

or nurse colleague by marking their anniversary, birthday, special event or occasion, or as a memorial.

Patients, or the patient’s family, may honor a nurse that truly made a difference in their care or the care of a

family member.

Your $50 donation will go toward continued support of the TNF and its work pertaining to scholarships, and

grants that support the needs of nurses in Tennessee. TNF is a nonprofit, 501(c),(3) organization. Donations

are tax-deductible to the fullest extent allowed by law and support the mission of TNF.

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TNF’s TNA Membership Dues Scholarship Program

TNF’s TNA Membership Dues Scholarship Program is a program that allows a tax-deductible donation to be

given for TNA membership dues, thereby sponsoring a Registered Nurses’s membership in the Tennessee

Nurses Association. Donation amounts are for annual dues only. TNF will accept a Reduced Dues donation

only if the person being sponsored qualifies for that dues rate. TNA Reduced Membership dues, ($145), are

for RNs who are not employed, RNs who are full-time students, newly licensed graduates, or age 62+ and

not earning more than Social Security allows. All other RNs will qualify for the Full Rate of TNA/ANA dues,

($290), or ($199) for the State-Only dues.

A secure online form is available at www.tnaonline.org. Please have the RNs name, mailing address,

daytime phone and email address ready before you click to make your donation. If you do not have a

specific RN you would like the donation to go to, check ‘A Deserving RN’ once you get to the donation

page and the TNF Board of Trustees will designate the membership for you.

The mission of the Tennessee Nurses Foundation is to promote professional excellence in nursing.

Membership in Tennessee’s professional nurses association, TNA, is the essence of being a nursing

professional. Your kind donation will help a nurse in pursuit of that endeavor.

Tennessee Professional Assistance Program (TnPAP)

The Tennessee Professional Assistance Program provides advocacy, referral, and monitoring services for

chemically dependent, psychologically or physically impaired health care professionals, who are licensed or

eligible for licensure in the State of Tennessee; and for students in health professional programs. Visit

www.tnpap.org.

For complete details on the Tennessee Nurses Foundation, visit www.givingmatters.com.

The mission of the Tennessee Nurse Foundation is to promote professional excellence in nursing.

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Nursing Ethics: Commitment, compassion, quality care

2015–2016 TNF Board of Trust

Janice Harris

MSN, RN

President

Wartrace

Michele Arns

DNP, FNP-BC

Sneedville

Sandra Marklin

MSN, RN, PhD

Nashville

Amy Hamlin

PhD, MSN, FNP-BC, APN

Vice President

Ashland City

Sharon Chapman

MSN, RN, APN-CNS

Treasurer

Maryville

Dara Rogers

BSN, RN, OCN

Secretary

Murfreesboro

Billie Sills

MSN, CLNC, RN

Ex-Officio

Johnson City

Doris Davenport

DNS, RN, PNP

Clarksville

Mary Bess Griffith

MSN, RN, PhD(c), CS,

FNP

Union City

Julie Hamm

MSN, RN, ACNP-BC

Hermitage

Bill Jolley

Vice President

TN Hospital Assn.

Non-Nurse Community

Leader

Phillip Moore

MSN, RN, FNP-BC

Louisville

Sandy Murabito

Ed.D, MSN, RN

Nashville

Tommie Norris

DNS, RN

Collierville

Karen Starr

MSN, RN, LADAC, MAC

Nashville

Sharon Adkins

MSN, RN

TNF Executive Director

Sue MacArthur

Ed.D, APRN, BC

Coumbia

Haley Vance

DNP, APN, PNP-AC

Nashville

Mike Harkreader

MS, RN, CARN

TnPAP Executive Director

Kathy Denton

TNF Program Director

Sue Willoughby

BSN, RN

Franklin

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Committed to Excellence.

Committed to You.

Bachelor of Science in Nursing

Accelerated BSN for Second-Degree Students

RN to BSN

Associate degree to BSN dual degree

LPN to BSN

Master of Science in Nursing

Clinical Nurse Leader

Post-Master’s Certificate Program

PhD in Nursing

Doctor of Nursing Practice (BSN or MSN to DNP)

Professional Development Programs

Many graduate and undergraduate programs

are available online.

ETSU.edu/nursing

888-37-NURSE

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Nursing Ethics: Commitment, compassion, quality care

2014 TNA & TASN Conference Highlights

63


RN - BSN Online

Contact Dr. Carol Murch, cmurch@murraystate.edu

BSN

Contact the School of Nursing, 270.809.2193

Advanced Practice DNP Options:

• Family Nurse Practitioner

• Nurse Anesthesia

• Post-Master’s DNP Program

For more information contact:

Dina Byers, Ph.D., APRN, ACNS-BC

dbyers@murraystate.edu

270.809.6223

• More than 15 years experience in educating advanced

practice nurses to meet the complex health care needs of

society.

• Strong faculty committed to excellence in education

and practice.

School of Nursing

www.murraystate.edu/nursing

Equal education and employment opportunities M/F/D, AA employer

BlueCare Tennessee recognizes that a multi-faceted strategy is necessary to support

effective provider education. Our goal is to provide up-to-date information in a

centralized location that will assist your office practice.

BlueCare Tennessee and BlueCare,

Independent Licensees of BlueCross BlueShield Association

Please visit our website at

bluecare.bcbst.com

to find the latest news regarding claims billing instructions,

TennCare program requirements, quick reference guides, specialized

programs, frequently asked questions, helpful forms, tutorials, and toolkits.

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