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SPRING 2016- Vol 24, No. 1

IMPROVING LIVES…THROUGH EVIDENCE-BASED PRACTICE

Phyllis Gordon,

MSN, ACNS, BC

SVN President, 2015-2016

“Quality is not an

act, it is a habit.”

- Aristotle (Ancient

Greek Philosopher,

Scientist and physician,

384 BC-322 BC

IN THIS ISSUE

- Member News

- Nurses at the Table

- Finding the

Evidence

- Research Corner

- Continuing

Education

SVN...prn Editor

Cristina Sola, BS, RN-BC

The Greek philosopher,

Socrates (470 BC), noted that

“the unexamined life is not

worth living.” Nursing is very

familiar with examining what

we do daily in our nursing

practice, striving to implement

activities that have proven

positive outcomes.

Evidence-based practice (EBP) is

the “conscientious and judicious

use of current best evidence in

conjunction with clinical expertise

and patient values to guide

health care decisions.” 1 The best

evidence includes a number of

resources: empirical evidence

from randomized controlled

trials, evidence from descriptive

and qualitative research, case

reports, scientific principles,

and expert opinion. 1

Nursing has a rich history of

examining our practices, i.e.

EBP, beginning with Florence

Nightingale who studied and

evaluated current practices, then

implemented change. 2-5 Nursing

is carrying on Nightingale’s

methods today through many

EBP endeavors. Today, we are

fortunate to have organizations,

such as the Agency for Healthcare

Research and Quality (AHRQ),

which collects and publishes

evidence and guidelines on

best practices. AHRQ notes

that “nurses are at the center

of patient care and therefore

are essential drivers of quality

improvement” and emphasizes

that all health care providers are

responsible for improving quality

and safety in their care. The

Society for Vascular Nursing

(SVN) members are part of

those health care providers.

Colin Powell, our 65th United

States Secretary of State and

retired general of the US army,

notes that “excellence is not

an exception, it is a prevailing

attitude.” We must live with the

attitude of excellence. So how

does SVN support excellence?

SVN promotes EBP in a number

of ways. That “prevailing

attitude” has been a part of our

mission statement for over 30

years, promoting excellence in

research and practice. During

the past two months, you, the

membership, supported a change

in the language of the mission

statement to include excellence

in research and practice in a

more uniform statement with

the following, “to provide a

professional community for

nurses focused on advancing

the care of persons living

with vascular disease through

excellence in evidence based

practice and education.” In the

previous SVNprn, I focused

on the education activities that

SVN is involved in to promote

excellence and improve lives. In

this issue, I will focus on SVN’s

role in promotion of EBP to

improve lives.

Providing vascular

disease-focused educational

opportunities for nurses

and promotion of EBP, SVN

improves the lives of those

living with vascular diseases,

which is our vision.

For many years, SVN has had a

Research Committee, Practice

Committee, and Clinical Practice

Guidelines (CPG) Committee.

In 2010, these were combined

into the Practice and Research

Committee (P&RC). Since

2010, this committee has been

very busy developing nursing

practice guidelines for care of

the patient with a number of

vascular diseases. It is one of our

largest committees and identifies

focused CPG Task Forces from

committee members who have

expertise in a specific vascular

disorder and/or treatment which

focuses on the development

of specific guidelines. The

committee has revised the

carotid artery endarterectomy

CPGs and is starting the revision

of the aortic aneurysm CPGs.

Keep in mind that this is a huge

task! Much time and effort is

spent on the quality of these

CPGs – to evaluate the evidence,

weight it, and search for empiric

and best practices when there

is no research documentation

available. These are then

published in the Journal of

Vascular Nursing (JVN).

The P&RC also includes the

Research Grant Task Force. This

is an important SVN promoter

of vascular focused research

through providing financial grants

for research. Several of our SVN

members have benefited from

this support and add to the body

of knowledge of vascular disease

management. The members of

the P&RC also provide research

information to SVN members

through publication of research

and clinical practice topics in our

newsletter and JVN.

SVN’s ABI Registry is another area

of best practice promotion. The

ABI Registry has been available

to our members for nearly 10

years and focuses on ensuring

quality in those health care

providers that obtain bedside

Ankle-Brachial Indices (ABI) to

measure severity of peripheral

artery disease. Trained SVN

members are willing to educate


IMPROVING LIVES…THROUGH EVIDENCE-BASED PRACTICE ...Continued

and qualify your practice’s measurement

of ABIs. If you want to be a part of this

quality measure, see our website for

more details at www.svnnet.org.

SVN accomplished another area of

quality promotion this past year

through the publication of the revised

Scope and Standards of Vascular Nursing

Practice, published through the American

Nurses Association (ANA). It was

originally developed by SVN in 2004.

This document identifies the scope and

standards required for the generalist

registered nurse and advanced practice

RN providing care for the patient

with vascular disease. Access to this

publication is also available on our

SVN website, www.svnnet.org,

under the Resource tab.

In the 1990’s, SVN developed the

Certified Vascular Nurse (CVN) exam as

a measure of excellence, helping nurses

achieve the highest levels of professional

knowledge and competence attainable

to care for patients with vascular

disease. SVN collaborated with the

American Nurses Credentialing Center

(ANCC), accredited by the American

Board of Nursing Specialties, which

raises the quality of the certification.

That certification now includes the

cardiac perspective of vascular care and

is called the Cardiac/Vascular Nursing

Certification. If you are interested

in obtainingthis certification, more

information is available on our

website, www.svnnet.org, under

the Certification tab.

“Don’t waste your time striving for

perfection. Instead, strive for excellence

-- doing your best.” These are the very

wise words of Sir Laurence Olivier. It is a

resounding theme in nursing today…that

of excellence and doing your absolute

best. All of us strive to “do our best”

every day. The work of SVN through our

committees, task forces, special projects,

and collaborations with organizations

continuously strives for excellence and

best practice in our care for patients

living with vascular disease. SVN needs

YOU to carry on these projects of

excellence in vascular nursing. Consider

participating in one of these important

projects. Contact the national office

through the website and one of our

board members, committee chairs or

myself can provide information about

the current projects. We can help you

find the right one for you.

Respectfully,

Phyllis Gordon, MSN, ACNS, BC

SVN President, 2015-2016

References:

1. Titler MG. The Evidence for Evidence-Based Practice Implementation. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for

Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 7. Available from: http://www.ncbi.nlm.nih.gov/books/NBK2659/

2. Nightingale F. Notes on matters affecting the health, efficiency, and hospital administration of the British Army. London: Harrison & Sons; p. 1858.

3. Nightingale F. A contribution to the sanitary history of the British Army during the late war with Russia. London: John W. Parker & Sons; 1859.

4. Nightingale F. Notes on hospitals. London: Longman, Green, Roberts, & Green; 1863.

5. Nightingale F. Observation on the evidence contained in the statistical reports submitted by her to the Royal Commission on the Sanitary State of the

Army in India. London: Edward Stanford; 1863.

6. Hughes RG (ed.). Patient safety and quality: An evidence-based handbook for nurses. (Prepared with support from the Robert Wood Johnson Foundation).

AHRQ Publication No. 08-0043. Rockville, MD: Agency for Healthcare Research and Quality; March 2008.

Call for JVN Editorial Board Members

The Journal of Vascular Nursing is soliciting interested colleagues

to apply for an Editorial Board appointment.

Editorial Board members are responsible for editorial review of manuscripts

for publication in JVN and for assisting the Editor as assigned. Service on the

Editorial Board is for one year to be renewed annually at the Editor’s discretion.

Qualifications for appointment consideration include the following:

1. Registered professional nurse; Master’s degree in nursing required.

2. Vascular nursing practice experience in areas of education, practice,

administration, or research sufficient to developing considerable

expertise in the area.

3. Documented writing ability as evidenced by publication.

4. Membership in SVN for a minimum of one year.

We invite interested colleagues to submit a letter of interest, including

your fields of interest and expertise, and current curriculum vitae to

the Editor, Cindy Lewis MSN, RN, ACNS-BC, at Cynthia.lewis@aurora.

org. All applications will be reviewed.

www.svnnet.org


Research Corner

RECENT FINDINGS FROM THE NURSES’ HEALTH STUDY (NHS):

Karen R. Bruni-Fitzgerald,

MHS, MSN, FNP-BC, CVN

The Nurses’ Health Studies are among

the largest and longest running

investigations of factors that influence

women’s health. Started in 1976 and

expanded in 1989, the information

provided by the 238,000 dedicated

nurse-participants has led to many

new insights on health and disease.

While the prevention of cancer is

still a primary focus, the study has

also produced landmark data on

cardiovascular disease, diabetes

and many other conditions. Most

importantly, these studies have

shown that diet, physical activity and

other lifestyle factors can powerfully

promote better health. Below are

some recent findings from the study.

Coffee Consumption and Diabetes

Previous studies found that higher

coffee intake is associated with a lower

risk for type 2 diabetes; but there

has not been a study examining how

changes in coffee consumption habits

influence subsequent risk of diabetes.

Using data from the NHS, NHS II and

HPFS (Health Professional Follow Up

Study), it was found that individuals

who increased their coffee consumption

by more than one cup per day over

a four-year period had an 11 percent

lower risk of type 2 diabetes in the

subsequent four years compared

to those who made no changes in

consumption. Those who lowered their

daily coffee consumption by more than

one cup had a 17 percent higher risk of

diabetes. Changes in consumption of

decaffeinated coffee and caffeinated tea

were not associated with changes in risk

for type 2 diabetes. (Bhupathiraju et al.

Diabetologia.2014 Jul;57(7):1346-54)

Mediterranean Diet and

Telomere Length:

The traditional Mediterranean diet

which is characterized by a high intake

of vegetables, fruits, nuts, legumes,

whole grains, fish, and olive oil-has been

consistently linked with an array of

health benefits, including decreased

risk of chronic disease and cancer.

It has been found that the greater

adherence to the Mediterranean diet is

associated with longer telomeres, which

are repetitive DNA sequences at the

ends of chromosomes. Telomeres are

considered biomarkers of aging. They

get shorter every time a cell divides, and

shorter telomeres have been associated

with a decreased life expectancy and

increased risk of age-related diseases.

The NHS calculated a Mediterranean

Diet score, indicating extent of

adherence to a traditional Mediterranean

diet, among 4,676 women in the NHS.

The difference in telomere length for

each one-point change in the diet score

was comparable, on average to the

difference in telomere length between

women 1.5 years apart in age-meaning

that the greater adherence to the

Mediterranean diet may promote

health and longevity. (Crous-Bou et al.

BMJ. 2014;349-g6674)

Diet, Hearing Loss, and Tinnitus:

Hearing impairment and tinnitus, a

ringing or buzzing sound in the ear

that can be severely disabling, are both

common in adults. Hearing impairment

affects almost 48 million Americans,

and nearly 25 million people in the U.S.

experience tinnitus. Recent findings in

the Nurses’ Health Studies’ Conservation

of Hearing Study (CHEARS) identify

potentially modifiable dietary factors

that may help prevent or mitigate these

conditions.

It was found that women who ate two

or more servings per week of any type

of fish or shellfish had a 20 percent

lower risk of hearing loss compared

with those who rarely consumed fish.

In addition, they found that compared

with women who consumed the least

amount of caffeine (less than one cup

of coffee per day), those who consumed

the equivalent of three to four cups of

coffee per day had a 15 percent lower

risk of tinnitus. (Curhan et al. Am J Clin

Nutr. 2014;100(5):1371-1377. Glicksman

et al. Am J Med. 2014:127(8):739-743.

www.svnnet.org


News Release

IAC Releases Cardiac Electrophysiology Accreditation Program

Facilities Can Now Access the Published Standards and Submit Applications

February, 2016

Intersocietal Accreditation

Commission

Offering a method for cardiac

electrophysiology facilities

to voluntarily document

a commitment to quality

patient care, the Intersocietal

Accreditation Commission

(IAC) announces the release of

its cardiac electrophysiology

accreditation program. IAC

Cardiac Electrophysiology is

designed to accredit facilities that

perform cardiac electrophysiology

procedures by ensuring that the

facility meets benchmarks for

quality based on published clinical

guidelines, best practices and

outcomes.

The program is widely respected

within the medical community,

as illustrated by the support

of the four national medical

societies related to cardiac

electrophysiology, who each

serve as sponsoring organizations:

• American College of Cardiology

(ACC)

• Heart Rhythm Society (HRS)

• Pediatric & Congenital

Electrophysiology Society

(PACES)

• Society of Invasive

Cardiovascular Professionals

(SICP)

IAC Cardiac Electrophysiology

accreditation is offered in the

following areas: Testing and

Ablation, Device Implantation and

Chronic Lead Extraction.

Serving as the basis for the

accreditation program, the

Standards are an extensive

document defining the minimal

requirements for cardiac

electrophysiology facilities

to provide quality care. The

Standards are used by facilities

as both a guideline and the

foundation to create and achieve

realistic quality care goals and can

be found at intersocietal.org/ep/

main/cardiacep_standards.htm.

The application for IAC Cardiac

Electrophysiology is accessible

through IAC Online Accreditation,

which features a user-friendly,

secure online format. Facilities

may visit intersocietal.org/ep/

seeking/getting_started.htm to

create an account.

“We are pleased to offer the cardiac

electrophysiology community an

accreditation program designed to

promote quality care and positive

patient outcomes,” said Frank

Vermeiren, MS, RT (R)(CV), RDCS,

Director of Accreditation, IAC

Cardiac Electrophysiology. “Both

clinical and administrative support is

available through the IAC as facilities

explore the Standards and work on

completing their applications.”

For complete details on the new

program, please visit the website at

www.intersocietal.org/ep or contact

the IAC Cardiac Electrophysiology

staff at 800-838-2110.

About the IAC:

A nonprofit organization highly

regarded for its accreditation

programs since 1990, the IAC

is committed to its mission of

Improving health care through

accreditation®, through a

rigorous peer review process.

The IAC provides accreditation

programs for vascular testing,

echocardiography, nuclear/PET,

MRI, diagnostic CT, dental CT,

carotid stenting, vein treatment

and management and cardiac

electrophysiology. To date, the IAC

accrediting divisions have granted

accreditation to more than 14,000

sites throughout the United States,

Canada and Puerto Rico. IAC

accreditation is widely respected

within the medical community,

as illustrated by the support of

more than 40 national medical

societies. Varying per modality and

practice setting, IAC accreditation

is required in some states and

regions by the Centers for

Medicare and Medicaid Services

(CMS) and by numerous private

insurers.

For more information,

please visit intersocietal.org.

www.svnnet.org


RESEARCH

Corner

Al-Khudairy L, Hartley L, Clar C, et al.

Omega 6 fatty acids for the primary

prevention of cardiovascular disease.

Cochrane Database Syst Rev. 2015 Nov

16;11:CD011094.

Anderson L, Thompson DR, Oldridge

N, et al. Exercise-based cardiac

rehabilitation for coronary heart

disease. Cochrane Database Syst Rev.

2016 Jan 5;1:CD001800.

Baker TB, Piper ME, Stein JH, et al.

Effects of Nicotine Patch vs Varenicline

vs Combination Nicotine Replacement

Therapy on Smoking Cessation at 26

Weeks: A Randomized Clinical Trial.

JAMA. 2016 Jan 26;315(4):371-9.

Berntsen CF, Kristiansen A, Akl

EA, et al. Compression Stockings

for Preventing the Postthrombotic

Syndrome in Patients with Deep Vein

Thrombosis. Am J Med. 2015 Dec 31. pii:

S0002-9343(15)30030-9

Coleman T, Chamberlain C, Davey MA,

et al. Pharmacological interventions

for promoting smoking cessation

during pregnancy. Cochrane Database

Syst Rev. 2015 Dec 22;12:CD010078.

Dentali F, Sironi AP, Gianni M, et al.

Gender Difference in Efficacy and

Safety of Nonvitamin K Antagonist

Oral Anticoagulants in Patients

with Nonvalvular Atrial Fibrillation

or Venous Thromboembolism: A

Systematic Review and a Meta-Analysis

of the Literature. Semin Thromb

Hemost. 2015 Oct;41(7):774-87.

de Oliveira Carvalho PE, Magolbo

NG, De Aquino RF, et al. Oral aspirin

for treating venous leg ulcers.

Cochrane Database Syst Rev. 2016 Feb

18;2:CD009432.

Dyakova M, Shantikumar S,

Colquitt JL, et al. Systematic versus

opportunistic risk assessment for the

primary prevention of cardiovascular

disease. Cochrane Database Syst Rev.

2016 Jan 29;1:CD010411.

Entezari-Maleki T, Dousti S,

Hamishehkar H, et al. A systematic

review on comparing 2 common

models for management of warfarin

therapy; pharmacist-led service versus

usual medical care. J Clin Pharmacol.

2016 Jan;56(1):24-38.

Hartley L, May MD, Loveman E,

et al. Dietary fibre for the primary

prevention of cardiovascular disease.

Cochrane Database Syst Rev. 2016 Jan

7;1:CD011472.

Kitzman DW, Brubaker P, Morgan

T, et al. Effect of Caloric Restriction

or Aerobic Exercise Training on Peak

Oxygen Consumption and Quality

of Life in Obese Older Patients With

Heart Failure With Preserved Ejection

Fraction: A Randomized Clinical Trial.

JAMA. 2016 Jan 5;315(1):36-46.

Perera R, McFadden E, McLellan J, et

al. Optimal strategies for monitoring

lipid levels in patients at risk or with

cardiovascular disease: a systematic

review with statistical and costeffectiveness

modelling. Health Technol

Assess. 2015 Dec;19(100):1-402.

Pfeffer MA, Claggett B, Diaz R, et al.

Lixisenatide in Patients with Type

2 Diabetes and Acute Coronary

Syndrome. N Engl J Med. 2015 Dec

3;373(23):2247-2257.

SPRINT Research Group A

Randomized Trial of Intensive versus

Standard Blood-Pressure Control. N

Engl J Med. 2015 Nov 9.

Wade R, Sideris E, Paton F, et al.

Graduated compression stockings

for the prevention of deep-vein

thrombosis in postoperative surgical

patients: a systematic review and

economic model with a value of

information analysis. Health Technol

Assess. 2015 Nov;19(98):1-220.

Xie X, Atkins E, Lv J, et al. Effects of

intensive blood pressure lowering on

cardiovascular and renal outcomes:

updated systematic review and metaanalysis.

Lancet. 2015 Nov 7. pii: S0140-

6736(15)00805-3.

Janice D. Nunnelee PhD RN

Practice and Research Committee

414.376.0001 info@svnnet.org


REGISTER TODAY!

SEPT

18 -22, 2016

WYNN LAS VEGAS

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Interaction with VIVA faculty and

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and other conference tools

Come early for The VEINS!

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SAVE THE DATE

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