SPRING 2016- Vol 24, No. 1
IMPROVING LIVES…THROUGH EVIDENCE-BASED PRACTICE
MSN, ACNS, BC
SVN President, 2015-2016
“Quality is not an
act, it is a habit.”
- Aristotle (Ancient
Scientist and physician,
384 BC-322 BC
IN THIS ISSUE
- Member News
- Nurses at the Table
- Finding the
- Research Corner
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
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 SVN…prn, 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
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.
Phyllis Gordon, MSN, ACNS, BC
SVN President, 2015-2016
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.
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.
Mediterranean Diet and
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.
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
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.
IAC Releases Cardiac Electrophysiology Accreditation Program
Facilities Can Now Access the Published Standards and Submit Applications
Offering a method for cardiac
to voluntarily document
a commitment to quality
patient care, the Intersocietal
(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
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
• Heart Rhythm Society (HRS)
• Pediatric & Congenital
• Society of Invasive
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
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/
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/
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,
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
For more information,
please visit intersocietal.org.
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Janice D. Nunnelee PhD RN
Practice and Research Committee
18 -22, 2016
WYNN LAS VEGAS
Witness the most
challenging cases from
around the globe
Leading experts from
over 35 countries representing
all vascular specialties
attend complimentary and present
at a world-class conference
Interaction with VIVA faculty and
attendees, resources, presentations
and other conference tools
Come early for The VEINS!
September 17-18, 2016
THE GLOBAL EDUCATION COURSE FOR VASCULAR MEDICINE AND INTERVENTION
SAVE THE DATE
35 th ANNUAL CONVENTION
APRIL 4-7, 2017
Loews Vanderbilt Nashville, Tennessee