Utah Nurse - August 2018

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Utah Nurse • Page 10 August, September, October 2018 GRC COMMITTEE REPORTS UNA Board of Directors & the State Board of Nursing Collaborate on Delegation Rules Language Change Diane Forster-Burke MS, RN & Kathleen Kaufman, MS, RN Over the past year, Kathleen Kaufman and I have been working with the Board of Nursing to clarify language in our Rules related to Delegation of tasks to an unlicensed person. Our concerns came about following a meeting in fall of 2017 at AARP when they discussed caregiving in the home setting for elderly while adult children are at work. Health Facility Licensing said they would develop some Rules for themselves that would outline how an aide could provide care including medication administration. Kathleen and I provided extensive feedback and comments on their draft, however, also determined that the subject of delegation in the Nursing Rules needed clarification to ensure patient safety. The language changes our collaborative BON task group developed over the past year include the following: • “Delegator” means a licensed nurse directly responsible for a patient’s care who assigns to another unlicensed person the authority to perform a task on behalf of the delegator. • Delegation will not be a decision made by an administrator for the purpose of cost containment. • Supervision (direct and indirect) was brought into Rules from DOPL’s Rules. • The delegating nurse will determine the competency of the unlicensed aide to perform a task. Competency can be determined through an employer sponsored annual skills event, or by review and onsite demonstration of the task. On June 14, the Board of Nursing approved the language and it will now go to a public hearing. There will be an opportunity to provide public comment or written comments to DOPL. Once these changes are published by DOPL, we encourage those of you who have comments, to direct them to DOPL. Kathleen Kaufman MS, RN ~ GRC Co-Chair Or what to do in policy during the Interim Season….. Think challenging problems, innovative “Utah way” solutions, air conditioned meetings……a perfect way to spend at least half a day and learn something new. The Health and Human Service Committee (HHS) discusses most of the issues pertinent to nursing and health care. Unlike some committees that mainly discuss new bills, this committee discusses issues in depth and sometimes reviews potential bills. This year the HHS has identified seven key issues. They are: 1. Substance Abuse: Continue to address the opioid epidemic and study how to improve services and treat substance abuse. 2. Mental Health: Continue to examine Utah’s system for responding to persons in a mental health crisis. 3. Cannabis: Ensure the appropriate implementation of legislation passed during the 2018 General Session. 4. Medicaid Eligibility and Services: Receive reports on implementation of recent legislation and continue to hear proposals for reform. 5. Services for Persons with a Disability: Ensure that there is a suitable system of care for persons with a disability. We Can Now Take Action on Fully Expanding Medicaid in Utah! Kathleen Kaufman MS, RN & RyLee Curtis, Director of Utah Decides Healthcare. As I reported last issue, the Medicaid Expansion Ballot Initiative did receive more than enough signatures to be placed on the ballot in November! Thanks to all of you who worked on this effort generating interest, or even simply signing the petition for the initiative. Every signature helped. Now our task is two-fold, to educate our friends, family and patients about the need to vote for the proposition. Many will see the inherent fairness in taking care of Utahns with very low incomes who have no health care coverage at work, and thus no access to any care except for emergencies in the ER. Those who oppose the proposition should reflect that any non-paying patient cared for or admitted, will generate a bill that is cost shifted to those with insurance. So, all people can see some benefit, regardless of ideological outlook. The following information is to refresh your knowledge about the realities of health care access and availability of funds to pay for this expansion in our state. Please study this carefully and decide how to vote. Finally get out and vote! If you are not registered, it is not hard to do. Make a difference, VOTE. (You can go to the link at UtahDecides. org under the “about us” tab to register to vote.) Utah voters should decide what to do with our tax dollars. For five years Utah has been leaving money on the table—nearly $800 million in federal funding per year is already set aside for Utah that we aren’t getting back. It’s money 33 other states already get, but we’ve been losing out on for years. Voting yes on the Medicaid Expansion Proposition will bring those funds home, provide health coverage to more than 150,000 Utahns, create 4,100 jobs, and generate $290 million in new economic activity in our state each year. The current Medicaid eligibility limits in Utah are severe—leaving hundreds of thousands of Utahns without access to healthcare coverage. When Utahns are denied access to basic insurance they can’t afford health checkups, they can’t pay for ongoing care and prescriptions for chronic conditions, and they are forced to seek treatment in Emergency Departments which ultimately drives up healthcare costs for all of us. Utah State Legislature 2018 Interim Topics 6. Prior authorization: Study the impact of prior authorization on access to timely and appropriate medical care. 7. Work force needs in the health care professions: Examine needs in urban and rural Utah including the possible need for more school nurses. Rep. Rebecca Chavez-Houck included the last item based on a request from Dr. William Cosgrove to look at the needs for school nurses. She considered the importance of accurate data regarding the Utah workforce status of all health professions. An increased need for care due to all other issues in this list may well demand more professionals in practice. There is a shortage of healthcare professionals in Utah. This author notes that the high suicide rate in Utah high schools might be decreased if there were more school nurses who KNOW the students in their assigned schools. (This could occur if one school nurse covered only two or three schools instead of the typical workload for a Utah school nurse of six to nine schools.) The Interim Session begins with meetings in May and lasts until December. Many meetings are held during this session; including meetings of committees, task forces, legislators, and appropriation committees. This session is where most of the real work of idea development and new bills for next year gets done. You owe it to yourself to attend at least one meeting. This years’ Interim Session has scheduled HHS Committee meetings at 1:15 to 3:45pm on the 3rd Utah doesn’t provide Medicaid protections to working adults without children with incomes less than $17,000 per year. Working parents are also denied access to Medicaid when their household income falls between $14,000 and $25,000 for a family of four. A parent working a low-wage job who gets a promotion or takes on more hours to get ahead shouldn’t have their healthcare taken away. When Medicaid covers working families as they pull themselves out of poverty, we should reward their hard work—instead of punishing it by cutting off their healthcare. Expanding Medicaid in Utah allows Utah taxpayers to support those in need while promoting individual responsibility and smart conservative financing. The Medicaid Expansion Proposition is asking Utah voters whether they believe raising the sales tax on nonfood items by 0.15%—equivalent to one cent on a movie ticket—is a valuable investment to ensure their friends and neighbors have access to healthcare coverage. This plan maximizes state dollars and returns the $800 million in federal funding that’s been set aside, back to Utah. We understand the moral obligation to help the less fortunate, and this Medicaid Expansion Proposition strikes the right balance between protecting the interests of taxpayers while providing necessary health coverage for Utahns in need. As part of the work to educate the citizens of Utah, the Utah Health Policy Project is gathering stories of people who either did not receive needed care due to poverty, or those who did qualify for Medicaid and stayed on Medicaid only long enough to get a job with health care benefits. If you or your family or friends know of such a story, ask them to contact Courtney@ HealthPolicyProject.org or call Courtney at 385-499- 7750. Do consider doing this, many of us know at least one situation/story. Take action to help the poorest members of our communities, people who often work minimum wage jobs for long hours, and no health care benefits. People who are held to part-time positions so that their employer does not have to contribute to their health care benefits. People like you and me who work hard, but, unlike you and me, they are unable to make ends meet. Wednesday of most months. The location on Capitol Hill may vary. Locations, agendas, and associated documents can be found by going to the le.utah.gov website and checking the calendar. Final agendas are required to be posted no later than 24 prior to the meeting. For those of you who live at distance, audio recordings of most meetings are available online at the legislative website. Again, go to the calendar for a past meeting and look at the minutes and all documents presented during the meeting. Note that the approved list of issues for HHS was amended twice during the meeting on May 16th to include additions by Rep. Chavez-Houck and Rep. Redd. The posted documents include in-depth material regarding the current opioid crisis in Utah. Utah is number NINE in the nation for fatalities due to Opioids. There is a wealth of information about our state’s statistics and efforts to counteract the widespread use of opioids. The UNA GRC Committee and Board of Directors see to it that the UNA is present at all Health and Human Services Interim meetings. If you would like to meet one of us at the Capitol to attend a session, we invite you to call the UNA office and make arrangements. Liz Close, our Executive director, can put you in touch with the GRC Committee. The office number is 801-272-4510. The office is usually open 9 to 3 on Monday through Thursday. The bulk of time in meetings consists of experts presenting key information. Sometimes there is an opportunity for public comment. These meetings are good learning opportunities and relatively painless as are appropriation and task force meetings. You will not understand all the data but you will learn a lot.
August, September, October 2018 Utah Nurse • Page 11 Practice Matters FROM YOUR ANA PRESIDENT The Nursing Now campaign launches Reprinted from American Nurse Today, Volume 13, Number 5 Investing in nurses to achieve global health. Health should be a recognized universal right. Having an equitable health system should be a universal standard. And having highly skilled nurses recognized for their expertise in providing care and leading efforts to transform a nation’s health and health system should be a universal practice. U.S. nurses are not alone in our quest to be a prominent voice at all tables in determining how to best shape and deliver healthcare. Just a few months ago, a three-year, global campaign was publicly launched called Nursing Now under the auspices of the Burdett Trust for Nursing in collaboration with the International Council of Nurses (ICN) and the World Health Organization (WHO). More than 30 countries, including the United Kingdom, Switzerland, South Africa, and the United States, were represented at launch-day activities held around the world. Catherine, Duchess of Cambridge, served as the official patron. The Nursing Now campaign is focused on improving health globally by raising the profile and status of nurses worldwide. The agenda is ambitious, but it’s critically important and can be accomplished with real investment in nursing and ongoing support. Nurses and midwives make up the largest segment of the health workforce worldwide, and they can have a great impact on the health and well-being of individuals and communities because of their expertise and extensive reach through their varied roles and settings. That said, we’re facing a global shortfall of nine million nurses and midwives projected by 2030. The WHO Triple Impact report, whose findings helped initiate the campaign, also noted that although there is “enormous innovation and creativity in nursing,” nurses “are too often undervalued and their contribution underestimated.” To achieve its vision, the campaign has developed goals that are similar to those outlined in the U.S.– focused Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health. Both the campaign and the report address advancing nurses’ education and professional development, including leadership skill-building and their ability to effectively function in rapidly evolving healthcare environments. The campaign and report also call for increasing nurses’ influence on health policy and engaging nurses in leadership roles at all levels. And both serve as clarion calls for investing in the nursing workforce and viewing nurses as the key to solving many healthcare-related issues. Lord Nigel Crisp, former chief executive of the National Health Service in England, and co-chair of the international board leading Nursing Now, recently met with the ICN Executive Committee. In discussing ICN’s action plans for the campaign, Crisp reinforced the importance of engaging the world’s nursing leaders to make an indelible impact on global health, saying, “I believe that strengthening nursing is one of the single biggest things we can do to improve health globally. Nurses, wherever they are, are the health professionals closest to the community and are invaluable in promoting health and preventing diseases as well as providing care and treatment.” As the U.S. representative from the American Nurses Association to ICN and its first vice-president, I have the privilege of talking with nurses from many of the 130-plus member countries. I’ve learned that no matter our country of origin, nurses share the ability to identify patient and population needs; implement effective, and sometimes very creative, interventions; and understand that health promotion and preventive measures are critical to raising the health of patients, communities, and nations. Many of us also share similar struggles, although to varying degrees: staffing shortages, workplace and societal violence, emerging infectious diseases, and barriers to practicing to our full education and expertise. Addressing these, too, will help achieve the impact we want on global health. The Nursing Now campaign will run to the end of 2020, which coincides with the 200th anniversary of Florence Nightingale’s birth and a worldwide celebration of nurses. I encourage all nurses to learn more about the campaign at nursingnow.org and to support each other in leading the way to helping people achieve health. Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN President, American Nurses Association NURSES ON THE NATIONAL FRONT Breaking news and down-to-the-minute updates on major health care and humanitarian issues added urgency and even greater purpose to the final day of the American Nurses Association’s 2018 Membership Assembly, held June 22-23 in Washington, DC. Eligible Assembly representatives adopted recommendations from the Professional Policy Committee and elected ANA board and committee members. Representatives approved recommendations that were developed following three separate dialogue forums held the previous day. The three forums focused on: secondary opioid exposure considerations in caring for patients with overdose; the ANA presidential endorsement process; and the ANA position statement Euthanasia, Assisted Suicide, and Aid in Dying. The recommendations call on ANA to: Identify informational tools to inform students and nurses about responding to patients who have potential opioid overdose, and advocate for funding and other support for research and development of evidence-based protocols regarding opioid overdose. Refer consideration of the ANA presidential endorsement procedure back to the ANA Board of Directors for development of a revised proposal following further input from ANA members and stakeholders. Incorporate the following into a revised position statement on aid in dying: Nurses must respect patients’ right to request aid in dying; nurses must be knowledgeable of the law regarding aid in dying in the state or territory in which they practice; while nurses are ethically permitted to participate in aid in dying, in states or territories where it is legal, they retain the right to conscientiously object; nurses must be able to provide information on aid in dying and provide emotional support to patients and families who face this decision at the end of life. New leadership Eligible voting representatives elected Ernest Grant, PhD, RN, FAAN, of the North Carolina Nurses Association as the association’s next president. 2018 ANA Membership Assembly acts on current issues and looks to a bold future ANA’s Membership Assembly also elected four other members to serve on the nine-member board of directors. The newly-elected board members are: Secretary Stephanie Pierce, PhD, MN, RN, CNE, of the Louisiana State Nurses Association; Director-at-Large Tonisha Melvin, DNP, CRRN, NP-C, of the Georgia Nurses Association; Director-at-Large Varsha Singh, MSN, APN, of the New Jersey State Nurses Association; Director-at-Large Staff Nurse Jennifer Gil, BSN, RN, of ANA Massachusetts. Additionally, three members were elected to the Nominations and Elections Committee. Terms of service for the newly elected members begin Jan. 1, 2019. New ANA Enterprise Chief Executive Officer Loressa Cole, DNP, MBA, RN, NEA-BC, FACHE, addressed the Assembly, expressing gratitude for the opportunity. Cole offered her vision of a future where nurses lead. “Our nation and our patients are counting on us to show up and speak up,” she said. “We must not fail them. ANA will be there, and I know you will join us.” Celebrating a victory ANA joined other nursing organizations commending the passage of H.R. 6, the SUPPORT for Patients and Communities Act, which will extend prescribing authority to nurses and help combat the opioid crisis. The bill has moved to the Senate. By acclamation, the Membership Assembly endorsed an updated ANA board statement on the Administration’s practice of separating children from families at the United States border. A reflection – and a look ahead ANA President Pamela F. Cipriano, PhD, RN, NEA- BC, FAAN, also gave her final Membership Assembly address. Her term will end at the close of 2018. Cipriano, who has been an ANA member since she graduated from nursing school, said that she will continue to support ANA “from the sidelines,” and called nurses “the most intelligent and dedicated individuals who are strong and smart and brave and bold.” UNA Assembly Representative, Dr. Barbara Wilson and UNA Executive Director, Dr. Liz Close attended the conference. The American Nurses Association (ANA) is the premier organization representing the interests of the nation's 4 million registered nurses. ANA advances the nursing profession by fostering high standards of nursing practice, promoting a safe and ethical work environment, bolstering the health and wellness of nurses, and advocating on health care issues that affect nurses and the public. ANA is at the forefront of improving the quality of health care for all. For more information, visit www. nursingworld.org. Usually, a healthcare provider’s license is their most important asset. Disciplinary and malpractice action taken against that license not only becomes public information, but can have a devastating impact on one’s ability to practice. Catherine Larson has over 20 years of experience defending providers in these matters. Her expertise can help guide you through this challenging process. www.strongandhanni.com clarson@strongandhanni.com • 801.532.7080 102 South 200 East, Suite 800, Salt Lake City, UT 84111 9350 South 150 East, Suite 820, Sandy, UT 84070
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Utah Nurse - August 2018

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