New Chapters Join the Preventive Cardiovascular Nurses Association
The Preventive Cardiovascular Nurses Association (PCNA) is happy to announce the formation of 3 new chapters in recent months: Central Kentucky, Boston, and Kentuckiana. Congratulations, and welcome to the PCNA family!
The Central Kentucky Chapter was formed in March 2015. Martha Biddle is the Chapter Leader and Debra Moser and Jennifer Miller are part of the leadership team. They hosted their first Continuing Education (CE) event October 3 in Lexington, Kentucky. The title of the CE presentation was "Secondary Prevention Cocktail: The Key Ingredients."
The Boston PCNA Chapter was formed in August 2015. Heather Harker Ryan is the Chapter Leader. Check their chapter webpage to stay tuned on the announcement of their first CE event.
The Kentuckiana Chapter was formed in September 2015. Heather Mitchell is the leader of this chapter, which will serve the Louisville area and parts Indiana. Be sure to visit their chapter webpage as they begin planning for their first CE event as well.
Interested in having a PCNA chapter in your area? Visit http://www.pcna.net/chapters to see the complete list of chapters currently petitioning (sign the petition if you see a chapter in your area) or find out what it takes to start your own chapter.
American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
On October 15, 2015, the American Heart Association (AHA) released the 2015 Guidelines Update for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care. A summary is available, as well as a full text version, in Circulation, at https://eccguidelines.heart.org/index.php/circulation/cpr-ecc-guidelines-2/.
Recognizing the unique contributions of both lay rescuers and healthcare professionals, new system-specific chains of survival were created for out-of-hospital cardiac arrests (OHCA) and in-hospital cardiac arrests (IHCA).
The OHCA Chain of Survival
* Recognition and activation of the emergency response system
* Immediate high-quality CPR
* Rapid defibrillation
* Basic and advanced emergency medical services
* Advanced life support and post arrest care
The IHCA Chain of Survival
* Surveillance and prevention
* Recognition and activation of the emergency response system
* Immediate high-quality CPR
* Rapid defibrillation
* Advanced life support and postarrest care
The AHA recognizes that some communities have benefited from systems in place to notify potential rescuers of a nearby arrest situation to hasten the start of chest compressions and initiate the chain of survival. Lay rescuers remain a critical link in the chain of survival, as bystanders of a person in arrest can receive timely assessment tips and CPR instruction from 911 dispatch centers via their mobile phones.
Key 2015 guideline revisions include the following:
* Healthcare providers are directed to perform critical assessments simultaneously, such as checking for breathing and a pulse, to reduce time to the first set of chest compressions.
* Chest compressions should be performed at a rate of 100 to 120 per minute, with compression depth between 2 and 2.4 in. for the average adult, to optimize effect. Allow full recoil after chest compression, minimize pauses, and ventilate adequately (each breath over 1 second or just enough to cause chest rise).
* A range of targeted temperature management between 32[degrees]C and 36[degrees]C, maintained for 24 hours after arrest, is considered beneficial to prevent brain function compromise.
* If opioid overdose is suspected in those unresponsive victims without normal breathing, who are still maintaining a pulse, basic life support providers (and appropriately trained lay rescuers) are guided to consider use of naloxone.
Each year, more than 326 000 OHCAs and 209 000 IHCAs occur with survival rates averaging 10%. For more than 50 years, CPR training has made a difference in saving lives and strengthening communities. Consider becoming an AHA Basic Life Support Instructor to guide others in implementation of the 2015 CPR/emergency cardiovascular care updates or take advantage of more frequent training intervals, with use of feedback devices and manikins that can optimize performance of CPR.
2016 Annual Meeting: New Footprint, Another Great Line-up
Registration is now open for PCNA's 2016 Annual Symposium, happening April 14 through 17 at the Renaissance SeaWorld in Orlando, Florida.
Please note that the "footprint" of the 2016 meeting has been shifted in response to many of our members who report difficulty getting time out of the clinic setting. We hope that having a larger portion of the conference over 2 weekend days may be helpful. This year, the meeting will open on Friday morning, April 14, and end at 12:30 PM on Sunday, April 17. The pharmacology preconference will be on Thursday afternoon from 12:30 to 5:30 PM.
This year's conference will provide attendees with the most critical "need to know" information and continue the PCNA tradition of hosting star-quality faculty with inspirational, cutting-edge content. Take a look at some of our 2016 sessions:
"Hypertension: A 2016 Update"-Renowned hypertension expert Jan Basile, MD, will guide us through clinical decision making to match the patient to the guidelines and help us answer the question: How low is low enough?
"Medication Reconciliation, Page 17: Just How Big a Problem Is Polypharmacy?"-Older adults take an average of 5 prescription medications a day. Dr Amanda Engle, an expert in adherence to complex medication regimens, will describe successful ways to help patients improve their medication self-management skills.
"Proactive Management of Afib: Prevention and Early Identification"-Dr Eileen Stuart, an internationally renowned nursing leader in the management of atrial fibrillation, will provide insights into the treatment strategies and long term management of atrial fibrillation. With between 3 million and 6 million cases in the United States alone, this is a diagnosis that is important to all of us.
"Strategies to Reduce CV Risk in the Hispanic Community"-Dr Eduardo Sanchez, the AHA's chief medical officer for prevention, is a world leader in prevention. He is passionate about closing the gap in access to healthcare for all and has a special interest in cardiovascular disease and stroke prevention in the Hispanic population-the fastest growing population in the United States.
"Leveraging Technology for Cardiovascular Health: How Fast Are We Moving"-Take 2 aspirin and Tweet me in the morning! As the use of technology in cardiovascular disease and stroke prevention is exploding, Dr Mary Cain will provide us with critical knowledge and guidance on how to make technology work for us and the patients we care for.
Learn more and register at http://www.pcna.net/symposium2016.
Trans-fats: Are They Gone for Good?
On June 16, 2015, the US Food and Drug Administration (FDA) announced that food manufacturers will have 3 years to remove trans-fats from their products. The decision was based on the scientific information to date: that partially hydrogenated oils (PHOs), which have served as the primary source of artificial trans-fat in our diets, are not safe.
Since 2006, the FDA has required that manufacturers list the trans-fat content in the nutritional label if they contained more than half a gram per serving. In response, some manufacturers adjusted the serving size, rather than remove the trans-fats.
In 2013, after reviewing scientific studies showing the relationship between trans-fats and the development of coronary heart disease, the FDA made a tentative determination that PHOs could not be considered safe foods. They requested additional information from scientific data and received more than 6000 responses, some in favor of elimination of the trans-fats and others not. After reviewing the information, they made the final determination that PHOs are not safe for human consumption.
This June 2015 decision by FDA requires food manufacturers to either remove the PHOs from their products or petition the FDA to allow specific uses of PHOs, demonstrating with reasonable certainty that no harm will occur with its use. Manufacturers have 3 years to remove the PHOs from their products. After 3 years, PHOs will not be allowed to be added to human food unless specifically approved by FDA. The compliance date is June 18, 2018.
Trans-fats are formed when liquid oil is infused with hydrogen gas, resulting in a solid form. This is called "hydrogenated" or "partially hydrogenated," and this manmade form is a contributor to atherosclerotic plaque formation in the arterial system. Small amounts of trans-fats can be found "naturally" in some animal and in dairy products. In addition, some oils that have not been hydrogenated may also contain small amounts of trans-fatty acids owing to high temperatures used in processing. The FDA did not include these products in their determination; the manmade process of partial hydrogenation is what is being banned.
So what should we tell our patients? Suggest that they read not only the nutrition label that lists the grams of trans-fats, but importantly, encourage patients to read the ingredient section. If partially hydrogenated oil is listed in the ingredients, then there is some amount of trans-fat in that product and it should be avoided.
References:
Department of Health and Human Services Food and Drug Administration. Final Determination Regarding Partially Hydrogenated Oils.
http://federalregister.gov/a/2015-14883
http://www.FDsys.gov
Celebrating Heart Month
February is "Heart Month." So what can we do in our communities to get the word out about heart disease?
Here are a few ideas recommended by the National Institutes of Health's National Heart, Lung, and Blood Institute
* Organize a "National Wear Red Day" event at a local mall, library, community center, local business, or manufacturing plant.
* Form partnerships with retail/clothing outlets to stage a "Red Dress Day" that donates a percentage of the profit for every red dress sold to a nonprofit heart disease organization.
* Organize heart health screening events and health fairs at businesses, faith-based organizations, hospitals, clinics, and health centers.
* Organize a "Red Dress Evening" or "Red Dress Luncheon" for a local restaurant to serve a creative "tasting menu" of heart-healthy foods.
* Partner with local beauty salons and spas to exhibit and reinforce the message that women need to take care of themselves both inside and out. Leave The Heart Truth fact sheets and brochures about heart disease for customers to pick up at the main desk or create a freestanding display.
* Hold a "Red Dress for Success" breakfast or luncheon with local professional women's organizations to feature a Red Dress fashion show.
* Plan a "Red Dress Sunday" for your place of worship. You can put a notice in the bulletin, hold an educational session, and distribute brochures.
* Ask your local library to set up a special heart health exhibit or organize a special reading center focused on women and heart disease.
* Partner with local large businesses and corporations in your community or state to promote heart health awareness in the workplace.
* Encourage local colleges or universities to host a heart health forum, using the educational materials.
* Ask your local high school art club or art classes to design artwork and advertisements for you event.
* Ask school children to decorate heart health gifts for their mothers or grandmothers, asking that they take care of their hearts.
* Write a letter to your local newspaper editor, encouraging a feature story on women ad heart disease.
* Contact a female legislative representative and ask her to spearhead a program of her own, or ask her to issue a statement in support of your program.
* Organize a Red Dress team to participate in a local walk, run, or sports tournament. The Red Dress team wears red.
* Host a Red Dress badge opportunity for local Girl Scout troops to encourage mothers and grandmothers to take care of their hearts.
2015 Fall Learning Series Recap
The 2015 Fall Learning Series made 7 stops across the country last fall, reaching hundreds of healthcare professionals in Denver, Fort Worth, Sacramento, Cincinnati, Chicago, Jacksonville, and Philadelphia. These free, half-day events provided participants with 2.5 CE credits, a heart-healthy meal, and excellent networking opportunities for local registered nurses, advanced practice nurses, diabetes educators, physician assistants, exercise physiologists, and dieticians.
This year's theme was "Therapies That Work: Translating Their Optimal Use into Clinical Practice." The goal of this series of talks was to provide clinically relevant information on a Saturday that practitioners could use on Monday. 2015's clinical education topics for the Fall Learning Series included the following.
Secondary Prevention Cocktail: The Key Ingredients
Thanks to great teamwork, we are doing a better job on getting those D2B (door to balloon) times below 90 minutes, but long-term outcomes for the post acute coronary syndrome patient depends on their persistence with the secondary prevention cocktail.
Statins and Beyond: New Tools for the Challenging Patient
There is still controversy around the 2013 prevention guidelines, and with new pharmacologic lipid-lowering agents on the horizon, there is a lot for cardiovascular professionals to know. Our session on lipid management provided the latest information to demystify the guidelines and the treatment of the complicated patient.
Venous Thromboembolism: Matching Patient Need to Optimal Therapy
Risk for deep vein thrombosis and pulmonary embolism increases in those undergoing orthopedic surgery and in those immobilized for a variety of reasons, including air travel. There are a number of options available to manage venous thromboembolism risk, including nonpharmacologic strategies and a host of new anticoagulant medications.
Stay tuned for 2016's cities at http://www.pcna.net/fls.