Preconference Workshops

*Please note: preregistration and an additional fee are required

Saturday, April 28

7:30 -9:30 am
(001) Aneurysmal Subarachnoid Hemorrhage: The Newest Guidelines
Angela Nelson, ACNP CCRN

Subarachnoid Hemorrhage (SAH), a potentially devastating condition associated with high mortality and morbidity rates that affects more than 30,000 Americans each year. The incidence increases with age, with a higher incidence seen in women and blacks. Additional risk factors include hypertension, smoking, alcohol use, certain sympathomimetic drugs and genetic syndromes. Patients usually present with a headache described as "the worst headache of my life". SAH causes profound reductions in cerebral blood flow, reduced cerebral autoregulation, and acute cerebral edema. Factors that can influence outcomes include initial severity of hemorrhage, age, sex, time to treatment, medical co morbidities, size and location of the aneurysm and the hospital that they are treated at. The purpose of this presentation is to examine the current literature and evidenced based guidelines regarding management of this patient population in order to achieve better outcomes.

8:00 – 12 Noon
(002) TBI: Special Populations with Unique Injuries and Unique Needs – Neurotrauma SFG Preconference Session
Cathy Cartwright, RN MSN PCNS, Kathleen Grudzien, MSN CDR NC USN, Hilaire Thompson, RN PhD CNRN FAAN, Mary Ann Brigante, RNC MSN CRRN, Hossam Bayoumy, PT

The preconference will focus on four unique patient populations with TBI: the abused infant, the soldier wounded in combat, the geriatric patient, and the patient with a severe disorder of consciousness in rehab. A nurse working with each population will highlight the clinical presentation, assessment, management strategies, and neuroscience nursing implications. Abusive head injury in infancy has devastating effects with approximately one –third dying and one third experiencing profound mental and physical disabilities. The most profound and devastating injuries in military TBI result in moderate and severe injury; however the largest and most perplexing population is those with mTBI and chronic post concussive symptoms. As aging occurs, both structural and physiologic changes occur that increase the geriatric patients brain injury and worsen their neurologic outcome. Finally as care has improved, a growing population of patients has emerged with severe disorders of consciousness who may benefit from rehab.

10:00 – 12 Noon
(003) Blood Thinners in 2012
Angela Nelson, ACNP CCRN

The management of Warfarin, a common anticoagulant presents many challenges to clinical practice such as having a narrow therapeutic window, variability in dose response, interactions with other drugs and diet, lab controls which are difficult to standardize and patient compliance. In addition, there are ever increasing parental anticoagulants that are being used for bridging therapy for patients who are either currently being treated with anticoagulants and having intercurrent invasive procedures, new to anticoagulation and being bridged until a therapeutic INR is obtained or simply not a candidate for Warfarin. The purpose of this presentation will be to present the newest evidenced based guidelines offered by the American College of Chest Physicians (ACCP), 8th Edition on Anti-Thrombotic and Thrombolytic Therapy for the management of both oral and parental anticoagulation, as well as offering practical solutions for dealing with the challenges that anticoagulation present. In order to more fully understand the bridging process, a review of the intrinsic and extrinsic clotting cascade will be presented. A discussion of the newest oral anticoagulant, Dabigatran as well as antithrombotic drugs that are in the Phase II and III clinical settings will be offered. In addition to this, areas of practice support will be reviewed such as the Anticoagulation Forum, types of point of care devices and computer software programs that are currently available to aid in the management of these patients.

10:00 – 12 Noon
(004) Caring for the Patient with an External Ventricular Drain - SOLD OUT
Nadine Nielson, ARNP CPNP, Donna Wallace, CPNP Cathy_Cartwright_2

External ventricular drains (EVDs) are common in neurosurgical patients. They can be associated with significant morbidity and require meticulous care. This informative presentation will include one hour of lecture and one hour of hands on practice setting up and working with EVDs. The didactic session will include evidence based practice in caring for such patients. It will cover information on the indications for an EVD, setting up and caring for patient with an EVD, possible complications, trouble shooting, documentation and policies. The lab session will include 4-5 case scenarios where the participant will be able to problem solve and demonstrate the skills to care for such patients using hands on practice with EVDs and models. The attendee with receive a certificate of completion of the course.

10:00 – 5:00 pm
(005) Neuromonitoring Simulation
Twyila Lay, MS ACNP, Cindy Sullivan, MN RN ANP-C CNRN, Linda R. Littlejohns, MSN RN CCRN CNRN FAAN, Karen March, MN RN CCRN CNRN, Tracey Berlin, RN BSN CCRN CNRN, Sandy Cecil, RN BA, DaiWai Olson, PhD RN CCRN

This procedural workshop is geared toward the Advanced Practice Nurse (APN) specializing in trauma and stroke care. The session will begin with an advanced evidence based didactic discussion of monitor selection, value interpretation and physiological implications of their use in these specialized patient populations. Unique to this session is the participant's ability to have an exclusive opportunity for a "hands-on" monitor evaluation, burr-hole and ventriculostomy insertion, and manipulation. Finally, using a case based approach to care, the session will conclude with an opportunity for value interpretation, creation of a differential diagnosis and development of an individualized plan of care.

1:00 – 5:00 pm
(006) Navigating the Nervous System: Neurological Assessment Skills for the Bedside Nurse – Joint SFG Preconference Session – Neurotrauma, Neuromuscular, Pediatric, Spine
Davonna (Davi) Ledet, RN MSN CNRN CFNP, Mary Kay Bader, RN MSN CCNS FAHA, Theresa Gabay, MSN APN CNRN, Jan Jenkins, MSN CNRN MSCN CNS

Superior neurologic assessment skills are essential for the bedside nurse providing patient care. Bedside nurses should be educated to focus on pertinent aspects of the neurologic system specific to each patient's disease process. The ability to evaluate and triage the findings of the examination for clinical relevance is essential. This seminar will correlate basic brain anatomy with neuroanatomical function and demonstrates tools and techniques used in the neurologic examination. Understanding the purpose of disease specific tools and techniques and their clinical relevance will allow the bedside nurse to perform a more meaningful, focused, and purposeful examination.

1:00 – 3:00 pm
(007) Ischemic Stroke: Diagnostic Imaging & Treatment
Debbie Summers, MSN ACNS-BC CNRN CCRN, Rachel Malloy MSN RN CNRN

Advanced imaging has expanded treatment time and options in the ischemic stroke population. Nurses can benefit in understanding the imaging techniques available, when to use them and how they drive treatment decisions for ischemic stroke patients. Prior to the development of advanced imaging it was impossible to know the viability of parenchyma and anatomical location of clot. This presentation will provide insight in the use of CT and MR imaging, perfusion scans and angiography to identify underlying pathology and anatomical regions during ischemia Participants will have an opportunity to discuss treatment options and patient outcomes based on imaging The goal is to provide a foundation of knowledge for nurses to draw on during interactive case studies.

3:30 – 5:30 pm
(008) Comprehensive Stroke Centers: A Sneak Peak at the Joint Commission Certification Requirements – Stroke SFG Preconference Session
Debbie Summers, MSN RN ACNS-BC CNRN CCRN, Anne Alexandrov, PhD RN CCRN FAAN, Kathy Morrison, MSN RN CNRN

Since the development of The Joint Commission (TJC) Primary Stroke Center certification in 2003, Comprehensive Stroke Centers (CSC) have advocated for similar recognition. Recommendations for CSC published in 2005 provided the first step in launching certification, and prompted debate and recent publication of proposed quality metrics by the American Stroke Association. This preconference session provides an opportunity to learn about newly proposed TJC standards and quality measures for CSCs, presented by 3 expert neurovascular nurses that serve as members on the CSC Expert Technical Advisory Panel for TJC. Evidence supporting each measure will be examined, alongside a detailed discussion of practice implications and an emerging call for changes which may affect future relationships between primary and comprehensive centers. The target audience for this session includes stroke program coordinators, program managers and administrators, stroke nursing staff, and advance practice nurses interested in both primary and comprehensive level certification for Stroke Centers.

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2012 Call for Commercially Supported Symposia