STN Annual Conference 2015

River of Dreams: Envisioning Best Practices in Trauma Care
March 25 - 28, 2015
Hyatt Regency Jacksonville Riverfront
Jacksonville, Florida

Conference Agenda

Oral and Poster Abstracts

Evidence Based Oral Abstracts
Research Oral Abstracts
Poster Abstracts

Wednesday, March 25

Britton Christmas, MD, FACS
Gary Marshall, MD
Brian van Ness, PA-C
Cassandra Winter, PA-C

The care of both Trauma and Acute Care Surgery patients requires knowledge and skill in managing complications that occur in the hospital. This workshop will address some common complications that the Advanced Practitioner in Trauma/ACS will encounter in their practice. Evidence based treatment will be discussed for these vexing problems. This workshop will address the diagnosis and treatment of common in-hospital complications to include Venous Thromboembolic Disease (VTE), Delerium in the Geriatric Population, Clostridium Difficile Colitis, and Pneumonia.

Keith Clancy, MD
Carol Immermann, RN
Amy Eberle, RN, BSN
Deb Syverson, RN, BSN, EMT

This is an essential course for regional trauma centers that support rural programs or those who work within rural trauma centers, where trauma volumes are low, distances long, and resources can be scarce. Rural regions house only 25% of the U.S. population, but have 60% of the trauma deaths. This course has been designed to help rural facilities achieve optimal outcomes through improved performance improvement.

Robert W Letton, Jr, MD, FAAP, FACS
Diane Fendya, MSN, RN
Rebecca Cook, DNP, APRN-BC
Mary Alice McCubbins, CPNP-PC, RN

Overview: Join our Pediatric leaders as they share their best practices on the following topics:

Clinical decision tools for TBI
Understanding Teens & Injury Prevention strategies
Current & future resources for children’s emergency medical care
New ACS (Orange Book) standards: Implications for pediatrics

Sean Elwell, MSN, RN, EMT
Amanda Elikofer, MSN, RN, NE-BC
Amy Krichten, BSN, RN, CEN
Elizabeth Seislove, MSN RN
Deb Harkins, MBA, BSN, RN, CCRN
Missy Hockaday, MSN, ACNP-BC

Trauma programs rely on leadership of practitioners from the bedside to the boardroom to produce high quality outcomes for injured patients. This workshop will cover five topics that are common to the trauma leader in the acute care setting. This workshop is applicable for leaders of different levels from novice to expert. The speakers will cover strategic planning, meeting management, role of the Trauma Program Manager, using data to influence change and budgeting.

Thursday, March 26

Welcome
John H. Armstrong, MD, FACS
Surgeon General, State of Florida

Presidents' Address and Annual Meeting
Julie Nash MSN, RN
STN 2015 President; Manager, Trauma & Acute Care Services, Barnes-Jewish Hospital, St. Louis, Missouri

Our outgoing STN president, Kathi Ayers, will give an update on STN activities, introduce the Board of Directors, introduce our new incoming president and present the annual STN awards. Our incoming president, Julie Nash, will be speaking on the importance of finding meaning in what you do. Additionally, she will be discussing stepping out of your comfort zone as well as becoming fully engaged in your trauma community.

Moderator: Kathi Ayers, MSN, FNP, RN – 2014 STN President

Kathryn VonRueden, MS, RN, CNS-BC, FCCM
Associate Professor, OSAH, University of Maryland, Baltimore, MD

Exposure to others’ traumatic events as a result of work, such as in a critical care unit, trauma center or an ED is secondary exposure and can lead to compassion fatigue, burnout and, depending on the situations, moral distress. Thus, nurses who care for critically ill and injured patients are at risk for developing burnout, compassion fatigue and moral distress. Awareness of factors associated with these may help nurses to prevent or offset the development of these conditions in themselves and others. Explore links between moral distress, compassion fatigue, burnout, and bullying; the signs and symptoms of these; and strategies to address and prevent them.

Moderator: Karen E. Doyle, MBA, MS, RN, NEA-BC

10:00 – 11:00 AM Concurrent Sessions
CLINICAL Advanced Interpretation of Adult Vital Signs in Trauma William Hampton, DO Using case-based vignettes, this lecture takes the listener through the five cardinal vital signs, dispelling myths, showing patterns, and improving patient care.
Leadership Leading The Generations Missy Hockaday, MSN, ACNP-BC The workforce is becoming increasing diverse with employees of all ages and expertise. The challenge for leaders is to recognize differences and adopt approaches to employees based on generational needs. The fundamental goal is to provide effective communication, reduce generational conflict, maximize the contribution of all the staff, and improve creativity, productivity and innovation among a diverse team. This course will give the audience tactics and strategies to become successful Leading through Generations.
RURAL Lessons Learned at a Rural Level 1 Pediatric Trauma Center Terri Elsbernd, MS, RN, CEN, CPEN This session will utilize case-based format to highlight issues unique to caring for injured children in the rural environment. Possible solutions and lessons learned from a Level 1 Pediatric Trauma Center located in a rural setting will be provided.
CLINICAL QUALITY Improving Patient Expectations and Satisfaction Using a Self-Education and Peer Support Process Babak Sarani, MD, FACS, FCCM Eileen Flores, MSW, LCSWA Stephen T. Wegener, PhD, ABPP The Trauma Survivors Network (TSN) is an initiative of the American Trauma Society that aims to educate trauma patients regarding their injury as well as to connect current patients and their families with trauma survivors. The Trauma Collaborative Care Initiative (TCCI) helps assure that services provided though the TSN are appropriately targeted and used by those who most need them. This session will discuss why and how to introduce the TSN and the TCCI in your trauma center. (PRESENTED BY EAST)
CLINICAL Shackled: Dealing with the Trauma Patient Who Is a Prisoner Cynthia Blank-Reid, RN, MSN, CEN Providing quality trauma nursing care is very challenging when your patient is a prisoner. Topics to be discussed include consent, care, research, safe work environment, etc.
PEDIATRIC Managing Pediatric Cervical Spine Injury Robert Letton, Jr, MD, FAAP, FACS What are the developmental differences in children & their effects on cervical spine injuries? The incidence of cervical spine injury in children is rare, however when this injury does occur the incidence of mortality is significant. Join Dr. Letton to discuss the current best practices for effectively managing pediatric c- spine injuries.
CLINICAL The Mangled Extremity: Best Practices and Optimal Outcomes Kristen Ray, MSN, RN This session describes assessment and treatment of mangled extremities, interventions for limb salvage and rehabilitation, and patient outcomes on best practices.

11:10 AM– 12:10 PM Concurrent Sessions
ORAL PRESENTATIONS – EBP ORAL ABSTRACT WINNERS – Evidence Based Practice Authors, TBA The top three submissions in the Evidence-Based Practice category are presented at this session: Core Team Members’ Impact on Outcomes and Process Improvement in the Initial Resuscitation of Trauma Patients: Rebecca Geyer, MSN, RN Impact of a Level Two Trauma Center on Organ Donation Rates in a Community Hospital: Jo-ell Lohrman, MSN Creating a Geriatric Focused Model of Care in Trauma with Geriatric Education: Kai Bortz, MSN RN, CMSRN, CNL
Leadership Building and Leading an Effective Team of Advanced Practice Providers: Lessons Learned C. Todd Borchers, MS, APRN, ACNP-BC This session will review the need, utilization and structure needed to build and lead a team of advanced practice providers in a level 1 trauma center.
MILITARY Trauma in Afghanistan: Lessons Learned Thomas Hornyak, BSN, RN, CEN, PHRN This lecture provides a brief overview of the treatment and measures currently being used by U.S. Forces to treat traumatic injuries and hemorrhage in Afghanistan. A review of how the pathophysiology of trauma leads to the “lethal triad of trauma” will be discussed, along with how damage control resuscitation aims to provide early and aggressive treatment for coagulopathies. Combat injuries and the challenges of providing care in a hostile and austere environment will be presented.
CLINICAL Adult Clinical Decision Rules For Trauma William Hampton, DO Who needs imaging and who doesn’t? This session will explain clinical decision rules, their derivation and how to accurately apply them to the adult trauma patient.
CLINICAL The Chaotic Inflammatory Response to Trauma: The “Oooh-La-La” Factor Christine Schulman, MS, RN, CNS, CCRN This session will review the inflammatory processes that drive a patient’s physiologic response to injury and describe strategies for mitigating them.
PEDIATRIC In the Beginning- Ensuring Optimal Pediatric Trauma Resuscitation Diana Fendya, MSN, RN This session will review evidence based emergency department guidelines for the care of pediatric emergency/trauma patients. Provide an overview of a 2013 national assessment to measure emergency department pediatric readiness and ED capabilities for providing care for children entering America’s EDs for emergency/trauma care and discuss national assessment aggregate findings and implications for enhancing the care of the injured child. Identify low cost/high value opportunities for improving pediatric emergency/trauma resuscitation in both trauma and non-trauma facilities.
LEADERSHIP Leading the Generations Missy Hockaday, MSN, ACNP-BC The workforce is becoming increasing diverse with employees of all ages and expertise. The challenge for leaders is to recognize differences and adopt approaches to employees based on generational needs. The fundamental goal is to provide effective communication, reduce generational conflict, maximize the contribution of all the staff, and improve creativity, productivity and innovation among a diverse team. This course will give the audience tactics and strategies to become successful Leading through Generations

1:30 PM– 2:30 PM Concurrent Sessions
ORAL PRESENTATIONS - RESEARCH Oral Abstract Winners - Research Authors, TBA The top three submissions in the Research category are presented at this session: A Narrative Inquiry Into the Experience of Being a Victim of Gun Violence: Stories From the Victims: Mary Francis, PhD, RN, ACNP-BC Compassion Fatigue, Moral Distress, and Work Engagement in Trauma SICU Nurses: A Pilot Study: Virginia Mason, PhD, RN, CCRN, ACNS-BC EMS and Trauma Bay Intubation: Is There a Clinical Difference in Patient Outcomes?: Michael Lloyd, MS, RN
CLINICAL QUALITY Effective Self-Management Programs for Survivors of Serious Trauma Ian Weston, MPP Patient-support programs for victims of trauma, can ease the burden of injury through the exchange of reliable info, education, peer support and, self-management programs.
Rural The Challenges and Triumphs of Developing and Maintaining a Rural Trauma Center Keith Clancy, MD Providing trauma care in the rural environment has significant challenges not seen in the urban setting. Resources are available to rural trauma centers that can address their unique needs. This session will explore how to utilize resources such as team training and partnerships with other trauma programs which can help maintain the long term viability of the rural trauma center.
ADVANCED PRACTICE Advanced Practitioner-Value & the Affordable Care Act: What You Need to Know Raquel Forsythe, MD Benjamin Reynolds, MPAS, PA-C The Director of the Office of Advanced Practice Providers for University of Pittsburg Medical Center will discuss strategies to maximize value from APPs in Trauma. A practicing Trauma/ACS PA, Mr. Reynolds also oversees 1700 APPs across a 22 hospital system. (PRESENTED BY EAST)
CLINICAL Family Feud: Test Your Knowledge of Best Practices in Trauma Care Lynn Gerber-Smith, MS, RN This fun, educational, and interactive session will quiz participants on best practices in trauma care using the format of a TV game show Family Feud.
PEDIATRIC Evaluating Non-Accidental Trauma in Infants & Children Rebecca Cook, DNP, APRN-BC This session will discuss risk factors and injury patterns characteristic of physical abuse and distinguish findings often mimicking abuse. Review diagnostic modalities to aid evaluation and management of suspected non-accidental trauma and define the practitioner’s role in evaluation and management of suspected non-accidental trauma.
CLINICAL The Chaotic Inflammatory Response to Trauma: The “Oooh-La-La” Factor Christine Schulman, MS, RN, CNS, CCRN Session reviews inflammatory processes driving the patient’s physiologic response to injury and describes strategies for mitigating them.

Making Sense of the Mayhem: Lessons from Colorado Shootings
Kim Muramoto, BS, RN
Director of Trauma Programs Centura Health Littleton, Castle Rock and Porter Adventist Hospitals, Colorado, CO

When the Storm Hits
J. Bracken Burns, DO, MS
Associate Professor, Department of Surgery, Division of Acute Care Surgery, UF Health, Jacksonville, FL

The past years have marked an increase in disasters of all types, from man-made to natural phenomenon. As disaster and mass-casualty activities have increased in recent years, many have been tasked with the issue and are scurrying to become prepared. Whatever the event—hurricane, flooding, wildfire, bus crash, building collapse, explosion, mudslide, or multiple shootings—lessons have been learned and re-learned. During this session the speakers will discuss experiences and lessons learned during the Colorado shootings and the role of the trauma center in disaster response. Also discussed will be key points to consider when preparing for and responding to natural disasters which strike your facility.

Friday, March 27

Round Table: Rise, Shine, Learn!
This session will give you a chance to network with colleagues and meet with some of the speakers and trauma leaders. Feel free to prepare your thoughts, ideas or questions for discussion.

Table#	Moderator/Topic
1	Chris Schulman: Precepting/ Training
2	Karen Doyle: Trauma Center Finance
3	Ian Weston: Injury Prevention/ Trauma Survivors
4	Jorie Kline: Emergency Preparedness
5	Judy Mikhail: Trauma Performance Improvement
6	Mike Glenn/Janet Howard: Starting ATCN at Your Facility
7	Kathryn Schroeter: Feedback from the JTN Editor
8	Melissa Harte: Telehealth
9	Stephanie Czuhajewski/Maria McMahon: Getting Involved in STN
10	Roy Ball/Liz Atkins: Trauma Careers Beyond the Bedside
11	Amber Kyle: Leadership
12	Regina Medeiros: Preparing an Abstract

CLINICAL
The Mangled Extremity: Best Practices and Optimal Outcomes
Kristen Ray, MSN, RN
This session describes assessment and treatment of mangled extremities, interventions for limb salvage and rehabilitation, and patient outcomes on best practices.

REHABILITATION
Exoskeleton Use for Persons Following a Traumatic Injury
Casey R. Kandilakis, PT, DPT
Learn about the development and use of an increasingly advanced exoskeleton that allow persons with traumatic injuries to learn to walk again. Focus will be on SCI and CVA.

PEDIATRIC
“You’re Killing Me Man!”: The Real Issues of Bullying and Teen Suicide
MaryAlice McCubbins, MSN, RN, CPNP-PC, LTC,USAF(ret)
This session will explore the key issues of bullying & teen suicide. Join this speaker to discuss what prevention & intervention strategies might be employed to address these behaviors.

Glen Tinkoff, MD, FACS
Associate Vice Chair, Surgery for Emergency Surgical Services, Christiana Care Health System, Wilmington, DE

The new color brings us new changes. Dr. Tinkoff will outline the development and current vision of the American College of Surgeons Committee on Trauma (ACS COT) PI efforts. He will also discuss fundamental structure and processes required for an effective trauma PI program. Finally he will review changes to the PI chapter (chapter 16) in the revised edition of the “Resources for Optimal Care of the Injured Patient”, the “Orange Book.”

Moderator: Amy Koestner, MS, RN

Joseph J. Tepas III, MD
Professor Department of Surgery, Division of Pediatric Surgery, UF Health, Jacksonville, FL

We all know that where we come from is a reflection of where we go. Have you ever thought of this with regard to trauma? Come walk the “River of Dreams” with Dr. Tepas as he discusses where we have come from with the evolution of trauma systems and where we are going identifying factors and forces impacting modern trauma care.

Moderator: Marla Vanore, MHA, RN

Stanley Kurek, DO, FACS
Trauma Surgeon, Lawnwood Regional Medical Center, Ft Pierce, FL
Oszkar Szentirmai, MD, FACS
Chief of Neurosurgery, Lawnwood Regional Medical Center, Fort Pierce, FL
Elizabeth Seislove, MSN RN
Director, Trauma Program, Lehigh Valley Hospital, Allentown, PA

The treatment of the traumatically brain injured patient is eclectic to say the least and very controversial. Join the panel as they discuss evidenced based research regarding treatment options for the traumatically brain injured patient giving you a better understanding of the various options identified and how to implement the care of the TBI patient.

Moderator: Cindy Blank-Reid, MSN, RN, CEN

Up the Neuromonitoring River: Navigating New Technologies to Improve Patient Outcomes
Diane Bräxmeyer Downey, BSN, RN, CNRN
Educator Legacy Emanuel Medical Center, Portland, OR

Intensive Care Management of the Open Abdomen
David Skarupa, MD
Assistant Professor, Division of Acute Care Surgery, UF Health, Jacksonville, FL

Management of Acute Coagulopathy of Trauma Using Point of Care Viscoelastography
Christine Schulman, MS, RN, CNS, CCRN
Critical Care Clinical Nurse Specialist, Legacy Health, Portland, OR

Join us in a discussion of Critical Care issues. Learn about advances in multimodal neuromonitoring technology: impact on injury identification, care and outcomes for traumatic brain injured patients. Review the lethal triad, damage control sequence and complex multi-system support required for patients near physiologic exhaustion with an open abdomen. Last but not least discuss the pathophysiology of acute coagulopathy in trauma and the clinical application of viscoelastography for evaluating coagulation.

Moderator: Amber Kyle, MSN, RN

Marcus Engel, MS
Co-Founder and President, I’m Here Movement, Orlando, FL
Jennifer Aycock, BSN, RN, CCRN
Co-founder and President, I’m Here Movement; Clinical Nurse Manager, Barnes-Jewish Hospital Orlando, FL

Learn about insight and strategies for excellent patient care…all from the patient’s perspective. They speakers will review universal perspectives of ill and injured patients and the importance of family and friends as primary support systems. Explore distinct communication difficulties from a patient’s viewpoint. Narcotics, the names of medications, procedures and tests are unfamiliar to those who are not HCPs. Use words and terminology a patient can easily understand. Explain the benefits, avoiding names of medications and technical terms. Finally, examine the best methods of communication with families and friends who are also suffering while their loved one is ill or injured.

Moderator: Julie Nash, MSN, RN

3:15 PM – 3:30 PM CLOSING REMARKS from the President
Julie Nash, MSN, RN Now you can relax or walk along the river!

Saturday, March 28 - Sunday, March 29

Glen Tinkoff, MD
Medical Director, Trauma Program, Christiana Care Health System Newark,DE
Carol Immermann, RN, CEN
Trauma Program Manager, Mayo Clinic, Rochester, MN
Jorie D. Klein, RN
Director, Trauma Program & Disaster Management, Parkland Health & Hospital System, Dallas, TX

TOPIC is a one-day course that was developed by a seasoned group of trauma leaders, to assist participants with the Performance Improvement (PI) process in trauma care.

TOPIC focuses on skill development for trauma program staff who are involved in the ongoing evaluation of trauma care across the continuum. It offers concrete strategies for the monitoring of trauma care, loop closure, and patient outcomes. The course provides practical lessons for all levels of trauma centers, from entry level to those who have achieved a mature phase of program development. It consists of 12 modules in PI and outcomes assessment, and includes over 50 case study examples, sample documents, and templates. TOPIC can now be co-taught by both nurse and physician faculty.

Frank “Tres” Mitchell, III, MD, FACS
Trauma Director, Scottsdale Healthcare, Scottsdale, AZ
Amy Koestner, MS, RN
Trauma Program Manager, Spectrum Health, Grand Rapids, MI
Judy Mikhail, MSN, MBA, RN
Program Manager, Michigan TQIP, University of Michigan, Ann Arbor, MI
Molly Lozada
Administrator, Trauma Verification Program, American College of Surgeons

The American College of Surgeons Committee on Trauma (ACS-COT) and the Society of Trauma Nurses (STN) have partnered to develop the Optimal Trauma Center Organization & Management Course. Both physicians and nurses teach this collaborative course. Its goal is to enhance trauma center performance and to improve patient care through implementation of the ACS COT Trauma Center Standards.

Whether yours is a mature verified center or a hospital preparing for designation, this course is designed to help participants develop strategies, processes, and operations to support trauma systems, based on their unique environments. It is designed to help you take your trauma center to the next level, beyond verification or designation. The nuances of implementing or improving upon trauma center criteria within the structure of your specific facility will be reviewed in an interactive forum.

Pina Violano, MSPH, RN-BC, CCRN, CPS-T, PhD (c)
Karen Macauley, DHA, RN, MEd
Dawn Daniels, PhD, RN, PHCNS-BC
Kenyattaa Hazlewood, BSN, MPH, RN

The ATS’s new Injury Prevention Couse was developed in collaboration with members of the Trauma Prevention Coalition (Including, the Society of Trauma Nurses (STN), American College of Surgeons – Committee on Trauma (ACS-COT), Eastern Association for the Surgery of Trauma (EAST), Trauma Center Association of America (TCAA) and American Association for the Surgery of Trauma (AAST). This 2-day course was developed by seasoned injury prevention professionals across the country and is designed to cover 14 chapters related to establishing and expanding a comprehensive Injury Prevention Program within hospitals and trauma centers. This course is designed for individuals and organizations actively engaged in developing and implementing policies or programs that primarily target or secondarily impact the prevention of injury.

To register please contact Kim Goff, kgoff@traumanurses.org.

MARCH 28-29 ATCN Instructor Course
Debra Kitchens, BSN, RN, CEN, NRP-P The ATCN Faculty Course is a two-day course designed to prepare students to become ATCN Faculty. This course will be held offsite at the Center for Simulation Education and Safety Research. Course Location: Center for Simulation Education and Safety Research (CSESaR) 655 W. 8th Street Jacksonville, FL 32209

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