Eager for the Education at ARN’s 2021 Rehabilitation Nursing Conference?
Attend sessions that inspire, invigorate, and enlighten—from wherever you want to learn
Rehabilitation nurses are experts at caring for patients’ bodies and minds—and now it’s time to focus that energy on yourself! Take the time to get inspired, invigorated, and enlightened at ARN’s 2021 Rehabilitation Nursing Conference.
Click through the topic areas below to see just a few of the educational opportunities available at the ARN conference November 9–12. Then, save your seat for programming designed to help you improve your practice and your well-being.
Both virtual and in-person attendees will have access to all sessions on-demand until February 10th, 2022, so you can take advantage of all sessions at the conference and gain more than 60 CNE credits.
Stroke, TBI, and Neurorehabilitation
Delirium Versus Dementia: A Compelling Case for Rehabilitation Nursing Education Across the Continuum of Care
Betty Clark, MEd BSN RN CRRN
This presentation will explore the onset of delirium in a memory care center during the COVID-19 lockdown. It will include how to distinguish delirium from dementia, and provide causes, symptoms, and interventions to manage delirium. During the pandemic, a tragic case involving an elderly woman led to death. This patient/resident remained undiagnosed with delirium and tested negative for COVID even up to the time of her demise. The presenter is an experienced rehabilitation nurse who will add a personal touch since she was the primary caregiver for her mother- the patient/resident in this presentation. Due to the strict lockdown, the primary caregiver could only manage by phone until the patient was admitted to a hospice service which then allowed her daily visits. Fortunately for the patient, her daughter identified the delirium events as she had been the research nurse /educator for a CMS delirium grant. The patient fell five times during lockdown causing multiple fractures. She experienced acute delirium after each fall. Her cardiac issues of chronic CHF and atrial fibrillation rendered her a non-surgical candidate. She presented with different delirium symptoms after each event. Both licensed and non-licensed staff failed to recognize these changes in the patient with dementia as they had extremely limited delirium education. Rehabilitation nurses need to be vigilant in cognitive assessment of delirium in all settings and be equipped with knowledge of multiple causes and make evidence-informed decisions. This presentation will provide techniques for assessment and suggestions for the implementation of nonpharmaceutical interventions to prevent devastating adverse outcomes such as falls.
Management of Neurogenic Bowel & Bladder and Autonomic Dysreflexia
Robert Winston, DO
This lecture will discussion physiology, neuroanatomy, as well as practice guidelines for management of neurogenic bladder, neurogenic bowel, as well as autonomic dysreflexia. Participants will be able to recognize various patterns of bladder dysfunction, understand acceptable bladder volumes, and indication for catheterization at a given schedule/interval after spinal cord injury.
An Evidence Review Targeting Patients with Severe Traumatic Brain Injury
Patricia Zrelak, PhD RN NEA-bc CNRN SCRN PHN FAHA, and Cristina Moran, MSN RN CCRN
Careers in Rehab Nursing: From Staff Management to Self-Care
Writing for Publication in RNJ
Pamala Larsen, PhD MS RN
Chaos of Crucibles to Grit with Grace: Resilience’s 7 Cs
Ruth Hansten, PhD MBA RN FACHE
Super-Sized Strength Needed: Can We Thrive!
Joy Parchment, PhD RN NEA-BC
Spotlighting a Specialty: Bringing Rehab into Nursing Schools
Abigail Mawhirter, BSN RN CRRN
Implementing and Sustaining a Shared Governance Program Within Nursing
John Best, MBA MSN RN
Staying Ahead of the Curve: How PSO Participation Impacts Quality and Patient Safety
Janet Pue, DPT NCS
With the continued focus on performance and quality, it is imperative that organizations can set targets and benchmark performance against their peers. Participation in a Patient Safety Organization (PSO) allows facilities the opportunity to benchmark against other rehab hospitals and receive timely feedback; helping to drive improvements in areas of patient safety and quality. Also, the sharing of best practices through webinars that are specific to inpatient rehabilitation hospitals, allows for a united focus for providing the best patient care across the country. The presenter will describe EQUADRSM, the first AHRQ-designated PSO targeted specifically to inpatient rehabilitation.
Updated Competency Model for Professional Rehabilitation Nursing—Application to Practice
Stephanie Vaughn, PhD RN CRRN FAHA FARN and Jill Rye, DNP RN CNL CRRN FARN
An ARN Competency Model Task Force of experts updated the original Model, developed in 2014, to reflect current rehabilitation nursing practice and the tenets of the current ARN strategic plan. Literature and Model Description. The Model identifies 14 essential role competencies across 4 distinct Domains: Nurse-led Interventions, Promotion of Successful Living; Leadership, and Interprofessional Care. The competencies were further defined into beginner, intermediate, and advanced levels of nurse proficiency. Strategy and Key Revisions. Upon thorough review by the Task Force, key revisions include: 1) addition of a competency to Domain One that focuses on the understanding of the worldview of individuals who are culturally different reflecting rehabilitation nursing’s multicultural approach and global reach. ARN, through its mission and strategic plan, purports that rehabilitation nursing care be inclusive, non-biased, and culturally sensitive. 2) Addition of the word interprofessional to the Domain Four title reflecting nursing peer collaboration and feedback process integral to professional nursing practice in the rehabilitation setting. 3) The definition of family throughout the Model was modified to include any person or persons who provide support and care to the patient (client). Rehabilitation nurses are strong advocates for the patient-family and acknowledge social conditions that may influence their ability to access and receive care in the appropriate setting. And 4) clinical exemplars were added for each Domain that illustrates its competencies for an evidence-based practice. Outcomes. Implications for Model utilization include integration into ARN educational materials, e.g., Core Curriculum book, webinars, etc. as well as a framework for onboarding of new and evaluating current rehabilitation nursing staff and explicating that nurse role on the interprofessional team in healthcare organizations.
Delivery of Patient Care
Sexuality, Reproduction, and Disability
John E. Bertini, MD FACS
This presentation will present the current evidence-based information and resources related to sexuality for patients with disabilities. Topics will include etiologies of sexual dysfunction, treatment options for sexual dysfunction, and issues in Sexuality and fertility medicine.
Sexuality Education: Pediatric/Adolescent Patients, their Family and Personnel: CARF Standards
Margaret Williams, PhD RN FNP-BC CRRN FABDA FARN
This presentation discusses the CARF Medical Rehabilitation, Pediatric Specialty Program, standards related to providing developmental and age-appropriate sexuality education for children/adolescents, for their family/support system and for the personnel who serve them. Information is covered concerning sexual development across the developmental span. along with methods and resources for providing education and anticipatory guidance. The focus is on how normal sexual development is impacted when children and adolescents have an injury, illness or impairment resulting in a developmental disability and unique issues related to sexuality. Included is information on recognizing sexual abuse and why these children/adolescents are at increased risk. Also included is information on the relationship of sexual abuse to self-esteem and social skills and how personnel can provide anticipatory guidance related to the risk for sexual abuse.
Advanced Treatment Options for Pressure Injuries
Stephanie Yates, MSN RN ANP ANP-BC CWOCN
Interventions to treat pressure injuries are widely varied. In addition to the usual topical care, adjunctive therapies have been evaluated, Use of the various interventions depends on the stage of the wound and patient-related factors. In this session, the appropriate use of advanced therapies will be reviewed resulting in an overall treatment plan. Patient agreement and participation in the treatment plan is essential.
Medical Cannabis 101
Michael McKenzie, MD
Cannabis (A.K.A. Indian Hemp, Gunjah, “Marijuana”, Bhang, Hashish, Industrial Hemp) is an ancient plant that has a 5000+ year history of cultivation and multipurpose use. From Fibers to oils to medicines, human beings have been utilizing this versatile plant for millennia. In terms of medical application in the US, extracts of Cannabis have been listed in the US Pharmacopeia from 1851 until 1942. Numerous factors from political to financial caused Cannabis to fall out of favor, to become banned and criminalized by the US Government in 1937, and to be listed as a Schedule I substance in 1970. In recent decades, there has been a renaissance of increased awareness and research of the medicinal benefits of the cannabis plant. At the same time, prohibitionist laws have been relaxed in numerous US states, allowing for the medical use (and in some cases nonmedical adult/ “recreational” use) of Cannabis. However, Nursing education as it relates to Cannabis has not kept up with the newly passed medical Cannabis laws in different states. Hence the need for nationwide Nursing education. The purpose of the lecture is to provide some basic knowledge of the clinical and therapeutic application of various Cannabis derivatives to different diseases. Hopefully, this serves as a springboard to encourage Nurses to engage in further research and study, thereby enhancing his/her knowledge base. The result is expanded patient options and improved patient outcomes.
Person-Centered Performance Measurement, Management, and Improvement Systems
Christine MacDonell, FACRM
Two key components of a quality rehabilitation program are a person-centered philosophy that is implemented across disciplines and embedded in daily practice and a robust performance system. The performance system is established to measure, manage, and improve results for the persons served in the programs. Many times, these two cornerstones are practiced without integration and become words on marketing information or gathering of data only. This session will review the foundations of both and give examples of how to merge and revitalize these foundations of rehab in your programs.
Rehab Nurses Instill Hope: Assisting Clients/Patients in the Pursuit of Travel Experiences to Promote Successful Living
Sue Brown, MSN RN CCM CRRN and Eric Bergman, RN CCM
Prior to the COVID-19 Pandemic, travel was a frequent leisure activity for many. In fact, domestic leisure travel increased 1.9% in 2019 to 1.9 billion person-trips. Leisure travel accounted for 80% of all U.S. domestic travel in 2019. These travelers included those with chronic illness or disability. With the increasing availability of vaccinations, it is anticipated that travel will resume; and it is important that rehabilitation nurses can educate and empower their patients to pursue domestic and international travel activities. It is especially important for those with a newly acquired illness or disability to understand that travel is an activity that they can still enjoy (or pursue), and actively participate in with their loved ones or independently. Adventure travel will be explored as an activity for the disabled population as an avenue to strengthen one's confidence and self-esteem. This presentation will incorporate the Competency Model for Professional Rehabilitation Nursing and explore the various websites and resources for the disabled traveler helping to guide attendees and enhance their ability to advise and support their clients. Data from accessible travel studies and IATA Global Accessibility Symposium will be discussed as well as the importance of destination research, travel insurance and planning for the "unexpected."
Implementing a Seamless Rehabilitation Plan 24/7: A Focus on Strategic Integration of Rehab Nursing and Therapy
Paula Martinkewiz, MS RN CRRN
Rehabilitation teams are often faced with difficulties in establishing a seamless care delivery system especially between nursing and therapy. This session will examine methods of integrating strategies to ensure a seamless 24/7 service delivery system that is focused on a patient-centered philosophy. Two teams will share their experience, program goals, strategic plan, focus areas, and strategies to create a seamless clinical delivery system 24/7.
Standardized Handoff to Bedside Reporting at a Pediatric Hospital
Debra Miller, MSN RN CNL CPN
A quality improvement initiative was implemented with the use of a standardized patient hand-off tool, IPASS, and was enhanced by moving the location of shift-to-shift report to the patient’s bedside. Clinical nurses were provided with the education of the evidence that demonstrates how standardized handoff combined with bedside reporting can prevent communication errors, which have led to sentinel events. Bedside reporting promotes patient safety, improved communication between nurses and patients, improved patient and staff satisfaction, and can prevent unnecessary hospital expenditures. Having the nurses engaged in the process of this quality improvement initiative has proven to be more effective than a top-down leadership approach. This nurse-led quality improvement initiative demonstrates how standardized handoff and bedside reporting can be achieved and sustained.
The Heels Are Red: What Do We Do Know?
Theresa Pietsch, PhD RN CRRN CNE; Beverly Reigle, PhD RN; Pamela Larsen, PhD MS RN; and Cynthia Jacelon, PhD RN-BC CRRN FGSA FAAN
Common clinical problems with rehabilitation patients lend themselves to solutions through a quality improvement process. This session describes a clinical problem, ‘their heels are red’, and how the rehabilitation nurse would address this patient problem using the Plan-Do-Study-Act (PDSA) framework. A clinical scenario of a typical patient with this problem is presented. Using this scenario, each step of the process is discussed from writing time-specific aims, reviewing the literature, implementing an intervention, analysis of the outcome, and how the results could be applied to practice.
Population-Specific Fall and Injury Fall Prevention
Patricia Quigley, PhD MPH APRN CRRN FAAN FAANP FARN and Amy Hester, PhD RN-BC
Within and across rehabilitation settings, clinical fall prevention programs continue to implement programs based on an over-reliance on a fall risk score and universal precautions, despite evidence that this approach is not successful. During this presentation, rehabilitation nurses (RNs) will be challenged to redesign their practices and apply expert clinical knowledge to develop fall and fall injury prevention based on specific populations, i.e., left vs. right stroke, Parkinson's Disease, chronic low back pain, TBI, and hip fracture, according to evidence-based fall and injury risk factors. Using the nursing process, RNs will generate individualized care plans, implementation, and response-to-care evaluation methods that result in changed plans of care. Finally, participants will redirect outcome measurement from fall incidence to mitigation and elimination of fall risk factors.
Collaboration Between Nurses and Speech-Language Pathologists to Support Patients Who Have Complex Communication Needs
Rebecca Koszalinski, PhD RN CMSRN CRRN , and Amanda Simmons, PhD(c)
This interactive module will a) increase nursing knowledge about patients who have complex communication needs and b) inform rehabilitation nurses about current collaborative efforts to support patient communication needs. Participants will be able to describe sources of missed communication opportunities and potential patient consequences.
Promoting Hospital Room Independence and Communication for Individuals with Complex Rehabilitation Needs
Tabatha Sorenson, OTD OTR/L ATP CAPS; Terasa Farlin, RN CRRN; Susan Fager, PhD CCC-SLP; and Judith Burnfield, PhD PT
Inpatients’ capacity to control their hospital room environment and communicate with healthcare professionals is critical for wellbeing during rehabilitation from serious injuries and illnesses, yet many adults and children with limited manual dexterity face barriers using traditional nurse call/pillow speaker systems. Barriers include poor compatibility between specialized switches and differing nurse call systems, fragility and complexity of integrating multiple controllers, regulatory barriers, and insufficient staff with appropriate expertise for technology set-up and maintenance. Additionally, many systems cobbled together in larger rehabilitation settings are simply not readily available for use in smaller rehabilitation units, or intensive and acute care settings. To address this therapeutic technology gap, our team developed an intuitive and easy-to-use adaptive controller that enables individuals to control their hospital room (e.g., lights, television, shades) and communicate needs (e.g., medication or toileting) using their residual function (e.g., a sip-and-puff of air or a toe wiggle). The system was designed to integrate with commercially available nurse call systems. Technology development, driven by existing literature and subsequent study, involved iterative design refinements based on feedback from inpatients with a wide range of abilities and clinicians including nurses, occupational, physical, and speech therapists, and physicians. This presentation will describe scientific underpinnings associated with the technology’s development, as well as clinical applications and research outcomes arising from use with different populations such as SCI, brain injury, and burns. Case studies will highlight customization and use across diverse levels of care. The impact of device implementation on patient satisfaction and nursing care delivery will be discussed. Patients recovering from serious injuries and illnesses often have complex needs that hinder independence. Affordable tools that promote patient independence and communication could not only improve patients’ emotional wellbeing but also free rehabilitation team members to direct greater attention to patients’ broader therapeutic needs.
Caring for the Caregiver
Caring for Those Who Care: Addressing Unmet Family Caregiving Needs in Diverse Communities
Jacqueline Boyd, BS
The Diverse Elders Coalition’s “Caring for Those Who Care: Meeting the Needs of Diverse Family Caregivers” training curriculum has two goals: to further our understanding of family caregivers of diverse elders’ experiences and to improve the multicultural capacities of healthcare and social services providers to better serve diverse caregivers. Many of the curriculum’s cited research and statistics were the synthesis of a literature review, stakeholder interviews, findings from a nationwide survey, and a series of focus groups with family caregivers, in collaboration with the Benjamin Rose Institute on Aging. The cultural competency components of the curriculum are continuously being refined to account for group differences and to represent the most accurate information regarding our diverse aging communities. This session will provide an overview of the needs of diverse family caregivers, specifically from LGBTQ, Latinx, African-American, Asian-American, Southeast Asian-American, and American Indian/Alaska Native communities. The workshop will highlight recent original research collected by the Diverse Elders Coalition, in addition to best practices and practical tips to provide culturally informed care.
Implementing a Caregiver Assessment and Plan of Care in Clinical Care: Challenges, Facilitators, and Benefits
Michelle Camicia, PhD RN NEA-BC CCM FAHA FARN and Barbara Lutz, PhD RN PHNA-BC CRRN FAAN FAHA
This session will provide an overview of the challenges, facilitators, and benefits of implementing the PATH2Caregiving™ Program. This program includes a caregiver self-assessment using the Preparedness Assessment for the Transition Home© (PATH) instrument supported by funding from RNF and available on the ARN website (www.rehabnurse.org/pathtool). This assessment is used to develop a tailored plan of care. We will discuss various methods of administering the assessment and integration into the electronic health record. Experiences of how rehabilitation nurses utilize this information to improve care delivery will be shared. The results from a study on the implementation of the program demonstrating patient and caregiver outcomes and recommendations for program implementation will be discussed. This will be a dynamic session that will provide practical information on how to optimize care by implementation a caregiver assessment and plan of care in clinical care. It is a culmination of foundational rehabilitation nursing research and translation into clinical care. This will be a dynamic session that will provide practical information on how to optimize care by implementation a caregiver assessment and plan of care in clinical care. It is a culmination of foundational rehabilitation nursing research and translation into clinical care. Further, we will demonstrate the possible trajectory and evolution of work through possible through RNF funding. This presentation will illustrate how RNF funding can be used to launch a collaborative program of research and rapid implementation to improve clinical outcomes.
Emerging Treatments and Research
National Program of PEVS Research—Patient and Workforce Safety Outcomes Before and During COVID-19
Patricia Quigley PhD MPH APRN CRRN FAAN FAANP FARN
This program of research provides participants with knowledge about the published body of evidence from 3 large-scale national multisite studies that confirm the effectiveness of an interactive video surveillance program that engages patients and the healthcare team. During the initial COVID-19 surge months, resilient, expert, nursing, and health workforce repurposed this successful program to meet the needs of patients, families, pastoral care during urgent and emergent isolation environments. Participants will learn about the structures, processes, and outcomes of program redesign to expand capacity during unprecedented demand on nursing and healthcare workforce.
Increasing Patient and Caregiver Engagement Using Mobile Health Applications
Mary Ann Laslo, MSN RN CCM CNL CRRN and Sun Young Park, RN CRRN
Family caregivers report they are ill-prepared for the caregiving role. This lack of preparation has been exacerbated by the COVID-19 pandemic and because of restricted visitation. Using evidence-based education and technology interventions, such as Teach-Back and the mHealth application has been shown to improve patient and caregiver education. This presentation will describe the development of a mHealth platform in a regional inpatient rehabilitation facility (IRF) to improve the family caregivers’ preparation for discharge. Written materials were selected by rehabilitation nurses and converted to digital format and included on a mHealth platform. The caregiver account is established upon acceptance to the IRF, and the caregiver(s) download and utilize the mHealth app to receive education. Materials are sent to the caregiver(s) based on the patient’s diagnosis on a schedule to gradually introduce information and resources. Educational materials to support skill-building based on the needs of the patient and caregiver are delivered in accordance with the timing of training. Videos are uploaded to share the patient’s performance and demonstration of skills with the patient involved. Input from family caregivers and staff was incorporated throughout the development of the mHealth platform. Challenges and lessons learned from this nurse-led implementation will be discussed. A demonstration of the mHealth application will be shared. Staff satisfaction, feedback from family caregivers, and clinical outcomes will be presented.
Designing an Augmentative and Alternative Communication Application/Device for Use in Hospitalized Patients: A Feasibility Research Study
Susan Fowler, PhD RN CNRN CRRN FAHA; Jennifer Foley; and Keely DeGroot, MSMOB
This presentation will address verbal communication challenges in hospitalized patients especially those with physical and/or cognitive barriers including endotracheal tubes, tracheostomies, and aphasia. The nuts and bolts of communication will be reviewed with a focus on augmentative and alternative communication applications. Research of use of a one application called the Arthur App will be presented from idea to study implementation and findings. Observation of patients with barriers to verbal communication yielded rich knowledge about their experience and for future direction of these type of applications. Case studies will be presented to highlight challenges and successes.
Embracing Telehealth to Bridge the Gap to Access to Care
Josef Mendez Lopez, BA BSN CRRN; Evangeline Collier, BSN; and Jacob Herzog, BSN
Access to care is something fundamental in medicine. Now, more than ever, we must find ways to bridge the gap in access to care with Telehealth. This presentation will show you how several nurses are contributing to the effort of using Telehealth to increase access to care in several ways. With their efforts, Telehealth has become one of the pillars of services in their departments. In comparison to 2019, there has been a 9100% increase in usage while covering approximately 46% of their respective patient registry. The patient population demographics comprise of all ages and ruralities, so Telehealth is applicable anywhere no matter who you are or where you live at!
Innovative Functional Clothing to Reduce Fall-Related Head Injuries
Patricia Quigley, PhD MPH APRN CRRN FAAN FAANP FARN; Amy Hester; and Nico De Wilde
All rehabilitation nurses know the importance of wearing head protection for people with higher fall risk. Ribcap is an amazing technology that revolutionizes how to approach head injury prevention. Ribcap is on a mission to change the lives of those in the falls & injury risk community. Innovative clothing empowers people to be themselves, break down stigmas by allowing them to be active without the fear of a (head) injury. All other helmet technology has been met with resistance due to the weight, design, and lack of personal appeal.
Rehab Outcomes of Seated Positioning—Research and Nursing Intervention
Lee Barks, PhD ARNP CRRN
This presentation is about conducting and using rehab nursing research. It will report findings of an older pediatric study about wheelchair positioning and pulmonary function and a more recent study with older adults about wheelchair seated posture and health outcomes. Translation to practice will be briefly discussed, as well as the grant process and publication for these studies. Ethical issues in research related to case management will also be briefly discussed.