50 Years of Excellence ET/WOC Nursing

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1 50 Years of Excellence Enterostomal Therapy/Wound, Ostomy, Continence Nursing R.B. Turnbull Jr., M.D. April 14-15, 2008 InterContinental Hotel & Bank of America Conference Center Cleveland, Ohio COURSE DIRECTOR Paula Erwin-Toth, MSN, RN, ET, CWOCN, CNS Director of R.B. Turnbull Jr., M.D. Education Register Online /etwoc or

2 Enterostomal Therapy/Wound, Ostomy, Continence Nursing Accreditation (OH-045/ ) is an approved provider of continuing nursing education by the Ohio Nurses Association (OBN ), an accredited approver by the American Nurses Credentialing Center s Commission on Accreditation. Acknowledgements center acknowledges partial support of this activity from the following: AdvaCare Systems Arobella Medical LLC CareTech Laboratories, Inc. Coloplast Cook Medical Urological Cymed Ostomy Co. Dale Medical Products Derma Sciences, Inc. DermaRite Industries LLC Edgepark Medical Supplies Hill Rom Hollister, Inc. KEM Liberty Medical Supply Marlen Manufacturing & Development Co. Medline Industries, Inc. Nu Hope Laboratories, Inc. Options TM Ostomy Support Barrier Inc. Sage Products Smith & Nephew Wound Management Join us as we celebrate historical events and milestones that changed the field of ET/WOC nursing around the world. Overview The is the recognized leader in Enterostomal Therapy/Wound, Ostomy, Continence (ET/WOC) Nursing, having started the Nursing School more than 50 years ago. Since then, the department has been the leading innovator in the management of patients with wounds, ostomies, and incontinence. The Digestive Disease Center is ranked second in the nation by U.S. News & World Report s 2007 Best Hospitals Survey. This live educational program will provide a review of the state-of-the-art nursing and surgical management of patients with wounds, ostomies, and incontinence through lectures and case studies. This educational conference will provide the most current practices and clinical data for the patient management. Clinical information on abdominal stomas, dermal wounds, pressure ulcers, and incontinence will be presented as well as discussions of recommendations and guidelines by experts regarding best practices. Objectives After completing this learning activity, the participant will be able to do the following: Describe the history of ET/WOC nursing and its impact on health care. Summarize current concepts in the care of the patient with an ostomy. Explain surgical advances in diagnosis and treatment of disorders of the colon and rectum. Relate nursing management options in the care of patients with complications related to wounds, ostomies, or incontinence. Target Audience The course is intended for home health care, acute, and long-term care nurses; wound, ostomy, and continence nurses; enterstomal therapy nurses; and gerontologic nurses. The current practices sessions are also relevant for health professionals in the areas of general surgery, oncology, digestive disease, post acute-care, medicine, and urology. Great Comebacks Reception and Dinner sponsored by

3 Agenda 50 Years of Excellence ET/ WOC Nursing at the Monday, April 14, :00 am Registration, Continental Breakfast, Exhibits Bank of America Conference Center 3rd Floor 7:55 am Welcome Paula Erwin-Toth, RN Victor Fazio, MD Moderator: Barbara Hocevar 8:00 am at the : A History of Caring Paula Erwin-Toth, RN 8:20 am Current Concepts in the Management of Inflammatory Bowel Disease Tracy Hull, MD 8:40 am Managing Complex Peristomal Skin Complications Barbara Hocevar, RN 9:00 am Surgical Management of Stoma Complications Ian Lavery, MD 9:20 am Case Studies: Pouching of Complex Ostomies Staff 9:40 am Panel Discussion 10:00 am Exhibits and Refreshments Moderator: Barbara Hocevar, RN 10:30 am Medical and Surgical Management of Enterocutaneous Fistulae Jon D. Vogel, MD 10:50 am Pressure Ulcer Prevention: A Call to Arms Steven Reger, PhD 11:10 am Chronic Wound Pain: How to Assess and What to Do for Your Patients Diane Krasner, PhD 11:30 am Early ETs - Stoma Required! Advantages and Challenges of the ET/WOC Nurse with an Ostomy Colleen Potts, RN 11:50 am Panel Discussion 12:00 pm Lunch and Exhibits Moderator: Barbara Hocevar, RN The Great Combacks Program began in 1984 through a cooperative effort between ConvaTec and the Crohn s & Colitis Foundation of America, providing guidance and inspiration for people facing the physical and emotional challenges of Inflammatory Bowel Disease and Colorectal Cancer and Ostomy Surgery. It is designed to raise awareness of quality-of-life issues and to demystify the ostomy experience and show opportunity where there was once only pain, frustration, and fear. About Rolf Benirschke 1:00 pm Case Studies: Management of Complex Fistulae Staff 1:30 pm The Pelvic Pouch: The Experience P. Ravi Kiran, MBBS 1:50 pm Genetics and Colorectal Cancer: What You Need To Know James Church, MD 2:10 pm The Patient Experience: What We Need From You Kristin Knipp 2:20 pm Survival Skills & Beyond: Patient Education in the 21st Century Brenda Stenger, RN 2:40 pm Norma Gill - Living With a Legend Sally Gill-Thompson, ET 3:00 pm Panel Discussion 3:10 pm Break: Exhibits and Refreshments Moderator: Paula Erwin-Toth, RN 3:30 pm Norma Gill Oration WOCN: Facing the Future Together Janice Colwell, RN 4:45 pm Evaluation/Adjourn 5:30 pm The Great Comebacks Reception and Dinner Tribute to Fifty Years of at Featuring Host and Guest Speaker Rolf Benirschke, Founder, Great Combacks Program InterContinental Hotel Ballroom Through his work as the founder of the Great Combacks Program, Rolf has provided patients and family members who face the physical and emotional challenges of IBD with hope, inspiration, and education for more than 20 years. As the place-kicker for the San Diego Chargers for 10 seasons, Rolf held 16 team records and was the third-most accurate kicker in league history when he retired. But what makes Rolf s football career so remarkable is that he played the majority of his career as a colitis patient and ostomate. For Rolf, his illness turned out to be more than learning to cope with IBD and ostomy surgery. It became an inspirational blessing that would define a mission for the rest of his life - a passion for patients that is exemplified in the spirit of the Great Combacks Program. Tuesday, April 15, :00 am Continental Breakfast and Exhibits 7:55 am Welcome Barbara Hocevar, RN Maureen Palmer, RN Moderator: Barbara Hocevar, RN 8:00 am Minimally Invasive Colorectal Surgery: The Future is Now Daniel Geisler, MD 8:30 am Urinary Incontinence: New Horizons Mikel Gray, PhD 9:00 am Fecal Incontinence and Pelvic Floor Assessment Crina Floruta, RN 9:20 am Case Studies: Skin Care and Incontinence Across the Lifespan Skin Pressure Ulcer Education and Consult Team (SPECT); Staff and Home Care 9:50 am Panel Discussion 10:00 am Exhibits and Refreshments Moderator: Barbara Hocevar, RN 10:50 am Unit Based Skin Care Nurses: The Experience Mary Ann Sammon, RN 11:10 am Challenges of Pay for Performance: Implications in Home Care Kathy Tavernelli, RN 11:30 am Long-Term Care: WOC Issues and Challenges for the Future Gwen B. Turnbull, RN 11:50 am Panel Discussion 12:00 pm Lunch and Exhibits Moderator: ET/WOC Nurse 1:00 pm Current Concepts in Urinary Diversion Michael Gong, MD 1:30 pm Pouching Tiny Tummies: Tips to Manage Infants with Ostomies Sally Gill-Thompson, ET 2:00 pm Case Studies: Challenges of Caring for Patients with Complex Wounds Ron Rock, RN Home Care; Staff 2:30 pm The Turnbull Legacy Robert W. Turnbull, BA 2:50 pm Panel Discussion 3:00 pm Exhibits and Refreshments Moderator: Paula Erwin-Toth, RN 3:10 pm R.B. Turnbull Jr., MD, Memorial Lecture Colorectal Surgery: Past, Present, and Future Victor Fazio, MD 3:40 pm Questions and Answers 3:50 pm Evaluation 4:00 pm Adjourn

4 Faculty COURSE DIRECTOR Paula Erwin-Toth, RN, MSN, ET, CWOCN, CNS Director, R.B. Turnbull Jr., Education GUEST FACULTY Janice Colwell, RN, MS, CWOCN Clinical Nurse Specialist University of Chicago Hospitals President, Wound, Ostomy and Continence Nurses Society Chicago, Illinois Sally J. Gill-Thompson, ET Manager, Ostomy Division Klein s Orthopedic & Medical Equipment Cuyahoga Falls, Ohio Mikel Gray, PhD, FNP, PNP, CUNP, CCN, FAANP, FAAN Nurse Practitioner and Professor Department of Urology School of Nursing University of Virginia Charlottesville, Virginia Kristin Knipp N.E. Ohio Chapter Crohn s & Colitis Foundation Development Coordinator Cleveland, Ohio Diane L. Krasner, PhD, RN, CWCN, CWS, BCLNC, FAAN WOC Nurse St. Agnes Hospital Baltimore, Maryland Gwen B. Turnbull, RN, BS Independent Ostomy and Wound Care Consultant Clearwater, Florida Robert W. Turnbull, BA, MS Clearwater, Florida CLEVELAND CLINIC FACULTY Amelia Agostinelli, RN, BSN, WOCN Jo Alexander, RN, BSN, WOCN Lori Arietta, MSN, RN, WOCN Antje Bogart, RN, BSN, CWOCN Home Care Services Jennifer Brinkman, RN, BSN, CWOCN Nursing Quality Management James Church, MD Vice-Chairman Head of Research Victor W. Fazio, MD, MS Chairman, Crina Floruta, RN, MSN, CNP, ET, CWOCN Daniel Geisler, MD, FACS, FASCRS Head of Minimally Invasive Surgery Michael Gong, MD, PhD Regional Urology Glickman Urological and Kidney Institute Barbara Hocevar, RN, BSN, CWOCN, ET Tracy Hull, MD Staff Surgeon Department of Colorectal Surgery P. Ravi Kiran, MBBS, MS, FRCS, FACS Staff Surgeon Department of Colorectal Surgery Judith Landis-Erdman, RN, BSN, CWOCN, ET Nursing Quality Management Collette LaValey, RN, BSN, CWOCN Ian Lavery, MD, BS Staff Surgeon Department of Colorectal Surgery Sandra Mapel, RN, BSN, WOCN Christine Moffet, RN, MSN, WOCN Maureen Palmer, RN, BSN, CRRN, MBA Surgical Acute Care Colleen Potts, RN, BSN, CWOCN, ET Steven Reger, PhD, CP Department Physical Medicine and Rehabilitation Department of Biomedical Engineering Sue Reif, RN, BSN, CWOCN Home Care Services Ron Rock, RN, MSN, CNS Nursing Education Chizu Sakai-Imoto, RN, BSN, CWOCN Mary Ann Sammon, RN, BSN, CWCN Nursing Quality Management Nora Sammon, RN, BSN, WOCN Brenda Stenger, RN, BSN, CWOCN, ET Kathy Tavernelli, RN, BSN, CWOCN, ET Home Care Services Jon D. Vogel, MD Program Director Department of Colorectal Surgery

5 General Information Location InterContinental Hotel and Bank of America Conference Center 9801 Carnegie Ave. Cleveland, Ohio Phone: or Through The Years... Hotel Accommodations Blocks of rooms have been reserved at the InterContinental Hotel for a special rate of $179 single/double (plus tax) and at the InterContinental Suites Hotel for a special rate of $149 (plus tax). Both of these hotels are located on the Campus. Complimentary shuttle service on the campus is provided. To secure this rate, you must make your reservation by 5:00 pm (EST) on March 14, Contact the Hotel Reservations Department at or Please identify yourself as being with the Conference room block code Z-22 and specify hotel or suites hotel. For online reservations, go to: Early History References to fecal diversion in the Old Testament. First documented surgical fecal diversion 200 years ago to relieve obstruction French surgeon M. Pilore performed the first ostomy surgery for bowel blockage. A sponge was attached to the opening with an elastic bandage to absorb any leakage Preparing supplies Nurse Eloise Fisher is shown here preparing a bandage with a supply cart visible behind her. Frequent dressing changes were part of the nursing care of Dr. Thomas Jones colostomy patients, since there were no colostomy bags at the time for in-hospital colostomy care. When Dr. Jones made rounds to examine his patients, he required that all dressings be opened Ostomy product development suffered from limited technology and resources. Stoma construction suffered from poor surgical techniques. Stoma care suffered from lack of nursing infrastructure and standards of care Norma Gill enters Hospital, severely ill, and meets Dr. Rupert Turnbull, Jr., to discuss the possibility of an ileostomy to save her life. After 9 weeks and several surgeries, Norma begins a new life. Wanting to give back to society, she contacts several surgeons offering to assist with patient education In August, Dr. Turnbull enlisted Norma Gill as a stoma technician to help his clients overcome the shock of ostomy surgery and resume a normal active lifestyle. First major cornerstone of Enterostomal Therapy (ET) or stomal therapy nursing was put into place Dr. Turnbull and Norma Gill start an ET program in Germany Gill Ostomy was opened by Norma Gill, one of the first dedicated ostomy dealers Norma Gill and Dr. Turnbull opened the School of ET at, requiring only that the trainee be an ostomate. Dr. Turnbull, then Chief of Colon and Rectal Surgery at the, assisted with the development of the post-operative pouch (referred to as the FURR BAG for the resident who designed it). The role of skin barrier was established. Ostomy products were rapidly changing from reusables to disposables; lightweight, low cost, odor-barrier plastic films were adapted from the food industry to the design of disposable ostomy pouches. United Ostomy Association, founded by Norma Gill and Archie Vinitsky, provided the first nationally organized network by and for the benefit of people with ostomies Wound Ostomy and Continence Nurses Society (WOCN) founded in Cleveland as the North American Association for Enterostomal Therapy. It became apparent to Dr. Turnbull that this new specialty was here to stay as an important adjunct to the medical profession. ET nurses spearheaded the development of the North American Association of Enterostomal Therapists (NAET) As the NAET s mentor, Dr. Turnbull helped organize the first national meeting of the group at the. A total of 33 therapists had joined the Association, and 21 of them were present at its first national meeting. Early 1970 s An accurate assessment of the current situation and needs of the patient occurred. Post-op hospital stays ranged between 2 and 4 weeks. Home care was fragmentary and the ostomy (surgical) dealer was providing the substantial amount of information. Focus was put on consumer needs. The principle concerns of people with ostomies were security, comfort, odor management, and convenience. It was also found that different products were needed in the hospital than at home NAET changed its name to International Association of Enterostomal Therapy (IAET). Charges for independent ET visits were approximately $25 for first hospital call, $10 for each hospital visit thereafter, and $15 for an outpatient visit Tuition for the course was $200 and $660 for travel and hotel. Medicare did not directly reimburse for enterostomal therapy visits and as of 1995, that had not changed. World Council of Enterostomal Therapists Journal (WCET) started. 200th person graduated from the ET School.

6 Parking Parking is free at the 100th Street Visitor s Parking Garage. Bring your parking ticket to the Conference registration desk for validation. Valet parking is available at the hotel for an additional charge. Ground Transportation The InterContinental Hotel is located approximately 16 miles from Cleveland Hopkins International Airport. Taxi service is available from Cleveland Hopkins International Airport to the InterContinental Hotel and Bank of America Conference Center. As an alternative, take the rapid transit train from the airport to the Terminal Tower in downtown Cleveland and from there take a taxi to the InterContinental Hotel and Bank of America Conference Center. About Cleveland Visit the Cleveland Visitors Bureau at to find in-depth information about the many exciting activities in the Greater Cleveland area. Information For further information about the Conference, contact UNITECH Communications at or toll free at Web Address: For emergency phone calls during the Conference, please call and ask for the Registration Desk. Special Needs If you have any special needs that require additional assistance, please contact UNITECH Communications. Requests must be received at least two weeks prior to the start of the Conference ET graduate Marie LaCroix, second from left, from Montreal, receiving her certificate from Dr. Turnbull. (Joan Kerr, left, an administrator of the school with Norma Gill, right) 1977 Norma Gill, first president of WCET ( ), introduced NEWSLINE in 1980, which became the WCET Journal. Suburban Ostomy, the first pharmacy-ostomy wholesaler in the US was founded, with a mail order catalog that included ostomy products. 1980s Because of the dramatic changes in Medicare reimbursement and DRGs, new ostomy patients were sent home within 7 days, increasing patient care in alternate settings. Enterostomal Therapists became integral players in the management of ostomy programs in the areas of consumer education, teaching colostomy irrigation as an alternative rather than the norm, and routinely prescribing the appliance. Virtually all products were disposable. Their insights guided industry toward greater sophistication in ostomy appliance design. Major surgical developments have major impact on ostomies, contributing to a dramatically improved life standard, and a reduction in the number of permanent ostomies. A concentrated effort was focused on products for pediatric and small stature patients. A unique non-adhesive appliance with a flexible silicone ring to create convexity and conformity with the body for use without a skin barrier was introduced Establishment of the Norma N. Gill Foundation funding international students Scope of practice expanded to include acute and chronic wounds. Established an 8-week ET school in Dusseldorf Germany as a WCET recognized school Congress of WCET Nursing starts Scope of practice expanded to continence care Membership opened to non-et Registered Nurses countries have recognized stomal therapy nursing and there are schools in 21 countries Named changed from IAET to WOCN Nortrud Schindzielorz and Dr. Turnbull went to Germany in 1977 to start an ET school Representatives from 32 countries assembled to constitute WCET Norma Gill with residents Paula Erwin-Toth with Kristi Pfeiffer, a pediatric ostomy patient ET/WOC Nurses were highlighted in Medical Miracles.

7 Registration Form 50 Years of Excellence Enterostomal Therapy/ Wound, Ostomy, Continence Nursing April 14-15, 2008 Course # Office Use Only Fee Date M.O.P. CXL/Fee REGISTRATION FEE: $ REGISTRATION AND CANCELLATION Pre-registrations are accepted by fax or online until 3:00 pm on April 11, Registration after this date may be done on site. In case of cancellation, a full refund will be made if cancelled by March 31, After March 31, 2008, a $50 cancellation fee will apply. Written notification of cancellation is required in order to process a refund. Refunds cannot be issued after May 15, Registration fee includes syllabus, continental breakfasts, refreshment breaks, lunches, and Great Comebacks Reception and Dinner. Payment must be received prior to admittance to the Conference. Purchase orders are not accepted. GO TO: Once you register online, please do not mail or fax in a registration form. CCF main campus, family health center and CCHS community hospital employees should register at the above web address. For questions about registering online, call Once registered online, please do not mail or fax a registration form. Complete the information below if registering by mail or fax: PLEASE PRINT Last First M.I. Degree Affiliation/Institution Address City State Zip Phone Number Fax Number Specialty/Profession Address I require vegetarian meals. I WILL attend the Great Comebacks Reception and Dinner on Monday, April 14, 2008 at 5:30 pm, included with registration fee. I will require an extra Reception and Dinner ticket for a spouse/guest at $50.00 per person Number of tickets requested I WILL NOT attend the Great Comebacks Reception and Dinner. Total amount enclosed or to be charged $ MAIL: Make check payable to: The Educational Foundation Or charge the following account: Visa MasterCard American Express Discover Card Number Expiration Date Signature (Not valid without signature) 3/4 Digit Verification Number FAX NUMBER: MAILING ADDRESS: The Educational Foundation PO Box Cleveland, OH

8 R.B. Turnbull Jr., M.D. COURSE DIRECTOR Paula Erwin-Toth, MSN, RN, ET, CWOCN, CNS Director of R.B. Turnbull Jr., M.D. Education 50 Years of Excellence Enterostomal Therapy/Wound, Ostomy, Continence Nursing April 14-15, 2008 InterContinental Hotel & Bank of America Conference Center Cleveland, Ohio Register Online /etwoc or The Foundation Center for Continuing Education AC313 Cleveland, Ohio NON-PROFIT U.S. Postage Paid Cleveand, OH Permit No Enterostomal Therapy/Wound, Ostomy, Continence Nursing April 14-15, 2008 InterContinental Hotel & Bank of America Conference Center Cleveland, Ohio Register Online

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