SMANN News! Volume 24 Issue 1

SMANN News! Volume 24 Issue 1 February 2014

Letter from the President January'starts'us'off'on'our'23 rd 'year'as'a'nann'chapter.'as'we'ended'2013'we'conducted'a'call'for'nomina>ons' to'fill'posi>ons'on'the'smann'board'of'directors.'at'the'november'holiday'dinner'we'confirmed'the'following' new'officers'to'the'board:!president*elect!jennifer!broginski;!secretary!linda!reid;!membership!chair!joan! Berry.'We'thank'and'recognize'the'following'SMANN'Board'members'for'their'service:'Secretary'Linda'Grundy;' Membership'CoPChairs'Kristen'Pelshaw'and'Audrey'Kalasky. A!professional!organizaBon!remains!engaged!only!through!the!acBve!parBcipaBon!of!its!members.!We! welcome!the!new!board!members!and!encourage!all!smann!members!to!consider!a!leadership!role!on!the! SMANN!board!in!the!future! As'we'start'the'New'Year,'lets'take'a'moment'to'reflect'on'the'accomplishments'of'2013.'SMANN'held'two' business'mee>ngs'with'ce'presenta>ons'at'beaumont'hospital'in'troy'and'the'new'children s'hospital'at'the' University'of'Michigan.'We'held'another'very'successful'all'day'conference'in'Frankenmuth,'with'wonderful' speakers'and'support'from'our'generous'corporate'sponsors.'at'each'event'we'collected'dona>ons'for'either' baby'items,'school'supplies'or'easter'baskets'to'share'with'community'agencies.'we'again'sponsored'a' community'baby'shower'in'detroit'a[ended'by'20+'new'moms'and'their'family'members.' As'we'end'2013'we'now'look'to'another'exci>ng'year'in'2014.'We'thank'IKARIA'for'sponsoring'our'first'event'in' January'with'a'dinner'/'educa>onal'presenta>on'in'Detroit'by'Dr.'Kondori'on' Early'Use'of'Inhaled'Nitric'Oxide' and'surfactant'for'hypoxic'respiratory'failure. ' March'will'find'us'in'Frankenmuth'again'this'year'sponsoring'our'22 nd 'annual'neonatal'nursing'conference' focused'on'congenital'anomalies'and'will'include'the'display'of'several'poster'presenta>ons'by'smann' members.'registra>on'is'open'on'the'smann'website.'cep'business'mee>ngs'will'again'be'held'in'may'and'sept' watch'the'smann'website'and'listserv'for'details.' In'the'Advocacy'sec>on'of'this'month s'newsle[er,'i'hope'you'enjoy'the'ar>cle'by'keri'urquhart,'rn'bsn,' outlining'michigan s'screening'program'for'congenital'heart'defects.' Each'year'SMANN s'goal'is'to'increase'our'membership'by'offering'neonatal'nurses'the'opportunity'to'network' with'colleagues,'obtain'free'ce s'and'provide'community'service'thru'dona>ons'and'hos>ng'of'events.'this'year' may'all'smann'members'make'a'new'year s'resolu>on'to'invite'2'colleagues'to'join'smann/nann'and' support'their'neonatal'profession:'www.nann.org Joyce Stein, BSN, RN SMANN President

Texas Hold Em at Northville Downs Submitted by Marie Thomson, SMANN Fundraising Chair SMANN's 3rd fundraiser of the year was again at Northville Downs Race Track November 10-13, 2013. With the new state regulations for gaming looming on the horizon, we did see a few changes to our event. Being the 2nd charity and the lack of participation on Sundays, we were asked to start at 3:30 instead of 11:30. Thank you to Linda Grundy, Winnia and Diane from Camp Michimac for agreeing to come in early for the 4:30 shift, to cover. We were then told we would get the 2nd gaming table and blackjack. The business was so slow that we did not get a table until late in the day on that day, and the other 3 days. Blackjack also took a hit as the players won on 2 of the 4 days. (We later learned, however, that aces gaming covered those losses for us:) Construction on the streets around the track may have also been a deterrent to play. Although it was slow, it is still an easy way for us to earn monies for our children's charities, nursing scholarships and funding for our community baby shower. Our profits were better than $2,300.00 for our charities. SMANN members (and family) Devetta Keller, Joan McShane, Joan Berry, Joyce Stein, Marilyn Maggioncalda, Linda Grundy, Nancy Stempien, Nancy Bogich, Audrey Kalasky's Dad, Jeff Hornyak, my husband, Jim and I manned the 4 day tournament. Five members representing Camp Michimac (along with the Nancys) again joined SMANN in the fundraising venture. A big thanks to all who came to support the event and a special mention to Joan McShane, Jeff, Linda and Joyce who worked multiple shifts to help cover our time. Thanks again to Chris Adams for making daily deposits of our profits in the bank, and getting our paperwork to the State on time. Dates for next year have been submitted pending the state gaming board's decision about continuing to hold the event. If it passes, volunteers will be needed for the 4-1/2 hour shifts each day. Please email me at DThom92912@aol.com if you are interested in helping with this profitable venture.!

March 26, 2014 Frankenmuth Bavarian Inn Lodge An Overview of Congenital Anomalies in the Newborn Registrations are being welcomed until March 14 Please join us! Conference brochures, registrations, and paypal are available on our website: www.smann.homestead.com

Membership Update SMANN is continuously brainstorming methods to help grow our group! We are happy that several neonatal nurses from the west side of southern Michigan joined us at last year s Annual SMANN conference! Please help us recruit our neonatal nurse colleagues by directing them to NANN s website @ www.nann.org From there, they can become a NANN member and indicate their desire to also be a member of SMANN. NANN is now taking care of all membership dues for their local chapters, including SMANN (which are just $15 a year!) Membership gives you the opportunity to attend educational offerings for CEs, register for our Annual SMANN Conference, participate in fundraisers, assist with community projects, join a committee, and network with other neonatal nurses! Our Annual Holiday Dinner is always fun with great food, wine, and neonatal trivia. (plus prizes!) We are always welcoming new members and strongly encourage participation on SMANN s board. GET INVOLVED!! www.homestead.smann.com

'' ' ' ' ' ' ' ' Keri%Urquhart,%RN%BSN% Congenital heart defects are the most common group of birth defects, affecting 9 in 1000 newborns. This adds up to 40,000 newborns with CHDs per year in the United States, with over 1,700 of those born in Michigan. CHDs account for 30% of deaths in infants with birth defects. Critical congenital heart defects (CCHD) are those requiring surgery or catheter intervention in the first year of life. CCHDs remain one of the most significant causes of infant death in the United States. Prenatal testing utilizing ultrasound technology is an important early screening mechanism for life-threatening heart disease. However, prenatal diagnosis may only be made in up to 50% of cases, depending on the type of CHD and other factors. Detection postpartum currently occurs after physical examination and/or by presentation of symptoms during the first 24 hours of life. These methods have proven successful in identifying 50% of live born infants with CHD. Pulse oximetry has been shown to detect some forms of congenital heart defects in the newborn. This screening targets twelve specific anomalies (Table 1) that have been classified as CCHD. Failure to detect such heart defects while in the hospital puts the baby at risk for serious complications within the first few days or weeks of life, often requiring emergency room care. In September of 2011 Secretary of Health and Human Services (HHS), Kathleen Sebelius, approved adding CCHD screening to the recommended uniform newborn screening panel, and this recommendation was later endorsed by the American Academy of Pediatrics. SCREENING FOR CRITICAL CONGENITAL HEART DISEASE USING PULSE OXIMETRY Statewide pulse oximetry screening for all newborns has also been recommended by the Michigan Newborn Screening Quality Assurance Advisory Committee and the Michigan Department of Community Health, was approved by the legislature and will become part of the mandated screening panel on April 1, 2014. Michigan joins thirty-one other states that have already mandated pulse oximetry screening for CCHD in their newborns. The original CCHD screening algorithm (Figure 1) focuses on well (asymptomatic) babies in the birthing center. There are currently no national guidelines on screening newborns in the neonatal intensive care unit (NICU). Infants in the NICU are often continuously monitored but do not routinely undergo pre- and post- ductal oxygen saturation assessment. Infants in the NICU should be screened for CCHD just as they are screened for other disorders on the recommended newborn screening panel.

With assistance from the CCHD Advisory Committee, as well as physicians, nurse practitioners, and nurses from NICUs throughout the state, the Newborn Screening Program developed a Michigan CCHD Screening Algorithm for the NICU. The method of screening remains the same as with well babies. However, screening in the NICU is performed based on the infant s oxygen status (Figure 2). Timely recognition of CCHD through the use of pulse oximetry, whether newborns are asymptomatic or in the NICU, allows for early diagnosis and can improve overall health o u t c o m e s t h r o u g h e a r l y treatment of children with CCHD.' Michigan Algorithm for Pulse Oximetry Screening Protocol(for(all(newborns(without(cardiovascular(or(respiratory(distress((asymptomatic).(( Screening(should(take(place(before(discharge(as(close(to(24(hours(of(life(as(possible,(at(or( after(35(weeks(gestation.** **(NICU(screening(should(occur(when(medically(appropriateI See(MDCH(recommended(NICU(screening(algorithm( 95%$or$higher$in$RH$or$F$and a$difference$of$3%$or$less$between$rh$and$f 95%$or$higher$in$RH$or$F$and a$difference$of$3%$or$ less$between$rh$and$f 95%$or$higher$in$RH$or$F$and$a$difference$of$3%$or$ less$between$rh$and$f Updated(Nov(2013 Negative$Screen$(Pass) Negative$Screen$(Pass) Negative$Screen$(Pass) Pulse Oximetry Screen 90%$%94%$in$RH$and$F$or a$difference$of$4%$ or$higher$between$rh$and$f Repeat screen in 1 hour* 90%$%94%$in$RH$and$F$or a$difference$of$4%$ or$higher$between$rh$and$f Repeat screen in 1 hour* 90%$%94%$in$RH$and$F$or a$difference$of$4%$ or$higher$between$rh$and$f RH$=$right$hand F$=$either$foot *Always(consult(your(unit s(policy(on(physician(notification. 89%$or$lower$in$RH$or$F 89%$or$lower$in$RH$or$F 89%$or$lower$in$RH$or$F Refer$for$clinical$assessment* Michigan Algorithm for Pulse Oximetry Screening-NICU All(NICU(infants(should(be(screened(prior(to(discharge Infants(with(a(previous(ECHO(or(known(CCHD(diagnosis(do(not(require(screening. ASSESS$INFANT S$OXYGEN$REQUIREMENT$DURING$NICU$STAY: Infants$not$requiring$supplemental$oxygen$and$asymptomaticJ screen$at$or$after$24$hours$of$life. Infants$requiring$oxygen$during$NICU$stayJ screen$24$hours$after$weaning$to$room$air$(requiring$ no$supplemental$o2$or$respiratory$support). Infants$going$home$on$oxygenJ consider$echo$if$not$already$done$during$hospitalization. For more information and educational materials for health professionals and families please visit our website www.michigan.gov/cchd Center for Disease Control and Prevention (CDC). 2013. Screening for Critical Congenital Heart Defects. Pediatric Genetics. Available from http:// www.cdc.gov/ncbddd/pediatricgenetics/ cchdscreening.html#ref Michigan Birth Defects Registry, Division for Vital Records & Health Statistics, Michigan Department of Community Health. Reports Processed through March 15, 2012 Children s National Medical Center. Congenital Heart Disease Screening Program Toolkit: A Toolkit for Implementing Screening. 2 nd Edition. Washington, DC: Children s National Medical Center; 2009. 95%$or$higher$in$RH$or$F$and a$difference$of$3%$or$less$between$rh$and$f Negative$Screen$(Pass) 95%$or$higher$in$RH$or$F$and a$difference$of$3%$or$less$between$rh$and$f Negative$Screen$(Pass) 95%$or$higher$in$RH$or$F$and a$difference$of$3%$or$less$between$rh$and$f Negative$Screen$(Pass) Sebelius, K. Letter to R. Rodney Howell, M.D [Internet]. 2011Available from: http://www.hrsa.gov/advisorycommittees/mchbadvisory/heritabledisorders Suresh, GK (2013). Pulse oximetry screening for critical congenital heart Updated$Nov$2013 disease in neonatal intensive care units. Journal of Perinatology 33, 586 588.' Pulse Oximetry Screen RH$=$right$hand F$=$either$foot 90%$%94%$in$RH$and$F$or a$difference$ of$4%$or$higher$between$rh$and$f Repeat screen in 1 hour* 90%$%94%$in$RH$and$F$or a$difference$ of$4%$or$higher$between$rh$and$f Repeat screen in 1 hour* 90%$%94%$in$RH$and$F$or a$difference$ of$4%$or$higher$between$rh$and$f 89%$or$lower$in$RH$ or$f 89%$or$lower$in$RH$ or$f 89%$or$lower$in$RH$ or$f Refer$for$clinical$assessment* *Always(consult(your(unit s(policy(on(physician(notification.

SMANN 2013 Holiday Dinner Photos ADEFGHIFADEFBADEFGDEF

2014 SMANN Calendar of Events January 29 Corporate Sponsored Educational Offering February 9-12 Texas Hold em Fundraiser March 26 SMANN Annual Conference May 21 (Tentative date) Educational Offering August 2 Garage Sale Fundraiser August 3-6 Texas Hold em Fundraiser Sept 10-13 Annual NANN conference Sept 24th Educational Offering Oct 18 Baby Shower Community Project November 9-12 Texas Hold em Fundraiser November 19 Holiday Dinner

Joyce Stein President Joan Berry Membership Marilyn Maggioncalda Education Marie Thomson Education Irene Watts Fundraising Maria Freeman Communications Chris Adams Historian Jeanine Simpson Treasurer Linda Reid Secretary Directory jazstein@me.com berryj@med.umich.edu mjmaggio@comcast.net Dthomson92912@aol.com nirenewatts@gmail.com boilerrnc@gmail.com adamscha@trinity-health.org jsimpson3@dmc.org reidlm@trinity-health.org