American Association of Critical-Care Nurses LIAISON REPORT Date: April 3, 2010 To: AACN Board of Directors Justine Medina, Director of Professional Practice & Education Susan Flynn, Senior Practice Associate From: Julie Miller, RN, BSN, CCRN Past AACN Board Member Staff Development Educator – Critical Care, Trinity Mother Frances Hospitals and Clinics, Tyler TX AACN Liaison to: 2010 American Heart Association (AHA) Stakeholder Meeting for the 2010 BLS, ACLS, PALS Guideline Changes _____________________________________________________________________ 1. Description of Group and Purpose: The AHA Stakeholders Meeting is held every time the AHA is about to release new guidelines for ACLS, BLS and PALS. Presently they have been holding this meeting every 5 years with guideline releases occurring every 5 years. Stakeholders with an interest in the proposed guideline changes are invited by AHA to offer comments, inquiry and dialogue about the proposed changes. This meeting is an important step in the process of finalizing the changes to the 2010 BLS and ECC guidelines. Although we were not provided with a list of attendees, the group consisted of physicians, emergency medical services (EMS) providers and nursing organizations. Below is a list of some of the groups represented: The National Nurses in Staff Development Organization Emergency Nurses Association American Association of Critical Care Nurses National Association of EMS physicians National Association of Emergency Medical Technicians National Association of EMS Educators National EMS Management Association American College of Emergency Physicians American Heart Association The attendees were required to sign a non-disclosure/confidentiality agreement about the proposed changes to the guidelines as the material is under embargo for publication. American Association of Critical-Care Nurses Liaison Report 2 2. Meeting Discussion and Outcomes: Over dinner the first night of the meeting, an overview of the AHA Emergency Cardiovascular Care (ECC) guidelines development process (from science to survival) was presented by Michael Sayre, MD ECC Committee Chair and Monica Kleinman, MD ECC Committee Vice-Chair. The guideline development process (begins immediately after the guideline release in 2005) began recruiting volunteers to provide evidence for PICO questions about the current guidelines. There are 2 separate volunteer data gatherers who provide worksheets for each question. These data gatherers then meet via conference call with the International liaison committee on resuscitation (ILCOR) (www.ilcor.org) to discuss, debate, and validate the collected evidence. The ILCOR is represented by resuscitation scientists from all over the world who provide perspective and input from an international lens on resuscitation. Following this meeting, the scientists meet for a Consensus on Science (COS) meeting to develop the proposed guideline changes. Following this meeting, the AHA gathers the stakeholders to seek feedback from the frontline users of the guidelines. This overview of the guideline development process set the stage for the presentation and discussion of the guidelines on the second full meeting day. {If you are interested in the vast number of questions and the evidence collected on the worksheets you can find this information at http://www.ilcor.org/en/consensus-2010/worksheets-2010 } On the second day of the meeting, the evidence and proposed guideline changes for BLS, ACLS and Pediatric BLS & ALS was presented by: BLS: Ben Bobrow, MD, ECC BLS Subcommittee Incoming Vice Chair ACLS: Robert Neumar, MD, ECC ACLS Subcommittee Chair Pediatric BLS, ALS & Neonatal: Marc Berg, MD, ECC Pediatrics Resuscitation Subcommittee Chair Following lunch, the stakeholders broke out in small groups and were given the opportunity to comment on and question the proposed changes to the BLS, ACLS and Pediatric BLS & ALS guidelines. Although I am not allowed to discuss the proposed changes I can share the goal is on simplification and making them more intuitive. I can also share the input from the stakeholders was valuable in providing perspective on how the changes would affect not only the provider at the point of care but on the resources needed and financial impacts to both the micro and macro health care systems. 3. Implications for AACN: This meeting is valuable for AACN as it allows the voice of acute and critical care nursing to be heard at the table before guideline changes are made which affect our members. Our voice also ensures the language used by AHA in its guidelines is consistent with the language used by the point of care provider. In addition, the meeting allows AACN to network with its peers and fellow healthcare providers, working as a team, to provide input on consensus guidelines which will affect the entire healthcare system. The guidelines are due to be released October 18, 2010. American Association of Critical-Care Nurses Liaison Report 3 What systems, processes and products do we have in place that will need to be revised / updated with guideline changes? On Friday November 12, 2010 The AHA will host 2010 Guidelines for CPR and ECC Instructor Conference at McCormick Place, Chicago IL. This conference will take place prior to the AHA Scientific Sessions and Resuscitation Science Symposium. More information at www.americanheart.org/eccguidelines How can we best inform our members of the opportunity to learn about the guideline changes? 4. Future Meetings: AHA is contemplating how to make guideline changes more agile and reviewing whether the 5 year cycle they are currently on is adequate to facilitate transfer of science to provider. If the decision is to continue on the 5 year cycle the next meeting would occur in 2015. I appreciate the opportunity to represent AACN at this meeting. I believe our presence at the table was valuable in providing feedback for the proposed guideline changes and their potential impact on our members. From AHA: